How can we care for scoliosis and kyphosis and spondylolisthesis better with conservative care like physical therapy, high-tech scoliosis braces, exercise and other techniques? What can be done to improve surgical care, and understand choices for surgery, learning from those around the world? How can we learn from aviation and from Deming's principles of "Standard Work" to constantly improve spine and all healthcare?
I saw this lady in her 50's this past week who drove all the way up from Savannah, GA who had minimally invasive surgery for her thoracolumbar scoliosis done in Georgia. This was performed after a lumbar laminectomy surgery was performed in the first round, but that surgery only gave very temporary relief as her collapsing spine collapsed back down on the spinal nerve. She was not interested in having a "big surgery" to help with her scoliosis and kyphosis, so she had about a 5-6 hour minimally invasive surgery, focusing on her lower back.
Unfortunately, her posture continued to collapse, and her pain has gradually worsened with a quality of life which is now intolerable. Her kyphosis with proximal junctional kyphosis is almost 90 degrees.
This will be a tough fix. Minimally invasive surgery can be an effective treatment for some spinal disorders, but it probably makes sense to seek out second and third opinions from surgeons with significant spinal deformity experience, perhaps located through the Scoliosis Research Society (http://www.srs.org) website when considering deformity surgery.
Dr. Lloyd Hey -- Hey Clinic for Scoliosis and Spine Surgery.
As promised, here are some more patient stories that have recently been shared at Hey Clinic.
Ashlee is an adolescent who had scoliosis surgery for her idiopathic thoracolumbar curve 6 weeks ago with Dr. Hey, and is doing well. She shares how she is already getting back into her drama with tryouts for the Wizard of Oz for this fall!
We saw Sheila for her 1 year postop visit doing very well after her T3-Iliac wing instrumentation and fusion for her large double curve scoliosis. She had adolescent idiopathic scoliosis (AIS) that progressed as an adult, causing her severe pain and poor quality of life, and had it fixed in her mid-60's and has done well postop.
Charlie had really severe back and leg pain and trouble walking, and shares his story postop after L3-Iliac wing instrumentation and fusion, and his very positive experience at Duke Raleigh Hospital with the nurses and a particular CNA who went the extra mile.
Tomorrow morning we'll be helping Patty, a woman in her early 50's with a collapsing thoracolumbar scoliosis that she has had since her teens, but had become symptomatic in recent years. I got a nice email from her friend Steve, from eastern North Carolina, who has sent me many of his friends and relatives with scoliosis and kyphosis after I got him straightened up years ago. Need to get to bed soon to rest up, and get up early to exercise and see her in preop area by 7:15am at Duke Raleigh Hospital. We have 4 big scoliosis and kyphosis surgeries this week, including a revision scoliosis / kyphosis surgery on an adolescent treated elsewhere initially. We will also be seeing several consults and second opinions coming in from out of town.It should be another interesting and exciting week. Hope you have a good week as well.
Dr. Lloyd Hey -- Hey Clinic for Scoliosis and Spine Surgery
Many years ago, when I was hit by a car as a teen, I spent over 3 months in the hospital, having 11 reconstructive surgeries on my leg, and undergoing countless wound treatments and therapy visits from many caring doctors, nurses, and therapists. It was a very painful, frightening and often depressing journey, but God worked through many caring people to encourage me and heal me. Eventually I was able to walk again, and even run again, and for several years after that experience, I would go back to that nursing floor at Glen Cove Hospital to thank the nurses and therapists who cared for me, and let them see that I could actually walk again! I also enjoyed going back to see my Doctor Mark Pitman back for follow-up to share how his "investment" in my life, taking on a very tough case made a huge difference not just in my physical life to save my leg and allow me to walk and stand without pain... but also made a difference in my life as a whole.
Each week at Hey Clinic we get a chance to see many families often coming back after major reconstructive scoliosis and kyphosis surgery --- from little children, teens, young adults and older adults --- sharing their story of recovery. Meanwhile, the hard-working nurses, and nurses aids, therapists and many others at Duke Raleigh Hospital, WakeMed Raleigh Children's Hospital, and at Hey Clinic -- have not had the chance to see the healing that has occurred. These hard-working folks, some behind the scenes, only see our patients at their "worst", yet continue to care with compassion and excellence.
Since it is not always practical for many of our patients to just pop in on the orthopaedic floor, (and they aren't allowed to "pop in" to the operating room or PACU/recovery room!), we've set out to use modern video / YouTube and blogging technology to allow these thankful families to share their stories here. Hopefully this will help all of us to continue to serve with even greater compassion for those who are truly suffering, and to lend relief and comfort.
These stories can be found on the HeyClinic YouTube Channel, and we'll try to add some each week. I discovered this week that some of our preop and postop patients have already found some of these stories encouraging as well for their motivation and progress! It is a total blessing to just have the opportunity to be a part of a web of caring relationships that brings joy and encouragement and healing in many ways. --- Dr. Lloyd Hey -- Hey Clinic for Scoliosis and Spine Surgery. http://www.heyclinic.com
We saw Tiffany and her husband Dewayne in clinic this past Friday. Tiffany is in her 30's, and works for one of the other excellent hospitals here in Raleigh, NC. She had scoliosis surgery with us here at Hey Clinic at Duke Raleigh Hospital, and shares her scoliosis story going all the way back to when she was initially diagnosed as a teenager. She shares how this summer was the first time since she was in middle school that she was able to wear a bathing suit to the beach now that her posture has been restored -- an important part of a holistic quality of life for many of our guests.
We saw Matthew and his mom Kristen, who are from the Charlotte, NC area about 2.5-3 hours away back for Matthew's 6 week postop visit this past Friday. He is doing well, and actually shares how he had a 2 inch growth spurt on the day of surgery at Duke Raleigh Hospital!!
Darlene, like Tiffany up above, also works in the healthcare field at another major North Carolina Hospital where she serves as a Patient Navigator. She suffered for many years with progressive degenerative scoliosis which made life pretty intolerable by her early 50's. She is now back for her 6 week postop visit with her husband Tommy sharing about her experience before and during the first few weeks after surgery, which are usually always the toughest.
Little Emma was in with her early onset scoliosis with her dad, who had a revision lumbar discectomy decompression with us 6 weeks ago.
Marilyn was back to see me August 23. She had a lumbar-sacral iliac wing instrumentation and fusion, and then developed proximal junctional kyphosis with a fracture above her fusion. She then underwent an extension instrumentation and fusion up to T3, and talks about her recovery from revision scoliosis / kyphosis surgery now doing very well with an erect posture and very good quality of life.
I have several more left to share.... but it's time to call it a night. Thanks to everyone who shared these past couple of weeks, and I will share this blog link tomorrow when I go into round at Duke Raleigh Hospital with the weekend staff. I am sure it will bring many smiles.
We started off the week of August 25 at WakeMed Hospital helping little 11 yo Kaitlyn, who has spinal muscle atrophy (SMA), and a nearly 90 degree progressive scoliosis treated elsewhere with VEPTR. We got her straightened up with some unique engineering using special sublaminar fixation, since her osteoporosis / bone strength was very weak. She can now sit up straight in her wheelchair, and this is also helping her with her breathing already. Her mom is just awesome, and is basically a "super nurse" for Kaitlyn, who was able to take Kaitlyn home on postop day 3 back to Fayetteville!
Tuesday I did scoliosis surgery for a 19 yo young lady who had syrinx surgery at age 9, and developed a postlaminectomy kyphosis and scoliosis which was very painful. Her surgery went very well, and she headed home with a great new posture, probably a couple inches taller.
Wednesday and Thursday were two back to back huge scoliosis surgeries --- the first one was for a woman in her 70's from Franklin, NC -- about 6+ hours away. Jerry met one of my scoliosis postop patients from Franklin over this past year named Pam, who has actually helped Jerry through the preop process and continues to pray and care for her now with Pam's husband, Fred. Jerry was really suffering badly with her deformity, shifted about a foot to the side, and about 2 fee forward. She is now doing well, off to rehab here locally before we get her back home to Franklin in a couple weeks.
Thursday was a similar surgery for a nice lady in her 50's, who was also quite "pretzel-like" , having suffered for 10+ years with progressive deformity. Both of these adult patients from Wed and Thu had adolescent idiopathic scoliosis, but then developed progression and severe pain and quality of life issues later in life. This emphasizes the importance of life-long follow-up for scoliosis and kyphosis and to not assume that everything is OK at the end of growing. She went home 4 days after surgery doing very well
Friday clinic before Labor Day was quite busy, seeing several of our teen and young adult postop patients back for follow-up. Things really got interesting when the power went out in our section of North Raleigh --- shutting off all our lights, computers, and X-Ray machine! The large group of patients we had in the waiting room and clinic rooms actually took it all in stride, and ended up creating a party atmosphere with a bunch of my long-term patients then turning to their neighbor and striking up a new conversation --- creating actually a festive family atmosphere. Luckily Hey Clinic has large windows on 2 sides of the building, so the waiting room was well-lit, overlooking the park next door, and we actually used several of our offices as exam rooms. We really appreciated everyone's patience during the power outage. One interesting coincidence: exactly 6 months earlier, we had to evacuate the building for a couple hours, also on a clinic day due to some smoke in an air handler. One of our scoliosis guests and her mom, up from Wilmington, NC was there that day for her 6 month postop visit! As shown in the link, we ended up seeing her and several other patients that day out in the beautiful gardens that are adjacent to our clinic building, on a beautiful sunny day.
Labor Day weekend was a nice break, getting a chance to catch up with family and visit the North Carolina coast for a couple days with the dogs. We came back to work this Tuesday and did scoliosis surgery Tues, Wed and Thu.... more on that later! Have a great weekend.
Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
http://www.heyclinic.com
I saw Tim and his daughter, both of whom are patients of ours here at Hey Clinic. He just sent us this note that he wished to share with all of you! Dr. Lloyd Hey
From: Tim Date: Fri, 6 Sep 2013 11:20:55 -0400 My first encounter with Dr. Lloyd Hey was during an initial visit for my 8 year old daughter's scoliosis condition nearly two years ago. Going into the appointment, my wife and I were on edge about the pending news about our daughter’s diagnosis and path forward. From the moment we entered the office, we immediately realized that the Hey Clinic was an exceptional place and that our daughter was in the best hands. Unlike most doctor’s offices, the Hey Clinic is decorated with success stories of those who have conquered spinal deformities. The Clinic also contains a significant amount of literature and hands on demos aimed at educating patients in a very clear manner about common spinal disorders and the actions often taken to address them. It was no surprise that the aura of the clinic is the product of its people. From that first visit to now ~2 years later, Dr. Hey and his staff have been extremely professional and cordial. Each member seems to have a strong sense of pride in what they do, possess a genuine compassion for improving lives, and coincidentally wear a big smile on their face each time you see them. From a clinical standpoint, Dr. Hey and his staff are top notch – very technical, knowledgeable, and highly skilled at taking complex information and distilling it down into a simple, layman’s description. Dr. Hey also routinely has taken extra time to make sure all our questions are answered and is careful to weigh in our opinion about what we think is the best treatment for our daughter. Moreover, he is a very empathic doctor which speaks volumes. Overall, my wife and I have been extremely pleased with our daughter’s experience with Dr. Hey and his clinic; HOWEVER, my review doesn’t end here. Little did I know that two years after first meeting Dr. Hey that he would treatment me too. Jokingly, during one of my daughter’s appointments I mentioned to him that maybe he should check me out given my own bouts with degenerative disk disease. He casually said sure, but at that point in time I had no issues. We were simply letting my daughter know that she’s not alone in dealing with challenges of the spine. Unfortunately though, my back woes returned with vengeance earlier this year. I eventually learned from an MRI conducted by my Orthopedic physician that my L4-L5 disc, the same disc on which I had surgery 12 years ago, had severely herniated. The herniation caused me an immense amount of pain, weakness, and numbness in my right leg and foot. This was also compounded by a smaller than average disc thickness. My physician recommend trying a directed steroid injection to help calm the nerves down. Knowing that relief that injections bring is often temporary, I gave Dr. Hey a call hoping that he would provide some consultation even though my condition was far less complicated than most scoliosis conditions. Dr. Hey kindly agreed to see me. Within minutes of viewing the MRI Dr. Hey identified numerous issues that were the likely reason for my intense pain and discomfort. He immediately mapped out a game plan. He also took the time to greatly ease my high anxiety stemming from the thought of battling my disc issues at such a young age and throughout the rest of my life. Rather than rushing into surgery, he recommend taking the conservative route and proceed with a steroid injection by my Orthopedic physician. His recommendation was backed by data he cited on the rate of success for different situations. He also said if the injection did not improve my situation within 7 days to come back and we’ll talk surgery. Seven days passed with no relief. I immediately scheduled a follow-up appointment with Dr. Hey. He and staff were able to squeeze me into a surgery the following week. Dr. Hey carefully reviewed the planned surgical procedure to be done and answered numerous questions. Surgery was an absolute success!!! Dr. Hey performed a microdiscectomy, laminectomy, and removed a portion of ligamentum flavum ( I think) that had coarsened over time due to my degenerative condition. The culmination of this work led to the freeing up of an immense amount of space. The end result, was a night-and-day difference with my conditions. Immediately after surgery I had no pain and virtually no numbness in my right leg except for some minor tingling in my toe. Now six weeks later, the numbness is miniscule and I have re-gained significant strength in my back. More importantly, I have a normal life again – free from the physical and emotional drain of pain. Overall my experience as father of a daughter with scoliosis and a patient with the Hey Clinic has been nothing short of superb. What’s been very unique is that my daughter and I have gained many life lessons together through this clinic. (We are also Back Buddies!) My daughter now has less fear and tons more confidence that the future surgery to be conducted by Dr. Hey will be well worth it. I think she kind of enjoys going to see Dr. Hey. Lastly, I’d like to emphasize that there have been very few people that I've met in life with the unique combination of qualities that Dr. Lloyd Hey possesses – humble, caring, empathic, super smart, funny, passionate, and firm believer in God. Dr. Hey is truly fulfilling God’s plan for him by making the lives of his patients and doing it the Right way! Thanks Dr. Hey!
