From another post on the old forum:
I was hoping to have the chance of creating a new topic to describe my experiences as I have had the LL operation twice. Since I am only allowed to start by replying to somebody, I will start from this post, although relatively old, hoping that someone will read my answer.
I did my first LL operation in Cairo, Egypt with Yasser Elbatrawy in 2007 and it involved tibia lengthening with external fixation. I have also had femur lengthening with the PRECISE2 recently (2014) with the same doctor in Cyprus, but I hope I will have the chance to talk about this in another post. I am only hoping that I will be able to help people who are willing to go, or are currently going through such an operation by answering reasonable questions (and that does not include questions of the type, 'will I look better if I am 3" taller?', etc. )
I will try to briefly describe my experience with external fixators in 2007 and answer some of the comments that I have read about Yasser:
- First contact with Yasser Elbatrawy: We met in Cairo in 2007 and had a talk regarding the operation and the overall process. He seemed fairly confident about the outcome of his technique and I had the chance of witnessing the progress of a little girl with unilateral tibia deformity correction, as well as an older patient with fixators on both tibias. They where both in late lengthening phase and they seemed very well (that of course does not mean they were jumping out of joy, but they seemed pleased with the outcome).
Dr. Yasser assured me that the process lasts 6 months (I came to believe that there is a natural cycle to it) and that no physiotherapy was required. This has to do with the stability of the frames. Patients are encouraged and should walk from the second day after the operation. Of course, this means more pins and therefore more scars. However, these scars deteriorate with time and generally are not very apparent on darker skin types. Of course, shortly after the operation, the scars don't look so great as the wounds take a few months to settle. I do believe however that this is probably a good trade-off for a quick recovery, since walking not only eliminates the need for physiotherapy, but it also enables blood circulation for improved bone growth. I stayed in Egypt exactly 6 months and 10 days and left walking without any problems (I used a cane for a week or so, just for my peace of mind).
About the pain: Yes, the first day feels as if a truck ran over your legs, but pain management helps you through it. Pain eventually recesses almost completely after 10 days. What I mean by "completely" is that you are thereafter left with these uncomfortable things on your legs which make your life a bit of a torment. In other words, pain gives way to this new way of living that you have to do everything with a walker and lie on a bed with your legs up in the air and the pins tearing the sheets (of course, if pins get tangled somewhere, that is painful).
- My opinion about Yasser Elbatrawy: He likes what he does, there is no doubt there. He has worked with renowned professionals in the field until the early 2000s and has created his own hybrid out of these methods. As far as I know he still publishes papers and he is invited in many conferences around the globe. As a person, he has this Asian-Mediterranean temperament and he is not suppressing it when talking to his patients. Western patients (e. g. from the US) sometimes feel intimidated by it; he tends to say what he thinks even in conversations over emails and that can frighten you sometime (for example, he can describe a horrible complication in detail and then tell you that it is almost unlikely to happen). He believes that his job is mainly to deliver a good operation which should lead to a less intensive (for him) follow up. That is why he builds the frames as stable as possible. Of what I understood, he avoids risks: This means, gor example, he will not do ISKD unless you insist (and only when the PRECISE2 came around did he decide to suggest nails and only for femurs). He doesn't want complications because he simply sees it as trouble. He will also forbid lengthening over 7cms, again for the same reason. In general, contrary to what I have read in a few posts, he values his reputation a lot, so he plays safe with this procedure. Another important aspect of Elbatrawy which one may find it difficult while being in frames, is that he has many obligations (travels a lot) and he tries to manage his patients by employing a housekeeper and/or another local orthopaedic doctor who answers to emergencies and runs errands such as X-rays, etc. (he had one in Cairo back in 2007 who was really a great person) for little things and he would try to answer everything over emails and occasional visits. So he may be a little distant sometimes, but always gets in touch about everything. He also changes his mind over little things such as x-ray dates, meetings, etc. , which can test the patience of someone who is wearing frames (but your forget about it once you are gone).
- The price of the operation: For bilateral tibia LL I believe it costed 14,000 euro at the time and I don't think it is much more expensive now. That included the operation and the accommodation in terms of flat rent, internet and TV in the center of Cairo. I really preferred the flat over a hospital room. Being able to walk and having some independence, you always need your privacy. Now living in the center of Cairo (but a relatively good neighborhood) with frames in both your legs is not exactly holidays, but with the help of a house keeper who does occasional cooking and cleaning (loundry I did myself), life is manageable. Of course, the house keeper, food and other expenses where extra. And of course, god forbid, resolving complications is additional cost.
- Other patients: I met or talked with several patients during my stay. Clearly, the 6 month period was generally the rule. I know of a couple of cases who had slow bone growth, but they eventually left after 8 or 9 months. But most of the patients, including me, left walking at exactly 6 months. I do know of a couple of patient cases who decided to leave Cairo before frame removal and I am guessing (and hoping) they probably are alright as they didn't have any complications other than psychological pressure.
- My overall impression: For my financial status, I would never be able to do this operation elsewhere. So, looking back now, it was worth it. Yasser offers very good prices for people who are not rich. He delivers an operation which potentially leads to a safe recovery, but accommodation is cheap. So, in my understanding, most of the money are spent for the operation and much less for rent and casual x-rays and other accessories such as walkers. My opinion was positive in overall and that is why I decided to contact Yasser for another LL operation recently. He is a very good surgeon and he generally plays safe. I am not aware however if he had any serious complications after 2007. But until then, I think he had a good score.
- About the psychology of a cripple: When you are going through the procedure, everything is annoying. Normal people cannot sympathize and I think doctors are not an exception (I would say, doctors are even worse than that because this is how the are trained).
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Topic: Dr Yasser Elbatrawy (Cairo, Egypt) CICLLR (Read 44245 times)