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Author Topic: No More Mal-Kahn-Tent - External Tibias - Dr Parihar  (Read 370175 times)

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LittleLiam

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #31 on: June 05, 2014, 01:20:40 PM »

ooops,  I  meant Serbia in my last post.
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Machine

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #32 on: June 05, 2014, 09:36:13 PM »

Hi kilo,
I know u r really very much excited and eager to find a good doctor to do CLL .
I would like to share my opinion and thoughts about ur interest in indian doctors for CLL .
My intention is not to discourage but to give u insight about india and indian doctors .
I m from india and i already did my CLL with dr sarin which i m still trying to recover from .
The thing is your list of indian doctors to consult are mostly irrelevent to CLL except for
dr suhas shah , dr manish dhawan , dr mangal parihar .
the word perfection is not in the dictionary of most indian doctors , i have consulted with all these three doctors from which i found dr mangal parihar to be the most genuine and perfect doctor for CLL .
I wonder y its costly to do CLL ? Well CLL is a very risky surgery , which is why the doctor doing the surgery needs to be very skilled and experinced .
you should consult all these doctors as planned and sort out yourself , i said all these things because i wanted to share my thoughts and experience and try to contribute something to this forum .
IMO its crystal clear that by far only mangal parihar is an option for CLL in india if you do not want to take risk .
Gud luck on your quest !!@!!



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KiloKAHN

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #33 on: June 05, 2014, 09:50:56 PM »

Hi Machine,

Thanks for your advice. I agree about your list for the three most relevant to CLL, but I do think Dr Talwar might possibly be a good option as well. I have not met him yet and from what Polycrates said from meeting him, by Dr Talwar's own admission Ilizarov is not his primary interest/business. However, I do think he is worth checking out due to his overseas training. His experience is kind of similar to Dr Parihar in the sense that they've both had fellowships with Dr Paley and trained under the same joint replacement specialists overseas.
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Surgery performed by Dr Mangal Parihar at Mangal Anand Center for Limb Lengthening & Reconstruction. http://www.limblengtheningforum.com/index.php?topic=634.0
Pre-surgery height:  164 cm (Surgery on 6/25/2014)
Post-surgery height: 170 cm (Frames removed 6/29/2015)

KiloKAHN

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #34 on: June 10, 2014, 04:57:30 PM »

First Moments In Delhi
I arrived at Indira Gandhi International Airport this morning at 3 am after two long flights that took a total of 17 hours. The guy who examined my passport and Visa looked at me and asked how often I work out, along with what supplements I take because his son is trying to bulk up. I told him that every once in a while I take whey protein powder but nothing aside from that. After I got my bag at the terminal I was supposed to go to customs to declare that I had brought more than 10,000 INR but customs was closed or busy with other stuff apparently because they just told me to go on through and didn't even take the card I filled out on the plane. I was supposed to meet a representative from Rockland Hospital who would take me to Rockland Hotel or Rockland Inn, but I was unable to find him. Some locals came up and asked me if I was staying at a hotel and if I needed a taxi.

I was a little suspicious, but because some of the roads were closed by Delhi police due to some sort of incident I figured I may as well go with them because I had no luck finding the Rockland representative. The guys wanted 3,000 INR to take me to Rockland Hotel and because I had no other choice at the time I went ahead and paid. One guy left after a short while and the driver continued on to the destination. As I was pulling up the Rockland Hotel address my phone powered down and I couldn’t remember it. The driver ended up taking me to a hotel that he knew of nearby, which coincidentally happened to be Hotel Indira that was mentioned by Rockland Hospital's representative.

I thought I had a break because Indira International Inn is supposed to be a pretty good hotel for a cheap price of about $22 nightly, including breakfast. However, after the guy behind the counter woke up and I registered for a room, the guy told me it would be 11,850 INR for two nights ($200 USD). I told him that that's way higher than what I was told the price is and he told me that at most he could give me a discount price of 10,500 INR aka $178 USD. With no working phone and it being 3:00 am, I thought I had no other choice and paid the fee. I followed another employee to my room on the third floor, which itself looked fine. Including cable TV, a large bed, fridge, bathroom, closet, a high powered air conditioner, and wifi, the room was more than adequate for my taste. I went to bed irritated at how my first moments off the plane started out. At least I was able to watch Stephen Spielberg's "Hook" in English before I fell asleep.

First Morning In Delhi
I woke up a little before 8:00 am despite going to bed around 4:00 am. Got changed and went to the hotel lobby where I used the wi-fi to check emails, Facebook, etc. I saw an e-mail from Mr Maini expressing concern because he had a representative waiting for me at the airport and he was unable to find me. I sent him an e-mail explaining the situation of the roadblocks, phone powering down, and being unable to find the guy. Also told him how Indira International Inn charged me $180 USD for two nights. After my e-mail I then asked the guy at the front desk for the location of an ATM machine. I walked outside and saw a black cow chained next to a building, which I took a picture of. I wanted to pet it but a guy was looking at me and I figured it was his cow. Walked a short way to the ATM, noticing the stares from locals, and after withdrawing money from the ATM came back to the hotel and got a reply from Mr Maini, who expressed his apologies for the way the night turned out. He told me that he will try and get me my refund and said to go to the lobby at Rockland Qutab’s reception area where they will also assist me in getting a sim card.

A short while afterward I used III’s taxi service to get to Dr Dhawan’s clinic, which was maybe only 7 to 8 minutes away in traffic. Unfortunately he was not there but the receptionist took down my name and set me up for an 8:00 pm appointment. She told me to arrive at 7:15 because it’s first come first serve and I might not have to wait as long if I arrive earlier than expected. I found out that I couldn’t just go see him at Sir Ganga Ram hospital as he schedules surgeries at the private clinic and only does his consultations there. Spent a long time walking back because I had not yet gone to get a local sim card for my cell that would allow me to call III's taxi service. I thought "what the hell" and decided to walk the opposite way I came from just to get a look of the city. On the streets I was stared at by practically everybody. I noticed that just about everything was in a state of disrepair, and even the cosmetic clinics and dental offices were in buildings that looked run down from the outside, but presumably the insides looked a little better.

I had my hair tied up and was wearing a black t-shirt and black knee-length shorts, which made the summer heat feel even hotter. It really made me appreciate the southern California summers a lot more. It wasn't the first time being exposed to this kind of heat and humidity though, as South Carolina has a very similar climate in the summer. Just as I felt I was going to die of heat stroke, I found a large mall about 4 stories tall. I went inside just to get away from the heat for a little bit and had to go through a security scanner as I walked in. I noticed that many of the office spaces had not been filled with businesses yet but I did see a dominoes and KFC inside. I walked inside a large store in the back that went up three stories and purchased a travel adapter for 505 INR (much cheaper than the 10 Euro it cost at the airport) and three pairs of ankle socks for 297 INR. I gave the guy at the register 500 INR and the funny thing is he gave me 200 INR and three pieces of chocolate candy that the register was filled with as change. He explained to me that they didn’t have small change to make up for the 3 INR that was left so he gave me a piece of candy for each one.

Went back to the first floor into a restaurant that was styled in such a way that was new to me. They had various sweets, desserts, drinks and sandwiches, and you ordered everything you wanted at the front desk so they could give you your receipt that you would show to the employees working the other sections of the restaurant. I didn’t feel like risking dysentery especially after not having found a taxi yet, so I skipped the solid food items and just got an iced tea and a scoop of vanilla ice cream. I’m not sure how they make their ice cream but it tastes different from the kind in the States. It’s hard to describe, I guess it’s more milky if anything, but still good. The iced tea was great. It took them about 5 minutes to make but it had large round ice cubes in it, a fresh squeezed lemon, mint leaves, and a straw with an umbrella top. It was probably the best iced tea I’ve ever had, or maybe it seemed that way because I was dying of thirst.

Once I left the mall I became surrounded by guys who got out of green taxi carts. I told them that I wanted to go to Hotel Indira and gave one of them the address and asked how much. I thought he said 100 INR so I agreed. That's like $1.70 USD. Imagine getting taxi service that cheap in the USA. I was so nervous in the back of the car because Delhi traffic regulations are apparently non-existent. So many times I thought the guy was going to crash into someone or someone was going to crash into him. I made it safely to the front of the hotel and gave the driver the 100 INR and he looked at me disappointed saying “Only 100?”. I responded “That’s the price you told me. How much did you want?” He cked his head once to the right and said “I said 200 please”. I wasn't sure if that's really what he said or if he changed his mind, but he saved me a lot of time looking for a taxi so I gave him the extra 100 INR and went back to my room to bathe, rest, and charge my phone.

The front desk called my room a few minutes later and transferred me to reception at Rockland Hospital Qutab. The receptionist asked if I had received Mr Maini's e-mail and wondered when they could expect my arrival for a consultation. I told her that I'd be there in about 20 minutes and got Indira Hotel's taxi driver named Chacha to drive me. He first took me to a local photographer so I could get more passport photos for my sim card, but the owner of the shop wasn't there and the teen behind the desk was unable to do the photos himself, so I decided to just come back for it later. Chacha proceeded to drive me to Rockland Qutab.

Thoughts On My Day
I've had two consultations today and though I felt good about the first one, the second one really made me take a good long look at whether or not I really wanted to do cosmetic lengthening, in addition to how vastly different the online CLL community views lengthening compared to certain orthopedic surgeons. I can also say with certainty now that I will not consult with some of the doctors I planned to consult with after all, due to the results of my second consultation today. Rather than post each consultation one after the other, I've decided to post them all together once after I complete them. I check out at 12 noon tomorrow and will be taking the railway station to Mumbai, where I will also meet with Dr Suhas Shah and Dr Mangal Parihar.

Lastly, I want to point out that the reason for the apparent price inflation at Indira International Inn, according to another at the front desk, is that bookings for a very short period of time are significantly more expensive than bookings for extended stays. If you were to book a room for a few months you could look at a price of around $20 something dollars per day, but not when only staying for a couple nights.

Photos of the Day
 
« Last Edit: June 10, 2014, 05:07:35 PM by Kilokahn »
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Surgery performed by Dr Mangal Parihar at Mangal Anand Center for Limb Lengthening & Reconstruction. http://www.limblengtheningforum.com/index.php?topic=634.0
Pre-surgery height:  164 cm (Surgery on 6/25/2014)
Post-surgery height: 170 cm (Frames removed 6/29/2015)

Medium Drink Of Water

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #35 on: June 10, 2014, 09:03:18 PM »

This is great, especially the photos.  Makes me feel like I'm exploring India to get LL with you.

Can't wait for the next entry.
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Gained 3 inches on tibias (Ilizarov LON) in 2007 at the Beijing Institute of External Skeletal Fixation Technology with Prof. Hetao Xia and Dr. Aiming Peng.

If you have any questions, ask them here rather than by Private Message:
http://www.limblengtheningforum.com/index.php?topic=64544

BilateralDamage

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #36 on: June 11, 2014, 05:03:05 AM »

Such an awesome entry, I really can't wait to read about your consults!

Btw, can you speak the language of the locals?  And are you treated just as a regular tourist?
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KiloKAHN

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #37 on: June 11, 2014, 02:29:59 PM »

The consultations were borderline hilarious in hindsight after the second doctor completely disagreed with some of the things the first one said. I'm in Mumbai now, two days early for my consultation with Dr Parihar. I just e-mailed him and asked if I could move up my consultation to tomorrow. I drove by his clinic and I have to say that the photos in that diary from the other site make it look much worse than it actually is, at least from the exterior as its all I saw up close. Right now I'm staying at a pretty awesome hotel nearby. It would be too expensive to stay here the entire duration of the lengthening if I choose to go with Dr Parihar, but I'm going to see if they have a discounted rate. Another hotel not far from this one offered me a special tariff when I sent an e-mail explaining that I'll be disabled the whole time and won't be able to fully enjoy their facilities because of it.

Btw, can you speak the language of the locals?  And are you treated just as a regular tourist?

Nope. I can speak a good deal of Mandarin but that won't help me, although I've seen a good amount of people who look like they could pass for a local in China - they all spoke Hindi though. I think I'm treated like any other tourist, perhaps I get a few more stares because I have this undercut where my hair is long and tied back but shaved bald all around the sides. They probably find it weird.
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Surgery performed by Dr Mangal Parihar at Mangal Anand Center for Limb Lengthening & Reconstruction. http://www.limblengtheningforum.com/index.php?topic=634.0
Pre-surgery height:  164 cm (Surgery on 6/25/2014)
Post-surgery height: 170 cm (Frames removed 6/29/2015)

LowerVilliers

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #38 on: June 12, 2014, 01:16:06 AM »

Hello Kilokahn, Hope everything is good in Mumbai. I really want to do Internal Tibias soon and in Delhi because of the low rate. Can I do this procedure with you? And well done for sharing all your information
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KiloKAHN

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #39 on: June 12, 2014, 03:31:02 AM »

Hello Kilokahn, Hope everything is good in Mumbai. I really want to do Internal Tibias soon and in Delhi because of the low rate. Can I do this procedure with you? And well done for sharing all your information

I still haven't decided which doctor or city I'll be doing my lengthening.

But this would be of interest to you. During my first consultation I was informed that not only is Precice available but that ISKD was also approved in India as little as a week ago.
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Surgery performed by Dr Mangal Parihar at Mangal Anand Center for Limb Lengthening & Reconstruction. http://www.limblengtheningforum.com/index.php?topic=634.0
Pre-surgery height:  164 cm (Surgery on 6/25/2014)
Post-surgery height: 170 cm (Frames removed 6/29/2015)

Medium Drink Of Water

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #40 on: June 12, 2014, 04:49:46 AM »

Really?  This is exciting news.  I think you're the most important person in the world of LL right now.  If your search turns up a competent doctor who does a good job (and offers internals too!) then that makes India an LL destination again.
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Gained 3 inches on tibias (Ilizarov LON) in 2007 at the Beijing Institute of External Skeletal Fixation Technology with Prof. Hetao Xia and Dr. Aiming Peng.

If you have any questions, ask them here rather than by Private Message:
http://www.limblengtheningforum.com/index.php?topic=64544

Taller

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #41 on: June 12, 2014, 10:26:41 AM »

Really?  This is exciting news.  I think you're the most important person in the world of LL right now.  If your search turns up a competent doctor who does a good job (and offers internals too!) then that makes India an LL destination again.

This! Thanks so much for giving us information and hope about the possibility of getting internals done in India at a more affordable cost, for those who are financially a bit less flexible. Personally, I was going to have to save and go with Dr. Jamal, which might take a good while, but depending on what information emerges on these Indian internals, you may have played a huge role in making my dream come true sooner. I'm sure many others are in the same boat. Thanks from the bottom of my heart, Kilo!
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KiloKAHN

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #42 on: June 12, 2014, 12:36:42 PM »

Just got back from Dr Parihar. On the subject of ISKD, he seemed surprised about its availability in India now but he said that because Precice is available there would be no point in using it because it would be putting unnecessary stress on both the surgeon and the patient due to the problems the device is known for.
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Surgery performed by Dr Mangal Parihar at Mangal Anand Center for Limb Lengthening & Reconstruction. http://www.limblengtheningforum.com/index.php?topic=634.0
Pre-surgery height:  164 cm (Surgery on 6/25/2014)
Post-surgery height: 170 cm (Frames removed 6/29/2015)

Taller

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #43 on: June 12, 2014, 03:58:29 PM »

He brings up a good point. Did Dr. Parihar mention what his price was for internal lengthening with the Precise 2?

Would anyone happen to know the difference in price between the Precise2 and ISKD nails only, without the costs of surgery, PT, and other associated costs?
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KiloKAHN

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #44 on: June 12, 2014, 04:21:26 PM »

He brings up a good point. Did Dr. Parihar mention what his price was for internal lengthening with the Precise 2?

$30,000 for the nails + $14,000 for the surgical costs. The price doesn't include complications and you will also be spending $5,000 or slightly higher for hotel stay. So it's very similar to Dr. Birkholtz's pricing.

Keep in mind that nobody in India has lengthened with internals yet, so if a doctor does internals for you there's still somewhat of a learning curve and you're taking a risk in that sense.
« Last Edit: June 12, 2014, 04:41:04 PM by KiloKAHN »
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Surgery performed by Dr Mangal Parihar at Mangal Anand Center for Limb Lengthening & Reconstruction. http://www.limblengtheningforum.com/index.php?topic=634.0
Pre-surgery height:  164 cm (Surgery on 6/25/2014)
Post-surgery height: 170 cm (Frames removed 6/29/2015)

Taller

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #45 on: June 12, 2014, 05:18:39 PM »

Awesome to know!

Even if the price is about the same as Dr. Birkholtz's, it's a great thing that we now have a second option in that price range. Dr. Birkholtz is an extremely busy man, so Dr. Parihar provides a very viable alternative in the event that Dr. Birkholtz has more important surgeries/commitments to attend to (i.e trauma and deformity cases versus a non-necessary elective procedure), or for those whose starting height falls above Dr. B's maximum starting height limit.

Do you know if PT is included in the $49,000 with Dr. Parihar, or must one privately hire a PT separately?

You bring up a very good point about the lack of experience of Indian doctors with internals. Hopefully, it won't be much more difficult for them than implanting a standard IM nail in the LON/LATN process, minus the complications of using an external fixator.
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KiloKAHN

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #46 on: June 12, 2014, 05:24:05 PM »

Do you know if PT is included in the $49,000 with Dr. Parihar, or must one privately hire a PT separately?

I believe you have to pay for physio during each visit but I'll have to get back to you on that.
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Surgery performed by Dr Mangal Parihar at Mangal Anand Center for Limb Lengthening & Reconstruction. http://www.limblengtheningforum.com/index.php?topic=634.0
Pre-surgery height:  164 cm (Surgery on 6/25/2014)
Post-surgery height: 170 cm (Frames removed 6/29/2015)

Taller

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #47 on: June 12, 2014, 05:27:30 PM »

I believe you have to pay for physio during each visit but I'll have to get back to you on that.

Alright, thanks a million for the information! These have truly been a wonderful few days for me in learning that internals are indeed available in my price range. It means a ton that you're helping out the community so much through your own journey. We're, without a doubt, extremely grateful.
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KiloKAHN

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #48 on: June 12, 2014, 09:26:22 PM »

Day 2: In Delhi & Mumbai
In the morning I ordered breakfast – an omelet wrapped around a slice of bread, a cheese sandwich, and coffee, which was brought promptly to my room. The breakfast was better than I expected – filling and free as part of the room package which was complimentary as long as the order was 150 Rupees worth of menu items or less. After eating I packed everything up and made it to the lobby before my 12 o’clock checkout time. I saw a man in the lobby brought in on a stretcher from Rockland Qutab's ambulance and placed in a room on the first floor. Judging from the accent of the man's wife I'd guess he was from Kenya originally. I had planned to take the train from the railway station to Mumbai, but I was told that the train would not be running and that I would be better off taking a plane. For 11,500 INR they booked me a 2:30 flight to Mumbai and included taxi service. I went to the ATM machine so I could pay in cash but my bank limit only allowed me to take out 10,000 INR during the day. Fortunately I was allowed to pay with my credit card.

The manager of Hotel Indira pulled up in his own car and drove me to the airport. On the way he asked me questions about what I thought of their service and what I thought about the real estate market back in the USA. He had a friend who was going to sell him her place in Flordia, which he was interested in getting, but after looking at the monthly maintenance costs he figured it wasn't worth it for something that was just going to be used as a vacation home. Arriving at the airport, he took out my bag and gave it to a paid porter that cost 150 INR to help me with check in. A guy at a touch screen took my booking information and gave me an aisle seat I requested and I was pointed to the check in counter. The lady behind the desk was quite nice looking and friendly. My bag was filled with so much stuff that I was 12 kg over the allowance, so I had to go to a separate counter and pay 3,000 INR to get my boarding pass. The security checkpoint was annoying because I had to wait in one line to put my carryon bag on the security belt and then wait in another line to get frisked by security. Once I got through that I had to go downstairs and wait in another line that was behind the outside area where airplanes were parked. From there I had to take a bus packed full of people to the IndiGo Airlines plane. Funny enough, there was an airline called SpiceJet. Were they stereotyping themselves? To get on the plane there were two large ramps, one for the front door and one for the back door. I climbed the front ramp and saw that the inside of the plane was pretty nice. The flight itself wasn’t bad. The effects of the cries from two infants were minimized by the flight attendants being so hot. They were probably the best looking women I’ve seen in India so far.

When I got to the airport I realized that I had not taken down the address of the hotel I planned to stay in so after I collected my bag from the baggage carousel I went to the Starbucks right outside the airport (and btw the Starbucks was the coolest one I’ve ever seen) for the wifi. I then realized that because I didn’t have a sim card yet, I wouldn’t receive the text message for the wifi password. Not only that, but the scratch card the employee gave me for free wifi didn’t work as an alternative. Fortunately I knew the address to Dr Parihar’s clinic, so I gave that to the prepaid taxi service and was driven the 6 miles to its front. The traffic was really insane and I began to think that maybe LA traffic wasn’t that bad. I’d really hate to learn to drive in Mumbai. After arrival in front of the clinic I told the driver that I didn’t actually need to go there now and was looking for a hotel nearby, so he took me the brief distance to The Fern Residency.

Check in was simple, which just required a passport, and for 13,000 INR I booked two nights in an executive suite just to experience what the nice hotels had to offer in Mumbai. I went back to the taxi to get my bag and gave the driver a 1,000 INR tip for being so helpful and then followed the guy from the front desk to my room on the fifth floor. I have to say I did not expect the hotel room to look as nice as it did. It contained a king size bed, large HD cable tv, two bedlamps, a desk, coffee table, comfy chair, large closet with a safe, and a bathroom with a nice shower. Once I got changed I walked outside a bit down different streets just to get a feel for the surrounding areas. The abundance of trees and humid climate really made me feel like I was walking in a city built inside a jungle. I went back inside my suite and ordered tawa mutton, baked cheesecake with berry compote, and fresh lime soda from the room service menu. Room service here was also prompt and I dug in to a meal that looked really tasty. The tawa mutton was pretty damn spicy for me even though I asked for it to be as mild as possible, though I suppose a local wouldn’t even sense the spice considering how spicy the food can get here. The cheesecake was not the best I had but still decent. I don’t think I’ll ever order lime soda again though. It was way too salty for a drink. After I was done I put one of my “Married…With Children” DVDs (I brought the whole season with me) in my laptop for entertainment. I called room service to take my plates from dinner but they took so long that I fell asleep before that, so when I woke up in the morning my plates were still there.

Day 3: Appointment with Dr Parihar
Woke up and took a hot shower, then went down to the lobby for breakfast. It was a decent buffet, with most things being bread and vegetable based. The only meat product they had were chicken sausages, but at least I was able to get fried eggs cooked for me by the chef. They also had good coffee, which is a must have for my mornings.

I asked the hotel receptionist where I could get my photos taken and a sim card. He gave me the directions of “go that way and you’ll find it”, pointing to the left. I went in the direction he told me, walking under a huge overpass and encountering flocks of crows, and a cow and goat kept in place with leashes. When I found the phone shop I was told that not only did I need my passport and a photo, but I also needed a visitors card from the hotel. The hotel hadn’t given me one so I left and got my photos taken ten shops away. I received 9 passport sized photos for 50 INR, a great deal, and walked back to the hotel. Considering my checkout would be tomorrow, I figured I’d just get my visitors card from the new hotel I decide to stay in.

My appointment with Dr Parihar was scheduled for June 13th at 4:00pm and although I e-mailed him to see if I could move it to today I never received a reply. I decided to call his clinic, but the lady who picked up just said ‘I can’t hear you, sir’ and hung up the phone. I decided to just show up at his clinic and ask if I could see him then. I didn’t quite remember where his clinic was and walked through streets in the area where I thought I remembered seeing his clinic. I asked several different taxis if they could take me to his address, but they all told me something in the local language in drove off. I could only assume they were saying “I can’t understand you man”. Back at the hotel I asked the front desk if they had any taxi service and they said they had packages for taxi service that I could purchase. When I showed the address they said that it’s way too close for taxi service and that I should just walk, but when I asked where exactly they said “oh it’s close, it’s over there somewhere”. So I walked back out again and stood in front of a busy main street packed with cars, wondering how the hell I was supposed to cross without getting killed. I was finally able to cross after many minutes by inserting myself in a group of people and crossing when they did – we still almost got hit. I was able to find Mangal Anand Hospital easily after I crossed that main street as I recognized some of the shops from when the taxi driver drove past them. After taking some pictures of the outside of the clinic I walked in and was directed to the second floor.

I left Dr Parihar's clinic with a good impression of him, and I wasn't put off by the look of it considering it didn't look to be in lesser shape than any of the other buildings here. Once I got back to the hotel I just lounged in my room and ordered room service. This time I ordered a chicken tikka submarine, pavlova (New Zealond Meringue baked dessert topped with whipped cream and cuts of green apple), and a drink called Black Cat, which is crushed black current, lime juice, salt and 7UP. Yet again the room service didn’t come up to take my plate after I called them, even though they told me to do so.

Photos of Days Two and Three





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Surgery performed by Dr Mangal Parihar at Mangal Anand Center for Limb Lengthening & Reconstruction. http://www.limblengtheningforum.com/index.php?topic=634.0
Pre-surgery height:  164 cm (Surgery on 6/25/2014)
Post-surgery height: 170 cm (Frames removed 6/29/2015)

GeTs

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #49 on: June 12, 2014, 09:40:23 PM »

looks comfortable
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Taller

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #50 on: June 12, 2014, 10:13:34 PM »

This is a pretty random question, but do you still feel short in India?
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KiloKAHN

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #51 on: June 13, 2014, 04:36:10 AM »

This is a pretty random question, but do you still feel short in India?

No. I feel completely average. That's why even at 5'5 one doc told me I don't really need lengthening. On the whole, India isn't a tall nation. I only felt particularly short when Dr Parihar stood in front of me. He was a whole head and neck taller. Then again he was taller than everyone in the lobby by far.
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Surgery performed by Dr Mangal Parihar at Mangal Anand Center for Limb Lengthening & Reconstruction. http://www.limblengtheningforum.com/index.php?topic=634.0
Pre-surgery height:  164 cm (Surgery on 6/25/2014)
Post-surgery height: 170 cm (Frames removed 6/29/2015)

Shortie

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #52 on: June 13, 2014, 04:07:26 PM »

Good luck  kilo
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ChrisIsaak

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #53 on: June 13, 2014, 09:55:54 PM »

Great photos, Kahn! Good luck.
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KiloKAHN

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #54 on: June 14, 2014, 08:51:12 AM »

Day 4: Switching Hotels and Frustration in Mumbai
Checked out of The Fern Hotel and got myself booked into Hotel Maharana Inn. I decided to get myself the best room they had for the three days before I downgrade to another room. The executive suite is really nice and the HDTV inside it is larger than any of the TVs I've seen in any of the hotels so far. Ordered  a cheese pizza and chicken masala, which were decent. I had no idea what pizzas in India were made like but I found that they were very different from the ones in the States. I had a laugh when I saw that they put peppers underneath the cheese in the pizza. Later I walked back to the phone store I went to the other day that said I needed photos for a sim card, but once I went in and told them I wanted a sim card the employee just said "no" and told me to go. By that point I got pissed because it was just about impossible to get a sim card without someone who could speak to people in the local language for you.

I decided to go and see Dr Shah afterwards and had the hotel receptionist call a cab for me. The staff explained to the driver where to go but he ended up dropping me off somewhere that was completely far away from it, as I found out from someone that I was really 6 km from Dr Shah’s clinic. I found that most of the cab drivers in Mumbai have no idea where the hell anything is. If you tell them an address they won’t have a clue unless it’s a famous monument or center and even then they still have to stop and ask for directions. It’s as of anybody in Mumbai can get a taxi and call himself a driver. It was much easier in Delhi to manage on your own and any tourist coming to Mumbai will probably have a difficult time alone. It would be much better to go as a group because at least you can have comfort in having people there with you when things don't go to plan. It started to rain hard, which made the weather even more humid and left me drenched. I eventually gave up trying to find Dr Shah’s clinic because I didn’t even have a working phone to call and ask them for directions. Maybe I’ll have better luck with that on Monday, but I’m not leaving the hotel until I’m sure I can see Dr Shah. It took forever to find a cab that knew how to get to my hotel even after telling the address and showing them the hotel card.

When I finally got back there was not much to do, so I ordered a mushroom cheese pizza, cold coffee with ice cream, and an orange juice and then watched some "Married…With Children" episodes on my laptop before connecting my PS3 to the HDTV. I saw that I had forgotten to pack the HDMI cable but I was at least able to get the composite cables to work. I do need to find an electronics shop with an HDMI though as Fallout 3 won't be the same without it. Played some Resident Evil 3: Nemesis and Final Fantasy IX for a bit before deciding to go back to sleep.

Photos of Day Four
 
« Last Edit: June 14, 2014, 10:42:01 AM by KiloKAHN »
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Surgery performed by Dr Mangal Parihar at Mangal Anand Center for Limb Lengthening & Reconstruction. http://www.limblengtheningforum.com/index.php?topic=634.0
Pre-surgery height:  164 cm (Surgery on 6/25/2014)
Post-surgery height: 170 cm (Frames removed 6/29/2015)

Medium Drink Of Water

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #55 on: June 14, 2014, 06:45:53 PM »

Another great entry.  It feels like I'm right there with you.  The excitement is palpable.
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Gained 3 inches on tibias (Ilizarov LON) in 2007 at the Beijing Institute of External Skeletal Fixation Technology with Prof. Hetao Xia and Dr. Aiming Peng.

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #56 on: June 15, 2014, 08:38:37 AM »

I hear Mumbai is a lot more confusing than Delhi. If I did lengthening in India I would want to do with a good doctor in Delhi because of that.
Also how come you have the website name and corner picture on all your photos?
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KrP1

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #57 on: June 15, 2014, 11:49:50 PM »

Wow the hotel room and the pizza looks aswesome
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KiloKAHN

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #58 on: June 16, 2014, 02:58:28 PM »

So I've decided which doctor I'll be doing surgery with. Before I reveal who I decided on, I'll start by sharing what I remember from notes I took down during the consultations.

First Consultation: Rockland Hospitals with Dr Rajesh Verma
Toward the end of my first day in New Delhi I was driven to Rockland Qutab by a driver at Indira International Inn named Chacha. As soon as I entered the hospital lobby, I heard my name called from the receptionist area. A young woman greeted me and had an employee get me a large bottle of water. I gave her my passport and she filled out a form with my relevant information before I was greeted by Mr Maini, the representative from Rockland who I had been communicating with by e-mail. He told me that in a few minutes we would go see Dr Talwar and after I paid the consultation fee (1,050 INR) he brought me down a floor to an office where I saw Dr Talwar's name on top with two others below it, Dr Gurdeep Singh Ratra and Dr Rajesh Verma. I sat down with Ishan and waited for Dr Talwar’s arrival, but a different doctor ended up coming in. He asked my height, how much I wanted to lengthen, and had me step on a scale. I was then told to take off my jeans and sit on the examining table while he went to go get a tape measure. While he was out the room I asked Ishan who the doctor was and whether or not I’d be seeing Dr Talwar. He told me that Dr Talwar was not at the clinic now but should I really wish to see him I could come back another time when he is available. For now, he wanted me to see Dr Rajesh Verma, as he would be the main surgeon during all cosmetic lengthenings, not Dr Talwar, though he would be part of the surgical team. Dr Verma came back and looked at my legs dangle for a bit before having me lie down on my back. He grabbed each tibia one at a time and had me bend my knees toward my body. Once that was over he started squeezing various sections of my tibias. I put my jeans back on and he told me that he thought tibias would be more appropriate for me to lengthen than my femurs. He sat at his desk and told me to ask him any questions that I have. The consultation lasted a full hour and I was able to get a good amount of information from him. Here's the gist of what I learned.

1) For cosmetic surgeries, Dr Verma much prefers monorail fixation to Ilizarov fixation because they're less heavy and bulky than the ring fixators and will restrict your movement less. He believes the results with a unilateral frame system are equal to those with Ilizarov fixators but has the added benefit of less discomfort to the patient. He said that you would have to do external only with monorails because the thick pins required for them would be blocked by the intramedullary rod with LON. However, if you are adamant about getting LON done, then he would use the ring fixators. He said that they haven't encountered any problems with stability using monorails because they use very thick pins.

2) When I asked what he would do if any malalignment started to happen during lengthening, he said that they would be monitor me through follow up visits. He stated that if you put the pins parallel to each other on the monorails then you shouldn't have problems with malalignment, but if you aren't careful and put the pins at an angle then that's when you start to have angulation/malalignment problems. Apparently if you put the pins parallel then that will help ensure the bone grows straight. 

3) I asked what nails the team would use if the patient decided to get LON and he said that they would use Zimmer nails.

4) When I asked why he prefers externals to LON, he said it's because he doesn't believe LON is good way to lengthen. An example he gave is that in the case of infection with external monorails, he could just remove the infected pin and replace it. But if you get LON and the infection goes into your bone, then it's difficult to replace the nail and your regenerate can also become infected. He recognizes the advantage of shorter fixation time and doesn't think LON is that much more difficult than externals, but he'd rather avoid the infection risk.

5) I told him that I was concerned about the possibility of chronic knee pain with LON due to having to split the patellar tendon to put the nail in and asked him what his take on that was. He said that it's one of the complications with nailing, but if you do it right then you shouldn't have any future incidence of knee pain because you wouldn't affect the patellar tendon too much.

6) He would not do bilateral plate fixation. He said that plating adds stability but there are no distracting plates and he would not want to do plating after the lengthening is done. He said it's because the regenerate at fist is immature "baby bone" and shouldn't be mishandled. Because of this he would not do LATN either because the bone is too soft for the nail to be put in right after lengthening.

7) I asked how long I would have to wear the monorails for external only if I were to hypothetically go for 6 cm. He said that after 10 - 14 days I would start distraction, depending on the results of the first x-ray. From there I would lengthen 1 mm per day for 60 days, making it 70 - 74 days for the distraction phase. After that I would keep the frame on for approximately 140 days, or double the time it took to lengthen, so I should expect to wear the monorails for around 210 days.

8 ) When I asked how knee flexion contracture and equinous contracture are treated or prevented, he said that his patients hardly get knee flexion contracture because they start mobilizing the knee from the day after surgery, and the chance of knee flexion contracture is even smaller with tibia lengthening. For equinous contracture he said that I shouldn't start to develop it for the first 4 or 5 cm, but they put the sandals strapped to the frame and have you stretch constantly. He said if that problem still continues then they would do a tendon release, but that it was rare and needed in maybe one or two out of every 100 cases. He also said that when you lengthen your tibia bone from one part you're not lengthening the tendon or the muscle fibers, which are located in various parts of the leg and don't lengthen while you distract, which is why you need to constantly stretch them to prevent equinous. Interestingly, he said that with my bulk I likely wouldn't have a chance of equinous for the first 5 cm.

9) For the first ten days he would make you walk with the monorails on, but after 10 days when you start distracting you will not be allowed to. Once distraction is completed and he sees good consolidation then he will decide when you can bear weight again.

10) Patients are required to wash their pins each day with saline and warm water. Once the osteotomy site is closed you can then bathe safely.

11) I told him about Dr Paley writing that you need to fixate the fibula at an angle both proximally and distally. He responded that they do not do any fibula fixation. They will just do the osteotomy and the fibula will distract itself. He said that they sometimes take out the middle of the fibula for bone grafts, starting around 4 inches from top and bottom joints, and that the fibula's main role is ankle stability, which is why they leave the bony part around the joints. I told him I had seen instances where the fibula doesn't consolidate after the osteotomy whereas the tibia does and he said it will not alter the way you walk, the mechanics of your foot, or affect you at all.

12) Regarding follow ups, they will see you in the hospital every day and may discharge you on the 3rd or 4th day depending on your pain level. After discharge they will see you after one week and make you start distraction on the 10th. On the 14th day they take out the sutures from where they did the osteotomy. One week after the start of distraction they will do an x-ray and follow up every week until the end of distraction. If they detect any problems they will do another x-ray. At the end of your lengthening they will check to see that both legs have lengthened the same amount by measuring with a radiograph.

13) They will check for valgus (x legs) during each follow up. At that point the regenerate is still malleable so if they see valgus they will correct it.

14) For pain they would give you painkillers for the last few cm of distraction. He said that you should have pain for the first two days after surgery and then not much pain again until the start of distraction, which according to him wouldn't be significant for the first 4 or 5 cm.

15) They would prefer you to have a calcium-rich diet so the quality of regenerate is better. They give their lengthening patients two pills a day of a drug (forgot what it was but I think it started with cisco) that is supposed to promote bone formation. If you have calcium and a normal diet then he said you shouldn't need to take any multivitamins.

16) The complications that can come up are knee flexion contracture, equinous contracture, pinsite infection, non-union at the osteotomy site, or implant failure (if internals are done). After surgery they give antibiotics to decrease the chance of infection and sometimes they may have to change one of the pins or wires. 

17) When I asked about the risk of embolism with LON or internals he said the chance is very low. He stated that embolism is a higher risk with fractures because they have to put in a larger diameter nail and ream more, whereas for cosmetic cases they would put in a smaller nail and the reaming would be less. 

18) I asked about the possibility of amputation and he said that he would never admit me for surgery if he thought there was even a 1% chance of it, as amputation is his least favorite surgery to perform. He also said that amputations have a higher risk of being necessary if the surgery is on someone who had gotten in an accident and messed up their limb and they had to perform surgery to try and save it.

19) When I told him I was worried that my bulk would affect my lengthening he said that it would not affect it significantly. His main concern was how the person taking care of me would manage. He also said they'd probably have a slightly more difficult time operating on me.

20) During each x-ray they will measure the amount of distraction in case of pin loss, and if I were to have a goal of 6 cm they may recommend lengthening to 62 or 63 mm, or even 70 mm if my body can take it because he thinks 172 cm would be a good height.

21) Their team does not have a height limit on who they accept as a candidate. They will generally accept a cosmetic patient less than 165 cm with no problems, but they may try and convince you not do do it if you're taller than that by stressing all that cosmetic lengthening requires of you. But, if the person agrees to all that then they think they shouldn't have a problem agreeing to do it. Dr Verma personally doesn't like lengthening people who have an average starting height, though he would do it if you don't show any signs that you wouldn't be a suitable candidate.

22) People who they will NOT accept for lengthening are those with bone disorders that prevent good bone formation, heavy smokers, drug addicts, people who don't seem to understand what will be required of them during the post-op, people who will seem to have a hard time following doctor instructions, or people who have HIV.

23) They do not do any psychological evaluations on prospective patients, but they will require a consultation before surgery and make you write a consent form stating that you came to them to get the procedure done. Up to now they've never had a patient who has turned out to be psychotic.

24) Their team has apparently done a lot of cosmetic procedures together, though I didn't get an exact number. Dr Verma did say that they don't get too many people coming for cosmetic lengthening, though. Maybe 2 or 3 a month at the very maximum, but often times they can go months without a single inquiry about it.

25) I asked if there's a real difference between lengthening for cosmetic cases and lengthening for discrepancy or deformity. Dr Verma responded that when you do cosmetic lengthening you have to be really precise about things, such as the corticotomy being the same level on both sides so you can easily estimate the length you're getting. Cosmetic lengthening also requires much more careful monitoring because if they lengthen for a discrepancy of 7 cm, for example, and it's brought down to a 1 cm discrepancy, the person can still make up for it with a shoe raise and they can consider it a success. But with cosmetic lengthening if there's even a 1 cm discrepancy at the end of it all, it would be considered a failure on his part as a surgeon.

26) Dr Verma prefers a clean cut osteotomy to a fragmented osteotomy.

27) They can lengthen with Precice but he stressed that the problem with internals is the chance of implant failure which would require replacement of the whole device and additional surgeries to remove the failed implant and reinsert the new one.

28) He was sent an e-mail a few days before the consultation from the makers of ISKD stating it's now approved in India. He was not sure if they sent just a trial assembly or a whole set but he e-mailed them back to find out more info.

29) I showed him a picture of the infected screw that was popping out of Russianblues's leg and asked him how something like that would happen. He said that something like that can happen with any implant you put in the body and the rejection of the implant is an individual reaction that you cannot determine beforehand. He said another possibility for that happening is if your body is too thin and has little muscle cover. Apparently he's seen cases of fracture fixation, spine fixation, and hip fixation where that sort of thing has happened. He said the chance of something like that happening is extremely minimal, though, less than a 0.00001% chance. He then went on to say that medical science is "not a dot" which I took to mean that unexpected things happen all the time. He said they could operate on someone who has a lot of complications and they think won't make it past a week but then they see walking fine later. Or they could do a very simple surgery on someone who ends up with a lot of complications.

30) Because of my bulk and nutrition he doesn't think I'm a high risk or even a medium risk patient but they'll investigate all that with blood tests, x-rays, and a pre-surgery checkup done before surgery.

31) I asked if my size would make lengthening harder and he said that bulk is always a good thing. He said that they could operate on two patients, one who is very thin and one who is very bulky. Due to the amount of muscle covering the bone, the bulky patient would have a better source of blood supply to the area of the corticotomy as well as more stability to his limbs. He said the thin patient would have less stability and have "very cheap" blood supply in the area, which could make healing take longer.

32) Dr Verma, Dr Ratra, Dr Talwar, consultants, and junior residents will make up the lengthening team. Dr Talwar is the Senior Director but Dr Verma and Dr Ratra will be the primary surgeons.

33) The cost of surgery is about the same as is shown on Dr Talwar's page, but there are things not covered. The first two follow up consultations are free. You have to pay for your x-rays though, which are $10 USD to $15 USD. Follow up checkups after the first two are also between $5 USD to $7 USD. The doctors at Rockland don't actually monitor the prices themselves, basically whatever you go there for is put into a computer and the computer calculates the price they will give you.


I'll post the other consultations next.
« Last Edit: June 16, 2014, 03:11:26 PM by KiloKAHN »
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Surgery performed by Dr Mangal Parihar at Mangal Anand Center for Limb Lengthening & Reconstruction. http://www.limblengtheningforum.com/index.php?topic=634.0
Pre-surgery height:  164 cm (Surgery on 6/25/2014)
Post-surgery height: 170 cm (Frames removed 6/29/2015)

paco1

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #59 on: June 16, 2014, 03:21:40 PM »

Very good information KiloKAHN,
I am doing my surgery in september with doctor Salameh, but this information is really interesting.
Cheers, paco
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KiloKAHN

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #60 on: June 16, 2014, 04:30:21 PM »

Second Consultation:  Dr Manish Dhawan at Private Clinic
After the consultation with Dr Verma I took a taxi back to Hotel Indira and hung out in my room for a while. It was nice to just browse the net and feel the cool breeze of the air conditioning. Around 7:30pm I took a taxi and arrived at Dr Dhawan’s clinic 15 minutes before my 8:00 pm appointment time. A male receptionist greeted me at the front desk and told me to have a seat. As usual I received intense stares from everyone inside the clinic that was waiting for Dr Dhawan in the main lobby. Soon a couple brought in their young daughter who was wearing a cast on her leg. From what I saw in the lobby, Dr Dhawan seemed to have a good mix of adult and child patients. After waiting for some time, Dr Dhawan rushed into the clinic wearing business casual attire and carrying takeout. After another 10 minutes of waiting the receptionist brought me into Dr Dhawan’s office and told me to sit at the desk and wait for him. I saw in the adjacent office that Dr Dhawan was checking on a patient currently. Taking a look around his office I saw various awards, pictures of himself at conferences, and a large assortment of models of different parts of the skeleton. The fan on the corner of the ceiling was focused on the chairs in front of Dr Dhawan’s desk and while I was sitting there people in the lobby were staring at me through the open door, which made the wait a little uncomfortable.

Dr Dhawan eventually came in at 8:30 and parked himself on his office chair. He reminded me a bit of the middle eastern guys in Beverly Hills that wear bling and have the top of their shirt unbuttoned.  He asked with a very thick accent “So what questions do you have for me? What is your current issue?” I wasn’t sure how good his English was just judging by the accent but after telling him that I was there to consult about cosmetic lengthening it was clear from his response that he understood English perfectly. After brief small talk about how he remembered me from the e-mails I sent and how he just got back from the USA and Canada, he decided to get right to business and asked what questions I had for him. The consultation was about a half hour, cut short by the large amount of patients waiting for him in the lobby that he needed to see before he closed for the night. Here's what I took from the consultation.

1) He really stressed the point that cosmetic lengthening has to be done extremely carefully because you are performing surgery on a normal person to increase stature, so the outcome has to be absolutely perfect.

2) Two inches is the safe limit for him. Beyond that, he said your ankles and knee joints take a hit by starting to get stiff and can develop all sorts of problems. There's a risk of your legs going into valgus and also a risk of procurvatum with extensive lengthening beyond two inches.

3) Dr Dhawan prefers to lengthen with two methods. One method is LON. The other is doing very precise lengthenings with a hexapod fixator (basically India's version of the Taylor Spatial Frame). He much prefers lengthening with a hexapod because he can use computer software to exactly relocate your mechanical axis while lengthening if anything goes wrong. The thing with hexapod fixators is that you cannot put a nail inside while doing it.

4) Dr Dhawan said I have to make a choice between LON or hexapod. He said with LON I can remove the fixator early but I cannot do any adjustments with the nail inside, although the need for adjustments shouldn't be too much as the nail inside helps the bone form straight. However, he said with LON I should be less greedy with how much I lengthen, in addition to being aware that I can get a bone infection.

5) I told him of the concern I had with developing chronic knee pain if I choose LON and he said that he's found that people have had that problem, but that he prefers using the hexapod anyway because everything is under his control and there won't be any incidence of knee pain. The only drawback is the fixation time being equal to your typical external fixators.

6) Distraction will start 7 to 10 days after the surgery at a rate of 1 mm per day. The amount of time you would need to wear the hexapod is around 2 and a half times the amount of days you lengthened. So for 5 cm taking 50 days, you should expect to wear it for 150 to 200 days to be safe.

7) He would make you stop at 5 cm with LON but would let you go up to 7 cm for tibia lengthening with hexapod.

8 ) He would not do LATN because the regenerate is very soft and inserting the nail can harm it.

9) Told me I should not worry about the time it will take to remove the hexapod because I should pick the method that is safest. He said that he is a very careful surgeon and that he doesn't like to do "mass production" lengthening like certain other doctors. He will do the surgery "with perfection and not very fast". Dr Dhawan was also curious as to how I found him because he never advertises his services beyond posting medical info on his website.

10) Apparently people who went to Dr Sarin have come to see him for advice on how to fix their problems, so he's aware of the controversy that happened as former Sarin patients told him about the whole Sarin/Sysop deal that was going on. He said he also knows pretty much every limb lengthening surgeon because he is Secretary of Limb Lengthening Society of India.

11) I asked about the availability of internal methods and he said that although it is true that Precice is available, the issue is that he personally has never performed internal lengthening, nor has anyone else in India due to the lack of approval for use. He said that he has seen internals performed in front of him, Fitbone specifically when he had a fellowship in Germany, but that he has not performed it himself and will not use any method that he is not confident about. He said that he will only do lengthening with methods that he is an expert on and knows will safely make you taller and that he will not experiment on anybody.

12) Price for LON and hexapod is similar to what Dr Sarin charged before his price hike. Hexapod would cost a little more because software has to be purchased. Price would not cover follow up visits or stay in India, though on his website you can see a list of hotels where you can get anywhere from a 20% to 45% discount on your stay depending on which hotel you go to. The discount is for patients who are treated at Sir Ganga Ram Hospital, where Dr Dhawan performs surgery.

13) He will perform follow ups at either Sir Ganga Ram or his private clinic, whichever is more convenient for you.

14) He will talk to each prospective patient to judge for himself whether or not he believes the person is a candidate for limb lengthening. He will not perform surgery on anyone he thinks has some sort of "psychotic complex."

15) Doesn't necessarily have a height limit but discourages every person who comes to see him. Even for me at 165 cm, he didn't get why I would want the surgery. He said there are too many problems that can happen with limb lengthening, which is why according to him "a good surgeon is not one who does it [cosmetic lengthening] en masse. A good surgeon is one who knows how to handle the complications which happen with Ilizarov."

16) Will not let you bear weight during distraction. Once distraction is complete, then he will let you bear weight depending on the bone strength.

17) Said he would not do externals with monorails because you cannot change its axis, whereas with the hexapod everything is under his control. Believes that a good surgeon would not choose to use monorails for cosmetic cases. It was pretty funny because when I asked about using monorails he said "Why do you want to go and f*** yourself?"

18) I asked him about his opinion on fibula fixation and told him that I've seen other surgeons not fixate the fibula. He replied along the lines of "People who do not fixate the fibula are foolish people and they do not know limb lengthening. Fibula has to be fixated with angle at upper part and lower part." When I asked him about the dangers of avoiding it he said if you distract and the fibula is not fixed in both parts it will collapse. When I told him that I was told you only need the last few inches of the fibula by the joints he responded that without question it's mandatory to fixate both proximally and distally.

19) Said I could expect some pin tract infection, stiffness of ankle joints, and stiffness of knee while lengthening, but complications can be reduced by being conservative in the amount.

20) Suggests for people who want to do cosmetic lengthening that they go to the gym and bulk up their leg muscles for 6 weeks before surgery, in addition to stretching regularly. 

21) Asked him if it's true you cannot get x-legs with LON and he said that it's very possible even with LON, especially if you lengthen higher amounts.

22) Will only lengthen femurs with monorails because he has experience with it, unlike internals. Said the limit for femurs would be 7 cm.

23) Follow ups will be every 10 to 15 days.

24) Asked him if he would perform limb shortening and he highly recommended against it because he said the "muscle gets pushed together and looks ugly."

25) Will do plate fixation if you really, really want it, but suggests to avoid it because of more scarring and possibility of infection.

After Dr Dhawan answered my last question, he called in a patient from the waiting room right as I shook his hand goodbye. The receptionist charged 2,000 INR for the consultation, twice as much as the fee for Rockland. I took one of those bike taxis back to the hotel and had a lot to think about. Dr Dhawan had effectively reduced the amount of consultations I planned to have by half. Speaking to him, it really drove the point home that I needed to do this with a specialist focused specifically on limb lengthening and not any orthopedic surgeon who will also do it. This is why I decided not to consult with the Spinal Injuries Center or Dr Murthy.

Photos By Clinic
Just a couple pics. One of the outside of his clinic and one of a relaxing park across the street.
« Last Edit: June 16, 2014, 05:02:19 PM by KiloKAHN »
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Surgery performed by Dr Mangal Parihar at Mangal Anand Center for Limb Lengthening & Reconstruction. http://www.limblengtheningforum.com/index.php?topic=634.0
Pre-surgery height:  164 cm (Surgery on 6/25/2014)
Post-surgery height: 170 cm (Frames removed 6/29/2015)

Taller

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Re: No More Mal-Kahn-Tent - External Tibias - Dr Parihar
« Reply #61 on: June 16, 2014, 04:45:28 PM »

Wow, Dr. Dhawan seems to really know his stuff and seems quite confident. But, did he ever come off as arrogant or belittling when you told him what Dr. Verma said about the fibula and monorails? The area around his clinic looks quite nice.
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