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Author Topic: Yardbird's Bilateral Tibia Lengthening w/ Dr. Shahab Mahboubian, D.O. CA, USA  (Read 26215 times)
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Yardbird
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« on: May 24, 2016, 05:24:44 PM »

Hello all,

I have just returned home following bilateral tibia lengthening with orthopedic surgeon Dr.  Shahab Mahboubian, D. O.  performed at Providence St.  Joseph's Hospital in Burbank, California U. S. A.  The surgery took around 6 hours to complete, and was followed by a two day stay in the hospital before being discharged.  I have a follow up appointment with the doctor this coming Friday.  There is a lot of information to share.  As is the custom, I will begin with some basic stats:

Age: 33
Gender: Male
Location: southwest USA
Pre-operative height: 170 cm (this is my second limb lengthening.  I was previously 163. 5 cm before lengthening my femurs)
Lengthening goal: 6. 5 cm
Method: Internal lengthening of tibias/fibulas using the Pecice II internal nail

I will post a more detailed discussion of the steps involved in setting up this procedure in the coming days.  I also need to read more about how to post pictures to this thread.  I have many photos that I'd like to share.  Many thanks to the members of this forum for providing the courage and inspiration necessary to undertake this life-changing procedure!



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SysOp
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« Reply #1 on: May 24, 2016, 10:01:48 PM »

Hello all,

I have just returned home following bilateral tibia lengthening with orthopedic surgeon Dr.  Shahab Mahboubian, D. O.  performed at Providence St.  Joseph's Hospital in Burbank, California U. S. A.  The surgery took around 6 hours to complete, and was followed by a two day stay in the hospital before being discharged.  I have a follow up appointment with the doctor this coming Friday.  There is a lot of information to share.  As is the custom, I will begin with some basic stats:

Age: 33
Gender: Male
Location: southwest USA
Pre-operative height: 170 cm (this is my second limb lengthening.  I was previously 163. 5 cm before lengthening my femurs)
Lengthening goal: 6. 5 cm
Method: Internal lengthening of tibias/fibulas using the Pecice II internal nail

I will post a more detailed discussion of the steps involved in setting up this procedure in the coming days.  I also need to read more about how to post pictures to this thread.  I have many photos that I'd like to share.  Many thanks to the members of this forum for providing the courage and inspiration necessary to undertake this life-changing procedure!

Thanks for telling your story. Where did you lengthen your femurs?
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Yardbird
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« Reply #2 on: May 25, 2016, 06:48:49 AM »

SysOp,

I lengthened my femurs over 7 cm with Dr.  Guichet back in 2009.  He is an outstanding surgeon and I can safely recommend him to others - particularly to those who enjoy a very active lifestyle, and are interested in lengthening their femurs quickly and with minimal disruption to their daily routines. 

It's been six days since my tibias operation.  I am feeling better and better each day.  Although I had considered several less expensive overseas options, I am amazed at the quality of care administered in a U. S.  hospital and I am very happy to have spent the money to do this safely at home.  My advice to others is to put in the hard work, make the necessary sacrifices, and pay for the highest quality you can possibly afford the first time.  Your future depends on a good functional result.  Trying to cut corners on a major orthopedic surgery leads to costly, long term complications and places a heavy financial burden and unnecessary stress on yourself (and possibly those around you).  It is in the nature of human beings to discount serious risk and replace it with unfounded optimism.  Make no mistake . . .  this surgery is a risk.  Please be safe and choose to minimize your risk.  I will update this diary tomorrow with specific information pertaining to the initial consultation, total cost of surgery and payment options, travel arrangements, and transportation. 
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nextinline34
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« Reply #3 on: May 25, 2016, 07:40:48 AM »

After lengthening your femurs, what % did you return to athletically?

Im looking to do 4 inches. 2 in femurs 2 in tibia. Tell me the honest truth about what I can expect, please. (Athletically and just normally)
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Yardbird
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« Reply #4 on: May 25, 2016, 09:57:34 AM »

nextinline34

After lengthening both bone segments 2 inches, your athletic ability will most likely be somewhat diminished compared to your original condition (assuming you are currently in peak physical shape).  However, if you invest in a top-quality surgeon, lengthen a reasonable amount (as you plan to), and dedicate yourself to the physical rehabilitation process, you can expect to return to a high level of athleticism afterwards.  As for an exact percentage, it is difficult to say, as it is dependent upon many factors.  However, we can look to certain veterans such as SysOp and Tall as indicators of what is possible in terms of recovery following two bilateral lengthening procedures.   
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Yardbird
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« Reply #5 on: May 25, 2016, 02:08:15 PM »

For those interested in having this procedure performed by Dr.  Mahboubian, the following steps must be taken:

1. ) The first action is to schedule a consultation.  This initial meeting is held at the doctor's office located at 10640 Riverside Drive, North Hollywood, CA 91602.  The cost of the consultation is $600 and is out-of-pocket.  During the consultation, you will discuss your lengthening goals and the available methods (external vs.  internal), as well as the risks and benefits associated with each method.  You will take x-ray images of your femurs or tibias to determine whether your procedure is purely cosmetic, or can be covered by medical insurance.  The images will also determine the appropriate nail diameter to be ordered from the manufacturer.  You will be given plenty of time to ask the surgeon any questions you my have related to the procedure, and he will answer all questions fully (it is recommended that you prepare a list of questions for your consultation, as there may be things you forget to ask once in the office).  Finally, you will be notified whether or not your case can be covered by insurance.  If not, you will be given a price estimate to be paid out of pocket.  This estimate is good for one year from the date of the consultation.  There are two separate costs associated with the estimate.  The smaller cost is the surgeon's fee and is payable directly to Dr.  Mahboubian's office.  The larger cost is the facility fee and is payable to Providence St.  Joseph Medical Center, Burbank.  Contact both the doctor's office and the hospital by phone to inquire about a prompt payment discount (you may be able to save several thousand dollars by paying directly in cash or by cashier's check).  In addition, Dr.  Mahboubian's office may offer a promotional discount through email that is good for a limited period of time. 

2. ) The next action is to secure a surgery date by putting down an initial deposit.  The initial deposit is in the amount of $5,000.  It can be paid in cash, by check, or by credit card.  In order for your deposit to be refunded to you, you must cancel your surgery within a specified number of days before the procedure.  Otherwise, your deposit is non-refundable and can only be applied to a surgery at some later date. 

3. ) Once you have scheduled a surgery date, you must arrive in L. A.  two days prior for a pre-operative clinical screening with Dr.  Dardashti and a pre-surgery appointment with Dr.  Mahboubian.  Dr.  Dan Dardashti, M. D.  is an internist located at 12626 Riverside Drive in Valley Village.  During the pre-operative screening, you will provide a urine sample, your blood will be drawn, and you will be asked a series of questions about your medical history, any underlying conditions you may have, any medications you are taking, and any allergies you are aware of.  You can pay for this appointment out-of -pocket or it may be covered by your health insurance plan.  Located below Dr.  Dardashti's clinic (in the same medical building) is the A TO Z Discount Pharmacy Ph.  (818)985-8151.  Any prescription written by either Dr.  Dardashti or Dr.  Mahboubian can be filled here.  Following the screening, you must go to Dr.  Mahboubian's office for your pre-surgery appointment.  During your appointment you will sign a consent form acknowledging the risks associated with the procedure, receive a prescription for painkillers and blood thinners to be taken after discharge from the hospital, and address any final questions/concerns you may have.  Before leaving the office, you must pay the remaining balance due on the surgeon's fee (remember to pay by cashier's check for a discount!).

4. ) You will have a day to yourself between the screening and the operation.  Use this time to drive to the hospital and pay the facility fee (in cashier's check for a discount!).  Also, return to A TO Z pharmacy to fill your prescription for Hydrocodone (Norco) and Xarelto.  I tried several chain pharmacies first, but none of them carried these drugs.  A TO Z has been used frequently and has Dr.  Mahboubian's office on file.  Providence St.  Joseph Medical Center is located at 501 S.  Buena Vista St.  in Burbank.  It is easily accessible off Ventura Freeway.  Visitor parking is free for the first half hour while you go into the main building and visit the cashier's office to pay the hospital bill.  The fee for anesthesia must be paid separately over the phone.  You must provide them with the location of your surgery (Providence St.  Joseph - Burbank) and a valid credit card number.  The anesthesia fee is around $1750.  Parking at A TO Z pharmacy is cheap.  However, remember to carry a few dollars in cash! Some parking garages do not accept credit/debit cards. 

5. ) Return to your home or hotel and get some rest.  Try to empty your bladder and bowels and do not eat anything after midnight. 

6. ) Return to the hospital by 6 a. m.  the next morning and check in at the admissions office.  If you're driving yourself, you can leave your car in visitor parking.  The maximum daily fee is $6.  Since you will be there about 3 days, the total cost will be less than $20, payable by cash, debit, or credit card.  Following admission, you will be transferred to the second floor (short stay) where you will be met by a nurse who will take your blood and vitals and prepare your body for surgery.  You will also meet briefly with Dr.  Mahboubian and the anesthesiologist before being transferred to the surgical ward.  You will soon lose consciousness and wake up in the afternoon in a single occupancy room.  The next days will be difficult.  Try to be patient while you slowly recover form the trauma and the effects of the anesthesia. 

. )  
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mgibson77
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« Reply #6 on: May 25, 2016, 09:35:59 PM »

Hey Yardbird,
thanks for the detailed info on your procedure. I've enjoyed reading it from top to bottom as it recounts everything I had to do before and after my own surgery on 2/18/16.

Wish you all the best in this final stage of your lengthening goal and we'll be following your progress.

Just a few questions for you.

1. It is my understanding that for the tabia, the nail is inserted via a cut to the knee, are you able to bend your need comfortably when sitting in the wheelchair?

2. For femur, or the cuts are made on the outside of the femur(as opposed to the inside), is this the same on the tibia?

3. For either of your surgeries (the previous one or this one), are you considering scar treatment to reduce scar visibility?

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mgibson77
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« Reply #7 on: May 25, 2016, 09:37:58 PM »

corrections:

tabia= tibia
2. For femur, or the cuts  = 2. For femur, all the cuts
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Yardbird
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« Reply #8 on: May 26, 2016, 01:17:19 AM »

mgibson77:

1. ) The patellar tendon is split down the middle to insert the nail into the tibia.  I asked the doctor about the possibility of chronic knee pain with this method, but he assured me that this would not be a problem.  I can sit in a wheelchair with my legs bent.  There is constant, low-level pain.  So far I wouldn't say that the tibias are any more or less painful than the femurs were.  The pain experienced seems pretty similar in both cases.  Of course, pain can be adequately controlled by the prescribed medication. 

2. ) I'm actually not certain about this.  I'll have to ask during my appointment on Friday

3. ) My legs are naturally covered with dark hair.  The hair obscures any scaring from the surgeries and the scaring is minimal anyhow.  I will have the scars removed very far down the road -  if at all. 

At the moment I'm a bit concerned about some looseness I am experiencing around the right ankle where screws fixate the tibia to the fibula.  While the left side feels very stable and secured, I can feel shifting of bones on the right side when I rotate my ankle or perform certain other motions.  My worst suspicion is that a screw has come out of place.  On the other hand, it may be just my imagination, as I am regaining sensation in my lower legs and experiencing all sorts of strange aches and pains.  I will be able to either confirm or dispel my suspicion when I have x-rays taken this Friday. 
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Yardbird
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« Reply #9 on: May 26, 2016, 01:10:32 PM »

Update:

Feeling better each day. Looking forward to by post-op appointment tomorrow morning. I apologize if this seems like a dumb question, but can someone explain to me in simple terms how to attach photos to this diary? I see that there is an option entitled "Insert Image" Clicking on it produces the following:

Do I need to type the image file name between the two brackets? I have good photos to share and would like to get them up.

-YB
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mgibson77
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« Reply #10 on: May 26, 2016, 08:35:22 PM »

Thanks for the detailed info. I was particularly concerned about the knee and where the incision is made but your answer clears that up.


I was probably not clear with my question in #2. I should have said incision and not cut. Cut makes it sound like I'm asking for where the bone is broken/cut but that's not what I meant. I meant the incisions for the screws and ultimately cutting of the tibia/fibular bones. For the femur, all incisions are on the outside of the foot, is this the same for the tibia? And by inside/outside, I don't mean in the flesh vs outside the flesh, I mean for example, inner thighs vs the other side of the thigh.

Of course,  you will get definite answers from the doctor regarding your concerns but I don't think there's a problem with screws being loose. I remember experiencing different types of pain the first few weeks post-op and even afterwards. A particularly trouble one was under my left butt-cheek going down the left hamstring. It woke me up in the middle of the night several times for about a week so I limited the amount of walking (on the walker), took more Norco (not recommended unless absolutely necessary) and most importantly did a lot of icing. Icing will be a good tool throughout the process. You can get some of those refrigerator-friendly ice pads from Walgreen or CVS. 

You probably know this but don't finish your Norco before the refill date because pharmacies wont refill early and you could be left in pain for days before you get your next prescription. I made that mistake with my first prescription because I was taking 4 pills a day. :-). I took 4 a day because of the problem describe above.
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Yardbird
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« Reply #11 on: May 26, 2016, 10:06:46 PM »

mgibson77:

Thanks for the heads up. I've been taking 2 Norco every 4 to 6 hours since I woke up and was taken of the drip. Did your prescription have a refill date? I was prescribed 80 pills initially with no refills indicated. Hopefully, I can get more when this bottle runs out because this stuff is magic!   Grin
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mgibson77
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« Reply #12 on: May 27, 2016, 10:51:05 PM »

Let me clarify on the refill statement I made.
I don't know whether this rule applies to your state; I'm only speaking with respect to my state, California.

Lets say you visit the doctor on May 1st and get your prescription and process it on that same date to get your 80 pills.  Lets say your next visit to the doctor is May 16th. You visit and then get another prescription because you told him you're running out of Norco.

Lets say to control overdose, the pharmacy in your state or by some Federal law, you cannot get more Norco's untill May 22nd (3 weeks from your first prescription on May 1st).

In this case you'd have to wait (without your magic Norcos) till May 22nd.
I went through this situation during my first two weeks post-op because like you said, those Norcos work magic. :-)

The pharmacies in Cali have a certain date on which you're supposed to finish your 80 pills. I don't know if this is a state or Federal requirement so Call them and ask when you can go in with a new prescription to get another set of 80 pills.
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Yardbird
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« Reply #13 on: May 28, 2016, 04:01:10 AM »

mgibson77:

Thanks for your reply. I'm going to try and cut back so that I don't run out. Without these pills, things could quickly become very unpleasant! On another note, I had my first postop appointment today. Dr. Mahboubian was out of the office and I won't meet him again until next week on Tuesday. However, I met with a representative from Precice to receive the magnetic lengthening unit and for a demonstration of the machine. I am stunned by how straightforward and painless this device is. I lengthened  0.25 mm in the office at 12 pm, another 0.25 mm when I got home around 6 pm, and I will lengthen the final 0.25 mm later tonight. Unexpected complications notwithstanding, the intense, dramatic phase of this journey is over. Now it's more or less a slow and steady path to the finish line. So far, I would certainly recommend this surgeon and device to prospective lengtheners.

-YB
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Yardbird
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« Reply #14 on: June 02, 2016, 07:00:04 PM »

Update:

I had my first post-op office visit with Dr. Mahboubian on 5/31. He was very happy with the condition of my lower legs and noted that he had added extra screws to stabilize the bones and prevent any migration during lengthening. The incisions are extremely small and should fade nicely over time. I have been lengthening both limbs 0.75 mm each day, and am currently around the 0.5 cm mark. My surgery was exactly two weeks ago today. I must say, what a difference that two weeks makes to your overall physical and mental state! To those who will pursue this procedure, I offer the following advice: When you wake up from the anesthesia in a hospital room and look down helplessly on your two broken legs - swollen, wrapped in gauze, and covered in ice, with a catheter draining your urine and an IV delivering saline and antibiotics through your hand - you may think to yourself, "What have I done!!! I've made a terrible mistake!!!" If this thought crosses your mind at that time, just try to relax and get some sleep. Each day you will notice your mood improving and strength returning to your body. You have to really want to be taller to put yourself through this - and I did. That being said - if you know you really want this - go for it. Just be prepared for those difficult first two weeks ...
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TIBIKE2002
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« Reply #15 on: June 02, 2016, 10:43:24 PM »

I wanted to ask you, why are you doing a second LL procedure? Is it because you are not content with being 170 or any other reason?

 Have a safe LL
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Yardbird
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« Reply #16 on: June 02, 2016, 11:07:29 PM »

I wanted to ask you, why are you doing a second LL procedure? Is it because you are not content with being 170 or any other reason?

 Have a safe LL

I chose to do LL because I wanted to be taller ... and for no other reason. If you start out as short as I did (163.5 cm), a single procedure may not be enough to get you where you want to be. For all sorts of personal and professional reasons, I desire to be at least as tall as the average male in my native country. Human society is a ruthless, Darwinian struggle with the outward appearance of civility! And let's be honest ... women do love their tall heels!
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TIBIKE2002
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« Reply #17 on: June 03, 2016, 12:46:34 AM »

Of course it is to be taller hehe.  But I just wanted to know why you want to do another one at the height of 170.  Do you still feel the heightism at your new height which might be somewhat short, but not like "Omg you are short"?
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Yardbird
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« Reply #18 on: June 03, 2016, 01:53:43 AM »

Of course it is to be taller hehe.  But I just wanted to know why you want to do another one at the height of 170.  Do you still feel the heightism at your new height which might be somewhat short, but not like "Omg you are short"?


I do still experience heightism at 170 cm, but not nearly to the extent that I previously did. If I really examine my motivation for doing this though, I must admit that ... really I just want this one thing for myself. I have an image in my mind of what I want to look like. I know that being 176 or 177 cm will just look and feel right for me. I will be who I should have been always, but wasn't. Also, I do think that lengthening both bone segments a moderate amount produces a better aesthetic result than does lengthening a single segment an extreme amount. Of course, this is all subjective. Each person must decide what is best for himself/herself.
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TIBIKE2002
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« Reply #19 on: June 03, 2016, 04:40:26 AM »

How did you experience heightism at 170?
  Sorry for all these questions. .  I am 171 myself and am just curious about other people experiences at my height.

 Have a safe and quick lengthening
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