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Osseointegration Part One

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I am back again with another update :D I now have the C-leg and it took quite a bit of getting used to. Previously when I had the socket I had an IP and I never had to roll over on the toe to make the knee bend before. I am still walking with the crutches and am putting around 50Kg of weight through the leg, I have another 25Kg to go and every slight increase in the weight I can tolerate seems to take ages. I feel like I have only managed a 5Kg increase over the last three weeks so my plans for a Christmas without crutches don't look like they will happen this year.

My physiotherapist says I need to use my hips more when I walk and I need to keep the weight on the toe a little longer before stepping down with the good leg. Not being able to put all my weight through is not getting the best out of the leg but I need to work on the correct way to use it now before I start to develop bad habits.

I am still doing my usual walking and now I have a new set of exercises to do each day and these are much more difficult than the ones I was doing before. I have to do them with the leg on and they are making my lower back ache. Some of the exercises have to be done lying on the floor and the hardest one is lying on my stomach and lifting the leg backwards off the ground.

I am making very good progress according to the Osseointegration team but as I get nearer to full body weight my progress will get even slower. Also with me having a short residual limb the amount of bone I need to grow to the implant at the top is more than people with a longer residual limb due to the bone widening near the top, so it may take me a month or two longer than I expected. I now hope to be without the crutches sometime in the New Year and I have been told not to try and rush things.

On a positive note I can wear the leg all day and I have managed to do a few little jobs on the cars in between my walking and the exercises I have to do. I haven't had any abscesses or infections and I haven't had any falls. The other good bit is that I can put the leg on and it only takes seconds and the days of putting it in a socket and finding I have to start again due to the discomfort have long gone.

I will try not to leave the next update as long and thanks again to everyone who has contributed to this post with words of encouragement.

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I'd been wondering how it was going, Paul... thanks for the update! Despite the time it's taking you (or maybe because of the time it's taking you), it sounds like you're starting to see some benefits!

This has been a fascinating thread... I really appreciate your sharing this journey with us. Have you noticed just how many thousands of views you've been getting? There are a lot of us who have read and wondered about osseointegration, and your first-hand reports provide so much information!

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Hi Paul

It great to hear about your progress. Unfortunately I'm not a suitable candidate for this procedure but had I been, the information you have put in your postings would have given me a little insight into what I might expect. Thanks for keeping us all informed, its really interesting to hear how you are getting on.

Regards

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Paul, Cheryl has said all for me. I hope you keep the reports coming as it is ground breaking stuff and not readily available to everyone - yet.

BTW, now that you are up and about and in your garage can I book my car in for a service? :)

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Great to have an update Paul.

Interesting about having to walk differently with the c-leg.

I always enjoy your posts.

Lynne

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I do wish you the best of luck woth thisans hope you keep us informed on your progress. This is history in the making.

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Hi Paul. happy New Year. I've been in New Zealand for a while so just wanted to catch up. he are you doing mate? Is it getting easier to weight bare? How are you finding the C-leg?

Paulpost-36-1199898279_thumb.jpg

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Hi Paul

Just wondered how you were getting on?

Lisa

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Happy New Year and thank you everybody for your interest, here comes my latest update :D

I did manage to loose the crutches for Christmas and I managed with two walking sticks. The 50Kg weight bearing I reported in the last post turned out to be an overestimation and to my horror I only managed 50Kg once in the Gait laboratory and the average was more like 45Kg. It turned out that over a three week period I had made no progress at all! After starting with the walking sticks I attempted my 1.5 mile walk with the sticks accompanied by my wife until I was confident enough to manage it on my own and since then it has got much easier.

I have been trying my best to make progress since the disappointment and I have done extremely well. I can now walk with only one walking stick around the house and to the garage and back and I am now starting to attempt part of the 1.5 mile walk with just one stick. I cannot make all the walk with one stick and I feel I should not attempt it yet as I don't want to cause any setbacks. I am officially putting 60Kg through the leg now and my walking looks more natural with one stick than it does with two.

I am really pleased with myself and maybe in two weeks time I will only need one walking stick instead of two. I have actually taken a few steps without any sticks but it looks quite untidy at the moment. The C-Leg has been a great help towards my confidence as it is a very stable leg, I have also been able to go foot over foot down stairs with it.

My lower back and leg muscles still ache but it is to be expected as the muscles are building up trying to develop in order to cope with the walking I am doing. Now that I can walk with only one stick I can now carry things with the other hand and it has made a considerable difference to what I can do. I can carry a bucket of water to the car to wash it, carry a cup of coffee from the kitchen to the chair and many more things. I am so thrilled to have got this far and I can't wait to be rid of the sticks all together. I didn't realise that the rehabilitation would require so much dedication, patience and frequent visits to my pain threshold and I still have a way to go. I have no regrets and I have only admiration and great respect for everyone who has been involved in the Osseointegration programme, those who are helping me in my rehabilitation, my family and all those who have shown concern and interest.

"History in the making" I like that one Stinker :D I hope I am able to be of help in the future to people who are considering the Osseointegration system. I am very fortunate to be part of history and as I continue to progress I will continue to keep you updated.

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Wow... what a lot of progress you've made, Paul! (And what a lot of patience and dedication you've shown!)

Thanks for the latest update... this has been fascinating.

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thanks for all the news Paul and good luck.

Well done on getting a C-leg from PCT.

my PCT refuses to go further than a Mauch as poliy and understood that no PCTs were prescribing.

Any Brits out there get "high-tech" from the NHS?

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cant write:

understood no PCTS were prescribing the likes of the C-leg even if they had in the past

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I don't know about C-Leg prescribing rules with PCT's but the one I have was prescribed by the rehab place in London. As my PCT agreed to contibute towards the operation they probably couldn't refuse to fund the C-Leg and go against the recommendations by the specialist in London. I spoke to someone who had the Osseointegration done 8 years ago and he has a Mauch knee and prefers it. He said that the C-Leg doesn't have enough flexion in it. I too have noticed that as I am unable to lean back at all when I am kneeling down as the C-leg only just bends a little further than 90 degrees. I am sure I can adapt to that and I did manage to change my wife's front brake pads yesterday along with changing the engine oil and filter.

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Hi Paul, a year or so a go I was having lower back issues, my wife is an osteopath and she sent me to see a physio. The physio said my spine was curving, so we started extensive exercises. I go to the gym at least twice a week, doing low weights and plenty of floor exercises strengthening my lower back. Within six months I had straightened my spine.

Try lying on your front look your hands behind your back, then lift your leg, stump and torso off the ground as high as you can. Start slowly but build up to 3 sets of 10. do this exercise without the prothstesis.

Lying on your back put your foot up on the wall, place a medicine ball or basket ball under your stump. Then try gentle sit up pushing on your stump, again start slowly, then build it up to 3 sets of ten.

You can work on your posture with sitting cross legged doing 180 degree arc with your head. Touching your toes while sitting also helps you stretch.

The muscles in our back are often forgotten, six pack counts for nothing without a strong back.

You have achieved an amazing amount, and your body has taken a hell of a hammering, try these exercises and see if they help?

Hats off to you Paul ;)

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Thanks Paul, One of the exercises I have to do is the one you mentioned where I am on my front lying down and lifting my stump back. However it is much harder as I have to keep the leg on when I do it. Also I have to do one on my back with both knees bent and lean forward as far as I can. I know what you mean about the back muscles being important and since I started this exercise regime I have ached in places I didn't know I had muscles!

Now that I am weight bearing more than before I have to try and shift my weight over to my affected side more so that when I do eventually try to walk without any sticks any limp I may have will be less pronounced. It is amazing how many muscles come into action when walking and at the moment I have to think about it a lot but eventually it will switch over to auto pilot. I have to line my belly button up with my toe on the affected side when I am stepping through with the leg but also I have to keep my shoulders horizontal. Also I have to push back with the leg to get me through to the next step and the worst bit is that I have to balance whilst doing this by pushing out to the side with the leg to stop me from falling over on the affected side.

You may have to think about that one as I did but the pushing out to the side seems opposite to how I did it with the socket and if I were to fall I would prefer to be headed the opposite way as I would do less harm to myself.

I better do my exercises now then there is the second walk and then I can do some work in the garage. :D

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I too will do the exercises.

my posture has deteriorated, tending to bottom out and tummy out (ahich has grown anyway!) I go to private osteo/phsio once a mnth for manipulation , but have been slack on exercise.

PCT not interested beyond getting me out the door walking. thats not a reflection on their skill but time/budget

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I too will do the exercises.

my posture has deteriorated, tending to bottom out and tummy out (ahich has grown anyway!) I go to private osteo/phsio once a mnth for manipulation , but have been slack on exercise.

PCT not interested beyond getting me out the door walking. thats not a reflection on their skill but time/budget

As A/K's we tend to push our bellys out, I think we have to live with that unless we have racing snake shape.

The improvements I have noticed since doing these exercises are at the sides. Ladies call them love handles!

Targeting these areas has helped me no end.

Of course nutrition is very important as well. If you have a good understanding trainer at your gym, they will build a program to suit you. Ex military instructors are excellant, they are used to amps and have great understanding. Also ask if the gym has IFI (Inclusive Fitness Initiative) the instructors will then, have to have had training for disabled people.

The rest is up to you...........no pain.........no gain :D

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Hi again and sorry I have left it so long. I am not quite there yet but I can now manage to do my walking outside with one stick. Around the house and garage I no longer use any sticks and there is not much pain at all now when I put full weight on the leg. I managed to injure my back a while ago and I had to rest for a week, then after that I was not able to walk my usual distance but I have managed to build back up to that now. The back injury was down to me putting considerable weight through the walking stick and my physiotherapist said that a back problem was inevitable with the amount of rehabilitation I had to do.

I am still doing all the exercises and the two walks a day and the only exercise that hurts is one when I am stood on the artificial leg and I step up with the good leg. I have to do this frequently and attempt to keep my balance whilst doing it. The muscles in my stump are now like concrete when I tense them and my abdominal muscles are much stronger than they were before.

I did expect to be where I am now by the end of February but a few weeks in the scheme of things is not that long I suppose. My next goal is to be able to do my walk with no sticks but I have no idea how long that will take. I still have a great deal of physiotherapy to do yet to achieve this and hopefully by the end of it all I should be able to walk almost normally. This last stage will probably take the longest as I will be trying very hard to reduce the dip to the left I have when I walk.

I will try not to leave it so long before I post again and thanks for reading. :D

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Thanks, Paul; I'd been wondering how it was going, and it sounds like it's still going well!

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Great hearing from you. Please keep us posted.

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Hi and I am honoured to see that my post has been nominated for one of the best threads. It is about time I did another update so here goes:

I haven't yet achieved my goal of doing the walk without a stick or cane as some of you call it, but the pain levels have dropped quite significantly. In addition to the set exercises I do I was advised by the physiotherapist to do more sit-ups as this would improve my abdominal muscles and help with my balance. I bought an abdominal exerciser which was only £7 ($15) and I now do 210 sit-ups a day. I have been using it for 5 weeks and I have lost over 2 inches from my waist. I invested in a second hand exercise bike too the other day and I have started pedaling 2 miles a day on that too. As I improve I will increase the amount of miles I pedal on it.

I amazed myself the other day as on top of all the exercises, the pedaling and my two daily walks I went around a large shopping centre in Manchester with my wife and we walked round for over three hours! I was dreading the next day as I thought I would be suffering but fortunately I didn't. I don't usually shop but my jeans had become too big for me so I had no choice.

I can't say enough about how wonderful this system is. No socket, no liners, no trying to get it on right many times, no swearing at it or throwing it across the room in frustration. I can have a bath then put it back on straight away and all it takes is the tightening of an Allen key. We managed a few days here when it nearly got to 80 degrees and I was able to carry on doing things and that was wonderful. I remember from before that I probably would have been sliding around in a sweaty mess and ending up with an abscess with the socket system.

I am only seeing the local physiotherapist in Manchester every two weeks now and I haven't yet been discharged from the team in London. The X-ray I had as part of the annual review showed full bone growth to the implant on the left half of it and just over 25% growth to the right half from the bottom upwards. I assume that once the implant has fully integrated there will be no pain any more.

I also have the Otto Bock Trias foot which was a bit of a struggle to get the alignment of the knee correct with but now the alignment is nearly correct it is a really good combination with the C-Leg.

As far as managing without the walking stick (cane) I still lurch to the left when I try walking without it and I am working on minimising this, I still intend to be able to manage without eventually, I don't think I will though until the pain has gone. I can't yet say when this will be but I would assume it will take no longer than another 6 months.

Thanks again for nominating my post for the best thread and I will compile another update soon.

Paul.

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Good on ya Paul..........Thanks for the updates

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