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[zidank]

I read many journals on this forum, and discovered lots of valuable information that helped me preparing and enduring this crazy journey. I want to write this journal to contribute and share my experience.  I hope some people may find this helpful.

This is a summary of my journey.

Info about me:
Age: 39
Sex: Male
Height: 157 cm
Race: East Asian
Femur Lengthened: 8 cm
Final Height: 165 cm
Status: In consolidation phase

Background:
I was depressed during most of my high school and college years due to my height. I am pretty much at the bottom of height percentile even for an Asian. I have thought about LL surgery many times, but I always thought that it’s a dangerous procedure, which it still is, and that the new bone would be more fragile.

The depression went away after I graduated from college and started working like a workaholic. I eventually got married, twice actually, to two beautiful girls by most standard.

I still hated my body.  I have short leg, long torso, and relatively big head which amplify my short height even more.

I recently divorced from my 2nd marriage and now back in the dating pool. A guy with my height will likely be dismissed by most girls, if I disclose it in the online dating game. If I don’t disclose my height, then I'd always fear and dread of meeting the girl in person.

The divorce and my age really motivated me to get LL.

Result:
When I woke up from surgery, I thought this was the dumbest thing I've ever done. After blood, sweat, and tear, I now think this was the best money I've ever spent.

While 165cm height is still considered short by most standard, I look so much better in the mirror standing up. My body is much more proportional than before. I no longer look like super short guy anymore, just merely short/below average height guy.  I feel content with that.   

To anyone with similar height (157cm), 7-8cm height increase would make a huge difference for your body. You don't have to have 2 surgeries to achieve +13cm in order feel any difference.  Get femur LL done first, recover then evaluate if you still want to get tibia LL later.   

Process:
I contacted Paley Institute, and they were able schedule the surgery in 4 weeks.  The consultation and surgery is within the same week.  I was lucky since surgery with Dr. Paley is usually scheduled months in advance.

Accommodation:
I booked 3 months stay at Homewood Suites, which is only 5 minutes from the Paley Institute and the hospital. The Paley Institute building is in the same campus as St. Mary’s hospital.  They provide free transportation from/to the campus from this hotel. 

My ex-wife (long story) is staying and helping me during this whole process. You definitely need a helper, at least for the first few weeks.

Work Arrangement:
My full time job is in engineering.  Due to COVID last year, we had to work from home for more than 6 months.  So my employer are now more receptive to remote working arrangement.

I informed my boss about my upcoming surgery, and will take 2 weeks of sick leave + vacation. I plan to return to work (remote) after 2 weeks.

Diet:
I’ve been eating a zero carb diet, on and off, for the last 4 years. Almost no starch, sugar, or even vegetable.  All foods I consumed are from animals: beef, pork, chicken, seafood, etc.  I believe this is the healthiest diet for my body and mind.  I’m not a doctor and I don’t recommend anyone following this diet without performing substantial research.   

I maintained this strict diet through the whole process.  I credit this diet for my quick recovery.

Lesson Learned:
I focused on stretching before surgery and neglected cardio and upper body strength training.

I’m a small guy, so I run out of breath very easily on cardio activities, if I'm not conditioned to it.  I haven’t done any cardio activities for 1-2 months before surgery so I was really out of shape.  I reason I stress cardio is that it let your heart and lung used to physical stress (e.g. surgery).  While the surgeons was drilling and reaming by bone, my lung didn’t like it.  It was not ready for this kind of stress, so they had to put me on a ventilator.

My upper-body strength was pushed to the limit post surgery for using the walker and transferring from/to wheelchair-bed-walker-toilet-car.  Luckily my body quickly adapted within the first week post surgery.  Probably thanks for the copious amount of proteins I consumed.

Pain Management:
I was prescribed Oxycodone and Tylenol.  Oxycodone did wonder for the pain, but I didn't feel any different with Tylenol.

To manage my pain, I took about 3-4 Oxy pills (5mg) each day. One before bedtime, one in the middle of the night, and one before each PT session. I was able to stop taking all pain meds on the fifth week post surgery.

Sleep:
I only slept 2-3 hours each night for the first 4 weeks. I took a 1-2 hours nap after each PT session. 

I found lack of sleep during the first 4 weeks very draining. The pain and bladder kept waking me up in the middle of the night.  Lack of sleep definitely took a toll on me physically and psychologically. 

I was able to sleep normally again, 6+ hours, without pain on my 5th week. 

Physical Therapy:
I go to PT once a day for 1 hour. I stretched myself after last lengthening session of the day, just before bedtime. 

For self stretching, I recommend to focus on 3 main stretches: hamstring, quad (knee bend), and Thomas.

I found PT pretty easy until I hit 3-4cm. My quad, hamstring and IT band all starting to get tight. Even though I never had duck ass or wide leg, PT started to became painful.  At this point, I started taking half of an Oxy pill 1 hour prior to  PT.  This helped me fly through PT with much less pain.

At 6cm, I was losing the battle with my muscle tightness, no matter how much I stretched. I kept on pushing as long as I was able to bend my knee more than 90 degree, and kept my leg straight while standing up or laying down. I eventually reached 8cm without slowing down the default distraction rate (1mm per day).

Equipment I bought:
I was losing much of my butt muscle and fat, to the point of my tail bone being painful while sleeping on my back.  I bought a mattress topper, which relieve most of the pain.
https://www.amazon.com/gp/product/B072Q5LYW2/ref=ppx_yo_dt_b_asin_title_o06_s00?ie=UTF8&psc=1

I also bought a seat cushion for the wheelchair.
https://www.amazon.com/gp/product/B07LB8TRL3/ref=ppx_yo_dt_b_asin_title_o09_s00?ie=UTF8&psc=1

Reading other journals, I knew that I would need to save/ration my pain med (Oxy) for the last few weeks of the journey.  I needed a pill cutter to reduce my Oxy intake.
https://www.amazon.com/gp/product/B001KYVO78/ref=ppx_yo_dt_b_asin_title_o07_s00?ie=UTF8&psc=1

Soft hand grip for walker:
https://www.amazon.com/gp/product/B004D0HWUE/ref=ppx_yo_dt_b_asin_title_o01_s00?ie=UTF8&psc=1

Strap for self stretching:
https://www.amazon.com/gp/product/B00065X222/ref=ppx_yo_dt_b_asin_title_o02_s00?ie=UTF8&psc=1

Hand rail for toilet:
https://www.amazon.com/gp/product/B075NRWN1Q/ref=ppx_yo_dt_b_asin_title_o04_s00?ie=UTF8&psc=1

Shower chair:
https://www.amazon.com/gp/product/B001CBA0EM/ref=ppx_yo_dt_b_asin_title_o06_s00?ie=UTF8&psc=1

Laptop desk for bed:
https://www.amazon.com/gp/product/B0149SD6T0/ref=ppx_yo_dt_b_asin_title_o07_s00?ie=UTF8&psc=1

Heating pad:
https://www.amazon.com/gp/product/B08MV3Z3GK/ref=ppx_yo_dt_b_asin_title_o07_s01?ie=UTF8&psc=1

I will update the journals with surgery, recovery and weekly experience later.

 

[Thorfinnn]

Congratulations on the 8cm you achieved looking forward to updates!

[SirStretchAlot]

1mm a day for 8cm, with no duck ass. You are a hero.

[LU213]

Thanks for the links.

[Limbfan2020]

@zidank

Great post! Which nail did Paley use for lengthening? And how is your new bone formation? Any problems?

[zidank]

@zidank

Great post! Which nail did Paley use for lengthening? And how is your new bone formation? Any problems?

PRECICE 2.2 10.7mm nail.  The 10.7mm nail can bear 50 pounds each.

My bone growth is great so far. I’m on 2nd week of consolidation. I expect to my bones heal enough to walk without a walker in 2-3 weeks.

[Limbfan2020]

Have you also used a wheelchair or was it not necessary?

[zidank]

Have you also used a wheelchair or was it not necessary?

I used the wheelchair most of the time during the 3 months distraction phase.  The wheelchair definitely was required for me to go from the hotel room to the shuttle, or going shopping in the mall.

The PT encouraged patients to use the walker more, but I wanted to minimize the risk of making mistakes that could lead to bending the nails.  Using a walker probably stimulate more bone growth and recovery of soft tissue. 

[Atomic]

Have you experienced any nerve complications? Like numbness, tingling, loss of strength or sciatic pain?

[zidank]

Have you experienced any nerve complications? Like numbness, tingling, loss of strength or sciatic pain?

I had some nerve pain behind the left knee at around 5-6cm, when straightening my leg or standing up. I was prescribed nerve pain medication. The condition didn’t improve but it kept the pain in check.  The nerve pain was gone less than week after I reached 8cm.

I still have some numbness on the left leg, that probably is not a coincidence. It’s improving slowly everyday.

I also had all kind of random pains during the distraction phase: pretty bad pain in the hamstring at the osteotomy site that went away within 1-2 weeks, random shooting knees pain 2nd week after surgery that went away within a week, knee pain at 5-6cm when I performed knee bend stretching that went away after I reached 8cm.

Some people will have all kind of random pains during the distraction phase, since soft tissues being stretched to the limit. With lots of stretching, your body will adapt and the pain will eventually subside.

[Growing]

Congrats bro.. Great report of events. Would it be possible to share a walking video?

[zidank]

Congrats bro.. Great report of events. Would it be possible to share a walking video?

Thanks. I will post a walking video once I can get off the walker, which is still a few weeks away.

[zidank]

2 Days Before Surgery:
COVID test, EOS x-ray and lab work.

My tibia to femur ratio is 0.79

1 Day Before Surgery:
Consultation with Dr. Robbins. He asked me more questions than I asked him, since I already done lots of research.

Dr. Robbins informed me that my femur and tibia are not straight, so they will work around that and this surgery would put them in a more neutral position.

Dr. Paley came in later just for a few minutes. We didn’t discuss much. I think he only wanted to perform a quick psychological evaluation before surgery.

Doctors at Paley Institute work as a team, so don’t expect Dr. Paley performing all of the surgeries and follow-ups.

PAT test afterward. They withdrew more blood and took a chest x-ray.  Was told no food after midnight. 

 
Day 1- Surgery:
I arrived at surgery building early at 6am. They walked me into the Pre-Op room.  Dressed in the hospital gown, and had IV injected into my left hand.  The anesthesiologist came by and informed me that they will give a numbing injection into the spinal cord, just before waking up from surgery.  I asked the nurse if I will have urine catheter. Thank God, she said it was not required.  I was able to use the urine bottle pretty easily on the recovery bed.

Near the surgery time at 8am, the nurse injected something in my IV, and I was disoriented and eventually passed out before they even rolled my bed to the surgery room. 

I woke up with a very heavy feeling on my leg.  I was cold, shivering and shaking.  The pain was about 3-4 since the numbing injection was still in effect. The heaviness of the legs and the inability to move was actually worse than the pain for me.  I also felt extremely weak.  I felt my strength reduced to about 10%.

The doctors and nurses told me the surgery went well, even though I was put on a ventilator due to my lung didn’t like my bones were being reamed and drilled.

The entire thighs were swollen, and the bottom of my hamstrings were heavily bruised. 

Learning from other diaries, I asked for pain medication before the pain escalated.  I always took 10mg of Oxycodone before going to sleep.  Without it, I wouldn’t able to sleep due to pain, heaviness, and tingling feeling all night.

Day 2:
Pain management was actually easy. I took 10mg of Oxycodone 3 times a day.  Always a 10mg dose before going to sleep. 

I peed almost every 2-3 hours due to the amount of fluid in the IV.

The nurse took my blood about 3-4 times daily to monitor my progress.  However, it took a toll on my body due to my small stature.  I was depleted and my blood pressure was very low if I start exerting physically.

The PT came by in the afternoon and tried to have me sitting up on the bed with my legs on the floor.  As soon as I moved my leg on the floor and sit up, I almost passed out from low blood pressure.  I had to lay back down. 

I felt very disappointed in myself. The nurse said the guy next door started walking with the walker 2 days post-surgery, and I couldn’t get even sit up straight on the bed.  At this moment, I really thought that my body is just much weaker than the average people.  I started having doubts about this surgery and if my body capable of reaching 8cm limit.

Day 3:
I allowed blood withdraw only once a day and declined when they tried to withdraw more than once.

The PT came by in the afternoon again. This time I was able to sit on the edge of the bed without passing out.  They wanted me to stand up on a walker.  It was probably one of the hardest things I ever done due to the pain and weakness.  I was able to stand on the walker for a few seconds, before laying back down due to low blood pressure again.  At least today was an improvement compared to previous day.

Day 4:
My strength was slowing recovering.  I was able to stand up on the walker and transfer to a wheelchair. 

Pain was about 2-3. 

Day 5:
I was discharged from the hospital in the morning.  Since the bus drivers from the clinic don't work on the weekend, I had to arrange my own transportation back to the hotel.

Using the walker to lower myself into the toilet and shower chair was very painful. The incision and muscle trauma were still fresh. I later used the wheelchair to transfer, which reduced the pain significantly.  So I ended using only the wheelchair in the hotel room.

I took a shower later that day for the first time since surgery.  Took an Oxy and slept like a baby.

[Atomic]

I had some nerve pain behind the left knee at around 5-6cm, when straightening my leg or standing up. I was prescribed nerve pain medication. The condition didn’t improve but it kept the pain in check.  The nerve pain was gone less than week after I reached 8cm.

I still have some numbness on the left leg, that probably is not a coincidence. It’s improving slowly everyday.

I also had all kind of random pains during the distraction phase: pretty bad pain in the hamstring at the osteotomy site that went away within 1-2 weeks, random shooting knees pain 2nd week after surgery that went away within a week, knee pain at 5-6cm when I performed knee bend stretching that went away after I reached 8cm.

Some people will have all kind of random pains during the distraction phase, since soft tissues being stretched to the limit. With lots of stretching, your body will adapt and the pain will eventually subside.

Thanks for your reply and informative post. I hope you get well soon.

[hamster7]

Did you only take 2 weeks off and then worked remotely? How did you fit in your PT sessions while working?

[zidank]

Did you only take 2 weeks off and then worked remotely? How did you fit in your PT sessions while working?

I only took 2 weeks off, then started working remotely.

Every Monday, I blocked out 2 hours on my calendar for each day for the whole week. I communicated this schedule to the team. They were able to work around it without issues. My job is also pretty flexible too, so I can work outside of business hours.