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Author Topic: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)  (Read 25234 times)

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mb53

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #31 on: November 02, 2015, 02:38:35 AM »

Update: It's been about 15 days I stopped lengthening on my left leg and 13 on my right. A little over 3 months since my surgery. My back was killing me the first day I got home from the constant use of stairs, but that went away pretty quickly. I'm much more flexible than I was last week, and that was a huge improvement over the week before. Last week I noticed that I'm able to take steps unaided. I have no intention of snapping my rods in half, so I've never taken more than 3 steps at a time, nor have I stood on one leg for more than a second. I'm 19, pretty light (like 125-130ish depending on how much I've eaten), and my bones began to consolidate in the last phase of my lengthening so I'm not too surprised by this. I'm getting pretty sick of crutches (haven't used the walker in over a month and didn't even take the wheelchair home with me) so hopefully my x-ray on the 16th will clear me to officially begin walking.
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Alu

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #32 on: November 02, 2015, 02:51:34 AM »

I have to ask out of curiosity, but besides walking are you able to operate a vehicle in anyway? Keep us updated and good luck.
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mb53

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #33 on: November 02, 2015, 03:11:05 AM »

Supposedly CLL patients are able to drive, but I have no intention of doing so for a while.
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Alu

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #34 on: November 02, 2015, 03:20:39 AM »

My guess is that it would all come down to sensitivity of our legs and whether you can properly account how much pressure you can give in. The other one would be not having drastic knee-jerk like reactions randomly
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mb53

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #35 on: November 12, 2015, 11:43:35 PM »

So contrary to what I said in my last post that I would wait for official clearance, I've been continuing to walk in the past 10 days. I've stopped using crutches entirely and I can safely and painlessly walk around my house. I've started taking normal showers (i.e. standing; without a shower-chair). My gait is still a little stiff but hopefully this'll go away over time with stretching and more walking. Before when I walked (as in 10 days ago) it felt as though I were carrying a large box as my back would tighten with each step, but this has gone away. I am able to walk up an entire flight of stairs without any assistance, though this does cause some pain and I normally use the railing. I have yet to try going down the stairs without the railing, however. My x-ray is on Monday, and I'm pretty confident as to what Paley's response will be.

And no, I've never heard of someone being able to start walking two weeks after finishing lengthening, but I'm certainly not complaining.
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Taller

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #36 on: November 13, 2015, 12:43:05 AM »

Would you be willing to post pictures of your new proportions?
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Alu

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #37 on: November 13, 2015, 12:46:08 AM »

Take it easy my man. I'm ecstatic you're managing so well but let's not push it lol. Eitherway good hear from ya.

Adding to what Taller said, can you at least inform us as to what your current true inseam is?
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goldenegg

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #38 on: November 13, 2015, 02:33:01 AM »

congrats mb53 on your recovery. sounds like it's going really well!  however, please take it easy until you have clearance from your doctor to fully weightbear.  like you said, it's uncommon for anyone to start walking 2 weeks after finishing lengthening.  you're so close to the end of your journey, no need to risk it now...   
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mb53

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #39 on: November 16, 2015, 07:23:16 PM »

I had the x-ray done today but apparently I won't get Paley's results back for about a week... lol. In the meantime, my walk is almost back to normal. The reason my gait was stiff was because (in addition to not walking for 3 months) I completely forgot about the iliotibial band stretch. After doing it a few times, my gait is much better.
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DoingItForMe

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #40 on: November 20, 2015, 02:56:18 AM »

I had the x-ray done today but apparently I won't get Paley's results back for about a week... lol. In the meantime, my walk is almost back to normal. The reason my gait was stiff was because (in addition to not walking for 3 months) I completely forgot about the iliotibial band stretch. After doing it a few times, my gait is much better.
According to Precice 2's manufacturer's manual on the Precice 2, the patient can be walking after 3 out of the 4 cortices (i.e. walls or sides) of the femur is solidly healed. So you can sort of figure out the answer for yourself by looking at your x-ray and checking the 4 sides of your gap (front, left, right, back). If at least 3 of them are healed, you are full weight bearing according to Ellipse.

What's interesting is out of the 155 times that the Precice 1 was installed, it only broke 3 times. And it broke where the welds are that connected the nail together. The Precice 2 has no welds, and is reportedly 4 times as strong because of it. This might explain why you've been able to walk with the Precice 2 without much issues. And I have a feeling that Dr. Paley and Ellipse are very very conservative with their safety measures and don't let you walk until they're absolutely certain that you have very little chance of breaking their nail. I personally have a feeling that it's very difficult to break the nail, because I took a few baby steps recently even though I haven't fully consolidated, and I didn't have much issues. I'm not going to do it again, but I'm almost 99.9% certain that the Precice 2 is stronger than they lead us to believe for liability and safety reasons.
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8 cm gained with Dr. Paley using Precice 2.1 internal femurs in Summer 2015.
Starting height: 167 cm (5'6") Currently at: 175 cm (5'9")
Link to my experience

goldenegg

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #41 on: November 20, 2015, 04:10:59 AM »

in the recent paley study there was one instance of the precice 2 nail breaking out of 58.  I guess the odds are really low and it's up to you if you feel walking a few weeks early is worth that risk, but I appreciate conservatism considering the additional surgery/money/time required to fix a broken nail 

here's the exact text from the study:
"In our P2 group, there was 1 nail breakage during late consolidation (Fig. 7). The nail silently bent into varus and produced a noticeable bump on the lateral side of the thigh. The patient continued to walk without pain and complained only about a thigh bump. This patient had disregarded the weight-bearing restrictions that were reinforced in writing to him each time he sent a follow-up radiograph during the consolidation phase. He too had stopped using crutches without being released to do so."

here's a link to the study. there are pics of the xrays where you can see the broken nail and amount of consolidation

http://journals.lww.com/techortho/Fulltext/2015/09000/Stature_Lengthening_Using_the_PRECICE.6.aspx#
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DoingItForMe

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #42 on: November 20, 2015, 05:26:43 AM »

Thanks for that study. It reaffirmed my theory that the welds no longer are the weakest link, and is only a weakness in Precice 1. Then in Precice 2, you see that the femur was broken too low during surgery for the one case where the nail broke. The femur should have been broken higher up to allow more bone to protect the new weak point, which is the 1 cm gap that connects the two rods together. Another patient while I was here also had his femur broken too low, and he had to stop 1 cm short of his goal of 8 cm or else he'd risk the same issue. I guess Paley became more cautious of the new weak point. Also the Precice 2 had fins at the end instead of being one circular piece. This made the end even more weak, as only one fin had to be broken out of the four to cause a total failure of the rod. The precice 2.1 released in Dec 2014 had fixed this issue by replacing the fin design with more complete circular design. From the link you posted: "Breakages of the crown and fins have been identified in some cases including this patient (Fig. 9). To strengthen the nail and avoid crown failures, Ellipse Technologies released the P2.1 in December 2014, which has a modified keying feature without “thru-slots” or tack welds." Also in my x-ray, I see the breakage point of my femur is higher up, so there is at least 1-2 cm of bone surrounding that weak point. I don't know what the new weak point is now, since there's no Precice 2.1 breakage yet. And I don't want to be the first one to find out, so I'm going to wait until I get the OK before I walk without support again. But looks to me that Precice 2.1 is harder to break, especially if you have bone surrounding the weak point. The paper recommends 3 cm of bone surrounding the weak point.

Something interesting to read in that same paper: "At our center we have seen patients from all over the world who arrive with disabling complications after failed SSL. These include: equinus deformity due to Achilles tendon contracture (ballerina feet); fascia lata contractures with hip flexion contracture and hyperlordosis (duckass); partial or complete failed regenerate bone formation, including fixators that cannot be removed due to failed healing; bent and broken hardware; malunions and nonunions of the tibia, fibula, and femur; proximal migration of the fibula; and many more. We must remind ourselves that these patients start functionally at 100%. The treatment goal is to end up with the same 100% functional level. Anything less than this is neither a good outcome nor a reasonable tradeoff for a few centimeters. Disablement is too often an outcome of this surgery when performed by unqualified or inexperienced surgeons, which leaves patients with debilitating conditions and gives this surgery a bad reputation.

A few years ago the senior author (D.P.) saw 7 patients in the course of 2 years who were disabled by complications from bilateral tibial lengthening. All of these had been treated by a single surgeon. This resulted in 7 separate malpractice lawsuits and ultimately the loss of that surgeon’s medical license. Such cases give SSL and undeserved bad reputation."

Stuff like this made me glad that I went to Paley.
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8 cm gained with Dr. Paley using Precice 2.1 internal femurs in Summer 2015.
Starting height: 167 cm (5'6") Currently at: 175 cm (5'9")
Link to my experience

mb53

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #43 on: February 26, 2016, 08:30:09 PM »

I haven't posted in a while (obviously), but I decided to check out the site today and saw that a lot of people were having complications. I must be fortunate in that regard, since my recovery is going perfectly, and pain is nonexistent. I stopped taking painkillers months ago. I'm walking fine, and as I'm slightly weaker in one leg than the other right now, nobody's questioned my story that I tore my ACL. I can jog and walk on my hands again, though I still can't run, and working out/sprinting is out of the question (at least for now). My legs are almost fully healed, as I've had some pretty bad falls (some while sober, some while drunk) but I recover after about a day.

Contrary to some of my fellow patients who are regretting doing the procedure, this has gone better than I could have ever have hoped for. I'm no longer ashamed of my size when I interact with people. Yes, at 5'7" I'm still short, and I'm still quite aware that most people are taller than me, but I just don't care anymore. Before the surgery, socializing would drain the life out of me, but now it's the exact opposite - I enjoy it. I've told so many people that I tore my ACL that I've started to believe it, and I can go for days without even remembering that I spent half a year doing such an insane procedure. Sometimes the scars (which are still in the process of healing so they look pretty bad) don't even bring back my memories. I didn't repress anything, I'm fully aware of what I did, but I'm able to forget about LL and enjoy myself.

My experience sadly seems to be an outlier, but deciding to get LL was probably the greatest decision of my life.
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TIBIKE200

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #44 on: February 26, 2016, 08:44:24 PM »

how is yoru recovery going?
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mb53

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #45 on: February 26, 2016, 08:50:32 PM »

I thought my post kind of made that clear...
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crimsontide

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #46 on: February 26, 2016, 09:02:27 PM »

so you cant run, and have to tell people you tore an acl... which means  that you dont walk  100% normally

but you're perfect

good for you
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TIBIKE200

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #47 on: February 26, 2016, 09:21:36 PM »

I thought my post kind of made that clear...

Oops... I missed that post haha
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mb53

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #48 on: February 26, 2016, 09:22:10 PM »

so you cant run, and have to tell people you tore an acl... which means  that you dont walk  100% normally

but you're perfect

good for you

I tell people I tore my ACL because I needed to explain why I took a semester off from school. And I can't run because I'm still in recovery. But kudos on the passive aggressive response.

Oops... I missed that post haha

It's fine, haha
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TIBIKE200

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #49 on: February 26, 2016, 09:23:22 PM »

In what sense does your experience is an outliner?
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mb53

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #50 on: February 26, 2016, 09:25:16 PM »

It's an outlier in that other people seem to be having much worse recoveries, as I've seen from the other threads.
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TIBIKE200

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #51 on: February 26, 2016, 09:31:55 PM »

Maybe they are having the same recovery as you, only you are less of a complaining person...
  Is your gain totally normal? Dont you feel stiff in any parts of your body?

 Your young age could also be a part of your fast recovery
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crimsontide

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #52 on: February 26, 2016, 09:39:30 PM »

you can't run because you can't run

maybe you will, maybe you won't


tbike.... I think that statement is accurate...  I complain a lot for example, so people assume I'm crippled.  I was doing full squats today,  maybe 20

 I can't accept not being 100% though

And my left leg is atrocious. Unless someone recovers to 100%, the success is a failure in my opinion, which is why I'm against this surgery


 
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TIBIKE200

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #53 on: February 26, 2016, 09:41:47 PM »

you can't run because you can't run

maybe you will, maybe you won't


tbike.... I think that statement is accurate...  I complain a lot for example, so people assume I'm crippled.  I was doing full squats today,  maybe 20

 I can't accept not being 100% though

And my left leg is atrocious. Unless someone recovers to 100%, the success is a failure in my opinion, which is why I'm against this surgery

 I wasnt talking about you when I said "complaining". You got butchered and have every right to complain. You were lied by your surgeon (who also doesnt know how to do a proper ATL) and got abandoned by your original surgeon.
  About 100% recovery, I am willing to accept a 90% one in terms of athletics
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crimsontide

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #54 on: February 26, 2016, 09:49:15 PM »

no offense taken tbike

90% is okay, though some people might consider me at 90%. I can walk,  can do squats, can go upstairs, etc

my left leg though is awful

my main issue is the following. 99% of  even the good diaries aren't good based on their now reality.. What I mean is, let's say mb53  didn't get better after today. There's no way that he would consider his recovery great,since he   can't run.

His  perfect recovery is predicated on his future recovery  continuing at the same rate, which is an unknown

we almost never get a diary that says  " guys, i'm fully recovered, i'm done, 100%, can run, etc"

This is concerning to me, especially since I'd like to say one day that  i'm  fully recovered. We almost never see this though

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TIBIKE200

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #55 on: February 26, 2016, 10:06:13 PM »

no offense taken tbike

90% is okay, though some people might consider me at 90%. I can walk,  can do squats, can go upstairs, etc

my left leg though is awful

my main issue is the following. 99% of  even the good diaries aren't good based on their now reality.. What I mean is, let's say mb53  didn't get better after today. There's no way that he would consider his recovery great,since he   can't run.

His  perfect recovery is predicated on his future recovery  continuing at the same rate, which is an unknown

we almost never get a diary that says  " guys, i'm fully recovered, i'm done, 100%, can run, etc"

This is concerning to me, especially since I'd like to say one day that  i'm  fully recovered. We almost never see this though

 Can you send me a video of you doing squats? Or in general how you walk?
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DoingItForMe

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #56 on: February 26, 2016, 10:33:43 PM »

Maybe they are having the same recovery as you, only you are less of a complaining person...
  Is your gain totally normal? Dont you feel stiff in any parts of your body?

 Your young age could also be a part of your fast recovery
MB's recovery is better than most people. It might have to do with the fact that he's a teenager and teens recover much faster. I've noticed from my time at Paley's that most of the younger people (under 20) recovered well and did not have pain, while the late 20's and above group were having a lot of pain and issues. For this reason, I'm actually very worried about Iamready's recovery, because he's actually older than me by a few years. If he doesn't go the full 8 cm in femurs, though, he might recover well.

But don't say that his recovery is the same as others. One of the other teenage patients I knew stopped taking pain meds WHILE lengthening. He said that he felt no pain. Meanwhile everyone else was popping pain meds just to be able to sleep. So everyone has a different recovery. And age does seem like the major factor.

I am in the same boat as crimsontide and don't recommend this surgery. It's a gamble. You could have a great recovery or you can have a bad one. If the bad recovery causes permanent side effects, then it'll lower your quality of life significantly, because walking/running is something you do everyday. If it hurts when you do it, you're screwed. If you can't even run ever again, then a lot of things in life will suck, such as sports, or running away from things, or chasing a train or someone.
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8 cm gained with Dr. Paley using Precice 2.1 internal femurs in Summer 2015.
Starting height: 167 cm (5'6") Currently at: 175 cm (5'9")
Link to my experience

TIBIKE200

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #57 on: February 26, 2016, 10:40:56 PM »

MB's recovery is better than most people. It might have to do with the fact that he's a teenager and teens recover much faster. I've noticed from my time at Paley's that most of the younger people (under 20) recovered well and did not have pain, while the late 20's and above group were having a lot of pain and issues. For this reason, I'm actually very worried about Iamready's recovery, because he's actually older than me by a few years. If he doesn't go the full 8 cm in femurs, though, he might recover well.

But don't say that his recovery is the same as others. One of the other teenage patients I knew stopped taking pain meds WHILE lengthening. He said that he felt no pain. Meanwhile everyone else was popping pain meds just to be able to sleep. So everyone has a different recovery. And age does seem like the major factor.

I am in the same boat as crimsontide and don't recommend this surgery. It's a gamble. You could have a great recovery or you can have a bad one. If the bad recovery causes permanent side effects, then it'll lower your quality of life significantly, because walking/running is something you do everyday. If it hurts when you do it, you're screwed. If you can't even run ever again, then a lot of things in life will suck, such as sports, or running away from things, or chasing a train or someone.

How old are you?
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DoingItForMe

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8 cm gained with Dr. Paley using Precice 2.1 internal femurs in Summer 2015.
Starting height: 167 cm (5'6") Currently at: 175 cm (5'9")
Link to my experience

TIBIKE200

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #59 on: February 27, 2016, 02:05:20 AM »

Late 20s.

So should I worry at being 25-26 years old? Idont know.... According to medical literature, being below 35 is still considered "young"
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chineseguy

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #60 on: February 27, 2016, 03:44:31 AM »

im 24, i will be doing at 25 yrs old in beijing 4.5 cm to make me 172 cm,  should i be worry?
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alps

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Re: Bilateral Femur Lengthening with Dr. Paley 2015 (Q&A, not Journal)
« Reply #61 on: February 27, 2016, 06:18:07 AM »

no offense taken tbike

90% is okay, though some people might consider me at 90%. I can walk,  can do squats, can go upstairs, etc

my left leg though is awful

my main issue is the following. 99% of  even the good diaries aren't good based on their now reality.. What I mean is, let's say mb53  didn't get better after today. There's no way that he would consider his recovery great,since he   can't run.

His  perfect recovery is predicated on his future recovery  continuing at the same rate, which is an unknown

we almost never get a diary that says  " guys, i'm fully recovered, i'm done, 100%, can run, etc"

This is concerning to me, especially since I'd like to say one day that  i'm  fully recovered. We almost never see this though

I know of ShyShy, OldieButGoldie, AndrewShizzles (from the old forum), ChrisIsaak, Houdini (from the old forum), femurs2014 (from the old forum) to name a few, (who put up videos) that have said they have recovered fine.

but I guess it also depends on what your expectations of a full recovery are.
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