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Author Topic: LON TIB + Mech Axis Corr (TIB+FEM) with Fatih Arslanoglu (+2 Surgeons) Turkey  (Read 3549 times)

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LLprime3

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Hi everyone, I have been on this forum since 2017 as LLprime2, later on threw the account away by renaming it into llendpoint (for all of you who want proof of history) and changing the pw into something random and deleting my email address to not come back again.
I continued as LLprime3 in order to provide useful content until my journey is actually finished.

I did my first LON Femur surgery in 2020 with Dr. Halil Buldu. See link below.
http://www.limblengtheningforum.com/index.php?topic=68666.0

This year I want to finish this whole thing by doing LON Tibias with Fatih Arslanoglu with the intent to fix my bowed legs as well.

If I went to this doctor the first time, I would have been much better off, read to understand why.

Day 1
I arrived in Istanbul, and was brought to the hotel (could choose between two). Nothing major happened on day 1.

Day 2
Was brought to the hospital, got a foot to hip x-ray  while standing and got other checks done.
(When I did LON Femurs I did not get such a full leg x-ray)

I met two of the 3 surgeons who later operated and we discussed my situation in their team office.

I think most of you, even I who looked into it, have or had no clue.
There are many ways to have "bow legs":

- Actually curved bones
- Only curved Femurs or curved Tibias
- Bad angled but straight bones near the knee and therefore being out of the mechanical axis.
 
Sample shows difference between normal and bow legged: https://ibb.co/FWSt0xr
My case:  https://ibb.co/1TCMk0S

I never understood why I had bow legs while looking at my x-ray. Both bones looked straight.
In my case I had slightly bad angled Tibias and even worse Femurs. Most of the bow legged effect came from the femurs before doing LON Femurs.
After completing LON Femurs the mechanical axis got even worse because the angle was worsened:
https://ibb.co/SPx8YJq

So I had finished LON Femurs in 2020 and my main problem (bad mechanical axis in the femurs, which I found out to be the main cause of my bow legs before this upcoming LON Tibias surgery) was not fixed while it could have been.

So we decided to do it like this:
Do LON Tibias as usual, fixing the angle on the Tibias on the frame removal surgery, and lock it. During the same surgery, breaking my femurs again, change the angle, using new nails, and lock it. (New nails will cost what they cost, but what can I do. Doctors can not and should not re-use old stuff)

Back to the hotel.

Day 3: Surgery and hospital experience
Back to the hospital.
After waking up, this was going on:
- My knees did not hurt at all, I did not have to breath like a dying person as if my legs had been shattered, like after LON Femurs surgery.
- I had all the other usual pains and discomforts.
- Had to wait 4h !! before I was allowed to drink water, was wriggling like a dying worm during the last 45min. It was more than 21h since I last drank water. It was horrible.
- My feet were swelling for the next few days.
- I was gettig a bit hot, the ventilation system had a certain problem. The valves to control the cooling water were closed, therefore it could only heat up my room, so I turned it off.
- The traffic noise could be clearly heard 24/7. This was the worst aspect of the hospital stay. It's bad. I brought ear plugs with me for the hotel, but I ended up only using them in the hospital.
- My catheter was not functioning properly. My bladder was full, and when I peed it went all on the bed. Took 3 attempts for nurses to realises I wasn't just complaining about the sensation of the catheter that makes you feel like you had to pee. I showed them that my piss bypassed the catheter and went on the bed. They took it out, and I got a nice bottle that did the job.
- Doctors came in, showing me the x-ray, saying that the surgery went really smooth. My knee bending barely reached 90° though. It's all okay today (day 7). It was just painful to bend my legs. LON Tibias does not affect bending.

Day 4
 - A service technician came to open the cooling water valves, now the ventilation was only able to cool the room down, but not heat it... (The valves need to be set on automatic to regulate)
- Got a little fever during night
- Went to the toilet for the first time. Staying or walking was very painful, no joke.

Day 5
- My left hand where the medical interface for the IV-lines was inserted began to hurt and swell. They removed it and used the spot on the other side of the elbow. Should have done it like that from the beginning.
Other than that 95% of the nurses are skilled, came quickly, some always smiled, were in general very friendly and helpful, and could speak basic english. The nurse experience was positive.
- Trying to sleep was hard, it was always loud, sometimes too bright, earplugs felt uncomfortable, wearing an eye mask is annoying too, and having slight fever on top of it just makes it impossible to fall asleep.
- Ended up sleeping on my belly, it worked

Day 6
- Got high fever, it was fixed in 4h, bed was all wet from the sweat, and my clothes too that I just put on right before the fever. Everything was changed into new dry ones.
- Traffic noise was horrible as always, everytime around 6 PM it sounds like GTA during a massive police hunt, no joke.

Day 7: Back to the hotel
- Bandages were changed, went back to the hotel
- At night I had a light fever, only took one pain killer, no other meds

Day 8: Medicine
- Getting up hurt so much on the legs, but I got a wheelchair, crutches, and a walker right when I came back to the hotel the day before. The wheelchair saved my live. I could move around without feeling like dying.
- Got myself loads of water from the market through the reception, 12L of water in 500ml bottles for 60 Lira in total, that's basically free.

- Medicine: Right now I'm taking
- a blood thinner called Ecopirin Pro (acetylsalicylic acid)
Not sure if using this Aspirin kinda thing is a proper blood thinner method. I will try to skip some and walk more. According to a doctor I met at home it's not the right medicine. But the alternative, an actual anti-thrombosis injection has just its own possible side-effects.
- something against swelling called rantudil (acemetacin)
- something to fight off infections called cipro (ciprofloxacin)
- and one pain killer called dolorex (diclofenac sodium)

All of those once per day. They gave me another pain killer type and anti-infection medicine, but I ignore those.
My goal is to not use any of them if possible, but I need to get my body in the condition for that to be okay.

- Physiotherapist comes daily for exercises, and every 2nd day she changes bandages.
- Was sleeping for 7h straight, no toilet in between, even slept on my back as a belly sleeper, nice.

Day 9
- The First step after getting up hurts the most. I simply stopped ignoring the pain and went normally with crutches, and all of a sudden the pain dropped a lot.
- My body temperature has failry stabilized after taking all necessary medicines at least once.
- Physiotherapist came by for physio and changing bandages, Murat came by as well.

I asked him through which methods of advertising they get their patients from. It's mixed right now. They will focus more on SEO. I mentioned that I could write a diary, maybe. He didn't respond to it since it was more like loud self-talk on my side. Guys he, is not hungry or desperate for promoting LL or getting the word out at any cost as some of you think. He changed the doc for a reason. He wants to promote LL with good conscience.
I write this diary on my own accord, in anticipation of a good result and because of the impression I got from day 2.
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LLprime3

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Day 10
Woke up completely wet. Had a slight fever again. Now I'm fine once again.

This is me in the frames:
https://ibb.co/ryrd00V

This is what you can get for 380 Lira (the lower three plates combined):
https://ibb.co/2ykS3BP

I only have an x-ray that shows the cut at the Tibias, not Fibula. A screenshoot from the operation room.
However, as of now the bone is not set in the position it has to be when it's locked. They shifted the bones at the cutting site, they did not change the angle as I thought. But it was intentional as the said.

This current alignment is suited for lenghtening, but it will be adjusted before locking is how I understood it.
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Ozzi6557

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Day 10
Woke up completely wet. Had a slight fever again. Now I'm fine once again.

This is me in the frames:
https://ibb.co/ryrd00V

This is what you can get for 380 Lira (the lower three plates combined):
https://ibb.co/2ykS3BP

I only have an x-ray that shows the cut at the Tibias, not Fibula. A screenshoot from the operation room.
However, as of now the bone is not set in the position it has to be when it's locked. They shifted the bones at the cutting site, they did not change the angle as I thought. But it was intentional as the said.

This current alignment is suited for lenghtening, but it will be adjusted before locking is how I understood it.

Ask your doctor if you have an infection.  Usually fever after surgery indicates infection!
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LLprime3

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Ask your doctor if you have an infection.  Usually fever after surgery indicates infection!

It's similar to that. I didn't get a new infection. It's more like the initial infection that I have yet to get rid of with the given medication.
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LLprime3

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Day 11 = 7 days after sugery = first lengthening day

My swollen legs have greatly recovered.
Sweat a good amount again this night.
Getting up in the morning is still the hardest task.
Got the allen key to lengthen, until 3 cm I have to go at a 1mm per day pace, after that I can reduce it as I please.

Starting tomorrow I will refer to day 12 as week 1 of lengthening and summarize my experience.

What's left for next week is a doctor visit, few more pt sessions and bandage changes, mobile x-ray at the hotel, and a flight back home with all the stuff I got here (wheelchair, crutches, dorsiflexion casket, big medical suitcase)
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LLprime3

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Week 1 of lengthening:
Getting up in the morning is not that painful anymore.
But throughout the day there always appears a new pain on a different spot, and disappears to the most part the nex day.
My left leg feels perfect in all apsects, it's my right leg that still suffers a bit from my previous surgery, considering the location of the pain.
Standig for 5 min is exhausting.
I can sleep 7h per day most of the time, sometimes even without waking up during the night.

I am at 5mm in terms of distraction, but the x-ray today showed that I need to increase the pace on the left leg a bit, and generally I need to create a decent space to prevent early consolidation.

right leg: https://ibb.co/jLGnDKb
left leg: https://ibb.co/mh287Tb

The way the bone is broken and slighty shifted is intended. It is supposed to correct the angle during lenghtening, and there is also the frame removal surgery during which the surgeons can make any final adjustments.
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LLprime3

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Week 2 of lengthening:

I'm taking two painkillers a day to get over the pain, in the morning and a few hours before sleeping. I have only used Dolorex as a painkiller, and I'll keep it that way.

On my way back home I caught Omicron. Been vaccinated twice btw. Had to deal with fever, mucus in my throat and LL pain, for a few days. It's so much better now. I have been eating so much more as of today, but I'm slowly losing weight regardless.

I'm at 1.5 cm distraction. I will stop at +5 cm. After around 2 cm I will do an x-ray and decrease the pace, if possible.

The lengthening has had no impact on my achilles tendon flexibility so far, but unexpectedly bending my kness while standing is the most difficult movement. Walking and flexing the leg muscles in general causes some pain that builds up over the day as the first pain killer wears off.

There has been no need for the dorsi flexion casket yet. I hope I won't ever have to sleep while using it.
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7cm

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May I ask you what was the cost of this surgery ?
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LLprime3

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May I ask you what was the cost of this surgery ?

16000 Euro + 2500 Euro for frame removal

You don't have to pay the total amount of 18500 all at once.
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LLprime3

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Week 4 of lengthening

x-ray
https://ibb.co/MVCFpYX

I'm at 25 mm. I think I lengthened a little bit too fast, even though it was intentional.
The callus formation looks only nice on the left leg at the upper cut. All other three cuts (right tib, left and right fibula) need to start forming proper callus. I will start takig vitamins again. I had completely neglected that part since my bone healing was very fast during my femur lengthening, so I assumed it would go like this without the vitamins.

The angle of the bones looks nice. I was sceptical looking at the first x-ray because the bones were merely shifted. Now I don't have to worry about that part any longer.

Sometimes I get a random spot of pain in one leg, then it disappears 3 days later, and a few days later a new pain appears on the other leg. It may have been caused by overstretching this time. The muscles are very unforgiving. Even if I can do certain exercises more that what is expected of me, it often fires back at me with pain the next day, if I unknowingly overdid it.

Other than that, sleeping and walking is fine most of the days.
As of now I use about 3 painkillers in 4 days.
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kilin

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Hello,
Funny, your diary is the same as my experience. I had an operation with Dr. Halil, and now with a new doctor Dr. Fatih. I had the operation on February 4, and probably you did it in the same period?
Now I have 3 cm of the tibia.
We can compare our experience, lol :)
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Bob

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What is Dr. Fatih's LON femur 3 month's package (surgery, hotel stay etc.) price ?
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kilin

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Week 4 of lengthening

x-ray
https://ibb.co/MVCFpYX

I'm at 25 mm. I think I lengthened a little bit too fast, even though it was intentional.
The callus formation looks only nice on the left leg at the upper cut. All other three cuts (right tib, left and right fibula) need to start forming proper callus. I will start takig vitamins again. I had completely neglected that part since my bone healing was very fast during my femur lengthening, so I assumed it would go like this without the vitamins.

The angle of the bones looks nice. I was sceptical looking at the first x-ray because the bones were merely shifted. Now I don't have to worry about that part any longer.

Sometimes I get a random spot of pain in one leg, then it disappears 3 days later, and a few days later a new pain appears on the other leg. It may have been caused by overstretching this time. The muscles are very unforgiving. Even if I can do certain exercises more that what is expected of me, it often fires back at me with pain the next day, if I unknowingly overdid it.

Other than that, sleeping and walking is fine most of the days.
As of now I use about 3 painkillers in 4 days.
Sorry for my English.
r
Recently, I have been worried about swelling of my right leg. If I'm lying down, then after half an hour I can't keep my leg in a horizontal position, as severe pain in the foot begins. If you press on the leg (bone) will you have a dent? Do you have the same pain?
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LLprime3

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Hello,
Funny, your diary is the same as my experience. I had an operation with Dr. Halil, and now with a new doctor Dr. Fatih. I had the operation on February 4, and probably you did it in the same period?
Now I have 3 cm of the tibia.
We can compare our experience, lol :)

We probably saw each other in the hallway. I had my surgery 1 day after you. I'm also at 3cm.
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LLprime3

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What is Dr. Fatih's LON femur 3 month's package (surgery, hotel stay etc.) price ?

Not sure about the exact price. The only extra is the 3 months stay compared to what I paid for. So I guess it's 18500 (surgery and frame removal) + approx 3000 for the hotel stay, something over 20k Euro,maybe 22k in total I don't know. It's way cheaper to fly back home, and it's not difficult since you will get a free wheelchair ride at the airport. Since they focus their advertising on search engine optimization, they won't advertize here. If you really want to know, message Murat, he's pretty much online 24/7.
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LLprime3

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Sorry for my English.
r
Recently, I have been worried about swelling of my right leg. If I'm lying down, then after half an hour I can't keep my leg in a horizontal position, as severe pain in the foot begins. If you press on the leg (bone) will you have a dent? Do you have the same pain?

First you should not press where the bone gap is. Who knows how it will affect the bone consolidation.
If you have only swelling, take "rantudil". If you suspect an infection, take "cipro". "Augmentin" is also for fighting off bacteria and infection, especially if you already have an infection, it will be what you need to use. I personally dislike the many side-effects Augmentin has, so I have only used cipro so far. But I will not hesitate to use it, if my pin sites start to look ugly.

In your case, I would at least take rantudil and cipro, and the mandatory ecopirin. And if it might be an infection, use Augmentin just to be sure. I don't know how your leg looks like. Send an image to Murat/doctor if you're not sure. They will tell you to take Augmentin for 1 week, I can tell you that already.

And don't do exercises that hurt. All exercises should feel like actual exercises and not like torture. When I was at the hotel and couldn't do one exercise, I didn't have to do it. I just did something else that worked.
 
That pain can also come from over-working your weakened muscles. What hurts the most for me right now is, when I'm standing, bending my lower leg backwards, not the whole leg. I can't even achieve a 90° knee-bending while standing with my femur being vertical, because the responsible tendon for the flexion just hurts. The rest is just fine.
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kilin

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First you should not press where the bone gap is. Who knows how it will affect the bone consolidation.
it's in any part of the leg


If you have only swelling, take "rantudil".
I'll check it. It's recommendation of doctor?

If you suspect an infection, take "cipro". "Augmentin" is also for fighting off bacteria and infection, especially if you already have an infection, it will be what you need to use. I personally dislike the many side-effects Augmentin has, so I have only used cipro so far. But I will not hesitate to use it, if my pin sites start to look ugly.
Murat said that I need to use augmentin all time until the fixators is not removed, to avoid infections. Although I don't have any side effects.

And don't do exercises that hurt. All exercises should feel like actual exercises and not like torture. When I was at the hotel and couldn't do one exercise, I didn't have to do it. I just did something else that worked.
 
That pain can also come from over-working your weakened muscles. What hurts the most for me right now is, when I'm standing, bending my lower leg backwards, not the whole leg. I can't even achieve a 90° knee-bending while standing with my femur being vertical, because the responsible tendon for the flexion just hurts. The rest is just fine.

I have no pain when walking or when I do exercise. Probably a problem with blood vessels or nerves. I hope it will pass. Now I can only fall asleep if my leg is slightly lowered.
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LLprime3

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My legs don't have these dets when I press them.

The reason for these dents is extra fluid below the skin. Could be from swelling, which is why I recommended rantudil. Rantudil is specifically for swelling.

I think rantudil and enough water should fix this, but this is already week 6. I wonder why you stil have that much fluid under your skin. You know if you drink enough water based on the color of your urin, it should be clear, not yellow.

You should let the doctor know about this, not me to be honest. It would be helpful if you let us know what the doctor tells you to fix it, so we all know too.


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LLprime3

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Week 7 of lengthening

I managed to not take pain killers for two full weeks. But recently I wake up once per night due to pain where the left tibia is cut.

These dents that appear when you press on the skin for too long with bandages or with your fingers, I got them too. Seems to be a common thing among LON Tibias.

Coming Monday I will post an x-ray. I will be at 4 cm on that day.

I train my upper body to improve my overall blood circulation about twice a day. From my point of view, even working on something other than the legs, in the end benefits the legs when blood circulation increases.

main pins at the knee without bandages (blood included)
https://imgur.com/DEatXAD
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kilin

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You should let the doctor know about this, not me to be honest. It would be helpful if you let us know what the doctor tells you to fix it, so we all know too.
I talked to the assistant, he said that this is a common problem and it's not a big problem. But just in case, he told me to stop taking antibiotics (which I have been taking for more than a month), as kidney problems are possible.
The doctor also advised me to find quercetin (dihydroquercetin) to improve blood circulation of veins.

Week 7 of lengthening
These dents that appear when you press on the skin for too long with bandages or with your fingers, I got them too. Seems to be a common thing among LON Tibias.
I wrapped my legs with elastic bandages for a couple of days and the swelling almost passed. Try it?

I also slowed down to 0.75 mm per day (a ~weeks ago), and now I have no pain, no swelling and I can sleep for a very long time.
I recommend you slow down too. Perhaps all these factors somehow help to get rid of problems.

Week 7 of lengthening
Coming Monday I will post an x-ray. I will be at 4 cm on that day.
What about ballerina syndrome?

Week 7 of lengthening
main pins at the knee without bandages (blood included)
https://imgur.com/DEatXAD
my pins look better (except one). What do you use to treat wounds? My turkish "crystalin" treatment has run out, so I switched to betadine. By the way, in the first days the doctor moistened the bandage with betadine and applied it to the wounds for a day. This helped to eliminate infection and bleeding. Try it?

We probably saw each other in the hallway. I had my surgery 1 day after you. I'm also at 3cm.
I was walking in the hallway with my friend, but it seems you were alone all your journey? It's incredibly hard to be alone. (mentally and physically)
My friend and I don't know English very well, so we were too shy  :-\ to talk to you, but we would really like to keep you company and provide support.
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LLprime3

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When I wrapped my legs with bandages, my left leg started to hurt from the inside. Next day I used more bandages to wrap it a bit tighter and the pain increased. That pressure may have a positive effect on the swelling and circulation, but for me it caused pain, so I unwrapped them all. That was when I noticed that my skin had all these pressure points and sunken skin.

I lenghten with 120° turns in general, not 90°. The allen key has six sides with six 60° angles each corner. You can not do precise 90° turns, but you can always to accurate 60, 120, 180, ... degree turns. At the beginning I did 480° per day, after reaching a 2cm gap I have only done 240° turns per day (0.666 mm per day). No need to do 1mm per day for Tibias lengthening since it consolidates slower than Femurs anyway.

I still don't use the dorsi flexion casket they gave us, except for maybe once per week for a few minutes only. I will stop at only 5cm, and my flexion before that was top. Just walking during the day or standing is enough exercise until I finish it.
I do feel tightness, and it feels like a stretch just standing, I do admit that. But it doesn't get worse than that so far, so it's fine.

I still have that bottle they gave us with like 20% of the liquid in it left. I use it frugally, and I don't change my bandages daily as they sometimes instruct us to do. If the bottle runs out I would look online for something similar. The thing they gave us clearly smells like chloride. That stuff does a good job, so I would buy something similar that can also be sprayed.

Also I only take care of the pin sites, all other spots/scars are closed and don't need to be cleaned extra. All these scars seems to heal better when I don't do anything with them, no lotion, nothing.

About being alone in Turkey. I do prefer it like that since I'm very introverted. I can spend a lot of time alone relative to most other people. I have always avoided meeting other patients directly because of that. I wouldn't want to talk about personal stuff and most other topics don't excite me either.
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LLprime3

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The date for the x-ray was postponed. I'll have a follow up date this week or in two weeks.

I'm at 4 cm. Out of those 4 cm I have lost 5 mm due to the nails giving in or bending a bit. Effectively only 3.5 cm were gained.

In addition to that, I have lost another 1.5 cm since getting up 4h ago. I always lose 1.5 cm after 4h during the day due to spine compression.

I will lengthen another 1.5 cm starting from this point.
« Last Edit: April 04, 2022, 12:04:47 PM by LLprime3 »
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LLprime3

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x-ray

https://imgur.com/YbASbOL

I had to increase the contrast on the right leg scan to see the callus formation properly. It is way less than on the left leg, but at least there is some.

The measured gap is approx 3.6 cm long, which confirms that I lost almost 5 mm relative to what I lengthened.
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LLprime3

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Final surgery is scheduled during the end of this month, it includes:

- Frame removal on Tibias
- Axis correction on Femurs and insertion of new nails. This will most likely restrict my ROM.
- Suture of a few scars and ripped fascia

--------------

Summary of my body specs before and after each LL surgery.

Before LON Femur -> after LON Femur (during 2020)

height: 156 cm -> 164 cm
wingspan: 164 cm
sitting height: 86 cm
weight: 64 kg -> 64 kg

Before LON Tibias -> after LON Tibias (during 2022)

height: 164 cm -> 169 cm
wingspan: 164
sitting height: 86 cm
weight: 64 kg -> 64 kg (Yes my weight has not changed yet. It will after gaining back all lost muscle mass)
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Oswego

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Wow this is amazing. I like the idea of reaching the full ~13cm but idk how much willpower I have to undergo femur then all over again with the tibia. Kudos to you. How does it feel to do the process twice in terms of the time/energy/willpower its taking?
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Current height: 165cm

Goal height: 173cm with Dr. Paley

LLprime3

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I almost finished my hospital stay.
My willpower is decreasing each time I wake up from the surgeries during the hospital stay. There is really something going on everytime in the hospitals that add to the negative experience of the hospital stay:

First hospital stay after getting femur frames:
My knees hurt like crazy and I caught a cold.

Second surgery for frame removal: For some reason it hurt more waking up than the first surgery. And being allowed to drink hours after waking up sucks, and I did get my first painkiller kinda late.
And while I was a wreck I had to get xrayed the same night and be moved. It teally hurt

Third surgery for tib frames:
I wrote that experience somewhere above.

Fourth surgery for frame removal:
Woke up really well, had to wait 2h for water but got the painkiller early.
Air conditioner didn't work again so they sent some who fixed it. Noise pollution as always. This time I got red spots everywhere as if blood vessels pop. And my stress increased so much that my tongue started to get so called geographic map on the side.

Now that I went from bow legs to normal legs walking is weird for me.  Will write more later and add xrays....
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LLprime3

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Back to hotel, just finished the first pt session.

This is the before after, from bow legs to normal legs (+ tib lengthening)
https://imgur.com/ubbfTPy

And these are the red spots I got in the hospital I mentioned earlier.
https://imgur.com/aYTr8Ql

Overall, I got a bit more ballerina foot after the surgery. I don't have any bone-related pain, even though additionally to removing the fixator they inserted new nails into the femur canal after breakig the bone ofc.
They fixed my scars (top femur main pins) and my ripped fascia that I got from the other doctor on my first LON Femurs surgery for free.

I do feel most pain coming from the suture. Right now my main objective is getting a healthy looking skin and a fit body that I can look at, and ofc a normal walk.

The visual side-effects I got from all the stress really put a huge dent into my self-esteem. And that is part of what makes LL difficult for me, seeing myself deteriorate a little bit after each surgery. Experiencing this for the fourth time now is really tough and disheartening.
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LLprime3

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LLprime3

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Something new happened.
Maybe some have noticed me bing not really ecited about the outcome. Why is that.
I knew something was off, but today I found out what it was.

First of all, my mechanical axis was fixed, and if I bend me knee, Femur and Tib are aligned to each other as they should.

Now it turned out I have had all my life so called Femoreal Anteversion
If you lie on your belly, bend your knees 90° and turn both tibs outward toards the bed surface, a normal angle would be 15° for each side measured from the vertical mid line.

Extreme Femoral Anteversion is about 45°
But mine is about 70° .....

Now this is a lengthening forum. Should I start a new diary for this deformity?
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LLprime3

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I'll continue here.

https://i.imgur.com/Z4cBng2.png
This image shows three walking patterns:
bow legged, normal, and what it feels like in my mind to walk normally.

It took me the whole day to realise how to walk. I have to focus solely on my feet and make them move in stright lines as drawn in the middle of the image.

Even if I can do this now, there is still a problem. It requires almost maximum femoral outside rotation AND a maximum inside kick with the foot that is moving forward.

I was kinda mad that something this obvious was not fixed with a simple rotation by the surgery team, since they said the noticed my femoral anteversion (inside rotation of the femurs). But on the other hand they only mentioned that they noticed this femoral anteversion after I explained to them how I found out the reason for my walking problem.

I dislike how my entire walking problem is being reduced to recovery and contracture of ligaments, and so on...
If they knew about it, they should told me, not the other way around, why walking and even standing and rotating my feet outside is so difficult. Cause I have no spare room of femoral twist  left to give.

-------------------

A person without femoral anteversion would not have nearly as much of a difficult time to walk normal after getting his legs corrected, becuáuse they have anatomical spare room to rotate their femur to adapt to walking normally.

I have no spare room. I'm basically maxed out on twisting my femur outside and kicking my foot inside that goes forward for the step.
It's not only a difficulty in the mind, but also a permanent offset that I have to adjust with conscious effort because of the way m femurs are rotated inside.

I'm sure this will be covered by my local medical insureance cause the angle deformity in the hips must be insane to have that kind of inward spin. But the issue is how it could have been fixed...

According to them they didn't want to interfere with my biomechanics. But the new difficulty added to walking normally was not worth the mechanical axis fix. My femurs want to naturally rotate inward by about 30°. For some reason being bow legged posed no issue to that. But now it's a problem having a normal mechanical axis.
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LLprime3

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A few new insights about the condition called femoral anteversion:

You can look at the whole range of hip motion, which allows to rotate your femurs inside and outside, as a spectrum of rotation distributation.

100% femur rotation is equally distributed so that a normal person can rotate his femur inside by 45° and outside by 45°.
It seems that in my case I can rotate my femurs by 60 degrees inside and 30 degrees outside, AFTER I fully heal.

For a normal walk a person needs to rotate his femurs approx 15 degrees outside.
But right now I can rotate my femurs just barely 15 outside. A few days ago I could only rotate my femurs about 5 degrees outside, which is why it felt like I didn't even have the capacity to roate my femurs enough to walk normally.

What restricts femoral outside rotation is also the achilles tendon
The doc explained how he treats children who suffer from cerebral palsy. They also have an inside walk with their femurs rotated inside.
"Equinus deformity is a common finding in children with cerebral palsy and may be treated by Achilles tendon lengthening."
What the doctor wanted to tell me with that is that I will regain a fair amount of outside rotation back, so that walking normally will not feel like I have to rotate my femurs 100% (15 degrees) but it will feel like I only require 50% outside femur roation (15 out of 30 degrees).

Basically at the end of the recovery I will be able to rotate my femurs 60° to the inside and 30° to the outside, and I will walk as comfortably as I did with my bow legs. Receiving a surgery to adjust and distribute the rotation equally (45° and 45°) will be optional, but not necessary.
That is one reason they did not perform any rotation surgery on my femurs. Because it will not even be necessary after I recover my achilles tendon flexibility fully and regain the remaining outside rotation which is within my capacity.

If I would receive a femoral rotation surgery based on what I feel I need, I would over-correct my femurs and rotate it too much as of right now.

The second reason they did not perform the rotation on my femurs is also because they don't perform it in general, which is fair enough to say.

So they knew better than me that I will be alright, but didn't explain it to me to the extend I needed to know. Or you could say they did over and over try to explain it to me, but I didn't understand two things:
The achilles tendon enables femoral outside roation AND I need femoral outside roation to walk normally and even more outside roation to walk normally without it feeling like effort.

Now that everything has been said and exchanged, I have nothing negative left to say about this team.

Here is a summary about pro and cons:

+ no bone related pain after walking up from the surgery
+ higher reliability due to having more than one surgeon perform the surgery
+ compared to my previous femur surgery, I received more extras, such as
free scar revision of actualy bad scars, free wheel chair, meals in this hotel are included in the price, the physical therapist wears gloves during bandage change (yes, I did not have that with the previous doc...), more medical equip to take home with to treat my scars
+ in hindsight up to today no errors have been performed on my legs, I want to make this clear because the last posts could leave a bad taste

- communication and misunderstandings
- hospital experience
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