Terri Gardner

The memory has a way of holding onto some things forever. Terri Gardner fully recalls all five years of humiliation and isolation as she struggled with incontinence -- the first signs something was wrong, the unexplainable stains, the ruined clothing.

And she knows the exact moment it stopped — on a Thursday, at 7:05 a.m.

Terri's life had seemed like it was out of a storybook: a strong marriage, four children, a farmhouse on 160 acres of perfect Ozark landscape, her horses, and 653 best friends — her entire Missouri hometown. "On Sundays, 20 or 30 folks would just show up for dinner. No invitation was needed," Terri laughs. "I loved it. It was paradise."

But in 1999, she took a hard fall while riding and ruptured two discs. The pain that came as a result was unbearable. Her doctor recommended surgery.

The surgery eased the pain, but it also caused numbness in her back and, she would soon realize, most of her pelvic floor. The implications soon became clear. The first sign was a little wetness right after she went to the bathroom. Then dark stains appeared on her underclothes. Soon she was leaking constantly. It was an unexpected start to years of struggle.

"I'd been riding and breaking horses all my life," Terri says. "And just like when you drive a car and have the occasional fender bender, I had some horse wrecks. I injured my knee, my shoulder, my wrist, neck, elbow, my other knee, my other shoulder. But I loved my life. Pain was part of the job, and I always got back in the saddle."

This time, however, it would take more than strong will and determination to come back.

The problem no one talks about
Most people would have headed for the nearest doctor. At the time, Terri had another priority. "My dearest friend was diagnosed with a terminal brain tumor. I wanted to care for her that last year," Terri said. "So I covered up with adult pads, cleaned up with baby wipes, lived on antidiarrheal pills, and never told a soul — not even my husband. People don't talk about this stuff. I even had trouble telling my doctor."

Terri's gynecologist concluded the numbness resulted from nerve damage from the back surgery. "He actually stuck a needle in me, and I couldn't feel it," she says.

During the next five years, Terri was referred to seemingly every specialist in her state. It was humiliating, she says, and ultimately hopeless.

"Sometimes I waited two months for an appointment just so I could tell another stranger I lose my bowels in public," Terri says. "I can't go to people's houses, I'm afraid to sit on their furniture. The mess just comes out, like a faucet you can't turn off. I can't ride my horse. I can't play with my children. I can't be with my husband, and I'm only 45 years old."

The problem affects 13 million Americans, 85 percent of whom are women. Incontinence can range from mild leaking to uncontrollable wetting and bowel discharge, disability and dependency.

For Terri, things were getting worse. The numbness went to her legs. "I was falling down. I needed a cane and a wheelchair. I was dirty, housebound and bedridden. My paradise became my prison."

Finally, Terri sought out a close friend. "We sat in my car, eating donuts, crying and praying together. I lost hope, but not faith, and I resolved to be a walking, living example of strength for my family."

They decided Terri had to go to Mayo Clinic.

Paul Pettit, M.D., a Mayo Clinic urogynecologist, was able to offer Terri Gardner hope of overcoming her condition, which had eluded her for years.

Terri called Mayo Clinic. "They told me Dr. Paul Pettit, a urogynecologist at Mayo in Jacksonville, had this specialty. When I called, Jacksonville said, 'You won't believe this. We just had an opening. Can you be here Thursday, at 7:05 a.m.?' I began to cry. It was so precise, 7:05 a.m. Somehow I knew my fight was over."

A glimpse of hope
"Dr. Pettit came in the room smiling," says Terri. "Instead of asking me to list horrible symptoms, he described what I was going through, and I thought, yes. That's it! They understand."

Dr. Pettit's expertise was backed by a full range of specialists to deal with all aspects of Terri's condition."

"Mayo is an integrated group practice," says Dr. Pettit. "I brought in the specialists, therapists, radiologists, and specific nurses Terri needed for evaluating her problem. Everyone else had said there was nothing they could do. We were able to say there's a lot we can do, and I saw the light come into her eyes."

The recommendation for Terri was InterStim therapy, a minimally invasive procedure done under local anesthesia. A computerized device about the size of a stopwatch would be implanted below Terri's waist and wired to the nerves of the bladder and bowel. Two devices would be networked for overall control of her bowels and bladder. The first part of the procedure is a test where the devices are worn but not implanted. If the patient sees an improvement in quality of life, then the second part is an internalization of all parts of the implant.

"Our goal wasn't just to give Terri relief and get her off medications, but to give her hope," says Gordon Deen, M.D., left, with colleagues Anita Chen, M.D., and Paul Pettit, M.D.

"I never imagined I'd be computerized," says Terri. "I thought nip and tuck, but not remote-controlled. For about eight weeks the wires were outside my body, coiled on my sides and hooked on my belt while I traveled back and forth for 'tweaking.' I carried a remote control to turn myself off in airports."

The therapy stimulated Terri's nerves. "The minute the wires went in, the incontinence ended," she says. "I was free. I was alive. I felt everything."

Dealing with an old foe
One of the feelings that returned for Terri, however, was disabling back pain. "This wasn't what I planned," she says. "I was full of wires and computers. Who could help me now?"

She called Dr. Pettit. And Dr. Pettit called in Mayo neurosurgeon, Gordon Deen, M.D., who put together a team that specializes in spinal problems.

"It was imperative to have a full workup," says Dr. Deen. "We had to know the cause of Terri's pain. We needed a treatment that wouldn't interfere with the InterStim. And we wanted to review every option before we considered surgery."

After consultation, Dr. Deen and his colleagues recommended IntraDiscal ElectroThermal Therapy (IDET). The outpatient procedure is an alternative to spinal fusion and relieves lower-back pain caused by degenerative disk disease. During this procedure, a special catheter, threaded through an X-ray-guided needle, was placed against the two damaged disks in Terri's spine and then heated to destroy the nerve fibers growing on the outer portion of the disk.

"IDET can't cure pain, but it can lessen it," says Dr. Deen. "Our goal wasn't just to give Terri relief and get her off medications, but to give her hope."

After feeling hopeless for so long, Terri started to see her life returning. And because of her experience, she wanted to tell her story, to share her hope with others. "Terri's spirit is a source of hope for others," says Dr. Pettit. "People are hearing her story and have called us with renewed hope for a better quality of life."

And Terri? In about two months, most of her back pain was gone, and she gave herself a special celebration.

"I told my family I wanted to go away, alone, for a week," she says. "I rode my horse to the top of a mountain. I wanted to do that, to go to the top of a mountain and say, 'Thank you, God, for that Thursday at 7:05 a.m.' I'm back in the saddle."