Limb Lengthening Forum

Limb Lengthening Surgery => Limb Lengthening Patients Experiences => Topic started by: Four Inch on April 26, 2017, 10:13:28 AM

Title: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on April 26, 2017, 10:13:28 AM
Background: I just had my first femur segment completed yesterday at the Clinica Diagonal. For those that are interested, I'll post my thoughts as I go through the procedure, however, my time is limited since I have to continue to work during my 5 week stay.  I am about 5' 7" and an American if you could not tell by the backwards ass way we use in calculating measurements.  Why we chose not to embrace the metric system is beyond me but i digress.  One important aspect about me is that I'm 50+ years old, I know most of you are much younger.  There is one patient much older than me that is going though the procedure as well. According to Dr. Monegal, he is doing great; I have not yet met this other patient but I look forward to meeting him at some point.

I have been contemplating this surgery for sometime now, about 15 years.   Although, I do feel I am expressing a certain amount of vanity in my decision to go though with this; my height has bothered me for a long time and I am still very conscience of my stature; something I could do without.    I had been corresponded with Dr. Monegal over e-mail for the last few months.  My impression at this point is that he is very caring and is very passionate about his work. I will say that I was expecting a more detailed discussion, with Dr. Monegal, about what I should expect during my 5 week stay.  However, I think Dr. Monegal is very confident in his work and since he will do what he needs to do in order to meet ones expectations; i think he is prone to leaving out details unless you press him which i did not.  Since i was here, I was already committed to doing this.

Risk Factor:

I have been on this forum long enough to know that at least one patient had complications and I can certainly sympathize with them.   However, I would not have come to Barcelona if I did not have full trust in Dr. Monegal.  This is not to say that I did a "ton" of research but i did consider the risks vs. benefits and decided to go though with it.

Clinica Diagonal:

The Clinic is terrific; private room, good food (although I'm not very picky) and a wonderful staff.  I only wish I had taken the time to learn Spanish before arriving.  I feel like I have wasted so much of the staff time by only speaking English. The pre-op experience was a bit frustrating for me because of my Spanish deficiency, I can only imagine how frustrating it was for clinic staff, but they did no show it.   I have visited France and Italy several times and found many more Italian and French that spoke at least broken English than I have found in Spain. You can defiantly visit Paris, Nice, Rome, Venice, and get though the day only speaking English.  This should not be construed in anyway to put down the Spaniards, this was defiantly my short coming since I'm he one visiting their Country - so far they have all been terrific to me!  One thing to note is that the average stature of Spaniards is less that other countries that I have visited.  I would not consider myself tall here by any stretch of the imagination, but I don't feel that I am overly short here either....just a thought, nothing more.

Pain/Discomfort.

My leg started to swell up during the night; I would think this is expected, I'll ask Dr. Monegal when i see him - hopefully today. At this point its' very uncomfortable but I would not classify it as painful yet.  I am now going without the pain relief drip so it may get a bit more painful.  In fact, I can feel the escalation of discomfort.

If you have any questions of me I would be glad to try and answer them but any in depth questions or medical advise should be left to be answered by Dr. Monegal or others on this forum who are qualified.


Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: helloworld on April 26, 2017, 11:13:13 AM
All the best to you!
Will you be staying at the Mic after you get out of the Clinica Diagonal?
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Body Builder on April 26, 2017, 11:35:18 AM
I will watch your diary very carefully my friend because it is very important to have more successful cases from Monegal.
If you have a good result like yagen, auron, helloworld etc and Monegal doesn't increase his prices then I'm sure he would be the first choice for many of us in Europe who want internal LL.

Keep strong and congratulations for your courage to do this surgery at that age !
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Auron on April 26, 2017, 11:41:49 AM
Hey Four Inch! I did meet that older person that you're talking and he was doing great indeed. Older people tend to feel more pain but hopefully it won't be the case for you. Good luck  ;)
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on April 26, 2017, 12:48:29 PM
Hi all, and thank you for the kind words of encouragement. 

Helloworld; Yes I will be staying at MIC, Dr. Monegal kindly offered to drive me there; I believe I will be at MIC next Monday.

Body Builder, it's very early of course but so far I'm impressed with Dr. Monegal.

Auron, that's great that you got to meet him.  I understand that he is doing so well that he is vacationing with his family somewhere on the coast.  i hope I my testimonial is just as positive.

Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: helloworld on April 26, 2017, 08:40:59 PM
I will see you at Mic then, when I come to visit next time to see some of my friends there. :-)
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Ozymandias on April 27, 2017, 05:57:02 PM
Hi Four Inch Fold,

From a fellow 5'7, wish you the best for this experience. Keep us informed!
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on April 28, 2017, 12:40:04 PM
Hello All,

It's been almost 3 full days since my surgery and I am feeling very confident at the moment.  I am not taking any pain killers.  Although I do have shooting pain in my knee when I twist my leg laterally, aside from that, the pain has been mild at best. I can move myself from my bed to a rolling recliner without assistance - although the nurse this morning caught me in that act and seemed a little startled and kindly suggested that I call her for assistance.   I am by nature very independent and like to be able to roll my recliner in to the bathroom and empty my own pee bucket. ;) 

Although I have never been hospitalized for days at a time,  my inexperienced perception is that the members of the nursing staff here at the Clinic are exceptional;  I think I'm developing a crush on one in particular  ;D.  Although I, like most I presume, don't like visiting hospitals in general, I am very comfortable here, no "hospital smell", very clean and modern and I even have a great view of Barcelona from the window in my room.

I do understand that there are risks associated with this procedure and it is exactly those risks that prevented me from doing this long ago.  I do believe the procedure has come a very long way in the last 10 years and my instinct is that it's time for me to have the procedure done or live the rest of my life feeling a little less confident in myself. Although I sometimes consider it pure vanity, it bothers me enough to accept the risks and get it done. 

To quote a line in a favorite movie of mine, "Screws fall out all the time, the world is an imperfect place".  :)  i.e. With any  surgical procedure, there can be complications. However, my research lead me to believe that Dr. Monegal's record of success is most impressive.    My biggest concern at the moment is not the complications of the procedure itself, but in disciplining myself to accept the responsibilities of a good patient in making sure that I respect the recovery process and refrain from inducing complications myself.

Albeit a third day impression, on a personal level I feel I made excellent choice in surgeons.  Dr. Monegal has been terrific and very supportive.  I think I could ask him for anything and he would go out of his way to make it happen.  The procedure seems to have gone very well and my x-rays look good. if there should be complications (knock on wood) I'm feeling I would be in good hands with Dr. Monegal.

We'll, it's 8:30 AM in New York, time for me to get logged in and working.  Until next time.

Cheers!

Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on May 02, 2017, 05:46:08 PM
Hello fellow forum members,

I have just moved over to MICs; Dr Monegal was kind enough to chauffeur me and another one of his patients over to the MIC's.  The facility here is very nice, much nicer than I expected. Everyone has been very friendly and helpful at MICs.

I am pretty excited that I was able to begin lengthening today and I remain confident that things will continue to progress smoothly.   Surprisingly, at no time did I ever feel anything that I would classify as pain thus far during this procedure, at least while resting my leg.  I did have some shooting pain when I moved my leg in order to get it positioned to stand up, it seems the lateral movements were the hardest.  I learned to use my good leg to assist the other leg with lateral movements, once that technique dawned on me the pain was gone.   In the beginning, there was also a bit of tolerable pain surrounding my knee cap when bending the leg more that 60 degrees or so. 

You are probably all familiar with the stretching machine that is used by the PT's on a daily basis.  I was chugging along daily, building from 80-85-90-95-100 degrees, with the same PT.  Then on Sunday walks in "Carlos the Slayer" (PT by profession).  Carols is a long bearded chap with a seemingly very calm disposition.  I got the feeling that there is not much that alarms or gets to Carlos.  Carlos enter my room, introduced himself and then  casually says, "You have been doing 100, lets try 110 degrees" -  and were off to the races.  The previous PT was moving me up in 5 degree increments so I was not sure what to expect with a 10 degree increase all at once.  Although I was up to it, I can't say that it did not hurt the first 10 repetitions, it did indeed.  In fact, the first five felt like my knee cap was about to explode.   However, I'm glad I did not complain or ask to tone it down a notch;  after the first 10 reps the pain did smooth out and I was actually looking forward to the upcoming rep.  I wish Carlos would have graced my room with his presence earlier in my stay;  I think the intense stretching really helps.  I wish I could have taken that machine and Carlos the Slayer with me to the MICs.

Although far from a pro, I can get around on crutches; I made a short jaunt to the Shop down the street to grab a bottle of Cola and napkins; I've been craving a Coke since my second day at the clinic.  Surprisingly the MICs provides everything your need but there was no starter package with things like a few napkins, condiments  etc. (but there was a bowl of fruit that was a pleasant surprise) -  I just now go up to check to see if there was any toilet paper as I had forgotten to check, luckily either the MIC's or the last occupant left a few rolls so I am fully stocked on that item. ;D

I have meet a few fellow LLer's since starting the procedure.  A young man at the clinic that very much impressed me with his control and wisdom.  I believe he was only lengthening 4cm, something that seems to be rarely done; many (me included) want as much bang for their investment as they can tolerate. This young man has inspired me to do some very hard thinking as I lengthen to determine where to stop the process.

The second person I met was from a neighboring country and was on his second limb.  He was the other patient that Dr. Monegal shuttled over to MICs today.  He seemed to be doing fabulous, he looked just as tall as Dr. Monegal to me (something I'm pretty sure is a foul in Dr. Monegal's rule book)  - he also spoke better English than me which kind of pissed me off  ;D

As i walked into the MICs, I met a very beautiful and friendly young lady. I learned quickly that she happened to be a forum member who I consider to be the most influential third party in helping me select my surgeon.  This influence was merely based on her public posts throughout the forum.

As mentioned, I am feeling very confident but continue to understand the risk that I have accepted with this procedure.  So far, I think I have been slightly lucky with how well things seem to have gone; however, I have nothing but kudos for Dr. Monegal thus far.

We'll time to get back to work......unfortunately, I still need to work for my living while here in Barcelona.


Cheers everyone!

Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: dawdawd on May 02, 2017, 08:48:57 PM
Great to see a new diary from Dr. Monegal's patient. We really need more like yours ! Please keep us informed. Wish you a pleasant lengthening journey ahead !

- Daw
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: helloworld on May 02, 2017, 08:50:35 PM
I am happy that you seem to be doing well!
I will pay a visit to Mic next week or week after.
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: notimportant on May 02, 2017, 10:31:09 PM
In the guesthouse ask people and you will see the truth
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: helloworld on May 03, 2017, 10:27:01 AM
I am happy that you seem to be doing well!
I will pay a visit to Mic next week or week after.
I guess I will see you tomorrow at lunch. :-)


Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: OldieButGoldie on May 03, 2017, 08:53:31 PM
Good luck with your LL.
I did it at the age of 45. I am now 49, doing sports like crazy, everything fine so far.
All the best to you,
Cheers
OBG
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Mdream on May 03, 2017, 09:44:12 PM
OBG, how much did you do? My theory is that 3inch is safe for 20's/30's but for 40's, maybe 2inches is safer.
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: TIBIKE200 on May 03, 2017, 09:47:28 PM
OBG, how much did you do? My theory is that 3inch is safe for 20's/30's but for 40's, maybe 2inches is safer.

He did close to 6cm
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on May 06, 2017, 04:38:15 PM
Hello Word
I guess I will see you tomorrow at lunch. :-)

It was a pleasure meeting you helloworld. It's nice to meet and chat with others that have gone through this procedure.
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on May 06, 2017, 06:55:17 PM
Just a quick update.

I have been sleeping though the night with no problem at all; no pain when leg is stationary thus far. That's been a blessing since I like my sleep. :) So far, no pain to speak of when my leg is stationary.  Bending my knee, to the point where there is resistance, creates a little pain - perhaps a 2 of out 10.  Based on feedback from Dr. Monegal, I am expecting to feel pain at some point during the lengthening process.  He gave me an estimate of about 2 weeks into lengthening.  I'm hoping it is bearable and does not cause me to slow down on my lengthening schedule.

I stretch 4 times a day, once right before I lengthen.  I stretch one hour in the morning while in bed, twice in the afternoon while standing, and then once again before I call it a night.  After lengthening I like to nap or at least remain stationary for 30 minutes.  Nothing that I have been told to do, and perhaps not even recommended...any thoughts on that?  I'm trying to hit the exercise bike one a day for 30 - 60 minutes depending on my energy level.  I have not started PT yet, I'm planning on starting this coming week.

While lying in bed, I still have a very sharp pain in my knee on occasion when I sometimes twist my leg laterally while its fully extended.  The pain level is a 10/10; it feels like my knee cap has exploded.  I can't seem to reproduce the pain by intentionally twisting my leg so I'm not sure exactly what I'm doing that is causing the pain.  I'm hoping it's related to the swelling which I had plenty of -even Dr. Monegal confirmed that I had a lot of swelling.  It's a little bit concerning since the other LL patients of Dr. Monegals that are here at MIC, have not experienced this sensation.  I would be very interested to know if anyone out there has had this same type of pain.  I now bend my knee before moving the leg laterally and that seems to prevent me from ever hitting that painful "sweet spot".  I'll have to ask the Dr. about this next time I see him; if this is a long term pain, it's definitely going to put a damper on my kiting/surfing activities.

I have been lengthening now for 5 days; the first two days I lengthened .8mm per day and the last three days I'm doing 1mm per day.  After lengthening there is minor pain in my knee, maybe a 1 or 2; I expect that is normal. As mentioned previously, my leg is still swollen but it has definitely starting returning to its normal size; I am thankful for that; it's hard to tell just how much tension the lengthening is causing on your leg muscles are when your leg is swollen.

Since I have already scheduled my flight back to have the second procedure done on my remaining femur, I am planing to continue lengthen at 1mm a day (unless my body tell me differently).  That will give me time to lengthen as much as I feel comfortable doing before the next procedure.  I can always postpone my trip if more days of consolidation are required before surgery on the second leg.   I hoping that even if I just a a week or two of consolidation before the next surgery, that it will be enough time to be able to place more weight on the leg - another topic of discussion for Dr. Monegal.

That's it for now.  I'll certain provide an update soon!







 
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: helloworld on May 07, 2017, 03:17:52 PM
Hello Word
It was a pleasure meeting you helloworld. It's nice to meet and chat with others that have gone through this procedure.
It was great to meet you as well as all the others!
Glad you are sleeping well! Seems like you are doing very well!
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on May 15, 2017, 08:34:51 AM
Hello everyone!

It's now day 19 since surgery update.  Dr. Monegal viewed a new set of xrays a couple of days ago and everything looked good.

I'm continuing to lengthen at 1.08 mm a day and i can feel the pressure in my knee from the lengthening, feels strange but I'm starting to see the results of lengthening.   As of today, I have lengthened 17.5mm ( that includes the 4mm that Dr. Monegal lengthened during surgery.  I was a little concerned that I was starting to feel muscle tension this early but I'm told this is normal.  I continue to stretch four times a day and ride an exercise bike for 50 minutes a day, at the moment it's requires more energy each day to get though my stretching and biking.  I'm not sure if it will continue to get more difficult each day but I suspect it will until I finish the lengthening; I have a long ways to go.

The pain in my knee that I was complaining about when I move my knee laterally seems to have gone away completely; very thankful for that.  I imagine it just took a bit of healing from the surgery to take care of it.

I do have moments of random, but mild, pain in my leg, mostly around the knee.  The pain level is not enough that I feel the need to take pain killers, however, I have them available should i need to resort to them.

I feel the need to vent a little about the Internet connection at the MIC.  It's pretty bad at certain times of day; in the evenings is seems to be the worst; I guess every one is streaming video at that time. Since I need to connect remotely to my company servers, keeping up with work has been challenging.  I did complain to the Director of the MIC and she was nice enough to send a tech here a few days later.  The tech told me that there is a line issue with the entire block; which would seem to make sense since I'm seeing 50%-60% packet loss at certain times of the day.  I think if they upgraded the measly 10MB connection to 60 or 100 MB that would help.  I'm not sure why they think 10MB is enough to share between all the residents staying here at any one time; forget about trying to connect to a SlingBox without getting completely annoyed. I'll need to find other accommodations for my next procedure or find some sort of affordable unlimited 4G LTE Internet option. I'll have to research that before my next visit.

Barcelona is a terrific city and the weather has been glorious.  I'm thankful to have a balcony, although there were no chairs or a table.  I pulled one of the living area chairs out to the balcony and was lightly reprimanded about doing that.  They brought me an wicker chair after that.  :). That's it for now....back to work.





Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: francisackerman on May 15, 2017, 02:51:10 PM
Hello Four Inch Fold! Happy to see you're doing great! Are you able to upload your latest X-rays? I'm really interested how consolidation goes with fitbone. It seems its better than other nails when looking at auron and helloworld x-rays.

Thanks - Francis
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Datum on May 19, 2017, 04:36:34 PM
Aren't you posting your X-rays? I would like to see th
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on May 20, 2017, 11:00:28 AM
Here is the link to my first xray, this was two weeks after surgery.

https://www.dropbox.com/s/f5ruqeljdaef2ub/xray-1.jpg?dl=0

 
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on May 20, 2017, 11:28:38 AM
If my calculations are correct, I should have lengthened about 2.3 cm so far.  A few days ago i did start feeling enough pain in the knee area  to keep me from sleeping much.   I started a routine of walking around the apartment for about 30 minutes, then going back to bed.  Walking seems to make the pain go away.   Although I would fall back to sleep quickly,  I was only sleeping 10 - 20 minutes before the pain would wake me up again.  I would repeat my walking/sleeping cycle for most of the night.

Dr. Monegal suggested that I reduce the amount of lengthening per day just a tad to see if that helps with sleeping.  However, I think I'll continue with the lengthening 1mm per day as long as I can. At the end of next week I'll also be returning home to continue lengthening - Yahoo!



Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: francisackerman on May 20, 2017, 04:46:48 PM
Good job Bro! But actually you should listen to your doc! And remember: When you reduce the rate, you will have a better recovery!

Your x-ray looks interesting. What is that bone piece on the side? Do you have another view from the x-ray?

Francis
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on May 20, 2017, 05:14:10 PM
Thank you Francis! Yes, perhaps you are right; I think he was just concerned about the reducing the pain rather than thinking I was lengthening to much. I'll check with the doc to be sure.

The bone piece on the side is what Dr. Monegal described as "the lucky spike".    He said it a good thing, i believe the way he described is that the "spike" will encourage the femur to heal with a greater diameter by including that fragment.  He mentioned that it's purely coincidental and he does nothing to try to produce the spike, it just happens sometimes.    He showed me several xrays where a spike was produced and the bone looks much stronger in that break area than those that were not lucky enough to get the lucky spike.

I'll be sure to check with him to be sure I'm explaining it accurately and report back if I need to retract or correct my explanation.
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: francisackerman on May 20, 2017, 05:19:46 PM
Ok interesting point. I don't have the experience to say anything about that. Do you have another view of your x-rays? How does the spike look from the side?
Was the spike already there on the x-rays right after the surgery?

francis
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on May 21, 2017, 10:45:24 AM
I just noticed that there is another xray on the disk that I received, I believe this is a side view.

https://www.dropbox.com/s/xclicar6osgs8l5/ScreenHunter_83%20May.%2021%2006.22.jpg?dl=0

I'm not an expert for sure, but at a different angle it does not look nearly as alarming.  From my laymen perspective,  I does seem like that particular area with the so called "lucky spike" would produce more bone making it stronger as Dr. Monegal described. The two different angles certainly make the area of the fracture look quite different, I'll question Dr. Monegal so that he can put these two different views in perspective.

I don't have copies of the xrays taken a day after surgery, but Dr. Mongegla did show them to me on his phone and made mention of the "lucky spike".

On another note, I did sleep my better last night.  The trick seems to be to elevate my upper body; I have no idea what that did; perhaps increased blood flow to my leg??? In any case, my leg did not bother me nearly as much and I slept for an hour or more at a time before having to get up and walk a bit.  I also skipped the 50 minutes of stationary biking last night but will resume that routine today.

Cheers!

Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: onemorefoot on June 16, 2017, 07:08:52 AM
How are you doing, buddy?
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on June 28, 2017, 12:16:18 AM
Hey onemorefoot,

Doing very well  I believe.  Still lengthening but I'll be done in the next few days and will be returning to Spain in a little over a month to start work on my remaining leg.  Looking forward to gaining 2.5 inches and getting this behind me. :D
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: onemorefoot on June 28, 2017, 01:26:42 AM
Very Happy for you, continue like this. :)
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: biggerdreams on June 28, 2017, 04:14:49 AM
Hey onemorefoot,

Doing very well  I believe.  Still lengthening but I'll be done in the next few days and will be returning to Spain in a little over a month to start work on my remaining leg.  Looking forward to gaining 2.5 inches and getting this behind me. :D

When did you return home and how has life been since your return? Anything mention-worthy?
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: ouroboros on July 01, 2017, 01:13:07 AM
Hey, how are you doing?

Have you finished lengthening? How many cm have you lengthened?

Can you comment on the difference between lengthening at home, vs Barcelona...... are you getting physio at home..... and finally are you currently suffering from any duck ass?

Sorry for all the questions, just want to know if lengthening one leg at a time is less likely to develop complications/stiffness because you are more mobile living regular life, instead of being confined to bed or wheelchair.

Thanks dude.
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Shadow91 on August 04, 2017, 11:53:23 PM
I wonder what the time frame is from surgery to walking semi-normal is when doing 1st stage internal femur with Dr Monegal. Does anyone know?
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: realpatient on August 04, 2017, 11:55:07 PM
Some people are not walking yet after 3 years.
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Shadow91 on August 04, 2017, 11:55:57 PM
Man, ive been wanting to do this surgery for 4 years but i am so scared of the risks.
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: realpatient on August 04, 2017, 11:56:55 PM
Risks are always there but you can avoid some if you choose a better surgeon
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Shadow91 on August 05, 2017, 12:08:28 AM
Who should you choose then. I thought for 4 years that Guichet was the best, but since ive been reading this forum for the past 2 days im freaking lost. Everyone seem to be incredible risky.
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Auron on August 05, 2017, 10:57:14 AM
Who should you choose then. I thought for 4 years that Guichet was the best, but since ive been reading this forum for the past 2 days im freaking lost. Everyone seem to be incredible risky.
Realpatient is a troll with many accounts, ignore him and his accounts. If you want to decide on which doctor you would like to have your surgery with I suggest you read the diaries in the forum. The more diaries you read, the less you can go wrong.

As a Dr. Monegal patient, I'd recommend him.
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on August 11, 2017, 11:57:35 AM
Hey ouroboros,

Sorry for the late reply.  Yes, I finished lengthening on July 10th; I lengthened about 7 cm.

As far as lengthening in Barcelona vs. home; I preferred lengthening at home.  However, had I not been single and access to a secondary (hide away) residence to continue lengthening, I would have probably opted to stay in Barcelona for the term.  Less distractions and relative privacy during the lengthening/recovery process was a must for me.  I am able to work remotely, so I had lots of flexibility as far as locations.

i did all the Physical Therapy on my own while both in Barcelona and home.  I bought a Nitrofit Limber Pro Stretch Machine and just went to town on it three times a day.  I seem to do the trick, bone of the PT techs at the Clinical Diagonal though the movement that I achieved on my first leg  was very good; even wanted to know who I used for therapy at home.

I honestly can't imaging being confined to a wheel chair, one leg at a time was the only option I was considering when deciding who to go see for the procedure. 

Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on August 11, 2017, 12:12:16 PM
Shadow91,

No doubt that having this procedure done is something that you should think hard and long about.  However, if you decide to move forward, I highly recommend Dr. Monegal; there is absolutely nothing that i went though during lengthening that Dr. Monegal did not already let me know about.  That includes, lengthening targets where the muscle tension will be the worst. 

I got xrays every two weeks when I got back home because I was so worried about some of the concerning PMs I got about the xray I had posted of my first leg.  I was mostly concerned about non-union of the bone.  The US radiologists never had any concerns about the consolidation process.

Dr. Monegal certainly has some quirks (as do I) ; but I'm convinced he is a very skilled.  I have absolute confidence in him and am really happy with my decision to come to Barcelona for the procedure. 
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on August 11, 2017, 12:44:18 PM
A quick update: 

I stopped lengthening on July 11th and was walking, maybe more of a shuffle, without crutches for about the last 10 days in July.   I felt it was important to start full weight bearing on my leg since I was about to return to Barcelona for the second procedure.

I arrived in Barcelona , on August 1st for my surgery on my second leg.  Surgery went very well and and the xrays look very good (IMHO).  I have been over at MIC for the since Tuesday.

I should have given myself more time to recover from my first surgery before returning; it is very difficult to walk on crutches because my knee is still a bit sore on my first leg.  I decided to only begin a slow lengthening regiment and stay off my feet for a few days to give my leg a little more recovery time;  I hope that I can walk more competently on crutches by Monday.

Unexpectedly, I do have more pain this time around, but it's still manageable without the need for pain killers.

Look forward to returning home in September and finishing up the lengthening of my second leg while continuing a rigorous stretching routine!
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Shadow91 on August 11, 2017, 02:42:13 PM
Thank you for taking your time to answer me and thank you for sharing your story. The more information we have, the easier it is for the rest of us to make a decision. I wish you the best on your journey to become taller:)
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: U only live once on August 12, 2017, 02:23:52 AM
A quick update: 

I stopped lengthening on July 11th and was walking, maybe more of a shuffle, without crutches for about the last 10 days in July.   I felt it was important to start full weight bearing on my leg since I was about to return to Barcelona for the second procedure.

I arrived in Barcelona , on August 1st for my surgery on my second leg.  Surgery went very well and and the xrays look very good (IMHO).  I have been over at MIC for the since Tuesday.

I should have given myself more time to recover from my first surgery before returning; it is very difficult to walk on crutches because my knee is still a bit sore on my first leg.  I decided to only begin a slow lengthening regiment and stay off my feet for a few days to give my leg a little more recovery time;  I hope that I can walk more competently on crutches by Monday.

Unexpectedly, I do have more pain this time around, but it's still manageable without the need for pain killers.

Look forward to returning home in September and finishing up the lengthening of my second leg while continuing a rigorous stretching routine!

Hi Four Inches,

Good on you and your accomplishments! I am also going with Monegal on 19 Sep(two stage). Hey buddy how many centimeters in total have you lengthened? Same as you I dont live in Spain so I will have to come back to my home country and go back later to Spain for the second surgery so if you dont mind me asking how was you whole experience of walking with one leg longer than the other. Did the insoles do the job?  Do you have any anecdote you wanna share of people questioning your temporary handicap? Any inconvenience such as loose screw in your home country? Thanks a lot buddy and I wish the best in your LL road!
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on August 12, 2017, 09:41:16 AM
Thank you Shadow!
Thank you for taking your time to answer me and thank you for sharing your story. The more information we have, the easier it is for the rest of us to make a decision. I wish you the best on your journey to become taller:)

Thank you Shadow!
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on August 12, 2017, 10:43:24 AM
Hi Four Inches,

Good on you and your accomplishments! I am also going with Monegal on 19 Sep(two stage). Hey buddy how many centimeters in total have you lengthened?


Hi U only live once!

I lengthened 7.58 cm, based on the number of "clicks" that i tracked though the lengthening process, (plus the initial 4mm of gain that Dr. Monegal included during surgery.)  However, my xrays were showed less gain so I more or less tracked lengthening based on my xrays and clicks.  Based on xrays in Barcelona, Dr. Monegal calculated that I had lengthened about 6.5 - 6.7 cm. and that seems to match up with the last xrays taken while in the US.

If think the discrepancy might have been from the Fitbone transmitter and receiver not being lined up right;  a click may still turn the nail but seemingly with limited power.  I remember when lengthening, I would sometimes hear the nail turn with a strained sound.  At the time I though it was due to muscle tension because I remember first hearing it when I was well into the lengthening process.  However, I have heard the same strained turns with my second leg and I'm nowhere near reaching muscle tension yet; when I realign the transmitter the turns sound health.

It's certainly possible that I just miscounted the number of times in lengthened on multiple days.  Maybe others that have been though the process can chime in on this thought.

if you dont mind me asking how was you whole experience of walking with one leg longer than the other. Did the insoles do the job?


The insoles did the job for me.  I felt very comfortable on crutches using the insole.

Do you have any anecdote you wanna share of people questioning your temporary handicap? Any inconvenience such as loose screw in your home country?

At times I was most definitely bearing more weight on the fitbone then recommended, so I was concerned about loosening screws.  However, the screws held up fine. No issues, other than the discrepancy in clicks.  I would recommend tracking the lengthening based on both clicks and xrays, that seems to be a workable approach. 

Thanks a lot buddy and I wish the best in your LL road!


Thank you, and a big congratulations on your decision to move forward with the procedure!  I wish you the best! 
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: helloworld on August 12, 2017, 09:09:17 PM
I interviewed 7 people that tracked their clicks about precision of supposed lengthening according to clicks versus real lengthening and 4 out of 7 had less distraction than what they should have had!
The discrepency between clicks and real lengthening increased for all patients. That means to me that either the bone density and thus the resistance became stronger or that the resistance made the winding inside the nail wear out.

The most extreme case seemed to be myself where I did clicks on the left side amounting to more than 10 cm but actually only lengthened 5 cm.

It is not a big deal as long as you follow your x-rays closely and then at the final stages have frequent x-rays to fine tune the length.
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Body Builder on August 13, 2017, 12:00:02 AM
This is a big drawback for fitbone imo.
But Helloworld haven't you done enough x rays during lengthening? Haven't you seen that the lengthening was less in reality than in clicks? Why in the end you lengthened less than you wanted?
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: onemorefoot on August 13, 2017, 01:36:21 AM
Does precice 2 have that problem ( Angle Q is real, but shouldnt be more than .5 cm)?

Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: helloworld on August 13, 2017, 10:25:55 AM
This is a big drawback for fitbone imo.
But Helloworld haven't you done enough x rays during lengthening? Haven't you seen that the lengthening was less in reality than in clicks? Why in the end you lengthened less than you wanted?
Yes, you are right.
The thing is that I was assuming that the difference was minor and/or that I must have made a mistake in the clicking schedule. Also, the difference was small at beginning and became much bigger at the end. Also, my PT told me it was almost impossible to have a preconsolidation and the only thing to be scared of was too little consolidation, so I went slow on purpose at the beginning. Later I accelerated, but likely because the actual lengthening was much less, I will still distracting too little.
The day I became full aware oft the magnitude of the difference after my last x-rays, I came home wanting to accelerate lengthening, but both nails simulatenously did not respond anymore as bone was consolidated.

Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: doomsday on August 13, 2017, 10:30:25 AM
Guys maybe it's good to stop using word clicks when you dont click anything in fitbone. People get confused.
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: helloworld on August 13, 2017, 10:34:55 AM
This is a big drawback for fitbone imo.
For me it is not such a big drawback, as nobody needs to lengthen a precise amount. In fact, I have not met any patient who knows the exact amount of lengthening that he wants to do at the beginning of the procedure. For example, for me it was 5-6.5 cm.
Also, you should take x-rays every 2 week anyway.
The problem is that patients need to be told beforehand that lengthening is not a precise 0.03 mm per click but somewhere in between 0.01 and 0.03 depending on much bone formation you have.
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Bander72 on August 13, 2017, 05:43:15 PM
Id be pissed having clicked expecting 10 cm and having 5. Know imgaine if this were to happen in guichets torture device. :'(
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on August 15, 2017, 08:45:16 AM
Hi Hello World,

How many days had you paused consolidating when the fitbone nails became unresponsive?

Thanks!
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: helloworld on August 15, 2017, 10:36:55 AM
Hi Hello World,

How many days had you paused consolidating when the fitbone nails became unresponsive?

Thanks!
0 days.
I was lengthening every day until I had an appointment with Dr. Monegal where I got x-rays and saw that 1. my legs where not 100% same length, 2. I still had not lengthened as much as I wanted.
So Dr. Monegal told me to accelerate lengthening because my bone would soon be consolidated, and not give me possibility to lengthen more.

When I arrived home from that appointment, both nails stopped responding, at the same time!
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Body Builder on August 15, 2017, 12:22:59 PM
0 days.
I was lengthening every day until I had an appointment with Dr. Monegal where I got x-rays and saw that 1. my legs where not 100% same length, 2. I still had not lengthened as much as I wanted.
So Dr. Monegal told me to accelerate lengthening because my bone would soon be consolidated, and not give me possibility to lengthen more.

When I arrived home from that appointment, both nails stopped responding, at the same time!
So at the end of lengthening your legs are not in the same length?
If yes what is the difference?
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: helloworld on August 15, 2017, 01:52:17 PM
So at the end of lengthening your legs are not in the same length?
If yes what is the difference?
I tried for several days, no response. So I packed my lengthening device away.
But then, like a week later I tried again on my shorter left leg and to my surprise it responded!
So I did in one go 60 clicks, which is much more then recommended, and continued to do over 200 clicks over the next 3 days, which should have been a big amount but I think was actually very little, so my left left leg should still be a bit shorter.

I think the difference is very small, but I will take a close look at the next x-rays.
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: afterall on August 17, 2017, 07:50:11 AM
I tried for several days, no response. So I packed my lengthening device away.
But then, like a week later I tried again on my shorter left leg and to my surprise it responded!
So I did in one go 60 clicks, which is much more then recommended, and continued to do over 200 clicks over the next 3 days, which should have been a big amount but I think was actually very little, so my left left leg should still be a bit shorter.

I think the difference is very small, but I will take a close look at the next x-rays.

hi all ,
it's my first post but it's months that i follow the forum , regarding this problem i have some questions for all of you
what happen if in 2 stages the second leg can't reach the lenghtening of the first leg ? example the first leg lenghtened 7,5 cm, the second leg for several reasons can't pass 5 cm, we have to live with discrepancy??
the same question in 1 stage
without frequently x-rays there are a lot of risks...

(sorry for my english )
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: helloworld on August 17, 2017, 09:32:07 AM
hi all ,
it's my first post but it's months that i follow the forum , regarding this problem i have some questions for all of you
what happen if in 2 stages the second leg can't reach the lenghtening of the first leg ? example the first leg lenghtened 7,5 cm, the second leg for several reasons can't pass 5 cm, we have to live with discrepancy??
the same question in 1 stage
without frequently x-rays there are a lot of risks...

(sorry for my english )
That is very unlikely to happen.
I had very good bone consolidation that is why Fitbone stopped.
But if it really happens, then you can always break the bone again.
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on August 17, 2017, 11:39:20 AM
hi all ,
it's my first post but it's months that i follow the forum , regarding this problem i have some questions for all of you
what happen if in 2 stages the second leg can't reach the lenghtening of the first leg ? example the first leg lenghtened 7,5 cm, the second leg for several reasons can't pass 5 cm, we have to live with discrepancy??
the same question in 1 stage
without frequently x-rays there are a lot of risks...

(sorry for my english )


I agree with Helloworld; based on the experiences of others that I have spoken to it seems unlikely.  However, there have been fitbone nail failures and the nail had to be replaced.  I'm guessing every type of internal nail has had some percentage of failure.

Although, I had xrays every two weeks; mostly because I wanted to be assured that the bone was consolidating.  I think the xrays become more important as you get close to reaching your desired height so that you can better confirm how much you have lengthened.  If you are a two-stage patient, its even more important with your second leg so that a significant discrepancy can be avoided. A minor discrepancy seems to be considered acceptable.  In fact, I had a 4mm discrepancy before surgery that I never knew about.

I'm thinking about returning to Barcelona in the final days of lengthening so that I can have easier access to more frequent xrays.
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on August 30, 2017, 09:54:13 AM
Quick update......so far things seem to be going fine. 

I had a round of xrays taken about a week ago and there is lots of bone formation activity on my first leg; very thankful for that.  I have lengthened 2.5 centimeters in my second leg so far and plan to lengthen a full 8cm to compensate for the lengthening in my first leg plus compensate for a preexisting discrepancy in my leg length.  With a little luck I should be walking without crutches in late November.

Quite by accident, I noticed that I can actually walk without crutches now! In a momentary loss of reality, I took a few steps without my crutches and was pleasantly surprised.  I know walking without crutches is a no-no at this stage, but it was a bit comforting to know that I can.

I'll be returning to the US, in the next few days.  As much as I love it here, I look forward to returning home so that  I can somewhat get on with my life! ;D



Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: U only live once on August 30, 2017, 10:05:51 AM
Quick update......so far things seem to be going fine. 

I had a round of xrays taken about a week ago and there is lots of bone formation activity on my first leg; very thankful for that.  I have lengthened 2.5 centimeters in my second leg so far and plan to lengthen a full 8cm to compensate for the lengthening in my first leg plus compensate for a preexisting discrepancy in my leg length.  With a little luck I should be walking without crutches in late November.

Quite by accident, I noticed that I can actually walk without crutches now! In a momentary loss of reality, I took a few steps without my crutches and was pleasantly surprised.  I know walking without crutches is a no-no at this stage, but it was a bit comforting to know that I can.


I'll be returning to the US, in the next few days.  As much as I love it here, I look forward to returning home so that  I can somewhat get on with my life! ;D


Hi Four Inch,

I am very excited to read your diary since my surgery is surely on the way, counting the days off, 18 days! Just out of curiosity  how often do you get your xrays done? Do you send them to Monegal every time you take them?

Thanks mate.
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on August 30, 2017, 10:26:59 AM
Hi U only liver once,

I had xrays taken every two weeks and I did indeed share them with Dr. Monegal.  Dr. Monegal will not pester you about xrays, at least he didn't remind or pester me, but my advise is to be sure to have xrays taken frequently and ask Dr. Monegal to review and respond to them.  I think almost all radiology clinics have the ability to provide the xrays on CD so it's easy to e-mail them over to Dr. Monegal.

Good luck to you!
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on January 18, 2018, 11:14:41 PM
Very sorry for the shamefully late reply, I am doing very well, thank you for asking.  Iv'e been absent form the forum due to some family matters.  It's really hard to get back in the swing of posting once you get away from it for a while.  I don't plan on being real active on the forum going forward but will periodically check in on others. 

A few weeks ago I crossed the point of knowing that all is well and I will be notch on the LL success totem pole.  I am walking at a near normal gait now and am slowly rebuilding the strength in my knees.  Walking up stairs is fairly routine but i still need to take a step at a time when going down stairs. I'm expecting to be fully recovered at about a year from stage one surgery....that is with lengthening about 7cm.

I can attest to the fact that the fitbone nails will take a lot more weight than advertised.  I have been doing some amazing weight bearing feats out of necessity for the past couple of months and xrays show the nails are in good shape.

There is a ridiculous amount of controversy surrounding Dr. Mongegal, I want to say that in my book he is a terrific person and Doctor.  I have absolutely no complaints; other than he is a bit absent minded about sending my xray orders with out a few nudging.   As I mentioned in previous posts, one you leave Barcelona, he is not going to be holding your hand but he is always a WhatsApp ping away.  For you Monegal naysayers, you are absolutely wrong about him; I'll have his back for a lifetime.

I'm toying with the idea of maybe doing my tibia's.........hummm, I need to think long and hard about that but i do its back to Dr. Monegal.

A shout out to Roy Boy, Auron and Music Maker.  You all made this experience a lot less fearful that it would have been otherwise without your support.

- Cheers!

Cheers!



Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Auron on January 19, 2018, 12:57:28 AM
It's great to know that you're recovering well, the fact that you are considering doing tibias tells me you're in good shape. I hope to meet you again in the future and have a laugh together at our past adventures!

Cheers ~
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Honore on January 19, 2018, 01:22:47 PM
OBG, how much did you do? My theory is that 3inch is safe for 20's/30's but for 40's, maybe 2inches is safer.

No disrespect intended but as a late 40's man myself, planning doing LL in 2018/19, I wonder what your basis is for this theory...

@Four Inch.. great that you did this, I am proud and humbled of/by your perseverance... Can I ask you why dr M insist of doing one leg at a time? Do other doctors really take a too great a risk doing 2 legs simultaneously? Because I am planning doing 4inch divided over tibia/femur... since Dr M is my preferred doc this would take me a long time...
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on January 23, 2018, 02:54:04 AM
Hi Honore,

Thank you for the kind words.

Dr M. really only recommends doing one leg at a time; the primary reason is to avoid being confined to a wheel chair.  I know he will do both legs simultaneously if you are doing tibia or femur if that is what you prefer; others have done the same.

I'm not sure about doing both tibia/femur simultaneously at the same time. 

Cheers!
Title: Re: Dr. Monegal (Barcelona) - Two stage internal Femur - Fitbone
Post by: Four Inch on January 23, 2018, 03:05:53 AM
Hey Auron,

Hope all is well.  We will most defiantly meet again; even if I have to hunt you down in Portugal, so be it!  :)