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[OzBoy39]

2 HANDS TWISTING

This technique is the one I prefer now because the conventional sometimes is hard to find the angle and I end up twisting and twisting my leg without finding the click and that puts a lot of strain and fatigue to my muscle.

So, wit this technique, as you can see from videos below, you use one hand on your knee to make it pivot and the other one on the calf/shin to pull the leg outwards.

If you do it slowly is really almost painless.
See videos below

LEFT LEG
https://streamable.com/z4xgzo

RIGHT LEG
https://streamable.com/l4ys7j

[Infinite]

2 HANDS TWISTING

This technique is the one I prefer now because the conventional sometimes is hard to find the angle and I end up twisting and twisting my leg without finding the click and that puts a lot of strain and fatigue to my muscle.

So, wit this technique, as you can see from videos below, you use one hand on your knee to make it pivot and the other one on the calf/shin to pull the leg outwards.

If you do it slowly is really almost painless.
See videos below

LEFT LEG
https://streamable.com/z4xgzo

RIGHT LEG
https://streamable.com/l4ys7j

Looks like a good technique!
This seems like a game-changer in the LL field.

Revolution has begun!

[RealLostSoul]

This method of clicking is exactly what I use too for my left leg but I can’t hold it in the air for too long so I need a band around my heel and then do the trick. It really is less painful because it needs less rotation.

[SpeedDialer]

Anyone in the Montaza hotel? Aside from the economy supermarket store nearby, any other useful locations to know about? Might be an ATM around, anything else?

[OzBoy39]

I'm not at Montaza but first thing I suggest you to do is

Download the app Wolt. You can order pretty much everything there, from food to groceries to laundry to electronic gadgets and more.

[OzBoy39]

This method of clicking is exactly what I use too for my left leg but I can’t hold it in the air for too long so I need a band around my heel and then do the trick. It really is less painful because it needs less rotation.

Same for me but I actually use my arm to hold the leg up. And I wedge my arm above a pillow so I don't really have to use much force to hold it in there. I'm still trying to improve the position but so far I can manage to do 4 or 5 clicks in one go...then rest for 30 sec and then go again.

[OzBoy39]

Looks like a good technique!
This seems like a game-changer in the LL field.

Revolution has begun!

Haha nice. Yeah let's revolutionise the world.
Joking aside, yeah this technique works well so far, but as posted by RealLostSoul in the other message it could be improved. When the nurses were here to help  they use to hold my leg up and then I twisted it. That allowed me to relax the leg even more and therefore reaching the click easier.  It'd be col to have some sort of stool or box of the right height to rest your leg on and just twist it. Anyway... enough with daydreaming, off  to some more clicking I go.

[OzBoy39]

Update at 20 days post-op (23mm distraction)

Yesterday I had my first x-ray and follow-up visit with Dr Giotikas

I can't yet upload the x-rays as they ve given those to me on a CD and ... Who has a cd player in his laptop these days? EU privacy laws are a bit outdated.

Anyway, the x-ray didn't show any particular problem. Nail is straight. Bone is starting to grow and the gap as of yesterday was at approximately 23mm.

We decided to lower the click rate from 15 to 12 clicks a day (0.8mm).
This is to reduce the stress on my legs and also reduce the duckass effect which i can already notice.

 I'm upping my stretching routine and incorporating more complex movements now that my legs allow me to do them.

Specifically I'll be adding:
- Hip flexor stretches on the edge of the bed (really useful and ... Painful at the same time).
- Abductor stretching in the form of butterfly pose and also laying lateral extensions using the strap provided by PT.
- Hamstring stretch both standing and laying on the bed with the strap.

I feel this is gonna be the real battle in the months ahead.  As the PT guy said, the secret to success is to always try to be a little ahead with stretching than your soft tissue requires.

And btw, at 23mm only, I already noticed the difference in height. Not much, but enough to give a boost of motivation. I can only imagine what it'd feel when I reach around 5cm and more.

Finger crossed as always and keep on strerching

[Infinite]

Update at 20 days post-op (23mm distraction)

Yesterday I had my first x-ray and follow-up visit with Dr Giotikas

I can't yet upload the x-rays as they ve given those to me on a CD and ... Who has a cd player in his laptop these days? EU privacy laws are a bit outdated.

Anyway, the x-ray didn't show any particular problem. Nail is straight. Bone is starting to grow and the gap as of yesterday was at approximately 23mm.

We decided to lower the click rate from 15 to 12 clicks a day (0.8mm).
This is to reduce the stress on my legs and also reduce the duckass effect which i can already notice.

 I'm upping my stretching routine and incorporating more complex movements now that my legs allow me to do them.

Specifically I'll be adding:
- Hip flexor stretches on the edge of the bed (really useful and ... Painful at the same time).
- Abductor stretching in the form of butterfly pose and also laying lateral extensions using the strap provided by PT.
- Hamstring stretch both standing and laying on the bed with the strap.

I feel this is gonna be the real battle in the months ahead.  As the PT guy said, the secret to success is to always try to be a little ahead with stretching than your soft tissue requires.

And btw, at 23mm only, I already noticed the difference in height. Not much, but enough to give a boost of motivation. I can only imagine what it'd feel when I reach around 5cm and more.

Finger crossed as always and keep on strerching

I'm proud of you, brother!

[ten]

hi, does giotikas allow going back to home country during lengthneing?

[OzBoy39]

He does, but only after 6 weeks post surgery

[ten]

He does, but only after 6 weeks post surgery

Why that period? to prevent clotting?

[Limbfan2020]

Hey OzBoy39,

which drugs do you take for anticoagulant prophylaxis? What's the treatment regimen?

[OzBoy39]

Not only clotting but in general I believe he wants you to stay here for the period necessary  to reduce risks of complications like yeah clotting, clicking, muscle contractures, bone healing... and also to allow you to make enough PT sessions to mitigate all the conditions that arise with the lengthening (duck ass, stiffness , contractures).

Before the surgery I was also asking and trying to understand if I could come home after just 2 or 3 weeks. Now that I'm into it fully, I wouldn't do it at all.

[OzBoy39]

Hey OzBoy39,

which drugs do you take for anticoagulant prophylaxis? What's the treatment regimen?

Xeralto pill once a day and I've been 3 weeks with the compression socks. I believe I'll be taking xeralto for the 1st month postop and then stop.

I've already taken the compression socks off.

[thankscience]

Thanks for the videos OzBoy39! Good to see your progress and that you're able to do the clicking completely independently with minimal pain. I'm sure these videos will be helpful for plenty of others using g-nail (or even Betz nail).

This is random but how many compression socks do they give you to wear? I imagine having only one pair would get rather smelly Also, do you have the option of asking Dr G to take xeralto for longer than one month (e.g. potentially for the whole lengthening period)?

[OzBoy39]

Hi Thankscience,
Hopefully they'll help someone. But for anybody who's doing this, please try to find what works best for you. Sometime it's just about slightly changing the angle of your quad or lower legs to make the clicking easy. Try, to not get discouraged if it doesn't work at first. But try and be concious of your body response and feeling. Adjust a little and try again, slowly. Don't push to the point of extreme pain. If you twisted 45 degrees and it didn't click yet... you're doing it wrong. You don't have to push harder. You gotta change the way you're doing it.

For the compression socks, I use to wash them every 2or 3 days. So one pair was ok. I'm sure if I had asked more they would give me right away.

Xeralto, I do t really wanna take it for longer than a month. Talking to the Doc he says that at that point, the risk of blood clotting (for G-Nail or other weight bearing patients) is extremely low, so there's no point in maintaining the same regime (and by doing so further damaging the liver).

It is a different thing for precice patients who cannot really move much other than the wheelchair. They will use xeralto throughout the lengthening if I understood correctly.

I'm already pretty mobile and active throughout the day, and I hope it'll only go up from here in terms of mobility.

He'll then give me xeralto again a few days prior and after my flight home together with the compression socks to wear during the flight.

[SpeedDialer]

Any LL veterans wanna help me theory craft good technique for transfers?

Scooching forward in bed seems alot more difficult for me than scooching back.

To scooch back in bed, I can push with my triceps and lats

To scooch forward in bed, I sort of grip the bed and try to pull my way forward, sometimes resulting in the legs bumping into some misc blanket/pillow stuff which is a bit uncomfortable

The grabber has been a godsend

I'm gonna venture to the toilet some time this weekend by myself without the nurses and the biggest challenges seem to be transferring off of the bed and also transferring off of the toilet

The issue is that although I can use more upper body to help (muscles associated with using a dip), I sort of need to find the right amount of legs/quads to use because a dip using upper body strength alone really cannot fully lift the body for me

And there is a bit of this uncertainty when pushing with quads ("Am I pushing too hard? Am I hurting my legs? But I need some of my quads to lift myself off of bed onto the walker) and I am sort of in the midst of working this out

[SpeedDialer]

Hi Thankscience,
Hopefully they'll help someone. But for anybody who's doing this, please try to find what works best for you. Sometime it's just about slightly changing the angle of your quad or lower legs to make the clicking easy. Try, to not get discouraged if it doesn't work at first. But try and be concious of your body response and feeling. Adjust a little and try again, slowly. Don't push to the point of extreme pain. If you twisted 45 degrees and it didn't click yet... you're doing it wrong. You don't have to push harder. You gotta change the way you're doing it.

For the compression socks, I use to wash them every 2or 3 days. So one pair was ok. I'm sure if I had asked more they would give me right away.

Xeralto, I do t really wanna take it for longer than a month. Talking to the Doc he says that at that point, the risk of blood clotting (for G-Nail or other weight bearing patients) is extremely low, so there's no point in maintaining the same regime (and by doing so further damaging the liver).

It is a different thing for precice patients who cannot really move much other than the wheelchair. They will use xeralto throughout the lengthening if I understood correctly.

I'm already pretty mobile and active throughout the day, and I hope it'll only go up from here in terms of mobility.

He'll then give me xeralto again a few days prior and after my flight home together with the compression socks to wear during the flight.

Thanks for the tip about Xarelto, I've also heard it has some adverse affects. Maybe I'll ask Evi/Bill/Dr Giotikas about this too

[Limbfan2020]

Hey Ozboy39.

There was a guy who died due to a pulmonary embolism some months ago. Did your doctor mention something about this case? Didn't he take the Xarelto pill?

[OzBoy39]

Hey Ozboy39.

There was a guy who died due to a pulmonary embolism some months ago. Did your doctor mention something about this case? Didn't he take the Xarelto pill?

Hi Limbfan2020, I don't know at the moment.

I'm not sure if he was referring to this specific patient, but the day before the surgery during the pre-op consultation, we were talking about the various schedules and the pros vs cons of each medication.

He stressed the fact that Xeralto was among the most important medication among all because not taking it could significantly increase the risk of clots that lead to clots and therefore could induce a PE.

Together with that he alluded to some patients not really cooperating with the doctor and nurses  in the way of basically not taking the meds (and not even informing them) which developed an embolism

I don't know if the two are related, I was just listening at the time, but I'll try to remember to ask next time I have a checkup with him. I'm curious too.

[OzBoy39]

Thanks for the tip about Xarelto, I've also heard it has some adverse affects. Maybe I'll ask Evi/Bill/Dr Giotikas about this too

Yeah, they all do. Especially if taken long term. Many of them are hard on your stomach/liver whereas some others (like the tramadol)  being an opioid can create addiction.

[SpeedDialer]

Yeah, they all do. Especially if taken long term. Many of them are hard on your stomach/liver whereas some others (like the tramadol)  being an opioid can create addiction.

What are your thoughts on the best times of the day to sleep? My first physical therapy session is Monday in the afternoon and then the nearby Strip Club loud music near Montaza starts at night (not sure when?). Not exactly sure what my regular physical therapy schedule will be. But putting this all together, I think that means that the evening is actually the best time to sleep + get in random naps at other times like the morning, but what has worked out for you?

Right now, the music isn't so bad, I just hear the loud beat of the strip club music

[OzBoy39]

What are your thoughts on the best times of the day to sleep? My first physical therapy session is Monday in the afternoon and then the nearby Strip Club loud music near Montaza starts at night (not sure when?). Not exactly sure what my regular physical therapy schedule will be. But putting this all together, I think that means that the evening is actually the best time to sleep + get in random naps at other times like the morning, but what has worked out for you?

Right now, the music isn't so bad, I just hear the loud beat of the strip club music

Judging by the time we're writing these messages, I guess sleep is not our strong point at the moment. Lol

Just kidding. I am trying (hard) to have as long a sleep as I can at night AND I'm keeping my mornings free for naps.

I say that because I believe that you'll also be doing PT between 12 and 1pm and that can last up to 2 hours.

At the beginning I was napping in the afternoon but that made it really problematic to fall asleep at night.

So, to maximise my sleep and at the same time be somewhat efficient and have some sort of decent routine itry to do this.

I'm going to bed relatively early (9 to 10pm) and try to get at least 6 hours of combined sleep. As you can see... I'm awake now at 442am so my sleep is still...patchy.

Then I wake up at around 6am...
Catch up with emails, socials, friends and basically just... Slowly wake up.
Around 7am i do my clicks routine (I just want to get them done asap and I like the sunrise light in my room at that time. It makes me feel relaxed and that helps with my clicking routine).which involves a light warmup (all in bed), light stretching, light twisting of the leg and then....the clicks.

Then I Go down and have a huge breakfast either in the hotel or in a coffee shop nearby.

The rest of the morning I chill and stretch and often (especially when I don't get much sleep the night before) I squeeze in another nap which comes much easier than at night.

Then PT, lunch, work, chill, clicks, dinner and repeat.

[thankscience]

How many days a week are you going to the PT centre? And if your hotel has a gym have you been using that at all?

[OzBoy39]

We do 4 days per week (Mon, Tue, Thursday and Fri).
Yeah Novotel has a "little" gym that I've been using.

It has an elliptical, a treadmill, a static bike and a compound weight machine where you can do a bit of chest presses and flies, lats puldowns, biceps and triceps, leg extensions.

They don't have benches or dumbbells unfortunately.

[thankscience]

We do 4 days per week (Mon, Tue, Thursday and Fri).
Yeah Novotel has a "little" gym that I've been using.

It has an elliptical, a treadmill, a static bike and a compound weight machine where you can do a bit of chest presses and flies, lats puldowns, biceps and triceps, leg extensions.

They don't have benches or dumbbells unfortunately.

Interesting. Do you find you have energy to do upper body workouts given how much energy and time is required for your legs? Also, I noticed some people seem to have static bikes in their rooms. Is this provided by Dr G's team?

[OzBoy39]

Yes, as the days go by I  am regaining normal energy levels and so I feel I can do some workouts. Not everyday still, but 3 or 4 times per week.

Yes I do have the bycicle provided by Dr G. He also provided the Walker, wheelchair and crutches. And the PT guys have me a strap and a nice manual with the summary of all stretches to do during lengthening.

Fyi... Many stretches are absolutely a no no given that you could damage the nail/screws

[Limbfan2020]

Hi Limbfan2020, I don't know at the moment.

I'm not sure if he was referring to this specific patient, but the day before the surgery during the pre-op consultation, we were talking about the various schedules and the pros vs cons of each medication.

He stressed the fact that Xeralto was among the most important medication among all because not taking it could significantly increase the risk of clots that lead to clots and therefore could induce a PE.

Together with that he alluded to some patients not really cooperating with the doctor and nurses  in the way of basically not taking the meds (and not even informing them) which developed an embolism

I don't know if the two are related, I was just listening at the time, but I'll try to remember to ask next time I have a checkup with him. I'm curious too.

Yes, please ask him about this particular case! It's very interesting for the LL community to know which behaviour led to his death.

Thank you!

[SpeedDialer]

Yes, as the days go by I  am regaining normal energy levels and so I feel I can do some workouts. Not everyday still, but 3 or 4 times per week.

Yes I do have the bycicle provided by Dr G. He also provided the Walker, wheelchair and crutches. And the PT guys have me a strap and a nice manual with the summary of all stretches to do during lengthening.

Fyi... Many stretches are absolutely a no no given that you could damage the nail/screws

Oh damn, didn't think of this. So when I get the manual of stretches, I should ask bill/evi which of the stretches in the manual are too dangerous?

[SpeedDialer]

Yes, as the days go by I  am regaining normal energy levels and so I feel I can do some workouts. Not everyday still, but 3 or 4 times per week.

Yes I do have the bycicle provided by Dr G. He also provided the Walker, wheelchair and crutches. And the PT guys have me a strap and a nice manual with the summary of all stretches to do during lengthening.

Fyi... Many stretches are absolutely a no no given that you could damage the nail/screws

I'm finding the hamstring stretch difficult because my quads/hip flexors are sore all the time and they get compressed during the hamstring stretch. Any tips for this?