It’s a dewy late-summer morning and June Sweeny is in her Wilmington backyard, tending to her raised bed of tall, white dahlias. Nearby, lush hydrangeas and fatsia japonica gently bob in the breeze. Sweeny, 77, reaches up with a pair of pruners and snips a blossom.
“They bloom better and stronger when you cut them,” she explained.
It’s a fitting metaphor for Sweeny’s own life. Just a few years ago, she feared that her days of surrounding herself with beautiful blooms had drawn to an end. Debilitating back pain brought her to her breaking point. Fearful of the complicated spine surgery techniques of the past, she resisted surgical intervention, suffering quietly for years.
Then she met Dr. J. Alex Thomas, a Wilmington neurosurgeon who specializes in advanced minimally invasive cranial and spinal surgeries.
Thomas used a technique called extreme lateral interbody fusion, or XLIF, to fix the source of Sweeny’s pain. The result is what keeps Sweeny, and her gardens, flourishing today.
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‘I couldn’t tolerate the pain.’
Sweeny’s passion for flowers was once her profession. She’s the retired owner of Beautiful Flowers by June, formerly located on Racine Drive and well-known in the Wilmington and surrounding beaches region for providing artful arrangements.
She started her business later in life. At age 59, following a career managing her husband’s law firm, she decided to follow her dream of mastering the art of floral arrangement and attend flower design school in New York City. When her business outgrew their home, her husband, Chuck, encouraged her to open the shop.
Beautiful Flowers by June required lots of standing, bending and heavy lifting, and Sweeny began to suffer intense pain in her lower spine and legs. Steroid injections and physical therapy offered little relief. After 12 years, she closed her business in May 2019.
“The quality of my life was going downhill,” Sweeny said. “I kept thinking to myself, ‘I will never have surgery.’” The caveat she told Chuck: “If there comes a day I can’t walk at all, then maybe I’ll look at surgery.”
That day came in 2021 when the Sweenys were visiting Charleston, one of their favorite vacation spots. “We got out of the car to take a walk, and I got halfway down a block, and the pain was so intense that I found a bench and I just could not keep going,” Sweeny said. “I really couldn't walk anymore. I couldn't tolerate the pain.”
On a scale of one to 10, Sweeny rated her pain as a 20. “No one who has a pain level of 20 has any quality of life,” she said.
A minimally invasive solution
Deeply upset, Sweeny made an appointment with her trusted family physician of more than 15 years, Dr. Thomas Lee at Novant Health New Hanover Primary Care - Ogden, who referred her to Thomas. An MRI and X-rays revealed one vertebra in her lower back was sliding out of position and putting pressure on the bone below it, a condition called spondylolisthesis.
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“That causes pain two ways,” Thomas said. “The instability causes the severe back pain that she was having, but it also can pinch the nerves as the bone slides forward, and that causes severe leg pain. It can be excruciating, particularly when the patient is up and walking around.”
A surgical procedure called a fusion can fix this instability, Thomas explained, by connecting the vertebrae to prevent movement between them. Thomas recommended XLIF – his fusion technique of choice for its high pain-relief success rate of more than 90%. It’s one of the most common procedures he performs, typically several times a week, and usually on patients in their 60s.
Unlike many fusion surgeries of the past, XLIF allows access to the front of the spine via a small, 1 1/2 incision on the patient’s flank. A spacer is inserted between the vertebrae to restore the height of the disc space and prevent the vertebrae from sliding against each other. The surgeon also makes two tiny incisions in the patient’s back to insert a rod and two screws on each side of the spacer for stability. The surgery is performed with the patient in a lateral position (lying on their left or right side), which reduces the time under anesthesia and leads to decreased risks and better outcomes.
“The whole surgery takes about an hour and the patients do great,” Thomas said. “Usually they are up walking right away and go home either the same day or the next day.”
Sweeny had feared surgery for years and met Thomas with a long list of questions, but after they spoke, she made up her mind to move forward with the procedure.
Like ‘a miracle’
Sweeny underwent XLIF surgery at Novant Health New Hanover Regional Medical Center on Dec. 17, 2021, and went home the following morning. Recovering her strength and mobility took patience and Chuck’s support. But she immediately noticed a significant change.
“The horrible pain down both my legs that I’d been living with for the past five or six years was completely gone,” she said.
Sweeny was careful to follow Thomas’ recommendations (“because that’s what I do,” she said with a laugh), among which was to walk one block that first day at home. “I simply could not do that,” she said, as her body ached with the effort of healing. But she knew moving was the key to getting better.
On day three, with Chuck’s help, she made it from their home to the end of the street, about a quarter of a mile. “As luck would have it, some of my great neighbors were out on their porches, and they were cheering me on,” she said.
As the weeks continued, Sweeny walked around her home with a walker, starting with 15 minutes a day and gradually increasing. For her 30-day follow-up appointment with Thomas, Chuck drove her. For her 60-day appointment, she drove herself. And although she felt the discomfort of regaining her strength, she never again felt the crippling back pain that was keeping her from living her life.
“It was like a miracle to me,” she said.
In the spring of 2022, Sweeny discovered a new, joyful way of surrounding herself with flowers by planting her backyard gardens. She started with six rose bushes and continues to expand to include more of her favorites, including her prized dahlias that bring her so much joy.
“Because I made that move and saw Dr. Thomas, I can say that today my pain level is a minus zero,” Sweeny said. “And it’s that way just about every day.”
