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Author Topic: Stewie Griffin - External Tibias - Dr. Xia - 2007 - My Quest in Beijing  (Read 89714 times)
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jj
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« Reply #300 on: February 21, 2010, 03:17:49 PM »

I am not exactly an authority on this particular case but I consulted a colleague of mine, who is an exceptional orthopedic surgeon, on the matter. It turns out, put aside all the complications and hazards associated with any type of surgery under general anesthesia (which you would require at least two), there are other factors which you have to consider before contemplating the idea of having internal nails.

It turns out for an internal fixation device to be a viable stress-bearing solution, the rod has to have a diameter of about 10-12mm depending on the material used, be it stainless-steel or titanium and the weight of the patient etc (I don’t know the exact specs of what is being used in Beijing). Now the diameter of the intramedullary canal in the bone, which happens to vary from person to person and also alongside its length, is around 7-8mm. To have the rod inserted, material has to be drilled out such that the inner diameter of the hole is slightly larger than the outer diameter of the rod. This would reduce the thickness of the high density, weight carrying bone shell around it, which for obvious reasons will not start to heal until the rod is removed. This is most problematic in the case of the tibia bone as it is generally thinner than femur but has to carry the same weight.

The other factor would be what is referred to as “Bone Demineralization” due to lack of stress on the bone. It is something similar to what the astronauts experience in zero G or long term coma patients or people with spinal injuries for eg. Normally when you are wearing a cast or an external fixator, which has a degree of flexibility, and you put weight on the fracture there is a microscopic squeezing effect. These micro-motions work analogous to packing tobacco in a pipe or coffee in a espresso machine, increasing the bone density. Having an internal nail on the other hand, minimizes this effect especially at the fracture site as most of the stress is taken up by the screws attaching the rod to the “healthy” bone hence prolonging the healing process. There is also another effect hypothesized called piezoelectric stimulation, by which the micro-motions and stress on the bone generates electrical signals that further stimulate bone growth.

Also by drilling out the bone, some of the blood vessels carrying the necessary building blocks are also cut out. It is something like having a root-canal procedure on a tooth after which the blood supply is cut by filling the canal. But it is not as dramatic in this case as there are still blood vessels on the exterior and inside the bone so it only prolongs the healing rather than leading to avascular necrosis (death of the bone). Now bone marrow has its own vital functions but it is not highly relevant to this case and I only mentioned it as a part of what has to be removed in order to insert the rod.

There are also other risks like bending the rod in an accident which makes it hard to remove, or having the rod stuck etc. which I’m sure you can read about more yourself.

I understand that you are already undergoing LL in Beijing, my professional advice would be, if at all possible and if you are interested in a faster healing, to keep the external devices on for the entire procedure until the bone is fully healed. Now I appreciate that having the Ilizarov fixator on for that long is not a very appealing thought, while other devices without 360* coverage, like the Mitkovic fixator are easier to wear. It is best if you consider all the implications before switching to an internal fixator, be it a nail inside the bone or even plates outside the bone.

As for when to remove the nails if you decide to put them in, that is only for the attending Dr looking at the X-rays to decide. Now it seems that in the Stewie’s case, he was let down by the medical staff who failed to explain to him the potential risks and the correct course of action after rod removal. So if in doubt, even a simple low-res MRI can shed light on everything as a cross-sectional analysis of the bone is worth a thousand X-rays.

Okay, hope that was helpful and if this information is already present somewhere else on this forum, sorry for repeating it.


PS. What I find really astonishing is people with no medical background or the relevant qualifications, apart from having gone through the process themselves, rejecting my diagnosis as mere nonsense! Just because someone has had brain surgery, no matter how much research they’ve put into it, does not make them a neurosurgeon, does it?  Wink

PPS. How come my credibility is negative?! I happen to have 3 (+)s and 3 (-)s, thanks to mmt and 55 wannabe…,  which by the intricate laws of mathematics should make it, eeh zero?

It seems there is very little “credibility” in the credibility system itself.  Cheesy


Thank you very much for this.  Your explanation regarding the width of the internal cavity vs the width of the nail and the width of nail that one would ideally insert for true weight-bearing capability are particularly illuminating.
It would appear that the doctors in this case did advise extreme caution before agreeing to remove the internal rod.
Your other comments seem sensible to me.
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« Reply #301 on: February 21, 2010, 03:29:09 PM »


Ouch!

It's clear from the X-ray that your bone wasn't healed fully - I think that it was only a couple of months away, though.

Hope that everything is OK from now on - I'd recommend that you keep taking something like 'Bone Formula' to help improve your bone density - and I hope that you have made milk part of your daily diet now...

Cheers, MMT
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« Reply #302 on: February 22, 2010, 09:47:11 PM »

Ouch!

It's clear from the X-ray that your bone wasn't healed fully - I think that it was only a couple of months away, though.

Hope that everything is OK from now on - I'd recommend that you keep taking something like 'Bone Formula' to help improve your bone density - and I hope that you have made milk part of your daily diet now...

Cheers, MMT

I have really up'd my milk intake over the last 3-4 months. I went to see the doctor few weeks ago and he told me I was fully healed now. So yes, MILK is definitely the way to go. I feel a lot stronger in my legs too. I think I'm never coming off the Milk diet as I seem to be hooked on it now. Smiley

Sg
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« Reply #303 on: February 22, 2010, 09:47:44 PM »

I have gotten a few questions about why I got the metal plate instead of the cast. Hopefully this post will answer them all.

Cast wasn't a good option for my fracture since it was so high up. I had the cast on temporarily for 2 weeks after I broke my leg until the day I had my surgery and it barely held my leg in place. There is a limit to how much they can tighten the cast around your leg. If they tighten it too much, you can loose circulation in your leg. But since the fracture was so high up, they had to put the cast on my entire leg up to just above the knee. However I could always feel my leg moving about inside the cast a few centimeters everytime I changed posture. Cast would have eventually healed the fracture but it would've taken a lot longer. ALSO, in my particular case, the bone on my right leg, on the opposite side of the fracture, hadn't fully consolidated at the time due to which I broke my leg in the first place. If you carefully observe the fracture, it seems my leg bent backwards and that's exactly what the case was. Because there wasn't enough strong bone to hold at the back, soft bone gave away and my leg basically bent backwards a little. The surgeon, while he was discussing my options, displayed my xray and drew some lines to show how much of a mis-alignment I had due to the fracture. Only possible way to re-align my leg was by either getting a rod inserted in the bone again, or a metal plate. After that they realized they couldn't insert the rod either since the fracture was so high up. Therefore metal plate was my only option. Also I was able to start moving about 3-4 days after my surgery which was good. With the cast on I had a lot more problems moving around.

Sg
« Last Edit: February 22, 2010, 09:48:37 PM by stewie_griffin » Logged

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« Reply #304 on: December 08, 2010, 04:53:06 PM »

hey stewie . .  juss finished reading your diary
how are u now . . .  it hs been over 9 months since u last posted . . .  100% recovered yet ?
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« Reply #305 on: December 11, 2010, 06:18:02 PM »

hey stewie . .  juss finished reading your diary
how are u now . . .  it hs been over 9 months since u last posted . . .  100% recovered yet ?

Hi, doing great. I haven't had a chance to get on here as I've been busy with work and stuff. My legs have now fully healed. I have even been doing body weight squats at the gym and jump rope. Occasionaly the plate in my right leg starts to bother me a bit but it gets better after a bit of rest. Also one thing I noticed is that my legs tend to get tired easily. That might be due to the extensive workouts (jump rope, squats and stationay bike). Once I give them enough rest, they are good to go. Any other vets experience the same situation?
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« Reply #306 on: December 15, 2010, 02:14:43 AM »

Quote from: stewie_griffin link=topic=207. msg40600#msg40600 date=1292091482
Hi, doing great.  I haven't had a chance to get on here as I've been busy with work and stuff.  My legs have now fully healed.  I have even been doing body weight squats at the gym and jump rope.  Occasionaly the plate in my right leg starts to bother me a bit but it gets better after a bit of rest.  Also one thing I noticed is that my legs tend to get tired easily.  That might be due to the extensive workouts (jump rope, squats and stationay bike).  Once I give them enough rest, they are good to go.  Any other vets experience the same situation?

Hey SG, I'm brand new to posting here and enjoyed your entire journal.   Wow, so many ups and downs, seriously.   Definitely respect your honesty and optimism with everything.   I've learned so much and appreciate it.    I sent a question to MMT by e-mail and told him I was going to post the following to the community as a whole and thought it was would be good doing it through your thread as I just finished reading it. . .

My main question is, before going for the surgery, what health preparation would you recommend? I have really thin legs and it seems all my weight gathers in my upper body.   I am about 5'4 (163 cm) around 150 lb and trying to achieve around 8 cm or so.   I hear that people become pencil thin from the procedure and sitting around so much so I'm wondering whether I should start bulking up in terms of trying to work out my legs a lot more with running and climbing stairs and such.   I also wonder whether just gaining more poundage (even if fat pounds) is good to make sure I have plenty of energy stores and nutrition beforehand (kind of a like being a bear before winter) :)  Ronne and some other places told me most important is stretching and yoga kinda of stuff.   Do you agree?   

-TT
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« Reply #307 on: December 18, 2010, 07:04:22 AM »

Hey SG, I'm brand new to posting here and enjoyed your entire journal.   Wow, so many ups and downs, seriously.   Definitely respect your honesty and optimism with everything.   I've learned so much and appreciate it.    I sent a question to MMT by e-mail and told him I was going to post the following to the community as a whole and thought it was would be good doing it through your thread as I just finished reading it. . .

My main question is, before going for the surgery, what health preparation would you recommend? I have really thin legs and it seems all my weight gathers in my upper body.   I am about 5'4 (163 cm) around 150 lb and trying to achieve around 8 cm or so.   I hear that people become pencil thin from the procedure and sitting around so much so I'm wondering whether I should start bulking up in terms of trying to work out my legs a lot more with running and climbing stairs and such.   I also wonder whether just gaining more poundage (even if fat pounds) is good to make sure I have plenty of energy stores and nutrition beforehand (kind of a like being a bear before winter) Smiley  Ronne and some other places told me most important is stretching and yoga kinda of stuff.   Do you agree?   

-TT

Hi TicTock, ("that's the sound of your life tickin away...Lumen" - from Dexter)

I wouldn't recommend bulking up or gaining any extra weight before doing this surgery. If you think about it, lighter you are, easier it is for you and your legs to carry your weight 5-6 days after surgery when they make you stand up. At first 100% of your bodyweight will be on your arms as you use the walker. You will benefit more if you are lighter. As far as becoming "pencil thin" is concerned, I wouldn't worry about that (you have bigger things to worry about). Just concentrate on your procedure and getting the heck out of there once everything is done. You can put the weight back on later. As far as nutrition is concerned, try to eat normal at the hospital. Also do a lot of research when you get their and fill up your fridge with goodies that hospital kitchen can't provide. My roommate had a huge box of food shipped to him from Poland which we both enjoyed for weeks as we were sick of eating hospital food. Regardless, in a weird way I kinda miss the pampering I received at the hospital. Breakfast, lunch and dinner all in bed while you're watching movies and playing video games on your laptop, what more can a guy ask for, other than ladies which, although challenging, is also doable Wink

Yea they tell that to everyone but I think unless you have been doing yoga and stretching your whole life, this last minute yoga/exercises wont' make too much of a difference. Just be fit physically and moreover mentally and you are good to go my friend.

Keep us all updated whether or not you decide to go for it.

Cheers~
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« Reply #308 on: December 20, 2010, 02:40:00 AM »

Quote from: stewie_griffin link=topic=207. msg40717#msg40717 date=1292655862
Hi TicTock, ("that's the sound of your life tickin away. . . Lumen" - from Dexter)

I wouldn't recommend bulking up or gaining any extra weight before doing this surgery.  If you think about it, lighter you are, easier it is for you and your legs to carry your weight 5-6 days after surgery when they make you stand up.  At first 100% of your bodyweight will be on your arms as you use the walker.  You will benefit more if you are lighter.  As far as becoming "pencil thin" is concerned, I wouldn't worry about that (you have bigger things to worry about).  Just concentrate on your procedure and getting the heck out of there once everything is done.  You can put the weight back on later.  As far as nutrition is concerned, try to eat normal at the hospital.  Also do a lot of research when you get their and fill up your fridge with goodies that hospital kitchen can't provide.  My roommate had a huge box of food shipped to him from Poland which we both enjoyed for weeks as we were sick of eating hospital food.  Regardless, in a weird way I kinda miss the pampering I received at the hospital.  Breakfast, lunch and dinner all in bed while you're watching movies and playing video games on your laptop, what more can a guy ask for, other than ladies which, although challenging, is also doable Wink

Yea they tell that to everyone but I think unless you have been doing yoga and stretching your whole life, this last minute yoga/exercises wont' make too much of a difference.  Just be fit physically and moreover mentally and you are good to go my friend.

Keep us all updated whether or not you decide to go for it.

Cheers~


Thanks so much SG!  I appreciate the input.   Right now I'm pretty sure that I'm going to do it.   Just want to go to Beijing and decide for sure when I go for my consultation.   If all goes all and everything is as expected, I'm going to do it.   It sure sounds like a long road but if its been done in the past, I can do it too :)  I found your diary really encouraging and will definitely keep people updated.   If I do it, expect to see a journal from me.   For now, my pre-surgery prep is work, stretch, work, stretch until the day I arrive.   I was actually planning on pigging out before arriving but now I've decided otherwise.   Thanks for the input and if anyone else has any other reccs I would appreciate any opinions out there :) Good luck to all and happy holidays!
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« Reply #309 on: January 25, 2011, 09:08:30 PM »

Hello, thanks for your imformative posts.  I am a 20 year old boy, and my height is only 161 cm.  I am not satisfied with my height at all, and it affects me in my dailylife. .  My goal is to gain 5-6 cm.  I have tried to contact the center by email, but I havent got any answers from them.  I wrote a email to them 3 days ago.  I would consider myself as a quite unpatient person, but I read at their website that they will answer emails within 24 hours.  Would it be better to contact the international officer Ronne Wang? I am still doing research, but I am sure that I am willing to go thrue a surgery to gain 5 cm.  First of all I would like to travel personally to Beijing to see the center, and talk to some patients and of course the medical staff.  I would like to travel to Beijing in october, and do the surgery in september/october next year.  Due to my studies. 

When did you receive answers from the center, did you have to wait for a long time? And when is it necesary to book date for the surgery, long waitinglists?

Thank you for your help
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« Reply #310 on: April 20, 2011, 10:31:44 PM »

great diary , wish you good luck !!

Same for me i have contacted them , sent like 3 emails over a month and no answer , nothing. . . .  funny when they say on their site that they ll answer within 24 hours. . .  o well must be really busy .
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« Reply #311 on: April 21, 2011, 03:23:32 AM »

symbiosis, if you have questions for the Beijing institute that you don't mind sharing, I can ask for you.  They have a local instant messaging service (for Chinese patients) that I've been using to communicate with them.  They have a staff managing the service (QQ messenger) for almost 24 hours coverage.
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« Reply #312 on: April 21, 2011, 04:45:03 AM »

hi Chlor , really?? thanks so much , that s awesome.  Well, i m in touch with Dr salameh for Syria in july, but as i m not sure yet , im still in dilemma between Beijing and Syria.  So i was trying to gather as much info as possible especially about the availability of a "bed" around that time in beijing ( begining of july would be perfect for me ) . 

I have some questions about the nail as well, im just wondering since it s "in" the bone . . .  i guess it grows over it? so how they take it out after?? i m sure i got it wrong, just need clarification on it. 

I also wonder about,. .  alot of people with accidental fractures have pain with cold and humidity/rain once it heals , i asked Dr salameh about this he told me it was nt the case for his patients , so i d like to ask the question on the board but i can t post :(  just wondering how the vets are dealing with this, any experiencing this? any input would be great !

And finally , they re updated packages quotes ( i heard they would up the prices just need to make sure to properly plan ahead)

I really didnt mean to hijack this thread but i used the search and read all the diaries and could nt find anything on  the subject , . . .

Hope your doing great stewie ! happy LL

PM me if it s better than here , thanks a bunch really appreciate buddy, it will help me make the right decision !
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« Reply #313 on: April 22, 2011, 12:38:55 AM »

hi Chlor , really?? thanks so much , that s awesome.  Well, i m in touch with Dr salameh for Syria in july, but as i m not sure yet , im still in dilemma between Beijing and Syria.  So i was trying to gather as much info as possible especially about the availability of a "bed" around that time in beijing ( begining of july would be perfect for me ) . 

Syria? Are you serious?!

http://www.telegraph.co.uk/news/worldnews/middleeast/syria/8466697/Easter-cancelled-in-Syria.html

Anyway, Stewie's diary is not the place to discuss this - please ask a question in the general board.

Cheers, MMT
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« Reply #314 on: April 22, 2011, 03:19:12 AM »

holy s***  i didnt know that lol thanks MMT . . .
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« Reply #315 on: April 22, 2011, 10:22:05 AM »

holy s***  i didnt know that lol thanks MMT . . .

You didn't know that Syria is a dangerous dictatorship and that there is a civil war there?!  Roll Eyes
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« Reply #316 on: April 22, 2011, 04:02:19 PM »

honestly nope, i dont watch tv at all, knew bout iraq though, must have been 5 years i dont watch tv or read news papers so. . .  anyways i ll look more closely into it, that s scary man

thanks
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« Reply #317 on: April 22, 2011, 04:12:33 PM »

Doctor Salameh assured me the other day that there was nothing to worry about. He said a lot of it was media hype, which I tend to believe. I've lived in South Korea and Japan for the past 12 years. American news describing imminent war with the North Koreans while I'm teaching a creative writing class to a bunch of middle schoolers with a northern-facing window . . . Osan military base a few miles away . . . jets and helicopter activity increased two fold . . . maybe. Nothing big. Just another day of teaching, nothing different. Heck, it's not even topic material at lunch. We're used to it . . . Go back to my classroom and load CNN's main page, and huh? Parallel universe, maybe?
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« Reply #318 on: April 22, 2011, 04:59:05 PM »

Doctor Salameh assured me the other day that there was nothing to worry about. He said a lot of it was media hype, which I tend to believe. I've lived in South Korea and Japan for the past 12 years. American news describing imminent war with the North Koreans while I'm teaching a creative writing class to a bunch of middle schoolers with a northern-facing window . . . Osan military base a few miles away . . . jets and helicopter activity increased two fold . . . maybe. Nothing big. Just another day of teaching, nothing different. Heck, it's not even topic material at lunch. We're used to it . . . Go back to my classroom and load CNN's main page, and huh? Parallel universe, maybe?

I think that Korea is a different situation - that is is long-standing, structured military dispute where two nations (admittedly, that used to be one) are in a strategic conflict that doesn't manifest much on a daily basis.

Syria is caught in a wave of unrest rippling across the Middle East where the government has recently used live ammunition against its own people - and where mass demonstrations have now reached the capital.

I have friends in Syria; trust me - this is not a situation to be ignored!
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« Reply #319 on: April 23, 2011, 01:11:35 AM »

Just in case anyone still has any doubts:

http://www.reuters.com/article/2011/04/23/us-syria-protests-idUSTRE73L1SJ20110423

http://www.reuters.com/article/2011/04/22/us-syria-usa-obama-idUSTRE73L48B20110422

<a href="http://www.youtube.com/watch?v=tsS49Zh-XWs" target="_blank">http://www.youtube.com/watch?v=tsS49Zh-XWs</a>

You'd be mad to consider going to Syria for LL now, but you don't have to listen to me  Grin
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