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[Camillo]

Hi guys, I did my surgery yesterday, I am still at the hospital San Camillo in Milan and I will leave it tomorrow.

Starting heigh: 172 cm
Desired result: 180 cm
Method: Hybrid of External Fixator

If you have questions, let me know.

[onemorefoot]

Waht is hybrid of external fixator, does he do monorial tibias?

[YourSpaceBoyfriend]

I guess he ment LON/LATN.

[TIBIKE200]

I guess he ment LON/LATN.

Nope. External hybrid is a different kind of Ilizarov apparatus developed in Italy a couple of years ago and used across Italy and some European countries.
  It's made of Carbon-something making it pretty light despite being strong.
It has different kind of wires and other stuff.

It's called hybrid because it uses principles from a couple of different Ilizarov approaches

[YourSpaceBoyfriend]

hmm, never heard about it.

OP, would you mind making a photo of the fixator? I'm quite curious.

[TIBIKE200]

Lumier has pics of the device in his diary. It doesnt look so much different from a standard ilizarov

[Whereintheworld?]

Hey Camillo,

I also had surgery with Pili/Catagi- I stopped lengthening last week.

Good luck

[Camillo]

Hey Camillo,

I also had surgery with Pili/Catagi- I stopped lengthening last week.

Good luck

Hi Whereintheworld, great to hear from you. How was it? How much did you do in term of cm? Did you have experience of any problem during the process of lengthening? Any suggestion for me?

Right now I don't have much pain, but I guess it is because of painkillers. I am a bit afraid because I am leaving the hospital now so I will be in my apartment a couple of hours far from Milan. I guess I will manage it, yesterday I tried to walk and it seems I can, but of course it is a strange sensation.

The most boring part at the moment is sleeping because I have to wear dr. scholl shoes pulled from elastic to prevent the clubfoot. You have made the operation of the Achilles tendon or you've managed to avoid it?. How much did you walk during the day? How much physiotherapy did you do? How frequently did you tighten the bolts of the EF and how often in a week did you do the medication?

Thank you in advance.

[Camillo]

hmm, never heard about it.

OP, would you mind making a photo of the fixator? I'm quite curious.

Sure
https://cl.ly/2S002r253O07

[Whereintheworld?]

Hi Whereintheworld, great to hear from you. How was it? How much did you do in term of cm? Did you have experience of any problem during the process of lengthening? Any suggestion for me?

Right now I don't have much pain, but I guess it is because of painkillers. I am a bit afraid because I am leaving the hospital now so I will be in my apartment a couple of hours far from Milan. I guess I will manage it, yesterday I tried to walk and it seems I can, but of course it is a strange sensation.

The most boring part at the moment is sleeping because I have to wear dr. scholl shoes pulled from elastic to prevent the clubfoot. You have made the operation of the Achilles tendon or you've managed to avoid it?. How much did you walk during the day? How much physiotherapy did you do? How frequently did you tighten the bolts of the EF and how often in a week did you do the medication?

Thank you in advance.

Hey Camillo,

These first few days will be the toughest, at least they were for me mentally. The prospect of lengthening for 80-100 days may seem terrible, but it will go by faster than you can imagine.
As far as tightening the bolts, the rule of thumb is once a week, but if you go out and about through town, you may want to check the bolts when you get home. Honestly though, I moved around a lot and only once or twice was anything even remotely loose.
Walking will be a little weird, you might hear/feel little clicks and such- I probably messaged Dr. Pili 10 times during the first two weeks thinking I had broken something-everything was fine.
The blue shoes and the rubber band are by far the most difficult aspect of the entire process, but you'll get used to them.
*I reached 5cm (turned about 5.4 cm) without really any problems to speak of, other than a few times having a pin site get irritated or else a tingling sensation that came and went for a couple of days. After each time that I turned, I would stand against the wall and do the exercises, then I'd walk across my apartment for about 5-10 minutes- so that, 3 times a day.
Despite being satisfied with the 5cm gain, I decided to push my luck for 6. When I met with Pili last week, he said I was a little stiff, but that since I did not intend to lengthen any more, we could try physical therapy before yielding to the achilles lengthening surgery.

I tried to stay away from the painkillers and it wasn't really too hard- there were of course a few times were I was very uncomfortable, but I could manage it.
One piece of advice I will give you is to sleep with your legs straight (although elevated). I realized early on that it was MUCH easier to fall asleep at night when I had my knees bent, but as Dr. Pili explained to me last week, this is counterproductive to the stretching that needs to occur.
Sleep well tonight, you're in very good hands with Pili/Catagni

[Camillo]

Hey Camillo,

These first few days will be the toughest, at least they were for me mentally. The prospect of lengthening for 80-100 days may seem terrible, but it will go by faster than you can imagine.
As far as tightening the bolts, the rule of thumb is once a week, but if you go out and about through town, you may want to check the bolts when you get home. Honestly though, I moved around a lot and only once or twice was anything even remotely loose.
Walking will be a little weird, you might hear/feel little clicks and such- I probably messaged Dr. Pili 10 times during the first two weeks thinking I had broken something-everything was fine.
The blue shoes and the rubber band are by far the most difficult aspect of the entire process, but you'll get used to them.
*I reached 5cm (turned about 5.4 cm) without really any problems to speak of, other than a few times having a pin site get irritated or else a tingling sensation that came and went for a couple of days. After each time that I turned, I would stand against the wall and do the exercises, then I'd walk across my apartment for about 5-10 minutes- so that, 3 times a day.
Despite being satisfied with the 5cm gain, I decided to push my luck for 6. When I met with Pili last week, he said I was a little stiff, but that since I did not intend to lengthen any more, we could try physical therapy before yielding to the achilles lengthening surgery.

I tried to stay away from the painkillers and it wasn't really too hard- there were of course a few times were I was very uncomfortable, but I could manage it.
One piece of advice I will give you is to sleep with your legs straight (although elevated). I realized early on that it was MUCH easier to fall asleep at night when I had my knees bent, but as Dr. Pili explained to me last week, this is counterproductive to the stretching that needs to occur.
Sleep well tonight, you're in very good hands with Pili/Catagni

Thank you for all your suggestions.

Right now as I am back home I feel hard to walk. I didn't expect it but actually I have some pain in the pins and wires when I walk. So I was planning to go to restaurants, gym, supermarkets when back home but I had actually to change my plans. I hope it will get better in the next days or weeks so I will be able to do it instead of staying home.

Something else that it is annoying to me is the fact that I have to keep my legs straight all the time (at least this was suggested). This position is tiring after a while and I would rather prefer to sit with bent knees.

Last thing that is worrying me is being worried about pins and wires infection, tightening the bolts etc. I would rather prefer just to focus in my lengthening and Don't worry about the rest. But I think it is part of the game.

[YourSpaceBoyfriend]

Sure
https://cl.ly/2S002r253O07

It looks like festival of ideas lol. Thanks for picture.

Good luck, know your limits so you won't regret it later.

[Whereintheworld?]

I'm not sure if it was a good thing or not, but I always bent my knees while sitting. However, I would put the balls of my feet a pile of books of something, and let the heels 'hang' off the back, so as to have a little stretching going on.
-I don't want to point you in the wrong direction though, so you my want to ask the doctor about this

[The Kaiser]

You will do 8 cm in femur or tibia?

and why you live far from Milan, not a good idea

[Camillo]

You will do 8 cm in femur or tibia?

and why you live far from Milan, not a good idea

Hi Kaiser, 8 cm in Tibia.

I live 2 hours from Milan, the doctor said it is fine because there are no serious complication with EF.
I have to meet him again in half November (after one month) and in the meanwhile I can contact him from remote for questions.

[Camillo]

I'm not sure if it was a good thing or not, but I always bent my knees while sitting. However, I would put the balls of my feet a pile of books of something, and let the heels 'hang' off the back, so as to have a little stretching going on.
-I don't want to point you in the wrong direction though, so you my want to ask the doctor about this

Hi Whereintheworld, would you mind to send me a video of how to tighten the bolts of the external fixator? I just received my two keys 10 but I'm not sure I know the procedure, and I am afraid to spoil the EF. If you do not want to post it here you can write me in private. Thank you.

[The Kaiser]

Hi Kaiser, 8 cm in Tibia.

I live 2 hours from Milan, the doctor said it is fine because there are no serious complication with EF.
I have to meet him again in half November (after one month) and in the meanwhile I can contact him from remote for questions.

8 cm is too much for tibia, maybe there will be no complication, but put in your mind the recovery will be tough

[Camillo]

8 cm is too much for tibia, maybe there will be no complication, but put in your mind the recovery will be tough

Yeah but why go through this and do less than 8 cm?
Yes it is terrible, it is much worse than anyone can expect. Your life change for a period (I hope) but I think if you do it, you should go through the full tunnel until the end, without taking any exit on the way. This is my idea, I know it will be hard, it already is, but since I am not going to do it again, I want to take the biggest advantage of it.

[Camillo]

Hi guys,

Just a quick update. Things are moving forward. It is not exactly how I expected this to be. I was planning to walk all the time, go gym, restaurant, cinema, supermarket etc. But the real story is that I have a continuous (but not strong) pain in all my pins and wires. The problem is that, when I walk, it became stronger, so I cannot walk that much, it is already a pain when I have to go to the toilet.
Does anyone have experience with EF? Was it like that for you too?

Also, yesterday night I woke up twice, first because of a strong pain in my low right leg, between the leg and the feet, it took a couple of seconds but it was super strong, i woke up screaming. Then again for the same kind of pain in the left leg. Has anyone of you ever experienced anything similar?

Thank you.

[apoxyomenos]

Hi Camillo,
Are you still taking painkillers, or are you trying to avoid them because they can slow down the bone generation?

[Camillo]

Hi Camillo,
Are you still taking painkillers, or are you trying to avoid them because they can slow down the bone generation?

yesterday was the first day I didn't take painkillers, before I was taking only 1 co-efferalgan at evening per day

[Camillo]

Hi Camillo,
Are you still taking painkillers, or are you trying to avoid them because they can slow down the bone generation?

I didn't know painkillers slow down the bone generation though, where did you read it?

[Whereintheworld?]

Hi guys,

Just a quick update. Things are moving forward. It is not exactly how I expected this to be. I was planning to walk all the time, go gym, restaurant, cinema, supermarket etc. But the real story is that I have a continuous (but not strong) pain in all my pins and wires. The problem is that, when I walk, it became stronger, so I cannot walk that much, it is already a pain when I have to go to the toilet.
Does anyone have experience with EF? Was it like that for you too?

Also, yesterday night I woke up twice, first because of a strong pain in my low right leg, between the leg and the feet, it took a couple of seconds but it was super strong, i woke up screaming. Then again for the same kind of pain in the left leg. Has anyone of you ever experienced anything similar?

Thank you.

You've probably noticed that the feeling in the pins and wires is worse when you first get out of bed in the morning, it's like when your leg is sore from sitting down in a weird position for too long - you need to walk it off. Try to walk around your room for a couple minutes every hour or so.
I'm not sure if it's what you're describing, but I had a similar pain that ran from around the outside of my ankle down to about mid-foot. The pain lessened with time but it actually took a couple of months before I no longer noticed it.

[Camillo]

You've probably noticed that the feeling in the pins and wires is worse when you first get out of bed in the morning, it's like when your leg is sore from sitting down in a weird position for too long - you need to walk it off. Try to walk around your room for a couple minutes every hour or so.
I'm not sure if it's what you're describing, but I had a similar pain that ran from around the outside of my ankle down to about mid-foot. The pain lessened with time but it actually took a couple of months before I no longer noticed it.

I see, thanks for sharing your experience. I think I found where I had the strong pain yesterday night, there are 2 fiches, one in my left leg and one in my right leg, that are giving me some problem. I just did the medication, and I can see already that some blood is forming there under the cap.

I am wondering if I should try to walk and do the exercise in this condition, or maybe if it would be better to wait until the wounds will consolidate further. Dr. Pili told me to walk and exercise since day 1, but right now I feel even worse after that.

[apoxyomenos]

Hi Camillo,
I wrote they can slow down, not that they necessarily slow down the bone generation ... there are different articles on the web if you search for "painkiller and bone generation", and there are different kind of painkillers...so I assume that the one you're using most likely won't interfere with the bone generation...

[Lgazer]

only some kind of painkillers slow bone generation

[onemorefoot]

With LON will I have to turn 5.4 to reach 5??? 4 mm is quite a lot more, more han 3 days.

[hype88]

Hey mate how much did it cost for the operation and living expenses in Italy? And what is your recovery time?

[Camillo]

only some kind of painkillers slow bone generation

I am using co-efferalgan, is this one of the painkillers that slow bone generation?
btw it is 3 days now I am not taking it

[Camillo]

Hey mate how much did it cost for the operation and living expenses in Italy? And what is your recovery time?

Hi Hype88,
the operation is around €18.000 but if you are not italian you will have to pay if you need achilles tendon operation or other complications, because you will not be covered by the italian public insurance (even if you may have other private insurance that will cover you for complications).

Milan is not more expensive than other European big cities, more than Berlin but less than London. You may also decide to stay in Lecco btw, that is where Dr. Catagni lives and work. Lecco is a smaller city with lake and mountain, very nice, and since you will not be 100% able to move etc. this could be a smart decision, since you will not get advantage anyway to stay in a big city like Milan.

[apoxyomenos]

Hey Camillo, how is it going? Have you started to lengthen? What about the pain, is it manageable without painkillers? How much do you walk during the day?