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Author Topic: Dr Franz Birkholtz (Pretoria, South Africa)  (Read 299362 times)

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TRS

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #124 on: February 18, 2014, 02:50:21 PM »

Hey Dr.Birkholtz,

Just wondering if Precice 2 has any mechanical/functional advantage over Precice other than giving longer length?
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Franz

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #125 on: February 18, 2014, 06:43:13 PM »

Dear Doctor,
I will be most likely to come alone. Do I need to hire a care taker or the package cost includes the helper?

Some of the precise patients have reported precise not distracting at the rate it supposed to and therefore they have premature consolidation. If similar occurrence happens how much it would ost for second osteonomy?

Thank you sir!

The price does not include a caretaker, but presumably you should be able to cope reasonably well without one. Of course it is possible to arrange someone.
Unlikely that premature consolidation will occur if process is managed correctly.
Cost for re-osteotomy in the region of 4K.
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Franz

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #126 on: February 18, 2014, 06:47:30 PM »

Dear Dr. Birkholtz,
Also, one of the precise patient had to cut his journey short because risk of severe nerve damage. He only lengthen ~3.5cm on femur. It took years of effort to saved up the money and now regrets profoundly having this done.

Could this be prevented early on or the course can be changed with surgery? I am very nervous and loosing my sleep over this.

Hoping to hear from you soon.

Thank you,
Cooper

There is a lot of individual variability and unpredictability. I have performed literally hundreds of lengthenings (for nonCLL reasons) and have not seen this complication. It is rare. Dont lose sleep over it, but remember that expectations and reality sometimes dont match up. Murphy is alive and well!
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rickybobby

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #127 on: February 18, 2014, 08:45:55 PM »

dr franz,

one of dr. lee's patients in korea is undergoing LL with precice 2 on his femurs. He is saying that his rod is malfunctioning because this muscle mass is too much for the rod to lengthen, do you have any more info about precice 2 malfuctions?
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mediocre

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #128 on: February 20, 2014, 05:38:20 PM »

Hi Dr Franz,

What oral anticoagulant will you be using?
How long to take it?
Roughly how much would be the cost?

Thanks.


Hi guys,

We've spent the last week number crunching and obtaining quotes from the relevant service providers.
Our cost for bilateral precice lengthening is 52K USD. This includes the following:
All professional fees for surgeon, anaesthetist, physio, psychologist, occupational therapist.
High care unit for 1 day.
Normal hospital ward for 5 days.
All followup visits, erc sessions and woundcare visits.
Daily physio for 75 days.
Doctor contact at least twice a week.
Support by a multi disciplinary team experienced in limb reconstruction.
Accommodation in a four star rated guesthouse close to hospital on a dinner bed and breakfast basis. Includes wifi and satellite tv. Also includes daily transfer to clinic for adjustments. The accommodation is for two people. This is a self catering unit.
As you can see, everything is included, except for potential complications.

Our lists are generally booked a couple of weeks in advance, but provided I am not on congress or holiday, we can accommodate most of the year.
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Franz

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #129 on: February 20, 2014, 06:51:45 PM »

We use subcutaneous low molecular weight heparin for 2 weeks after discharge. Incl in cost
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paco

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #130 on: February 20, 2014, 08:03:53 PM »

Hello doctor Franz,

I would like lengthening 5cm my tibias, i think that for my small goal is better only external device, to avoid problems with my kness.

if i would make this surgery with you? Which method would you use with me?.

I am 36 years old, my heigh is 1,63 with 63kg. I'm not a child, and i like you are very conservative, i don't knew anything about you

until know this fórum. My option is doctor salameh but i am reading  about one patient here and i have a lot doubt about him

Thank you very much to cooperate in this fórum.
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Franz

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #131 on: February 21, 2014, 05:33:44 AM »

Hello doctor Franz,

I would like lengthening 5cm my tibias, i think that for my small goal is better only external device, to avoid problems with my kness.

if i would make this surgery with you? Which method would you use with me?.

I am 36 years old, my heigh is 1,63 with 63kg. I'm not a child, and i like you are very conservative, i don't knew anything about you

until know this fórum. My option is doctor salameh but i am reading  about one patient here and i have a lot doubt about him

Thank you very much to cooperate in this fórum.

I tend to use TSF or Truelok rings in an Ilizarov type construct.
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kneehowguys

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #132 on: February 22, 2014, 12:00:18 PM »

I am uncertain but read that Bilteral Damage is 5'6 or higher without LL.

What would need to happen for you to accept a 5'7 patient for cosmetic LL?

Excluding surgery to fix a botched attempt by another doctor?
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kneehowguys

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #133 on: February 22, 2014, 01:11:30 PM »

And do you see yourself ever doing cosmetic precise 2 tibias for 5cm?
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Franz

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #134 on: February 24, 2014, 07:21:25 PM »

@kneehowguys:

Thanks for your comments.
Firstly, I stand by our rough selection criteria of 165cm in males as the upper limit. There are cases where, after thorough evaluation, it may be appropriate to perform CLL. This should not be seen as the norm and is definitely not a topic for open discussion. Patient confidentiality also prevents me from commenting on another patient's treatment or surgery indications. Hope you understand. I would suggest that you follow the outline elsewhere in this thread on how to go about CLL in our unit.

With regards to precice 2 for tibias. It certainly is feasible, but again this will be up to an individual patient's preference and decision.
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paco

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #135 on: February 24, 2014, 09:47:34 PM »

hello doctor franz,

In my case i would like lengthening my tibias 5 cm but i would like only external to avoid problems with my kness. i am 36 years old,

how much time do i need with external fixator?, I like doctor salameh device, and doctor mitkovic. they offer smaller external devices,

but i like your ethics and conservative doctor. how much do you charge for one appoinment?
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theuprising

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #136 on: February 25, 2014, 03:31:10 AM »

Hello again Dr. B my question is why did you become interested in cosmetic
limb lengthening? It seems that many doctors shy away from it due to ethics
and that it's deemed unnecessary and too risky.

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Franz

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #137 on: February 25, 2014, 09:29:16 PM »

hello doctor franz,

In my case i would like lengthening my tibias 5 cm but i would like only external to avoid problems with my kness. i am 36 years old,

how much time do i need with external fixator?, I like doctor salameh device, and doctor mitkovic. they offer smaller external devices,

but i like your ethics and conservative doctor. how much do you charge for one appoinment?

5cm in an adult means between 7 and 10 months in an exfix.
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Franz

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #138 on: February 25, 2014, 09:33:18 PM »

Hello again Dr. B my question is why did you become interested in cosmetic
limb lengthening? It seems that many doctors shy away from it due to ethics
and that it's deemed unnecessary and too risky.

This is a very good question. Firstly, lengthening and limb reconstruction is a long-time interest. I just love the magic that happens when you create new tissue from nothing - like magic.

The ethical question is more complex. I guess I have a sort of reverse ethical opinion about this. My take is not whether it is ethical to perform the surgery, but whether it is ethical not to. You see, I know I can lengthen patients safely with relatively low complication risks and I do that almost daily. I also know that there are individuals who will get CLL no matter what the risk. They often end up with the wrong doctors and end up losing function etc. If I have the tools, skills and capabilities, am I not unethical by not preventing these disasters?

Anyway, this is controversial, but there's my 5 cents worth...
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paco

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #139 on: February 25, 2014, 10:23:14 PM »

very good answer.
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just4cm

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #140 on: February 25, 2014, 11:28:57 PM »

This is a very good question. Firstly, lengthening and limb reconstruction is a long-time interest. I just love the magic that happens when you create new tissue from nothing - like magic.

The ethical question is more complex. I guess I have a sort of reverse ethical opinion about this. My take is not whether it is ethical to perform the surgery, but whether it is ethical not to. You see, I know I can lengthen patients safely with relatively low complication risks and I do that almost daily. I also know that there are individuals who will get CLL no matter what the risk. They often end up with the wrong doctors and end up losing function etc. If I have the tools, skills and capabilities, am I not unethical by not preventing these disasters?

Anyway, this is controversial, but there's my 5 cents worth...
Even I've decided to do CLL, there is always smth that boders me about it especially when u're reading diaries from patients who went through agony. Reading Your posts dr. Birkholtz I become more and more confident in doing CLL. I wish all the doctors are like You! From what I've been reading here on forum I can say You are such a great doctor and I love how You behave and act as a human being.
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mediocre

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #141 on: February 26, 2014, 06:47:09 AM »

Hitting the nail on its head.

My take is not whether it is ethical to perform the surgery, but whether it is ethical not to...
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Arche

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #142 on: February 26, 2014, 04:08:41 PM »

Hitting the nail on its head.

Hitting the bone with the osteotome! haha
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mediocre

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #143 on: February 26, 2014, 04:11:12 PM »

Exactly! ;)

Hitting the bone with the osteotome! haha
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Daylight

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #144 on: February 26, 2014, 04:19:51 PM »

Hi guys,

We've spent the last week number crunching and obtaining quotes from the relevant service providers.
Our cost for bilateral precice lengthening is 52K USD. This includes the following:
All professional fees for surgeon, anaesthetist, physio, psychologist, occupational therapist.
High care unit for 1 day.
Normal hospital ward for 5 days.
All followup visits, erc sessions and woundcare visits.
Daily physio for 75 days.
Doctor contact at least twice a week.

Support by a multi disciplinary team experienced in limb reconstruction.
Accommodation in a four star rated guesthouse close to hospital on a dinner bed and breakfast basis. Includes wifi and satellite tv. Also includes daily transfer to clinic for adjustments. The accommodation is for two people. This is a self catering unit.
As you can see, everything is included, except for potential complications.

Our lists are generally booked a couple of weeks in advance, but provided I am not on congress or holiday, we can accommodate most of the year.
It would be super nice if you can post some pictures of the guest house. If I decide to go through 2 operations with you, could it be possible for me to have some discounts?
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mediocre

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #145 on: February 26, 2014, 04:26:03 PM »

The guesthouse link is posted on BigD's thread

http://www.natanja.co.za/

Are you thinking of Precice 2 for both femur and tibia? Or Precice 2 femur and tibial LON?

It would be super nice if you can post some pictures of the guest house. If I decide to go through 2 operations with you, could it be possible for me to have some discounts?
« Last Edit: February 26, 2014, 04:31:12 PM by mediocre »
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Franz

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #146 on: February 26, 2014, 07:54:30 PM »

Hey Dr Birkholtz!
For the last several years, I have made a transition to a lacto-vegetarian diet for personal reasons.
My diet includes wide range of grains, seeds, nuts, vegetables/fruits, milk, soya products etc.
I am wondering if this would affect me during CLL and also whether the guest house you mentioned earlier provide vegetarian meals?
Your diet will not be a problem provided you take enough calcium magnesium vit c and d.
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Franz

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #147 on: February 26, 2014, 07:56:22 PM »

Hey Dr Birkholtz!
For the last several years, I have made a transition to a lacto-vegetarian diet for personal reasons.
My diet includes wide range of grains, seeds, nuts, vegetables/fruits, milk, soya products etc.
I am wondering if this would affect me during CLL and also whether the guest house you mentioned earlier provide vegetarian meals?

With enough lead time, I am sure your requirements could be accommodated. Within reason.
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Franz

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #148 on: February 26, 2014, 08:00:49 PM »

It would be super nice if you can post some pictures of the guest house. If I decide to go through 2 operations with you, could it be possible for me to have some discounts?

Look at www.natanja.co.za

My prices are mostly dependent on subcontractors. My practice sees around 10% of the cost quoted. I have no financial interest in the xrays, hospital, nails, guesthouse etc, so the price is essentially already cost price. This is why it is cheaper than anywhere else in the world for a similar service. I hope you can understand that discounts under these circumstances are virtually impossible.
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mediocre

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #149 on: February 26, 2014, 09:18:23 PM »

Hey Dr Franz. If I want to arrange for personal consultation by April, do I just arrange it with madelein?

I'm planning on staying in Pretoria for a couple of days tour and at the same time consultation with you and also do my bone x-ray there.

This is of course if my April dates would be okay with your schedule.

Thanks.
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Franz

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #150 on: February 27, 2014, 05:01:04 AM »

Hey Dr Franz. If I want to arrange for personal consultation by April, do I just arrange it with madelein?

I'm planning on staying in Pretoria for a couple of days tour and at the same time consultation with you and also do my bone x-ray there.

This is of course if my April dates would be okay with your schedule.

Thanks.

Thats perfect. You can mail her at reception@walkamile.co.za. Xrays are done close by so can be done on the day. Alternatively you can phone the office at +27 12 6442641
I have a conference and a short break in april, but there are a number of dates that could work.
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JP

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #151 on: February 27, 2014, 06:44:07 AM »

Dear Dr. Franz,

I’m interested in doing internal femur lengthening in Africa.
 
How many operations did you do for femur lengthening and what is the percentage of compartment syndrome out of every 500

cases, could internal lengthening have a higher risk rather than external?

Thank you
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Franz

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #152 on: February 27, 2014, 11:43:10 AM »

Please read the rest of the thread with regard to experience and patient numbers.

In more than 1000 distraction osteogenesis cases, I have yet to see a compartment syndrome. The risk is low, but present.
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Polycrates.

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #153 on: March 04, 2014, 04:51:02 PM »

This is a very good question. Firstly, lengthening and limb reconstruction is a long-time interest. I just love the magic that happens when you create new tissue from nothing - like magic.

The ethical question is more complex. I guess I have a sort of reverse ethical opinion about this. My take is not whether it is ethical to perform the surgery, but whether it is ethical not to. You see, I know I can lengthen patients safely with relatively low complication risks and I do that almost daily. I also know that there are individuals who will get CLL no matter what the risk. They often end up with the wrong doctors and end up losing function etc. If I have the tools, skills and capabilities, am I not unethical by not preventing these disasters?

Anyway, this is controversial, but there's my 5 cents worth...

Dr. Birkholtz's philosophy is sound in my book. There seems, in general, to be an enlightenment occurring in medicine, as doctors seem to be realizing that certain physical quiddities people obsess over can most easily and most readily be ameliorated by treating the condition directly. This is proven by the fact so many people completely distance themselves from their LL story and simply enjoy their new height, as if it were always there.

This not only applies to a height complex, but a whole variety of procedures. People get braces to straighten crooked teeth, breast augmentation for small breasts, laser eye surgery for poor vision, etc. Of course, some of these procedures carry far more medical necessity than an increase in height, but leaving someone to deal with height dysphoria when they are willing to pay their own hard earned money to free themselves of it should be allowed to do so, in my humble opinion. Leaving someone in a lifetime of mental anguish is more cruel than informing them of the complications that can occur during this procedure and allowing them to decide for it of their own volition.

Take this story for instance: I remember when I was young I developed moderate gynecomastia and my family doctor told me that I had to simply accept it and that it would resolve itself eventually.  This condition affected me severely through adolescence. I finally saw a doctor at 19 and had it removed. Now its torment is but a distant memory and it was even covered by my country's health insurance, so it was free. In this case, I deemed my doctor to be more of a tormentor than a helper.

Even Dr. Paley himself has revamped his philosophy towards cosmetic LL and checked conventional ethics at the door. He's conceded to the fact that many people obsess to no end over this procedure and will venture to other worlds to have it done if it cannot be performed in their own countries. He's also done what many other doctors still feel trepidation in allowing: he's removed the height contraindication from his checklist. This makes complete sense to me, as someone can be entirely happy at 165cm as a male, while in a country with a taller average, such as the Netherlands or most other developed countries, we can see a young male at 170-175cm despise his height. It is of course all relative and I applaud Dr. Birkholtz for offering his services to those who want them. I hope it will save a great many from venturing to shady doctors as a last resort in the future.
« Last Edit: March 04, 2014, 05:02:08 PM by Polycrates. »
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Tibial LON for 6cm- Nov 2013, Dr Sringari -177/178cm to 183/184cm
Prospective Femoral Lengthening w/ Precise 3 (if out) Nail for 7cm- Jan 2019, Dr Birkholtz -183/184cm to 190/191cm

And it was here that he professed to his disciples: all of life's bounties lay somewhere upon the dreaded bell curve

mediocre

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Re: Dr Franz Birkholtz (Pretoria, South Africa)
« Reply #154 on: March 05, 2014, 07:54:03 PM »

For those doing LL this year with Dr Franz, I wonder if you'll be able to catch the live trial of Oscar Pistorius in Pretoria.

This would be a welcome distraction during LL—good time to pass by.

Not sure how long trials in S. Africa last.
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