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Author Topic: Phoenix.. Rising !! External Tibias with TSF Frames @ Dr. Dhawan, New Delhi  (Read 43932 times)

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microman

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I thought you could not do 1mm/day with tibia, only with femur, is it possible to do this with tibia because of TSF?

how does the doctor feel about leaving for consolidation, is he okay with that, and you can send him x-ray etc.
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IMO your tibia and femur shown in your pre-surgery X-ray has a good shape to get two straight legs after you finish your bowleg correction. I believe you wrote that you will complete your bowleg correction next week. So I think you will have two straight legs next week - Good luck.   

Thanks just_me, I have completed straightening my legs today. They look straight to me, but we can only be sure after taking the X-Rays in a couple of days.

I thought you could not do 1mm/day with tibia, only with femur, is it possible to do this with tibia because of TSF?

how does the doctor feel about leaving for consolidation, is he okay with that, and you can send him x-ray etc.

We can do 1mm with Tibia, irrespective of which frame we use. The limit per day depends on the individual lengthening capability. Soft tissues react in different ways for different people, few people get pain at 1mm, but I did not really get any problem due to it. And it was not my choice, Dr. Dhawan gave the schedule with 1mm lengthening per day as a standard. He might have reduced the limit if I complained of pain, but I didn't.

I am planning to stay here throughout consolidation, so did not ask him, but I am sure he will approve a request to stay away during consolidation. Will cross check with him in the next visit.
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KiloKAHN

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That's great you're not having any pain. I tried alternating between .75 mm and 1 mm daily and the pain was unbearable for me on the 1 mm days.
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Initial height: 164 cm / ~5'5" (Surgery on 6/25/2014)
Current height: 170 cm / 5'7" (Frames removed 6/29/2015)
External Tibia lengthening performed by Dr Mangal Parihar in Mumbai, India.
My Cosmetic Leg Lengthening Experience

upandaway

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*I'm coming to delhi end of June/July for a consult! 2 July just booked flights.

I speak perfect English must stop rushing my typing. Would you recommend Dr. Dhawan? How would you rate your treatment? 
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I went to the hospital today for consultation and for taking new set of X-Rays. Dr. Dhawan was present during the whole time to supervise if the X-Rays were taken properly. Legs look straight in the X-Rays, but there is a slight misalignment. Dr. Dhawan took the X-Rays to re-calculate the leg angle and length, and he will give me a new lengthening schedule for 3 cm more in a couple of days. I will decide when to stop lengthening after I reach 5 cm total lengthening. Most probably I might go a few mm above 5 cm.

I also took X-Ray of the left ankle to determine if there is any issue, as I have pain from a few weeks. There seems to be no problem with the ankle, and the pain most probably is due to nerves pressing against the bone due to realignment of bone angle; Not a big problem. Also the pain is mostly subsided, and I can feel pain only during physiotherapy and during weight bearing. Ankle stiffness is a lot better than it was a week back, but still not perfect.
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*I'm coming to delhi end of June/July for a consult! 2 July just booked flights.

I speak perfect English must stop rushing my typing. Would you recommend Dr. Dhawan? How would you rate your treatment? 

Hi upandaway, Thats Great, it is not even a month from now.. When are you planning to have your surgery? and who else are you consulting in India?

Dr. Dhawan is a very good doctor, and I do not see any big problems yet in my case. He is very busy all the time, but will answer your calls any time of the day. I can recommend him for External tibia surgery with Hexapod / TSF . The hospital is also very big and has good facilities.

The only minor inconvenience I have is with the post-op consultations. The hospital is very big, with many buildings and there are lot of patients so where ever I go there is a big crowd. There is a waiting involved every where. Every consultation takes almost 2.5 hrs, where most of the time is consumed for x-rays. This is not even an issue for many, but I hate hundreds of people staring at my legs, and I hate waiting before the X-Ray room, as I feel like a disabled, helpless patient when I sit in that hospital wheel chair for that long. :)
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upandaway

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Well I am starting to lean towards Dr, Dhawan. He's on the ASAMI board and has a great rep. I want the surgery as soon as possible after first consult. How quickly can he perform sugery do you think? You say his busy--> Could you ask the Dr. for possible surgery dates for me? 

I will also see Dr Sangari, and Talwar if I can get hold of him. Not Dr, Sarin. Rather be short. Any other Dr. in Delhi you could recommend?

Im bringing my girlfriend for support and nursing. So rather avoid guesthouse type places and get an apartment. She's a great gal.

Is there no way to do check ups in the private clinic? That surely would be better? 

You ended up paying $15,000? Why was that? He quoted around $10000. Was it because of the TSFs? They worth the extra $$?   I have saved around £7,000 plus overdrafts, loans I can get around £10,000 for the trip...

Thanks for the diary + details ... truely inspiring me! Should be seeing you soon..

upupandaway
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Well I am starting to lean towards Dr, Dhawan. He's on the ASAMI board and has a great rep. I want the surgery as soon as possible after first consult. How quickly can he perform sugery do you think? You say his busy--> Could you ask the Dr. for possible surgery dates for me? 

I will also see Dr Sangari, and Talwar if I can get hold of him. Not Dr, Sarin. Rather be short. Any other Dr. in Delhi you could recommend?

Im bringing my girlfriend for support and nursing. So rather avoid guesthouse type places and get an apartment. She's a great gal.

Is there no way to do check ups in the private clinic? That surely would be better? 

You ended up paying $15,000? Why was that? He quoted around $10000. Was it because of the TSFs? They worth the extra $$?   I have saved around £7,000 plus overdrafts, loans I can get around £10,000 for the trip...

Thanks for the diary + details ... truely inspiring me! Should be seeing you soon..

upupandaway

Dr. Dhawan took around 10 days in my case after I gave him confirmation. But it will really depend on how fast he can procure the frames, his schedule, availability, etc. You better check it directly with Dr Dhawan.

Once you are in Delhi, its not that difficult to get hold of Dr. Talwar. There is no one else in Delhi. I don't even prefer Dr. Sringari.

Getting apartments in delhi is not that difficult. But getting an apartment with a lift and other amenities near hospital is a bit tricky. You have to plan ahead.

You might do checkups in private clinic too. But when I asked him before my surgery, doctor asked me to stay near the hospital as he is mostly available here. But if you talk to him, it can be worked out.

Yes, the extra cost is due to the TSF frames. It is really your decision if you want to go with hexapod or TSF. I will not be able to judge which of them is better, as I never saw anyone with Hexapod before. But, TSF sure looks sturdy enough. Also, there are only 2 rings, so I feel comfortable.

I suggest you to talk about the finances properly with the doctor before committing to the surgery. You should be very careful while planning your finances. Plan your living expenses, physiotherapy costs, medicines etc.

Approx costs would be:

$17000 --  Approx Surgery (TSF) + First week expenses.
$700     -- per month living expenses
$2000   -- Approx total cost for Physiotherapy sessions, it will depend on number of sessions. Doctor insists on a lot of physio.
$1000   -- Approx cost for X-Rays and consultations for all your future visits.
$1000   -- Approx cost for medicines.


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parmida

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Hi Phoenix

congratulations for 3 cm height gain and leg correction :)

i believe you are still in Delhi and somewhere close to Sir Ganga Ram hospital , i am also from Delhi and somehow i am interested in opting for LL , after going through KiloKahn's diary i made up my mind to visit Dr.Dhawan for a consultation but to be honest, reading about all complications and pain & the long time one needs to wear those frames i was discouraged to go ahead :o

would it be possible for me to come and visit you as i am really curious to see a patient (specially scars) in real instead of online pics, i visited Dr.Sarin's guesthouse around 1 month back but there were around 5-7 guys (all Indians) in the room who all had done their LLs there and being a girl i was embarrassed to ask questions while others were all staring at me  :-\ so i couldnt even check anyone's frame and left in few minutes as doctor Sarin was waiting for me outside

please let me know if it would be possible, you can drop a private message in my inbox

all the best with your LL journey  :)

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Hi Phoenix

congratulations for 3 cm height gain and leg correction :)

i believe you are still in Delhi and somewhere close to Sir Ganga Ram hospital , i am also from Delhi and somehow i am interested in opting for LL , after going through KiloKahn's diary i made up my mind to visit Dr.Dhawan for a consultation but to be honest, reading about all complications and pain & the long time one needs to wear those frames i was discouraged to go ahead :o

would it be possible for me to come and visit you as i am really curious to see a patient (specially scars) in real instead of online pics, i visited Dr.Sarin's guesthouse around 1 month back but there were around 5-7 guys (all Indians) in the room who all had done their LLs there and being a girl i was embarrassed to ask questions while others were all staring at me  :-\ so i couldnt even check anyone's frame and left in few minutes as doctor Sarin was waiting for me outside

please let me know if it would be possible, you can drop a private message in my inbox

all the best with your LL journey  :)



Hey Parmida,

Thank you!!

After going through the surgery, I will not recommend LL surgery for anyone unless it is absolutely required. It is a very big commitment and you should know all the pros and cons before getting into it.

I am still in Delhi, and you can visit me anytime. I will PM my contact number to you. Also, if you want I might even introduce you to a female LL patient from Delhi. She is currently in her consolidation phase, and being a female she might be more helpful to you  :)


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I have started my lengthening again after a one week break. I am doing physiotherapy regularly, and weight bearing at least a couple of times per day. Left ankle is still stiff, but I can bring my ankle to neutral position during weight bearing.

Also from a few weeks, there is a lot of itching sensation around the pin sites. I know it is very common and natural, but its really irritating. Is there any way to stop it ?
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Between my last post and now, my leg issues have doubled. Initially I was weight bearing daily, and only left ankle was stiff, but that too used to come to neutral position after some time. I stopped walking from a long time since my ankle pain started. But, 10 days back, I decided to walk; when I  tried to take my first step itself, I lost control and luckily I managed to fall back onto the bed. But, in the process, I put a lot of pressure on my legs I suppose. After a couple of days, my right leg calf muscles started paining and the pain subsided in 2 days. Meanwhile my left leg calf muscles also started paining. I thought it will be back to normal in 2 days too. But, even after almost a week, left leg calf is still paining, and the pain extended to my thighs too. Moreover, I am not able to make my left leg completely straight. It is slightly bent at the knee. This problem started with the calf muscle pain. I am still hopeful that it is not a big problem, and will subside shortly.

Despite all these, the main problem still is my left ankle. I think the ankle stiffness is not because of stretching. I can notice the difference between my left ankle and right ankle. When I stretch my right ankle, the stiffness and pain is usually on the back of leg, in the calf muscles and below knee. I can feel muscles pulling naturally. But, when I stretch my left ankle, it is very stiff, like it is struck there before even my muscles stretch in the back. It is like my ankle bones and my tibia bones are colliding, not the natural elastic movement which I have in right ankle.

Also, in those few days when I did some weight bearing, it put a lot of pressure on my left ankle, and I feel, ankle fixation screw has moved out around 2mm. I can just feel a bulge of the screw head under my skin now. It was not noticeable before. Ankle fixation was good before, but after my 8 degree bow leg correction, the leg angle has shifted a lot, and that might have put the ankle fixation at a wrong angle with respect to new leg structure. I am starting to think that might be the whole reason for this ankle issue.

In fact, I spoke to Dr.Dhawan about it in my last visit, he took a ankle X-Ray and thought everything is fine. And I was also not sure what the problem was then. That was almost 20 days back. So, I will take another fresh X-Ray on my next visit and see if it validates any of my theories.

For now, my physio has asked me not to put too much pain on the legs till the muscle pain is subsided. So, I am resting again. No weight bearing for now, only stretch exercises.
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upandaway

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Well I'm here in Delhi.

First thing is when people say Indians are not trustworthy they are not underestimating. Delhi is a bit of a nightmare. The Hospitals are completely packed and it's completely dog eat dog. You really have to be on guard 24/7. Being white is an automatic red flag as well.

Saw Dr. Dhawan and seems geniune enough. Pushed me for TSF frames for a 6 month period. LON or LAPN was not reccommended or talked about at all. He mentioned knee pain and pushed for TSF as his personal recommendation. Which from what I have read is sensible opinion but may not be practical for me. 

He said the price is around 10 to 11 Lat which is now with exchange rate changes is quite expensive. No specifics though which is unsettling (but usual). The price is more than Russia now (at 14500 euros).

I am seeing a patient of his tomorrow. Which may or may not be you? Phoenix?

What I have noticed as well is Delhi is run on Kick backs. So basicly as soon as you say any sort of information, a recommendation will come whereby they will get money for it. Taxi, sim card, food, anything and I really do mean ANYTHING. It's really underhand. They will call ahead. Run out to you and hassle you. Follow you. Anything to get your money. This is the vibe you get from everyone in Delhi. So it's hard to get a handle on this doctor or anyone. It makes you question everything and everyone. A lot of people here are actively working to take, by any means, your money.

The hospital for one does not feel like a safe, healthly environment. Wards (in this particular hospital) if you can call them that are under construction and overrun. What provisions there are for any sort of surgery let alone complex surgery it is difficult for me to see at the moment. You are really rolling the dice.     
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KiloKAHN

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Hmm, when I was there he told me that I had to make a choice between LON or the hexapod. TSF wasn't talked about, but I guess he has direct contact with the manufacturer of TSF now so he can offer them. Did you ask him about just lengthening with the classic frames and then switching to hexapod (their version of TSF) if you develop any misalignment? That will reduce the price a fair amount. I was quoted $9,000 USD for LON and $10,000 for the hexapod, and that's when the USD was weaker against the INR than it is now.

So you saw Dr Dhawan at Sir Ganga Ram hospital instead of his private clinic?

You might also be interested in checking out the Rockland Hospital team and consulting with Drs Verma, Talwar, and Ratra.
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Initial height: 164 cm / ~5'5" (Surgery on 6/25/2014)
Current height: 170 cm / 5'7" (Frames removed 6/29/2015)
External Tibia lengthening performed by Dr Mangal Parihar in Mumbai, India.
My Cosmetic Leg Lengthening Experience

upandaway

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Hi Kilo.

Yeah I saw him at Sir Ganga'. Wanted to check out the hospital. He obviously has more expirenced with the TSF now and for making adjustments it does make sense however I do believe the fact that he can charge more for it does come into it.

He reuses the TSF frames it has nothing to the manufacturer in my opinion. I asked 'would it be possible to get the frames removed in the UK'. 'No, the frames are very expensive and we need to reuse them' was his reply. Which is sort of tells you he really gets them on an ad hoc basis and really needs them back. I doubt he has ever bought new TSF frames.

I'm pretty sure the frames are to justify the added cost in comparision to other people offering surgeries in India. So he can now charge £11,000. If he was to offer just hexapod and his qualifications (which may be superior) this does not really differentiate him. TSF are a mark of quality which the hospital and the level of care provided (from first impressions) do not live up to from what I have seen.

I think if he said £9000 hexapod people would flat out say no. The hospital is way below substandard. So donated TSF frames equals £11,000 price and the name and look reassures rich westerners.   

Think Africa aid clinic then triple the amount of people ten times. You have to be honest. The 'private' rooms are just in the middle of it and patients are flung around the corridors in all manner of states amoungst hundreds of people. I do mean hundreds. I don't doubt his qualifications or skill as such. It's the state of equiptment and facilties which are of grave concern. His recommendations are in line with the best options available for height surgery but he does understand that's why people would come to him and not others and how he will be judged. If he said anything else he would have no patients.

This is obviously a lucrative business as the number of assistants more than tripled when I talked to the dr. They all had the air of wanting to make money about them. Their faces of some of them when I said I wanted to see another Dr were instantly telling. Dr Dhawan even got them to get the doctors number and one was very perterbed by this and remarked in hindi. (Dr was Dr Talwar). There is always that pressure it seems in Delhi. The majority honestly have the constant, I do mean constant, drive to squeeze every penny out of you. More than 50% of Delhi live in extreme proverty and you can feel its effects. People need money. I'm not talking about medical assistants, these are non medical persons. The more people around the more likely there is going to be the Delhi 'mindset'. So the number and their reaction of the 'assistants' worries me. It makes sense that the price will and has been driven up.

Drs, from what I can see, being educated classes can isloate themselves somewhat and Dr Dhawan could be geniune but it's so hard to tell honestly. Most will happily and is somewhat part of the culture to lie to your face (in semi polite manner).   

I have just come from Russia. I didn't visit any hospital or anything related to LL as I could only get 1 month visa. But the standards there are leaps and bounds above India. Sanitation? There is zero in India. Russians do have standards. How can you trust a hospital with live construction, doors falling off etc. It's a big ask. Incidence of infection etc. This is the centre of Delhi. Thousands of sick people with untold diseases streaming through. Would you risk open wounds in a shared room for £11,000? Not only that they usually tell the truth and price said is the price paid. No tricks or sob stories etc. Maybe Rocklands might have better standards.

I would happly pay that with decent standards. Tomorrow. 

*There has to be some lines. My lines are pretty low. Low, low, low for this. So please don't take my comments lightly if you are reading and thinking whatever. I want this for the right reasons, for me and I am willing to do more than you to get it. I am honestly still considering Dr Dhawan and looking forward to changing my mind tomorrow..  Trust is in short supply...


 
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Hi upandaway, I was busy from a couple of days.. Didnt check ur replies.. You might be meeting me. When Doctor called me to inform that someone from UK is interested to talk to me, I figured it might be you.


The only minor inconvenience I have is with the post-op consultations. The hospital is very big, with many buildings and there are lot of patients so where ever I go there is a big crowd. There is a waiting involved every where. Every consultation takes almost 2.5 hrs, where most of the time is consumed for x-rays. This is not even an issue for many, but I hate hundreds of people staring at my legs, and I hate waiting before the X-Ray room, as I feel like a disabled, helpless patient when I sit in that hospital wheel chair for that long. :)

I informed you before hand how the hospital would be wrt the people. India has 3 times the population of that in US, within one third of its area. So there would be lot of people around, and Delhi is national capital, so very crowded. Also, due to your skin color you will get a lot of stares. Delhi people are shameless at that.

Sir Gangaram hospital is the largest hospital in Delhi catering to both rich and poor. What you saw yesterday was the old building which was built in 1954. It is undergoing some renovation. Old building is used for doctor consultations only. And that is where most people come to, and that is where you went to I suppose. It is not modern and I am sure you did not like it. There is a new building behind this where most of the modern equipment is. That is where the surgery will take place, and that is where you stay post-surgery. They do maintain standards and hospital is clean enough. It is built recently and is modern enough. Many rich politicians and rich people have surgeries here, as the hospital has modern equipment and the doctors are skilled enough. But if you are going to compare it with the hospitals in US/UK, it will be a no match for obvious reasons (The same rich people go to US/UK for complex surgeries.. :)).

This hospital gets government funding as it was service oriented, so they do surgeries to some poor trauma patients every year free of cost, or for some nominal price depending on their financial capability. I am sure they will re-use the TSF rings for such patients for deformity correction. After the consolidation, you are not obliged to take off rings here, irrespective of what D. Dhawan wants. You can do it anywhere, and any doctor will do it easily. Dr Dhawan might "like" it if you returned the frames, so he can use it for other poor patients, but he has no right what so ever to insist you to return them.

Also 2 days back I went to hospital for changing my Struts on the frames. They brought there a big TSF Kit, which has a lot of screws, Struts, Rings etc., all new in TSF branded boxes. Doctor does say they get it directly from the manufacturer, and I dont think the rings I saw in the kit are old, or re-used. After wearing the TSF for 3 months, I know that even if frames are used for 10days, they will wear out. It is made of aluminium with black paint on it. Same as a black IPhone which looses its paint around its edges after a few days of use, TSF frames lose a lot of paint after using for a few days. Also there will be lot of nicks on the edges. So, it is easy to distinguish a re-used TSF frame. But I think it is not that easy to recognize a re-used classic ilizarov frame, as there is no paint on it, and everything is aluminium (or what ever that metal is).

I am not trying to convince you to do surgery here with Dr.Dhawan, in fact he sent few of his prospective LL patients like you to talk to me before too (or just to look at my TSF frames, and generally I am happy to talk to new people, so I let them visit me), and I always manage to scare them off if I think they do not understand the depth of their decision, and just want to be tall. I sent a few of them for further consultation with Dr.Talwar too. I believe people should have a complete understanding of what they are getting into before having this surgery. If you are basing your decision on the infrastructure available, before taking a decision, just have a look at the new building too. And being a foreigner, you will not be sharing room with anyone, you will get a separate room after surgery. There are many options for room facilities you can choose from. Even if you decide to go with Dr. Talwar, you will face similar issues. But, may be his hospital might have more corporate look (Not sure, never visited his hospital) as it is completely private and profit oriented. I did not prefer Dr. Talwar as he prefers Monorails, does not fix fibula, and the surgery is actually done by other doctors, he just supervises them (I got this last part from someone from Dr dhawan's team, so I might be wrong too). I did not like that idea.

Also, you can just have surgery with Illizarov/Hexapod frames as Kilo suggested if you dont want to spend more on TSF frames. That will reduce a lot of cost. Dr. Dhawan has started trusting TSF more than classic frames due to their good performance, and comfort. But, he do offer classic ilizarov if insisted. Like many indians, even he might have assumed you are the richest person around (It is a kind of racism though not explicit), so suggested the best option he offers. Most of the surgery cost in my case, (Almost 5 Lakhs) is for the TSF frames itself. So, opting for Hexapod will reduce the cost.

Irrespective of the doctor you go to, or the hospital you have surgery in, all my comments are generic, and apply to pan-india or at least for delhi.

Where ever you go in India, you will face people who look to make some money out of a foreigner. Their salaries are not so high, but cost of living is very high in metro cities like delhi. So, they tend to approach rich people for tips for services they provide. And in their narrow, limited view, a foreigner is like the richest person they ever saw in their life. But, generally, they are not very greedy and it might be a dollar or two more than they charge an Indian (2 Dollars is 120 Rupees which is a considerable amount for them). And considering all that, you should be able to negotiate to save few bucks. In a way you should be street smart to deal with people here. The silver lining out of this is, in India, you can get anything if you are willing to spend money. You can have maid cooking food for you, cleaning, washing and all help.. under $60. You can find a hair stylist(or rather I should call him a barber) who comes to your house and does a hair cut under $5 and so on. Finding english speaking maid/barber is a bit difficult though.. :)

You should be ready to deal with all these issues and people, if you decide to do surgery in India, or look else where.
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KiloKAHN

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I did not prefer Dr. Talwar as he prefers Monorails, does not fix fibula, and the surgery is actually done by other doctors, he just supervises them (I got this last part from someone from Dr dhawan's team, so I might be wrong too). I did not like that idea.

That is true. Dr Talwar is the head of the orthopedics department at Rockland so it's considered his team, but the main surgeon doing the Ilizarov surgery at Rockland is Dr Rajesh Verma. http://www.hbgmedicalassistance.com/doc-details.php?did=275

He's the one who I did my first consultation with. It's true that they prefer monorails, and they prefer externals, but they will use classic frames if you go with LON. They're now offering Precice for femurs too.
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Initial height: 164 cm / ~5'5" (Surgery on 6/25/2014)
Current height: 170 cm / 5'7" (Frames removed 6/29/2015)
External Tibia lengthening performed by Dr Mangal Parihar in Mumbai, India.
My Cosmetic Leg Lengthening Experience

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Many things have happened in the past few days.  On Tuesday this week, I went to consult with Dr. Dhawan. Initially, he changed a few struts which reached their maximum capacity for lengthening, and replaced with longer struts. Then I told him all about my left leg pain and stiffness at the knee and ankle. And how I feel it is not a problem due to lengthening. He asked a few questions, and then suspected it might be due to fibula consolidation pre-maturely. He advised me to take X-Rays to confirm the same. My fibula did consolidate quickly, and the two ends attached with thick re-generate. It happened due to bow leg angle correction of my left leg. It being a 8 degree bow leg, I had to bend the whole leg outwards by that angle, which brought together the two fibula ends. This led to quick consolidation over the last two weeks.

Doctor has advised me to have a surgery immediately to break the fibula again. As my legs are already straight, and since my main concern was not lengthening, I wanted to avoid extra surgery and offered to go back by 1cm, and stop lengthening at 4cm only if it can avoid surgery. But he said, that will not really help, and that fibula should be broken to ensure I do not have any problems in the future. And he didn't like the idea of lengthening only 4cm, just to avoid a simple surgery. Dr. Dhawan also assured me he will do the surgery as inexpensive as possible.

At last I agreed, gave blood sample for some medical tests for surgery and went back home. On doctor's advice, I turned back left leg by 5mm to ease off some pain and pressure on the leg. On thursday, I arrived at hospital by 8am. Immediately they prepared me for surgery, and I insisted on speaking to Dr.Dhawan before giving me anaesthesia. He came to talk to me. I explained him all the pain areas again, and then asked him to remove the fibula fixation screw too in the same surgery. I felt that post bow angle correction, the fibula fixation screw is giving me problem. More like my instincts were telling me I might have issue with that in the future. He explained to me that all the issues I experienced was due to fibula consolidation issues, and removing the screw might displace fibula and cause mis-alignment. But In a way I insisted, and half heartedly he agreed as my lengthening is almost done, and hence less chance of misalignment now. In a couple of hours, after surgery, I woke up and my leg was straight. It was not stuck in 90 degree angle at knee anymore. And no more pain in leg, probably due to pain killers.

By evening I was discharged, so came home with a much better leg, though it was cut open and bone broken on the same day. Surgery cost me $320.

Now I am just taking all the painkillers and antibiotics which he prescribed after surgery. Apart from the possible fibula mal-alignment issue, my leg is in better shape now. I am not sure about ankle movement yet, as it is covered in lot of bandage which is restricting active movement.

My right leg lengthening is completed. I stopped at 5.2cm. I started my left leg lengthening again today. Need to still lengthen 7mm, which includes the 5 mm I went back before surgery. Still 1 more week to go. By then I need to practice and be able to stand straight for X-Rays to finalize my leg angle and length. Doctor has asked me to go till 6cm if needed, but I said I am not interested in that. I cannot be in frames for that long. I have to be off this frames by December or January, and walking without aid by february. Just hoping I can achieve that.

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That is true. Dr Talwar is the head of the orthopedics department at Rockland so it's considered his team, but the main surgeon doing the Ilizarov surgery at Rockland is Dr Rajesh Verma. http://www.hbgmedicalassistance.com/doc-details.php?did=275

He's the one who I did my first consultation with. It's true that they prefer monorails, and they prefer externals, but they will use classic frames if you go with LON. They're now offering Precice for femurs too.

Dr. Verma seems to be a spine surgery specialist. Limb lengthening is not even his focus area. He just has interest in limb lengthening. Its his hobby same like stamp collection or coin collection for regular kids. Dr. Talwar has good credentials, but if he is not doing the surgery personally, then we should not even talk about his credentials. We should be talking about Dr. Verma's credentials. And he has none in limb lengthening.

But personally, I rate his team way better than Dr. Sarin or Dr. Sringari, who both are not specialists in limb lengthening too. If not for anything else, Dr. Talwar will supervise the surgery at least to maintain his reputation. And he is a reputed doctor in Delhi.

There was one teenage girl who came to meet me with her parents. In fact Dr. Dhawan has sent her to me, to get a hint of what she will go through during lengthening. She was really short, around 4'5", and had height neurosis, and was ruining her social life by isolating herself from her friends and cousins due to height issues. I felt she really needed LL. But she was freaked out looking at my frames, and I couldn't even explain the look on her parent's face. They were actually imagining their daughter in those frames and were very worried. I personally did not like to put such a young girl through such a gruesome process. So, I showed them some monorail pics on google, and asked them to have a second opinion by consulting Dr. Talwar. Though I do not prefer monorails, they are less cumbersome, and might be better for her. They called me later and felt Dr. Talwar and his team is more professional than Dr.Dhawan. But the only concern I had was, he guaranteed them 3 inches gain atleast. Dr Dhawan assured them more than 2 inches depending on her muscle capacity. After looking at that girl, I am worried if she can handle that. She is very young, may be 16, she tried HGH too, but her growth plates fused recently, and her legs are really short. Her tibia looked not more than a feet long. I am not sure if her muscles will stretch that long. So, I advised them to take it slow, first make her do a lot of stretching for one year, and then go for surgery. They were planning to appoint a personal physio therapist for her stretching (Yea.. They seem to be rich). Never heard from them again, but I hope she will be fine..
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KiloKAHN

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How are you doing these days, Phoenix?
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Initial height: 164 cm / ~5'5" (Surgery on 6/25/2014)
Current height: 170 cm / 5'7" (Frames removed 6/29/2015)
External Tibia lengthening performed by Dr Mangal Parihar in Mumbai, India.
My Cosmetic Leg Lengthening Experience

upandaway

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Hi y'all,

Just to further my comments on doctor Dhawan. He also stated that he does not recommend LON or LATN as let me quote here 'I do not recommend lengthening over nail as nail insertion effects the bone healing'.

He suggested that inserting a nail would inhibit the healing of the bone. Which from what I have read from other Dr's (such as Dr Paley) is and not true and they even say it was bad science. This is where I lost all faith in him. He probably was trying to hood wink me into the costly equipment and overpaying for less. As he walked in through the chaos with his Prada bag, I think probably that's true.

You do describe the situation well Phoenix. I understand you are of Indian (decent) and you are used to 'conditions' but even for Indian standards the situation is pretty bleak. You say the modern equipment is in another building. Well I was shown the single rooms (he recommended the shared rooms for the £11,000 price) and they were in the middle of the chaos. No one could possibly recover well in that environment. It's an absolute mad house.

Maybe if you had a super human 'Indian' immune system you might escape but If you are not used to it you have no chance. And pray to god a really bad complication came up, I wouldn't trust them to tie my shoe lace.

'Renovations' is too generous. This is regular men with circular saws sitting cross legged on the floor, sparks flying everywhere as women, children and extremely ill patients are inches away. I kid you not. Doors hanging off, smells from the toilets, flys, you name it. The hospital is not up to scratch. No sugar coating it. Sorry. The chances of something going wrong is too high.

There are decent hospitals in India. This is not one. Politicians would often go to the 'peoples hospital' to show that they have the common touch. But I'm pretty sure they would be away somewhere else as soon everyone stopped looking. This hospital is used by millions and is over capacity about 20 times over and so would surely be a vote winner.       

I noticed this though. I believe the Dr Dhawan 'might' do the surgery well. But he has already cut out any sort of care. This is how these LL guest house places start. He's shooting himself in the foot. Just pay slight more for a better hospital around the corner. It would only be few extra laks!! But this Delhi mentally seems to blind everyone. It's totally stupid. We are westerners yes, but we're not stupid. We want the going rate in India for the service. We have google. We know how much everything costs. We know the standards we can get. We won't go okay, take my money, break my legs and I'll cross my fingers. If someone is going to try and blag you, there is ZERO chance I can trust him to fix complications or administer the correct level of care when I can only drag myself a few feet. And we will inform other people which will stop people coming. It is so silly.

The Indian doctor works the same as the Indian Hotel manager, he'll try and get a kick back for anything. Dr Dhawan wanted one for a Sim card! Which is maybe the way it's done in India but it seems so strange to me.   

If he paid the rate of a decent hospital, provided the latest information and a detailed price. People would literally flock to him. 

This is why India is a totally NO from the options and doctors available. Go to Russia people. They are at least sanitary. The hospitals are correctly maintained and have enforced standards. You won't be stepping over people or praying you don't get Osteomyelitis. (Still not perfect though)   

Delhi is a desperate place at the minute. Crime Levels are really bad and outlook of most people there is totally warped. Women are treated so badly. It's a scary place to be if you are a woman or a westerner. Even to walk the streets. Don't go there is my opinion. Mumbai seemed a lot better but the standards are same and there are no real options you should take. 

You are really spot on with what you say again though Phoenix. I think you know how it runs in India but I don't its a place for westerners at the minute... if I can say it... white people in particular can go. You'll have to fight to get anyone to do anything and if you start paying over the odds then your troubles really will start. Not to be too down on it, it is definitely on the up though........ the plane I left on was absolutely fantastic!!  :) 

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OregonMade

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Hey phoenix, 

Can you private message me as well.  I am basically wanting to follow your exact path with the same Dr. and same living arrangements, as well as same maid haha.  I have a few questions for you though:

Did you obtain Medical Visa before entering India or after entering India.  Right now I am having a hard time finding hospitals to write me a letter of intent which is needed before you can get your medical Visa. 

Like you I also want to travel to india and scope things out before I actually get the treatment work done, so I am wondering if you got your Medical Visa after you consulted with the Doctors in person or if all you were able to get the letter from your home country before hand. 

Any information will help.  Thank you.
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OregonMade

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Re: Phoenix.. Rising !! External Tibias with TSF Frames @ Dr. Dhawan, New Delhi
« Reply #84 on: February 28, 2016, 05:52:46 AM »

I am doing my lengthening with doctor Dhawan, and I staying with Phoenix, and everything is going fine.  I had the surgery done, and I am walking.  I start growing in 4 days, and phoenix has been like a brother to me.  Its unfortunaite that it didn't work out while you were here. 

I am from US, in particular Palo Alto, CA, so Stanford Medical hospital, which is a research hospital was my hospital.  So I for the last 5 years I was using probably one of the top 5 hospitals in the entire world.  The hospital has like 40 complexes spread all across Stanford Universities campus.  It truly a sight to be hold. 

In my personal experience, I believe the India philosophy towards medical is better, and has less fraud when looking at the system as a whole.  I believe I will heal better with the medications and physio here than I would in the US because doctors here are prescribing vitamins, supplements, and drugs for their limb lengthening patients.  In the US, if a doctor prescribes anything other than a drug they risk their job, blow back from pharmacutical companies, and risk being sued.  I am going to hire a physical therapist to come to my house everyday, so I won't even have to leave my Airbnb. Oh yeah and its 10.00 usd to have a physical therapist come to my house.  I plan on doing the exact same physical therapy recommended on paley's website.  A physical therapy session at Dr. Paley's place is $220.00 per session.  I can also higher help here, and pay him 2 dollars per hour, vs in the states on Paley's website hired help is 18.00 dollars an hour..

Don't get confused now, and don't be naive.  American doctors are fully capable of  "hood winking," as you called it their patients.  More than a lot of people would imagine, because they have a lot of external pressures, from pharmaceutical companies, insurance companies, and the private equity firm that backed their initial start up costs, assuming the doctor opened his practice.
Americans and in this case, american doctors are just better at deceit, and can look you in the eye, smile and nod when they lie, so I do agree that their is a level of mistrust I experience here with people.  People are mostly the same.   Do Americans lie less, thats the reason they seem so genuine, or are they just better liars. 

As far as being an absolute mad house you are right.  But you are wrong when you say that you can't recover in the hospital your wrong.  I did, and I was only in the hospital for 4 days.  When I was their I always wore my protective air mask into the hospital.  As well as when I went any where.   I also brought with me to the hospital my air purifier, so I was breathing the freshest air in Delhi haha   Yeah in US hospitals you don't have to take such precautions, but who cares they only cost me 50.00 usd for the precautions, and I was fine.



I do agree with some of  the last part of the of what you said about Delhi, but dude walk around Detroit, baltimore, Compton, or South side bronx at night.  You think the crime in Delhi is that bad its really not. Here people don't carry guns.  In the inner cities, you have crack heads carrying pistols.  Organized crime at the highest levels. 

I do agree, he could provide detailed information before hand.  They do after the fact though, and I was able to get through the whole process with only paying 10,500 usd.  With LON. 

One last thing.  Women are treated badly, and its not safe for them, but most all know how progressive things are in the States, and like US guys for that.  The first week I was here, I had sex with two indians, and one more before I lengthened,  So I think India is a perfect place for White American guys:) 
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vietguy12

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Looking forward to do my future surgery with this doctor. How long before you can walk without support? Thinking of doing 7.5 cm or 3 inches
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Sorry guys, I did not update my experience on this thread from over 6 months now. But I kept replying to my private messages as much as I can, and still chatting with few LLers from this forum.

My consolidation is complete now, and the frames are removed on March 17th, 2016. I am very glad that at last the frames are off. Doctor took measurements and a cast of my legs yesterday. They will give me a custom-made brace tomorrow to put on my legs when ever I walk for some support. I will start walking tomorrow with the braces, he asked me not to walk without braces for next 6 weeks or till I am completely confident.

I currently have a temporary cast on my legs, but I saw my legs without frames yesterday when they were taking measurements for new braces. My legs looked ridiculously straight, like someone has drawn a straight line with a ruler. Also due to muscle loss, my legs look very thin. Scars are very small, not a big deal. I might consider scar removal in future for a couple of scars, but I wouldn’t worry much either way.

My task for the next couple of months is to do a lot of physiotherapy, build muscle on legs, and a lot of walking. I am planning to go back to my regular life only when my walking style is normal. So, I might hang around a couple more months here.

Overall, very happy with the outcome of the surgery till now. I will try to post some videos of my workout with frames in a few days.
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Update on my Consolidation period:

My consolidation period went very smooth, No big issues, not even small infections. I had mostly a normal life ( minus walking obviously) . I live in one of the bed room in a fully furnished 4 BHK apartment with shared kitchen and living room. All the other rooms are occupied by mostly travelers from around the world. So, I got to meet many new people over the time from different countries. Lot of cultural exchange. I was a bit hesitant to show my legs with frames to every new person, so mostly covered my legs with towel when ever i went out into kitchen or living room, but showed them only to a few people who became friends.

All these days I was doing some physio therapy and walking now and then, but rest of the time, I was just watching TV Shows, learning some new stuff, cooking, gym etc. I tried working remotely for a month in august, but I decided to just chill out and spend my time in peace, and concentrate on healing, so I quit.

The whole area is wheelchair accessible, so I can move around freely, cook my food and be active without depending on others. I hate to be dependent, so I took special precautions to be able to manage all my stuff myself though we have helpers a phone call away to assist you in anything. I order all my grocery and other stuff online which is home delivered. We have a gym downstairs, so I used to go there some times and mostly do upper body exercises. In the last couple months I started walking with out zimmer frames or any support, started climbing steps and go upstairs, even did cross walk and treadmill few times in the gym. It is easier than I thought. My legs have good strength to walk right now, and I learnt to walk without support long back, so no worries going forward. I just need to work on the flexibility of my ankle, which has a tendency to go stiff even if I doesn’t walk for a couple of days. I am sure it will be ok once I start walking regularly.

OregonMade from this forum had his surgery recently and living in my apartment. Also sudheer from the forum is here for consultation and possibly surgery in few days. Also, I meet all Dr. Dhawan's would-be patients and help them with any questions about LL, so I met many LLers from the forum and off the forum and happy to do my part contributing to the community.
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KiloKAHN

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Good to know you're doing well. What are your thoughts of Dr Dhawan overall? Anything that could use improvement?
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Initial height: 164 cm / ~5'5" (Surgery on 6/25/2014)
Current height: 170 cm / 5'7" (Frames removed 6/29/2015)
External Tibia lengthening performed by Dr Mangal Parihar in Mumbai, India.
My Cosmetic Leg Lengthening Experience

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I got my new leg braces today. Doctor asked me to first start with exercises, then standing, and gradually progress towards walking slowly. 

I did some 45 mins of cycling in the gym with the braces without putting lot of weight directly. No pain, it was good, no issues with flexibility. I have enough strength in the leg, but not going to walk anytime sooner.

I am a bit worried when i remove the brace. I am taking lot of care not to put any weight on them, still very afraid of leg bending or fracture. Do not want any issues at this stage, I will not even let a physio therapist touch my legs for next couple of weeks.

I just removed the braces, and about to go to sleep now, and it feels good to be able to sleep with my normal legs, without frames or braces or plasters.
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TrueSpartan

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Thank you for the update phoenix.

You have been on this journey almost 11 months so far. You still have a while to go. If you knew before you started that it would be this much work for 2 inches. Would you do this again.
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Thank you for the update phoenix.

You have been on this journey almost 11 months so far. You still have a while to go. If you knew before you started that it would be this much work for 2 inches. Would you do this again.

People here have a tendency to just look at my height gained, but my main concern was bow legs when I decided to have this surgery.
 
1 year looks a big deal, but in 1 year, I got my biggest problem fixed (bow leg, which might have led to arthiritis in next few years), achieved something that might as well be my biggest asset (height) going forward, became very strong mentally and got enough time to take many important decisions of my life. If you ask me, this is the most productive year in my life which gave many important tangible results.

If I can go back in time, I will do this all over again.


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Bob

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Any standing postoperative images and x-rays you can show ?
« Last Edit: March 26, 2016, 10:01:41 PM by Bob »
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