Saturday, December 22, 2012

124 Degree Adolescent Idiopathic Scoliosis in 20 yo young lady

I apologize for not blogging sooner, but this is the first time I have had a moment to put my feet up for the last couple weeks as we have all been quite busy caring for many scoliosis and kyphosis patients of all ages at Hey Clinic and Duke Raleigh Hospital.  Over the next couple weeks, I'll get a chance to catch up on some of the stories and will share some of them with you here on the blog.

Kayla's story is quite dramatic.  At some point Kayla and her mom may get a chance to write up their full story to share with all of you.  The short story is that Kayla was diagnosed with scoliosis when she was around 8 or 9 years old, and then was braced for a period of time.  Her pediatric orthopedic surgeon decided to stop practicing, and Kayla's mom did not really have somewhere else to take her.  When Kayla was 11, she saw another doctor who told her that she needed surgery right away because the curve was getting very big.  Kayla's mom was very concerned though, because Kayla in her mind had much more growth remaining and the surgery might stunt her growth.  She was especially concerned about this because Kayla's brother grew well into college.  Apparently the orthopaedic surgeon at that time didn't explain to Kayla and her mom about remaining growth and the possible risks of delaying Kayla's surgery, and Kayla's mom was really against surgery.

So, Kayla just grew up, but as she got to be in her later teens began to develop severe low back pain, and a very obvious severe deformity.

As the pain got to be too much to handle, she went and saw another spine surgeon this fall in Charleston, SC, who then texted me with her X-Rays from his clinic.  The curve was so big that he could not be confident of the curve measurement.

cord abnormalities.

We then saw her and her mom at Hey Clinic.  Her curve measured around 124 degrees and she had severe collapse.  Pulmonary function tests showed that the scoliosis was definitely having a large effect on her pulmonary capacity.  The MRI showed the severe deformity but no spinal cord abnormalities.



A couple weeks ago, Kayla and her mom came up from South Carolina for her surgery.  Her surgery took around 9 hours, and involved making several complex osteotomies around the apex of her deformities, including a partial vertebral column resection, and pedicle subtraction osteotomy.  A bony tether was identified along the apex of her deformity on the left thoracic side, which probably occurred during early childhood, and set her up for this very severe deformity.


While the surgery was long, she did very well with good cardiopulmonary and evoked potential monitoring function.  4 levels of the spinal cord were exposed along the apex of the deformity to complete the osteotomies.  As shown in postop X-Ray above,  were able to get a very good correction, and she is how several inches taller, and in good balance, very pleased with her new posture.

She did well postoperatively, but was in the hospital for about  a week, returning home to South Carolina earlier this week.  Both Kayla and her mom were thankful for care they received at Duke Raleigh Hospital.

We are all thankful Kayla has done so well after this major reconstruction.  While it is truly amazing what can be done with modern scoliosis surgery, there is no doubt that "a stitch in time saves nine".  Cases like Kayla should encourage families who have children with possible scoliosis to ensure their children do get screened and continue with follow-up X-Rays and examinations and earlier treatment.  This helps to decrease risk, and maximize correction and long-term outcome.  Yesterday in clinic, for example, I saw at least 4 postop patients who I corrected with curves like Kayla who I fixed when the child was 9-12 years old, who had about a 3-4 hour surgery, with much less risk, and much easier recovery, shorter fusions, and better final correction.  Here ia a photo of one of these children I fixed a year ago this week, doing great, with no visible deformity.  She had her surgery when she was 12, with preop curves around 60 degrees.  Usually we prefer to fix these curves when they are in the 40's.

In previous blogs, we have talked about the issue of remaining growth, and when we have to worry about that, and consider growing rods or Shilla Technique instrumentation, which both allow for growth with the hardware guiding the scoliosis during further growth.  This is usually an issue for children under age 8 or  9, who still have significan spine and chest wall growth remaining.  The key thing to realize is that different parts of your body grow at different rates during the entire growth process. For example, babies start off with relatively large heads (which is one reason they look cute!), and the rest of the body grows relatively quicker over time, so the head ends up being smaller relative to rest of the body.  Similarly, the spine grows more slowly during adolescence, with most of the remaining growth coming in the lower extremities.  Some growth can occur in the spine in the area where the fusion occurs, which actually may help make the curve get somewhat straighter, and the area of the spine outside the fusion also grows normally after spinal fusion.  The scoliosis correction itself obviously creates a sudden "growth spurt" on the operating table, as the lost height through the curve is restored as curves are straightened out.   In the old days, before we had strong segmental instrumentation, there was concern about a problem called "crankshaft phenomenon", where the spine could potentially curve around the Harrington rod, causing some increased deformity after fusion in very young children.  That problem seems to not occur with modern pedicle screw segmental instrumentation.

In any case, seeing X-Rays like Kayla's should certainly motivate any parent to keep a close eye on their children's curves with the help of your local scoliosis expert.  You can find scoliosis experts near you through the Scoliosis Research Society (http://www.srs.org) website.  I wanted to thank my SRS colleagues Dr. Sig Berven, Dr. Steve Glassman and Dr. Larry Lenke for their preoperative input on Kayla's surgical plan options.

Get well soon Kayla and have a good Christmas!

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

Thursday, November 29, 2012

15 yo young lady with 46 degree progressive painful thoracolumbar adolescent idiopathic scoliosis straightened up this morning

Olivia's surgery went very well this morning.  Estimated blood loss 350 cc, 115 cc returned with cell saver.  Correction really nice in both sagittal and coronal plane, with her preop "hump" now gone.

Surgical time was 3 hours and 10 minutes.
Evoked potential monitoring normal.

We have several postop scoliosis and other postop spine patients upstairs at Duke Raleigh Hospital, none currently at WakeMed Raleigh.  Olivia will go to a private orthpaedic room upstairs where there is a separate bed for mom or dad.  No ICU or PICU needed.

This afternoon we are helping a man who is losing the use of his arms and legs with severe cervical spinal stenosis.

Time to go talk to Olivia's parents and show them this X-Ray!  I think they will be happy.  Olivia told me she wanted to be "as straight as possible"!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
"Experience, Service, Compassion and Results".  --  http://www.heyclinic.com

Wednesday, November 21, 2012

Thanksgiving

I just got a chance to put my feet up for a few minutes this evening and chill out a little.  We have family starting to gather for holiday weekend.   It's been a good week, filled with lots of special people.

Monday we straightened up a 22 yo young lady with a painful 49 degree progressive painful adolescent idiopathic thoracic scoliosis from Charleston, SC.  We also helped a lady with a degenerative scoliosis from Virginia Beach, with collapse above an old L4-S1 fusion done many years ago.   Both are recovering well and will go home sometime this week.

Today I did a half day clinic with a bunch of adolescent and young adult scoliosis follow-ups.  Highlights included college swimmer from Virginia Tech now 6 months out from her scoliosis surgery swimming now 1.5 hours per day, and starting major weight training after Thanksgiving break.  Also saw one of my dear younger adolescent young ladies from Morehead City, about 3 hours away, who had severe double curve now 8 weeks postop, and 4 inches taller after her surgery!  She's back to school now doing well, and thankful for her new posture.

We also got to see Marie back for follow-up.  She's a lady around 50 who is now 6 weeks postop from a thoracolumbar fusion for a painful progressive kyphosis secondary to a spine fracture.  She is now doing very well, standing up straight with good relief.   Her before and X-Rays are shown on he lef side.

After clinic today, Leslie and I helped Dan, a very athletic guy in his 50's with a severe multilevel cervical spinal stenosis.  I performed a C34, C45, C56 and C67 anterior cervical discectomy and fusion (ACDF) using innovative PEEK cage technology to correct an issue he had with previous collapsing allograft bone plugs.  His wife Rachel and I had a good chat about how to tie Dan down a little bit after surgery so he gives himself a chance to heal!

My In-Laws are up visiting from Florida, and they brought a gift from one of my patients who is their next door neighbor there:  home made cranberry scones!  That was our dessert after lasagna tonight.  Awesome.  This is actually the second batch we've enjoyed -- the last batch was this past winter when our family visited them at their home in Florida.  Dear people.  My in-laws have both had successful lumbar spondylolisthesis and stenosis surgery done years ago, and are both extremely active with dance, tennis, jogging, swimming, travel, gardening and the like.   My In-Laws are still thankful, for their improved quality of life even more than 12 and 7 years ago since their spine surgeries.

And finallly, here's a note I received this evening from Neal, one of our lumbo-sacral spondylolisthesis postop patients:


Dr. Hey,

Needless to say, you and my new back are on my Thanksgiving list!  I am so grateful to you and your “second opinion.”

I’m still amazed at all the “coincidences” that put me in your office:  the referral by my nephew, that my daughter and Brittany were on a medical mission trip together,  your last-minute cancelled trip to Chicago last November that allowed you to spend so much time with me on a day you had not scheduled appointments, that I was able to see you with a few hours notice because a friend had delivered the MRI results to me the same day I requested it……amazing.

I hope Thanksgiving Day’s  a good one for you. Thank you!

--Neal


Thanks for taking the time to send a note, Neal.  
Thanksgiving is definitely a good and healthy thing.  

Wishing all of you and your families a very Happy Thanksgiving.

Dr. Lloyd Hey 
Hey Clinic for Scoliosis and Spine Surgery 
"Experience.  Compassion.  Service.  Results"
http://www.heyclinic.com

Friday, November 16, 2012

Little Quinna w/ Rett's Syndrome Postop from Scoliosis Instrumentation and Fusion


Quinna Preop
Quinna X-Ray Today at Hey Clinic
I just left the exam room with little Quinna, who is growing like a weed!  Her surgery blog entry can be found by clicking here, and her 3 month Postop Blog can be found by clicking here.  We did scoliosis surgery for her a few months ago, and she is doing just great.  She now can sit up straight in her wheelchair,  is smiling widely, and does not appear to be having any back pain.  Her postop X-Rays look quite good.  This is  good example of a younger child, even with neurologic involvement, can sometimes be treated with definitive instrumentation and fusion rather than growing rods or Shilla.

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

Laney 6 weeks postop from Adolescent Idiopathic Scoliosis Surgery Doing Well

 I just saw Laney and her mom and dad back for 6 week follow-up doing really well.  Check out the scoliosis surgery journey story her dad wrote, and I shared a few weeks ago.   She went back to school a little more than 2 weeks, and is all caught up on her school work.  She is an inch or two taller, and very happy with her new posture. She can return to sports as soon as she would like now.  Her X-Rays from today look really good, and you can see how her "hour glass" figure has been returned to normal (trunk shift), which now decreases the loads on the lower back.  On physical examination, her right rib hump is gone, and incision looks great.

Her family brought us wonderful cookies x 2 boxes - one box for us, and one box for the nurses and staff over at Duke Raleigh Hospital they are heading over to visit right now.  Their family also made a donation to the Inter-Faith Food Shuttle, and gave us the nice card below:  "Thank you so much for the hope and healing for Laney - as well as our family!"

This looks like a good non-profit to support.  They work with local restaurants to take leftover food to the hungry, and actually have a "back pack program" to help provide weekend meals to needy kids in school to bring home for food over the weekend.  Will check this out.


How do Early Onset Scoliosis Patients do in first few days and weeks after surgery? Saw Cayleigh, our 11 yo back for f/u today

Cayleigh had just turned 11 a few days before we did her very large Early Onset Scoliosis (EOS) double curve scoliosis last week, which can be found on my blog.   I got a chance to see her just now for a brief postop visit today in the clinic, and she looks great!  She's excited that she is 2 inches taller, and loves her new posture.  She is off all pain meds, and says she really is not having any significant pain.  Go Cayleigh!


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


Postop Scoliosis Patient, Retired Nurse Practitioner Gives Thanks 1 Year after Scoliosis Surgery

I just saw Nancy back for follow-up after her revision thoracolumbar sacral iliac wing revision extension instrumentation and fusion now one year postop doing extremely well.  She had a small lumbar fusion done years ago, but then had degenerative scoliosis collapse above that with severe pain, trouble walking and severe spinal stenosis.  She is now doing great, and brought me a wonderful gift bag filled with home made jams, pickles and much more -- perfect timing for our family guests coming in for Thanksgiving!

Nancy shares a word of thanks to all of the caring nurses, physical therapists, surgical techs and others over at Duke Raleigh Hospital who cared for her with her surgery.  She also expressed her thanks also to the Hey Clinic staff as well.

Take care Nancy!    Dr. Lloyd Hey -- Hey Clinic for Scoliosis and Spine Surgery


Thanksgivings from adolescent with multiple congenital spine abnormalities now doing well 1 year postop.

On Nov 16, 2012, at 10:02 AM, Emory wrote:
Dear friends and family,
I am happy to announce that today, November 16th, is officially one whole year after my scoliosis surgery in 2011! I am doing great and am basically pain free! Thank you to all who prayed for me and all you did while I was recovering! What a blessing! Thank you again. God bless.
Love,
Emory

Just got this nice note from Emory, a 13 yo who had a very complex congenital upper thoracic scoliosis and lumbar scoliosis with severe preoperative pain, and large shoulder obliquity.  Thanks Emory for taking the time to send out your thanksgiving to everyone!

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

Thursday, November 15, 2012

Can Scoliosis be fixed with minimally invasive microsurgery?



Here's a real short video on YouTube I shot yesterday with a 29 yo woman who has a 19 degree scoliosis with severe radiating left leg pain, secondary to large L45 disc herniation on the left.  In response to the pain, she's developed a significant scoliosis and lean to the right. (She was psyched to be on YouTube and Blog --- received her permission to post)

We'll be fixing her sciatica and scoliosis soon with minimally invasive microdiscectomy surgery!

Meanwhile, our 18 yo who had the revision scoliosis surgery is recovering well upstairs, except for some nausea and borderline ileus, which he had with his last surgery done elsewhere.  He is psyched about his new posture and chest shape, which he can tell is significantly better, both front and back.

Did a huge revision scoliosis surgery today on a lady from Florida, who had a Harrington Rod fusion years ago now with adjacent level failure, kyphosis and severe pain.  Her surgery went well.

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

Monday, November 12, 2012

Getting ready for the big game: Complex Revision Deformity Surgery Planning.


Today I completed two complex deformity surgeries, did two surgery consults, picked up vegetarian Thai food on the way home for my daughter and I, and then sat down to get ready for the "Big Game" for tomorrow: a revision double curve scoliosis surgery for an adolescent who had surgery 8 months ago elsewhere, with painful, inadequate correction.

I just spent the last hour studying his spine from top of thoracic to bottom of lumbar planning out each level of the surgery, with angular measurements, and which screws need to be added, and which screws need to be replaced and / or redirected.

Now I can get to bed early, and sleep on this surgical plan, then get up and make it happen tomorrow!

I'll have 3D imaging technology in the operating room tomorrow with my ace surgery team, including Nurse Kelly Hohman coming in on her day off to help out.

The 11 yo girl who had scoliosis surgery this past Wednesday went home from the hospital this past weekend doing great.  Mom and dad very happy with her rapid recovery, posture, and the care they received at WakeMed Children's Hospital, Raleigh Campus.  Many thanks for everyone who helped little Cayleigh and her family.

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


Wednesday, November 7, 2012

11 yo young lady we straightened up today

This morning we straightened up this 11 yo girl, who just turned 11 within the past week!  Her double curve has been rapidly progressing, and she is in the midst of a very big growth spurt.  Fortunately she has gained enough trunk length that we were able to fix her with a definitive instrumentation and fusion, rather than having to use the growing rods or Shilla technique.   We did a special technique that allows us to get a really nice correction gently and safely.

Her surgery took about 3.5 hours, with a 300 cc blood loss, no blood transfused.  Her two "humps" are gone, and her X-Ray shows a very nice correction.  When I showed mom and dad the X-Ray after surgery, mom gave me a big hug, and dad a nice handshake.  A nice end to a great morning.  Patient was able to go to a regular pediatric bed tonight with her parents in the room with her.  No PICU needed!

In the afternoon, I did a revision scoliosis surgery on a 43 yo woman, who did very well.  Whew, now I am tired and ready for bed.  Two big surgeries for tomorrow including a cervical-thoracic kyphosis surgery.

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

Second Opinions for Scoliosis Bracing, and Including Your Child / Adolescent In The Decision Process.

We do quite a few second opinions for scoliosis and other spine surgeries at Hey Clinic, many of whom travel from out of state to come in for a visit.  It makes sense -- scoliosis surgery is a big deal, and can be helpful to learn more, and consider whether surgery is really best option, and/or what techniques and surgical team's approach and experience might be best fit for you or your loved one.

7:30 yesterday morning,  my nurse practitioner Brittaney and I  did a second opinion for a very nice family whose 14 yo daughter has adolescent idiopathic scoliosis (AIS) measuring about 38 degrees.

The family had seen a pediatric orthopaedic surgeon just recently for a few minutes, who quickly wrote a prescription for a scoliosis brace, and sent them down the hall to get the brace made.

The mom described how they were in a state of shock, and did as they were told, and ordered the brace.

After going home, they started to think about it a bit more, and decided to come in to see us for another opinion, and a friend recommended coming in to see us at Hey Clinic.

When we saw this young lady, we took a careful history, remeasured all her films, and then spent some time exploring the benefits vs. the "costs" of bracing.   We actually took out a Boston Brace and showed it to the patient and family ---- this was the first time they actually saw a real brace!  Yikes!  How can you expect a young lady to decide whether she is willing to wear the brace if she's never even seen one!  The young lady's eyes got quite wide.  We drilled down on specific growth parameters for this young lady that allowed us to risk stratify the potential benefit of bracing and risk of progression for her.  We explained the prospective bracing literature which has shown that bracing may decrease the rate of scoliosis surgery by as much as 50% at the time of skeletal maturity.  We also explained, however, that the brace does not straighten the curve, or improve her posture / appearance, and it is no guarantee that she will not need surgery in the future.   We explained that bracing for scoliosis was different than bracing for your teeth, where you don't have the option of taking your braces off, and braces typically make your teeth straight!  (This young lady messed up my story though.... because she told me that her teeth went crooked when her braces came off!  :)  )

Not unlike surgery, scoliosis bracing is a big commitment, and there is usually no medical emergency to get your child or adolescent in a brace within the next week or two.  Take your time, collect information, feel out your child a bit, and then decide.  Bracing in some ways is a  BIGGER commitment because it requires the compliance of the teenager to wear the brace for at least 18 hours a day, usually over several years.  At Hey Clinic, we spend time, quite a bit of time, engaging the teen as well as his or her parents in the decision-making process, pulling up special growth remaining and other tables and literature to help families make an educated decision.  For the younger children we see with Early Onset Scoliosis (EOS), the issue of bracing is not as traumatic --- the younger kids actually don't mind the brace as much, and actually like to decorate it with stickers, etc.  Bracing in the EOS group also has some big advantages as we seek to at least slow the curve while their bodies are gaining crucial size.

We do brace quite a few children and adolescents at Hey Clinic, but always have a good dialogue first and let the patient and the parents make the final decision on an individualized basis.    Let's face it: as a parent, you have to pick your battles when you are trying to mold a teen into a successful, independent adult!

So, if you feel like you just got whisked down the hall to the brace shop with your son or daughter's new scoliosis diagnosis, it may make sense to slow the doctor or other provider down and ask some more questions, and then, most importantly, talk to your son or daughter about the decision and include them in the process.  This can make it a very positive journey, and build trust.

This particular family left my office yesterday morning really glad that they made the trip, and were going to go home as a family and have that dialogue!  That is time well spent.  An extra hour for a second opinion, or going back to see your pediatric orthopedic surgeon before having your son or daughter wear a brace for 6,500 hours per year for 2-5 years is probably a good investment!  In general, a more holistic, developmental approach that fully engages the adolescent or child in the process is the way to go. That is what I would want for my teen, which is why that's the way we do it this way at Hey Clinic.

If you are looking for a good place to get a second opinion for scoliosis bracing, the Scoliosis Research Society (http://www.srs.org) is a great resource.  They also have all sorts of great references online, including their new eText site which you can sign up for....

Dr. Lloyd Hey
http://www.heyclinic.com


Sunday, November 4, 2012

Hannah smiling after revision scoliosis surgery

I rounded at Duke Raleigh Hospital around 7 am this Sunday morning on our four inpatients up on the Orthopaedic Floor, including Hannah, who is the 23 yo featured in the short video posted yesterday.

Hannah stood up and was thrilled with her new posture after I performed revision deformity surgery for her.  She had scoliosis surgery back when she was 13 done at a Shriner's Hospital.  She had difficulty with pain, and just under a year ago, her spinal hardware was removed to try to help her with the pain.  However, instead of the hardware removal helping, she actually got a lot worse, and her curves progressed over this year significantly.

On Monday this week, I performed a complex revision deformity surgery with 3D Brainlab Navigation, and multiple spinal osteotomies, and used segmental instrumentation with pedicle screws and 2 cobalt chrome rods.  Hannah says that her back already feels significantly better, in that the deep pain she used to have is gone, and now she has a less significant surgical incisional pain which is being well controlled.  She also notices that her humps are significantly smaller, which even makes it more comfortable for her to lie down and stand up.  She also has gotten her "hour glass" posture back.

In the photo below, her mom took a picture of me showing Hannah her new X-Ray.  You can tell that she is smiling, even though you are looking over her shoulder.  She told me that the new correction is actually even better than the original one done 10 years ago.   Her mom is smiling too.  They have both been very happy with the nursing and physical and occupational therapy care at Duke Raleigh Hospital as well.


Hannah and her mom checked out Sarah's mini video and really liked it as well...

Get well soon Hannah!

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

Saturday, November 3, 2012

Mini Video Portrait of Dr. Hey done this week!

This has been just a great week.

It all started off bright and early Monday morning when my daughter Sarah came in early with me to shoot some video for a video project she needed to do for school:  a 2 and a half minute "mini-portrait" of me at work.  We received permission from each of the families she ended up video-taping, and I actually got a chance to share her final product with Hannah, the 23 yo woman that I did the revision scoliosis surgery for that morning.  She smiled from ear to ear as she watched it, and wanted me to post it as soon as possible, so she could share it with her friends.

Sarah only had about 3 hours total to shoot the whole video, then edited it this week, and showed it to her professor today, who loved it!

Let's see what you think.  Welcome to a snippet of my world, seeing a new adolescent scoliosis patient, and then getting ready for surgery, and doing surgery!


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

Thursday, October 25, 2012

"Dangerous Curves Ahead" -- A dad of a girl going through adolescent idiopathic scoliosis surgery tells his story.

We received the story below from Laney's dad today describing their daughter's journey through scoliosis surgery with us.  Laney and her family would like me to share with all of you on the blog.  Laney is a 14 yo young lady with adolescent idiopathic scoliosis who had surgery with me at Duke Raleigh Hospital on October 1 2012 --- 24 days ago -- and is now back to school. I have edited out Laney and Tony's last name for their confidentiality, and also removed the name of the other surgeon.  I left everything else in his story, including the part in there where Tony describes me (Dr. Hey) as a "Scoliosis Geek" (No one's perfect, and as an MIT grad, I've been called a "Geek" before!)  This is a real story from a real scoliosis dad that explains the journey through surgical decision-making, surgery and recovery from a loving parent's perspective.  

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


From: Tony  <tony@>
Date: Thu, 25 Oct 2012 09:45:08 -0400
To: Tracy - Hey Clinic
Subject: A story about going thru the process of healing Laney...

I found writing stuff down about these sorts of events really helps me put my thoughts together...  

Thought you might like it - get a feel for the sort of difference you, Dr Hey and everyone there have made in our lives.

Thanks so much --
T

------------------------

Danger – curves ahead.
(by Tony C -- Adolescent Scoliosis Dad -- October 25 2012)

So - the clearest moment in all this was about four months ago in Boston.  I was working on a video for a new client within IBM and I was really wanting to make this project solid.  Literally 5 minutes before I sat down to run the main interview I got a call from Laney’s doctor.  “Mr. C___…  I don’t know how to make this easy.  I looked at her x-rays and her scoliosis is far more severe than I had hoped.  Corrective operations for this usually happen when the spinal curve is at least 45 degrees.  Laney’s is far beyond that.  It’s around 60 degrees.”

Laney, my 14 year old daughter, has scoliosis, a major childhood illness, and she will be having corrective spinal surgery. 

That’s what echoed thru my head during the following 30-minute interview, while finishing the rest of the shooting that day, while sitting alone in the airport waiting for my flight home to Raleigh.   In those hours, Laney became frail and helpless.  I imagined her pain increasing with every minute I was away.  By the time I had picked up my suitcase from baggage claim, I was sure that she was in absolute misery and distress.  I came home to a very typical night.  Dinner was ready to be reheated, Logan (my 9 yr old) was doing her homework with Susan, and Laney was in the office – watching weird youtube clips on the computer and texting with her friends.  “Hi there!”  “hi”  “Good day today?”  “yea”  “Whatcha doing?”  “nuthin”  She still had the teenage disconnected attitude.  She was still the girl I left several days ago.  No pain, no weakness.  No change.

I found being around her to be the most reassuring thing I could do for the 4 months leading up to her surgery.  It’s so easy to assume the worst and magnify the issues in a parent’s mind.  This is one of those worst-case scenarios that came true, and it messes with your mind around the clock.  Being around my family also helped balance out all the stuff I was reading online.  There’s a wealth of truth, lies and exaggerations online, but all of it can seem so real – and unfortunately, I think it’s human nature to be drawn towards to worst…  towards the most extreme.   I found images online that looked almost like Ripley’s Believe-it-or-not wax statues, x-rays of bizarrely twisted spines… and then I would see Laney coming downstairs for dinner.  I could never connect the two, but my anxiety grew daily.

We visited 2 doctors to determine who would be best for us.  As a friend told me: “ This is a bad thing, but it’s got to feel better knowing you are living in the absolute best place in the country for medical attention.”  He was right.  This part of North Carolina is home to the most amazing collection of top-of-their-field medical experts – including Dr. _____ and Dr. Hey.  Dr. _____ was our first doctor.  His track record was truly amazing, but he was cold and aloof.  Not much interest in our concerns or need for information.  Dr. Hey, who was also personally recommended by a neighbor, was something a dream-come-true.

Dr. Hey spent almost 90 minutes talking with us, but he mostly talked directly to Laney.  He knew we had concerns, but he also knew that it was Laney who going thru this operation and recovery.  He was slightly awkward, had a very sincere interest in Laney and is a scoliosis geek!  (I mean that in the most endearing way possible.)  All he does is scoliosis corrections – to the tune of 5 or so a week.  He is also a deeply religious man…  respectful to people’s differing beliefs, but very solid in his own.  There’s something very settling in knowing the man who will operate on your child has a deep-held “work of God” ethic with every person he heals.  There was no question who we were going to go with.

However, there’s also a profoundly scarring process of listening to your 14-yr-old daughter talking with her doctor about the survivability odds of her upcoming operation…  the number of people/ her chances of becoming permanently paralyzed regardless of the doctor’s best intentions.  1 in 7000 die.  1 in 1500 paralyzed.  Are there any odds you would be comfortable with regarding your child?  Dr. Hey was very reassuring, but he was honest and very straightforward.  He was not going to soft pedal around the realities with Laney – he knew she deserved to know everything she was going to face.

She was so amazingly strong during that conversation.  I found myself wondering if she was in shock or if maybe she just missed some of the more fearful aspects.  She didn’t, she knew what she had been told.  She just accepted it and decided  to move forward.   Once in a while you get the idea that maybe, just maybe, you raised your child right… that your child has far more depth than you thought.

The next few months were an odd assortment of fear, anticipation and forgetfulness.  Laney started High School.  We took the family to New York City for a vacation, as well as a trip to Southport, NC.  Sometimes one of us would feel overwhelmed by the upcoming surgery and all of it’s unknowns, but mostly, the operation just slipped into the background.  I kind of felt the way I did in the middle of each of Susan’s pregnancies.  That odd point between 4 months and 8 months, where you don’t really forget, but you just kind of move along without really thinking about it so much.  I did notice that I was sending a lot more texts to Laney during the day, just to check in and say hi…

Susan did mention to me, a day or two before the surgery, of a conversation she and Laney had about her surgery.  We had tried to talk to Laney whenever it felt right, and this occurred when Laney and Susan were standing in the kitchen one afternoon.  Susan had just talked a little, trying to understand Laney’s quiet mood.  She asked if there was anything she feared.  Laney thought for a second and said: “I’m afraid I’ll die.”  Pause.  Then she smiled like she was just kind of kidding.  Does it really matter if she was joking?  How the hell do you face those words if you’re a parent?  (We did prod a bit after that, but Laney really did seem to accept and be OK with the decision of surgery.)

And then the day for surgery arrived.  4:15am Monday Oct. 1st.

I think they get you to the hospital so early because being half awake has kind of a dulling affect.  Susan’s parents spent the night at our house so they could get Logan up and off to school.  Laney, Susan and I stumbled into our clothes, got into the car.  A 30-minute drive and we were at the hospital.  There, we sat for almost an hour waiting on the process to begin.  I had no idea what to do.  Susan seemed OK.  Laney seemed kind of bored.  We all just sort of waited for the pager/buzzer thing they gave us to go off.

The little buzzer/pager they gave us went off…  and we all went thru the double doors and down to room #11.  What we were getting ready for was very real, but we went thru the whole process on auto-pilot.  Laney got into her hospital gown, Susan made sure Laney wasn’t wearing any jewelry…  we both kept making sure Laney was OK.  One nurse after another came in to do something…enter info on the computer…  basically, 45 minutes of little things.  Then the nurse came in to put in Laney’s IV and take some blood.  I don’t think Laney had been expecting this, and she seriously hates shots.  This was too much for her.  She broke down crying…  Susan tried to hold back tears and pretend it was all just typical stuff…  I can’t remember what I was doing except I know I felt like I was slowly coming apart at the seams. 

I breathed deeply, tried my absolute best to put on a brave face…  Susan and I took turns holding Laney’s shaking hands…  the nurse came with some happy juice to make Laney relax.  It worked quickly.  One fear I had was when it was brought up that we could just back out of this and go home.  I don’t think it was explicitly said, but the idea was just kind of there.  Laney never considered it.  Once she was calm, things moved pretty quickly.  Dr. Hey came in – gave us a quick update, and then said a quick prayer.  I’ve always felt kind of distant from religion – but in this case, I wanted to make sure Dr. Hey knew we were all in this together…  and I figured it couldn’t hurt.  It was also a very short but very real moment together.  That felt good.  He then asked Laney, “does she want just a little bit of correction or the most correction he could possibly give her?”  She obviously went for the most possible.  To me, it was an odd question, but it kind of goes to the heart of the way Dr. Hey really communicated first and foremost with Laney.  It would always be her choice, so that was what he was going to do.

And then Susan and I did the hardest thing we have ever had to do.  We walked back down the hall into the waiting room, leaving Laney alone with the nurses on her way to surgery.  We did it because it was what they told us to do – and it was what we knew we needed to do, but everything inside me was screaming to run back to Laney.  How the hell can someone’s dad just walk away while their kid faces such danger?  My insides were going nuts, but I just tried to breathe and look normal…  I think Susan was doing the exact same thing.  I remember looking at her while we were walking down the hall and we both just sort of mentally said to each other “what the hell else are we suppose to do?”  So, we ended up in the waiting room…  waiting.

The nurse had my cell number and promised to call about every hour and give us an update.  Susan and I waited in the waiting room for a bit, but got very tired of that area, so we went down the hall to the cafeteria and thought about getting something to eat.  Neither of us were hungry, but my stomach was starting to feel torn up from all of coffee, nerves and no food – so I ate.  The cafeteria was a much better place to hang out…  warmer colors, a large fish tank, far fewer anxious people.  So we hung out there and pretended not to look at the clock.

The nurse called us at 8:25am to tell us that the surgery was starting.  Wow, it took them almost an hour to just get started.  She said she’d call us back in about an hour to let us know how things were going.  It’s difficult to explain how slowly time moved.  I knew in my mind what was happening now to Laney – Dr. Hey was opening up her back, twisting her spine and ribs back into normal alignment, implanting the titanium rods…  but that’s not something I could really get my head around, nor did I want to.  I also knew when the nurse would be calling, so Susan and I just did whatever we could to wait out the time.  I had loaded a lot of games onto my iPhone to help with this time…  I knew it was coming, but the only game I had the mental capacity to play was Yatzee. 

The nurse called with very good news – things were going very well, and the doctor already had 70% of the hardware in place.  Wow! Hardware in place.  I guess it’s a trick your mind plays to help minimize the intensity of what you face and I knew that there was hardware involved with Laney’s corrections, but damn!  70% of hardware in place…  OK, that’s one of the most messed up things I’ve ever heard.  The good news was the no-bad-news in that call.  I kind of figured that if there were difficulties with the procedure the bad news would most likely happen early on.  I will never be able to explain how that first phone call changed everything in my mind.  Fear, death, paralysis – they all started feeling like irrational worries and were being replaced by the simple worries of the drama of recovery and getting Laney back up to speed in school.

Another hour slowly passed, another call with the nurse – everything went extremely well and the doctor would call us back soon to go over everything.  I was really starting to feel OK about everything.  There were strange residual fears and since it wasn’t completely done, there were still things that could go wrong…  but there was light at the end of this tunnel.  A few minutes later, our pager went off again and we walked back to the surgical waiting room – and immediately we taken back to the little conference room.  The nurse who met us there told us that Dr. Hey would be out shortly and that everything went very well.

Dr. Hey got there about 5 minutes later.  He was very serious, but happy.  He told us that everything went well and that since we had asked for the best correction possible…  “Taa Daa!”  He pulled out an x-ray of Laney’s corrected spine.  Almost absolutely perfect. 

Susan immediately started crying and gave Dr. Hey a hug.  Dr. Hey shook my hand and then left.  The next thing I knew, I was hugging Susan and crying my freakin’ eyes out.  I was shaking uncontrollably with sobs and jerks.  I have no idea how long that lasted – I think it may have only been a minute or so, but it was the most intense relief I have ever experienced.  I cut it short because it actually hurt…  and I kind of freaked myself out a little.

It’s amazing how big of a mental damn you can build without ever knowing it.  I had been feeling maybe 5% of the emotion I went thru each day – storing it all up to deal with later.  I had expected bad things… I had expected failure with the best intensions.  Success was oddly unexpected and the damn broke completely.

And then Susan and I held hands and went back to the waiting room until they assigned a room to Laney.  I can’t imagine what others in the waiting room thought we had just gone thru.  We both looked a wreck. 

We met a guy close to our own age – his wife was having lower back surgery due to an accident at work.  We had an immediate connecting to him and had a good conversation for a while.  Then, for some reason, we found him talking about politics – and he was obviously far different from us.  I immediately found something to do on my phone…  I’m usually a political junkie, but there was no way I was going to spoil my good mood with such pointless crap.  Susan had some pent up frustrations that needed a place to go.  She was nice and I missed a good bit of that conversation, but when I next looked up, our conservative friend was sitting way back in his seat with a the smile of man trying to reason with a grizzly bear.  That’s when we heard our name called for room assignment – everyone seemed relieved to part ways.

It was such a relief to have a place to settle into – room 3226.  The room was obviously empty without the bed, but it was a place we could call our own for a bit.  So, we waited… again… to see Laney.

As Laney was wheeled into the room, I was thrilled to see her and say hi…  and tried as best I could to ignore everything attached to her.  She weakly smiled with her eyes partially open and waved to me slightly with 2 fingers… and immediately fell back to sleep… the sweetest ‘hello’ imaginable.  In 5 minutes of activity, everyone set up whatever was needed to be set up and then left us alone in the room together.  I touched Laney’s arm and tried to take it all in.  On one hand she had multiple IV tubes.  She also had a catheter... I talk with Laney about the catheter but Susan did – but who knows what Laney actually would think about this when she was more awake.

Pale from the loss of blood, unconscious from the anesthesia, tubes feeding her drugs and fluids…  I wasn’t sad – and I can’t quite put my feelings into words.  This is the state we elected to put her into.  We were lucky, our doctor was skilled, and Laney was cured.  Now, the long road of recovery.

The high point – Laney and I had gone searching for a Tigger Pillowpet many times over the summer, but to no avail.  No one had one in stock.  Uncle Stephan saw one in Wal-Mart and thought she’d like it (he had no idea it was the one thing she had been wanting – but he knew she loved Tigger from the prior Christmas)  Way to go Stephen!  (Sorry Sara.  I know Laney really loves the bumble bee Pillowpet you got her, but Tigger will always go to Laney’s heart.)

What’s it like to see x-rays of the (2) foot long titanium rods and brackets attached to your daughter’s spine?  To see the 14 inch incision all the way down her back?  To watch her lay frozen - perfectly still in bed and whimper from the excruciating pain despite all the drugs?  Or to watch her take her first steps?  (The nurse thought Laney would just walk to the door of her room and back to bed  but Laney walked the full length of the hallway, twice, with surprising ease!)  Did I mention that she grew 3 inches in as many hours from the surgery?!?  They also had to rotate her ribs 3 inches to get them back to normal…  and Laney’s chest is at best 4 inches deep.

We had planned on Laney coming home Wednesday afternoon, but conversations quickly became about maybe Thursday but probably Friday.  Dr. Hey had to do so much work to get Laney’s spine and ribs back to normal, and that sort of work has a cost.  Tuesday night, during a point when the drugs weren’t enough, Laney simply cried that all she wanted was to go home and sleep in her own bed.  The nurse mentioned that if she could work hard on her mobility, she might get to go home earlier.  The next day Laney walked the hallways twice, did the rehab ‘obstacle course’ of steps and in/out of a car test in 5 minutes flat.  This is Laney leaving for home Wednesday afternoon at 3pm.


Home s a great to place to get better.  Everything is here, and you can actually sleep uninterrupted.  Well, OK, Laney can sleep uninterrupted – we still have to get up and get her medicine every few hours.  One thing we learned when Laney and Logan had their tonsils removed: do NOT let the pain get ahead of the medicine or life will really suck.  I had to download a medicine app for my phone so I can track all the different pills she needs to take at different times.  There are still a few times when her pain overwhelms her, but she’s making a truly remarkable recovery. 

On Friday, Laney started sitting up and reading…  watching TV, or just to stretch.  His was the last of the big things to get back into doing, and by far the most painful.  Think about what happens to your spine when you sit.  Now imagine rivets and rods attached to your spine to keep it straight.  I think boredom is a really motivator for teenagers.  Laney is tired of laying down, and of course there’s only so much room to walk around in our house.  I’ve also notice that distant, rolling-of-the-eyes attitude creeping it’s way back into our home.  Laney still wants hugs, and says “I Love You” and “Good night” to us, but I expect that to end any day now. 

It’s now been 5 days of recovery,  and from the highs and lows experienced , I feel oddly calm.  I remember talking with friends whose daughter had surgery for cancer at the age of 6 months.  They said it took far longer to actually come to grips that their daughter was cured than it took for the initial realization that she had cancer.  All my worst fears surfaced during the past 4 months, and with obnoxious regularity.  I avoided as many quiet times as I could… tried to stay busy and focused on anything else.  There’s a saying about bad things around the office: “Well, at least is isn’t your baby.”  Well, this time it was my baby and I learned that you can fake being clam, put on a brave face, make rational decisions, but you can’t hide from real world harm to your child. 

I’ve always been good at counting my blessings…my life has been amazingly good, I’m surrounded by sincere and good-hearted people and my family is an absolute bedrock.  However, I’ve always felt that this life was held together by a very thin, frail bubble, and this whole event felt like what I had always imagined that bubble popping would feel.  Fear, chaos and the worst of what is possible.  What I discovered was a very thick wall of love and support that I have from friends, family and work-family.  My life, like my daughter, is nowhere near as fragile as I had thought.


Tony C -- October 25, 2012

Monday, October 15, 2012

Hey Clinic, Outside Clinic In the Garden!!

One of the greatest joys of elementary school is that rare time when your teacher allowed your class to go outside for class.

At Hey Clinic, we have Duke Raleigh Hospital on our South side,  and a BEAUTIFUL GARDEN on our our north side.  My conference room where I usually meet with new guests overlooks this beautiful garden, including a white gazebo and small waterfall and rose garden.  At many times I've gazed out that window and joked that it would be great to go outside and finish clinic in the garden --- just like elementary school outside!!

Well, last Thursday that dream came true.  It was late afternoon, and I was in the middle of a consultation with a 22 yo young lady with progressive scoliosis from South Carolina and her parents.  We began to smell some smoke, and actually had to evacuate due to a malfunctioning air handler just above our clinic!  The fire alarms started to go off!!!  Everybody in the building scampered outside.

The next thing you know, we're standing outside our clinic building wondering what to do next.  It was clear the smoke was going to take a while to clear.  "Aha!  It is time for Clinic Outside!!!"  Our nurse practitioner Brittaney and physician assistant Leslie are seen with me here with our visiting family from South Carolina.


The next thing you know, it was picture day, with my PA Leslie and Tracy joining in on the family pictures with scoliosis friends and family!



Man, it's too bad we can't do surgery outside!


My last three families headed in through the garden entrance, and hung out on the wooden benches with plants all around, with bright sunshine and blue sky above!  

As I was finishing up my consultation with the 22 yo young lady, I realized that my next patient, sitting on the bench across from us was a 24 yo patient who was about 6 months out from her scoliosis surgery.  In an effort to try to preserve confidentiality, I asked if each of these young ladies separately if they would be willing to talk to each other.  They both joyously agreed to meet and share, HIPAA aware!



The next thing you know, these two young ladies, and their parents -- one family from North Carolina and another from South Carolina -- were all sharing together out in the garden!  New friends were made.





My last patient of the day was one of my younger very early adolescent scoliosis patients -- just out of elementary school.  She was very psyched about our outside clinic.

Lots of sunshine and smiles at Hey Clinic.
I was definitely smiling as I left the gardens that day.  Dream come true.

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

Tuesday, October 9, 2012

Gentleman with myelopathy, adjacent level stenosis T12-L1 helped today

Just got out of surgery on gentleman who had L1-Iliac wing fusion done about 5 years ago, who has had progressive myelopathy with stenosis just above his fusion, with some proximal junctional kyphosis.

His surgery today went well, with decompression of spinal cord, and extension of instrumentation up to T10 using less invasive T10 fixation to help prevent PJK.

Just met with patient's wife, and went over X-Rays.  She wanted me to post this to the blog asap so her son Derek in Seattle could take a look!

Derek:  your dad did great!  

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

Wednesday, October 3, 2012

Ace Team. 10 yo 60 degree scoliosis and yesterday's surgery

 Saw this 10 yo girl yesterday with very large double curve, who was picked up actually during an asthma flareup --- good pickup by pediatrician.  Note her large lumbar hump and use of scoliometer.  She will need surgery this fall.


Yesterday we straightened up this 53 yo woman who was really suffering with a collapsing idiopathic and degenerative scoliosis.  Her surgery went very well, and we got a very nice correction.  She is doing well this morning, and smiled big time when she saw this X-Ray hanging up on her window. She did not need to go to ICU, and will get up walking today.

I had my ace Room 12 Team with me, including Motorcycle "Scrubs" Dan and Robert -- two of my top techs who really enjoy working with our great team each week, 4 days a week doing scoliosis surgery here at Duke Raleigh.

This is definitely is a team sport.

About to scrub in on a really bad scoliosis shown below.  This lady is on big time pain meds, as she has suffered with collapsing curve.  Notice her severe sideways slip, called lateral listhesis.  This can cause significant back pain as well as severe spinal stenosis with leg symptoms and trouble walking. Spinal cord stimulator did not work.  Big day.

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


Monday, October 1, 2012

"You must sleep well at night." Smiles and Tears. I love my job.

Folks that know me know that I really love my work as a spine surgeon.  However, as a surgeon and engineer, I often do not reflect very often about my work and life, but focus more on just the next task in front of me.

But now and then I get a chance to reflect. Yesterday I had opportunity to go fishing with a couple real good friends -- one who is a medical resident, and the other an attorney.  We had a really wonderful day, and through our evening and long day together got a chance to share and enjoy the outdoors.  I left that day feeling refreshed, and thankful for developing friendships, but also thankful for the work that I get to go back to each day.  Even tough my days can be quite long, and at times can be stressful, it is a real joy to work with great people, and to be able to get to know and serve patients and families of all types, and all sorts of different backgrounds.  A surgeon can hold a special place in the lives of families.

This morning I had a great example of the special connection we can have with other people.  At 7 am this morning, I met with my 14 yo adolescent scoliosis patient with a 60 degree curve, and her parents, in the preop area at Duke Raleigh Hospital.

I asked her "How straight did she want to be", and she answered with the usual answer I get:

"As straight as possible."

"All right then... that's what I will do!" ... was my reply.  I had a brief prayer with the family with their permission, and we were all united, ready for the big day.

I had my usual ace team in OR Room 12, who were ready to rock and roll when I got in there to position the patient.  My proper Pandora station was playing through the good sound system, and after full prep and drape and time-out, we got to work.

Her curve was big and stiff, and I had to use all my little tricks to help slowly get her curve to straighten out.  I had to work hard also to pull her sunken chest on the left side out, while pressing the large right rib hump down with some special derotation maneuvers.  Lots of trained hands were on deck to help me, including my wonderful PA Leslie, and two ace scrub techs, and my favorite circulator Nurse Kelly.

At the end of the correction, her spine looked nice and straight, with the chest leveled.  The X-Ray looked really good.  We "hi-fived" as a team, and I headed out to talk to the family with the X-Rays in hand.  When I showed the parents the X-Rays, the mom started to cry for joy.  And she kept crying!  Dad didn't cry, but he was clearly relieved.  What a privilege to be in this little conference room with these parents, who entrusted their child to me so that I could help her.  We had a quick prayer of thanksgiving, and mom gave me a big hug, I headed off to see my next patient.

As I left the conference room, my neck felt wet.  Her tears were on the side of my neck.  Precious times I need to remember, and not just blast through.  Connecting with people in love is what life is all about.

As I was leaving the building to run over to Hey Clinic next door, the dad yelled out to me:

"You must sleep well at night!"

I wasn't exactly sure what he meant, but since he knew I had another big spinal deformity case to follow, I yelled back:

"Yeah... after 2 big surgeries I am pretty wiped out."

He yelled back.... "No, not because you did 2 big surgeries....

"Because you help people like my daughter."

Got it.  I smiled.

Later that afternoon after finishing my second deformity surgery, I went back to check on the morning's adolescent scoliosis family up on the Duke Raleigh Hospital Orthopaedic floor.  Our young lady looked great, and was pretty comfortable.  Her mom and dad where there, looking very relieved.  I asked the young lady if she had seen her X-Ray yet.  "No", she said.

I turned on the bright light over her bed, and held up the X-Ray so she could see the before and after X-ray which all of you can also see above.  She broke into a big smile, and a little tear ran down her right eye.  Her wish came true.  Prayers were answered.

As I walked over to Hey Clinic, I smiled too.

Now it's 10 pm.  Time for bed.  Reflecting on what happened today and this weekend.  Time to sleep.  Just went over X-Rays for the lady who has a big scoliosis I will be helping tomorrow morning.

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

Tuesday, September 18, 2012

11 yo scoliosis straightened up nicely -- intra op photo

Our 11 yo scoliosis patient straightened up nicely with less invasive, shorter fusion.  She had good preop bending X-Rays showing her upper curve bends out nicely, as well as lowest part of her lumbar curve.

Surgical time:  2 hours 15 minutes.
EBL:  300
Correction:  very nice.

Out to talk to family.  They should be quite happy!

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

40 yo woman with painful thoracolumbar curve fixed yesterday; 11 yo 50 degree thoracolumbar adolescent idiopathic scoliosis (AIS) to be fixed this morning

Yesterday we straightened up a 40 yo woman with painful collapsing thoracolumbar scoliosis, just under 40 degrees.  She had been suffering with back pain for quite some time, and it was definitely affecting her posture and appearance.  She developed a lateral spondylolisthesis at L34 as a result of the curve, with the L3 vertebra gradually sliding downhill on the sloped L4 vertebra, resulting in progressive disc degeneration and facet arthritis.

Her surgery went very well, and fortunately as shown on her MRI, her L45 and L5S1 discs were still in good shape, so we could stop her fusion at L4 rather than going to the pelvis/iliac wing.    We got her straightened up quite nicely, and her big hump on lower left back is gone, and "hourglass" figure restored.














This morning I am at WakeMed, here to straighten up an 11 yo young lady who has the same curve as the woman we straightened up yesterday.  This young lady has a 50 degree curve already, which is why we are fixing it now.  Will get you an update later.  Time to scrub in!

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

Monday, September 10, 2012

Back from SRS. This morning's scoliosis surgeey

Got back to Raleigh Saturday afternoon from SRS in Chicago.
Had to cancel first scoliosis surgery, so moved up second surgery for our 58 yo woman w very painful collapsing scoliosis.
Time to suit up. Good to be back w to clinic and OR Room 12!
If you get a chance, sign up for eText at Srs.org. awesome free online spine textbook!!!
Lloyd A Hey, MD MS

Friday, September 7, 2012

Art Institute of Chicago!!!

Very cool!


Ok. NOW I GET THE "WINDY CITY" THING!

I am riding bus to Art Institute here in Chicago after another action-packed day at SRS international scoliosis meeting.

After the meeting, i quickly changed into my running gear and ran down to the Navy Yard. It looked kinda windy out on the water w lots of white caps, but i was running in the lee of the buildings. As i got out to the point of dock, all of a sudden i was hit ny a blast of wind that literally stopped me in my tracks!!  Moving forward seemed impossible!  I stuck my arms out to see if i could just take flight, but was unsuccessful.

Rest of run went great. Pretty city!

Dr. Lloyd Hey
Hey Clinic