When the 15-year-old ninth-grader first met Dr. Uzma Samadani, her back pain was so severe she couldn't participate in gym class at Richfield High School. Climbing stairs was a chore and she couldn't tie her own shoes. Her right leg was showing signs of paralysis.

The patient, Guadalupe "Lupe" Galeno-Rodriguez, thought she knew the source. In 2014, she had been diagnosed with myxopapillary ependymoma, a form of cancer, and a tumor was removed from her spine. Radiation to deter future tumors was not an option because she was too young.

"I was feeling the same pain as before," said Lupe. "I thought the tumor came back, but I didn't think there would be five of them. I was really disappointed and sad."

Samadani, a neurosurgeon at Hennepin County Medical Center, knew surgery would be difficult, but she didn't know just how difficult.

"I've never taken out five tumors at once in my career," she said. "Most of the time we think that if you see five tumors, there are probably more you don't see. Sometimes the thinking is that you let nature run its course and wait, that you never take out a spinal tumor until someone is disabled. But this was such a young kid. I was not ready to see her become paralyzed. It would have been very hard to live with."

Together, Samadani and Lupe, along with her parents Oscar Galeno Garcia and Teresa Galeno-Rodriguez, decided to trust the medical team and proceed with the operation.

"She understood that if we didn't do something she would eventually lose control of her legs, bowel and bladder," Samadani said. "Once you lose function, it's harder to get it back."

Sometimes, difficult surgeries like Lupe's are done in stages a month or two apart. But doctors decided it was best for her to do it all at once. They warned Lupe that spinal surgeries are difficult and can cause damage to her legs and organs. Lupe is a good student who likes to study history and read romance, comedy and horror novels. She has a bright future, her parents say.

"The day of the surgery I wasn't scared," said Lupe. "I had trust in my doctors."

She had trust for good reason. Born in Wimbledon, England, Samadani moved to Wisconsin at age 2. She matriculated into the University Wisconsin-Madison's Medical Scholars Program after high school and graduated Phi Beta Kappa with majors in molecular biology and English literature (Dickens, Austen, Fielding are favorites), according to her web page. Among a long list of accomplishments, Samadani performed more artificial cervical disc procedures than any other surgeon in Manhattan during her time in New York.

Her philosophy of practice: "I believe in providing the highest quality health care regardless of the patient's ability to pay."

Lupe's surgery at HCMC in mid-March lasted 28 hours over two days, a grueling endeavor for Samadani, chief neurosurgery resident Dr. Catherine Miller, and a rotating team of about 30 people.

"This is one of the cases I knew was going to be really, really hard," said Samadani. "I psychologically girded myself. I had to carbo load for this one."

Samadani, Miller and their team started the task of removing the tumors at 7:30 a.m. Following surgery, at about 2 a.m. the next morning, they took Lupe to have an MRI to make sure they got all the tumors. Samadani went home, just a few blocks away, and slept until returning at 7:30 the next morning to fuse Lupe's spine, which took another 10 hours.

During the first day of the surgery, Samadani took two 5- to 10-minute breaks to grab a quick snack and use the restroom. Miller took one. "I've done long cranial cases," said Samadani, "but this is by far the longest spinal case we have done, or that I've ever heard was done."

"It was a very big surgery and we were very worried," said Lupe's father, Oscar. "They told us she could have problems with walking. We were expecting she would be in therapy for more than a month, but she recovered very quickly."

Lupe's parents stayed in the waiting room, worrying and praying. "We believe the prayers of our family and friends and church really helped," Oscar said. "We believe God performs miracles."

"It was one of the longest days of my life," said Teresa, her mother, fighting back tears. "My daughter is a soldier; she has been through so much at such a young age. She is so strong."

Lupe spent two weeks in the hospital. Last week she and Samadani met for the first time since she was released from the hospital. Lupe worked with physical therapist Kelly Rettman on a stationary bicycle and exercise ball to regain her strength as her parents watched over her.

"How did you feel after the surgery?" Lupe asked Samadani.

"I was so happy," said Samadani. "One of the happiest moments of my career is when I went on my rounds and saw you get up and walk to the bathroom, doing things most of us take for granted."

Lupe will meet with oncologists to discuss whether she is a candidate for radiation, but there is no guarantee that the cancer won't return. For now, however, the teen is just happy to be back to school and hanging out with friends.

"She had to make a huge leap of faith to trust us not to hurt her during surgery more than the tumors were already hurting her," said Samadani. "She's an amazing and resilient kid."

jtevlin@startribune.com • 612-673-1702 Follow Jon on Twitter: @jontevlin