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[two]

1 in 7000 chance of death from PE. Giochet has done 700 cases and has had 1 known death. Giotikas probably far fewer cases and has had 1 known death. Paley probably way more but no known deaths (I think?)

We should get stats from Betz. If even he has had deaths then maybe the clicking mechanism MIGHT have something to do with it.

[Masteryourlife]

Hi, I don’t know which doctors you are referring to, but the doctors I know do not present LL as “ unpredictable”. Giotikas said that dying from PE and fat embolism is a  rare but real possibility. like 1 in 7000-10000 cases. Now if you think for a moment that that there have been 2-3 deaths from PE and another few cases of fat embolism in the last let ‘say 10-15 years, and there are maybe 1000-1500 LL surgeries done par year then the numbers do add up and make sense. This not unpredictable imo.

You don’t know the type of complains the died patient did. Maybe they were completely irrelevant to PE. Most of Giotikas’s patients say that he is always very responsive to provide solutions to patient’s concerns, problems etc. Afterall PE is not something that you have for weeks in your body before it decides to kill you. It happens within hours or a couple of days.

A verdict of an independent scrutiny  would never use words like “very good, excellent, fantastic etc” they use terms like “ satisfactory- non satisfactory/ acceptable non acceptable etc”. You need to interpret these terms literally and binary. If they didn’t find anything I tend to believe that the incident was unavoidable or random or within statistics.

The informed  consent process is very important in the West. It is one thing if you have a complication during a treatment as a doctor and a whole different story if you haven’t informed the patient about this possibility when you were discussing the treatment. Giotikas is a UK trained surgeon so this is inside him now.

I understand that you hate Giotikas but systematically defaming him based on your personal explanations of unproved facts is unethical, or at least wrong. I believe that you would be more relactunt to do it if for example giotikas was working in the same country with you and could sue you for professional defamation.

All your points makes sense to me but  as you said ,the patient complaint might have not been related to PE as they might have .
I was not there and you were not there either .
Also , former patients said he had no clue of the ratchet mechanism...how do you perform a surgery on people like that ?
Another said the PT damaged him  .
Some say something and some the opposite but they all agree that he had not clue about the mechanicm and that the guy complained and no one cared ;not my words but about patients at the hospital .
As I said ,I don't think giotikas did all he could to save him and I think this is kinda clear because he did not dide under treatment but untreated (as far As I read so far) .
I don't hate giotikas but as guichet has a death case and got demonized for the same exact kind of death , I don't understand why giotikas earned a better treatment after the same scenario .
Guichet also crippled a girl and we all agree he is to avoid , but I don't see giotikas any better ;
Several  patients said he suggested a lenghetning of 1.33 (one was for fear of pre cons but the other was totally fine and got suggested so and he stated he still did 1mm and ended up fine ,but not thanks to giotikas) .

We are here to speak freely and I always say "my opinion" and I don't put them out there as universal rules ,but facts are facts and the one I mentioned above are not my words but current patients that might be hiding also something because still under treatment .

So it is not correct as well to come at me and say that I have no facts because if u scroll through recent posts and topics all I said has been said by current patients not my assumptions.
You are free to make your choiche , I just don't understand why some of you defend him even if he did not display any particular care or skill out of ordinary .

[Masteryourlife]

If you read previous posts you will see that Paley had his fair share of fat embolisms in the past, which proves that it can happen to anyone. I also think that the more cases you do the more the chances statistically of something going wrong. From that prespective, rare things are more possible to occur in more experienced doctors who do more cases and maybe more complex cases. I dont think that Betz, Lee and A do as many LL cases as Giotikas does, and certainly not as many as Paley!

Giotikas literally became famous this couple past years .
So maybe right now with the wb nail he is doing more but total amount no way he has more then Lee or Paley .not a chance .
And you also proved my point in a certain way :
-Paley and Lee 0 death cases in a long lasting career with lots of CLLs
-giotikas literally just started doing CLL with many patients and look at the outcome he just had .
Am I wrong ?
Was he famous 10 years ago? Or 5 ?
Actuall question cause I saw posts about him literally just 1 or max 2 years ago .
Anyway no way he has more cases then 2 doctors like Paley or Lee , not a chance.
I don't want to start a "beef"with you but I hope this can be a constructive argue even with totally different opinions .

[two]

Guys we need to find such statistics from all surgeons before assuming anything. How many cases has each surgeon done, how many cases of PE and then death.

for Betz, Paley, Assayag, Rozbruch, and so on

[Phoenix21]

@LU213 whatever you do in life, do not become a lawyer.  Your interpreting skills and conclusions need some serious work.  Leave opinions/emotions aside and stick to logic. Using a dead person comically to raise a point is the most childish thing I’ve seen on this forum by far and overall says a lot about your maturity. This must be the difference between paying for your own surgery vs someone’s parents paying for their surgery. I initially wasn't going to bother but crossed the line like a kid with a tantrum. Do you even read what you write? Jesus

Have you used any of the nurses services?  Nurses were mainly with their uniform and extremely competent.  You have no idea what you’re talking about if this is the judgement you perceive on the nursing team.  Make some money for your self first and then come back to this forum because it’s the only way I see it making you an adult, fellow American.

P.S. We can see your edit.

If by uniform you mean the "Cheap Slutty Nurse Uniform- collection 2021", so yes, they wore the uniform to the letter.

Although again, if you want to have access to those kinds of services while having your bandages changed by a junior college student, the role couldn't be more realistic.

Now, if you are an intelligent person who is conscious about the risks or this surgery, and you're looking for a professional and qualified team and service, with a head nurse who really knows what she/he is doing, then I would look elsewhere.

There is no way in hell I would put myself in the hands of the same team of nurses under whose command a patient has died, for one reason or another. Especially not with the head nurse.

And for the record, if a nursing professional accepts money from her patient to go take pictures of him, or take him to the movies hand in hand, explain to me what kind of nursing job she is doing for him.

If you are looking for escort girls who play being nurses, this is your team.
If you're looking to go home alive after this surgery, is not.

But it's your life, in the end you decide what value you put on it.

[indication]

Not a patient from here, but I just remember reading in another patient's diary (LU213) that he was asked to turn to the side and throw up on a piece of cloth or something they put on the floor during his hospital stay and his family members helped clean up. That was quite questionable. He even put a photo of this arrangement on his diary.

But commenting on their clothes is not appropriate. If it's the uniform there, then it's the uniform. Cultures are different and we should not comment on such things. It is unfortunate that they don't get to wear comfortable clothing like nurses in the US but if it's the norm, we should not blame the nurses for this.

[Arcon]

1 in 7000 chance of death from PE. Giochet has done 700 cases and has had 1 known death. Giotikas probably far fewer cases and has had 1 known death. Paley probably way more but no known deaths (I think?)

We should get stats from Betz. If even he has had deaths then maybe the clicking mechanism MIGHT have something to do with it.

Albizzia nail and family(betzbone and guichet nails) and other clicking nails (like ISKD) have been around since the 90's and more than a few thousands must have been implanted by all surgeons of that generation. Paley and Lee themselves have used them and have published studies that you can find online. If PE was related to the implant itself it would have shown through all these years, there wouldn't just have been 2-3 cases. You can't really have the same parameter applied to thousands of patients and only cause problem in 2 or 3 and then you come out and say that it was that paritcular parameter that caused it; Statistics doesn't work like that.
What is a proven fact is quite the opposite: Non weight bearing  and immobility  is a proven common factor for thrombosis. All doctors seem to agree with this because they prescribe blood thinners for the whole immobility period ie 4-5 months. But even with blood thinners the risk of blood clot is around 1-2%! from that prespective mechanical nails must theoritically be safer because of their weight bearing capacity.

[Masteryourlife]

Albizzia nail and family(betzbone and guichet nails) and other clicking nails (like ISKD) have been around since the 90's and more than a few thousands must have been implanted by all surgeons of that generation. Paley and Lee themselves have used them and have published studies that you can find online. If PE was related to the implant itself it would have shown through all these years, there wouldn't just have been 2-3 cases. You can't really have the same parameter applied to thousands of patients and only cause problem in 2 or 3 and then you come out and say that it was that paritcular parameter that caused it; Statistics doesn't work like that.
What is a proven fact is quite the opposite: Non weight bearing  and immobility  is a proven common factor for thrombosis. All doctors seem to agree with this because they prescribe blood thinners for the whole immobility period ie 4-5 months. But even with blood thinners the risk of blood clot is around 1-2%! from that prespective mechanical nails must theoritically be safer because of their weight bearing capacity.

Ok so we are gonna ignore the fact that surgeons with was less cases had a death but renowned ones like Paley,Rozbruch or Lee have 0 deaths with far more cases (1k+) and assume it was just luck based according to you/some others .

[MorningStar]

If by uniform you mean the "Cheap Slutty Nurse Uniform- collection 2021", so yes, they wore the uniform to the letter.

Although again, if you want to have access to those kinds of services while having your bandages changed by a junior college student, the role couldn't be more realistic.

Now, if you are an intelligent person who is conscious about the risks or this surgery, and you're looking for a professional and qualified team and service, with a head nurse who really knows what she/he is doing, then I would look elsewhere.

There is no way in hell I would put myself in the hands of the same team of nurses under whose command a patient has died, for one reason or another. Especially not with the head nurse.

And for the record, if a nursing professional accepts money from her patient to go take pictures of him, or take him to the movies hand in hand, explain to me what kind of nursing job she is doing for him.

If you are looking for escort girls who play being nurses, this is your team.
If you're looking to go home alive after this surgery, is not.

But it's your life, in the end you decide what value you put on it.

Escort girls? Dude, what's wrong with you? Some nurse tried to rape you or what that you are texting such BS here? And who the hell are you at all? Every patient knows each other here both in forum and in reality. When you did this surgery at all?

[Megatron]

I pray for this guy that passed away and hope his family and other loved ones get through this pain. Can only imagine who he told and didn't tell and they find out he passed away like this. This is a good reminder to all of us to keep in mind of the risk when doing this. I also heard from a doctor that this isnt the riskiest cosmetic surgery out there. Is it possible operating doctor on this patient just wasnt as qualified as others in catching whatever happened soon enough to save the patient? I also think about how kanye west mom died during a cosmetic procedure. So it is true that any surgery has risk by i also agree with others who stated why havent we heard about this from other doctors. This definitely isn't a common thing. Is it possible that qualified doctors just know how to make proper adjustments based on complications while this doctor didn't?

[thankscience]

An independent review found there was no fault on behalf of the doctor or the hospital. Plus Giotikas has been working for the NHS in the UK over a decade and frequently deals with war injuries. Cosmetic limb lengthening cases are amongst the easiest cases he treats. Granted, he is fairly new to the G-nail but I don't think the method makes much of a difference. I really think this is mostly down to bad luck.

[world]

Do you guys find the doctor warm and willing to answer questions? Or does he appear cold and with the attitude "just do as I say, don't ask too many questions"?

[canterk]

Do you guys find the doctor warm and willing to answer questions? Or does he appear cold and with the attitude "just do as I say, don't ask too many questions"?

You can more or less see for yourself by doing his 15 minute consultation. its free.

[world]

You can more or less see for yourself by doing his 15 minute consultation. its free.

I'm hoping to hear from patients who've gone through the procedure with him.

[Nyc brother]

I'm hoping to hear from patients who've gone through the procedure with him.

I’m here in Athens. Week 5 for me. The doctor is very professional and always answers my WhatsApps. He believes strongly in his protocol and that he is doing the right thing. However you can ask him to try different medicines and more dosage and he works with you. The only thing most patients don’t understand is why during the inflammation phase ( clicks are painful for 8-10 days) we need to increase clicks to 21 a day for 7 days. . Some patient do it, some don’t, everyone turned out fine. 

 

[world]

I’m here in Athens. Week 5 for me. The doctor is very professional and always answers my WhatsApps. He believes strongly in his protocol and that he is doing the right thing. However you can ask him to try different medicines and more dosage and he works with you. The only thing most patients don’t understand is why during the inflammation phase ( clicks are painful for 8-10 days) we need to increase clicks to 21 a day for 7 days. . Some patient do it, some don’t, everyone turned out fine.

He does not get angry if you ask him to change any protocols like "I don't want to click 21 a day during inflammation phase, I don't want to take pain killers" or other questions you might repeatedly ask because of fear and worry?

[V21]

He is not like Betz in the sense of stopping to answer your messages after a while. I'm more than 3 months post-op and he always answers all my doubts, regardless of how many they are. In fact, he does it pretty fast usually. So he is very professional in that regard. Of couse, he is not "warm", but that's his character. For example, he tends to give short explanations because he is the doctor and he is the one who has knowledge about the situation. From a personal standpoint, I like people like Assayag who dedicate time to explain patients even the most minor things, but that's not common between doctors: the common rule is that they just expect you to comply.

This is not a critic to Giotikas because, as I said, that is the common character for doctors. To sum up, I would say he is pretty professional and won't let you hanging like other doctors, but of course, you can't expect "moral" support if that's what you are asking.

[Nyc brother]

He does not get angry if you ask him to change any protocols like "I don't want to click 21 a day during inflammation phase, I don't want to take pain killers" or other questions you might repeatedly ask because of fear and worry?

No, he does not get angry. He just speak very official. Most patients did not do 21 clicks. Everyone’ has concerns so he understands we ask him lots of questions. Also because we are 10 patients here, we all speak to each other and try to  give the best advice that worked for each of us. .

[Nyc brother]

He is not like Betz in the sense of stopping to answer your messages after a while. I'm more than 3 months post-op and he always answers all my doubts, regardless of how many they are. In fact, he does it pretty fast usually. So he is very professional in that regard. Of couse, he is not "warm", but that's his character. For example, he tends to give short explanations because he is the doctor and he is the one who has knowledge about the situation. From a personal standpoint, I like people like Assayag who dedicate time to explain patients even the most minor things, but that's not common between doctors: the common rule is that they just expect you to comply.

This is not a critic to Giotikas because, as I said, that is the common character for doctors. To sum up, I would say he is pretty professional and won't let you hanging like other doctors, but of course, you can't expect "moral" support if that's what you are asking.

Exactly. Well said. He gives answers and is very respectful but he is not a therapist who encourages you and deals with emotional or moral support. He does not give long detailed explanations for his reasoning etc. Its more like this is what’s doctor said let’s try our best to follow it. 

[canterk]

No, he does not get angry. He just speak very official. Most patients did not do 21 clicks. Everyone’ has concerns so he understands we ask him lots of questions. Also because we are 10 patients here, we all speak to each other and try to  give the best advice that worked for each of us. .

10 patients and are you all G-Nail patients?

[Nyc brother]

10 patients and are you all G-Nail patients?

No. 2 presice. 2 Externals on Tibias. The rest G-nail.

[canterk]

it is nice to hear that you guys have formed a group with each other. at least you have each other for support during the process! good luck to all of you

[MorningStar]

Actually, he can even be supportive. Maybe that's not very common. But for example I was very disappointed about my condition after the nailing surgery. We had 2 talks: first one while I was still in the hospital and another one via video call. He really tried to motivate me.

[MorningStar]

No. 2 presice. 2 Externals on Tibias. The rest G-nail.

Bro, a little correction: 2 Precise, 2 LATN tibia, the rest G-nail.

[c]

你做手术了吗

[alwayslucky]

Although I understand that the cause of this tragedy is not anyone's fault, I still want to ask, if the symptoms of this unfortunate patient can be detected early, whether by himself or by the hospital, and attract enough attention from doctors to save the crisis? Or can patients just watch themselves get embolism and die willingly?

[canterk]

i want to know too. it seems this patient was just doing his normal routine, walking a lot and going to PT and suddenly died?
what could he have done to prevent it? was he showing any symptoms at all but thought it was just because of his "flu" ?
honestly, im still very concerned about this and makes me want to reconsider doing Gnail in 2022..

[Bagga]

i want to know too. it seems this patient was just doing his normal routine, walking a lot and going to PT and suddenly died?
what could he have done to prevent it? was he showing any symptoms at all but thought it was just because of his "flu" ?
honestly, im still very concerned about this and makes me want to reconsider doing Gnail in 2022..

Well, there is always risk in any surgery.
There was also thrombosis happened in Stryde nail after 2 months operation.
However, this patient was cautious and went for a check after finding his leg was swollen and painful.
Always check with the Doc or go for examination if the pain and swelling did not improve, do not assume it is normal for LL.

Generally speaking in life: If your fears or concern about something overshadow your hopes.
You should consider changing/postponing/cancelling your LL Plan.

[Masteryourlife]

Well, there is always risk in any surgery.
There was also thrombosis happened in Stryde nail after 2 months operation.
However, this patient was cautious and went for a check after finding his leg was swollen and painful.
Always check with the Doc or go for examination if the pain and swelling did not improve, do not assume it is normal for LL.

Generally speaking in life: If your fears or concern about something overshadow your hopes.
You should consider changing/postponing/cancelling your LL Plan.

We know that a surgery carries risks but what they (and me too) are wondering its :what could be been done and what will be done in case this happens to someone else .
Someone will have an embolism and we don't know who ,therefore knowing a way to detect/prevent it asap is key and that is what we are asking .
Maybe make it scans frequently?
Ll is panifull and it's like normal flu and covid , how can you 100% know what u are experiencing?
No one after such a trauma want to think at all the stuff we have to PLUS try to see any sign of embolism here or there because it's just unfair after all ..so we get it surgery has risks but what can we and the surgeon do to prevent those things from happening?
Sure that xeralto from day 1 till end of distraction and walking as much as possible are 2 factors, but what else to be more sure ?

[Bagga]

We know that a surgery carries risks but what they (and me too) are wondering its :what could be been done and what will be done in case this happens to someone else .
Someone will have an embolism and we don't know who ,therefore knowing a way to detect/prevent it asap is key and that is what we are asking .
Maybe make it scans frequently?
Ll is panifull and it's like normal flu and covid , how can you 100% know what u are experiencing?
No one after such a trauma want to think at all the stuff we have to PLUS try to see any sign of embolism here or there because it's just unfair after all ..so we get it surgery has risks but what can we and the surgeon do to prevent those things from happening?
Sure that xeralto from day 1 till end of distraction and walking as much as possible are 2 factors, but what else to be more sure ?

Self awareness of underlining illness or family blood clot history, daily sure of swelling or abnormal pain, breathing or chest pain.
Always tell Doc or go for examination if needed

Periodic Ultrasound scan for blood Clot helps for detection but again not 100% as the Clot can form within days.
We cannot be doing the scan daily.

There is no 100% protection net - what we can do is to minimize that hitrate of 1%

[-]

They are brain dead. It happened in the 6th week of lengthening and he was only given 2 weeks of Xeralto (blood thinner). So far I've seen maybe 4 deaths from LL and all of them were from DVT/PE.  One this, another that indian guy whose sister wrote the blog about it and another 2 were in India (1 African girl and 1 indian girl). Maybe there are more that are not public.

Were they all doing internal femur lengthening? I've always believed that internal femur is more dangerous and that more things can easily go wrong.

And to add, Dr. Catagni and Dr. Solomin have reported 1 death each from anesthesia complications the last time I talked to them. Maybe the number has increased since but I certainly hope not.

I find it tiring how a lot of people here try to justify all bad outcomes with "rare conditions" or "bad doctors"... this is a high-risk surgery, even when doing everything correctly there is a TRUE chance you may die. You have to make peace with it...

I'm not sure about that. It shouldn't be so dangerous especially for the tibias. It's far from internal organs like heart, lungs or brain. I don't think we should say there is a true chance of dying. But again, there is also a true chance that we may die on the airplane on the way to Athens.