[Regular patients] It is time that we show effort
Hello.
I am a 23-year-old male and I have the leg lengthening surgery in February of 2011. I first heard of the surgery when I was in high school, but I had more negative thoughts about this surgery back then. I gave up having the surgery after the TV show “I want to know that” specifically talked about the side effects and complications of the surgery. But I got to know more about the surgery by coincidence and realized that it was actually different than what I had been thinking. So I thought of having the surgery after I get discharged from the hospital. So I discussed about it with my parents when I came out for a vacation. My parents were not totally against it, and they told me to consult a doctor first. In the end, I was scheduled for the surgery. I think it is important to get support and agreement from the family too, because not only the patient but also the family has to go through the process.
As many other people probably do, the things I was most concerned about were the side effects and complications of the surgery. My parents were also very concerned about this. Because no matter I much taller I got, it would be useless if I didn’t have good health. I was especially sensitive about it because I loved football. The patients who already had the surgery told me that there is a safe range as to how much a person can lengthen, and it gets dangerous once the safe range is exceeded. The patients who were operated within the safe range are now doing normal daily activities doing the sports they want. There are also patients who can even play tennis and basketball with no problem. This means that there are personal differences in healing. So I decided on the length with my family and had my lengthening up to that range.
1st surgery
I had a consultation at the hospital and discussed about it with my parents, then scheduled the surgery on the phone. Usually the patient is admitted to the hospital 3~4 days prior to the surgery and goes through physical examinations. I was put to sleep during the surgery and it was around 2 o’clock when I woke up. I noticed that my legs were wrapped in bandages, other than that I didn’t really know what was going on. The pain was pretty bearable. The bandages were taken off after 2 days, and I wasn’t really sure if they were really my legs. I was a bit scared and thought that it’s not an easy job after I saw all the drill-like pins and stitches on my legs. I couldn’t stand because I didn’t have any strength on my legs. After the surgery, I went to sports medicine clinic to learn how to use crutches and do exercises. But after exercising at the clinic, I was able to walk without crutches. I think I couldn’t give strength to my legs at first because I was too afraid. The external fixator worked as my bone and supported my leg and my muscle strength wasn’t too bad since I just had the surgery. So as long as I wasn’t too afraid, I was able to walk. I started lengthening my leg 1mm a day. You see a lot of these patients at the hospital. There was an older guy who had had calf lengthening surgery before and thigh surgery then. I asked him a lot of things that I was curious about. It is good to get to know the patients around you and get advice from them. I am usually shy around strangers but I still asked them many things and exchanged information and got close to them. After one week of lengthening, we made sure that the lengthening process was going well, and was discharged from the hospital. Afterwards, I was examined at the hospital every 2 weeks.
Lengthening
The purpose of surgery is to lengthen your leg by turning the dice on the screw on the Ilizarov device. The dices are from 1 to 4 and it makes 1mm of lengthening when you turn it around once. An analogy I heard from the hospital is that, like it is bad for the body to have a tremendous shock in a car accident at an unexpected moment, it is just as bad if the leg is lengthened too fast or irregularly. There were days when I lengthened 1mm or 0.5mm. But surely the pain was less when it was lengthened less. So I think it is better to take time and lengthen at a safe speed so that it is not harmful for the body. At first, the leg looks shorter on the x-ray than the actual lengthened amount. I had a difference of 8mm at first. On the x-ray, you can see the empty space in the bone getting filled up as time passes, it shows bone generation. I had to decrease my speed from 1mm to 0.5mm because of slow bone generation. The professor said I have to show effort myself for bone generation. It is more important and better to have firm bone generation at a slow speed because you can’t take out the external fixator otherwise, even if it is lengthened.
Rehabilitation exercises
Exercise is important during lengthening. I was walking the most because walking not only helps a lot with preventing leg muscle weakening, but also with stimulating and accelerating bone generation. I read from someone’s writing that he walked for 2.5 hours after the surgery so I walked for 3~4 hours. It is better to walk as much as you can. But exercising is not so easy because muscle weakening and pain due to lengthening. Stretching also needs to be done because the bone is being lengthened and you will feel that your skin and tendon have reached the limit. Equinus deformity will occur eventually when the Achilles tendon has reached its limit. Equinus deformity itself makes it harder to exercise. So you should pay more attention to stretching that area. When you do walking exercises, you should also pay more attention to working out your Achilles tendon. Also, you won’t be able to stretch out your legs straight. There are lots of websites that explain about stretching exercises and the doctors kindly explained effective methods to me.
Pain
The pain was alternating between my two legs, and learned that other patients experienced the same. One leg was hurting while one was ok, and after pain came about, it would go away after a few days. I read from one of patients’ writings that he could only sleep for 2~3 hours at night because of too much pain, but I never had so much pain that I couldn’t sleep. Whenever I thought the pain was too much, I stopped lengthening, and the pain disappeared. Massaging the area or getting prescription for painkillers also helps with pain relief. I took quite a bit of painkillers to be able to exercise well. But I only took it when I felt like I wasn’t going to be able to exercise because of pain. You should refrain from taking painkillers because it builds up tolerance. It was painful especially when I moved my ankle, but it hurt the most when I flexed it. That is why it is difficult to exercise of equinus deformity.
Nutrition
I took a lot of vitamin C and pork skin for bone growth. I don’t know in details, but I learned that in bone generation, some kind of net forms first, then calcium gets attached to the net to form new bone. Also, vitamin and collagen accelerates bone growth, so I am taking vitamin C right after every meal. I also heard that vitamin D is important, I used to sunbathe by the window every 30~40 minutes unless it was a rainy day. I heard 30~40 minutes of sunlight helps with vitamin D formation. (In the winter, however, because the amount of sunlight is not regular and enough, it is better to take supplements or eat enough food with vitamin D). You don’t tend to see the sunlight when you are just in your room after the surgery. So staying in the sun is good for your body and refreshing your mind even if it might seem like a hassle (I heard the sunlight coming through a window is not helpful.) I consumed a lot of calcium and protein. I especially focused on calcium consumption, but if you feel that the amount of calcium you are taking is not enough, you can get prescription of it during your outpatient visit.
Disinfection & Inflammation
Pin disinfection needs to be done regularly during the lengthening period after the 1st surgery. It is difficult to exercise once you get inflammation and pain. If it gets worse, you might have to be hospitalized. So it is important to disinfect the operated area meticulously to prevent inflammation. I learned how to disinfect during hospitalization after the 1st surgery. Alcohol is used at the hospital, but if you look up online, people also use hydrogen peroxide or betadine for disinfection. I used alcohol one day and hydrogen peroxide the next two days. If you continuously use alcohol, the skin around the pin gets too dry and keratinized. So I started using hydrogen peroxide to prevent that. The reason I used alcohol one day out of three is because the mechanism of disinfection is different. Alcohol has sterilizing property by itself so it is also used for disinfecting objects or hands, but hydrogen peroxide could be used only in the wounded area because it needs to be in contact with some elements in the blood. So when I was using alcohol, I cleaned the upper part of the pin and the surrounding area with it. You might also see blood or pus coming out while exercising, but you shouldn’t worry about it too much and if you think it’s too much you can use sterilized gauze. If you are worried about inflammation, you should get prescription before discharge, so that you can take it in time of inflammation.
Concluding my thoughts
I found other patients’ experience very helpful, so I tried to write as much as I know in the hopes of being helpful to other patients as well. Once thing I noticed is that one time of experiencing it is much more difference than hundred times of listening and reading about the surgery. I am not completely done with the process, so I don’t think I’m in the right position to talk too much about the surgery.
The most important thing is that the patient should think about it very carefully, find out about it as much as possible, and figure out if the surgery is really what he/she wants. This surgery is definitely not easy and the patient absolutely has to pay what it is worth. The patient also needs to be prepared to show effort after the surgery. I am simply thankful for the fact that I had the surgery I wanted, and I will try hard for better results. I thank many people and hope other people would get great outcomes too.
[Regular patients] It is time that we show effort
Hello.
I am a 23-year-old male and I have the leg lengthening surgery in February of 2011. I first heard of the surgery when I was in high school, but I had more negative thoughts about this surgery back then. I gave up having the surgery after the TV show “I want to know that” specifically talked about the side effects and complications of the surgery. But I got to know more about the surgery by coincidence and realized that it was actually different than what I had been thinking. So I thought of having the surgery after I get discharged from the hospital. So I discussed about it with my parents when I came out for a vacation. My parents were not totally against it, and they told me to consult a doctor first. In the end, I was scheduled for the surgery. I think it is important to get support and agreement from the family too, because not only the patient but also the family has to go through the process.
As many other people probably do, the things I was most concerned about were the side effects and complications of the surgery. My parents were also very concerned about this. Because no matter I much taller I got, it would be useless if I didn’t have good health. I was especially sensitive about it because I loved football. The patients who already had the surgery told me that there is a safe range as to how much a person can lengthen, and it gets dangerous once the safe range is exceeded. The patients who were operated within the safe range are now doing normal daily activities doing the sports they want. There are also patients who can even play tennis and basketball with no problem. This means that there are personal differences in healing. So I decided on the length with my family and had my lengthening up to that range.
1st surgery
I had a consultation at the hospital and discussed about it with my parents, then scheduled the surgery on the phone. Usually the patient is admitted to the hospital 3~4 days prior to the surgery and goes through physical examinations. I was put to sleep during the surgery and it was around 2 o’clock when I woke up. I noticed that my legs were wrapped in bandages, other than that I didn’t really know what was going on. The pain was pretty bearable. The bandages were taken off after 2 days, and I wasn’t really sure if they were really my legs. I was a bit scared and thought that it’s not an easy job after I saw all the drill-like pins and stitches on my legs. I couldn’t stand because I didn’t have any strength on my legs. After the surgery, I went to sports medicine clinic to learn how to use crutches and do exercises. But after exercising at the clinic, I was able to walk without crutches. I think I couldn’t give strength to my legs at first because I was too afraid. The external fixator worked as my bone and supported my leg and my muscle strength wasn’t too bad since I just had the surgery. So as long as I wasn’t too afraid, I was able to walk. I started lengthening my leg 1mm a day. You see a lot of these patients at the hospital. There was an older guy who had had calf lengthening surgery before and thigh surgery then. I asked him a lot of things that I was curious about. It is good to get to know the patients around you and get advice from them. I am usually shy around strangers but I still asked them many things and exchanged information and got close to them. After one week of lengthening, we made sure that the lengthening process was going well, and was discharged from the hospital. Afterwards, I was examined at the hospital every 2 weeks.
Lengthening
The purpose of surgery is to lengthen your leg by turning the dice on the screw on the Ilizarov device. The dices are from 1 to 4 and it makes 1mm of lengthening when you turn it around once. An analogy I heard from the hospital is that, like it is bad for the body to have a tremendous shock in a car accident at an unexpected moment, it is just as bad if the leg is lengthened too fast or irregularly. There were days when I lengthened 1mm or 0.5mm. But surely the pain was less when it was lengthened less. So I think it is better to take time and lengthen at a safe speed so that it is not harmful for the body. At first, the leg looks shorter on the x-ray than the actual lengthened amount. I had a difference of 8mm at first. On the x-ray, you can see the empty space in the bone getting filled up as time passes, it shows bone generation. I had to decrease my speed from 1mm to 0.5mm because of slow bone generation. The professor said I have to show effort myself for bone generation. It is more important and better to have firm bone generation at a slow speed because you can’t take out the external fixator otherwise, even if it is lengthened.
Rehabilitation exercises
Exercise is important during lengthening. I was walking the most because walking not only helps a lot with preventing leg muscle weakening, but also with stimulating and accelerating bone generation. I read from someone’s writing that he walked for 2.5 hours after the surgery so I walked for 3~4 hours. It is better to walk as much as you can. But exercising is not so easy because muscle weakening and pain due to lengthening. Stretching also needs to be done because the bone is being lengthened and you will feel that your skin and tendon have reached the limit. Equinus deformity will occur eventually when the Achilles tendon has reached its limit. Equinus deformity itself makes it harder to exercise. So you should pay more attention to stretching that area. When you do walking exercises, you should also pay more attention to working out your Achilles tendon. Also, you won’t be able to stretch out your legs straight. There are lots of websites that explain about stretching exercises and the doctors kindly explained effective methods to me.
Pain
The pain was alternating between my two legs, and learned that other patients experienced the same. One leg was hurting while one was ok, and after pain came about, it would go away after a few days. I read from one of patients’ writings that he could only sleep for 2~3 hours at night because of too much pain, but I never had so much pain that I couldn’t sleep. Whenever I thought the pain was too much, I stopped lengthening, and the pain disappeared. Massaging the area or getting prescription for painkillers also helps with pain relief. I took quite a bit of painkillers to be able to exercise well. But I only took it when I felt like I wasn’t going to be able to exercise because of pain. You should refrain from taking painkillers because it builds up tolerance. It was painful especially when I moved my ankle, but it hurt the most when I flexed it. That is why it is difficult to exercise of equinus deformity.
Nutrition
I took a lot of vitamin C and pork skin for bone growth. I don’t know in details, but I learned that in bone generation, some kind of net forms first, then calcium gets attached to the net to form new bone. Also, vitamin and collagen accelerates bone growth, so I am taking vitamin C right after every meal. I also heard that vitamin D is important, I used to sunbathe by the window every 30~40 minutes unless it was a rainy day. I heard 30~40 minutes of sunlight helps with vitamin D formation. (In the winter, however, because the amount of sunlight is not regular and enough, it is better to take supplements or eat enough food with vitamin D). You don’t tend to see the sunlight when you are just in your room after the surgery. So staying in the sun is good for your body and refreshing your mind even if it might seem like a hassle (I heard the sunlight coming through a window is not helpful.) I consumed a lot of calcium and protein. I especially focused on calcium consumption, but if you feel that the amount of calcium you are taking is not enough, you can get prescription of it during your outpatient visit.
Disinfection & Inflammation
Pin disinfection needs to be done regularly during the lengthening period after the 1st surgery. It is difficult to exercise once you get inflammation and pain. If it gets worse, you might have to be hospitalized. So it is important to disinfect the operated area meticulously to prevent inflammation. I learned how to disinfect during hospitalization after the 1st surgery. Alcohol is used at the hospital, but if you look up online, people also use hydrogen peroxide or betadine for disinfection. I used alcohol one day and hydrogen peroxide the next two days. If you continuously use alcohol, the skin around the pin gets too dry and keratinized. So I started using hydrogen peroxide to prevent that. The reason I used alcohol one day out of three is because the mechanism of disinfection is different. Alcohol has sterilizing property by itself so it is also used for disinfecting objects or hands, but hydrogen peroxide could be used only in the wounded area because it needs to be in contact with some elements in the blood. So when I was using alcohol, I cleaned the upper part of the pin and the surrounding area with it. You might also see blood or pus coming out while exercising, but you shouldn’t worry about it too much and if you think it’s too much you can use sterilized gauze. If you are worried about inflammation, you should get prescription before discharge, so that you can take it in time of inflammation.
Concluding my thoughts
I found other patients’ experience very helpful, so I tried to write as much as I know in the hopes of being helpful to other patients as well. Once thing I noticed is that one time of experiencing it is much more difference than hundred times of listening and reading about the surgery. I am not completely done with the process, so I don’t think I’m in the right position to talk too much about the surgery.
The most important thing is that the patient should think about it very carefully, find out about it as much as possible, and figure out if the surgery is really what he/she wants. This surgery is definitely not easy and the patient absolutely has to pay what it is worth. The patient also needs to be prepared to show effort after the surgery. I am simply thankful for the fact that I had the surgery I wanted, and I will try hard for better results. I thank many people and hope other people would get great outcomes too.