Limb Lengthening Forum
Limb Lengthening Surgery => Information About Limb Lengthening => Topic started by: MirinHeight on November 12, 2017, 12:10:20 PM
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I always try to help people out on here, and I think I have thought of a new safety precaution for you all to go through.
If you want to if your bone is healthy enough to go through such an operation and consolidate at a very good rate, you should get a bone blood/urine test done to check your bone turnover rate.
-The Bone Marker test is used to detect and measure the presence of certain biochemicals in blood and/or urine. This helps determine if there is either an excess of bone formation, or an excess of bone destruction (called resorption)
-This information helps predict the risk of bone fracture, diagnose conditions like osteoporosis, help make a treatment decision, and also serve as a baseline to measure the effectiveness of a future treatment
-The human bone is in a constant state of remodeling, even after the body growth stops. New bone is continuously being formed, while old bone continuously being absorbed in the body. This process is termed as ‘bone turnover’
-Formation of new bone is carried out by specialized bone cells called osteoblasts. The absorption of old bone occurs with the help of another special type of bone cells called osteoclasts. This ‘bone turnover’ is important for the normal bone health and helps in repair and response to stress (such as fractures)
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Finally a very interesting thread.In the recent past I have made a lot of threads regarding bone regeneration getting few answers.Figure out some crappy "veterans" that bother answering to stupid questions instead of the interesting ones.
They are the worst ever,even worse than new users starting 1000 topics for day always asking the same questions
So,have you already done this test ? How does it work ? Can you simply go in hospital asking for that ?
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why dont LL docs do this test beforehand?
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why dont LL docs do this test beforehand?
Because what he is talking about has nothing to do with knowing if you will have good regeneration.. He is talking about tests that indirectly can show if you have osteoporosis.
OP, if you want to help, atleast post something that has to do with the subject at hand and not something you quoted from webmed
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http://www.scielo.br/pdf/aabc/v87n2/0001-3765-aabc-201520150008.pdf
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3143987/
https://www.ncbi.nlm.nih.gov/pubmed/20190300
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0001-37652015000201049
@TIBIKE200,
After doing more research, you are correct in that these tests can not exactly tell you how your consolidation will be after surgery.
However it is important to do these tests to see if your bones are indeed healthy enough for this procedure. Some have osteoporosis and do not even know they have it. It does not cause pain in all cases. Furthermore, these tests also check your mineral/vitamin levels such as Vitamin D. This is important to see if your bones are getting all the vitamins and minerals it needs to consolidate after surgery.
Furthermore, I have posted some studies which show that this exact test has the possibility to tell you how your consolidation will go early in your healing period. It can tell you if you are more susceptible to a nonunion depending on the levels of some enzymes VERY EARLY in the process.
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bump for anyone considering LL, these are tests you might want to consider!
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these tests can show if your bones are healthy enough for the surgery and consolidation. + risk of fracture of the partially-consolidated bone post surgery depending on bone mineral density and strength
i have linked some studies for you to read if interested
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Good idea to do the test anyway, even if it doesn't totally predict the outcome because it can identify unknown risks early. @MirinHeight, how do you go about ordering these tests? Do we know the CPT code(s)? Is it just this:
https://www.labcorp.com/help/patient-test-info/bone-markers#
Thanks.
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I'm probably a good example of a person that did a massive amount of pre-op tests for this surgery. I tried logging into my insurance portal, but the historical claim tab is currently down, so I can't locate the codes at this time. I have an unknown bone disease with full blown -4 Z score osteoporosis. I was re-diagnosed at 30 years old. Below is the blood-work I did to diagnose my bone disease. (If you all wanted an example of what the results look like.) Some of my results were abnormal, but nothing really out of the ordinary for someone with osteoporsis as bad as i have. I am 8 months post op of doing almost 9 cm and it didn't appear to impact my rate of regeneration. I had one of the the doctors say my bones appeared to be weak from my initial frame surgery, but so far, I have performed as well, if not better, than the healthy patients with no pre-existing conditions. I will add that most patients are deficient in vitamin D3 and it takes a long time to get D3 blood levels back up to par from deficiency. I suspect it's why some patients have terrible regeneration. So getting your supplements and nutrition straightened out are probably crucial for this surgery. Though with every random case I've seen, there still doesn't appear to be a clear pattern of what your regeneration will be like, even with healthy bones and good supplementation/working out.
My takeaway -- Getting your blood levels checked is a good thing, but having a pre-existing condition even as bad as osteoporosis is no guarantee that your regen will be bad. I've seen so many random cases of regeneration rates, and there does not appear to be a clear pattern. I've seen people with perfect health + nutrition + regiment workout schedules with terrible regeneration. And I've also seen those that ate next to nothing nutritious and hardly worked out with incredible regeneration. A popular theory most of us held is this surgery is 80-90% genetics. The blood-work may help determine if you have the genetics, but again, no guarantees.
Cons: If you can't insure the blood-work, the tests can easily run into over 1k+ or more. It was like 5 vials of blood they took from my arm, so it's not just a single test. The most important test is to get your D3 levels checked, but I'm not a doctor, so please verify this.
https://www.scribd.com/document/372943217/Bone-Disease-Bloodwork-Late-2016
Proof (7 months post-op) x-ray: https://imgur.com/a/uh1VC
Pre-op Tests I've done 6 months pre-op:
1. Spine MRI
2. Paley full 3d bone survey scan
3. Random X-rays
4. Bone DEXA density scan of spine + hip
5. Full blood panel
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I'm probably a good example of a person that did a massive amount of pre-op tests for this surgery. I tried logging into my insurance portal, but the historical claim tab is currently down, so I can't locate the codes at this time. I have an unknown bone disease with full blown -4 Z score osteoporosis. I was re-diagnosed at 30 years old. Below is the blood-work I did to diagnose my bone disease. (If you all wanted an example of what the results look like.) Some of my results were abnormal, but nothing really out of the ordinary for someone with osteoporsis as bad as i have. I am 8 months post op of doing almost 9 cm and it didn't appear to impact my rate of regeneration. I had one of the the doctors say my bones appeared to be weak from my initial frame surgery, but so far, I have performed as well, if not better, than the healthy patients with no pre-existing conditions. I will add that most patients are deficient in vitamin D3 and it takes a long time to get D3 blood levels back up to par from deficiency. I suspect it's why some patients have terrible regeneration. So getting your supplements and nutrition straightened out are probably crucial for this surgery. Though with every random case I've seen, there still doesn't appear to be a clear pattern of what your regeneration will be like, even with healthy bones and good supplementation/working out.
My takeaway -- Getting your blood levels checked is a good thing, but having a pre-existing condition even as bad as osteoporosis is no guarantee that your regen will be bad. I've seen so many random cases of regeneration rates, and there does not appear to be a clear pattern. I've seen people with perfect health + nutrition + regiment workout schedules with terrible regeneration. And I've also seen those that ate next to nothing nutritious and hardly worked out with incredible regeneration. A popular theory most of us held is this surgery is 80-90% genetics. The blood-work may help determine if you have the genetics, but again, no guarantees.
Cons: If you can't insure the blood-work, the tests can easily run into over 1k+ or more. It was like 5 vials of blood they took from my arm, so it's not just a single test. The most important test is to get your D3 levels checked, but I'm not a doctor, so please verify this.
https://www.scribd.com/document/372943217/Bone-Disease-Bloodwork-Late-2016
Proof (7 months post-op) x-ray: https://imgur.com/a/uh1VC
Pre-op Tests I've done 6 months pre-op:
1. Spine MRI
2. Paley full 3d bone survey scan
3. Random X-rays
4. Bone DEXA density scan of spine + hip
5. Full blood panel
How is your walking after almost 9cm in terms of ballerina foot etc?
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I can walk without crutches, but I only do short distances without them. I still prefer to use at least one crutch. I have many more months of consolidation left, so I expect to do this for a while. I don't want to risk having the nail pop out. I only got pre ballerina in my right foot, not the heel lifting off of the floor kind. My heels could always touch the floor, but the foot still sort of twisted until recently. Now the left leg is completely fine, but the right still feels a little tight.
https://www.instagram.com/p/Bed1yTdg-12/?taken-by=mwserie_irl
This was me walking a short distance 7 months post op (initial external surgery).
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I ve been in similar stage , you should be walking normally within 2 months , keep stretching and walking. BTw which doctor did go with?
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Hopefully! It's just a waiting game with the right leg at this point.
I did it with Dr. Barinov and his team.
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Hopefully! It's just a waiting game with the right leg at this point.
I did it with Dr. Barinov and his team.
did you do lon or latn? btw u are recovering well , from the video.
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I think it makes a lot of sense to have an idea of the state of the bones and any indication about it's turnover rate when planning LL.
Have you LL candidates who already had preliminary consultations to help prepare LL (asking opinions, making qyestions, etc.) been advised or asked the doctors by yourselves a test such as an osteodensitometry for example?
Even if the state of bones doesn't always predict rate of ossification, poor quantity of Vitamin D in the blood should be adressed immediately, the sooner the better, before starting LL....
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How many time after lengthening is over can anyone walk without crutches or any support?
I can walk without crutches, but I only do short distances without them. I still prefer to use at least one crutch. I have many more months of consolidation left, so I expect to do this for a while. I don't want to risk having the nail pop out. I only got pre ballerina in my right foot, not the heel lifting off of the floor kind. My heels could always touch the floor, but the foot still sort of twisted until recently. Now the left leg is completely fine, but the right still feels a little tight.
https://www.instagram.com/p/Bed1yTdg-12/?taken-by=mwserie_irl
This was me walking a short distance 7 months post op (initial external surgery).
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Good doctors perform this check beforehand, or you can ask them about it during consultation. In my exp, they drew 4 blood samples of mine the day before surgery. I'm not a doctor but I believe blood test is more accurate than others like urine test.
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I always try to help people out on here, and I think I have thought of a new safety precaution for you all to go through.
If you want to if your bone is healthy enough to go through such an operation and consolidate at a very good rate, you should get a bone blood/urine test done to check your bone turnover rate.
-The Bone Marker test is used to detect and measure the presence of certain biochemicals in blood and/or urine. This helps determine if there is either an excess of bone formation, or an excess of bone destruction (called resorption)
-This information helps predict the risk of bone fracture, diagnose conditions like osteoporosis, help make a treatment decision, and also serve as a baseline to measure the effectiveness of a future treatment
-The human bone is in a constant state of remodeling, even after the body growth stops. New bone is continuously being formed, while old bone continuously being absorbed in the body. This process is termed as ‘bone turnover’
-Formation of new bone is carried out by specialized bone cells called osteoblasts. The absorption of old bone occurs with the help of another special type of bone cells called osteoclasts. This ‘bone turnover’ is important for the normal bone health and helps in repair and response to stress (such as fractures)
Can you elaborate