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(http://s5d1.turboimagehost.com/t1/18734320_greetings_meat_things.jpg) (http://www.turboimagehost.com/p/18734320/greetings_meat_things.jpg.html)
Kilokahn Is Going To India
It is almost a shock that I am finally able to get started on writing this patient experience after so many unexpected events led me to postponing my trip. My landlord kicked all the tenants out of our building suddenly, followed by projects stalling me at work that required me to stay and take care of them. My planned September, 2013 flight to India was postponed indefinitely as a result. Fortunately, after keeping my mind on working and taking care of my priorities, I am now booked for a flight early June and will be heading to India to change my life permanently.
I suppose people will think I am nuts for deciding to go to India even after everything that has been discovered by the online CLL community about particular doctors there, and I can't say I blame them. But I do think there is a good doctor to be found out there, maybe even a few. One of the reasons I decided to start writing this experience now rather than after I've already done the surgery is that I plan to consult with many doctors and post summaries of my consultations in detail within this thread. I think it will be good information for those who still see India as an option for their particular needs.
These are the doctors that I will be consulting with:
New Delhi- Dr B.S. Murthy - http://www.limblengtheningforum.com/index.php?topic=253.0 (http://www.limblengtheningforum.com/index.php?topic=253.0)
- Doctors located at Indian Spinal Injuries Center http://www.limblengtheningforum.com/index.php?topic=305.0 (http://www.limblengtheningforum.com/index.php?topic=305.0)
- Dr Naveen Talwar and Dr Gurdeep Singh Ratra http://www.limblengtheningforum.com/index.php?topic=469.0 (http://www.limblengtheningforum.com/index.php?topic=469.0)
- Dr Manish Dhawan http://www.limblengtheningindia.com/ (http://www.limblengtheningindia.com/)
- Dr Punit Jain http://www.drpunitjain.in/ (http://www.drpunitjain.in/)
Mumbai
- Dr Suhas Shah http://www.suhasshah.com/ (http://www.suhasshah.com/)
- Dr Mangal Parihar http://www.limblengtheningforum.com/index.php?topic=87.0 (http://www.limblengtheningforum.com/index.php?topic=87.0)
I won't be consulting with Dr Sringari or Dr Sarin, as I really see no point in doing so. However, rest assured that I will post my thoughts on each doctor I consult with. My goal is to make this patient experience as neutral as possible, as my goal is to give realistic expectations to any prospective patient for India, not try to sell anyone here on going.
Why Do I Want Limb Lengthening?
To be taller, duh. ::)
Okay that's not the whole story, haha. Yes I want to be taller, but it's not so much a want as a need in my opinion. We've all seen the studies correlating height with potential success in multiple areas of life. Even more so, many of us have been personally affected by heightist bigotry from the tall guys who just don't get what short men have to go through, and even outright distaste from those who think we deserve to be treated differently because of our stature. There are specific instances I can recall where my height has been a barrier - I was fired from a sales position after there was a change in upper management and the new boss thought I couldn't represent the quality of their product with my stature, was left without a prom date my senior year of high school because the girl I asked canceled last minute and said she didn't want to wear a dress where she couldn't wear heels, have a mom who cried in front of other parents at the endocrinologist's office when they said I wasn't going to grow anymore at age 15, had been excluded from group activities, etc. The biggest blow was that I realized I couldn't be a really successful professional wrestler among the greats like Hulk Hogan because of my stature, and a pro wrestler was something I had wanted to become since I was a kid.
Hitting the gym and dressing nice didn't really change these things for me or the way I feel about my height all that much. Now I'm not saying that if you're short, you've got no hope. I've known quite a lot of short men who seem to be unaffected by their height or at least are very good at showing they're not bothered by it. I've even known some who are quite popular and have no apparent problems with the ladies. If you ask me, I'd tell you that unless you're absolutely miserable over your height, know all the risks with CLL, and cannot attribute your unhappiness to other factors that are not height-related, then CLL is not for you. With me, CLL is something that's been on my mind for 8 years and it's not going to go away until I do it. Unfortunately I do not think I can move on until this leg lengthening is dealt with.
My next post will detail all the necessities I'm packing and the medications I've been prescribed by my doctor for stay in India. I hope this patient experience ends up helping many.
Special Thanks (in no particular order):
Dameon - for creating this forum and giving us a place where nobody is afraid to speak out on issues pertaining to limb lengthening.
All those who have done or are currently going through CLL and have chosen to share their experience with others.
All members of LL Forum who continue to make this a community I'm happy to be part of.
Edit: Realized my title was too similar to someone else's so I decided to change it. Curse this OCD of mine.
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Woooo grats Kilo! ;D
I know you'll make the right decision on your doctor, and you'll even pave the way for others to do LL in India with some peace of mind.
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Thanks for this post! The sense of anticipation, excitement, and suspense I feel regarding your imminent journey is forcing me to go grab some popcorn (I can't help myself, lol) : ;D But, on a more serious note, I want to sincerely say thanks so much for offering to share your thoughts and recollections of all of these interviews with us. It means a ton that, on your personal journey, you are doing so much to help others in the same boat, when you have no obligation to. Congratulations on making it to this point, the point so many people on this forum only currently dream of. You're truly an inspiration. I wish you all the luck in the world and hope that LL will be as meaningful and rewarding as possible for you.
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Best of luck for you Kilokahn!!
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It's good to see you're going to give the other Indian doctors a chance in hopes that you'll find a good one (or more than one). It could bring hope to a lot of the short guys who can't afford the more expensive clinics. You're going to have a lot of people hanging on your every word in here from now on. Best of luck to you. I already can tell this will be one of the best or the best LL diary ever.
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Woooo grats Kilo! ;D
I know you'll make the right decision on your doctor, and you'll even pave the way for others to do LL in India with some peace of mind.
Thanks. Choosing a doc is going to be tough I think, at least among three of them.
Thanks for this post! The sense of anticipation, excitement, and suspense I feel regarding your imminent journey is forcing me to go grab some popcorn (I can't help myself, lol) : ;D But, on a more serious note, I want to sincerely say thanks so much for offering to share your thoughts and recollections of all of these interviews with us. It means a ton that, on your personal journey, you are doing so much to help others in the same boat, when you have no obligation to. Congratulations on making it to this point, the point so many people on this forum only currently dream of. You're truly an inspiration. I wish you all the luck in the world and hope that LL will be as meaningful and rewarding as possible for you.
Thanks, Tall. Hopefully I can help people with this. I think the biggest worry of mine is catching something while abroad. Hopefully the meds work.
Best of luck for you Kilokahn!!
Thanks Ubermensch :)
It's good to see you're going to give the other Indian doctors a chance in hopes that you'll find a good one (or more than one). It could bring hope to a lot of the short guys who can't afford the more expensive clinics. You're going to have a lot of people hanging on your every word in here from now on. Best of luck to you. I already can tell this will be one of the best or the best LL diary ever.
That's been on my mind for a while. I don't want to lead anyone with false expectations so I want to make this as unbiased as possible. Thanks for the encouragement.
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Really good post hope you find the fiest Dr :D how about mesuration ?
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whats ur height and goal
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Kilokahn the boss!
Good luck bro.
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You and I seem to have almost identical past history (except for the part about the endocrinologist office) and the same motivations for taking the leap of faith in doing LL.
Good luck with your journey..
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Good luck Kilo 8), nice list of docs
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Bro, take me with you we do the surgery together,
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Bro, take me with you we do the surgery together,
Thats some nice Bromance, "fly away with meee... (whispering at the end of the song: "Take me")" 8)
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Bro, take me with you we do the surgery together,
I think that’s how it should be.. Doing LL in group of 3-4.. ( if you agreed to do with same dr)
It’s not that you only can save some cash from that, but also it would be much easier to see someone going through the same thing .. when it comes to how we as human being could feel sad if we see someone is suffering to the end of this crap.. but when it comes to LL you’d feel better to see that you’re not the only one who is suffering.. of course you still have to say I’m so sad for your pain bla bla but deep inside you’re really happy.. you may get what I mean when you do LL.. so yeah better to do it with group
Good luck kilo, but who is mal khan tent???
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Good luck Kilo! I'm excited for you :), keep us posted on how your trip to India (and happiness) goes!
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Thanks for the well wishes guys. I'll update more as I get things ready. I'm just going to relax today though :D
Really good post hope you find the fiest Dr :D how about mesuration ?
My Measurements
Total Height: 165 cm
Sitting height: 89 cm
Wingspan: 170 cm
whats ur height and goal
I'm shooting for 5.5 cm on tibias. That'll get me just over 170 cm.
Good luck kilo, but who is mal khan tent???
It's a manipulation of the word malcontent.
1. mal·con·tent noun \ˌmal-kən-ˈtent\
- a person who is always or often unhappy or angry about something
- one who bears a grudge from a sense of grievance or thwarted ambition
The definition fits my thoughts about me thinking that my height has always prevented me from doing things, both by my own psychological barrier that I put on myself and from others who thought my height made it so I wasn't 'allowed' to do things the taller guys could, so to speak.
I just replaced 'con' with 'Kahn' from my username to make the title more personal.
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Wow, you have a really tall sitting height relative to your overall height. Good for you!
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I'm shooting for 5.5 cm on tibias. That'll get me just over 170 cm.
No offense but I think it's a really bad choice to only do 5.5 cm for lengthening when spending so much money. You should go for 8 cm and be 173 for one surgery. Also do Russia instead of India. Everyone there gets f***ed up.
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No offense but I think it's a really bad choice to only do 5.5 cm for lengthening when spending so much money. You should go for 8 cm and be 173 for one surgery. Also do Russia instead of India. Everyone there gets f***ed up.
None taken. I just think getting from 5'5 to 5'7 with one surgery is good enough and that my recovery will go a lot smoother at that amount as opposed to three inches on tibs, and if I decide to lengthen femurs in the future I'll be better off. If I do two surgeries I don't want to go beyond 11.5 cm, and I believe 5.5 cm on tibs followed by 5.5 or 6 cm on femurs would be better from a biomechanical standpoint than 8 cm on tibias followed by 3.5 cm on femurs. It would also mean that I'm paying a lot more per cm for the second surgery if I lengthen a lot on tibs and decide to go for a second surgery for the added 3 to 4 cm. Besides, lengthening both segments closer to the same amount would probably look a lot better aesthetically.
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No offense but I think it's a really bad choice to only do 5.5 cm for lengthening when spending so much money. You should go for 8 cm and be 173 for one surgery. Also do Russia instead of India. Everyone there gets f***ed up.
I am about the same height as Kilokahn and I had a goal of about 8cm on tibs for the same reason as Gichelu. More bang for the buck. But now my goal is 5.5 on tibs to ensure I get at least 5cms. I take the train to work everyday and I compare knee height to everyone I sit by. The guys who have 8cm longer tibs are usually around 190cm. I think 5cms is very good gain and will put me close enough to average and will heal much quicker than 8cms.
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No offense but I think it's a really bad choice to only do 5.5 cm for lengthening when spending so much money. You should go for 8 cm and be 173 for one surgery. Also do Russia instead of India. Everyone there gets f***ed up.
Voted for worst advice ever haha although I agree with the India part, but not with the Russian part either (they don't do LON/LATN/LATP). Saying you'll spend 7-10 months in frames and then actually doing it....
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You have to be a complete moron to go to any Indian doctor at this point. Have all the cases of people getting messed up not communicated well enough that India is a country best avoided for this kind of procedure? Not to mention that going from 5'5 to 5'7 you're still going to be short anyway.
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You have to be a complete moron to go to any Indian doctor at this point. Have all the cases of people getting messed up not communicated well enough that India is a country best avoided for this kind of procedure? Not to mention that going from 5'5 to 5'7 you're still going to be short anyway.
I'm sure there are some competent, ethical Indian docs out there who do LL. Maybe none of them would get in bed with Apo/SysOp/Prophet of LL and that's why we don't have much evidence.
But I would need to see many successful diaries in order to going to India.
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You have to be a complete moron to go to any Indian doctor at this point. Have all the cases of people getting messed up not communicated well enough that India is a country best avoided for this kind of procedure? Not to mention that going from 5'5 to 5'7 you're still going to be short anyway.
What a mean comment. You're suggesting that, just because he'll never be subjectively "tall" according to you, he should just give up. Well, news flash: not everyone is as lucky/narcissistic as you to start LL at average height. You have no idea what 5'5 people have to put up with through no fault of their own. LL is not about beauty for them, it's about being treated fairly. Honestly, I think that there should be a "social rights movement" for shorter folks. Surely you'll agree that Kilo will be treated better at 5'7 than 5'5. I know that I'd take being 5'7 over 5'5 any day without a doubt. I know at least ten times more 5'7 people than 5'5 people, so, Kilokahn, I honestly feel that you'll be much more normal looking at 5'7. Your height will no longer stand out, it will just look slightly bellow average but perfectly normal and common. Don't let the haters grind you down 8)
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You have to be a complete moron to go to any Indian doctor at this point. Have all the cases of people getting messed up not communicated well enough that India is a country best avoided for this kind of procedure? Not to mention that going from 5'5 to 5'7 you're still going to be short anyway.
I love you, too! :-*
Serously though, it's silly to dismiss an entire country because of the results of two doctors who were both affiliated with the same webmaster and had most of the same staff. I don't think it's a huge surprise that the problems carried over to the second doctor especially when you can't find anything related to Ilizarov surgeries when you look up his credentials.
What a mean comment. You're suggesting that, just because he'll never be subjectively "tall" according to you, he should just give up. Well, news flash: not everyone is as lucky/narcissistic as you to start LL at average height. You have no idea what 5'5 people have to put up with through no fault of their own. LL is not about beauty for them, it's about being treated fairly. Honestly, I think that there should be a "social rights movement" for shorter folks. Surely you'll agree that Kilo will be treated better at 5'7 than 5'5. I know that I'd take being 5'7 over 5'5 any day without a doubt. I know at least ten times more 5'7 people than 5'5 people, so, Kilokahn, I honestly feel that you'll be much more normal looking at 5'7. Your height will no longer stand out, it will just look slightly bellow average but perfectly normal and common. Don't let the haters grind you down 8)
Although I won't be tall even if I decide to do two surgeries, it's still an improvement and my I won't be nearly as held back psychologically. I think my proportions will look better after one surgery as well. As it is my shoulders are very wide and my upper body is a decent enough length. My legs are where it's noticeably shorter than others. On the wrestling team half the quips I got about my body were height jokes, the other half were on my short legs in particular.
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I'm thrilled who's Dr you're going to choose Kilo 'cos I'm thinking of going to India too probably later this year. ;D
Best of luck!
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Flight is in 11 days. Time for another update.
Medical Visa Requirements For India
Those thinking of going to India for CLL are recommended to obtain a Medical Treatment visa before entering the country rather than a Tourist visa and trying to extend their stay or switch to a Medical Treatment visa later. This will give you peace of mind and just make everything easier in the long run, as Medical Treatment visas (at least in the USA) are valid for an entire year from the date of issue. The easiest way to obtain a Medical Treatment visa is to send an e-mail to a hospital you are considering for surgery and tell them that you desire to have CLL and wish to have a Medical Treatment visa for entry. The hospital should have no problem writing a letter addressed to your nearest Indian Embassy/Consulate General of India Office and e-mailing it back for you to include with other documents to send in to the appropriate visa application center. I submitted my application to BLS International Services of San Francisco, which handled all applications for California and other parts of the Pacific Coast. They were a royal pain to deal with, mainly due to their haphazardly placed and contradictory information on appropriate fees to send in and what documents were really required, but fortunately they are no longer authorized to handle applications as of May 21, 2014. The Embassy of India has given the new contract for providing Visa applications to Cox & Kings Global Services, and based on their website it looks like their process is much more straightforward.
http://www.in.ckgs.us/visa/type-of-visa/medical-visa.crapml (http://www.in.ckgs.us/visa/type-of-visa/medical-visa.crapml)
If you are able to have attendants with you, you can bring two people under Medical Attendant visas that have the same validity as a medical tourist visa. If you have close friends or family who you trust and can bring with you, I'd highly recommend it so you don't have to be alone.
Awkward Doctor Visit
In order to obtain a Medical Visa I not only required a letter from a hospital in India, but also needed a letter from my primary physician to accompany my other documents. I got to my doctor's office in the early morning and after a brief wait in the lobby had my height, weight, and blood pressure checked by a nurse before my doctor came in. Out stepped the nurse and now I had to try and get that letter of recommendation from my doctor that would okay me for treatment in India. The following is how I remember our conversation going down.
Doc: Hey, how's it going?
Kilokahn: Good. How about yourself?
Doc: Not bad, not bad. So what's going on today? The nurse said you're going on a trip. Where to?
Kilokahn: India.
Doc: Wow, okay. Why India? Business, vacation?
Kilokahn: Well...not exactly. It's actually for a cosmetic surgery. Can't really afford the top doctors in the States for it so I found some doctors over there within my price range that have the credentials. Reason I came today is that in order to get this done I need a recommendation letter from you giving me the green light so I can get a Medical visa.
Doc: Interesting. What kind of cosmetic surgery is this?
Kilokahn: *jokingly* An elective one.
Doc: Hah, well what's this cosmetic surgery that you're electing to have done?
I had planned on keeping the real purpose of my trip to India a secret from everyone, including my physician, but it just wasn't going to work out that way.
Kilokahn: *after pausing a bit* Limb lengthening. To get taller.
Doc: I see. How does that work?
I then proceed to describe what I had learned about the process of limb lengthening, from placement of the fixators, to distraction, to consolidation and fixator removal.
Doc: That sounds scary. What would make you want to do that to yourself?
Kilokahn: It's something I can't get out of my mind. After years of being the butt of jokes, getting fired from a job because my new boss thought I wasn't tall enough, and having to deal with the social stigma that made me miserable in times parents tell their kids they should be happy, like prom, college, etc, I figure that if I can change how I look at myself and how others look at me, then I might as well go for it, then put it behind me and try to enjoy my life from that point.
My doctor didn't say anything for a while and looked deep in thought. It was awkward for me, not only because I had just revealed to him that I had height neurosis, but because my doctor also wasn't much taller than me. I didn't know if he was personally insulted, was thinking that he knew what I was going through, or was thinking that I'm like one of those anorexic women who think they're too fat and would recommend me to a psychologist. He finally spoke after what seemed like minutes of silence.
Doc: Well look, I understand what you're saying. Certainly there are settings where stature is advantageous, and I know there are women who can get picky about height. But I can't just write you a recommendation to go and get your legs pulled apart in a foreign country. Kaiser prefers that we don't recommend people get procedures elsewhere, especially elective ones. And with something like this, I wouldn't be comfortable giving you a recommendation in writing that you get this done to yourself.
As soon as my doctor said this I thought my goal was finished before it even started.
Kilokahn: But I'm not saying for sure that I'll absolutely get it, you know? I just want to be able to talk to some of these doctors at least, see what sort of practice they have going on there, get their opinions and all that. Honestly, if I saw things there that were sketchy or alarming I'd forget about it and come right back home. But this is one of those things where if I don't at least go over and talk to them I'll be thinking about this constantly and I'll just be stressed day in, day out.
This was all true. If none of the doctors in India seem any good, I will decide to do the surgery elsewhere.
Doc: Hmm... if that's what you want to do, then by all means. I still can't personally recommend they do this, though. The best I can do is write you something worded in a way that says I am not prohibiting you from seeking medical treatment over there. Will that do?
Kilokahn: Yes, that's fine. I just need something saying I saw you and you're not against it.
Doc: Okay I'll write you something up real quick. Good luck over there and remember to call our international travel clinic before you go so we can get you medication before you enter the country.
I wasn't exactly sure if that type of letter would suffice, but fortunately BLS International accepted it. The letter itself didn't mention anything about cosmetic leg lengthening and just said that I wasn't prohibited from seeking medical treatment in India.
Medications for India
After my doctor visit I was prescribed three medications for use in India.
(http://s5d1.turboimagehost.com/t1/18891649_prescription.jpg) (http://www.turboimagehost.com/p/18891649/prescription.jpg.html)
Left: Vivotif Berna Vaccine - For typhoid fever. Taken once every other day starting two weeks before departure date.
Middle: Atovaquone-Proguanil - Anti-malarial medication. Taken once daily starting one day before entering India.
Right: Ciprofloxacin - Antibiotic for bacterial infections. Taken twice a day with food for up to three days while symptoms persist.
You definitely don't want to contract any of these things while lengthening, so go to your doctor and get prescriptions necessary for international travel to India, should you decide to do your lengthening in the country.
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Malaria and typhoid fever?! India sounds so scary.
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Btw guys, if you have any questions in mind that you want me to ask these doctors, then PM me and I can make a list. I have questions of my own but maybe you'd like to know something specific like their opinion on weight bearing, how they would address a specific issue, accommodation options, etc.
My cirst consultatin is in 4 days :o
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Hi Kilo
I am following your investigation with great interest and like you am eager to get LL soon but with minimal risk and lowest cost possible. I am actively discussing with China and Syria right now with a view to flying to both countries to investigate in July/August. Had disregarded india until I started reading your views. I want to have my femurs lengthened (already very short compared to people with shorter torso by 5-7 centre metres). Would like LON or LTN and want to live in house/apartment during lengthening.
Who knows we might be in India together ?
Cheers
Liam
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Definitely ask doctors about the method (if any) that they use to keep the fibula bone in place relative to the tibia while lengthening. This is super important because you could end up with permanent ankle pain if it isn't done properly.
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ooops, I meant Serbia in my last post.
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Hi kilo,
I know u r really very much excited and eager to find a good doctor to do CLL .
I would like to share my opinion and thoughts about ur interest in indian doctors for CLL .
My intention is not to discourage but to give u insight about india and indian doctors .
I m from india and i already did my CLL with dr sarin which i m still trying to recover from .
The thing is your list of indian doctors to consult are mostly irrelevent to CLL except for
dr suhas shah , dr manish dhawan , dr mangal parihar .
the word perfection is not in the dictionary of most indian doctors , i have consulted with all these three doctors from which i found dr mangal parihar to be the most genuine and perfect doctor for CLL .
I wonder y its costly to do CLL ? Well CLL is a very risky surgery , which is why the doctor doing the surgery needs to be very skilled and experinced .
you should consult all these doctors as planned and sort out yourself , i said all these things because i wanted to share my thoughts and experience and try to contribute something to this forum .
IMO its crystal clear that by far only mangal parihar is an option for CLL in india if you do not want to take risk .
Gud luck on your quest !!@!!
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Hi Machine,
Thanks for your advice. I agree about your list for the three most relevant to CLL, but I do think Dr Talwar might possibly be a good option as well. I have not met him yet and from what Polycrates said from meeting him, by Dr Talwar's own admission Ilizarov is not his primary interest/business. However, I do think he is worth checking out due to his overseas training. His experience is kind of similar to Dr Parihar in the sense that they've both had fellowships with Dr Paley and trained under the same joint replacement specialists overseas.
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First Moments In Delhi
I arrived at Indira Gandhi International Airport this morning at 3 am after two long flights that took a total of 17 hours. The guy who examined my passport and Visa looked at me and asked how often I work out, along with what supplements I take because his son is trying to bulk up. I told him that every once in a while I take whey protein powder but nothing aside from that. After I got my bag at the terminal I was supposed to go to customs to declare that I had brought more than 10,000 INR but customs was closed or busy with other stuff apparently because they just told me to go on through and didn't even take the card I filled out on the plane. I was supposed to meet a representative from Rockland Hospital who would take me to Rockland Hotel or Rockland Inn, but I was unable to find him. Some locals came up and asked me if I was staying at a hotel and if I needed a taxi.
I was a little suspicious, but because some of the roads were closed by Delhi police due to some sort of incident I figured I may as well go with them because I had no luck finding the Rockland representative. The guys wanted 3,000 INR to take me to Rockland Hotel and because I had no other choice at the time I went ahead and paid. One guy left after a short while and the driver continued on to the destination. As I was pulling up the Rockland Hotel address my phone powered down and I couldn’t remember it. The driver ended up taking me to a hotel that he knew of nearby, which coincidentally happened to be Hotel Indira that was mentioned by Rockland Hospital's representative.
I thought I had a break because Indira International Inn is supposed to be a pretty good hotel for a cheap price of about $22 nightly, including breakfast. However, after the guy behind the counter woke up and I registered for a room, the guy told me it would be 11,850 INR for two nights ($200 USD). I told him that that's way higher than what I was told the price is and he told me that at most he could give me a discount price of 10,500 INR aka $178 USD. With no working phone and it being 3:00 am, I thought I had no other choice and paid the fee. I followed another employee to my room on the third floor, which itself looked fine. Including cable TV, a large bed, fridge, bathroom, closet, a high powered air conditioner, and wifi, the room was more than adequate for my taste. I went to bed irritated at how my first moments off the plane started out. At least I was able to watch Stephen Spielberg's "Hook" in English before I fell asleep.
First Morning In Delhi
I woke up a little before 8:00 am despite going to bed around 4:00 am. Got changed and went to the hotel lobby where I used the wi-fi to check emails, Facebook, etc. I saw an e-mail from Mr Maini expressing concern because he had a representative waiting for me at the airport and he was unable to find me. I sent him an e-mail explaining the situation of the roadblocks, phone powering down, and being unable to find the guy. Also told him how Indira International Inn charged me $180 USD for two nights. After my e-mail I then asked the guy at the front desk for the location of an ATM machine. I walked outside and saw a black cow chained next to a building, which I took a picture of. I wanted to pet it but a guy was looking at me and I figured it was his cow. Walked a short way to the ATM, noticing the stares from locals, and after withdrawing money from the ATM came back to the hotel and got a reply from Mr Maini, who expressed his apologies for the way the night turned out. He told me that he will try and get me my refund and said to go to the lobby at Rockland Qutab’s reception area where they will also assist me in getting a sim card.
A short while afterward I used III’s taxi service to get to Dr Dhawan’s clinic, which was maybe only 7 to 8 minutes away in traffic. Unfortunately he was not there but the receptionist took down my name and set me up for an 8:00 pm appointment. She told me to arrive at 7:15 because it’s first come first serve and I might not have to wait as long if I arrive earlier than expected. I found out that I couldn’t just go see him at Sir Ganga Ram hospital as he schedules surgeries at the private clinic and only does his consultations there. Spent a long time walking back because I had not yet gone to get a local sim card for my cell that would allow me to call III's taxi service. I thought "what the hell" and decided to walk the opposite way I came from just to get a look of the city. On the streets I was stared at by practically everybody. I noticed that just about everything was in a state of disrepair, and even the cosmetic clinics and dental offices were in buildings that looked run down from the outside, but presumably the insides looked a little better.
I had my hair tied up and was wearing a black t-shirt and black knee-length shorts, which made the summer heat feel even hotter. It really made me appreciate the southern California summers a lot more. It wasn't the first time being exposed to this kind of heat and humidity though, as South Carolina has a very similar climate in the summer. Just as I felt I was going to die of heat stroke, I found a large mall about 4 stories tall. I went inside just to get away from the heat for a little bit and had to go through a security scanner as I walked in. I noticed that many of the office spaces had not been filled with businesses yet but I did see a dominoes and KFC inside. I walked inside a large store in the back that went up three stories and purchased a travel adapter for 505 INR (much cheaper than the 10 Euro it cost at the airport) and three pairs of ankle socks for 297 INR. I gave the guy at the register 500 INR and the funny thing is he gave me 200 INR and three pieces of chocolate candy that the register was filled with as change. He explained to me that they didn’t have small change to make up for the 3 INR that was left so he gave me a piece of candy for each one.
Went back to the first floor into a restaurant that was styled in such a way that was new to me. They had various sweets, desserts, drinks and sandwiches, and you ordered everything you wanted at the front desk so they could give you your receipt that you would show to the employees working the other sections of the restaurant. I didn’t feel like risking dysentery especially after not having found a taxi yet, so I skipped the solid food items and just got an iced tea and a scoop of vanilla ice cream. I’m not sure how they make their ice cream but it tastes different from the kind in the States. It’s hard to describe, I guess it’s more milky if anything, but still good. The iced tea was great. It took them about 5 minutes to make but it had large round ice cubes in it, a fresh squeezed lemon, mint leaves, and a straw with an umbrella top. It was probably the best iced tea I’ve ever had, or maybe it seemed that way because I was dying of thirst.
Once I left the mall I became surrounded by guys who got out of green taxi carts. I told them that I wanted to go to Hotel Indira and gave one of them the address and asked how much. I thought he said 100 INR so I agreed. That's like $1.70 USD. Imagine getting taxi service that cheap in the USA. I was so nervous in the back of the car because Delhi traffic regulations are apparently non-existent. So many times I thought the guy was going to crash into someone or someone was going to crash into him. I made it safely to the front of the hotel and gave the driver the 100 INR and he looked at me disappointed saying “Only 100?”. I responded “That’s the price you told me. How much did you want?” He cked his head once to the right and said “I said 200 please”. I wasn't sure if that's really what he said or if he changed his mind, but he saved me a lot of time looking for a taxi so I gave him the extra 100 INR and went back to my room to bathe, rest, and charge my phone.
The front desk called my room a few minutes later and transferred me to reception at Rockland Hospital Qutab. The receptionist asked if I had received Mr Maini's e-mail and wondered when they could expect my arrival for a consultation. I told her that I'd be there in about 20 minutes and got Indira Hotel's taxi driver named Chacha to drive me. He first took me to a local photographer so I could get more passport photos for my sim card, but the owner of the shop wasn't there and the teen behind the desk was unable to do the photos himself, so I decided to just come back for it later. Chacha proceeded to drive me to Rockland Qutab.
Thoughts On My Day
I've had two consultations today and though I felt good about the first one, the second one really made me take a good long look at whether or not I really wanted to do cosmetic lengthening, in addition to how vastly different the online CLL community views lengthening compared to certain orthopedic surgeons. I can also say with certainty now that I will not consult with some of the doctors I planned to consult with after all, due to the results of my second consultation today. Rather than post each consultation one after the other, I've decided to post them all together once after I complete them. I check out at 12 noon tomorrow and will be taking the railway station to Mumbai, where I will also meet with Dr Suhas Shah and Dr Mangal Parihar.
Lastly, I want to point out that the reason for the apparent price inflation at Indira International Inn, according to another at the front desk, is that bookings for a very short period of time are significantly more expensive than bookings for extended stays. If you were to book a room for a few months you could look at a price of around $20 something dollars per day, but not when only staying for a couple nights.
Photos of the Day
(http://s5d1.turboimagehost.com/t1/19017275_indira_airport_watermarked.jpg) (http://www.turboimagehost.com/p/19017275/indira_airport_watermarked.jpg.html) (http://s5d1.turboimagehost.com/t1/19017283_indira_alley_1.jpg) (http://www.turboimagehost.com/p/19017283/indira_alley_1.jpg.html) (http://s5d1.turboimagehost.com/t1/19017289_indira_alley_2.jpg) (http://www.turboimagehost.com/p/19017289/indira_alley_2.jpg.html) (http://s5d1.turboimagehost.com/t1/19017297_indira_outside.jpg) (http://www.turboimagehost.com/p/19017297/indira_outside.jpg.html) (http://s5d1.turboimagehost.com/t1/19017303_indira_room_1.jpg) (http://www.turboimagehost.com/p/19017303/indira_room_1.jpg.html) (http://s5d1.turboimagehost.com/t1/19017309_indira_room_2.jpg) (http://www.turboimagehost.com/p/19017309/indira_room_2.jpg.html) (http://s5d1.turboimagehost.com/t1/19017314_indira_room_3.jpg) (http://www.turboimagehost.com/p/19017314/indira_room_3.jpg.html) (http://s5d1.turboimagehost.com/t1/19017317_indira_room_4.jpg) (http://www.turboimagehost.com/p/19017317/indira_room_4.jpg.html) (http://s5d1.turboimagehost.com/t1/19017320_indira_room_5.jpg) (http://www.turboimagehost.com/p/19017320/indira_room_5.jpg.html) (http://s5d1.turboimagehost.com/t1/19017322_indira_room_6.jpg) (http://www.turboimagehost.com/p/19017322/indira_room_6.jpg.html)
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This is great, especially the photos. Makes me feel like I'm exploring India to get LL with you.
Can't wait for the next entry.
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Such an awesome entry, I really can't wait to read about your consults!
Btw, can you speak the language of the locals? And are you treated just as a regular tourist?
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The consultations were borderline hilarious in hindsight after the second doctor completely disagreed with some of the things the first one said. I'm in Mumbai now, two days early for my consultation with Dr Parihar. I just e-mailed him and asked if I could move up my consultation to tomorrow. I drove by his clinic and I have to say that the photos in that diary from the other site make it look much worse than it actually is, at least from the exterior as its all I saw up close. Right now I'm staying at a pretty awesome hotel nearby. It would be too expensive to stay here the entire duration of the lengthening if I choose to go with Dr Parihar, but I'm going to see if they have a discounted rate. Another hotel not far from this one offered me a special tariff when I sent an e-mail explaining that I'll be disabled the whole time and won't be able to fully enjoy their facilities because of it.
Btw, can you speak the language of the locals? And are you treated just as a regular tourist?
Nope. I can speak a good deal of Mandarin but that won't help me, although I've seen a good amount of people who look like they could pass for a local in China - they all spoke Hindi though. I think I'm treated like any other tourist, perhaps I get a few more stares because I have this undercut where my hair is long and tied back but shaved bald all around the sides. They probably find it weird.
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Hello Kilokahn, Hope everything is good in Mumbai. I really want to do Internal Tibias soon and in Delhi because of the low rate. Can I do this procedure with you? And well done for sharing all your information
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Hello Kilokahn, Hope everything is good in Mumbai. I really want to do Internal Tibias soon and in Delhi because of the low rate. Can I do this procedure with you? And well done for sharing all your information
I still haven't decided which doctor or city I'll be doing my lengthening.
But this would be of interest to you. During my first consultation I was informed that not only is Precice available but that ISKD was also approved in India as little as a week ago.
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Really? This is exciting news. I think you're the most important person in the world of LL right now. If your search turns up a competent doctor who does a good job (and offers internals too!) then that makes India an LL destination again.
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Really? This is exciting news. I think you're the most important person in the world of LL right now. If your search turns up a competent doctor who does a good job (and offers internals too!) then that makes India an LL destination again.
This! Thanks so much for giving us information and hope about the possibility of getting internals done in India at a more affordable cost, for those who are financially a bit less flexible. Personally, I was going to have to save and go with Dr. Jamal, which might take a good while, but depending on what information emerges on these Indian internals, you may have played a huge role in making my dream come true sooner. I'm sure many others are in the same boat. Thanks from the bottom of my heart, Kilo!
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Just got back from Dr Parihar. On the subject of ISKD, he seemed surprised about its availability in India now but he said that because Precice is available there would be no point in using it because it would be putting unnecessary stress on both the surgeon and the patient due to the problems the device is known for.
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He brings up a good point. Did Dr. Parihar mention what his price was for internal lengthening with the Precise 2?
Would anyone happen to know the difference in price between the Precise2 and ISKD nails only, without the costs of surgery, PT, and other associated costs?
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He brings up a good point. Did Dr. Parihar mention what his price was for internal lengthening with the Precise 2?
$30,000 for the nails + $14,000 for the surgical costs. The price doesn't include complications and you will also be spending $5,000 or slightly higher for hotel stay. So it's very similar to Dr. Birkholtz's pricing.
Keep in mind that nobody in India has lengthened with internals yet, so if a doctor does internals for you there's still somewhat of a learning curve and you're taking a risk in that sense.
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Awesome to know!
Even if the price is about the same as Dr. Birkholtz's, it's a great thing that we now have a second option in that price range. Dr. Birkholtz is an extremely busy man, so Dr. Parihar provides a very viable alternative in the event that Dr. Birkholtz has more important surgeries/commitments to attend to (i.e trauma and deformity cases versus a non-necessary elective procedure), or for those whose starting height falls above Dr. B's maximum starting height limit.
Do you know if PT is included in the $49,000 with Dr. Parihar, or must one privately hire a PT separately?
You bring up a very good point about the lack of experience of Indian doctors with internals. Hopefully, it won't be much more difficult for them than implanting a standard IM nail in the LON/LATN process, minus the complications of using an external fixator.
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Do you know if PT is included in the $49,000 with Dr. Parihar, or must one privately hire a PT separately?
I believe you have to pay for physio during each visit but I'll have to get back to you on that.
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I believe you have to pay for physio during each visit but I'll have to get back to you on that.
Alright, thanks a million for the information! These have truly been a wonderful few days for me in learning that internals are indeed available in my price range. It means a ton that you're helping out the community so much through your own journey. We're, without a doubt, extremely grateful.
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Day 2: In Delhi & Mumbai
In the morning I ordered breakfast – an omelet wrapped around a slice of bread, a cheese sandwich, and coffee, which was brought promptly to my room. The breakfast was better than I expected – filling and free as part of the room package which was complimentary as long as the order was 150 Rupees worth of menu items or less. After eating I packed everything up and made it to the lobby before my 12 o’clock checkout time. I saw a man in the lobby brought in on a stretcher from Rockland Qutab's ambulance and placed in a room on the first floor. Judging from the accent of the man's wife I'd guess he was from Kenya originally. I had planned to take the train from the railway station to Mumbai, but I was told that the train would not be running and that I would be better off taking a plane. For 11,500 INR they booked me a 2:30 flight to Mumbai and included taxi service. I went to the ATM machine so I could pay in cash but my bank limit only allowed me to take out 10,000 INR during the day. Fortunately I was allowed to pay with my credit card.
The manager of Hotel Indira pulled up in his own car and drove me to the airport. On the way he asked me questions about what I thought of their service and what I thought about the real estate market back in the USA. He had a friend who was going to sell him her place in Flordia, which he was interested in getting, but after looking at the monthly maintenance costs he figured it wasn't worth it for something that was just going to be used as a vacation home. Arriving at the airport, he took out my bag and gave it to a paid porter that cost 150 INR to help me with check in. A guy at a touch screen took my booking information and gave me an aisle seat I requested and I was pointed to the check in counter. The lady behind the desk was quite nice looking and friendly. My bag was filled with so much stuff that I was 12 kg over the allowance, so I had to go to a separate counter and pay 3,000 INR to get my boarding pass. The security checkpoint was annoying because I had to wait in one line to put my carryon bag on the security belt and then wait in another line to get frisked by security. Once I got through that I had to go downstairs and wait in another line that was behind the outside area where airplanes were parked. From there I had to take a bus packed full of people to the IndiGo Airlines plane. Funny enough, there was an airline called SpiceJet. Were they stereotyping themselves? To get on the plane there were two large ramps, one for the front door and one for the back door. I climbed the front ramp and saw that the inside of the plane was pretty nice. The flight itself wasn’t bad. The effects of the cries from two infants were minimized by the flight attendants being so hot. They were probably the best looking women I’ve seen in India so far.
When I got to the airport I realized that I had not taken down the address of the hotel I planned to stay in so after I collected my bag from the baggage carousel I went to the Starbucks right outside the airport (and btw the Starbucks was the coolest one I’ve ever seen) for the wifi. I then realized that because I didn’t have a sim card yet, I wouldn’t receive the text message for the wifi password. Not only that, but the scratch card the employee gave me for free wifi didn’t work as an alternative. Fortunately I knew the address to Dr Parihar’s clinic, so I gave that to the prepaid taxi service and was driven the 6 miles to its front. The traffic was really insane and I began to think that maybe LA traffic wasn’t that bad. I’d really hate to learn to drive in Mumbai. After arrival in front of the clinic I told the driver that I didn’t actually need to go there now and was looking for a hotel nearby, so he took me the brief distance to The Fern Residency.
Check in was simple, which just required a passport, and for 13,000 INR I booked two nights in an executive suite just to experience what the nice hotels had to offer in Mumbai. I went back to the taxi to get my bag and gave the driver a 1,000 INR tip for being so helpful and then followed the guy from the front desk to my room on the fifth floor. I have to say I did not expect the hotel room to look as nice as it did. It contained a king size bed, large HD cable tv, two bedlamps, a desk, coffee table, comfy chair, large closet with a safe, and a bathroom with a nice shower. Once I got changed I walked outside a bit down different streets just to get a feel for the surrounding areas. The abundance of trees and humid climate really made me feel like I was walking in a city built inside a jungle. I went back inside my suite and ordered tawa mutton, baked cheesecake with berry compote, and fresh lime soda from the room service menu. Room service here was also prompt and I dug in to a meal that looked really tasty. The tawa mutton was pretty damn spicy for me even though I asked for it to be as mild as possible, though I suppose a local wouldn’t even sense the spice considering how spicy the food can get here. The cheesecake was not the best I had but still decent. I don’t think I’ll ever order lime soda again though. It was way too salty for a drink. After I was done I put one of my “Married…With Children” DVDs (I brought the whole season with me) in my laptop for entertainment. I called room service to take my plates from dinner but they took so long that I fell asleep before that, so when I woke up in the morning my plates were still there.
Day 3: Appointment with Dr Parihar
Woke up and took a hot shower, then went down to the lobby for breakfast. It was a decent buffet, with most things being bread and vegetable based. The only meat product they had were chicken sausages, but at least I was able to get fried eggs cooked for me by the chef. They also had good coffee, which is a must have for my mornings.
I asked the hotel receptionist where I could get my photos taken and a sim card. He gave me the directions of “go that way and you’ll find it”, pointing to the left. I went in the direction he told me, walking under a huge overpass and encountering flocks of crows, and a cow and goat kept in place with leashes. When I found the phone shop I was told that not only did I need my passport and a photo, but I also needed a visitors card from the hotel. The hotel hadn’t given me one so I left and got my photos taken ten shops away. I received 9 passport sized photos for 50 INR, a great deal, and walked back to the hotel. Considering my checkout would be tomorrow, I figured I’d just get my visitors card from the new hotel I decide to stay in.
My appointment with Dr Parihar was scheduled for June 13th at 4:00pm and although I e-mailed him to see if I could move it to today I never received a reply. I decided to call his clinic, but the lady who picked up just said ‘I can’t hear you, sir’ and hung up the phone. I decided to just show up at his clinic and ask if I could see him then. I didn’t quite remember where his clinic was and walked through streets in the area where I thought I remembered seeing his clinic. I asked several different taxis if they could take me to his address, but they all told me something in the local language in drove off. I could only assume they were saying “I can’t understand you man”. Back at the hotel I asked the front desk if they had any taxi service and they said they had packages for taxi service that I could purchase. When I showed the address they said that it’s way too close for taxi service and that I should just walk, but when I asked where exactly they said “oh it’s close, it’s over there somewhere”. So I walked back out again and stood in front of a busy main street packed with cars, wondering how the hell I was supposed to cross without getting killed. I was finally able to cross after many minutes by inserting myself in a group of people and crossing when they did – we still almost got hit. I was able to find Mangal Anand Hospital easily after I crossed that main street as I recognized some of the shops from when the taxi driver drove past them. After taking some pictures of the outside of the clinic I walked in and was directed to the second floor.
I left Dr Parihar's clinic with a good impression of him, and I wasn't put off by the look of it considering it didn't look to be in lesser shape than any of the other buildings here. Once I got back to the hotel I just lounged in my room and ordered room service. This time I ordered a chicken tikka submarine, pavlova (New Zealond Meringue baked dessert topped with whipped cream and cuts of green apple), and a drink called Black Cat, which is crushed black current, lime juice, salt and 7UP. Yet again the room service didn’t come up to take my plate after I called them, even though they told me to do so.
Photos of Days Two and Three
(http://s5d3.turboimagehost.com/t1/19044453_indira_breakfast.jpg) (http://www.turboimagehost.com/p/19044453/indira_breakfast.jpg.html)
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looks comfortable
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This is a pretty random question, but do you still feel short in India?
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This is a pretty random question, but do you still feel short in India?
No. I feel completely average. That's why even at 5'5 one doc told me I don't really need lengthening. On the whole, India isn't a tall nation. I only felt particularly short when Dr Parihar stood in front of me. He was a whole head and neck taller. Then again he was taller than everyone in the lobby by far.
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Good luck kilo
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Great photos, Kahn! Good luck.
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Day 4: Switching Hotels and Frustration in Mumbai
Checked out of The Fern Hotel and got myself booked into Hotel Maharana Inn. I decided to get myself the best room they had for the three days before I downgrade to another room. The executive suite is really nice and the HDTV inside it is larger than any of the TVs I've seen in any of the hotels so far. Ordered a cheese pizza and chicken masala, which were decent. I had no idea what pizzas in India were made like but I found that they were very different from the ones in the States. I had a laugh when I saw that they put peppers underneath the cheese in the pizza. Later I walked back to the phone store I went to the other day that said I needed photos for a sim card, but once I went in and told them I wanted a sim card the employee just said "no" and told me to go. By that point I got pissed because it was just about impossible to get a sim card without someone who could speak to people in the local language for you.
I decided to go and see Dr Shah afterwards and had the hotel receptionist call a cab for me. The staff explained to the driver where to go but he ended up dropping me off somewhere that was completely far away from it, as I found out from someone that I was really 6 km from Dr Shah’s clinic. I found that most of the cab drivers in Mumbai have no idea where the hell anything is. If you tell them an address they won’t have a clue unless it’s a famous monument or center and even then they still have to stop and ask for directions. It’s as of anybody in Mumbai can get a taxi and call himself a driver. It was much easier in Delhi to manage on your own and any tourist coming to Mumbai will probably have a difficult time alone. It would be much better to go as a group because at least you can have comfort in having people there with you when things don't go to plan. It started to rain hard, which made the weather even more humid and left me drenched. I eventually gave up trying to find Dr Shah’s clinic because I didn’t even have a working phone to call and ask them for directions. Maybe I’ll have better luck with that on Monday, but I’m not leaving the hotel until I’m sure I can see Dr Shah. It took forever to find a cab that knew how to get to my hotel even after telling the address and showing them the hotel card.
When I finally got back there was not much to do, so I ordered a mushroom cheese pizza, cold coffee with ice cream, and an orange juice and then watched some "Married…With Children" episodes on my laptop before connecting my PS3 to the HDTV. I saw that I had forgotten to pack the HDMI cable but I was at least able to get the composite cables to work. I do need to find an electronics shop with an HDMI though as Fallout 3 won't be the same without it. Played some Resident Evil 3: Nemesis and Final Fantasy IX for a bit before deciding to go back to sleep.
Photos of Day Four
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Another great entry. It feels like I'm right there with you. The excitement is palpable.
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I hear Mumbai is a lot more confusing than Delhi. If I did lengthening in India I would want to do with a good doctor in Delhi because of that.
Also how come you have the website name and corner picture on all your photos?
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Wow the hotel room and the pizza looks aswesome
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So I've decided which doctor I'll be doing surgery with. Before I reveal who I decided on, I'll start by sharing what I remember from notes I took down during the consultations.
First Consultation: Rockland Hospitals with Dr Rajesh Verma
Toward the end of my first day in New Delhi I was driven to Rockland Qutab by a driver at Indira International Inn named Chacha. As soon as I entered the hospital lobby, I heard my name called from the receptionist area. A young woman greeted me and had an employee get me a large bottle of water. I gave her my passport and she filled out a form with my relevant information before I was greeted by Mr Maini, the representative from Rockland who I had been communicating with by e-mail. He told me that in a few minutes we would go see Dr Talwar and after I paid the consultation fee (1,050 INR) he brought me down a floor to an office where I saw Dr Talwar's name on top with two others below it, Dr Gurdeep Singh Ratra and Dr Rajesh Verma. I sat down with Ishan and waited for Dr Talwar’s arrival, but a different doctor ended up coming in. He asked my height, how much I wanted to lengthen, and had me step on a scale. I was then told to take off my jeans and sit on the examining table while he went to go get a tape measure. While he was out the room I asked Ishan who the doctor was and whether or not I’d be seeing Dr Talwar. He told me that Dr Talwar was not at the clinic now but should I really wish to see him I could come back another time when he is available. For now, he wanted me to see Dr Rajesh Verma, as he would be the main surgeon during all cosmetic lengthenings, not Dr Talwar, though he would be part of the surgical team. Dr Verma came back and looked at my legs dangle for a bit before having me lie down on my back. He grabbed each tibia one at a time and had me bend my knees toward my body. Once that was over he started squeezing various sections of my tibias. I put my jeans back on and he told me that he thought tibias would be more appropriate for me to lengthen than my femurs. He sat at his desk and told me to ask him any questions that I have. The consultation lasted a full hour and I was able to get a good amount of information from him. Here's the gist of what I learned.
1) For cosmetic surgeries, Dr Verma much prefers monorail fixation to Ilizarov fixation because they're less heavy and bulky than the ring fixators and will restrict your movement less. He believes the results with a unilateral frame system are equal to those with Ilizarov fixators but has the added benefit of less discomfort to the patient. He said that you would have to do external only with monorails because the thick pins required for them would be blocked by the intramedullary rod with LON. However, if you are adamant about getting LON done, then he would use the ring fixators. He said that they haven't encountered any problems with stability using monorails because they use very thick pins.
2) When I asked what he would do if any malalignment started to happen during lengthening, he said that they would be monitor me through follow up visits. He stated that if you put the pins parallel to each other on the monorails then you shouldn't have problems with malalignment, but if you aren't careful and put the pins at an angle then that's when you start to have angulation/malalignment problems. Apparently if you put the pins parallel then that will help ensure the bone grows straight.
3) I asked what nails the team would use if the patient decided to get LON and he said that they would use Zimmer nails.
4) When I asked why he prefers externals to LON, he said it's because he doesn't believe LON is good way to lengthen. An example he gave is that in the case of infection with external monorails, he could just remove the infected pin and replace it. But if you get LON and the infection goes into your bone, then it's difficult to replace the nail and your regenerate can also become infected. He recognizes the advantage of shorter fixation time and doesn't think LON is that much more difficult than externals, but he'd rather avoid the infection risk.
5) I told him that I was concerned about the possibility of chronic knee pain with LON due to having to split the patellar tendon to put the nail in and asked him what his take on that was. He said that it's one of the complications with nailing, but if you do it right then you shouldn't have any future incidence of knee pain because you wouldn't affect the patellar tendon too much.
6) He would not do bilateral plate fixation. He said that plating adds stability but there are no distracting plates and he would not want to do plating after the lengthening is done. He said it's because the regenerate at fist is immature "baby bone" and shouldn't be mishandled. Because of this he would not do LATN either because the bone is too soft for the nail to be put in right after lengthening.
7) I asked how long I would have to wear the monorails for external only if I were to hypothetically go for 6 cm. He said that after 10 - 14 days I would start distraction, depending on the results of the first x-ray. From there I would lengthen 1 mm per day for 60 days, making it 70 - 74 days for the distraction phase. After that I would keep the frame on for approximately 140 days, or double the time it took to lengthen, so I should expect to wear the monorails for around 210 days.
8 ) When I asked how knee flexion contracture and equinous contracture are treated or prevented, he said that his patients hardly get knee flexion contracture because they start mobilizing the knee from the day after surgery, and the chance of knee flexion contracture is even smaller with tibia lengthening. For equinous contracture he said that I shouldn't start to develop it for the first 4 or 5 cm, but they put the sandals strapped to the frame and have you stretch constantly. He said if that problem still continues then they would do a tendon release, but that it was rare and needed in maybe one or two out of every 100 cases. He also said that when you lengthen your tibia bone from one part you're not lengthening the tendon or the muscle fibers, which are located in various parts of the leg and don't lengthen while you distract, which is why you need to constantly stretch them to prevent equinous. Interestingly, he said that with my bulk I likely wouldn't have a chance of equinous for the first 5 cm.
9) For the first ten days he would make you walk with the monorails on, but after 10 days when you start distracting you will not be allowed to. Once distraction is completed and he sees good consolidation then he will decide when you can bear weight again.
10) Patients are required to wash their pins each day with saline and warm water. Once the osteotomy site is closed you can then bathe safely.
11) I told him about Dr Paley writing that you need to fixate the fibula at an angle both proximally and distally. He responded that they do not do any fibula fixation. They will just do the osteotomy and the fibula will distract itself. He said that they sometimes take out the middle of the fibula for bone grafts, starting around 4 inches from top and bottom joints, and that the fibula's main role is ankle stability, which is why they leave the bony part around the joints. I told him I had seen instances where the fibula doesn't consolidate after the osteotomy whereas the tibia does and he said it will not alter the way you walk, the mechanics of your foot, or affect you at all.
12) Regarding follow ups, they will see you in the hospital every day and may discharge you on the 3rd or 4th day depending on your pain level. After discharge they will see you after one week and make you start distraction on the 10th. On the 14th day they take out the sutures from where they did the osteotomy. One week after the start of distraction they will do an x-ray and follow up every week until the end of distraction. If they detect any problems they will do another x-ray. At the end of your lengthening they will check to see that both legs have lengthened the same amount by measuring with a radiograph.
13) They will check for valgus (x legs) during each follow up. At that point the regenerate is still malleable so if they see valgus they will correct it.
14) For pain they would give you painkillers for the last few cm of distraction. He said that you should have pain for the first two days after surgery and then not much pain again until the start of distraction, which according to him wouldn't be significant for the first 4 or 5 cm.
15) They would prefer you to have a calcium-rich diet so the quality of regenerate is better. They give their lengthening patients two pills a day of a drug (forgot what it was but I think it started with cisco) that is supposed to promote bone formation. If you have calcium and a normal diet then he said you shouldn't need to take any multivitamins.
16) The complications that can come up are knee flexion contracture, equinous contracture, pinsite infection, non-union at the osteotomy site, or implant failure (if internals are done). After surgery they give antibiotics to decrease the chance of infection and sometimes they may have to change one of the pins or wires.
17) When I asked about the risk of embolism with LON or internals he said the chance is very low. He stated that embolism is a higher risk with fractures because they have to put in a larger diameter nail and ream more, whereas for cosmetic cases they would put in a smaller nail and the reaming would be less.
18) I asked about the possibility of amputation and he said that he would never admit me for surgery if he thought there was even a 1% chance of it, as amputation is his least favorite surgery to perform. He also said that amputations have a higher risk of being necessary if the surgery is on someone who had gotten in an accident and messed up their limb and they had to perform surgery to try and save it.
19) When I told him I was worried that my bulk would affect my lengthening he said that it would not affect it significantly. His main concern was how the person taking care of me would manage. He also said they'd probably have a slightly more difficult time operating on me.
20) During each x-ray they will measure the amount of distraction in case of pin loss, and if I were to have a goal of 6 cm they may recommend lengthening to 62 or 63 mm, or even 70 mm if my body can take it because he thinks 172 cm would be a good height.
21) Their team does not have a height limit on who they accept as a candidate. They will generally accept a cosmetic patient less than 165 cm with no problems, but they may try and convince you not do do it if you're taller than that by stressing all that cosmetic lengthening requires of you. But, if the person agrees to all that then they think they shouldn't have a problem agreeing to do it. Dr Verma personally doesn't like lengthening people who have an average starting height, though he would do it if you don't show any signs that you wouldn't be a suitable candidate.
22) People who they will NOT accept for lengthening are those with bone disorders that prevent good bone formation, heavy smokers, drug addicts, people who don't seem to understand what will be required of them during the post-op, people who will seem to have a hard time following doctor instructions, or people who have HIV.
23) They do not do any psychological evaluations on prospective patients, but they will require a consultation before surgery and make you write a consent form stating that you came to them to get the procedure done. Up to now they've never had a patient who has turned out to be psychotic.
24) Their team has apparently done a lot of cosmetic procedures together, though I didn't get an exact number. Dr Verma did say that they don't get too many people coming for cosmetic lengthening, though. Maybe 2 or 3 a month at the very maximum, but often times they can go months without a single inquiry about it.
25) I asked if there's a real difference between lengthening for cosmetic cases and lengthening for discrepancy or deformity. Dr Verma responded that when you do cosmetic lengthening you have to be really precise about things, such as the corticotomy being the same level on both sides so you can easily estimate the length you're getting. Cosmetic lengthening also requires much more careful monitoring because if they lengthen for a discrepancy of 7 cm, for example, and it's brought down to a 1 cm discrepancy, the person can still make up for it with a shoe raise and they can consider it a success. But with cosmetic lengthening if there's even a 1 cm discrepancy at the end of it all, it would be considered a failure on his part as a surgeon.
26) Dr Verma prefers a clean cut osteotomy to a fragmented osteotomy.
27) They can lengthen with Precice but he stressed that the problem with internals is the chance of implant failure which would require replacement of the whole device and additional surgeries to remove the failed implant and reinsert the new one.
28) He was sent an e-mail a few days before the consultation from the makers of ISKD stating it's now approved in India. He was not sure if they sent just a trial assembly or a whole set but he e-mailed them back to find out more info.
29) I showed him a picture of the infected screw that was popping out of Russianblues's leg and asked him how something like that would happen. He said that something like that can happen with any implant you put in the body and the rejection of the implant is an individual reaction that you cannot determine beforehand. He said another possibility for that happening is if your body is too thin and has little muscle cover. Apparently he's seen cases of fracture fixation, spine fixation, and hip fixation where that sort of thing has happened. He said the chance of something like that happening is extremely minimal, though, less than a 0.00001% chance. He then went on to say that medical science is "not a dot" which I took to mean that unexpected things happen all the time. He said they could operate on someone who has a lot of complications and they think won't make it past a week but then they see walking fine later. Or they could do a very simple surgery on someone who ends up with a lot of complications.
30) Because of my bulk and nutrition he doesn't think I'm a high risk or even a medium risk patient but they'll investigate all that with blood tests, x-rays, and a pre-surgery checkup done before surgery.
31) I asked if my size would make lengthening harder and he said that bulk is always a good thing. He said that they could operate on two patients, one who is very thin and one who is very bulky. Due to the amount of muscle covering the bone, the bulky patient would have a better source of blood supply to the area of the corticotomy as well as more stability to his limbs. He said the thin patient would have less stability and have "very cheap" blood supply in the area, which could make healing take longer.
32) Dr Verma, Dr Ratra, Dr Talwar, consultants, and junior residents will make up the lengthening team. Dr Talwar is the Senior Director but Dr Verma and Dr Ratra will be the primary surgeons.
33) The cost of surgery is about the same as is shown on Dr Talwar's page, but there are things not covered. The first two follow up consultations are free. You have to pay for your x-rays though, which are $10 USD to $15 USD. Follow up checkups after the first two are also between $5 USD to $7 USD. The doctors at Rockland don't actually monitor the prices themselves, basically whatever you go there for is put into a computer and the computer calculates the price they will give you.
I'll post the other consultations next.
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Very good information KiloKAHN,
I am doing my surgery in september with doctor Salameh, but this information is really interesting.
Cheers, paco
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Second Consultation: Dr Manish Dhawan at Private Clinic
After the consultation with Dr Verma I took a taxi back to Hotel Indira and hung out in my room for a while. It was nice to just browse the net and feel the cool breeze of the air conditioning. Around 7:30pm I took a taxi and arrived at Dr Dhawan’s clinic 15 minutes before my 8:00 pm appointment time. A male receptionist greeted me at the front desk and told me to have a seat. As usual I received intense stares from everyone inside the clinic that was waiting for Dr Dhawan in the main lobby. Soon a couple brought in their young daughter who was wearing a cast on her leg. From what I saw in the lobby, Dr Dhawan seemed to have a good mix of adult and child patients. After waiting for some time, Dr Dhawan rushed into the clinic wearing business casual attire and carrying takeout. After another 10 minutes of waiting the receptionist brought me into Dr Dhawan’s office and told me to sit at the desk and wait for him. I saw in the adjacent office that Dr Dhawan was checking on a patient currently. Taking a look around his office I saw various awards, pictures of himself at conferences, and a large assortment of models of different parts of the skeleton. The fan on the corner of the ceiling was focused on the chairs in front of Dr Dhawan’s desk and while I was sitting there people in the lobby were staring at me through the open door, which made the wait a little uncomfortable.
Dr Dhawan eventually came in at 8:30 and parked himself on his office chair. He reminded me a bit of the middle eastern guys in Beverly Hills that wear bling and have the top of their shirt unbuttoned. He asked with a very thick accent “So what questions do you have for me? What is your current issue?” I wasn’t sure how good his English was just judging by the accent but after telling him that I was there to consult about cosmetic lengthening it was clear from his response that he understood English perfectly. After brief small talk about how he remembered me from the e-mails I sent and how he just got back from the USA and Canada, he decided to get right to business and asked what questions I had for him. The consultation was about a half hour, cut short by the large amount of patients waiting for him in the lobby that he needed to see before he closed for the night. Here's what I took from the consultation.
1) He really stressed the point that cosmetic lengthening has to be done extremely carefully because you are performing surgery on a normal person to increase stature, so the outcome has to be absolutely perfect.
2) Two inches is the safe limit for him. Beyond that, he said your ankles and knee joints take a hit by starting to get stiff and can develop all sorts of problems. There's a risk of your legs going into valgus and also a risk of procurvatum with extensive lengthening beyond two inches.
3) Dr Dhawan prefers to lengthen with two methods. One method is LON. The other is doing very precise lengthenings with a hexapod fixator (basically India's version of the Taylor Spatial Frame). He much prefers lengthening with a hexapod because he can use computer software to exactly relocate your mechanical axis while lengthening if anything goes wrong. The thing with hexapod fixators is that you cannot put a nail inside while doing it.
4) Dr Dhawan said I have to make a choice between LON or hexapod. He said with LON I can remove the fixator early but I cannot do any adjustments with the nail inside, although the need for adjustments shouldn't be too much as the nail inside helps the bone form straight. However, he said with LON I should be less greedy with how much I lengthen, in addition to being aware that I can get a bone infection.
5) I told him of the concern I had with developing chronic knee pain if I choose LON and he said that he's found that people have had that problem, but that he prefers using the hexapod anyway because everything is under his control and there won't be any incidence of knee pain. The only drawback is the fixation time being equal to your typical external fixators.
6) Distraction will start 7 to 10 days after the surgery at a rate of 1 mm per day. The amount of time you would need to wear the hexapod is around 2 and a half times the amount of days you lengthened. So for 5 cm taking 50 days, you should expect to wear it for 150 to 200 days to be safe.
7) He would make you stop at 5 cm with LON but would let you go up to 7 cm for tibia lengthening with hexapod.
8 ) He would not do LATN because the regenerate is very soft and inserting the nail can harm it.
9) Told me I should not worry about the time it will take to remove the hexapod because I should pick the method that is safest. He said that he is a very careful surgeon and that he doesn't like to do "mass production" lengthening like certain other doctors. He will do the surgery "with perfection and not very fast". Dr Dhawan was also curious as to how I found him because he never advertises his services beyond posting medical info on his website.
10) Apparently people who went to Dr Sarin have come to see him for advice on how to fix their problems, so he's aware of the controversy that happened as former Sarin patients told him about the whole Sarin/Sysop deal that was going on. He said he also knows pretty much every limb lengthening surgeon because he is Secretary of Limb Lengthening Society of India.
11) I asked about the availability of internal methods and he said that although it is true that Precice is available, the issue is that he personally has never performed internal lengthening, nor has anyone else in India due to the lack of approval for use. He said that he has seen internals performed in front of him, Fitbone specifically when he had a fellowship in Germany, but that he has not performed it himself and will not use any method that he is not confident about. He said that he will only do lengthening with methods that he is an expert on and knows will safely make you taller and that he will not experiment on anybody.
12) Price for LON and hexapod is similar to what Dr Sarin charged before his price hike. Hexapod would cost a little more because software has to be purchased. Price would not cover follow up visits or stay in India, though on his website you can see a list of hotels where you can get anywhere from a 20% to 45% discount on your stay depending on which hotel you go to. The discount is for patients who are treated at Sir Ganga Ram Hospital, where Dr Dhawan performs surgery.
13) He will perform follow ups at either Sir Ganga Ram or his private clinic, whichever is more convenient for you.
14) He will talk to each prospective patient to judge for himself whether or not he believes the person is a candidate for limb lengthening. He will not perform surgery on anyone he thinks has some sort of "psychotic complex."
15) Doesn't necessarily have a height limit but discourages every person who comes to see him. Even for me at 165 cm, he didn't get why I would want the surgery. He said there are too many problems that can happen with limb lengthening, which is why according to him "a good surgeon is not one who does it [cosmetic lengthening] en masse. A good surgeon is one who knows how to handle the complications which happen with Ilizarov."
16) Will not let you bear weight during distraction. Once distraction is complete, then he will let you bear weight depending on the bone strength.
17) Said he would not do externals with monorails because you cannot change its axis, whereas with the hexapod everything is under his control. Believes that a good surgeon would not choose to use monorails for cosmetic cases. It was pretty funny because when I asked about using monorails he said "Why do you want to go and f*** yourself?"
18) I asked him about his opinion on fibula fixation and told him that I've seen other surgeons not fixate the fibula. He replied along the lines of "People who do not fixate the fibula are foolish people and they do not know limb lengthening. Fibula has to be fixated with angle at upper part and lower part." When I asked him about the dangers of avoiding it he said if you distract and the fibula is not fixed in both parts it will collapse. When I told him that I was told you only need the last few inches of the fibula by the joints he responded that without question it's mandatory to fixate both proximally and distally.
19) Said I could expect some pin tract infection, stiffness of ankle joints, and stiffness of knee while lengthening, but complications can be reduced by being conservative in the amount.
20) Suggests for people who want to do cosmetic lengthening that they go to the gym and bulk up their leg muscles for 6 weeks before surgery, in addition to stretching regularly.
21) Asked him if it's true you cannot get x-legs with LON and he said that it's very possible even with LON, especially if you lengthen higher amounts.
22) Will only lengthen femurs with monorails because he has experience with it, unlike internals. Said the limit for femurs would be 7 cm.
23) Follow ups will be every 10 to 15 days.
24) Asked him if he would perform limb shortening and he highly recommended against it because he said the "muscle gets pushed together and looks ugly."
25) Will do plate fixation if you really, really want it, but suggests to avoid it because of more scarring and possibility of infection.
After Dr Dhawan answered my last question, he called in a patient from the waiting room right as I shook his hand goodbye. The receptionist charged 2,000 INR for the consultation, twice as much as the fee for Rockland. I took one of those bike taxis back to the hotel and had a lot to think about. Dr Dhawan had effectively reduced the amount of consultations I planned to have by half. Speaking to him, it really drove the point home that I needed to do this with a specialist focused specifically on limb lengthening and not any orthopedic surgeon who will also do it. This is why I decided not to consult with the Spinal Injuries Center or Dr Murthy.
Photos By Clinic
Just a couple pics. One of the outside of his clinic and one of a relaxing park across the street.
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Wow, Dr. Dhawan seems to really know his stuff and seems quite confident. But, did he ever come off as arrogant or belittling when you told him what Dr. Verma said about the fibula and monorails? The area around his clinic looks quite nice.
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Wow, Dr. Dhawan seems to really know his stuff and seems quite confident. But, did he ever come off as arrogant or belittling when you told him what Dr. Verma said about the fibula and monorails? The area around his clinic looks quite nice.
He definitely knows his stuff and will likely be a perfectionist with his cosmetic cases. I wouldn't say he came off as arrogant, more like he's very sure that there's a specific way the surgery has to be performed and if he hears anything that deviates from that he thinks it's incorrect. Although, I did definitely get the impression that he doesn't think you should get lengthening done by any orthopedic surgeon whose primary focus is not on the sub-specialty of Ilizarov. He doesn't like the idea of you going to a spine or knee surgeon for leg lengthening, most definitely.
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Dr.Dhawan seems very knowledgeable and confident in the Ilizarov techniques. I reckon he would be a very good option in India.
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Haven't gotten around to typing up my notes of the other two consultations. In the meantime, here are my x-rays.
(Click for full size)
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Third Consultation: Mangal Anand Hospital with Dr Mangal Parihar
After taking some pictures of the outside of the clinic I walked in and was directed to the second floor. The lady at the front desk was very inquisitive and when I said I wanted to see Dr Parihar she wanted to know who my reference was, where I was staying, and to see the visitor’s card from the hotel, which I didn’t have. I showed her the room key to my hotel and just wrote down my stepfather as my reference from back in the States, figuring if they called him it would be better because he can speak Hindi anyway. She told me to have a seat and after a few minutes of waiting in the lobby I was directed to a room in the back where I saw Dr Parihar himself, the man whose Youtube videos I had been watching for a long while now. He didn’t notice me when I first walked in as he was looking at some x-rays on his computer monitor, so I sat down on the chair in front of his desk. When he turned around and said hello I got right to it with the questions. My consultation lasted around 2 hours. Here's the information that will be worthwhile to you guys.
1) I asked him if I should lengthen over my goal to ensure I get my target height in case of compression. He said that once the bone has been lengthened and locked into position then there is no real compression/shortening of the bone. He said that you have to factor in magnification when looking at x-rays.
2) I went on to ask him if I should be concerned about subsidence loss, which causes people to lose a few mm. He said it's possible but the loss is inside 3 or 4 mm. However, one could make a mistake in measuring the height gain in the first place due to x-rays not always being done in the same rotation and having a little bit of obliqueness. Basically, if the x-ray is not centered perfectly and slightly oblique you can get a different measurement by a few mm. He pointed out again that it is next to impossible to lose height and most cases of loss are likely just errors of measurement.
3) When I asked about pin loss, he said that it's almost always present but not to worry because what goes on outside is not mirrored by what is going on inside. He said that initially there is some lag because everything bends a little so the first 5 or 6 mm may not show a lot of distraction.
4) He knows that Dr Paley is an advocate of ITB release for femur lengthening, but he said that maybe 8 out of 10 times he would not find one necessary. He said that those who have the ITB release tend to have less pain while lengthening, but you have to consider whether or not it's beneficial in each case.
5) He thinks cosmetic lengthening is more difficult than lengthening for correction or discrepancy. He gave the example that patients with dwarfism have genetically more lax and stretchy tissues to start with so they don't have any trouble lengthening huge amounts. The same goes with a person with discrepancy, the shorter leg has soft tissues around it that were genetically supposed to be longer, so they're more elastic as well. With normal patients, the soft tissues are genetically supposed to be at the length they are, so they don't respond well to the lengthening.
6) Will not allow you to distract away from Mumbai.
7) If equinous is severe he would do a tendon release. As far as losing push off strength, he said it only matters if you want to be Usain Bolt or something, but it should not affect your day to day activities or your ability to do recreational sports. He said they can lengthen the tendons with what they call percutaneous techniques, where they basically slide the fibers. It leads to a certain amount of weakness but he said the data available shows it's not a significant loss in strength. He also said that the problem is that in medicine not everything is documented and not everything can be documented either. The example he gave was that if he does CLL in 10 patients and they are all from different backgrounds with different physiques, then you cannot extrapolate the results because there will be individual differences, just like how a bunch of siblings raised the same and having the same genetics may have different allergies from each other. So there are things that are reasonable and logical but not always 100% true, which is why one can argue many different ways.
8 ) He's found that in tibial lengthening most patients start having trouble by 5 cm and definitely have issues by 6 cm. If someone were willing to work extra hard then they could probably go a little more, but he has not lengthened anybody more than 6.5 cm. The 6 cm limit is not so much his doing as much as people starting to have difficulty walking and other issues developing at that point. He said someone who is extremely committed might get over that but he doesn't believe it would be a difference of more than 1 cm.
9) Is very skeptical of those who say they can lengthen large lengths like 9 cm and above with no significant problems when he sees so many have problems much earlier than that. He likes to look at what the literature (peer reviewed studies) say and as of now he hasn't seen anyone do 10 cm. He said that maybe doing that much lengthening is very important to someone but then the question is how long are you spending just trying to recover back to where you were.
10) Does not have a fixed height limit in mind but is very wary about taking on cosmetic cases as he's accepted patients before who had no clue what they were getting themselves into. He said with deformity correction the patient may experience a lot of pain with Ilizarov but they don't have much of a choice to start with because they have the deformity, and after the pain is done their major issue is solved. There could also be someone with a condition that requires constant surgery but there's still the prospect of being healed one day so they tolerate the pain and are grateful. With cosmetic patients, he can't make them understand what the pain will be like, and if they don't tolerate it well then the situation is bad, especially for international patients like myself because you have no family to fall back on. He said that around 90% of the people who inquire about cosmetic lengthening never return once they hear about the extent of surgery and recovery time, which he said is good because that means they didn't know what they were going to get into. He mentioned how Dr Paley says the persistent ones interested in CLL have height dysphoria, and said he doesn't have a black or white about who he will and will not accept, or whether CLL is a good or bad thing. He said he can do the surgery technically well but regarding whether or not he should do it for cosmetic reasons are different questions.
11) Said that one of the ways he can filter patients is through their psychologists, but unfortunately they're not always available. So he decides himself whether or not the prospective patient is a candidate, but most of the time the ones who are not have selected themselves out.
12) Said he's interested in function over length, and if he finds someone with serious equinous then he will tell the person to stop lengthening.
13) Is not one to do cosmetic lengthening in mass production because of the differences in each patient.
14) When discussing the costs of leg lengthening, he said part of the reason it's so expensive in the West is because they dispose things that can be used again after being sterilized, such as drill bits and fixators. Part of the reason he can charge less is because they can recycle a lot of the materials used in the fixators.
15) Interestingly, he said that the medical counsel in India finds doctor advertisements unethical so you won't find billboards or anything advertising specific doctors in India. Kind of reminded me of Dr Mahboubian's billboard in LA.
16) I told him that in my consultation with Dr Dhawan he made it seem like there are very few people I could go to for CLL with peace of mind that I'm getting it done safely. I asked why that is when I see that there are plenty of orthopedic surgeons world over. Dr Parihar responded that even though there are plenty of surgeons out there who can treat deformities, CLL is something that needs to be done by those at the top of the pyramid because you need someone who has the experience to fix any complications which can occur.
17) Does not perform LATN and hasn't met anyone who prefers it over LON. He doesn't like LATN because you have to fixate the wires in such a way that the nail can be put inside later, and if you don't do it properly then you may have to remove a wire, which runs the risk of subsidence. He doesn't think there is a demonstrated benefit with LATN over LON so you're going through extra trouble for nothing.
18 ) With LON he'll put in the largest diameter nail that he can under the circumstances, but the nail will always be of a smaller diameter in cosmetic lengthening than lengthening for trauma, because reaming is something that is injurious and he'd want to preserve the patient's biology as much as possible.
19) Won't do plate fixation after lengthening for a few reasons. Plate fixation is not as stable as LON, and it has also not been done frequently enough in cosmetic patients to justify its use. For him it would not be something he'd be willing to risk.
20) He's the one who teaches others how to use the hexapod fixation device. He said the hexapod is used only once you finish lengthening and take a full length x-ray, and if you find there's same malalaignment you can use the hexapod to adjust it. So the lengthening is done with the standard Ilizarov and the struts get put on later to turn it into a hexapod to make the adjustment.
21) Told him that I'm concerned about the higher rate of re-fracture with external fixation. He said that statistic is because people take the frame off earlier than it should have been taken off. He said their golden rule is "a month too late is better than a day too early." He avoids the risk of re-fracture due to his experience and ability to resist patient pressure to remove the fixator early.
22) Says one month per cm lengthened is the absolute minimum you would need to wear the fixator, but normally it comes to 1 and a half months. So for 6 cm lengthening you would need to wear the externals for 8 months or longer.
23) With his patients apparently nobody has complained of knee pain after LON as of yet, but in terms of healing for cosmetic cases he recommends going with external fixation over LON.
24) Would lengthen at .75 mm per day starting 7 days of rest after surgery because tissues have to get used to distraction. 1 mm per day is just the outer limit of how fast you can distract tibias.
25) He has used monorail fixators for lengthening before, but said the disadvantage of using it over the Ilizarov fixators is that there is nothing to hold the foot. With Ilizarov fixators, if you develop trouble in terms of equinous you can use rings to get the foot straight by gradual stretching. With monorails you have nothing to hold the foot. Although monorails superficially look easier, he finds them more complicated than Ilizarov because you have to be absolutely perfect with it, or you can run into other complications.
26) Also on the subject of monorails, he said that as a general rule, bulkier patients almost always have a tendency to develop valgus with monorails. The monorails are pulling only from one side and the monorail doesn't get much of a hold on the soft tissues on the other side, especially with bulkier patients, whereas with ring fixators you've got a hold on both sides. So for someone of my width, in order for me to walk around well he'd choose to use the ring fixators.
27) Is not convinced either way whether bulk is good or bad, but says for sure that while lengthening you need to concentrate a lot on stretching. He said he's even more convinced on the importance of stretching because they've had fracture patients who developed foot drop and after three or four years over time with stretching of the foot they've straightened out without the requirement of surgery. So he's convinced if you stretch well then your lengthening will be much easier.
28) Said there's no sense in using the ISKD and subjecting himself and the patient to stress even if it is available. He would use the Precice if internals were chosen because it has a good reputation and is controllable. The only issue is the cost because they charge the same for him to use it as they charge surgeons anywhere else. Doesn't think there's much of a learning curve because putting the nail inside in itself is not a big deal and pretty standard.
29) Apparently, right now the use of Precice in India is on a per patient basis and there are special permissions required for Precice to be used. The whole set comes from UK to India.
30) Worst case scenario, if I were to have problems with healing in the external fixator, then the option to put a nail inside can be done at a later date, even in the US if I were to have to do it.
31) Corrections to the bone can be done all throughout lengthening, even toward the end of distraction.
32) Procurvatum (forward bend), valgus (x-legs), and other malalignment should not happen if your fixator is stable enough.
33) The fixator he uses would have a combination of wires and pins. As long as you have the fixator on you would have to clean the pins each day, so you'll be changing a lot of dressings and doing a lot of cleaning in those months :D
34) There is a small risk of pinsite infection with externals, and if it happens then I would just take antibiotics. It would be next to impossible to get a deep bone infection with externals.
35) Would follow up on you once every two weeks while lengthening.
36) Can give you pain meds during lengthening to help with pain.
37) Is not a believer in weight bearing during distraction. Said there is no problem with weight bearing especially when doing external only, but because you are distracting in a goal to get taller, and when you stand you are compressing it, he finds it paradoxical. He allows weight bearing to the extent that you keep your feet neutral, basically standing. Once lengthening is over, then you should be walking as the more you walk the sooner the bone heals during the consolidation phase.
38) Showed him the snippet about fibula fixation that Dr Paley wrote about and told him how my first consultation determined that there would be no fibula fixation. He said that fibula fixation is very important and began to show me x-rays of how he did fibula fixation. As expected, it mirrored Dr Paley's method by having the fibula fixed at an angle both proximally and distally.
39) Talked a little bit about his fellowship with Dr Paley and said that Dr Paley has a maximum of 5 fellows located in India, one of which is him. Dr Shah and Dr Chaudhary are others.
40) He has never performed limb shortening and would not do it for someone.
41) Told him how there's a split in idea between the safety of humerus lengthening, Dr Paley saying it's the safest to lengthen in the body and Dr Guichet saying it's too dangerous because you can damage nerves and higher risk of paralysis. Dr Parihar shared Dr Paley's thought and said it's the easiest lengthening to do. He said there are ways to avoid nerve damage and that he has performed humerus lengthening before, so he'll do it. However, he thinks that as long as your hands can reach the pockets of your trousers then there should be no need for humerus lengthening.
42) Externals and LON don't have a noticeable difference in price. They'll both be around 900,000 INR for the surgery.
After the consultation was over I paid the receptionist the 2,000 INR fee for the consultation. When I got back from Dr Parihar’s clinic I just lounged in my hotel room and ordered room service. This time I ordered a chicken tikka submarine, pavlova (New Zealond Meringue baked dessert topped with whipped cream and cuts of green apple), and a drink called Black Cat, which is crushed black current, lime juice, salt and 7UP. Yet again the room service didn’t come up to take my plate after I called them, even though they told me to do so.
Photos of Clinic
(http://s5d1.turboimagehost.com/t1/19109812_m_hosp_1.jpg) (http://www.turboimagehost.com/p/19109812/m_hosp_1.jpg.html) (http://s5d1.turboimagehost.com/t1/19109813_m_hosp_2.jpg) (http://www.turboimagehost.com/p/19109813/m_hosp_2.jpg.html) (http://s5d1.turboimagehost.com/t1/19109815_m_hosp_3.jpg) (http://www.turboimagehost.com/p/19109815/m_hosp_3.jpg.html) (http://s5d1.turboimagehost.com/t1/19109816_m_hosp_4.jpg) (http://www.turboimagehost.com/p/19109816/m_hosp_4.jpg.html) (http://s5d1.turboimagehost.com/t1/19109818_m_hosp_5.jpg) (http://www.turboimagehost.com/p/19109818/m_hosp_5.jpg.html)
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You sure weren't kidding when you said you were bulky. Look at those thick legs! :o
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You sure weren't kidding when you said you were bulky. Look at those thick legs! :o
Is that fat or muscle?
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I wish you all the best Kilokahn, hope you get a succesful surgery and quick and smooth recovery. I personally would not be able to handle doing 2 surgeries, but in the looong run its probably healthier and more safe to do 2 surgeries with around 5 cm on each compared to doing one surgery with 8 cm.. if one can afford it of course.
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Wish you all the best KiloKahn, I think your diary is awesome. The consultations, travelling logistic and the photos are very detailed and should be a massive help to those considering India.
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The suspense is killing me. How soon do you plan to have the surgey? Good luck with whoever you dicide on.
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PS - Alot of good info from the consults. Your doing a tremendous help with all the information you obtained, especially for those who might still consider India for this.
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Hi guys. I had planned to update more before this but I've been in bed for three days, having caught some awful stomach virus. I had to cancel my appointment for getting my measurements because of it. My insides are on fire and I've got a killer fever. I'll update one I get over this thing.
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Sorry to hear this. Get better soon.
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I guess that's one of the hazards of lengthening in India. Get well soon Kilo.
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Probably got sick from contaminated chocolate ice cream that I bought from a market with an outside freezer. I got sick almost immediately after eating it. Fortunately this has calmed down.
I'm putting down the points of my final consultation, which was with Dr Suhas Shah. I was rather impressed with him and all the info I gathered will be put on my next update.
Have to check out of my most recent hotel tonight. I'm going to the hospital in an hour or so and my surgery is booked for tomorrow morning. After waiting about 8 years for this moment I almost feel like I'm in a dream now that it's finally happening.
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VERY, VERY GOOD LUCK WITH YOUR SURGERY.
Your information is very important for the community.
Cheers paco.
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Looking forward to read your diary, all the best!
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Best of luck to you! Looking forward to hearing much more!
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Good luck Kilo!!! You're going to do great :D Excited to hear who you ended up choosing.
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Best of luck for a smooth lengthening and recovery! :)
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Good luck in your journey
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Fourth Consultation: Ashwinii Accident Hospital with Dr Suhas Shah
I had tried to find Dr Shah's clinic once before and failed, but I was lucky enough to find a taxi who knew exactly where it was. When I arrived I realized why I had not found it before. Dr Shah's clinic is actually in an apartment building located right behind a Michelin tires shop, and the hospital sign is partially obstructed in the front. The only noticeable sign from the hospital is hung in the alley leading to it and its entirely in the local alphabet. I saw an open door to the left when I entered the main area to the apartment and saw that it was clearly a clinic. Though small, it was clean and the floors were shiny. A receptionist greeted me and had me put my shoes on a rack next to the door. When I sat on one of the chairs inside I watched a video playing of Dr Suhas Shah describing the Ilizarov method. The wait was about 20 minutes as Dr Shah was meeting a group of three people, but I eventually got to ask all I wanted. The consultation was about a half hour and the fee was 1,000 INR. I was pleasantly surprised at how jovial Dr Shah was, which was very different from his serious appearance and way of speaking in his video on Youtube. The following are the points I can remember.
1) Dr Shah has studied in Germany in addition to USA as a fellow of Dr Paley and Italy as a fellow of Dr Catagni. He has performed over 5,000 surgeries within the last 20 years.
2) He is a fan of weight bearing during distraction and will have you start weight bearing from the third day after surgery.
3) Prefers lengthening tibias over femurs as he says femurs come with a lot more complications.
4) Believes external fixation is the safest method of tibia lengthening but will also perform LON. Is not a fan of LATN.
5) He will perform plate fixation (LATP) as a way of reducing external fixation time. Said he has done plate fixation many times before and he thinks it's as good as LON.
6) He doesn't use the hexapod fixator for corrections after lengthening, unlike Dr Dhawan and Dr Parihar. Will monitor you during follow ups and check for things like valgus, procurvatum, etc, and do the corrections then.
7) Lengthening limit for tibias is 7.5 cm.
8 ) Told me I'd be crazy to consider lengthening a large amount like 10 cm on one segment and would be surprised if I'd be able to walk normally later
9) Also follows Dr Paley's method of fibula fixation both proximally and distally. He fixes the fibula with Shanz screws.
10) Said that in all of his cosmetic cases for tibia lengthening he will release the fascia and nerves. Told me that in his experience, 110% of the time you will face serious problems with equinous later if the releases are not done.
11) Prefers to do an ITB release in all femur lengthenings for cosmetic patients.
12) Asked me what the result of a car accident would be if I were wearing a seat belt versus if I were not wearing one. Said I may survive in either case but I'd be far better off if I took the precaution by wearing the seat belt. Explained that this is why he does the releases in all cases so he can avoid or minimize complications before they happen instead of running into them first and then trying to correct them after the fact.
13) Told me that I could expect to be able to run starting one year after date of surgery if I wanted 6 cm with exfix only.
14) Will perform limb shortening. Said it's not too difficult a procedure but you'll lose significant muscle power after the bone is taken out and would have to work particularly hard to regain the lost strength
15) Will perform humerus lengthening and says it's the easiest segment to lengthen in the body. Doesn't think anyone would need to consider it though after reasonable lengthening in tibias, but said it might be a necessity if you overdo it with two lengthenings and can barely reach your trouser pocket afterward.
16) Thinks internals are a straightforward procedure and if you want Precice lengthening he can do it for you. Only drawback he said was the cost. However he prefers it now over monorails because loss of ROM is a very common complication with them.
17) Showed me a video of a woman walking in shorts with her face blurred. Told me she's an actress who came to him for cosmetic lengthening to help her career. So he's done cosmetic lengthening before, not sure how many though.
18) At the same time, he also said that the reason so few surgeons can do cosmetic lengthening safely is because Ilizarov has a very, very steep learning curve. Said you need to go to someone with years of experience in correcting deformities and the like because those are the surgeons that have the experience with these complications to know how to fix them when they happen or avoid them from coming up in the first place.
19) Told me it's a very bad idea to go to any surgeon in India for leg lengthening who does not specialize in it. Said he's the Vice President of ASAMI (Application of the Method of Ilizarov) and that two certain other surgeons are unknown in India for leg lengthening and certainly not recognized for it internationally.
20) Would prefer to see you once every two weeks during treatment but said once a month is also acceptable.
21) Wants you to stay in India for the entire duration of treatment (meaning consolidation phase also) but said if you can't stay that long then he would want you to stay for distraction and then send him an x-ray every month through e-mail.
22) Said he is a very straightforward person who will tell you beforehand exactly what he plans to do to you during surgery, meaning you won't wake up later with specific releases or what have you done to you without knowing you were getting it beforehand.
23) Price quoted was very affordable.
24) Regarding the chronic knee pain after LON, said it often happens due to the diameter of the nail being improper or the insertion being done incorrectly. He said that with the right technique the chronic knee pain probability should be very minimal.
After the consultation was over I ended up going back to the hotel to deliberate on just who out of the four surgeons I met I'd feel most comfortable with doing my surgery.
Note: This is what i can remember. I wrote down notes but they're in my backpack and I'm not near it at the moment. I'll add anything from the notes that I forgot along with pictures of Dr Shah's clinic on my next update. If you plan on visiting Dr Shah you'd need pics to find his clinic anyway.
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Tx again for the very detailed info, your diary will definitely be captivating!
I am curious about statement 15.
How does femur and tibs lengthening affect ur arms reaching your pockets?? Upper body and waist line stay the same, unless you lengthen your torso, your pockets will always be at the same reach.
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Number 11. What is itb release?
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How are you doing after surgery man?? Keep us updated! ;D
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what doctor did he choose?
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Other points from Dr Shah consultation:
25) Has no height limit. Will lengthen you as long as he determines that you're sane.
26) He and his own psychologist will evaluate serious prospective patients.
27) Has a physiotherapist who can come to your hotel for extra cost. His assistamt can also come to help change dressings or with other fixator issues.
28) Also stated that LON does not prevent x-legs.
29) Says psychologically unstable patients or people with low pain tolerance are not candidates. Patients who are the most optimistic and dedicated often have the best results.
Here are the pictures from the clinic. The first picture shows a bit of the tire shop on the left, which is directly in front of the apartment complex where Ashwinii hospital is located.
(http://s5d1.turboimagehost.com/t1/19251382_ashwinii_road.jpg) (http://www.turboimagehost.com/p/19251382/ashwinii_road.jpg.html) (http://s5d1.turboimagehost.com/t1/19251378_ashwinii_alley.jpg) (http://www.turboimagehost.com/p/19251378/ashwinii_alley.jpg.html) (http://s5d1.turboimagehost.com/t1/19251380_shah_apt.jpg) (http://www.turboimagehost.com/p/19251380/shah_apt.jpg.html)
(http://s5d1.turboimagehost.com/t1/19251387_ashwinii_apt_sign.jpg) (http://www.turboimagehost.com/p/19251387/ashwinii_apt_sign.jpg.html)(http://s5d1.turboimagehost.com/t1/19251390_ashwinii_alley_sign.jpg) (http://www.turboimagehost.com/p/19251390/ashwinii_alley_sign.jpg.html)
(http://s5d1.turboimagehost.com/t1/19251386_shah_name.jpg) (http://www.turboimagehost.com/p/19251386/shah_name.jpg.html)(http://s5d1.turboimagehost.com/t1/19251384_ashwinii_lobby.jpg) (http://www.turboimagehost.com/p/19251384/ashwinii_lobby.jpg.html) (http://s5d1.turboimagehost.com/t1/19251385_ashwinii_kitchen.jpg) (http://www.turboimagehost.com/p/19251385/ashwinii_kitchen.jpg.html) (http://s5d1.turboimagehost.com/t1/19251392_ashwinii_waiting.jpg) (http://www.turboimagehost.com/p/19251392/ashwinii_waiting.jpg.html) (http://s5d1.turboimagehost.com/t1/19251393_ashwinii_shah_tv.jpg) (http://www.turboimagehost.com/p/19251393/ashwinii_shah_tv.jpg.html)
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Tx again for the very detailed info, your diary will definitely be captivating!
I am curious about statement 15.
How does femur and tibs lengthening affect ur arms reaching your pockets?? Upper body and waist line stay the same, unless you lengthen your torso, your pockets will always be at the same reach.
I guess he means your arms will look even shorter if you lengthen your femurs a good amount in addition to your tibia, like you're wearing stilts or something. That's what I decided he meant anyway.
Number 11. What is itb release?
It's where the iliotibial band is cut. It relieves pressure and it apparently makes lengthening easier.
How are you doing after surgery man?? Keep us updated! ;D
I've been writing a lot in MS Word as the days pass. Just haven't gotten the time to post it yet. I'm hoping to post it within the next day or so.
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Hi KiloKAHN,
Hope everything went well with your surgery! Do tell us which doctor and method you chose.
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Out of all responses from the meetings I think Doctor Shah looks like best choice. He does the releases like Paley and he is the only one who does the plate fixation. Looks like he has the most experience too.
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I would like to know more about number 10, can anyone describe the necessity/benefit?
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As you all can see from the topic title, I had decided to do surgery with Dr Mangal Parihar at Mangal Anand Center for Limb Lengthening & Reconstruction. It wasn't easy choosing a surgeon as I met more than a couple good ones, and my ultimate decision came after a full weekend of thinking it over. Despite choosing Dr Parihar, I would have felt safe with a couple of the other surgeons as well, so for those considering India I think it would be a good idea to meet them too and not just use my patient experience as your basis for choosing a surgeon. You might actually find one of the other ones better for you in terms of personality, CLL methods they offer, location, budget, etc. However, I do think I made the best choice for me and have high hopes for a positive outcome in all this.
Initially I was planning to do plate fixation and did not like the idea of spending so many months wearing frames. But after talking it over with Dr Parihar and Dr Divya, I changed my mind and decided to go with exfix only. If someone decides to go with Dr Shah or Dr Dhawan, perhaps then we'll have a patient experience regarding plate fixation. After being in frames for a bit now, I think I can tolerate wearing these for the time required.
Now on to what I guess would be the official start of my patient experience.
Visa Extension Troubles
A very annoying part of my CLL quest in India was being able to extend my visa. When I originally applied for a medical visa, Rockland Hospital in New Delhi had sponsored it. I was told that because tourist visas cannot be extended or changed, it would be far less of a hassle to just come on a medical visa and extend that if necessary. I came to India under the impression that although Rockland was on my visa, I wouldn’t be beholden to them if I decided that I would like treatment from a different doctor. Of course, if I had come to India right after I received it back in the mail, then I wouldn’t have needed an extension as they’re typically granted for just a day under 6 months. Unfortunately, the date of issuance was January 27 and I was unable to get free from work until mid June. This meant that as of my arrival in India, I only had a month and a half left.
When I finally decided on having treatment with Dr Parihar, he had a doctor downstairs submit my documents to Airtel so I could get a sim card and had another person escort me the following day to the FRRO to get my visa extended. The trip there was about 20 minutes by taxi and the one who escorted me was unable to go with me through the checkpoint (which was guarded by a soldier wielding an assault rifle). I climbed to the third floor, noticing that Pakistani nationals had their own special section to register on the second floor, and waited in line a good while before I reached the front desk. I informed the woman that I wanted to extend my medical visa and was told to go to a room on the side to make copies of my documents. After making copies, the lady took them and disappeared for a bit before coming out with a document which said I did not need to register because my visa was issued for a duration of less than 6 months. I looked at her bewildered and told her that the reason I came to the FRRO was to extend my Visa by three months (I even had a letter from Dr Parihar explaining everything). She gave me my passport and simply told me that I was endorsed by Rockland Hospital in Delhi so they could not extend my stay in Mumbai. All I could do was go back to Delhi and see the FRRO with an extension request from Rockland Hospital.
Now obviously if I was not planning to get treated by Rockland Hospital, there would be no reason for them to go through the trouble to register me. I was screwed and it looked like the only thing I could do was return to the States and wait for my visa to expire before applying once again with a letter from Dr Parihar to the Indian Embassy. I went back to Dr Parihar’s office and explained the situation. He went to the immigration bureau website and pulled up an e-mail address that he wrote to, asking if officers have some discretion in situations such as mine because he already accepted me as a patient and it would just be needless expense, time, and trouble for a genuine case to go back to the US just to apply all over again. He explained that he was an honorary surgeon at the Nagpata Police Hospital, so the guys at FRRO should be familiar with him and not to worry about it.
When I got back to my hotel I wrote to Cox and Kings Global Services for advice on what to do and in the morning they just said I had to follow the FRRO’s rules. I was about to start browsing flights back home when I was forwarded a message sent to Dr Parihar from the e-mail he wrote to, which said to have me see the chief of police at the registration branch to re-examine my case. When I went back to the FRRO a second time and showed that e-mail along with the other necessary documents, the same lady at the front desk didn’t even have me see the chief of police, but instead took my blood reports from Mangal Anand Hospital and directed me to a room where I was to wait for an agent. After some questions about what exactly my medical problem was and where I was staying, I was given an extension until October 27, effectively giving me more than four months in India. I think that lady at the desk may have been spoken to or something, but it was good to not have to fly all the way back to the States before treatment.
Checking into Mangal Anand Center for Limb Lengthening & Reconstruction
I was picked up at my hotel by a driver sent from Mangal Anand at around 9:30 pm and told to go to the first floor, where I would be taken to my room. I took room number 23, the first room on the first floor (which was actually the second floor but the first is called ground), and was approached by a nurse who had me sign a consent form and other paperwork agreeing to the surgery. She had me step on the scale and I saw that I had lost 9 lbs since arriving in India. No doubt I’d be losing even more weight in the coming months, both from lack of appetite and muscle atrophy. I unpacked some things from my suitcase and watched some Lord of the Rings: Two Towers on the tv, which had good cable access with a decent amount of English channels, one of which played movies all day. The room I was in had a large fan on the ceiling, an air conditioner, an extra bed, and its own restroom, so it was quite roomy.
Once my movie watching was over I entered the restroom and shaved my tibias, which took forever because I only had a single Gilette razor and no shaving cream. What worked the fastest was putting my foot in a bucket, filling it with water, and using the bucket water from the sink to continuously add lubricant for the razor. I tried to go to sleep afterwards but I was too anxious and slept maybe 20 minutes before being woken up at 8:30 and connected hands and feet with some tubes that acted like suction cups on my skin. One of the assistant surgeons came in afterward and told me to step out so he could take pictures of my legs from various angles. After that, Dr Divya came to stand next to me for a picture that I assume will be used as a “before and after” photo. I was then taken to Divya’s office to use his wifi so I could forward e-mail attachments from my banker to Dr Parihar, confirming that my payment had been wired. Divya told me then that the surgery would take around 6 hours and rather than be put under general anesthesia I would just be given an epidural that would make me numb from the waist down. I spoke to my parents a brief moment on Dr Parihar’s cell phone to inform them that I was about to enter surgery and then went back to my room to wait for the anesthesiologist to arrive.
Regarding Payment
Something I should mention that’s very important is how you should make payment to your chosen surgeon. The easiest way is through a wire transfer, but most banks will require you to make the wire transfer in person because they need your signature on the transfer request witnessed by a banker. Most likely you won’t want to transfer any money to a doctor before you go to India and meet him yourself. If you are still ‘doctor shopping’, then you definitely wouldn’t be in a position to transfer money before you leave for India.
The best way to get around this is to set up a joint account with a person you really trust, probably one of your parents. That joint account should be accessible online along with your checking account and whatever other account you may have. Once you’re sure you want to initiate the wire transfer, just transfer online the payment from your checking or wherever that money is stored to that joint account you set up (the transfer will show immediately), then send the doctor’s bank details to the other person on your joint account. That person can then go to the bank in the States for you and transfer the money to your doctor on your behalf. This is the simplest and fastest way I’ve found to make the payment.
Surgery
I walked into the Operating Theater and sat on a medical table in the center of the room, which was clean and had all the equipment you’d find in any OT I presume. It all looked modern and that relaxed me considerably. As all the medical assistants entered the room, Divya had me scroll through his iPod to choose background music. I decided to put on a classical playlist as I thought it would have the best ambiance. One of the operating assistants then put the needle for the IV into the top of my right hand, which stung a bit but wasn't bad. The worst part of the whole surgery came next, which was placement of the epidural. It was like a xenomorph from the Aliens series pierced my back with its tail and started squirming it up my spine. Aside from the initial stinging sensation, the worst part was the constant throbbing on my lower back in the side regions. The throbbing was similar to a throbbing toothache, just in your back, and the pressure felt like a hole was going to burst open. After a few minutes I was unable to feel anything at all from the waist down and I imagined I knew what a paraplegic feels like, or perhaps a tarantula after getting paralyzed by a tarantula hawk. The heaviness of my body was a little unnerving and my imagination raced (what if I had gotten this done on a boat and it started to sink right after? I’d be screwed!) but my concentration soon went on my legs being bent in the air and contorted to various angles as they were covered in Povidone-Iodine. I had something on my waist so I couldn’t see exactly what they were doing, but I saw them maneuver the catheter tube and knew they had put that in already. At that point I was thankful for the epidural.
Dr Parihar arrived not long after and asked me if I had chosen the music playing in the room. I hadn’t realized it but it had switched to Italian opera. “I told Divya that classical music was fine” “Yes but this is way too classical” said Dr Parihar as he switched it to music that was symphony and not opera. I dozed off for a little bit from lack of sleep and woke up with Divya asking me if I was tired. I could see one of my legs being cut into by Dr Parihar from a reflection on the wall to the right of me and looked at it out of curiosity a bit before falling asleep again until I was woken up and told by Dr Parihar that the surgery was over. I then moved onto a gurney and was maneuvered to another room where I was to spend the rest of the day. I fell in and out of sleep until a woman came and told me that she was the physiotherapist. She explained the different exercises to me and had me perform them. Every 30 minutes or so I was supposed to move my ankle up and hold it there for five seconds before moving it down and holing it there for five seconds. This was to be done on each leg for a set of 10. I had to do the same reps and sets for raising my legs in the air and moving my knee toward me. My left leg was unable to move at all but my right leg was fine for some reason.
Divya, Sister Molly (a very nice nurse and one of the operating assistants), and another operating assistant named Sumanyu came in to see me. They said I could have a sandwich if I was starving but said I should just drink liquids and start with light foods the next day, which was fine by me as I didn’t feel like eating. When I woke up again I had three slices of bread and a cup of water. A different physiotherapist came during the day and showed me some other exercises. Basically just tightening my knee on each leg for five seconds and releasing, moving my leg up and to the side, and back raises to help with the back pain from laying so much. After a few hours Sister Molly ordered me fried rice with chicken and egg inside from a nearby restaurant. I told her I could eat anything as long as it wasn’t spicy (non-spicy food was pretty limited up to this point) but I was pleasantly surprised at how good and non-spicy the rice was when it arrived. I hadn’t any pain as my body was still numb, which made doing the exercises very easy. So I did them for a while until I went back to sleep.
Photos (Click to Enlarge)
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I'm glad you chose Dr. Parihar. He's the one I would've picked too after reading your consultation summaries, specifically because of his thoughts on fibula fixation, not doing releases unless necessary, and hexapod fixation to correct misalignment.
The hospital doesn't look like anything fancy, but it seems clean and nice enough. It's about on par with what we had in Beijing, maybe a little better especially the bathroom. After getting used to Guang Ji Hospital I now think most western hospitals are too luxurious to the point of being overkill and a waste of money.
Thanks on behalf of the LL community for being a pioneer in India and writing this detailed diary, and thanks on my personal behalf because I'm having fun reading your diary and imagining I'm there. LL is an exciting time in a person's life, and I remember mine fondly, so this brings back good memories.
I hope everything continues to go well for you. Stay strong and smart through it all.
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Congratulations KiloKAHN on beginning your journey, I wish you all the best for your distraction and a speedy recovery! Hopefully, I will be joining your ranks soon. BTW do you plan to stay at Mangal Anand Hospital or move to an apartment nearby? What are the associated costs with everything so far?
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First Day Post-Op
The next morning I was wheeled into the room I had checked into originally. A large group of the staff came in with a frosted vanilla cake with cut mango on top and sang me Happy Birthday. I felt okay aside from earlier when I had a brief moment of wifi connection from upstairs. My mom messaged me through the Line app with “How does it feel to be two inches taller on your birthday?” I lost my connection before I could respond that it doesn’t work that way and I had to slowly get to that point over a period of months. Oh well, she’d soon find out.
One of the nurses scolded me and said I had to drink more liquids because my urine volume was low and also slightly red colored, which meant I had a mild urinary infection, so she came in with a carton of Tropicana juice and a pepsi, saying I had to drink all of it so I would urinate. The first physiotherapist I saw the day before arrived and guided me through exercises, which were pretty hard to do as the post-surgery pain had started and was located entirely on my right leg. I was glad that my left leg was still completely numb. After the exercises she told me that we were going to try and get me walking to the bathroom the next day. I wasn't looking forward to it, not even starting distraction yet and already hating the annoying discomfort of my right leg. It felt like a growing pain that just went on constantly without letting up. A nurse came in and shot some saline into my IV and said it would help with infection. She left and another nurse came in with the same chicken and rice meal I had earlier. They wanted me to get something else from a different menu, meat based in particular, but I wasn’t up for heavy foods. One reason was because I didn’t want to do any number two until I could use the toilet. I refused to let myself ask for a bedpan. Dr Divya and one of Dr Parihar’s fellows came to my room to check on me. We talked a little while about limb lengthening before they left and I fell asleep.
I woke up to a sharp sensation on the bottom of my right femur and a combo of throbbing and aching on the top of my right tibia. I tried to tough it out and ignore it. Hopefully the pain would go away, I thought. But the constant throbbing and aching pain eventually made me cave and I started swearing, calling myself a total f-ing idiot for ever being eager to do this to my body. What made the pain worse was that I had nobody to vent toward and I wished one of my parents would call me just so I could tell them how much pain I was in and how stupid I was for doing this. One of the nurses came in and saw that I had my hands covering my eyes and forehead. She asked if I was in severe pain and brought in a doctor I hadn’t seen before. I described to him what the pain was like and where it was located before he stepped out and came back with a needle, proceeding to give me a shot on the side of my right femur. A short while later the nurse came back and injected tramadol into my IV. The pain started to go down slowly but was severe enough to prevent me from sleeping more than a few minutes at a time.
Second Day Post-Op
I was given three slices of bread and tea in the morning along with a side of pain killer tablets, which I took right away. I managed to fall asleep finally and was woken up by one of the members of the surgical team who came to change my dressings for me. I noticed the right leg was very clean, but when the left dressings came off I saw the leg was covered in dried blood. He told me it was because that leg was operated on first and so the blood accumulated there. After the dressings were off he changed them all and gave me instructions on how to do it on my own in the future. The physio came and had me stand with my walker for support and walk a few steps. At that point, an elderly man stepped into the room and introduced himself. The surgeon who changed my dressings told me that the man was Dr L.M. Parihar, owner of the hospital and Dr Mangal Parihar’s father. L.M. was really nice and told me he wanted to introduce himself because he heard about the FRRO issue I had. He jokingly said “The FRRO didn’t want to register you as a foreigner, so you are Indian now.” But it turned out he worked hard to have the FRRO register me in Mumbai even though I was registered in Delhi. Apparently the change was definitely not typical, so I had a lot to be grateful to him for. After he left I went back to my bed. Divya then came and I told him of the severe pain I had.
Another physio came and had me do exercises. Eventually I called her because I wanted to walk to the toilet to release all the number two I had been holding. The walker was narrow for my body, despite me using the hospital’s larger walker and wearing narrower frames, and every few steps I would accidentally hit them together, which caused intense vibrating pain for a few seconds each time. It was even more difficult to sit down on the toilet and after the physio waited outside the door I had to slide my shorts off while sitting. Cleaning myself and putting the shorts back on was even more difficult, though I still managed it. After I was assisted back to my bed I was so exhausted from going to and from the bathroom that I did much more poorly on my physio than I had the last times, which was apparently very good for only my second day after surgery – they said it was because I had built up a lot of muscle beforehand. While the second physio was still in my room, a third physio who trained in the States came and got information on the exercises I was doing from the physio who assisted me to the restroom. Divya told her beforehand my lengthening goal and I let her know how long I was able to stay in India, and with that information she left to create a physio plan for me for her visits at my hotel after discharge from the hospital.
At night a young guy stepped into the room with my name and room number written down, asking to see me. Dr Parihar hired him to be my attendant and help me with things like getting on and off the bed, fetching me the urine pot, etc. Divya came back with sandals I had purchased earlier and helped the physio tie straps to them to attach to the fixator for helping prevent equinous. The forcing of the 90 degree angle wasn’t as bad as the slight burning sensation at the bottom of me feet from constant pressure of the sandals. Eventually a nurse came with a wheelchair because I told Divya that I’d like to go to the second floor briefly where there was wifi so I could check my mail. There I saw Dr Parihar again who discussed with me the pain I was having and told me they didn’t want to give me too many painkillers but if I was in severe pain to let the nurse know anyway. Got all my mail checking done, saw that only two people on my whole FB friend list sent me happy birthday greetings the other day, and told my computer screen ‘ah fk you guys’ before turning off the computer and returning to my room with the assistance of the guy Dr Parihar hired.
About My Frames
I saw Dr Parihar before surgery so he could let me know what the external fixators would be like. He decided that because of my bulk he would use smaller diameter rings - during surgery he decided to go even smaller than what he showed me and put on 160 mm diameter rings. Due to the small diameter there is some crowding on the side where my leg is close to the frame, but I prevent them from touching using cotton pads slid in between my leg and the frame. There are four wires and two pins at the distal and proximal ends, twelve points where the leg is being pierced with a pin or wire. There are three rings, and the middle rings typically have two pins going through the leg at the middle of the bone. This would make the frames more stable, but then that would also mean more skin tearing and a long scar down the middle during distraction. Because of this he decided to leave off the pins of the middle ring for now. He explained that leaving the middle pins off would allow more microscopic motion in the middle and result in thick callus forming. This might cause some degree of malalignment at the end of lengthening, but if malalignment happens he will replace the rods with hexapod struts and correct the malalignment. After that is fixed, he will replace them with the standard rods and add the two pins at the middle ring for added stability during consolidation.
You can see them in the photos below. I took closeups of all the pinsites, one of which had stuff coming out of it.
Photos
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I'm glad you chose Dr. Parihar. He's the one I would've picked too after reading your consultation summaries, specifically because of his thoughts on fibula fixation, not doing releases unless necessary, and hexapod fixation to correct misalignment.
The hospital doesn't look like anything fancy, but it seems clean and nice enough. It's about on par with what we had in Beijing, maybe a little better especially the bathroom. After getting used to Guang Ji Hospital I now think most western hospitals are too luxurious to the point of being overkill and a waste of money.
Thanks on behalf of the LL community for being a pioneer in India and writing this detailed diary, and thanks on my personal behalf because I'm having fun reading your diary and imagining I'm there. LL is an exciting time in a person's life, and I remember mine fondly, so this brings back good memories.
I hope everything continues to go well for you. Stay strong and smart through it all.
Dr Parihar has been really cool so far and the hospital itself is more than adequate for what you would need. The staff is attentive and you're never left abandoned while in pain, and that's what was important to me. I think the description of Mangal Anand Hospital in that other diary is way too dramatic about how rundown the place is supposed to be. I mean if you're coming to India you shouldn't expect 5 star scenery anywhere aside from a select few hotels.
Thanks for the well wishes. It helps having a community to write too, especially during the times when the pain gets worse.
Congratulations KiloKAHN on beginning your journey, I wish you all the best for your distraction and a speedy recovery! Hopefully, I will be joining your ranks soon. BTW do you plan to stay at Mangal Anand Hospital or move to an apartment nearby? What are the associated costs with everything so far?
Thanks a lot. I don't think you're allowed to stay at the hospital during the entire distraction period. I'm staying at a hotel nearby. They gave me a rate of $48.00 nightly inclusive of tax. Mumbai is the most populated city in India and it would be difficult finding an apartment with the amenities you'd want to be comfortable. The surgery itself is around $15,000, which includes the hospital stay, an attendant during hospital stay, food, and medication during discharge. Other costs just come from flight costs, blood test and x-rays before the surgery, hotel stay, food after discharge, and whatever bills you still have to pay while here.
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Beautiful little osteotomy cuts he did there. :-*
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good luck kilokhan,
finally you choose doctor mangal parihar.
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Third Day Post-Op
Woke up a little late. Sister Molly came and asked if I changed my dressings, which I told her no. A little while later my other assistant that switched places with the first guy in the morning ordered me food from the non-veg menu. As I was eating, Sumanyu came and asked when I would be ready to change my dressings. He returned after I was finished and brought the boiled water with saline and gauze strips with him. I had to change my dressings by myself this time and he gave me verbal instructions on how to do it. I had to wash my hands twice, once before I started changing dressings and once soon after because I touched my hair when it was dangling in front of my face. It took me a little over an hour to clean all my pinsites and change the dressings but I was confident afterwards that I would remember how to do it always after that. A guy came in today and brought in an extra-wide walker that was ordered for me. It easily fit both my frames in the center so I could now walk without accidentally clashing my frames together.
Physio came and had me do exercises and walk around the room a bit. I decided to walk all the way to the toilet and back because I really had to go. I still don’t want anyone bringing in a bedpan for me as long as I’m here. After the physiotherapist left I watched the Brazil vs Chile game with my assistant. I forced myself to walk to the toilet again and by the time I got back in bed my legs were throbbing so much that I wasn’t confident I’d be able to do all that well in physiotherapy the next day. It’s amazing how much energy walking takes out of you while in frames. The only bad part about it is actually walking. Standing doesn’t hurt at all and I could probably do it all day without even touching my walker because the frames are stable enough to take my weight.
6/30/2014
Had physio three times today. Woke up to the assistant’s voice saying “Eleven o’cloooock. Time is eleven.”, which irritated me because one of my pet peeves is being told the time when I wake up. I can't explain it, it's just a quirk I have I guess. I didn't say anything to the guy though. I was supposed to have a sponge bath and he pulled my shorts down while I was staring at the ceiling so he could wash my genital area. I pulled them back up immediately nd told him I could do that area on my own. Some things about this assistant get on my nerves, like his insistence that I scrub soap in my hands in the morning for a full minute despite having my hands covered in soap long before that, or missing the bowl by a good deal and getting water all over me when pouring water into it.
A different physio came in the morning. A quite lovely Indian woman who I’d totally try to pick up if I wasn’t in frames. Didn't think getting my crippled flirt on would be the best thing to do though. Dr Parihar came at the end of the day with Divya and Sumanyu to check up on me and offer encouragement.
7/1/2014
Woke up early today despite getting to bed around 4 am. Got a sponge bath and hair washed then had jam and bread with some tea. Physio came today and after my usual exercises she had me walk outside down the hall and back to my bed. Sumanyu came in and marked my rods with directional arrows and painted the nuts on one side. He explained how I was to turn for distraction and said I told to buy my own turning devices. My assistant was told where to purchase them the following day. Dr Parihar wants me to turn .75 mm per day at .25 mm each turn, spread throughout the day almost evenly. Walking was a lot less painful than usual but my pin sites hurt worse when changing the dressings. I saw that one pin site had gotten crusty stuff hanging out of it. I’m just hoping I don’t get any infections after I go back home. Got my dirty laundry sent to the cleaners. Twelve pieces for 480 rupees and I should have them at 4:00 pm the next day. The second physiotherapist said I had to drink a lot more water because my urine output was still low. Went to bed at 4 am after watching USA get embarrassed by Belgium in the finals.
7/2/2014
Woke up at 12 o’clock. Sumanyu came with some tools and showed me how to distract. I turned for .25 mm on all the knuts. I was still exhausted after he left so I told the assistant that I wasn’t going to do a sponge bath when he brought out the bucket and towel. Had the standard breakfast of bread and jam with tea (I don’t drink the milk as it gives me stomach problems). Later in the day Dr Divya came and replaced my rods with other ones that have a knob that turns after you click a button and lock after distracting .25 mm. It also has a distraction chart on the rod, so I was happy with the change as it makes distraction a whole lot easier. It made it so I didn't have to purchase any turning devices, so I wouldn't have to remember everything Sumanyu showed me about turning the other way. The new rods also add even more stability to the frame.I started a distraction chart too so I always remember how much I turn. The physiotherapist named Pratiksha came again. Did my exercises and walked out to the hallway today. Talked with her a bit about her career plans and informed her that I would be discharged to a hotel tomorrow. Hopefully she’ll be able to see me in the hotel every once in a while because she's the most talkative and friendly of the group of physios. Only got 9 out of the 12 pieces of laundry today. The place said to come back the next day in the afternoon for them to be finished. Oh well.
Below you can see the new distraction devices that were put on the frames. There are four on each one that I have to turn. You press a button down on the round silver part to unlock it and then turn it to the right until it automatically locks at .25 mm of distraction. This makes recording your distraction amount very easy.
Photos
(http://s5d2.turboimagehost.com/t/19317229_right_knobs.jpg) (http://www.turboimagehost.com/p/19317229/right_knobs.jpg.html)(http://s5d2.turboimagehost.com/t/19317202_knobs_close.jpg) (http://www.turboimagehost.com/p/19317202/knobs_close.jpg.html)(http://s5d2.turboimagehost.com/t/19317201_knob_close_2.jpg) (http://www.turboimagehost.com/p/19317201/knob_close_2.jpg.html)(http://s5d2.turboimagehost.com/t/19317200_knob_close_1.jpg) (http://www.turboimagehost.com/p/19317200/knob_close_1.jpg.html)(http://s5d2.turboimagehost.com/t/19317199_knob_close.jpg) (http://www.turboimagehost.com/p/19317199/knob_close.jpg.html)
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Hehe I had a gut feeling that you'd pick Dr.Parihar and do externals :) Thanks for pioneering CLL with Dr.Parihar. He seems like the best option in India. Your experience will be invaluable for prospective LL'ers who are considering Dr.Parihar or India.
Stay strong buddy, you will be taller in no time.
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How much does Doctor Shah charge for Precice?
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Hehe I had a gut feeling that you'd pick Dr.Parihar and do externals :) Thanks for pioneering CLL with Dr.Parihar. He seems like the best option in India. Your experience will be invaluable for prospective LL'ers who are considering Dr.Parihar or India.
Stay strong buddy, you will be taller in no time.
Thanks. The experience has been going well so far and I'm hoping it stays that way for the duration of treatment. Dr Parihar was best for me, but if someone wanted to go to a doctor more willing to do other methods like plate fixation, or believes that releases are always necessary for CLL, then I think Dr Shah would also be a good option to check out. Dr Dhawan also appeared to be technically good. Dr Parihar, Dr Shah, and Dr Dhawan all vouch for each other too, so you're probably safe with any of the three.
How much does Doctor Shah charge for Precice?
His external only price is $8,000 and LON is $9,000. I didn't ask him about the cost of Precice, but I imagine it would be the $30,000 for the nails plus the surgery fee. So I'd guess between $38,000 - $40,000 USD, accommodation excluded.
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I wish you all the best luck Kilokahn, thank you for this very detailed and well written diary.
One thing i wonder about, what was the specifics of the plate fixation you discussed with the surgeons that made you decide not to do it and go for exfix only instead? Was it simply because that there isnt enough patients who have done it already and thus a lack of knowledge of the results?
Also has the Dr Parihar given you any kind of estimate as to how long you will need to wear the frames? Like if he had some kind of average time frame based on his former patients.
Thank you again :D
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7/3/2014
Woke up at 11:30 am and distracted another .25 to bring me to 1 mm of distraction. The physiotherapist named Mohini came but I wasn’t done with my sponge bath so she said she’d come in 10 minutes, but I had spent a long time coming back from the bathroom and getting ready so she eventually left without me doing my physio. It’s a shame too because she’s the physio I’ve got a thing for. A team of three physios came later, one lady trained in the US in Connecticut for physiotherapy and was the leader of the group. She told me that they noticed even before the operation that my dorsiflexion was below average and that I have a naturally tight fascia, so they were going to try and release it a little to improve the ROM of my feet. She put some cream on her hands and started on my right tibia where she felt around for a bit and then pressed down before spreading her fingers across the surface in various areas of the top, side, and back of my tibia. There was a deep throbbing sensation that responded to the physios work and when she spread her fingers across the middle of my tibia it felt like I had a really bad bruise that was sensitive to touch. After the session she saw with her measuring equipment that my dorsiflexion had improved by 8 degrees. She gave me exercises to do with my feet to add to the other physio exercises I’m required to do. I’m willing to do it as much as possible though because I want to fight this equinous before it happens.
So far things have been really good here, the only real annoyances I had were with a couple of the attendants. One of them asked a bunch of times for me to help him get a visa into the USA, and when I said I had no way of doing that he told me that I must have a way of knowing how he could get one – somehow he had the idea that I could make it happen. The rest of the day was kind of awkward when I told him that there was nothing I could do. The other attendant was just really... not too smart. Example, I walk to the bathroom on the walker and he straightens out the slippery rug for me to walk on instead of removing it. I’ll come out of the bathroom and he’ll have a bucket of water right by the door that’s too heavy for me to move. He’ll put a bucket with very little water in it directly near the toilet so I accidentally knock it down. He’ll insist on trying to put on my sandals even when I tell him I’ve got it. These are minor things I guess, but when you're in pain in fixators the smaller things tend to grate on your nerves a bit more. I think the only big complaint I had with the guy though was that he would just sit on the bed across from me and stare intently while I’m writing or using the laptop, even though he doesn’t have to stay in the room and at least has a phone with 3G access so he can occupy himself with something other than staring at me.
Some days when that second attendant was there, the scene would like like this for minutes at a time:
(http://s5d4.turboimagehost.com/t1/19337153_1_pic.png) (http://www.turboimagehost.com/p/19337153/1_pic.png.html)
7/4/2014
Continuing distraction. Left leg is very sore and I have lots of knee pain. Encountered a new kind of pain today that hurt like hell every time it happened. I find that if I am about to fall asleep and quickly regain alertness, or fall asleep completely and wake up in the morning, I end up getting a muscle contraction that tightens around all the pin sites and relaxes after a split second. The pain is very brief but hurts a lot, especially on the pins and wires by the ankles. Legs were in a lot of pain today even after getting two physiotherapy sessions and exercising to loosen up the muscles. The few painkiller tablets I took didn't help much either.
7/5/2014
Woke up at around 12 o’clock with a really painful muscle contraction around all the pin sites. After washing and having breakfast, Mohini came into my room to do physiotherapy. I always like seeing Mohini. The thing I have for her makes any discomfort from the physio more tolerable. I had my second physiotherapy session at around 6 o’clock with Pratiksha. She taught me three new exercises, which were to help with back pain from lying down so much. Dr Divya came later and told me how discharge was going to work and had the chemist from downstairs meet me. Whenever I was to run out of dressings I would have to give this guy a call and order boxes in advance. I could get a discount of 100 INR ordering from him instead of going to the store. Ten boxes of dressings would cost about 600 INR. After everything was packed, I was taken in a wheelchair to the ground floor where I was put on a stretcher and into the back of the hospital ambulance. They took me to Maharana Inn and I had to use my walker to enter the elevator. The assistant from the room came with me and help set things up in the room. I was given a rate of $46.50 per night due to the extended stay. There was an even cheaper rom but they recommended this one as the other didn’t have any of the nice amenities and my stay would have been far less comfortable. They gave me a room closest to the front desk. Inside was a mini fridge, closet space, table, desk, bathroom with toilet, shower, towel and toilet paper, HDTV and internet access. Room service was all day and laundry service was available as well. Did physio on my own and had a Married...With Children marathon from the DVDs I brought.
X-Rays
Dr Parihar sent me my first set of post-op x-rays. I noticed that instead of a clean cut through the bone, it looked cracked or shattered. When I asked Dr Parihar about this, he said that he doesn't go in the surgery looking to shatter the bone intentionally, actually he prefers a clean cut. But he said not to worry about it. Sometimes the bone is just to solid to do a clean cut at the time of surgery and it ends up shattering, but the shattering allows for more surface area for healing. So I'm not really worried about it anymore. Dr Parihar is a very cautious doctor who tells it like it is, so I trust him that it's not something to be alarmed about.
(http://s5d1.turboimagehost.com/t/19336750_Set_2_1_Watermark.jpeg) (http://www.turboimagehost.com/p/19336750/Set_2_1_Watermark.jpeg.html)(http://s5d1.turboimagehost.com/t/19336751_Set_2_2_Watermark.jpeg) (http://www.turboimagehost.com/p/19336751/Set_2_2_Watermark.jpeg.html)(http://s5d1.turboimagehost.com/t/19336753_Set_2_3_Watermark.jpeg) (http://www.turboimagehost.com/p/19336753/Set_2_3_Watermark.jpeg.html)(http://s5d1.turboimagehost.com/t/19336754_Set_2_4_Watermark.jpeg) (http://www.turboimagehost.com/p/19336754/Set_2_4_Watermark.jpeg.html)
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I wish you all the best luck Kilokahn, thank you for this very detailed and well written diary.
One thing i wonder about, what was the specifics of the plate fixation you discussed with the surgeons that made you decide not to do it and go for exfix only instead? Was it simply because that there isnt enough patients who have done it already and thus a lack of knowledge of the results?
Also has the Dr Parihar given you any kind of estimate as to how long you will need to wear the frames? Like if he had some kind of average time frame based on his former patients.
Thank you again :D
Thanks Wannabegiant.
The reason I didn't do plate fixation really came down to choosing Dr Parihar as my surgeon. I found out he would not perform plate fixation for cosmetic patients at this time when it comes down to it. He said there haven't really been peer reviewed studies on the outcomes of bilateral plate fixation for cosmetic patients, so he wouldn't be able to say how my course of healing would be affected. He also didn't like the idea of doing them instead of LON because plates aren't as stable as nails. I wanted to avoid the knee pain possibility and any malalignment could be corrected with the hexapod if I did exfix, so I decided to go that route. Had I decided to go with Dr Suhas Shah, who was my second choice, I think I would have done plate fixation then because he seemed to be confident about its use and said he's done it a lot.
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His external only price is $8,000 and LON is $9,000. I didn't ask him about the cost of Precice, but I imagine it would be the $30,000 for the nails plus the surgery fee. So I'd guess between $38,000 - $40,000 USD, accommodation excluded.
That's probably cheapest in the world for Precice! Is it Precice 1 or 2?
Separate question how much do you weight? You said doctors told you your bulk would help with healing. How much bulk is it? I am a little heavier than average also. That will help with healing?
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That's probably cheapest in the world for Precice! Is it Precice 1 or 2?
I believe it's the latest version of Precice as Ellipse is the one contacting specific surgeons in India who they will allow to use it. I don't think they'd contact them for use on an older product. Could be wrong though. Best to send Dr Shah an e-mail:
http://www.suhasshah.com/contactus.html (http://www.suhasshah.com/contactus.html)
Separate question how much do you weight? You said doctors told you your bulk would help with healing. How much bulk is it? I am a little heavier than average also. That will help with healing?
Well only a couple doctors said outright that bulk is good. Dr Parihar for example said it depends on what kind of bulk you're talking about and didn't really say yes or no about bulk being a good thing. Only thing for sure the bulk caused was me having to wear frames of a smaller diameter than most patients.
When I got on the scale at the hospital it said I was 96 kg (211 lbs). I'm very compact and most people don't guess I weigh that much. I've got a wide frame for my height though:
(http://s5d4.turboimagehost.com/t1/19337600_10260014_485215021623694_3720062529829879633_n.jpg) (http://www.turboimagehost.com/p/19337600/10260014_485215021623694_3720062529829879633_n.jpg.html)
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That's a lot of weight for someone your height! I am about 167 and my highest weight when I worked out a lot was about 85kgs.
Do you think you might have too much muscle and resistance to lengthening on your legs? I remember reading captain Americas diary and he had a lot of muscle and he had problems. But maybe Sarins frames were just weaker.
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So glad to hear you're doing well Khan. The nights get lonely, I definitely know this, but once you start standing next to people and realizing you're almost average height, it makes it all worth it. Stay strong!
Btw, I envy your starting weight. You're built like a brick man! You're going to look great post lengthening. ;D
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Thank you for the fantastic dairy! These are definitely some great pictures you took ;D The beginning two weeks are very painful. I hope you are feeling better now. In terms of the crust you see around the pin site, don't worry, they are normal. If the discharge is yellow and clear then it's just regular bone discharge. However, if the color gets opaque and you are in pain then it's infection. For me, I on purposely leave these dried discharge on my pin site, they seem to help stabilizing the wound to the pin and cause less pain from movements.
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kilo... do you have an email for dr shah??? i have to get release for my equinus
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How is the air quality like there?
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Is that weight of muscle or fat?
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Lol i thought i was fat. i guess i don't have to tighten up anymore then. Pizza order incoming..
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That's a lot of weight for someone your height! I am about 167 and my highest weight when I worked out a lot was about 85kgs.
Do you think you might have too much muscle and resistance to lengthening on your legs? I remember reading captain Americas diary and he had a lot of muscle and he had problems. But maybe Sarins frames were just weaker.
I'll have to ask Dr Parihar tomorrow about whether or not he'll think muscle resistance will end up a problem for me later down the line. As of now I haven't noticed any particular tightness or resistance to the turning. Fortunately my frames aren't bending like Captain America's did, though it's because exfix only frames are more sturdy and full of more components than frames you wear for LON.
So glad to hear you're doing well Khan. The nights get lonely, I definitely know this, but once you start standing next to people and realizing you're almost average height, it makes it all worth it. Stay strong!
Btw, I envy your starting weight. You're built like a brick man! You're going to look great post lengthening. ;D
Yeah, one of the downsides of doing lengthening here is that not only am I the first international cosmetic patient (Dr Parihar has done 10 cosmetic cases all for locals), but nobody in this hotel is international. Actually since I've been here I'm the only Westerner I've seen. I saw one guy from Africa and a Chinese family at the Foreigner registration office and that's it. Not quite used to Indian cuisine either so there's that hurdle.
Hah, well my build definitely helped when I was on the wrestling team. I was often wrestling people much taller than me as nobody my height was close to my weight. It was awkward for them and it resulted in a lot of wins for me. :D
Thank you for the fantastic dairy! These are definitely some great pictures you took ;D The beginning two weeks are very painful. I hope you are feeling better now. In terms of the crust you see around the pin site, don't worry, they are normal. If the discharge is yellow and clear then it's just regular bone discharge. However, if the color gets opaque and you are in pain then it's infection. For me, I on purposely leave these dried discharge on my pin site, they seem to help stabilizing the wound to the pin and cause less pain from movements.
Yeah the first two weeks seem like they'll have been the worst. I'm just over that and despite continuing distraction the pain has lessened with more physiotherapy and increased standing. From what both you and Dr Divya described about infections, I think I have an infected pin near my ankle. I'm going to check on it tomorrow and see if I can get antibiotics for it. By the way, do you change your dressings every single day? I change them each day and clean them by soaking sterile gauze in boiled water. Is that the same procedure you were given for cleaning the pins?
How is the air quality like there?
Air quality is similar to what I'm used to, though I lived in downtown Los Angeles so I guess I'm used to bad air. It seems clean enough, but there are definitely areas of Mumbai where you just get this sewage smell that's not at all pleasant. I've found that Mumbai is very similar to Shanghai in a lot of ways.
Is that weight of muscle or fat?
Well when I was at my peak level of fitness on my university's wrestling team, I weighed 84 kg (185 lbs) and had very little body fat. I've done weight training for mass gain since the age of 13 so most of that weight was made up in solid muscle. However, after two years of being forced at a desk job for 10 hour days and slowed metabolism, I packed on the fat. Pretty much all of it was concentrated on my abdomen. Judging from my wrestling team body weight and level of fitness, I would guess that I have around 30 lbs of fat that I could stand to lose.
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Nice diary KK, i think you have chosen the best doc for this procedure in India. From looking at your pic i think you could go down near 80 kilos. Man Indians are "funny".
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Update: 7/13/2014
The other day I went to see Dr Parihar. For some reason I was out of breath every few steps on the walker and I had to rest for a bit. It was very odd because each day before I had no breathlessness. Getting on the auto rickshaw was a pain and it took me probably ten minutes to walk to the ATM. It was raining outside and one of the hotel staff had to cover me with an umbrella. I arrived at Mangal Anand Hospital and had to wait downstairs a bit for the x-ray guy to arrive and get the updated x-rays of my legs. After that I went to the second floor and walked slowly and out of breath toward Dr Parihar's office. He was standing at the end of the room with a concerned look and asked me how long I had this issue. He had me get a chest x-ray immediately after moving me to a wheelchair, but fortunately there was nothing wrong with my lungs. He supposed that my tiredness was due to putting too much weight on my arms while moving with the walker and not enough on my legs.
I was led into one of the doctor's offices and had my osteotomy staples removed. They were taken out with pliers but I hardly felt it at all. Dr Divya then changed all my pin sites and looked at the ones I thought were infected, but he and Dr Parihar both said it was normal discharge. A few of the wires near the knee and ankle have larger holes surrounding them than the others, which was done intentionally by Dr Parihar. He cut the skin around them because there's naturally more movement in those areas and doing so would reduce pain and skin tearing. The issue with this is that more discharge tends to get stuck in those areas and I have to work harder to clean them.
You can see in the photos below that the fibula osteotomy is a lot larger than the tibia osteotomy. Dr Divya told me the reason it's much longer is because there's a blood vessel right behind it as well as muscle blocking the bone. They don't do a fibula osteotomy similar in size to the tibia osteotomy because the smaller it is the more blind the surgeon is getting to the fibula and the risk of damaging something is further increased. The tibia osteotomy can be very small because the bone is right underneath so there's no real risk involved.
I was given antibiotics and more pain medication. I had to pay for them so any further medication you get is not covered by the original surgery cost. You also have to pay for your own dressings, which are 500 INR per box.
I had to have a physiotherapy session downstairs after seeing the doctors and this time I had to do 15 reps on all the exercises. I was also given new exercises for arm strength in addition to breathing exercises.
The last couple days have been very uncomfortable and I've had a hell of a time trying to get to sleep due to discomfort from the pin sites. Dr Divya said he'll get me some sleeping medication to help with it.
Photos
(http://s5d4.turboimagehost.com/t1/19408940_checkup_office_1.jpg) (http://www.turboimagehost.com/p/19408940/checkup_office_1.jpg.html) (http://s5d4.turboimagehost.com/t1/19408941_checkup_office_2.jpg) (http://www.turboimagehost.com/p/19408941/checkup_office_2.jpg.html) (http://s5d4.turboimagehost.com/t1/19408942_fib_osteotomy.jpg) (http://www.turboimagehost.com/p/19408942/fib_osteotomy.jpg.html) (http://s5d4.turboimagehost.com/t1/19408943_fib_osteotomy_close.jpg) (http://www.turboimagehost.com/p/19408943/fib_osteotomy_close.jpg.html) (http://s5d4.turboimagehost.com/t1/19409383_tib_osteotomy_1.jpg) (http://www.turboimagehost.com/p/19409383/tib_osteotomy_1.jpg.html) (http://s5d4.turboimagehost.com/t1/19408946_tib_osteotomy_2.jpg) (http://www.turboimagehost.com/p/19408946/tib_osteotomy_2.jpg.html)
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Hi Kilo, glad that you didn't get pin infection! I don't dress my pin site everyday. It's either every other day, or every three days. What I do is I use iodine swaps to clean the sites. After letting them dry for 5-10 mins, then I wrap them tightly with gauze.
Looking at your picture of the fibula scar, woo, they do look quite long. I am looking at mine now. Yes, mine is also longer than the tibia scar, but not by much. Also, it seems quite interesting that doctors in India like to use surgical staples to close scars. Mine is done with surgical glue.
Have tried to take Melatonin to go to sleep? For me, that world even better than sleeping pills, plus it doesn't have much side effect. I usually take 10gm. Hope you feel better!
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Responding to ShortyMcShort's question from Dr Dhawan's page:
I read your other posts Kilo and Im not sure if it was you or another poster who said add another $15,000 or so for accommodation, food, physio and etc. So another $15,000 and its at $25k, and it could even reach $30k. My question is why did you choose going to India with Dr Parihar over say Dr Birkholtz in South Africa who has a package for $30k externals and $35k for LON/LATN, yes I understand Dr B is still more expensive, but no hassle of having to find accommodation and etc. And the hospital and accommodation seems really nice in South Africe(based on the pictures of course) and clean, which is the complete opposite of India
Genuine question by the way, not trying to discourage you or anything like that and I hope it doesnt sound that way. Very curious about your journey as it could help me to decide on my decision soon when Im ready. Thanks
With Dr Parihar I think everything will total around $25,000 USD maybe a little extra. For Dr Dhawan it might be closer to $15,000 + depending on the hotel you stay in (generally cheaper in Delhi than Mumbai) and how lucky you are with finding cheap flights. You might save even more with Dr Dhawan if you can arrange a flat and a caretaker.
One of the reasons I chose India was because I have a little extra security over here. I have family with a lot of personal connections in India and valid visa status, so should anything go wrong I could have some trusted people come to assist me at quick notice. Finding accommodation here wasn't really difficult. It could be if I wanted a flat or apartment in Mumbai, but I preferred to stay at a hotel anyway because the hotel staff takes care of so many things that there's no real need for a caretaker. Plus it's just way more comfortable, so I don't mind spending the extra money. The hospitals themselves may not be fancy but they have what you need for the surgery and the brief stay at the hospital. I wasn't able to be all that mobile so even if the hospitals were fancy I don't think I could have made much use of it. Being seen by a doctor who was trained and recommended by Dr Paley but also in my price range was a huge plus as well. Dr Parihar is very active in workshops teaching Ilizarov and is probably the most famous Ilizarov surgeon in the country. If you look online he's attended a lot of ASAMI conferences that Dr Paley, Dr Guichet, and others have attended too. So there's that extra layer of confidence that my surgery was done well.
Hi Kilo, glad that you didn't get pin infection! I don't dress my pin site everyday. It's either every other day, or every three days. What I do is I use iodine swaps to clean the sites. After letting them dry for 5-10 mins, then I wrap them tightly with gauze.
Looking at your picture of the fibula scar, woo, they do look quite long. I am looking at mine now. Yes, mine is also longer than the tibia scar, but not by much. Also, it seems quite interesting that doctors in India like to use surgical staples to close scars. Mine is done with surgical glue.
Have tried to take Melatonin to go to sleep? For me, that world even better than sleeping pills, plus it doesn't have much side effect. I usually take 10gm. Hope you feel better!
I slept so hard with the sleeping pills I took the night before that I slept all throughout the day and didn't change my dressings. I was worried a bit but reading that you do yours every other day or every three days is comforting as you don't have any pin site infection issues. Yeah the staples were fun to look at. It made me think I was put together like a Frankenstein creature lol. I'm feeling better now but I've got a lot of sensitivity on the osteotomy site on my right leg and on the back of my left calf muscle.
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Thanks for the reply KK
I have a few questions I'd like to ask
1/ How long do you intend on staying in India for? Just for the distraction phase or will you be staying there until frame removal?
2/ Could you take some pictures of the hotel you are currently staying at, when you are ready of course and only if you can.
3/ How did you pay the hotel? In instalments or did you pay for your whole stay in one transaction?
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Thanks for the reply KK
I have a few questions I'd like to ask
1/ How long do you intend on staying in India for? Just for the distraction phase or will you be staying there until frame removal?
2/ Could you take some pictures of the hotel you are currently staying at, when you are ready of course and only if you can.
3/ How did you pay the hotel? In instalments or did you pay for your whole stay in one transaction?
I'll be here just for distraction. Dr Parihar said I should be fit to leave in the second or third week of October. I can take pics later but here's the link to the hotel I'm staying at so you can get an idea of what it's like. It's about 5 minutes away from Dr Parihar's clinic by auto rickshaw. www.hotelmaharana.com
I'm paying the hotel in one payment once I leave but they will give you other payment options if you ask. I got a discount rate due to extended stay of 2877 INR per day, which is around $46 USD. They have their own restaurant, complimentary wifi, all rooms have a private bathroom and shower, HDTV with cable access, and laundry service which is a separate charge.
Biggest challenge for me is getting used to Indian cuisine. I just want a steak or a burger.
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I'll be here just for distraction. Dr Parihar said I should be fit to leave in the second or third week of October. I can take pics later but here's the link to the hotel I'm staying at so you can get an idea of what it's like. It's about 5 minutes away from Dr Parihar's clinic by auto rickshaw. www.hotelmaharana.com
I'm paying the hotel in one payment once I leave but they will give you other payment options if you ask. I got a discount rate due to extended stay of 2877 INR per day, which is around $46 USD. They have their own restaurant, complimentary wifi, all rooms have a private bathroom and shower, HDTV with cable access, and laundry service which is a separate charge.
Biggest challenge for me is getting used to Indian cuisine. I just want a steak or a burger.
I'd be happy as long as it's healthy , then would enjoy everything i wanted to after LL
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Felt like posting a video showing how easy it is to distract with the turning devices put onto the frames. Every turn equals .25 mm of distraction.
http://www.youtube.com/watch?v=W8LAeIrtgnw
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How's the pain ?
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I've got swelling on my left calf and an aching pain when I walk on that foot. My right shin is sensitive to touch. I haven't really experienced any pain due to the distraction itself though.
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Easy distraction , rings are quite big ain it ?
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hi Kilokahn, how often do you meet with Dr Parihar during lengthening period?
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Hi there,
Very informative diary, best of luck in your journey!
I finally wrote my first post on this forum
:)
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hi kilokahn...i'm new member in this forum, currently saving money for surgery. may be do surgery in the next 1 or 2 years. your experience with exfix will be very valuable for me since i could not afford internal...i have problem with my eczema during winter it is like an allergy which is occur only during winter (i'm south east asian now work in US)...this problem rule me out of russia korea china or any other country with cold winter season..how about india? is there cold winter in india? also i want to know about electricity in india, last time i read from old forum there is always power cuts there but its in akola may be mumbai different? could not imagine power cut when it is cold or during hot summer...how about water quality? most patients infection in india probably because of water they use to take a bath or clean pin sites if the source is from a well.
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hi kilokahn...one more question, what kind of medicine dr parihar give to you..any blood thinner? muscle drug? etc.....is 900.000 INR price include any complication surgery (if needed)?
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Update: 7/24/2014
I saw Dr Parihar two days ago to get another batch of x-rays and a check up. I explained to him that lately my left leg has been largely fine, but that all the pain is concentrated on my right leg. It's hard to describe what the pain is like. I think it's similar to a tearing sensation, which goes from the osteotomy site all the way down to the ankle. I also pointed out that where the two wires are closest my knee I have pain surrounding them. If I turn my leg too much inward or too much outward it feels like the bone is being pulled. If I sleep on either of my sides, a ton of pressure builds up there and I have to lie on my back again to prevent from hurting. The pain has made my walking a lot slower, but at least I've been able to put more weight on my left leg due to absence of pain. Dr Parihar saw nothing out of the ordinary with my x-rays and after listening to the problem and testing my knee extension strength he told me to massage the painful areas and also set an ice pack on them.
He said that my x-rays show around 1.2 cm of distraction even though I had turned up to 1.5, but he told me that for the first few mm there typically isn't any distraction when you turn because of resistance. In any case, he would make sure that my goal length is reached and both leg lengths are equal before I leave back to the US. I was also told to change my distraction rate from .75 mm each day to alternating days of 1 mm and .75 mm for the next 10 days. If my body can tolerate that then he would consider having me lengthen 1 mm each day.
After Dr Parihar and Dr Divya saw me, I went down to the first floor and walked to the physiotherapy room where Pratiksha guided me through the exercises again, although this time with less repetitions on my right leg because I couldn't do certain movements without the pain arriving near the pins by my knee. The good news was that she told me she spoke to Divya and they would get me a wheelchair right before I leave for home. Dr Parihar isn't really keen on me using one right now and wants me to gain strength through physio and standing, along with brief walking when I have to do bed to toilet transfers or walk to the elevator when I have to leave the hotel and see him for checkups. The main reason I want one though is so I can just put a blanket over my frames when I go into work each day as my office is next door to a company that hires a bunch of wannabe model types who are judgmental as hell and I don't want them talking if they see me walking in frames to work.
Yesterday I lengthened for 1 mm and didn't notice any pain. But last night I was woken up twice by a sharp pain in my right leg that went from my ankle to just below my knee, and soon after I had an aching pain underneath my right femur again like I had a couple days after surgery. The pain was so intense that I couldn't fall asleep again and walking to the bathroom was the most painful thing so far. For the first time it actually felt like I was walking on a shattered bone. I had to be careful that most of the weight was on my left foot and it took me maybe 5 minutes to reach the toilet just a few feet away. I'm hoping that it's just a temporary reaction to lengthening more than usual. I'm only taking a very light painkiller medication for now and taking it along with a sleeping pill didn't help me sleep for more than a few minutes at a time. Thankfully I brought my PS3 and can play Far Cry 3 to take my mind off things in these moments.
Here's the most recent batch of x-rays.
(http://s5d4.turboimagehost.com/t1/19533420_Set_3_1_Watermark.jpg) (http://www.turboimagehost.com/p/19533420/Set_3_1_Watermark.jpg.html) (http://s5d4.turboimagehost.com/t1/19533421_Set_3_2_Watermark.jpg) (http://www.turboimagehost.com/p/19533421/Set_3_2_Watermark.jpg.html) (http://s5d4.turboimagehost.com/t1/19533422_Set_3_3_Watermark.jpg) (http://www.turboimagehost.com/p/19533422/Set_3_3_Watermark.jpg.html) (http://s5d4.turboimagehost.com/t1/19533423_Set_3_4_Watermark.jpg) (http://www.turboimagehost.com/p/19533423/Set_3_4_Watermark.jpg.html)
Easy distraction , rings are quite big ain it ?
The rings I have on are of a smaller diameter than usual. Due to my frame and weight he wanted to be sure that I have as much stability as possible, especially because he isn't adding the middle pins until the lengthening period is over. The smaller the diameter of the rings, the more stable the frame.
hi Kilokahn, how often do you meet with Dr Parihar during lengthening period?
I see him once every 10 days. In between that I stay in communication through e-mail with him or through Whatsapp with Dr Divya.
Hi there,
Very informative diary, best of luck in your journey!
I finally wrote my first post on this forum
:)
Thanks, BeyondGenetics.
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This right leg just sucks right now. I can't even do physio on it from the pain and even the lightest step on the floor feels like I'm stepping down with a shattered leg. Dr Parihar said to keep weight off it for a couple days and to let him know if there is no change. Getting to the restroom I now have to lie on my butt and use my arms to scoot myself across the floor. I had a slight misstep with the walker earlier which made me put more weight on my right leg and the pain shot so high that I had to immediately sit down and grasp my leg for a good ten minutes before I could bring myself to lie down. Not sure why the right leg is so crappy and the left leg feels just fine.
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im not in pain, but because of my ballerina... i do the same thing as you.... exactly
i get out of chair, scoot on my butt, pull myself up, then go down,etc again.... its quite the process
my leg hurt a few times, but i think its normal
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Everyone at the Beijing Institute had what they called a bad leg and a good leg, but I thought it was always a bad leg and a worse leg. Sometimes peoples' bad legs would improve, and then the other one would become their bad leg. And the bigger guys always seemed to have more pain, especially in the beginning.
So, Kilo, congratulations on being a normal LLer so far. ;)
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hi kilokahn...i'm new member in this forum, currently saving money for surgery. may be do surgery in the next 1 or 2 years. your experience with exfix will be very valuable for me since i could not afford internal...i have problem with my eczema during winter it is like an allergy which is occur only during winter (i'm south east asian now work in US)...this problem rule me out of russia korea china or any other country with cold winter season..how about india? is there cold winter in india? also i want to know about electricity in india, last time i read from old forum there is always power cuts there but its in akola may be mumbai different? could not imagine power cut when it is cold or during hot summer...how about water quality? most patients infection in india probably because of water they use to take a bath or clean pin sites if the source is from a well.
Can't believe I missed this question. Sorry Yudha.
Mumbai is a damp/humid climate and the winter isn't particularly cold. It's around 70 degrees Fahrenheit. Summer hasn't been to bad either. It can get hot but it's not nearly as bad as Delhi heat because it rains a lot. I have yet to experience a power outage since I've been here. That might be more common in Delhi where the heat gets a lot worse. You can't drink the water from the tap here, have to drink bottled. For pin site cleaning you just need to make sure the water is boiled first and you'll be okay even if you use tap water. My hotel room has an electric water heater that boils up the water very fast. I've been boiling up bottled water though because I don't need a lot of it each time I do the pin cleaning and it's easier to just grab the water bottle than go all the way to the restroom for sink water.
hi kilokahn...one more question, what kind of medicine dr parihar give to you..any blood thinner? muscle drug? etc.....is 900.000 INR price include any complication surgery (if needed)?
This is the medication I've taken:
Shelcal (Calcium + vitamin D)
Cefadroxil (antibiotic) - only until suture removal
Ultracet (pain relief) - as needed
Nimesulide (NSAID) - only for 5 days
Zevit (zinc)
The price covers the initial surgery, hospital stay, food while in hospital, physiotherapy sessions, and all follow up x-rays and checkups. It won't cover your first set of x-rays or blood tests, and aside from the first set of medication you get after discharge, you have to pay for any follow up medications they decide you need. You also need to pay for your dressings, which is 500 INR per box. Anything else like a walker, wheelchair, etc will also cost extra. Additional surgery in case of complications are also a separate cost.
im not in pain, but because of my ballerina... i do the same thing as you.... exactly
i get out of chair, scoot on my butt, pull myself up, then go down,etc again.... its quite the process
my leg hurt a few times, but i think its normal
I've found I get by quicker now by scooting than walking with the shape my right leg is in now.
Everyone at the Beijing Institute had what they called a bad leg and a good leg, but I thought it was always a bad leg and a worse leg. Sometimes peoples' bad legs would improve, and then the other one would become their bad leg. And the bigger guys always seemed to have more pain, especially in the beginning.
So, Kilo, congratulations on being a normal LLer so far. ;)
Man this sucks. :D Funny about the worse leg switching from one to the other. It did that a couple times in my first 10 days post surgery. They never seem to both be equally in pain.
My knees are starting to get sore now too from my legs being stretched out all day.
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Update: 7/30/2014
This last week has been so damn frustrating. Every night it takes me longer than the night before to mange to get a moment's sleep. I have bags under my eyes and am dead tired but the discomfort and pain prevents any chance of dozing off. If I find one comfortable position, that same position is no longer comfortable the next night. I can't lie with a pillow between my frames, can't fan my legs out, can't have my legs straight and my upper body sitting up, nothing works and I'm even taking sleeping pills. Walking is still impossible and standing makes my legs hurt now. At this point I don't care if a stronger pain killer will be injurious to my liver. I just don't want to be up another week. Takes me up to 8 hours just to doze off for a half hour and when I wake from that there's no going to sleep again.
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That's terrible news. What sleeping pills and pain medications are they giving you?
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kilo, yes, this is how it is
and to be honest, i'm almost 4 months from surgery, and still not comfortable sleeping, though nothing like the first week... that was the worst, i couldn't imagine how bad it would be until that first night after the surgery
you'll get used to it, but won't like it of course.... i think once the frames off, sleeping largely goes back to normal... i know it's the frames now that are destroying my sleep
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That's terrible news. What sleeping pills and pain medications are they giving you?
I ran out of the Sumol ER 650 mg tablets for pain relief, which is the lowest level pain killer available. Dr Parihar wanted me to start off easy on the pain relief medication and said he has stuff that can take away the pain completely but I risk harming my liver if I take them for too many days. I have to ask for something stronger next time I see him though, which is probably in three days. I was given Alprazolam for sleep.
kilo, yes, this is how it is
and to be honest, i'm almost 4 months from surgery, and still not comfortable sleeping, though nothing like the first week... that was the worst, i couldn't imagine how bad it would be until that first night after the surgery
you'll get used to it, but won't like it of course.... i think once the frames off, sleeping largely goes back to normal... i know it's the frames now that are destroying my sleep
I'm just hoping it gets a lot more tolerable during consolidation. A lot of the discomfort comes from the tearing and pulling sensation I get when I put pressure on any side of the frames.
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the discomfort from that never goes away, at least for me.... it's the most annoying thing now for me, other than ballerina
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and as far as pain.... tramadol is the way to go, as it's intended to be taken a while, if you needed to do so
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I just got a reply from Dr Parihar after telling him about the pain issue. He wants me to go back to .75 mm per day each day instead of alternating days between .75 mm and 1 mm. He said if that does not help with the pain then he will consider adding the two pins to the middle ring early to improve stability instead of adding them once distraction is complete. It would mean a scar in the middle that goes the length of how much left I have to distract, but he said the longer scar is probably preferable to the pain I'm experiencing now. I have to update him in a few days and he's going to have someone get in touch with me to deliver a wheelchair here so I don't have to be stuck in bed all day and can at least wheel out to the lounge or something for a change of scenery.
and as far as pain.... tramadol is the way to go, as it's intended to be taken a while, if you needed to do so
I took that for a bit but they took me off it. I'll ask about taking it again next time I see him.
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the scar will look a bit gnarly... but is worn it if it reduces pain.... i have a bolt that seems to have lengthened along with me
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Can I go back length home ?
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Dr Parihar doesn't allow patients to lengthen away from Mumbai anymore.
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Another night of mind numbing pain and no sleep. It's 3:20 am and I've been trying to ignore the pain in my left leg that just popped out of nowhere since 10 pm. Judging from this to not even being able to stand anymore, I'd say it's clear my body is not responding well to lengthening. Worst constant pain in my life.
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kilo... it was bad for me too... really bad... try to endure the next few days... i thought about quitting the first month.... it was insane how bad the pain was
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Kilo, I totally know how you feel that this point. About 2 months ago, I was in the exact same situation as you. My first two weeks of lengthening was hell. I felt a combination of skin tearing pain, nerve pain, bone pain, muscle pain... You name it, I've had it. I finally cried one day out of desperation that I am in middle of nowhere - I already spent the money and did the surgery, I can't exactly turn back and say screw this, but I am also only two weeks into lengthening, I cannot fast forward to the end as the end of lengthening seems way too far away to even imagine. One thing I kept doing was I read everybody's dairy, it made me feel better to know that everyone eventually all complete this hard process despite the unique obstacles they have encountered. The good thing is as we dwell on the present, time is always going forward. Lengthening is a very unpredictable process, same as life, except the events happens ten times faster. You will find situations take unexpected turns before you realize. Turning 0.75 should help you a lot with pain. Right after I started turning 0.75, the pain all of the sudden became non existing. In term go sleeping, I think it's not just a matter of taking pain killer or sleeping meds. Sleep can be a mental thing. Once you had several episodes of bad experiences, your mental becomes anxious when you try to sleep. Of course the more anxious you get, the harder it is for you to fall asleep,therefore creates a bad cycle, despite the physical exhaustion. Maybe try to do something to calm your mental? Like eating bananas and drink milk before going to bed as it contains natural potassium, listening to calm music is another way to relax your mental state. Maybe if you do this with a combination of sleeping meds, you will have a easier time to fall asleep? The other thing I do is I try to tell myself that it's OK if I don't fall asleep as I would have nothing to do the next day anyway. When the pressure is off, it's also easier to fall asleep. All of above are just merely my suggestion, you will slowly find what works for you the best ;D
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kilo... it was bad for me too... really bad... try to endure the next few days... i thought about quitting the first month.... it was insane how bad the pain was
When the pain hits it definitely does make you think "Why the hell did I do this to myself?" at first.
Kilo, I totally know how you feel that this point. About 2 months ago, I was in the exact same situation as you. My first two weeks of lengthening was hell. I felt a combination of skin tearing pain, nerve pain, bone pain, muscle pain... You name it, I've had it. I finally cried one day out of desperation that I am in middle of nowhere - I already spent the money and did the surgery, I can't exactly turn back and say screw this, but I am also only two weeks into lengthening, I cannot fast forward to the end as the end of lengthening seems way too far away to even imagine. One thing I kept doing was I read everybody's dairy, it made me feel better to know that everyone eventually all complete this hard process despite the unique obstacles they have encountered. The good thing is as we dwell on the present, time is always going forward. Lengthening is a very unpredictable process, same as life, except the events happens ten times faster. You will find situations take unexpected turns before you realize. Turning 0.75 should help you a lot with pain. Right after I started turning 0.75, the pain all of the sudden became non existing. In term go sleeping, I think it's not just a matter of taking pain killer or sleeping meds. Sleep can be a mental thing. Once you had several episodes of bad experiences, your mental becomes anxious when you try to sleep. Of course the more anxious you get, the harder it is for you to fall asleep,therefore creates a bad cycle, despite the physical exhaustion. Maybe try to do something to calm your mental? Like eating bananas and drink milk before going to bed as it contains natural potassium, listening to calm music is another way to relax your mental state. Maybe if you do this with a combination of sleeping meds, you will have a easier time to fall asleep? The other thing I do is I try to tell myself that it's OK if I don't fall asleep as I would have nothing to do the next day anyway. When the pressure is off, it's also easier to fall asleep. All of above are just merely my suggestion, you will slowly find what works for you the best ;D
Thanks, Classical. I think what caused the pain was alternating the distraction between .75 and 1 mm because the pain didn't get that bad until I introduced 1 mm days. I think it's primarily nerve pain because it was almost like a burning sensation. Listening to music helped so thanks for that suggestion.
I was delivered an NSAID called Voveran SR last night along with an antacid called Rantac. It took a while to help because I got this burning on my right leg last night and couldn't sleep no matter what, so I sat down on the edge of the bed and rested my head on my walker. I fell asleep doing that and when I woke up in the morning I didn't have any pain. It still pops up from time to time but it's a lot more manageable now. My stepdad called me and suggested I ask Dr Parihar for some cortisone injections but I'm not sure if it helps with this kind of pain. I have to ask Dr Parihar if he ever uses them on patients for pain relief.
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in the beginning, i died to do 1 mm, after doing 75 mm a while.. i didn't think there would much of a difference, as i did not experience any pain while doing .75 a day....
the night i did 1 mm, i was very uncomfortable, and had to take a lot of pain meds.... there was a huge difference in how i felt
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I totally missed your LL Kilo, I need to read this entire thread.
Meanwhile, all the best and hopefully less (or no) pain for the coming future.
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hi KILOKAHN here me again....glad you had a good sleep for awhile, i read WANNABEGIANTS diary he is doing with dr bagirov, i noticed that he get blood thinner prescribed by the dr for cheap (as he wrote)...from information on internet blood cloth is one of most dangerous complication that can occur with this kind of surgery as it can caused deep vein trombosys. have you discuss this with dr mangal? want to know why he doesnt prescribed this to you..may be he has another reason though....secondly, i have a bow leg (not too much) which may limited my option to external only since the bowing would cause difficulty to insert the nail and also i have rotational deformity on my leg (my foot face outward when my knee sees the front). so my option is only india due to weather and cost. i only 160cm height so doing surgery with hexapod is the best option i think...it could fix the bow and rotation in the same time i could lengthen....i tank you very much for your contribution in this forum. my question is about dr suhas shah with hexapod...you write that he doesn't use hexapod to fix problem at the end of distraction like dr mangal and dr dhawan, is this mean that he doesn't perform any surgery using hexapod?
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I totally missed your LL Kilo, I need to read this entire thread.
Meanwhile, all the best and hopefully less (or no) pain for the coming future.
Thanks, Mediocre. Better late than never, right? ;)
hi KILOKAHN here me again....glad you had a good sleep for awhile, i read WANNABEGIANTS diary he is doing with dr bagirov, i noticed that he get blood thinner prescribed by the dr for cheap (as he wrote)...from information on internet blood cloth is one of most dangerous complication that can occur with this kind of surgery as it can caused deep vein trombosys. have you discuss this with dr mangal? want to know why he doesnt prescribed this to you..may be he has another reason though....secondly, i have a bow leg (not too much) which may limited my option to external only since the bowing would cause difficulty to insert the nail and also i have rotational deformity on my leg (my foot face outward when my knee sees the front). so my option is only india due to weather and cost. i only 160cm height so doing surgery with hexapod is the best option i think...it could fix the bow and rotation in the same time i could lengthen....i tank you very much for your contribution in this forum. my question is about dr suhas shah with hexapod...you write that he doesn't use hexapod to fix problem at the end of distraction like dr mangal and dr dhawan, is this mean that he doesn't perform any surgery using hexapod?
That's a good question. I never asked Dr Parihar about blood thinners or the deep vein thrombosis risk. I had so many questions that I often forget to ask certain things. I have my next check up with him in a few days so I'll be sure to ask him about that and report it back here.
I don't believe Dr Shah uses the hexapod at all. Not only did he say he would only use the regular frame and not the hexapod, but during my consultation with Dr Dhawan he told me that Dr Shah doesn't use the hexapod device so if I did exfix then either himself or Dr Parihar would be the ones to consider. On the other hand, Dr Shah will do Precice lengthening and Dr Dhawan won't so he's a possible internal option for those considering it. Dr Shah does deformity corrections also though so I'm sure he's got ways of doing it without using the hexapod.
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What a very comprehensive account! Lots of info here for those eyeing India.
Who do you think is the most viable alternative for Precice in India which would be significantly cheaper than Dr Franz (eg 10K less)?
Thanks.
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What a very comprehensive account! Lots of info here for those eyeing India.
Who do you think is the most viable alternative for Precice in India which would be significantly cheaper than Dr Franz (eg 10K less)?
Thanks.
I don't think anyone would be significantly cheaper than Dr Birkholtz when you factor in accommodation cost. Dr Shah is $40,000 USD for Precice 2 femur lengthening which includes stay in hospital for two weeks. If you stay at a hotel It's probably around $1,500 a month. Dr Parihar is $45,000 not including complications or accommodation.
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how are you KILO....for the last two days you seem no more talking about pain...no more sleep and pain problem? i hope so...so dr mangal give you stronger painkiller? how do you think (i'm 40 years old) about i take this surgery can i stand the pain?
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how are you KILO....for the last two days you seem no more talking about pain...no more sleep and pain problem? i hope so...so dr mangal give you stronger painkiller? how do you think (i'm 40 years old) about i take this surgery can i stand the pain?
Very much older people than you have done it. Some with good result, others with bad.
It's all individual and nobody can say if you're suitable or not.
If you want to be taller then you know what you need to do.
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how are you KILO....for the last two days you seem no more talking about pain...no more sleep and pain problem? i hope so...so dr mangal give you stronger painkiller? how do you think (i'm 40 years old) about i take this surgery can i stand the pain?
He gave me an NSAID called Voveran SR and I also went back to turning .75 mm per day each day instead of alternating between .75 mm and 1 mm. These combined helped a great deal in reducing pain. Sometimes it is still hard to sleep but that's mainly because the frames are awkward and make it hard to get comfortable.
Pain is different for everyone. Some end up with a lot and some hardly any while lengthening. It's something you won't really know until you do it.
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He gave me an NSAID called Voveran SR and I also went back to turning .75 mm per day each day instead of alternating between .75 mm and 1 mm. These combined helped a great deal in reducing pain. Sometimes it is still hard to sleep but that's mainly because the frames are awkward and make it hard to get comfortable.
Pain is different for everyone. Some end up with a lot and some hardly any while lengthening. It's something you won't really know until you do it.
Glad you're feeling a bit better due to the decreased turning. Taking breaks and/or turning less can work wonders with LL problems.
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Man i hope all goes well for you, I just have to say that in hindsight maybe you should consider the plating option, maybe you can do it with Shah later if you change your mind.
Because exfix only takes an absolutely insane ammount of time, thats part of the reason why i didnt want to do more than 4.3 cm. At 5.5 cm lengthening, it could end up taking 8 -10 months in frames i think. Its very very hard mentally, especially if you want to keep it hidden from all your friends.
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Just make sure you take that after meals because it can cause gastric ulcers.
Also long-term intake of NSAID is related to heart attack and stroke.
Opioids on the other hand can cause dizziness and potentially addictive
But of course if the pain is there, no choice but to take these meds.
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At 5.5 cm lengthening, it could end up taking 8 -10 months in frames i think.
That's only if you have ty consolidation rate. At Ilizarovs centre the number they give is 2 month for 5cm and 1 month extra for every 1cm over, and that's standart cons rate. I've lengthened 8cm on femur, and my doc told me I can take the frames off in a month, but I'll probably give it 2 months just to be safe.
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Update 8/8/2014
This last week has been much better than the week before. A combination of the NSAIDS and turning less has worked great for pain management. I hadn't put any weight on my legs for about a week, scooting to the restroom and staying in bed all day, and when I first tried walking again it was as if I was trying to put weight on my legs for the first time. I realized then that walking would not get any easier if I kept avoiding it, so I pushed myself to stand for longer periods and to start walking to the bathroom and back again. The first few days were very difficult, but after getting over that hurdle it just got easier. The other day I managed to walk out into the lounge, downstairs, and to the ATM machine from the auto rickshaw after being driven near it from the hotel parking lot. Aside from some pressure on my legs after resting, I feel a lot stronger than before.
Yesterday I saw Dr Parihar again and he gave me an examination and went over my x-rays. He decided that 8 days of the NSAID were enough and put me back on Ultracet, which is a pain reliever that's much less strong and isn't an NSAID but should help some. He didn't want me taking more of it because of its effects on the quality of regenerate and the acidity (though he did give me an antacid to take with it earlier). He talked a bit about how in India they're probably more used to pain tolerance than people in Western nations, and unlike some Western doctors who will decide to pump you full of drugs for pain relief a lot of doctors in India would try to avoid giving you a bunch of pain meds if possible. Dr Parihar isn't keen on giving strong pain relief medication after discharge from the hospital, because of the effects from taking such drugs, not only in terms of bodily side effects but also how some will affect you mentally - he doesn't do cortisone injections for example because they can make you loopy. One interesting thing he said is that in terms of pain, half of it is a mental thing and that if you're depressed or not occupying yourself with things throughout the day and only focusing on the pain, then it will seem much worse than if you were in a good mood or you were giving yourself things to do. He said it's like the difference between lighting a candle in the day or at night. The candle is the exact same no matter what time you light it, but you'll perceive it differently based on the surroundings. I agree with him that half of it is completely mental and that's probably why some doctors have told me that the most optimistic patients have the best results.
When I left and was waiting for the chemist to give me my medication, a woman came up to me downstairs and asked all sorts of questions about the frames and why I was in them. I just told her I was correcting a slight bowing to relieve pain and didn't feel like telling her I was doing this cosmetically. A few other people came up to me and asked me if I had an accident. Fortunately they didn't inquire further when I just said no.
Got myself a wheelchair today from a guy who makes orthopedic appliances named Mr Shringare. He's the one who gave me my extra wide walker earlier. I paid 26,000 INR for it but it should come in handy back home because our parking space is so far from the apartment. Mr Shringare is a nice guy whose English is rather good and it was nice to be able to communicate with someone new - the only people here who I can communicate well with in English are Dr Parihar, Dr Divya, the physios, and the hotel general manager. He showed me his leg where he had an injury that Dr Parihar operated on and I saw the faint pin site scars from the monorail fixator. He told me that he knew Dr Parihar from when he was still an undergrad and that he's the only doctor I should see in India for Ilizarov-related surgeries. I asked if he knew about Dr Shah and he told me that he know him but that Dr Parihar should be the only one to consider for these things. It was nice talking to a prior patient who was pleased with his surgical result. I have to say that Dr Parihar has a really good reputation here, especially considering that because doctors aren't allowed to do mass advertising in India his rep had to be built almost entirely of word of mouth.
According to my x-rays I've distracted about 2.5 cm where I've turned for 2.8 cm. Looks like it's caught up from the lag. I'm actually surprised that the total distraction is that close to how much I've turned as I was expecting a greater difference to still be present.
(http://s5d2.turboimagehost.com/t1/19663008_Set_4_1_Watermark.jpg) (http://www.turboimagehost.com/p/19663008/Set_4_1_Watermark.jpg.html) (http://s5d2.turboimagehost.com/t1/19663009_Set_4_2_Watermark.jpg) (http://www.turboimagehost.com/p/19663009/Set_4_2_Watermark.jpg.html) (http://s5d2.turboimagehost.com/t1/19663010_Set_4_3_Watermark.jpg) (http://www.turboimagehost.com/p/19663010/Set_4_3_Watermark.jpg.html) (http://s5d2.turboimagehost.com/t1/19663011_Set_4_4_Watermark.jpg) (http://www.turboimagehost.com/p/19663011/Set_4_4_Watermark.jpg.html)
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Glad you're feeling a bit better due to the decreased turning. Taking breaks and/or turning less can work wonders with LL problems.
It's definitely helped. It's kind of amazing how big a difference an extra .25 mm of distraction per day makes in how well you feel.
Man i hope all goes well for you, I just have to say that in hindsight maybe you should consider the plating option, maybe you can do it with Shah later if you change your mind.
Because exfix only takes an absolutely insane ammount of time, thats part of the reason why i didnt want to do more than 4.3 cm. At 5.5 cm lengthening, it could end up taking 8 -10 months in frames i think. Its very very hard mentally, especially if you want to keep it hidden from all your friends.
During my most recent visit with Dr Parihar I brought up plating and he again expressed an unfavorable opinion of bilateral plate fixation. He said you could do it in young children and on one leg for injuries, but he's really against doing it bilaterally in adults and doesn't think you'd heal well with it. Although Dr Shah would do it I don't think I'd be comfortable having a separate doctor work on my legs that another doctor did surgery on first if my healing is going smoothly.
I think I can manage the frame time. Dr Parihar is expecting around 9 months total. Judging from how long I've been alone in India I could probably pull off some more months of being hidden from friends until I get these frames off.
Just make sure you take that after meals because it can cause gastric ulcers.
Also long-term intake of NSAID is related to heart attack and stroke.
Opioids on the other hand can cause dizziness and potentially addictive
But of course if the pain is there, no choice but to take these meds.
Yeah I'm done with the NSAIDS after those 8 days. Risking bad regenerate would worry me too much so I'll stick with the Ultracet even though it's not as effective.
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That's only if you have s**tty consolidation rate. At Ilizarovs centre the number they give is 2 month for 5cm and 1 month extra for every 1cm over, and that's standart cons rate. I've lengthened 8cm on femur, and my doc told me I can take the frames off in a month, but I'll probably give it 2 months just to be safe.
sounds confusing, 2 months for 5 cm?? you mean after the lengthening period is done i guess? So 5 cm might take 2.5 or 3 months to lengthen, and then 2 extra months?
Doesnt sound like an average time frame since most doctors say 1.5-2 months per cm is average. That would mean 7,5 months total for 5 cm would be lower end on the average.
Femur is different and i dont know when you started lengthening the femur so i wont get into that.
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sounds confusing, 2 months for 5 cm?? you mean after the lengthening period is done i guess? So 5 cm might take 2.5 or 3 months to lengthen, and then 2 extra months?
Doesnt sound like an average time frame since most doctors say 1.5-2 months per cm is average. That would mean 7,5 months total for 5 cm would be lower end on the average.
Femur is different and i dont know when you started lengthening the femur so i wont get into that.
He's not that wrong, you need 30-40 days per cm (starting at the day of your operation) for the bone to be consolidated enough for weight bearing. You will likely get the frames taken of before the bone is fully consolidated but consolidated enough for weight bearing.
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He's not that wrong, you need 30-40 days per cm (starting at the day of your operation) for the bone to be consolidated enough for weight bearing. You will likely get the frames taken of before the bone is fully consolidated but consolidated enough for weight bearing.
ah okey, i guess some doctors are more conservative and want to avoid the risk of the bone bending, so they dont allow you to remove the frame until it is fully consolidated..(at least it seems to be the case with Bagirovs clinic).
Maybe just maybe i will be done at the end of this month when i take my next x-rays.. at that point i will have worn the frames for 6 months and i did 4.3 cm...
Maybe they can give me some cast or braces for my legs if i remove them a little earlier than expected..
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ah okey, i guess some doctors are more conservative and want to avoid the risk of the bone bending, so they dont allow you to remove the frame until it is fully consolidated..(at least it seems to be the case with Bagirovs clinic).
Maybe just maybe i will be done at the end of this month when i take my next x-rays.. at that point i will have worn the frames for 6 months and i did 4.3 cm...
Maybe they can give me some cast or braces for my legs if i remove them a little earlier than expected..
Yeah, after frame removal you have to wear a cast for a 1-2 weeks until you are good to go. Btw you should use more supplements, maybe you can accelerate your consolidation. Take vitamin D, protein shakes with all the amino-acids, and something called Ossopan (google it). Also try cacao powders which contain all the vitamins and minerals, they surely have those in russia.
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Yeah, after frame removal you have to wear a cast for a 1-2 weeks until you are good to go. Btw you should use more supplements, maybe you can accelerate your consolidation. Take vitamin D, protein shakes with all the amino-acids, and something called Ossopan (google it). Also try cacao powders which contain all the vitamins and minerals, they surely have those in russia.
Okey yeah it would feel safer walking with the cast after frame removal so thats good.
I have been taking vitamin D and calcium supplements every day since the surgery day. I also took zink for a while and another supplement called Ostegenon (i guess this is similar to ossopan), which is some kind of russian brand supplement for bone regen, i still take that one although i ran out temporarily, so for 2 months of the whole thing i didnt take it, but i bought more.
I also take protein shakes although i started quite late with it, but before that i ate yoghurt with extra protein ever morning
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hi KILOKAHN here me again....glad you had a good sleep for awhile, i read WANNABEGIANTS diary he is doing with dr bagirov, i noticed that he get blood thinner prescribed by the dr for cheap (as he wrote)...from information on internet blood cloth is one of most dangerous complication that can occur with this kind of surgery as it can caused deep vein trombosys. have you discuss this with dr mangal? want to know why he doesnt prescribed this to you..may be he has another reason though....
I asked Dr Parihar about the risk of deep vein thrombosis and if I need to have blood thinners. He said that he gives blood thinners to some of his patients but he doesn't think I need it. He said it's theoretically possible that I could get it, but if I continue doing my physiotherapy exercises and keep using the walker then he doesn't see a risk of it. According to him the ankle exercises and knee flexing exercises are taught first right after surgery in order to minimize the DVT risk. It's primarily a concern if you're always immobile and don't do any of your physiotherapy. That's when you would need to take blood thinners.
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Okey yeah it would feel safer walking with the cast after frame removal so thats good.
I have been taking vitamin D and calcium supplements every day since the surgery day. I also took zink for a while and another supplement called Ostegenon (i guess this is similar to ossopan), which is some kind of russian brand supplement for bone regen, i still take that one although i ran out temporarily, so for 2 months of the whole thing i didnt take it, but i bought more.
I also take protein shakes although i started quite late with it, but before that i ate yoghurt with extra protein ever morning
Ahh, then you have to wait i guess :D
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Ahh, then you have to wait i guess :D
Btw, sent you a PM :P
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sounds confusing, 2 months for 5 cm?? you mean after the lengthening period is done i guess? So 5 cm might take 2.5 or 3 months to lengthen, and then 2 extra months?
2 months usually for 5cm and another 2 months of consildation and few weeks with a cast. That's the numbers they gave me. The bone isn't fully healed, but allows weight bearing, obviously if you fall you will break it, so you have to be careful.
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thanks KILO....next time you visit dr parihar can you ask him or discuss about compartment syndrome and fat embolism...this is another dangerous complication that i want to address before decide to choose surgeon or method of surgery...i mean is he ever face this with his patients? i mean if you can please talk about this in detailed, such as how he know that his patient got this complication and how he address such a thing...another thing i want to know is whether i could do blood donor in his hospital for the purpose of blood transfusion if needed during surgery as i just want my own blood for transfusion...again thanks KILO...
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2 months usually for 5cm and another 2 months of consildation and few weeks with a cast. That's the numbers they gave me. The bone isn't fully healed, but allows weight bearing, obviously if you fall you will break it, so you have to be careful.
very interesting, i think i should definitely be able to remove my frames at the end of august then if i wear a cast, even though my doctor in Russia might think i should wait longer.. My swedish doctor seems to think i dont have much time left at least.
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Update: 8/13/2014
Most things have been going well so far so there hasn't been much to write about lately. Though I still can't walk at all without support from a walker (as to be expected) it's gotten easier. I think I've just gotten used to my legs feeling heavy and learned how to walk without making sudden movements that cause pain. The swelling in my legs has gone down allowing more room between my legs and the fixators and there hasn't been any significant stretching pain from distraction. However I now finally have some skin tearing pain on the furthest left wire closest to the knee on my right leg. The skin that Dr Parihar cut out around the wire during surgery finally closed up around it and because there's more movement near the knee there's now skin tearing. It's a constant stinging irritation and I have to keep my leg at just the right position or it will start stinging again. Maybe that's something I'll point out to the doctor during my next visit if it's still a problem.
I got tired of constantly eating South Indian food so I finally ordered Domino's and was happy that it was in the style of the pizza back home and not just a circular piece of naan with shredded cheese on top like the hotel pizza. Price was a little over $15 USD for what I got. The last few days I've slept throughout most of the day and now have sleep drunkenness - you know that hangover-like feeling you get from sleeping too much. Trying to wake myself up now.
(http://s5d1.turboimagehost.com/t1/19704642_Walker.jpg) (http://www.turboimagehost.com/p/19704642/Walker.jpg.html) (http://s5d1.turboimagehost.com/t1/19704643_Wheelchair.jpg) (http://www.turboimagehost.com/p/19704643/Wheelchair.jpg.html) (http://s5d1.turboimagehost.com/t1/19704644_Dominos.jpg) (http://www.turboimagehost.com/p/19704644/Dominos.jpg.html)
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Glad things are getting easier for you Kilo. The skin tearing issue is starting to remind me of the dark side of my time in Beijing (the pain!) which are the first memories to fade. The plan they had was just to let it tear and hurt rather than doing anything about it. I wanted them to cut and sew my pinsite tears as they needed it, but they wouldn't do it. Maybe doing nothing is the most advisable form of treatment. It'll be interesting to hear what Dr. Parihar says.
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Hey Kilo!
Do you at times consider getting internal nails locked in once you reach you lengthening target and not keep the frames on for the entire duration?
Would Dr.Parihar allow nailing if one considers to remove the frame since I read that the fixator is placed is differently for LATN and pure externals?
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Hey Kilo!
Do you at times consider getting internal nails locked in once you reach you lengthening target and not keep the frames on for the entire duration?
Would Dr.Parihar allow nailing if one considers to remove the frame since I read that the fixator is placed is differently for LATN and pure externals?
I'm committed to wearing the frames for the duration required. I'd prefer to keep it as minimally inasive as possible for tibias. Dr Parihar did say that I could choose to have nails put in at a later date if I decided though.
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Good job KiloKahn! Keep strong!!
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Great diary KiloKAHN! This is helping everyone.
I am from UK and am thinking of doing LL externals LON in India, with one of the Doctors KiloKAHN had consultation with.
My aim is 7.5 tibia.
Would like to do this in JANUARY, with someone who also wants to do a LL procedure there.
Anyone interested?
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hi kilo...so far it seem everything is ok with the surgery...this encourage me more to do this, do you doing routine physio? how many a week? and how much is it cost you a month?
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Good job KiloKahn! Keep strong!!
Thanks. Easier to do so these days because I haven't had any complications yet, not even a minor one. Hopefully it stays that way for the duration of treatment.
hi kilo...so far it seem everything is ok with the surgery...this encourage me more to do this, do you doing routine physio? how many a week? and how much is it cost you a month?
Physiotherapy exercises are taught to you in the hospital and while there you have two physio sessions per day. Those sessions are included in the payment to Dr Parihar. When you're discharged you're expected to do the exercises on your own a few times a day. Dr Parihar can arrange for one of the physiotherapists to come visit you at the place you stay and help with the exercises if you request it, but I didn't find it necessary. I get a new set of x-rays and a check up by Dr Parihar and Dr Divya once every two weeks and after the check up they may have you do a physio session downstairs with the physiotherapist or you can request one if they don't tell you to go for a session. I haven't been charged a separate price for physiotherapy but during each check up you still have to pay a fee at the front desk and if there is a physio charge then it's included in that fee. The x-ray and checkup costs aren't really expensive. I paid 2700 INR in total cost for the previous two visits to the hospital, which would be a cost of around $45 USD a month.
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I just slipped off the step leading into the bathroom and fell backward while holding onto the walker. Bumped my head on the wall behind me before my body slid to the floor. Holy balls was the pain in my tibias enormous for a while. I checked them out and took some steps, stood for a bit also, so I think they're okay. Going to just scoot into the bathroom from now on though.
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If it was a pretty hard fall, try to make sure you didn't sustain a concussion as soon as possible! That could be extremely dangerous if present and not addressed by a doctor, especially since your body was already under a lot of stress.
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Holy you bastard - MAN do I miss the Domino's pizza from India together with Red Bull ;D
Do you need some company? I could go there for the pizza only.....
I tried Domino's in Ukraine but it was awful :o
It doesn't exist in Sweden. Closest one for me is in Denmark.
I think I'll go there tomorrow. It'll be an expensive pizza though ;D
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Be careful when moving around. Think about every step you take.
I never fell when I was in India except one time from the chair, slowly, and a little down a stairstep the day I was going home.
I think I was too careful and had a much longer recovery.
I urge the pizza.......
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Sorry to hear about the fall. The bsthroom is definitely the most hazardous place. You have to be extra extra cautious in the bathroom. I also fell several weeks ago and experienced bad muscle spasm. But falling with external frames is beyond imaginable. OUCH! :o
Btw do you feel that the external frames are becoming part of you or do you feel it being foreign despite the amount of time with it?
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Btw do you feel that the external frames are becoming part of you or do you feel it being foreign despite the amount of time with it?
This is a great question!
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This is a great question!
For me the frames were never an issue at all. They became a part of me from day 1 and it was nothing I ever thought about.
It was just strange seeing my legs when the nurse cut the cast. My thighs were as thin as the femur bone and my shins were a mile long. Barely any muscle power to lift my legs.
I guess I was really prepared after reading about it for 6 years.
Yet I still missed that you have to stand up during lengthening in order to prevent bad ballerina. The physio who came every day should have said something.
I should also have questioned much more about x-legs than I did. Every time I just got the answer: Don't worry, it'll be fine.......
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Holy s**t you bastard - MAN do I miss the Domino's pizza from India together with Red Bull ;D
Do you need some company? I could go there for the pizza only.....
I tried Domino's in Ukraine but it was awful :o
It doesn't exist in Sweden. Closest one for me is in Denmark.
I think I'll go there tomorrow. It'll be an expensive pizza though ;D
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Be careful when moving around. Think about every step you take.
I never fell when I was in India except one time from the chair, slowly, and a little down a stairstep the day I was going home.
I think I was too careful and had a much longer recovery.
I urge the pizza.......
Yea the Dominos here is pretty good. Did you ever try Pizza Hut while in Delhi? Supposed to be pretty good too. I like it in the States because they stuff the crust with melted cheese.
Getting to the bathroom is difficult because it's a narrow door on top of a step and I have to enter it sideways with one side of the walker on the elevated area so the walker is lopsided until I manage to get both feet through the doorway to pull up the walker. Decided it's too dangerous after that slip so I just scoot into it and pull myself onto the toilet by putting one hand on the rim and another on a chair I brought inside.
Sorry to hear about the fall. The bsthroom is definitely the most hazardous place. You have to be extra extra cautious in the bathroom. I also fell several weeks ago and experienced bad muscle spasm. But falling with external frames is beyond imaginable. OUCH! :o
Btw do you feel that the external frames are becoming part of you or do you feel it being foreign despite the amount of time with it?
Falling the way I did (body sliding to the ground first with feet still planted) almost feels like getting your legs pushed down on two sides until the middle gets pulled in half, like snapping a pencil. Everything was left intact though and it surprised me how resilient the frames are. I don't feel the frames most of the time when lying still, but they feel foreign as soon as I have to move my legs from the bed to the floor or have pain by one of the wires, which are a lot more irritating than the pins, btw. I suppose they'll feel more part of me once I've started consolidating.
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Yea the Dominos here is pretty good. Did you ever try Pizza Hut while in Delhi? Supposed to be pretty good too. I like it in the States because they stuff the crust with melted cheese.
Getting to the bathroom is difficult because it's a narrow door on top of a step and I have to enter it sideways with one side of the walker on the elevated area so the walker is lopsided until I manage to get both feet through the doorway to pull up the walker. Decided it's too dangerous after that slip so I just scoot into it and pull myself onto the toilet by putting one hand on the rim and another on a chair I brought inside.
Falling the way I did (body sliding to the ground first with feet still planted) almost feels like getting your legs pushed down on two sides until the middle gets pulled in half, like snapping a pencil. Everything was left intact though and it surprised me how resilient the frames are. I don't feel the frames most of the time when lying still, but they feel foreign as soon as I have to move my legs from the bed to the floor or have pain by one of the wires, which are a lot more irritating than the pins, btw. I suppose they'll feel more part of me once I've started consolidating.
from a overview from aaaaalll of this. Would you say that "meh...it's OK...I can do this" ??
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from a overview from aaaaalll of this. Would you say that "meh...it's OK...I can do this" ??
Yep. Some days are worse than others, but it's tolerable most of the time, especially because I've been fortunate enough to not have had any complications thus far.
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Update: 8/31/2014
On the 28th I saw Dr Parihar again after getting another set of x-rays. He was impressed with how good my ankle flexibility is still. I haven't had any signs of getting equinus. Definitely due to a combination of my weight, constantly doing the ankle movement exercises the physiotherapist taught me, standing each day, and always wearing the shoe straps tight. I've distracted 4.5 cm now. I can feel the end of my lengthening coming that much closer. Distraction is starting to get more painful, but I was told to expect that to happen at this point. I've been taking Ultracet which has tramadol in it and it's helped reduce the pain considerably. As far as complications go, I only had some inflammation on one of the pin sites. Dr Parihar said it's too early to tell if it it infection, but he gave me antibiotics to take just in case. When I got back to the hotel from the hospital I had a lot of pain just below the knee on my right tibia and it was too painful to use my walker to go all the way to my room again so I had my wheelchair brought down to me and rode it up the elevator. Even back in bed I was in a ton of pain and resorted to taking an Ultracet combined with an NSAID. That did the trick and I was able to sleep fine. After some stretching the morning after the pain in that area went down to negligible.
Ganesh Chaturthi has started, the Hindu festival for the elephant god Ganesh. It lasts for ten days and you can hear all the music and festivities for miles around. Unfortunately there's a massive tent set up directly outside my window and I can hear the singing and drumming much louder than I would have liked when the music starts up. Fortunately it starts and stops at different times of the day and isn't constant.
About an hour ago I wheeled out to the lobby for a bit just to get a change of scenery and saw a bunch of young locals go through the large double doors at the other end of the lobby. The hotel set up a nightclub in that area and currently a lot of people are dancing the night away to Indian dance/electronica music. Looked like a lot of fun, but I looked at my frames and decided to wheel back into my room. It will be a while before I can dance again.
I'll post my most recent x-rays once Dr Parihar sends them to me. I forgot to ask for them to be sent to my e-mail at my last appointment.
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The pain is less than in the beggining?
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The pain is less than in the beggining?
No. At this point the distraction is starting to hurt more after every time I turn. I was told it will get harder after I hit the 4 cm mark and it's proven true in my case.
Edit: The beginning few days after surgery were much more painful in general for sure. But in terms of the actual distraction, it hurts more now than when I first started turning.
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Are you stopping at 5cm or going for more?
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Are you stopping at 5cm or going for more?
I think I'm going to go for 6 cm.
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No. At this point the distraction is starting to hurt more after every time I turn. I was told it will get harder after I hit the 4 cm mark and it's proven true in my case.
Edit: The beginning few days after surgery were much more painful in general for sure. But in terms of the actual distraction, it hurts more now than when I first started turning.
you think 4 cm just For Your case? So For someone taller that would be 5 cm and so on and so forth, where you elastic before this?
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you think 4 cm just For Your case? So For someone taller that would be 5 cm and so on and so forth, where you elastic before this?
Well the first doctor I consulted with said that once 4 cm is hit distraction will be more painful. He was speaking generally about it so I think it might be something that would hold true for a lot of people of varying heights. Not sure though.
Despite stretching a whole lot before arriving here, I wasn't elastic at all. One of the physiotherapists even had to do a quite painful fascia release with some massage technique because she said that the physios noticed I had particularly tight fascia. Perhaps it has to do with all the leg exercises I did to bulk them up.
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Your goal of 6CM seems very reasonable, and you will definitely notice the height increase. Do you notice it already?
Also, a pretty random question, how tall is Dr. Parihar? Does he have an upper height limit on who he will consider for LL?
You seem to be bearing weight with crutches before consolidation, but, by most accounts, I hear that Dr. Parihar isn't a big fan of this. How and why did he let you bear weight so early? Also, why did you opt not to use the hexapod TSF-equivalent fixator?
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Your goal of 6CM seems very reasonable, and you will definitely notice the height increase. Do you notice it already?
Also, a pretty random question, how tall is Dr. Parihar? Does he have an upper height limit on who he will consider for LL?
You seem to be bearing weight with crutches before consolidation, but, by most accounts, I hear that Dr. Parihar isn't a big fan of this. How and why did he let you bear weight so early? Also, why did you opt not to use the hexapod TSF-equivalent fixator?
I haven't really stood next to anyone to compare where I was before so I haven't noticed anything yet. Haven't really been paying attention to the current gains either. Just been focused on reaching the end.
I think Dr Parihar is 6'2 judging from the height difference between himself and Dr Divya who's 5'11. He doesn't set any height restrictions on who he will accept for cosmetic lengthening. He just said he's very wary about taking cosmetic cases, so he'll probably want to have a sense that the person knows what he's getting himself into and is very dedicated. He's pretty strict about the 6 cm safety limit though so if someone tells him they want to go for 7 - 10 cm on tibias he might not accept the person as a patient.
It's true that Dr Parihar isn't a fan of weight bearing during distraction, but it doesn't mean he'll forbid you from doing it. Him not being a fan just means that he's not going to insist that you get up and start walking around a few days after surgery and going through the pain to do so like many other doctors do. Walking is only necessary for bed to toilet transfers in his view. He's cool with you standing for long periods with walker in hand though. And if you can tolerate the weight bearing and feel like walking with the walker then he's not going to make you stop. On the other hand, he really emphasizes the importance of doing daily phsyiotherapy and stretches and wants you to go through them multiple times a day so you don't spend double the time later on trying to regain that lost muscle strength and ROM.
He only uses the hexapod once distraction is completed and a full length standing x-ray is taken. If he sees any misalignment then he'll replace the rods on the frame with hexapod struts and make the correction while the bone is still malleable.
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Latest x-rays.
(http://s5d4.turboimagehost.com/t/19898507_Set_5_1_Watermark.jpg) (http://www.turboimagehost.com/p/19898507/Set_5_1_Watermark.jpg.html)(http://s5d4.turboimagehost.com/t/19898508_Set_5_2_Watermark.jpg) (http://www.turboimagehost.com/p/19898508/Set_5_2_Watermark.jpg.html)(http://s5d4.turboimagehost.com/t/19898509_Set_5_3_Watermark.jpg) (http://www.turboimagehost.com/p/19898509/Set_5_3_Watermark.jpg.html)(http://s5d4.turboimagehost.com/t/19898510_Set_5_4_Watermark.jpg) (http://www.turboimagehost.com/p/19898510/Set_5_4_Watermark.jpg.html)
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Latest x-rays.
(http://s5d4.turboimagehost.com/t/19898507_Set_5_1_Watermark.jpg) (http://www.turboimagehost.com/p/19898507/Set_5_1_Watermark.jpg.html)(http://s5d4.turboimagehost.com/t/19898508_Set_5_2_Watermark.jpg) (http://www.turboimagehost.com/p/19898508/Set_5_2_Watermark.jpg.html)(http://s5d4.turboimagehost.com/t/19898509_Set_5_3_Watermark.jpg) (http://www.turboimagehost.com/p/19898509/Set_5_3_Watermark.jpg.html)(http://s5d4.turboimagehost.com/t/19898510_Set_5_4_Watermark.jpg) (http://www.turboimagehost.com/p/19898510/Set_5_4_Watermark.jpg.html)
omg, I think u might get bowed leg/legs, I just hope not, but ask your doctor, I just assume it cause of your weight, amount of lengthening u will do
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why bow legs??? I can not read x rays, so i'm clueless about this...
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Bone healing looks kinda bad. Walk more!
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Actually his consolidation looks great. Only thing I'm worried about is that his right leg looks a little misaligned.
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(http://i.imgur.com/WhgpEM4.jpg?1)
What's this? (second pic from the left). Looks scary. And I'm not an expert, but it looks like it may consolidate too soon? On the left side
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His doctor probably knows more than us since he emailed him the x rays ;)
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omg, I think u might get bowed leg/legs, I just hope not, but ask your doctor, I just assume it cause of your weight, amount of lengthening u will do
I don't think there's a risk for getting bow legged. The bones look a bit curved but comparing them to my first x-ray before surgery it looks like my tibias had a nature curvature about them.
(http://s5d3.turboimagehost.com/t/19108841_Set_1_3_Watermark.jpeg) (http://www.turboimagehost.com/p/19108841/Set_1_3_Watermark.jpeg.html)(http://s5d3.turboimagehost.com/t/19108842_Set_1_4_Watermark.jpeg) (http://www.turboimagehost.com/p/19108842/Set_1_4_Watermark.jpeg.html)
Actually his consolidation looks great. Only thing I'm worried about is that his right leg looks a little misaligned.
Dr Parihar said some misalignment could happen due to not putting any pins in the middle to prevent the long scars, and that would result in the bones moving a bit. He's planning to use the hexapod once I've stopped lengthening to correct any misalignment present.
(http://i.imgur.com/WhgpEM4.jpg?1)
What's this? (second pic from the left). Looks scary. And I'm not an expert, but it looks like it may consolidate too soon? On the left side
I asked him about that too. Apparently my bones were too solid for the clean cut and they shattered during the surgery. He doesn't think it will consolidate too soon at the current .75 mm per day rate.
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i think the surgery itself fixes bow legness
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Interesting read so far :)
However I have a few questions:
- Is it possible to do internal femurs in India?
- How tall do you aim to be at the end of your surgery?
And a final question:
- How tall is Dr Parihar, would you say? From reading all this, he must be at least 6'3" (very tall for India)
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Interesting read so far :)
However I have a few questions:
- Is it possible to do internal femurs in India?
- How tall do you aim to be at the end of your surgery?
And a final question:
- How tall is Dr Parihar, would you say? From reading all this, he must be at least 6'3" (very tall for India)
1) Precice 2 is approved for use in India currently. If you tell your surgeon you want internal femurs then he would contact Ellipse and then after you pay Ellipse the cost of the nails they will be shipped from the UK to the doctor.
2) 5'7
3) From the height difference between himself and Dr Divya, who's 5'11, I would guess he's 6'2 or slightly taller. Here's a picture with both doctors in it. You'll notice Dr Parihar is standing next to Dr Solomin, who was recently added to the doctor directory.
(http://s5d4.turboimagehost.com/t1/19906922_903447_494918927222042_1519772070_o.jpg) (http://www.turboimagehost.com/p/19906922/903447_494918927222042_1519772070_o.jpg.html)
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Great picture. It's fantastic to put faces to names. What was Dr. Solomon doing in India?
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He was one of the instructors at an Ortho-SUV frame course.
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Here's a sample of the food I've been eating at Hotel Maharana. The hotel has its own restaurant but it's vegetarian, so anything on the menu that has meat in it is brought from Hotel Sai Darshan across the street. Everything tastes pretty good and I've become quite partial to the butter naan and mutton masala combo (first pic).
(http://s5d3.turboimagehost.com/t/19955739_ykn0lyy.jpg) (http://www.turboimagehost.com/p/19955739/ykn0lyy.jpg.html)(http://s5d3.turboimagehost.com/t/19955729_2qo4hj1.jpg) (http://www.turboimagehost.com/p/19955729/2qo4hj1.jpg.html)(http://s5d3.turboimagehost.com/t/19955731_3rfyn3c.jpg) (http://www.turboimagehost.com/p/19955731/3rfyn3c.jpg.html)(http://s5d3.turboimagehost.com/t/19955735_mx4d2ok.jpg) (http://www.turboimagehost.com/p/19955735/mx4d2ok.jpg.html)(http://s5d3.turboimagehost.com/t/19955736_n53mz5m.jpg) (http://www.turboimagehost.com/p/19955736/n53mz5m.jpg.html)(http://s5d3.turboimagehost.com/t/19955732_fl03v04.jpg) (http://www.turboimagehost.com/p/19955732/fl03v04.jpg.html)(http://s5d3.turboimagehost.com/t/19955734_gc3yxwy.jpg) (http://www.turboimagehost.com/p/19955734/gc3yxwy.jpg.html)(http://s5d3.turboimagehost.com/t/19955738_uaz1zsz.jpg) (http://www.turboimagehost.com/p/19955738/uaz1zsz.jpg.html)
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Just turned to 5.5 cm today. I have my next appointment with Dr Parihar tomorrow. Hopefully the actual amount lengthened is close to the amount turned. If it is, I think I'll just need to turn .75 until the following Tuesday or Thursday and then my lengthening phase will be over. Next step after that is adding the extra pins to the middle of each leg and converting the frame into a hexapod fixator to fix any misalignment.
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Stop at 6
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Gonna go for 7 cm in the final week and stop at 13 cm.
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What do you mean you are stopping at 13cm lol :o
Im assuming you meant you are stopping at 7cm... Anyway do you plan on going back home with the frames on or are you staying there until its off? How long is your visa valid for and do you know long it can be extended to? What does +5.5cm feel like, do you notice anything, do you feel taller or do you think 5cms on tibia as a first operation is not yet sufficient? Any pictures on your tibs would be a huge plus if you dont mind showing them. Thanks
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What do you mean you are stopping at 13cm lol :o
Im assuming you meant you are stopping at 7cm... Anyway do you plan on going back home with the frames on or are you staying there until its off? How long is your visa valid for and do you know long it can be extended to? What does +5.5cm feel like, do you notice anything, do you feel taller or do you think 5cms on tibia as a first operation is not yet sufficient? Any pictures on your tibs would be a huge plus if you dont mind showing them. Thanks
Haha, it was just a joke. I don't plan to go higher than 6 cm and I might stop just short of that. I'll be returning home in frames as I'll probably have to wear them for 9 months or so.
Medical visas are normally issued for six months. You can request an extension by going to the immigration bureau with your blood tests and a medical report from your surgeon. My visa was extended by four months because I couldn't come to India until 5 months after my visa's issue date due to things I had to take care of at my office.
I think 5 cm makes a big difference already. It doesn't sound like it just by the number, but a 5 cm height difference between two people makes a big difference, especially at shorter starting heights. At this point I feel a little stiffer but I think that's because the last 7 days I increased my lengthening speed to 1 mm per day from .75 mm per day. After doing a lot of ankle movement exercises the stiffness went away. But the faster I lengthen, the more uncomfortable it feels afterward. I'm going back to .75 mm per day until the end now.
Here's a side view pic of what my left tibia looks like now. Right looks the same.
(http://s5d4.turboimagehost.com/t1/19983773_Tibias_after_5.5_cm_turn.jpg) (http://www.turboimagehost.com/p/19983773/Tibias_after_5.5_cm_turn.jpg.html)
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Ahh okay, Im assuming you mean the immigration bureau in India while you are still there lengthening/consolidating? I might stay there until the frames are removed if I go to India then :o
How many months have you been there in total now?
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Ahh okay, Im assuming you mean the immigration bureau in India while you are still there lengthening/consolidating? I might stay there until the frames are removed if I go to India then :o
How many months have you been there in total now?
Yep. Been here since June 10th and had my surgery on June 25th.
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Do you think the temperature in the room has to do anything with your process
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Do you think the temperature in the room has to do anything with your process
Can you clarify what you mean by this?
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relatedd to pain if its colder the more it hurts if it warmer the more soft the muscle tissue is and it dosnt hurt as muc,
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Oh. Yes, I notice that my muscles feel a bit sore if I leave the air conditioner on for a long time. They feel fine again after turning it off for a short while.
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Would you happen to know Dr Parihar's Precice 2 price including hospital and doctor fees?
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Would you happen to know Dr Parihar's Precice 2 price including hospital and doctor fees?
It's 900,000 INR (about $15,000 USD) on top of the cost for the nails, which is $30,000. That will cover your hospital stay along with food, meds, pin site dressings, and twice daily physiotherapy while there. You need to arrange your own accommodation at a hotel and x-rays, medication, and gauze strips for your pin sites are all extra cost once you're discharged from the hospital.
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Does he have a limit on femurs or will he allow the full 8cm for Precice 2 femurs?
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Does he have a limit on femurs or will he allow the full 8cm for Precice 2 femurs?
I don't think his 6 cm limit applies to femurs.
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Update: 9/11/2014
Today all my good luck ran out and I have entered the limb lengthening realm of post-op complications. I had the brilliant idea of increasing my lengthening speed from .75 mm to 1 mm per day for seven days and it completely bit me in the ass. I woke up for the second day in a row with stiff ankles. Did ankle movement exercises for about 20 minutes until the stiffness went away. Thought I'd try standing a while and as soon as I made a move to stand up I had a sharp pain underneath my right knee. I spent a few minutes massaging it and pulled myself up onto the walker, ready to begin my standing. But it wasn't happening. I found that I could no longer touch the floor with the heels of my feet. Only my toes made contact with the floor, and as I tried to press my heels to the ground I was greeted with sharp pain below my knees again. I had gotten equinus out of nowhere. When I got my x-rays taken I found that despite me lying with my legs straight as much as I could tolerate each day, only my most distal ring made contact with the table and the middle and proximal rings remained elevated no matter how much I pressed my knees down. Knee flexion contracture decided to greet me with its ugly presence. It was like a nightmare.
Dr Parihar was held up at another hospital and so I only saw Dr Divya during my appointment. He checked my flexibility with his assistant and forced my legs to extend, while also checking how much he could bend my feet toward the rings. It was decided that I stop lengthening for the next three days and focus entirely on physiotherapy. I now have a physiotherapist coming to the hotel each day for sessions until this gets fixed. My x-rays showed that I hit exactly 5 cm after turning 5.6 cm. Divya told me that with the way things are he thinks I can get another half centimeter, and optimistically i can probably push to 6 cm provided the physiotherapy goes well. I was given a shot on my thigh to relieve pain and had a physio session downstairs with Pratiksha. She brought in a device that was attached with sticky pads on my quads. It gave me muscle stimulus through electric currents for 30 minutes before I had to do leg extensions and fight the equinus. The whole session hurt worse than usual and I had to do it in a room with a lower bed because I could no longer bring myself up onto the higher one I always did my sessions on due to the equinus.
Pretty awful day all in all.
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Update: 9/11/2014
Today all my good luck ran out and I have entered the limb lengthening realm of post-op complications. I had the brilliant idea of increasing my lengthening speed from .75 mm to 1 mm per day for seven days and it completely bit me in the ass. I woke up for the second day in a row with stiff ankles. Did ankle movement exercises for about 20 minutes until the stiffness went away. Thought I'd try standing a while and as soon as I made a move to stand up I had a sharp pain underneath my right knee. I spent a few minutes massaging it and pulled myself up onto the walker, ready to begin my standing. But it wasn't happening. I found that I could no longer touch the floor with the heels of my feet. Only my toes made contact with the floor, and as I tried to press my heels to the ground I was greeted with sharp pain below my knees again. I had gotten equinus out of nowhere. When I got my x-rays taken I found that despite me lying with my legs straight as much as I could tolerate each day, only my most distal ring made contact with the table and the middle and proximal rings remained elevated no matter how much I pressed my knees down. Knee flexion contracture decided to greet me with its ugly presence. It was like a nightmare.
Dr Parihar was held up at another hospital and so I only saw Dr Divya during my appointment. He checked my flexibility with his assistant and forced my legs to extend, while also checking how much he could bend my feet toward the rings. It was decided that I stop lengthening for the next three days and focus entirely on physiotherapy. I now have a physiotherapist coming to the hotel each day for sessions until this gets fixed. My x-rays showed that I hit exactly 5 cm after turning 5.6 cm. Divya told me that with the way things are he thinks I can get another half centimeter, and optimistically i can probably push to 6 cm provided the physiotherapy goes well. I was given a shot on my thigh to relieve pain and had a physio session downstairs with Pratiksha. She brought in a device that was attached with sticky pads on my quads. It gave me muscle stimulus through electric currents for 30 minutes before I had to do leg extensions and fight the equinus. The whole session hurt worse than usual and I had to do it in a room with a lower bed because I could no longer bring myself up onto the higher one I always did my sessions on due to the equinus.
Pretty awful day all in all.
I had the same problem. Just force your heel down as much as you can, it will hurt like hell but that's the way it is. In 2 weeks you should be fine again. Do 5-10 min physio every few hours, worked out best for me.
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Wow sorry to hear, that is bad news but Im sure you'll get through it. So up until 5cm and while you were still on .75mm per day everything was smooth sailing?
With the extra physio you are doing atm, are you paying extra money for it or is it inclusive in the price?
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I had the same problem. Just force your heel down as much as you can, it will hurt like hell but that's the way it is. In 2 weeks you should be fine again. Do 5-10 min physio every few hours, worked out best for me.
The shot I received at the hospital made it so I didn't have pain below the knees while standing with the walker so I tried your suggestion and managed to get my heels to the floor and keep them there for a few minutes. I sometimes find myself bending forward a bit which lessens the stress on the heels and have to straighten my body out again to get the full weight on them. I like the stretch this gives and because I was actually able to get both feet planted on the ground and keep them there while concentrating I'm going to keep on doing this exercise. It relieved a lot of anxiety just now and made me more confident that I can beat this through stretching alone. Thanks a bunch, 123. :)
Wow sorry to hear, that is bad news but Im sure you'll get through it. So up until 5cm and while you were still on .75mm per day everything was smooth sailing?
With the extra physio you are doing atm, are you paying extra money for it or is it inclusive in the price?
Yep, outside of the lingering and random pains that come from lengthening, I haven't had any complications before this point. I probably wouldn't have had them now if I had stuck with .75 mm per day though. Lengthening faster really does increase the speed at which complications will arrive.
The physiotherapy will be extra because he's going to be coming to my hotel. I'll have to pay him directly and I don't think Dr Parihar gets any of that money. I'm able to arrange with the physiotherapist when I'll pay him though (i.e. once after each session or a lump sum at the end of it all).
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What you described is common and normal, and nothing you can't stretch your way out of pretty quickly. Do you have sandbags or other heavy things you could put on your knees? Those helped me out a lot as a form of passive physical therapy that I could do just while lying in bed.
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just a question, how old are you and what's the average age at the hospital?
Thanks & good luck!
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A few more questions Kilo
1/ Can you ask about the Precice 2 nail when you next see Dr Parihar again. In the case of malfunction where the patient is not at fault like the recent one in South Africa, what does Dr Parihar do in those situations in terms of help for the patient? Will the replacement be extra charge or just an extra charge for the hospital fees?
2/ Do you think the food in India helps or is it bad for bone regeneration?
3/ What is your typical day like, I mean what do you do? Do you go out the hotel often?
4/ The extra physiotherapy you are doing atm, how much is that a session and do you think the price will be similar for Precice 2?
5/ How slow is the internet, for example Youtube, does it load slowly?
Probably a bad time to ask so many questions given you just had your first major complication and for that I apologise in advance. Answer them when ever you are able to
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What you described is common and normal, and nothing you can't stretch your way out of pretty quickly. Do you have sandbags or other heavy things you could put on your knees? Those helped me out a lot as a form of passive physical therapy that I could do just while lying in bed.
No sandbags. I've been going to the edge of the bed and elevating my feet onto the walker, which locks my knees out and causes them to push downward due to the walker being much higher. So far it seems to be working.
just a question, how old are you and what's the average age at the hospital?
Thanks & good luck!
Early 20s.
Not sure what the average age is. I've seen a bunch of children, teens, middle age, and geriatrics.
A few more questions Kilo
1/ Can you ask about the Precice 2 nail when you next see Dr Parihar again. In the case of malfunction where the patient is not at fault like the recent one in South Africa, what does Dr Parihar do in those situations in terms of help for the patient? Will the replacement be extra charge or just an extra charge for the hospital fees?
2/ Do you think the food in India helps or is it bad for bone regeneration?
3/ What is your typical day like, I mean what do you do? Do you go out the hotel often?
4/ The extra physiotherapy you are doing atm, how much is that a session and do you think the price will be similar for Precice 2?
5/ How slow is the internet, for example Youtube, does it load slowly?
Probably a bad time to ask so many questions given you just had your first major complication and for that I apologise in advance. Answer them when ever you are able to
1) I'll ask him about the first one. I let him know about some of the issues with the nails not distracting that happened with patients of Dr Lee and Dr Birkholtz so he knows it could be an issue later. I've asked him about getting another internal option available to choose from and he's been thinking about it.
2) You can get all your nutritional needs here. Dr Parihar gives you pills for calcium and zinc, and you can also get it from the dairy and fish here. You can get your proteins through chicken, fish, and mutton. And there's no shortage of vegetables with so many here being vegetarian.
3) I haven't been going outside the hotel room much, just for a little bit to lounge in the lobby every once in a while. I have an HDTV in my room and a PS3 along with a bunch of DVDs and books in addition to my laptop, so that helps with the boredom. There's not much in terms of social interaction though being the only foreigner here and only one in frames.
4) I don't know yet. I've had two sessions so far and Dr Chaudhary hasn't said anything to me about money so I haven't paid anything so far.
5) I can watch youtube vids up to 480p fine. I have to pause for HD vids to load though. I think the average speed according to my cell phone is 19 mbps at this hotel, though at time it goes higher or lower depending on how many in the hotel are using it.
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I've confirmed the price for physiotherapy is 1,000 INR (around $16.00 USD) per session when done outside the hospital. Worked out that I'll pay every 5 sessions.
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Wow thats really cheap. So thats for the physio to come over to your hotel and do it in your room? Ooops that sounds kinda wrong :o
And thats for a one hour session?
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Yep.
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Hey Kilo, just reread your diary again and seems like you've changed my mind regarding LL in India :)
Regarding Precice in one of your earlier post you said that you'd have to pay Ellipse the $30,000 first before they ship it to Dr Parihar. As I'd like to go to India first and look around at the place, the facilities, what Dr Parihar is like I'd rather not want to pay the $30k upfront incase I back out and lose that money. I know Dr Birkholtz patients didn't have to pay upfront before the nails get shipped and only paid for them on arrival and after their consultations(I think). Can a patient pay after a consultation with Dr Parihar and not have to wait for it to arrive? Could you ask Dr Parihar about this when you can?
Also I dont think you've said anything regarding showering unless I missed it, are you allowed to shower fully as in get the frames wet as well? Or do you need to cover them up before showering?
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How is the equinus Kilokahn? Has your therapy been of any relief yet?
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Hey Kilo, just reread your diary again and seems like you've changed my mind regarding LL in India :)
Regarding Precice in one of your earlier post you said that you'd have to pay Ellipse the $30,000 first before they ship it to Dr Parihar. As I'd like to go to India first and look around at the place, the facilities, what Dr Parihar is like I'd rather not want to pay the $30k upfront incase I back out and lose that money. I know Dr Birkholtz patients didn't have to pay upfront before the nails get shipped and only paid for them on arrival and after their consultations(I think). Can a patient pay after a consultation with Dr Parihar and not have to wait for it to arrive? Could you ask Dr Parihar about this when you can?
Also I dont think you've said anything regarding showering unless I missed it, are you allowed to shower fully as in get the frames wet as well? Or do you need to cover them up before showering?
I believe Dr Parihar has to contact Ellipse first and request the nails for a patient before they ship them and then from there the payment to Ellipse is worked out and everything. I see Dr Parihar again next Thursday and I'll ask for more details on how it all works. The process for him should be the same as the one for any of the other doctors here, like Dr Shah for example.
Once the stitches are removed from the osteotomy sites you're allowed to bathe. You leave your dressings on and wash your legs as normal, getting the fixators and the dressings wet, and right after bathing you dry the fixators with a towel and replace the wet dressings with new ones.
How is the equinus Kilokahn? Has your therapy been of any relief yet?
There's been solid improvement. My right leg has it almost all the way sorted out but my left leg has always been tighter and it takes a little more time and force to get the heel to the ground. Still also have knee flexion but after some time I'm able to get my legs fully extended. I'm not really worried about them anymore, but my quads have taken such a hit from atrophy that I can no longer fully extend my legs while sitting or lift my legs up high from a lying down position. I've been doing electric muscle stimulation on my quads twice a day to try and get that strength back. My physiotherapist is hopeful though and he thinks based on my progress that I can get all my issues sorted by next Thursday.
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Update: 9/19/2014
I spoke with Dr Divya again and have decided that I'll continue lengthening .75 mm per day until I see Dr Parihar again on Thursday, at which point I'll stop. I've currently turned 5.8 cm and I'll stop turning at 6.3 cm. Due to the discrepancy between my turning amount and lengthening amount in prior checkups I'm expecting the actual distraction to be 5.7 cm at the end of it. I figure that even though Dr Parihar recommends 6 cm as the safe maximum it doesn't mean I need to stretch to that limit as it's close enough. Looking at my legs now and judging from how I feel battling equinus and ankle tightness currently, I'm going to call it a day at the next check up and let the bone consolidation commence. If any misalignment is present they'll replace the rods with hexapod struts. The good thing is that Dr Divya told me correcting misalignment with the hexapod should only take a few days because I don't have to lengthen as well. He told me that hexapod will be no extra charge, which was nice to hear.
Not much more going on now. My left leg is still tighter than my right one and it's made me have pain right above where the top of my foot begins when I have the straps on. Also trying to figure out how I'll manage at the airport and flying home. I was watching videos about the Twin Towers a week ago and that's got me nervous about flying again, too.
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Hi kilokhan, can you ask to doctor parihar if he know doctor salameh was in congress of india, beacuse he wasn't in the programe but
i talked with him by email and he told me that he was in india in a congress. THAN YOU.
Cheers, paco
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Hi kilokhan, can you ask to doctor parihar if he know doctor salameh was in congress of india, beacuse he wasn't in the programe but
i talked with him by email and he told me that he was in india in a congress. THAN YOU.
Cheers, paco
Hi,
He attended ASAMI 2014.
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Update: 9/26/2014
Got my x-rays again on Thursday and afterwards had to wait for two hours to see Dr Parihar and Dr Divya because they were still in the OT and then had to see patients who arrived before me. They spent quite a while looking at my x-rays before calling me in and Dr Parihar told me that depending on the angle of the x-ray and factoring in magnification, I have lengthened somewhere between 5.4 and 5.6 cm. However, to get to my goal of 6 cm it's not going to be a matter of just lengthening for a few more days. The x-rays show that I have some bending in the bones and the right one has more bending than the left, which is why the equinus is not as bad in that one because the bones don't stretch the tissues as much. This means that my bones are not aligned properly and I'll need to correct them. But in order to correct them he may have to compress the legs a little. Because of this, in order to reach my 6 cm goal he wants me to distract another centimeter to around 6.5 cm. After the distraction is done I will need to be admitted to the hospital once again for two days so he can add two pins to the middle of each leg for added stability and then change my frames to a hexapod.
Originally I was supposed to leave for home in the first or second week of October but now he wants me to stay until October 23, just 5 days before my visa expires. I'm continuing my physio and am supposed to practice standing barefoot against the wall as long as possible every day so I can prepare for my full length standing x-ray for the final measurement before I get the pins added. My legs are feeling sore each day and the pin sites and wires are getting more uncomfortable. I still wake up with ankle stiffness in the mornings that I have to alleviate each day with ankle movement exercises, too. Around this amount of distraction is where many patients end up having these sorts of complications which is why Dr Parihar has his 6 cm limit, but he says these can all be corrected and is just one of the things you have to expect to come across in cosmetic lengthening.
Latest X-Rays
(http://s5d1.turboimagehost.com/t1/20222239_Set_6_1_Watermark.jpg) (http://www.turboimagehost.com/p/20222239/Set_6_1_Watermark.jpg.html) (http://s5d1.turboimagehost.com/t1/20222241_Set_6_2_Watermark.jpg) (http://www.turboimagehost.com/p/20222241/Set_6_2_Watermark.jpg.html) (http://s5d1.turboimagehost.com/t1/20222242_Set_6_3_Watermark.jpg) (http://www.turboimagehost.com/p/20222242/Set_6_3_Watermark.jpg.html) (http://s5d1.turboimagehost.com/t1/20222243_Set_6_4_Watermark.jpg) (http://www.turboimagehost.com/p/20222243/Set_6_4_Watermark.jpg.html)
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Do u know ho much he will charge you for that?
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No charge.
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Isn't this still his fault?
I think one can control alignment in LON.
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He made it aware before my surgery that with exfix this could happen because of the motion that takes place in the middle and said that if it does he would add the pins and correct with the hexapod. LON should prevent this sort of thing but you're taking the knee pain risk and have to get your bone canals reamed, which I didn't want to deal with.
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Do you know how long it will take to correct? A week?
Also what do you do these days to keep active and ease boredom? The usual laptop movies, shows, games, etc? Outside those things what else is there to do everyday by yourself?
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Correction with the hexapod won't take long. Divya said it should only take a few days because I don't have to distract and just need to correct the angle.
Yea just the usual. Outside of physiotherapy I've just been using the laptop and occasionally pull out a PS3 game. The days are monotonous and just seem to blend into each other. The most human interaction I get is during my hospital checkups talking to various staff members and sometimes others in the lobby who are there for deformity correction. I had planned to come with a friend but he couldn't get time off work, and because there are no other international cosmetic patients currently I don't really talk to anyone outside of FB messenger.
I think if people came for lengthening with Dr Parihar or Dr Shah it would be cool if they all booked rooms in the same hotel because the doctors are close enough together by taxi and you'd have better social interaction which would help prevent you from feeling down. I've been watching a lot of comedies to keep my mood up.
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Update: 9/30/2014
These last couple days of physiotherapy have been hell. I found out that my equinus was actually worse than I thought it was. My physiotherapist Dr Chaudhary pointed out that when I stand using the walker I end up putting my hips back, which I didn't realize I was doing, and standing with your hips back makes it easier to touch the floor. It's probably why I ended up getting the equinus in the first place because I wasn't standing completely straight. When I have my back and legs touching the wall behind me while standing I get more of a stretch and I can't readily touch the floor with my right foot like a could before. I managed to get my right foot completely touching the floor three days ago and almost did so with my left one, but the last two days my calves have been really sore and the equinus is a little worse, despite me standing a lot and having the straps on constantly. I think it's mostly due to the soreness in the calves from the stretching but I'll have to wait a few more days to see if there's any progress.
The worst part is that the wires by my knees have been extremely painful the last few days. Most positions I move my legs will give me sharp pains at the wires and near one of them if I even touch the top of the skin lightly it feels like electricity in that area. Totally jacked me up during leg extension exercises today. I'm going to ask Dr Parihar if he can cut some skin surrounding the wires by the knees again during the surgery for the extra pins so I can at least extend my legs without wincing.
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Kahnny,
The electric jolts should subside immediately after distraction as I said before. I also do the same with my hips and it does really fk up your whole gait, so you're lucky they pointed that out to you so you can't cheat. Bette to hear the truth than be told it's okay and think it's fine when it's not. Hang in there.
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Hey Kilo I'd like to ask about humerus lengthening, which method did Dr Parihar say he'd use?
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Hi Kilo, I am impressd by ur diary bro. How u chose ur doctor by actually visiting them and measuring the pros n cons n providing all this imp information abt all the doctors. I m also planning my visit to India to meet various Indian doctors n do this surgery by this month end. Could u plz have a look at my thread n suggest me accordingly. I would really appreciate that.
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i am newbie here...i have a question...may b its stupid....what u people think its better to have slim leg(tibia bone with least muscles) or its better to have big(tibia bone+lot of muscles) for external fixture??
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Kahnny,
The electric jolts should subside immediately after distraction as I said before. I also do the same with my hips and it does really f**k up your whole gait, so you're lucky they pointed that out to you so you can't cheat. Bette to hear the truth than be told it's okay and think it's fine when it's not. Hang in there.
Yea I'm glad it was pointed out to me. Just disappointed that I was spending a lot of time doing that without realizing it. Seems like a whole lot of time standing was wasted because of it.
Hey Kilo I'd like to ask about humerus lengthening, which method did Dr Parihar say he'd use?
I didn't get into real specifics with him but I know from talking to Dr Divya that you can use externals with the unilateral frame and even use LON on humerus. For cosmetic cases I think he'd do both arms at once, as Divya said you can do so and that you don't really lose much function while lengthening the humerus.
Dr Parihar has done humerus lengthening many times before and said it's the easiest segment to lengthen. He showed me some x-rays of non-cosmetic humerus lengthening cases as well.
i am newbie here...i have a question...may b its stupid....what u people think its better to have slim leg(tibia bone with least muscles) or its better to have big(tibia bone+lot of muscles) for external fixture??
Your calves are going to atrophy regardless, but I've spoken to some surgeons who seem sure that adding muscle to your calves before lengthening will be beneficial because it will mean increased blood flow to the area. Having more muscular calves sure seems to make the distraction hurt more than someone with thinner calves though.
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This question is almost exclusively just out of curiosity, but, while we're on the topic of arm lengthening, do you know of your team of doctors does forearm lengthening and if they'd be comfortable/safe doin it for cosmetic purposes? I've heard mixed opinions on forearm lengthening and am just curious. I've read that Dr. Solomon will do it for cosmetic reasons, but was wondering about Dr. Parihar, who is one of the few doctors I think I'd trust with such a risky procedure.
Personally, I don't expect my arms to look short after LL. I only plan on exceeding my wingspan by 2-3CM. However, as a last resort, if I did end up looking disproportionate, I think that humerus lengthening might only worsen proportions for me, because my humerus bones are already slightly longer than my forearms.
I was wondering if you could get Dr. Parihar's opinion on this if it isn't too much trouble. Thank you, by the way, and hang in there with the final stretch (pun intended) of your lengthening journey.
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This question is almost exclusively just out of curiosity, but, while we're on the topic of arm lengthening, do you know of your team of doctors does forearm lengthening and if they'd be comfortable/safe doin it for cosmetic purposes? I've heard mixed opinions on forearm lengthening and am just curious. I've read that Dr. Solomon will do it for cosmetic reasons, but was wondering about Dr. Parihar, who is one of the few doctors I think I'd trust with such a risky procedure.
Personally, I don't expect my arms to look short after LL. I only plan on exceeding my wingspan by 2-3CM. However, as a last resort, if I did end up looking disproportionate, I think that humerus lengthening might only worsen proportions for me, because my humerus bones are already slightly longer than my forearms.
I was wondering if you could get Dr. Parihar's opinion on this if it isn't too much trouble. Thank you, by the way, and hang in there with the final stretch (pun intended) of your lengthening journey.
I asked Dr Parihar about forearm lengthening a while ago and he told me that he does do it (though I forgot to ask him if he would specifically do it for a cosmetic case). He showed me a case where he had to do lengthening and deformity correction along with pictures showing the patient's retention of pronation and supination movements. He runs a blog for his site and the most recent blog posts are about forearm cases. The second one in particular is the case he showed me where lengthening was involved. It might be of interest to you.
http://ilizarov-india.blogspot.in/ (http://ilizarov-india.blogspot.in/)
I'll ask him next time I see him if he'd do forearm lengthening for cosmetic reasons.
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Thanks for the information Kilokhan. Dr. Parihar's blog sure serves as a nice reminder that, compared to so many other people out there, we do have it very nice and are fortunate that we are getting put in frames voluntarily instead of out of necessity. Dr. Parihar's work is incredible in trauma cases, though, and it's uplifting to see him making such a positive difference in the lives of many injured and disabled people through his trauma repair procedures.
If you do ask him about cosmetic forearm lengthening, ask him if it is realistic to expect/hope for the retention of full pronation and supination capacity and capability after such lengthening.
Thanks!
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Really though, going through the stories and treatments of the trauma patients featured on Dr. Parihar's blog really makes cosmetic lengthening seem like a silly and stupid thing and height neurosis like a trivial matter when compared to these often grotesque and tragic injuries and deformities. It's good to see these cases to put things into perspective.
Kilokhan, is it difficult, psychologically, to have to be in the clinic getting a procedure that you physically don't need while trauma patients who physically need Ilizarov look at you and possibly realize what is going on? Just out of curiosity, how do you rationalize cosmetic LL with a doctor who also does trauma cases from a moral or justice standpoint? How does Dr. Parihar rationalize or make sense of CLL? Does he only do it in cases of "debilitating" height neurosis, or also to fix "annoying" height neurosis. Both assuming that the patient is understanding of the procedure and willing to make the commitments required. Why does he preform CLL when the trauma/deformity patients "need" his Ilizarov skills so much for than cosmetic patients? I apologize if this is too personal, but this is something that has been on my mind a lot lately and I thought I'd ask.
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If you do ask him about cosmetic forearm lengthening, ask him if it is realistic to expect/hope for the retention of full pronation and supination capacity and capability after such lengthening.
Will do.
Kilokhan, is it difficult, psychologically, to have to be in the clinic getting a procedure that you physically don't need while trauma patients who physically need Ilizarov look at you and possibly realize what is going on? Just out of curiosity, how do you rationalize cosmetic LL with a doctor who also does trauma cases from a moral or justice standpoint? How does Dr. Parihar rationalize or make sense of CLL? Does he only do it in cases of "debilitating" height neurosis, or also to fix "annoying" height neurosis. Both assuming that the patient is understanding of the procedure and willing to make the commitments required. Why does he preform CLL when the trauma/deformity patients "need" his Ilizarov skills so much for than cosmetic patients? I apologize if this is too personal, but this is something that has been on my mind a lot lately and I thought I'd ask.
Funny you should ask this now, because last Thursday while I was getting my rods changed by Dr Divya I told him that I sometimes feel a little awkward in the waiting room when I see people come in with bad deformities and extremely complicated frames on them. Mostly because they're going through so much time and pain just to get to functioning normally and here I am voluntarily having my legs broken. I've had people at the hospital come up to me more than once asking what happened to me and pointing out that it's strange I'm wearing a frame on both legs. I always just lied and said I was doing a bowleg correction, but it did force me to look at myself and realize that although I'm doing this in large part to escape the discrimination I've gotten throughout life for being shorter, part of it is definitely due to vanity to a degree.
I haven't spoken to Dr Parihar about his opinion on CLL. He did say during my consultation that he could do the surgery technically well and will do so for serious cosmetic patients, but whether or not he should do it for cosmetic cases is a different question entirely. I didn't go deeper than that, but I think I'll ask him about how he rationalizes cosmetic cases.
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When you see Dr Parihar next, could you also ask him on his thoughts on lengthening both segments(tibia and femur) consecutively in the space of a whole year? For example, doing 5 or 6cms on tibias first using externals only and stay in India for the whole duration until frame removal and then proceed with Precice 2 femurs for 6 or 7 cms? And go home once the femurs are finished lengthening and be wheelchair bound until femurs are ok for weight bearing?
In my country you can get a one year medical visa so im quite curious about this, not sure if advisable but would like to get Dr Parihars input on the matter.
Thanks in advance Kilo
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This question is almost exclusively just out of curiosity, but, while we're on the topic of arm lengthening, do you know of your team of doctors does forearm lengthening and if they'd be comfortable/safe doin it for cosmetic purposes? I've heard mixed opinions on forearm lengthening and am just curious. I've read that Dr. Solomon will do it for cosmetic reasons, but was wondering about Dr. Parihar, who is one of the few doctors I think I'd trust with such a risky procedure.
Personally, I don't expect my arms to look short after LL. I only plan on exceeding my wingspan by 2-3CM. However, as a last resort, if I did end up looking disproportionate, I think that humerus lengthening might only worsen proportions for me, because my humerus bones are already slightly longer than my forearms.
I was wondering if you could get Dr. Parihar's opinion on this if it isn't too much trouble. Thank you, by the way, and hang in there with the final stretch (pun intended) of your lengthening journey.
Just got out of Dr Parihar's office not long ago and he would not be comfortable doing forearm lengthening for cosmetic purposes. He said there are too many things happening in the forearm and that it's very delicate in that there's a fine balance in the muscles of the forearm. So for him forearm lengthening for cosmetic purposes is as out there to him as clavicle lengthening and hip narrowing.
Humerus lengthening has none of those issues and he'd be okay with doing it. Might not be your ideal but it might look better with the humerus lengthening than with the shorter wingspan. Then again you may even look better with the shorter wingspan and it won't be noticeable.
How does Dr. Parihar rationalize or make sense of CLL? Does he only do it in cases of "debilitating" height neurosis, or also to fix "annoying" height neurosis. Both assuming that the patient is understanding of the procedure and willing to make the commitments required. Why does he preform CLL when the trauma/deformity patients "need" his Ilizarov skills so much for than cosmetic patients? I apologize if this is too personal, but this is something that has been on my mind a lot lately and I thought I'd ask.
He told me that he doesn't have a black and white about it, and that he's not in the head of someone who thinks CLL is something they absolutely need in life so he can't say whether or not CLL is useless to that person. He then said that if there was a state sponsored thing where they provided medical treatment to people, then one has to think as to what patients have the priority and where should the money go, so in that sense treating deformities would take priority over CLL, but in a private setting it doesn't matter. He also said the reason I probably feel a little guilty about getting CLL is that I'm getting it done at his clinic where it's primarily deformities being treated, whereas if I went to one of the flashier settings with a doctor primarily doing CLL, I wouldn't see that side of things. It's also down to individual perception. Someone who isn't sympathetic to others in that situation would not feel guilty if 300 patients were paraded in front of them.
In the end I think he cares more about the prospective patient being absolutely sure that it's the right choice for him.
When you see Dr Parihar next, could you also ask him on his thoughts on lengthening both segments(tibia and femur) consecutively in the space of a whole year? For example, doing 5 or 6cms on tibias first using externals only and stay in India for the whole duration until frame removal and then proceed with Precice 2 femurs for 6 or 7 cms? And go home once the femurs are finished lengthening and be wheelchair bound until femurs are ok for weight bearing?
In my country you can get a one year medical visa so im quite curious about this, not sure if advisable but would like to get Dr Parihars input on the matter.
Thanks in advance Kilo
In regards to lengthening femurs after tibias or vice versa, he said that you should wait until you're back at normal life after the first lengthening before considering a second. Dr Parihar is pretty conservative with how ambitious you should be. He won't even do cross lateral lengthening (even thinks it's crazy for people to do so).
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nice info KiloKahn, hope all is going well for you.
Have to say, Dr Parihar sounds like a very respectable person, seems like a very good choice for anyone who wants to do LL for a good price.
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Dr. Parihar is my ideal choice to do femurs with. I just have to see if he is willing to take me on as a patient. From what Kilokahn says, there are many people at his clinic undergoing external procedures on the femur for various deformities, so I am confident he can lengthen me safely with that method. The pain of external should be less than the pain of shelling out 40kUSD for a pair of precice nails.
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Thanks for asking Dr. Parihar about forearm lengthening. While it's unfortunate that it doesn't seem possible to safely lengthen this particular segment, Dr. Parihar's response demonstrates once again what a responsible and careful surgeon he is. Anyone doing lengthening procedures with him is definitely in very good hands.
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its just a shame that all those people who went to sarin and sringari could have gone to dr parihar instead for the same price. :(
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its just a shame that all those people who went to sarin and sringari could have gone to dr parihar instead for the same price. :(
Agreed, had Sysop/Apo or what ever else he goes by these days(I've lost count) took his time, did his research and not rush into picking the first Indian person with the title Dr. in front of their names, we wouldnt have this forum and previous patients would not have been butchered all in the name of greed. Sigh...
Thanks for the reply Kilo, on a personal note how are things going with you atm? How much have you lengthened and are you having any pain/discomfort atm?
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Dr. Parihar is my ideal choice to do femurs with. I just have to see if he is willing to take me on as a patient. From what Kilokahn says, there are many people at his clinic undergoing external procedures on the femur for various deformities, so I am confident he can lengthen me safely with that method. The pain of external should be less than the pain of shelling out 40kUSD for a pair of precice nails.
Your ideal choice would be to see a psychiatrist...
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I think external femur can be done safely according to clinical studies. but its true we need more diaries to be 100% sure.
I think polycrates is making a logical decision. I think 123 you should rethink why people see psychologists. its not applicable in this case.
I too want to do external femurs. im not going to pay the price of a house for LL when I don't need to.
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I think external femur can be done safely according to clinical studies. but its true we need more diaries to be 100% sure.
I think polycrates is making a logical decision. I think 123 you should rethink why people see psychologists. its not applicable in this case.
I too want to do external femurs. im not going to pay the price of a house for LL when I don't need to.
It's not about external femur, it's that he still isn't satisfied with his height at 184cm + he can't even walk. Sorry, but this is just insane...
I have a lot of friends who are around 185cm and they all consider themselves tall (because they are). So why would you even think about LL at 184cm? Sorry but I just don't get that...
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It's not about external femur, it's that he still isn't satisfied with his height at 184cm + he can't even walk. Sorry, but this is just insane...
I have a lot of friends who are around 185cm and they all consider themselves tall (because they are). So why would you even think about LL at 184cm? Sorry but I just don't get that...
he just hate his femur to tibia ratio, he say it looks really bad
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123, it's not as simple or trivial as his tibiae to femur ratio looking bad. It's a matter of it being bad, biomechanically, for running, jumping, balance, and even walking. That is no way to live life.
Femur lengthening would restore an anatomically normal ratio and prevent potential knee and back issues from altered biomechanics down the road, plus allow running and jumping once muscle and nerves have recovered.
Sorry if I'm missing something, but can a psychiatrist do that?
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hmm. well I agree with 123, it is already a tall height and no one should have any height issues at this height.
but I also agree with taller and the biomechanical aspects need to be fixed.
I guess he has no choice but to fix the biomechanical issues (femur to tibia ratio)
in hindsight polycrates should have got less lengthening on tibia, and spread it over both tibia and femur.
4.5cm on each would have been much safer, especially considering external femur.
I personally think that no LL patient should only get 1 segment done. but if people are getting 2 segments done they should not max out each of the segments.
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in hindsight polycrates should have got less lengthening on tibia, and spread it over both tibia and femur.
(http://i.imgur.com/gopacGI.jpg)
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123, it's not as simple or trivial as his tibiae to femur ratio looking bad. It's a matter of it being bad, biomechanically, for running, jumping, balance, and even walking. That is no way to live life.
Femur lengthening would restore an anatomically normal ratio and prevent potential knee and back issues from altered biomechanics down the road, plus allow running and jumping once muscle and nerves have recovered.
Sorry if I'm missing something, but can a psychiatrist do that?
To be honest I had no idea about his proportions. If someone gives me his exact lengths of tibia and femur we can talk again about that. But he lengthened 6cm, his proportions can't be that bad, unless he had extremely long tibias, to have some "biomechanically" problems. There are millions of people who have longer tibia then femurs and vice versa, heck my father has longer tibia than femurs and he never had (and never will have) any problems. There is no "anatomically normal ratio", it's around 50:50.
For me that's just an excuse from him to do even more LL, or did some doctor tell him that he needs femur lengthening because he has too long tibias? I think femur-LL would make it even worse, but that's just my advice, do whatever you want with that.
And btw. a psychiatrist would really help you :)
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We're all entitled to our opinions. Right now, I definitely feel that a psychiatrist could help you deal with your aggression against people who want LL at average height. What's wrong with someone wanting LL at an average height anyways? There's a thread where you can discuss this if it makes you angry and you'd like to share your opinion on the matter in a civilized way.
Anyways, femur:tibia ratios of 1:1 do not occur naturally unless it is due to a deformity. Please study your biomechanics. Typical human balance wouldn't work nearly as well as it does with such a ratio and strides would be very short. Please find proof of what you are saying as it would really revolutionize the study of biomechanics.
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Polycrates main problem is that he went to an unproven doctor and the doctor messed him up. He will have problems down the line and it is not because of his tibia:femur ratio. Getting that ratio back will not automatically make things better. For someone in his current situation to even think about femur lengthening is a bit ridiculous. His main concern now should be getting back to full health. Time to move on.
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We're all entitled to our opinions. Right now, I definitely feel that a psychiatrist could help you deal with your aggression against people who want LL at average height. What's wrong with someone wanting LL at an average height anyways? There's a thread where you can discuss this if it makes you angry and you'd like to share your opinion on the matter in a civilized way.
Anyways, femur:tibia ratios of 1:1 do not occur naturally unless it is due to a deformity. Please study your biomechanics. Typical human balance wouldn't work nearly as well as it does with such a ratio and strides would be very short. Please find proof of what you are saying as it would really revolutionize the study of biomechanics.
I don't really care if you do LL, go for it if you want, in my opinion it's retarded, but I guess my opinion doesn't matter. So why don't you go and ask your nearest orthopedic if he thinks that's a clever idea? Because I can guarantee you that he won't lengthen your legs. Rinse and repeat that for every orthopedic in your area, no one will do LL with you. You know why? Because there is no reason to. So you have to go to doc who sees this as an opportunity to make money. So me and all the orthopedics are stupid and need to see a psychiatrist (after your logic) and you are the sane and much more civilized person? Sorry I didn't know that :)
So to be on topic again, I wish you the best No More Mal-Kahn-Tent, if you have any questions, I'm here to help you. I got my exfix removed after 8 months (which is btw a fast consolidation rate, if you lengthen 6cm your consolidation can take easily up to 10 months) and can walk perfectly fine now, I have no ballerinas whatsoever, neither do I have some "biomechanical" problems because I lengthened my tibia 6 cm. But I think you are in good hands with your doc.
Cheers.
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well I agree. polycrates is already damaged from his first surgery and because of that should really not have a second.
it is the doctors fault.
and if he wanted better anatomical proportions he should have thought about it before he did his first surgery.
either way. to lengthen a massive amount on his femur now would be dangerous, with no advantage.
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Mal-Kahn-Tent
would you ever consider doing external femurs with dr parihar?
I am just curious.
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I think he already said Dr Parihar is heavily against it and wont do it?
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Thanks for the reply Kilo, on a personal note how are things going with you atm? How much have you lengthened and are you having any pain/discomfort atm?
I had a goal of 6 cm and stopped turning at around 6.3 cm so the actual distraction was slightly less than 6, but Dr Parihar wanted me to distract another 1 cm to account for margin of error in measurement and the compression during surgical correction of some of my misalignment. So total distraction showed 6.2 cm. If I get any subsidence loss during frame removal it will be within 3 or 4 mm so either way I'm cool with how much I've done. Dr Parihar said it's still within the safe range and it's not like I'll be automatically messed up going 2 mm above the recommended max.
I don't really care if you do LL, go for it if you want, in my opinion it's retarded, but I guess my opinion doesn't matter. So why don't you
So to be on topic again, I wish you the best No More Mal-Kahn-Tent, if you have any questions, I'm here to help you. I got my exfix removed after 8 months (which is btw a fast consolidation rate, if you lengthen 6cm your consolidation can take easily up to 10 months) and can walk perfectly fine now, I have no ballerinas whatsoever, neither do I have some "biomechanical" problems because I lengthened my tibia 6 cm. But I think you are in good hands with your doc.
Cheers.
Thanks, 123. Dr Parihar also told me that at the absolute minimum after lengthening 6 cm I'll have to wear these for an additional 4 months for a total of 8 months. I hope I'll have that good a consolidation rate but I'm expecting 9 or 10. I might choose to wear them that long just to be safe. Good to know you're doing well as that gives me more confidence about what to expect.
would you ever consider doing external femurs with dr parihar?
I am just curious.
I feel happy enough to have gotten my tibias done that femur lengthening seems more like a fantasy at this point than something I'd really want to do. So if I did go for femurs I'd probably wait until I'm in a very comfortable financial position to afford internals. I just don't think of femur lengthening bad enough to go through the difficulty of external femurs.
I think he already said Dr Parihar is heavily against it and wont do it?
He does external femurs. He won't do cross lateral lengthening though.
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Good to hear Kilo, so how many more months will you be staying in India for? Didn't you say you were going to consolidate at home?
So if Dr Parihar doesnt do cross lateral that means he'll be doing both femurs together externally in one surgery? Thats going to be very uncomfortable I'm guessing
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He does external femurs. He won't do cross lateral lengthening though
the more I hear from this doctor the more I like him. he is saying all the things he should. cross lateral is not a good thing. its just a fad. scientifically not very smart approach.
Mal-Kahn-Tent, can you ask pariah what he thinks is the safe external femur length to stick to?
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I had a goal of 6 cm and stopped turning at around 6.3 cm so the actual distraction was slightly less than 6, but Dr Parihar wanted me to distract another 1 cm to account for margin of error in measurement and the compression during surgical correction of some of my misalignment. So total distraction showed 6.2 cm. If I get any subsidence loss during frame removal it will be within 3 or 4 mm so either way I'm cool with how much I've done. Dr Parihar said it's still within the safe range and it's not like I'll be automatically messed up going 2 mm above the recommended max.
Thanks, 123. Dr Parihar also told me that at the absolute minimum after lengthening 6 cm I'll have to wear these for an additional 4 months for a total of 8 months. I hope I'll have that good a consolidation rate but I'm expecting 9 or 10. I might choose to wear them that long just to be safe. Good to know you're doing well as that gives me more confidence about what to expect.
I feel happy enough to have gotten my tibias done that femur lengthening seems more like a fantasy at this point than something I'd really want to do. So if I did go for femurs I'd probably wait until I'm in a very comfortable financial position to afford internals. I just don't think of femur lengthening bad enough to go through the difficulty of external femurs.
He does external femurs. He won't do cross lateral lengthening though.
does he do monorail external femurs or with illizavor?
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Update: 10/23/2014
So this will be my first real update in a little while. Just over a week ago I was admitted back to Mangal Anand Hospital after notifying Drs Parihar and Divya that my additional 1 cm of distraction was complete. I arrived by auto rickshaw and had to wait about 5 minutes for the helper (I think they call them "mausi") to bring the wheelchair before being taken to a back room in the male ward on the second floor. One of the sisters (nurses) came in and had me sign some consent forms before I lied back in bed to watch Comedy Central. They had put a refrigerator in each room since the last time I had been in the hospital and I really wanted to pull out that orange delight tropicana but I wasn't allowed to eat anything because of the surgery next day. I was too anxious to go to sleep so I started playing an indie point and click survival horror game on the PC called Five Nights at Freddy's, which lasted me through the night.
The next day I had my x-rays taken again before being wheeled into the operating theater. This second surgery was to add two pins in the middle of each leg in order to add stability. This would help with faster consolidation down the line and also reduce aches and pains (as added stability tends to do). One of the ladies on the surgical team stuck me with the IV and then I had to lean forward and stay still while they performed the awful spinal epidural, which I still think is the worst part of going into the OT because it makes your sides pulsate and you feel an uncomfortable tube wriggling its way into you. Dr Parihar came in and placed my x-rays on a wall with a back light at the other end of the room so he could examine them before surgery. I fell asleep from not having slept before surgery started and woke up some time later to my muscles contracting from the cold temperature in the OT. I was lying at a decline but I lifted my head just brief enough to see Dr Parihar take a large pair of pliers and hear a loud snapping noise. It startled me and I put my head back down and tried to sleep again, but later I found out he had just cut the ends off the top pins and that's what caused the noise. I spent the rest of the night in the same room I was in after my first surgery. The numbness of the legs was nice but I had to sleep at a slight decline to not get sick from the epidural and because my lower body was numb and I had no catheter it took forever to take a piss in the urine pot.
For the rest of the week I spent my days watching cable TV or playing on the PC for entertainment, interrupted by my two physiotherapy sessions each day - one around noon and the other around 6:00 pm. I also had to change my dressings every day, which was the most annoying part because each change takes over an hour and 40 gauze strips. At least the sisters gave me a menu where I could order whatever I wanted from a veg or non-veg restaurant nearby. It was nice to eat from a restaurant other than the one my hotel ordered from just to try out the difference in cooking style.
I developed a severe pain on my right leg that was just underneath the two left wires below the knee, which prevented me from moving my leg certain angles or doing extensions without a jolt of pain. Using the walker was certainly harder as well. The pain kind of worried me but I got a visit from Parihar and Divya, and Parihar told me that the pain was likely due to the load on the pins along with the stretch of the muscles. He told me that he would consider adding another pin in the area to share the load with the wires if the pain doesn't subside but said to start doing electrostimulation and ultrasound therapy for a few days. For the rest of the week I had ultrasound and electric stimulation on that spot for 15 minutes each before I did all my exercises. Dr Parihar was right as it did the trick and by the end of the week I no longer had that pain bothering me.
My previous x-rays showed that I had somewhere around 8 or 9 degrees of misalignment in my legs. My tibias are naturally quite curved so they were looking at my straight fibula bones to determine the correction. During the surgery Dr Parihar had manually corrected most of the misalignment in each leg, so when Dr Divya converted my frames to hexapods and brought back the scan from the hexapod software that showed how to do the corrections, he informed me that I only had 3 degrees of misalignment left and that correction with the hexpod would only take a day. Dr Divya did the first and final turns on the hexapod in the morning and night, but during the afternoon it was one of Dr Parihar's two fellows that did the turns for me.
By the end of the week my rods were changed to thicker more stable ones on the top and the hexapods were removed. The last night I was at the hospital I had a talk with Dr Parihar for about an hour to ask him some more questions and chat for a bit. His two fellows then had me stand and lie at various angles so they could take pictures to see the degree of equinus I had left and what level my leg extensions were at the time. They informed me that along with monthly x-rays I had to send to Dr Parihar, I also needed to send pictures showing how my equinus is coming along and if my extensions have improved.
I got back to my hotel yesterday and was glad to see the familiar setting. I've started looking for flights back home and will book one tonight most likely. Dr Divya told me to visit the hospital one more time the day before I leave just to say goodbye and all that, so I'll likely be able to get some more pictures of the hospital or staff. I'll be consolidating at home and although Dr Parihar says it will take a minimum of 4 months, I expect it will be 5 or 6 for me. In any case, I'll still wait that long before coming back for frame removal. Dr Parihar said that for removal they like to do it slowly and loosen the frame a bit first to see how the walking is before deciding whether to keep the frame on longer or remove it. Being an international patient, he advised I wait a full month after he tells me the bone looks fully consolidated before I go back to him for frame removal.
Right now the only annoyance is the remaining equinus contracture, which Dr Parihar says should take a month or a month and a half to correct. Although it sucks to have equinus, I'm fortunate enough to have gotten it later towards the end of my lengthening as that means it will be more easily fixed with stretching. The ones who have the real issues are those who get their equinus early on. Additionally, my knee flexion contracture is fully corrected so I've got that good news to be happy about.
My experience here has honestly been better than I could have hoped. Despite doing a lot of research I was still nervous at deciding on a doctor because I'm the first to report with any experience. But I think the very positive experience I've had with Dr Parihar strengthens my thoughts that patient diaries should not be the primary basis for choosing a surgeon. I took the time to seek out other avenues without focusing on patient diaries and it paid off as a result. So if you find a doctor that doesn't have any patient diaries, yet you have a really good feeling about him and have heard good things, don't disregard him anyway because you haven't read accounts from other patients. You may be missing out on a great option that can also be good for future lengtheners.
Some Pictures (I'll post my final x-rays later)
The hospital bought me a mango cake and sang to me for my birthday the day after surgery. Made staying in a hospital then less of a depressing experience.
(http://s5d4.turboimagehost.com/t1/20641884_mangokahn.jpg) (http://www.turboimagehost.com/p/20641884/mangokahn.jpg.html)
These are two of the four physiotherapists employed by Dr Parihar. The woman on your left is Tejal and she is the one that does the massage technique to loosen the fascia, which hurts during it but makes your legs feel nice and loose afterwards. The woman on your right is Pratiksha. She was my regular physiotherapist for my evening sessions. Both are very sweet ladies with a lot of experience doing physiotherapy on Ilizarov patients.
(http://s5d4.turboimagehost.com/t1/20641891_Tejal_and_Pratiksha.jpg) (http://www.turboimagehost.com/p/20641891/Tejal_and_Pratiksha.jpg.html)
Top down view of my legs in the hexapod frames.
(http://s5d4.turboimagehost.com/t1/20641879_dual_hexapod.jpg) (http://www.turboimagehost.com/p/20641879/dual_hexapod.jpg.html)
Side view of left leg in hexapod frame.
(http://s5d4.turboimagehost.com/t1/20641880_hexapod_left_right_side.jpg) (http://www.turboimagehost.com/p/20641880/hexapod_left_right_side.jpg.html)
Another angle of left leg in hexapod frame.
(http://s5d4.turboimagehost.com/t1/20641881_hexapod_left_side.jpg) (http://www.turboimagehost.com/p/20641881/hexapod_left_side.jpg.html)
Top down view of left leg in hexapod frame.
(http://s5d4.turboimagehost.com/t1/20641885_mlqsfkl.jpg) (http://www.turboimagehost.com/p/20641885/mlqsfkl.jpg.html)
Top down view of right leg in hexapod frame.
(http://s5d4.turboimagehost.com/t1/20641883_hexapod_right_top.jpg) (http://www.turboimagehost.com/p/20641883/hexapod_right_top.jpg.html)
Top down view of current frames I'm wearing for consolidation.
(http://s5d4.turboimagehost.com/t1/20641890_new_frame_top.jpg) (http://www.turboimagehost.com/p/20641890/new_frame_top.jpg.html)
Current frames, right leg.
(http://s5d4.turboimagehost.com/t1/20641889_new_frame_right.jpg) (http://www.turboimagehost.com/p/20641889/new_frame_right.jpg.html)
Current frames, other angle of right leg.
(http://s5d4.turboimagehost.com/t1/20641888_new_frame_right_side.jpg) (http://www.turboimagehost.com/p/20641888/new_frame_right_side.jpg.html)
Current frames, left leg.
(http://s5d4.turboimagehost.com/t1/20641887_new_frame_left.jpg) (http://www.turboimagehost.com/p/20641887/new_frame_left.jpg.html)
Current frames, other angle of left leg.
(http://s5d4.turboimagehost.com/t1/20641886_new_frame_left_close.jpg) (http://www.turboimagehost.com/p/20641886/new_frame_left_close.jpg.html)
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Hi Kilokhan.
I hope things are going well for you. Your tibias look like long.
Cheers, paco.
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does he do monorail external femurs or with illizavor?
I've seen patients there for deformity correction on femurs with monorails, rings, and hexapod, so I'm not sure which ones he'll do for cosmetic lengthening. It might be on a case by case basis.
the more I hear from this doctor the more I like him. he is saying all the things he should. cross lateral is not a good thing. its just a fad. scientifically not very smart approach.
Mal-Kahn-Tent, can you ask pariah what he thinks is the safe external femur length to stick to?
When I asked him about cross lateral lengthening he said it's one thing if you're doing internals but externals is a different issue all together. I then asked "even if you use the monorails on femurs?" and he responded that monorails are a different issue all together. He said that stretching the tissues is independent of what fixator is used, and if you're doing 2 or 3 centimeters then that's okay, but 6 cm for example really puts the load on whatever device you're using. He then said that monolateral fixators are great for collapsed fractures so the soft tissues are meant for a greater length, so even if you do 5 or 6 cm in that instance you're just taking them back to where they were originally. But for someone who is otherwise normal, the moment you start reaching 6 cm, you're putting a lot of strain on the tissues. You also have a risk of internal scarring which can inhibit your knee ROM.
If I have a chance to ask him what his max is for external femurs during my last visit to the hospital I will.
Hi Kilokhan.
I hope things are going well for you. Your tibias look like long.
Cheers, paco.
Thanks :) Doing well. Biggest thing to worry about now are the flight arrangements.
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Did the hexapod cost extra from what you paid for surgery?
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I paid the price for LON and the cost for the nails that I didn't use covered the hexapod, additional pins, meds, dressings, food, and week hospital stay.
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Can you also double check with him that he has no limits for internal Precice 2 femurs? So he'll let patients go the maximum of 8cms?
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He'll let you go the full 8 cm if you do Precice femurs.
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Ah okay thanks
Regarding those physio sessions you've been having, how much were you charged? And was there ample space in your hotel to do the stretches and exercises?
And do you think your body could have taken more lengthening? Say another cm should Dr Parihar approve of further lengthening?
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All physiotherapy sessions done at the hospital come with the surgery fee, meaning you won't be charged anything. You'll only be charged by the physiotherapist if he or she comes to your hotel. I'm not sure if they each have their own rate, but Dr Chaudhary charged me 1,000 INR (around $17 USD) per session and left me an electric muscle stimulator that I could use whenever during the day. Hotel room had more than enough space to do everything. Half the exercises can be done on the side of the bed and there was plenty of wall space for the standing exercises.
I think I could have pushed to 7 if I wanted to but it would have resulted in equinus that would take much longer to correct as well as more time spent in the hexapod to correct misalignment. By the time I got to 6 cm I already felt a change in muscle tightness. I think 6 cm is definitely a reasonable maximum for tibias.
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how much does he charge for precise femurs?
also I think it was a wise choice stopping at 6 cm. you can always get femurs done later if you want to be even taller. its important not to play the numbers game at the price of sacrificing healthy limbs :).
congratulations.
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how much does he charge for precise femurs?
also I think it was a wise choice stopping at 6 cm. you can always get femurs done later if you want to be even taller. its important not to play the numbers game at the price of sacrificing healthy limbs :).
congratulations.
Thanks. I think 6 cm is even kind of pushing it because if I stopped at 5 cm I wouldn't have had equinus or the greater aches and pains for the last 1 cm.
Dr Parihar charges around 900,000 INR, for his surgery fee. The rest would have to be paid to Ellipse for them to send the nails to him, and the nails are supposed to be around $30,000 USD. So you're looking at around $45,000 USD for nails and surgical expenses plus around $1,500 USD per month for hotel and food.
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u said u experienced ankle stiffness and soreness in ur last CM, did u experience any of it during those 5 cm ?
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Only really when I increased from .75 mm of distraction per day to 1 mm of distraction.
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Final X-Rays
(Total distraction 6.2 cm)
(http://s5d3.turboimagehost.com/t1/20665867_Set_7_1_Watermark.jpeg) (http://www.turboimagehost.com/p/20665867/Set_7_1_Watermark.jpeg.html) (http://s5d3.turboimagehost.com/t1/20665868_Set_7_2_Watermark.jpeg) (http://www.turboimagehost.com/p/20665868/Set_7_2_Watermark.jpeg.html) (http://s5d3.turboimagehost.com/t1/20665869_Set_7_3_Watermark.jpeg) (http://www.turboimagehost.com/p/20665869/Set_7_3_Watermark.jpeg.html) (http://s5d3.turboimagehost.com/t1/20665871_Set_7_4_Watermark.jpeg) (http://www.turboimagehost.com/p/20665871/Set_7_4_Watermark.jpeg.html) (http://s5d3.turboimagehost.com/t1/20665872_Set_7_5_Watermark.jpeg) (http://www.turboimagehost.com/p/20665872/Set_7_5_Watermark.jpeg.html)
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Only really when I increased from .75 mm of distraction per day to 1 mm of distraction.
why did you increase the rate?
Also the reccuring theme seems to happen, so if we just lengthen .75 mm it all will go smoother.
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http://www.ilizarov.org/new1/upload/8162007102843AM1.JPG (http://www.ilizarov.org/new1/upload/8162007102843AM1.JPG)
See more here:
http://www.ilizarov.org/casemore.asp?id=224 (http://www.ilizarov.org/casemore.asp?id=224)
This is the thing im so affraid is gonna happen. Hope they take good care of me in china.
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What does it feel like being 6cm taller now? Is it that much of a difference?
What are some new things you've noticed?
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hehe you couldn't resist the extra 2 mm :) I have a feeling it will be the same with me.
congratulations :) how does it feel to finally finish?
it is very tempting to do more than .75mm everyday, I don't know if I could stick to that limit but I will try. did you get equinox when you were lengthening at 1mm or 0.75mm each day?
anything you would have done different in hindsight?
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Wow man I would like to take this moment to thank you for all you have done for future LL'ers.
For ppl like me on a budget your effort to obtain information and post it put here has been priceless. You feel like a brother to most of us in this forum. You respond to questions u don't have to answer and I am amazed by your ability to help others at no benefit to yourself.
You might remember that I am looking for a Dr to do 4cm monorail external only on my tibias. However, since yesterday I have been wondering if I should just get this all done and over with.
What do u think about 4cm in my tibias external with comfortable monorails and 8cm in my femur with precise simultaneously? I intend to break my femurs 3 weeks after tibias to minimise embolism and other risks.
I figure that if tibias consolidate slower and I only lengthen 4cm that I could be walking with crutches 6 month s from the first operation.
I only weigh 58kg and I expect that to drop to 55kg during LL so I should be able to partially weight bear on the monorails and the precise during distraction.
Please ask Dr Parihar what he thinks as he is my first choice for my LL adventure?
Thanks mate for ur MASSSIVE and SELFLESS contribution to this site. I will be in India around mid November so its a pit yI will miss yah.
Cheers mate
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Adriano.
you cant do both as I understand it.
apart from the obvious. when you lengthen femurs you loose range of motion, and so it is not possible to even do tibia stretches while lengthening femur. it would be impossible to prevent extreme ballerina.
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Wow man I would like to take this moment to thank you for all you have done for future LL'ers.
For ppl like me on a budget your effort to obtain information and post it put here has been priceless. You feel like a brother to most of us in this forum. You respond to questions u don't have to answer and I am amazed by your ability to help others at no benefit to yourself.
You might remember that I am looking for a Dr to do 4cm monorail external only on my tibias. However, since yesterday I have been wondering if I should just get this all done and over with.
What do u think about 4cm in my tibias external with comfortable monorails and 8cm in my femur with precise simultaneously? I intend to break my femurs 3 weeks after tibias to minimise embolism and other risks.
I figure that if tibias consolidate slower and I only lengthen 4cm that I could be walking with crutches 6 month s from the first operation.
I only weigh 58kg and I expect that to drop to 55kg during LL so I should be able to partially weight bear on the monorails and the precise during distraction.
Please ask Dr Parihar what he thinks as he is my first choice for my LL adventure?
Thanks mate for ur MASSSIVE and SELFLESS contribution to this site. I will be in India around mid November so its a pit yI will miss yah.
Cheers mate
Do Tibias first wait to consolidate or fix ballerina and the go internal.
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Thanks guys but how can u get ballerina from lengthening 40mm??
AT 55kg I should be able to partially weight bear with any devise (thus preventing Ballerina).
I based most of conclusions on ppl who used monorails. I also checked out Diso*s diary.
I have noticed that ppl who are immobile for 3 months or more get ballerina or duck ass regardless of what LL method they r doing.
We have also learnt that muscles shorten after a while if they r not used. This should be obvious to any1 and not just the LL community.
I read diaries of guys who almost got ballerina at 3cm.
I am sure we all read diaries of guys who had ZERO ballerina at 4cm (sometimes 5 cm) but suddenly ended up with 7cm (approx.) BL after they reached 7-9cm lengthening!!
this suggest to me that BL is a function that depends mostly on how long one is immobilised and not only on how much u have lengthened.
NB the more u LL the more u r IM and therefore the more u r IM.
I am sticking to 4cm on my TIBIA, this can be done in 6 weeks. I can tell u right now that there is no way u can get ballerina after just 1.5 months!!!
stand flat footed and then stand on ur toes. the diff in height will just be over 6cm but no more than 6.5cm.
Ever wonder why the safe limit is 6,5cm max !!!!!
this is why anything under 6cm is safe.
The monorail fixator is also stable up to 5cm !!!
Read Body builders' diary up to the point he reached 5.8cm as well as Crazy + 6's comment.
I honestly expect that if one did 4 cm tibia external only that they would be fully consolidated after 90mdays from surgery if they took bone healing and medication the day after surgery. lets face it u wont consolidate with this time period if u do 1mm a day.
WE COMPLICATE LL BY TRYING TO LL Beyond THE SAFE LIMIT OF 5CM..
Look at Old But Goldie. the guy is around 40yrs old. he had a rod in his bones which slows consolidation and yet he was running around at the beach within 70 days after LLing the safe limit of 5cm.
When r we going to learn and stop pushing the limits??
I think that consolidation LL external only gains goes something like this.
2cm = 1 month distraction + 2 months + 1 months = 4 months
4cm = 2 month distraction + 4 months + 2 months = 8 months
6cm = 3 month distraction + 6 months + 3 months = 12 months
8cm = 4 month distraction + 8 months + 4 months = 16 months
10cm= 6 month distraction + 10 months + 6 months = 22 months
This is actually very realistic if u look at the guy who did 9cm (external only) in Russia and the fact that he bent one of his tibias by walking too soon on his tibias after LLing for 1.5 yrs aprrox.
Apo also did 1cm tibia and he is still not consolidated. his consolidation is further slowed by the rod inside his bones.
Another case in point is Good Foot Baller.
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Thanks guys but how can u get ballerina from lengthening 40mm??
AT 55kg I should be able to partially weight bear with any devise (thus preventing Ballerina).
I based most of conclusions on ppl who used monorails. I also checked out Diso*s diary.
I have noticed that ppl who are immobile for 3 months or more get ballerina or duck ass regardless of what LL method they r doing.
We have also learnt that muscles shorten after a while if they r not used. This should be obvious to any1 and not just the LL community.
I read diaries of guys who almost got ballerina at 3cm.
I am sure we all read diaries of guys who had ZERO ballerina at 4cm (sometimes 5 cm) but suddenly ended up with 7cm (approx.) BL after they reached 7-9cm lengthening!!
this suggest to me that BL is a function that depends mostly on how long one is immobilised and not only on how much u have lengthened.
NB the more u LL the more u r IM and therefore the more u r IM.
I am sticking to 4cm on my TIBIA, this can be done in 6 weeks. I can tell u right now that there is no way u can get ballerina after just 1.5 months!!!
stand flat footed and then stand on ur toes. the diff in height will just be over 6cm but no more than 6.5cm.
Ever wonder why the safe limit is 6,5cm max !!!!!
this is why anything under 6cm is safe.
The monorail fixator is also stable up to 5cm !!!
Read Body builders' diary up to the point he reached 5.8cm as well as Crazy + 6's comment.
I honestly expect that if one did 4 cm tibia external only that they would be fully consolidated after 90mdays from surgery if they took bone healing and medication the day after surgery. lets face it u wont consolidate with this time period if u do 1mm a day.
WE COMPLICATE LL BY TRYING TO LL Beyond THE SAFE LIMIT OF 5CM..
Look at Old But Goldie. the guy is around 40yrs old. he had a rod in his bones which slows consolidation and yet he was running around at the beach within 70 days after LLing the safe limit of 5cm.
When r we going to learn and stop pushing the limits??
I think that consolidation LL external only gains goes something like this.
2cm = 1 month distraction + 2 months + 1 months = 4 months
4cm = 2 month distraction + 4 months + 2 months = 8 months
6cm = 3 month distraction + 6 months + 3 months = 12 months
8cm = 4 month distraction + 8 months + 4 months = 16 months
10cm= 6 month distraction + 10 months + 6 months = 22 months
This is actually very realistic if u look at the guy who did 9cm (external only) in Russia and the fact that he bent one of his tibias by walking too soon on his tibias after LLing for 1.5 yrs aprrox.
Apo also did 1cm tibia and he is still not consolidated. his consolidation is further slowed by the rod inside his bones.
Another case in point is Good Foot Baller.
If you lengthen 5cm external tibia, consolidation will take around 7 months (until you can take of the frames and walk with crutches).
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4 cm is safe limit
but even if you lengthened 5cm. and you had ballerina, it would go away by itself one month after the distraction.
during distraction I had ballerina, and you could ask "machine" about it as he mentioned it's almost about the same as his ballerina but 1 month after I finished distraction it disappeared and I wasn't even standing for a min at that time.
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Update: 10/28/2014
I arrived at LAX around 12:15 pm yesterday after a ridiculously long flight from Mumbai to Newark and a not so short flight to Los Angeles. One of Hotel Maharana's managers took the cab with me to Mumbai International Airport (which is super nice and much better than Delhi's btw) and helped me with my luggage until he could no longer proceed through security. The security in Mumbai asked me a bunch of questions about my frames but let me through after looking at Dr Parihar's doctor note. I had to go through customs and not only did they need to see the FRRO stamp on my passport, but they also wanted to look at my Stay Visa form allowing my visa extension provided by the FRRO (make sure you don't lose that if you extend your stay). I booked an economy plus seat on United that had a bunch of leg room, and although that helped I had to lift myself off the seat and hold myself in the air many times during the flight to get relief from the butt soreness. I didn't eat or drink the entire day previously so I didn't have to go to the restroom multiple times, but I still ended up going once on the flight. I was allowed to bring my walker on the plane and one of the flight attendants helped me to the restroom across from me, even blocking people from waiting by the door while I was in there. The on flight movies were good and I saw a bunch of new releases, but I got a little nervous when I saw on the flight route that we flew over Pakistan and Afghanistan. I couldn't stop thinking "what if we got shot down?"
At Newark I had to collect my baggage and go through customs again before checking in my luggage and going through security once more. A lady who worked there pushed me on the wheelchair and held my walker for me at the same time, making the process easier. Unfortunately I missed my flight because TSA said they found trace amounts of explosives when they swabbed my hands so I had to be taken to a side room for a private screening which involved another pat down and more attention to my groin area from the TSA agent. At least I was able to get put on another flight to LAX only 30 minutes afterward, but man was I annoyed.
The flight attendants on both flights were very curious about what happened to me so I made up a story about how I had a double fracture landing from a high balcony while trying to perform a stunt. They felt really bad for me and I felt a little pathetic, but hey this procedure was worth it I think. When my mom picked me up at baggage claim the first thing she said was that I became as thin as a rail and looked like John Lennon with my below shoulder length hair and Ned Flanders mustache (which I've really got to shave). My sister met us at the car and she was excited to see me, partly because she got to put her medical assistant work to use and assist me in the car and fold up my wheelchair. She's been a big help and volunteered to be the one to prepare my boiled water and pour the pitcher of water over my hands while I scrub them during dressing changes.
Dr Parihar and Dr Divya both sent me an e-mail asking if I made it home safely. I replied the affirmative and gave them my thanks for my positive experience with them. Haven't gotten a reply yet though.
My legs got really sore last night and my left calf and hamstring began to throb like crazy. I was in so much pain that I took three Ibuprofin NSAIDs throughout the night so I'd stop having to rub them vigorously. I'm hoping the pain goes away completely within the next month. I also saw that my equinus had become less serious when I did my standing with my walker. These new reinforced straps that Mr Shringare attached to my sandals a few days ago allowed me to make my feet stay at a tighter neutral position and really stretched out my calves, which I think is the main reason my equinus seems to have gone down significantly in the last few days.
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why did you increase the rate?
Also the reccuring theme seems to happen, so if we just lengthen .75 mm it all will go smoother.
I foolishly thought I'd save some time in the distraction phase but all it did was make it take longer because Dr Parihar told me to abstain from distracting for a while to rest my tissues and work on the equinus.
What does it feel like being 6cm taller now? Is it that much of a difference?
What are some new things you've noticed?
I see the difference in my tibia length and my mom and sister commented that I look much taller, but I haven't been up and walking near people so I haven't yet seen how much of a difference that 6 cm makes me feel around others.
hehe you couldn't resist the extra 2 mm :) I have a feeling it will be the same with me.
congratulations :) how does it feel to finally finish?
it is very tempting to do more than .75mm everyday, I don't know if I could stick to that limit but I will try. did you get equinox when you were lengthening at 1mm or 0.75mm each day?
anything you would have done different in hindsight?
When I finished distraction I was at 6.5 cm. I kind of wanted to just stop at 5.5 cm but Dr Parihar said that if I wanted 6 cm I'd need to turn another cm because he had to compress my tibias and I should also account for margin of error in x-ray measurement. He said I might be a little over 6 after the second surgery but it wouldn't make a difference in my recovery with that small an amount.
I wouldn't have done 1 mm per day ever if I could go back and do it differently. The first time I alternated between .75 and 1 mm per day I ended up with severe pain that made walking almost impossible and weakened my legs so that extensions were almost impossible by myself. The second time I did 1 mm per day for 7 days and at the end of that I had developed equinus. 1 mm daily is too fast for tibias, imo.
Wow man I would like to take this moment to thank you for all you have done for future LL'ers.
For ppl like me on a budget your effort to obtain information and post it put here has been priceless. You feel like a brother to most of us in this forum. You respond to questions u don't have to answer and I am amazed by your ability to help others at no benefit to yourself.
You might remember that I am looking for a Dr to do 4cm monorail external only on my tibias. However, since yesterday I have been wondering if I should just get this all done and over with.
What do u think about 4cm in my tibias external with comfortable monorails and 8cm in my femur with precise simultaneously? I intend to break my femurs 3 weeks after tibias to minimise embolism and other risks.
I figure that if tibias consolidate slower and I only lengthen 4cm that I could be walking with crutches 6 month s from the first operation.
I only weigh 58kg and I expect that to drop to 55kg during LL so I should be able to partially weight bear on the monorails and the precise during distraction.
Please ask Dr Parihar what he thinks as he is my first choice for my LL adventure?
Thanks mate for ur MASSSIVE and SELFLESS contribution to this site. I will be in India around mid November so its a pit yI will miss yah.
Cheers mate
Thanks Adriano. I hope your lengthening goes smoothly and await with interest to see which doctor you will choose. I know Dr Parihar isn't exactly a fan of monorails for cosmetic lengthening. He said they're good for lengthening a fracture that collapsed and left the leg shorter than usual, so when you lengthen it just takes you back to your original length. But for lengthening beyond your natural length it becomes more difficult than Ilizarov frames. He also said that it's easier to get equinus with monorails and if you've got thick legs it's easier to develop valgus (x-legs) with them also. If you're keen on monorails though just talk to him about it and he might do them if you really want them, though there's a chance he'll say no. I know for sure that he won't lengthen four limbs at once so you won't be able to do simultaneous internal/external with him. I'm not sure about Dr Shah's stance on that though. I know for me, external tibias was hard enough by itself. I can't imagine lengthening tibs and femurs at once.
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I'm glad you made it home, post LL flight is a challenge!
When I finished distraction I was at 6.5 cm. I kind of wanted to just stop at 5.5 cm but Dr Parihar said that if I wanted 6 cm I'd need to turn another cm because he had to compress my tibias and I should also account for margin of error in x-ray measurement. He said I might be a little over 6 after the second surgery but it wouldn't make a difference in my recovery with that small an amount.
Why did Dr.Parihar compress your tibias and how much length did he expect to lose? Did Dr.Parihar say anything about callus subsidence after frame removal?
I wouldn't have done 1 mm per day ever if I could go back and do it differently. The first time I alternated between .75 and 1 mm per day I ended up with severe pain that made walking almost impossible and weakened my legs so that extensions were almost impossible by myself. The second time I did 1 mm per day for 7 days and at the end of that I had developed equinus. 1 mm daily is too fast for tibias, imo.
Do you think I will be able pull off 1mm/day if my maximum target is 4cm with externals without risking equines or any other contractures associated with tibia lengthening? I barely have any muscle mass on my lower leg, you can think of me as a stick figure.
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I'm glad you made it home, post LL flight is a challenge!Why did Dr.Parihar compress your tibias and how much length did he expect to lose? Did Dr.Parihar say anything about callus subsidence after frame removal?
Do you think I will be able pull off 1mm/day if my maximum target is 4cm with externals without risking equines or any other contractures associated with tibia lengthening? I barely have any muscle mass on my lower leg, you can think of me as a stick figure.
Yeah the airport was one of the most annoying parts about this whole thing lol.
He had to straighten the bones out and correct some misalignment during the second surgery. I forgot the exact reason for why the compression was done afterward but it had to do with that. He said the compression would only be a few mm, but if I hadn't turned the extra cm under his instruction, then I might have ended up with just a little over 5 cm instead of closer to 6 cm.
He made it seem like subsidence loss should not happen usually even with exfix, but on the chance it does happen it shouldn't be more than 3 or 4 mm.
Your body might respond differently to it than mine did. If you aren't suddenly getting heavy pain and your calf muscles don't feel tight then you could probably go up to 4 cm at 1 mm per day without issue. Dr Parihar first wanted me to test out the 1 mm per day by alternating days between .75 and 1 mm but my muscles didn't respond well to the increased distraction rate.
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Update: 11/7/2014
Yesterday I had an appointment with an orthopedic surgeon that my GP referred me to, conveniently located a mere 5 minute drive away from my office. The co-pay was $40 because I had to get an x-ray of my tibias in the radiology department before meeting the ortho. The two guys doing the x-rays were very curious about the Ilizarov frames and one of them was in disbelief that I chose to lengthen my legs. After his initial shock he didn't pester me about it though. After my x-rays were done I saw the ortho, who was genuinely interested in my case. He's not an Ilizarov surgeon but he's had people come in with frames who were operated on for discrepancy or deformity. When I told him I voluntarily lengthened my legs and said it was primarily due to social situations being less than ideal for me while having very tall half-siblings, I was prepared for a response along the lines of "you're an idiot for doing this to yourself" or general rudeness that other lengtheners have experienced from their orthos back home. To my surprise he was sympathetic about it and just told me that it's unfortunate that I felt I had to go to such an extreme to feel better about myself.
My GP who wrote the referral put down that I had gone to India for lengthening and he asked about who I went to see over there. I told him a little about my multiple consultations and how I decided on Dr Parihar due to my good impression of him and his prior fellowship with Dr Paley, to which my ortho replied "Dr Paley is the king". Looks like Paley is held in high regard by orthos across the board, not just Ilizarov surgeons. He examined my legs a bit, going over the pin sites and checking to see if there was any soreness before looking at the x-rays I had just taken. To my relief he said my healing looks to be going exceptionally well and that I have "massive regenerate" in both legs. He gave me a prescription for oral antibiotics in case of pin site infection later and said I can just get over the counter supplements for my calcium and zinc intake. I'm supposed to continue weight bearing as much as I'm able and see him every three weeks.
Right now I still have a lot of aching in the calves, but a lot of it is on my hamstrings and near my hips, which I believe is from the atrophy. The left calf is a little swollen but I took an ibuprofen which helped it go down. I thought all the aches and soreness would go away as soon as distraction was over but I guess it's more of a gradual thing.
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Update: 11/7/2014
Yesterday I had an appointment with an orthopedic surgeon that my GP referred me to, conveniently located a mere 5 minute drive away from my office. The co-pay was $40 because I had to get an x-ray of my tibias in the radiology department before meeting the ortho. The two guys doing the x-rays were very curious about the Ilizarov frames and one of them was in disbelief that I chose to lengthen my legs. After his initial shock he didn't pester me about it though. After my x-rays were done I saw the ortho, who was genuinely interested in my case. He's not an Ilizarov surgeon but he's had people come in with frames who were operated on for discrepancy or deformity. When I told him I voluntarily lengthened my legs and said it was primarily due to social situations being less than ideal for me while having very tall half-siblings, I was prepared for a response along the lines of "you're an idiot for doing this to yourself" or general rudeness that other lengtheners have experienced from their orthos back home. To my surprise he was sympathetic about it and just told me that it's unfortunate that I felt I had to go to such an extreme to feel better about myself.
My GP who wrote the referral put down that I had gone to India for lengthening and he asked about who I went to see over there. I told him a little about my multiple consultations and how I decided on Dr Parihar due to my good impression of him and his prior fellowship with Dr Paley, to which my ortho replied "Dr Paley is the king". Looks like Paley is held in high regard by orthos across the board, not just Ilizarov surgeons. He examined my legs a bit, going over the pin sites and checking to see if there was any soreness before looking at the x-rays I had just taken. To my relief he said my healing looks to be going exceptionally well and that I have "massive regenerate" in both legs. He gave me a prescription for oral antibiotics in case of pin site infection later and said I can just get over the counter supplements for my calcium and zinc intake. I'm supposed to continue weight bearing as much as I'm able and see him every three weeks.
Right now I still have a lot of aching in the calves, but a lot of it is on my hamstrings and near my hips, which I believe is from the atrophy. The left calf is a little swollen but I took an ibuprofen which helped it go down. I thought all the aches and soreness would go away as soon as distraction was over but I guess it's more of a gradual thing.
Glad to hear you are doing fine. You're almost done, congrats!
One tip I want to give you is to walk 20-30 min a day in the evening around your house/apartment, try to walk completely normal and also you don't have to worry about other people, no will notice your frames in the evening under pants. That really boosted my consolidation by a ton, but be careful, don't overdo it or you will get some ugly infections and that will slow your consolidation process.
Good luck!
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Hi,
Are u in UK? Im LL patient. I added u in skype, pls accept.
Thanks.
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Glad to hear you are doing fine. You're almost done, congrats!
One tip I want to give you is to walk 20-30 min a day in the evening around your house/apartment, try to walk completely normal and also you don't have to worry about other people, no will notice your frames in the evening under pants. That really boosted my consolidation by a ton, but be careful, don't overdo it or you will get some ugly infections and that will slow your consolidation process.
Good luck!
Thanks for the advice. Right now I still have some ballerina and the soreness in my legs is incredible from standing, so I'm unable to pick up the walker and move it forward without feeling like I'm going to tip over like a tree. Probably have some ways to go before I'm okay in that regard. Right now I've been standing as much as possible as it seems like that's the most I can do for recovery besides my PT exercises.
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Hey does Doctor Parihar always put the pins in the middle of the leg? I think one Doctor Sarin patient said the middle ones damages your fascia. Is that true? Do you feel its damaged?
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He puts the pins in the middle for a lot of reconstruction cases but the difference is that he puts the middle pins during the initial surgery, whereas with me he put it on at the end so I didn't get a long scar in the middle from lengthening as I'm a cosmetic case. You won't get any fascia damage from it.
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Here's a video I took while in the back of an auto rickshaw in Mumbai. You get to see a glimpse of what the environment is like over there.
https://www.youtube.com/watch?v=T8vmpuJK2c4&feature=youtu.be
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Hey Kilo, in the end how did you end up paying for the hotel? Did you pay in monthly instalments or did you pay for everything at the end of your stay?
Also how often did they clean the room like changing bed sheets, pillows, towels and so on?
And in that video did you have the fixators on?
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They ended up telling me that I had to pay them every two weeks, which I did through debit and credit card.
Room service would call me every couple days to ask if I wanted the room cleaned. You can tell them no if you're not in the mood to have a bunch of people in your room cleaning it at once or you could ask the front desk to clean your room daily. They were very flexible with it.
I had the frames on in the video although you can't see them. I had to take one of those rickshaws to get to Dr Parihar's clinic every two weeks. They're very cheap. It cost me about 30 cents each way for a ride on one of them.
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Were there any surcharges through debit/credit card?
Also how did you keep tabs on how much you were spending every fortnight on stuff like food and what ever else you used in the hotel?
Did you have anything to cover over the fixators while on those rickshaw rides every two weeks or did you just wear shorts and let them be?
If the latter, did people stare a lot at them while you were out in public on your way to Dr Parihar?
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Every time the hotel staff bought food for me I'd have to sign a receipt and I'd record the price on a word doc, then at the end of the two weeks they would staple all the receipts together with the bill and give me a copy. If it was something I had them purchase for me outside the hotel then they'd give a receipt and I'd pay in cash from the ATM right when they gave me the receipt.
There wasn't any surcharge with my Discover card but Wells Fargo had a transaction fee of 3%.
I just went on the rickshaw wearing stretchy gym shorts without anything covering the frames. It was a little tricky entering it but the hotel staff was always very helpful getting me in there. I suppose I could have covered my frames with a small blanket when pushed outside on the wheelchair but I didn't bother with it. There were a lot of stares from people but most didn't say anything. The most inquisitive about the frames were actually others in the hospital. Most are there for deformity correction, injury, and leg length discrepancy, requiring only one frame. Seeing me with a frame on each leg got other patients curious and some would ask questions about what happened to me.
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I don't know if you have answered this previously, but what was the name of the hotel you stayed in and the daily rate for your entire 3 months stay? Is the hotel located in Chembur where Dr.Parihar's hospital is located?
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I stayed at Hotel Maharana Inn, which is located in Chembur just a 4 minute drive (10 minute walk) from Dr Parihar's clinic. I attached a snippet from Google Maps to show just how close it is. There's another hotel or two just across the street from it as well.
Here's the website where you can see what the rooms look like: http://www.hotelmaharana.com/ (http://www.hotelmaharana.com/)
It's normally 3500 INR a night but the hotel manager Paul gave me a 30% discount because of the extended stay. Including the luxury tax it was slightly over $44 USD per night.
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I wonder if he can or rather will, go lower if someone stays for say 10 months...? Lol ;)
Did you negotiate with him beforehand or upon your arrival at the hotel?
Was it a busy sort of hotel, were there plenty of guests staying there do you think?
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I sent an e-mail explaining that I was having major surgery and was going to be handicapped for a while, also asking if they had any discounts for those with handicaps or needing extended stay. He replied back with an e-mail giving me the special offer. If you plan to stay there for 10 months then you may even be able to negotiate a lower price than I was given. There's also a hotel where Dr Parihar is friends with the manager and the rate for his patients is even lower than the discounted rate I paid at Hotel Maharana, but it was always booked full and I never saw the interior. If you speak with him he can let you know about it and if there's space available you might even prefer staying there.
Maharana Inn isn't especially big compared to a lot of the other hotels in Mumbai as it was originally an apartment complex, so the environment is pretty quiet (although the rooms on the left side have windows facing traffic so if you want even more quiet at night it's best to ask for a room on the right side). From what I saw there were always people staying in some of the rooms but it was never booked full, and all the guests were Indian. There were times during the festivals where it was more packed and noisy, like for a few nights when they turned a large conference room into a nightclub, but that wasn't typical.
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Thanks for the info.
Mumbai seems to be alot more expensive than Delhi especially accommodation.
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Hotels are definitely more expensive and it's far more difficult to find an apartment or flat compared to New Delhi. But at least food and transportation is as cheap as it is over there. The difference between Mumbai and Delhi is pretty much the same as the difference between Shanghai and Beijing.
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Update: 11/26/2014
I've been taking oyster shell calcium+vitamin D, zinc, and vitamin C each day to help with callus formation. Every once in a while I'll have a whey protein shake for the amino acids but I usually have a good amount of meat during the day instead. My legs have started to feel better, although there are still some issues. The side where the fibula is located on each leg is still sensitive and I'll have to massage them from time to time when they start to feel sore. I still get pain at the tops of my legs just below the knees if I move my legs too fast, particularly on the right one. The equinus is still present but barely. I was told when I left that it would probably take a month and a half to go away and it seems like I'll make that time frame. Standing is fine but walking is still too awkward for me at this point. Dr Parihar told me to mobilize slowly and continue with the exercises so I'm not killing myself over not walking around yet.
I thought only my mom, stepfather, and a close friend knew about my CLL, but I found out a few moments ago that my mom told most of her friends, one of which told her daughter who is visiting us now and probably thought I was pathetic when I lied and told her I was in an accident. My mom also told her aunt, who then told her kids, and now a ton of my cousins know and I get to see them in my frames for Thanksgiving tomorrow. Really irritated to find out so many people know. There are a few people who I would be horrified to find out that I got this however and I guess I'm lucky enough that they didn't find out about it. Probably because they haven't met my mom.
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Mums will be mums, sorry about that.
I'll be staying in India for the whole process to avoid this as people tend to come over our place frequently
Did you tell her and the rest of your family to keep it a secret? This is one of the reasons why I wont be telling my family why Im going to India, will let them know when they pick me up at the airport and see me in a wheelchair lol. I would imagine my mother to be the exact replica of yours, she has a habit of telling her friends random things too.
How did the daughter react when she saw you again knowing you lied earlier? Did she say anything?
I'd also like to ask regarding the hotel you stayed at, I read about most of the things you had to say but if you were to go back for your femurs and did it in India would you stay there again? Was the vegetarian food ok? What about the staff? Were they ok with you being disabled and staying in your room all the time? Did they ask questions regarding the frame?
I plan on staying there too if they give me the same discount
Thanks
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Rule 1 of LL: you do not talk about LL
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ah dude! you should have made it crystal clear to your mom about this!
that's what I'll do. Tell my family again and again and again and again and again and again to NOT tell anyone.
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Wisn't it simplier to not tell?
ah dude! you should have made it crystal clear to your mom about this!
that's what I'll do. Tell my family again and again and again and again and again and again to NOT tell anyone.
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Well this sucks major balls. That's why shouldn't tell anybody. Now you will be known as the crazy guy who broke his legs to get taller.
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Mums will be mums, sorry about that.
I'll be staying in India for the whole process to avoid this as people tend to come over our place frequently
Did you tell her and the rest of your family to keep it a secret? This is one of the reasons why I wont be telling my family why Im going to India, will let them know when they pick me up at the airport and see me in a wheelchair lol. I would imagine my mother to be the exact replica of yours, she has a habit of telling her friends random things too.
How did the daughter react when she saw you again knowing you lied earlier? Did she say anything?
I'd also like to ask regarding the hotel you stayed at, I read about most of the things you had to say but if you were to go back for your femurs and did it in India would you stay there again? Was the vegetarian food ok? What about the staff? Were they ok with you being disabled and staying in your room all the time? Did they ask questions regarding the frame?
I plan on staying there too if they give me the same discount
Thanks
Out of the three people I told about it the only one who said anything to anyone else was my mom. She swore up and down that she wouldn't say anything to anyone and then last night in the car her friend's daughter says "That sucks you have to wear those for so long, I wish I was taller too". When she and my sister had gone into the store for a bit I pressed my mom for information and then she admitted how many people she told about it. I didn't realize that she was such a huge gossip. It's amazing that I can trust a friend from school with this information more than I could trust my own mother. Anyway, I'm not too upset about it because I was prepared for the possibility that it might be found out by some people, but I'd rather have had them figure it out on their own instead of finding out my mom betrayed my trust like that.
Hotel Maharana was cool. I never got hot because of the big ceiling fan and powerful air conditioner, and the HDTV on the wall was pretty big. Not all the staff spoke English but there were three managers there and one or two people who brought food in that knew English pretty well. But they were all helpful with getting me to Dr Parihar's clinic and helping me back in my room. The only things that were irritating were the step leading into the bathroom that made getting in there by walking difficult (I found it easier just to scoot into it on the floor) and the elevator was a little small so it took a lot of experimentation to fit inside it on the wheelchair. Vegetarian menu had some pretty good items. The tawa mushroom and naan was great. If you get tired of veg food though they have a non-veg section on the menu and you can get those meals within minutes because they order them from a hotel right next door. If I went back for another round of lengthening I might look for another hotel just so I could experience a new setting for the months required, but I wouldn't mind staying there again based on my experience the first time around.
Rule 1 of LL: you do not talk about LL
I don't think I would have been able to keep it a secret from my parents anyway because of how I ended up having to do the bank transfer into Dr Parihar's account. I don't think I could trust anyone else to go on a joint account with me and transfer a large sum of money without taking any of it. In hindsight I could have just told my stepfather and I would have been better off.
ah dude! you should have made it crystal clear to your mom about this!
that's what I'll do. Tell my family again and again and again and again and again and again to NOT tell anyone.
That's what I did and only the guys I told listened. It seems like women are more inclined to spill out a secret because they get together and talk for hours about all sorts of things.
Well this sucks major balls. That's why shouldn't tell anybody. Now you will be known as the crazy guy who broke his legs to get taller.
Yep. Though it's primarily people I don't even see or talk to that know about it. At least all the people I hang out with and see often are oblivious to my current situation.
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Don't hate ur mother, just learn to never tell her anything
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Update: 11/30/2014
Thanksgiving ended up not being bad at all. My aunt was supportive of my decision to get CLL because she spoke to a surgeon about it at her hospital (she's a nurse) and he informed her about how the process works, which quelled her concerns. I showed her and two cousins a LON surgery video on Dr Parihar's YT channel and the reaction from my cousins (one who's an EMT) was "Man you've got balls." They were concerned about how much the frames look like they would constantly have me in pain, but they were also supportive and didn't make fun of it or criticize me at all.
In other news, my equinus seemed to have lessened again overnight. After a minute or less of doing standing calf raises my feet were completely neutral and touching the floor. I'll try walking from my room to the living room in the next few days. If I can do it successfully then I'll post a video of it.
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Was gonna post my latest x-rays but my Kaiser Permanente insurance is stupid and they won't e-mail them to me. My ortho said he's not allowed to just e-mail me my x-rays and that I have to call the radiology department. When I called they said I had to pick up the x-rays after they notify me that they're ready. So in order to send x-ray updates to Dr Parihar I have to pick up the physical copy every five weeks or so and I guess scan them to the computer to send through e-mail. Total pain in the ass.
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How are they looking Kilo? Any progress from the last xray?
Hows your walking atm? Using support?
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Update: 12/12/2014
X-rays from December 2, 2014. Ortho says it's healing really well. The fibulas don't have as much regenerate showing as the tibias, but my ortho said the fibulas usually take longer to consolidate.
I'm able to walk, but I've got this pain and slight inflammation just below the right knee that makes walking a bit painful. Ortho said it's due to having the frames on for so long and the pain likely won't go away until I remove them.
(http://s5d3.turboimagehost.com/t1/21461251_12-2-2014-1.png) (http://www.turboimagehost.com/p/21461251/12-2-2014-1.png.html) (http://s5d3.turboimagehost.com/t1/21461252_12-2-2014-2.png) (http://www.turboimagehost.com/p/21461252/12-2-2014-2.png.html) (http://s5d3.turboimagehost.com/t1/21461256_12-2-2014-3.png) (http://www.turboimagehost.com/p/21461256/12-2-2014-3.png.html) (http://s5d3.turboimagehost.com/t1/21461258_12-2-2014-4.png) (http://www.turboimagehost.com/p/21461258/12-2-2014-4.png.html)
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What a mean comment. You're suggesting that, just because he'll never be subjectively "tall" according to you, he should just give up. Well, news flash: not everyone is as lucky/narcissistic as you to start LL at average height. You have no idea what 5'5 people have to put up with through no fault of their own. LL is not about beauty for them, it's about being treated fairly. Honestly, I think that there should be a "social rights movement" for shorter folks. Surely you'll agree that Kilo will be treated better at 5'7 than 5'5. I know that I'd take being 5'7 over 5'5 any day without a doubt. I know at least ten times more 5'7 people than 5'5 people, so, Kilokahn, I honestly feel that you'll be much more normal looking at 5'7. Your height will no longer stand out, it will just look slightly bellow average but perfectly normal and common. Don't let the haters grind you down 8)
Pretty much exactly. I'm a little less than 5'7, and I've never been called short before. Those two inches can make a big difference.
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If I grew up in India I wouldn't even want CLL. At my pre-op height I felt entirely average to the point where I didn't understand some of the patients in India who felt they needed to gain 10 cm in their lengthening quest. Even Dr Dhawan thought I was a good enough height to not need CLL. Dr Parihar is like 6'2 and looks totally huge compared to everyone else in his pictures unless he's standing next to a European, at which point he looks a little above average.
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So Doc Parihar wants me to start walking with crutches now. A bit nervous in transitioning to crutches from the Zimmer frame. Would hate the thought of falling again. What's it feel like walking with crutches while wearing frames? Does it feel stable or does it feel as if you're going to topple over like a tree?
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So Doc Parihar wants me to start walking with crutches now. A bit nervous in transitioning to crutches from the Zimmer frame. Would hate the thought of falling again. What's it feel like walking with crutches while wearing frames? Does it feel stable or does it feel as if you're going to topple over like a tree?
I had big problems with walking with crutches first. I would take it step by step 5 min in afternoon and 5 minutes in the evening and ask for someone to stand next to you in case you will fall (which you won't but you will be thinking about falling a lot while starting to walk with crutches ;D). Then you will get used to it, and remember left crutch, right leg, right crutch, left leg and keep your back straight and try to not look on the ground.
After 3-4 days of "training" you will walk like champ, just concentrate on your movements and everything will be alright.
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I had big problems with walking with crutches first. I would take it step by step 5 min in afternoon and 5 minutes in the evening and ask for someone to stand next to you in case you will fall (which you won't but you will be thinking about falling a lot while starting to walk with crutches ;D). Then you will get used to it, and remember left crutch, right leg, right crutch, left leg and keep your back straight and try to not look on the ground.
After 3-4 days of "training" you will walk like champ, just concentrate on your movements and everything will be alright.
so left crutch as support, right leg move forward. now right crutch as support, left leg move forward???
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Update: 1/9/2014
Just picked up my dicom images from the medical records office, so I posted the most recent set of x-rays. I had them taken on 12/30/2014 before I saw my orthopedist's assistant (usual ortho was at a seminar or something). He decided to check all of my pin sites for infection and took off all the dressings. No infections, but the skin had stretched more underneath one of the pins, leaving a lot more ooze when I clean it. Two people who worked in the hospital changed my dressings for me. Turns out they like to cover the gauze in antibacterial soap and wrap it around each individual pin as opposed to using boiled and cooled water and scrubbing each pin and wire from all directions as I've been doing. The ortho assistant told me to come back in six weeks and he and my usual ortho will have a plan ready for when they think I should get my frames removed. I think my insurance is going to cover removal, so I don't have to fly all the way back to Mumbai for that fortunately. I'll still wait for the okay to have my frames removed from Dr Parihar before I let my local ortho do it though.
The frames have become much more annoying recently. As the muscles continue to atrophy over time the pain from walking continues to increase, particularly below my knees. It's also become more difficult to go to sleep, reminiscent of my lengthening days. I've been drinking hot tea or whiskey to help knock me out. I guess my body is signaling that it's sick of wearing these things. Right now the worst part is that because my mom is out of town for a week I have to stay at a friend's house, and it's not at all handicap friendly. The bathroom is far from the living room where I have to sleep and there are two sets of large steps that I have to go down in between. I'm exhausted by the time I go to the restroom and back.
Consolidation progress just over 6 months after my initial surgery (lengthened 6.2 cm).
(http://s5d4.turboimagehost.com/t1/21815456_12-30-2014-1.png) (http://www.turboimagehost.com/p/21815456/12-30-2014-1.png.html) (http://s5d4.turboimagehost.com/t1/21815479_12-30-2014-2.png) (http://www.turboimagehost.com/p/21815479/12-30-2014-2.png.html) (http://s5d4.turboimagehost.com/t1/21815480_12-30-2014-3.png) (http://www.turboimagehost.com/p/21815480/12-30-2014-3.png.html) (http://s5d4.turboimagehost.com/t1/21815481_12-30-2014-4.png) (http://www.turboimagehost.com/p/21815481/12-30-2014-4.png.html)
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You should have 2-3 more months left, by the way did the doctor tell you that u're doing well in terms of consolidation?
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Looks like he's doing quite well in terms of consolidation, but I think 2-3 months is a little too optimistic. Alignment looks good though.
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Out of the three people I told about it the only one who said anything to anyone else was my mom. She swore up and down that she wouldn't say anything to anyone and then last night in the car her friend's daughter says "That sucks you have to wear those for so long, I wish I was taller too". When she and my sister had gone into the store for a bit I pressed my mom for information and then she admitted how many people she told about it. I didn't realize that she was such a huge gossip. It's amazing that I can trust a friend from school with this information more than I could trust my own mother. Anyway, I'm not too upset about it because I was prepared for the possibility that it might be found out by some people, but I'd rather have had them figure it out on their own instead of finding out my mom betrayed my trust like that.
Hotel Maharana was cool. I never got hot because of the big ceiling fan and powerful air conditioner, and the HDTV on the wall was pretty big. Not all the staff spoke English but there were three managers there and one or two people who brought food in that knew English pretty well. But they were all helpful with getting me to Dr Parihar's clinic and helping me back in my room. The only things that were irritating were the step leading into the bathroom that made getting in there by walking difficult (I found it easier just to scoot into it on the floor) and the elevator was a little small so it took a lot of experimentation to fit inside it on the wheelchair. Vegetarian menu had some pretty good items. The tawa mushroom and naan was great. If you get tired of veg food though they have a non-veg section on the menu and you can get those meals within minutes because they order them from a hotel right next door. If I went back for another round of lengthening I might look for another hotel just so I could experience a new setting for the months required, but I wouldn't mind staying there again based on my experience the first time around.
I don't think I would have been able to keep it a secret from my parents anyway because of how I ended up having to do the bank transfer into Dr Parihar's account. I don't think I could trust anyone else to go on a joint account with me and transfer a large sum of money without taking any of it. In hindsight I could have just told my stepfather and I would have been better off.
That's what I did and only the guys I told listened. It seems like women are more inclined to spill out a secret because they get together and talk for hours about all sorts of things.
Yep. Though it's primarily people I don't even see or talk to that know about it. At least all the people I hang out with and see often are oblivious to my current situation.
maybe it is difficult to tell lies .... and some people just have bigger mouths. dont worry about it. she means no harm....
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You should have 2-3 more months left, by the way did the doctor tell you that u're doing well in terms of consolidation?
He said my bone healing shows good progress but the x-rays point out changes at the knee which indicate that I haven't been doing enough exercises. He suggested I get a physiotherapist through my local orthopedist for helping with ROM of the knee, muscle strengthening, ankle stretching and weight bearing ambulation training.
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kilom,
regarding infections... do you shower every day?? would keep the pin sites clean...
dr rozbruch is the one that let me know its ok to shower if you have frames on
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I get in the shower every three days. I sit in the bathtub and turn the shower on, getting the frames wet and everything. For the first two days I just get a bowl and a washcloth and scrub myself so I don't get the dressings wet. I haven't been getting infections so far. I've had a couple minor infections on a pinsite or two before, but I just take oral antibiotics for a few days and continue to clean the infected pin, and the infection goes away pretty fast.
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He said my bone healing shows good progress but the x-rays point out changes at the knee which indicate that I haven't been doing enough exercises.
what kind of changes?
also forgive me if it has been answered but I am curious. does pariah pin down the top and bottom of the fibula or just the bottom?
thank you. and I wish you a speedy recovery.
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I'll ask him what specific changes in the x-ray when I e-mail him with the pictures of my pin sites that he wanted. Though I think he can tell from the x-ray that the muscle atrophied.
Dr Parihar fixates the fibula at both the proximal and distal ends.
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How much money did you have saved up before you decided to go. I'll have about 17,000 dollars saved up. Do you think that would be enough for a seven month stay. and for the operation.
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How much money did you have saved up before you decided to go. I'll have about 17,000 dollars saved up. Do you think that would be enough for a seven month stay. and for the operation.
I had around $25,000 saved up and I spent pretty close to that. With the current exchange rate, the cost of surgery would be $14,530. Then you'd have to spend roughly $1,500 per month for hotel accommodation/food in Mumbai. So that's around $21,500. Add maybe $500 total for the purchase of a walker and a wheelchair. You also have to purchase your own gauze dressings. I was caught off guard by how expensive they were at the pharmacy downstairs near the hospital - 600 INR/$11.30 per box! And each box lasts two days if you change your dressings every day like Dr Parihar wants you to. So that's another $170 per month/$680 for 4 months. I'd recommend bringing a bunch of gauze with you on the way over there. You can buy large boxes of them from Dollar Tree online and it comes out much cheaper, and they can all fit in your suitcase well if you take them out of the box and just bring them in the small packages covering the gauze.
With $17,000 you won't be able to afford Dr Parihar if you include all the extra costs. However, I think you'll have enough money to afford Dr Dhawan in New Delhi, who has worked with Dr Parihar before and is ASAMI certified/secretary of Limb Lengthening Society of India. He's $9,000 - $10,000 for surgery and hospital stay, depending on whether you choose exfix or LON, and hotels in Delhi are much cheaper for extended stay. There's a Hotel Indira nearby that said extended stays could be $22 daily or around $660 per month, breakfast and wifi included. There are a bunch of hotels which give discounts to Sir Ganga Ram Hospital patients, where Dr Dhawan performs his surgeries. So you could probably find a bunch of hotels there that are rather affordable.
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With $17,000 you won't be able to afford Dr Parihar if you include all the extra costs. However, think you'll have enough money to afford Dr Dhawan in New Delhi, who has workIed with Dr Parihar before and is ASAMI certified/secretary of Limb Lengthening Society of India. He's $9,000 - $10,000 for surgery and hospital stay, depending on whether you choose exfix or LON, and hotels in Delhi are much cheaper for extended stay. There's a Hotel Indira nearby that said extended stays could be $22 daily or around $660 per month, breakfast and wifi included. There are a bunch of hotels which give discounts to Sir Ganga Ram Hospital patients, where Dr Dhawan performs his surgeries. So you could probably find a bunch of hotels there that are rather affordable.
This is good info Khan. Thanks for this. I will look into Dr Parihar
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Today I tried walking with crutches the first time. As I moved my left crutch I guess I lost balance or something and I fell on my ass. Had a ton of pain below the knees after the fall where the muscles are weak from atrophy. My legs still feel just as weak as they did during the middle of the lengthening process. Times like this I think maybe I should have gone with LON.
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Today I tried walking with crutches the first time. As I moved my left crutch I guess I lost balance or something and I fell on my ass. Had a ton of pain below the knees after the fall where the muscles are weak from atrophy. My legs still feel just as weak as they did during the middle of the lengthening process. Times like this I think maybe I should have gone with LON.
That exact same thing happened to me when I first tried to use crutches, about 5 1/2 months after the initial surgery.
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I recommend eating lots of protein, I eat a massive amount of chicken and milk and I have not lost any weight during my LL.
fingers crossed that it continues :)
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I recommend eating lots of protein, I eat a massive amount of chicken and milk and I have not lost any weight during my LL.
fingers crossed that it continues :)
if ur fit u might gain weight (fat)
i think i gained 2-3 kilograms
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This is probably what is happening.
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if ur fit u might gain weight (fat)
i think i gained 2-3 kilograms
nope its not fat. I stopped the gym for the last 2 years so that I could focus on this surgery. and I didn't loose any weight either after 2 years. I still have my 8 pack abbs.
I thought I would loose weight when I did LL, but again nope I did not. it surprised the doctor, the doctor said everyone looses weight.
I am a true mesomorph. I gain very fast in the gym and loose next to nothing even if I stop.
how much do you lift in the gym readrothbard?
anyway. kilokhan. how are you finding steps?
I found that steps initially were very difficult, but I kept going up and down them regardless, and after 4 weeks steps were easy. conversely other people thought steps were too hard and then stopped going up and down them during lengthening and so it continued to be a problem for them. I think the best advice is to make sure your body practices the correct biomechanics for whatever function you want it to perform, if you want to have no problem going up and down steps, then you have to do that exercise specifically, no other form of exercise will seem to fix it, it will only strengthen your other daily life functions I have found. in short, if you don't use it you loose it (for the specific exercise) :)
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Worksets are 335 deadlift (fives), 200 bench press (fives), and 260 squat (fives).
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anyway. kilokhan. how are you finding steps?
Steps f****** suck. I hate the zimmer frame because my balance is so crappy that I can barely stand and lift the zimmer frame at the same time. I once got stuck standing up against a wall while holding on to the zimmer frame because I couldn't lift it over this big rug that was in front of me and the leg got caught in it.
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Hi KiloKAHN! I have some questions for you:
1) How did you make your first consultation apointment with Doctor Mangal Parihar - Did you contact him personally and was it by phone or e-mail?
2) How big was the key to twist the nuts and screws in the six-axis hexapod devices - was it 10 milimeter or 12 milimeter and could you twist it by your self?
3) How far was the ATM machine from your hotel - and how did you go to the ATM - by yourself or did you need help?
4) Do the hotel and the hospital take both credit card (visa) and cash?
Thanks!
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1) I sent an e-mail telling him what date I would be in Mumbai and asked to book an appointment with him. He replied with his dates of availability and after I chose the date he responded with the time I should arrive at his clinic to see him.
2) I only had the hexapod on for a little over a day so the turns were done by Dr Ahuja. IIRC, he turned it by hand.
3) The ATM was at the bank next door. I would have a hotel employee help me down the elevator and then push me in my wheelchair up the driveway that led to the street. Quick left turn and the ATM was right there. Then they'd wait outside for me to assist me back into my hotel room afterward.
4) They take both. I'd pay for my food items or things I asked them to get me outside with cash and pay with my debit and credit cards for the cost of the room every two weeks.
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2) I only had the hexapod on for a little over a day so the turns were done by Dr Ahuja. IIRC, he turned it by hand.
Were the adjustments done in one session or throughout the day? Did you feel any pain during the process?
Was it during this time that Dr.Parihar compressed your tibias?
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Throughout the day. I think there were four turns. I had to keep it on only a very short time because there was only 3 degrees of misalignment after the second surgery where Dr Parihar added the middle pins, compressed the tibias, and fixed the majority of the misalignment.
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Throughout the day. I think there were four turns. I had to keep it on only a very short time because there was only 3 degrees of misalignment after the second surgery where Dr Parihar added the middle pins, compressed the tibias, and fixed the majority of the misalignment.
Kilo could you do me a favor to ask DR Parihar how much he charges to insert a nail? ANd if there is any lengthening limit I must abide to, if i want nailing after tibia ex-fix. Thanks so much.
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Kilo could you do me a favor to ask DR Parihar how much he charges to insert a nail? ANd if there is any lengthening limit I must abide to, if i want nailing after tibia ex-fix. Thanks so much.
I don't think there's any limit to lengthening as far as taking the nails into account. People who have lengthened 10 cm get nails put in as well.
You can e-mail Dr Parihar with your query at the following e-mail addresses:
mangalparihar@parihar.net
mangalparihar@gmail.com
You can also e-mail Dr Ahuja with your questions:
divya@parihar.net
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Hi KiloKAHN! I have some questions:
1. At the hotel Maharana Inn did the hotel staff brought you your meals into
your room - And did they brought you knife and fork?
2. What about bathroom things like toilepaper etc. did you have to buy
these things yourself?
3. When you went to the hospital for your first operation to do leg lengthening -
Did you then brought all your stuff (bag, clothes etc.) with you at the hospital - Or
did you left some of your stuff at the hotel Maharana Inn?
4. Is it necassary to have a mobile phone with you - Arent there a phone in every room
at the hotel Maharana Inn?
5. How did you connect to the Internet at the hotel Maharana Inn?
6. During your stay at the hotel after your leg operation how did you keep in contact with Doctor Mangal Parihar - By phone or by e-mail?
Thank you
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1) Staff was great about the food. I'd just ring the front desk and say what I wanted from the menu and minutes later they would bring it to me in my room, along with the silverware. They don't come back to take your tray and everything unless you call them. What I'd do is just leave it there until I was hungry again, then when they brought the new food item they'd take out the old tray.
2) The cleaning staff would replace toilet paper if it ran out (you could always ask the front desk for a replacement if they don't). They would restock the soap and shampoo/conditioner as well.
3) I brought all my stuff with me to the hospital and they locked it in a cabinet to keep it protected. I was brought back to Maharana by ambulance and the staff at the hotel brought up all my stuff.
4) The phones at the hotel don't dial outside, so it's best to buy a local phone. I recommend getting a last generation Galaxy or iphone for cheaper at a nearby cell phone provider when the hospital staff takes you to get your sim card installed. That way you can call local numbers as well as use the 4G internet in case the hotel wifi goes down.
5) They have wifi that's accessible with a password that lasts 24 hours. Once the time expires you need to call the front desk and ask for a new passcode. The wifi is complementary with the hotel stay though, so you don't need to pay anything extra for it.
6) I was in contact with Dr Parihar primarily through e-mail, but I used Whatsapp to communicate with Dr Ahuja whenever I had a question or needed anything. He was pretty fast with responding and would even send someone from the hospital to come see me if I needed a refill on pain killers or something.
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Thank KiloKHAN. I have a follow up question to 3.
When you were at the hospital for your operation - Did you also paid for your room at the hotel eventhough you were not staying at the hotel - Or did you make an arrangement with the hotel about when you will be back from your operation and then they will book you from that day?
Thank you!
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The first time I was at the hospital, I just checked out of Maharana the night before and told them when I'd be back. When I had to stay for my second surgery to add the middle pins, I didn't check out and was still charged the daily hotel rate for the time I was in the hospital.
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I don't think there's any limit to lengthening as far as taking the nails into account. People who have lengthened 10 cm get nails put in as well.
You can e-mail Dr Parihar with your query at the following e-mail addresses:
mangalparihar@parihar.net
mangalparihar@gmail.com
You can also e-mail Dr Ahuja with your questions:
divya@parihar.net
thanks kilo for ur kind reply!
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Hello KiloKAHN! I have three questions about bowls used for pinsite care:
1. Where did you bought these bowls (Please click on the links under here and look at time 1:06) to your pinsite care?
https://www.youtube.com/watch?v=7QAF_S4aiQ8&list=PLH8Iv30ACLxWICA_RJxUFu8H14Xzoq3fi&index=5 (https://www.youtube.com/watch?v=7QAF_S4aiQ8&list=PLH8Iv30ACLxWICA_RJxUFu8H14Xzoq3fi&index=5)
2. What are these bowls called?
3. What are these bowls made of?
Thank you!
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I'm not sure what they're made of or if they have any special name, but those are the cups and bowls used at the hospital for just about everything from eating, drinking, and storing sterilized gauze. You might be able to buy a few at the hospital to take with you to the hotel, but I just used the hotel room's water boiler to sterilize the water and poured it into a regular coffee cup.
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How's the recovery?
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KIloKAHN ! Did Doctor Parihar made a computerbased "Traumacad" of your legs from long x-rays both before your surgery and after you were finished with your lengthening and deformity corrections?
Please click this link to see an example of a "TraumaCad: http://www.voyanthealth.com/products.jsp (http://www.voyanthealth.com/products.jsp) - And when you come to the webpage click on the picture below the text "TraumaCad".
Thank you!
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KIloKAHN ! Did Doctor Parihar made a computerbased "Traumacad" of your legs from long x-rays both before your surgery and after you were finished with your lengthening and deformity corrections?
Please click this link to see an example of a "TraumaCad: http://www.voyanthealth.com/products.jsp (http://www.voyanthealth.com/products.jsp) - And when you come to the webpage click on the picture below the text "TraumaCad".
Thank you!
He used some kind of software when making the measurements but I'm not sure what it was.
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Update: 2/12/2015
Saw my local orthopedist again today after getting my x-rays done. The bone is healing very well and he made an appointment for me to come back in 4 weeks time to start dynamization - loosening of some of the pins on the frame to transfer more weight to the bone. He said from the x-rays it looks like I'll only have to wear these for another two months, and after frame removal he'll want me to wear some walking braces for an extra month or so for added protection. He also referred me for a consultation to a phsyiotherapy department. I have to call tomorrow and arrange my sessions. I'll be charged a co-pay at the beginning of each physiotherapy session, but the price is yet to be determined. It'll surely be less than the $80 co-pay I make when I get my x-rays and ortho appointment, however.
Last time I sent my x-rays to Dr Parihar he e-mailed me back saying that there were changes at the knee indicating that I haven't been doing enough exercises/weight bearing. I assumed that meant my knees looked like they've atrophied, but when I told my local ortho what Dr Parihar said, he showed me the x-rays and explained what Dr Parihar was talking about. Apparently if you don't do enough weight bearing for a while, your x-ray then starts to show small pockets in the bone where the color isn't as solid white, indicating that not enough pressure is being put on them. It's something to look out for when you get your x-rays.
My local ortho is fine with following Dr Parihar's recommendation as he's the one who performed the surgery on me, so before I allow any frame manipulation from the local ortho I'll wait for approval from Dr Parihar.
I've been doing a lot more standing since the last x-rays and now my feet can go completely neutral, although there is still a good amount of tightness in my left calf muscles which makes walking a bit painful and leaves me with swelling in the calves for a couple hours after doing so. I have to force myself to walk more and push through it though, especially since my ortho wants to start loosening the frames. I can lift both legs during leg raises and my right leg can go completely straight during leg extensions. The left leg is still lagging behind at halfway up, but I think it's due to the pain I still get below the knee on the left leg.
I'll post my x-rays after I receive them. I suspect it will be on Tuesday.
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I am glad to read that you are progressing in your healing, Kilokahn.
Very recently in another thread, several forum members were stating that pretty much anyone can lengthen 5CM on their tibiae and still look completely normal, proportionally. Having lengthened a little over that amount yourself, do you personally agree with that sentiment? I read the comment in which you stated that your tibiae are the same length as those of your six foot friend, which made me wonder a bit more about the importance of proportionality after LL. What is your take on this?
Did Dr. Parihar let you know what kind of athletic recovery you could expect after lengthening 6CM on the tibiae?
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@KiloKAHN, As I see it from your pictures of the devices then it was "Ortho-SUV Frames"
(http://www.rniito.org/download/ortho-suv-frame-eng.pdf (http://www.rniito.org/download/ortho-suv-frame-eng.pdf)) that Doctor Parihar used on your legs to correct your leg deformity. "Ortho-SUV Frame" is used with software - So it make sense to me that he used software to make some measurements with your devices.
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I am glad to read that you are progressing in your healing, Kilokahn.
Very recently in another thread, several forum members were stating that pretty much anyone can lengthen 5CM on their tibiae and still look completely normal, proportionally. Having lengthened a little over that amount yourself, do you personally agree with that sentiment? I read the comment in which you stated that your tibiae are the same length as those of your six foot friend, which made me wonder a bit more about the importance of proportionality after LL. What is your take on this?
Did Dr. Parihar let you know what kind of athletic recovery you could expect after lengthening 6CM on the tibiae?
I think if you lengthen 5 cm you should still look okay, but when you hit 6 cm your tibs look a little long. 7 cm and above I think you can definitely tell that the tibias are longer than they should be in proportion to all your other limbs. I've already had comments from relatives telling me how long my legs look now. It shouldn't be at all noticeable in pants or even shorts unless you're sitting next to someone and they decide to scope your legs, though. The people who made comments already knew what I did which made it more noticeable. Because my doctor said 6 cm is usually when complications start to happen like bone misalignment, equinus, stiffness, etc, it's probably a good idea not to go beyond that.
He said I should make a complete recovery over time. The only instance he indicated where I might lose some athletic ability was when he said achilles tendon lengthening leads to a certain amount of weakness but wouldn't be significant enough to affect participation in recreational sports unless I wanted to be like Usain Bolt.
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Latest X-Rays (2/12/2015)
(http://s5d1.turboimagehost.com/t1/22366381_2-12-2015-1.png) (http://www.turboimagehost.com/p/22366381/2-12-2015-1.png.html) (http://s5d1.turboimagehost.com/t1/22366382_2-12-2015-2.png) (http://www.turboimagehost.com/p/22366382/2-12-2015-2.png.html) (http://s5d1.turboimagehost.com/t1/22366383_2-12-2015-3.png) (http://www.turboimagehost.com/p/22366383/2-12-2015-3.png.html) (http://s5d1.turboimagehost.com/t1/22366384_2-12-2015-4.png) (http://www.turboimagehost.com/p/22366384/2-12-2015-4.png.html)
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Looks like you have some substantial callus. Congratulations!
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im jealous of your callous :) very nice :)
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Update: 2/12/2015
Saw my local orthopedist again today after getting my x-rays done. The bone is healing very well and he made an appointment for me to come back in 4 weeks time to start dynamization - loosening of some of the pins on the frame to transfer more weight to the bone. He said from the x-rays it looks like I'll only have to wear these for another two months, and after frame removal he'll want me to wear some walking braces for an extra month or so for added protection. He also referred me for a consultation to a phsyiotherapy department. I have to call tomorrow and arrange my sessions. I'll be charged a co-pay at the beginning of each physiotherapy session, but the price is yet to be determined. It'll surely be less than the $80 co-pay I make when I get my x-rays and ortho appointment, however.
Last time I sent my x-rays to Dr Parihar he e-mailed me back saying that there were changes at the knee indicating that I haven't been doing enough exercises/weight bearing. I assumed that meant my knees looked like they've atrophied, but when I told my local ortho what Dr Parihar said, he showed me the x-rays and explained what Dr Parihar was talking about. Apparently if you don't do enough weight bearing for a while, your x-ray then starts to show small pockets in the bone where the color isn't as solid white, indicating that not enough pressure is being put on them. It's something to look out for when you get your x-rays.
My local ortho is fine with following Dr Parihar's recommendation as he's the one who performed the surgery on me, so before I allow any frame manipulation from the local ortho I'll wait for approval from Dr Parihar.
I've been doing a lot more standing since the last x-rays and now my feet can go completely neutral, although there is still a good amount of tightness in my left calf muscles which makes walking a bit painful and leaves me with swelling in the calves for a couple hours after doing so. I have to force myself to walk more and push through it though, especially since my ortho wants to start loosening the frames. I can lift both legs during leg raises and my right leg can go completely straight during leg extensions. The left leg is still lagging behind at halfway up, but I think it's due to the pain I still get below the knee on the left leg.
I'll post my x-rays after I receive them. I suspect it will be on Tuesday.
start dynamization after 4 weeks ...hmmm .. are you worry that you may lose some mm during that .. I remember Dr naveen said once that you shouldn't lose any significant amount of your height gain if you would do so ( I think 2mm at top) , but like I still sometime think that what caused my height loss , or maybe monorail is different case .. I don't know ..
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Looks like you have some substantial callus. Congratulations!
im jealous of your callous :) very nice :)
Thanks. I was quite surprised at how much callus formed since the last x-ray. Hopefully it continues.
start dynamization after 4 weeks ...hmmm .. are you worry that you may lose some mm during that .. I remember Dr naveen said once that you shouldn't lose any significant amount of your height gain if you would do so ( I think 2mm at top) , but like I still sometime think that what caused my height loss , or maybe monorail is different case .. I don't know ..
That's something I've considered. I think you compress less if your callus is more developed once you start dynamization, but if it does compress I'm not really bothered by it. I lengthened 0.2 mm over my lengthening target so if it compresses 2 mm that will bring me right to 6 cm exactly. I've e-mailed Dr Parihar my latest x-rays and told him of my local ortho's plans to see if he agrees. If he suggests to wait longer before we dynamize the frames then I'll go along with his suggestion.
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Hey KiloKhan
Regards to supplements, did you buy any vitamins or protein while in India?
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Hey KiloKhan
Regards to supplements, did you buy any vitamins or protein while in India?
The doc prescribed Shelcal for calcium and vitamin D and Zevit for zinc. I got my proteins and other nutrients from ordering fish , mutton, chicken, mushrooms, and other veggies on the hotel menu. The supplements prescribed are very cheap at the hospital pharmacy, unlike the gauze.
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@KiloKAHN, What kind of tests did you have to take at the hospital before your surgery? And what kind of questions did you have to answer and sign at the hospital before your surgery?
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Update: 3/2/2015
Today I had my first session with the physiotherapist. The clinic was about 15 minutes from my office in a very nice medical center. Very thankful for the insurance my office currently provides. My physiotherapist is very friendly and he asked a lot of questions about the frames, what I'm able to do as far as walking and stretching, how long ago I got the surgery, etc. We chatted a bit about games and wrestling and I told him that I had had the surgery for cosmetic purposes because 1) I'm going to be seeing this guy a lot so no need to lie and 2) all my half-siblings are huge and I'd get a ton of crap from others when going out with them after they found out we were related (i.e. "Omg, what happened to you?"). He was cool about it and didn't criticize me for doing it. He's very tall and said himself that he's 6'5, so perhaps he understands the advantages that extra height provides. What was funny though is when I told him I wrestled in high school and college he said I should have taken down whoever gave me crap about my height with my wrestling moves.
Anyway, I had a belt wrapped around my torso and I wheeled onto this platform in between two bars that I had to grasp while standing up. He held onto the belt from behind to make sure I didn't fall down and had me walk forwards and backwards while grasping onto the bars for a while. He then brought out a walker and had me walk around the room. After doing all the walking he measured my ankle dorsiflexion, which I found out is -25 for both legs. A solid improvement from before as I can touch my heels to the ground (though with my body still slightly bent forward while walking even though standing against the wall I go completely neutral) but still requiring a lot more work. I was told that my equinus should lessen in severity even faster as I start walking more and that removing the frames would possibly help because I won't have wires sticking through me near my ankles. I was shown some exercises to reduce swelling in my feet after walking. There are more stretches he'll have me do once my frames are off but he said that the best thing I could do at this point is walk as much as possible. I will now have physiotherapy sessions once a week for the next few months, meaning they'll continue even after the frames are removed.
One other thing I got from this session is that I should probably invest in a walker that has wheels in the front. Mobility is so much easier with them than with the walkers that don't have wheels, especially in areas with heavy carpeting. I was actually quite surprised with how much my walking has improved within the last month. Looks like there's light at the end of the tunnel.
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@KiloKAHN, What kind of tests did you have to take at the hospital before your surgery? And what kind of questions did you have to answer and sign at the hospital before your surgery?
I just had to get blood work done so Dr Parihar could go over the results. Aside from that, a series of measurements had to be taken. The forms you sign aren't atypical for this sort of thing. Just consent forms authorizing the hospital to perform surgery as well as a questionnaire about your medical history and allergies.
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really good to hear that u r nearing the end of the long procedure, keep us posted :)
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So two weeks ago I told Dr Parihar of my local orthopedist's plan for frame dynamization:
KK: My local orthopedist said he wants to loosen some of the pins when I see him again on March 10, and then 4 weeks after that he said the frames should be ready to come off. He then plans to have me wear protective walking braces for an extra month or so.
I just received a reply from Dr Parihar advising otherwise, along with an attachment to help me see what he was talking about:
Dr P: I would suggest - do not loosen the pins.
instead, back off the nuts on the rings where the threaded rods are attached (the thinner ones, not the thick aluminium ones). they must be alternately on the first and second rings.
they can be backed off by 2 mm on each and the nuts retightened in the new position. this will allow more weight bearing thru the bone, and help in healing it faster.
removal of the pins is not needed or advisable in my opinion.
also - the physio - have you started physio yet or not?
(http://s5d4.turboimagehost.com/t1/22541603_parihar_sent_image.jpg) (http://www.turboimagehost.com/p/22541603/parihar_sent_image.jpg.html)
Perhaps I won't be taking the frames off as soon as I thought. ???
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Perhaps I won't be taking the frames off as soon as I thought. ???
Not if you just listen to your local doctor. Just do what your doctor close by says since he's actually seeing you and able to give you advice in person and not just through email.
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Not if you just listen to your local doctor. Just do what your doctor close by says since he's actually seeing you and able to give you advice in person and not just through email.
I don't think it's a good idea to go against Dr Parihar's advice as he's the one who performed the surgery and everything.
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I agree. I would definitely listen to dr Parihar's advice since he has looked at countless x-rays of LL patients and would have the best experience regarding what your x-rays should look like before attempting to remove the frames.
Btw, I read in your diary that you have been taking Ibuprofen a couple of times. I don't know if it has been brought up before, but you are supposed to stay away from such medication since it slows down bone regeneration. At least that what I read from Paley. Sorry if it has already been addressed, I am trying to catch up with reading many diaries in my limited spare time.
Congrats on being so close to getting the frames removed..... you must really be looking forward to it
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If it was me then I would listen to Doctor Parihar - Good luck with your decision. Your X-rays look good. Good luck with your legs.
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Hey Kilo - did you see your orthopedist yesterday? If so, how did it go?
How are you feeling at your new height, are you definitely gonna do a second LL?
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Do you think someone used to western standards would be able to manage Dr. Parihar's hospital? There was another consultation on the old forum where the prospective patient decided he wouldn't do surgery with your doctor because the hospital was supposed to be some godawful mess. Is the poor quality of the hospital exaggerated or did you just suck it up?
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Do you think someone used to western standards would be able to manage Dr. Parihar's hospital? There was another consultation on the old forum where the prospective patient decided he wouldn't do surgery with your doctor because the hospital was supposed to be some godawful mess. Is the poor quality of the hospital exaggerated or did you just suck it up?
I've seen American hospitals and they are sometimes so messy.
But I suppose indian hospitals are worse.
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Hey Kilo - did you see your orthopedist yesterday? If so, how did it go?
How are you feeling at your new height, are you definitely gonna do a second LL?
My local orthopedist used a 10 mm wrench to loosen the nuts on each of the rods. A lot of them were on really tight and by the time everything was loosened I had terrible soft tissue pain just below the knees that lasted for 5 days. He still wants to get my frames removed in mid-April and put me in walking braces for a month or two afterward, so he said to ask Dr Parihar if he thinks differently.
Do you think someone used to western standards would be able to manage Dr. Parihar's hospital? There was another consultation on the old forum where the prospective patient decided he wouldn't do surgery with your doctor because the hospital was supposed to be some godawful mess. Is the poor quality of the hospital exaggerated or did you just suck it up?
You can see pics of my room earlier in the diary. I really thought the condition of the hospital was fine. Yeah you're not going to see shiny marble floors, but it's got everything you would need to be comfortable. I honestly think that someone who won't do surgery there solely based on how it looks is a drama queen. The hospital's OT is clean and sterilized so there's no need to worry about that.
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Update: 3/19/2015
Got back from another physical therapy session. He decided that the only exercises I can do at the moment are things I can do at home and don't need to be there for, so he decided that I'll have my next session once these frames are removed (mid-April if Dr Parihar allows it) and to just keep doing home physio. Good news is that since my appointment last week my dorsiflexion has improved from left leg -30 degrees and right leg -25 degrees to left leg -15 degrees and right leg -10 degrees. My goal for the next meeting is to get to 0. He said for normal walking you want 10 degrees dorsiflexion on each leg, which I think will be possible for me with enough time. I'm waiting longer than usual for my x-rays to be processed for pickup. Hopefully they'll be ready for me to post tomorrow.
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Wow man, you're recovery is taking quite long.
It'll soon be a full year. Did you anticipate this?
Do LON patients usually take this long?
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I did slightly over 6 cm so I expected it to be 9 months wearing frames at a minimum. It's amazing that a woman can develop a baby faster than my bones can heal with exfix only lol.
LON patients have the benefit of walking around sooner and taking the frames off in one third the time you have to wear frames for exfix only.
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Wow man, you're recovery is taking quite long.
It'll soon be a full year. Did you anticipate this?
Do LON patients usually take this long?
Dr.Parihar is quite conservative and recommends external fixation for 1.5 months per cm. Kilokahn did his surgery on the 25th of June, 2015, lengthened around 6 cm and it's nearly 9 months. This is normal. Some doctors are even more conservative, for example Dr.Birkholtz and Dr.Rozbruch both recommend 2 months of external fixation per cm.
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Latest X-Rays (3-10-2015)
(http://s5d3.turboimagehost.com/t1/22700358_3-10-2015-1.jpg) (http://www.turboimagehost.com/p/22700358/3-10-2015-1.jpg.html) (http://s5d3.turboimagehost.com/t1/22700359_3-10-2015-2.jpg) (http://www.turboimagehost.com/p/22700359/3-10-2015-2.jpg.html) (http://s5d3.turboimagehost.com/t1/22700360_3-10-2015-3.jpg) (http://www.turboimagehost.com/p/22700360/3-10-2015-3.jpg.html) (http://s5d3.turboimagehost.com/t1/22700361_3-10-2015-4.jpg) (http://www.turboimagehost.com/p/22700361/3-10-2015-4.jpg.html)
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definitely takes over a year of getting back to full recovery, so tbh, no reason not to wear frames a while
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Your X-rays looks good. Nice to read a diary which always show the progress as it goes on. Good luck.
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It's quite possible I'll be wearing the frames for a whole year, based on Dr Parihar's response to my last set of x-rays. He's not in agreement with my local orthopedist about removing the frames and putting me in walking braces in mid-April.
i have seen the X-rays.
they show progress. since the nuts have been loosened only on this visit, i would expect to see the improvement due to that only on the next set of X-rays.
removal of frames:
i usually remove the frames only when i can see corticalisation of at least 3 out of 4 sides of the bone - (medial cortex and lateral cortex are seen on the AP X-ray, and anterior and posterior cortex on the lateral X-ray)
in patients who have a nonunion etc, the leg can be protected in a brace after fixator removal. in patients who have a long regenerate (as in your case 6 cms), i believe that the risk of refracture or bending of the regenerate is too high to trust a brace, unless the 3 cortex sign as mentioned above is present.
as i may have told you at the initial consult.
- a month too late is better than a day too early.
- the consolidation phase is when the most patient patient becomes impatient, and i think i can ascribe the lesser number of complications that we have to the fact that i am able to resist patient pressure to take off the frame, before i am convinced that it is ready for removal, based on my clinical and X-ray findings, rather than on patients feelings or discomfort.
feel free to share this with your local orthopedist.
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sux to wear the frames...
but if you take off too early, you might need to get leg rebroken again and wear a frame anyway... there's just no way of getting around the long time frame with external fixation
and after a year, you'll not be walking normally right after they come off
this whole process takes a while
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Hey Kilo,
Great diary so far! I am still undecided when it comes to the method of lengthening (LON\external). How do the frames affect your daily life? Are you able to do stuff like buying grocceries or just take a stroll?
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The frames are sometimes not a bother at all and sometimes a real pain in the ass. The longer you wear them, the more the pin sites slowly open up due to skin stretching and movement, and the more uncomfortable wearing them gets on average in a day. Right now I'm back to having a lot of difficulty sleeping without taking pills before bed. I don't think I'd be able to go grocery shopping with them on considering how slow I walk, plus I probably wouldn't be able to carry much while having to grip on to the walker. If you have a wheelchair you can get around fine so long as you have someone to drive you to your destinations.
Exfix is certainly more uncomfortable long term than LON, but I did it to avoid the possibility of chronic knee problems that comes with insertion of the nail into your tibias.
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Hey Kilokahn,
Being in external fixators ,for one year, is a long time. Hang in there. You are almost there. When it comes to LL, I would rather be safe than sorry. Good luck to you.
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Here's what my walking looks like now. I still have a tendency to lean forward while walking but it's getting better.
https://www.youtube.com/watch?v=IMnjDG5meZw
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Here's what my walking looks like now. I still have a tendency to lean forward while walking but it's getting better.
Looks awesome man! I don´t see anything wrong with your walking, it´s just a little slower.
Do you think you could use crutches instead of a walker, I´d feel a little weird using a walker in public (like an old man ;D).
Keep us updated, I really appreciate your diary it´s so detailed and well written. This is definitely one of the most valuable sources available for future patients.
I must say that your tibias look very good, not disproportionate at all!
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Looks great and natural. Your proportion seems to be better now as lengthening your lower legs have balanced out your wider upper body. LL definitely benefited you. Without the frame, I wouldn't be able to detect that you have done LL.
With the external frames though, I would be careful of x-leg or knee knock. That seems to be a common occurrence both in India and Russia. But I'm sure Dr. Parihar is a great doctor and I just want to put this out so you are aware of it and prevent it from happening. Cheers.
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KiloKAHN, your proportions look phenomenal. And your walking is really coming along. Great job bro!
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i dont feel so bad about my walking now... external fixation when you do 6- 8 c simply takes forever to recover from
kilo... the odds are you wont be walking normally without any assistance until more than a year after surgery...same thing for me
did you expect this or has the duration surprised you??
i think those considering having external fixation should pay attention.... especially if youre doing 7 or more cm....it will realistically take over a year to function somewhat normally without any walking aid
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Huh, your proportions look completely normal. Congratulations.
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Looks awesome man! I don´t see anything wrong with your walking, it´s just a little slower.
Do you think you could use crutches instead of a walker, I´d feel a little weird using a walker in public (like an old man ;D).
Keep us updated, I really appreciate your diary it´s so detailed and well written. This is definitely one of the most valuable sources available for future patients.
I must say that your tibias look very good, not disproportionate at all!
I might be able to use crutches now, but it's something I don't want to attempt until I have a friend around. I tried walking with crutches a month or two ago and I lost my balance and fell. Didn't feel good at all. The walker is a bit cumbersome but I feel safe with it. I'm thinking of buying a smaller one that has wheels in the front though, because they're a lot easier to move.
Looks great and natural. Your proportion seems to be better now as lengthening your lower legs have balanced out your wider upper body. LL definitely benefited you. Without the frame, I wouldn't be able to detect that you have done LL.
With the external frames though, I would be careful of x-leg or knee knock. That seems to be a common occurrence both in India and Russia. But I'm sure Dr. Parihar is a great doctor and I just want to put this out so you are aware of it and prevent it from happening. Cheers.
Thanks. Fortunately I don't have valgus. Yeah it did seem a lot of patients developed it with other docs while wearing the frames.
KiloKAHN, your proportions look phenomenal. And your walking is really coming along. Great job bro!
Thanks.
i dont feel so bad about my walking now... external fixation when you do 6- 8 c simply takes forever to recover from
kilo... the odds are you wont be walking normally without any assistance until more than a year after surgery...same thing for me
did you expect this or has the duration surprised you??
i think those considering having external fixation should pay attention.... especially if youre doing 7 or more cm....it will realistically take over a year to function somewhat normally without any walking aid
I thought I'd be walking better by now even though I figured I'd still have the frames on. Didn't realize how long it would take to get my balance back. Those who want to do 7 cm or longer should probably think about just risking the possible knee pain issue with LON. I don't know if I could tolerate 14 months of these. 12 months is already going to really stretch my patience. lol
Huh, your proportions look completely normal. Congratulations.
Thanks.
I'm a bit surprised that you guys think my proportions look totally normal. I left India thinking that my tibias looked really long, but I guess I had the different perspective because I've been used to how short my legs are. I guess my frame helps with the proportions. Right now my wingspan and standing height should be roughly the same, + or - 1 cm. I was a little concerned about arm length because my arms are a bit on the shorter side, but I guess they look in proportion with everything else.
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KiloKahn to be fair it's hard to judge your proportions when you walk a bit hunched over, plus both the frames and the walker clutter things, you arms aren't straight for example.
We'll know for sure when the frames are off and you can stand up straight, walk run etc.
Wouldn't surprise me if you will appear very normal though.
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Makes sense. I can stand straight when my back's against a wall. No idea how long it's going to take me to walk normally. Boy, this takes forever.
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dudee.... i feel the same way
i thought id be walking fine in a few months... if someones doing external.... man... if you do over 7 cm... youre looking at like 14 to 15 months until you sort of walk normally... thats the reality
sux!!!
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It's why I wouldn't recommend doing another segment without a huge break in between. After I get walking normally, I'd at least want 2 or 3 years of feeling normal before I decide to handicap myself again. Doing two segments at once, you'll probably feel like crap in the recovery period.
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My local doctor responded to the e-mail I sent him that had Dr Parihar's response to me about not removing the frames. He wants me to get a third opinion with a separate otho at the same office. I just told one of the staff who notified me of it that instead of getting a third opinion I'd rather just wait until both doctors (local and Parihar) are in agreement about frame removal.
It would be nice to remove the frames now and if I were a more impatient person I'd book the removal appointment right away. But if Dr Parihar says the risk of the regenerate bending or refracture is too high, then if he's correct and it does happen I could probably be faced with a number of problems, such as having to put a frame back on or even losing height that I gained.
Kind of sucks having doctors in the same field telling you completely different things, though. It would be nice if their reccommendations were the exact same so I didn't have to make my own decision on who to listen to. :D
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do you try to walk without a walker or crutches?
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I haven't been brave enough to try walking unaided. I get the feeling my muscles are still too weak to hold myself up.
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I haven't been brave enough to try walking unaided. I get the feeling my muscles are still too weak to hold myself up.
I know what you mean. That's what held me back for a while, even though my doctor was telling me I could walk. You will get there my friend!
Does your doctor believe you can walk unaided now?
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Kilokahn,
It's always better to be safe than sorry. Make sure you take those frames off only when the doctor absolutely say that you can.
What about the calcium tablets (vegan variety), multivitamins, and greens? Have you been taking those? I believe they aid with bone formation. I would recommend that you perform daily physical activities, which will help with circulating those blood to the calf areas.
Personally, I did 200 sit-ups daily plus a variety of other exercises routines while I was in India. Is there a gym where you stay? Inactivity will lead to muscle atrophy and hinder recovery. Make sure you exercise whenever possible, though I know the frames and the pain will make it difficult to move around.
It's also good to have a LL buddy or a roommate, so you guys can encourage and advise one another.
And I don't know about the place where you are stay, but mine was close to the mall. I used it make it a habit of going there every day (even in frames) for a cup of coffee or for lunch. You'll be surprised by the number of Indian women who are interested in you just because you are a foreigner.
I had a nurse who said she liked me (while I was laying in a hospital bed going for my 4th surgery) and a few contacts at the mall (while I was in wheelchair). Life is short, make sure you have fun whenever possible.
Cheers,
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I know what you mean. That's what held me back for a while, even though my doctor was telling me I could walk. You will get there my friend!
Does your doctor believe you can walk unaided now?
I haven't asked him, but my body is telling me the answer is no. Freaking tibias, man...
Kilokahn,
It's always better to be safe than sorry. Make sure you take those frames off only when the doctor absolutely say that you can.
What about the calcium tablets (vegan variety), multivitamins, and greens? Have you been taking those? I believe they aid with bone formation. I would recommend that you perform daily physical activities, which will help with circulating those blood to the calf areas.
Personally, I did 200 sit-ups daily plus a variety of other exercises routines while I was in India. Is there a gym where you stay? Inactivity will lead to muscle atrophy and hinder recovery. Make sure you exercise whenever possible, though I know the frames and the pain will make it difficult to move around.
It's also good to have a LL buddy or a roommate, so you guys can encourage and advise one another.
And I don't know about the place where you are stay, but mine was close to the mall. I used it make it a habit of going there every day (even in frames) for a cup of coffee or for lunch. You'll be surprised by the number of Indian women who are interested in you just because you are a foreigner.
I had a nurse who said she liked me (while I was laying in a hospital bed going for my 4th surgery) and a few contacts at the mall (while I was in wheelchair). Life is short, make sure you have fun whenever possible.
Cheers,
Most of my exercise consists of walking in a circle over and over in my office. According to Dr Parihar you need to walk around and not just back and forth, although I didn't ask him why one is better than the other. I've been taking oyster shell calcium, zinc, vitamin D and vitamin C. I get a lot of protein too b/c I eat a lot of red meat.
There is a gym at my apartment complex but I feel too vulnerable going outside with my frames still on. I think I'll be able to do a lot more exercises once these frames are off because I'll have more ROM in my ankles. These wires impede a lot of movement just because of the pain they cause.
When I was in India I didn't like talking to any of the women there outside of my physiotherapists. Was too nervous about making a cultural faux pas. I get the feeling that most women there aren't into flings and would want to attach herself long-term to any guy they get physical with.
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Hey , Bud was reading about you, actually i too want to go through LL, its hard but from this suffering,
where are you now in which hospital of india, coz i am also from India want see what exactly the procedures is about,
It will also boost you as i am a very happy go lucky guy.
please replay.
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Most of my exercise consists of walking in a circle over and over in my office. According to Dr Parihar you need to walk around and not just back and forth, although I didn't ask him why one is better than the other.
Walking in circles involves a constant change in directions which obviously is more challenging.
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walking really is the only thing that gets you better
i did the same thing you did in my apt... walked a lot the other day...then got very sore
today my calves are not toght at all, and feeling much better
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I haven't asked him, but my body is telling me the answer is no. Freaking tibias, man...
Most of my exercise consists of walking in a circle over and over in my office. According to Dr Parihar you need to walk around and not just back and forth, although I didn't ask him why one is better than the other. I've been taking oyster shell calcium, zinc, vitamin D and vitamin C. I get a lot of protein too b/c I eat a lot of red meat.
There is a gym at my apartment complex but I feel too vulnerable going outside with my frames still on. I think I'll be able to do a lot more exercises once these frames are off because I'll have more ROM in my ankles. These wires impede a lot of movement just because of the pain they cause.
When I was in India I didn't like talking to any of the women there outside of my physiotherapists. Was too nervous about making a cultural faux pas. I get the feeling that most women there aren't into flings and would want to attach herself long-term to any guy they get physical with.
thats another negative to externals... the damn ankle ring definitely contributes to the ballerina issues... my ankles were swollen until i had frames removed
realistically, to be able to walk unaided normally, 5 or 6 months should do it for you
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Hey , Bud was reading about you, actually i too want to go through LL, its hard but from this suffering,
where are you now in which hospital of india, coz i am also from India want see what exactly the procedures is about,
It will also boost you as i am a very happy go lucky guy.
please replay.
Hi,
I left India way back in October. Now I'm healing back home. I did my surgery at Mangal Anand Hospital in Chembur, Mumbai with Dr. Mangal Parihar.
Walking in circles involves a constant change in directions which obviously is more challenging.
I guess the constant shifting puts more pressure on the bone than just walking straight constantly.
thats another negative to externals... the damn ankle ring definitely contributes to the ballerina issues... my ankles were swollen until i had frames removed
realistically, to be able to walk unaided normally, 5 or 6 months should do it for you
The funny thing is the ankle ring didn't bother me at all while I was lengthening, but during consolidation it's quickly become the most bothersome. I wouldn't mind having to continue wearing this if it weren't for the ankle ring. My physiotherapist said he doesn't want me to come back until my frames are removed because the ankle ring prevents him from doing a lot of stretching exercises on me.
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yes, the ring and pins suck!!!!!
i could not do a thing with the frames on...they limit motion...
life will be easier oce the fixator is off
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Congratulations on your awesome journey. It looks like you really planned this out well and have got the process down to a text book response so far. No major complications. Good follow up by your doctors. Good consolidation so far. Playing it safe. Really fantastic. You seem like a very even-keeled, calm, and measured person which has served you well.
I have a few comments/questions.
1) First, I might have missed something, but I didn't see how you came to decide between Dr. Dhawan and Dr. Parihar. Both offered Hexapod and had similar concepts of how to fix the fibula. What made your choice Dr. Parihar?
2) In all of your research, did you come across any surgeons who struck you as reputable and were using the Hexapod in North America or Europe?
3) One of the things that struck me reading your diary, especially in the context of the other discussion we were having about methods to avoid chronic joint pain and OA in LL, is that of all the pains you describe in this thread, none of them seemed to be deep joint ankle/knee pain. Most of the pain you experience seems to be related to stretching of the soft tissues and nerves, as well as perhaps pressure from the pins themselves. Calf pain, equinus pain, below the knee pain, etc.
Understanding that you are still in your frames and thus can't truly test them yet, how do your joints themselves feel? Besides the stiffness externally from the muscles and ligaments, do the axes "feel" correct? Does the front/back motion feel natural? Do you have any sense of a "catching" or "clicking" or "internal friction/grinding"? I know it will be hard to get a clear answer on what I'm asking. Even children with growing pains can get a deep joint ache as everything stretches, and it doesn't mean there's anything wrong inside their joints. But still I'm curious for your perspective.
4) I agree with your idea that if you can avoid drilling into the tibia it may be ideal. This sort of Ilizarov with Hexapod you chose is really as "minimally invasive" a leg lengthening as can be performed while maintaining good alignment.
I wonder if an even better alignment (with the risk of more skin scarring) could have been attained via adding the middle pins from the start. I didn't do a before/after comparison, but your tibias appeared a bit curved in the post op. I don't think this will be a problem. Lots of people seem to have a bit of curvature to their tibias. The most important aspects of alignment seem to be whether your joint lines are horizontal in plane, and whether your vertical axis measured from top of tibia to bottom of tibia is good. But for those of us who don't care what our skin looks like, I wonder if the middle pin option from the start would add greater stability and thus lower risk of deformity.
If you're talking to Dr. Parihar and can ask him his opinion on this, I'd appreciate it.
5) Lastly, have you experienced any psychological benefits from the new height yet? I know as you said you are not yet again socially active, but even with the crutches/walkers, have you noticed yourself taller back home around family and how has it felt if so?
Keep up the good work. If I can have as relatively uneventful a journey as you have when my time comes, I will consider myself very lucky! 8)
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Congratulations on your awesome journey. It looks like you really planned this out well and have got the process down to a text book response so far. No major complications. Good follow up by your doctors. Good consolidation so far. Playing it safe. Really fantastic. You seem like a very even-keeled, calm, and measured person which has served you well.
I have a few comments/questions.
1) First, I might have missed something, but I didn't see how you came to decide between Dr. Dhawan and Dr. Parihar. Both offered Hexapod and had similar concepts of how to fix the fibula. What made your choice Dr. Parihar?
- It was a combination of things. Having been a fellow of Dr Paley certainly helped, as well as his greater amount of experience (he's been doing this since 1991). He's also just got a really good vibe about him. I really got a feeling during our consultation that I would be in good hands. He's also constantly leading workshops on Ilizarov surgeries, probably more than anyone else in India.
2) In all of your research, did you come across any surgeons who struck you as reputable and were using the Hexapod in North America or Europe?
I found some doctors that use a TSF as standard practice, but most would respond that they absolutely do not perform cosmetic lengthening. I think there are maybe 5 surgeons in the USA that will do it, and all of them seem to prefer or insist doing internals, which were out of my budget.
3) One of the things that struck me reading your diary, especially in the context of the other discussion we were having about methods to avoid chronic joint pain and OA in LL, is that of all the pains you describe in this thread, none of them seemed to be deep joint ankle/knee pain. Most of the pain you experience seems to be related to stretching of the soft tissues and nerves, as well as perhaps pressure from the pins themselves. Calf pain, equinus pain, below the knee pain, etc.
Understanding that you are still in your frames and thus can't truly test them yet, how do your joints themselves feel? Besides the stiffness externally from the muscles and ligaments, do the axes "feel" correct? Does the front/back motion feel natural? Do you have any sense of a "catching" or "clicking" or "internal friction/grinding"? I know it will be hard to get a clear answer on what I'm asking. Even children with growing pains can get a deep joint ache as everything stretches, and it doesn't mean there's anything wrong inside their joints. But still I'm curious for your perspective.
I don't have any of those odd sensation that you mention. As far as I know everything is normal in my joints. I just continue to have some muscle pain which I assume will go away once I get these frames off and stretch my muscles out some more.
4) I agree with your idea that if you can avoid drilling into the tibia it may be ideal. This sort of Ilizarov with Hexapod you chose is really as "minimally invasive" a leg lengthening as can be performed while maintaining good alignment.
I wonder if an even better alignment (with the risk of more skin scarring) could have been attained via adding the middle pins from the start. I didn't do a before/after comparison, but your tibias appeared a bit curved in the post op. I don't think this will be a problem. Lots of people seem to have a bit of curvature to their tibias. The most important aspects of alignment seem to be whether your joint lines are horizontal in plane, and whether your vertical axis measured from top of tibia to bottom of tibia is good. But for those of us who don't care what our skin looks like, I wonder if the middle pin option from the start would add greater stability and thus lower risk of deformity.
If you're talking to Dr. Parihar and can ask him his opinion on this, I'd appreciate it.
If the pins were added in the middle at the get go there would have been greater stability. Probably wouldn't have needed a hexapod to correct the alignment later if those were there first. But from what I was told, there's no difference in the final alignment between adding the pins first or adding them at the end like was done to me. My tibias had a natural curvature about them from the beginning:
(http://s5d3.turboimagehost.com/t/19108843_Set_1_5_Watermark.jpeg) (http://www.turboimagehost.com/p/19108843/Set_1_5_Watermark.jpeg.html)
From what I've been told, lengthening just makes the curve look a little more pronunced simply because you're stretching the ends further apart. But from the x-rays Dr Parihar said my alignment was good and that opinion's been repeated by my local ortho and radiologist reports.
5) Lastly, have you experienced any psychological benefits from the new height yet? I know as you said you are not yet again socially active, but even with the crutches/walkers, have you noticed yourself taller back home around family and how has it felt if so?
I've had comments from family members and friends that make it seem like th added 6 cm was a dramatic difference. That alone has done a lot to help my self-esteem.
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Thanks for the xrays. It's hard to see your femoral heads exactly on my monitor and this is just a crude drawing so it may be off, but looks like you have a subtle bit of varus to your knees to begin with. If you still want a few inches more after you're done and the price of internal femoral nails comes down as expected, you might be a good candidate for it. It will be interesting to see your post lengthening alignment.
Did they ask you to stand with a bit of intoeing for that xray (particularly to the left foot) or do you normally stand that way on your own? I'm not sure if that throws off the axis measurement.
When are you and Dr. Parihar expecting you'll be able to walk without the fixators or walkers/canes and semi-normally?
Also how old are you (approx)?
(http://s24.postimg.org/bx6hl8ek5/kilokahn_lines.jpg)
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too much info requested
anyway
kilo, its been about 10 months??? im feeling a bit better... though wont be really good until left leg is fixed... takes forever to heal
youre very realistic about all this though, and seem to have the right attitude
do you have any ballerina?
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Did they ask you to stand with a bit of intoeing for that xray (particularly to the left foot) or do you normally stand that way on your own? I'm not sure if that throws off the axis measurement.
They made me position my feet that way for the x-ray. It felt unnatural to me and isn't how I usually stand but it's the position they take all their x-rays in.
When are you and Dr. Parihar expecting you'll be able to walk without the fixators or walkers/canes and semi-normally?
He hasn't given me a date, just updates me on my healing progress as determined by the x-rays. I expect it will be a few more months until I can walk unaided but I'm not at all sure.
Also how old are you (approx)?
24.
too much info requested
anyway
kilo, its been about 10 months??? im feeling a bit better... though wont be really good until left leg is fixed... takes forever to heal
youre very realistic about all this though, and seem to have the right attitude
do you have any ballerina?
9.5 months as of now. That's good you're feeling better. Any date set on when you're going to get your leg looked at?
I have a small degree of ballerina left but with around 5 minutes of walking my feet go completely neutral. I think I'll make my next big step in progress as far as loosening the muscle goes once I get these frames off and can walk without the ankle wires bothering me.
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getting leg fixed in may or june 1
im feeling ok, but def not 100% but i dont think thats possible until left leg is fixed... disturbs the endtire body
when u eventually take frames off, then eventuall walk without walker, your feet might feel odd
mine do, but again, might be caused by my left leg... i definitely dont experience pain though as i see others post.. just cant walk normally yet
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Update: 4/24/2015
Tomorrow is the 10 month anniversary of my operation date. Hard to believe the surgery was that long ago. I've been walking a lot more, but with the added walking came more frequent pin site infections. I currently have two infections, one on each leg. They're both at an upper wire close to the knee where most of the movement takes place. I had to drain them today and it did not feel good. I'm taking the oral antibiotics so they should be gone soon but I'll expect more to pop up before I get these frames off.
I saw my orthopedist on April 14th. He still thinks I should be okay to take the frames off now, but he's going to wait until Dr Parihar says it's okay since I'm uncomfortable with removing them before that. He thinks Dr Parihar probably just wants to have the frames removed at the one year mark so I'll have 2 months per cm of consolidation. However, he did say that if Dr Parihar says something like "remove them in September" then he'll start to feel uncomfortable, because he said that although thinking about consolidation is important, the longer I wear the frames the longer it will take for me in rehab because my muscles will continue to get tighter and we're continuing to delay restoration of full ROM and muscle strength. He said that once we're ready to take these off he'll still want to loosen the pins first just to see how my bones feel with the added load and then he'll want me to wear walking braces for some more months to be safe.
Latest X-Rays (4/14/2015)
(http://s5d4.turboimagehost.com/t1/22975280_4-14-2015-1.jpg) (http://www.turboimagehost.com/p/22975280/4-14-2015-1.jpg.html) (http://s5d4.turboimagehost.com/t1/22975281_4-14-2015-2.jpg) (http://www.turboimagehost.com/p/22975281/4-14-2015-2.jpg.html) (http://s5d4.turboimagehost.com/t1/22975282_4-14-2015-3.jpg) (http://www.turboimagehost.com/p/22975282/4-14-2015-3.jpg.html) (http://s5d4.turboimagehost.com/t1/22975283_4-14-2015-4.jpg) (http://www.turboimagehost.com/p/22975283/4-14-2015-4.jpg.html)
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Update: 4/24/2015
Tomorrow is the 10 month anniversary of my operation date. Hard to believe the surgery was that long ago. I've been walking a lot more, but with the added walking came more frequent pin site infections. I currently have two infections, one on each leg. They're both at an upper wire close to the knee where most of the movement takes place. I had to drain them today and it did not feel good. I'm taking the oral antibiotics so they should be gone soon but I'll expect more to pop up before I get these frames off.
I saw my orthopedist on April 14th. He still thinks I should be okay to take the frames off now, but he's going to wait until Dr Parihar says it's okay since I'm uncomfortable with removing them before that. He thinks Dr Parihar probably just wants to have the frames removed at the one year mark so I'll have 2 months per cm of consolidation. However, he did say that if Dr Parihar says something like "remove them in September" then he'll start to feel uncomfortable, because he said that although thinking about consolidation is important, the longer I wear the frames the longer it will take for me in rehab because my muscles will continue to get tighter and we're continuing to delay restoration of full ROM and muscle strength. He said that once we're ready to take these off he'll still want to loosen the pins first just to see how my bones feel with the added load and then he'll want me to wear walking braces for some more months to be safe.
Latest X-Rays (4/14/2015)
(http://s5d4.turboimagehost.com/t1/22975280_4-14-2015-1.jpg) (http://www.turboimagehost.com/p/22975280/4-14-2015-1.jpg.html) (http://s5d4.turboimagehost.com/t1/22975281_4-14-2015-2.jpg) (http://www.turboimagehost.com/p/22975281/4-14-2015-2.jpg.html) (http://s5d4.turboimagehost.com/t1/22975282_4-14-2015-3.jpg) (http://www.turboimagehost.com/p/22975282/4-14-2015-3.jpg.html) (http://s5d4.turboimagehost.com/t1/22975283_4-14-2015-4.jpg) (http://www.turboimagehost.com/p/22975283/4-14-2015-4.jpg.html)
Why did you fail a succesfull LL procedure? so i can avoid it in the future. Doing femurs.
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i dont think anything went wrong with his surgery
it takes a while when you go exfix
this is the reality... i love this diary, because kilo's experience is really the average one... its not a bad one... people here just dont like seeing the reality of how long it takes to recover,especially when you dont have nails to take some of the load off
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i dont think anything went wrong with his surgery
it takes a while when you go exfix
this is the reality... i love this diary, because kilo's experience is really the average one... its not a bad one... people here just dont like seeing the reality of how long it takes to recover,especially when you dont have nails to take some of the load off
This is the average procedure? His leg leaking?. Yeah i dont know about this surgery now..if this is kinda normal.
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not leaking
he had 2 infections, which had to be drained
and yes... infections while wearing fixartors happens around 99% of the time
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KiloKAHN, Do you use crutches as aid when you walk or do you use zimmerframe or maybe both?
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not leaking
he had 2 infections, which had to be drained
and yes... infections while wearing fixartors happens around 99% of the time
and no in Volgograd with dr. Barinov infections happen very rarely.
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yes.... with barinov, infections happen too
case in point... rgkey.... he posted photos of his infections
no dr is immune to pinsite infections... if you wear fixators, you will almost always have pinsite infections
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yes.... with barinov, infections happen too
case in point... rgkey.... he posted photos of his infections
no dr is immune to pinsite infections... if you wear fixators, you will almost always have pinsite infections
Man I just told you that it RARELY happens with Dr. Barinov! I did not say it is not happening at all. Am I talking spanish?
I have seen about 15 patients and only one guy had a pinsite infection.
Yes Rgkey had an infection. Does that mean almost everybody has it? No! What kind of argumentation is that?
It rarely happens here. I am here. I see it.
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it means ive seen 1 diary of barinov
and an infection
and there have been studies on this.... vast majority get pinsite infections... not a big deal, but happens with external fixators...
theres multiple foreign objects creating open wounds for months
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Infections are just part of the process while wearing frames. I got infections rarely in Mumbai too, maybe twice or so from what I remember. Once you start walking around a lot more you'll get infections more often because you're continuously irritating the skin around the pin sites.
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This is why I dont do lengthening in India. I am Indian but I will still do lengthening with Paley. With Paley there is no way you will be having frames for one year. I think Parihar probably messed up in surgery to make your bone take so long to heal.
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This is why I dont do lengthening in India. I am Indian but I will still do lengthening with Paley. With Paley there is no way you will be having frames for one year. I think Parihar probably messed up in surgery to make your bone take so long to heal.
I don't think Kilo's doctor messed up...tibias just take a LONG time to heal man.
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Dr. Parihar didn't mess anything, this is just the timeframe it takes for everything to heal up.
I think Kilo's diary is acutally a very succsessful one.
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you will definitely not be in frames a long time if u go to paley... because he doesnt even do externals
ll takes a long time to recover from... my ankles feel normal now just for the last week, and this was about 12.5 months after surgery
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I don't think Kilo's doctor messed up...tibias just take a LONG time to heal man.
Dr. Parihar didn't mess anything, this is just the timeframe it takes for everything to heal up.
I think Kilo's diary is acutally a very succsessful one.
you will definitely not be in frames a long time if u go to paley... because he doesnt even do externals
ll takes a long time to recover from... my ankles feel normal now just for the last week, and this was about 12.5 months after surgery
One full year time is crazy even for externals. So many leg lengthening info says 1 month per centimeter and maybe 1.5 months per centimeter to be safe. So that makes me think Parihar did something to mess up bone healing because otherwise it wouldn't be like this.
Crimson, I know you are taking long too but you had complications with your doctors and did extra surgeries. Kilo didn't have extra surgeries to fix things and it is still taking forever. This is why people say don't go india.
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im doing ok actually
and most people take over a year... not just in india... the person i mentioned that wasnt ok for 15 months went to russia
i do have to fix left leg which sux, but ankles,etc are fine now
kilokahn will get there too
i dont disagree about india though. id avoid it. its possible dr parihar is being too conservative... 12 months in a frame is really going to prolong recovery
i know that me eing in a cast for 9 weeks prolonged mine... took me months to get back to normal... after a year in frames, the recovery time is gonna be insane.... it'll happen though
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One full year time is crazy even for externals. So many leg lengthening info says 1 month per centimeter and maybe 1.5 months per centimeter to be safe. So that makes me think Parihar did something to mess up bone healing because otherwise it wouldn't be like this.
The reason Dr Parihar is on the conservative end for frame removal is because he says it minimizes the incidents of post-op complications that happen with early fixator removal, such as re-fracturing of the bone or bending of the new regenerate. He's been a specialist in Ilizarov surgeries for 24 years, so his recommendation is likely spot on. He's not the only doctor with this philosophy. According to TRS, both Dr Rozbruch and Dr Birkholtz recommend wearing the frames for 2 months per cm lengthened, and for 6 cm lengthening like I've done that would equal 12 months of frame time.
With Paley there is no way you will be having frames for one year. I think Parihar probably messed up in surgery to make your bone take so long to heal.
If Dr Paley was still offering external fixation for cosmetic cases, he'd probably recommend the same as Dr Parihar. Here's the excerpt about external fixation from Dr Paley's website:
External Fixation Alone
When only an external fixator is used, the fixator needs to remain in place for both the distraction and consolidation phases. If the fixator were removed at the end of the distraction phase, the new bone would collapse and reshorten. Therefore, the external fixator needs to remain in place until the regenerated bone appears solid enough on the radiographs (x-rays). At that point, the device can be removed. Often, a cast is applied to temporarily protect the bone from breakage for an additional short time. The total time in the external fixator can be estimated to be approximately 1 month for each centimeter lengthened in children and 1.5 to 2 months or longer per centimeter in adults.
http://limblengtheningdoc.org/limb_lengthening_intro.html
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Hey Kilo has there been any mention of you needing to have a release surgery?
From the diaries I have read it seems to come up often when people go over 7 cm on tibia,
how are you fairing?
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i just read an article that a member here posted about ballerina in tibial lengthening
im convinced now regarding achilles release
mine is fnally almost healed and i definitely would not be doing well with my ankles now if i hadnt have gotten a surgery
ballerina is by far the worst complication of tibial lengthening.... excluding non union
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Hey Kilo has there been any mention of you needing to have a release surgery?
From the diaries I have read it seems to come up often when people go over 7 cm on tibia,
how are you fairing?
I'm able to walk with feet neutral after a couple minutes of walking. The wires near the ankles give me a sharp pain when I walk at times and it prevents me from pushing myself with stretching as much as I'd like to. I think I'll be able to get my dorsiflexion to 20 degrees eventually once I get these frames off. The local orthopedist seems to think so anyway. Dr Parihar doesn't think I need a release also. His tibia lengthening limit is generally 6 cm so I think that's why he rarely needs to do them for equinus treatment.
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Update: 5/8/2015
I'm walking around twice as fast as I was in that walking video I posted. I've been focusing on trying to get my balance back. Tried walking with crutches again and fell about four times. I seriously hate these things and have no idea how anybody manages to walk with them while having frames on both legs. Went back to using the walker which I like a lot better. I put it in front of me and try to stand as straight as possible while taking steps forward with all my weight on one leg while the other is in the air before stepping down. I really stretch out the calves this way, but on one step I felt a huge stretch on my left leg by the ankle and around an hour after that my ankle started swelling badly.
It's been a day and a half now and the pain has only become worse. If I lightly brush my foot across the floor I get heavy pain on the lower sides of the left leg as well as in the Achilles tendona area. Hoping it goes away soon but I stayed in the wheelchair all day today because even standing hurts now. I have my next appointment on the 19th. There should be more progress with the bone healing. Really want to get these frames off come end of June.
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the achilles area just takes time... a long time
im guessing when you walk that your achilles starts to feel incredibly tight?
i would just rest until the area feels okay. i think the achilles tightness is very common. it sucks , but i think the only way it goes away is with time and walking
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Hey crimsontide. At how many cm of lenthening do you think achiles lengthening could be necesary for most people? Around 5/6?
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it depends really
i think kilo and i have the worst combination for lengthening, which is stocky legs with big tight calves
Even with out surgery, achilles area always feels tight for a while. just look at the diaries. everyone that does tibias complains about a tight achilles when walking. takes a while to go away. for people like swden, it never seems to go away
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I think that sweden would be in a better condition if he have done achiles lenghtneing
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yes, i agree
it takes a while to recover from, which is the biggest negative to achilles surgery, but if he would have had it a year or more ago, he'd be much better now
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Quick question: did you have the Achilles Tendon lengthening surgery? If not, how would you prevent ballerina foot? I'm now at about 4 cm of lengthening, I'm going probably for 6.5 or 7 cm, and I'd really like to avoid such surgery..
Lumiere
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Seems that internal femurs are way better surgery to take on. Less compliactions and more aestethic than long tibias.
What is the best doctor for itnernal femurs and what is the cost Thanks !!! XO
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the achilles area just takes time... a long time
im guessing when you walk that your achilles starts to feel incredibly tight?
i would just rest until the area feels okay. i think the achilles tightness is very common. it sucks , but i think the only way it goes away is with time and walking
The tightness is still there, but it's gotten better. The main issue I have now from the sprain is that I get very sore near the left ankle joint on my left leg. If I touch it it feels like I have a bad bruise.
Quick question: did you have the Achilles Tendon lengthening surgery? If not, how would you prevent ballerina foot? I'm now at about 4 cm of lengthening, I'm going probably for 6.5 or 7 cm, and I'd really like to avoid such surgery..
Lumiere
My surgeon told me he didn't think achilles lengthening was necessary and that over time with stretching I'd be okay. He doesn't really like to perform achilles lengthening unless he finds it absolutely necessary. His lengthening limit is 6 cm so that's probably why he doesn't have to do it as much. If I did 7 cm I feel like I probably would have needed it.
Best thing to do is constantly do your ankle stretching exercises and stand as much as you can. Wear your straps to keep your feet neutral as much as you can, too. You might end up with equinus anyway though and if it's severe enough your doctor might recommend the tendon lengthening anyway. He does that for a lot of his lengthening patients, right?
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Seems that internal femurs are way better surgery to take on. Less compliactions and more aestethic than long tibias.
What is the best doctor for itnernal femurs and what is the cost Thanks !!! XO
How is this troll still on the forum?
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Keep up the good work. You're well on your way. Hope everything feels great once those frames come off.
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Hopefully will see pics of you after frame removal and have a nice time bro ....
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Update: 5/19/2015
Went to the ortho today and for the first time used my walker to get around the building instead of my wheelchair, so everyone was a bit surprised to see me standing up. I took x-rays and waited a bit for my ortho, who showed me what the x-rays looked like and revealed that my left fibula is finally fully connected. The consolidation looks good on the left leg and he said he'd even be confident removing the frame now. The right leg has good consolidation on the tibia, but on the fibula he said it doesn't look like it will consolidate fully. The regenerate was really good up to a certain point, but then the regenerate narrowed and it looks like it will only connect at a very narrow point, kind of like the narrow middle portion of an hourglass. He said it's not a big deal though because the fibula isn't responsible for the weight bearing.
He's interested in doing a two-stage frame removal and thinks I should see him at the end of June to get my left frame removed and then keep the right frame on for another month or so before I go back to him to remove that one. I need to see what my co-pay for surgery will be though, because if it's really pricey then he's just going to remove them both at the same time when he feels the right leg is ready.
His assistants removed all my dressings and we saw that on some of my pinsites I have granulation tissue forming. They look like blood pockets. He was also concerned about the amount of drainage coming out of the pinsites on both legs, so he took a sample from each leg and he's going to have them tested to make sure I don't have any antibiotic-resistant bacteria. He's concerned about me getting a bone infection later so he prescribed me a really strong antibiotic that I'm going to pick up tomorrow.
Right now my frame removal surgery is tentatively scheduled for June 29.
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Dude screw a two stage removal. Just do one surgery to get it both removed and you will get it over with. Might as well just leave the left one on a little longer until the right one catches up.
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Hey Kilo is there any reasons as to why your fibula won't fully consolidate?
What was your rate of lengthening btw.
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Hey Kilo is there any reasons as to why your fibula won't fully consolidate?
What was your rate of lengthening btw.
Not that we know of. My regenerate on the right fibula was looking really good up until recently, maybe like the last month or so, and from that point on the regenerate started thinning out and getting narrow in the center. I'm told it's not really an issue as the fibula is only responsible for weight bearing, although it does have a role in stability. The only thing it will affect is that my ortho wants to be a little more cautious about removing the frame.
My rate was .75 mm throughout distraction except for a week where I alternated between .75 and 1 mm every other day. But the regenerate was normal throughout my entire lengthening phase and this narrowing happened during consolidation.
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I assume no major changes in activity or diet in the past month.
What did Parihar have to say about it? Has he seen it happen before?
I have heard that fibula is often used for bone grafts so it is not a major
issue if it doesn't consolidate but obviously it's something you would
prefer to rather than not.
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Latest X-Rays (5-15-2015)
(http://s5d4.turboimagehost.com/t1/23232537_5-15-2015-1.jpg) (http://www.turboimagehost.com/p/23232537/5-15-2015-1.jpg.html) (http://s5d4.turboimagehost.com/t1/23232539_5-15-2015-2.jpg) (http://www.turboimagehost.com/p/23232539/5-15-2015-2.jpg.html) (http://s5d4.turboimagehost.com/t1/23232541_5-15-2015-3.jpg) (http://www.turboimagehost.com/p/23232541/5-15-2015-3.jpg.html) (http://s5d4.turboimagehost.com/t1/23232543_5-15-2015-4.jpg) (http://www.turboimagehost.com/p/23232543/5-15-2015-4.jpg.html)
So as a reminder of what I updated earlier, when my local orthopedic surgeon went over the x-rays with me, he told me that he thinks I'm going to have incomplete consolidation of my right fibula. He said he doesn't think it's a big deal because the fibula isn't responsible for weight bearing, but because of how the consolidation is going he said he wants to do a two-stage removal of the frames. He said he thinks the left frame should be removed on June 29th and then he wants to wait a little longer to remove the right one. I was also told that he would be uncomfortable leaving the frames on too much longer because he said the more my pin sites open up the larger my chances are of getting a bone infection.
Turned out I don't have any antibiotic-resistant bug. Just had mild staph infection that should be treated with the antibiotics he gave me (clindamycin).
Radiologist left some notes on my x-rays this time and said I have periarticular osteopenia at the ankles (there are other x-rays of the lower leg which show my ankles) and knees bilaterally.
I sent my x-rays to Dr Parihar with my concerns and await his reply.
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wish you the best kilo
I'd be concerned about ankles, but this is the risk we take
Your leg though looks a bit crooked to me?? the second x ray from the left. i might be wrong though
Eventually, even if it takes a year more, you'll be okay. this surgery seems to never go according to plan
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I was told that the curvature just looks more than it is because my tibias were naturally curved and elongating the gap just makes it look more pronounced. On all my radiology reports they say that the alignment is normal and Parihar and the local ortho haven't said anything about it being off. So I'm guessing that aspect is okay. I've been taking this supplement called Bone Up since just after my last x ray to try to help with the bones. Hope it works.
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Radiologist left some notes on my x-rays this time and said I have periarticular osteopenia at the ankles (there are other x-rays of the lower leg which show my ankles) and knees bilaterally.
That's too bad about the incomplete consolidation of the fibula. I wonder if it will consolidate further once the frames are off. Even if it doesn't affect weight bearing, obviously it would be preferable if it consolidates.
As for the osteopenia, I wouldn't worry even in the slightest. Just don't go playing any rugby right now. :) Your bone mineral density will improve rapidly once the frames are off and you are full weight bearing. As a young otherwise healthy guy, your bone mineral density should bounce to original levels within at most a year or two. It shouldn't affect your day to day function in any way in the interim.
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I guess I'm not too worried about the incomplete fibula consolidation. Even if the ends are going to consolidate at a narrower point, it's at least going to attach. Better than having a complete gap between the bone ends. Fortunately the regenerate on the tibia turned out more bulbous than the original bone, so that should make up for it. Just strange that it happened though, because I haven't been doing anything differently and the regenerate was coming at the same width as the rest of the fibula at first. Other fibula didn't have any problem too, so it just strikes me as odd.
The osteopenia mainly sucks because Dr Parihar mentioned it happening months ago and told me to work on it with more walking, yet I haven't been able to reverse it. I probably disappointed him a little in that regard lol.
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Kaiser Permanente insurance is so great. My frame removal surgery is only going to cost me $250.00 USD. Was worried it was going to be a few thousand.
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Good news on the financial saving. Also, agreed on the fibula. As long as it connects it should be fine. Only problem with a weak connection is you're prone to breaking it in the future if you get in any trauma. But I guess then avoid trauma. :)
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what do we think about Exogen system for bone consoldation/
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Driver accelerated into the back of a Ford instead of breaking at the light and when it hit I was thrust forward ontothe dashboard and all my weight was put on my left leg to brace myself from the impact. It got really swollen and I can't lift it now so I'm heading to the ortho for an early x-ray to see if anything happened with the regenerate or alignment.
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Ooooh. That's scary. Good luck. Hopefully it's all just bruised.
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Sorry to hear that Kilokhan. Any update from the X-Ray yet?
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that sucks
youll be a better man after all this
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So sorry Kilo. Sending positive thoughts your way. You're tough, you'll be fine!
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You'll make it Kilo, I know you will. You're not the kind of guy that gets shut down by something like this.
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Omg so sorry to hear about the accident. Prayers sent Kilo.
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Wishing you the best, Kilokahn. Very sorry to hear about the accident. After all you've been through already, I'm confident that this experience will only make you a stronger man capable of handling whatever life throws at him.
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crap!!! so sorry to hear of it.
How are you now, what do the x-rays say??
*fingers crossed* you'll be fine!!!
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so this is my first post on this forum , i went through your patient diary from day first and was very happy that finally someone has done LL in India with no serious complications but im worried about what happened to you and i hope your driver's blunder hasn't ended up in a mess :-[
Please update kilo i think all are waiting to know what happened to you :-\
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Update: 6/16/2015
Thanks for the well wishes guys. I just got back from my pre-op appointment to get a final set of x-rays before surgery as well as talk about what the procedure will be like and how I'll proceed with rehab. When I got my x-rays after the road accident everything looked okay. He did say that because of the way my tibias naturally curve there's a slight degree of misalignment - he estimated about 3 degrees or so just based on eye view - but he said that the knee and ankle joints are level and aligned properly, which is where alignment really matters. I don't have any risk of osteoporosis or anything and he said it's nothing to worry about.
Good news is that my right fibula looks like it's going to fully consolidate after all. He was pretty shocked at how much the consolidation has progressed there within the last month. It's definitely due to a combination of pushing myself to walk constantly throughout the day and taking my Bone-Up supplements with strict discipline. Because of the progress he decided that we'll take off both frames on June 29th instead of just taking off the left one and waiting a month for the right one like he originally intended.
After surgery I will be given walking braces to wear for a few months. I might decide to keep them on for a really long time just to be extra safe and make me feel more confident. One point I had to take note of is that for a few weeks I'll have to wash my legs with soap and water daily but I'm not allowed to immerse myself in bath water or anything until the pin sites have healed sufficiently. I'm also going to resume physiotherapy once a week at a nearby clinic after I have my post-op appointment two weeks after frame removal.
I notified my ortho that I still get muscle pains and asked if it should go away once the frames are off. He said that the trade off with the lengthening and growth of new bone is that I'll now have to deal with muscle tightness, which is the cause for the random pains. However, he said that with consistent physiotherapy I can get rid of the muscle tightness eventually. It's just something I need to be really dedicated towards improving.
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Wow.. Thats some good news bro. :)
Wish you all the best for your frame removal, and hope for a speedy recovery.
Also do you know how long it will take, after your frame removal, for you to walk normally?
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Good to hear Kilo!
Keep up the discipline, great work :)
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I'm glad to hear that you're fine.
What does Dr.Parihar say about your recent X-rays?
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Glad to hear you're ok man. I was legit worried about you and have actually been thinking about you. Stay strong my friend!
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Happy and relieved that things turned out to be fine. Keep it up :)
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Wow.. Thats some good news bro. :)
Wish you all the best for your frame removal, and hope for a speedy recovery.
Also do you know how long it will take, after your frame removal, for you to walk normally?
No idea how long it will take me to walk unaided yet. I'll probably try walking more unaided as soon as the frames are off though because falling will hurt a lot less.
I'm glad to hear that you're fine.
What does Dr.Parihar say about your recent X-rays?
I haven't sent any to him yet. I first have to wait for another radiologist to review them and make a report, then I have to call in and request a copy on a CD and pick it up from the clinic before I upload it onto the PC and e-mail them to Dr Parihar. Usually takes me about a week and a half to get them to him after they're first taken.
Good to hear Kilo!
Keep up the discipline, great work :)
Glad to hear you're ok man. I was legit worried about you and have actually been thinking about you. Stay strong my friend!
Happy and relieved that things turned out to be fine. Keep it up :)
Thanks. Just one week now until the one year anniversary of my surgery! Can't believe it's been that long already.
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Today I say Happy Anniversary to frames. One year ago today exactly I had the biggest surgery of my life.
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Today I say Happy Anniversary to frames. One year ago today exactly I had the biggest surgery of my life.
Congrats! Just passed my 6 month anniversary last week.
I found a picture of my legs just hours after surgery on my iPad. I totally forgot that I took that picture. Maybe I'll post it on here as a throwback lol
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Congrats KiloKhan.. 2 months in frames, and I am already tired of them. I can only imagine the level of patience, and commitment required to be in frames for a year.. Hats off for that bro :)
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Congrats! Just passed my 6 month anniversary last week.
I found a picture of my legs just hours after surgery on my iPad. I totally forgot that I took that picture. Maybe I'll post it on here as a throwback lol
That would be cool to see. Looking at pics from early on in this diary it's still hard to remember the pain I was in during those days. It's like a distant memory.
Congrats KiloKhan.. 2 months in frames, and I am already tired of them. I can only imagine the level of patience, and commitment required to be in frames for a year.. Hats off for that bro :)
The frames do get annoying, but you'll be out of them eventually and will feel much better. How's everything on your end? All still going okay?
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The frames do get annoying, but you'll be out of them eventually and will feel much better. How's everything on your end? All still going okay?
Yea, everything is good so far. A bit of stiffness in ankles, but luckily nothing close to ballerina foot. A few minutes of excercise is bringing back the flexibility in the ankle. And as I am only doing 5 cms, I hope I will not get any major issues.
Also I am eagerly waiting for your frame removal bro.. Fingers crossed..
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Latest X-Rays (6-17-2015)
Report says "External fixation hardware along the bilateral lower legs is stable in appearance. The osseous structures are stable in alignment." Just sent Dr Parihar the x-rays and notified him of my frame removal surgery on the 29th. Asked him for advice on how I should handle walking for the first few weeks after frame removal.
(http://s5d2.turboimagehost.com/t1/23432379_6-17-2015-1.jpg) (http://www.turboimagehost.com/p/23432379/6-17-2015-1.jpg.html) (http://s5d2.turboimagehost.com/t1/23432380_6-17-2015-2.jpg) (http://www.turboimagehost.com/p/23432380/6-17-2015-2.jpg.html) (http://s5d2.turboimagehost.com/t1/23432381_6-17-2015-3.jpg) (http://www.turboimagehost.com/p/23432381/6-17-2015-3.jpg.html) (http://s5d2.turboimagehost.com/t1/23432382_6-17-2015-4.jpg) (http://www.turboimagehost.com/p/23432382/6-17-2015-4.jpg.html)
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Looking good - Soon will be the 29th - Soon you will be walking without aid :-)
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Have you figured out how you're going to celebrate your frame removal day yet? Make it something special. It's a big day. You've earned it.
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This is a picture of one of my swollen feet. but the other foot looks the same. I get this bad swelling every once in a while after I've done a lot of walking. Sometimes it gets so swollen that it hurts and I can't even move my ankle without enormous pain. Just because you stop lengthening doesn't mean you won't get ankle pains and swelling like this or random muscle pains on your calves. I'm hoping it lessens in severity once the frames are off, but we'll see.
(http://s5d2.turboimagehost.com/t1/23451959_swollen_foot_june_29.jpg) (http://www.turboimagehost.com/p/23451959/swollen_foot_june_29.jpg.html)
Looking good - Soon will be the 29th - Soon you will be walking without aid :-)
Hopefully. Not sure how many months it will take me to walk without the walking aid. I might also walk around in my leg braces a few months longer than I have to just to be safe.
Have you figured out how you're going to celebrate your frame removal day yet? Make it something special. It's a big day. You've earned it.
Not yet. I might go and buy myself a six-pack of my favorite beer or something. Or stop the low-carb thing for a day and get some french fries.
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damn, that's swollen
but it happened to me too. definitely has a lot to do with the frames around the ankles. my feet went down right after i had frames taken off
its better to be cautious and take it slow. aim to walk well in around 5 to 6 months. wont need any additional surgeries this way
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wow, that's really swollen dude! particularly on the foot because the foot is supposed to be all bony.
Hope it goes away frame removal. Good luck!
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Just filled out my pre-op paperwork and am waiting in the lobby to get called in by the nurse for surgery prep. Little less than two hours and I'll be free of these devices. Surgeon told me he'll give me back the rods, pins, and rings to keep. He's just going to dispose of the sharp wires. I'll have a symbol of this difficult process to keep with me forever.
damn, that's swollen
but it happened to me too. definitely has a lot to do with the frames around the ankles. my feet went down right after i had frames taken off
its better to be cautious and take it slow. aim to walk well in around 5 to 6 months. wont need any additional surgeries this way
These damn ankle rings and wires, man! Lol. They're the most irritating part about consolidating and waiting. Yeah Im in no hurry to push myself. I'll be cautious for a hood few months.
wow, that's really swollen dude! particularly on the foot because the foot is supposed to be all bony.
Hope it goes away frame removal. Good luck!
Thanks. I hope I don't have clown feet like this forever, hah.
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This is a picture of one of my swollen feet. but the other foot looks the same. I get this bad swelling every once in a while after I've done a lot of walking. Sometimes it gets so swollen that it hurts and I can't even move my ankle without enormous pain. Just because you stop lengthening doesn't mean you won't get ankle pains and swelling like this or random muscle pains on your calves. I'm hoping it lessens in severity once the frames are off, but we'll see.
(http://s5d2.turboimagehost.com/t1/23451959_swollen_foot_june_29.jpg) (http://www.turboimagehost.com/p/23451959/swollen_foot_june_29.jpg.html)
Hopefully. Not sure how many months it will take me to walk without the walking aid. I might also walk around in my leg braces a few months longer than I have to just to be safe.
Not yet. I might go and buy myself a six-pack of my favorite beer or something. Or stop the low-carb thing for a day and get some french fries.
Oh god.. how long does it take for swelling to subside generally? Thankfully my legs are not swollen, but I have calf muscle pain in the left leg from a week and as usual ankle stiffness. Now may be due to calf muscle pain, but I am not able to make my knee completely straight. Issues are building up in my left leg, and I am not able to get it back to normal what ever I do. Right leg is completely fine. The only reason I could think of is, left leg has higher degree of bow angle to start with, compared to right leg. Dr. Dhawan is out of country from 10 days. May be once he is back, I will check if he has any suggestions for me.
I think your frames are off by now. Happy for you dude.. !! Post some pics..
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Oh god.. how long does it take for swelling to subside generally? Thankfully my legs are not swollen, but I have calf muscle pain in the left leg from a week and as usual ankle stiffness. Now may be due to calf muscle pain, but I am not able to make my knee completely straight. Issues are building up in my left leg, and I am not able to get it back to normal what ever I do. Right leg is completely fine. The only reason I could think of is, left leg has higher degree of bow angle to start with, compared to right leg. Dr. Dhawan is out of country from 10 days. May be once he is back, I will check if he has any suggestions for me.
I think your frames are off by now. Happy for you dude.. !! Post some pics..
I don't really know what the average rate is. I think it alleviates in the morning after having them elevated for the whole night. Just keep doing your stretching exercises as much as you can. You're right to contact Dr Dhawan and ask for advice though.
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Update: 6/29/2015
Frames are off after one year and 4 days!
The day has finally come. My frames are off and I instantly feel a whole lot better. My legs feel a bit light and loose after moving without that weight on them that was present for so long.
Now I have these nifty walking braces to wear for the remainder of consoliation.
(http://s5d4.turboimagehost.com/t1/23454393_unnamed.jpg) (http://www.turboimagehost.com/p/23454393/unnamed.jpg.html)
When I arrived at the hospital at 4:30am I waited for a half hour before the receptionist arrived. She took my info and signature and had me fill out a questionnaire for the anesthesiologist. When the nurse called me in, I was taken to a scale that can fit wheelchairs on it. She weighed me before taking me over to the bed and weighing my wheelchair so she could subtract the difference and find out my weight.
[As of April 2014 when I was last weighed, I was 99 kg or 218 lbs. I found out today that with the frames on I weighed 80.1 kg or 176.5 lbs. A lot of it is muscle loss but it's also fat loss as I've been eating a lot healthier and cut out all the flour and artificial sugars from my diet. Should make it easier for walking around.]
I changed into my patient cap and gown and then my mom was brought in to wait with me while I was attached to an IV and heart monitor. My orthopedist showed up not long after and explained that the procedure would take about an hour, answered some of her other questions, and said because of my muscle tightness I'll need many months of physical therapy to ensure I get a very positive outcome. I also met with the anesthesiologist and my surgeon's assistant, who were both very friendly and answered questions. There was another guy that came out to take me to the OR and once I was inside and transferred to the operating table I had the oxygen mask put on and was out like a light.
I woke up to a very attractive nurse named Stacey greeting me. She fed me a spoonful of ice and cranberry juice to help alleviate the dry mouth I had upon awakening. We made small talk for a while and an Indian nurse stopped to join our conversation once she heard me say I was in Mumbai, as that is where she is from.
When I looked at my legs I could see that the frames were off, but only one of them had a walking brace on it. My surgeon's assistant Roger came out after the nurse called him to ask about that and he explained that for the only size that fit my tibia (medium), they only had a single walking brace there. He made a call and after I left the hospital I went to the building I usually go to for appointments and was fitted with the left one. Before I left the hospital a nurse asked if I wanted the visiting priest there to bless me and I declined. the nurse got mad and said "You do realize that it's because of our Lord and Savior Jesus Christ that you're here on this Earth, right?" and my mom joined in on voicing her disapproval. I ended up running into the priest later when another nurse named Honey escorted me to the parking lot and she asked him to bless her. He touched her head and did a blessing and then said it extends to me also.
I'm not allowed to be near my cat until these holes close up. The skin is wrapped in bandages and I'm taking antibiotics again because some pus was present in a few of the holes when the pins were removed. I've been given a narcotic called Norco for pain relief to be taken as necessary.
Planned to take my frames home but because there are so many parts it was taking hours to sterilize. I'm going to pick them up tomorrow.
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My right foot was swollen after I finished LL, right after clicking, but it went away after like a day (and was never that bad). Crazy!
Congrats on getting the frames off man. You are seriously a trooper. Very happy for you.
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jesus an entire year man, that's way too long.
i noticed on the first page you said you were aiming for 5.5cm, and your 165 which is about my height, so why did 5.5cm take you a year to remove frames.
and yeah pretty funny about that discussion you had with your local doctor about your height you mentioned in the first page, i had same discussion with mine, i was in 3.5cm lifts and we were both the same height, but then again after LL i'd be taller than him so yeah i kinda felt a bit odd in that situation as well.
but i don't see why you should be embarresed about admiting you want to be taller if you were 165 that's really short so yeah.
and yeah your soo lucky to have 170 wingspan, for me its just 1 LL i only have 167 wingspan so i have no hope of getting to 5 9 , so will have to settle on 5 7, such is life.
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Congrats Kilo
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Congrats Dude.. You should really celebrate this event.. :D
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congrats man , it has been hard but here is the recompense
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Congratulations
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Such happy for you man, keep us informed about your recovery!
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You did it, way to go man!
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Do you think you got swollen feet as a punishment from the lord/savior Jesus Christ? :P
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Very happy for you. Post op, post lengthening, and now just getting back to life. And no major complications besides the time it took being longer. Well done.
I hope I'm as successful as you when it's my turn.
Congratulations.
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"You do realize that it's because of our Lord and Savior Jesus Christ that you're here on this Earth, right?"
Lol'd.
Grats on the liberation. Take care.
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Over a year for 6 cm? LOL
Should have done 10 cm and gone with internals man.
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Over a year for 6 cm? LOL
Should have done 10 cm and gone with internals man.
10 cm in one section will cause disproportion
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Thank you all for the kind words.
Here's a picture of what my legs currently look like. Some granulation tissue needs to be burned out in a couple weeks and it's what makes some of the holes darker than the others.
(http://s5d2.turboimagehost.com/t1/23482811_leg_scars.jpg) (http://www.turboimagehost.com/p/23482811/leg_scars.jpg.html)
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I thought 6cm would take 10 months, was there some issues along the way, sorry if I didn't read the whole diary accurately.
I think maybe you should get scar revision as well, they look like nasty holes, do you know if monorail scars would be worse?
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Looks like you didn't have much pin cutting, which would've been painful and made the scars into lines rather than dots. I had really bad pin cutting.
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I thought 6cm would take 10 months, was there some issues along the way, sorry if I didn't read the whole diary accurately.
I think maybe you should get scar revision as well, they look like nasty holes, do you know if monorail scars would be worse?
My local ortho wanted to take them off after 10 months, but Dr Parihar said there'd be a risk of the regenerate bending if I took them off then, so we waited for the 1 year mark which would equal 2 months of consolidation per cm lengthened. Within the normal healing range.
Looks like you didn't have much pin cutting, which would've been painful and made the scars into lines rather than dots. I had really bad pin cutting.
Did you have them around both the knee and the ankle? For the other wires by the knee, Dr Parihar made the holes bigger so they'd have some room and not tear the skin there as much. Was kind of irritating because they let out a lot more ooze than the other holes.
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Holy dude - awesome. Those scars look badass. You could do like the joker and make up a different story every time. "I took a shotgun blast to the legs", "A grenade went odd nearby and I got hit with the shrapenal", etc. Tell them you were an army get, a bear hunter, a debt collector for the mob. ;D
Seriously though, cool scars. I imagine you'll want to get rid of them, but you could also wear them like badges of honour. Souvenirs of your journey and fight.
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I think this is a fake diary like that other India one. How do we know that this is even a real patient when we haven't seen his face or a picture uploaded where he's written his username on a paper and is holding it next to his frames?
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Holy dude - awesome. Those scars look badass. You could do like the joker and make up a different story every time. "I took a shotgun blast to the legs", "A grenade went OFF nearby and I got hit with the SHRAPNEL", etc. Tell them you were an army VET, a bear hunter, a debt collector for the mob... ;D
Wow typos that's what I get for trying to use a phone to post.
I think this is a fake diary like that other India one. How do we know that this is even a real patient when we haven't seen his face or a picture uploaded where he's written his username on a paper and is holding it next to his frames?
Agreed. It's clearly all prosthetics, makeup, and Hollywood magic.
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Holy crap dude - awesome. Those scars look badass. You could do like the joker and make up a different story every time. "I took a shotgun blast to the legs", "A grenade went odd nearby and I got hit with the shrapenal", etc. Tell them you were an army get, a bear hunter, a debt collector for the mob. ;D
Seriously though, cool scars. I imagine you'll want to get rid of them, but you could also wear them like badges of honour. Souvenirs of your journey and fight.
Hah, I'll probably have to come up with some stories. They should be a lot less noticeable over time though, especially once the granulation tissue is removed since my legs are kinda hairy. The scars don't really bother me though. I'm just happy I didn't get a severe case of x-legs or anything.
I think this is a fake diary like that other India one. How do we know that this is even a real patient when we haven't seen his face or a picture uploaded where he's written his username on a paper and is holding it next to his frames?
Shoot, and here I thought my secret was safe.
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Alternatively:
- You were wading through the waters of Amazon hunting for rare orchids and you were attacked by a swarm of ravenous snakes/leeches/piranha.
- You were rescuing your buddy from behind enemy lines. On the way back your legs got tangled in some barbed wire ... But like hell if that was going to stop you!
- A woodpecker mistook your legs for tree trunks, and you were too passed-out drunk to notice until after the damage was done.
Okay that's all I've got. I'll stop now. :)
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The woodpecker one made me lol. I'm going to definitely respond with that one and see how it goes.
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Alternatively:
- You were wading through the waters of Amazon hunting for rare orchids and you were attacked by a swarm of ravenous snakes/leeches/piranha.
- You were rescuing your buddy from behind enemy lines. On the way back your legs got tangled in some barbed wire ... But like hell if that was going to stop you!
- A woodpecker mistook your legs for tree trunks, and you were too passed-out drunk to notice until after the damage was done.
Okay that's all I've got. I'll stop now. :)
I enjoyed reading this, good post ;D
My local ortho wanted to take them off after 10 months, but Dr Parihar said there'd be a risk of the regenerate bending if I took them off then, so we waited for the 1 year mark which would equal 2 months of consolidation per cm lengthened. Within the normal healing range.
Congratulations on removing your frames. Life must be tremendously better now!
What is your local ortho's impression about Dr.Parihar's surgical skills and his work on your legs?
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Congratulations on removing your frames. Life must be tremendously better now!
What is your local ortho's impression about Dr.Parihar's surgical skills and his work on your legs?
Everything feels so much better now. It's awesome to be able to sleep so easily and get in a bathtub with no hassle. I feel slight pain at times on some of the pin sites that haven't completely healed, and brief pangs of muscle pain on the calves, but I suspect those will subside in time.
My doc hasn't commented on what he's thought of Dr Parihar's technique, although he did say it's a good thing that I went to a prior fellow of Dr Paley. He did think that Dr Parihar was being too conservative in waiting to remove the frames, though. But because I don't have any misalignment, non-union, or x-legs, I'd say he did a good job.
Current ortho did his training with Dr Mark Brinker: http://drbrinker.com/mark-brinker-md/index.html
He's a surgeon I coincidentally had contacted a long time ago to see if he offers CLL, but his office responded that he doesn't.
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if I saw those scars on a person the only thing I could think of is maybe someone shot you at close range with a bb gun or something.
but yeah explaining the scars would be far too hard to do, especially since they exist only on your lower leg and are practically symmetrical to each other, which indicates it wont be an accident or something.
I think if you can get rid of the bottom scars, it would look 10x more normal, so maybe you just have to get rid of half of them.
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Your legs look good KiloKhan.. scars will heal over time, and most of them will not be so visible in a month or so. Did you try walking after the frame removal? How was that experience?
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if I saw those scars on a person the only thing I could think of is maybe someone shot you at close range with a bb gun or something.
but yeah explaining the scars would be far too hard to do, especially since they exist only on your lower leg and are practically symmetrical to each other, which indicates it wont be an accident or something.
I think if you can get rid of the bottom scars, it would look 10x more normal, so maybe you just have to get rid of half of them.
There's a cosmetic center that does scar removal nearby. I might drop in just to see what their prices are, but I'll wait and see how well these hide after healing for a while.
Your legs look good KiloKhan.. scars will heal over time, and most of them will not be so visible in a month or so. Did you try walking after the frame removal? How was that experience?
Thanks. I haven't tried walking unaided because my ortho told me to take it easy and put a little more weight on my left leg for now until later x-rays show some more healing in the right leg. But walking without the frames certainly feels much better and my legs feel very light. I received my frames back after they were disinfected and they're really heavy. Can't believe I was walking with those this whole time.
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There's a cosmetic center that does scar removal nearby. I might drop in just to see what their prices are, but I'll wait and see how well these hide after healing for a while.
Thanks. I haven't tried walking unaided because my ortho told me to take it easy and put a little more weight on my left leg for now until later x-rays show some more healing in the right leg. But walking without the frames certainly feels much better and my legs feel very light. I received my frames back after they were disinfected and they're really heavy. Can't believe I was walking with those this whole time.
I will definitely opt for scar removal later, at least for that nasty fibula scar. Though other scars are hardly visible under the hair on my leg, the scar made for fibula is long, and easily recognizable. I love wearing shorts, and I do not want to be cautious about scars all my life. But some say laser scar removal also removes the hair around the scar, in that case we are drawing attention to the scar, highly counter productive. I hope it is not true. :)
Just waiting for the day when my frames will be off my legs. I spoke to one of the current patients of Dr.Dhawan who is in consolidation phase right now. She said my frames will become more heavy once they replace the struts with rods, after lengthening. Not sure how heavy they would be, my frame weight is comfortable right now, may be got used to them, but any more added weight will make them heavier for my legs.
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Your tibiae don't look very long at all Kilo. You wanna post a pick with your whole leg in it so we can see the femur/tibia difference?
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Your tibiae don't look very long at all Kilo. You wanna post a pick with your whole leg in it so we can see the femur/tibia difference?
I'm not allowed to stand without the walking braces yet, so it'll be hard to see the difference between tibs and femurs clearly. Here's one of my legs while lying down though. That work?
(http://s5d2.turboimagehost.com/t/23553225_Kilokahn_Postop_Legs.jpg) (http://www.turboimagehost.com/p/23553225/Kilokahn_Postop_Legs.jpg.html)
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Mate your tibiae don't look too long at all, hard to say for sure but I think your biomechanics might be safe.
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wow your tibias must have been tiny before hand.
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Hello Kilo do you have measurements of your femur and tibia length?
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The camera angle is making your femur look very long, and the tibia very short. That pic will not help in measuring your Tibia-Femur ratio. Instead, if you have a standing X-Ray, taken after lengthening, that should help. Alternately, a similar picture, if taken by some one else with camera directly above your knees, might give better results.
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I'm going to need to find someone willing to take a pic of me in my underwear. Went to the ortho today and saw his assistant (ortho that I've been seeing now works at another clinic) to get my granulation tissue burned off and I was told that they don't do standing x-rays because the radiation is dangerous to your reproductive system. Have to ask my regular ortho when I see him in four weeks and request it once again. If they won't do it then I may have to find some other place where they won't object to it.
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I will definitely opt for scar removal later, at least for that nasty fibula scar. Though other scars are hardly visible under the hair on my leg, the scar made for fibula is long, and easily recognizable. I love wearing shorts, and I do not want to be cautious about scars all my life. But some say laser scar removal also removes the hair around the scar, in that case we are drawing attention to the scar, highly counter productive. I hope it is not true. :)
Just waiting for the day when my frames will be off my legs. I spoke to one of the current patients of Dr.Dhawan who is in consolidation phase right now. She said my frames will become more heavy once they replace the struts with rods, after lengthening. Not sure how heavy they would be, my frame weight is comfortable right now, may be got used to them, but any more added weight will make them heavier for my legs.
The frames sure are heavier than you'd expect. I was shocked at how heavy the disassembled frames were in my hands after I got them back all disinfected.
I wouldn't worry too much about the fibula scars. My fibula osteotomy cuts were quite long, as you can see:
http://www.limblengtheningforum.com/index.php?topic=634.msg12881#msg12881
But right now you can't even tell where the incision was made:
(http://s5d3.turboimagehost.com/t1/23572401_left_leg.jpg) (http://www.turboimagehost.com/p/23572401/left_leg.jpg.html) (http://s5d3.turboimagehost.com/t1/23572402_right_leg.jpg) (http://www.turboimagehost.com/p/23572402/right_leg.jpg.html)
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I'm going to need to find someone willing to take a pic of me in my underwear. Went to the ortho today and saw his assistant (ortho that I've been seeing now works at another clinic) to get my granulation tissue burned off and I was told that they don't do standing x-rays because the radiation is dangerous to your reproductive system. Have to ask my regular ortho when I see him in four weeks and request it once again. If they won't do it then I may have to find some other place where they won't object to it.
LOL in Beijing they give you, no kidding, a small plastic bag with lead in it that you hold in front of your junk during the standing x-ray. ;D
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I'm going to need to find someone willing to take a pic of me in my underwear. Went to the ortho today and saw his assistant (ortho that I've been seeing now works at another clinic) to get my granulation tissue burned off and I was told that they don't do standing x-rays because the radiation is dangerous to your reproductive system. Have to ask my regular ortho when I see him in four weeks and request it once again. If they won't do it then I may have to find some other place where they won't object to it.
Don't worry about taking an X-Ray now. We are just curious to know specifics.. I would not put my manhood at stake to satisfy someone's curiosity.. LOL But your proportions look very normal, I wouldn't worry about 1 cm here and there, hardly anyone will notice.
Your fibula scars are almost invisible. I couldn't find it even when I zoomed the picture. Great!!
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In other news, today I graduated from using the walker to using crutches. My ankles now have enough flexibility where I can walk on my feet using the crutches without falling now, too. So much nicer to use and far less cumbersome and noisy. I'm hoping I can walk on my own soon after my appointment next month. The only thing stopping me from trying it out now is that I want to get an updated x-ray to see the most recent state of my bone healing first.
LOL in Beijing they give you, no kidding, a small plastic bag with lead in it that you hold in front of your junk during the standing x-ray. ;D
Need to get myself a bag of lead. Check. :D
Don't worry about taking an X-Ray now. We are just curious to know specifics.. I would not put my manhood at stake to satisfy someone's curiosity.. LOL But your proportions look very normal, I wouldn't worry about 1 cm here and there, hardly anyone will notice.
Your fibula scars are almost invisible. I couldn't find it even when I zoomed the picture. Great!!
Yea well now I'm curious, haha. I might just pull out some measuring tape tonight just to have a rough estimate.
Yea the fibula cuts fading so well surprised me. For the other scars, my ortho's assistant said regularly massaging and rubbing them with vitamin E will make the scars fade quicker and the indentations rise up, so I'm going to head to the Vitamin Shoppe tonight since I don't have any vitamin E on me.
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Yea the fibula cuts fading so well surprised me. For the other scars, my ortho's assistant said regularly massaging and rubbing them with vitamin E will make the scars fade quicker and the indentations rise up, so I'm going to head to the Vitamin Shoppe tonight since I don't have any vitamin E on me.
Did you do anything for the fibula cut to fade too?? Like vitamin E etc?
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Nope, they just healed that way on their own.
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KiloKAHN
In your signature I see that you had your external frames on June 25, 2014 and Frames removed June 29, 2015.
You stayed a full year in the frames. How many cm did you length ?
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I lengthened 6 cm. Maybe a little over by a couple mm.
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I lengthened 6 cm. Maybe a little over by a couple mm.
But why this long time for 6 cm ? you had a problem with the new bone cells ?
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No. Dr Parihar is just very careful about when to remove the fixator so you avoid bone bending or re-fracture. This is what he says about it:
A month too late is better than a day too early. This is a useful thing to remember at a time when even the most cooperative patient is usually becoming impatient for the frame to be removed. The ability of the regenerate for unprotected weight bearing must be ensured prior to taking off the frame. The x-rays must show at least three cortices; i.e. out of four cortices (anterior, posterior, medial and lateral) in AP & lateral projections, at least three should be fully ossified, with a sharp outline of the cortical bone. Finally before actually removing the frame the patient may be administered a 'stress test'. in which all the uprights connecting the proximal and distal segments of bone are disconnected and the patient asked to use the limb in a functional manner (weight bearing for the lower limb and functional activities for the upper limb). If the patient is able to do this the frame can then be removed with confidence.
http://www.limblengtheningforum.com/index.php?topic=22.msg166#msg166
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Hi Kilo, I haven't posted before but I have read your diary from the start and I really appreciate it. It is the most useful Indian diary by a mile particularly the part where you posted about all the different doctors you met.
I have a question that I think I remember you answering but I want to see if your view has changed and that is why did you not opt for LON? I will be lengthening in India (maybe with Parihar) and I intend on LON so I can get out of frames in 3-4 months (I'm only doing 5cm). And also did you ever regret not going LON?
All the best with your recovery dude :)
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Hi Kilo, I haven't posted before but I have read your diary from the start and I really appreciate it. It is the most useful Indian diary by a mile particularly the part where you posted about all the different doctors you met.
I have a question that I think I remember you answering but I want to see if your view has changed and that is why did you not opt for LON? I will be lengthening in India (maybe with Parihar) and I intend on LON so I can get out of frames in 3-4 months (I'm only doing 5cm). And also did you ever regret not going LON?
All the best with your recovery dude :)
Hi, thanks Wintersleep.
As for why I didn't do LON, the risk of permanent knee pain was brought up on this forum and a doctor who offered CLL said something along the lines of "50% of people who get LON have knee pain after the procedure, and 25% of those 50% end up with chronic knee pain." MDOW also posted that he had discomfort in his knees, so I wanted to avoid it if possible.
When I consulted with Dr Dhawan and Dr Parihar, both admitted that knee pain is a possibility with LON, but Dr Parihar said that as of yet none of his patients have complained to him about knee pain. He said that either LON or externals would be appropriate and it was up to me to decide. When I pushed him for an answer though on what he thinks is better for recovery, he leaned very slightly toward exfix only.
MDOW did say his knees have been feeling better, and others who had nails put in have said that they have no knee issues. Also, being in external frames for an entire year was a total pain. So if I were to have started my journey to India now and was more realistic beforehand about how long I'd have to wear the Ilizarov frames, I'd probably opt for LON.
On the other hand, now that the cages are off I never have to worry about getting the nails taken out later and it was less trauma overall on my body, so that's one benefit of externals. I will say though that if I wasn't self-employed with a desk job, no way could I have survived with exfix only. It just takes far too long to recover and most people can't survive a year on no income.
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Why haven't you chosen Dr Naveen Talwar (Rocklands Hospital)?
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Why haven't you chosen Dr Naveen Talwar (Rocklands Hospital)?
Leg lengthening wasn't the surgeon's primary interest and I wanted to get my leg lengthening done by someone who does it as his specialty.
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Is it possible to go to India with Tourist Visa and let it extend with with the help of the hospital?
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Is it possible to go to India with Tourist Visa and let it extend with with the help of the hospital?
That may be possible but I was told by one hospital that they would prefer I come on a medical visa because coming on a tourist one and extending it can be a pain. Getting a medical visa isn't hard for India at all though.
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Can you tell me what you needed for the Medical Visa?
I just don't want to go to my local doctor telling i'm going to do this surgery ;d
I have on how to get a visum but it was way to complicated
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Can you tell me what you needed for the Medical Visa?
I just don't want to go to my local doctor telling i'm going to do this surgery ;d
I have on how to get a visum but it was way to complicated
You need a note from your GP, which can simply say that you're not prohibited from getting the surgery. Then you just submit that with the other documents you would need. The steps can be found here: http://www.in.ckgs.us/visa/type-of-visa/medical-visa.crapml
It's not a comfortable discussion, but you probably should tell your local doctor before you go to India. You should be up to date on vaccines before you enter the country anyway.
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Had my first height measurement since before surgery (didnt get measured after lengthening in India because I had equinus that prevented me from standing with my feet neutral).
At 1:50 pm I'm exactly 170 cm. I was just at 164 cm before the surgery so it looks like I didn't lose any of the height gained after frame removal.
Nice relief as the whole subsidence loss thing was always a nagging concern of mine at the back of my head.
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subsidence is overrated
pretty much everyone keeps all their height
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yeah some forum posts mentinoed i might lose up to 2mm on the mitkovic device due to pin bending, not sure how true that is though, i will have to ask him.
im glad you got your full height though.
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How bad was your equinus?
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Yea it's possible I may have gained a little more than 6 cm because of spinal compression throughout the day, but either way it's just a nice thing mentally that I'm officially at the 5'7 mark.
How bad was your equinus?
Only my toes could touch the ground, and it happened suddenly as in one night my feet were completely neutral and the next morning I stood up and I had equinus.
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Only my toes could touch the ground, and it happened suddenly as in one night my feet were completely neutral and the next morning I stood up and I had equinus.
May I ask what did you do to get rid of it? And how is your dorsiflexion currently?
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had a word with my doctor, he said there is a chance you could lose 1.5mm of height due to pin bending, he said with ilzarov you could lose 4mm!
just thought i'd throw that out there.
so your final height is 170, im so sure you said your starting height was 164 then you said 165. i think you should use a medical stadiometer to measure your height to make sure, that's what i use.
may i ask if you plan to wear any lifts and are you considering a 2nd LL, sorry if this has been asked before, we are both in the same boat you and I so im interested.
personally post op. i will be wearing lifts, likely 4cm to be an aweome height hehe, ill just be like tom cruise in that regard.
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May I ask what did you do to get rid of it? And how is your dorsiflexion currently?
I'd use the zimmer frame and walk around my office for a half hour at a time, pressing my heels down as far as they would go with each step. Another exercise that helped was to stand and hold on to the frame, put one foot forward, and with the other foot put all my weight on it and try to push my heel to the floor as much as possible for as long as I could hold it, then switch legs and do the same thing.
Also had to go back to using the foot straps tied to the frame while sleeping at night. I stopped using them because I could never get any sleep and it set me back in progress quite a bit. Once I got back to using them at night, the progress with the stretching during the day was a lot faster.
I haven't measured my dorsiflexion exactly, but I'll get it done at the physical therapy office at the end of this month. I believe it's around pre-op level though (which was still less than average according to the hospital physio).
had a word with my doctor, he said there is a chance you could lose 1.5mm of height due to pin bending, he said with ilzarov you could lose 4mm!
just thought i'd throw that out there.
so your final height is 170, im so sure you said your starting height was 164 then you said 165. i think you should use a medical stadiometer to measure your height to make sure, that's what i use.
may i ask if you plan to wear any lifts and are you considering a 2nd LL, sorry if this has been asked before, we are both in the same boat you and I so im interested.
personally post op. i will be wearing lifts, likely 4cm to be an aweome height hehe, ill just be like tom cruise in that regard.
The loss would really just be your turns not matching up with your actual distraction. For the first few mm a lot of it is due to muscle resistance, but once everything is in place you shouldn't lose your actual distraction amount that's shown from an x-ray measurement. That's what my doc told me and my gain seems to match up with what the x-ray showed for total distraction.
I thought before getting measured before surgery that I was exactly 165, but it turned out to be 164. Got measured with the stadiometer at the doctor's office so I'm sure it's exactly 170 cm in the afternoon.
I tried multiple types of lifts before and hated all of them because by the end of the day I'd have bad pain in my feet and lower back. Lifts are a no go for sure.
As for another leg lengthening, I really couldn't pull it off without getting an arm lengthening done as well. At the moment it looks like I'm done, but if I happen to have a lot of time and am financially better off with my business a few years down the line, I may consider it.
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no im refering to the x ray saying 5.0cm at the end of distraction, then you remove the device and if you took a new x ray it would say 4.9cm.
it apparently does happen, but only some of the time, and no way to tell, i have seen old posts on the old forum about this a few times, maybe its only a 5% chance and 1mm at most, maybe it can only be checked if you do another x ray after removal, maybe people don't bother.
oh right so your 170, i will be that height after my LL.
i think rg key has pic of him in 4cm lifts, i would say given our final height we should put up with lifts of some kind, we would be like tom cruise who is 170 in lifts to a great height of 174.
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its only if you remove the device early, or if you get pin bending, or if the x ray was inaccurate.
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but is there anyway to tell if you have pin bending before the removing of the device? and anyway to sort that.
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but is there anyway to tell if you have pin bending before the removing of the device? and anyway to sort that.
You can see the bent pins in the x-rays.
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okay great so if my x ray says 5.0 cm and there is no bent pins visible on the x ray i will get 5.0cm of height upon frame removal.
thanks.
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I saw some picture of you without frames on, it's really unviewable you had lengthened your tibiae... Cou you post a frontal picture of you??
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Attempt at Revealing Proportions (8/7/2015)
I had the pictures taken at a few different angles and distances to try and give a good sense of what my proportions are currently. I suppose the most detailed would be a nked pic, but I won't go that far just yet. For your eye convenience I've also blurred out my penis bulge so you don't feel like you're looking at softcore erotica. :D
The angle the pic is taken definitely matters with the perception of how long the tibs look in relation to femurs. I can't quite say if my proportions now are good or bad, but I think it's a given that I can't pull off a femur lengthening without an arm lengthening, and I don't know if I'd ever be willing to go that far. Right now my biggest peeve is that I look like the dude that skipped leg day at the gym throughout his entire life. Can't wait until I'm allowed to exercise them again in comparable intensity to when I was on the wrestling team in college.
(http://s5d1.turboimagehost.com/t/23777104_kilo_proportions_1.jpg) (http://www.turboimagehost.com/p/23777104/kilo_proportions_1.jpg.html) (http://s5d1.turboimagehost.com/t/23777106_kilo_proportions_3.jpg) (http://www.turboimagehost.com/p/23777106/kilo_proportions_3.jpg.html) (http://s5d4.turboimagehost.com/t/23777119_kilo_proportions_2.jpg) (http://www.turboimagehost.com/p/23777119/kilo_proportions_2.jpg.html)
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That looks perfectly fine, nobody will notice that, but once you recover 100% you must train your calves, than it will be perfect :)
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This is a 6CM increase?
Your tibiae looks about equal to your femur length or perhaps slightly less. I would assume your surgeon measured them thouroughly so it suprises me a bit that you don't know for sure. Proportionally you look alright (I say this as a fanatical proportions nazi), your legs look long but not strangely so and your arms are on the stubby side. Perhaps show us a picture in shoes?
You get plus points thanks to your haircut, very cool.
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Looks so so. Not bad as many guys who had surgery with Dr. Sarin but you have high amount of x legs. Maybe Paley can fix it for you before you get joint issue. This is why I wont do this in India.
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I think you could pull off femur lengthening. Maybe you're used to seeing yourself as a person with a thick body and that's why it looks off to you, but it doesn't to me.
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Looks so so. Not bad as many guys who had surgery with Dr. Sarin but you have high amount of x legs. Maybe Paley can fix it for you before you get joint issue. This is why I wont do this in India.
X-legs is when the tibias point outward. He doesn't have x-legs.
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Thumbs up, KiloKAHN. Yeh, u just need some work out on those legs and they'll be perfect.
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Is that only 6 cm? Honestly I shoud say that I think that it is visible that you lengthened, but not too much... Maybe it's just because I know it :)
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it would be good to find out tibia and femur length.
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it would be good to find out tibia and femur length.
Yes they look to be quite close but he still looks fine. I would not recommend more lengthening
as you would need to lengthen your arms and then all other sorts of weird proportion issues pop
up. Like others said once you start going to the gym you'll look better.
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I agree with MDOW that you could definitely pull off femoral lengthening if you decided later that you wanted it. Your torso would easily handle it. But you look badass as is. What's your weight post LL?
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have you got your full legs xrays before surgery or now? , measure your femur in the xray, then your tibia and do this:
tibia/femur= x to know your ratio
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if you were 166 before the operation do you think you would have stopped at 5cm, in other words you went that extra cm due to your start height more than anything.
how would you rate the difficulty of going from 5cm to 6cm, i noticed your lengthening rate wasn't lowered a whole lot so i assume it can't be that bad.
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Since you're too old to have grown naturally, do you foresee the change in height causing any issues when you renew your driver's license?
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You look fine height wise, but you look high-kneed, just as I do in the thread with my pic in the proportions segment. I think 6-7cm can be accomplished on anyone, but it should be done 3cm tibia, 4cm femur, to prevent this high knee look. Just stands out so much, and there's not much you can do to hide it, since the joint is so exposed to the eye's view.
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I think you could pull off femurs pretty easily as well. You might even look better with 5-6cm on femurs than you do now. If I could go back, it's what I'd do going to Mitkovic. Do femurs, then tibia while femurs consolidate.
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im guessing your tib and femur are the same length, but i'd like to know.
personally i want to keep the ratio more natural so closer to 0.8, so in my case i may lean towards 5cm instead of 6cm lengthening.
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I think you could pull off femurs pretty easily as well. You might even look better with 5-6cm on femurs than you do now. If I could go back, it's what I'd do going to Mitkovic. Do femurs, then tibia while femurs consolidate.
wrong order. don't do it that way, tibia first and then femurs while tibia consolidate.
im doing both tibia and femur back to back with mitkovic.
if you have the money go to guitchet for femurs. the pain for external femurs is unbelievable. i don't recommend femurs for weaklings, its on a completely different level than tibias.
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your pinhole scars look just like mine, except i have fewer
whats with these scars??? the scar looks like dead skin to be honest... not flat, dark,etc
same thing with yours?
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if you have the money go to guitchet for femurs. the pain for external femurs is unbelievable. i don't recommend femurs for weaklings, its on a completely different level than tibias.
This applies for EXTERNAL femurs only, right? Internals are fine.
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This applies for EXTERNAL femurs only, right? Internals are fine.
yes external femurs only. internals are much less painful.
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Attempt at Revealing Proportions (8/7/2015)
I had the pictures taken at a few different angles and distances to try and give a good sense of what my proportions are currently. I suppose the most detailed would be a nked pic, but I won't go that far just yet. For your eye convenience I've also blurred out my penis bulge so you don't feel like you're looking at softcore erotica. :D
The angle the pic is taken definitely matters with the perception of how long the tibs look in relation to femurs. I can't quite say if my proportions now are good or bad, but I think it's a given that I can't pull off a femur lengthening without an arm lengthening, and I don't know if I'd ever be willing to go that far. Right now my biggest peeve is that I look like the dude that skipped leg day at the gym throughout his entire life. Can't wait until I'm allowed to exercise them again in comparable intensity to when I was on the wrestling team in college.
(http://s5d1.turboimagehost.com/t/23777104_kilo_proportions_1.jpg) (http://www.turboimagehost.com/p/23777104/kilo_proportions_1.jpg.html) (http://s5d1.turboimagehost.com/t/23777106_kilo_proportions_3.jpg) (http://www.turboimagehost.com/p/23777106/kilo_proportions_3.jpg.html) (http://s5d4.turboimagehost.com/t/23777119_kilo_proportions_2.jpg) (http://www.turboimagehost.com/p/23777119/kilo_proportions_2.jpg.html)
I'm very jealous of your thick bone structure. You look like you're built like a truck. The tibs don't look bad because you have such beefy bones and thus muscle build. You could easy lengthen another 2 inches in your femurs. Nice alignment too.
Congrats. You are a good candidate for this because you have the bone thickness and total mass of a 6'2" guy. You're lucky that way.
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This is a 6CM increase?
Your tibiae looks about equal to your femur length or perhaps slightly less. I would assume your surgeon measured them thouroughly so it suprises me a bit that you don't know for sure. Proportionally you look alright (I say this as a fanatical proportions nazi), your legs look long but not strangely so and your arms are on the stubby side. Perhaps show us a picture in shoes?
You get plus points thanks to your haircut, very cool.
Yep, exactly 6 cm. We were looking at my standing x-ray on Dr Parihar's computer but I had so much going through my mind that I forgot to ask him about my measurements. He should still have it though so I sent him an e-mail asking for the measurements and then I'll just add 6 cm on top of it to figure out the new ratio.
Agree about the arms. Helps with weight lifting and hooks during sparring but my arm length has been commented on once before when I was on the wrestling team. That could also have been because it was really hard for people to get me in an arm bar so they noticed it more.
For the picture, did you mean exactly like before (with legs exposed) but with shoes or wearing usual clothing to hide the legs?
Looks so so. Not bad as many guys who had surgery with Dr. Sarin but you have high amount of x legs. Maybe Paley can fix it for you before you get joint issue. This is why I wont do this in India.
You know what x-legs are, right? I understand that people have an aversion to India for a number of reasons, but I think Parihar did as good a job as a popular CLL doctor in the West would have done.
I think you could pull off femur lengthening. Maybe you're used to seeing yourself as a person with a thick body and that's why it looks off to you, but it doesn't to me.
That could be it. Not used to my lower body being as thin as they are now. I think my shorter arms is the main hindrance in pursuing a second lengthening.
Thumbs up, KiloKAHN. Yeh, u just need some work out on those legs and they'll be perfect.
Thanks, Bluebarbie. How have you been? Legs feeling good?
Is that only 6 cm? Honestly I shoud say that I think that it is visible that you lengthened, but not too much... Maybe it's just because I know it :)
Hah, maybe. I don't think anyone is going to look at me on the street and go "That guy's legs are too long!" although I did go to a diner the other day wearing my walking braces and as soon as I stepped inside a waitress told me "Wow man, your legs look gnarly!"
I agree with MDOW that you could definitely pull off femoral lengthening if you decided later that you wanted it. Your torso would easily handle it. But you look badass as is. What's your weight post LL?
Right now I weigh 176 lbs/80 kg. I'm not concerned about the torso length or body width, it's the arms that discourage me.
have you got your full legs xrays before surgery or now? , measure your femur in the xray, then your tibia and do this:
tibia/femur= x to know your ratio
I have my standing x-ray from prior to surgery. If Parihar doesn't answer my e-mail then I'll see if my local doc can measure with my x-ray film.
if you were 166 before the operation do you think you would have stopped at 5cm, in other words you went that extra cm due to your start height more than anything.
how would you rate the difficulty of going from 5cm to 6cm, i noticed your lengthening rate wasn't lowered a whole lot so i assume it can't be that bad.
I might have stopped at 5 cm. I think getting to 170 cm was important for me mentally so if I got to that point with 5 cm I might have thought "what's a 1 cm difference, I'm still 5'7." It's hard to recall the difference in pain at this point, but I do remember the last stretch being more difficult. The worst days were when I turned 1 mm a day. I only lasted alternating between .75 mm and 1 mm per day for a week though, because the 1 mm days were hell and I had to stop turning that fast.
Since you're too old to have grown naturally, do you foresee the change in height causing any issues when you renew your driver's license?
Before I left for India I had to renew my state license and when I went to the DMV I changed it from 5'5 to 5'7. They didn't say anything to me about it.
You look fine height wise, but you look high-kneed, just as I do in the thread with my pic in the proportions segment. I think 6-7cm can be accomplished on anyone, but it should be done 3cm tibia, 4cm femur, to prevent this high knee look. Just stands out so much, and there's not much you can do to hide it, since the joint is so exposed to the eye's view.
The knees do look a little high in the pictures. Although I think it isn't an issue in most circumstances because people look at you from the top down, which gives the perception that the tibiae are shorter than they really are.
your pinhole scars look just like mine, except i have fewer
whats with these scars??? the scar looks like dead skin to be honest... not flat, dark,etc
same thing with yours?
Some of them look purple and there's still some indentation. They should rise up with time. I probably won't get any scar reduction unless they end up healing really ugly or something.
I'm very jealous of your thick bone structure. You look like you're built like a truck. The tibs don't look bad because you have such beefy bones and thus muscle build. You could easy lengthen another 2 inches in your femurs. Nice alignment too.
Congrats. You are a good candidate for this because you have the bone thickness and total mass of a 6'2" guy. You're lucky that way.
Haha, at 164 cm I think my width made me look a bit ridiculous, tbh. The added height likely helped me look more normal. I want to get back to training my calves again and the added width should help them look shorter, but I need to be completely sure that I'm allowed to train them without worry of bone bending or re-fracture. My local ortho said I shouldn't attempt running for at least 8 months after my frames were removed. Going to ask him if he thanks I should wait that long to get back into doing lower body exercises as well.
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A picture in shoes (wearing pants at the hips) and perhaps even next to another person of similar height would be very helpful if you'd like our thoughts.
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Frankly KiloKAHN, you look great. No non-LLer could even make out your arms are smaller or legs are lengthened. I wish I could be like that post-lengthening. My torso-legs ratio will be fine but my arms will definitely look smaller.
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Nice straight legs, he did a good job! I don't focus on proportions so your arms look perfectly normal to me, you could do femurs no prob.
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I haven't yet seen a tibial patient who looks as natural as you do. The longer tibias let you look taller than you are, wich is a great side effect of course.
If it isn't too much effort, you could perhaps post a picture of you standing next to someone your height, like Uppland already asked.
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Mockups Tomfoolery
I decided to do mockups for a femur lengthening after mixed member comments and my own doubts about being able to get away with a second round, which would be far off in the future if it were to happen, as far as that's concerned. This is really just for fun and opinions all around as I'm not seriously considering more lengthenings at the moment. Still need to focus on recovering from the first one. Anyway, have at it with evaluations.
Oh, and I'll try and find someone around my height to take a pic next to me, for those who were interested.
1st pic: Current
2nd pic: 5 cm femurs
3rd pic: 6 cm femurs
4th pic: 7 cm femurs
5th pic: 7 cm femurs + 4 cm humerus extra tomfoolery
(http://s5d3.turboimagehost.com/t1/23805747_170cm-forum.jpg) (http://www.turboimagehost.com/p/23805747/170cm-forum.jpg.html)(http://s5d2.turboimagehost.com/t1/23805412_5cm-femur-forum.jpg) (http://www.turboimagehost.com/p/23805412/5cm-femur-forum.jpg.html) (http://s5d2.turboimagehost.com/t1/23805413_6cm-femur-forum.jpg) (http://www.turboimagehost.com/p/23805413/6cm-femur-forum.jpg.html) (http://s5d2.turboimagehost.com/t1/23805415_7cm-femur-forum.jpg) (http://www.turboimagehost.com/p/23805415/7cm-femur-forum.jpg.html)(http://s5d2.turboimagehost.com/t1/23805414_7cm-femur-4cm-humerus-tomfoolery.jpg) (http://www.turboimagehost.com/p/23805414/7cm-femur-4cm-humerus-tomfoolery.jpg.html)
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Mockups Tomfoolery
I decided to do mockups for a femur lengthening after mixed member comments and my own doubts about being able to get away with a second round, which would be far off in the future if it were to happen, as far as that's concerned. This is really just for fun and opinions all around as I'm not seriously considering more lengthenings at the moment. Still need to focus on recovering from the first one. Anyway, have at it with evaluations.
Oh, and I'll try and find someone around my height to take a pic next to me, for those who were interested.
1st pic: Current
2nd pic: 5 cm femurs
3rd pic: 6 cm femurs
4th pic: 7 cm femurs
5th pic: 7 cm femurs + 4 cm humerus extra tomfoolery
(http://s5d3.turboimagehost.com/t1/23805747_170cm-forum.jpg) (http://www.turboimagehost.com/p/23805747/170cm-forum.jpg.html)(http://s5d2.turboimagehost.com/t1/23805412_5cm-femur-forum.jpg) (http://www.turboimagehost.com/p/23805412/5cm-femur-forum.jpg.html) (http://s5d2.turboimagehost.com/t1/23805413_6cm-femur-forum.jpg) (http://www.turboimagehost.com/p/23805413/6cm-femur-forum.jpg.html) (http://s5d2.turboimagehost.com/t1/23805415_7cm-femur-forum.jpg) (http://www.turboimagehost.com/p/23805415/7cm-femur-forum.jpg.html)(http://s5d2.turboimagehost.com/t1/23805414_7cm-femur-4cm-humerus-tomfoolery.jpg) (http://www.turboimagehost.com/p/23805414/7cm-femur-4cm-humerus-tomfoolery.jpg.html)
You look fine with 5cm in femurs. If you ever want to be 5'9, go for it. How does it sound, being 5'9? ;D
Anyway, if you're happy with your height don't do more LL and fk with your body. Just live life.
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5 cm femurs makes your legs more proportional.
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Pic 4 even looks fine to be honest. I don't think anything looks off about it.
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7cm femurs and arm lengthening is the best for you. But. Do you really want to go throught that?
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You look great man. I think your proportions look totally fine. Proportions are important, but I don't think as important as total height (when you're below 5'9", that is).
I'll probably do 3cm-4cm on tibias in a few years. Doing such a low amount because 5'9"+ is fine with me, and tibias just terrify me (I'll be doing internal tibias to speed things up).
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I think you're now at a reasonable normal height, please don't go through that! Everything has been gone well, enjoy your life with your new height, this is my advice :)
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If you ever opted to go for femurs without arm lengthening, I'd say you look best with 5-6CM added on to femurs (looks even better than with just 6CM on tibaie because legs look more balanced). Plus, if you add 5-6CM to your femurs, you'd be 5'9 which is where I feel height descrimination really ends in the United States.
But a ripped and built 5'7 guys probably wouldn't get much descrimination either.
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Arm lengthening sounds way too brutal. How are you supposed to do anything with your arms not functional for a few months? They're also not as strong as legs generally.. the thought makes me cringe.
Plus he'd look fine with just 5cm in femurs.
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I'm in the minority here but I think Kilo has reached his limit proportions wise. Any further lengthening will make his body look very odd.
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Kilo, what is your wingspan. I know you were like 165 before the surgery. I was 166/166.5, and my wingspan is somewhere between 172 and 173 (so matches my current height 173 perfectly).
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Interesting to read the varied opinions. Proportions is a very divided topic.
Kilo, what is your wingspan. I know you were like 165 before the surgery. I was 166/166.5, and my wingspan is somewhere between 172 and 173 (so matches my current height 173 perfectly).
Wingspan is 170 but I think a lot of that is because of shoulder width. Not sure of actual arm length but it might be shorter than the typical person my height.
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I think you could do another 3-4cm and still look entirely ok. Then you'd be like 5'8/5'8.5"
My torso/leg and wingspan proportions are all fine right now, and I think I could pull off another 2 inches (perhaps even a bit more) and not have it be a problem at all. But if I do tibias, I'm just doing 3.5/4cm to keep the risks/astronomical recovery time in check.
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Interesting to read the varied opinions. Proportions is a very divided topic.
I think expectations vary, myself I am not sufficient with looking "passble" or "normal", I want my body to look good. Would rather be average and proportionate than tall and lanky or otherwise weird.
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My torso/leg and wingspan proportions are all fine right now, and I think I could pull off another 2 inches (perhaps even a bit more) and not have it be a problem at all. But if I do tibias, I'm just doing 3.5/4cm to keep the risks/astronomical recovery time in check.
Have you done any mockups yet to aid your decision on whether to do another round on femurs or go for tibs?
I think expectations vary, myself I am not sufficient with looking "passble" or "normal", I want my body to look good. Would rather be average and proportionate than tall and lanky or otherwise weird.
That's something to consider. Posting the mockups on a forum that's primarily populated by women and leaving the height increase info out of it, it would be interesting to see what body type they vote as most aesthetically pleasing. I wonder if anyone has done that before.
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Have you done any mockups yet to aid your decision on whether to do another round on femurs or go for tibs?
That's something to consider. Posting the mockups on a forum that's primarily populated by women and leaving the height increase info out of it, it would be interesting to see what body type they vote as most aesthetically pleasing. I wonder if anyone has done that before.
No but I'm going to. Can you maybe send me a link to do the mockups? Thanks!
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If you're serious about it Yellow then I'd advice you to wear different clothes or make the mockups bodies look different from one another; wouldn't want to make seem like you're gonna alter your body. Or not, mainly up to you.
But I do think people who do mockups or have already gone through LL should do this; getting outside perspective from people that might not necessarily know about this operation would be an interesting case study in terms of aesthetics of the human body.
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I'm the optimist one so if you show pic #4, 99.99% of the population won't see anything wrong with those proportions but chicks will dig the height.
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Update: 8/20/2015
Went to the ortho and got updated x-rays. Will post them after I pick them up. Anyway, the tibiae are solid enough to walk without the braces, so as of now I'm walking without any support. Pin sites have healed fine and there's no more drainage. Ortho said that my legs are still tight so he wrote a referral to continue physical therapy at a nearby clinic. He wants me to continue stretching vigorously because the problem with tight ankles is that when your feet bend upward when walking on an incline it puts a lot of pressure on the area at the top of your feet where the leg starts, and you can develop arthritis there if it goes on for long enough. He wants to give me six months to try and loosen it up sufficiently, otherwise he said he'd recommend a tendon release. I really don't want to do that so my stretching is going to be hardcore.
Walking feels okay. I have a little bit of pressure in the middle of my right leg, and when I wake up in the morning my calves are tighter than usual but it goes away after walking around briefly. I imagine I look normal enough walking but I probably won't be able to run for months. I was told to start using an exercise bike though so now I have a reason to unfreeze my 24 Hour Fitness membership.
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Update: 8/29/2015
So this last week was really interesting. I was doing a whole lot better walking, but I think I overdid it at a concert and county fair and ended up with a right ankle sprain that makes it impossible to put weight on it without a great amount of pain at the moment. I went back to using a crutch to get around so I can let it heal. This isn't the first time that walking a lot has caused this problem, but after I heal from it I find that I have more flexibility than before, so this is probably just the way the body gets over muscle tightness.
I also had a ton of sex these last few days and it got rid of a bunch of frustration that was building up over a year of lengthening and recovering. Not only was the woman really fine, but her bf is 6'3 and she was attracted to me to the point where she wanted me to do her despite being 8 inches shorter than him. She even wants this to be a regular thing. Maybe it had to do with people asking me on the street while we were hanging out if I was a military man or a professional wrestler. Was probably a turn on or something. Lol.
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Update: 8/29/2015
I also had a ton of sex these last few days and it got rid of a bunch of frustration that was building up over a year of lengthening and recovering. Not only was the woman really fine, but her bf is 6'3 and she was attracted to me to the point where she wanted me to do her despite being 8 inches shorter than him. She even wants this to be a regular thing. Maybe it had to do with people asking me on the street while we were hanging out if I was a military man or a professional wrestler. Was probably a turn on or something. Lol.
My boy...despite this being somewhat horrible I couldn't be any prouder :'(. How did you even manage to meet her anyways? hahaha
Those things aside I hope your recovery is going well and that it gets better. :)
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Update: 8/29/2015
So this last week was really interesting. I was doing a whole lot better walking, but I think I overdid it at a concert and county fair and ended up with a right ankle sprain that makes it impossible to put weight on it without a great amount of pain at the moment. I went back to using a crutch to get around so I can let it heal. This isn't the first time that walking a lot has caused this problem, but after I heal from it I find that I have more flexibility than before, so this is probably just the way the body gets over muscle tightness.
I also had a ton of sex these last few days and it got rid of a bunch of frustration that was building up over a year of lengthening and recovering. Not only was the woman really fine, but her bf is 6'3 and she was attracted to me to the point where she wanted me to do her despite being 8 inches shorter than him. She even wants this to be a regular thing. Maybe it had to do with people asking me on the street while we were hanging out if I was a military man or a professional wrestler. Was probably a turn on or something. Lol.
What a savage. 8)
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Update: 8/29/2015
I also had a ton of sex these last few days and it got rid of a bunch of frustration that was building up over a year of lengthening and recovering. Not only was the woman really fine, but her bf is 6'3 and she was attracted to me to the point where she wanted me to do her despite being 8 inches shorter than him. She even wants this to be a regular thing. Maybe it had to do with people asking me on the street while we were hanging out if I was a military man or a professional wrestler. Was probably a turn on or something. Lol.
Damn son, what a beast.
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My boy...despite this being somewhat horrible I couldn't be any prouder :'(. How did you even manage to meet her anyways? hahaha
Those things aside I hope your recovery is going well and that it gets better. :)
Thanks.
I met her at the county fair I went to. She, her friend, and her friend's bf were talking about how bad this one Rolling Stones cover band was, and because I thought she was hot I approached her and made some joke about the band being terrible, which got her laughing. That got the ball rolling and I eventually spent the rest of the day with her at the fair while the people she came with did their own stuff. Found out her bf was out of town and asked if she wanted to hang out with me for a while since I was on vacation myself. She accepted and one thing led to another.
The best part was when she told me how thick I was. Between that and being able to bag her despite the large height difference between her bf and myself, my confidence level went through the roof. ;D
What a savage. 8)
Damn son, what a beast.
I almost didn't do anything because of moral reasons, but then I figured that if she's going to sleep with someone else anyways, it might as well be me. I deserve a break after all this, dammit. lol
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Nice job Kilo. We are all proud of ya, even if she did have a bf ;)
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[video]https://www.youtube.com/watch?v=T_rB119MFBY[/video]
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Nice job bro. How tall is she? What did she say about your LL scars? How bad was that Stones cover band?
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She's 5'4. I just told her that I was in an accident that caused compound fractures which required pins to stabilize the bone. She wasn't grossed out by them at all. Just thought they were interesting.
Stones cover band was awful, especially when comparing them to a great performance by Cheap Trick, who had just played an hour before.
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Hi Kilo, I've already said this but thanks so much for your diary :)
I'm sorry if you've said this all before but do you mind giving us a few details on your accommodation in Mumbai? I am looking at hotels which have positive reviews on sites like tripadviser and such for $40/night - but all advice I have heard so far claims I'll need to budget $80+/night for accommodation.
Do you mind telling us how much your accommodation cost and how it was? If you don't mind giving the name of the hotel that would be great too. Also did you find it independently or did the hospital point you in it's direction? Anything you would recommend to someone getting the surgery with regards to accommodation?
Thanks, and sorry for asking so many questions :D
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Hi Kilo, I've already said this but thanks so much for your diary :)
I'm sorry if you've said this all before but do you mind giving us a few details on your accommodation in Mumbai? I am looking at hotels which have positive reviews on sites like tripadviser and such for $40/night - but all advice I have heard so far claims I'll need to budget $80+/night for accommodation.
Do you mind telling us how much your accommodation cost and how it was? If you don't mind giving the name of the hotel that would be great too. Also did you find it independently or did the hospital point you in it's direction? Anything you would recommend to someone getting the surgery with regards to accommodation?
Thanks, and sorry for asking so many questions :D
I stayed at Hotel Maharana, which is something like 2 minutes by auto-rickshaw from Dr Parihar's hospital.
http://www.hotelmaharana.com/
If you send them an e-mail you'll get a response from their manager most likely. Just state in the e-mail that you are having surgery at a nearby hospital and will require a room for a few months. Ask if they have any discount prices for those with disability or for extended stays. I was able to get a pretty good discount from the usual rate and was charged roughly $50 per day. I thought it was a fair price because they had a large ceiling fan, air conditioner, HDTV, free wifi, coffee maker, private bathroom, laundry service, room cleaning, and their own restaurant that delivered food to your room. You might be able to get a cheaper price than I did simply because the USD is stronger now in relation to the Rupee than when I was there.
I found the hotel on my own. Dr Parihar knows the manager of Hotel Shanti Palace and pointed me in their direction: http://www.hotelshanti-palace.com/
You could probably get a better rate from these guys, but they were always booked solid when I was in Mumbai.
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Update: 9/8/2015
Just getting over this right ankle sprain. Feeling a bit better but there's still some pain and I've got it in the brace again.
Has anyone else who had their tibiae lengthened experienced pain in the front portion of the ankle just above your foot? I'm getting that when I walk, as my ortho said would happen, due to the ankle tightness still present. If you had this issue, how long did it take to resolve?
I have another physical therapy session in 4 days and will see if they have any particularly useful exercises to combat this. My local ortho is pushing for a tendon release and I really don't want to do it. Next time I see him I'll ask if he performs a gastroc-soleus recession as an alternative. I've read of a few orthos who much prefer that method to improve flexibility in the foot and ankle, and if it comes down to it it looks like that will have less downsides than cutting my tendon.
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Update: 9/8/2015
Just getting over this right ankle sprain. Feeling a bit better but there's still some pain and I've got it in the brace again.
Has anyone else who had their tibiae lengthened experienced pain in the front portion of the ankle just above your foot? I'm getting that when I walk, as my ortho said would happen, due to the ankle tightness still present. If you had this issue, how long did it take to resolve?
I have another physical therapy session in 4 days and will see if they have any particularly useful exercises to combat this. My local ortho is pushing for a tendon release and I really don't want to do it. Next time I see him I'll ask if he performs a gastroc-soleus recession as an alternative. I've read of a few orthos who much prefer that method to improve flexibility in the foot and ankle, and if it comes down to it it looks like that will have less downsides than cutting my tendon.
I have, I think it's just because some soft tissue in that zone has to be stretched... In my case, I used to wear, during lengthening, slippers + rubber band 24h/24, this make my Achille tendons follow the lengthening, but frontal soft tissue doesn't... I don't know if for you is the same, but I feel that little pain when I overflect my feet frontally. It is going away with exercises...
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Thanks for your input, Lumiere. I guess I'm going to continue with stretching to see if I can make this pain go away on its own.
I e-mailed Dr Paley and asked if I should let my local ortho do an Achilles tendon lengthening or if I should get a gastroc-soleus recession instead. He replied that in general one should NEVER (all caps) do an Achilles tendon lengthening and that a GS recession is a much better option, but there is a risk of permanently weakening your push off strength with both procedures. He offered to examine me in person to fully advise because he said there may be other options. Fits in line with Dr Parihar's thoughts. He said stretching would get rid of it over time and he would not do a release or anything.
I guess I'm being too impatient with this though. Soft tissue recovery just seems to take way longer than everything else.
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Is it as much as a normal sprain you'd have on a normal day? Just keep up with the exercises if the doctor's said that'll get rid of it. :)
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It seemed more severe than a normal sprain, but it's gone now and I'm back to walking on both legs again without any brace for support. Been walking two miles a day so far and back to my mass building workouts with 1.5 - 2 hr gym sessions that include weight lifting and a whole lot of stretching afterward. My ankle and calf flexibility has improved once again thanks to the stretching. The gastroc and soleus stretches have been the most helpful, but stretching out the hamstrings has also resulted in improvement. Muscle tightness is the worst when I wake up in the morning, but it's also gone down in severity. Most of it is concentrated in the lower hamstrings behind the knees.
Although my scars are clearly visible I don't mind them at all. I've seen a few people glance at them in the gym, but they don't seem to make a huge issue out of it. Another woman I slept with recently told me she thought they were like sexy battle scars. Maybe I should keep them :o
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This is a 6CM increase?
Your tibiae looks about equal to your femur length or perhaps slightly less. I would assume your surgeon measured them thouroughly so it suprises me a bit that you don't know for sure. Proportionally you look alright (I say this as a fanatical proportions nazi), your legs look long but not strangely so and your arms are on the stubby side. Perhaps show us a picture in shoes?
Finally got a response back from Dr Parihar telling me my pre-op and post-op measurements. He had to reinstall the software he uses and that took some time.
Pre-op Measurements
Femurs
Right 43.1 cm
Left 43.0 cm
Tibiae
Right 31.4 cm
Left 31.5 cm
Post-op Measurements
Tibiae
Right 37.4 cm
Left 37.5 cm
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It seems like you are good with women. Was it the same before the surgery ? Could you write the difference please
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I was able to get laid every now and then, but my height was a total barrier for dating because girls weren't keen on introducing a short guy as a bf to friends or parents. It certainly feels like now people are more receptive to me, but I haven't actually tried to date or anything yet so I can't say how much that aspect has changed for sure.
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hey bro congrats on ur lenghtening
jst wanted to know where are u exactly in ur recovery process
i mean can u run without putting to much pressure on ur ankles
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This is the best part in this whole thread IMO.. You deserved it lol
Just one question, did you know anyone in her group? Or you just approached her without knowing anyone?
I'm afraid that my question might turn this thread from helping guys for LL to getting laid LMAO, but helping is helping after all :-* I hope you'll be able to answer my question.
Thanks.
I met her at the county fair I went to. She, her friend, and her friend's bf were talking about how bad this one Rolling Stones cover band was, and because I thought she was hot I approached her and made some joke about the band being terrible, which got her laughing. That got the ball rolling and I eventually spent the rest of the day with her at the fair while the people she came with did their own stuff. Found out her bf was out of town and asked if she wanted to hang out with me for a while since I was on vacation myself. She accepted and one thing led to another.
The best part was when she told me how thick I was. Between that and being able to bag her despite the large height difference between her bf and myself, my confidence level went through the roof. ;D
I almost didn't do anything because of moral reasons, but then I figured that if she's going to sleep with someone else anyways, it might as well be me. I deserve a break after all this, dammit. lol
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Here's a short clip of what my standard walking looks like at this point.
http://www.youtube.com/watch?v=fxF4gWTYWeY
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Looks good and your proportions look very good. What's your true inseam?
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Looks great. :)
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Hii docter I want to ask u about my height problem. .sir my height is 5'11 and inseam in inches 93.98,long legs femur and tibia... Full leg around 3 feet...sir I want to shorten leg
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Looks good and your proportions look very good. What's your true inseam?
80 cm inseam.
80 cm/170 cm x100 = 47.05%
Looks great. :)
Thanks, Penguinn.
Hii docter I want to ask u about my height problem. .sir my height is 5'11 and inseam in inches 93.98,long legs femur and tibia... Full leg around 3 feet...sir I want to shorten leg
I'm just a patient of Dr Parihar. Here is his contact info:
Tel: +91-22-2522 4845 / 022-2526 0000.
Fax: +91-22-2523 5416
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Dr Parihar is available to anwser my question?
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Dr Parihar is available to anwser my question?
If you call the number of his clinic you can ask to speak to him or leave him a message.
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U know about this or limb shortening possible both legs? And In this site he anwser the question so y not me
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U know about this or limb shortening possible both legs? And In this site he anwser the question so y not me
Dr Parihar doesn't visit this forum or answer questions here. You have to e-mail or call him directly to get a response from him.
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K but you tell me m I perfect 189.34 height m 20 year old.. Inseam 37 and hip to foot leg is 107...I am uncomfortable for standing... Leg femur is around 48,tibia 42... U only say I am okay or m different from other please anwser me long and tell me
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Not 189.34 it's 180.34
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K but you tell me m I perfect 189.34 height m 20 year old.. Inseam 37 and hip to foot leg is 107...I am uncomfortable for standing... Leg femur is around 48,tibia 42... U only say I am okay or m different from other please anwser me long and tell me
It's difficult to answer that type of question on a forum. Best thing to do is make an appointment with an orthopedic specialist.
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im doing LL right now and we're about the same height and we are using an external device which is the longest time, im at 4cm and my original goal was 5cm.
however i have been thinking on doing 6cm now, how do you feel about the time it took to do 6cm, do you regret it and wish you did 5cm, if 7cm was an option for you would you take it, or at the end did you feel that you had spent enough time doing this and woudn't want to do 7cm.
i can only do 1 LL due to my wingspan so i guess our positions may be a bit different.
did you find out your tibia and femur bone length, if i do 6cm my femur would be 3cm longer than tibia.
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I also have a question Kilo: how significant is a 6CM increase in height, and how noticeable is it?
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im doing LL right now and we're about the same height and we are using an external device which is the longest time, im at 4cm and my original goal was 5cm.
however i have been thinking on doing 6cm now, how do you feel about the time it took to do 6cm, do you regret it and wish you did 5cm, if 7cm was an option for you would you take it, or at the end did you feel that you had spent enough time doing this and woudn't want to do 7cm.
i can only do 1 LL due to my wingspan so i guess our positions may be a bit different.
did you find out your tibia and femur bone length, if i do 6cm my femur would be 3cm longer than tibia.
if I had thought to myself that I'd more realistically expect 2 months per cm in cages than 1.5 months per cm, I more than likely would have chosen LON. I'm not sure how Dr Mitkovic's external device's feel, but having the cages on my legs for 12 months really sucked some days and always sucked at night. As it is with external fixation time, I wouldn't have pushed to 7 cm even if Dr Parihar told me that I could. Started to feel like my soft tissues were having a hard time a little after 5 cm, but I pushed to 6 cm just because mentally it felt good to be at the 170 cm mark.
Tibia length post op is 37.5 cm and femurs are 43.0 cm.
I also have a question Kilo: how significant is a 6CM increase in height, and how noticeable is it?
It made a big difference, both in how I perceive myself now and in how others view me. Also with some practical things, like shopping for pants. I think aesthetically I look better than before since I was very stocky for my height to begin with and probably looked a bit silly. A lot of people who know me prior to surgery remarked that I look really good now and saw the difference right away, and those who haven't seen me in a while have said something along the lines of "Something's different about you..." I haven't been called out over my height yet in conversations since I've been back either. That may change since I'm still below average height here, but I think it will happen with less frequency than before.
Not entirely sure, but it's probable that if you increase your height 6 cm it will be less instantly noticeable than when I did it. I think the shorter the starting height, the more obvious the change will be. But going from 5'10 to 6'0 mark should definitely have a social benefit.
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okay thanks, i hardly feel anything with the mitkovic device, the typical gain with 15 or so mitkovic diaries is 7cm so i guess i answered my own question.
i will get mitkovic to feel how tense my soft tissues are soon and he can advise.
thanks
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Wow you look really good and your walk seems normal. Considering that you have an I/H ratio of 47% how do you feel with those longer legs of yours now? Does it effect any of your movement and depth perception? Also how do you fit clothes now; are you much more conscious about how you look in general? How do you think you'd look like with a suit?
My curiosity is kicking in because I'd also end up with a 47% inseam to height ration after 9-10 cm increase in both segments which is my goal. Thanks
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Wow you look really good and your walk seems normal. Considering that you have an I/H ratio of 47% how do you feel with those longer legs of yours now? Does it effect any of your movement and depth perception? Also how do you fit clothes now; are you much more conscious about how you look in general? How do you think you'd look like with a suit?
My curiosity is kicking in because I'd also end up with a 47% inseam to height ration after 9-10 cm increase in both segments which is my goal. Thanks
I got used to walking pretty fast, but going upstairs and especially downstairs still feels kinda weird to me. Not quite used to the change there yet and I walk stairs a lot slower. I had to do a lot of clothes shopping since the lengthening because not only did I get taller, but I went down from 212 lbs to 173 lbs so I had to find slimmer fits. Shopping got easier for me since I could finally go in the adult jeans section and get pants that didn't require hemming to be worn properly.
I don't think 47% really looks long legged so you'll probably look normal with the same percentage. I looked at some threads on inseam to height ratio, mostly on biking forums, and it seems within the average range.
http://weightweenies.starbike.com/forum/viewtopic.php?p=246447
http://forums.soompi.com/en/topic/244813-the-real-leg-percentage-calculation/
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Yeah I guess so. I don't by any means look freakish with 44%, the thing is it's so normal to be that I do have my doubts with what 47% could look like. So you saying that is really reassuring for me in many regards. I just want to make sure I get the very clear perspective of what 47% feels and looks like before I jump on that train. If you have anything else to add about how's it changed you that would be appreciated :)
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wow this is soooo funny
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^Which part?
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Attempt at Revealing Proportions (8/7/2015)
I had the pictures taken at a few different angles and distances to try and give a good sense of what my proportions are currently. I suppose the most detailed would be a nked pic, but I won't go that far just yet. For your eye convenience I've also blurred out my penis bulge so you don't feel like you're looking at softcore erotica. :D
The angle the pic is taken definitely matters with the perception of how long the tibs look in relation to femurs. I can't quite say if my proportions now are good or bad, but I think it's a given that I can't pull off a femur lengthening without an arm lengthening, and I don't know if I'd ever be willing to go that far. Right now my biggest peeve is that I look like the dude that skipped leg day at the gym throughout his entire life. Can't wait until I'm allowed to exercise them again in comparable intensity to when I was on the wrestling team in college.
(http://s5d1.turboimagehost.com/t/23777104_kilo_proportions_1.jpg) (http://www.limblengtheningforum.com/p/23777104/kilo_proportions_1.jpg.html) (http://s5d1.turboimagehost.com/t/23777106_kilo_proportions_3.jpg) (http://www.limblengtheningforum.com/p/23777106/kilo_proportions_3.jpg.html) (http://s5d4.turboimagehost.com/t/23777119_kilo_proportions_2.jpg) (http://www.limblengtheningforum.com/p/23777119/kilo_proportions_2.jpg.html)
Your legs are nice and straight but do the holes in the legs fade? The scarring is one thing that makes me think I should save up a few more years for internals. Has anybody mentioned your scars if you are wearing short pants?
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Your legs are nice and straight but do the holes in the legs fade? The scarring is one thing that makes me think I should save up a few more years for internals. Has anybody mentioned your scars if you are wearing short pants?
Some of the scars at the top have faded. The ones close to the ankle haven't shown much of a difference though. I haven't looked at any before and after pics of those who had scar revision done for their pin sites, but it could be effective enough to make doing externals worth it for those worried about scarring. Imo, there's not much reason to do internals on the tibiae since internals for them are even more expensive than internal femurs.
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So your tibia length was 37.5 before or after the surgery?
Mine are around 35-36 centimetres right now without surgery!
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Went snowboarding yesterday and wore my braces under the boots just in case. Had no problem with my legs at all, but I wiped out hard on a steep slope and fractured my tail bone because I was reckless and decided to forego buying the tail bone guard (I paid $110 just for the lift ticket). Can still walk but I do so looking like a dumbass. Aargh.
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Finally got a response back from Dr Parihar telling me my pre-op and post-op measurements. He had to reinstall the software he uses and that took some time.
Pre-op Measurements
Femurs
Right 43.1 cm
Left 43.0 cm
Tibiae
Right 31.4 cm
Left 31.5 cm
Post-op Measurements
Tibiae
Right 37.4 cm
Left 37.5 cm
That´s so weird, my femurs are only 3cm´s longer than yours but my tibias are 8cm longer than those you had before your surgery :o I was hoping to get tibias done since I only want 4 cm´s but it seems like I´m a femur patient.
Femurs: 46cm´s
tibias 39.5
Do you know how your femurs were measured? Did the measurment stop at the end of your bone or did it stop at the point where your joint entered (around 2cm´s earlier)?
I´m 5´10 btw
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That´s so weird, my femurs are only 3cm´s longer than yours but my tibias are 8cm longer than those you had before your surgery :o I was hoping to get tibias done since I only want 4 cm´s but it seems like I´m a femur patient.
Femurs: 46cm´s
tibias 39.5
Do you know how your femurs were measured? Did the measurment stop at the end of your bone or did it stop at the point where your joint entered (around 2cm´s earlier)?
I´m 5´10 btw
I'm not sure how he measured them, but it was done using the image of my standing x-ray. Are your measurements from an x-ray or did you do them yourself with measuring tape?
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Update: 12/14/2015
Getting Back Into Shape
Decided to make this update because I had grabbed a pair of work pants without realizing that they were my old ones and it was totally comical at how over-sized they were for me. It reminded me that I was in denial about my weight gain in the year leading up to surgery. I had become obese without realizing it. In my depression over how terrible I felt about myself I stopped taking care of my body and it really showed. After losing all the weight and getting back into shape, I now realize more than ever that it's far worse to be short and fat than short and fit.
To the short guys worrying that people will say you're compensating for lack of height by weight training - do not even think about that. It's total crap. I've been hooking up with women lately who have usually dated much taller guys, and I attribute a lot of it to the much better shape I'm in. That's not to say that the height gain isn't a factor, because it is. The jump from roughly 5'5 to 5'7 is rather significant, imo. But there's absolutely no drawback to taking better care of yourself, and weight training in particular is good for bone health - you decrease the risk of osteoporosis and increase your bone density through weight lifting.
(http://s6d8.turboimg.net/t1/24692406_weight_loss.jpg) (http://www.turboimagehost.com/p/24692406/weight_loss.jpg.html)
(http://s6d8.turboimg.net/t1/24692404_progress_1.jpg) (http://www.turboimagehost.com/p/24692404/progress_1.jpg.html)
(http://s6d8.turboimg.net/t1/24692405_progress_2.jpg) (http://www.turboimagehost.com/p/24692405/progress_2.jpg.html)
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You are in very good shape. I'm happy for you.
Now you are more happy with yourself and that is the most important, to do more things.
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Hey KiloKahn
Strong upper body and good arms (biceps/triceps). You are looking good! Congratulations :)
Greetings Morpheus
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You look great man!
Have you tried any kind of longer running or jogging yet?
I forgot to answer your question from an earlier post, the measurements were taken with an x-ray and were very acurate. Which is pretty annoying for me since I don´t really have a choice than to do femurs.
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Going from Obese to lean, I always thought I was in good shape. How wrong I was, especially when I am dismissed by strangers as a kid :D. I don't know at about 171cm weight training is better than aerobics I suppose. But if I were 180cm I would have preferred being lean.
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You are in very good shape. I'm happy for you.
Now you are more happy with yourself and that is the most important, to do more things.
Thanks Paco. And you're right, feeling better has encouraged me to be more outgoing than I was before, and I seem to enjoy my days a lot more than previously since I'm not thinking about my height as much. Admittedly, I do still feel on the smaller side since I'm shorter than average and have very tall siblings, but I feel a lot better at 170 cm than 164 cm.
Hey KiloKahn
Strong upper body and good arms (biceps/triceps). You are looking good! Congratulations :)
Greetings Morpheus
Thanks, Morpheus! Triceps and delts are my favorite muscle groups to work. Eventually I will have to work these leg muscles though, because now I still have chicken legs compared to the rest of my body lol.
You look great man!
Have you tried any kind of longer running or jogging yet?
I forgot to answer your question from an earlier post, the measurements were taken with an x-ray and were very acurate. Which is pretty annoying for me since I don´t really have a choice than to do femurs.
I haven't done any running or jogging because I'm paranoid about getting a stress fracture. Would hate to go back in casts after wearing those frames for a year. My local ortho recommended that I don't do any high impact sports or running until a year after frame removal, so at the end of June I'll get another x-ray and send those to Dr Parihar as well. If they give me the go ahead at that point then I'll start running and post some videos showing what it looks like.
Seems I just had particularly short tibiae to begin with, as others around my starting height have said that their tibs are around 5 cm longer. You could still do tibiae for 5.5 cm with your femurs still slightly edging them out in length. Unless you're thinking of lengthening a higher amount?
Going from Obese to lean, I always thought I was in good shape. How wrong I was, especially when I am dismissed by strangers as a kid :D. I don't know at about 171cm weight training is better than aerobics I suppose. But if I were 180cm I would have preferred being lean.
It's not necessary to become a meathead, that's for sure. Being lean is great especially if you have good muscle definition. I do wish I was more vascular because I always liked the veined look on the arms, but it's just not on the cards for me as far as genetics go.
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A stress fracture would indeed be horrible after being in frames for such a long time. How is your functionality in the everyday use? Walking longer distances or walking down some stairs?
I don't plan to lengthen more than 5cm's, but I'm afraid that my biomechanics get affected by increasing my already long tibias.
You had really short tibias before this surgery that's probably the reason why your legs look completely normal after doing 6cm's.
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Hey congrats on doing this, your legs look great no homo. So this whole process took you a year? Is that how long you stayed in India?
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I wish you the best man <3
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how are you doing Kilo?
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FINAL X-RAYS (1-28-2016)
(http://s6d8.turboimg.net/t1/25315467_1-28-2016-1.jpg) (http://www.turboimagehost.com/p/25315467/1-28-2016-1.jpg.html) (http://s6d8.turboimg.net/t1/25315469_1-28-2016-2.jpg) (http://www.turboimagehost.com/p/25315469/1-28-2016-2.jpg.html) (http://s6d8.turboimg.net/t1/25315470_1-28-2016-3.jpg) (http://www.turboimagehost.com/p/25315470/1-28-2016-3.jpg.html) (http://s6d8.turboimg.net/t1/25315472_1-28-2016-4.jpg) (http://www.turboimagehost.com/p/25315472/1-28-2016-4.jpg.html)
Just picked up my final set of x-rays that I took last Thursday. My local ortho was surprised at how much dorsiflexion my ankles now have. Because I was in Ilizarov frames for over a year, he thought it would take me much longer to regain my flexibility. He was also surprised that my right fibula connected, as a while back it looked like the ends would only connect a narrow center, yet now the right fibula is thicker than the left one. I was told that it would be my final ortho appointment because he's confident I'll have no problems down the line. Of course I asked him when I could get back to running, jumping, and weight training on the legs. He replied that I should do the elliptical machine as much as I can and that I'll have no problem doing leg curls, extensions, or the leg press machine right away. However, I should do these exercises for two months before I start running again so I can train my legs to get used to the constant impact that comes with running. I haven't sent these to Dr Parihar yet but I wonder if he'll recommend the same thing.
I did my first leg workout in over a year a few days ago. I could do presses, curls, extensions, and elliptical without problem. No pain or anything, but the muscles in my legs are definitely a lot weaker, especially in the upper legs just above the knees. I think I'll stick to waiting two months before trying to run on pavement again and just focus on strengthening my legs with weights and the elliptical machine.
Without question, I can say that I'm very happy at taking the plunge with leg lengthening. A big sigh of relief that I didn't have to deal with any major complications. I'm thankful to the forum members for letting me share this process, thankful to my local orthopedist for removing my frames and helping me recover, and especially thankful to Dr Mangal Parihar, Dr Divya Ahuja, and the rest of Dr Parihar's team for their surgery and aftercare during the lengthening process.
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It's really go to hear you're doing well mate. I'm happy for ya.
Remember to make those exercise videos one day ;)
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Thanks, Alu. Will do. Dr Parihar also told me to do strength training and stretching with light jogging for two months, and after that I'm "free as a bird". So I'll get some videos done in a few months from now.
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It's awesome that you're doing well.
How "back to normal" would you call yourself in terms of percentage? 95%?
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Kilokahn,
I just saw your recent xrays and pictures and I must say they all look good.
It's amazing to see how you have transformed from the photos you took over a year ago.
You're in very good shape and doing extremely well.
Keep it up!
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Kilokahn,
I just saw your recent xrays and pictures and I must say they all look good.
It's amazing to see how you have transformed from the photos you took over a year ago.
You're in very good shape and doing extremely well.
Keep it up!
Thanks, TRS. Hoping in a few months I'll be running and doing other exercises without problem.
It's awesome that you're doing well.
How "back to normal" would you call yourself in terms of percentage? 95%?
Upper body is stronger than its ever been and I've regained just about all of my prior flexibility in the legs. I no longer have any random muscle pains but waking up in the morning I do have a little tightness in the upper part of my calves that goes away with a one minute gastroc-soleus stretch on each leg. I did some light jogging up and down a hill 1.5 miles each way, and it felt a little weird. Hard to describe the exact feeling but it has to be due to the legs not being used to any sort of running impact in a whole year and a half.
What's not so great is that while jogging I build up a lot of pressure in the calves that makes me have to take breaks often. It's possible that it has to do with muscle weakness, but I think it's possible I have chronic exertional compartment syndrome. I don't think this is due to the leg lengthening, but CLL likely didn't help it either. Before leg lengthening I didn't run a lot and I'd get lower leg pain/pressure pretty fast. But I just chocked it up to being really overweight. I did find out about exertional compartment syndrome online sometime ago and read that building mass in the calves can exacerbate the issue, and when meeting with Dr Parihar I asked if he would do fasciotomy during surgery for me just in case I do have it. He said I'd have to take tests to figure out if I do have CECS and that he doesn't do fasciotomy as a routine because with any sort of procedure it's possible to have drawbacks. But I told myself that the pain while running was just due to me being heavy and decided I wouldn't ask him to test me for CECS.
I'll continue with stretching, strength training, and light jogging over the next few months to see if the pressure problems persist. If it does then I'll probably take a test for CECS and if I do have it the fasciotomy is apparently not a big deal with few (nothing major) side effects.
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Have you tried swimming instead? It works all of the same muscles as running without the impact pain you seem to be experiencing.
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hey Kilo, I am a newbie here. First of all, I need to say Thank You So Much! Your diaries are very informative and I have to admit, you are so patient and helpful to all the LLers. I am impressed with your decision over the exfix, one year with the frames... dude, you are the man! I honestly don't think I could do it, though I am also determined to gain height, one year is such a pain in the neck!
I am considering LL, and definitely Dr Parihar if I am to go to India. At the moment, I need some information to work out a plan and start saving for it. I would appreciate much if you could share some of your experience on below questions:
1. I am about your pre-op height, 138lb. I remember you were saying that muscular calves would provide better blood supply and hence lead to better recovery. But, I read on others' diaries that muscular calves would indeed, make the distraction more painful, and limit the stretching. Since you have completed the procedure, I would like to know your thought on this. Should I put on more weight/muscles or my current weight is actually an advantage for early weight bearing if I am to go for the LON tibiae? I really want to avoid having equinus, ballerina foot, duckass, knee pain and other complications.
2. Why did you decide to go for the tibiae instead of femur? Given the fact that tibiae has longer recovery rate, possibility of knee pain (I know you were worried about this and it made you chose external) and safe limit of 6cm rather than 8cm.
3. Does it different much on the surgery cost between LON femur and LON tibiae? You had 3months for 6cm on 0.75mm/day, is it possible to have 8cm on LON femur with 1mm/day within 3 months?
4. You mentioned you would have gone for the LON tibiae, does that mean that you will need to travel all the way to India again for the third surgery or you are allowed to remove it at the local hospital? Would the third surgery be another additional cost if you were to travel to India?
5. If you happened to have higher budget. Would you go to Dr Aimin Peng in China or you would go to Dr Parihar for Precise2?
Thanks in advance, mate.
By the way, you look fantastic with your new look :)
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Have you tried swimming instead? It works all of the same muscles as running without the impact pain you seem to be experiencing.
Read DoingItForMe's diaries, swimming definitely the best and most effective physio
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Read DoingItForMe's diaries, swimming definitely the best and most effective physio
Why are you telling me my own advice? I know this
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No no, I Read (past tense). I agree with your advice.
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hey Kilo, I am a newbie here. First of all, I need to say Thank You So Much! Your diaries are very informative and I have to admit, you are so patient and helpful to all the LLers. I am impressed with your decision over the exfix, one year with the frames... dude, you are the man! I honestly don't think I could do it, though I am also determined to gain height, one year is such a pain in the neck!
I am considering LL, and definitely Dr Parihar if I am to go to India. At the moment, I need some information to work out a plan and start saving for it. I would appreciate much if you could share some of your experience on below questions:
1. I am about your pre-op height, 138lb. I remember you were saying that muscular calves would provide better blood supply and hence lead to better recovery. But, I read on others' diaries that muscular calves would indeed, make the distraction more painful, and limit the stretching. Since you have completed the procedure, I would like to know your thought on this. Should I put on more weight/muscles or my current weight is actually an advantage for early weight bearing if I am to go for the LON tibiae? I really want to avoid having equinus, ballerina foot, duckass, knee pain and other complications.
Some surgeons said that muscular calves would help because it would increase blood flow to the area. My surgeon isn't convinced one way or the other on muscles being a good or bad thing, however he's a big proponent of regular stretching and physiotherapy. I think it's better to focus on stretching and not worry about trying to add bulk to your legs. They'll atrophy a lot no matter what you do, but improving your flexibility before surgery can only help.
2. Why did you decide to go for the tibiae instead of femur? Given the fact that tibiae has longer recovery rate, possibility of knee pain (I know you were worried about this and it made you chose external) and safe limit of 6cm rather than 8cm.
The most basic reason for choosing tibiae lengthening instead of femur lengthening is that I couldn't afford surgery with an internal nail, and there's no way I'll be willing to put myself through external femur lengthening.
3. Does it different much on the surgery cost between LON femur and LON tibiae? You had 3months for 6cm on 0.75mm/day, is it possible to have 8cm on LON femur with 1mm/day within 3 months?
My guess is there would be a slight difference in cost between LON femurs and LON tibiae, but not major. Dr Parihar is very reluctant to do external femurs (he might flat out say no) for any amount for cosmetic cases due to the scarring and higher risk of knee stiffness that comes with exfix or LON femurs. Bluebarbie and Dozer would be in better position to tell you what to expect for femur lengthening with a frame or a bar.
4. You mentioned you would have gone for the LON tibiae, does that mean that you will need to travel all the way to India again for the third surgery or you are allowed to remove it at the local hospital? Would the third surgery be another additional cost if you were to travel to India?
You don't have to get the nails removed by the surgeon that put them in, although there are instances where it made the most sense for people to get the nails taken out by the same doctor. Because of my company insurance, if I did LON with Dr Parihar I could have gotten the nails taken out by my local traumatologist for only $250 USD. Nail removal wouldn't be included in the surgery cost. I didn't ask for the price but it would be cheap considering the initial surgery was roughly $15,000.
5. If you happened to have higher budget. Would you go to Dr Aimin Peng in China or you would go to Dr Parihar for Precise2?
My experience with Dr Parihar was very positive. If I were to do internal femurs I'd choose him to do it because I've already been a patient of his and that eliminates the guesswork on whether I can trust my surgeon or not. I'm not sure that Dr Peng has access to Precice nails for internal lengthening. Have you heard from him about that being an option at his clinic?
Thanks in advance, mate.
By the way, you look fantastic with your new look :)
Thanks 8)
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Yo mate, thanks for the prompt reply, very useful.
One very stupid question, please correct me if I am wrong.
There are basically two main types of lengthening surgical procedure, the internal and external. Internal may refer to the Precise while External can be either LON/LATN or ex fix. You were paying $15000 for the ex fix, so LON tibiae may cost even higher since there will be an installation of the intramedullary nails?
It has been nearly 8 months since your frame removal, do you still experience any discomfort at all? Have you get used to your new height, and feel "short"? We are on the same boat, have tall siblings and relatives.
Regarding Dr Peng, I haven't heard much about him, haven't even started reading Medium's diaries yet. The cost is definitely an issue, which means I may need to postpone the surgery to another year, not ideal. And, I really like the sound of Dr Parihar, a little bit of old-school, safe and put patients' safety as the priority based on his said, "function over length". People may feel reluctant to seek medical treatment from developing country due to the stereotypical views, but there are good/bad doctors everywhere, just like there are good/bad patients. So, I would say, wise choice ;)
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Yo mate, thanks for the prompt reply, very useful.
One very stupid question, please correct me if I am wrong.
There are basically two main types of lengthening surgical procedure, the internal and external. Internal may refer to the Precise while External can be either LON/LATN or ex fix. You were paying $15000 for the ex fix, so LON tibiae may cost even higher since there will be an installation of the intramedullary nails?
The 900,000 INR quote is the price for LON and includes the nails. After I decided on exfix only, Dr Parihar recommended I pay the LON amount because of how he planned to do the follow ups. It covered the additional surgery I needed to correct some misalignment and add the middle pins for stability, the changing of the rods to hexapod struts to improve alignment, and the extra hospital stay that I needed for that second surgery.
It has been nearly 8 months since your frame removal, do you still experience any discomfort at all? Have you get used to your new height, and feel "short"? We are on the same boat, have tall siblings and relatives.
I've reached recovery to the point where I have no discomfort walking or going up and down stairs. The only discomfort I now get has to do with pressure in the calves while running. If it doesn't get any better within the next few months I'm going to go back to my local ortho and test for CECS.
I still recognize that I'm shorter than average, but now I rarely come across a woman who is taller than me and I feel more normal than I did previously. There were cases where people would blurt out matter-of-factly how short I was, but since the surgery I've yet to have my height mentioned by strangers. I could live at 5'7. Any extra height would be considered a luxury that I'd only do if I came across a lot of time and money to spend.
Regarding Dr Peng, I haven't heard much about him, haven't even started reading Medium's diaries yet. The cost is definitely an issue, which means I may need to postpone the surgery to another year, not ideal. And, I really like the sound of Dr Parihar, a little bit of old-school, safe and put patients' safety as the priority based on his said, "function over length". People may feel reluctant to seek medical treatment from developing country due to the stereotypical views, but there are good/bad doctors everywhere, just like there are good/bad patients. So, I would say, wise choice ;)
Dr Parihar definitely has a safety first attitude and he never gave me the "don't worry, no problem" response that other docs in India have given patients when they were worried about something. In fact, there was one visit where I was walking into the lobby with the zimmer frame, very exhausted and breathing heavily, and he immediately had me get my chest x-rayed to make sure I didn't have any issues. Turns out it was just fatigue, but he never ignored me when I had a concern. I'd say the difficulty of doing surgery with Dr Parihar primarily lies in being in a foreign country and not having much opportunity for social interaction outside of the hospital - all of his patients are Indian and I was the only person going to him for CLL at the time. However, if you're willing to spend the money for a long term stay at a hotel, it's very comfortable under the circumstances.
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The 900,000 INR quote is the price for LON and includes the nails. After I decided on exfix only, Dr Parihar recommended I pay the LON amount because of how he planned to do the follow ups. It covered the additional surgery I needed to correct some misalignment and add the middle pins for stability, the changing of the rods to hexapod struts to improve alignment, and the extra hospital stay that I needed for that second surgery.
So, I suppose I will need to pay extra if I am to have LON and additional surgery for the misalignment? Or the LON itself reduce the chances of misaligment?
I've reached recovery to the point where I have no discomfort walking or going up and down stairs. The only discomfort I now get has to do with pressure in the calves while running. If it doesn't get any better within the next few months I'm going to go back to my local ortho and test for CECS.
Yea, give them a wee bit more time, they are still baby muscles.
I still recognize that I'm shorter than average, but now I rarely come across a woman who is taller than me and I feel more normal than I did previously. There were cases where people would blurt out matter-of-factly how short I was, but since the surgery I've yet to have my height mentioned by strangers. I could live at 5'7. Any extra height would be considered a luxury that I'd only do if I came across a lot of time and money to spend.
I've always thought US is an easy-making money country, or it is just a misconception? I am from the UK by the way.
Dr Parihar definitely has a safety first attitude and he never gave me the "don't worry, no problem" response that other docs in India have given patients when they were worried about something. In fact, there was one visit where I was walking into the lobby with the zimmer frame, very exhausted and breathing heavily, and he immediately had me get my chest x-rayed to make sure I didn't have any issues. Turns out it was just fatigue, but he never ignored me when I had a concern. I'd say the difficulty of doing surgery with Dr Parihar primarily lies in being in a foreign country and not having much opportunity for social interaction outside of the hospital - all of his patients are Indian and I was the only person going to him for CLL at the time. However, if you're willing to spend the money for a long term stay at a hotel, it's very comfortable under the circumstances.
Do you think if Dr Parihar may go up to 6.5cm if the patient seems fit and potential?
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Do you think if Dr Parihar may go up to 6.5cm if the patient seems fit and potential?
I think if your condition is fine then he may let you push it that extra half centimeter, but if you have significant knee bend and equinus way before that then he'll advise against it. He mainly has a 6 cm limit for tibiae lengthening because by that point almost every patient has issues they need to correct, and the complications increase exponentially the more you lengthen beyond it.
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The 900,000 INR quote is the price for LON and includes the nails. After I decided on exfix only, Dr Parihar recommended I pay the LON amount because of how he planned to do the follow ups. It covered the additional surgery I needed to correct some misalignment and add the middle pins for stability, the changing of the rods to hexapod struts to improve alignment, and the extra hospital stay that I needed for that second surgery.
So, I suppose I will have to pay extra if I am to have LON and need additional surgery for the misalignment? Or the LON itself reduces the chances of misalignment?
Tried to insert multiple quotes in one post, end up I screwed up lol! Please allow me to ask some previous question again.
What about gym activities like leg presses? Can you manage at this stage?
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So, I suppose I will have to pay extra if I am to have LON and need additional surgery for the misalignment? Or the LON itself reduces the chances of misalignment?
What about gym activities like leg presses? Can you manage at this stage?
LON helps prevent misalignments in the bone. If Dr Parihar put the middle pins in during the initial surgery it would have helped prevent misalignment as well, but it would have left a long scar in the middle of my legs after distraction so he decided to add them after the lengthening phase was completed. I'm not sure about the costs for correcting complications if you decide to go the LON route. Best to e-mail him directly about that.
I'm allowed to do leg presses now, but I'm just doing them light at 110 lbs. My leg muscles got a lot weaker.
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Does he do femur lengthenings on a regular basis. Non cosmetic I mean. All his videos seem to be about tibiae.
Also what's his email? Thanks
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Does he do femur lengthenings on a regular basis. Non cosmetic I mean. All his videos seem to be about tibiae.
Also what's his email? Thanks
He has instructional videos on his channel about applying fixators to femurs. I think they start with 'Sawbones Workshop'. I saw a number of patients in his lobby with all kinds of external fixators throughout my visits to the hospital for checkups and physio. I saw some wearing the unilateral fixator on one femur and some wearing the half-ring.
You can e-mail him at mangalparihar@parihar.net or Dr Ahuja at divya@parihar.net
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Helloo
are there chances of height compression or we will get the full height turned?
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Helloo
are there chances of height compression or we will get the full height turned?
Once the bone has been lengthened and locked into position then there is no real compression. At most a couple mm. Dr Parihar told me that articles showing a difference between amount lengthemed on x-rays and total height actually gained is due to magnification of the x-rays not being taken into consideration and measurement errors.
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I take fentanyl patches mixed with a little bit of Hashish, and I go to sleep, and sleep like a baby. I have everyday since my surgery. The hashish was right after I left the hospital though. I plan on switching to Coconut oil hash oil for sleep. I am from US, and we believe Marijuana to be a healthier alternative to pain. And sleep problems.
Update: 7/30/2014
This last week has been so damn frustrating. Every night it takes me longer than the night before to mange to get a moment's sleep. I have bags under my eyes and am dead tired but the discomfort and pain prevents any chance of dozing off. If I find one comfortable position, that same position is no longer comfortable the next night. I can't lie with a pillow between my frames, can't fan my legs out, can't have my legs straight and my upper body sitting up, nothing works and I'm even taking sleeping pills. Walking is still impossible and standing makes my legs hurt now. At this point I don't care if a stronger pain killer will be injurious to my liver. I just don't want to be up another week. Takes me up to 8 hours just to doze off for a half hour and when I wake from that there's no going to sleep again.
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I just start distraction like 4 days ago. I was able to walk just fine. But Now when ever I walk, my bones pop right around the area of where the bones broke, so it has made me skeptical about walking, and fearful of it.
I am doing it with Dr. Dhawan.
I just got a reply from Dr Parihar after telling him about the pain issue. He wants me to go back to .75 mm per day each day instead of alternating days between .75 mm and 1 mm. He said if that does not help with the pain then he will consider adding the two pins to the middle ring early to improve stability instead of adding them once distraction is complete. It would mean a scar in the middle that goes the length of how much left I have to distract, but he said the longer scar is probably preferable to the pain I'm experiencing now. I have to update him in a few days and he's going to have someone get in touch with me to deliver a wheelchair here so I don't have to be stuck in bed all day and can at least wheel out to the lounge or something for a change of scenery.
I took that for a bit but they took me off it. I'll ask about taking it again next time I see him.
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I take fentanyl patches mixed with a little bit of Hashish, and I go to sleep, and sleep like a baby. I have everyday since my surgery. The hashish was right after I left the hospital though. I plan on switching to Coconut oil hash oil for sleep. I am from US, and we believe Marijuana to be a healthier alternative to pain. And sleep problems.
Weed probably would have helped with pain, but if you do lengthening in Mumbai you'd need some sort of connection to help you get it. I know for sure the hotel management wouldn't get any for me and the hospital definitely wouldn't if you asked them. At most it's some NSAID in the first couple weeks and then you're moved to a light pain medication. It's possible that prolonged use of NSAIDS can negatively affect bone healing and Dr Parihar doesn't like to give out anything that can affect your mental state too much, like norco or morphine. I do like that prescription drugs are very inexpensive in India. Spent maybe $40 on them for my entire stay, IIRC.
I just start distraction like 4 days ago. I was able to walk just fine. But Now when ever I walk, my bones pop right around the area of where the bones broke, so it has made me skeptical about walking, and fearful of it.
I am doing it with Dr. Dhawan.
Is Dr Dhawan telling you to walk? When I consulted with him he told me that I should not make myself walk during distraction, but once lengthening is complete he'd encourage gradual weight bearing depending on the bone strength. From my own experience, I don't think forcing yourself to walk early is all that beneficial, and if you accidentally fall (which I did a couple times) it could cause problems. A lot of stretching and physio exercises would benefit, and to help prevent equinus you should wear the foot splints and stand as much as possible with your back against a wall to prevent your hips from sticking back and minimizing the stretch.
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So I've received a couple messages regarding concern over the shape of my tibiae. I decided to post my response here because it would likely be something others are curious about. Below from left to right is a closeup of my tibiae on my pre-op x-ray, the final x-ray for the right tibia and the final x-ray for the left tibia. I rotated the latter two using lunapic and they may not be perfectly straight up, but it's close enough I think.
(http://s6d8.turboimg.net/t1/25759720_pre-op_tibiae_closeup.jpg) (http://www.turboimagehost.com/p/25759720/pre-op_tibiae_closeup.jpg.html) (http://s6d7.turboimg.net/t1/25759704_right_upright.jpg)(http://s6d7.turboimg.net/t1/25759703_left_upright.jpg) (http://www.turboimagehost.com/p/25759704/right_upright.jpg.html)
You'll notice that my tibiae are not straight like a nail and have a bend to them. I was a little curious about it after my first x-ray, but I didn't pay much attention to it. After I received more than one message asking about their shape, I started to wonder why neither Dr Parihar or my local ortho, or any of the radiologists who saw my x-rays said anything about something that was clearly noticeable to others. I e-mailed Dr Parihar and Dr Paley about this, pointing out that my tibiae aren't as straight as other people's in x-rays I have seen, and asked if the curves could be an issue later down the line.
The response from both of them is that a bend in the tibia like seen in my x-rays is a normal variation. They do not cause functional issues or increase the risk of arthritis, etc. Tibia alignment is what matters, not the straightness of the tibial shaft. As long as the center of the femoral head, knee, and ankle are in one straight line in a standing x-ray, and the knee joint and ankle joint are more or less perpendicular to the floor, bends in the tibia are no problem. I was sent x-rays of other cosmetic patients with tibiae of similar shape, confirming that it's not uncommon.
A tibia shaped like mine does affect whether or not a patient qualifies for doing LON, however. A tibia with a bend similar to mine is in many instances unable to accommodate the nail used in LON and prospective LON patients have been told for this reason that they can only do externals.
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Realized above I put "the knee joint and ankle joint are more or less perpendicular to the floor". That's incorrect. I should have said "parallel to the floor".
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I actually just looked at my current X-RAY and your old X-RAYS and compared them both to your new X-RAY and it actually looks fine. I was one of the worry warts who thought it looked bent at first but it's not bent at all from what I can see. And your walking seems fine.
Paley and Parihar definitely would know a bent bone when they see one, so if they say it's fine then it's fine!
Hope you've been recovering well KIlokahn!
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Normal variation indeed. Nothing to worry about, KK.
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Going skydiving in a half hour. Will let you guys know if my legs withstand the landing lol.
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Going skydiving in a half hour. Will let you guys know if my legs withstand the landing lol.
Sounds great!
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don't lose any height from the landing.
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Going skydiving in a half hour. Will let you guys know if my legs withstand the landing lol.
Good luck man.Where will you do it?Please tell us what it feels like,i really want to do it someday :D
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Going skydiving in a half hour. Will let you guys know if my legs withstand the landing lol.
no way dude! as per crimson, youre supposed to have a bad outcome. youre not even supposed to be walking. kek ::) only elites can do those
anyways goodluck man
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Should be ready to make a running video within the next two weeks. As of now the only pain I have left is in one of the pin sites, which is still pretty sensitive and hurts if I get hit there. Wondering if that will go away.
Good luck man.Where will you do it?Please tell us what it feels like,i really want to do it someday :D
There's a popular skydiving location in Southern California at Lake Elsinore. The experience was really fun. You don't get that sensation of butterflies in your stomach when dropping and it's really peaceful after you deploy the parachute and you coast to the ground. The most nerve wracking part of it is when the plane reaches its 16,000 ft elevation and starts coasting. That's when you realize "Oh man, I'm really about to do this". The jump itself is much less scary than bungee jumping though. The most uncomfortable thing is that the harness wraps tight around your thighs and you get a little rope burn from it.
don't lose any height from the landing.
Turns out that when you land you're supposed to do so on your butt, so no impact on the legs.
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How would you describe your recovery in terms of %? how much % are you from your pre LL self?
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Hard to say. I haven't gained back the muscle in the thighs that I lost from this whole thing, and I haven't yet tried to run any faster than a mild jog.
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hello bro ..how are u now?
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Hard to say. I haven't gained back the muscle in the thighs that I lost from this whole thing, and I haven't yet tried to run any faster than a mild jog.
Walking wise are you walking strange? Can anyone notice something off with your daily walking in the streets?
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I feel 100% normal when walking and people I've asked who know what I did don't think my walking looks weird at all. Here's a quick vid of what it looks like. Not really good for seeing my proportions though because I fished out my old pants from when I was a lot heavier and they're way too big for me now.
http://www.youtube.com/watch?v=HBYTdoqDVz0
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amazing kilohan :) doesnt look strange at all (I looked where your knees are). You look perfectly normal
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Looks great, could never tell you had LL.
Excellent body language, well dressed...looking good man.
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do you still feel numb or hurt anyway?
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amazing kilohan :) doesnt look strange at all (I looked where your knees are). You look perfectly normal
Apparently my tibiae were very short even for my starting height. I guess the lengthening normalized them in comparison to my femurs.
Looks great, could never tell you had LL.
Excellent body language, well dressed...looking good man.
Thanks.
do you still feel numb or hurt anyway?
There's a soreness around the middle pin site on my right leg whenever my feet make impact with the ground while running. Aside from that, nothing outside of the pressure that builds up after running or walking on a steep incline. That's a separate issue from the CLL. I believe I have CECS, but won't know for sure until I test for it around the end of April.
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Wow, No one will believe that you had a LL surgery unless you tell them. Happy for you man.
I removed my frames recently, I hope I will be able to walk as good as you in a few months. Fingers crossed.
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My girlfriend left me for another guy today and it really came as a shock. Surprisingly I didn't get emotional about it or anything beyond having a sunken feeling in my chest for a while. But I think having had CLL helped me. If I didn't get the procedure I know the first thing I would have told myself is "she left me because of my height". Right now that's not even in my mind, so the CLL helped me psychologically in that sense.
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Sorry, mate.
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Well that freakin sucks.
Bravo on the mindset!
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I feel 100% normal when walking and people I've asked who know what I did don't think my walking looks weird at all. Here's a quick vid of what it looks like. Not really good for seeing my proportions though because I fished out my old pants from when I was a lot heavier and they're way too big for me now.
http://www.youtube.com/watch?v=HBYTdoqDVz0
Nicely done Kilo. Congrats on being done.
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sorry for you
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I'm now able to run without it feeling weird, so I'm hoping in the next week I'll be able to show a video doing various physical activities and have a friend film it. I've been biking to and from work for a total of 15 miles 5 days a week and it's really helped restore leg strength.
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I'm now able to run without it feeling weird, so I'm hoping in the next week I'll be able to show a video doing various physical activities and have a friend film it. I've been biking to and from work for a total of 15 miles 5 days a week and it's really helped restore leg strength.
Nice, great to hear.
Thanks for the update
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I'm now able to run without it feeling weird, so I'm hoping in the next week I'll be able to show a video doing various physical activities and have a friend film it. I've been biking to and from work for a total of 15 miles 5 days a week and it's really helped restore leg strength.
Hey,
Glad to hear the recovery is going well. Do you now feel confident that you will be able to recover to pre op leg strength and explosiveness or does it feel like that will not be possible?
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Wait, Kilo, what's your wingspan if you dont mind me asking.
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Same as height now. 170 cm.
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Wait, Kilo, what's your wingspan if you dont mind me asking.
170CM
Edit: huh..posted at nearly the same time..
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A couple people asked me about my scars. Here's what they look like now. Some have faded well, but others retained a dark color. They don't bother me, but if you have frames put on and are concerned about scars, you're likely going to want to get scar revision done later on to lighten them.
(http://s6d7.turboimg.net/t1/27355834_scars_left_leg.jpg) (http://www.turboimagehost.com/p/27355834/scars_left_leg.jpg.html) (http://s6d7.turboimg.net/t1/27355836_scars_right_leg.jpg) (http://www.turboimagehost.com/p/27355836/scars_right_leg.jpg.html)
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A couple people asked me about my scars. Here's what they look like now. Some have faded well, but others retained a dark color. They don't bother me, but if you have frames put on and are concerned about scars, you're likely going to want to get scar revision done later on to lighten them.
(http://s6d7.turboimg.net/t1/27355834_scars_left_leg.jpg) (http://www.turboimagehost.com/p/27355834/scars_left_leg.jpg.html) (http://s6d7.turboimg.net/t1/27355836_scars_right_leg.jpg) (http://www.turboimagehost.com/p/27355836/scars_right_leg.jpg.html)
doesn't look bad at all Kilo!
are you planning on getting laser scar removal?
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doesn't look bad at all Kilo!
are you planning on getting laser scar removal?
Most likely not. To me they look like bug bites or something, but the women I've asked find them attractive after I tell them they're from an injury. I might try out a skin bleach for the dark ones though, just to lighten them a tiny bit.
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hi .congratulations..
::) ::) ::) ::)
you are one of the lucky patient ...
are you satisfy with your current height ?
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Hey, I have been following your diary since day one and just wanted to ask. Do you think it's possible to do what you did but also insert a nail to be able to not wear the frames for a year. Ideally I would like to just tell people I'm injured while I'm on a cain or on a wheelchair waiting for consolidation. I just don't want to wear the frames for the whole year
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hi .congratulations..
::) ::) ::) ::)
you are one of the lucky patient ...
are you satisfy with your current height ?
Well I'm still shorter than average and still a lot shorter than most of my siblings, so it would be nice to be a couple inches taller. But at least now I'm taller than most women and not one person has commented on my height negatively, whereas before I'd randomly have people tell me how short I am, as if I didn't know. Getting from just under 5'5 to 5'7 was a necessity for me. Getting from 5'7 to 5'9 would be a luxury if I had the extra time and money.
Hey, I have been following your diary since day one and just wanted to ask. Do you think it's possible to do what you did but also insert a nail to be able to not wear the frames for a year. Ideally I would like to just tell people I'm injured while I'm on a cain or on a wheelchair waiting for consolidation. I just don't want to wear the frames for the whole year
You could do LON and get the frames removed in 4 months.
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You could do LON and get the frames removed in 4 months.
But I thoght that you couldn't do lon with the hexapod? From my understanding it is the main reason you ended up so well or am I wrong?
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But I thought that you couldn't do lon with the hexapod? From my understanding it is the main reason you ended up so well or am I wrong?
If you want to use something like a hexapod or TSF you can't have a nail inside. I think it's possible to put a nail inside afterward, but I know Dr Parihar doesn't like to do LATN for regular cosmetic cases because there's a chance of harming/bending the regenerate during nail insertion because the newly created bone is still soft and malleable. He might agree to do it if you have commitments that prevent you from wearing the frames that long though, or he might just say you should simply go the LON route.
I'm not sure what my good recovery can be mostly attributed to. I think it's a combo of the initial surgeries being done technically well by my surgeon and doing a lot of walking and biking once the frames were removed, allowing my muscles to recover strength relatively fast.
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sorry if you've already mentioned this, but how did you manage to travel from the hotel to the clinic and back?
from what I know, India is not very disability friendly in terms of having wheelchair ramps, etc.
do you think someone who couldn't even weight bear with crutches would have been able to manage?
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sorry if you've already mentioned this, but how did you manage to travel from the hotel to the clinic and back?
from what I know, India is not very disability friendly in terms of having wheelchair ramps, etc.
do you think someone who couldn't even weight bear with crutches would have been able to manage?
The hotel staff would help me down the elevator and they'd call one of those auto-rickshaws to park in front of the hotel before they helped me inside. Once I arrived at Mangal Anand one of the staff would bring a wheelchair and would help me out of the rickshaw. I didn't go anywhere aside from the hotel lobby and the hospital. I don't think it's possible to go out and see things after surgery even with an attendant due to the crowds, traffic, and many high and uneven curbs.
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wow, you look great after that procedure man. Congrats on that one. I'm currently the height you started at but im 19 years old. How do you feel about pushing to 6ft if you had the money and time? Would you do it ?
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Pushing for 6ft is pretty dangerous and uber risky. You don't want to go beyond your muscle tissues and nerves' elasticity. Even if Kilo had the money, time, and mentality for another LL.. I don't think 6ft is worth the bloody risks.
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Took a standing pic with a friend of mine just because we have very different body types. He has a long wingspan for his height, but it helps to imagine what I'd look like in comparison to him if I were to attempt lengthening femurs later. He's slightly over 6'0.
(http://s6d4.turboimg.net/t1/28244873_fiveseven_vs_sixoh.jpg) (http://www.turboimagehost.com/p/28244873/fiveseven_vs_sixoh.jpg.html)
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You look good mate. I do have two questions:
1) Where are you knees at? Are they really located where that rip/wrinkle adjacent to it? Seems relatively low considering that you did 6 CM.
2) Is your waist located at your belt/end of the pants? Or are the pants more pulled up?
Cheers!
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Hypothetically if you went for femurs, would you go to Parihar again?
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Took a standing pic with a friend of mine just because we have very different body types. He has a long wingspan for his height, but it helps to imagine what I'd look like in comparison to him if I were to attempt lengthening femurs later. He's slightly over 6'0.
(http://s6d4.turboimg.net/t1/28244873_fiveseven_vs_sixoh.jpg) (http://www.turboimagehost.com/p/28244873/fiveseven_vs_sixoh.jpg.html)
It's pictures like this that show why something as insignificant as 2" on a ruler, is actually huge when it is height on a person. You don't look that short compared to his 6' now, but a 5'7 to 5'9 jump would close that gap in height significantly.
Lot's of lifting time, looking good man.
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you should put a pic in the before and after section Kilo.
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Same as height now. 170 cm.
Pure curiosity: how long is your arm?
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You look good mate. I do have two questions:
1) Where are you knees at? Are they really located where that rip/wrinkle adjacent to it? Seems relatively low considering that you did 6 CM.
2) Is your waist located at your belt/end of the pants? Or are the pants more pulled up?
Cheers!
1) The knees are higher than the rip. On the left leg (my right) I believe the knee is at the bottom point of that white line that goes down, just before the indent.
2) The belt is a little higher than waist level. Because I tied it tight it hiked up a bit and pushed my shirt up, where you can see it's puffed on the sides.
Not a good pic for accurate proportion comparison, although I could probably convince my friend to take a similar pic with us in our boxers.
Hypothetically if you went for femurs, would you go to Parihar again?
Most definitely.
Pure curiosity: how long is your arm?
I'll have to get back to you on that. Haven't measured arm length by itself.
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wow, you look great after that procedure man. Congrats on that one. I'm currently the height you started at but im 19 years old. How do you feel about pushing to 6ft if you had the money and time? Would you do it ?
Missed this question.
If I were to do femurs, I'd stop at 176 cm. Even at that point I'd probably feel self-conscious about my arm length. Getting to six feet would require just over 7 inches of lengthening in total, and that's way too much for anyone, imo.
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I can't do a proper recovery video until my friend has time to go to the gym with me so he can record things like running, jumping, squats, and the like. However I was able to record doing things like the leg press, leg extensions, and both standing and seated calf raises. As far as I can tell I haven't lost any potential calf strength. The big hit from the CLL was actually in my quads. Those months of lying in bed weakened them severely and all the biking and walking I've done still hasn't brought them back to where they were. Now that I've finally gotten over the mental barrier of working out my legs again, I'll be hitting the leg workouts hard.
https://www.youtube.com/watch?v=9poZkHJGvZI
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Crikey! How much weight did you have on there?
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1) The knees are higher than the rip. On the left leg (my right) I believe the knee is at the bottom point of that white line that goes down, just before the indent.
2) The belt is a little higher than waist level. Because I tied it tight it hiked up a bit and pushed my shirt up, where you can see it's puffed on the sides.
Not a good pic for accurate proportion comparison, although I could probably convince my friend to take a similar pic with us in our boxers.
That picture would be interesting and appreciated lol.
Also thanks for the video. Glad the damage wasn't as severe and debilitating for you!
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what's your inseam now?
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Does Dr Parihar do external femurs? What's the approximate cost and is it monorails?
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Parihar prefers using The Precise Nail for femurs. It's a lot safer. It's around 30,000 US dollars for The Precise. But for external femur it's around 15,000 US dollars. External Femur is slightly more riskier than external tibias.
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Is it on monorails? I Just need 3-4 cm. Sorry I will reply your PM tomorrow as I exceeded three a day.
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I wanna avoid internal femurs because of embolism risk, risk of knee issues.
I prefer external monorails (if done properly with skilled doctors) but the key problems are pin-site infections (which are a chore), long fixation time(6 months to wear the fixators), correction needs to be done properly to keep angulation correct (lots of X-rays and CTs - which means radiation), scars (but these can be fixed).
I wouldn't pay so much money to do internals if it poses its own set of problems. It isn't exponentially better. I've done external tibias before, and it was pretty fine.
Having to go through two surgeries (implant and explant) is also a chore for the femurs. But I guess I would prefer to remove my external monorails under General Anaesthesia - it is less barbaric! Apparently I can bulk bill it.
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In that case Dr. Parihar would be the best option to go if you are going to India. He's the most careful and risk free surgeon I've ever seen. Just look at how well Kilokahn turned out.
About the pm, no worries at all. Reply whenever you can. :)
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My Moscow doctor was very good as well.. But lots of corrections needed to be done.. Was worried of deviation, but it turned out so well. I could even walk without crutches most of the time when I was on fixators and wasn't in any much pain at all. Was able to work, study and even bike. I remember Kilo had lots of pain, snapped pins, etc, which I never had at my doctor... I think they definitely have a more stable and compact frame and/or more experience. I could also walk well 1-2 months after fixator removal, and run about 2-3 months after as well as climb stairs but Kilo had a slower recovery somehow.
But definitely I would agree hes the best in India. I think price will be the deciding factor. If the price could be cheaper, I might be going to India instead of Moscow.
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I wanna avoid internal femurs because of embolism risk, risk of knee issues.
I prefer external monorails (if done properly with skilled doctors) but the key problems are pin-site infections (which are a chore), long fixation time(6 months to wear the fixators), correction needs to be done properly to keep angulation correct (lots of X-rays and CTs - which means radiation), scars (but these can be fixed).
I wouldn't pay so much money to do internals if it poses its own set of problems. It isn't exponentially better. I've done external tibias before, and it was pretty fine.
Having to go through two surgeries (implant and explant) is also a chore for the femurs. But I guess I would prefer to remove my external monorails under General Anaesthesia - it is less barbaric! Apparently I can bulk bill it.
From what I understand (And correct me if I am wrong) the knee pain from internals is when you do internal tibias. Surgeons insert the nail through the hip when doing internal femurs so the knee is out of harm.
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Yes I think you are right... Can anyone clarify? Would there be problems at the hip area?
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My Moscow doctor was very good as well.. But lots of corrections needed to be done.. Was worried of deviation, but it turned out so well. I could even walk without crutches most of the time when I was on fixators and wasn't in any much pain at all. Was able to work, study and even bike. I remember Kilo had lots of pain, snapped pins, etc, which I never had at my doctor... I think they definitely have a more stable and compact frame and/or more experience. I could also walk well 1-2 months after fixator removal, and run about 2-3 months after as well as climb stairs but Kilo had a slower recovery somehow.
But definitely I would agree hes the best in India. I think price will be the deciding factor. If the price could be cheaper, I might be going to India instead of Moscow.
Well at the start of my surgery I was 220 lbs. From a lot of accounts, the bigger patients tended to have a lot more pain during distraction than others, and it was true in my case. But my pins didn't snap on their own. During my second surgery to add two additional pins in the middle of the frame he intentionally cut off the ends of the pins so they weren't in the way during the consolidation phase. My frames were the most compact they could be (only 160 mm in diameter) and still fit, but there was intentional instability by leaving out the middle pins during frame installation. If he put the two pins in the middle like he usually does it would have had optimal stability from the beginning, but that would have created a 6 cm scar down the middle of the leg, which he wanted to avoid in a cosmetic procedure. Was fine in the end though because the hexapod corrected the misalignment.
Yes I think you are right... Can anyone clarify? Would there be problems at the hip area?
I remember reading of someone having remaining hip pain after consolidation. Have to find that example though.
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I remember reading of someone having remaining hip pain after consolidation. Have to find that example though.
http://www.limblengtheningforum.com/index.php?topic=882.0
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http://www.limblengtheningforum.com/index.php?topic=882.0
Whoa. :-\
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http://www.limblengtheningforum.com/index.php?topic=882.0
Thanks for the link, that's the one.
Whoa. :-\
It's hard to take much from it though, considering the OP never responded to the question "How much did you lengthen?" My impression is that if you lengthen the full 8 cm with Precice you'll have more issues than if you were to stop under 7 cm.
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Well, he makes this post about pain...and then a few months later defends internals as not causing pain:
http://www.limblengtheningforum.com/index.php?topic=680.msg24775#msg24775
I spent 10 hours in a car yesterday. My back hurts, my hips hurt. Does he know his pain is from LL? Is he fat? Is he lazy?
He gives so little info, it's impossible to know the truth. Concerning though, for sure.
So Kilo, are ya seriously thinking about another LL?
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So Kilo, are ya seriously thinking about another LL?
I'd like to lengthen my femurs for about the same amount as I did tibiae as getting to a US average of 176 cm would be nice. But I'm not really working toward it seriously. While the first lengthening was something I thought about every day for 6 years, internal femur lengthening is just something I'd do if I had that kind of money to spare.
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Many a times there is no causal connection between what a patient reports many months/years after a procedure and the procedure itself. May merely be being overweight or some other health issues which popped up. Are there any other cases in the literature?
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Getting a feel for what squats are like with plates on the bar after the lengthening (I tried a couple squats before with just the bar). It's just one plate on each side but I want to transition to heavier squat weight at a slower pace. But it seems like there's no reason you shouldn't be able to do squats after recovery so long as you are dedicated to training your legs hard (and don't go crazy with lengthening amount).
http://www.youtube.com/watch?v=0NLc56eEZCI
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Good stuff Kilo.
Not really getting ass to grass in that vid though, is that by choice or is it because of LL?
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I believe Kilo has dorsiflexion in his ankles similar to my left leg, which is 2 inches away from a wall before the heel comes up performing the test I posted in the general discussion. This makes deep squatting especially difficult.
Even normal people are often limited in ankle mobility when it comes to squatting, so tibial LL is definitely a contraindication to deep squatting unless you get some sort of release to improve dorsiflexion, which I am currently contemplating.
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Good stuff Kilo.
Not really getting ass to grass in that vid though, is that by choice or is it because of LL?
Combo of nervousness about falling on my ass and squatting feeling different. The muscles just above my knees are still pretty weak. I'm hoping in about another month I'll have gained enough muscle strength to feel okay going all the way down. My stance had to change a bit from before and I think it's because of the proportion change. So there's no reason you won't be able to do squat movements after surgery, but it will probably feel different.
Edit:As Polycrates said, my dorsiflexion isn't the best, at about 2 inches on each leg with the test. I have the symptoms of CECS and I read that CECS can inhibit dorsiflexion, so if I do end up needing a fasciotomy to treat it I expect my dorsiflexion will improve and squatting will get easier after recovering from it.
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I believe Kilo has dorsiflexion in his ankles similar to my left leg, which is 2 inches away from a wall before the heel comes up performing the test I posted in the general discussion. This makes deep squatting especially difficult.
Even normal people are often limited in ankle mobility when it comes to squatting, so tibial LL is definitely a contraindication to deep squatting unless you get some sort of release to improve dorsiflexion, which I am currently contemplating.
Besides he said he is just getting back.
Btw how much you were able to squat before LL?
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Btw how much you were able to squat before LL?
When I was the same weight in college that I am now I never squatted more than 315 lbs for 3 sets of 8. Always went to the gym solo and didn't want to fail a squat rep with nobody to help me out of it. 1-rep max was probably around 395 lbs just by those numbers.
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I never squatted weights, but I had good range of motion for the position and I used to regularly perform sets of 15 reps on one legged squats, going all the way down with hands and arms forward and no assistance. It's unfortunate I did not perform the wall test prior to LL. It wasn't something on my mind at the time.
I can do one legged squats holding onto something now, and it is clearly seen that my tibia is completely upright when doing so. There is no forward movement available, due to my limited dorsiflexion, thus inhibiting me from doing the one legged pistol squat.
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Great effort Kilo
Your legs look great btw
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I have the symptoms of CECS and I read that CECS can inhibit dorsiflexion, so if I do end up needing a fasciotomy to treat it I expect my dorsiflexion will improve and squatting will get easier after recovering from it.
Hey Kilo,
Is there a thread on CECS somewhere? Google isn't helping me much. It's one of the LL related issues I don't know much about, and I plan to also talk to the doctor about tibia LL during the consult.
Thanks man.
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Hey Kilo,
Is there a thread on CECS somewhere? Google isn't helping me much. It's one of the LL related issues I don't know much about, and I plan to also talk to the doctor about tibia LL during the consult.
Thanks man.
I don't think there's a whole thread dedicated to the subject, but MDOW ended up with CECS and here's what he had to say about it:
http://www.limblengtheningforum.com/index.php?topic=680.msg10966#msg10966
His CECS developed after CLL but I have a hunch that what I thought was shin splints from being fat before surgery was actually CECS, and now that I'm trying to run a lot more it's just affecting me more than it used to. I'm getting a referral this month to test for it.
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I thought it was just an LL thing, didn't know it could just happen anyway. Got it, thanks Kilo.
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I thought it was just an LL thing, didn't know it could just happen anyway. Got it, thanks Kilo.
Yeah, quite a few athletes get it. Here's a really interesting and detailed case report about a special forces soldier who developed CECS.
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3811735/
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Update: 8/22/2016
This morning I saw the local orthopedist who removed my frames last year because I wanted to see if I have Chronic Exertional Compartment Syndrome (CECS). I told him about my symptoms of pressure building up on the front and side of my shins whenever I start running, walk up a steep incline for a long time, or carry something heavy for a while.
He checked my dorsiflexion and said I was still a little tight, although that wouldn't account for the pain I've been experiencing. What surprised me is that he said I shouldn't have started high impact activities yet and that with 6 cm of lengthening I should wait for a full year starting from my last set of x-rays taken after frame removal. Since my last set of x-rays was taken January, 2016 he said I need to stop any sort of running starting now and wait until January, 2017. He also told me that doing strength training on my calves will only aggravate the problem and to stop trying to build mass. Instead, he wants me to focus on improving my flexibility and endurance conditioning. The exercises he wants me to focus on are: swimming, elliptical, spinning, and rowing. Ideally he wants me to progress slowly, starting with 15 minutes each exercise, then ice my legs once I'm done. Later on he'll want me to increase the duration. If I see no improvement come January, he said he'll refer me to a foot and ankle specialist who will test for CECS by having me do high intensity exercises for 20 minutes or so and then stick a needle in each compartment to check the pressure. He said the reason he doesn't want to test me for CECS right away is because compared to a lot of lengthening patients he's seen I've had a great result and he doesn't want to set me back by having me go through a surgery and recovery phase once again.
Btw, I have a slight bulge on the side of each calf that pops up whenever I exercise or have my feet in a neutral position. It's more noticeable on the left leg. My ortho said the reason it's there is because apparently Dr Parihar intentionally cut the fascia to give the muscle more room to expand and prevent CECS from happening. But if it turns out that I do have CECS in a different compartment, he said they'll do the same thing Dr Parihar did but in a different compartment, and I'll have another one of those bumps on each leg. He said that they try as much as possible not to cut the fascia on female patients because women really hate it (a lot of them complain that it looks like they have a cyst).
Took a pic to show you what the legs look like. You'll notice that there's an indentation on my thighs by the knee, and it's the result of muscle loss. Even with tibial lengthening, your thighs take the biggest hit with muscle loss. It's taking a long time to build them back up.
(http://s6d6.turboimg.net/t1/29397290_leg_bumps.jpg) (http://www.turboimagehost.com/p/29397290/leg_bumps.jpg.html)
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I think swiming with flippers is very good for the recovery in tibias lengthening and walking in the beach are the best exercises for this recovery.
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KiloKAHN, I thought Parihar requires patients to have a caretaker? How come you were able to do it alone?
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I think swiming with flippers is very good for the recovery in tibias lengthening and walking in the beach are the best exercises for this recovery.
I swam at the gym the other day. A great conditioning workout for the muscles, even though I'm not that good at swimming. I really don't want another surgery so I'm doing all I can.
KiloKAHN, I thought Parihar requires patients to have a caretaker? How come you were able to do it alone?
He requires a family member or caretaker present for local Indian patients. For international patients, if you stay in a hotel the staff acts as caretakers since they have room service, cleaning, laundry and the like. So he doesn't make you hire a caretaker (in fact he brought someone in to act as mine for my first week in the hospital), but he does insist that a friend or family member is informed that you will be undergoing surgery at his hospital before he agrees to accept you as a patient.
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I'm graduating soon and I was wondering when should I schedule a surgery with Dr. Parihar? (1 year before or 3 months before etc)
Also, how much money should I save in total for this surgery? Because I read your post that it will cost about 30,000 USD in total, not including food and other stuff. In your case, how much did you spend in total?
Lastly, how many months after surgery were you able to go back to work? Was it after you got your frames removed?
Answering your message here so others can see.
I sent an email to Dr Parihar in May, 2014 requesting a consultation and told him that my flight was confirmed for June 10. He replied with dates that were open for him and after I picked he told me what time of day to come in. I recommend deciding on a month that you think works best for you and then asking him if he's avaliable then for consultation plus surgery at the time you picked before you buy a plane ticket. There are times when he has a lot of reconstructive patients and won't take any new CLL ones until his schedule is more open and it would suck if you flew out there only to be told that he wasn't taking new CLL patients for a while. So you could get lucky and he'll be available within a week or you might be told to schedule for months down the line.
Here's the list of expenses I put together after I returned home (2014 exchange rate):
Surgery - $14,977 / 900,000 INR
X-Rays & Appointment - $240.00 (charges at front desk ranged between 1,000 - 3,000 INR. I think it depended on how much time I spent in Dr's office)
Physiotherapy at Hotel - $17.00 / 1,000 INR per session (Mr Chaudhary's rate)
Medications - $40.00
Zimmer Frame - $60.00
Wheelchair through Mr Shringare - $434.00 / 26,000 INR (I bought the most expensive wheelchair in the catalog but there were many cheaper options available)
Mr Shringare's Custom Splints - $55.00 (I recommend each patient to get splints made through him. The splints from local carpenters would eventually break from tension but Mr Shringare's were very sturdy and never did)
Dressings - $265.00 (each box cost 600 INR and had enough gauze for 2.5 changes)
Hotel Stay - $1,500 per month (at Hotel Maharana Inn)
It only goes up to $30,000+ expenses when you factor in lost income from not working while lengthening. I was able to go to work a week after I returned with frames on and in a wheelchair with a blanket covering my legs. I had a desk job though and my position was one in the company where I didn't have to move a lot. I can't imagine any other scenario where I could work in frames though. If you have to move around a lot for work then I don't see a way to go back until you get your frames removed, which could mean a year of unemployment.
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It'll be cheaper now. The rupee has gone down. For example, $14,977 isn't 900,000INR.. it's 1,005,555.
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I swam at the gym the other day. A great conditioning workout for the muscles, even though I'm not that good at swimming. I really don't want another surgery so I'm doing all I can.
He requires a family member or caretaker present for local Indian patients. For international patients, if you stay in a hotel the staff acts as caretakers since they have room service, cleaning, laundry and the like. So he doesn't make you hire a caretaker (in fact he brought someone in to act as mine for my first week in the hospital), but he does insist that a friend or family member is informed that you will be undergoing surgery at his hospital before he agrees to accept you as a patient.
Whaat, so he has to talk to a friend or a relative before the surgery? I live with a friend so he will know about it, but does he really have to talk to Dr. Parihar?
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It'll be cheaper now. The rupee has gone down. For example, $14,977 isn't 900,000INR.. it's 1,005,555.
Yea it should be roughly $1,500 cheaper now. Sucked in 2009 when the USD was weak and surgery alone was $20,000.
Whaat, so he has to talk to a friend or a relative before the surgery? I live with a friend so he will know about it, but does he really have to talk to Dr. Parihar?
Probably whoever you put as your emergency contact. But yea, he spoke to my mom before surgery, and he had a prospective patient who ended up going to Dr Dhawan because Dr Parihar said he had to inform his parents what he was going to do and he didn't want them finding out.
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Yea it should be roughly $1,500 cheaper now. Sucked in 2009 when the USD was weak and surgery alone was $20,000.
Probably whoever you put as your emergency contact. But yea, he spoke to my mom before surgery, and he had a prospective patient who ended up going to Dr Dhawan because Dr Parihar said he had to inform his parents what he was going to do and he didn't want them finding out.
Awww, but I've been living on my own since forever lol. I even paid for my own tuition in college. Do you think this would disqualify me? :(
I'm 23 years old btw.
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Awww, but I've been living on my own since forever lol. I even paid for my own tuition in college. Do you think this would disqualify me? :(
I'm 23 years old btw.
I was living on my own for a while and at 24 I still had to inform a relative. No harm asking him about it through email though. Maybe he'll make exceptions in certain cases based on individual circumstances.
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I was living on my own for a while and at 24 I still had to inform a relative. No harm asking him about it through email though. Maybe he'll make exceptions in certain cases based on individual circumstances.
Sorry if I ask a lot of questions, its just that it has always been my dream to be taller.
Last question please, did he talk to your mom in person or over the phone. Also did he required her to sign some documents etc?
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Sorry if I ask a lot of questions, its just that it has always been my dream to be taller.
Last question please, did he talk to your mom in person or over the phone. Also did he required her to sign some documents etc?
He talked to her on the phone. After surgery she called him again all hysterical wanting to know if I was still alive and he spent some time explaining to her that everything was fine, even sending a pic to her of me smiling on the operating table.
I was the only one who needed to sign anything.
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But yea, he spoke to my mom before surgery,
this was really nice and ethical of him I'd say.
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Your last x ray looked very promising tho.
It has been over a year and half, you should be able to do normal activities tho.
I hope its normal and you dont have CECS.
Try slowing things down and wait untill 2017 :)
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Your legs look like you have some muscle not thin sticks like some people get at all. Always sucks when rehab takes a long time. I'm hoping that does not happen to me. I've enjoyed your diary. thanks for doing it! Good luck and hang in there.
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Took another set of x-rays when I went to get checked out for CECS on August 22. Figured I'd post the images so you can see what the bones look like more than 2 years after the initial surgery.
(http://s6d5.turboimg.net/t1/29804884_8-22-16-1.jpg) (http://www.turboimagehost.com/p/29804884/8-22-16-1.jpg.html) (http://s6d5.turboimg.net/t1/29804885_8-22-16-2.jpg) (http://www.turboimagehost.com/p/29804885/8-22-16-2.jpg.html) (http://s6d5.turboimg.net/t1/29804886_8-22-16-3.jpg) (http://www.turboimagehost.com/p/29804886/8-22-16-3.jpg.html) (http://s6d5.turboimg.net/t1/29804887_8-22-16-4.jpg) (http://www.turboimagehost.com/p/29804887/8-22-16-4.jpg.html)
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For those telling others that my x-rays are proof that people should avoid Dr Parihar for CLL, what do you see is the issue with them? According to my US trained and based traumatologist, and multiple radiologists who reviewed my x-rays each time they were taken, my bones and alignment are fine.
The latest radiology report said the following:
No acute fracture is identified. The alignment is normal. Stable postsurgical changes are seen along the tibial shaft and fibular shaft related to previous limb lengthening procedures. Joint spaces are grossly intact.
If you're concerned over the fact that my tibias are not stick straight like a lot of other people's tibias, that's been addressed in an earlier post in the diary. It's a normal variation in the shape of the tibia shaft and when looking at my pre-op standing x-ray it's seen that they were shaped that way before surgery. It's because of this variation that some people are not suitable for LON and can only do externals.
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For those telling others that my x-rays are proof that people should avoid Dr Parihar for CLL, what do you see is the issue with them?
Someone actually did that?
Looks fine for me aswell.
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Someone actually did that?
Looks fine for me aswell.
Yeah, someone's scaring people through PM over this latest batch it seems. Would prefer any concerns to be laid out in the open.
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Must be the user calling him a novice cause he won't let patients do 25cm in one bone.
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It is envy, you are fine and you feel good, that is the prove.
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Thanks for sharing the x-ray pics. How is it walking, running, and moving around now? Would you say you are back to pre-LL levels in mobility? Are there any chronic aches?
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Thanks for sharing the x-ray pics. How is it walking, running, and moving around now? Would you say you are back to pre-LL levels in mobility? Are there any chronic aches?
Walking and moving around are completely normal.
Running would feel normal now if it wasn't for the pressure that builds up. My ortho believes I need to do conditioning until January before he sends me to a foot and ankle specialist to test for CECS. But he said being in frames for so long would make it so my muscles aren't used to the impact that comes with running, so I need to try that out first before looking to correct it with surgery.
Other differences are:
1) Not as much ankle dorsiflexion as I had prior.
2) Whenever my legs fall asleep and I move them around to get the blood flowing again, my legs feel a lot heavier than they did before surgery, almost as if a weight were attached to them. I think it's because my shins are actually a little heavier due to being elongated and because my quad muscles are weaker.
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Awesome. The best diary I've read for tibias yet. Have you considered femurs in the beginning? If cost wasn't an issue, would you have done that instead?
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Did Parihar evaluate you psychologically before limb lengthening? I understand that he will somehow interview you. But I mean, did he check for self-harm scars or any of that sort? I'm quite stable but back in my teenage years I've had some self-harm scars that aren't that visible unless inspected thoroughly.
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Awesome. The best diary I've read for tibias yet. Have you considered femurs in the beginning? If cost wasn't an issue, would you have done that instead?
My tibiae were pretty short even for my height so I wanted to lengthen them first anyway.
Did Parihar evaluate you psychologically before limb lengthening? I understand that he will somehow interview you. But I mean, did he check for self-harm scars or any of that sort? I'm quite stable but back in my teenage years I've had some self-harm scars that aren't that visible unless inspected thoroughly.
No, none of that. But he does try and get a read of whether or not you know what you will be getting yourself into, as well as if youre the kind of person who has realistic expectations and can listen to instructions.
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Update: 10/27/2016
Not much else new to report except that I've continued to work on conditioning my legs to see if the issue of pressure and pain building up while running goes away eventually. I really think it's CECS and not an issue of my calves being weak, but I'm sticking to the exercises my local ortho gave me so he'll clear me to test for CECS if the problem hasn't gone away by January.
Lately I've been wearing short shorts at the gym so I can force myself to work on building my quads again. I got this idea from Arnold Schwarzenegger, who would cut off the bottoms of all his training pants so that everyone could see his weakness and he'd be forced to work on strengthening his legs to match his upper body. You can see a big dark spot right above both my knees - and those aren't scars! They're indentations in the skin from my quads shrinking, and they look dark because of the hair covering them. Once your quads atrophy, they're a real b**** to grow back again. Took a couple pics to show you what I mean, and the shorts with the shirt tucked in gives a clearer picture of what my leg to torso ratio is like.
(http://s6d2.turboimg.net/t1/30297529_Gym_shorts_1.jpg) (http://www.turboimagehost.com/p/30297529/Gym_shorts_1.jpg.html) (http://s6d2.turboimg.net/t1/30297530_Gym_shorts_2.jpg) (http://www.turboimagehost.com/p/30297530/Gym_shorts_2.jpg.html)
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Yup... you look good mate. Besides the scars you look great. I can't even complain or find fault in proportions or anything like that, despite me being such a hard-ass with proportions. I think that's just a deep-rooted inner hatred I have of having to change my natural body in someway...
But you really do have a great physique even after lengthening man; looks like many other people I see in the gym. Congrats! Thanks for the picture reference. It does help clear up some worries I normally have!
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Your tibias look like if they were natural, not long at all.
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Proportionally speaking tibias look great so does your torso to leg ratio. Legs don't look skinny at all either maybe not muscular but definitely not skinny
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(http://s6d2.turboimg.net/t1/30297529_Gym_shorts_1.jpg) (http://www.turboimagehost.com/p/30297529/Gym_shorts_1.jpg.html)(http://s6d2.turboimg.net/t1/30297530_Gym_shorts_2.jpg) (http://www.turboimagehost.com/p/30297530/Gym_shorts_2.jpg.html)
Looking great man! No problems whatsoever in your torso/leg length ratio. You could definitely do another surgery for 6cm on the femur. Any plans to go back to Dr. Parihar and lengthen your femurs with PRECICE?
Those are some bad ass scars and chicks dig scars so make the most of them ;)
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Looks good and your proprtions look natural too. :)
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5 more cm on femurs would look still proportionated.
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Kilo when you got your frames removed did you notice a big difference in your leg tightness? Once the frames were removed was it easier to stretch etc? Thanks
Also you say you are struggling to get your quads back, why do you think that is? Has your dorsiflexion improved any since frame removal?
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Yup... you look good mate. Besides the scars you look great. I can't even complain or find fault in proportions or anything like that, despite me being such a hard-ass with proportions. I think that's just a deep-rooted inner hatred I have of having to change my natural body in someway...
But you really do have a great physique even after lengthening man; looks like many other people I see in the gym. Congrats! Thanks for the picture reference. It does help clear up some worries I normally have!
Your tibias look like if they were natural, not long at all.
Proportionally speaking tibias look great so does your torso to leg ratio. Legs don't look skinny at all either maybe not muscular but definitely not skinny
5 more cm on femurs would look still proportionated.
Looks good and your proprtions look natural too. :)
I guess my tibia were pretty short even for my height before CLL. I'm not sure what the average length is for tibias but mine pre-op were 31.5 cm and post-op are 37.5 cm based on x-ray measurements.
I'm okay with my calves but my thighs are still a bit flabby and lacking in muscle. I guess that's to be expected though since pre-CLL I was close to 220 lbs, and even after going down to my current weight of 160 lbs I've got some extra flab to take care of.
Looking great man! No problems whatsoever in your torso/leg length ratio. You could definitely do another surgery for 6cm on the femur. Any plans to go back to Dr. Parihar and lengthen your femurs with PRECICE?
Those are some bad ass scars and chicks dig scars so make the most of them ;)
That would be a long way off. Maybe after I pay my remaining $20,000 in student loans I can think about it. If I decide to do femurs later I'd go back with Dr Parihar, but I figure I can wait some years before a second round since I was slightly under 5'5" for about 10 years and have only been 5'7" for 2.
Girls seem to love the scars. Probably won't do any scar revision.
Kilo when you got your frames removed did you notice a big difference in your leg tightness? Once the frames were removed was it easier to stretch etc? Thanks
Also you say you are struggling to get your quads back, why do you think that is? Has your dorsiflexion improved any since frame removal?
My ankles immediately felt better and were far less stiff. I did have some slight ballerina left to take care of but even then my ankles felt less tight than when I had the frames on. Definitely easier to stretch when they're off. With the frames, my ankles and feet would swell up good if I exercised them with stretching too much.
Dorsiflexion has improved, though I'm not really a flexible person, even pre-op. I think I just need to change my routine and blast my quads harder than I've been in order to jump start muscle hypertrophy. I go to the gym after work but it's taken longer since my work requires me to sit at a desk from 10 to 6 most days.
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I'm not sure what the average length is for tibias but mine pre-op were 31.5 cm and post-op are 37.5 cm based on x-ray measurements.
Mine were 33.6... almost an inch longer than yours at 5'2. ;D
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I think knee height is not accurate, is better x-ray, do you know what is t
he average knee height?
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I think knee height is not accurate, is better x-ray, do you know what is t
he average knee height?
It's not the knee height. At Mangal Anand they determine lengths with a full body X-Ray.
Kilo, what was your femur length? Were your legs short in general or just tibia?
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Mine were 33.6... almost an inch longer than yours at 5'2. ;D
Maybe mine were especially short or you just had long tibiae for your height :D
It's not the knee height. At Mangal Anand they determine lengths with a full body X-Ray.
Kilo, what was your femur length? Were your legs short in general or just tibia?
My femur length is exactly 43 cm.
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My femur length is exactly 43 cm.
Mine were 42, so I had longer legs than you at 5'2 lol. And mine have always looked short. All this makes me think proportions are overrated.
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So Kilo, all things considered, would you say you feel normal and have the ability to massively improve to a point where you were pre-LL?
Mine were 42, so I had longer legs than you at 5'2 lol. And mine have always looked short. All this makes me think proportions are overrated.
Do tell when you finish your lengthening and consolidated Penguin! I look forward to that and your journey!
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Do tell when you finish your lengthening and consolidated Penguin! I look forward to that and your journey!
I doubt I'll post my own pics. Just imo, besides those doing bizarre amounts or multiple LLs, height gained overrules proportions by far.
Kilo hypothetically if you did femurs now, would you do 2 or 3"?
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I doubt I'll post my own pics. Just imo, besides those doing bizarre amounts or multiple LLs, height gained overrules proportions by far.
Kilo hypothetically if you did femurs now, would you do 2 or 3"?
Oh no that's fine man. I'm just saying, when it's all said and one I just want to hear your opinion about it is all!
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My tibs pre op were 27cm and my femurs were 43cm at 5'6 some one wanna remain me again how important proportions are? Lol
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27? A 10" tibia for a 5'6 person? :o
27/43 is 0.62, that's a crazy natural femur:tibia ratio.
Oh no that's fine man. I'm just saying, when it's all said and one I just want to hear your opinion about it is all!
I'm not worried at all about my body:leg ratio. Your whole body is way too big for 3" to be that noticeable, I was a bit worried about my femur to tibia ratio which will be 0.67 after LL... but reading about Morissette's pre-op proportions makes me think I was being silly.
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They were at 27.87 around that so 11" but still crazy unnatural and at no point in my life did anyone ever point out my short tibs neither did I feel out of proportion. Comes to show many on this forum take proportions too far
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My tibs pre op were 27cm and my femurs were 43cm at 5'6 some one wanna remain me again how important proportions are? Lol
And your sitting height is...?
As a fellow 5'5 i measured myself too.
166cm of height, 32cm tibias but 37cm femurs.
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Okay so tibs were 28cm femurs 43cm sitting height 91cm puts me at 163cm. I was standing at 168cm but neither of there account for your feet and the MCL which connects your tibia and femur.
To me the most important proportion is arm length because it's rare to see a male with at span shorter then his height and if it is it's not usually more then 2" in total
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Okay so tibs were 28cm femurs 43cm sitting height 91cm puts me at 163cm. I was standing at 168cm but neither of there account for your feet and the MCL which connects your tibia and femur.
To me the most important proportion is arm length because it's rare to see a male with at span shorter then his height and if it is it's not usually more then 2" in total
Well that's something i don't need to worry about since my wingspan is 5'9. But imho arm length is better measure for it since you can just have wide shoulders but still short arms.
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If you have muscular shoulders it shouldn't logically affect your arm span. For example if you straight your arm out to your side you'll see the definition build up on your shoulder your humerus still connects to your clavicle in the same spot something that would affect your arm span that could make it inaccurate jo would be clavicle length and finger length. You're lucky you're built with such long arms for your height you'd definitely be a good candidate for LL in the future in my opinion.
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Unless you mean something else about wide shoulders? Because when I started working out at 16 years old my arm span was just under 5'9 and I was 16" wide(yea I measured my shoulder width I have an obsession with measurements). By the time I was 19 my shoulder width was 21.5" and my arm span was 5'9
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Okay so tibs were 28cm femurs 43cm sitting height 91cm puts me at 163cm. I was standing at 168cm but neither of there account for your feet and the MCL which connects your tibia and femur.
To me the most important proportion is arm length because it's rare to see a male with at span shorter then his height and if it is it's not usually more then 2" in total
You can lengthening your humorous which will give you a longer wingspan if you need too.
unlike leg lengthening an 8cm increase to wingspan is 4cm on each arm rather than 8cm on both arms :)
I would never get 8cm added to my arms but that's an option for some.
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Unless you mean something else about wide shoulders? Because when I started working out at 16 years old my arm span was just under 5'9 and I was 16" wide(yea I measured my shoulder width I have an obsession with measurements). By the time I was 19 my shoulder width was 21.5" and my arm span was 5'9
I ment natural wide shoulders which come from your general body build. Some people have narrow shoulders some people really wide one naturally.
You can lengthening your humorous which will give you a longer wingspan if you need too.
unlike leg lengthening an 8cm increase to wingspan is 4cm on each arm rather than 8cm on both arms :)
I would never get 8cm added to my arms but that's an option for some.
Imho not worth it, risks of reduced/dimnished ability of using your own hands? no thank you...
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I would never do arm lengthening just because of the time and money LL is enough time lost for me, but on the other hand I could see the benefit for someone with shorter arms
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Just in case anybody has doubts, I am a real patient. I paid Dr Parihar for the surgery, Mr. Chaudhary for the physical therapy, Mr. Shringare for the wheelchair, zimmer frame, and custom splints, the pharmacy for medication, and Hotel Maharana Inn for my accommodation. At no point did I ever receive money from Dr Parihar, his team, or any orthopedic manufacturer for writing a patient experience. I was only Dr Parihar's patient and am not an affiliate of his or anyone else. Dr Parihar has no interest in starting up a line of cosmetic limb lengthening patients as it is a very small part of his work. He much prefers treating people for congenital deformities or accidents and even says that cosmetic patients are the most demanding and difficult patient subgroup. I wrote this experience as honestly as I possibly could, and did so both to provide a realistic view of what to expect if you choose to have surgery at Mangal Anand, and to give me some form of social interaction while lengthening alone in another country (that's the only selfish benefit I take out of this). I have posted below this paragraph some of the e-mail interaction between me and Dr Parihar's team as well as a letter he wrote for me, with my personal information redacted for obvious reasons.
(http://i.imgur.com/xWXXCyI.jpg?1)
(http://i.imgur.com/Lfec6G4.jpg?1)
(http://i.imgur.com/v7Ua0gYh.jpg)
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I wonder what the intention of that guy that was bashing you was. He probably the same one as before that said it was a fake diary.
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What sucks more than the troll claiming your diary was fake are the retards that believed it.
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What sucks more than the troll claiming your diary was fake are the retards that believed it.
Most of these f**king morons are the same ones promoting their "BROSCIENCE" or talking about how patients will be just fine having surgery with confirmed butchers.
These people have the same intellectual capacity as a living room couch...
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Most of these f**king morons are the same ones promoting their "BROSCIENCE" or talking about how patients will be just fine having surgery with confirmed butchers.
These people have the same intellectual capacity as a living room couch...
I don't mean most of the people that commented on there, they were calling him a troll.
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I don't mean most of the people that commented on there, they were calling him a troll.
You should mean most of them, as most of them were not calling that guy a troll. They were actually posting questions or their mindless musings as though what was being said was even remotely close to making any kind of logical sense.
Anyone who posted questions or their brainless contemplations on that thread can't possibly have an IQ above 70....
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The only thing I want to know about that troll was who exactly was he? Sure I don't mean his identity, but his past accounts and relations to the forums.
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In fact we werent trying to find a logical sense to his arguments, just asking him in a polite way indirectly to stop banning.
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It look like he was trying to discredit khan in particular and not parihar. Maybe trying to paint him as a new apotheosis so people leave the forum.
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What sucks more than the troll claiming your diary was fake are the retards that believed it.
Nobody believed it, surely?
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You can sleep tonight Nightwish.
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Was kinda hoping for an epic showdown between the two kilos like Obi-wan and Anakin in 'Revenge of the sith'...."you've turned them against me!" "I'm afraid you've done that yourself" lol😂
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Was kinda hoping for an epic showdown between the two kilos like Obi-wan and Anakin in 'Revenge of the sith'...."you've turned them against me!" "I'm afraid you've done that yourself" lol😂
What if lluser showed up and saw people praising mongeal and did the vader noooooooo.
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I can't recall if I've mentioned this earlier, but one thing to note that's changed from pre-CLL is that my legs fall asleep more easily than they did before, and usually it happens when seated on a toilet or something. When a leg falls asleep it pretty much turns into an anchor and I have to shake it a little bit and remove the tingling sensation before trying to walk again. It feels a bit different from when a leg would fall asleep before CLL in that my legs feel a lot heavier now, which is due to a combo of longer tibias and comparatively weaker quads. Not something that's life changing, but definitely a noticeable difference. I haven't read of others noticing this change after CLL though.
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I have that tooo... Legs feel MUCH heavier when standing up after sitting down for a while, such as a long trip in a car.
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I wonder if LL reduces the diameter of blood vessels in the legs. That's just my intuition but I couldn't find any research confirming this.
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did you ask your doctor about your legs falling asleep?
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My local ortho referred me to a foot and ankle specialist and I'm in his office waiting now. Just got measured and weighed. I weigh 164 lbs (74.5kg) and height is 5'7.22" Gonna have to explain to a new doc that I got CLL. That's never fun lol.
Will know if I have CECS shortly.
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You are above 170 cm, is cool that you didnt experience subsidence.
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Tell us the reaction/opinion of the doc when you tell him you did CLL
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So he just read the notes that I had CLL. Didn't say anything about it at all, it was just 'matter of fact' for him. He said that leg lengthening would put the legs at risk for CECS because you're expanding the muscle to a size greater than was intended and the compartments have a harder time getting the blood flow through. Closest they could test me is March 13, and that involves sticking a needle in each compartment and measuring the pressure, then having me run on a treadmill until I'm in pain and measuring the pressure again. If I have it, then we schedule surgery to do fasciotomy.
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So he just read the notes that I had CLL. Didn't say anything about it at all, it was just 'matter of fact' for him. He said that leg lengthening would put the legs at risk for CECS because you're expanding the muscle to a size greater than was intended and the compartments have a harder time getting the blood flow through. Closest they could test me is March 13, and that involves sticking a needle in each compartment and measuring the pressure, then having me run on a treadmill until I'm in pain and measuring the pressure again. If I have it, then we schedule surgery to do fasciotomy.
You'll get through this KiloKAHN. A fasciotomy would be an annoyance but if it solves the issue then it needs to be done and then you are on the road to recovery. Best of luck man, you deserve to enjoy your new leg length without all of these complications.
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Well I just got laid off so fasciotomy will be postponed until further notice. Not going to pay out of pocket, that's for sure.
I knew I hated Mondays the most.
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Damn that's rough dude at least you had your surgery paid and recovered so you can go on the job hunt right away.
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Hey Kilo if you had to redo your LL experience would you do external only again or would you do LON?
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So I tested for chronic exertional compartment syndrome today. Not exactly a fun experience as they put an injection in all 4 compartments of each leg and then stick a tube connected to a pressure monitor in each compartment afterward. They recorded the resting pressures and then had me run on a treadmill until the pain started. Next they inserted the tube into each compartment again and recorded the after-exercise pressures. Involved getting poked a total of 24 times and my legs are still sore after hours.
Confirmed I have CECS in the anterior compartment of each leg. Pressure shouldn't be higher than a reading of 12 in any compartment after exercising, but the left anterior compartment had a pressure reading of 36 and my right had a reading of 42. If I can get my surgery scheduled for this month, then I'm covered. If not, I have to see how much it would cost to extend my coverage a little longer.
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Sorry to hear about that. I'm wondering whether your symptoms of CECS occurs after exercising or does it even occur during inactive days?
You did mention in a previous post that your legs would often "fall asleep", is that the reason why the doctors wanted to check for CECS or do you face any other symptoms of CECS?
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Would like to know if its mandatory to get surgery for CECS or does it go away non surgically. I hate scars and would like to avoid getting too many.
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Sorry to hear about that. I'm wondering whether your symptoms of CECS occurs after exercising or does it even occur during inactive days?
You did mention in a previous post that your legs would often "fall asleep", is that the reason why the doctors wanted to check for CECS or do you face any other symptoms of CECS?
They referred me to a foot and ankle specialist to test for it because even after going on an exercise regimen for a month I'd still have pain when running or walking on an incline. It's possible that the falling asleep sensation might have something to do with it, but not sure. MDOW had the same issue after CLL and he said fasciotomy got rid of it so I think this will work.
Would like to know if its mandatory to get surgery for CECS or does it go away non surgically. I hate scars and would like to avoid getting too many.
If it's truly CECS then it's unlikely that anything other than fasciotomy will cure it. If you hate scars then unfortunately you're gonna have to stick with internals, because otherwise you'll end up with a whole lot of dots around your legs.
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Im okay with the external tibia scars since theyre pretty small and can be corrected through scar revision surgery, besides it kind of makes for a cool story. The scar from a fasectomy seems wayyy too big for my comfort zone. Can I ask if the CECS is really bad or can you sort of live with it?
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best of luck Kilo!
is this a possibility with femur lengthening too?
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Im okay with the external tibia scars since theyre pretty small and can be corrected through scar revision surgery, besides it kind of makes for a cool story. The scar from a fasectomy seems wayyy too big for my comfort zone. Can I ask if the CECS is really bad or can you sort of live with it?
If you run semi-regularly or even want to do recreational sports or hike, CECS is freaking terrible. It starts off as not a big deal but when it happens all the time without fail you then focus on it a lot. Also, if there were ever any situation where you had to run away from someone, you'd be screwed.
best of luck Kilo!
is this a possibility with femur lengthening too?
It mostly happens as acute compartment syndrome after injury. CECS is very rare in the thighs because the compartments are so big compared to the ones in shins.
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If you run semi-regularly or even want to do recreational sports or hike, CECS is freaking terrible. It starts off as not a big deal but when it happens all the time without fail you then focus on it a lot. Also, if there were ever any situation where you had to run away from someone, you'd be screwed.
It mostly happens as acute compartment syndrome after injury. CECS is very rare in the thighs because the compartments are so big compared to the ones in shins.
Did regular long distance walking or prolonged standing ever provoke the onset of CECS, for example relaxed walking for 30 mins and long duration standing?
How long would the pain last and did you take painkillers?
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Thanks! ;D
One last question, is CECS common during lengthening? Im a swimmer and singapore is way to hot for climbing or sports so I think I can live with CECS.
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Did regular long distance walking or prolonged standing ever provoke the onset of CECS, for example relaxed walking for 30 mins and long duration standing?
How long would the pain last and did you take painkillers?
Nope, it would only come around when walking up any sort of incline or running, and running on pavement made it come up faster. I could walk or stand with no issues.
Thanks! ;D
One last question, is CECS common during lengthening? Im a swimmer and singapore is way to hot for climbing or sports so I think I can live with CECS.
I'm not sure how common it is. There's probably something that makes one predisposed to getting CECS but even doctors aren't sure about it. One of my doctors told me that in theory getting your legs lengthened could make the likelihood of getting CECS higher because your muscles have to work harder to pump blood in there. If it happens, it's most common in the anterior compartment, and it can cause things like temporary mild foot drop after exercising. Happened to me a few times when I tried to push through it.
Ah, I forgot to mention that CECS will cause you pain while swimming as well. If you're an avid swimmer, it will cut your laps short.
You could see if your doctor will perform a fasciotomy during the initial surgery as a preventative measure. Dr Parihar did with me but he did it on different compartments and not the anterior. It's possible I would have had to get those done as well if he didn't do so initially.
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Had my bilateral fasciotomy performed today. The operation took just over an hour and it all went without a hitch. They put me under general anesthesia and I woke up a couple hours after it was over. I had it done in the same OT where I had my frames removed, but with a different specialist. I have to get my stitches removed in 2 weeks and until that time I can't submerge my legs in water. I'm able to walk without support, but my legs are really sore and they want me to keep my legs elevated as much as possible for the next few weeks in order to reduce the swelling. I'm most likely not going to be allowed to run for another 6 to 8 weeks, but I'm not in any hurry. I took a single hydrocodone pill for pain relief since I paid for the prescription, although the pain hasn't gotten high enough for me to really need it so far. I'm really curious to see what the scar is like once I get these bandages removed, considering one of the main complaints patients have with fasciotomies is that the scar can get pretty big. My surgeon also said that because the lower legs have a lot of nerves in the surrounding areas, they open them up quite a bit so they can see absolutely everything and don't accidentally damage one of the nerves. One of the good things about getting this done, however is that once I'm recovered from this and able to run without pain, I'll finally be able to make a proper post-CLL recovery video.
(https://s6d3.turboimg.net/t1/34790899_4252017_bandages.jpg) (https://www.turboimagehost.com/p/34790899/4252017_bandages.jpg.html)
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Did you feel a little confused like strange after you wake Up for the anesthesia? Good that they solved your problem.
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Did you feel a little confused like strange after you wake Up for the anesthesia? Good that they solved your problem.
No side effects occurred with the anesthesia. Just had a sore throat because of the breathing tube they put in me during the op.
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My fasciotomy scars along with my CLL scars in all their monstrous glory.
(https://s6d1.turboimg.net/t1/34800594_4272017_bandages_off.jpg) (https://www.turboimagehost.com/p/34800594/4272017_bandages_off.jpg.html)
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I'm sorry Kilo that you had the fasciotomy but I think you'll be better soon. For scars use scaraway or similar.
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May i ask why there is a curve?
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^ I turned my legs inward to show all the scars. Also the legs are swollen and lumpy on the outher side from the fasciotomy, so it just looks like they're curved.
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If you're into having heavily tattooed legs, that's one way to take care of the scars.
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is this a riskier surgery than CLL or safer?
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Well the first few days were fine but holy hell are my legs hurting now. It might be because I started walking too early, but I can barely move my legs today. Now I'm glad that I was prescribed the hydrocodone because my legs are throbbing like crazy.
is this a riskier surgery than CLL or safer?
It's possible to get pulmonary embolism, deep vein thrombosis, or nerve damage. Probably a little safer than CLL though since it's one procedure and you aren't spending months distracting your muscles.
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I think my incision sites are infected on each leg as the slightest movement makes them burn and I now have a high fever. On the way to the nearest Kaiser to see about getting antibiotics because tonight is my last day of coverage before the start of June since I got laid off.
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I've just been directed to a different hospital with higher level care because the surgeon present said I need to test for deep vein thrombosis based on the symptoms I described. Even having surgery in the US doesn't prevent you from having a crap result.
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DVT is easy to diagnose. Just a bedside ultrasound.
All the best and hopefully you make a full recovery.
I've just been directed to a different hospital with higher level care because the surgeon present said I need to test for deep vein thrombosis based on the symptoms I described.
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how did it all go?
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Turned out no DVT but was given antibiotics and oxycodone along with morphine injections and stayed at the hospital overnight so they could keep an eye on me. Developed bruising that enveloped both shins and is especially prominent on the left side. The painkillers only work if my feet are elevated and as soon as I bring them down it's like I haven't taken anything and there's severe swelling and burning pains. My ortho said it's never happened to any of his prior patients and he wants to see me again in two weeks. I've had my stitches removed. It helped with pains somewhat but it's still there. The muscle in the space at the front of the ankle is all knotted and it's caused a small bit of equinus that should go away with time along with the bruising, but who knows when that will be.
(https://s6d1.turboimg.net/t1/34913557_bruising.jpg) (https://www.turboimagehost.com/p/34913557/bruising.jpg.html)
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Thanks for keeping us up to date. I'm now very curious about this post procedure since I hope to do 7.5-8cm on my tibia. Did insurance give you crap about it since it was a post cosmetic thing?
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Nope. It's in my medical records that I lengthened my legs for genetic short stature but I've never had an issue with my medical insurance. The doctor just puts down a recommendation for surgery and I pay based on my rate. I had a Platinum HMO plan through Kaiser Permanente so the surgery was only $150. I recommend them if you're okay with only getting medical treatment through a specific network.
Thanks for keeping us up to date. I'm now very curious about this post procedure since I hope to do 7.5-8cm on my tibia. Did insurance give you crap about it since it was a post cosmetic thing?
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Nope. It's in my medical records that I lengthened my legs for genetic short stature but I've never had an issue with my medical insurance. The doctor just puts down a recommendation for surgery and I pay based on my rate. I had a Platinum HMO plan through Kaiser Permanente so the surgery was only $150. I recommend them if you're okay with only getting medical treatment through a specific network.
Just out of curiosity, what's the threshold for being short stature in US?
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Just out of curiosity, what's the threshold for being short stature in US?
In most environments, I think 5'7 is the threshold where people won't point out your height as something to ridicule, like "wow, you're really short" or "hey shorty", even though it's still shorter than average. I've been to a lot of places since my CLL and not once has my height been mentioned even though I'm rarely the tallest in a group.
For official records that list you as "genetic short stature", I'm not sure what the cutoff is. Maybe under the US average height of 5'9" I'd guess.
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Thanks for updating. You may not know, I have been reading your diary for a long time. Was worried about you. Hope you will be completely fine soon. I have even met Dr Mangal parihar and Dr suhas shah. Planning to go with dr Suhas shah since the cost of surgery is low with him.
My height is 160 cm ,Which is short even in India ( I'm from India) . But as I don't want any complications I'm only thinking of doing 5 or 6 cms on my tibias. Do you think there will be much difference if I lengthen only 5 cms?
I'm sorry for asking but you seem like the most reasonable person to ask suggestions from. Should I only target for 5 cms or 6 cms? Please answer... take care!
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6 cm is very good amount. I think is with 6 cm when you feel taller than before.
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For official records that list you as "genetic short stature", I'm not sure what the cutoff is. Maybe under the US average height of 5'9" I'd guess.
I mean here to be officially short stature(at the point that you can receive hormone treatment for example) you need to be under 5'6(167cms) and people in poland are a bit taller than in US.
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For official records that list you as "genetic short stature", I'm not sure what the cutoff is. Maybe under the US average height of 5'9" I'd guess.
Eh? Pretty sure at 5'8'', no doctor or medical record will ever refer to you as having "genetic short stature".
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"Compared with a well-nourished, genetically relevant population, short stature is defined as a standing height more than 2 standard deviations (SDs) below the mean (or below the 2.5 percentile) for sex."
This is a quote I got from this website: http://emedicine.medscape.com/article/924411-overview#a1
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"Compared with a well-nourished, genetically relevant population, short stature is defined as a standing height more than 2 standard deviations (SDs) below the mean (or below the 2.5 percentile) for sxx."
This is a quote I got from this website: http://emedicine.medscape.com/article/924411-overview#a1
Looks like this is the answer then.
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Genetic short stature is different of course from short or less than average.
I am sure the threshold would be 1.60 for a man or maybe even less.
An 1.65 man is completely normal, just short.
An 1.55 man on the other hand (except maybe asians) may included in what we call short stature syndrome.
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hi kilokhan. i read your diary and found that you stayed in maharana hotel. did they ask u for any proof of visit or anything like thiat for long stay? if i take a hotel i do not want to tell the hotel people i want to do surgery to increase my height ::) ;D
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Genetic short stature is different of course from short or less than average.
I am sure the threshold would be 1.60 for a man or maybe even less.
An 1.65 man is completely normal, just short.
An 1.55 man on the other hand (except maybe asians) may included in what we call short stature syndrome.
The threshold is always below 3rd percentile for particular population. Then youre talking about short stature which in most cases is a idiopathic short stature.
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Hi Kilo
I am following your investigation with great interest and like you am eager to get LL soon but with minimal risk and lowest cost possible. I am actively discussing with China and Syria right now with a view to flying to both countries to investigate in July/August. Had disregarded india until I started reading your views. I want to have my femurs lengthened (already very short compared to people with shorter torso by 5-7 centre metres). Would like LON or LTN and want to live in house/apartment during lengthening.
Who knows we might be in India together ?
Cheers
Liam
Minimal Risk and you think in syria?
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hi kilokhan. i read your diary and found that you stayed in maharana hotel. did they ask u for any proof of visit or anything like thiat for long stay? if i take a hotel i do not want to tell the hotel people i want to do surgery to increase my height ::) ;D
They did want an address when I checked in. I gave them the address of Mangal Anand Hospital and told them I was having surgery, but I never said it was for height increase. For all they knew I was just correcting a bone issue.
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Hey man. How's it going?
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The front of my ankles still feel a bit knotted from the fasciotomy, but other than that I'm fine. Not much else to report although I hope to have a running video out at some point.
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Hi kilo. I new here I didn't understand it clearly but is the recent correction surgery the fault of limb lengthening?
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Hi kilo. I new here I didn't understand it clearly but is the recent correction surgery the fault of limb lengthening?
I don't think there have been any studies focused on leg lengthening's effect on risk for chronic exertional compartment syndrome, but both my trauma surgeon who removed my frames and the foot and ankle specialist who performed the fasciotomy told me that in theory leg lengthening puts you more at risk for developing CECS. They both think it's because the limb is made longer than it was supposed to be naturally and therefore the muscles have to work harder to move it than before, creating increased pressure in the compartments. The user Medium Drink of Water developed CECS after lengthening his tibiae 3 inches in Beijing, so I wouldn't be surprised if it's a relatively common CLL side-effect that for some reason doesn't get mentioned a whole lot.
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Kilo.
I had shortering in leg and had a surgery to increase by 5cms. But now when I have increased around 4. I see a lot of pain and due to which I am unable to do my excersises.
Which resulted in poor knee flextion dropping from around 50° to 10-15°.
Did you face any such issue and how did you come across the same? I am worried because it pains alot due to the pins
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On the days where I had unbearable pain for a prolonged period I was usually advised to decrease the distraction rate. Have you talked to your surgeon about the pain you have?
Kilo.
I had shortering in leg and had a surgery to increase by 5cms. But now when I have increased around 4. I see a lot of pain and due to which I am unable to do my excersises.
Which resulted in poor knee flextion dropping from around 50° to 10-15°.
Did you face any such issue and how did you come across the same? I am worried because it pains alot due to the pins
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Yep. Had a word with my doctor. He told me to apply ice packs and massage.
But at times pins pain alot.
When I bend my knee by 5° the pain starts. Seems the knee has stiffness now.
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Hey, how's going I remember when you still were during lengthening phase and were ordering pizza and such ;D
Btw I see you did 6cm, did you do .3mm more or something like that to avoid loss ? Or you just stopped at 6 and didn't lose anything
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Do you think it was worth it to get your LL done, after all this time?
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By the way, I've read the main bulk of your diary now and it seems it was obviously worth it for you. Sorry about making that previous question without having had read enough. I had no idea CLL was a thing, and I made some hasty, stupid posts in diaries in my initial period after registering here.
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how are you doing OP? have you got a running video? :-)
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Been meaning to do a running video but keep getting side tracked. I'll try and get one made soon.
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Hello kilokahn
I finished reading your diary a few days ago. Details you provided in your diary is extremely helpful. Do you think the compartment syndrome caused was due to surgery? I researched a bit about compartment syndrome and it seems that one can lose the affected limb because of it. How are you now? Have you fully recovered i.e athletic abilities and do you feel any after effects of the surgery. I intend to get this surgery done. Unsure of the doctor parihar vs catagani ( external tibias). Money is not an issue as of now only limited because of time constraints. Could u throw some light on how much time realistically it would take to return to work.
About me
Ethnicity- Indian
Sex- male
Age- 28
Current height- 170.5 cm
Desired height- 175 after first surgery
Ideal would be to reach 180
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Well I would hope you'd be able to run 4 years post op.
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@kiloKAHN
Did you lose any CM of height overtime?
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Anyone reading this diary or this forum,be aware kilo and penguin are paid advertisers of Parihar. Be aware be cautious, be informed while taking any major decision. Read how they have intentionally made their signatures(the msg at the end) to promote their doctors. Don't be naive. Who on the earth has time to waste to answer queries years after their surgeries. Total non-sense and time waster paid advertisements are what these posts are. Stop fooling yourself.
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Why would someone not have time to answer questions about LL after his surgery? Does having LL mean you will never have free time ever again?
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I feel 100% normal when walking and people I've asked who know what I did don't think my walking looks weird at all. Here's a quick vid of what it looks like. Not really good for seeing my proportions though because I fished out my old pants from when I was a lot heavier and they're way too big for me now.
http://www.youtube.com/watch?v=HBYTdoqDVz0
Another fake video fake person with no CLL done. Folks this is all a big trap to fool naive people unhappy with f their heights. Be brave. Don't be foolish to fall in these laid traps.
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Why would someone not have time to answer questions about LL after his surgery? Does having LL mean you will never have free time ever again?
Yes not 3 years after I had the surgery. I have other things to do.
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totally red - i think now you have lost it... :(
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Another fake video fake person with no CLL done. Folks this is all a big trap to fool naive people unhappy with f their heights. Be brave. Don't be foolish to fall in these laid traps.
You must be that same user who accused me of being a fake a while back. I'll just direct you back to this post I made on the subject:
http://www.limblengtheningforum.com/index.php?topic=634.msg60909#msg60909
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You must be that same user who accused me of being a fake a while back. I'll just direct you back to this post I made on the subject:
http://www.limblengtheningforum.com/index.php?topic=634.msg60909#msg60909
-These emails and the letter can easily be forged.
-Also, in the video, what exactly are you proving, Is not it a random person walking up and down, How do you prove that the person has gone through ilizarov?
-If you still believe you are a person full of conscience, then it is your supreme moral responsibility to clear the air by giving some solid proof that you are really a person who has gone through CLL or else accept the post to be fake. Believe in the law of Karma, by misguiding/harming thousands of innocent people, no one can escape unharmed.
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-These emails and the letter can easily be forged.
-Also, in the video, what exactly are you proving, Is not it a random person walking up and down, How do you prove that the person has gone through ilizarov?
-If you still believe you are a person full of conscience, then it is your supreme moral responsibility to clear the air by giving some solid proof that you are really a person who has gone through CLL or else accept the post to be fake. Believe in the law of Karma, by misguiding/harming thousands of innocent people, no one can escape unharmed.
Ah yes, the photos, hospital seal, e-mails, all forged ::) Same with the videos where I put fake Ilizarov frames on my legs and walked around slowly for lols
If you believed in the law of karma, you wouldn't be trying to convince people that a legitimate CLL patient is a fake and try to stir up controversy. It's unoriginal trolling dude, someone else did it before you.
I don't care if someone decides to go to Dr Parihar or not. He has his own qualifications as to who he accepts as a patient anyways and has denied people the procedure before. If you don't like the way he operates, go to someone else. Simple?
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Ah yes, the photos, hospital seal, e-mails, all forged ::) Same with the videos where I put fake Ilizarov frames on my legs and walked around slowly for lols
If you believed in the law of karma, you wouldn't be trying to convince people that a legitimate CLL patient is a fake and try to stir up controversy. It's unoriginal trolling dude, someone else did it before you.
I don't care if someone decides to go to Dr Parihar or not. He has his own qualifications as to who he accepts as a patient anyways and has denied people the procedure before. If you don't like the way he operates, go to someone else. Simple?
Dude, to be honest, I can't comment on the veracity of your diary neither positive nor negative. In fact, your diary was first thing, which had ignited spark to bring an end to my plight. Then there was Penguin's diary, which is no doubt dubious, read it once if you have not already. You supporting him and then both supporting a certain dr. would have led anyone to doubt veracity of your diary as well. I can give you benefit of doubt, just a request would it be possible for you to put a photo of you before and after surgery, standing at the same place and same posture. I did't want to sound offensive or harsh, and I apologize if I have unintentionally done it. Thanks for the reply.
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I've just read this amazing diary - and i hope you the best kilokhan. i think your doctor is a very good surgeon.
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I have just these comments
1 - Using Hexapods for correction is one of the best in your diary. i think your doctor did a great job correcting the misalignment of your tibia from side view but from front view i have no information - because you need to have a long film x ray or standing x ray so he can draw the perfect mechanical axis and correct your tibia.
2 - LATN or LON ensures that the bone is completely straight but to make it clear the bone shaft is straight for a simple reason it's hard to insert a nail in non straight bone. so people who insert nails tend to have deformities (Not perfectly aligned mechanical axis).
3 - when lengthening for example the lower leg the bone tend to bend to the direction with lower resist. for example you are lengthening your tibia if you look at the x ray from the side your bone will bend to the opposite direction of the calf muscle. and this means that your lengthening doesn't mean at all that the muscle is stretched the same distance. and the faster the lengthening the more misalignment. so imagine that your doing 1.5 mm per day the muscle can for example only grow less than 1mm your bone have the ability to bend in a free resistance direction so it will go in this direction.
4 - so when doing correction you may feel a very good tension in your muscles - now it's time to correct the bent bone by the external fixation manipulation so the muscle will be stretched - if you are for example ignoring the training and you muscles are tight you will lose a lot of flexibility during correction.
5 - straight bone shaft doesn't mean at all perfect mechanical axis. so good doctors tends to correct for the mechanical axis and not for the straight bone shaft. i may make your bone straight but you will have x - legs or bow legs. that's why it's ok that your tibia is curved or bend and this doesn't mean a bad thing at all. and that's why it's really hard job to correct the front view without x ray of the patient being standing with straight legs so the doctor can draw the mechanical axis and do the correction. and this type of frame manipulation is done only by hexapods or TFS. other than that is not accurate. so guess what most of the patients of the external fixators don't have perfect mechanical axis. and this is why the external methods are still exist - so if you are ready to accept the scars - and lengthening a small amount ( not exciding 5 cms in tibia ) so you will be of the frame very quick . go for externals but make sure to chose a doctor who do TSF or have the hexapods correction otherwise you will end with deformity
Again good luck in your life KILOKHAN and enjoy your new height
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I wanna know if doing tibias with external fixators and using ilazarov frames is ok? what will be the pros and cons?
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hi dear friend, congratulation for your 6cm get! Could I ask you about your current condition? Do You feel good without pain and could you run?
Kind regards
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hi dear friend, congratulation for your 6cm get! Could I ask you about your current condition? Do You feel good without pain and could you run?
Kind regards
Physically, the lasting changes are the numbing sensation in my legs when sitting certain angles, and my scars are weaker than the surrounding skin so they tend to bleed more easily when scratched. Also my running stamina isn't quite to where I used to be, but I've never been much of a runner anyways.
Psychologically, I feel much better about myself and am currently in a relationship with a woman who's 6'0 tall. I never would have bothered approaching her pre-CLL and that's for certain.
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Physically, the lasting changes are the numbing sensation in my legs when sitting certain angles, and my scars are weaker than the surrounding skin so they tend to bleed more easily when scratched. Also my running stamina isn't quite to where I used to be, but I've never been much of a runner anyways.
Psychologically, I feel much better about myself and am currently in a relationship with a woman who's 6'0 tall. I never would have bothered approaching her pre-CLL and that's for certain.
Hi Kilokahn, if you don't mind could you please share your accurate age at the time of starting your LL journey. It would be helpful for us to learn from your case regarding ant. compartment syndrome.
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Congrats on the relationship! I recall you mentioning her when we met, glad that it's working out. Can't undermine the confidence boost!
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So dear, how are you feeling post 3 years...did you achieve 100% of your gait and agility?
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^what he said
...?
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^what he said
...?
Don't know dude...kilo did not reply.
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Kilo man please reply...
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hey Kilo, do you think that having pins throught the muscles affected your athletic function or recovery? because those pins are going to do muscle damage and scar tissue.
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The front of my ankles still feel a bit knotted from the fasciotomy, but other than that I'm fine. Not much else to report although I hope to have a running video out at some point.
How are you doing now? I'm reading your diary, but I'm in the begining yet. It is too much things.
Sorry to ask this here, but did you lengthen the achilles tendom? How long at total you stayed with the frames for how much lengthening?
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Amazing story, i wish you well
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Kilo, would you prefer had done tibias with stryde?
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How are you doing now? Do you have any constant pain? Are you able to jog or run?
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Kilo you are ON now, could you tell us how you doing?
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Users going ghost give me the most hesitation about performing this surgery. A light needs to be shined on limb lengthening, warts and all for us to accurately assess whether there is a point to doing this.
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They have no obligation to post. It is their freedom to not post any further.
The very fact that he is not posting any complaints, it is the best assurance that one can give.
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I guess they have no obligation, but I would have thought that they would have more empathy for people in our situation, since it wasn't so long since they were in a similar one.
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Why no reply?
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have you decided for 2nd operation for femurs kilokahn?
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Hows ur walking these days? Are u back to 80-90%?
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Now having thoroughly read your diary, you did an amazing job for sure, keeping those frames on for a year takes patience and judging by the way you wrote your detailed diary it seems to me you are extremely dedicated in whatever you do. The walking and everything seems perfect and no one would be able to tell you have had any kind of surgery. Best of luck in the future and thanks for sharing the experience.
Jamesey
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Hey kilo! How are you?
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Some have asked about calf hypertrophy after leg lengthening. Posted an image of my calves currently to give an idea of what hypertrophy can look like post-CLL. Imo, this is something that will be more of a detriment in the eyes of many women, whereas for men it will be most welcome. On average I only do calf raises once a week when working out, but it takes significantly less effort to keep my calves larger compared to before my cosmetic lengthening and fasciotomy.
(https://s8d8.turboimg.net/t1/70156330_20211118_194218.jpg) (https://www.turboimagehost.com/p/70156330/20211118_194218.jpg.html)
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Hello! Sorry if this is evident but did you do tibias?
And can you solve the hypertrophy if you want to?
I am very small that would be weird on me because I also don't exercise for muscle elsewhere in the body.
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Hello! Sorry if this is evident but did you do tibias?
And can you solve the hypertrophy if you want to?
I am very small that would be weird on me because I also don't exercise for muscle elsewhere in the body.
Yeah, tibial lengthening. I'm not sure there's anything to do if it happens unless you find yourself in a wheelchair again. Your leg muscles will naturally be working harder just to cope with the increased length of your bones.
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Can you run?
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Can you run?
Yes. Just not as long as I used to before my legs get tired.
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Hi Kilo
It’s been eight or so years for you. I have a few questions if you have the time
1.) would you overall say it was worth it for you? I am exactly the same height as you pre-LL and would increase by the same amount. Just curious on how it’s impacted your life
2.) would you say that you are physically back to normal? Any changes for yourself?
3.) would you recommend the route you took (India and the doctor) to others?
4.) what do you think the total spend was?
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Do you have the constant feel of harmstring stretch or no?
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Hi Kilo
It’s been eight or so years for you. I have a few questions if you have the time
1.) would you overall say it was worth it for you? I am exactly the same height as you pre-LL and would increase by the same amount. Just curious on how it’s impacted your life
2.) would you say that you are physically back to normal? Any changes for yourself?
3.) would you recommend the route you took (India and the doctor) to others?
4.) what do you think the total spend was?
1. A night and day difference. Here in Los Angeles, nobody bats an eye at seeing someone who's 5'7". Heck, even when I visited Texas I wasn't ever called out for height particularly. I'm still on the shorter side no doubt, but it's no longer something that controls my life. I bartend at 2 nightclubs now and getting laid is never an issue. Part of that is just the environment, but no longer being roughly 5'5 also helps.
2. My legs get tired faster while running and they also fall asleep easier than before. The first would have killed any chance at being an athlete at a pro level, so I say those with those aspirations should avoid this. Any amount of lengthening, you'd be fooling yourself thinking you'll reach pre-lengthening stamina through training. Not gonna happen. Since I'm only interested in recreational sports it's not an issue.
On the plus side, my calves increased in size permanently and I constantly have people in the gym asking how to get calves as big as mine. The other day a pair of bicyclists at Coffee Bean told me I had cyclists legs (even though I haven't ridden a bike in years).
3. I maintain that Dr. Parihar is a phenomenal surgeon and even though his clinic looks outdated is still a better option than most Western docs. Especially if you'll be doing externals or LON, which many docs in the West don't even offer. He's been doing Ilizarov since the early 90's and offers India's version of a TSF frame, which ensures proper alignment at the end of your lengthening.
4.
Here's the list of expenses I put together after I returned home (2014 exchange rate):
Surgery - $14,977 / 900,000 INR
X-Rays & Appointment - $240.00 (charges at front desk ranged between 1,000 - 3,000 INR. I think it depended on how much time I spent in Dr's office)
Physiotherapy at Hotel - $17.00 / 1,000 INR per session (Mr Chaudhary's rate)
Medications - $40.00
Zimmer Frame - $60.00
Wheelchair through Mr Shringare - $434.00 / 26,000 INR (I bought the most expensive wheelchair in the catalog but there were many cheaper options available)
Mr Shringare's Custom Splints - $55.00 (I recommend each patient to get splints made through him. The splints from local carpenters would eventually break from tension but Mr Shringare's were very sturdy and never did)
Dressings - $265.00 (each box cost 600 INR and had enough gauze for 2.5 changes)
Hotel Stay - $1,500 per month (at Hotel Maharana Inn)
Do you have the constant feel of harmstring stretch or no?
Nope.
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hi kilo,
I might get LON with Parihar towards the end of the year. Did you have a helper during your stay? If not, do you think you could have used one ? I am just concerned that being incapacitated this way, I might need more help than regular hotel staff. I am Indian btw but I don't live in Mumbai and don't think I could have family out to help, atleast not for long.
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hi kilo,
I might get LON with Parihar towards the end of the year. Did you have a helper during your stay? If not, do you think you could have used one ? I am just concerned that being incapacitated this way, I might need more help than regular hotel staff. I am Indian btw but I don't live in Mumbai and don't think I could have family out to help, atleast not for long.
I only had helpers hired by Dr Parihar while staying in his hospital. Maybe if I were staying in another hotel that didn't have available staff, then I could have used one. The reality was that everyone employed by the hotel was able to take care of whatever I needed, be it killing a spider, helping me order food, calling me a cab, changing bed sheets, etc. On top of that, some days I was in a really bad mood from either discomfort or tiredness and could be irritable. I wouldn't want to have a helper present with me when I was in one of those moods.
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I won't be consulting with Dr Sringari or Dr Sarin, as I really see no point in doing so.
presumably because you expect a surgeon to be nice? can you say more about your negative opinion regarding the pearls of their surgical technique
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presumably because you expect a surgeon to be nice? can you say more about your negative opinion regarding the pearls of their surgical technique
Because Sarin has no business operating on people when he has left even a single patient with an end result like this:
http://www.limblengtheningforum.com/index.php?topic=25.msg7287#msg7287
This case was so bad it prompted another leg lengthening surgeon to go against his policy and advise him medical attention on this forum:
I would normally not give detailed medical advice on an open forum, BUT you need to have those legs attended to. You have bilateral nonunions in evolution, possibly with dead bone ends and plates that will fail at some point.
You need proper fixation, bone debridement and grafting asap. We do this sort of thing regularly.
Send me an email at franz.birkholtz@walkamile.co.za then we can discuss privately.
Not sure where you are from, but hopefully I could recommend someone you could go and see?
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Hey KiloKHAN! I just read your whole diary and I feel like you’re a friend in a way now that’s just weird haha! I just wanted to thank you for all the informations you gave us! That’s really nice to take the time to do that! Also so many people ask you the exact same questions and I know that could be tiring but you answered them again and again! Sometimes I wanted to say, just read the whole diary and your answer is prolly there smh! Anyway I’m planning on doing LON femur and still shopping for a good surgeon that is not too pricey! Maybe I’ll write a diary myself but there are tons of trolls and negative people on here so I don’t know if I want all this negativity that could upset me during this tough journey…
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If you have recent imaging data please put it at this thread. Redact any information that could be used to dox you.