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[lessthanavg8300]

Holy sh!t you just made me realize I have like 10k in suits that ill have to toss.

[leonazul99]

are you sure that patient in mid 60s?  so old to do LL...

In my late 30s. 

[leonazul99]

Holy sh!t you just made me realize I have like 10k in suits that ill have to toss.

Yep jajaja

[Taller90]

Holy sh!t you just made me realize I have like 10k in suits that ill have to toss.

yep, LL is an expensive journey

[leonazul99]

9 days. Dr G is cool.

[Bagga]

i think early 50 is ok but 60s...i dun think it is worth to do LL anymore.
I am really surprised to learn people over 60 still doing LL.

[leonazul99]

Hey guys, had the IT band release and can touch knees together with knees flexed.  Made me realize when I met the doc that I had a significant problem with hamstring tightness and knee extension.  It is very painful to extend the knees to 0 degrees when legs are close together.  I have been working on it in physio for the past two weeks and have seen big gains; though, they are costly in terms of excruciating pain. The team with Dr. G is caring and organized well.  Fisio team is superb.  Hoping to get walking really well with crutches soon.  I have an issue with my pelvis as well where one side is higher than another that I think can we worked out in fisio. When I met Dr. G, I was told to stop clicking, so I am satisfied with 9.8cm gain on femurs to put myself at 179.5.  I can stand straight now with legs much closer together and can feel the height, it's awesome.

[RealLostSoul]

just out of curiosity, not meaning to be rude, how much did you stretch per day? Those issues sound like they come from definitely not stretching enough during lengthening.

For reference, I have neglected hamstring stretches for some time and have had the exact same issue with knee extension on my right leg. Although I am now focusing a lot more on it and it already got much better. I also had extra PT sessions focusing on it and it was indeed very painful so I can confirm that.
about wide legs I had them pretty bad at 3-4cm but then ramped up the stretching even if it hurt a lot and now I am close to 7cm and I have 0 wide legs, my It band flexibility got much better so idk if it’s because I stretched the ITB itself or the TFL, it did work very well for me. My knees touch in resting position and when standing. I also don’t have the inward foot rotation thing anymore. Only the knee flexion on my right leg is still slightly there.

Anyways great to hear you finished your process and are happy with your results.

[leonazul99]

Great point.  I went to físio daily and then when I got bad he came to my house twice a day.  The problem is they never stretched me to elicit pain and never told me that was part of the process.  They never had a specific goal in mind like 0 degree knee extension.  When wide leg started around 5.5cm they never pushed to fix it, when stretching the IT Band became too painful they just stopped.  I assumed wide leg was part of the process and would resolve itself later and I also assumed my IT band was cut.  I later came to find out the IT band was not cut property or at all and I was not stretched to the proper pain points or told I have to suffer pain.  I found out about the bad físio when I started the good físio here in Greece.  And at around 8cm is when I found out the IT band was not cut and I gave up on more aggressive stretching with físio because I had a date in the future to cut it in Greece. So in the last two months before Greece, especially in the last month I suffered the effects of extreme wide leg and knee extension problems.  The knee extension was not obvious since I wasn’t walking much and físio never told me.  The knee extension is problem only happens with legs together and my legs were never together to even notice it since I had the wide leg.  In the end it’s a series of poor IT band cutting, poor físio communication and subsequent stretching and my fault for not being more vigilant earlier in this process.  I have had great improvement in Greece and I thank my body that it is capable of doing the stretching that was needed the whole time now that my it band is cut.  The reason it is more painful is it is more extreme since it is now a lot of stretching that is being asked of my hamstrings and it band instead of it being a gradual process.

At the 6cm mark, 3 months after surgery, I also suffered a mild pulmonary embolism after being more stationary for two weeks after a muscle tear after a near fall and was in the hospital.  Restating oral anticoagulants again cleared it up and I am
Healed 100% from that incident.  I didn’t want to write about it, but here it is.  We all know the potential consequences of an embolism to the lungs, I got lucky or G-D, take your choice.

just out of curiosity, not meaning to be rude, how much did you stretch per day? Those issues sound like they come from definitely not stretching enough during lengthening.

For reference, I have neglected hamstring stretches for some time and have had the exact same issue with knee extension on my right leg. Although I am now focusing a lot more on it and it already got much better. I also had extra PT sessions focusing on it and it was indeed very painful so I can confirm that.
about wide legs I had them pretty bad at 3-4cm but then ramped up the stretching even if it hurt a lot and now I am close to 7cm and I have 0 wide legs, my It band flexibility got much better so idk if it’s because I stretched the ITB itself or the TFL, it did work very well for me. My knees touch in resting position and when standing. I also don’t have the inward foot rotation thing anymore. Only the knee flexion on my right leg is still slightly there.

Anyways great to hear you finished your process and are happy with your results.

[RealLostSoul]

Great point.  I went to físio daily and then when I got bad he came to my house twice a day.  The problem is they never stretched me to elicit pain and never told me that was part of the process.  They never had a specific goal in mind like 0 degree knee extension.  When wide leg started around 5.5cm they never pushed to fix it, when stretching the IT Band became too painful they just stopped.  I assumed wide leg was part of the process and would resolve itself later and I also assumed my IT band was cut.  I later came to find out the IT band was not cut property or at all and I was not stretched to the proper pain points or told I have to suffer pain.  I found out about the bad físio when I started the good físio here in Greece.  And at around 8cm is when I found out the IT band was not cut and I gave up on more aggressive stretching with físio because I had a date in the future to cut it in Greece. So in the last two months before Greece, especially in the last month I suffered the effects of extreme wide leg and knee extension problems.  The knee extension was not obvious since I wasn’t walking much and físio never told me.  The knee extension is problem only happens with legs together and my legs were never together to even notice it since I had the wide leg.  In the end it’s a series of poor IT band cutting, poor físio communication and subsequent stretching and my fault for not being more vigilant earlier in this process.  I have had great improvement in Greece and I thank my body that it is capable of doing the stretching that was needed the whole time now that my it band is cut.  The reason it is more painful is it is more extreme since it is now a lot of stretching that is being asked of my hamstrings and it band instead of it being a gradual process.

At the 6cm mark, 3 months after surgery, I also suffered a mild pulmonary embolism after being more stationary for two weeks after a muscle tear after a near fall and was in the hospital.  Restating oral anticoagulants again cleared it up and I am
Healed 100% from that incident.  I didn’t want to write about it, but here it is.  We all know the potential consequences of an embolism to the lungs, I got lucky or G-D, take your choice.

Man at least you are recovering now and are happy that is what counts.
Were you with Betz or with Becker (Mooswald or Elkes House)?

Because with Becker and the rehab center I was told a million times how we have to stretch 4h a day and push the tension so it hurts. I must say it really sucks and I hate it but it‘s the really only thing that fixes my gait and loosens me up + removes all pain. If I have a day where I can stretch less I immediately feel like garbage. Anyways you are right it‘s a gradual process. If you fall behind it sucks especially with the it band bc that‘s hardest to stretch. And then your range of motion is limited so the rest is harder to stretch too. I know. But at least now everything is good.

For the pulmonary embolism, was it unrelated to blood thinners or were you the guy who stopped xarelto too early against the doctors will?
It‘s very important to never stop xarelto before the end of lengthening.

[Rockstarz5]

 Hey!.. ¿how long did you trip at germany last? I know betz would let you back to your country en 2-3 weeks

[leonazul99]

Wanted to give you guys an update.  Big improvements after Dr G surgery and intensive physio.  Wide leg is gone.  Some knee extension issues remain but almost gone.  I am left with issues with external rotation of the feet and an issue with my pelvis.  My L pelvis is bent caudally on the L causing my R leg to be longer even though they were both measured to be the same again at a recent doctor's appt.  Pelvic exercises are helping to get it even.  It bands are still tight in general and have more stretching to go and R gluteus muscles are weak.

I stopped using wheelchairs a month ago.  Can walk about 20 min with crutches and about 5 min without crutches. Inclines, broken roads, no issues, legs feel strong.  Don't use crutches when indoors.  Bone consolidation is excellent.  Still taking daily calcium/vitamin d/magnesium.  Working on my gait and transitioning to walking without crutches and continuing to stretch out the tight it bands and hamstrings.  As measured by xray-9.6cm on the L and 10.0cm on the right.  L leg was longer by 0.4 to preop.  This puts me at 179-180cm (179.5cm?).  I haven't measured because I still have the 1.5cm L/R difference due to pelvic tilt.

[leonazul99]

I was given 3 months of Xarelto which I took to the last tablet.  Betz told me take it for 3 months not until you finish lengthening during the initial consult.  Later Becker said until you finish lengthening after the PE.  Dr. G along with some other surgeons only do prophylaxis for a month or so.  There was no noncompliance on my part.  Highest risk for PE  is in the beginning when patients are less mobile.  My PE happened after a mild muscle tear and I was more bedbound after the 3 month mark.  I was told nothing but “keep stretching” at the time.  I was at the cusp of the betz/becker transition and I don’t think it was handled very well.

Man at least you are recovering now and are happy that is what counts.
Were you with Betz or with Becker (Mooswald or Elkes House)?

Because with Becker and the rehab center I was told a million times how we have to stretch 4h a day and push the tension so it hurts. I must say it really sucks and I hate it but it‘s the really only thing that fixes my gait and loosens me up + removes all pain. If I have a day where I can stretch less I immediately feel like garbage. Anyways you are right it‘s a gradual process. If you fall behind it sucks especially with the it band bc that‘s hardest to stretch. And then your range of motion is limited so the rest is harder to stretch too. I know. But at least now everything is good.

For the pulmonary embolism, was it unrelated to blood thinners or were you the guy who stopped xarelto too early against the doctors will?
It‘s very important to never stop xarelto before the end of lengthening.

[leonazul99]

Hey!.. ¿how long did you trip at germany last? I know betz would let you back to your country en 2-3 weeks

2 weeks and then one week vacation with girl in Munich/Austria.

[Infinite]

Wanted to give you guys an update.  Big improvements after Dr G surgery and intensive physio.  Wide leg is gone.  Some knee extension issues remain but almost gone.  I am left with issues with external rotation of the feet and an issue with my pelvis.  My L pelvis is bent caudally on the L causing my R leg to be longer even though they were both measured to be the same again at a recent doctor's appt.  Pelvis exercises are helping to get it even.  It band are still tight in general and have more stretching to go and R gluteus muscles are weak.

I stopped using wheelchairs a month ago.  Can walk about 20 min with crutches and about 5 min without crutches. Inclines, broken roads, no issues, legs feel strong.  Don't use crutches when indoors.  Bone consolidation is excellent.  Still taking daily calcium/vitamin d/magnesium.  Working on my gait and transitioning to walking without crutches and continuing to stretch out the tight it bands and hamstrings.  As measured by xray-9.6cm on the L and 10.0cm on the right.  L leg was longer by 0.4 to preop.  This puts me at 179-180cm (179.5cm?).  I haven't measured because I still have the 1.5cm L/R difference due to pelvis tilt.

Hi leonazul99,
I am so happy to hear you're doing well.

If I understand correctly, your original doctors were Dr. Betz and Dr. Becker, and you had wide legs.

Why did you not fix the IT band at Dr. Betz/Becker? Why did you fly especially to Dr. G for the IT Band release?

[leonazul99]

Loss of trust given “soft release” which lasts until 6cm per Becker despite my chart saying I wanted ten, never hearing the name Becker before he walked into the OR with betz, still not sure who did my surgery, was not asked what I preferred, being charged for IT band cutting at initial surgery when others were not, poor communication with betz (ignored me, not one message), unclear history of Becker’s expertise as an orthopedic surgeon outside of recent LL training with Betz, only being offered 10 days (not nearly enough and at 160 euros a day) of físio after the proposed 2nd surgery instead of the 3 months I will have here.  Wide legs, tight hamstring with resulting knee flexion, external rotation of feet and tilted pelvis. This is due to poor it band cutting and subsequent inadequately trained physio in Mexico.  I read sirstretchalot’s diary where he flew to Dr. G for it band cutting after betz surgery. Don’t regret my decision for a minute.

Hi leonazul99,
I am so happy to hear you're doing well.

If I understand correctly, your original doctors were Dr. Betz and Dr. Becker, and you had wide legs.

Why did you not fix the IT band at Dr. Betz/Becker? Why did you fly especially to Dr. G for the IT Band release?

[Infinite]

Loss of trust given “soft release” which lasts until 6cm per Becker despite my chart saying I wanted ten, never hearing the name Becker before he walked into the OR with betz, still not sure who did my surgery, was not asked what I preferred, being charged for IT band cutting at initial surgery when others were not, poor communication with betz (ignored me, not one message), unclear history of Becker’s expertise as an orthopedic surgeon outside of recent LL training with Betz, only being offered 10 days (not nearly enough and at 160 euros a day) of físio after the proposed 2nd surgery instead of the 3 months I will have here.  Wide legs, tight hamstring with resulting knee flexion, external rotation of feet and tilted pelvis. This is due to poor it band cutting and subsequent inadequately trained physio in Mexico.  I read sirstretchalot’s diary where he flew to Dr. G for it band cutting after betz surgery. Don’t regret my decision for a minute.

I appreciate your informative response, leonazul99.

If I could get you back on time, would you still do the LL surgery at Betz/Becker or would you do the surgery with Dr. G the first time?

[leonazul99]

I would do Betz because of the possibility for 10cm if I had a guarantee it was actually Betz the whole time as I thought that’s what I was paying for.  And I would have stayed for a longer time in Germany doing físio.  Outside of the increased length of the betznail, I would choose Dr. G.
I still believe betz is a good surgeon and I got left behind in their transition.  I don’t have enough info to comment on anything concerning Becker.

[Limbfan2020]

I was given 3 months of Xarelto which I took to the last tablet.  Betz told me take it for 3 months not until you finish lengthening during the initial consult.  Later Becker said until you finish lengthening after the PE.  Dr. G along with some other surgeons only do prophylaxis for a month or so.  There was no noncompliance on my part.  Highest risk for PE  is in the beginning when patients are less mobile.  My PE happened after a mild muscle tear and I was more bedbound after the 3 month mark.  I was told nothing but “keep stretching” at the time.  I was at the cusp of the betz/becker transition and I don’t think it was handled very well.

Do you think that the PE was due to the muscle tear or the lenghtening?

[Infinite]

I would do Betz because of the possibility for 10cm if I had a guarantee it was actually Betz the whole time as I thought that’s what I was paying for.  And I would have stayed for a longer time in Germany doing físio.  Outside of the increased length of the betznail, I would choose Dr. G.
I still believe betz is a good surgeon and I got left behind in their transition.  I don’t have enough info to comment on anything concerning Becker.

Dr. G. offers the G-Nail, a weight-bearing nail with the same 10 cm length possibility as the G-Nail.

[leonazul99]

Do you think that the PE was due to the muscle tear or the lenghtening?

Being in bed and not moving much (físio came to house) secondary to the tear.

[ten]

Maybe doing unilateral lengthening is not a bad idea after all. There have been quite a few cases of PE reported on the forum and doctors seem to have varying protocols to prevent it.

[leonazul99]

In fact my Mexican inpatient doctor wanted me to stop clicking and didn’t want to hear anything about my surgery.  Becker said I could keep going. Betz ignored me.  If I stopped clicking it would have meant preconsolidation and end of lengthening at 6cm. Told hospital I am going to leave against medical advice.  Was not even hooked up to IV on day 2 and just getting oral anticoagulants.  Oxygen saturation improved to 95% without supplemental oxygen and vitals were stable.  Mexican doctor said I risk dying if try to click.  I went home and clicked after reading more on the medical science of DVTs and subsequent PEs and given my condition.   The fear was palpable though.

[Limbfan2020]

In fact my Mexican inpatient doctor wanted me to stop clicking and didn’t want to hear anything about my surgery.

Why? Doesn't he trust german doctors? Or was he just envy?

[leonazul99]

Why? Doesn't he trust german doctors? Or was he just envy?

Lots of reasons: ignorance, arrogance, fear of lawsuit or bad outcome,etc.

[RealLostSoul]

Why? Doesn't he trust german doctors? Or was he just envy?

I can confirm that local doctors can be really really arrogant about it. In that case I would advice to not listen to them, listen to your surgeon that did LL on you.

Maybe doing unilateral lengthening is not a bad idea after all. There have been quite a few cases of PE reported on the forum and doctors seem to have varying protocols to prevent it.

Instead of choosing unilateral that won’t even reduce the risk of PE from DVT, it is more important to never skip bloodthinners. Never, not a single day. It’s the only real dangerous risk of death if you are many weeks post OP.
There are 2 types of PE.
1) fat emboli. This indeed has a lower risk if you do unilateral. But fat emboli syndrome happens right after surgery. Not weeks later.
2) thrombosis (DVT). This happens due to immobility and a blood clot forming in your leg veins. This is what leonazul experienced. If you are mobile (bike, walk) etc you have a much less risk. But it’s not enough to do only that. You need oral blood thinners until you are almost normally mobile again (most likely a few weeks post lengthening). With xarelto 10mg daily you will most definitely not experience it.  Paley, Becker and many others follow this obvious protocol. It’s the most important medication bc skipping it could lead to death even weeks/months post OP.
With unilateral you are also barely more mobile than with weightbearing and if you skip the blood thinners you have the same risk. Just saying.

[ten]

Instead of choosing unilateral that won’t even reduce the risk of PE from DVT, it is more important to never skip bloodthinners. Never, not a single day. It’s the only real dangerous risk of death if you are many weeks post OP.
There are 2 types of PE.
1) fat emboli. This indeed has a lower risk if you do unilateral. But fat emboli syndrome happens right after surgery. Not weeks later.
2) thrombosis (DVT). This happens due to immobility and a blood clot forming in your leg veins. This is what leonazul experienced. If you are mobile (bike, walk) etc you have a much less risk. But it’s not enough to do only that. You need oral blood thinners until you are almost normally mobile again (most likely a few weeks post lengthening). With xarelto 10mg daily you will most definitely not experience it.  Paley, Becker and many others follow this obvious protocol. It’s the most important medication bc skipping it could lead to death even weeks/months post OP.
With unilateral you are also barely more mobile than with weightbearing and if you skip the blood thinners you have the same risk. Just saying.

I think you are overstating the importance of blood thinners because many other world renowned doctors don't prescribe it for beyond 2-3 weeks after surgery. Guichet, Giotikas, Assayag, Gdalevitch off the top of my head. Some of them are Precice docs and even then don't give blood thinners for months after surgery.

I wish we could know if ratcheting nails make the problem worse. But we'll never know unless these doctors publish data. Has Betz published a paper after his decades of experience documenting all the complications his patients faced? I don't think anything like that exists for GNail also. I personally know of 3 cases of PE so far in people who used ratcheting nails.

[RealLostSoul]

I think you are overstating the importance of blood thinners because many other world renowned doctors don't prescribe it for beyond 2-3 weeks after surgery. Guichet, Giotikas, Assayag, Gdalevitch off the top of my head. Some of them are Precice docs and even then don't give blood thinners for months after surgery.

I wish we could know if ratcheting nails make the problem worse. But we'll never know unless these doctors publish data. Has Betz published a paper after his decades of experience documenting all the complications his patients faced? I don't think anything like that exists for GNail also. I personally know of 3 cases of PE so far in people who used ratcheting nails.

Can‘t speak for any Doctor but a Giotikas patient I was texting with had it for almost the end of lengthening. I am not overstating it. If you don‘t want PE, you take it. It has very little side effect profile so no reason to quit it early in my opinion. Seems like some people just like to be in trouble.

Tell me one logical reason that albizza nails could increase PE risk? There is like no connection. Research how it develops first please. I already told the PE we talk about is a dislodged Deep Vein Thrombosis, the risk for that is a general risk in (orthopedic) surgeries. It‘s not LL specific. In medicine there is the three F for risk factors. Female, fat, fourty. So females who are obese and 40+ years old.
Ok so how does it develop. Because of bedrest and immobility your veinous blood isn‘t pulled back to your heart as it‘s supposed to. So blood clots can form because it‘s standing still more than it should. A swollen heated painful leg on one side is a symptom of DVT. If it dislodged it will travel to the lungs which is then called PE. what blood thinners do is increasing the antithrombolytic effect. So your blood doesn‘t clot that well. That‘s also why you bleed longer and more with them.

So knowing that. I am curious why albizzia nails should have any difference with that?

And yea Betz had lots of German Papers over the years. He showed me back then.

Your claims are kinda pulled out of nowhere with little causality, but please feel free to prove me wrong.

[ten]

Can‘t speak for any Doctor but a Giotikas patient I was texting with had it for almost the end of lengthening. I am not overstating it. If you don‘t want PE, you take it. It has very little side effect profile so no reason to quit it early in my opinion. Seems like some people just like to be in trouble.

Tell me one logical reason that albizza nails could increase PE risk? There is like no connection. Research how it develops first please. I already told the PE we talk about is a dislodged Deep Vein Thrombosis, the risk for that is a general risk in (orthopedic) surgeries. It‘s not LL specific. In medicine there is the three F for risk factors. Female, fat, fourty. So females who are obese and 40+ years old.
Ok so how does it develop. Because of bedrest and immobility your veinous blood isn‘t pulled back to your heart as it‘s supposed to. So blood clots can form because it‘s standing still more than it should. A swollen heated painful leg on one side is a symptom of DVT. If it dislodged it will travel to the lungs which is then called PE. what blood thinners do is increasing the antithrombolytic effect. So your blood doesn‘t clot that well. That‘s also why you bleed longer and more with them.

So knowing that. I am curious why albizzia nails should have any difference with that?

And yea Betz had lots of German Papers over the years. He showed me back then.

Your claims are kinda pulled out of nowhere with little causality, but please feel free to prove me wrong.

I know of a patient who was using clicking nails and was asked to speed up his lengthening and do a lot of clicks on one day because he was lagging behind. He was told to take xarelto on that day in particular and not on other days. My understanding is trauma and rest causes blood clots to get formed and clicking is more traumatic than using magnetic nails. This + how many docs don't prescribe xarelto for the full duration of lengthening made me think it could be slightly related to clicking. I have no scientific evidence. Can you give any links to Betz German papers where he has mentioned complication rates? I think that would elucidate this for us.

Btw when Stryde was around, even Paley used to give just aspirin to his patients. With precice it is xarelto. This info is in his official guide doc. It says "Since you have the S nail and are allowed full weight bearing as tolerated we only use 81mg aspirin twice a day for prophylaxis."

https://paleyinstitute.org/wp-content/uploads/StatureLengtheningGuide-Website.pdf

[RealLostSoul]

I know of a patient who was using clicking nails and was asked to speed up his lengthening and do a lot of clicks on one day because he was lagging behind. He was told to take xarelto on that day in particular and not on other days. My understanding is trauma and rest causes blood clots to get formed and clicking is more traumatic than using magnetic nails. This + how many docs don't prescribe xarelto for the full duration of lengthening made me think it could be slightly related to clicking. I have no scientific evidence. Can you give any links to Betz German papers where he has mentioned complication rates? I think that would elucidate this for us.

Btw when Stryde was around, even Paley used to give just aspirin to his patients. With precice it is xarelto. This info is in his official guide doc. It says "Since you have the S nail and are allowed full weight bearing as tolerated we only use 81mg aspirin twice a day for prophylaxis."

https://paleyinstitute.org/wp-content/uploads/StatureLengtheningGuide-Website.pdf

The trauma argument I do kind of understand but I don‘t think it‘s that much of a difference tbh. Else people who use mechanical nails would have a significantly increased risk but nobody I ever knew had that complication unless they actively stopped using bloodthinners against the doctors orders (that goes for both mechanical and magnetical nails). I mean you could do a study yourself perhaps that hasn‘t been done before: See the incidence of DVT in mechanical vs magnetic nails. But I think that‘d be hard because a) you couldn‘t make a control group where you don‘t give patients bloodthinners b) too much bias and confounders in noncompliance (see how many people don‘t follow doctor‘s orders. Also very hard to get everything out of the equation, like different activity levels of patients etc)

it‘s not like magnetic nails don‘t lengthen. And lengthening is always trauma, either way. 

Yes, so it‘s been 2 years since I had the initial consult with him. I remember he sent me some publications back then. I just did a quick search and found he has 94 publications tracked on researchgate. Some of which are english, some german. Tbf, I don‘t have the time on Christmas today to go through all of them.
I think if you are really curious you can just check it out yourself, here you go:
https://www.researchgate.net/profile/Augustin-Betz

Yea so? I said that weightbearing and being mobile reduces the risk, but they still give you aspirin as a bloodthinning med. just proves my point that even with weightbearing you still need some form of bloodthinners

But man why are we even arguing about that? I got like literally 0 side effects from blood thinners. I could take them forever. So no reason to not take them, why does this have to be such a debate? If you don‘t want or can‘t take bloodthinners for whatever reason than don‘t do the surgery. It‘s that simple.

[ten]

The trauma argument I do kind of understand but I don‘t think it‘s that much of a difference tbh. Else people who use mechanical nails would have a significantly increased risk but nobody I ever knew had that complication unless they actively stopped using bloodthinners against the doctors orders (that goes for both mechanical and magnetical nails). I mean you could do a study yourself perhaps that hasn‘t been done before: See the incidence of DVT in mechanical vs magnetic nails. But I think that‘d be hard because a) you couldn‘t make a control group where you don‘t give patients bloodthinners b) too much bias and confounders in noncompliance (see how many people don‘t follow doctor‘s orders. Also very hard to get everything out of the equation, like different activity levels of patients etc)

it‘s not like magnetic nails don‘t lengthen. And lengthening is always trauma, either way. 

Yes, so it‘s been 2 years since I had the initial consult with him. I remember he sent me some publications back then. I just did a quick search and found he has 94 publications tracked on researchgate. Some of which are english, some german. Tbf, I don‘t have the time on Christmas today to go through all of them.
I think if you are really curious you can just check it out yourself, here you go:
https://www.researchgate.net/profile/Augustin-Betz

Yea so? I said that weightbearing and being mobile reduces the risk, but they still give you aspirin as a bloodthinning med. just proves my point that even with weightbearing you still need some form of bloodthinners

But man why are we even arguing about that? I got like literally 0 side effects from blood thinners. I could take them forever. So no reason to not take them, why does this have to be such a debate? If you don‘t want or can‘t take bloodthinners for whatever reason than don‘t do the surgery. It‘s that simple.

I didn't say people shouldn't take blood thinners (I think people should listen to their doctors, period). This whole debate is around whether clicking nails can cause PE. I was proposing the idea that clicking may have had a role to play in PE while downplaying the link between extended (3-4 months) use of  blood thinners and PE and your stance was the opposite. We need data to be sure.