Growth.Journey - Femur lengthening w Betz - Sep 2022

Hi all,
I have surgery booked in with Betz in September 2022.
I thought I would prepare a diary in order to share my story, thoughts, feelings, journey and learnings along the way (with the idea that they may help someone else).
 If you have questions, please send me a DM and i will try to answer, just to there is somewhat of a consistent flow of my posts vs off topic discussion.
If you have advice of the back of a particular topic, please post below so that it has a chronological order that can help people (including myself).

Days from surgery - Minus 10

About myself:
- 173cm
- Australian (most people, especially newer generation, are very tall here, often 180cm) from Melbourne.
- Early 30's
- I have done very well career wise for my age. The money for the surgery is huge (& will hurt my bank)  but it will not set me back long-term in my financial goals as i already own an apartment which is 60-70% paid off, have a few small online businesses and will be maybe 7 months post tax salary for me. I also think my next job will be around 1.5x - 2x this salary so in tomorrow's money it is not as much. I do worry about interest rates going up though as I am using this money from excess mortgage that i have paid down already.
- I currently work in the office 75% of the month (we have to at minimum).
- I have a girlfriend who lives with me.
- I have a long upper body and shortish lower body. I am relatively muscular but don't do much cardio or sports, just mostly upper body weights but am flexible.

Why do the surgery:
- I have always had bad height neurosis, ever since high school. I was around my height tall in year 7-8 but everyone outgrew me from year 8 onwards. I started wearing thick shoes, shoe lifts. This made me embarrassed to take off my shoes which meant i avoided beaches, peoples houses where i had to take off shoes and even around the home by myself i would wear shoe lifts in my inside shoes. Whenever i went somewhere i compared my height and it was literally always on my mind, like a cancer eating away at my happiness.
- My father is taller than me and my cousins are all 6 foot 2 or above. It is embarrassing going to family events.
- I have always researched from a young age how to get taller. There are a lot of things that don't work which are advertised, like drinking milk,

Why Betz
- Only remaining weight bearing nail in market.
- Ability to do lengthening process from my home country.
- Recent journals in the last 2-3 years have all been overwhelmingly positive with great outcomes. I had some serious concerns about earlier journals but it seems like he has improved his nail material, improved his surgery technique (with very clean breaks and being more conservative now on rates of lengthening), has a new assistant doctor (who might be bringing a fresh and youthful perspective on the above matters) and Betz is even now doing ITB releases, which he was not doing previously. I think all of these factors are leading to some really good outcomes, but i am still very nervous about this as it is a major surgery. Am i crazy for wanting to do this? I would never tell another person in real life about this, i know for sure they would think i am crazy, especially since i hide my real height.
- Initially i wanted to do tibia lengthening, as i communicated before i think my tibias look shortest (albeit my whole lower body is much shorter than upper body). But after doing more research i realised this surgery was quite risky, couldn't lengthen as long and Betz was known for Femurs. Whilst i would still prefer longer tibias i have decided the most practical approach is to do femur lengthening.
- The advice of others is not to target a specific length, rather to aim for a conservative number, listen to your body and if you are performing well to do more. The length recommended to stay under is 8cm. Personally if i got 7cm i would be incredibly happy. It is a good number, would get to me to 180cm and is under the 8cm danger mark. That being said if i need to stop at 6cm i would also be ok with this and also if things are going great, then i am also ok to push to 8cm, but not more than that.

The booking / surgery planning
- I booked the trip several months ago, i cant remember exactly, maybe 9 months ago. I wanted to have my lengthening completed by Christmas so i could be ok when i see family and go into 2023 a new man. July or August would have been ideal but the earliest i could do was September.
- The strategy is for me to spend 3 weeks with betz (i booked 3 weeks of leave), fly back, and communicate to my work at this point in time that i will need to work from home, spend 3 months (or ideally less) lengthening whilst working from home, and then maybe for consolidation start going back into the office everyday.

How i am feeling / mental preparation
- I have been relatively nonchalant going into the process (didn't seem quite real) up until about 3 weeks ago , when it started becoming more real by the day. I have been madly researching previous diaries, trying to learn as much as possible, visualise every step of the trip and every question or problem that might arise. To be honest i am probably still unprepared. I don't think i can properly comprehend what i am getting into until i actually arrive. That being said, logically i know this is something that i need to do, but emotionally i am absolutely terrified. I am afraid of making the wrong decision, the huge guilt of what i am putting my girlfriend through, of lying to people about the surgery, of the upcoming pain and huge inconvenience to my life that will come up, what if severely impact my career/work/reputation, what if someone finds out. What if i have a physical issue like non-consolidation, pre consolidation, or have a nail or screw break and have to fly back.
- I am dreading the 3 week process, including the flights, the surgery, the pain, being away from friends and family. But i know once i get past this 3 week process things will only get better from there. It is like a V shape, where it is at its worst initially, then a long steady improvement, and then for the rest of remaining 50-70 years of my life will be significantly better than my life before (i.e. removing neurosis)
- If anyone has any supporting advice or went through the same thing but now they are really glad they made the decision, please let me know, it will be helpful and reduce the chance that i don't freak out at the last minute and pull out.
- I also haven't paid yet but will need to pay next week, so i am also worried about making the payment, then pulling out, whether i can get this money back. But i am trying to see it through for a better life for me long-term.

That's all i've got for this post, but i am not flying out for another week, so i am starting quite early. I will try and keep this updated with a greater level of detail than i have seen in other posts.

You're off to a good start buddy.
It is as you say. Worst part are the first 2 weeks IMO.

Try not to stress too much about it. Betz or other good doctor (im at week 2 post op with Giotikas) are good surgeon with good teams behind them.

Surgery day will come soon and in a matter of hours you'll be done and dusted with the hardest part.  Try to focus on the present moment at rach stage and in some (perhaps weird) way, enjoy the process. That helped me mentally through the first week (hardest by a long shot).


Good luck!

Best of luck, Growth.journey! I look forward to reading your diary.

Your post says you haven't told anybody so I'm assuming you haven't told your girlfriend either. Does she think you're going on holiday for three weeks?

Also just curious why you chose Dr Betz over Guichet or Giotikas with the g-nail?

Thanks @Ozboy39 - actually this is really good advice. Taking it day by day, not stressing and trying to enjoy the process (as much as one can). I am trying to adopt this mindset as much as possible, i can see the excitement in a trip, something different, a completely unique life experience. I think my stress definitely subsided a lot this week because of this, but maybe i am just distracted or being naïve.

Thanks @thanksscience, that's correct, something like that. Re Betz over Guichet/Giotikas, i guess it was reading through diaries and seeing some really great patient experiences with Betz recently (as well as the points I have written in my post above, though I'm sure some could apply to all of them.

Anyway, i will keep going with my diary.

Days from surgery - T minus 8 days

My fear has subsided slightly (thanks OzBoy) but still very nervous and it is like a huge weight on my chest. I find writing in this diary helps to get some off my chest too since i feel like i cannot talk to anyone about this.

I have shifted into planning and packing mode. I have bought a exercise bike as I read another article which had really good outcome and they used a bike a lot. I think exercise promotes bone growth. I have also bought exercise stretch bands heavy duty and started doing some stretches with them, like pulling leg towards me, pulling leg towards me and to the side (ITB stretch), putting the bands around my thights and pushing outwards wiht my legs as well as practising the movement i have seen in Betz videos for the clicking. I think whilst i am quite flexible i have tight hips which might be a problem.

In terms of packing, i read somewhere that people brought too much stuff before. I also realise i am coming home on a long journey, i will not be able to walk on crutches and bring a suitcase, that will just not work for me, so i have decided to bring a backpack. I guess the question is how big of a backpack and how many clothes i will need. I have emailed Betz but if anyone can provide some guidance here (i.e. can they wash your clothes which will mean i can bring less). I am thinking of bringing 1 pair of jeans, 1 pair of shorts, 2 weeks worth of undies and shirts. Hoping they can wash it. I think i can fit all of this, a laptop, charger, power converter and a few other things in a backpack. Let me know if you think otherwise.

I am trying to think about what other things i need to do to prepare, e.g. stretching now, certain exercises, practising clicking movement, thinking about items to pack etc. I am also thinking about when i get back if i can get physio covered under private health insurance, but i am trying to do as much as possible myself i.e. disciplined stretching and exercise on the bike machine.

Questions for others based on my current stage of journey:
1. What should i be packing (e.g. key things i might forget) and how much should i be bringing (e.g. 1.5 -2 weeks of clothes in a backpack work?)
2. Any things i should be doing before i go, e.g. certain stretches or exercises

No worries GrowthJourney,

Feel free to reach out anytime if you feel like it (sent you  DM). Many of us are doing this thing "solo" so it's helpful to be bale to talk openly to someone during the process.

My 2 cents on what to bring
- long USB cable (2mt). Thst saved me in the hospital where the charging port was kind of distant from my bed

- if you haven't done so , purchase a e-sim with plenty of data. Inknow it's only 3 weeks but staying connected is what helped me most and wifis here are crap. I found one with 60Gb per month and it was around 50 euro or so.

- Download whatever food delivery app is available there in your region. That's a a game changer if you haven't done so yet. If there's any good restaurant that'll help you mentally  (last night I got myself a tub of artisan ice cream.... soo good). Sometimes you need that.

-if you can afford it, please upgrade the return fight to business class. My but/hips hurt a lot if I stay seated for more than 20 mins.

Lastndont worry too much. If you forget anything I'm sure the team at Betz will help you out in no time.

Good Luck, you should be fine with Dr.Betz as long as you dont overlengthen! Dont do more than 8cm on femurs!

Wow, wish you good luck. This will be the first diary I get to keep up with consistently. Just wondering, how long do you think you can hide this from your gf? Not to be negative but I don't think you'll be able to hide this from her for long. It's months of recovery.

Thanks everyone for your support. If i haven't answered your question it means it is too personal, no offence, just prefer to keep some things private. Here is an update.

Last week before i flew out was a rollercoaster of emotions. I was so stressed, couldn't think straight at work, felt enormous guilt for leaving my gf/family/friends/job etc. for something which i am sure if told anyone they either wouldn't believe or me or would think i was crazy. So i basically held off making the deposit until the last minute just in case i had any late changes of mind. It was a really tough week mentally. Anyway, i decided to proceed and I made the payment. Because i had to make an international payment, my bank actually used a 3rd party called OFX. So i was already late and then they wanted to use another third party - i said no way, especially since OFX has like a 2/5 rating on google. SO i ended up transferring the amount to my other bank account and paying from there. I had to visit the branch in person and make the payment, they made me fill out forms to ensure i knew i wasn't being scammed etc. Also they totally screwed me on the forex spread. Ended up costing a lot more than i thought.

Anyway i flew out and my god the journey was so long and difficult. It was 8 hours, then 7 hours layover, then 11 hour flight. All in one day. I made up in my mind that there is no way i am flying back again unless it is for the final nail removal. It is just too painful. I arrived and Thomas, the driver picked me up from the airport. It was very surreal arriving in a foreign country, not knowing anyone and speaking to someone who knew what i was about to do. It was weird but Thomas made it feel a bit more normal as a i spoke to him and after a while i was comfortable speaking with him and asking him lots of questions etc.

It was a long drive, surprisingly long, i didn't realise how long it was. It took about 2 hours, but looking out the window the countryside was very beautiful, but i missed my home country (Melbourne where I am from). Eventually we arrived, i was feeling positive after the conversation with Thomas. He dropped me at an ATM to get cash for his trip as I did not have any (i assumed the driver was part of the package, but it is not, it is actually 200 EURO which i thought was a bit too high of a price but what choice did i have).

When I arrive, i checked into my hotel. I chose a cheap option, i would not recommend this, spend more to get the more expensive option. As soon as I checked in, Thomas came and told me the Xray machine at the hospital was not working today and that we would need to go to another hospital they had lined up. Thomas drove me there, helped me get the xrays (it was quite quick - though i haven't done this before, its quite weird, they get you to stand in different positions with an xray cover over your balls) and drove me to a PCR test ($100 EURO). No-one really spoke english, everyone only spoke german but Thomas helped me communicate. At the end, Thomas asked me for another $50 Euro for this extra driving around and help which was not scheduled. I paid him but i wasn't really happy about this as it was not my fault. But it is fine / done now.

At 1pm i was meant to have an initial consult with Betz. However Daniela messaged me and said this was too early, so I walked around, got lunch, bought a sim card (7gb) and waited in my hotel room. At 3pm Daniela came to pick me up. To my surprise, there was another patient in the car. He had done the surgery a month ago. When i was speaking to him, i found out that he left the hospital after 7 days (not usual 14) and was having trouble clicking and had to come back to have it under anaesthesia. When i heard this my heart sunk and felt that fear/panick feeling coming up through my stomache. My god, if this happens to me i cannot imagine having to fly back to here AGAIN.

At 3.10pm i went into betz office, they measured me (171cm actually, i got it wrong) and weighed me (74kg), and took photos of me in different angles. I filled out a bunch of forms and then I went into Betz's office. We had a conversation, i was still feeling panicked after what i saw. Betz told me that only about 6% of patients have this issue and need to fly back under anaesthesia, he also said it was more of a mental problem and that he could have pushed through it. Finally he mentioned this patient left hospital after 7 days (not 14 recommended) and that it was not good to do this, this also contributed to the problem. You need to stay until you are confident in clicking and they can monitor you etc. Still, this is my biggest fear. Any tips here on how to mitigate this risk, e.g. can i practice clicking early / do any particular stretches which will make clicking a breeze? I have been taking a stretch band, wrapping it around my foot and pulling it out to the side similar to the click motion. I also saw in a video the m doing the motion whilst sitting down so i have been practising it. Any help here would be appreciated.

Betz was fantastic in his meeting, he was caring, patient, knowledgeable and intelligent. He stayed with me 5 hours going through everything and answering every possible question. I might do a post below in more detail about some of the questions i had and his responses, to save others time. He definitely made me feel comfortable i had made the right choice in terms of other nails etc. Betznail just makes so much sense, none of the other nails really compare. The only downside is manual clicking motion but you have to accept this as otherwise it means iron/magnetism/risk of corrosion. I signed all of BEtz's documents, he drove me home in his car. I went straight to bed as i was exhausted.

I have anaesthesia booked today. Surgery is booked for day after. I will be in hospital 14 days, then back at hotel for 3 days then fly back. I was going to stay at Elke's but Betz correctly identified that it was 60km away, not worth it for this time and i would be better of using the time at the gym, plus i will be close to hospital and betz. Betz said this was enough time, no issues, but i hope everything goes smoothly, especially the clicking and i also hope time goes quickly as I really want to be back home in Melbourne as soon as possible. I am very nervous, please wish me well.

Thats all for this diary.

who will do the surgery? betz or becker?

Good luck Growth.journey! Hope everything goes smoothly.