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[Kenda]

Hi Tiggy so basically how old are you?
do you think age is a factor for non union of bone?
or maybe not eating enough calcium, vit d and so....

Also whats your over view on rozbruch do you regret not going to one of these los angeles or las vegas Drs??

regarding your walking, how many hours you walk per day?

[tiggy]

Tiggy, bone graft is not that simple, and it does not always work.
Why don't you slow down the rate of distraction? Maybe to something like 25mm per day. Stryde is weightbearing anyway. I think 6.5cm a good gain.

Hey,
Well so far I have done no lengthening at all for over 2 weeks due to the accordion mechanism I've described earlier. Until mid next week I am also not going to lengthen. When I see him next week we will decide how much to lengthen. Truthfully I will not be happy with anything less than 7.5 (which is 3 inches) and I'm so close to that at the moment (the left leg is) that I see no point to stop now. At least I'll know mentally that I've gained a firm 3 inches from this.

Anyway I don't want to jump too much ahead. I'll update once I see him next week after the latest X-rays. Doing .25 a day is always an option though and surely we will discuss that as well.

[tiggy]

Hey tiggy, we seem to have similar problems regarding bone growth. Good luck!

Hey man, don't fret. It will work out in the end. Just a matter of time! Keep strong 💪

[Renaissance]

I tiggy.

When you start the bone distraction phase during the first few weeks your doctor needs to be aware if the bone fusion is fast or slow.

In case it is slow why not use this as an advantage to reduce the number of bone distractions for example to 0.33 mm per day?
Of course the procedure will be 3 times longer to be exact but your soft tissues will suffer 3 times less damage and your recovery will be faster and the trauma will be much less.
Finally it seems to me but I may be wrong.
LL 1 mm a day and about 30 times faster than the natural lengthening of the human body in growth phase. And therefore very demanding for the body and especially for the soft tissues.
If you had the opportunity would you have chosen this method of distraction for 6 months with low risk and low level of pain or would you have chosen one mm per day to reduce the process to 2 months knowing that there is a risk of pain and trauma?
Thank you for your reply.

[tiggy]

Hi Tiggy so basically how old are you?
do you think age is a factor for non union of bone?
or maybe not eating enough calcium, vit d and so....

Also whats your over view on rozbruch do you regret not going to one of these los angeles or las vegas Drs??

regarding your walking, how many hours you walk per day?

Hi Kenda,
I know I mentioned my age before. To reiterate, I'm in my early 30s. I think everything is a factor in bone growth but I've done very little walking in the time between my last x ray and the one before that. Since then I've been walking significantly more, at least 10 min every hr or so. I hope that leads to at least some improvement. I've also mentioned this before but I will repeat that I do not nor have I ever had any bad habits. I barely even drink. Sometimes   just happens and you really can never predict how it will all turn out even if you do everything right. It's just how the body reacts, nothing you can do about it (besides the normal things you must do in your recovery regimen).

I do not regret going to dr R but only because he is local to me. If I had to travel to see him from far and incur additional costs to an already very expensive procedure (especially with him), while being away from my family, I truthfully may have regretted my choice. It's a balancing decision and each factor must be weighed based on how important it is to you. I think going to a reasonably priced surgeon who is reliable would be the best choice for this surgery. Good luck with whatever you decide

[tiggy]

I tiggy.

When you start the bone distraction phase during the first few weeks your doctor needs to be aware if the bone fusion is fast or slow.

In case it is slow why not use this as an advantage to reduce the number of bone distractions for example to 0.33 mm per day?
Of course the procedure will be 3 times longer to be exact but your soft tissues will suffer 3 times less damage and your recovery will be faster and the trauma will be much less.
Finally it seems to me but I may be wrong.
LL 1 mm a day and about 30 times faster than the natural lengthening of the human body in growth phase. And therefore very demanding for the body and especially for the soft tissues.
If you had the opportunity would you have chosen this method of distraction for 6 months with low risk and low level of pain or would you have chosen one mm per day to reduce the process to 2 months knowing that there is a risk of pain and trauma?
Thank you for your reply.

Hey,
Well we did drop the sessions to .75 per day after my growth appeared slow. I believe this was about a month in. To answer your question, no I would not prefer that method. Nor would I prefer 1mm a day. I think that's simply too much. But doing .33 a day is also too little. I believe somewhere in the middle is best, which is what we did (almost). The only thing is, I just wish I did what I am doing now about a month earlier. This would've given the tissues less gap to fill, which would have made  filling that gap easier. This process is trial and error. I think the best route is anywhere between .5-.75 distraction a day assuming decent bone growth. Of course if the bone is filling in faster, you have no choice but to speed up the process and just deal with the pain and discomfort. If the growth is slow, as is the case with me, then it's really a matter of figuring out what works best given how much bone is filling in. None of this can be predicted ahead of time, and for that reason, speaking about what I prefer is really a fruitless exercise. I know what you meant to ask by your question, but your question assumes a perfect world with normal bone growth and the patient having the latitude to decide - something that is not as frequent as you may think.

[tiggy]

Hey guys,
This question is for the vets. I've been experiencing knee pain in my left leg (the leg that's longer) and it started about 2 weeks ago. I notice it began after my last follow up appointment. The only thing that's changed since that appointment is that I started taking strontium for bone growth as recommended by my dr. I don't know if that's what's causing the issue but the pain is always there when I'm walking. I don't feel anything when at rest. Of course another possibility could be the length I've reached, which could explain that the pain is in the left knee only and not the right (which is the shorter leg).  I was brainstorming that what if it hurts because I've lengthened too much. But I'm only at 6.5 cm which for femurs is more than normal. I'm 3.5 months post op. Any feedback would be greatly appreciated guys.

[Renaissance]

Thank you tiggy.
I'm sorry for the pain you feel during this process I hope everything will be ok at the end.
Unfortunately I don't have the answer to your question but I have another for you did you ever consider using an  electro stimulator, a professional one like compex to relax muscles and reduce the pain during the process ?
Or maybe it is not recommended because you have an electromagnetic device in your bones what do you think ? 

[tiggy]

Thank you tiggy.
I'm sorry for the pain you feel during this process I hope everything will be ok at the end.
Unfortunately I don't have the answer to your question but I have another for you did you ever consider using an  electro stimulator, a professional one like compex to relax muscles and reduce the pain during the process ?
Or maybe it is not recommended because you have an electromagnetic device in your bones what do you think ?

No I haven't considered it, nor do I believe in any of that stuff. To me those machines seem like a gimmick to extract money from the gullible who are in pain. This is just my opinion. Perhaps they may work for some but in honesty this process, in terms of pain, was not at all bad. My issues were numbness, pins and needles and burning. Those are just nerve related issues and I doubt the machine would've made any difference with them

[Renaissance]

You must be really flexible then.
From what I read and I understood a lot of patients felt  their muscles really stretched during the process and described that as a constant pain.

Just 1.5 cm to gain to reach your aim.
Be strong and please don't forget to keep us posted about your recovery after the lengthening.
Be strong.

[tiggy]

You must be really flexible then.
From what I read and I understood a lot of patients felt  their muscles really stretched during the process and described that as a constant pain.

Just 1.5 cm to gain to reach your aim.
Be strong and please don't forget to keep us posted about your recovery after the lengthening.
Be strong.

Thanks man, I'm doing my best and will continue my updates. Stay tuned!

[Resilience]

Can you pitch into http://www.limblengtheningforum.com/index.php?topic=64338.msg165617#msg165617?

[tiggy]

Hey everyone,

I'm happy to report good news. As of my post op this week I have had great improvement on my left leg (longer leg). Callus is filling in nicely and evenly. The right leg also had improved, though not as significantly and the callus is filling in unevenly. It appears the inner gap is filling better than the outer. Dr Rs advice was to equalize the legs, meaning lengthen more on the right to bring it even with the left, which is currently at 65mm and stop. I told him I have no intention to stop until I reach 7.5cm. That is a firm 3inches and I'd be happy with that result. This way I would cut my goal of 8cm and truthfully the difference between 7.5cm and 8cm is practically nonexistent since you really can't even tell the difference. It wouldn't make sense for me to push to 8cm and put stress on my legs.

Anyway I am due to see him in few weeks once I reach 7cm on both legs at which point we will reassess the situation.

I don't know what improved  the callus situation since as you recall from my last update, I've made many changes to my regimen. It could be a combination of everything but I'm glad that there has been improvement which allows me to proceed. I wish the right leg was filling in better but no such luck. I just want to finish with the lengthening as quickly as possible and just let the legs start fully recovering. It appears that the right leg just needs longer time to recover and before resorting to any bone graft surgeries I want to give it at least a few months of recovery and see how things progress.

Another theory I have is that given my leg length discrepancy, it makes sense that I've been putting more weight on my left leg (as the longer leg) and perhaps that helped to speed up the callus formation in that leg. Surprisingly, it appears that dr R doesn't really believe that walking more would make a difference in terms of callus formation. The reason I say that is because when I saw him I did express optimism that I could try and walk more to improve the callus formation on the right, to which he replied that I'm already doing everything I can. Honestly that logic makes no sense to me. While yes I have read about patients who do practically no walking at all (as precise patients) and have their bones filling in very quickly, I believe there is another class of patients like myself who may need to help the process by putting on weight to stimulate growth. I think this is only logical, though as I've said, he appears to dismiss this reasoning.

Either way, my plan is to reach 7.5cm and wait out a few months to see the progress on the right leg. At which point I'll decide whether to go for bone graft or just give the leg more time. I do not want to jump to additional surgeries unless I see that the bone is not filling in with time at all.

So that's about it for the update. I'll touch base again after my next visit. Be well!

[PANDA:BEAR..]

Great news tiggy.... your on your way to reach that milestone...
Stay positive ... 

[tiggy]

Great news tiggy.... your on your way to reach that milestone...
Stay positive ... 

Thanks Panda 💪

[cena]

Great news tiggy ! !

It appears like Dr R is quite conservative with walking while lengthening even with stryde nail. Or did you yourself hesitate to walk much? From other stryde diaries like Dr M and Dr Paley it appears to me like some of those patients walked a lot while lengthening.

And yes it is well known that weight bearing helps regenerate bone. Strange he didn't agree. Why didn't you probe with more questions ? 

Are your meetings with him rushed? From watching a video of Dr R about 'stature lengthening' about a boy called 'Sam' it had appeared to me that he does a super detailed meeting each time.

And are you going to be back to college soon? I read that you are a student on summer break.

Sorry for so many questions 

I hope you achieve your goal !

[tiggy]

Great news tiggy ! !

It appears like Dr R is quite conservative with walking while lengthening even with stryde nail. Or did you yourself hesitate to walk much? From other stryde diaries like Dr M and Dr Paley it appears to me like some of those patients walked a lot while lengthening.

And yes it is well known that weight bearing helps regenerate bone. Strange he didn't agree. Why didn't you probe with more questions ? 

Are your meetings with him rushed? From watching a video of Dr R about 'stature lengthening' about a boy called 'Sam' it had appeared to me that he does a super detailed meeting each time.

And are you going to be back to college soon? I read that you are a student on summer break.

Sorry for so many questions 

I hope you achieve your goal !

Hi Cena,

He is conservative when it comes to walking, even with stryde. I think because it's still a new nail, he likes to exercise caution and not invite patients to do too much too quickly. I never hesitated to walk, in fact I've been able to walk without assistance for quite some time. He told me not to do so and use at least one crutch so as not to bend a nail. I follow his advice even  though he was able to insert a larger nail into my femurs.

Re bone regeneration and weight bearing, I didn't probe him much because I didn't care to. At this point I do what I think is right while also taking what he says into account. I firmly believe walking helps growth and I do so whether he also believes this or not.

My meetings with him are not rushed. In fact he tends to take his sweet time with patients and this results in extremely long wait times to see him. I waited almost 3 hrs to see him last time. I find this absolutely ridiculous and frankly it pisses me off every time I'm there. Thankfully I don't have pain that makes it difficult to sit and wait (as opposed to laying down) so the visit is tolerable. But in those early days when discomfort was there, it was extremely annoying having to wait for long periods of time. It's been almost 4 months of follow up visits and the earliest I was ever seen is after almost 2 hrs of waiting.

I'm already back to school (grad school) and again killing hrs at his office really takes the valuable time I have away from my school work. In addition, now that I started lengthening, I expect discomfort to kick back in, especially on my right leg. I actually drive to class so you can imagine it becomes quite difficult because pain kicks in while driving (since you use the right leg when driving). I have another month of lengthening to reach 7.5cm so I expect some major discomfort on this front. I actually drive over an hr to get to class so this is going to be challenging to say the least. But it is what it is. Oh and I'm also sporting a crutch in school lol. It's annoying limping around people but my eyes are on the price so I couldn't care less what others think!

If I missed a question, please feel free to point this out.

[cena]

Hi tiggy,

Thanks for answering my questions.

It is amazing that you drive a car to school. It is also great that it's close to your family's home. I am still trying to imagine how you are able to hop into a car, drive, hop out, walk to classes sit on a chair for an entire lecture, all while being on crutches! It seems impossible to do without putting full weight on one leg?

I am thinking I will be in a similar situation as you because I cannot afford to quit my job for multiple reasons. I am not sure if I will be able to manage to go to work after 1 month. Some diaries paint this easy picture of walking crutch free after LL which is actually quite scary to imagine (walking on 2 broken bones).

Dr R seems to be good after all. He at least seems to care and be on the safer side.

[cena]

tiggy one more question - Did you have to pay 125k after surgery? That is how most surgeries in US happen. You get surgery and then they send you a receipt. Or did you have to pay it all before (like Paley asks)? How much time do you get to pay the whole amount?

Thanks buddy!

[tiggy]

Hi tiggy,

Thanks for answering my questions.

It is amazing that you drive a car to school. It is also great that it's close to your family's home. I am still trying to imagine how you are able to hop into a car, drive, hop out, walk to classes sit on a chair for an entire lecture, all while being on crutches! It seems impossible to do without putting full weight on one leg?

I am thinking I will be in a similar situation as you because I cannot afford to quit my job for multiple reasons. I am not sure if I will be able to manage to go to work after 1 month. Some diaries paint this easy picture of walking crutch free after LL which is actually quite scary to imagine (walking on 2 broken bones).

Dr R seems to be good after all. He at least seems to care and be on the safer side.
[/quote

Dr R is definitely a safe option, too safe at times lol. Getting in and out of the car is quite simple actually. You first sit sideways on the seat and when you are comfortable enough, you lift your legs and place them in. Same process is used to get out of the car.

Yea sitting in lectures that are 2-3 hrs long is going to be a challenge once the discomfort kicks in. But I will try to lift my legs up on a chair if I have too much discomfort. But I will keep you guys posted on how well I do with this. Dr R even flirted with the idea of me deferring a semester until I finish lengthening and then resuming next semester but I told him that's not an option. I just want to get this over with and not postpone my life any longer because of the surgery. It's definitely tough and will get tougher for the next 4 weeks but that's temporary, I just need to pull through a little longer! It's totally doable.

As to going to work a month post op, I think that is absolutely insane. While you will feel much more comfortable with the process at that point, it is still extremely difficult to walk for long periods and your legs get tired extremely quickly, within minutes (at least for me). I would stay home at least couple of months if I were you, though again putting hard timelines is not very realistic now because you will only know how you feel once you are going through this yourself. But 6 weeks I'd say is the bare minimum to take off.

Walking crutch free is not recommended, at least this is what dr R urges me not to do (mostly because my bone growth isn't all that great right now). It's ok for you to put full weight on a leg from time to time because you won't be able to avoid doing so completely. But that's different from ditching the crutches altogether and putting that type of pressure on the legs all day. Again this all would depend on how well you are taking the lengthening and how quickly your bones are healing, none of which you can predict in advance.

[tiggy]

tiggy one more question - Did you have to pay 125k after surgery? That is how most surgeries in US happen. You get surgery and then they send you a receipt. Or did you have to pay it all before (like Paley asks)? How much time do you get to pay the whole amount?

Thanks buddy!

Correct me if I'm wrong but your question suggests that you are not American. If you are not, you will be expected to pay the full cost upfront. I did not pay the entire amount upfront because I was awaiting insurance approvals/denials. However, I did pay dr Rs costs upfront. Hope that helps

[cena]

Thanks tiggy. You are right, not yet a citizen, but I doubt that changes anything because I'm insured through my employer.

I am a quite disappointed that going to work (desk job) will not be easy after a month. I am looking forward to reading how it works out with your school. Remember to take it easy! This is a once in a lifetime thing.

[Smallpackage]

Hi Tiggy, hope you are well.
I sent you a DM; please let me know if you have received it.
Thank you in advance.

[tiggy]

Thanks tiggy. You are right, not yet a citizen, but I doubt that changes anything because I'm insured through my employer.

I am a quite disappointed that going to work (desk job) will not be easy after a month. I am looking forward to reading how it works out with your school. Remember to take it easy! This is a once in a lifetime thing.

You are correct, it doesn't change anything. If your insurance does not cover the cost, dr R will want his fees paid upfront and the hospital will also. However because my insurance denied coverage right before the actual procedure, the hospital was more flexible with me. So it's all very individual.

You shouldn't be disappointed whatsoever. This is a demanding surgery and requires dedication and hard work in terms of constantly stretching and lengthening. If you went back to work within a month, it would be difficult for you not only to attain your goals but also to properly stretch your legs to accommodate the height. You really can't cut corners with this thing. You will only truly know what I mean when you get this done. Yes indeed, this is a once in a lifetime thing, so you gotta do it right. I wish you luck!

[Xander001]

Hey Tiggy,

Been lurking on your diary for a while. I'm usually not the type to post a response in a forum post, but I feel that I should since I'm also going through the same thing that you went through. I had my surgery back in June 2019.  I had 0-1 level pain all the way through. My bottle of Oxy is still full. My case is pretty unique. I was able to walk unassisted a week after thanks to the Stryde nail and never really used my crutches around the house. I resumed working from home after 1 month. Everything went exceptionally well until my recent check-up with Dr. R. I'm currently at 56 mm distraction and the bone formation on my left leg is really lagging behind. Dr. R has me doing the accordion method and prescribed Strontium. Pretty much everything he prescribed you. This happened on Tuesday 9/10.

I have a question regarding you diet before the improvements. Were you eating enough? I noticed that I really haven't been eating. I think that could be causing the slow consolidation. I was 160 lbs. before the surgery and now I'm at 144 lbs. and seems to still be dropping. You also mentioned that R didn't want you to walk unassisted and that was interesting, because he told me I can walk as much as I can tolerate. If you have any tips on what you think you did during the 1 month of shortening and lengthening to help with bone growth, can you share with us?   

[tiggy]

Hey Tiggy,

Been lurking on your diary for a while. I'm usually not the type to post a response in a forum post, but I feel that I should since I'm also going through the same thing that you went through. I had my surgery back in June 2019.  I had 0-1 level pain all the way through. My bottle of Oxy is still full. My case is pretty unique. I was able to walk unassisted a week after thanks to the Stryde nail and never really used my crutches around the house. I resumed working from home after 1 month. Everything went exceptionally well until my recent check-up with Dr. R. I'm currently at 56 mm distraction and the bone formation on my left leg is really lagging behind. Dr. R has me doing the accordion method and prescribed Strontium. Pretty much everything he prescribed you. This happened on Tuesday 9/10.

I have a question regarding you diet before the improvements. Were you eating enough? I noticed that I really haven't been eating. I think that could be causing the slow consolidation. I was 160 lbs. before the surgery and now I'm at 144 lbs. and seems to still be dropping. You also mentioned that R didn't want you to walk unassisted and that was interesting, because he told me I can walk as much as I can tolerate. If you have any tips on what you think you did during the 1 month of shortening and lengthening to help with bone growth, can you share with us?   

Hey man,
I'm glad you've been following my diary. Your case seems to be very similar to mine. Well I made a whole bunch of changes, some of which I've already mentioned earlier. Just to reiterate, I had stopped ALL medication (even including finasteride for hair loss). I've just been taking, and still continue to take, vitamin d, c, strontium, and citracal. I also made sure to walk at least 10 minutes every hour (with a walker mostly) and consumed yoghurt and protein shakes. I can't say my improvement was spectacular but it was an improvement nonetheless. I am sure your bone growth is at a much better place than mine, hence why he told you that you can walk unassisted as tolerated. I assume this is the case because you had surgery a month after I did and you are almost at a similar distracted length to me. This tells me your growth has been doing fine up until now. I don't think you have much to worry about. Just walk as much as you can and I'm sure you ll be fine. Sometimes some of us take longer to fill the gap than others. This is why I try not to stress much about his advice to stop lengthening. Since my last follow up I haven't been walking as much as before, mainly because I am extremely busy with classes and studying. So it's tough for me to find time to break every hour to walk. So of course during my next follow up I expect growth to have slowed again (especially because I am lengthening now also). Just give it time and don't fret. May I ask how old you are? What's your goal?

[Xander001]

Hey Tiggy,

Thanks for the reassurance. I'm 35 and my goal is to get at least three inches. Like you, I was pretty upset when R told me that I might need to rethink my goal. I've been trying to increase my food intake and will probably pick up a ton of yogurt tomorrow. I'm also on finasteride, did you find studies that suggest it may slow bone formation?

[tiggy]

Hey Tiggy,

Thanks for the reassurance. I'm 35 and my goal is to get at least three inches. Like you, I was pretty upset when R told me that I might need to rethink my goal. I've been trying to increase my food intake and will probably pick up a ton of yogurt tomorrow. I'm also on finasteride, did you find studies that suggest it may slow bone formation?

Hey,
No I haven't found any such studies. He also searched on his phone to see finasteride side effects and also found none relating to bone growth but I told him I'll stop for now just to be safe. It's not as if stopping for a month or so is going to make all my hair fall off lol.

The way I see my situation (and perhaps yours as well) and this is what I've stated to him also during my last follow up, is this: if I stop now and cut my goal short and assuming all heals well within months, I will regret not seeing my goal through. If I reach my goal now and give it time to heal, hopefully things may take let's say a month longer to fully heal but that is a sacrifice I am willing to take.

If after say 4 or 5 months post consolidation things don't heal very well, at that point I can have bone graft. It's not ideal of course but at least I'll know i gave this all I could and still reached my goal. If, in the unlikely case, my bone graft surgery isn't successful I can always shorten the gap (though this would require an additional surgery to accomplish). Either way it's not as if we don't have options here. In the end everything will work out. Plus even he said that none of his patients have ever had permanent nonunion that couldn't be fixed.

My larger point is, what guarantee do I have that if I stop at 7cm instead of 7.5 or 8 that my bone will heal completely. What if I still end up dealing with the same issues at 7cm that I would've dealt with had I gone all the way? None of course, this is unknowable. In the end I just want to play the hand I've been dealt and hope for the best. Plus I think the 1 cm difference isn't really going to make it or break it. Dr R is just extremely cautious, which is good but this is a matter of cost and benefit analysis. You may not share my sentiment but this is my outlook on the situation.

I am actually very curious if you had any luck with insurance coverage. Can you pm me (if you don't wish to discuss it publicly)?

[cena]

How are you holding up tiggy? Did university start?

[tiggy]

How are you holding up tiggy? Did university start?

Hi Cena,
Yes life is back in motion at full force and it doesn't ask whether you have 2 limbs broken lol. Anyway a quick update, I have reached 7.5cm as of a day or so ago. I was due for a follow up with dr R this week but I have decided to postpone my visit. Given that I have been lengthening all of last month I don't see the point in having X-rays taken at this time because they are unlikely to show much bone growth (if at all) since I was lengthening. I think it's best to see him in about 4 or 5 weeks to get a better idea of where things stand. Keep in mind that I pay him now during every visit. 

In addition, I haven't been walking much lately. I felt no tightness at all when resuming lengthening but I do have pain and discomfort when I stand for too long and then sit down. It hasn't been all that pleasant to walk to say the least. However I hope that the legs start regaining strength within the next few weeks so that I am able to walk better and longer and with much less pain and discomfort. I think it's very important to stay active so I will most certainly pick up the pace of walking in the next few weeks.

 I think that's about it re updates. I don't visit this forum very often now not only because of lack of time but also because once you put this surgery behind you it sort of defeats the need to visit. However I will continue my updates and will try to check my diary every week or two to make sure I answer questions. I actually wanted to take a photo of my X-rays during my visit and post it this week but given that I've postponed my appointment, I will do so after my next visit. Feel free to send questions my way, if any. Be well.

[cena]

Good to know tiggy! So are you able to sit in class for hours?

And yes please show the xrays. It's strange how different stryde patients have different experiences. Movie climbs stairs unaided. Lalbadshah continued to go to work during lengthening. One other guy I forget also went to work as he walked while lengthening.

But it's always better to be safe! You do this only once (or twice)