Before coming to Carte, Misha had seen 18 different doctors without answers. Here is how we finally helped her get her life back.
The Challenge
When Misha came to us, she and her family were exhausted. She’d been to the ER three times, seen dozens of doctors, and put on a slew of new pain medications — all without answers.
When she insisted that something different had to be done, doctors refused, telling her that she “wasn’t disabled enough” for a re-evaluation.
18+
Doctors seen
187
Appointments in 6 months
3
ER visits
Misha, in her own words · 2 min
The Investigation
Carte’s first step was to look at the case independently — not building on the existing reads, but re-doing the foundational work over all symptoms and specialties.
01
The evolution of Misha's symptoms was real and surgically consequential. Each specialist was only able to comment that their purview had no answer for why she was in pain. None persisted beyond their area of expertise to find the different specialist who could answer.
02
Reviewing the totality of Misha’s medical history raised concern for undiagnosed hypermobility. We brought in a clinic with experience in the full spectrum of hypermobility disorders — beyond the common variants the first specialist had screened her for. She was finally diagnosed.
Document — redacted
FORENSIC REVIEW · M-2024-MISHA-01
Imaging re-read · findings
Imaging: Lumbar spine MRI · ██/██/████ Phenotype: Hypermobile EDS Re-read: 14 sequences, 2 prior comparators Finding: Recurrent disc herniation, ███████ Discrepancy with prior read: Yes · Impact: surgical
A redacted decision document, not a deck.
The Care
Diagnosis was the start, not the finish. Carte stayed with Misha through her second surgery and recovery, doing the work most practices stop short of.
“Once I had my second surgery, which was thankfully successful, while I was experiencing very acute post-op pain, Dr. Ashley came by my house in person and taped me up.”
— Misha
03
Spine surgery, pain management, hypermobility specialist, rehabilitation team — Carte coordinated across them, briefed each one on Misha’s full picture before her appointments, and made sure their recommendations didn’t work against each other.
04
When Misha was in acute post-op pain, Dr. Alwood went to her home in person to tape her up for additional support. Carte was attentive to key details in pain management through the first weeks of recovery that no other doctors were managing.
The Result
Care fragmentation, before Carte → today
18+ doctors → 1 team
Mobility, before Carte → today
Bedridden → Dancing
TIME TO ANSWER, BEFORE CARTE → TODAY
Months of dismissal → Surgery in <1 month
Misha had her second disc herniation surgery successfully. In the weeks that followed, with structured rehabilitation and ongoing Carte coordination, she got back the parts of her life she’d been forced to give up — her career ambitions, music, and time with friends.
The Method:
01We listen.
Her pain had evolved. Other doctors had stopped looking.
02We check assumptions.
Insisted on the correct repeat imaging. Found the disc herniation others had missed.
03We find experts.
A clinic that screens for the rare hypermobility phenotypes, suited to her case.
04We follow through.
Successful surgery. Dr. Alwood involved through recovery. Misha hopeful about her future again.
The eight steps Misha’s family wished they had support with before the first round of specialist visits.
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