Tuesday, July 27, 2010

Mildred from Naples FL w scoliosis, x-stops fixed today

Mildred had a 52 degree Thoracolumbar degenerative and idiopathic scoliosis. She was treated down in Florida w 2 level X-Stops.

We fixed her today T5-iliac wing w L5S1 TLIF, osteotomies, laminectomies.

You could really see the severe nerve pinch on the R side which I fixed by thorough "roti-rooter" and distraction of those foramen. That is where the instrumentation and fusion really helps.
Surgical time: 4 hours 35 minutes.
Correction: excellent w 19 degree curve and excellent lordosis.
Complications: none.

Monday, July 26, 2010

Charlotte spends the day with us in surgery

This morning we helped Magnolia who had a severe lumbar spinal stenosis with L45 spondylolisthesis.
Her surgery went well.
Today we had Charlotte with us in surgery — an NC State Honors student interested in going into medicine (Pre-Med).
Charlotte is doing a one month internship @ Hey Clinic, and is doing a great job in clinic, and with the clinical research / literature search projects she has been given.
Here we are at the very end of the surgery she watched.
Great job Charlotte!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Saturday, July 24, 2010

Gail tells her story of early flat back syndrome recovery

Recently I saw Gail back for follow-up for her flat back syndrome revision surgery.  She was doing great, but told me that she never saw her Blog entry that she wrote up several months earlier and emailed to me.  My Bad!  I get quite a few emails every day, and do my best to handle them quickly and thoroughly, but somehow this one fell between the cracks.  

So here it is Gail --- thanks for sharing, and I apologize for the delay.  Thanks for also taking the time to share.

Dr. Lloyd Hey --- Hey Clinic for Scoliosis and Spine Surgery


Dear  Dr. Hey, Hey Clinic staff, and Duke Raleigh Hospital,
    Since it's a bout midway in my first eight weeks of recovery I wanted to let you know that my recovery is proceeding exceptionally well..My initial contact with you was a request for a second opinion.  Having  had a previous surgery elsewhere, I wanted to determine if the treatment for my flat back was still surgery, what kind of surgery, and what would likely be  the outcome. In addition to  responding to your comprehensive form  I independently wrote a detailed  chronology of my long standing lumbar naturopathies .   
    My problems had been further exacerbated by our relocation from NY to  AZ, and finally NC over the past 7 years as my severely degenerated lumbar spine continued to deteriorate.  I had endured numerous conservative therapies from strength/conditioning, steroids, both oral and injected, nerve blocks, high radiofrequency ablations, electrical stim, and of course, oral medications for inflammation, spasm control, and pain.  I shared that both previous surgeries had improved the quality of my life as it was, but there was so more to do, and in a downward spiraling  environment .  I didn't want to hold anything back giving you the opportunity to tell me my expectations for further improvement were unrealistic.  The odds given my age, fitness level, and opioid tolerance  would make me a poor surgical candidate.  
     As  it happened you felt I was a good risk and we proceeded with the surgery on November 11th. I had very positive experiences at my visits to the Clinic and at the Duke Raleigh Hospital. I want to sincerely thank you, Dr. Hey, Jennifer, and Dr Watters for your superior surgical skills.  I also wish to thank Dr. Rieker from Pain Management for his efforts to manage my discomfort, the kindness of the physical and occupational therapists for their patience , and finally the many nurses whose caring and helpfulness made my stay productive and comfortable.  Through all of your efforts I am now already enjoying a more pain free existence.
    I would like to extend my sincere best wishes to you all for a wonderful holiday .  
    Warmest Regards,

Friday, July 23, 2010

Olivia and her family!

We had a really good and busy week at Hey Clinic.
Last weekend, I got a chance to see my folks and sister and her family up in Pennsylvania, and also see many old friends at my high school reunion up in Long Island - New York.    Best part was seeing my old friend Colin, who has really helped fix up my home town as the town attorney.  

Well this week we did 8 surgeries – 2 cervical and 6 thoracolumbar.
One was a very complex osteotomy revision case, for a young lady with complex congenital scoliosis and history of anterior fusion with terrible degeneration, collapse and apparent 1 inch leg length descrepency.  I did a asymmetric TLIF combined with osteotomies and laminectomies and extension instrumentationa and fusion around her anterior Kineda instrumentation.

She stood up perfectly straight after surgery and walked to the bathroom on her own the day after surgery.
She went home from surgery after 2 nights doing great. Appreciate the help from my SRS colleagues including Sig Berven and Chris Shaffrey who helped out reviewing her films.  Big help.

We had a very interesting clinic today, starting off with Janelle, who is 5 year 10 month old with a 100 degree progressive Early Onset Scoliosis (EOS).  I met with Janelle and her parents to go over their treatment options, after also getting great input from several SRS members around the country.  Thanks so much to Dr. John Emans, Behrooz Akbarnia, Richard McCarthy, Rick Schwend, Jack Flynn who all helped in this complex case.   Many thanks also from our Hey Clinic staff and our summer awesome intern Charlotte, who did a great job on the literature review!  I was able to assemble a great Powerpoint presentation with the various references and feedback received, combined with description of surgical options which included anterior instrumentation and fusion, posterior osteotomy and fusion, growing rod, and Shilla procedure.

Got a nice hug from our 7 yo patient Olivia who we are treating in a brace for juvenile scoliosis.  She really seems to like coming to Hey Clinic, and insisted on this photo today with her mom, and Jenny my PA and I --- she wants to be on our “Wall of Fame” out in our Guest Room where people hang out when they first arrive at Hey Clinic.  She is sporting her new Hey Clinic T-Shirt.  She gave me a basketball that she drew for me, with her name on it.  Last visit she sang us a song a did a dance!  Never a dull moment.

Next photo shows me today with one of my 26 yo patients with severe kyphoscoliosis who is actually doing great without surgery!

We also saw Bonnie and her mom for follow-up.  I did Bonnie’s scoliosis surgery when she was in her 40’s and she’s doing and lookin’ great now several years later.  Her mom is now just 3 months out from surgery and doing great.  I remember that she cried big time when I first suggested surgery.  It was a tough decision, but her quality of life was really getting bad and she had a bad collapsing degenerative scoliosis with a lot of radiculopathy / leg pain and back pain.  What a joy to see the mother-daughter combo smiling together, standing up straight!

We saw one of our college-age adolescent scoliosis patients back from Georgia who is premed.  She is looking great!  Back to school soon, and someday to be a doctor.  Perhaps she’ll join our internship program!

Watched BostonMed with my wife this week.  Enjoy this show as it shows the hospitals I trained in for internship, residency, chief residency, etc:  Brigham and Women’s Hospital, Boston Children’s Hospital, and the Mass General Hospital (MGH).  Usually don’t watch TV, but the aerial shots of Boston are beautiful, and the patient-doctor-nurse stories are quite good and real.  When you see the heartache of the surgical team after a multi-trauma child dies, or the joy of the patient and family after a successful cardiac transplant in a teenager, or successful brain surgery tumor removal in a young dad --- you just realize how precious life is, and what a difference caring people can make in the lives of others.  I loved the window art the girl who had the cardiac transplant at Children’s made, which said something like “Life is Beautiful!”  so that everyone outside could see it.  Life indeed is Beautiful and Precious.  There was no talk of healthcare reform, just precious individuals finding life and healing and hope.

More later.  Gotta get stuff off grill for dinner.
Have a great weekend!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Monday, July 19, 2010

19 yo Rachel straightened up!

Rachel was having quite a bit of pain w her adolescent idiopathic
We got her very straight today.
I was doing my postoperative check on her just now and she reminded me
to please do her blog!

I had to borrow her xray back and run downstairs to shoot the picture
on my iPhone!!!

I think she will enjoy her improved posture.

Dr. Lloyd Hey
Hey Clinic

Thursday, July 15, 2010

Encouraging words back from our Hey Clinic guests from last week.

Brittany was wonderful with Maddie- very reassuring but honest and straightforward as well.  I
feel this was a very thorough consultation/exam and all our concerns and questions were
addressed.  Thank you!
Madeline’s Mom

Everyone was very kind.  We really like the office just from the website, before we even came in.

Dr Hey performed a miracle on my back.  I am only 8 weeks out but I’m already doing so much


Thanks to Jenny for spending so much time with me today.  I drove 2.5 hours for appt.


Comments from postop patient about Hey Clinic Team.

Date: Thu, 15 Jul 2010 08:10:22 -0400
To: Lloyd Hey
Subject: Jaylene Positive Comments

You guys are “the bomb”!!  Everyone from office staff to PA’s are wonderful, helpful to the “endth” degree.  Being an RN & married to a surgeon, I know a great office when I run into one.  Most doctor’s don’t realize that their office is their face to the community.  Dr Hey, thank you from the bottom of my heart for getting me back to my previous “ornery self”

Love, J

Monday, July 12, 2010

Sunset over Madison Wisconsin

I am at a special spine conclference for comparative effectiveness
research here iMadison Wisconsin. It has been a long day of
presentations and meetings. Tonight I got to wander around beautiful
downtown Madison. Down at the lake, a spectacular sunset has slowly
unfolded and is lingering for much longer than in our lower North
Carolina latitudes. Simply gorgeous. Lots of other folks are sitting
nearby enjoying the warmth and the warm glow reflecting off the calm

My batteries are now officially recharged!

I will be back in Raleigh tomorrow evenin and back in OR 12 first
thing Wednesday morning. Hopefully Dan will be there to give us all an
update on his birthday Harley weekend in the mountains.

A big hello to all from beautiful Madison!!

Saturday, July 10, 2010

"I'd Rather Be Fishin'!!!" --- Hey Clinic Update for the Week ending July 10 2010

Well, so ends another exciting week at Hey Clinic and Duke Raleigh Hospital.
A lot has been going on since I was enjoying a good fish dinner at Sanitary Fish Market a week ago, down in Morehead City, NC. That's where I met one of my adolescent scoliosis friends — Brittany, who was our family’s greeter at the door!

Since then, we helped Austin, a 17 yo young man with a 70 degree severe thoracic adolescent idiopathic scoliosis. His curve was causing a major deformity of his rib cage, which was already quite narrow. When I saw him in the Preop Area at Duke Raleigh with his family, he was wearing his Hey Clinic Hat. His hat, however, had been upgraded with several slogans written on the front and side and back of the hat. The most striking one was across the front of his hat: “I’d rather be Fishin’” ----- which sure made sense in comparison with having major scoliosis surgery! On the side of his hat it says “Let’s You and Me get One Thing Straight!” The other side of the hat says “What would Bubba Do?” We all had a good laugh about that. Austin clearly has a potential future in advertising and marketing.

I didn’t admit that even I might even rather be fishin’ than being inside doing complex surgery all day. Well, we can’t fish all the time, so getting straightened up, or bending scoliosis rods to help straighten up Austin is just about as much fun (and probably more important in long run) as bending fishing rods out on the ocean with a big fish! ---- Hey Austin, maybe sometime soon you and I can go out there and actually go catch that big one, and bend a rod or 2!

Austin did great with his surgery, and gained probably over 2 inches. His girl friend, who I met after the surgery, found this to be a little bit of a problem since she was already at a height disadvantage to Austin. Oh well. At least she can wear high heels! Austin’s posture looks a whole lot better now, and I was able to pull that really sunken area on the left chest out quite a bit, and derotate the spine so that the hump on the right was leveled out, and his shoulders are level. He went home after I think 3 nights in the hospital. His family stayed with him in the large private Duke Raleigh Hospital Orthopaedic room.

Other memorable scenes for this week:

I did a big anterior/posterior reconstruction for a 48 yo woman who had a thoracolumbar fusion done when she was a teenager without instrumentation, which gave her flat back syndrome, similar to what we typically see with Harrington Rod fusions. She was fused down to L5, and over the years, that last disc wore out, and collapsed, pitching her forward, and making it difficult and painful to walk and stand. I reconstructed this with anterior L5S1 discectomy and ALIF (anterior lumbar interbody fusion), followed by posterior osteotomy, with laminectomy and posterior instrumentation. We got a huge correction of her lumbar lordosis through that one segment, and now she can stand up and walk straight! She’s now home doing well. Her daughter an mom stayed with her in the hospital. I need to get her X Rays up on the blog, since her daughter keeps looking for them!

As soon as I finished that anterior-posterior reconstruction, I met a new patient who was a 45 yo hair dresser from Puerto Rico, who also had almost the exact same flat back problem with a Harrington Rod. Her flat back is really affecting her quality of life and ability to work. She’d like to get it fixed as well.

We did surgery on a lady from Tupelo, Mississippi with a degenerative scoliosis and severe spinal stenosis, here with her delightful niece. She has done quite well postop, and will be heading home to Mississippi probably Monday morning.

Friday was a busy clinic, seeing a bunch of our adolescent scoliosis patients back for follow up, looking great and with lots of great stories from summer. Some of our adult patients were back as well, including a gentleman from West Palm Beach doing great after revision scoliosis and stenosis surgery with excellent relief of his back pain, and much improved gait. His son-in-law is a doctor at Duke Medical Center. This patient still runs a group of funeral homes down there, and is a delightful man. He is sending us a pastor he met who is suffering with severe kyphosis.

We saw a couple of older patients, both in their 80’s who had scoliosis, but actually had stable curves, and were both doing very well. One of them, in the picture here, actually plays golf, and exercises regularly. Her curves are well balanced, and are not very large. Good example that some people do fine without surgery in the long run, but everyone with scoliosis should still be followed throughout life with routine exams and xrays to ensure that the curves are not progressing.

We got some special 3D CT reconstructions on one of our 5 yo patients who has a severe juvenile scoliosis which has been markedly progressive, planning osteotomy surgery for later this summer. Our skilled radiologists have been so helpful here to help us map out the anatomy so we can plan the surgery.

Our attorney guest from Myrtle Beach who had revision surgery for adjacent level stenosis and problems with osteoporosis around top pedicle screws is doing well after his surgery this week, and will be heading home early part of week. We supplemented his bone with some bone cement called “PMMA”, which will help increase the strength of the construct, and also took the pressure off where the nerves at the level above his fusion were getting pinched. It seemed to help quite a bit even the day after surgery.

I saw a pastor with severe disc herniation at C56, C67 in clinic who has been suffering fairly badly now for 4 weeks. Traction doesn’t seem to be helping, and he has some weakness in his tricep muscle. We’re trying some steroids as well. While I usually like to give it at least 6 weeks of conservative treatment before considering surgery, I think we’ll need to get him fixed before then, since his pain and weakness are significant. I can definitely relate to his pain, since I suffered with a severe C67 disc herniation about 7 years ago for a whole year — wow did that hurt, and affect my quality of life. When I had it fixed, it was like someone took the ice pick out of the back of my scapula and arm. My tricep strength also came back. That was a very happy day. Going through that pain gave me greater insight into what my patients also experience.

I did an L45 microdiscectomy on a 24 yo gentleman who is the son of one of my other surgical patients, who had similar problem a few years ago. Herniated discs may have a genetic component. There have been quite a few families where I have done surgery on spouses, or children, or even grand children! There is one family where I did surgery on all 3 generations — the youngest had a spine fracture from a rollover of a lawnmower on a hill. Since most of the surgeries I do are major deformity surgeries, we all enjoy helping our guests with the simpler problems of herniated discs in the neck and low back area. This gentleman had severe sciatica going down his right leg. I took out the disc herniation using microsurgical techniques, and his leg pain was gone in the recovery room! He spent the night, gave me a hearty hand shake and headed home the next morning. A few years ago, one of my scrub nurses gave me an “Easy Button” from Staples --- When you push the button, this little device then says “That was Easy!” -- the advertising slogan for Staples. For while, when we had an easier surgery like a discectomy or single level fusion, one of the staff would then hit the “Easy Button!” I’m not sure where that Easy Button went, but we could have hit it Thursday afternoon.

The Hey Clinic staff are doing well. Some of our staff went up to see Jaclyn, our former (and still well loved!) physician assistant for a batchelorette gathering tonight. Jaclyn gets married in the fall up in northern Virginia. Hope you guys had a great time today Jac!

Our OR surgical team is also doing very well. “Dan the Man” -- one of my “Black Belt” surgical techs celebrated his 49th birthday on Friday by riding his Harley Davidson out to the mountains of western North Carolina. Dan plans to write a book, called “The Last Room Running” -- about great stories from our surgeries. Since my OR room seems to be one of the last rooms running each day, doing 2 large surgeries, I think many of his stories may be from our room. Maybe I’ll get a chance to write the Introduction. I think Dan may also include some of his stories of his “Bike Weeks” in Florida, and his motorcycle club/gang experiences as well. Stay tuned. Should be a best seller! Be safe out there, Dan!

Nurse Kelly continues to keep all of us in line as our circulating nurse. Kelly helps keep our patient’s families up to date during surgery, while also ensuring the surgical team has everything they need at every time, and that all check lists are thoroughly completed. She runs a very tight ship! Scrub Sheila was with us for a couple days this week, and was helping train up Jill, who is doing just awesome. Scrub Robert was with us as well this week --- another Hey Clinic Black Belt Scrub Tech. Scrub Erline has also become a regular part of our team. She shared with me on Thursday some of her experiences growing up in the segregated NC South. We’ve come a long way since then, but still have some ways to go, no doubt.

One of the funniest scenes from this week was when one of my patients, in her mid 80's, took out a magazine during her appointment and told me that I reminded her of "Dr. Oz" on TV. Now I knew who the Wizard of Oz" is, but I had to confess I hadn't heard of the gentleman. She showed me his picture, and described his caring ways, and good ways of explaining medical conditions. She also thought his wife looked like my wife! Right after seeing this patient, my next teenage patient was wearing a "Wizard of Oz" T-Shirt, which prompted further discussion of Dr. Oz. The mom of the teenage patient thought my personality was similar to Dr. Oz, but that I didn't look much like him! So there you have it. Light moments like this help us all to have a little smile together.

Our family has taken great interest in the new reality TV show about the Boston Hospitals, which include some of the hospitals I trained in years ago, including Boston Children’s Hospital, and Mass General Hospital. We’re taping them on DVR, and plan to take a look. I was on a Discovery Channel reality TV show years ago, before Reality TV was such a big deal. Bill Hayes did an awesome job as the producer of this show called “The Hospital” -- and they followed the story of one of my young adult scoliosis patients through the process of pre-surgery, surgery and postop follow-up. That was quite an experience, including having about 8 extra people in the operating room with booms, cameras, and lots of questions! I hear I’m still on the re-runs on the Discovery Channel, although I haven’t seen the show for years.

Well now you all know a little bit more about our Hey Clinic “Reality” this week. I hope all of you are doing well. Please drop us a note, add a comment, or drop us an email. We’d love to hear from you.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Saturday, July 3, 2010

Seeing one of our scoliosis teenagers working at Sanitary Fish Market

When I was walking into Sanitary Fish Market in Morehead City Nc this
evening I got a real big "Hi Dr. Hey!" from Brittany --- one of our
Hey Clinic Adolescent Scoliosis guests who is now all straight! It
was great to see you Brittany --- give my best to your folks. You look
great, and it's good to know you are back to work!

Dr. Lloyd Hey
Hey Clinic

Friday, July 2, 2010

So ends another very busy week at Hey Clinic. Everybody loves Shelbi's T-Shirt design for Hey Clinic!

Sorry I haven’t been good about writing this week.  It’s been wide open!
Did 6 surgeries this week, including several adolescent scoliosis and kyphosis surgeries.
Teenagers are all home now.... Still a couple of the older scoliosis patients recovering, to go home tomorrow and to Rehab on Monday.
Had great clinic today --- everybody loves the new T-Shirts!

More later---
Have a great 4th of July Weekend.

Dr. Lloyd Hey