Quote from: Dr Monegal on September 15, 2014, 10:27:26 PMImplant price is 13700€ for unilateral And 11000€ for bilateral lengthenning.
Price is set by the Company.
Then you have to add Medical expenses end Clinic expenses.
For a unilateral procedure it is approximately 19500-20000€
For bilateral 2 femur or 2 tibia 32000-34000€
36k Euros for tibia and femurs, so its 72,000 Euros for all 4 bones?
61,200 Euros I'd do it, 72,000 Euros is kind of pushing it over. Thats a difference of $16,000 for me when converted
This is what I got from him:
TWO STAGE LENGTHENING:
1 leg (femur + tibia) + the other leg later (femur + tibia) = 64-65000 euros
1 femur + the other femur later = 34-35000 euros
1 tibia + the other tibia later = 34-35000 euros
----------------------------------------------------------------
ONE STAGE LENGTHENING
2 femurs in a single operation = 32000-33000 euros
2 tibias in a single operation = 32000-33000 euros
He doesn't recommend the one stage lengthening (both femurs or both tibias at the same time) because of the increased risk of fat embolism, but it doesn't mean he won't do it if you really want it. It's just that doing one leg at a time also has added advantages since you won't be stuck in a wheelchair for 2-3 months minimum. So it's a no brainer for him to recommend a two stage lengthening even though it adds to the cost because of the two separate surgeries to insert the nails, since it increases safety and mobility for the patient.
I'm seriously considering this doctor and I don't plan on using lifts at all. I'll just walk around in crutches with my operated leg growing longer than the other and keep it from toughing the ground like I had an accident or something. I'll stretch it and exercise it when I'm in bed or on a sofa following the doctor's physio instructions. Then I'll come back when the doctor tells me the operated leg is strong enough to bear my weight and that it's time to repeat the procedure with the other leg.
You'll be "out of order" for an aggregate total of around 4 weeks during the entire two stage procedure, not like in the one stage procedure where you'll spend several months in a wheelchair and then need to start to "learn" how to walk again with crutches because you've lost your muscle strength in both your legs.
I can't really imagine myself in a wheelchair for several months (going to the toilet, washing myself, shaving, climbing stairs, not being able to do the things I want and go where I want, always depending on someone else), when I can choose not to. How do you take the bus in a wheelchair? 
Yes, it will take longer, but in my opinion this is a much better approach.
Quote from: Dingo on December 18, 2014, 12:50:09 PM
I can't really imagine myself in a wheelchair for several months (going to the toilet, washing myself, shaving, climbing stairs, not being able to do the things I want and go where I want, always depending on someone else), when I can choose not to. How do you take the bus in a wheelchair?
Yes, it will take longer, but in my opinion this is a much better approach.
Dingo, I agree with you on this one. Having freedom of mobility is a plus to drive (with your good leg) and be independent during the treatment. Let us know if you happen to go with Dr Monegal 'cause I'm also considering him.
Not to mention the psychological benefits of having a functional leg.
TomB
I'm 99% sure that the price is about €66k for all 4 bones. Half if you do 2 bones.
Leo
Quote from: Dingo on December 18, 2014, 12:50:09 PMThis is what I got from him:
TWO STAGE LENGTHENING:
1 leg (femur + tibia) + the other leg later (femur + tibia) = 64-65000 euros
1 femur + the other femur later = 34-35000 euros
1 tibia + the other tibia later = 34-35000 euros
----------------------------------------------------------------
ONE STAGE LENGTHENING
2 femurs in a single operation = 32000-33000 euros
2 tibias in a single operation = 32000-33000 euros
I'm seriously considering this doctor and I don't plan on using lifts at all. I'll just walk around in crutches with my operated leg growing longer than the other and keep it from toughing the ground like I had an accident or something. I'll stretch it and exercise it when I'm in bed or on a sofa following the doctor's physio instructions. Then I'll come back when the doctor tells me the operated leg is strong enough to bear my weight and that it's time to repeat the procedure with the other leg.
Hey Dingo
From what I read , the doctor wants you to put 20% weight bearing on the operated leg right after surgery . I feel the bone will grow faster and we can avoid ballerina if we walk around on it with crutches.
I am getting the lifts, but again only when I am at home during the evening or feel like going for a short walk. Going to work I would stick my broken leg in a sling or some other apparatus and just use the good leg and crutches.
I am for doing the right leg first. This is because during the first surgery we dont know how to deal with the crutches, pain, and our hobbled leg. So we probably wont be doing much driving anyways.
Then what that is done and we are used to the side effects of the surgery, our right leg will be full weight bearing when we do the left leg. Now we can drive a vehicle and with our experience with the crutches we should be able to be a lot more mobile .
Just my .02
There is one thing that we must be aware of and follow the instructions of the doctor very closely when doing the two stage procedure, and that is to keep the distracted length within reasonable limits.
This advice is valid for all limb lengthening procedures but in a two stage procedure it takes on a new dimension.
Why? Because most of the times, people want to do large amounts of lengthening to get a bang for their buck and then at one point one of their legs stops them from going any further due to muscle or tendon pain, ballerina, etc. So they stop lengthening and end up far from their crazy initial goal of 10cm per segment but with both legs the same length.
When doing a two stage procedure, one must really be conservative about the amount of lengthening per segment (<6cm), because you might be able to do say 8cm with your right leg during the first stage of lengthening, but then get insane amounts of pain after reaching 6cm on your left leg at the second stage, disabling you from going any further and making you end up with a 2cm discrepancy. You really don't know which leg will be the first to say "NO MORE!", when your initial goal is unrealistic.
So stick with a conservative amount of lengthening and follow your doctors instructions very carefully.
Quote from: Dingo on December 19, 2014, 11:21:00 AMThere is one thing that we must be aware of and follow the instructions of the doctor very closely when doing the two stage procedure, and that is to keep the distracted length within reasonable limits.
This advice is valid for all limb lengthening procedures but in a two stage procedure it takes on a new dimension.
Why? Because most of the times, people want to do large amounts of lengthening to get a bang for their buck and then at one point one of their legs stops them from going any further due to muscle or tendon pain, ballerina, etc. So they stop lengthening and end up far from their crazy initial goal of 10cm per segment but with both legs the same length.
When doing a two stage procedure, one must really be conservative about the amount of lengthening per segment (<6cm), because you might be able to do say 8cm with your right leg during the first stage of lengthening, but then get insane amounts of pain after reaching 6cm on your left leg at the second stage, disabling you from going any further and making you end up with a 2cm discrepancy. You really don't know which leg will be the first to say "NO MORE!", when your initial goal is unrealistic.
So stick with a conservative amount of lengthening and follow your doctors instructions very carefully.
This is a very good point. I did put some thought into it but the amount of patients who have to stop short of 5cm is very rare.
Perhaps the doctor can shed some light on this because no matter how cautious you are, if you lengthen your first leg any amount, you have to lengthen the other one the same.
I suppose they would have to stop the lengthening, let the bone consolidate as you tendons and muscle repair, then rebreak it and finish the job. That would be a major hassle but not the end of the world as you already have the internal devices still in there.
You must be logged in to post a reply.