A tale of Old Ilizarovs from Australia Number One
As related via e-mail to me and his family and associates by
Mark Northage
Hi Slim,

Good to hear from you. Thanks for asking about my operation.

Just before the op' I visited your website again to show my sister and brother-in-law and their kids (here in Brisbane) what they could expect when I came back to stay with them from hospital. They were duly impressed but nothing could prepare them for the shock of seeing "the device" in situ at the hospital after the operation! My 10 year old neice recoiled exclaiming "that's disgusting".
The op' was a success (despite being very long) and I came out of hospital just 6 nights later, virtually pain free, (op' and post-op' analgaesia having been achieved with an epidural). That changed 2 days later when I went thru' some severe joint and muscle pain on mobilisation for about a day. I then swapped from paracetamol to nurofen (the only form of ibuprofen you can buy over the counter here) which coincided with much reduced pain levels.
I've been distracting at the corticotomy site since Monday last week (started 5 days after the op') and also trampolining the break site simultaneously (spanner work on the lower frames - 5mm up then 5mm down over a ten day cycle). In theory, this means I've already distracted 7mm on the corticotomy but Dr Holt (who I found out was the Head of Orthopaedics at Royal Brisbane Hospital until he went private) said he'd built some tension into the frame which would have to be "unwound" before any actual lengthening began.
Something must be happening tho' because I have some lovely holes opening up and weeping at the sites where the top pins go into my thigh! On the femur, thickish pins (two up, two down) are used to lengthen because you can't get a frame (with wires) to go all the way round the leg and still be able to sit down or go to the loo!
I see Dr Holt tomorrow when he will be taking foam pads off all my wire and pin sites. These have absorbed discharges since the op and were impregnated with some kind of disinfectant. One has already fallen off (hence the weeping) but these pads have saved me the chore of cleaning so far. My impression is that I'll be keeping the pads thru'out this treatment because they reduce the chance of infection.
I'm sorry to hear your body is recalcitrant and hope all will be well soon. How is the actual bone growth progressing?
Thanks for your thoughts and support. I try to remember you in my prayers too. I've added below the text of the full email I sent all my family and mates when I got out of hospital. Don't feel obliged to read it all. It may get rather boring for the truly initiated...
Take care,
Mark

.....................................................................
exTRa, eXtRA, rEAD aLL aBoUt iT
mORpHInE CrAzEd hOsPItaL eScApEE RUNs amOcK wItH UnfEasAbLe Leg AttAcHMEnT

That's how the Brisbane papers descibed it or was it all my own little dream? Anyhow, this is the chance to put my side of the story. Young children and nursing mothers may well have been shocked and offended at the sight of my el grande body piercing but it was no publicity stunt and, as fashion accessories go, it's plain awkward. I was formally released from hospital on Tuesday evening after only 6 nights "inside" and am now comfortably ensconsed at che sibling. Stories of my faint on Saturday whilst trying to walk in a zimmer frame have been grossly exaggerated - I was away with the fairies for not more than 3 minutes.
So, life with "the Thing", what's it really like? . Like being hog tied to a mechano set or stepping right thru' a drain grating and walking off with it... Metaphors and similies don't leap to mind.
I'm literally skewered by 3 wires just above the knee (leaving only about 20 degrees flexion) which are clamped into the lowest ring (about 1 foot wide) encircling the bottom of my femur. A further 4 pins, embedded on the outside of the femur, sticking out just below the hip and just above halfway, respectively, complete the piercing elements.
These 4 pins are attached in pairs to the middle ring (a full circle) and the upper half ring (rather than encircling, it is literally a semi-circle) also about a foot in diameter. These latter rings are connected to each other by long screws fitted with hand adjustable, click-stop, rotators which allow me to increase the gap between them (the rings) by 1mm per day, thereby achieving the lengthening at the corticotomy site (fancy word for place where surgeon sawed the bone).
The lower and middle rings are also bolted together by long screws and nuts which are only adjustable using a spanner! The spanner adjustment is being used to "trampoline" the break site, 5mm up (longer), then 5mm down, to achieve union. This action takes 5 days each way or 10 days for the full cycle and will go on until union is achieved. When both union and lengthening are complete, the frame with all it's impaling bits will come off (yipee!) leaving only a nail (a new one was put in during the op) inside the femur.
This nail will then have 3 locking screws inserted to stabilize the bone while it hardens. After that, the nail and screws can be removed and my femur should be as naked of metal as the day I was born... It all seems a long way off right now, but that's the plan.
Everday activities like doing no. 2's (yes, that's poo's) in the lu, showering and getting pants on/off now require NATO levels of planning and execution (let's hope my targetting is better than some of NATO's) and are exhausting, particularly the showering . At night, to avoid ponderous trips to the lu, I have an ex-squash bottle beside the bed which is now carefully labelled after one of my neices mistook it's contents for apple juice!
Perching on a low stool (and cushion) at dinner time, with the affected buttock only just supported, it's not long before I'm dying to lie down again, although things have improved since we managed to wedge my foot (on the gammy leg) against the horizontal table foot, thereby keeping my bum on the stool. My office chair, from which I type this email, has an unusual cushion arrangement to permit both buttocks adequate support and a stool to carry the gammy leg straight out in front of me.
Adjustments take place 4 times a day, including midnight, so the alarm is set for that one. I've become adept at the quarter turns on the spanner adjustable screws but can't really believe that after 5 days in one direction, the frame will be parallel!
When I began writing this email, yesterday morning, there was no perceptible pain due to the adjustments - indeed no invasive pain at all. Since then things have changed considerably for the worse. By the grace of God, I got a good sleep last night and nearly missed the midnight alarm! However, it is mobilisation that is now so painful I am moving as little as possible.
Both hip and knee joints seem to be loose due to low range and power of movement (use it or lose it). This causes sharp/shooting pain in the joint for certain movements. In addition, the upper pins now seem to be disturbing the flesh/muscle at the top of my femur. This is exacerbating the pain on use of the upper leg and seems to have affected strength considerably (perhaps due to pain).
The main thing I have difficulty with is stepping forward with the bad leg (whilst walking with crutches) and getting on/off the horizontal plane (eg. in/out of bed, in/out of this chair). As a result I have spent most of today in bed after some rudimentary, agonising "exercises" and the onset of a high temperature/headache. The only cure for exertion is inactivity! I'm feeling better now, after another couple of paracetemol but suspect some more serious pain-killers are called for...
Things could be a lot worse (and I mean it) were it not for the attentive service and good graces of my sister, Margaret and her husband, Paul. They cater to my every need (whim?), particularly Marg, who must have a PhD in Care of the Impossible and manages to think of miriad little ways to make life easier! Paul has just returned from the chemist with a pack of Nurofen...
My next appointment with Dr Holt is on Tuesday and I'll be asking some questions about serious physio...No doubt he will then be changing all the little sponge pads which presently cover each pin/wire entry point.
We knew this wasn't going to be easy but with all your prayers and encouragement it's just a matter of time. One friend recently sent me a copy of the latest (London) Vineyard CD, "Hungry", and I can echo a lot of those cries to God. He is faithful...
Apologies for the length/excessive detail (for the squeemish) of this missive but, as we know, information is power. Photos will come in due course...
Love to all

Mark


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