At 20 years old, Lenny Roth has seen his share of hospitals and doctors, and he has battled medical adversity from a young age. When he was 13, he was treated for cancer in a salivary gland.
Now Roth, who once was 5-foot-1, faces another challenge, an extraordinary procedure that should bring him eye-to-eye with many of his peers. His bones are being lengthened in a millimeter-by-millimeter mechanical process that will make him taller.
Ethicists and laymen have long debated the merits of adding height to young men and tamping down excessive growth in girls. Many have come out hotly against height adjustment for either gender.
But Roth is well aware of height's allure for many men. Beyond the supertall who loom over those of average height - and populate the ranks of pro basketball - Roth believes many others wouldn't mind "a couple of extra inches in height."
"I was always the shortest kid, and it was noticeable. As a kid my legs were severely bowed," said Roth, of East Meadow. As a youngster, he said, being taller wasn't important: "I just wanted to go outside and play. But when I went to college it did become an issue. I am one of the shortest people I know."
Roth knows exactly why nature denied him height. A miscue indelibly scripted in his DNA led to a rare genetic bone disorder known as metaphyseal dysplasia Schmidt type.
The procedure, known as the Ilizarov Method and developed in Siberia during the Cold War era, will correct the bowing in Roth's legs, which is why his insurer is paying for it. The procedure began in February, and by the time it is complete in May, Roth expects to stand about 5-foot-5.
In the operation, Dr. Robert Rozbruch, Roth's orthopedist, made cuts midway in each of Roth's femurs - his thigh bones - and anchored two rods - internal and external - to each leg.
The rods have external nuts that Roth turns daily at 1 millimeter. As the rods incrementally lengthen, so do his legs. The stabilizing internal rods will remain in place for at least a year, said Rozbruch, of the Hospital for Special Surgery in Manhattan.
It's painful at times, in part because the muscles and blood vessels of the legs also are being stretched. Roth has a prescription for the potent painkiller Percocet, which he takes every six hours.
Roth must be attentive to keeping the sites clean to avoid infection, especially because pins extend through the inner cavity of the bones.
A sophomore at the University of Connecticut majoring in accounting, Roth has taken a leave of absence to undergo bone-lengthening, a technique performed for a variety of reasons. Doctors primarily use it to correct bone injuries or deformities, while some people, especially those with a certain type of dwarfism, seek it to gain height or to add length in their arms.
"Stature lengthening is what I am doing for Lenny," said Rozbruch.
In 2006, the most recent year for complete statistics, 2,295 limb-lengthening procedures of all kinds were performed in the United States, according to the American Academy of Orthopaedic Surgeons. Those done to increase stature account for a small subset of the cases, says Rozbruch. Lengthening can run as high as $100,000.
Doctors say limb-lengthening taps into the skeletal system's ability to regenerate healthy bone at fracture sites.
"Basically what happens as the bone starts to heal, as you pull it apart [at the cut], the gap will fill in with new bone," said Dr. Svetlana Ilizarov, an orthopedic specialist at Stony Brook University Medical Center. She's the daughter of the late Gavriil Ilizarov, the physician who invented the technique.
Developed after World War II, the procedure has a storied past. As the only doctor in a Siberian village, the senior Ilizarov wanted something to aid the injured veterans.
Doctors are certain regenerated bone lasts a lifetime. Rozbruch said muscles, nerves and blood vessels "grow in response to the slow stretch like they do during a growth spurt or in pregnancy."
Limb-lengthening pales compared to Roth's prior experience with doctors. "When I was a freshman in high school I had cancer, acinic cell carcinoma in my parotid gland," or the largest of the salivary glands. "It was tough for me."