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Our son Noah was born with Fibular Hemimelia and we noticed it immediately because he had a smaller foot and missing toe. We live in Houston TX and soon discovered that most Pediatric Ortho doctors have minimal to no experience treating this condition. We bounced around a bit and ended up at the best facility in Texas. We were following another patient who has similar severity a couple of years ahead of us at the Texas clinic and noticed that she had a failed surgery. This caused us to want to find a second opinion on what surgery Noah should have. We came across the Paley institute and scheduled a consultation at the beginning of covid in 2020, when Noah was 11 years old. Dr Paley took the time to explain all the options and what he would do if he were in our shoes. The two options we were considering were growth plate arrest surgery or leg lengthening. We chose lengthening so Noah would not lose his overall height. He said he could get him in that summer because of international cancellations and that due to his slight case the discrepancy would be negligible between doing the surgery at 11 years old vs 15 yrs old. Dr Paley’s expertise and treatment plan was such a gift to us and our family is so grateful to the Paley institute. Our 2 months in Florida was not easy but the therapy was the best part because we loved the team and how they built a relationship with Noah. Now Noah is 16 and when I asked him the other day what he remembers about Florida, he said it was the best because we fished every day! I was so surprised I thought he would say pain, or how hot it was, or missing friends; no, he remembers fishing, legos, video games and family games. Now Noah wants to go to college in Florida, his favorite state, besides Texas of course. Noah is now about 6’ tall, swimming competitively, involved in FFA in high school and such a confident young man. When we went to the Paley institute Noah was just a little boy with a leg discrepancy, now he is on his way to being a man. We are so thankful for the impact Dr. Paley and his team made on Noah’s life. The Paley Institute was an answer to many of our prayers. If you have FH or any other complex ortho issue the Paley institute is the best on the planet and you or your loved one will be in good hands. If you find yourself in West Palm Beach, eat a Cronut at Jupiter Donuts and enjoy a sunset stroll at Lighthouse Park. Love, The Costons

My name is Abdulhakim Almadi, a 37 year-old male from Saudi Arabia. I was born with a combination of a congenital short femur and short tibia with absent fibula. In 1982, I underwent a surgery in London, UK to stabilize my right hip joint, which was the immediate problem then. Later on, I was provided with an extension prosthesis, through which I was able to walk. Over the years, I tried to cope with wearing different kinds of prostheses. However, I was never quite comfortable with all those prostheses because they looked ugly and were too heavy. Moreover, I would have backaches and some pain in my right hip from time to time. Last year I was referred to Dr. Dror Paley by Dr. Saad Almohrj the Chief of Medical Affairs at the National Guard Hospital in Riyadh, Saudi Arabia. Dr. Paley examined me in his clinic and proposed a treatment plan that targeted reconstruction of my right hip and preparing my ankle joint to function as a knee joint. I went back home to prepare myself and my family to the planned treatment. Few months later, I returned to the US to start the proposed treatment plan. In a course of 9 months, I underwent 4 surgeries: super ankle, super hip, knee freeze and rotationplasty. In addition to that, I have been concurrently given a lot of physiotherapy sessions. Toward the end of my plan, a completely new prosthesis that suits my lower right limb has been designed and made. On April 25th 2017, I plan to go back home to start a new life with a nice looking prosthesis, and for sure, a much better functional situation, especially in my hip. I would like to thank Dr Paley, to whom I am greatly indebted, and his professional team for all the care and help they have provided me with in all my treatment stages. I would definitely recommend the Paley Institute to anyone who has congenital defects in their limbs. Abdulhakim Riyadh, Saudi Arabia  

I clearly remember the first day we found out that our perfect little girl had an issue with her leg. We were at one of our first few ultrasounds, where they were counting bones, fingers, toes, etc. Abigail, being our first child, we were not very sure exactly what we were looking at, but one thing I will always remember was the look on the technician’s face when she realized that Abby had only four toes, and that her foot was turned out to the side. She was not allowed to go into specifics with us, telling us that we would have to speak with a doctor. It was that very moment that we began dreading the worst. We immediately began looking to the internet for all the things that could be wrong, or how to deal with things of this nature. We were scared, to say the least. This was our introduction to the condition known as Fibular Hemimelia. My wife as convinced that amputation was going to give Abby the best chance to function normally, after having been told by a doctor that it was the best solution. We decided to wait until after she was born to make any real plans. Abby was born on November 24, 2006. She was perfect in every way, and we were very proud. Her beauty gave us a moment to forget all about the decisions we would have to face. We were just happy to have our little angel, trusting that everything would just fall into place, and that’s exactly what happened. We were sent to see Dr. Todd at Bethesda Naval Medical Center within a very short time after her birth. He calmed us down and told us about this “great doctor” who was doing “great things” in Baltimore, MD. That doctor was Dr. Dror Paley. After pulling many strings and sorting through tons of red tape with military insurance, Dr. Todd got us in to see Dr. Paley within a few weeks of Abby being born. We walked into that office terrified, and then something magical happened. We saw other kids who had similar conditions in the office smiling, playing, and happy. After a bit of a wait, we finally got to see Dr. Paley, and he immediately made us feel better. He spoke of things that he was going to do to make her leg better, treating her condition like it was a common cold. For the first time, we felt better, and certain that we would be with Dr. Paley for years to come. Abby’s first surgery took place on June 25, 2008. She was fitted with an external fixator, and Dr. Paley had corrected the extreme bowing in her tibia, and reconstructed her ankle so it was no longer turned out to the side. Abby’s lengthening lasted from July 1 until September 8. In that time, her bone grew a little over 2 inches. During the lengthening phase, Abby played like any other child, not letting her frame keep her from doing anything. She went to playgrounds, swam in pools, and any other thing that other kids were doing. Unless you were looking at her leg, you’d never know anything was different. The fixator came off December 8, 2008, which was followed by a full leg walking cast. Once she got used to walking in that, she was once again back to her usual, active self. The cast was removed January 5, 2009, and after some physical therapy to strengthen her leg, Abby was walking, running, and playing like any other child. Abby, now 8 years old, had her second procedure on January 9, 2014. This time was a little tougher since Abby was a little older and more aware of what was happening, but things still went pretty smoothly. Abby and her mother had to stay down in Florida for closer monitoring, but all the while she still did all the fun things that children do. She played, swam, went to movies, and had tons of fun. She even got the chance to meet and hang out with other patients of Dr. Paley’s. There is something soothing and wonderful about being able to speak with other parents and children who are having similar procedures done. The community that Dr. Paley and his team have built is a wonderful collection of kids, parents, doctors, nurses, and other staff, full of wonderful, supportive people. The mere fact that we’ve followed him from Baltimore to West Palm Beach to make sure Abby is with the best doctor possible speaks volumes. We trust Dr. Paley and his staff, and we are very happy to have been sent to see him. Abby had her second fixator removed October 6, and was once again in a cast until December 15. She is currently going through her physical therapy to get her leg strong again, but she’s back in school, back to playing, and almost back to 100%. In fact, she will be starting swim lessons again tomorrow. We know that we have at least one more surgery to go, but unlike those terrified parents we were back in 2006, we are completely comfortable with what’s to come. We have Dr. Paley and his wonderful staff to thank for that! Thank you Dr. Paley, for all that you do, and for taking such good care of our little girl. You do so much for so many people, and we really appreciate you and your wonderful staff! Lea and Eric Madison, Alabama

The Fisherman and the Shoes I want to share a human story. In this convulsed world of ours things happen that teach us that love and happiness have not disappeared and that we must never lose faith that wonderful and generous people will always be around. Andrea, my first granddaughter, was born on September 24th 1998. Four months before she was born an echogram revealed a shorter right leg. The next month brought fear, tears, hope and lots of prayers. Two months before her birth I wrote a letter to Pope John Paul II’s secretary, Fr. Stanislaw Dziwisz, asking for the Pope’s prayers. He answered immediately telling me that the Pope was praying for the little girl and her courageous parents. At 2:00 am, with four grandparents and her father in attendance, on September 24th 1998 Andrea Maria Rivero-Toledo was born at Lucille Packard Hospital, Stanford University in Stanford, California. Her right leg was shorter. She had a short femur, bowed tibia, absence of the fibula and small toe. Everything else was completely normal. A long and narrow road lay ahead of Andrea, all the family and scores of wonderful people. My first phone call was to my dear friend and colleague Federico Fernandez-Palazzi a pediatric orthopedic surgeon in our native Venezuela who assured me that there was a surgical solution to her defect. The Fisherman Andrea was baptized on October 7th. A card with her photo was sent to our friends and among them Fr. Dziwisz, who a couple of weeks later wrote us a letter with his congratulations, continued prayers, and to my surprise he returned the photo! I almost fainted when I realized the photo was autographed in latin “Cum Benedictione, Joannes Paulus II 19-1-99” A photo of Andrea with a blessing and signature of John Paul II. My friends have always said that no one like me to “work the phones” and this proved to be true when I found the man that would change Andrea’s life and that of the whole family. Dr. Dror Paley saw Andrea for the first time in Baltimore in September 1999 and scheduled her first surgery for March 2000. That same week of September we met in New York with Daniela Navarro Eggleston, who had been born 21 years earlier with the same problem and had undergone countless surgeries and complications. Her invaluable advice “Don’t spoil her, treat like a normal child.” That was the best advice we could ever receive. Since March 2000 Andrea has been operated on 17 times, all by Dr. Dror Paley, to whom Andrea and family are indebted for life. Today both her legs have the same length. She has been a courageous and exemplary patient loved by her doctors, nurses and rehabilitation team. She underwent what should be her last lengthening surgery last July and is doing beautifully. She practices many sports, is an honor student, has a great personality and tons of friends. Of her good looks, you be the judge. The Shoes A couple of years ago Andrea, then 14 years old, went with her maternal grandmother to NORDSTROM in Boca Raton, FL and while grandma shopped, a pair of shoes caught Andrea’s eyes. Grandma decided to buy them and told the sales lady that she needed two pairs because her grandchild’s left foot was larger than her right. No, replied the sales lady “It is our policy to give you the right size for each foot. We will sell one pair that will fit both feet. You don’t have to buy two pairs.” For years buying shoes was a big problem, we had been buying two pairs each time and afterwards the sole of the right foot had to be modified. It was difficult to find a shoe repair store that would do a good job. It was the first time we bought her shoes in an upscale store like NORDSTROM. Last September for her 16th birthday they returned to NORDSTROM and bought several pairs. Again she did not have to buy two pairs of each model. Never in our wildest dream did we ever imagine that shoes and a store, an upscale store like NORDSTROM would play such an important role in Andrea’s long road to a normal life. It has been a long road but it has built Andrea’s character. We have a very large family and all of us have been enriched by her strength and example. Andrea is starting her junior year in high school and she wants to go to college and major in biomedical engineering, a career very much related to her birth defect.