I have been conflicted as to whether to share this experience. However, if my experience can help others decide if this is the correct course of action for them then it is at least worth sharing as I had some unique experiences.
Background information: Male, about 40, starting height 5'3 and 1/2
March: I did two surgeries three weeks apart - one leg at a time. In each surgery, they did femur lengthening and corrected my bowleg from my tibia.
Pre-surgery: Spent three months prior to surgery going to Stretchlab and working on flexibility. I went to Stretchlab 5-7 days/week and my flexibility improved substantially. I recommend everyone stretch as much as possible prior to the procedure. I shudder to think about what my experience would have been like if I did not do this.
Initial recovery (first two months): Pain was 10 out of 10 for me. It took some time to figure out pain management. I was definitely the odd man out compared to others. Everyone else I spoke with had nowhere near as much pain as I did.
Mid recovery (months 3-6): Pain was manageable to almost non-existent. Legs feel heavy and sore all the time. Muscles tightened substantially. Outside of this though, the process was very manageable and it's just a daily grind. I had to accordion on one leg and slowed down lengthening substantially towards the end of the process. I went for the full 8cm and was able to accomplish this.
Late recovery (months 6-now): Went home after lengthening and was able to book time on anti-gravity treadmill as well as go to Stretchlab frequently. This has helped recovery move at a very fast pace. I was able to fully consolidate and weight-bear about two and a half weeks after lengthening in each leg.
Was it worth it? 100% Absolutely! Would do it again in a heartbeat! I am adjusting to the experience of being taller. I am about 3 and 1/4 inches taller now and still have some slight duckass. I anticipate I will be about 3 and 1/2 inches taller from the first surgery when all is said and done. 3.15 inches from lengthening and up to 1/2 inch from bowleg correction.
Next steps: I am going back to Sinai to do Tibia lengthening. My surgery is scheduled for early November. I am aiming for two inches from Tibias and will be happy to get to that point.
If you have any questions please feel free to ask and I will respond as well as I can.
Dr. Assayag - 3/22 Femur Lengthening/Tibia Bowleg - 11/22 Tibia Lengthening
Quote from: EndGame on October 11, 2022, 09:43:44 PMSo you had bowlegged tibias on both right and left?
They couldn't do the correction and lengthening on tibias at the same time? Or just easier to do it first since already surgery for femurs?
There were a few different options all with their own pro’s and con’s.
Quadrilateral
I knew I wanted to lengthen as much as possible. The highest probability of success was doing that over two surgeries. We have all heard how difficult quadrilateral lengthening is. We have also seen how many people have tried that and come up short of their goals so that approach was not a serious consideration. I was interested in getting six inches if possible.
Femur lengthening followed by Tibia later
Ideal approach. Allows you to get the most length possible in the safest way. Staging it this way also provides a more clean exit point if I decided after the first surgery I am happy with my height. If I did tibia lengthening first, then I would get less height most likely. If it was a horrible experience, I would also be less inclined to do a second procedure. Lengthening from Tibias only also increases probability of knee/joint pain later on.
Bowleg correction and Tibia lengthening at the same time
While it can be done together, it gets complicated and harder to control results. Separating them seems to be the best course of action.
Femur lengthening and bowleg correction - followed by Tibia lengthening later
This is the option I settled on. It addressed my desire to lengthen and get the most height possible if I only did one lengthening procedure. It also allowed me to correct my bowleg and knee alignment issues at the same time. Otherwise, I would need to wait 6-12 months and then get them corrected. I didn’t imagine I would want to do that again, particularly if I had a bad experience in the first surgery. Another upside of this approach was that because a portion of the surgery was medically necessary, insurance was able to cover costs associated with that part of the procedure.
Quote from: shortisnotfun on October 11, 2022, 09:58:39 PMInteresting. Do you feel more confident now?
Hmmm, not sure how to answer this. I didn’t really have confidence issues prior. I was at the extreme end of short for an American male which makes people less likely to take you seriously. Despite this, I have had a lot of professional and personal success. Instead of spending time fixated on my height, I spent time and effort working on everything I can control.
With that said, I found out about the procedure through an IG meme October 2021 and spent about a month researching before flying out to meet Dr. Assayag and scheduling surgery. I feel that the increased height will open more doors for me professionally and socially. The ugly truth is that there are a lot of doors that are harder to open when you’re short. Not impossible, just more difficult. The height increase levels the playing field.
I can give a more thorough update on life after the surgery when I am 6-9 months post the next procedure. I think next summer I will get a better feel for that.
Quote from: cllin2022 on October 12, 2022, 08:17:29 PMHow much calcium/vitamin D did you consume throughout lengthening? Did it differ when you started consolidating? I’m in the consolidation phase for 8cm Precice femur but consolidation is taking longer than expected. I’m scheduling tibias to hit 6’ but I don’t want it to be a year-long ordeal.
I may be off on the numbers as I am doing this from memory but I took the same amount that I was taking throughout the entire procedure. I think that is 500mg of calcium 3x/day and then vitamin D as well. Don’t kill me if I have the dosage wrong and you are seeing this Dr. Assayag.
The things that I think helped my consolidation along were the following:
- I had slowed down to 0.50 towards then end and had to accordion one leg so there may have been more bone there than others at that point
- I did the alter G at least 2x/week while in Baltimore. When I went back home, I found a place where I could buy alter G sessions and went 4-5x/week. Each time I went I raised the body weight % by 1-3%. The bone responds to stress and I think this probably helped.
- I used the walker and stood a lot, even for stretches and moving around as much as I could. I noticed I did more than others throughout the procedure. Now if I bent a nail from putting on too much weight before I was ready, I could be singing a different song right now but I did not.
- I purchased one of those ultrasound bone growth stimulation devices. Dr. Assayag doesn’t recommend them that often but he was able to write me a script for one which I purchased and used a lot during consolidation.
The cost of the first procedure was partially covered by insurance. The second procedure costs about $55k not including PT after that.
Every Procedure is Different - 6 Week Update
The difference between the first two surgeries in March and this surgery in November is night and day. On a scale of 1-10, my pain level with the first series of procedures was a 10 out of 10. I needed to remain on opioids for much longer than the standard time of 10-14 days. This time around, my pain level on a scale of 1-10 was hovering around 2-4 when I first got out. By about days 8 and 9 after the procedure, I was able to stop taking all pain medication. I have taken Tylenol occasionally since then, but pain levels are much more manageable than the first set of procedures. From my interactions with others here, I seem to have an experience that is more in line with the norm this time.
Dr. Assayag made some slight adjustments in my right tibia for bowleg and therefore I did not start my lengthening until November 16, 2 weeks after my procedure. People normally start lengthening 7 days after the procedure. Since then, I have lengthened .75mm every day. The time is moving by fast, and I am almost halfway to my goal of 2 inches. I am currently at 22mm.
Bone growth has been great and I have an appointment with Dr. Assayag this Friday and will get an update on how things look.
Other things I would note are:
1) Just like my first set of surgeries, each leg seems to have its own experience and the aches and pains will come and go. This time around my right leg hurts at the osteotomy site (still there). The top right portion of the left foot tingled and felt numb for a few weeks (that has now gone away). Back left where the tendon release was performed felt like a muscle was tearing weeks 4-5 and that is now going away. Right knee is starting to hurt at times but that is going and coming. Everyone has random pains, its just part of the process.
2) I have used my TENS and EMS machine much more frequently. Really helps when trying to address any aches and pains as well as when doing exercises and ensuring the correct muscles are firing.
3) I have the 75lb weight-bearing nails. I was standing frequently but have cut back on that due to the pain in the right leg at the osteotomy site.
4) My new routine is to stretch while in the shower both in the morning and the evening. The heat helps, and it is really easy to put your leg up and stretch your calf on the shower ledge that they have at HP house.
5) I purchased a shiatsu foot and calf massager. That has really helped to massage my calves and release tension. Also, by controlling the tilt, I can get a foot massage and stretch my calf muscles simultaneously. I use this at least twice a day.
All in all, this time around the procedure has been much easier than the last time, and I have no complaints. The major difference that I would highlight is more about the daily grind. I'm past the excitement and now it's just the daily grind of getting up and making sure you are doing everything you should do. I will be happy to get through lengthening and consolidation to focus on building muscle and getting back to walking and being mobile.
Quote from: Ceiling on November 13, 2022, 05:34:03 AMThank you for sharing your experience!
May I ask whether you stay near Sinai for the first few months, e.g months 1-3? If not, is it okay to have PT in your local clinic?
My concerns are mostly about time management for the recovery stages since my daily working hours are pretty long (WFH). I am not sure whether the pain and the PT would take up most of my day to deal with.
I would appreciate any of your input!
I am staying at the HP house, which has great logistics and is only $15 per night. If your insurance covers outpatient PT at Sinai, it is right across the street. The majority of us purchase mobility carts, and we just drive ourselves over to get PT when we need to. The mobility cart also gives you the ability to go the hospital cafeteria or park whenever you want. If your insurance does not cover outpatient PT, you can use Moshe, and he comes right to your room.
Finding handicap-friendly accommodations in Baltimore is challenging. I would suggest just staying at HP house and making things easy on yourself.
Quote from: Black Android on November 17, 2022, 08:27:15 AMInsightful. May I ask:
1. Did you use plate fixation for the tibial correction part?
2. When did you start lengthening for the first and second legs? Did the first leg reach its goal first, soon followed by the second leg?
Yes, I had plates for the tibia correction. I also could not bear weight for six weeks on each leg. Think about this being a total of 9 weeks when you include the three-week break between each surgery.
I started lengthening about a week after surgery. The first leg finished lengthening about 2-3 weeks before the second leg.
Quote from: SpeedDialer on November 13, 2022, 05:52:37 AMWhat were some differences (if any) in stuff you would bring with you for tibia lengthening?
Compared to femur lengthening I mean
I'm doing gnail femurs now in Athens, I'm thinking of doing tibia precise 2.2 in Athens about 1 year from now and I'm thinking about my packing list
I'm also thinking about doing nail removal with Dr. Assayag eventually and am trying to work out the logistics of it, I might be able to stay at someone's house a few hours drive away from him in Maryland
I somewhat discussed this but the things I am using more frequently than I did during my first surgery are:
- TENS/EMS machine
- Shiatsu Massager (wouldn't bring with you but would order when there)
- Orthofix Bone stimulator; using it a lot more frequently this time around
- Slant Board; used a lot for a week or two but have cut back recently. Also another item I wouldn't bring but would get delivered to me when I get there.
You will probably need to buy a plantar fasciitis leg brace as well. Outside of that, I don't think the packing list is much different and the majority of items are things you can order when you get to the facility.
Regarding the removal, staying at HP house is always an option. I met a guy who came in to have his nails removed and stayed at HP house for about 4 days. It is $15/night to stay so no reason why that is not a viable option.
I haven't been as consistent with this as I would have hoped but I would like to provide some quick updates.
Lengthening Complete - February 8, 2023
I finished lengthening. I stopped at 50mm and was happy with the process. Compared to the first procedure, the pain was a lot less. My right leg, however, was extremely tight. At this time, I was unable to straighten my right knee while laying down or standing. Outside of the extreme tightness in my right leg, everything else went smoothly. One thing I would note is that my bone growth during the procedure was particularly strong. Dr. Assayag indicated that this is one of the best regenerates they have ever seen.
Final Appointment with Assayag - March 3, 2023
I had my final appointment with Assayag before heading home on March 4, 2023. Bone growth continued to look really solid and I was cleared to walk as tolerated. I flew home the following morning, and have been home since.
Recovery at Home
This Saturday, will make it three weeks since I have been home. Compared to last September/October when I came home, I feel a lot weaker. This makes sense given I had another procedure prior to fully recovering from the first. The first week home was a bit of a wash as I was focused on transitioning care to new physical therapists/etc. The second week and this week have been much more productive. I have put in place a routine of PT 2-3x/week coupled with 3-5 days of stretching at StretchLab and also working out at the gym or on the alter G treadmill. I am aiming to be walking without crutches or support sometime in May with a more normalized gait by June/July. Friends have been super supportive and I am looking forward to that engagement.
It seems like a lot of people disappear from the forums after they go home so I will try and stop in every few weeks with an update so people can understand the amount of work and time it took to recover.
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