Monday, November 28, 2011

CAN I RUN AFTER ADOLESCENT / ADULT SCOLIOSIS SURGERY? ANSWER: YES! AND WIN!! FW: 1st Place in Thanksgiving 5k 45-49 Females!

From: M
Date: Mon, 28 Nov 2011 21:27:29 -0500
To: Lloyd Hey <>
Subject: Re: 1st Place in Thanksgiving 5k 45-49 Females!

Hahaha! I feel like 34! You're so sweet! By the way, last time you referred to me as "M" on your blog- so let's stay with that for now.
Thanks Dr. Hey! I am so proud!
M

Connected by DROID on Verizon Wireless
-----Original message-----
From: Lloyd Hey <hey@heyclinic.com>
To: M
Sent: Tue, Nov 29, 2011 02:18:26 GMT+00:00
Subject: Re: 1st Place in Thanksgiving 5k 45-49 Females!

M,
This is awesome news!
Congratulations!!!

I will put this on blog tonight.

Only one questions: --- why were you allowed to run in the 45-49 yo group when you are only 34?
:)

Dr. Hey



From: M
Date: Mon, 28 Nov 2011 08:39:21 -0500
To: Lloyd Hey <>
Subject: RE: 1st Place in Thanksgiving 5k 45-49 Females!

Good Morning Dr. Hey!

I hope your Thanksgiving was great and you enjoyed precious time with your family. Well I wanted to pass along another first place run on Thanksgiving day in Raleigh for “Just Think First” 5K.

Stats:
· 1st Place in Females 45-49—1st/ 29 in class-Time- 25:19!

· 22/244 females overall

· 90/440 runners males and females

· 22/244 females overall

I am so thankful! I actually run faster after my surgery!
J…I think you made me the “bionic woman”!!!

Many blessings Dr. Hey
J
M



------ End of Forwarded Message


--- “M” has shared with us before --- she really does look 34, and continues to do well after having her adolescent idiopathic scoliosis fixed when she was in her 40’s. It’s cool when we see our adolescent patients going back to sports/training within the first few weeks/months after kyphosis and scoliosis surgery, but it is also amazing what a lot of our adult patients do as well. The self-image / posture improvement experienced by these younger adult patients is also a real kick, since many of them have been self-conscious about their posture for a long time. The patient I saw originally from Chicago last week, who I fixed her kyphosis years ago told me it totally changed her outlook and confidence.

Hope you all had a good Thanksgiving. I did, thankfully, with family. Good break with beautiful weather. Today did very complex revision scoliosis this morning, and an extension fusion for proximal junctional kyphosis on a nurse from South Carolina. Both surgeries went well, but was a long day. Big anterior / posterior tomorrow am, so time for bed!

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

Tuesday, November 22, 2011

11 yo with 50 degree early onset scoliosis (EOS) idiopathic curve fixed yesterday. Other patients seen today.

This young lady’s curve has progressed rapidly over this past year up to 50 degrees, with 20 degree progression since last October 2010!

Fortunately she has grown enough that we can do the definitive scoliosis instrumentation as opposed to the Shilla Technique, which is a special growing rod technology we use for smaller children --- this allows ongoing growth with hardware sliding over time.

Her surgery yesterday went great! Estimated blood loss 250 cc.  Her “hump” on the right side was gone after surgery.
This morning she looks great in the PICU at WakeMed Children’s Hospital — a great unit and great hospital.

This morning, I saw a 12 yo boy with 33 degree curve with first diagnosis, and had long talk with patient and mom going over bracing options vs. observation, and gave them several good resources available through our blog and at SRS.org for further info.  It is important to think through and educate the families about the pluses and minuses of bracing before starting the process.  This boy is in a 50%+ risk category for progression, given the size of his curve and the number of years remaining.  The brace can help in some cases to slow the curve progression, but does not actually make the curve smaller.

Mom and patient felt good about discussion.

I was next greeted with a big hug from  my wonderful patient originally from Chicago that I fixed years ago with her 90 degree kyphosis.  Her story and video is out there on my web archives somewhere!  Her kyphosis surgery with me years ago @ Duke solved her neck pain which was a mystery to doctors in Chicago who kept MRI’ing her neck!  The neck pain was actually secondary to the hyperlordosis her neck had to do to make up for her kyphosis.  She looks great today, and is still very with her awesome posture and pain relief.

Her daughter Charlotte is a Pre-Med at NC State, and is super bright.  She does research with us now.  Very bright future for this young lady!

Will be doing anterior/posterior reconstruction today for good part of day.

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

12 yo girl with severe 75 degree congenital and idiopathic scoliosis fixed last Wednesday.

Last week we straightened up Emory, who is 12 who had complex congenital scoliosis measuring about degrees at Wakemed.    Due to complexity of her deformity, I did extensive preop planning, including 3 dimenensional analysis of her cervical and thoracic spine using special software.  I actually presented her case at Boston Children’s Hospital special Fellow Reunion Conference right before the Grice Dinner and Lectures.  Many thanks to Dr. John Emans, and others who helped give their input!

Intra-operative O-Arm Navigation and 3D analysis was also performed.  I took the preop 3D analysis I did for each pedicle level, and actually arranged them into a PowerPoint presentation which I then printed and posted on the wall in the operating room!  That was very helpful.   Surgery was T1-T12 instrumentation performed along with several osteotomies.  WakeMed OR team did great.

Her surgery went well, with 3 night stay at WakeMed Raleigh Children’s Hospital, going home on Saturday doing well.
This surgery helped with her severe shoulder obliquity caused by the severe scoliosis.

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

Tuesday, November 15, 2011

55 yo w painful collapsing degenerative scoliosis and stenosis fixed this am

23 degree Preop curve w Spondylolisthesis and stenosis.

L1-iliac instrumentation and fusion w multilevel laminectomies.

Surgery time: 3 hrs 10 min.
Ebl: 800 cc.
Complications: none.

Sunday, November 13, 2011

FW: playing soccer pics 4 mo post op (returning to sports after adolescent idiopathic scoliosis surgery)

------ Forwarded Message
From: Judy W
Date: Sun, 13 Nov 2011 19:07:35 -0500
To: Lloyd Hey <>
Subject: playing soccer pics 4 mo post op

Here's a few pictures of Brynna playing soccer.  Her team won the U16 Girls NC Challenge State Cup today!

Thanks for the fantastic success of the operation.  7/7/11.  You are welcome to use these photos. 

Judy W
------ End of Forwarded Message

Judy --- thanks so much for sharing these great photos, and giving your permission to share them on the blog.
Congratulations Brynna!

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


Friday, November 11, 2011

Janelle Doing Ballet Hey Clinic after Shilla Procedure Early Onset Scoliosis

Here's Janelle's Video Doing Ballet down hallway of Hey Clinic today!!!
Janelle is just about a year after Early Onset Scoliosis (EOS) with Shilla Technique with Dr. McCarthy at Arkanas Children's -- a surgery I got to participate in, and learn from!
Dr. Lloyd Hey, Hey Clinic for Scoliosis and Spine Surgery
http://www.heyclinic.com
video

Question: Is it possible to do ballet after a Shilla Procedure for Early Onset Scoliosis?

Janelle answered this question as a definitive "YES!" today in clinic, as she danced right down the Hey Clinic hallway this afternoon.

Janelle and her family were back for her one year anniversary from her Shilla Procedure I performed with Dr. Dick McCarthy out at Arkansas Children's Hospital.

She is doing just great, and her posture looks super.

Janelle also made me a wonderful drawing while she was in clinic. It shows a beautiful fall scene here in North Carolina, with beautiful tree, sky, sun and bushes. She signs her artwork beautifully as well!

We definitely encourage the arts at Hey Clinic!!!!

Thanks for the great picture, Janelle!

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

Thursday, November 10, 2011

Do. Done. 17 yo w AIS fixed today

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

17 yo w adolescent idiopathic scoliosis for surgery today

High thoracic curve.
Mom, a nurse, will be sending out updates during day.
Using 3d navigation in operating room like O-arm from Brainlab.

Sunday, November 6, 2011

A Hey Clinic Guest's Story of the Mysterious Spinal "Clunk"

I received this write up from one of my patients this past week. As she says- -- I had never seen anything quite like this before!!   I think you will all enjoy it!
Things have been very busy as Hey Clinic routine.  I did two surgeries yesterday on Saturday, but thankfully was able to catch my breath and enjoy the beautiful North Carolina fall weather today.  

Hope you are all doing well.
Dr. Lloyd Hey — Hey Clinic for Scoliosis and Spine Surgery — http://www.heyclinic.com

-----------------------------------
11/2011

My Back Story:  Susan

In early 2010, I didn’t consider myself as someone with “back problems”.  Sure, my back would feel tired if I stood for a long time, but I figured that was just a part of being on the high side of my 40s.

In March 2010, I leaned over while sitting at my desk to adjust the small heater at my feet, when I felt something wierd.  There was no pain, no noise, but a feeling that I almost got stuck in that twisting, bent over position.  It was fleeting, so I didn’t give it much more thought, but it felt strange enough to be memorable.  

In the following couple of months, I developed a random “clink” sound in my back when I bent over to reach something in a lower drawer or off of the floor.  This “clink” was a precursor of the “clunk” that developed soon after.  It was a loud clunk, but it occurred randomly in the spring of 2010.  It was loud and uncomfortable enough to mention to my rheumatologist during a routine visit in late May.  I described it as occurring in my mid-back and I wondered out loud to him if it could be related to my RA.  I was confidently told that it very likely was NOT RA-related since the thoracic part of the back typically isn’t affected by RA.  I was not able to reproduce the clunk during that doctor visit, but he ordered an MRI to evaluate it further.  

My insurance company agreed with me that this seemed to be coming right out of the blue.  So much so, that they opted to cover a flexion/extention x-ray rather than MRI.  These x-rays showed displacement as I bent over and arched back.  

By this time it was June/July.  The clunk was much more consistent and louder and generally more “violent” for me to experience; along with a noise, I experienced a jolt-type sensation with the clunk that seemed to shake me right through my legs, with knees buckling, giving me an instant’s sensation of my legs giving out on me - though I never actually fell down, it seemed darned close a time or two!  The noise was loud enough for others to hear from another room.  I would be dressing in our closet when my back would clunk and my husband would ask from the kitchen table “Was that you!?”.  In July, I was able to get an MRI to further evaluate what in the world my back was doing.  Through all of the evaluations, it was noted that it was a pretty strange level of my back to be having problems.  The instability demonstrated on x-ray was at T10-T11 rather than in the lower back region.  It didn’t seem too strange to me, since that was the area where I always experienced aching and tiredness when I stood for a long time.  

By August, I had about had it with the clunk!  It seemed to be progressing at a pretty good clip in terms of how loud it was, how often it occurred, how it seemed to shake through my whole body.  And then I began to have an odd pain in my lower ribs; like someone was stabbing me with a knitting needle verrrry slowly.  No change in position would alleviate that pain.  Finally, when I met with my rheumatologist to review the back MRI results, we chose to explore surgical consultation since I additionally described vague urinary symptoms of feeling the need “to go” recently after using the bathroom (and ruling out UTI).

By August, the clunk would occur with laughing and sneezing as well as with forward bending, which I tended to avoid at this point.  Fortunately, I learned how to make my back clunk “on demand” so that the doctors could witness it:  I would distract myself by pretending to bend over my purse to get something out of it.  It worked every time!

I met Dr. Hey in September 2010 and was able to demonstrate “The Clunk” for him with the purse trick.  By this time, my mid-back would not only clunk while bending forward, but clunk again while straightening back upright again.  Ewww!  It was all very uncomfortable!  

I was relieved to learn that though Dr. Hey readily stated that he had never seen anything like my condition, he was very confident about how to correct it and offered a detailed explanation with a visual model that helped my husband and me understand exactly what he offered to do for a surgical repair of this awful clunk.  I was absolutely ready to do what was necessary to eliminate this quickly progressing problem and Dr. Hey was the surgeon to do it.  We immediately made arrangements to schedule this for the following month and voila!  I haven’t “clunked” since, nor had any other creepy pains or problems!  

In terms of thinking about how or why this occurred at this unusual level of my back; I have a theory that an old injury that was never evaluated became aggravated by age.  When I was in sixth grade, while doing intramural gymnastics, I was doing multiple back handsprings in a row.  I was in “the zone”!!  I could’ve done back hand springs all the way home!  Except I realized that I was probably fast approaching the end of the mat and had no confidence in my co-sixth grader spotter to let me know that.  When I had that thought, I over arched my back in an attempt to have my hands land on the mat.  Instead, my fingers hit the back of my legs rather than the floor and I hit the floor with my chest with my legs over my head and kind of “sproinged” my back in that arched position.  The fall definitely took my breath away, but I felt silly for causing this and immediately jumped up and acted like I was fine before the coach noticed my boner of a fall.  No specific injury ever occurred from that fall.  I didn’t hurt enough to let my coach or parents know what happened - ever.  But I can’t help thinking that any slight damage from that fall could have made that particular thoracic level be the “weak link” to cause problems later in life.  

Now, thanks to Dr. Hey, the top half of my body is securely attached to the bottom half!  All is well healed and no more problems!