Limb Lengthening Forum
Limb Lengthening Surgery => Limb Lengthening Discussions => Topic started by: .. on May 10, 2018, 06:46:37 PM
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1. What should I eat for the next 3 years? Like calcium or vitamin D?
2. Should I stop consuming sugar? I am not sure but I could be mildly diabetic due to excessive sugar intake since childhood.
3. I have nasal polyps that makes it difficult to breath through nose at times. Would it be a problem during anesthesia?
4. Body better be muscled or not? I read that it's better to bulk up the thighs if doing internal femurs.
5. Could sleep deprivation or staying awake at night affect it?
6. Is unilateral worth it even with Paley?
7. Would Paley mind me not telling my family that I do LL?
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My thoughts based on observations:
1. Eat healthy. Exclude junk food and soft drinks. It is always better to be in good shape when it comes to CLL. Take vitamins during your lenghtening and recovery phases.
2. Yes, well at least try for these 3 years, pretty sure it will help you in the long run.
3. (JUST SPECULATING!) If they give you the general anesthesia it can be a little problematic if you ask me, sure not a great risk but better safe than sorry, tell Paley just in case.
4. Actually for external it is better if you do not have build muscles in the legs. I assume that is also the case with internals.
5. No.
6. He is one of the best, if he can tell you he can do it, you have nothing to fear.
7. Well here I am not sure. He may agree to not tell your parents, but I am pretty sure you have to write who he has to contact if something gets complicated/wrong with you, but like I said Paley is worth the money. Also try to tell your family, it will be much better for both you and your close ones, instead of making them worrying about you and you lying to them. 100% not worth it.
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1. What should I eat for the next 3 years? Like calcium or vitamin D?
2. Should I stop consuming sugar? I am not sure but I could be mildly diabetic due to excessive sugar intake since childhood.
3. I have nasal polyps that makes it difficult to breath through nose at times. Would it be a problem during anesthesia?
4. Body better be muscled or not? I read that it's better to bulk up the thighs if doing internal femurs.
5. Could sleep deprivation or staying awake at night affect it?
6. Is unilateral worth it even with Paley?
7. Would Paley mind me not telling my family that I do LL?
1. consume your normal dietary needs of calcium and vitamin d. obviously you don't want to be low in either when under going orthopedic surgery.
2. you should try your best to be as fit as possible prior to surgery. This means lower body fat. This will not only help you during recovery and weight bearing, but also it reduces the chances of fat embolism in research studies.
3. I believe you can opt for epidural anesthesia if it is a concern for the physician operating on you
4. idk about this one. You should try to be as fit and healthy as possible prior to surgery though.
5. idk what you are asking here. But this ties back to #4. You need to make sure you are as fit and healthy prior to surgery and this means you should not be sleep deprived. Your body recovers when you are sleeping.
6. Unilateral surgery cuts down the chances of you developing fat embolism drastically. Even dr. paley has seen 4 cases of fat embolism syndrome when doing cll on the femurs. If I undergo internal femurs, it would be unilateral spread one month apart.
7. I don't think Paley would make you get validation from your parents if you are over 18.
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https://www.youtube.com/watch?v=Iz2ePdIKIPo
I'm not sure anymore he mentions that stretching isn't that important before LL(unlike Guichet)
concerning muscle mass I don't really remember anymore but he mentions that also
Paley doesn't accept patients who smoke
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I think somewhere in this video Dr. Paley says that having muscled legs before is not an advantage for recovery
I believe you are referring to the point in the video he talks about Guichet. It's because Guichet gets his patients to muscle up before surgery. Paley essentially called that worthless.
Whether it's a positive, a negative, or even completely irrelevant how built your legs are, I can't tell. I haven't looked up any published material on this subject.
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Yes, at 51minutes he talks about it
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You do wear down the cartilage in your bones/joints with high-intensity exercise, though, don't you? Any fact-checked replies would be much appreciated.
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Flexibility is by far the best thing you can do. It wont help you lengthen additional centimeters. It will only make the process more bearable and less painful day to day. Stretching for a few months before surgery is worthless. Spend 8-12 months prior to surgery doing serious yoga, pilates or mixed martial arts.
Spending time and money to build muscle before limb lengthening surgery is beyond worthless.
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My thoughts based on observations:
1. Eat healthy. Exclude junk food and soft drinks. It is always better to be in good shape when it comes to CLL. Take vitamins during your lenghtening and recovery phases.
2. Yes, well at least try for these 3 years, pretty sure it will help you in the long run.
3. (JUST SPECULATING!) If they give you the general anesthesia it can be a little problematic if you ask me, sure not a great risk but better safe than sorry, tell Paley just in case.
4. Actually for external it is better if you do not have build muscles in the legs. I assume that is also the case with internals.
5. No.
6. He is one of the best, if he can tell you he can do it, you have nothing to fear.
7. Well here I am not sure. He may agree to not tell your parents, but I am pretty sure you have to write who he has to contact if something gets complicated/wrong with you, but like I said Paley is worth the money. Also try to tell your family, it will be much better for both you and your close ones, instead of making them worrying about you and you lying to them. 100% not worth it.
Hey man, thank you for your answer. Actually I meant to say that I'm gonna do the surgery in 3 years from now so it's about these 3 years of preparation. Do you think it's necessary to start eating healthy as you described and stop consuming sugar from now on?
Paley said that unilateral is nonsense. But I still think that it minimizes the chance of fat embolism and I will have one healthy leg.
I most certainly will not tell my parents because they will be against it without doubt.
1. consume your normal dietary needs of calcium and vitamin d. obviously you don't want to be low in either when under going orthopedic surgery.
2. you should try your best to be as fit as possible prior to surgery. This means lower body fat. This will not only help you during recovery and weight bearing, but also it reduces the chances of fat embolism in research studies.
3. I believe you can opt for epidural anesthesia if it is a concern for the physician operating on you
4. idk about this one. You should try to be as fit and healthy as possible prior to surgery though.
5. idk what you are asking here. But this ties back to #4. You need to make sure you are as fit and healthy prior to surgery and this means you should not be sleep deprived. Your body recovers when you are sleeping.
6. Unilateral surgery cuts down the chances of you developing fat embolism drastically. Even dr. paley has seen 4 cases of fat embolism syndrome when doing cll on the femurs. If I undergo internal femurs, it would be unilateral spread one month apart.
7. I don't think Paley would make you get validation from your parents if you are over 18.
Hi, thanks for answering. Actually I'm gonna do the surgery in 3 years from now so it's about these 3 years of preparation.
I've never been fat in my life. But do you mean that the lower the fat is the lower the chance of FE? In that case, I shall not eat much. :)
How does epidural anesthesia favor my nose condition?
Regarding the unilateral, Paley actually said that it's nonsense and he charges 30-40 extra k for 2-stage which means 1/3 of the original price. How difference do you think between unilateral spread one month apart and 6 months apart?
Flexibility is by far the best thing you can do. It wont help you lengthen additional centimeters. It will only make the process more bearable and less painful day to day. Stretching for a few months before surgery is worthless. Spend 8-12 months prior to surgery doing serious yoga, pilates or mixed martial arts.
Spending time and money to build muscle before limb lengthening surgery is beyond worthless.
What do yoga, pilates or mixed martial arts have to do with LL again? I am actually talking about 2-3 years prior to surgery. :)
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Hey man, thank you for your answer. Actually I meant to say that I'm gonna do the surgery in 3 years from now so it's about these 3 years of preparation. Do you think it's necessary to start eating healthy as you described and stop consuming sugar from now on?
Paley said that unilateral is nonsense. But I still think that it minimizes the chance of fat embolism and I will have one healthy leg.
Regarding the unilateral, Paley actually said that it's nonsense and he charges 30-40 extra k for 2-stage which means 1/3 of the original price. How difference do you think between unilateral spread one month apart and 6 months apart?
By the time you do LL, Stryde/Precice 3 will have had some good years of experience under its belt.
So theoretically you'd have "good legs" soon. We shall see how Stryde actually fares.
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By the time you do LL, Stryde/Precice 3 will have had some good years of experience under its belt.
So theoretically you'd have "good legs" soon. We shall see how Stryde actually fares.
Does this have anything to do with the chances of me ending up dead/permanent disabled on the operating table compared to PRECICE 2? I thought it's just about full-weight bearing and the ability to walk immediately post-op. When I said "a good leg", actually I was referring to a leg that's not broken.
Also, do you think Paley's skills will be significantly improved by that time? Maybe there will be something even more advanced than Stryde!
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Paley said that unilateral is nonsense. But I still think that it minimizes the chance of fat embolism and I will have one healthy leg.
How does epidural anesthesia favor my nose condition?
Regarding the unilateral, Paley actually said that it's nonsense and he charges 30-40 extra k for 2-stage which means 1/3 of the original price. How difference do you think between unilateral spread one month apart and 6 months apart?
What do yoga, pilates or mixed martial arts have to do with LL again? I am actually talking about 2-3 years prior to surgery. :)
Does this have anything to do with the chances of me ending up dead/permanent disabled on the operating table compared to PRECICE 2? I thought it's just about full-weight bearing and the ability to walk immediately post-op.
Also, do you think Paley's skills will be significantly improved by that time?
These questions and statements from you are frighteningly bad.
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Why is unilateral nonsense?
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These questions and statements from you are frighteningly bad.
Why? lol
Why is unilateral nonsense?
(http://oi63.tinypic.com/28cmvy8.jpg)
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(http://oi63.tinypic.com/28cmvy8.jpg)
I'm thinking of doing LATN so maybe it's a bit different considering it's not weight baring?
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Dr. Paley even told you that you have a lot of misinformation. Like I said, frighteningly bad.
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I'm thinking of doing LATN so maybe it's a bit different considering it's not weight baring?
I think you're considering external femurs, correct? Very different from unilateral internals.
The reason for recommending unilateral externals over bilateral externals for femurs is because your mobility is severely hindered, substantially lowering the quality of life during recovery. This is not the case for internal femurs; I would totally choose bilateral femurs over unilateral femurs with Precice.
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1.6-2% chance of fat embolism syndrome which can be fatal or cause coma/brain death is actually pretty high lol.
he had same response when i bought this up in an email a while back. Yeah hospital fees will increase, but he can't deny the fact is lowers the chance of fat embolism syndrome by a lot. Makes that 2% almost non-existent.
This is why I prefer Dr. Rozbruch over Paley.. he has no problem performing unilateral and understands why a pt would want it. And you can also get a majority of the hospital fees covered with Rozbruch if you have good ppo insurance.
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I'm good with those odds. I'm probably more likely to get into a fatal car accident on the way to the clinic.
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1.6-2% chance of fat embolism syndrome which can be fatal or cause coma/brain death is actually pretty high lol.
he had same response when i bought this up in an email a while back. Yeah hospital fees will increase, but he can't deny the fact is lowers the chance of fat embolism syndrome by a lot. Makes that 2% almost non-existent.
This is why I prefer Dr. Rozbruch over Paley.. he has no problem performing unilateral and understands why a pt would want it. And you can also get a majority of the hospital fees covered with Rozbruch if you have good ppo insurance.
Is the difference between unilateral and bilateral really 2% and non-existent? Probably it's worth the extra 30-40k.
I wonder why he doesn't encourage unilateral if it's good for the patients' safety and more money for him also.
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I wonder why he doesn't encourage unilateral if it's good for the patients' safety and more money for him also.
If the risk of fat embolism syndrome is that low, I'd rather decrease the number of times I get operated on under general anesthesia.
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Dr. Paley has seen fat embolism syndrome 4 times in his career. All from BILATERAL FEMOR LENGTHENING. And I don't buy him saying he's done 250 bilateral cosmetic leg lengthening surgeries. Compare that to the thousands of unilateral orthopedic surgeries for deformity and lengthening he has done up to this point without seeing a single Fat embolism syndrome.
the risk of dying from general anesthesia is 1 in 100,000. And you can't even say "but what about the risk of an allergic reaction from the anesthesia?" This won't be possible because you would have already been operated on under the same damn anesthesia the first time around. So it is foolish for anyone to not consider a unilateral lengthening because you think the risk of anesthesia is somehow higher than the risk of fat embolism syndrome from a bilateral lengthening. That must be one of the dumbest things I've read on here.
If you don't think 2% risk of fat embolism is significant, then you have little value for your life.
Fact is you won't even have to pay the 30k extra for unilateral lengthening if you have a good insurance and you go to Dr. Rozbruch...
You can do what you like man after doing your own research. I just want to get the surgery done with the lowest risk possible, even if it costs me more $..
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Dr. Paley has seen fat embolism syndrome 4 times in his career. All from BILATERAL FEMOR LENGTHENING. And I don't buy him saying he's done 250 bilateral cosmetic leg lengthening surgeries. Compare that to the thousands of unilateral orthopedic surgeries for deformity and lengthening he has done up to this point without seeing a single Fat embolism syndrome.
the risk of dying from general anesthesia is 1 in 100,000. And you can't even say "but what about the risk of an allergic reaction from the anesthesia?" This won't be possible because you would have already been operated on under the same damn anesthesia the first time around. So it is foolish for anyone to not consider a unilateral lengthening because you think the risk of anesthesia is somehow higher than the risk of fat embolism syndrome from a bilateral lengthening. That must be one of the dumbest things I've read on here.
If you don't think 2% risk of fat embolism is significant, then you have little value for your life.
Fact is you won't even have to pay the 30k extra for unilateral lengthening if you have a good insurance and you go to Dr. Rozbruch...
You can do what you like man after doing your own research. I just want to get the surgery done with the lowest risk possible, even if it costs me more $..
wont the doctors look for fat embolism anyway and make sure you are okay regardless?
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Never mentioned mortality risk with general anesthesia, that's your interpretation; I just meant that it's a hassle and stressful on the body to go through additional surgeries. That being said, my grandmother died due to a mistake in administering general anesthesia; she went under and never woke up.
Not trying to have anyone agree with me, it's just my opinion of what I'd do. The odds are very good, and the reward outweigh the risks. Even if you are unlucky and get FES, your chances of survival is high.
I suppose I got subjective. I'm not answering the topic objectively.
The best way to increase the chances of success on the operating table is to consult with several doctors, get their opinions, and listen to them instead of relying too heavily on the opinions of strangers on the internet.
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Chances of dying in an airplane crash = 1 : 11.000.000
Chances of dying in a car crash = 1 : 5.000
So yes, 1-2 : 100 is real significant. But he might have meant that 1-2% is the chances of significant complications (that can be treated) and not dying.
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Chances of dying in an airplane crash = 1 : 11.000.000
Chances of dying in a car crash = 1 : 5.000
So yes, 1-2 : 100 is real significant. But he might have meant that 1-2% is the chances of significant complications (that can be treated) and not dying.
Do keep in mind that we travel a lot more often than we get operated on. I'd take the 1-2% risk. Again, my opinion.
Correct, he has never had a person die from FES. Risk of death by FES is 10-20% if you get it at all, so mortality is fraction of a percent (20% of 2% is 0.004%). It is not a death sentence.
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how are the odds of a car crash 1:5000? ??? most people drive 10 times a week. so in 10-15 years everyone should have been involved in a car crash? think of third world countries like Vietnam where traffic is very chaotic.
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Dr. Paley has seen fat embolism syndrome 4 times in his career. All from BILATERAL FEMOR LENGTHENING. And I don't buy him saying he's done 250 bilateral cosmetic leg lengthening surgeries. Compare that to the thousands of unilateral orthopedic surgeries for deformity and lengthening he has done up to this point without seeing a single Fat embolism syndrome.
the risk of dying from general anesthesia is 1 in 100,000. And you can't even say "but what about the risk of an allergic reaction from the anesthesia?" This won't be possible because you would have already been operated on under the same damn anesthesia the first time around. So it is foolish for anyone to not consider a unilateral lengthening because you think the risk of anesthesia is somehow higher than the risk of fat embolism syndrome from a bilateral lengthening. That must be one of the dumbest things I've read on here.
If you don't think 2% risk of fat embolism is significant, then you have little value for your life.
Fact is you won't even have to pay the 30k extra for unilateral lengthening if you have a good insurance and you go to Dr. Rozbruch...
You can do what you like man after doing your own research. I just want to get the surgery done with the lowest risk possible, even if it costs me more $..
Paley and his team consider and monitor for FE so I wouldn't be as worried about it. If it's been accounted as something that can happen and the team is prepared and takes measures for it, it doesn't seem as concerning. Compartment syndrome sounds much scarier to me.
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Do keep in mind that we travel a lot more often than we get operated on. I'd take the 1-2% risk. Again, my opinion.
Correct, he has never had a person die from FES. Risk of death by FES is 10-20% if you get it at all, so mortality is fraction of a percent (20% of 2% is 0.004%). It is not a death sentence.
Isn't it 0.4%?
That is comparatively much higher than the car crash scenario (0.02%), but given that it'd be just once or twice in our whole lives... (I'm assuming removing the IM nails can also trigger FE, but I'm not sure.)
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how are the odds of a car crash 1:5000? ??? most people drive 10 times a week. so in 10-15 years everyone should have been involved in a car crash? think of third world countries like Vietnam where traffic is very chaotic.
Yeah, I'm not sure where Bruce got his numbers from.
https://www.thrillist.com/cars/nation/how-likely-you-are-to-die-in-a-car-accident-in-every-us-state-the-most-dangerous-roads-in-america
It seems it can vary drastically.
I'm not sure if Bruce's numbers refer to normal city traffic or road traffic, either. I'd say that's an important distinction to make.
Either way, it really puts driving into perspective.
https://www.iii.org/fact-statistic/facts-statistics-mortality-risk
(Lifetime chance of dying in a car accident, as the occupant, being 0.15% according to this last link.)
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Do keep in mind that we travel a lot more often than we get operated on. I'd take the 1-2% risk. Again, my opinion.
Correct, he has never had a person die from FES. Risk of death by FES is 10-20% if you get it at all, so mortality is fraction of a percent (20% of 2% is 0.004%). It is not a death sentence.
Isn't it 0.4%?
That is comparatively much higher than the car crash scenario (0.02%), but given that it'd be just once or twice in our whole lives... (I'm assuming removing the IM nails can also trigger FE, but I'm not sure.)
So that's about a 1 in 250 chance of dying to FES.
(0.4%)
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So that's about a 1 in 250 chance of dying to FES.
(0.4%)
Oh , really need to consider 2-stage then. How different do you think between a month apart and 6 months apart?
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Oh , really need to consider 2-stage then. How different do you think between a month apart and 6 months apart?
I'm not a LL vet or a medical doctor. I'd rather just not comment on this.
E-mail Paley about your concerns, and use your own critical thinking to weigh the costs and benefits of unilateral/bilateral femur procedures with Paley/Rozbruch, given all the data and related issues we know about those.
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Oh , really need to consider 2-stage then. How different do you think between a month apart and 6 months apart?
I think you're reading too deeply into the issue. I'm going to agree with Android here and say undergoing 2 separate surgeries is far riskier than doing both legs at the same time. Even Dr. Paley is saying it is more advantageous to just do both legs at the same time. I think your chances of just some general complication from one of 2 different surgeries is far greater than the risk of getting FES. Not to mention the extra cost and recovery time.
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wont the doctors look for fat embolism anyway and make sure you are okay regardless?
lol people in here just talk nonsense when they don't know anything about fat embolism syndrome to begin with.
there is no specific therapy for fat embolism syndrome once you get it. All you get is supportive treatment (oxygen) and even with the supportive treatment you can still die or go into an induced coma. If it leads to cerebral fat embolism, you will be brain dead almost immediately. But since there are so many research scholars in here who just want to talk without actually reading up on these things, I will leave it up to them to decide what is best.
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people think that a 2% chance of getting fat embolism syndrome that can lead to death or coma is insignificant.
or that a 0.4% chance of death from fat embolism syndrome is insignificant.
ask yourself this: Do you really want to be the unlucky 1/200 that dies from this surgery?? Or the 2 in 100 who actually get fat embolism syndrome? Or would you rather avoid it all together and make it almost nonexistent by doing a unilateral LL?
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I have a heart defect from birth that I need repaired before I'm too old (before 50), and the operative mortality rate is 1.5-5.5%. I'm not thinking twice about it, definitely doing it. I wouldn't be able to leave the house if my decisions demanded zero risk.
But hey, that's just my two cents!
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lol people in here just talk nonsense when they don't know anything about fat embolism syndrome to begin with.
there is no specific therapy for fat embolism syndrome once you get it. All you get is supportive treatment (oxygen) and even with the supportive treatment you can still die or go into an induced coma. If it leads to cerebral fat embolism, you will be brain dead almost immediately. But since there are so many research scholars in here who just want to talk without actually reading up on these things, I will leave it up to them to decide what is best.
This is why I am very cautious when I make my posts. But it's been too long and the forum won't let me edit my post about FE on the first page. :(
Paley has never had a patient death AFAIK, but I shouldn't have made a post that kind of downplayed the severity of FE & FES just because they've been able to manage the cases they have had under their hands.
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So what is it about unilateral that prevents the FE?
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So what is it about unilateral that prevents the FE?
50% less fat globules get reamed out of the bone canal, and subsequently your body's mechanism for dissolving these fat globules is faster/more efficient. This decreases your chances of fat globules getting dislodged in your lungs, brain or brain stem. Even by very very rare chance, fat embolism syndrome does occur in unilateral lengthening, it will also most likely have low incidence of mortality due to less fat globules that are dislodged or are in your blood stream
Look at how many unilateral deformity corrections/leg length discrepancy surgeries are done around the united states and the incidence of fat embolism syndrome and compare that to the ~2% chance from cosmetic bilateral femoral lengthening.
It should also be noted that femurs have higher chance of getting fat embolism than tibias. Dr. Paley has never seen a fat embolism syndrome from bilateral tibia lengthening. Also research papers have shown that femurs trauma has a higher incidence of FES than tibias. Bilateral internal tibias should be generally safe when it comes to fat embolism syndrome if anyone is considering that. However internal tibias can cause permanent knee pain due to the rod going through the knee joint.
Thus, my own research has shown that external tibias are the safest and least invasive form of lengthening, although recovery will take longer and must wear frames for long time. Also I can only advise a max of 5 cm for tibias due to biomechanical and proportion issues. And if you want to do internal lengthening, you should do unilateral femurs.
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50% less fat globules get reamed out of the bone canal, and subsequently your body's mechanism for dissolving these fat globules is faster/more efficient. This decreases your chances of fat globules getting dislodged in your lungs, brain or brain stem. Even by very very rare chance, fat embolism syndrome does occur in unilateral lengthening, it will also most likely have low incidence of mortality due to less fat globules that are dislodged or are in your blood stream
Look at how many unilateral deformity corrections/leg length discrepancy surgeries are done around the united states and the incidence of fat embolism syndrome and compare that to the ~2% chance from cosmetic bilateral femoral lengthening.
It should also be noted that femurs have higher chance of getting fat embolism than tibias. Dr. Paley has never seen a fat embolism syndrome from bilateral tibia lengthening. Also research papers have shown that femurs trauma has a higher incidence of FES than tibias. Bilateral internal tibias should be generally safe when it comes to fat embolism syndrome if anyone is considering that. However internal tibias can cause permanent knee pain due to the rod going through the knee joint.
Thus, my own research has shown that external tibias are the safest and least invasive form of lengthening, although recovery will take longer and must wear frames for long time. Also I can only advise a max of 5 cm for tibias due to biomechanical and proportion issues. And if you want to do internal lengthening, you should do unilateral femurs.
MirinHeight, is it even better to have 6-month gap between unilateral surgeries than 1-month?
And are you sure that that external tibias is the safest and least invasive? Maybe less chance for FE, but what about knee pain, possible requirement of ATL, etc? Also doctors told me that in general femur is less complex than tibia. "Tibias have a risk of equinus contracture and (although small) of compartment syndrome." says Dr Franz Birkholtz
Even if external tibias is the safest, the best doctor who can give the most guaranteed outcome (aka Dr. Paley) don't perform external tibias no more.
I'm not a LL vet or a medical doctor. I'd rather just not comment on this.
E-mail Paley about your concerns, and use your own critical thinking to weigh the costs and benefits of unilateral/bilateral femur procedures with Paley/Rozbruch, given all the data and related issues we know about those.
All these doctors have their own personal interest and can be bias at times. There must be a reason why Paley doesn't encourage unilateral and not necessarily for the patients' own good. It may be dangerous to the surgery's reputation if everyone knows that bilateral isn't as safe and everyone does unilateral. And more time spent for him, he waste more time that could be spent for taking another case. Just possibility, but we don't know.
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1% possibility of major complication in LL is really not much if you consider how unvasive this surgery is with internals.
Only full externals are not so risky, anything else is. Thats why I believe that LON or LATN are truly stupid, cause you risk so much only to save 3-4 months max from your consolidation.
Anyway, embolism is not so frequent as deep infection but still both problems can be treated in the vast majority of cases, if you go to a good doctor in a good hospital and not in india or places like that.
If someone is not willing to take those risks then he should forget about LL.
After all this surgery is not for anyone, you must be really brave or crazy to do it.
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1% possibility of major complication in LL is really not much if you consider how unvasive this surgery is with internals.
Only full externals are not so risky, anything else is. Thats why I believe that LON or LATN are truly stupid, cause you risk so much only to save 3-4 months max from your consolidation.
Anyway, embolism is not so frequent as deep infection but still both problems can be treated in the vast majority of cases, if you go to a good doctor in a good hospital and not in india or places like that.
If someone is not willing to take those risks then he should forget about LL.
After all this surgery is not for anyone, you must be really brave or crazy to do it.
Risks are always there. But we can minimize it as much as possible.
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I believe you are referring to the point in the video he talks about Guichet. It's because Guichet gets his patients to muscle up before surgery. Paley essentially called that worthless.
Whether it's a positive, a negative, or even completely irrelevant how built your legs are, I can't tell. I haven't looked up any published material on this subject.
I'd like to note that if you talk to the Physical Therapists who work for Paley, they will all tell you that stretching beforehand can make a big difference. I would highly advise it, personally.
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I'd like to note that if you talk to the Physical Therapists who work for Paley, they will all tell you that stretching beforehand can make a big difference. I would highly advise it, personally.
Thank you for the information.
Starting to stretch beforehand definitely seems like a good idea. The body takes some time to build flexibility. I have some personal experience with spine stretching exercises.
I was just not sure about "muscling/bulking up" thing Guichet requires of his patients. That definitely seems like it makes no difference (at best).
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Thus, my own research has shown that external tibias are the safest and least invasive form of lengthening, although recovery will take longer and must wear frames for long time. Also I can only advise a max of 5 cm for tibias due to biomechanical and proportion issues. And if you want to do internal lengthening, you should do unilateral femurs.
And also because increasing T/F ratio is associated with hip and knee arthritis. (If only you only lengthen the tibias.)
https://www.ncbi.nlm.nih.gov/pubmed/26398436
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Risks are always there. But we can minimize it as much as possible.
Only with going to a good doctor. You cant do anything else!
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Only with going to a good doctor. You cant do anything else!
The methods are not all equal. You said it yourself externals are safer.