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[ShortLivesMatter]

Hi SLM,

I've been a lurker here for about a year and but found your posts to be especially helpful since I'm in NY as well and planning on LL with Rozbruch in mid 2020.

Really curious, as someone who did both precice 2.2 and stryde, what were the new costs/differences?
is 2.2 cheaper now than before? or is it the same and stryde was more expensive.

I want to do 5cm tibia 5-6cm femur for about 10-11 total.. and really want to know what price i would be looking at to better prepare.
I would love to know if you have any info on whether he offers a better rate for doing both.

Thanks and best of luck on your second LL!

The tibia surgery was about 3k more than the femur but I think that was due to tibia vs femur and not precise vs stryde.  I highly doubt he offers a discount for doing both but you can always ask, however I do strongly recommend him since he is at the top of the game and you are in the area.

Day 35 - I have lengthened 2.4cm, almost an inch.  Pain has gotten alot better, the sharp pain has disappeared.  Waking up in the morning doesn't hurt as much anymore either. I am slowly walking more and more and gaining more stamina. Managing going to work at the office and LL at the same time is pretty rough tho and I don't recommend anyone doing it, if you must try to work from home. I should have taken more time off. My dorsiflexion is decreasing so I need to step up my stretching.  I can still keep my legs straight so that's good. Got about another month and a half of lengthening to go, just have to grind thru it.

[raku]

Really happy to hear of your sharp pain over! Hope everything goes well!
knowing that you have a very tough experience now, I hope you keep strong. Just imagining the 6.7cm gained of the femur and how the world changed.
I am sorry to hear that you seem a little frustrated not to recommend people do internal tibia.
I know internal tibia is harder than internal femur a lot... I think maybe 6cm is too much..
Maybe 4.5-5cm is more tolerant and relately safe.
Keep strong my dear Asian friend! You re my idol!

[ShortLivesMatter]

Really happy to hear of your sharp pain over! Hope everything goes well!
knowing that you have a very tough experience now, I hope you keep strong. Just imagining the 6.7cm gained of the femur and how the world changed.
I am sorry to hear that you seem a little frustrated not to recommend people do internal tibia.
I know internal tibia is harder than internal femur a lot... I think maybe 6cm is too much..
Maybe 4.5-5cm is more tolerant and relately safe.
Keep strong my dear Asian friend! You re my idol!

Thanks man, nah it's not that I'm against internal tibia at all, I'm just not recommending people to come back to work only after 4 weeks post surgery like I did thinking that the Stryde nail would allow me to function as normal. It's tough as really you should be dedicating most of your day on the LL recovery process to achieve the best possible outcome but now you are losing at least 8 hrs to do so and it will compromise that. It's brutal waking up without a full night of sleep, your body hurting and aching all over, and then having to get up and go to work.  But it is getting better day by day.  I am still aiming for 5.5cm but might stop at 5.

[wannagrowtaller]

Can you tell us how is your physical therapy doing tibias? Is very different from doing femurs? What kind of stretch you do with tibias (if you link videos would be nice)?

[ShortLivesMatter]

Can you tell us how is your physical therapy doing tibias? Is very different from doing femurs? What kind of stretch you do with tibias (if you link videos would be nice)?

PT for tibia is different from femur since the soft tissues that are being stretched are different. With tibia you are focusing on maintaining your dorsiflexion and preventing knee contracture. For dorsiflexion, I bought some incline stretch wedges from amazon and stand on them for a good stretch.  For preventing knee contracture stretch, I sit on a hard surface with my legs straight out and have someone press down on my knee cap to force my leg to be as straight as possible.

Day 43 update - I just passed 3cm.  No complications to report so far other than the gradual tightening of my legs.  No matter how much you stretch, it's a losing battle and you will get tighter and tighter.  Work is still pretty rough. I am walking without a cane for the most part, the walk is slow and there's a slight hip sway but it's not bad.  I think I have 2-2.5cm left of lengthening in me.  Due to my previous femur lengthening I don't think my soft tissues can take much more abuse. 

[raku]

Thanks for your update! 5~5.5cm in tibia is great and safe!
Keep strong SLM you have achieved over half of your goal!

Could I ask the gain height of your femur and tibia is measured by Xray? Or measured by precice machine?
Thanks!

[InFullStryde]

PT for tibia is different from femur since the soft tissues that are being stretched are different. With tibia you are focusing on maintaining your dorsiflexion and preventing knee contracture. For dorsiflexion, I bought some incline stretch wedges from amazon and stand on them for a good stretch.  For preventing knee contracture stretch, I sit on a hard surface with my legs straight out and have someone press down on my knee cap to force my leg to be as straight as possible.

Day 43 update - I just passed 3cm.  No complications to report so far other than the gradual tightening of my legs.  No matter how much you stretch, it's a losing battle and you will get tighter and tighter.  Work is still pretty rough. I am walking without a cane for the most part, the walk is slow and there's a slight hip sway but it's not bad.  I think I have 2-2.5cm left of lengthening in me.  Due to my previous femur lengthening I don't think my soft tissues can take much more abuse.

Almost there buddy.

[Ghostfish]

Hi SLM

You are almost there!!  You have been doing great!! Keep up the good work!!
Best,

[azman]

Hi ShortLivesMatter

Thank you for your awesome diaries, it gives me hope.

I was wondering if your insurance cover your recent LLS on your Tibia since they cover the HSS, Anesthesia, and 7k to Dr. Rozbruch for your Femur?

What kind of insurance do you have, if you don't mind me asking and what medical biling codes did they use to get your insurance to cover Cosmetic surgery, Cosmetic Limb Lengthening?

I'm planning on consulting with Dr. Rozbruch and are deciding between him if my insurance will cover the HSS or Dr Dimitrios Giotikas.

Thanks   

[wannagrowtaller]

Due to my previous femur lengthening I don't think my soft tissues can take much more abuse.

Don't you think it's better to do tibia first for this reason?

[wannagrowtaller]

What is your daily rate of distraction? 75mm per day?

I bought some incline stretch wedges from amazon and stand on them for a good stretch.

https://www.amazon.com/ProStretch-Blue-Stretcher-Fasciitis-Tendonitis/dp/B000GAAXGK
Is it this?

[Kenda]

Hi ShortLivesMatter,
just read your diary and I have alot of questions tbh :
_______________________________________________
1) First of all Are you a girl ? & how old are you exactly? Were you skinny to start with (low muscle mass)?

2) How did you say that when you did femur they couldnt fit the nail in your leg of the stryde but then the stryde nail fit in your tibia ?? Isnt the tibia muscle smaller and narrower than femur ?

3) From your experience did you feel a difference between both Precice 2 & Stryde? with precice 2 were you sitting all the time or when could you start walking?

4) Knee Pain : How was the knee pain in both experiences ? 
-----> Did Tibia hurt more as the nail went right through your knee patella ?

5) When it comes to Pure External Tibia VS Pure Internal Tibia.....what would you advice , I an a girl & having major scars and infection allover my tibia isnt easy or favorable and also walking with a huge circular frame for 6 months or more is hard but they say pure external avoids Knee pain, do you think I should wait better & do Stryde in Tibia However ??


*Sorry for all these questions lol .

[ShortLivesMatter]

Hi ShortLivesMatter,
just read your diary and I have alot of questions tbh :
_______________________________________________
1) First of all Are you a girl ? & how old are you exactly? Were you skinny to start with (low muscle mass)?

2) How did you say that when you did femur they couldnt fit the nail in your leg of the stryde but then the stryde nail fit in your tibia ?? Isnt the tibia muscle smaller and narrower than femur ?

3) From your experience did you feel a difference between both Precice 2 & Stryde? with precice 2 were you sitting all the time or when could you start walking?

4) Knee Pain : How was the knee pain in both experiences ? 
-----> Did Tibia hurt more as the nail went right through your knee patella ?

5) When it comes to Pure External Tibia VS Pure Internal Tibia.....what would you advice , I an a girl & having major scars and infection allover my tibia isnt easy or favorable and also walking with a huge circular frame for 6 months or more is hard but they say pure external avoids Knee pain, do you think I should wait better & do Stryde in Tibia However ??


*Sorry for all these questions lol .

1. I was a very short and small boned guy, very skinny, in my early 30s now.

2. I did femurs in 2017 with Precise as Stryde was not available yet. We used the smallest Precise 8.5mm nail as that one fit better than the next size which was 10.5mm. My femurs could have probably handle the 10.5 nail but that would have required reaming so going with the 8.5 nail was the safer choice. 

3. Yes with precise I could not weight bear until after 4 months so my leg muscles were all deteriorated and weak. With Stryde I started walking unassisted after 3 weeks so my muscles are recovering alot better this time. 

4. There was no knee pain with the femurs as the knee was untouched.  There was knee pain with the tibia after the surgery but it's been getting better and better, almost no pain now but I havn't dare try to stand on my knees, I'm sure that would hurt like hell since my surgery was only recently and I'm still healing. 

5. Sorry I do not know much about external tibia.  I only chose to do internal tibia because of Stryde which allows for comfort and fast recovery.  Even with Stryde you will still get scars.

Day 53 update - at 3.6cm now. I had a checkup this week. My ROM is still ok, dorsiflexion is getting tight at only 10 degrees.  I was instructed to slow down distraction rate to 3 times a day for .6mm total. This is due to my bone growth being a little slow which I was not surprised since I had the same issue when doing femurs.  I will probably stop at 5cm so 3 more weeks of lengthening, that's a good enough length for me for tibia.

If you have questions about insurance please send me a PM and I'll be glad to answer them. 

[InFullStryde]

1. I was a very short and small boned guy, very skinny, in my early 30s now.

2. I did femurs in 2017 with Precise as Stryde was not available yet. We used the smallest Precise 8.5mm nail as that one fit better than the next size which was 10.5mm. My femurs could have probably handle the 10.5 nail but that would have required reaming so going with the 8.5 nail was the safer choice. 

3. Yes with precise I could not weight bear until after 4 months so my leg muscles were all deteriorated and weak. With Stryde I started walking unassisted after 3 weeks so my muscles are recovering alot better this time. 

4. There was no knee pain with the femurs as the knee was untouched.  There was knee pain with the tibia after the surgery but it's been getting better and better, almost no pain now but I havn't dare try to stand on my knees, I'm sure that would hurt like hell since my surgery was only recently and I'm still healing. 

5. Sorry I do not know much about external tibia.  I only chose to do internal tibia because of Stryde which allows for comfort and fast recovery.  Even with Stryde you will still get scars.

Day 53 update - at 3.6cm now. I had a checkup this week. My ROM is still ok, dorsiflexion is getting tight at only 10 degrees.  I was instructed to slow down distraction rate to 3 times a day for .6mm total. This is due to my bone growth being a little slow which I was not surprised since I had the same issue when doing femurs.  I will probably stop at 5cm so 3 more weeks of lengthening, that's a good enough length for me for tibia.

If you have questions about insurance please send me a PM and I'll be glad to answer them.

5'1" to 5'6/5'7isque.  You're incredible man.  What a fighter.  Good luck rest of the way, buddy. I'm on your side.

[Kenda]

Thank you for your reply and I wish you the bets recovery!

1) Okay but do you feel that if you would have done Stryde in your Femur you would have achieved the full 8 cm ?

Because for me having Financial problems i can only do this surgery once and by once i need to get the maximum which is 8, thats why im going for femurs even tho my proportion would be so weird ! But since i have No muscle mass like you im scared what may stop me from achieving the 8cm, because some doctors wont just say they will say we will see after surgery or so!


2) so after you did femurs When could you start walking like a Normal person as if you didnt do anything ?

3) Did you have problems with Tight/ short tendons or ligaments that prohibited your lengthening??

[MyEvolution]

Hey just wanted to wish you all the luck possible & send you some good vibes! I finished my femurs end of December 2018 for 8cm & am waiting to be able to do Tibias sometime in Late September of this year. Super amped for it although reading this reminded me of HELL WEEK (first 1-3 weeks) lol but whatever it’s all worth it my guy keep going

[PANDA:BEAR..]

Hi..ShortLivesMatter, I hope your are doing well?  Can you give us an update..
panda 

[wannagrowtaller]

Can you walk unaided indoors?

[ShortLivesMatter]

Thank you for your reply and I wish you the bets recovery!

1) Okay but do you feel that if you would have done Stryde in your Femur you would have achieved the full 8 cm ?

Because for me having Financial problems i can only do this surgery once and by once i need to get the maximum which is 8, thats why im going for femurs even tho my proportion would be so weird ! But since i have No muscle mass like you im scared what may stop me from achieving the 8cm, because some doctors wont just say they will say we will see after surgery or so!

I think I would have definitely hit at least 7.5cm. With the stryde, you are up and walking after a week so your muscles don't get so weak, they also stay more flexible and not as tight, and bone consolidation is quicker

2) so after you did femurs When could you start walking like a Normal person as if you didnt do anything ?

It took me about 8 months from the day of the surgery to walk as if nothing ever happened. 

3) Did you have problems with Tight/ short tendons or ligaments that prohibited your lengthening??

I had a knee bending problem at around 5cm but I stepped up my PT and resolved it by the end of the lengthening, the main thing that made me stop was my bone consolidation was slow and I was sick of the entire process and wanted to get back to normal life asap

[ShortLivesMatter]

Hey everyone, sorry for the late update, I've just been really busy with work and LL.  It's been about 2.5 months since my surgery.  I am at 4.9cm and am going to stop in a couple of days.  I had another checkup and everything looked good, me slowing down lengthening to 3x a day has helped improve the bone formation and helped my muscles keep up better.

There is no pain when I'm sitting or laying but there is pain when I walk right below the knee.  Dr. R. attributed it to me walking too much without crutches when I'm still lengthening and my bones havn't consolidated, which kind of makes sense since it doesn't really hurt in the morning but by the end of the day after work, it's pretty rough. I just hope it isn't some permanent knee pain issue associated with internal tibia. 

Let me know if you have any questions. 

[InFullStryde]

Hey everyone, sorry for the late update, I've just been really busy with work and LL.  It's been about 2.5 months since my surgery.  I am at 4.9cm and am going to stop in a couple of days.  I had another checkup and everything looked good, me slowing down lengthening to 3x a day has helped improve the bone formation and helped my muscles keep up better.

There is no pain when I'm sitting or laying but there is pain when I walk right below the knee.  Dr. R. attributed it to me walking too much without crutches when I'm still lengthening and my bones havn't consolidated, which kind of makes sense since it doesn't really hurt in the morning but by the end of the day after work, it's pretty rough. I just hope it isn't some permanent knee pain issue associated with internal tibia. 

Let me know if you have any questions.

Glad you're doing well man.  How does it feel to be about 5'6 with absolutely no shoe on, after living most of life as 5'1" (My original height)?

[Movie]

How is it looking SLM? Done with lengthening yet?

[korok123]

Hi SLM. Great diart, a lot of useful information here! One question I'd like to ask is if you had to wear foot splints after your tibia surgery and for how long? Also, how did you manage to sleep through the night if you did wear these casts? Thanks and I hope you're making good progress on your lengthening. Keep at it!

[ShortLivesMatter]

Hi SLM. Great diart, a lot of useful information here! One question I'd like to ask is if you had to wear foot splints after your tibia surgery and for how long? Also, how did you manage to sleep through the night if you did wear these casts? Thanks and I hope you're making good progress on your lengthening. Keep at it!

Never had to, which is odd since Paley has his patients wear them. 

Day 80 - I finished my lengthening last night at 5.3cm.  I could have gone on but decided to stop here as I didn't want to do too much in tibia and my tibia/femur ratio is now at a good 80%.  I am obviously pretty tight but fortunately did not develop ballerina foot. I credit this to STRYDE and the ability to weight bear allowing me to stand/walk which helps against it.  My dorisflexion is 10 degrees on my left foot and 5 on my right.  I do have a little knee contracture, hopefully with continued PT I will be able to regain full knee extension soon. 

There is no pain while sitting/laying or just standing but there is while I'm walking, probably due to overuse of legs when they have not consolidated yet.  My walk is not normal as due to that pain, I try to minimize the ROM so my legs don't get lifted off the ground as much as a normal gait.  Anyway I'm walking around with a cane now outside the house, which helps me walk faster than w/o it as it provides balance. 

Hopefully it won't take too long to consolidate, I know tibia healing is slow but should be quicker with STRYDE .  Nothing much between now and the next 4 weeks when I'll get my latest xrays done. I'll post a copy of them when I do. 

[MyEvolution]

I’ve done femurs before for 8cm & my goal is to get as close to 8cm on tibs as well so i jus have some questions so i can be properly prepared

1. When did “hell weak” wear off? For me the first 2-3 weeks were a nightmare when i did femurs! I was too ambtious and was forcing myself to walk unasisted 5 days after surgery which.. i proved to myself that I could but it just made me super sore all the time & for tibs, i’m gonna be taking it much easier. But so i guess
When were u able to ACRUALLY have a solid night of good sleep? For me it was like 3 weeks

2. When did u transition from walker - crutches - cane - nothing

I work from my labtop so i’m gonna be dedicating fulltime to recovery. Assuming you had this kind of time & also someone to do it with (doing it w a friend). How far do you think you physically could have gone if u REALLY wanted to? Is 6 possible? 7? 8? Thoughts?

Thank you in advance for your replies!!

[MyEvolution]

Last question

Pain wise, what hurts more on a day to day basis assuming all activities are equal
Tibias or femurs?

I heard femurs hurt more cause bigger muscles
But tibias are more annoying to stretch & maintain

[Curiosity]

no update ?

[RenaissanceMan]

Did you ever ask what exactly caused those sharp pain spikes of level 8? What did the doctor say?

[dreamingtobetaller]

Great and helpful diary thank you! Can I ask if you’re male or female? Thanks

[ShortLivesMatter]

Hi everyone sorry for the long absence since my last update.  It's been exactly 5 months post my tibia surgery. I ended up stopping at 5.6cm and with the straightening of my bowed legs adding about another .5cm I think the total is probably just a little past 6cm. 

Tibia recovery has been tough, I've have had alot of pain and still a little but it's getting better day by day.  Both legs were very tight by the end of lengthening in that whenever I was standing and then had to lift either leg to start a walking movement, there was an extreme sharp pain. It was odd because in the left leg the pain was behind the knee while in the right leg it was in front. I also had alot of knee pain whenever I stood up or sat down.  Thankfully all these issues have improved tremendously starting from the 4th month til now. I think it was due to my soft tissues already being tight from the previous femur lengthening and then them getting stretched again. My gait is pretty good now but my walk is still not back to normal speed as there is still a little pain at the top of the tibia but again it's improving daily. I didn't have any issues with my dorsiflexion, so did not develop ballerina foot. 

All in all, while my tibia recovery w/ STRYDE has definitely been more painful than my femur recovery w/ PRECISE, my gait and walk at the 5 month mark now is better than my 5 month post femur surgery. Just have to continue to push on.

You can find my xrays here. There is a bit more bone formation on my right leg which makes sense since it's been the stronger leg day one so I've been using it more and stressing it more.

https://imgur.com/a/9ScAIbm

[E Z]

Awesome diary. Any updates?