Dear readers,
I have recently undergone the IM nails removal from my tibias with the same doctor/company, so allow me to share my experience here with you. I didn’t want to post anything earlier, as I am still convinced writing it in this way – that is, concentrating the information into a large post, instead of small posts scattered throughout multiple pages – makes this more readable, more concise. Also, despite not posting more, I still come here and reply to the private messages, so please, don’t hesitate to ask about anything. To all the people in my private messages – thank you for your kind words and of course, best of luck with your own LL. Im always happy to help and talk, so please, don’t hesitate to message me.
Let me separate this post into two parts: first, a summary of the time period from when I started walking unassisted until the nail removal (the consolidation phase), and then, second, the nail removal experience and following months.
CONSOLIDATION PHASE (07/2023 - 09/2024)After the frame removal (16.03.2023), the recovery rate felt fairly quick. Around every week or two, there has been some improvement in walking, in ballerina, in the feeling inside of the legs. After I dropped the crutches (around 07/2023), I slowly began to forget I even had leg surgery (for context, you progress from two crutches to using only one to eventually none). My walking was normal, nothing hurt, I could ride the bike, I could swim. I didn’t run or jump, as I was trying to prevent any possible damage to the nails and screws, but eventually, after a few months, I recall jumping to a pullup bar and thinking “oh huh that didn’t feel any different”. So eventually, your legs heal and your condition pretty much normalizes. My main sport/hobby is yoga, which I do about daily, and over the year, I watched by body recover and improve. Early on, positions using knee strength or pushing knees into the mat still hurt a bit and I felt a little uncertainty when doing any form of a squat. But towards the end, I was easily able to do some of the more leg-intensive positions, like archer squats, dancer or bird of paradise.
Here are some tips and ideas that I would like to emphasize after living with the IM nails inside my legs for almost two years:
Can you feel the screws/nails?I did feel the nails and screws in a number of positions and angles. Not necessarily pain, but a sensation, a feeling, simply knowing they are there. The lower screws are pretty close to the skin, so you can feel them when you run your hand over.
Before I had LL, I read on this forum from somebody that the nails make your legs feel “less pliable”. I can confirm. The bones do have a natural tendency to very slightly bend/make micromovements under certain angles, but the nails can make them feel stiffly straight. This is not a strong sensation btw, just something I have noticed in some specific situations. Like climbing a ladder or a bunch of leg-focused yoga positions. I wouldn’t say the sensation of the nails and screws is painful or in any way making your life worse. But looking back now, it definitely feels better – mostly mentally – to not have them inside my legs.
I have also had a sensation that turns into pain in an area under my right knee if I bent the right leg and put it over the other leg for a prolonged (few minutes) period of time (basically sitting cross-legged). I wasn’t sure if this was some permanent condition, but when I told this to the assistant prior to nail removal, he immediately went “oh that’s definitely the upper screw, it will disappear after removal”. And he was completely right! It was gone basically right away.
What was the most difficult during recovery?I originally thought that it might be difficult to protect the lower screws. They are so close to the skin that any larger cut in that area would immediately expose them. But I think due to them being on the inside of the legs, the risk is generally low. I have never had a moment when I had to specifically watch out for that area.
What probably took the longest to get used to was going down stairs. For a couple of months, I felt the upper part of the nail with the screws with each downward step. Not necessarily pain, but I could tell the area was under stress. It improved after a couple of months, but it was probably the sensation that stayed with me the longest. Completely fixed after nail removal.
Tips for consolidation phase, ballerina, stiffness?To reduce equinus (ballerina), pick a bunch of exercises that push the heels down or stretch the calves area and find out which works good for you. Mix them up. Maybe get a rubber band and use your hands to pull the foot towards you, maybe try doing some downward facing dogs. Find what works for you and feels right. Mix it up. A very effective stretch for me was a simple standing position with my back against the wall, each hand holding something for stability and pushing one of my heels down with force, using the hands as counterforce. To demonstrate, I have attempted to make a little picture:
(picture of a stretch that greatly helped me reduce my equinus. Hopefully it uploads)
Under no circumstances consider ATL surgery (achilles tendon lengthening to surgically fix equinus (ballerina)). Ballerina, even pretty bad one, can and will be fixed by walking and stretching. There are many people on this website that will attest to that. If you want to read about the ATL and see it is not worth it, search this forum, I believe the user @Bodybuilder had some insightful posts about it.
My supplement stack for leg recovery was a solid amount of D3 (about 8000IU) paired with K2 MK-7 (they are usually sold together), some vit C (1000+ mg), some calcium, some collagen building supplement (collagen/glycine/gelatin) and usually I got a vitamin complex/mineral complex/vit+min complex to cover any deficiencies. I will leave the supplement effectivity and necessity debate and research up to you, but this was my stack, which I believe was useful, although I of course don’t have a comparison, so I cant say how much work it did. BUT, do keep in mind that no supplement will substitute proper sleep, proper nutrition and physical activity.
Ages ago, I read an exchange on a fitness forum that went something like this: Question: “How do I get better at bench press?” – Answer: “Do bench press.” It sounds like an anecdote, but that is my main advice for the consolidation phase. You improve your walking by… walking. Just go out there with your crutches and walk until you get tired. Do it again in a few hours. Go on morning walks, go on evening walks, walk to the store, walk to the forest. Simply practice, practice, practice. Dont rely on some miracle stretch, miracle supplement or some miracle meal plan. Simply walk. That is how you improve your walking, your ballerina, get the blood flow, get the oxygen in the legs and properly stimulate your recovery. Walk, eat well, sleep well.
A massive help in the first months after frame removal when I was learning to walk with and later without crutches were shoe lifts. Not some orthopedic ones, but cheap trash that lifts only your heels. Be careful though, its very easy to get used to them since they add height, but long term, they damage your posture, your back. Use them only to help yourself in the beginning.
A great way to gauge your recovery is putting on socks while standing. Can you do it without stumbling? Can you pull your leg sufficiently high? Is your balance normal? Can you do it with the same speed and ease as before surgery?
Can people tell you’ve had surgery?No. I have never had anyone bring up my scars unless I told them about this. And I have walked around the city in shorts, routinely go swimming, go to the sauna… never. I don’t think most people would ever press you about this in any way. I did lie a few times when I was in crutches. I used the “I was a reckless retard and fell off a bike in Vietnam lol” and it always worked flawlessly. Remember that when people see a scar, they think about it differently than you do if they are unaware of its origin. You look at it and see pin sites, nail insertion points… normal people just see a scar and think something along the lines of “oh I guess he got surgery or something. Anyway…”
NAIL REMOVAL (11.09.2024)I didn’t have an exact date in my mind for the nail removal. They suggest waiting 1-2 years. My plan was to wait at least a year and then decide. Since it has been about a year, the legs felt fine, I had the money and the option to take 2-3 weeks off, in the summer of 2024, I thought it was the ideal time to go. I saw some opinions here about going to a different doctor for the nail removal, as its an easier surgery, so you don’t have to fly all the way across the world again, but I am of the opinion that not only is Dr. Quynh good, but it makes the most sense to have the nails taken out by the same doctor who put them in.
For reference: my first surgery was on 12.11.2022, frame removal on 16.03.2023. That makes it 1 year and 10 months from nail insertion to nail removal and 1 year and 6 months from frame removal to nail removal.
Just like before (see link in my first post), I made a little day-to-day journal for the nail removal. I have trimmed it and tried to only keep useful info in it, so here is a shortened, summarized version:
22.07.2024
Today, I have contacted the company about planning my nail removal. I learned that they have capacity for me during Sept/Oct and we exchange some other info. Im told my stay in there should be at least two weeks. Apparently, you can walk pretty much the next day after the surgery, but for the stitches to heal, they prefer you don’t walk for about 5 days, with the stitches removal being around day 10. Or day 12-14, if you opt for scar revision during your surgery. They recommend walking with crutches for about 1-2 months after the removal, just to be safe.
08.08.2024
Tickets are bought, visa is in process. Few weeks left.
23.08.2024
I asked whether I can make the payment already, as I want to have everything done and in order as soon as possible. No problems, I sent the money again with Wise (Transferwise changed its name), again with no issues. Payment was done within few short hours. 2500 USD for all including surgery, accommodation, food, etc. Its paid, I got the plane tickets, im ready. Im going only with a carry-on bag, as I don’t think I will need much stuff for the 2ish weeks Ill spend there. Im not even taking a laptop. Interestingly enough, Im not worried about anything surgery related at all. Like 0/10 worry. If anything, im excited to finally have this last piece of the entire process ahead of me. Part of me feels like since I went through the initial surgery and then the frame removal already, I can do this one. The only thing im worried about is probably the flight. Man I don’t like flying.
06.09.2024
Safely made it to Ho Chi Minh City, met with the assistant and once again made the apartment building Dragon Hill my temporary home. Very nostalgically, I even got the same apartment on the 9th floor, but this time, the larger room in the back.
07.09.2024
Right in the morning, the hospital and all the tests. Surgery is scheduled for Wednesday, today is Saturday. Later on, we discuss my x-rays – the front of the left leg is not fully healed yet. But its still solid, so there should be no issue. In the evening, Mr. T asked me if I would join him in meeting a Japanese guy that came last night to answer some of his questions. I agreed, we met and had a nice dinner together. Through the use of a translator, he asked me a bunch of classic questions about pain, surgery, etc. I recall one of them being "do you have any regrets?". I said no.
08.09.2024
Got a message about my health check results, will have to go to the hospital tomorrow morning to have an additional cardio check. I had the same thing happen last time, and I recall Mr. T told me last time that a large number of patients get this, so its nothing unusual.
09.09.2024
Morning hospital visit. A very pleasant cardiologist lady asked me a bunch of stuff, looked at the results of my heart tests and at the end told me all my results are good.
11.09.2024 (SURGERY DAY)
Funny coincidence, I got hospital room 709 again, same as last time. Im told this surgery is easy compared to the first one. Mr. C said an important thing - for all the patients he saw, they always succeeded in removing the IM nail. Worst case a screw breaks, they leave it there for now, but again, Mr. C tells me for all removals he saw, they always took it out. Im a little nervous. About 4-5/10 nervousness. When I got wheeled into the operating room, this time, we waited there a bit. They put both my arms to armrests along the bed and hooked both of them up to something, so I was lying there in a T pose for a while. Mr. C and the Dr talked a bit, and just like before the first surgery, the Dr, while talking, casually examined my legs and touched them a few times. And just like the first surgery, this calmed me down a bit. The Dr simply gives off a feeling like he knows what hes doing, which is very reassuring. Once again, just out of curiosity, when being put to sleep, I counted how many breaths it took. This time, I made it to 10 before falling asleep.
Waking up in the ICU, Mr. C was next to my bed, telling me right off the bat that the operation was a success. I felt minimal pain, which during the few hours I stayed at the ICU completely faded away. I could move my toes and feet just fine, even my whole legs if being very careful about the stitches. Overall, I was pretty happy it was over and excited that it went well. I think it was 6 pm by the time I got wheeled back to my hospital room. Nurses changed my iv and i didn’t hesitate to devour the lukewarm chicken & rice broth waiting there for me. Delicious.
Mr. C sent me a message with a summary of the following days. Apparently, I can try standing up with crutches by Tuesday if theres no pain or tightness. Thats about 6 days from now. Also, I’ll be taking antibiotics and stitches removal should be around the next Saturday. About 10 days from now. Of course, all of this depends on an x-ray that will be taken tomorrow morning. I’ll apparently leave the hospital tomorrow around 2 pm. I feel good.
12.09.2024
Around midnight, nurse changed my iv and checked my legs. Theres a bit of blood around the outside upper part of my right leg, so she puts an extra bandage around it. I remember I had the same thing happen last time after the frame removal surgery, so I dont pay it any mind. I didnt really feel very sleepy, so I spent the night mostly in hibernation, sometimes falling asleep for a short period of time. But I still felt good and fresh in the morning. During the morning, it was the classic x-ray, iv removal and then a bandage change. Went back to the apartment after lunch.
13.09.2024
I woke up after a deep, delicious sleep with the legs feeling good. I felt this sensation - which might sound a bit esoteric, but nonetheless - that energy can flow freely through the legs, completely without any metal as an obstruction to it. Like my legs were once again part of the whole body as one unit and can finally fully and properly heal.
15.09.2024
Knee tightness seems to have mostly disappeared. I did some light movements each day to help it. By today, I can again bend my legs so that calves touch the hamstrings. During bandage change, seeing the stitches, all seems to be healing well to me.
19.09.2024
In the morning, they brought me a pair of crutches. I did some light leg exercises to warm up the legs and prepared for my first stand up. I was genuinely worried. I had no idea what its going to feel like. Considering the front of my left leg hasn’t fully healed yet, I was afraid that too much pressure on it will cause damage. At the same time, I had no idea how its going to feel without the nails inside - what if it feels weak? What if I lose balance? Will I have to move really slowly? Carefully, I plant my bare feet on the floor and with the support of the crutches, lift myself to a standing position. To my surprise, all feels completely normal. I put on my shoes - I thought, for greater stability - and start a slow walk with the crutches. All feels completely fine. No pain, no pressure, no weird sensations. I turn. I walk a bit faster. I make multiple laps. I go into the kitchen and back multiple times. Stand, sit, walk... to my surprise, all is and feels completely fine. I am elated and genuinely happy.
23.09.2024
Even the entire flight home, despite having to go through the entire airport hassle (I flew Ho Chi Minh → Doha → Prague) and having to walk or stand with the crutches for a while at a few points, the legs felt completely fine.
02.10.2024
exactly three weeks since surgery. I’m very surprised at how well the legs are.
05.10.2024
First full day without crutches. Walked a good amount, and even did some garden work at my mom’s place. All completely fine. Good amount of stairs up and down. All fine.
05.11.2024
I am retarded and have overestimated myself. Of course I have dropped the crutches too early. Later in October, I had a streak of days when I walked a lot and felt my left leg a little bit in the evenings. On about day three of this, I felt some pain in the left leg. Well, back to walking with a crutch. I used one crutch again to support myself for about two weeks now and all seems better again. I had a little walk without it today and all seems well. But I can tell it still needs a little while to be certain. I will keep the crutch for the next week.
03.01.2025
This will be my last entry to wrap it up. After the last journal entry, I have taken a few more days walking with the crutch and then dropped it completely. My walking has returned to normal, my life has returned to normal. I got back into yoga fully, back into the gym. Walking normally, living free with my new height. There are no more issues with the legs, they feel completely normal, pain free and even strong.
X-RAYS:(there should be 4 pictures, hopefully they upload. X-rays were taken basically right before and after nail removal)



At the end, I would like to add three disclaimers: 1) this is my experience and yours might differ. Don’t take anything in my journal at absolute face value, you never know what issues you might run into or how will your body respond; 2) the time it took me to go from crutches to complete walking to fully healed legs was probably longer for me than average, as I lengthened by an amount that is generally considered beyond the safe limit (7,28cm); 3) I stretch a lot, basically daily, for years now. I will be a certified yoga instructor this year (finally!). That means my leg flexibility and mobility are probably above the average person, so what im trying to say is, please don’t be discouraged if you dont see an immediate response to your stretches or if your equinus is not moving and it feels like the muscles hit a wall with tightness that just feels impossible to overcome. It isn’t. Keep at it and im certain you will eventually see results.
Once again, good luck to all of you going through your own LL journeys and of course, don’t hesitate to pm me, im always happy to help. I might post a few pics or videos in a few months that show how the legs recovered.