Limb Lengthening Forum
Limb Lengthening Surgery => Limb Lengthening Discussions => Topic started by: deletedaccount on November 10, 2020, 11:19:51 AM
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The Stryde nail is available now and the cost and accomodation would be very convenient for me given it's pretty close to where I live but the lack of number of cases done (zero in Stryde yet) is a little concerning despite Dr. Parihar's good reputation, although he does undertake a lot of deformity cases.
"Stryde nail is available - has only recently been available in India, so we haven't done any with the Stryde yet. However the technique is similar to the Precice 2, which we have done 6 in Femur & 2 in Tibia.
The cost for the Stryde nails is INR 23,50,000/- and additionally the hospital cost is around INR 9,00,000/-
The removal is done minimum after 2 years - the cost can therefore vary - the current price for the removal is around INR 2.75-3,00,000/-
The stay in Mumbai for the lengthening period (should plan for 140 days stay in Mumbai) can vary from INR 5000-15000 per day, depending on the type of accomodation one chooses.
Please have a look at
Cosmetic Lengthening:
http:// bit.ly/CosLen "
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I wouldn't want to be the guinea pig for a Stryde nail tbh. I say wait until a few people get it.
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Thank you for the link, Scarface. I’ve been looking around for this kind of information about dr. Parihar’s options. In my opinion, $200 for a 20 min skype call is a steep fee.
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I think it's a good idea to go to him. Inserting a nail is pretty much the same no matter what model it is.
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are you Indian? then I dont think u have any other option bro.
trust me Ive thought of several other doctors but Indians need visa to visit most countries and no one country is giving 3 month visas. greece, south korea, germany, you name it. its just impossible. if you get job somewhere or a PR of some country then maybe you can do it while living in other country.
if you are not Indian then maybe you can try some american doctor. paley is good obviously.
just dont go to someone who does only cosmetic.
parihar is good I think. he had told once if he sees anything wrong with nail or something during surgery he will cancel it instead of somehow doing it. stryde nail being new might be ok. but if you have ability to go to foreign country, then go to america or south korea since they did stryde already.
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The main difference between Stryde and Precice is its weight bearing capacity. Since he has experience with one, being the first to do Stryde isn't being a guinea pig.
He's a better option than Dr Lee, imo.
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Hey KiloKhan,
After 6-7 months post op were you able to do some light weight leg exercises? Or were you not allowed to do any type of physical activity until the frames were removed? I’ve had my mind set on doing LON with dr. Parihar for a while now, but I’m debating whether fully externals would be better for me since I’m worried about the risk of getting permanent knee pain and also my tibias are very thin, but if fully external means living as a cripple for a year or more than I think I’ll be sticking to LON.
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are you Indian? then I dont think u have any other option bro.
trust me Ive thought of several other doctors but Indians need visa to visit most countries and no one country is giving 3 month visas. greece, south korea, germany, you name it. its just impossible. if you get job somewhere or a PR of some country then maybe you can do it while living in other country.
if you are not Indian then maybe you can try some american doctor. paley is good obviously.
just dont go to someone who does only cosmetic.
parihar is good I think. he had told once if he sees anything wrong with nail or something during surgery he will cancel it instead of somehow doing it. stryde nail being new might be ok. but if you have ability to go to foreign country, then go to america or south korea since they did stryde already.
Yes, I am Indian. If I go to Parihar I can do the surgery next year or so and my parents can pay for it but if I resort to my original plan of going with Paley that sort of sounds like a distant pipe dream and I will have to save up for it and do it in a few years.
I'm inclined to go with Dr. Parihar.
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Yes, I am Indian. If I go to Parihar I can do the surgery next year or so and my parents can pay for it but if I resort to my original plan of going with Paley that sort of sounds like a distant pipe dream and I will have to save up for it and do it in a few years.
I'm inclined to go with Dr. Parihar.
Why not do Giotkas or Donghoon? Paley is expensive and really far from India.
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The main difference between Stryde and Precice is its weight bearing capacity. Since he has experience with one, being the first to do Stryde isn't being a guinea pig.
He's a better option than Dr Lee, imo.
Hi Kilo, I am aware you have first hand experience of doing surgery with Dr. Parihar, who i also believe is a a competent doctor. I have visited him few years back and did some research on him.
I am still curious to know your reasons for rating him higher than Dr. Lee, is it mainly due to your personal experience?
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The Stryde nail is available now and the cost and accomodation would be very convenient for me given it's pretty close to where I live but the lack of number of cases done (zero in Stryde yet) is a little concerning despite Dr. Parihar's good reputation, although he does undertake a lot of deformity cases.
"Stryde nail is available - has only recently been available in India, so we haven't done any with the Stryde yet. However the technique is similar to the Precice 2, which we have done 6 in Femur & 2 in Tibia.
The cost for the Stryde nails is INR 23,50,000/- and additionally the hospital cost is around INR 9,00,000/-
The removal is done minimum after 2 years - the cost can therefore vary - the current price for the removal is around INR 2.75-3,00,000/-
The stay in Mumbai for the lengthening period (should plan for 140 days stay in Mumbai) can vary from INR 5000-15000 per day, depending on the type of accomodation one chooses.
Please have a look at
Cosmetic Lengthening:
http:// bit.ly/CosLen "
If you plan to do it in India Dr. Parihar is one of the better options. Although the accomodation prices you quoted below seems way off the chart 15k rupees = 200 USD those are the prices for staying in a 5 star hotel :)
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If you plan to do it in India Dr. Parihar is one of the better options. Although the accomodation prices you quoted below seems way off the chart 15k rupees = 200 USD those are the prices for staying in a 5 star hotel :)
Not surprising. In Delhi in 2014 it was 115 a night at a standard hotel with nothing special. There are some amazing hotels in Mumbai that might be worth 200 a day, but many hotels will give discounts for long-term reservations. I stayed at Hotel Maharana a few blocks away from Dr Parihar's clinic and they gave me a deal of $50 a day.
Hi Kilo, I am aware you have first hand experience of doing surgery with Dr. Parihar, who i also believe is a a competent doctor. I have visited him few years back and did some research on him.
I am still curious to know your reasons for rating him higher than Dr. Lee, is it mainly due to your personal experience?
Aside from my personal experience bias, I also think that even if South Korea is a more appealing destination than India for most everyone, certain things make me favor Dr Parihar:
1) He's $30,000 - 40,000 more inexpensive compared to Dr Lee for internal methods.
2) His criteria for patients is more strict and the patient-doctor relationship seems more personal than being one of Dr Lee's assembly line cosmetic cases.
3) http://www.limblengtheningforum.com/index.php?topic=64486.msg176547#msg176547
"Oh yea.. I just remembered haha, he doesn't like people asking too many questions. I got yelled at by Dr Lee when I was questioning my x rays too much...
He basically said "something something... trust him hes the doctor" which is true, but in my opinion its my legs and I am the type of person that likes to understand so it wouldn't hurt to help me do so."
A doctor yelling at someone for asking questions doesn't sit well with me. Cosmetic patients are naturally going to be more concerned/demanding over pain or what have you as opposed to a deformity correction patient, and a doc who heavily caters to a cosmetic market should have the patience and understanding for that.
4) Most of the highly regarded doctors such as Paley will tell you to only go to surgeons at the top of the pyramid for cosmetic lengthrning for the reason that you want a doctor who can not only prevent complications, but also has the experience to deal woth the ones that arise. Both Dr Parihar and Dr Lee definitely have the experience to deal with potential complications, but Dr Parihar's location has him treating more patients with complex, gnarly birth deformities and bone injuries from road accidents and bomb blasts, etc, so I'd have that extra bit of confidence that he has seen just about everything that can go wrong and knows how to respond accordingly.
5) He did his residency with Dr Paley 19 years before Dr Lee did his. Maybe it means nothing, but that extra 20 years of experience doesn't hurt.
6) Dr Parihar is also a knee replacement specialist, I'd hazard a guess that if permanent knee pain is something you're worried about, a specialist in both fields is a good person to talk to.
The one advantage Dr Lee has over Dr Parihar that is significant to most people is the location. Dr Lee's location is much nicer than Dr Parihar's, but at least for me personally it doesn't matter because when youre in the hospital for a week, you're practically bed ridden and just eating light meals while watching TV and doing small movements. After that, the location factor can be mitigated by staying at a hotel in Mumbai. Could probably use that extra amount Lee would cost to stay at one of Mumbai's 5 star hotels for the lengthening period.
Just my 2 cents, don't take it as an absolute fact.
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Yes, I am Indian. If I go to Parihar I can do the surgery next year or so and my parents can pay for it but if I resort to my original plan of going with Paley that sort of sounds like a distant pipe dream and I will have to save up for it and do it in a few years.
I'm inclined to go with Dr. Parihar.
ya paley is very very costly. but I Hope you are taking my word of caution. I saved money to go to south korea dr lee and get lon procedure. I even closed some of my bank deposits and began making all arrangements to go. thats when I was told by lee's team that I need to go on a tourist visa, get surgery and then get medical visa. I was shocked!!! how can I take such big risk? what if medical visa is rejected after surgery? and should I tell lie while entering south korea?? then even giokitas team said the same thing!! come on 2 week tourist visa and then try to extend it after surgery!! wtf.
then I found out for Indians we cant go to any of these countries USA, south korea, germany, greece other than with short term tourist visa (2 weeks max usually). no doctor is willing to arrange medical visa from the start.
so money is not the only problem. its very hard to get long term visa for Indians. if you have USA passport then you can go to most countries and stay of 3 months with no visa. thats why think this through. or LL is long term goal ? then immigrate to some other country like canada thru job and as canadian you can go anywhere but this will take 5 years atleast.
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ya paley is very very costly. but I Hope you are taking my word of caution. I saved money to go to south korea dr lee and get lon procedure. I even closed some of my bank deposits and began making all arrangements to go. thats when I was told by lee's team that I need to go on a tourist visa, get surgery and then get medical visa. I was shocked!!! how can I take such big risk? what if medical visa is rejected after surgery? and should I tell lie while entering south korea?? then even giokitas team said the same thing!! come on 2 week tourist visa and then try to extend it after surgery!! wtf.
then I found out for Indians we cant go to any of these countries USA, south korea, germany, greece other than with short term tourist visa (2 weeks max usually). no doctor is willing to arrange medical visa from the start.
so money is not the only problem. its very hard to get long term visa for Indians. if you have USA passport then you can go to most countries and stay of 3 months with no visa. thats why think this through. or LL is long term goal ? then immigrate to some other country like canada thru job and as canadian you can go anywhere but this will take 5 years atleast.
I see, I'll definitely take caution. LL initially was a long term goal but now Parihar as an option I can see myself doing it earlier and financed by my parents and I'm probably going to go with him now.
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Not surprising. In Delhi in 2014 it was 115 a night at a standard hotel with nothing special. There are some amazing hotels in Mumbai that might be worth 200 a day, but many hotels will give discounts for long-term reservations. I stayed at Hotel Maharana a few blocks away from Dr Parihar's clinic and they gave me a deal of $50 a day.
Aside from my personal experience bias, I also think that even if South Korea is a more appealing destination than India for most everyone, certain things make me favor Dr Parihar:
1) He's $30,000 - 40,000 more inexpensive compared to Dr Lee for internal methods.
2) His criteria for patients is more strict and the patient-doctor relationship seems more personal than being one of Dr Lee's assembly line cosmetic cases.
3) http://www.limblengtheningforum.com/index.php?topic=64486.msg176547#msg176547
"Oh yea.. I just remembered haha, he doesn't like people asking too many questions. I got yelled at by Dr Lee when I was questioning my x rays too much...
He basically said "something something... trust him hes the doctor" which is true, but in my opinion its my legs and I am the type of person that likes to understand so it wouldn't hurt to help me do so."
A doctor yelling at someone for asking questions doesn't sit well with me. Cosmetic patients are naturally going to be more concerned/demanding over pain or what have you as opposed to a deformity correction patient, and a doc who heavily caters to a cosmetic market should have the patience and understanding for that.
4) Most of the highly regarded doctors such as Paley will tell you to only go to surgeons at the top of the pyramid for cosmetic lengthrning for the reason that you want a doctor who can not only prevent complications, but also has the experience to deal woth the ones that arise. Both Dr Parihar and Dr Lee definitely have the experience to deal with potential complications, but Dr Parihar's location has him treating more patients with complex, gnarly birth deformities and bone injuries from road accidents and bomb blasts, etc, so I'd have that extra bit of confidence that he has seen just about everything that can go wrong and knows how to respond accordingly.
5) He did his residency with Dr Paley 19 years before Dr Lee did his. Maybe it means nothing, but that extra 20 years of experience doesn't hurt.
6) Dr Parihar is also a knee replacement specialist, I'd hazard a guess that if permanent knee pain is something you're worried about, a specialist in both fields is a good person to talk to.
The one advantage Dr Lee has over Dr Parihar that is significant to most people is the location. Dr Lee's location is much nicer than Dr Parihar's, but at least for me personally it doesn't matter because when youre in the hospital for a week, you're practically bed ridden and just eating light meals while watching TV and doing small movements. After that, the location factor can be mitigated by staying at a hotel in Mumbai. Could probably use that extra amount Lee would cost to stay at one of Mumbai's 5 star hotels for the lengthening period.
Just my 2 cents, don't take it as an absolute fact.
Hi Kilo,
Thanks for sharing and detailed reply i am sure it will be helpful to many of the undecided.
50 USD a day seems more like a reasonable price of a budget hotel or if you are a local, like OP is, than perhaps it is possible to do a short term rental for circa 1000 USD month at good standard apartment.
Regarding the point you mentioned all valid points. I would just add something which Dr. Parihar mentioned himself (and i agree) that there is a difference between the expectations of a trauma patient and Cosmetic one. In the former's case the patient is grateful for whatever the surgeon can do for him to salvage his limbs and will be an improvement on his current condition but in the later case the surgeon is basically breaking perfectly healthy limbs to enhance the patient's life from psychological point of view where the margin for error is relatively smaller and expectation much higher. Hence experience of Dr. Parihar as a trauma orthopedic surgeon although very relevant and helpful, i wouldn't hold that against Dr. Lee as he is doing a lot of cosmetic cases which brings the added pressure and expectations. So far from what i have seen (and read) his patients seems to be quite satisfied.
Lastly i agree that the clinic setting and the facilities of Dr. Parihar can be a little off putting but if one can look beyond that, Dr. Parihar is a very good option specially at that price point as you also mentioned in your post.
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Hey KiloKhan,
After 6-7 months post op were you able to do some light weight leg exercises? Or were you not allowed to do any type of physical activity until the frames were removed? I’ve had my mind set on doing LON with dr. Parihar for a while now, but I’m debating whether fully externals would be better for me since I’m worried about the risk of getting permanent knee pain and also my tibias are very thin, but if fully external means living as a cripple for a year or more than I think I’ll be sticking to LON.
@KiloKhan
I see, I'll definitely take caution. LL initially was a long term goal but now Parihar as an option I can see myself doing it earlier and financed by my parents and I'm probably going to go with him now.
Honestly, from what you explained, I don’t understand why you would be considering going to another doctor. After listening to most of the conferences he spoke at, I knew he was one of the doctors I would want to go to. You have the advantage of being close to one of the most experienced doctors in this field, the opportunity to have your parents pay for the operation and save your money, and being able to do it much sooner than anticipated. If I were you, I would be arranging the surgery as we speak. The sooner you do it, the more time you’ll have to enjoy your new height. Hope this helps clear some doubts you might be struggling with.
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Not surprising. In Delhi in 2014 it was 115 a night at a standard hotel with nothing special. There are some amazing hotels in Mumbai that might be worth 200 a day, but many hotels will give discounts for long-term reservations. I stayed at Hotel Maharana a few blocks away from Dr Parihar's clinic and they gave me a deal of $50 a day.
Aside from my personal experience bias, I also think that even if South Korea is a more appealing destination than India for most everyone, certain things make me favor Dr Parihar:
1) He's $30,000 - 40,000 more inexpensive compared to Dr Lee for internal methods.
2) His criteria for patients is more strict and the patient-doctor relationship seems more personal than being one of Dr Lee's assembly line cosmetic cases.
3) http://www.limblengtheningforum.com/index.php?topic=64486.msg176547#msg176547
"Oh yea.. I just remembered haha, he doesn't like people asking too many questions. I got yelled at by Dr Lee when I was questioning my x rays too much...
He basically said "something something... trust him hes the doctor" which is true, but in my opinion its my legs and I am the type of person that likes to understand so it wouldn't hurt to help me do so."
A doctor yelling at someone for asking questions doesn't sit well with me. Cosmetic patients are naturally going to be more concerned/demanding over pain or what have you as opposed to a deformity correction patient, and a doc who heavily caters to a cosmetic market should have the patience and understanding for that.
4) Most of the highly regarded doctors such as Paley will tell you to only go to surgeons at the top of the pyramid for cosmetic lengthrning for the reason that you want a doctor who can not only prevent complications, but also has the experience to deal woth the ones that arise. Both Dr Parihar and Dr Lee definitely have the experience to deal with potential complications, but Dr Parihar's location has him treating more patients with complex, gnarly birth deformities and bone injuries from road accidents and bomb blasts, etc, so I'd have that extra bit of confidence that he has seen just about everything that can go wrong and knows how to respond accordingly.
5) He did his residency with Dr Paley 19 years before Dr Lee did his. Maybe it means nothing, but that extra 20 years of experience doesn't hurt.
6) Dr Parihar is also a knee replacement specialist, I'd hazard a guess that if permanent knee pain is something you're worried about, a specialist in both fields is a good person to talk to.
The one advantage Dr Lee has over Dr Parihar that is significant to most people is the location. Dr Lee's location is much nicer than Dr Parihar's, but at least for me personally it doesn't matter because when youre in the hospital for a week, you're practically bed ridden and just eating light meals while watching TV and doing small movements. After that, the location factor can be mitigated by staying at a hotel in Mumbai. Could probably use that extra amount Lee would cost to stay at one of Mumbai's 5 star hotels for the lengthening period.
Just my 2 cents, don't take it as an absolute fact.
I just read the diary link you posted. I think now i have a better understanding of the point you were making, the assembly line approach and treating patients just as paying customers doesn't sound good.
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Btw, why do people keep mentioning only hotels as an option? Are there no Airbnb rentals available in India?
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Dr Parihar is an amazing option, far better than Dr Lee because he won’t try to extortionate money at every possible opportunity as dr Lee do. Also, Parihar has far better work ethics than many top CLL surgeons ... if we had like 6-7 Parihar dairies, I would have considered him for sure.
People who say Mumbai is sub-standard - if you are willing to spend, you will see class 1 service... but bcz people don't want to spend too much on rent, they end up taking an Okish accommodation.
Mumbai has every kind of option for you- cheap, reasonable, nice and amazing ... it depends on how much you willing to pay. Just check out Airbnb or Oyo app.
Regards
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Dr Parihar is an amazing option, far better than Dr Lee because he won’t try to extortionate money at every possible opportunity as dr Lee do. Also, Parihar has far better work ethics than many top CLL surgeons ... if we had like 6-7 Parihar dairies, I would have considered him for sure.
People who say Mumbai is sub-standard - if you are willing to spend, you will see class 1 service... but bcz people don't want to spend too much on rent, they end up taking an Okish accommodation.
Mumbai has every kind of option for you- cheap, reasonable, nice and amazing ... it depends on how much you willing to pay. Just check out Airbnb or Oyo app.
Regards
I think Dr. Lee is a very good option specially for Asian patients, if price is not an issue as he provides one stop shop and everything is cutting edge. Parihar is a great option if you are considering India, which i believe is not everyone's cup of tea for various challenges it presents. It has nothing to do with Dr. Parihar's ethics or skills, which i believe to be quite good rather certain issue related to general hygiene conditions of the environment.
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ya paley is very very costly. but I Hope you are taking my word of caution. I saved money to go to south korea dr lee and get lon procedure. I even closed some of my bank deposits and began making all arrangements to go. thats when I was told by lee's team that I need to go on a tourist visa, get surgery and then get medical visa. I was shocked!!! how can I take such big risk? what if medical visa is rejected after surgery? and should I tell lie while entering south korea?? then even giokitas team said the same thing!! come on 2 week tourist visa and then try to extend it after surgery!! wtf.
then I found out for Indians we cant go to any of these countries USA, south korea, germany, greece other than with short term tourist visa (2 weeks max usually). no doctor is willing to arrange medical visa from the start.
so money is not the only problem. its very hard to get long term visa for Indians. if you have USA passport then you can go to most countries and stay of 3 months with no visa. thats why think this through. or LL is long term goal ? then immigrate to some other country like canada thru job and as canadian you can go anywhere but this will take 5 years atleast.
What you write is factually incorrect. I have a few Indian friends and they visit USA and Europe and can stay there for 3 months just on tourist visa.
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What you write is factually incorrect. I have a few Indian friends and they visit USA and Europe and can stay there for 3 months just on tourist visa.
bro Im writing from experience
if I from India want to travel to europe for 90 days thats very unusual. very high chance of denial. europe trip is super expensive. who would decide to travel europe for 90 days out of blue?
they always ask for these documents:
-letter of employment from your company giving you leave for the required period.
-full trip plan (day to day). like "I will visit this city on this day and this city on this day."
-hotel booking details of all days.
there is no way anyones company can give leave for 90 days. impossible. in fact you would have to leave your job for this surgery. so you wont even be employed.
unless you can prove strong attachments to India you wont get a visa for 90 days. if you have a $5m property in India and have a wife and 3 children who youre leaving behind in India and have prior travelling experience to europe then they might consider it. but for an average salaried guy, its VERY unusual to get visa to travel 90 days.
If EU is this hard, USA I cant even imagine. but one good thing about USA is once you get a visa, its valid for 5-10 years usually and you can travel for upto 6months per visit after that.
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any way I dont want to discourage anyone. you can always do your own research and I might even be wrong. even from a simple google search you can find visa requirements for most countries.
Im just stating my experience when I decided to go for south korea for LL and once before when I traveled to EU for tourism purposes
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Hey KiloKhan,
After 6-7 months post op were you able to do some light weight leg exercises? Or were you not allowed to do any type of physical activity until the frames were removed? I’ve had my mind set on doing LON with dr. Parihar for a while now, but I’m debating whether fully externals would be better for me since I’m worried about the risk of getting permanent knee pain and also my tibias are very thin, but if fully external means living as a cripple for a year or more than I think I’ll be sticking to LON.
You're allowed to do light exercises at that time, as even when you're in the middle of lengthening you're expected to do physiotherapy exercises daily, from clenching and unclenching your muscles, to leg raises and various stretches. Also once the lengthening is complete you'll be expected to start walking around more and more. I never could balance correctly on crutches and felt much more confident with a walker.
Basically, you'll be more mobile at that point but you still are limited by the frames. The more you move, the more the wires (especially by the ankles) irritate the surrounding skin and the more prone you are to infections. Plus you'll still wake up with random pains from muscle contractions every once in a while do long as the frames are on.
Externals are annoying as hell, but somehow I managed keeping them on for a year.
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For some reason the links not working, what information did you find out about Dr parihar other then there’s a new stryde option. Thanks a lot I thought parihar wasn’t doing the surgery anymore so the Surgeon I had in mind was Dr giotikas but might change to Dr parihar as I’m from india too so it will be easy for me to go to India ... Please send me the link and any other details / information you know about parihar , thanks !
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how is the hospital cost so much? can you not do that and choose to go outside and rent instead?
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"The outcomes have been successful - all patients achieved their target lengthening - 2 patients reached 8 cm (max allowed in the nail), 1 patient wanted 5.5 cm and achieved that. 2 patients lengthened to 7.5 cm.
One nail malfunctioned - that was right after surgery - we check if the nails are functioning/lengthening after implantation - that nail was changed at that time and then the patient didn't have any trouble.
All of them have successfully healed and they are back to their routine work.
One patient the nails have been removed.
Physical therapy while in the hospital is included in the costs mentioned. After discharge a therapist can be hired to visit at a cost of INR 1000-1500/- per visit.
regards,
Dr Divya Ahuja
डॉ दिव्य आहूजा
CLLR Team
Mangal Anand Hospital
Mumbai
www.ilizarov.in"
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Nice scarface. looks like promising option.
I think for LON also India is better than south korea for me. not worth doing so much hassle just to experience some modern looking hospital and be around people who wont understand english ( in south korea ) and not find my favourite foods.
if Im going to do in India I can think of stryde also, since I Will save a lot of money being in India.
whats your plan buddy?
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bro can you ask if dr Parihar only does surgery himself and on both legs?
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Excited for your diary... You have given us hope that Dr Parihar is still an option... Do you know the new price list for surgery with Parihar, if so please could you send me the link on mention it here. If possible In $ or £. I believe it’ll be around 50k for one surgery ???
Also I am from India too but live in Uk so it’ll be a better option for me. Please reply, thank you !
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Nice scarface. looks like promising option.
I think for LON also India is better than south korea for me. not worth doing so much hassle just to experience some modern looking hospital and be around people who wont understand english ( in south korea ) and not find my favourite foods.
if Im going to do in India I can think of stryde also, since I Will save a lot of money being in India.
whats your plan buddy?
Indeed, my plan is to go for it after I graduate from high school, my parents financing it or maybe in some time off I get during college.
You can ask your queries at info@bonedocs.in. They REALLY need to switch up their website design though lol.
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Excited for your diary... You have given us hope that Dr Parihar is still an option... Do you know the new price list for surgery with Parihar, if so please could you send me the link on mention it here. If possible In $ or £. I believe it’ll be around 50k for one surgery ???
Also I am from India too but live in Uk so it’ll be a better option for me. Please reply, thank you !
Thanks Gman! :)
"How Much Lengthening is possible:
5 cms can be safely done in most situations
Usually not more than 5 or 6 cms in the tibia, depending on function (see other comments at bottom of page)
internal lengthening nails may allow 7.5 cm of length in the FEMUR (again depending on clinical progress)
We don't do external lengthening of the femur in cosmetic cases, only for unilateral LLD due to unequal growth in the femur.
There are three methods that can be used:
"lengthening over nail" (LON) method.
External fixator only - if patient does not want to undergo the LON or if the anatomy does not allow the use of the nail.
internal lengthening nail (precice 2).
Description of the technique:
1. LON:
at the initial surgery, a fixator is applied on both the legs and a rod is put inside the bone.
The bone is then cut and gradual lengthening begun after 7 days. This lengthening is done at 0.75 mm to 1 mm per day.
at the end of lengthening, (usually 50 to 60 days if distracting at 1 mm per day, more if 0.75 per day), the rod which was place inside earlier is locked, so that the fixator can be removed. the rod then holds the bone in its lengthened position till such time as the bone matures. this process normally takes a minimum of additional 120 days.
The overall period before a patient gets back to normal for a lengthening of 6 cms is a minimum of around 6 months.
However, oftentimes, depending on the patient it may take anything from 8 – 12 months.
2. External Fixator only:
Similar to the above, except that an internal rod is not implanted. Therefore the fixator has to remain on the legs till the bone is fully healed.
3. Internal Lengthening Nail:
No external fixator is used. A special, imported nail is implanted in the bone to be lengthened, and a magnetically actuated mechanism in the nail lengthens the nail (and thus the bone) by 1 mm per day.
Once desired length is achieved, the distraction is stopped and bone heals.
Advantages / Disadvantages of each:
LON:
Advantage: The “external fixator time” is much less than the “healing time” and patient is free of the inconvenience of the fixator. (fixator is removed after the lengthening – about 2.5 to 3 months)
Disadvantage: small risk of infection in the bone due to the nail inside. Small risk of pain in the knee from the insertion site of the nail.
External fixator:
Advantage: least risk of intramedullary infection. No risk of knee pain
Disadvantage: The ‘external fixator time” is the same as the “healing time”. i.e. fixator has to be on the leg till the bone is healed.
Internal lengthening nail:
Advantage: no external device, therefore no problems with scars, least amount of pain of the three methods.
Disadvantage: cost. Small risk of complications related to the nail – embolism, infection etc.
Time periods involved:
hospitalisation is usually for 7 days, but the patient has to stay in mumbai till the distraction is complete as this is the time till which problems if any can occur. once the rod is locked, patients can go back home and just send xrays to monitor the healing.
overall return to normal activity would take a minimum of 6-8 months.
in the initial period while the distraction is going on, the patient is relatively
incapacitated, and is only able to do bed to wheelchair transfers. after the locking is done, patients can begin putting weight on their legs and walking with the aid of a walker (zimmer frame) depending on pain and the xray apperance. usually i would expect most patients to be taking almost full weight about 4 months after surgery (with crutches)
The time taken to heal depends on multiple factors, which are primarily related to the patient – i.e. LON or external fixation or internal nails, will all heal at the same rate for a given patient .
Stay in Mumbai:
Since the patient needs to stay in Mumbai for the duration of lengthening, a stay of 90 - 100 days is envisaged
Short term rentals are not easy to find, and patients most likely would need to stay in a hotel in the vicinity. Hotels would give you cheaper rates for a long stay. This is not included in the costs of treatment.
Other comments:
normally we do not do lengthening more than 5 or 6 cms for cosmetic reasons, as the rate of complications rises exponentially after that length.
in any case, we are very clear that function is more important than length, and in case any problems with function (such as stiffness in the ankles) arises during the treatment, we stop at whatever length has been achieved, and concentrate on the physiotherapy to regain function.
the process is fairly taxing for the patient, and needs good emotional support from a partner or other member of family.
For Surgery, we need an accompanying Relative to be present in the hospital. Only in very rare situations we do we undertake surgery without a relative present.
Costs:
The overall costs for the procedure come to around Indian Rupees 9,00,000/- (Rupees nine lac only).
This includes, stay in hospital for the surgery, doctors fees, physiotherapy, OT charges materials used in hospital / surgery.
in case of internal lengthening there is an additional cost for the nails which is ordered directly by the patient from the company –see below for costs.
This does not include stay in Mumbai after discharge from hospital, physio after discharge from hospital etc.
Future Function after lengthening:
Once the bones have healed, there should be no problem with exercise and full activity.
When the LON Cannot be done:
If the bone to be lengthened is too thin, or too narrow, or too short, to accept a nail, LON cannot be done.
In that case, only External fixator lengthening can be done. In that event, the fixator remains on the leg till the bone is completely healed, (a process which may take 10 – 12 months for a 6 cm lengthening).
The patient is able to move around and perform most activities, but the fixators on the leg may be a bit of an impediment, depending on the patients personal and job profile.
More about Internal Lengthening: (Precice 2 nails):
Precice 2 nails are available in India.
The cost for the nails (in addition to hospital charges) is 10.55 lakhs per nail (total 21.10 lakhs). This includes the costs to do the paperwork for the import of the nails (by the local distributor). (This is a new, reduced price)
This cost is ONLY the nails, and costs for hospital and professional fees are additional.
Patient needs to stay in India during the lengthening phase.
Using this nail, the femur, or the tibia can be lengthened. The femur is preferred.
Once a patient decides for the surgery, the entire payment for the nail is to be made to the local distributors, who in turn will start the paperwork to import the nail to India, specifically for that patient.
It takes 6 weeks, after payment for the nails to be available for implantation.
After the paperwork is completed, a clinical support person from Nuvasive USA will double check the sizes etc and discuss with us, prior to despatching the nails.
A clinical support person from Nuvasive USA, will be present during the surgery, for support.
in case of malfunction, a replacement would be provided without charge. there would be some OT charges etc involved, which would be charged by the hospital, but no surgeon charges
More Information (Skype Consultation):
we apologise that we do not do email consultation (replying to and fro to various questions on email)
If you have a lot of questions that need answering, we would be happy to do a 20 minute Consult on Skype, @ at cost of US$ 200, at a time that is mutually convenient to you and us.
Please write down a list of questions that you may have, so that you can make the most of the time available.
email us at info@bonedocs.in with 'skype consult' in the subject line, and your convenient times to speak (with your time zone) and we will get back to you with possible times and details of how the payment is to be made, before the consult.
Alternatively, if you live in India, we are happy to see you in Mumbai for a consultation in person.
"
Just quoted from the link sent here. Also in the original post for Stryde.
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bro can you ask if dr Parihar only does surgery himself and on both legs?
okey
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bro can you ask if dr Parihar only does surgery himself and on both legs?
That is a good point and should be clarified as a few of the doctors do only 'One' leg and his colleague is doing the second leg at the same time.
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I think Dr. Lee is a very good option specially for Asian patients, if price is not an issue as he provides one stop shop and everything is cutting edge. Parihar is a great option if you are considering India, which i believe is not everyone's cup of tea for various challenges it presents. It has nothing to do with Dr. Parihar's ethics or skills, which i believe to be quite good rather certain issue related to general hygiene conditions of the environment.
I agree with you, Dr Lee is a great option because there is no issue with his workmanship, but after reading marathonrunners diary I just don't feel like Dr Lee is the best option. Parihar’s technology is certainly not cutting edge but I am curious about his pain management... Penguin had almost a painless journey but was it specific to him ? or pain management at Parihars is just fantastic? I NEED to know... Also, Penguin never uploaded any x-ray and scars images which would have helped many folks to make decisions... I am badly looking for Parihar dairies.
About the general hygiene - once you will visit Mumbai I am sure you will realize its somewhat exaggerated...
@Scarface: Under the given circumstance, you cant travel to Greece or Korea... India and US are the only options but acquiring US medical visa due to COVID is almost impossible .. here is the list you can see to know India's current travel bubble:
https://www.civilaviation.gov.in/en/about-air-transport-bubbles#:~:text=%E2%80%9CTransport%20Bubbles%E2%80%9D%20or%20%E2%80%9CAir,of%20the%20COVID%2D19%20pandemic.
Make your decision wisely and I wish you all the best mate...Thanks for sharing the info
Regards
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I agree with you, Dr Lee is a great option because there is no issue with his workmanship, but after reading marathonrunners diary I just don't feel like Dr Lee is the best option. Parihar’s technology is certainly not cutting edge but I am curious about his pain management... Penguin had almost a painless journey but was it specific to him ? or pain management at Parihars is just fantastic? I NEED to know... Also, Penguin never uploaded any x-ray and scars images which would have helped many folks to make decisions... I am badly looking for Parihar dairies.
About the general hygiene - once you will visit Mumbai I am sure you will realize its somewhat exaggerated...
@Scarface: Under the given circumstance, you cant travel to Greece or Korea... India and US are the only options but acquiring US medical visa due to COVID is almost impossible .. here is the list you can see to know India's current travel bubble:
https://www.civilaviation.gov.in/en/about-air-transport-bubbles#:~:text=%E2%80%9CTransport%20Bubbles%E2%80%9D%20or%20%E2%80%9CAir,of%20the%20COVID%2D19%20pandemic.
Make your decision wisely and I wish you all the best mate...Thanks for sharing the info
Regards
I have visited parihar's facility and stayed in Mumbai for few days. My comments about general cleanliness and hygiene were based on first hand experience. Without sounding offensive or stereo typing, i believe there is a big difference between Indian and western standards of hygiene and cleanliness.
If scars and other other cosmetic factors are an issue the scars on Dr. Lee patients are barely visilble. So far I have see scars only on Parihar's LON/external patients and they a very visible and significant as he uses metal staples for closing of the skin opening. I am not sure how they are with his internal nails.
As i said earlier i am not trying to dissuade anyone from going to India and specially to Dr. Parihar, who i think is a good honest doctor. But if money is not an issue and, one has to do do the surgery in Asia, i will be more inclined to go to Dr. Lee.
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Point taken Infinity... we have different eligibility criteria so I understand your views.
Well lets hope you have a great experience in korea so we all can have good faith in Lee.
Regards
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Point taken Infinity... we have different eligibility criteria so I understand your views.
Well lets hope you have a great experience in korea so we all can have good faith in Lee.
Regards
I think most sensible people generally would agree both are good options depending upon budget and few other factors. I am not going to either of them, at least not in next few months :)
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I believe Dr Parihar is probably the cheapest best surgeon out there... As he also trained with Dr paley ... I don’t know who this Dr lee is or Dr Halil budul but Dr giotikas seems like a decent surgeon...
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Dr. DongHoon lee is actually recommended by Dr. Paley and also trained with him.
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If scars and other other cosmetic factors are an issue the scars on Dr. Lee patients are barely visilble. So far I have see scars only on Parihar's LON/external patients and they a very visible and significant as he uses metal staples for closing of the skin opening. I am not sure how they are with his internal nails.
Metal staples aren't much of an issue long term for scarring, if at all. I had pretty bad scars and my doctor did not use staples. Other factors such as how bad the wound was and genetics determine how bad they are.
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Metal staples aren't much of an issue long term for scarring, if at all. I had pretty bad scars and my doctor did not use staples. Other factors such as how bad the wound was and genetics determine how bad they are.
From my limited knowledge base it seems stapling is not the best option for wound closure and from what I have seen parihar was using this method as he is primarily a tauma and deformity correction surgeon, which can be both good and bad when it comes to choosing a surgeon for CLL.. I am not sure if he still does so but this point might be relevant for some people who do LL for cosmetic purposes. Below I share some text I came across, ..
" FACTORS TO CONSIDER WHEN USING STAPLES
1. APPLICATION AND REMOVAL
Stapling can usually be performed quicker than suturing, saving about 2-3 minutes of time, which is why stapling is the preferred method of choice for trauma care involving mass casualties, whether it’s a natural disaster, major vehicular accident, or even a shooting. In a physician’s office. And while both stapling and most suturing require return visits for removal, staple removal in particular requires usage of a special tool versus a simple set of scissors for sutures. There are times when staples can become embedded in the skin, making removal difficult; on rare occasions, staples can become completely lodged within the skin, requiring a new incision to remove the buried staple.
2. RISK OF INFECTION
Wound complications are one of the main sources of illness following surgery, extending a patient's stay in the hospital or even leading to readmission. To find out which were less likely to lead to infection—stitches or staples—researchers analyzed the results of six trials, comparing both methods following surgeries in over 680 adults. They compared the use of staples to sutures following orthopedic procedures in adults. Their conclusion? The risk of developing a superficial wound infection was over three times greater after staple closure than suture closure, and for hip surgery in particular, staples were four times more likely to lead to infection.
3. SCARRING
Just as with sutures, staples can cause scarring. Because staples do not allow for precise wound alignment, healthcare professionals should not use staples on the face or neck (and discomfort makes them a poor choice for usage in the hands or feet). In patients who easily scar, staples could make their scar more pronounced, especially if the staples are left in for any stretch of time (>5 to 15 days, depending upon the location). Between 2013 and 2016, 163 women were analyzed, including 84 who received staples and 79 receiving sutures. There was some variance in weight and aging, but women with staples reported worse median cosmetic scores, darker scar color, and more skin marks compared to women with suture closure. "
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Dr. DongHoon lee is actually recommended by Dr. Paley and also trained with him.
Suggest me a good diary from Dr Donghoon lee please haven’t really read any of his diaries
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I actually would really like to go with Parihar and stay in one of those fancy Mumbai hotels. I’m actually Indian myself living in the US as a US Citizen. I have a Indian Visa that allows me to stay there for 6 months at a time. Would Dr. Parihar allow me to come back to the states after 2 months lengthening is complete?
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I actually would really like to go with Parihar and stay in one of those fancy Mumbai hotels. I’m actually Indian myself living in the US as a US Citizen. I have a Indian Visa that allows me to stay there for 6 months at a time. Would Dr. Parihar allow me to come back to the states after 2 months lengthening is complete?
Yes you can definitely go back after distraction. You can actually leave whenever you want and won't be stopped or anything but you would have to rely on a local surgeon for follow ups and also figure out how to return the ERC machine.
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From my limited knowledge base it seems stapling is not the best option for wound closure and from what I have seen parihar was using this method as he is primarily a tauma and deformity correction surgeon, which can be both good and bad when it comes to choosing a surgeon for CLL.. I am not sure if he still does so but this point might be relevant for some people who do LL for cosmetic purposes. Below I share some text I came across, ..
" FACTORS TO CONSIDER WHEN USING STAPLES
1. APPLICATION AND REMOVAL
Stapling can usually be performed quicker than suturing, saving about 2-3 minutes of time, which is why stapling is the preferred method of choice for trauma care involving mass casualties, whether it’s a natural disaster, major vehicular accident, or even a shooting. In a physician’s office. And while both stapling and most suturing require return visits for removal, staple removal in particular requires usage of a special tool versus a simple set of scissors for sutures. There are times when staples can become embedded in the skin, making removal difficult; on rare occasions, staples can become completely lodged within the skin, requiring a new incision to remove the buried staple.
2. RISK OF INFECTION
Wound complications are one of the main sources of illness following surgery, extending a patient's stay in the hospital or even leading to readmission. To find out which were less likely to lead to infection—stitches or staples—researchers analyzed the results of six trials, comparing both methods following surgeries in over 680 adults. They compared the use of staples to sutures following orthopedic procedures in adults. Their conclusion? The risk of developing a superficial wound infection was over three times greater after staple closure than suture closure, and for hip surgery in particular, staples were four times more likely to lead to infection.
3. SCARRING
Just as with sutures, staples can cause scarring. Because staples do not allow for precise wound alignment, healthcare professionals should not use staples on the face or neck (and discomfort makes them a poor choice for usage in the hands or feet). In patients who easily scar, staples could make their scar more pronounced, especially if the staples are left in for any stretch of time (>5 to 15 days, depending upon the location). Between 2013 and 2016, 163 women were analyzed, including 84 who received staples and 79 receiving sutures. There was some variance in weight and aging, but women with staples reported worse median cosmetic scores, darker scar color, and more skin marks compared to women with suture closure. "
From my experience, the staples didn't leave any scars. I only have indentations where the pins and wires from the frame were located.
You can see the initial appearance of the staples here:
https://www.turboimagehost.com/p/19408943/fib_osteotomy_close.jpg.html
And what it looked like after the staples were removed while I was still in frames:
http://www.limblengtheningforum.com/index.php?topic=634.msg38454#msg38454
I couldn't even tell there were staples earlier.
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Hey KiloKhan,
I was checking the images of your legs after frame removal and then some of your mock-ups came up. Is it still in your plans to get 7cm on femurs and with who would you think of doing this?
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very informative