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[Stadiometer, Esq]

$50,000-$100,000 is an unreachable amount of money for most people in a single payment. Dr. Debiparshad has stated he is trying to work with NuVasive to arrange financing options for patients, but that is currently not in place with no specific target date.

The following companies offer financing with competitive rates for up to $100,000 in the form of a straightforward personal loan. These products can potentially offer patients financial access to the top doctors around the world listed in the previous posts in this thread who are or will be using the full weight bearing STRYDE nail. Everyone should be able to have this surgery without taking extremely dangerous risks to their legs and life simply because they don't have the money.

[hanshi]

Hey guys, sorry to rain on your parade, but there are some misconceptions here about the weight bearing thing in general. As I pointed out earlier there is a big mistake in the presentation from Dr. Paley. The 4-point bending test he is referring to is certainly the one defined by the standard ASTM F1264. The results of these tests are bending moments which are measured in Nm, I.e. Newton meters. Pounds make no sense whatsoever because the force needs to be multiplied with half the distance between the loading point and the support.
The resulting value does not constitute the maximum weight of a patient or something similar. It is only used to compare different nails. Therefore the figures presented by Dr. Paley mean that Precice Stryde is stronger than Precice2 by a factor of around 2.2. That's a very good result, however doesn't mean full weight bearing for all patients.
So if you want to know the weight bearing capacity of Stryde you must take the capacity of Precice2 and multiply with 2.2.

Hope this helps.

[Honore]

Hey guys, sorry to rain on your parade, but there are some misconceptions here about the weight bearing thing in general. As I pointed out earlier there is a big mistake in the presentation from Dr. Paley. The 4-point bending test he is referring to is certainly the one defined by the standard ASTM F1264. The results of these tests are bending moments which are measured in Nm, I.e. Newton meters. Pounds make no sense whatsoever because the force needs to be multiplied with half the distance between the loading point and the support.
The resulting value does not constitute the maximum weight of a patient or something similar. It is only used to compare different nails. Therefore the figures presented by Dr. Paley mean that Precice Stryde is stronger than Precice2 by a factor of around 2.2. That's a very good result, however doesn't mean full weight bearing for all patients.
Hope this helps.

Thx for your math, but can you clarify whom (if not all patients) stryde will benefit?

[Stadiometer, Esq]

Hey guys, sorry to rain on your parade, but there are some misconceptions here about the weight bearing thing in general. As I pointed out earlier there is a big mistake in the presentation from Dr. Paley. The 4-point bending test he is referring to is certainly the one defined by the standard ASTM F1264. The results of these tests are bending moments which are measured in Nm, I.e. Newton meters. Pounds make no sense whatsoever because the force needs to be multiplied with half the distance between the loading point and the support.
The resulting value does not constitute the maximum weight of a patient or something similar. It is only used to compare different nails. Therefore the figures presented by Dr. Paley mean that Precice Stryde is stronger than Precice2 by a factor of around 2.2. That's a very good result, however doesn't mean full weight bearing for all patients.
So if you want to know the weight bearing capacity of Stryde you must take the capacity of Precice2 and multiply with 2.2.

Hope this helps.

hanshi-

While I appreciate your mathematical abilities, you aren't revealing any new information or raining on anyone's parade. The reason why is that you are simply converting already known existing quantities. 

Explanation: The fatigue load of PRECICE (v2.2) = 66kg. The fatigue load of STRYDE = 145kg.

66kg * 2.2 = 145kg

[hanshi]

hanshi-

While I appreciate your mathematical abilities, you aren't revealing any new information or raining on anyone's parade. The reason why is that you are simply converting already known existing quantities. 

Explanation: The fatigue load of PRECICE (v2.2) = 66kg. The fatigue load of STRYDE = 145kg.

66kg * 2.2 = 145kg

Man you don't get it. Do you understand the difference between kg, N and Nm?

[hanshi]

From the Precice Instructions for Use:"During the distraction phase, patient should not participle in....... activities that cause more than 20% of body weight to be loaded on implanted leg"

With the new nail being 2.2 times stronger, why do you assume you can do full weight bearing? Your misconception comes from the fact that the only 2 nails which are advertised as fully weight bearing are manufactured by the doctors themselves (Guichet and Betz). They do this advertising because they can destroy the evidence I'm case something happens. Also, they are both known as crooks.
A serious manufacturer like Nuvasive won't ever do such a thing.

[vangeo]

If search on internet about receant publications regarding toxicity of cobalt implants there is many as these two from 2017 from UK and from Netherlands:
https://www.hindawi.com/journals/crior/2017/9123684/
Fatal Cobalt Toxicity after a Non-Metal-on-Metal Total Hip Arthroplasty - from Netherlands
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5259873/
Neuropsychiatric symptoms following metal-on-metal implant failure with cobalt and chromium toxicity

[FormerKidd]

From the Precice Instructions for Use:"During the distraction phase, patient should not participle in....... activities that cause more than 20% of body weight to be loaded on implanted leg"

Where exactly did you see this?  Can you link the source?  It doesn't jive with anything I've been told at the Paley Institute, plus there are several sizes of precice nails that can hold different amounts of weight and people weigh different amounts.

[hanshi]

Where exactly did you see this?  Can you link the source?  It doesn't jive with anything I've been told at the Paley Institute, plus there are several sizes of precice nails that can hold different amounts of weight and people weigh different amounts.

Just google Precice IFU. It's also in the patient brochure.
Don't get me wrong, I'm all in favor of Precice and Stryde. It's the very best there is and you should go for it. However, due to those 2 unethical doctors who peddle their own nails the expectations with regard to mobility during lengthening are too high here.
I am sure that Stryde is as stable as e.g. the Guichet nail, however a responsible manufacturer will never advertise their nail as fully weight bearing. And it's silly and dangerous to walk around during lengthening. You should always play it save.

[myloginacct]

Just google Precice IFU. It's also in the patient brochure.
Don't get me wrong, I'm all in favor of Precice and Stryde. It's the very best there is and you should go for it. However, due to those 2 unethical doctors who peddle their own nails the expectations with regard to mobility during lengthening are too high here.
I am sure that Stryde is as stable as e.g. the Guichet nail, however a responsible manufacturer will never advertise their nail as fully weight bearing. And it's silly and dangerous to walk around during lengthening. You should always play it save.

What if you do unilateral and put all the load on the good leg?

[hanshi]

What if you do unilateral and put all the load on the good leg?

Yes, that was always possible. The only drawback is you'll need 2 surgeries and longer time. But it's the safest method.

[FormerKidd]

I am sure that Stryde is as stable as e.g. the Guichet nail, however a responsible manufacturer will never advertise their nail as fully weight bearing. And it's silly and dangerous to walk around during lengthening. You should always play it save.

Correct, but you are generally permitted to stand on both feet freely if you are under or close to the weight limitation.

[amigos]

Correct, but you are generally permitted to stand on both feet freely if you are under or close to the weight limitation.

For that you should have a very low low low weight

[FormerKidd]

For that you should have a very low low low weight

Two femur nails is usually 150lbs.  Tibia is less, of course.

[hanshi]

Correct, but you are generally permitted to stand on both feet freely if you are under or close to the weight limitation.

Yes of course. When you are standing the load is only static. Also your weight is distributed 50/50 on both legs. The dangerous thing is walking, because that's unpredictable. Nobody can know the exact forces which impact the implant during walking. That's why one has to play it save.

[fokid]

fitbone manufacturers say nothing about the weight bearing ability of the nails. the doctor decides for the patient.

however hanshi has a point. even with traditional im nails for fractures, patients are not encouraged to walk on a broken leg. this whole weight bearing thing is a cll fad. most traditional orthos would not recommend walking without crutches until the fractured bone is well healed up.

[OverrideYourGenetics]

The following companies offer financing with competitive rates for up to $100,000 in the form of a straightforward personal loan.

I also took loans from one of these companies, plus three others that weren't mentioned. Note that they probably only loan to US residents. More information at http://overrideyourgenetics.com/cost

PS: yesterday a PT from Paley Institute told me that the first STRYDE patient came into physical therapy this week. I don't know any other details. The PT said their nails could bear 200lbs.

[Dmtseeker]

I understand that for Dr. Rozberch, medical insurance covers the hospital stay. But do you happen to know exactly what is covered by insurance and what has to be paid out of pocket.

1) what exactly is covered by medical insurance: estimated $ value
2) what has to be paid out of pocket: estimated $ value
3) if this is true why is there not a lot of hype about this information?

Detailed answers would be very much appreciated. I’ve read a few diaries on Dr. Rozberch but the LL patients seem to skim over this detail. Idk why they would but for me this is like make it or break it when it comes to deciding when to do LL (in one year or four) and with who I’ll do LL with (Paley or Rozberch)

On a side note, I wonder when the first precice STRYDE diary will be made. My main question is to find out whether or not you can really walk during lengthening and if so, to what extent. It would be great way to avoid atrophy and maintain mobility before consolidation. Hope someone makes one in the near future.

[OverrideYourGenetics]

On a side note, I wonder when the first precice STRYDE diary will be made. My main question is to find out whether or not you can really walk during lengthening and if so, to what extent. It would be great way to avoid atrophy and maintain mobility before consolidation. Hope someone makes one in the near future.

I don't know about the "side" note - the other concerns you had are better suited for a different thread.

Now onto this thread - today I met the first STRYDE patient. He's aware of the forums and I suggested that posting his diary will gain him a minor celebrity status. Until then, here are a few non-identifiable things I've learned (in case he wants to be super private):

• Had femurs surgery last week on Thu and looks in great shape and positive
• 5'8" going for 5'11". The 8cm is the nail's max but Paley said the recovery will be much better than for the old nail patients who aimed for 8cm.
  
• He does take Xarelto and was prescribed a 1-month supply
• Paley said he should be able to walk without assistance in three weeks, and that he should come to PT using a walker instead of the wheelchair as soon as possible
• He could stand without a walker for 30 seconds.
• The post-op pain manifests mostly at night.
• He's been talking with Paley since Jan, and Paley did not explicitly mention STRYDE (!). The patient saw an option in the surgical cost estimate for "STRYDE, $5k extra" and asked about that.

The last bullet is a bit odd to me because I met another patient who had quadrilateral surgeries (both tibias and femurs on the same day, because she had old rods in the femurs, so no extra risk of fat embolism from the femur marrow) and she had no idea about the STRYDE.

Anyway, this is what I have for now. I hope he does post a diary - even though it will render my blog largely obsolete

[FormerKidd]

and that he should come to PT using a walker instead of the wheelchair as soon as possible

I thought this was generally advised?  PTs seemed to think it made for a better(quicker?) recovery.

[Android]

Interesting that Stryde wasn't explicitly offered, it sure does pay to read the fine print sometimes.

Thanks for sharing!

[OverrideYourGenetics]

I thought this was generally advised?  PTs seemed to think it made for a better(quicker?) recovery.

Yeah, it helps to walk whenever possible, but in some cases, it's just not practical to get to PT in any way but in a wheelchair. My room at Homewood Suites is the farthest possible from the entrance, getting to the first floor involves using elevator buttons, and using a walker to get out would be a feat I'm not sure I would try even pre-op, let alone now when my endurance is shot after 2 months without much use of my legs.

Interesting and sad fact: it used to be quite a bit easier to wheel myself the ~500ft out of the room to the lobby a month ago than it is now.

[LLPatientAdvocate]

$50,000-$100,000 is an unreachable amount of money for most people in a single payment. Dr. Debiparshad has stated he is trying to work with NuVasive to arrange financing options for patients, but that is currently not in place with no specific target date.

The following companies offer financing with competitive rates for up to $100,000 in the form of a straightforward personal loan. These products can potentially offer patients financial access to the top doctors around the world listed in the previous posts in this thread who are or will be using the full weight bearing STRYDE nail. Everyone should be able to have this surgery without taking extremely dangerous risks to their legs and life simply because they don't have the money.

Dr. Debiparshad is not the doctor you want to have doing these procedures. On both a clinical level or a cost friendly level for patients. Don’t make yourself an advocate for this surgeon. Or, if you think you are, please tell this group exactly how many cases Dr. Debiparshad has done in Las Vegas since he’s been there? Either normal LL or cosmetic? I know the answer....do you? It’s zero. Zero cases in three years there. There are other surgeons that have used Precice there in those three years, he can’t even get patients for the regular LL cases.

[lemonade311]

Anyone know if the UK does something similar for loans like this? Would be nice to take out a £40k loan for this to help me pay. Not sure if they care what you use it for though. I feel like a thread where the best lenders are for around the world for people doing CLL would be cool (if that's even possible)

[Honore]

Anyway, this is what I have for now. I hope he does post a diary - even though it will render my blog largely obsolete

You are a great contributor and not even precise 4 (hover mode) will render your blog meaningless 

[Great321]

Dr. Donghoon Lee: * Includes 90 Days of Food, Housing, Medication, Physical Therapy
Femur: $72,900

Would the 90days be enough for Stryde ? Or do you have to stay longer there afterwards? And how can you actually contact Dr. Lee? On his website he doesn't seem to respond frequently..

[TemakiSushi]

Would the 90days be enough for Stryde ? Or do you have to stay longer there afterwards? And how can you actually contact Dr. Lee? On his website he doesn't seem to respond frequently..

You don’t even need hospitalization for months.

Doctor told me that a week after the surgery I can go home and come back and forth from japan every 2weeks for consultations.

now he is probably very busy because his new clinic is opening in June.
I only have the email address of a Japanese translator.  I heard there was an English translator.

[TemakiSushi]

Interesting that Stryde wasn't explicitly offered, it sure does pay to read the fine print sometimes.

Thanks for sharing!

Even nuvasive told me that the release date was a top secret at that time .
I guess they didn’t want patients to delay the surgery schedule to wait for the stryde.
They may have a monthly sales goal

[OverrideYourGenetics]

Even nuvasive told me that the release date was a top secret at that time .
I guess they didn’t want patients to delay the surgery schedule to wait for the stryde.

I don't know if that's really true or speculation, but it's misguided because:

• PRECICE can still be used in children, who are way under the weight limitations
• doctors can still not highlight STRYDE in their offering (as we've seen above)
• many patients don't care and would just do PRECICE 2.2 (I met one myself)

[TemakiSushi]

I don't know if that's really true or speculation, but it's misguided because:

• PRECICE can still be used in children, who are way under the weight limitations
• doctors can still not highlight STRYDE in their offering (as we've seen above)
• many patients don't care and would just do PRECICE 2.2 (I met one myself)

Wow! I wonder why don’t see much difference?
This is what I have been told...
Precise: 6 months on a wheelchair
Stryde: 3 weeks with cruches(wheelchair/walker a several days)

even if 3 weeks of wheelchair with stryde seems much easier than precise.

[OverrideYourGenetics]

Talked with the STRYDE patient again today. Two weeks after the surgery, he's walking with crutches.