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[stretched]

Hello everyone
Just a little about me, I've always been a short fellow growing up and at first I didn't really care too much because I thought I would keep growing, but now I am in my low 20s and my doctor told me my plate's have already closed. I wouldn't really care if I was just a little short but since I'm 5'3 in the States, that is a major concern moving forward, and I would like to have this surgery to avoid my height really screwing up my career (cybersecurity). I am planning on lengthening my femurs 7-8cm if possible.
So, to the point. I've been doing lots of research into what is the best nail on the market currently and my primary concern is the pain levels. I am ok with pain here and there as long as it is well controlled. I don't want to be in agonizing pain for weeks on end. Since money is not a concern to me (my parents are help me a lot), I was wondering what do you all think is my best bet for a somewhat bearable femur lengthening experience? I was thinking the precise 2.2 internal method or the betzbone but I am unsure as I have heard lots of conflicting information regarding the pain levels. I know that pain varies a lot between person to person, but to anyone who's went through these surgeries, is there a general consensus on which nails are supposed to be less painful than the others? Any advice would be greatly appreciated.

[shortisnotfun]

Pain depends on the individual. Some have reported 10/10 pain, some have reported very little pain. You should expect 10/10 pain for this procedure.

[Medium Drink Of Water]

People have had worse experiences using the mechanical clicking nails, in which you have to move your legs in certain ways in order to get them to expand.  So using one that lengthens with a remote would be better, such as Precise.

[stretched]

Yeah the clicking motion on betzbone makes me uneasy, it looks like some sort of medieval torture technique

[stretched]

Pain depends on the individual. Some have reported 10/10 pain, some have reported very little pain. You should expect 10/10 pain for this procedure.

I'd assume the people who have experienced 10/10 pain were the one's with a lower pain tolerance. I am going to ask my doctor and see if there is some sort pain tolerance test I can take to make sure I'm not setting myself up for agony for months.

[Height Journey]

Precice 2 is the least painful.

Mechanical nails are more painful and uncomfortable.

Any external fixator is most painful.

[tallmen]

Precice 2 is the least painful.

Mechanical nails are more painful and uncomfortable.

Any external fixator is most painful.

Pain and discomfort are two different things. I think full external will be less painful because there's no trauma from nailing.

[SpeedDialer]

Precice 2 is the least painful.

Mechanical nails are more painful and uncomfortable.

Any external fixator is most painful.

100%

[stretched]

Precice 2 is the least painful.

Mechanical nails are more painful and uncomfortable.

Any external fixator is most painful.

What was your pain level when undergoing precise 2.2 femurs?
Was there ever a time where you couldn't bear the pain?

[Medium Drink Of Water]

Pain and discomfort are two different things. I think full external will be less painful because there's no trauma from nailing.

True when you're lying still.  Those frames can really hurt when you move, though.

[SpeedDialer]

Pain and discomfort are two different things. I think full external will be less painful because there's no trauma from nailing.

Best of luck with your externals surgery!

[trademitech]

I had been researching this surgery for 15+ years, starting with the illizarov frames. I ended up getting the precice 2.2 in August. All I can tell you is 10/10 pain for me here. I’m not trying to scare you, but make sure you stretch a ton before surgery because there’s surgery pain and then there’s lengthening pain from when your joints and nerves stretch. Too that with weeks of strenuous physical therapy.

If you decide to proceed with this surgery just make sure you know that there is no other pain you have felt in this lifetime quite as similar to this.

[SpeedDialer]

Based on what I see in Athens, based on the screams during physio and complications, and based on the forum comments, I think maybe its something like this:

I think technically someone who is doing femur internal + external tibia at the same time might be the most painful option but lets not include that situation because I don't know anyone who did it

Most painful: full externals frames (the metal cage with pins) based on the screams I've heard from the externals patient here and his description of his pain.  the main thing is like during physio, his pain is not like even really that much from muscle stretching so much as pain related to the pins it seems

next most painful: probably LON?

I know that ISKD and Fitbone still exist but Betz does not like them because of corrosion problems + other doctors don't like ISKD for rate control issues I think? can't remember

Next most painful: Quadrilateral (ex: 4 nails in you lengthening), I feel like this is alot of stretching pain to do, even if its precise. I can't remember if Betz/Guichet ever do 4 clicking nails in someone but I imagine that would be short term more painful than precise (but clicking pain decrease as time passes I find)

if we rate pain on a scale from 0 to 10..

Next: I think clicking femur nails (gnail, betzbone, though rumor is betzbone might be easier to click than gnail) are in the short term more painful than precise, but I am not sure about the long term across the 6 months after the surgery. My clicking pain went from like 2 to 7 pain at first now down to like 0-1 pain after a few weeks, its usually about 0-0.5 pain now for gnail femurs for me. So I feel like in return for a few weeks of clicking pain, the rest of the months are easier compared to precise and my walking seems to be better (due to weight bearing for clicking nails) than the precise femur patient who got the surgery done around the same time as me. But yes clicking in the first weeks or so can be stressful

Next: probably precise femurs because of the femur muscle stretching

Next: hm... I think clicking tibias and precise tibias might almost be a tie, most people seem to say that clicking tibias doesn't hurt that much and in return you also can stand up which seems like less suffering in the long term during your recovery compared to precise tibias. I might be wrong. So I think it's another situation where precise tibias should be short term less pain than clicking tibias technically, but not necessarily by that much

Anyone wanna correct me?

With gnail femurs, the most pain I've ever had is during physio stretching (hamstrings and quads, mostly hamstrings). I described that pain as 8 out of 10 but maybe I should have rated it 10 like the guy above since it was the most physical pain I've ever felt in my life --and so maybe it should have been 10 by definition. The only reason I didn't rate it higher was because I was also hearing the screams of the guy doing externals and assumed my pain is probably less than his. Recently my physio stretching pain at about 1.5-2 months after the surgery has been closer to 6-7 out of 10 pain mostly

[stretched]

Interesting, was it still 10/10 pain with the intravenous pain meds? I know pain levels vary through out different patients but high/low pain tolerance shouldn't be the difference between a 2/10 (annoying) pain and 10/10 (torture) pain, right?

[stretched]

I had been researching this surgery for 15+ years, starting with the illizarov frames. I ended up getting the precice 2.2 in August. All I can tell you is 10/10 pain for me here. I’m not trying to scare you, but make sure you stretch a ton before surgery because there’s surgery pain and then there’s lengthening pain from when your joints and nerves stretch. Too that with weeks of strenuous physical therapy.

If you decide to proceed with this surgery just make sure you know that there is no other pain you have felt in this lifetime quite as similar to this.

Interesting, was it still 10/10 pain with the intravenous pain meds? I know pain levels vary through out different patients but high/low pain tolerance shouldn't be the difference between a 2/10 (annoying) pain and 10/10 (torture) pain, right?

[stretched]

Based on what I see in Athens, based on the screams during physio and complications, and based on the forum comments, I think maybe its something like this:

I think technically someone who is doing femur internal + external tibia at the same time might be the most painful option but lets not include that situation because I don't know anyone who did it

Most painful: full externals frames (the metal cage with pins) based on the screams I've heard from the externals patient here and his description of his pain.  the main thing is like during physio, his pain is not like even really that much from muscle stretching so much as pain related to the pins it seems

next most painful: probably LON?

I know that ISKD and Fitbone still exist but Betz does not like them because of corrosion problems + other doctors don't like ISKD for rate control issues I think? can't remember

Next most painful: Quadrilateral (ex: 4 nails in you lengthening), I feel like this is alot of stretching pain to do, even if its precise. I can't remember if Betz/Guichet ever do 4 clicking nails in someone but I imagine that would be short term more painful than precise (but clicking pain decrease as time passes I find)

if we rate pain on a scale from 0 to 10..

Next: I think clicking femur nails (gnail, betzbone, though rumor is betzbone might be easier to click than gnail) are in the short term more painful than precise, but I am not sure about the long term across the 6 months after the surgery. My clicking pain went from like 2 to 7 pain at first now down to like 0-1 pain after a few weeks, its usually about 0-0.5 pain now for gnail femurs for me. So I feel like in return for a few weeks of clicking pain, the rest of the months are easier compared to precise and my walking seems to be better (due to weight bearing for clicking nails) than the precise femur patient who got the surgery done around the same time as me. But yes clicking in the first weeks or so can be stressful

Next: probably precise femurs because of the femur muscle stretching

Next: hm... I think clicking tibias and precise tibias might almost be a tie, most people seem to say that clicking tibias doesn't hurt that much and in return you also can stand up which seems like less suffering in the long term during your recovery compared to precise tibias. I might be wrong. So I think it's another situation where precise tibias should be short term less pain than clicking tibias technically, but not necessarily by that much

Anyone wanna correct me?

With gnail femurs, the most pain I've ever had is during physio stretching (hamstrings and quads, mostly hamstrings). I described that pain as 8 out of 10 but maybe I should have rated it 10 like the guy above since it was the most physical pain I've ever felt in my life --and so maybe it should have been 10 by definition. The only reason I didn't rate it higher was because I was also hearing the screams of the guy doing externals and assumed my pain is probably less than his. Recently my physio stretching pain at about 1.5-2 months after the surgery has been closer to 6-7 out of 10 pain mostly

Everything I've read on the forums pretty much matches what you've said, thanks for the write up.
Here is a brief description of the 1-10 scale IMO
1-3 pain : Annoying but you can still function on a day to day basis
4-6: Mildly interferes with what you can do on a day to day basis, but not terrible
7-8: Interferes with daily tasks, pain is still bearable but is exhausting and sleep is incredibly difficult.
9+: Torture, you involuntary scream out in pain, traumatizing and unbearable.

When you went through your LL journey, based on this description and your experience, what do you think is the worst pain you've felt during your journey?
Also do you happen to know where most precise 2.2 patients fall on this scale? From me reading multiple diaries, it seems that during the first day or 2 after surgery the pain is between a 6 and a 7 (with pain meds), maybe up to an 8 during physical therapy, and then after that, it goes down to about a 3 and slowly tapers off.

[SpeedDialer]

When you went through your LL journey, based on this description and your experience, what do you think is the worst pain you've felt during your journey?

Hamstring and quad stretches during physio with the PT manual stretching. 8 out of 10 pain sometimes. Hip flexor stretches too occasionally 6-7 pain but those feel a bit weirder during physio.

Also do you happen to know where most precise 2.2 patients fall on this scale? From me reading multiple diaries, it seems that during the first day or 2 after surgery the pain is between a 6 and a 7 (with pain meds), maybe up to an 8 during physical therapy, and then after that, it goes down to about a 3 and slowly tapers off.

I know a few precise 2.2 femur patients and I think what you said is completely accurate for precise femurs.

But for the unrelated precise 2.2 tibia, it seems different, it seems like it is much easier pain wise (with some moderate achilles tendon pain) unless you have a complication for tibias. Someone did have a compartment syndrome complication in Athens for tibias recently and from what I heard it was excruciating/much worse pain than physio, like the leg being strangled and all painkillers not doing much. Based on what I've read, compartment syndrome seems to be somewhat more common in tibias than femurs, not sure by how much

 above

[LIVELIFETHEWAYIWANT]

my 2 cents here .

I did precise 2.2 , 8/10 pain level out of surgery , was quickly handlered by pain meds .

nail was not fully weight bearing so i stayed in bed or in wheelchair most of time except 4 lengthing sessions and 1 pt every weekday . 

minimum to no pain , i was taking less than recommended pain meds . muscle relaxer help a lot with stiffness.



 

[SpeedDialer]

my 2 cents here .

I did precise 2.2 , 8/10 pain level out of surgery , was quickly handlered by pain meds .

nail was not fully weight bearing so i stayed in bed or in wheelchair most of time except 4 lengthing sessions and 1 pt every weekday . 

minimum to no pain , i was taking less than recommended pain meds . muscle relaxer help a lot with stiffness.

Hm... I'm jealous, I didn't get a muscle relaxer in Athens for gnail femurs, I wonder if I should ask about it. Alot of mornings I sort of have to fight against stiffness (sometimes massage gun to wake my muscles up, and then I go to the pedal machine to move a bit to fight the stiffness, it takes some time). Also jealous, I only got PT 4 times a week, not 5

I do feel like with big soft ice pads, pain becomes quite manageable

What was the name of the muscle relaxer they prescribed?

[LIVELIFETHEWAYIWANT]

DIAZEPAM

[tallmen]

Hm... I'm jealous, I didn't get a muscle relaxer in Athens for gnail femurs, I wonder if I should ask about it. Alot of mornings I sort of have to fight against stiffness (sometimes massage gun to wake my muscles up, and then I go to the pedal machine to move a bit to fight the stiffness, it takes some time). Also jealous, I only got PT 4 times a week, not 5

I do feel like with big soft ice pads, pain becomes quite manageable

What was the name of the muscle relaxer they prescribed?

It's better to suffer than taking these meds. They have side effects and overall bad for your body.

[trademitech]

Interesting, was it still 10/10 pain with the intravenous pain meds? I know pain levels vary through out different patients but high/low pain tolerance shouldn't be the difference between a 2/10 (annoying) pain and 10/10 (torture) pain, right?

I had a lot of issues with the pain meds, taken as prescribed I got very sick when I tried to taper off. 3 months to 7.8cm but about 2 months of nausea and vomiting, doctors couldn’t figure out what it was and basically attributed it to post acute withdraw from Percocet. I went to Dr. mahboubian out in LA. What’s absolutely crazy is there’s people who take to the surgery very well and have full ROM after a week, then there’s people like me who could only get to 80-90 degrees 4 months post op.

To answer your question - even with pain meds I’d expect a 6-7/10 in pain. However it’s different for everybody. I was very active before this surgery, I’d lift weights about 4x a week and ju jitsu in the mornings 5x a week.

[SpeedDialer]

It's better to suffer than taking these meds. They have side effects and overall bad for your body.

Oh interesting, Diazepam and Percocet have bad long term effects?

I sort of wonder about the USA sometimes -> they don't have clicking nails (I guess they have fitbone technically but who would ever use it given the alternatives) and they use stronger painkillers compared to Europe?

I guess it won't affect me probably.. because if I go back to Athens for tibias then I imagine that Dr. Giotikas will just put me on the same paracetmol/tramadol plan.

And I actually wonder for precise tibias if I will really need painkillers, it sort of feels like the worst pain is from the achilles tendon and I wonder if soft ice pads will just squash that pain?