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[ForcedPuberty]

good lad.

my understanding is that the best lengthening rate for your soft tissue is 0.66mm per day.

its better to do this because you will not develop any micro tears in the soft tissue which will allow a better final outcome in the later stages as your soft tissue will still be in optimal form for being stretched.

0.75 is close enough I think.

[ReadRothbard]

I'd agree with him. Between 0.66-0.83 mm a day on the tibias is likely the best. However, I'd stick to the lower end if that range.

[ItsMyLife]

Yup, today I am lengthening 0.75 (and cut down to 0.5 if i need sleep)

Even with painkillers, 1.25 mm/day discomforts!

[ReadRothbard]

Yeah, 1.25 mm a day is simply too fast. Unless you're doctor gives other advice, I'd stick to about 0.75 mm a day.

[ItsMyLife]

i have now lengthened about 1.5 cm without any difficulties....
infections are mostly resolved. (four wound site infections earlier due to getting them wet when bathing)
please learn proper technic now to bathe...
i am around 20 percent done with my lengthening process... so god pls empower me with strength courage and wisdom to go further!
standing at 175.5 now... if pins did not bend
dorsiflexion decreased a few degrees but if i stretch realhard it is back....
i am also on many anti-oxidant supplememts...
some hearsay about LL aging u?...
so im on this regimen
is there any truth to LL aging u

[ItsMyLife]

Anna's negligence caused me to commit an offence. I was not registered as a patient at the hopsital. this is an immigration offence which is very serious!

Now i write my mitigation plea before the court:

1. When I applied to the visa agent, I showed them the medical documents regarding my medical trip. These documents were sent by Anna from the clinic.

2. The visa agent did not inform me of any need to register. They said that, "that is all".

3. Once I reached the hospital, I paid the monies, and did the examinations, and after that, all was done. I asked if anything else needed to be done. They said no.

4. After surgery I was in intense pain and surgery (I arrive in Russia 7 December, and surgery date was 8 December).

5. For the next 7 days or more, I was intense pain. Constant shots of painkillers and sedation. I could not have registered. Nobody told me I had to register.

6. When I was discharged from the hospital on the 22 December, I had infections and I had to concentrate getting antibiotics and medication to keep my infection under control. I was in severe pain.

7. When I arrived at hotel, they told me about registration and immediately once I knew that registration protocols were not followed, I took immediate steps to plan and go to the immigration office the very next morning, to settle the matter.

8. At no point of time, did I show any delay in my actions.

9. I do not wish to commit this offence, and I am sorry for the trouble. But the hospital was totally negligent, and they should be punished severely also, if not totally. Please understand my situation.

[ForcedPuberty]

that's hardcore  lol

[crimsontide]

could have avoided these issues by going to a different clinic....

[ItsMyLife]

I have been exonerated of the charges pressed against me by the district court of moscow. This is all because I was lucky, had a good translator from my embassy and pretty high ranking embassy support. the judge was also very pretty and though she looked stern, i felt she sympathised my situation... she twisted the law backwards and upside down and came out with just conclusion... i am a free man and will have no restrictions against me.

this is very lucky. however, the company may be liable to fine of 40,000 rubles for failing to register me as a patient (they have  responsibility to register me as a patient, but failed to do so).

if i had gotten a different judge, i will be put behind bars and be deported from russia thereafter.

also. i wasted one entire day (and in pain)... at the police station, federal migration service and at the russian courts.

thank you Anna ! i will tell doctor bagirov about all these issues. she is very responsible!

this is the code:
Article 18.8. Violation by an Alien or a Stateless Person of the Regime for Staying in the Russian Federation
 
  Violation by an alien or by a stateless person of the regimen for staying in the Russian Federation, manifesting itself in non-observance of the established procedure for registration, or movement, or choice of the place of residence, as well as in failing to leave the Russian Federation on the expiry of a definite term of staying there, or in failure to observe the rules of transit passage across the territory of the Russian Federation - 
 shall entail the imposition of an administrative fine in the amount of from five to ten times the minimum wage with or without an administrative deportation from the Russian Federation.

[ItsMyLife]

could have avoided these issues by going to a different clinic....

the doctors are ok but Anna is fked up,,,

[ItsMyLife]

Im now lengthening at 0.75 mm/day

sleep is possible without anti-histamines.

dr fahri and dr bagirov and the nurses have been pretty good to me. though the nurses can be unresponsive at the last few days maybe because they are too busy??

besides from my horrible experience due to anna's negligence in failing to register me, I would rate this clinic 8/10, if you bring your own antibiotics and painkillers.

i am still battling a few pin-site infections but i am still doing 0.75 mm/day.

[ItsMyLife]

I am doing very well. Not taken any sedatives for days. Probably anti-histamines for better sleep. I swear that ophendraine relaxes you and your muscles so well.

Here is the letter to my local A&E department once I reach back to my country:

Ski accident in Moscow, on 8 december 2014.
•   Sedated and forgot the MOI.
•   Illizarov fixation.
Started on Augmentin on 23rd Dec.
•   Did not keep proper records.
•   But 1000 mg was used.
•   Systemic infection signs like fever (37.5) and general feeling of unwellness.
•   Pus noted, and pain at infected wound sites.
•   Dosage was increased 1-2 days later to 2000 mg.
•   Subsequently, dosage was increased to 3000 mg (x3 a day)
Started on ceftriaxone q.d. IM on 29 Dec, for a total of five days (until 2 January inclusive).
•   1 gram = 15 ml dilution (N.S)
•   3 ml = 250 mg was injected Q.D. on Rt. Thigh muscle
•   Pain reported post-inj, but resolves in 5-10 minutes
•   Sterile technique used & no sign of local infection at site of injection or systemic signs.
•   Started on Ceftri because Augmentin did not work well.
Elevated sitting BP 132/64, HR is 98 (before 22nd it was 110/70 continuously)  Before sx, BP was about 100/60,and HR = 60-70
•   Possible reasons??
•   Painkiller Excedrin has caffeine??
Pain Mgt
•   Excedrin (2 tablets)  4 hourly, as needed.
•   Tramadol (50 mg, by mouth)  2-3 times daily.
o   Need more Tramadol
•   Oxycodone for rescue analgesia.

Basically just telling them I need more tramadol and oxycodone (even though Russia does not prescribe)
Naughty me, haa.

BUT I have read that katadalon causes liver failure if used more than 2 weeks at high dose in some patients..... I started it on 22nd December. So I have to stop on about 4 January, which is around the date I am going back home)......

I will use Tramadol for about 2-3 weeks before stepping down and switching to a milder painkiller.

Anyway I swear the Russian docs do NOT believe in antibiotic even if you hve pinsite infection and feel so sick. I am on very high dose augmentin and intramuscular antibiotics now. Augmentin prescribed by doctor. But the intramuscular antibiotics, I bought it from the pharmacy myself (without prescription)...

Amazing what stuffs you can buy in Russia; you can also buy the infamous sedative ..... Phenazepam... even the hotel staff knows it.. cardiologist at the hospital says no no no its no good, nurses say no good as well... well its pretty evil as it fks up 5-10% of your short-term memory.

I am VERY tolerant to benzos because I have undergone some surgery in the past.....  but this really fks u up and your emotions. I only took 1 or 2 pills about 5-6 days ago. I can function well on this, but I do nt recommend it. It has  a looooooong half life of more than 2 days. It is a muscle relaxant too so I would use it, IF and only IF I have unbearable pain.  a nice medicine to put into your arsenal.

I am taking all these drugs because I need to do intensive PT. I have not lost ANY dorsiflexion, and I am about close to 2 cm. 1.7 cm to be precise; so now, my height is 174 + 1.7 cm = 175.7 CM, pretty much 176.

[ItsMyLife]

Today and tomorrow I will lengthen 1.0 instead of 0.75, I will be using strong muscle  relaxants and do intensive PT!
Because, I don't know if the strong drug Phenazepam will pass customs!
Anyway, here is my video of my walking at 18.5 mm.
Average lengthening rate is 0.9 mm.
Next month, will decrease to 0.75. I want to shock my muscles into recovery!
i am also taking korean prescription anti-scar tissue to reduce any scarring internally and externally.
the patch on my leg is lidocaine (EMLA) cream because later, doing antibiotic injection.

[ItsMyLife]

Tomorrow my final consult with doctors before I fly home; here are my Questions! let me know if you wanna know the answers:

Ask about the various types of medicines.
Ask the nurses to teach me how to care for my wounds.
I need to recover my athletic ability totally. If I want that,
•   7 cm tibia
•   8 cm tibia
•   (x cm) Tibia + (x cm) external femur
Which is the best choice?
Based on the radiological examinations,
•   How is the bone formation?
•   Should I continue to lengthen at 0.75, or 1.0?
•   Any misalignment?
•   Bent pins?
•   What is the increase in height observed on the radiological examination? For both legs..
You mentioned my legs have slight discrepancy (bilateral)
•   Can I correct and make my tibia length the same only?
•   my knees will be the same height. But hip will be different height.
•   Can we do this? Is this advisable?
If I lengthen very well and no soft tissue issues, can I do 8.5 cm? What do you think is the limit for my tibia?
I am currently taking NSAID (Ketorolac). This is similar to Ketoprofen. Does this stun bone growth? If I take 3-6 pills everyday, how much longer do I have to wait, before I can remove frames?
I am covered by insurance. If I go to emergency room in my country (just to get 3-4 weeks of pain medicines, after that I will see specialist and tell the truth), will they believe that I am involved in ski accident? The osteotomy sites look clean and symmetrical! There are no external signs of injury, or soft tissue damage.
In your experience, How common is knee contracture? What about equinus?
How is my status for equinus and knee contractures?
I have been very lazy, walking only 30-60 minutes a day. I also stretch  maybe 20 minutes a day. Should I increase?
In your experience, is 4 cm external femurs safe? Misalignment problems?? I know the only problem is severe pain.
If I am comfortable and lengthening 1 mm/day, is it OK? Does it increase total recovery time? Does it affect athletic ability??
They say pain is more, when you approach 8 cm, is this true??
I may go for minor cosmetic surgery. Can I stop blood thinning medication and painkillers for  5 days?

[GeTs]

To me 4 femur+ 5/6 tibia

[ItsMyLife]

bro, dont want trauma of a second surgery

i am eyeing 7-8.5 cm of tibia. no more

that puts me at 183 safely:) 6 foot! or very close!

[goodlucktomylegs]

bro, dont want trauma of a second surgery

i am eyeing 7-8.5 cm of tibia. no more

that puts me at 183 safely:) 6 foot! or very close!

My friend
I dont know exactly about bio mechanic changed for longer tibia over femur .
Is it good for health?
You should ask your doc to double sure before lengthen over safety limit "5-6"cm
and ask him for reason why some doctor have constrast opinion with him?

My point to make you ask doc to double sure for your life long healthy with out compromise too much.
By the way .Wish you best from my truly heart.

[ItsMyLife]

My friend
I dont know exactly about bio mechanic changed for longer tibia over femur .
Is it good for health?
You should ask your doc to double sure before lengthen over safety limit "5-6"cm
and ask him for reason why some doctor have constrast opinion with him?

My point to make you ask doc to double sure for your life long healthy with out compromise too much.
By the way .Wish you best from my truly heart.

bro that is  a good question
he know i play basketball and am basketball player
but anyway I will ask him

[GeTs]

Doing 5 cm in tibias and then femurs will result into a better and faster recovery than 8-9cm tibia itself

[goodlucktomylegs]

Doing 5 cm in tibias and then femurs will result into a better and faster recovery than 8-9cm tibia itself

He dont want to do ll in the second part bc it is very hurt and waste lot of money.
By the way .I dont know .Is it a bet game for cross 5cm?

[ItsMyLife]

yes, ext femur is very painful... n all the trauma does age u.
also, if you lengthen femur, u cant jump so high (loss of athletic ability)- search internet: long femurs = low vertical leap....
and its another $10000... and the down-time.... i can't afford
i rather put in another 1 month of lengthening and 1 month of consolidation.

[ItsMyLife]

my theory... for first 2 cm, if you feeel comfortable, lengthen at 1mm. no problems. here's my spreadsheet... what do u think:

0.25 (4th day post-op)
1
1
1.25
1
1
0.75
0.75
0.5
0.25
1
0.5
1
1
1
1.25
1
0.75
1.25
1
1
0.75 (today)

total= 1.9+ cm

[ForcedPuberty]

this is silly.

as an average you are doing 0.86 mm per day.

and by the time you finish lengthening as you get into the later stages it will be an even lower average.

you are only hurting yourself by trying to rush this.

you are building up scar tissue.

why go through all this crap and develop micro tears and buildup of scar tissue which is permanent when in the end your average will be 0.66mm anyway?

why go through all this rubbish of rushing when you will in the end still only get 0.66mm per day as an average.

the only thing you will achieve is less elastic soft tissue when your lengthening is over. your soft tissue changes in fiber type.

let me educate you:

A contracture develops when the normally stretchy (elastic) tissues are replaced by non stretchy (inelastic) fiber-like tissue. This tissue makes it hard to stretch the area and prevents normal movement.

Contractures mostly occur in the skin, the tissues underneath, and the muscles, tendons, ligaments, and joint areas. They affect range of motion and function in a certain body part.

if you lengthen faster you are converting slowly but surely the type of soft tissue structures present In your soft tissue. in the end you will be permanently to a small degree have less biological capability.

and the most astounding thing is that you will still take an average of 0.66, but the ratio of change in the soft tissue to inelastic fiber like soft tissue will be greater.

my god its so annoying seeing people trying to be smart to save time when in the end they don't save time and actually damage their soft tissue.

no your not lengthening to fast as to get major soft tissue damage, but every single day you lengthen more than 0.66mm you are converting ever greater levels of elastic fiber like soft tissue into inelastic fiber like soft tissue.

unless you are in danger of pre consolidation. stick to 0.66mm.

[GeTs]

Do u risk pre consolidation only in the beggining assuming u lengthen 0.66/day

[ForcedPuberty]

everyone risks pre consolidation. the slower you go the worse the risk. it depends on you as an individual how fast your bones consolidate.

check with your doctor if they charge you to re break the bone and how much just in case premature consolidation occurs.

make sure you get x rays to prevent premature consolidation. even if you have to check 2 weeks after surgery and 4 weeks after surgery just to be sure.

I do not advise these next methods because I cant be sure of the outcome. but these are some ways to avoid premature consolidation. some pain killers can prevent bone consolidation, you could also take in less supplements, and you can increase your lengthening speed.

the only 1 I can be sure on is to increase the lengthening speed. the other might have unforeseen side effects and interactions.

[ForcedPuberty]

if something is going to consolidate I find it very unlikely that it will be your tibia. it will most likely be your fibula. but this also depends on surgical technique. 

[ItsMyLife]

this is silly.

as an average you are doing 0.86 mm per day.

and by the time you finish lengthening as you get into the later stages it will be an even lower average.

you are only hurting yourself by trying to rush this.

you are building up scar tissue.

why go through all this crap and develop micro tears and buildup of scar tissue which is permanent when in the end your average will be 0.66mm anyway?

why go through all this rubbish of rushing when you will in the end still only get 0.66mm per day as an average.

the only thing you will achieve is less elastic soft tissue when your lengthening is over. your soft tissue changes in fiber type.

let me educate you:

if you lengthen faster you are converting slowly but surely the type of soft tissue structures present In your soft tissue. in the end you will be permanently to a small degree have less biological capability.

and the most astounding thing is that you will still take an average of 0.66, but the ratio of change in the soft tissue to inelastic fiber like soft tissue will be greater.

my god its so annoying seeing people trying to be smart to save time when in the end they don't save time and actually damage their soft tissue.

no your not lengthening to fast as to get major soft tissue damage, but every single day you lengthen more than 0.66mm you are converting ever greater levels of elastic fiber like soft tissue into inelastic fiber like soft tissue.

unless you are in danger of pre consolidation. stick to 0.66mm.

contracture is prevented by intense PT and use of Tranilast (rizaben)

but my plan is to do 0.75 from 4 Janaury when i return to SGP

[ItsMyLife]

Do u risk pre consolidation only in the beggining assuming u lengthen 0.66/day

acc to doctor, only risk is if u lengthen at 0.5

but doing x-ray will solve and prevent/mitigate this prob

[ForcedPuberty]

contracture is prevented by intense PT and use of Tranilast (rizaben)

but my plan is to do 0.75 from 4 Janaury when i return to SGP

actually PT does not treat contracture. it treats the symptoms of contracture.

you are changing soft tissue fiber type. PT can not change it back.

I think you perhaps missed my point. I am not taking about contracture per say. contracture is not important for my discussion. I am talking about lengthening to quickly slowly changes your soft tissue type whether you get contracture or not. you don't go from 100% function to 0% function over night. each and every single day you over lengthen you affect your tissue in micro amounts.

for example if you lengthen for 5 days. (D1= 0.1mm,  D2= 0.1mm,  D3= 0.1mm,  D4= 4.6mm,  D5= 0.1mm)

then you will incur massive soft tissue damage on day 4 and no soft tissue damage on the other days. it does not matter that your average is 1mm per day. if the amount lengthened is over you incur micro tearing. even if you don't notice it. at the end of your lengthening the micro tearing builds up over time and will express it self at the end. even if you have "normal function" you will still have a decrease in soft tissue power. in the end you will not have lengthened any quicker but will have a small level of soft tissue scar tissue damage.

[ForcedPuberty]

if the over lengthening done each day is smaller (as in only a little bit above the levels soft tissue can lengthen) then it will take a greater amount of time for the damage to occur. but it will be occurring. and you will see it at the end of your lengthening.

[goodlucktomylegs]

if the over lengthening done each day is smaller (as in only a little bit above the levels soft tissue can lengthen) then it will take a greater amount of time for the damage to occur. but it will be occurring. and you will see it at the end of your lengthening.

I agreed with you and appreciate in your suggestion
I have 2 questions .
Why Dr Guichet lengthen it too much in femur?
1cm first day and 2mm per day?constrast with dr paley and donghoonlee only1mm?
Have you done ll yet?
I want to gather more information bc i will have femoral ll as first section  in this july for 6 cm max maybe guichet or paley.and if it not be good for soft tissue i will tell dr guichet lengthen me 1 mm perday