Perhaps a maximum height for LATN exists based on the length of available nails, but that is a question best put to Kulesh or somebody with similar expertise.
You are already tall so perhaps you are Scandinavian or want to be an American movie star? I was not tall to start so the length of available nails for me is not a problem.
Hexapods Installed Today for Final Correction
Distraction= 8.3
Correction calculated for three days.
Then, long films to rule out leg length discrepancy.
Then, final distraction to 8.6 cm via hexapods.
Then, hexapod removal and locking of frames at 8.6 cm.
Then, LATN surgery on 20 Jan.
Less than two weeks from the finish line (excluding consolidation and recovery).
Long Films
First scheme of correction via hexapods completed. Second scheme consisting of only one day of corrections required for exact alignment.
Long films show leg length discrepancy of 2 mm. Shorter leg will be distracted via hexapod to make up difference.
Final height gain will be 8.7 cm.
A bit confused. What exactly is long films? Is that a type of x-ray? How exactly are they determining alignment and distraction?
I'm in a post-soviet facility now and they can barely read my distraction from an x-ray.
As I have come to understand things, the size of an x-ray image is the size of the film canister. Film is rarely used nowadays; the canister is digital--but it helps to think about the plastic x-rays that MDs used to put up on light boxes to understand the concept.
I incorrectly believed that to make a full length (long film) x-ray of legs, a film canister measuring about 3.5' x 2' was used. However, I've come to understand that no such animal exists. Absent very specialized equipment, the largest film canister is the size of the light box MDs used to use.
To obtain a full length x-ray of legs, three images are taken--top, middle and bottom. Then, using very specialized software, these images are stitched together to form a single digital image.
When trying to get long films done in the USA, I discovered that very few x-ray machines have the software that allows the stitching together of images. Fortunately, the Vreden Institute has the technology to make long films.
Long films are used by Kulesh and Solomin primarily to assess leg length. Alignment and distraction are easily assessed on short films. However, short films are not enough because you can lengthen both legs equally but doing so does not ensure that your overall legs are the same length.
By example, I learned that one of my legs is 1 mm longer than the other. Consequently, I don't want exactly equal distraction because to do so would would perpetuate an overall leg length discrepancy--I want my shorter leg to be distracted the additional mm so that my overall leg length is equal. Long films are used for this purpose.
Even older digital x-rays machines should have calibrated software that allows measurement of distraction. Usually, it is as easy as placing the cursor to obtain measurements. St. George Hospital got a new machine while I have been here. I was one of the first persons to use it. My short films said I increased distraction by over 2 cm in 10 days--we knew this was impossible so Kulesh took images of his radiographic rulers to help get the new machine properly calibrated.
Alignment is a similar process. Kulesh uses the software to draw lines and take measurements, etc. All of these calculations are backed up by physical measurements. In fact, it was remarkable to watch 4 MDs perform physical measurements--two on each leg. One would measure while the other recorded. Then they switched--if they did not get exactly the same measurement, they would remeasure and dialog to sort out the difference.
Even if the machine you use does not have calibrated measuring software, a ruler can be added to your image so that distraction can be measured manually. All of my recent images include rulers so that a manual double-check can be performed.
Hexapods Removed
I have to admit that I have never imagined this much medical attention, expertise, or attention to detail.
Today I had five (5) MDs working on me.
Dr. Kulesh was stationed at the foot of the table supervising everything.
Drs. Roma and Maxim worked on my left leg while Drs. Nikita and Nicholi worked on my right leg.
Each team was responsible to install hinged rods EXACTLY mimicking the hexapods so that the precise correction in place was not even slightly altered.
This means each team had to create a rod installation with absolutely no tension when tightened--everything had to line up exactly even when tightened down. They went through each connection multiple times loosening the connection to confirm that it was still not binding despite tightening other connections.
The work, expertise, and attention to detail was amazing to watch.
Part of what was amazing was how focused each team was on its own leg. Each team collaborated together and with Kulesh--crawling under the table to visualize a screw-hole and confirm the screw-hole was 100% aligned was a common occurrence.
Today, I literally watched the difference between doing things and doings things absolutely right. Craftsmen are not dead.
Before the hexapods were fully removed, x-rays were taken to confirm they got things right.
So, I am locked in at just shy of 9 cm.
LATN surgery is Sunday.
I knew the Solomin/Kulesh team was good, but today I was embarrassed because I saw just how good they are and fear I have not given them adequate deference and respect.
any pictures /video?
Is Dr kulesh doing surgery in the municipal hospital now ir It is now doing surgery in the prívate clinic?
To Sanity:
Pictures or video of what?
To Heightchange:
As I understand things, for the time being, Solomin/Kulesh are limiting surgeries to MEDEM because they have more ability to direct the actions of MEDEM staff and the staff seem to be more able to deal with unexpected contingencies.
In explanation, when performing surgery at a municipal clinic, it is complicated to get the best anesthesiologist; then, after the procedure Solomin/Kulesh must rely on clinic staff to follow-up on the procedure but staff MDs and nurses could be called away for other matters. Plus, if follow-up is less than desired, Solomin and Kulesh cannot really do anything about it--the staff works for the clinic; not Solomin and Kulesh.
So, to provide the best level of care, and a level of care acceptable to Solomin and Kulesh, they are currently doing elective leg lengthening surgery at MEDEM only.
This is an evolving situation and you should really dialog with Kulesh if you want surgery at a municipal clinic.
With that written, I had all of my surgeries at St. Elizabeth's and can attest that I received a better quality of care than at any USA hospital.
My final LATN surgery will be at MEDEM but because of this potentially temporary change in policy midstream, Kulesh will honor the municipal clinic price structure.
"Pictures or video of what?"
of ur existance...
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