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Recovering From Back Surgery: A Journal

In February of 2009, Beth Israel Deaconess Medical Center Director of Marketing Communications Rhonda Mann underwent a major operation to correct a lifelong spinal curvature. The surgery took two days and she spent ten days in the hospital. Over the next six months, she updated family and friends on her progress through an internet tool called Carepages. Below is her log, detailing the ups and downs of her recovery, including the incredible support of her children Alisha, Madyson and Jackson and her husband, Jay. To watch a video of her story, click here.

Ready Or Not?: One Week & Counting

Posted Jan 30, 2009 11:00pm (PRIOR TO SURGERY)

Life is funny.
For years, I was so ready for this surgery. I was in pain. I just wanted to stop this curve from getting worse. And a month ago, when my surgeon finally agreed that it was time, I was relieved.

But within a day, that relief morphed into nervousness. I've done stories on this surgery. I've talked to other patients. I know how its done, what to expect. But somehow when the surgeon tells you exactly what he's going to do --to YOU-- it all feels like a Twilight Zone episode.

I guess anyone would be anxious. Any surgery has risks. And this is a big surgery. It changes your anatomy -permanently. Sure, I'll get a bit taller, but I'll never do another cartwheel, for instance (not that I do any now, it would really hurt--but I COULD do one if I wanted to. Once you have a rod fused to your spine, cartwheels are kinda out). The surgery will take time away from the things I love-- my family, my friends, my work. And the recovery, I hear from reliable sources, will be "ten times worse than childbirth."
But recently, I've been thinking of all the great people I've been fortunate enough to meet over my career. People who have lifethreatening illnesses that require big surgeries. Like gifted painter Gerry Fellows who needed a new liver--and got one. Like my channel 5 friend and colleague Kelley Tuthill who underwent a mastectomy. Like my mom, who had an aneurysm rupture and needed major brain surgery to repair the damage. Like Dana Shuhan, a single mother of three young boys, who no surgery could save. Pancreatic cancer often doesn't cooperate.

I am so fortunate. I have a bad back but my health is good. And I will continue to draw on the courage of these amazing people as I go through this challenging time.

I also have my children. My beautiful and strong daughter Madyson (who just got accepted to Johnson & Wales, we're so proud), my elegant and talented daughter Ali (who is kicking butt in her job as an assistant planner at an architect firm in town) and my adorable young man Jackson (go number 9- I'll be at your hockey games in spirit, buddy). And I know my amazing husband Jay -- I don't know how I got so lucky-- will find a way to make me laugh, often, throughout this ordeal (although I'm sure laughing really hurts. I'll let you know).

So, sure. I'm nervous. But waking up in pain everyday isn't a way to live. Neither is avoiding movie theaters or red sox games(two of my favorite hobbies) because I can't sit for more than 20 minutes. Or sitting in my car crying because I drove 45 minutes to work, parked in a tight space, and my back is so seized-up that I can't figure out how to get out of the drivers-side door without setting off major muscle spasms.

I am ready.
Bring it on.

WIPE OUT...

Posted Feb 19, 2009 3:31pm (9 days after being home from the hospital)

It happened to me again yesterday as I sat in a high backed chair transplanted from Jay's office to within perfect viewing range of the living room TV. I had been watching that Madonna movie classic, "Desperately Seeking Susan" and attempting to write an update to this Carepage site (at Jerry Berger's excellent urging). My eyes must have closed for just a second--because I saw myself falling to the the paved ground, hitting it with a hardy thump.

In reality, what my daughter-- now my babysitter-- saw, was my entire body jump off the seat and into the air. Luckily, I landed back in the chair, and somehow my computer landed right back onto my lap.

Everyone experiences this feeling once in a while, right? Just before you officially fall asleep you sorta twitch and wake up enough to think-- what was that? before turning your entire body over to Mr. Sandman.

For some reason, these "twitches" have happened to me a lot since my surgery. Enough so that I've learned a few things:
a) keep the laptop on the desk when I type
b) don't watch Madonna movies (is there more than one?)
c) understand that even the easiest of tasks, like trying to formulate a thought, is just going to wipe me out.

I guess I can understand why I was so tired yesterday. I did a lot -- basic stuff. I made dinner. I helped Ali fold my laundry. I was able to open the mail and figure out which items belonged in the circular file and which needed to be paid. I journeyed up and down stairs without assistance. Mady and I reviewed tattoo designs just for fun ( I HOPE if was for fun). I even put on a different (clean) pair of men's flannel pants.

So, life is good. That's a lot to do given that I was just 15 days from major surgery. The pain isn't as bad either. While I am sore, It's tough to take in a deep breath with my brace on. My left shoulder hurts when I move it various ways. However, the chronic pain I once had in my back and my right hip appear to be gone! I will be seeing Dr. Glazer tomorrow so he can give me the real scoop on my progress. I'll pass it along to all of you.

I'm starting to "nod off" again. See-- I'm wiped out just writing these few paragraphs.
Thanks for your concerns and your prayers.
Love,
Rhon

What Day Is It?

Posted Mar 5, 2009 2:41pm

Lately, I've relied on my 9-year-old to tell me the day of the week.

I'm not sure why I have such a hard time remembering. I've got nothing else to do. Really, nothing.

I get up around 7 to get Jackson ready for school. When he leaves at 8, I glance at the newspaper and then I'm so tired I need a nap. I awake at 11 and need to eat (even though I'm rarely hungry). I check some e-mails. I may return a call from a friend. I try to watch a movie (National Treasure: Book of Secrets and My Cousin Vinny are on a lot this month), but I keep nodding off --a sign that it's time for my afternoon snooze. When I wake up, I turn to fourth grade math (which was exhausting even before I had the operation). Around 5, I try to start dinner, but since I can't bend down, I need to bother Jay or Jackson to grab the pots and other supplies I need. Once I serve dinner, I don't have the energy to really eat, or clean up.

The highlight of my day is my nightly shower. I'm able to do this all by myself now (although Jay spots me so I don't fall). It's amazing how something I did every day out of necessity has morphed into an empowering, spirit-lifting exercise. It feels good to have my brace off for a few minutes. And because it's the only time I can see all the stitches, it's really the only time I'm reminded of the severity of the procedure and how far I've come in recovery.

This routine is basically the same everyday so maybe there's no reason to know whether it's Tuesday or Saturday. But it should be easy to remember, given the lack of other brain activity. (Hey-- I didn't realize it was March until yesterday). I feel like knowing the day of the week is kinda the cornerstone to being back "in the loop."

For instance, I should be reminding Mady she has a doctor's appointment on Friday. I should be the one telling Jackson which day he needs to bring money in for lunch tickets. Someone will call and ask if they can visit on Tuesday (I LOVE visitors, by the way) and I need to really think about when Tuesday is. Not that I'm going anywhere. I'll be here no matter what day it is. But I end up writing it down so I can make sure I'm not wearing my PJs when they show up.

Hopefully, the day thing will come back to me shortly. Next week, I'm going to try to start working again from home a few hours each day. I'm excited about that. I love what I do and I think this should really help both my mind and my emotional state. Physical therapy will begin as soon as my fusion solidifies (3-4 weeks). I think moving and strengthening my body will also help me--not only physically but mentally.

Or maybe it's not that big a deal?

Maybe I should just blame the whole thing on American Idol? Unlike any TV show in history, Idol is on different days/times each week.

No wonder I'm so messed up.

It's Like Riding A (Stationary) Bike...

Posted Mar 11, 2009 6:13pm

What are you doing right now?

Well, right now, you are reading this update.

But what were you doing just before this? Were you e-mailing a colleague, shopping for groceries, opening the mail, taking the dog for a walk, cooking dinner..?

It's amazing how many things we do in a day, and don't even think about them. They are automatic.
Until you can't do them anymore.

This week, I admit, I was getting frustrated. My crossword-puzzle slid off the table and onto the floor-- 22 across had to wait a few hours until someone got home and could retrieve it for me. Jackson needed clean pants and socks. I figured out how to put the clothes in the washer, but I couldn't reach down and grab them out of the wash machine bin to transfer them to the dryer. Then, I was trying to make pasta, but realized as soon as I put water in the pot, it would be too heavy for me to carry over to the stove.
Many simple things that need to be done, that are part of life, I can't do right now because I am not allowed to bend, lift or twist as I inch my way to recovery. And that's depressing.

But then something remarkable happened. My surgeon called to check up on me and in my rant about how I was feeling physically weak and emotionally useless, he told me I could try a few minutes on a stationary bike.

Before my back pain got really bad, I worked out every day. My daily routine included 20 minutes at level 8 on a stationary bike at the gym around the corner. Sure, I would drag myself there each morning-- but whenever I missed my workout (because of work, family or just laziness), I felt tired and just horrible. What would it feel like to get back on that bike, even for a few minutes?

Jay took me right over to the health club. I clumsily climbed on (brace in all) one of the older bikes, threw on my iPod and started pedaling. It felt great! It was just like old times. Sure, I was using hardly any resistance and I only survived seven minutes, but I could feel my muscles remembering how to work. It was the first time I felt like I had some control over my own recovery.

I spent the rest of the day feeling proud of my little accomplishments -- climbing the stairs, tying my own shoes, washing my hair. I worked out the next day, too (that's today) and my positive outlook continues. Even if I can't wear anything but extra large sweatpants right now, I feel good to be able to put them on by myself-- and I know soon enough, I'll be pulling my jeans out of the closet ( or maybe I'll be grabbing shorts because of this warm weather trend).

Whatever it is that you are doing after you read this, feel good that you CAN do it, even if it's something trivial like that dreaded daily work out. Enjoy the control you have over every minute of the day. Appreciate it.

I certainly do. Because now I realizes you can go places...even on a stationary bike.

MY STILETTOS

Posted Mar 30, 2009 8:03am

At first it sounds pretty good. You can roll out of bed, stay in your pajamas, and without even combing your hair, you're at work. Logging into the computer. Having conference calls from home. Taking a break to walk the dog. No makeup. Just your favorite, fuzzy slippers and a sweatshirt.

There are no critical decisions at 6 am in the dark--what will I wear to work today? It doesn't matter because only you are going to see you. All you need is your shot of joe and you're "on."

Don't get me wrong. You can be quite productive this way. Creatively, I find I'm thinking of all kinds of weird ideas (wait, maybe that's the pain medicine)... Or maybe it's the fact that I'm more relaxed. I don't have to gear up for that long commute to the office. In fact, it's nice not losing that 2 hours a day to travel and traffic.

But what you do lose is significant. A piece of yourself, of who you are, slips away. And even though no one outside the house would ever know, it's a big step you need to overcome as you recover.

I've never been a girly-girl. I can count the number of times I've paid to get my nails done. I don't spend lots of money on clothes. I don't have a million pairs of shoes (and the ones I do have are pretty flat and boring). These things have never been important to me. But they are part of being a woman. And at age 46, they become part of any attempt to feel desirable as a woman.

You may say -- what does it matter? You were so lucky to find such an amazing man who you adore--and who tells you everyday you are beautiful. But how you think you look, what you put into your physical self, is part of the core of how you feel about yourself. It impacts your confidence. Your energy. Your emotional well being.

Any woman who has had kids has been through this to some degree. Remember after delivery? You were so happy all went well and you knew your life had changed. But you were tired and it was hard to see a time ahead when you wouldn't be tired.

You "mailed it in" most days -- the baby didn't mind you in sweatpants. You felt big and ugly, so why even try? I had experience with mild post-pardum depression-- as do so many women. For me, the turning point was when I recognized the need to find myself again, starting with the physical. Taking a shower, Shaving my legs. Straightening my hair. Little things to make yourself look like your old self that you are doing not to impress someone else, but truly for YOU.

For me, working out has always been the core of my physical and emotional well being -- going to the gym is my shopping spree, my stilettos. Those final months prior to my surgery, I was in too much pain to exercise and I've never felt so miserable. Not only was my body failing me, but emotionally I hit the bottom.

So you can see why when I was told I could get on a stationary bike for a short time everyday, it was like the injection of a powerful medicine. I found a glimmer of my old self. More importantly, I found hope.

I started picking out clothes that would fit over this clunky brace but would look okay. My hair had started to turn mostly gray. When I asked Jay to help me dump color in it (not easy when you can't tilt your head back, by the way) he first questioned why I would need to do that. Like-- "that should be the least of your worries." But he quickly understood. It was important to me. Another small piece of the recovery puzzle.

Now knowing all of this, you can see why I am writing you so, so happy today. Six weeks after surgery, my fabulous surgeon has okayed the slow start of some physical therapy. It will be basic -- bending forward, some water therapy, working on my shoulders to get them back (my brace has made me walk hunched over). But it is exercise. It is movement. It is the core of me.

I'll let you all know how it goes. The hardest part will be going slow-- taking one step at a time. As you all know, I'm pretty competitive and not a woman of great patience...

At the same time, I'm cleaning out my closet. Hell, I may even get a manicure. But the polish won't be "fire engine red" --at least not yet.

One step at a time.

Like Being Hit In The Gut

Posted Apr 5, 2009 8:21pm

This probably hasn't happened to you in a while...so just roll with it.

You're in a bar and you're having what you think is a decent time with your friends, when some jerk bumps into you, hard. Words are exchanged (not appropriate for this venue) and the next thing you know, you see a clenched fist coming right at your stomach.
What do you do? You brace yourself-- you pull your stomach in at your belly button, hardening all your muscles and wait for the blow.

Since your eyes are closed you aren't sure why it hasn't hit--but you realize you need to breathe--while keeping everything tense in your midsection.

That's the exercise at the heart of my recovery.

Try it... suck in the muscle at your belly button and hold it. Breathe while you continue to hold. Now read on...

If I can master this exercise, I will be able to stand, sit, roll from side to side in bed....with a strength I have yet to feel--and certainly with a lot less pain.

This is the first trick I learned at physical therapy last week.

To be honest, I never was a big fan of PT. I had been sent many times to a variety of places with my screwed up back, trying to find some exercise that might straighten me out or at least decrease my pain. But it never worked. How could it? My spine was like a pretzel, pinching major nerves! A few exercises were not going to make a noticeable difference.

But as you all know, I was thrilled to get the thumbs up for post-surgery PT and very anxious to meet Ben and Angela at Rebound Physical Therapy in Natick (it's located a couple of blocks from my house and is recommended by my friends at the hospital and elsewhere). These people really do know how the body is supposed to move. And I am giving them an empty canvas. A whole new back to train.

So, I embraced this first exercise. Doesn't seem like much. But since I've been doing it, as I work, as I cook, as I type this entry.... in just a few days, my mid-section feels stronger. I don't have complete control over it yet, but it's getting there.

The second thing I learned is that my legs must get stronger. The way it was described to me, I can only picture that I will soon have thighs like those Olympian discus throwers. It makes sense--I can't bend at my waist anymore, so if I ever want to pick something up off the floor (without using my toes) my legs better be strong enough to squat all the way down and lift me back up.
So this week we worked on pulling in the core, while doing reps of sit to stand (sitting on the side of the bed, then standing without using my arms, and sitting back down) and lunges (one foot in front of the other, bending both knees).

Which brings me to my third lesson. This stuff, while basic and not exciting in the least, is completely exhausting. I get out of breath. I sweat.

It sent me into a bit of a panic, at first. How did I fall into such bad shape? Where was the endurance I had before my surgery that I worked so hard on? After just a few of these exercises, I felt like I had barely survived a 45-minute aerobics class.

But then I caught a glimpse of my body in one of those wall-sized PT mirrors. Straight. No big hump on my right ribcage. And it hit me.

I might have had more endurance six months ago--but every attempt to work out was painful. Every attempt at anything was painful. I may be starting from scratch, but the foundation is good and I can only get stronger.

So bring on those 1-pound hand weights.
Me (and my gut) are ready.

A Special Gift

Posted Apr 13, 2009 8:30am

Receiving a gift is special whatever the occasion. But the gesture is particularly meaningful when you are not feeling well--not feeling like yourself.

Thru my ordeal, I have been blessed with many great gifts. I can say positively that each has helped in my recovery. Whether it was a gift of time (a visit where we could talk and laugh), a kick-butt banana bread, DVDs, meals, crossword puzzles, or a note of encouragement written on this Carepage -- each gift has doubled as a hug from you to me--a reminder of our friendship.

These reminders are important because being sick is lonely business. Your thoughts are sometimes hopeful, but more often dark. When recovery is especially slow, you have time to over-think the pain or the immobility or the stiffness and it's easy to let "what if it never gets any better?" creep in. When you feel alone, it becomes much more difficult to battle all the negative feelings--physical and mental. Your friends are your cheerleaders, your strength.

This week, I had an unusual gift. You might have heard it, too, if you were watching the Red Sox home opener on TV last Tuesday. Just after Ortiz popped out in the 3rd inning, one of the announcers, Jerry Remy, said, "The Red Sox would like to make a shout out to Rhonda Mann, Marketing Director at Beth Israel Deaconess who is recovering from major back surgery...get well soon."

I was stunned. Did I hear that right? Then announcer Remy continued, "Rhonda is a huge red sox fan, so much so that she named her dog, "Remy." The dog's ears perked up. Yup, I heard it right. I half slid/half jumped of my chair and started yelling, "come watch this, come watch this..." and others in the house came bounding.

I will never forget this gift. But it wasn't that the announcer wished me well in such a public way that made it special. It was the fact that my colleagues and my boss had thought enough of me to figure out how to get this done. Whatsmore, as soon as the announcement was made, my phones, e-mail and text went crazy. OK, it WAS the highest rated home opener in red sox history--but it was still a Tuesday at 5pm! Weren't any of you working? Anyway, I had calls from friends as far away as Connecticut and New York as excited as I was to hear my name on the broadcast. In essence, it was a gift that kept on giving.

Each card, gesture or present I have received has given me inspiration and a physical and emotional energy that has directly impacted my recovery. Some have a direct impact--like when my friend Claire, a massage therapist showed up at my house a day after my hospital release to work on my arms and feet; some not as direct--like the big stuffed bear with a purple bow whose trip from Vermont to Natick was funded by the parents on my son's youth hockey team, or the German family down the street that rang the bell to give me tulips because they heard I was under the weather. A dear friend at my former workplace sends these Carepage postings to everyone at Channel 5 -- so I get dozens of hellos from there each week.

If recovery is directly related to support from friends, I'm doing extremely well. For this, I thank you. Thank you for caring enough to read this. It means everything.

But I would be remiss to write about gifts without mentioning the most special one. I can't imagine going thru this hard time without friends. But it would be impossible without my soul-mate. To Jay...for staying with me in the hospital when I said I was scared, for all the times you rub my shoulders and tell me it's going to be okay, for making me laugh when I am at my absolute worse... thank you. I could never give you a gift as special as the ones you have given me these past 10 weeks. (Now might be a good time to talk me into that flat-screen for the pool table room).

Jay--you are my most special gift.

(Hula)Hoops, Goals & The Game Of Life

Posted Apr 26, 2009 2:08pm

Yesterday, on a beautiful summer-like Saturday, I got to enjoy a proud parental moment.

My son, Jackson, took the mound on opening day of AAA baseball in Natick. He pitched three perfect innings and led the Tigers to a 4-3 win over the Giants.

There is nothing more gratifying than cheering on your child as they set a goal and accomplish it. Except, maybe, setting your own goal and reaching it.

Career-wise, I've been very fortunate in meeting self-set challenges. My dream since Junior high was to work for the best local television news organization on the planet. I watched Natalie Jacobson growing up and Channel 5 was the place. When it was time to choose a college--I picked Natalie's Alma Matter (not Emerson or BU--but UNH) and after many years sweating it out in the minor leagues, I got there. After a while, my ambition changed. I decided I wanted to spend my days helping people in the health arena, and was fortunate enough to wind up at a non-profit hospital with a great mission.

Whether it's saving up for a vacation abroad, renovating your downstairs bathroom or training for a charity ride to fight cancer (Jay is joining a few of you who read this page for this year's Pan Mass Challenge) setting and reaching a goal not only brings with it the benefit of what you accomplish--it really makes you feel good.

Bottom-line: You have to have a goal--something to work toward.

The problem is, when you are recovering from major surgery, you are unsure what your goal should be. It's not like bathroom tile--you just don't buy the grout and spend a day laying it in. Sure, at the beginning you can set small benchmarks -- walking up the stairs, showering without help, rolling over in bed. But after those initial victories it's mostly a long process with numerous ups and downs.

For instance, I've been going to physical therapy three times a week. I do all the exercises I'm told to do (mostly squats and arm weights to build strength in my shoulder blades and upper back), and on my off days I also do them, along with some stationary bike work. I can say that I feel stronger today than I did a few weeks ago. But I had one day last week when I was just exhausted. I barely could get out of bed. I try not to be frustrated at these days, because I know it's just my body's way of saying 'slow down.' But it's hard to set goals -- like going back to work-- when you're unclear if your body is going to cooperate.

Sure, I continue to set my sites on small steps in recovery. Like seeing my son play ball. That meant 3 hours in the 80 degree sun in a back brace. Because I wasn't comfortable sitting or standing, I basically paced the entire time. I was sore at the end of the day, but the reward of seeing Jackson's smile was worth it.

Still, I feel the need for a more tangible goal. Something I can say "look, I did it!" And since I have no idea what I will be able to accomplish, I might as well pick something illogical.

The other day when I was at Physical Therapy, in front of the surrounding mirrors, I noticed I could move my hips. I was surprised by this, because my fusion goes down to L3, which is pretty low. I thought I would lose all flexibility in this area, and pretty much deleted "The Twist" from my list of favorite dancing tunes. Now I'm thinking that while cartwheels are definitely out for me...I may be able to regain another favorite childhood activity.

So, my goal is by July 4 -- independence day-- to use a hoola hoop. No, I can't do it yet. I'm still very stiff. But I think I can.
And Jackson (who took the photo below) will be cheering me on.

SPIN

Posted Jul 5, 2009 9:17pm

Success in life comes down to this -- spin. In other words, while what you do IS important, how you frame it is just as critical.
When my 18 year old daughter goes to a college party, her description to me, while honest, (it was wild and we're hurting today) is much different than it may be (in words and photos) on her facebook (you can use your imagination). The same daughter may fail a final exam, but somehow talks her way into getting a B for a semester grade. The ability to spin is indeed a life skill that is necessary to survive.

As a health journalist, I learned to "spin" the stories I did to get the biggest audience. Exercise and eating right is boring. What's the twist? In fact, it took some thought to just get story ideas approved thru the editor. A story on new research on nutrition and cancer prevention was framed as "5 foods that fight cancer." You get the idea.

So here I am, July 4, sitting on my front porch on (finally) a sunny morning, and thinking about spin.

And I am doing it because I've led you all astray.

The good news is, I'm doing great. The other night, Jackson starting coughing at about 3am and I ran in to see if he was okay. I came back to bed and Jay said, "did you see what just happened? You jumped out of bed." He was right, of course. It had been years since I've jumped out of anything. Typically it would take me a a good 30-seconds to sit up and a few minutes of dangling my feet on the side of the bed before I would dare push myself to a standing position. But I had in one fluid movement raced out of bed without even thinking about it.

How cool is that?

I can drive now, get out of my car without pain, unload the dishwasher without really thinking about it. I can sit in the seats at Fenway for an entire game without any pain medication. We had a lovely engagement party for my daughter here at my house which was a ton of work but totally doable. And I've been back to the job I love full-time for a bunch of weeks without much problem.
That said, I do get tired. Easily. By 3 in the afternoon, my back feels heavy. By 5 or 6, I often have to lay vertical to take the pressure off. And there are days where I suddenly and without any warning become absolutely exhausted. I'm told this is normal, being 4 1/2 months outside of major surgery. But it is still frustrating. Like most other interruptions in life, those exhausted days seem to hit at exactly the wrong time.

I've also started a whole new type of physical therapy. Alerted to my doctor's concern that I was doing "too much" in the gym, I am now going to PT at Beth Israel Deaconess where Tina is easing me out of weight work and more into stretching. It's not the type of exercise I like. It's tedious and unsatisfying. But it's what I need right now.

What I don't need, I am told, is a hoola hoop.

In a previous posting, I had set a goal of "using a hoola hoop by independence day." My friend Michael at work even had a special, beautiful purple hoola hoop made for me (thank you, my friend). But what my new PT folks tell me is that kind of motion, or spin, at this point in my fusion process is simply counterproductive. I need to let my spine harden first, and then we can work on flexibility. By that point, I'm told, it will be almost impossible to achieve the motion needed to keep the hoop twirling.

Being a person of my word, I have posted a short video of me "using a hoola hoop" on this site: http://www.vimeo.com/5466890. I hope it will make you smile.

For now, I'm working on accomplishing my new goal -- simply enjoying every moment of my new life. I am so thankful to you, all my friends, for coming on this journey with me. I could not have done it without you.

Now, who can use a purple hula hoop???

To contact Rhonda Mann, you can e-mail her at rmann@bidmc.harvard.edu.

Above content provided by Beth Israel Deaconess Medical Center. For advice about your medical care, consult your doctor.

Posted December 2009