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[SpeedDialer]

Congrats on finishing your adventure in Athens!

If you could do it over again, what do you wish you had known or would have done differently?

[m7liam]

Thanks for making this diary, m7liam!

1. If you were allergic to nuts, sesame seeds, shrimp/crab/lobster, peanuts, what are some common foods in Greece to watch out for?

2. What are some other foods to consider buying common in Greece that are cheap, nutritious, taste good and are easy for someone who has trouble walking/standing to prepare?

Thank you in advance

I'm not allergic sorry so can't really answer the first question.

For the 2nd - there are normal groceries out there that you can order all your food from. You can stand up to prepare food from week 2 onwards. I was time poor so I ended up just ordering food off eFoods (deliveroo equivalent) everyday. Unfortunately selection there is much more limited - basically kebabs, greek salads, mcdonalds, or pasta.

[m7liam]

Hey bro, your diary is amazing! The way you pushed through the whole distraction phase is nothing short of INSPIRING!
I myself plan to do 6.5cm femurs around this time next year and I wanted to know how I can prepare physically:

*stretches that would be useful if trained now?
*I heard weighted squats are bad as too much muscle around the  quads and hamstring are bad?? Slim runner's legs is more optimal?
*Any other physical preparations?

Hi mate - I did no preparations whatsoever since I decided to do this surgery almost on the spot. I was also told by Giotikas I had average flexibility prior to surgery (I could not quite touch my toes before the surgery).

Based on the guys who did it with me, I do think that the people with more muscles suffered the most. The guy who did the best (basically no pains and was walking pretty much normal as soon as he hit 8cm) was skinny as hell and the guy who had pains everyday and didn't quite finish 8cm (think he made it to 7cm)  owned a gym and was built like Hulk.

[m7liam]

Is it true that scarring from internal tibias is worse?

I think it would be similar. You would just have the scar marks lower on your leg.

[m7liam]

It would mean a lot if you reply to this
Hypothetical question: Assume you wanted 3cm femur and 3cm tibia (quad lengthening). Just take it as fact for now, ignoring whether it’s a good idea or not. You were fully motivated on getting this done, just as you have done with your actual lengthening which has just taken place, and plotted out the best path to achieve this in the shortest time possible. By my count from your diary, you would’ve stopped lengthening femur at day 37 or so (when you hit 3cm mark). Now with the benefit of hindsight, based on your general recollection and if you were to approach the hypothetical with as much motivation and efficiency as you have done with your actual procedure, do you think you could have, at this 37 day mark (once lengthening of your femur hypothetically concluded), gone in for the second (tibia) surgery and commenced the 3cm of lengthening on your tibias. If not, how long would you have waited and why?

Very curious to hear how you would have approached this as your motivation to get things done and over with from start to finish, and the general efficiency with which you approached this, is something I want to emulate. I need to have my procedure (the hypothetical which I’ve posed to you) over and done with, and be as close to back to normal as possible, within 6 months. Though it might sound ridiculous I’m hoping it’s possible given the minimal lengthening and the motivation which I have to get it done and over with (similar to yours actually).

Yes. It definitely should be possible. There were multiple people at Giotikas who did it with me who did quads with the 2nd surgery scheduled ~3 weeks after the 1st surgery. I know some of them after the 2nd surgery also lengthened the femur and tibias simultaneously as well (so they were lengthening at 2mm per day). I personally didn't do it because I didn't want to risk a 2nd surgery when I didn't really care about proportions. But it should be possible. Just keep in mind the speed of tibias lengthening is slower than femur lengthening - we had a few guys who had to drop their tibias speed lengthening to 0.5mm or 0.75mm.

[m7liam]

Knowing the state you’re in now, a month and a half after finishing lengthening, perhaps you would chose to do tibias now? How do you feel about that? Bear in mind that you would have technically been done with lengthening for 4 months by now having stopped femurs at just 3cm (end of August) in accordance with our hypothetical so you would’ve had an extra 2.5 months to recover.

That aside though, curious to hear when you personally think is the soonest you could’ve gone in for the second surgery if you had stopped at just 3cm. Whilst still staying on track with the efficient recovery and return to normal which you’ve been aiming for.

The quad patients at Giotikas did their 2nd surgery 3 or 4 weeks after their 1st surgery. I don't think it would have been possible to do the surgery any sooner than that. Week 1 you basically can't move.

I would not have done a 2nd surgery as getting exact proportions wasn't important to me and I probably had decent length tibias to begin with. The only situation I would do a 2nd surgery is to get another 4cm or 5cm above and beyond the 8cm femur lengthening - but for now, I am focused on recovering from femur and enjoying the benefits.

As some have posted from their experiences, the impact of going from 169cm to 177cm has been nothing short of world-changing for me as well. 

[m7liam]

Thanks for making this diary!

a. If you were flying from D.C. to get to Athens, Greece, probably with an intermediate stop in between, how many days total would you budget for the consultation including which to leave D.C. and how much time to leave just in case your flight gets delayed?

b. What are the most uncomfortable things about sitting at a desk and using a computer when you are doing LL?

a) I would budget a few days for consultation and delays... this is a 3 month minimum journey. A few days earlier won't hurt. Plus it'll be good to visit the historical sites in the city which you wouldn't be able to post-surgery.

b) There's nothing uncomfortable about sitting at a desk and using a computer. You don't feel pain when doing that. The pain only exists when you move (for week 1) or are walking.

[m7liam]

As mentioned thnks for yr diary. Love the brevity, no fluff here.

Regarding this vid do you have a pre-LL walking vid to compare this to? Not sure if just me, or perhaps u had skinny legs before, but it looks like the 4cm has transformed u lol. Would love some perspective by way of an old walking video if u have one.

Wonder how he’s going 🧐

Sorry all for the delay! Have been busy settling into my new city. I don't have an old video of me walking.

Here is an updated video (6 weeks post-distraction). Note that due to slightly bent nails, I didn't want to risk training too hard in the first few weeks and bend the nails so stayed off strength exercises until last week.

I'll note:
+My walking gait has improved considerably, particularly in the last week, although still a bit stiff. Most noticeably, I don't have as much of the penguin body swings and wide legs anymore. Most of the improvement has happened in the last week and has been due to a mixture of flexibility and strengthening exercises
+As others have pointed, I start to do body swings again if I get tired
+I weigh 65kg now, which is about the same as my pre-surgery weight and 6kg higher than my post-surgery weight (think I was at 59kg at the bottom)
+I have resumed going to PT a few times a week after 4 weeks
+I can stand up continuously without feeling tired. I don't need to sit down after a while
+I can probably walk 500m-1km without any issues (but haven't really tried)
+I can now do stairs up and down with no big issues
+I can get up from a chair with just my legs now (although with effort)
+I cannot put underwear on without holding onto something although hopefully this will improve soon
+I cannot do doggystyle thrusts properly yet, the pelvic area remains tight
+I cannot touch my toes (about 5 cms off)
+I cannot run yet

[m7liam]

double post

[RB]

Wow the walk looks awesome mate! It's crazy how quickly things seem to improve once the consolidation phase begins. If I can walk like that at 6 weeks consolidation I will be extremely happy! Look forward to seeing your continued recovery.

Do you feel any pain when you walk at all?

[SpeedDialer]

Thanks!!

What's Giotikas's policy on doing nerve decompression during the first surgery and how much extra does it cost? I know Dr. Janet Conway does nerve decompression preemptively to prevent nerve problems later

[StrydeNailChallenge]

Hi m7liam,

Congrats. on the major progress. Keep up the great work!

Also since there was some negative discussions here, I'd like to share my honest opinion as well! You look handsome as hell man! like blockbuster movie hero handsome! I bet you have a great personality too. Please don't get negative energy from negative posts.

[limbcllnea]

That's amazing progress. Can't believe you look this great walking so quickly.

P.S. you might want to edit the video because you didn't blur it correctly and there are mirrors.

[SpeedDialer]

Did most patients who were doing both segments stay in Greece for the 3-4 weeks in between to go to the PT center/see Dr. Giotikas in between surgeries?

[infinity&beyond]

This dudes a poster boy. Ironically I actually liked his walk a little better before in those vids he posted with the Darth Vadher mask. It was aesthetic in a boss man kinda way. Obviously the legs were too wide though and this is a noticeable improvement on that front. My only constructive criticism about as is shown in this new vid is that it looks a little un-natural. This will improve with time. Real potential here, as if enough improvement hadn’t been made already!

[Tokito_Ohma]

Wow bro you look very aesthetic having done the entire 8cm! Absolute congratulations, wish you the healthiest recovery! Can't wait for my turn December when I grow in height, starting point 175cm

[ghkid2019]

1) don't notice proportions literally at all in fact you give off a natural 176cm vibe

2) you are very handsome eyebrows on fleek

3) walk looks great and a huge step up from before

Thank you for the video and good luck m7

[m7liam]

Hi guys - really bad news.

I did x-ray's yesterday and one of my 2 screws on the right hand side has broken. Which means the structure is now reliant on a single screw.

I would like to hear options to get this fixed from anyone who might have experience.

It seems the alternative is to basically stop all walking and get back onto crutches for the next 3 months until my bones fully consolidate which is not attractive....

[azaghul]

Hi guys - really bad news.

I did x-ray's yesterday and one of my 2 screws on the right hand side has broken. Which means the structure is now reliant on a single screw.

I would like to hear options to get this fixed from anyone who might have experience.

It seems the alternative is to basically stop all walking and get back onto crutches for the next 3 months until my bones fully consolidate which is not attractive....

The screw is broken after ur completely done lengthening? How does that happen? Were u lifting weight or something? Pretty concerning, what did ur doc say?

[precice strider]

They screwed and gave him the 10mm nail.

[m7liam]

They screwed and gave him the 10mm nail.

Yeah it broke after lengthening.

I didn’t lift any weights but I did do stair climbing and light exercises.

[permanentlybanned]

Stair climbing results in effective weight bearing of more than 1.5x body weight to up to 4x body weight depending on how you walk up and how much sway. It is about the worse activity you could do on weak weightbearing nails. Probably 250 lbs of stress just by going up stairs is a good average estimate. Even standing on one leg may kiss the stress threshold or go slightly above a 11.5 nail, so think about how 10 nail would do. Even just walking is stressing the nail. Over time this is what causes bending and eventually stress breaking of the nail or screw. Considering the stress threshold of the 10mm nail is a measly 150lb, you would need to be literally underweight and anorexic to safely stair climber with the 10mm nail,  and even then should be handrail holding and support alot. I strongly condemn any doctor who does 10mm for men and still allow full weightbear. Only women petite should get this nail. And considering your nails are already bent, the effective weight bearing limits is even less than the allowed numbers, as it assumes a straight nail. you gotta be really careful careful

I am sorry m7 you had to go through this, I highly recommend to start using Walker or crutches, avoid all stairs, if you need movement. And stand for extended periods of time while partial weightbearing to get the callus growing asap. Like hours a day. No moving. Frankly this isn't even safe considering there is only one screw. Ideally would be an emergency operation to fix the screws. I'm just saying this not Medical advice. A re-operation is my best recommendation, but obviosuly not everyone wants that or can afford that.

Paging @ Michael J. Assayag, MD  to help, he is by far the most qualified active user on this forum, I will try to get him here

[V21]

Well, at least it has happened after lenghtening, you will have to be careful for a while but it could be worse... sorry mate

[m7liam]

Well, at least it has happened after lenghtening, you will have to be careful for a while but it could be worse... sorry mate

Thanks GHDKid very helpful. So far it looks like my options are 3:

1) basically don’t move for 3 months until full consolidation. I’m not sure how feasible this is. Also this doesn’t fix the bend and I’m concerned that the bend may mean other complications down the line.
2) go to Korea to Dr Lee to get screw surgery (since I’m in Asia at the moment not Europe). I’m not adverse to getting it as the thoughts of the other screw breaking is an awful situation
3) go to get full surgery. Ie take the stryde out and insert a stronger nail with new screws and at same time fix the bend. Go through pretty invasive surgery again and will require a month to heal.

[Tartar]

Very sorry to hear that. Unluckily stryde is not always a full weight bearing, these problems can occur quite easily.
Anyway, last time I've seen your Xray the nails were bending, are at the same status or getting worse?
If you have no discrepancy as you told, a bending like that is still tolerable. I would avoid another surgery if possible, if your last screw is in good condition i would prefer to use crutches. You should be already almost done with consolidation, if you like to have an opinion you could show the last XR.
To know if the bending could lead to your posture, standing XR are needed.

Thanks GHDKid very helpful. So far it looks like my options are 3:

1) basically don’t move for 3 months until full consolidation. I’m not sure how feasible this is. Also this doesn’t fix the bend and I’m concerned that the bend may mean other complications down the line.
2) go to Korea to Dr Lee to get screw surgery (since I’m in Asia at the moment not Europe). I’m not adverse to getting it as the thoughts of the other screw breaking is an awful situation
3) go to get full surgery. Ie take the stryde out and insert a stronger nail with new screws and at same time fix the bend. Go through pretty invasive surgery again and will require a month to heal.

these proposal Giotikas said you, right?

Paging @ Michael J. Assayag, MD  to help, he is by far the most qualified active user on this forum, I will try to get him here

I don't think is very nice/right to ask a doctor about another doctor's work...they are colleagues

[6CMFemurs]

Honestly, man a couple of months is nothing in the grand scheme of things. Take this from a 7-year post-LL vet. If you gotta rest for a couple months, do it. It goes by quick, LL is a long game.

[m7liam]

I don't think is very nice/right to ask a doctor about another doctor's work...they are colleagues

Thanks, that's right. But I would love another doctor's opinion on next step. I know it's only a few months but I thought I had just left it all behind to be suddenly pulled back and told I have to effectively sit in bed for another 3 months is extremely frustrating.

I am basically going to scared of putting any weight on my right leg for the next 3 months hence why I am seriously considering a screw replacement surgery if it isn't that technically difficult. It would at least give me comfort that I can do normal walking. However, I was told that another incision would need to be made to extract the broken part of the nail out.

X-Ray's below:

[m7liam]

On second reflection, there are 2 upper screws holding the structure in place, not just the 1 bottom screw. So 3/4 still working?? Maybe I don't need another surgery as long as I avoid all stairs??? Zzzzz!!!!

[Tartar]

As I told you months ago it's not that bad even if it could be better. Bending seems to have not gotten sensibly worse.
In my opinion the bone is forming slower than before, in 3 months there is not much progress in the callus but it was good at the beginning, it needs still a bit to heal.
The screw is a problem not only for weight bearing but for its removal too, half of it could be kept inside the bone if it get worse bending, right now I think it's still removable quite easily.
If i were you I would start using crutches, until you can heal and don't have major deformities it's better to avoid any other surgery. You need patience.
Screw replacement is an option but I don't know if it's worth it, because even after that you'd need to use crutches anyway to avoid others bending. I think doctors could have differnt thoughts among them about it, you can ask to Dc Lee, Giotikas or others doctors in Europe, up to you.

[pownzorgeek]

Hi m7liam,

just wanted to ask here: Could it be that the nail bending/broken screw can have come as a result of wrong placement (even if just a few mm) in the bone during surgery?

[permanentlybanned]

M7liam, remember that all you need is that one single other screw on the bottom to break on the bottom for you to end up in the hospital like Unicorn with your rod sticking through your skin and 2 year recovery timeline.. DONT DO anything without weight bearing helper tool like crutch or walker and eventually wheelchair. Just lay in bed don't even stand anymore. Act like your rod is about to break, because frankly, it is about to break.

Do not weight bearing without assistance.

I would consult around and get the screw replacement surgery ASAP. Donghoon is great