4/4/2016 – Day of the surgeryInitial Height: 160.5 cm
Target Height: 166 cm
Wingspan: 173 cm
Method: Externals using TSF
Doctor: Manesh Dhawan
Cost: 15k USD
Preface: Before I begin this diary, I would like to thank
KiloKhan and
Phoenix for all the valuable information/support they have provided on this forum, which has immensely helped me in choosing the right doctor.
On the day of the surgery: I was very nervous on the day of my surgery. I got admitted the night before the surgery on 4/3/2016, at around 10:00pm. I was told not to eat or drink after 12:00am, and to sleep tight and wake up at 6:00am.I couldn’t sleep at all due to the nervousness and anxiety. At 6:00 am, my surgery preparations have started - which includes conducting a series of tests like blood test, urine test etc. I had history of seizures. So my surgeon and the anesthesia team had to get consent from neurology department that I’m ready for the surgery and don’t show any signs of seizures. So I was taken to the neurology department. They performed MRI scan and ECR reports, and gave their blessings for the surgery. I was then on my way to the operation theatre at around 11:00am.
During the procedure: On my way to the Operation theatre, I got to have a quick chat with one of the anesthetist. She explained the finer details of the procedure – like how many folks would be present in the surgery room and what their responsibilities were. We have the anesthesia team (3 members), Surgeon’s team which includes Dr. Dhawan and his two assistants, three nurses (dedicated to clean blood), and couple of folks from TSF team (they need to keep track of and provide necessary TSF equipment – like rings, screws, pins and distractors, to Surgeon’s team). First the anesthesia team would induce local anesthesia, and once it’s active the Surgeon team and the remaining teams would start operating. They put a green robe front of my chest, while lying down on the surgery bed, so that I don’t see my lower half. I looked around the room for any reflective surfaces
behind me, so that I can peep, but couldn’t find any. So I just stayed relaxed and waited for the procedure to be over.
I was given spinal anesthesia, instead of general anesthesia, because I have a history of seizures. Spinal anesthesia wouldn’t knock you off completely. It’s a form of regional anesthesia – In my case, I couldn’t feel the lower half of my body, but I was awake during the procedure. So I got to see how the team operates, how they coordinate and interact with each other, and trust me it was very funny and scary at the same time. Funny because the Dr. Dhawan was constantly yelling (like tough love) at his team members to ensure they do their work correctly, and scary because I could hear loud noises of my bones getting broken with the chisel. The procedure was done first on my right leg, which took about 3 hours. Then the teams took about 30 mins break and performed the same procedure on my right leg. After operating on my right leg, Dr. Dhawan’s team members were swapped by new folks. He however continued to remain throughout the procedure. From what I heard during the procedure, he handles critical aspects of the surgery, leaving the rest less critical jobs to his team mates under his supervision.
I would like to mention that Dr. Dhawan had reiterated multiple times to everyone in the operation theatre that this is a cosmetic surgery and not a typical leg lengthening surgery for trauma or leg-length discrepancy patients. So the room for error should be zero, and the teams have to make sure they don’t introduce any new complication, and I should be able to return back normal after the procedure. That felt very reassuring that I chose the right doctor.
Post-surgery, I was taken back to my room at around 11:00pm. I was given pain killers round the clock for the next 4 days, so I didn’t feel much pain. On day 2, the physiotherapist asked me to stand up with assistance of Zimmer frame. On day 4, he asked me to walk for few steps. I was able to manage both the sessions with little pain. I was discharged from the hospital on April 7th. Dr. Dhawan said that lengthening would begin from 10th day. I came home on April 7th, and relaxed for the next couple of days. I was given medication for the next two weeks. It includes anti-biotics, pain killers (I’ll include a separate post about pain killers), antacid tablets. I started physiotherapy sessions at home from April 9th for 1 hour. Antacid neutralized acidity in the stomach. I had to take this pill first thing in the morning on empty stomach, for as long as I’m taking anti-biotics.
Images:
X-Ray of my legs before surgery:
TSF Frames:
Key Info regarding my frames –
TSF frames have about 2 or 3 big rods, per leg, that protrude outside the ring. These rods are usually placed in such a way that they protrude towards the other leg. This kind of set up would lead to constant collision while walking, sleeping and while cycling in gym, which is very inconvenient. To my pleasant surprise, these rods where placed towards outward side of the leg, so I’m able to perform above tasks without collision of rods. If you have plans for LL, you may request your doctor to install these rods like mine, which can be a huge deal. See below screenshot for clarity.
Why did I decide to go with TSF?I have mild bowleg and I’m quite over weight (76kgs – BMI = 29.8 ). TSF allows for very precise correction of Varus (bowleg). Also, Dr. Dhawan insisted to go with TSF as the complications are less, and it provides full weight bearing (which is a must for fat ass like me) from next day of the surgery. It also provides better structural rigidity over other illizarov frames, and it has only two rings with ample space above my ankle (Standard illizarov frame has 3 rings, and the bottom ring would be very close to ankle, making it difficult to exercise ankle. This makes difficult to control foot drop). See below screenshot for clarity
Right Leg:
Left Leg:
April 15th – Unbearable nerve pain that made me cry; More about Painkillers for dummiesOn the night of April 15th, I got severe nerve pain on my left leg near the pin site (left side) below my knee. It was unbearable and I cried couple of times due to the severity. I had to put my left leg in static position the whole night (9:00pm to 8:00am). I never in my life experienced such a pain. I called doctor at 8:00 in the morning and he prescribed Lyrica tablet. I ordered it in the nearby medical store and they delivered it at around 12:00pm. I took the tablet and slept tight for few hours. Since this incident, I developed stiffness in my left knee which lasted for the next 10 days. Now, I want to take a moment and explain of various types of pains I experienced post-surgery.
- Skin pain near the pin sites. Prescription – Hifenac-D is prescribed for this pain. This is a heavy dosage pain-killer, therefore doctor asked me to take this only for the first two weeks post-surgery. Ultracet tablet is prescribed after two weeks, which is a milder version of Hifenac.
- Muscle ache/tightness/stiffness/Sprain – I apply some pain killer spray (used for sprain) and massage on the target area. This pain is prevalent on my calf. Sometimes it gets so annoying that you cannot sleep. You can also heat coconut oil and massage daily on your thighs and calf, it feels very relaxing.
- Nerve Pain – This is the worst pain that I encountered so far. Doctor has not given me any medication for this pain because I shouldn’t be getting this pain in ideal scenario. But you know that LL journey is nothing but ideal. I was taking Hifenac pills but they didn’t work at all. Lyrica tablet should be used for this. The way it works is that it numbs your neurons, making them less susceptible to pain. This is a very addictive tablet, so I only took these pills for 3 days (1 pill per day). I suggest you to keep this pill with you, even if your doctor doesn’t prescribe it, as it can help you in emergency situations like mine.
May 4th – 1.5 cm doneI finished lengthening 1.5 cm. So far, my journey has been smooth with little discomfort. I felt severe calf pains when I distracted 1mm per day. I then distracted .75 mm for 3 days, and the pain reduced. I’m now distracting .75 mm per day to avoid muscle pain. I’m also having a tough time sleeping. I sleep only for around 2-4 hours per day. Regarding physiotherapy, I perform 2-3 sets of physiotherapy exercises on my bed per day. One the morning, one in the evening and the last one late night. Along with that, I stand up/walk for about 30-45 mins per day during evening/late night. We have a gym downstairs, so I spend 30 mins cycling and about 30 mins on upper body exercises. I think I’m getting used to this life.
Author
Topic: Bilateral Tibia Lengthening and Varus correction with TSF (Read 37789 times)