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[BreaktoGrow]

Would love all of your inputs and possible corrections.

Unless you are already booked for a procedure or simply cannot wait, I argue that waiting for Stryde is in your favour. Perhaps this is cognitive dissonance, but the balance of time is greatly compensated when using Stryde. For instance, weight-bearing with Precice takes 6 months, while weight-bearing with Stryde takes 2 weeks, at most. If we assume that Stryde is released 6 months from now, I'd rather have full-functioning movement and then get Stryde as oppose to being reduced to sitting for 6 months (especially during Covid). Even if we assume Stryde comes in 8 months, I believe that the wait is worth the efficiency.

Of course, this argument is void if we assume that Stryde will not be re-released.

What are you thoughts? And please, correct me if I've stated anything fundamentally incorrect.

I am currently in the midst of deciding what to do, and these are the conclusions I've developed.

Thanks

[VeteranLL]

I‘d go for the method that is available right now. Its not only about the weightbearing, its about the healing too. With stryde you wont have a faster healing than other nails. The difference is that you can bear weight very early and have a somewhat normal life during lengthening.

[BelowTheMean]

If you have a caretaker and don't mind not being able to walk for months, then Precice is probably fine. If you're doing this on your own, then you probably need a weight-bearing nail, otherwise I don't see how you could take care of yourself.

[RB]

I agree with both VeteranLL and BelowTheMean in terms of having a life of normality etc during lengthening. 

Just think about how psychologically devastating and damaging it would be to not be able to even walk around your own house or take a dump or walk to the fridge without needing a walker and potentially assistance from someone for 6 months. It's not just about being finished with the process by the time stryde is back, you have to consider just how tough those months will be by not being able to weight bear. Look at older precise diaries for examples of how depressed people got during lengthening. If you could use crutches comfortably with precise it would be a different story but it's not even recommended to use crutches as that simulates weight bearing.

This is exactly the reason I didn't choose precise. I went with the Betzbone because after speaking with several patients, it is the closest thing to the stryde nail that is available right now in terms of being able to walk around with crutches outside and without crutches for smaller distances. People telling people to simply do precise are vastly underestimating just how tough of a process it is. Long-term recovery will be similar between stryde and precise, but those 6 months or so while you're waiting for weight bearing clearance are going to be psychological torture.

I think you should wait for stryde or consider an alternative method. That being said if you can handle all that, precise will get you the height.

[BreaktoGrow]

My thoughts exactly. The fundamental gain is the same. But, the psychology impact is significantly different. Even with a caretaker, not being self-sufficient in the most compulsory of tasks (hygiene, cooking, etc) would be very difficult. If technology like Stryde didn't exist, there would be no doubt about a decision to pursue Precice. But, it is simply (hopefully) a waiting game. I'd rather wait 8 months if it means I can sustain my psychology comfort throughout the process.

[RealLostSoul]

I'm in the same boat. Unfortunately, I have to do it this summer since it is going to be the last year for many years where I have more than a 2 close months time-frame. Next time will be after my Dr. degree which will take 9 more years or so lmao. It's really a stroke of fate that STRYDE got taken down NOW. I guess I'll have to move forward with precise.

as oppose to being reduced to sitting for 6 months (especially during Covid).

covid is the best time for LL. you don't leave the house anyways right? That's another reason why I'd prefer doing it soon, you lose much less than you would when you would do it after the pandemic.

This is exactly the reason I didn't choose precise. I went with the Betzbone because after speaking with several patients, it is the closest thing to the stryde nail that is available right now in terms of being able to walk around with crutches outside and without crutches for smaller distances. People telling people to simply do precise are vastly underestimating just how tough of a process it is. Long-term recovery will be similar between stryde and precise, but those 6 months or so while you're waiting for weight bearing clearance are going to be psychological torture.

I think I have to agree with that though. 4-5 months (I think it takes 1-2 months after lengthening and 3 months for lengthening but it may depend) being stuck sounds terrible. I think it really forces you to be strong mentally. The height achievement and the overall recovery should be similar but having to use a wheelchair and walker... not even crutches... for that long... damn... I guess another alternative is going anorexia but I doubt you are fit for surgery then nor can your bones heal properly. Why did you choose Betzbone? and what is your experience with it?

[RB]

I'm in the same boat. Unfortunately, I have to do it this summer since it is going to be the last year for many years where I have more than a 2 close months time-frame. Next time will be after my Dr. degree which will take 9 more years or so lmao. It's really a stroke of fate that STRYDE got taken down NOW. I guess I'll have to move forward with precise.


covid is the best time for LL. you don't leave the house anyways right? That's another reason why I'd prefer doing it soon, you lose much less than you would when you would do it after the pandemic.

I think I have to agree with that though. 4-5 months (I think it takes 1-2 months after lengthening and 3 months for lengthening but it may depend) being stuck sounds terrible. I think it really forces you to be strong mentally. The height achievement and the overall recovery should be similar but having to use a wheelchair and walker... not even crutches... for that long... damn... I guess another alternative is going anorexia but I doubt you are fit for surgery then nor can your bones heal properly. Why did you choose Betzbone? and what is your experience with it?

Yeah 4-5 months, maybe 6 depending on how much lengthening you do is the rule of thumb based on the precise diaries.

The reason I decided on Betzbone is that I spoke to several recent patients who had a good experience with it and were weight bearing from 2-3 weeks after surgery. I know this forum has mixed views on Betz and his nails did have problems in the past but it seems that from 2018 or so, majority of his patients have had a great experience and were able to weight bear in a similar way to stryde patients as he has an updated Betzbone now.

I'm actually scheduled for surgery on Wednesday so will keep you updated haha but this is my opinion based on speaking to recent patients. 

[RealLostSoul]

Yeah 4-5 months, maybe 6 depending on how much lengthening you do is the rule of thumb based on the precise diaries.

The reason I decided on Betzbone is that I spoke to several recent patients who had a good experience with it and were weight bearing from 2-3 weeks after surgery. I know this forum has mixed views on Betz and his nails did have problems in the past but it seems that from 2018 or so, majority of his patients have had a great experience and were able to weight bear in a similar way to stryde patients as he has an updated Betzbone now.

I'm actually scheduled for surgery on Wednesday so will keep you updated haha but this is my opinion based on speaking to recent patients.

Interesting. How much height do you plan to do? Isn't with Betzbone like 12cm "possible"?

[RB]

Interesting. How much height do you plan to do? Isn't with Betzbone like 12cm "possible"?

My goal is 7cm, with the most I will go to being 8cm. Yes it is technically possible to go to 12.5cm with the Betzbone but even Betz himself said not to exceed 9 or 10cm (which I still think is too much).

[RealLostSoul]

My goal is 7cm, with the most I will go to being 8cm. Yes it is technically possible to go to 12.5cm with the Betzbone but even Betz himself said not to exceed 9 or 10cm (which I still think is too much).

Yea I see. They don't do quadro lengthening do they?
I wanted to go for 4 inches in quadro lengthening with Paley but precice really turns me off. crutches would be okay but wheelchair for months sucks ngl.

[RB]

Yea I see. They don't do quadro lengthening do they?
I wanted to go for 4 inches in quadro lengthening with Paley but precice really turns me off. crutches would be okay but wheelchair for months sucks ngl.

I'm not too sure. I don't think they offer quadro as in femurs then 3 weeks later tibia like they do in the US but I'm sure you could do femurs then start tibias right after you finish lengthening femurs.

[RealLostSoul]

I'm not too sure. I don't think they offer quadro as in femurs then 3 weeks later tibia like they do in the US but I'm sure you could do femurs then start tibias right after you finish lengthening femurs.

Yea that for sure. It's also a lot cheaper but I kind of doubt it's anywhere close to Paley in terms of safety. Have you talked with the surgery team there already? I'd be interested in what they said about some things.

[RB]

Yea that for sure. It's also a lot cheaper but I kind of doubt it's anywhere close to Paley in terms of safety. Have you talked with the surgery team there already? I'd be interested in what they said about some things.

Yeah had my final consult with Betz on Friday and spoke with the anaesthetist etc today. Fee free to PM me if you have any questions about it.

[RealLostSoul]

Yeah had my final consult with Betz on Friday and spoke with the anaesthetist etc today. Fee free to PM me if you have any questions about it.

Nice, thanks a lot I will do.

[BreaktoGrow]

Hey,

Congrats, bro. Few questions - what country, how much with everything in (living, food, etc) aprox?

[one]

Why not consider full external which is weight bearing? I think we will get used to the frames. If it's inconvenient to wear them for a year then LON tibias is an alternative.

I think both external and LON tibias might be better than Precice which is not weight bearing.

One can also do Precice one side at a time. Do one leg and hop on the good leg. Let the lengthened leg recover (4-6 months) and then do the short leg.

The idea of doing Precice bilaterally at once seems so scary to imagine, especially if you are doing it all alone.

As for waiting for Stryde, the news is not promising so far. We might have to wait for long.

[RealLostSoul]

Why not consider full external which is weight bearing? I think we will get used to the frames. If it's inconvenient to wear them for a year then LON tibias is an alternative.

I think both external and LON tibias might be better than Precice which is not weight bearing.

One can also do Precice one side at a time. Do one leg and hop on the good leg. Let the lengthened leg recover (4-6 months) and then do the short leg.

The idea of doing Precice bilaterally at once seems so scary to imagine, especially if you are doing it all alone.

As for waiting for Stryde, the news is not promising so far. We might have to wait for long.

I asked Paley this he laughed and said externals is a bad idea and he wouldn't go back to this in a pure cosmetic procedure. His argument was that it's unreasonable to do cosmetic surgery yet gain tons of scars (which I kinda agree since external scars really are devastating in some cases). Other than that, externals are super uncomfortable, possibly more painful, and you run the risk of infections etc.

One side at a time is also a bad idea imo, the discrepancy will be too big honestly.

My current hopes are that I am able to get the large-diameter precise since they apparently can hold a weight of 146 pounds (even the second-largest nail is capable of 118 pounds btw). I am only at about 115 pounds, of course, that doesn't mean a guarantee but maybe I can use crutches for most of the time, which will definitely be acceptable for me.

[BreaktoGrow]

From my understanding, the pain and scars from external method is significantly worse when compared to the available technology. Also, I assume you're just kidding about the one leg at a time suggestion, but lengthening one leg at a time would not be a good idea since one of your legs would be significantly overcompensating for the weight and balance for too long a time. This would only cause further problems down the line.

[BreaktoGrow]

I see it this way - the world isn't going to return to "normal" for quite some time (1-2 years). If you can wait for the Stryde, you're going to have a much better time getting through all of this as oppose to incurring the emotional weight that comes along from being wheelchair-bounded for 6 months. Image that - for 6 months, you're in pain, you aren't at all self-sufficient, you can't complete even the easiest of tasks on your own. Even if you have a caretaker doing it for you, the frustration from being unable to do it yourself would be very difficult. I'm not trying to discourage you at all, I'm just trying to paint a realistic picture. If it isn't possible for you to wait for Stryde, and you sincerely believe you have the mental fortitude to make it - then all the power to you. Otherwise, you'd have a much better time just chillin' out for a few months 'till Stryde pops back into the market and you're able to walk within a weeks time.

[RealLostSoul]

From my understanding, the pain and scars from external method is significantly worse when compared to the available technology. Also, I assume you're just kidding about the one leg at a time suggestion, but lengthening one leg at a time would not be a good idea since one of your legs would be significantly overcompensating for the weight and balance for too long a time. This would only cause further problems down the line.

Exactly.

I see it this way - the world isn't going to return to "normal" for quite some time (1-2 years). If you can wait for the Stryde, you're going to have a much better time getting through all of this as oppose to incurring the emotional weight that comes along from being wheelchair-bounded for 6 months. Image that - for 6 months, you're in pain, you aren't at all self-sufficient, you can't complete even the easiest of tasks on your own. Even if you have a caretaker doing it for you, the frustration from being unable to do it yourself would be very difficult. I'm not trying to discourage you at all, I'm just trying to paint a realistic picture. If it isn't possible for you to wait for Stryde, and you sincerely believe you have the mental fortitude to make it - then all the power to you. Otherwise, you'd have a much better time just chillin' out for a few months 'till Stryde pops back into the market and you're able to walk within a weeks time.

I kinda doubt that it will take that long. Corona has been around for a long time now and people are getting vaccinated, even if it's slow already, I think thinking that summer is normal again is kind of too optimistic but fall-winter, beginning of new year max, it will be over I guess. That's also the time stryde will be back probably. Like I said, you have walker, maybe even crutches, yes I understand, for me it's pretty frustrating too that stryde has to be gone when I want to do it but I can only think about the positive and possible aspects now, it's all I can do. There is no other option, I can't "chill out" and do it whenever since I am not an unemployed doing nothing. This summer is the only summer I have enough time for the next... almost decade... I can't do it next year since I will only have 2 months off, the same goes for 2023 etc. I need to travel to a whole different country, continent even. The only other option would be Betzbone which has it's benefits (weight bearing? cheaper and on the same continent) but I value safety so much I wouldn't really want to go with them. Wheelchair sucks, yea absolutely but what is the other possibility, not doing it at all, hell nah. Maybe Betzbone :/

[BreaktoGrow]

I understand that, bro. If you truly are constricted on time, then getting the surgery done is the most important thing. I support you, bro. If you don't mind my asking, what's your starting height and your goal?

[RealLostSoul]

I understand that, bro. If you truly are constricted on time, then getting the surgery done is the most important thing. I support you, bro. If you don't mind my asking, what's your starting height and your goal?

Thanks bro I appreciate. Yes it's really unfortunate time-wise for me. I am 5'10 (tall country, height dysphoria and shortest in family .) and my plan is to do 4 inches with paley (2 on tibia 2 on femur)

[RB]

Hey,

Congrats, bro. Few questions - what country, how much with everything in (living, food, etc) aprox?

Hey mate, if you're referring to me, I am doing it in Germany and it was roughly 52k euros (for femurs) for a 2 week hospital stay and roughly another few thousand for plane tickets, accommodation afterwards and food etc. Let me know if you have any other questions.

[BreaktoGrow]

Damn, 5'10 is a solid height, but mental health discriminates against no one. My philosophy is this: if it makes you happy and there is something you can do about it in a safe manner, go for it. Life and short, live it up. I hope the best for you, keep me posted.

[BreaktoGrow]

Thanks for the info, bro. I do have a few more questions. What country are you coming from? How long will you have to stay in Germany? Who is your doctor? What is your starting and goal height? Are you travelling with a partner or by yourself for this surgery? Thanks for the info my man

[one]

I asked Paley this he laughed and said externals is a bad idea and he wouldn't go back to this in a pure cosmetic procedure. His argument was that it's unreasonable to do cosmetic surgery yet gain tons of scars (which I kinda agree since external scars really are devastating in some cases). Other than that, externals are super uncomfortable, possibly more painful, and you run the risk of infections etc.

One side at a time is also a bad idea imo, the discrepancy will be too big honestly.

My current hopes are that I am able to get the large-diameter precise since they apparently can hold a weight of 146 pounds (even the second-largest nail is capable of 118 pounds btw). I am only at about 115 pounds, of course, that doesn't mean a guarantee but maybe I can use crutches for most of the time, which will definitely be acceptable for me.

The discrepancy will be too big but it will get fixed.

You're lucky if you can get the largest diameter precice and that you're only 115 pounds. But for most of us, precice means only standing up on both legs very carefully and not walking. I think it would be emotionally difficult to handle this and you need a support person at all times.

[RB]

Thanks for the info, bro. I do have a few more questions. What country are you coming from? How long will you have to stay in Germany? Who is your doctor? What is your starting and goal height? Are you travelling with a partner or by yourself for this surgery? Thanks for the info my man

Traveling from Australia and planning to stay in Germany for 4 weeks. My doctor is Dr. Betz. Starting height is 163cm and my goal height is 170/171cm on the femurs. Travelling by myself, if I was using a non-weight bearing nail like precise then I would be unable to do it alone and would probably need to hire help for majority of lengthening and not be able to fly home during lengthening, all major reasons why I decided against it. No problem mate, anytime.

[V21]

Giotikas just offered me a hybrid technique in case I want weightbearing: https://www.athensbjr.com/methods-of-bone-fixation-in-limb-lengthening/#1615151032722-7307679a-d07d

However, even though I just do 5 cm, I'd rather do femurs with Precice.

[VeteranLL]

If you’re considering LL, Betz he is the best option atm.
I was a Betz patient too and I had an easy time without any complications.

[one]

Giotikas just offered me a hybrid technique in case I want weightbearing: https://www.athensbjr.com/methods-of-bone-fixation-in-limb-lengthening/#1615151032722-7307679a-d07d

However, even though I just do 5 cm, I'd rather do femurs with Precice.

That is a really well written page.

You can change it to one leg pure external and one leg precice 2.

The scars will suck on one leg but on leg it can be explained as an accident.

I just don't know if the 2 legs will turn out to be same in alignment though haha.

[RealLostSoul]

Damn, 5'10 is a solid height, but mental health discriminates against no one. My philosophy is this: if it makes you happy and there is something you can do about it in a safe manner, go for it. Life and short, live it up. I hope the best for you, keep me posted.

Thanks man and yea I absolutely agree. Safety is the most important thing for me too which is why I really want to go with paley despite the fact that it's more effort (different continent, expensive, etc). I am currently planning to maybe get an x-ray here and send them so they can judge if I can fit the big diameter precice nail. if that's the case, I am 30 pounds lighter than the maximum weight limit - would be great news. if not I am maybe considering Dr Betz since I could travel to Germany by train actually (but like I said, i would prefer Paley).

Do you guys think for weight bearing does it make a difference if you have a nail in both femur and tibia or only in one? physically I think it shouldn't reduce or increase the weight bearing limit but I might be wrong here.