As a paramedic and busy mom of six, Jen’s life changed after an illness, the diagnosis of multiple autoimmune diseases, and severe nerve pain in her ribs.

In 2019, Jen worked long shifts as a paramedic that required physical exertion daily. At the end of 2019, Jen came down with what she described as the worst cold of her life, marking the start of years of symptoms, pain, doctor visits, and surgeries.

Jen was diagnosed with several autoimmune diseases and Ehlers Danlos Syndrome, a group of inherited connective tissue disorders characterized by joint hypermobility, skin fragility, and other systemic manifestations. Despite her diagnoses, her pain was almost always dismissed. “I was told that I had a psychosomatic disorder,” recalled Jen. “It was all in my mind. I was referred to a psychiatrist.”

Jen’s body was covered in rashes, her hair was falling out, and she was in constant pain. After one appointment with a psychiatrist, she was told that she did not have a mental disorder, and her psychiatrist dismissed the previous physician’s diagnosis. Over time and after many doctor visits, Jennifer was also diagnosed with lupus and arthritis. She was also diagnosed with Hashimoto’s disease, an autoimmune disorder in which the body’s immune system attacks the thyroid gland.

A recent article in the Washington Post highlights research showing that women are less likely to be taken seriously when presenting at the emergency room. Doubts about women’s pain can affect treatment for a wide range of health issues. “I’ve been advocating for myself and hunting down specialists,” said Jen.

As her health slowly improved, Jennifer began to research surgeries and specialists that could help manage her pain. The severe pain in her ribs made it difficult to sit up in bed, hold her small children, or bend over the washing machine to do laundry. Jen also felt severe pain up her back.

Eventually, Jen was diagnosed with intercostal neuralgia, a condition characterized by pain in the nerves between the ribs. “The less pain you have, the more energy you’ll have,” she said. “I’ve had 18 surgeries, and Dr. Attiah performed my sixteenth surgery.”

Jen wanted more energy back and wanted to pursue surgical options that could help manage her severe pain. Through her research, Jennifer found peripheral nerve surgeon Dr. Mark Attiah at UNC Health. “I Googled neurosurgeons who specialize in peripheral nerve,” said Jennifer. “Dr. Attiah’s resume was impressive, and I thought ‘this is the man that I need to go see.’”

During Jen’s consultation visit with Dr. Attiah, he explained to her that while a nerve block provided pain relief, he believed that Jen could benefit from surgery. “Jen had constant neuropathic pain mediated by the nerves that run underneath each of the ribs, the intercostal nerves,” said Dr. Attiah. “I discussed with her the possibility of cutting the nerves to turn her pain into numbness.”

Jen decided to proceed with the surgery. On the day of surgery, Dr. Attiah performed right T7 and T8 intercostal neurectomies. Using x-ray fluoroscopy, he was able to identify the affected ribs. He then made an incision and dissected out the intercostal nerves from underneath each of those ribs. Dr. Attiah “crushed” the nerves closer to the spine, cut them, and buried them in the intercostal muscle, then sealed them in place with fibrin glue. The surgery took about three hours, and Jen was discharged the same day without complications.

After her surgery, Jen’s recovery went well, with her rib pain eventually going away. Jen notes that she will probably never have the health or career that she had before 2019, but she remains grateful for the care she received from Dr. Attiah and his team at UNC Health. “He gave me the ability to do laundry by myself again,” said Jen. “To lean over and put stuff in. To sweep and vacuum. It means more to me than being a paramedic.”

Jen noticed that after her rib pain was gone, she still had lower abdominal pain. Further imaging showed that she had gallbladder disease and needed to have her gallbladder removed. “The intercostal neuralgia pain was masking my gallbladder disease,” said Jen. “Had Dr. Attiah not listened, I don’t know what would have happened. He indirectly saved my life.”

Now, Jen advocates for other patients with Ehlers Danlos Syndrome in the North Carolina triangle and connects with other patients to help them navigate their care. “I think I have more surgeries in the future,” said Jen. “Dr. Attiah will do some of the procedures. All of this stuff together has really improved my life.”