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[longerlegzzz1980]

Hello all,

I have been reading diaries and information between here and old forum  for a while, but still feel a good amount of information is either unanswered or just so variable based on reading diaries that its hard to get an average or an idea of some aspects of the "typical LL" experience.  Some of the Doctor's have provided information on their site, but it doesn't seem to mesh well with diaries.  For example, Dr. Paley's website states 4 months to return to walking unaided (this matches a moderate amount of diaries, albeit Paley fails to mention that they are walking with duck ass and ballerina) and about 6 months to return to sports (NOT A SINGLE DIARY I HAVE READ SHOWS THIS! More like 1.5-2 years). 

So I turn to those who have been around longer and know more about LL than I.

My situation, I am a medical student who is incredibly busy and have very little free time.  I simply can't "take off" 6 months to do leg lengthening; however, I do have a period that I may be able to rearrange things in the summer that give me about 2 months to do LL without having to worry about classes or hospital duties.  I'm sure many others who are have chosen a education/profession are in the same boat and many of the following questions also pertain to them.  Basically I am seeking advice as to the best route for how someone who is busy can accomplish LL.

Given the details of my situation below, do you all recommend I do externals or Precise 2, tibia or femurs or its not possible given my situation?

Summary of my situation: 

1.  Height 5'6"
2.  Minimum gain 3".           
3.  I only have 2 months to focus strictly on LL, then I go back to ridiculous school hours.
4.  Must at least be on crutches by 7-8 weeks after operation (even if still lengthening). 
5.  I only weigh 140 lbs.
6.  I am an athlete in good shape.         
7.  I am prone to calve cramps on occasion, but this usually when I am dehydrated.
8.  I can touch my toes from straight stretch, but my lower back and hamstrings feel tight if I don't stretch regularly.     
9.  Already made full recovery from a major shoulder injury that required a reconstructive operation. 1.5 years recovery time, 2 years back to very heavy weight lifting (near pre-injury performance on some lifts, surpassed pre-injury performance on other lifts). 

[Medium Drink Of Water]

Finishing 3 inches completely in 7-8 weeks isn't realistic, so you'll need to do internals and then go back to school with them still in your body.  People complain about Guichet making them do exercises before he'll operate on them, but as an athlete I don't think that'll be a problem for you.  If you've got the money I think Guichet is your best bet.

[longerlegzzz1980]

I am not expecting to be done in 7-8 weeks or walking unaided.  I'm asking what is the best method given my other criteria, that would allow me to USE CRUTCHES at 7-8 weeks to get around. 

[hand_sanitizer]

3 inch in 7-8 weeks? Not possible. Im currently lengthening and it took me close to 3 months to reach 6cm. The only method that meets ur criteria is internals but 7-8 weeks is really pushing it. Ideally, u need at least 4 months.

[Sweden]

7-8 weeks? Forget about it.

You need at least 4-5 MONTHS for this and then pray everything goes well.

[Medium Drink Of Water]

I am not expecting to be done in 7-8 weeks or walking unaided.  I'm asking what is the best method given my other criteria, that would allow me to USE CRUTCHES at 7-8 weeks to get around.

I'm pretty sure Guichet would have you on crutches by 7-8 weeks, probably much sooner.  It's worth emailing him about your situation to see what he says.  From what I know of his practice, it seems like a possibility.

[longerlegzzz1980]

I don't think most of you are actually taking the time to read my post...  Can you please reread it and see that I am NOT SAYING that I will be lengthened 3 inches in 7-8 weeks. 

Mediumdrinkofwater, thank you, your response is the type of input I am looking for. 

I am asking about being able to WALK WITH CRUTCHES in 7-8 weeks.  Some doctors allow assisted walking DURING LENGTHENING.  What method would best allow me to WALK WITH CRUTCHES IN 7-8 WEEKS? 

[Medium Drink Of Water]

Definitely not Ilizarov frames.  I used a wheelchair for long trips and a walker for short trips.  I wasn't using crutches until a few weeks after I'd finished lengthening.

[BilateralDamage]

I'm assuming a Gnail, betzbone, or Bliskunov Nail would be your best options, since they provide a lot more weight bearing early on compared to most options.  Bliskunov Nail is good because it is made entirely of titanium, you have much less likelihood of bending/breaking the nail, but there hasn't been much experience with it so far.

My recommendation with your schedule would be to lengthen your femur with one of the above nails and only lengthen up to 6 cm to reduce the recovery time.  You're a med student so even though you're probably loaded with debt right now, you'll be making that money back one day, so then do a second surgery on your tibias later in life to fulfill your lengthening needs.

[longerlegzzz1980]

Thanks for the feedback guys.

So Illizarov won't work for quick return to crutch walking... 

I don't trust Betz given nail bends and breaks are reported very frequently on old forum , before they are deleted of course...

I don't want to risk using a doctor that I have not heard much about.

As for waiting until later, I thought of doing exactly what you are saying BilateralDamage, doing 6-6.5 cm on femur via precise, then doing 4-5 cm tibias later.  There are several problems with that given my circumstances.  First I am getting older, almost 30, my ability to heal decreases each year. 
Second, not sure when in my life I would have another opportunity to do this besides the one summer break.  My schooling has no more breaks after this summer, besides very minor times such as a few days or a week off at a time.  Then residency does not allow time off besides a few days.  And then my career starts and I would never EVER be allowed to have more than a month off and a month would be pushing it.  USA is very different than Europe in terms of work, most people only get 1-2 continuous weeks for vacation per year maximum.  So, my only option is to do this during that 2 month period and finish the recovery while in school and if I can't gain 3 inches its just not worth the hell I will pay for it.

[longerlegzzz1980]

Maybe if I did External Only with Tailor Spatial Frame....  Dr. Mahboubian in this video states that he had Alex walking with the external device and the only time Alex could not walk was 1 month after the external device was removed to insert the internal nail (LATN).   

Any opinions? 

[Medium Drink Of Water]

Yeah but do you really want to go back to school with frames on?  People who return to their normal life during LL use internals.

[longerlegzzz1980]

I don't see how you can quickly return to normal life with any other method besides Taylor Spatial Frames because normal life requires you to walk, or at least walk with crutches.  I thought with Precise 1 that you were wheelchair bound for 4 months if you did 7.5 cm.  Precise 2 doesn't have enough patient reports to indicate any difference; however, it can support up to 75 lbs per nail, thus is "rumored" to be able to allow crutch walking much sooner.  I can't do leg lengthening unless I can walk or use crutch walking fairly soon after surgery.  You simply cannot do hospital duties and university in a wheelchair.

[Medium Drink Of Water]

You're not going to be walking around like normal with the Taylor Spatial Frame on.  AT BEST your mobility will be the same as with one of the stronger internal devices.  Guichet Nail or Betzbone is what you're going to want to get.  From Guichet's website it says you'll be walking within a few days after surgery and might even be able to finish the lengthening phase in 2 months at his clinic if your body can handle it.

Nobody here has done LL with the Taylor Spatial Frame because it's an external device that costs a lot of money.  The cosmetic market for it is very small.  Mostly it's be used in corrective surgeries covered by insurance.  Rich LLers typically go to Europe for expensive internals, poor ones typically go to Asia for the cheap externals.

[LLL]

As far as I know, Feythe at the other site did external tibias cosmetically with the TSF at Dr. Mahboubian's. There are promo videos about his lengthening on YouTube.

[LLL]

Haha, sorry, didn't see the video above, I'm typing on my phone.

[Taller]

I would not recommend it, but I did read that Dr. Sringari offers LL'ers the option of getting their lengthening done with Taylor Spatial Frames for an extra $6000, bumping the cost of the whole procedure to $20,000. If you do decide to go this route, at least wait until more is known about Dr. Sringari and his capabilities/competency as a doctor. If he does prove to be a safe option, going with him would be cheaper than even tibial lengthening at Beijing's Guang Ji Hospital, and might be a viable prospect for you. You would likely have to do some lengthening at home, though, and this will definitely increase your chance of getting complications and not catching them in time.

[VegasLights]

Surely the Taylor Spatial frames are not a good idea if he intends to go back to University?

I'm in a similar situation almost. I have graduated but now have a period until March 2016 where I'll be working temporary legal jobs (I start my training to become a solicitor in 2016).

I'm sure most of you would say to go ahead and do it as early as possible to give myself maximum recovery time, but I need to save. I think I would prefer the internal methods as I've read some real horror stories and ideally I would like to minimise any risk to my sports-based hobbies as possible. And as you all know, they're the most expensive options!

[Doflamingo]

I think 2 inch in tibias in 2 months is very possible for an athlete.
Later u can come back again for femurs for another 1-2 inch.
Maybe that's a better solution? More expensive, but better. And I assume you'll earn good in the future anyway since you do medics.

[Rivers]

I'm assuming a Gnail, betzbone, or Bliskunov Nail would be your best options, since they provide a lot more weight bearing early on compared to most options.  Bliskunov Nail is good because it is made entirely of titanium, you have much less likelihood of bending/breaking the nail, but there hasn't been much experience with it so far.

That's what Dr. Betz and Dr. Guichet will tell but it's not true. A very high percentage of patients will at some point bend or break their Guichet Nail or Betzbone nail, including the 13mm nail. That is a fact! The Precice 2 is also made entirely out of titanium just like the Bliskunov (Jamal nail) so there is no difference. Whether you believe it or not all the internal nails are basically the same strength. FACT!

Precise 2 doesn't have enough patient reports to indicate any difference; however, it can support up to 75 lbs per nail, thus is "rumored" to be able to allow crutch walking much sooner.

The Precice 2 is not "rumored" to support 75lbs per nail it DOES support 75lbs per nail and you CAN walk with crutches during lengtheing as long as you are not careless and follow directions. Please tell me you are not believing the lies that Sysop is telling on old forum  because he is still trying to promote the Betzbone. These numbers are coming directly from Dr. Paley who helped invent the Precice 2 and Ellipse Technologies who manufactured the nail. I wouldn't call those rumors. I would call that terrible news for that pile of junk known as the Betzbone. Believe me I have two of them in my body right now and can't wait until they are removed. Pure crap!

[longerlegzzz1980]

"The Precice 2 is not "rumored" to support 75lbs per nail it DOES support 75lbs per nail and you CAN walk with crutches during lengtheing as long as you are not careless and follow directions."

I never said the 75 lbs weight was a rumor, I stated "it can support up to 75 lbs per nail, thus is "rumored" to be able to allow crutch walking much sooner".  Meaning what is not verified is the real world benefit of having 75 lbs support per nail.  Paley had previously been recommending 4 months wheelchair with Precise 1, 50 lbs. per nail support.  Even with Precise 2, you obviously can't do full weight bearing on with it during lengthening because if you walked you would exceed the 75 lbs load with each step. 
So the real question is how functional can you be on a crutch with an allowance of 75 lbs. per leg?   

I also stated earlier in the thread that I do not trust Betz because of the high number of reports of nail bends and breaks.  I haven't heard as much negative things about Guichet's nails other than them failing to click sometimes.  However, that doesn't mean his nails do not experience the same bends and breaks, I just haven't read enough of Guichet's diaries at old forum . 

[longerlegzzz1980]

Rivers, how do you know Guichet experiences just as many breaks and bends as Betz nails?  Have you heard or read this from his patients?

Also, where did you find information regarding walking with crutches during lengthening with Precise 2? 
Paley has practically no diaries on old forum , and I don't know of any other places to find patient reports besides here and old forum .  So the information I have from Precise 2 is on the Recommended Doctor page at old forum  and I remember for Precise 1 the page stating that a patient would be stuck in a wheelchair during lengthening, if for Precise 2 you can use crutches during lengthening this would be a big deal for me and it would help sway my decision (I weigh less than 150 lbs.)

[Rivers]

It seems like you're new to LL so i'll cut you some slack but you really need to do more research. All of this information can be found by simply going to Dr. Paley's website or sending him an email and asking for his most recent PDF about the Precice 2. Here is a quote from Dr. Paley about the Precice 1

Ideally each rod should not be loaded by more than 50lbs. That means we can allow standing of up to 100 lbs. on both legs. Patients weighing under 100 lbs. can walk full WB without unweighting. Patients weighing 150lbs must unweight 50lbs with the arms.

The Precice 2 can hold 75lbs per nail so what do you think that means for someone who weighs 150lbs or less? Here is a quote from Stadiometer on old forum  who constantly updates information about the Precice 2 from Dr. Paley.

Weight Bearing Guidelines for the PRECICE-2 (8cm) from Dr. Paley: 20-November-2013

Patients weighing under 68kg (150lbs) can walk full weight bearing using crutches.

Patients weighing 90kg (200lbs) must unweight 22kg (50lbs) with their arms while walking with crutches.

*Patients requiring the 8.5mm diameter PRECICE-2 (5cm) should contact Dr. Paley for specifics regarding weight bearing.

      

[BilateralDamage]

I weigh under 150 lbs too but the weight restriction is just too little for me to take the risk.  Just because you're under 150 lbs does not means that you're always going to apply under 75 lbs of weight per leg while even on crutches.

If you're really worried about bending the betzbone, just lengthen in the states, fly back and have the nail switched out for titanium.  Btw, you seem to basing a lot of your knowledge off of what you read here and old forum .  My suggestion- don't do that.  Talk to the doctors and see the facilities in person.