Sunday, October 12, 2014

What is Life Long Effect of Scoliosis? 40 year old scoliosis patient tells his story from childhood, adolescent diagnosis through surgery recently

42 yo woman with 89 degree preop kyphosis corrected by Dr. Hey October 2014

40 yo thoracolumbar curve fixed by Dr. Hey Oct 6 2014 (6.5h)
This week we performed scoliosis surgery on two 13 yo young ladies with adolescent idiopathic scoliosis and a 40 yo gentleman with 73 degree thoracolumbar scoliosis, and a 42 yo woman with a 89 degree kyphosis.  All 4 patients are home now, both teens went home after 3 nights in the hospital, with very nice straight spines!  The 42 yo woman had lost 6 inches in height in last few years, with rheumatoid arthritis and ankylosing spondylitis. Her pain was becoming excruciating, and her deformity was just crippling for her.  Her desire to live was waining.  Her surgery went very well, requiring 9 osteotomies, and a lot of my best deformity tricks to get her straightened up nicely.  She has a completely new posture, and was sitting up in the chair the first morning after surgery with a whole new outlook on life.

As I get older and have more and more experience treating thousands patients with scoliosis and kyphosis across the whole age spectrum from child, adolescent through adult, I am continually impressed how it is often so much easier and usually better to "catch" the scoliosis earlier during adolescence or young adulthood before the degenerative changes combined especially with thoracolumbar imbalance leads to cascade of possible curve progression, curve and chest wall stiffening, and pain and issues with self-image and posture, as well as possible cardio-pulmonary affects later in life.  If you are the parent of a scoliosis teenager concerned about your child needing scoliosis surgery, be sure to read "B"'s story below -- there are risks to scoliosis surgery, but there are also risks for NOT doing scoliosis surgery as well, in the short run and the long run.  Whatever decisions you make either way will affect your child for the next 80+ years.  I also remember what Dr. John Hall told me as Chief Resident at Boston Children's the day I asked him why he wasn't doing adult scoliosis anymore:  "Lloyd, it's just too hard!"  Adolescents and younger adults heal quicker, with less chance for medical or wound complications, and tend to get much better curve and chest wall corrections -- and more years to enjoy the improved posture with a shorter fusion.

13 yo with thoracolumbar curve fixed October 7 2014 Dr. Hey (3h)

This week we had sort of an "adolescent scoliosis sandwich"  -- two 13 yo scoliosis surgeries on Tuesday, and a 40 yo scoliosis on Monday and a 42 yo on Wednesday.  The fact that we could get two adolescent surgeries done on one day as opposed to one adult surgery should tell you something -- adult scoliosis surgery is usually harder and takes more time -- often twice as long as the adolescents, and usually involves needing to fuse more segments, and in some cases fusing all the way down to the ilium/pelvis.  So this week, for example, I fixed a 13 yo with a progressive thoracolumbar curve, with a fusion down to L3, got her very close to perfectly straight, which saved her bottom 3 discs, which should now last a lifetime, and her "humps" are gone, and "hourglass" figure restored for the next 80+ years.  The 40 yo gentleman named "B", who shares his story below had a 6 hour surgery for the same type curve as the 13 yo had, but had progressed during his adulthood to 73 degrees and had become very painful, disfiguring and greatly affecting his quality of life -- ever since he was a young teenager!!  These patients turned out to be in rooms right next to each other postop, and both did well postop, but their life stories have been, and will always be much different.

The 40 yo gentleman who had the 73 degree scoliosis told me postop day 1 how happy he was to have his surgery done, and his nice new posture.  He told me he would write up his story this week before he left the hospital…. which he did, and I received this Friday, as he was going home.  I always love to hear my patients stories, since I have been a patient myself -- each story is unique, although there are some elements that always seem to repeat.  B's story is a good follow-up to the dialogue I had with the Cornell students last week as we talked about compassion, and following your internal compass, and being more sensitive to the heart and soul of your patients, and your own.  While I never force my faith on anyone, I know that faith has been important in my own recovery from major trauma, and is often the key foundation for many of my patients.  At the very least, we, as physicians should be open to hear their stories and be respectful of their beliefs.  It is interesting to see in B's story given below that he, like many of my patients does not see a conflict between faith and modern medicine -- they can actually work together.  In B's life, he indeed sees God working THROUGH healthcare providers and modern medicine --- something I had felt as a patient many years ago.  When we think of what might allow these future physicians to not end up in the unhappy 94% of doctors disenchanted with their jobs as we discussed in the recent WSJ article, it seems that one antidote could be for more physicians in training to realize that maybe they too could be "administering God's grace in its various forms" (1 Peter 4).

So for my new friends at Cornell University that I met last week, enjoy B's story and stay in touch!

Time for bed.  Enjoy my patient B's story below.  Thoracolumbar scoliosis surgery tomorrow morning, as well as second opinion for broken scoliosis hardware on a young lady coming in from central NC, for second opinion for revision surgery.

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

40 yo B's Scoliosis Story

My name is B________; I am 40 years old and have been living with scoliosis for as long as I can
remember. I was diagnosed with this condition at 11 years old. At the time, of course I did not know 
what it really meant to have scoliosis nor did I realize the impact this condition would have in my life for the years to come. Upon this diagnosis, my loving parents immediately began searching for the most experienced and knowledgeable doctor in New Jersey to treat this condition. They were informed that surgery is an option but there would be a fifty percent chance that the surgery may result in paralysis.   We opted for the second option which was to wear a back brace 24/7 to assist in correction of the curve. 

Needless to say that as a pre-teen/teenager the brace was certainly not part of the image that I was trying to portrait. Therefore; I wore the brace only when I was home or when my parents harass me to put it  on. As I got older I became increasingly sub-conscious about my appearance and the curve of my back; I also noticed that my posture was not normal. I leaned to one side, my left shoulder was significantly higher than the right shoulder, and there was an abnormal bulge on the left side of my stomach (in my rib hump). I started to feel a sense of shame and began hiding my body as much as I could by wearing bigger size clothes and/or multiple layers of clothing. Going to the pool, beach or partaking in any activity that requires having to reveal my upper body was extremely painful and uncomfortable. Not to mention the pain I often felt due to my condition.

As the years passed I surrendered to my condition and had accepted this as ‘my normal’. I even conditioned my mind to endure most of the pain and to be grateful for life no matter how it comes. I gave my life to Jesus Christ in 2004 and received baptism in 2007 and started my journey to a greater 
knowledge of the Lord and His word. As I read ‘His’ Word I made a decision to believe what the Word said about me and my health. It says that I ‘should be in good health, as I am well with my soul.’ 3 John 1:2 and most importantly it says that ‘whatever I ask in prayer, believes that I have received it, and it will be mine.’ Mark 11:24. I started praying for good health, a straight back (something that I NEVER thought could happen), and no more pain in my body. I know that this was not going to happen by divine intervention as I believe that God uses His people to do His work here on earth (My wife often says that we are God’s hands and feet-we are here to be used by Him). Therefore I started praying that God leads me to ‘the’ Dr. that he has already picked to assist in this healing process. In April 2014, the pain started to increase and had become more consistent and was accompanied with numbness in my neck and legs. I decided to go back and see a doctor that I had seen a few years ago in attempt to discover if there are any changes in the curve and what options I now have to assist with this progression of my condition.   He informed me that there was a slight increase in the curve (approximately 5 %) which he will monitor and suggested that start on steroid injection to help relieve that pain. I respected his medical opinion but felt that God wanted me to be completely healed not a healing but a complete permanent healing that is ordain by Him. I kept praying and started to do some research of scoliosis doctors in the area. 

I remember one morning driving to work, I was praying to God to help me find ‘My’ spine doctor; I have lived with this condition all of my life and was ready for my healing. Later on in the day I came across Dr. Hey website which included several reviews from people who had received treatment from him. I read several testimonial from his patients about his work and his faith; he is a ‘Christian’ and he ‘prays’ before and after he perform his surgeries. I couldn’t believe it- God has such a sense of humor. When He does something; He makes sure you know that it is ‘Him’ that is doing it. With excitement I contacted the Hey Clinic that afternoon and scheduled an appointment with Dr. Hey, but unfortunately I had to wait close to 2 months to see him. That evening my wife went to a speaking engagement with a friend (whom is also a physician) and was talking to her friend about the recent sensations that I have been experiencing and asked her if she knew of any doctor that specializes in scoliosis. She stated that she had lunch with a physical therapist that day and he informed her that “if anybody has scoliosis then the best person to go to is Dr. Hey.” When my wife told me this, I thanked God for ‘confirmation.’

I decided not to move forward with the suggestion of the other doctor to start steroid injection therapy and waited to meet with Dr. Hey to obtain a second opinion. As I walk into the Hey Clinic for my 1st consultation a feeling of comfort and excitement rushed through my body; I instantly felt as if this is exactly where God needed me to be at this very time and space in life. Dr. Hey reviewed my documents and x-rays and was able to immediately determine to root cause of the pain and numbness stating that the degree of my curvature increased by night degrees from 4 years prior and provided several options and surgery was one of the options. Believing in God’s plan for my life and His promise, I decided that surgery would be the best option at this time. Dr. Hey provided me with all the information and resources that I needed to make this decision including the opportunity to speak to a patient that had undergone a similar surgery and God gave me the strength and the peace to proceed with my decision to do the surgery.

October 6, 2014: The day of the surgery I was full with excitement; my family and I arrived at the hospital at 5:30 am to begin pre-op preparation, by 7:30 Dr. Hey met us in the pre-op room where he prayed and asked God ‘to use him as an vessel and to work thru him to ensure the success of this surgery.’ There is peace in knowing that the surgeon is not going to perform this surgery by strength alone but have welcome the strength of the Most High to take on what his strength is incapable of doing. The surgery lasted approximately seven hours as my lower back discs were completely damaged and required additional attention. At 4:30 pm Dr. Hey completely the surgery and happily reported that my surgery was ‘blessed by God from the beginning until the very end.’ Praise be to God. 

I am so thankful to Dr. Hey for fulfilling his purpose here on earth allowing himself to be used as a 
vessel by God to heal His people. I am thankful that he surrenders his mind and talent over to the Lord to be used for His Glory. Thankful that God used him to bring restoration to my life, not only physical restoration but also spiritual restoration as this experience greatly increased my faith and trust in the Lord.

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