Working together for pain relief

Nadiya poses on a boat after receiving pain relief
PHOTOS COURTESY OF NADIYA ROY

When asked what she loves about lacrosse, 19-year-old Nadiya Roy pauses, searching for an answer. It’s not that she doesn’t know why she enjoys the sport — she can’t choose just one aspect of it. “I like the fast pace,” she says finally. “I love that it involves such teamwork. Even if you’re not the best individual player, if you work together, you can succeed.”

They’re qualities that are integral to medicine, too. Last winter, Nadiya — an accomplished athlete who has been playing elite-level lacrosse for eight years — was running on a treadmill when she injured her hip. At first, she treated it like any other sports injury, getting physical therapy and regular cortisone injections from Dr. Pierre d’Hemecourt, director of Medical Sports Medicine in the Sports Medicine Division at Boston Children’s Hospital.

A deeper problem

Yet nothing seemed to truly help. In search of answers, d’Hemecourt referred free of pain, Nadiya cheers at a football game Nadiya to Dr. Eduardo Novais, an orthopedic surgeon in the hospital’s Orthopedic Center. As it turned out, the teenager’s problem went far deeper than a simple injury. Novais and his team discovered that Nadiya had hip dysplasia, a congenital condition in which the hip joint doesn’t develop normally.

In Nadiya’s case, her hip socket didn’t fully cover the top of her femur (thigh bone). Without realizing it, she had been moving in ways that compensated for the dysplasia. “When I injured myself, that threw everything off,” she explains.

 

Multiple options

To treat the problem, Novais performed a surgical procedure called a periacetabular osteotomy (PAO). During a PAO, a surgeon makes a series of cuts in the pelvis, rotates the socket into proper position and inserts metal screws to hold it in place.Free of pain, Nadiya plays lacrosse

The procedure is as intense and complex as it sounds. Under the direction of Dr. Charles Berde, Boston Children’s Inpatient Pain Service and Regional Anesthesia Program worked together to help Nadiya keep on top of the inevitable pain associated with PAO and its recovery.

Following surgery, Jean Solodiuk, nurse practitioner in the hospital’s Pain Treatment Center, met Nadiya and her parents and discussed her plan of care as it related to pain management. For example, a nerve catheter inserted by Dr. Anjali Koka provided a local anesthetic that helped control Nadiya’s pain with the push of a button. “It made the initial post-surgical pain a lot more manageable,” says Nadiya. “And I appreciated that I had another option than just opioids — I didn’t want to feel loopy.”

After receiving pain treatment, Nadiya stands by the ocean

Staying ahead of the pain

The teen admits that her recovery was initially challenging. In addition to narcotic pain relievers, the team tried different combinations of medications to ease her discomfort. They also experimented with inspired non-drug solutions, such as a machine that vacuumed ice water from a bucket into an inflatable pack strapped to her hip, keeping the area cold and numb. “They used all these different little things for pain that we had never seen before,” remembers her mother, Leah.

That attention to detail remained as Nadiya prepared to leave the hospital for home. Solodiuk “kept checking on me to see how things were going,” says Nadiya. “She gave me advice for staying ahead of the pain.”

After spending the rest of her summer receiving physical therapy at Boston Children’s Waltham location, Nadiya is now a freshman at Johns Hopkins University, where she plans to start playing lacrosse in the spring. And the pride she takes in teamwork is carrying over to academics, too: She’s on a pre-med track, exploring an interest in public health.

Learn more about the Inpatient Pain Service.