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?
Wednesday, January 18, 2012
Woman and daughter drop in to Hey Clinic yesterday 15 years after complex cervico-thoracic kyphoscoliosis surgery to say "thanks"
Kathleen, now 89 years old, and her daughter literally dropped into our clinic late yesterday afternoon. She lives many hours away from Hey Clinic, but was visiting an ophthalmologist in Cary to have eye surgery. She was telling the surgeon there about me and the surgery I performed for her years ago. She then told her daughter that she wanted to go and "see Dr. Hey right now" -- so they jumped in the car after their appointment and drove the extra 10 miles to Hey Clinic in North Raleigh.
I am usually NEVER in clinic at 4:30 on a Monday through Thursday, but usually in OR 12 hard at work. But this day finished a little early, after doing an ACDF on a nurse from South Carolina who also has history of kyphosis. I remembered her and her daughter right away! What a blessing it was to see her, and to hear how her surgery changed her life. I was only in practice at Duke Medical Center for about two years in 1997 when I tackled her kyphoscoliosis surgery involving her neck and upper thoracic spine. Her head was literally in her chest, and twisted around about 75 degrees. She could basically not do anything, and was losing weight because she would choke on her food commonly, requiring her husband to do the Heimlich Maneuver. I remembered that she considered suicide her only way out. I also remember spending a lot of time trying to figure out whether it was even fixable or not, and how to handle this in a lady who was over 70 years old with osteoporosis concerns. The sublaminar wire technique with the old Luque box seemed like best option, and was really probably the ONLY option at that point since none of us were doing pedicle screws or lateral mass screws in the cervical spine in 1997.
She wanted to share her testimony with her daughter, which is given with her permission in video below. Her story brought tears to Tracy's eyes, who has worked with me for quite some time here in Hey Clinic --- a real encouragement to all of us at Hey Clinic, and to other spinal deformity surgeons through Scoliosis Research Society (SRS.ORG) to continue to help patients of all ages who have major quality of life challenges.
While I haven't seen Kathleen for over 13 years now, I remember her and her daughter well, and have actually recently been recalling her sublaminar wire and Luque box technique as I have been developing the new "U-Rod" technique, as well as sublaminar fiber wire techniques with more flexible rods to help treat patients with this condition. In fact, tomorrow I have another severe cervico-thoracic kyphosis case in patient with severe spastic quadriplegia. The mom emailed me a couple days ago and asked if I had ever done a "U-Rod" up to C2. I could only recall one going up to C4. Well, in actuality, Kathleen had a "U-Rod" -like construct, or more appropriately an "O-ROD" construct up to C2 with sublaminar wire which changed her life for the past 15 years and has held up wonderfully.
It amazes me how tough challenges, learning, innovation, repetitive experience and follow-up all work together to help figure out the next challenge. Each one is like a puzzle: at the time it can be difficult, but afterward, when you see the end result, it usually brings real joy and satisfaction to see the difference it makes in the lives of real people and their families. That solved challenge then provides greater experience and lessons learned that helps me face the next patient in need with more tools and growing wisdom to know what might be done. Surgery is NOT always an option. and I do not recommend surgery for everyone I see. But the long series of surgeries I have planned out and carried out since starting out at Duke in 1995, and years of training before that in Boston (Children's Hospital, etc) and at Duke have provided an ever-growing toolbox of skills that help me each day to serve better.
It keeps life interesting and rewarding.
Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
http://www.heyclinic.com
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1 comment:
Hearing Kathleen's own words about her story are so very touching. Thank you for posting this moving story. It reminds people working in health care what it's all about. Les
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