Limb Lengthening Forum

Limb Lengthening Surgery => Limb Lengthening Patients Experiences => Topic started by: DEM on September 20, 2013, 05:22:33 PM

Title: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: DEM on September 20, 2013, 05:22:33 PM
From New York
Starting Height: 171.5cm
Lengthening Goal- 7.0-8.5cm
Method External LON on Tibias


Monday, May 6th Flight Arrival

My flight landed at 3pm but due to an incident at the airport, I did not get out the terminal to meet Sunny until 5pm. I was surprised he was still waiting. He took me to the Enkay Residency where I stayed for the next 3 days. Cost is about $40 to $50 per day I believe.

My flight arrived at the New Delhi airport and Sunny came with a driver to pick me up and take me to the hotel. It is very hot in Delhi around this time of year, the average high is 110-120 F every single day. This drops down to 90F at nighttime.

I ordered room service food during my stay at the hotel for lunch and dinner. I had a chicken sandwich, chicken biryani, and grilled cheese sandwich during my stay. For water, you can either order additional bottles of water through room service or boil your own using the tea/coffee maker in the room. Free breakfast is served from around 7:00-8:30am.

The breakfast selection is not great, but there is milk, cereal, some toast, and usually a couple of Indian dishes which changes everyday. The good thing is that you can request eggs to order free of charge so that makes the free breakfast much better. There are English magazines and newspapers which you can read while you eat your breakfast.

As you know, power outages are frequent in India but the generator at the hotel kicks in almost instantaneously so you have nothing to worry about. There is free wifi at the hotel.

For television, I was watching mostly MTV and an English comedy channel.

The staff at the hotel were very nice and helpful.

Tuesday May 7th- Consultation with Dr. Sarin

Sunny took me to meet with Dr. Sarin not at the hospital at one but at of the clinics he works in. Dr. Sarin asked if I had any questions for him and I really didn't. I had done my research coming into this so I already knew what to expect from leg lengthening and that I am definitely getting the operation done.

The consultation was therefore very brief, less than 5 minutes. Afterward, Sunny took me back to the hotel.

Wednesday May 8th-

Sunny took me to the only Bank of America in Delhi, which was about an hour drive from the hotel. We had a lot of trouble finding it even though we were in the right district. A lot of the buildings here don't have house numbers or exact street names so finding a place might mean having to ask the local cab drivers or policemen for directions along the way.

When we arrived though, disappointment ensued. It turns out the Bank of America location was for corporate accounts only and was useless to me. The rep who spoke with me on the phone apparently didn't know this when she gave me the address. Not to worry, however. I still believe the best way to get money is to send a wire transfer to Dr. Sarin and ask him to withdraw it for you. You can send a big lump sum once and have him withdraw it incrementally as you need funds. This way you avoid having to pay bank wire transfer fees multiple times.

I wired Dr. Sarin $15,000 before coming to India for the surgery and 3 months of accommodation.
I wired him an additional $3,500 and asked him to give me $1000 converted to rupees.. I anticipate staying in India for 5 months so I will need to pay him an additional $2,500 anyway during my 5 stay here in India. The extra $1,000 is spending money I've budgeted for additional food, supplies,etc.

I went by the guesthouse in the late afternoon to meet the current patients.

Thursday May 9th- Check into the Hospital

I checked into the hospital in the afternoon. The nurses there took blood and did a bunch of other tests. I had my x-ray but never had my starting height measured or the exact lengths of my legs measured. Here the workers wheel you around in a wheelchair even though I was perfectly capable of walking by myself.

The tv doesn't work in my room and the internet was down. Communication is a bit of an issue here as the nurses don't fully understand English. Some speak better English than others. If you want something, you must insist on it and ask for it repeatedly. Even if they tell you they are going to do something or if they say "okay", it doesn't mean anything. I guess that's the way things work around here. Don't be afraid to be persistent here if you need something important.

Friday May 10th

I woke up around 6:30am and was dressed for surgery. They put me on a stretcher and wheeled me to the waiting area outside the operation area. Dr. Sarin came around 8am and told me surgery was surgery for 9. I had to sign several waivers before they took me into the operation room. The operation area was very cold. I was still awake while I lied on the operation table.

They put a catheter in my left hand. They didn't give me any signal before I passed out. The next thing I know I woke up about 4 hours later in the waiting area outside the operation area. I noticed the penis catheter on me and the bag of urine by my bedside.

I felt like vomiting and they gave me a small bucket. This is normal as the general anesthesia wears off. After about 30 minutes after i woke up, I was transferred back to my room in the hospital.

I initially did not feel any pain from the surgery. All I focused on was keeping my ankles at 90 degree angles by sticking pillows in front of the bed post and pressing my feet on them while I keep my legs straight.

You are going to be lying on your back for the entire time. The spinal epidural analgesia is going to render your legs pretty much immobile. The food at the hospital is horrible. It is vegan and the selection repeats after 2-3 days. The takeout menu was also vegan.

I would suggest asking for a menu of local take-out places. I ate mostly dahi (plain) yogurt, banana, cornflakes and milk at the hospital. The rest of the food items I did not have the appetite to eat.

I did not get my appetite back until after my second day after surgery.

I needed to use the bathroom for #2 around the 4th day after surgery. Th ey bring you a wheelchair type device with a hole in the seat and a pan below. I was very constipated and wasn't able to go even though i felt a huge pressure in my stomach. Quite uncomfortable, but this subsided.

Even when I moved back to the guesthouse I wasn't able to do #2 properly until about 6-7 days after my surgery. I think this is due to lying on my back all day in bed. The lack of physical movement affects the bowel movement.

Tuesday, May 14th- Discharge from hospital

Sunny picked me up from the hospital and took me to the guesthouse.I felt a lot of pin cutting in my legs when they picked me up from the minivan and carried me to the bed in my room.

I hated the external frames from beginning. You can not achieve a natural sleeping position while having them on and you feel sort of disabled. Obviously you cannot stand on your own so you will be bed ridden or sitting down during the entire day and night. This can be mentally draining.

Thursday May 30th

Xray- Left: 1.1cm Right: 1.6cm
Amount turned: 1.2cm

It looks like the callus on my right leg is denser than my left leg. It also looks like my left leg has some pin loss. The reason why the actual amount distracted can be higher than the amount turned is due to two reasons:
there is an initial gap of a couple millimeters after the initial fracture at surgery
The x-ray measurement is not 100% accurate

At this point, I am not exactly sure if my left leg has any pin loss because I do not know what the initial gap was on my left leg. If it was close to 0mm, then it means I don't have any pin loss since I turned 1.2cm and got 1.1cm. If my left leg had the same gap as my right leg then it means there is a 0.5cm difference between the two which is quite a lot at this point.

However, all this is speculative. The next x-ray, when I am at 2.5cm should be much more useful to see how much pin loss I have.

Tuesday June 4th
1.7cm

I have been turning at 1mm/day. My goal is to continue this up until 3-4cm and adjust depending on how my callus looks like and how my muscle feels. I take a muscle relaxant almost every day and sometimes painkillers.

I haven't had any major striking pain. However, the pain I did have were persistent nagging pain, kind of like a really bad shin split or a muscle cramp in the calves.

The days are pretty much identical here. I spend time watching movies/tv shows on my computers, reading, and learning about how to build a web business. The days blend in with one another here. I sleep a lot while I am here. I go to bed around 10-11pm and wake up around 8am for breakfast.

After breakfast, I usually go back to bed from 9am-12pm and basically just wait for lunch at around 1:30pm. Even though the days seem really boring and mundane, time passes by really quickly here and that is the general consensus with the other patients. I think this is because in the back of our minds we subconsciously want to get this leg lengthening phase over with and continue on living our normal lives, so our mind find ways to pass the time.

It is kind of like working at a job you hate. Time goes by slowly if you look at the clock everyday waiting to leave, but suddenly one day you realized you've been working there for 2 years and wondered where all the time went. The food here get here gets monotonous very quickly so I order food once or twice a week. Each delivery costs me about $10 and lasts me for 2 meals.

I get physiotherapy six days a week. The session I have are relatively short but I will demand to have more physio as I get deeper into my lengthening phase. There are five exercises/stretches during the sessions:

The physiotherapist massages my feet and presses on it to get a stretch my ankles and my calf muscles
lying on back straight leg raises
lying on side straight leg raises
I lie on my back and the physiotherapist keeps my legs straight and pushes my thighs towards my body

Thursday, June 6th.

1.9cm


I have been in India for exactly one month as of today.

My physical therapy is getting longer which I like. I will be starting to stand in 3 days using the walker with my arms to support some of the weight. I actually started standed when I was a 0.5mm but stopped when the physiotherapist said this was not advisable.

I intend to prevent or reduce ballerina foot as much as possible. I wear sandals with straps which keeps my feet at a right angle to my legs. I believe standing and walking is the best way to restore strength and flexibility back to the muscles, tendons, and bones in the legs. Just as importantly I believe it minimizes ballerina foot


Friday June 14th
2.6cm

I am taking 3 muscle relaxer pills a day, and a painkiller during the night to help with sleeping.

Wednesday June 19th
3.0cm

So far so good. No complications yet (knock on wood). Calves and ankle muscles are starting to feel a bit more tight. Still going at a rate of 0.833mm (5 turns) per day.

Frame not fully weight bearing. Twisted rods near ankles. Dont stand for too long at a time

Moving out of old guesthouse end of this month either to new guesthouse or hotel

Friday June 28th
3.7cm

Xray results

I've turned 3.7cm and have 3.4cm and 3.5cm on my right and left legs respectively.

If you look at my x-ray, it appears there are two distinct gaps on each legs. However, the doctor said that this was just due to the way the bone is broken--- it isn't a straight horizontal line. He said this was actually a good thing as it increases the surface area and will help with recovery. I still don't completely understand so if anybody could offer additional insights into this I would appreciate it.

The physiotherapist suggest I increase turning to 1mm/day to avoid preconsolidation and the doctor agreed.

Thursday July 4th
4.4cm

Flexibility in both legs are still good. No ballerina yet but I can feel my calves getting tighter.

There has been some politics going on at the guesthouse lately. We have a new guesthouse manager and one of the physiotherapists was let go due to complaints. The patients are still split between the guesthouse and hotel with about 7-8 patients at each location based on what I've been told. We will be moving to a new guesthouse in August since our lease expires at the end of July.

August 6th
Actual lengthened: ~5.6-5.8cm
Amount Turned: 6.8cm

I have been turning 0.833/day but Dr. Sarin told me to turn at least 1mm/day for the next 10 days and have another xray. I am also stopping my 500mg daily calcium supplementation. Lastly, I will be standing only 10-15minutes twice a day whereas I was standing 20-25 minutes before. The point is to avoid preconsolidation.

Because I have almost lengthened 6cm, preconsolidation risk is now less than at the beginning However, the callus on my right fibula looks awfully dense and my previous roomate did have his fibula preconsolidate at around the 6cm mark. Better to be safe than sorry. At the rate I am going, I should have my frames off at the end of August so roughly 3 more weeks to go. Very excited to get these frames off and start walking with crutches!

The good news is I have essentially little to no ballerina. Ballerina is one of the biggest secondary complication here.
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: DEM on September 20, 2013, 05:30:11 PM
September 14th Google Group Update

Here is an update on my progress. My frame removal surgery is scheduled for Tuesday September 17th. I will have lengthened 7.70cm by then achieving my goal of 7.50cm. This should put me at 1.79m or 5'10.5

My original goal was 1.80m or 5'11 but I don't think the 1cm difference is worth it to stress my legs any further. Ballerina on left leg is negligible (I would guess 0.5cm) and 2.0cm on my right leg. I feel I have a better chance of avoiding major complications by stopping now.

I also want to have at least 6 weeks here in India for post-frame removal recovery and start walking. Callus is good based on the amount I have lengthened and I expect bone growth to speed up after I stop lengthening and take the frames off.

My reason for not lengthening beyond 7.5cm is to prevent complications. I am not saying you will have complications if you go beyond 7.5cm but there is a high chance you will due to the reasons below

1. There has been literature documenting that stretching any muscle fiber beyond this amount will result in irreversible damage. This means the muscle fibers won't be as strong or flexible as before even after the body heals itself. Think of it like a rubber band that gets overly stretched and loses its elasticity. Look at 7.5cm on a ruler and imagine how stressful this is for the body.

2.Two of the patients at the guesthouse that I have met personally who lengthened 8.5cm or more had poor callus growth and problems with ballerina and x-legs.  The patients who I have seen with good recovery did 7cm or less. Very few patients end up going to 8.5cm or more; maybe we would see more successful +8.5cm cases if more patients attempted to do it but the truth is that most end up stopping at or below 7cm.

The funny thing is that when I started my leg lengthening journey I told people my goal was 8.5cm. Everybody said "hey, me too! I wanted to do 8cm or 9cm when I first started too." but when you talk to them towards the end of their journey they change their mind. 

Again, I am not saying that going beyond 7.5cm will give you these complications but you are really playing Russian roulette with your legs here. 5cm is supposed to be the safe limit for tibias for most people. 6.5cm is supposed to be the safe limit for healthy young people in great shape. Honestly anything beyond 7cm is pushing your luck so doing one more cm to get to +8.5cm is not worth it, to me.

Interesting note: We did have this legendary patient who did +10cm and was able to walk after only 7-8 months from the first surgery. He left before I came here to India so I never met him and dont know much about the details of his ballerina or callus but he has been the one and only patient who lengthened this much and was able to recover enough to walk in a reasonable amount of time.

On the other hand, we also had this crazy fellow from Australia who lengthened 2mm/day and did +9.0cm total. His ballerina was so bad that his foot was locked permanently downwards with no mobility whatsoever. He left in a wheelchair. He will most likely require a tendon release surgery if he ever wants to walk or even stand

I will be posting updates on my walking after frame removal. I am very excited to start my recovery after having been in these frames for exactly 4 months.
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: Sweden on September 20, 2013, 05:34:45 PM
But you already finished(?)!  :o

Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: krin0610 on September 20, 2013, 05:52:37 PM
Any update dude? frame removal already?
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: Sweden on September 20, 2013, 11:44:37 PM
I know who the +9cm guy was. Why am I not surprised?
Everyone told him not to do it.

That's great you don't suffer any ballerina. Try to work it every day or else it'll be worse.
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: KiloKAHN on September 21, 2013, 12:33:23 AM
Thanks for posting your diary here (btw Dameon are they going to be called diaries on this forum or something else? I'm not sure how far the extent of copyright claims go, if Sysop were to say this forum was copying site text).

Good call on stopping your lengthening. Will help recovery for sure. I remember the diary from that Australian guy on old forum . IIRC, he got into it with Dr. Sarin a few times and Sarin ended up telling him to go to hell  :D
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: DEM on September 21, 2013, 02:47:31 AM
Latest X-rays. I have achieved 7.5cm on both legs exactly.

RIGHT LEG
(http://i859.photobucket.com/albums/ab153/sxrchang6/DSC00359_zpseb3a77a7.jpg)

LEFT LEG
(http://i859.photobucket.com/albums/ab153/sxrchang6/DSC00360_zps7d7f3936.jpg)

Will post updates once I start walking. I have my bandages on for about a week after frame removal surgery (Sept 17th) so no standing until September 23.
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: Sweden on September 21, 2013, 03:07:36 AM
I remember the diary from that Australian guy on old forum . IIRC, he got into it with Dr. Sarin a few times and Sarin ended up telling him to go to hell  :D

That guy wasn't from Aussie. He was from UK, Korean guy.

This guy from Australia came to my room and told me about his plan and then we spoke for a while. He was friendly but sorry to say that he wasn't LL-material. 45+ years and wanted to do 10cm in only 3 months. He didn't know what ballerina was either.
I don't know why Dr Sarin did surgery on this guy even though many of us said it would be dangerous.
To me this guy was very kind so I can't say anything bad about his behavior towards me but I know he threatened another patient and was moved alone to the new guesthouse.

It's nice to see your updating in here DEM.

Don't be shy to tell about the conditions in the guesthouse?

Why is all the gym equipment at Dr Sringari now? Even the paintings......
Don't you have a gym right now?

Are there any patients doing their femurs with the HLN?

Are there still coming patients as before or has it reseeded?

What does the food schedule look like from morning to evening?

Did you guys have any parties or other fun stuff you did together?

Alright, gotta go.
Tell my Japanese ex roomie I wish him a good recovery.
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: Muse on September 21, 2013, 12:02:00 PM
Thanks for posting your diary here (btw Dameon are they going to be called diaries on this forum or something else? I'm not sure how far the extent of copyright claims go, if Sysop were to say this forum was copying site text).

Ya, probably will need to start a section for "diaries" or if there's other names (journal, blog) please suggest.  The posts are starting to clutter up so will organize them.

Not worried about the copyright issue as DEM is the creator of the diary and agree to post here.  DEM could even ask old forum  to remove his diary if he chooses, as he is the owner of the written material. .
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: DEM on September 22, 2013, 03:31:16 PM
I remember the diary from that Australian guy on old forum . IIRC, he got into it with Dr. Sarin a few times and Sarin ended up telling him to go to hell  :D

That guy wasn't from Aussie. He was from UK, Korean guy.

This guy from Australia came to my room and told me about his plan and then we spoke for a while. He was friendly but sorry to say that he wasn't LL-material. 45+ years and wanted to do 10cm in only 3 months. He didn't know what ballerina was either.
I don't know why Dr Sarin did surgery on this guy even though many of us said it would be dangerous.
To me this guy was very kind so I can't say anything bad about his behavior towards me but I know he threatened another patient and was moved alone to the new guesthouse.

It's nice to see your updating in here DEM.

Don't be shy to tell about the conditions in the guesthouse?

Why is all the gym equipment at Dr Sringari now? Even the paintings......
Don't you have a gym right now?

Are there any patients doing their femurs with the HLN?

Are there still coming patients as before or has it reseeded?

What does the food schedule look like from morning to evening?

Did you guys have any parties or other fun stuff you did together?

Alright, gotta go.
Tell my Japanese ex roomie I wish him a good recovery.

Dr. Sahil (your dentist) is doing a good job of firing bad managers and keeping the caretakers in line. We finally have a more western standard of care here. For example, when I got sick with dengue, a potentially fatal virus, I was given prompt medical attention and blood tests. Also, we can now ask for extra food whenever we want instead of having fixed portions.

No more HLN patients since the one we had in the guesthouse. Patients are still trickling in although at a slower rate than before. We hang out till real late quite often now, sometimes till sunrise just chilling and talking. Patients who cannot walk yet crabwalk up and down stairs by ourselves after midnight before the caretakers are all asleep.
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: kinglee on September 27, 2013, 04:50:39 PM
i am waiting for calic dairy .when he will start his diary in this forum??????????????
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: TomD on September 27, 2013, 06:05:43 PM
old forum  has no legal right to the patient diaries. Unless the patient objects, and then we have to take it down.

The author can post and repost his/her diary as many times as they wish anywhere they wish under the first amendment.
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: kinglee on September 27, 2013, 06:15:49 PM
yes you are right TomD
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: Carter on September 30, 2013, 12:35:23 AM
So you reached 179cm, that's right about the average height of U.S Males.   Congratulation!  Look forward to your next update.

So you had little ballerina foot, did you do any special exercises or something?  How long would you recommend standing and PT everyday?
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: alps on September 30, 2013, 04:23:10 PM
DEM, what about the gym equipment?
Some people here were saying Dr. Sringari was given the new guest house by SysOp and that all Dr. Sringari patients reside there now. How true is this?
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: TomD on October 07, 2013, 12:25:09 AM
Dem

Any updates on your progress? let us know !!!  8)
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: DEM on October 07, 2013, 10:44:02 AM
I am at 20 days post operation for frame removal and I have started walking unaided. I will be posting an update and a video of my walking and proportions soon!
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: Sweden on October 11, 2013, 01:47:01 AM
I am at 20 days post operation for frame removal and I have started walking unaided. I will be posting an update and a video of my walking and proportions soon!

That's not even 3 weeks. Dr Sarin wanted us to wear the casts for at least 10-14 days. After that you're so weak you can barely sit up.

I believe you it's not that but I find it very amazing. Congratulations to you!

Did you inject yourself with something or how on earth do you heal faster than all the people in the world who did this?  ;D
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: KiloKAHN on October 11, 2013, 02:28:13 AM
I am at 20 days post operation for frame removal and I have started walking unaided. I will be posting an update and a video of my walking and proportions soon!

Good that you're making a steady recovery.
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: krin0610 on October 11, 2013, 04:30:23 AM
Congrats dude! Any video please?
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: DEM on October 11, 2013, 04:44:15 PM
September 17, 2013 - Frame Removal
I took 3 days off from lengthening before frame removal. I felt this helped "soften" my muscles up before taking off the frame to minimize snap-back. My muscles were rock hard towards the end of my lengthening and I wanted to relieve some of that prior to frame removal.

Video Taken 3 weeks after frame removal
http://www.youtube.com/watch?v=gFMY25eSsi4&feature=youtu.be (http://www.youtube.com/watch?v=gFMY25eSsi4&feature=youtu.be)

Video shows me walking first with crutches and then unsupported. This is my first time walking after being 5 months bedridden and it feels great to feel normal again!

I waited 7 full days after frame removal before I started standing again with the supporters. After that, I used the walker and crutches to walk around for 2 weeks. One day my legs felt particularly warmed up and ankles flexible enough so I decided to see if I could stand up on my own without support. I found out I could. I started by holding one hand onto the wall, then I slowly took it off. This gave me the confidence to walk across the room and later take a video of it. I still have 1-2cm of ballerina on my right foot so you can see me kind of "limp" towards that side whenever I move my right foot forward. Left foot has 105degrees of flexibility while right foot only has 90degrees (after being warmed up). If my right foot catches up to my left I am confident I can walk normally.

Proportion Photos
I think my proportions are fine. I will not be doing another surgery. I lengthened 7.5cm to be at 1.79m. I might be 1.80cm due to spinal decompression. The photos were taken when my feet were warmed up and heels touching the floor.

(http://i859.photobucket.com/albums/ab153/sxrchang6/DSC00371-Copy_zps2036869e.jpg)
(http://i859.photobucket.com/albums/ab153/sxrchang6/DSC00372-Copy_zpsd6b1211b.jpg)
(http://i859.photobucket.com/albums/ab153/sxrchang6/DSC00383-Copy_zpsda31321f.jpg)
(http://i859.photobucket.com/albums/ab153/sxrchang6/DSC00387-Copy_zpse4131a1c.jpg)


My Lengthening Regiment
One thing I did differently than other patients was a lot of standing while I was in frames. At the beginning it was only 5 minutes twice a day. Then 10 minutes twice a day for a while. After 6cm, I did 15minutes twice a day, then 3 times a day. Towards the end of my lengthening, I was standing 4 times a day for 15 minutes each. I start each session with a 75 % leg/25% arm split and it ends up being 95%/5% towards the end when my legs are warmed up. My x-rays showed good callus throughout so I was never too worried whether my bone was strong enough to support my weight. I also never felt pain and the xrays showed no screw or rod bending. I dont know whether my callus was good because I was standing so much or whether I was able to stand so much because I had good callus. I was taking 1000mg calcium at beginning of lengthening (the daily recommended value for adults) through 50% pills and 50% dairy products, and bumped this up to 2000mg at the end of my lengthening. 

I don't think any other patient stood as much as I did while in frames as I did. The transition from standing in frames to walking without frames was very seamless for me.  I did not do any walking while in frames due to my weight (63kg with frames). I don't think my results are extraordinary because patients in other places where they do BOTH intensive standing and walking while in frames have similar walking recovery time. To be honest, I feel I didn't stand enough at the beginning of my journey. I felt like the frames weren't strong enough to support my developing callus so I only stood for 5-10minutes at a time. If I stood more at the beginning maybe I could have prevented ballerina on my right foot. I started getting ballerina around the 5.5cm-6cm point. It came on suddenly and I fought it with sickening work ethic.

I also made sure I got enough nutrition, especially protein, in my diet. If I didn't like the guesthouse food, I would order out. I spared no expenses with food and made sure I was never hungry.

Guesthouse Status
No complaints with the guesthouse situation. Food is better and bad managers were fired. When I had dengue fever I was very well taken care of---I felt like I was in good hands with the new management. We have three patients currently walking including myself, Calic, and one other patient who lengthened 5cm.

I have 21 more days before leaving India. I believe the physiotherapists here and hard work will allow me to leave the airport without wheelchair or crutches. 
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: LLL on October 11, 2013, 05:00:06 PM
Good update. But wow! Is there something weird about the camera's lens or do you have EXTREMELY broad shoulders, at least compared to your waist?
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: krin0610 on October 11, 2013, 05:24:35 PM
Only 3 weeks after frames removal and you walk so good? Well done buddy!!!
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: DEM on October 11, 2013, 05:37:04 PM
Good update. But wow! Is there something weird about the camera's lens or do you have EXTREMELY broad shoulders, at least compared to your waist?

I just have a small waist. I don't think I have broad shoulders now--lost about 8kg of upper and lower body mass since the surgery.
Before coming to India I had a pretty sharp V-taper from working out.

Only 3 weeks after frames removal and you walk so good? Well done buddy!!!

Thank you my man! I think you guys at the guesthouse now are in better hands than before because you can build off old patient's past experiences. The physios know more about what they are doing now and understand more the importance of standing and stretching than before.
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: DEM on October 11, 2013, 07:00:26 PM
Please also note that my standing posture is far from perfect. My body is slightly tilted to one side and my left leg is shifted outwards to balance against my ballerina right leg. The right foot cannot bend beyond 90 degrees and the muscles in that leg are in general tighter than the left.  I can shift all my weight towards the left leg while standing but I cannot do the same for the right leg. This causes imbalances on my body starting from the legs up to the hips and throughout the lower back. My hamstrings and lower back muscles are quite tight.

My goal is to get the ballerina down on my right leg so that I can fix both my standing posture and walking posture.

Also, even though I can walk unaided, I am still using crutches when walking to fix my posture. My hips have a slight backward tilt while walking and my back has a slight forward tilt to balance against the ballerina foot which doesn't fully touch the ground unless pressure is applied.
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: Leonardo2013 on October 11, 2013, 07:06:50 PM
Very well done, DEM -- your proportions look great, and I'm even surprised that you bend your toes a bit when you walk. You're definitely going to be walking totally normal in no time. But let me ask you: Do you have any rotation of your knees like other patients have, do you have any pain when you sit down and cross your legs, could you give us an upclose pic of your legs after frame removal. Thank you and keep up the great work.
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: TomD on October 11, 2013, 08:10:43 PM
Dem you look fantastic. Good job!!  8)

Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: DEM on October 11, 2013, 08:20:56 PM
Very well done, DEM -- your proportions look great, and I'm even surprised that you bend your toes a bit when you walk. You're definitely going to be walking totally normal in no time. But let me ask you: Do you have any rotation of your knees like other patients have, do you have any pain when you sit down and cross your legs, could you give us an upclose pic of your legs after frame removal. Thank you and keep up the great work.

Here is a photo of my legs taken 1 week after frame removal
(http://i859.photobucket.com/albums/ab153/sxrchang6/DSC00367_zps84e880ec.jpg)

I am able to sit down and cross my legs without any pain. I don't think I have knee rotations but my right foot was starting to turn outwards from about 6cm to the end of my journey. You can see this in the photo above. I believe this is due to tight tendons around the ankle area as the foot has corrected itself about 2-3 weeks after frame removal and standing/walking.
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: Sweden on October 11, 2013, 08:24:37 PM
Well done. I'm jealous. Really.

I can't walk really good even now, 6 months after frame removal. I barely stood at all. Stupid me.....
So now I have to suffer.

You'll be back to 100% in no time at all.
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: DEM on October 11, 2013, 08:32:50 PM
Well done. I'm jealous. Really.

I can't walk really good even now, 6 months after frame removal. I barely stood at all. Stupid me.....
So now I have to suffer.

You'll be back to 100% in no time at all.

Sweden, don't forget you were an inspiration to me and many others to perform LL. Your diary on old forum  inspired me to take the leap and get it done. 8)

Keep up the positivity and I look forward to reading your diary on your femurs.
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: TomD on October 11, 2013, 08:47:36 PM
Agreed

Keep your chin up Sweden.  :D
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: Adriano on October 12, 2013, 04:40:33 AM
u have done really well DEM.

u have good proportions. dont do ur femurs because it will throw ur proportions off. at 180cm there isnt much to gain but make it obvious to the regular person that u have done something to ur legs.
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: Leonardo2013 on October 14, 2013, 08:55:57 PM
Dem, I agree with others. You look just fine and any more height will definitely throw you out of proportion. BTW, could you post a side by side pic of you before CLL and now with your new height? Thanks and good recovery.
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: DEM on October 16, 2013, 08:55:19 AM
I was told by a doctor that I should use crutches for 6 more weeks to avoid potential screw bending. He is a very conservative doctor and I trust him. The crutches also help with posture while walking so they are a useful thing. I will try to use crutches when I go outside for extended periods of time and only walk unaided while indoor.
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: DEM on October 16, 2013, 08:57:26 AM
Dem, I agree with others. You look just fine and any more height will definitely throw you out of proportion. BTW, could you post a side by side pic of you before CLL and now with your new height? Thanks and good recovery.

Unfortunately I did not take any before pictures of legs before. I did have a 10cm difference between my femurs and tibias so my tibias were quite a bit shorter than others of my same height before. After surgery my femurs are still about 2.5cm longer than tibias.
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: alps on October 16, 2013, 09:21:05 AM
Hey DEM, good progress there!  :)

But I find something awkward about your knee. Maybe like you said, it's your posture, but I wanted to clarify.
One leg is more further away from the center than the other in those standing pics.
Do you have knock knees?
How were your knees before the surgery? The same? or more apart like bow-legs?
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: Leonardo2013 on October 16, 2013, 06:27:50 PM
Hey DEM, from what you have seen there with other patients that you've met, do most people develop keloid scars below the knee. I know that after full consolidation when it's time to remove the nail there's going to be another cut in the same spot so there's a higher chance of keloid formation, right? I ask because I had a cousin who had an accident and develop keloid scars in his arm; he had surgery to remove them, but a few months after it just grew back.
Title: Re: DEM - External Tibas - Dr. Sarin - 2013 - From New York to India
Post by: BullSurfer on November 26, 2013, 04:14:39 AM
Bro, how much did you lengthened on the tibia? No need for femur lengthening, if you do, you're too greedy.