It’s almost surreal to be writing a diary. You begin this journey years before getting the surgery done, vicariously living through the day to day diaries and updates of other patients, but almost never quite believing you will go through with it. 
My surgery was in July, 2023, with world renowned surgeon Dr Birkholtz, for bilateral femoral lengthening, including an ITB release. It took place at IOR (world class private orthopaedic institute) in the affluent region of Stellenbosch. I am between 30-40, half Italian, half Asian.
Starting height: About 175cm early noon
Goal height: 181-182cm early noon
Ammount to lengthen: 6.5cm Precise 2.2 FEMURS
Finding the right surgeon has been an almost gruelling and painstaking process. You need to be certain. You need to sometimes look yourself in the mirror and truly be brutal honest - no matter how invested you might be in a particular surgeon.
I had spoken to several surgeons, flown across the world, and had even had my surgery booked in a European country, before cancelling it altogether because I just could not allow myself to undergo this procedure when there were significant doubts and causes for concern. It was painful to walk away, it was painful to cancel a dream I had aligned my whole life around for the last few years.
When doubts surface, when you begin to learn more about worrying surgical techniques, omissions of critical aspects, and you see these manifest in current patients, there is no way I could justify taking this risk, no matter how determined I was. If you take anything from this diary, if anything I am writing makes any difference to your life, do not take the random opinion of lay people online who make claims like “ITB release is not needed” having no medical background at all. Do not fall for well-made websites, good marketing, or the gimmick of weight bearing nails. Engage in objective, meticulous and truly sober research.
Dr Birkholtz - The road to new heights | { 175 --> 181-182}| PRECISE FEMURS
PART TWO
Ignore the noise, and ignore any desire you may have within your own self to accept half baked explanations just so you can justify a surgeon or a particular nail. Engage in objective, meticulous and truly sober research. Accept harsh truths, rather than convenient lies.
Part of me didn’t want to even make this diary. The work to afford this surgery, the many disappointments I have been through in surgeons I consulted, and the surgery itself, put me in a place where I genuinely just wanted to lengthen, change my life forever, and move on quietly.
However, I ethically can’t allow myself to do this. There are people out there who are intelligent, determined, who have this deep rooted dream, excitement and courage to undertake CLL, but because of the misinformation, may well make choices which adversely affect their lives, or cause significant unneeded suffering.
The advice I will give also applies to this diary itself. Don’t just take what I write as gospel truth. Don’t trust any random anecdotal accounts, but perform your own rigorous and objective research. Find out for yourself.
In my next post, I will detail why I made my decision to go with Dr Birkholtz, and why I believe this is arguably one of the few world-class surgeons/packages. Now approaching four weeks POST OP in about a weeks time, I am living through this, so whatever you read are real experiences.
I want to make my diary detailed and brutally honest, and I hope, and sincerely pray, that I am successful in my journey, and that, whoever you choose as a surgeon, you are safe and successful in yours too.
I had consulted with over four to five different surgeons, and even had my surgery booked with one of them. However, in my year or two of research, I began to realise that this was a very unregulated field. I am not here to name any surgeons directly, but I will instead focus on what I looked for, and why I found it in Dr Birkholtz.
He wasn’t just an orthopaedic surgeon who qualified and then went into CLL. He has extensive experience in trauma, research, teaching. In fact, he is one of the surgeons people often go to when they are botched/butchered in other countries. That is the caliber of surgeon I wanted, someone whose breadth, depth, and expertise expanded far deeper than CLL, but still retained a significant and long standing body of work in both medical and cosmetic limb lengthening.
To put this in perspective, during my time in the waiting area before viewing X-rays, I saw patients of his of all ages. I then consulted with him and he discussed research. The next morning he came to see me first thing before anyone else, suited up, and about to go lecture/support at a university facility. Anyone in the medical field will tell you that a doctor of high caliber does exactly this - operates, researches, teaches and grows.
He is regarded as world class by respected peers in the US and abroad, and has partaken in training some of the doctors. You can verify this for yourself.
Ethically, he has had to deal with many cases of botched surgeries. During my meetings with him, it was clear how saddened he was by adverse outcomes, and aside from his obvious skill and experience, I could sense the empathy and genuine desire to put safety at the absolute forefront. Of course this is ultimately a business - but this is not a surgeon with money at the forefront of his mind. This is a surgeon who wants to provide quality , safe, and world class treatment - and if money comes as a result of providing value, then that is accepted.
And ultimately, when you’ve left your family and flown half way across the world, I can’t express the peace it beings to my heart to see him walk in - very tall, but extremely personable and friendly, and a truly calming presence.
He in someways, is ultra protective over every single patient. This to me was critical. Some surgeons will happily perform the surgery and have you fly home after a few weeks. Dr Birkholtz follows the same model as elite US surgeons - he wants you to remain for the lengthening period minimum / has a 3 month package.
You will get X-rays every 2 weeks, he will meet you right after in person and extensively discuss them. While in hospital , I was there for 3-4 weeks and he came to see me almost twice a day, sometimes three times, to the extent we joked that we were running out of topics to say to each other.
I recall how he once said to me that if there was an adverse outcome, he would look after me - he was not one to refer me elsewhere or add on a big bill. There’s a personal sense of pride and true value here.
There is a world-class post-OP care. Some surgeons will send you home and you find people having Skype physio sessions or once a week after the first two weeks. With Dr Birkholtz, he hasn’t tried to skim money off and take short cuts.
You have physiotherapy at your bedside / and then gym twice a day for a whole month, followed by 5x a week (more if needed) for the next two months. This is arguably the most important part of the journey. So many people simply underestimate the critical importance of rehabilitation.
And who do you get as a physiotherapist? An ex elite rugby player, and an individual who has extensive experience in dealing with trauma patients, and running his own business. Dr Birkholtz is clearly overqualified, and the main physiotherapist, falls into this category. This is someone with extensive medical experience, who is bringing that - and also experience in CLL. That gives you a lot of confidence. You want someone with breadth and depth of knowledge and expertise to call upon, because they can identify when thing go wrong, what things are safe.
In typical Dr Birkholtz style, he has employed a dietician and a psychologist, who also work with you for your journey. I received another tub of high strength protein, and a tailored diet from my dietician. I have weekly sessions with my psychologist to truly process all of the many feelings and emotions, highs and lows this surgery can make one go through.
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Is he losing money by going the extra mile? Yes. Is he increasing value, safety, and providing a truly ethical package? Absolutely.
It was Mid July, and I made the leap and had a zoom consultation with Dr Birkholtz. Of all the surgeons I spoke to , flew to, and met, by far, he instilled the most confidence in me.
He immediately identified all of the key areas where one would be concerned and explained to me how he would address them. He wasn’t here selling me dreams of 10cm, he was blunt, honest and clear about his safety first approach - which still yields very good results and my target anyway.
In Summary:
1. World class osteotomy technique, unlike in many other places where the technique is dangerous.
2. ITB release par on par the same technique used by Paley. A proper ITB release mind.
3. No over-reaming , no electric bone saw, and he orders two sized nails to ensure during surgery the best and safest is used.
4. Rather than throwing you on a ward for three days and discharging you, he places you in HDU/ICU for one day to ensure if there is fat embolism you will be looked after well.
5. A 2-3 weeks hospital stay at a private, award winning hospital , nobody else does this.
6. Bi-weekly X-rays, just like other world class surgeons. You meet him right after. He has very close eyes on you.
7. You lengthen and stay here 3 months minimum. He provides accommodation, food, x-rays, taxi, laundry, physio. No half doing it and flying in 2 weeks and compromising your safety.
In short, he offered the safest , and most comprehensive approach. As a doctor I get very anxious, over worry, and have a hundred outcomes in my head. Especially with all the lies/unsafe surgeons and half truths. He was the only one I actually trusted.
You are the ITB guy. Good luck with your journey. You made the right decision to change the doc and I am happy to see you listened to others.
I must admit I didn't believe you would go through with it. Again, good luck and have a safe lengthening
Now the nerves started to climb, and everything began to feel very real. There was a feeling of genuine excitement, to pursue a path to fulfil a deep-rooted dream and change your life, but also a sense of nervousness about what might happen.
As Dr Birkholtz said, to calm my nerves, if you weren’t nervous, then you would not be normal. Having spent time with my family, packed a lot of shorts, Vitamin D, Calcium, I made my way to the airport.
It was a gorgeous flight (with one moment of scary turbulence) , direct, to SA. Dr B and the team had arranged pre-op accommodation for me, two days prior to the surgery, at a 5 star hotel. All my meals were brought to me. I met with the driver at the airport, who looked after me, and then took me the next day to Dr B for extensive x-rays and a one to one conversation a day before the surgery.
I spent two days reflecting, talking to close friends, watching a lot of Netflix at the hotel, and mentally getting ready to make the leap.
Impression? Beautiful country, and you get a sense - a real appreciation - that they are going to absolutely look after you.
When landing, I remember just being blown away by the mountains and natural beauty. I remember thinking to myself, when all is said and done, I have to travel and explore this breath taking nature. How on earth are there penguins in South Africa?
Stellenbosch, in Cape Town, is safe. I would compare SA to a place like the US. Would you compare Baltimore with up-state Manhattan? From the hotel, to the subsequent accommodation I was placed, in this specific area, which appeared extremely affluent and well governed, I felt very safe. But I would not venture into other parts of SA, in the same way I would not venture into random US states.
And then the big day came.
“If you can dream and not make dreams your master, if you can think and not make thoughts your aim” - Rudyard Kipling poem “IF”.
Stellenbosch:
Krieger hotel, where they housed me 2 days pre-op:
Very nice and interesting diary so far. Looking forward to hearing more. Especially on the post op care which by the sounds of it is perhaps the best. Could we ask how much you paid for the whole thing approximately? I can imagine it would be somewhere in the likes of 100k EUR.
Quote from: TheDream on September 02, 2023, 11:48:13 AMVery nice and interesting diary so far. Looking forward to hearing more. Especially on the post op care which by the sounds of it is perhaps the best. Could we ask how much you paid for the whole thing approximately? I can imagine it would be somewhere in the likes of 100k EUR.
60k dollars actually
Quote from: informationispower on September 02, 2023, 12:26:17 PM60k dollars actually
Does this include all the post op recovery, food, accommodation for the entire duration?
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