Quote from: Deads on August 02, 2016, 07:14:32 PMHad to comment on this.... Hate getting sucked into this s**t haha..... Climbing the corporate ladder has nothing to do with height. Leadership skills are based on your character and the interpersonal skills you possess.. Respect from your peers; I'd say that this has a ring of truth to it, but over emphasised. Sexual attractiveness; it's one tick in the box when it comes to overall attractiveness. Confidence; Hell yeah!
Lol, so true.
I haven't done as well as I have professionally because of height, that's for damn sure. Hell, the guy I bought out in the company I own half of is 6'4
(I know, because he's a friend of mine and likes to brag about it. He's now married to a 6'2 amazon that likes to wear 4" heels. Wanna feel short? Stand next to a woman that is 6'6 in heels... 
)
Quote from: LLuser1 on July 30, 2016, 04:26:50 PMFor all cases, youll never be 100% ok
For some of them you wont come alive or wont walk anymore. There are some examples in this forum
Yes, LL is so deadly that some guys don't even survive the initial consultation. 
I have a consultation in September...I hope I don't deaded.
Quote from: CCMidwest on August 02, 2016, 07:30:45 PM
(I know, because he's a friend of mine and likes to brag about it. He's now married to a 6'2 amazon that likes to wear 4" heels. Wanna feel short? Stand next to a woman that is 6'6 in heels... )
She probably has pretty dopeass legs lol.
Quote from: YourSpaceBoyfriend on August 02, 2016, 07:37:49 PMShe probably has pretty dopeass legs lol.
Let's just say...at her current body weight I feel sorry for her heels.
One thing that I find mind shattering on this forum(and on the old forum as well) is the kind of issues people obsess over as they are inquiring about or even doing LL. I find people obsessing over proportions(which does not even register as a concern for me.)
Even 'health' related discussions are mostly about soft tissues, while no body is addressing(or maybe even noticing) the elephant in the room. Your main concern should be: what kind of bones will I have after this is all over? and how will my LL choices affect this aspect of the outcome.
Here, I am referring mainly to osteoporosis(since bone deformities are a short term complication, and by the time lengthening and consolidation are finished a patient will have known if he\she has to deal with it or not.) I have found forums to provide little to no information on this complication. A patient's LL might be over for 15-40 years before they suffer this condition, and it just MAY BE that it was caused by LL.
Upon comparing methods(internal vs external) with this in mind, I find a strong tendency to think that externals provide better LONG TERM outcome(what a shock, right? I mean this is totally against conventional wisdom.) With internals you lose the bone marrow(and perhaps other stuff as well) of the operated bone segments. Bone marrow plays a major role in your bone remodeling
http://www.ncbi.nlm.nih.gov/pubmed/7816067
I am guessing here(but this is an educated guess) that when this process becomes faulty one becomes likely to develop osteoporosis. Sure your body might find a way to compensate for the absence of bone marrow, when you are still young, but will this go on through your older-elderly years?
Any help in answering these questions would be appreciated(especially if it comes in the form of information extracted from medical articles.)
Quote from: El Greco on August 28, 2016, 06:31:27 PMOne thing that I find mind shattering on this forum(and on the old forum as well) is the kind of issues people obsess over as they are inquiring about or even doing LL. I find people obsessing over proportions(which does not even register as a concern for me.)
Even 'health' related discussions are mostly about soft tissues, while no body is addressing(or maybe even noticing) the elephant in the room. Your main concern should be: what kind of bones will I have after this is all over? and how will my LL choices affect this aspect of the outcome.
Here, I am referring mainly to osteoporosis(since bone deformities are a short term complication, and by the time lengthening and consolidation are finished a patient will have known if he\she has to deal with it or not.) I have found forums to provide little to no information on this complication. A patient's LL might be over for 15-40 years before they suffer this condition, and it just MAY BE that it was caused by LL.
Upon comparing methods(internal vs external) with this in mind, I find a strong tendency to think that externals provide better LONG TERM outcome(what a shock, right? I mean this is totally against conventional wisdom.) With internals you lose the bone marrow(and perhaps other stuff as well) of the operated bone segments. Bone marrow plays a major role in your bone remodeling
http://www.ncbi.nlm.nih.gov/pubmed/7816067
I am guessing here(but this is an educated guess) that when this process becomes faulty one becomes likely to develop osteoporosis. Sure your body might find a way to compensate for the absence of bone marrow, when you are still young, but will this go on through your older-elderly years?
Any help in answering these questions would be appreciated(especially if it comes in the form of information extracted from medical articles.)
Good post, Greco.
Yep, I'm also shocked by some people's priorities. Things like proportions or being or not able to squat 150 kg post-op should be the last concern!
As for the bone marrow thing, it is a serious question and it would be great if a doctor answers it. Too bad all the registered doctors have abandoned the forum after the continuous trollololing and false accusations.
I'm not an expert, but -as far as I know- the yellow marrow to be found inside femurs does not play the highly important roles the red marrow does.
"Yellow bone marrow is found in the hollow interior of the diaphyseal portion, or shaft of long bones. Its main function is to store adipocytes whose triglycerides can serve as a source for energy. The marrow fat is physiologically different than the subcutaneous fat in the body, and is the last fat to be lost due to starvation."
Source: http://www.conversantbio.com/blog/red-bone-marrow-vs.-yellow-bone-marrow-what-is-the-difference
There is also red marrow inside the femurs, but in adults it is mostly located at the epiphyseal ends ("heads") of the bones.
I'm not sure if this is also reamed when the nails are inserted.
I also appreciate any feedback on this topic.
Hi Ozymandias,
Well I have asked one of the doctors who do internals about the effects of losing the bone marrow of the operated bone in an email, and he said that it would be better if I talk it over with him in a consultation(so no answer.)
Quote from: Ozymandias on August 28, 2016, 10:59:09 PMThere is also red marrow inside the femurs, but in adults it is mostly located at the epiphyseal ends ("heads") of the bones.
I'm not sure if this is also reamed when the nails are inserted.
The proximal end of the femur(this is the one highlighted in your picture) probably gets reamed as well(the drill goes right through it.)
Reaming also raises other concerns. Here it says that the surgeon would ream the canal so that it's diameter would become 1.5 mms greater than that of the nail to be inserted:
http://www.bjj.boneandjoint.org.uk/content/89-B/11/1421
I would expect that this would mean that your endosteum as well as part of the inner wall of your compact bone would have to go(the compact bone is only a few mellimeters thick)
This is a reference picture for the anatomy of a long bone:
the thinning of the bone wall as well as the loss of marrow also raises biomechanical concerns about the resilience of the resulting bone(a cylindrical object A that has some viscous material inside should be more resilient than a hollow cylindrical object B, even more so when B has a thinner wall than A)
Back to the cellular aspects of the topic:
Your body would still have red bone marrow in other bones, but could this marrow stored far away from your operated bones supply them with osteoblasts and osteoclasts in the same efficiency, as did the marrow which they lost?
It would be great if somebody gets these questions to a surgeon who does internals.
In any case... ideas?
Interesting stuff, Greco (and kinda worrying, to be honest)
As for reaming the "head" of the bone, I'm not sure. I've seen x-rays where the nail is placed next to the top, however others look like this one:
http://www.abc.es/Media/201406/02/image%202--478x891.jpg
In a paper by Frank Birkholtz I posted here quite recently, he discussed a failure of nail distraction during femoral lengthening, which was apparently caused by an insufficient reaming. Therefore, it seems that surgeons are quite cautious about reaming too much.
I will try to investigate this as far as I can. Hope others contribute as well.
Found some nice stuff about bone reaming and its consequences (I have highlighted the words "bone" and "reaming" in order to make lecture kinda easier)
Obviously the book is huge, and includes some interesting data about intramedullary rodding, but focusing on the reaming part (pages 279-281)
https://books.google.es/books?id=8sLNBQAAQBAJ&pg=PA279&lpg=PA279&dq=bone+reaming&source=bl&ots=WfOqZcHm-F&sig=TX21I_CTVfsWpsdoKnOqL7RoP-I&hl=es&sa=X&ved=0ahUKEwjxy_mAhevOAhWBXRoKHSk4AEgQ6AEIHDAA#v=onepage&q=bone%20reaming&f=false
(Hope the link works for everyone. I have screencaped some parts in case it doesn't. If some pages are not shown, you can always google the following parts, and hopefully they will appear)
"Destruction of the medullary contents by reaming has both local and systemic consequences. Reaming obliterates the remaining medullary blood supply after injury. This vascular system reconstitutes in 2 to 3 weeks."
"Therefore, destruction of marrow during reaming does not produce anemia, apart from that created through blood loss into the soft tissues"
So I'm guessing that the vascular system of the bone does not suffer long-term effects. Can someone confirm this?
Why are proportions, biomechanics, soft tissue damage or anything else any less important than this basically "new" thing about bone marrow?
Bone reaming is also being done for the installation of titanium rods which have nothing to do with LL or CLL... If the method would have dire consequnces, the reaming for any reason would not be practiced....
Adult bone marrow is a viscous fluid made of fats and water (And that's from where the risk of fat embolism comes from during internal CLL). There is nothing important in this fluid according to what science know till now. Maybe it is important maybe it isnt but no one knows now... People live pretty good without an entire leg (loss of limb for whatever reason)... They dont suffer any kind of anemia or immune disfunction which means that the body can compensate..
Sorry, but it almost sound like trying very hard to find a reason as to why not to do this surgery... There are enough risks as it is... No need to add a new imaginary one
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