Quote from: Great321 on November 07, 2019, 12:28:24 AMI overlooked your sentence that you are now walking unaided. If you are really walking unaided more often than using a walker then chances are good that your bones will grow better now. Just be honest with yourself. I did wait until the 10th month and I almost wanted to wait even longer just to save money but don't wait as long as me 
But giving it about 6 weeks more until deciding sounds still safe for you.
Walking, PT, proteins and supplements are the key I guess. I underestimated PT before but it's really important! But with the frames and its certain pains in my case it was almost impossible to do enough.
Yes I will come to a conclusion regarding my decision in about a week. How much did u lengthen total and what will u say was the biggest 1 advantage you felt the nail gave you?
Dr Barinov external tibias 2019 Volgograd, Russia
Quote from: Sanity on November 07, 2019, 04:14:57 PMoh thanks for that. Yea i have started to walk unaided but real penguin walk. p.s i understand what you mean but my doctors do inform me frames could be on me upto a year mark and most probably more than that considering my slow growth and slow consolidation. You did LATN so i wanted to ask you what are the advantages for it u think?
I knew from the start that I would do LON or LATN because I did NOT want to be in frames for up to a year because I wanted to get back to work. I couldn't see a good way to explain away the frames to the general public.
I chose LATN on Professor Solomin's recommendation because he advised me it would provide greater stability because he could use a larger nail after distraction.
At the time, I did not realize (or maybe I did not fully appreciate) that I could NOT start walking immediately once the nail was inserted. That is, I did not realize I still had to achieve 75% consolidation before I began to bear my full weight.
The overarching point of the nail is to facilitate weight-bearing before the bones are fully healed; and, weight-bearing promotes bone growth which speeds up healing.
However, if you are already walking unassisted, I am not sure the risk of another surgery is warranted. Stated differently, you are already bearing weight so adding the nail really adds nothing in that regard.
It seems you are basically accepting the risks of a nailing surgery for the sole benefit of getting out of frames. Don't get me wrong--getting out of frames is a big deal but you have made it this far and the finish line is in sight.
Quote from: California2 on November 07, 2019, 07:46:35 PMI knew from the start that I would do LON or LATN because I did NOT want to be in frames for up to a year because I wanted to get back to work. I couldn't see a good way to explain away the frames to the general public.
I chose LATN on Professor Solomin's recommendation because he advised me it would provide greater stability because he could use a larger nail after distraction.
At the time, I did not realize (or maybe I did not fully appreciate) that I could NOT start walking immediately once the nail was inserted. That is, I did not realize I still had to achieve 75% consolidation before I began to bear my full weight.
The overarching point of the nail is to facilitate weight-bearing before the bones are fully healed; and, weight-bearing promotes bone growth which speeds up healing.
However, if you are already walking unassisted, I am not sure the risk of another surgery is warranted. Stated differently, you are already bearing weight so adding the nail really adds nothing in that regard.
It seems you are basically accepting the risks of a nailing surgery for the sole benefit of getting out of frames. Don't get me wrong--getting out of frames is a big deal but you have made it this far and the finish line is in sight.
when u say u couldnt walk even after nails u mean not walk without crutches? and how long was this?
I don't remember my exact timeline but you might be able to decipher it from my diary.
My LATN surgery was January 20, 2019.
I was cleared to begin carefully bearing significant weight on July 4, 2019.
In between, I went from wheelchair, to rolling walker, to crutches, to a cane. I was probably in a wheelchair until at least May 2019. Once out of the chair, I progressed pretty quickly through the other devices. After July 4, I stopped using the cane altogether within a few weeks.
Most of my significant bone growth occurred after July 4 as shown in my October 2019 x-rays that I posted.
Even so, Professor Solomin told me to expect full recovery by March 2020 -- that is 2 months for every centimeter of distraction. His advice seems right on target so far.
@Sanity I advise you to ask your doctor wether the LATN nail will be full weight bearing and how many weeks or months it will take you to leave walker/crutches/cane behind.
As you can see California2 and I have been through different experiences so far although we did the same surgery. Dr. Barinov might have a different approach aswell.
Below I quoted a passage out of one of Rozbruch's studies about LATN:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2628243/
QuoteBone healing in the LATN group was substantially quicker than that seen in the classic group.
We speculate the reaming through the regenerate enhances and speeds bone healing. In our patient group, bone healing was sufficient to allow full weight bearing without pain within 6 to 8 weeks in most patients. We have observed extraordinary radiographic healing during the first several weeks after IM nailing. This is in comparison to our 8-year clinical experience [24, 29–31, 33–35] observing bone healing after conventional distraction osteogenesis.
I don't know Great's healing timeline so I cannot speak to our differences or similarities but write to remind you that two schools of thought exist on the topic of weight-bearing before significant consolidation.
One says walk early and often and make bone grow. The other says walking before 75% consolidation is too risky because it is easy to break your ankle screws and drive your nail through your heel.
My surgical team strongly holds the latter opinion. I suspect I could have began walking earlier; however, I decided it was prudent to follow the advice of my surgical team.
But even after understanding this split in doctrine, you are already cleared for walking so your issue seems to be more of "will LATN improve my recovery at this stage?" And if so, "does the probable improvement justify the risks of surgery?"
Best of luck whatever you decide.
Quoteoh thanks for that. Yea i have started to walk unaided but real penguin walk. p.s i understand what you mean but my doctors do inform me frames could be on me upto a year mark and most probably more than that considering my slow growth and slow consolidation.
But how often and how long per day do you walk unaided? If you really want to save that money and the risks you could try to walk unaided as much as possible. I assume your bone growth would be faster than now. But that would require really a lot of walking and PT. You have to know for yourself if that is possible. But if your doctors told you that you could wear the frames for at least a year that’s also important to factor in your thoughts.
QuoteYou did LATN so i wanted to ask you what are the advantages for it u think?
Before LATN I was mostly tied to my bed. Walking (with mostly the walker) was painful. On some days I couldn’t walk at all. My bone healing was below average like yours. I was wearing the frames for 11 months and I could not imagine them to consolidate anytime soon. Getting out of the house or even the bed or a chair seemed like a challenge. Now that time is over.
- 2 weeks and 3 days after LATN surgery I changed from walker to crutches.
- 1 day later I tested walking unaided (a few steps) and it was possible (video available)
- 3 weeks after LATN surgery I was able to walk for 21 minutes straight (with crutches)
- 4 weeks after surgery I for the first time was able to leave the house without a wheelchair, and use the front stairs by
holding one railing, I could walk for 21-30minutes
- 5 weeks and 3 days after surgery I could leave the house and drive the car completely on my own (still hold the crutches for safety reasons)
- At the same day I published a video of me walking unaided (I was allowed to walk unaided but I was in frames 11 months prior so every case is different)
- 6 weeks after surgery I started walking completely unaided at first only inside the house, soon after also outside.
- 7 weeks after surgery I was on my feet for 2 hours straight (walking, standing) without pain
LATN will definitely improve your recovery and the surgery will be worth for everyone who has to be in frames for at least a year. I was far from consolidation even after 11 months. Jfk (a member of this forum) also did externals with Dr. Barinov. After 8months he did LATN and was happy about his decision until this day.
Quote from: Great321 on November 08, 2019, 12:14:10 PM
Before LATN I was mostly tied to my bed. Walking (with mostly the walker) was painful. On some days I couldn’t walk at all. My bone healing was below average like yours. I was wearing the frames for 11 months and I could not imagine them to consolidate anytime soon. Getting out of the house or even the bed or a chair seemed like a challenge. Now that time is over.
- 2 weeks and 3 days after LATN surgery I changed from walker to crutches.
- 1 day later I tested walking unaided (a few steps) and it was possible (video available)
- 3 weeks after LATN surgery I was able to walk for 21 minutes straight (with crutches)
- 4 weeks after surgery I for the first time was able to leave the house without a wheelchair, and use the front stairs by
holding one railing, I could walk for 21-30minutes
- 5 weeks and 3 days after surgery I could leave the house and drive the car completely on my own (still hold the crutches for safety reasons)
- At the same day I published a video of me walking unaided (I was allowed to walk unaided but I was in frames 11 months prior so every case is different)
- 6 weeks after surgery I started walking completely unaided at first only inside the house, soon after also outside.
- 7 weeks after surgery I was on my feet for 2 hours straight (walking, standing) without pain
LATN will definitely improve your recovery and the surgery will be worth for everyone who has to be in frames for at least a year. I was far from consolidation even after 11 months. Jfk (a member of this forum) also did externals with Dr. Barinov. After 8months he did LATN and was happy about his decision until this day.
Good reason to do stryde.
http://www.limblengtheningforum.com/index.php?topic=9814.0
Quote from: Michael01 on November 08, 2019, 04:51:48 PMGood reason to do stryde.
http://www.limblengtheningforum.com/index.php?topic=9814.0
of course stryde is superior but in Sanity's case LATN would be the better option now 
Quote from: Great321 on November 08, 2019, 12:14:10 PMBut how often and how long per day do you walk unaided? If you really want to save that money and the risks you could try to walk unaided as much as possible. I assume your bone growth would be faster than now. But that would require really a lot of walking and PT. You have to know for yourself if that is possible. But if your doctors told you that you could wear the frames for at least a year that’s also important to factor in your thoughts.
Before LATN I was mostly tied to my bed. Walking (with mostly the walker) was painful. On some days I couldn’t walk at all. My bone healing was below average like yours. I was wearing the frames for 11 months and I could not imagine them to consolidate anytime soon. Getting out of the house or even the bed or a chair seemed like a challenge. Now that time is over.
- 2 weeks and 3 days after LATN surgery I changed from walker to crutches.
- 1 day later I tested walking unaided (a few steps) and it was possible (video available)
- 3 weeks after LATN surgery I was able to walk for 21 minutes straight (with crutches)
- 4 weeks after surgery I for the first time was able to leave the house without a wheelchair, and use the front stairs by
holding one railing, I could walk for 21-30minutes
- 5 weeks and 3 days after surgery I could leave the house and drive the car completely on my own (still hold the crutches for safety reasons)
- At the same day I published a video of me walking unaided (I was allowed to walk unaided but I was in frames 11 months prior so every case is different)
- 6 weeks after surgery I started walking completely unaided at first only inside the house, soon after also outside.
- 7 weeks after surgery I was on my feet for 2 hours straight (walking, standing) without pain
LATN will definitely improve your recovery and the surgery will be worth for everyone who has to be in frames for at least a year. I was far from consolidation even after 11 months. Jfk (a member of this forum) also did externals with Dr. Barinov. After 8months he did LATN and was happy about his decision until this day.
Yes i can walk unaided but there is this one thing. Somedays there is pain and difficulty moving muscles due to the restrictions of the pins on hte leg musculature. So thats that but i would say its very achievable to walk unaided if a practice more. im more lazy.
-walking undaided is not in equation as i can already do that somewhat.
-cost for staying such a long time in a foreign country could almost be upto the cost of surgery at the end of it all (80% possibly)
Right now its only like staying in frames for a long time VS getting to life quicker(also working out and stuff). thats pretty much it.
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