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Author Topic: I did fully externals, change to LATN after 8 months?  (Read 1514 times)

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Great321

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I did fully externals, change to LATN after 8 months?
« on: June 27, 2019, 03:58:50 PM »

Hey I did fully externals 8 months ago with Dr. Giotikas. My X-rays are still not very good. I only have 3 months left until university would start. I can't imagine that my bones will consolidate until then because it already takes so much time for little change. I haven't talked to my Dr. yet about the new X-rays.

I had decided for fully externals because the risk of permanent knee pain from LON/LATN sounded too bad.
So now I might have to decide wether to keep the externals until the end and I have no idea how many months more it could take. Who knows maybe even half a year more? What if it never fully consolidates?

Or to change to LATN:
- Another surgery.
- Another 6.000€.
- Risk of permanent knee pain (3%?)
- Maybe antibiotics during surgery is needed again which is risky by itself as antibiotics can cause germ diseases like Clostridium Difficile (I once got that because of antibiotics from the first surgery)

Plus would be:
-faster recovery
-walking would be possible earlier

I don't want to attend university with frames, I can delay my admission for another year. But that would mean that I basically loose another year of my life, because with frames on I can't/don't want to participate much in activities outside my home.

What would you do in my position?


Quote
I only post the X-rays where I see some progress. Everything else (Especially the sideways views of the tibia look almost the same as last time)  On the left you see the X-ray of 03.05.19, on the right you see the X-ray of today.

Left Fibula: https://i.imgur.com/gNcL9TJ.jpg

Left Front: https://i.imgur.com/7EYFFmv.jpg

Right Front: https://i.imgur.com/4mv3SPV.jpg
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KrP1

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Re: I did fully externals, change to LATN after 8 months?
« Reply #1 on: June 27, 2019, 04:03:37 PM »

To do external only is a great mistake. If I were you I would have done Latn so many months ago. Ask your doctor to see how much time do you need to get off of the fixators.
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Yannick

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Re: I did fully externals, change to LATN after 8 months?
« Reply #2 on: June 27, 2019, 04:22:10 PM »

I wouldn't call it a mistake per se, but it is true, that pure external relies a lot on your own biology (and the stability of the frame, what is considered to be spot on with the proper technique). There are many patients who got off the frame after 5 cm around 8-9 months, some even earlier, so if it is a good option depends on many factors.

Do you eat enough calories and protein after your infection? What did your doc say about your consolidation? Do you have any other condition (type 2 diabetes, smoking etc...). Did you talk to other patients, what did they do differently in details? Maybe you should try to accelerate the process in the next month, see, what happens, but talk to your doc first.
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Great321

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Re: I did fully externals, change to LATN after 8 months?
« Reply #3 on: June 27, 2019, 06:22:14 PM »

To do external only is a great mistake. If I were you I would have done Latn so many months ago. Ask your doctor to see how much time do you need to get off of the fixators.

Yes, I wish I had done it 4 month ago. The best would have been LON in the first place. But you never know your own biology. It was a try. I'll ask him tomorrow. But I don't think that at this stage any doctor can really tell how long it will take.

I wouldn't call it a mistake per se, but it is true, that pure external relies a lot on your own biology (and the stability of the frame, what is considered to be spot on with the proper technique). There are many patients who got off the frame after 5 cm around 8-9 months, some even earlier, so if it is a good option depends on many factors.

Do you eat enough calories and protein after your infection? What did your doc say about your consolidation? Do you have any other condition (type 2 diabetes, smoking etc...). Did you talk to other patients, what did they do differently in details? Maybe you should try to accelerate the process in the next month, see, what happens, but talk to your doc first.

I guess people can try fully externals. But the first 4 months will tell wether your bone growth is slow or fast. And then you should decide to do either LON or LATN soon. Because while zakikas bone growth was already pretty good in the first months, mine was just normal. My frames are very stable I think because I have only had 2 infections so far that needed antibiotics. And that allegedly has sth to do with the stability of the frames... I will talk to my doc tomorrow. Maybe certain vitamins are missing. My biology probably does play a huge part. Even though I'm more from the middle east, I might have some of those typical Asian genes from far back of my family. I have no diabetes nor am I a smoker.
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Great321

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Re: I did fully externals, change to LATN after 8 months?
« Reply #4 on: June 27, 2019, 06:49:37 PM »


Do you eat enough calories and protein after your infection?

Well.. I gained a few kilograms after my time in Athens for sure and I drink a protein shake every day.
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Yannick

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Re: I did fully externals, change to LATN after 8 months?
« Reply #5 on: June 27, 2019, 06:54:47 PM »

Keep it up, and try to eat quality food, vitamins as much as possible!
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Activatedx

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Re: I did fully externals, change to LATN after 8 months?
« Reply #6 on: June 27, 2019, 07:30:54 PM »

Hey I did fully externals 8 months ago with Dr. Giotikas. My X-rays are still not very good. I only have 3 months left until university would start. I can't imagine that my bones will consolidate until then because it already takes so much time for little change. I haven't talked to my Dr. yet about the new X-rays.

I had decided for fully externals because the risk of permanent knee pain from LON/LATN sounded too bad.
So now I might have to decide wether to keep the externals until the end and I have no idea how many months more it could take. Who knows maybe even half a year more? What if it never fully consolidates?

Or to change to LATN:
- Another surgery.
- Another 6.000€.
- Risk of permanent knee pain (3%?)
- Maybe antibiotics during surgery is needed again which is risky by itself as antibiotics can cause germ diseases like Clostridium Difficile (I once got that because of antibiotics from the first surgery)

Plus would be:
-faster recovery
-walking would be possible earlier

I don't want to attend university with frames, I can delay my admission for another year. But that would mean that I basically loose another year of my life, because with frames on I can't/don't want to participate much in activities outside my home.

What would you do in my position?


If your bones aren’t consolidated it is a reflection of your nutrition or sleep deficiency. Some people’s body naturally produce more, you probably have a calcium or vitamin d deficiency stacked with you not eating the right vitamins. Do you go out at all? You realize exposing skin to the sun is how your body produces a lot of it’s vitamin D. Drink milk, take calcium and Vit-D supplements, sleep good and your bones should consolidate, a few months is plenty of time


Don’t do nailing; you’re already at the end why would you drill through your knees and bones when you’re already at the end thats pure stupidity. And on top of that you’re risking knee pain and paying 6k euros
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Great321

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Re: I did fully externals, change to LATN after 8 months?
« Reply #7 on: June 27, 2019, 08:16:55 PM »


If your bones aren’t consolidated it is a reflection of your nutrition or sleep deficiency. Some people’s body naturally produce more, you probably have a calcium or vitamin d deficiency stacked with you not eating the right vitamins. Do you go out at all? You realize exposing skin to the sun is how your body produces a lot of it’s vitamin D. Drink milk, take calcium and Vit-D supplements, sleep good and your bones should consolidate, a few months is plenty of time


Don’t do nailing; you’re already at the end why would you drill through your knees and bones when you’re already at the end thats pure stupidity. And on top of that you’re risking knee pain and paying 6k euros

I do take calcium and vitamin D daily. I do go outside, maybe not enough. But in the last months not much has changed :/ And I only have 3 more months. One year off was fine. Another year would be a waste of my lifetime. I want to study as soon as possible. My sleep is fine.

I rather feel like I'm just half way through. Look at my X-rays of the beginning of May. Not much has changed.
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Activatedx

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Re: I did fully externals, change to LATN after 8 months?
« Reply #8 on: June 27, 2019, 09:11:36 PM »

I do take calcium and vitamin D daily. I do go outside, maybe not enough. But in the last months not much has changed :/ And I only have 3 more months. One year off was fine. Another year would be a waste of my lifetime. I want to study as soon as possible. My sleep is fine.

I rather feel like I'm just half way through. Look at my X-rays of the beginning of May. Not much has changed.



I’m sure there are ways to consolidate quicker see an orthopedist that’s local, just personal advice don’t drill into your knees and bones... you’re long after post op, just wear baggy sweatpants to university, say you had bowed legs or something if someone sees your tsf frames
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Great321

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Re: I did fully externals, change to LATN after 8 months?
« Reply #9 on: June 27, 2019, 11:03:11 PM »

Look at this image:  https://i.imgur.com/tIoioL4.png
It's a scary thought to do LATN or LON.

I have just realized that I can also start University in April 2020 instead of October. 9 months from now must be enough I hope to consolidate...

I guess I will wait.

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Activatedx

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Re: I did fully externals, change to LATN after 8 months?
« Reply #10 on: June 27, 2019, 11:23:45 PM »

Look at this image:  https://i.imgur.com/tIoioL4.png
It's a scary thought to do LATN or LON.

I have just realized that I can also start University in April 2020 instead of October. 9 months from now must be enough I hope to consolidate...

I guess I will wait.


Don’t let it delay you bro just go to university with the frames, you’ll probably be able to take them off for sure 3-5 more months
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cheekycabs

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Re: I did fully externals, change to LATN after 8 months?
« Reply #11 on: June 27, 2019, 11:53:31 PM »


If your bones aren’t consolidated it is a reflection of your nutrition or sleep deficiency. Some people’s body naturally produce more, you probably have a calcium or vitamin d deficiency stacked with you not eating the right vitamins. Do you go out at all? You realize exposing skin to the sun is how your body produces a lot of it’s vitamin D. Drink milk, take calcium and Vit-D supplements, sleep good and your bones should consolidate, a few months is plenty of time


Don’t do nailing; you’re already at the end why would you drill through your knees and bones when you’re already at the end thats pure stupidity. And on top of that you’re risking knee pain and paying 6k euros

This is the best advice you're going to get here. You and I are as you know quite comparable in our stages of recovery, but my bone growth seems to be way better. If I was you and my bone growth sucked, it is 100% a nutrition problem. I think I'm much older than you actually. I'd do this:

Start eating absolutely as many fruits and vegetables (specifically green ones) as much as you can. Spinach, brocolli, onions, and eat a lot of them. So much that your pee is neon. 1 protein shake will do nothing. You need vitamins and minerals, and almost entirely mostly vegetables. Lean meat like chicken is okay, a good diet drives it all. Eat complex carbs, no white bread, naan, lavash, if it's white don't eat it. Wheat and grain heavy with grains and brown or dark as it can get. Eat until you crap  all day.



Start banging the pavement with your legs a whole lot more. Get super comfortable shoes and walk, walk walk. Wrap your ankles so they don't get swollen. I made this mistake that I didn't walk enough. Don't touch any NSIADS. And when you're not walking, use an electro stimulator if you can find one. Take it very seriously.

Man you are literally at the edge of it, you're almost there. We'll do it together.

I need you to lay out your full eating program and exercise. Let's figure it out and get you out of those fking frames together.

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External Tib Ilizarov, Azerbaijan: http://www.limblengtheningforum.com/index.php?topic=9418.0
Drugs, preparation, training: https://docs.google.com/document/d/1V2bNA_OsVwqR5Qp6fAWH7VFN6DaZPJ8YroUELsIy28k/edit

1 year post can run slowly, walking/gym everyday. Issues are zero, ankle tight waking up.

Great321

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Re: I did fully externals, change to LATN after 8 months?
« Reply #12 on: June 28, 2019, 08:03:25 AM »

This is the best advice you're going to get here. You and I are as you know quite comparable in our stages of recovery, but my bone growth seems to be way better. If I was you and my bone growth sucked, it is 100% a nutrition problem. I think I'm much older than you actually. I'd do this:

Start eating absolutely as many fruits and vegetables (specifically green ones) as much as you can. Spinach, brocolli, onions, and eat a lot of them. So much that your pee is neon. 1 protein shake will do nothing. You need vitamins and minerals, and almost entirely mostly vegetables. Lean meat like chicken is okay, a good diet drives it all. Eat complex carbs, no white bread, naan, lavash, if it's white don't eat it. Wheat and grain heavy with grains and brown or dark as it can get. Eat until you crap  all day.



Start banging the pavement with your legs a whole lot more. Get super comfortable shoes and walk, walk walk. Wrap your ankles so they don't get swollen. I made this mistake that I didn't walk enough. Don't touch any NSIADS. And when you're not walking, use an electro stimulator if you can find one. Take it very seriously.

Man you are literally at the edge of it, you're almost there. We'll do it together.

I need you to lay out your full eating program and exercise. Let's figure it out and get you out of those fking frames together.

Hey thanks for your through response!
Dr. Giannakos had told me that meat everyday was the most important of all and Vitamin D. Is there an electro stimulator that you can recommend?

So far I had eaten

a sandwich for breakfast (the most healthy: salmon, tomato, cucumber, cheese), the least healthy (bread with nutella)

right now I eat a plate of mango sclices

Lunch: a lot of meat (all kinds of) with sides (especially rice, sometimes vegetables, aspargus but I never liked it much...that will change from today)

Evening: some fruits, a bowl of oats and milk,  afterwards a bowl of natural yoghurt and a banana inside

then a protein shake

Lately I couldn't walk as much because of the inflammation. How much would you recommend in minutes/hours per walk/day?
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cheekycabs

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Re: I did fully externals, change to LATN after 8 months?
« Reply #13 on: June 28, 2019, 10:00:32 AM »

Hey thanks for your through response!
Dr. Giannakos had told me that meat everyday was the most important of all and Vitamin D. Is there an electro stimulator that you can recommend?

So far I had eaten

a sandwich for breakfast (the most healthy: salmon, tomato, cucumber, cheese), the least healthy (bread with nutella)

right now I eat a plate of mango sclices

Lunch: a lot of meat (all kinds of) with sides (especially rice, sometimes vegetables, aspargus but I never liked it much...that will change from today)

Evening: some fruits, a bowl of oats and milk,  afterwards a bowl of natural yoghurt and a banana inside

then a protein shake

Lately I couldn't walk as much because of the inflammation. How much would you recommend in minutes/hours per walk/day?

There really isn't anything wrong with eating so much protein. Here is the honest truth: Protein will help build muscles, not bones. Your problems are because of bone growth, not protein deficiency. Just remember, that every bite of protein or meat gives you less space for vitamins and minerals. Start switching to salads, and eat a lot of them. Like all the foods I listed above. If it's not green and colourful don't eat it!

https://en.wikipedia.org/wiki/Bone_remodeling

Vitamin D is derived from sunshine, that means walking outside as much as possible, 20-30 minutes in the hottest part of the day. I believe you have an indian background? Get outside and soak in the sun. Pills are good but you need natural food. What part is getting inflammation? I have problems with my ankles, so I wrap them with tensor bands. I honestly believe you need to walk until it hurts. because each step bangs on your bones to start growing.

Then, you need to do physio, when you're in bed and resting, do everything in this video when you're finally home, full or sunshine and vegetables.



After this video above, then you have your protein shake. Build the muscles to start strengthening your balance and legs. I think this is less of your problem but treat it as importantly. The only thing that will stop you is laziness.

I would suggest an Exogen 4000+ but do some research before you buy, I'll help you.
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External Tib Ilizarov, Azerbaijan: http://www.limblengtheningforum.com/index.php?topic=9418.0
Drugs, preparation, training: https://docs.google.com/document/d/1V2bNA_OsVwqR5Qp6fAWH7VFN6DaZPJ8YroUELsIy28k/edit

1 year post can run slowly, walking/gym everyday. Issues are zero, ankle tight waking up.

Great321

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Re: I did fully externals, change to LATN after 8 months?
« Reply #14 on: June 30, 2019, 06:15:38 PM »

There really isn't anything wrong with eating so much protein. Here is the honest truth: Protein will help build muscles, not bones. Your problems are because of bone growth, not protein deficiency. Just remember, that every bite of protein or meat gives you less space for vitamins and minerals. Start switching to salads, and eat a lot of them. Like all the foods I listed above. If it's not green and colourful don't eat it!

https://en.wikipedia.org/wiki/Bone_remodeling

Vitamin D is derived from sunshine, that means walking outside as much as possible, 20-30 minutes in the hottest part of the day. I believe you have an indian background? Get outside and soak in the sun. Pills are good but you need natural food. What part is getting inflammation? I have problems with my ankles, so I wrap them with tensor bands. I honestly believe you need to walk until it hurts. because each step bangs on your bones to start growing.

Then, you need to do physio, when you're in bed and resting, do everything in this video when you're finally home, full or sunshine and vegetables.



After this video above, then you have your protein shake. Build the muscles to start strengthening your balance and legs. I think this is less of your problem but treat it as importantly. The only thing that will stop you is laziness.

I would suggest an Exogen 4000+ but do some research before you buy, I'll help you.

Okay I have took your advice. Now I'm eating more vegetables and fruits. Not Indian. More in the central of Asia. There is one pin that always causes troubles in my right knee. On some days it prevents me totally from putting my weight on the right leg. On the better days it still bothers me, so I can't put my whole weight on it like I do with my left one. Maybe the pin hits a sensitive part.

Luckily I have no problems with my ankles. When I stretch a lot they get a bit swollen but it disappears soon.

It is weird because in the very beginning and during the whole time in Athens I was able to stand up and make my steps shortly after. Now I need a few minutes + until I'm used to the pins in my legs and only then I can make my first steps. That's almost the most annoying part of this process.

Thanks again for all the information!
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cheekycabs

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Re: I did fully externals, change to LATN after 8 months?
« Reply #15 on: June 30, 2019, 10:31:03 PM »

Well good, I'm in Central Asia and I can eat food like this (my dinner). This is exactly how your meals should look as well.

https://i.imgur.com/uGPD2Aj.jpg

It's a turkish dish cig kofte which is basically carb loaded buckwheat with tons of spices and vegetables, Eat leafy greens and you'll never really need tablets or proteins.

Greece and turkey have exactly similar cuisines so you'll be able to make and find it. I also wanted to share with you I'm almost completely walking unaided, and am using my crutches for stairs and minor steps. My gait needs some small improvement but not much, and I'll approach my doctor soon to get these damn frames off.

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External Tib Ilizarov, Azerbaijan: http://www.limblengtheningforum.com/index.php?topic=9418.0
Drugs, preparation, training: https://docs.google.com/document/d/1V2bNA_OsVwqR5Qp6fAWH7VFN6DaZPJ8YroUELsIy28k/edit

1 year post can run slowly, walking/gym everyday. Issues are zero, ankle tight waking up.
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