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14 yo young man w adolescent idiopathic scoliosis double 56 deg curves fixed today

T5-L3 instrumentation and fusion
Surgical time: 3 hr 10 min.
Complications: none
Ebl: 1000 cc
Correction: excellent.
Postop location: private ortho room w family

L45 spondylolishesis and lumbar spinal stenosis fixed this am

Surgical time; 2 hr 5 min.
Complications: none

Encouraging word from a nurse after spine surgery with us.

From: VICKI
Date: Thu, 19 Nov 2009 17:38:47 -0800 (PST)
To: Lloyd Hey
Subject: surgery

Dr. Hey,
Wanted to just drop a line and thank everyone involved in my care, most
especially you. This was without exception the best hospital experience I
have ever had. Your office staff, inclusive of yourself are the best. Duke
Raleigh Hospital excellent, I mean from pre admissions, the speed and skill
level are excellent, they are extremely caring people. The day of surgery
at all levels went like a well oiled machine, with a lot of caring people at
every aspect. The OR staff, Recovery, my 2nd floor nurse, PT, OT, yourself,
always seeming to show up, just the overall experience was exceptional. As
you know I am a Nurse, and probably more expecting than most, well, it was
the Best!. Would love to work for an organization like yours. I feel
really good, much less pain, but I am careful to be to hopeful since it is
so early in the recovery.

Your are without exception the best, and I will recommend you to all I know
who need your help. Thank God Pam Waldhauser sent me to you. You were a
gift from God to me, thanks! See you soon.
Thanks so much,
Vicki

Beautiful radiant new morning

Severe cervical myelopathy with arm and leg weakness and clumsiness fixed today

C34 ACDF.
Had bridging osteophytes below that shifted load to C34 level.
Good day had by all.

Leaning tower of Pisa straightened up today

Had laminectomies years ago, now in agony w severe stenosis and
degenerate scoliosis and flat back syndrome.
Fixed today w L2-iliac instrumentation and fusion w complex 4 level
revision laminectomy.
Surgical time: 4 hr 15 min.

Nice letter we received from parents of adolescent scoliosis young lady who recently had surgery with us.

November 14, 2009

Dear Dr. Hey & Staff,
lt has been several weeks since Terri’s surgery and she is doing great, just
like you said she would! We want to thank you for this whole experience.
It‘s never easy having to put your child through any surgery, especially a
child with special needs, and a seizure disorder. We were referred to you by
my chiropractor, and we are so thankful we were. From the time we met
you, we felt so comfortable with you. In our appointment you answered all
of our questions, included Terri in the conversation, and tried to explain to
her what she was going to experience. We never felt rushed in the
appointment, and your staff was above and beyond excellent! We met
almost everyone that day in the office, and everyone was so polite, and
treated us like we were old friends they hadn’t seen in a while. In the days
after our initial meeting, my husband and I had come up with several
questions we needed answers to and you told us to call you on your cell
phone about anything. We were so shocked to have a doctor give out his
personal cell number; WOW, that never happens; a doctor gives you his
personal cell phone!!! You answered every time, or called back within the
hour. We were so impressed with you and your professionalism, as well as
your personal touch. It was like Terri was your daughter going in for the
surgery. Thank you for taking personal time away from your family one
evening to speak with us for an hour about questions and concerns. You
continued to amaze my husband and me and go above and beyond. You also
spoke to Dr. Peterson and recommended that he follow Terri in her
procedure and days in the hospital to follow. When we met Dr. Peterson
prior to the surgery, we felt so good about our decision to go with you. We
would definitely tell our friends and family about Dr. Hey and The Hey
Clinic. You have a great reputation for a reason, and it showed! We Wish
more doctors would have the professionalism and personal touch that you
take pride in. It makes the patient, and their families feel so much better
about things.

The day of the surgery, of course as parents, we were extremely nervous.
We had said many prayers, as did many other family members and friends.
We prayed that Terri’s surgery went well and of course no seizures! We
were so happy that our prayers were answered. In addition to out-prayers,
you also took the time out and prayed with us before and after the surgery.
That meant so much to us, to have you take that much interest in your
patients. We never felt like, we were just another patient or surgery you had
to accomplish. God put you in our lives for a reason, and we are eternally
grateful. We could never thank you and your staff enough for the kindness,
professionalism and personal touch! Thanks to you and your staff for what
you do. you have no idea the impact you have on your patient lives and their
families. God bless you all!

Sincerely,
The S___ Family

Wow. That's a tight spinal stenosis w disc herniation!

Fixed this morning along w degenerative scoliosis.
L2-iliac wing instrumentation fusion an revision laminectomies.
Ebl: 600 cc
Blood transfused: none.
Surgical time: 3 hrs 10 min.
Complications: none.

Email from grateful adolescent idiopathic scoliosis (AIS) mom after surgery. FW: Ann Cox/Nov. 9th surgery

From: COURTNEY
Date: Sun, 15 Nov 2009 15:50:08 -0500
To: Lloyd Hey
Subject: Ann /Nov. 9th surgery

Hello, Dr. Hey!

It's Sunday so I thought I'd e-mail you, just in the event you might
check your mail,  and tell you that Annie has really turned the
corner.   She's watching a movie, has had a shower (hated every minute
of it but that's fine) and is looking much better!  She actually
laughed out loud at an old episode of Mary Tyler Moore, which made her
father's day.  Mine too.  She came home yesterday on my 47th birthday
and I've never had a better present in my life.  It was a rough first
day home but I imagine that's typical.

She still has quite a bit of abdominal distention, a lot of
discomfort, etc.,  but that seems to be getting incrementally better
too.

If I had the words to thank you, I'd say them a thousand times -- at a
minimum.

I will call your office tomorrow to schedule our follow-up appointment.

God has really blessed us with your skill and expertise -- not to
mention your perfect bedside manner and concern for our whole family.

Love from our whole family,
Courtney


------ End of Forwarded Message
Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
http://www.heyclinic.com

Reflecting on the week and Life as a Precious Gift.

Memorable moments from this week, (besides the fact that a teddy bear was named after me by Ann!)

Retired general surgeon giving me a real big “thanks” and “addaboy” this morning for being aggressive when he arrived quite sick a couple nights ago to take action to check his back for possibly infected wound hematoma and possibly infected knee. It turned out that he had bad case of pseudogout, and no evidence of infection, but he was grateful that I did something quickly to get him relief without ordering tons of tests which could have been painful and delayed his treatment and eventual recovery. I was really touched by his very sincere, and even forceful recognition of the tough decision-making I had to make, and after his 35+ years as a general surgeon, with me much to his junior, I appreciated his words of affirmation and encouragement.

We’ve been swamped with physician, dentist, nurse practitioner and nurse patients and family members this past few weeks. One evening this week, I had a total of 7 such healthcare professional patient and family members on evening rounds! I had 2 pair of physician-daughter physician combinations and a husband/wife dentist duo for starters. We could start our own clinic! It’s actually been really cool and rewarding to care for this group of people.

My PA Jenny and I were really missing Brittany this week who is at NASS. The workload in clinic, hospital and the operating room is always better spread out over 3 of us rather than 2, but we got through the week with smiles and sharing the load. They whole Hey Clinic staff also pitched in to help things run smoothly to make sure Brittany’s calls were answered, images read, and emails checked.

I also got to see the boy I fixed a few months ago from the Philippines who had the arthrogryposis and scoliosis and severe hypokyphosis or thoracic lordosis which made his chest cavity extremely thin — too thin for growing heart and lungs. He’s doing just great, and his family has decided to move to Arkansas! Best Wishes, JohnPaul!!! JohnPaul plans to be a doctor some day, and may choose to work for Hey Clinic! He’s a driven young man.

I got a lot of very positive feedback on some of my blog writings this week via Facebook and via email. That’s encouraging as well, since I never received great teaching from my public high school English teachers, and went to engineering school for college, where I wrote software and solved engineering problems, but did not grow as a writer.

But every day I feel that I do meet some wonderful people, and am blessed to be a part of the healing and life journeys for many people that makes life powerful, and leads to further learning and joy. It seems right to share some of these special experiences with others. I want to write them down so I don’t forget them, and so I can hopefully be more in tune each day to recognize the small miracles that are always going on, but we often miss.

My wife and I enjoy watching some of the reality tv shows now and then on the Learning Channel (TLC), where families with 18 or 20 kids live out their lives on TV, or “Little People” families share their experiences and challenges. One of my friends Bill Hayes produces these shows, and his company once filmed me and one of my scoliosis patients years ago at Duke for the Discovery Channel show called the “Hospital.” --- That was my big experience on TV, with surgery and clinic being filmed. My wife and I were discussing tonight why these reality shows seem to be so appealing. I think it is because people and life is incredibly interesting, especially when you get to look into a world which is challenging and so much different than your own. I know my daily life is quite a bit different than most. Intense. Rewarding. Stressful. Full of decisions, setbacks, unexpected joys, and always tons more to learn. But what really makes my daily life special is the precious people that cross my path anew, and the precious people I get to live with, love with, work with and learn with every day. Every life is precious. Infinitely precious. Every day we get to spend with other people is also extremely precious. Grab it. Experience it. It’s a gift.

Seeing JohnPaul’s family’s big smiles today in clinic, and a couple of previously severely myelopathic patients walking down the hall with a stable gait makes me just thank God for chance to be here, and to be a part of these people’s lives — trying to help ensure or restore quality of life for many years to come. It’s a gift.

In fact, most mornings before I get out of bed, I thank God for the the new day, and thank Him for another day to be alive and to serve Him and others. I know quite clearly that every day is indeed a gift, because 31 years ago I could have easily died in the street or in the hospital after being hit by a car and being severely injured. God spared my life for a reason, and at least part of that reason is to serve. We always seem to appreciate things more when they are taken away, or almost taken away.

Life and time are both precious gifts often taken for granted that we all need to enjoy and share with others.

Have a great weekend.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
http://www.heyclinic.com

Teenage Molly from Michigan doing great still after kyphosis surgery. Email from her mom.

From: Lysanne
Date: Wed, 11 Nov 2009 01:10:30 -0500
To: Lloyd Hey
Subject: Molly update

Hello Dr. Hey,

How are things in North Carolina?  Things are great here and Molly is doing fantastic.  She just finished a season on the swim team for Hackett Catholic Central High School in her freshman year.  She is amazing....after her 13 level spinal fusion.  Wearing the swimsuit bothers her not at all!  I even call her "zipperback" for the obvious reason and "Supergirl" because she's made of steel! I've even enclosed some recent pics!

Lysanne
Kalamazoo, Michigan

---------------
Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC  USA

Pat's adult scoliosis and "heart" story, sent up from southern Florida

From: Pat
Date: Mon, 9 Nov 2009 17:46:49 -0500
To: Dr. Hey
Subject: my story - hope you get it!

November 2009

Dear Dr. Hey and staff,

It has taken me quite a while to be able to sit down and write my feelings about the miracle that has taken place in my life. The miracle, of course, is the back surgery that you were able to perform on my 56 year old back.

As long as I can remember I had always known that I had scoliosis. But I always had known it was something I should not discuss or complain about. And so I never once said one word about it to my family and if someone ever brought it up it was immediately dismissed. It was a sort of secret.

I suppose the thought of surgery was just too much to bare for my parents. Back in the days when I was diagnosed, the surgery was relatively new and I would have to be in a body caste for a year. And so, my life went on ignoring the issue. Unfortunately, it trained me well to deny and ignore many things in my life as I am now discovering. Although, I have been very happy in my adult years, marriage and a successful career, there was something always nagging at me. My confidence and self esteem were always a struggle but I managed to overcome those and other obstacles despite my inadequacies.

And then, I discovered that my faith in God was also inadequate. I began going back to my church and reading the bible. I began to feel stronger and more confident. And then one day I said to myself, “I am going to confront my fears and get to the core of my problems.”  which I knew was my back. As I was aging I was noticing my body changing, my clothes were fitting strangely and I was thinking that my ribs were closing in on my pelvis. I was beginning to get scared. I mustered up the courage and opened discussions about all of this with my husband and we began researching scoliosis and researching our options. We started with our primary doctor who referred us to a doctor at a major teaching hospital. Our visit with him was quite discouraging and we walked away realizing he did not want to do surgery on me. He suggested physical therapy. Then we went to another well known hospital and we basically got the same diagnosis. By now, we were discouraged and more frightened for my future having learned a lot more about the complications that could happen later on in life.

One day I was on the internet and I came across your website and read about your story. I realized then that God had guided me to your site and a peace had come over me. I was finally on the right track! I gathered up my MRI and x-rays and filled out the forms and before I knew it, we were talking on the phone discussing my situation. At that point I felt HOPE, something that was foreign to me. God was guiding me along and I was going for the ride. I really didn’t have much apprehension, because I knew it in my heart it was right.

Even though the surgeries were tough and the recovery tougher, I am emotionally stronger, taller and happier than ever.

How can I thank you for what you have done for, not only, me but for my whole family? Because of this surgery we have all become closer and more honest with each other. The truth does set one free. The whole dynamics of our family has changed and it is all because of your ability to help people like me.

I only hope that I was able to express my gratitude in a way that tells how I feel. I thank God every day that I had this chance to renew my life.

And so, this is my story, my testimony, my personal miracle.

God bless you,

Pat

-------------------------
Pat -
Life is definitely a journey.  
Facing and working through challenges can be the catalyst for not just physical, emotional, career, and/or relationship changes, but  transformations of heart.
Thanks for sharing your heart with us at Hey Clinic, and with our many blog readers with your permission.

You have encouraged all of us.

Lloyd A. Hey MD MS
Hey Clinic for Scoliosis and Spine Surgery
Raleigh, NC USA
http://www.heyclinic.com

FW: THANK YOU! Encouraging email from daughter of our surgery guest from yesterday.

------ Forwarded Message
From: Michelle
Date: Mon, 9 Nov 2009 23:15:44 -0500
To: Lloyd Hey
Subject: THANK YOU!

Dear Lloyd,

Words cannot express how grateful I am for your professional and personal care toward my dad today.  My dad is quite a character (which you will experience over the next few days) and has a heart that is tender and deeper than most men I know.  It has pained me throughout the months to see him suffer and to watch his level of activity decline so rapidly. Thank you for spending time with us in clinic last week and for working him into your schedule so quickly.

It has been a pleasure to learn more about you through your website and blog and to see how God has used your accident at 16 years old, your incredibly gifted intellect, and your heart for people to give you this wonderful  spine surgery ministry.  May God continue to bless you, your family, and your practice.

Thanks again!
Blessings,
Michelle

"Dr. T" and "Dr. Chika" head back to San Francisco, then home to Tokyo

2 or 3 weeks ago, I got an email from “Dr. T”, a physician from Tokyo, Japan that I had fixed his lumbar spine back at Duke Medical Center several years ago.  He did great for many years, playing tennis, etc, but over past few months had developed severe clumsiness in both legs, to the point where he was having trouble walking.

A couple weeks ago, after getting up extra early at 4 am, I sipped on cup of coffee, and was answering some patient emails, before going off to exercise.  While I was sitting there, up popped email from “Dr. T” -- outlining his progressive troubles.  He was surprised that I emailed him right back at 4am!  He then emailed me the MRI images that allowed me to see the problem, with two areas of tight pressure / stenosis on thoracic spinal cord above his previous lumbar fusion, which could explain his progressive myelopathy.

I offered to send him the special wrenches that he would need to have surgeons in Tokyo fix it there, or set him up to have surgery with one of my SRS colleagues in San Francisco, where his daughter Dr. “Chika” lives, but he chose “Choice C:  Come to Raleigh and have Dr. Hey Fix it.”

Our Hey Clinic team got to work right away to make necessary arrangements.
We even coordinated his return travel to San Franciso to recover at Chika’s home to coincide with the beginning of the North American Spine Society (NASS) meeting, so that my OR nurse Kelly could actually be on same airplane as Dr. T to help with transportation before we knew that Chika could get the time off from work to come out for his surgery, and travel back with him.

When I saw him in clinic last week, it was great to see him again, but his gait was quite bad with severe clumsiness.
His surgery late last week went great, and his walking is already much stronger and more stable.
Today, Chika and Dr. T gave me a couple of generous presents, and we took our picture together with my iPhone before they headed off for the airport at RDU (15-20 minutes away).

Get well soon Dr. T, and keep in touch.  Chika:  good to see you again, and stay in touch.
Kelly: thanks for being willing to accompany them on the trip out, and enjoy the NASS meeting with Brittany!

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
http://www.heyclinic.com

14 yo Ann gets her wish for a "straight as possible" spine with scoliosis surgery. Tears of concern / Tears of Joy.

First thing this morning, I met with 14 yo Ann and her parents in the preop area at Duke Raleigh Hospital.
Ann had a severe adolescent idiopathic scoliosis (AIS).
Ann introduced me to her new little bear, wearing a Duke Raleigh Hospital blue sweater.
She told me that she named her new bear "Lloyd", after me! How cool is that? I felt really special that she would choose to name her bear after me, even using my first name rather than the more formal bear name, "Dr. Hey". Teddy bears I think prefer to be less formal, more personal I guess.

I then asked her this morning: "How straight do you want to be?"
Her answer: "As straight as possible!"
We shook on it, and I promised to get her as straight as I could! She smiled.
After sharing a short (optional!) prayer together, I could see that her dad had a tear in his eye. I shook his hand, and let him know that I would take excellent care of his daughter. With a teenage daughter of my own, I could definitely put myself in his shoes. This is intense stuff. Really important stuff.

As I walked out of preop, and up to round on my patients upstairs, I took a moment to reflect on the way in which I get to connect with my patients and their families each day in such an intense way, discussing big surgeries, getting ready for big surgeries, and seeing love at work between parents and children, spouses, brothers and sisters, and good friends. This is an intense life, sometimes stressful life, but it is very, very real, and very powerful, and very moving. I'm so thankful to have opportunity to serve in this way, and to be involved in this web of relationships that really matter every day.

Her surgery went great, with an awesome correction, very little blood loss, and about 3 hour surgical time.
I used a couple new techniques that I have been perfecting for better screw placement and better correction using some special "pursuader" techniques with simultaneous rod insertion and derotation. These new techniques are really bringing some better corrections. Very Cool. I love to learn and innovate and improve these techniques.

After surgery, I came out to see Ann's mom and dad, and both sets of her grandparents were there as well.
I held up the X-rays shown below, with the before and after so that mom and dad could see them.
I could actually see both of their faces through the X-ray, and I could see that they both began to weep.
Weeping not for concern for their daughter going into surgery, but weeping for joy and relief.

Tears of loving concern.
Tears of joy and relief.

This evening, after my second surgery, I went up and saw Ann and her mom in her room. She's doing great, and gave me a HUGE smile, knowing that her wish had indeed come true: she was indeed "as straight as possible."

Her bear, "Lloyd", was next to her, wearing a surgical mask, and keeping a close eye on her recovery.

Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
http://www.heyclinic.com
Check out Scoliosis Research Society (SRS.org) website.

Ann gets her wish for a "straight as possible" spine with scoliosis surgery. Tears of concern / Tears of Joy.

First thing this morning, I met with 14 yo Ann and her parents in the preop area at Duke Raleigh Hospital.

Ann had a severe adolescent idiopathic scoliosis (AIS).

Ann introduced me to her new little bear, wearing a Duke Raleigh Hospital blue sweater.

She told me that she named her new bear "Lloyd", after me!  How cool is that?  I felt really special that she would choose to name her bear after me, even using my first name rather than the more formal bear name, "Dr. Hey".  Teddy bears I think prefer to be less formal, more personal I guess.

I then asked her this morning: "How straight do you want to be?"

Her answer: "As straight as possible!"

We shook on it, and I promised to get her as straight as I could!  She smiled.

After sharing a short (optional!) prayer together, I could see that her dad had a tear in his eye.  I shook his hand, and let him know that I would take excellent care of his daughter.  With a teenage daughter of my own, I could definitely put myself in his shoes.  This is intense stuff.  Really important stuff.  

As I walked out of preop, and up to round on my patients upstairs, I took a moment to reflect on the way in which I get to connect with my patients and their families each day in such an intense way, discussing big surgeries, getting ready for big surgeries, and seeing love at work between parents and children, spouses, brothers and sisters, and good friends.  This is an intense life, sometimes stressful life, but it is very, very real, and very powerful, and very moving.  I'm so thankful to have opportunity to serve in this way, and to be involved in this web of relationships that really matter every day.

Her surgery went great, with an awesome correction, very little blood loss, and about 3 hour surgical time.

I used a couple new techniques that I have been perfecting for better screw placement and better correction using some special "pursuader" techniques with simultaneous rod insertion and derotation.  These new techniques are really bringing some better corrections.  Very Cool.  I love to learn and innovate and improve these techniques.

After surgery, I came out to see Ann's mom and dad, and both sets of her grandparents were there as well.

I held up the X-rays shown below, with the before and after so that mom and dad could see them.

I could actually see both of their faces through the X-ray, and I could see that they both began to weep.

Weeping not for concern for their daughter going into surgery, but weeping for joy and relief.

Tears of loving concern.

Tears of joy and relief.

This evening, after my second surgery, I went up and saw Ann and her mom in her room.  She's doing great, and gave me a HUGE smile, knowing that her wish had indeed come true:  she was indeed "as straight as possible."

Her bear, "Lloyd", was next to her, wearing a surgical mask, and keeping a close eye on her recovery.

Dr. Lloyd Hey

Hey Clinic for Scoliosis and Spine Surgery

http://www.heyclinic.com

Check out Scoliosis Research Society (SRS.org) website.

IMG_0022

 

Talk Given to School Nurses

Slideshow of a talk given to school nurses about spine health in children and adolescents: http://gallery.me.com/drhey#100150

IPhone X-Ray!!!

Dr. Hey
Hey Clinic for Scoliosis and Spine Surgery

What does a iPhone look like on X-Ray?

Here it is, next to a lumbar decompression and fusion!

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Pisces tattoos designs

Pisces tattoo designs are quite flexible in that the universal symbol of this sun sign is two fish. These fish, called Ichtyes by the Greeks, are commonly represented in a yin yang style – each fish head followed by the other’s tail forming a circular shape. Besides fish, there are numerous other sea creatures that can be incorporated into Pisces tattoos to create a more personalized design: twin dolphins, whales, sharks, sea horses or mermaids for example. Pisces tattoos commonly include this zodiac’s glyph symbol. Mirroring the double fish pattern, the Pisces glyph has an "H" shape in which the two vertical lines bend toward each other in the middle while bowing out at the tops and bottoms. The simplicity of this symbol lends itself to limitless design possibilities. For example, women seeking more feminine Pisces tattoos may choose designs featuring roses intertwined with the glyph while men may prefer snakes slithering up the glyph. The Pisces zodiac is a water sign that reveals a dreamy, gentle, affectionate, compassionate and deep nature. However, Pisces individuals are noted as having dual, or split, personalities: silent then highly talkative, happy then very unhappy, lazy then highly motivated. If this sounds like you then go ahead and get the design inked.
View pictures of Pisces tattoos. Find out the different meanings behind the Pisces sign and learn what designs can be incorporated into Pisces Tattoos.

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Link Freinds

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Gangsta tattoos Designs

A gang sure have tattoos for symbol. many symbol tattoos gangsta for save in your pc if you want. in this site you can find free. this Gangsta tattoos ....Gangsta Tattoos | Many people find that it is very easy to look and feel tougher with their own customized Gangsta Tattoos . The hard part is often times the process of finding the best design to fit your image.

You must keep in mind that the Gangsta Tattoos design that you select will be with you for many years to come, so it is important for you to take your time. One mistake that a lot of people make is that they would pick a Gangsta Tattoos design that relates to another person like a friend or girl friend. What happens if you break up from the girl friend? It is mush easier to pick a design that doesn't relate to a person.

Pick a design that makes a personal statement about you. What would be the point of picking a Gangsta Tattoos design that is common in the market. You want a tattoo that defines your fillings and general outlook in life. Many shops only offer designs from their in house artist's, that may not be as vibrant as some other alternatives. The last thing you would want to do is purchase a design that hundreds of people already have. You are trying to make a personal statement that you are not like everyone else.

Making the final selection is one of the hardest things for a person to do. There are thousands of designs to choose from. Your Gangsta Tattoos can be designed specifically for your type of personality and views of the nation. You should pick an art style that tells a story about your life. If you are not completely happy with your selection, start over and find a design that you love.

For many years tattoos have offered many individuals a way to stand out in a crowd of many people. A design should be unique to you and it should reveal some of the most outstanding areas of your life experience.

Gangsta tattoos Design " japanese girl bathing tattoo"

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