Odd numbness in climber’s right foot turns out to be … a spinal tumor

Cameron “Cam” Pudney understands risk. His career as an actuary means he’s constantly analyzing data to calculate insurance risks.

The 29-year-old Charlottean is aware of the risks involved in his favorite sport.

Pudney is a boulderer. He climbs on rock formations (or artificial rock walls) without ropes or harnesses. Most often, he goes to Inner Peaks, which is local, and to the North Carolina mountains with bouldering buddies. “Bouldering focuses on shorter, more powerful movements than roped climbing,” he said. “You rarely go higher than 15 or 20 feet, and you have crash pads and spotters instead of ropes to catch your fall.”

Still, all climbing comes with risks. “Climbing has a reputation as a dangerous sport—and rightfully so,” according to a 2019 article in Outside magazine. “Last year, 204 accidents resulting in 210 injuries and 22 deaths were reported.” By comparison, avalanche deaths among skiers in the U.S. average around 15 per year.

Pudney loves it for the physical and mental challenges it poses. “It’s like a puzzle you solve with your body,” he said.

So, when he started experiencing numbness in his right foot last March, he chalked it up to a climbing injury. His foot felt cold all the time, but it wasn’t interfering with his life, so he ignored it and kept walking, hiking and climbing.

Symptoms persist

But a few weeks later, the numbness had spread. His right leg was now weak, and that eventually made walking up the stairs difficult. In hindsight, Pudney can see that he was compensating for the impacted limb. “The numbness got worse over time,” he said. “You just keep adapting without even noticing until, all of a sudden, it’s really bad.”

Last summer, Pudney saw an orthopedist for what he thought was a sprained ankle. The doctor saw no evidence of injury.

When his symptoms persisted into February 2024, he began physical therapy. After a few sessions, the therapist suggested he see a neurologist. He made an appointment with Dr. Joseph Chipman of Novant Health Neurology & Sleep - Midtown.

On May 5, Chipman sent him for an MRI (four, in fact), which he assumed would “rule out scary stuff.” The MRIs didn’t rule out anything scary. They revealed something scary.

Later that day, Pudney got a call from Novant Health after doctors reviewed his MRI. “I was basically told I had a tumor compressing my spinal cord and that I should check myself into the ER,” he said. “My girlfriend drove me there immediately after that call.”

Pudney had a rare schwannoma tumor on his spinal cord. That’s a type of tumor that can grow off a nerve that isn’t functioning. What are the odds of a hard-core climber landing in the hospital due to a tumor, rather than a climbing injury? An actuary might know.

The good news was that it was benign, as 99% of all schwannomas are.

Pudney was referred to neurosurgeon Dr. John Berry-Candelario of Novant Health Spine Specialists - Huntersville, who recommended surgery over simply monitoring it. “When schwannoma tumors grow to a certain size, the most appropriate treatment is surgery,” he said. “They occur in confined compartments, so when they reach a certain size, they begin to cause problems.”

The doctor said numbness can be a symptom of many things – some mild and some major. It’s when the numbness doesn’t improve (or worsens) that you should talk to your doctor.

‘We have to get into your spine’

Pudney had surgery on May 7, 2023. “His surgery – specifically, a gross total resection (GTR or complete removal, ) of the tumor – took place at Novant Health Presbyterian Medical Center. Some people with schwannoma tumors opt for chemo and radiation rather than surgery, Berry-Candelario said. But because of the size and location of Pudney’s tumor, those weren’t options.

A GTR is “as complex as neurosurgery gets,” Berry-Candelario said. “It’s a high-wire act. You’re operating on the spinal cord, but you have to protect the spinal cord. I always tell patients there’s a risk of neurological compromise, and it could be major.”

But surgery went smoothly – Berry-Candelario was able to remove the entire tumor – and Pudney did remarkably well. He’s in peak physical condition and has a lot of family support.

He remained in the hospital for a week. Then, he needed a walker and next, a cane. Thanks to physical therapy he did both pre- and post-op, he could walk on his own about six weeks after surgery. He was discharged from physical therapy after meeting all his goals and was also cleared by his doctor to return to his normal activities – including bouldering! – in late August.

Back to bouldering

Pudney has “been bouldering quite a bit,” he said. His first time back was “incredible. I could feel my feet and use my legs like I never even had a tumor. It's hard to believe how much better everything feels. I just have to ease back into it, given that my upper body is a bit weaker than it was. But that will come back given some time and patience.”

He’ll be monitored every three months for a year. That entails an MRI at each follow-up visit – but just a single one rather than the four he needed for a diagnosis. After the year of monitoring is over, he can put the whole incident behind him.

Berry-Candelario said anyone experiencing the symptoms Pudney had – numbness and tingling, as well as headaches and nausea – for an extended time should talk to their primary care doctor.

What advice does Pudney have for someone experiencing the symptoms he had?

“See a neurologist,” he said. “I had no idea I had a spinal tumor because I only felt the effects in my lower body. I never had pain anywhere else.”

Unexplained numbness that doesn’t go away would be worrisome to anyone. It was especially so for someone as active and fit as Pudney. But Berry-Candelario made him feel comfortable and confident, despite how scary this was.