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More than 5 cm - 6 cm (inclusive)

More than 6 cm - 7 cm (inclusive)

More than 7 cm - 8 cm (inclusive)

More than 8 cm - 9 cm (inclusive)

[ItsMyLife]

When do we lose dorsiflexion?

I am at 5 mm and my dorsiflexion is still the same, about 20-30 degrees.

Actually I am pretty lazy, i walk only 1 hour a day in total, I think. Mostly going to the toilet! Not walking on purpose.

But I dorsiflex a lot.

Here's  a video you can see!



And here's my questions for Doctor Fahri when we meet today:

Questions for Dr Fahkri
1) If I do not feel comfortable, at 0.75 mm/day, can I do alternate everyday?
1st day 0.75; 2nd day 0.5; 3rd day 0.75; 4th day 0.5

2) I have pin site pain and bleeding sometimes. (show him the sites). Is this normal? Pain at some pin-sites when walking.

3) When do I know there is pin-site infection??
 When do we start antibiotics?
   Oral
   Topical

4) If I want to resume basketball, should I lengthen 6 cm instead of 8 cm?
 lengthen 6 cm and then femur 4 cm
 lengthen 8 cm and stop
 lengthen 8 cm and femur 4 cm
Which is the best for basketball?

4) Do you have any medicines for sleep, in case I really cannot sleep? Can you prescribe me?
5) Can I borrow a wheelchair? Which agency do you recommend? My friend wants to take me around Moscow!
6) When do patients  notice a loss of dorsiflexion? What is my angle of dorsiflexion now? Different angle for left and right foot.
7) Will there be more pain after 5 cm? What type of difficulty will I have after 5 cm?
I find it difficult to walk without aid. Is it OK?
9) Can you teach me how to clean the pin sites?
10) can I have x-ray now?
What about before I leave Moscow? (3 January)

11) I need the prescription for Katadalon now.
12) Can you give me the intramuscular injections? I know how to inject.

13) If I do 8 cm, how long do I have to wear the frames until?
14) What about 7 cm?

15) Is Knee contracture uncommon? I rarely see this on the forum.

[ItsMyLife]

Dorsiflexion at 5.25 mm (Right leg)



much less dorsiflexion..

what should i do?

[ItsMyLife]

Doctor Responses in Bold

1) If I do not feel comfortable, at 0.75 mm/day, can I do alternate everyday?
1st day 0.75; 2nd day 0.5; 3rd day 0.75; 4th day 0.5

Yes

If no or little pain, continue at 0.75 mm/day
If moderate pain, do alternate.
If pain, continue at 0.5 mm/day

2) I have pin site pain and bleeding sometimes. (show him the sites). Is this normal? Pain at some pin-sites when walking.
Normal


3) When do I know there is pin-site infection??
 When do we start antibiotics?
Only at 3-8 days if not cleared with Iodine and antiseptics.


4) If I want to resume basketball, should I lengthen 6 cm instead of 8 cm?
 lengthen 6 cm and then femur 4 cm
 lengthen 8 cm and stop
 lengthen 8 cm and femur 4 cm
Which is the best for basketball?
Answer: He thinks just 8 cm tibia. Athletic function will be restored if I do PT. I ask him why the russians usually do 5-6 cm. he says 8 cm is OK, i am a hero?!


4) Do you have any medicines for sleep, in case I really cannot sleep? Can you prescribe me?
Didnt ask yet

5) Can I borrow a wheelchair? Which agency do you recommend? My friend wants to take me around Moscow!
Didnt ask yet

6) When do patients  notice a loss of dorsiflexion? What is my angle of dorsiflexion now? Different angle for left and right foot.
Notes that my dorsiflexion is good. He says patients develop problem at 5 cm sometimes. If physical therapy, no problem. Walking is important. about 10-15 times going to toilet. and physical therapy.

7) Will there be more pain after 5 cm? What type of difficulty will I have after 5 cm?
Didn't ask yet!

I find it difficult to walk without aid. Is it OK?
Didn't ask!

9) Can you teach me how to clean the pin sites?
Nurse will teach you

10) can I have x-ray now?
No need x-ray. Do not prescribe unnecessary inveestigations.

What about before I leave Moscow? (3 January)
Didnt ask


11) I need the prescription for Katadalon now.
will be given.

12) Can you give me the intramuscular injections? I know how to inject.
OK


13) If I do 8 cm, how long do I have to wear the frames until?
Didnt ask!

14) What about 7 cm?
Didnt ask!

15) Is Knee contracture uncommon? I rarely see this on the forum.
yes common!

[ItsMyLife]

Further questions!

Questions for Dr Fahkri (2)
For medicines, can I have a receipt?
Can i have both oral and topical antibiotics just in case?
WILL FEMUR SURGERY WEAKEN MY JUMPING ABILITY? I HEAR THAT FEMUR IS VERY IMPORTANT FOR JUMPING.
CAN I HAVE SOME MEDICINES, FOR SLEEP, JUST A LITTLE.
Can I borrow a wheelchair? Which agency do you recommend? My friend wants to take me around Moscow!
When do patients  notice a loss of dorsiflexion?  Different angle for left and right foot. What’s the dorsiflexion angle now?
Will there be more pain after 5 cm? What type of difficulty will I have after 5 cm?
X-ray  before I leave Moscow? (3 January)
If I do 8 cm, how long do I have to wear the frames until?  What about 7 cm?
Would topical cream applied to muscles help? For muscle strains? Avoid diclofenac.
Show him the standing on book exercise. Is it correct?
I need footholders!
Can I walk outside tomorrow for a short distance?

[Medium Drink Of Water]

No matter how much PT you do, you're not going to keep up with the lengthening.  What should you do?  Just live with it until your muscles and tendons can catch up.

[ForcedPuberty]

maybe 0.75mm is too much. im only doing 0.66

the ligaments can only grow/stretch so fast.

[ItsMyLife]

Yup Dr suggests 0.75 mm if I can take it, otherwise just 0.5/0.75 alternate, or even 0.5

[ItsMyLife]

This is walking at 5.5 mm of lengthening!



Can still walk unaided, but less!

[FedUp]

You make this feel so real with the daily vids, keep it up 

[ReadRothbard]

I don't think you need to do any more than 7 cm. 180 cm (5'11) is a pretty respectable height, plus most chicks you're 6'1 or taller, anyways (chicks are notoriously bad at estimating height lol).

[ForcedPuberty]

I agree its very nice to have a video diary for walking ability keep up the good work

[ItsMyLife]

I agree its very nice to have a video diary for walking ability keep up the good work

I figured if I can train my ability to walk unaided after surgery, it will be better for healing.
Dr Fahkri is supportive that I can walk without help.
Hopefully this continues into 1 cm , 2 cm, 3 cm.

[ReadRothbard]

Just lengthen slow and steady, and you should be fine.

[ItsMyLife]

Thanks!!

I am now doing 0.75 instead of 1 mm/day as per doctor fahkri's instruction.

And I think it should be much better!

I would not recommend staying in the hospital for so long. I've stayed for already more than one week. Frankly, one week is enough for them to monitor you.

This is especially if you know how to administer the pain injections yourself intramuscularly which is pretty easy also.

The intramuscular injections are ketoprofen.

[ItsMyLife]

Even though ketoprofen is an NSAID there are  a few studies that show that it (together with Ibuprofen) have limited or no effect on healing of bone fractures.

Also, I was thinking, since bone heals faster than muscles can stretch, it does not matter or have that much importance as regards this issue of bone healing.

Ketoprofen is indicated for injection intramuscular and intravenuously but there is no difference in effect so would just suggest IM: http://www.ncbi.nlm.nih.gov/pubmed/11942868

I am getting my pain medications today. They include the injections as well as several blood thinning agents, paracetamol with codeine, and katadanol. The Russians apparently don't believe in opiates and tramadol.

I've asked for a few sleeping pills to help me as I cannot really sleep here in Moscow.

[ItsMyLife]

Here are doctor's answers:

Questions for Dr Fahkri (2)
How often to clean the infected wound with Iodine?
Как часто для очистки зараженных рану йодом?
Everyday one time


My friend from Singapore bought chlorhexidine. Can that be used?
Мой друг из Сингапура купил хлоргексидин. Может ли это быть использован?
Yes. it can.

For Medicines (лекарства на сегодняшний день)
Can i have both oral and topical antibiotics just in case?
Могу ли я иметь как устные, так и актуальные антибиотики на всякий случай?
Yes.

Могу ли я иметь Katadanol and Excedrin? Могу ли я что-то еще больше? У меня есть много мышечных спазмов 

What kind of injections can I buy? What is the name of medicine?
какие инъекций я могу купить? что название лекарства?
Ketoprofen injetion, IM.

For the medicines today, can I have a receipt?
Для сегодняшнего дня лекарства, я могу иметь квитанцию?
Yes.

Sleeping pills just a few are required.
Могу ли я иметь некоторые лекарства, для сна, просто несколько таблеток
Discuss on Friday.

Other questions:
will femur surgery affect jumping ability? how high I can jump? heard that femur bone and thigh muscles is very important.
будет бедро хирургии влияет способность к прыжкам? как высоко я могу прыгать? Слышал, что бедренная кость и мышцы бедра является очень важным.
No effect.


Can I borrow a wheelchair? Which agency do you recommend? My friend wants to take me around Moscow!
Могу я взять инвалидную коляску? Какой орган вы рекомендуете? Мой друг хочет взять меня вокруг Москвы!
There are wheelchair agencies. Contact nurse.


If I do my exercise, will I keep dorsiflexion even about 5 CM? What’s the dorsiflexion angle I have now?
Если я делаю упражнения, и буду хранить сгибание даже около 5 см? Что угол сгибание меня сейчас?
Dorsiflexion will still be OK at 5 cm if do exercises. But it will be more difficult.


Will there be more pain after 5 cm? What type of difficulty will I have after 5 cm?
Будет ли больше боли после 5 см? Какой тип сложности у меня будет после 5 см?
Pain might be there until 4 cm.
After 4 cm, less pain
Finish distraction = pain less!

Can I have an X-ray  before I leave Moscow? (3 January)
Могу ли я иметь рентген, прежде чем я покинуть Москву? (3 января)
Yes. OK.

If I do 8 cm, how long do I have to wear the frames (in total) until?  What about 7 cm?
Если я делаю 8 см, как долго мне придется носить кадры (в целом) до?  Как насчет 7 см?
12 months – 16 months.

Would topical cream applied to sore muscles help? For muscle strains? Avoid diclofenac (NSAID).
•   Arnica
•   Ibuprofen
•   Menthol Будет кремов применяется к боли в мышцах помочь? Для штаммов мышц? Избегайте диклофенак (NSAID).
• Арника
 • Ибупрофен
• Ментол
• Метилсалицилат

They can be applied.


I need footholders! How often should I wear?
Мне нужно footholders! Как часто я должен носить?
Provided.




Can I walk outside tomorrow for a short distance?
Могу ли я выйти на улицу завтра на короткие расстояния?
Yes.


Can you give me a prescription for the medicines (katadalon, injections, antibiotics)? So i can go to any pharmacy in Moscow to buy when my Singapore friend comes to Moscow.
Можете ли вы дать мне рецепт на лекарства (katadalon, инъекции, антибиотики)? Так я могу пойти в любой аптеке в Москве, чтобы купить, когда мой Сингапур друг приходит в Москву.
OK.


During surgery, we did not dissect the archilles tendon??
No.


What are the causes of equines?Muscle not long, or tendon not long?
Muscle and Tendon.

Во время операции, мы не проанализируем ахиллова сухожилия ??
Каковы причины, конская? Мышца не долго, или сухожилия не долго?
Do plyometrics help? When can i do them?
http://www.bodybuilding.com/fun/ss5abig.jpg
Плиометрика помочь? Когда я могу это делать?

No basketball and running for how long?
Нет баскетбол и работает как долго?
1 year!

Can i borrow the walkers until the day before I fly? (3 January)
Может я заимствовать пешеходов до того дня, прежде чем я летать? (3 января)
Walkers are provided for me free.

When can I walk unaided after surgery?
Когда я могу ходить без посторонней помощи после операции?
Depends.

Any stretches i can do?? To relax tense muscle??
Любые участки я могу сделать ?? Чтобы расслабиться напряженную мышцу ??
The ones he showed me.

Mj7Need a small gauge needle for injection. When i inject myself. 30 gauge.
Нужна небольшая иглы для инъекций. Когда я вводить сам. 30 калибр.
Speak to the nurse.


Professor says to wrap something underneath to prevent infection? Second layer is cargo pants?
Профессор говорит, что для того чтобы обернуть что-то внизу, чтобы предотвратить инфекцию? Второй слой брюки-карго?
OK.

Need a letter for airport security (metal detectors)
Нужна письмо для безопасности аэропорта (металлодетекторы)
OK.

[ItsMyLife]

I will ask Dr Fahri today whether it is safe to lengthen 0.25 mm every 2 hours!

Some useful russian phrases and words I learnt!

1) Spasi-bah/Spicy-ba: thank you
2) Itz-li-ni-tzia: Excuse me, or Sorry!
3) Ku-reet-sa: Chicken
4) Ry-ba: Fish
5) Ree-ba: Arm
6) Toilat: Toilet
7) Shampun: Shampoo
Chas: A moment please
9) Spa-tchz: Sleep
10) Nyet: No
11) Da: Yes
12) Bol: Pain
13) Ochen Bol: Very Pain
14) Ya Ni Panimayo: I don't understand
15) Ang-ga-lese : English
16) Injektion/U-kol: Injection
17) Dobrile Ooo-tra: Good morning
18) Pree-vat: Hello
19) Harasho: Good/ OK
20) Kra-See-Vah: Beautiful
21) Infeksion: Infection
22) Pa-zhal-ulsta: Please
23) Add-miem: Exchange (currency)
24) Kra-see-vee: Beautiful
25) Mala-det: Excellent
26) Spa-see-ba Balshoye: Thank you very much
27) Vee-Cher-Rom: in evening
28) Zavtra : tomorrow

[ItsMyLife]

Final things for doctor

1) I need airport security letter (to clear metal detectors)
2) I need a letter in English to my university to say that I have done surgery (please do not say it is cosmetic surgery)
3) I need a letter to certify that I am fit for volunteering. I intend to volunteer at a hospice. And they want a letter from the doctor to say that I am well enough to help out.
4) Can I take tramadol with katadalon if pain is too severe?

[paco1]

Hi itsmylife, your diary is very informative.
You are doing very well.
cheers paco.

[ItsMyLife]

thank you!

I did look at crimsontide and wannabegiant diary.

I think crimsontide didn't do enough walking.....at day 10 post op he was barely walking, but I was walking from the first day; that is why he had ballerina, I am taking care it doesnt happen to me!

I hope he is better now after his release surgery!

I still have no sleeping pills, ketoprofen injectables and muscle ache gel. Sigh. Problems with transalations at the pharmacy!

[ItsMyLife]

Probably the last video I am uploading on walking without aid:



read the description for more information

I think I am getting fatter, all the junk food I order everyday, hahaha. Today, no junk food, except one instant noodle I had earlier this morning

Okay, someone asked me if there was pain. Hell, yes.

If there are Four words to describe this journey: pain, boredom, sleep problems, ill-tasting (most of the time) hospital food!

Pain: Painkillers never relieve 100% of the pain. Sometimes though you have 100% no pain. Pain comes and go, different kinds of pain and different sites of pain. This is the most terrible part of the whole journey perhaps. The first few days was so painful. Now, it is better, but still painful. It is painful to keep my left leg straight. My right knee hurts now. The pin-sites hurt less now. Thank God.

Boredom: pretty much nothing to do, or no mood to do productive stuff. I brought a book but haven't read much of it! So, don't bring medical textbooks expecting you will read most of it. Well, I actually did read a lot about the procedure, what to expect, patient's experiences, about the drugs that they gave to me (more on that later, if anyone cares to ask; its really detailed and I'm not gonna write if nobody's going to Bagirov)

Sleep problems: Yes, even with Chlorpheniramine (at high doses) I have trouble staying asleep. I usually sleep for 5-7 hours. Last night, I woke up at 2 hours with quite bad pain at my legs. I also had stomach discomfort (first time in Russia, besides the diarhooea inscidents recently); I beared with it. Did some hypnotherapy, and took painkillers. Managed to sleep another few hours. I try to get as close to 7 hours of sleep as I can. Our body needs that to heal. (cf: a study says that healing of fractures not affected by sleep deprivation); the hospital environment is not really conducive for sleep, so I lock the door at night; I don't know why but this helps me. I will explore more on hypnotherapy. But hypnotherapy does not really work for me when I tried to sleep again, because there was quite bad pain! You WILL find that sometimes, maybe because of the environment, AND the awkward sleeping positions, you will have trouble sleeping! Today, tomorrow  and the day after, I will use benzodiazepines to help me to sleep. After that, I will be back to chlorpheniramine. (using anti-histamines too long destroys their drowsiness effect).

And yes, the hospital food, most of the time, tastes really bland and weird. Even the Russians admitted they have a bit different food. It's a godsend when the nurse buys food from the nearby Burger King. Really. Or when you get pushed out on a wheelchair to buy food

[ReadRothbard]

Probably the last video I am uploading on walking without aid:



read the description for more information

I think I am getting fatter, all the junk food I order everyday, hahaha. Today, no junk food, except one instant noodle I had earlier this morning

Okay, someone asked me if there was pain. Hell, yes.

If there are Four words to describe this journey: pain, boredom, sleep problems, ill-tasting (most of the time) hospital food!

Pain: Painkillers never relieve 100% of the pain. Sometimes though you have 100% no pain. Pain comes and go, different kinds of pain and different sites of pain. This is the most terrible part of the whole journey perhaps. The first few days was so painful. Now, it is better, but still painful. It is painful to keep my left leg straight. My right knee hurts now. The pin-sites hurt less now. Thank God.

Boredom: pretty much nothing to do, or no mood to do productive stuff. I brought a book but haven't read much of it! So, don't bring medical textbooks expecting you will read most of it. Well, I actually did read a lot about the procedure, what to expect, patient's experiences, about the drugs that they gave to me (more on that later, if anyone cares to ask; its really detailed and I'm not gonna write if nobody's going to Bagirov)

Sleep problems: Yes, even with Chlorpheniramine (at high doses) I have trouble staying asleep. I usually sleep for 5-7 hours. Last night, I woke up at 2 hours with quite bad pain at my legs. I also had stomach discomfort (first time in Russia, besides the diarhooea inscidents recently); I beared with it. Did some hypnotherapy, and took painkillers. Managed to sleep another few hours. I try to get as close to 7 hours of sleep as I can. Our body needs that to heal. (cf: a study says that healing of fractures not affected by sleep deprivation); the hospital environment is not really conducive for sleep, so I lock the door at night; I don't know why but this helps me. I will explore more on hypnotherapy. But hypnotherapy does not really work for me when I tried to sleep again, because there was quite bad pain! You WILL find that sometimes, maybe because of the environment, AND the awkward sleeping positions, you will have trouble sleeping! Today, tomorrow  and the day after, I will use benzodiazepines to help me to sleep. After that, I will be back to chlorpheniramine. (using anti-histamines too long destroys their drowsiness effect).

And yes, the hospital food, most of the time, tastes really bland and weird. Even the Russians admitted they have a bit different food. It's a godsend when the nurse buys food from the nearby Burger King. Really. Or when you get pushed out on a wheelchair to buy food

Buy an Xbox or play station. That should relieve some boredom.

If you've never played Skyrim, now is the time!

[KiloKAHN]

Skyrim: Legendary Edition, Fallout 3: GOTY, and Fallout: New Vegas really helped me.get through lengthening. Especially on the big HDTV I'm the hotel room.

[ItsMyLife]

HAHAHA you gaming freaks.

I will read my textbooks (or try to) later!

And also watch some movies. Damned it that torrent doesn't work on me in this crucial time. Can't download any movies. And those streaming movie websites are all fake, just trashy ads. Does anyone know of any good place to stream movies? legit? Please!

Watching music videos, reading a book, surfing the net, texting friends, speaking to a LL patient, and doing physio has been taking up most of my time. Its pretty boring!!

[ReadRothbard]

Netflix and Hulu Plus

[ItsMyLife]

Thanks bro, just register? They are genuine?

[ItsMyLife]

Just got my university grades for my fifth semester. NOT GOOD. Sigh. I was too lackadaisical. Totally!
Now, I will study. And read my textbooks. To prepare for my semester after the gap semester.
NO MORE tramadol. I will just lengthen at a slow rate (0.5mm) if the pain is too much!
Does lengthening at a slow rate have any disadvantages?
Tramadol has scary effects on the mind and I am not sure if it is reversible. The same goes for Xanax and benzos.
I need to improve my grades.......!!!
Maybe some Xanax whilst in hospital won't hurt.
But not after I leave the hospital!

[ItsMyLife]

Netflix and Hulu Plus

NOT AVAILABLE in Russia! jesus. any other sites?

[ReadRothbard]

Try Amazon Prime.

[ItsMyLife]

Again! another painful night! God save me.
Just popped one ibuprofen and one katadolon....
I have to wait at least 30 min to one hour for it to take effect.
If it does not help I will inject painkillers!
Tonight I will take Xanax to sleep. This is bad. Real bad. Pain is 6/10. How to sleep?
Tomorrow I will lengthen at 0.5 mm and 0.75 mm alternately.
Then I will not need sleeping pills.

[ItsMyLife]

Popping another pill of Kata, and Ibuprofen. The Russians should really should learn something about pain management. 1.0 mg Xanax knocked me out only 10 minutes (and that was with help of hypnotherapy). I awoke to pain and urination urge. The doctor does not believe in antibiotics. God save me. If you want to lengthen in Russia, please bring your own antibiotics else you will have endless pain and suffering.