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Author Topic: My LL Journey - Dr. Jamal Abu Nemer, Kiev  (Read 16724 times)

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Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #62 on: May 11, 2018, 03:10:56 PM »

good to know you're doing fine, man! keep going

this is an interesting diary tho.

Thank you very much my good friend.

I read your email today. I will reply to you shortly.

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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #63 on: May 20, 2018, 03:54:23 PM »

Day 25 Update:

I haven't been updating my journey for a while. I thought I would wait a bit till I have more information on my left leg.

Left leg operation was done last week. I am back at the apartment now and waiting for my left leg to recover. I can't emphasize how helpful my right leg is regarding the weight bearing. My left leg is very weak right now, so the right leg is taking almost all the heavy load when I go back and forth to e.g. the bathroom, when I sit on a chair, etc.

Dr. Jamal is checking up on me every day as usually. He has been checking the wounds on my left leg every evening and changing the plasters. He gave me today waterproof plasters on the left leg. By the way, I have no more plasters on my right leg. The stitches are also removed.

He helped me to enter the shower with the walker to take my first shower after a week now and waited for me in the kitchen with my helper. It was very refreshing to take a warm shower after almost a week.

We did also our first few clicks on the left leg. We did only 7 clicks today.

Otherwise I am clicking 18 clicks on right leg every day (1 mm per day). There were couple of days at the hospital after the left leg operation where I was exhausted, so I didn't do any clicking. But I am back on track on the right leg clicking routine.

We are waiting for the left leg to get more strength so we can start clicking 1 mm per day too.


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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #64 on: May 22, 2018, 07:39:38 AM »

Dear experts

I can see from the forum that the majority talks about lengthening 1 mm per day. Even Dr. Jamal advised me to click 1 mm every day.

Just out of curiosity. Is it unheard that anyone from here (trying to reach about 5 cm in total) ever clicked 1.5 mm or 2 mm per day without complications?

Its just a thought that crossed my mind, so I thought I would hear it from you experts.
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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

Body Builder

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #65 on: May 22, 2018, 09:51:57 AM »

Dear experts

I can see from the forum that the majority talks about lengthening 1 mm per day. Even Dr. Jamal advised me to click 1 mm every day.

Just out of curiosity. Is it unheard that anyone from here (trying to reach about 5 cm in total) ever clicked 1.5 mm or 2 mm per day without complications?

Its just a thought that crossed my mind, so I thought I would hear it from you experts.
So big distraction rate will lead to nerve damage and soft tissue problems, even it may cause non union.
So there is no reason at all to lengthen mire than 1mm. On the contrast, I would suggest even less like 0.66mm per day, especially on tibias.
Slow lengthening makes consolidation easier and safer. Fast lengthening could easily cripple the patient.
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Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #66 on: May 22, 2018, 10:24:31 AM »

So big distraction rate will lead to nerve damage and soft tissue problems, even it may cause non union.
So there is no reason at all to lengthen mire than 1mm. On the contrast, I would suggest even less like 0.66mm per day, especially on tibias.
Slow lengthening makes consolidation easier and safer. Fast lengthening could easily cripple the patient.

Thanks for the explanation Body Builder

Interesting to know that.

By the way, I click 0,5 mm in the morning and 0,5 mm in the evening. I saw some youtube videos where patients are lengthening 0.25 mm four time a day. Do you know if it makes any difference?

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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #67 on: May 24, 2018, 09:22:38 PM »

Day 30 Update:

I am still clicking the right leg as expected. I sometimes give it extra clicks during the day. According to my counting, I should have passed 2 cm on right leg by now. So I would guess I am as a minimum around 172.5 cm by now, taking right leg calculation only into consideration.

Since my left leg is still weak, Dr. Jamal is helping me clicking it during his visits. We increased the clicks today to 1 mm per day.

Regarding my walking, I am still relying alot on the right leg to support my weight. I can ofcourse stand still with both legs without any issues. I do it for example when I brush my teeth or do other daily activities. I can ofcourse feel that the left leg is getting stronger every day, but it is going slower comparing to my right leg after the first operation.

I asked my helper to stop giving me the 5 hours injections today. I switched to the pain killer pills. I will give it till tomorrow and see how it will go. I might go back to less injections and add the pills as a supplement into the daily routine or just stick to the pills only.

When I watch Netflex, I am lying in bed either on my right side or my back. The left side is not ready yet. I will give it a week or two till it becomes stronger and we remove the stitches from left leg.

I'm very excited about future progress in June. It will be very interesting.

Other than that. I'm eating healthy & sleeping well. So far so good.

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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

Android

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #68 on: May 24, 2018, 10:10:25 PM »

Glad you're doing well Rocky, hope that your pain management to pills is a smooth transition.
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5'4" and 1/4" (163.2 cm) | United States | early 30s | Cross-lengthening with Dr. Solomin & Dr. Kulesh

Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #69 on: May 25, 2018, 10:03:21 AM »

Thanks my friend Android. So far its going fine. The muscles are a bit stiffer when I take the pills. But it is manageable.

Unless it becomes worse, I will keep taking pills instead of injections.
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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #70 on: May 27, 2018, 10:15:51 PM »

Day 34 Update:

I am clicking now both legs every day. I split the clicks for the right leg during the day. I still can't click the left leg alone since it is still weak. So I wait for the evening time to get it done by Dr. Jamal's help.

I can walk back and forth and perform daily activities and do full weight bearing without issues, but my walking has decreased due the fact that my left leg is still recovering.

I have noticed that my hamstrings muscles on the right leg are beginning to be tight when I stand still.

I have consulted Dr. Jamal about it and he said that is it expected and it will be more tense the more I lengthen. His advice was to keep walking during the day, so I can keep the muscles active. He also advised to sit in the shower tube and fill it with hot water to relax the muscles. I was also informed to stretch as much as possible and put a pillow below my feet when I am laying in bed. That way, my hamstrings will be stretched. I started doing so and I can feel how tense they are when I stretch this way.

Another detail about pain killer injections. I stopped the injections totally and I am getting pain killer tablets every 4 hours. It is working fine with me this way.

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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

Hamiltonzac

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #71 on: May 28, 2018, 04:43:18 AM »

Good luck Rocky, I wish you a decent recovery. Very precise and detailed diary. Good for future patients. Its nice to know your family supports you and you have great motivation for recovery, much respect!
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Johnson1111

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #72 on: May 28, 2018, 06:04:35 AM »

Good to hear everything is going pretty well. Hang in there you have our support and thank you for continuing to update the diary.
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Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #73 on: May 28, 2018, 07:40:01 PM »

Good luck Rocky, I wish you a decent recovery. Very precise and detailed diary. Good for future patients. Its nice to know your family supports you and you have great motivation for recovery, much respect!

Hello Hamiltonzac

Thank you very much. Limb lengthening is a lengthy process. You click day-in/day-out and try to occupy your self to kill the day. If you don't surround your self with family or friends, even if it is online, it can be a very lonely journey. I have completed my first month and looking for another two months or so. I hope it will be a smooth journey all the way.

Good luck to you too in the future.

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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #74 on: May 28, 2018, 07:42:49 PM »

Good to hear everything is going pretty well. Hang in there you have our support and thank you for continuing to update the diary.


Hello Johnson1111

Thank you very much. So far so good. I'd always appreciate any advises or support for the experts in here. Did you do limb lengthening or just about to?

Have a pleasant evening.
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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #75 on: May 28, 2018, 08:02:18 PM »

Day 35 Update:

Not much new. Since few days I have been asking Dr. Jamal to replace my Russian speaking helper with an English speaking helper.

I told Dr. Jamal that I am not expecting the helper to have a PhD. in English. If she just can pick up simple words in English, its more than enough for me.

Frankly speaking I had language difficulties with the previous helper. She didn't know any word in English and I don't know any word in Russian. Every time I wanted to say something or she wanted to communicate with me, we had to use my translator app on my mobile or Google Translator. Sometimes the app gave strange translations and in few cases we just didn't know how to communicate.

Today was the last day for my previous helper. He introduced me to another helper who can speak a little bit English. She uses simple words in English, but it is more than enough for me to have a smooth communication.

It is a big relief that I don't have to carry my mobile with me or go back to my laptop to open Google Translator to be able to communicate.

Since I can walk freely and can take care of myself without issues, we agreed that she will only be at the apartment for max 5 hours daily. She will buy grocery, cook, clean, wash my clothes, and make sure I don't miss anything, etc. and then leave home once she is done. I promised that I will still give her full day payment.

I'd like to have some privacy. Especially when I talk online (loudly  ;D) and get silly with my wife and kids :) so this agreement is perfect for me.

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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #76 on: June 04, 2018, 05:22:38 PM »

Day 42 Update: (Right Leg = 3,8 cm & Left Leg = 2,5 cm)

The latest updates are as follow.

The back muscle of the right leg started to be more tense now. I mean the hamstrings muscle. That means when I walk my knee is bending a little bit. Left leg is still straight while I am walking but I started feeling a minor tension in the left hamstrings muscles as well.

I am still clicking twice a day with Dr. Jamal's help. We are doing different amount of clicks every day but its higher than 1 mm per day. Dr. Jamal visits me around noon time where we do half of the clicks and in the evening we complete the remaining clicks. The nail that I am using clicks only when you relax your leg. After I passed around the 2 cm, I tend to not relax my muscles when I try to click alone. Therefor the nail does not give any sound when I do it while I am tense.

When Dr. Jamal does it, he holds my leg and moves it gently back and forth and from side to side several times to make the muscle relax. Then he starts clicking. It goes smoothly when he does it, so I decided to let him to it on my behalf and save me alot of efforts during the day.

Now that we have passed more than 1 month, it is time to begin with physio therapy. So he is planning with a Russian physio therapist to begin the daily treatment. I will hear more about the details in the coming few days.

Today we did X-Ray scanning to examine both legs. We are now around 3,8 cm for right leg and 2,5 for the left leg.

I have 1,2 cm left to reach 5 cm on right leg, and I am thinking: "Is that it??? It went fast".

Maybe I should go higher than 5 cm! ;D

Here are some photos.

https://imgur.com/a/e4zBEon

« Last Edit: June 04, 2018, 06:38:36 PM by Rocky »
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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #77 on: June 05, 2018, 02:28:22 AM »

Hello experts... I need your help please  :)

I have been thinking all night about my new height after yesterday's X-Ray. I couldn't sleep thinking about it :)

I am very close to my goal (5 cm) on right leg, and it went easier than what I was expecting. I am therefor thinking about changing my goal to a higher height. Although I am very excited now, but I am trying to think rational.

Will anything between 7-10 cm on my femurs be too greedy? I'd really like to have a second opinion or advice from experts like you guys.

Pros/Cons from real life experience? From other people that you know maybe?

Please help  :)
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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

Johnson1111

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #78 on: June 05, 2018, 03:04:50 AM »

Hello experts... I need your help please  :)

I have been thinking all night about my new height after yesterday's X-Ray. I couldn't sleep thinking about it :)

I am very close to my goal (5 cm) on right leg, and it went easier than what I was expecting. I am therefor thinking about changing my goal to a higher height. Although I am very excited now, but I am trying to think rational.

Will anything between 7-10 cm on my femurs be too greedy? I'd really like to have a second opinion or advice from experts like you guys.

Pros/Cons from real life experience? From other people that you know maybe?

Please help  :)

I'm pre LL but from experiences i've read and what i've heard from doctors i've spoke with that do the surgery, 3 inches seems to be the upper "fairly safe" limit for patients. So I believe that's around 7.63cm ( I suck at the conversions ) if i'm not mistaken or around there. Anything higher than that and I believe you are put in the "moderate/high risk" category.
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Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #79 on: June 05, 2018, 04:28:12 AM »

I'm pre LL but from experiences i've read and what i've heard from doctors i've spoke with that do the surgery, 3 inches seems to be the upper "fairly safe" limit for patients. So I believe that's around 7.63cm ( I suck at the conversions ) if i'm not mistaken or around there. Anything higher than that and I believe you are put in the "moderate/high risk" category.

Many thanks dear Johnson1111. I guess your conversion is fine my friend.

But I was wondering about what does it mean to be in a moderate/high risk category? I mean, what could go wrong if I go for anything between 7-10 cm? I'm really curious to know.

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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

Christopherbulder

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #80 on: June 05, 2018, 08:00:51 AM »

7CM is best for me  no disproportion
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Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #81 on: June 05, 2018, 03:17:27 PM »

7CM is best for me  no disproportion


Hi Christopherbulder

7 cm is a respectable amount. No doubt. But disproportion is the cosmetic part of it. I wanted to understand the risks going above 7 cm.
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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #82 on: June 06, 2018, 03:04:10 PM »

Day 44 Update:

Today was probably the most relaxing day since my journey.

I've got a visit from the Russian physiotherapist. I've got 2 hours oil massage for both legs. 1 hour per leg.

That was amazing. It was like flying to heaven and come back 8)

From now on I will be getting 2 hours massage every day as part of the treatment.

I strongly recommend having physiotherapy massages included as part of anyone's journey.
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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

doomsday

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #83 on: June 07, 2018, 12:00:52 AM »

I looked at your xray and your callous looks very weak. Whats the diameter of the nails?
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Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #84 on: June 08, 2018, 11:35:55 AM »

I looked at your xray and your callous looks very weak. Whats the diameter of the nails?

Hello doomsday

What is a callous exactly? And how can you tell it is weak?
I will ask about the diameter today. I don't remember that information.
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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

Body Builder

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #85 on: June 08, 2018, 02:43:51 PM »

Hello doomsday

What is a callous exactly? And how can you tell it is weak?
I will ask about the diameter today. I don't remember that information.
Callous is the bone bridge between two sides of the bone after the break.

Indeed it is very weak and you risk non union. Ask your doctor to stop lengthening for a few days and if callus remains so weak I dont believe you can lengthen much more or you'll end up with a non union.
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Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #86 on: June 08, 2018, 09:04:41 PM »

I looked at your xray and your callous looks very weak. Whats the diameter of the nails?

Hello doomsday

I have Dr. Jamal visiting me now. He informed me that the diameter of the nail is 12.5 mm.
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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #87 on: June 08, 2018, 09:12:33 PM »

Callous is the bone bridge between two sides of the bone after the break.

Indeed it is very weak and you risk non union. Ask your doctor to stop lengthening for a few days and if callus remains so weak I dont believe you can lengthen much more or you'll end up with a non union.

Hello Body Builder

I am consulting Dr. Jamal right now. He is informing me that it is too early to judge the callous after a month of my lengthening. Regarding non union, he has different methods to solve it. One of them is the stem cell treatment that I will be getting at the end of my lengthening, which is a new and effective method. He has also other traditional ways regarding non union. So this is his least concern.
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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

Body Builder

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #88 on: June 08, 2018, 09:29:22 PM »

Hello Body Builder

I am consulting Dr. Jamal right now. He is informing me that it is too early to judge the callous after a month of my lengthening. Regarding non union, he has different methods to solve it. One of them is the stem cell treatment that I will be getting at the end of my lengthening, which is a new and effective method. He has also other traditional ways regarding non union. So this is his least concern.
I dont know what methods Nemer has to treat non unions.
But if the gap is big, no much things can be done, like Unicorn's case where she may need to shorten the gap and lengthen again as a last solution.

So dont trust blindly your doctor like Unicorn did and ened up with an 8cm non union,  non unions are the first concern after infection, not the last. With almost non existent calus I wouldn't lengthen further until it gets thicker otherwise you are risking troubles.

Anyway, on your next x ray if your calus is so minimum you should stop asap. But I hope it gets better.

Keep strong!
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Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #89 on: June 08, 2018, 09:53:19 PM »

Day 47 Update:

Today was a relaxing day. I've got my oil massage on both legs (fantastic as always) ;D, watched a couple of movies and did the daily clicking. So nothing really new.

I heard some noise when Dr. Jamal came to visit me just before. He brought with him a step machine and placed it in the living room. He asked me to start using it slowly during the day to keep my muscles active and strengthen them.

I haven't tried it yet. I will test it out tomorrow morning.

This is how it looks like:

https://imgur.com/a/92tTkiW

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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #90 on: June 08, 2018, 10:11:51 PM »

I dont know what methods Nemer has to treat non unions.
But if the gap is big, no much things can be done, like Unicorn's case where she may need to shorten the gap and lengthen again as a last solution.

So dont trust blindly your doctor like Unicorn did and ened up with an 8cm non union,  non unions are the first concern after infection, not the last. With almost non existent calus I wouldn't lengthen further until it gets thicker otherwise you are risking troubles.

Anyway, on your next x ray if your calus is so minimum you should stop asap. But I hope it gets better.

Keep strong!



I'm afraid I have to trust my doctor. He is more qualified to guide me through my journey ;)
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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)

Shadow91

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #91 on: June 08, 2018, 11:26:10 PM »

Stop with lengthening until you see some growth, then you can continue. And nonunion is not a small matter. Please take it seriously, we want the best for you mate.
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Rocky

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Re: My LL Journey - Dr. Jamal Abu Nemer, Kiev
« Reply #92 on: June 09, 2018, 12:13:48 AM »

Stop with lengthening until you see some growth, then you can continue. And nonunion is not a small matter. Please take it seriously, we want the best for you mate.

Hello Shadow91

No one is neglecting the seriousness of the non union matter.
If it is the case, stem cells treatment will do the job.
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Current situation: Failed limb lengthening
 
Future goal: Even the legs & Non-union treatment... (Maybe shorten the legs to close the non-union)
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