Limb Lengthening Forum
Limb Lengthening Surgery => Limb Lengthening Patients Experiences => Topic started by: MarriedUp on March 08, 2021, 11:59:13 PM
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Hi all --
I'm doing some community service with this diary. My husband got his femurs done with the Stryde2 Nail on the last day it was legal in the United States (Feb 18th). We picked Paley because of his "safety first" mantra, his claim to be the best in the world, and also because my husband planned to do quadrilateral lengthening. He wants 4 inches, but wants to be proportional. He'd also like to be taller than I am ;). It definitely bothers him more than me - but we're finally in a position to do something about it.
He's experienced some complications, and these journals have been invaluable to me as I've tried to research what is happening in his recovery, and tried to avoid pitfalls. I'll hop back on and try to do a backwards look at the first 2.3 weeks and give more detail from what he's been telling me, as well as chronical what's happening now.
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Selection and Surgery Background:
We talked to Debiparshard in Vegas first and almost pulled the trigger on that program. They offer remote lengthening and we live fairly close. While diligencing that surgery, husband figured he better talk to Paley about his practice. He was ultimately sold on the idea of doing Tibias, followed by Femurs three weeks later, and gaining a total of 4" (100mm) while still maintaining proportionality.
Husband is mid-30's, fit, and 5ft 8inches. I happen to be just a little bit taller.
Another reason we picked Paley was they had a ton of literature about the procedure and background information, a massive clinic, and a lot of practice doing the procedure. Dr Paley warned us as we planned the trip that the Stryde nail was potentially being recalled because of rusting issues, but that he felt comfortable continuing forward and didn't think it posed safety risks. We scheduled surgery for Feb 18th, and husband kissed the babies goodbye to move to West Palm Beach.
The Home Suites recommended by Paley Institute is a pretty gross hotel in person and is overpriced for what it is. (dirty carpets, medical tape on the walls the cleaners didn't remove, etc...) So Husband located a hotel by the airport (Home2 Suites) that matched the Paley pricing and is significantly nicer, and new. Since he has a car, he planned to drive once he got his sea legs.
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Good luck! Sounds like he got in under the wire and definitely went all in with both segments. Keep us posted and best to all - you and babies included 👍😁
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What an unusual diary. Does your husband's height bother you at all?
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Amusing user name. This could be a real interesting diary. Was Paley able to do the second segment for the quad lengthening with stryde ? (Has the second segment surgery even occurred yet?)
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I have the same question, was he able to put in the second set of stryde nails considering the recall?
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Delete plz
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You must be one tall lady, being taller than 5'8 :)
I am going to be doing the same thing as your hubby next year, same doctor as well :). Thanks for taking care of husband and reporting to us.
Good luck to husband!
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You must be one tall lady, being taller than 5'8 :)
I am going to be doing the same thing as your hubby next year, same doctor as well :). Thanks for taking care of husband and reporting to us.
To the other posters, I believe they did the tibias first, and the femurs after, and thus the very last day Stryde was allowed was actually the second surgery: the femurs was the second set of nails. Thus tibias is already been done Feel free to correct me MarriedUp
Good luck to husband!
I'm 5'9. Believe it or not, we dated for years and I just sort of slouched around him so we avoided the conversation entirely. ;). To be clear -- this doesn't bother me at all. I've dated plenty of taller guys. I like mine just the way he is, but he doesn't love being the smaller person haha.
Husband is going in for Tibias this week. He got an exception since he had already purchased his nails. Just in case, he did Femurs first. Apparently Paley used to do Femurs first, but there were some issues with flexibility and you have to really bend the knee to position the Tibias correctly. Husband has in writing that they're going to put him under, and then test flexibility on both legs before putting in Tibias. So he'll probably be the last quad patient for at least a year.
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Amusing user name. This could be a real interesting diary. Was Paley able to do the second segment for the quad lengthening with stryde ? (Has the second segment surgery even occurred yet?)
He's scheduled for Thursday. Just got the covid test today and met with Robbins and Paley yesterday on it. He has good flexibility so they'll be able to place the tibias appropriately.
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What an unusual diary. Does your husband's height bother you at all?
I married him and had babies for him. Does this answer your question?
To be candid - I think he's doing this for our relationship in large (punny) part. The decision is not coming from my side though. He's more attracted to ME when he feels taller. (I think he's hot all the time.) Height is such a mindtrap I think for guys. I've had the opposite issue -- on a dance floor, I was always the giant human surrounded by small people dancing in my girl group. But for guys, there is more validation, and more confidence at a taller height. Husband is very smart and very capable. Because this surgery is relatively low-risk, because he's working remotely right now, and because I was supportive, he figured this was a good time to do it so we could enjoy boating this summer.
I actually volunteered to lose an inch if it was that important to him, but he figured since I had the babies he could take this one for the team. ;)
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Surgery: St Mary's Hospital and the first Four Days
I'm going to try to catch up quickly to present day so I'll do a few entries at a time.
Husband went into surgery and came out about six hours later. During the surgery itself, they place the nails and then test in the operating room. Apparently one nail bent during placement. They pulled that nail out, and put in a second nail. The second nail was tested and actually was not working, so they pulled THAT one out and put in a third. I'll have to share some photos -- because that leg looks like they beat it with a stick.
They took him to a recovery room for several hours where the post-surgery patients cry about their life choices. [Yes, they all cry. They've just broken their bones - on purchase.] When the nurses brought him to his room at about 3pm, they didn't bring his personal items with him. I called the hospital several times and got progress updates (Covid protocol allows vistors but we have a newborn) . Eventually they connected me to his room where he was confused and out of it and just wanted his phone. It took a number of phone calls and finally escalating to the hospital manager to finally get his personal items up to his room at about 11pm.
Couple of things to know about the hospital:
The drugs they give you are timed, but they're administered "as needed". What that effectively means is that you'll start feeling pain, and then you'll ask a nurse for drugs. During this particular weekend the nurses were overwhelmed, and so in some cases it took longer than an hour for them to get back. I recommend that you do what any good maternity ward will do, and ask to have the time of your last dose written on the whiteboard along with when you can take the next pill. Proactively call to get your next dose of meds.
Peeing. It's a real thing. Husband was in significant pain, and asked for help. Nurses disappeared for a few hours before getting permission to put in a catheter. 40oz came out once that was in. If you can pee post surgery, you're awesome. If you can't on that first day, be proactive and get a catheter for a day. I just can't imagine hold in that much.
St. Mary's is not my favorite hospital. I would never choose that as my surgery site. There's a lack of coordination between nurse care. On the day of discharge, a new nurse came in and gave a bunch of meds on an empty stomach and husband ended up puking and getting crazy dehydrated and ended up staying overnight one more time for a total of four nights.
You start walking the day after surgery. Husband checked in with me and was proud to be the first person post-surgery to lap the floor. I say "walking" but I more mean something like "very old, very feeble person slowly inching forward with their walker." The ability to lift your leg is gone.
If pain is overwhelming, they have IV morphine. Husband used that twice to sleep and the rest of the time was on oral medication.
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That's shocking ... 3rd attempt with 1.. Nail..
And poor patient care..
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Yes shocking indeed; thanks though for the unvarnished truth and straight scoop. Appreciate the updates. Best to you all as the journey continues 👍
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Did your husband get his cadmium levels tested? Another poster on a different thread said his cadmium levels after Stryde implantation were higher than healthy levels.
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Very poor patient care and one nail three times , I think this diary going to expose dr. Paley. who think he is perfect dr.
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Because this surgery is relatively low-risk, because he's working remotely right now, and because I was supportive, he figured this was a good time to do it so we could enjoy boating this summer.
Please tell me one another commonly performed cosmetic procedure less riskier than this one..The risk of bad/severe complications is less than 5% but the severity can vary..I wish your husband a safe LL journey though..
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Would really also be curious to see how a weight-bearing nail was possibly bent during its placement?😳...Again wishing you all a safe journey 👍
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Very interesting diary - keep us posted!
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Very poor patient care and one nail three times , I think this diary going to expose dr. Paley. who think he is perfect dr.
Stop expecting perfect outcomes for everyone, things go wrong sometimes but it can be fixed, thats just life for you pal.
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Wish you the best of luck on the journey.
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Hello,
I agree with some of you here that the risks of CLL are high. The chance of a perfect surgery and recovery is slim.
As I had also noted in my diary, a very safe option for anyone considering CLL is to just walk away from it!!! they would save themselves from a lot of pain and possible complications and issues.
One more thing: I don't know Dr. Paley. What I write here is solely based on this diary: The fact that he let it be known that there were complications during the surgery makes him honest. I also hope someone informs Dr. Paley about this terrible hospital experience. Dr. Paley should have it fixed; or change his hospital :P
In any case I wish this patient the best. Please feel free to reach out if you think I can help in any way.
SNC
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Post-Surgery: Days 5-9 (Monday-Thursday Outpatient)
The Monday-Saturday out of surgery, from a support person care perspective, really bled together. The pain levels were pretty constant and the routine was similar. After making the mistake of hiring a wheelchair van the first two days (it was $90 a trip!), we wheelchaired to the car, transferred, and then husband hobbled into physical therapy.
Physical Therapy:
OK, physical therapy. Your life revolves around this. Let's start with the pros. Every PT was professional, caring, and very competent. This is the reason you do this with Paley - because they have a giant facility with so many therapists. They know what the surgery looks like, and they know how to get you moving and stretching. I felt really comfortable trusting them with the broken legs. Husband came in tight and left feeling better each day. You can pick your therapy schedule and they book you out for a week or month in advance. You can buy extra PT sessions but they are like $200+ (I believe) after your initial sessions that come with surgery. You can schedule Saturday PT but the normal schedule is Monday-Friday.
Cons? Because it's so busy, you don't have great continuity of care during week one when you're hurting and also fresh to the experience. We didn't repeat a PT until Friday. I sat outside and literally dozens of people are coming and going every hour. I like to be able to understand things well, and the first two therapists said there wasn't any printed information on how to do these exercises and stretching at home. I was baffled by this -- again, there was a lot to read and very good information on the sale side, so I expected something like a packet on what to be doing. The third PT session, we got printouts of exercises and stretches to do at home. You're supposed to do them for 2 hours a day (we managed in 30 minute increments), plus your PT session.
Sleeping
I guess I should title this night-time, because sleeping was not happening regularly. I read in another journal to practice sleeping on your back -- which we totally should have done. Husband is a sidesleeper, and the back position is all you've got for the first several weeks. We made a rookie mistake in how we positioned during the first week, so beware --- you don't want to just elevate the legs, but allow the knee to bend. If you sleep in a bent knee position, it keeps your knee from stretching out and can cause problems.
The best solution we found was to prop a couch cushion under the knees to the feet, and then I stuffed two pillows -- one in the hole under the thighs, and one underneath the feet. That elevated the legs in a way that allowed the blood and inflammation to go to the torso.
We made another dumb mistake (thanks to a complete lack of discharge directions) of keeping ice on too long. Ice needs to go on about 20 minutes, and then come off. We iced 100% of the time the first two days. It helps with inflammation, but it's not good for your body. We were given a Polar Ice machine that had gel pads to place on the legs. Initially we just put them on the top of the thighs, but after the swelling in the right leg hadn't subsided after several days, we had an epiphany moment and started icing underneath the knee as well.
Swelling and Inflammation
I read another journal entry (I think it was MyElevate?) that talks about inflammation. YES. Husband took the doctor's recommendations to move as a personal challenge, and I think really overdid it. That caused further inflammation. We will never do this again after Tibias, but our plan with Tibias is to take it a lot easier after the initial surgery in order to keep swelling down. A little less walking during week one. The docs said that movement causes blood flow to move out inflammation-- but it also triggers inflammation if overdone.
PT Veronica suggested very light massage touch to run the inflammation from the knees up to the torso, to pull the swelling out. My personal opinion is that pulling the nail in and out displaced a lot of marrow -- causing more swelling. But I'm not a doctor. The bruising on the right leg was substantial. The hips also swell up at the incision points.
The biggest issue was pain in the knee. Husband was feeling instability and a lot of swelling. He was concerned about buckling when walking. Ice helped with pain management, but nothing was pulling it down.
Showering
Sitdown showering worked and there were no issues with bandages peeling off. The warm water feels good on the legs, according to husband.
Let me just be clear from a care standpoint --> This whole thing looks pretty horrible in week one. The pain is high. Mobility is limited and pain-filled. There's emotional regret about breaking your perfectly healthy body. And you're not even lengthening yet. Husband planned to start working remotely on like Tuesday, but there was no way in the first few days.
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Please tell me one another commonly performed cosmetic procedure less riskier than this one..The risk of bad/severe complications is less than 5% but the severity can vary..I wish your husband a safe LL journey though..
Oh, I got you! Boob Jobs. Implants cause all sorts of issues and many, many people have theirs removed after the implants either fail or make them ill. There are many permanent negative side effects :p
Yes, this is a risky cosmetic procedure - which is why we went to Paley, who claims to have operated on 20,000+ patients. He lists all the risks, and then lists what they'll do to catch those issues before they become issues. For example, they make you stay on site so you can't lengthen past what is safe for your body.
It's pretty amazing to see the kids at his clinic that are repairing their bodies. It's hard to see ones with the external fixations that I'm sure are so dang painful. I'm really grateful that this kind of procedure exists - minimally invasive and internalized - in large part because it can change the lives of so many people who have congenital defects or injuries.
The Paley institute is a who's who of doctors and surgeons. They've poached great doctors from around the country do they can do everything from spinal to legs and hips and knees. Robbins and Paley do all the leg-lengthening at this point.
https://www.plasticsurgery.org/cosmetic-procedures/breast-augmentation/safety
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How goes it? Things getting better? Hope so....😁
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Hey any news?
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Thanks so much for the diary! Maybe I missed it but what is the lengthening split to reach the 4”? Also you sound like an amazingly supportive person good luck :)
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How its going ? I heard stryde nails has problems and called back
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Surgery: St Mary's Hospital and the first Four Days
Peeing. It's a real thing. Husband was in significant pain, and asked for help. Nurses disappeared for a few hours before getting permission to put in a catheter. 40oz came out once that was in. If you can pee post surgery, you're awesome. If you can't on that first day, be proactive and get a catheter for a day. I just can't imagine hold in that much.
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Is it mandatory to use a catheter to pee? This part kinda freak me out... Is it possible to wear a diaper and pee in it? Or maybe sit on the side of the bed and pee on a bowl?
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you can ask your surgeon if they can pull out the catheter while your still knocked out
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Is it mandatory to use a catheter to pee? This part kinda freak me out... Is it possible to wear a diaper and pee in it? Or maybe sit on the side of the bed and pee on a bowl?
you don't need a catheter if you opt for the right anesthesia strategy. If you get an epidural you will need one for a couple of days because you are paralyzed for some time. If you go with general anesthesia or spinal block you won't get one.
I asked paley this because I was freaked out like you too but don't worry. Just ask the doctor in before and opt to go for the method without one.
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you don't need a catheter if you opt for the right anesthesia strategy. If you get an epidural you will need one for a couple of days because you are paralyzed for some time. If you go with general anesthesia or spinal block you won't get one.
I asked paley this because I was freaked out like you too but don't worry. Just ask the doctor in before and opt to go for the method without one.
Good to know! I will definitely try and do that or at least have them remove before I’m awake
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Good to know! I will definitely try and do that or at least have them remove before I’m awake
As for as I understood it the problem isn't about during the surgery. The surgery neither lasts long enough, nor is within close proximity to the prostate/foley/lower abdomen, nor is a major one compared to brain or heart surgery to really make a catheter a must in and of itself. The reason why you get one if you get epidural is that you are paralyzed for some time and you can't pee which is dangerous if it stocks up too long. If you just wake up from general anesthesia (which is more like a controlled drug OD to put it in a morbid way) you will be confused and dizzy but you are able to move around. You will pee in a bottle afterward.
Both doctors I have spoken to told me that.
Anyways, I understand your guys' fears haha. I wouldn't want that to be in my UT either.
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you don't need a catheter if you opt for the right anesthesia strategy. If you get an epidural you will need one for a couple of days because you are paralyzed for some time. If you go with general anesthesia or spinal block you won't get one.
I asked paley this because I was freaked out like you too but don't worry. Just ask the doctor in before and opt to go for the method without one.
whats the pros/cons of epidural vs spinal block vs general anesthesia?
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whats the pros/cons of epidural vs spinal block vs general anesthesia?
Many. It will depend on what combination/option your doctor offers. You will want to discuss this with them or the anesthesiologists.
Typically, epidural is great for post surgery pain relief as it gives of a constant flow of anesthetics. However you will need a foley catheter during that time.
If you don't get one you are mobile much earlier and won't need a catheter but the pain might be worse.
There are many different layers to this and unfortunately I haven't had anesthesiology in my studies yet (sucks because I find it more interesting than what the topic is rn) so I can only refer to internet research and what the Doctors I have spoken to told me.
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Thanks, good to know!
Is there a cons for taking the general anesthesia/spinal block vs epidural? Like if you take epidural there will be less pain because you will be paralyzed?