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Posted on May 12, 2024, 8:53 am
#21
Your experience with clicking the G-Nail is EXACTLY what happened to me.

Clicking the right leg was very difficult after 2cm and it wasted me hours every day and became a torture.

Seems like there are people that this doesn't happen to them, but for me this was exactly the experience. You can check my diary.

I hope it will become easier for you somehow.
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Posted on May 12, 2024, 3:43 pm
#22
Why did the PT team stop visiting you? Shouldn't visit you r times a week? Do you pay for PT? Are you able to do PT by yourself?
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Posted on May 12, 2024, 11:49 pm
#23
Quote from: WishMeLuck on May 12, 2024, 08:53:47 AMYour experience with clicking the G-Nail is EXACTLY what happened to me.

Clicking the right leg was very difficult after 2cm and it wasted me hours every day and became a torture.

Seems like there are people that this doesn't happen to them, but for me this was exactly the experience. You can check my diary.

I hope it will become easier for you somehow.
I'm one of those lucky patients that clicking was extremely easy for me on both legs. Most of the time I spent no more than 10 minutes each leg. I flew back home couple days ago after ~8cm lengthening (2.5 months total).

Quote from: wes07 on May 12, 2024, 03:43:27 PMWhy did the PT team stop visiting you? Shouldn't visit you r times a week? Do you pay for PT? Are you able to do PT by yourself?
The PT person stopped visiting us at the hotel after about 1-2 weeks post surgery but we still went to the PT center 4 days a wk (MTThF)
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Posted on May 28, 2024, 4:14 pm
#24
Any update on your progress? Over a month, hope you're doing ok.
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Posted on Jun 2, 2024, 12:29 pm
#25
End of distraction update

Height increase: 57mm L / 60mm R

Days since operation: +67

Final height: 178cm


It has been a long time since the last update. I went back to work, which has taken a lot of my time.

I’m happy to say that I’ve finished lengthening, successfully reaching the upper limit of my goal (6cm), while also correcting a minor discrepancy between femurs. While the process has been challenging, I’m lucky to not have had any complications, and still retained a good amount of muscle.

Clicking
At the time of my last update, I was struggling significantly with clicks. It did get easier (5/10 stress) after I took a break day and reduced the distraction rate to 0.8mm (12 clicks).

However, around 5 weeks post-op I had a friend over and decided to go to the beach for a few hours. The extra strain on my muscles from that day caused another ~10 days of stressful clicks (8/10 stress).

I would strongly recommend taking it easy with your muscles during the distraction phase, especially if you have significant muscle mass around the femur. The biggest mistake I’ve made during the process was going too hard too soon.

A few other things that helped with clicking:
  • Taking a warm shower or using a warm compress before clicking
  • Raising your foot progressively as you gain more length. I progressed from 1 pillow -> 2 pillows (@20mm) -> 3 pillows (@45mm)
  • Not rushing the clicks, taking as much time as needed and stretching into it. If you put too much force, not only will it cause more pain, but it will condition your brain to be more stressed for the next clicking session.
  • Putting on something distracting that you enjoy while you click. My drug of choice was binging Haikyuu.
  • For the worst days, CBD helped. However, the Dr. said there is a study linking CBD to slower consolidation.
  • Reducing the rate to 12 clicks.

Moving to Airbnb
After just under a month of staying at the hotel I moved to an Airbnb. It was definitely the right decision, as I had more space and independence. I felt more like a functioning adult and less of a vegetable.

I still strongly recommend staying in an accessible room of a hotel for at least the first 3 weeks. You will have a very hard time showering or going to the bathroom otherwise.

Things to look for or ask the owner when getting an Airbnb in Athens:
  • Make sure it’s on the ground floor. Very few buildings have a lift.
  • The shower box must be big enough to fit a showering seat.
  • It’s best to find an Airbnb near the Physical Therapy center, as you’ll be going there 4 times a week. I made the mistake of getting a farther out Airbnb and was spending 50m a day uncomfortable in a car.
  • Check that there are no or very few steps to access the place.
  • You can negotiate a cheaper price for a long-term stay by directly contacting the owner. I got ~30% off.

Lengthening
I’ve decided to stop at the upper limit of my goal: 5.7cm on my left (shorter) leg, and 6cm on my right. Although my original post said I was at 171cm, I believe that was a measurement error, as I later measured 172cm before clicking and now have been measured at ~178cm. I'm happy with this height, as it's slightly above average where I live, and I believe I have a high likelihood to get back to doing sports at a similar level.

Final x-ray:
Dr. Giotikas 5cm bilateral femurs with G-Nail (detailed)

Beyond 4.5cm, muscle tightness got pretty bad. I would need to wake up and stretch ~3 times during the night to get back to sleep. It was also hard to sit down and work for more than 1 hour at a time without having to stretch. The PT sessions became increasingly painful, especially the quads and glutes stretches. I would recommend doubling down on quads and glutes stretches before you do the surgery.

At the end of distraction, the tightness has slightly decreased every day. Although I don’t have the same mobility yet, it feels really good to have positive progress rather than negative.

Mobility
At the Airbnb I was walking with crutches most of the time, only using my chair to move large things or working.

At the physio, I was walking for 15 minutes with 50-40% support at ~1.6km/hr (slow, I know). My walk looked very natural.

Now after distraction I’ve been taking a few unassisted steps every day. My walk is looking pretty good, although slow. The doctor was (I think purposely) ambiguous if I could or couldn’t take unassisted steps, but I will continue to progressively walk more every day. I might upload a video later.

Sleep
Sleep has gotten better at around ~4 weeks post op. I was able to consistently get 5-6 hours of sleep. Then it has gradually improved, especially recently that I can comfortably sleep on my side.

Work
I went back to work part-time +33 days post-op, then full-time 2 weeks later. It was challenging to work while keeping up with the PT and clicking routine. I would say I was around a ~70% level of productivity as before. Though before the operation I would normally put in 55-60 hrs/week at work.

Trip back
The trip back was a bit taxing, but manageable. Dr. G’s driver took me to the airport, where they had a special assistance person assigned to me. They wheeled me around, going through priority queues (felt like a VIP), until the flight was ready. Since the plane was parked outside, they put me on a lift to get on the aircraft, before the other passengers boarded.

I had some pain in my leg from sitting down for too long, but I stood up and stretched my legs 3 times during the 3hr flight which helped.

Height and perception
I’ve started noticing a big difference from 3cm onwards. The nurses and PT staff were noticeably shorter at every 1 cm increment. At around ~177cm, I stopped having the feeling I used to have around men taller than me of being subtly inferior. I felt more on “equal footing”. Also, a significant number of women started looking “petite” to me, when before that was rare.

At the airport on my way back, I was within a crowd for the first time. I definitely felt more confident and masculine than before.

I met my dad again recently who is ~174cm. The difference in cm is small, but the perception is wildly different and noticeable. I’m very skeptical that you can hide this change from your closest friends and family, unless you’re already very tall.

Overall, so far I feel like I got exactly what I did this for. However, it’s early days, so it’s possible that the effect can wear off over time. I’ll keep you guys posted.

Consolidation
I expect the consolidation phase to take another 3 months. I’ve been given strengthening exercises mostly for the glutes, and have been recommended to continue the stretching routine. As mentioned above I will gradually resume walking.

For supplementation I will continue on Vit D, Calcium, Milk, and Whey protein and will start taking L-arginine for the blood flow.

BJR team
I am happy with the experience and support from the BJR team. The head nurse (V), head PT (H) and the PT assigned to me at the center (N) were standouts.

Dr. G. seemed to be a capable surgeon. My alignment, consolidation so far and scarring are great. All the other patients I’ve met had overall successful journeys. The complications that happened were few, but well managed by the team.

My only complaints are:
  • Responsiveness via Whatsapp: Dr. G. ignored some of my non-urgent messages or replied days later. I’ve heard from other patients that it gets worse after you leave Athens.
  • Difficulty clicking is somewhat normalized. Don’t get me wrong – the nurse/PT are available to help with clicking if you ask. And if you’re having a hard time they will prescribe you anti-inflammatories which help a bit. But Dr. G seems to consider 5/10 stress when clicking twice a day “normal”. Clicking is by far the most difficult part of the process (confirmed by every patient I met there), and I would suggest that the team invests more to make it easier. For example clearer instructions on what to avoid to not make it harder, specialized pillows, help with clicking daily in the Physio center.

From my own experience and from reading other diaries, I really do believe Dr. G. is the best value surgeon. While the amenities are not “premium” (Hospital, PT center), they are good enough, and the people were great. I would not consider going for a cheaper surgeon in Europe, and I would try to understand if I’m getting much more from an expensive surgeon to be worth the cost.



Quote from: earti193 on May 06, 2024, 02:47:35 PMDamn my friend looks like a tough couple of weeks! Really hope your stress levels decrease going forwards and clicking pain starts to abate. Keep it up looks like you're follow up went really well.
Thanks mate! At the time when you don't know if you'll be able to endure clicking, things get pretty hard and you think about quitting. But it worked out in the end. In retrospect I should've taken more breaks from clicking during that time, and slowed down the process.

Quote from: WishMeLuck on May 12, 2024, 08:53:47 AMYour experience with clicking the G-Nail is EXACTLY what happened to me.

Clicking the right leg was very difficult after 2cm and it wasted me hours every day and became a torture.

Seems like there are people that this doesn't happen to them, but for me this was exactly the experience. You can check my diary.

I hope it will become easier for you somehow.

Thanks for the wishes! I wonder why they don't make a mirrored version of the nail so you can get a soft click first on the right leg. Feels like an oversight.

Quote from: wes07 on May 12, 2024, 03:43:27 PMWhy did the PT team stop visiting you? Shouldn't visit you r times a week? Do you pay for PT? Are you able to do PT by yourself?

There are two teams (1) Dr. G. has a nurse and PT person (2) There is an associated PT center with about ~5 staff. Both were included in the original price.

Dr. G's team visited me twice a day for the first week to make sure I was ok post-surgery and teach me how to click. After that they would visit once a week or when I asked.

I would go to the PT center 4 times a week during the whole process.

You can do stretches at home, but it's not the same as having someone else push you. Also at PT you get to use the anti-gravity treadmill and 3 machines: shock therapy, pressure therapy, and cold therapy. I would definitely recommend doing PT at a center during the distraction phase.
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Posted on Jun 3, 2024, 3:15 pm
#26
Hey
Congratulations for your achievement.
Taking few steps unassisted 67 days after the surgery is amazing.
Knowing what you know now, do you think you would have chosen to do precice instead of Gnail? If money wasn't an issue at all?
I wonder if having a magnetic device instead of a clicking mechanism, but not being able to put weight (unlike Gnail) is a worthwhile tade of...

Also, is it possible to upload a pictures showing the scars?
Thanks and best wishes
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Posted on Jun 9, 2024, 1:00 pm
#27
Congratulations! That’s a phenomenal achievement to complete your distraction in that time and even take a few steps unassisted. Looking forward to hearing more about the consolidation phase.

I have my surgery in exactly one week… wish me luck.
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Posted on Jun 9, 2024, 3:18 pm
#28
I plan to do 4.5 cm with the dr. Giotikas with the Precise 2 method. Is it a good choice?
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Posted on Jun 9, 2024, 7:33 pm
#29
Some follow-ups from the previous post:

Walking 1 week after distraction, +69 days post surgery.


Scars
Dr. Giotikas 5cm bilateral femurs with G-Nail (detailed)
Dr. Giotikas 5cm bilateral femurs with G-Nail (detailed)

Not much changed since the last post. I'm walking unassisted about 50% of the time in my apartment. And I have been able to make small continuous trips within a few hundred meters from my apartment without crutches.

I'm currently looking to book a weekly PT session and start frequenting a public pool to practice my walking.



Quote from: earti193 on June 09, 2024, 01:00:28 PMCongratulations! That’s a phenomenal achievement to complete your distraction in that time and even take a few steps unassisted. Looking forward to hearing more about the consolidation phase.

I have my surgery in exactly one week… wish me luck.

Good luck man, wishing you the best! Please DM me or post here if any info would be useful to you.

Quote from: limby101 on June 03, 2024, 03:15:20 PMHey
Congratulations for your achievement.
Taking few steps unassisted 67 days after the surgery is amazing.
Knowing what you know now, do you think you would have chosen to do precice instead of Gnail? If money wasn't an issue at all?
I wonder if having a magnetic device instead of a clicking mechanism, but not being able to put weight (unlike Gnail) is a worthwhile tade of...

Also, is it possible to upload a pictures showing the scars?
Thanks and best wishes

Appreciate it!

I would still choose the G-nail. Walking 2 months sooner and preventing more muscle atrophy is worth the short term sacrifice for me.

I've attached some pictures of the scars. I'm applying silicon cream every day to help with scarring.

Quote from: Omar on June 09, 2024, 03:18:08 PMI plan to do 4.5 cm with the dr. Giotikas with the Precise 2 method. Is it a good choice?

I'm not an expert, so I suggest reading other diaries, or ideally asking an experienced doctor. I did meet a precise femur patient while I was in Athens. My limited understanding about the tradeoffs of going with precice are:

Advantages:
- Not having to click (this is a huge advantage)
- Can be reverted (not such a big deal as accidental clicks are rare)

Disadvantages:
- More risk of nail bending
- Having to use a walker and chair for the whole distraction process
- More time to get back to walking
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Posted on Jun 9, 2024, 8:18 pm
#30
Thanks for these informations. But how do you click? do you have to bend your leg? I'm not very flexible Dr. Giotikas 5cm bilateral femurs with G-Nail (detailed)
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