Haiti is a beautiful country, with beautiful people, but the needs there were seemingly overwhelming.
We had a wonderful medical team, and although I did not get a chance to do spinal surgery on this trip, I did get a chance to screen many children and adults for spinal deformities and other problems. I did help cure a lot of kids of “worms”, and saw some osteomyelitis, and some non operative orthopaedic injuries. I also treated a LOT of hypertension and diabetes, which is very common there. Many people also need simple reading glasses. Many have GI complaints, with reflux, and stress-related gastritis, as well as likely hunger. Many complained of eye symptoms of burning and itching — there is a lot of smoke, and tons of dust flying around in the air — my eyes burned as well, but sun glasses helped to protect the eyes a bit.
There were many children with scoliosis at a special home we visited outside Port au Prince, which cared for children with severe cerebral palsy.
Family Health Ministry (FHM) does a really wonderful job with their medical ministries, working with, and supporting Haitian physicians and other healthcare workers.
They are also helping out with an orphanage and school up in Fondwa in the mountains of Haiti. We would like to see the orphanage and school combined into one upgraded “boarding school”, and are in the process of raising funds and plans for this group. The existing orphanage is very dark, and small with dirt floors and cinder blocks, no electricity, and very little water, and a tiny kitchen. It is also located way down the side of the mountain, down a small footpath — a hard place to get to, and a very hard place to do construction.
After arriving back in Raleigh on the 22nd of June, the past 2 weeks have been very busy caring for many younger adolescents with scoliosis, and adults with deformity and other spinal problems.
Kids definitely come in all sorts of different shapes and sizes! My first scoliosis surgery when I got back was on a 12 year-old with a severe double curve, who weighed only 70 pounds.
Yesterday I fixed a 10 yo old girl’s large R thoracic curve who is 100 lbs heavier than the 12 year-old from last week, much more mature.
This difference between skeletal age and chronologic age is something we take into consideration when examining children and adolescents with scoliosis.
Also this week we helped a lady who had a spinal fusion done 8 years ago who had horrible flat back syndrome, with 17 degrees of lumbar KYPHOSIS!
I performed a pedicle subtraction osteotomy (PSO) at L2, and got her back into excellent lumbar lordosis.
She is now getting up and around, standing up straight for the first time for many years.
On Tuesday this week we “straightened up” a 56 yo woman who had a pseudarthrosis at L5S1 with painful kyphosis.
She had previous anterior surgery L1-5 done elsewhere, but they did not put anterior cage in L5S1.
That level developed pseudarthrosis with painful kyphosis.
We were able to dissect out that L5S1 disc through the adjacent scar through anterior approach, and then “jacked up” the space to give her more lordosis. After this, we turned her over, and did a posterior osteotomy with decompression of the neural elements, and then revised her instrumentation from L1 down to the pelvis.
She is doing very well now, standing up much straighter with less pain.
In the morning yesterday, we “straightened up” the 10 yo girl who had a 51 degree R thoracic scoliosis. Her pre and postop films are shown toward the bottom.
Her surgery took approximately 2 hours, and the estimated blood loss was 500 cc, requiring no transfusions and 250 given back in cell saver.
Her correction was approximately 90 percent, and she has done great postoperatively, going home likely tomorrow.
Our adolescent scoliosis patients rarely if ever require blood transfusions, and have not had to go to ICU postoperatively, except for children with severe disabilities (cerebral palsy, seizure disorders, etc).
Yesterday, also did a simple L45 microdiscectomy for a lady who had a HUGE free fragment disc herniation on the R side.
She went home today feeling much better.
We’ve seen a bunch of surgery postop patients in clinic with their families, as well as seeing a lot of new scoliosis patients for second opinions, and initial evaluations.
I saw one of my 1 yo congenital kyphoscoliosis patients back for follow-up, who has actually very nicely grown out of most her kyphosis! Mom was definitely psyched!
I saw a very nice lady from Vermont, as well as a couple people from Florida, and several from South Carolina.
Our premed summer intern, Chris, is working hard on his “spine growth” paper, which we will be publishing on the Blog here shortly. This will address some questions several families have asked recently, regarding the concern about limiting spine growth with spinal fusions. More on that later. Chris, an engineering graduate from NC State is also helping with our biomechanical research this summer. He also takes his MCAT’S in a couple weeks. Work hard, Chris! We’ve had a bunch of other summer students so far, who have all been great, including a couple who are former Hey Clinic patients, now going into the medical field!
Our biomechanical research with NC State is coming along nicely, with new computer models for spinal deformity and spinal instrumentation constructs.
Some new constructs are also being tested with “real” (not just computer) testing this summer as well.
Never a dull moment!
It’s good to be back @ Hey Clinic.
Dr. Lloyd Hey
http://www.heyclinic.com
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA
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