Things I can do to increase the chances of success on the operating table?

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1. What should I eat for the next 3 years? Like calcium or vitamin D?

2. Should I stop consuming sugar? I am not sure but I could be mildly diabetic due to excessive sugar intake since childhood.

3. I have nasal polyps that makes it difficult to breath through nose at times. Would it be a problem during anesthesia?

4. Body better be muscled or not? I read that it's better to bulk up the thighs if doing internal femurs.

5. Could sleep deprivation or staying awake at night affect it?

6. Is unilateral worth it even with Paley?

7. Would Paley mind me not telling my family that I do LL?

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Quote from: justaveragedude on May 10, 2018, 09:28:22 PMMy thoughts based on observations:
1. Eat healthy. Exclude junk food and soft drinks. It is always better to be in good shape when it comes to CLL. Take vitamins during your lenghtening and recovery phases.
2. Yes, well at least try for these 3 years, pretty sure it will help you in the long run.
3. (JUST SPECULATING!) If they give you the general anesthesia it can be a little problematic if you ask me, sure not a great risk but better safe than sorry, tell Paley just in case.
4. Actually for external it is better if you do not have build muscles in the legs. I assume that is also the case with internals.
5. No.
6. He is one of the best, if he can tell you he can do it, you have nothing to fear.
7. Well here I am not sure. He may agree to not tell your parents, but I am pretty sure you have to write who he has to contact if something gets complicated/wrong with you, but like I said Paley is worth the money. Also try to tell your family, it will be much better for both you and your close ones, instead of making them worrying about you and you lying to them. 100% not worth it.

Hey man, thank you for your answer. Actually I meant to say that I'm gonna do the surgery in 3 years from now so it's about these 3 years of preparation. Do you think it's necessary to start eating healthy as you described and stop consuming sugar from now on?

Paley said that unilateral is nonsense. But I still think that it minimizes the chance of fat embolism and I will have one healthy leg.

I most certainly will not tell my parents because they will be against it without doubt.

Quote from: MirinHeight on May 10, 2018, 09:29:19 PM1. consume your normal dietary needs of calcium and vitamin d. obviously you don't want to be low in either when under going orthopedic surgery.

2. you should try your best to be as fit as possible prior to surgery. This means lower body fat. This will not only help you during recovery and weight bearing, but also it reduces the chances of fat embolism in research studies.

3. I believe you can opt for epidural anesthesia if it is a concern for the physician operating on you

4. idk about this one. You should try to be as fit and healthy as possible prior to surgery though.

5. idk what you are asking here. But this ties back to #4. You need to make sure you are as fit and healthy prior to surgery and this means you should not be sleep deprived. Your body recovers when you are sleeping.

6. Unilateral surgery cuts down the chances of you developing fat embolism drastically. Even dr. paley has seen 4 cases of fat embolism syndrome when doing cll on the femurs.  If I undergo internal femurs, it would be unilateral spread one month apart.

7. I don't think Paley would make you get validation from your parents if you are over 18.

Hi, thanks for answering. Actually I'm gonna do the surgery in 3 years from now so it's about these 3 years of preparation.

I've never been fat in my life. But do you mean that the lower the fat is the lower the chance of FE? In that case, I shall not eat much.

How does epidural anesthesia favor my nose condition?

Regarding the unilateral, Paley actually said that it's nonsense and he charges 30-40 extra k for 2-stage which means 1/3 of the original price. How difference do you think between unilateral spread one month apart and 6 months apart?

Quote from: Oh So Arrogant on May 10, 2018, 10:23:09 PMFlexibility is by far the best thing you can do. It wont help you lengthen additional centimeters. It will only make the process more bearable and less painful day to day. Stretching for a few months before surgery is worthless. Spend 8-12 months prior to surgery doing serious yoga, pilates or mixed martial arts.

Spending time and money to build muscle before limb lengthening surgery is beyond worthless.

What do yoga, pilates or mixed martial arts have to do with LL again? I am actually talking about 2-3 years prior to surgery.

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Quote from: myloginacct on May 10, 2018, 10:44:34 PMBy the time you do LL, Stryde/Precice 3 will have had some good years of experience under its belt.

So theoretically you'd have "good legs" soon. We shall see how Stryde actually fares.

Does this have anything to do with the chances of me ending up dead/permanent disabled on the operating table compared to PRECICE 2? I thought it's just about full-weight bearing and the ability to walk immediately post-op. When I said "a good leg", actually I was referring to a leg that's not broken.

Also, do you think Paley's skills will be significantly improved by that time? Maybe there will be something even more advanced than Stryde!

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Quote from: Oh So Arrogant on May 10, 2018, 10:51:47 PMThese questions and statements from you are frighteningly bad.

Why? lol

Quote from: Johnson1111 on May 10, 2018, 10:53:50 PMWhy is unilateral nonsense?

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Quote from: MirinHeight on May 11, 2018, 02:14:39 AM1.6-2% chance of fat embolism syndrome which can be fatal or cause coma/brain death is actually pretty high lol.

he had same response when i bought this up in an email a while back. Yeah hospital fees will increase, but he can't deny the fact is lowers the chance of fat embolism syndrome by a lot. Makes that 2% almost non-existent.

This is why I prefer Dr. Rozbruch over Paley.. he has no problem performing unilateral and understands why a pt would want it. And you can also get a majority of the hospital fees covered with Rozbruch if you have good ppo insurance.

Is the difference between unilateral and bilateral really 2% and non-existent? Probably it's worth the extra 30-40k.

I wonder why he doesn't encourage unilateral if it's good for the patients' safety and more money for him also.

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Chances of dying in an airplane crash = 1 : 11.000.000

Chances of dying in a car crash = 1 : 5.000

So yes, 1-2 : 100 is real significant. But he might have meant that 1-2% is the chances of significant complications (that can be treated) and not dying.

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Quote from: myloginacct on May 11, 2018, 01:17:20 PMSo that's about a 1 in 250 chance of dying to FES.
                         (0.4%)

Oh  , really need to consider 2-stage then. How different do you think between a month apart and 6 months apart?

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Quote from: MirinHeight on May 12, 2018, 03:37:14 AM50% less fat globules get reamed out of the bone canal, and subsequently your body's mechanism for dissolving these fat globules is faster/more efficient. This decreases your chances of fat globules getting dislodged in your lungs, brain or brain stem. Even by very very rare chance, fat embolism syndrome does occur in unilateral lengthening, it will also most likely have low incidence of mortality due to less fat globules that are dislodged or are in your blood stream

Look at how many unilateral deformity corrections/leg length discrepancy surgeries are done around the united states and the incidence of fat embolism syndrome and compare that to the ~2% chance from cosmetic bilateral femoral lengthening.

It should also be noted that femurs have higher chance of getting fat embolism than tibias. Dr. Paley has never seen a fat embolism syndrome from bilateral tibia lengthening. Also research papers have shown that femurs trauma has a higher incidence of FES than tibias. Bilateral internal tibias should be generally safe when it comes to fat embolism syndrome if anyone is considering that. However internal tibias can cause permanent knee pain due to the rod going through the knee joint.

Thus, my own research has shown that external tibias are the safest and least invasive form of lengthening, although recovery will take longer and must wear frames for long time. Also I can only advise a max of 5 cm for tibias due to biomechanical and proportion issues. And if you want to do internal lengthening, you should do unilateral femurs.

MirinHeight, is it even better to have 6-month gap between unilateral surgeries than 1-month?

And are you sure that that external tibias is the safest and least invasive? Maybe less chance for FE, but what about knee pain, possible requirement of ATL, etc? Also doctors told me that in general femur is less complex than tibia. "Tibias have a risk of equinus contracture and (although small) of compartment syndrome." says Dr Franz Birkholtz

Even if external tibias is the safest, the best doctor who can give the most guaranteed outcome (aka Dr. Paley) don't perform external tibias no more.

Quote from: myloginacct on May 11, 2018, 03:43:11 PMI'm not a LL vet or a medical doctor. I'd rather just not comment on this.

E-mail Paley about your concerns, and use your own critical thinking to weigh the costs and benefits of unilateral/bilateral femur procedures with Paley/Rozbruch, given all the data and related issues we know about those.

All these doctors have their own personal interest and can be bias at times. There must be a reason why Paley doesn't encourage unilateral and not necessarily for the patients' own good. It may be dangerous to the surgery's reputation if everyone knows that bilateral isn't as safe and everyone does unilateral. And more time spent for him, he waste more time that could be spent for taking another case. Just possibility, but we don't know.

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Quote from: Body Builder on May 12, 2018, 10:58:40 AM1% possibility of major complication in LL is really not much if you consider how unvasive this surgery is with internals.
Only full externals are not so risky, anything else is. Thats why I believe that LON or LATN are truly stupid, cause you risk so much only to save 3-4 months max from your consolidation.

Anyway, embolism is not so frequent as deep infection but still both problems can be treated in the vast majority of cases, if you go to a good doctor in a good hospital and not in india or places like that.
If someone is not willing to take those risks then he should forget about LL.
After all this surgery is not for anyone, you must be really brave or crazy to do it.

Risks are always there. But we can minimize it as much as possible.

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Quote from: Body Builder on May 12, 2018, 07:13:30 PMOnly with going to a good doctor. You cant do anything else!

The methods are not all equal. You said it yourself externals are safer.