Athens – Stryde Tibias with Dr. Giotikas – Jan. 8, 2020

Hey everyone.

Undergoing cosmetic leg lengthening has been in my mind for quite some time. With the Stryde nail, I felt the technology was here to recover with minimum downtime. My decision to undergo this procedure is a result of Height Dysphoria I have from being in the last 5th percentile of men in regards to height. I would like to think I am successful in most areas of my life, and my height has never held me back from anything in a meaningful way. Still, the thought of feeling better about myself, and my tendency to fixate on what I want, led me to this point. This procedure is not necessary, and I would advise anyone thinking about this to consider evaluating their mental health primarily. Perhaps such an operation says something about my mental state, however optimistic I may be.

Age: 23

Height: 164cm

The first step of my journey was to visit Athens to meet with Dr. Giotikas back in August of 2019. There, I met him and his staff, and I had a consultation which included X-rays, flexibility assessment, body proportions assessment, potential risks and complications, and also a little bit about myself. Dr. Giotikas presented a calm atmosphere, admitting to all potential risks, which surely trended me towards trusting in his judgment. My contact with the doctor and his team were professional, respectful, and responsive at all times throughout the past couple of months.
 
A body proportion analysis uncovered my femurs being much larger than my tibias. A growth of just 4cm would put me in unnatural territory. Conversely, a growth of 6-7cm in tibias, provided it is safe, will allow for a normal femur-to-tibia ratio, according to the largest sample size of body proportions (n=6000). At first, I was disappointed with the option of not going for femurs, but now I am delighted knowing that with the proper effort and stretching, I may reach very close to the 8cm I could have gotten from femurs, while maintaining a perfect femur-to-tibia ratio. My other proportions such as wingspan to height, legs to height, sitting height to height, are at the upper end of normal after the lengthening is completed. I would not do two operations due to time & money, unnatural proportions, and worse athletic recovery.

Fast forward to today, I am back in Athens. This day prior to my surgery had consisted of my preoperative checks. I once again met with Dr. Giotikas, signed a consent form, and I had a chance to go over any more questions I had. An important note to point out to anyone considering tibias is the reeming process. An intrapatellar approach (guiding the nail through the patellar tendon), had resulted in reports of anterior (front) knee pain, according to a study in which about 47% reported this being the case. Theoretically, going around the patellar tendon, would eliminate this anterior knee pain. Fortunately, Dr. Giotikas has used the suprapatellar [above (but technically going around) the patella] approach for much of his career, and it is in his opinion, which matches the research, that participants do not complain about anterior knee pain in any significant magnitude. This is not to say there is a significant reduction in nerve injuries or risk of compartment syndrome, but this alone, as well as less loss of blood, and quicker fluoroscopy times, lead to a more efficient surgery. Time will tell if I feel the positive effects of it, or rather, the absence of long term anterior knee pain. Following that, we went over logistical concerns (where I stay, internet access, passport for visa extensions, next of kin, etc.). Then I went to get an EKG and blood work, followed by a chat with the cardiologist, followed by further X-rays of my tibias and chest, and finally meeting with the anesthetist.

Athletic recovery is of the highest importance. My full, undivided effort will be towards recovery. I will be running at my normal speed in 9 months (God willing).

My surgery is tomorrow, wish me luck. 😊

P.S. In case anyone is coming to Athens in the next three months and would like a roommate, feel free to reach out.

Hello again!

Currently on day 8. My surgery went great as far as I can tell. Will have to wait for another week to know for sure there is no latent infection due to the incubation period of these surgeries, but fingers crossed.

The surgery day itself consisted of visiting the hospital, getting an IV, walking to my room, getting changed into surgery attire, and getting fluids. It was at this point 15 minutes prior that I was understandably nervous. I was picked up and transported away quickly, and before I knew it, I was on the operating table. Not even a minute goes by, a mask goes on my face, and I blacked out. Can't remember how I went to sleep. I woke up after it was all done.

The hospital itself had three patients to a room in my case. The nurses mostly spoke English, and were generally good at controlling my pain. It was rather uncomfortable for me at times those four days in the hospital, each better than the last though. I took my first steps the next day. My legs were understandably swollen, so much so, that my compression socks were hurting. On the last day before discharge I met Dr. Gionnakis, and he provided the appropriate medications and advice. I was impressed with all the staff there. I have also been given Dr. Giotikas' personal line for any medical related questions throughout the process.

A transporter was scheduled for me to leave in my wheelchair. I left on day 4 to my airbnb and stayed most of the night in my bed, but also using my walker to get to the bathroom. Days 5 - 8 I have been wide awake, pain controlled, and getting looser and looser. Still slowly using my walker to get to the bathroom. Still swollen on parts of my legs. Finding a good position for my legs while sleeping is sort of difficult. Tomorrow I will meet with physiotherapy. I had a representative from Nuvasive come over today to teach me how to lengthen. My plans assuming everything goes well is to lengthen 0.75mm a day and eventually reach 7cm. This was my wish to Dr. Giotikas, and despite his recommended limit of 5-6cm, I may be permitted to go all the way to 7cm if my recovery allows me. Lengthening starts midnight.

Overall, pain managed, able to sit up and focus on studying/entertaining myself all day. Food can be delivered. Looking forward to my first consultation with the Dr. Giotikas on the 20th. As of now, very doable. God willing, it stays this way!

Quote from: Zamii on January 15, 2020, 08:04:18 PMYour young age should play a big positive factor into this, how was the psychological assessment? (if any)

Did he completely deny you from doing femur or was it more of a recommendation that he insisted that you got tibias instead?

Hope everything goes well

Hey, yes I had to fill out the cosmetic procedure screening scale (COPS) and based on my responses, I was not referred for additional psychological evaluation prior to the surgery.

He did not deny me, but he made it clear it was in my best interest based on my proportions, and he made the right call. Had I been adamant about doing femurs, he would let me know it would be beyond naturally occurring proportions.

Quote from: llj on January 16, 2020, 04:17:44 PMAthens, congrats on making it happen! Hopefully it will be my turn soon 

I will be keeping an eye on your progress as Im considering Dr Giotikas as well!

Have you seen your incisions yet? How do they look?

Are you pulling this off alone? How will you go to physiotherapy?

Hope you're doing well, best wishes!

Have not yet looked at my incisions. Alone. I use my crutches to get outside and order a taxi to get to physiotherapy. Otherwise you can go there and back with a wheelchair and someone to pick you up from the hospital, at 20 EUR per day.

Day 18

I have for the past week been mostly laying on my bed in my airbnb. The struggle to get up is getting lesser with each day. Proper medication timing is a must to avoid pain. For food, I use a website to order once a day. I use my crutches to walk outside my airbnb, and catch a taxi to Theseus Rehabilitation center, and back. I have been doing well at physiotherapy and I am quite flexible. My right knee seems to be more tight than the left. I am able to take small steps without any device, and stabilize myself standing up for a short time. I have a slight hunch that i need to fix by flexing the right muscles. I had my consultation with Dr. Giotikas last Monday, and the x-rays were good and showing proper lengthening. I am lengthening at 0.75mm a day. I should be at 9.25mm through lengthening alone, and an additional 3-5mm from the osteotomy, so I should be at ~1.3cm now. I am doing some stretches in my bed, and I am pushing myself more and more each day to walk normally, but of course I am taking it easy. The worst part is the boredom of being on your computer, and also looking ahead knowing it is going to be a while before you see your loved ones, all the while you wake up each day to a bed in which you spend all your time on. Make sure you have clearly defined goals to accomplish in this time.

Quote from: Hatch on January 26, 2020, 04:13:07 AM"I am lengthening at 0.75mm a day"

What I have understood, bad idea start under 1mm/day. It might cause preconsolitation.

For the first seven days, I lengthened at 1mm a day. For the next 85 days, I lengthen at 0.75mm.

Quote from: AppleFanBoy on February 07, 2020, 01:45:22 AMGreat diary Athens.  I was considering Dr.M for the most part but now because of this diary, I might consider Dr.Giotikas.  How much would you say the cost is of the surgery + your stay and food? I couldn't seem to find this information on his website.

His website (https://www.athensbjr.com/cost-pricing-of-cosmetic-limb-lengthening/) is very clear with pricing, to include the surgery itself, the hospital stay, the medications, and the physiotherapy. What is not included is a taxi ride from your accommodation to Theseus Rehabilitation, and back. Every two weeks or so, you will also need to take a taxi to Mediterraneo Hospital and back for X-rays & follow ups. Considering your accommodation is likely close to Theseus, you should expect to pay around 20 EUR round trip, but thankfully it is only once every two weeks. If you stay somewhere reasonably close (5-7 mins away) to the rehab center, you pay the minimum a taxi is allowed to charge you per ride, which is 3.47 EUR. So every time I have physiotherapy, 4 times a week, I pay 3.47 EUR x 8 =27.26 EUR. Later on when physiotherapy is 5 times a week, I will pay 34.70 EUR per week. You can get a spacious airbnb between 800-900 EUR. You can be cheaper, and depending on what's out there, you might need to pay a little more. I would recommend you find someone to room with. I am alone here, and it could have been fun to room with someone else and keep your mind off things. You can pay 10 EUR approx per day if you have food delivered to you. Keep in mind, I did this for about a month, and I was malnourished. You need fruits and vegetables. I went to the grocery store (over here you would be looking to go to a place called Lidl), putting a large bag on my lap and getting around using my wheelchair, I spent about 60 EUR and I should be good for a week or two. You may also hire a nurse to shop, clean or do anything for you. Mind you, they like to stay for about 5 hours at a minimum and charge 10 EUR per hour. I didn't need to use them so far. Aside from food, accommodation, taxi rides, and maybe your reoccurring music/TV subscriptions, I haven't spent money on anything else. You can easily live here on (much) less than 1500 EUR per month.

Day 48

I'm days from the halfway point. I just had my biweekly check with Dr. G. My bones are healing well, and I am at ~3.0-3.5 cm. I have developed ballerina foot in some sense. I am stretching a lot more than before as a result to combat it. My right leg is actually a couple millimeters shorter, I must have not been pressing hard on the machine. It shouldn't matter at the end, only a couple days of correction on the right leg. I have pain on both of my inner knees when straightening them (painful if accidentally straightened at night), pain on my left ankle, and pain at the osteotomy site of my right leg. It is manageable, and I have been very conservative with my medication so far. I practice walking with my crutches back and forth in the hallway, as well as use a slant board every hour and a half. So far, not totally comfortable, but doable.

Quote from: WannaGrow on February 27, 2020, 02:07:50 PMGood to see that your journey is going well.
How long are you going to stay in Athens?
Is it a requirement to stay there for an X amount of time?
Good to see that you can do this on your own, that's how I'm thinking about doing it, just wondering how long you have to stay in Athens

I am staying in Athens for 100 days approximately, just enough to complete the lengthening. Dr. Giotikas does require you to be under his supervision during lengthening, so you must stay in Athens during this time.

I stopped lengthening at 6cm last week, 1cm short of my goal. For the past few months, standing up was hard due to pain in my inner knees due to tightness, and the pain from shin splints, so I got tighter and tighter. X-rays last week were good and aligned. Only the muscles need to catch up. It was super depressing for me the whole time, from ruined relationships to isolation while slowly tightening up and losing function. Fast forward to now, my once considerably tight calves are showing signs of improvement. No more inner knee pain, and shin splints are mostly resolved. Going to stand some more using the walker. In about 6 weeks time, I should be cleared to lightly jog. In that time, I need to gain the muscle flexibility  and strength to stand upright and walk. For now, I can't straighten my knees for example, and I can't get my heels to the ground. I suspect that I will progressively get back to normal. I couldn't study at all during this time, due to depression and isolation. While Tramadol, lyrica and paracetamol were the correct medications to prescribe to me, as to not hinder the bone healing process, none of them had a pain relieving effect on me. I disliked my physiotherapy. I would not recommend Mediterraneo Hospital at all, and Dr. Giotikas knows this from many patient reports. I suspect he will not send patients there anymore. When Covid began ramping up in Greece, we were moved to a different physio place far away (which was costly via taxi). It was only one week of going there that they decided the new center would close down too. Very inconvenient for planning my living situation, but it wasn't their fault completely. Fed up from the uncertainty, I left back home the next day. Now I'm back home and I am not as depressed as before. When I can start to walk and see my friends again, things will look up. All in all, things are headed in the right direction. I seemed to have a harder time than the average, so results may vary. So far, I would say Dr. Giotikas is a safe choice. He was always available via whatsapp, and I enjoyed his demeanor and professionalism from the start. The thing to be happy about now is that 6cm on my tibias has created the perfect porportions for me, as my femurs were much longer in the beginning. They look great, and with muscle building, they will hopefully look better. I'd also like to give a big shoutout to cyborg4life for giving me his routine for post lengthening recovery, as well as my friend eddiemorra for keeping me company in Athens through it all.  That's all for now.