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.

No comments: