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[fujitora]

I had sleeping issues too during the first 2 months and it was terrible - could only sleep for 3 hours per day. Then I met with a psychiatrist to provide medication for sleep. I'm sharing his prescription, hope this is helpful -

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I'm providing you with the points of sleep hygiene.
Sleep Hygiene:-
1. Sleep schedule: fixed time to sleep and to get up from bed.
2. Use bed only for sleeping.
3. Between dinner and going to bed, at least 1-1.5 hrs gap.
4. Light dinner, avoid tea/coffee at night before sleep, avoid plenty of water before sleeping.
5. Avoid alcohol/ smoke before sleeping.
6. Ambient environment for sleep: low noise, adequate temperature, turn off lights/ mobile/tv/ laptops before sleeping.
7. Before sleeping a cup of warm milk would help.
8. Reading a light novel before sleeping also helps.
9. Regular exercise and healthy life style also helps.

Besides sleep hygiene, melatonin congener- ramelteon (RAMITAX) also helps in regularising sleep.
It comes in dose of 8 mg. To beginning with you can start with 4mg, take it regularly at a fixed time.
Thank you.
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[Penguinn]

Day 4
So yesterday(Friday) was rather ok. The physios were hard on me. Dr. P was out of town for a lecture so I didn't meet him. Ordered Dominos. Worst part of the day was having to use the bedpan..let's just say you're not living anyone's dream using that thing. As I said earlier, I didn't sleep all night.



Day 5
After not sleeping all night, I randomly slept at 7am and was woken at 10(UGH!!) by my dad cause the physios wanted me. Physio is hard. Imagine having muscle pulls all over your leg and having to cycle really hard, that might explain some of it. I also hate turning on either side cause that's where the stitches are. They won't tear but the feeling isn't good. Met Dr. P a bit past noon and him & co showed me how to stand for a while putting only 20kgs(capacity is 25kgs per leg) weight on each leg while putting a lot of weight on the walker. Makes the arms and hands sore. Apparently Dr. Parihar e-mailed Dr. Paley to ask about the weightbearing.
Note: Even though I've been told it's 20kgs, it was said that I should practice 20 so if I ever accidentally go to 25, I'll be fine. I'm guessing they're being extra safe and the real amount is 30kgs but obviously I'm listening to their instructions. Since I'm 60kg(30 each side), should the worst happen, I think or rather hope the nails will not snap.
The weight bearing might also depend on the size of the nail. Anyway, if you pre-LLers want my advice, build LOTS of arm strength and don't be fat - for the walker, that is.
So far my days are not painful but rather boring and uncomfortable. Physio is really exhausting and I'll learn to use the walker properly soon. I think by Monday, 6 days post-op, I will be discharged. Two things I can't wait to do are mastering the walker & going home.

[Mtall]

After not sleeping all night, I randomly slept at 7am and was woken at 10(UGH!!) by my dad cause the physios wanted me. Physio is hard. Imagine having muscle pulls all over your leg and having to cycle really hard, that might explain some of it. I also hate turning on either side cause that's where the stitches are. They won't tear but the feeling isn't good. Met Dr. P a bit past noon and him & co showed me how to stand for a while putting only 20kgs(capacity is 25kgs per leg) weight on each leg while putting a lot of weight on the walker. Makes the arms and hands sore. Apparently Dr. Parihar e-mailed Dr. Paley to ask about the weightbearing.
Note: Even though I've been told it's 20kgs, it was said that I should practice 20 so if I ever accidentally go to 25, I'll be fine. I'm guessing they're being extra safe and the real amount is 30kgs but obviously I'm listening to their instructions. Since I'm 60kg(30 each side), should the worst happen, I think or rather hope the nails will not snap.
The weight bearing might also depend on the size of the nail. Anyway, if you pre-LLers want my advice, build LOTS of arm strength and don't be fat - for the walker, that is.
So far my days are not painful but rather boring and uncomfortable. Physio is really exhausting and I'll learn to use the walker properly soon. I think by Monday, 6 days post-op, I will be discharged. Two things I can't wait to do are mastering the walker & going home.

So if I can get to under 50 kg by the time I have my operation, I can just stroll around without a care in the world? 

[Penguinn]

Also learned to walk via the walker today, just a couple steps but my arm is sore. My upper body strength was never that good despite working on it, and it shows.

So if I can get to under 50 kg by the time I have my operation, I can just stroll around without a care in the world? 

They'll probably still make you use the walker for balance but you'll have a super easy time.

[Mtall]

Also learned to walk via the walker today, just a couple steps but my arm is sore.

How painful is the walking? And can you tell us what pain meds they're giving you, how strong they are, and how the doctors and you are generally managing all the pain?

[Penguinn]

How painful is the walking? And can you tell us what pain meds they're giving you, how strong they are, and how the doctors and you are generally managing all the pain?

The walking isn't painful, it's very strenuous, at least the first time. The lighter you are and the stronger your arms are, the easier it'll be.

Current pain meds I know of are a pill called Nice and 2 pain relief patches put on my thighs. They are both very mild, but so is the pain. When I'm like this: http://i.imgur.com/JPfUYpA.png just watching a movie or something the pain's like a 2. Occasionally I forget I even have nails in me. If the pain was higher, they'd definitely give you strong pain meds.

Pain is not something you should be worried about. Worry about exhausting(and I guess painful) PT, arms strained after overusing the walker, lack of sleep, lack of function and being very dependent and the first 2 days are pretty nasty.

[onemorefoot]

Penguinn  can you move quadriceps upwards in your leg when you want or it cannot be done( Maybe yes  because PT involves that)?

[Penguinn]

Just flex my quads or move my knee upwards? Both but not NEARLY like I could pre op.

[onemorefoot]

contracting the quadriceps, is the thing I wanted to say, is that possible for you now?

[Penguinn]

Yes, but my patella can be moved when I've contracted my quads which means the contraction is weak. My quads were pretty ok pre-op and seem to have taken a massive hit.

[TrueSpartan]

Hey penguin,

Not sure how legit this is but there's a study done that says listening to nature sounds promotes faster healing haha. Turn up your audio with some beautiful nature sounds haha.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2872309/

[Penguinn]

That's only for mental stress. Could still make for a good relaxing session.

[petite]

Congrats on a successful surgery.  Do you still have the feeling of "WTF did I do this for?" now after 5 days?  You've been trained to walk with a walker, is it still impossible at this stage to to walk with crutches?

[Penguinn]

The "WTF is this?" feeling was only for a day or so. I'm way more comfortable than 4-5 days ago. I miss being able to go to the toilet so easily and being a free bird. Most of my little frustrations results from having not started lengthening yet and the PT here being so demanding, but you gotta do what you gotta do.

Crutches are a LOONG ways away.

[frank]

Hey Penguinn! Your doing all of us a great service by being Parihar's first precice 2 patient on this forum! Your view of the pain has been very interesting however. Most people on the forum say they average a 3-5 pain constantly with internals, so you doing so well with weaker than average pain meds is very impressive. Why do you think this is the case? Is it because of Parihar's superior technique or that your just mentally stronger? Best wishes on your recovery man <3

[gokharol]

Thanks for sharing, Penguinn. Do you feel too weak by now? And why start stretching only after 10 days?

[Penguinn]

@frank: I don't know if Parihar's technique had to do with my low pain. My pain has been manageable since Day 2. The epidural got turned off at 5am that day and I didn't once complain about pain(I'd say it was a 4-5 though, but I never hit that excrutiating phase. I was legit waiting for it lol). My pain tolerance is average at best too, so I really don't know what it is. Maybe it's luck, maybe really painful days are yet to come.

@wololo: My legs feel weaker. My quads are almost non-existant. Upper body is ok, the only strain it has is using the walker anyway.
Stretching started Day 2. It does'nt start Day 10.. lengthening was supposed to, but after seeing my X-Rays, Dr. P preponed it to Day 7. This is because my left leg had to be operated twice which meant even with no errors, the cells get damages more(his words) so he wanted to give it time to heal.

[exmachine]

Did Parihar evaluate you psychologically before limb lengthening? I understand that he will somehow interview you. But I mean, did he check for self-harm scars or any of that sort?  I'm quite stable but back in my teenage years I've had some self-harm scars that aren't that visible unless inspected thoroughly.

[Penguinn]

Did Parihar evaluate you psychologically before limb lengthening? I understand that he will somehow interview you. But I mean, did he check for self-harm scars or any of that sort?  I'm quite stable but back in my teenage years I've had some self-harm scars that aren't that visible unless inspected thoroughly.

I'll PM you about my meeting with him, maybe it will help.

Your self harm scars won't matter lol, just wear a full sleeve or something if you think otherwise. I actually have scars on my left forearm that people mistake for big self harm scars; they're from accidents couple years ago- don't think anyone even noticed them.
I think as long as you have a pretty rational talk, don't expect to lengthen over 9,000cm in one segment and don't expect to become President once you're 3 inches taller, any doctor will grant you LL.

[Penguinn]

Day 6[Sunday]
The day went by slow. The bedside camode had some challenges, like sitting on it from my walker was really hard because my knee flexes at 90° with lots of difficulty while sitting and to go from standing to that was tricky. Getting up I needed assistance like someone putting their arms under my shoulders and helping me up cause I was too paranoid I would mess it up and snap my femur or nail. Morning physiotherapy was decent, Dr. Chaudhary is not as harsh as the lady physios. Later that evening one of Dr. P's assistants whose name I forget came over and reminded me to do it on my own in the evening since the physios aren't there Sunday night.
I did one kind of leg raises(lie down, place a folded pillow under one knee and raise that leg as straight and high as possible, hold for 5 seconds and then slowly lower)- 120 repetitions per leg and as a result I've woken up with sore legs Monday morning. Somehow yesterday my right leg was painless while left was a bit sore while sitting around, today my right aches(like 3/10) and left is free. Must be because of how I slept.

I have some questions I'd love answered by LL vets, especially those who did femurs:
How much physio did you guys do at the start? I haven't started lengthening and I'm getting worked; are they playing it safe or is it actually necessary?
Did your knee bend 90° easily while sitting?
How important did you find physio throughout the process on a scale of 1-10?

[exmachine]

Bro, how early did you meet with Parihar? Did you meet him a year before the surgery, or maybe a month before the surgery? If I was planning on having a surgery with Parihar, how many months before should I meet him?

[Penguinn]

Bro, how early did you meet with Parihar? Did you meet him a year before the surgery, or maybe a month before the surgery? If I was planning on having a surgery with Parihar, how many months before should I meet him?

I met him thrice, courtesy of a slightly paranoid family. Honestly even 1 meeting should do.

[exmachine]

How many months before the surgery was your first meeting?

[Penguinn]

How many months before the surgery was your first meeting?

Exactly a year but that was so I could schedule how to spend the upcoming year depending on whether he agreed to operate on me.

[Mtall]

Hey Penguinn. Nice to hear you're doing fine, not going through any hell.
Do the physiotherapists need to visit you everyday during the lengthening phase or are they just going to teach you the exercises and then you're on your own at home?
How much will they charge per time to come home?
And what's the update on that electronic muscle stimulator that you were talking about?

[KrP1]

Day 6[Sunday]
The day went by slow. The bedside camode had some challenges, like sitting on it from my walker was really hard because my knee flexes at 90° with lots of difficulty while sitting and to go from standing to that was tricky. Getting up I needed assistance like someone putting their arms under my shoulders and helping me up cause I was too paranoid I would mess it up and snap my femur or nail. Morning physiotherapy was decent, Dr. Chaudhary is not as harsh as the lady physios. Later that evening one of Dr. P's assistants whose name I forget came over and reminded me to do it on my own in the evening since the physios aren't there Sunday night.
I did one kind of leg raises(lie down, place a folded pillow under one knee and raise that leg as straight and high as possible, hold for 5 seconds and then slowly lower)- 120 repetitions per leg and as a result I've woken up with sore legs Monday morning. Somehow yesterday my right leg was painless while left was a bit sore while sitting around, today my right aches(like 3/10) and left is free. Must be because of how I slept.

I have some questions I'd love answered by LL vets, especially those who did femurs:
How much physio did you guys do at the start? I haven't started lengthening and I'm getting worked; are they playing it safe or is it actually necessary?
Did your knee bend 90° easily while sitting?
How important did you find physio throughout the process on a scale of 1-10?

Hi. 90° is ok. It depends on each person. In my case i couldnt reach 90 easily after the op. It took me some weeks to get there. But the most important is the extensión. Full extensión.
Physio is important but i think that is much more important the physio that you could do by your self. Cheers

[Penguinn]

Hi. 90° is ok. It depends on each person. In my case i couldnt reach 90 easily after the op. It took me some weeks to get there. But the most important is the extensión. Full extensión.
Physio is important but i think that is much more important the physio that you could do by your self. Cheers

The extension on my knees is actually decent but nowhere near pre-OP. Do you mean full extension should happen at this time or eventually as an end result? Also what physio could I do myself? I do leg raises, contractions and sitting knee flexing sometimes.

[patientdad]

I met him thrice, courtesy of a slightly paranoid family. Honestly even 1 meeting should do.

LOL, the last time someone used the word "thrice" was in the year 1867, lol.

[KrP1]

I had full extensión since the begining to the end of my lengthening. It depends on each person. Others had better flexión than me but worse hiperextensión. You need to stretch your quadriceps and femoral. http://team.redolat.com/wp-content/uploads/isquiotibilaes-estiramientos.jpg

[Penguinn]

Update
Nothing much to update about passing my days here, life is slow but surprisingly comfy. When I'm lying down like I am right now, my pain is zero. Sometimes I almost forget I'm a patient, except that my butt is sore from sitting so much and I have to continue sitting exactly on my plums cause I can shift but I can't tilt(cause stitches). Not that the stitches "hurt" either but with all their dressing it can feel like a lego block is pressing against you. Even the pain meds I'm getting right now are pretty much a formality. My pain when I woke up was higher, I remember thinking it was a 3 or 4, like muscle aches all over but it only lasted 15 minutes or so. It could be because I got a glorious 8 hours of sleep. If the pain is like this, almost non-existent throughout the procedure I'll consider myself extremely lucky but I highly doubt that'll be the case. Note that my lengthening begins from tomorrow.

I've been told that while chilling like working on my laptop I should do some exercises from time to time, like flex my quads hard for 10 seconds and release, 10 repetitions per hour. My quad flexion is still weak. Dr. P says physio is like climbing a steep hill that gets plateau'd slowly, but you slide a couple steps down and then you've a long climb up. He also does not encourage walking or weight bearing for my case. Once I'm discharged & lengthening, my days will be spent chilling on the bed on my laptop or something, putting work into physio for around 40 minutes thrice a day, then walking 4 steps for using the bedside camode.

Speaking of, I'm getting discharged tomorrow(it's 11pm, Tuesday right now) and honestly I've been here for more than a week...while the nurses have been really nice, I'm tired of this place and I'm glad to go home and play some League of Legends and watch some HD TV to feel rejuvenated. Exactly a week ago I'd woken up in the ICU realizing surgery was over, feeling bittersweet. Time passes fast.

Tip that may or may not be helpful: If you're booking a hotel room, make sure the bed isn't too short. If your knee has trouble flexing a full 90, and your quads are shot like a lot of patients' are, getting up will be hell. The one where I'll stay has been adjusted to 25" of height through tough foam mattresses.

[goldenegg]

It could be because I got a glorious 8 hours of sleep.

so many current LLer's are probably really jealous of you right now haha