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[LLSouthAmerica]

Changing the topic... I'm meeting Dr Guichet January 26th. Does anyone have any questions (regarding the lengthening, post-op or nail itself) that you would like to ask Dr. Guichet? For example, I'm gonna ask him what to do when you "lengthened too much" and have reduced range of motion, or other complication since the Guichet Nail can't go backwards as TIBIKE200 said.

[helloworld]

I was an avid reader of Unicorn diary and now she does not write anymore, and latest news was not so good.
So would be great if you could ask him about her and maybe be put in touch with her.

On a separate note: It seems you have done a lot of research of LL and about which doctor to go to.
One thing that I did, is find the worst case patients of the doctor and talk to them. Maybe you already have done, but just in case not I would recommend it.
For example, in case of Dr. Monegal the worst case patient I could find was "musicmaker". When "musicmaker" told me about the complications but still recommended Dr. Monegal as one of the best surgeons, I became convinced this must be true.

[The Kaiser]

Changing the topic... I'm meeting Dr Guichet January 26th. Does anyone have any questions (regarding the lengthening, post-op or nail itself) that you would like to ask Dr. Guichet? For example, I'm gonna ask him what to do when you "lengthened too much" and have reduced range of motion, or other complication since the Guichet Nail can't go backwards as TIBIKE200 said.

Ask him about the price in Milan

[LLSouthAmerica]

Ask him about the price in Milan

I answered that question earlier. For the surgery you have to pay in 2 different bank accounts: 28000 euros (nail implants) 31000 GBP (surgery itself). You can do the math. Pre-op exams, medications, cardiac and dentist consultation are not included.

[LLSouthAmerica]

Please stop advertising for Dr. Monegal in this thread. Thank you!

[notimportant]

They're hijacking your thread. They should be banned.

[Col92]

The more I read on this forum the more confused I get. I just wanted to comment on the statement that the skill of a surgeon is all about numbers. Of course , within common sense parameters, this is true but be careful about assuming that more surgeries equals superior surgeon. I had back surgery a few years ago. I was lucky, a guy who worked in the same part of the country was doing my procedure at the same time and was later taken to court for crippling people.

Thankfully I hadn't chosen to go with him. He got greedy, took on far too many surgeries per year and it turned out that he was relying on alcohol because of stress and was unfit to do his job. He was well known and as far as I know highly regarded, he just got too sure of himself and thought he could do whatever he wanted.The scary thing was that the staff around him were concerned but because of the culture of medicine didn't feel that they could whistleblow. Surgeons are gods!!

If I had gone by surgery numbers I dread to think how my mobility would be now. The other thing that was interesting was that this guy had a great bedside manner, the doctor I went with I found very hard to like as he was very cold and to the point. In the end I wanted his skills not his friendship but I can't say it wasn't hard . Both skills and bedside manner would be the ideal.

[helloworld]

I was justed stating my opinion, trying to be helpful.

You have posted on my diary and I enjoyed your posts!
 So from my diary you must know that I am not saying everything is 100% perfect and that my final judgement on Fitbone and Wittenstein company is still out.
But so far, and after having gotten so much more information over the last 2 months from other patients, I am confdent that I made the right choice with Dr. Monegal and Fitbone.

But, I will stop posting here.

[Col92]

I apologise if I caused any offence, I wasn't even thinking about your particular surgeon when I posted and nor was I saying that your point about numbers of surgeries was wrong. I was trying to warn that there are lots of other things that have to be looked at than the upfront number. I  For instance I think Dr Pariwar sounds great but it makes me nervous that he hasn't had a lot of experience with Precise 2.

 Spain, in fact, would be a great choice for me and I am trying to keep an open mind and following your journey with interest, and I am very grateful to anyone who puts in the effort to share their journey when I'm sure they have a lot of other things to deal with.

[onemorefoot]

Col92, precice is a nail, if a doctor knows how to insert a nail, there is not much problem(he has done tons of nailings). That is surgery easier that for example an Ilizarov surgery or Ilizarov+nail(LON).

[Col92]

Yes I agree, and I did think that his experience with other nails counts for a lot. To be honest I think reading so much on this forum about the pros and cons for different doctors starts to make you look for reasons to cross them off the list to try to narrow it down.

[LLSouthAmerica]

Hi everyone. I arrived to Milan 2 days. Today I met Dr. Guichet and the anesthesiologist. Dr Guichet definitely knows what he is doing. He is very rigorous about all the pre op preparation (training and exams). When he evaluated me, he noticed that I had some orthopedic problems with my knees which unfortunately will limit my lengthening to 6 - 7 CM. He asked me to take an additional exam: a CT of my knees. I will also have to answer a very long "Motivation letter" which more or less requires to explain your reasons for having the procedure and how you will face the consequences of this decision; and also a PreOp Agreement, where he asks your opinion on the many risks and possible situations that may happen. Finally, I had the opportunity to meet 2 of his patients. They were both at about 1 month but were completely different in their lengthening. One had no pain and finished his lengthening in 45 days and the other one had moderate to severe pain with some difficulty to "click".

[assa13ssin]

Hi everyone. I arrived to Milan 2 days. Today I met Dr. Guichet and the anesthesiologist. Dr Guichet definitely knows what he is doing. He is very rigorous about all the pre op preparation (training and exams). When he evaluated me, he noticed that I had some orthopedic problems with my knees which unfortunately will limit my lengthening to 6 - 7 CM. He asked me to take an additional exam: a CT of my knees. I will also have to answer a very long "Motivation letter" which more or less requires to explain your reasons for having the procedure and how you will face the consequences of this decision; and also a PreOp Agreement, where he asks your opinion on the many risks and possible situations that may happen. Finally, I had the opportunity to meet 2 of his patients. They were both at about 1 month but were completely different in their lengthening. One had no pain and finished his lengthening in 45 days and the other one had moderate to severe pain with some difficulty to "click".

Can you ask Dr Guichet the following questions?

1) why so many patients have problems clicking?? pain level too high or just mental??

2) like the case of unicorn who got a fracture, is that because Dr guichet is sometimes too over confident with his nail?? and sometimes is not cautious enough?? too rude (violent) with patients ?? push them too hard?? forcing them to click with the risk to break something??

3) seems there is a risk of the nail bending if you are not cautious with it?? what would Dr Guichet do if the nail bend?? another operation to replace it??

4) why many years ago some of his patients can walk unaided 2 weeks after operation and now you have to use a walker??

5) how many flexibility exactly do you need to do for example 8cm and not finish with duck ass??

thanks

by the way when is your operation?

[LLSouthAmerica]

Can you ask Dr Guichet the following questions?

1) why so many patients have problems clicking?? pain level too high or just mental??

2) like the case of unicorn who got a fracture, is that because Dr guichet is sometimes too over confident with his nail?? and sometimes is not cautious enough?? too rude (violent) with patients ?? push them too hard?? forcing them to click with the risk to break something??

3) seems there is a risk of the nail bending if you are not cautious with it?? what would Dr Guichet do if the nail bend?? another operation to replace it??

4) why many years ago some of his patients can walk unaided 2 weeks after operation and now you have to use a walker??

5) how many flexibility exactly do you need to do for example 8cm and not finish with duck ass??

thanks

by the way when is your operation?

1) From what I've seen, most of the patients who have problems clicking, have too much pain and are more likely to miss rehab / stop walking because of it. Will ask him that!

2) Maybe you can rephrase that...

3) Will ask him that

4) According to the patients I have talked with, they only use the walker the first few days. Afterwards, you only use crutches.

5) Will ask him that

My operation will be at the end of February hopefully

[assa13ssin]

hi south america!!

so if I understood you are starting preOP training in Milan?? how much does the preOP training cost?? is it one month training or two months??

my last 2) question was : a patient from this from named Unicorn (you can read her journal) got a bone fractured/broken during LL maybe because Dr Guichet asked her to do too many clicks... because Dr Guichet has a very army-general like personality and he always pushes his patients to go over the pain is there a risk that sometimes he misjudge the conditions and ask a patients to do too much (like too many clicks) which cause injuries?? I would like to know how he would react to that question

[AlwaysRoomForImprovement]

I will be following your diary closely. I'm also South American living in the US around the same age. Dr Guichet would be one of my top choices but he's quite expensive. I'm surprised you being a medical student and 22yo can afford him, unless you have support from parents of course. Good luck and hope the process goes smooth for you.

[LLSouthAmerica]

hi south america!!

so if I understood you are starting preOP training in Milan?? how much does the preOP training cost?? is it one month training or two months??

my last 2) question was : a patient from this from named Unicorn (you can read her journal) got a bone fractured/broken during LL maybe because Dr Guichet asked her to do too many clicks... because Dr Guichet has a very army-general like personality and he always pushes his patients to go over the pain is there a risk that sometimes he misjudge the conditions and ask a patients to do too much (like too many clicks) which cause injuries?? I would like to know how he would react to that question

Actually, the preOP training is included in the estimate I wrote before. Yes basically, preOP training and appointments (xray, blood tests, psychiatrist assessment, etc). The training is supposed to make you increase your strength by 30% according to CYBEX testing, therefore it is a one month training that may be extended if you are lazy. During that time you learn about the post op management and also do stretching and crutches/walker training.

[Chard]

Good luck with the training LLSouthAmerica.

I contacted Guichet last week as I would like to have an op with him next year, so I'll definitely be following your progress.

Do you have any intention of doing Tibias after your Femurs? Or are you just going to wait and see? One thing I am curious about is whether Guichet offers any 'package deal' to do both segments (in 2 ops over time).

Cheers,
Chard.

[guichethope]

You shouldn't tibs with him . Precise nail seems way more easy for this . Stay safe and good luck .

[1683131665]

Hi llsouthamerica
Prices can be negotiated? He told me ￡52000

[jojo]

great stuff , when are you going ?

[LLSouthAmerica]

I don't know if prices can be negotiated. The idea never crossed my mind. I had my surgery 3 days ago. The pain is manageable but limits my mobility, I am on paracetamol IV and it works very well.

First day: Vomited 20 times or more, I think they overdid it with the morphine because I wasn't feeling ANY pain. After all my suffering they put me on naloxone which is a opiod antagonist and then ondasetron. This made it impossible to stand up and do bike on the first day. Did my first 3 clicks easily.

Second day: Little pain without movement, lot of pain with movement but tolerable. Did 6 clicks, 3 in the morning and 3 in the afternoon and a lot of stretching. I did 45 minutes on bike and also walk, went up and down 3 stairs. I believe I have an increased response to opiod since that day I felt dizzy and tired every time I sited or walked.

Third day: Clicked 3 times in the morning, moderate pain that eases with paracetamol, but no pain if I don't move my legs. Did a little bike, stretching and walking. Also basic stuff like going to the bathroom, eating while sitting in a chair. It's hard but I hope it gets easier later

[682]

Your reaction may be due to the anesthetic during surgery. How much have you lengthened thus far? I believe Guichet distracts an amount during surgery.

[jojo]

yes ask for a paper with data for how many is back to 100 life. and if he have any people you can ask about there LL with him

[LLSouthAmerica]

Your reaction may be due to the anesthetic during surgery. How much have you lengthened thus far? I believe Guichet distracts an amount during surgery.

Yes it was an inhanced reaction to the morphine. I hated it. Today is my post op 6 and I am 1.5 cm taller. This week almost all the patients I met a month before when I arrived for the pre op training are leaving and starting to walk without crutches. The best case I saw, in 55 days post Op he was walking with almost no gait abnormalities. Lucky him. I hope to be like him.

[Unicorn888 by Elaine Foo]

hi south america!!

so if I understood you are starting preOP training in Milan?? how much does the preOP training cost?? is it one month training or two months??

my last 2) question was : a patient from this from named Unicorn (you can read her journal) got a bone fractured/broken during LL maybe because Dr Guichet asked her to do too many clicks... because Dr Guichet has a very army-general like personality and he always pushes his patients to go over the pain is there a risk that sometimes he misjudge the conditions and ask a patients to do too much (like too many clicks) which cause injuries?? I would like to know how he would react to that question

Firstly, Guichet is God.  He'll never admit he's done anything wrong.  So it will always be the patient's fault.

Secondly, yes, there are more stories that are not reported for ALL the docs because patients become fearful of their very own doctors for reasons like...  they still need them to repair them, or they think they still need them to remove nails later.  So all patients walk on eggshells.  Welcome to the stockholm syndrome and being held hostage for a king's ransom if you do not want to remain crippled.

So these days, docs do get away with murder or acting like God.  So be very careful which devil with whom you're making a deal.  That's the lesson I've learnt after speaking to many silent patients.

[TIBIKE200]

Firstly, Guichet is God.  He'll never admit he's done anything wrong.  So it will always be the patient's fault.

Secondly, yes, there are more stories that are not reported for ALL the docs because patients become fearful of their very own doctors for reasons like...  they still need them to repair them, or they think they still need them to remove nails later.  So all patients walk on eggshells.  Welcome to the stockholm syndrome and being held hostage for a king's ransom if you do not want to remain crippled.

So these days, docs do get away with murder or acting like God.  So be very careful which devil with whom you're making a deal.  That's the lesson I've learnt after speaking to many silent patients.

Care to elaborate? Many silent patients of which doctor?

 Also, you shouldn't feel hostage of anyone. Many LL patients went back to their home countries to get "repaired" by docs who specialize in LL and are not doing it for cosmetic reasons. One of them is bigfaker who wrote about getting treatment for a LL gone wrong in india with Saringari with a doc in the states (Not Paley, Mahboubian or Rozbruch)

[Bander72]

Well looks like what notimportant was saying is not foolish as it common sense that would occur.

[682]

Firstly, Guichet is God.  He'll never admit he's done anything wrong.  So it will always be the patient's fault.

Secondly, yes, there are more stories that are not reported for ALL the docs because patients become fearful of their very own doctors for reasons like...  they still need them to repair them, or they think they still need them to remove nails later.  So all patients walk on eggshells.  Welcome to the stockholm syndrome and being held hostage for a king's ransom if you do not want to remain crippled.

So these days, docs do get away with murder or acting like God.  So be very careful which devil with whom you're making a deal.  That's the lesson I've learnt after speaking to many silent patients.

This just further validates my numerous concerns with Guichet and his methods. I think it's time he is no longer mentioned with the likes of Paley, Rozbruch and Baumgart. 

[LLSouthAmerica]

I'm also concerned about how Dr Guichet chooses his patients. I've seen him operate a TALL (more than 1.84) man undoubtedly more than 50 years old. As Unicorn is Asian and female, these are 2 risk factors for bad bone consolidation. I don't know the details but if he made the same fast lengthening as in his other patients. That would have been very unwise of him.

[Joe]

I am a silent one. What Unicorn said, its true. During my LL, I have witnessed lots of bad staff. You must prepare extra money for the possibility that things go wrong and things do go wrong. I also saw one leg which got Compartment Syndrome due to negligence of one doctor. Very scary, he nearly lost the leg and if not caught on time maybe he would have lost his life too. Its rare but it can happen. I will only add that it was in Germany. and yes, the doc is a God and of course, it was not his fault.