682, i appreciate your response. I would like to ask for further help from you. Honestly man, I'm going to share my understanding of this procedure with you, in a way influenced by how I want it to go for myself. This will be your opportunity -and anyone elses- to find flaws or approvals in my logic.
1) Limb lengthening suggestions under the care of Dr. Dror Paley:
-under 5cm is theoretically low risk. I may opt of 6cm depending on the doctor and his team's suggestions.
-5cm to 6cm is at least two months of distraction, for which I am willing to stay in Florida for.
-consolidation could be done at home, for which I have a orthopedic surgeon from Stanford Hospital to cover for, be it x-rays, weekly checkups, or the three to four hospital PT sessions a week for rehabilitation.
-5 days of PT during distraction are required. Learning from old forum diaries, -along with the 5 hospital PT sessions- doing stretching sessions and 1-3 hour pool PT daily during distraction and consolidation is what I plan for myself.
-the Paley team recommends silica for vitamin D3 and calcium. I plan to stick to their prescriptions, while also supplementing my distraction phase and consolidation phase with a CPAP machine for sleep, and for the consolidation phase, I plan to supplement the silica in particular with the exogen stimulator.
-per the paley team's suggestion, I should be able to walk close to 6 months post operation. I plan to start up mild yoga at that point, in addition to the continued three to four stretching/PT sessions per week at Stanford hospital. My hope is to start reincorporating deep tissue massaging back into my life two to three weeks following the approval to walk again.
2) Could massage therapy be potentially detrimental due to the screws or other precise parts still being within my legs?
3)The most valuable part of this whole situation is obviously my longevity and physical ability. I appreciate you emphasizing the reality of the short term immobility; however, 5-6 months of immobility to overwhelm a dysphoria permanently is to me an appropriate trade off. However, sacrificing significant physical ability in my athletism two years post operation is not reasonable for me. Understand that I do not trust most patients on this forum over the opinion of doctors, but I also recognize doctors' bias favoring the procedure, so I feel reluctant to believe anyone but my own body. I feel if I lengthen conservatively, withstand prolonged PT continuously while still giving my body recovery periods, and do this for at least one to two years, then I can get back to some degree of my current athleticism. Going from personal experiences, my broken ankle and my broken wrist are both stronger than the opposing body parts. I do recognize the concept of stretched muscles, but muscles regrow and tear -I've experienced that as well. I feel if I can help stimulate repair to my stretched muscles, that I will be able to withhold a solid recovery. In regards to the ratio or femurs to tibias, I will not be willing to surpass 6cm. Currently, I favor 5cm, but even 5cm might cause too much of a difference in the ratio, and from a functional standpoint, I can recognize how a close to 10cm longer femur than tibia could severely affect functionality. Overall, in regards to my hopes of recovering, do you think I am delusional?
See if Dr Paley will fill you with testosterone too since you're obviously full of estrogen for crying about your height at 5'11 XD
Aren't you being a little precious? You're objectively closer to being a tall guy than a short guy. If it's severe BDD, then surgery isn't the right answer is it?
According to Dr Franz Birkholtz, there is no such thing as a 100% recovery doing any lengthening on tibia or femur.
Don't think it's easy because of internals. It's a life-altering surgery either way you do it.
At your height it's stupid to consider this surgery unless you're in the Netherlands. Sure you'll help your BDD but you will have new problems. The only question is the extent of those problems.
Think long and hard.
At first i was being simpathetic to you op. But the way you answered some questions make it clear without doubt you are deranged. Good luck with your LL
Reading some crap here recently i probably should just go and shoot myself in the nearest occasion with my glorious 5'5.
Your money your health but don't expect any gains except few additional cms after this surgery. You obviously should invest more in a shrink or something.
Besides you are saying that you are in your early twenties so still in an age when tons of people have problems with accepting their own appearance.
I don't understand why most of you guys ,talking that this is not worth it in his case ,179 is Okay,dead on average,but this is his choice anyway,maybe he wanna be in tall zone
kool1818, I will be happy to provide my help where possible. For a final time, I suggest you think deeply about your decision to undergo this decision with the substantial risks as I would with anyone seriously considering undergoing this procedure, Body Builder has provided good advice to consider but I won't attempt to dissuade you nor criticize your decision. Moving on to your main post;
1) A - Correct, under 5CM is generally considered low risk, every centimeter after that appears to substantially increase the risks of complications as soft tissue damage isn't linear and is exponential when lengthening beyond the elastic limit of soft tissue, therefore the more you lengthen beyond the allowances of soft tissue, the more damage occurs. Because of your starting height (when all else is the same, a longer length bone will be able to be lengthened slightly more than that of a shorter bone with the same result) and choosing femoral lengthening, I wouldn't consider 6CM unrealistic though it would be the absolute upper limit in my opinion.
1) B - ~2 months is a realistic time frame for a lengthening rate of 1MM daily. Err on the side of caution and lengthen at the lowest rate possible without pre-consolidation if you can sacrifice more time (0.6MM has been the standard rate of lengthening) - I hold the opinion that much of the damage that occurs is from rapid lengthening (possibly as much as excessive lengthening) in which the soft tissue can not adapt sufficiently causing damage, while animal studies should not be extrapolated to humans, the studies done seem to agree with this.
1) C - By 5 days of PT, do you mean per week? I feel that your personal physical therapy regimen is ideal with focus on flexibility and low impact exercise. I am still in the process of deciding whether strenuous cardiovascular exercise such as that of the stationary bike is beneficial or detrimental to the healing process.
1) D - Good supplementation alongside the Exogen stimulator at worst will provide negligible benefit and at best may provide tangible benefits to recovery and consolidation. I see no reason to not use them during the process. After much personal research on the benefits of a CPAP machine when the patient does not suffer from apnea, the results have been inconclusive but I cannot see the harm. One thing that has promising research is the use of a hyperbaric chamber to aid recovery of soft tissue - something to consider.
1) E - Emphasis on flexibility and physical therapy is important during both the lengthening and consolidation phases. I will give my opinion on massage below.
2) - No. I believe it would be beneficial to incorporate massage prior during the whole process, both during lengthening and after, flexible, supple muscular structures lengthen considerably better than if stiff and inflexible, I would recommend deep tissue massage as often as can be afforded and self massage when possible, ideally up to twice daily during lengthening and timed prior and post lengthening with the Precice device. The medical hardware should cause no issues.
3) - As long as you have truly taken the time to consider the risk/sacrifice to 'reward', then I fully respect your opinion that short term issues are of less importance than addressing dysphoria. Your view on doctor advice/patient evidence is reasonable - I am also wary of taking either as universal fact, especially the latter as I believe it would be wrong to compare the procedure and results of a poorly planned process with finances being the deciding factor under a questionable, 3rd world doctor and hospital with little experience, lengthening an unreasonable amount at a rapid rate with little to no physical therapy, sub-optimal nutrition and supplementation, sub-optimal flexibility prior and throughout to what could be achieved and the risks mitigated substantially when done in an optimal manner, unfortunately the former seems to be viewed as the standard outcome.
I would still advise that there is risk and some sacrifice of athletic potential, what a doctor considers a satisfactory recovery may vary greatly to yours. I recommend reading Dr Birkholtz's thread on this forum as he has been very open and candid with his advice and what he believes is or isn't possible. In terms of muscular damage and repair, they aren't comparable. The stretching of soft tissue where insertion points and tendon length is changed cannot be 'healed' - but if lengthening is done reasonably and conservatively, the soft tissue should be able to adapt to a reasonable degree. I agree that 6CM is a reasonable target and appreciate that you aren't willing to sacrifice remaining in a biomechanical 'normal range' for excess lengthening, but yes 5CM would be better in all regards. The smallest amount of lengthening in which you would be satisfied with and feel the procedure worthwhile should be the length chosen. Tibia/Femur proportion falls into a general range but varies greatly, it is unlikely that 5CM of femoral lengthening will take you outside of this range nor alter function/biomechanics substantially and is almost always preferable to tibial lengthening which can affect functionality and biomechanics greatly - especially with excessive lengthening, as the femur is the longest bone in the body.
I do not believe your hopes of recovering are delusional, possibly slightly optimistic but not unreasonable to the degree that you deny any detriment to your physical ability, especially with the plan you have put together which will undoubtedly lead to a much higher chance of having a satisfactory outcome. The thought and effort you have put into research is testament to your rational and reasonable attempt at having the best recovery possible.
Regards, 682.
Quote from: YungGud on March 26, 2017, 02:05:44 PMI don't understand why most of you guys ,talking that this is not worth it in his case ,179 is Okay,dead on average,but this is his choice anyway,maybe he wanna be in tall zone
The fact of he matter is his breaking a perfectly healthy perfectly aligned 100% bone even when ur with a top doc like paley ur still putting trauma on ur leg. All the guys that run the industry are average to short and banging legit 9s and 10s with no problem. Why? Because the guy has to fit in the same shot as the actress. Nobody wants to see a mammoth body overshadowing over a chick and many girls would turn down a 6'2 guy because nobody wants to feel like a midget all the time or look like their daughter.
Michael Ealy 5'10 and banged Halle Berry. Taylor Lautner 5'9 and banged Selena Gomez. Josh Hutcherson 5'7 banged Vanessa Hudgens. Brad pitt weak 5'11 and can bang any girl he wants.
yourspaceboyfriend, why would you feel compelled to shoot yourself? I worry you might be in harms way. If it was said humorously, then know you are and will never be allowed to fk with my life, nor could you ever compare yourself to me or anyone else -be the best version of yourself. To some of the others who seem so full of negativity, stop building a pedestal of standards to conform to. You'll always get disappointed if you go into something with expectations. Follow your heart, use your logic to navigate through what you feel is right or wrong, listen faintly to everyone, but closely to yourself. This world is full of disgusting people, and this forum post is an example of it -I posted a question specific to my health, but a large turnout was a crowd too focused on manipulative behavior, wanting to control the standards of what is right or wrong. Ignore people like them. This is my one and only message to people needing support to follow their goals -people will attempt to dissuade you your whole life. don't let them. don't give them any reason to keep their hatred alive in front of you.
682, I plan to ask the paley team what they feel about a 4cm to 5cm lengthening in the femur. Again, it was really cool of you to share your thoughts.
You must be logged in to post a reply.