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Author Topic: The Fastest Way To Get Taller - What I Should Have Done Differently  (Read 29309 times)
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Apotheosis
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« on: May 24, 2013, 07:12:14 PM »

I've learned a lot from doing leg lengthening twice, and there are a few things I would do differently if I could start over back in 2010 and do it all again:

#1. I would have done only 8.5 CM in my femurs. I could have finished lengthening in three months, and my overall recovery would have been faster.

#2. I would have had titanium rods put in as soon as I finished lengthening my femurs. I have generally thought that the additional cost and trauma of swapping out your lengthening nails for titanium rods wasn't really worth it, but if I was trying to recover as fast as possible, I would have had titaniums put in and been walking without crutches around 3-4 months after my initial surgery. I could have then gone back and done my tibias six months after I finished lengthening my femurs.

#3. I would have done only 6.5 CM in my tibias. I could have finished lengthening in three months. I got caught up in the numbers game of wanting a certain height, rather than just wanting to be a lot taller. If I had done only 6.5 CM in my tibias after doing 8.5 CM in my femurs, I would have still been 15 CM taller, which is quite a difference.

#4. I would have had titanium rods put in as soon as I finished lengthening my tibias. Even though it's normally not really necessary, if I would have had titanium rods put into my tibias when I finished lengthening them, I could have been walking without crutches between three and four months after I had my initial tibia surgery.

If I had followed this plan (and I had spent the gigantic sum it would have all cost), I would have been walking without crutches 13-14 months after my first surgery, which would have been October or November of 2011. I would have been six inches taller than I started and by today, May 2013, I would surely have been back to sports at the highest level I could possibly be post-LL.

Food For Thought
Apotheosis
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My personal apotheosis to the very best me I can be. Starting height: 171 cm. 9.5+ cm added to femurs. 10.5+ cm added to tibias. Final Height: 189.5 cm +/-

My femur diary: http://www.makemetaller.org/index.php/topic,3530.0.html
My tibia diary: http://www.makemetaller.org/index.php/topic,4202.0.h
jmnj06
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« Reply #1 on: May 24, 2013, 07:27:40 PM »

Apo,

You had the 13mm rod in your femurs and you STILL would of swapped it for titanium??   Huh?

Plus femurs consolidate so much faster, I can understand tibias but femurs too?? You are correct that is some major cash...
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BtzLandLiberator
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« Reply #2 on: May 24, 2013, 07:30:43 PM »

Interesting.

I'm really happy with my extra 10cm, so I don't think I'd change that. But your number #2 is spot on for me: even though I didn't needed (no problem with my 11mm nail or screws) I wish I had done the titanium rod (if I had the money). If we start walking earlier the soft tissue recovers faster. It's astonishing the difference of speed in my recovery before and after I left the crutches.

Number #3 is very reasonable to me too. If some day I decide to have LL in my tibia, I'll only do 5cm or 6cm and definitely put a titanium rod. Depending on the person, the tibias can take a looongggggg time to consolidate. I met this beautiful former patient from France at Park Hotel that did 4cm in her tibias and she was still NOT consolidated after 4 years. This seems an extreme case, but it could happen.
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darkchylde
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Just like Claudia, only shorter :-)


« Reply #3 on: May 24, 2013, 07:30:57 PM »

Thank you so much for this post, it is invaluable!
Do you think that someone that's 40kg still needs titanium nails?
Were you walking on crutches because you truly needed them or because you were simply afraid of bending/breaking the nail?
Finally, do you believe that 8. 5cm for femurs and 6. 5cm for tibia is a magic threshold number above which things start to get really difficult?
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Tewmoer
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« Reply #4 on: May 24, 2013, 10:05:01 PM »

Thank you for this post!

8cm on the femurs and 6cm on the tibias is exactly what Dr. Paley told me is the absolute limit for maintaining safety when the 8cm PRECICE is released.  He also said it won't be easy and there is definitely a higher risk of complications.

Well i'm going to at least try damn it!  Grin
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Joesler
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« Reply #5 on: May 26, 2013, 08:38:43 PM »

yes sir the titanium nails are a huge benefit if you can afford them
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a1_z1
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« Reply #6 on: June 06, 2013, 04:37:40 PM »

Thank you for this post!

8cm on the femurs and 6cm on the tibias is exactly what Dr. Paley told me is the absolute limit for maintaining safety when the 8cm PRECICE is released.  He also said it won't be easy and there is definitely a higher risk of complications.

Well i'm going to at least try damn it!  Grin

I am a little confused: if 8 cm is absolute limit for maintaining safety...than  why would there "be a high risk of complications" ? Unless I am reading your post incorrectly !

Also  why would it "not be easy"...in what sense....pain - discomfort, more preparation required ?
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LLGrateful
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« Reply #7 on: June 06, 2013, 06:41:20 PM »

I've been reading here for years. I am not inexperienced with being in a wheelchair for months, knee issues, broken leg issues. 
Taking this "fastest" theory to an extreme does not deduct from my sanity and understanding of the benefits of being minimal and gradual with LL. That being said...

We saw this coming to this thread, didn't we?
In Dwarfism, quadrilateral lengthening has even been performed with external fixators and to an extreme extent.

Apotheosis, (and Tall?, and other likewise experienced Vets that took things to an extreme?)

I have always respected your intelligent analysis combined with your audacity to lengthen to extremes. I recall that when the PRECICE talk first started, in early 2012, you mentioned somewhere, that if you had the PRECICE option when you started you would consider doing quadrilateral lengthening in a wheelchair to expedite the lengthening phase on all 4 segments. The lack of clicking required reduces bone consolidation issues, soft tissue stress issues, pain issues; and, this made it seem more idealistic and feasible to you regardless of your keen awareness of the challenges from your experience.

Obviously, each segment would be lengthened at the same rate that they would be if they were done individually or bilaterally; however, when done bivertically there is added pressure on the connecting knee joint / tissues. Since the point of separation / growth is central to each segment, this is not the same effect as the bones being pushed together at the knee joint; however, some, if not all, of the tissues around the joint are subject to a pulling tension from both directions, i.e. above and below, simultaneously. More careful consideration of exactly how each of the joint tissues are affected would be better than assuming.

So, without thus far belaboring obvious nuances about soft tissues and recovery, and while idealistically overlooking the extra cost and stress which results in the possibility of this still not being realistically pursued by most interested parties:

What are all of your thoughts, pro and con, for simultaneous quadrilateral lengthening with 8cm PRECICE on each segment while in a wheelchair and doing as much physical therapy as possible, especially hydrotherapy (pool, hot tub) , followed by immediate titanium rod replacement and more aggressive PT for recovery?

Obviously, a lighter weight patient especially, and a more flexible patient, has a better chance at making this work.

The new rods are "4x" stronger and the original were already estimated to take, what?, 150 lbs?
Take a patient that has dropped weight to below 150, maybe 120-130 lbs, and does a lot of hot tub stretching / hydrotherapy (not to mention the meds which help with soft tissues).
The Ti rods are supposed to endure what kind of weight / force? (Screws / Pins always being the weakest link).

At roughly 1 inch per month, a standard rate + complications factor of roughly 3.5 months to finish the 8cm (3.15 inches). 
Thus, 6.5 inches in 3.5 months + Ti rod replacement (and Stem Cells) for more aggressive / full weight therapy for recovery.
Yes, approaching fantasy world. Still...
What do you think? Seriously. Think it through. Talk it out. Please. Thanks.

I mean, it might hurt like hell around the knees, and recovery might take longer; but, it is very possibly not the nightmare that many fear it could be. The biggest nightmare to it is possibly just the cost and the extra stress of being in the wheelchair for utmost precaution during lengthening.
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LLGrateful
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« Reply #8 on: June 06, 2013, 06:50:56 PM »

 Roll Eyes Sorry. I did not put my best effort into that post and I am now reminded of the lack of option to "edit" and my general preference to not post on forums.

I could have better clarified many things. Please excuse my imperfections.
Most notably: Every time you see "quadrilateral" you should actually be reading "simultaneous quadrilateral". Also, 6.3 inches total, technically, not counting any extra spacing provided by the surgical manipulation. Hopefully 6.5 inches was an accepted estimate.
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egghead
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« Reply #9 on: June 06, 2013, 07:10:15 PM »

The body is different for people with achondroplasia or similar issues so what works with them is not what is best for someone else. They can handle it with 4 rods but they're built different than someone is doing this cosmetically. Cosmetics is a side effect for them. They need it for function.

The first Precise is designed for 50 lbs for each rod. If it becomes weight bearing maybe that could change protocol. I don't think many Doctors will do all 4 at once yet ,too many potential complications for a cosmetic procedure.
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SysOp
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« Reply #10 on: June 06, 2013, 07:26:20 PM »

In general, stretching both leg sections on both legs at the same time is a bad idea because of the damage to your soft tissues. It has be done to a maximum of 5 CM on the femurs and 5 CM on the tibias at the same time, but it is not recommended. The best way to lengthen is one section at a time.
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LLGrateful
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« Reply #11 on: June 06, 2013, 07:36:52 PM »

The body is different for people with achondroplasia or similar issues so what works with them is not what is best for someone else.

This has been tossed around a lot over the years. The truth is, every individual has a slightly different body to take into consideration, Dwarfism or not. A dwarf, in theory, might have more soft tissue to spare or different joint gaps. Overall, I think the anecdotes of Dwarf patients having much of an advantage are overstated.

The first Precise is designed for 50 lbs for each rod. If it becomes weight bearing maybe that could change protocol. I don't think many Doctors will do all 4 at once yet ,too many potential complications for a cosmetic procedure.

http://www.makemetaller.org/index.php/topic,6073.0.html
This is my source of Paley saying that the new rod, i.e. "PRECICE 2", is "4 times stronger". If you both are correct, that means the new rods are estimated to support 200 lbs each. Unfortunately, I have forgotten all of the stats I once collected over the years and I am not in the mood to search for them.

What is most important to note here is not only the allegation of 4 times more strength for the PRECICE rod. It is also important to note that when Apotheosis originally mentioned his idea of simultaneous quadrilateral lengthening in 2012, he was discussing what I am: Being primarily confined to a wheelchair during the 3-4 months of lengthening so that the weight bearing on the lengthening rod is hugely diminished. Combine this with that we are both talking about in this updated thread: solid titanium rods replace the lengthening rods immediately after lengthening is finished to increase weight bearing potential.

In general, stretching both leg sections on both legs at the same time is a bad idea because of the damage to your soft tissues. It has be done to a maximum of 5 CM on the femurs and 5 CM on the tibias at the same time, but it is not recommended. The best way to lengthen is one section at a time.

1. Thank you very much for how you have improved this forum since the ownership change. I cannot say enough how much I have noticed a positive change and you deserve a lot of appreciation.

2. The figure of a "safe" range for lengthening a segment has previously been theorized to be 7.6cm in some studies. It was also often stated that 5cm is the most safe. Many patients have still gone 11cm or 20cm in some cases.

I recognize what you are saying to be reasonable and based on many years of observations.

What I am hoping for in this thread is less commentary on the same old theories and more commenting on the specific methods being discussed here: PRECICE 2 (200 lb strength?), wheelchair confinement during lengthening phase to minimize weight bearing on the PRECICE 2 rods regardless of their possible 200 lb strength, solid titanium rod replacement immediately after lengthening to theoretically add stability and weight during recovery (amount of weight bearing?), 8cm of lengthening (which is not "too much" more than 5cm, although some wold argue 3cm x 2 bivertical segments is "a lot").
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LLGrateful
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« Reply #12 on: June 06, 2013, 08:11:59 PM »

For the record:
   
Quote
Re: a interesting video about precise nail
Reply #10 on: March 23, 2012, 09:29:18 PM
Quote from: kaandereli on March 23, 2012, 09:01:35 PM
it seems to have considerable advantage over betz's nail.

I almost spit out my juice laughing when I read this comment. Dr. Betz's nail can lengthen as much as 5 inches on a single bone section. Not that I would advocate doing that, but it is possible. Dr. Betz's nail also allows you to walk on crutches while you are lengthening, which reduces your recovery time considerably. I'm sorry, but being stuck in a wheelchair for four months while lengthening two inches does not seem to be the best way to do LL in my opinion. It is laughable to say that the PRECISE has a "considerable advantage" over the Betzbone. If you can't handle the pain of clicking, then you probably can't handle the pain of of muscle stretching, the pain of physical therapy, and the long term pain and fatigue of LL. The Betzbone and the Guichet Nail are still the best way do to LL.

I will admit that there are some people that are probably better suited for LL with the PRECISE than with the Betzbone or Guichet Nail, but I think most of those people might not really be good candidates for LL to begin with.

It was mentioned on the news program that you can lengthen 6 inches in 3 months. This is technically true, and this is the one place where I think the PRECISE is a great option. You can do bilateral lengthening of tibias and femurs at the same time with the PRECISE. I would normally not advocate for such a thing, but under Dr. Paley's care and with this technology (once he has the 8 cm nails) I think it is a viable option. You would be stuck in a wheelchair for a minimum of four months, and recovery would take longer because you would not be weight bearing, but it would be the absolute fastest way to gain a large amount of height and recover. Once the 8 cm rods are available, you could be 6.5 inches taller and up walking without crutches in as little as 5 months. Awesome.

Apotheosis

Now,
8 cm nails are supposed to be approved this summer AND supposed to be "4 times stronger" which some would say should mean "200 lbs each" and thus "weight bearing". Also, add the idea of solid titanium rod replacement.
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LLGrateful
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« Reply #13 on: June 06, 2013, 08:20:50 PM »

Mantra's reply to Apotheosis, and the same 5 cm per segment theory for simultaneous quadrilateral lengthening as mentioned by Paley in the Doctor's section of the forum. Me mentioning this here is more about collective psychological acceptance and thus a potential diminishing of the stigma in the medical community. If I were only interested in the scientific theory behind this, I would keep this conversation between my brain, medical journals and private emails with physicians. In other words, part of the reason why a doctor might tell you that this should not be done is because of what people think more than because of what the facts are. Here is a link to thread I am recently referencing: http://www.makemetaller.org/index.php/topic,4788.msg54626.html#msg54626

"Insert Quote
Quote from: Apotheosis link=topic=4788. msg54628#msg54628 date=1332538158
It was mentioned on the news program that you can lengthen 6 inches in 3 months.  This is technically true, and this is the one place where I think the PRECISE is a great option.  You can do bilateral lengthening of tibias and femurs at the same time with the PRECISE.  I would normally not advocate for such a thing, but under Dr.  Paley's care and with this technology (once he has the 8 cm nails) I think it is a viable option.  You would be stuck in a wheelchair for a minimum of four months, and recovery would take longer because you would not be weight bearing, but it would be the absolute fastest way to gain a large amount of height and recover.  Once the 8 cm rods are available, you could be 6. 5 inches taller and up walking without crutches in as little as 5 months.  Awesome.   

Apotheosis"

I'm confused about this statement on four segments at once.  Under Paley's information in the recommended doctors list, Paley's info states four segments with external fixators as an option w/ 5cm per segment as a max.  It also states that internals (Precise) bilaterally are one segment at a time.  Just curious if his policy has changed since the info on the recommended list was posted.  I agree if all four segments could be safely lengthened at once w/ Precise and w/ 8cm as possible, then this is a very attractive way to go for someone who wants to do both tibia and femur lengthening.
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Tewmoer
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« Reply #14 on: June 06, 2013, 08:51:35 PM »

I am a little confused: if 8 cm is absolute limit for maintaining safety...than  why would there "be a high risk of complications" ? Unless I am reading your post incorrectly !

Also  why would it "not be easy"...in what sense....pain - discomfort, more preparation required ?

Below is what Dr. Paley told me when I emailed him.  The same answers are in Stadiometer's thread about the 8cm PRECICE   http://www.makemetaller.org/index.php/topic,6073.0.html       

After 6.5cm the soft tissues become very tight and the risk of complications is much higher.  The day to day discomfort especially during stretching and physical therapy will also be much higher.
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Apotheosis
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« Reply #15 on: June 06, 2013, 08:56:50 PM »

It was mentioned on the news program that you can lengthen 6 inches in 3 months.  This is technically true, and this is the one place where I think the PRECISE is a great option.  You can do bilateral lengthening of tibias and femurs at the same time with the PRECISE.  I would normally not advocate for such a thing, but under Dr.  Paley's care and with this technology (once he has the 8 cm nails) I think it is a viable option.  You would be stuck in a wheelchair for a minimum of four months, and recovery would take longer because you would not be weight bearing, but it would be the absolute fastest way to gain a large amount of height and recover.  Once the 8 cm rods are available, you could be 6. 5 inches taller and up walking without crutches in as little as 5 months.  Awesome.         

I said this before personally doing my tibias a short time after doing my femurs. My personal experience would now make me think that simultaneous lengthening of 6.5 inches split between two bone sections would be a bad idea. I also think the immobility while lengthening this much will make recovery take much longer.

If you are going to use the new PRECICE 8 CM, why not just lengthen 3.25 inches in one bone section and come back and lengthen the other one a few months after you are done lengthening and have a reasonable degree of recovery? Especially if the new one provides partial weight bearing? A few months of your life on crutches is much better than risking complications because you pushed your body too fast while being in a hurry.

You should never try to rush anything while doing leg lengthening. Be careful, be sane, and listen to your body.

Apotheosis
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My personal apotheosis to the very best me I can be. Starting height: 171 cm. 9.5+ cm added to femurs. 10.5+ cm added to tibias. Final Height: 189.5 cm +/-

My femur diary: http://www.makemetaller.org/index.php/topic,3530.0.html
My tibia diary: http://www.makemetaller.org/index.php/topic,4202.0.h
Donnie Brasco
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« Reply #16 on: June 06, 2013, 09:24:34 PM »

Below is what Dr. Paley told me when I emailed him.  The same answers are in Stadiometer's thread about the 8cm PRECICE   http://www.makemetaller.org/index.php/topic,6073.0.html       

After 6.5cm the soft tissues become very tight and the risk of complications is much higher.  The day to day discomfort especially during stretching and physical therapy will also be much higher.

Actually for me and a few other patients I've spoken to, lengthening became much easier after the 5-6cm mark. For me personally, from 1-2cm was easy, 3-5cm was a rough patch(mainly temporary muscle spasms, knee tendons pains), 5cm and onwards was wasn't bad at all and quite easy I can say. This whole procedure is very relative and personal. Some have a real tough time through the whole procedure, while others breeze through it and like Apotheosis mentioned in his diary "you won't know until you have the actual surgery". And females patients usually have a easier time compared to male lengtheners.
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« Reply #17 on: June 06, 2013, 09:35:13 PM »

I said this before personally doing my tibias a short time after doing my femurs. My personal experience would now make me think that simultaneous lengthening of 6.5 inches split between two bone sections would be a bad idea. I also think the immobility while lengthening this much will make recovery take much longer.

If you are going to use the new PRECICE 8 CM, why not just lengthen 3.25 inches in one bone section and come back and lengthen the other one a few months after you are done lengthening and have a reasonable degree of recovery? Especially if the new one provides partial weight bearing? A few months of your life on crutches is much better than risking complications because you pushed your body too fast while being in a hurry.

You should never try to rush anything while doing leg lengthening. Be careful, be sane, and listen to your body.

Apotheosis

How exactly has your experience altered your analysis? Something about the pain and recovery. What specific pain and where specifically? Is this about significant stress noticed around the knee soft tissues? How has your ROM (Range Of Motion) been with your knee as you added more length to your tibias after you already stretched tissues so much with your femurs? How has recovery been? Including and beyond this, please try to describe all nuances that you take into consideration while stating your new perspective.
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« Reply #18 on: June 07, 2013, 12:01:37 AM »

Actually for me and a few other patients I've spoken to, lengthening became much easier after the 5-6cm mark. For me personally, from 1-2cm was easy, 3-5cm was a rough patch(mainly temporary muscle spasms, knee tendons pains), 5cm and onwards was wasn't bad at all and quite easy I can say. This whole procedure is very relative and personal. Some have a real tough time through the whole procedure, while others breeze through it and like Apotheosis mentioned in his diary "you won't know until you have the actual surgery". And females patients usually have a easier time compared to male lengtheners.

This is interesting. Could you, perhaps, tell us a little more about yourself? (i.e: age, height, weight, original height, goal, etc...) I'm young and very thin, and I heard that being young/thin makes lengthening a bit easier than older/bulkier people.
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« Reply #19 on: July 24, 2013, 03:45:53 PM »

Apotheosis
thank you for your detailed diary.  I have been reading it. 
I am an 18. 5 year old who has not grown in 3 years.  my friends have past me.  I am starting college in the fall.  I am 5 foot 6 and half inches.  I would like to be taller.  however, I am concerned about recovery.  it looks like it took you over 2 years and you are still not running or playing sports.
playing sports has been my outlet for feeling good about myself.  I have worked hard and been a good American footballer, basketball and lacrosse.  I have varsity letters in all three.
I am concerned with having to give this up.  what do you think ?
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