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[Auron]

50 days after surgery, X-rays day

I’ve been lengthning between 0,54 and 0,81mm a day. I’m not in a hurry and it feels really good to be lengthning at this pace. I can’t remember the last time I had pain. As you can see by looking at the x-rays below I am at 3,72cm and will be stopping at 5cm for 2 reasons, proportions and recovery. I am doing unilateral so I can compare my starting height and proportions with the newly adquired ones. Proportions wise I’d say they were at its best when I hit 3cms, meaning that, imo, I had slightly short femurs and will end up with slightly long femurs. The height difference at 3,7cm is major, I had no idea it would be so noticeable, so much that if I stopped now I’d be pretty happy with my new height. X rays are next, sorry for the bad quality.

X-Ray 1 month post op at 2,37cm


X-Rays today, 50 days post op at 3,72cm




All Monegal’s patients here at MIC seem to be doing very well, we were comparing our X rays earlier to see who had the best bone formation so far and helloworld beat us hands down 

Thats it for today folks!

[helloworld]

:-) I have to admit I (helloworld) did not play fairly, lengthening at a slower rate of 0,6 and thus causing more bone cloud density.
But you got a gain of 3,7 while I got 3,3!

[Auron]

Can't edit my previous post to add another picture of my last X rays so I'll just post it here.

[Auron]

Something I forgot to mention, might be relevant to some people so I'll just drop it here.

Last month there was a medical team from Lisbon taking part in one of the Dr. Monegal's CLL surgery but only as spectators. It seems they were very interested in learning the technique used by Dr. Monegal. At the end they were very impressed by the the doctor and his team. I've also noticed that the Dr. Monegal's schedule has been filled with alot CLL surgeries so I'd say that more and more people are choosing him to do their CLL.

I understand now why Musicmaker keep telling me that Dr. Monegal is the best doctor in the world! We also always have a good time all together when he visits us.

Btw, tomorrow I'll reach 4cm!

[helloworld]

I almost agree:
I think MusicMaker said he is "one of the best Limb Lengthening surgeons in the world".

But I agree with your point.

[forrestgump]

Hi Auron,

Thanks for providing details on your journey so far! Glad to read you're doing well and best wishes on reaching your goal. Just had a few questions around additional costs such as food, transport, PT's, + any other everyday expenses?

Would be awesome if later on you could upload some photos of your points of incision too 

Cheers!

[Col92]

I just read something written by Dr Monegal , written in 2014, where he mentions Fitbone bringing out an updated Fitbone in 2017/2018. Does anyone know what the improvements will be and would it change anyones mind about Fitbone v Precise. I have been in touch with Dr Rozbruch and he has quoted 100k for surgery with a lot of things still to be added so will add up to 130-140k. He would be my first choice but will be many years before this could be afforded whereas Dr Monegal is a more realistic goal.

Also thinking about India or South Africa for precise 2 but as I come from Europe I'm a bit nervous about those choices.

[yyes]

Doesn't Dr monegal require two surgeries though? One surgery per leg?

[Auron]

@forrestgump

It's my pleasure to provide the details of my journey as I know they will be useful to future LL'ers. Hopefully I will reach my goal by the end of the month.As for the costs, I usually eat food cooked at home but most people at MIC order their food and I'd say its quite cheap. We use justeat.es alot and by spending 20€ a day you get around 3 meals. If you use MIC's restaurant you'll be spending like 12€ per meal but they very good meals I'd say. I've got the bus and the subway just beside MIC and each ticket is 1€. PT's charge you between 25 to 40€ per session, depending on what PT you choose. I asked the doctor to recommend me a PT. You might spend money on daily coffee's while you hang out with other patients from MIC, we do it quite frequently. 

@Col92

I don't have any news about the new fitbone but I'll make sure to ask the doctor about it. All I can tell you is that Monegal has had many patients from the US. If you're undecided about coming to Monegal or not just take your time to read the new diaries to make your decision, my diary has just started so I don't really have much information to give but so far I haven't had any problems and I'm very happy with my decision.

@yyes

He usually operates one leg at a time (he prefers doing so) which we call unilateral but if the patient still wants to do bilateral (the 2 legs at the same time) hes up for it as well.

[Col92]

Glad you are doing well. I'm actually based in the UK, one of the reasons that the US is such an expensive option. If money was no option then Dr Rozbruch would be my choice but I can only imagine the cost of staying in New York for 3 plus months.

[Auron]

Glad you are doing well. I'm actually based in the UK, one of the reasons that the US is such an expensive option. If money was no option then Dr Rozbruch would be my choice but I can only imagine the cost of staying in New York for 3 plus months.

To be frank I don't know much about Rozbruch but we finally have a diary of one of his patients in the making, maybe you can take advantage of that. Being away for 3 plus months while handicapped doesn't sound like a good idea but some people want this surgery badly enough to do it. Some patients here do unilateral and get back to their jobs 1 month after each surgery and one of the reasons that made me choose Monegal is that he does unilateral.

The only advice I can give you is that you make your list of possible doctors you would like to go to and pay them a visit.

[yyes]

To be frank I don't know much about Rozbruch but we finally have a diary of one of his patients in the making, maybe you can take advantage of that. Being away for 3 plus months while handicapped doesn't sound like a good idea but some people want this surgery badly enough to do it. Some patients here do unilateral and get back to their jobs 1 month after each surgery and one of the reasons that made me choose Monegal is that he does unilateral.

The only advice I can give you is that you make your list of possible doctors you would like to go to and pay them a visit.

I don't understand this. If he does one leg at a time and you go back to work after one month, wouldn't you eventually have one foot longer than the other?

[helloworld]

I don't understand this. If he does one leg at a time and you go back to work after one month, wouldn't you eventually have one foot longer than the other?

The foot size should be the same, but the leg length would indeed be different!
Here is my take on the issue:
Bilateral vs unilateral lengthening

My surgeon, Dr. Monegal, prefers unilateral lengthening and I am sure there a good reasons for that. However, after having gone through bilateral procedures and having shared experience with many unilateral patients, I very glad I did bilateral and wanna tell you why:

Mobility
A unilateral patient is supposed to be more mobile as he as one “normal” leg. However, I have not seen a big difference between me and unilateral patients:
Neither of us can walk normally.
I am faster in a wheelchair than they are on crutches.
I have been able to stand up early on, which is actually easier for me as my legs are equal length.
I am able to swim, to bike, to walk with arm support.
Many exercises seem to be easier for me as I have both legs in the same conditions.

Pain
A bilateral patient is supposed to have twice the pain. I think the opposite is true. Comparing pain levels it seems that mine are the same or lower to unilateral patients. My explanation is that pain is a signal of the body that something is wrong. Having 2 legs broken instead of 1 does not make that signal stronger. In fact, I believe it is easier for your brain to accept the condition as normal and thus stop the pain, as your brain does not have a “normal” leg to compare to, while a bilateral patient always knows what a normal leg should feel like and that this is different from the broken leg.

Mindset
You need a lot of determination to do everything you can as a patient to speed up recovery as well as to endure pain and bad sleep.
For that it is important to see the light at the end of the tunel! For me I will be done with the lengthening in about 2 weeks and then just consolidate. For the unilateral patients they are going through the same bad time as me only to know that after one is finally done they still have to do another!

Speed
As far as I have understood, the total time of lengthening + recovery is decreased by increasing the lengthening speed. So if you extract at 2 mm a day you will have tight muscles and a big gap in your bone that takes a long time to recover. If you do 0.7 mm a day your muscles at the end of lengthening will already have adjusted and your bone gap will almost be consolidated so the total recovery time is not longer but maybe shorter!
And of course lengthening at 0.7 mm means you have much less pain!
On the other hand, I understand people that want to just get over with this process asap, which is possible if you both legs at the same time, but at a slow rate.

Work
Unilateral patients are supposed to be able to work while lengthening.
Personally, I think that this will be difficult unless you are able to sleep well during night which most patients are not.
On the other hand I am working from home office with a similar productivity as before, just not able to work from the office. Actually, I guess by now I even could work from the office, but as I need an afternoon nap, I work from home.

For all those reasons, from a patient experience I would advise bilateral lengthening.

[Auron]

I don't understand this. If he does one leg at a time and you go back to work after one month, wouldn't you eventually have one foot longer than the other?

Yes, you would have a longer leg, just lke I do now. However, everytime I go out with pants on (and I do go out with my pants on everytime) I wear an insole in one of my shoes so I can walk evenly and no one notices that I've one longer leg. I'll have a longer leg until I finish the lengthning phase of my 2nd leg, but tbh, it hasnt been an issue.

[Auron]

I've asked Dr. Monegal about the new fitbone version and it seems it won't be out for another 3~4 years. They will be testing prototypes meanwhile. If you are wondering what changes will bring the new fitbone I've got some news for you.

-The biggest change is that they will remove the antenna and its cable;
-They will also install a software in the control unit in order to receive feedback from the implant;
-Right now fitbone can go backwards but the patient cannot do it. With the new version the patient will be able to control the implant with the control unit so it can go backwards at any given time.

[Auron]

2 months and 10 days post op (x rays day)

Me and a few patients had x rays today and I'm very pleased with mines. I've such a good bone cloud and I'm sure that if I stopped lengthening today I'd be walking unaided in no time.

X Rays:



As you can see I am at 4,1cm. I'm actually thinking of stopping at 5cm so I am 9mm away from my goal. The doctor advised me to pick up my lengthen pace so my bone doesn't consolidate before I reach my goal.

[yyes]

I know alot of us here see this surgery as a risk and it is risky. But it is freaking amazing how far technology has come and what we are able to do in the 21st century. I can only imagine the technology that will come out 50 years from today

[notimportant]

Seems good callus. You're young. Hope your second leg is OK too.

[AlwaysRoomForImprovement]

Looking good. What's the worst pain you've had in your journey so far? And what do you do during the day? It must be pretty boring lol Hopefully Monegal doesn't raise his prices by the time I can get my surgery done.

[onemorefoot]

Do you know if amount lengthened is the same as amount gained??If thats the case how many mm?

[Auron]

I know alot of us here see this surgery as a risk and it is risky. But it is freaking amazing how far technology has come and what we are able to do in the 21st century. I can only imagine the technology that will come out 50 years from today

Yes, this surgery is risky. In my case, I've been following the doctor's advices and everything seems to go perfect. I'm not really amazed by the techonoly though, I still think there is room for improvement in every nail in market.

Seems good callus.

You look impressed 

Looking good. What's the worst pain you've had in your journey so far? And what do you do during the day? It must be pretty boring lol Hopefully Monegal doesn't raise his prices by the time I can get my surgery done.

The worst pain was surely at night when I hit 2cm (I wasn't very flexible to begin with). I had to ice my leg quite a few times before falling asleep. Thats when when I begun to lengthen at a lower pace and it worked like a charm. During the day I usualy work on my thesis, go to the gym to do my daily exercises twice a day, sometimes I go to the pool, hang out with other patients out of mic, etc.

Do you know if amount lengthened is the same as amount gained??If thats the case how many mm?

Right now I've a discrepancy so it's hard to tell my accurate height but during the consultation Dr. Monegal did tell me that I should expect a slightly lower gain in height compared to the amount lengthened. Not too much though.

[Auron]

Last saturday I whatsapped Dr. Monegal saying I was stopping to lengthen in that same day at 4.8cm. He was surprised as most of the patients I hang out with. The reason why I stopped so early is because I feel confortable with both my height and proportions right now. If you followed my diary I said that my proportions looked at their best at 3cm of lengthening so, from that day on it was all about gaining height without damaging my proportions too much.

Why 4.8cm and not 5cm?

Simply because I was never chasing a number to begin with. It's not like im walking around with a number above my head. I feel that I should stop at my current proportions and I did so.

X rays on 15th feb

Dr. Monegal asked me to go the clinic to do X rays and go through my proportions to make sure I wouldn't regret it later. We did X rays and had a look at my leg, he said I could easly do another cm as my proportions looked great. Even though I can still click, my decision still stands.





These x rays were taken on the 15th of february in the morning.

So right now it's all about recovery for my left leg! The doc told me to start walking with 1 crutch and I will do so.

[TIBIKE200]

Be sure man. There is no going back afterwards

[Auron]

Be sure man. There is no going back afterwards

Yup, that's why I've stopped now.

[TIBIKE200]

how tall are you now? Were you measured?

[Auron]

Yes, I was measured at 176cm but I do have a bad posture and a hard time standing fully straight on my operated leg. My guess is that I will only reach my peek (as of real height) 1 month after stopping the lengthening phase on my 2nd leg. I measured myself a while ago standing on my good leg and it was 172cm, dead on.

[682]

Auron, I'm very impressed with your restraint in not over lengthening when you personally know it's time to stop. This appears to be difficult as many who undergo the surgery find the temptation of 'just 1 more CM' to tempting to pass and believe they should with the pain, time and money invested. Here's to a speedy recovery.

[Auron]

Auron, I'm very impressed with your restraint in not over lengthening when you personally know it's time to stop. This appears to be difficult as many who undergo the surgery find the temptation of 'just 1 more CM' to tempting to pass and believe they should with the pain, time and money invested. Here's to a speedy recovery.

Thank you very much 

[onemorefoot]

Auron, I think the x-rays should be 10 per cent more than real height, your gap shows 4.8, however I think in real life it should be 4.2-4.3, I hope you can confirm you peak height in the afternoon. Have a great recovery.

[Auron]

It's pretty easy to walk unaided in my room, no pain at all. It's a great feeling but I'll avoid to do it until the doc gives me the green light. To every future Monegal patient: you'll feel like you can walk unaided right after the lengthening phase but always listen to your doc, walk with 1 crutch when he says so and only ditch both crutches when asked. Until the bone has a consolidated bridge, your nail and screws are still bearing most of your weigh.

Auron, I think the x-rays should be 10 per cent more than real height, your gap shows 4.8, however I think in real life it should be 4.2-4.3, I hope you can confirm you peak height in the afternoon. Have a great recovery.

Yes, you're right, or at least not too far off. I'm waiting for the other patients to finish their lengthening phase in order to calculate their height gained and compare it all together. Thank you.

[Ozymandias]

Last saturday I whatsapped Dr. Monegal saying I was stopping to lengthen in that same day at 4.8cm. He was surprised as most of the patients I hang out with. The reason why I stopped so early is because I feel confortable with both my height and proportions right now. If you followed my diary I said that my proportions looked at their best at 3cm of lengthening so, from that day on it was all about gaining height without damaging my proportions too much.

Congrats Auron, I think you made a good decision. 1.76 is a nice height, and a 4.8 cm lengthening should imply a quick recovery, with less long-term effects. And short-term thinking, the temporary 4.8 cm leg discrepancy must be quite easy to correct with a thick insole.

It's pretty easy to walk unaided in my room, no pain at all. It's a great feeling but I'll avoid to do it until the doc gives me the green light. To every future Monegal patient: you'll feel like you can walk unaided right after the lengthening phase but always listen to your doc, walk with 1 crutch when he says so and only ditch both crutches when asked. Until the bone has a consolidated bridge, your nail and screws are still bearing most of your weigh.

Sounds like a good advice.