Thursday, May 31, 2012

Emory sends "Thank You" for her kyphosis surgery and pictures to share hiking!

 One of the questions many of our athletic younger patients ask us is this:  "Can I return to an active, athletic outdoor lifestyle and sports after scoliosis / kyphosis deformity surgery?"

Well, I received nice email below a couple weeks ago from Emory, who would answer this question "YES!"

I had helped back in October 2008 (3.5 years ago) with an instrumentation and fusion and osteotomies for her severe kyphosis around age 40.   She said it was AOK to share her recent email and photos with all of you.  Enjoy!

On Fri, May 11, 2012 at 7:53 PM, wrote:
Dear Dr. Hey,

I hope this finds you and your staff well. I recently had someone ask how long ago my fusion was performed and I realized how quickly the three plus years have passed.

I wanted to thank you again for the wonderful care and fantastic surgical outcome. When I tell folks I am fused from T2 to L1, they often have many questions. When I share I am virtually pain free, they are speechless.

Many years ago, as my kyphosis got worse, I gave up my love of hiking and backpacking. It was too painful to hike let alone carry a 35lb pack for miles. I am thrilled to share some recent pics. My long term goal is to thru hike the AT or the Pacific Crest Trail.

Thank you, thank you, thank you!!!


17 yo Ashley's Scheuermann's Kyphosis Straightened Out Today

Ashley has been suffering with back pain for several years with her progressive Scheuermann's Kyphosis, which progressed to 78 degrees recently.  It also was having a huge effect on her posture.  After being followed at Hey Clinic for a while for this deformity, she opted to get it fixed.

I saw her and her large family in preop this morning, and she was downright psyched to move forward with her surgery.  She has a very supportive extended family.

Austin, a pre-med student from NC State observed her surgery, and we had our top gun Room 12 Duke Raleigh Hospital spinal deformity on hand to help including Dr. Scouras from anesthesia, Nurse Kelly, circulator, and Motorcycle Dan as well as Brother Robert as my scrubs.  My physician assistant Leslie did an awesome job assisting as usual.

I helped position Ashley on the operating table, along with the whole team.  As shown in the picture below, I was sorry to see that her huge "hump" did not get any smaller when we positioned her prone, even under general anesthesia!  That is fairly typical with Scheuermann's kyphosis, and required doing 4 posterior osteotomies and some other tricks to help get rid of the hump.

Estimated blood loss from the surgery was 450 cc, and no blood transfusions were needed.  About 200 cc of her own blood went back to her in form of cell saver.  Evoked potential monitoring was normal, and surgery took 4.5 hours.  We got a really nice correction, getting her kyphosis down to a very normal 40 degrees, T3-L3, using new innovation for proximal fixation with sublaminar fiber-wire construct to prevent proximal junctional kyphosis (PJK).

Met with the family after surgery, and the mom and dad were both so happy after seeing her new posture on X-Ray and photographs that they both wept for joy.  My pre-med "shadow" Austin got to see the real joy of helping real families as a physician.

I went back and saw Ashley with her whole family in her large private room at Duke Raleigh Orthopaedic Floor (not ICU).  She was comfortable, smiling and very happy after seeing her new posture as well.  I think there were about 8-10 family members in her room including grandparents!

Sorry for big lag since my last blog.
I actually have 3 blog entries backed up that I've promised to get out for several different patients, but my "day job" is definitely interfering with my blogging / writing career.

Hope you are all well.

Dr. Lloyd Hey

Thursday, May 17, 2012

19 yo young lady w 46 degree r thoracic adolescent idiopathic scoliosis w large rib hump fixed this am

T4-L1 instrumentation and fusion w posterior apical osteotomies.

Surgical time: approx 3 hrs.
Complications : none.
Ebl: 250 cc
Cell saver 120 cc

Correction: nice. Hump is gone!

Little Quinna recovering well over WakeMed postop day 2.

Dr. Lloyd Hey --

Tuesday, May 15, 2012

7 yo 9 month yo young lady with Rett's Syndrome and 81 degree progessive Early Onset Scoliosis (EOS) Fixed this morning

We've been following this wonderful young lady and her family for past couple years with rapidly progressive early onset scoliosis.

This morning, we got her straightened up.  Treatment options considered included growing rod, Shilla Technique vs. definitive instrumentation and fusion.  After considering this patient's specific clinical presentation, biological age, and other factors with the mom and dad, they opted for a definitive instrumentation and fusion with some new innovations in scoliosis correction.

Little Quinna did great this  morning.
Surgical time:  3 hours 40 minutes
EBL:  400 cc.
Blood transfused: none.

Complications:  None.

We got a really nice correction, and she is now just waking up and breathing on her own, so they are extubating her here in the operating room!  I think the parents will be very happy.

Time to go out and see her parents here at WakeMed Children's Hospital, not far from our Hey Clinic office in North Raleigh, right next to Duke Raleigh Hospital.

Great morning.  Team did great.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Monday, May 14, 2012

13 yo young lady with 51 degree thoracolumbar scoliosis fixed this am

Well I'm back to work after being off for a week for a little break, and also to attend and present at the annual Piedmont Orthopedic Society Meeting held down in Florida this past week.  It is good to be back to North Carolina!  Will share more about my talk in future blogs.  It was great to see many of my former Duke Residents at this conference, and my other Duke friends and mentors including Dr. William Richardson, William Hardaker, Jim Nunley, Jim Urbaniak and many more.

This morning I got to see Rachel, a 13 yo young lady with severely progressive thoracolumbar adolescent idiopathic scoliosis (AIS) with her folks in the preop area here at Duke Raleigh Hospital.  Rachel and her parents asked if I could "blog" her X-Rays right away so their friends and family back in Texas could get the word that she did well!!  Well here you go!

Got an awesome correction, T5-L3, with estimated blood loss 550 cc, 250 cc of which was given back to her as cell saver.  No blood transfused.  Surgical time almost exactly 3 hours skin to skin.

She is now waking up, and I'm off to show her folks the X-Rays in our special conference room.

Early this morning I saw an 18 yo young lady graduating from High School who was braced for scoliosis for several years, and thought she was all done a couple years ago when she was done growing and her curve was around 30 degrees.  Surprise!!  X-Ray now shows her curve is over 40 degrees with big progression of her right thoracic rib hump.  It is important to realize that bracing does not always work, and that adolescents who are done growing should continue to be followed every year for repeat X-Rays at least until age 25, and then 5 years thereafter. 

Enough Blogging. Time to go talk to the family!  It is good to be back.  Sandra and Sheila, some of my favorite scrubs who have worked consistently on "Team Hey"since I've been at Duke Raleigh past almost 8 years were here as well as wonderful "Nurse Kelly"  and great CRNA's and neuro monitoring folks. 

Hello to all of Rachel's friends and family, especially those out in Texas!!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery