Friday, November 29, 2013

Fwd: My First 1/2 marathon


I just received this email from Marcia, who had scoliosis surgery with me a few years ago, and just finished writing her own book about her experience with scoliosis and scoliosis surgery as a teen, then mom, and athlete.  More on her book later!
Happy Thanksgiving weekend to all of you.  Dr. Hey

---------- Forwarded message ----------
From: Marcia 
Date: Thu, Nov 28, 2013 at 9:22 PM
Subject: My First 1/2 marathon
To: Lloyd Hey <>

Hi Dr. Hey!

Happy Thanksgiving! Another year to be more thankful for you! I ran my first 1/2 marathon today and placed first in my division!
        Net Time
Overall :       85 / 539
Gender :        25 / 290
Categ : 1 / 10

I have my books for you too and will stop by. Here's a few photos from today! Thank you again for YOU! I am stronger than ever!

Sent from my iPhone

Lloyd A. Hey, MD MS
Hey Clinic for Scoliosis and Spine Surgery

Friday, November 22, 2013

Happy Thanksgiving at and from The Hey Clinic! Can you straighten out congenital scoliosis? Does it make sense to travel for scoliosis consultation? Can just parents meet with scoliosis doctor?

My staff surprised me today with a huge pot luck Thanksgiving lunch they had put together, including a home-made ginger-bread house made by "Pic" and SarahRuth.  I kept my meal very "low carb" today, taking only a short break to enjoy a piece of ham and turkey with cold diet Coke!  In this picture you see our wonderful Hey Clinic staff and also Pat (behind the ginger bread house) who is a volunteer greeter down in the entrance lobby to our Hey Clinic building at 3404 Wake Forest Road here in Raleigh.  

Last Friday we saw 4 patients from out of state, including Chicago, IL,  Washington, DC,  Richmond VA, and NY, NY (NYC).  Today in clinic I saw a very nice lady with bad collapsing scoliosis from West Virginia, who actually used to be a coal miner!  This week in surgery we did 2 days of scoliosis surgery at WakeMed on two 13 yo boys -- Matthew, with a very painful congenital scoliosis with collapse in his thoracolumbar spine, and William who had a about 60 degree double curve.  William has severe ADHD.  Both of those patients went home today, postop day 3 and 4.   We had gotten some very sad news about Matthew's mom the day he had his surgery --- his mom, sick for about a year with metastatic colon cancer, had taken a turn for the worse and was transferred to hospice.  Yesterday at noon, Matthew's mom passed away while he was still in the hospital.  Both Matthew and his dad are hanging in there, but there are definitely some plans in the works to reach out and help this family in need through our Hey Clinic extended "family."  Will keep you posted here how you may be able to join in and help.

 On Wednesday we helped a delightful 40 yo young lady from Atlanta, GA who had really severe flatback syndrome from an old Luque instrumentation with sublaminar wires done as a teenager, and loose spinal hardware going down to her iliac wings from an attempted extension instrumentation and fusion.  I completed a complex revision instrumentation and fusion with multilevel osteotomies, and resection of her old "Harrington Rods", which were way straight, and forcing her to lose her lordosis, making it impossible for her to stand up straight.  She actually stood up straight today, and is ready to start a whole new chapter of her life, including having a "butt" for the first time in over 20+ years, which she is very happy about, in addition to the pain relief and being able to stand and walk again.

Today in clinic we were busy as usual, but had plenty of time to spend with each of our guests, including guests from Columbia, SC, Virginia Beach, VA and West Virginia.   I actually spent over an hour with the mom and dad of one of our scoliosis patients who has a thoracolumbar curve of 34 degrees, which has been progressive.  We had a really good long talk about the possible long-term affect of this particular curve type, especially because this patient also has about a 5 cm trunk shift to the side due to the scoliosis.  The dad was not there for the initial visit, and he had lots of questions, and both parents were so glad for this time to learn more before their daughter comes back for her next follow-up xray in a few months. We talked through the choice for scoliosis bracing again with the pro's and con's, and I shared with them the latest clinical research data including Weinstein's recent randomized control trial (RCT), which showed some effect from bracing in some patients at least in the short-term.  However, longer term follow-up studies are needed and there is still a "cost" to bracing in terms of the potential psychological/emotional and social effects of wearing a brace for 18+ hours per day for possibly several years.  It is sometimes a good idea to get a second opinion when considering bracing, and to take the whole patient and family situation into account.

Yesterday we helped a couple people with severe recurrent spinal stenosis and spondylolisthesis -- one of whom I moved up from surgery this coming week because he was in such severe pain, and could barely walk because his spinal stenosis was so severe at L34 that it was literally pinching off the nerves.  He is doing great today less than 24 hours postop, and quite THANKFUL, heading home tomorrow.  

Many thanks to my awesome staff who bust their butts every day and every week to help arrange our schedules to meet the needs of our spinal deformity guests and their families from all over.  Many thanks also to our co-workers at Duke Raleigh Hospital and WakeMed Children's Hospital who also work so closely with us to deliver excellent care to the children, adolescents, and adults we care for on a regular basis.  We also really appreciate the thank you notes and verbal thank you's and hugs from our guests each week -- it really inspires us to keep serving, and keep improving our services.
More to follow.  I am planning journey north over Thanksgiving to visit a couple of patients up in Philadelphia, PA and NYC area, and also make arrangements for future trip to Washington, DC area.

Have a great weekend and a wonderful Thanksgiving!

Sincerely,  Lloyd A. Hey, MD MS and Hey Clinic team.

Sunday, November 17, 2013

Will scoliosis surgery make my quality of life better or worse? Will I ever be able take long walks and enjoy family again? Or will it be the biggest mistake I have ever made and regret it? Andrea tells her story 2 months postop.

Every Thursday morning at Hey Clinic, we gather as a team to discuss upcoming surgery guests, and work on ways to continue to improve quality of care.  One of the things we do is share thank you cards that are sent to our clinic staff each week. Below is a note that we received on November 5th from Andrea:

Here is the text of what is written above:
"November 5, 2013
Dear Dr. Hey and all of your staff at the Hey Clinic,
I will never be able to express how thankful I am for all that you have done for me.  My life has changed for the better and I'm only 2 months out from my surgery (8/29/2013)  I took my 3 year old granddaughter to the zoo last weekend and walked around for 2 and 1/2 hours!  Before my surgery my legs would have gone totally numb after only 5 MINUTES!  I've been so excited just thinking of places I want to go that requires walking -- places I avoided for many years.  God has truly blessed you with the ability to help so many people.  I'm so grateful that I found you and your staff.  Everyone is always so compassionate and understanding.  Everyone is amazed at the difference in me and I am so very thankful.   --- Andrea J"

Dr. Lloyd Hey -- Hey Clinic for Scoliosis and Spine Surgery.

Saturday, November 9, 2013

Can congenital scoliosis become painful in adults? Can it be fixed?

At Hey Clinic, we see quite a few young children with congenital scoliosis, some of whom have other congenital abnormalities like heart disease, kidney disease, or other extremity or neurologic abnormalities.  For many children, congenital scoliosis is not a big deal -- they are often stable, with good spinal balance and often don't progress during growth and/or adulthood.  However, there is a subset of patients with congenital scoliosis who end up having significant curve progression, and even neurologic weakness issues in the case of some cases of congenital kyphosis. There is also another group that does fine during childhood, but the misalignment of their spine especially in the lumbar area causes premature disc degeneration, and facet degeneration and can lead to significant pain, and troubles with quality of life and activities of daily living.  Yesterday we saw a young lady back for her 1 year postop visit who had such a problem  In the attached YouTube video below, she briefly tells her story on how she suffered more and more as an adult, and now is doing very well after having the lumbar spinal stenosis (nerve pinching) released using laminectomies, and her congenital scoliosis angulation corrected using osteotomies (bone wedges) and then stabilized with the hardware and bone graft.  She reports that she now has no pain, works full-time running a CVS store, is raising her family, and exercising regularly --- a marked improvement from last year when her quality of life was becoming unbearable!  --- Dr. Lloyd Hey Hey Clinic for Scoliosis and Spine Surgery

Wednesday, November 6, 2013

Will I lose flexibility in my spine with a scoliosis or kyphosis instrumentation and fusion?

Ben, 18, several months postop from scoliosis surgery
 One of the common questions we get from our adolescent idiopathic scoliosis and kyphosis patients and parents, as well as our adult patients and some of our early onset scoliosis patients is this:  "Will I (or my child) lose mobility in my spine after I have a spine fusion for my deformity?"

The answer is: "Yes, you will lose some mobility in the sections that are instrumented and fused."  However, fortunately most people do not notice any decrease in mobility for several reasons:

1. The thoracic spine moves very little, if at all due to the rib cage and very narrow discs at those levels.

2. In the adult patient population, degeneration and arthritis tends to decrease spine range of motion, including in the lumbar area so there is not much motion.

3.  You can easily make up for the few degrees of lost flexion / extension since you can bend over 130 degrees through your hips at the femoral-pelvic joint, just below your spine.

To prove this point, many of our patients have returned to very aggressive athletic activity including lacrosse, basketball, soccer, volleyball, swimming, tennis, baseball, football, gymnastics and roller coasters!

Benjamin doing the limbo 6 months after scoli surgery
We have other patients, however, that have gone back to all sorts of different forms of dance:  jazz, ballet, hip-hop, musicals... you name it!  Often they are getting back to these dance and other activities during the first few weeks and months after surgery, which is certainly important for high-performance athletes and dancers --- they cannot afford to be out of their sport for a year!  Plus, sports and dance are so important to the social and psychological development of young people... and some older people as well!

So, to round out our list of sports our postop scoliosis patients have been able to accomplish and send to us, I received these photos this week of Benjamin, a 18 yo young man who had scoliosis surgery with us several months ago.  Here are some links to Benjamin's surgery, postop posture improvement,  recovery, postop lunch visit  in Baton Rouge, LA and Duke Raleigh Hospital Blog.  He is doing great in college now and his mom and dad Rachel & Mark (both physicians) who sent me these pictures  and this short note from her iPhone:

Just another chance to thank you for a healthy and very happy and still limber Benjamin! " -- Rachel and Mark

Benjamin with his mom and dad at college

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery

Sunday, November 3, 2013

Postop Patient/Husband Video: Adolescent followed by adult progressive scoliosis -- is there any chance for good deformity correction and pain relief?

There is no doubt that we would always like to PREVENT the progression of scoliosis in adulthood before it gets to the point that it causes a significant drop off in quality of life as well as posture and appearance, but there are certainly many times we end up seeing people come into Hey Clinic who have suffered for many years with progressive, painful deformity.  While many children and adolescents will have curve that seem to stabilize with bracing or just follow-up without bracing at the end of growth, some curves continue to progress slowly during adulthood.  Then, as the curves become larger, and the discs and facet joints in some cases start to give way, the curves can start to progress more rapidly often causing a "spike" in pain and trouble with activities of daily living, and possibly leg symptoms as well.

In the video below, Natalie and her husband share briefly her scoliosis story, and gets a chance to thank the Duke Raleigh Hospital and Hey Clinic staff for her new posture and new and improved life moving forward.

Natalie's YouTube Video

Lloyd A. Hey MD MS -- Hey Clinic for Scoliosis and Spine Surgery