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Author Topic: Houdini - External Tibias - Dr. Salameh - 2009 - Houdini Escapes Short Stature  (Read 173473 times)
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Houdini
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« on: October 19, 2009, 09:36:18 PM »

DAY 1

Well, folks, I did it! Today I had surgery to attach limb lengthening fixators to my tibias.  Surgery started this afternoon
at around 12:30, and finished at around 4 o‘clock.  I had a nice dinner in my hospital room at around 7 o‘clock, and now
my nurse is changing my bandages.  I almost can’t believe I am actually here!

First, the essentials:


Starting Height:   5’4” (5 feet 4 inches) = 64 inches = 162. 6 cm

Location for Surgery and Lengthening:   Frankfurt, Germany

Physicians:    Drs.  Gassan Salameh and Michael Schmidt

Lengthening Device and Method:   Salamehfix External Fixator
                  
            Internal Nail - No


I’ll try to complete this first diary post before my evening pain med drip kicks in and spaces me out
or puts me to sleep.

Photos and videos will be coming your way, maybe as soon as tomorrow.  Before I left home, I bought
a GSM unlocked cell phone with a 5 mega pixel camera and a “Flip” video recorder.  I also brought
along my Casio digital camera - so we should have a photographic and video diary covered.

I am fortunate to have a lovely room in a private hospital (Dr.  Schmidt performs his surgeries here)
My room is private, spacious, attractive (really!), with a separate seating area , and get
this - floor-to-ceiling windows with a gorgeous view and even a terrace! I couldn’t be more satisfied.
My afternoon nurse and evening nurse couldn't be nicer or more helpful.  Psychologically, I feel I am off
to a good start.

Details for follow tomorrow.

Houdini
« Last Edit: April 17, 2011, 10:12:28 AM by SysOp » Logged
star-trek
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« Reply #1 on: October 19, 2009, 10:09:37 PM »

^^ Fantastic we have a second diary under this surgeon. Best of luck. I hope to join you soon with my femurs.

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« Reply #2 on: October 19, 2009, 10:43:45 PM »

Congratulations. I wish you the best during your escape.
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sakis
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« Reply #3 on: October 19, 2009, 11:36:25 PM »

heyyy, nice news man !

I will be tomorow afternoon in frankfurt to have x-rays with dr.salameh and dr.schmidt , If you like, I could give you a visit.

good luck in your journey :-)
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« Reply #4 on: October 19, 2009, 11:42:33 PM »

Great! Thanks for starting your diary, Houdini - looking forward to hearing how it goes! Smiley
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« Reply #5 on: October 20, 2009, 12:02:09 AM »

Very nice. Glad to hear you're doing so well. If you don't mind me asking, how much did the operation cost? And how much is accomodation?
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« Reply #6 on: October 20, 2009, 12:07:26 AM »

Goodluck Houdini with your LL adventure. I hope all goes terrific for you and the end result is all that you hoped it would be. It is excellent to see another diary from Germany other than through Dr. Betz to give us all insight to how other surgeons perfom LL plus the hospital and environment in which it is conducted.

Midget
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Houdini
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« Reply #7 on: October 20, 2009, 12:55:16 PM »

Day 2

Thanks all, for the words of encouragement. 

They don’t mess around here.  This morning, my German nurse (whose English is limited, but who is
very sweet and tries hard) came into my room and told me it was time for some “gymnastics!” When
I saw who followed her into my room, i. e. , a physical therapist, I figured my nurse had meant “exercise. ”
It was time for my first steps after yesterday’s surgery!

They brought me some rather stylish crutches, and I managed to sit up and slowly swing my legs over
the side of the bed.  I was now sitting on the edge of the bed.  The nurse and therapist showed me how
to use the crutches to stand from a seated position, and before I knew it, I was standing.  They told me
to take small steps, using the crutches for balance, and to not be afraid to put all of my weight on my
legs (on the fixators, actually).  Let’s just say I was glad there was still some pain medication in my system,
as I am sure this helped me to overcome my trepidation.  I did okay! I was “walking” in small steps around
the room, oftentimes risking to put my full weight on my legs in between stabilizing crutch plants.  The nurse
and therapist said they were very impressed with how well I was taking to it.

Then it was back to the bed for therapist to show me some leg and ankle exercises.  They included leg lifts,
knee bends, ankle flexion, and toe scrunching, some in combination.  Some were performed on my back, and
others while I was sitting on the side of the bed.  I am supposed to do these three times a day, or more often
as I can tolerate.

The nurse asked if I wanted to walk to the bathroom and clean up.  I told her I was ready for a break.
After a nap, and my last infusion of pain med (its pills and oral drops from here on in), it was time for
my trip to the bathroom.  (By the way, I they didn’t insert a catheter for my surgery, for which I am most
grateful.  They give you a pee bottle you can use in bed. ) I must say, this second go-round of “walking”
was more uncomfortable and less stable than the first, probably because everything was inflamed and sore
from all the activity of the morning.  But I managed.  I cleaned myself up, gave myself a sponge bath, and
said goodbye to my hospital gown and hello to a t-shirt and lightweight camping pants with zip-off legs that
transform them into shorts. 

About an hour ago, Dr.  Salameh came to check on me, change my dressings, and fine tune the fixators.
It was a bit like watching an auto mechanic at work, two larger wrenches and two smaller wrenches, tightening
things here and there up and down the fixators.  Because I have some bowing of my tibias, we will be correcting
that as the lengthening goes along.  There are small, bi-lateral hinges towards the top of each fixator, which can
be adjusted to correct for deviances and alignment issues.  The doctor finally seemed satisfied, so he put his tools
away and took some photographs.  He stressed how important is was to start getting in the habit of keeping my
legs flat while in bed and extending my knees and tibias by flexing my thigh muscles.

I start lengthening one week from yesterday, at midnight.   The protocol to start is to loosen each of three six-sided
nuts on the fixator one “step” every six hours, for a total of four steps per day.  (The corresponding nut on the top side
of the hemi arc is tightened to secure the elongating nut in position. ) I will have to get the exact measurement, but
this amounts to a little over . 8 millimeters per day. 

Interestingly, the doctor said I could sleep on my stomach if I wished, which is good for extending the knees
if a small pillow is placed under each fixator.  I’ve never slept on my stomach, so we’ll have to see.  He also
said it would be okay occasionally to sleep on my side with a pillow between my legs, but he cautioned against
the fetal position because of knee bend.

I am trying to arrange to rent a treadmill and exercise bike for the apartment where I will be staying
during lengthening.  Even though there is a spa and fully equipped gym/workout room on the grounds,
I think I am more likely to spend more time exercising if I have equipment right there in the apartment,
staring me in the face.

So that is my second day.  The weather is cold but sunny, and my view is of the lush, forested hills
surrounding the Frankfurt area.  All in all, I am feeling okay and hope to be able to take this extremely
challenging marathon one moment at a time.

Houdini (the escape continues)
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Legolas
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« Reply #8 on: October 20, 2009, 01:47:19 PM »

Congrats, man. We're about the same height, so I'm particularly interested in your lengthening story. Are you shooting for the 170 cm mark?
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« Reply #9 on: October 20, 2009, 03:12:48 PM »

Will58 -- For me, because I wanted to have my surgery in Frankfurt rather than Damascus (where Dr.  Salameh is based), the cost was a matter of negotiation with Dr.  Salameh.  I think he and Dr.  Schmidt (who is an orthopedic surgeon in Frankfurt) are attempting to make Frankfurt a regularly available location for limb lengthening using Dr.  Salameh's external fixator.  Dr.  Salameh proposed an all-inclusive price for the surgery and hospital stay, which was agreeable to me and I accepted.  I don't know whether he would quote the same or a different price to others who wish to do limb lengthening in Frankfurt.  My guess is that he and Dr.  Schmidt will eventually come up with a set price, but for now, I think it is a matter of negotiation.  The price we agreed on was certainly competitive.  The price Dr.  S quoted me was in U. S.  dollars rather than Euros, which he probably now regrets.   :)

Once I leave the hospital in three or four days, I will be moving to an apartment for the duration of the lengthening phase.  I will have to cover all housing and living costs.  For at least the first month, I will be living in an extended stay apartment in a resort that is just down the road from Dr.  Schmidt's office.  I wanted to be sure to have convenient, regular access to him.  Dr.  Salameh will be visiting Frankfurt from time to time for limb lengthening surgeries and to check up on patients.

Legolas -- 7. 6 cm is my rough goal, although I am open to going less or more depending on how things go.  My tibias are "stumpy" compared to my femurs, so I should have some leeway with proportions.  I don't want to lock myself into a number, but 7. 6 (3 inches) is about what I am shooting for.

Houdini

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« Reply #10 on: October 20, 2009, 04:21:56 PM »

Day 2 (cont'd)

Just a quick update, folks.   I just took my first unassisted "walk" to the bathroom.   (How odd
that I would be writing those words at my age.  ) I had finished some ankle flexes, toe scrunches,
leg raises, and knee bends, and felt up to trying the eight foot stroll to the bathroom.   I decided not
to call the nurse, who was busy signing out to the evening shift.   I was pleasantly
surprised not to have much trouble at all standing up by the edge of my bed, and walking, step by
slow, small step, the eight feet to the bathroom.   Per my physical therapist's and doctor's advice,
I made sure to put all my weight on my legs/feet rather than relying on my crutches for support. 
I experienced suprisingly little discomfort.   I think that the minor twinges I did feel were residual
soreness from the surgery itself and some fluid that collected around my left knee
immediately after the surgery (it is being treated, and is subsiding).   

I hope by tomorrow to be able to snap some pics and post them. 

Time for dinner, and a well earned rest!

Houdini
« Last Edit: October 20, 2009, 04:30:08 PM by Houdini » Logged
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« Reply #11 on: October 21, 2009, 12:59:46 AM »

This diary is interesting since I would like to 6.5 to 7 cm like you target goal is. I hope you can reach your target height of 170 cm.
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« Reply #12 on: October 21, 2009, 01:28:40 AM »

Great posts Houdini. Keep up the good work with your exercises as Im sure it will benefit you heaps over the coming months.

Midget
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Houdini
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« Reply #13 on: October 21, 2009, 09:52:14 AM »

Day 3

A happy day for every limb lengthener seems to be the day they have their first BM following surgery.  My happy day was today!

Before I get too far into Day 3, I should say that Drs.  Salameh and Schmidt stopped by last night and were very satisfied with how I am getting along.  I showed them my walking, and they were impressed that I was able to stand around and chat, without crutches (I kept them close by, of course), for many minutes without pain or discomfort.  Keep in mind that this was the second day following my surgery.  I am not deluding myself.  I know the hard part doesn’t start until I actually start lengthening, but at least I seem to be starting things off on track.

So I recorded my first “walking” video with my Flip video recorder.  I just plugged it into my computer this morning and was able to navigate to the mp4 video file.  Can someone please help me with getting it posted? MMT? Techies?

Okay, back to Day 3.  I had a good night’s sleep.  As recommended by my doctor, I tried sleeping partially on my side with pillows cushioning my fixators.  Not bad! I was awakened to a good German breakfast: two kinds of fresh bread, honey, blueberry jam, butter, and a selection of cold cuts and cheese.  I have to say, the food is very good in this hospital.  The bread in Germany is especially delicious.  I am told they have something like 200 varieties. 

Then it was off to x-ray for the first post-surgical films of my tibias.  After that, it was time for a visit from the physical therapist (a different one than the one I had on Day 2).  We did some leg exercises with me on my back in bed, including ankle flexion, holding that, then lifting the leg about 18” off the bed, hold that, slowly let the leg descend to the bed, then relax the ankle.  We also did some upper body work where I would resist the therapist trying to push my arm down towards my torso, and then resist the therapist trying to pull my arm back upwards - sort of like rotator cuff exercises, but they exercise your core and engage your thigh muscles.  The therapist said that I should not neglect my upper body after I leave the hospital.  It is easy to focus on just your legs, but I am supposed to do complete workouts, including bicep curls, triceps pushdowns, chest presses, stationary rowing, and pull-ups.

My nurse just came in to give me an anti-thrombosis injection.  These sting.  I had my first one yesterday.  They use a tiny needle, and inject the stuff in either your belly or your arm, but the medicine smarts as it goes in.  My nurse today was very gentle, and she injected the stuff very slowly. 

Right now, my only real complaint (besides having surgical grade steel fixators attached to my tibias) is some residual left knee fluid, which causes soreness and makes it more difficult to bend the left knee, as well as some minor “clicking” of my left patella when I walk.  I imagine the two are related.  I am scheduled for some therapeutic massage of my knee tomorrow by the physical therapist, which is supposed to help drain the fluid.

Thanks again for all the support.  Please let me know how to get my video posted.  I will record another one later today.
 
Houdini
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« Reply #14 on: October 21, 2009, 01:18:11 PM »

hey Houdini,

am happy that everything going smooth with you in your first days.

about how posting a video, go to www.youtube.com and creat an account, then you can upload many video as you like, after that just post the link to that video here !

cheers

sakis
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« Reply #15 on: October 21, 2009, 05:30:21 PM »

Quote from: sakis link=topic=2891. msg31590#msg31590 date=1256131091

about how posting a video, go to www. youtube. com and creat an account, then you can upload many video as you like, after that just post the link to that video here !

cheers

sakis

Day 3 - continued

Thank you, Sakis.  I am trying that now.  If it works, what everyone will see is me taking a little stroll away from my video camera and then back, in my hospital room, on the second morning (Wednesday) following my Monday surgery.  Please, no wolf whistles for my sexy legs.   Smiley

Before I post the link, I will share some good news and some not-so-good news.  First the good news: When the doctors viewed my x-rays this afternoon, they said that everything looked absolutely perfect.  

One reason they think I haven't experienced much post-surgical discomfort is they used a very tiny wire saw to do the osteotomy (cutting through the bone), rather than the more conventional method of breaking through the bone with a surgical chisel.  They were able to do this using only two tiny incisions, one on each side of the tibia (same for the fibula), and then feeding the wire saw through to make the cut.  This is less traumatic than the larger incision plus chisel method.  The doctors say they will think about using this technique for all their leg lengthening surgeries.

Now for the not-so-good, but not terrible news: The second thing the doctors noticed from viewing the x-rays is (drum roll) .  .  .  they left one of the anchoring pins out of the fixator on my right tibia! It isn't one of the primary supportive pins (obviously), but it needs to be there.  The docs said they had never missed a pin before in countless fixator surgeries and were very apologetic.  Anyway, tomorrow morning (Day 4), at 9 a. m. , I will have a ten minute procedure under twilight anesthesia (me, not the doctors) to insert the last pin.  The docs say this shouldn't set me back at all and is only a minor inconvenience.  They still plan to discharge me from the hospital on Friday.

Okay, let's try putting in the link to my first YouTube video:

<a href="http://www.youtube.com/watch?v=nBhe1LXXo1o" target="_blank">http://www.youtube.com/watch?v=nBhe1LXXo1o</a>

Time for dinner, a little television, then to sleep so I am rested for my procedure in the morning.

Thanks again to everyone who has expressed encouragement.

Houdini
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« Reply #16 on: October 21, 2009, 05:31:18 PM »

about how posting a video, go to www.youtube.com and creat an account, then you can upload many video as you like, after that just post the link to that video here !

I've just updated the link that you posted so that everyone can see it - great video

I have now added Dr. Salameh to the list of doctors in the Doctors section.

Cheers, MMT
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Houdini
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« Reply #17 on: October 21, 2009, 05:41:22 PM »

Quote from: MMT Admin link=topic=2891. msg31594#msg31594 date=1256146278
I've just updated the link that you posted so that everyone can see it - great video

I have now added Dr.  Salameh to the list of doctors in the Doctors section.

Cheers, MMT

Thanks for your help, MMT.  The video looks pretty good! Did you have to do something to embed the
video?

Houdini
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« Reply #18 on: October 21, 2009, 07:07:40 PM »

How are you able to walk that "normally" 2 days after surgery, wiggle your hips for a few dance moves ? This looks too good to be true Roll Eyes :O
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« Reply #19 on: October 21, 2009, 07:26:59 PM »

I typed the URL and I still can not see it. Maybe its because using an American connection.
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