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[Descreteuser]

Yeah if u tell the doctor before leaving he will show u how u have to remove it and he will give u money so u can post the device back to him.. He done that with a previous patient..any nurse will know what to look for with infections.. U will need a wheelchair probably up until 4 months post operation.. So better if nurse can come to u.. Ur mobility will be very poor for the first 4-5 months

[microman]

okay so say in the situation of 5cm.

after 10 weeks of lengthening I go home.
nurses come into my home everyweek to clean pin sites & check for infections.
I need to re-dress the bandages every other day.

but what about if there is an infection, would i then need to go to the hospital to get work done by the doctor, or would i need to fly to serbia for mitkovic to do something that only he can do?

can mitkovic also do femur with this device, and if that does get done, is the recovery much faster, what would be advantages and disadvantages of femur lengthening over tibia.

can I double check that this way of removing the device itself at home cannot be done with externals offered by barinov, bagirov and solomin.

im glad he will pay me to send the device back, that's really cool of him.

[Descreteuser]

Don't be too optimistic about the lengthening period.. If u read my diary u can see the troubles I had only doing 4cm.. It depends on each patient.. But I'd say after 10 weeks ud be finished lengthening but allow for more just in case..u don't need to change ur bandages every day.. Only weekly..When nurses check your pins they remove the bandages, clean around the pin sites than do the bandages for u. I've had 2 minor infections and it's no big deal, they just clean it.. Major infections are extremely rare as long as u wear track pants to protect the device from dirt.. I dont know about any other doctors devices. But this device just requires an adjustable spanner.. Taking the pins out requires you to turn them out with the spanner.. Apparently it's a bit painful.

[microman]

oh right I will see if i can do the same thing with externals, pretty sure it requires another surgery to remove the device on those ones, which will require another flight back which i really don't want to do.

when you left the hospital, did mitkovic keep good contact with you.

during lengthening did nurses change bandages weekly in your hotel, or was it doctor.

for painkillers, is there not a special painkiller that you need that requires an injection, so in that case don't you need a nurse to administer it to you.

I understand that the hotel is £350 a month, how much per month is food, and are you paying a maid to bring in food that is pre-made, like room service in a way, or is it microwave meals, and if so does the hotel have things like microwaves or ovens, most hotels I have been in don't have microwaves etc.

and is it a common service for maids to bring in food, is it something they do well, and they will understand your situation.

[Descreteuser]

did u mean do the same thing with internals? because mine was externals. dr mitkovic comes visits you when ever u ask for his assistance. weekly you go back to where u had the surgery and the nurses change and clean ur bandages. u just get cabs and it just around the corner from the hotel very cheap cab fair. something like 1 pound each way. he can give u a prescription for pain killer tablets. you wont need too many painkillers. pain is bearable and only last for a couple of weeks from surgery. i pay for my breakfast in advance when i pay for my room. cost me an extra 40 pounds a month.. i get them to boil me 6 eggs every morning and i have that with a few bowls of cereal that i get from across the road.. just before lunch time i call down to reception and i get them to order me food from a place across the road that cooks meat and stuff. one of the staff will come up to collect the money for the food and at which time ill give him a list of other groceries such as milk, cereal, fruit etc. and they go get it for you. the hotel takes a service charge of about 2 euros. rent will cost you 390 pounds a month if u include breakfast. and food for the week including all service charges will cost you no more than 50 pounds a week. i pretty much have 4 meals a day, breakfast -cereal with 6 boiled eggs,
brunch- spaghetti that i get from the corner shop(they cook it for me when they boil my eggs in the morning) and 2 bananas
 lunch 200 grams of chicken in a bread roll and 2 oranges,
dinner - 200 grams of chicken and low fat yoghurt

it probably costs me a total of 40 to 50 pounds a week on food. im very anal about maintaining as much muscle mass as possible so you might not spend as much on food as what i do. everything is cheap here.

[microman]

thank you for that much fuller description on how the food is brought to you, it paints a much better picture of what I would have to do.

if i understand you correctly we are taking about £600 a month to live in the hotel with food brought up to you etc,

i have to say £200 a month on food is expensive, did you not mean to say £100 a month on food?, anyway it does not matter much.

and i see you travel to the hospital weekly, I understand now, I guess I will have to do something similar to that when I'm at home during consolodation.

some other diary said you have to change bandages every other day, but you say its okay to just do it each week, and it gets all done for you by nurses.

for devices no i meant exteral ilazarov, i don't know if you need surgery to remove that device, or if you can just do it yourself at home.

also do you know about the femurs, does mitkovic allow for femurs and how much faster is recovery compared to tibia.

what would you say advantages and disadvantages are for femurs over tibia using mitkovics device.

[Descreteuser]

no i meant 200 pounds a month. but thats maximim.. i dont think i spend that im just saying allow that... i probably spend closer to 180 pounds a month but ud rather allow more. the reason u even spend that much is because of the service charge each day, but considering the situation its a small price to pay, i eat more than than most people aswell.. so im not sure on ur diet but u might spend even less again. remember when u r lying around all day u wont get as hungry as ud usually get.. i probably only eat 70% of what id normally eat when im more active. to be honest i think 180 to 200 pounds a month is cheap anyway.. i use to spend twice that where i came from. i dont know anything about the lizarov device to be honest.. all i know that lizarov is much more painful than the device mitkovic uses. u can imagine all the muscle that the pins go through on the lizarov.. with mitkovic device you just have 6 pins on the front of the shin which dont penetrate any muscle. yes they do femurs here..
femurs advantages - lengthen faster (1mm a day)
                                   - faster consolidation. Because there is so much muscle surrounding the femur it heals much faster.
                                   - scars wont be seen unless ur in underwear
femur disadvantages - more pain (pins penetrate muscle)
                                     -more extensive physio. stretching would be full on as you need to do stretches for the hips and the knees. with tibias the stretches are very basic.
                                    -dr mitkovic has much more experience doin tibias.. i dont knwo of anyone that has done femurs with his device.
                                       

[microman]

Oh so its less painful using mitkovic’s device, that’s good news.

Lengthening faster :    so that would be 7 week to lengthen 5cm?, instead of the 9 weeks in tibia?

faster consolidation.    would you say 6 moths post op. you would get frame removal, instead of 8 month using tibia.

For more pain in femurs, maybe the pain is stlii less than tibia using ilazarov?
some people would prefer more pain but less time, so 7 weeks of pain instead of 9 weeks of lesser pain, who knows, it’s a trade off.

dr mitkovic on femurs:here are two diaries on old forum

http://www. /index.php/topic,1571.0.html
http://www. /index.php/topic,1313.0.html

they say ‘internal’ though, I thought his device was external regardless of tibia or femur?

to qoute the diary

you don't want to go external on femur, Not only the pain will be horrible, but you won't be able to move your legs for several weeks, that means you will be laying on a bed for weeks. You can't even sleep on your side, because of the device. I don't even know if you can go to the toilet by yourself in the first two weeks.

[Alittletooshort]

Oh so its less painful using mitkovic’s device, that’s good news.

Lengthening faster :    so that would be 7 week to lengthen 5cm?, instead of the 9 weeks in tibia?

faster consolidation.    would you say 6 moths post op. you would get frame removal, instead of 8 month using tibia.

For more pain in femurs, maybe the pain is stlii less than tibia using ilazarov?
some people would prefer more pain but less time, so 7 weeks of pain instead of 9 weeks of lesser pain, who knows, it’s a trade off.

dr mitkovic on femurs:here are two diaries on old forum

http://www. /index.php/topic,1571.0.html
http://www. /index.php/topic,1313.0.html

they say ‘internal’ though, I thought his device was external regardless of tibia or femur?

to qoute the diary

you don't want to go external on femur, Not only the pain will be horrible, but you won't be able to move your legs for several weeks, that means you will be laying on a bed for weeks. You can't even sleep on your side, because of the device. I don't even know if you can go to the toilet by yourself in the first two weeks.

I have heard that he used to have an internal nail but he is not using it anymore. He doesn't accept a lot patients in general.
Microman, internals is probably your only option to get your femurs lengthened, everything else doesn't seem to be a smart idea. What about going to a bank and get a credit for 10 000-15 000£?  Or go for tibial lengthening but there are some disadavantages which are not avoidable.

[microman]

my budget will always be about £10K.

interestingly the doctors page still says he does femur, i guess it's external only, which may mean that it's a bad idea, but if its not recomended, then why allow it?

I think maybe his device may be different to the ilazarov so maybe his external is quite decent, that diary may have been from the past where he offered a different device for femurs.

but it will be my proportions that will decide, will be getting x-rays soon.

[Alittletooshort]

Can you imagine of being in these huge frames for 6 months? Also think about all the damage that is done to the soft tissue that gets pierced by the huge pins of an external femur device.

[itzrammi]

Greetings Descreteuser  Hope you're doing well now  ,  can I see some pics of your Frames ? To be frank am a Huge fan for Monolateral frames lol 

[Descreteuser]

theres my frame

[Descreteuser]

theres my mis alignment in my left leg after 4cm finished lengthening

[Descreteuser]

as u can see the bottom part of the top segment is what is causing the bump on my shin.. doctor tells me it will not effect my functionality or consolidation at all

[crimsontide]

mono fixators are  weaker than regular fixators

I must say though,

What is with these Drs lately?? It seems that almost every patient  has  misalignment,etc which requires additional surgery

and with all due respect to your dr,  i would not take what he says as gospel

Every Dr I've been to has  told me dont worry, regardless of the issue

If your leg isnt normal compared to before, there will be issues down the line.  but mono fixators arent good at correction, that is why hes saying this.  what's  acceptable to him is  not equivalent to what is acceptable by you

[Descreteuser]

theres my right leg..

[Descreteuser]

what issues are you talking about.. and what evidence is there to back up your claim?

[crimsontide]

my evidence is your leg


it looks really bad, to be honest. your  osteotomy  looks bad, and your bone is bending outward

that's not normal. if you think all will be okay, that's your choice. I don't know what else to say. It wouldn't  be acceptable to me.

[Descreteuser]

you say the evidence is my leg? but are you experienced in knowing if it is a problem or not? what im trying to say is , yes to any normal person who doesnt know much about medicine it looks like a serious problem. 2 doctors ive spoken to have said its only a problem if you cant get full extension in your knee, which i can. i understand what u r sying but your reaction was like mine. but the truth is that people like me and you arent trained or experienced to know if it is a problem or not. telling someone their leg looks really bad can be mis leading unless you know what you are talking about

[microman]

wow that looks like a major complication no? what are the chances of that with only 4cm of lenghtening.

but that device looks way cooler than external ilazarov, would you say the process is better using that device over the ilazarov, i think you mentioned less pain and it being much smaller.

[Descreteuser]

It's a minor complication.. But it doesn't effect functionality unless it restricts the movement of the knee joint.. The movement in my left leg is fine and when I put weights on my legs it straightens out completely which means by the time I have the frames off my legs will be normal.. I just have to deal with the fact that I'm going to have a bump on my leg.. I can ask the doctor to loosen the device and push the bone in but by doing that can cause other functional complications.. So I might just leave it.. No ones ever going to notice the bump on my shin..

[microman]

so now you have a permanent bump on your shin due to the surgery?

[Descreteuser]

Yep. . The last patient had the same problem but he ended up having to put clamps and thingscan on the device to push the pins back down which in turn pushed the bone back in.. He said the doctor tried to correct it but didn't get it do he took matters into his own hands..He had to deal with a lot of stress to get his legs where he wanted. He only did 5cm so u  imagine the problems u would have if u lengthened more with this device.. I'm not happy that I have a bump there but if I try to correct the bump than it could cause me a lot more stress than I've already been through..

[Descreteuser]

At the end of the day if I'm told that my functionality will be completely back to normal than I can live with a bump there.. But honestly the stress Im going through has really pushed me to limit..

[microman]

can the bump not be corrected with cosmetic surgery in your own country.

how large is the bump, maybe you can show a picture of some kind.

is this bump an issue that cannot happen using the ilazarov device?

because if it cannot happen with ilazarov, i will be going to russia instead, i don't want a bump on my leg.

[Descreteuser]

my doctor told me the bump will eventually disappear over time.it can be corrected once lengthening is finished but you have to be careful.. in my case because i dont care about the bump so much and am told it wont effect my functionality whatsoever than im not gonna bother as it can be a hassle. lizarov frame is bulkier which is good for keeping your leg in good alignment.. but theres other problems with lizarov you have to worry about such as damaging nerves and stuff as it penetrates alot of muscle.. the other thing is if you have bowed legs or x leg monolateral is good for correct that at the same time as lengthening.. so not only you get longer legs you get straighter legs.

[microman]

oh so it will disappear over time, well that's different then.

let's hope he is telling the truth, can you not describe the size of the bump, and its placement, so i can gauge how it would look on me.

is mitkovics device really less painful than ilazarov? this is an important aspect as i need to have the mental will to do 5cm.

[Blackhawk]

my evidence is your leg


it looks really bad, to be honest. your  osteotomy  looks bad, and your bone is bending outward

that's not normal. if you think all will be okay, that's your choice. I don't know what else to say. It wouldn't  be acceptable to me.

I agree with this^  Its not just a simple bump that you have to live with.  I would be surprised if this won't affect your walking.  I would try to get this fixed before consolidation.

[Descreteuser]

I agree with this^  Its not just a simple bump that you have to live with.  I would be surprised if this won't affect your walking.  I would try to get this fixed before consolidation.

i thought the same thing.. but after speaking to 2 doctors they told me if my knee joint can be completely straightened than it wont effect my walking.. im going to have my doctor visit me on monday or tuesday at which point i may have him push it back in a little it to have some piece of mind..

[microman]

how are you seeing other doctors in serbia?