Dr. Assayag - 3/22 Femur Lengthening/Tibia Bowleg - 11/22 Tibia Lengthening

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What 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

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Insightful. 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?

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whoops, I made an unnecessary post please ignore this, see above

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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.

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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.

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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.

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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.

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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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Hey, congrats and thank you for this thread, would it he possible to share some post pics of proportions after youre finished? Just because i am planning to do quadri too. If its too personal for you i understand that. See ya and take care

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Quote from: slowed & reverb on March 24, 2023, 08:39:58 AMHey, congrats and thank you for this thread, would it he possible to share some post pics of proportions after youre finished? Just because i am planning to do quadri too. If its too personal for you i understand that. See ya and take care

I did not have plans to post pictures but I will think about it. What I can share is that my wingspan indicated I should be about 5' 8" while my starting height was 5' 3.5". I gained at least 5" and I am now the same height as one of my friends. When he came over, we compared the torso/leg ratio and we are pretty much the same.

Taking a step back, I believe proportion concerns are generally overblown. There are racial differences in torso/leg ratios -- black people tend to have shorter torsos and longer legs while white and asians tend to have longer torsos and shorter legs. On top of that, there is also a lot of variability in the population. Unless you are adding an excessive amount of height, I don't think it's anything to worry about. I guess we can always debate what an excessive amount of height is but for most people who do this surgery I think there should be no concerns with 2-3" and based on my experience and what I saw at the clinic also no concerns for less than 5" for most people.