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[midnightninja]

Post a photo of your legs.

[redesky00]

Post a photo of your legs.

Excuse me
Dose Dr Paley,s Email have any change?
I have written Email to him two months ago that two Email  (dpaley@lengthening.us,  inquiry@paleyinstitute.org) but it did not any respond.

[deniscef]

I try it either and I cannot any answer, please somebody could help us out

[OverrideYourGenetics]

Dr. Paley's email is dpaley AT paley-institute DOT org, without the dash.

So I have my consultation with Dr. Paley next week, for femur lengthening. Any questions you guys want answered? Some questions I have so far that are of general interest:

• Do I need a wheelchair with the PRECICE 2 at my 150lbs weight, or can I use crutches?
• Why would I opt for PRECICE 2 when Guichet/Betzbone (Albizzia) can bear my full weight and I can walk with crutches on week 2?
• Worth waiting for PRECICE 3?

Any others?

[Dr. Sarcastic]

Holy sh*t! You just typed out an email address in long form and you actually need an answer to question #2. You definitely took the short yellow bus to school everyday.

[Bleda]

Holy sh*t! You just typed out an email address in long form and you actually need an answer to question #2. You definitely took the short yellow bus to school everyday.

So why is this guy not banned??

[OverrideYourGenetics]

Why would I opt for PRECICE 2 when Guichet/Betzbone (Albizzia) can bear my full weight and I can walk with crutches on week 2?[/li][/list]

From http://www.paleyinstitute.org/centers-of-excellence/stature-lengthening-center/stature-lengthening-complications:

"With the ISKD and Albizzia internal nails, premature consolidation was a well-recognized complication due to the lack of rate control. Since lengthening in both of these devices occurred by movement through the osteotomy site and since movement through the osteotomy site can cause pain and muscle spasm, the patient’s muscles sometimes would prevent the movement and therefore the lengthening would not occur. In other cases, both the ISKD and the Albizzia have had broken mechanisms that fail to lengthen during the distraction phase leading to premature consolidation. The treatment in these cases was to not only re-break the bone but also to change the device to a new one. Although in each case the company provided a new device at no additional cost, the patient still had to bear the cost of an additional outpatient surgery. With the PRECICE and the PRECICE 2, this complication almost never occurs.

Rapid distraction was the most common cause of poor bone formation with the ISKD. This is not a problem with the PRECICE nail since it has complete rate control. Poor bone healing can be recognized during the lengthening process. Once it is recognized, the rate of distraction can be slowed. With the PRECICE the lengthening can be reduced to any level or even stopped. If, despite these changes, the bone healing remains poor, the lengthening can be reversed until better bone formation is seen. The bone can then be re-lengthened. This can only be done with the PRECICE. Going in reverse is not possible with the ISKD, Albizzia, or the Fitbone. This is a huge advantage that is possible with external fixation and now with the PRECICE. "

From http://www.paleyinstitute.org/centers-of-excellence/stature-lengthening-center/history-of-stature-lengthening:

"The Gradual Lengthening Nail, also known as the Albizzia Nail (Depuy, Villerbanne, France) was later modified and released as the Betzbone and the Guichet nail, for use by its two namesakes, respectively. It takes 20 degrees of rotation to move the ratchet one notch. Each notch is 1/15 of a millimeter. Many reports exist of patients suffering from severe pain and discomfort, which limit their ability to independently perform the lengthenings. In some cases, these patients required readmission to the hospital with general anesthesia and closed manipulation. In other reports, 12% of the lengthenings remained incomplete because the patients were simply unable to tolerate the pain of the manipulation.

When the Albizzia nail became available in the United States, Dr. Paley worked with the French company to develop a tibial lengthening Albizzia for stature lengthening, which he started using in 1996. The severe pain experienced by patients from the 15 to 20 degree rotation of the thigh through the break in the bone, as well as several implant failures, lead Dr. Paley to stop using the non-FDA-approved device."

[Dr. Sarcastic]

So let me get this straight. You read all that information from Dr. Paley on his website, post it for everyone else to read, and you still need an answer to question # 2. I know Dr. Rozbruch requires patients to meet with a psychiatrist, if Dr. Paley required his patients to take an IQ test then you would be f**ked...

Q: What is 1+1?
A: 11

"I'm sorry fivefive, you are disqualified from limb lengthening surgery. Height doesn't matter when you live out your days chasing pigeons around a public park"

[Stadiometers]

Link: http://www.paleyinstitute.org/media/file/Cosmetic%20Stature%20Lengthening%20FAQs14_1.pdf

[Stadiometers]

Link: http://www.paleyinstitute.org/media/file/Cosmetic%20Stature%20Lengthening%20FAQs14_1.pdf

[myloginacct]

Thanks for sharing the .pdf. Interesting read.

So Paley's team doesn't go over 5cm in tibias.

Also interesting they don't seem to do externals on tibias, going by the prices there.

[Stadiometers]

Thanks for sharing the .pdf. Interesting read.

So Paley's team doesn't go over 5cm in tibias.

Also interesting they don't seem to do externals on tibias, going by the prices there.

Paley will not go over 5cm on tibias in a single lengthening. If you want more you have to stop at 5cm, go back and rebreak the tibias a year later to lengthen the remaining 3cm in order to achieve the full 8cm. Paley has not done external tibias in close to a decade for cosmetic patients.

[Stadiometer, Esq]

[Johnson1111]

Sounds good. If only I was a millionaire

[Stadiometer, Esq]

[JON SNOW]

So i made some calculations if i go to Dr.Paley would cost me around 255K $  -  300K $

inicial consultation  1.3K
Tibia ( STRYDE) + femur (STRYDE) 3 weeks apart 190K
Medications 4K
Accommodations  (22 weeks,  17-18 weeks distraction + 4-5 extra for rehabilitation/Consolidation Phase in WPB)  24K
extra PT  (only first 13 weeks are cover, so 9 more weeks  )   10K
Food and other supplies + transport 11K
Home health aides 15K

complications extra surgeries  35K - 45 K
 
Do you think that is correct? I'm forgetting something?

[Johnson1111]

So i made some calculations if i go to Dr.Paley would cost me around 255K $  -  300K $

inicial consultation  1.3K
Tibia ( STRYDE) + femur (STRYDE) 3 weeks apart 190K
Medications 4K
Accommodations  (22 weeks,  17-18 weeks distraction + 4-5 extra for rehabilitation/Consolidation Phase in WPB)  24K
extra PT  (only first 13 weeks are cover, so 9 more weeks  )   10K
Food and other supplies + transport 11K
Home health aides 15K

complications extra surgeries  35K - 45 K
 
Do you think that is correct? I'm forgetting something?

lmfao absolutely absurd prices

[Purushrottam]

So i made some calculations if i go to Dr.Paley would cost me around 255K $  -  300K $

inicial consultation  1.3K
Tibia ( STRYDE) + femur (STRYDE) 3 weeks apart 190K
Medications 4K
Accommodations  (22 weeks,  17-18 weeks distraction + 4-5 extra for rehabilitation/Consolidation Phase in WPB)  24K
extra PT  (only first 13 weeks are cover, so 9 more weeks  )   10K
Food and other supplies + transport 11K
Home health aides 15K

complications extra surgeries  35K - 45 K
 
Do you think that is correct? I'm forgetting something?

Hey man, I appreciate the research, but I think the prices are way off.

I had my LL in Sept 2017 and heres what I paid:

Medications: $440 *3 (I don't remember the exact amounts, but it was Xaralto and Pain killers. Xaralto was the most expensive one, at about $400/mo). If you are doing 2 se

Accomodations: I booked a handicapped accessible room with shuttles to the Paley Center last minute during the busiest season at Homewood Suites. The cost was about $90/night inclusive of taxes. If you choose to stay for the entire 90 day period, it would be about $8100

Transport: $0 if you are staying at a hotel with the shuttle. Otherwise, factor in $40-$80/ day for a wheelchair accessible cab.

Food: This is Florida. Food should not cost more than $600/month. However lets say you order outside food every day for 90 days. I don't think any standard meal in FL costs more than $15. So lets include delivery fees and make it $20 (which is way more than what the actual cost would be. That would amount to $20 x 3 x 90 = $5400.

Home health aides: You only need them for 2-3 weeks. If you want a good one, you probably want to pay extra... say $25/hour. Lets say you take extra long and need a live in aide (you most likely wont. you can do with an aide visiting for a few hours per day to clean/do basic stuff). Then the cost would be 24 x $25 x 7 x 3 = $12600, but remember this is the total max scenario if you choose the most expensive options for everything. You may have to pay for an extra room at the hotel for them. $60 (remember you don't need a handicapped room for them) x 7 x 3 = $1260. Total = $13860.

Complications: Thankfully nothing happened to me, but Paley recommends that you keep $25,000 on hand.

EDIT: I just realized I did the calc for 1 surgery, not for 2 segments. If you are doing the 2 segments 3 weeks apart, just add 3 more weeks to the calculations, as the lengthening for both segments should stop at around the same time (femur is lengthened faster than the tibia).

[Purushrottam]

Recalculated for 2 segments 3 weeks apart:

Med: $440 x 4 = $1760

Accommodations: $90 x (90 + 21) = $9990

Food: $  $20 x 3 x (90 + 21) = $6660

Home aide: (6 weeks): $25200 (but you really don't need an aide for that long). Included hotel stay for aide: $2520. Total: $27720.

Extra money for complications: Still probably $25,000.

[mrblack]

That's the thing. You have to pay the highest price and if a complications occurs you need another 25 k$ even when it's not your fault or what?

[Messenger]

Yeah the extra you have to keep in reserve for complications is rediculous.
I am planning on gokng to Paley in Late October early November for my surgery and my cost breakdown was something like:

$97,500 (he increased the price by $2500 compared to 95000) for bilateral internal femur using Stryde
$25000 in reserve for complication (hopefully don’t have to use)
Physical therapy and x days etc are all apart of the $97,500 so the only thing I need to worry about is a caretaker since I’ll be going at it alone (I’m from Canada),  I’m doing 5.5 cm so if no complications take place I’ll need to stay for 8 weeks  lengthening + 12 weeks consolidation.  I’m hoping after 12 weeks I’ll be able to do normal activities and won’t look like a weirdo when walking because no one knows I’m doing the surgery.  So I’ll  be back in Canada in 5 - 6 months. 

The first 3 months I’m planning on staying at the quantum house which is located in the St Mary hospital campus and is offered to patients at $40/night.  Food is included most of the time since volunteers come and cook for everyone.  The last 2 months if I’m able to do it I’ll be staying at an Airbnb at around $80/night. 

Do you guys think my timeline is pretty accurate for being able to walk properly and perform activities at 80% 6 months post surgery using styrde?  I’ll  also be uploading a diary when I go.

Would love to see if someone is planning on going around the same time so we can do it all together. 

[Leggs]

For up to date information on Dr. Paley's pricing and information about the PRECICE-STRYDE click on the following link. There are several posts so simply scroll down to view all the information.

http://www.limblengtheningforum.com/index.php?topic=5507.msg93315;topicseen#msg93315

[taller_in_Kiev]

Dude, you can save yourself half the cost or more if you go abroad.  Why have you got your mind set on Paley in particular? You're from Canada so you'll need to travel anyway.  I know of at least one Canadian that came and did both femurs and tibias with Dr Jamal way back. He was a young kid, paid for by the parents. Had an excellent result.

I just posted some gym videos under my diary.

http://www.limblengtheningforum.com/index.php?topic=9000.0

Needless to say, I am very happy with my result and recovery. Paley is good, I wouldn't say he's necessarily the best.

Wherever you decide to go, wishing you the best on your journey.

[Messenger]

Hey thanks for the recommendation.  I want to do internal femurs for 5 - 6 cm, currently sitting at 5’8.5 in the evening and 5’9.25 in the morning.  Sometimes it varies a bit but I’m looking forward to my consult so I can see exactly what my height is according to him. 

The main reason I want to go to paley is because of the Stryde nail.  I’ll be able to put full weight on my legs 2 - 3 weeks after surgery and it appears that the recovery times are quicker.  If I can walk with a normal gait 4 months post surgery I consider it a huge success.  I have thought about going overseas especially to Kiev because it seems like dr Jamal visits you everyday on this journey which is amazing.  My one criticism of Paley based on other diaries etc is that it seems like he’s more rushed since he has sooo many other patients.  Checks you real quick and leaves, but he does have the best track record so I don’t mind spending $150k MAXIMUM (97,500 for surgery + 30000 k reserve + 20k to live (food, hotel, caretaker for part of my stay) ) for 4 - 5 months in Florida.  I know it’s alot of money but I just want the safest option and quickest recovery possible.

[taller_in_Kiev]

The Jamal mail is fully weight bearing too.  Paley seems to be doing ok, definitely has the best exposure and marketing.
And yes, doctor will visit you daily here, do all your clicking, give you pills and jabs if you're in more pain than usual, physio etc. Definitely a more personalised experience.
Have a look at my gym videos I just posted.

[Leggs]

Spend 4 - 5 months in Florida. I just want the safest option and quickest recovery possible.

Messenger, I understand why you want to stay in Florida close to Dr. Paley even after your lengthening is complete. The extra physical therapy and the added piece of mind makes sense. In my opinion many parts of your plan are completely unnecessary with the new STRYDE nail and a waste of a whole lot of money. 

You could easily spend the 60-70 days in Florida lengthening with your already paid for physical therapy, then go back home to Canada and do your own physical therapy or use a physical therapist near your home. That saves you a ton of money.

You only need a caretaker for maybe the first 10-14 days after release from the hospital, with STRYDE probably not even that long, beyond that is a waste of your money.

Unless you are a kid with a medical condition, the house you mentioned is not available to you. Hotel or AirBnb are your options.

You could find an AirBnb for half the price of the hotels, your only added expense would be the cheap roundtrip Uber rides to the hospital for physical therapy, instead of the free vans from the hotel. You save money plus you get more of a home atmosphere instead of the small confines of a hotel room. If you can find someone else lengthening at the same time as you, then you two could get a 2bd/2ba AirBnb and really save a lot of money on accommodation. You two could also Uber pool together for physical therapy. Plus, going through this process with a lengthening partner is a massive psychological benefit for both of you.

The money in reserve in case of a complication that requires surgery only applies to 1% of patients. No reason to even worry about that.

You are over preparing & over thinking. Those are good signs. You'll be just fine and save yourself quite a large sum of money if you just follow the fundamentals of what Dr. Paley tells you.

[Purushrottam]

You could find an AirBnb for half the price of the hotels, your only added expense would be the cheap roundtrip Uber rides to the hospital for physical therapy, instead of the free vans from the hotel. You save money plus you get more of a home atmosphere instead of the small confines of a hotel room.

AirBnBs can be potentially cheaper and more homely, but don't forget: You can't just take a regular Uber. You will need a Uber that is wheelchair accessible (although with STRYDE, it may be different). That was my plan originally, but its really hard to find wheelchair Ubers in West Palm Beach. The suites at the hotels nearby aren't that small.

If you can find someone else lengthening at the same time as you, then you two could get a 2bd/2ba AirBnb and really save a lot of money on accommodation. You two could also Uber pool together for physical therapy.

Don't count on being able to Uber Pool together if you are doing LL with a buddy. The Paley center schedules you for 1 hour segments in therapy. They will take your PT and timing preferences into account, but there is no guarantee. There is little chance that the other person will have therapy at the same time, meaning you will not be able to Uber Pool (unless one of you waits for several hours.. and trust me, when you are in pain, you want to get back to your bed immediately instead of waiting at the clinic).

You only need a caretaker for maybe the first 10-14 days after release from the hospital, with STRYDE probably not even that long, beyond that is a waste of your money.

The money in reserve in case of a complication that requires surgery only applies to 1% of patients. No reason to even worry about that.

You are over preparing & over thinking. Those are good signs. You'll be just fine and save yourself quite a large sum of money if you just follow the fundamentals of what Dr. Paley tells you.

On point.

[Messenger]

Leggs that makes a lot of sense.  I’m defiantly going to play the caretaker by ear, the first 2weeks definitely I’ll have one, but since I’m going to be all alone I don’t really know how I’m going to feel after 2 weeks and if I’ll be able to do everything I need to do by myself.  I’m definitely staying in Florida for the entire PTs which is 11 weeks worth.  I’ll be done lengthenjng (Max 6cm) in 8.5 weeks. So I’ll be getting 2.5 weeks of PT during my consolidation phase and if I can walk without sway at that point I’ll definitely go home back to Canada.  But I’m not sure if that is possible, I know with normal precise nail that it isn’t, but with Stryde it could be.  I plan on doing nothing but focusing on recovery (no laziness whatsoever).  And yeah I called and talked to paleys co-ordinar the other day and she said I can’t stay there which is a bummer.

The only reason I would stay at the hotel would be to meet other LLers and do this whole thing together as a team, but my original plan was the air BNB since it’s cheaper.  I wrote in the travel part of the forum that I am looking for someone to do this with since that was my original idea since we could share the price of the air BNB and even the caretaker would be split so we could have her for more days and still be paying less then what We would pay alone. 

It’s just that no one knows I’m doing this surgery so if I come back home I need to be able to seem like nothing happened which is just a normal gait.  I’m not sure how long that would take though especially with Stryde.

[Purushrottam]

The first 3 months I’m planning on staying at the quantum house which is located in the St Mary hospital campus and is offered to patients at $40/night.  Food is included most of the time since volunteers come and cook for everyone.  The last 2 months if I’m able to do it I’ll be staying at an Airbnb at around $80/night.   

As I mentioned in the PM, I am not 100% sure, but I think the Quantum House is for people under age 18 who are getting LL with Paley and their parents. Call them to confirm. During peak season a lot of the wheelchair accessible hotels (and local AirBnbs) will be fully booked so book your stay early. I stupidly booked a room that was not wheelchair accessible but I lucked out by finding an open room at the next hotel.

[Messenger]

Yeah I saw you write about that.  I’m definitely going to book it when I go for my consult with paley in 2 weeks.  Once the consult is done I’m going to book the surgery for late October and then book Airbnb, caretakers etc.  I just wanted paleys opinion on it as well and his recommendations.  I’m really looking forward to this journey.

[Messenger]

The quantum house is unavailable to me.  It would have been awesome since i would be in the st Mary campus, but it’s okay.  A big debate for me now is Airbnb or hotel.  I would go Airbnb all the way, but damn being all alone for the couple months with no one else around you that is doing LL I feel like it would make everything worse.  If only someone would do this with me that would be wicked.  The hotel would be good since there will be a lot of people there that is doing LL and from what I read in diaries usually they get together have bbqs in the back and hang out around the hotel during the days so just being with someone would be awesome but i just need to figure out the price difference and see if it’s really worth it.