Store to get rid of your nerves

Recently a store opened, within a shopping centre in the city of Shenyang (China), where customers can enter and brake whatever they want and anything they can find within the shop in order to get rid of their nerves. However this store allows only women to enter. That is why the shop is decorated as a house and the items are placed in such a way to reflect this atmosphere. Thus they walk into the living room and brake the television, in the kitchen to smash the plates (opa)...

The items are actual items, not fake in any way, which are bought cheaply. However if the customers spend more than 38 yuan in the shopping centre they get a free go in smashing what they want. This might be relaxing for some people and could truly get rid of nerves, but I cannot help think that in a way it promotes violence, as being one option of solving any problem. 

Travelling to the centre of the earth

Jules Verne's story will soon be realised by a team of British and French scientists, who will try to travel as close to the earth's core as possible. Their goal is to conduct drilling for the first time towards the earth's core, specifically reaching the mantle layer. The scientists come from Southampton and Montpelier. 

The excavation of rocks from this region will greatly help the scientists understand the way with which our planet was created. The project is programmed to commence in 2018, at some point in the depths of the Pacific Ocean, where the external layer is thinner, making the process easier to achieve. The specimens found at the mantle layer will most probably contain most if not all of the rocks found on our planet. The results found from this research will help understand the Earth's past and seismic activities. 

Geologists in past eras tried to achieve this goal, of reaching the mantle, but with no luck. The main reason being that the technology used was not strong enough to withstand the enormous pressure and temperature, which was about 300 C. However any myth or false fact which has existed for decades will cease to exist, after and if this project is successful.

Amazing Photos from Space

NASA astronaut Douglas Wheelock, who is currently aboard the International Space Station, has shared some of the pictures he has taken from space of the world. He has shared these pictures through Twitter, which is a way of communicating with our planet, since the space station where he is located has internet access. He has currently more than 105.000 followers on Twitter. 

Italy and Malta is seen here. Lovely lights during a summer night.

Florida and South-Eastern U.S.A. in the evening. 

Eastern Mediterranean.  

The Northern lights in the distance are evident here, one of the finest nights over Europe. Paris and other French cities are clearly seen. A fog is seen over London. 

The beautiful and colourful Bahamas. Also part of the space ship is photographed here. 

The astronauts travel at a speed of 28.163 kilometres per hour (8 kilometres per second), they rotate the Earth's orbit, making one revolution every 90 minutes and watch sunsets and sunrises every 45 minutes. This means that half of the journey is in darkness. 

A beautiful Pacific Ocean island, south of Honolulu. 

Eastern Mediterranean, reflecting the sun. Cyprus, Turkey, Greece, Israel, Lebanon and Palestine are seen here. 

Over the Sahara desert, approaching the ancient lands and thousand years of history. 

Night view of the River Nile, stretching like a snake through Egypt to the Mediterranean. Its interesting to see how most of the lights in Egypt are surrounding the Nile.

Greece as seen from the North of the Balkan region. Athens and Thessaloniki are the two shiniest cities in this picture. Douglas quotes " Unreal feeling arises when one sees the beauty of the ancient earth from space".

Astronaut Douglas Wheelock

Alexander the Great's final wishes

A story, which many believe is a mythical one but still obtains its importance, refers to Alexander the Great's last moments. Just before he died, the Macedonian King called all his generals and he informed them of his final 3 wishes. 

1. His coffin is to be held by the best doctors of his time. 

2. The treasures he had won (including silver, gold, valuable stones) should be scattered on the way to his tomb. 

3. His hands should be left to wiggle in the air, outside the coffin, for everyone to see. 

One of the generals surprised by the king's obscure requests asked the reason why he asked for these 3 final wishes. 

Alexander then replied:

1. I want the best doctors to carry me, in order to emphasise how they do not even have the power to cure, when it comes down to death. 

2. I want the treasures to be scattered on the way so everyone can see that the treasures won here remain here. 

3. I wish my hands to wiggle in the air, so people can see that we come and go from this life with our hands empty, when the most valuable thing we have ends, i.e. time. 

This is a very important teaching given to us by Alexander. Time is one of the most important gifts we could have, since it is limited. We can gain money, power but not more time. That is why it is important to have, as my father tells me all the time, TIME MANAGEMENT. When we give someone our time, we inevitably give them part of our life. 

Dr. Hey's past week in review. Biomechanical Models, Tinkering, and Adolescent Scoliosis at Age 40.

All 4 of our adolescent idiopathic scoliosis surgery patients went home by Friday this week, having had their surgery Mon-Wednesday! Great families, and all very pleased with the care they received at Duke Raleigh Hospital. My daughter actually helped film David's surgery, and provided a copy for him and his PreMed Sister as they headed home to Winston-Salem. She literally narrated the video, asking me lots of questions, just like they did when I was filmed for the Discovery Channel doing scoliosis surgery at Duke Medical Center years ago. What a joy it was to have my daughter with me psyched to watch me at work. I will never forget that day. It was like my "home world" broke into my "work world" -- it felt almost like a dream!

When my daughter was very young, maybe 4 or 5 years old, used to come on rounds with me at Duke University Medical Center, and used to make get well cards for every single one of my patients in the hospital. She would ask me as we were driving into the hospital "Daddy, how many patients do you have in the hospital?" I would say "7". She would carefully count out 7 pieces of blank paper, then carefully make up a card for reach one, with picture on front and inscription inside which would say "Get Well Soon. I love you. " After we finished rounds, we would always go for a ride on the electric train which connected Duke North with Duke South. She would ride up front and we'd pretend we were at Disney World riding the Monorail!

Well, now that little girl has grown up, and is getting a chance to see what daddy does in the operating room, as she considers serving others in the future in the healthcare field.

I spent a lot of time with a very nice 40 yo woman with a 56 degree long right thoracolumbar curve. She was at Hey Clinic with her husband seeking a second opinion regarding her painful, and possibly progressive scoliosis. She was diagnosed with scoliosis as a teenager, braced and never had surgery. She thinks her curve was around 25-30 degrees when she was done growing.

She did well for many years, but over past 8 years or so has noted increasing lower back and mid back pain. It has increasingly affected her quality of life, so she cannot kayak, take long walks, garden and do some household chores. She thinks her posture may have changed a bit with a bigger hump appearing on the right.

We spent a long time going over all of her films, and carefully measuring all of them and putting them into our database and special scoliosis electronic medical record (EMR or EHR for Electronic Health Record).

We talked about importance of tracking the curve over time. Her curve has progressed 8 degrees over past few years, which is more than the expected 1 degree per year for most curves if they are progressing.

She came into clinic very concerned about risks of surgery, but was also very concerned about the risk of doing nothing, since her quality of life now is not acceptable, and things seem to be progressing.

We answered all her questions, and she's going to think things over. We took over an hour with her, showed all her films up on big screen and discussed in detail what were the benefits vs. the risks of doing scoliosis surgery now as opposed to later, or not at all.

This couple really seemed to appreciate the time my physician assistant and I took to go over her particular situation, and equip them with the information they need to make an educated decision now, or sometime in future.

This also illustrates importance of screening for, and following scoliosis in younger people, especially during the adolescent and young adult years. If this woman would have had her scoliosis fixed years ago before the lowest levels of her spine became degenerative, we could have more likely fixed it with a shorter fusion, preserving the bottom 2-3 discs. As people get into their late 30's and 40's, often those lowest discs have degenerated so much that they must be included in the fusion -- not the end of the world, but it sure is nice to have "a stitch in time that saves nine!" - or that saves some mobile disc spaces.

Also saw a bunch of our smiling teenage scoliosis patients back for follow-up from the large group of adolescents we "straightened up" last summer! They all looked great, and were very happy and very smiley and VERY active with sports and camps and dancing.... What a joy it is to care for any patient, especially these younger folks.

Saw a 26 yo woman who has a collapsing scoliosis almost 90 degrees now 13 years after having her adolescent scoliosis surgery performed elsewhere, which was complicated by intra-operative loss of evoked potential monitoring and wake up test with paralysis. They took out all the hardware and just put in bone graft. She woke up paralyzed, but has made remarkable recovery since then, able to ambulate with cane but some remaining spasticity. Unfortunately now she has severe pain and deformity, since the curves have continued to progress since the fusions done without instrumentation have high likelihood of progression. We're getting CT scan to check quality of fusion, and to take closer look at cause of her progressive pain.

Did urgent/emergent surgery yesterday on woman with progressive spondylolisthesis above scoliosis fusion. Came up with a new technique for correcting kyphosis in both the cervico-thoracic junction and thoracic spine at the same time using a specially contoured "U-Rod" --- using technique similar to Luque Rod technique, but using Zimmer Universal Clamps. She got an excellent correction of deformity, excellent relief of pain, and went home today! In order to create this special U-Rod, I had to do a very special bend using my big vice I brought in from home, and a piece of pipe I bought from Lowe's Hardware Saturday morning that I used as a lever to help make the proper U bend that I needed to match the cervical spine. I then contoured the rod into the proper cervical lordosis and thoracic kyphosis. Once the rod was contoured, it was washed and sterilized and was ready for surgery! This single rod was then placed with the top of the "U" up at C4, and the 30 cm lengths coming down over the thoracic spine. It was attached using the Universal Clamps and the pedicle screw instrumentation.

The overall surgery took about 5 hours, with about an hour and a half setup time. I spend A LOT of time preparing for this surgery, doing drawings, talking to instrument reps, and mentally going over each step of the surgery in my mind. I learned this mental preparation from my Dad, who is a flight instructor, who encouraged me to mentally practice landings and other maneuvers in my mind even before I got into the airplane. It really helped. Friday evening though, at dinner, and even later that evening and night, I could tell that my mind was still churning, working out all the details, and "what if''s" --- woke up even that night going over things one more, until I had it just right.

Really appreciate my physician assistant Rachel staying all day to help, and the excellent staff at Duke Raleigh Hospital who worked together with me as well. We all had a good time together, and got a great job done and really helped relieve some suffering while preventing bigger problems that were brewing, including a spinal cord pinch at the level of the spondylolisthesis.

What a joy it was to see her this morning with her husband -- both with a big smile, as she showed off how well she could now move both arms up over her head without any pain.

As many of you know, I started "tinkering" at a very young age, fixing just about anything: lawnmowers, go-carts, outboards, inboards and more. That led to me "tinkering" with the Hoffman external fixator on my left leg which was not strong enough to hold my complex Grade IIIB tibia fracture still -- leading to new design using triangular structure which was much stronger and helped it to heal. This led to my desire to combine engineering with my patient experience to help future patients who had complex problems as I did, which set my course throuth MIT Engineering, HST Program at Harvard-MIT, and Harvard for Medical School, Residency, Chief Residency and Fellowship at Boston Children's Hospital.

This week we also helped out a young lady who had a pseudarthrosis of a scoliosis fusion. Using our biomechanics lab at NC State with Professor Andre Mazzoleni and his graduate student, we were able to create a finite element computer model using this patient's spine parameters, and were able to measure the relative strength of revising her fusion using anterior ALIF technique vs. TLIF technique. This interesting research revealed that we could get very close to the ALIF strength, but with the much less invasive TLIF technique if we focused on getting the TLIF as far anterior as possible. This would also have comparable strength to the XLIF technique. So, we were able to use the lab to help a physical therapist patient and her MD husband to make a very educated choice on which way to go with their surgery. The TLIF technique worked great, and she went home after just 2 nights in the hospital feeling great!

Many thanks to Professor Andre Mazzoleni and his grad student from NC State University Dept Mechanical Engineering who put in countless hours to create this new computer model to help us in our decision analysis. Look forward to further research together with you which will help patients and surgeons in the future.

After all this, I was pretty darn tired by last night. Got home about 6:30 pm, and had restful day today after rounding this morning at Duke Raleigh Hospital. Slept in til 7:20, Rounded at Duke Raleigh Hospital, had good church service with family and lunch out. Caught up on some things around the house, took a long walk, had a swim, and caught up on email and the Blog!

Hope you all have a great week and a great 4th of July.
We have a busy week coming up, and hope to send you an update later this week before the long weekend.

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

Flat Back Syndrome Young Lady Tells Her Story after Anterior / Posterior Reconstruction at Hey Clinic

This past week was a real busy and exciting one at Hey Clinic, after having a very nice week off the week before. We saw many thankful smiling faces in clinic on Thursday and Friday, including this woman and her husband. She had an anterior-posterior (A/P) reconstruction for flatback syndrome including L45 L5S1 ALIF, and posterior L1-Iliac wing instrumentation and fusion with bone grafting and osteotomies. She is now a few months postop, and shares what a difference the surgery has made in her quality of life. This patient is now I believe in her 30's, and had instrumentated fusion as teenager for adolescent idiopathic scoliosis (AIS), and then had hardware removed. She subsequently developed the flatback syndrome with progressive pain and difficulty walking.

She gave her permission for us to share this video with all of you!

Take care,
Dr. Lloyd Hey
Hey Clinic for Scoliosis and Spine Surgery
http://www.heyclinic.com
Raleigh, NC USA

Did you know the BOOK?

I can't imagine a world where a book and the idea of a book does not exist. Mankind has used it for millennia in order to achieve the highest possible level of knowledge. Without it history, tradition, religion, philosophy, politics and in essence our whole history would have been very different to what it is. However, even its non existence in the future will result in a more and more electrical based knowledge, where everything is on-line, altering the way with which knowledge is passed down to the pupils and students at both school and university. Although this is currently evident through the existence and prevalence of the i-books (kindle), the smart phones etc. Lets hope that the platonic idea of a book, which exists in the world of ideas will also exist in our world for centuries to come. 

The most popular names in Europe

Its funny how many people have the same name within certain regions and countries. According to Facebook the most popular names within Europe, both for men and women are:

MEN

WOMEN

However this is a general research result. For example in Greece the two names given are Giorgos and Maria, but in many regions and islands you would find other names, such as Manolis in Crete, Gerasimos in Kefalonia, Dimitris in Thessaloniki. In the UK other names are found in Wales, England, Scotland and Northern Island. This of course is evident in all countries around the world.   

Celebrities portraits without make-up ( part 2 of 2 )

Adverts on Benches

Now anyone can see advertisements everywhere. One example is advertising on benches, which evidently are unique. Where else will they find to advertise in the future? Enjoy the nice and weird adverts.

Syntagma Square Metro

It is evident that Greece will be the centre of attention for the next months if not years, due to the economic crisis that has hit the Mediterranean country since the global economic crisis in 2008. Because of this I though I'd write about the capital's central Metro Station, in Syntagma Square, where all the riots take place. This is an important place, seen as one of the reasons for Greece's economic downfall, i,e, the establishment of the Metro system in the Greek capital due to the Olympic Games of 2004. 

Needless to say that once you start digging in the centre of Athens you will most probably hit on something of historical value. As a result, in an unprecedented move, teams of archaeologists worked alongside the metro engineers for years in what became not only Athens' first subway, but also the largest archaeological excavation in the city's history. Tens of thousands of artefacts were discovered and the end result is both a greater knowledge of Athens' buried history and metro stations which double as museums. 

Syntagma Square is the stop for the Greek Parliament and the city's centre. In ancient times this area lay outside the city's walls; it was a natural location for cemeteries. The station, which is also a museum, exhibits several finds, including grave goods and ancient Greek plumbing. Visitors can clearly see the myriad layers of human history at this site, including Byzantine, Roman, ancient Greek and finally prehistoric periods. Also the open grave of the ancient necropolis which existed here originally is evident. However it does not only have ancient monuments, it is a place where many exhibitions take place, making it a cultural centre, combining the ancient and the modern!

The Tournai Marble Font, Winchester Cathedral

The Tournai Marble Font, situated within Winchester Cathedral, is one of its great treasures. It is believed to date back from the second half of the 12th century. Henry III (Henry of Winchester), the son of King John, was baptised in this font in 1207. It remains the only font in the cathedral, used till this day. 

The stone used is often described as Tournai Marble; however it is not a marble in the modern sense, but the term was used in medieval times for a stone that took a polish. The Winchester font is one of seven of its type, with its square upper section, to be found in England. 

The visual imagery in the stone, glass and wood of medieval churches were major media for communicating with the largely illiterate population. The carvings on the font are part of this tradition, which in Eastern Christianity is evident through the icons, considered to be the books of the illiterate. On two panels of the font are depicted legends associated with St. Nicholas, who is venerated in both East and West. 

The picture here illustrates probably the earliest story associated with the Saint. An impoverished nobleman had three daughters for whom he was unable to provide dowries, and whom he was about to abandon to a life of prostitution. They were saved from this fate by the Saint's secretive gifts of three bags of gold, which he said to have thrown through the window of the nobleman's house at night. Due to this story Saint Nicholas is identified as Santa Clause in Western Christianity. 

In the other two panels symbolism is evident through the depiction of animals, such as the dove and the salamander symbolising the Holy Spirit, as was promised in the Gospels, "He will baptise you with the Holy Spirit and with fire", (St. Luke 3, 16). 

Back from Vacation. Scoli Camp Week In Full Force!

I was on vacation last week celebrating 25th wedding anniversary.  Great break.
This week we’re doing “Scoli Camp” at Duke Raleigh Hospital, with 4 adolescent scoliosis and kyphosis surgeries already during our first 2 days!
Patients are doing well postop, getting up and around.  
One of my 15 yo patients who had very severe kyphoscoliosis gave me a big smile right after surgery since she could feel that her back was sitting comfortably on bed for first time in years!!  She had an 80 degree kyphosis, probably Scheuermann’s kyphosis, combined with 42 degree scoliosis!

Yesterday also fixed up a 17 yo young man with severe 68 degree progressive right thoracic adolescent idiopathic scoliosis.  His curve was SO MUCH STIFFER than the 15 yo girl I fixed yesterday afternoon, who had a smaller curve.  It really does help to fix the curves when they are smaller, and a bit younger to take advantage of the increased flexibility, less rib deformity, and easier/safer and more complete correction.  Sometimes people put off scoliosis and kyphsosis surgery due to concerns about playing sports.  With modern instrumentation and fusion techniques, we can get people back to sports fairly quickly, including golf, lacrosse, cheer leading, soccer, baseball, softball, and even highly competitive diving and swimming.


Had a real joy of having my daughter looking in on surgery for past couple of days — she’s been very enthusiastic student.


Have a great week!

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

Ancient Egyptians discovered prosthetic medicine

The first prosthetic evidence (two technical foot toes) were constructed in ancient Egypt, according to the magazine "The Lancet".  The evidence found of the two toes, dated before the 7th century B.C. show how they were used not only to complete the physical integrity of the mummy but actually for the better walking process of the patient. 

Experiments took place in order to identify the usefulness of the prosthetic parts, which gave positive results. Evidently this part of medicine (i.e. prosthetic toes) finds its origins in Egypt before the 7th century B.C., whilst a prosthetic leg dated back to the 4th century B.C., found in a Roman tomb in Santa Maria di Capua, was until now considered the most ancient prosthetic limb. 

Waiter Robots

On this blog I wrote here about the robot teachers in South Korea. Now a new invention has produced the waiter robots in a local restaurant in Eastern China, where they are responsible for waiting and entertaining the customers. They always serve with a smiley face, they never loose their temper (especially with demanding customers) and of course they never expect a tip. Whilst the customers eat their food they also enjoy the robot's dance, which dances to the rhythmical eastern background music.

The question is what do people prefer? A human who has his ups and downs or a neutral robot that merely repeats what it has been programmed to do. What happens when a special circumstance occurs? Then do they call for the human to resolve it? Modern Technology has achieved many things, however some technological inventions are unnecessary. 

The healthiest fruit

Its very important we consume a substantial amount of fruit on a daily basis. They have many vitamins that we need and which contribute to our healthy diet.

The ten healthiest fruit are:

10. Kiwi

9. Watermelon

8. Strawberry 

7. Papaya

6. Orange

5. Apple

4. Banana

3. Avocado

2. Guava

1. Pineapple 

So lets not forget to eat fruit daily!

Complex housing architectures