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[GenralizedAnxietyDisorder]

Hi LL veterans,

I have looking into doing this since over a decade. But I have been putting it off due to anxiety. I have even booked and cancelled the surgery. I can't forget the surgery and move on. And I can't get myself to do it. I am stuck in this middle state, unable to mentally function normally.

I probably suffer from generalized anxiety disorder where I imagine the worst outcome of taking any decision. Doing any type of surgery is new to me. With LL, I constantly think about fat embolism, infection, blood vessels bursting during surgery, amputation, prosthetics, etc. Irrational, but I can't control this.

So I have decided to get one leg done at a time. Left femur first and then right femur (or the other way haha).

Benefits
I have to be worried about one leg at a time. Lesser at stake. Worst thing that happens would happen to one leg. I still have a good leg. If LL is my worst decision ever, I will have one good leg and can still live independently. I can finally get past this nightmare of having to decide whether to do this procedure or not.

Now I do know the disadvantages of doing one leg at a time:

* 2 surgeries. 2 times anesthesia. 2 times first 2 week horror.
* longer duration of pain
* I can't really walk until both legs are equal length. I must use insoles or lifts on the shorter leg.
* if one leg goes smooth, the other leg might not. at what length do I stop with the first leg?
* I am CREATING a deformity by lengthening the first leg. I am knowingly creating a discrepancy with the goal of fixing it later.
* 2x the costs for surgery, travel, hotel, whatever else that needs to be repeated

The doctor advises against this. He says it's better to do both at the same time and stop whenever and be done with it. I agree, but can't get myself to do it. I will spend another 10 years on this forum reading every word and still not be done with it.

People who have done LL, please let me know your opinions. Is this doable? Please don't tell me how it's faster to do both together, I know that haha. Do you see any major problems of doing one side at a time that would make you advise me to not do it at all?

[GenralizedAnxietyDisorder]

any suggestions guys? Do you know of people who did one leg at a time? how was their experience?

[precice strider]

There's something called cross lengthening, where 1 femur and 1 tibia are lengthening at once followed by the other femur and tibia.

It makes walking difficult in between the lengthenings, but people do it. The purpose of this is because it is done with external fixators, and 2 external femurs at once is extremely inconvenient.

I've heard somewhere, although I don't remember where, that there is at least one doctor who does one leg at a time.

However, if your anxiety is really bad you might want to see a therapist. Maybe then you might get over it and do LL normally.

[kingjesse]

Geez I think you should do both get them done move on. The amount of time you’ll waste and Even with one leg we can’t function 100percent. Those complications you mentioned are rare. You’ll be fine don’t let anxiety take over

[Medium Drink Of Water]

I can't think of any other downsides other than what you posted.  The problem with the second one going wrong and leaving you with a first one longer than it, therefore needing a third surgery for shortening, might be solved by doing tibias.

If you do tibias, the worst that could happen would be half a bad leg (cut off below the knee).  Then you could build your resolve up to living with the fear of two half-legs being the worst case scenario if you did them both at the same time.

[ChefCurtis30]

Ay bro ik its scary as hell and the complications could end up doing bad things to u. But the chances of this happening can be minimized with a good experienced doctor. May I ask which doctor you are going to do CLL with?

[m7liam]

From thinking about doing this surgery to actually doing this surgery was a total of one months time. Just fyi

[kingjesse]

From thinking about doing this surgery to actually doing this surgery was a total of one months time. Just fyi

Any problems? How are things and length how much?

[BetzLandLiberator]

You didn't think this through. You are actually increasing your risks. Don't be stupid.

[GenralizedAnxietyDisorder]

I can't think of any other downsides other than what you posted.  The problem with the second one going wrong and leaving you with a first one longer than it, therefore needing a third surgery for shortening, might be solved by doing tibias.

If you do tibias, the worst that could happen would be half a bad leg (cut off below the knee).  Then you could build your resolve up to living with the fear of two half-legs being the worst case scenario if you did them both at the same time.

You are right. Tibias are "safer" in the worst case situation. In terms of long term outcome femurs seem to be more reliable based on the experiences of members here and preference shown by surgeons.

[GenralizedAnxietyDisorder]

From thinking about doing this surgery to actually doing this surgery was a total of one months time. Just fyi

That's insane man. I'm clearly not like you haha. I worry way too much. It's probably genetic, how much we all worry.

[GenralizedAnxietyDisorder]

You didn't think this through. You are actually increasing your risks. Don't be stupid.

How so? I am foregoing the base case outcome (where I can live normally only 3 months after surgery) but I'm bettering the worst case outcome (if something goes wrong it will be on one leg).

Time and money are not a problem. I just don't know what it's like to lengthen and how it will be to spend a full year through the process. And whether any rehabilitation is possible with one lengthened leg and one short leg.

[GenralizedAnxietyDisorder]

However, if your anxiety is really bad you might want to see a therapist. Maybe then you might get over it and do LL normally.

No therapist will help me if my goal is to get LL haha.

[BetzLandLiberator]

How so? I am foregoing the base case outcome (where I can live normally only 3 months after surgery) but I'm bettering the worst case outcome (if something goes wrong it will be on one leg).

No you're not. You are trading a theoretical worst outcome (losing your leg) which in practice never happens by multiplying the risks of real complications (that do happen) because you will have way more surgeries.

Also, months with a gigantic leg discrepancy will fk up your body.
I had a 2cm leg discrepancy (not that big) before LL. It was horrible to my back. A 7cm will be disastrous, your body will take way longer to heal and you will probably have an unbalanced recovery.

[HeightGain]

There are doctors out there that do support this strategy. Doing one leg at a time will reduce your risk of PE and fat embolization has been linked to polytrauma so a reduction in trauma should help.

Activity levels will be higher and load bearing and bone regeneration fast

You could start the 2nd before the first is completed

[BetzLandLiberator]

There are doctors out there that do support this strategy.

Not the best doctors.

[HeightGain]

Betz does as do many others

[germanlim]

Do it together. U will regret to do the process a second time instead of beeing ready

[BetzLandLiberator]

In 2012 I've spent 8 months in Germany and I met pretty much all of Betz patients during that time. I never saw one doing one leg at the time.  Maybe some did but that's rare.

He does do tibias in two surgeries now (it wasn't the case years ago), but that's different. The surgeries are just one week apart and the lengthening phase will be with both legs at the same time anyway. And he only do that for tibias, as the tibia surgery is more complex and he had more tibias complications in the past.

It's nothing like the crazy plan from OP.

[HeightGain]

Ask him, he does it for femur. Doctors do support strategies that patients seek provided there are no contraindications.

[BetzLandLiberator]

Ask him, he does it for femur. Doctors do support strategies that patients seek provided there are no contraindications.

As I said, if ge does it, it's a rare case. It's not the norm.

[Hagane]

i think the reason its not usually done is simply because most patients dont have the patience to do one surgery per segment.
id say  from a surgical perspective it would be safer:
shorter operating time, half the blood loss, shorter time under anaesthesia.

id say most patients wouldnt agree to it simply due to the fact they they have to pay for twice the operating time. ( your surgeon may not charge you, but most likely the hospital will and your anaesthesiologist will)

[Michael J. Assayag, MD]

Lengthening 1 leg at a time happens more often than you think.

It is safe, and if you have the time and ressources to do so, it is not a bad idea at all.

I currently have a patient who underwent tibia lengthening with fixators 1 leg at a time and he is doing great.

There is another one who will soon start tibia lengthening with Stryde 1 leg at a time as well.

I hope this helps!

[GenralizedAnxietyDisorder]

Hi everyone,

I just wanted to update everyone that I went ahead with this plan but have only lengthened one leg so far. I have mixed feelings about this approach.

- I was much less anxious going into the operating room knowing it will be one leg. This was huge for me.
- I was very mobile during lengthening. In fact, I did not feel "disabled". I have known people who had injuries in one leg and I was like them. I was overall in good spirits. I knew the risks of most complications were only half for me. That gave me peace of mind.
- I stopped at only 4.8cm because I became paranoid about something going wrong while lengthening the other leg. My goal was 7cm so I fell short of it. This was primarily because I knew every mm I distract on my left leg, I would have to repeat on the other.
- Now, I feel like there is a mountain to climb again since I have to match my leg lengths now. I am quite tired of this whole ordeal. I am not afraid anymore, but just tired.
- I haven't been able to go out because my discrepancy will be visible to others. So this sucks big time.
- Cost wise it will not be twice as expensive, obviously. But it turns out to be around 40% more expensive than doing it bilaterally.

Hope this helps someone. I think doing it bilaterally is better but if you can't get yourself to do both sides together, it's a way to start I guess. Better than being afraid of doing it for years. I did it this way only because I was extremely afraid and there was no way I could do both sides together.