After learning so much from everyone on this forum, I thought I should give back by starting a dairy with Dr Betz. I will give a full analysis of my motivations, why I chose Dr Betz and Betzbone, as well as a cost breakdown. I will also try to post daily/weekly updates and answer any questions curious lurkers may have.
Motivation
1) Dating in the West is difficult when the average adult male is 176cm+. This average can reach 183cm in northern European countries. Women have anecdotally told me that they tend to judge height over appearance and even money.
2) COVID and working from home has given a great excuse to disappear from society for 4 months without suffering economic consequences.
Why Dr Betz
1) Over 3000 surgeries. The most experienced doctor in Europe.
2) Researcher and publisher. Inventor of Betzbone and co-inventor of Fitbone. This adds to his level of expertise.
3) Younger doctors like Giotikas is also a great value alternative. He uses Stryde and is very well educated. I likely would have went with Giotikas had it not been for the Stryde recall.
Why Betzbone
1) Availability. Stryde has been recalled due to corrosion. Precise 2.2 has halted shipping in the EU after losing its CE Mark. The only well-known nails available in Europe are Betzbone and Guichet (same mechanism). There are other less known partial-weight bearing nails available in Turkey and other regions that have stockpiled Precise.
2) Allows for up to 12.3cm in lengthening versus 8cm for Stryde. Although I will likely only lengthen 10cm, this allowance is useful for those who wish to squeeze out every last mm. It is less meaningful to those who do not want to lengthen past 8cm for personal or safety reasons.
3) Full-weightbearing. After Stryde, Betzbone is the only frequently used weight-bearing nail on the market. There seems to be talk of Betzbone snapping in the past. Since then, the nail has been re-designed and it has a much longer track record than Stryde. I've taken the decision to go with Betz given his wealth of surgical and nail design expertise which should result in a lower relative (perhaps not absolute) complication rate, over a less experienced surgeon with lower absolute complication rate.
4) The corrosion issue in Stryde is unlikely going to be fixed as long as it contains a sealed iron compartment. This is not changeable as only ferronous metals respond to the magnetic coil in the external lengthening devise. This is exacerbated in weight-bearing nails as they go through much more and frequent stress, resulting in more influx of bodily fluids into the sealed joints of the nail. Betzbone is cobalt chrome which does not corrode. Personally, I don't see any problems with minor corrosion, but I wasn't going to wait 8 months just to get on a waitlist for Stryde.
Cost
1) Dr Betz costs €54179.69. This includes consultation, X-rays, measurements, nails, the operation, followed by a 14-day hospital stay with physio, food and pain medication. This may be cost-effective compared to Paley in US or Donghoon in Korea.
2) This does not include any post-hospitalization (outpatient) physio, x-rays, medication, and accomodation. This does not matter as much to me as I will be returning to the UK for my rehab, where my private insurance will cover physio and x-rays. NHS will offer discounted medication. And I will be living at my own flat.
3) Please also consider additional costs such as hospital Covid tests, Airbnb, food, train, and flight which added an additional €1500 for a 4-night pre-op stay. The removal procedure in 1.5 years time is €7200.
4) Note that Dr Giotikas from Athens charges €47445 for the whole package and uses Stryde. His package also includes outpatient physiotherapy and medication during lengthening. If you do not have health insurance, and believe in Stryde, definitely consider him. His prices are likely more competitive due to Greece's proximity to Turkey where Dr. Buldu is offering Precise 2 packages for €35000 versus Dr. Giotikas' €42400.
Personal Stats
Pre-op Height: 171cm
Post-op Goal: 181cm
Age: 29
Weight: 67kg
Ethnicity: East Asian
Location: UK
Fitness: Defined arms and waist. Been lifting 3 times a week for the past 5 years
Flexibility: Average, but has been making progress over the past 4 months by incorporating hip flexor, quadriceps, and hamstring stretching into my daily routine. It has also been recommended to stand whenever possible (ie. working on a standing desk) to train the muscles.
Dairy
Day 0: After arriving in Frankfurt, I took a personal tour of the city and sat on a 2.5 hour train ride to Sankt Ingbert. It's a small town, and when I arrived I was unpleasantly surprised by the crudeness of the hospital and consultation office. The fascilities were basic. I had to pay €182 for a PCR test out of pocket. The nurses and even the anesthesiologist were not proficient in English, so I had to use Google Translate on many instances. Dr Betz said it didn't make much of a difference to him whether I used regional or general anesthesia. The anesthesiologist however recommended general anesthesia, as regional may be inadequate and urethra connections may have to be made. Finally, the hospital visit was disorganized. I had to find my own way to the X-ray room (Röntgen). After that my handler Daniela became very helpful in guiding me to the office where my measurements were taken. I enjoyed a 3-hour consultation with Dr Betz. He knew the answer to every single question I had.
My surgery is tomorrow. I'll try to write an update if I'm conscious. Wish me luck!
Bilateral Femur Lengthening Dairy: May 2021 with Dr Betz and Betzbone
@chasing_higher_dream
1) Wingspan: 177cm
2) I booked with Dr. Betz for July, but someone cancelled their nail removal due to COVID. I originally requested for ASAP, so when they asked if I wanted to take the canceller's place, I jumped on it.
3) Good question. Dr Betz mentioned it in passing. I'll confirm tomorrow.
4) Covid test is mandatory everytime you enter the hospital. I had to wait an hour for my test since it was Monday morning.
5) I'll stay until May 16.
Hope we can run into each other too!
@TheDream
Thanks for your concern. I'll definitely see how my flexibility is past 6-7cm.
@RB
Nice to see another Betz patient! How many cm have you lengthened and any pain/stifness so far?
@Johnp86
Sorry to hear! I'll try to add more details to my diary. I think things get better after the initial consultation. They should have sent the handler out right away, to smooth the process, though Daniela had 3-5 patients to deal with so it might be hard.
@RealLostSoul
Thanks!
@Medium Drink of Water
Ok I'll give it a try.
Day 1
As it was Monday morning, I had to wait an hour to get my PCR test. This delayed the surgery by an hour. I put on the surgery clothes and was rolled to the surgery room on a bed. The last thing I remember was the anesthesia coming through my right hand causing some pain/cramp. The next thing I knew, I was in my personal hospital room. Dr Betz and Daniela helped me stand up to walk a few steps. I was also able to stand up myself to urinate in a bottle.
The pain was a lot lesser than I expected. Dr Betz used local anesthesia on the wounds. I only felt some pain when turning. I havent used any of the painkillers they've given me (yet). The key problem was that I was nauseous every time I sit up/stand up. This is likely due to the anesthesia causing diziness. I was told it will get better tomorrow as the anesthesia leaves my system. Walk training also starts tomorrow. 
The long journey begins!
@chasing_higher_dream
I have confirmed with Dr Betz that I used the 13mm nail. There was also an initial surgery gap of 5mm (so I'm already 0.5cm taller).
@RealLostSoul
I believe the mask was only for oxygen. I was pretty sure that I was knocked out by IV. The initial cramp is the main problem. I woke up fully dressed, so I was glad I got general anesthesia. The nausea during day 1 was intense though. Couldn't sit up or eat because of the nausea.
@RB
Thanks! I was just wondering when I can shower. Hopefully my legs will be strong enough tomorrow.
@Zatoichi
Great to see you join in on the action! I personally didn't have any issues travelling around Germany or getting to the clinic. A 40 Euro train ticket takes you from the airport to the local train station with a single connection. Booking your Airbnb between the station and the hospital helps!
@DonBones
Glad to hear! He's the only one around now with weight-bearing nails. I think it's a no-brainer until maybe next year when Stryde is back. I think you've made the right decision!
Day 2
The nausea from anesthesia is now gone, so I could finally eat! The hospital food quality was poor though. For breakfast, I got 2 stale bread. Lunch was slightly better with schnitzel, fries and salad. Dinner was just ham and bread... Most nurses, including my physiotherapist have limited understanding of English. So I have to use Google Translate or just not make certain requests. I took several pills which included supplements and blood thinners. The staff are all very nice but I would say the hospital stay has been a downer overall.
On a more optimistic note, I have been able to walk back and forth in the hallways with crutches! I can walk for probably about 20 minutes before tiring. No more peeing in bottles. There's barely any pain now when I'm still. They come up only when I twist or turn. I have been able to brush my teeth, but not shower (my Day 3 goal).
RB
Daniela and Betz just told me that it has to be third day not including surgery. And the nurses have to re-wrap me. UGH
DonBones
Yeah so a previous Betz patient just rolled into my room, after having his nail removed. He was at a hospital 10 miles nearby, and said it was state of the art! Good food, good fascilities, hot nurses even >_>. I think Dr Betz had to change because of Covid, though he didn't lower his hospital costs.
chasing_higher_dream
Aww, maybe we will be able to do the removal together? 13mm is indeed the widest nail. Dr Betz said I had very wide bone marrow. I think it really comes down to high thick-boned one is, otherwise the nail would not fit the curvature of your femur. Yeah, The hospital has been a downer, but it's great that we caught Dr Betz, since he should be retiring soon. He's training Nada, another surgeon right now.
Day 4
Still no shower, since Dr Betz said not until day 3 after surgery (not counting the surgery date). After the anesthesia wore off during last night, I couldn't sleep. Had to take painkillers to sleep. But to my surprise a former patient who came in to get his nail removed was rolled into my room. We had a blast chatting about his lengthening journey, the confidence he built, and the overall improvement in life quality he experienced. I'm more optimistic than ever.
Day 4
Just realized I've been given painkillers 3 times a day. It has caused some constipation, hence why I only shat a little today. Was able to duck walk slowly over small distances without crutches. Walking with crutches is much easier. Bought external food because the hospital food is terrible. Got another person who has gotten his nail removed coming in this Friday. Clicking starts on Monday, so I still have a few days to recover.
inchesmatter
Wow. I'd also like to keep my upper body muscles. Is that possible?
DonBones
Unfortunately not, as it's dependent on where the surgery took place. :/ Maybe in 2 months time it'll be different?
Day 5
By far the best day so far. I was given a moderate laxative, so I completely cleaned out my bowl, and my lower belly feels great. I could walk without crutches fairly robustly, though still like a super duck. My appetite is back, mood is also better. My gym physio is also starting today, so I'll definitely update you guys tomorrow on that. Aparently my company's insurance will cover the physio and x-rays when I get back to London, which is fantastic news too. The guys who got their nails removed told me to pack as much pain meds as I can before leaving, so I'll have to look into that.
Told my company about the surgery. They actually don't want too much technical details, since they want to respect health privacy. What they do need is a letter from the surgeon outlining the date of surgery, hospital stay, and rehab time/needs. This is mostly for compliance purposes. The way it works is that a GP under my insurance network will assess my needs, which is partially communicated to him by Dr Betz. The GP then refers me to x-rays and physio that are then covered by the insurance.
Day 6
The physio on day 5 really hit the spot. I was partially recovering from my gait too. However day 6 was a retraction in many ways. I had a pretty poor breakfast which caused nausea, which led to somewhat of a depression. I started questioning why I was doing this and if all the pain was worth it, and struggle was worth it. My walking regressed as well. My clicking will start on Day 8, and from everything I've heard, it causes a lot of pain and distress for most people, unlike what Dr Betz' ads suggest. It will start with a few clicks, then up to 20. I just hope I'm one of the few lucky ones who don't experience tremendous pain during clicking.
inchesmatter
O_O What's the internal hip rotation?
RealLostSoul
RB
Thanks!
Day 8
It's exactly one week from my initial surgery and I've done my first 6 clicks! The left leg was trivial. The right was extremely painful (expecially the first 1). As far as I could recall, it's the first time I've screamed out due to pain in my life. The 6th click was a lot easier than the 1st with only minor pain. I could feel there's something mechanical inside me as when I rotate my lower leg, I could feel a mechanical resistance, and a reduction in said resistance when it clicked. For those who have problems clicking, Stryde completely replaces this process with controllable magnets, which I think is correct way forward.
As for the depression, it was mainly due to me skipping painkillers. I thought I should have as little as possible (less than what the hospital prescribes me) since it was an opoid. However, this was a mistake as it caused chronic (not sharp) pain given the slightest movement. I didn't realize it could cause depression. I'll likely never skip my pain meds again.
I really hope I can update everyone with pleasant rather than dreadful experiences in the coming week.
Serilium & Future Skycraper & Zatoichi
Thanks for the encouragement!
chasing_higher_dream
At my current pace of recovery, I believe I will be able to go back to London this Sunday without aid. A slight gait will still be there especially if my muscles are not relaxed, so I still need to come up with an excuse.
Day 9
Today the clicking for my right leg was equally painful, with scream-worthy pains in 2 of the 10 clicks. I am honestly worried it will hurt my knee at some point. It is worth to note that my left leg is recovering much better than my right. My right has persistant and accute pains, less flexibility, and sharp pains during clicking. Dr Betz is a brilliant surgeon, and I trust that most patients have no problem with Betzbone. But given the pain that a good portion of patients go through (like myself), I would recommend using Stryde for its magnetic lengthening if you're willing to wait for its return.
Further, I would also like to try grouping my naps together into one long sleep if possible. Sleeping during active hours is a waste since the painkillers are in effect. When the painkillers aren't in effect, I should be fast asleep.
I started stairs training for the past 2 days. Surprisingly walking up stairs is easier than down, as the movement to go down stairs is quicker and therefore more likely to shock your muscles. Again my right has much more difficulty doing it. I essentially feel like there're 2 patients in me. My left leg is recovering perfectly, without pain, gait, and clicking as advertised. My right is the exact opposite with all the complications.
Future Skycraper
Will do!
DonBones
Asked Betz, and he said there's no particular reason, the left might become more difficult at somepoint etc...
Serilium & inchesmatter
I just tried those methods until they clicked, and the pain level is very similar. Betz told me that the reason why clicking is harder for some legs is because of the tight fit of the nail within the bone marrow. He said it will get better as the rotors loosen. Don't know if that's neccessarily a good thing, but I'll take it if it means less pain.
Day 10
Did 15 clicks on the left leg in 5 min. Only 10 on the right so far because of the pain. I screamed for a minute straight on the first click. I really hope the clicking gets better as everyone says. For those who haven't done the surgery yet, I strongly recommend waiting for Stryde for its magnetic rather than mechanical clicking if possible.
Stairs training has seen much more success. I can now walk upstairs without handrails, and downstairs with some pain (when the knees bend). The muscles have definitely stiffened up further so I need to be more active with the stretching. I noticed that my legs are spread apart when walking, which causes the waddle. I've been conciously trying to close them, and that has improved my gait substaintially.
I also noticed the lack of ibuprofen and reduction in size of novalgin in my pill tray. They're trying to ween me off painkillers, which I'm happy with, but just not during clicking.
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