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[arnoldhams10]

After attending consultations of multiple surgeons, I've come to the decision between these two.

Based on consults, both come off as extremely competent surgeons that care about healthy patient outcomes as a top priority.

Giotikas has an extremely competitive price (I'd pretty much save 10k), however, Birkholtz seems to offer a package that is moreso "all-inclusive" and extremely fast responsiveness. My only concern is that I'd have to stay in South Africa as opposed to Greece.

Does anyone have any insights/suggestions? Are there any clear advantages of one over the other?

[Omar]

personally I prefer Giotikas for the simple reason that he is serious and above all competent. He has corrected a lot of patients coming from Turkish butchers and his price is competitive

[Omar]

how much do both cost

[GrowGrow123]

Birkholtz is the more experienced orthopedic surgeon with a longer track record. But the difference is realistically pretty minor in the grand scheme of things.

Personally, the all inclusive thing is not a huge draw for me. You need your surgeon to do the surgery. You need a PT who has experience with LL patients to push you 4x a week. That’s it. (Maybe a caretaker for the first couple of weeks, but this varies patient to patient).

If the price were the same, I’d definitely go for Birkholtz though.

[Staystrong]

When do you plan to do it?
I plan in 2024 and also thinking about this 2 plus Marie Gdalevitch from Montreal because I'm already in Canada.
And where are you from?
I might be interested to meet if we will have same doctor, might be easier to recover I guess.
And I will need visa to Greece or South Africa because I plan to stay at both places 6-9 months.
I would say that Giotikas, Birkholtz and Gdalevitch are all experienced and should be good!

[Nord_Gutt]

I am having durgery (femur Precise) with Dr. Giotikas on 3rd of October. He is very competitive doctor. Please come to Greece. We will have fun

[Rockstarz5]

  How have you been so far nord?.. any conplications?

[Hldrive]

Dr Birkholtz is the far better choise.

Avoid Giotikas at all costs.

[Body Builder]

Dr Birkholtz is the far better choise.

Avoid Giotikas at all costs.

Bs. Giotikas for its price is the best option you can get and generally speaking he is maybe the best european doctor right now for LL. Much better than some clowns in Germany who lengthen 12cm without even itb. Birkholz is a good doctor but I would't do anything in a third world country like.South Africa.

[CLLvet]

I would agree with many of the points that Body Builder raises. I had 2 successful lengthenings with Giotikas (one in 2019 and one in 2023). My signature block briefly discusses which methods we used.

Both times, I felt he was competent, safe, and even open to feedback/suggestions from his patients on how to improve the patient experience. He also seems to care. Case in point- he gives all patients his personal WhatsApp and responds to their questions/ concerns day and night (unless he is actively in the operating room, of course). I am not certain if other doctors do that as well. I am sure some of the European ones do, but I am not convinced that every LL surgeon does that. Another example- he actually seriously tried to talk me out of doing the surgery the 2nd time around, citing that I was already too tall and didn't need it. He was ready to refund me all the money even though it was already the day of the surgery. But I told him I really want to do it and would regret not doing it. So we pushed through. But I cite these points to showcase my opinion that I do feel he places patient well-being over financial considerations. There are other examples to further illustrate this, but I don't feel this is the right post to go into all those details.   

Nothing is perfect (anywhere), including Athens. But something to keep in mind when you are selecting surgeons are the following characteristics:

-How open are they to criticism/ feedback from patients? When you raise a concern, do they brush it off arrogantly or do they genuinely listen and even try to implement your suggestions if it makes sense to do so?
-How adaptive/problem-solving does the surgeon/ doctor's staff mindset and attitude seem to be? Does he quickly react when a problem arises or is the problem-solving approach slow? Is there a system in place to deal with complications?
-Do things seem to be getting better within the operation or are things stagnating/ not improving? I feel a CLL surgical practice is NEVER perfect and can always grow and improve over time. Even the top surgeons (like Dr. Paley) probably have room for improvement, but I can't speak towards that because I have never been under their care.
 
 So comparing my experience in 2019 versus my experience in 2023, I felt things were now better and more organized-

1). About logistics, things are just much easier now than they were a few years ago. Logistics is certainly not as important as the health/ medical part of the experience, but reducing logistical concerns causes much less stress on the patient so we can focus on the lengthening process. The Giotikas clinic now has partnerships with hotels that offer a reduced stay rate to his patients, drivers to physical therapy, the 4-night hospital stay post-surgery is MUCH better than it was before, there is dedicated nursing support, etc.

2).  I also find he is actually very open to criticism/ feedback from his patients and he genuinely tries to learn from his mistakes and resolve issues as they arise. He listens to what you have to say and he wants to hear how things can be better.

3).  Regarding some of the critical diaries about Giotikas- those are very legitimate concerns and I feel bad for any patient that had a bad experience with him. Nothing is perfect and things do go wrong. But things go wrong everywhere, even with the top doctors.  But going back to Giotikas, I have also seen some of the diaries on here that are critical of him. I agree with some of the points raised in those diaries. In fact, before I did my surgery with him in 2023, I printed off a few the forum diaries on here that criticized him. During our consult, I asked him for his side of the story, just to see how he would respond. I will not get into the details of those interactions here on this post, but I can honestly say that his responses made sense. He even acknowledged fault on one of the cases and told me that he adjusted his methods to avoid something like that going wrong again. In other cases, he gave me additional details about the case that were not present in the diary description. This eased my concerns and made me realize that (sometimes) a critical diary/ patient experience may omit certain details that are necessary to get the full picture of why a complication arose in the first place. Again, I am not saying that Giotikas  didn't make mistakes. I am just saying that it is difficult to judge a lengthening case properly unless you know the full picture of what was going on. The full picture includes hearing the surgeon's side of the story, which is usually omitted because a diary on this forum is a patient-centric affair.   

I say all this just to emphasize my point that (while he makes mistakes at times) he seems to have a problem-solving (self-improvement/ adaptive) mindset. That is critical for a CLL surgeon, because something can easily go wrong and a quick reaction is necessary to prevent further (more severe) complications down the line.

All things considered, my experiences in 2019 and 2023 were not perfect, but they were overall positive. I had a successful outcome both times and am free from pain and/or complications.

I sincerely hope this post was helpful and maybe gave you some additional guidance in terms of what to consider when interviewing your surgeons. Remember- choosing a CLL surgeon is just like choosing a lawyer or a high-level/ technical service provider. You need to interview/ consult with several of them, come prepared with notes/ questions, ask them tough questions, and listen to your gut regarding who makes you feel safer and who is more competent. If the interaction with the surgeon leaves red flags in your mind, make sure you write those things down, research them, and ask follow-up questions later down the line.

If anybody wants to know more about my time in Greece or my 2 lengthenings, please feel free to respond here and/ or message me over DM, if you wish. I will try to get back to everybody who reaches out. Best of luck in your decision-making.


 

[Staystrong]

I would agree with many of the points that Body Builder raises. I had 2 successful lengthenings with Giotikas (one in 2019 and one in 2023). My signature block briefly discusses which methods we used.

Both times, I felt he was competent, safe, and even open to feedback/suggestions from his patients on how to improve the patient experience. He also seems to care. Case in point- he gives all patients his personal WhatsApp and responds to their questions/ concerns day and night (unless he is actively in the operating room, of course). I am not certain if other doctors do that as well. I am sure some of the European ones do, but I am not convinced that every LL surgeon does that. Another example- he actually seriously tried to talk me out of doing the surgery the 2nd time around, citing that I was already too tall and didn't need it. He was ready to refund me all the money even though it was already the day of the surgery. But I told him I really want to do it and would regret not doing it. So we pushed through. But I cite these points to showcase my opinion that I do feel he places patient well-being over financial considerations. There are other examples to further illustrate this, but I don't feel this is the right post to go into all those details.   

Nothing is perfect (anywhere), including Athens. But something to keep in mind when you are selecting surgeons are the following characteristics:

-How open are they to criticism/ feedback from patients? When you raise a concern, do they brush it off arrogantly or do they genuinely listen and even try to implement your suggestions if it makes sense to do so?
-How adaptive/problem-solving does the surgeon/ doctor's staff mindset and attitude seem to be? Does he quickly react when a problem arises or is the problem-solving approach slow? Is there a system in place to deal with complications?
-Do things seem to be getting better within the operation or are things stagnating/ not improving? I feel a CLL surgical practice is NEVER perfect and can always grow and improve over time. Even the top surgeons (like Dr. Paley) probably have room for improvement, but I can't speak towards that because I have never been under their care.
 
 So comparing my experience in 2019 versus my experience in 2023, I felt things were now better and more organized-

1). About logistics, things are just much easier now than they were a few years ago. Logistics is certainly not as important as the health/ medical part of the experience, but reducing logistical concerns causes much less stress on the patient so we can focus on the lengthening process. The Giotikas clinic now has partnerships with hotels that offer a reduced stay rate to his patients, drivers to physical therapy, the 4-night hospital stay post-surgery is MUCH better than it was before, there is dedicated nursing support, etc.

2).  I also find he is actually very open to criticism/ feedback from his patients and he genuinely tries to learn from his mistakes and resolve issues as they arise. He listens to what you have to say and he wants to hear how things can be better.

3).  Regarding some of the critical diaries about Giotikas- those are very legitimate concerns and I feel bad for any patient that had a bad experience with him. Nothing is perfect and things do go wrong. But things go wrong everywhere, even with the top doctors.  But going back to Giotikas, I have also seen some of the diaries on here that are critical of him. I agree with some of the points raised in those diaries. In fact, before I did my surgery with him in 2023, I printed off a few the forum diaries on here that criticized him. During our consult, I asked him for his side of the story, just to see how he would respond. I will not get into the details of those interactions here on this post, but I can honestly say that his responses made sense. He even acknowledged fault on one of the cases and told me that he adjusted his methods to avoid something like that going wrong again. In other cases, he gave me additional details about the case that were not present in the diary description. This eased my concerns and made me realize that (sometimes) a critical diary/ patient experience may omit certain details that are necessary to get the full picture of why a complication arose in the first place. Again, I am not saying that Giotikas  didn't make mistakes. I am just saying that it is difficult to judge a lengthening case properly unless you know the full picture of what was going on. The full picture includes hearing the surgeon's side of the story, which is usually omitted because a diary on this forum is a patient-centric affair.   

I say all this just to emphasize my point that (while he makes mistakes at times) he seems to have a problem-solving (self-improvement/ adaptive) mindset. That is critical for a CLL surgeon, because something can easily go wrong and a quick reaction is necessary to prevent further (more severe) complications down the line.

All things considered, my experiences in 2019 and 2023 were not perfect, but they were overall positive. I had a successful outcome both times and am free from pain and/or complications.

I sincerely hope this post was helpful and maybe gave you some additional guidance in terms of what to consider when interviewing your surgeons. Remember- choosing a CLL surgeon is just like choosing a lawyer or a high-level/ technical service provider. You need to interview/ consult with several of them, come prepared with notes/ questions, ask them tough questions, and listen to your gut regarding who makes you feel safer and who is more competent. If the interaction with the surgeon leaves red flags in your mind, make sure you write those things down, research them, and ask follow-up questions later down the line.

If anybody wants to know more about my time in Greece or my 2 lengthenings, please feel free to respond here and/ or message me over DM, if you wish. I will try to get back to everybody who reaches out. Best of luck in your decision-making.


 

Where did you live in Athens? How much was it?
Did Giotikas give you blood thinners? Somebody here was saying that he doesn't do that

[CLLvet]

Where did you live in Athens? How much was it?
Did Giotikas give you blood thinners? Somebody here was saying that he doesn't do that

Yes, Giotikas gives blood thinners (Xarelto) to all his patients. How much blood thinners you take depends on whether you are using a weight-bearing nail or not. In my case, I was weight bearing (the external frames are fully weight-bearing). So I took Xarelto until I was able to walk more. I believe I took it for 15 days past my surgery date. After that, he encouraged me to walk 30 mins-1 hour per day and we stopped my blood thinners. It is a similiar protocol for G-Nail patients because that is also weight bearing.

For Precice patients, I believe they take Xarelto for the entire duration of their lengthening, since their nails are not weight-bearing. Don't quote me on that, but that is my understanding. 

I initially stayed in the Grand Hyatt Athens. I emailed their reservations department beforehand, told them I was an Athens BJR patient, and told them my dates of stay. They offered me a reduced rate for that period. Eventually, I moved out of the Hyatt and stayed in an Airbnb apartment because I ended up staying in Athens longer than I had originally planned. The hotel rate began to get too high because it was now peak tourist season, so I moved into the Airbnb to save some money. Both lodging accommodations were suitable.

Regarding hotel rates and Airbnb rates, those will depend on your dates of stay in Athens. The months of January-April and September-December are much cheaper than May-August. If you want specific advice regarding accommodations/ rates, feel free to send me a DM with your situation and I can probably advise a bit better. I would have to check exactly how much I spent/ paid, because the rates began to vary according to the month/ date. Either way, I feel the prices were competitive and fair, especially considering the Grand Hyatt Athens is a 5-star hotel. There are also cheaper hotel choices around the area.   

 

[TheDream]

I would say one of the positives of Birkholtz approach is that he sounds very present during lengthening phase as he requires his patients to remain in South Africa to remain close. The facility looks nice from the little I’ve seen. Seems to be a sports hotel with focus on rehab with nice open green surroundings. But then again this is just from reading up on it never actually been there.

If you have the money for it if I were you I’d visit both Dr. G in Athens and Dr. Birkholtz in South Africa to get a first hand impression.

[CLLvet]

I would say one of the positives of Birkholtz approach is that he sounds very present during lengthening phase as he requires his patients to remain in South Africa to remain close. The facility looks nice from the little I’ve seen. Seems to be a sports hotel with focus on rehab with nice open green surroundings. But then again this is just from reading up on it never actually been there.

If you have the money for it if I were you I’d visit both Dr. G in Athens and Dr. Birkholtz in South Africa to get a first hand impression.

I agree with both points from TheDream. A firsthand visit is great because you can view the facilities yourself and meet the doctor in person. You will also potentially be able to speak to other patients under his care, which is extremely valuable.

I also think that it is great for a patient to try to complete lengthening before leaving and heading back to their home country. I know Giotikas requires patients to stay for at least the first 6 weeks of lengthening before they leave. He strongly advises patients to stay until they complete lengthening. And while you are in Athens, you will be doing physical therapy 4 times per week (Monday, Tuesday, Thursday, and Friday). I think that having supervised PT while you are lengthening is critical. There should be a dedicated facility and the process must be monitored. The physical therapists should be updating the surgeon on the patient's progress on a weekly basis (or thereabouts). 

With regards to timing, in a perfect world, I think a patient should try to remain physically in Athens/ South Africa until they complete lengthening and they are 1 month into the consolidation phase. That is what I did for my 2nd lengthening and I really feel that extra month into consolidation was worthwhile. If a surgeon lets you depart only 2 or 3 weeks after you get the surgery (and doesn't have a solid/ systematic approach to physical therapy while you are lengthening) I think that is kind of risky. 

[Hldrive]

Bs. Giotikas for its price is the best option you can get and generally speaking he is maybe the best european doctor right now for LL. Much better than some clowns in Germany who lengthen 12cm without even itb. Birkholz is a good doctor but I would't do anything in a third world country like.South Africa.

I also had this opinion at first, however I talked with one Giotikas patient in Greece which gave me a different outlook. Based on his words, Giotikas wasn't as present in his patients journey as some claim and in some cases he even threatened to not help a patient if he writes a negative review.

While Giotikas is skilled, he isn't as a good person who truly cares about patients

[CLLvet]

I also had this opinion at first, however I talked with one Giotikas patient in Greece which gave me a different outlook. Based on his words, Giotikas wasn't as present in his patients journey as some claim and in some cases he even threatened to not help a patient if he writes a negative review.

While Giotikas is skilled, he isn't as a good person who truly cares about patients

Thank you for sharing this information. I will say that was not my experience at all and I have known Giotikas since 2019. However, if any of that is true, then it is disturbing.

I just have a question- how could Giotikas know who wrote him a negative review if all the reviews and/or diaries on the forum are anonymous? Couldn't that patient just post a negative review and/or negative diary without mentioning it to Giotikas? and then Giotikas would have no way of knowing for sure who it was? He gets several patients every month, so it would be relatively easy for a certain patient to keep the emails safe and still post a bad review...

Just a thought.   

[CLLvet]

Thank you for sharing this information. I will say that was not my experience at all and I have known Giotikas since 2019. However, if any of that is true, then it is disturbing.

I just have a question- how could Giotikas know who wrote him a negative review if all the reviews and/or diaries on the forum are anonymous? Couldn't that patient just post a negative review and/or negative diary without mentioning it to Giotikas? and then Giotikas would have no way of knowing for sure who it was? He gets several patients every month, so it would be relatively easy for a certain patient to keep the emails safe and still post a bad review...

Just a thought.

I made an error in my last post. I meant to say "for a certain patient to keep their identity safe." I wrote "keep the emails safe" by mistake.