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If you had to redo the LL again the same way, would you do 5cm or 5.5cm or 6cm?

[Phoenixtears]

Say you were mid 20’s again in 2022, who would you choose to operate on you if you had a similar budget to the past. AKA can’t choose Paley, Betz, or other US doctors

[zaozari]

Hi, can you summarise how was your "physiotherapy" or exercise routine after surgery as advised by the surgeon? Mostly normal walking on crutches? Fixed bike? Both? Professional physiotherapist specific movements? Same in lenghtening as in consolidation phases? Thanks!

[Medium Drink Of Water]

If you had to redo the LL again the same way, would you do 5cm or 5.5cm or 6cm?

I'd probably just stick to 5.

[Medium Drink Of Water]

Say you were mid 20’s again in 2022, who would you choose to operate on you if you had a similar budget to the past. AKA can’t choose Paley, Betz, or other US doctors

Probably Giotikas.  If not him, Parihar.

[Medium Drink Of Water]

Hi, can you summarise how was your "physiotherapy" or exercise routine after surgery as advised by the surgeon? Mostly normal walking on crutches? Fixed bike? Both? Professional physiotherapist specific movements? Same in lenghtening as in consolidation phases? Thanks!

The gym at the hospital had wooden wedges for patients to stand on, a leg extension machine, and a treadmill.  Few people went there though.  Lying in bed and lifting your whole leg was recommended.  Everyone used walkers, so using them was encouraged, as was standing in place.  Also, they provided sandbags to put on your knees.

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I'd probably just stick to 5.

If your starting height were 5'6", how much would you do?

Probably Giotikas.  If not him, Parihar.

Wouldn't the death case bother you though? If you were to do external tibia lengthening and money wasn't an issue, which surgeon would you go to?

[zaozari]

The gym at the hospital had wooden wedges for patients to stand on, a leg extension machine, and a treadmill.  Few people went there though.  Lying in bed and lifting your whole leg was recommended.  Everyone used walkers, so using them was encouraged, as was standing in place.  Also, they provided sandbags to put on your knees.

Thanks! As English is not my native language could you include a link to any picture of what an wooden edge in this case is? Also, how long did you try to do active exercise or at least walk or stand, daily?

[Medium Drink Of Water]

If your starting height were 5'6", how much would you do?

I think 5 cm is a good number.

Wouldn't the death case bother you though? If you were to do external tibia lengthening and money wasn't an issue, which surgeon would you go to?

No.  I don't know anything about the death case since I haven't been researching doctors lately, but patient deaths from surgery happen.  As long as it wasn't due to his negligence I wouldn't think he's a bad surgeon because of it.

Paley.  He's the best.

[-]

I think 5 cm is a good number.

But at 172cm, you're still rather shortish while at 173-174cm you're closer to average.

No.  I don't know anything about the death case since I haven't been researching doctors lately, but patient deaths from surgery happen.  As long as it wasn't due to his negligence I wouldn't think he's a bad surgeon because of it.

Well the thing is we can't know for sure if it's his negligence or not. But if a surgeon already has one death in a very short career of 4 years and another like Paley has 0 death in 3 decades of career, there is probably something there.

Paley.  He's the best.

But Paley doesn't do external CLL and also don't you think he is a bit old by now?

[Bournelli]

Do u know the rate of Americans who are part-working to pay the total fees when studying as graduates?
I am willing to migrate over America to study abroads and my family can't afford the total fees so I must part-work there to pay the fees.

[Medium Drink Of Water]

But at 172cm, you're still rather shortish while at 173-174cm you're closer to average.

Well the thing is we can't know for sure if it's his negligence or not. But if a surgeon already has one death in a very short career of 4 years and another like Paley has 0 death in 3 decades of career, there is probably something there.

But Paley doesn't do external CLL and also don't you think he is a bit old by now?

Starting shorter means you should lengthen less though.

One is not a pattern so don't read too much into that.

Paley won't do externals anymore even if you ask for them?  I'm doubting that.  He's probably still good at his present age.

[Medium Drink Of Water]

Do u know the rate of Americans who are part-working to pay the total fees when studying as graduates?
I am willing to migrate over America to study abroads and my family can't afford the total fees so I must part-work there to pay the fees.

I don't know but it's different for international students anyway.  I don't believe there are any Work+Study visas.  You'd only be allowed to work at the university. 

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Paley won't do externals anymore even if you ask for them?  I'm doubting that.  He's probably still good at his present age.

I've talked to him many times and I conclude that he is anti external lengthening for cosmetic. Well, I do think that if I insist hard enough, I should be able to convince him to do it but that would mean that he wouldn't do it whole-heartedly.

but patient deaths from surgery happen.

Btw, your previous statement makes me think, were you really prepared to die for your surgery back then?

[z3dennis]

Hi MDWater,

I’m currently doing Precice Tibias and has lengthened 5.7cm.  Atm knees are kind of tight but I can still fully extend them with a bit of force.  I have slight ballerina with heels about 3cm off the ground but after 3-5?minutes of standing they go down and touch the ground.  I want to gain 7cm given my conditions are good with no pain and I can walk well with a walker. 

My questions are:

1. Back then when you lengthened yours past 6cm did you feel pain or see signs of over-extending which may lead to repercussions?  Or were the potential complications unforseeable?

2.  I understand you wished you had only done 6 instead of 8 due to the exertional compartment syndrome you experienced later on, but as you mentioned most people who did tibias in China during that time went well past 6 on tibias.  Do you know the percentage of good recovery rate among them?  Or do most regret going past 6?

Thanks for your answers.  I have a strong desire to get to 7 but am wondering if it’s worth the risk.

[Medium Drink Of Water]

I've talked to him many times and I conclude that he is anti external lengthening for cosmetic. Well, I do think that if I insist hard enough, I should be able to convince him to do it but that would mean that he wouldn't do it whole-heartedly.

I don't think that's an issue.  He's done them thousands of times, and he knows how to do them well.  Whether he recommends them or not for cosmetic purposes won't affect his performance in the operating room.

Btw, your previous statement makes me think, were you really prepared to die for your surgery back then?

I knew it was a risk and I went anyway.

[Medium Drink Of Water]

Hi MDWater,

I’m currently doing Precice Tibias and has lengthened 5.7cm.  Atm knees are kind of tight but I can still fully extend them with a bit of force.  I have slight ballerina with heels about 3cm off the ground but after 3-5?minutes of standing they go down and touch the ground.  I want to gain 7cm given my conditions are good with no pain and I can walk well with a walker. 

My questions are:

1. Back then when you lengthened yours past 6cm did you feel pain or see signs of over-extending which may lead to repercussions?  Or were the potential complications unforseeable?

No new/special problems occurred after going past 5, 6, or even 7.  Totally unforseeable, yes.

2.  I understand you wished you had only done 6 instead of 8 due to the exertional compartment syndrome you experienced later on, but as you mentioned most people who did tibias in China during that time went well past 6 on tibias.  Do you know the percentage of good recovery rate among them?  Or do most regret going past 6?

Thanks for your answers.  I have a strong desire to get to 7 but am wondering if it’s worth the risk.

I still keep in touch with one other person (a female) who started out a few inches shorter than me, lengthened just a little more than me, and didn't get compartment syndrome.  I had duck feet my whole life (like my father and all his siblings) which was fixed by rotating everything below the osteotomy site during the frame removal surgery.  A different orthopedic surgeon (who doesn't do LL) examined me afterward and told me I had flat feet, but I don't know if I had them before LL or not and there's no way of finding that out now, obviously.  I don't know if either of these issues had anything to do with the compartment syndrome or not.

[thaw1010]

No new/special problems occurred after going past 5, 6, or even 7.  Totally unforseeable, yes.

I still keep in touch with one other person (a female) who started out a few inches shorter than me, lengthened just a little more than me, and didn't get compartment syndrome.  I had duck feet my whole life (like my father and all his siblings) which was fixed by rotating everything below the osteotomy site during the frame removal surgery.  A different orthopedic surgeon (who doesn't do LL) examined me afterward and told me I had flat feet, but I don't know if I had them before LL or not and there's no way of finding that out now, obviously.  I don't know if either of these issues had anything to do with the compartment syndrome or not.

About the duck feet, I have had a bit of this. Do you know if it's possible to fix it with internal Precice nails? Or is it only possible with externals?

[Medium Drink Of Water]

It could be fixed since it involves the surgeon twisting the leg by hand, below the osteotomy site, during surgery.  The device doesn't do anything for duck feet.  For an internal it would have to be done during the insertion surgery.

[-]

I don't think that's an issue.  He's done them thousands of times, and he knows how to do them well.  Whether he recommends them or not for cosmetic purposes won't affect his performance in the operating room.

I'd say that it might affect his performance.

[SpeedDialer]

For tibias, how do LON scars vs LATN scars vs Precise 2 scars compare?

[Medium Drink Of Water]

For tibias, how do LON scars vs LATN scars vs Precise 2 scars compare?

LON and LATN will have the same scars.  Precise scars I don't know about, but probably the same internal nail-related scars as they hybrid approach without any pinsite scars.

[Alija2]

Hey medium drink of water. After your surgery what would you say was the most important stretches you did?

Thanks

[Medium Drink Of Water]

Standing pike with my forearms on the seat of an adjustible-height chair.

[Medium Drink Of Water]

Hey MDW,

I see that you recommend 5cm for tibia
What are your thoughts on patients doing 6 or 7+ tibia in places in turkey? Do you think they will be able to recover 100% pre-surgery athletic level?

I think people should stick to 5 cm regardless of where it's done.  You most likely won't recover to 100% no matter how little you lengthen.  LL is a big deal.

[oklama]

Can you play sports?

Can you run/jump and for how long or how many times?

People are very unclear with Long term effects of LL. Some tell me your max atlethicism is limited and some say you will never run again.

[Medium Drink Of Water]

Can you play sports?

Yes.

Can you run/jump and for how long or how many times?

I don't know.  I haven't tested my limits in that way and it doesn't sound like much fun.

People are very unclear with Long term effects of LL. Some tell me your max atlethicism is limited

These people are right.  I'm one of them.  It's an issue of biomechanics: longer legs are harder to move than small ones.

There's one member here, Sweden, who was a professional athlete, had LL, and then went back to competing at the professional level.  If he'd trained just as hard without having LL, how much better could he be right now? It's impossible to say, but it's reasonable to assume he'd be at least a little more agile.

and some say you will never run again.

These are people who don't know anything about LL, unless they're talking about people who had botched surgeries.

[oklama]

yeah I mean. im not an athlete by any means and definitely don't plan to ever compete. just want to be as a normal person even if it requires training

[Medium Drink Of Water]

I walked a lot, sometimes for 2+ hours at a time, after lengthening to get my legs back to normal.  Now I don't need any special training to stay normal.

[YungGud]

I love to run and generally to work out , go for walk for a long distance...but not as professional athlete.
It is really to be flexible enough for that after making 6 cm on femur?

[oklama]

I haven’t done cll but from all the info I’ve gathered I don’t see how that would remotely be an issue at your height and with that lower level of lengthening. I’m 5’5 so my max LL height is your current height. Is it really that bad to be 5’10.  Before I got into Cll community I thought that 5’6 and above was pretty normal heights (I wear shoes that make me an inch taller, well really two inches but it’s relative to everyone else wearing shoes, and I don’t really feel weird in public). I was planning to stop at 5’8 but it just seems that 5’8 isn’t even enough. I pray I grow taller in college so I can reach 5’10 through one surgery.