- hace 5 meses
- #documentales
- #espanollatino
- #historia
- #relatos
La escoliosis o curvatura de la columna vertebral se encuentra en todo el mundo en aproximadamente una de cada 10 personas. Casi todos los casos ocurren en mujeres adolescentes. Es una condición de por vida que no se puede prevenir ni curar.
En el mejor de los casos, se puede estabilizar con aparatos ortopédicos o cirugía. pero en los casos más graves, no se sabe cuándo puede comenzar a progresar nuevamente.
Presentado por el genetista y ambientalista de renombre mundial, David Suzuki, cada semana presenta historias que son impulsadas por una comprensión científica del mundo.
Episodio 8 de la temporada 39
Titulo original:
The Nature of Things: Weighing the Options: Elective Scoliosis Surgery
Sigue mi pagina de Face: https://www.facebook.com/VicsionSpear/
#documentales
#españollatino
#historia
#relatos
En el mejor de los casos, se puede estabilizar con aparatos ortopédicos o cirugía. pero en los casos más graves, no se sabe cuándo puede comenzar a progresar nuevamente.
Presentado por el genetista y ambientalista de renombre mundial, David Suzuki, cada semana presenta historias que son impulsadas por una comprensión científica del mundo.
Episodio 8 de la temporada 39
Titulo original:
The Nature of Things: Weighing the Options: Elective Scoliosis Surgery
Sigue mi pagina de Face: https://www.facebook.com/VicsionSpear/
#documentales
#españollatino
#historia
#relatos
Categoría
🛠️
Estilo de vidaTranscripción
00:00La naturaleza de las cosas
00:30Escoliosis, opción de riesgo
01:00La naturaleza de las cosas
01:02Es realmente mi decisión
01:05Y es una terrible, terrible
01:07La naturaleza de las cosas
01:10En escoliosis surgery
01:12We can give a patient the facts
01:14Both in having the surgery
01:15And not having the surgery
01:16But they have to make the decision
01:19The upside for patients
01:22Is that they get far more information
01:24Than they ever had before
01:25The downside is
01:26They have to take far more responsibility
01:28Than they ever had before
01:29If a doctor tells you
01:31What the risks and the benefits are
01:32And a doctor tells you
01:33How you can be helped
01:34Or can be hurt
01:35And you make that choice
01:37You're taking responsibility for yourself
01:39When you look at the spine from the back
01:41It should be straight
01:42A scoliosis means
01:44That there is an S-shaped
01:45Or C-shaped type curve to the back
01:48It also rotates
01:50And so when children come in
01:53That have scoliosis
01:54The major complaint of the family
01:56Is that they have a hump in their back
01:58La scoliosis
02:00La scoliosis fue identificada
02:01Y considerada una enfermedad
02:03Hace aproximadamente 1900 años
02:05Sin embargo, hasta la fecha
02:06No se conoce método preventivo alguno
02:09Es una afección progresiva
02:10No desaparece en la edad adulta
02:12Si los casos severos no se tratan
02:14Puede causar parálisis
02:16Problemas cardíacos
02:17Respiratorios
02:18E incluso la muerte
02:19When Caitlin was 12
02:24I saw that one of her shoulder blades was higher
02:28More prominent than the other
02:29One of her shoulders was higher
02:30And her waistline was uneven
02:32I had her bend over
02:34And she had a rib hump
02:36And I was stunned
02:38I couldn't believe it
02:40It was really hard to deal with
02:42Because I couldn't see it
02:44I couldn't see my scoliosis
02:45I couldn't see how crooked my back was
02:47What it looked like
02:49So I didn't know
02:51Part of the problem of having scoliosis
02:53Is otherwise the kids are perfectly normal
02:56But it runs in families
02:57And I think the hard
02:59We know scoliosis to some degree
03:01Occurs in even about 2 to 3 individuals
03:03Out of 100
03:04There's about 0.1 to 0.2%
03:06Of those people that will come
03:08To some attention for treatment
03:10Meaning brazing
03:11Or for surgery
03:12Unfortunately if we look at the series
03:15Of x-rays over the last 8 months
03:18There is a true progression
03:20Of about 10 degrees
03:22Which is what we might expect
03:24If curve is going to get much worse
03:26About a degree to 2 degrees a month
03:29The options are not do anything
03:32And there's a role for that
03:34And number 2 would be trying to do
03:36Everything possible to avoid surgery
03:39And the only thing that's been proven
03:42Out there to have any impact
03:44Is bracing
03:45It will stop it from getting worse
03:47Right
03:48But if in the brace
03:50You continue to progress
03:52Which sometimes happens
03:54That would mean that we would go
03:56Towards surgery
03:57So you have some options
03:59There are fairly good studies
04:00That you can use
04:01That underarm brace
04:03However that brace needs to be worn
04:0520 to 22 hours out of the day
04:08Now the second option
04:10Known as a Charleston brace
04:12Actually takes this curve
04:14And actually the brace
04:16Almost twists you inordinately
04:18Into the opposite direction
04:20We discussed the options of a brace
04:23Versus not bracing
04:25Caitlin's a competitive swimmer
04:26At that point in her career
04:28She was getting very fast
04:30I wasn't really sure
04:33How I was going to deal
04:35With the whole swimming issue
04:37It was swimming was my whole life
04:39So the possibility of having to give it all up
04:42Was really scary
04:43I wasn't sure about
04:45What I was going to be allowed to do
04:47Or if I would be able to swim
04:48If I decided I wanted to keep swimming
04:50I was really scared
04:53That everything was going to go wrong
04:56And I was not going to be able to do anything again
05:00Scoliosis has a huge impact on an adolescent
05:03Because of the psychological things
05:06They're going through at that time
05:08They want to look alike
05:10They are usually involved in activities
05:13That require them to not have to live with the limitations
05:19That a brace or surgery is going to impose on them
05:25Desde los tiempos de la antigua Grecia
05:27Se intentó inútilmente corregir la escoliosis
05:30En la actualidad existe un sinnúmero de soportes ortopédicos
05:34Que han probado ser efectivos
05:36Si esta enfermedad se detecta a tiempo
05:38La mayoría funciona bajo el principio de rotación e inclinación contraria
05:42Mediante cojinetes de presión o cojines de aire
05:45Los cuales ejercen presión sobre las costillas o los músculos de la parte baja de la espalda
05:50Para hacer rotar la columna y mantenerla en la posición correcta
05:53Los soportes se consideran uno de los dos tratamientos comprobados para la escoliosis
05:58Si estos fallan, la cirugía constituye el otro método
06:01Creo que la parte más difícil de la escoliosis es el hecho de que si funciona en una familia
06:07Puede tener un gran impacto en el curso de años
06:11As opposed to maybe a more short-lived illness
06:14Or potentially a death-causing illness
06:18In the past, I would have considered this ballet class an easy one
06:28But now, as I turned and looked at myself in the mirror
06:31I was greatly disappointed when I realized my leg was still almost touching the floor
06:37I wanted to quit right then
06:39I wanted to run out of the classroom and never come back
06:41Because I felt I had failed
06:43In a matter of seconds, I had realized that all my hopes and dreams for the future were unrealistic
06:49Dana Beneman actually came to me at a time when her curve was relatively advanced
06:56She knew that going to a surgical route was going to take her away from ballet
07:04So she pushed the surgical decision aside, as many adolescents would
07:10Until it certainly became just so apparent that she really, really needed it
07:15She had a double major curve
07:18She was in a family that was known to have scoliosis
07:23So that there were, there was a known factor in the family
07:27The worst thing in the world as parents
07:30With Dana, we were taking away ballet
07:32And that's what she'd wanted to be since she was four years old
07:35We were taking away her life
07:38And it was a decision that we had made
07:41The surgery is almost always optional
07:46And it's a hard call to make as a parent
07:50You're going to change the way they are for the rest of their lives
07:55There are a lot of emotional things
08:01Very traumatic things
08:03In fact, as on top of it as I think we were with our girls
08:08I didn't realize Dana's depth of depression
08:11My greatest fear of this surgery
08:15Is first of all dying
08:18I don't want to leave so many people that I have here
08:21My family
08:22And then I think about how they would hurt and feel
08:25And it's, it's awful
08:27My second biggest fear is that something horrible will go wrong in the surgery
08:34And that I will survive
08:36That I'll actually be more disabled than what I was before I went in
08:40And there's the other fear that if I don't have this surgery
08:46What the future holds for me
08:49And it's pretty frightening
08:51To see that I've lost three quarters of an inch in height
08:55That my spine has digressed by 16 degrees in only three years' time
09:00It makes me feel like I'm in a race against time
09:04And that I need to stop this before it's too late
09:10It is a tremendous loss of control of your life
09:15You're literally handing yourself into the hands of someone else
09:19And you hope that you've made the right choice in physicians
09:23You hope that you've made the right choice in having whatever you're having done
09:31I notice some changes taking place in my back
09:34I've always been aware of the scoliosis
09:36But in the last few years I've noticed more significant things happening with my back
09:43It's been difficult for me to walk for any length of time
09:49That's correct
09:50Want to tell me about it?
09:51I always have to be careful not to overdo things
09:57Because my back will tire easily
09:59And it will become very strained
10:02The x-rays
10:05Looking at you from the front
10:07This shows your curve
10:08Which really runs from just above your waist
10:12Down through the waist area
10:13Into the lower part of your back
10:15And it measures about 46 degrees
10:18A moderate amount of curvature
10:21One that we would be concerned about its future
10:24Your head seems to be balanced over your pelvis on that x-ray
10:29And this is an x-ray taken today
10:32That the curve has increased significantly
10:36And that it now measures 60 degrees
10:39Which is a lot of change for just a little over three years
10:44And forebose for a not a very good future related to what might happen as you age
10:51Unless we do something about that
10:53It's not my imagination that it was getting worse
10:55Certainly not your imagination
10:58I think the most challenging things that I see in spinal surgery are two
11:03One is the ability to relieve pain
11:08And the other is to help restore function
11:12The specialty has evolved incredibly over the 30 years I've been practicing it
11:19And there's always new mountains to climb which is sort of fun
11:23I think Dr. Kostwick's reputation nationally and internationally
11:29Is now firmly established as one of the leading men in spinal surgery for this century
11:36He applied the instrumentation to the front of the spine in a way that had never been done before
11:40And created an area of spine surgery that allows us to do the type of scoliosis and reconstructive surgery we do now
11:47But I believe when he started his concepts were considered more than cutting edge
11:54He was considered maybe a cowboy
11:56I like to think of him as the grand poobah of spine now
12:01I hate to paint a dim picture because it really isn't a dim picture
12:05But certainly your long-term outlook is one of slowly progressed problems
12:09Now that doesn't mean next year
12:11It doesn't mean maybe even five or ten years from now
12:14But certainly when you're in your 60s this could be a really big problem for you
12:18So I do think the only solution is a surgical one
12:22I'm racing against time trying to strengthen myself
12:28I should have started this months ago
12:31To many people the fear of paralysis is worse than the fear of death
12:36And although the risks are quite low
12:38One in ten thousand sounds like a small number
12:41If you win that lottery it's 100%
12:48March 11th
12:50The expected
12:51The faith
12:52We never doubt that every day we will have another day
12:55Another night
12:56Another hour
12:57Megan just expects that I'll be there another time
13:04And it is these isolated moments
13:09These conversations
13:11That become memories more precious than all the gold in the world
13:16During this period when I felt like I was obsessed with death
13:25I walked
13:27There must be a tremendous benefit to exercising
13:31And getting away from everything
13:35And just being alone
13:39And looking up at the sky
13:41And all the stars in it
13:43And just being in awe of what's out there
14:00Next step is to keep doing what I'm doing
14:06And keep pushing myself physically
14:10To get ready for this surgery
14:12Maybe eat a little better
14:13Quit smoking
14:15Next week
14:16Walking
14:18Running
14:19And
14:20Trying to find those moments
14:23Of just really appreciating everything I have
14:28I can't believe how fast March is going
14:31Went to Johns Hopkins on Wednesday for my discogram
14:34And all in all
14:36It was pretty intimidating being there
14:38I suddenly feel suffocated by the world of medicine
14:42Must be in good condition for my surgery
14:44Gotta stop smoking in the next two weeks
14:47Good news and bad news
14:49Good news is that we know what we need to do
14:52The bad news is that it is
14:54Means we have to fuse you to the tailbone
14:56Okay
14:58The test where we put the needle in your back
15:01Shows the tailbone here and the disc
15:03There's some dye in it
15:04When we pressurized it reproduced a lot of your back pain
15:08While you're young and you're healthy
15:10So that makes it technically easier to do
15:12If we did it just either from the front of your spine
15:16Or from the back of your spine
15:17The chances of it not healing
15:19Are between 20 to 40%
15:21Which isn't acceptable
15:23Doing it front and back
15:25The chances of you not healing are reduced to about 3%
15:30And that includes all comers from age 20 up to in their 80s
15:35So you will have under the same anesthetic
15:38The same day
15:39Two operations
15:42You'll have an incision along the front of your spine
15:44Which runs up from the middle of your tummy
15:46Up around your tummy button
15:48And then we go behind the contents of the tummy
15:52They're all involved in a sack
15:54And it's easy to move apart
15:56And then we have to fuse the slower part
15:58So what we will do is
16:00Through that incision
16:01We will take the disc out here
16:03And we will put into its place
16:06A combination of some bone from a cadaver
16:09And your own bone
16:11The cadaver bone consists of taking a piece
16:14From the thigh
16:15Because that's the right size
16:16And can be easily shaped
16:18And it's very strong
16:19And heals well
16:21Like a napkin ring
16:22The center will be filled with some of your own bone
16:25From your hip
16:26These were not just words that I was hearing
16:28They were graphic details of what would be done to my body
16:32Although somewhere inside of my head
16:34There was a whirlwind of terror
16:36On the outside I remain none to it all
16:39And then we'll turn you over
16:40And at the back of your back
16:42Shown in this model
16:44We'll make an incision
16:45And then we will fix to your spine
16:47In pre-selected areas
16:49And place in those screws
16:52And then we'll attach to those screws metal rods
16:55And then to the metal rods
16:57We'll attach a special instrument
16:59And we will untwist your spine
17:01And we'll take some chips of bone
17:03From your pelvis along here
17:05And those will be
17:07The bone will be roughened up
17:09And then those chips will be grafted to the spine
17:12Much like if you graft a type of flower
17:14Or an apple tree
17:15Different type of apple tree
17:16Same idea
17:17Except it heals in a different way
17:20I haven't mentioned this to Dr. Kostowick yet
17:23But I'm considering not going through
17:25With this surgery at all
17:27It's a hard decision
17:35For many, many years
17:37Up until the late 50s or 1960
17:42Patients who had a deformity
17:44Would be corrected
17:45By putting them in a cast
17:47And then cutting the cast
17:49And then putting turnbuckles on one side
17:51And jacking them on one side
17:53And tightening them on the other side
17:55Very difficult, very painful
17:58Lots of risk
17:59Patients wouldn't be in bed a year
18:01The results were generally not anywhere near comparable to today
18:07A finales de los años 50
18:09Paul Harrington revolucionó el tratamiento quirúrgico para la escoliosis
18:13Con el uso combinado de instrumentos y fusión ósea
18:16Así nació la era moderna de la cirugía de la columna
18:19La columna se estiraba durante la operación
18:22Con barras de acero ajustadas con un trinquete
18:25Lo cual permitía una corrección más recta
18:27El sistema de inclinación contraria posee aganchos en cada extremo
18:31Los cuales corregían solamente los extremos movibles de las curvaturas
18:35Cuando tienes una curva y te empiezas a los dos lados
18:41Lo hará eso
18:43Bueno, todos tenemos un arco normal en nuestro back
18:46Y cuando esos rodos se meten y te empiezas a los dos lados
18:50Las personas pierden el arco en su back
18:52Ahora, la gran mayoría de adolescentes
18:5680% de las cirugías se han hecho compensaciones
19:00Hasta que lleguen a la mitad de la vida
19:04Las personas empezaron a saltar hacia adelante
19:08Y desarrollar lo que se llama la cirugía de acero
19:10No sway, no arco en su back
19:12La barra de Harrington debe ser removida
19:16En muchos de los primeros pacientes tratados con esta técnica
19:19La columna se separa al frente y atrás
19:22Para reestablecerla y crear el arco natural en la parte baja
19:25Y así corregir la alineación del cuerpo
19:28Con la introducción de instrumentos segmentados
19:30La columna se trata como una estructura tridimensional
19:33Lo que permite obtener una corrección más natural
19:36Y vamos
19:40Dere Journal
19:41I think today might be the worst day of my life
19:43I had to go to Dr. Miller again
19:45My scoliosis is getting worse very fast
19:48I don't want to have to have surgery
19:51But I want it to get better
19:53I'm so scared
19:55I don't think I've ever been this scared before
19:57Well we looked at your x-rays again
20:00And things don't look like the bracing is really working
20:04And that's going to mean a lot for you
20:07And I know because your swimming is such a big part of your life
20:10And I would hope to get you back
20:13But unfortunately this means that we have a choice
20:17Allowing you to just get worse with time
20:20And let you do surgery
20:23And that's a big step
20:29What are you thinking?
20:35I don't want to have it
20:37As parents we are supposed to protect our children
20:44This was a silent thing that happened to her
20:47We were broadsided by it
20:49I mean you're talking about being away from your friends in the pool
20:53At least to three if not up to six months
20:59So that's why I think you want to think about exactly
21:04When maybe you might want this to happen
21:07So I would not expect you to be back up to your full training
21:10To really cut you loose for that
21:12Until almost a year after surgery
21:15I think this is, you know, pretty overwhelming to hear all this at one time
21:19But did you say, if she has the surgery then
21:25What's the chances that she'll need to have another one?
21:28I mean, will this likely stop it?
21:31Or the...
21:32I wish I could say yes, but we can't say that
21:35And I would expect, unfortunately, that she may come back
21:38Or may have to have a second surgery
21:41You'll leave me, and you'll do fine
21:44But twenty, thirty years from now
21:46You may need additional surgery
21:48Which I cannot necessarily predict
21:50How much mobility will she have after this?
21:56If she had expected to be a prima donna ballet dancer
22:01Unfortunately, I would say
22:02You know, I think that road is probably going to be closed
22:05But we would expect that she would be able to pursue
22:08A fairly normal lifestyle
22:10Dana went back to ballet on a very limited basis
22:21Four months after her surgery
22:23Eleven months after her surgery
22:25Dana danced the Nutcracker
22:27And eighteen months after surgery
22:29Danced the classical ballet Laisselle Fide
22:31And that was the last one I did
22:33And after that, I don't dance anymore
22:36It's minor changes, like you don't notice
22:38But your balance is different
22:40And you don't have the ability to do turns
22:42Because of the balance
22:43If you can't do an air vest
22:44And if you can't bend backwards
22:46And that kind of thing
22:47That's what I, like, pretty much realized
22:49Like, as soon as I went back
22:50That I wasn't going to be able to be a professional dancer
22:53And Dr. Miller was right
22:55And that was kind of disappointing
22:57But I found something else to gear my career towards
23:01So that's helped a lot
23:04Because I don't miss ballet so much anymore
23:07She's found a career for herself
23:12And her interest in scoliosis
23:14It's become a passion
23:16And I'm hoping that it'll, in turn, help Madeline, my daughter
23:19And future generations if they do find, in fact, it is a genetic disorder
23:24So I think that's a wonderful thing
23:26It's good that something good could come out of it
23:28It's terribly frightening
23:30To lose control
23:32Of everything
23:33And I've learned
23:35To deal with my pain
23:37And my aches
23:38I guess because of my determination
23:40Possibly because
23:43I still needed to be in charge
23:45Oh, do I ever hate saying that
23:48I will never hear the end of this
23:50How can I do that?
23:52I can do that
23:53La prueba potencial se realiza antes de la operación
23:56Con el fin de registrar la respuesta de los nervios ante los estímulos
24:00Y proporcionar una línea de referencia para utilizarla como punto de comparación durante la cirugía
24:05Durante el estiramiento de la columna
24:08El cirujano puede determinar hasta donde puede llegar la corrección
24:12Sin afectar los nervios de la columna
24:16It's a good feeling
24:18To know that
24:19You're getting the best of care and the best of technology
24:23I just hope that electricity doesn't go out
24:27I find that my emotions go up and down
24:30There's days and times when
24:32I feel
24:33I'm okay
24:34This is no problem
24:36I'm gonna go through the surgery
24:38Everything's gonna be fine
24:40Sometimes at the drop of a hat
24:43I'll just lose control
24:45And just cry and cry
24:51I had a day this week that was extremely difficult for me
24:55I was taking my son to camp
24:57And when it was time to say goodbye to him
25:00I fell to pieces
25:05In my mind
25:06I know I'm going to see him again
25:08And then it was everything after that
25:13It was all the fear and anxiety about what's about to happen
25:18If I've been told once I've been told a hundred times at Johns Hopkins
25:23This is a very big operation
25:25And it echoed through my mind that day
25:28It frightened me
25:30I honestly think if I hadn't had that emotional breakdown for one day for just an hour
25:40I would not be feeling as well as I'm feeling right now
25:42Can I change my mind at this point?
25:45You sure can until the moment you're asleep
25:47No problems about that
25:49Okay
25:50Yeah, you certainly can
25:52Okay, I want to go over your surgery
25:54That's a big operation
25:56Now, some of the specific risks
25:59When you cut the skin, there's a risk of infection
26:02At the front part of the spine, that's about one in a thousand
26:05The back part of the spine, two, three percent
26:08We will also give you blood thinners
26:10The type of surgery we do
26:12Makes you more susceptible to blood clots
26:15You get a blood clot most of your lungs
26:17That can be bad news even in a young person
26:19The risk of transmission of disease from other people's blood
26:23Is very uncommon nowadays
26:25HIV is about one in a million
26:27Hepatitis is a bit more common
26:29I try to keep in mind that every surgical procedure contains risk
26:37And that it is something by law that you must be informed of
26:42No matter how minute those risks are
26:46I'm trying to maintain a positive attitude that they're minimal at best
26:54It's nice to have a virgin back
26:56I don't see many
26:57Oh, that hasn't been cut off
26:59I've created a lot before
27:00Okay
27:01All right
27:02Hopefully it'll only be a one-time day
27:04Okay
27:05Well rested
27:07Not me, I'm not going to sleep probably all night
27:14With the surgery being just a few days away
27:17I feel like I've let go of everything
27:21The only way you can reach a point like that is by going through
27:26All the other emotions like anger and fear and anxiety and denial
27:33And ultimately you do get to a point where maybe you're just so tired of having all those emotions and feelings
27:41But you do get to a point where you can just let everything go
27:44And you just know that this is the way it is and that's okay
27:49June 28th
27:52The weirdest thing about that whole weekend was the eerie calm that finally came over me
27:58I feel like I have a pretty normal life and a pretty boring life
28:04But I've come to the conclusion that I really like my life
28:09I really like my family
28:11I really like my house
28:13I even like my dog again
28:15I like the sky
28:19I like the birds
28:20I like the stars
28:21There's an awful lot of wonderful things here in just my normal insignificant life
28:32So I'm very grateful at times like this
28:38You look and you're very very grateful for what you have
28:51From the moment that you arrive at the hospital
28:54Your stomach is just tied up in knots
28:57You're weak because you haven't eaten for a couple of days
29:00And it feels as though the volcano is going on inside and it's bursting out
29:05Every step that you take
29:07Once you check in at the desk
29:09You know you're getting closer and closer and closer
29:15It was incredibly frightening
29:19They took me away from my family and my friends
29:22And on the stretcher escorted me through all sorts of hallways
29:27And they left me in what they called a holding room
29:31It felt like I was in solitary confinement
29:34Any type of spinal surgery is high risk surgery
29:40Because you operate with large instruments around very delicate structures
29:46The spinal cord, the nerve roots
29:48All of which if they are touched with an instrument in an inappropriate way
29:51Will be permanently damaged
29:53On the other hand, by the very nature of the spine
29:56You have to exert tremendous amounts of force to make corrections
30:00To cut bone out right next to these delicate structures
30:03So it is very intolerant of small errors
30:06Bone bleeds quite heavily
30:08And it's very difficult to control that type of bleeding
30:11In the past, the anesthesia techniques
30:14Along with the surgical techniques
30:15Would not allow us to sustain a person
30:17While having this blood loss
30:19To accomplish the structural surgery
30:21Okay, now you can see here
30:23That the patient has two curves
30:26This is much less severe looking than on her x-ray
30:29Because she is asleep
30:30And the spine has been cleansed
30:33The muscles taken off
30:34The capsules of the joints taken off
30:36So the spine is quite flexible now
30:39Which is good, that means we get good correction
30:41Can I have a bone cutter and a bone dish please?
30:44Now what we have done here is expose the joint between the sacrum
30:49What have you got?
30:50And L5
30:51Taking off the articular cartilage of the surface of the joint
30:59And now we are going to drill a hole for a screw in the sacrum
31:05Dr. Costwick is an incredibly fast surgeon
31:13The combination of both rapid surgical technique
31:16Accompanied with the very great support of neuroanesthesia
31:20Allow us to perform these type of major operations on patients
31:24At much lower risk, but there are no no-risk surgeries
31:27This is a special screw that has a swivel head
31:32So that makes it easier to insert the subsequent rod
31:36Dr. Costwick sees the spine in three dimensions at all times
31:40He has the ability to look at an x-ray
31:42And both through his intellect and his vast experience
31:46To know what that spine is doing in space
31:49And his additional talent is to know
31:51How he wishes to make the correction in space
31:55This rod has been slightly contoured to put into the pelvis
31:59Segmental spinal instrumentation
32:02Or the latest generation of spinal instrumentation
32:05Allows us to grab the vertebral bodies themselves
32:09Through the pedicles with long screws
32:11That go from the back of the spine to the front of the spine
32:14Allow us to put rotational forces on the spine
32:17They allow us to conform the rods
32:21That the instrumentation, the segmental linkages
32:25Are hooked to, to the spinal deformities
32:28And correct them in situ or in place
32:31If you look at Dr. Costwick's application
32:34Elective surgery of such magnitude
32:37For people with scoliosis
32:40Was beyond what most people were willing to try
32:44That's it
32:45Sorry, it's fine
32:46One, two, go ahead
32:47It took an enormous amount of nerve to think
32:50That you could go into a body
32:52That is twisted due to scoliosis
32:54And make it better with this enormous operation
32:57And make a person happy
32:59Because their back hurt
33:00Or because they did not like the way they looked
33:02This is a bone screw
33:04Made of titanium, looks like gold
33:06About the same price
33:08And we're gonna put this through the body of L5
33:12In through the graft which we put in
33:14Into the tailbone
33:16His techniques are still as advanced now
33:18As they were when he first started
33:20Paul, come on
33:24When Dr. Miller said surgery
33:26And the thought of putting my child through that
33:28Was just, it's like a nightmare
33:30We're being asked to make a decision
33:34To accept the risks of surgery
33:37And the possible side effects of surgery
33:39To stop her from progressing
33:43And to prevent something down the road
33:46Her father and I decided
33:48That Caitlin should really be the person
33:51To make the decision
33:53She was 12 when she made the decision
33:56I think my surgery impacted my parents pretty hard
34:00Especially my dad
34:02I'd only ever seen him cry a couple times
34:05And he got really emotional
34:07The whole thing upset my mom a lot
34:10She likes to be in control of things
34:12And she couldn't do anything to control it
34:15It was really scary kinda
34:18Cause they didn't know what to do
34:20And they're always there to help me
34:23And I didn't know what to do
34:24And they didn't know what to do
34:26I think the surgery was the right thing to do
34:33The first time, I'm sorry I'm getting emotional
34:35But the first time she got in the water
34:37There were adults that knew her
34:40But weren't that close to her
34:42That were crying on deck
34:43The first time she got in the water
34:45And the first time that she competed
34:47It's so hard to see your child go through something like that
34:52And not be able to help them
34:54And I really admire her
34:58Because there's so many adults
35:00That wouldn't have had the courage
35:02Wouldn't have had the pluck
35:04To go back to the sport that they loved
35:06And might not ever be able to compete
35:12On the level that she was able to compete at before
35:15I admire her every day when she goes to practice
35:18Because every day it's hard
35:20Every day it's different
35:22And every day she's not as fast as she was
35:24And has to work at it
35:26And I find that to be very admirable
35:29In a child so young
35:36Sorry
35:38A year and two months passed
35:40And I'm still feeling very strongly about it
35:47I'm really happy I had the surgery
35:49I don't know what my life would be like right now if I didn't
35:55We're still not sure at what level she's at right now with her swimming
35:59Because Caitlin still can't flip turn or dive
36:02And especially the shorter events
36:05Flip turns and dives make or break the time
36:08And her times are very good
36:10Her coach is very happy with him
36:11He thinks she may be back on to where she was when she left the sport
36:14But we won't know for sure until she can flip turn and dive again
36:18It's kind of discouraging because I still can't do a lot of things
36:22But I have to wait because there's no sense rushing it
36:26If it's just going to make it worse
36:27There was a tremendous amount of relief
36:32And exhilaration
36:34To be able to look at that date and say
36:37Wow I did make it
36:38It's the same day
36:39I've only been out a few hours
36:41It's very exciting
36:42Even though you're so heavily medicated
36:45That was the thing that I focused on
36:48I remember the sensation of lying on a bed of knives
36:54That was all the staples inside
36:56Take care, Jenny
36:57See you later
36:58Hi, my name's Jennifer
37:00I'm a physical therapist here in the spine service
37:02How you doing?
37:03A little out of it
37:04A little out of it
37:05And what I'd like to do is try and get you sitting up a little bit
37:08And that may help with some of the stiffness
37:10And I know you just had the pretty big surgery yesterday
37:12But we do like to try and get people up day one
37:15What I'm going to have you do is
37:17If you can bend your knees up for me
37:19Good
37:20You're already on your side
37:21So you're halfway there already
37:23When you're dealing with spinal patients
37:25It's a lot harder for them to move
37:28Because any way you're moving is affecting your spine
37:31Okay, I'm going to help you get up onto your elbow
37:33Ready?
37:35One
37:37Two
37:39Two
37:47Okay, good job
37:48Take some deep breaths for me, okay?
37:50So what do you think?
37:52You want to try for the chair?
37:53You're going to do it, right?
37:55Yes
37:56Alright
37:57Good
37:59Great
38:00Keep coming
38:01Keep coming
38:02I remember the first time getting out of bed
38:05How exciting it was
38:08That I was able to stand up
38:13I had survived the surgery
38:14Things were going to be okay
38:16Deep breaths
38:17In through your nose
38:18Keep you out of bed for a little bit
38:20I think that will be good
38:22Okay, take care
38:23You're doing wonderful
38:24You're doing wonderful
38:25You're doing wonderful
38:26All
38:27The first two weeks were very hard
38:34You are very stiff, very uncomfortable
38:37And cannot stay in any one position for any length of time
38:41Generally feels like someone stuck a piece of plywood in my back
38:47Just tell us you can't have them, okay?
38:48Take some deep breaths
38:49Take some deep breaths
38:50You're a little imaginative
38:51You're a little imaginative
38:52You're a little imaginative
38:53Plus you've been sitting up a lot today too
38:56Yeah
38:57You alright?
38:58Welcome to the hallway
38:59With the scoliosis patients you have to relearn where your center of gravity is and where you can move in relation to that and it is challenging for people
39:15It's terribly exciting to be so incredibly weak and helpless and everyday you move towards feeling better
39:39It's really a wonderful progression
39:42I look forward to working my way back to independence
39:48I'm determined to be that way again
39:51And I'll deal with the difficulties as they come
39:53Yeah, we'll have you racing him next week
39:55That's pretty scary
39:56I learned to not underestimate myself
40:01I've also learned that I'm probably braver than what I thought I was
40:05Because I think it takes a lot of courage to face all those fears
40:09And despite the fact that you have them, you go ahead and you go through with it
40:12Yay!
40:15When you fuse a significant portion of the spine, the levels above fusion masses tend to degenerate at a faster rate
40:22And we're not sure exactly how to solve that problem
40:26If you have a surgery in the thoracic or chest part of the spine, the odds of you ever requiring anything further in later life are very, very low
40:36Whereas in the lumbar, if the fusion goes into the lumbar spine, depending how far down it goes, anywhere from 60 to 80% will get into difficulties
40:45Not all of those will require further surgery some 10, 20, 30, 40 years later
40:51But certainly a significant percentage do
40:54Okay, ready?
40:55Uh-huh
40:56All right
40:57It's hard to not be still
41:07You gotta get up and move around or let you just go crazy
41:12I miss my home
41:14Yeah, yeah
41:15Home's sick now
41:17Surgery will never be prevented until we find maybe what the cause is based on looking at genetics and growth factors
41:29If we were able to look at a gene or discover a gene or a group of genes
41:34I'm very hopeful that we may be able to first of all better understand the biology of the spine and spinal mechanics
41:42The second thing is that with that knowledge, we'll be able to understand how the spine responds specifically to hormonal stress
41:51And to our growth spurts
41:53Lastly, we'd be able to use that information to predict in some individuals that yes, we would fuse you at an earlier timeframe
42:02In which we would be able to fuse a smaller segment
42:06And we would even be able to skip bracing altogether
42:09Perhaps we could use gene therapies that we know that you have a particular gene type that is very responsive to bracing
42:17If we're able to get it early
42:19I knew Dr. Miller had asked for our family's blood for her study that she was doing
42:26And I had to have a science fair project for my chemistry class
42:30And so I asked her if I could come into her lab and see what they were doing
42:36And she said that was fine
42:39Dana worked right side by side with me in the laboratory
42:43She did everything from helping me isolate the DNA from blood samples
42:47To actually running the PCR, running the gels, developing her own films
42:52Really all the work she did for her science fair, she did it on her own
42:56After she was able to learn all the techniques
42:59She's an extremely good student, extremely bright
43:04And surgery did change the course of her life
43:06She turned a bad situation around to work for her
43:10And that's to the credit to her parents and herself
43:14If I hadn't had scoliosis, I would have never thought to go into science
43:19I probably would still be planning on being a ballerina for the rest of my life
43:24July 28th
43:27It has been four weeks and one day since my surgery
43:30And I am just beginning to feel like my old self again
43:34I'm literally pain free
43:37I feel great about myself
43:40So the difference that that's made in my life is really quite tremendous
43:45I think that chronic pain probably affects us a lot more emotionally than what we may realize
43:55It probably gives us an overall tired sensation
44:00All the time
44:02And certainly that's got to affect the people that you're living with on a regular basis
44:08Really good throw in there
44:10Thanks
44:11Five weeks after surgery
44:14A little frustrated
44:16Feeling like I should be able to do more
44:19I think that there's a payoff
44:22For having the surgery
44:25And I am much more restricted in my activities than what I was before
44:30Bending down and picking things up is frustrating
44:34I can't just bend over and put on socks
44:36Or paint my toenails
44:39It's a very simple thing that everybody does every day of your life
44:44And in the whole scheme of things if that's all I ever have to deal with I can deal with it
44:49But there are mornings that it is most frustrating
44:54August 28th
44:55It's only been eight weeks since my surgery
44:58There are times and moments when I still feel awkward walking
45:03I feel as though I haven't quite got it down
45:06And I must look a little like Frankenstein
45:08There's this little part in me that feels like I'm not human anymore
45:14Between the fillings in my teeth and all the steel in my back
45:18I feel tight, tense, rigid, and totally inflexible at times
45:24When I sit in a chair, I must sit straight up
45:27I look as though I am never able to relax
45:30In a sense, I feel like a stranger
45:33Although I know I'm still the same me
45:38I'm finally at the point where I can honestly say that it was very much worth having the surgery
45:44I was worried because while I was recuperating
45:48There were days when I didn't feel so good
45:51And I was really afraid that I would not be able to say that I'm glad I had this surgery
45:56I don't have that concern anymore of how my scoliosis is going to affect me
46:01In later years
46:04It's over with
46:05And I feel good
46:0635 degrees
46:07Wow
46:09So it's 60 something, right?
46:10Yeah
46:12Cool
46:13You've really done well
46:15I'm really, really happy
46:16You know what I've never seen before?
46:18The arch in my back
46:19Right
46:20I've never had that
46:21No, you didn't have that before
46:22That's right
46:23You're going to have to go home and look in the mirror
46:24See what it really looks like on the outside
46:31September 30th
46:32I'm beginning to have a sense of completion
46:35My surgery gets further and further behind me
46:38It is over with
46:40And while I will always have the scars to remind me
46:43I have great relief from the pain and achiness I used to experience everyday
46:47That's good too
46:49More and more I'm becoming accustomed to my new body
46:52And getting comfortable with it
46:54I'd like to think that I will always have some quiet times in my life where I just reflect on anything
47:15Whether it is looking at a sunrise or a starry sky
47:20Or looking at one of my loved ones
47:23And just stopping for a moment to realize why I love them
47:30I think it's so important to take time to do those things
47:35And so far I've been able to do that for a few years
47:40So I hope that I'll always have that attitude that you have to just pause every now and then and be grateful
47:47I hope that I'll always be grateful
48:17There it is
48:18I hope that I've always faudra
48:20You can follow him
48:21And doing everything
48:26Remember the thing that really is
48:28Is something that looks an alien
48:29You can't tomorrow
48:30It probably isn't even a hero
48:31It might look for you
48:33But even when it is sunny
48:34I might be like
48:36The I love is sunny
48:40That's great
48:41Patal
Sé la primera persona en añadir un comentario