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[Lennys]

Currently 15$ daily which is about a third of what my apartment costed

Sorry, I meant the tibial surgery cost.

[Activatedxx]

Sorry, I meant the tibial surgery cost.

Insurance covered most of it because I had bowed tibias. If you have some sort of bow legs/knock knees or rotational deformity or discrepancy (x>1cm) insurance may cover some codes. You can always take X-rays and schedule consult.

[Lennys]

Insurance covered most of it because I had bowed tibias. If you have some sort of bow legs/knock knees or rotational deformity or discrepancy (x>1cm) insurance may cover some codes. You can always take X-rays and schedule consult.

Okay, but how much was it actually?

[Activatedxx]

For me they would have billed my max out of pocket. Varies per person and by network, I anticipated doing my rod removal this year so I picked the 2200/4400 in/out network one with BCBS PPO. It also covers 30 PT sessions but it sucks for pharmacy benefits. I had to fight with them tooth and nail to get them to cover painkiller refills. I wouldn’t mind paying out of pocket but they wouldn’t allow me to for opioids. It has to go through insurance and if they don’t approve you’re SOL. Again, this is relevant for externals. The internal patients barely use their painkillers.

Today was my last day of lengthening
The coolest thing about this is my knees feel higher-up/natural. You get used to it and don’t notice it after lengthening femurs, but your knees sit a little lower. After doing tibias my biomechanics feel completely normal again. Like my center of gravity (standing out of a chair) and knees feel quite literally where God intended them to be again.
I’ve reached 4.8cm and have an apt tomorrow to do corrections over the next couple weeks to fully straighten my tibia. Technically, the week before my removal I’ll start turning my left leg again as I had a 4mm discrepancy (90% humans are born with a discrepancy under 1cm) so I should end up finishing with 5.2cm on the left, 4.8cm on the right.

I could go to 6 or 6.5, but I don’t have the mental and emotional willpower to do another month, and I wouldn’t want to sacrifice function as I still have very good flexibility on my heel. It’s not worth it to me to trade that for half an inch. Also, I would be completely out of painkillers.

[wes07]

How much flexibility in tibias does a flxible person maintain if they lengthen tibia by 5 cm? I'm planning on doing 4.5, but i would like to go to 5 if my flexibility is good and I don't lose too much function.

[Activatedxx]

Most people would have ballerina foot by my stage, as I didn’t wear the splints (they’re super annoying to sleep with and I already have a very difficult time sleeping) and I don’t always attend PT.i just had very flexible heels to begin. Im middle eastern and my mother had me in wrestling from the time i was a young child up until i finished high school. We would stretch before every practice and stand crouched on our heels a lot. Theoretically, you shouldn’t lose much flexibility until you hit 3-4 you start to notice/feel it. After that it exponentially decreases, I think 4.5/5 is solid, as at something like six I really don’t think you could stretch enough to get more than somewhat above neutral. Any competitive physical activity I doubt you can do with the tightness you would have at 6cm without extreme PT. I see patients from Dr. Lee doing 6-7 running and stuff but I’m not sure if they have to stretch daily and their recovery to get there must have been tough.

I know I was able to touch my toes again after doing 8cm femurs but I would have to stretch a few min daily. Once I stopped doing that my hamstrings got tight again. I don’t know if it’s the same case with those patients. I like where I’m at because it doesn’t require any extra effort for me to go far above neutral on my heels once I recover. Even if I don’t stretch I have good ROM, and it’s not worth trading a CM for that

[lengthenme]

Hey Activatedxx,

Congrats on getting this over with , Similar to u I have had my femurs lengthined in 2022 in Turkey with the Buldu and now I am at 5'8 and yes that cured a lot of the problem but part of me still considering stretching the tibias out as well , it is only in thought that I am trying to not entertain but you know once you start the lengthining i believe it is invetibile to stop as long as you know that you could do better and max your bones out all the way.
But I am on a dilemma now as I am getting my   togather financially and maybe and paying off a loan,etc.. Along with getting done with my studies and once having the money i am thinking of considering  Dr Assayeg for tibia lengthining hopefully internally using oreise max in have heated this is how been in use ? ,
may as well take the buldu femur nails out as I am quite sure I am fully healed by now and since Dr Assayag took yours out he would be familiar with the Turkish nails whatever trauma nails they were using who knows hahah
Just out of cursioty, how much it costed u to take the femur nails out and say if I wanted to take those out and do tibia right away do you think this is fesble and doable not sure even if this can be done within one surgery , I imagaine not to be honest as every process is traumatic and needs time to heal
Also as an honest view of yourself now standing and looking at yourself in the mirror is it worth stretching those 5 cm out , I know u was lucky enough with the insurance thing so itnisnmore of additonalmpreiliage id say butni can see that you're happier now and certainly u look like thatbu noticed a different from being at 5'8
However, I am considering paying this out of pocket as I am not from the US , so I am trying to see if it feasable to pump in all the money into this or I rather invest in some lifts :p
As in how is it shifting from from 5'8 to 5'10 , also what is ur view on the propertions , i know it this is quite dum thing to ask hahah but i started with relatively shorter arms as in my wingnspan was around 171 cm I guess so wanted to know if I will be looking funny after that
Thanks man and good luck with your removal and trauma nails insertion

[Activatedxx]

Hey guys, I’m supposed to be a few days away from removal God willing. I was able to also get prescribed more pain medicine after speaking to my insurance, they allowed me a grace fill. Honestly, I feel guilty about exaggeration of pain throughout this process to get more pain medicine, but it’s the only thing keeping my anxiety away. At night it feels like the walls are caving in. It’s that feeling you get when in an MRI or tight space. It’s just enough minor pains and uncomfort to make it impossible to sleep. It’s hard to describe, but mentally I’m at the end of the road the last few weeks, and the only thing that kept me going was the light at the end of the tunnel knowing I’d get these off soon. I might have some underlying mental issue or something because I’ve read of other patients that have had these on for a year and I would never be able to handle that. I’m a pretty normal person but when I freak out, I start freaking out more because I am freaking out, if that makes sense comically

Also I have a herniated disc from when I was hit by a drunk driver some time ago. It didn’t bother me much in normal life but after surgery and sitting down most of the time, the constant minor back pain is debilitating. The opioids are the only thing allowing me to get a good nights rest, otherwise I feel like I had the sleep quality of sleeping in the passenger seat of a car, and feel like an agitated zombie.

It’s like death by a thousand paper cuts. The first dozen are a piece of cake, after 600 you’re begging for mercy and have 400 more to go. Towards the end I had starting turning my fixator faster even after I promised Assayag not to. I just felt like my mental gas tank was almost drained.
I’ve been done with lengthening since 1/13 and the correction since 1/20. Thankfully everything went well even though I’m like 4 weeks ahead of schedule. Assayag is conservative I found  out from other people, because another patient who went to another reputable doctor who did everything right (not Assayag, but don’t want to mention who) that did precice and .75mm on tibias developed some nerve damage. Paley and HSS couldn’t even figure out how to fix it. So it’s for good reason he’s conservative. I’m an idiot for turning faster and taking on the risk but going .5 was rough.

All in all, I made it to the end and just need to switch my fixators for a trauma nail.
Assayag is an exceptional and amazing doctor. Truly passionate about what he does, and genuinely has a heart. I had consults with two other US doctors and it just felt like a cash grab. I honestly advise against doing LL if you’re able to find another way to deal with your height insecurity or therapy, but if you’re going to do it, there is no better option in the USA than Assayag. A combination of the HP house, PT, and price, he is almost half the price of other doctors if you factor those in, and they are all overqualified so you’re splitting hairs by looking at credentials. They all handle complex trauma cases and breaks, so starting with a good pair of legs is very easy for them all. There is nearly no difference.

[Activatedxx]

My fixators came off thank God. Had surgery at 10am. Having them off feels euphoric, despite the pain. Maybe the nailing is more painful than the initial break. I was in significant pain for some reason, and it’s hard to type as some the fingers on my right hand are numb. No clue why. Mainly my thumb. I’m barely awake anyways. Very sleepy. Will try to update later

[lucindaris]

Glad to hear, what was your final gain?

[Activatedxx]

4.8 on the right 5.2 on the left

[Activatedxx]

Hey guys, I’m officially off the forum. Feel free to read my other diary in depth about recovery etc. I feel as I’ve completed this and don’t want to think about it or linger around any longer. Best of wishes to you all.

I’ve had my nails inserted, and I’ll be in the process of recovery. LL is brutal in general, and externals are even more so than internals, so I always advise to go with internals for mental health. That being said, if you are going to do it, Assayag and Sinai are exceptional in every way.