Houston woman now saves lives at the same rehab facility that changed hers.

Houston woman now saves lives at the same rehab facility that changed hers.

These days, Claudia Martinez makes the rounds at TIRR Memorial Hermann, the very research hospital where once she was a patient. Now, in her third year of residency, she traverses the same hallways where, not too long ago, she relearned to walk.

In the same rooms where Martinez, 31, once worked with physical trainers to master the steps of dressing and feeding herself and transferring from a wheelchair, she helps others facing similar challenges.

Dr. Lisa Wenzel, attending physician at TIRR, recalls when Martinez first arrived, and Wenzel treated her as a patient. Now Wenzel supervises her as a resident, providing patient care.

“Claudia was able to not only rehab here – but also to work here as a student,” Wenzel said. “She is quite an inspiration. Hopefully, one day, she’ll be an attending here as well.”

That’s Martinez’s dream too.

She wanted to be a doctor since childhood and, during medical school, considered becoming a surgeon.

It was her time at TIRR that changed the course of her career. But her path was arduous.

Martinez’s symptoms — headaches and a tingling sensation or numbness in her legs — began alongside her classes at the University of Houston, where she earned her major in biology and minor in chemistry.

“It was frustrating,” she recalled. “And the things I would do in everyday life were getting harder and harder for me.”

The symptoms worsened with time. Martinez started feeling weak. Within a year, her hands and legs shook. Sometimes she would fall when trying to stand. She was often nauseous and vomited.

Doctors initially thought college stress was the culprit. But Martinez knew that couldn’t be the case.

“I was the type of person who really enjoyed school,” she said. “It wasn’t stressful to me.”

At the beginning of her senior year, in 2012, she finally found a doctor who listened.

She was diagnosed with a cyst on her spine and a Chiari malformation, a rare condition resulting from the brain not having enough room in the skull. The brain anomaly forms in the cerebellum, an area key to motor function and balance. The lack of space results in the cerebellum pressing into the spinal cord.

Martinez had never heard of a Chiari malformation before – but she understood the gravity of the diagnosis.

“My neurosurgeon said, ‘You need brain surgery as soon as possible – or you could end up paralyzed from the neck down,’” she recalled.

Within a week, she was in the operating room for a craniotomy, as well as a posterior fossa suboccipital decompression with laminectomy and duraplasty — a procedure that removes a small section of bone in the skull to reduce pressure.

Afterwards, Martinez recovered quickly – and all the headaches and nausea were gone.

“I felt great,” she said.

But it didn’t last for long.

Symptoms return and worsen

The headaches returned – worse than before.

“I couldn’t sit up,” Martinez said. “I started blacking out.”

She was rushed to the hospital that October, and learned there was a leak. Fluid was filling her brain cavities, and a shunt was placed in her skull to drain it.

“Recovery took a while that time,” Martinez said. “It was slower.”

And her symptoms returned—again. She again had headaches, tingling and difficulty swallowing.

The herniation in her spine had reformed, lower down this time. She needed a third surgery to relieve the pressure. In January 2014, surgeons repeated the decompression procedure.

Martinez then developed chemical meningitis from a synthetic patch placed in her head to allow for greater room. The patch had to be replaced and a shunt was placed in February 2014.

In addition, Martinez had trigeminal neuralgia, a condition that causes painful sensations to the side of her face.

“It gives you such severe pain that you’re not able to eat or talk,” she said.

She then underwent a fourth operation — called a microvascular decompression surgery — in November 2014, months after enrolling at the McGovern Medical School at UTHealth Houston.

“Here I was trying to be the best I could be, doing well in school, and these things kept happening to me,” she said. “I didn’t understand why.”

Whenever Martinez went to the hospital, she would ask her parents Alicia and Johnny Martinez to bring her laptop and books. They were more than happy to comply.

Even if Martinez did not open the texts, it was comforting to have them nearby. She explained that their presence helped her focus on her future in medicine, when she would be the doctor, not a patient.

“At least I had that,” she said. “Most of my education I did from the hospital bed or at home.”

A whole new problem

At age 25, Martinez was working on a research project at the start of her second year of medical school with Dr. David Sandberg, professor and chief of the division of pediatric neurosurgery at the McGovern Medical School at UTHealth.

At the time, Martinez was having trouble swallowing and began losing weight. She was rushed back to the hospital for being malnourished. She also developed issues with balance, vision and sight – and began having seizures.

Martinez shared her story with Dr. Sandberg, who also serves as director of Pediatric Neurosurgery at the Memorial Hermann Mischer Neuroscience Institute.

“Her case is very unusual,” he said. Something rarely, if ever, seen.”

Most patients with Chiari malformation recover after one procedure and never need another. “But she had a number of surgeries,” he said.

And still, Martinez suffered symptoms.

“She was getting worse and worse,” Sandberg said.

An MRI revealed her brain stem appeared attached to scar tissue. Normally, Sandberg said, a space exists between the dura, or lining that covers the brain, and the brain stem.

“Her brain stem looked pulled back,” Sandberg recalled.

And any surgery affecting the brain stem can be dangerous.

“The brain stem controls life – breathing and heart rate,” he said. “But there weren’t great alternatives in her case.”

Martinez would need a fifth surgery – and Sandberg agreed to take over her case.

“It was really high-risk at this point,” she said. “But I felt like he could do it. I had complete confidence in him. I felt at ease.”

The operation was scheduled for July 2016. Sandberg said the procedure essentially opened her previous incision, cutting away scar tissue and untethering her brainstem.

“It’s like fly paper,” Martinez said. “He had to go in and unstick it.”

The same issue recurred in February 2017 – and Sandberg again operated – for her sixth and final brain surgery.

Recovery from stroke

When Martinez awoke from her surgery, she tried to reach and grab something. That’s when she realized that she had no control over her arms — or her legs.

“I was like, ‘What is happening?’ she recalled. “I had a stroke during surgery.”

She was transferred to TIRR in March 2017.

Martinez was at her lowest point, she explained. It wasn’t simply the inability to function or the fact that she would have to relearn how to use her body. She felt like this could be a sign that practicing medicine would no longer be in her future, and others competed. She was heartbroken.

“Everyone was pointing out what I couldn’t do,” she said.

But at TIRR, everything changed.

“Everyone was so positive,” she said. “It was all about restoring my life and my function. They would point out what I could do – and that was a complete 180.”

Wenzel said that was a critical part of her recovery.

“Claudia had all these challenges to overcome,” Wenzel said. “But there is life in the future; that was our key focus. ‘There’s so much you can still do.’ We wanted to give her hope.”

The approach was multidisciplinary, including physical and occupational therapists, nurses, case managers and psychologists.

“When Claudia first came in, she required total assistance for bathing, eating, grooming and dressing,” Wenzel said.

After two months, Martinez was almost totally independent in all of those activities. She could walk a bit, get out of her wheelchair and climb a few stairs.

“She made significant progress,” Wenzel said.

Martinez would return to TIRR for two more stays that year. The other sessions were dedicated to standing, walking and moving her hands.

“I was getting stronger,” Martinez said.

In 2018, Martinez took a year of medical leave for rehab. The following fall, she returned to school, still with a feeding tube.

Making something out of the pieces

Martinez graduated in May, 2020.

Along the way, she reached various milestones – including having her feeding tube and port removed.

She learned to examine patients on her own and to become her own advocate as a med student with disabilities.

Martinez also found that her career goals changed. She was still working on regaining movement in her hands – and knew that ruled out surgery.

Wenzel told her, “I think you’d be a fabulous rehabilitation doctor. You’d be able to help so many people with functional improvement.”

Martinez took her TIRR physician’s words to heart.

“She told me, ‘I’m going to apply,’” Wenzel recalled.

Martinez started her residency at TIRR in July, 2020.

“She is in a unique position to know both sides,” Wenzel said. “The things that she has learned as a patient, she can now apply as a physician.”

Sandberg agreed, “In terms of compassion for patients, she’s going to really understand what they are going through.”

He recalled that she was a top-notch student.

“Now she’s a busy resident,” he said. “She was plagued with challenges that most medical students never have – and she handled it with great poise. She persevered.”

Lindsay Peyton is a Houston-bsaed freelance writer.

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