How can we care for scoliosis and kyphosis and spondylolisthesis better with conservative care like physical therapy, high-tech scoliosis braces, exercise and other techniques? What can be done to improve surgical care, and understand choices for surgery, learning from those around the world? How can we learn from aviation and from Deming's principles of "Standard Work" to constantly improve spine and all healthcare?
Friday, December 31, 2010
Follow-up thank you from young adult woman after kyphosis surgery back to hiking
She gave her permission to share her email and photos with all of you!
Great to hear from you Frances and glad to hear you are doing so well!
Sincerely,
Dr. Lloyd A Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
From: Frances
Date: Wed, 1 Dec 2010 19:52:20 -0500
To: Brittany
Dear Brittany,
Last week, it was so good to see you. I've been meaning to stop in for
months, but it has been so busy with work and family. I will always be so
grateful for all your care and encouragement. I remember not understanding
why I was so tired after surgery and became so frustrated with myself and
you reminded me that I did have a huge surgery and to cut myself some slack!
I sometimes forget surgery, although is correcting something, is really just
trauma under anethesia...LOL!
Thankfully, my procedure went well and I have been able to hike, ride roller
coasters and enjoy driving for miles and miles. My posture is awesome and my
clothes fit so much better and best of all, the lumbar pain went away and
NEVER returned. I am also so grateful to have you as my PA and Dr. Hey isn't
so bad either!
I've enclosed a few pics. Since my surgery, I have done things I long gave
up on and am thrilled to experience once again.
Thanks again for everything!!!!
Frances
---------------
Thursday, December 23, 2010
FW: Merry Christmas to ...... Christmas Wish to Hey Clinic from West Virginia's Pauline, Scoliosis Guest.
From: PAULINE
Date: Thu, 23 Dec 2010 07:15:59 -0800 (PST)
To: Lloyd Hey
Subject: Merry Christmas to ......
Good Morning, Dr. Hey,
Just wanted to say Merry Christmas to you and all of our wonderful, extended family there at Hey Clinic! Many Blessings to you, your wonderful family, and The Hey Clinic Staffers during this the most wonderful and meaningful season.
Will see you January 3rd (weather permitting!)
Pauline
------ End of Forwarded Message
Thursday, December 16, 2010
19 Yo lady w painful Thoracolumbar adolescent idiopathic scoliosis fixed this am
Complications none.
Ebl: 450 cc.
Blood transfused: cell saver only.
Famiily from Winston-Salem Nc.
Dr. Lloyd Hey
Tuesday, December 14, 2010
Thank you note to Hey Clinic from 6 Yo Janelle
Thanks Janelle! Get well soon!!!
Friday, December 10, 2010
School Vice Principal 1 year after scoliosis Surgery. FW: One year later
Date: Fri, 10 Dec 2010 09:55:20 -0800 (PST)
To: Lloyd Hey
Subject: One year later
Hey Dr. Hey. I will be coming in today for my one year post-op visit. Wow,
what a year it has been. I am attaching a picture for you with this email
just to thank you for making my life so much better!! Merry Christmas!! I am
glad I will be able to remember Christmas this year. haha!! You're a
blessing to so many people, including me!
Dave
------ End of Forwarded Message
Sunday, December 5, 2010
6 yo Janelle's Shilla Procedure w/ Dr. McCarthy, Arkansas Children's: Chance to Learn and Serve Better
As mentioned in previous blog, I did surgery at Duke Raleigh Hospital, and saw some patients at Hey Clinic. I then jumped on an airplane Monday evening, and then did an anterior release surgery with Dr. Richard McCarthy at Arkansas Children’s Hospital, on one of my patients named Janelle, who recently turned 6 years old. She has severe case of Early Onset Scoliosis (EOS) which has been very resistant to brace treatment.
Through my involvement with the Scoliosis Research Society, and combing the literature, I researched and presented several different treatment options to Janelle’s parents, after talking to several SRS surgeons from around the country that I know. Dr. McCarthy’s Shilla Procedure seemed like best option, since this procedure fixes the main deformity with a fusion around 3 disc levels usually at apex, but leaves the rest of the spine to grow in a guided way using rods that can slide through pedicle screws. Dr. McCarthy was not only willing to see Janelle, but allow me to come out for both the anterior portion of the surgery, and posterior portion to scrub in and learn and help.
The anterior release portion consisted of going in through Janelle’s side, and taking out three discs around the worst part of the curve. We found some benign neural tissue on the side wall of the vertebra and overlying the disc spaces that may have stimulated her unusual scoliosis, which we partially removed and sent for pathology. Bone graft from the removed rib was placed in those disc spaces.
A couple of days ago, on Friday, I was back out in Little Rock, and having breakfast with Dr. McCarthy at 6:30 am, who bought me breakfast and coffee as he reviewed a couple of talks on his laptop on the Shilla and other techniques. We went and talked to Janelle’s parents, discussing details of surgery. Dr. McCarthy shared how his first Shilla was done about 7 years earlier on a 2 year old patient, who has done just great, and has been able to get into little league baseball. The parents of this child have helped talk to other parents considering Shilla.
The posterior portion of the surgery went very well, doing fusion on the apical 3 vertebra and 4 vertebral bodies, placing bilateral pedicle screws in these vertebra.
Above and below this section, the muscle was preserved, and pedicle screws were placed percutaneously through the muscle using image guidance and special guidewires that went through the pedicle and into the vertebral body. The screws actually had holes in them, so they would go down the path of the guidewire. This prevented us from needing to dissect the muscle off the bone, which could cause unwanted fusion. These percutaneous screws above and below the fusion have holes at the top of them, so the 4.5 mm rods can actually slide through them as Janelle grows, allowing her chest and entire torso to grow more, but not needing multiple surgeries as is usually required with growing rod technology. Dr. McCarthy’s Junior Resident Eric was scrubbed in as well, and was great to work with. An excellent correction of the deformity was obtained, and she woke up and moved her legs well, and was extubated.
After the surgery, Dr. McCarthy and I got a chance to meet with Janelle’s parents, and show them the before and after X-Rays. They were so thankful.
And I was thankful too, for Dr. McCarthy’s excellent care of Janelle and her family, and for Dr. McCarthy’s excellent team at the hospital and in his office, especially his assistant Cindy who was very kind with all of the arrangements that were necessary to allow me to operate out of State, and at a whole new hospital!
I flew home Friday night as the sun was setting over the Mississippi River writing down all my notes from what I learned from this adventure. I learned a lot! I also feel like I made some new friends in Little Rock, Arkansas. I’ll be seeing Janelle back in Raleigh at Hey Clinic, and will do all of her postop care. I look forward to being able to share this new Shilla technique with some of our younger guests like Janelle who have severe Early Onset Scoliosis that does not respond to conservative management.
Many thanks again to Dr. McCarthy and his wonderful team for Janelle’s care, and helpful teaching and inspiration.
This is a great example how the Scoliosis Research Society helps to deliver better care to children, adolescents and adults around the world: surgeons and others working together to learn from each other, and research and develop better treatments with life-long learning. Learn more about SRS at http://www.srs.org.
Get well soon Janelle, and we look forward to see you back in Raleigh.
Lloyd A Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery
http://www.heyclinic.com
Wednesday, December 1, 2010
Janelle's Surgery at Arkansas Children's Hospital
One of my patients, Janelle, who is 5 and a half years old, has had a rapidly progressive scoliosis, despite bracing. Janelle and her parents flew out to Little Rock Arkansas for this surgery, and I got a chance to meet with them before surgery yesterday in preop. Dr. McCarthy, and his junior resident Eric and I worked together to do a 3 level anterior release and fusion yesterday afternoon. His administrative assistant Cindy was incredibly kind to me, getting me set up with my badge, getting me oriented to the med center, buying me lunch, and then rushing me to catch the last flight out of Little Rock yesterday evening!
Little Rock is a beautiful city. The folks at the Peabody Hotel treated me very well, and gave me a ride from the airport, and then to the hospital yesterday morning. There was a beautiful view of the Capitol building from the front of the Arkansas Children’s Hospital.
I am back in Raleigh to do surgery today, and clinic tomorrow.
Tomorrow night I fly back to Little Rock to do the second half of Janelle’s surgery, doing th posterior Shilla Technique.
Many thanks to Dr. McCarthy and his team for helping Janelle and his family, and for allowing me to learn this new technique!
More to follow.
Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery.