I want to take a year off for CLL, Dr. Koehne (Munich) who I consider does it preferably two staged (first one leg and then the other) in order not to end up in wheelchair which I don't want either,
since I plan to do 10cm (femur and tibia, each 5) I wonder if that's even a good plan or a complete nonsense, what do you say? Or should I do femurs first, pause and do tibias later? That might be more expensive too because of the additional surgeries
Initially I thought about doing femurs with precise and then tibias with externals but I can't imagine being done with that in only one year...or is it possible?
Please give me some advice, since I want to do the surgery this year.
(I think Dr. Koehne has learned from Dr. Baumgart but the latter is much more expensive and also recommends to do it in two stages)
Is my plan possible? Please give me an advice
Quote from: Great321 on April 29, 2018, 08:44:45 PMI want to take a year off for CLL, Dr. Koehne (Munich) who I consider does it preferably two staged (first one leg and then the other) in order not to end up in wheelchair which I don't want either,
since I plan to do 10cm (femur and tibia, each 5) I wonder if that's even a good plan or a complete nonsense, what do you say? Or should I do femurs first, pause and do tibias later? That might be more expensive too because of the additional surgeries
Initially I thought about doing femurs with precise and then tibias with externals but I can't imagine being done with that in only one year...or is it possible?
Please give me some advice, since I want to do the surgery this year.
(I think Dr. Koehne has learned from Dr. Baumgart but the latter is much more expensive and also recommends to do it in two stages)
I think on average with what your looking at you’d likely need at least a 1.5 - 2 years for a full recovery I also want to do the same amount of LL as you and in the same amount so any new information you get would also help me out a lot hope that helped though
You can manage 5 cm in unilaterals in a year (approximately 4 months per segment), but definitely not both tibias and femurs. You'll have to abandon one or the other and do it later.
Dr. Giotikas in Greece does the internal/external cross-lengthening. He mentioned he could do 6 cm tibias and 7 cm femurs (13 cm), frames off in 12 to 15 months; this means that 10 cm should take less time. You'll be in a wheelchair and/or crutches for sure.
Thank you for your answers:)
@Android: Dr. Giotikas sounds like a very good option! I will read into it:) I might even have 15 months. He is affordable, too. Munich costs 80.000€ in comparison but there I wouldn't have to pay hotels since I'd live there, too... I wonder how much Athen costs... and how long I should stay there to be on the safe side? The advantage of Germany is that I'd have my family with me, my mom could take care of me for almost the whole process. Well she could be in Greece in the beginning..I might be allowed to go back to Germany for some time of the lengthening..
I found this quote on their website...well Dr. Birkholtz and other members said that externals are better for tibia, here the greece doctor says they recommend precise 2 for tibia..but what about the knee pain?
QuoteWe routinely suggest the tibia PRECISE 2 nail when lengthening of the tibia is contemplated. Only in cases where an intramedullary nail is contraindicated (i.e increased risk for pulmonary embolism, patient not deemed compliant for weight bearing restrictions, need for concomitant correction of bone deformity, patient not willing to be restricted in weight bearing) we recommend the use of circular frames.
@Racurz:I'll start a diary when I start my journey 
It is a good price, especially when you consider that physiotherapy is included. The downside is that while his credentials seem good, there are no patient diaries for Dr. Giotikas. If you look around you'll find information about him as he's a non-cosmetic orthopedic surgeon as well. Just an FYI.
As for how long you'd need to be there, you'll need to be there for the distraction phase, which is about 3 months. Then you can either stay or return home during consolidation, sending the doctor your x-rays every couple weeks. After consolidated, which may take 4+ months, you'll return for the opposite set, and stay local again for another 3 months during distraction.
After which you can go home, but you won't be able to walk unassisted (i.e. without crutches) for a couple months. So you'll be out of Athens in under a year, but do expect to struggle with walking for a while after that, and this is of course if there are no complications.
Quote from: Android on April 29, 2018, 11:27:43 PM The downside is that while his credentials seem good, there are no patient diaries for Dr. Giotikas. If you look around you'll find information about him as he's a non-cosmetic orthopedic surgeon as well. Just an FYI.
That is true indeed. I'll google his name searching for some reviews..because even though there aren't any patient diaries here concerning Dr. Koehne as well, there are a few reviews on the internet outside this forum. Unfortunately you never know if they are genuine.
I noticed that PT is included:) Tomorrow I'll write him/his staff an e-mail soon with some questions.
For example:
- Why do you prefer Precise 2 for tibia although permanent knee pain is linked to the nail insertion? Are externals not safer for tibia?
- How much does MESKA (Mediterranean rehabilitation Centre) costs for a patient monthly or if he/she wants to stay for about 3 months?
- Are there accessible (not too expensive) places you can recommend close to your clinic for patients or their family members?
- How fast can I get an appointment for consultation and surgery?
- How long should I stay in Greece if I want to lengthen 10cm in total. (Either femur and tibia with Precise 2 or by cross-leg lengthening) and is it possible to fly to my home country (Germany) inbetween?
- with which method will I be able to walk normally sooner?
- How many CLL patients do you operate per year?
Are these too many questions? 
I might just get a short answer like: "all these questions will be answered during consultation" Should I ask something different? Any suggestions? If I get an answer I'll post it here
Quote from: Great321 on April 29, 2018, 08:44:45 PMI want to take a year off for CLL, Dr. Koehne (Munich) who I consider does it preferably two staged (first one leg and then the other) in order not to end up in wheelchair which I don't want either, since I plan to do 10cm (femur and tibia, each 5) I wonder if that's even a good plan or a complete nonsense, what do you say? Or should I do femurs first, pause and do tibias later? That might be more expensive too because of the additional surgeries. Initially I thought about doing femurs with precise and then tibias with externals but I can't imagine being done with that in only one year...or is it possible? Please give me some advice, since I want to do the surgery this year. (I think Dr. Koehne has learned from Dr. Baumgart but the latter is much more expensive and also recommends to do it in two stages)
Quite interesting, can you tell us more about this doctor?.. I plan to do the same way 10cm..
If I were you I'd stay in Munich..if the doc is any good and you can afford the price, why bother with an other country.
I would not do one leg at the time, but that's just my opinion. I would prefer to start with 5/6cm femurs and a 1/2 year later 5cm tibia..
keep us informed
@ Honore: here's their website http://limblengtheningsurgery.com/
I think they use precise instead of precise 2 otherwise it would have been mentioned somewhere...
What's the difference between precise and precise 2?
80.000 compared to 54.000 is a big difference though. The re's even more included in the price with the latter. Like PT for 10 weeks, walking aids...and my surgery wouldn't be in August which makes it cheaper to live there...on top of that you'd have to pay PT afterwards yourself and 80.000 is rather my maximum level
Anyways I asked Dr. Betz if they offer externals for tibias since of the risk of long term knee pain, but Mrs. Betz only replied that in all their 17 years they only used internals and that they supposedly never heard of any patient having long term knee pain and she said she doesn't recommend externals for tibia because of reasons like: infection risk and less aesthetic
Dr. Birkholtz says the opposite..I don't know who to trust
Quote from: Great321 on April 30, 2018, 10:23:30 AM@ Honore: here's their website http://limblengtheningsurgery.com/
I think they use precise instead of precise 2 otherwise it would have been mentioned somewhere...
What's the difference between precise and precise 2?
80.000 compared to 54.000 is a big difference though. The re's even more included in the price with the latter. Like PT for 10 weeks, walking aids...and my surgery wouldn't be in August which makes it cheaper to live there...on top of that you'd have to pay PT afterwards yourself and 80.000 is rather my maximum level
Anyways I asked Dr. Betz if they offer externals for tibias since of the risk of long term knee pain, but Mrs. Betz only replied that in all their 17 years they only used internals and that they supposedly never heard of any patient having long term knee pain and she said she doesn't recommend externals for tibia because of reasons like: infection risk and less aesthetic
Dr. Birkholtz says the opposite..I don't know who to trust
Not trying to get into this as I'm no doctor, but I just wanted to say Dr. Birkholtz looks like one of the most ethical CLL doctors to me.
(By the way, you can ask any questions or concerns you might have about these procedures with local orthopedic surgeons of your country. They don't do cosmetic LL, but should be acquainted enough with it.)
Quote from: Great321 on April 30, 2018, 10:23:30 AM@ Honore: here's their website http://limblengtheningsurgery.com/ I think they use precise instead of precise 2 otherwise it would have been mentioned somewhere...
thx mate... i must say that Greece sounds very appealing... good luck making the right choice... do you mind sharing your current height and age? Do you smoke?
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