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Author Topic: Bilateral Femurs Dr. Mahboubian Sept 2015 - LongCoolWoman81)  (Read 2624 times)
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Tall
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« on: April 03, 2016, 01:46:23 AM »

LongCoolWoman81) requested that I start a new diary for her about her femur lengthening with Dr. Mahboubian.
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LongCoolWoman81
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« Reply #1 on: April 15, 2016, 10:09:04 PM »

Hey guys! Dr.  Mahboubian asked me at my appointment last week to share my   experience with the forum.  Hopefully it answers some questions and gives some perspective from the female side for you future LLers :) the diary is kind of a general overview because it's looking back on the experience rather than a day to day, but I tried to recount important facts/thoughts I had while I was going through LL that may be helpful for others.

Let me start with my background.  I feel like I'm a little different than the routine LL patient in a few ways. . .

I wasn't a short kid by any means.  I've always been comfortably average when It came to height.  For some reason, this always bothered me though.  I could remember measuring myself obsessively with a tape measure at 12 years old, hoping the final height the doctor predicted for me would be off by and inch or two. . .

Throughout high school and college this discomfort with my height continued to bother me.  (I am currently mid twenties)  I stopped growing at about 5'4-5'5--a very respectable height for women.   I felt "wrong" though, like my personality and identity did not match with my outward appearance. 

It's still not completely understandable to me as I write this. . 5'6-5'7 has always seemed more "me" though.  I felt guilty and weird about being so obsessed with it but finally I couldn't take it anymore.  I heard about precice limb lengthening and thought, this is the answer to all this crazy mental anguish!

Because I'm very athletic and my occupation requires fitness (I work for the government) the only two doctors I ever considered were Dr.  Paley (florida) and Dr.  mahboubian (Cali).  The only surgery I felt comfortable with was the precice method since it is much safer with less complications than other methods. 

I ended up choosing Dr.  Mahboubian because he is closer to me geographically than Dr.  Paley.  He is also a little more relaxed about distance during lengthening and traveling back and forth (Paley requires patients to stay in Florida the entire lengthening time and this was impractical for me with work. )

I knew I had made the right choice as soon as I met Dr.  M in person.  He is very warm and caring and didn't make me feel uncomfortable about wanting the surgery even though I was average height.  I'm pretty intuitive with people and I trusted he would be the best choice for me and a 100 percent safe recovery.

After talking with him I decided on bilateral femurs.  There is less risk of complication (it's one bone instead of two) and the lengthening is finished faster. 

 ( as a side note: if your a female femurs are Definently the way to go in my opinion.  Femur lengthening shapes your legs beautifully and they look very proportioned :)

Dr.  M is not cheap by any means.  Bilateral femurs are around 70000.  Money is less a factor than safety for me though and the idea of finally shedding my height dysphoria for good is something I couldn't put a price on.  (If you are a federal employee certain parts of the procedure may be covered by insurance as well--check with your provider. )

Week before:

I flew into Cali about a week before to prepare for the surgery.  ( you want to do this because you need to get blood tests, a psych eval, and complete a pre surgical consult with Dr.  M. ) you also need to pay up front for the procedure ( your insurance may or may not reimburse) so I utilized a few personal loans and a credit card for the rest of the money I didn't have on hand. ) I suggest contacting the office for more information about the payments you are required to make. )

Day one:

I was very nervous but excited walking into St.  Joseph's medical hospital.  You come in at 5 am to process downstairs in billing.  There you need to pay in full (about 40000) then they admit you upstairs to start the surgery.  ( I had some conflict with the hospitals billing because they told me the procedure would be billed through insurance first when i talked to them earlier that week.   Luckily Dr.  M remedied this and the issue was resolved.  He was super helpful and really wanted to get me into surgery as soon as possible.   Be aware they WILL expect you to do this though and may make you reschedule if you can't provide the full amount of $$ the DAY OF.

When I finally got upstairs a team of nurses and techs were waiting for me to help me get into a robe and do a few last tests before the surgery started.  This is the part where you start questioning your sanity a little. . lol.  I was alone for the procedure so that made it a little more nerve wracking.  Definently recommend a family member or friend for support if they are available. 

I requested meds to calm me down a bit and the nurse started an IV for me which helped me relax and mentally prepare as I was wheeled into the operating room.  Dr.  M and his team greeted me and he asked me what music I wanted to listen to while they were doing the operation.  I requested Led Zeppelin.  They started to pump the general anesthetic and I was out in a few minutes. 
-----------------------------------------------
Post Op:

Waking up was not a comfortable experience for me.  I felt no pain but all I could remember Was how thirsty I was.  All I wanted was water and the nurse would only let me suck on icecubes for the first hour or so.  I remember looking down at my legs and being shocked at how swollen they were. 

I was wheeled into a private room and given a dialaudid button to push.  (Basically one of the strongest painkillers in the world) I remember being in and out of sleep the rest of the day for the most part. 

Day 2:
The second day was probably the most painful day of my life.  I consider myself to have a pretty high pain tolerance and I've been through a lot mentally and physically, but the first few weeks in general fluctuate  around a pain scale of 1-10 with a pain rating 8-65.  You Definently have to be prepared for that. 

Anyways, day 2 Dr, M came in to talk to me and tell me the surgery went very well the next day.  I did have a minor fracture in my right femur but he didn't seem too worried about it (slight risk of compartmental syndrome) I was relieved to hear the surgery went ok.  That was the scariest part to me to be honest. 

The nurses, who weren't completely educated on the exact surgery I had attempted to change my sheets/help me use a bedpan which on a pain scale of 1-10 hurt as a 65.  I got slightly frustrated working with them because some of them were extremely insensitive to how much pain I was in.  Even slight movements such as my foot being lifted an inch sent waves of pain through my whole body and they acted like I was being crazy or something. 

The physical therapist also came in to meet me and work with me on basic movements.  I was in so much pain I didn't do much more than flex and try to sit up at the side of the bed.  I don't even think I did that the first few days. . . he was really helpful and a nice guy too though.  He pushed me a lot but I don't think I would have stood/walked as fast without his help.   

When I was able to finally stand I started with the walker which is what Dr.  M wants you to use initially.  I didn't do much more than stand for a few seconds during my 6 day stay in the hospital.  I was supposed to be 100 percent WB on my left with the walker and 50 percent WB with my right foot ( because of the fracture)  with the walker.

I lagged behind a lot the first few weeks with my recovery from LL.  I'm not sure if it was just my body's reaction or how I reacted to painkillers but I was in a lot more pain then most people are who get precice.  I kept being encouraged to start transfers to the wheelchair and use the walker but I wasn't very successful.  I was supposed to be discharged a few days after the surgery but I ended up being at the hospital a total of six days because movement was so painful.  I remember pulling my body up by the rails of the bed just to use a bedpan.  The whole process took a nurse or two and extremely careful balance.  The one thing that kept me going was hope that the pain would eventually calm down and the fact that I would start lengthening next week :)

Day 6: discharge

I personally wasn't ready to leave the hospital the 6th day. . . I still couldn't do transfers and I couldn't sit up by myself without severe pain.  I had to discharge though because staying longer would be extremely expensive.  I was switched off dialaudid and told to start norco pills which was not as effective pain wise but they gave me less nausea and didnt knock me out every time I took some.  The nurse wanted to send me to an extended intensive care service but i insisted I would be ok at an extended day hotel with nursing help daily. 

I attempted to transfer to a wheelchair but the pain was too severe.  I ended up being transferred in a stretcher by ambulance which looking back was kind of funny but slightly traumatic lol.  I made it to the hotel though and had a home nurse help me with dinner and getting settled that night. 

The next two weeks were still difficult but not  as horrible as the first.  I had a home health nurse and physical therapist from the hospital come to help me daily with physical therapy and meals/bed changes/errands etc.  I went through a lot emotionally because I did not have a friend or relative there for support.  (The surgery is not something I feel comfortable talking about to people I know).  My health nurse was awesome though and we became friendly which was nice. 

The biggest irritation for me was being stuck in one spot most of the day.  Using a bedpan is obnoxious after a while and I was constantly trying to wiggle or shift an inch to make myself more comfortable.  I couldn't move to take a real shower so I had to rely on baby wipes and wipe downs with the home nurse.   The painkillers also made me super sleepy so I was in and out of it a lot.  I spent most of my days watching movies/tv.  I kept working with the physical therapist and was eventually able to transfer effectively around week 2 and could use the wheelchair alone around week 3. 

I was set to fly back the second week after surgery but I ended up postponing it another week because of my difficulty with transfers.  When I did actually get the airport though it wasn't too bad.  The airport is great about handicap service and they got me safely on the plane and back home.  I do recommend calling ahead though so they can plan ahead and provide you a handicap seat on the flight.  The flight was about 5 hours and sitting in the same position with no flexibility is agitating as it is with a seat that has extra legroom. 

Once I got home at the 3 week mark I was proficient enough with the walker to move comfortably.  Dr.  M had removed the weight bearing restrictions by then so I was allowed 100 percent weight bearing on both sides with walker.  Being able to walk with the walker made things considerably easier.  My house is one level so I used the wheelchair/walker to get around inside most of the time. 

The biggest issues I had at that point were everyday errands and the distances of things.  My car for example is a sporty stick shift.  My legs were too weak to push the clutch so I had to switch cars with a friend so I could drive (at about week 3-4 driving was fine since automatic cars don't require much leg strength to control) my neighbors helped me out with grocery shopping, cleaning, laundry etc. 

The lengthening had just started so I didn't feel much pain from that, my legs started to get noticeably tighter which assured me the precice was working.  I also noticed my appetite skyrocketed after I began lengthening.  I would eat 4-5 times a day and still be famished.  I also couldn't get enough sleep.  I think the combination of the major surgery and your body trying to adjust to the new height everyday raise your metabolism a little bit. 

As I got further into the lengthening the biggest challenge was keeping my flexibility and some strength.  I wasn't able to get to the physical therapist 3x a week like I was supposed to.  (Anyone who has done federal service knows the waiting list for physical therapy is elaborate) what I did do was go about once weekly and do the exercises they gave me independently which helped.  I still recommend 3x a week though because it's hard to be motivated about them unless someone is telling you to do them. . . (exercises? Meh they hurt. . maybe after this three hour nap. . . ) lol. 

My only major issue besides everyday tasks was around week 4 when the lengthening really started to be noticeable.  Anyone who has done LL will tell you, there is no pain quite like being stretched like a laffy taffy at the legs.  It is not anything intolerable as long as your stretching and have a good supply of painkillers on hand, but it's a very uncomfortable feeling for sure.  I don't think I slept uninterrupted for more than a few hours every night.  I would sleep, wake up, take painkillers, repeat. 

Around this time I developed a really bad muscle spasm in my left thigh.  This, combined with the fact that my PRimary care doctor would only prescribe tramadol for me had me in tears for a few days before I flew back to meet with Dr.  M for my follow up around week 5.  It was hard because the spasm kept getting worse as I kept lengthening.  I ended up taking two days off in frustration from the 3x a day because I couldn't stand the pain without heavier painkillers. 

After I met with Dr.  M things cleared up considerably though.  He reassured me nothing was wrong with the rods/bones so it Definently was just a muscle spasm.  He gave me a script for Percocet and flexeril.  Long story short I couldn't get the perc prescription filled because of stupid regulations on painkillers in California and where I live.  I did get the flexeril though which helped to relax the muscle and eventually work the kink out.  I also got an hour long deep tissue massage for my legs/quads feet and let me tell you, if you have the money DO this.  It hurts a little while the massage is happening but the result is soooo worth it.  My legs felt 100 percent better after it and I helped me walk way better during the entire lengthening process. 

Around this time (4-5 weeks in) I started noticing my height gain.  I had gained about an inch and was standing about 65. 5.  I couldn't get enough of my legs in the mirror! They looked so long and pretty even though they weren't toned or anything :) I had a brief scare after I paused in lengthening for two days where I wasn't feeling any tug like usual  and freaked out.  I called dr.  M worried they had preconsolidated or something.  He told me to just keep lengthening and eventually the tightness came back again.  I tried to do 4x a day instead of 3 but only was able to do it for about a week before the pain became too much. 

The last 25 or so days (my last inch) was not bad except for the fact that I had to rely on tramadol and flexeril for pain and tightness.  I went back to work around this point.  (I was still on a walker but could do clerical work/computer stuff. ) mostly my days just consisted of staying on routine and squeezing out the last inch I wanted.  I was in the pool as much as I could be ( feels great and helps you stretch better :)

I was considering 3 inches for a while but I kind of had a reevaluation around the second inch.  It felt like a very natural height to me and I was getting to the point where I was in the taller side of the female population (5'6. 5). . . I felt comfortable and I was also very ready to get off crutches and start walking again and enjoy my new legs:)

I stopped lengthening about two months after my surgery which I had mixed feelings about.  What if I wasn't permanently happy with the two inches? I didn't feel like continuing for multiple reasons though.  I went through a lot emotionally and physically and I'm not sure I could have handled another 26 days of the lengthening pain and not sleeping without proper painkiller meds.  I also had a lot going on workwise and lifewise that was mentally heavy.  (Working full time during lengthening is a huge challenge. . your tired/immobile/in pain a lot) that and the last inch was a back and forth for me.  I felt pretty tall already after two inches.  It was a hard decision but I ended up stopping in the end.

(Side note) I ended up switching from a walker to crutches about a month and a half after the surgery.  I didn't discuss this with dr.  M but I worked with a physical therapist who helped me practice a safe gait that was still ok with the WB restrictions.  I don't weigh much (125lbs) and I have good upper body strength so I started using crutches (both legs nonweightbearing) this made life much easier and I could move a lot faster.  I was a little afraid at first ( crutches make you more accident prone) but once my balance was good enough they were not hard at all to transition to.  If you want to do this please talk to dr M first and your pt for sure).

Anyways, once I stopped lengthening (about 2 months after surgery) your just waiting to get better.  The pain in your legs and inflexibility fade away pretty quickly and you can sleep through the night again.  I was able to work pretty comfortably and continued to use the crutches/start walking again.  I stopped going to PT around this time and started remedying myself in the gym with biking, leg press, swimming etc.  As long as your motivated to get better you will do fine IMO.  As I write this I'm still walking with a small limp but it's been about three weeks without crutches and everything is almost back to normal flexibility wise and with basic walking :) I would say I felt about normal again at three months give or take a few weeks).

A lot of people I've talked to ask me if I would do LL all over again, and the answer is a big YES.  The pain was excruciating at certain points and I don't think I had ever cried so much in my life from physical pain or emotional frustration.  To me it was VERY worth it though as soon as I saw the 1 inch gain.  It was literally like I was becoming the person I was supposed to be all along! my body/self image is a million times better, and I feel comfortable in my own skin for the first time since I was like 11 or 12, which is an amazing thing to experience after 15 years of  discomfort and dissatisfaction.  The precice method is very tolerable compared to all the other external contraptions and the only thing I had to manage externally were the very minor scars on my knees and hips (insertion points. ) I can personally recommend Dr.  M as a wonderful choice for LL.  He is a great doctor and really cares about your full recovery.

My experience is a summary so let me know if there are any specific questions and I can do my best to answer.  Tried to make it as complete as possible. ~~~peace and good luck on your LL journey!!

~~~Longcoolwoman (:















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tallerz
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« Reply #2 on: April 15, 2016, 11:20:52 PM »

Great Post,

Would you mind updating us over the next few weeks on your recovery? I'm considering getting this procedure done next may(20-25), but I would have to return to classes late august(25-29).  I am wondering if it is possible to lengthen 7-7. 5 cm in that time span and get back to classes for the consolidation phase.

I am also curious as to the recovery of your athletic ability.

Thanks in advance.
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tallerG4u
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« Reply #3 on: May 01, 2016, 12:01:19 AM »

Thanks for having such a detailed entry of your surgery!

I am trying to decide if I really want to do the LL surgery or not.  My main concern is money.  Did your insurance cover any costs? And if it's not too personal, how did you pay for the surgery?
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Bigfaker
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« Reply #4 on: May 02, 2016, 06:46:46 AM »

Wow, that was a crazy fast (yet very detailed) summary of your lengthening experience!

I'm sure plenty of people would think you're insane to put yourself through the risk and ordeal when you were a woman and not exactly short, but hey we're ALL a bit crazy in this LL World...and on this planet in general. It's just a matter of degree. If you're happy with your new self, that's awesome and all that matters.

It's so bizarre to think of St. Joe's as a LL hospital. One of my nephews was born up there. And being where it is, they also use it in a ton of TV shows and movies.

I think the combination of the major surgery and your body trying to adjust to the new height everyday raise your metabolism a little bit. 
I've read quite a few articles explaining that your caloric needs are greatly increased with just one normal fracture...let alone multiple breaks that are being slowly distracted. It's why so many of us who go overseas lose a bunch of weight during lengthening (that and the crappy food at some places).

Anyway, big congrats on your new height LCW...and your new life.
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Prev. Height: 5'-5.25"/165.7cm (Morning)
External LON with Dr. Raj Sringari - Install: 12/17/13 * Lengthened: ~3"/7.6cm * Frame Removal 04/17/14
Diagnosed with Partial Non-Union: 02/09/16
Ankle Debridement Surgery: 02/22/16
Rev. Nailing/Bone Graft/Tenotomy - Loma Linda Medical Center: 05/12/16
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