Unlike the vast majority of the comments on this thread, my point of view is based on my actual experience lengthening 10.5cm with Dr.Betz. I had my nails removed during the second week of October, on the same day as
OldieButGoldie who has a diary here.
Generally, I think forums such as this one are great, but they also tend to be afflicted by a phenomenon known as 'arm chair' experts. If you have ever attended a bull fight, there is always row upon row of buLL Forumight critics, all of them giving their 'professional' opinion on bull fighting. Ultimately, the only folks who
really know what its like to fight a bull, are those who get into the arena and fight the bull. Everyone is free to voice their opinion, but be wary of taking buLL Forumighting lessons from a spectator.
Before I voice my opinion about Dr. Betz, let me clarify a couple of things from first hand experience. Many of the points below have been previously elucidated by gettingtaller in this same thread, so to some extent I'm just rehashing the experience of someone else who has also spoken from first person experience.
- The vast majority of LL patients will not keep a diary. Many of them don't even know of LL forums or speak/write English. In the time that I spent in Germany for the initial surgery, I knew more than a dozen patients and only two of them started diaries (Torontian & DCLongFemurs). Both of them stopped posting to their diaries even though they did go on to complete LL successfully. When I went back to get my nails removed, I met 9 patients at the hospital, (2 for nail removal the rest for nail insertions), and only one (OldButGoldie) had a diary.
- Many of the LL patients I met, myself included, did not want to disclose the LL procedure to friends or even familiy. I wager that many of the visitors to this forum who are thinking of getting LL also have the same sentiment i.e. get the procedure done quietly, recover and get back to life. Of the 80+ patients each year who get the surgery done with Dr.Betz, most do just that i.e. put on your game face, wrestle the bull that is LL, recover, go on with your life and enjoy your new height. Many people are attracted to Internal LL because of the possibility of doing the process discreetly i.e. no external fixators & you can walk without crutches faster than the alternatives, so it should come as no supprise that many of them don't want to advertise the fact they are doing LL, even in an anonymous forums such as this.
- The diaries and shared experiences of those who have gone through LL is a great resource for those others who are considering the procedure. However, most of the folks who have done LL will tell you that it's a frustrating experience trying to convey realistic expectations to prospective LL'ers. Between the folks who think they know it all based on what they have read and those who want to hear their assumptions validated, however unrealistic they might be, many LL'ers opt to steer clear of posting in the forums. Believe me, when you are in the 2nd or 3rd month of lengthening, the last thing you want to spend your time doing is banter with an 'arm chair' LL expert. And once you are done with LL, most people want to forget about the experience and move on with their lives.
- The stats posted above about the complication rate for Dr.Betz are just plain moronic to the verge of being criminal. There are 38 diaries spanning the period beginning 2007. During that period, approximately 600 patients have done LL with Dr.Betz. How daft would someone have to be, to conclude that for the ~600 patients, you'll take 12 dairies that mention complications, and resolve that the complication rate for Dr.Betz is between 36% and 52%. With that kind of proficiency in math, one ought to consider asking for a refund from whoever taught them math. 12 out of 600 is 2% and even that cannot be considered a valid figure because the vast majority of LL patients don't patronize LL forums or care to maintain a diary. During the time that I stayed in Germany for the initial procedure and then subsequently for the removal, I met at least 20 patients personally. Out of these, there was one guy who fell in the bathroom and bent his nail such that it had to be replaced with a titanium fixator. Then there was another who was well on his way with LL but decided to go back to his construction job and not use crutches. He broke the screws on one leg which resulted in a fracture and he had to get titaniums and stop lengthening since you can't continue LL with a fractured bone. So that is 1% of the patients who I knew personally, but even I would be foolish to take that as a representative sample and use it to postulate what the complication rate for Dr.Betz is.
- Since 2007 there have been Betz patients who have used LON, ISKD, Fitbone, Albizia, Precice, BetzBone, etc. all of which have different performance profiles. Some like the Fitbone had a notoriously high failure rate due to the electrical mechanism failing, and hence methods like Fitbone are no longer used, even though Fitbone spared patients the tribulation of clicking. The point is, if your going to analyze complication rates, you have to consider the method used.
- It's never wise to tempt fate, least of all, when you have two broken bones in your legs being held together by screws. The 13mm BetzBone will comfortably hold the weight of a 240lb guy. But the same does not apply to the screws that attach the nail to your bones, and that is where most structural failures occur. This means that if mother nature gave you bones that are on the brittle side, then use the damn crutches until you have achieved consolidation, even if you have a nail that can bear your whole weight. This also means that as the weeks and months drag on and you are eager to stop using the crutches, you have to be judicious about when to walk without crutches. Most of the instances of broken screws & bent nails have occurred after the lengthening period and prior to consolidation. So regardless of which doctor you use, if you over exert the nails & screws, there's a good chance you'll end up back in the OR to get titaniums.
I did my LL surgery with Betz in August of 2012, and went from 173.5cm to 184cm on the 13mm BetzBone. Based on my starting height, LL for me was obviously for cosmetic reasons and with a gain of 10.5cms, I did more than most patients do on a single section. The passage of time since when I finished lengthening in December 2012 has somewhat obscured how difficult the lengthening was, particularly towards the end of the process. But what is apparent even to this day is that the process was 20% Betz, 30% Physiotherapist and 50% me. Let me explain.
- Surgery is trivial. They roll you into the OR. You fall asleep. You wake up 3-4 hours later. The nails are in. Betz plays a big role here.
- You spend the first week in the hospital, getting used to walking around on crutches with two broken legs. Betz comes in to check on you every day, but its mostly the nurses, therapist and other LL patients that interact with you.
- On the second week, you start clicking. Betz will help with this but many patients start clicking on their own or with one of Betz's assistants. Some patients have a hard time with the initial clicking which necessicates more involvement from Betz.
- After the second week, you leave the hospital and go to a residence of your choosing. From this point onwards, Betz will continue to visit as well as his assistants, but most of the therapy is from the physio therapist.
- Once confortable with clicking, many patients leave Germany and go back home. I left after one month and continued to lengthen for 2 more months at home. During this period, you take xrays every month and send them to Betz to make sure that the nail and screws are still fine. But mainly you continue with your physio 4-5 times a week.
- After lengthening, the consolidation period begins and the length of this depends on how much lengthening you did as well as how quickly your bone consolidates. You continue to take xrays every month and send them to Betz and you also keep up with physio. As your legs get stronger and you get more bone consolidation, you are able to stop using the crutches gradually. Unfortunately, some patients get too confident with their stronger legs and assume that they can get back to doing all sorts of activities, and the resulting over-exertion causes the screws or nail to bend.
What I'm trying to illustrate above is that in the typical 3 month LL duration, the doctor will play a pivotal role in the first 2 weeks, then it'll be up to you to be disciplined and follow instructions for the remaining 10 weeks. Most patients do so successfully but it requires discipline & dedication. In this particular respect, Guichet is different in that he insists that most of his patients stay in Milan for the entire lenthening period. This approach has its merits since most patients have difficulties staying focused and doing what they need to do for the entire LL period.
Before I decided to go with Betz, I interviewed with both Guichet & Betz and found both of them to be very capable. However, I was not keen on doing LL in such a big city as Milan, so I opted for the quiet German country side. I'm from the US, so both places would have been foreign and with foreign languages, neither of which I knew. Prior to the surgery, I actually did the Isometric training that Guichet requires although Betz said he didn't think it was necessary in my case.
As a doctor, I think Dr.Betz is as good as they come, and the vast majority of this patients, even those who have had complications will probably share the same sentiment. Aside from his command of the surgical procedure, I don't know many doctors who will physically carry you to the toilet when you are unable to walk (tibia patients can't walk at all during the first 5 days after surgery), call hotels, physical therapist and massage therapist and personally make reservations for you, drive half an hour out of his way so that he can visit you at your hotel, or sit with you until all your questions are answered. The one downside I will mention is that he runs such a busy schedule so if you do go for an interview, you'll probably be waiting for an hour or so, but once you get in, he'll stay with you until you run out of questions.
Having said that, my advice is that if you are considering Dr.Betz, then at the very least vist both Betz and Guichet and then make your choice. In both cases, insist that you be allowed to visit some of their current patients, particularly the ones who are already clicking. I say this because the patients who are 1-2 weeks after surgery are in too good shape to convey the real nature of LL. Best to see patients who've been clicking for a while. You don't know LL until you've been clicking for a while. If you can, visit Peter Woll in Wadern and ask to observe one of the therapy sessions. Ultimately, it would be fool hardy to choose a doctor based on what you read on these forums. If you're gonna expend that much money, pain, sweat and tears doing LL, you owe it to yourself to observe first hand what its all about.
I'm 6.05ft tall now and for the rest of my life I'll be thankful to Dr.Betz for making that possible, althought like I said above, 50% was me struggling to keep going. If I woke up and found myself at 173cm, I'd go back to Betz. I am also sure that other doctors such as Guichet, Paley, etc are also capable, but I can only speak from my personal experience.
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Topic: Dr Augustin Betz (Neunkirchen, Germany) The Betz Institute (Read 136644 times)