Limb Lengthening Forum
Limb Lengthening Surgery => Limb Lengthening Doctors => Topic started by: Muse on October 10, 2013, 07:54:35 PM
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Doctor information and response from Mangal Anand Center for Limb Lengthening & Reconstruction, located in Mumbai, India. Contact them for specific information and latest updates.
Note: Please refer to our disclaimer about the Doctors Directory http://www.limblengtheningforum.com/index.php?topic=55.0 (http://www.limblengtheningforum.com/index.php?topic=55.0)
(http://s5d1.turboimagehost.com/t1/19545762_Mangal_Parihar.jpg) (http://www.turboimagehost.com/p/19545762/Mangal_Parihar.jpg.html)
Background, Training and Qualifications:
Profile
Dr. Mangal Parihar is an Orthopedic Surgeon, whose area of specialization includes Deformity Correction, Limb Lengthening using Ilizarov techniques and Orthofix fixators and Joint Replacement.
Dr. Parihar’s reputation and expertise extends equally to children and adults in the diagnosis and treatment of special orthopedic conditions including congenital limb deformities, post-traumatic limb conditions, bone healing problems, bone defects, skeletal dysplasias, metabolic disorders, foot deformities, peripheral nerve disorders, and other miscellaneous developmental deformities. For the past many years, Dr. Parihar has dedicated his career to improving the lives of patients with limb disorders.
He has performed numerous limb reconstruction surgeries using some of the most advanced surgical methods used for lengthening and deformity correction. He is the leading reconstruction orthopedic surgeon in the country and holds an acclaimed presence amongst his peers. He regularly receives referrals from across the country and overseas, for problems that have not resolved with conventional orthopedic surgery. He is constantly updating himself with the latest techniques to bring the best to the patient. Recently, he has been instrumental in bringing Hexapod — the six-axis correction system to India, which has revolutionized the world of deformity correction and limb reconstruction.
Dr. Parihar's expertise includes performing the whole gamut of orthopedic surgeries; be it soft tissue surgeries, or internal or external fixation for fractures, or internal or external fixation for deformity correction and limb reconstruction, or combined internal and external fixation for limb lengthening and reconstruction, or joint reconstruction using external fixation or joint replacement.
The surgeries are performed using state-of-the art equipment and techniques, with the utmost care for the soft tissue using minimally invasive techniques especially minimally invasive osteotomies. Dr. Parihar has popularized the Fixator Assisted HTO — a minimally invasive technique for precise correction of alignment in osteoarthritis of the knee, and intra-articular osteotomy for treatment of malunited proximal tibial fractures.
Qualifications:
Undergraduate and Postgraduate training at Seth G S. Medical College and KEM Hospital, Bombay
MBBS: University of Bombay (1984)
MS (Orth): University of Bombay (1988)
Hon. Orthopedic Surgeon
- Sir. H.N. Hospital
- Fortis Hospital
- Police Hospital, Nagpada
Academic Honors:
First in the University at the Final MBBS exam of June 1984
MS (Orth) at first attempt in July 1988
Fellowship and Specialized Training:
Visiting Orthopedic Fellow, Total Joint Arthroplasty
with Dr. C. S. Ranawat; at Hospital for Special Surgery (sponsored by the Ranawat Orthopedic Research Foundation), New York, USA (10/15/93 - 1/15/94)
Post-Doctoral Fellow, Ilizarov Techniques
with Dr. Dror Paley at the Maryland Center for Limb Lengthening and Reconstruction, Baltimore, USA (1/8/92 - 2/28/93)
Registrar, Orthopedics
Blackburn Royal Infirmary, Blackburn, England (1/8/91 - 7/31/92)
Clinical Training:
Registrar, Orthopedics
Seth G. S. Medical College and K. E. M. Hospital, Bombay (1/8/87 - 7/31/89)
House Surgeon, Orthopedics
Seth G. S. Medical College and K.E.M. Hospital, Bombay (1/8/85 - 7/31/87)
Rotating Internship
in Medicine, Surgery, Gynae and Obstetrics, Seth G. S. Medical College and KEM Hospital, Bombay (6/25/84 - 6/24/85)
Academic Staff Appointments:
Lecturer, Orthopedics; Seth G S. Medical College and KEM Hospital, Bombay (11/24/89 - 3/15/91)
Hon. Assistant Professor, Orthopedic Surgery, Sir J.J. Group of Hospitals & Grant Medical College
Examiner, Orthopedic section Third MBBS Examination, University of Bombay
Professional Memberships
Vice President (2014), ASAMI (Association for Study & Applications of the Methods of Ilizarov), India.
Executive committee member, BOS (Bombay Orthopedic Society) 1998 - 2001
Life Member, Indian Orthopedic Association (IOA), Pediatric Orthopedic Society of India (POSI), & Bombay Orthopedic Society (BOS)
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Here's the response from Dr Mangal Parihar about Limb Lengthening surgery
1) How many patients have you operated for cosmetic Limb Lengthening so far and How many patients do you operate yearly?
10 up to now. about 1 or 2 a year.
2) What is the estimated total cost, including post-op treatments, stay, medications, physiotherapy? Are unscheduled surgeries covered and How much does a consultation cost?
The overall costs for the procedure come to around Indian Rupees 9,00,000/-(Rupees nine hundred thousand). This includes the hospital stay, professional fees while in the hospital, the cost of the ring fixators and the nails. The stay after discharge has to be in a hotel (rates can vary from Rs3000-7000/- per day).
3) What kind of physical therapy is assigned to the patient?
All patients have been local, they usually continue with physio at their residence. For non locals, you could have a therapist visit you.
4) What maximum amount of lengthening do you recommend per segment, regarding patient safety? What is the daily rate of lengthening?
Max 6 cms. daily rate 0.75 to 1 mm, depending on pain and muscle tightness.
5) What are your opinions regarding the weightbearing of the patients?
i am not a big fan of walking while the distraction is going on. patients are allowed bed to chair transfers, bed to toilet, and standing while distracting. i don't encourage walking. after the nails are locked, in the early period they are not strong enough to take full weight, so again about 4 weeks of protected weight bearing, and increase weight bearing as the X-rays show progress in healing.
6) How often will you follow up with patients during lengthening?
patients stay in mumbai during the distraction phase, and i see them in clinic every 2 weeks. if any problems, i see them at shorter intervals.
7) How fast can patients return to normal life (walking without support)? What is the time required to lengthen 5 cm and 7.5-8 cm ?
in my experience, none of the patients have been walking without support before 6 months. (thought they may get onto a single stick by 4 months or so)
Dr Mangal Parihar
Orthopedic Surgeon
Tel: +91-22-2522 4845 / 022-2526 0000.
Fax: +91-22-2523 5416
Email: info@ilizarov.in
Website: http://www.ilizarov.in
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Great post.
US dollar = 61.30 Rupees
Euro = 83.04 Rupees
900,000 Rupees / 61.30 = $14861
900,000 /83.04 = 10838 Euros
Price seems reasonable. He only takes 2 people per year? :o
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Ah, good to see Dr. Parihar on the list. He's one of the Indian docs I think people can be sure isn't a quack. He's trained under Dr. Paley.
One thing to remember is that due to lack of accommodation, if you are there for 5 months you may spend an additional $7,500 - $15,000 just on a hotel. So the cost will be between $20,000 - $30,000, not including all the other stuff you may need.
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Too bad we cant get any patient testimonials for him.
If one did go , cant they rent a flat for a lot less than a hotel? ???
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To rent a flat is easy and almost free if you compare to a hotel. Physios are cheap too.
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Hotel is expensive if you stay for months (applies anywhere in the world). But if you rent a room or apartment in india, it'll be much cheaper.
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To rent a flat is easy and almost free if you compare to a hotel. Physios are cheap too.
From what my friend in India tells me, it's much more difficult to rent a flat or apartment in India than in other places if you don't have a local to vouch for you, so most foreigners opt for staying in hotels. My old professor is from India as well and she told me the same thing when I expressed interest in staying in India. Apparently, many Indian landlords have certain rules you're expected to follow unless you want to get evicted, such as no alcohol, no eating meat, no staying out past a certain hour, no males and females staying together, etc. Many won't rent to foreigners, period. If someone were to decide to go to Dr. Parihar, it's best to have someone in Mumbai you can stay with, or see if the doctor can help arrange something or connect you with someone willing to rent.
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He doesn't seem to be persuasive about gaining patients which is a good thing.
But however, he doesn't provide any physiotherapy options himself. He doesn't seem to stress the need of physiotherapy.
You "could" have a therapist visit you? :o
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He doesn't seem to be persuasive about gaining patients which is a good thing.
But however, he doesn't provide any physiotherapy options himself. He doesn't seem to stress the need of physiotherapy.
You "could" have a therapist visit you? :o
He does realize the importance of physiotherapy.
"Much is spoken about physiotherapy and it's importance in the Ilizarov method. Unfortunately, this is infrequently translated into practice. One just has to look at many cases with iatrogenic problems to realize that lack of physiotherapy lies at the root of the majority of these. The patient has to participate in a proper program of exercises, mobilization and ambulation. This cannot be stressed enough. Lack of proper physiotherapy can turn even the technically excellent surgery into a poor result, and nowhere is this more true than in the subspecialty of Ilizarov surgery. In fact Ilizarov's original technique requires the patients to stay in hospital and participate in at least two hours of therapy in various forms every day. In our circumstances, the services of a physiotherapist are not always available. The only recourse in such cases is for the surgeon himself to supervise the therapy for the patient. Achieving length or correcting a deformity at the cost of decreased motion, mobility or function is certainly not a worthwhile goal."
http://www.limblengtheningforum.com/index.php?topic=22.0 (http://www.limblengtheningforum.com/index.php?topic=22.0)
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Yeah, but his reply to Daemon doesn't indicate the importance of PT.
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PT is overated especially for tibia LL.
from what i can see in LL patients experiences, it appears stading and walking during distraction are the most important.
So how hard is it to add those 2 or atleast just standing to what ever cheap PT u will have.
I dont think it is that hard.
As long as my doctor is good with the surgery I'm happy. all i have to do is put up with the frame, turn the nut/bolts every day to distract and then stand as much as i can.
the other stuff can be done by any PT since its only massaging and stretching which only helps relief pain and lossen tendons. I see it as temporary relief that helps u lengthen more. If u really want to combat balerina iu are going to have to walk or atlest stand a lot while lengthening. and u dont need a fancy PT for that.
For femurs then yes u need a good PT because pf the many muscles that r involed when u lengthen.
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PT is overated especially for tibia LL.
from what i can see in LL patients experiences, it appears stading and walking during distraction are the most important.
So how hard is it to add those 2 or atleast just standing to what ever cheap PT u will have.
I dont think it is that hard.
As long as my doctor is good with the surgery I'm happy. all i have to do is put up with the frame, turn the nut/bolts every day to distract and then stand as much as i can.
the other stuff can be done by any PT since its only massaging and stretching which only helps relief pain and lossen tendons. I see it as temporary relief that helps u lengthen more. If u really want to combat balerina iu are going to have to walk or atlest stand a lot while lengthening. and u dont need a fancy PT for that.
For femurs then yes u need a good PT because pf the many muscles that r involed when u lengthen.
Agreed. I did almost no PT in Beijing and the end result was fine. Most of us thought the physical therapists there weren't helpful and we stopped going to them. By the time I left, they'd been let go by the hospital. When I came back a year later for my internal nail removal, the PT room was half its old size (they built a wall to turn it into 2 rooms; I don't know what they did with the other half) and was unstaffed. There was equipment for you to use on your own, if you could find where the light switch was. ;D
The most important thing during lengthening is standing. That fights ballerina foot and stimulates bone growth. Once you're done, the most important thing is walking. Walk a lot and your body will eventually adjust to your new bone length. I walked at least 2 hours a day for several months after my LL. Even after that I'd try to fit long walks into my schedule whenever I could for another couple of years.
I'm really impressed by Dr. Parihar's philosophy of being conservative about physical activity. Take it easy in the hospital: moving around a lot in the fixators can cause problems. Take it easy when you first get out of the hospital: if you put too much pressure on your legs before the bone has fused with the IM nail's screws, that can cause problems that'll send you BACK to the hospital after you thought you were done. Some people in Beijing with me had to learn these lessons the hard way.
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Agreed. The physio at Dr Sarin was totally useless. Today it's more than 6 months after frame removal and I'm still suffering like crazy from ballerina.
Standing is the most important thing!
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There's no magic treatment they can do for you during the distraction phase that'll make your legs come out as a finished product when you're released from the hospital. When I came back for my nail removal, I told the Beijing patients that were there at the time that LL doesn't end when you get out of the hospital, that's when it BEGINS.
Six months after my frame removal I was distraught, wondering what I was thinking to have done this to myself. My right leg was quite a bit worse than the left. I was worried I'd have to get surgery on my Achilles for it. But I just kept walking and walking, pushing through the pain, and eventually my legs evened out and got better.
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There's no magic treatment they can do for you during the distraction phase that'll make your legs come out as a finished product when you're released from the hospital. When I came back for my nail removal, I told the Beijing patients that were there at the time that LL doesn't end when you get out of the hospital, that's when it BEGINS.
Six months after my frame removal I was distraught, wondering what I was thinking to have done this to myself. My right leg was quite a bit worse than the left. I was worried I'd have to get surgery on my Achilles for it. But I just kept walking and walking, pushing through the pain, and eventually my legs evened out and got better.
It is precisely this that we don't hear about enough.
How soon did you return to work? Do you think you are tapped out in terms of recovery now? Or do you feel your muscles will keep adapting if you start to (progressivly) stretch them further.
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Here are videos of Dr. Parihar doing voice over commentary on a surgery he performed where he uses LON for a case of tibial hemimelia. You get to see what this sort of operation looks like while the patient is under anesthesia.
*Not for the squeamish.
http://www.youtube.com/watch?v=5m2qcGhmnqw
http://www.youtube.com/watch?v=7j4YzxgzsJQ
http://www.youtube.com/watch?v=4efA23hHbdc
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fk me, to think I voluntarily did a similar thing to my own legs make me sick to my stomach.
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How come this guys patients seem to recover so slowly? 4 Weeks just to stand, on crutches for 4 months and minimum 6 months unassisted walking?
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Nice videos, should be required pre-surgery viewing for anyone considering LL, to know what's really going on.
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Hey Guys,
I have a friend I've been talking to on Emm Emm Tee who is meeting with Dr. Parihar tomorrow. Actually, it's TODAY for him, since he's already over there. Its REALLY last minute, but if you have any specific questions, post them and I will try to get them to him (possibly over the phone as he's said the Internet in his hotel is really bad and he may not be able to get online again before his consultation.)
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Oh my mistake realized hes quoting times since the first surgery not frame removal.
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Hey Guys,
I have a friend I've been talking to on Emm Emm Tee who is meeting with Dr. Parihar tomorrow. Actually, it's TODAY for him, since he's already over there. Its REALLY last minute, but if you have any specific questions, post them and I will try to get them to him (possibly over the phone as he's said the Internet in his hotel is really bad and he may not be able to get online again before his consultation.)
I don't have any particular questions but it would be excellent if he were to post his CLL experience on this site, should he decide to undergo surgery with Dr. Parihar.
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Can you ask him why full weight bearing only begins after 4 weeks when the standard titanium nails can take 60-65kgs? Harry/Sringari do a similar practice which seems very strange considering one nail alone can take peoples weight.
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Gladiator (Crazy+6) copied stuff and Sysop deleted post request from Shorty asking for removal of his LL photo, it's fair do the same back. I have a prediction, BigFaker will choose Dr. T. Sringari when all his consultations are over, let's see what happens.
From Big Faker
" PARIHAR:
FEES: 900,000 INR = $14,400 USD = €10,538 EUR (They quoted in Rupees)
INCLUDES : 1st Surgery (Osteotomy and Nail/Frame Installation), 5-7 Day Hospital Stay, Check-Ups, 2nd Surgery (Frame Removal), Consults after Patient returns home (might be a trial process, since most of their patients have been local)
Local Room & Board during Lengthening NOT INCLUDED
Physical Therapy During Lengthening and Consolidation Included? - Not Sure. Forgot to ask. Explanation and more on this later
NAIL REMOVAL - Price? Not Sure. Forgot to ask. Explanation and more on this later "
I think, in my mind, the decision of whether I would do my surgery in Mumbai was settled right then and there -- standing outside in the parking lot -- but I had come ALL that way, so I went in for my scheduled consultation.
The inside of the place looked just as old and run-down and scary as the outside. It really looked like they only served Indians of lesser means. For example, if you have seen barely-funded County/public hospitals in the US (like on the show "e.r."), this would be the Third World equivalent.
MY CONSULTATION
I had compiled a decent list of questions I planned to ask all three docs and I took copious notes, but when I am in rushed, it usually looks like I was writing with my feet, so some details may suck.
I had been in email contact with Dr. Divya Ahuja, one of Dr. P's staff members, since I had called for an appointment from back home. He came out to meet me a few minutes after my appointment time, and brought me back into his office.
I asked him to explain his take on Reconstructive LL vs Cosmetic:
He said the main difference is that Cosmetic is bilateral and rarely do they have to deal with reconstructive lengthening on both legs. Additionally, reconstructive patients start with muscle and soft tissue of a certain length already and the bone has become short (because of injury, infection etc). The patient has to lengthen his bone to reach the length of those tissues. With Cosmetic, we want to lengthen, but the limiting factors are different. The muscle and tendon tightness adds those factors which are not really as present in Reconstructive. He said the recovery for both is "almost the same". Complications for lengthening are all "correctable, eventually, by surgery". But we want to try to prevent the need for that by hard work through PT.
Other notes:
Dr. Parihar does NOT allow/encourage standing/walking/weight bearing during distraction because, as Dr. Ahuja said, when you stand, you compress. Once the frames come off, gradual weight-bearing is done as the callus develops.
They use Synthes nails. I asked how many rings the frame would have, considering that I am really heavy, and he said 3.
I asked about the pins going the muscle and he said they make a "track through muscle" to place the pins, so as not to catch them as they go through. He said they also "take care not to go close to the nerves"
For the osteotomy, they DO split the patellar tendon with a small incision. He said the knee's recovery from that is not a big deal.
They do not typically do ankle-locking, but now use the sandals strapped to the frame.
In hospital: 5-7 Days
Distraction: after 7-10 Days
There is NO Care Home/Guest House, they have been looking for one, but basically I inferred that we would need to figure it out ourselves.
PTs would be sent from hospital. I asked the difference between an LL physical therapist and a standard one. He said "communication", as the ones they work with will treat within the LL doctor's instructions, rather than going off on their own
X-Rays are done every 10-14 days during lengthening
Dr. Ahuja then did a physical exam, checking my flexibility and my problem ankle and old knee injury. The total time with him was about 35 minutes. After this, he sent me back to the waiting room. I waited there for another 20 minutes or so -- needing to go to the bathroom -- but I opted to wait until after I got back to the hotel....maybe that says something about the place.
I then got in to see Dr. Parihar. He went over the intake Dr. Ahuja did, discussed risk factors, and so on. We talked about him training with Paley in Baltimore (in the early 90s), the tremendous costs of LL in Europe and the US. He expressed that he did not discourage LL patients, but was not actively seeking them, either. It's just not his primary practice/business. All of his lengthening patients have been Indian, and most had no knowledge of the risks and downsides. He talked about the fact that many lengthening docs are doing primarily cosmetic work and deemed it "a paradox" because (in his opinion) the people doing lengthening should be the ones with very solid backgrounds in Ilizarov (which I took to mean Reconstructive/Deformity specialists like himself). An example he gave: if he treats a guy with an infected non-union, heals his bone, gets him to where his functionally is much improved...but still having a 1cm length discrepancy between legs... it's a success, a great positive result from where he was.
With a cosmetic patient, if a doctor gives him 6cm gain, but reduces the dorsiflexion of the knee to just neutral, he has "made that patient abnormal". The margin for error in cosmetic lengthening is much less. Furthermore, he said, cosmetic patients are "probably the most demanding subgroup of patients". But they will be aware of the potential risks and complications. I think the most memorable thing he said is that any of the complications (non-union, neurological injuries) that can come up in cosmetic are "part-and parcel of the Ilizarov techniques", so he would give the edge to a doc who has done 1000 reconstructive Ilizarovs over one who had 50 cosmetic. I WISH I had thought to ask about (touching on what Dr. Ahuja had mention earlier) how (or whether) a strictly reconstructive doc would have the knowledge and experience with the soft tissue stretching issues. Cr*p. Sorry, Peeps. That would have been a good one.
We discussed the frames and he also said the nail is much more significant factor than the frame. He said he is only a proponent of standing and walking in terms of reducing Ballerina.
Dr. Parihar said he was aware of the "LL community", but claimed he had never been on any of the "bulletin boards" and I really believed him. He's very much an Old School, no-nonsense, conservative doctor. Also evidenced by the fact that he then talked about the lack of peer-reviewed studies out there (and yes, you may sense a drastic difference between this consultation and the one I had with Sarin two days later). Dr. Parihar said he usually favors "function over length". 6cm is the general limit he practices, but if he sees a patient with equinus at 5cm, he would advise the patient "to call it a day". The amount of complications goes up "exponentially" after 6cm. I was pretty shocked though, that he said a patient can come back for a second round of tibia lengthening! I had never heard of this, aside from Jungle.
I asked (because of what I had read here, in one of the Sringari diaries) of where he would do a re-break, in the case of preconsolidation. He would do the 2nd osteotomy "slightly higher or lower".
Lastly, Dr. Parihar was pretty humble, as opposed to some other doc (to be named later). The total time with him was around 30 minutes as well. So I did not in any way feel rushed through there.
They had told me previously (over email), that there was a fee for the LL consultation. I had seen the $350 - €400 listed under those doc interviews and took a big gulp...until I kept reading and it said 800INR. That's like 12 bucks! I emailed them back to make sure it wasn't a typo (but didn't get a reply). Anyway, when I went to pay, they said it was 1500 INR. Not thrilled at the bait-and-switch (possibly once they realized I was American?), but still, only about 1/20th the cost of a consultation with Paley or Betz.
But anyway, if you hadn't guessed by now:
The discouragement of weight-bearing is a debatable subject and goes against so much of what I had been learning. I know how much SysOp encourages it and how Sweden seems to have had a rougher recovery for lack of it. Still, that was not the factor that ruled this doctor out. The hassle and work of having to find my own place to stay and arranging basic domestic care (in Mumbai no less) would have been hard enough to accomplish....but having to pay for that on top of the surgery and (possibly) the daily PT made this doctor an no-go. Anyway, if you hadn't gleaned from the beginning, I knew I could never have surgery at Mangal Anand from the moment I caught sight of it from the taxi.
Mind you, this removal from consideration as my LL surgeon has NOTHING to do with Dr. Parihar as a doctor, nor with him personally. He has a very impressive resumé:
http://ilizarov.in/about-us/dr-mangal-parihar.html
...and is clearly well-respected. I think because he trained extensively in the West (2 stints in the UK, as well as 2 in the US -- including a postdoc fellowship with Paley), we communicated very easily.
And, though he came off as somewhat cold/distant (or maybe just all-business) at first, he turned out to be a pretty cool guy. After the bulk of the consultation, we chatted a bit and somehow got onto the subjects of music, Vocal Live and Garage Band, and then audio/video production. He edits and narrates those surgery videos himself. Interesting, multi-talented man. Undoubtedly a good doctor. If, God forbid, a loved one or I were in a serious accident next time in Mumbai, I would have no qualms with Dr. P being my doctor.......just hope it would be at a different hospital.
I was trying to figure out where I had read the exact phrase in which Dr. P stated that he's "not a fan of weight-bearing" and I found it: it was on the interview that he did on that other site. I distinctly remember reading those words because it tipped me off that his English would be pretty good.
Anyway, in my consultation, he specifically said wants standing and walking "to the extent that it helps minimize equinus deformity". And he said in my case (with my considerable weight), he would want to go much much slower in getting back to weight bearing. There is, he explained, a need for being more conservative with cosmetic nails than with ones used for traditional fractures, because he would not ream out the bone canal to use a bigger nail in a cosmetic patient (would not want to harm a person's natural biology in that way, I think he said.) Basically, there is already enough risk in regenerative healing that he doesn't want to push it.
Also: keep in mind that these statements were from two different guys and each one said something sliiightly different.
Dr. Ahuja said the thing about "when you stand you compress it"
And when I asked "not even standing with crutches or a walker?"
He said "Just a little bit. Only so that it allows you go to the toilet"...and then, after frame removal, it is still just a gradual process.
I asked about ankle locking and he said they sometimes do that in Recon patients. I mentioned the sandals and he replied that they do that currently.
When they notice the foot dropping, they have the patient stop distracting for a few days to "work on it". It was actually a somewhat funny moment (for me) because I wasn't sure if he was saying "work" or "walk" and I even tried to have him repeat it, but despite his English being very good, I just couldn't make it out and gave up (probably because I knew deep-down I wasn't going to do LL there....and because I really had to go to the bathroom)
About tackling issues promptly, it's confusing because he said something like "any troubles that are supposed to happen will have come up during distraction".
ME: Isn't Ballerina the major issue that comes up?
Doc A: :That's actually what happens during distraction. Whatever has not been corrected during distraction and whatever remains and then becomes fixed.
(not sure if I wrote that part down exactly right)
So, in the end, I am not really clear on Dr P's work as a cosmetic LL surgeon. If I had met one of his PTs there, that might have given me a better idea of what one his LL patients would be in for. As he has no international patients, and so few cosmetic ones to boot, we really have no idea of his "success rate". Quotes because I am still not sure how LL "success" is actually defined. Eye Of the Beholder, I guess?"
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Gladiator (Crazy+6) copied stuff and Sysop deleted post request from Shorty asking for removal of his LL photo, it's fair do the same back. I have a prediction, BigFaker will choose Dr. T. Sringari when all his consultations are over, let's see what happens.
From Big Faker
Makes for very interesting reading. And it is right. If you feel reluctant to go to the bathroom in one of those hospitals you don't want surgery in them!
This LL game is full of twists and turns. I am constantly oscillating between thinking "this is my life target, do it and live happily" to "do I want to risk all I have for 2-3 more inches?" absolutely confusing and frustrating as hell all this.
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Dr Mangal Parihar is a specialist and respectable doctor in india regarding Limb lengthening , deformaty correction , complex trauma , reconstruction .... and i m not bluffing i did my research .
i m from india delhi and i have visited a doctors who is also specialist in Limb Lengthening and he told me that Dr Mangal Parihar is
most famous doctor in india regarding these issues .
he is like the Dr Paley of india .
And if anyone wants to do surgery in india then they should consider him as the first options.
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Dr Mangal Parihar is a specialist and respectable doctor in india regarding Limb lengthening , deformaty correction , complex trauma , reconstruction .... and i m not bluffing i did my research .
i m from india delhi and i have visited a doctors who is also specialist in Limb Lengthening and he told me that Dr Mangal Parihar is
most famous doctor in india regarding these issues .
he is like the Dr Paley of india .
And if anyone wants to do surgery in india then they should consider him as the first options.
I'd certainly feel more comfortable getting my surgery done with him than any of the other currently known doctors in India. I think it's just the location and lack of accommodation provided that urges people to go elsewhere. Still, I'd rather deal with the hassle of finding a place to stay and get my surgery done by the most credible LL specialist in the country than going to someone with hardly any real training but have a guesthouse to stay in.
Of course Sysopotheosis found a reason to criticize Dr. Parihar after Bigfaker posted his consultation with him on old forum .
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who know about dr Milind Chaudhary and dr tejwanin?
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I'm going to have a consultation with Dr. Parihar later. Here's information I received from him in a few e-mail exchanges recently.
Kilokahn:Hello, I saw on www.limblengtheningforum.com that the estimated total cost for the cosmetic lengthening procedure at your clinic is 900,000 INR. I'm assuming that is considering lengthening with a standard Ilizarov frame. If one were to opt for lengthening using the Taylor Spatial Frame, what would the difference in cost be? Thank you.
Dr Parihar: We do the lengthening with the LON technique. The Taylor Spatial Frame is not available in India. We have used the TSF in the past, but with donated frames from friends in the UK and USA, as six axis systems were not available in India. We now use the Ortho-SUV six axis system which is locally manufactured under licence, (http://pitkar.com/orthosuvframe.html (http://pitkar.com/orthosuvframe.html)), (https://www.youtube.com/watch?v=M4U2M4VpXhc&list=UU0eT2D9Wv88GFeCx-BJS0vA (https://www.youtube.com/watch?v=M4U2M4VpXhc&list=UU0eT2D9Wv88GFeCx-BJS0vA) ), but that is more for deformity correction, and i do not see any major advantage to using it in a LON scenario.
Kilokahn: Thank you for the information. The reason I asked about TSF was because I had heard that it will help better prevent malalignment than traditional frames. Regarding the use of LON, I have read some studies that said there is a probability of having permanent knee pain even after rod removal due to having to split the patellar tendon to insert the nail. Because my interest in this is cosmetic, the possibility of permanent knee pain is somewhat worrying. Would doing plate fixation after frame removal be a possibility?
Dr Parihar: TSF vs Ilizarov - when frames are properly applied and stable, the likelihood of malalignment is quite small. One advantage of the ortho-suv we use is that it can be applied on standard ilizarov rings (unlike the TSF). So if there is a deviation, it can be corrected by exchanging the straight rods for ortho-suv struts at the end of lengthening when the regenerate is still ‘plastic’, correct the deformity, and then put on straight rods (with coupled washers to accommodate the deformity correction) again.
plate/LON/frame - there are upsides and downsides to every option.
fixator only -
plus - . no incision, no knee pain, early weight bearing, ?quicker healing
minus - frames need to be stronger i.e. more components, more wires/pins, long fixator time
LON -
plus - relatively lesser number of wires / pins, shorter fixator time, ?earlier weight bearing compared to plate.
minus - some more scars, possibility of knee pain (can be minimized by technique), very small but real chance of IM infection, second surgery for implant removal
Plate -
plus - relatively lesser number of wires / pins, shorter fixator time, no chance of IM infection,
minus - some more scars, very small but real chance of infection around plate, not enough data of use in CLL to definitely predict how it will affect healing (most studies are about children and / or unilateral lengthening), i would not allow early weight bearing with plates on both legs, till reasonable amount of ossification - so functionally patient could still be relatively impaired for a longer time, second surgery for implant removal, implant removal a little more difficult than nail removal.
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I'm going to have a consultation with Dr. Parihar later. Here's information I received from him in a few e-mail exchanges recently.
Thank you very much for posting this Kilokahn! Considering Dr Parihar's knowledge and experience in LL and trained by Dr.Paley, I believe that he is the best option for tibia LL in India. That is if you can cope staying in his hospital for a few days and then renting an apartment or hotel in Mumbai.
I am keeping him as an option for tibia LL once I recover from my femur LL
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Thank you very much for posting this Kilokahn! Considering Dr Parihar's knowledge and experience in LL and trained by Dr.Paley, I believe that he is the best option for tibia LL in India. That is if you can cope staying in his hospital for a few days and then renting an apartment or hotel in Mumbai.
I am keeping him as an option for tibia LL once I recover from my femur LL
I definitely agree that Dr. Parihar is the best option for CLL in India. Frankly I could care less about the look of the hospital because I would only be staying in it for a very short time and you can find nice quality hotels all over Mumbai. If I am able to arrange my stay in Mumbai, then if the consultation goes well I'm hoing with Dr. Parihar. There's another doctor in India who also trained under Paley that I'm going to meet, but I am not sure on him yet because limb lengthening is not his primary interest, though he does seem to have a considerable amount of knowledge in it.
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I definitely agree that Dr. Parihar is the best option for CLL in India. Frankly I could care less about the look of the hospital because I would only be staying in it for a very short time and you can find nice quality hotels all over Mumbai. If I am able to arrange my stay in Mumbai, then if the consultation goes well I'm hoing with Dr. Parihar. There's another doctor in India who also trained under Paley that I'm going to meet, but I am not sure on him yet because limb lengthening is not his primary interest, though he does seem to have a considerable amount of knowledge in it.
Agree 100%. The man is clearly proficient in the art of Ilizarov. The hospital looks grimy but what doesn't in India? Even Paras is not as pristine as depicted in photo. I'm sure he utilizes sterility in his OT to such a degree that infection will not occur. If you're considering India, it's gotta be Dr. Parihar.
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Agree 100%. The man is clearly proficient in the art of Ilizarov. The hospital looks grimy but what doesn't in India? Even Paras is not as pristine as depicted in photo. I'm sure he utilizes sterility in his OT to such a degree that infection will not occur. If you're considering India, it's gotta be Dr. Parihar.
My friend in India told me the other day that he e-mailed Dr Paley asking him about what Indian doctor he should go to, and Dr Paley's reply was to go to either Dr Chaudhary or Dr Parihar, so apparently Paley would back Dr Parihar as one of the best surgeons for lengthening in India (kind of surprising he apparently said Dr Chaudhary is a good choice based on all we've heard, but I guess Dr Chaudhary is technically a good surgeon but his attitude about his patients is where the real problem lies.)
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Here's a video with a part that shows Dr Parihar's opinion on post-operative weight-bearing. Clearly he thinks people overstate the importance of weight-bearing while distracting.
Part about weight-bearing starts at 4 minutes 37 seconds.
http://www.youtube.com/watch?v=yHUrLL9Kiv4
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if i knew what i know now back then i would blindly go with Dr Mangal Parihar . i would only recommend him for LL in india at this stage .
Dr Paley of india..!!
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What a boss. Looks like he's trying to instruct to a bunch of clowns.
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Machmanye, why???? I do not get the love affair with Dr Parihar.. perhaps he's good Perhaps He's not but how can be recommended? How many successful patients does he have that we know about? 0?
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I had sent an email to Dr.Parihar asking him to elaborate on why he thinks full weight bearing during lengthening with ilizarov is a bad idea and his philosophy on touch down weight bearing, but I still have not received his reply.
Here's a video with a part that shows Dr Parihar's opinion on post-operative weight-bearing. Clearly he thinks people overstate the importance of weight-bearing while distracting.
Part about weight-bearing starts at 4 minutes 37 seconds.
http://www.youtube.com/watch?v=yHUrLL9Kiv4
In this video, Dr Parihar does say that people who weight bear on the first or second day of surgery still end up recovering the same time as a person who does touch down weight bearing. But is there any significant risk with full weight bearing with ilizarov/LON during lengthening besides pin bending? As far as I know, isn't the Ilizarov apparatus full weight bearing?
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I'm considering Dr. Parihar to do nail rod in femur, however I gave him brief about my situation and asked him about the nail rod or plate fixation , and he said you have to visit me..
and Mumbai is so far from Delhi, I really don't want go there then he'll say what other dr recommend to keep the monorail, that would be a real waste of time and money,,
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You should just go see Dr Sringari. He has the same skills as Dr Parihar and costs fraction of the price. Also you don't have to go all the way to a scary place like Mumbai.
Not even close.
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My friend in India told me the other day that he e-mailed Dr Paley asking him about what Indian doctor he should go to, and Dr Paley's reply was to go to either Dr Chaudhary or Dr Parihar, so apparently Paley would back Dr Parihar as one of the best surgeons for lengthening in India (kind of surprising he apparently said Dr Chaudhary is a good choice based on all we've heard, but I guess Dr Chaudhary is technically a good surgeon but his attitude about his patients is where the real problem lies.)
Just as an update to this, my friend in Delhi sent me a screenshot of the e-mail he sent to Dr. Paley asking about which doctor he would advise to go to over there for limb lengthening. I blocked out the majority of the e-mail so his personal info is kept private of course, but you can still see that Dr Parihar is one of the limb lengthening surgeons Paley suggests in India.
(Click to enlarge)
(http://s5d1.turboimagehost.com/t1/18526397_deepaks_to_paley.png) (http://www.turboimagehost.com/p/18526397/deepaks_to_paley.png.html)
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Just received an email from Dr. Parihar regarding his weight bearing philosophy and the availability of the PRECICE nail in India!!
Weight Bearing
we do allow touch down weight bearing, and weight bearing to the extent required to prevent equines.
on externals weight bearing can be done, because the frames are stronger -
on LON, we are a little more careful as the frames in comparison are lighter and less complicated.
should not have subsidence more than a couple of mm (if at all)
yes you can get in touch with us when you are ready for surgery.
the precice nail is now also available as an option in india, (rules which allow special access to implants to particular patients), and so you could have an option on the tibial lengthening too.
PRECICE Nail
we have not implanted the precice yet. the distributors for india, just met me couple of weeks ago. (i will have to check with them though whether they were talking of the precice or precice2)
however, the insertion of the implant in itself is a standard procedure which is routinely done for trauma cases.
there are some additional points to be taken care of when a nail is used bilaterally for lengthening, which we do when we insert nails for the LON technique.
therefore, i do not foresee any issues in relation to inserting the nail.
overall, in the lengthening (postoperative), there would be a certain learning curve, but i do not anticipate any trouble there, as we have been regularly adopting newer methods / technologies such as six axis fixators without too much of a problem.
much of the supportive treatment such as physiotherapy, exercises etc, are the same, whatever the method. especially when we are talking of reasonable amounts of length.
so yes, if you were to choose to do an internal lengthening, i believe we would be able to carry it out for you.
regards
dr mangal parihar
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Sweet news about PRECICE. I'll ask Dr Parihar about it when I have a consultation with him. Of course I won't be ready for internal femur lengthening for a couple years, but that would give Dr Parihar practice with it as well.
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That is sweet news about precise, but with the nails costing $30kUSD themselves you're still probably looking at a 45-50k surgery price. So you might as well go to an American doc like Mahboubian... I wish Parihar would design a cheaper nail for use. I'd trust his engineering ingenuity and manufacturing arrangements since he is so well versed in this procedure. Internals in the sub-$25kUSD would be revolutionary.
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In the meantime maybe it would be better to go to Dr M, but after Dr Parihar has had access to the PRECICE for a little while I think he'd be the better option so long as you had the money to cover the expense of accommodation there (and if you can afford the PRECICE fees then an extra $5,000 shouldn't be out of the question). I think Dr Parihar has the superior credentials in Ilizarov.
And this won't apply to everyone, but I just decided to never go to Dr M because not only are his advertisements offensive to me personally (that one with the little guy looking desperately at the tall woman in heels http://heightlengthening.com/wp-content/uploads/home_1.jpg), but he also markets CLL so heavily. I just prefer the doctors who have patient requirements for suitable candidates or who don't seek out CLL patients but will accept them if they come to them. It gives me the sense that the surgeon is more doctor than salesman.
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Yeah that ad is just messed up.
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Yeah that ad is just messed up.
Yep. I can't imagine how he or anyone else thought that kind of degrading marketing tactics would be a good idea. I don't think it's that hard to get CLL patients after all. In many other countries those ads/billboards would probably be borderline illegal simply because of their content and presentation. Imagine if someone advertised in that fashion for breast implants or liposuction by playing on flat chested or overweight women's insecurities and portraying them as hopelessly unattractive... they would risk going out of business immediately because of the subsequent public outrage.
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That is a shameless ad. No wonder Mahboubian and Apotheosis get along so well. They share the same sense of inane humour.
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That is sweet news about precise, but with the nails costing $30kUSD themselves you're still probably looking at a 45-50k surgery price.
For that price, I think you'd be better off going to South Africa and do it with Dr Franz for 52K USD (internals with Precice), which is a package price with everything you need already set up.
For such a small difference in price, you should weigh in the following:
- Dr Parihar has never used the Precice
- You'll have to find accommodation, a physio therapist and catering yourself
- Do you trust the Indian legal system?
- After all the horror stories we've heard about LL in India, do you really still want to go there?
There's also New Born in South Korea, where they're currently offering ISKD for 48k USD including all you need for 90 days. South Korea is an advanced country and they're really into cosmetic surgery. New Born seems to have a lot of experience.
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Just wanted to add from my experience. You won't need to find a physiotherapist on your own while staying in Mumbai. While in the hospital you will have physio twice daily. They had 5 physiotherapists there, three who are there all the time and two who visited. They all have experience with physio on people wearing frames so they know the proper exercises (Dr Parihar chooses all his staff so he makes sure they know how to handle lengthening patients).
If you want phsyiotherapy at your place of stay, then Dr Parihar will arrange for them to come see you on certain dates. Otherwise you will have a physiotherapy session once every two weeks in the hospital's physiotherapy room after you get x-rays taken and Dr Parihar does a checkup. I haven't been charged anything for physio sessions so I think it's included in Dr Parihar's fee.
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Just got around to watching this video of a lecture Dr Parihar made at an Ilizarov course last year. He talks about how the hexapod works and shows many examples of fixators put on patients by other surgeons, even pointing out mistakes in some of the frames put on by other doctors. A little over a half hour long but very interesting information.
http://www.youtube.com/watch?v=w4pBrm3K_Vw
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Not very interesting for patients, if you ask me, unless they plan putting on the frames themselves :o :o :o
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Not very interesting for patients, if you ask me, unless they plan putting on the frames themselves :o :o :o
I don't know. Having frames on at the moment and having been wanting to get lengthening done for years beforehand, I've become pretty fascinated by the science of Ilizarov fixation.
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Always good to know that your doctor is knowledgeable!
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Does he give discount for surgery? His price is to expensive so if I write diary for him can he go to Dr Shah 8,000 price?
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Does he give discount for surgery? His price is to expensive so if I write diary for him can he go to Dr Shah 8,000 price?
He doesn't give discounts for cosmetic lengthening and it would be insulting to ask him to match another doctor's price. If you can't afford him, then you may want to pay Dr Shah a visit to see if he'll be a good choice for you.
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Does anyone know of any developments regarding the availability of the Finnish nail or Guichet nail with Dr. Parihar?
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No known time frame on the Finnish nail from the last time I corresponded with him through email, which was mid-October.
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No known time frame on the Finnish nail from the last time I corresponded with him through email, which was mid-October.
Ok. It is probably still a long way from release, then. Did he indicate what price range the nail is expected/hoped to have?
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I don't think Dr Parihar will end up going after an Albizzia nail or a variation of it. He might go through with getting Fitbone though. As Polycrates said there's no set timeline for the Finnish nail but he said from speaking with them they seemed open minded in allowing Pitkar to manufacture it to lower costs and he thinks if that happens it will be cheaper than any nail currently on the market.
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Here are Dr Parihar's recommendations for weight bearing and stretching once the distraction phase is complete. While he does not encourage walking during lengthening and wants you to focus on physiotherapy, once distraction is over he is a proponent of walking to stimulate bone healing. This is what he advised:
1. You have to walk in a continuous fashion for at least two half hour sessions in a day. This should be a continuous walk (in a circle as around a building or in a yard) rather than to and fro (as in a room)
2. It is necessary to continue using a floater splint during consolidation if you have developed equinus, because otherwise, your feet are in equinus for 8 hours a day, which leads to continuation of the equinus.
3. Continue doing ankle stretching exercises - see the following link - especially number 5. http://www.physioadvisor.com.au/8047950/ankle-stretches-ankle-flexibility-exercises-ph.htm
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its been like a year and somewhat since i last posted - so hi i guess? Life got me sidetracked a little.
i believe to achieve this in the near future this doctor would be my most likely hood of bets -
i'm more then likely to be looking at external route so was looking to see if i could be filled in on two things for this specific doctor;
rough costs of everything, hotels, food, surgery - etc
and length of time for lengthening 5CM-6CM
i know these have been answered a multitude of times but im looking for more of a direct answer from idealistically anyone who has been to this doctor.
i know Kilokhan had, i have had a look but i know a lot of his stay was deciding between doctors.
I'm going in hard headed - i want this doctor, and externals for 5-6cms.
thanks, if anyone answers.
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i'm more then likely to be looking at external route so was looking to see if i could be filled in on two things for this specific doctor;
rough costs of everything, hotels, food, surgery - etc
and length of time for lengthening 5CM-6CM
Here's the list of expenses I put together after I returned home (2014 exchange rate):
Surgery - $14,977 / 900,000 Rupees
Hotel Stay - $1,500 per month (at Hotel Maharana Inn)
X-Rays & Appointment - $240.00 (charges at front desk ranged between 1,000 - 3,000 INR)
Physiotherapy at Hotel - $17.00 per session (Mr Chaudhary's rate)
Medications - $40.00
Zimmer Frame - $60.00
Wheelchair - $434.00 / 26,000 INR (I bought the most expensive wheelchair in the catalog but there were many cheaper options available)
Custom Splints - $55.00 (I recommend each patient to get splints made through Mr Shringare because they're sturdier than ones from local carpenters)
Dressings - $265.00 (each box cost 600 INR and had enough gauze for 2.5 changes)
Food is cheap. If you eat at local places and don't go to Domino's each day you'll only need to add a couple hundred bucks for expenses. I think it was around $23,000 USD total for everything when not including the cost of airfare.
I stayed 4 months for 6 cm. Frames were removed after 1 year from the initial surgery date.
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Wait, so you stayed at a hotel for 4 months? But weren't your frames removed only after a year? Does that mean you can go home after 4 months already?
Because I'm computing the expenses and lol, if I get LON from parihar and stay at a hotel for 6 months, the hotel cost will be bigger than the medical and surgery costs.
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Most of the doctors let you go back home after lengthening phase.
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Is better to have a doctor near when you are doing this process.
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Wait, so you stayed at a hotel for 4 months? But weren't your frames removed only after a year? Does that mean you can go home after 4 months already
You can go once the lengthening is over.
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Also, did Parihar evaluate you psychologically before limb lengthening? 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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sexmachine if you think he will think that you are suicide, the scars in your body wouldnt be on your back, if scars were in some part that could be touched by hands be a little worried.
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Notes from my consultation- October 2016:
So my consultation is done. After months of reading about him, it was a good thing to finally be sitting across the table and talking to Dr. Parihar.
Points I noticed about Dr. Parihar:
1. Straightforward and no-nonsense type, he won't bs about anything to you
2. May come across as aloof in the start, but warms up once the conversation progresses
3. He doesn't try to "sell" the surgery to you. In fact, he continuously questioned my beliefs about how life will be after I become taller, asked me what if my expectations are wrong, etc etc.
4. He really knows his stuff, he came across as pretty confident and knowledgeable.
I landed up at the clinic at around 5 PM, and was taken to Dr. Divya's room first. I had to introduce to him what I was there for, and he asked me how I came to know about the surgery, what research I've done, and basically wanted to see whether I know what I'm getting myself into. We talked about how height affects success with women (Dr. Divya pointed out some celebrities who were my height, and asked me if I'm sure height was really causing a problem or it was just my imagination).
Dr. Parihar and I also had an extensive debate on whether I'm right in worrying about my height affecting my success in women. But I told him my other concerns as well (moving to the West, career aspects, etc). In the end, I think we did finally reach a middle ground on the impact my height is or could have in the future.
I was clear to both Dr. Divya and Dr. Parihar that I only wanted 5-6 cms.
I also assured them that my parents will be in on this, because they both said that it is required for them to know.
Both Dr. Divya and Dr. Parihar did not have any specific comments on the forum, but cautioned me against taking medical advice from anyone here, saying people either overstate problems or understate them.
I asked a whole lot of questions, which are listed below with the answers I got from Dr. Parihar. I think he was slightly amused that I was asking so many questions, because he asked whether I'm really a college student, or a PhD researcher. Lol :D I don't blame him, because I just went on and on, from one question to another.
Here's the Q&A:
1. Since I have a slight case of bowlegs, I asked if femural lengthening would worsen the condition. He said it won't, especially considering I'm doing only 5-6 cms, and even if it did, it can be simulated on a computer and preventions can be done. Nothing to worry about.
2. I asked about lingering and permanent pains like screw pains and rod pains, and he said I shouldn't worry about it if I'm doing only 5-6 cms. These problems usually come with insane amounts of lengthening.
3. Permanent pains should not happen, if you keep to safe lengthening limits.
Once the lengthening phase is over, the pains & aches reduce drastically; they may come & go here and there, but after full recovery you shouldn't feel anything. You could expect come-and-go aches & pains for upto a year post-op.
4. Dr. Parihar inserts the nail from the hip. He said he could do it from the knee also, but prefers not to.
5. The main painkillers they prescribe immediately after the surgery are Ibuprofen and Nimesulide.
After that, Paracetamol or Ultracet is prescribed. He hasn't come across a patient till now that has needed stronger than this.
About pain, he said that there's a line to draw between "no-pain" and "tolerable pain", but anyway, he said not to worry so much about the pain, and not to try and micro-manage it. We'll take it as it goes, he said.
None of his patients have ever gotten so bad with pain that they said "I wish I never did this".
6. I asked him about how to determine whether your bones are strong enough for LL, and he said that through the blood tests, they will know how your general health is; and if your general health is good, your bones should be good too.
7. With the Precice nail, he doesn't see a chance of losing height already gained.
8. My worst fears were confirmed when he said that the catheter, in most cases, is required and non negotiable :( He said that this a serious surgery and they need to monitor you so they need the catheter in.
9. IT Band Release: He said that he will make an on the spot decision towards the end of the surgery as to whether to release the IT band or not, but will most likely do it.
He said that if he has a doubt on whether to do it or not, he would go ahead and do it, so he would err on the side of release.
10. Rate of lengthening: 1 mm per day, could come down to 0.75 mm depending on how my body reacts.
The lengthening from start to finish is more or less continuous, but some lengthening holidays could be granted here and there, if there was excessive pain.
11. If the lengthening had to stop on any one leg, for any reason, they would rebreak my femur at a slightly different location and restart the lengthening.
12. Costs: 9,00,000 INR from the hospital's end plus the cost of the Precice 2 nails (which is subject to the exchange rate)
13. I also asked him what I could do to make it easier for me, and since I have at least 6 months to go, he said I should start stretching and working on my flexibility.
Flexibility is always a good thing for LL, he said.
I hope this contributes to the knowledge of this forum. When I start my LL journey, I will definitely write a diary too.
Special thanks to KiloKahn and Penguinn for introducing this doctor to us.
I feel this consultation was a watershed moment; now I know that I'm 100% doing it, and I'm already on the way. Some lose ends in life need to be fixed first, but I'm reasonably sure about doing this sometime next year. Exactly when, I can't say, but this is a given now: MTall needs those 5 cms. Period.
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is Parihar like 6 2"???? Just curiosity.
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is Parihar like 6 2"???? Just curiosity.
He's really tall, yeah.
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is Parihar like 6 2"???? Just curiosity.
Like 6'2 or 6'3. He dwarfs all other Indian doctors, including Dr. Divya who's probably 5'8.
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Divya 5 8", I thought he was 5 10". are a lot of people in India such heights??
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Divya 5 8", I thought he was 5 10". are a lot of people in India such heights??
For the middle and upper classes, 5'7" to 5'9" is generally what you will see, although you will have a fair amount of company if you're 5'5" or 5'6" as well.
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Divya 5 8", I thought he was 5 10". are a lot of people in India such heights??
He could be 5'10...little hard to tell from my angle. ;D
What Mtall said. I've said this before, the average college going dude I see must be 5'7 or so, but anywhere from 5'5 - 5'9 is the normal range.
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I didn't see one person even close to Dr Parihar's height while I was in India. He's a tall dude at around 6'2 from what I could gather, but from his hospital pics I thought he was around 6'6+ based on how much taller he is than his staff. I almost wanted to ask him if he ever felt uncomfortable growing up being so much taller than his peers, but decided against it.
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And Divya, in some post one said that he was 5 11", what do you think Kilo?
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My guess would be 5'10, give or take, just from photos and what I can remember. I did a before and after standing photo with one of Dr Parihar's team, which IIRC was Dr Divya. That could help me better guess how tall he is, but I never asked for a copy of the photo lol.
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(http://i63.tinypic.com/ic945t.png)
(http://i67.tinypic.com/wth9vc.png)
(http://i67.tinypic.com/2yni3wl.jpg)
(http://i66.tinypic.com/9039zs.png)
(http://i66.tinypic.com/aaeiwn.png)
(http://i64.tinypic.com/28i3tch.png)
(http://i66.tinypic.com/wkpjzq.png)
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Website: http://www.ilizarov.in/index.html
Dr. Parihar- Question & Answer https://sites.google.com/site/cllrpatients/faqs/cosmeticlengthening
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Thanks for this! So external only with ilizarov is 900,000 Rupee? Is there an extra frame cost or is it included? I looked in the links but I don't think I found a definitive answer.
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The fixators are for free in Mangal Anad, just pay for nails if you go for LON. Do you think that precice 2 will be out of the market soon or it will stay for at least 5- 6 years? I may can pay my surgery with Dr. Parihar, but if precice nails continue increasing in cost then will be near to impossible.
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Seems like the prices went down from last year?
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Complications not included? ???
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With Dr. Parihar complications will be uncommon. The only concerning complication you have to keep in mind would be delayed consolidation because that could stop lengthening process, but is not common less if you are not smoker.
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His price has remained constant in Indian Rupees. The favorable exchange rate has made it less costly than years prior though.
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What does it cost in terms of food, housing, and physical therapy to stay close to Dr. Parihar while lengthening?
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What does it cost in terms of food, housing, and physical therapy to stay close to Dr. Parihar while lengthening?
When I was there it was about $50 per day at a hotel when a long term discount was applied. Phsyiotherapy is part of the surgery fee if you do it at Dr Parihar's clinic. Home visits will probably depend on how far you are for the physio to travel, but I was charged 1,000 INR per session which was $17.00 then and less than $15 now. Forget the exact prices, but food was very inexpensive unless I ordered from Domino's which was the same as what they'd charge here in the States.
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Hey Kilo, I'm new to the forum. I'm thinking of heading over next month with Dr Parihar for external tibias. I just had a couple questions?
How did you pay? As in, how do you transfer money from accounts in India?
Does he allow you to lengthen less than .75 mm per day? Say, .66mm?
What percent would you say you've recovered? Do you think you'll ever return to normal?
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Hey Kilo, I'm new to the forum. I'm thinking of heading over next month with Dr Parihar for external tibias. I just had a couple questions?
How did you pay? As in, how do you transfer money from accounts in India?
Does he allow you to lengthen less than .75 mm per day? Say, .66mm?
What percent would you say you've recovered? Do you think you'll ever return to normal?
It may depend on whether or not your bank has a branch in Mumbai, but because I bank with Wells Fargo what I had to do was talk to a banker in the States over the phone and set up a joint account with a relative. Once the account was set up the same day, I transferred my money into that joint account and had the relative in the States then transfer that money to Dr Parihar's bank with his account info that he provided me. Wells would only execute wire transfers that large if one of the account holders did it at the bank in person, so I couldn't just call and ask them to do it over the phone and that's why I had to have the relative do it. If you're 100% going with Dr Parihar and you have a surgery date scheduled, then you could make it easier by transferring to his bank ahead of time. Or you could contact your bank and ask them for recommendations on wiring to accounts that are with Indian banks. They might have a different procedure.
I had distraction devices put on that did .25 mm per turn automatically, so I could only do .75 or 1 mm on a lengthening day - THIS (http://www.limblengtheningforum.com/index.php?topic=634.msg12502#msg12502) is what they looked like. If he doesn't put them on then you can do .66mm per day if you want by turning the knuts yourself, but lengthening is more tedious since you have to get a small wrench from a hardware store to do the turns.
I have chronic exertional compartment syndrome so I can barely run without the pressure in my shins building up so much that it hurts. Once I get a fasciotomy and recover from that then I think the only real long term differences from pre-CLL are that my legs fall asleep more easily than before and my ankle dorsiflexion isn't as good.
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As someone has already noted, it is unbelievable that if a nail malfunctions the patient has to pay anything , especially if it involves a second surgery. How do they get away with this? The patient has extra expense, trauma worry etc and the nail manufacturer only gives you what you should have had originally- a working nail. Would this happen in any other field?
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How was it getting around during consolidation when you came back home? Because I'm currently in community college and plan on doing my last semester online before I transfer out to either UCSB or hopefully UCLA (I live in LA). Which means I will be consolidating the summer before I start university and during my first fall quarter. What's mobility like in the months post CLL.?
Do you think you'll ever gain back you ankle flexibility and cure your Cecs? What has Dr. a Parihar said about it? Does the hospital have Wifi? Missing a week and not being able to study might set me back if take classes online.
I was reading on one of your posts in which you said Dr. Parihar said , the pain is less if you are occupying your mind with something. Did you have energy to do stuff while lengthening or where you always tired?
Sorry, I have a lot of questions, lol. But Dr. Parihar hasn't responded to my email. Only I've been talking to his assistant Dr. Ahuja.
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I have chronic exertional compartment syndrome so I can barely run without the pressure in my shins building up so much that it hurts. Once I get a fasciotomy and recover from that then I think the only real long term differences from pre-CLL are that my legs fall asleep more easily than before and my ankle dorsiflexion isn't as good.
Is this pain in your muscle? My actual bone aches when I run. Right where the doctor put in a big screw to straighten my Tibias out.
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How was it getting around during consolidation when you came back home? Because I'm currently in community college and plan on doing my last semester online before I transfer out to either UCSB or hopefully UCLA (I live in LA). Which means I will be consolidating the summer before I start university and during my first fall quarter. What's mobility like in the months post CLL.?
Do you think you'll ever gain back you ankle flexibility and cure your Cecs? What has Dr. a Parihar said about it? Does the hospital have Wifi? Missing a week and not being able to study might set me back if take classes online.
I was reading on one of your posts in which you said Dr. Parihar said , the pain is less if you are occupying your mind with something. Did you have energy to do stuff while lengthening or where you always tired?
Sorry, I have a lot of questions, lol. But Dr. Parihar hasn't responded to my email. Only I've been talking to his assistant Dr. Ahuja.
Getting around was difficult initially. I had to use my wheelchair because I had a bit of ballerina left and I'd tip over and fall if I didn't hold onto a walker, which took a long time. Plus the wires near the ankles caused a bit of pain if I moved around too much. Cases where I was forced to use the stairs I had to lower myself to the ground and pull myself up each step while seated. When I was able to walk after the ballerina had lessened enough, it just took a very long time to get anywhere.
My ankle flexion has no issue but dorsiflexion will probably always be slightly worse than before I had surgery, no matter what stretching I do. Only way to improve it to pre-CLL levels would be an Achilles tendon lengthening or a gastroc-soleus recession, I think. Although I have read that CECS can inhibit dorsiflexion, so it's possible that after I'm treated for it it will improve slightly. CECS treatment is usually successful, but I'll have to wear walking braces for a while again and won't be able to do any strenuous physical activity on the legs for an additional few months. Right now I'm just trying to find an appropriate time window to request surgery. I haven't spoken to Dr Parihar about it, although he's treated people for it before. I'm getting mine treated locally though since I have a Kaiser HMO Platinum Plan through my job and surgery is only going to cost me $150.
When I was at Mangal Anand there was only wifi on Dr Parihar's floor, which is right above the patient ward. If I really had to use the internet they'd take me to his floor to connect to wifi, but if you bring a wifi dongle you should be set.
I was often tired and would take a lot of naps, but I'd be able to play Skyrim on PS3 or watch movies and stuff, which did help with pain at times. Showering, cleaning the pin sites, and replacing the gauze would usually take 2 hours and I'd immediately want to fall asleep after that. The problem is the frames are very uncomfortable and combined with the lengthening discomfort, you can go some nights without getting any sleep at all. I once went two days unable to sleep and I had to request sleeping pills, which just barely helped. You can get some studying done, but almost everyone usually feels too exhausted to get much productive done.
Is this pain in your muscle? My actual bone aches when I run. Right where the doctor put in a big screw to straighten my Tibias out.
Once I was able to run again I initially had a bone pain in the middle of my shins where Dr Parihar added the additional pins for stabilization during my second surgery, but that eventually went away. If yours is coming where the screw was inserted, then that will probably go away too in a few more months.
The pain is in the muscle and it comes from too much pressure building up in those compartments. Dr Parihar cut the fascia in one spot on each leg, likely to prevent this issue happening later, but looks like I'll need to get it in 1 or 2 more areas. I believe I had CECS to a lesser degree before CLL since I couldn't run long and I mistakenly thought it was due to being overweight, but I think lengthening exacerbated the issue since my muscles have to work harder than before when running.
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There is one detail I still dont understand, if you get equinus early, would he release the tendon or tell you to stop lengthening?'
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If you proved you were to have adequate support at home and was able to converse with an orthopedic at home, do you think they would allow you to lengthen at home? I really dislike the idea being anywhere I don't want to be for long period of time which is why I'm still contemplating injury spinal centre.
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He wont allow you, he had a patient lengthening at home and developed severe equinus.
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why do lazy fks ruin it for other people -.-
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He doesnt want to do cross-lengthening, some bad experiences should have happened.
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does he perform LON? If so, anyone know the cost?
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14k USD for the surgery.
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does he perform LON? If so, anyone know the cost?
in inr 10Lacs whih include nails...and just extrrnal 9Lac
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His email does not work anymore (comes back with a failure)
Are any of you in here, aware of maybe a new email adress?
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Update:
Price went up and the cost is now ~$15,038 USD (1000000 inr)
Email from Dr. Divya:
For LON the cost is Rupees 10,00,000 (includes hospital cost and the cost of implants). Besides these the other expenses after discharge from hospital would be around US $1500-1700 - these would be for medication, followup, xrays, physiotherapy if needed at the hotel, dressing material for pin site care.
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Looks like it's just to combat the weakening rupee against the dollar. New price is the USD amount I paid in 2014.
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Update:
Price went up and the cost is now ~$15,038 USD (1000000 inr)
Email from Dr. Divya:
For LON the cost is Rupees 10,00,000 (includes hospital cost and the cost of implants). Besides these the other expenses after discharge from hospital would be around US $1500-1700 - these would be for medication, followup, xrays, physiotherapy if needed at the hotel, dressing material for pin site care.
the price for lon is Rs 10,00,000 but for pure externals it still is Rs. 9,00,000
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why do lazy fks ruin it for other people -.-
Sometimes it cannot be avoided, you simply have a natural limit.
I wore the foot holders every night and always had my feet in some type of stretch during the day, but I still ended up getting stiff. At 5.4 turned I was in great shape, at 6.4 I would have needed achilles lengthening if not for the physical therapy.
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Sometimes it cannot be avoided, you simply have a natural limit.
I wore the foot holders every night and always had my feet in some type of stretch during the day, but I still ended up getting stiff. At 5.4 turned I was in great shape, at 6.4 I would have needed achilles lengthening if not for the physical therapy.
In the case of Dr Parihar's cosmetic patient, he was told not to go over 6 cm and he lengthened to 8 cm while at home anyway. It's because of that case that he no longer allows lengthening outside of Mumbai.
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Anyone can contact Dr Parihar?, seems the email info@ilizarov.in doesn't work
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I understand the natural limit aspect and it also sounds like you did this fully aware of what was needed of you but as kilokhan pointed out - a CLL patient who didn't listen ruined it for anyone else who wants to lengthen at home
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I don't think it's a hard rule. He might agree if you have reasonable expectations and express a good understanding of LL. He doesn't do too many cosmetic cases, so I doubt he has a strict rule.
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Its a bit of whim as it would probably need to be confirmed in consultation and if no - then it would be a wasted tripped, plus not feeling the whole just leave without the doctor knowing as well ...
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I don't think it's a hard rule. He might agree if you have reasonable expectations and express a good understanding of LL. He doesn't do too many cosmetic cases, so I doubt he has a strict rule.
I highly doubt he'll let anyone lengthen at home. His analogy was: Knee replacement is like carpentry, you operate and that's it. Limb lengthening is like gardening, you(the surgeon) need to constantly tend to it.
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Hey, KiloKAHN. I was wondering how you found the best accommodation and transport for your surgery. I'm not Indian, so I'm afraid my expenses would be higher, or I'd make a bad decision. Which accommodation did you choose?
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Hi, would anybody know Dr. Parihar's email?
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Does he also make internal? If yes what is the price of internal?
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Does he also make internal? If yes what is the price of internal?
50-52 k USD including staying.
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(http://i63.tinypic.com/2eb4myd.jpg)
(http://i63.tinypic.com/27xe2p5.jpg)
(http://i66.tinypic.com/wlagk3.jpg)
Conversion to U.S. Dollar: 14-January-2018
LON: 9 Lakhs = 900,000 Indian Rupees = $14,150
PRECICE: 32 Lakhs = 32,000,000 Indian Rupees = $50,300
Link: https://sites.google.com/site/cllrpatients/faqs/cosmeticlengthening
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Was told by Dr Parihar that he has used the Precice on 5 patients. 3 cosmetic femur patients, one of which was international, and 2 unilateral tibia patients for limb length discrepency, who were both local. Seems like there are a lot of people in Mumbai who have that kind of money for Precice and inquire about it often.
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Here are videos of Dr. Parihar doing voice over commentary on a surgery he performed where he uses LON for a case of tibial hemimelia. You get to see what this sort of operation looks like while the patient is under anesthesia.
*Not for the squeamish.
http://www.youtube.com/watch?v=5m2qcGhmnqw
http://www.youtube.com/watch?v=7j4YzxgzsJQ
http://www.youtube.com/watch?v=4efA23hHbdc
Is precise 2 as barbaric? Any videos of the procedure with precise 2?
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Is precise 2 as barbaric? Any videos of the procedure with precise 2?
A bit off topic, but yes. Whichever method you choose, it's quite grisly. The difference being that externals look the part for much longer.
https://www.youtube.com/watch?v=C4Hmq4WEpjA
https://www.youtube.com/watch?v=Ko3OZzm35jk
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A bit off topic, but yes. Whichever method you choose, it's quite grisly. The difference being that externals look the part for much longer.
https://www.youtube.com/watch?v=C4Hmq4WEpjA
https://www.youtube.com/watch?v=Ko3OZzm35jk
Thank you Android you are always very helpful.
It is what it is I guess. Anyone who can go through this is a brave warrior and there is nothing that can be said otherwise.
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The surgeries are grisly, but you won't be watching and feeling it from third person.
Someone here once said his peak CLL pain level was the highest he ever felt in his life, and he mentioned he had gotten hit by a car before.
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The surgeries are grisly, but you won't be watching and feeling it from third person.
Someone here once said his peak CLL pain level was the highest he ever felt in his life, and he mentioned he had gotten hit by a car before.
5:10 in the 1st Parlihar video is fking horrifying. But I know this is irrelevant to the post so my apologies.
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I had a little glimpse while on spinal epidural when the team were removing my nail and yes it looks just as barbaric. The hammering sound and the surgeon physically pulling the nail out with the legs all over the place, blood everywhere. I would imagine the nail insertion to be even more worse with the reaming, releases and breaking of the bone.
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I had a little glimpse while on spinal epidural when the team were removing my nail and yes it looks just as barbaric. The hammering sound and the surgeon physically pulling the nail out with the legs all over the place, blood everywhere. I would imagine the nail insertion to be even more worse with the reaming, releases and breaking of the bone.
I'm definitely going to sleep. lol.
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I'm definitely going to sleep. lol.
Yeah I was under general anaesthesia for my nail insertion surgery. But then I insisted on getting spinal epidural for the removal since I wanted to be aware of whats going on throughout the surgery and to make sure that it's my femurs that got operated on lol. I kept on raising my back to have a glimpse of whats going on and the anaesthetist would routinely tell me to lay back down.
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Yeah I was under general anaesthesia for my nail insertion surgery. But then I insisted on getting spinal epidural for the removal since I wanted to be aware of whats going on throughout the surgery and to make sure that it's my femurs that got operated on lol. I kept on raising my back to have a glimpse of whats going on and the anaesthetist would routinely tell me to lay back down.
Jeeze. It's definitely a life experience. I guess it doesn't matter how extreme it is as long as we're asleep it makes no difference that's how I see it. The mental trauma and nervousness leading up to being given anesthesia is probably going to be the worst part.
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nail removal is usually more violent because the nail gets stuck in the bone cavity. you have to hammer it out. nail insertion involves reaming which ensures smoother passage. the osteotomy is definitely scary though.
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on Dr. Parihar's site it's written that the precice nails are available at a new reduced price. https://sites.google.com/site/cllrpatients/faqs/cosmeticlengthening
it used to be 23 lacs rupees and is now 18.5 lacs rupees. that is about $6.5k cheaper!
this is actually surprising because the rupee rate has fallen tremendously and the nails should have become only more expensive in india.
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on Dr. Parihar's site it's written that the precice nails are available at a new reduced price. https://sites.google.com/site/cllrpatients/faqs/cosmeticlengthening
it used to be 23 lacs rupees and is now 18.5 lacs rupees. that is about $6.5k cheaper!
this is actually surprising because the rupee rate has fallen tremendously and the nails should have become only more expensive in india.
>:( damn. I paid 23 for mine
Maybe they got cheaper because STRYDE has come out?
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>:( damn. I paid 23 for mine
Maybe they got cheaper because STRYDE has come out?
unlikely because dr paley hasnt reduced his precice 2 prices. actually no other doctor has. must be some indian import duty that got dropped? still $6.5k is a huge drop.
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Any idea when stryde will come to India and what price will be?
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18.4 Lakhs is like, 1840000 rupees.
Besides that we should also add up the 900000 for the surgery itself, right?
That would come to 2740000 which is around 40k dollars for the whole procedure, I'm not so sure about the internal prices for other doctors, is this the normal range?
I need to do femurs because of my proportions, if it wasn't so bad to do externals on femurs I would do it on the fly, but since internals is the way to go for that, I will just have to wait longer to do it~
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Hi, I am researching a bit for last few months. I would like to consult Dr. Parihar.
Could any of you please provide me the mail Id of Dr. Parihar or any of his staffs. info@ilizarov.in does not work. Kindly help a fellow height deprived. :(
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Dr Divya Ahuja <info@bonedocs.in>
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Dr Divya Ahuja <info@bonedocs.in>
Thanks a lot mate. Will drop a mail ;D
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If you want an in-person appointment you might just want to call them. You can find the hospital's phone number on Google.
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How should we go to his hospital from the hotel we are staying?
Do taxies take us?
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Dr Suhas Shah and Dr Mangal Parihar are now able to offer Stryde nail as they have done Precice in the past and Stryde is now available through the same vendor now. It is possible other doctors also do.
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Does anyone know what Dr. Parihar is charging for Stryde? I assume it will be INR 9 lacs + the cost of stryde so does anyone knows how much does strye cost in India?
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Also as there are concerns about the hygiene standards in Dr. Parihar's hospital, does anyone know if he offers to perform surgery in any other hospitals for example Fortis? There is no lack of international standard hospital in Mumbai, is anyone due for consultation with him would care to ask this question?
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Also as there are concerns about the hygiene standards in Dr. Parihar's hospital, does anyone know if he offers to perform surgery in any other hospitals for example Fortis? There is no lack of international standard hospital in Mumbai, is anyone due for consultation with him would care to ask this question?
Apparently he does but usually only in emergency situations. But he operates primarily in his own hospital.
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Does anyone know what Dr. Parihar is charging for Stryde? I assume it will be INR 9 lacs + the cost of stryde so does anyone knows how much does strye cost in India?
INR 25 lacs for 2 nails
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INR 25 lacs for 2 nails
Thank You.
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Anyone planning Dr Parihar by next year mid or end? please text me. Thanks.
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I’m thinking of doing surgery with Dr parihar as he seems to be the best doctor for under 80k and for two surgeries one on the femur and once again on tibia. If anyone had done surgery with surgeon Parihar then please let me know. Or if there are any other good cheap surgeons who will help me gain 10cm, with two surgeries possibly.
Thank You !
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He's a good doc, but I would suggest contacting him.
He doesn't take many patients, asks that someone of your entourage be available for call or to be there with you for surgery.
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Hi could anyone let me know if dr.parihar is offering stryde nails surgery
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Hi, I sent an email to Dr. Parihar's office and got the response :The current cost of pair of Stryde nails is - INR 23,50,000/- and pair of Precice 2 nails is 22,10,000/-.The cost of nails will be in addition to the hospital cost.The hospital cost is INR 9,00,000/-. This includes the hospital stay for 7 days, operation theatre charges, professional fees including surgeon's fee, anaesthesia charges, medicines, disposables and physiotherapy. Any additional days of stay are chargeable in addition to this.
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Thank you so much for the reply I had a consultation with him 2years back where in stryde was not in picture this information is of great help thanks a ton, any idea of a diary who’s had stryde surgery with dr.parihar
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I don't think there are any stryde diaries on the forum. Also about 6 months or so ago when I had asked him he said he had not done any stryde cases. With precice he said he had done 3 cosmetic femur cases and 3 unilateral cases (not sure tibia or femur)
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the Stryde is both available for Femur and Tibia, and Dr. Divya Ahuja who is the assistant of Dr. Pariha told me the safe possible lengthening for tibia is around 6.5 cm,(I didn't ask femur which I think would be around 8cm or less). Depending on the cost, there is nothing I can complain about except the old building and horrible environment in India. I hope to see the diary of Stryde by Dr. Pariha at this forum before I collect enough money :D
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There is one diary with Stryde it was his first.
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Nope, Penguinn's is the only Parihar diary and it was Precice. Stryde was approved in India only towards the end of 2019.
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Anyone looking get it done with Dr. Parihar in 2020 / 2021? In India covid-19 might subside around September or even till end of 2020. I'm looking to get this done with Stryde method after that.
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Anyone know the new prices for surgery with Dr parihar? Also please suggest any good diaries thank you
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Can anyone please tell me. Who's the best doctor in India for leg lengthening surgery. What's the cost? What methods do they use? I'm from India. Hoping to get this surgery done. Reason being I've always felt like an outcast. Every where I go every time people kept reminding me that I'm short. And It hurts. Although I can't describe it. I almost think about my height every time. It's not only about growing my height. It's about the life long satisfaction. I just want to feel what's it like to be tall. I'm depressed of being called short. I'm happy but not happy. At this point I don't really know what happy mean. I'm earning good but what's the point of making that much money. And not being satisfied.
Btw I'm Indian. If any Indian individual have gone through the limb lengthening surgery successfully. Please do reply me.
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Mrvictor: No you are not alone, how tall are you ? I think Dr Parihar could be a good option but Dr Dimitrios Giotika (Greece) is better because he did lots of cosmetic LL surgeries.
Depends on your age also, if you should go for it or not, In case you have hit the rock bottom in your life (Say 32 years old and no gf or wife) , bloody do it. Thats what I am planning for now. Will wait till 31-32 and thn will go to Parihar or Dimitrios. My height is 167 cm goal is 172-173 cm. Stay strong and meanwhile, go to gym and prepare your body for this torture. May god brings happiness to you and each and everyone on this forum.
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Hey anothershorty... I'm 21 and my height is 162cm. I've been going to gym since last two years. Not consistently. You know 4 months a year. But I do run 4 times a week at least 7km..followed up by 50pushups 12pullup 12chinup. 60situps. After doing all these I still feel a void inside me. I hope I can get at least 172cm. It's my ideal height goal. What's your story?
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Mrvictor : My story is that I am always the shortest guy in the room, and I am unable to accept my height. I would love to be around 5'8'' zone... I am 28 and will turn 29 in Jan-2021. Waiting for more advancements because you know, how crazy you have to be to go through this process ( l mean you need courage). But some people are going through sex-change operations, taking harmful injections for the sake of bodybuilding so why can't we try this because we only live once.
if you have crazy money, and you are still not happy... go to US or Korea for this Surgery else Dr Parihar and Giotika are the only options we have.
If I will be in this state of mind ( the way I am today), will get this done in 3 years from now ( Probably will have more LL dairies to make my decision by that time and money).
You are young, you still have time to analyze your situation. Probably you will forget about your height if something great happens to you while waiting.
Frankly – I didn’t care about my height when I was your age, I had 3 crushes and all of them became my GFs( now Ex). They all were 1 inch taller than me( I have a type – Super fair super tall ) and I was very proud and happy. It's all the matter of time ( atleast what I feel ) because I am unable to connect with anyone maybe because of my high standards and body image issue.
I might sound superficial but God created me this way and I will suffer though this process if this is meant to be.
Be cheerful meanwhile bro …. Buy good clothes and wear insoles. At least enjoy your youth and consider this surgery later point in time.
God bless you...
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I don't really know what you mean by wait for some years. This is not about money, it's not about girls, it's not about any of those things. I just feel like this height thing is eating me from inside. All my friends are fking tall. I have 4 friends and all of them are above 180cm. Where ever I go what ever I do. I just can't feel the stuff. My growth plates are fused. 1.5 or 2 year later. I'll definitely do this surgery.
Bro let me tell you one honest thing... When I first heard about this limb lengthening. I was just scared of it. I heard horrible things about it. Specifically from Indian. Stories like people got paralyzed after doing this procedure. This was back in 2017....but recently 2 month back I found out about how much this surgery has evolved. I've seen plenty of videos of successful patients. And I also found out this YouTube channel called cyborg for life. He just filled me with the great knowledge about this procedure.
After finding out all these information I was fkin smiling from inside. My brain started telling me that I do have a chance. It's not over yet. I can still grow. And this is surgery is the last option I have. What else am I suppose to do.
Anyway
I hope you're life become better. Good luck bro for your future and surgery.
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there will be no new advancement in next 3 years my friend... stryde is the max. what more do you expect a nail to provide?
and waiting till 30 to do this is pointless. 20s is best part of life. if you dont have money then I would understand, but waiting for something to change in the procedure is time waste. better to assume you dont need this surgery and be happpy...
"Stories like people got paralyzed after doing this procedure. This was back in 2017....but recently 2 month back I found out about how much this surgery has evolved"
the surgery has not evolved or anything... maybe you heard about butchers like SARIN or SRINGARI or those scam physios who work with any new doctor they can find. there are excellent LON method results from Dr Lee in South Korea. or even external frames. kilokahn did it years ago and he is good.
good luck friend
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Any new updates from parihar or any other good Surgeons in India ?? Dr Giotikas sounds good but not sure...
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Consultation done with Dr Parihar on 02/10/2020 current price for fully external is 900000 rs
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Consultation done with Dr Parihar on 02/10/2020 current price for fully external is 900000 rs
did you go to Mumbai bro??? is it safe to go now?
and has he done any stryde cases also? did you speak about that with him?
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Yes it safe national patient only allowed for 7 days you need to show return ticket at airport exit other wise they put stamp on your hand and you have to self quarentine your self in your hotel room for 14 days
Didnt ask about stryde
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Yes it safe national patient only allowed for 7 days you need to show return ticket at airport exit other wise they put stamp on your hand and you have to self quarentine your self in your hotel room for 14 days
Didnt ask about stryde
sorry Im a bit confused, are you locall or international?
and are you going ahead with LL in Mumbai soon?
please tell anything new you learned from parihar
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Hey Reborn,
So you are getting this done( like booked date or something ) or just went there to understand CLL better?
How was Dr Parihar’s response when you told you were there for cosmetic surgery consultation?
Did he recommend any psychiatrist? If yes, could you please share his details?
If your meeting was not online, did you see any patients going through that surgery right now?
Let us know your takeaways from that meeting...
Best regards
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Yes I'm indian
Assistant surgeon Dr divya explain the surgery in detail
On psychological part he just ask why you want this surgery
He first try to discourage me by saying there is chances of death even on surgery table but very very rare.
Consultation going for 2 hrs and in last 15 min Dr mangal Parihar came and answer my questions
Even I ask x ray guy how's the outcome of cll inhere as he sees all ll and cll cases here he says every outcome is good here but why you want surgery at 5.2 you are good🤨
Dr Parihar also said function is more important then
lengthening so when he said stop I had to stop
Won't allow lengthening more than 6cm
One thing is bit akward that you mostly never able to talk about this surgery in privacy there as students of doctor mangal always there as learner listing to every word of mangal Parihar and takes notes
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Dr mangal Parihar is very serious guy he didn't talk much he straight forward answer your questions he neither encourage me nor discourage me for surgery.
He never physical examine me there just saw my x ray and said there is no obvious bone deformation and your are fit for surgery
Not yet decided for surgery im gathering some bravery🙂
No cll patient right now there.
I also dicuss about two most feared topic ie pain and non union
He said pain is very individual thing and either it is very manageable or not for you either way after two week it reduced sharply at marginal level
About non union he said may or maynot be happen there is no way to tell before surgery depend upon patient biology , genetics
After consultiion I realised it not what I think, that is go under surgery and after a year comes out taller.no
It very demanding and draining for body you may loose sex drive, appetite, sleep for months ,body just can't handle this much stress 😒
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yes bro this is no joke. atleast they were honest about it all and not pushing for it through some marketing agent LOL
5.2 is indeed very short in urban India but if you remove it frm your head and focus on other things in life you may not need this. just forget about this procedure and focus on making money and developing great personality.
good luck bro and thanks for providing the details :)
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Hi Reborn
Many thanks for sharing your experience in detail. There are people who are living as short men who don't care about it, also there are a few who are getting this procedure done... So it's your choice buddy what kind of man you wanna be. So glad to know Parihar and team is so transparent about this... Just on a side note- choosing external instead of internal is not a wise choice... Your recovery will be exponentially better if you go with internals... But for that money comes into the picture so I would suggest to gather courage and money as well before opting for this...
God bless you bro...
Best regards
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externals is actually safer in worst case. no reaming, no spoiling bone / biology, no nail removal surgery, no risk of deep infection.
if you start loving ur frames for making you taller, then it would be toleratable for a year also.
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Thanks!
1. What's Parihar's price for internal femur or tibia?
2. What's his price for nail removal?
3. Is nail removal dangerous at his place because it is dirty?
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Thanks!
1. Will Parihar let patients lengthen at home if they live near ish (like within 5 hours drive) of a LL doctor in their hometown in America?
In other words, do surgery with Parihar b/c he is cheaper but go for checkup visits with a local doctor in the USA?
2. What are the worst things about Parihar in your opinion?
3. What are your thoughts on the concerns that his facility is dirty?
Thank you in advance!
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Thanks!
1. Will Parihar let patients lengthen at home if they live near ish (like within 5 hours drive) of a LL doctor in their hometown in America?
In other words, do surgery with Parihar b/c he is cheaper but go for checkup visits with a local doctor in the USA?
Thank you in advance!
I know that the answer to this is "no".
Dr Parihar will not budge on this. If you can't agree to stay in Mumbai for the entirety of the lengthening phase and come to him for your follow-ups, then he will not operate on you. Even if you get checked up by another doctor wherever you live, he'll expect that you send him follow-up x-rays.
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Is Parihar cheaper than Giotikas for internals?
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https://www.youtube.com/watch?v=8VsBkCMhnIw
Write diaries if you decide to go with him, Cyborg did an interview with him
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I think someone said they got a stomach virus going to India. What can you do to decrease the odds of getting a stomach virus if you go to Mumbai?
Ex: which foods/liquids might seem safe to consume but actually aren't safe?
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Happy New years everyone!
I have a consultation with the assistant surgeon Dr. Divya tomorrow, please post/PM your questions and I will try to get them answered for you!
Anyone looking get it done with Dr. Parihar in 2020 / 2021? In India covid-19 might subside around September or even till end of 2020. I'm looking to get this done with Stryde method after that.
I am looking to get the surgery with Dr Parihar with Stryde done around mid Feb - early March 2021, let me know if you're also doing it with him
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Can you ask him if he gives a corticosteroid injection for fat embolism prevention? Also, Does he prescribe anticoagulant after the surgey? Dr Paley said in his interview that his patients are on anticoagulants for the whole lengthening period.
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Will do!
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Thanks Dark! Definitely make a diary and tell us how it goes with Parihar :)
I think you're in good hands if you choose to go with him. I heard that some people got sick going to Mumbai if they were not used to living in India. Are you considering using face mask/gloves/face shield when walking around Mumbai and maybe using a VR headset when alone to help distract you from the pain?
1. Could you ask him what is the cost to pay for nerve decompression upfront (for femurs and also for tibias)? I know Janet Conway does it preemptively to prevent nerve problems later
2. Could you also ask him what his policy is on doing nerve decompression and if its dangerous to perform it?
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Hey Dark, what kind of immunizations do you think are good to get before going to Mumbai? I heard that malaria, some kind of stomach virus, maybe wearing a mask/face shield/gloves might be good, being careful w/ what foods you eat b/c a few members on the forum got sick when they went to Mumbai to see Dr. Parihar
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Hey kilo can u guess what Dr parihar's height is.
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He is tall bro. Like 6+. I've seen him. He did the joint replacement surgery for someone I know.
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I know that he is tall....but not sure how much exactly....some one in this forum mentioned that he is like 6'3..if he is anywhere like that then men he is a big dude😅🦍⚕️👨⚕️....he is really like a superhero in india then..coz even in urban india 6'3 is pretty tall....SUPERHERO in the form of a DOCTOR⚕️👨⚕️....lol
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Thanks Dark! Definitely make a diary and tell us how it goes with Parihar :)
I think you're in good hands if you choose to go with him. I heard that some people got sick going to Mumbai if they were not used to living in India. Are you considering using face mask/gloves/face shield when walking around Mumbai and maybe using a VR headset when alone to help distract you from the pain?
1. Could you ask him what is the cost to pay for nerve decompression upfront (for femurs and also for tibias)? I know Janet Conway does it preemptively to prevent nerve problems later
2. Could you also ask him what his policy is on doing nerve decompression and if its dangerous to perform it?
Hey SpeedDialer,
I will definitely be using mask & gloves while in Mumbai, thanks for the reminder. Thou I might just binge watch a few shows & work during the distraction phase, aren't too worried about the pain as I've broken a few bones before so I understand the pain.
I will definitely forward your questions to Dr Divya tomorrow.
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I think 5'10 is the average height in urban India in most states. In Punjab, it's easily 5'11 or 6. Maybe in east or northeast and Gujarat it's 5'5. Punjab/Haryana/Rajasthan are tall states. India is very very diverse. In Mumbai, it's 5'7 or 5'8.
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I am half Indian half Chinese living in Mumbai so I asked by email to Doctor Paley about the Mumbai doctors that trained with him. Doctor Paley said he has worked a lot with Doctor Parihar and that he is a very good doctor. Still he recommended that because I can afford internal surgery I go to him in the USA because his facility is number one. Unfortunately my mom is afraid of flying and wants to be with me all the way through so my options are centered in India and rest of Asia because I have to travel by vehicle or at most by boat. I still have not decided but I already cross off any doctor who uses salesmen to advertise. I crossed off Doctor Shah in Mumbai because he does tv commercials for it and so I don't know if he will be honest with money. Maybe I am wrong but Doctor Parihar is the top choice for me if I stay in India. If my parents are okay with the expense to travel then I can shop around other good doctors in Asia.
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Is Precice still available with Parihar? Or has it been withdrawn from India also?
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withdrawn
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d
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Did you ask Dr. Parihar?
Because apparently Nuvasive has not withdrawn Precice nails as from the other threads.
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Sorry, I thought you are talking about stryde.
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Anyone thinking of going with him this year?
I am wanting to go in the second semester. I sent an email and the doctor said that the price for precice costs around 43k.
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Anyone thinking of going with him this year?
I am wanting to go in the second semester. I sent an email and the doctor said that the price for precice costs around 43k.
I am.
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cool. will you use precice or stryde?
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cool. will you use precice or stryde?
LATN tibia and Stryde femur.
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Borders won't open until 2022 in India. Their covid cases are skyrocketing. I think Greece is a better option right now.
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Borders won't open until 2022 in India. Their covid cases are skyrocketing. I think Greece is a better option right now.
Greece was always a better option. You are saying as if prices are same.
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Yeah for precice they are comparable, not for external methods.
Regardless it's unlikely anyone will be able to enter India this year.
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Hi
Does anyone know if there is and additional import tax for the nails precise/styrde to Mumbai?
If I recall correctly the nails total (precise 2 : 22 lakhs 10 thousand) is there an additional fee on top to import?
Thanks
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Hi
Does anyone know if there is and additional import tax for the nails precise/styrde to Mumbai?
If I recall correctly the nails total (precise 2 : 22 lakhs 10 thousand) is there an additional fee on top to import?
Thanks
that's including tax
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that's including tax
nice, thanks
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I am curious though, since your are not indian native, could you get duties and taxes reimbursed from the nail ?
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any chances these prices can reoccur ?
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i know he says it can take upto 8 weeks but realistically how long does it take?
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Thanks for posting this information!
1. Does Parihar use gnail (Guichet nail)? How much does it cost?
2. What are your thoughts on going to India after getting a third covid shot? I'm considering it but am still a bit worried about the covid cases
I'm not sure between Giotikas and Parihar. Parihar has more year of experience + is cheaper. But Mumbai and his hospital seem not as clean. Then there is Kilohan and some others getting malaria in Mumbai. And there are the covid cases in India.
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Thanks for posting this information!
1. Does Parihar use gnail (Guichet nail)? How much does it cost?
2. What are your thoughts on going to India after getting a third covid shot? I'm considering it but am still a bit worried about the covid cases
I'm not sure between Giotikas and Parihar. Parihar has more year of experience + is cheaper. But Mumbai and his hospital seem not as clean. Then there is Kilohan and some others getting malaria in Mumbai. And there are the covid cases in India.
1. No, although years ago he considered it when Precice wasn't available. He wasn't a fan of it not being able to reverse lengthening if needed, though.
2. If you're fully vaccinated and even have an additional booster, if you still manage to get covid your symptoms are going to be much lower than that of someone not vaccinated, so you should be fine if you just take your standard precaution with mask use.
3. I didn't get malaria, I got some stomach bug after eating some ice cream from an outside lowboy cooler. Malaria is a potential risk though if you're not protected so I took anti-malarial medication called Atovaquone-Proguanil prescribed by my doctor starting the day before I flew there.
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Better to avoid India if you want 100% privacy. There are no laws in India that protect medical privacy and people don't care generally.
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Better to avoid India if you want 100% privacy. There are no laws in India that protect medical privacy and people don't care generally.
I think in the term of privacy Violation Turkey stand 1st and India 2nd
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Better to avoid India if you want 100% privacy. There are no laws in India that protect medical privacy and people don't care generally.
India is now being a sthole and if you rather die you can go there for LL.
Indian sitations of Covid-19 are very awfully blue and the viruses have mutated.
Now there are stacks of rotten away corpses along the Ganges river.
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India is now being a sthole and if you rather die you can go there for LL.
Indian sitations of Covid-19 are very awfully blue and the viruses have mutated.
Now there are stacks of rotten away corpses along the Ganges river.
I am yet to see ONE death in front of my eyes. Have people died? 100% yes. Just like people have died in the US or germany or elsewhere. Media in India is run by the opposition to a large extent( some are directly controlled by the ruling party though). So one section of the media blows things out of proportions.
India is a big place. Bombay and Kanpur have nothing in common. Delhi and Bangalore are very different. Calcutta and Lucknow have a ZERO in common. The river thing youre talking about is of UP and Bihar. Two of the poorest states that we always avoid.
Many people died in Delhi Idk why. Delhi is India's capital and for some reason the healthcare there collapsed. But it happened to all countries.
One should be fully vaccinated if they come here though since humantohuman transmission rates are far far far higher than any other country because of which there might be many mutants.
so although there is an element of truth to your words but it's highly exaggerated
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Thanks! What's a specific example you heard about that would affect someone, ex: so in India you are saying they would publicize your leg lengthening to other people?
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My current plan is:
1. Do a virtual consultation w/ Giotikas like April of 2022 ish , gather the labwork/x rays, etc needed to clear me for the surgery, etc
2. September of 2022, Giotikas femurs to 7.5 cm w/ weight bearing Gnail
Then wait a year to recover
3. 4 months before planned surgery, do a virtual consultation w/ Parihar + start gathering all the labwork/xrays etc
4. Then to save money, go w/ Parihar 6 cm tibia Precise 2
And then my hope is w/ the experience of doing it once w/ Gnail, I'll be ready for a more difficult challenge of:
- not being in a western nation
- wheelchair the whole time w/ Precise 2
- differences in cleanliness of Greece vs India
- I'm guessing that Athens, Greece and Mumbai have similar percentage of English speakers?
I am wondering to myself 'is my idea retarded? Am I overlooking anything?' I emailed Parihar asking if he uses gnail. He just said look at my website and I only see mention of precise 2. Is my timeline not realistic/not enough time to do things like get the labwork/prepare?
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Thanks! What's a specific example you heard about that would affect someone, ex: so in India you are saying they would publicize your leg lengthening to other people?
Who told you that lol? There is no country where it won't be considered a crime. A doctor can't reveal anything at all. We do have privacy laws. India is just another country where humans live lol.
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Someone told me that Dr. Parihar is as expensive as Dr. Giotikas now for precise 2.2. Where on Dr. Parihar's website do you find this? I can't seem to find it
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Someone told me that Dr. Parihar is as expensive as Dr. Giotikas now for precise 2.2. Where on Dr. Parihar's website do you find this? I can't seem to find it
total cost of precice 2,2 in india -> 32,844 USD
Surgery cost -> 11,822 USD
Giotikas price -> 46,841.40 USD
so parihar is still cheaper but the difference is like $ 2k.
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Reaching Lee is very easy while Parihar very Hard , If You have any problem Lee Institute will listen while with Parihar you have to take appointment which may take days
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Reaching Lee is very easy while Parihar very Hard , If You have any problem Lee Institute will listen while with Parihar you have to take appointment which may take days
Yes parihar is very hard to get hold of for a consultation or even to get an email reply. But once you become a patient they will respond well.
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Yes parihar is very hard to get hold of for a consultation or even to get an email reply. But once you become a patient they will respond well.
Mumbai, Are you planning for the surgery this year with Parihar? I got an appointment with him fortunately
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Mumbai, Are you planning for the surgery this year with Parihar? I got an appointment with him fortunately
Yes, planning for this year. Are you consulting with him via Skype? Which method are you planning for?
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Yes, planning for this year. Are you consulting with him via Skype? Which method are you planning for?
I am consulting with him over zoom. Can I DM you?
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I am consulting with him over zoom. Can I DM you?
sure
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sure
Done.thanks
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For a USA citizen, on the east coast, what are the pros and cons of Dr. Parihar vs Dr. Giotikas?
"total cost of precice 2,2 in india -> 32,844 USD
Surgery cost -> 11,822 USD
Giotikas price -> 46,841.40 USD
so parihar is still cheaper but the difference is like $ 2k."
I think that the price of travel vaccines + extra price of the ticket cost pretty much 2000 USD which makes me think their prices is now the same
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Does Dr. Parihar do rebreaks of bones?
Ex: what if I lengthened just 1-2cm on tibias with another doctor (considering doing gnail 7cm on femur then 2 cm on tibia with precise 2 back to back with only 1 month rest in between, might be enough lengthening tbh but want the option to rebreak the tibias later if want more length). Purpose of back to back: get that precise 2 nail before prices increase from inflation
Or at that point, would it be cheaper just for me to do rebreak of the tibia bones in the USA with a local leg lengthening doctor? (there are two who are within a few hour s driving distance of my place)?
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He's one of the Indian docs I think people can be sure isn't a quack. He's trained under Dr. Paley.
for a year only. if there was a recent HSS affiliation at some peer reviewed case study perhaps this statement would hold some weight at assessing the pearls of Mangal's surgical techniques. I'd project that at 2022 it takes around 15 years at an elite community to refine surgical technique to become an expert and approximately 30 without these resources. You would keep this in mind while selecting a surgeon in general
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Where can I contact this Dr?
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Video was made 4 months ago. He's still offering internal lengthening with Precice nails.
https://youtu.be/mijNNobkFvw
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Video was made 4 months ago. He's still offering internal lengthening with Precice nails.
https://youtu.be/mijNNobkFvw
precise was recently put on hold in india not sure if its available now.
we should know soon I hope
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Hi, im new here.
Im interested in LON method on tibia but think im not the right candidate and also ive heard there is some risks to have prolonged knee pain.
Anyways from what i understand in my case the right option is to have external fixator that, from what ive read in the past, has to be on your legs for the whole process until you can walk fully.
But recently i saw in a interview with indian surgeon Dr. Mangal Parihar he said that they now can use "locked plates" that they can do the lengthening with a fixator but then put a plate on so that the patient doesnt have to have the fixator for a long time.
Does anybody have experince/knowledge about this? Thanks.