Hello there! If you are looking for surgery pictures and last week's x-rays, they are on their way, but not just yet. I apologize for the delay as I know some of you have been patiently waiting to see them. I promise that they are coming. I just haven't gotten to transferring them from my phone to my desktop and from there onto my laptop. My desktop has a sim-card reader, but my laptop does not. Why not just blog from my desktop, you ask? Because I can't actually sit at my desk to do so. This requires sitting in a chair and that causes swelling. And we all know that swelling equals pain and discomfort. Couldn't you just elevate your leg on something? Unfortunately, I can't. I had already been doing this for a good four or five months. Doing so requires turning my neck sideways to look at the screen which, in combination with the crutches, causes pinched nerves and numbness/tingling in my hands. As such, I can only choose one of these activities - using my desktop (when I have a perfectly good alternative) or using my crutches. As you might have guessed, I have chosen the latter. The reasons for this are obvious and self-explanatory. So, I sit in bed with my laptop and that means no pictures yet. But that is not why I am blogging today. No! I actually have something quite baffling that I want to bring up.
As any long term reader of this blog knows by now, I have something called an external fixator. It's big, it's blue, it acts as a beacon for attention, it is the bane of my pajama pants and, most importantly, it holds my leg together. I have my external fixator for a very legitimate reason - I had a chronic bone infection that kept coming back, leaving my surgeon with no choice but to cut out 6.5 cm of my tibia. That's not exactly a surgery you can walk away from...and cue the collective groan.
So I have this thing on my leg, and it's being used for something called distraction osteogenesis via bone transport. A loose piece of bone in my leg is moved downwards a tiny bit each day (this is the transport part), and new bone, or it's precursor - cartilage, fills in the ever widening gap between the two ends of bone (the distraction osteogenesis or new bone part). Right now I am in the final stage - compressive loading. In this stage, the entire bone is put under pressure to help the ends at the docking site knit together. This is similar to how the two ends of regular broken bone would knit together and heal. If it wasn't happening to me, it would be fascinating. Oh, who am I kidding. Even with the ex fix securely drilled into my bones, it still is fascinating, albeit painful. But my point is that it is possible to regrow bone. I do not know where I would be without this process. Nor would many other people. It is used to correct limb length discrepancies and regain length lost due to injuries, infections or cancer. Fixtor's themselves can also be used to stabilize fractures, correct external malalignments and, among other things, allow swelling to go down before surgery can be performed to fix a broken bone.
There is, however, another use for external fixators and the whole distraction osteogenesis thing. It is called cosmetic limb lengthening. In many ways, cosmetic limb lengthening works in the same way as re-growing a missing section of bone. There are, of course, some differences, but the main principles remain the same. The biggest difference can be found in the name itself: cosmetic. That's right. There are people going through what I am right now just so that can be taller. Say what?
I first came across the concept of cosmetic limb lengthening while I was watching a documentary about it on TVO. I thought it was absurd and, seeing how I myself am pretty short (5'1". 5'2" if the person measuring me is generous), rather silly. Yeah, there are things that can be a bit more challenging when you are short, like being able to reach items at the grocery store or finding pants that fit without needing to be hemmed, but there are also perks, like the over all cuteness factor and being able to fit into small places. So being short is not an issue for me. Anyways, I watched the documentary, was a bit baffled by it and then kind of forgot all about it.
Fast forward to last September, a week after finding out I would be getting an external fixator and a day or so after being discharged from the hospital, and I found myself sitting at home in front of the all mighty Google. I both wanted and didn't want to know about external fixators. I knew I couldn't avoid them, but by god did I not want to have to accept that I would actually be getting one. Never the less, I typed in those magical words external fixator and presto(!), they popped up before my eyes. Between the tears that followed, I managed to read little bit about them a bit. That was followed by more tears and turning off the computer for the day. I couldn't handle it. Hadn't I already been through enough? After everything, would I really still have to get a metal contraption drilled into my bones like some sort of Frankensteinian monster? I didn't want anything to do with external fixators. All I wanted was to be healthy again and get my ability to walk back.
After getting over the initial shock and inevitable fear and feelings of unfairness, I decided that I wanted to know everything I could about external fixators. I wanted to be prepared. I couldn't control what was happening to me, but at least I could make sure that I was a well-informed patient. So I read and read and read and then I read some more. And between all of that reading, I started seeing links to sites about cosmetic limb lengthening. There I was, sitting in bed, emotionally drained, missing 6.5 cm of my tibia and dreading what I was going to go through while looking at a forum of people who wanted to willing do it, despite all the risks, just to be a bit taller. In a way, it is beyond comprehension. I had absolutely no choice; meanwhile a perfectly healthy person was contemplating something horrific, and for what? To get more dates at the bar? Be taller than his/her peers? Become a model? Because they thought that being taller would increase their self-confidence?
Those are actually the reasons people gave on those forums - job success, self-confidence, finding a date or spouse, modelling, feeling more self-confident. All of these people thought that increasing their height would somehow improve their lives or solve their problems. All I could think was that they seemed pretty fixated on one thing - their height. Height is not the most important thing in life. Given the huge problem's faced my countless people around the world on a daily basis, I think that height is actually quite insignificant. And anyways, if you are that unhappy with your life that you are willing to go through a process as barbaric as limb lengthening, and it really is barbaric, being a few inches taller will not solve those self-esteem or self-worth problems. Instead of learning to love and accept themselves, these people want to undergo major surgery, months (often longer) of pain, discomfort, and infection risks, and gamble against all the complications that could arise for something as trivial as height. In that time, they will be completely dependent on other people; they can't accomplish any of their daily needs - cooking, cleaning, laundry, groceries; their careers will be on hold (possibly those of their family members who are acting as caregivers) as well. The list goes on and on. It just absolutely baffles me.
To try to comprehend why anybody would do this to themselves is pretty difficult, if not impossible. This is especially difficult to do for individuals who are forced to go through this process for legitimate medical reasons - people do not have a choice I, for one, can't understand how somebody would willingly opt to this and therefore willingly go through months of pain, uncertainty, and mind numbing boredom as they sit at home for months on end. In addition to all that, it costs a hell of a lot of money. From what I have read on sites, like the ever controversial Make Me Taller, getting cosmetic limb lengthening comes at a hefty price, often upwards of 100,000$ dollars (both legs included!).
I can't grasp why people would do it but I can think of quite a few reasons why they shouldn't:
1) In relation to everything else, height is pretty irrelevant. Yes, there are issues with height-ism in the world, especially in places like China and India. Height discrimination even happens in the Western world - women seem to prefer taller men, models have to be really tall, tall people have an easier time finding work in the upper levels of big corporations and taller people are often taken more seriously than shorter individuals. But is it worth the time and money to lengthen your legs? As a shorter person, people often assume that I am very young and therefor treat me like a child just because of my height. This is not fair, but I get over it. While it can be a nuisance, would I really spend one-hundred grand, risk everything that could go wrong, and go through all that pain/discomfort, plus the inherent risks of any surgery, just to be a bit taller? Hell no. I would learn to be happy with who I am.
2) As previously stated - cosmetic limb lengthening costs one-hundred freaking grand. That's half a house. That would pay for both my entire college and university tuition twice and there would still be money left over. A retirement fund, a nice car or vacation, a way to help a non-profit organization. People can do what they want with their money, but it seems so wasteful to spend it on being, at max, 2.6 inched taller. That's not even that much height! The muscles and tendons in your legs, like the achilles tendon, can only stretch so far before they are irreparably damaged, leading to something called foot drop or ballerina foot. If you don't want to risk foot drop, the safe limit for cosmetic lengthening is 2 inches or 5 centimeters. Is that really worth 100,000$? If you have to pause for even a moment to think about this, I would refer you back to number one - work on your self-esteem and self-worth.
3) The risks. This is a giant can of worms, ranging from the foot drop mentioned above (which, by the way, often requires surgery to fix or wearing special lifts in your shoes for the rest of your life), non-unions (ends of the bone fail to knit together once lengthening is done or the new bone fails to harden properly), chronic bone infections (that's what I had), hardware failure (the fixator actually breaks and needs to be replaced), pin site infections, permanent nerve damage and the inherent risks of any surgery. Is it worth it? No, no, no. A thousand times no!
4) Fixators cause pain and discomfort. Pain medication helps and can be tailored to each individual, but there is no way it can be avoided altogether. On a daily basis I experience bone pain, nerve pain, muscle pain and tissue pain. That's a lot of different types of pain. I am on long acting pain medication 24/7 and have fast acting medication for break through pain. Usually it covers everything, but it's not always enough, leaving me lying awake in bed at night for hours at a time. The external fixator has caused some of the worst pain that I have ever experienced. Te worst pain is often bone pain. And then there are the aches and pains that come from muscle wastage and weakness, muscle stiffness (I can't bend my toes anymore), and pain if you bump the fixator into something (as careful as you are, it will happen at some point).
5) Speaking about pain and discomfort, you will get it from using your crutches. It doesn't matter how strong your upper arms are or how properly you use the crutches; it is unavoidable. After eight months, I have major callus on my palms, I get tingling (and sometimes numbness) in my hands, and the muscles in my back and around my neck or insanely tense. Combined with the pain and discomfort caused by the fixator and the inability to walk on my right leg and the muscles wastage in my leg and loss of endurance overall, I feel like a frail elderly woman. I get excited when I see a grab bar in the bathroom to hold onto; it can be difficult to stand up from a sitting position - sometimes it takes me several attempts. By body is exhausted. So limb lengthening doesn't just affect a person's height; it affects the whole body over the course of however long the limb lengthening process will take, which is often a year or more). It is also important to keep in mind that the long term use of crutches can cause permanent nerve damage in your arms/hands. Is this all worth a few inches of height? You tell me...
6) As numbers four and five illustrate, the whole thing plain old sucks, and it's not over when the fixator comes off. Once my leg is better, there is the challenge of learning to walk again and getting my over all strength back. It's not just about your time in the external fixator. So something taking a year or year and a half instantly turns into something much longer, and some side effects or problems that pop up are permanent, and that means life long.
7) Depending on how much length you grow, you might have to give up physical activities, like high impact sports. It being two inches taller worth giving up something that you love?
8) Although I am the one with the external fixator and it is in many ways an immensely personal battle, this process has had a profound affect on my entire family. Beside my self, of course, this ordeal has affected my mum more than anyone else. She is with me every step of the way. She is there in the waiting room as we wait anxiously to see the surgeon. She is there with me in the car when we drive to the hospital. She is there with me when we get bad medical news. She is always there at the hospital, anxiously waiting for me every time that I have surgery. She is at home with my when I break down and cry or say that I can't do this any longer. Although in a different way, it affects her too. Is it fair of you to impose this on your relatives? Do they agree with your choice? If they do not, are you going to do it anyways, ultimately meaning that they have to care for you anyways? Do you realize that it affects their lives and can put their own plans on hold? Is it fair of you to place your desire to be a little bit taller ahead of their needs or goals? Have you considered that your choices affect others; that your parents go through all the stress of the whole getting longer legs process too? Will they have to listen to you moan and complain about the pain or discomfort you are going through, or get upset about any complications that arise, all which were completely preventable if you didn't do it to begin with? These are important questions to ask. When you read the following sentence, keep in mind that you are talking to someone who has medically required a fixator, somebody who has gone through the pain/emotional difficulty/stress, someone who has seen the impact of it on her own relatives. Given everything I just listed off, I think that it is quite self-ish and egocentric to get cosmetic limb lengthening done. Unless your willing to pay for a private caregiver, of course, but seeing as you'll already be shelling out a hundred grand for the ,limb lengthening itself, I doubt it.
9) If something goes wrong, you will be in actual need of medical attention. You are therefor utilizing resources in order to fix something that was entirely preventable; resources that could have gone to a patient with an actual medical problem; patients like me who did not cause the situation they are in. I do not know if this is ethical. Breaking a leg playing soccer is on thing - it's an accident. But purposefully having both of your legs broken (yes, both legs are lengthened at the same time), having both legs placed in external fixators and having the ends of your bones slowly pulled apart? That is not an accident. It is done with very clear intent. If it goes well, you are a bit taller. Yay? I guess if that's what you want but I would seriously question your self-esteem and values. But if it doesn't? You will have major medical problems on your hand. Trust me, you don't want a non-union, or a mal-union, or nerve damage or a bone infection. I have had all of these things happen to me - it is no walk in the park. In fact, there is no walking. If any of these happen, you will require treatment, lots of it, and that is taking resources and doctors away from other patients.
10) Here is the thing that bothers me the most about cosmetic limb lengthening - some people who have had it done lie about the scars the process leaves on their legs. Yup. They want the benefit (or at least what they think is a benefit, but I'm not convinced) of being taller but not the stigma that goes with it. I don't know how many times I have heard people on cosmetic lengthening forums or posts say that they will lie about their scars. Some say car accident, others say torn muscles, others say it was to correct a deformity (one that never actually existed). When people lie like this, they get sympathy. Sympathy they don't deserve. They choose to go through this horrendous process, which has been likened to medieval torture by doctors themselves just so you know. I find this incredibly rude and offensive to individuals like myself who have actually been required to get an external fixator and go through the distraction osteogenesis process for legitimate medical reasons. It makes me very angry to read about individuals doing this. They are insecure about their height so they go through an invasive and completely unnecessary medical procedure. After that, they are insecure about people finding out that they went through that very same procedure. How does that end up increasing self-esteem? On top of that, then they have the gall to lie about it. That is wrong. If you can't be proud of the scars, don't bother going through this process.
And that's it really. I am against cosmetic limb lengthening and think that is should be illegal. In fact, it is banned in some countries. I have tremendous respect for my surgeon and what he does. He says that he works with external fixators because there is a need, even though it is difficult. He might be the only one in the province to do this type of orthopedic stuff on adults. I'm not sure that I would think about him the same way if he offered it to patients for cosmetic reasons. I would be very angry if I were sitting beside somebody in the fracture clinic waiting room who was doing this for cosmetic reasons. In all likelihood, they would want to talk to me about fixators, as if it was some form of shared experience But it is not - I didn't have a choice. Anyways, the point of this post was to introduce you to the world of cosmetic limb lengthening and why I think it is a horrible idea. It's just incomprehensible.
* Just a note here: I think it is fantastic that individuals with abnormally short stature (e.g, around 4'10" or shorter) can have limb lengthening done. For those individuals it can be life alternating. When I say that I am against limb lengthening, I am referring to indiviausl who want to have it done but are already a normal height (E.g., 5'1" like myself, 5'4", 5"7, etc.).
No comments:
Post a Comment