Saturday, August 16, 2014

Back from vacation…."She Looks AWESOME" text from Bree's Mom correction of 110 degree Early Onset Scoliosis (EOS)

This Wednesday I got back from a wonderful two and a half week vacation with family, which included some phenomenal time out in the Pacific Northwest, including Glacier National Park --- breathtakingly beautiful!!!  If you ever get the chance to go there, GO!!  Also got a chance to see San Juan Islands, Seattle, and Helena, Montana.  We were also part of my brother's wedding celebration out in Seattle, which was just wonderful with lots of family gathering together.  It was a good break, although I did have to spend some time on my break working on some research papers and committee work for Scoliosis Research Society, which has a big meeting coming up in September.  I flew back into town Tuesday evening into RDU, glad to be home. I actually met 2 of my surgical scoliosis patients at the airport, and got a couple of hugs as I went through baggage claim!  So good to see some folks I haven't seen for a while doing well, enjoying travel.

The next morning, I was back in the scoliosis crafting "shop", and glad to be back.   I performed 2 scoliosis surgeries at WakeMed Children's Hospital, in Raleigh on a 9 yo Michael and 12 yo Jackson, both of whom had rapidly progressing right thoracic curves.  Both surgeries went very well, taking about 3 hours each, with very nice corrections, and no blood transfusions.  Jackson went home today  -- (he gave me a big green balloon before he left) on postop day 3, and the other will be going home tomorrow.  Both were up walking postop day 1 with one night in the PICU, extubated in the operating room.

Thursday we helped a girl at WakeMed Children's Hospital named Bree who just turned 10 who had a 110 degree early onset scoliosis (EOS).  Depending on the size of the patient, chest wall size, and other factors, we consider 3 options for treating such curves in younger children:  Growing Rods or Shilla Technique for a multistage surgical approach vs. a definitive instrumentation and fusion, possibly anterior/posterior and/or with posterior osteotomies, or possible larger vertebral body resection (VCR).  In the "old days", we used to worry about "crankshaft phenomenon" when performing definitive fusions in kids under 10, but with the dawn of stronger segmental instrumentation with thoracic and lumbar pedicle screws, this no longer appears to be an issue even for younger kids, down to even 6 or 7 in some cases.  We often do second opinions to help families decide which is best approach, and the best timing to optimize growth, minimize surgical risk and number of surgeries needed, and maximize curve correction.  the other issue that has to be addressed is when to use preop skeletal traction.

Over the years, I have been working on figuring out less and less invasive ways of trying to get better and better scoliosis curve corrections with less surgical risk and surgical time.  Bree's surgery this week gave us ample opportunity to hone this "craft" of curve correction in a very severe 110 degree curve.

Bree was totally psyched for her surgery Wednesday morning and let me know how straight she wanted to be!  She did not have preoperative skeletal traction.  Using some less invasive, but multiple osteotomies over several levels, and some creative instrumentation engineering leverage, we were able to get a really nice correction for Bree without any changes in her evoked potential monitoring, and no blood transfusions, and about a 5 hour total surgical time, extubated at the end of surgery.

I also used some new twists on a pedicle screw insertion technique I have been perfecting that worked very well, helping to direct the screws in her incredibly twisted and deformed spine in a very safe and efficient way bilaterally.

Bree was extubated in the OR, spent a short time in PACU, and one night in the PICU off the ventilator.  On postop day one, she was transferred to the floor, got up and walked around, and was 3 inches taller!!  Around lunchtime I received the "before and after" picture below texted to me by Bree's mom which said

 "She looks AWESOME!"


Get well soon, Bree!  You do look Awesome!!!

The learning never stops, learning every day -- day after day -- year after year how to serve and "straighten" children, adolescents and adults better and better.  This job is never ever gets boring.  The families are awesome, the people I get to work with in the clinic and hospitals are awesome, and it is just so great to see how together, as a team we are literally able to change a life for the better -- a change that will benefit children like Bree for the rest of her life -- even her first day back to school.  Her smile, and her mom's smile seeing her X-Ray and new posture after surgery makes us smile too!

Friday I did another scoliosis surgery on a 13 yo and made his "hump" that was painful and on right side of chest go away.  His preop curve was 53 degrees.

While it was great to be on vacation, my passion, and our passion at Hey Clinic and with our team members at Duke Raleigh Hospital and WakeMed Children's Hospital is definitely helping kids like Bree, Michael and Jackson, as well as some older teens and adults as well.

It's good to be back.

Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
http://www.heyclinic.com

Tuesday, July 22, 2014

Matthew flipping off a trampolene doing well 1 year after adolescent idiopathic scoliosis surgery.


We saw Matthew and his mom today in clinic for his 1 year postop visit after his adolescent idiopathic scoliosis surgery, doing very well.  Mom then sent me this email, with a picture of Matthew doing a flip off of a water trampoline!!!

---------------------- Forwarded message ----------
From: Kristen 
Date: Tue, Jul 22, 2014 at 12:52 PM
Subject: Matthew
To: "hey"

Here's Matthew on vacation one year post-op. Thank you so much for working miracles on him. We never dreamed this would be possible for him. You're a blessing and will always have a special place in our hearts.





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Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
http://www.heyclinic.com

Thursday, July 17, 2014

9 yo Janelle's smile tells the whole story: the final step of early onset scoliosis after Shilla Technique.

Back in December 2010, over 3 years ago, Dr. Rick McCarthy, (an SRS colleague) and I worked together to help Janelle, a 6 yo with a severe 110 degree early onset scoliosis, using an anterior fusion/release followed by the Shilla Technique -- a special growing rod technique that Dr. McCarthy has helped develop.

Yesterday, I took Janelle back to surgery to revise her Shilla to the final instrumentation and fusion, and got a chance to show her the new X-Ray, that shows her back very, very straight!  Her smile says it all.

I think she's gonna be quite a bit taller now!!
Janelle asked me what that big thing was on her X-Ray --- that is the bur that we use for surgery, that was not left in there, but was just resting on top for the film.

Many thanks again to Dr. Rick McCarthy and his team for helping Janelle, and teaching me this new technique which has helped other children since then here in the North Carolina / Southeast region with this improved type of growing rod technique.  I was very pleased to see that the levels above and below the apical fusion where still flexible, so I could get a very good final correction, which is often an issue with standard growing rods, where they tend to get very stiff with auto fusion.

Many thanks also to the excellent staff at WakeMed Children's Hospital!

Dr. Lloyd Hey -- Hey Clinic for Scoliosis and Spine Surgery -- http://www.heyclinic.com


Janelle's X-Rays from her last surgery back when she was 6!


Wednesday, July 16, 2014

Re: Sydney: Watch "Horse back riding after scoli surgery?" on YouTube

Julie,
Thanks for the photo and your encouraging note!
I unlocked the YouTube video so you can see it, and put together a new blog just now with the new photo, and the videos and photo together!

Here's the link:


Would you be willing to look up Hey Clinic on Google Maps and give "Hey Clinic" our first review?
Thanks for your help.

Take care,
Lloyd Hey


On Wed, Jul 16, 2014 at 4:25 PM, Lloyd Hey <drlloydhey@gmail.com> wrote:
From: Julie 
Date: Wed, Jul 16, 2014 at 10:50 AM
Subject: Re: Sydney: 
To: Lloyd Hey 

Dr. Hey,

Thank you for sharing the video and blog about Sydney and her progress. 

Thank you for everything you did for Sydney and us.  As you know, she is doing fantastic and we are so thankful.  Last week it was exactly one year since her surgery and she won FIRST place in jumping at the state horse show!  She won first place in jumping and third place overall.  I've attached a picture of her last week - Exactly one year from her surgery!

Thank you again.
Julie




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Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
http://www.heyclinic.com




--
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Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
http://www.heyclinic.com

Fwd: Sydney: "Horse back riding after scoli surgery?" on YouTube

From: Julie 
Date: Wed, Jul 16, 2014 at 10:50 AM
Subject: Re: Sydney:
To: Lloyd Hey

Dr. Hey,

Thank you for sharing the video and blog about Sydney and her progress. 

Thank you for everything you did for Sydney and us.  As you know, she is doing fantastic and we are so thankful.  Last week it was exactly one year since her surgery and she won FIRST place in jumping at the state horse show!  She won first place in jumping and third place overall.  I've attached a picture of her last week - Exactly one year from her surgery!

Thank you again.
Julie










Lloyd A. Hey, MD MS
http://www.heyclinic.com
Hey Clinic for Scoliosis and Spine Surgery