Pediatric dwarfism clinic
[Regular patients] Thank you for making such a difference in my life
Hello, I am 25 years old and I go to a university in Seoul. I had the Ilizarov surgery in my calf with Professor Song in June of last year. My height was 160.5 cm at first, but now I am 170 cm tall.
Deciding for the surgery and its process
It is tough to make a decision for an Ilizarov surgery because of the big surgery, long recovery time, expensive cost, and the pain. It was the same for me. Even though a lot of advanced technology methods and skills are being suggested by Professor Song, it is still a very tough decision to make for the patient.
The incentive that gave me to decide for the surgery was “confidence”. I don’t know if anyone who is not in my situation would understand what I mean. I had a quite tidy appearance and was doing well in school and other areas, and didn’t really have anything missing. Especially up until my high school years, I wasn’t worried about anything because everything around me and I were focused on solely on my education. But a lot of things changed after I moved to Seoul for university. After leaving the little fence called “high school”, I realized the grades I get are not the only existing standards when I meet numbers of new people and live in a community and build relationship with them. It was also awkward talking to girls since I went to all-boys middle and high school.
I realized physical appearance plays a huge role in building relationships that are based on one’s own confidence and not grades. Of course there are many people with unsatisfying height or appearance who don’t pay much attention to their appearance and focus more on other confidence. But the reason I am writing this is to explain that the change in your height will bring a great difference to the people who do care about appearance.
After that, I started looking up all the possible ways to grow taller. There are many methods such as oriental medicine therapy, acupuncture, oral medicine, calf surgery, and hormone therapy. But there aren’t that many available treatments for a 20-year-old person, which was my age at that time. But the safest and most effective method turned out to be Ilizarov surgery. So I started studying about Ilizarov surgery through Professor Song’s two books, internet blogs, and online encyclopedias and discussed it with my parents.
Actually, I also talked to other orthopedics doctors who were my parents’ acquaintances – they weren’t specialized in Ilizarov surgery. But due to the fact that this surgery belongs to a very specialized area, other doctors just advised me to think very carefully rather than giving me assurance. A lot of things happened during the process, but I eventually made an appointment at KUMC in Guro after explaining to my parents that I would not regret going to Professor Song who is the most specialized.
The leg lengthening Ilizarov surgery is rather unfamiliar to healthy people like me, unlike those who have disabilities. Even now, it is still an unfamiliar process to people who are not interested in the area. So there was a degree of indescribable uneasiness and doubts about not being able to walk properly, bend my knees, and do strenuous exercise and leading to other diseases. My parents, who were supportive of me at all times, were at times hesitant due to the doubts.
I still remember the first impression of Professor Song when I met him on the first day at the university hospital. Professor Song is chic in a way (haha). When I entered the examination room with busy doctors and nurses, he explained to me, who was worried about the scale and side effects of the surgery, in a very chic way as if it was nothing big. Really?
Some people say kind doctors are the best, but at that time I thought that doctors who can give assurance to patients are the best doctors. (haha) My parents told me later that they were also able to get rid of most of the doubts after talking to the professor. After simply explaining the process and the steps of the surgery, he introduced me to a patient next door and told me to ask her any details that I was curious about.
The patient in the next room was 2 years older than me and she was waiting for the 2nd surgery after the 1st one, which means that the Ilizarov device was almost extended and that she was waiting for the fixation and equinus correction surgery. She was getting an appointment for the 2nd surgery in the examination room. At that time, I actually saw a person having an Ilizarov device put on for the first time. She kindly explained to me about the process and Ilizarov. Then I had the surgery in about 1.5 months.
I had the surgery in June, 2005. The professor usually has surgeries scheduled on Monday and Tuesday, but because he had so many surgeries scheduled already, I was supposed to wait for quite a while. Generally it takes 3 months after the appointment, but luckily I was placed in a spot of a patient who delayed the surgery, and it was 1.5 months afterwards. I think it still takes about 3 months to schedule. I was admitted to the hospital the day before the surgery. Fasting starts on the day before the surgery and the surgery begins the next day morning.
Next morning, I went to the operating room on the 2nd floor. Honestly I remember falling asleep while talking to the nurses and when I woke up I was in the ward again. My parents told me that the surgery took about 5.5 hours and I slept for another hour in the recovery room and was moved to the ward.
As a lot of sources and professor’s books explain, the surgical procedure can simply be explained like this – Ilizarov surgery is where a part of your calf bone is cut and the surrounding is fixated with the device externally. The height-lengthening process includes increasing the distance of the Ilizarov device 1mm a day. After the surgery, you stay for another 10 days in the hospital, to make sure that the surgery went well and check through x-ray images. After that, you are discharged.
Usually, you rest at home after the surgery. Young teenagers even run around 2~3 days after the surgery without much pain. But if you are in your 20’s like me, it is still painful after a week. But after this period, you will feel peaceful for quite a long time. Because you will be growing 1mm every day. I rotated the pin in the morning, afternoon, and at night, one third of a rotation each time. So one complete rotation means lengthening of 1mm. When you do that for a month, it becomes 3 centimeters.
When you increase the gap between the incised leg bones, the once flexible leg becomes more solid after lengthening of 5~6 centimeters. This is when the skin has reached its limit of flexibility and has to adjust to the forceful lengthening done with the device.
This is the point where your peaceful times end and the battle within yourself begins. Of course you get used to this after a certain point as well. How much ever you may when to lengthen your legs, the professor will check how well the new bone is forming and tell you the maximum lengthening you can have. That is why the 1st surgery is very important.
Ilizarov surgery is not a surgery where Professor Song can do everything. Even though he is responsible for the entire surgery, safety, and the process, it is up to me to I take care of it and make bone growth and ankle flexion come to normal as fast as possible. Bone lengthening is done forcefully with the Ilizarov device, but “diet” and “exercise” are very important to solidify the bone. I was reminded of this by the professor when I went to KUMC for follow-up every month after hospital discharge, but it wasn’t easy for me because of the pain.
As for eating, I didn’t have much appetite because I only stayed home for rest. So even though it might sound dull, you really need to have a fun and enjoyable time at home. You will have indigestion and even less of an appetite if you just spend each day suffering from pain and complaining to your parents. Also, you need to eat different kinds of food since your skin, nerves, muscle, and vessels grow along with bone growth. My mom thought eating only meat was not good, so she made different vegetable dishes every day. Also I had one red ginseng a day. My body can take red ginseng well, but it is beneficial to take nutritional supplements and eat black beans, pear puree, bone soup, or any food with lots of calcium in it.
Exercising is hard. It is really hard. But there are two benefits to exercising. First one is that the bones grow more solid because walking stimulates the gap in between the incised bones. Secondly, because the bones are regularly lengthened in a fixated position, the muscle behind the calf gets relatively shorter. But everyday walking lengthens the calf muscle naturally and grows as long as the bone.
Rather than walking normally after you can walk well, you should walk until you definitely feel the stretching from the muscle behind. Once again, exercising is very important, but painful. Forceful skin and bone stretching itself is painful, but walking makes it a bit worse. So basically the amount of exercise you do decides how fast your bone grows, how long the surgery duration will be and whether equinus deformity correction will be done during the 2nd surgery.
So I decide to exercise 5 times a day – 9 AM, 11 AM before lunch, 1 PM, 4 PM, and 7 PM. I walked for 30 minutes at those 5 times. At first it is easy but it gets harder and more painful. But as the professor always told me, the Ilizarov is very safe because it is firmly fixated. As long as you walk regularly and not run, the recovery will occur faster and make your bone firmer.
Other than all that, “enjoying your time” is important. Even though it might sound dull, I spent about 8 months resting at home. Since I am at home only for a long period of time, a regular and enjoyable schedule is very important.
I spent a lot of time sitting on the wheelchair. Other than exercising at those definite times, going to bed around 11 PM, waking up around 7, and having nutritional meals are important. It is not good to sit in front of the TV or the computer all day long. Not only those activities are not bad for bone growth, but they will affect your mental health in a negative way as well.
So it is also good to talk with your parents or close relatives at a certain time every day. I snuck out of my house late at night a couple of times to get some air. When I met anyone outside, I told them that I hurt my legs while playing sports. I usually went for a walk to a nearby park with my legs covered up in a blanket. Because I went out like this 2~3 times a week, I didn’t feel like I was only stuck in my house. I also read a book for 1 hour every day. Other than the ones I mentioned, any leisure activities of your own will be helpful for long-term recovery.
During the surgery duration and for my every-week follow-ups after the surgery, I went to KUMC by our car. It was a bit difficult to situate myself in the car because of the Ilizarov fixators. I will give you a tip here – I sat on the back seat on the right side and put on my seat belt. Then we put the backrest of the right front seat all the way down, which landed on the seat base of the back seat. Then when you take out the head rest of the front seat, it becomes a very comfortable seat where you can rest your legs on.
People who live in a rural area like me have to ride on the car for a long time. It may cause carsickness or pain because of blood accumulation. But if you put the seats as I described, the leg is fairly elevated so it will be more comfortable and you can also enjoy the scenery outside. Of course, definitely don’t forget to fasten your seatbelt.
At first my decision was to lengthen 8 centimeters. But people get greedy once they start lengthening. But because the professor makes safety his priority, he didn’t let me lengthen extremely. So I think he only agrees with lengthening a bit more when he judges that the speed of new bone formation matches up to the amount of lengthening.
I went up to Guro KUMC once a month to have my progress checked by the professor. There, you can vividly see your lengthened bone and how it is shaped through x-ray. The distance between the bones on the x-ray is the increase in your height and the white threads forming are your generating bone. As I saw the growth of the bone and height with my own eyes, I was more motivated to eat more and exercise more joyfully.
Sometimes, I went to a nearby hospital to take x-rays, which were burned into a CD and sent to Professor Song by mail. At that time, I was able to open the files of my bones myself. I still have the pictures and I think the pictures really motivated me to be happy when I was in pain every day. But then, you will already start finding joy from realizing the elevation of the level of your vision each day.
My first surgery was in June, 2005 and the second one was in November. In this surgery, lengthening is paused and the Ilizarov device is more firmly fixated. Also, the muscle behind the calf is lengthened for equinus deformity correction. Mostly the Ilizarov device is not removed during the 2nd surgery. But Professor Song made an exception during my surgery and had the device removed with only the pins inserted in the upper and lower parts of the leg.
Because the leg had been lengthening with no problem, he told me that removing the device would be ok and be more convenient for doing exercise and daily activities. I was very thankful to the professor and exercised more diligently in a manner that wouldn’t cause shock to the leg as Professor Song has instructed.
So after lengthening my leg about 10 centimeters after the 1st surgery in June of 2006, I had the 2nd surgery in October, which led to duration of pin fixation and bone filling. The equinus deformity correction actually causes pain during this time. Because, as I mentioned earlier, the muscle behind the calf is lengthened in the deformity correction, and this is done by making slight cuts in different areas in the upper part of Achilles tendon. When the scar heals and lengthens, the calf muscle will be as long as the lengthened bone. Scarred muscle lengthens more easily than normal muscle when forcefully stretched.
At this time calf muscle requires new type of exercise. The professor told me that I would have to do another surgery if the muscle didn’t lengthen as much. So he told me to do leg exercises regularly because the muscle would lengthen only before all the scars heal.
To lengthen the calf muscle, I did “leg pushing exercises” against the wall while sitting on the wheelchair. Of course walking exercises are the most ideal but on top of the pain from deformity correction, walking for a long time becomes extremely difficult. So the first step of the exercise is to putting your legs against the wall perpendicularly. You will be surprised when this starts to happen by itself. Because the muscle doesn’t tend to lengthen easily, the foot actually becomes fixated pointing downward after lengthening exceeds 8 centimeters. So you will feel the consequence of equinus deformity correction when the foot perpendicularly lands on the floor by itself. Starting from this, the next steps are gradually lowering down the level where you put the sole of your feet against the wall. As you lower down you leg, the angle of your bent ankle decreases. This is how you can lengthen the muscle that was operated in the deformity correction surgery. I spent most of the day doing this exercise for about an hour each time with a short break in between. This is how the calf muscle can lengthen. The muscle should be kept this way for it to be stabilized in the end. I drew a little line on the wall every time. This way, I was able to see up to where I exercised the day before. I think exercising this way is better because without walking, you can sit on the wheelchair and constantly push against the wall to lengthen your calf muscle.
After regular exercise for about 10 days, you should be good to walk and the ankles should bend while walking. So the last step is to practice walking a lot. This step makes me happy than any other steps do. Because at this point, the lengthened legs aren’t as painful as before.
Oh, my eye level has elevated this much! I realized that 8 months of pain has come back to me as joy. After Professor Song removed the device, I still walked around in the park during the day with a Zimmer frame. Walking too much is not good, so I walked around for about 30 minutes.
Returning to school after surgery
After spending the winter of 2005 like that, I returned to school in March of 2006. After looking at the x-ray, Professor Song told me to use crutches because the bone had not filled in completely. So after using crutches for about a month, he told me not to use it any more.
I went to school carefully for a year. And in December of 2006, I had a surgery for removal of the fixation device and fixation nail inserted in my calf bone. The duration of surgery was quite short and was hospitalized only for 3~4 days. After the surgery, for the first time in 1 year, I suddenly felt the pain I used to have for 8 months. I used crutches for about 2 weeks.
After all the treatments have been complete, I was able to continue with my school happily. I became talker and had not even a small side effect that I was almost forgetting that I even had the surgery. I am forever grateful to Professor Song for his immaculate guidance starting from the point of decision for surgery till the removal of the pins.
Right now I am a member in a tennis club at school and play quite well. I also play basketball often after school on the weekends. I have no difficulty standing up, and no pain in my legs and kneeling feels the same as before.
Concluding my thoughts
I will be graduating from college soon. I got to meet Professor Song upon pondering for a long time with my parents in the big hopes of being taller right after I entered college. I am very thankful to him for letting me realize that such big difference can be made in my life. Sometimes I am surprised at the fact that I once used to be worried about my short height and that now I usually forget about the surgery
I would like to thank Professor Song once again for guiding me safely throughout the entire process. I will be sure to visit him in the future. I also want to take this opportunity to thank my parents for their endless sacrifice. I hope many people who are in despair can meet Professor Song and find help through him.
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