End of distraction updateHeight increase: 57mm L / 60mm RDays since operation: +67Final height: 178cmIt has been a long time since the last update. I went back to work, which has taken a lot of my time.
I’m happy to say that I’ve finished lengthening, successfully reaching the upper limit of my goal (6cm), while also correcting a minor discrepancy between femurs. While the process has been challenging, I’m lucky to not have had any complications, and still retained a good amount of muscle.
ClickingAt the time of my last update, I was struggling significantly with clicks. It did get easier (5/10 stress) after I took a break day and reduced the distraction rate to 0.8mm (12 clicks).
However, around 5 weeks post-op I had a friend over and decided to go to the beach for a few hours. The extra strain on my muscles from that day caused another ~10 days of stressful clicks (8/10 stress).
I would strongly recommend taking it easy with your muscles during the distraction phase, especially if you have significant muscle mass around the femur. The biggest mistake I’ve made during the process was going too hard too soon.
A few other things that helped with clicking:
- Taking a warm shower or using a warm compress before clicking
- Raising your foot progressively as you gain more length. I progressed from 1 pillow -> 2 pillows (@20mm) -> 3 pillows (@45mm)
- Not rushing the clicks, taking as much time as needed and stretching into it. If you put too much force, not only will it cause more pain, but it will condition your brain to be more stressed for the next clicking session.
- Putting on something distracting that you enjoy while you click. My drug of choice was binging Haikyuu.
- For the worst days, CBD helped. However, the Dr. said there is a study linking CBD to slower consolidation.
- Reducing the rate to 12 clicks.
Moving to AirbnbAfter just under a month of staying at the hotel I moved to an Airbnb. It was definitely the right decision, as I had more space and independence. I felt more like a functioning adult and less of a vegetable.
I still strongly recommend staying in an accessible room of a hotel for at least the first 3 weeks. You will have a
very hard time showering or going to the bathroom otherwise.
Things to look for or ask the owner when getting an Airbnb in Athens:
- Make sure it’s on the ground floor. Very few buildings have a lift.
- The shower box must be big enough to fit a showering seat.
- It’s best to find an Airbnb near the Physical Therapy center, as you’ll be going there 4 times a week. I made the mistake of getting a farther out Airbnb and was spending 50m a day uncomfortable in a car.
- Check that there are no or very few steps to access the place.
- You can negotiate a cheaper price for a long-term stay by directly contacting the owner. I got ~30% off.
LengtheningI’ve decided to stop at the upper limit of my goal: 5.7cm on my left (shorter) leg, and 6cm on my right. Although my original post said I was at 171cm, I believe that was a measurement error, as I later measured 172cm before clicking and now have been measured at ~178cm. I'm happy with this height, as it's slightly above average where I live, and I believe I have a high likelihood to get back to doing sports at a similar level.
Final x-ray:
Beyond 4.5cm, muscle tightness got pretty bad. I would need to wake up and stretch ~3 times during the night to get back to sleep. It was also hard to sit down and work for more than 1 hour at a time without having to stretch. The PT sessions became increasingly painful, especially the quads and glutes stretches. I would recommend doubling down on quads and glutes stretches before you do the surgery.
At the end of distraction, the tightness has slightly decreased every day. Although I don’t have the same mobility yet, it feels really good to have positive progress rather than negative.
MobilityAt the Airbnb I was walking with crutches most of the time, only using my chair to move large things or working.
At the physio, I was walking for 15 minutes with 50-40% support at ~1.6km/hr (slow, I know). My walk looked very natural.
Now after distraction I’ve been taking a few unassisted steps every day. My walk is looking pretty good, although slow. The doctor was (I think purposely) ambiguous if I could or couldn’t take unassisted steps, but I will continue to progressively walk more every day. I might upload a video later.
SleepSleep has gotten better at around ~4 weeks post op. I was able to consistently get 5-6 hours of sleep. Then it has gradually improved, especially recently that I can comfortably sleep on my side.
WorkI went back to work part-time +33 days post-op, then full-time 2 weeks later. It was challenging to work while keeping up with the PT and clicking routine. I would say I was around a ~70% level of productivity as before. Though before the operation I would normally put in 55-60 hrs/week at work.
Trip backThe trip back was a bit taxing, but manageable. Dr. G’s driver took me to the airport, where they had a special assistance person assigned to me. They wheeled me around, going through priority queues (felt like a VIP), until the flight was ready. Since the plane was parked outside, they put me on a lift to get on the aircraft, before the other passengers boarded.
I had some pain in my leg from sitting down for too long, but I stood up and stretched my legs 3 times during the 3hr flight which helped.
Height and perceptionI’ve started noticing a big difference from 3cm onwards. The nurses and PT staff were noticeably shorter at every 1 cm increment. At around ~177cm, I stopped having the feeling I used to have around men taller than me of being subtly inferior. I felt more on “equal footing”. Also, a significant number of women started looking “petite” to me, when before that was rare.
At the airport on my way back, I was within a crowd for the first time. I definitely felt more confident and masculine than before.
I met my dad again recently who is ~174cm. The difference in cm is small, but the perception is wildly different and noticeable. I’m very skeptical that you can hide this change from your closest friends and family, unless you’re already very tall.
Overall, so far I feel like I got exactly what I did this for. However, it’s early days, so it’s possible that the effect can wear off over time. I’ll keep you guys posted.
ConsolidationI expect the consolidation phase to take another 3 months. I’ve been given strengthening exercises mostly for the glutes, and have been recommended to continue the stretching routine. As mentioned above I will gradually resume walking.
For supplementation I will continue on Vit D, Calcium, Milk, and Whey protein and will start taking L-arginine for the blood flow.
BJR teamI am happy with the experience and support from the BJR team. The head nurse (V), head PT (H) and the PT assigned to me at the center (N) were standouts.
Dr. G. seemed to be a capable surgeon. My alignment, consolidation so far and scarring are great. All the other patients I’ve met had overall successful journeys. The complications that happened were few, but well managed by the team.
My only complaints are:
- Responsiveness via Whatsapp: Dr. G. ignored some of my non-urgent messages or replied days later. I’ve heard from other patients that it gets worse after you leave Athens.
- Difficulty clicking is somewhat normalized. Don’t get me wrong – the nurse/PT are available to help with clicking if you ask. And if you’re having a hard time they will prescribe you anti-inflammatories which help a bit. But Dr. G seems to consider 5/10 stress when clicking twice a day “normal”. Clicking is by far the most difficult part of the process (confirmed by every patient I met there), and I would suggest that the team invests more to make it easier. For example clearer instructions on what to avoid to not make it harder, specialized pillows, help with clicking daily in the Physio center.
From my own experience and from reading other diaries, I really do believe Dr. G. is the best value surgeon. While the amenities are not “premium” (Hospital, PT center), they are good enough, and the people were great. I would not consider going for a cheaper surgeon in Europe, and I would try to understand if I’m getting much more from an expensive surgeon to be worth the cost.
Damn my friend looks like a tough couple of weeks! Really hope your stress levels decrease going forwards and clicking pain starts to abate. Keep it up looks like you're follow up went really well.
Thanks mate! At the time when you don't know if you'll be able to endure clicking, things get pretty hard and you think about quitting. But it worked out in the end. In retrospect I should've taken more breaks from clicking during that time, and slowed down the process.
Your experience with clicking the G-Nail is EXACTLY what happened to me.
Clicking the right leg was very difficult after 2cm and it wasted me hours every day and became a torture.
Seems like there are people that this doesn't happen to them, but for me this was exactly the experience. You can check my diary.
I hope it will become easier for you somehow.
Thanks for the wishes! I wonder why they don't make a mirrored version of the nail so you can get a soft click first on the right leg. Feels like an oversight.
Why did the PT team stop visiting you? Shouldn't visit you r times a week? Do you pay for PT? Are you able to do PT by yourself?
There are two teams (1) Dr. G. has a nurse and PT person (2) There is an associated PT center with about ~5 staff. Both were included in the original price.
Dr. G's team visited me twice a day for the first week to make sure I was ok post-surgery and teach me how to click. After that they would visit once a week or when I asked.
I would go to the PT center 4 times a week during the whole process.
You can do stretches at home, but it's not the same as having someone else push you. Also at PT you get to use the anti-gravity treadmill and 3 machines: shock therapy, pressure therapy, and cold therapy. I would definitely recommend doing PT at a center during the distraction phase.
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Topic: Dr. Giotikas 5cm bilateral femurs with G-Nail (detailed) (Read 8386 times)