Surgery Day +64, Lengthening Day 60 (+0.66mm, 50.53mm total)I was charging my watch before bedtime last night and forgot to put it back on so I don’t have any sleep data today. I would estimate that I slept between 6.5 and 7 hours since I only remember waking up once briefly before being awakened by my alarm. When I got up I ate my morning pills and then did my morning routine. After my shower I applied scar gel on all my LL scars. This is supposed to make them smaller or less noticeable. I’ve only used it twice so far, but if it works I’ll definitely make it known in my journal. I had to wait until the gel dried before getting dressed, but it dries pretty quickly. I ate breakfast, which was better than usual since I just went shopping. I then had to call into a morning meeting. I squeezed a stretching session and lengthening into a 30 minute gap this morning, but otherwise was busy working all day.
I got a call from the chiropractic facility that I’m getting my messages from, asking me to pay a copay for the exam I got earlier. I’m not sure if the overall math will work out in my favor, but it does look like they are charging me less than they billed the insurance company. If I was paying the same amount as my EOB stated I would be quite upset since they quoted me a lot less for the visit. I probably have to do at least 3-5 massages here billed to my insurance to have saved money on massages compared to just paying with cash. I don’t plan to visit them until I get my first massage EOB and after my shin nerve tingling is gone because I don’t want to experience another nerve pain attack on the massage bed again. While I was dealing with medical costs I also called the PT billing customer service line to complain again, but the rep said that their system was down, so I guess they don’t want my money yet.
In the early afternoon I did another full stretching session. I’m trying to do 3-4 of these every day, hitting every muscle group necessary but it’s not easy. These sessions are definitely not as intense as PT, but I think my stretching at home is pretty effective. If I sit in bed with my legs straight for a while, then my shin tingling turns into a bit of nerve pain. It’s not the shooting type of nerve pain; it’s more that it’s tingling really hard to the point of pain. I don’t know how else to describe it. I completely forgot to eat my afternoon meds and didn’t realize it until after dinnertime, but I wasn’t feeling any major pain so I decided to just wait until bedtime to take my nighttime meds. Later at night I did another full PT workout and stretching session and lengthened and then went to bed.
Surgery Day +65, Lengthening Day 61 (+0.33mm, 50.86mm total)I woke up to my alarm this morning to take my morning meds. I’m starting to think I should just set a later alarm so I can get a bit of extra sleep, but it probably makes more sense for me to go to bed earlier. As soon as I got up I knew I wouldn’t be able to fall back asleep. I checked my stats and I had 7 hours of sleep out of 7.2 hours in bed, with 90 minutes of deep sleep. I think that’s enough to not feel tired in the morning. I got up and did my morning routine, then ate breakfast. I had an early morning meeting to start the day, but otherwise had a pretty big chunk of free time in the middle of the day. I managed to complete a full stretching session this morning before PT, which clearly means I have some energy today. I noticed today that my insurance company actually paid for my Xarelto this month. That doesn’t make any sense to me since I haven’t met my 2021 deductible yet. I’m not going to argue with it though. Gotta love the American healthcare system where you’re more surprised when a claim gets paid than when it doesn’t. I took a Norco and headed over to PT.
When I entered the PT facility it was very quiet. There was only one other patient and they just happened to be riding on the stationary bike so I couldn’t use it to warm up. I was going to suggest warming up on the treadmill, but my PT told me to get on the table instead and that she would work on me first. After she rolled my quads and IT bands, I did some exercises while lying down, and then all my standing leg stretches. The PT increased the height of the footrest for my hamstring stretches, which made them a bit harder. I hope that means my flexibility is getting a little better. After a few standing exercises it was time for the leg press. I moved up to 30 reps of 105 pounds for both legs, which wasn’t that hard. Then I had to do 30 reps of 85 pounds on each leg. I split it into sets of 10 alternating between legs and I was barely able to finish it. However, this is more than half my body weight, so that means in theory I should be able to do a full body weight squat with both legs now. I’m not going to try it though. I also did sit-to-stands on a regular chair and had no problems with that. Finally, the PT told me to ride the bike for 10 minutes as a cooldown. Since it was a cooldown I tried to keep my heart rate under 150 bpm the whole time and ended up going only 1.32 miles at resistance level 4.5. It looks like if I maintain a 50 watt output, my heart rate will pass 150 bpm. It’s interesting to track these things to see how strong my legs are getting and how efficient my cardiovascular output is. It would be pretty amusing if I ended the distraction phase with better cardiovascular health than pre-surgery, but it looks like that’s what's actually going to happen.
After PT I got some takeout and went home. I ate first before remembering that I had to lengthen. Fortunately my legs were still decently warmed up, so I just did a quad stretch and hip stretch and then ran the ERC on both legs. I felt a few clicks on my right leg while I was running it, which makes me nervous about preconsolidation, but based on my last x-rays it doesn’t seem like my bone growth is fast enough to make Dr D. concerned about preconsolidation at my current rate of lengthening. After lengthening I casually stretched a bit and then I had to call into a meeting. I remained busy at work for the rest of the day. Later in the evening I cooked dinner, but without a big appetite I wasn’t able to finish. I got one more half hearted stretching session in at night before going to bed.
Surgery Day +66, Lengthening Day 62 (+0.66mm, 51.52mm total)I woke up this morning to my alarm and instantly hit snooze even though it was set 30 minutes later than usual. When it went off again I was a little groggy but got up to start the day. I remember feeling some nerve pain in my leg overnight - the tingly type of pain that I’ve been feeling in my shin sometimes. I don’t think the nerve pain interrupted my sleep too bad though, because I got a 99% rating in the sleep app. That’s 8.2 hours of sleep out of 8.5 hours in bed with 2.2 hours of deep sleep. I got up and did my morning routine, then sat back down in bed. I had no meetings early in the morning and work was not busy otherwise so I spent some time browsing the web and eating until it was time to do my morning lengthening. I don’t have any additional problems aside from the occasional nerve pain in my shin right now, but I’m not sure if speeding up lengthening will increase my pain. I’m not that tight in my legs right now, and I can lay down with my legs perfectly straight and next to each other hardly feeling a stretch. I spent about 25 minutes stretching as I added a couple of new exercises (hip abduction for my bad gait) and then lengthened with no issues.
I spent the rest of the afternoon working. By the time I finished with work it was time for dinner. I heated up my leftovers from last night and some other foods. I need to get better at eating more nutritious foods during lengthening, but it’s hard since I have less energy than I would normally (and that’s saying a lot during the pandemic.) Somehow I’m gaining weight while everyone else is losing weight during lengthening. I thought it was just swelling at first, but my thighs are not swollen right now and I’m still 4 pounds heavier than a week ago! After dinner, I had a bunch of other things to do so I kept busy until late at night when I had to do a stretching session and lengthen. It was a full 30 minute stretching session, which is usually my target. I was sufficiently tired at this point and decided to try and go to sleep.
Surgery Day +67, Lengthening Day 63 (+0.33mm, 51.85mm total)I had a ton of trouble falling asleep last night and didn’t end up properly going to sleep until very late. I remember waking up a couple of times in the middle of the night and also around dawn. I hit snooze on my alarm a few times until I absolutely had to get up. My sleep rating was only 70%, with 5.4 hours of sleep out of 6 hours in bed and 45 minutes of deep sleep. This morning I felt sore both bending my knees and straightening my legs. It’s a good thing that the weekend is coming soon, because I think I need some extra sleep to help with my recovery. I did my morning routine a bit later than usual, with a bit of tingling nerve pain in my shins as I walked around. Doing some light quad and hamstring stretches helped with that and I started working and getting ready for a relatively early meeting.
I wasn’t able to do a full stretching session before PT, but I did get up and do some quad and hamstring stretches every so often since those are the most needed and it helps a bit with the nerve issues in my lower leg. When I left for PT I forgot to take Norco and I also forgot my house keys. I was already in the car when I realized this so I just said screw it and drove over. At PT for the last few sessions I haven’t been using my cane. I just set it by the coat rack when I get inside and grab it when I leave. There’s a lot of stuff to grab onto if I lose my balance, but I’m pretty confident in walking normally nowadays. I’ve also stopped using the cane at home. The first exercise was a warmup on the stationary bike. I tried to push myself a bit, though I was pretty tired. I did 1.49 miles at resistance level 6. That’s probably averaging 70 watts for most of the ride, but I was able to output 150 watts for the full last minute of the ride. I was very warmed up and ready to go at this point, but the PT had me lay down on the table to work on me. After that I did some stretches and then all my leg exercises. It’s getting pretty tiring to do all the leg exercises since every session the PT increases the weights or switches to a tighter resistance band on every exercise. I can definitely say that an hour of PT right now makes my legs way more tired than an hour of PT did a month ago, and that’s with my legs being way stronger than they were a month ago. I don’t mind though, since I probably need the training. I just wish there was some way they could directly train my gait, but I think they are more focused on overall leg strength and recovery. On the leg press I did 30 reps of 110 pounds with both legs today, and then 30 reps of 90 pounds on each leg. I broke it into sets of 10 and took a 20 second break between each set and was still only barely able to do it. It took forever, but after the leg press I went home.
After I got my backup key and went inside I had a lot of work to do in the afternoon, but because I didn’t sleep enough last night I was sleepy and unproductive and even fell asleep for 30 minutes. After I woke up from my nap I was able to work for a bit more but then it was time to go to my scheduled haircut appointment. Those of you who have been following my journal know that I live alone and don’t plan to meet any friends or family until my gait has recovered. Therefore, this was actually the first time I got a chance to see someone that I was kind of familiar with before the surgery. I showed up at the salon and the first thing he said was, “Did you get hurt?” If that’s not an obvious sign that my gait is terrible then I don’t know what is. I used my ski accident excuse that I’ve been telling people and he said, “You’re not my first client that got into a ski accident this year.” I bemusedly chuckled to myself at the absurdity of the situation. Aside from gait there is also the issue of height. I was the same height as this guy before the surgery, so when I entered the salon I instantly noticed that I was very clearly taller than him, to the point where I wanted to hunch my back so it wouldn’t be so obvious. Fortunately, I don’t think he remembered how tall I was so he didn’t call me out on it and it wasn’t an issue. I guess this test with an acquaintance shows me that LL will be very obvious to anyone who knows me well from before, especially if I max out the nail. Also, I still need a lot of work on my gait, but now I’m motivated to get better and to walk more. After sitting in the barber’s chair for over 30 minutes, I had some strong nerve pain in my right shin just like I did on the massage table. I feel like maybe it’s being caused by staying in a position where I can’t move my legs the way I want to. It was fortunately right before the end of my haircut so I just had to bear it for a minute or two before I got a chance to stand up. As soon as I stood up, the pain went away.
After the haircut I went home feeling refreshed since my hair was getting really wild and I finally got a chance to clean up my look. It was dinnertime and I had to cook the ribeye steak that I bought earlier otherwise it might go bad and I don’t like wasting money. However, my grill is on the balcony and it was dark already and the temperature was well below freezing outside. I forced myself to weather the elements and grill the steak with only a hoodie on and when it was finally done, I quickly retreated indoors to eat. After I ate I kept myself busy for the rest of the evening, then got ready to go to bed. I did an extra stretching session before going to bed because both my numb shins were hurting a bit. My left shin was also pulsating from just above the ankle into my leg, which felt like an early sign for shooting nerve pains. The stretching session helped a bit, but I still feel like I’m always on edge for heavy nerve pain to come back at any time. I went to bed at a reasonable time after a long and tiring day.
Surgery Day +68, Lengthening Day 64 (+0.66mm, 52.51mm total)Last night I turned off all my alarms before going to bed. I was determined to get a full night's sleep. I would just have to take my meds whenever I woke up naturally. I remember randomly waking up throughout the night when my shins hurt from tingling nerve pain, but not to the point where it was significantly disturbing my sleep. I also woke up once after dawn and saw that it wasn’t even 7am yet so I passed back out quickly. When I finally got up I checked my sleep app and I got a 100% rating with 8.9 hours asleep out of 9 in bed and 2.5 hours of deep sleep. Now that’s what I call sleeping in! I got up for my morning routine and meds, and noticed while walking that my left knee hurt slightly when I put weight on it. For once I don’t think it’s related to nerve pain (which I was also feeling in my shins of course.) The ibuprofen helped with the knee pain and after eating breakfast it was already time to lengthen.
I did a proper 30 minute stretching session with full reps of every stretch, then I ran the ERC. No problems with lengthening as usual, though I’m sure I’ll feel some aftereffect in my shins later. After lengthening I remembered to call the customer service line for PT billing. I felt a bit bad for having gone to PT for over a month and not paying anything yet except a couple of paltry copays, even if they have been billing me ridiculous amounts. They had an automated voice message saying that their systems are still down and to try calling back on Monday. Their IT department must be terrible, but that’s not my problem. I had a lot of other errands to do at home that I’ve been putting off for a week so I quickly got busy. I ended up walking around for a good hour or two. At one point when I was walking around the living room my right foot started feeling nerve pain in the shin, up near the knee, which is a first. I sat down for a bit and then did a quad stretch and it seemed to resolve the issue.
By the time I got everything done, it was late in the afternoon already. I skipped my mid-day stretching session and just did a couple of quad and hamstring stretches instead since I walked around so much I didn’t feel like I needed it. I was planning to get some work done this weekend, since I would have to sneak out a lot next week during work hours to go to PT and get X-rays. I ate some snacks and planned to work until I was hungry enough to cook dinner. I was quite focused and ended up working until pretty late. I then cooked dinner, ate, and then did another full 30 minute stretching session. Afterwards I lengthened, and then it was about time to go to bed.
Surgery Day +69, Lengthening Day 65 (+0.66mm, 53.17mm total)I couldn’t fall asleep again and was browsing the web until I finally got sleepy and passed out. I woke up a bit later than usual, but not to the point where it was sleeping in. I got a 86% on my sleep rating with 7.4 hours asleep out of 7.5 hours in bed and 1 hour of deep sleep. I got up and did my morning routine. Aside from a little stiffness in my legs, I surprisingly did not have any pain anywhere this morning. My shins were still numb, but only a little tingly and not really painful. After breakfast I sat on my computer for a bit, but realized I had to lengthen soon. Today would be my first time lengthening 0.66mm for two consecutive days in what feels like a really long time, but has only actually been two weeks. I did a 30 minute stretching session and then lengthened. I felt a little weird in my left thigh while lengthening, but the feeling went away as soon as I stood up.
I spent most of the afternoon working and watching football. I had some random nerve pains in my shins while sitting on the couch, and had to get up and do some quad stretching, which only partially relieved the pain. At one point I did a full set of hamstring and calf stretches as well. In the evening I cooked a ton of food and somehow managed to finish it all. I scooped out a giant bowl of ice cream for dessert and drew a hot bath to eat it in. I noticed that today (and maybe even the last few days) I’ve been feeling a lot more emotionally sensitive to random things. Like I’ll laugh hard at YouTube videos that are only kind of funny and I’ll feel sad watching clips that are only a little sad. I feel nostalgic about the past and uncertain about the future and frequently find myself lost in my thoughts. I think this long distraction phase is impacting how I perceive the world and my place in it due to how isolated I am. I think that doing LL during the pandemic is killing two birds with one stone, but at the same time the psychological impact of yearning for normalcy in both my legs and the ability to socialize in person/travel is a double whammy and I probably feel like I miss “the good days” twice as much as someone who is merely trapped inside due to the pandemic.
Anyway, after my bath I continued to work until almost bedtime. I did another 30 minute stretching session and then lengthened. This time I didn’t feel any weirdness in my left leg which is a good sign. One of my teeth had been hurting for the last hour or so and I had already taken Ibuprofen and it didn’t do anything, so I took an Acetaminophen as well. I wouldn’t be able to sleep in tomorrow and I was a little tired already, so after that I went straight to sleep.
Surgery Day +70, Lengthening Day 66 (+0.00mm, 53.17mm total)Last night and this morning I woke up a few times before my alarm. Each time I woke up I felt like I wouldn’t be able to fall back asleep again, but each time I somehow managed to fall asleep. I got a 91% sleep rating for last night, with 7.7 hours of sleep out of 8.1 hours in bed and 1.5 hours of deep sleep. I got up and did my morning routine, then ate a small breakfast. I hopped back in bed to do some work and everything was normal for about an hour, but then everything went to . At this point, completely out of the blue my left leg started experiencing severe nerve pain. This pain was different than anything I have felt before. It was not the shooting nerve pain or the burning nerve pain. I don’t even know how to describe it other than it was just there. It was easily a 7/10 pain emanating from my left ankle into my calf along the inside of my leg. I was not able to focus on anything else and I was grimacing and clenching my teeth. The little bit of control I still had is the only reason I wouldn’t rate it an 8 or higher. It was so bad though, that it made me want to end the distraction phase right then and there. I don’t know what’s wrong with my nerves, but they are really bad at lengthening. I have absolutely no other soft tissue problems like tightness or pain, but my nerve issues are making the distraction phase a continuous nightmare.
About 30 minutes into the pain, it was still showing no signs of stopping so I took a Norco just to see if it would help. I’m still on gabapentin right now, so in theory nerve pain should be dampened or stopped, but this pain didn’t care one bit about gabapentin. Every single stretch I tried was unable to alleviate the pain, which is also why I think it’s a new form of pain. At least stretching didn’t increase the pain either. All my previous nerve pain could be relieved at least somewhat by quad stretching and bending the knee joint as hard as I could. Also, this pain was enhanced by impact. When I’m trying to walk with the pain, I have to be extra careful when putting my left foot down. If my foot hits the ground too quickly, the vibration increases the nerve pain briefly. Also, just touching any part of my shin would make the pain increase. At this point I even considered how long I would wait for this non-stop pain to go on before going to the ER. While waiting for the Norco to kick in, I called the PT office and told them that I wouldn’t be able to make it today due to severe acute nerve pain that came up an hour ago and wasn’t going away. The PT said if I could make it in then they could try working on my piriformis muscle and see if that would help relieve the pain. I told her there was no way I could safely drive over at the moment even if it’s less than a mile away. She then said that I could use a tennis ball and roll it up and down my butt to try and roll out my piriformis muscle myself. Doing it against the wall or on a hard chair would be the most effective.
After getting off the phone with the PT, I did exactly what she told me to, and it did absolutely nothing for my pain. I went back to sit in bed, since I figured if I was going to suffer non-stop like this, I could at least suffer in a comfortable sitting position not making any movements that could potentially trigger more pain. After sitting down for about 15 minutes, I noticed that the pain was starting to decrease. Maybe it was the Norco, or maybe it was the tennis ball rolling, or maybe it just happened to go away now. Regardless, soon I was not feeling anymore pain when my leg is still, and just a little bit of pain when I moved my foot or leg. After another 15 minutes I felt no more pain at all even when moving. I also felt a little lightheaded/high from the Norco, so I think that may have helped a little with tolerating the pain, if not reducing it. The last two hours was a terrible experience, and by far the worst pain I’ve felt since my surgery. I’m glad I wasn’t busy at work this morning, because I did absolutely no work.
At this point my left shin started hurting a bit with the burning nerve pain. This type of nerve pain I’m familiar with as I usually get it from sitting in one position for too long. It can be alleviated by a quick quad stretch, which I did. I also realized I was kind of hungry, so I got up, stretched quickly, and made a simple lunch. I was able to walk around with no pain. When I got back to bed I lay on my stomach and rolled my butt (piriformis muscle) some more with the tennis ball. Oh, and of course while I was in severe nerve pain I was complaining to Dr. D’s team the whole time. I think he was in surgery though since it’s Monday morning, so all I could do is leave them with as much information as possible so Dr. D could read it when he was available. Since I didn’t have any more pain and I had eaten lunch, I started working. I had no more nerve pain for the next few hours and felt pretty comfortable sitting in bed. Dr. D got back to me and told me to take a 48 hour break from lengthening. I would skip today and tomorrow. I planned to get an X-ray on Wednesday so again, hopefully my bone growth rate compared to my lengthening rate is manageable with all these breaks.
Of course good things can’t seem to last for me when it comes to nerve pain, so in the late afternoon I started getting more nerve pain. This time it started on my right leg, with a 3/10 burning pain in my shin. I stretched a little bit to hopefully alleviate it, but the stretching did nothing. Then, just minutes later, my left shin started hurting, but not the burning pain. I was feeling the same pain that I felt this morning inside my left calf. Over the next few minutes, the pain grew more and more intense, all the way up to an 8/10. This was ongoing pain and it was worse than during the morning. I was grunting, panting hard, grabbing my bedsheets, and squeezing the tennis ball as a stress ball. It was nearly unbearable pain and I couldn’t do anything about it. Since it had been a couple of hours since I took meds, I limped over to the kitchen and took everything I could: Norco, gabapentin, ibuprofen, acetaminophen. Maybe something would work. I was barely able to walk, as every time I put weight on my left leg it would trigger the nerve pain even more. I went back to my room and tried rolling my piriformis muscle with the tennis ball in different positions, and tried every stretch in the book to no avail. Nothing was working at all and it was just nonstop intense suffering. This is not what I signed up for. I would trade this for tightness and terrible flexibility anyday. I sat in bed as the nerve in my left leg throbbed and pulsated, sometimes so hard that my leg would twitch by itself. If I closed my eyes and focused hard enough, I could briefly get the pain down to a 6/10, but the next time the nerve pulsed it would go back to 8/10.
The lightheaded feeling from the Norco kicked in so I knew it was working, but the pain was still there so it wasn’t doing anything for the nerve pain. I lay down on my side and curled into a fetal position. The medications I took were making me drowsy and it felt really good laying in the fetal position even with my leg in pain. I drifted into sleep from the severe drowsiness but then quickly woke up again from the nerve pain. This happened again and again for about half an hour. However, what I was feeling during this process was much more tolerable than the intense initial pain. I sat back up on the bed and moved my feet and legs around. I still had about 3-4/10 non-stop nerve pain on the left side, but that felt like absolutely nothing compared to the start of the episode. I hoped that it would go away soon and leave me feeling okay again just like this morning. I was still quite lightheaded from the medications, though my mini nap had cleared out the drowsy feeling. It was around time to sign off work, but since I didn’t do much work today, I tried to get a little more done so I wouldn’t have wasted the whole day. I really hope I don’t have any more of these nerve pain attacks. I don’t know how much more of this I can handle.
I didn’t end up working that much, and ended up talking to people on my phone as I tried to eat a light dinner. However, late at night before it was time to go to bed, I unfortunately had another nerve pain episode. Again, it started at 8/10 pain with me clenching my teeth and panting hard just to bear it. Nothing I did could make the pain go away. I messaged Dr. D’s team again and told them this was the worst pain I’ve experienced in my life (which is completely true.) This time Dr. D said that he wants me to contract the nail by 4mm and that they’ve already reached out to the Nuvasive rep, who would call to reprogram my ERC tomorrow. For now there wasn’t much I could do. I asked if I could increase my Gabapentin dosage at least for now while I was having these nerve pain episodes and they said I could go up to 600mg 3x a day. I took 600mg of Gabapentin, 400mg of Ibuprofen and a Norco pill, chased it down with some fatty foods, then limped back to sit in bed again. I continued chatting on my phone for a while and it was mildly distracting and the pain slowly went down to a 6/10, which I consider to be tolerable compared to the initial pain. Then it eventually went down to 0/10. The whole process took well over an hour again, maybe closer to two hours. After this it was definitely time to go to bed since I was not in pain anymore. Who knows how much sleep I would be getting if I was awakened by another episode of this pain. I realized I was a bit woozy; I’m not sure if it was from the Gabapentin, Norco, or maybe both. Regardless, I fell asleep pretty quickly.
Surgery Day +71, Lengthening Day 67 (-2.00mm, 51.17mm total)I woke up many times last night, but fortunately none of it was due to the type of nerve pain episode that I was having yesterday. I did have some pain in my right leg, but each time it was only about 2/10 and I just rolled to my side and fell back asleep. I’m so glad that I can sleep on my side now. It makes sleeping so much better every night. Still, last night was not good at all, with a 61% sleep rating; I got 6.7 hours of sleep out of 7 hours in bed and 15 minutes of deep sleep. I got up for my morning routine and took my pills, with double Gabapentin again. My legs were pretty tired and stiff since I didn’t stretch or exercise yesterday, but there’s not much I could do about that. I had an early morning meeting to call into so I sat in bed working.
After a while, the Nuvasive rep texted me to set up a call, and I said I was free, so he called and we programmed my ERC to do -1mm per session twice a day for two days. It’s sad to think about shrinking in height but I have to do this if I want to grow over the next few weeks or maybe even months. After everything was set up I decided to do my first session right away. It took over 3 minutes for the machine to shrink each nail by 1mm, and I was sad the whole time as I was literally making myself shorter. One that finished I was busy with work and then I had to go to PT.
At PT they knew that I was suffering from nerve issues since I had cancelled yesterday, so they tried to go light on me. I did the bike warmup weakly at 1.34 miles on resistance level 4. The PT spent more time working on me today. After rolling my quads and iT bands, she also manually stretched my hips and knees. She did not roll my piriformis muscle though, which might have been helpful. After that I did my regular stretches and standing exercises. At the end I did the leg press with the same weight as last time (110 for both legs and 90 for each individual leg) I was able to do 30 reps of each, but I barely made it through the single leg pushes. After that I got some takeout and went home.
Once I got home I ate while watching some YouTube; had no problems sitting in a relatively high chair. Then I had to call into a meeting and get some work done in the afternoon. I was mostly productive in the afternoon and before I knew it, it was dark out. I still wasn’t in the mood to cook so I just ate some healthy snacks for dinner. I was fairly confident that I wouldn’t have anymore nerve pain today. Throughout the day I had been getting random nerve pulses in both my left and right legs, in the shins and near the ankle on the left side. Each time it would make me very nervous that I would have severe nerve pain but up through this point in the day I hadn’t had any nerve pain. I think the shortening of my nail definitely helped my nerve issues already since both my shins were noticeably less numb than before.
At this point I figured I needed some rest and relaxation so I decided to take a warm bath and watch a TV show in the bath. After the trauma from yesterday I could definitely use it. After my bath I ate some snacks and went into my room. I did a mini-stretching session of the main three leg muscles and then ran the ERC. Again, losing another millimeter made me sad, especially since the ERC ran for over 3 minutes on each leg with the negative mm count ticking up so I could watch my femur shrink slowly.
After that I did a couple of hip stretches and then rolled out my peroneal nerve with the tennis ball, which I still kept right by my bed. After that I was going to go to sleep, but ended up watching funny YouTube videos for a while, which was a total waste of time and I slept very late.
Surgery Day +72, Lengthening Day 68 (-2.00mm, 49.17mm total)The first time I remember waking up was to my alarm this morning, so sleep couldn’t have been that bad. I also remembered that I had an incredibly weird dream last night. After I turned off my alarm, I fell asleep for over an hour. Fortunately I didn’t have any morning meetings to miss. My sleep rating was 92%, with 7.3 hours of sleep out of 7.4 in bed and 1.5 hours of deep sleep. This was not bad considering how late I went to bed. I’m glad that my sleep has gone back to normal. I wonder if later on in the process I’ll have difficulty sleeping again. I think most of the journals I’ve read can continuously sleep well once they stop having trouble sleeping in the first place. I got up for my morning routine and pills. Then I hopped back in bed and checked my work email. I remembered that I needed to shrink my nail early today, so I could get the second session in before going for X-rays. I ran the ERC on each leg and then ate breakfast. I went back to work for a while until it was time to go to PT. Unfortunately, I got dragged into something at work and wasn’t able to head out until 20 minutes after I wanted to. Right when I got to the PT parking lot, they called me and asked me to reschedule to tomorrow instead.
I picked up some extra ibuprofen at a nearby drugstore and got some takeout and then went home. I continued to try and get work done since I needed to leave early to go to the hospital for X-rays. Before heading to the hospital, I did my 4th and final shortening for the last two days. As I shortened, I thought about how difficult it was to get those last 4 millimeters and how they’ve now disappeared in such a short period of time. I really hope it’s easier to lengthen back to where I was the second time around and even beyond that. Who knows what will really happen though, with how terribly my nerves are reacting to LL. After lengthening it was about time to head to the hospital.
I left home with my X-ray orders in one hand and cell phone in the other. As I drove out of the garage I realized that I didn’t bring my cane with me. However, since I didn’t do PT today and my legs weren’t tired I decided I decided not to go home and get it. I might have to do a bit of walking around the hospital, but I don’t think it would be too hard. Plus a limping person is not going to look out of place in a hospital. I arrived and didn’t look too hard for a parking spot, so the one I got was not very close to the elevator. I was walking down the ramp toward the elevator, which felt like going on a treadmill that was slightly too fast in my current state. I got into the elevator and went straight to radiology since I already knew where it was. I gave them my orders and they set everything up quickly since I was already in the system. This time I got charged upfront, about the same as a month of Xarelto. Ouch! Good thing I’m hitting my deductible soon, because these medical costs are insane.
They eventually called my number and I went inside for the X-rays. It was the same tech as last time, but I don’t think she remembers me. Maybe that means she’s taken X-rays for many other people with IM rods in their legs in the last month. Anyway, after the X-rays she tried to get me to leave immediately, but I said I wasn’t leaving without a CD, so she had me wait in the waiting room again while she was making the CD. She came back with the CD and said she didn’t want to make one at first because the MRI people were hogging the machine. With the X-ray CD in hand I went straight home afterwards. When I got back, I picked up the CD drive I had ordered earlier from the mailroom. I went home and plugged it into the computer and tried to load the X-rays onto my computer. Of course my Windows computer couldn’t find drivers for the CD drive, and my Mac couldn’t open the executable to view the X-rays. I ended up making a copy of the CD on my Mac and then virtually mounting it on my PC to open up the program. I couldn’t figure out how to export an image in the program, so I just did a print screen and made a copy of all the X-rays in case I needed them. Then I went back out to mail the CD to Dr D’s office.
I also texted them to give them an update on everything. Dr. D then asked for a copy of the X-rays since the CD might not arrive in the mail until Monday. I sent them the screenshots I had taken, which were pretty high resolution. It was getting pretty late when I sent them this so I’m assuming Dr. D will take a look at it tomorrow morning. My ERC is currently not even programmed, so I can’t lengthen until the Nuvasive rep calls me to set up a new lengthening program. If my callus growth isn’t putting me at risk for preconsolidation, then I don’t mind resting for another day or two before resuming, but I definitely want to resume soon since the distraction phase is taking way longer than I thought was possible. Aside from that, nothing else interested LL-related today except that while I was at the hospital very self conscious about my gait, I noticed the movement of my reflection in a glass window and realized that I’m actually swaying pretty hard on both sides, not just the left side. I looked up some videos on improving gait through hip strength, and found a couple of exercises, which I will add to my routine.
Surgery Day +73, Lengthening Day 69 (+0.00mm, 49.17mm total)Last night I slept fairly late and I got up a bit later than usual as well this morning. My tracker showed 7.8 hours of sleep out of 8 hours in bed, but only 75 minutes of deep sleep, for an 89% rating. I realized this morning that I was finally able to subconsciously roll around in bed. It probably has been happening for a while since my sleep has been good overall, but it seems like I can roll to my side in the middle of the night without waking up now. Also, when I lay on my side for a long time, my legs don’t hurt from the position anymore. I’m not sure if it’ll get worse again as I lengthen more, but for now it’s a great improvement in feeling normal again. I got up for my morning routine and then signed into my work computer. I had a very busy day today with a lot of meetings.
I stayed busy until it was time to go to PT, at which point I drove over to the clinic. When I got inside the PT asked me if I wanted to warm up on the bike or treadmill today. I elected the treadmill because I had noticed how bad my gait was while walking around the hospital yesterday. I walked a bit on the treadmill and the PT reviewed my gait and gave me some pointers. I tried to practice a proper walking gait on the treadmill and slowly walked 400m in 13 minutes. I think it actually helped a ton because even after I got off the treadmill I was able to walk without as much hip sway. I guess gait is psychological as well as learnt in addition to muscle function. I plan to film my gait again for my next journal update in a few days. After that I lay on the table and the PT worked on me for a bit. The knee bends actually felt really good for once. In fact, I would say almost every exercise felt pretty good. This is probably what things would feel like four days post-consolidation. The only exercise that I struggled on was the squat. I was given a 15 pound dumbbell to hold onto on one end and I needed to squat with my butt back the best I could until the bottom of the dumbbell hit a footrest that was about one foot high off the ground. I could barely touch the footrest with the dumbbell when I was coming down. I haven’t learned how to balance my squat with longer femurs yet, so it was a struggle. The tendon connecting my knee to my quads hurt on both legs when I was squatting, at maybe a 3-4/10 at the peak of the stretch. I can handle any pain that’s not nerve pain though. The PT also had me do a bunch of gait improving hip exercises and I didn’t have to do the leg press today. I got takeout after PT and went home.
During PT, I had received a bunch of texts from Dr. D’s team and the Nuvasive rep. Dr. D had reviewed my X-rays and wanted me to rest for today and restart the next day at the previous rate that I was going at. I contacted the Nuvasive rep and he called to set up the ERC. My new program was basically the same as my old one, but maxing out at 28.83mm, which means someone somewhere failed on the math. It should be 30.83mm to get me to 80mm. I’m not too worried about it right now though since I’m not very confident in getting anywhere near 8cm. When my ERC was previously showing 52.17/79.00mm, the 79mm felt really far away. Now that it says 28.83mm, it really does not feel as hard to achieve even though it’s really the same thing. I guess that’s the psychological difference of smaller numbers. Since I didn’t have to lengthen today, I put the ERC away and finished my lunch, and then went back to work. I worked quite late until after dark, and then got my personal laptop out and was reading the news and watching some YouTube videos. At this point I realized that I could be stretching at the same time as watching videos to increase my productivity. I was also feeling a little sporadic tingling in my inner ankle nerves, which didn’t hurt, but was making me a little nervous, so I got up to get some movement in.
Nothing else too interesting to report related to LL today. I have been using the scar gel fairly consistently, but have not seen any results yet. I don’t mind fixing the scar with the gel only to reopen it again with nail removal because at least I’ll know that the scar gel works. I think the scars are kind of dark against my skin, but I’m very happy with how small and flat they are (not bumpy or indented.) I went to bed a little earlier than yesterday so hopefully I can get a decent amount of sleep tonight.
Surgery Day +74, Lengthening Day 70 (+0.33mm, 49.50mm total)I ended up watching YouTube videos in bed again for quite a while and I went to sleep very late. I got up and checked my work computer and an important morning meeting had been cancelled so I slept for a bit longer. In total I somehow ended with a 92% sleep rating with only 6.4 hours asleep out of 6.7 hours in bed, but I guess I got 2 hours of deep sleep, which seems about right since I had a ton of weird dreams. I got up for my morning routine, then took my meds and ate a protein bar. I had gotten up so late that it was almost time to go to PT.
I rushed over to the PT clinic, which was very quiet today. The PT gave me the choice of warming up on the stationary bike or treadmill again today. I chose the treadmill to work on my gait, though the stationary bike is a much better warmup and cardiovascular exercise. I could always ride the Peloton at my own gym instead of PT, though I could also use the treadmill at the gym as well. After walking for 10 minutes at a slightly faster pace than yesterday, I realized that my gait was best after warming up, but before my legs got too tired. It would probably be smart to walk at least that much every day while focusing on my gait. The PT stretched me out manually on the table and then we did a bunch of standing stretches and exercises. The focus was on my hips and improving my abduction for a more stable gait. Unfortunately I had to do the leg press today, with increased weight. I did 30 reps of 117.5 lbs with both legs, and 20 reps of 97.5 pounds on each leg. The PT wanted me to do 30 of the single leg presses, but after I got to 20, my legs were so sore that I was certain I couldn’t do 10 more on either leg. As usual, after PT I got takeout and headed home.
When I got home I did a quick session on the ERC before eating. I felt absolutely nothing when running the ERC on either leg, which is probably what one would expect after shrinking the nail and resting for days. However, it made me a little nervous since I have grown so used to the uncomfortable aftereffect of tightness and nerve issues that not feeling anything makes me fearful that the IM nails aren’t working! After I ate lunch I had to focus on work for the rest of the afternoon. In the evening I wasn’t hungry since I ate so much for lunch, and I spent a lot of it just watching YouTube videos and stretching a bit. I’m still trying to stay in the habit of stretching, but it’s not easy to remember to stretch when I’m not feeling tight at all. I know I need to stretch my nerves but I’m nervous about triggering nerve pain as well. I still get random pulses occasionally in both my left and right legs between the inside of the ankle and the calf. It’s not painful at all, but it’s a reminder that my nerves are still very sensitive.
I also wanted to point out that I noticed I was taller than pre-surgery a couple of times today. This is a little amusing since I’m technically shorter than I was a few days ago. The first time was in the morning when I was brushing my teeth. Instead of the bare skin of my stomach touching the stone countertop of the vanity, it was the top of my boxers. It’s a subtle but clear difference not feeling the coldness on my skin. The second time was when I was walking back to my car from PT. When I was standing next to my car, I realized I could see all the dirty spots on my moonroof from the snowfall earlier this week. I was looking down at the roof instead of across it, so the spots on the glass were much more noticeable. I also noticed that I can’t see the reflection of my eyes in the microwave anymore. My eye level used to be the same as the glass part of the microwave door so I could always see my face in it. Now that my eye level is at the level of the metal above the glass, I can only see half my face in the reflection when I walk around the kitchen. None of these things have an actual impact on my life, but they are clear indicators that I’m growing!
Surgery Day +75, Lengthening Day 71 (+0.66mm, 50.16mm total)Last night I ended up watching YouTube videos on my laptop before going to sleep yet again. I think it’s getting to be a bad habit, heh. I went to sleep very late, but I also slept in pretty hard, so I got 8.5 hours of sleep out of 8.6 hours in bed, and with an amazing 3 hours of deep sleep. This gave me a 100%+ sleep rating in the app. I awakened feeling pretty groggy and stretched my legs in bed. Now that I sleep on my side a lot I can sleep better, but I find that just straightening my legs in the morning is a stretch. However, once I complete the stretch, stiffness is greatly reduced and I can sit or lay down with straight legs and not feel tightness. I got up for my morning routine and while walking around my left knee was in a little bit of pain again. Nothing too serious and I’ve felt this before; it usually just goes away once I do a little workout session or take my morning pills. After eating a light breakfast I sat back down in bed to use my laptop and phone for a bit to catch up with the outside world.
I remembered that I had to do two lengthening sessions today, which my body should tolerate after the break I took, but I’m still a bit nervous about it. I guess I don’t yet have the confidence to lengthen very quickly at the moment. I started my PT exercises and stretches to get ready for lengthening. I did a full 30 minute workout since I had plenty of time to spare. I ran the ERC afterwards and felt a little weird in my left shin while I was lengthening, but no other problems otherwise. In the afternoon I kept myself busy and cooked dinner in the evening. After dinner I did some light stretching to keep my legs from getting too stiff. I kept busy for the rest of the night and finally, before bedtime I did another full 30 minute stretching session before lengthening. I ran the ERC on each leg again, and again felt a tiny bit of tingling in my left shin, making me very nervous. However, lately when I’ve been walking around it’s actually the nerve on my right leg that feels tighter. I don’t know which side’s nerve will start hurting first, but I really hope it’s neither!
So now, twelve days after I last reached the 5cm mark, here I am reaching it again. When I last updated my journal I would never have dreamt that I would have made zero progress in nearly two weeks (and I’m sure none of you could have guessed either) but here we are. I will say I’m in a much better position in terms of flexibility and nerve issues than I was two weeks ago. I don’t feel tight in any of my muscles (though I’m sure my quads and calves are clinically tight and I don’t really notice since I’m so used to it by now) and I haven’t had any nerve pain since day 1 of my most recent break from lengthening. However, in terms of consolidation I’m certain that I’m in a much “worse” position in terms of bone growth as I have more callus than I did 12 days ago, especially with the boomerang maneuver (shortening and then lengthening the nail) which is actually one of the methods that doctors use to promote bone growth in the case of slow growth or non-union. Although I’m taking Ibuprofen right now, if I run into more nerve issues down the line I don't know how many more lengthening breaks or nail shrinkages my femurs can handle before consolidating. I’ll have to think a lot about what conditions I would consider stopping the distraction phase early, though I may not even get to make that choice depending on how things go.
Surgery Day +76, Lengthening Day 72 (+0.33mm, 50.49mm total)Last night I finally went to bed earlier than I have been lately, although only slightly earlier. I slept in again and I remembered having a really weird dream where I bought a ton of overpriced and ugly limited edition sneakers. On the app I had a 100% sleep rating with 8.8 hours of sleep out of 9 hours in bed and 2.3 hours of deep sleep. I also had the lowest resting heart rate I’ve had since surgery, which hopefully means my body is recovering well. I got up since any more sleep would probably make me more groggy. After my morning routine, I planned out the day. I only had one lengthening to do, which is nice. However, I also have some work to catch up on, so today would probably be pretty busy and boring.
I was feeling a little stiff walking around this morning, so I did a full stretching session. After that I tried to get some work done before going to the gym. My gym alarm went off and I headed down to the gym. I walked on the treadmill for 20 minutes focusing on good gait to warm up. Then I spent the rest of my allotted time working my upper body with dumbbells. After I left the gym I set up my tripod in the hallway to record the following walking video:
I think my gait is a tiny bit better than last time, but still not that great. Any random observer can still easily tell that something is wrong. However, at least it’s pretty easy to walk around right now, I can go grocery shopping or walk around indoors without really feeling like I’m struggling to walk.
Since I was warmed up already when I got home, I did a few light stretches and then ran the ERC. I didn’t feel anything weird on either leg this time. After that I had some snacks and then worked for the rest of the afternoon, only taking a break to cook dinner. After uploading this entry I’m going to go take a hot bath and relax, then probably work until it’s time to go to bed, though I should be able to fit in a stretching session too. I'm trying to stay optimistic, though it's not easy. All I can really do is continue taking this one day at a time and hope that my body allows me to lengthen some more.