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Author Topic: x10 - External Humerus - Dr. Dror Paley - 2010 - My Arm Lengthening Experience  (Read 122065 times)
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x10
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« on: April 19, 2010, 08:36:03 PM »


Greetings MMT community members / guests

I just started my Arm lengthening (AL) journey and would like all who are interested to benefits from my experience as well as i benefit from your advices/experiences.  

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My AL experience : http://www.makemetaller.org/index.php/topic,3332.0.html
x10
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« Reply #1 on: April 21, 2010, 03:34:31 AM »

Greetings everyone. . .

Here is my story:

First of all, I don't want to spend time talking about Dr. Paley since he's one of the finest limb lengthening surgeons in the world rather I would share my experience with him and his treatment plan.

Pre-op history

- I've one hand shorter than the other by 5. 5 cm due to some birth complications.
- Thus, wingspan = 160. 5 cm >> should be (naturally) = 166 cm
- Target = 5. 5 cm
- Time: 8 weeks lengthening  + 8 weeks consolidation (4 months) on external fixture
- healthy and active adult playing soccer almost everyday since childhood

Consultation

I came to know that Dr.  Paley is very skillful surgeon specializes in bone deformity as well as lengthening almost 5-6 years ago but I was not determined to take the steps to approach him even for a consultation because I was afraid from such long treatment especially having these metal rods into your body through the skin  Shocked.  Lately, I decided to go ahead because I simply was not happy about the difference in my arms length.
Consultation was extensive from both sides.  I mean I expressed what I wanted and he explained what can be achieved.  Fortunately, everything I needed was satisfied (doable)  Cheesy and felt that my dream will come true.  It's a matter of time.  We did comprehensive x-ray for both hands ( from many angles) as well as 3D CT.  Now, don't get me started to talk about this 3D CT, It's truly an amazing piece of technology.  In the end, we decided to compensate for the difference by lengthening 5. 5 cm as initial target.  

Operation - 14th of April 2010

In this day, I was admitted to St.  Mary's Medical Center in west palm beach - FL and dressed for the surgery.  The nurses attached a heating device to keep me warm while I was waiting for the surgery (to share an image of it).  Under general anesthesia, external fixture was attached to my arm during 1 1/2 hr.  I woke up feeling good and examining my new bodymate.  The after surgery pain was very minimal and it was centered in the place where the Doc cut the bone.  After few hours I was able to walk and use my hand normally with a 2/10 pain level.  I was discharged from the hospital on the 16th ( 2 days after surgery) and was able to drive and do everything except lifting heavy weight objects



Current status:
I started turning the device 5 days post- surgery & I was instructed to do 4 turns a day  = 1/4 of 1 mm every turn = 1 mm per day.  Currently, I should've lengthened 0. 325 cm (0. 025 done at the hospital).  Pain level is 1/10 and I'm able to do most of what I used to do prior to surgery.  

Pin care
I take a shower on a daily bases and each time I check the 6 pins sites for any signs of infection.  I use anti-bacterial soap every other day and I've to change the bandages ever day.  Thus so far, everything looks just great.  


Finally, I am truly looking to see what I dreamed of really happen very soon.  Wish me luck. . . . .  

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The best way to predict the future is to create it. . .

My AL experience : http://www.makemetaller.org/index.php/topic,3332.0.html
Kidrobot
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« Reply #2 on: April 21, 2010, 06:02:51 AM »

WOW! This is absolutely fascinating. Thank you so much for sharing your experience with us. Sounds like everything is going very smoothly and that you're virtually pain free. Pics would be great of course to have some sense of how big the device is etc. Sounds like it won't take very long either --4 months is nothing mate! Will your arms be symmetrical after the operation?

take care and best of luck!

Kid
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« Reply #3 on: April 21, 2010, 07:33:04 AM »

Only 8 weeks for consolidation and then you can remove the device?  Shouldn't it be longer than that for a 5.5 cm distraction?
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« Reply #4 on: April 21, 2010, 07:46:26 AM »

If you don't mind me asking, was the procedure covered by insurance?  I am guessing it was since it is an actual deformity correction and not a purely cosmetic procedure.  Too bad being short isn't considered a deformity!
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« Reply #5 on: April 21, 2010, 03:40:51 PM »


Quote
4 months is nothing mate!
I know. . .  it's like a breeze when compared to other lengthening experiences (leg for example).  Let's see how it progress.  I might be wrong especially when reaching +3 cm

Quote
Pics would be great of course to have some sense of how big the device is etc.

I tired but for some reasons I am not able to insert outside uploaded JPEG images

Quote
Will your arms be symmetrical after the operation?

They should be according the treatment plan

Quote
Only 8 weeks for consolidation and then you can remove the device?  Shouldn't it be longer than that for a 5. 5 cm distraction?

The idea here is that if you were able to distract 5. 5 in 8 weeks, then you need to keep the external fixture for the same period for consolidation i. e.  another 8 weeks. 

Quote
was the procedure covered by insurance?  I am guessing it was since it is an actual deformity correction and not a purely cosmetic procedure. 

You're right, Insurance covers specific cases other than for cosmetic purposes
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The best way to predict the future is to create it. . .

My AL experience : http://www.makemetaller.org/index.php/topic,3332.0.html
x10
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« Reply #6 on: April 21, 2010, 04:28:19 PM »

The Amazing heating / cooling device used before surgery




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« Reply #7 on: April 21, 2010, 04:43:36 PM »

Here is a picture of the device: You'll see the distractor + the fixture


..
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x10
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« Reply #8 on: April 21, 2010, 09:13:49 PM »

Again...

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« Reply #9 on: May 10, 2010, 02:01:44 AM »

Well everyone, itís definitely the time for fatty update as  a lot of things have happened since my last post. For example. I had to reduce the turning to 0.5 mm per day as opposed to 1.0 mm ??

Elapsed days since operation = 26 days
Achieved length =1.25 cm
Lengthening speed = 0.5mm/day down from 1.0 mm/day
Pain level: 1/10 ~ from start until now

I guess Iíd better kick off by saying that this should help everyone to understand what to expect when considering AL. I really hope that everyone will benefit from my experience and also I'd like to hear from those who can help me during my journey as i can see that not too many ppl are interested in AL cases.

I was very happy to have a very successful surgery and start fix an existing problem to me. I had my operation on 14th of aprilí10 and 5 days later I started to lengthen by following 1.0 mm/day schedule. 4 days after I started to lengthen, I woke up in the morning feeling that something is very wrong with my hand. I went to eat my cereal and noticed that I canít extend my wrist outward along with the fingers. I freaked out and went to ask my physical therapist.  She did not confirm or denied anything and said that it could be temporary or youíre facing some kind of palsy !!!
I contacted and explained to Dr. Paley and he said you are experiencing a radial nerve palsy and about 5% of ppl face this kind of problem under AL surgeries. He scheduled me for a decompression surgery (you can see an example of such operation in youtube Ė type radial never decompression). I ended up having a 10 cm scar in my arm after the surgery and Dr. Paley said and assured me that he checked the nerve and freed it from a compressing soft tissues. He went further and explained that the original surgery its self did not cause this otherwise Iíd have experienced this problem right after surgery. I responded saying ď yes Iíd agree that the time-to-failure was 9 days post surgery = 4 days after starting lengtheningĒ but i need to know what has happened. He explained that ď the radial nerve is very sensitive and the true cause could be a combination of the swelling after surgery + lengthening pressures. He kept reassuring that this is a temp situation and I may wake up the next morning feeling better or I would wait 6 weeks or the whole period of lengthening  Shocked. He said ď leave the worries to me but reduce the your lengthening pace by 1/2 so that the nerve gets some rest. He seemed to be so confident that Iíd have spontaneous recovery very soon since he intervened very quickly to decompress the nerve.

Today marks the 13th day post 2nd surgery and the nerve seems still sleeping and Iím experiencing this inconvenience of having wrist drop and wearing sprint most of the time. Truly, I was prepared for the worst pain and nightmares except such a complication. So, I went to read many medical articles about radial nerve palsy and all of them confirmed that radial nerve is very sensitive to humerus fractures/breaks. Some articles mentioned that even when you sleep for very long time pressing on ur arm or sleeping on a chair for couple of hours, you would end up having this palsy and this is commonly known as Saturday night palsy  Huh?
Also, these articles mentioned that in most cases, the radial nerve would recover spontaneously and if it did not within 3-4 months, surgical exploration need to be done but the question is would it recover while stretching ?? Iíll have to find the answer very soon by seeking 2nd opinion from both orthopedic and neurologist. Any thoughts/hints guys?   

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The best way to predict the future is to create it. . .

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« Reply #10 on: May 24, 2010, 07:47:30 PM »

Hi.   Thanks for making this thread about your experience.   It's very much appreciated.   Please keep us updated and I really hope the complications with your wrist go away.   This information is very useful to me.   Thanks.
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« Reply #11 on: May 31, 2010, 02:22:49 AM »

Hi.   Thanks for making this thread about your experience.   It's very much appreciated.   Please keep us updated and I really hope the complications with your wrist go away.   This information is very useful to me.   Thanks.

Well, thanks for asking. Things are getting better with intensive physical therapy. I got personal reassurance from Dr. Paley himself as he said that I'm getting some extension which is a sign of spontaneous recovery hopefully very soon. I do feel some improvement and actually I can extend my wrist while resting on my back however, I still can't do it against gravity i.e. while my wrist is parallel to the ground. 
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The best way to predict the future is to create it. . .

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« Reply #12 on: July 18, 2010, 07:09:42 AM »

Your diary is a great reminder for all the crazies that talked about doing AL just to get porportional after they do LL as if it was that simple.
- Let face it, you are doing AL to correct a deformity and you are doing only 1 arm which allows you to use your other arm to do normal daily functions.
- Your problem with your wrist should eliminate anyone crazy enough to think about AL for purely cosmetic reason.

I've said it times and times again that your arms/hands are 100x more important than your legs.
We know that people can function just fine confined to a wheelchair but imagine everyday life without the use of your arms...and for what ?? just so you can look more porportion even though noone will ever notice.
Too much risks and no reward when dealing with AL.
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« Reply #13 on: August 06, 2010, 12:52:37 AM »

Quote from: x10 link=topic=3332. msg37388#msg37388 date=1275272569
Well, thanks for asking.  Things are getting better with intensive physical therapy.  I got personal reassurance from Dr.  Paley himself as he said that I'm getting some extension which is a sign of spontaneous recovery hopefully very soon.  I do feel some improvement and actually I can extend my wrist while resting on my back however, I still can't do it against gravity i. e.  while my wrist is parallel to the ground.  

Hi
Please update, did your wrist get better?

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« Reply #14 on: August 06, 2010, 05:54:24 AM »

Thanks for asking.....it has 100% recovered
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dControl
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« Reply #15 on: August 06, 2010, 02:41:25 PM »

this was a pretty interesting read

but 3 questions:
1. was there a reason you did humerus instead of the forearm?
2. does dr paley operate on forearm as well?
3. do you know if you can use your arms again post surgery as quickly as you did if you lengthened the forearm instead?
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« Reply #16 on: October 01, 2010, 05:15:30 AM »

this was a pretty interesting read

but 3 questions:
1. was there a reason you did humerus instead of the forearm?
2. does dr paley operate on forearm as well?
3. do you know if you can use your arms again post surgery as quickly as you did if you lengthened the forearm instead?


Hi dControl, 1. Yes there was a reason because the discrepancy in length appears in humerus. 2. yes he does . 3 not sure but I' guess the operation will produce the same results if the Dr. uses external fixture. In my case, I was able to do most of the things 5 days after the surgery. good luck
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« Reply #17 on: October 01, 2010, 10:24:16 AM »

Hi,

I'm really interested in the physiotherapy component of your treatment!

Do you do your physiotherapy at St.Mary or were you able to find a good clinic near where you live?


I am having a forearm lengthening with Dr.Paley, we should meet up!!!


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« Reply #18 on: October 02, 2010, 02:18:38 AM »

Hi,

I'm really interested in the physiotherapy component of your treatment!

Do you do your physiotherapy at St.Mary or were you able to find a good clinic near where you live?


I am having a forearm lengthening with Dr.Paley, we should meet up!!!




I do my PT away from St.Mary as I can't afford to stay away from my hometown. Are you doing both hands ? and is there a reason (s) why forearm ?

X10

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The best way to predict the future is to create it. . .

My AL experience : http://www.makemetaller.org/index.php/topic,3332.0.html
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« Reply #19 on: January 08, 2011, 12:58:36 AM »

This post concludes my AL experience. I removed the fixture early Nov10 & currently enjoying wearing long sleeve  Grin I was able lengthen 7 cm. This is beyond the original target of 5.5cm. However, I took "elbow-to-elbow" as guide to reach this new target. Now I'm fully recovered and under light PT for another two months. 

 
Thank you everyone for your visits / comments and advices.

Safe journey to all new dreamers
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The best way to predict the future is to create it. . .

My AL experience : http://www.makemetaller.org/index.php/topic,3332.0.html
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