Sunday, August 12, 2012

Spine Surgeon On Vacation and Treating Serious Fishermen with Spine Problems!

Well, for the first time in many years, I actually took a two week vacation.  Although the weather was a bit on the rainy side, it was really nice to have some time with family and friends, and get some time outdoors.

The first week, I got a bunch of projects done around the house, cleaning gutters, fixing some drainage problems, and such.  I've always been a "Mr. Fix It", and really still don't mind getting my hands dirty, and getting things fixed up and ship shape.

I also roughed it for a couple of days, hiking a section of the Appalachian Trail out along the Tennessee - North Carolina Border with family, sleeping out under the stars (as well as rain and thunder and lightening!)  Went to an awesome coffee shop called the Coffee Company, in Elizabethton, TN for lunch and late afternoon coffee on return trip.

I bought a new backpack for this trip at REI, and was quite impressed how the newer backpacks really mold themselves to the thoracolumbar spine, and also bear the load well on the iliac wings!!  My friend Jim suggested getting a new air camping mattress -- that helped my back too.  We hiked all over the place, across Roan Mountain and adjoining bald-topped mountains, made up our campsite with fire, and saw awesome sunset.  Did not see any bears!  I did, however, learn that I can actually survive without my phone and pager receiving wireless signal for a couple days!  The peace and quiet was actually quite therapeutic!

This past week, spent quite a bit of time on the ocean, getting together with friends and family, and doing other repair jobs.

I spent some time with an expert fisherman named Bob, who has a problem with his low back with spondylolisthesis and spinal stenosis.  Saw him in my Beaufort NC clinic back in June that we started up, and got him connected with some great conservative therapy including special back brace, NSAID's, core exercise program, etc.  A couple weeks later, he sent me an email with a bunch of pictures showing me how he used this new back brace to help capture the smallest Blue Marlin he had ever seen!  After taking these photos, the marlin was released back into the Gulf Stream.  He said the brace really helped!

Over the last 15 years of practice, I've taken care of a lot of athletic and outdoor enthusiast patients with spinal problems, many of which I have stayed in touch with.... many have memorable stories.

I will never forget "Captain JJ"  -- who I met probably 15 years ago when I was on faculty at Duke, and had a remote clinic in Smithfield, NC.  Captain JJ was from Morehead City, NC, and captained the "Blue Marlin" charter boat out of Morehead.  He had a severe collapsing degenerative scoliosis, and severe spinal stenosis and was getting to the point where he could not only not fish, but could hardly walk across the room due to back pain, leg pain and leg weakness and spinal claudication.

After trying conservative therapy for quite a while including epidural steroids, bracing and the like, he continued to do worse, so I scheduled him for surgical consult back at DUMC.

On that day, I remember my clinic nurse called me and told me that "There were some very large gentleman down here who wanted to speak to me" ----  I arrived downstairs and found Captain JJ in the room with 3 huge guys in front of him, arms crossed --- his son and two crew members.  His son said in firm voice:  "What are you plannin' to do with our Cap'n JJ?"  ... and went back to a grimace along with his well-tanned rough-looking crew buddies.

I explained Captain JJ's spine problem, showing them the spine model, and X-Rays, but they didn't seem to understand.

So I used another analogy:  "What if you went down to the Blue Marlin and found that the flybridge was coming loose due to dry rot, and was collapsing.  Would you go back to sea?

"Of course not", he answered.  "I'd fix it and then go"

"Well, your dad's spine is collapsing, and the nerves are getting pinched in between causing to have pain going down the legs and trouble standing and walking", I replied.

I could see the light bulb go on in all 3 crew members, and they softened their stance, and actually smiled a little.  "Well, let's get Captain JJ fixed up then!"

Captain JJ did very well with his surgery, and was back walking and actually back on the water running charters a few months later.  I actually got to fish with him once, and he took my family all out to lunch, introducing us to the Morehead/Beaufort area, and actually was the first to tell me about the National Seashore including Cape Lookout.  It was great to see him back to life.

A few years later, I cared for owner of another offshore fishing boat named Dave, who is in the flooring business.   He's convinced he banged the heck out of his low back with rough offshore running for fishing tournaments, crashing over waves, lifting heavy ice chests, and lugging equipment.  He had a Grade 1 spondylolisthesis with severe stenosis, and after failing conservative treatment, I helped him with an L45 decompression fusion with instrumentation and L4 laminectomy, removing the hugh ugly arthritic facet joints there are L45 and taking pressure off the compressed nerves.

Dave did great after surgery, and actually took me out for a day to fish the Big Rock Fishing Tournament for a day out of Morehead City.  What an exciting day, and a great introduction to offshore fishing.  The Gulf Stream is truly a magical place -- a dark blue, clear river in the middle of the ocean, filled with sea life including flying fish, dolphin, and countless species of fish.  You feel like you are on another planet.

Well I didn't get out to the gulf stream this past week, but I did get to do some fishing, and caught some Spanish Mackerel which we then had for dinner the same night.  Nothing beats fresh fish.  I also got to take some long walks on the beach, and take a swim, and make some new friends while just enjoying the outdoors while "recharging the batteries."

Now it is almost 9:30 pm, and I've looked over my surgical schedule for the next week or two.... and the vacation is definitely over!  We start off at 7:15 am tomorrow morning with a big adolescent scoliosis, then a revision extension instrumentation and fusion.  There are a bunch of scoliosis surgeries on for the next several weeks, and I am seeing scoliosis and kyphosis consults every day this coming week as well.  I am thankful for my wonderful Hey Clinic staff who have held down the fort while I was away.

It will be good to be back at Duke Raleigh Hospital and Hey Clinic tomorrow.  It's been a good break, but I'm ready to go back and see the team again, and get back to serving in the clinic and operating room again.

Thanks for being patient while I took my break!

Hope you are all well.
Thanks Bob for sharing the Blue Marlin photos and for being a good coach!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

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