Hey, California2. I'm back with some extra questions, if you don't mind.
Most people have a slight limb length discrepancy (LLD). Did you have it, and if so, do you remember by how much? How did Dr. Solomin and Kulesh take that into account during your lengthening?
How was the PT during your lengthening?
Hey California , what is the expected time to be walking unnaided after nail insertion ? are you walking now with crutches ?
Regarding the last two questions/posts above:
Leg Length Discrepancy
I doubt I had a material leg length discrepancy before the procedure. However, you should remember that distraction can (and probably will) create a small discrepancy because your distraction will not likely be exactly equal on each leg.
Solomin/Kulesh use the following format: surgery-->distraction-->correction-->surgery-->consolidation.
Once you get your desired length change, you stop distracting. Then, you get tall film x-rays to check for a leg length discrepancy.
Then, you enter the corrections phase. Hexapods are installed that address both alignment and length discrepancy, if any. Once everything is exactly in position, frames are locked in place and hexapods are removed for your final surgery (unless you are doing pure externals--then, no final surgery.)
PT During Lengthening
I am usually not a fan of PT because I can usually do on my own better, whatever it is the therapist wants me to do. In St. Petersburg, I had Dr. Irina--a Ph.D. therapist. She was remarkable AND she did things that I could not do myself.
She trained me 3 days a week and I worked out on my own all other days.
Walking During Consolidation
The rule of thumb for total consolidation is 2 months for every centimeter of lengthening. Because I lengthened 9 mm, I should not expect to be fully consolidated for 18 months.
Solomin/Kulesh opine that the risks of weight-bearing prematurely do not justify the potential benefits.
Orthopedists are historically challenged by the dilemma presented by the need to bear weight to promote hard bone growth balanced against the risk of device failure--here, that the two little screws that anchor the base of my nails will break.
You can imagine the problems that might arise if I sheared my screws and drove my nail into my foot.
So, until I have 75% hard bone touching hard bone, I am to limit my weight-bearing to 30% of my weight.
It is impossible to accurately estimate the amount of weight you put on your feet when walking so walking is out for now. Instead, I stand on a bathroom scale with my walker so that I can accurately manage my weight bearing.
Also, when I am working on the computer, I will put my feet on the scale; then, slide the edge of the desk on top of my bent knees so that the desk pushes down on my tibias. If I need more weight, I put some folders between my legs and the desk.
If things go well (as evidenced by monthly x-rays) I should be able to start walking with a walker in another month or two.
It is easy to stand and to walk; that is, I have plenty of strength to do it and feel no pain, it is just that I go way over 30% when I do so I am taking my time and being careful.
Hi California2
Thanks for sharing your journey! You are brave and strong. You have made it!! I really hope you have a good recovery and enjoy your life!
Wish you the best of luck!!
Hi California,
I have done my nailing a week ago and I have a few questions,
One of the major problem I'm dealing with is my feet are suler numb,
I can't move my right toe at all don't feel anything on my right foot, it's like a dead piece of flesh, I can't lift my feet with my leg, so I have to use my arms. looks like nerve damage to me.
Did you have this issue after nailing?
I have that issues and on top of that god damn Edema.
My third major problem is very limited knee contractions.
Any advice? have you gone through any of those, how long did it last
Quote from: Big Decision on March 24, 2019, 08:27:08 PMHi California,
I have done my nailing a week ago and I have a few questions,
One of the major problem I'm dealing with is my feet are suler numb,
I can't move my right toe at all don't feel anything on my right foot, it's like a dead piece of flesh, I can't lift my feet with my leg, so I have to use my arms. looks like nerve damage to me.
Did you have this issue after nailing?
I have that issues and on top of that god damn Edema.
My third major problem is very limited knee contractions.
Any advice? have you gone through any of those, how long did it last
Seems to me you didnt stretch enough while distracting and got nerve damage after nailing due to that. Are you able to lift your foot up or does it just drop down? Should have really done LON
Quote from: Big Decision on March 24, 2019, 08:27:08 PMHi California,
I have done my nailing a week ago and I have a few questions,
One of the major problem I'm dealing with is my feet are suler numb,
I can't move my right toe at all don't feel anything on my right foot, it's like a dead piece of flesh, I can't lift my feet with my leg, so I have to use my arms. looks like nerve damage to me.
Did you have this issue after nailing?
I have that issues and on top of that god damn Edema.
My third major problem is very limited knee contractions.
Any advice? have you gone through any of those, how long did it last
Congratulations on entering the consolidation phase. From now on, things should get easier.
Get some support hose (compression stockings) and wear them all the time; keep your feet above your heart when you can. Edema (and the associated pain) should decrease substantially over the next two weeks.
It is normal for your feet to be numb now. If you can move ANY toes, you are ahead of the game.
What do you mean, "you can't lift your feet with your legs?"
When you lie flay on your back, can you keep your leg straight and lift it off the ground (moving from the hip)?
When you sit in a chair, can your extend your lower leg out (moving from the knee)?"
Can you like on your back and do bicycles?
You must have patience while your legs can heal but you must also work to help your body heal. Except for stretching and trying to move parts that are stiff, most of healing will come naturally.
You will start eating more, and gaining more strength, and sleeping better, and feeling better. As you do, you will naturally do more with your legs. This is how things should work. If they don't, contact your MD.
Remember, the rule of thumb for complete consolidation is 2 months per every centimeter of lengthening. If you lengthened 6 centimeters; then, you should not expect to be fully consolidated for one year.
You may begin to bear weight and resume most activities within months, but full healing takes time.
Hey guys thanks for getting back to me,
Unfortunately I can't lift my feet with my hip, the only way to lift any of my foot in using my arm.
I can move my left toe, but right one is numbs, no feeling.
That has happened after nailing...
And my knee contraction is pretty bad, I do strength everyday.
Depressing time, I have to drag my feet around, I can't extend my feet using my knee when I'm on wheelchair. My right foot feels really heavy.
I get some random nerve pain on both feet, makes me hope life will be back to my feet someday..
Sounds like you should talk with your MD. You did not have a procedure that would effect your ability to move your lower leg from your hip or your knee. Is the problem in your head rather than your body?
Quote from: California2 on March 26, 2019, 07:46:00 PMSounds like you should talk with your MD. You did not have a procedure that would effect your ability to move your lower leg from your hip or your knee. Is the problem in your head rather than your body?
In your head? LoL
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