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Author Topic: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019  (Read 4344 times)

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ShortLivesMatter

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SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« on: March 31, 2019, 05:33:44 AM »

Well I have been debating whether to start up a new diary or not for my 2nd surgery as I'm not much of a writer and really InFullStryde's awesome diary is all you need to know about the Stryde nail but since I don't really see any internal tibia diaries around I figured mine would still be somewhat helpful.

Anyway a little background, I did my femurs using the partial weight bearing Precise nail back in August 2017 with Dr. Rozbruch in NYC and lengthened to 6.7cm to go from 5'1.5 to 5'4.  I got the nail removed in October 2018 so it's been about 1.5 years and it honestly has been the best decision I ever made.  I do not have any pain whatsoever and the new height feels great, the downsides have been I have obviously lost some flexibility, my butt is still pretty flat, my thighs are toothpick skinny, and running still feels weird and slow.  But those things can be worked on.  Since the first surgery went so well and with the weight bearing Stryde nail now available, I went ahead and did my tibia using the smallest 10mm Stryde nail. So here we go -

Pre Op Day: I had to come to NYC 4 days before my surgery for some pre op blood work and met with the team to go over the procedure. It was pretty standard and quick as I had already gone thru it for my femur surgery. Afterwards I took this opportunity to meet 3 prospective LLers and a vet LLer Puru. The guys had alot of questions for Puru and I. It was a blast and everyone was in good spirits and was well adjusted in their lives with legitimate reasons to do LL, unlike some mentally ill dudes in here who are already tall but still want to get taller and "mog" everyone else in sight.  2 of the guys will be doing LL with Dr. R and they might start their own diaries in here in the near future.

Surgery Day: I'm not from NYC so I took a 4hr bus ride and arrived at the hospital around 5:30am and checked in.  The nurses shaved me down and Dr. R came in to have a chat. He asked if I wanted to do a gastroc release which is to loosen the calf muscle to help with tightness which people typically experience after 4cm lengthening. It's similar to the ITB release for the femur.  I decided to do it since I was aiming for 6cm.  I didn't want to have to stop after 4cm. We also discussed how my bowed legs would also be straightened in the same procedure and I would gain an additional .5cm from that as well which is pretty awesome. I was then rolled into the op room.  There was a team of at least 10 people in there.
 The anesthesiologist did his magic and I went under. The next thing I knew I was in the recovery room.  A catheter was hooked up so I could pee freely. I didn't really feel any pain as I was on a ton of painkillers, my legs were hooked up to a machine that kept my legs moving to have good blood flow.  I was pretty tired so I ate a quick dinner and fell asleep.

Day 1 post op: The PT team came by and had me get up and move around using the walker and damn it was rough. My legs were inflamed and it hurt pretty badly as I forgot to have the nurses give me an oxycodone right before hand.  Dr. R. also stopped by to do some post surgery checks and informed me that the surgery went well. The night was pretty brutal pain wise even with the painkillers. 

Day 2 post op: Same as the prior day, the PT came by again and had me walk around again with the walker. The Stryde representative stopped by to give the ERC device and did a lengthening demonstration. this ERC device was heavier than the Precise device but had a much better UI that displayed all sorts of information like how much have you lengthened for the day and how much have you lengthened total. I was to lengthen 4x a day at a rate of .2mm each time for a total of .8mm.  I was then discharged and had my parents pick me up. The staff rolled me down to the hospital entrance in a wheelchair and I transferred into the car using a walker.  I laid in the backseat and went to sleep.  4hrs later we arrived home and I got out of the car and into a wheelchair and was rolled into my house as I was too weak to use the walker to get to my bed.

First week post op:  my legs were still pretty inflamed and swollen but I wanted to recover quickly so I started using the walker aggressively, big mistake, this only made the inflammation worse. I also had a scary fall as I was pushing the walker too quickly on an uneven surface and it toppled and fell over over. I was suddenly without any support and my legs were still too weak to stand on their own so I fell to the ground. Thankfully it was the full weight bearing Stryde nail,  would have been bad otherwise. This set me back a week as the still inflamed legs screamed in agony for having to stand without any support for several seconds. 

Second week: Legs were now getting better, swelling and pain had gone down and I was moving around using the walker with little difficulty. I started to settle into a routine of eating, stretching, using the lengthening machine and napping as I cannot sleep for more than 1-2 hrs at night before waking up and having to move/stretch the legs. They get locked after staying in the same position and it hurts like a bitch to move them after I wake up.  The longer I had been asleep, the more painful it was to move them after waking up.

Third week:  I had a post op visit with Dr. R. We checked the x-rays and things were looking good, I had lengthened about .8 cm and there was good callus formation on the tibia and fibula. We also confirmed that my bowed legs had been fixed which was amazing.  Back at home, my legs were continuing to improve and I could now stand without any support. I decided to ditch the walker and switch to crutches as I need to improve quickly as I was planning to return to work in 2 weeks.  Hopefully I can transition to a cane by then. 

Well that's all I got for now, let me know if you have any questions. The Stryde nail is indeed a game changer, I am now completely independent due to the ability to fully weight bear.   
 
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ok

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #1 on: March 31, 2019, 05:42:06 AM »

Thanks for starting this diary SLM! You are a great writer.

You have a real privilege of being in a country which has some of the best surgeons and the best hospitals. I am confident you will do great.

Quick question - how was it that the 10mm Precice nails didn't fit your femurs but the 10mm Stryde nails fit your tibias? Because tibias are supposed to be thinner.

Thank you
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Purushrottam

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #2 on: March 31, 2019, 06:38:54 AM »

Thanks for making a new diary. It’s much easier to keep track of!

And it was really nice meeting you!
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Starting height: 168.5 cm (5'6.5"); Ending height: 175 cm (5'9")
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Ghostfish

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #3 on: March 31, 2019, 07:52:57 AM »

Hey SLM

Congrats on your second lengthening!  You are a true warrior!!  Yes, Stryde is the game changer!   I am also very happy that I was able to use Stryde for myself.  You will enjoy the benefit of full weight bearing!!

Wish you the best of luck for your journey!!
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wannagrowtaller

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #4 on: March 31, 2019, 10:32:20 AM »

Thanks for doing a new diary. Good luck on your journey.
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wannagrowtaller

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #5 on: March 31, 2019, 10:48:46 AM »

Why did you stop at 6.7 on femurs?
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ShortLivesMatter

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #6 on: March 31, 2019, 03:58:08 PM »

Thank you for all the support guys, I appreciate it :).  I used the 8.5mm Precise nail on my femur as the 10.5mm one was a little too big and would have required more reaming of the canal which you should try to avoid. We all saw what happened with Unicorn when Guichet put in a 13mm nail on her small bones.  While the tibia is indeed smaller than the femur, the benefits of the 10mm Stryde nail outweighed the smaller 8.5mm Precise nail so Dr. R. did do some reaming to fit it in there, he did say it was quite a tight fit. 

I stopped at 6.7cm with the femurs as I was getting pretty tight and my bone growth was slow and I was sick of LL by that time and wanted to start consolidation.  Hopefully I will have better results with the tibia as the ability to walk should help with flexibility and have better bone formation. 

Going to try to get some shut eye now as I only got about 2-3 hrs of sleep last night, the pain was really rough even with the oxycodone.  It wasn't a small constant dull pain but rather a very sharp one every couple of seconds, I think it was because I pushed myself too hard and walked around with crutches too much yesterday. 
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wannagrowtaller

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #7 on: March 31, 2019, 04:06:13 PM »

I'm rooting for you to get the full 8cm with tibias if thats what you want.
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InFullStryde

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #8 on: March 31, 2019, 04:18:31 PM »

Really excited for you, SLM.  I'll be a regular follower of your diary and I'm very interested to learn about the tibia experience through your steps. 

All the best!

IFS

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In Full STRYDE with Dr. Mahboubian - Jan 2019
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Status: Gained 3" and Now in Consolidation/Recovery Phase. I am WALKING again!
Diary: http://www.limblengtheningforum.com/index.php?topic=9671.0

ShortLivesMatter

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #9 on: April 03, 2019, 02:46:25 AM »

So I have made some pretty nice improvements since the last update. I am now walking confidently on crutches. I was able to stand up from my bed without any support and took a few steps unaided today.  I have another week before I return to work so need to get my strength back. I will most probably use crutches when I do return as I am terrified of someone bumping into me and even a slight breeze will probably make me fall over. 

Unfortunately all is not well, the sharp shooting pain on my left leg is still present and comes and goes throughout the day but is most prevalent at night when I'm trying to sleep. The only way to alleviate it is taking an oxy which I'm trying to stop but it's near impossible. Hopefully it will get better soon.
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Ghostfish

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #10 on: April 03, 2019, 03:28:14 AM »

Hi SLM

Good to hear your updates!  You are doing great!  I saw a patient with Stryde tibia and he was able to walk with a cane about 3-4 weeks.  Since then, he was able to continue to walk with or sometimes without a cane until the end of lengthening. Now you are roughly at 4 weeks, if I am correct.  So you have made a good progress!  Walking with crutches is also a good idea especially in public or at work, since your posture is not stable.  But when it is safe, try to walk with a cane as much as you can.

As for the pain, as you know, CLL always brings pain and most of patients have a bad leg and a good leg. I also have the right leg as a bad one. But it will get better.  I think taking oxy when needed, it is not a bad idea.  Most of time people tend to be overcautious about oxy for addiction.  But with this low dose and limited amount of oxy, it is very unlikely to get addicted to oxy.  So don't feel too bad when you need to take it.  You can gradually reduce dose or increase interval and will eventually run out of oxy prescription anyway.

By the way, I admire you that you are going back to work soon.  That really requires courage and strong will.  You are a true warrior!

Good luck!
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InFullStryde

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #11 on: April 03, 2019, 05:49:31 AM »

So I have made some pretty nice improvements since the last update. I am now walking confidently on crutches. I was able to stand up from my bed without any support and took a few steps unaided today.  I have another week before I return to work so need to get my strength back. I will most probably use crutches when I do return as I am terrified of someone bumping into me and even a slight breeze will probably make me fall over. 

Unfortunately all is not well, the sharp shooting pain on my left leg is still present and comes and goes throughout the day but is most prevalent at night when I'm trying to sleep. The only way to alleviate it is taking an oxy which I'm trying to stop but it's near impossible. Hopefully it will get better soon.

The left leg has been my Nemesis leg to this day! Carry on SLM, as you know as a CLL veteren...it gets better.  Good idea on crutches.   Believe it or not; I've been sporting the crutches for 3 months. You're ahead of the game.

Will stand by to hear and learn more. Have a good night.
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"Make the BEST of what you have and Make what you have, the BEST"
In Full STRYDE with Dr. Mahboubian - Jan 2019
Start Height/End Height: 5'1.25"/5'4.25"
Status: Gained 3" and Now in Consolidation/Recovery Phase. I am WALKING again!
Diary: http://www.limblengtheningforum.com/index.php?topic=9671.0

wannagrowtaller

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #12 on: April 03, 2019, 01:00:19 PM »

I really want to know how is a tibia lengthening with stryde with a good doctor. Great diary.
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tiggy

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #13 on: April 05, 2019, 02:02:51 AM »

Hi SLM,

Thank you for this diary and good luck with your journey! While IFS's diary has been excellent and very informative, it never hurts to read another diary of STRYDE and especially with Dr. R with whom I will be having surgery next month as well.

I've read in other diaries of people taking pain killers with a Tylenol pm at night time to help them sleep, and this appears to have worked well. Perhaps you can give it a try as well.

Since you had your femur surgery already and with PRECISE, can you compare the pain levels between them? Which would you say was more painful so far and why?

Honestly pain is a very big concern of mine and frankly I am a little terrified of how bad it could get. Those shooting pains in your leg, can you put a number on them on a scale from 1-10 just to give us an idea? And perhaps the same for the pain in the mornings when you wake up with your legs locked?

Lastly if you have any recommendations or advice for pain management, please kindly send it forward. We all would greatly appreciate it!
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ShortLivesMatter

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #14 on: April 05, 2019, 10:52:38 PM »

Yeah I am taking tylenol pm and and oxy at night now and it is helping with the sleep but I still wake up in the morning in pain, mostly on my left leg.  The sharp pains in my left leg I would say is about an 8 on the pain scale.  In the morning it's probably a 6.  The tibia surgery has definitely been more painful as there were two bones broken instead of just one like in the femur so you have 2 pain sites to deal with.

As for an update, it's been almost 4 weeks since the surgery, I have lengthened about 1.5cm and am now walking around the house without any support, slowly of course but it feels great. My hips do sway when I walk so I need to work on that but it's not that bad. 
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tiggy

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #15 on: April 05, 2019, 11:25:02 PM »

Thanks for your prompt reply. I am very happy to hear you are walking without any support in only 4 weeks man. Keep up the great work!

Just couple more questions from me. When you take oxy for that shooting pain, how much does the pain drop from the 8 level pain?

Also, you just said its been a month since surgery and you have lengthened 1.5cm. I don't remember exactly what dr. R said about the timeline of lengthening and please correct me if my measurement time scale is off, but I believe he told me within 3 months patients reach about 3 inches. If this is correct, your lengthening seems to be slightly behind, as it should be closer to 2.5cm right about now.  Are you lengthening .8mm every day or have you taken breaks in between?
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Ghostfish

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #16 on: April 06, 2019, 06:53:21 AM »

Thanks for your prompt reply. I am very happy to hear you are walking without any support in only 4 weeks man. Keep up the great work!

Just couple more questions from me. When you take oxy for that shooting pain, how much does the pain drop from the 8 level pain?

Also, you just said its been a month since surgery and you have lengthened 1.5cm. I don't remember exactly what dr. R said about the timeline of lengthening and please correct me if my measurement time scale is off, but I believe he told me within 3 months patients reach about 3 inches. If this is correct, your lengthening seems to be slightly behind, as it should be closer to 2.5cm right about now.  Are you lengthening .8mm every day or have you taken breaks in between?

Hi tiggy

Regarding your question, normally you need to wait for a week after the surgery to start lengthening.  General rate for tibia lengthening is 0.75mm a day.  4 weeks = 1 week after the surgery (0 mm) + 3 weeks x 7 days x 0.75mm = 1.575 cm.   
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wannagrowtaller

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #17 on: April 06, 2019, 04:26:31 PM »

You are on 4th week of surgery and yet have so much pain?
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tiggy

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #18 on: April 06, 2019, 07:25:22 PM »

Hi tiggy

Regarding your question, normally you need to wait for a week after the surgery to start lengthening.  General rate for tibia lengthening is 0.75mm a day.  4 weeks = 1 week after the surgery (0 mm) + 3 weeks x 7 days x 0.75mm = 1.575 cm.   

Actually no, dr. R has his patients start lengthening 3 days after surgery (so on the 4th day from what I remember from my consultation). But this applies to the femurs, not sure if tibias are different, and I doubt they are. 
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ShortLivesMatter

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #19 on: April 06, 2019, 08:11:06 PM »

Actually no, dr. R has his patients start lengthening 3 days after surgery (so on the 4th day from what I remember from my consultation). But this applies to the femurs, not sure if tibias are different, and I doubt they are.

I was instructed to start lengthening a week after the surgery so GhostFish's calculation is right.  Started on the 18th of March, today is the 6th of April so that's 20 days * .8mm per day = 1.6 cm now

You are on 4th week of surgery and yet have so much pain?

No, most of the time my pain level is 2-3. It's just at times i experience the sharp pain that's like a 7-8 but it's gotten a little better in the past couple of days. 
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tiggy

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #20 on: April 06, 2019, 08:26:47 PM »

I was instructed to start lengthening a week after the surgery so GhostFish's calculation is right.  Started on the 18th of March, today is the 6th of April so that's 20 days * .8mm per day = 1.6 cm now

Very interesting, I did not expect that tibia lengthening start date would be different from femurs. I wonder why. I will ask him when I can and will keep everyone posted when I find out.
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myloginacc

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #21 on: April 07, 2019, 12:39:26 AM »

Hey, SLM. Thank you very much for another diary. Very kind of you.

Do you have a goal height, or are you going for the most you can get?
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Yes I do want to add, before doing this surgery, ask yourself if you have optimized your life to the fullest extent possible (job/career, personality, etc).

wannagrowtaller

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #22 on: April 07, 2019, 02:49:04 AM »

No, most of the time my pain level is 2-3. It's just at times i experience the sharp pain that's like a 7-8 but it's gotten a little better in the past couple of days.
Good to know. I thought after third week pain would decrease a lot. 8/10 is very hard.
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Ghostfish

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #23 on: April 07, 2019, 07:11:00 AM »

No, most of the time my pain level is 2-3. It's just at times i experience the sharp pain that's like a 7-8 but it's gotten a little better in the past couple of days.
Hi SLM
I think you are doing great!! The sharp pain seems to be common for tibia in the shin area. It comes and goes. Hopefully, you feel better soon.
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ShortLivesMatter

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #24 on: April 10, 2019, 04:15:04 AM »

Hi SLM
I think you are doing great!! The sharp pain seems to be common for tibia in the shin area. It comes and goes. Hopefully, you feel better soon.

Thanks for all your advice Ghostfish, you seem to be pretty knowledgeable about LL! Yeah thankfully that sharp pain is lessening day by day.

I am aiming for 5.5-6cm, not too much, this will get me back to my original tibia-femur ratio and it's a good amount for me. I will be a little over 5'6 when it's all done for a total of +5 inches. Sure that's still short but it's an extraordinary increase from where I started with. Can't cry about the hand you were dealt, you can only improve it, I'm just grateful I have the ability to do so.

Anyway I went back to work yesterday after 4 weeks. I used a cane and it was tougher than I expected. Walking around the house here and there is one thing but having to walk at work (from parking lot to building and then to desk, walking to meetings, to the bathroom that's located at the other end of the floor) is another matter. By the end of the day I felt like the nail was going to break at any moment and my legs would fall off.  I will definitely use crutches from now on at work.

Today (Day 29) had another follow up with Dr. R. I have lengthened 1.8cm and everything was looking good. ROM was still good as well as callus formation. Dr. R was surprised I was already just using a cane and told me to take it easy and use crutches instead. He said that while Stryde is indeed amazing and weight bearing, there have been instances of the nail breaking so it's not indestructible.  The cane doesn't offer any weight bearing while the crutches do.  He said to be extra careful since I am doing tibia and obviously the tibia nail has to support more weight as opposed to if it was inserted higher up in the body in the femur. All in all things are good, I think I am settling into a rhythm now that I'm back to work and the pain at night is much more manageable. 

 
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Ghostfish

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #25 on: April 10, 2019, 05:56:03 AM »

Hi SLM

I am so surprised that you are already getting back to work!  That is amazing but it should be tough.  When I was in Paley institute, I knew one guy who did tibias with Stryde nails.  He was able walk with a cane by a month or so but complained about sleep deficiency and pain, from which I suffered even more than he did, since I am quite sensitive and have trouble in sleeping anyway.  Based on his case, it is hard for me to imagine that someone with tibia nails is working while lengthening.  Hopefully, everything goes smoothly!

Take care! SLM

Ghostfish   
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kanye007

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #26 on: April 11, 2019, 03:55:51 PM »

hey slm hope youre doung good. I had a question for you, do you smoke or have you ever had a history of smoking in the past. Ive heard smoking can cause poor bone consolidation. I used to smoke but have switched to JUUL ( vape ) was wondering what the results would look like if a person had a smoking history.
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ShortLivesMatter

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #27 on: April 11, 2019, 10:33:39 PM »

hey slm hope youre doung good. I had a question for you, do you smoke or have you ever had a history of smoking in the past. Ive heard smoking can cause poor bone consolidation. I used to smoke but have switched to JUUL ( vape ) was wondering what the results would look like if a person had a smoking history.

Nope I don't smoke, and yes smoking can cause slow bone consolidation. If you are planning to do LL, it's best to stop it completely. 
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tiggy

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #28 on: April 12, 2019, 01:56:42 AM »

Hey SLM,

Im very happy that you are doing well, keep up the great work. And I don't think 5'6 is short. Its just below average. To me short is where you started from and where I will be starting from (5'3). I too plan to reach 5'6 with my femur surgery and have no plans for tibias (though I don't think I would actually proceed with tibias). With regular shoes our heights would be 5'7, which is a great life changing difference from where we began!

I just realized as I was typing this that I forgot to ask you whether dr R ever prescribed you some nerve meds for that shooting nerve pain in your tibias. I hope it has gotten much better since your last update
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wannagrowtaller

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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #29 on: April 13, 2019, 03:07:39 PM »

Do you still have that sharp pain 8/10?
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Re: SLM Stryde Internal Tibia with Dr. Rozbruch March 2019
« Reply #30 on: April 14, 2019, 11:04:42 PM »

Hi SLM,

I've been a lurker here for about a year and but found your posts to be especially helpful since I'm in NY as well and planning on LL with Rozbruch in mid 2020.

Really curious, as someone who did both precice 2.2 and stryde, what were the new costs/differences?
is 2.2 cheaper now than before? or is it the same and stryde was more expensive.

I want to do 5cm tibia 5-6cm femur for about 10-11 total.. and really want to know what price i would be looking at to better prepare.
I would love to know if you have any info on whether he offers a better rate for doing both.

Thanks and best of luck on your second LL!
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