Bilateral Femur with Dr. Paley 11/2022

Introduction
Hi everyone. I have been reading diaries on this forum since early 2018 when I first found out about this procedure. I have been thinking about this ever since 2018, and it's been almost 5 years now. I can say that I've read almost all the diaries of those who did the surgery in the US. After visiting Paley's institute at WPB last summer, I decided to do it this year. Surgery is scheduled in late Nov 2022. I will update here around the time I begin the procedure. BTW, I stole this formatting from a diary by "belowthemean", credit to him/her.

I am going to do bilateral femur lengthening with precice 2.2. My goal is to reach 8 cm, but would be happy as long as I got above 7 cm.

Basic Stats
Demographics: early 20s, male, Chinese
Starting Height: 174 cm (5'8.5")
Wingspan: about 6 feet
Lengthening Goal: 7-8 cm
Starting weight: 197 lbs (I am pretty fit. Weight mostly come from muscle)

Starting Height and Lengthening Goal
174 cm. Goal is to reach 182 cm.

Physical Shape
My weight is pretty high - 197lbs. I love benchlifting so I have big chest muscle. I also do snowboarding in winter, so my thigh is pretty bulky. I plan to do some cardio to bring my weight down a little, but not sure how much I could lose without losing some muscle as well. Will update my weight again before the surgery.

Sports
Nothing regularly. On-snow sports in winter.

Flexibility
I've been doing PT since June, twice a week. It is covered by my insurance because of my back injury. I just ask my PT trainer to include half an hour of hamstring and front-of-thigh stretch. He's happy to do it. My flexibility was rated "tight, like everyone else" when I visited last summer. We will see how it goes. Not sure if it will help.

Health Status
Overall healthy, other than I have herinated disc l5/s1. It's been a few years since the incident happened (from snowboarding). This is also the main reason why I visited last summer. Back then, Dr. Robbins told me that this injury shouldn't have any impact on my lengthening.

My Backstory
I've been thinking about this since around the end of high school. It's been so long that I am convinced that if I don't do it I would regret it for the rest of my life. Jeff Bezo mentioned this regret minimization framework in one of his early interviews:

I am pretty much a follower of this framework.

Who Knows About This
Every one in my family and my extended family (think of grandparents, parents' sibliings and their kids). All my close friends who are at least my height and my girlfriend. My mental health consoler (I've known her for years). I am pretty open about it. I just don't want my choice to have an impact on other people.

Cost of the Procedure
97.5k plus room and board and food (budget is 30k). If you stay in one of Paley's partner hotel, it will cost around 15k for the time I am doing the surgery because it's peak season in FL. All is in USD.

How I’m Paying
My parents pay for room and board. My savings can pay for the surgery.

Time Off Work
I work in tech so I can work remotely. Also for the past 1.5 years, I didn't use a single day of vacation or holidays or sick days, so that summed up to be around 50 days of PTO (unused PTO days roll over). My company also has very generous PTO policy for short-term disability, which I am waiting on the result of my application.

Why Dr. Paley?
Paley is widely recognized as the best. I also visited the hospital last summer and really liked it. At the end of the day, you pay premium for his experience. If everything goes well, maybe the experience and the result would be the same if I do it somewhere cheaper. The premium goes to the possibility where things don't go as planned, and I trust Paley's experience on dealing with these.

Next Steps
Just booked tickets to WPB yesterday and arranged my hotel stay at the SHS I95. I will update more as we get closer to the surgery date.

Some Motivation
Sometimes late at night I would get scared thinking about the procedure. I would watch this video:

Vader was my favourite Star Wars character when I was a kid. Picturing this procedure as Anakin's transformation to Darth Vader would give me strength to move forward.

Thanks dude! That's good advice. Do you think just stretching and all that help with the lengthening? Also would love to read your story if you decide to write it out someday. I will keep updating mine here.

In the pre op room now. Kinda nervous but tired at the same time because I couldn’t fall asleep earlier. Will update here hopefully tonight or tomorrow.

The surgery went well. They were able to put the biggest mail in my femur because I have big bones. This means weight bearing is 75 lbs per leg.

Day 0:
I was wheeled in around 7 am and woke up in recovery room around 12 pm. It was a strange experience, but I remembered nothing. I tried to move my legs and they are heavy. The movement also hurts a little bit. They let my girlfriend in. I then passed out again and slept for another 2 hours probably because I didn’t sleep at all the night before. Around 3 pm, they wheeled me in my private room. So far all is good. The pain level was 3-4. The nurses came in regularly to check on me and gave me painkillers and also antibiotics injection. The pain increased steadily as anesthesia worn out. I was nauseous when eating the dinner they gave me. It was good food. I am just nauseous due to the anesthesia.

Day 1:
Nurses came in once a few hours at night to check my vitals. They also gave me the ice machine which really helped my femur pain. The painkiller is not as effective as it was yesterday. It is 12 pm as I am writing this post. I will be doing PT soon. I am in a lot of pain but I believe this is the worst it will get, so it’s only uphill from here.

Thanks for the tip! I haven’t started stretching yet as the PT is mainly focused on standing up. I think I will start stretching next week when lengthening starts.

Day 1-2:
Overall is great. I was able to stand up and sit in my wheelchair and tour the floor, but standing up and sitting up get me dizzy pretty soon. Also I feel nasty because I haven’t showered for a long time. I will probably just use wash clothes before wound check next week. I am scheduled to get discharged tomorrow or in two days.

Sorry about no updates. Has been busy with resting and tolerating the pain. Overall, all is well. I will post a few lessons I learnt around Christmas when my parents get here. I am excited to remove my wound patches tomorrow and lengthen for the very first time.

No I stayed the same weight going into the surgery. I think most of my weight comes from my leg though. I also got the biggest nails so I am not too worried. From time to time, I do wonder: what if the nails are broken and I just don’t know it. I am going to do a wound check and follow up today so we will see.

Woke up in the middle of the night probably because I slept too much in the day. Life is getting better and more routine every day. Now I don’t feel much pain because the surgery pain has mostly gone (sometimes no pain at all) and can move my legs without much pain. I can roll onto my belly, sit at the edge of the bed for an extended amount of time, etc. I still hire a caregiver for the day 8am to 8pm. PT is the one thing I look forward to every day. I’ve lengthened 8 mm so far. With the 1 mm that they did at the surgery, I will hit the 1cm mark tomorrow. I do 3-4 stretches a day, once before every turn. The only worry is bending the mail but statistically it’s very rare that the bending will impact lengthening. Some people will have some small degrees of bending to their nails but most of them still okay to continue lengthen. I asked the most experienced PT, and he can only recall 2-3 cases of nail bending where they had to do another surgery. If you do a search with keyword “bend” on this forum you’ll get the same impression.

Quote from: Chinese Actor on December 17, 2022, 08:54:44 PM希望你顺利 请问你怎么看待p针大小腿各做4.5厘米 这对于我们中国大部分人来说是容易的吗 还是需要很多拉伸才能完成

Little to no stretching is definitely a bad idea. I don’t think you can get very far with little stretching. For tibia 4.5cm + femur 4.5cm, I think it is a reachable goal. Most people I talked to that are doing both legs end up with more than 9 cm. I am only doing femur so I can’t give much info about tibia. Most people will have nerve pain at one point and then will be on gaba. As of myself, I am pretty confident that I can reach at least 6 cm and most likely 7.x cm.

I am on day 19 post op. Surgical pain is almost completely gone. I’ve lengthened 1.2 cm myself, and there’s the 1 mm they put in during the surgery. I just stopped taking oxy today. I was advised by other patients to save some oxy (at least 100 mg) for the later days when I get tight. I don’t feel much pain most of the time. I get shooting pains once in a while but they disappear in a few seconds. Sleeping is good. I just can’t get a full night of sleep because I need to do a turn every 6 hours, but my total sleep time is healthy. For flexibility, the key is to make sure that my knees can bend at least 90 degrees and that I can keep my legs straight when standing.

Hi Seattleperson, it is very possible but not guaranteed. Here is what I learned from conversations with PTs and other folks. It is basically guaranteed that you will reach 5 cm as long as nothing crazy happens like you fall and break your rods etc. Most people make it very close to 7 cm. The last centimeter is the most difficult. A few people I met stopped at 7.x cm because they are happy with it and honestly a few millimeter difference is not significant. If you don’t smoke and are relatively young like 20 to 40, average flexibility, you have a pretty good chance of reaching 7 cm as long as you stretch diligently at the hotel.