The symptoms of her overactive bladder came out of nowhere, 37-year-old Shonae Williams said.

In the weeks before she was referred to Ayman Mahdy, M.D., a urology specialist at the University of Arkansas for Medical Sciences (UAMS), Williams had no choice but to buy adult diapers.
 
“I was at the extreme, and I needed help,” she said.

Williams, of Little Rock, received a comprehensive evaluation from Mahdy, who has expertise in voiding dysfunction, urinary incontinence, female urology, urodynamics and urologic reconstruction.

The evaluation included tests to rule out bladder infection and other curable problems. Mahdy conducted a urodynamic study – a performance assessment of the bladder and urethral function. This revealed overactivity of the bladder muscle, which was causing Williams to urinate involuntarily. The study also revealed a hypersensitive bladder, and a low cystometric bladder capacity, meaning she had the urge to urinate when only a small amount of urine was in her bladder.

Mahdy determined that there was no defined cause for Williams’ bladder overactivity. He recommended that she try an implant that uses electrical impulses to calm the sacral nerve, which influences the behavior of the bladder.

Before implanting the InterStim^® device under Williams’ skin at her lower back, Mahdy first had to test with a device that she would wear externally. The test device was linked to the sacral nerve with a tiny wire, and Williams tried it for five days. She kept a record of her experience and reported to Mahdy that she had 100 percent improvement of her urine leakage, 90 percent improvement of frequency symptoms and 70 percent improvement of urgency symptoms.
Mahdy and Williams were pleased with the results, so Williams chose to have the implant surgery. She was under conscious sedation for the 1 ½ hour procedure, and she went home the same day.

Made by Medtronic, the InterStim^® Therapy implant is the only FDA-approved device of its kind. The implant allows patients to resume daily activities without having to carry or see the device. A remote control allows Williams to turn it on and off and to change the stimulation amplitude up and down. Otherwise the device works on/off automatically.

More than a month after the implant, Williams said she is essentially cured, thanks to the device.

“It helped me instantly,” she said. “I’m just glad that I found UAMS and Dr. Mahdy.”

Solita Johnson-Davis was reeling as she got off the phone.

The oncologist had bluntly informed the 27-year-old Little Rock realtor that she had cervical cancer.

“I was in such a state I was dizzy. I went to my mom and said, ‘I need a second opinion.’ I wanted a doctor I could easily talk to.”

That’s when she called UAMS and Dr. Alexander “Sandy” Burnett. The gynecologic oncologist had recently become the first surgeon in Arkansas to use a robotic procedure called a trachelectomy to remove a patient’s cancerous cervix through small incisions in her abdomen while preserving her ability to have children. Could he help her?

As a young adult, Johnson-Davis was punctual in getting her annual Pap smear. Her grandmother had died from cervical cancer when her mother was just 10 years old. Johnson-Davis’ tests had always been fine until the spring of 2007 when it showed abnormal cells on her cervix.

She underwent a colposcopy, a procedure that uses an instrument with a magnifying lens and a light to examine the cervix, and a biopsy. Afterward, the doctor’s office called her to come in immediately.

“My stomach was in knots. I had no idea what they were going to tell me,” said Johnson-Davis.

Her gynecologist sent her to see the oncologist, who performed a procedure to remove the abnormal cells. After receiving the startling cancer diagnosis by phone, she went for her next appointment and was told, “You’ll never have kids. You need a full hysterectomy.”

Something rose up in her. She thought, “You’re not going to decide my future. I’m going to decide it.”

After she turned to UAMS, Burnett studied her file and repeated the colposcopy. The cancer had grown. Burnett recommended she undergo the trachelectomy.

But before she could be scheduled for surgery, she discovered she was pregnant. Surgery would have to wait. Since going into labor could disturb the cancer, Burnett scheduled a C-section two weeks before her due date.

A perfectly healthy Hadley Davis was born July 31, 2008. On Nov. 21, 2008, Burnett performed a robotic radical trachelectomy, removing the cervix and five lymph nodes. The cancer was finally gone.

“I just can’t thank Dr. Burnett enough,” said Johnson-Davis, now 29. “Had I not found him, I’d have a huge void in my life. I think I would have a little bit of a broken spirit.”

The new procedure allows a woman to have more children, though Johnson-Davis is not sure she will choose to due to the high risks. “Dr. Burnett is so positive. He said, ‘Give that baby some brothers and sisters. If you want to have another one, I feel confident that you can.’”

These days she is back working full time. She is grateful to her husband, Josh Davis, who with their parents helped care for her and the baby during her weeks-long recovery.

“We have such strong faith in my family. That’s the only thing probably that kept all of us from breaking down,” she said. “I tried to just hold positive and be so grateful that yeah, I’m going through this, but look at this blessing that I’m holding.”

When Isabella celebrates her birthday in March, she probably won’t remember how she spent her first birthday. But her grandmother, Grace Donoho, will. Grace was at UAMS undergoing a procedure to treat a brain aneurysm, and Isabella was by her side.

One afternoon Grace was gardening in her backyard in Springdale, Arkansas. While digging up a plant to give to a co-worker, she felt a fierce pain. “It felt like my head exploded,” she said. “At first, I couldn’t imagine what it was. I was really scared.”

The pain started going down her neck, so Grace thought she could be having a stroke. Grace knew she wasn’t able to drive, so she walked to her neighbor’s house to ask for help. Her speech was slurred, and right away the neighbor knew something was terribly wrong. Grace’s neighbor drove her to the local hospital, and a CT scan revealed a brain aneurysm. Since her local hospital was unable to treat a condition of this nature, Grace was airlifted to UAMS.

Grace was in intensive care until the procedure was performed. She was not allowed to watch TV or do other simple activities that might stimulate her brain and cause further bleeding. But Grace’s family could be there to comfort her, and that included her granddaughter, Isabella. “Everybody was so kind. They allowed my grandbaby to sleep in my arms,” Grace said.

Grace was comforted by the high quality of medical care she received from her UAMS physician, Dr. Eren Erdem. “He had a kind and gentle voice, and he explained all the pros and the cons,” Grace said.

“All my questions were answered. I never thought I wasn’t going to make it. They were confident of the procedure, and I was confident in their abilities.”

Since her aneurysm was already ruptured, the best course of action was to undergo endovascular coiling. This involved a catheter going through her groin area, and then being navigated through blood vessels up to the aneurysm. The coils, which are made of soft, platinum based hair-thin wires, are then wound into the aneurysm like a ball of yarn. Over time, the coils become a dense mass that prevents blood from going to that area and causing more damage. Eventually the coils turn into scar tissue.

The procedure has only been actively performing for about 15 years, Dr. Erdem explained. He has been performed the procedure for 10 years at UAMS. “Studies have shown that there is a better outcome with this minimally invasive surgery,” he said. “The patient recovery time is much faster.” Without the minimally invasive techniques, Grace’s quality of life would have been affected for months. Now this surgery is being used more frequently to treat brain aneurysms and has become the preferred method of treatment for ruptured aneuryms.

Grace’s procedure was performed on Isabella’s first birthday. “Everybody at UAMS was sensitive to that and let me be with my granddaughter,” she said. She spent a week in the hospital following the surgery, and she was grateful that the staff allowed Isabella to be there and help in the recovery process. “I couldn’t have asked for a nicer environment to have this done. It meant so much to be treated with such kindness, understanding and compassion. I don’t think that people in Arkansas realize the top notch health care we have available at UAMS.”

Since her surgery, Grace has shown no signs of complications. She feels that her attitude and outlook definitely helped her recovery process. She said that the procedure made her look at life differently. “It has made me realize the importance of the time that Isabella and I have and that we are able to build memories together.”

Grace has completely returned to normal activities including participating in many community activities. She has also helped other patients who have gone through what she did. She meets with people in the Springdale area who have shared her experience so that they can support and encourage each other.

Grace is extremely grateful to the treatment and care she received at UAMS. “Everybody at UAMS was wonderful to my children and grandchild. I owe my life to UAMS and Dr. Erdem,” she said.

Interventional Radiology
Department of Neurology