Limb Lengthening Forum
Limb Lengthening Surgery => Limb Lengthening Patients Experiences => Topic started by: LU213 on October 28, 2021, 09:57:57 PM
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I did Limb Lengthening last month and I decided to create a diary because I did 5 weeks in Athens and came back to USA. This is for those who cannot stay 3-4 months in Athens so they will know the experience of someone who did not stay. I am in University and just finished midterms so my posting time is behind schedule.
I had surgery 14 Sept 2021. I am 20. I started at 176 cm and will go 8 cm and maybe 9. I will wait until I reach 8 until I decide.
I started with a free 15 minute consultation with Giotikas before he had GNail. I found out through this forum (V21) that he had GNail. I then paid for an hour consultation once he had GNail. One of my concerns was the pain control. He told me that U.S. doctors don't want to lose business and they want us to think they have better pain control but the European doctors have the same medicine the U.S. has. Another concern was I could not stay 3 months in Greece. He said I could stay 5 weeks which was the minimum, although his preference was for all to stay 3 months. I think Dr. G is pretty business savvy to come up with this idea to a nonexclusive license for use of GNail. Too bad this wasn't done in the U.S. but probably due to the FDA and all sorts of medical device clearing procedures that might take years (this is just speculation).
Prior to this it was my plan to do Precise with Dr. Assayag in the U.S. My family was very impressed with his standard of care, reputation and abilities. One of my parents is paying for the surgery. Something happened that the surgery did not occur in early July in Maryland and all future dates before school started were booked. So with my school schedule I would have to wait until December or January to have a schedule that would allow me to be non-weight-bearing again. So I decided I wanted a weight bearing nail. I still highly recommend Dr. A.
I tried Betz but he had no availability until January. I was concerned about weather and possible changes in January due to COVID and Delta Variant that could cause a cancellation. I paid for a consult with him as well. I did not want Guichet because of the requirement of a 3-4 month stay in Italy or the UK (also at the time no real positive reviews to speak of).
Due to the late change of plans - finding out about GNail in August and trying to get there in 4 weeks, many airbnbs were booked. We could not find an acceptable one in Peristeri. We wanted 3 br, 2ba. We found one in Athina that we sent to Giotikas office and they said it was close enough. It was about 12 minutes by taxi and 4-6 euros. Definitely close enough. We would eventually move from that place due to the size of the elevator, neighborhood and other things.
The hospital is in Glyfada so maybe if you have family spend the first week in Glyfada. Because we didn't know this, my family paid for another place to be close to me during my hospital stay. The anesthesiologist asked me if I am prone to get seasick. She said if not, I should get an epidural/general anesthesia combination because it would be better for pain. She made me feel more comfortable about surviving the surgery, so I agreed. The surgery was scheduled for 1:30 pm. The day before I had xrays, filled out paper work and took a COVID test. On surgery day, I got there early - about 11:30 and they put you in this ultrathin see thru hospital gown made of blue paper. Another nice older gentleman who had back surgery was in the room. I was nervous but my family being there helped me out. The anesthesiologist gave me pills for my nerves so that I would sleep. They rolled me to the operating room at 2:30. My family said Dr. Giotikas called them at 10:00pm to tell them I was okay. They were near panic. He said he put the nail in one of my legs but it wouldn't click so he had to take it out, make sure it would click and then put it back in.
I appeared back in the hotel room at about 11:00 pm. I asked my family if the surgery was almost over. My family went to check in to the Bomo Palace Hotel to be close to me although we had the airbnb in Athina it was 30 minutes away. By then I was vomiting. No one told me how to call the nurse. I think the person next to me called the nurse. She put some kind of pad on the floor and told me to turn over and vomit on the floor. She didn't return and I vomited nonstop with stuff going everywhere.
My family returned about 1:00 am and cleaned up the floor and the bedrails. They asked the nurse for a garbage bag or bucket for me to vomit in. The picture is right after my family cleaned up and I threw up again (didn't attach I will get an imgur acct). Eventually the nurse came back with a small bed pan for me to vomit in. This was much more sanitary. Otherwise vomit particles were spewing throughout the room. Most nurses were annoyed at any request. There was no machine monitoring my blood pressure or to see if I flatlined and the nurses didn't come in unless you called for them. Certainly even when you called, they usually didn't come. Family was not allowed to be present if they injected me with anything. It was like they wanted to eliminate any evidence if they committed malpractice. While Dr. G was good, the majority of the nurses I encountered were without compassion or care, including the hospital head nurse (different from the homecare head nurse). Perhaps they are overworked and very underpaid. Either way it was a factor that I had not properly considered when I decided to have surgery overseas. I could not imagine I would not have flatline monitoring. I would not go back to that hospital to be treated by those nurses. Because it was so late, no walking that night. The next day, Dr. G came with a hospital therapist and tried to get me to walk. I nearly passed out so he said he would come again.
After a day of vomiting without leg pain, the nausea stopped and excruciating pain came. This was the 16th and I ate a little for lunch. I was being given paracetamol (tylenol) by IV and it wasn't doing the trick. I could not sleep more than 30 minutes due to the pain. My family was timing it. My family had to go get the nurses after sufficient time passed to get me more medicine. No one came otherwise. More pain than I ever experienced. The doctor came again for me to walk. I was out of bed but I was so weak. The Dr said I needed to be stronger and I wasn't trying hard enough. My family said I spent a day throwing up, I haven't eaten much and I was in pain. The dr said maybe it was jetlag. Either way, I threw up again about 5 minutes after Dr. G left.
By the third day, I was able to eat and able to get out of bed and walk. I still had a lot of pain but Dr. G showed me how to go up and down the stairs and use the walker. I walked up and down the hall and did the stairs. They followed me with the wheelchair because they were afraid I would pass out but I didn't. I believe it was this day that Dr. G showed me how to click. It didn't seem too bad. I couldn't wait to get out of the hospital. One family member slept in the room with me on the chair or floor every night.
On the fourth day, Dr. G showed my family how to help me click. The left leg seemed easier. Still it didn't seem too bad at this point. The first click is loud and kind of a shocker at first. On the right leg, the loud click first and then the light reset click. On the left side the light click first and then the loud click is the reset click. The anticipation for the loud click caused some anxiety. When it was time to check out, I met the homecare head nurse and she had a nurse working with her, with a car big enough to take my family and I along with the shower, chair, walker, crutches and wheelchair provided by Dr. G's program, to the airbnb. That was a relief because having to take a taxi would have been hard. More to come.
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Images
Hospital Room
https://i.imgur.com/W8tPcpj.jpg
Legs at 1 month
1 https://i.imgur.com/c2Y5k1U.png
2 https://i.imgur.com/xdBwNF1.png
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Hi Bro, congrats on your LL, certainly it's not for the faintherted!
I can't help thinking that you might have already been prejudiced against Giotikas because it was not your first choice (you mention Assyaag and Betz as your first and second choice respectively) and then you became a bit paranoid with everything that was happening there .I am saying this because I've been an inpatient or visitor at hospitals in the US and UK a few times myself and never saw flatllne monitoring in the ward, only in the ICU. Also it is common that visitors leave the ward when ward rounds are done or the nursing care is provided. Maybe Dr Assyaag can tell us more about his hospital here.
Anyway, I understand that everything is alright for you now and your x-rays look good, so good luck and have a quick recovery.
(PS How on earth did you manage to convince your family to allow you to do LL at 176cm starting heigght? I could use a little help here bro! :) )
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Hi bro, how's your overal experience using G-nail? Do you have problem clicking? Is clicking painful?
I heard that some need clicking under anesthesia. I am considering between Precice or G-nail. Anyway i wish the best for your LL journey
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I am not prejudiced against Giotikas. He was not my first choice because I live in the U.S. and he only had nonweight-bearing nails - the same nails as the US doctors. Why would I go to Europe to get Precise, when there are excellent doctors here that do it? I wouldn't do it to save $10,000 because it wouldn't be worth it to me. Not liking the hospital, which is a common experience among others I spoke to, doesn't mean I have anything against him. As I said I think he is a good doctor. Also where I am from in the U.S (that includes two states) when you come out of surgery, you are hooked up to a machine that monitors your blood pressure and pulse constantly. Thus when you lose your pulse, it knows you flatlined and beeps and the nurses run in. Even those in the ER are hooked up to a machine. Also from the Betz diaries, it seems they are hooked up to a machine that monitors their blood pressure. I will explain my clicking next but no I never needed clicking under anesthesia. I just haven't finished writing my diary and my recommendation of Dr. A was not meant to imply that I do not recommend Dr. G. I went with Dr. G - just saying that because I chose him didn't mean I didn't like Dr. A. In fact I also liked Dr. D in Nevada. I definitely recommend Dr. Giotikas so far - of course I haven't finished so things may change.
As far as the surgery at my height, My father is about 196cm and my mother is the most compassionate person on this earth.
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So mentally prepare yourself for the clicking for the first few weeks.
We were sent home with deepon, tramal, vitamin D liquid for once a week and lyrica. At surgery Dr. Giotikas provides the patient with 1 cm. On Sunday (surgery was Tuesday) was my first day clicking - 3 sets of five. Someone in the family helped me do it the way we were shown in the hospital for the first set. The left clicks were quite easy, though not without some pain. The pain level on the loud click was about 5 and then it subsided. Clicking caused great anxiety. For the second set, we could no longer get the right leg to click as we had just done it 8 hours earlier. So we looked up videos on Youtube and found a Betz patient video. We were able to get it to click in that manner. The left leg I could click without assistance from family. So we used that method. At that point, we realized that I may click one way and then not be able to click that way the next time, so I decided to click twice a day, 1 at 8 and the next at 7. I went to PT on Tuesday. The PT was good. It was small but had all the equipment plus more. It had an AlterG and you get to meet and talk with other patients. The PT staff are excellent and just very nice people. I had clicks on my left leg during PT. I just logged them in my spreadsheet and reduced the number I did at home. PT really work on Range of Motion (ROM) exercises. They push you to the limit and it is painful at first. I am much more flexible because of it.
From PT accidental clicks, I learned that if I attempted to lay on my right side and bring my left leg to close on top of my right leg, I could click my left leg pretty easily. So I started doing my clicks on my left leg that way. The Betz way stopped working on my right leg. We searched another video on Youtube and found Guichet patient videos on Dr. Guichet's channel on how to click 2 ways, 1 with a couch cushion and leaning on a stool. I then began to click my right leg leaning on the walker with my right leg on the bed. This worked for a while. The Guichet video was instrumental in understanding that the Albizzia nail prodigy were not made individually for each leg so that the right leg was almost always harder than clicking the left leg. Clicking got increasingly painful and harder. A little before 2 weeks, Dr Giotikas sent a text to take ibuprofen for a number of days and increase clicks to 21. I got the ibuprofen from the PT clinic. I though, after the first few days, could do my clicks without assistance from anyone but there was always anxiety and pain. I needed encouragement to do it otherwise I would procrastinate. I should mention I also take ZMA and before the surgery I took a blood builder iron pill.
I still dislike clicking but it is much better. Now I do the right leg on the couch or sitting on the bed with the right leg bent up beside me and push my thigh or knee forward until it clicks. Deepon never helped. Tramal made me vomit (always take it with food). Advil actually helped. My family brought ibuprofen with them so I was taking it before it was provided because of V21's experience. I understand it may affect bone growth so not too much.
My first appointment was 10/4 and I was 21 mm on 1 leg and 24 on the left. I don't know how that happened. Dr. Giotikas said that was about 45 clicks difference. He had a margin of error of+-1mm though. Anyway by time I was to leave they were about the same. I left 10/15.
On 10/6, I received the foldable forearm crutches I bought from amazon.de. The ones I ordered in September from amazon.uk never arrived. The forearm crutches were a game changer for my mobility. I left the american style crutches at PT for them to donate.
I came with a massage therapy gun, a tens unit, urinal and a narrow comfortable raised toilet/toilet riser set. I left the toilet at the PT to see if another patient wanted to have it. https://www.amazon.com/gp/product/B07TSFX9PL/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&th=1
Things a weight bearing nail allowed me to do while in Greece, I toured the Acropolis and Parthenon, the National Museum, saw the guards changing, first Olympic stadium. I also went to Santorini for 3 days flying Aegean air. Flights are must cheaper in the offseason.
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Throwing up is very common after surgery. I am really surprised the nurses weren't prepared to help. To ask a patient to turn to the side and throw up on the floor on a pad sounds unbelievably bad. Maybe there are underpaid as you said.
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According to reports, Greece's economy (like many other countries including some US states) is having some difficulty so that is certainly a possibility. It could also be that the nursing staff had not planned for someone coming out of a planned surgery at 11pm. At least in the U.S. you have to show up at some ungodly hour in the morning for surgeries - like 6 am and the hospital is fully staffed. When I came out,the hospital was probably not fully staffed. I learned later that 1 LL patient had gone before me that day.
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I see. It seems like it's going to need some experiment with clicking. Compare to PT session, which one more paintful, clicking or PT session?
Can this clicking problem be solved by asking a nurse to come to our home everyday to help clicking?
It would be anxious and painful if one day we tried many position for clicking but it's always failed. Have you ever experienced one day you always fail to click until the next day?
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For me, the nurse is not better at clicking. They are new to Gnail as well not like Guichet's nurses who probably have done this for years but maybe by the time you are there they will know more. My most painful clicking was the one time at the PT with the head nurse. I have been always able to click and after the first few days without assistance from others. The PT pain is like the pain of working out hard where you decide to endure it to reach a goal and it lasts for the 10-20 seconds they keep you in a difficult position, rest and then repeat. It is not something that caused me anxiety. They also have this equipment to make your legs feel better before you leave. PT pain gets less as the flexibility increases. The clicks are worse than PT.
There are those who come alone that pay for a nurse to help them click twice a day. I found the videos on the internet instructive enough so I could do it myself (of course I have family too but I do them alone and log them on my phone). Now they are pretty easy - still some pain but bearable.
There was a day or two where I procrastinated, fell asleep and failed to do my second set of clicks so I had to do 10 and 11 for a few days until I caught up. It was not though that I was unable to click. In those early days, I always found a way to click even when we had to to different methods. Once you get the first click, you are golden the rest come easier. PT owner recommended heat therapy prior to starting the clicks. He said hot towels if you didn't have a heat pad. Others recommend bike riding. I also have had no problem sleeping since the first few days. I did take melatonin and zma just in case though to avoid a problem.
I made videos of myself clicking any time I was successful so I could remember the positions and the different ways I do it. If I had difficulty one day, I would look at a video and get it.This is only for first 2-3 weeks, now of course, it is not necessary.
At this stage of 1.5 months, I can really see the height difference. It feels good. My family sees it but I have visited many friends and they don't even notice.
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@Lu213 Some good insight on what to expect during the clicking process.
Thanks for posting.
Best.
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Thank you! Could you post the X-ray? I would like to know/analyze how Giotikas inserts the nail and locking screw with G-nail because the nail is bigger than Precice nail.
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@Stretch - my pleasure.
@Raden - The links to the xrays on imgur is posted above.
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For me, the nurse is not better at clicking. They are new to Gnail as well not like Guichet's nurses who probably have done this for years but maybe by the time you are there they will know more. My most painful clicking was the one time at the PT with the head nurse. I have been always able to click and after the first few days without assistance from others. The PT pain is like the pain of working out hard where you decide to endure it to reach a goal and it lasts for the 10-20 seconds they keep you in a difficult position, rest and then repeat. It is not something that caused me anxiety. They also have this equipment to make your legs feel better before you leave. PT pain gets less as the flexibility increases. The clicks are worse than PT.
There are those who come alone that pay for a nurse to help them click twice a day. I found the videos on the internet instructive enough so I could do it myself (of course I have family too but I do them alone and log them on my phone). Now they are pretty easy - still some pain but bearable.
There was a day or two where I procrastinated, fell asleep and failed to do my second set of clicks so I had to do 10 and 11 for a few days until I caught up. It was not though that I was unable to click. In those early days, I always found a way to click even when we had to to different methods. Once you get the first click, you are golden the rest come easier. PT owner recommended heat therapy prior to starting the clicks. He said hot towels if you didn't have a heat pad. Others recommend bike riding. I also have had no problem sleeping since the first few days. I did take melatonin and zma just in case though to avoid a problem.
I made videos of myself clicking any time I was successful so I could remember the positions and the different ways I do it. If I had difficulty one day, I would look at a video and get it.This is only for first 2-3 weeks, now of course, it is not necessary.
At this stage of 1.5 months, I can really see the height difference. It feels good. My family sees it but I have visited many friends and they don't even notice.
For those who is coming alone and do it alone, my advise to engage the nurse service.
They are not only helping you to click and also check on you daily.
You pay a bit more for them to company you PT center and back home.
They are helpful to purchase the stuff and do simple housekeeping for you.
To date, my experience is positive one as they do help me a lot.
Dont be Hero and end up a Zero!
You will never know what will happen to you after big surgery.
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I don't recommend going it alone because it is true that you never know what may happen.
Back in the states, I get physical therapy from this countrywide Company that provides PTs who have doctorate degrees and come to your home. The PT I have is very good. I also have found an outside place that I can go to once a week for the Alter-G. It's $30 for a 60 minute session. The PT company that Dr. Gio uses provides a book with pictures of all the stretches. I provided it to the PT here.
I am blessed enough to have Dr. Assayag as my US doctor and I visited him and he said the bone formation is excellent. I also got to be treated by PT Moshe Roth. Also a very good experience. I continue my consultations with Dr. Giotikas who is the primary doctor. Dr. Gio is very responsive on Whatsapp. He has not abandoned me despite my leaving Athens. I hear achieving the last 3 cm will get exponentially harder. That is what I will be doing for the next month but I am keeping my eyes on the prize. :-\
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Can you elaborate on your flight journey? Must have been hard? I am quite afraid to fly after surgery because of risk of embolism.
It is indeed amazing that Dr Assayag is seeing you despite not being the main surgeon and not the method he uses (Gnail). He seems like a gem of a doctor. What are this thoughts on Gnail?
If there are clicking problems will you go back to Athens?
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Can you elaborate on your flight journey? Must have been hard? I am quite afraid to fly after surgery because of risk of embolism.
It is indeed amazing that Dr Assayag is seeing you despite not being the main surgeon and not the method he uses (Gnail). He seems like a gem of a doctor. What are this thoughts on Gnail?
If there are clicking problems will you go back to Athens?
I am concerned about this too. I think I'll just take blood thinner before boarding the flight and one after landing and the next day to be safe.
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Before you go email the office and ask how the other G-Nail patients are getting along and if all are doing well. I did it before I went.
I don't anticipate clicking problems. It is only getting easier. Also although tightness gets worse as you gain more inches, clicking gets better. However, if I did have problems where I could not click, I would have to fly to Athens.
Flight - Dr. Gio gives 14 days of Xarelto and because of my flight he gave me 2 extra. He told me to take one the day before and one the day of.
Airline special assistance - When you book your flight or after you book it go online and ask for special assistance - make sure you check that you cannot climb stairs, - It's an option at every airline. I checked that I would be bringing my own manual wheelchair. They gate check it when you get on and it is there when you get off. I was treated like a king as I was wheeled through the lines of customs and security ahead of everyone and placed on a lift so I would be level with the plane. The same when I got off. I had to change planes too. I also had flown to Santorini using special assistance. I was boarded first and used the forearm crutches. They have the option of an aisle wheelchair and they will wheel you to your seat if you need it.
Seats I chose the comfort level seats sometimes known as main cabin extra or plus at the bulkhead that have extra legroom(but the middle aisle not the end- on some planes, the ends have equipment that can take up space). I had complete room to stretch my legs fully. I bought a foot cushion on Amazon. Also you can fly at night when the plane is empty and have a whole row to yourself. One thing to note though is I have a large bladder or something because I never had to go to the bathroom on the 11 hour flight. I took a Kirkland Sleep Aid Doxylamine Succinate 25 Mg and I slept the entire time except when I was awakened so I could eat. The Dr said to get up once in awhile to stretch my legs which I didn't need to do since I was stretched out. I wore the compression socks they gave me at the hospital.
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Correct me if i'm wrong but i think most of the doctors (at least all american ones), prescribes Xarelto during all lenghtening, whereas Doctor Giotikas prescribes it around one month.
I prefer to be well informed of all the consequences of taking it 2-4 weeks vs 3 months to avoid possible complications, you never know what can happen, and less after all that has happened in Athens.
I prefer to be 100% sure of every step I take and with whom I take it, before I do anything. You never know what or when something can happen to you, until it happens, no matter how small that probability may be.
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Doctor Giotikas is the only one who prescribes Xarelto for such a short time, all the other doctors prescribe it until the end of the lengthening. I think this is weird.
I prefer to be well informed of all the consequences of taking it 10-14 days vs 3 months to avoid possible complications, you never know what can happen, and less after all that has happened in Athens.
I prefer to be 100% sure of every step I take and with whom I take it, before I do anything. You never know what or when something can happen to you, until it happens, no matter how small that probability may be.
I asked him the same thing and he talked about the risk-benefit ratio. I am gonna insist on getting more than that.
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I asked him the same thing and he talked about the risk-benefit ratio. I am gonna insist on getting more than that.
What is the risk of xarelto?
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As far as know Giotikas also prescribes xarelto for the whole 3month lengthening period when he uses non weight bearing methods like Precise2 nail. It is the weight bearing limitation that is most important in relation to the length of treatment.
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What is the risk of xarelto?
Bleeding.
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What is the risk of xarelto?
At the very least your liver will suffer from it, i.e. increased ALT and AST enzymes. This is what I had. This is a documented side effect and you can Google for it.
In the worst case xarelto causes bleeding to internal organs, liver failure or a stroke after discontinuation.
Xarelto is not to be underestimated and people have died from taking it. Nor does it prevent blood clots under all circumstances, merely reduces the chances of them happening.
They say the risk of blood clots after a surgery is elevated until three months after surgery. My thinking is the doctor should keep giving at for that amount of time but also monitor blood values and liver function.
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At the very least your liver will suffer from it, i.e. increased ALT and AST enzymes. This is what I had. This is a documented side effect and you can Google for it.
In the worst case xarelto causes bleeding to internal organs, liver failure or a stroke after discontinuation.
Xarelto is not to be underestimated and people have died from taking it. Nor does it prevent blood clots under all circumstances, merely reduces the chances of them happening.
They say the risk of blood clots after a surgery is elevated until three months after surgery. My thinking is the doctor should keep giving at for that amount of time but also monitor blood values and liver function.
Thank you for the answer!
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As far as know Giotikas also prescribes xarelto for the whole 3month lengthening period when he uses non-weight-bearing methods like Precise2 nail. It is the weight bearing limitation that is most important in relation to the length of treatment.
This is not true. He does not.
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I am concerned about blood clotting. Particularly seeing the post that something terrible has occurred to someone I know -having surgery when I had surgery.
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I am concerned about blood clotting. Particularly seeing the post that something terrible has occurred to someone I know -having surgery when I had surgery.
Was it because of blood clot or fat embolism? fat embolism happens without 24-48 hours from the surgery. Did he not take xeralto? I'll force doctor to give me xeralto for full lengthening.
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I am concerned about blood clotting. Particularly seeing the post that something terrible has occurred to someone I know -having surgery when I had surgery.
Man force giotikas to give you xeralto. If he disagrees then get it from someone else maybe ask your home country doc to give it to you. In the meantime, take ginger powder or turmeric powder (natural blood thinners).
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Man force giotikas to give you xeralto. If he disagrees then get it from someone else maybe ask your home country doc to give it to you. In the meantime, take ginger powder or turmeric powder (natural blood thinners).
Inspite of the recent incident if Dr Giotikas doesn't want to give xeralto then don't you think it's in the best interest of his patients?
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Inspite of the recent incident if Dr Giotikas doesn't want to give xeralto then don't you think it's in the best interest of his patients?
Then it means he is not a good doc. Paley and literally everyone is the US give xeralto for the whole lengthening period. Assayag even injects some blood thinner into your stomach right after the surgery [source: raaz diary]. I guess it's a bigger issue for a doc if a patient dies in the US than in EU.
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Then it means he is not a good doc. Paley and literally everyone is the US give xeralto for the whole lengthening period. Assayag even injects some blood thinner into your stomach right after the surgery [source: raaz diary]. I guess it's a bigger issue for a doc if a patient dies in the US than in EU.
Well if he hasn't been giving blood thinners beyond 2 weeks for his patients all this while what do you make of that?
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Well if he hasn't been giving blood thinners beyond 2 weeks for his patients all this while what do you make of that?
Every doc thinks differently in terms of risk management. Blood thinners can cause liver issues and blood in your pee and stuff like that. It's not black and white. I'll still try to get blood thinners for the whole lengthening period otherwise will move back to my country and will get them here. In my current country, you can get asprin from amazon without any prescription or anything or I can just go to a doc here and ask for Xarelto. Other option is to consult with a vascular surgeon in giotikas hospital if giotikas won't give it then maybe they will. If you really want to get it you can get it I don't think giotikas can stop you from getting blood thinners.
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... Paley and literally everyone is the US give xeralto for the whole lengthening period...
They give xarelto full time now in the US because they are only using precise, which is non weight bearing; they didn't do the same when they were using Stryde, which was full weight bearing. I wrote elsewhere: It is the weight bearing limitation of Precise which makes the difference here and I don't think giotikas suddenly went nuts
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They give xarelto full time now in the US because they are only using precise, which is non weight bearing; they didn't do the same when they were using Stryde, which was full weight bearing. I wrote elsewhere: It is the weight bearing limitation of Precise which makes the difference here and I don't think giotikas suddenly went nuts
Read the raaz diary he did stryde with Assayag also you can read Assayag interviews. Paley said in many conferences and on his website that he gives blood thinner irrespective of the nail (stryde or otherwise).
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Every doc thinks differently in terms of risk management. Blood thinners can cause liver issues and blood in your pee and stuff like that. It's not black and white. I'll still try to get blood thinners for the whole lengthening period otherwise will move back to my country and will get them here. In my current country, you can get asprin from amazon without any prescription or anything or I can just go to a doc here and ask for Xarelto. Other option is to consult with a vascular surgeon in giotikas hospital if giotikas won't give it then maybe they will. If you really want to get it you can get it I don't think giotikas can stop you from getting blood thinners.
If you don't trust your own surgeon that is not a good thing. You are agreeing to go unconscious and let the surgeon operate on you as he wants. You are already relying on him to not cause a fat embolism or damage some artery.
And do you really want to fly back to your home country knowing that flying increases the risk of PE? It's better to stay 3 months in Athens and then fly back. People have reported clicking problems with Guichet nail and you may have to travel back and forth. If you get PE on a long plane ride they have to make an emergency landing in a random country and your emergency care will get delayed. And who knows what country that will be and what their facility is like.
And finally Aspirin is over the country in many countries but xeralto is definitely not. Aspirin is way lighter.
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If you don't trust your own surgeon that is not a good thing. You are agreeing to go unconscious and let the surgeon operate on you as he wants. You are already relying on him to not cause a fat embolism or damage some artery.
And do you really want to fly back to your home country knowing that flying increases the risk of PE? It's better to stay 3 months in Athens and then fly back. People have reported clicking problems with Guichet nail and you may have to travel back and forth. If you get PE on a long plane ride they have to make an emergency landing in a random country and your emergency care will get delayed. And who knows what country that will be and what their facility is like.
And finally Aspirin is over the country in many countries but xeralto is definitely not. Aspirin is way lighter.
It's not about trust it's about disagreement.
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It's not about trust it's about disagreement.
What your saying is, you trust his intentions but not his abilities to keep you safe. So it is about trust.
Anyway it is your call. I just wanted to state my opinion.
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Then it means he is not a good doc. Paley and literally everyone is the US give xeralto for the whole lengthening period. Assayag even injects some blood thinner into your stomach right after the surgery [source: raaz diary]. I guess it's a bigger issue for a doc if a patient dies in the US than in EU.
I also saw Buldu injected blood thinner to their precice patient during lengthening on LLT IG story november 6.
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It is not about trust, you have to manage your own health to an extent (be proactive) and doctors are human. Also, the doctor cannot know everything. No one on earth can. I don't put complete faith in man only our creator. For example, if my father says he is going to pick me up from University, I trust him because he always comes and has five days a week for the last 3 years but I keep taxi money just in case because he is human and events beyond his control can stop him from coming or even his own negligence in running a light and getting into a car accident.
I just saw an interview with Cyborg4Life last week and Betz also gives blood thinners the whole time. So I am not sure it has anything to do with weight bearing but maybe it does. Anyway I flew home for 14 hours total (2 flights) and the other guy didn't and I am doing well. So I don't think staying in Athens is the key. If you aren't having any problems clicking, they won't suddenly arise. Clicking only gets easier. I left at 5 weeks, and never was unable to click.Although clicking was always the worst part while I was there. Almost all of Betz's patients fly home after 2-3 weeks.
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I thought the point of a weight-bearing nail is so that you can exercise frequently after surgery and keep the blood flowing. Shouldn't this mean there's a much smaller chance of DVT/PE?
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I thought the point of a weight-bearing nail is so that you can exercise frequently after surgery and keep the blood flowing. Shouldn't this mean there's a much smaller chance of DVT/PE?
I don't think walking can substitute blood thinners.
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I don't think walking can substitute blood thinners.
I agree. I just know that technically there should be a much smaller chance with a weight-bearing nail of this happening.
Anyway, Giotikas is currently at the top of my list so I'm curious as to whether he will change his protocol (assuming it's related to not prescribing Xarelto for long).
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It is not about trust, you have to manage your own health to an extent (be proactive) and doctors are human. Also, the doctor cannot know everything. No one on earth can. I don't put complete faith in man only our creator. For example, if my father says he is going to pick me up from University, I trust him because he always comes and has five days a week for the last 3 years but I keep taxi money just in case because he is human and events beyond his control can stop him from coming or even his own negligence in running a light and getting into a car accident.
I just saw an interview with Cyborg4Life last week and Betz also gives blood thinners the whole time. So I am not sure it has anything to do with weight bearing but maybe it does. Anyway I flew home for 14 hours total (2 flights) and the other guy didn't and I am doing well. So I don't think staying in Athens is the key. If you aren't having any problems clicking, they won't suddenly arise. Clicking only gets easier. I left at 5 weeks, and never was unable to click.Although clicking was always the worst part while I was there. Almost all of Betz's patients fly home after 2-3 weeks.
Trust is both trust in intent and trust in ability/competence. My point was that we are talking about the latter.
Anyway it's just a choice of words. All I meant to say was that the surgery itself requires enormous trust in the surgeon and one should trust that the surgeon is knowledgeable to enough to keep the patient safe after surgery. In your case if you are consulting with another US doctor near you then it's fine. But taking blood thinners over the counter isn't (the other poster was talking about this).
As for flying, flying is known to be a danger after any ortho surgery. Mobility reduces chances of PE and if someone is terrified of PE they shouldn't fly long flights ideally.
As for clicking difficulties, they can arise as the bone grows. So even if it is easy today it can become difficult in the future.
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Trust is both trust in intent and trust in ability/competence. My point was that we are talking about the latter.
Anyway it's just a choice of words. All I meant to say was that the surgery itself requires enormous trust in the surgeon and one should trust that the surgeon is knowledgeable to enough to keep the patient safe after surgery. In your case if you are consulting with another US doctor near you then it's fine. But taking blood thinners over the counter isn't (the other poster was talking about this).
As for flying, flying is known to be a danger after any ortho surgery. Mobility reduces chances of PE and if someone is terrified of PE they shouldn't fly long flights ideally.
As for clicking difficulties, they can arise as the bone grows. So even if it is easy today it can become difficult in the future.
I don't trust any doc in the world it doesn't mean I shouldn't get treatment. It just means I'll do my own research and will be skeptical of the doctors. Also, who is stopping someone to walk in the plane. Book first class and keep walking in the area back and forth.
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As a former LLer, I absolutely recommend booking first class or extra leg room and walking every hour. I even used compression socks during my first flights.
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As a former LLer, I absolutely recommend booking first class or extra leg room and walking every hour. I even used compression socks during my first flights.
Would you say this is still necessary even after three months has lapsed since surgery? My understanding is the risk of blood clots is almost zero after three months.
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Necessary? No, but I strongly advise it. The risk of blood clots may be closer to your baseline (depends on many factors: age, mobility, etc), definitely not zero. However, if you remain in the same position you may be uncomfortable and maybe stiff. You need space. Even after 3 months, you may experience pain and other problems.
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Read the raaz diary he did stryde with Assayag also you can read Assayag interviews. Paley said in many conferences and on his website that he gives blood thinner irrespective of the nail (stryde or otherwise).
Can you share links? I had asked Assayag via message once and he had said he gives it only for 2 weeks or so. Maybe LU213 can help confirm this.
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While I was in the hospital, i was given blood thinners and then I was provided a little over 2 weeks of blood thinners when I left, so it is probably about 3 weeks of blood thinners total. Dr. Assayag only provided me with enough blood thinners for my flights to and from Baltimore. On my next appointment I will ask him about his protocol but he doesn't perform surgery with these nails developed off of the original Albizzia nail. I will say that we cannot jump the gun and say anyone is to blame. Certainly I go over and over in my head how someone can show up to PT telling them he has pain and then receive the full, difficult PT and then have a heart attack on his way out waiting for a taxi without it coming to the PT's head that perhaps this patient needs to be seen by a doctor. However often the main PT owner/specialist was not there and still I don't know if the PT employees were told how to identify the signs of DVT or PE. The incapacity of the person that had surgery the same day as I did haunts me. However, it doesn't mean that Dr. Gio is not a good doctor. Go in knowing the risks. If you are considering him, talk to him and tell him your concerns and what you heard. If he addresses your concerns and you feel comfortable, you can use his services. Doctors cannot speak in terms of names/PII but they can speak about publicly known information and address real situations without names/PII.
Also remember you pay the doctor, he or she does not pay you. Do not be afraid or intimidated to ask questions tactfully and respectfully (as you should do any human) no matter how they react. Do not be afraid to call for emergency or call the doctor, who gives everyone his phone number, --who cares if it happens to be a false alarm? still call. You paid for this service.
If you have someone with you, you get help right away and you don't need to wait for someone to find you. I know that option is not available for everyone.
Do not do any special diets. Eat well-balanced meals. Don't consume protein to the exclusion of the other things such as carbs and fats. (this I learned from Dr. Assayag - stay away from keto diets while LL)
As far as clicking, I can do my clicks while riding in a car safely confined in a seatbelt. It has not been a source of stress and anxiety for a number of weeks. I saw a message in ab608's diary that distraction with the magnet was extremely painful with precise in her left leg. So painful that it was a level 8 for hours and she skipped it altogether one day. Everyone's body is different. So I believe my choice of the GNail with Giotikas was the best choice for me. Still I have a lump in my throat.
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... Certainly I go over and over in my head how someone can show up to PT telling them he has pain and then receive the full, difficult PT and then have a heart attack on his way out waiting for a taxi without it coming to the PT's head that perhaps this patient needs to be seen by a doctor...
Hi @LU213, as far as I know the heart attack happened before the PT session when the poor guy had just arrived there and the taxi driver called everyone out to help.
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I think LL patients are quite tired, anxious, feeling a bit sick, etc all the time and it is probably hard to tell the difference between early onset of PE and just usual fatigue.
All that really matters now is whether the protocol for dealing with PE needs to change. But we just heard that even Assayag doesn't give blood thinners even for Precice cases after the initial couple of weeks.
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I have not been feeling fatigued or sick since the first 2 weeks. I felt pain during clicking for sure for probably 4 weeks after surgery but when I was not clicking, I did not feel sick. Most days, the other guys at PT did not look sickly when I saw them, although dealing with serious pain. We had a good time laughing and talking during PT. One of the guys even has a great voice and sang for us. I have slept well this entire process but I started with melatonin and ZMA based on previous experiences of others. I have a month left and I do feel tightness in one leg or the other but I feel okay. My PT is focusing on my Frankenstein walk. I flew to visit family this weekend and they definitely noticed I was taller.
I spoke to Dr. Giotikas and he said it was a unique case with rare background factors affecting it. He said he evaluated his protocol and is not going to change it. These are the signs of a PE that he provided:
The symptoms of PE usually are shortness of breath or shallow or quick breathing, cough, pain in the chest. Symptoms may be subtle in a mild incident of PE.
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I am now at 6.8 cm. I have not felt any more difficulty since 5 cm. I can walk to kitchen and bathroom without crutches. Otherwise, I always use the forearm crutches. New at this length is Dr. Giotikas said not to walk more than 1-1.5 hours even with the crutches so as not to put too much stress on the implant. As we know the more you lengthen, the more stress is placed on it because you are getting closer to the edge of the thick part of the implant. X-ray below
https://imgur.com/fQtlnOE
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I am now at 6.8 cm. I have not felt any more difficulty since 5 cm. I can walk to kitchen and bathroom without crutches. Otherwise, I always use the forearm crutches. New at this length is Dr. Giotikas said not to walk more than 1-1.5 hours even with the crutches so as not to put too much stress on the implant. As we know the more you lengthen, the more stress is placed on it because you are getting closer to the edge of the thick part of the implant. X-ray below
https://imgur.com/fQtlnOE
Thank you for sharing your x-rays, the regenerate looks very good.
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I appreciate that. I am 7 days away from 8 cm.
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They give xarelto full time now in the US because they are only using precise, which is non weight bearing; they didn't do the same when they were using Stryde, which was full weight bearing. I wrote elsewhere: It is the weight bearing limitation of Precise which makes the difference here and I don't think giotikas suddenly went nuts
You are 100 percent right. When Giotikas does precise he does give Xarelto for the full time of Lengthening.
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any updates
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Can I ask what the nails look like externally?
I've been trying to Google for pictures of the G-nail on patients and all I've seen are the nails on their own or an x-ray, but I can't see what they look like on a person normally. Like do the nails come out of your thigh so your wounds are basically exposed all the time?
Would be great if you can post a picture (and censor your privates of course).
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wow so you basically have done 8 cm in about 3 months. g nail is really fast compared to other methods it seems!
i am curious about the recovery period of g-nail too. since most gnail patients are still in the consolidation phase or lengthening phase there is not much detail about when to expect normal walking and athletic recovery for gnail patients. i have yet to read a diary of a gnail patient about nail removal :)
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hi how are you doing now
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You are 100 percent right. When Giotikas does precise he does give Xarelto for the full time of Lengthening.
I have noticed that recently blood clots cases have increased among ll patients. One common thing is that none of them had Xarelto while got blood clots. So im pretty convinced that even patients who using weight bearing nails should use Xarelto at least whole lenghtening period.
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@LU213 Hope you're doing well brother. How're things looking?
Considering Dr Giotikas after consultation with him -- your diary has been very helpful.
Are there things you wish you'd known before surgery or what you'd put in place either before or after surgery to help folks like myself better prepared?
Thanks again for the diary
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Any updates mate ?
considering Giotikas myself but needed more validations that we we will not be screwed with G-nails ;)
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Any updates?
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If you have recent imaging data please put it at this thread. Redact any information that could be used to dox you.
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Any update?
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The nurse service where cand you ask for, plaing do ho alone just myself
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Just Ask Evi the head nurse