Exerpt from Sarabeth's Blog regarding her adolescent Scoliosis Surgery

Sarabeth’s mom shared with me Friday her Blog at http://sarabeth13.wordpress.com.

Here is an excerpt from just a week or so ago.
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Thursday August 21st (written by Mommy)

August 21, 2008 by sarabeth13

Well we are finally home and Sarabeth is continually getting better.  Let me start by saying that her surgery was a huge success and all went well. Dr. Hey and Jaquelyn were great! She did fine with anesthesia and truly seemed calm the entire time in pre-op. Dr. Hey’s staff provided us with updates through out the surgery time which meant more then he probably knows. Pastor Tony and Tori came up and stayed with our family until he was able to pray with her in post-op. I was having a tough time just realizing all my precious daughter was going through and it helped to have them there to talk with. Pastor Tony has a huge heart for the Lord and it is always showing! Mr. Bradd (our youth leader) called and prayed with her before going into surgery. Aunt Cathy, Chris, Matt, NaNa, Jordan, me and her dad, Pastor Tony, and Tori were all there waiting for her. Immediately after Dr. Hey came out and met with all of us and showed us the x-rays. Its amazing she is STRAIGHT! Praise be to God for guiding Dr Hey’s hands and for Dr. Hey’s ability and desire to help Sarabeth and those like her. Pastor Tony and I was able to go and be with her in recovery  but I quickly learned it wasn’t the best place for me to be and I couldn’t handle seeing my baby in so much pain. Sp Colby went back for a bit then swapped and Cathy stayed with her until she came up to her room. She was glad to see anyone and everyone. She wanted a hug and to touch each of us. She asked all staff there names and told them hers. She could see two of everyone and things she tried to read were very blurry.  She told Cathy there were two of her and Cat Cat said that would be bad wouldn’t it and she said no and smiled her first smile! D-daddy (my dad) came with Mike and Hunter to see her. He brought her a card and flowers and that made her smile. Mike and Hunter brought her a card and balloons. Cathy and the boys brought her balloons, a singing card, a pretty bracelet, and a cool bookmark. She also got flowers from our friends Lorrie, Kayla, and kay from VA. Her Aunt Carey and Uncle Jamie sent a blanket, a pen, a word search book, flowers and a cool horse stuffed animal that she hung on to. The nurse who did her pre-op really liked her a lot and gave her a Duke stuffed bear whom she named Duke. Pastor Tony and Tori came back up to visit in the afternoon and were glad to see them again. Then on Wednesday Mrs. Jewel, Tori, and Jordan gave us a pleasant surprise visit and brought a balloon and lots of candy for when she feels better. Monday she mostly rested and pushed her Morphine pump. Tuesday she had about the same kind of day with some visitors. She fell asleep about 4:45 p.m. and slept through her 5pm dose. She woke up about 7:15 p.m. in extreme pain. She finally got some relief @ 7:55 due to shift change and was just about out of her skin in pain. The rest of the evening went as well as could be expected because I set my alarm for her to receive her meds every four hours so that would not happen again. Wednesday we were preparing to go home and she was struck with severe pain again however this time it was in her stomach. She said her back didn’t hurt at all but her stomach was killing her. From 11 am on the nurses tried everything they could think of to help her and nothing worked. From 10 pm through 5 am this morning we rolled her from side to side trying to wake her bowels and help with the gas and constipation. This morning she woke to see Dr. Hey and Jacquelyn and was feeling so much better. We left the hospital around 10:30 and came home. She was excited to see her family, Tori and her children, and her pets. She is resting now and in good spirits. We are so thankful to God for being with us during this entire experience. We are also thankful for his care, love, and presence throughout the whole experience. God is the Great Physcian and we all have proof of that through Sarabeth. Thank you also to all of you for loving her, praying for her, being there for her, and us. We love you all and will try to update you as often as we can.

Blessings,

P_____ Family

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http://www.heyclinic.com
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC  USA

13 yo Sarabeth comes by to visit just a few weeks after scoliosis surgery

Yesterday, Sarabeth dropped by Hey Clinic to say “Hi” with her mom and sisters.
Their family was in town to go to a special horse equipment show — Sarabeth’s passion!
We were able to get a quick team photo before I ran off to the operating room with Jaclyn and Brittany from our team.

You look great Sarabeth!!
I’ll try to take a look at your Blog!  http://www.sarabeth13.wordpress.com.

Lloyd A. Hey, MD MS
http://www.heyclinic.com
Raleigh, NC  USA

FW: Thank you. Spending the time answering questions.

From: Frances
Sent: Saturday, August 30, 2008 9:53 AM
To: Dr. Lloyd Hey
Subject: Thank you

 

Dear Dr. Hey,

 

I hope this finds you and your staff well.  I wanted to thank you for the time you spent with my husband and I. If you recall, my husband (with the fractured left knee cap) and I came to consult with you  on August 8.

 

I have been working in the medical field for nearly twenty years and it is rare to find a surgeon who is willing to spend an hour answering questions. Both my husband and I appreciate your time and compassion.

 

It is odd to say, but I am looking forward to having my kyphosis corrected and then will be able to FINALLY stand up straight and say goodbye to chronic low back pain. 

 

Thank you so much,

 

Frances

FW: follow up.

------ Forwarded Message
From: J, RN.
Date: Mon, 25 Aug 2008 16:01:40 -0400
To: "Dr. Lloyd Hey"
Subject: follow up


Hello Dr. Hey:

I was in your office on Thursday with my fiance, _____________.  ______________, my boss , suggested that we come to your clinic.
I just wanted to  let you know how very pleased Bruce and I were with our experience at your clinic.
From check in to check out , the visit  was excellent and efficient, the staff friendly and informative.  ____ was seen by Jaclyn  who provided a very comprehensive assesment/exam and was very clear in describing his condition and her plan of care for him.

I will highly recommend your clinic to others.  

Sincerely,

J_______RN, CPSN
Nurse Clinician
Duke University Medical Center

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FW: A Big Thank you from Michigan

------ Forwarded Message
From: Ronald R
Date: Mon, 25 Aug 2008 08:59:14 -0400
To: "Dr. Lloyd Hey

Subject: A Big Thank you from Michigan

Dr. Hey,

I just wanted to write and express my gratitude.

Lysanne and I received the DVD and the software and we are overwhelmed with your generosity.  I know that Lysanne will put the software to good use this fall with the sports-photography, slide-show and end-of-season DVD work that she does so well.   Since receiving the DVD on Saturday,  Lysanne has watched the surgery twice and I have seen it one-and-a-half times.  Molly watched it with her best friend Sydney.  Sydney wants to be a doctor.  Who knows, maybe a future surgeon has been inspired!

You have fused Molly’s back and made it straight and secure.  Equally you have made my family secure and confident through a very scary and anxious time.  You have greatly helped Molly with her posture (and indirectly her esteem at this tender age in her life).  You have inspired Lysanne to greater heights in her work through your gift of “Final Cut”.

I shared our story and your good work with a friend of mine, ________.  Her sister is __________.  I am told that _______’s daughter, ______ is an accomplished 6’4” basketball player in Indianapolis.  Like Molly , ________ is also kyphotic.  I have given them your name and they may call you.

Once again, thank-you for all that you have done and continue to do.  

May God Bless you.

Ron ________

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Friday Hey Clinic "Graduation". Many Thanks and Best Wishes for Jenna from Inpatient Physical Therapy.

We saw several new families today in clinic, as well as several smiling postoperative patients in their families.
One of our postop scoliosis patients who I straightened up a couple years ago, who is from West Virginia was doing great, and brought her daughter for scoliosis screening. She had a L lumbar hump, and had a 17 degree curve on X-Ray. Like mother, like daughter!
We saw several patients from Pinehurst, who have gotten back to their active lifestyles. There is quite a big group of Hey Clinic patients from Pinehurst who all seem to know each other, and send their friends and family to Hey Clinic in Raleigh for their spine care.

The postop patients I saw ranged from a woman who had a single level L5S1 decompression and fusion for a spondylolisthesis and stenosis, up through a young lady who had a 15 level kypho-scoliosis reconstruction, including an anterior-posterior L5S1 extension instrumentation and fusion down to iliac wing with osteotomies.

I finished clinic today with a very nice family from Cary, NC to discuss treatment options for their 12 year-old girl with a 27 degree curve, discussing bracing vs. observation options.

Afternoon rounds went well, with the inpatients from surgery this week doing well.
Our 18 yo who had the big double curve scoliosis reconstruction on Wednesday went home today after 2 nights in hospital with her mom.
Our antero-posterior thoracolumbar sacral iliiac wing instrumentation and fusion was up walking around this afternoon, smiling with her new straight up posture. Her sisters have been coming to visit regularly. Our nurse from South Carolina who had the antero-posterior reconstruction from yesterday is recovering well, and will get up and do some standing and walking tomorrow. She is in very good spirits, and her legs already feel better.

I wanted to express my sincere thanks for Jenna, who is an EXCELLENT physical therapist at Duke Raleigh Hospital who is moving on to a new job to experience outpatient physical therapy in Durham. Jenna, you have been just AWESOME!! Best wishes to you in your new career endeavors. You are always welcome back at Hey Clinic.

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




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Anterior-Posterior (A/P) Reconstruction for 60 yo nurse with severe flat back syndrome, stenosis and pseudarthrosis.

Today we helped this 60 yo nurse from Charleston, SC who has had several surgeries in South Carolina.
She has severe flat back syndrome, degenerative scoliosis, spondylolisthesis, L5S1 disc degeneration with vacuum disc phenomenon.
She also has rheumatoid arthritis, which contributed to her original degenerative scoliosis.

I removed the degenerative disc anteriorly, and jacked it open, and replaced the disc with an ALIF spacer with bone morphogenic protein (BMP) and anterior instrumentation to prevent cage migration.
I then removed her old unilateral instrumentation, explored the fusion mass, and found loose hardware and instability at L12.
The spinal stenosis at L12 and L5 was relieved with laminectomies, and posterior osteotomies were performed to help further improve her lordosis.

She did well with surgery, and her lordosis was dramatically improved.

After her surgery, I spent an hour with another nurse ICU manager (in her 50’s) who has a double curve 50 degree scoliosis surgery to discuss her potential upcoming surgery.

She was told by local neurosurgeon that “nothing could be done” except pain management for her scoliosis, but her primary care doctor researched it further, and suggested that she be evaluated by a scoliosis center.

She was glad to hear that there was hope, since she has become increasingly symptomatic during past couple of years, and is strongly suspicious that her curve is progressing.

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

18 yo Double Curve Scoliosis Corrected today

Today we helped Michael, an 18 yo young man with severe double curve with documented progression and back pain.
We were able to get an excellent correction.
He did well through surgery, and was sleeping soundly when I came by to check on him in his private room, with his mom in bed next to him.
His instrumentation was from T5-L4, and his bone quality was excellent.  I have some special techniques for screw and rod insertion and rod bending that allows us to get the spine back into excellent alignment in both the sagital (side view) and coronal (back to front view) plane.
Fortunately, because he was still fairly young his curve was relatively flexible, which helped us to get a great correction.
His surgery took about 5 hours, and he was transfused one unit of blood, plus cell saver.  His surgery was a bit more complex, due to his huge size, including huge paraspinal muscles (He’s 6 ft 4 in tall!)
His postop hemoglobin is excellent, and his evoked potential monitoring was normal throughout surgery.
Tomorrow, we’ll get him up.
He was already around 6 ft 4 inches, and now will probably be a couple inches taller!
His mom and girlfriend were very happy to see his new X-ray and hear that he did well through surgery.

After finishing his surgery, I saw my preop patient for tomorrow’s surgery, who came up from Charleston, SC, who needs a complex anterior/posterior revision reconstruction.

Late afternoon, we helped a woman with severe spinal stenosis and spondylolisthesis and rheumatoid arthritis with a L2-5 decompression and fusion.

Our 13 scoliosis from Monday goes home tomorrow morning, waiting for her bowels to fully awaken.  Otherwise she is doing great, comfortable, and walking the halls w/ her mom.
Monday’s spondylolisthesis and stenosis correction patient went home, doing well.

Our big kyphosis correction from yesterday is doing very well, extubated this AM in ICU, and will get up tomorrow to try out her new posture.

Lloyd A. Hey, MD MS
http://www.heyclinic.com
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC  USA
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How do you make a severe thoracic kyphosis and lumbar "flat back" person stand up straight again?

Today, I spent 8 hours straightening up 62 yo Roberta, who had developed a severe kyphosis with severe lumbar flat back syndrome, and thoracic kyphosis which all added up to her being totally hunched over, barely able to walk, and looking down at the floor with severe pain.
Before surgery, she got a thorough preoperative assessment performed, including a cardiac stress test to help ensure that she was able to get through such a big operation.
We also spent quite a bit of time going over the surgery in detail, along with conservative treatment options which she had failed, and reviewed the benefits and risks of the surgery w/ her.

To fix this problem, I first did anterior discectomies at L45 and L5S1, working with Dr. Chris Watters, an excellent general surgeon who works with me a lot.
Chris and I got down to these lower, completely flattened discs, and then I was able to remove them, and gradually jack them open, back to the height they were many years before.
I then replaced the discs with special titanium hollow ALIF interbody spacers packed with bone graft.  These spacers, or “cages” hold that space open, and begin to help restore the lumbar lordosis.
I then fasten some hardware anteriorly to ensure that the cages do not migrate out anteriorly.

The anterior incision is then closed.
The patient is then turned to a prone position on the OR table, and prepped and draped again.
I then did a T3-Iliac Wing instrumentation and fusion with titanium pedicle screws and titanium alloy rods.
I did a 5 level laminectomy to relieve the severe lumbar spinal stenosis she had at several levels.
I then did 5 lumbar osteotomies, removing wedges of bone posteriorly (Smith-Peterson Osteotomies), to help allow me to fold the lumbar spine back into proper lordosis so she could stand up straight.
I then put in the bone graft, and a couple cross-links, and then checked X-rays from AP and lateral directions which showed that her posture was restored.
Since I can’t get the whole lateral spine on an X-Ray on OR table, I took lateral photo from head down to buttock which shows how her big “C” shaped spine is now a gentle, normal “S” shape.
We did her surgery in our high-tech laminar flow room, with my excellent experienced OR team, who has helped me do hundreds of these complex cases before.  Jaclyn was my awesome physician assistant PA.
Teamwork and experience really pays off to get these complex surgeries done effectively and efficiently so we can minimize the perioperative risk, which goes up with surgical time.

Her surgery took right around 8 hours, and she was extubated after surgery, and will spend the night in the ICU.
Her family was very thankful for this “total body reconstruction” which will allow Roberta to get back to a much better, and straighter quality of life.
After 8 hours of surgery for her today (2 hours for anterior, and 5 hours posterior, 1 hr turning and re-prepping and draping), I was very glad to sit down with the family and go over her X-Rays and new overall shape photo.

If Roberta had come to me a few years earlier, I might have been able to fix this without having to go front and back, which would have made the surgery less invasive.
Many of the patients I see for second opinion, including Connie, who consulted me from Los Angeles, have been told that they HAVE to have an anterior/posterior approach for their scoliosis or kyphosis reconstruction.  In Connie’s case, since she was well-balanced especially in the sagital plane (no severe flat back), I was able to offer her a less invasive approach, going posterior only, and putting in the bottom cage through a transforaminal (TLIF) approach.
When anterior/posterior surgery is strongly indicated, it can often be performed all on the same day as we did today for Roberta, as opposed to doing it on 2 separate days, separated by a week or 2 in the hospital on bed rest.

Roberta  should do very well, even though she definitely needed the anterior/posterior (A/P) approach.
She will probably stand up about 4-6 inches taller tomorrow, with her face looking straight ahead at the world, as opposed to down at the floor.
One of the happiest moments for me and my staff and the physical therapists , occupational therapists and nurses is to see the smile of these patients when they get to stand up for the first time and they can actually stand up straight!
Their smile tells the whole story.
It’s worth the sweat to get there!

Despite the long day in the operating room, I was able to catch the second half of my daughter’s volleyball team.  What a joy it was to watch her play, and captain her team to victory, with a tight match right down to the last couple points.
My staff at Hey Clinic work hard to allow me to get to family events during the week, when possible to watch the kids play sports, etc.

Now it’s time to rest up.  It’s been a great day.  But tomorrow is another big day.
We will be helping an 18 yo young man with a really big thoracolumbar scoliosis who is already 6 ft 4 in tall, followed by another 3-level decompression and fusion at the end of the day.


Lloyd A. Hey, MD MS
http://www.heyclinic.com
Hey Clinic for Scoliosis and Spine Surgery
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Yesterday morning's Scoliosis Surgery: 13 yo R thoracic scoliosis

Yesterday morning, we helped straighten up Sarabeth, who had a 44 degree R thoracic curve that has progressed significantly over the past year.
One of the nurses in the Preop Area, gave her a really cool little bear, who kept an eye on us during surgery, and has been snuggled in with her ever since!
Her surgery took a little less than 3 hours, and she got an excellent correction, with complete elimination of her R rib hump.
She did well during surgery and in recovery room, not requiring any blood transfusions, receiving cell saver only.
Her mom got to stay with her in her large private room last evening.
Today, she got up and around, walking up and down the halls, and going up and down stairs.
Tomorrow, she will learn how to go in and out of the car, and then will likely go home tomorrow after 2 night stay in hospital.
Some of our teenagers stay 3 nights, but most stay 2. Once in a while a teenager or young adult may stay 4 nights when they are from far away, but that is pretty rare.
Most are eager to go home!
We do let them shower right after surgery, since we do a subcuticular plastic surgery-type closure with Dermabond, which allows them to shower right away.
The R thoracic curve post-surgery patients can also return to virtually all sporting activities right away, including swimming, tennis, cheer-leading, soccer, etc.

I have a special place in my heart for the teenage patients, since I was a teenage patient many years ago, and have 2 teenagers of my own.
My physician assistants and I also really enjoy doing the scoliosis screenings and follow-ups for the many scoliosis patients who visit us each day.
This morning before and after surgery I got a chance to see 2 very happy teen-agers with small curves, both of whom are interested in becoming doctors someday.
Friday, my last patient of the day was a 12, almost 13 yo girl who had a curve progress up to 35 degrees since the last visit. She was there with her mom and dad and little brother, and my PA and I had a long talk going over the pro’s and cons of bracing vs. continued observation. The girl and her parents were able to make a team decision that they all felt comfortable with, taking into consideration the best literature and clinical experience.

We have a special internship program at Hey Clinic, where we “inspire” the next generation of high school and college-age students to get a taste of what it is like to care for patients in the clinic and in the hospital.
Several of our scoliosis teenagers and college-age students hang out with us each year, as well as Pre-Med students from local universities including Duke, UNC, and NC State.

Surgery for the teenager and younger adult is much simpler and with much better surgical corrections with less levels needed to be fused, and much quicker recovery.
It’s nice to have a mix of scoliosis patients across the full age range, though, from the little toddlers up through the pre-teens, teenagers, college-age, young adult, mid-range adult and older adult.
The many years of experience I have had caring for both the adult and adolescent and child with scoliosis has allowed me to develop and learn “tricks” from the adult group which I then can use in the younger group, and vice versa.
All groups can benefit from surgical and nonsurgical treatment, and each have their own unique quality of life issues they wish to solve.

Last night I stayed up kinda late finishing Connie’s movie, the 57 yo from the Los Angeles area, who had the very large double curve scoliosis that I fixed last Tuesday. That surgery was quite a challenge, requiring 6 hours of surgery, with much longer fusion and instrumentation needed. I was hoping to run it over to Connie and Ed’s hotel this morning on my way into the hospital, but they left WAY early this morning for the airport. Connie did extremely well, but Sarabeth’s surgery yesterday was like a dream compared to Connie’s! However, both are thankful for their new shape, and I am very glad that Connie got her curve fixed when she was 57 and not 67 or 77.

On a separate note, I’m a little nervous what Connie’s husband Ed is going to think about my 5 minute movie of Connie’s surgery. He is a professional expert animator for Dreamworks with 30 years experience also with Disney. We mailed it off to California this morning, as Connie flew out early this morning via Atlanta to Los Angeles. If Connie and Ed say it is OK, I may share her surgery video on the blog after they have a chance to see it.

In general, it is easier and safer, and you end up with a better correction with quicker recovery when scoliosis and/or kyphosis is fixed when you are younger.
However, many older patients can still benefit from scoliosis and/or kyphosis reconstruction if their quality of life is greatly affected, or if the curve is progressive.

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

"Definitely Worth The Trip": Connie heads back to Los Angeles tomorrow after Scoliosis Surgery just a week before.

A week ago today, I got to meet Connie and her husband Ed, who I shared about in last week’s blog.  Connie is in her 50’s, and had a progressive thoracolumbar scoliosis, with increasing pain, and even had some ribs removed from her chest wall when she was in California, since the ribs were rubbing on her pelvis / iliac crest.

Connie’s surgery went very well last week, and has been recovering well in the hospital, advancing on her physical therapy and occupational therapy.  Her husband Ed has been a huge encouragement, and has stayed with her in her room, in his own separate bed.

This morning, Connie was discharged from Duke Raleigh Hospital next door to Hey Clinic, and came over to see me in Hey Clinic in between surgeries.  Connie and Ed were both full of smiles, and had lots of encouraging words about their experience this past week — something she has looked forward to for a long time.  Connie’s X-Rays look great, with excellent correction of her deformity, and an extra inch and a half or 2 inches in height.  NOW her ribs are all lifted off of her pelvis, with her T3-Iliac wing instrumentation giving her a whole new shape and appearance.  Her shoulders are nice and level, and trunk is well balanced over the pelvis from both the front and side view.  She has excellent lumbar lordosis, and her huge hump on her left lower back is flattened out. I got Connie a light-weight lumbar brace, called an “Aspen”, which will give her a little extra comfort and support over the next few weeks.

Connie, Ed and I will stay in touch via the internet, and phone, and she will get X-Rays done locally, and sent to me periodically.  While it may not happen, it would be nice to share a meal together in the years to come, when I am on west coast, or if Connie and Ed make the trip out to the East coast.

Connie, Ed and I got our picture taken together, as she gets ready to fly home tomorrow.
We exchanged handshakes and hugs, and Connie’s parting words to me were:  “It was definitely worth the trip!”

Thanks to all of the Duke Raleigh Hospital and Hey Clinic Team who worked together to help Connie and Ed through this important journey.

Get well, Connie, and have a safe trip home.  You look great!

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

Connie's 10 year, 2,420 mile Journey to get her scoliosis fixed, now recovering well.

On Monday this week, I finally got to meet Connie and her husband Ed, who are from a Los Angeles California suburb.
Connie and I have been in phone and email contact over past few months regarding her scoliosis.
She was initially picked up with scoliosis about 10 years ago, and initially had little pain.  At that point her double curve was roughly 50 degrees for upper and lower.
Over past 10 years, her pain and deformity has gotten progressively worse to the point where her quality of life is greatly affected.
A surgeon out in California removed some of her lower ribs when they were hitting her pelvis and causing pain --  which didn’t help very long.

Earlier this week at Hey Clinic her curves are 56 upper and 76 lower with severe collapse and height loss.
She did a lot of research, and sent me some X-Rays and clinical photos a few months ago, and then we talked on phone.
We talked again on the phone on Friday before she flew out Saturday to RDU (Raleigh Durham Airport) which is about 15-20 minutes from Hey Clinic.
Monday, between surgeries I got to meet her and her husband Ed, who is a phenomenal cartoonist for Dreamworks, after working for Disney for many years.

Connie was definitely psyched up for getting her scoliosis fixed, but was understandably nervous in the week leading up to the surgery and travel.

Her surgery was Tuesday morning, and went great.
Surgical time was around 6 hours.
She got a couple units of blood plus cell saver.
I placed a TLIF at L5S1, and instrumented her spine from T3 down to the Ilium, with multiple thoracolumbar osteotomies to help with her correction of the severe deformity.
She got an excellent correction despite the curves being fairly stiff. The osteotomies definitely helped.
She spent the first 2 nights in ICU, but did very well and has gotten up to walk, standing up very straight.
Her large “hump” she had on the lower left is gone, and her ribs are now a couple inches or more above the pelvis (the ones that are left!)

This evening I saw both of them up in her big private orthopaedic room with 2 beds.
She really looks great, and both her and Ed are quite thankful for the care they have received.
It was a special, joyful and peaceful time with this special couple.

Ed took a few minutes to show me some of his amazing artwork for his next film he is working on, which is the sequel to “Kung Fu Panda.”
He was working on it in Connie’s room, using the free high speed wireless Internet to stay in touch with work, and family and friends back in California and around the country.

My daughter is very artistic, but my art is limited I think to “titanium sculpture.” :)

Connie will be discharged from the hospital probably by Saturday morning, and stay here in Raleigh through the weekend.
She’ll come in to see me in clinic Monday, where we will get some new X-Rays, and answer any questions they have, and get a team photo.
Then Tuesday she flies 2,420 miles back to Los Angeles looking a lot straighter, and very relieved to have this 10 year concern behind her.

Get well soon, Connie!


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

FW: Thank you from Brandon's Parents. Teenager Brandon goes home after 2 nights in hospital for kyphosis surgery.

------ Forwarded Message
From: mike
Date: Thu, 14 Aug 2008 01:49:19 +0000
To: <DrHey
Subject: Thank you

Dear Dr. Hey,
 

My husband and I would like to thank you for what you have done for our son Brandon. We also appreciated your prayers before and after the surgery. Brandon also appreciates you too. He asked for you immediately after he was moved to the recovery room, so he could thank you. We would also like to write a testimonial to further thank you and your staff at the Hey Clinic and also to the wonderful staff at the Duke Raleigh Hospital. Brandon is continuing to do well.
 

Evelyn and Michael S___________


Courage is fear holding on a minute longer.
George S. Patton <http://by121w.bay121.mail.live.com/quotes/quotes/g/georgespa125178.html>  

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

74 yo "Wrambling in the Woods and Climbing Deer Stand" 3 + yrs after spinal surgery

------ Forwarded Message
From: Marie
Date: Thu, 14 Aug 2008 14:39:36 -0700 (PDT)
To: <DrHey>
Subject: my back

dear dr. hay,  and you are dear!  you promised me in 2005 i could wramble thru the wood and climb my deer stand.  i have and love every minute of it.  now i'm having radiation for breast cancer.  Im 74, will turn 75 christmas.  the coleman clinic and raab center seem to think i will benifit from yoga.  i went to a 40 mionute session yesterday.  but my back bothered me a little last night.  i dont want to mess up my back again.  im enjoying my 2 great grandchildren and another on the way too much.  and i promised nicholas the 6 year old to take him up the deer stand.
 
is yoga right for me or should i pass on it and just walk, walk, walk and then walk some more.  that was your advioce before, and it has really worked.
 
my surgery was may 25, 2005,  marie ______  newport, nc
                                             
please i need an answer from someone i really trust

---

It is always great to hear back from patients who are enjoying restored quality of life after surgery.
Whatever age, quality of life matters, and for each individual their goals for quality of life are as unique as each individual --- even grandma being able to climb up into deer stand with her grand-son and going for a walk through the woods!

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

Lots of Hugs @ Last Friday's Clinic. Today's clinic visit from Los Angeles, CA

I got 14 hugs in clinic this past Friday, and several handshakes from the guys from many of our postoperative patients, including patients from Florida, South Carolina and Virginia.  I also saw one of my 6 year-old patients, who had a significant progression of her curve into the 30’s.  We will be getting her fitted with a brace.

I also saw our Nancy our first “Quad Rod” patient back for follow-up doing great at her happy 1 year follow-up.  We are continuing to pursuing our biomechanical research on the “Quad Rod” and other constructs with new computer models and new “test rigs” working with NC State’s Department of Engineering.  Nancy is a walking success story of this applied technology to solve very difficult spinal deformity cases.

Today in clinic I saw a lady from Los Angeles with severe scoliosis, here with her husband.
Tomorrow we will be fixing her scoliosis here in Raleigh, NC.

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

Aug 11 Afternoon Surgery: 14 yo "CeCe" gets new "Hour Glass Figure"

CeCe noticed the skin crease and prominent hip when she looked in the mirror.
Her back was also becoming painful.
Her Scoliometer showed a TL hump measuring more than 7 degrees.
X-Ray shows 41 degree thoraco-lumbar scoliosis with large trunk shift.
This afternoon, I corrected her curve with a T6-L3 Instrumentation and fusion.
Estimated Blood Loss (EBL) was 450 cc.  
Surgical Time was 2 hours 15 minutes.
Spinal cord monitoring was normal.
Three discs below the fusion were spared.
She got an excellent correction, with excellent restoration of her coronal balance.
Her “hourglass” should be back when she gets up tomorrow.

Her dad is associate pastor locally, and his pastor partner led us in excellent prayer after surgery, while CeCe’s dad led us in powerful prayer before surgery.  

Many answered prayers here today, including CeCe and her family making it here today from Washington DC, where their flight was delayed this morning!

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

August 11 Kyphosis Surgery. 14 yo young man w/ 78 degree kyphosis straightens up.

This morning we helped Brandon, who had a progressive 78 degree kyphosis with some pain.
We were able to get a near-anatomic correction with T2-L2 instrumentation and fusion with 4 thoracic posterior osteotomies.
His EBL was 1250 cc, and did not require transfusion.  Cell saver was used.
OR Time was 3 hrs 45 minutes.
Postoperatively, he was able to go to the Orthoapedic Unit to a very large private room where his whole family was there to greet him this evening.
He looked great on evening rounds, with happy parents and siblings!
He’ll get up and around tomorrow, quite a bit taller.


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

Last Monday's Scoliosis Surgery: 17 Hannah's 80 degree Double Curve

Hannah is a 17 yo girl who developed progressive back pain.
Her initial back X-Ray shows 80 degree double curve scoliosis.
I corrected her deformity a week ago today.  She had extremely severe double curves with a lot of vertebral body rotation, and stiff curves which required multiple osteotomies.
She got a nice correction, and is in good balance.
Surgery was approximately 6 hours.
Postoperatively she did very well, and went home Friday.

Get well soon, Hannah!

Lloyd A. Hey MD MS

Which one has scoliosis? Why scoliosis screening has some benefits.

One or both of the patients above has scoliosis.
Can you tell which one(s)?
If they both have scoliosis, which one do you think is worse?

The answer is given in the picture below.
In fact, the first patient has an 80 degree double curve scoliosis, and the other patient has a 41 degree thoracolumbar scoliosis.

This is a good example how looks can be deceiving, and that bug curves can sometimes be hidden, especially double curves in larger-frame patients.  This emphasizes the benefits of careful scoliosis screening, including using the scoliometer and careful physical examination combined with appropriate ordering of standing X-Rays.

While some curves, especially R thoracic curves in thin patients, become fairly obvious on observation, this is not always true, depending on curve type.

As we have discussed earlier, it is always helpful to “catch” a curve when it is smaller, and then follow it over time.
It is clearly easier to fix the 41 degree curve, which I fixed today in 2 hours and 15 minutes with 450 cc blood loss.
The 80 degree double curve took almost 6 hours to fix, and required 2 units of blood, and 4 day length of stay, compared to the typical 2-night stay for the smaller curves.  Both will end up doing well, but the curves can be fixed with less risk when identified and followed early and consistently.

Most patients and families prefer to know that they have scoliosis, and can follow it over time.

Looks can be deceiving, but careful evaluation and follow-up can lead to excellent outcomes with less risk.


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

FW: Bless you all! Special Postop Scoliosis Thanks from Nurse from Osprey, Florida

------ Forwarded Message
From: “Ginger”
Date: Mon, 11 Aug 2008 20:21:40 -0400
To: Lloyd Hey <hey@heyclinic.com>
Subject: Bless you all!

Hi All,
    I just wanted to express my appreciation for all you have done to greatly improve the quality of my life.  I am a 64 year old nurse/counselor with 64 year old vertebrae that had hurt for a very long time prior to my surgery in Jan. 2008.  In 1972 I had a 2 level disc and fusion which worked well for a number of years.  As my scoliosis got worse the pain greatly increased so that I could not walk very far, swim, climb stairs or tap dance without extreme pain.  The first 10 days after the surgery were not memorable (thanks to the miracle of modern pharmacology).  After that it has been all uphill with less and less pain each day.  I was able to walk 2 miles in 6 weeks and  able to get back into the pool to exercise.  It is exquisite to be without pain.  The tap dancing will have to wait another 6 months for further healing.
    Bless you all for the skill and grace of your many talents

Ginger

Aug 6 '08 Surgery: Scoliosis Reconstructive Surgery for recurrent pseudarthrosis in 18 you with Down's Syndrome

On Wednesday this past week, we helped Lindsay, who is a delightful 18 yo young lady with Down’s Syndrome and a history of severe scoliosis.
Lindsay had scoliosis surgery performed elsewhere, corrected using Leuke Rods and Sublaminar Wires and Galvaston technique fusing into the pelvis
Both of her rods broke through, and she developed severe pain and recurrent deformity.
Her surgery was revised, but it broke again, and her quality of life has gone steadily down hill, with inability to to much of anything. Even sitting in a chair was painful for her.

Wednesday, we did a complex reconstruction, taking out all of the old hardware (which took over 3 hours to remove!), and then reconstructed her spine with strong pedicle screw instrumentation.  I clearly identified the “crack” in the fusion mass, which is called a pseudarthrosis, and took out the tissue around that area, also performing an osteotomy at that level to help straighten her up a little more to help decrease the loads at that spot.  I then performed a complex reconstruction using our new “quad rod” technique (closely coupled rod) on the R side, and a new parallel rod technique on the concave side on the L, which also dramatically improves the strength of the construct.  Several pedicle screws were placed right around the area of highest load, using laminectomy at that level to help direct screw placement.

What is very cool is that some of the instrumentation techniques we used for Lindsay have been developed with our biomechanical research we are performing with NC State’s Department of Mechanical Engineering, where we are developing computer models and testing systems for figuring out the best spinal reconstruction techniques.

Bone Morphogenic Protein (BMP) as well as copious amounts of bone graft taken off of her posterior fusion mass was used to help improve the biological healing rate as well.

Lindsay is recovering very well in the hospital.  Her surgery was one of the longest I have had to do during past 3 years or so, taking almost 9 hours to finish, in large part due to the time required to remove all of the old hardware with sublaminar wires.

She spent a couple days in ICU, but is now out on the orthopaedic floor ready to go home soon.

I think Brittany and I and the rest of the surgical team are still recovering too!

It’s worth it, however, to get Lindsay back on her feet, and back bowling again!
Some of our most thankful patients have been our revision scoliosis/kyphosis patients and their families.

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

FW: Many Thanks for Kyphosis Assessment at Hey Clinic

From: Crystal _________

Sent: Friday, August 08, 2008 10:14 AM
To: Dr. Lloyd Hey
Subject: Many Thanks

 

Dear Dr. Hey,

 

Our family wanted to send a note of gratitude to you and your staff.  To refresh your memory, you saw our daughter, Ashley, in clinic on Wednesday, August 6, 2008.  Ashley  had been diagnosed with Scheuermann's kyphosis on July 3.  After receiving a month of physical therapy, it was being recommended that possibly brace fitting would be a good next alternative for treatment.  Outside of the research which we had performed on our own, we still had very little information from her physician; and, in fact, we had not even been told the degree of her kyphosis.  After 5 weeks of uncertainty, worrying, praying, turning it over to God, taking it back (the mother in me), I decided that the overwhelming tug on my heart telling me I needed to pursue this in a different direction, was my answer from God.  He was just waiting for us to take the next step.  Thus, we embarked on our journey to find a physician who dealt only with the spine, preferably spinal deformities.  Working with medical professionals on a daily basis, I began asking respected physicians for leads.  To make a long story short, with my probbing and the help of the wonderful world-wide web, I found the Hey Clinic.  Talk about an answer to prayer!!!

On August 6, 2008, we were scheduled to see your P.A., Brittany.  After Brittany comes in and introduces herself and gets settled in, one of the first things I'm impressed with when she hangs the x-ray (which we brought from our previous physician) on the little "light box", SHE (Brittany), not our previous physician,  had marked the degree of Ashley's kyphosis, as well as the lordosis, on the film.  This was the first time we had been given these numbers.  I had wanted those numbers for what seemed like an eternity.  It turns out, Ashley has a 71 degree kyphosis and an 88 degree lumbar lordosis.  Anyways, I had a list of about 20 questions regarding Scheuermann's which I had intended to ask Brittany that day.  Let's just say, I never HAD to ask the majority of them.  Once Brittany began explaining Ashley's kyphosis, over 3/4 of my questions were answered simply in that context; she was that thorough.  AMAZING!!  The even greater part, though, was that you were able to be in the office for a short time that morning, and we were able to meet you, especially great for Ashley.  You went over all the same things Brittany had previously with even more thoroughness, especially regarding what the surgery would involve.  We are so grateful to you and your staff for your truly caring nature.  You were very professional and knowledgeable while at the same time speaking in terms that non-medical individuals can understand.  I especially liked the fact that you talked with Ashley with eye-to-eye contact, not just her dad and me.  This really helped Ashley in digesting all the information.  After all, she may only be 13, but it is her spine.  Although sometime later on, Ashley may possibly be faced with surgery for this kyphosis, we know she will be in well-skilled hands.

 

Dr. Hey, if we have any advice to offer other parents or adults with this disorder, scoliosis, or even other spinal problems, don't just sit around in uncertainty as we did for too long, and especially not if they are suffering.  If folks feel uncomfortable with information or treatment they are being given, or lack thereof, I would recommend they call your office and see if their problem fits within the scope of your practice and schedule an appointment with your clinic.  We are so grateful to you and are so relieved just to have it thoroughly explained, our questions answered, and know what our options are for the future.  You truly have been given a wonderful gift, and I am thankful that you have been obedient to God's calling for your life!  When you told us to stop worrying and turn it over to you guys, I knew this was God speaking to me, through you, and saying to me, "Will you give it to me now, Mom?"

 

We are truly thankful our paths crossed!!

 

Until December....

 

The T_______’s

Johnny, Crystal & Ashley Brooke

Archdale, NC

 

 

"Candy" - lordosis curvature 22 yo scoliosis emails us with good report 6 days postop

From: _______________ Candice  [mailto:___

Sent: Wednesday, August 06, 2008 5:00 PM
To: Tiffany Whitehorn
Subject: RE:Your picture with Dr. Hey

 

Hi Tiffany,

 

Thanks so much for emailing me the pics!  I'm feeling great without the meds.  The side effects from the medicine were more painful than my actual back pain, so I decreased my dosage alot.  Here's a little blog you could forward to Dr. Hey for the website.  Thank so much again!

 

Dr. Hey and his wonderful staff performed surgery from T5-L1 and corrected my lordosis which is an inward curvature of the spine 6 days ago. I would like to thank them for making me feel so comfortable during my surgery & stay at the hospital. Dr. Hey is not only an extremely skilled surgeon, he is also greatly invested in his patients' medical well-being as well as quality of life. I could not be any happpier with the outcome of my surgery, and it's only been less than a week! I look forward to seeing all the changes of my body in the next few months. Thank you Dr. Hey, PAs, Nurses and staff for everything you have done! I look forward to seeing you all at my post-op appointment!

With love & thanks,
Candice ____________

Graduate Student Clinician

Communication Sciences & Disorders

Graduate Assistant for the CAHS Dean's Office

Chair of the Student Leaders' Council

____________ University Health Sciences Building

 

Last week was a busy scoli week. Today's 80 degree double curve in 17 yo young lady

Last week, we helped a 14 yo girl with Marfan’s Syndrome and severe scoliosis.  She was in the hospital 2 nights, and is doing well now at home.
We also operated on a 17 yo young man who had a huge thoracolumbar curve, with very large trunk shift.  We were able to get his center of gravity back in line.
On Thursday we also fixed a 22 yo woman with R thoracic scoliosis, and severe hypokyphosis --- nearly thoracic lordosis, which caused her chest cavity to be very narrow from front to back.
I also performed a kyphosis surgery on a teenager, as well as an older woman who had kyphosis above a previous fusion.  Both are standing up straight now.
I got a chance to see quite a few postop follow-ups in clinic this week as well.
I had an interesting talk with a woman from Canada who has severe scoliosis with a Harrington rod, discussing the Canadian healthcare system for scoliosis, which seems a bit different than the States.
Also had some interesting interactions with a family from Tennessee who have an adolescent with a very severe Scheuermann’s kyphosis, with one particular vertebra which is a 30 degree wedge, with overall kyphosis measuring almost 90 degrees.  More on this later.

Today we had to help a very nice 17 yo young lady who had a very severe 80 degree double curve scoliosis.
I was able to spare her bottom 2 discs, and got an excellent correction, using multiple osteotomies, and some instrumentation tricks to help get things “straightened out”, and balanced.
Mom and Dad and Sister were very excited to see her new straightened spine on X-Ray when I came out to talk to them right after surgery.
She is doing well in the hospital on the orthopaedic unit, with her mom sleeping in bed next to her with a large room
When I came in to check on her this evening, she had about a dozen people in her room, including lots of friends and relatives.
Everyone was glad that the surgery was over, and that she is doing so well.

Late this afternoon, I helped a gentleman with severe back and radiating leg pain with a L45 spondylolisthesis and stenosis.  Surgical time was 2 hours.  Estimated blood loss 250 cc.
He did well, and will likely be in hospital 2 nights.



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

4 week postop email from adolescent scoliosis mom thanking staff.

I received a nice email this morning from one of our adolescent scoliosis moms, who works in the pharmaceutical industry.

Her daughter had surgery a few weeks ago, and she emailed me a few questions.

At the bottom of her email she included an encouraging word for the Team.

 

---

From:  Cindy

Sent: Fri 8/1/2008 4:22 PM
To: Dr. Lloyd Hey
Subject: FW: Brooke

      Most importantly, we would like for you and Dr. Hey to know that we were and are very pleased with the care, professionalism and compassion that each of you provided for both Brooke and our entire family.  When we say “each of you,” we mean all of Dr. Hey’s office staff (I won’t remember everyone’s names) and also the hospital staff at Duke Raleigh Hospital.  It means more than any of you could possibly know.  I have worked in Medical Surgical Units before (specifically orthopedics) and also in physician’s offices, and I know how demanding the jobs are.  All of the nursing staff, nursing assistants/technicians, OT, PT, Housekeeping and even Dietary staff were so kind, courteous and professional at the hospital.  I have never met or worked with a surgeon like Dr. Hey, who would provide his cell phone for us to contact him at any time (Unbelievable!), who would pray with the whole family and who would freely answer any and all questions we had (including moments before her scheduled surgery time and before the consent form was signed!).  Neither you nor Dr. Hey ever gave the impression that you were rushed or didn’t have time for our many questions, phone calls or emails and for that we Thank You!

 

With Sincere Gratitude from the whole T______ family (Michael, Cindy, Brooke and brother Andy)     

Cindy ________, RN, BSN

Product Safety Associate

___________ Pharmaceuticals

 

________________

http://www.heyclinic.com