Finding EXTRAordinary in the Ordinary

Harmisha Gandhi, PA-C, is a practicing APC at North Okaloosa Medical Center, in Crestview, Florida.

Reason for Visit:
Patient presenting with worsening lower back pain, new urinary incontinence, and inability to ambulate despite prior negative imaging.

Patient Outcome:
Despite initial imaging interpreted as negative and recommendations for outpatient follow-up, the patient was ultimately diagnosed with spinal cord compression after further evaluation. The patient underwent urgent surgical decompression the following morning and made a full recovery.

Harmisha Gandhi, PA-C, smiling in a red blazer and black top in a blurred hospital hallway.

EXTRAordinary Care

After assuming care, Harmisha Gandhi reassessed a patient with worsening lower back pain. While the neurological exam remained intact, the patient’s history raised concern. Progressive pain, new-onset urinary incontinence, and a decline in function pointed to something more serious.

Initial CT imaging and MRI showed no evidence of cauda equina syndrome and outpatient follow-up was recommended.

At the bedside, the patient and her family were adamant that something was wrong, describing a clear deterioration. Prior to arrival, the patient had been ambulatory and able to sense urination. When Gandhi attempted ambulation, the patient was unable to walk and had new loss of bladder control, revealing a significant decline.

Despite reassuring imaging, Gandhi recognized the clinical picture didn’t align. She advocated for admission and pushed for further evaluation.

She worked closely with the admitting team to ensure the patient was evaluated in person, leading to a direct review of the MRI by a spinal surgeon, who identified spinal cord compression. The patient underwent surgical decompression the following morning with full decompression and recovery. Gandhi’s clinical judgment, patient advocacy, and cross-team collaboration ensured a serious diagnosis was recognized in time, leading to timely intervention and a positive outcome.

“Harmisha really trusted what she was seeing in front of her. Even when the imaging didn’t point to anything urgent, she didn’t ignore how much the patient had changed. She kept pushing until the patient got the care she needed, and that made all the difference.”

Ted Patras, MD

Regional President

Hospital Partner

building next to a palm tree, with a sign that says okaloosa hospital

North Okaloosa Medical Center, located in Crestview, Florida, is a 110-bed community healthcare facility providing comprehensive inpatient and outpatient services. The emergency department treats more than 40,000 patients annually and is supported by dedicated physician and advanced practice clinician coverage. The hospital is a certified stroke-receiving facility and offers advanced services including a fully interventional cardiac catheterization lab. Crestview is a fast-growing community known for its welcoming environment, strong schools, and proximity to the Emerald Coast.