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Author Topic: Dr. Monegal - Tibia and Femur - Fitbone - glenn  (Read 67263 times)

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glenn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #62 on: September 07, 2015, 04:27:29 PM »

Hi Penguinn,

Cooking, grooming, and PT homework take up a large portion of my day. As well, through my work I'm actually finishing up my Master's degree. Luckily, I can complete my few final credits online, so doing my course assignments here in Barcelona also takes a lot of my time.

Since my schedule is pretty busy, I don't really feel any boredom. In fact, there is so much more stuff that I want to learn and study I really have to make tradeoffs on my time!
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Penguinn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #63 on: September 07, 2015, 04:32:20 PM »

It's awesome that you're studying through this. How much time does PT take?
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glenn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #64 on: September 07, 2015, 07:01:20 PM »

Hi Penguinn,

Yeah, it's actually quite difficult to concentrate and hit the books with the nagging leg pain, but I get by.

Right now, PT is 10mins on the elliptical (at 15 kph today), walk about 2 or 3 mins along the parallel bars, and the rest of the time is exercises and stretches while laying down on the bench. The type of exercises evolve over time, getting more and more difficult as you master the previous ones. Total PT time is about 50 mins. And then he gives you PT homework for the day that you're supposed to do when you're at home ..
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Penguinn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #65 on: September 07, 2015, 09:33:11 PM »

That doesn't sound bad at all. Anything wrong so far?
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glenn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #66 on: September 07, 2015, 09:59:40 PM »

Nope!
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glenn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #67 on: September 13, 2015, 04:14:00 PM »

Two days ago Dr. Monegal stopped by and removed my stitchings for me. I was happy to see him and we got back to joking around in no time. He was satisfied that things were on track and as he was leaving I asked him if there was anything I could do. "Just be my friend," he says. Funny guy. I still remember the first time we met in person. I think there is a joke he tells everybody when he asks them how many cm they want to lengthen: "Glenn, there is only one rule to lengthening, you can't be taller than me!"   :D :D :D

Under Claudio's recommendation and with Dr. Monegal's permission, I've been told to get off the wheelchair and start using a walker. I must say I'm suffering a little bit of Stockholm Syndrome towards my wheelchair and missing the comfort of its seat.

So ironic. At the start of my LL planning, I was dreading the wheelchair stage, and now I find that I miss it. It's funny how our perceptions can be so changeable as we broaden our horizons and experience more things with an open mind.

My perception of disabled people has been altered, as well. I now have a better appreciation for what it's like for someone to live in a wheelchair. It takes both inner strength and inner peace to get through the day. Take, for example, something as simple as a piece of paper that has dropped on the floor: It's no one's fault that the paper has fallen, but for the person in a wheelchair that can't pick it up I tell you is one of the most profound feelings of mockery one can feel. From electrical sockets that are just out of reach, to doors that open the wrong way, everything is a constant reminder that the world has passed them by. So the next time you see someone in a wheelchair, don't avert your gaze. Instead, be the first to smile. He doesn't need your help; he just wants to know that he's a participant in this world and that society hasn't forgotten about him.

There was some miscommunication with my booking at the MIC, and they only have double rooms for single use left (no single rooms, I'm told). For Dr. Monegal's patients it's supposed to be 1470 euro but now I'm told it's 1560 euro for some reason. There are other tenants that have been told the same thing so it's not just me. User Bohemia, on the other hand, who is also staying in a double room, is paying 1470 as agreed without any problems. But he paid the day he checked-in, so maybe it's just bad luck for me. I prefer not to quibble too much about it because I don't want it to affect my mood during my recovery.

PT is painful and challenging, but I love it. Claudio is really amazing and I try hard to live up to his standards. It's not a matter of "going through the motions" everyday, because I can tell that he is keeping track of the nuanced progression of each muscle group and pushing my pain envelope ever so slightly each time. It is a tough job, because he must balance the pain inflicted with my own internal pain threshold. ROM is a moving target - if he takes it easy on me now my flexibility will suffer as I distract more and I may not achieve my target height.

I try to put on a brave face each time and say, "Give me more!" Luckily, Claudio doesn't let my bravado influence his judgment and does only what is necessary. I used to think I have a high pain threshold. Not anymore. All it takes is a few more degrees of flex to reduce me to a whimpering baby. I've been through the gamut of pain reactions: from calling out for mommy, to crying, to laughing hysterically, to grunting obscenities, to seeing spots and damn near passing out, to twitching uncontrollably. One thing I am particularly proud of myself though, is that despite the pain I've never asked him to let up or take it easy on me.

It sounds tortuous, but in reality PT is less than an hour everyday. But trust me, you will emerge from every PT session feeling like a real man, and that's just priceless.

As I finished today's PT session I limped back into the elevator, a mass of sweat and quivering legs. I was so dazed from PT I didn't even recognize my friend in the elevator. As it dawned on me, I lighted up and I grabbed my friend's hand awkwardly and we chatted ecstatically. I was originally worried about my friend, but it made me really happy and grateful to see that my friend was in high spirits.

I came back to my room and fell asleep with an ice pack on my leg.

The reason I take so many naps during the day is because I'm not able to sleep very much at night. Nights are purgatory. I average about three hours of sleep per night, waking up after one hour of sleep and spending the next two hours tossing and turning, trying to go back to sleep. I can feel it slowly taking a toll on my mental willpower, but I haven't figured out a way to combat this yet. Dr. Monegal says that sleeping pills require a prescription so maybe I will just have to suck it up. I would really prefer to just sleep for a few hours straight at night, since I'm not getting enough slow-wave sleep right now, which I personally believe is influential for bone growth. We'll see how much of a difference it makes when I do my x-rays in 10 days...
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Penguinn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #68 on: September 13, 2015, 05:29:55 PM »

You seem like a really pleasant person. I hope I enjoy my LL experience as much as you're enjoying yours. How many cm have you lengthened so far?
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G-Man

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #69 on: September 14, 2015, 07:56:05 PM »

You seem like a really pleasant person.

Of course, he's Canadian!  :P
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Penguinn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #70 on: September 18, 2015, 01:15:30 PM »

Of course, he's Canadian!  :P

That explains it. :D
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glenn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #71 on: September 27, 2015, 08:25:59 AM »

Today is the one-month anniversary of my surgery! Although I must admit it feels like a lot longer time has passed than that.

I've lengthened about 31 mm so far. To update a few things:

1. A few days ago, Dr. Monegal took user Bohemia and I to do some x-rays to check our progress. We went to a hospital about 400 meters from MIC. Part of the path towards the hospital is a steep slope, and Dr. Monegal told me to wait at the foot of the hill so he could wheel us up one by one. I didn't listen of course ::) and tried to follow behind Dr. Monegal as he wheeled Bohemia up first. It was a lot more difficult than it looked, but luckily for me, partway up the hill a young man, walking his dog, offered to help. Very nice of him.

Dr. Monegal was very happy with both Bohemia and my x-rays and said the results were "A++" I'm glad to receive Dr. Monegal's expert opinion and it gives me a certain peace of mind that he thinks things are going well so far.

2. Thanks Penguinn and G-man for the nice compliments! Truth be told I'm just a normal everyday guy with the same skepticism, cynicism, fear and doubt as anybody else. I feel very strongly though, that a positive attitude is required for a healthy recovery and I work very hard to keep myself optimistic about everything during this time. LL is tough enough, and inner negativity serves no one.

Also, I've met some really exceptional people here at MIC that have endured so much in their lives, it really makes me in awe of their humanity. There's something very transcendent and beautiful about the human spirit that seizes the day and pursues their dreams despite obstacles and hardships. When you see things like that you automatically become inspired to become more appreciative and helpful with those around you.

3. Sleep is still difficult for me, though. I find myself more and more in "zombie state" during my waking hours. I have to push myself hard to stay focused and concentrate when doing my coursework. Aside from the sleeping pains, I would say this is one of the most difficult things for me at my current stage. Even writing this post has taken more effort than I care to admit. :)

4. Somebody PM'ed me and asked if I feel that LL is worth the pain, money, and effort. I suppose the answer would differ from person to person. For me, it is something that I've wanted for many years so there is no question in mind whether it is worth it. But for others that are only borderline short, their motivation might not be as potent. In the end, I think the only thing a person has to ask is, how bad do you want it?
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glenn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #72 on: September 27, 2015, 10:04:49 AM »

(Loss of focus, forgot to mention some more things...)

5. Remember how I said MIC was charging me extra in a previous post? Well, Dr. Monegal saw that post and talked to the MIC. The next day the MIC came back to me and gave me the original price of 1470 EUR for a double room. Thank you Dr. Monegal!

6. KrP1 and I didn't room together and decided to get our own apartments ultimately. For the better I think since the sleepless nights would have driven both of us crazy  :D Everybody is on their own sleep schedule at the MIC anyway

7. The day after my x-rays I decided to only lengthen 0.81 mm per day (instead of 1.08mm previously). Dr. Monegal is ok with that, he said the only downside is that the number of lengthening days increase proportionally.
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axelf

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #73 on: September 27, 2015, 11:04:03 AM »

hey glenn,

nice to hear that you seem to be fine!

can you describe your pain level when:

(1) lying in bed

(2) moving your legs

(3) transfer with the walker

(4) PT


you said it's hard to focus during the day. is it because of your sleep deprivation or the pain or both?
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glenn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #74 on: September 27, 2015, 04:55:05 PM »

Hi Axelf,

For the most part, pain is not too much of a big deal considering the other options. Other Barcelona diaries have also said the same thing.

To put it in perspective, I still have 3 different types of painkillers from when I was discharged at the hospital (entyneum, nolotil and tramedol, for different degrees of pain). I actually haven't even opened the tramedol yet. A few times I thought I was taking tramedol, but it turns out it was just nolotil..just goes to show you the power of the placebo effect.

At my present stage, muscle stiffness is more of an issue. I'm not even sure I would call it pain; It's more like a nagging nuisance (like a migraine).

1. Lying in bed: The first inch of lengthening, up to pain level 3 or 4 perhaps? I relied mostly on ice packs and occasional nolotil. Nowadays, there is not much pain (level 2 at most?), but my legs get stiff if I don't move them around for a time.

2. Moving Legs: zero pain, except in the mornings when I wake up and my muscles are cold.

3. Using the walker: There's no sharp pain at all, but there is stiffness pain from all the tightened ligaments and muscles.

4. PT stretches: about 7 or 8 pain when I'm challenged at the extreme end of my flexibility. That is a good thing: If PT doesn't hurt then you're wasting your time and you might as well stretch at home.  :)

Difficulties concentrating during the day are probably due to about 65% lack of sleep and 35% muscle soreness.

....

Interesting thing happened just now as I took my clothes to the laundry room. The "laundry room" of the MIC is actually just a small closet space on the second floor with one washer and one dryer. The space can fit only one wheelchair so I would estimate it's about 2 or 3 square meters.

As I wheeled in, I met one of the staff here at the MIC, who was folding up towels. She introduced herself as Rosa, and we got talking. She was keen on practicing her English but my non-existent Spanish skills made communication difficult. Luckily, Google Translate saved me again.  ;D
 
What I found interesting in our conversation was the lack of discrimination towards LL. The staff here talk about limb lengthening matter-of-factly. "Did you do tibia or femur?" "How many centimeters will you do?" etc. etc.  I didn't feel like I had to give reasons for my decision or make any excuses. It was really liberating to just be myself to a stranger like that. Maybe it's because the staff here at the MIC have seen so many LL'ers by now so it's not a big deal for them.
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Aturro

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #75 on: September 27, 2015, 09:23:00 PM »

Hi Glenn,
sounds like you are doing just fine! I now how hard it is to sleep. will let you know how it improves after the lengthening phase...
31mm in a month is really good, I couldn't do as much over the whole period but if you are not in a hurry .8 should be sufficient and it makes like easier...

I never went to 7-8 pain level during PT, but I think I should have...more work for me now, but good for you...

keep up your positive attitude, you know its worth the effort...
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glenn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #76 on: September 28, 2015, 04:19:43 PM »

Hi Aturro,

Good to hear from you again! I read your diary update and am happy for you now that you've finished your first leg without problems. Please do let me know about your sleep patterns now that the lengthening is over.

Thank you for your kind words again, let's both keep up the positive attitude!
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Penguinn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #77 on: October 10, 2015, 01:27:18 PM »

How's it going? No updates?
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glenn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #78 on: October 10, 2015, 02:40:59 PM »

Hey Penguinn!

Nothing much to update on. Days are quite uneventful (which is a good thing, I think. Been reading about the different complications experienced by Programdude and Crimsontide..ouch). Every day is eat-lengthen-sleep-study, with PT on Monday/Wednesday/Friday. Basically I just try to stay safe and not do anything excessive that might injure myself.

Just lengthened to 40mm today so feeling pretty good. My tibia is great, no ballerina yet so far. My ankle has better-than 90 degree flexibility still. Femur is good, but I have to constantly work on hyperextension everyday to maintain my flexibility and straight knees. Quadriceps I have 90+ degrees ROM as well. Muscles can be pretty stiff and weak when I first wake up, but everything is fine when I get them warmed up. Soft tissue tension is expected and comes and goes.

Other than that, nothing too exciting really... Honestly, hope to keep it that way! And to all those other users on the forum that are going through issues right now, stay strong and hope you guys sort out those issues!
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glenn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #79 on: October 21, 2015, 07:51:03 AM »

Yesterday Dr. Monegal came to the MIC with three prospective patients. It was nice to talk to them and relate my experiences and tell them what to watch out for. People ask me all the time, "what would I do differently, knowing what I know now?" And the answer I give everyone is the same: stretch, stretch, stretch! I stretched like a maniac the months before my surgery, but even now I wish I had stretched even more. I could do standing pike stretches no problem, but maybe I should have stood on some books or something to increase the difficulty.

Also, people ask me if I feel any difference, or if I feel taller. Not really, since I'm always on a wheelchair and all the counters and tables at the MIC are lower anyway. But yesterday, after standing next to Dr. Monegal I was pleasantly surprised to see how much I had grown. That was a good psychological boost for me. Dr. Monegal even joked that he wouldn't complete the second round of surgery for since I was getting too tall (I still remember his joke when we first met: "There's one rule to LL, Glenn. You can't be taller than me!" hahahaha).  So although I'm still considerably shorter than Dr. Monegal (who I estimate at 180), it was cool to see how the gap was lessened.

How tall am I now? I estimate I should be nearing 170 or so. The reason is because I was definitely shorter than user Adonis, who I met days before my surgery. He measured his height on a stadiometer and was 165.5cm, so I was definitely shorter than that before my surgery.
 
Anyways, the three people I met yesterday were great guys. They said they were all on the forum, but I didn't get their contacts at the time. So fellas, if you're reading this, feel free to drop me a message or something. Would love to stay in contact and see how your journey turns out.

In other news, I'm almost done my tibia. It was getting tough and I started losing 90-degree-flexibility on my ankles at about 42mm or so. I've been fighting hard to stave off the ballerina feet, but it's ok since I'm almost done. I am at 47mm today, aiming for 50mm, so things should ease up in another 3 days.

Barcelona is getting cold now. I need to sleep in long sleeves and long pants to sleep comfortably. Mornings are nippy.

Off to physiotherapy now!
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treemonger

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #80 on: October 21, 2015, 09:00:35 AM »

Hi glenn, been following your journal and the other Monegal kids. I consider you guys the first wave.

Thanks for your advice in needing to stretch more pre-surgery.

I have plans to come early December for consultation and surgery. Hopefully we can meet when you're back February for the 2nd leg of your journey (pun intended).

Keep us updated with your progress.
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glenn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #81 on: October 21, 2015, 04:27:05 PM »

Hi Treemonger!

Actually I think there are few forum guys here that have already went back to their home countries after operation with Dr. Monegal, but I don't think they bothered to do diaries.

Haha, "2nd leg"  ;D ;D ;D ;D  Sounds good! Would be awesome to meet you in February, looking forward to it!
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glenn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #82 on: November 04, 2015, 04:50:40 PM »

Hi All!

So it's been about three days since I arrived back in Canada.

I'm sad to leave the MIC, but it was time to go. Even though I miss all my MIC friends, I was starting to go crazy with all the seclusion.

Susana, the manager at the MIC, arranged for a special disabled taxi to take me to the airport, and even asked the driver to help me carry my bag all the way inside the airport to the disabled counter. The disabled counter is a free service offered by the airport to help disabled people board their planes. The workers will help you check in and get through the security check. This was extremely helpful for me since I was traveling with my own wheelchair. 

Some notes:
They let me bypass the metal detectors on my wheelchair, so I don't know if Fitbone sets off the metal detectors or not.
I put the distraction machine in my carry-on luggage and it passed through the x-ray scrutiny without incident.
I had my x-rays and Clinica Diagonal discharge papers with me, but were unnecessary since nobody asked me to prove my disabled status.

The disabled service was extremely efficient, and within an hour of leaving the MICs I was already in front of the boarding gate waiting for the plane.

For the two months at the MIC I only interacted with a handful of people, and upon getting to the airport I was flooded with new experiences. I probably interacted with more people in two hours at the airport than I did for the past two months! Although I miss my MIC friends, I think it was necessary to move out of the comfort zone and get out there.

I've noticed that people are nicer to you when you're on a wheelchair, but tend not to directly look you in the eyes. Oh well, at least I can use the handicap washrooms without guilt now. :-)

Normal wheelchairs can't fit along the aisles of a plane, so boarding the plane requires that the airport staff transfer you to a small wheeled-chair. From there, two airport staff will drag/lift you to your designated seat. Although I didn't get any special seat considerations, the seat that I chose was right next to the lavatory, which made me going to the washroom a lot easier for everybody. I also made a note to constantly stretch and move my legs as much as I could. After touching down, the airport staff will get you off the plane the same way and then will help you through customs and getting your luggage.

At home, I told my parents and brother about the surgery and answered their questions about the procedure. They were shocked at first, but handled it quite bravely. In the end they were quite supportive of everything, which I am very grateful for. Although I'm quite sad to have to put them through the stress. Sometimes I think it might have been easier on them if I didn't come home and recuperated on my own elsewhere.

It's interesting to note, nobody noticed my height change until after I had told them about the surgery. Then it was, "Oh hey, you're taller now!" 

My home isn't wheelchair adapted, so I'm forced to get by around the house with a walker and crutches. I think this is a good thing to get out of the comfort zone. I was getting a bit too attached to my wheelchair.

Straight out of bed my legs feel weak and unbalanced, so I use the walker. When my legs are warmed up after stretching and working out, I use the crutches without problem. Using either the walker or crutches I feel pressure on both my knees, and also weakness on my left adductors when I left my leg to take a step. I'm not too worried about it and I'm sure it will get better over time.

Getting up from a seated position (like the bed, or the toilet) is difficult, mostly because they are quite low and there aren't any handholds to grab onto. Also, going up and down stairs is laborious, so I try to keep that at a minimum. My current aim is to not do anything excessive risky that might cause injury or a loose screw or something since I am all the way back in Canada now.

Also, in my province of Ontario, I think there is a law that requires a local doctor to refer for x-rays. In other words, I can't just walk-in and pay cash for x-rays. I need to have a requisition by a local doctor to tell me to do it. I don't have a local doctor, or OHIP, so if anybody here on the forum has any advice, please let me know!

Other than that, I'm quite surprised actually at how fast the progress is. I'm on day 65 of my lengthening, and I'm currently at 61 mm for my femur. Seems like a lifetime ago, but in reality it's only been slightly over 9 weeks since I flew to Barcelona and had my surgery!
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yagen

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #83 on: November 05, 2015, 11:21:36 AM »


Nice news about you.

Just 2 weeks and the consolidation phase will be over. How many time do you need to start to walk with confidence.

How many cms have you done in your tibia?? the same that in the femur??

Could you do a normal job in a office, just light??

Many thanks and good recovery
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glenn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #84 on: November 05, 2015, 12:43:41 PM »

Nice news about you.

Just 2 weeks and the consolidation phase will be over. How many time do you need to start to walk with confidence.

How many cms have you done in your tibia?? the same that in the femur??

Could you do a normal job in a office, just light??

Many thanks and good recovery

Hi Yagen,

Well, just over about a week or so I will finish lengthening in my femur (I am aiming for 7cm). My tibias I stopped at 5cm, so right now there is a slight discrepancy already between my two legs.

I think it will take a long time for full consolidation to take place. (I've read papers that say about on average it takes 1 month per each cm lengthened, but I'm not sure). About walking confidently, I don't know.. stay tuned to this diary to find out! :-)

Yes, I think it's absolutely possible to work a normal office job at this stage. The only problem would be mobility (does your office have a lot of stairs? Elevators? Wheelchair access maybe? etc)..

Good luck with your consultation with Dr. Monegal next week!

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yagen

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #85 on: November 05, 2015, 04:31:31 PM »


Thank you Glenn,

My main dilema its about if to do a bilaterial femur in one phase or in two phases. I live to 500 km from barcelona.

Doctor Monegal has recommended me in two phases but I prefer feel the pain just one time.

In my office there are some elevators and its easy to move in crutches, but if I will do the bilateral femur in one operation, I dont know when I could star to work at the office.

In your case, when would you be able to come back at work if you only need stay in the office 4 hours?

Many thanks


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glenn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #86 on: November 05, 2015, 08:01:33 PM »

Hey Yagen!

If you are in a rush to go back to work, two stages is the only sensible option. Even in two stages I think you would still need a few weeks to realistically recuperate enough to start going to work. Your body will be in a very frail state after surgery. It's not like a nose job or a boob job; I assure you LL is serious stuff and you really have to give time for your body to recover.

Aside from accessibility of the office you also have to think of transportation. Not just how to get to work everyday, but also how will you transport yourself to and from the clinic after the surgery.

For bilateral femur in one phase, I think one whole month is the barest minimum you would need (if you look at my diary, I was only back up to working speed at about week 7 or so). But one month is only the minimum, I think two months is better. Bohemia and KrP1 both did bilateral femur in one stage, and I think they would say the same thing, that two months is better than one.

Also, I would suggest that you really to have to be serious with yourself and ask yourself about the amount of time you can commit to LL. It's ok to have a recovery timeline, but I know more than a few patients that have had to extend their absence to unpaid leave because they were too optimistic about their own recovery times. Best to have a very conservative timeline in your head.

Hope this helps! Let me know if you have any more questions.

« Last Edit: November 05, 2015, 08:22:04 PM by glenn »
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Deutsch Mark

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #87 on: November 06, 2015, 12:43:40 AM »

I think you should do one phase. Doctors disagree about it but this is what Dr Guichet says in his page and it makes sense to me.

"Operating on one leg at a time means two separate procedures. Dr. Guichet's patients have only two to three surgeries in total (including the nail removal surgery) when he operates on both legs at once. By lengthening one leg at a time, you will spend twice the amount of time in surgery, twice the amount of post-operative pain and have a twice as long period of rehabilitation. There are no benefits in treating each leg as a separate case.
 
Studies on bilateral operations have shown that the cumulative risk of a two-step bilateral surgery is a 2 (1+1), while doing the two operations at once lowers the risk to 1.6. In other words, the more surgeries you endure, the greater your risk of complications both during and after the surgeries."
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goldenegg

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #88 on: November 06, 2015, 02:13:27 AM »

Also, in my province of Ontario, I think there is a law that requires a local doctor to refer for x-rays. In other words, I can't just walk-in and pay cash for x-rays. I need to have a requisition by a local doctor to tell me to do it. I don't have a local doctor, or OHIP, so if anybody here on the forum has any advice, please let me know!

Hey glenn, the US is the same way - you can't get xrays without an order from a US doctor.  I made an appointment with a local family doctor and came clean on what I did to myself and explained that I needed to take regular xrays to send back to the surgeon.  It was awkward at first but she's been fine with writing the orders.  on the plus side, my insurance covers mosts of the xray costs now.  I've heard canada has great health coverage.  I read some other diaries where patients get referred to a local orthopedic surgeon so they have a 2nd person reviewing the case.  My local physician is just an internist so she can't really give a qualified opinion but I don't mind as long as I have the xrays to send to my LL doctor.  hope that helps!   
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yagen

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #89 on: November 06, 2015, 10:55:51 AM »



Deutsch and MusicMaker,

Thank you for you recomendation, On monday I will talk with monegal both options  and the pros and cons.

Glenn,

Your opinnion is very important for me because now you know what things you can do it , and canĀ“t do it, the pain and the problems that you have to solve every day. Yes I think if I will do in two phase i will be rest one month after the surgery till I came back to work, if I will be done in one phase I think like you, Bohemia and Krp1 I will need at least two months.

Good recovery

I am very apreciate for your best opinion.

Thank you.
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glenn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #90 on: November 07, 2015, 01:22:42 AM »

Thanks Deutsch Mark and Musicmaker for your different viewpoints!

My belief is that there are pros and cons between one-stage and two-stage.

My personal opinion is that two-stage is "slightly safer, but takes slightly longer." I say safer because there are less variables to manage at one time, meaning less things can go wrong. Also, in terms of day-to-day mobility, if you lose your balance while moving on your crutches, or in the bathroom, you can always save yourself by putting your weight on your good leg. I'm on crutches now so I realize that this is a big plus.

For Fitbone, there's no need for a wheelchair when doing two-stages. That's not a trivial consideration. For G-nail there is no need for wheelchair either (I think), since it's full weight-bearing. But is the mobility really comparable to two-stage patients? I'm not sure that it would be. 

But the big disadvantage for two-stage is the time involved (both in terms of number of surgeries and recovery time) and more importantly the prolonged psychological stress for the patient. This too, is not something that is trivial.

I guess every patient's value system is different, and it just depends on what aspect is more important to them.
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glenn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #91 on: November 07, 2015, 01:28:07 AM »

Hi Goldenegg, thank you for the advice!

Yep, I think I will have to do the same and find a walk-in clinic. I wonder if I can get away with just telling them that it was to correct axis deviation or valgus?

btw, how's your recovery coming along?
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glenn

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Re: Dr. Monegal - Tibia and Femur - Fitbone - glenn
« Reply #92 on: November 07, 2015, 01:31:26 AM »

Hi Yagen,

No problem at all, my pleasure! Feel free to let us all know how it turns out.

Good luck!
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