Wednesday, 23 November 2016

Leg lengthening, 0-5mm

I've been to physiotherapy today in Liverpool. I got picked up in a car by East Midlands Ambulance Service by a nice driver who took me to Liverpool. It was very good, I was comfortable in the back. We arrived about 0940. I had my appointment at 10. I showed the physiotherapist the strut that's not behaving properly, seems like the nut is threaded maybe and I've been using pliers to make sure it works. He took one look at it and decided to replace it - I'm still not sure if adjusting this with it threaded matters or not. He put on a temporary strut to keep the tension while the other one was taken off and a new one put on. Then he went and got me clip removers so Rebecca can take the clips out later (the clips from where they cut in to chisel my tibia) and I also asked for and got a big bag of dressings so Rebecca and I can be change them again in about a week from now. It's really great how they trust me so I can just ask for stuff and get on with it myself and with Rebecca's help. That has been a constant throughout my treatment at Preston and here - I really can't speak highly enough of all those NHS professionals that have looked after me.

For actual physiotherapy we did stretches of my knee, my forefoot and my toes. It really makes a difference to the range of movement in my forefoot which has to be maintained so that I can walk properly without an ankle that moves. I must also do the knee stretches to try to stay in the 'honeymoon period' for longest. What is the 'honeymoon period' I hear you ask? Well I asked him about not being sure anything was really happening and them having built this lengthening procedure up as a really tough thing etc. So he explained.

There's always a 'honeymoon period' while the natural stretch in your tissues is used up - it varies for different people, you can check it just by stretching your skin with a finger, but it could easily be 5mm so I'm obviously still in that period now. What happens when the limit is reached is that the soft tissues can no longer keep up with the extension you're making, so then it's like over-stretching a muscle. If you overstretch it for a few seconds and then relax, no problem. If you were to hold the stretch for more than a few minutes, you'll probably feel pain and want to relax. If you hold it for more than an hour, the pain gets worse because you're having to constantly deal with it. Until you relax the stretch. So what's going to happen is that once I get as far as the natural limit of my tissue, it will be like stretching a muscle and never relaxing it. That will be painful. Oh and there's the other stuff I talked about previously about wounds around pin sites. So that's where we're headed - the knee stretches may help increase the length of this period so I'll be keeping on doing them ha ha ;)

Anyway after this enlightening conversation about pain I went for an X-ray and since I can't wait until next Tuesday to see, I asked the radiographer if I could see them. You really can see the gap, it's not my imagination, it might even be 5.25mm ;) Fab! See below, where I have also made some blow ups of the interesting bits!

Here's my photo of the screen in radiography, this is the top view x-ray. Once you orient yourself to
what you're seeing, you can see my fibula, still (and forever) in several pieces, and you can see the gap opening up,
see the blow-up below.

And here on the right is the side view, close up of my knee, you can see the gap opening up.

This is a close up of the side view knee x-ray, you can see the gap and the staples over the wound to the right.

Here you can see the three nails or screws that they put in to hold my ankle together.  One of them is at an angle that I can't really understand, like it went in from the top going downwards, I'll ask about that next week because it doesn't seem to fit with the description before the operation. 

Here's a blow up of the top view x-ray, you can see the staples and underneath the gap opening up in my tibia. It's definitely there, it could even be 5.25mm!

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