My diary of quadrilateral Precice2 LL with Dr. Gokhan

Day 99-100

Here the weather is sunny and too hot for my room, because is facing South, so these days I turned on the AC.

There are 2 PT guys who are coming to help me and I named them “the bad boy” and “the good boy”.
The bad boy is forcing my muscles and tendons to work and also he push me to go to the pool. This is great and I need to be forced and pushed, so I can regain my motor function. But these are coming with big pain after, for 24 hours...
The good boy is doing all these softer and gentle, plus he is still doing electro-therapy, so overall is like a massage therapy after 24 hours of pain, which I really need.
So, they are both great and I like these cycles of pain and relief !

Yesterday came the “bad boy” and “killed” me like usually…so for the rest of my day and especially night time I had bad pain in my bones and knees… and because of that I couldn’t sleep for hours… Finally i not even heard the waking alarm at 8 AM today … and I slept to 10: 30 !... And I lost the breakfast too, because they close at 10…
Crazy !

I keep doing reversing, so after 5 days the soft tissues will be 5mm shorter and the PT guys should feel that in my ankles, which should be more elastic and mobile.

Last night I dreamed that I was walking normally !.... In the dream I knew I did LL and I was happy and surprised I can finally walk like before, with no pain !
And I almost cried for joy I could walk...
Well, only guys who have done quad LL can understand that...
For the moment I am not even do a simple step, I just lived 3 month and a half in wheelchair and I have to keep doing it maybe for 2-3 more months more...

Quote from: Ted68 on March 31, 2024, 08:18:45 AMYes, Juju, its and interesting biochemical and electrical "phenomenon" which should trigger the osteosynthesis. I hope will happen, so I will not do all these for nothing...

No, I never did EOS before. Its an expensive radio-imaging 3D system. They do it only after finishing the elongation period, so they can measure accurate the bones.
So far the doctors measured my bones approximately, but I need to know exactly, so I don't go home with discrepancies !

Interesting. Thanks for sharing. However if you can only do the EOS once you’re fully weight bearing - would that not mean only once your bone has healed (consolidated) - meaning even if you see a length difference in the EOS it’ll be too late to adjust it since your bones will have consolidation?

Quote from: GoodJuju on March 31, 2024, 11:38:01 PM
Interesting. Thanks for sharing. However if you can only do the EOS once you’re fully weight bearing - would that not mean only once your bone has healed (consolidated) - meaning even if you see a length difference in the EOS it’ll be too late to adjust it since your bones will have consolidation?

You're welcome, Juju.

EOS I have to do it before consolidation, just to measure accurately my bones so I can do the final adjustments, before leaving Turkey. Doing EOS after consolidation is useless for me...
For EOS I must stay vertically but for Precice is not allowed and for me is not possible so far.
But, I heard there are some handles on that machine, so I can hold my body vertically not to force down on my implants.
I will see...

Ah yeah if you can use the handles and semi weight bare that makes sense as for EOS you need to stand up. Good luck!

Quote from: GoodJuju on April 01, 2024, 01:16:11 PMAh yeah if you can use the handles and semi weight bare that makes sense as for EOS you need to stand up. Good luck!

Yeah, but my main problem is with the feet, because I cannot touch the ground with the heels...
I am trying to put something, like a two-by-four piece of wood, so I can have at least the heels equals.

How’s the recovery going so far doing the -5mm then + 5mm ? Ha your tightness and pain fully subsided or is it still high?

Quote from: GoodJuju on April 12, 2024, 12:03:19 PMHow’s the recovery going so far doing the -5mm then + 5mm ? Ha your tightness and pain fully subsided or is it still high?

In few days I am doing a new x-ray so we can check if all these cycles helped.
I still have pain when I straighten the legs and I felt a slight decreased of pain when reversed.
in 6 days I will finish these cycles, because are another stress for me.
Overall my pain is less and I can sleep finally in all body positions, without waking up suddenly...
My main concern now is the EOS, because I must find a way to do it properly. It should be done tomorrow, being the best moment because the reversing is in the lowest point... but is Saturday and then Sunday, so nobody work. That means I will do it later when I regain my 5 mm lost.
Too bad !

Ok good luck with it and let us know .

Btw - did your doc recommend standing at all (even while still lengthening) to help encourage bone growth? I have heard of several doctors saying standing (weight bearing) even before the bone is healed is a good way to speed up bone growth (even with precise 2.2).

Quote from: GoodJuju on April 14, 2024, 04:01:19 AMOk good luck with it and let us know .

Btw - did your doc recommend standing at all (even while still lengthening) to help encourage bone growth? I have heard of several doctors saying standing (weight bearing) even before the bone is healed is a good way to speed up bone growth (even with precise 2.2).

Thank you, Juju...

Standing up on Precice is allowed only in the first 5 days after the FIRST surgery, when the nails are strongest (because they wasn't elongated yet) but after that it is completely forbidden to stand-up.
And I didn't, especially because of my femur sensitive nails.
That advice to do it no matter what is for Ilizarov, LON, Betzbone/Gnail and Stride/Max.

And, yes, because of that, the callus formation could start later than others, especially on tibias. That happened to me.

So, totally I will stay in wheelchair 6-7 months, 4 and a half here and 2-3 months home, till the strong  callus formation.
The guys with 12mm nails diameters are more lucky, they can stand up a month earlier, due to the strengthen of nails.

Day 101-114

The general pain decreased, including the lengthening pain, which used to woke me up every 5 minutes in midnight. I still have big pain when I straighten my legs, but when I sleep usually I keep them in semi-flexion, so I can sleep with no breaks…

As you know my callus is not great developed in my tibias, so i had to reverse my length in 2 cycles. Now i have 4 more days and done.

In these 4 months only one time i found the pool water really warm, as +28C, and that day i felt amazing good, no muscle contraction and i could walk wit no pain... but the rest of days water was 20-22, so too cold for me.
That means the pool in this hotel was useless for me.

Also, the gym has no Alter-G walking machine and not even rehab paralels... so, again, a ussless gym for me.
These 2 lacks wasted my time of recovering with many weeks.

Four days ago I got another problem, a tendon jumped, on medial side of my knee, from Semi-Membranos or Semi-Tendinos muscle, and I got so much pain that I had to stop the PT. I had pain even in night time on that tendon. Next day at PT it was even worse. In every movements I felt that painful jump, so I had to stop 80% of my exercises for few days. Now I am very careful, to not forced the left knee movement too much anymore.

And, because nothing went smooth in my lengthening process, now i got a new problem !... One of a proximal  tibial screw bumped up a lot and yesterday scared me.
This bumping screw started about 2 weeks ago, slowly day by day... till it came up 1 cm !
That is bad and i am pretty sure i need another surgery, to screw it back in the bone... Crazy !
I have less than 2 weeks to stay in Turkey and i dont know yet what is my real length of my bones and i got this bump on top of these...
I sent a message to doctor, with pictures, and tomorrow I will go to X-rays to what is going on actually.
You have here the pictures…

https://photos.app.goo.gl/yCQ3vd8SXYxNU7Ln7

https://photos.app.goo.gl/HFe8JKBfS4DHJA9D8

https://photos.app.goo.gl/14X5No57yVSR3iAH7