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[StrugglingHard]

[StrugglingHard]

31/01/2014:

Reached hospital by around 7am. Frame removal surgery was finished by 11 am and they told I was shivering and shouting due to pain after surgery but I didnt realise anything.

I got very high BP( 160 before surgery, reaches 200 during or after immediate surgery as informed to me). Took medicine and my BP became normal by 9pm. Pain continued till next day only then no more pain.


I am really scared if I can get straight/normal foot before I fly back but Harry is confident that my foot will be normal before I go.

[StrugglingHard]

08/02/2014:

Harry says my twisted foot will be fine soon . I have ballerina but my fear is abt twisted foot.
My callus is ok not so excellent, it would have been worse if I didnt go through stem cells. I am expecting my stem bone healer soon and hope to get my callus better soon.

[OverrideYouGenetics]

shocking pictures and shocking diary

[hand_sanitizer]

I applaud u for being courageously determined. Congrats.

[kinglee]

how much bellerina do you have? It is looking bad bellerina and twisted feet too. .i will take time dude to be normal

[Machine]

Oh my god ... i m sorry to say that this is a very serious issue , actually i also had this issue on my left foot along with 2 other patients under Dr Sarin but my condition was way better then those other 2 that i know off .

i will explain to you since i had the same problem but my was way better then yours and i did my research and consulted other doctors ,,
there are only two possible causes to have this complication ;

1. Over stretching of your achilles tendon . it means since you might have lengthen too much , your achilles tendon couldn't resist the stretch which resulted in your heel turn inward . that's what the other doctor told me .

2. alignment of your bone is not correct . In your X-ray compare your right tibia to your left , it clearly shows that your right tibia is not straight which resulted in foot turn inward . And this is caused because of improper installment of frame or the IM nail by your doctor. try to align the both end of the cut of your tibia and compare to one another and you will know the difference .

i has consultation with another doctor and he said that my case is acceptable but i will need another surgery for correction in future .
well for me its been almost a year ... frankly i didn't do much exercise because it was really very hard and uncomfortable to make the foot straight because 100% pressure will be on a small portion of your foot just below fourth toe and pinky toe which made me give up many times . i guess i was scared and lazy . my left foot is much better then before but i still its not completely normal for which i will counsult another doctor next month (i was waiting for a long time for this).

try hard to make your foot straight and never give up , but what ever you do you will need another surgery to fix it which is by making your tibia straight . until then i don't think you will be able to walk normal . i know its hard to hear the harsh reality at this point of your LL journey but its the truth and i m sorry for that .

making your foot straight is much harder the removing a ballerina ... you are 100% right to be worried about twisted foot.



the 1st bone is perfectly aligned bone and its really very important to have a correct anatomical alignment of a leg bone to walk normal again and specially to prevent early arthritis , knee pain , twisted foot , X legged (genu valgum) and bow legged (genu varum).

[StrugglingHard]

@Machine,

Thanks a lot for the invaluable info. I think my twisted foot is due to 1st reason but not 2nd one. I have seen my both tibia and it seems quite  straight to me. Right tibia starts bending just from ankle or a bit above the pin areas. I see my heels bending inwards due to inablitity to stretch Achilles any more.

I have been doing heavy exercise to make it straight, while I dont see much improvement in bending in last 4 days of excercise, I see bit softer ankle which was so tight before, which means I feel when I stand it may help in making it straight.

I am doing excercise like
- putting wax to soften and Harry putting pressure from ankle to make foot straight, when  I do this I see larger part of foot touching ground not only small part on left tip (near last finger).

- putting 20 kg of weight on foot from inner side of foot & inner heel, for 30 min to 1 hour

- cycling for 1 to 2 hours by tightening foot with foot lace and putting pressure on foot to turn so that larger part of foot press on cycle pedal

- Putting pressure to straighten and then wrap with crepe bandage and keep for few hours as long as I can tolerate.

It makes ankle softer & flexible a lot but the moment I stop these exercise, foot comes back to bending position again & softness/flexbility decrease slowly.


Wont these exercise and softening & more flexible ankle cure this problem when I start walking?

And how much time it takes to walk after surgical lengthening of Achilles? Any idea? What ur doctor says?

Do u have contact with other 2 guys who suffer like this and their foots ok now and how?

Dr. Sringari feels I may need a surgery to extend my achilles but Harry thinks it will be fine by physio. I am really worried a lot
I have booked my flight for 28th Feb and join work on 3rd March.

Present condition:

It is extremely very hard and uncomfortable to make the foot straight & keep on ground because 100% pressure is on a small portion of foot just below fourth toe and pinky toe. So I am not able to put even weight on my knee.


Thanks again.

[hand_sanitizer]

Sorry to hijack ur thread strugg but i have a q's for machine in regards to misaligned tibial bone.
- Does the symptom include pain in the joint? Sometimes i feel the bone rubbing each other in the joint causing discomfort. I believe this maybe caused by the IM nail. It does go away when my achilles are warmed up tho and it's always more painful in the morning. I had had knee pain in that leg, the other one is perfect, no pain what so ever. Thanks.

[Polycrates.]

Hey Hand Sanitizer,

If I were you I'd take advantage of the free advice Dr Birkholz is currently offering on the forum. Go to the hospital and take the x-ray he suggested me to take and post it in his thread. He'll be able to determine if you have the correct alignment or not. He stated something along the lines of 5-10 degrees acceptability of deviation in the bone.

[hand_sanitizer]

Yo Polycrates. Good suggestion! ait, I'll do that.
Btw, I kinda regret not doing 7cm, lol.

[Machine]

Wont these exercise and softening & more flexible ankle cure this problem when I start walking?

And how much time it takes to walk after surgical lengthening of Achilles? Any idea? What ur doctor says?

Do u have contact with other 2 guys who suffer like this and their foots ok now and how?

Dr. Sringari feels I may need a surgery to extend my achilles but Harry thinks it will be fine by physio. I am really worried a lot
I have booked my flight for 28th Feb and join work on 3rd March.

Present condition:

It is extremely very hard and uncomfortable to make the foot straight & keep on ground because 100% pressure is on a small portion of foot just below fourth toe and pinky toe. So I am not able to put even weight on my knee.
Thanks again.

yeah if you do exercise it will definitely help your ankle flexible when you walk , its a common sense .

the doctor said it will take somewhere around 6 weeks or a little more depending upon the recovery when you do surgical lengthening of Achilles .

no i do not have any contact of those 2 patients but my roommate does have contact with 1 patient .
they were from england and malaysia .. the guy frm england had foot drop http://en.wikipedia.org/wiki/Foot_drop  imagine what he went through and no q's he will go for another surgery .... the other guy from malaysia had a conditions much like yours and believe my roommate still keeps in touch with him and last time he told me that he will go for another surgery .

whatever Dr Sringari or Harry says i think you should first know the reason of your problem ;
is it achilles tendon issue or misalignment ..?? to know your problem you should take a standing X-ray from hip below and consult other doctor . don't just take decision on an assumption man .
this is my x ray that i took right after frame removal ....
you can see my left tibia is 5% to 10% misaligned for which my doc said its acceptable but i will have knee pain and early arthritis in future if i don't do surgery for correction .

usually recovery is the hardest part of limb lengthening and yeah it will be very hard to make your foot straight and for that you need to stand and walk alot . it will be very annoying a times but you gotta keep pushing ... its time to use your name in practical 

[Machine]

Sorry to hijack ur thread strugg but i have a q's for machine in regards to misaligned tibial bone.
- Does the symptom include pain in the joint? Sometimes i feel the bone rubbing each other in the joint causing discomfort. I believe this maybe caused by the IM nail. It does go away when my achilles are warmed up tho and it's always more painful in the morning. I had had knee pain in that leg, the other one is perfect, no pain what so ever. Thanks.

yeah Poly is right..!! you should use Dr Birkholz's advise about your condition which will be accurate..!!

but i will share my opinion and experience if it will help others ;
when we do tibia lengthening we need to stretch our achilles tendon by standing and walking to make our ankle joint flexible so that we can walk but not many people realize that we are giving pressure back on our knee joints which causes harm to the knee joint space . this is also a reason to not to exceed more than 5 cm to 6 cm i believe .
this image to compare healthy knee joint space with unhealthy knee joint space

anyway your question was symptoms about knee pain and misalignment tibia ..
well i want to tell you that my left tibia is misaligned of 5% to 10% as you can read in my previous post on this thread , i feel very little pain in my left knee sometimes but on my right knee no pain at all .
it will be better if you take a full leg x ray to know if your bone is misaligned and consult other doctor .
TC

[Smallguy]

Good-luck buddy.

I'm not a doctor so can't give you any medical advice

What is done has already been done. Personally, I wouldn't go with a newbie like Dr. Sringari. So far, there hasn't been any record of any of his patient running again. Though, I admit his intentions are superb and he is very helpful. Plus Harry. Harry even took his patients to the Tal Mahal.

However, in my humble opinion... your legs have gone through some serious trauma so I wouldn't attempt anymore surgery at this point. Your best choice is go back home. Wait several months to see if your complication still persist. If you still have injury, go find an orthopedic in your country which is covered by your government healthcare and ask them for help.

Anyway, congratulation on becoming taller.

[hand_sanitizer]

That was me! Harry brought Messi88 and I to Taj Mahal.

[StrugglingHard]

My twisted foot is 60% recovered. Thanks to Management for immediately providing 2nd physiotherapist on request. Thanks Harry and Muhammad Nisar for their effort on my foot.

[Smallguy]

My twisted foot is 60% recovered. Thanks to Management for immediately providing 2nd physiotherapist on request. Thanks Harry and Muhammad Nisar for their effort on my foot.

Good for you. Glad you are improving!

That was me! Harry brought Messi88 and I to Taj Mahal.

You guys must of have fun. Harry and Nishar are taking really good care of you guys.

[StrugglingHard]

26/02/2014:
Walking with crutches with twisted right foot:

[mediocre]

I hope you recover well with that inverted foot.

If not, if I were you, I'll see a reputable orthopod to fix it. Your previous doctor/s mismanaged it.

Also, with your foot bent like this, there'd be increase amount of stress on one of the muscles called peroneus brevis. It arises from fibula and its tendon inserts to base of 5th metatarsal (the side of the foot). If you further invert it, like you walk and twisted your foot further, that tendon can be forcefully pulled and you'll fracture that 5th metatarsal.

All the best!

[Smallguy]

If not, if I were you, I'll see a reputable orthopod to fix it. Your previous doctor/s mismanaged

India is out of my list for LL. I won't ever go back there again. Too many horror stories and unnecessary complications which can be prevented had the doctor better monitor the patient.

The lowest I ever recommend anyone to go for now is China.

But the sick idea is, if you get screw over in India for a 15k surgery and if you live in North America, you're covered to see a real physician once you come back home under your medical insurance.

[mediocre]

Is that same as for Americans?

Hey Smallguy, how much is your ballpark figure budget for your next LL if you don't mind?

India is out of my list for LL. I won't ever go back there again. Too many horror stories and unnecessary complications which can be prevented had the doctor better monitor the patient.

The lowest I ever recommend anyone to go for now is China.

But the sick idea is, if you get screw over in India for a 15k surgery and if you live in North America, you're covered to see a real physician once you come back home under your medical insurance.

[Smallguy]

Is that same as for Americans?

Hey Smallguy, how much is your ballpark figure budget for your next LL if you don't mind?

Same for USA because not being able to walk is a medically necessary treatment. In fact you can head straight to Paley and be covered. It will make you feel like you are the hands of the best doctor in the world for a steep discount.

My next budget is 100k. I bought some stocks before heading for India which doubled in value and I also own a home in Vancouver. So I can take out a mortgage for this next one.

My choice at the moment is Franz, Guichet, or Paley (or even turkey).... or even Danghoon cuz I listen to korean music. Paying more doesn't guaranteed that you will be complication free (eg Betz) but it will make you feel like you have made the right choice the first time around

[StrugglingHard]

[mediocre]

Yeah. My choices also mirror yours, but not necessary in that order.

But if you choose Franz, Lee, Paley (or even Guichet?), they don't advice coming home before distraction is done, right?

BTW, do you think 100K is enough for Paley (including stay in Florida)?

Same for USA because not being able to walk is a medically necessary treatment. In fact you can head straight to Paley and be covered. It will make you feel like you are the hands of the best doctor in the world for a steep discount.

My next budget is 100k. I bought some stocks before heading for India which doubled in value and I also own a home in Vancouver. So I can take out a mortgage for this next one.

My choice at the moment is Franz, Guichet, or Paley (or even turkey).... or even Danghoon cuz I listen to korean music. Paying more doesn't guaranteed that you will be complication free (eg Betz) but it will make you feel like you have made the right choice the first time around

[mediocre]

Is your right leg also shorter than the left?
Or it's just an illusion due to your inverted right foot?

[StrugglingHard]

26/02/2014:
First Walking with crutches with twisted right foot(60% recovered):

[mediocre]

Way to go brother. Tough, tough journey!

You're stepping on your left forefoot. I hope you don't have foot drop.

26/02/2014:
First Walking with crutches with twisted right foot(60% recovered):

[Machine]

I can't help myself but to comment on your twisted foot ... Do you really think it is 60% recovered !!

from my experience my condition was way better then yours but still it took forever to get even 60% which i think i m at right now after 1 year post surgery ... i admit that i didn't do much exercise like standing and walking after frame removal for almost 3 months because i always gave up cause of the twisted foot which was so much annoying to me during recovery time ie; i couldn't put pressure on my achillis tendon like i can put on my right leg , instead all my pressure was just below pinky toe which was so annoying and painful ... now after 1 year i can walk normal without any support but still my twisted foot bothers me because the pressure we put on our foot while walking is not the same on my left foot which was twisted before and still is a little bit ... i intentionally took it slow for recovery because i thought that if i put too much pressure on my left foot it could damage the ligaments and all those stuff since our foot is made of so many joints .
May be that's another reason for big brothers to do femur lengthening since only one joint is there .

i consulted another doctor for correction right after frame removal ... he said that my case was acceptable since my tibia is 5% to 10% deviated from alignment and told me that i will need another surgery to fix it after recovery or else i will have early arthritis in future .. so after 1 year post CLL  i m going to mumbai 2morrow to consult those doctors who are real experienced regarding Ilizarov techniques and do the correction .

i can only say that you will definitely need another surgery to fix it ... i think the sooner the better but it entirely depends if any surgeon is going to take the responsibility since you just did lengthening and all the trauma you went through and IM nail is in your tibia bone .

anyways i m really sorry to give you this bad news but you are in a very serious complication ..!!

my suggestion is that you should consult another surgeon asap if possible ..!!

[StrugglingHard]

@Machine,

I say 60% as compared to my foot just after frame removal. My ankle was so tight and now its quite loosened and when I put weight on my foot, pressure is no more in small area. And when I stand, I can make my foot 100% straight when someone press on my foot and I see improvement everyday. I am giving full effort daily. What u see is result of 20 days physio.

[Machine]

i understand what you trying to say ..
i just shared my experience and opinion cause i thought it might help you .
CLL is a very lengthy process and especially recovery ... you will realize later what i m trying to say .

Over all it will be better if you consult other doctor about your condition ASAP ..!!

[BilateralDamage]

26/02/2014:
First Walking with crutches with twisted right foot(60% recovered):

Sorry but your gait is the stuff nightmares are made of... even more disturbing is that your PT seems fine with it.