Running on resilience

When Elise Howes wrote "Ironman" on the whiteboard in her hospital room at AdventHealth Avista, it became more than a word - it was a promise to herself, a symbol of the strength she was determined to reclaim. A seasoned endurance athlete who found joy in the discipline of training and the thrill of crossing finish lines, Elise was determined to reclaim her active lifestyle after undergoing lumbar fusion surgery.

Elise’s journey began with a dare and a dream. “A friend talked me into doing a small triathlon in 2000, and the bug bit me,” she said. “I went from being slow at short distances to being slow at long distances. I’m not a natural athlete, but I loved the discipline of training and the rush of crossing the finish line.”

But by 2010, lower back pain began to creep in. Spinal injections helped for a while. By 2020, as she trained for a full Ironman, the pain had become unbearable. “Searing pain down the back of my leg, all the time,” Elise recalled. “Either I live with a lot of pain every day and stop doing the things I love, or I get surgery.”

Elise scheduled her first lumbar fusion surgery with AdventHealth Avista’s Dr. Sharad Rajpal, just two days after her daughter’s wedding in 2022.

Dr. Rajpal described Elise’s case as complex. “She had spondylolisthesis, where one vertebra slipped forward, compressing her spinal canal and nerves,” he explained. “Our goals were to decompress the nerves and stabilize the spine. With spinal robotics, we’re able to perform surgery with greater precision and smaller incisions, which means faster recovery.”

Elise’s recovery was nothing short of remarkable. “I was up and walking the same day,” she said. “I was shocked at how low the pain was. I used a walker for five days, then it became a spot to hang shirts and pants on. Kind of like a good treadmill, right?!”

Her care team made all the difference. “Jen Tierany showed me my scans and answered every question. Bianca helped me navigate testing. My nurses, Mary and Renee, kept me comfortable, and Golden, my CNA angel, was there in the night with ice and water. Seeing the operating room before surgery was amazing - such a cool, professional setup.”

Elise never doubted she’d return to athletic activity. “I trusted the process and my physical therapists. I knew I couldn’t run for a year, so I didn’t. But I could swim, bike, and lift, and I did. I regained everything. It was wild.”

Her motivation? “Exercise is my go-to drug,” she said. “It helps me manage stress, sleep well, keep emotions in check - and lets me eat sweets, my absolute downfall!”

Training wasn’t always easy. “The last blocks before a race are tough - mentally and physically. I don’t bounce back as fast in my 60s as I did in my 40s. But I built in little treats: beautiful places to run, naps, nice dinners, Payday bars with apples on rides (like caramel apples!).”

Crossing the finish line of a half Ironman was a moment of triumph. “It’s always a relief and a huge sense of accomplishment,” Elise said. “The race is a big, long catered training event with thousands of people. It’s a total mind game of counting steps, singing, praying, guessing people’s jobs, saving the best gel for the top of the hill. It’s conquering minutes, not miles.”

Dr. Rajpal sees Elise’s story as a powerful example of what’s possible. “We want patients to be better than they were before surgery. Elise’s success reinforces that we’re helping people get their lives back.”

Elise’s perspective on health and resilience has evolved. “I try to enjoy what I have today, life has zero promises. I’ve learned I can put up with a lot. Mental state is huge. Things change - a breeze, a kind word, a downhill stretch. None of it lasts forever.”

Her advice to others? “Embrace what you CAN do. Comparison is the robber of joy. I’ve never been a podium finisher, but I show up and do my best. That works for life too. Everyone has something going on, and they deserve kudos for showing up.”

As for what’s next? Elise is eyeing the Denver Century Ride in 2026. “Beyond that, maybe a bike ride across Canada? Half Ironman by walking the run? Rock climbing? Aerial dancing? Ballet? Improv - now THAT is terrifying!”

If you or a loved one is struggling with back pain, click here to make an appointment with Dr. Rajpal.