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[Sweden]

How long did it take to get back to normal after IMnail-removal?

Does your split knee tendon still hurt?

My knee tendon aches all the time.

[Medium Drink Of Water]

I noticed your signature now says you did LON. I thought the Guang Ji hospital only offered LATN, or at least gave LATN by default. How come you ended up getting LON? Was this their preferred method when you did your lengthening? Do you see any particular advantage to one method over the other? I have read that multiple LATN patients experience "bone popping", which is when the broken bone somehow pokes against inside of the skin, despite the frame which supposedly holds it in place. I guess LON would prevent this, but would make axial corrections more difficult, if not impossible. What are your thoughts?

Yes, LON was the default in 2007.  I don't see any significant advantages between LON/LATN.  When you put the nail in makes little difference.  I don't think it prevented corrections since it was only fixed on one side of the osteotomy cut and had a smaller diameter than a lengthening nail.  With internal lengtheners, corrections and lengthening are indeed separate surgeries/processes.  We had a guy who was going to do internals in the U.S. but came to Beijing because the correction he needed and lengthening he wanted could be done together faster.

How long did it take to get back to normal after IMnail-removal?

Does your split knee tendon still hurt?

My knee tendon aches all the time.

Just a few weeks.  I was almost back to normal with the nails in.

Yes my knees still hurt.  That'll forever be the legacy of that psychiatric snafu in Serbia, since I would've gotten external-only with Dr. Mitkovic otherwise.

[Sweden]

So I guess our knees will forever ache. 

Well that sucks for sure.....

[LLL]

So I guess our knees will forever ache. 

Well that sucks for sure.....

No way to be sure if that will be the case, but seems like it's quite normal?

https://en.wikipedia.org/wiki/Intramedullary_rod

"Long-term complications a patient may develop after the implantation of an intramedullary rod may include persistent or permanent knee pain (present in 73.2% of patients studied), atrophy of the calf muscle (27.3%), atrophy of the quadriceps (27.3%), and arthritis (35.4%).[5]"

It's kind of screwed up if LON/LATN patients aren't being informed of these stats beforehand (if the surgeon is aware of it, that is). 73.2% is the MAJORITY of patients.

Source study: http://www.ncbi.nlm.nih.gov/pubmed/18758282

CONCLUSIONS:

At a median 14 years after tibial nailing of isolated tibial fractures, patients' function is comparable to population norms, but objective and subjective evaluation shows persistent sequelae which are not insignificant. This study is the first to describe the long-term functional outcomes after tibial shaft fractures treated with intramedullary nailing nails. It may allow surgeons to better inform patients on the expected long-term function after intramedullary nailing of a tibia fracture. It may also prove useful when comparing intramedullary nailing nailing to other treatment techniques.

[inquisitivemind]

I asked this in another thread but perhaps I should have asked this in this one:



I've got a question that I have been googling and havent been able to get a solid answer for.

My height is 155cm with an armspan of 158cm. If I were to follow Dr Franz's advice (which is to lengthen 5 (or 6?) cm in each part as a maximum), then I would be 165/167 cm with a 158cm armspan.


Would this be painfully obvious? Obviously not Apo level of obvious, but still very obvious?

[Medium Drink Of Water]

No way to be sure if that will be the case, but seems like it's quite normal?

https://en.wikipedia.org/wiki/Intramedullary_rod

It's kind of screwed up if LON/LATN patients aren't being informed of these stats beforehand (if the surgeon is aware of it, that is). 73.2% is the MAJORITY of patients.

Source study: http://www.ncbi.nlm.nih.gov/pubmed/18758282

Yeah, it sucks. But as long as I keep doing my kickboxing exercises, the knees don't feel that bad.  If there were no other way I'd still do it the way I did.

My height is 155cm with an armspan of 158cm. If I were to follow Dr Franz's advice (which is to lengthen 5 (or 6?) cm in each part as a maximum), then I would be 165/167 cm with a 158cm armspan.

Would this be painfully obvious? Obviously not Apo level of obvious, but still very obvious?

I actually looked pretty goofy with my long arms and long neck before LL so I've never researched proportions that much.  After doing 3 inches my armspan and height are equal now.  On top of that, I think Apo doesn't look that bad, so I'm really not the guy to ask about proportions.

[BilateralDamage]

MDoW,

How was your sex life affected after LL?  Did you have any problems with girls of certain heights or positions?  I ask because I'm a little worried how LL is going to affect my sex life with my gf!  She's already about 4 inches shorter than me and my plan is lengthen around 5 inches, so we'll have a real noticeable gap between us.  Did you notice any different between sex pre-LL and sex post-LL?

[Medium Drink Of Water]

No difference.

[Machine]

hi MDOW ,

thanks for helping alot of people regarding valuable information about LL , i really appreciate your contribution from my heart.

i want to ask something about ballerina , how long does it take to walk without any support ? like how long does it take for you to
get you ankle flexiblity to 110 or 120 degree .
thanks

[Medium Drink Of Water]

hi MDOW ,

thanks for helping alot of people regarding valuable information about LL , i really appreciate your contribution from my heart.

i want to ask something about ballerina , how long does it take to walk without any support ? like how long does it take for you to
get you ankle flexiblity to 110 or 120 degree .
thanks

It varies from person to person.  My roommate and I finished LL at about the same time.  A few days before we left, Dr. Li came to visit us and said his knees were better than mine, but my ankles were better than his, and that I'd be able to walk sooner because of it.

One patient in Beijing was walking, without support, the day after his frame removal even though the doctors told him not to.  I was very conservative so it was several weeks before I started doing that.  Even though you can, it's a bad idea to do it until the titanium screws holding the IM nails in place have fused to the bones.

[Doflamingo]

After frame removal, how long did it took you to be able to walk properly again?

[Medium Drink Of Water]

I think it was about 2-3 months before I was walking properly/normally so nobody would notice something was wrong.

[Doflamingo]

Ok ty

[NMG]

Just out of curiosity can you remember roughly what the distribution of starting heights was like for patients, particularly the international patients. Were you one of the tallest or around average? and were you strongly discouraged from LL due to your starting height which is probably average for a Chinese male? I read in your diary about the lady who said your height was fine, was that the only time someone tried to discourage you based on your height? Were there any patients with surprising high starting heights? (175cm+)

Thanks so much for this invaluable thread.

[Medium Drink Of Water]

Probably 2/3 of the patients or more were between 5'5 and 5'8, hoping to reach average height in their countries.

Most of the rest were between 5'2 and 5'4.

Three guys came in at 5'9 wanting to get to 6'.  Some people didn't like the fact that they were there.

[Sweden]

Is it ok if I ask you in here? Maybe Dameon can move it if it's inappropriate.

Why did you feel like you needed to remove the IM-nail? It is double trauma to your knees, and a serious kind too.
My doctor here in Sweden tells me I don't need to take the nails out and it's a reinforcement to my shins.

Did the screws in your knee bother you or any other?

Can you run 10kilometers and sprint like Usain Bolt? Does your knees ache for like 2 days if you do?
Tight ankle problems?

Sorry to bother you but I just want to know what I should look forward to....

I can now press real 100kilos in the leg press machine, but my knees ache for 2-3 days after I do it.
I can't run. 

[Medium Drink Of Water]

Is it ok if I ask you in here? Maybe Dameon can move it if it's inappropriate.

Why did you feel like you needed to remove the IM-nail? It is double trauma to your knees, and a serious kind too.
My doctor here in Sweden tells me I don't need to take the nails out and it's a reinforcement to my shins.

Did the screws in your knee bother you or any other?

Can you run 10kilometers and sprint like Usain Bolt? Does your knees ache for like 2 days if you do?
Tight ankle problems?

Sorry to bother you but I just want to know what I should look forward to....

I can now press real 100kilos in the leg press machine, but my knees ache for 2-3 days after I do it.
I can't run. 

I do think this belongs in the MDOW questions thread, but I'll respond here and Dameon can move it.

It was standard procedure to remove the nails at the Beijing Institute.  I know in the west they like to leave IM nails in because it's less risky than having a second surgery, but in Beijing you take the risk with their experienced surgeon and try to go for the best possible result.  I never really thought of not removing it.

The screws didn't bother me, but sometimes I felt some kind of internal pressure/tension like the bone and the nail were fighting each other for which angle the leg would have.  This was especially noticeable when climbing ladders for some reason.  My bone was 100% consolidated before that started happening though.

I haven't tried to run 10km ever in my life.  I can sprint fine, but I rarely do it.  My knees don't hurt afterward.  I never tried sprinting with the nails in; I always just took it easy.  The most I did was jog short distances before I got them out.

When I did leg presses with the nails in, my knees always felt better rather than worse, and the same was true for any exercise.  That goes for without the nails too.

[Taller]

Do you think that anyone got lower quality of care and treatment than other patients or descrimination of any kind at the Guang Ji Hospital as the result of any factor (country of origin, starting height of 5'9+, political/religious identity etc)? I am from the United States and don't know if all Chinese would take too kindly to that. Happy new year by the way!

[Medium Drink Of Water]

Do you think that anyone got lower quality of care and treatment than other patients or descrimination of any kind at the Guang Ji Hospital as the result of any factor (country of origin, starting height of 5'9+, political/religious identity etc)? I am from the United States and don't know if all Chinese would take too kindly to that. Happy new year by the way!

They have a new religion in China, and it's called foreigner worship.  Especially American or British, because that signifies international power/status.  The lighter your hair/skin the better, also.  Several Chinese people wanted to take their picture with me just because I'm white.

The people who are discriminated against there are the local Chinese patients.

[Wannabegiant]

Thanks for all the info Medium drink of water,

Just have one big question for you 

You say that you have lost agility in your legs, and you think the reason is because you have a longer bone now but the same muscle mass you did earlier but stretched further to match the new bone length. That sounds logical.

However ive read on some FAQ on old forum and i believe this forum as well, and heard many people claiming that the muscles, nerves and tendons will "grow" when you do LL, only it does it more slowly as the body regenerates the soft tissue slower than the bone. So at first the soft tissue is stretched as it cannot regenerate at the same speed of the bone, but eventually new soft tissue would be created to match the new bone lenght.

Considering how your own body have healed, do you believe that info above to be false? or does it depend on the individual? (i know some people claimed their calf muscles experienced hypertrophy and grew in size larger than they were before LL)

[Medium Drink Of Water]

I think it depends on the person.  I'm skinny and have trouble putting on weight.  I might've been rejected entirely if I'd gone to Guichet since he insists on many patients putting on extra muscle before he'll operate.

[Moubgf]

1.Have there been people who have aborted the operation after feeling to much pain in their legs?
2. How fast did the time seem to go. What i mean is time and days.

[Medium Drink Of Water]

1.Have there been people who have aborted the operation after feeling to much pain in their legs?
2. How fast did the time seem to go. What i mean is time and days.

1.  Yes!  There was a guy who went home after not even 2cm because of the pain.
2.  Once I'd gotten into a nice routine, the time went by pretty quickly.  If you have a schedule and stick to it, the days will pass quicker.  Here's one that worked for me:

8:00 get up and eat breakfast
9:00 brush teeth then take a nap
11:00 internet
1:00 eat lunch
1:30 videogames
3:00 internet
4:00 movie
6:00 eat dinner then go out and socialize
10:00 internet
10:30 bedtime

That was approximately what I did every day towards the end.

[Taller]

8:00 get up and eat breakfast
9:00 brush teeth then take a nap
11:00 internet
1:00 eat lunch
1:30 videogames
3:00 internet
4:00 movie
6:00 eat dinner then go out and socialize
10:00 internet
10:30 bedtime

That was approximately what I did every day towards the end.

Wow, if it weren't for the pain involved, that would sound to me like a pretty nice and relaxing, albeit perhaps painfully uneventful, life. How often did you exercise, and what kinds of exercises did you have to do? Was the relative isolation minimal enough to keep most of the patients from going cuckoo? I've read your diary (I admit I check for updates almost daily), and sometimes wonder if more people didn't become a little depressed and weird after being crippled and stuck in China so long. Did mummy have issues before LL, or did the LL experience mess with his mind pretty bady?

[Taller]

Also, did anyone try lengthening at home, or at least going home with frames on? If so, how did they fare?

[Moubgf]

Medium Drink Of Water,

All in all i feel that it all was a positive experience..almost to good to be true.

But can you tell us about the dark side of the trip. Just one of those days where everything went wrong.

[Medium Drink Of Water]

Wow, if it weren't for the pain involved, that would sound to me like a pretty nice and relaxing, albeit perhaps painfully uneventful, life. How often did you exercise, and what kinds of exercises did you have to do? Was the relative isolation minimal enough to keep most of the patients from going cuckoo? I've read your diary (I admit I check for updates almost daily), and sometimes wonder if more people didn't become a little depressed and weird after being crippled and stuck in China so long. Did mummy have issues before LL, or did the LL experience mess with his mind pretty bady?

The memories of the pain and misery fade and I'm left looking back on a really relaxing 5-month vacation sometimes. No responsibilities, no obligations, it was like being a kid again in some ways.

For exercise I'd do leg lifts, ankle flexes, standing, and walking.  I didn't exercise regularly though, due to problems with my knees.  I'll make sure to include the details about the complications and what I could and couldn't do because of them in my future Patient Experience entries.

Most people had roommates so we weren't totally isolated, but a lot of people did end up going a little bit cuckoo, including me.  The locals called it shen jing bing.  Some turned it inward and got depressed and wanted to be isolated, some turned it outward and started fighting and causing mischief (that was me), and some fit in both categories at different points during their LL.  I'm pretty sure Mummy had issues before coming, but I can't be 100% sure since he was already there when I arrived and I didn't get to know him until the middle of my LL journey.

Also, did anyone try lengthening at home, or at least going home with frames on? If so, how did they fare?

Yeah, the guy who quit after less than 2cm went home with his frames on.  I was a 2007 patient and he was a 2008 patient, so I actually first met him when I was there for my internal nail removal.  We were both there for the same reason.  He was mostly consolidated so his frames and one of the nails were removed at that time.  I haven't met or heard of anyone leaving and lengthening a bunch, then coming back.

Medium Drink Of Water,

All in all i feel that it all was a positive experience..almost to good to be true.

But can you tell us about the dark side of the trip. Just one of those days where everything went wrong.

Near-constant knee issues, difficulty getting to and from the toilet, staff not answering the hospital phone when I needed them on many occasions, hospital filth, getting in fights with other patients, getting in fights with the staff, getting betrayed by my so-called girlfriend... it's all coming in future chapters of Fear and Lengthening in Beijing.

[Smallguy]

Near-constant knee issues, difficulty getting to and from the toilet, staff not answering the hospital phone when I needed them on many occasions, hospital filth, getting in fights with other patients, getting in fights with the staff, getting betrayed by my so-called girlfriend... it's all coming in future chapters of Fear and Lengthening in Beijing.

You seem to be an advocate for Beijing. Did you met someone there who has created an everlasting good impression for you? Like a female nurse or a Chinese stranger?

"betrayed by my so-called gf" lol.. that sounds familiar. Can't wait to read it!

I'm also working on my chapter 2 for my LL diary.

[Medium Drink Of Water]

You seem to be an advocate for Beijing. Did you met someone there who has created an everlasting good impression for you? Like a female nurse or a Chinese stranger?

"betrayed by my so-called gf" lol.. that sounds familiar. Can't wait to read it!

I'm also working on my chapter 2 for my LL diary.

Wang Bei.   

[theuprising]

Hey mdow I have a few questions if you don't mind answering.
I have similar starting measurement's to you and am still weighing
up whether to do tibs or femurs.

Since I may only do one ll surgery in leaning towards tibs as too long
femurs just look weird. What is the length of your tibias
compared to your femur before and after your surgery? If your tibias become as long as your femurs
does it cause permanent problems.
Im aware after reading talks diary on old forum  that quite a few ll patients
have knee problems after just doing femurs.
Do you believe that it is going outside the range of normal tib and femur ratios
that causes knee problems?
Also what is your opinion on doing precise 2 on tibias?
Finally would you ever take a girlfriend along for support while doing ll.

Many thanks
theuprising

[Medium Drink Of Water]

I agree with you that overly long femurs look kind of weird.  People are used to seeing high knees due to shoes but nobody's used to seeing low knees.

My tibias and femurs are both approximately 18 inches now.  So my original femur:tibia ratio would've been 6:5.  Professor Xia said most short people have disproportionately short tibias but that wasn't the case with me.  I almost ended up doing femurs but he said that tibias would be okay as long as I didn't pass a 1:1 ratio.

Could you tell me which old forum  patients did only femurs and have knee problems as a result?  I'd like to read about that but I don't check old forum  regularly.  The only precaution Professor Xia gave me was not to make the tibias longer than the femurs, but perhaps that was because I was doing tibias and the too long femur information wouldn't have been relevant to me.

I don't know if going outside a normal femur:tibia ratio is what causes knee problems or not.  My guess is that it would make you walk funny - too long tibias would shorten your stride too much while too long femurs would lengthen it too much.  That may be a cause of knee problems.  My knee sensitivity is right where the patellar tendon is so I'm leaning toward the IM nail surgery as the cause of my knee issues, but that doesn't mean LLers can't get knee issues in other ways too.

I don't have any opinion on Precise since that was never an option in 2007.  My knowledge of the new devices isn't very good.

No way, I'd never take a girl along with me.  LL is about going away a short man and coming back a new man.  It's a journey of personal growth and change best taken alone in my opinion.  Maybe you'll meet a nice girl who's also doing LL while you're there.  Or a not so nice girl like I did.