Bilateral Femur with Dr. Paley 11/2022

erenyeager1， that is very nice of you for sharing all this and i am considering Paley as well. I am quite jealous of you. I am 1.65 and my gaol is 1.73 with femur LL. In your opinion, is it that possible?

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.

understood, thank you very much!

Day 25:
Surgical pain is completely gone. 99% of the time I feel no pain at all. Also stopped taking oxycodone on day 20. I am only taking Tylenol for pain, around 1000 mg every day. X ray was taken on day 23, and everything looks good. Quads are great. Hamstrings are average tight. No nerve pain yet. Most people start to get nerve pain somewhere between 2 cm to 6 cm, so I are expecting it to happen at one point. Honestly, the pain that bothers me the most is my lower back pain from my herniated disc (injury a few years ago), because I sit on the wheelchair a lot. Also it makes stretching my left hamstring much difficult because hamstring stretches all irritates my lower back. The pain is the same as pre-surgery so nothing to worry about.

Day 30:
So far so good! I’ve reached 2.4 cm. Flexibility is good. No nerve pain yet. Stretching every other day for 3 months before the surgery definitely helped me with the lengthening process. Life is getting routine, and I am planning on getting back to work remotely starting next week.

Quote from: erenyeager1 on December 29, 2022, 03:20:46 AMDay 30:
So far so good! I’ve reached 2.4 cm. Flexibility is good. No nerve pain yet. Stretching every other day for 3 months before the surgery definitely helped me with the lengthening process. Life is getting routine, and I am planning on getting back to work remotely starting next week.

You are doing great, stay strong buddy! Thanks for keeping us updated.

Hello and thank you for sharing your experience, may I ask what exercise regime you followed before your surgery? And how helpful has it been because I thought Payley said on his interview it doesn’t make much of a difference to the surgery outcome

Quote from: Harry1309 on December 30, 2022, 11:54:35 AMHello and thank you for sharing your experience, may I ask what exercise regime you followed before your surgery? And how helpful has it been because I thought Payley said on his interview it doesn’t make much of a difference to the surgery outcome

I have a herinated disc (L5S1) so my insurance offers me physical therapy. I just asked my PT to add in a few stretches recommended by Paley's PT like Thomas stretch, hamstring stretch, and some quad stretch. How flexible you are is not going to help the surgery itself, i.e. putting the rod in your legs, but I do think it helps a lot with the lengthening process. The daily PT during the lengthening phase is basically some leg exercises to strengthen the muscles that you don't use because of inability to walk and some stretches (hamstring, quad, and hip flexor). If you put in a lot of efforts and stretch 3 times a day at the hotel (the same intensity as you do at the PT), you would likely get the same outcome as not doing any stretch at all before the surgery, but not many people are like that. You don't really know if you can religiously follow what the PTs tell you to do at home until you actually have the rods in your body. Does stretching before the surgery enable you to lengthen longer? I am not sure and probably doesn't make much of a difference. However, getting a habit of stretching these muscles pre-surgery is definitely going to make your life in lengthening phase much easier. If you are 100% sure that you can religiously follow whatever the PT ask you do at home and push yourself very hard, then stretching pre-surgery is not really necessary, but at least I can't follow that routine 100%. I say I've been trying my best and can do like 70%. Sometimes I just get really tired and procrastinate. 

Also, I met a patient who is in his 60s. He maxed out the rods and gained full 8cm. I was very impressed. He was stretching in the hotel very religiously and pushed his body to do everything that was asked. It was very inspiring to me. He recommended taking an aquatic therapy session every week, which I am planning to do starting next week if there is an open spot. The PT's been telling me to try to get into pools for exercise but I am just not comfortable with the hotel pool. I have to pay an extra 25 dollar for the pool therapy session, and I need to uber there, but I think it is worth it. I just didn't know this was an option. I did cross country running in high school, and we did a lot of pool exercises then. Running in pool is more intense than running on land. As long as the pool waterline is around your chest level, it is okay for the rods. Plus, there will be someone watching me. I will update here later on how it is in a few weeks.

I am getting back to work next week. So far nothing scary happen, and honestly I think most patients have a pretty smooth journey, albeit painful (tight + nerve pain). The number of Paley diaries on the forum is pretty low compared to the number of cosmetic LL patients they take every year. Probably 1 in 80 writes a diary here if not fewer. Most patients just come here, go through the journey and go back home. Scary things do happen but it is very rare.

Hello erenyeager1, thank you for posting your diary it was great to read.

During your first few days post op, was there any point at which the pain was unbearable or was it generally kept under control with the help of pain meds? How would you rate the pain on a scale of 1-10? Do you know if your experience of the pain is similar to others at the Paley institute?
Thank you.

Quote from: stretched on January 04, 2023, 10:50:27 PMHello erenyeager1, thank you for posting your diary it was great to read.

During your first few days post op, was there any point at which the pain was unbearable or was it generally kept under control with the help of pain meds? How would you rate the pain on a scale of 1-10? Do you know if your experience of the pain is similar to others at the Paley institute?
Thank you.

Hi stretched! When I woke up after surgery, because the anesthesia is still there, I didn’t feel any pain, just legs are heavy. Then anesthesia goes away in a few hours maybe a day. Then they give you oxycodone 5mg every 8 hours or so for a few days. The pain level was low like 2 for the first 2 days. Then it starts to go higher to like 4-5 for last two days in the hospital mostly because they stop giving me oxycodone and switched to a different pain killer. From time to time there is like a 1-sec level 7-8 pain, but that’s like once an hour or so. The surgical pain remained like this for two weeks, then it slowly goes away. For most people, the surgical pain should be gone in around 3 weeks. Looking back, the pain wasn’t that bad. It was manageable for 99% the time, and most people have similar experience. Apparently, tibia hurts less than femur for most people. I didn’t do tibia but I talked to a few who did both femur and tibia, and they say that the pain after femur surgery is much worse than that of the tibia surgery.

After surgical pain is gone, you probably have already lengthened like 1.x cm. Soon, depends on your flexibility, you are going to get muscle tightness. Then some people get nerve pain. If you get nerve pain, it’s probably going to stay for the entire lengthening period. The only way to delay or prevent this is by stretching religiously. It is a painful process too, but it’s a different kind of pain than the surgical pain. And this pain you can experience pre surgery. Just find a physical therapist and ask them to stretch you real hard. As of now for me, 5 weeks post op, I feel 0-1 pain for the most part. The only pain in my life is when I do stretches. Hopefully I don’t get nerve pain. Most people get it between 2 to 6 cm lengthened, but I’ve met a few who never got it, but they are either very flexible to begin with or stretched really hard.

Also my overall energy level was low until recently, like the first few weeks I am always super tired everyday. It slowly gets better as time goes on.