Femur lengthening with Dr. Betz - 2021

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Hello everyone 

    I would like to contribute to this forum by sharing my journey of limb lengthening.
   
    Starting height: 170 cm
    Desired increase: 10 cm
    Desired final height: 180 cm
    Wingspan: 174 cm
    Tibia to femur percentage: 86%
    Gender: Male
    Age: 29 years
    Weight: 75 kg
   

    I had an initial consultation with Dr. Betz around start of Feb 2021 (Consultation cost is 500‎€). We had a 4 to 5 hour thorough conversation about the procedure and regarding all of its technicalities. Dr. Betz was very patient and explained all of the questions very diligently. Overall I had a positive impression of Dr. Betz. At the end of the conversation, I decided that I would go for femur lengthening since my tibia to femur ratio (0.86) is more than the average. Also, Dr Betz said that he would most likely use 11mm Betzbone nail for me. I am planning to have the surgery in May 2021. Since I have roughly around 2 months, I have started with daily 30 minutes of stretching.

    I will update this diary whenever I have made some progress. Also do share your thoughts/ideas if any, if you would like to share with me 

    Thank you.

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Re: hanshi

No not yet. I am awaiting for the further instructions from Dr. Betz.
Are you also a patient of Dr. Betz?

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@ ghkid2021: The surgery costs around €53,000 for femur lengthening (for taking out rods after 1 or 2 years you would have to pay extra € 6,700).

@ Limbfan2020:  We did had a talk regarding Stryde, but Dr. Betz showed great confidence in Betzbone. Also he said in recent years, he has greatly improved the quality of his nail, thus there are no bending issues anymore with Betzbone. Also, Stryde with him would cost more (I do not know the exact amount). Hence, I decided to go ahead with Betzbone nail.

Thanks for the well wishes.

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Just an update:

After thorough consideration, I have decided to reduce my lengthening goal to 8 cm, since I would prefer function over length. After lengthening 8 cm, I would stand at 178 cm which I guess is a pinch below average in Germany but I would be more than happy with this height. This decision has been made after talking to previous patients from Dr. Betz on this forum.

Also, I am regularly doing all the stretches to prepare myself for the surgery. Very much excited for the upcoming surgery day on the 3rd of May.

@ pownzorgeek: No I did not get to see the clinic due to corona restrictions.

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@maximize Yes, my consultation started at 3 pm and it lasted till 7.30 pm. I presume this much amount of time is normal with his consultation.

During this consultation below points were covered:
- X-rays were taken
- Height and wingspan were measured
- With help of software simulation images were shown how I would like at 4 cm, 6 cm, 8 cm, and 10 cm lengthening.
- Explanation of how the femur and tibia bone looks like along with the surrounding tissues.
- Explanation of how my bone looks in X-rays and also the ratio between tibia and femur.
- Explanation of femur vs tibia lengthening
- Different nails in the market and the differences between them (of course Dr. Betz was showing great confidence in Betzbone). According to Dr. Betz, the only competitor he sees to Betzbone nail is Stryde. He also said that Betzbone has a very high resistance to rusting and he did not have any case of rusting on his nails till now.
- Size of the nail which would be suitable for my bones. Dr. Betz said he does not like to ream the bone canal too much with bigger diameters.
- Short overview of how the surgery would look like on the femur.
- Stories from his past patients who lengthened 7 cm, 8 cm, 10 cm, and one guy even lengthened 12 cm (the max you can go with Betzbone)!!! He did say that he does not recommend lengthening to this amount and he recommends his patients to stay under 8 cm. Max 10 cm.
- Gist of how the lengthening phase would look like. He said he is available for all his patients via Whatsapp whenever possible.
- I also asked Dr. Betz whether he does IT band release? And he said he does not do IT band release. When I asked him the reason for not doing it, it was along the lines that it may cause problems in long run. He said that with proper PT, the IT band should stretch over the period of months, though this make take a considerable amount of time.
- And lastly, all the complications which may occur and all the preemptive measures he takes to prevent them.

We may have discussed more, but right now I do not recall everything.
At the end of the consultation, I was almost out of questions but Dr. Betz was like take your time and think if you want to ask something more.
But finally, I decided that this was all I had to ask, I thanked him, and then exited his clinic.

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@VeteranLL: Thanks

@RealDamagedLostSoul: I did not have a conversation with Dr. Betz regarding arm lengthening since my wingspan was on a good side (174 cm). IMO, its not noticeable until you have wingspan 10cm less than your target height. But if its less beyond that (like 15 cm less and so on), then some people (who have keen eye on proportions) would be able to tell that something is off.

@RB: I just saw you diary, all the best. I wish that you reach your target height with breeze

@maximize: Thanks for sharing your article, it is insightful.

Risk of nonunions
Yes and you are right, Dr. Betz also said along the same lines that the first 3 cm he recommends to lengthen 1mm per day and after that 0.75mm per day for the rest of the lengthening. If this rate of lengthening is followed, most of the patients do relatively well. But incase if there is a delayed bone formation he recommends to not click at all for few days or reduce the amount of lengthening per day to even less further.

Frequency of x-rays
He recommends to post X rays every 2-3 weeks.
But I guess I will have X rays every 10 days and send it to him, I do not want to take any risk and its better to shell out some extra money and be on safer side.

Regarding your questions:
- What he aims for in terms of x-ray monitoring through the distraction phase?
- How much of a gap is he comfortable with when there is no visible callus?
I cannot answer these at the moment since we did not talk about this. Though I will try to ask this in my next consultation before the surgery.

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Update:

I got an email from Betz institute stating that all the surgeries till end of May have been cancelled and have been postponed. So, I had to book a new surgery date in June (almost 1 month ahead postponed). When I asked the reason for cancellation of the appointment till end of May, I just got the reply that "Prof. Betz is not allowed to perform any surgeries until end of May". There was not any reason on why! I presume this is because of worsening Corona situation in Germany. Anyway, I will still have to wait till June to get this surgery done.

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Brief update: Upcoming surgery in 1 day.

Arrival
I came to Sankt Ingbert 3 to 4 days before, it's a small town from where Dr. Betz operates. I have booked an Airbnb for 4 days now. Sankt Ingbert is well connected via train to a nearby main city called Saarbrücken.

Appointment with physiotherapist Peter Woll
The reason I came a few days earlier is that I had an appointment with physiotherapist Peter Woll. He has been the PT instructor for all of the Betz patients who stay back in Germany, his practice is in a town called "Wadern" which is around 50 km away from Dr. Betz's office. It takes roughly 2 hours via public transportation to reach his practice. I would recommend staying at Elke's place since Peter Woll's practice is close by to her. I had been in contact with him via video call 1 month before, he had given me some stretching exercises to do, so as to prepare me as well as to make me comfortable with the stretching exercises which I need to perform during the lengthening phase. At his practice, during face-to-face consultation, he further explained various stretches, the importance of proper posture, with which posture to sleep, past patient experiences, and the journey I should expect. Also, he highly advocates to not sit more post the surgery, since sitting shortens the hip flexor muscles, thus leading to duck ass. He has given me few exercises to avoid/minimize duck ass and widening of legs. I will be staying in contact with him via video call during my lengthening phase. I would highly recommend Peter if anyone wants some advice on stretches or gait improvement.

Covid check and signing documents in hospital
When I went to the hospital "Kreiskrankenhaus St. Ingbert", I had a covid test on the 1st floor. Also, one important point is that you have to pay €182 in cash for the Covid test (sadly the Mastercard is not accepted). So please take cash with you, since there is no ATM nearby the hospital. The hospital seems to be okay, I was not impressed with the hospital, but what's important to me is the surgeon who would operate on me. So, I will overlook this aspect.
Also, I met with the anesthesiologist, she explained to me the pros and cons of various anesthesia, I choose "General anesthesia" and had to sign few documents.  Also, most of the staff speaks German, since I understand (most of it) and speak (a little bit) German, it was easier for me to navigate around the hospital. But, you can request the staff to speak in English if necessary. The anesthesiologist spoke with me in complete English.

Appointment with Dr. Betz
Daniela who is the assistant of Dr. Betz picked me from the hospital and drove to Dr. Betz's office. She is a lovely lady who is jovial and tries to assist every now and then. One interesting fact is that she had a discrepancy in one of her legs in past and she too had one of her legs lengthened with Dr. Betz and she seemed to walk now perfectly fine and fast.
After meeting Dr. Betz, I was a little bit surprised, I was expecting his energy to be a bit low, since he had surgery on his back past month. But it was completely the opposite. He seemed to be full of energy and enthusiasm, the same person I had met in February 2021. This made me happy. It seems that having back surgery did not affect him in a big way.
Dr. Betz and I again went through the process of how the surgery would look like, he gave me few documents to sign and also explained the content of those documents.

I asked a few questions to Dr. Betz which I saw on this forum:
1. Will Dr. Betz retire soon?
--> He said he does not plan to retire anytime soon, atleast not for 3 more years.

2. What will happen to Betzbone nail after he retires?
--> He has been giving training to few doctors who are willing to inherit Betzbone. He said particularly he is giving training to "Dr. Baker" (I may have pronounced this wrong) who is a plastic surgeon located in "Freiburg im Breisgau" (southern part of Germany). He may most likely inherit Betzbone nail too and probably would be the successor to Dr. Betz.

Miscellaneous
In my free time, I am strolling around the nearby "Saarbrücken" city. I loved the city so far, since the city seemed lively, lots of eateries and a big park with the Saar river around. I will definitely visit this place more often, once I recover from the surgery!
I have my surgery now on upcoming Monday (just 1 day remaining) at 6.30 am in the morning. I will probably not update this diary anytime soon. I will write once I feel okay and have the energy to write since the initial few days after surgery would surely be tough. With all this said, I am determined to go through this surgery and to get rid of my height neurosis once and for all.

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Thanks, RB. Will keep it in mind. Appreciate it.

I am too following your diary closely. Great progress so far!

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I am glad it helps you.

Thanks for luck @DonBones