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[Zatoichi]

Hi everyone! After many (many) years of looking and intending to do this procedure, I have finally taken the plunge! I gained a lot from this forum and everyone’s reported experiences, both the good and the bad. I want to pay it forward as much as possible. Also, regular uploads will (hopefully) help keep me sane as I work through the day-to-day of the process. I’ll be as honest as possible and as regular as possible, as much as I can be.


ABOUT ME: (I’ll keep details not directly relevant to CLL, a little vague for the sake of privacy):
o   Current height: ~166 cm morning). I underwent puberty very early, but also stopped growing fairly early – I’d say I was done by ~14. I kept hoping for a second burst, even as all my friends blasted past me, but it never came.
o   Current span: ~174-175 cm. I’m pretty happy with my general frame, apart from my legs length – I look like a gorilla with my current ape index!
o   Desired gain: Minimum 6.5 cm bilateral femurs. Anything above is a bonus. I’m hoping to get this one process, and then never think about the issue again, so maybe aiming for ~8.5 cm might be better; +6 cm looked pretty unimpressive/made little difference on the Betz simulated mock-ups. However, I am also something of an obsessive personality, and I may come back to tibias in a couple of years, in order to get a few more centimetres… 
o   Age: Early-thirties
o   Ethnicity: S. Asian
o   Currently work/live: E. Asia
o   How to afford procedure: Work and investments – scrimping and saving over many years.
o   Who have I told: a couple of friends and my siblings.
o   What I told work: I plan to have operation on my legs. I also mentioned I would be on crutches when I returned. No further questions were asked and no further information was necessary (what little I told them was already treated as TL;DR :p).


WHY I WANT CLL: I have lived a pretty blessed/fortunate life to-date, in almost all other aspects (i.e.; professional, social, etc.). CLL is one of the final things I wanted to address, but it is not a magic pill that I am expecting to change everything else in my life. That, I have (mostly) managed to get right already, although it is all a work in progress of course. Simply, height issues take up valuable bandwidth that could otherwise be spent elsewhere and give me far greater returns. After CLL, I want to not have to think about height as an issue/excuse ever again.     


HISTORY: I first looked into the procedure >10 years ago with Guichet (!). To be fair to him, I found my email interactions to be perfectly cordial and he gave a detailed, technical overview of the entire process. Unfortunately, I had nowhere near the required money at the time and no way to get it. Fast forward a decade and things are a little more feasible. I thought now was the time to take action, especially given the unprecedented flexibility afforded by the pandemic. Plus, the CLL process will only get harder and increase the risk of complication the longer I delay.


THE ROAD TO BETZ: Like many others, I planned to do Stryde initially (with Giotikas), but as soon as I received the notice about the delay, I made a booking with Dr Betz. That original Stryde return date seemed wildly optimistic when I received the notification, and so I gave up on that avenue completely. I picked the Betzbone because it was the only other fully weight-bearing internal nail - this was a minimum condition of my even doing the surgery, and also because of the possibility to return to my residence for at least part of the lengthening. I had no interest in Precise II, or any of the external fixators. Plus, there have been some really inspirational and detailed Betz diaries over the past few years (e.g.; OldieButGoldie, Constantine, etc.) Also, and this is highly under-rated, Dr Betz’s team is very responsive and organised. For some of the other superstar surgeons on this forum, whilst their surgical skills may be excellent, the admin, engagement, speed/quality of response, and organisation seems a little lacking… No-one likes to be ignored, or to wait weeks to receive a perfunctory response.

I had the online meeting with Dr Betz in early 2021. Like for others, it was marathon session of >3 hrs. It was extremely detailed. All my questions were answered (i.e.; the remaining ones after my conversations with other CLL doctors – mainly to do with variations between the nails than anything else). Once that was done, I booked my appointment the next day - for the summer period. Apart from a small delay to the originally intended operation date, everything else is has gone smoothly so far.


THOUGHTS ON GERMANY & SAARLAND: Idyllic. It’s Germany, so everything is well-developed, maintained etc. The air is clean and there is lots of greenery. The weather is pleasant this time of year – not oppressively hot or cold. Mid 20’s°C; perfect! A very decent place to do at least part of the recovery!


PLAN FOR THE NEXT COUPLE OF WEEKS: I arrived ~1 week early. I am not in prime physical shape, but I have spent the past few months trying to do at least something daily, whether it is strength, cardio etc. Nowhere near as much as I would have liked, but the pressures of life, etc., always get in the way. That’s one of the reasons I wanted to arrive a little earlier to Germany. Whilst not much, it would give me a little bit more time to get in some daily runs, daily yoga/Pilates, etc., in order to raise my general condition, rather than jump in completely unprepared.

I arranged for airport pick-up via the Institutes’ designated driver – I want to minimise as much stress etc., as possible for this entire process. Plus, Thomas is a talkative guy and his English is good, if that is a worry for anyone. Frankfurt airport is pretty easy to navigate.

I’m currently staying at an Airbnb (I didn’t know that staying at Elke’s was a possibility prior to the surgery, which might otherwise have been a better and similarly priced option). I’ve completed all the other meetings, PCR tests, X-rays, mock-ups and all other pre-check appointments over the course of the week. The actual surgery is scheduled for Friday morning.

My intention/plan is to stay at the hospital for the two weeks, then stay at Elke’s for another ~4 weeks. However, if I get sick of the hospital, I may leave to Elke’s earlier, and if I think I am good to return home earlier, I may cut short my stay at the guesthouse. It is good to have that flexibility. Regardless, a 1 month minimum period will be spent here. Basically, I want to stay long enough to build a system/habit required for the lengthening, and learn the required methods, but then, provided there are no complications, get back to more familiar surroundings as soon as possible.


CURRENT THOUGHTS: I have no fear, there is no trepidation. Only a desire to get started and get going! Enough time has been wasted. For now, I am enjoying the full and free use of my legs – running daily and exploring the area by foot. It will be a while before I can do this freely again!

Another potential benefit is that I am looking forward to eating multiple meals a day again! Ever since I hit my thirties (exacerbated by a semi-sedentary, office-type job), life is a choice between eating what I want and blowing up like a balloon, or trying to eat ~1 meal a day, in order to try and keep some weight off. I’m ready to throw off the shackles and let loose for this procedure!

[DonBones]

Thanks for the detailed introduction. I am in sort of a similar situation as you are. I wanted to have it done about a decade ago, didn't have the money, saved it up once I got a good job, wanted to go for Stryde, then Stryde was recalled...and now my surgery with Betz is scheduled for the 28th of July.

I will be at Elke's before my surgery from the 11th of July to the 28th, so we might see each other

Anyways, best of luck for Friday and enjoy the good weather 👍🏻

[Will955]

Looking forward to seeing your progress, man. Wishing you good luck and a speedy recovery

Do you mind sharing the total cost of it all?

[Zatoichi]

Looking forward to seeing your progress, man. Wishing you good luck and a speedy recovery

Do you mind sharing the total cost of it all?

Thanks man! No issue with sharing costs at all, but please bear in mind that it is a running (and seemingly ever-increasing) total. I'll give more information as I make the relevant payments. To keep things simple, I've normalised everything to Euros and used round numbers:
Operation costs (~53k) + Betz interview, mock-up, x-rays etc (~500) + 2xPCR tests (~500; one for my flight and one for the operation) + airbnb (~300) + Driver pick-up (~200) + flights, food etc (~1k).

I think the remaining major costs will be the guesthouse, PT sessions and possibly further PCR tests. I'll update these as they come in.

Thanks for the detailed introduction. I am in sort of a similar situation as you are. I wanted to have it done about a decade ago, didn't have the money, saved it up once I got a good job, wanted to go for Stryde, then Stryde was recalled...and now my surgery with Betz is scheduled for the 28th of July.

I will be at Elke's before my surgery from the 11th of July to the 28th, so we might see each other

Anyways, best of luck for Friday and enjoy the good weather 👍🏻

Thanks!!! Look forward to seeing you in a few weeks.

[RB]

Good to see you going with Betz! Looking forward to following your progress. You are well prepared and in good hands so I'm sure you will do great! Say hi to Elke for me

[Limblengtheningwarrior]

Wish you all the best

[DonBones]

Hope all went well 🙏🏻

[Zatoichi]

Alright dudes!

Hope all went well 🙏🏻

Wish you all the best

Good to see you going with Betz! Looking forward to following your progress. You are well prepared and in good hands so I'm sure you will do great! Say hi to Elke for me

Thanks for the wishes!

I thought it was time for an update. It’s now 4 days post-surgery.

The surgery itself seemed to be fine. The first day was a haze. I remember walking ~20m (aided).

The second day was a little more lucid; I walked a little, but mainly focused on stretches. I also used the toilet for the first time. It was exhausting; like trekking through the Amazon!

Third day: Walked with a walker and crutches (~100 m in total), as well as ~1 km on the bike (no resistance) for 10 minutes. Then lots more stretching. I also took a shower – another extremely challenging event.

Fourth day (today): Seemingly a turning point! Things just felt a lot better and I feel much sharper! The first three days were very tough but today gives me hope that the process should be possible to stay on top of. Lots of walking, cycling and stretching. But even then, I was also able to do some work, catch up with family and friends, update the diary, etc.

General thoughts:
-   Stiffness: This is probably the most under-rated/under-estimated part of the procedure. I don’t think I paid attention to this enough, when reading past diaries. No matter how much stretching you do, you will always be stiff, especially in the mornings. But generally after any period of inactivity of in any colder climate. And not just a mild discomfort, but rather a deep, aching soreness, that only alleviates for short periods, and only after the most incessant of stretching routines. Also, unlike in real-life, where when you do yoga/pilates/martial arts etc., the next day you feel fantastic, you get none of that with this procedure. Only compounded soreness and stiffness.
-   The implant: You can definitely tell that there are implants in your thighs. Whilst my legs were short, they were always quite powerful, sturdy and did what wanted them to. With the nails in, that certainty is gone; there is uncertainty and instability where there was surety previously. The closest thing I can liken it to is ice-skating; some muscles completely betray you while others take on the bulk of the support work, but then become completely exhausted and ridiculously sore afterwards.
-   The set-up/general level of care: Dr Betz’s team has been great. We have seen either him or one of his team daily. In addition, the hospital staff are excellent! The hospital itself seems to be some sort of specialist clinic for people recovering from various joint maladies, e.g.; new knees, hips, etc. (the crazy CLL’ers only make up a small number of the population; a handful of us in the hospital currently), so all the staff (nurses, physio staff, etc.) are fully prepared to deal with most likely eventualities. Like other diaries, there were issues with the food initially, but my roommate and I simply asked for more and greater variety. The staff were very gracious and accommodated us. Since day 3, the volume and variety of food has been very good – so much so that I cancelled the emergency food supplies that I was otherwise going to have bought in!). Beware though, it is a very central European diet; lots of potatoes, cheese and bread (of decent quality and variety) – it’s not for everyone.
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[DonBones]

Alright dudes!
Thanks for the wishes!

I thought it was time for an update. It’s now 4 days post-surgery.

The surgery itself seemed to be fine. The first day was a haze. I remember walking ~20m (aided).

The second day was a little more lucid; I walked a little, but mainly focused on stretches. I also used the toilet for the first time. It was exhausting; like trekking through the Amazon!

Third day: Walked with a walker and crutches (~100 m in total), as well as ~1 km on the bike (no resistance) for 10 minutes. Then lots more stretching. I also took a shower – another extremely challenging event.

Fourth day (today): Seemingly a turning point! Things just felt a lot better and I feel much sharper! The first three days were very tough but today gives me hope that the process should be possible to stay on top of. Lots of walking, cycling and stretching. But even then, I was also able to do some work, catch up with family and friends, update the diary, etc.

General thoughts:
-   Stiffness: This is probably the most under-rated/under-estimated part of the procedure. I don’t think I paid attention to this enough, when reading past diaries. No matter how much stretching you do, you will always be stiff, especially in the mornings. But generally after any period of inactivity of in any colder climate. And not just a mild discomfort, but rather a deep, aching soreness, that only alleviates for short periods, and only after the most incessant of stretching routines. Also, unlike in real-life, where when you do yoga/pilates/martial arts etc., the next day you feel fantastic, you get none of that with this procedure. Only compounded soreness and stiffness.
-   The implant: You can definitely tell that there are implants in your thighs. Whilst my legs were short, they were always quite powerful, sturdy and did what wanted them to. With the nails in, that certainty is gone; there is uncertainty and instability where there was surety previously. The closest thing I can liken it to is ice-skating; some muscles completely betray you while others take on the bulk of the support work, but then become completely exhausted and ridiculously sore afterwards.
-   The set-up/general level of care: Dr Betz’s team has been great. We have seen either him or one of his team daily. In addition, the hospital staff are excellent! The hospital itself seems to be some sort of specialist clinic for people recovering from various joint maladies, e.g.; new knees, hips, etc. (the crazy CLL’ers only make up a small number of the population; a handful of us in the hospital currently), so all the staff (nurses, physio staff, etc.) are fully prepared to deal with most likely eventualities. Like other diaries, there were issues with the food initially, but my roommate and I simply asked for more and greater variety. The staff were very gracious and accommodated us. Since day 3, the volume and variety of food has been very good – so much so that I cancelled the emergency food supplies that I was otherwise going to have bought in!). Beware though, it is a very central European diet; lots of potatoes, cheese and bread (of decent quality and variety) – it’s not for everyone.

Glad to hear from ye

With the surgery done and the first few days overcome, I think the worst is now behind you. It's encouraging that you were able to walk and even cycle. I wouldn't have thought it be possible shortly after the surgery - or perhaps your body adapted particularly well.

Good luck for the next few days 👍🏻

[chasing_higher_dream]

The initial couple of weeks would be tough, but post that you would make good progress.

I wish you the best of luck in your lengthening journey ahead!

[Zatoichi]

The initial couple of weeks would be tough, but post that you would make good progress.

I wish you the best of luck in your lengthening journey ahead!

Glad to hear from ye

With the surgery done and the first few days overcome, I think the worst is now behind you. It's encouraging that you were able to walk and even cycle. I wouldn't have thought it be possible shortly after the surgery - or perhaps your body adapted particularly well.

Good luck for the next few days 👍🏻

Thanks guys! Much appreciated.



Hi All,

Time seems to be flying. I thought I’d jump in with another update.

CLICKING: I started clicking 4 days ago. The first day was only 7 clicks. The second was 12 clicks. Yesterday and today are both 20 clicks. I think 20 a day is a little high to be honest, and I’ll be glad to go back down to a lower rate after the first few centimetres. The clicking itself has been completely painless for me (although my roommate has had great trouble, so it differs from person to person). Clicking itself is also relatively fast. However, the biggest headache is trying to find the right position and angle. I have had more pain/discomfort from contorting my legs into weird angles in order to get the click. Hopefully things will move quicker with experience. For the clicks, I think 20 in one day is a little too much, and trying to do all that in one go is simply crazy! I have split my clicks into three sessions; morning (7), afternoon (7) and early evening (6). I do stretches before clicking and then a series of walks, star climbs etc., afterwards.

Whilst there is a little tightness, I have found the entire process pretty straightforward and hassle-free; disconcertingly so… I am expecting something to go wrong at some point. Honestly though, if it all continues like this, I will keep extending as far as I can go!

HOSPITAL: I take back everything said about the food in the last post. It is utterly miserable. Whilst the staff are doing their best, the food itself is probably the lowest of all the low points for the entire process. I am looking forward to leaving, simply to not have to ingest this swill!
   Otherwise, the clinic staff are great. Super kind and helpful, and the physios are slowly but constantly increasing the amount and variety of exercise and stretch.

PHYSIOS: We started training for an hour daily at the gym from the second week onwards. It is mainly biking and various leg weights (e.g.; leg press, adduction, abduction etc.). The focus is on volume rather than weight, but things have gone very smoothly with that too. None of the exercises are overly difficult or exotic, which gives me confidence that I can continue (and perhaps do even more), once I return home.

GENERAL CONDITION & THOUGHTS:  Apart from small gripes (e.g.; food etc.), everything has gone very smoothly! So much so that I am kicking myself that I did not do this earlier (e.g.; two summers ago I talked myself out of it…). Once the operation is done, it is mainly down to you, your body and how much you push yourself. I have always been pretty good at the latter requirements and so have not had much issue. The only thing I am anxious to resolve are the bandages from the surgical wounds. They take forever to heal. Once they are gone, I am happy to leave the hospital and get on with life.
   On that related note, I am extremely thankful that Betz offers two weeks of hospital stay as part of the procedure. It is crazy that some let you leave after only four days. Those that do even shorter hospital stays are bordering on irresponsible in my opinion. Everything sounds great and easy when you read forums and listen to interviews, but when you go through the process, you appreciate how tough it is and how unrealistic some of the timelines being given, are. For example, those that say they go a back to work in the first or second week, etc. – that sounds like airburushed Instagram bulls*** to me.  For a fraction of a percent of people, that may apply (and even then, I’d have my doubts), but for most, it will realistically be closer to a month before you can consider doing other things in addition to the CLL. This whole process is a big commitment. Make sure you take off the relevant time and don’t overload yourself!

Until the next update!

[SirStretchAlot]

Thanks guys! Much appreciated.



Hi All,

Time seems to be flying. I thought I’d jump in with another update.

CLICKING: I started clicking 4 days ago. The first day was only 7 clicks. The second was 12 clicks. Yesterday and today are both 20 clicks. I think 20 a day is a little high to be honest, and I’ll be glad to go back down to a lower rate after the first few centimetres. The clicking itself has been completely painless for me (although my roommate has had great trouble, so it differs from person to person). Clicking itself is also relatively fast. However, the biggest headache is trying to find the right position and angle. I have had more pain/discomfort from contorting my legs into weird angles in order to get the click. Hopefully things will move quicker with experience. For the clicks, I think 20 in one day is a little too much, and trying to do all that in one go is simply crazy! I have split my clicks into three sessions; morning (7), afternoon (7) and early evening (6). I do stretches before clicking and then a series of walks, star climbs etc., afterwards.

Whilst there is a little tightness, I have found the entire process pretty straightforward and hassle-free; disconcertingly so… I am expecting something to go wrong at some point. Honestly though, if it all continues like this, I will keep extending as far as I can go!

HOSPITAL: I take back everything said about the food in the last post. It is utterly miserable. Whilst the staff are doing their best, the food itself is probably the lowest of all the low points for the entire process. I am looking forward to leaving, simply to not have to ingest this swill!
   Otherwise, the clinic staff are great. Super kind and helpful, and the physios are slowly but constantly increasing the amount and variety of exercise and stretch.

PHYSIOS: We started training for an hour daily at the gym from the second week onwards. It is mainly biking and various leg weights (e.g.; leg press, adduction, abduction etc.). The focus is on volume rather than weight, but things have gone very smoothly with that too. None of the exercises are overly difficult or exotic, which gives me confidence that I can continue (and perhaps do even more), once I return home.

GENERAL CONDITION & THOUGHTS:  Apart from small gripes (e.g.; food etc.), everything has gone very smoothly! So much so that I am kicking myself that I did not do this earlier (e.g.; two summers ago I talked myself out of it…). Once the operation is done, it is mainly down to you, your body and how much you push yourself. I have always been pretty good at the latter requirements and so have not had much issue. The only thing I am anxious to resolve are the bandages from the surgical wounds. They take forever to heal. Once they are gone, I am happy to leave the hospital and get on with life.
   On that related note, I am extremely thankful that Betz offers two weeks of hospital stay as part of the procedure. It is crazy that some let you leave after only four days. Those that do even shorter hospital stays are bordering on irresponsible in my opinion. Everything sounds great and easy when you read forums and listen to interviews, but when you go through the process, you appreciate how tough it is and how unrealistic some of the timelines being given, are. For example, those that say they go a back to work in the first or second week, etc. – that sounds like airburushed Instagram bulls*** to me.  For a fraction of a percent of people, that may apply (and even then, I’d have my doubts), but for most, it will realistically be closer to a month before you can consider doing other things in addition to the CLL. This whole process is a big commitment. Make sure you take off the relevant time and don’t overload yourself!

Until the next update!

1) Glad you were one of the lucky patients who get to click pain-free. It's one of the mysteries of Betzbone that Betz doesn't even know exactly the reason of. It is likely due to your muscle flexibility in that area as well as the angle of the nail. Your unfortunate roomate will likely suffer for the first 3cm. I personally recommend 10 clicks in the morning and 10 in the afternoon. You won't feel it yet, but clicking at night, will disrupt your sleep once lengthening starts stiffening your muscles.

2) The hospital food is disgusting because it is a very cheap hospital. Most doctors offer 2 weeks of stay, so I don't think Betz stand out from that aspect. The first week is actually where most of the risk lie. I had fast surface wound recovery, but minor iron difficiency due to surgical blood loss.

3) If you continue to use crutches and don't walk dangerously, the only common complication most people see are wide leg / duck ass. They are inter-related, both deriving from weak glutes and tight IT bands. Depending on how much you lengthen, you should find difficulty closing your legs around 2cm, and have visible wide legs around 3cm. You shouldn't see much complication during your hospital stay, though Betz did forget to screw in one of my screws so I had to do a follow-up surgery. Be sure to stretch the bands as much as possible. If it's wide to my extent (60cm), you will need to perform a seperate ITB release, as function recovery through PT is less likely.

[Johnp86]

Good to read that everything is going well. Still looking for the surgery with Dr Betz as I cancelled it in March but tbh this hospital is just terrible. I asked for the komfort clinic one week ago but they are no longer doing surgeries there... so what you see with this beautiful commercial on the website and what you get when you arrive there is simply a disaster.. but if there is no other choice now.
Are you able to go train in the gym when you want? like for upper body for example ?

[chasing_higher_dream]

Good to know that clicking has been a good experience for you.
For me too, 20 clicks in a day was a bit too much, initially, it was exhausting for me. Doing 1.04 mm per day made my legs stiffer, and was starting to create wide legs.
But since I reduced my clicks to 15 clicks (0.78 mm) after reaching the 2 cm mark, things have been going pretty well. I have managed to reduce my wide legs with stretching and also the stiffness is very well under control.
Now, I am almost around 1-month post-surgery, and the strength in my legs has started to come back and I am feeling good about it.

Regarding, the 14-day stay provided by Dr Betz, I am too thankful for him for this. I cannot imagine travelling back alone just after 4 days or a week post-surgery, it would have been a disaster!
Anyway, you would surely do good, you are in the good hands of Dr Betz.

All the best with starting the distraction phase.

[Zatoichi]

Good to know that clicking has been a good experience for you.
For me too, 20 clicks in a day was a bit too much, initially, it was exhausting for me. Doing 1.04 mm per day made my legs stiffer, and was starting to create wide legs.
But since I reduced my clicks to 15 clicks (0.78 mm) after reaching the 2 cm mark, things have been going pretty well. I have managed to reduce my wide legs with stretching and also the stiffness is very well under control.
Now, I am almost around 1-month post-surgery, and the strength in my legs has started to come back and I am feeling good about it.

Regarding, the 14-day stay provided by Dr Betz, I am too thankful for him for this. I cannot imagine travelling back alone just after 4 days or a week post-surgery, it would have been a disaster!
Anyway, you would surely do good, you are in the good hands of Dr Betz.

All the best with starting the distraction phase.

Thanks dude! 12-15 clicks a day sounds perfect!

I look forward to tracking your progress!

Good to read that everything is going well. Still looking for the surgery with Dr Betz as I cancelled it in March but tbh this hospital is just terrible. I asked for the komfort clinic one week ago but they are no longer doing surgeries there... so what you see with this beautiful commercial on the website and what you get when you arrive there is simply a disaster.. but if there is no other choice now.
Are you able to go train in the gym when you want? like for upper body for example ?

Yeah, nothing to be done. Stryde will likely take longer than they are saying. Betz is also extremely in demand at the moment, from my conversations. Opportunities will be hard to find - take it when they come.

For the gym, I think normal oppression would be free use. But because of pandemic, they are strict with numbers and sppointment times. We haven't been able to get access outside of our slots. It's pretty busy...

1) Glad you were one of the lucky patients who get to click pain-free. It's one of the mysteries of Betzbone that Betz doesn't even know exactly the reason of. It is likely due to your muscle flexibility in that area as well as the angle of the nail. Your unfortunate roomate will likely suffer for the first 3cm. I personally recommend 10 clicks in the morning and 10 in the afternoon. You won't feel it yet, but clicking at night, will disrupt your sleep once lengthening starts stiffening your muscles.

2) The hospital food is disgusting because it is a very cheap hospital. Most doctors offer 2 weeks of stay, so I don't think Betz stand out from that aspect. The first week is actually where most of the risk lie. I had fast surface wound recovery, but minor iron difficiency due to surgical blood loss.

3) If you continue to use crutches and don't walk dangerously, the only common complication most people see are wide leg / duck ass. They are inter-related, both deriving from weak glutes and tight IT bands. Depending on how much you lengthen, you should find difficulty closing your legs around 2cm, and have visible wide legs around 3cm. You shouldn't see much complication during your hospital stay, though Betz did forget to screw in one of my screws so I had to do a follow-up surgery. Be sure to stretch the bands as much as possible. If it's wide to my extent (60cm), you will need to perform a seperate ITB release, as function recovery through PT is less likely.

Thanks for the advice. I switched up the numbers during the three slots. Still, whatever way you do it, 20 leaves you exhausted.

Yeah, I've been pretty happy with purges. I can't see anything going wrong as long as I start careful. I'm not looking to take risks like walking without crutches, or doing silly exercises. Slow, steady progress is enough!

[Zatoichi]

Hi All!

Time for another update I think.

Clicking/Lengthening: I am now ~2 cm into lengthening and it has been over 2 weeks of clicking (over 3 weeks since the surgery).  The clicking rate has been pretty fast and I’ll be glad to decrease the rate in another week or so. There is always an annoying stiffness and soreness that is impossible to shake at this higher clicking level. On the odd day that I’ve done fewer clicks, I feel much freer and have better range-of-motion.

These first couple of weeks of clicking have also been very rough. Like with most others patient diaries, the clicking mechanism has been very tricky to master. Because the leg dimensions are constantly changing, the angle, orientation etc., required for each leg shifts daily. Thus, there is a lot of trial and error involved. While I still have not had any great clicking pain directly, unfortunately, the effort, time and constant testing required to get the correct clicking configuration often leaves your leg feeling like tenderised chuck meat, before you can start clicking. It is agony! This was the reason for some of the slower days. Those were also the days when I rued the loss of the Stryde nail the most – automated lengthening simply makes more sense! Manual clicking is a headache. Next to the requirement of a fully weight-bearing internal nail, I would recommend to future LL’ers that automated lengthening be the second most important factor in any decision-making process. Unfortunately, there is no other nail that offers such a combination currently.

Despite all the setbacks, I feel like I have finally gotten to grips with clicking and now am both regular and progressing well with my lengthening progress. However, now that getting the clicks is no longer an issue, another fear has taken over (there is always another fixation that replaces the first during this CLL process) – that of accidental clicks and a potential runaway nail! I know such an outcome is rare, and I plan to be super careful going forward by decreasing clicks etc., especially as I get to the longer lengths, where accidental clicks become more prevalent. Still, the fear is always lingering in the background…  I hope it doesn’t happen.

Apart from the clicking however, everything else seems to be progressing smoothly. I feel good, sleep is not really an issue for me (although other housemates are having problems), and my general physical state also feels good (although it is still very early, so nothing is expected at this stage). Whilst I was expecting to lose a lot of weight during the process, it feels like I have barely lost any! Perhaps that will come later.

Germany/Guesthouse/Physio: I have stayed in Germany for a further two weeks beyond my initial two week hospital stay. I initially intended to stay a month at the guesthouse, but I am happy with how things are progressing as well as my general shape. And I am confident enough to return a little earlier. Also, I am quite keen to get out of the CLL bubble. While everyone is super nice and the environment is great for getting the lengthening done, I feel I am going a little crazy just obsessing over this one aspect of life. I am looking forward to getting back to real-life.

I have stayed at the guesthouse (Elke’s). It is a good set-up, with all meals, washing etc., included such that you can fully focus on training, lengthening, etc. Also, there is a wealth of knowledge that can be shared by both Elke and the other LL-housemates, to help with the lengthening process. For example, I am across a much easier method of clicking that really helped to speed up my output and minimise muscle irritation. However, for those that don’t want the guesthouse, staying at the local hotel (Park hotel), is also an option that several patients have taken. The benefit of that is that you get access to all their fitness facilities, which may be useful for those wishing to push themselves a little more with physio.
 
Speaking of physio, I strongly recommend those going with Dr Betz to stay for a week or two beyond their hospital stay. Whilst the physios at the hospital are good, they are very much generalists. Once you leave the hospital, you start with a different physio (Peter), who is a CLL specialist with over a decade of experience dealing with patients. Like with most things in life, there are levels to everything. Peter is fantastic and the stretches/exercises he gives are extremely useful and precise in helping deal with the specific issues that will be encountered at different stages of lengthening. He can also advise on what to expect in the next stages, and how best to try and combat the issues. I cannot recommend him highly enough! It is worth staying just an extra week to get this experience/knowledge.

I hope this is useful. I’ll keep (irregularly) updating things as I go and as things develop!

[DonBones]

Hi All!

Time for another update I think.

Clicking/Lengthening: I am now ~2 cm into lengthening and it has been over 2 weeks of clicking (over 3 weeks since the surgery).  The clicking rate has been pretty fast and I’ll be glad to decrease the rate in another week or so. There is always an annoying stiffness and soreness that is impossible to shake at this higher clicking level. On the odd day that I’ve done fewer clicks, I feel much freer and have better range-of-motion.

These first couple of weeks of clicking have also been very rough. Like with most others patient diaries, the clicking mechanism has been very tricky to master. Because the leg dimensions are constantly changing, the angle, orientation etc., required for each leg shifts daily. Thus, there is a lot of trial and error involved. While I still have not had any great clicking pain directly, unfortunately, the effort, time and constant testing required to get the correct clicking configuration often leaves your leg feeling like tenderised chuck meat, before you can start clicking. It is agony! This was the reason for some of the slower days. Those were also the days when I rued the loss of the Stryde nail the most – automated lengthening simply makes more sense! Manual clicking is a headache. Next to the requirement of a fully weight-bearing internal nail, I would recommend to future LL’ers that automated lengthening be the second most important factor in any decision-making process. Unfortunately, there is no other nail that offers such a combination currently.

Despite all the setbacks, I feel like I have finally gotten to grips with clicking and now am both regular and progressing well with my lengthening progress. However, now that getting the clicks is no longer an issue, another fear has taken over (there is always another fixation that replaces the first during this CLL process) – that of accidental clicks and a potential runaway nail! I know such an outcome is rare, and I plan to be super careful going forward by decreasing clicks etc., especially as I get to the longer lengths, where accidental clicks become more prevalent. Still, the fear is always lingering in the background…  I hope it doesn’t happen.

Apart from the clicking however, everything else seems to be progressing smoothly. I feel good, sleep is not really an issue for me (although other housemates are having problems), and my general physical state also feels good (although it is still very early, so nothing is expected at this stage). Whilst I was expecting to lose a lot of weight during the process, it feels like I have barely lost any! Perhaps that will come later.

Germany/Guesthouse/Physio: I have stayed in Germany for a further two weeks beyond my initial two week hospital stay. I initially intended to stay a month at the guesthouse, but I am happy with how things are progressing as well as my general shape. And I am confident enough to return a little earlier. Also, I am quite keen to get out of the CLL bubble. While everyone is super nice and the environment is great for getting the lengthening done, I feel I am going a little crazy just obsessing over this one aspect of life. I am looking forward to getting back to real-life.

I have stayed at the guesthouse (Elke’s). It is a good set-up, with all meals, washing etc., included such that you can fully focus on training, lengthening, etc. Also, there is a wealth of knowledge that can be shared by both Elke and the other LL-housemates, to help with the lengthening process. For example, I am across a much easier method of clicking that really helped to speed up my output and minimise muscle irritation. However, for those that don’t want the guesthouse, staying at the local hotel (Park hotel), is also an option that several patients have taken. The benefit of that is that you get access to all their fitness facilities, which may be useful for those wishing to push themselves a little more with physio.
 
Speaking of physio, I strongly recommend those going with Dr Betz to stay for a week or two beyond their hospital stay. Whilst the physios at the hospital are good, they are very much generalists. Once you leave the hospital, you start with a different physio (Peter), who is a CLL specialist with over a decade of experience dealing with patients. Like with most things in life, there are levels to everything. Peter is fantastic and the stretches/exercises he gives are extremely useful and precise in helping deal with the specific issues that will be encountered at different stages of lengthening. He can also advise on what to expect in the next stages, and how best to try and combat the issues. I cannot recommend him highly enough! It is worth staying just an extra week to get this experience/knowledge.

I hope this is useful. I’ll keep (irregularly) updating things as I go and as things develop!

Thank you very much for the update, it's much appreciated that you took the time to write it for us.

The clicking scares me a little, to be honest. I literally had people tell me they cried and screamed when they did it. But as you say, it's the only nail out there right now, so no way but this way. It does appear that on the whole your journey is going well though, which is great. I am happy for you. Hopefully you won't have any major troubles until your next update and beyond

May I ask if you keep in touch with Betz or another doctor? For example, if you have pain and want to know why there is a particular type of pain, who is there to help you?

[SirStretchAlot]

Thank you very much for the update, it's much appreciated that you took the time to write it for us.

The clicking scares me a little, to be honest. I literally had people tell me they cried and screamed when they did it. But as you say, it's the only nail out there right now, so no way but this way. It does appear that on the whole your journey is going well though, which is great. I am happy for you. Hopefully you won't have any major troubles until your next update and beyond

May I ask if you keep in touch with Betz or another doctor? For example, if you have pain and want to know why there is a particular type of pain, who is there to help you?

I cried and screamed during the first cm of clicking on my right. The next 2cm was painful. Clicking after 3cm was dreadful but somewhat bearable. Even at 5.5cm, it is occassionally painful.

My left? Can do 20 clicks in 20 seconds with minimal discomfort.

All depends on the angle of nail insertion by Betz. All luck.

[DonBones]

I cried and screamed during the first cm of clicking on my right. The next 2cm was painful. Clicking after 3cm was dreadful but somewhat bearable. Even at 5.5cm, it is occassionally painful.

My left? Can do 20 clicks in 20 seconds with minimal discomfort.

All depends on the angle of nail insertion by Betz. All luck.

It does sound terrible, but well done on the 5.5 man, you're already further than I can dream about. Honestly - if someone offered me as good a bone consolidation as you have (or RB), even with the wide legs and the pain, but without infection or non-union, I would probably take it! All things considered I think you're all pretty much out of the woods, while I don't even know if will wake up from surgery Just wanted to give you my perspective as someone who will have it soon.

[inchesmatter]

The clicking is by far the biggest challenge. It is a nightmare for the first several weeks. It is a skill you must master through a lot of time-consuming and painful trial and error, but you will eventually see a rapid improvement until it becomes super easy and pain-free. My experience was so bad I didn’t believe it would ever improve, but it did. Do not leave Germany too soon. Stay for at least a month so you know you can click, otherwise you may be flying right back there to have them click for you under anesthesia…

[Zatoichi]

Hi All,

I thought I should post an update. It's been a few weeks! I flew back from Germany after a month, and after serving two weeks hotel quarantine, I returned to my flat and to work. Things have generally been progressing, although now I have other things to consider in addition to the lengthening issues.

I have also been keenly following the various other diaries Betz and non-Betz) and it is interesting and heartening to see everyone is generally making good progress (although nothing ever goes perfectly smoothly with a procedure like this).

Here are my current thoughts:
CLICKING & LENGTHENING: The lengthening process has become relatively fast and issue-free now. Much like other diaries, after the first inch, all issues seem to have resolved themselves. In addition, and unlike some other diaries, I have been going super slow for lengthening. I know the process is not fun and does drag on, but I’ve never understood the need to power through the process. The risk of damage is too high. Slow and steady is always the way!

For example, after the first inch, I started feeling faint nerve pains on my shins. I immediately went down to 15 clicks a day (from ~20). That resolved the issue. Once I returned to work, I found that 15 clicks a day was stopping me from being productive (as a result of tightness, exhaustion, etc.). So I went down to 12 clicks a day. Once I get past the 5 cm mark (by next weekend hopefully), I will likely go down to 9-10 clicks a day. 
I have also not been shy about taking the odd day off. Sometimes, the tightness has been so great that I simply took a day off – stretching, moving, but not lengthening. Even a single day of rest has a remarkable loosening effect, more so than any drug can offer. I have used this (sparingly), as required.


IT BANDS & TIGHTNESS: Thankfully, I have not had extreme wide legs even after >4 cm, and am taking various steps to minimise the risk. Whilst there is some slight wideness in my stationary stance, it is readily resolved and walking (with crutches), seems to look pretty normal. I hope my prophylactic steps continue to work, and I offer a list below of my approaches (in no particular order):

E-stim acupuncture: This is fantastic and I go twice a week; ~20 mins per session. They punch holes into various parts of the leg with needles (including the IT bands and hips), and then use an electric field to maximise the effects. I do not know the exact mechanism of action but, the IT band relief may be a result of introducing perforations into the fibrous sheet, such that stiffness is decreased and strains eased

Stretching: Probably the most important thing to do, at least 2-3 times a day. Use many types of stretch, applied from many angles and from many positions.

Cupping: It helps but is not necessarily super-effective on its own. Useful in combination with the other approaches and whilst incorporating range-of-motion exercises. I have been warned that because of the Xarelto, cupping may cause internal bleeding. So, I have used it sparingly.

Massage gun: Others have mentioned this before. Invaluable when things get too much or there is a particular knot/area that needs special attention.

Full leg massager: Available on (e.g. Amazon. Similar to a massage gun, although less intense and applicable to the entirety of the leg(s). These things have been very helpful after lengthening and stretching sessions in helping promote circulation, and to soothe general aches and pains.

TENS: Offers similar relief to a massage gun, but via a completely different pathway. Again, really useful when there is a particular area of the leg giving you bother.

Walking: Whilst walking is exhausting, once you regularly start with the longer distances, your legs do feel stronger and more alive. I would recommend trying to do at least 1-2 km a day, although you will be going at the same pace as geriatrics on zimmerframes. *I always use crutches when walking*

Stationary cycling: Again, one of the best activities for improving general strength, looseness and well-being. I try to do 2-4 km a day.


RETURN TO WORK: For those of you that are career-oriented I would strongly advise careful planning for this procedure. I returned to work after ~6-7 weeks away and am only operating at ~50% (at best), of my previous performance. Thankfully, I have been at my current employer for a few years, and have had relatively good periods, so much so that the current slowdown is being accommodated as a temporary dip.
The performance lag from the CLL operation will really hinder your outputs. Once you factor in the discomfort, stiffness, need to stretch/exercise, need to lengthen, extra sleep required, the numerous drugs (and their attendant side-effects), etc., you will find that a lot of the day is gone! And the remaining time is not as productive or optimally used as it was when you were at your physical and mental peak. Similarly, while walking is recommended – I can easily do >10k steps a day at my workplace – it ends up exhausting every fibre of my being.

If you are on a career path that you really want to see through to the end, then you may have to put off the CLL for a period. I definitely would not recommend it in the first year of any new position. You will not be performing anywhere near your best, certainly not for the lengthening period and likely not in the consolidation period either (i.e.; 3-6 months of sub-standard performance).

I think this would also apply to those (very lucky few who can afford it) at the university level as well. Unless it is the first year, where little matters (&/or you have time to make up any shortfalls), I would recommend waiting until after your degrees are done, or carefully timing the operation so that it does not interfere with your studies. Your performance will drop off massively. And if you do subjects that require practical work/physical presence (e.g.; science, engineering, architecture, etc.), then be prepared for an even greater drop!


IMAGES: Finally, I appreciate that x-rays are currency on this forum, and while I do not intend to share everything, I thought I should post at least one or two images to prove my bona fides as well as highlight how things are progressing. The attached x-ray image is just after the ~4 cm point. I am pretty happy with how it is all shaping up!

https://imgur.com/a/RkqnI88

[SirStretchAlot]

Very good progress!

Couldnt agree more on the work performance part.

Note on the slow lengthening. I had the exact schedule as you but clicking resistance has increased significantly after 7cm, because the callus is hardening. Dont go too slow unless you are stopping at 8cm.

[Zatoichi]

Thanks man!

I think you may be right or the consolidation issues. But I think I will call it at the end of the month (September) anyways. I should be at 7 cm by then and I think that is plenty. the trade-offs (potential complications, getting back to work, etc.) mean I would be hapy with that return.

Fingers crossed for the final month!

[Zatoichi]

Hi All,
 
UPDATE: This is likely to be the penultimate major update before I call it quits. I have passed the 5 cm mark this weekend, and now my intention is to see out September and get to 7 cm, hopefully by the end of the month, give or take a week. I’ve grown weary of the lengthening process and it is taking out far too much from other aspects of my life. Everything is a compromise, and 7 cm seems like a good balance (hopefully I can get it!). 
   So far, I still have not had any major issues. No nerve pain, contractures, or duck-ass. I have no major secrets to success beyond that which I’ve listed previously. The most important thing is to build a routine, stay regular and push yourself a little further every day. My IT bands are tight, and it is always more comfortable to stand with legs a little wider apart, but I can still get my legs together without too much effort and I can stand with legs a normal distance apart when I focus on my stance. The longer the legs are forced together, within reason, the less uncomfortable it gets. With things going so well with the process, it seems silly to push my luck. My biggest weakness are probably my hamstrings; they get very tight. My knees also get a little sore when in a single pose for too long. That’s it though, so far.
   Also, the extra height is a little noticeable now, but it is not something world-changing! Even with the eventual 7 cm, I don’t think it is something that will turn my world upside-down! Just something that will allow me a greater degree of self-confidence, and to waste less of my finite bandwidth spent worrying about it. Thankfully, I have a pretty decent life in general and I wasn’t expecting revolutionary changes from the process! For those of you that are, perhaps re-evaluate your approach and expectations.
   
UPDATES ON COSTS: Previously, I promised an update on costs. Once the housing costs in Germany were included, as well as the multiple PCR tests, flights, hotel quarantine, various extra instruments that I bought (in addition to items listed below, a walkpad, stepper, bike, various other gym items), extra drugs and supplements, taking taxis everywhere instead of public transport, hiring a cleaner, paying for a meal prep & delivery service (3 meals daily) to avoid cooking distractions, etc., the total cost of the entire bilateral femur process is EUR~70k. I’m hoping there are no further surprise costs. I'm lucky in that after returning home, my x-rays, physio and acupuncture etc., have all been covered by employer insurance. That may have added a few thousand to the running total otherwise. While 70k is a decent sum of money overall, I think it is perfectly reasonable for the result that has been achieved and the various extra steps I have taken to either make life easier for myself, or to maximise the likelihood of a positive comeback. I imagine the total cost for bilateral tibias would be in the region of 5-10k extra.

BEYOND 5 cm: From now on, in addition to continuing with lengthening and stretching etc., I will also look to speed up bone recovery (beyond 5 cm, my early consolidation fears have disappeared!). To this end, I have bought various toys to help me along with the process (each used once daily) including:

• Osteotron/LIPUS: Supposedly will help speed up bone healing, improves bone quality and so, return to normal life
  Extracorporeal Shock Wave Treatment: Same benefits as for osteotron.
  Infra-red light therapy: similar benefits as for osteotron.
  TENS: I mentioned this before during lengthening and it helps massively with soreness/pain relief. But, it may not necessarily do anything for bone regrowth.
  E-stim acupuncture: Again, another that was mentioned during lengthening. I go twice a week. This is supposedly also useful for callous formation and growth.

Supposedly, these aids may decrease bone consolidation time by 30-40%! I thought it was worth splurging if it can help me save that amount of time. Hopefully it works.

I hope to update the diary with a successful lengthening conclusion in early October!

[Want-3-inches]

Hey, sorry if I missed this, but did you not do any follow-ups with Betz after leaving Germany? How many hours away from Betz are you?

[Zatoichi]

Hey, sorry if I missed this, but did you not do any follow-ups with Betz after leaving Germany? How many hours away from Betz are you?

Hi,

So I am 10-12 hours away from Germany. That was one of the big fears - having to traipse back halfway around the world in case of complications. But no issues yet!

For contact, I have Dr Betz's number, and I have messaged him sporadically, as required. He is always good about replying etc. But I haven't really had much need to contact him. I know what needs to be done. Now I just need to get on and do it. The last exchange we had was a few weeks ago, about x-rays and general progress. He seemed happy. I was happy.

I have also been in touch with the Betz Institute physio, Peter (probably more so than Betz tbh). Again, checking on progress, having sporadic video calls to check progress etc. Likewise, things seem to generally be positive in this regard.

[Zatoichi]

Hi All,  

COMPLETION: This update reports on the completion of my bilateral femur lengthening journey at ~7 cm. This is beyond my original 6.5 cm minimum target. I reached ~173 cm on 23nd October 2021; a nearly 4 month-long process from surgery to clicking completion. 

STOPPING AT 7cm: While I could have continued and tried to reach 9 cm (the top end of my initial goal), the interference of CLL with my daily life(including work performance that I mentioned in a previous post), tiredness with the lengthening process, and the knowledge that risks exponentially increase as more extreme lengths are encountered, have convinced me to call it a day. In addition, while the first ~5.5 cm were relatively straightforward, the final ~1.5 cm have been extremely tough. It doesn't look like much on a ruler, or sound a great deal, but the difference in stiffness, discomfort and exhaustion is night and day. For example, knee pains, hip pains, cramps in calves etc. Slowing down to just below 0.5 mm a day helped a lot (i.e.; 9 clicks from 13 clicks), but I didn't see the value in pushing on, especially with all these new and unwanted issues suddenly coming up. For those that have gone on to 8/9/10 cm, I salute you! It is a phenomenal effort and test of will.

All those in my cohort went through the same decision process. One wanted 5 cm, and got around that. Of the others, we all planned for 9-10 cm at the beginning. One finished at 5.5 cm. I finished at 7 cm. Another finished at 7.5 cm. All simply reached a point where they were happy with the length achieved, all had excellent x-rays, and no major complications to that point. Once you pass the halfway point, you start to think about recovery and return to normal life etc. Most people don't see the need to push on  to the very end, especially as potential risks exponentially increase and the process continues to drag-on for months on end (I took it very slow and was the last of the cohort to finish lengthening). Also, if I really feel the need for extra height, I can always return for another 4-5 cm on the tibias (5'10" would be nice)! I have a few other things I want to deal with and invest money into first though.    

Now, most of my height issues are resolved - although I appreciate that many people would not consider my new numbers overly impressive, I am content. Also, I currently feel pretty good and have had zero major complications along the way(i.e.; no nerve issues, no numbness, no serious IT band issues, excellent bone health and regeneration etc.). I have been extremely lucky and it seems silly to push that luck just for a couple of extra cm – no need to be too greedy, nearly 3 inches is plenty! In addition, in my current state, I feel very confident that I can get back to my original fitness level (if not better!), which was one of my big fears before starting the CLL procedure. Again, if I continue lengthening, I may pass the elastic limit of the soft tissue, and so impair my physical performance forever. 

FUTURE: From now on, I plan to continue with stretching etc., but also incorporate more weight-bearing and other exercises in order to speed up recovery and rehab during the consolidation period. I will speak with Peter Woll, the Betz Institute physio, to develop an effective plan for the consolidation phase. My aim is to return to full function (minus sprinting and other extreme activities), by Xmas. I plan to stop using crutches asap, and move onto a walking stick for a month or so (more as a protective measure when walking among crowds), before I start to do away with any and all walking aids. 

I’ll continue to update the diary with my progress, and answer any PMs, although future updates are likely to be even more sporadic than my posts to-date! I hope that my thoughts, recommendations and the record has been/will be helpful to those considering the CLL journey. I’m very glad I went through with the process. I’ve had a blessed run with no major complications, and come out of the other side having exceeded my initial aims (thanks to the whole team at the Betz Institute for their facilitation and help along the way!). I only wish I had done this 10 years ago (either by having the means, or the procedure being a lot cheaper... especially as I was never willing to contemplate externals). I had few commitments back then and could probably have reached the very top end of the lengthening range, with little trouble. Still, better late than never!

However, it is not something that should be expected to change your life in one fell swoop - the change, while noticeable, has not been world-changing. I would suggest getting all your other life goals lined up/sorted as well, when planning for this procedure. I had a pretty good/successful life before the surgery (one that I am very keen to fully get back to), and I return to it a little taller, and with fewer height-related issues taking up my attention and energy. The larger benefits for me were from the longer-term preparation. Learning how to make, save and invest money. Learning specialist skills. Learning to work with and make the best of what you have, regardless of any shortcomings. Etc.  

Good luck to everyone on the journey currently, as well as those of you considering it. While the cost is steep (i.e.; financial, physical, mental, etc.), and every experience is unique (i.e.; pain, complications, length gained, etc.), it is something I have zero hesitation in recommending. You will come out of the other side a changed (hopefully for the better) person, in every way. Also, while I have no interest in fanning flame wars between acolytes of different surgeons, I would happily recommend Dr Betz and his whole team to those of you considering the procedure. I have been very happy with the whole process and felt fully supported and taken care of from the first enquiry, all the way up to now. But, do your own research and make your own informed picks! Although slow, I could not have asked for a smoother process with a successful outcome. I hope this continues into consolidation and full recovery.

[Will955]

Wow, what an ending man. I just wanted to say that I enjoyed your diary and very much appreciate you put this up.


I think this thread should've gotten more attention. Very well written out and great with the details. But it seems 7.5cm is more common now a days. Which is great for this community.

How has your height been treating you?

Did you ever get back your fitness level?(You seemed very confident about this one).

Ever considered the thought of going back for more?


Cheers bro

[Zatoichi]

Hi All,

For the sake of completeness, and a couple of weeks shy of my 1 year operation anniversary, I thought I should post an update on my recovery progress. This is likely to be the last major update to this diary (although I may post again in a year or two when I have the nails removed!). Much like most others that have had this surgery, I've looked to get on with life and move on from the procedure - I rarely visit the forum and don't even think about height any more. Most days I forget I even had the procedure done! I love the fact that I have so much free bandwidth to focus on other, useful and more valuable things! Peace of mind has been my biggest takeaway from this whole process. However, during my planning phase, I liked to read on the progress of patients well after they finished their lengthening process to see how things panned out into consolidation and beyond. I felt that many diaries ended on a cliffhanger. As such, I wanted to bookend my experience and so provide a realistic overview and record of the full process.

AFTER CLICKING COMPLETION: So, I finished clicking in late October 2021. I am now ~7.5 months into consolidation and recovery. It took around a week after clicking completion for my body to feel the benefits/relief. It took me ~3 weeks into consolidation to get off the forearm crutches, and onto a single walking stick. After another ~3 weeks I moved (very gingerly and awkwardly) onto aid-free walking. However, the timeline is not smooth or linear. It is very frequently one step forward, two steps back. For example, one day I might walk the full day without any aids. The next couple of days, I would have to revert back to crutches, as my body betrayed me. This is likely because I was pushing too hard and too fast. In addition to movement, any other issues also quickly resolved. For example, I had some slight numbness on my right leg, around the knee. A couple of months into consolidation and that numbness etc., completely disappeared.

INITIAL BACK-PAIN: The biggest headache, beyond the legs, for the first ~6 weeks of consolidation, was the excruciating lower back pain. This involved huge amounts of tightness and pain after walking relatively short distances. The first few weeks, I needed to sit after a couple of hundred metres. The distances between walk-rest gaps slowly increased with practice.

MUSCLE MASS RECOVERY: Excepting this back issue, everything else improves extremely fast into consolidation. My thighs and glutes have rapidly recovered their volume (and may even be bigger than before!), so much so that the tibias look a little small bulk-wise, next to them. The legs also feel extremely solid, muscle tightness is mostly gone and the speed and stamina during walking have also returned (although quickly changing direction etc., is still not all that smooth or fast). Walking up stairs is completely normal and fast now, although going downstairs is a little trickier, but still pretty good.

WALKING SPEED & RECOVERY: So, 7.5 months in, I would say I am pretty much back to normal walking including the speed. I still cannot run yet nor can I fully sit 'seiza'-style, with ass to heel, but very light jogging for ~50 m bursts has been possible. Nevertheless, I am generally happy with where I am at, within a relatively short recovery period. It is not as fast or as comprehensive a recovery as I had first hoped, but perhaps I was being unrealistic with my plans. Truthfully though, I don't think I will be completely back to normal until the nail is taken out. But that is still some time away. So to clarify, I am still not back to my original fitness level, yet.

AESTHETICS: In terms of aesthetics, I think the longer legs look great and not at all weird/abnormal! This is likely because; 1) My femurs (and femur:tibia ratio) were relatively shorter to begin with; 2) I didn't lengthen an overly abnormal amount (~7 cm), and; 3) Once the muscle volume comes back (my thighs were always pretty meaty), it all starts to balance out very well and look extremely natural.

CONTINUED PHYSIO & RECOVERY: With respect to physio and activities; I am doing a variety of things (pandemic restrictions did delay many of my intended recovery plans, but things have opened up this past month, so thankfully faster progress is being made). For example; 1) gym twice a week - every day is leg day, and; 2) single weekly sessions of yoga, pilates and alexander technique. All those focus on alignment, posture, stretching etc. Learning to walk and reorient yourself properly again is important and there are various bad habits that are picked up during lengthening (e.g.; feet pointing at weird angles during standing, etc.) as well as due to tight muscles and imbalances. I would strongly recommend practicing movements in front of a full-length mirror to regain movement precision.

RESPONSES FROM OTHERS: With regards to people's perception of the change, honestly, there has been very little so far! Apart from a couple of weird looks from one or two people, most of the people I've met have not noticed a thing (or if they have, they have not voiced their opinions). There might be a few reasons for this (beyond people simply keeping their reservations to themselves for fear of sounding silly...);
1) I kept my gain to a relatively sensible amount;
2) I was always relatively broad and well-built. So perhaps they simply see the difference as weight-variation in bodily dimensions;
3) Perhaps we overestimate how closely people pay attention to us - everyone is wrapped up in their own worlds and have little bandwidth to spend on others, and;
4) (Most likely) More for the sake of foot and leg health, I have been wearing various types of 'barefoot shoe' since the operation, which does otherwise rob me of ~1-1.5 inches of height from standard boots/trainers etc. Thus, the height change that others observe is far more modest than the actual gained. I plan to re-start wearing boots and other footwear styles in a couple of months, although I am now extremely fond of the minimalist style shoes (and also have no fear about wearing them!) - my feet, ankles and calves feel fantastic and it forces you to adopt a more 'natural' gait! In addition, I have also found it liberating to not constantly have to worry (perhaps pointlessly) about what I wear (clothing and footwear) and how tall/short I appear. I've also thrown out many of the ugly shoes I used to wear simply for the fact that they would give an extra couple of cm or so, of height (I never really got the hang of lifts as they gave me painful calf cramps!).

More generally, apart from quizzical looks and brief questions initially, I honestly doubt if most people will truly notice the change if it is kept conservative. The only people that I am certain will notice (and have zero fear asking/berating me about) are my parents. Due to the pandemic, I haven't managed to see them since the operation. That will change soon and I am interested to see/hear their reactions!

TIBIAS(?): For the general outcome, I am extremely happy and very glad that I finally did the procedure. Would I consider tibias in future? Never say never - I know I would be very happy with the end result, based on the positives from the first procedure. But, realistically, I don't think I could (or would even want to, should the opportunity arise) use so much of my life, time and energy on another procedure like this. It takes a lot out of you, and there is a lot of time, social, professional etc., sacrifice required. From my original height, the price of all those sacrifices was worth it. From my new height, I'm not so sure... Life is short. There are lots of things to do. I can't be forever ruminating and investing in this one aspect.

SCARS: Finally, a note on the scars. While I am not that bothered about the scarring/skin discolouration, I found the deep pits (~3 mm depth) at the hips, a little off-putting - it was more pronounced on one side than the other, but both were still a little unsightly. I imagine this pitting would be worse and more numerous for those that use externals. While I appreciate that these same openings will be re-used for rod removal, that is at least another year or two away for me (I don't want to remove too soon). So, I decided to get the pitting treated. The dermatologist recommended HLA injections as well as Fotona laser skin treatments. Together, they helped fill out the pits and apart from the scar/discolouration (which has also been reduced), you can barely see any other artifacts. Again, many of you will see this as pointless, but for those that have had externals, you might want to use the same protocol, to fix any of the more numerous and apparent skin pitting issues fixed using the HLA and laser treatment combo. It worked really well for me, although it is not cheap...

CONCLUSIONS: OK, I think that wraps things up and brings the diary up-to-speed. I think the improvements from now onwards will be far less marked and really, only perceptible to me. Hopefully, things will continue moving forward smoothly. Thanks for following my journey - I may update again in a couple of years. Good luck to you all!

[c]

加油

[Will955]

Thanks for the update, man. You got a great way of explaining things. Always helpful for people like me who haven't done LLS yet.

I am hopefully doing this in 2023 at earliest, if not 2024.

Again, thanks for sharing your journey. Cheers, bro