Print

Please login or register.
1 Hour 1 Day 1 Week 1 Month Forever
Login with username, password and session length

[Rod Thick]

I started a thread earlier this year about all the negatives I saw with Dr. Guichet. That thread turned out to be more correct than I ever anticipated thanks to Unicorn888 documenting her unimaginable nightmare experience with Dr. Guichet.

I'm sad to say that i'm staring to get the same impression about Dr. Parihar for different reasons. Dr. Parihar is incredibly affordable for limb lengthening, but his patient outcomes on this forum are not impressive in the least. In fact, I look at his patient outcomes as a major warning sign.

KiloKAHN- External fixator only tibia lengthening with Dr. Parihar in India. Years later developed a serious case of CECS, needed surgery performed in the United States.

Penguinn- Internal PRECICE femur lengthening with Dr. Parihar in India. Surgery took nearly 10 hours, normally a 2.5-3 hour surgery. Severely delayed recovery time. Incredibly slow bone consolidation. Non union risk seems very high.

We all want limb lengthening to be more affordable, but with these patient outcomes i'm now highly skeptical about Dr. Parihar...

[Zeo]

Penguinn- Internal PRECICE femur lengthening with Dr. Parihar in India. Surgery took nearly 10 hours, normally a 2.5-3 hour surgery. Severely delayed recovery time. Incredibly slow bone consolidation. Non union risk seems very high.

Is slow consolidation an issue of surgical placement of the PRECICE nail though and subsequent management? or is it genetics?

I am all for being skeptical of doctors especially when they are new to the technology, but I dont know if those examples are good enough to say whether a doctor is good or not.

I wish Useful dude would update his diary, it looks like he messaged Penguinn about something and won't update his diary until his question gets answered, I dont know what it was though

For those who are curious about my status. I will update you soon only if the Moderator interacts with my inquiry.

Sucks that there has been a decline in diaries in general

[KiloKAHN]

CECS is a risk for anyone undergoing leg lengthening, because when lengthening the bone you are still stretching the soft tissues and making the muscles work harder than they normally would have. This results in the muscle in the area increasing in even greater volume and causing higher pressure in the compartments. The risk increases further if you already have muscular calves, and athletes like runners, basketball players, soccer/football players,etc, are prone to getting it just through their activities. In my case, I was a former amateur bodybuilder who added 50 lbs of fat on top of the muscle I had built. One can see the bulk my leg muscles had during surgery: http://www.turboimagehost.com/p/19108841/Set_1_3_Watermark.jpeg.html

It doesn't have to do with a doctor's surgical technique and can spring up on any patient. Medium Drink of Water had his surgery at the Beijing Institute and developed the same issue. I asked the traumatologist who removed my frames and the F&A specialist who did the fasciotomy, and both said CECS developing is likely just one of the possible side effects of stretching your soft tissues 6 cm (or in MDOW's case, 7.5 cm).

As for Penguinn, only he can update with how he is doing now. But the case of his surgery taking longer than usual is due to one of the Precice nails sent by Ellipse being faulty out of the box - Dr Birkholtz received a faulty nail before as well. Slower consolidation isn't the same as non-union.

Neither situation has to do with fault of the surgeon.

Useful Dude didn't really say much about his experience in his initial posts, so determining that his silence is the result of something catastrophic is jumping the gun.

Unicorn's experience with Dr Guichet isn't anywhere near comparable.

[Rod Thick]

CECS is a risk for anyone undergoing leg lengthening, because when lengthening the bone you are still stretching the soft tissues and making the muscles work harder than they normally would have. It doesn't have to do with a doctor's surgical technique and can spring up on any patient.

As for Penguinn, only he can update with how he is doing now. But the case of his surgery taking longer than usual is due to one of the Precice nails sent by Ellipse being faulty out of the box.

Neither situation has to do with fault of the surgeon.

Useful Dude didn't really say much about his experience in his initial posts, so determining that his silence is the result of something catastrophic is jumping the gun.

I seriously doubt that patients of Dr. Paley or Dr. Rozbruch develop CECS after lengthening. In fact, Dr. Paley describes the sometimes necessary "release" of muscle tension during surgery to prevent this very problem. Meaning, the surgeon has to recognize the higher risks of some of his patients developing compartment syndrome during evaluation or during surgery. He talks about this right on his website. Saying it's not the surgical technique is letting Dr. Parihar off the hook way too easily.

Same goes for Penguinn's 10 hour surgery. Just because a nail malfunctions does not mean the length of surgery increases by 7 hours! Come on, that's absurd when the total time to implant 2 nails is about 2.5 hours. We all know Dr. Parihar has little to no experience with surgery for internal nail femur lengthening. What happened was he came across a problem with Penguinn during surgery, and it took him way too long to figure out how to fix it because he has no experience. BTW, being under anesthesia that long, when it's not originally planned for, is very dangerous. This is all on top of Penguinn's incredibly slow recovery, slow bone consolidation, and high risk of non union. If Penguinn were to post any kind of timeline videos showing his recovery, or a progression of his x-rays month by month, everyone would see exactly what i'm talking about, but he refuses when asked.

Useful Dude abruptly stopped posting for no reason. That in itself is not always a major red flag. However, combined with these other warning signs, it is another reason to be highly skeptical of Dr. Parihar.

[Penguinn]

I started a thread earlier this year about all the negatives I saw with Dr. Guichet. That thread turned out to be more correct than I ever anticipated thanks to Unicorn888 documenting her unimaginable nightmare experience with Dr. Guichet.

I'm sad to say that i'm staring to get the same impression about Dr. Parihar for different reasons. Dr. Parihar is incredibly affordable for limb lengthening, but his patient outcomes on this forum are not impressive in the least. In fact, I look at his patient outcomes as a major warning sign.

KiloKAHN- External fixator only tibia lengthening with Dr. Parihar in India. Years later developed a serious case of CECS, needed surgery performed in the United States.

Penguinn- Internal PRECICE femur lengthening with Dr. Parihar in India. Surgery took nearly 10 hours, normally a 2.5-3 hour surgery. Severely delayed recovery time. Incredibly slow bone consolidation. Non union risk seems very high.

We all want limb lengthening to be more affordable, but with these patient outcomes i'm now highly skeptical about Dr. Parihar...

You have a misconception of what non-union is. I can jog if I want to. My right leg is totally consolidated and my left leg is mostly consolidated, and if it doesn't fully consolidate on all sides, the remaining can be filled with a simple aspirate injection. Surgery took 10 hours because of a faulty PRECICE implant that Parihar had to remove and put another one in. My surgery was basically dual nailing + wtf this implant doesn't work + nail removal in 1 leg + nail insertion in the leg again. I did recover slow, but I don't see how a doctor is to blame for slow consolidation. (Edit: Also, Parihar had straight up told me that PRECICE was a learning curve for him in our first meeting, a problem which he doesn't even have now after 2 Precice patients)

I respect the skepticism, but if anyone asked me, I would recommend the doc. I'm 100% happy with my LL. Sure it doesn't compare to the guys running in 6 months, but if I could spin the LL Roulette wheel again, would I? Hell no. "A few extra months" is the least dangerous complication to have.

Also, I don't know what you mean by "Penguinn refuses to post X-rays". I've posted almost every x-ray I've taken, month by month. Read my diary again. I haven't posted one in a while because I haven't taken one in a while.

My case isn't comparable to Unicorn's. I'm a completely normal person right now except for running/sports/strenuous activities, which I will update on in 6 months or so. If you spent a day with me, you would never realize anything was wrong.

[KiloKAHN]

I seriously doubt that patients of Dr. Paley or Dr. Rozbruch develop CECS after lengthening. In fact, Dr. Paley describes the sometimes necessary "release" of muscle tension during surgery to prevent this very problem. Meaning, the surgeon has to recognize the higher risks of some of his patients developing compartment syndrome during evaluation or during surgery. He talks about this right on his website. Saying it's not the surgical technique is letting Dr. Parihar off the hook way too easily.

Not everyone will develop CECS after lengthening, even those who may look more prone to it. Paley likes to do the fasciotomy in pretty much every case (as well as Dr Shah) as a preventative measure, but Parihar's idea is that because every surgical procedure carries certain side effects, it's better not to do it as part of standard procedure because it may not be necessary at all later. Weight loss itself could remove the need for fasciotomy, as well as taking NSAIDS for a certain period, in some cases. Fasciotomy has a negative effect on ankle stability and creates more scars, so if I didn't have a history of CECS and the surgeon did a fasciotomy anyway, I'd be pretty upset because it's not something you can just reverse. Going straight to fasciotomy as a preventative measure is highly atypical, and it's almost always the case that for symptoms of CECS they put you on a physiotherapy regimen and combine it with medicines first to see if symptoms go away.

Isn't Paley getting sued for inserting a plate on the wrong limb of one of his patients? I seriously doubt that patients of Dr Parihar have devices inserted where they aren't supposed to during surgery.

[Dr. Sarcastic]

If you travel to India just to have your limb lengthening surgery you are out of your f**king mind! India is a third world sh*t hole, there is no way around this fact. It's the reason places like the U.S. Canada, Australia, UK have paperwork from Indian immigrants stacked to the moon and back. Educated Indians want to get the hell out of their own dirt poor, filthy, corrupt country as quickly as possible. Meanwhile, losers from first world countries are flocking to India to have their surgery so they can save the equivalent of the yearly salary of a pizza delivery boy.

[LLSouthAmerica]

Respect other countries. There are good and bad doctors anywhere in the world. There are  ty doctors in the US (I know some), Canada, Australia, etc. Even if the conditions are not the best in India, if it is not your country, you should be more respectful.

Regarding Dr. Paley, even the best can make mistakes. However, when they reach his level, they usually oversee parallel interventions and his residents or interns are the ones who do the job. Even so they take the fall others make.

[419]

You have a misconception of what non-union is. I can jog if I want to. My right leg is totally consolidated and my left leg is mostly consolidated, and if it doesn't fully consolidate on all sides, the remaining can be filled with a simple aspirate injection. Surgery took 10 hours because of a faulty PRECICE implant that Parihar had to remove and put another one in. My surgery was basically dual nailing + wtf this implant doesn't work + nail removal in 1 leg + nail insertion in the leg again. I did recover slow, but I don't see how a doctor is to blame for slow consolidation. (Edit: Also, Parihar had straight up told me that PRECICE was a learning curve for him in our first meeting, a problem which he doesn't even have now after 2 Precice patients)

I respect the skepticism, but if anyone asked me, I would recommend the doc. I'm 100% happy with my LL. Sure it doesn't compare to the guys running in 6 months, but if I could spin the LL Roulette wheel again, would I? Hell no. "A few extra months" is the least dangerous complication to have.

Also, I don't know what you mean by "Penguinn refuses to post X-rays". I've posted almost every x-ray I've taken, month by month. Read my diary again. I haven't posted one in a while because I haven't taken one in a while.

My case isn't comparable to Unicorn's. I'm a completely normal person right now except for running/sports/strenuous activities, which I will update on in 6 months or so. If you spent a day with me, you would never realize anything was wrong.

Bu why is your recovery so slow? I mean with Guichet and Betz (except the bad experiences) in general the recovery is much faster. Any input?

[onemorefoot]

Bu why is your recovery so slow? I mean with Guichet and Betz (except the bad experiences) in general the recovery is much faster. Any input?

Guitchet And faster? Take a look to Unicorns diary or meta for Dr Betz

[Penguinn]

Bu why is your recovery so slow? I mean with Guichet and Betz (except the bad experiences) in general the recovery is much faster. Any input?

*was slow
I can jog now if I want to for short distances. My legs don't feel like I've done LL at all anymore.

I don't know man, my bones consolidated slower. I think that has to do with every individual body and not the doctor.

[419]

*was slow
I can jog now if I want to for short distances. My legs don't feel like I've done LL at all anymore.

I don't know man, my bones consolidated slower. I think that has to do with every individual body and not the doctor.

Thanks for your valuable input. I agree. I think Parihar is a safe bet. I will start my journey in October 2018 and most probably it will be with Parihar. I want to do 3 inches in tibia, external. If i decide to stay in india until I am consolidated and walking then how much total aprox. you think I will spend (including all costs?). I am indian citizen but I studied and live and work in US, I have no family in Mumbai. Thanks for your help.

[KiloKAHN]

^He won't allow 3 inches of tibial lengthening. 6 cm max.

[419]

^He won't allow 3 inches of tibial lengthening. 6 cm max.

Thanks Kilo, I keep hearing that and that is a concern for me on going with Parihar, but did not Penguin do 3 inches? also if I insist would he agree? or is it a strict no more than 6 cm policy that he has?

[Penguinn]

I did 3 inches in my femurs, with internals. That's different from externals on tibias.

Even then, in one of our pre-LL meetings he had told me that if things didn't go smooth, he might make me stop around 6 to 6.5cms even with internals and I had to agree to that. Unlikely scenario which thankfully didn't happen. He's careful and I'm almost certain you won't be allowed 3" on tibias.

[419]

I did 3 inches in my femurs, with internals. That's different from externals on tibias.

Even then, in one of our pre-LL meetings he had told me that if things didn't go smooth, he might make me stop around 6 to 6.5cms even with internals and I had to agree to that. Unlikely scenario which thankfully didn't happen. He's careful and I'm almost certain you won't be allowed 3" on tibias.

ok, thanks for clarifying

[Dr. Sarcastic]

Please point out mine or Penguinn's terrible results that you post of.

This whole thread is exactly what i'm talking about. If you have surgery with Dr. Parihar in a third world sh*t hole like India you are f*cking stupid!

http://www.limblengtheningforum.com/index.php?topic=5012.msg78962#msg78962

[0184946]

Sure, use two patient experiences to represent how one doctor is bad. Thats logical. Most patients don't even know this site exists.

[KiloKAHN]

This whole thread is exactly what i'm talking about. If you have surgery with Dr. Parihar in a third world sh*t hole like India you are f*cking stupid!

http://www.limblengtheningforum.com/index.php?topic=5012.msg78962#msg78962

Not seeing any terrible outcomes. Like was posted, slower than usual consolidation is not the same as non-union, and if you think slower consolidation in a leg automatically makes a doctor bad, then not even Paley or Rozbruch would qualify as a good surgeon. Healing time is individual, what matters is how the surgeon responds to issues that arise.

Sure I could have not needed fasciotomy if Dr Parihar routinely did one on every CLL patient, but if you end up not needing a fasciotomy and get one done anyway, you just gave yourself more scars and less ankle stability for no reason.

[myloginacct]

CECS is really scary, though. Wouldn't it eventually lead to amputation if left untouched just a bit longer? Excuse my ignorance.

[KiloKAHN]

CECS is really scary, though. Wouldn't it eventually lead to amputation if left untouched just a bit longer? Excuse my ignorance.

No, only acute compartment syndrome could lead to that and it usually happens after serious injury, like a road accident. Chronic Exertional Compartment Syndrome only shows symptoms during exercise and subsides once the activity has stopped. It's highly annoying if you're an active person, but you can live your whole life with it.

[myloginacct]

No, only acute compartment syndrome could lead to that and it usually happens after serious injury, like a road accident. Chronic Exertional Compartment Syndrome only shows symptoms during exercise and subsides once the activity has stopped. It's highly annoying if you're an active person, but you can live your whole life with it.

Gotcha. Thanks for clearing that up for me.