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[sermai]

Hey everyone, I was wondering if anyone had any suggestions or similar experiences to what I'm going through now.

Basic background:
Left limb lengthening to correct a LLD of a little over 3 cm using PRECISE 2 nail (USA).  I had the surgery late in June and am 3 months post op.  I've been done distracting for the past month and a half and after visiting my doc, he said I that I'm not consolidating as fast as he would like (have a small amount of ossification posteriorly that has only progressed a little in the past 6 weeks.  I'll be doing bone stimulation starting later this week, have been taking Vitamin D/multivitamin, and waking a decent amount. Do yall have any suggestions as far as additional supplements, exercises, sun tanning, or anything else to help consolidation move along? If things don't progress I'll have to have a hip graft/injection and would like to avoid that if at all possible.

I checked the forum but didn't see anything specifically on this. If I overlooked it, I'd appreciate a link.

Thanks.

[ghkid2019]

Are you smoker? Then stop


Calcium supplements and the jarrows Bone up pills. Buy them. Now

Take 10000iu vitamin D daily

Take some vitamin k2 (this is important)

Take calcium pills, AND milk if possible.

Bone up supplement. This is extremely good


stop smoking if you are doing so. Nic is still smoking

The most important thing is the Bone-Up and Vitamin D+K2 and the Calcium pills. You can use exogen but focus on the k2 and calcium pills.

What k2 does is divert calcium into your bones instead of arteries

Unfortunately you shouldn't weight bear precice 2 is weak and you can later on when more callus is developing but not now since you said delayed consolidation

[sermai]

Thanks, appreciate it.

[ghkid2019]

Bone up is incredibly good by the way. Focus on getting bone up at minimum, jarrows brand

[marathonrunner]

I wouldn’t worry too much.

I’m 1 year and 2 months and I’m just finally almost finished consolidating.

For me personally I didn’t take calcium or other vitamin supplements.

I ate a lot of protein, like I would have extra each meal and then I would add + 2-3 scoops of whey protein isolate with water for a drink after the meal.

Oh I dunno how much it helps but I juice every morning, regardless of whether it’s LL or not. Just a personal habit. I get around 8 different vegetables (w maybe 1 or 2 fruits) (try to get less surgery stuff cause all that sugar ends up in your juice so I focus more on kale and broccoli and stuff like that rather than apples and oranges cause of the sugar content) and I juice every morning.

And for meals it is pretty healthy stuff w a focus on lean meat + the additional protein and juicing

And I walk, cycle or just stand.

That worked for me.

Oh and another thing I really liked is the power plate at the fitness here. It sends vibrations through out your entire body but you can kind of squat down to focus on your legs. I usually do some stretches on there. I think it helps? But I did that only when my bones had connected in the back and I just needed to fill in the front. I dunno how dangerous it is to do it if there is 0 bone support and the top/bottom is still very much disconnected.

But yea summary: eat healthy meals (focus on lean meat) + whey protein isolate (non sugar for me) + juicing fresh veg each morning + standing/walking/cycling whatever you can do while upright.

Sorry I can’t comment on other vitamins and stuff cause I didn’t need it. But I think fresh veg and lean meat and lots of protein is the key. And being on your legs moving or standing. Don’t sit.

[brondo]

Hey everyone, I was wondering if anyone had any suggestions or similar experiences to what I'm going through now.

Basic background:
Left limb lengthening to correct a LLD of a little over 3 cm using PRECISE 2 nail (USA).  I had the surgery late in June and am 3 months post op.  I've been done distracting for the past month and a half and after visiting my doc, he said I that I'm not consolidating as fast as he would like (have a small amount of ossification posteriorly that has only progressed a little in the past 6 weeks.  I'll be doing bone stimulation starting later this week, have been taking Vitamin D/multivitamin, and waking a decent amount. Do yall have any suggestions as far as additional supplements, exercises, sun tanning, or anything else to help consolidation move along? If things don't progress I'll have to have a hip graft/injection and would like to avoid that if at all possible.

I checked the forum but didn't see anything specifically on this. If I overlooked it, I'd appreciate a link.

Thanks.

Hi Sermai,

Just curious, who is your doctor exactly? Did he not inform you of what you should be doing to consolidate the bone? Hope everything works out for the best.

-brondo

[6CMFemurs]

I had some serious delayed consolidation at 3 CM (Almost no bone growth). The Doctor was super concerned and ordered a panel of blood tests. I started taking the highest dose of Vitamin D you can get with a prescription (I think it was like 50,000 IU once per week), and spending hours a day in the sun. Surprisingly that variable alone did the trick for me, and I consolidated at a normal rate afterwards.

[brondo]

I wouldn’t worry too much.

I’m 1 year and 2 months and I’m just finally almost finished consolidating.

For me personally I didn’t take calcium or other vitamin supplements.

I ate a lot of protein, like I would have extra each meal and then I would add + 2-3 scoops of whey protein isolate with water for a drink after the meal.

Oh I dunno how much it helps but I juice every morning, regardless of whether it’s LL or not. Just a personal habit. I get around 8 different vegetables (w maybe 1 or 2 fruits) (try to get less surgery stuff cause all that sugar ends up in your juice so I focus more on kale and broccoli and stuff like that rather than apples and oranges cause of the sugar content) and I juice every morning.

And for meals it is pretty healthy stuff w a focus on lean meat + the additional protein and juicing

And I walk, cycle or just stand.

That worked for me.

Oh and another thing I really liked is the power plate at the fitness here. It sends vibrations through out your entire body but you can kind of squat down to focus on your legs. I usually do some stretches on there. I think it helps? But I did that only when my bones had connected in the back and I just needed to fill in the front. I dunno how dangerous it is to do it if there is 0 bone support and the top/bottom is still very much disconnected.

But yea summary: eat healthy meals (focus on lean meat) + whey protein isolate (non sugar for me) + juicing fresh veg each morning + standing/walking/cycling whatever you can do while upright.

Sorry I can’t comment on other vitamins and stuff cause I didn’t need it. But I think fresh veg and lean meat and lots of protein is the key. And being on your legs moving or standing. Don’t sit.

Hi marathonrunner,

Do you think if you were to do it all over again you probably would have taken the supplements? 1 year and 2 months seems like a long time to get consolidated? How much did you lengthen btw?

-brondo

[ghkid2019]

I had some serious delayed consolidation at 3 CM (Almost no bone growth). The Doctor was super concerned and ordered a panel of blood tests. I started taking the highest dose of Vitamin D you can get with a prescription (I think it was like 50,000 IU once per week), and spending hours a day in the sun. Surprisingly that variable alone did the trick for me, and I consolidated at a normal rate afterwards.

😍😍😍😍😍😍😍

[marathonrunner]

Oh I had a lot of complications haha. Sorry I should have mentioned.

Actually my last surgery was around mid of Feb this year.

And the consolidation was probably at 1-2% only for right leg, left leg was a bit more maybe like 5%.

So you can say I consolidated 90%+ of 5.7-5.8cm from then to now.

And I would say stitch out was around end of Feb, so really all the walking and stuff I did I around beginning to mid March.

So Let's say we count at beginning of March to now for 5.7-5.8cm consolidation, start to finish.

I would say that is not bad 7+ months for tibia 5.7-5.8cm from basically nothing to almost full finished.

It was only 1 year 2 months because Aug - Feb, I was dealing with tons of complications.

Honestly.. I don't know how much vitamins would help. I do know protein helps a lot though so that was where I put my focus. Protein and walking (putting pressure on the legs).

[brondo]

Oh I had a lot of complications haha. Sorry I should have mentioned.

Actually my last surgery was around mid of Feb this year.

And the consolidation was probably at 1-2% only for right leg, left leg was a bit more maybe like 5%.

So you can say I consolidated 90%+ of 5.7-5.8cm from then to now.

And I would say stitch out was around end of Feb, so really all the walking and stuff I did I around beginning to mid March.

So Let's say we count at beginning of March to now for 5.7-5.8cm consolidation, start to finish.

I would say that is not bad 7+ months for tibia 5.7-5.8cm from basically nothing to almost full finished.

It was only 1 year 2 months because Aug - Feb, I was dealing with tons of complications.

Honestly.. I don't know how much vitamins would help. I do know protein helps a lot though so that was where I put my focus. Protein and walking (putting pressure on the legs).

Hi marathonrunner,

Was your complication due to your doctor (Dr. Singh correct?) not executing the surgery properly? And then you had to get this corrected by Dr. Lee in Korea? Do you think you would've had a proper consolidation and a smooth process if you had gone to a reputable doctor in the first place?

-brondo

[marathonrunner]

Yea that's the gist of it.

I can only guess but I think consolidation would have been faster if the bone was growing while lengthening every day vs lengthening fully and then trying to grow the bone.

That is just my guess after talking to others who have done it.

For reputable doctors, yes it will be safer, but then again someone with as much experience as Lee, my left tibia is bent/curved. I asked another doctor for his opinion and yea it aint straight. Which is weird because Lee does LON all the time so moving from LON to regular IM nails should be a walk in the park for him, so I can only guess as to why he didn't do it properly.

But yes to answer if it is a smoother consolidation process with a reputable doctor, yes I would think so, at least for doctor's who are hands on from start to end. There are 'reputable' doctors who do the surgery and then off you go with take home instructions or getting your own PT or what not. So a bit hard to answer, but if I was completely new to LL, I think yes a reputable doctor who can guide you from start to finish would make it smoother.

But now that I have done tibia, I think in my opinion it is possible for me to do femur without staying full time at the hospital. Since I know approximately what to do and what not to do.

So if I do go to Doctor XYZ and they offer like those hospital stay packages and what not, I would probably only pay for 1 month's worth of stay. Surgery + 2 weeks pre stitch out + 2 weeks post stitch out and doing the PT stretches there for a month. I would then do it myself at home for the remaining time.

But that is just me personally given my experience to date.

[brondo]

Yea that's the gist of it.

I can only guess but I think consolidation would have been faster if the bone was growing while lengthening every day vs lengthening fully and then trying to grow the bone.

That is just my guess after talking to others who have done it.

For reputable doctors, yes it will be safer, but then again someone with as much experience as Lee, my left tibia is bent/curved. I asked another doctor for his opinion and yea it aint straight. Which is weird because Lee does LON all the time so moving from LON to regular IM nails should be a walk in the park for him, so I can only guess as to why he didn't do it properly.

But yes to answer if it is a smoother consolidation process with a reputable doctor, yes I would think so, at least for doctor's who are hands on from start to end. There are 'reputable' doctors who do the surgery and then off you go with take home instructions or getting your own PT or what not. So a bit hard to answer, but if I was completely new to LL, I think yes a reputable doctor who can guide you from start to finish would make it smoother.

But now that I have done tibia, I think in my opinion it is possible for me to do femur without staying full time at the hospital. Since I know approximately what to do and what not to do.

So if I do go to Doctor XYZ and they offer like those hospital stay packages and what not, I would probably only pay for 1 month's worth of stay. Surgery + 2 weeks pre stitch out + 2 weeks post stitch out and doing the PT stretches there for a month. I would then do it myself at home for the remaining time.

But that is just me personally given my experience to date.

Thanks for responding. What is going to happen to the curve in your tibia? Does Dr. Lee know about it and will he fix it?

[marathonrunner]

Dr Lee knows. Dr. Lee kept telling me its fine its fine, the curve is fine.

The curve is around 5-7 degrees depending on how you measure it. So it is not terrible.

But for everyday life I can feel it. The way the left foot hits the ground, going down stairs, sometimes even just standing, I can feel the difference since for the last 30+ years I've been using my legs 1 way and now the angle has change enough to notice daily.

Will he fix it? He can, if I pay more lol. He won't fix it for free for sure. Gotta open the skin, break the bone again, remove a section in the back (as it is curved backwards) make it straight, put on an external fixator again and wait for the 2 parts of the bone to heal into 1. It would be much faster though as it is the same as healing a broken bone, maybe 2-3 weeks tops.

But its gonna cost another XX amount of money and then gotta pay for those 2-3 weeks stay in the hospital again and pay for flights and everything. It's just such a hassle, especially now given COVID, I can't fly back to the country where I am residing if I leave.

So yea. I told him face to face several times make it straight, make it straight, make it straight please in all the consultations I had with him. Even right before my last surgery I said PLEASE DO YOUR BEST TO MAKE IT STRAIGHT. Because I know there are consequences to a bone not being straight and it's going to cost more money to fix if it isn't.

My guess is he wasn't prepared with the right nail, right before surgery I saw him going through a box of nails, it didn't seem like he ordered one specifically for me. So the type of nail he used was not the same as other LON patients. I dunno, maybe because I wasn't his original LL patient since I was a corrective case? Dunno and I don't want to speculate.

All I can say is the end result = curved bone which is unlike his other LON patients. Whether I will fix it or not depends on how much it keeps bothering me.

[brondo]

Dr Lee knows. Dr. Lee kept telling me its fine its fine, the curve is fine.

The curve is around 5-7 degrees depending on how you measure it. So it is not terrible.

But for everyday life I can feel it. The way the left foot hits the ground, going down stairs, sometimes even just standing, I can feel the difference since for the last 30+ years I've been using my legs 1 way and now the angle has change enough to notice daily.

Will he fix it? He can, if I pay more lol. He won't fix it for free for sure. Gotta open the skin, break the bone again, remove a section in the back (as it is curved backwards) make it straight, put on an external fixator again and wait for the 2 parts of the bone to heal into 1. It would be much faster though as it is the same as healing a broken bone, maybe 2-3 weeks tops.

But its gonna cost another XX amount of money and then gotta pay for those 2-3 weeks stay in the hospital again and pay for flights and everything. It's just such a hassle, especially now given COVID, I can't fly back to the country where I am residing if I leave.

So yea. I told him face to face several times make it straight, make it straight, make it straight please in all the consultations I had with him. Even right before my last surgery I said PLEASE DO YOUR BEST TO MAKE IT STRAIGHT. Because I know there are consequences to a bone not being straight and it's going to cost more money to fix if it isn't.

My guess is he wasn't prepared with the right nail, right before surgery I saw him going through a box of nails, it didn't seem like he ordered one specifically for me. So the type of nail he used was not the same as other LON patients. I dunno, maybe because I wasn't his original LL patient since I was a corrective case? Dunno and I don't want to speculate.

All I can say is the end result = curved bone which is unlike his other LON patients. Whether I will fix it or not depends on how much it keeps bothering me.

Wow dude. Dr. Lee just went down a few notches in my book. Still think he is a good doc, but that just seems terrible he wasn't able to make is straight. I hope it doesn't cause you too many problems. I don't know much about anatomy, but I'm thinking you might have to get that fixed down the line. All the best to you marathonrunner.

[marathonrunner]

Thanks man. Yea most likely down the line gonna have to make some adjustments to it.

I haven’t tried yet to run or sprint but given how it affects just going down stairs I think if I do want my athleticism back to 100% or as close as possible I will probably have to undergo 1 more surgery to get it straight. I just hope the length doesn’t change, if I cut the bone again and make adjustments there’s no guarantee the length will be the same after it heals.

The joys of LL lol.

[Machine]

In my opinion if you r gonna go for another surgery then you should go with TSF , it is a software controlled fixator to fix the alignment and it is 100 % accurate . It is weight bearing and you can go anywhere with it . Total duration for the fixator is until bone consolidation which may vary (avg duration is 4 to 5 months) .
Or they can put the TSF fixator and align your bone with software and then put IM nail ( but the problem here is that for 2 to 3 months partial weight bearing and IM nail will be there for at least a year and one more surgery to take it out )
If there is a length issue and if you comfortable with a scar then u might need to take a small part of bone out .
It’s just my opinion !!

[marathonrunner]

Thanks Machine. I didn’t know about the software controlled fixator, that’s interesting, learn something new everyday.

For sure I will take a look at this. Not sure how it’ll work since my bone is basically done consolidating and I need to remove bone instead of grow it but yea interesting thanks.

[ghkid2019]

U have a pic of this "curved bone"?

[marathonrunner]

http://www.limblengtheningforum.com/index.php?topic=64813.msg171716#msg171716

There should be photos in the link above.

[marathonrunner]

Here is an April xray.

Look carefully at both the tibia and fibula.

Both are curved backwards.

This is what I mean by "curved", the bone is healing "curved" backwards.

You see how the alignment is off?

The nail he used isnt the same as other LON patients from what I have seen from their x rays.

So not sure why he didn't prepare properly beforehand. He knew I was coming, I even paid to stay there an extra week before the final surgery to "make sure everything will go 100% fine", actually the plan was to fly in, do surgery, fly out. But I wanted it to be straight and I made it clear several several times even right before I was put to sleep before the final surgery, I said "please dr lee make sure it is straight up and down please"

And this is the outcome. So ¯\_(ツ)_/¯

[ghkid2019]

I'm no doctor, but if he made it straight it would probably require reaming extremely and dangerously close to the periosteum on the top. Idk. I think your only option now is let it full heal in 2-3 years, then do an outpatient correction surgery with simple plating than u will prolly recover in a month. Prolly covered by insurance maybe if you can prove arthritis and   or just scream pain and suffer

I'm sry this happen to you. It sad but hopefully I think you will overcome it eventually. And I will be waiting for the day you do 8cm Femurs to get from 165 to 173. That day even if take 5 years from now, will cure ur neurosis. Sorry for bringing it up again. I just always get depression when I see hard worker and suffering person like you who got fücked by surgeons then have to do correction and still maintain the short feeling complex

Sry bro

[marathonrunner]

All good man. Thanks for the advice. I think if he had used a different nail, one in the same shape as the stryde nail, he could have made it straight. Other LON patients who had an IM nail implanted, the nail was the same shape as stryde. Also he didn't have to ream (if he did it would have been very very very minimal), I had stryde in that leg already so he just needed to insert.

Even this patient who went to Vietnam out of all places who did LON there, when he took off EF and moved to im nail (I think it was a finnish? brand nail) he had one that had the same shape as the stryde nail.

So that is the part that baffles me, how come Lee didn't plan ahead, I was there an extra week? Instead he used whatever he had on hand.. in that box.. box of nails.. I'm also a paying customer who paid quite a lot at his clinic. I know he could have done it. He has done LON hundreds of times as he told me himself. So ¯\_(ツ)_/¯  maybe he has too many patients, and 1 patient ain't that big a deal, especially one patient that wasn't so sure about giving them marketing material in the form of a youtube interview.

But anyways, thanks, ghkid. Tbh in Asia 165 isn't horrible, but I know when I'm back in LA it'll be like argggg haha. Gotta do that extra 5 in the femurs when I can, I'm fine with 170. Don't want t-rex arms now.