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Author Topic: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019  (Read 49981 times)

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daikioni

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #279 on: November 06, 2019, 01:27:09 AM »

Looks fine to me personally keep us posted when you talk with your doctor!
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TemakiSushi

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #280 on: November 06, 2019, 01:36:05 AM »

Also the right tibia looks more bent backward than left tibia.
This might be the cause of less callus on the front.  Please ask other doctors

Does any doctor have 3D X-rays in Germany?
Or 3DCT
« Last Edit: November 06, 2019, 02:38:16 AM by TemakiSushi »
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Ghostfish

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #281 on: November 06, 2019, 02:37:58 AM »

Hi Great321
I am glad that you are doing great!  Your bones look much better than before.  I don't think it is non-union.  However, overall the rate of your bone growth seems slow  .  So be careful for another a month or so until your bones grow enough.  In addition, your rod in the right leg seems a little bent as you said.  I don't know whether that is normal or at least acceptable.  It would be better for you to ask the second opinion from some other doctor.
Take care!
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Great321

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #282 on: November 06, 2019, 08:11:02 AM »

Dr. Giotikas wrote me per mail that my X-rays "look so very good" as both sides "have progressed significantly". And that I can continue doing  my daily routine including single leg standing. Regarding the nail looking outside the tibia and the shape of the nails that's what he wrote: "The entry point of the right nail (the one you circled in the whatsapp photo yesterday) is a touch anterior but this is not a problem. The nails are not bent this is the normal shape they have"

I will pay attention the next week(s) and see if the shin pain occurs again. (Yesterday my shoe insoles finally arrived but they are too thick for all of my shoes ^^) If sth occurs that worries me much I will go see a local orthopedist first. I had contacted Dr. Köhne in the past and I got an automatic e-mail like always. Just information about CLL in general. Also I can't recommend the LL doctors in Hanover. I made a very bad experience with them. I might write a review some time later.
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Great321

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #283 on: November 06, 2019, 08:16:23 AM »

thanks for your concerns guys :) I will keep walking but I will probably not do the single leg standing for another month as I now remember that my shin pain might have to do with single leg standing days before although I told my PT that my doctor did not allow it. -.- I'll keep you updated


Dr. G had told me that bone growth usually starts in the back. Let's wait for another X-ray  first :) What happened to RGKey @TemakiSushi?

Yesterday I took a hot bath for the first time. With some stuff that is supposed to enhance blood circulation.
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TemakiSushi

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #284 on: November 06, 2019, 10:30:04 AM »

If even a slight callus on the front exist, there should be some cloudy looking signs.
But your right tibia, no cloud is there in the dent and consolidated callus has C shape
Superficial is already looking dead and not gonna produce any callus in this dent

RGKey did bone graft finally

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Ghostfish

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #285 on: November 07, 2019, 12:33:58 AM »

Hi Great321
I am glad that Dr. G said everything looks fine.  I think it is a good idea not to do single leg standing until you get more bones in both legs.  California said that LATN is not a full weight bearing and you need 75% or more consolidation to let it bear the full weight.  I don't have enough knowledge about LATN.  He is likely right since he has done it.  So walk slowly and carefully.  Don't put too much weight or pressure to your legs yet perhaps until another month or so.
Take care!
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Great321

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #286 on: November 07, 2019, 12:49:30 AM »

Well let's hope for the best first TemakiSushi:) I'll just wait another 6-7 weeks and hope that my next X-rays will show more callus in the front.

Dr. Giotikas assured me again that that's the way tibias heal. From the back to the front.

@Ghostfish: Thanks :) LATN nail is full weight bearing. But LLers are advised to use crutches at least in the first 6 weeks after the nailing. Afterwards it depends on the patient's callus. At least I've read it from a LATN study from 2008 and Dr. G also said that it is full weight bearing. In the study all the patients were allowed to fully weightbear after 6 weeks. Dr. Giotikas wrote me that I'm at 85% in one leg and at 90% in the other leg and that I can weight bear now without restrictions. I honestly think that that is the best method for my consolidation now. But I won't do single leg standing yet :)

Today I was on my feet for about 2 hours straight (walking through town and standing). My shoe insoles did fit in one pair of shoes and I had no feet pain.

When I walk I have no ballerina at all. But standing straight is not as easy yet. It's possible but in order for it to look more natural and easy, a lot of stretching is still needed. My main PT (the better one) is currently only working on my Achilles Tendons. I'll post the other exercise I do soon.
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Movie

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #287 on: November 07, 2019, 06:04:00 AM »

X-rays look like they have decent callous in my opinion, not the best, but decent now. I'm glad you're making progress, hope everything keeps moving forward
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Great321

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #288 on: November 08, 2019, 12:52:47 AM »

Thanks Movie! I'm one of your subscribers on youtube :D Happy to see you doing well.

Today I walked for 40minutes straight unaided again and without any pain. Only my new shoe insoles are causing discomfort but that was expected.

I also purchased supplements (worth around 100€) so depending on what you try during your journey you might spend a couple of hundred euros additionally just for supplements and protein... I don't know wether it helps but it's worth a try

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Great321

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #289 on: November 08, 2019, 01:22:02 AM »

http://imgur.com/a/vao44ct

These are other exercises I do. The last exercise is a bit difficult to explain.
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SpeedDialer

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #290 on: November 09, 2019, 10:47:17 PM »

http://imgur.com/a/vao44ct

These are other exercises I do. The last exercise is a bit difficult to explain.

1. Did you need to fly to his office to do an in person consultation months before the surgery? (ex: had to make two trips to Greece to make this happen?) Do you recommend a hotel near his office for the first consultation? I guess a one night air bnb might be better for the first in person consultation before finalizing the surgery?

2. Was the below their address? From what I can tell on the website https://www.google.com/maps/place/Leof.+Vasileos+Konstantinou+44,+Athina+116+35,+Greece/@37.9721479,23.7435028,18z/data=!4m5!3m4!1s0x14a1bd419ef089c3:0xb47e7ca4b25ad8fd!8m2!3d37.9725518!4d23.7441814

3. I am thinking of going with MESKA (the mediterrnean rehabilitation center in Loutraki that is associated with Giotikas, as their inpatient) during lengthening. Do you know of anyone who went this route? How did their experiences go? Who might be good to ask on this forum?

Thanks!!!!
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Great321

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #291 on: November 12, 2019, 11:58:47 PM »

On Monday I went to a local orthopedist who seemed to be curious about my X-rays when I contacted him because of my feet problem a few weeks earlier.

He did notice that my callus is better in the back than in the front but he said that we should wait a couple of months and see if it gets better. He said that I should come again in February and if it doesn't grow much more until then he would recommend a shock wave therapy / extracorporeal shockwave therapy. He wants me to ask my doctor (Dr. Giotikas) what he thinks about it. I haven't done it yet but I'll e-mail him. He also advised me to walk completely unaided as I don't weigh much and the nail is supposed to be strong enough. It's better for the bone growth.

Besides my daily PT, I walked for 53 minutes straight and later for 30 minutes again today. I am capable of much more but I have to do a lot of research about my future studies lately which keeps me behind my laptop. I need to change that and be more active.

My left foot was fine again but now that I use the shoe insole my orthopedist had prescribed me for my flat feet it hurts again when I take off my shoes. Maybe it'll adjust itself sometime.

The shin pain is gone, too.

1. Did you need to fly to his office to do an in person consultation months before the surgery? (ex: had to make two trips to Greece to make this happen?) Do you recommend a hotel near his office for the first consultation? I guess a one night air bnb might be better for the first in person consultation before finalizing the surgery?

2. Was the below their address? From what I can tell on the website https://www.google.com/maps/place/Leof.+Vasileos+Konstantinou+44,+Athina+116+35,+Greece/@37.9721479,23.7435028,18z/data=!4m5!3m4!1s0x14a1bd419ef089c3:0xb47e7ca4b25ad8fd!8m2!3d37.9725518!4d23.7441814

3. I am thinking of going with MESKA (the mediterrnean rehabilitation center in Loutraki that is associated with Giotikas, as their inpatient) during lengthening. Do you know of anyone who went this route? How did their experiences go? Who might be good to ask on this forum?

Thanks!!!!

1. I did fly to Athens for the consultation and flew there again for a second time for the surgery. In my case it wasn't a big deal since I live in europe. Maybe you can ask Dr. Giotikas if you can arrange the consultation a few days before the surgery. I heard that there are doctors that make that possible.  I stayed in a very cheap hostel in the city center and paid 12€ for a taxi to the hospital (The taxi app BEAT is very good). But there is a good public transit which you can also use to get there. Of course airbnb nearby the hospital is also possible.

2. I had my consultation in the hospital in which the surgery will be made.
--> Mediterraneo Hospital, Ilias 8-12, Glifada 166 75, Greece (E-mail athensbjr to be sure!)

3. I'm sorry I don't know much about MESKA maybe Jolien knows more about it.

I hope I didn't reply too late! Good luck!

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Great321

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #292 on: November 17, 2019, 12:25:56 PM »

just walked for 62 minutes straight. sidewards or backwards walking is no problem either.

the only challenges left are:

- to squat down
- to kneel
- to go downstairs without holding on to sth
- to stand completely straight without effort

I currently have 3 times PT per week with one physiotherapist who is good at his job. The PT is even paid by my insurance because it is prescribed by my doctor. Next week I will start to go to the gym once a week. It's not a normal gym as it is run by physiotherapists. I will be counseled by my PT and I will pay the gym myself.
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cena

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #293 on: November 17, 2019, 01:19:26 PM »

Good update Great321. Hope to see you get past these challenges soon!
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Great321

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #294 on: November 17, 2019, 10:26:02 PM »

Good update Great321. Hope to see you get past these challenges soon!

Thank you! Working on it :)
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Sanity

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #295 on: November 25, 2019, 02:14:46 PM »

just followed on ur diary. ur journey has been nice with its ups and down just like me. anyways keep me updated and hope for the best now in future for you.
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Great321

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #296 on: November 25, 2019, 05:05:18 PM »

Yes it was quite difficult some times. I will, good luck to you as well!

The last few days I had a little pain on a certain area of both my shins. It was weirdly the same spot. For a few days I used the crutches again which let the "pain"/discomfort disappear as it had only occured when I was walking. Today the shins feel normal again but I will be cautious.

@Leviathan: Da ich in dieser Stunde schon zwei private Nachrichten verschickt hab, kann ich dir erst in frühestens ca. 40 Minuten antworten...geht hier irgendwie nicht anders
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Great321

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #297 on: November 30, 2019, 09:16:39 PM »

I noticed an improvement today. When I was done with working out I wanted to leave the gym, there were a couple of steps for which I had used the railing for support in the past. But today I tried to climb them down without holding onto something and it worked :) I don't dare to try it on every stair yet but I'll get there.

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Sanity

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #298 on: December 01, 2019, 01:13:25 PM »

it might not look huge but i think its a big. It reveals the legs newer found capabilities without trying it much. gudluck further
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Great321

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #299 on: December 03, 2019, 05:29:13 PM »

Update - New video - 81 days after LATN surgery

This is me climbing stairs. I'm still a bit slow at it but I'm getting there soon.
(I hold my hands like that, so that you can see that I'm doing it unaided)
You can see two railings, a darker one on the right (from the viewer's perspective) and a brighter one to the left. We had to install the brighter railing after the first surgery because I couldn't use the force of my legs to climb stairs, I mostly used my arms to get up and down. It was very difficult sometimes, especially when I had a problem with one of my legs. It's only a few days ago when I still had to use at least one railing to feel safe. Conclusion: Don't expect to use stairs with TSF frames without a railing on each side. It might be possible for some people, but I wasn't able to. With LATN on the other hand, it will be possible to use one railing from the beginning on.

--> https://imgur.com/4DKRZBN


it might not look huge but i think its a big. It reveals the legs newer found capabilities without trying it much. gudluck further

Yes it's a milestone! I hadn't been able to climb stairs unaided for over a year now. I don't know if I could have done it without all the PT and (since recently the workout in the gym). I guess even without PT your body will adapt and grow muscles but that might take much longer.

Challenges left

- to squat down
- to kneel
- to go downstairs without holding on to sth
- to stand completely straight without effort
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Movie

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #300 on: December 03, 2019, 06:35:06 PM »

congrats bro looks good as if you'd never got surgery, a tad bit slow going down but that's you being careful and the beginning stages of what's to come.
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California2

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #301 on: December 03, 2019, 10:19:38 PM »

Congratulations on your progress.  You look great on the stairs and are ahead of me on recovery.

By comparison, our initial surgeries were within one month of each other; however, I lengthened about 9 cm compared to your 5 cm so it is expected that my recovery will take longer.

Even so, I walked about 7 uneventful miles this Saturday just to see if I could but still would like to be able to go down stairs like you.

Keep working at it!

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Great321

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #302 on: December 04, 2019, 12:38:42 PM »

congrats bro looks good as if you'd never got surgery, a tad bit slow going down but that's you being careful and the beginning stages of what's to come.

Thanks! Yes I'm still cautious! I don't even want to imagine how it could be like falling on my knees.

Congratulations on your progress.  You look great on the stairs and are ahead of me on recovery.

By comparison, our initial surgeries were within one month of each other; however, I lengthened about 9 cm compared to your 5 cm so it is expected that my recovery will take longer.

Even so, I walked about 7 uneventful miles this Saturday just to see if I could but still would like to be able to go down stairs like you.

Keep working at it!



Thank you! Right 9cm is a whole different level but I'm sure with enough PT and stretching of the calves you will be climbing stairs like a pro soon ;) 7 miles sound quite a lot! I think I could do that only with a lot of stops ...
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Great321

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #303 on: December 14, 2019, 09:41:16 PM »

just want to share how my PT looks like currently. I still go to my PT 3 times per week, we exercise things like kneeling and I definitely notice an improvement but I don't dare yet to put my knees/shins with its whole weight on a surface, also because numb skin(parts of my shins) on a hard surface just feels "icky". I also go to the gym 3 times per week and thus I don't do anything additionally at home except for stretching my calves/Achilles tendons and walking around.

At the gym I work on machines that are part of something called "Milon Zirkel" which according to my PT can replace the exercises I normally should have done at home. There are 12 machines. About half of them are for the legs/lower body and the other half for the upper body. In the beginning I did the elliptical trainer a few times but I stopped since it causes pain in the shins that I might not be ready for yet. All the machines are automatically adapted to one's own body and strength after letting it scan your wristband. I was able to increase the difficulty level of all machines except for two. One of them you see in the picture below with the woman using it. There you have to raise your legs and push something up. For me it's set to the lowest level it can get but it is still exhausting. I believe that it's because 1. my muscles are still too weak and 2. because certain parts of my upper shin (where the cut was made I guess) and sometimes the knees still hurt with certain exercises (but not always)

The other machine I still can't do better is the machine you can see in the back (man with yellow/green shoes), just the opposite, where you have to press something down. My left leg is stronger than my right, so only my right tibia (fracture area) seem to have a problem with that machine. (happens whenever I have to stop this thing for a moment as it goes upwards automatically.)

Weirdly my left shin hurts when I stretch my calves/Achilles tendons (but the right tibia doesn't), and when I do the "pushing something down movement" it's only the right tibia that hurts. The "pain" is not always the same level, sometimes less, sometimse more but it never stops me from doing those exercises.

I assume that it's the nails that cause those problems. My local orthopedist had told me that it would be better to remove the nails after complete consolidation because it could be possible that I'd need a knee replacement in like 50 years (not because of LL, but generally) and the nails need to be out for such a thing which won't be possible then. Dr. Giotikas on the other hand said that if the nails don't cause any problems they can be left inside. Since he does knee replacements according to his website I will ask him what he thinks about the other doctor's statement. I think that I will let the nails be removed either way even if I'm afraid of another surgery because that might lead to more numbness. (I hope not)


« Last Edit: December 15, 2019, 12:46:51 AM by Great321 »
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Great321

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #304 on: December 14, 2019, 10:43:24 PM »

New video - 3 months since the LATN surgery and about 14 months after the first surgery

--> https://i.imgur.com/c2Zi2d6.mp4

I'm living everyday life without any major problems. I can sit up and down without the help of my hands unless it's really quite low. I can go into the bath tub, shower, go outside on my own, drive the car, walk, sit down for a longer time.

What I still can't is

-squatting without holding on to sth
- kneeling
- "Indian style sitting" <- that's what was written in the online dictionary
- sometimes I can walk for an hour or more, sometimes half an hour tires my tibias

- I can stand straight but unlike before the LL surgery I literally feel my femur muscles tight in order to keep my body straight, the more I stretch my calves/achilles tendons before the easier it gets but in everyday life I don't think that anyone would notice it as you can also stand by putting one foot a bit in front or behind the other foot and that makes you stand straight without any effort as well. I have to confess that I don't stretch the calves as much as I should. I'll start to do more now and stand on my calf board for half an hour, tomorrow I'll do certain exercises and then I'll stand on the calf board for an hour (probably not in one sitting). I'm sure that this will be solved with time. The only time I notice it is when I walk right after waking up, my achilles tendons need a few steps to stretch until my gait looks normal again, and when I try to stand straight with both feet right next to each other
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Great321

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #305 on: December 15, 2019, 12:58:24 AM »

Here is a summary of my walking videos so far. you have to know that before my LATN surgery I still used the walker most of the time because of knee pain on the right side. My mistake was that I didn't let remove one wire/pin a lot earlier when it had started to constantly cause problems.

Video of me walking

https://imgur.com/a/UqvQquN

New video

https://imgur.com/a/YPgA2jz


New Video

This is me walking unaided: (I hold the crutches for safety reasons)

https://i.imgur.com/uLSMEUl.mp4



.
Here is a video of me walking unaided from today:

https://i.imgur.com/fVLoEHZ.mp4


New video - 3 months since the LATN surgery and about 14 months after the first surgery

--> https://i.imgur.com/c2Zi2d6.mp4


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Great321

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #306 on: December 17, 2019, 04:02:39 PM »

My physiotherapist wanted me to kneel today on a rather soft surface on the floor and it worked. I kneeled, first with only one knee and then with both knees. I supported myself with holding on to sth with one hand.

I can also touch the floor with my finger tips when I bend down.
« Last Edit: December 17, 2019, 06:06:11 PM by Great321 »
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Great321

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #307 on: December 18, 2019, 07:09:22 PM »

Just came back from the gym. Today was the first day that my right shin didn't bother me when I did that certain exercise on the machine (see picture above) I guess that my legs got stronger now. I can also climb down the gym stairs faster.
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Great321

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #308 on: December 19, 2019, 03:54:17 PM »

Update - X-rays - 3 months, 1 week post LATN surgery

These are my new X-rays. On the left side you see the X-rays from last month. On the right, the ones from today. I'm especially happy to see my "left side tibia" progressing much better.

Right Front: https://i.imgur.com/7WwxTkc.jpg
Right Side: https://i.imgur.com/7b6yjHg.jpg

Left Front: https://i.imgur.com/WwATTur.jpg
Left Side: https://i.imgur.com/vzB59RD.jpg
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Great321

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Re: Dr. Giotikas - external tibia/Stryde - Diary 2018/2019
« Reply #309 on: December 20, 2019, 10:43:33 PM »

I have talked to Dr. Giotikas about my X-rays. He said that I won't need bone grafting in the future which I was very afraid of. He noticed that my left leg's bone growth is faster but that there was progress in both legs and that the callus will get even stronger in the next months. He said that unless the nails cause pain I shouldn't worry about removing them in preparation of something like a knee replacement in 50 years (which I'm not more at risk as any other person). And that the nails can be removed also in many years if needed. The nail removal surgery would cost under 2.000€. In 10 weeks I'll get next X-rays. Until then I'm not supposed to jump or run, we will talk again then.
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