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Daechan Hospital's Pediatric Deformity & Short Stature Clinic walks with patients.

[General - Limb Lengthening] My Heart Has Grown as Much as My Legs Have Lengthened...

Admin2023-01-30
My school days when I was called cute despite my small stature
Since I was young, I was always in the first 5 in attendance number due to my small stature and height. When I graduated elementary school, I was 157cm tall, and I didn't think I was short compared to my peers. However, when I entered middle school and reached puberty, contrary to my expectation that I would naturally grow taller, I always remained at the front of the line, and my friends who were similar to me began to grow noticeably taller. At least when I was young, I was called cute, but as I felt that I was the only one standing still, I began to feel anxious and worried.
In particular, my parents were very worried when my height, which had been growing by about 5-6cm each year, slowed down to about 3-4cm. My parents' heights were average, but my older brother, who was one year older, was 183cm tall, and my middle school-aged younger sister was 165cm tall, which was above average. Therefore, my parents believed that I would naturally grow when the time came.
 
However, seeing me grow slower than my peers, they felt impatient and serious and sought out a growth clinic at a certain university. After several tests, it was diagnosed that my growth plates were almost closed, so I would not be able to grow any taller, which greatly frustrated my parents and me.
My mother regretted not taking action earlier, and in an effort to grow even a little taller, I received hormone injections for a few months and consistently took famous herbal medicine that was said to increase height. However, my height did not increase as much as I had hoped, and my complex about my height only grew.
Moreover, as I loved to exercise, I was often pushed back in physical fights when playing soccer and basketball, and I often felt the limitations of my innate physique even when I tried my best.
 
After entering university, I received a physical examination for the military, and my height was 163.8cm! Suspiciously, I measured my height again at the hospital, and it was 164cm, not much different. Feeling a little ashamed, I would say 166cm or 167cm when someone asked, and I would wear high-heeled shoes with high insoles to overcome my height complex when I went out to meet friends or when there was a family gathering.
However, I resented and regretted the fact that I was short, thinking, "Do I have to live like this, making efforts to look taller for the rest of my life?"
Around last fall, a female university student made a statement that "anyone under 180cm is a loser," which became a social issue. Of course, it was said for fun during a broadcast without much thought, but it became an example of how much society is going towards height-ism or look-ism.
 
When I was in middle and high school, it was a place full of male students, so I didn't pay much attention to my appearance. However, after entering university, I experienced a co-educational life for the first time since elementary school. While majoring in 'Sports Media Studies,' I met many classmates, juniors, and seniors, and I also hung out with students from other departments. It was good to hang out together, but for some reason, I had hardly ever seen men shorter than me. All I could think about was, "What did they eat, and how did they exercise to grow so tall?" I went on a blind date before enlisting in the military, and as we were talking and walking outside, the female student seemed embarrassed when she found out that she was about the same height as me. I really wondered if being short was a sin and why I had to feel so miserable and humiliated... In fact, I couldn't even get a few blind dates because of my height, and I even worried that I might never be able to have a girlfriend in my life. Even if I tried to show other charms, I wasn't given a chance.
 
Surgery Decided After Seeing an Advertisement
After being discharged from the military, I returned to school and was preparing to take a leave of absence for language training. One day, while walking in the Gangnam subway station, I saw an advertisement for surgery to increase height and took the phone number. My parents, who were more heartbroken than I was, suggested that I inquire about it, so I visited an orthopedic clinic in Gangnam.
I had no prior knowledge about height-increasing surgery and had never seen it around me, so I didn't expect much. However, the story about the surgery I heard there was so hopeful and exciting that it was enough for me to make a decision. I decided to have the surgery because I was told that my height could increase by about 8-9cm in about 3 months and that I could walk in 6 months. Naturally, I stopped my planned language training.
While discussing the surgery date, my father asked his close orthopedic doctor friend for advice. He strongly advised me to get another examination and make a decision because the surgery was not a simple one. I also quickly calmed down my excited heart and visited Professor Song Hae-ryong of Korea University Guro Hospital, whom my father's friend had recommended after inquiring around.
 
I still can't forget the sight on the day of my outpatient appointment. The professor's room was full of patients, and I especially noticed many short stature patients. The professor was busily treating patients, going back and forth between several rooms. When it was my turn, I told the professor about my condition. However, the professor repeatedly asked about my will and allowed me to meet a patient who had experienced the surgery so that I could reconsider.
 
Seeing the appearance of patients who had undergone Ilizarov, the excitement and hope I had just had disappeared, and I lost confidence. My mother also seemed shocked when she saw the appearance of a patient who had undergone Ilizarov for the first time, and after listening to the patient's parents' explanation, her decision to have the surgery seemed to waver again.
After returning home, I searched the internet for information about Ilizarov surgery. As I read the articles on the internet, I suddenly became scared and worried that I might not be able to use my legs due to side effects, and I wondered if I, who love to exercise and attend a sports college, should undergo surgery while taking such a risk. My parents were also skeptical about the surgery and disappointed.
However, when I thought about the hope I had briefly had, I didn't want to give up. I thought that I could go to language training next time, but this surgery would be difficult or regrettable if not now, so I decided to try again. My parents also encouraged me, saying, "Let's suffer for a year," while secretly worrying.
This surgery is not covered by insurance, so the expenses are very high, and the financial burden is not easy. Some people sneer, saying that I'm doing all sorts of things even though it costs a lot of money. However, I wanted to find the confidence I had lost by growing even a little taller if I could.
 
While setting the surgery date and undergoing pre-operative tests, I saw two patients who had the same surgery. The first was Y, who had surgery in November last year, and the second was S, who had surgery about 10 days before me. Y was very tired, perhaps because he was weak, and he told me about his suffering from inflammation and water retention. And he kindly told me to call him anytime and ask questions.
On the other hand, S, who had surgery two weeks ago, had almost no pain yet, and his surgical site was clean, so he didn't seem to be having a hard time. I met with the two patients and their guardians and asked them about their motives for having the surgery, how painful it was after the surgery, what the problems were, how they were living, and how much the costs were in detail. Even after making a decision and setting the surgery date, conflicts and worries continued.
I also reproached myself, saying, "Why is a young man like me bothering his parents and himself by not overcoming such a handicap?" On the other hand, I also felt motivated, saying, "I've already served in the military, so I should work hard for another year and build my future life with confidence." Above all, what I was most afraid of was not the multiple surgeries, but whether I would be able to live a normal life after the surgery, and whether I would have a disability. It was a huge adventure for me, and I needed courage. I was conflicted and worried until the moment I entered the operating room.
 
Finally, the surgery date was set for March 16, and I was admitted to the hospital on Saturday, 3 days before the surgery. After being admitted to the hospital and checking into my room, I was very shaken when I saw another patient I met in the same room. Because he was a 20-year-old university student who had undergone Ilizarov surgery, and he was suffering from great pain due to major aftereffects and alcohol disinfectant allergies after surgery in January. His mother seemed sorry for me and showed a worried reaction, saying, "What's wrong with being short? Being healthy is the best." My parents and I were greatly shaken, and it was not an easy situation because we could not go back on the surgery date. However, after a long period of conflict, I felt that I would regret it whether I had the surgery or not. I kept thinking about it, but I decided to have the surgery with the thought, "I don't know anymore. I'm just going for it now!"
 
Surgery Relying on and Following the Professor Unconditionally
The surgery, which started at 9 am on Tuesday, March 16, 2010, took about 5 hours, including preparation time, surgery time, and recovery time, under the direction of Professor Song Hae-ryong. After the anesthesia wore off in the recovery room, I came up to the hospital room and saw that I was wrapped in thick bandages and it was difficult to move.
I had a lot of conflicts, but seeing my appearance after undergoing Ilizarov surgery, I realized that the long journey of suffering had begun. During the rounds after the surgery, Professor Song Hae-ryong told me that the surgery went well and gave me words of comfort and precautions. From now on, I decided that "the professor's words are the law and the truth. I will believe and follow him unconditionally." In fact, the consent form that the attending physician had received the day before the surgery told me about various possible prognoses, which made me very scared at the time. But from now on, I thought that I could get good results by trusting the doctors and putting them into practice as they were.
 
The bandages were removed 3 days after the surgery, and there was a slight swelling. I reduced the swelling with a cold compress, and 4 days later, at the professor's discretion, I went to the sports medicine room on the 1st basement floor of the hospital and was able to stand using a walker to walk with crutches for 1-2 laps. The inserted iron was uncomfortable and there was a slight pain, but it did not feel severe yet, perhaps because of the effect of the painkiller.
The sports medicine teacher looked at my walking and told me that I would be able to walk with crutches after the weekend, and taught me how to use crutches and how to balance and walk. At first, it was difficult to take even one step, but I practiced steadily at the set time and was able to repeatedly go back and forth between the hospital room bathroom and both wards.
I received help from my mother and caregiver in the hospital room, and as the discharge date approached, I was worried about how I would live at home. Since I couldn't keep receiving help from someone, I had to go to the bathroom and wash myself.  
After the surgery, the nurse taught me how to disinfect the implanted iron and the surrounding area cleanly for about 3 days, so I started disinfecting it myself twice a day, morning and evening. The importance of disinfection cannot be overemphasized. Because I drilled through the bone and inserted iron, bacteria and invisible fine dust can enter through the gaps where the iron is inserted and cause inflammation, so alcohol disinfection must be thorough.
I started stretching 0.5mm at a time 1 week after the surgery, and after a few days, I changed to 1mm and started stretching. Two weeks after the surgery, I had the stitches removed from the surgical site and was discharged from the hospital. While I was in the hospital, I was under the care of the doctors, but I was anxious and worried because I thought I would have to do this myself at home.
Since I was being discharged, the sports medicine room taught me stretching exercises that I could do alone, walking while putting strength on the back heels to touch the ground, and exercising by pulling my feet with a string. This exercise was said to prevent tiptoeing that occurs when stretched more than 6cm and to affect the Achilles tendon, which is not easy to stretch, so I was asked to practice steadily.
 
When I was discharged, the professor asked me to come to the outpatient clinic every two weeks and to live the same way as usual and exercise a lot. As each week passed, stretching 1mm every day, I started to feel a little pain as time passed, and it started to hurt from the point when my height grew by about 3-4cm. When I live and walk, the pain is less, but the nights when I have to sleep are really frustrating and painful, and I wanted to scream. From 3cm or more, I sometimes received help from the prescribed painkillers, but I woke up and tossed and turned every day with the medicine being effective for only about 2-3 hours.
 
Because I saw Y's second surgery (tiptoe surgery) when I was hospitalized, I thought, "I have to practice hard so that I don't have to have tiptoe surgery." Because I saw another difficulty of having to install two rings on the instep to stretch the calf muscles (Achilles tendon) that did not stretch together and turn the screws to stretch them.
If you loosen the two screws embedded in the ring and turn the number of the square dots from 1 to 4 to match the direction, it will stretch 1mm per day, but even if you stretch regularly, the difference between the two feet was about 3mm. If the difference is too large, it is said that one bone grows faster or slower, and in severe cases, you need to receive emergency treatment or partial surgery again, so it is important to stretch regularly and go to the outpatient clinic regularly for treatment.
 
Sometimes, if you have a fever due to inflammation, you may have to give up stretching and remove it. Inflammation can be confirmed by checking the level through a blood test. If the CRT level is about 5, it is normal, and if it is too severe according to the professor's judgment, the antibiotic drug is taken to lower the level and eliminate the inflammation.
I check the bone through X-Ray every two weeks, and the process of bone filling between the cut bones is amazing, but the time is slow, so I get tired thinking, "When will my bones grow?"
For a while, the bones were not formed, so I waited for the bones to form without stretching. The key is not stretching, but making sure that new bones follow as much as you stretch. As a result, it seemed to take much longer than expected, and I welcomed the hot summer.
Looking at the legs, which have become remarkably thinner and noticeably longer due to the reduced muscle mass, was amazing and rewarding, but the time of pain that followed was felt to be long and tiring. Even though it has progressed relatively smoothly compared to other patients.
In the meantime, I felt severe pain in the thin bone (TIBIA) side. As a result of checking with X-Ray when I came to the outpatient clinic around July 21, the thin bone grew quickly and the situation did not stretch. It was a problem that the bones were not formed quickly, and it was also a problem that they were attached too quickly. The professor finished by cutting the hardening thin bone and fixing it with a pin in about 30 minutes as an outpatient surgery on the same day. Even though unexpected situations occurred several times, I could not help but be amazed at the professor's experienced coping ability.
 

Types of Rehabilitation Exercises
The professor mentioned the importance of exercise every time I went to the outpatient clinic, saying that exercising a lot can help the bones grow faster and prevent the muscles from hardening. However, there were limitations to exercise because the rings were embedded. Life was uncomfortable, but the hardest thing was sleeping. Because the posture changes without even knowing it, you often bend your knees to sleep. So, the sports medicine room kept training me to straighten my knees. In addition, if you stack high books or cushions and put them on the back heel side to raise your legs, and then put a sandbag on your thighs that the patient can endure for a set time (5 minutes to 10 minutes) twice a day, you can prevent your knees from bending.
 
Another action is to strengthen and stretch the back heel muscles (Achilles tendon) on the back with a string to prevent tiptoeing. This posture is related to stretching and is the most basic exercise that helps strengthen the muscles in the calf. There is an exercise that is similar to cycling, but focuses on arm exercises. When using crutches, it plays a role in helping the arms withstand the lack of strength in the lower body.
No matter how much you exercise, the thigh and calf muscles naturally fall out because the iron is embedded in the bone and flesh. This is because strength-using exercises are limited and problems can occur on the side of the cut bone if you overdo it. But you can't not exercise. You must leave at least the minimum amount of strength so that you can endure the exhaustion when you live with the rings. This is an exercise where you put your legs on the bed and lift them up. It is a win-win action because it strengthens the thigh muscles and straightens the knees that are difficult to stretch.
Lifting both legs one by one strengthens the muscles in the thighs, waist, and calves. If you feel that the part is pulled, it means that you are seeing results.
 
Walking is essential, but posture is important. It is the most essential and basic exercise to prevent tiptoeing by making sure that the crutches are in front of the feet, and bending them about 20 degrees to put strength on the heels on the back to touch the ground.
For example, in stretching movements, bend the right leg in front and stretch the left leg all the way back to make the back heel touch the ground. This is an action to stretch the Achilles tendon, which is not easily stretched. Since ordinary people will not be able to reach it easily if they do this action, I think the above explanation will help patients who have undergone Ilizarov surgery.
I especially want to introduce more, but I have first written out a few actions. There are many actions I learned in the sports medicine room, but the actions I can do at home are limited. Based on my experience, I said that the actions explained above would minimize the tiptoeing and the falling muscle strength.

 
Mental Growth as Tall as the Lengthened Legs
What was difficult for me while undergoing Ilizarov surgery was that it was not easy for a young man to roll around at home all day, and it was also difficult to endure the time of increasing pain. At times like this, I felt like I was going to explode, and I often regretted what I was going to do. When I was hospitalized or went to the outpatient clinic, when I went outside, people around me were surprised, saying, "Oh my! That must be so painful. What is that?" I was burdened by this attention, and it was also very painful and difficult to not be able to meet and live in seclusion because my neighbors and friends still thought I was studying abroad.
As I write about the process of suffering from height and undergoing Ilizarov surgery by chance, I feel like even the long time of pain has passed quickly. As I look at my lengthened legs, I feel proud and proud of myself for enduring it well.
Before having surgery, I used to ask for advice from patients who had experienced it first in a blank state, but now I am in a position to tell patients who are going to have surgery in the future about things they are curious about without adding or subtracting. Sometimes I am at a loss as to how to help patients who ask for advice. Because it is a choice that requires extreme patience and perseverance, I can't easily say whether to do it or not.
 
The most frequent questions are how painful it is, whether it is tolerable, and how much it costs? These are the questions I asked first. Of course, I cut my body and put iron in my bones, so how can it not hurt, and it takes a long time, so there is no need to say how much patience is required. I feel that your will must be firm. It is so painful and difficult, but I am just gritting my teeth and enduring it because I don't want to disappoint my family and myself, who believe in me and watch over me.
I go to the outpatient clinic on average every two weeks, and after doing X-Ray and blood tests before receiving treatment, the professor evaluates my efforts for two weeks through the length I have stretched so far, the level of inflammation, and the way I walk, and points out the problems, and carefully checks what I need to be careful about.
Since it was my first time, I had a lot of worries and asked questions often, so I bothered the professor quite a bit. However, the professor was always witty and humorous, and despite the annoyance, he responded to the questions with a bright face. In my eyes, all the patients really felt like the teacher's friends or family.
 
In the outpatient clinic, I saw many patients with dwarfism who were suffering from congenital deformities who were having surgery or were trying to have surgery. If those who desperately need Professor Song Hae-ryong's touch see me, they might point fingers at me and say that it is a luxury. But I wanted to get rid of the mental illness that comes from appearance. As a young person with more days to live than I have lived, I wanted to have better opportunities. I imagined myself growing to about 170cm tall, and I wanted to become a mature adult in body and mind who would not be mistaken for a middle school or high school student, even though I had been to the military.
Although the important surgery and difficult time have not ended yet, there are so many things I want to do when all this is over. I want to meet friends, travel, and take off my boring patient clothes and dress up. When I get back to normal, I want to buy a suit and visit Professor Song Hae-ryong of Korea University Guro Hospital and thank the teacher who took care of my legs and mind so that I would not get tired while going through many twists and turns.
I personally think it is lucky that I met the professor. I think I endured this process smoothly because I completely trusted and trusted the professor. I sincerely bow my head and thank my parents who gave me the opportunity and Professor Song Hae-ryong who gave me excellent medical skills. I will take this opportunity to resolve to strive to lengthen my mental maturity along with my lengthened legs.
 
Tiptoe Surgery
However, 6 months have passed since the surgery and living with the rings. When I went to the outpatient clinic at the end of August, the X-Ray showed that I had grown about 9cm. That day, the professor told me to stop stretching and have tiptoe surgery, and immediately set the surgery date.
Not long after the first surgery, I was shocked to see Yang's appearance after tiptoe surgery, and I wondered where the determination to "exercise hard and never have tiptoe surgery" had gone, and I felt regretful as I looked at the instep that was stretched straight and hardened like a mannequin. I was more worried and anxious than the first surgery because I saw Yang's hospitalization life where he couldn't go to the bathroom and suffered from the inconvenience of life after tiptoe surgery. But I decided to think more positively because this is also a process of completion.
 
After being hospitalized two days before the surgery, I heard an explanation about the approximate surgery time and surgery details from the attending physician. The professor also gave me courage and hope, saying that it would be much easier to walk after the surgery and that I would be able to take off the rings and walk in about 2-3 months.
The surgery started around 8 am on the morning of the surgery, and I came out of the recovery room around 1 pm, about 5 hours later, and went to the hospital room. The legs wrapped in bandages felt heavier than the first surgery. Three days later, I saw the feet with pins (4 on one foot) in the heel and front heel (near the toes) and 2 more rings attached, and I felt like I knew why the patients who had experienced it first said it was difficult.
The attending physician told me how to stretch, saying that unlike stretching the bones, I should stretch the muscles by 1mm three times a day, that is, 3mm. At first, I didn't feel any pain, but after about 2 weeks, it suddenly hurt so much that I couldn't sleep. I couldn't stand the pain because it was already uncomfortable because of the embedded rings. I had a hard time losing a lot of weight. However, the left ankle and angle that had turned while stretching the bones returned to normal, and the tiptoeing noticeably went up to normal, and I was able to put my uneasy mind down.
There was pain every time I moved because there were pins embedded in the instep, but I was able to walk because there were rings under my feet. There are a few actions that can be done even though exercise is limited after tiptoe surgery. To prevent the legs from bending, put cushions that can raise the legs high when lying down, and put a heavy sandbag on the thighs and hold it for about 10 to 15 minutes, and you will naturally adapt and straighten them. Doing the action of raising and lowering the legs on the bed can also add strength to the thigh and calf muscles if you set a time and do 3 sets of 10 times each day.
After spending Chuseok in the hospital, I took an X-Ray and saw that the angle of the bones was almost all up, so I thought I would be able to take it out soon, but the professor said that if I took it out in a hurry, I could become tiptoeing again due to lack of exercise, and it would be better to take it out slowly for safety because I could suffer from reoperation.
 
After a long 6 weeks, the teacher who managed the Ilizarov rings took out the pins on the feet. Without anesthesia, I loosened the screws and cut them off to easily remove the pins. The time it took was a short 5 minutes, but it hurt so much that it felt long, and the pain did not go away all day. A few days later, I stood barefoot and was able to touch the ground with my heel. It was overwhelming to stand on my heel. I felt more relaxed because I had overcome another hurdle, but on the other hand, I felt more impatient and frustrated.
I remembered the words of an experienced person, "The finishing point is more difficult than the beginning." When I was stretching the length of the bones, I didn't know how the time passed due to the increasing pain and disinfection, but after the tiptoe surgery was over, I felt more bored and frustrated every day because there was nothing else to do except disinfection. It's the feeling that the frustration from a year of unintentional seclusion has reached its limit.
After about 2 months after removing the tiptoe pins, I was going to take off the rings, but the X-Ray showed that the right side did not fill up with bones as much as the left side, so I was able to take off only the left ring first. I took out the pins in the cast room, put on a cast, and fitted an orthosis. I wanted to take them both off, but I had no choice. After taking one off, I kept touching it, thinking, "Is this my leg?"
 
I went to the outpatient clinic every 3 weeks to check the condition of my right leg, and in the meantime, I removed the cast on my left leg, put on an orthosis, and walked. I had the rings removed about two months after I took out the left leg because the right leg was growing slowly. The teacher wanted me to stay a little longer considering the condition of the bones, but the inflammation continued to occur because I was pinned for too long. One time, I felt heat and pain, and I thought it was a rare occurrence, but I passed it by, but the legs swelled and heated from the center of the ring to the ankle overnight, and the legs became heavy and I couldn't even walk, so I went to the emergency room with my mother at dawn. The blood test result showed that the inflammation level had risen to about 110. I was hospitalized for a few days and lowered the inflammation level and reduced the swelling with injections.
It's a burden that one bone is growing less, but the inflammation is causing trouble, so I was worried and depressed, thinking, "What if something goes wrong with the function?" After many twists and turns, I have removed all the rings on both sides and am now doing rehabilitation exercises in the sports medicine room. The function of the left leg that I released first is in good condition, and I am working hard to stretch the muscles of the right leg that I released late. Of course, my legs have not recovered to normal now, but I feel that I am getting better day by day.
I had a relatively good surgical prognosis, but I suffered from inflammation in the final stage, which made my parents and the professor very tired, but in the end, it seemed important to have trust and follow the professor. I was frustrated because the progress was slower than I expected, but when I take off the rings and exercise, I feel something awkward and lighter. The amount of strength has decreased significantly, so it is very difficult to rehabilitate, but I am working hard in anticipation of returning to school for the second semester with normal legs.
 
The past year has been a huge event in my life. From the decision to have surgery to today, it was something I never imagined. Looking at the length of my pants, which have become noticeably shorter, I forget the past hardships. It's ugly and embarrassing, but I feel like I've cured the mental illness of having a short height.