By the numbers
Number of Americans suffering from fecal incontinence.
Approximate time it takes to implant the spinal stimulator.
Battery life of the spinal stimulator.
Average improvement in fecal incontinence after implant procedure.
Five years ago, Mary Jane Watson needed part of her colon removed.
The Sullivan’s Island Elementary schoolteacher had a small bowel obstruction and her colon twisted because of it. Eventually, gangrene set in.
It was unpleasant, but relatively simple to fix. But an unintended consequence of the procedure changed Watson’s life: She couldn’t control her bowel movements any more.
“The frequency was like — and I’m not exaggerating — 20 or 30 times a day,” said Watson, 50.
She stopped going out, stopped traveling with her family. Fecal incontinence controlled her life.
“We just didn’t do anything, just kind of stayed at the house,” she said. “I had been everywhere. I had seen a multitude of gastroenterologists. I went to the Mayo Clinic in Jacksonville and tried at least a dozen different treatments to try to combat it and nothing worked.”
Then, she said God led her to Dr. Margarita Murphy.
The National Institutes of Health estimate 18 million people in the U.S. live with fecal incontinence. Murphy, a Charleston colorectal surgeon, said it may be even more than that.
“People suffer silently,” Murphy said. Many of them are women who damage their nerves during childbirth and are too embarrassed even to talk to their doctors.
“They have a terrible life. I hear this from my patients. They say, ‘I’ve had this problem for 40 years.’ Doctors don’t ask,” she said. “We have these women who are totally devastated and before we didn’t have anything to offer them.”
That is, until last year. That’s when Murphy learned about a new minimally invasive procedure that improves fecal incontinence by 90 percent. A small spinal stimulator implanted near the root of a sacral nerve yields “amazing results,” she said.
That nerve controls muscles that regulate bowel movements, but still, doctors don’t completely understand why the procedure works so well.
“It’s a very small procedure for the amazing results that we get,” Murphy said.
“Before, the only thing we had was for young women. It was a very big, horrible operation where we reconstructed the muscles around the anus. The wound would always open up,” she said. “It was a miserable surgery. It was the only thing we had.”
And the results were short-lived. The reconstruction only improved incontinence by about 60 percent and improvement only lasted five years. Very few patients were considered good candidates for it, too. Everyone else had to manage their fecal incontinence through diet, medication and bowel control exercises.
So when Murphy found out about the stimulator through the American Society of Colon and Rectal Surgeons, she started a letter-writing campaign. She reached out to 450 former patients to tell them about this new option.
And they came to her in droves. By the end of 2012, Murphy says she had performed the procedure on dozens of patients — more times than any surgeon in the country.
She doesn’t hold that distinction anymore, but doctors from around the country and the world travel to Charleston each month to observe her in action because she is more practiced at it than most physicians.
In October, Medtronic, the company which manufactures the device, flew several surgeons from South America to Charleston so they could watch Murphy implant the stimulator into several patients at Mount Pleasant Hospital.
“It doesn’t matter if they’re young, old, overweight or diabetic,” she said. “It’s been the most unbelievable, incredible results. This is very minimally invasive ... the patient doesn’t even have to have a general anesthetic.”
Several doctors in the area now perform the procedure at other local hospitals, too.
“It works fantastic,” said Dr. Jorge Lagares-Garcia, a Roper St. Francis Healthcare surgeon. “The patients are very happy.”
‘There’s an answer’
Watson first learned about the procedure through a friend. Then, Murphy called her directly to discuss her options.
“She’s like, ‘I can fix you. You need to come in,’” Watson said. “It’s unbelievable the change it’s made.”
The stimulator will remain implanted in Watson’s lower back for the rest of her life, but in about four years, she will need to have it’s battery changed.
She admits she has good days and bad days and that the implant hasn’t been a cure-all for her fecal incontinence, but she still says, “it was the best thing I ever did.”
She travel to Thailand with her husband this summer, a trip that would have been impossible without the stimulator, she said.
“I think, for five years, I just didn’t share with anybody what I was going through because of the social stigma of it. You just don’t talk about it,” she said. “I know there are plenty of people in the same boat I was in and there’s an answer.”
Reach Lauren Sausser at 937-5598.
Dr. Murphy discusses the case.×
In a doctor’s lounge at Roper St. Francis Mount Pleasant Hospital, Dr. Maria Murphy (right) speaks with doctors from Mexico and Colombia before heading into surgery to implant a device in the lower spine of a man suffering from fecal incontinence.×
During surgery, doctors from Mexico and Colombia watch the monitor showing the relative position of the implantable device and nerves in the lower spine of a male patient suffering from fecal incontinence at Roper St. Francis Mount Pleasant Hospital.×
A doctor from Colombia, South America, photographs a monitor in the operating room during a surgery at Roper St. Francis Mount Pleasant Hospital.×
A monitor in the operating room shows the electronic implant in the lower spine of a male patient suffering from fecal incontinence, during surgery at Roper St. Francis Mount Pleasant Hospital.×
A monitor in the operating room shows the lower spine of the patient.×
Dr. Maria Murphy prepares for surgery at Roper St. Francis Mount Pleasant Hospital to implant a device in the lower spine of a man suffering from fecal incontinence.×
Dr. Maria Murphy shows doctors from Mexico and Colombia part of the device that she was about to implant in the lower spine of a male patient suffering from fecal incontinence during surgery at Roper St. Francis Mount Pleasant Hospital.×
Dr. Fabian Hurtado from Colombia, South America, photographs a monitor in the operating room at Roper St. Francis Mount Pleasant Hospital. The monitor shows the electronic implant in the lower spine of a male patient suffering from fecal incontinence.×
Attentive spectators in the operating room.×
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