I'm currently undecided about which doctor/method to go with. Here are the pros/cons I deduce after scouring this forum. Experts on this group: please add your comments - would really appreciate it.
Becker/Betz
Good
- Clean bone cut, good surgical technical
- Great rehab center
- Betzbone easier to click than G-nail (is this true?)
- Patients generally walking faster on crutches with less swelling compared to Dr. G's patients (based on my reading of diaries)
Bad
- More expensive than Dr. G, and cost of therapy/lodging after surgery quite high (was recently quoted by Betz Institute up to 300 euros/day)
- Slow follow up care after leaving facility and returning home
Dr. Giotikas
Good
- Cheaper surgery price, cheaper cost of living in Athens
- Physical therapy, meds, crutches, wheelchair all included in price
- Living in big city with lots of activities outside of hospital
- Can stay in nice hotel like Novotel with buffet, gym, rooftop pool at reasonable cost
Bad
- Dr. G rotates his time between Athens and London, so might not be available when needed
- Harder to click G-nail comparied to Betzbone
- More incidences of complications with Dr. G (misalignment, one death, higher rates of swelling and muscle stiffness and more pain - perhaps due to G-nail vs betzbone?)
- Stingy with painkillers
Comments, corrections welcome please.
Becker vs Giotikas (Betzbone vs G-nail) - which better?
I think it would be very unreasonable and unethical for anyone but yourself to decide which Dr to go to so I refrain from recommending anything.
Few things I could correct on that list: I think clicking is exactly the same. The hospital and rehab in Freiburg is anything but “ran down”
Also you will see once you go home during lengthening it is a huge upswing in mental health. If you understood what to do and not to do I think it’s doable at home imo.
Quote from: elanxr on November 09, 2022, 01:37:07 PMI'm currently undecided about which doctor/method to go with. Here are the pros/cons I deduce after scouring this forum. Experts on this group. please add your comments - would really appreciate it. I'd like to have the surgery around March based on the responses from others.
Becker/Betz
Good
- Clean bone cut, good surgical technical
- Great physical therapy facilities
- Betzbone easier to click than G-nail
- Patients generally walking faster on crutches with less swelling compared to Dr. G's patients (based on my reading of diaries)
Bad
- More expensive than Dr. G, and therapy/lodging after surgery quite high (up to 300 euros/day)
- Hospital a bit run down
Dr. Giotikas
Good
- Cheaper surgery price, cheaper cost of living in Athens
- Physical therapy, meds, crutches, wheelchair all included in price
- Living in big city with lots of activities outside of hospital
- Can stay in nice hotel like Novotel with buffet, gym, rooftop pool at reasonable cost
Bad
- Dr. G rotates his time between Athens and London, so might not be available when needed
- Harder to click G-nail comparied to Betzbone
- More incidences of complications with Dr. G (misalignment, one death, higher rates of swelling and muscle stiffness and more pain - perhaps due to G-nail vs betzbone?)
- Stingy with painkillers
Comments, corrections welcome please.
Recently there may have been a compartment syndrome issue in Athens for a tibia patient but evidently it was dealt with swiftly and he turned out fine I heard. I'll probably bump into that patient some time next week. I'm still trying to learn about what this "compartment syndrome" complication is / what causes it/ how a patient can recognize it in time
Does anyone know the pricing for betz's Elke's House?
This is the information Nora from BetzInstitute sent me:
"Please find below the different packages in the case you decide to stay longer at the Rehab (Mooswaldclinic) centre which is connected to a Hotel (Dorint).
Version 1:
Clinic deluxe room/ full board clinic/ 3x 20min therapy/day/ training area €300/day
Variant 2:
Clinic deluxe room/ full board clinic/ 2x 20min therapy/day/ training area €251/day
Variant 3:
Hotel classic room/ full board hotel/ training area €211/day
Variant 4:
Hotel classic room/ full board hotel/ 2x 20min therapy/day/ training area €311/day"
Quote from: SpeedDialer on November 09, 2022, 02:44:01 PMRecently there may have been a compartment syndrome issue in Athens for a tibia patient but evidently it was dealt with swiftly and he turned out fine I heard. I'll probably bump into that patient some time next week. I'm still trying to learn about what this "compartment syndrome" complication is / what causes it/ how a patient can recognize it in time
Compartment syndrome = pressure in the fascia of the muscle from trauma and swelling basically bottlenecking blood supply. Patients notices it in time haha. It’s extreme pain that’s not even diminishable with pain medication.
Quote from: elanxr on November 09, 2022, 05:00:33 PMThis is the information Nora from BetzInstitute sent me:
"Please find below the different packages in the case you decide to stay longer at the Rehab (Mooswaldclinic) centre which is connected to a Hotel (Dorint).
Version 1:
Clinic deluxe room/ full board clinic/ 3x 20min therapy/day/ training area €300/day
Variant 2:
Clinic deluxe room/ full board clinic/ 2x 20min therapy/day/ training area €251/day
Variant 3:
Hotel classic room/ full board hotel/ training area €211/day
Variant 4:
Hotel classic room/ full board hotel/ 2x 20min therapy/day/ training area €311/day"
Mooswaldclinic =/= Elke’s house. Mooswald is an orthopedic rehab center (there are a lot of elderly patients with hip and knee replacement, stuff like that)
G-nail stands for Guichet nail
Becker/Betz
- "Betzbone easier to click than G-nail (is this true?)"
-> Although I can't prove it, I believe it may be true based on my experiences with gnail + the official video of Betz's patient doing clicks + videos from Dr. Guichet (the G in Gnail is from guichet in France, not giotikas if anyone is curious)
- "Patients generally walking faster on crutches with less swelling compared to Dr. G's patients (based on my reading of diaries)"
-> You might be right, but I am not sure if there is a significant difference for g-nail femurs vs betzbone femurs. Alot of patients seemed to be able to use crutches walking for g-nail pretty early. Confusingly, there are two Dr. G's (Guichet from France, the g-nail inventor, and Giotikas in Athens who did not invent g-nail)
Its good to see some of Guichet's (the French doctor, not the Athens one) official youtube videos to get a sense for how quickly you can walk
I would say most likely the hospital with Becker/Betz is nicer than the Athens hospital( Athens one feels as if its a bit old but neat and clean inside for the most part)
Dr. Giotikas
Bad
- I disagree with this statement: "More incidences of complications with Dr. G (misalignment, one death, higher rates of swelling and muscle stiffness and more pain - perhaps due to G-nail vs betzbone?)"
-> I actually doubt that Dr. Giotikas has more complications than Betz. I doubt this because Betz patients lengthen more on average than Giotikas patients. So probably Betz patients have more complications, but its not a fair comparison since Betz patients tend to go for more length. And also more Betz patients lengthen far away from Betz, which I think also adds other variables. Unsure if we could ever get a fair comparison without the data. However, I will say that for some people, the first big click for the gnail on the right leg is a b___ and I wonder if its related to more patients I've talked to having problems with their right leg compared to left leg. I don't know, though, its just a hypothesis. That being said, my pain for clicking with gnail is less than at the start and is now rarely above 3/10 pain and is usually much less. But some patients are getting more pain than this from clicking still.
- Stingy with painkillers
-> Sorta. In Athens, you get alot at the start and then you sort have to keep asking the physical therapists for more painkillers when you run out and they give you a pack or so at a time, but they generally say yes.
You are right that alot of Athens is run down but if you stay in Novotel you won't have to deal with that
After some thinking, I've come to the conclusion that the full IT band release and 1cm distraction performed by Dr. Giotikas during surgery is what's causing the initial difficulties post-surgery for the first few days (compared to soft IT release and no(?) distraction by Dr. Betz/Becker). So it's not the surgical skill or nail that causing the difference in initial outcomes. I'm ready to stand corrected if mistaken.
Quote from: elanxr on November 10, 2022, 01:36:26 AMAfter some thinking, I've come to the conclusion that the full IT band release and 1cm distraction performed by Dr. Giotikas during surgery is what's causing the initial difficulties post-surgery for the first few days (compared to soft IT release and no(?) distraction by Dr. Betz/Becker). So it's not the surgical skill or nail that causing the difference in initial outcomes. I'm ready to stand corrected if mistaken.
They also did 0.5cm initial gap for me. Some other patients here had more. We lengthen 1 mm / day until like about 3cm while Giotikas does 1.5mm. More radical IT band release indeed makes it tougher to walk in the beginning that’s why they are on a walker first while we were on crutches from day 1.
Quote from: elanxr on November 10, 2022, 01:36:26 AMAfter some thinking, I've come to the conclusion that the full IT band release and 1cm distraction performed by Dr. Giotikas during surgery is what's causing the initial difficulties post-surgery for the first few days (compared to soft IT release and no(?) distraction by Dr. Betz/Becker). So it's not the surgical skill or nail that causing the difference in initial outcomes. I'm ready to stand corrected if mistaken.
I'm a giotikas patient doing gnail. The PT's tried to teach me to use crutches I forget (maybe 2nd day? after the surgery can't remember) but unlike most of the other patients I felt too unstable doing it. Maybe I suck, dunno? I feel like most of the gnail patients used the walker for at least 1 week, some 2 before switching to crutches. I was behind schedule and didn't use the crutches until 2 weeks ish
So in the interview with cyborg4life, Giotikas claimed he does 0.8 cm during the surgery instead of 1cm (anyone can correct me on this? I did not really pay attention to the total length early on)
At the start, I did 15 clicks per day = 1mm per day
Then during what he called the "inflammation phase" shortly afterwards we did 21 clicks per day, which I believe is 1.4 clicks per day (? 21/15) for I forget 1 or 2 weeks which might be the origin of the 1.5 the reallostsoul mentioned?
And then for me personally at least and a few other patients, a few weeks later Giotikas lowered my clicks down to 10 clicks per day (about 0.66 mm per day I believe based on 10/15)
Based on what I see in Athens on who is suffering the most during PT, it looks like the guys with lower flexibility/even pre-existing mild health conditions are suffering alot and having issues. I've talked to almost all the patients during PT and that's my impression. Whereas there is a 23 year old with great flexibility who is.. doing great, I can't believe how good of range of motion he is still getting when I see it. And ozboy39 seemed to do pretty well when he was here. I think I'm doing a bit worse than ozboy but I have less nerve pain than him I think. The guy who got compartment syndrome did quadrilateral, I'm not exactly sure what happened. There's a precise femur patient and honestly his walking on the antigravity treadmill looks not that great compared to most of the gnail femur patients
You're correct that the IT band surgery at the start causes significant short term pain/difficulty. But recently a guy who I believe (?) did not do IT band surgery (he went with a diff doctor originally) came to Athens to get an IT band surgery because he is no longer able to close his legs (his legs are always in a V shape). So I'm pretty happy I got the IT band surgery done.
Anyone wanna correct me?
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