Hey everyone September 18th I did my LL Precice II internal femurs surgery with Dr. Mahboubian in Los Angeles. My starting height was 167cm and my goal is 175cm. More importantly I'm in my 40s and that is the main reason I'm doing this blog. I believe I'm the first to write a diary in my age range and successful or not want to give others, like me, a sense of what to expect. Many of you probably think I'm crazy for doing this at my age but I'm not one to follow the beaten path. I'm relatively fit, to highlight my level of fitness I've recently climbed Kilimanjaro and done several century cycle rides (100 miles). Make no mistake I've read the diaries and know this will be hard and painful but so have many other things in my life. Hard should never be a reason to stop you from accomplishing the things that will make your life more fulfilling and meaningful. I will do everything in my power to make this a successful experience.
Why am I doing this you may ask. Many of you know the answer for it's similarly themed to yours. I hate being short and the insecurity associated with that reality has robbed my attention and thoughts for way too long. Let me be clear I love myself (in a health not narcissistic kind of way) I'm not depressed and although I've never achieved James Bond level of success with the ladies I've never really had a problem getting a beautiful women to spend time with me. I'm doing this because it's a bonus to an already good life and don't think 4-6 months is that much of a sacrifice.
Between now and my LL I will be sharing with you the details of my preparations and activities pre-surgery. I look forward to taking this, hopefully not too bumpy, ride with all of you. This community has helped me immensely with my decision and I want to give back so if you have any questions ask away.
Afonso - Precice II Internal Femurs - Dr. Mahboubian - Sept 2014
I have been maintaining a diary on the old forum and want to post one here as well in the hopes that me sharing my experience can help others interested in going down this road. To spare everyone as much reading as possible I will limit my initial post to my week to week experiences.
Operation Day
Operation Day: You walk into the hospital at 5:30 AM and get registered and taken into a pre-operation Room. You are put on a gurney half nked as your medical team swarms around poking and asking questions. If it wasn't for the nervousness of what’s about to happen you feel quite special with all the attention. I’m serious when I say team you have an anesthesiologist, surgeon, operating nurse, and another half dozen other medical personal all focusing on breaking your legs. Once all the necessary needles have been attached and administered you are wheeled into the operating room. The anesthesiologist walks in and starts his countdown and its lights out. It’s amazing how hard and fast you’re out the next thing you remember is waking up in your hospital room attached to an IV and catheter up your penis. The heavy duty pain killers they inject directly through your IV ensures you don’t feel a thing but it does feel like a 2 ton truck is parked on your legs. This day your only job is to meet your post operation team and feel as comfortable as possible.
Day 1: This is when you start questioning your sanity for doing this and experience some of the most painful and uncomfortable moments of your life. Physical therapy(PT) starts day 1 and you can’t imagine the pain that comes with each slight move and step. At the end of my first PT session I serious doubts I would every walk again and if there was anyone in this world that could make me do another PT session. The other new for the day was learning how to urinate into a urine bottle. To get this right you really have to get your blather aligned just right with the bottle. This took several tries before I could get a solid blather movement. The good news for the day Dr M came in a told me the surgery was successful and everything look good.
Day 2: PT is getting better I was able to transfer from the bed to the wheel chair without wanting to kill everyone in the room. You really just have to keep pushing yourself that is the only way your mobility will come back. With a clean bill of health from the hospital and Dr M was released today. To get home I rented a van that transported me in a wheelchair for about $100. Worth every penny I have a sports car and couldn’t imagine even attempting to navigate getting into my car. For the day only experienced pain when moving.
Recommendations
Strong upper body strength is a must it’s the only way PT is even slightly tolerable.
Weight below 150 - I didn’t do a great job at this it would have helped being under 150 to avoid the nervousness of passing the 150LB weight limit with Precice II.
Family and/or friends - I have my stepmom with me which is really like my mother and couldn't imagine trying to do this without someone being with me every step of the way.
Two weeks post operation
Saturday October 4 marks exactly two weeks since I was discharged from the hospital and as suspected a tough week but much better than the week prior. Here are the highlights:
Mobility: here is where I had the most positive changes. Every step still required thought but no where nearly as much as the 1st week. The 1st week every time I transferred from wheelchair and walker I had to mentally brace myself for the pain. It would, at times, take me minutes to get the courage to transfer. Now my transfers are relatively easy and much less painful. Some new firsts for the week I can now lay on my side and stomach. I normally sleep on my stomach so this makes me very happy. I can get into my car with just the walker meaning I can now go for rides. I'm very pleased with my progress and new mobility. Last week I was seriously concerned about how much mobility I would have this week gave me hope.
Pain: This week wasn't painless but I think that mostly had to do with my aggressive PT after making my PT and LL changes the pain hasn't been that severe. That said I'm still very dependent on pain killers.
detraction: I've been detracting 1mm per day .33 3x daily. So far this hasn't been painful nor has it produced any muscle tightening but its early in the process.
All and all it has been a better than expected week and hope it's the start of a trend.
Week 3
Mobility: Some things improved and others not so much. In terms of progress I don’t think I’ll ever match the 2nd week where everyday I was able to do something new and exciting like lying on my stomach. Although I did add sitting on the couch to my repertoire. Variety is good switching back and forth from bed to wheelchair gets old quick. Week 3 has been more about making slight improvements like being able to transfer and move into positions faster and with less pain. My upper body strength has significantly improved. Using a walker I can lift myself to a standing position from any sitting position solely using my arms to lift me. I’m hoping I can come out of this with seriously defined arms. For the future LLers upper body strength will make your life much easier.
Stretching and exercise: I’m seeing a PT 3 times a week and am maintaining a 3x daily stretching regiment. I put my exercise bike together this weekend and plan to start that next week.
Pain: pain has been manageable but I’m never pain free there’s always a constant ache to remind you that you’re a LL patient. The days are better than nights. I haven’t been able to go one night without pain meds. One thing that does annoy me to no end I can’t stay in any one position for any lengthen of time without having to shift. My left knee is still problematic some lateral moves can be eye opening. I don’t think this is from the detractions it’s something to do with the operation. I have to ask Dr M. his opinion on what to do when I see him this coming Friday.
Interesting observations and lessons learned
Weight loss: I’ve been progressively losing weight I’m now 154lb (164lb at day of surgery) This is kind of intentional. Cooking isn’t really practical these days so I had to look for a way to get already prepared meals delivered. If you didn’t know the weight loss people have this segment of the market corned. Since I can lose a few pounds I’m fully embracing this and have been trying out different programs. My goal is to get down to 150lb and maintain any plan should get me there. The hardest part is finding a program that tastes good. So far I’ve tried Diettogo last week and just ordered Bistro MD for this week. Diettogo wasn’t tasty at all especially for the cost (approx $10 per meal) let’s see how Bistro MD is this next week. I’ve also bought some Weight Watchers, Healthy Choice, and Lean Cusine to compare.
P.S. weight loss is easy if you’re not going out for martinis, steak dinners, wine bars. All things I miss deeply!!!
Neosporin: has really helped with the wounds from the operation and more importantly it keeps down the urge to scratch.
Wheel chairs get premium seating: being in a wheelchair sucks unless you’re going to the movies. You get a reserved seat up front every time and if you go to a new theatre they even have a regular seat next to you for your friend or family.
Week 5
Mobility: I can easily do everything I need to do short of walking and can probably do that as well if it wasn’t for the weight baring restriction. Everything means transfers to and from bed, couch, stationary bike, walker, toilet, shower, car, and wheelchair.
Flexibility: Stretching 3x daily with 3 formal PT sessions weekly. Flexibility is a moving target now that I’m detracting at 1.33mm per day. Literally my ability to do and any given stretch can change from session to session for the better or worse. It has become a constant challenge to maintain an acceptable level of flexibility. I’m on the never ending run from the atrophy monster and feel his hand grasping at my back to often for comfort. I’ve metalized myself that this is how things are going to be for a while and am taking things one day at a time. I’m going to maintain the 1.33mm for as long as I can. I see Dr. M on 11/7 hopefully I can keep it up till then and will be enough ahead of the consolidation threat to slow down a little.
Pain: Since the detracting increase definitely more pain. Have been taking 2 Narcos per day - 1/2 pill every 6 hours. The prescription calls for 1 pill every 6-8 hours I’m staying below that not because I’m a hero but because Narco (Hydrocodone / Acetaminophen 10- 325) can become addictive. To avoid addiction I’m only taking it if I feel pain and will taper off at first opportunity. Unfortunately pain has been consistent especially at night. Like clock work 4AM comes and my legs let me know its time for my next fix. The good news is that I haven’t felt any numbness nor sharp bursts of pain just the constant dull pain that increases as the Narco wearing out.
Diet Plan: Bistro MD was much better than Diettogo but still not worth the almost $40 per day average if you factor in their snacks and shipping. Instead I’m setting up my own plan using Weight Watchers Smart Ones, Healthy Choice, and Lean Cuisine. I order these biweekly through Vons (local LA grocery chain). They deliver for $9 per delivery. These meals are typically $3-5 dollars and in many cases taste just as good if not better. My goal is to maintain a weight of 150-155 lbs presently at 154lb.
Week 6 Oct 27 - Nov 2
Mobility: Went backwards here but only because I started cycling last week and over did it the first time. Spent ½ the week nursing serious charley horses in both calves. If not for that mobility would have been the same I think. Let see what this week brings.
Flexibility: Stretching 2-3x daily with 3 formal PT sessions weekly. For most of the week wasn’t able to maintain 3 PT sessions because of the tightness. Flexibility sucked up to the point of reducing my detractions back to 1mm. I was really hitting a wall and every PT session was hell. On Thursday 10/30 Rob (physical Therapist) said my legs were like rocks even the skin was taut. Since scaling back detractions on Friday I can already see improvements in flexibility. I hope I don’t have go back to 1.33mm don’t think my body can handle that.
Pain: on Thursday 10/30 was up to 4 Narcos have since been able to scale back to 2.5. At 1.33mm the pain was unbearable and sleeping at night impossible. Night time continues to be the worst. Can’t manage to find any position that is tolerable for more than a few minutes.
Lessons learned
The least worst (because up till now there hasn’t been a good position) position to sleep in is on my side with a pillow between my legs.
Narco hardens stool and when you’re up to 4 pills it petrifies it and makes bowl movements feel like labor pains. Sorry for the visual just keeping it real.
Week 7
Yesterday had my scheduled appointment with Dr M. Great news pre-consolidation is no longer a threat I can now permanently go back to 1mm per day. I almost bursted into song and dance (kidding can't do either very well) I was miserable lengthening at 1.33 it was very painful. Another bit of good news I'm currently at 4.8cms lengthening nicely and evenly on both legs. Dr M says that it shouldn't be a problem for me getting to my 8cm goal. Yesterday was truly a good day and hope it’s a good sign of things to come.
Flexibility/Mobility: Mobility is still very good and improving I can get around rather well. As for flexibility that is another matter completely going backwards. PT sessions are turning into the Spanish inquisition. I can still lock my knees but it’s not fluid and easy any more. My left leg feels very tight and my right is just slightly better. I’ve started using Tiger Balm to help with the muscles. It’s helps a little I’ve just ordered FlexPower heard it works even better. I’m hoping 1mm detraction, cycling, frequent PT and any other aids such as tiger/FlexPower will get me to my 8cm.
Pain: only using 1 Narco pill at night and regular Tylenol during the day as needed. Night time is bad can’t find any position that’s comfortable for very long. Sleeping on my side with pillow seems to be the best but it doesn’t last long. To get my somewhat regular zzzs I’ve become a napper. I’m told Benadryl (active ingredient Diphenhydramine) is a very good sleeping aid and might knock me out. I’ve ordered some for next week will let you know how that works.
Week 8 (November 10 -16)
The Ellipse lengthening device says that I’m 5.7cm taller and at 1mm per day that translates to 23 more days of lengthening. Generally speaking the week has been hard and easy all at the same time.
Flexibility/Mobility: I’m having a hard time straightening my knees. I can straighten them if I’m laying stomach down on the floor but not if I’m on my back. The only way I can lock my knees then is if my legs are angled up on books, pillow, exercise ball etc… I also have a knee bend when walking on walker. I haven’t received the FlexPower cream so not sure if that will help. I did hear that sandbagging helps with knee straightening. That’s when you force your knees to straighten by laying a sandbag on your legs. Going to try this to see if it helps.
Pain: day time is fine sometimes I take a Tylenol but not always. Night time now that is a different story read my previous post for more details. Sleeping sucks on my last post I was going to sleep on the couch to see if that would improve things. That didn’t work same issue persists. As stated previously I will live with this for the next 23 days and become a napping expert. If I catch myself complaining too much I think back of the first 2 weeks of this process and move on happily I’m not there.
Overall Mood: The knee bending bothers me I’m concerned that if this keeps getting worse it will prevent me from reaching my goal. If it’s only pain and discomfort in the short term no worries that I can handle but I will not chance walking like a crippled.
Week 9 (November 17-23)
Achieved: 6.4cm
Goal: 8cm
Days to completion: 16
Early on in the process of researching LL I was talking to an Ellipse rep (makers of Precice) and she told me that most people don’t reach 8cm. When they get close to the 7cm range they rationalize that the difference to 8cm isn’t worth the extra effort. I was baffled by this rationalization considering the power of Height Neurosis and the LL cost (approx 1K per MM). Barring legitimate health concerns, I couldn’t understand why anyone would not balls to the wall go for the max. Now that I’m in their shoes I can understand the thinking. After weeks of sleep deprivation, exhausting stretching exercises (3x daily), cycling, and the nagging concern that your bent knees might be permanent the distance of a cm on a ruler isn’t that impressive. I’m not stopping but now I really do understand.
Overall Mood: Optimistic the week was still sh!ty but not any worse than the week prior - that’s progress in my book. Bent knees and sleep are the two biggest threats to completing my goal. Still can’t sleep more than 2-3 hours at a time but as long as I can supplement with naps I’m ok.
Flexibility/Mobility: My bent knees are getting slightly better with PT but If it gets worse I will have health concerns. I’m scheduled to see Dr. M on Dec 2 we will see what he recommends.
Pain: Day time is still fine not much pain very manageable. Night time is very crappy usually take 1 Narco. The only silver lining are my dreams the struggle with sleep produces some off the wall weird and very entertaining dreams. I’m going to start a sleep diary.
Lessons learned
Sleep aids like ZZzquil and Benadryl don’t work for me. You go to sleep fast sure but then you wake up 2 hours later groggy and unable to sleep because of the leg pain. If they aren't going to get me more total hours of sleep then they are no help.
Avoid using heavy blankets or comforters during lengthening phase. The effort needed for your legs to move under these will bring pain very quickly. Use heating pads, more clothing, and light sheets instead.
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