Quote from: ten on December 25, 2022, 04:24:25 AMI think you are overstating the importance of blood thinners because many other world renowned doctors don't prescribe it for beyond 2-3 weeks after surgery. Guichet, Giotikas, Assayag, Gdalevitch off the top of my head. Some of them are Precice docs and even then don't give blood thinners for months after surgery.
I wish we could know if ratcheting nails make the problem worse. But we'll never know unless these doctors publish data. Has Betz published a paper after his decades of experience documenting all the complications his patients faced? I don't think anything like that exists for GNail also. I personally know of 3 cases of PE so far in people who used ratcheting nails.
Can‘t speak for any Doctor but a Giotikas patient I was texting with had it for almost the end of lengthening. I am not overstating it. If you don‘t want PE, you take it. It has very little side effect profile so no reason to quit it early in my opinion. Seems like some people just like to be in trouble.
Tell me one logical reason that albizza nails could increase PE risk? There is like no connection. Research how it develops first please. I already told the PE we talk about is a dislodged Deep Vein Thrombosis, the risk for that is a general risk in (orthopedic) surgeries. It‘s not LL specific. In medicine there is the three F for risk factors. Female, fat, fourty. So females who are obese and 40+ years old.
Ok so how does it develop. Because of bedrest and immobility your veinous blood isn‘t pulled back to your heart as it‘s supposed to. So blood clots can form because it‘s standing still more than it should. A swollen heated painful leg on one side is a symptom of DVT. If it dislodged it will travel to the lungs which is then called PE. what blood thinners do is increasing the antithrombolytic effect. So your blood doesn‘t clot that well. That‘s also why you bleed longer and more with them.
So knowing that. I am curious why albizzia nails should have any difference with that?
And yea Betz had lots of German Papers over the years. He showed me back then.
Your claims are kinda pulled out of nowhere with little causality, but please feel free to prove me wrong.
Quote from: RealLostSoul on December 25, 2022, 10:33:29 AMCan‘t speak for any Doctor but a Giotikas patient I was texting with had it for almost the end of lengthening. I am not overstating it. If you don‘t want PE, you take it. It has very little side effect profile so no reason to quit it early in my opinion. Seems like some people just like to be in trouble.
Tell me one logical reason that albizza nails could increase PE risk? There is like no connection. Research how it develops first please. I already told the PE we talk about is a dislodged Deep Vein Thrombosis, the risk for that is a general risk in (orthopedic) surgeries. It‘s not LL specific. In medicine there is the three F for risk factors. Female, fat, fourty. So females who are obese and 40+ years old.
Ok so how does it develop. Because of bedrest and immobility your veinous blood isn‘t pulled back to your heart as it‘s supposed to. So blood clots can form because it‘s standing still more than it should. A swollen heated painful leg on one side is a symptom of DVT. If it dislodged it will travel to the lungs which is then called PE. what blood thinners do is increasing the antithrombolytic effect. So your blood doesn‘t clot that well. That‘s also why you bleed longer and more with them.
So knowing that. I am curious why albizzia nails should have any difference with that?
And yea Betz had lots of German Papers over the years. He showed me back then.
Your claims are kinda pulled out of nowhere with little causality, but please feel free to prove me wrong.
I know of a patient who was using clicking nails and was asked to speed up his lengthening and do a lot of clicks on one day because he was lagging behind. He was told to take xarelto on that day in particular and not on other days. My understanding is trauma and rest causes blood clots to get formed and clicking is more traumatic than using magnetic nails. This + how many docs don't prescribe xarelto for the full duration of lengthening made me think it could be slightly related to clicking. I have no scientific evidence. Can you give any links to Betz German papers where he has mentioned complication rates? I think that would elucidate this for us.
Btw when Stryde was around, even Paley used to give just aspirin to his patients. With precice it is xarelto. This info is in his official guide doc. It says "Since you have the S nail and are allowed full weight bearing as tolerated we only use 81mg aspirin twice a day for prophylaxis."
https://paleyinstitute.org/wp-content/uploads/StatureLengtheningGuide-Website.pdf
Quote from: ten on December 25, 2022, 12:22:23 PMI know of a patient who was using clicking nails and was asked to speed up his lengthening and do a lot of clicks on one day because he was lagging behind. He was told to take xarelto on that day in particular and not on other days. My understanding is trauma and rest causes blood clots to get formed and clicking is more traumatic than using magnetic nails. This + how many docs don't prescribe xarelto for the full duration of lengthening made me think it could be slightly related to clicking. I have no scientific evidence. Can you give any links to Betz German papers where he has mentioned complication rates? I think that would elucidate this for us.
Btw when Stryde was around, even Paley used to give just aspirin to his patients. With precice it is xarelto. This info is in his official guide doc. It says "Since you have the S nail and are allowed full weight bearing as tolerated we only use 81mg aspirin twice a day for prophylaxis."
https://paleyinstitute.org/wp-content/uploads/StatureLengtheningGuide-Website.pdf
The trauma argument I do kind of understand but I don‘t think it‘s that much of a difference tbh. Else people who use mechanical nails would have a significantly increased risk but nobody I ever knew had that complication unless they actively stopped using bloodthinners against the doctors orders (that goes for both mechanical and magnetical nails). I mean you could do a study yourself perhaps that hasn‘t been done before: See the incidence of DVT in mechanical vs magnetic nails. But I think that‘d be hard because a) you couldn‘t make a control group where you don‘t give patients bloodthinners b) too much bias and confounders in noncompliance (see how many people don‘t follow doctor‘s orders. Also very hard to get everything out of the equation, like different activity levels of patients etc)
it‘s not like magnetic nails don‘t lengthen. And lengthening is always trauma, either way.
Yes, so it‘s been 2 years since I had the initial consult with him. I remember he sent me some publications back then. I just did a quick search and found he has 94 publications tracked on researchgate. Some of which are english, some german. Tbf, I don‘t have the time on Christmas today to go through all of them.
I think if you are really curious you can just check it out yourself, here you go:
https://www.researchgate.net/profile/Augustin-Betz
Yea so? I said that weightbearing and being mobile reduces the risk, but they still give you aspirin as a bloodthinning med. just proves my point that even with weightbearing you still need some form of bloodthinners
But man why are we even arguing about that? I got like literally 0 side effects from blood thinners. I could take them forever. So no reason to not take them, why does this have to be such a debate? If you don‘t want or can‘t take bloodthinners for whatever reason than don‘t do the surgery. It‘s that simple.
Quote from: RealLostSoul on December 25, 2022, 01:26:29 PMThe trauma argument I do kind of understand but I don‘t think it‘s that much of a difference tbh. Else people who use mechanical nails would have a significantly increased risk but nobody I ever knew had that complication unless they actively stopped using bloodthinners against the doctors orders (that goes for both mechanical and magnetical nails). I mean you could do a study yourself perhaps that hasn‘t been done before: See the incidence of DVT in mechanical vs magnetic nails. But I think that‘d be hard because a) you couldn‘t make a control group where you don‘t give patients bloodthinners b) too much bias and confounders in noncompliance (see how many people don‘t follow doctor‘s orders. Also very hard to get everything out of the equation, like different activity levels of patients etc)
it‘s not like magnetic nails don‘t lengthen. And lengthening is always trauma, either way.
Yes, so it‘s been 2 years since I had the initial consult with him. I remember he sent me some publications back then. I just did a quick search and found he has 94 publications tracked on researchgate. Some of which are english, some german. Tbf, I don‘t have the time on Christmas today to go through all of them.
I think if you are really curious you can just check it out yourself, here you go:
https://www.researchgate.net/profile/Augustin-Betz
Yea so? I said that weightbearing and being mobile reduces the risk, but they still give you aspirin as a bloodthinning med. just proves my point that even with weightbearing you still need some form of bloodthinners
But man why are we even arguing about that? I got like literally 0 side effects from blood thinners. I could take them forever. So no reason to not take them, why does this have to be such a debate? If you don‘t want or can‘t take bloodthinners for whatever reason than don‘t do the surgery. It‘s that simple.
I didn't say people shouldn't take blood thinners (I think people should listen to their doctors, period). This whole debate is around whether clicking nails can cause PE. I was proposing the idea that clicking may have had a role to play in PE while downplaying the link between extended (3-4 months) use of blood thinners and PE and your stance was the opposite. We need data to be sure.
Went to Istanbul and walking around well without crutches. Can go about 10 min without crutches and 25 min with. PM if you want a video. No pain outside of fisio stretching but still on tramadol.
How much did you lengthen? How much time did it take?
Went through 3 airports while pushing luggage with no help including waiting in lines; though, the crutches typically get you moved to wheelchair line. Going to the gym regularly now. I am able to walk faster and more confidently without crutches including stairs. Can treadmill walk with and without the rails for 30 minutes at the gym at a speed of 4.0. I take short walks outside but here (I'm in the Phillipines now) there's lots of people during the day and I'm scared of someone knocking into me so I keep the crutches. Have been keeping up with stretches here but have to find a fisio here locally. Working on R sided Tredelenburg because of R sided gluteus weakness. Consolidation is excellent and nail and screws have not moved or bent etc since surgery. Pain is 0 in the legs most of the time with occasional soreness/tightness when waking up. Go to Dr. G guys.
See video
https://youtube.com/shorts/0LjpSEtMTzE?feature=share
Quote from: leonazul99 on November 19, 2022, 10:18:56 AMWhen I met Dr. G, I was told to stop clicking, so I am satisfied with 9.8cm gain on femurs
Quote from: leonazul99 on December 24, 2022, 05:08:42 PMAs measured by xray-9.6cm on the L
you stopped at 9.8cm but it measures 9.6cm
where did the 0.2cms go ?
3 week update with walking without crutches. Gait significantly better and tredelenburg almost gone. The effort required to walk is lessened and walking further distances is less intimidating. Steps are easier with no rails. Flexibility continues to improve daily. Continuing with intense therapy in Manila. Físio is excellent and much more personalized than Greece. Pelvis is now 95% even and back in place. Lower back pain gone. Started tapering off anticoagulants this week. Only pills now are occasional tramadol for upper back pain and I continue daily supplements of vitamin d/calcium/mag. Also started protein shakes given I’m back in the gym.
Filtered for ages 18-24 = )
I thought 9+cm would be a lot but you look good and well proportioned. Congrats on the recovery.
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