Bilateral vs unilateral lengthening
My surgeon, Dr. Monegal, prefers unilateral lengthening and I am sure there a good reasons for that. However, after having gone through bilateral procedures and having shared experience with many unilateral patients, I very glad I did bilateral and wanna tell you why:
A unilateral patient is supposed to be more mobile as he as one “normal” leg. However, I have not seen a big difference between me and unilateral patients:
Neither of us can walk normally.
I am faster in a wheelchair than they are on crutches.
I have been able to stand up early on, which is actually easier for me as my legs are equal length.
I am able to swim, to bike, to walk with arm support.
Many exercises seem to be easier for me as I have both legs in the same conditions.
A bilateral patient is supposed to have twice the pain. I think the opposite is true. Comparing pain levels it seems that mine are the same or lower to unilateral patients. My explanation is that pain is a signal of the body that something is wrong. Having 2 legs broken instead of 1 does not make that signal stronger. In fact, I believe it is easier for your brain to accept the condition as normal and thus stop the pain, as your brain does not have a “normal” leg to compare to, while a bilateral patient always knows what a normal leg should feel like and that this is different from the broken leg.
You need a lot of determination to do everything you can as a patient to speed up recovery as well as to endure pain and bad sleep.
For that it is important to see the light at the end of the tunel! For me I will be done with the lengthening in about 2 weeks and then just consolidate. For the unilateral patients they are going through the same bad time as me only to know that after one is finally done they still have to do another!
As far as I have understood, the total time of lengthening + recovery is decreased by increasing the lengthening speed. So if you extract at 2 mm a day you will have tight muscles and a big gap in your bone that takes a long time to recover. If you do 0.7 mm a day your muscles at the end of lengthening will already have adjusted and your bone gap will almost be consolidated so the total recovery time is not longer but maybe shorter!
And of course lengthening at 0.7 mm means you have much less pain!
On the other hand, I understand people that want to just get over with this process asap, which is possible if you both legs at the same time, but at a slow rate.
Unilateral patients are supposed to be able to work while lengthening.
Personally, I think that this will be difficult unless you are able to sleep well during night which most patients are not.
On the other hand I am working from home office with a similar productivity as before, just not able to work from the office. Actually, I guess by now I even could work from the office, but as I need an afternoon nap, I work from home.
For all those reasons, from a patient experience I would advise bilateral lengthening.