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Thread: Dr. Hey

  1. #1
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    Dr. Hey

    Has anyone seen Dr. Hey in NC? I sent him my X-rays and he called me back. He was WAY more thorough than Dr. Tribus in Madison. He got the measurements right to the T. My upper curve 45.5, lower thoracic curve 38* not 28* like Dr. Tribus said. My pictures are quite clear and I had a hard time believing 28* with how bad it looks (which means I have progressed about 20* since diagnosis!). I also have severe hypolordosis of my upper spine which he says can squish the heart and lungs. He also does the same surgeries in about 1/2 the time with minimal blood loss, which is quite impressive. I'm just afraid if it sounds too good to be true, then it probably is. I don't want to put my hands into the care of someone who will do more harm than good. Any feedback is appreciated. Thanks!

    Rohrer01

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    hey rohr
    i sent you a P.M.

    jess

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    Dr. Hay has a good reputation. Oddly, I actually met him today, as he attended a meeting at UCSF about spinal surgery outcomes, and a spine conference that we put on. He seems like a very thorough and thoughtful man. Check out his blog if you want to get a sense of what he's like.

    --Linda

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    Quote Originally Posted by LindaRacine View Post
    Dr. Hay has a good reputation. Oddly, I actually met him today, as he attended a meeting at UCSF about spinal surgery outcomes, and a spine conference that we put on. He seems like a very thorough and thoughtful man. Check out his blog if you want to get a sense of what he's like.

    --Linda
    Although I would only consider a pediatric guy for my kids, I am sufficiently impressed with Hey to go with him if I need anything for my lumbar. He's got top schelf schooling and training. The speed of his surgeries is off the scale it seems.
    Last edited by Pooka1; 06-18-2010 at 04:40 PM.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
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    "We are all African."

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    Quote Originally Posted by Pooka1 View Post
    Although I would only consider a pediatric guy for my kids, I am sufficiently impressed with Hey to go with him if I need anything for my lumbar. He's got top school schooling and training. The speed of his surgeries is off the scale it seems.
    Hi...

    I thought about this today when there was a bit of a lull at the conference. I think I'd be less concerned about picking a surgeon who treats mostly adults for my child who needed traditional scoliosis surgery. While these surgeons certainly treat far fewer patients than the pediatric surgeons, I think adult surgeons (that is, surgeons who treat mostly adults), are far more likely to think about the problems that the kids will face 10+ years from now. I was in a conversation earlier in the day, talking with several surgeons about kids being told that their scoliosis problems are over with surgery. I actually thought that was a thing of the past, but I still hear of kids being told that. Since the incidence of spine pain is so common in normal adults, it seems that people with (or without) scoliosis fusions as children, are going to be at least as likely, or potentially more likely, to have additional problems in adulthood. In other words, I doubt that adjacent level issues are going away any time soon.

    Sorry, I sort of went off on a tangent...

    With all that said, I think that adolescent scoliosis surgery is still a very good thing. Kids with 50 degree curves are likely to have a real deformity issue, and probably a lot of pain and loss of function, if they don't have surgery. I guess my message is, pick the best surgeon you can find, so that you reduce the potential for needing additional surgery in the future.

    Regards,
    Linda

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    Quote Originally Posted by LindaRacine View Post
    Hi...

    I thought about this today when there was a bit of a lull at the conference. I think I'd be less concerned about picking a surgeon who treats mostly adults for my child who needed traditional scoliosis surgery. While these surgeons certainly treat far fewer patients than the pediatric surgeons, I think adult surgeons (that is, surgeons who treat mostly adults), are far more likely to think about the problems that the kids will face 10+ years from now.
    Yes but the list of potential problems down the road is known to all surgeons, yes? Do you think that a surgeon who does adults and kids would do a kid's surgery any differently solely due to having done a bunch of surgeries on adults also? How so?

    I was in a conversation earlier in the day, talking with several surgeons about kids being told that their scoliosis problems are over with surgery. I actually thought that was a thing of the past, but I still hear of kids being told that. Since the incidence of spine pain is so common in normal adults, it seems that people with (or without) scoliosis fusions as children, are going to be at least as likely, or potentially more likely, to have additional problems in adulthood. In other words, I doubt that adjacent level issues are going away any time soon.
    Well I was told w.r.t. my first daughter at least that she is back in the general population on risk for all future back issues. That means, like everyone else, if she lives long enough, she will get DDD at least.

    Now that said, I do not think successfully fused areas of the spine are subject to any issues whatsoever. So the ten levels each of my girls are fused, assuming they are successfully fused, are out of the picture in terms of ever causing any issue whereas the general population has many more discs to potentially be involved in problems.

    W.R.T. adjacent level disease, I suspect surgeons surmise that is simply not likely to be an issue with fusions that end at L1 and above. He said they start to see problems when they end at L3 and below and the risk increases with each vertebra doing down as I understood him and I may not have. So when my eyes bugged out when he said he may go to L2 on the second kid he said the risk of adjacent level disease doesn't really increase compared to stopping at L1.

    So between removing several vertebrae from the picture and where the fusion ended, I think that is why I think our surgeon said my daughter was back in the general population on risk for future back problems. If that isn't his reason then I don't know it.

    If you have specific information about why he is likely wrong on this point I would like to know it. My other kid is hitting the 8 month mark tomorrow and is therefore off restrictions and into general monitoring for one or two more years. It is my impression they are done with scoliosis for if not the duration then a long time hopefully. And even if they are not then I certainly expect by the time any issue occurs that there are good solutions in hand. As it stands now, the worse I think that can happen is that they would need an extension at the distal end though I don't think that would be expected with a fusion ending at L1.

    Sorry, I sort of went off on a tangent...

    With all that said, I think that adolescent scoliosis surgery is still a very good thing. Kids with 50 degree curves are likely to have a real deformity issue, and probably a lot of pain and loss of function, if they don't have surgery. I guess my message is, pick the best surgeon you can find, so that you reduce the potential for needing additional surgery in the future.

    Regards,
    Linda
    I don't think my kids had a choice. I think the one at least would be dead by now and possibly the other also.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

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    Quote Originally Posted by Pooka1 View Post
    Yes but the list of potential problems down the road is known to all surgeons, yes? Do you think that a surgeon who does adults and kids would do a kid's surgery any differently solely due to having done a bunch of surgeries on adults also? How so?
    It could be known, but often is not. Working for surgeons who do mostly revision work, I can tell you that there are plenty of kids whose surgeries were done without the future in mind.

    Quote Originally Posted by Pooka1 View Post
    W.R.T. adjacent level disease, I suspect surgeons surmise that is simply not likely to be an issue with fusions that end at L1 and above. He said they start to see problems when they end at L3 and below and the risk increases with each vertebra doing down as I understood him and I may not have. So when my eyes bugged out when he said he may go to L2 on the second kid he said the risk of adjacent level disease doesn't really increase compared to stopping at L1.
    Ah, but you forget about proximal adjacent level issues. While probably not as common as degeneration on the distal end, it's still a big issue.

    One of the discussions today was on whether or not potential degeneration is greater in patients with fusions. Unfortunately, I don't remember the specifics of that talk. It seems to me, however, that the discs above and below a fusion have more stress put on them than a disc without that same load.

    I hope I'm not scaring any parent out of putting their kid through surgery if it's recommended by a good professional. I just hope that those good professionals are no longer telling their patients that this will definitely be the last they'll ever have to think about scoliosis.

    --Linda

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    Quote Originally Posted by LindaRacine View Post
    It could be known, but often is not. Working for surgeons who do mostly revision work, I can tell you that there are plenty of kids whose surgeries were done without the future in mind.
    Can you be specific here? What exactly do you mean by this? How would a surgery be done differently with and without keeping the future in mind? Are you referring to choice of levels to be fused?
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  9. #9
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    Quote Originally Posted by LindaRacine View Post
    I hope I'm not scaring any parent out of putting their kid through surgery if it's recommended by a good professional. I just hope that those good professionals are no longer telling their patients that this will definitely be the last they'll ever have to think about scoliosis.

    --Linda
    By the way, you may recall that Pam reports that Hanson told her she was back in the general population also. Given that the general population largely doesn't have scoliosis, that necessarily implies no more scoliosis issues. That's how I understood what I was told about my kids but maybe I am missing something.

    So it's not just pediatric guys telling patients they are back in the pool.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  10. #10
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    Quote Originally Posted by Pooka1 View Post
    Can you be specific here? What exactly do you mean by this? How would a surgery be done differently with and without keeping the future in mind? Are you referring to choice of levels to be fused?
    Definitely levels. I think that when the perfect levels are chosen, patients have less of a chance of having adjacent level issues. The proximal level of my fusion was obviously wrong, as very soon after my surgery, I had symptoms of proximal junctional kyphosis.

    --Linda

  11. #11
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    Quote Originally Posted by LindaRacine View Post
    Definitely levels. I think that when the perfect levels are chosen, patients have less of a chance of having adjacent level issues. The proximal level of my fusion was obviously wrong, as very soon after my surgery, I had symptoms of proximal junctional kyphosis.
    Yes that is the perennial challenge to stabilize the spine with as few levels fused as possible. Many considerations go into this and each case is different. Both my girls had a right T curve in the high 50*s with apex of T9. When I asked the surgeon something about the two cases he indicated my first daughter was more complex and not as straightforward as the second kid. I don't know why he said it but I think the extreme rotation in the first kid may be the reason he said that. To a bunny like me, I assumed they were essentially the same deal whereas he said they were very different to correct.

    I thought you were trying to draw a distinction between the great run of pediatric guys breaking one way (perhaps not being conservative enough?) whereas the great run of guys who do adults break the other way (fuse more levels) because they have a perspective of the "future" having the adult patients for years and years as opposed to the pediatric guy who is possibly short-sighted.

    I read all of that into your short comments. Is that the point you are trying to make?
    Last edited by Pooka1; 06-06-2010 at 11:33 AM.
    Sharon, mother of identical twin girls with scoliosis

    No island of sanity.

    Question: What do you call alternative medicine that works?
    Answer: Medicine


    "We are all African."

  12. #12
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    [QUOTE=Pooka1;100613]Yes that is the perennial challenge to stabilize the spine with as few levels fused as possible. Many considerations go into this and each case is different. Both my girls had a right T curve in the high 50*s with apex of 9. When I asked the surgeon something about the two cases he indicated my first daughter was more complex and not as straightforward as the second kid. I don't know why he said it but I think the extreme rotation in the first kid may be the reason he said that. To a bunny like me, I assumed they were essentially the same deal whereas he said they were very different to correct.

    QUOTE]

    It would be interesting to know the surgeons thoughts on these differences in your identical twin girls. Why was Willow an easier case to correct? Funny how you start with the same thing and have slight differences in the end. What causes the change? I guess this proves exactly how sensitive the body actually is.

    In Linda's case, was it the difference of 1 level that would have made the difference in outcome? Can we assume that with adult cases, its generally better to go longer, to be safer? The older you are, the longer you fuse?

    I tried to get my surgeon to fuse a little lower on me, T4 or T5? but he just wouldn’t do it. I asked several times. He does have specialty training in the cervical area, and knew that I would have neck issues going shorter. He was right, I'm glad I listened to him. My neck has been ok so far. No Chiro adjustments since December.... There was no dispute down low. I'm proof that having a baseball bat for a back, really isn't that bad, and that the spine is an awfully complex mechanical device for what it actually achieves.
    Ed
    49 yr old male, now 58, the new 53...
    Pre surgery curves C12,T70,L70
    ALIF/PLIF T2-Pelvis 01/29/08, 01/31/08 7" pelvic anchors BMP
    Dr Brett Menmuir St Marys Hospital Reno,Nevada

    Bending and twisting pics after full fusion
    http://www.scoliosis.org/forum/showt...on.&highlight=

    My x-rays
    http://www.scoliosis.org/forum/attac...2&d=1228779214

    http://www.scoliosis.org/forum/attac...3&d=1228779258

  13. #13
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    risk of additional surgery

    I am having fusion of T10-pelvis in October, for severe lumbar degeneration, instability, sciatica, and a 47 degree lumbar curve that increased 12 degrees in the past year. I also have a thoracic curve that is about 30 degrees and will be left untreated, but my surgeon warned me that since I am only 42 now, there is a good chance that the area above the fusion could wear out over time. There are already some minimal degenerative disc changes there. He told me if the adjacent level(s) wear out, I will then have to have a fusion extension of the entire thoracic curve, which did surprise me. I thought if the upper level(s) wore out you could just have a one-level extension--I guess not, not in my case anyway.

    Anyway, I am sorry this is way off-topic for the original inquiry about Dr Hey, but I wanted to chime in about what I was told about risk of additional/future surgery.

    Curious also, Rohrer1, did Dr Hey charge for his x-ray review? And did he give you a formal surgical recommendation/2nd opinion? Did you have to make an appointment with him before he would look at your films? Thanks!
    Last edited by leahdragonfly; 06-06-2010 at 11:48 AM.
    Gayle, age 49
    Oct 2010 fusion T8-sacrum w/ pelvic fixation
    Feb 2012 lumbar revision for broken rods @ L2-3-4
    Sept 2015 major lumbar A/P revision for broken rods @ L5-S1


    mom of Leah, 15 y/o, Diagnosed '08 with 26* T JIS (age 6)
    5/10 VBS Dr Luhmann Shriners St Louis
    5/16 6 yrs post-op, 24*T/ 22* L, mild increase in curves, watching

    also mom of Torrey, 12 y/o son, 16* T, stable

  14. #14
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    Quote Originally Posted by Pooka1 View Post
    Yes that is the perennial challenge to stabilize the spine with as few levels fused as possible. Many considerations go into this and each case is different. Both my girls had a right T curve in the high 50*s with apex of T9. When I asked the surgeon something about the two cases he indicated my first daughter was more complex and not as straightforward as the second kid. I don't know why he said it but I think the extreme rotation in the first kid may be the reason he said that. To a bunny like me, I assumed they were essentially the same deal whereas he said they were very different to correct.

    I thought you were trying to draw a distinction between the great run of pediatric guys breaking one way (perhaps not being conservative enough?) whereas the great run of guys who do adults break the other way (fuse more levels) because they have a perspective of the "future" having the adult patients for years and years as opposed to the pediatric guy who is possibly short-sighted.

    I read all of that into your short comments. Is that the point you are trying to make?
    Hi...

    I think(!) that I was trying to say that pediatric surgeons don't usually get to see the long-term results of their work, while adult surgeons see it all the time. The experience of treating patients who had fusions as adolescents or teens, makes for more technical expertise, and probably a lot more thought on the topic of selecting the appropriate levels.

    Regards,
    Linda

  15. #15
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    Quote Originally Posted by leahdragonfly View Post
    I am having fusion of T10-pelvis in October, for severe lumbar degeneration, instability, sciatica, and a 47 degree lumbar curve that increased 12 degrees in the past year. I also have a thoracic curve that is about 30 degrees and will be left untreated, but my surgeon warned me that since I am only 42 now, there is a good chance that the area above the fusion could wear out over time. There are already some minimal degenerative disc changes there. He told me if the adjacent level(s) wear out, I will then have to have a fusion extension of the entire thoracic curve, which did surprise me. I thought if the upper level(s) wore out you could just have a one-level extension--I guess not, not in my case anyway.

    Anyway, I am sorry this is way off-topic for the original inquiry about Dr Hey, but I wanted to chime in about what I was told about risk of additional/future surgery.

    Curious also, Rohrer1, did Dr Hey charge for his x-ray review? And did he give you a formal surgical recommendation/2nd opinion? Did you have to make an appointment with him before he would look at your films? Thanks!
    Gayle...

    T10-pelvis is probably the most typical fusion done for spondy patients who need revision. At least, that's what I'm seeing the vast majority of the time.

    --Linda

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