musicmaker, I am interested in surgery with external fixation. Do you know if Dr. Monegal often use external fixation like Taylor Spatial Frame and Truelock Hexapod in surgeries in leg deformity corrections and LL ?
why it is so expensive to fix cooper $10,0000 and it is a minor complication?
Of course easy complications... Curved tibia (worse that malallignment) with a malplaced fibula. Sure you can just open and move all the lengthened bones like nothing happened (Stupid Ilizarov for inventing a device that was created just for that! Since curved bones are not easily dealt with).
You are a liar music maker. The fact that you defend a doc that screwed your leg shows that something is mentally broken with you. 1 years crippled and you are ok with it.
Quote from: musicmaker on April 02, 2016, 12:27:23 AMWe should distinguish between obstacles, problems and complications, according to Paley's classification ("Problems, obstacles, and complications of limb lengthening", Clin Orthop Relat Res 250, 1990, 81-104) (http://www.ncbi.nlm.nih.gov/pubmed/2403498). In Dr. Paley's words,
Since Cooper's problem could be easily fixed when doing his second leg, his was not a 'complication', according to Paley's classification, whereas mine indeed were. Dr Monegal was not lying.
Oh give over please.
Complication
2.
MEDICINE
a secondary disease or condition aggravating an already existing one.
The definition there is quite clear. When Dr Birkholtz talks about complications, the definition is quite clear. When Dr Guichet talks about complications, the definition is quite clear.
The e-mail from Dr Monegal states he has only had screw pushes and yourself (I wish you a speedy recovery), when I ask about complications I think it's fairly obvious to all and sundry that I'm going by the dictionary definition, not some medical classification of different issues. There is a quite clear admittance of Cooper's situation. I think anyone would understand Cooper's is a complication, and if you are redefining words, I still think it is clear that when I ask about complications, Cooper's condition is something I would very much want to know. I certainly view failure to mention Cooper's situation as lying by admission.
See Cooper's point 1.
Having had a conversation with another person who was debating Dr Monegal, he was also under the same impression as I regarding complications. I also understand from Lluser's earlier post, it was this that pissed him off.
At the end of the day, I am, we all are, playing roulette with our health and mobility plus it costs an absolute ton. What we all want is accurate information in order to gauge our most appropriate move.
This man has a load of bad cases. All doctors have bad cases but the facts prove this one isn't honest.
One of the problems I think that we encounter with leg lengthening is that orthopedic surgery in general is a very crude practice. I have never been in a leg lengthening procedure, but I have assisted in hip and knee replacements and similar principles and techniques apply.
Reaming out bone cavities and screwing bone fragments into rods feels far more like rough carpentry in the operating room than it does a precise science. And when we're talking about alignments of joints which can lead to early arthritis with only a mm or two off, there is a lot of room for very easy to make, very significant error.
Take the fixation of the distal femur/tibia relative to the proximal. Even a slight misalignment in any one axis (which can be induced even by the process of drilling in the screws) could cause chronic joint problems down the road. Bones are rigid, and once they heal in place, they will just grind on any points of unequal stress until arthritis develops.
It seems apparent based on the case reports of guys like Guichet/Paley that some doctors are very good at maintaining sufficient alignments that such issues do not become chronic problems at least for 10+ years post-op. Beyond then? Who knows.
But if you have seen a hip replacement or knee replacement by a good academic surgeon, you will understand that even the best orthopedic surgeons are not that "precise", and why there is such a variance in outcomes. It is just intrinsic to the nature of the crude "hack, slash, break, saw, and drill" kind of surgery that we are dealing with.
This is one of the reasons I have always been such a big fan of the external hexapods like Taylor Spatial or what KiloKAHN went with. They are the only way to go back AFTER the initial surgical cuts are made and progressively throughout the recovery period maintain and control axis in all three dimensions of space.
The Reverse Planning Method championed by Dr. Baumgart should in theory offer the same degree of control, but that degree of control is limited by the human element of trying to get all the screws and rods in exactly the right position during the first operation, which is really, really hard to do down to the mm. Any slight error may be potentially amplified by lengthening.
If I was an orthopedic surgeon, it is not a surgery I would be eager to provide cosmetically given the enormous range of possible outcomes even with best efforts and experience, and the unknown consequences of a slight misalignment 20 years from now. I think I would only want to do it with a TSF/hexapod, because that's the only way you truly have mm-level control over fixing the almost inevitable small misalignments that may occur during the first part of the procedure.
That said, as someone who wants to get LL, if I go ahead with it I will still probably go with an internal femur approach, because the benefits of speed are worth it. I would be sure I go with someone who has a good reputation and many years of experience. I would also want to make sure I select a doctor who has a measured and even, calm demeanor, rather than one that is prone to excessive emotionality or too eager to downplay risks.
It's too bad you've had a bad outcome Cooper. I'm glad you're getting it sorted out. It sounds like from what the other patient said here Dr. Monegal wanted to fix it but not until you were finished extending. This is as I said the reality of going with a non-hexapod device - if errors take place, it limits the ability to fix them straight off.
You probably made the right decision getting it fixed sooner than later. I don't know what happened to bluebarbie in the end, but I practically begged her to go get a TSF correction of her horrible monorail misalignment rather than just wait like her surgeon was telling her to. The longer you wait with misalignments, the more consolidation you get. It's true the callus is soft and can be "bent" manually during a refixation process, but this will to my understanding just be done roughly by hand. It won't have the precision of a true hexapod/TSF correction.
Good luck on getting better. I'm sure you'll bounce back.
How are you managing financially with this level of extended and unexpected disability? If you don't want to answer here, you can PM me. I'm mostly curious because my biggest impediment to LL outside of the alignment error fears is difficulty getting sufficient time off work and from having steady income.
Thanks for sharing your experiences with all of this. It's unfortunate you went through it, but it's valuable to everyone that you have shared it.
Not sure if you've answered this elsewhere but if you don't mind my asking why did you go to this Dr.? From my impression when we met, you seemed to do well for yourself and could have afforded the best.
Hope recovery is going well my friend.
Cooper I enjoyed your diary and posts, thank you for sharing. I'm hoping you have a great resolution to issues with your tibia lengthening. Looking forward to your next update 
. If I may ask, did Monegal tell you it was ok to finish lengthening at home instead of spain?
Most patients finish lenthening at home, even those doing a one stage procedure, and patients who do 2 stages always go back home some days after surgery: Paco1, Yagen and Aboli. Patients are allowed to leave as early as 4 days after sugery according to the doctor's thread. Paco and musicmaker have no diary but they left as early as that according to their posts last year. No wonder these patients have complications.
It seems to me this doctor underplays risks and doesnt' care much about his patients once he gets his money. I think Cooper has reason, he is using this forum to fish new patients. He seems to care more about getting new patients than taking care of current patients. His patient Nomad said that. This doctor brags a lot and he seems more concerned about his reputation than about his patients. That's very sad.
After reading this whole diary, my final understanding of it is, Cooper might have been right, and he kind of warned us of what could happen. I am not sure if anyone else have noticed but, cooper is not replying to any posts anymore. I would guess that he’s been banned from posting. Also have you noticed how "ShortDarkAndHandsome", and "musicmaker" only commented on the post when cooper was unable to reply back? 
"ShortDarkAndHandsome" even claimed that he knew cooper. which I can’t help but think that both musicmaker, ShortDarkAndHandsome, and possibly the moderator have been manipulated or bribed in order to remove cooper from the forum and post those comments. In my opinion, I don't think cooper would stop replying to this post after everything he’s been through. On top of this all, ‘ShortDarkAndHandsome’ and musicmaker only posted once (as agreed) to clear the air, and didn't post again. That shows that they had no intentions or interest to be involved in this topic, but they were simply fulfilling an agreement. RIP to cooper, one lost soldier, I am probably the next one to be removed off the forum for posting this. I believe the same happened to another patient of Dr Monegal called "Bohemia". He was doing so well, then all over sudden stopped posting...mmmm
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