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Author Topic: How come Guichet patients recover so fast immediately post-op?  (Read 2636 times)

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OverrideYourGenetics

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From the journals I've read, it seems Guichet patients are able to do stationary bike right after waking up from the surgery, while Paley patients are bedridden for days.

Is this accurate, or Paley patients just aren't instructed (rather than able) to do this kind of physical exercise right after the surgery?

What makes Guichet patients recover so fast that patients of other doctors can also do (rather than the surgical technique itself)?
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My diary. Tibias+femurs 3.75+3.75cm at the Paley Institute (5'5" -> 5'8") in my late 30s.
One of the last patients to use the PRECICE 2.2 nail. I met the first STRYDE patient and I strongly recommend the new STRYDE nail instead.

LongueEpopée

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Re: How come Guichet patients recover so fast immediately post-op?
« Reply #1 on: March 02, 2018, 09:34:41 AM »

Guichet philosophy is to gain a good amount of strengh with an intense physical preparation before undergoing LL, in this regard he hates when his patients use crutches or a wheelchair, he wants all his patients to exploit the weight bearing nail and exercice a lot to maintain a good physical condition, which is what helps recover. I think Paley for exemple sees LL more as a safe journey and don't want his patients to physically push themselves
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Auron

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Re: How come Guichet patients recover so fast immediately post-op?
« Reply #2 on: March 02, 2018, 11:54:03 AM »

Guichet philosophy is to gain a good amount of strengh with an intense physical preparation before undergoing LL, in this regard he hates when his patients use crutches or a wheelchair
Poor patients, without the use of crutches they would be sitting ducks.

I don't think that doing stationary bike on the surgery day is a good idea. You just had a major surgery in your legs, rather than pushing yourself from day one, you need to rest. Guichet is probably the only doctor in the world who thinks otherwise.
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Body Builder

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Re: How come Guichet patients recover so fast immediately post-op?
« Reply #3 on: March 02, 2018, 12:44:54 PM »

Guichetnail than guichet uses (a type of the obsolete albizzia) is fully weight bearing while modern nails like precise 2 aren't, thats why Paley and all sensible doctors don't let their patients walk unaided after surgery.

However, what Guichet does makes lengthening more painnful in addition to his crap nail that you should rotate your broken leg to start clicking and lengthening and all the working out bs that makes his patients do before LL in reality just makes lengthening harder.

Guichet follows a completely different patern about lengthening and rehabilitation compared to the best doctors in the world, that many times lead to disastrous stories like Unicorns which would have been completely ok if the protocol was the same as the one of other doctors'.
Guichet is one of the worst doctors to do LL nowadays, plain and simple.
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YellowSpike

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Re: How come Guichet patients recover so fast immediately post-op?
« Reply #4 on: March 02, 2018, 04:15:59 PM »

Guichetnail than guichet uses (a type of the obsolete albizzia) is fully weight bearing while modern nails like precise 2 aren't, thats why Paley and all sensible doctors don't let their patients walk unaided after surgery.

However, what Guichet does makes lengthening more painnful in addition to his crap nail that you should rotate your broken leg to start clicking and lengthening and all the working out bs that makes his patients do before LL in reality just makes lengthening harder.

Guichet follows a completely different patern about lengthening and rehabilitation compared to the best doctors in the world, that many times lead to disastrous stories like Unicorns which would have been completely ok if the protocol was the same as the one of other doctors'.
Guichet is one of the worst doctors to do LL nowadays, plain and simple.

Many times? How many other horrible Guichet stories have we heard about, aside from Unicorn? I'm sure she isn't the only Guichet patient with complications, but I'm talking about really bad cases like hers and MusicMaker's (though the latter isn't a Guichet patient).

As a Guichet patient myself, I agree that he can definitely be a jerk and is very disorganized. Although I managed to get through the ordeal mostly unscathed (I did have slow consolidation on my left leg, but per Dr. R, both of my legs are fully healed and ready to have the nails taken out), I will agree with you that maybe he does make the process more painful and arduous than it needs to be. The main draw for me was simply not wanting to be in a wheelchair for 6 months. If the Precice 3 is weight bearing, then I will agree, given the price, it's best to go to Paley or Rozbruch at that point.

But I don't believe that Guichet is "one of the worst" doctors as you make it. Yes, maybe I'm biased because he was my surgeon and my outcome was pretty good. But aside from Unicorn's (who is understandably being very vocal about her terrible experience - my heart goes out to her!), are we aware of any other Guichet patients have a similar experience? I don't mean slow consolidation, lots of pain, etc., but really severe complications requiring several surgeries like she has. I'm genuinely asking.
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Metanoia

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Re: How come Guichet patients recover so fast immediately post-op?
« Reply #5 on: March 02, 2018, 04:34:05 PM »

The "fully weight bearing" thing is rubbish. Nails and screws as well as bones all can break easily during lengthening. There are only 2 ways to be safe: either lengthen both legs simultaneously and stay in a wheelchair or lengthen 1 leg at a time and hence enable partial weight bearing. If people walk while lengthening both legs simultaneously the risk is unacceptable. The fact that many patients have been lucky is no argument and doctors who allow or even encourage this are irresponsible  and, tbh, criminals.
The biggest drawback of the clicking nails like Albizzia is the negative influence of the clicking mechanism on the callus, which often leads to delayed union or even nonunion.

So people should stay away from doctors who use those nails.
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YellowSpike

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Re: How come Guichet patients recover so fast immediately post-op?
« Reply #6 on: March 02, 2018, 05:15:55 PM »

The "fully weight bearing" thing is rubbish. Nails and screws as well as bones all can break easily during lengthening. There are only 2 ways to be safe: either lengthen both legs simultaneously and stay in a wheelchair or lengthen 1 leg at a time and hence enable partial weight bearing. If people walk while lengthening both legs simultaneously the risk is unacceptable. The fact that many patients have been lucky is no argument and doctors who allow or even encourage this are irresponsible  and, tbh, criminals.
The biggest drawback of the clicking nails like Albizzia is the negative influence of the clicking mechanism on the callus, which often leads to delayed union or even nonunion.

So people should stay away from doctors who use those nails.

I'm not talking about actually walking. I mean being able to be on crutches throughout lengthening. I of course did not actually walk for more than very short periods of time while I was lengthening. No way!

However...I agree that clicking rods like G-Nail/Albizzia definitely have a bad impact on callus growth. That happened to me, and I was very fortunate to avoid needing a bone graft on my left leg.

Although, I will add, there have been Precice patients who have had very slow callus formation too. If you read DoingItForMe's diary, he went to Paley, and I think he needed or almost needed a bone graft on one leg too. So it can happen to anyone.

There's a good amount of luck involved with LL. Going to the best doctors or avoiding a clicking nail can certainly help, but sh*t can still hit the fan.
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7231

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Re: How come Guichet patients recover so fast immediately post-op?
« Reply #7 on: March 12, 2018, 06:52:18 AM »

The "fully weight bearing" thing is rubbish. Nails and screws as well as bones all can break easily during lengthening. There are only 2 ways to be safe: either lengthen both legs simultaneously and stay in a wheelchair or lengthen 1 leg at a time and hence enable partial weight bearing. If people walk while lengthening both legs simultaneously the risk is unacceptable. The fact that many patients have been lucky is no argument and doctors who allow or even encourage this are irresponsible  and, tbh, criminals.
The biggest drawback of the clicking nails like Albizzia is the negative influence of the clicking mechanism on the callus, which often leads to delayed union or even nonunion.

So people should stay away from doctors who use those nails.

Hi,

I read your post about clicking nails having negative effect on callous formation and I must say this is a very new topic that I have never seen anybody posting earlier and I must thank you for that. my question is what is your view/input on LATN and which doctor would you recommend for LATN on tibia? Money is not a concern. Thanks.
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Unicorn888

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Re: How come Guichet patients recover so fast immediately post-op?
« Reply #8 on: June 25, 2018, 12:59:45 PM »

But aside from Unicorn's (who is understandably being very vocal about her terrible experience - my heart goes out to her!), are we aware of any other Guichet patients have a similar experience? I don't mean slow consolidation, lots of pain, etc., but really severe complications requiring several surgeries like she has. I'm genuinely asking.

Yes there are.  But they do not want to even come on this forum to read or to contribute.  They're just trying to cope with life and not drowning.
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Johnson1111

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Re: How come Guichet patients recover so fast immediately post-op?
« Reply #9 on: June 25, 2018, 01:37:19 PM »

Guichetnail than guichet uses (a type of the obsolete albizzia) is fully weight bearing while modern nails like precise 2 aren't, thats why Paley and all sensible doctors don't let their patients walk unaided after surgery.

However, what Guichet does makes lengthening more painnful in addition to his crap nail that you should rotate your broken leg to start clicking and lengthening and all the working out bs that makes his patients do before LL in reality just makes lengthening harder.

Guichet follows a completely different patern about lengthening and rehabilitation compared to the best doctors in the world, that many times lead to disastrous stories like Unicorns which would have been completely ok if the protocol was the same as the one of other doctors'.
Guichet is one of the worst doctors to do LL nowadays, plain and simple.
Is there any specific limit or number to how much the Guichet nail can weight bare? Or did people just listen to him when he said that it is full no matter how much weight you are and just listen to him? That is where I’m confused and could never trust that. At least precise has a known limit and it is straightforward. It would suck to be in the dark about how much weight a nail in your leg can bare while you have it in you for a year.
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hanshi

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Re: How come Guichet patients recover so fast immediately post-op?
« Reply #10 on: June 25, 2018, 02:03:54 PM »

Is there any specific limit or number to how much the Guichet nail can weight bare? Or did people just listen to him when he said that it is full no matter how much weight you are and just listen to him? That is where I’m confused and could never trust that. At least precise has a known limit and it is straightforward. It would suck to be in the dark about how much weight a nail in your leg can bare while you have it in you for a year.
There is no way to know exactly the forces and moments which impact the nail. Hence it is not possible to know the limits of "weight bearing". Therefore advertising a nail as " fully weight bearing " is a scam.
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