Aaaaaaand we're done!

We've stopped stretching! Whooo!

There have been two check-ups since the last entry, but nothing much to report. Everything has been going pretty much to plan with not a heap of change other than the space between bone fragments.

My fourth process x-ray, approx. 3.5 stretch.

Since we've stopped stretching, the pain has definitely settled down, which is great! I get a bit of pain at the outer top wire - the most annoying of the wires because like I've explained before, it's lodged in the muscle group that is most involved with general leg movement. Cleaning is still painful, but a lot less than it had been previously. Before I would take two Panadols before my shower and then an Endone after cleaning, but now I only take the Panadol.

The four smaller wires are able to be removed now, there are two options: to have them cut and pulled out in Dr Astori's office with just a couple of Endone and Panadol or to go back into surgery and be completely under while they are removed.

After having agreed with my Mum over what a baby I am when it comes to pain, we both prefer if I was put under anesthetic for the process lest we scare Dr Astori's other patients off with my cries of pain (the walls in his office are pretty thin). My parents are going overseas soon for about four weeks, and they want me to wait until they back due to lack of fundage. The plus of getting them removed in his office is that it wouldn't cost any extra, but...yeah. Pain. I'm being a baby, I know. My next appointment isn't for another month, so I have that time to change my mind/talk myself into having momentary courage. We'll see.

So right now the only thing I'm having to do is to stretch my calf muscle out. Because while the bone

Post-stretch! 4cm length attained!

fragments have been stretched into the correct position - my calf muscle hasn't quite caught up yet. This means my foot drops down a bit and I have limited range of motion in my foot.

My goal for my next appointment is to be beginning to put more weight on my leg and only rely on one of my crutches rather than the both of them. I'm not too sure what else to write, there really hasn't been a whole heap going on, but if anyone has any questions, feel free to ask. :)

Oh, and happy Easter! Enjoy your guilt-free chocolate eating today. ^_^

I am not fond of Telstra.

Had my last check-up with Dr Astori on Wednesday the 13th, wasn't able to update since then because our WiFi connection at home has been pretty sketchy the last few days. More so than it usually is, I mean. Telstra, do not like.

Everything is still on track, Dr Astori still seems quite happy with how everything is proceeding and says that everything looks as it should.

I've started the Keflex/Ielex anyway, as a couple of the pin sites on the outer side of my leg have been seriously bugging me. They were quite a nice shade of purple for a little while, which worried us slightly, but apparently they're not infected until they turn red. A really bright, fire engine red. Basically if it does get infected, we won't have any doubts about if it looks infected or not, we'll know for sure. I'm just going to finish this round anyway, but we have another script if I actually need to take them for a serious infection.

Progress x-ray number 3. Eep.

It's been suggested that instead of doing all the turns at night, when my boyfriend gets home from work/before bed, that we attempt to do as many as we can during the day or before he leaves so that my body adjusts to it before we go to bed and hopefully, that should ease the night pains. The night pains haven't been so bad recently, maybe because of that, but just in case, I take a couple of Panadol before going to bed and if I wake up again, then I take the Endone. I'm allowed to take 10mg (two tablets), but I've been trying to limit myself to just one at a time because I don't want to become too reliant on pain meds. It's still pretty sore in the morning when I wake up, though. My morning ritual is to immediately have a couple of Panadol with coffee before even tucking into breakfast. I've been trying to eat a bit healthier too, I went off the fruits, vitamins and green tea for a bit and that's when my pin sites seemed to bug me a bit more. I have no idea if that had anything to do with eating like crap (eat all the junk food!), but y'know - better to be safe than sorry, I guess. Too bad lychee's are out of season now, though...banana, strawberry and lychee smoothies are amazing..

Anyway, there's still about a week and a half until we stop stretching, I think, and I've been told that once we do - everything that's annoying me about my leg should ease up. I'm also having the four smaller wires removed once the stretching has stopped, which I'm really excited/nervous for! I'm excited to finally start being able to take the device apart, even if the majority of it is staying on another five months, but I'm nervous because it can be done whilst in his office by having the ends cut and then pulling the wires out through the skin. I seriously hope I'm getting some pain killers for that. I'm pretty anxious as to how it's going to feel during the removal...but I cannot wait to get these things out of me! Haha. The five big pins/screws in my tibia are fine, my tibia isn't exactly having too much movement when I'm trying to get around, but it's the smaller pins/wires that I've been told everybody complains about. Especially the two on my outer side as they're going through muscles that do deal with quite a bit of movement when the leg is being moved, flexed, etc. They're also the most painful areas to clean, so I'm looking forward to eventually only having five pin sites (and the easier ones, at that) rather than having the entire nine to get through.

My foot is still swelling up, obviously, which has been a pain in the butt when it comes to sitting down to study or standing for too long. I still have my leg compressor socks from the hospital, it was put over my leg that wasn't to be operated on (the left), but we've found that if I put as much of it as I can over my right foot - the swelling gets better! My foot is feeling like a foot now, and not more like a glove filled with water.

We'll see how tonight goes though, because tonight is that concert I mentioned earlier that I'll be working. I'm sure I'll manage to get through the night, but it's the next couple of days (nights...) that I'm worried about. Damn you, stubbornness! Ah well. We shall see...

Sunday = SBS PopAsia

Haven't had Endone in about three weeks now, then BAM. Two separate doses, plus another two of Panadol last night.

Try not to overdo it with the weight-bearing, guys.

Haven't been doing too much of it besides walking (shuffling?) to/from the toilet (with crutches, of course) and the dining table (which is about two metres away from the bed...) - and then on a 2mm stretch day, went to a friend's gig in pirate costume and spent four hours without putting my foot up and trying to weight-bear as much as possible. Without any Panadol or Endone, which I should have taken with me. That switch was not entirely welcomed by my body, as evidenced when I tried going to bed after the gig last night.

I was waking up every half hour (at least) with searing pain down the front of my leg. It felt like either somebody was trying to hammer a nail through my leg, or my tibia was trying to break through the skin. Take your pick. My boyfriend actually ended up being woken up a couple of times when I woke up screeching in pain - and he's a heavy enough sleeper that there have been times I've pushed him from one side of our queen-sized bed to the other and it hadn't bothered him in the slightest.

Sleeping is usually not that bad, I'd even found ways to get somewhat comfortable by sleeping on my left side by moving the pillow in between my legs. I keep a pillow under my leg usually when I'm lying in bed - especially since we have feather pillows, I find it helps accommodate the framework more while resting. But last night, there was nothing I could do to ease the pain. The Endone and being generally extremely tired kept drifting me off to sleep, but never for long enough and it did not help the pain. Or, if it did, then I do not want to know what it would have been like with no pain relief at all. Definitely in the top three most painful nights I've had so far.

So today is going to be spent predominately in bed. I'm definitely not trying to stop you from trying to walk or weight bear, not at all. You're supposed to be trying to do all of that. Just trying to warn you not to try and do too much, too soon. As much as you may think you'll be fine and you can handle it - never force yourself too much, or you'll just end up paying for it later. Do what you can, where you can, but do try to take it as easy as possible so you don't set yourself back.

Which means next weekend is going to be interesting, as I'm working merch for Ensiferum (European folk metal band) and since they're one of my favourite bands, I'm being too stubborn to turn the gig down. I figure being behind the desk is better than being out on the other side of it, but that's still at least an eight hour shift. Going to try and work myself up to it through out the week.

Ah. Well, we'll see.

Don't forget to keep flexing your foot.

You know you're desperate to find ways to get out of studying when you catch yourself daydreaming about scrubbing the toilet...

Hospital check-up yesterday, not so much to have an x-ray or monitor the stretching process than to have my pin sites inspected. We suspected a couple of them may be starting to become infected, so Mum made an appointment with our local GP because we didn't want to be bugging Dr Astori with every little obstacle when he can get really busy. Astori's office suggested we go in to see him instead though, since GPs don't generally know how to handle the entire process and apparently don't often feel qualified enough to make decisions when there's something like this attached to my leg. Which is fair enough, I guess.

So we went in, stripped off the band aids, and he gave them a look-see. Whole appointment was about five minutes. Turns out while one of them is very slightly inflamed, they all have the A-OK from Dr Astori. While they have been weeping blood and pus, he said this was entirely normal and to be expected. It was suggested that the cleaning over the next couple of days should be a tad more vigorous than previously, and if the redness and swelling from the one wire that's bugging me hasn't gone down - then I'm to start some antibiotics, Keflex (cephalexin) and should start to see an improvement in a couple of days after that. But the wires are the ones that will be giving you the most grief and be the most annoying. Once the stretching process has finished (another 18 days to go!), then the wires can actually be removed right in his office. ("I can just cut them and pull them straight through the skin!" - Oh, *that's* going to be fun...)

Just a heads up if you haven't glanced over to the photos already - they're a little gross. That's how they're supposed to look though. Apparently. I still feel like they don't look right, but then again what's right about a metal pin sticking out of your leg?

The cleaning has started to get seriously more painful. Last night's cleaning was a near horrid experience. Turned from being a quick pinching feeling to being akin with being stabbed in the leg. So y'know, fun times all around. I like to think that my pain tolerance is being increased every day I have my frame on. I shall soon be indestructible, just you wait.

These photos were taken right after coming out of a shower, but before cleaning. Another warning: I haven't shaved my leg in a couple of days. I am the hairy woman! Haha. I'm trying not to irritate the skin too much.

This is the wire pin site that Dr Astori agreed was a bit red and puffy.

A close up of the bigger pins that we were also worried about.
But no. This is normal.

During the cleaning process.

Random Shots

Here, have some random photos!
My only regret is not getting a 'before' picture. Ugh.

Right after having a shower, about to start the pin site cleaning.
A couple of the pin sites looking slightly red and irritated, but nothing
too bad as yet. Very small amount of pus came out of one.

Another just before we started cleaning.
Open wounds are yummy (not). It's a strange feeling knowing
these pins are going through my bones...

The cleaning process.

All clean and patched up again! First time using different band aids other
than the IV ones, since we've run out of them for the moment...

One of the IV band aids, with a bit of medical tape over the cut into it,
just to make sure it's completely covered the wound.

Swollen foot. It'll look like that for about a year, even
though my frame comes off in about four/five months.
The cut you can see is where Dr Astori went in to cut the bones,
the small, dark, round mark above my ankle is where a screw has been put in
at the bottom of my tibia.

And this is why I don't like standing up for long periods of time.

Rainy day procrastination...

First of all, wow.

I've gotten so many positive comments from people not even going through the process and it's absolutely amazed me. Thank you all so very much, your support is very much appreciated! Just had to say that before continuing...


THE FRAME
I said I'd go into more detail regarding the frame, so here we go. Now, there are a few different frames that are in use for leg lengthening, but I'll just be covering the one that I'm using.

Like I mentioned before, the frame that I've got on my leg is a Taylor Spatial Frame (TSF). It was 'invented' by Dr Charles Taylor, but it's based upon the same method as the more widely known Ilizarov Apparatus - "the theory of tensions". This just refers to the way the pins in the bones are connected to the framework, allowing a person to apply tension stress in order to regenerate soft tissue and bone in a fairly reliable manner. It was all based off the shaft bow horse harness, and the original frames were made out of bicycle parts. I won't go too much into Ilizarov - during your research, you'll probably come across Ilizarov's name many, many times. He's the guy who perfected limb lengthening in the Soviet Union (back in the day!), before it was taken to Italy and then the USA.

Left, front, right and back views
of my frame.

Here's some pictures of my TSF. My boyfriend likens the two black rings to mini Stargates and now that's all I can think of when I look at it. It's a good thing, it's good to be able to make light of not the greatest situation ever. So these two rings have six telescopic struts that can each be individually shortened or lengthened according to the need of the user. Because they can all be changed differently, it give you six different axes of movement, making it extremely able to manipulate bones in multiple directions. This is really handy for me, because of the curvature of my tibia. We're not only trying to stretch it, but we're also trying to straighten it out in the process. We do this very slowly, most of my struts get changed 1mm per day, but occasionally one, or even two of the struts have a 2mm change in a day.  These 2mm change days are not altogether fun, because there's more stretching in a 24 hour period, your leg feels much tighter than most other days. There is a general feeling of tightness as you go on, for obvious reasons. Apparently this is why I'm going to be having a rough time when it comes to the last week of stretching, according to Dr Astori. I can't believe I'm not even half way there yet, so the further we go and as the gap between the bone fragments increases, the more anxious I get. I guess we can only wait and see...

Each strut has measurements on them
so it's easy to lengthen accurately.

Each frame will be different for each person, depending on the size and shape of your leg (or whatever you're getting lengthened). But you get the basic idea. I'm pretty short regardless (152cms/5ft flat), so I've got short legs anyway. My frame is about 22.5cm in length from the bottom tibial pin up to the top black ring.

The frame itself is approximately AUD$15,000 - thank God for private health insurance! For a bit of an extra bling, the dressings that were originally around my pin sites after the surgery were lined with silver, but the hospital paid for those apparently. The silver acts like an anti-bacterial agent, for reliable infection control.

For more information on the frames, you can go here:
http://www.smith-nephew.com/us/professional/products/featured-products/taylor-spatial-frame/

They're a bit bulky, and you'll knock it on things occasionally. I felt really clumsy at first, because I kept doing that as I was getting used to it being there - but it doesn't hurt to gently knock. I wouldn't recommend going around bashing the crap out of it - but it can take it, and it won't leave you in pain in the slightest. I've even fallen over once, and rather than anywhere on my leg hurting, it was my backside that hurt the most from landing on the edge of the shower, bruised quite impressively. Speaking of showers...




SHOWERING/BATHING

Right, so for the first night, I didn't shower. Obviously, because I hadn't been allowed out of bed and was still out of my mind with drugs. I was able to shower the very next day though, with help taping a bag around my leg and I had help wrapping a towel around my head and being dried off as well (remember, it was two days before I could dry my own butt? My balance was horrible). The shower itself I was able to handle on my own, by having a chair placed in the shower. For the first week and a half, I would sit down in the shower. Both the hospital and the shower downstairs at home are the models that are mounted to the shower on an adjustable rail and the nozzles themselves are detachable from their holder. This comes in handy, and I'm glad I decided to move downstairs because the upstairs shower is permanently fixed to the wall.

As the muscles in my left leg slowly got used to being the primary weight bearer, I was able to actually stand in the shower and balance best I could through out the duration. This was highly preferable for me, because it turns out sitting down in the shower the entire time is a right pain in the posterior. I did this for a while with my crutches either just outside the door, or even once or twice I took my crutches in with me. I don't do that anymore, as we've since gotten a walker for me to put in the shower to use for my balance. As I mentioned before, I've actually fallen over while trying to come out of the shower - I put a crutch down on the edge of the bath mat, and the mat flew out from under me. I managed to twist my body well enough that I landed on my side with my upper body and my leg was facing up, so I landed on the back of the frame rather than the front and it didn't hurt my leg and none of the pins hit the ground, but my backside definitely ached for a few days. So just be careful with your crutches. Also with slippery floors. There's been a couple of close calls where I've put my crutch down on a slippery surface and it's come out from under me but managed to catch my balance in time not to stack it. Again.


So the picture is of how we have our shower set up for when I use it. We still have the chair in there for when my leg does get tired, but also have the walker as it provides a more stable support. That wasn't even my idea, I think I accidentally scared the living daylights out of my mum when I stacked it though, because she went out and bought it the very next day. It was about AUD$100 brand new.

I wore a bag around my frame for the first three and a half weeks, until I got the okay from Dr Astori to bathe without it. And like I've mentioned before - I was told no soap, just water. It helps soften the skin before cleaning, too, so it doesn't hurt as much as it did if the skin needs to be broken from the pins. I shower at night because that's the best time for us to clean my pin sites as well, and the pin sites need to be done straight after showering. And this was the worst part, as far as I'm concerned - because I had to bag my leg up, it meant no shaving my right leg for three and a half weeks! Gasp! The first night I was able to shower with no bag, I made damned sure to make that baby as smooth as possible, without getting *too* close to the pin sites so not to irritate or get any stray hairs in the wounds. Another tip I was given from one of the nurses at the hospital, was to spend some time going around my leg with an eyebrow trimmer, or something similar. It's all rather fiddly, but you do what you can to feel clean!

I change towels (I use two, one for my hair and one for my body) about once every four or five days, but I'm probably going to change that to every second day, just to be on the safe side. It's recommended that you change your towels once every three to five uses to avoid mildew or mould bacteria from growing inside your towel. When we wash the towels, we wash them like normal but also with a capful of  Canesten Hygiene Laundry Rinse, which has anti-fungal and anti-bacterial properties.