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Author Topic: Bigfaker - External Tibias - Dr. Sringari - 2013 - Fakin' The Funk No Longer  (Read 111031 times)
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Bigfaker
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« Reply #180 on: July 21, 2016, 02:24:58 AM »

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Prev. Height: 5'-5.25"/165.7cm (Morning)
External LON with Dr. Raj Sringari - Install: 12/17/13 * Lengthened: ~3"/7.6cm * Frame Removal 04/17/14
Diagnosed with Partial Non-Union: 02/09/16
Ankle Debridement Surgery: 02/22/16
Rev. Nailing/Bone Graft/Tenotomy - Loma Linda Medical Center: 05/12/16
Bigfaker
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« Reply #181 on: July 23, 2016, 11:28:24 PM »



https://youtu.be/jp_tegR6tG0


Quote Of The Week
Don’t look at the summit; keep your attention on your next step. One day you’ll get to the top, but right now appreciate where you are.
– Mountain climbers adage
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Prev. Height: 5'-5.25"/165.7cm (Morning)
External LON with Dr. Raj Sringari - Install: 12/17/13 * Lengthened: ~3"/7.6cm * Frame Removal 04/17/14
Diagnosed with Partial Non-Union: 02/09/16
Ankle Debridement Surgery: 02/22/16
Rev. Nailing/Bone Graft/Tenotomy - Loma Linda Medical Center: 05/12/16
Bigfaker
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« Reply #182 on: July 26, 2016, 10:28:24 AM »


I think this is the last of my old 2014 videos...at least that I can find. Yeah, I know how bad my legs look in this one. I'll round up some notes (and possibly x-rays) and try to talk about what was going on in detail.
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Prev. Height: 5'-5.25"/165.7cm (Morning)
External LON with Dr. Raj Sringari - Install: 12/17/13 * Lengthened: ~3"/7.6cm * Frame Removal 04/17/14
Diagnosed with Partial Non-Union: 02/09/16
Ankle Debridement Surgery: 02/22/16
Rev. Nailing/Bone Graft/Tenotomy - Loma Linda Medical Center: 05/12/16
Hamilton
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« Reply #183 on: July 26, 2016, 10:48:53 AM »

dear Bigfaker

for your opinion,

internal method or external method, which is better for Tibias?

thanks
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Bigfaker
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« Reply #184 on: July 31, 2016, 12:04:10 PM »

Hey Hamilton,

Can't wait to see your musical.  Grin

It sounds like you're pretty new to LL and I know how all the options can seem overwhelming.

To most (I believe), Internal is much better overall. There's no pin cutting along the skin and thus much fewer scars. There's no nerve catching (maybe stretching pain?...but no pins catching them) as the frame distracts. And best of all, you have sooooooo much more mobility and comfort for those 2-_ months while you're lengthening. You can get your shorts on and off without help (though I eventually figured out how to do it myself). You can get onto the toilet without clanging onto everything. You can go out in public on a wheelchair with fewer WTF stares at you...though the leg covers (like in our India Gate picture) help a lot with that.

The only reason I and most patients ever opt for External is the prohibitive cost. IIRC, the only other drawbacks of internals are:
  • The possible uncertainty of transmitting your lengthening to the nail inside your body, whether it's via clicking on the BetzBone, the electromechanics of Precise, or the oil tube of HLN.
  • The need to have the lengthening nail replaced with solid titanium ones.

I think it's almost always a financial decision. No one should opt for External if they can afford Internal.


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Prev. Height: 5'-5.25"/165.7cm (Morning)
External LON with Dr. Raj Sringari - Install: 12/17/13 * Lengthened: ~3"/7.6cm * Frame Removal 04/17/14
Diagnosed with Partial Non-Union: 02/09/16
Ankle Debridement Surgery: 02/22/16
Rev. Nailing/Bone Graft/Tenotomy - Loma Linda Medical Center: 05/12/16
Arch
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« Reply #185 on: November 01, 2016, 08:49:59 PM »

Hi Bigfaker

How have you been doing these days, is your non union healed?

Let us know my friend!
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Romy
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« Reply #186 on: February 20, 2017, 12:15:55 PM »

Hi Bigfaker, how are you?
How's your recovery going on? Is there still any complication persist?
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Bigfaker
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« Reply #187 on: February 27, 2017, 05:31:46 AM »

Hi Bigfaker

How have you been doing these days, is your non union healed?

Let us know my friend!

Hey Arch. I appreciate you checking on me back in November. I did see your question and responded via email. Did you get it? I didn’t get a reply, so I’ve kinda been left hanging ever since, Man!

And if y’all wondering why I used offsite email instead of posting in my diary, there are just times I try to stay off the sites altogether …or at least, as much as I can. I’m such an all-or-nothing type of personality that whenever I go on here, I would get so sucked into reading -- like every thread and multiple diaries -- that I’m trapped here for days, it seems. #OCDIsABitch

Hi Bigfaker, how are you?
How's your recovery going on? Is there still any complication persist?

Greetings Romy

I'm doing okay. Thanks for asking. I'm have a couple updates in the pipeline. First a little commentary about my early recover days, then some videos from after the Revision Nailing/Bone graft/Tenotomy from last year. Stay tuned.
Logged

Prev. Height: 5'-5.25"/165.7cm (Morning)
External LON with Dr. Raj Sringari - Install: 12/17/13 * Lengthened: ~3"/7.6cm * Frame Removal 04/17/14
Diagnosed with Partial Non-Union: 02/09/16
Ankle Debridement Surgery: 02/22/16
Rev. Nailing/Bone Graft/Tenotomy - Loma Linda Medical Center: 05/12/16
Bigfaker
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« Reply #188 on: February 27, 2017, 06:09:08 AM »


Damn, y'all. Been a while. I think I get a little self-conscious anytime I don't post for a bit because this kind of talk here:
Bad things, it would appear. . .

Heck knows what going on with bigfaker I was keeping track of this diary aswell. Man india for LL..... would never do it in a million years

and this noise here:
This diary went from being really great to being really shady. I hope BigFaker pops in soon to prove me wrong!

Well, maybe with all the diaries flooding this place now, things have possibly changed. I don't really spend any time on these forums nowadays...at least, I haven't in a few months.

Anyway, as always, its daily life and work that hinders my ability to update. [I actually typed the preceding 3 sentences during the Rio Olympics, so that shows you how often I get around to this now]

Yet with a couple hours to kill, we journey on...but FIRST (since I had written this last year and never posted it)




Movie Reviews

Well I FINALLY ran out of 2014 videos...at least of the ones that I could find and that were already screened and edited. I guess I should make a comment or two. Well, here are two:
1) My walking was really goddammed fucked while I was in India.
2) My walking was still pretty fucked once I got home.

But I suppose y'all have grown accustomed to more detail from me. Lemme see what I can dig out of the dark memory corners of my skull:

IW (05/21/14)
: This was 34 days post-frame removal. Unlike most of my fellow Sringari patients, as well as many LON patients in general, I wasn't allowed to walk while lengthening. So other than walking my feet up the wall, I hadn't moved my legs across a flat plane in 5 months. #AtrophyIsAKiller

WTW (05/29/14): More of the same. I had gotten good enough to switch from walker to crutches...well, I think I DEMANDED that we switch ASAP so I could prepare for going home (which was less than two weeks away at this point).

WOB (06/01/14): Wanting to spend my last couple weeks in India at a nicer place, I had just transitioned to a new hotel (Leisure Inn West Gurgaon). Including the hotel in Mumbai, the hotel before surgery, the hospital, the guest house, the second hotel in Gurgaon, and this last place, that's six different places I stayed...wait, we stayed one night in Agra to see the Taj Mahal, so seven! My ballerina was getting steadily better at this point -- I could easily get my heels down while sitting, and press them down against the wall or while standing with the walker -- but walking was a whole different animal. When you have to take steps and actually walk, you can't just put all your weight on the leg to deal with the equinus. It's kind of hilarious when I look back and know that I would be practically flying on crutches eventually...and to see these infant steps when I had to literally think to myself "Right Crutch. Left Foot. Left Crutch. Right Foot..."

WLAM (06/07/14): The tiny little gym in the last Gurgaon hotel. This was after I had gone off of “The Wizard’s” $1200/month aftercare plan -- actually things had already collapsed the month before – so in addition to paying for/arranging my own room and board, I had booked the guys on my own to come for my twice-daily PT. Sounds rough at first, but they were only charging me INR600 (about $9 then) per day!

I had picked this place because it had a pool.











Well, it was about the 6th hotel with a pool I had looked at. The gym was an incredible pain in the ass because the elevator stopped one floor short of the floor the gym was on. So I had to butt-scoot up the last flight of stairs...and down another couple of f.ucking steps to get into the little crappy-ass gym that had like this one treadmill, a stationary bike and a couple dumbbells.


It paled in comparison to even my home gym in my garage...let alone the gigantic UFC where I'm a member.

WOS (06/30/14)
: HOME! Hooooome Sweet Hoooooooome! This was the first footage of my long (and ongoing) love/hate relationship with the Alter-G Antigravity treadmili. One thing you might notice is that my ballerina got worse after it had gotten better. FIRSTLY, I have it to attribute it to slacking off my in my last couple weeks in India. The Leisure Inn was pretty far for my PTs Harry and Nishar to get to, having to traverse across Gurgaon, usually during rush hour. Plus, I took a little time to get in my last-minute sightseeing, so it wasn’t always twice-daily near the end. Then, once I first got back home, it took a couple weeks to get an appointment with a PT place near where I was staying.  Yes, I could have done more on my own, but I was probably overcome with many reunions with friends/fam/fiancé, gorging on comfort (i.e. non-Indian) food, and tremendous fatigue from getting around with no wheelchair.

In the first few days, I got a SERIOUSLY shocking slap in the face with the reality of my situation. I had about INR10000 left in my wallet that I needed to exchange. It was a Saturday, the nearest currency place open was in a local mall, so I went, thinking it would be easy enough. I parked in the structure and headed out into the outdoor mall. Of course, the exchange kiosk was at the faaaaaaar end of one of the mall wings. And (of course), I went down a wrong path at first. It was June, it was hot, I was sweaty, I was still getting used to crutches…let alone two broken legs…I was STRUGGLING. I kid you not, it took me an HOUR AND A HALF to get to this place…a walk that would have taken fewer than 10 minutes on healthy legs. Sobering…truly sobering. And this is what my feet looked after a day like that:





IWA (07/16/14): This was where I started getting to the doldrums of recovery. My L leg was not showing nearly the signs of rebuilding and strength that the R was. And my R ankle issue was starting to rear its ugly head. So the thought creeping into the back of my mind was that I was fucked…truly fucked.

DWA (07/27/14): A little glimpse of the nifty new Mobilegs crutches I bought. I can’t remember if my hunching over was due to duck ass or fatigue. I definitely did have the former, but there were definitely times when using crutches for long periods of time was wearing out my arms and shoulders. The Mobilegs exacerbated this, because they are designed to not allow one to lean one’s armpits onto the pads, so all of the weight is borne by the arms. I guess my little guns got a bit of a boost, at least. LOL
The slow incline walk I’m doing (around 1:42) was something I discovered after about a month of using the Alter-G. It was akin to the pushing on our feet that the PTs on India had done…but with this, I was able to put a good 70-80 lbs. of my weight on the stretch. I think this had a significant factor in fighting equinus contracture.

WOTS (08/08/14): Yeah, I was truly fucked. At first glance, one would think the alignment of my tibia and femur were totally off, but of course doing just tibias LON as I did, it didn’t make sense that my knee would point inward like that. What it turned out to be -– as I learned many months later -- was a combination of: the weakness of the L tibia non-union, plus the weakness of the hip (not pulling the leg into place), in addition to the constant pain in my knees (from the nail insertion). As far as the piece-of-shi* R ankle, I eventually (finally!) did have surgery on in February of last year, but sadly, it was not improved much. I’m able to get around and live my life okay, but most mornings when I’m cold and stiff (not like that! LOL) I limp considerably. The end of long fatiguing days are pretty bad as well.

We’ll be back soon with more Men On Film.
[none of y’all old enough to get that reference]

« Last Edit: February 27, 2017, 07:00:19 AM by Bigfaker » Logged

Prev. Height: 5'-5.25"/165.7cm (Morning)
External LON with Dr. Raj Sringari - Install: 12/17/13 * Lengthened: ~3"/7.6cm * Frame Removal 04/17/14
Diagnosed with Partial Non-Union: 02/09/16
Ankle Debridement Surgery: 02/22/16
Rev. Nailing/Bone Graft/Tenotomy - Loma Linda Medical Center: 05/12/16
Bigfaker
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« Reply #189 on: February 27, 2017, 07:40:47 AM »

I originally wrote this on Walking Tall's diary, but I always intended to post these pics and thoughts here so . . .


Murdering The Ballerina

Hi Bigfaker,

You mentioned you handled ballerina pretty well. Can you tell me how you handled? How long did it take for you to remove ballerina completely?
how long you were walking with crutches?

Why hamstring stretch? It has nothing to do with ballerina foot.
You should hire a physio in your home city.

WalkingTall: I agree TIBIKE2002 hire physio. Physio is really important to recover soon. Get off BF is a long time process according to my roommate. He get off BF 5 cm around 5 months and he hire physio 2 times per week.

TBIKE, the hamstrings and gastroc/Achilles are inter-connected by nerves and fasciae. Everything works together. Some call it "muscle interdependence", some call it the "Kinetic Chain"
http://breakingmuscle.com/au/mobility-recovery/everything-is-connected-fix-weak-links-to-prevent-injury
http://www.runnersworld.com/training-video/inside-the-doctors-office-strengthen-your-kinetic-chain
This is why working on just the calf muscle in isolation is not enough. It's why stretching the gastroc/Achilles while seated is not enough. With moderate (or severe) equinus conrtracture, when you stretch out the lower leg muscles, it can cause the knee to bend in response (more below).

These guys are right about the help a legit PT can provide. I go twice a week now, down from 3x/week when I first got home (once I found a place, that is). But you already know from the time in India that it's not all about the time you spend with PTs. A LOT of the work you have to do on your own, pretty much every day, if not multiple times per day.

LOL [WalkingTall], I've been meaning to write about this forever. I guess you're finally egging me to do it. This is not a simple question, especially since equinus can be so aggressive and persistent.

The first part, I'm sure you did with Harry: the pressing down on your knees while seated, right?:





Once I got my heels down to the floor consistently, I rolled up a towel under my foot to get a bit of dorsiflexion:



Remember I said Harry used to use hot wax:



...which we all though was pretty pointless and way too time-consuming. It only warmed up the skin. Soaking in hot water was much more helpful. When I soaked while seated, I put weights on my knees to press down:



But as I said, my knees (esp. the R, which had worse BF) would want to bend when the heels were pressed down to the floor (or toes pulled up, while lying down). So standing is really important. I wasn't quite ready to stand on a step (and the hotel didn't have railings close enough to hold both sides, so I used the towel again while standing:



I spent a LOT of time standing like this. When my arms got tired, I just bent over the walker and let my torso hold me up:



But now that you're home you could buy or build something like this:



...especially if you don't have a step that works for stretching.

But you can only do so much on your feet in a day...and your arms can only hold you up for so long. Probably the MOST important thing I did in India was press my heels against the wall...well, specifically, the headboard:



See the knee bend? That's why I started piling weights on my knees:



And then added the towel roll:



LOL. I bought the Monopoly to play with fellow patients in the guest house. We never played once. I do remember one night playing poker, using pizza seasoning packets as "chips", though. Grin

I would set up this crazy position, put on some good music, and literally lie there for HOURS! I remember I used to fall asleep and our caretaker Sukesh, the PTs or (once) Dr. Sringari would wake me up and I was still in this position.

WHEN I GOT HOME:
OK, the persistence part: I got my heels to the floor and a bit of dorsiflexion while in India. Once I was home, I was so busy catching up with work, trying to re-connect with fiancé/family/friends, and I couldn't get an appointment at a PT center for almost two weeks. I was too lax stretching on my own. So by the time I started with the PTs in the US, I was feeling the Ballerina had regressed partly and I lost some of the flexibility I had gained the month before. I definitely remember because my PT said I "walked in on my toes" when she met me.

So once I got back to fully-stocked gyms in the US, I added calf stretching on the leg press machine, about every other day:



Probably the best thing about PT at home was starting on the Alter-G anti-gravity treadmill:



If you've never heard of it, it's a NASA-designed machine that has an air bubble which lifts you and helps you walk or run without putting your full body weight on your legs. You can see it in most of my US videos. I would walk for up to an hour, at 40-70% of my body weight, at the maximum incline, at a veeeery slow pace (like 0.7 MPH). Remember how Harry would stretch the calves for a couple minutes by pressing the balls of your feet toward [us, Sringari patients]? This is the same idea, except using your body weight, and much more slowly. I can't preach enough about how this thing is amazing, but if you can't get to one (or don't want to pay), you could always walk on a regular treadmill and hold yourself with your arms. This is pretty strenuous after 10 minutes, though. Especially, in initial recovery, when you're not allowed to put much weight on your legs.

With regular stretching, I would say most of the equinus was handled in the first 3 months after frame removal. I had good dorsiflexion soon after that, but my ankle issues have always complicated things. And mornings are STILL tough to this day. In the morning, when everything is stiff, it still takes a couple minutes for my heels to come down. It probably will be easier for (most of) you, since you're (likely) younger...and (probably) don't have bone fragments floating in your ankle.

As of the end of 2014, I'd say...(hesitantly) um...I guess ...well...the Ballerina was officially dead. And the Revision Nailing/BoneGraft didn't change her state of mortem. But the R ankle issue and Tenotomy...well, they can occasionally resurrect that b!tch and bring her back to life.
« Last Edit: February 27, 2017, 08:22:53 AM by Bigfaker » Logged

Prev. Height: 5'-5.25"/165.7cm (Morning)
External LON with Dr. Raj Sringari - Install: 12/17/13 * Lengthened: ~3"/7.6cm * Frame Removal 04/17/14
Diagnosed with Partial Non-Union: 02/09/16
Ankle Debridement Surgery: 02/22/16
Rev. Nailing/Bone Graft/Tenotomy - Loma Linda Medical Center: 05/12/16
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