After complex spine surgery, ‘Everything does feel better’

May 31, 2024
Felicia Chargingelk takes a moment with her dog, now sitting straight and without pain after her complex spine surgery.
Felicia Chargingelk takes a moment with her dog. Photo by Chuck Bigger, for UCHealth.

A bullet severed Felicia Chargingelk’s spine when she was 3. She had been playing in the front yard of her home in North Platte, Nebraska. Mercifully, she does not remember the drive-by shooting that left her paralyzed from the chest down.

Now 23, she lives in Colorado Springs with her husband, Caleb Gouge, who is about to honorably leave the Army. They love their three dogs and take them on daily walks through their neighborhood.

A resilient woman, Chargingelk grew up in a family that valued education and hard work. She graduated from Pickens Technical College and works as a pharmacy tech at a national retailer.

Some months back, she began to feel a weird sensation in her upper body when she reached for a pharmaceutical on a shelf, or when she had to twist in her wheelchair for some reason. At home, she could not comfortably lie on her back or right side. It made her miserable.

Caleb Gouge and Felicia Chargingelk. Photo by Chuck Bigger, for UCHealth.
Felicia Chargingelk with her husband, Caleb Gouge. Photo by Chuck Bigger, for UCHealth.

“I wasn’t getting good sleep, and my breathing wasn’t great either,’’ she said, noting that she felt sluggish all the time.

Chargingelk could see that when she sat in her wheelchair, her body slumped to her right. She did some research, looking for a physician who may be able to help her, and made an appointment with Dr. Sergiu Botolin, an orthopedic surgeon at UCHealth Memorial Hospital North.

The first time Botolin saw Chargingelk, he saw the imbalance right away.

“You could see the asymmetry with the right shoulder being lower and the left shoulder being higher,’’ Botolin said. “Truly, when I saw her, her shoulders were completely off.’’

Born in Moldova, Botolin has spent 25 years in training to become a spine surgeon with expertise in complex spine surgery. In the next months that Botolin would care for Chargingelk, he would come to see her as remarkable.

“I have not met many people in my 49 years of life who are as strong as her,’’ he said.

Scoliosis develops and needs fusion surgery

After the drive-by shooting in Nebraska, Chargingelk lived in a children’s hospital in South Dakota.  By age 9, Chargingelk had developed scoliosis, curvature of the spine, and a surgeon placed titanium rods and screws along her spine to keep her body upright.

Botolin said that “patients with neuromuscular diseases and paralyzed patients lose control over the muscles and that renders the spine unstable because the muscles are the main stabilizers.”

The muscles atrophy, and the spine starts curving. The muscles that are supposed to control and keep the spine steady don’t receive electrical signals from the spinal cord, from the brain, because the spinal cord is injured. That’s why scoliosis develops, Botolin said.

Feclicia Chargingelk maneuvers her wheelchair up a ramp and into a van. Photo by Chuck Bigger, for UCHealth.
With help from her husband, Feclicia Chargingelk maneuvers her wheelchair up a ramp and into a van. Photo by Chuck Bigger, for UCHealth.

In 2010, Chargingelk’s doctor in South Dakota performed fusion surgery to correct her scoliosis.

“The purpose of the fusion surgery is to correct the deformity to some extent, to the best extent possible and then to stabilize that correction with screws and rods. Within 6 to 12 months, usually a human body will build bone around and those vertebrae become fused forever.  In her, that didn’t happen. The vertebrae did not fuse in two places in the thoracic spine. So what happens if the fusion doesn’t happen?

“When the bone doesn’t fuse, the human body keeps moving those rods and eventually the rod develops fatigue, and it breaks. This is what happened to her,’’ Botolin said. “Many are mistaken thinking that these rods and screws, although they are made of titanium, are so powerful and strong, they can last forever.’’

Chargingelk does not know when the rods in her back broke, but in the last several years, her posture deteriorated.

In a person who is paralyzed, the lopsided posture could cause other medical problems, Botolin said.

Dr. Sergiu Botolin, a complex spine surgeon at UCHealth Memorial Hospital, reviews x-rays of Felicia Chargingelk's spine. Photo: UCHealth.
Dr. Sergiu Botolin, an orthopedic surgeon at UCHealth Memorial Hospital, reviews x-rays of Felicia Chargingelk’s spine. Photo: UCHealth.

“For people who are paralyzed and, in a wheelchair, it’s extremely important to have a well-fitted wheelchair and have routine skin inspection, because people who are paralyzed don’t have feeling on their skin. Because of that, they are at high risk to develop a pressure ulcer and skin breakdown with possible subsequent infection from a pressure creating irregularity in the wheelchair.’’

Since Chargingelk has no use of her lower body or legs, the movement of Chargingelk’s upper body is essential to her quality of life. She immediately appreciated Botolin’s expertise and affable nature.

“When I first met him, he explained it perfectly to me. He is extremely passionate about what he does, and he was able to explain what he wanted to do for me,’’ Chargingelk said.

She was able to have her surgery in December, 2023.

Undergoing complex spine surgery

After anesthesia, Botolin made a nearly two-foot-long incision in Chargingelk’s back, from her neck to lower back, and began the surgery, which lasted 9 hours.

“Her rod was broken, so I had to cut them a little bit lower than where they broke, I had to add new connectors and then add new rods,’’ he said.

Feleicia Chargingelk enjoys taking walks with her husband and their pups. Photo by Chuck Bigger, for UCHealth.
Feleicia Chargingelk enjoys taking walks with her husband and their pups. Photo by Chuck Bigger, for UCHealth.

Because Chargingelk’s neck had twisted, Botolin extended the rod, which had previously ended at thoracic 4, to thoracic 2. That meant the rod would now extend into a part of her neck that had not been paralyzed.

“The first risk is always infection. This is almost a two-foot-long incision, so a wound like that, making it heal, that’s No. 1. Second, I had to extend to above her level of paralysis, so you are working in the normal spinal cord area so there is always risk for paralysis. Other risks are non-union. The bones need to fuse but sometimes they don’t.

“You also have a risk of adjacent-level disease. When you fuse a joint or two or 10, the joint above or below sometimes has to work a little harder to compensate and because of that, it has a higher chance to deteriorate in the future,’’ Botolin said. “There’s also the organs. If you are not careful, you can plunge into the lung, into the chest cavity and things like that. Those are bad things, and you don’t ever want to hear about that.’’

Thankfully, Chargingelk did not experience any of those more serious complications, and she was able to leave the hospital within several days.

To allow healing, Chargingelk is restricted for six months from lifting more than 10 pounds or twisting in any way.

“Everything does feel better,’’ Chargingelk said. “The whole sleep thing, I was tossing and turning and not getting good sleep and that affected me at work. Every day, I was sluggish through the day – just kind of making it through the day. But now I feel like I am actually living again.

“When I first got home, and I was actually able to lay in my bed and get some sleep, it felt amazing. I’m still getting a little bit more mobility, so when we go and walk our pups, there’s no pain and during my transfers (from the wheelchair to a car, for example), there’s not any pain.’’

‘My dad never limited me’

During her childhood, Chargingelk spent six years living in the children’s hospital in South Dakota. When the hospital transitioned from an orthopedic hospital to one that serves children with autism, Chargingelk needed a new place to live.

Fortunately, a family that lived a few hours away learned of Chargingelk and adopted her. Her new parents had already completely adapted their home to accommodate a wheelchair because their son, Andy, is quadriplegic. After living in South Dakota for a while, Chargingelk and her parents moved to Colorado. Chargingelk attended public school and then enrolled in Pickens Technical College, where she earned certification as a pharmacy tech.

Her strength, she says, comes from her father.

“Being in the chair and everything, people either look down on you or look at you like you’re a turtle without a shell. But my dad, he never limited me. He never told me there was something I couldn’t do.

Felicia Chargingelk, who underwent complex spine surgery.
Felicia Chargingelk. Photo by Chuck Bigger, for UCHealth.

“He was always like, ‘you’re going to work hard, you’re going to get a job, you’re going to do great things, you’re going to go to school.’ He never said that I couldn’t do something because I was in a chair.’’

Chargingelk met her husband on Facebook, and they fell in love quickly.

“He doesn’t see my chair,’’ Chargingelk said.

“Until I run into it,’’ Gouge says, smirking.

The two tied the knot Feb. 10 at the El Paso County Courthouse. But like any young woman, Chargingelk wants to wear a beautiful white gown and have a grand ceremony and celebration with family and friends.

“When I wear a wedding dress, I don’t want to be crooked, so I’ll definitely send Dr. Botolin pictures of me in the wedding dress.

“That will definitely be a big day for me, and my shoulders will be straight.’’

About the author

Erin Emery is editor of UCHealth Today, a hub for medical news, inspiring patient stories and tips for healthy living. Erin spent years as a reporter for The Denver Post, Colorado Springs Gazette and Colorado Springs Sun. She was part of a team of Denver Post reporters who won the 2000 Pulitzer Prize for breaking news reporting.

Erin joined UCHealth in 2008, and she is awed by the strength of patients and their stories.