Patient travels thousands of miles for spine surgery at IU Health West

Written by Charlotte Stefanski, cstefanski@iuhealth.org, writer for IU Health's Metro Region

Dr. Motasem Al Maaieh, MD, had previously operated on Felipe Osterling Letts when working in Miami. In 2025, the patient needed a second surgery and traveled from Peru to IU Health West for the procedure.

There’s not much in life that has slowed Felipe Osterling Letts down.

Originally from Lima, Peru, the 65-year-old (pictured above, with his wife) has spent his life’s work in several industries, including mining and food. He’s married with three children and has homes in Miami, Panama and Madrid. In 2017, Osterling Letts decided it was time to sell his businesses and retire.

“I thought I had enough in my life. So, I sold everything and decided to do nothing,” he jokes.

He couldn’t “do nothing” for long though. Osterling Letts picked up surfing as a hobby and traveled the world to do it. After about a year and a half of retirement, he went into the agricultural industry.

In 2019, Osterling Letts began experiencing lower back pain. With connections across the world, he began researching orthopedic spine surgeons, and came across Motasem Al Maaieh, MD, who then worked at the University of Miami in Florida.

After a successful first surgery with Al Maaieh in Florida, Osterling Letts would need his care again in 2025. However, Al Maaieh had moved to Indiana to help build the Spine program at IU Health West.

Because of Al Maaieh’s professionalism and compassionate care, Osterling Letts traveled thousands of miles for his second surgery.

A successful first operation

Al Maaieh explains when he first met Osterling Letts, his patient was experiencing lower back pain in the L4 and L5 vertebrae.

“He had what we call stenosis, or compression of the nerves in the lower back, and some instability in the vertebra,” he says.

“I was very nervous, as you can imagine, going into spine surgery,” Osterling Letts adds. “But I had suffered a lot of pain, and I told myself, ‘Right now, I’m healthy. I can do it.’”

The surgery was a success, and Al Maaieh would continue seeing Osterling Letts for follow-up appointments for about two years.

Al Maaieh explains that one possibility for spine patients is that years after they heal from their initial surgery, they may have a similar problem in another level of the spine.

This happened with Osterling Letts, and he began experiencing pain in the L3 and L4 vertebrae.

Osterling Letts visited Miami to schedule an appointment with Al Maaieh and discovered he was no longer there, but instead seeing patients at IU Health West.

That didn’t deter Osterling Letts though—he trusted Al Maaieh and would be willing to travel for his care.

“He’s an excellent, professional. He’s very clear and direct,” Osterling Letts says. “He does not fool around.”

An international affair

Since Osterling Letts would come all the way from Peru for his second procedure, the Orthopedic department reached out to Maria Siddons, operations manager of International Patient Services at IU Health.

Siddons has worked at IU Health for nearly 12 years. She leads a small team that helps coordinate experience for patients traveling from around the globe to receive care at IU Health. Their work goes far beyond logistics—they serve as trusted guides, advocates and cultural liaisons throughout each patient’s healthcare journey.

The team specializes in end-to-end coordination, beginning with the initial inquiry and continuing through post-treatment appointments. They manage medical record reviews, facilitate physician consultations, provide cost estimates, coordinate appointments, and assist with travel, lodging and visa documentation.

"Each case is handled with precision, urgency, and a deep respect for the unique cultural and emotional needs of international patients and their families," Siddons explains.

The team understands international patients often face uncertainty navigating a foreign healthcare system. Their role is to eliminate barriers, streamline communication and ensure clarity at every step. By collaborating closely with clinical teams, financial services and more, they create a cohesive and supportive care experience that reflects the highest standards of excellence.

“Throughout Felipe’s full experience with IU Health International Patient Services, we made sure he was comfortable, confident and in the know," Siddons says.

“Maria is number one. They were beside me, and they were beside me until the last day I was at IU Health West, until the last appointment,” Osterling Letts adds.

A motivated patient

Osterling Letts had his surgery at IU Health West in November 2025. He was up and walking the same day, and since then, hasn’t had any pain.

“I feel so good,” he says. “It's like I had never had surgery.”

He and his family stayed in Indiana for two weeks, so Al Maaieh could keep an eye on post-surgery progress. He came back for a six-week check-up and x-rays, which all looked good.

“I don't take all the credit for this,” Al Maaieh says. “He’s a motivated patient. He's a good healer too. He was doing all these exercises. He wanted to get better.”

While spine surgery can be daunting, Osterling Letts advises potential patients to be direct with their surgeons and to ask lots of questions. He also physically prepared for the surgery, two to three months in advance. He kept his physical activity up, so that his recovery could be easier.

“You have to build up your muscle. You have to build up your core muscles, your back, your legs—everything,” he says. “You have to go into it in the best shape possible.”

Thanking his team

Now about five months post-operation, Osterling Letts continues to be pain free. He appreciates the collaboration and care he received at IU Health West, and while he hopes to not have any other surgeries for a while—he knows where he’s going, if he does.

“I think I've been very lucky and I’m thankful for all the people that have been beside me. I have an angel. Two spine surgeries, and I’m feeling good. There’s no pain,” he says. “Any kind of surgery, I have no doubt that I will do it in IU Health.”

Al Maaieh appreciates his patient’s loyalty, and for him, it’s reassurance that he’s doing the right work. He notes that it’s a team effort, from nurses, to physician assistants and spine nurse navigators.

And, within a few short years, IU Health West has opened a ninth operating room, allowing for more spine surgeries to take place. Additional imaging technology has also been installed near the Spine suite. More surgeons have been brought on, and IU Health West also launched one of IU Health's first hospital-based spine nurse navigator roles.

“It’s a reassurance that you're doing the right thing for your patient and you're getting good outcomes. Felipe is a great example of that,” Al Maaieh says. “Everybody that's involved in the process, they make this a seamless experience.”

To learn more about IU Health’s Spine program, visit  https://iuhealth.org/find-medical-services/back-spine-care. More information on International Patient Services can be found here.