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[Doflamingo]

Beside your toe everything else is "ok".
I'm happy you have visited an neurologist and that he described you a drug; he did told your toe would "heal" in time even without the drug.

[Polycrates.]

Little update on my condition:

Got another x-ray today. My last x-ray was taken on Fri Feb. 14. My measurements were 4.6cm in the left leg and 4.7cm in the right on that x-ray. Today's x-rays were 4.9cm and 5.2cm in those respective legs. I have identified a loose pin on my left knee. I suspected it broke inside, it was so loose, but the doctor insists if it were broken it would have done so on the outside of the leg. He said there's no point in replacing it this late, it'll be fine/it'll calm down...Regardless, I've been turning 1mm/day on both legs this past week. Therefore, I've gotten 71% of what I've turned this past week on the right, and only 43% of it on the left.....

I've created this tentative turn scheme (attachment, turns1.jpeg) for the last week. It's what I'll most likely follow. If the loss percentages remain constant, I should end up with equal distraction on both legs. I guess I'll need to spend a couple days to even out at the end. I am aiming for 5.5cm-6cm, so I will book a frame removal for the week of March 3rd.

71% of 5.5mm on right leg---> 4mm
43% of 9.25mm on left leg ---> 4mm

I'll post the x-ray ASAP.

[Polycrates.]

This is just a plan, of course. These x-rays have been so shoddy, I honestly am at a loss with what to do.... I have no idea what my actual distraction/discrepancy is, and the doctor doesn't seemed too concerned about it.

[Medium Drink Of Water]

In Beijing they didn't trust the devices' turn rate at all.  Measurements were all done on x-rays.  My advice would be to trust the doctors' x-rays over how much you've turned, however unreliable you think the x-rays might be.

[Polycrates.]

Bilateral X-ray:

Right Leg:



Left Leg:




The actual length of the object is 5.3cm. This rod was used at the discretion of the doctor. The rod was situated in the anterior position and approximated to the sagittal plane of the bone. So if I use that formula, I get 4.8cm for the right leg and 4.5cm for the left. But the physio told me that it's not accurate in the x-ray...

[Polycrates.]

The doctor has never made a measurement on an x-ray himself. He just quickly peruses. I'll ask him of my plan and what he recommends on Monday. If I continue to turn equally I fear it'll exacerbate the growing discrepancy.

[Smallguy]

Hey man,

I'm rooting for you!

Your doctor is correct. If you can reach your goal and your loose pin can be maintained without having to go through another traumatic surgery, then just maintain it.

Yes, the x-ray is not accurate. But give or take, it shouldn't be too far away from your actual length. Did you measure your tibia externally? It doesn't matter if your gaps are equal but your legs are disproportion. I would care more about the external length of my legs than my x-ray.

How is your toe coming along? Have you tried slowing down or taking a break to recover the sensory of your toe? Machine's roommate's toe recovered after he came back to Canada and is now walking around freely.

Pop a few pain-killer and man-out this last few weeks of your lengthening. Good-luck!

[Polycrates.]

I'll deal with the toe after frames are off. The neuro-consultant is a gold medallist (according to Harry-- apparently that's a medical accolade here) and he is of the opinion the nerve is intact. From your experience, do my x-rays look okay? Everyone's x-rays appear straight from the anterior but always misaligned in the lateral. Sringari always tells us this lateral misalignment won't be an issue, but I can't say I am content with that answer.

He has also been adamant all along that the nail will ensure the bones do not misalign, but Dr. Birkholtz reasoned that a nail does not possess the capacity to prevent this happening and a doctor should therefore remain prudent in combating deviations. This is in the x-leg thread under general. Sringari has never performed a single correct on any patient. Ever.

[Smallguy]

I'll deal with the toe after frames are off. The neuro-consultant is a gold medallist (according to Harry-- apparently that's a medical accolade here) and he is of the opinion the nerve is intact. From your experience, do my x-rays look okay? Everyone's x-rays appear straight from the anterior but always misaligned in the lateral. Sringari always tells us this lateral misalignment won't be an issue, but I can't say I am content with that answer.

He has also been adamant all along that the nail will ensure the bones do not misalign, but Dr. Birkholtz reasoned that a nail does not possess the capacity to prevent this happening and a doctor should therefore remain prudent in combating deviations. This is in the x-leg thread under general. Sringari has never performed a single correct on any patient. Ever.

Yes, Dr. Sarin also told me that the nail will prevent the bones misalignment. I brought this up issue of x-leg many times to many people, including Modh, Harry, Dr. Sarin, his staff, and my roommate. They all assure me that once I start walking again, the x-leg on my right tibia will go away. And guess what, I now have x-leg on my right. So I think Dr. Franz is right. But if your doctor is so adamant and refuses to correct your problem, then there is nothing you can do about it... maybe harass him more? Now that you see this post and my result, I think you should try to get this corrected before your bone consolidate. Otherwise, when you come back to Canada, you'll have this problem to contend with.

If you have x-leg, you can visually see it externally without having to view the x-ray.

But if you turn out to have x-leg in the end, dont feel too bad about it. Even Dr. Dragoon patient has it (sick joke).

[Polycrates.]

I think x-leg is cause by a misalignment in the longitudinal axis, but I honestly haven't a clue. The lateral shows deviation in the lateral axis.

[Polycrates.]

This is what x-legs look like in an x-ray (attached image). All of our x-rays from the anterior have appeared straight.

[Smallguy]

I think x-leg is cause by a misalignment in the longitudinal axis, but I honestly haven't a clue. The lateral shows deviation in the lateral axis.

I haven't got a clue neither.

Can you take a photo of your external tibias and post it? I'm not a doctor but if you have x-leg, then you can visually see it by now, externally.

I had the same frames on as you. Went through the whole ordeal. But x-leg only happens to my right. I spotted it visually when it was at 3cm. Don't worry about some theoretical concept. If you can't see your x-legs visually by now, then you won't have it.   

[Polycrates.]

I'll get Sukesh to take a pic tomorrow.

[Muse]

The doctor has never made a measurement on an x-ray himself. He just quickly peruses. I'll ask him of my plan and what he recommends on Monday. If I continue to turn equally I fear it'll exacerbate the growing discrepancy.

This is just a plan, of course. These x-rays have been so shoddy, I honestly am at a loss with what to do.... I have no idea what my actual distraction/discrepancy is, and the doctor doesn't seemed too concerned about it.

From a patient's advice about limb length discrepancy,  quoting the message. 

" The proper way to measures is from Hip to feet similar in fashion to Dr. Paley or Dr. Rozbruch, and the measurements are done by computer software. 

Anyone who is thinking about taking off their frames and worries about limb length equality OR misalignment (Ex. X-Legs) and how to correct it (Frames are required BUT IM Nail/Rod need to be taken out) should go contact another, hopefully better Orthopedic Surgeon."

[Polycrates.]

Pics of legs didn't come out very well. I'll get a standing shot tomorrow with a DSLR. Found an interesting case study by Dr. Chuadhary, who I know has a poor reputation among some. His article seems concise and well written though:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2739482/

I've been anxious over the possible consequence of my lateral misalignment in the right leg. From what I've gathered, this type of axial misalignment works to cause either a procurvatum or recurvatum condition (shown in attached picture). Sringari says it's fine, but as I've stated, he says most anything is fine. In Chaudhary's study, he states:

"In our series, we had 29.6% complications (eight in 27 lengthenings). There was one problem, three obstacles and three sequelae. We had to perform only four surgeries - two major (deformity correction with Taylor Spatial Frame (TSF)fixator, iliac crest bone grafting) and two minor (percutaneous TA Lengthening, repeat corticotomy). One of our sequelae was minor - a deformity of 10° tibial procurvatum, which did not interfere with function. One patient developed a premature consolidation of the femur, which left him 8 cm short. Most important, we did not have any deep medullary infection as compared to one out of 42 in Kocaoglu's series and three out of 20 in the series of Simpson (15%). However, two of the three infections in Simpson's series had shortening due to compound fractures and previous infection."

Feared Complications:
Procurvatum--

Valgus X-Legs (third legs)--


His statement would indicate that Sringari is correct in his assertion that an angular deviation within specific parameters will not cause a defect or malfunction of the leg. My deviation seems to be very subtle, so I am soothed by this. I turned my outer rods an extra two turns today, and it may be placebo, but I feel like so outward stresses have been relieved. I'll get an anterior x-ray if not tomorrow then by Wednesday to see how my alignment in that axis is doing. Haven't had an anterior x-rays in well over a month and I don't want x-legs!!!!!!!!!!!!

[Polycrates.]

Anterior X-ray from 2 months ago with straight bone apparent. Haven't had anterior since.



---LL Forum Exclusive Content---
Standing:
Bearing weight awkwardly. Excuse the soiled shirt. Haven't stood in so long, and it felt very awkward:

[Smallguy]

Procurvatum--

Are you afraid of the above? (picture) I don't know what people call it. Ox leg? If you do, take a side-way photo, then we can tell whether you develop it or not.

Looking at your front, I think it looks fine. The metal frame mechanism makes your tibias lengthen outward, but I can see the lower part of your tibias are curving inward. So I can imagine when you put your knees together, your ankles will touch.

However, I think you should send these pictures to a qualified doctors for their opinion (maybe Dr. Franz or Paley?). But if it was me, I wouldn't be too worried about it.

And congratulation. Maybe no one comments on your photo so far because they are drooling over your 2 inches height increase. 2.5 by the time you finish.

[Polycrates.]

I'm afraid of many things right now. Feel like I have to play my own doctor to a certain extent. Yes, I hope by the grace of the unforgiving and cruel gods that everything lines up and comes out right, but may that be naive? We'll see how straight it looks after my CT. If it's bent significantly I'll try to correct it myself by turning the outer rods more and retracting the inner rod. This is what I've been told should be done by other various sources.

Sringari saying a nail cannot allow an x-leg formation to occur has been contradicted by 3 other doctors I've enquired with now.... Dr. Barinov, Dr. Birkholtz and Dr Chaudhary all say that deviation and malalignment must be actively monitored by the surgeon during LON. Sringari tried making the assertion that deviation about the nail was an impossible notion. Just want to get out of here and back home to assess the damage done.

[Smallguy]

You're doing everything correctly at this moment. Access the situation and try your best to minimize the complication as much as possible. That doesn't mean that your tibias are misaligned. I find they look alright from the frontal view. But taking precaution is always the correct step.

I don't really believe in any god. I stop praying when I was 17 when I wished to become 1inch taller and look more handsome. Both wishes were never fulfilled.

Feeling fear is a good thing. It confirms that you are still alive. Believe it or not, if you own any nike garment at this moment, Nike the god of war is currently with you. You may be putting them on right now or they may be tucked away underneath your bed or stored in your suitcase. I think the best way to die is to die fighting in the battlefield where you have the chance to grip for your last breath. But if you make it out of this procedure alive and come back home, you will forever be changed.

Look forward to your CT scan. But whatever happens, Nike the god of war is with you.

[Medium Drink Of Water]

Could you use MS Paint to mark where you think the deviation is?  That photograph looks fine to me.

[Polycrates.]

I received benedictions from the ancient gods at a young age, and I supplicate to Jupiter as if it were a second nature. The old guys lay dormant beneath the crust of the earth, and their omniscience is present through the celestial sphere. I don't pray to false gods, and I don't pray for joy. I pray in fear of committing hubris. Perhaps a sacrifice is in order to appease their will.

Got the CT scan done today. Measurements were 4.3cm in the left and 4.7cm in the right, so it's good I took it as it shows the x-rays were 5mm inaccurate. Bones appear straight. Will post ASAP.

[Polycrates.]

CT Scans:

[Polycrates.]

I've hit a tremendous setback. Since Saturday, whenever my left foot is pulled upward even slightly, there is a severe and painful sharp shooting sensation originating in the small toe and travelling all the way down the foot and up the back of the leg. I can still move all the toes (bar the big one). I was hoping to get to 5.5cm, but it looks like now I might not even reach 5cm. I haven't turned since Saturday. I'm hoping I'm around 5cm now, but my left leg was already a few mm behind my right, so I might need to turn the right back. We'll see what the doc says....

Been reading more on nerves and it seems the nerve that functions as the sensory nerve in the fifth toe is an absolute cutaneous nerve, meaning it serves no motor function. The sural nerve is apparently removed quite often for biopsy. I don't know if this means I should ignore the shocks and continue turning or if I should keep waiting. Haven't turned since Saturday and haven't gotten the opportunity to consult the doctor about it either.

http://en.wikipedia.org/wiki/Sural_nerve

Regardless, this being the foot with the disabled first toe, I'm certain something is amiss with the nerves on the whole in this leg. Just hope everything fleshes out in the end.

[Smallguy]

He can make the argument that he tried to help me, but what he really did was con me. I could very well be in Serbia with Dr. Mitkovic or one of the other doctors who have been revealed by this forum that would have fit well within my budget. Instead of leaving the Sarin disaster behind and counting the site's losses, he went out of his way to find the next willing surgeon to participate in his scheme. Unfortunately for me, I didn't establish a solid presence on this site until too late. My surgeon is by no means a quack, but he is clearly inexperienced/rusty in Ilizarov. I just hope I come out okay, but if not I should be able to receive care back home. Some patients here, due to their nationalities, may not be as fortunate...

Yeah, had we know about this site, I would have gone to Russia because I was cheap at that time. But seeing the seriousness of the complication and the down-time at the result of these complications, I should have pay more and have gone to a more qualified doctor.

Help at home is available. However, they will only operate on you if your complication is a serious threat to your current well-being, like a bone non-union. Otherwise, you will have to wait for several years until you fully recover before they will operate on you again, for such hassles, like x-leg, numbness, nerves, and other issues. This is what my friend in Edmonton told me.

I was supposed to see my doc back in January but due to the long wait list, I won't be able to see him until the 17th of this month. I pray that he will fix my complication (1cm discrepancy and x-leg); otherwise, it will be a blow to my future plan. Like Germany, they may turn around and say my discrepancy is not enough to affect my well-being or give other kind of excuses to not fix it. But we'll see on the 17th.

Well, whatever that con-artist said, he was certainly not happy at Sarin for not accepting his deals. For all the idiots like us who were lured to his advertising scheme, he made some commissions... maybe not a sizeable amount of money but probably enough that he won't need a full-time job, could spend all his time on his website, and spend all the time at the gym to fix his freakiest proportion... not to mention, learn a little photo-shopping skill here and there which might be useful, like for lengthening his arms in his photo. We're lucky that our doctors were not all-quack (mine was borderline) but had we been disabled for life, I don't think that man would really care. As you can see his comments regarding Dr. Franz, his logic is twisted and he is manipulative.

[mediocre]

I think what he meant was be careful with any present or forthcoming old forum  diaries. That's the problem with the site owner who has conflict of interest; there's always suspicion somewhere.

I think the present Precice 2 old forum  diaries by Dr Paley, Dr Donghoon Lee and Dr M are real. I could be wrong though but unlikely.

Are you saying Precice2 diaries in old forum  are fake???

[Polycrates.]

 

The irony that he can accuse others of specious employment because they spend too much time on a forum is especially humorous. There's never a moment in time where you'll not see either Sysop, Apotheosis, or one of the many other potential alter-egos active on the site. I'm well-conditioned to having something occur before me, and then having someone immediately tell me to my face that it never occurred, after having spent four months in India.

A liar is a liar, but I'd think you'd want to exercise some cunning and deception in your art, not just try to piss on someone's leg and call it rain day after day. Needless to say, my mind is now thoroughly boggled. What is truth, what is fiction? What is based in reality, and what is not? Am I still in mortal existence or have I experienced my "Apotheosis" to the realms of the gods? These are the profound questions I ask myself at every moment now. If I were told otherwise, I'd believe it with fierce conviction by now.

[mediocre]

It looks like he paranoically monitors this forum that he knows a doctor regularly posts here. But he's wrong, Dr B only visits this site at night (local time) which is the time after his clinic hours.

The irony that he can accuse others of specious employment because they spend too much time on a forum is especially humorous.

[jerry]

I appreciate your honesty in this diary, unlike another person who is keeping silence on all this.   I've been pm'ing a guy on LL Forum and I am disgusted. 

Big faker is a coward for keeping his mouth shut about his complications, far from a honest diary he promised.   A new guy wants to come to Dr Sringari, the management told bigfaker to talk to him on skype  and he's not telling him the truth.

[Polycrates.]

Update: Had new x-rays on Saturday. The measurements are sporadic as usual, but I think I've gotten over 5cm by now, so I'm calling it quits. I've booked frame removal for Thursday, which probably means sometime between the 17th and 21st in reality. The doctor came today. I told him I'm worried about a discrepancy. I told him the left leg has been lagging behind the first on all x-rays except for this last one, where they're said to be equal. He glanced at my legs, touched the ankles of both legs, and somehow deduced from this act that they were equal and told me not to worry. To me, the gap on the right leg looks substantially larger, but perhaps this is just the way it's cut. Not going to worry about it too much I guess... it is what it is.

Regarding the Big Faker, he is alive and well here. He's not as vocal as I may be, but he is just as discontent as I am on many issues. I've definitely become the most outspoken here, so perhaps the others feel no need to speak out as much. I'll let him speak for himself though. I've heard of the new patient, but he's not contacted me as yet, and the management haven't put me in contact with him (big surprise?). If he comes to the guest house, I'll definitely be telling him there look to be better options out there for the money.

New x-rays ASAP.

[Polycrates.]

*Actual length of rod: 5.4cm

Left leg anterior:

Left leg lateral:

Right leg anterior:

Right leg lateral:

[Medium Drink Of Water]

Looking good in terms of bone growth and alignment.  It's hard to tell the exact gains by just measuring the gaps.  Are you going to have a standing x-ray taken so the entire legs can be measured?