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[KiloKAHN]

anyway. kilokhan. how are you finding steps?

Steps f****** suck. I hate the zimmer frame because my balance is so crappy that I can barely stand and lift the zimmer frame at the same time. I once got stuck standing up against a wall while holding on to the zimmer frame because I couldn't lift it over this big rug that was in front of me and the leg got caught in it.

[just_me]

Hi KiloKAHN! I have some questions for you:

1) How did you make your first consultation apointment with Doctor Mangal Parihar - Did you contact him personally and was it by phone or e-mail?

2) How big was the key to twist the nuts and screws in the six-axis hexapod devices - was it 10 milimeter  or 12 milimeter and could you twist it by your self?

3) How far was the ATM machine from your hotel - and how did you go to the ATM  - by yourself or did you need help?

4) Do the hotel and the hospital take both credit card (visa) and cash?

Thanks!

[KiloKAHN]

1) I sent an e-mail telling him what date I would be in Mumbai and asked to book an appointment with him. He replied with his dates of availability and after I chose the date he responded with the time I should arrive at his clinic to see him.

2) I only had the hexapod on for a little over a day so the turns were done by Dr Ahuja. IIRC, he turned it by hand.

3) The ATM was at the bank next door. I would have a hotel employee help me down the elevator and then push me in my wheelchair up the driveway that led to the street. Quick left turn and the ATM was right there. Then they'd wait outside for me to assist me back into my hotel room afterward.

4) They take both. I'd pay for my food items or things I asked them to get me outside with cash and pay with my debit and credit cards for the cost of the room every two weeks.

[TRS]

2) I only had the hexapod on for a little over a day so the turns were done by Dr Ahuja. IIRC, he turned it by hand.

Were the adjustments done in one session or throughout the day? Did you feel any pain during the process?
Was it during this time that Dr.Parihar compressed your tibias?

[KiloKAHN]

Throughout the day. I think there were four turns. I had to keep it on only a very short time because there was only 3 degrees of misalignment after the second surgery where Dr Parihar added the middle pins, compressed the tibias, and fixed the majority of the misalignment.

[ItsMyLife]

Throughout the day. I think there were four turns. I had to keep it on only a very short time because there was only 3 degrees of misalignment after the second surgery where Dr Parihar added the middle pins, compressed the tibias, and fixed the majority of the misalignment.

Kilo could you do  me a favor to ask DR Parihar how much he charges to insert a nail? ANd if there is any lengthening limit I must abide to, if i want nailing after tibia ex-fix. Thanks so much.

[KiloKAHN]

Kilo could you do  me a favor to ask DR Parihar how much he charges to insert a nail? ANd if there is any lengthening limit I must abide to, if i want nailing after tibia ex-fix. Thanks so much.

I don't think there's any limit to lengthening as far as taking the nails into account. People who have lengthened 10 cm get nails put in as well.

You can e-mail Dr Parihar with your query at the following e-mail addresses:

mangalparihar@parihar.net
mangalparihar@gmail.com

You can also e-mail Dr Ahuja with your questions:

divya@parihar.net

[just_me]

Hi KiloKAHN! I have some questions:

1. At the hotel Maharana Inn did the hotel staff brought you your meals into
your room - And did they brought you knife and fork?

2. What about bathroom things like toilepaper etc. did you have to buy
these things yourself?

3. When you went to the hospital for your first operation to do leg lengthening -
Did you then brought all your stuff (bag, clothes etc.) with you at the hospital - Or
did you left some of your stuff at the hotel Maharana Inn?

4. Is it necassary to have a mobile phone with you - Arent there a phone in every room
at the hotel Maharana Inn?

5. How did you connect to the Internet at the hotel Maharana Inn?

6. During your stay at the hotel after your leg operation how did you keep in contact with Doctor Mangal Parihar - By phone or by e-mail?

Thank you

[KiloKAHN]

1) Staff was great about the food. I'd just ring the front desk and say what I wanted from the menu and minutes later they would bring it to me in my room, along with the silverware. They don't come back to take your tray and everything unless you call them. What I'd do is just leave it there until I was hungry again, then when they brought the new food item they'd take out the old tray.

2) The cleaning staff would replace toilet paper if it ran out (you could always ask the front desk for a replacement if they don't). They would restock the soap and shampoo/conditioner as well.

3) I brought all my stuff with me to the hospital and they locked it in a cabinet to keep it protected. I was brought back to Maharana by ambulance and the staff at the hotel brought up all my stuff.

4) The phones at the hotel don't dial outside, so it's best to buy a local phone. I recommend getting a last generation Galaxy or iphone for cheaper at a nearby cell phone provider when the hospital staff takes you to get your sim card installed. That way you can call local numbers as well as use the 4G internet in case the hotel wifi goes down.

5) They have wifi that's accessible with a password that lasts 24 hours. Once the time expires you need to call the front desk and ask for a new passcode. The wifi is complementary with the hotel stay though, so you don't need to pay anything extra for it.

6) I was in contact with Dr Parihar primarily through e-mail, but I used Whatsapp to communicate with Dr Ahuja whenever I had a question or needed anything. He was pretty fast with responding and would even send someone from the hospital to come see me if I needed a refill on pain killers or something.

[just_me]

Thank KiloKHAN. I have a follow up question to 3.

When you were at the hospital for your operation - Did you also paid for your room at the hotel eventhough you were not staying at the hotel - Or did you make an arrangement with the hotel about when you will be back from your operation and then they will book you from that day?

Thank you!

[KiloKAHN]

The first time I was at the hospital, I just checked out of Maharana the night before and told them when I'd be back. When I had to stay for my second surgery to add the middle pins, I didn't check out and was still charged the daily hotel rate for the time I was in the hospital.

[ItsMyLife]

I don't think there's any limit to lengthening as far as taking the nails into account. People who have lengthened 10 cm get nails put in as well.

You can e-mail Dr Parihar with your query at the following e-mail addresses:

mangalparihar@parihar.net
mangalparihar@gmail.com

You can also e-mail Dr Ahuja with your questions:

divya@parihar.net

thanks kilo for ur kind reply!

[just_me]

Hello KiloKAHN! I have three questions about bowls used for pinsite care:

1. Where did you bought these bowls (Please click on the links under here and look at time 1:06) to your pinsite care?
https://www.youtube.com/watch?v=7QAF_S4aiQ8&list=PLH8Iv30ACLxWICA_RJxUFu8H14Xzoq3fi&index=5

2. What are these bowls called?

3. What are these bowls made of?

Thank you!

[KiloKAHN]

I'm not sure what they're made of or if they have any special name, but those are the cups and bowls used at the hospital for just about everything from eating, drinking, and storing sterilized gauze. You might be able to buy a few at the hospital to take with you to the hotel, but I just used the hotel room's water boiler to sterilize the water and poured it into a regular coffee cup.

[egocentrical]

How's the recovery?

[just_me]

KIloKAHN ! Did Doctor Parihar made a computerbased "Traumacad" of your legs from long x-rays both before your surgery and after you were finished with your lengthening and deformity corrections?
Please click this link to see an example of a "TraumaCad: http://www.voyanthealth.com/products.jsp - And when you come to the webpage click on the picture below the text "TraumaCad".
Thank you!

[KiloKAHN]

KIloKAHN ! Did Doctor Parihar made a computerbased "Traumacad" of your legs from long x-rays both before your surgery and after you were finished with your lengthening and deformity corrections?
Please click this link to see an example of a "TraumaCad: http://www.voyanthealth.com/products.jsp - And when you come to the webpage click on the picture below the text "TraumaCad".
Thank you!

He used some kind of software when making the measurements but I'm not sure what it was.

[KiloKAHN]

Update: 2/12/2015
Saw my local orthopedist again today after getting my x-rays done. The bone is healing very well and he made an appointment for me to come back in 4 weeks time to start dynamization - loosening of some of the pins on the frame to transfer more weight to the bone. He said from the x-rays it looks like I'll only have to wear these for another two months, and after frame removal he'll want me to wear some walking braces for an extra month or so for added protection. He also referred me for a consultation to a phsyiotherapy department. I have to call tomorrow and arrange my sessions. I'll be charged a co-pay at the beginning of each physiotherapy session, but the price is yet to be determined. It'll surely be less than the $80 co-pay I make when I get my x-rays and ortho appointment, however.

Last time I sent my x-rays to Dr Parihar he e-mailed me back saying that there were changes at the knee indicating that I haven't been doing enough exercises/weight bearing. I assumed that meant my knees looked like they've atrophied, but when I told my local ortho what Dr Parihar said, he showed me the x-rays and explained what Dr Parihar was talking about. Apparently if you don't do enough weight bearing for a while, your x-ray then starts to show small pockets in the bone where the color isn't as solid white, indicating that not enough pressure is being put on them. It's something to look out for when you get your x-rays.

My local ortho is fine with following Dr Parihar's recommendation as he's the one who performed the surgery on me, so before I allow any frame manipulation from the local ortho I'll wait for approval from Dr Parihar.

I've been doing a lot more standing since the last x-rays and now my feet can go completely neutral, although there is still a good amount of tightness in my left calf muscles which makes walking a bit painful and leaves me with swelling in the calves for a couple hours after doing so. I have to force myself to walk more and push through it though, especially since my ortho wants to start loosening the frames. I can lift both legs during leg raises and my right leg can go completely straight during leg extensions. The left leg is still lagging behind at halfway up, but I think it's due to the pain I still get below the knee on the left leg.

I'll post my x-rays after I receive them. I suspect it will be on Tuesday.

[Taller]

I am glad to read that you are progressing in your healing, Kilokahn.

Very recently in another thread, several forum members were stating that pretty much anyone can lengthen 5CM on their tibiae and still look completely normal, proportionally. Having lengthened a little over that amount yourself, do you personally agree with that sentiment? I read the comment in which you stated that your tibiae are the same length as those of your six foot friend, which made me wonder a bit more about the importance of proportionality after LL. What is your take on this?

Did Dr. Parihar let you know what kind of athletic recovery you could expect after lengthening 6CM on the tibiae?

[just_me]

@KiloKAHN, As I see it from your pictures of the devices then it was "Ortho-SUV Frames"
(http://www.rniito.org/download/ortho-suv-frame-eng.pdf) that Doctor Parihar used on your legs to correct your leg deformity. "Ortho-SUV Frame" is used with software - So it make sense to me that he used software to make some measurements with your devices.

[KiloKAHN]

I am glad to read that you are progressing in your healing, Kilokahn.

Very recently in another thread, several forum members were stating that pretty much anyone can lengthen 5CM on their tibiae and still look completely normal, proportionally. Having lengthened a little over that amount yourself, do you personally agree with that sentiment? I read the comment in which you stated that your tibiae are the same length as those of your six foot friend, which made me wonder a bit more about the importance of proportionality after LL. What is your take on this?

Did Dr. Parihar let you know what kind of athletic recovery you could expect after lengthening 6CM on the tibiae?

I think if you lengthen 5 cm you should still look okay, but when you hit 6 cm your tibs look a little long. 7 cm and above I think you can definitely tell that the tibias are longer than they should be in proportion to all your other limbs. I've already had comments from relatives telling me how long my legs look now. It shouldn't be at all noticeable in pants or even shorts unless you're sitting next to someone and they decide to scope your legs, though. The people who made comments already knew what I did which made it more noticeable. Because my doctor said 6 cm is usually when complications start to happen like bone misalignment, equinus, stiffness, etc, it's probably a good idea not to go beyond that.

He said I should make a complete recovery over time. The only instance he indicated where I might lose some athletic ability was when he said achilles tendon lengthening leads to a certain amount of weakness but wouldn't be significant enough to affect participation in recreational sports unless I wanted to be like Usain Bolt.

[KiloKAHN]

Latest X-Rays (2/12/2015)

[Taller]

Looks like you have some substantial callus. Congratulations!

[ForcedPuberty]

im jealous of your callous very nice

[Disobedient]

Update: 2/12/2015
Saw my local orthopedist again today after getting my x-rays done. The bone is healing very well and he made an appointment for me to come back in 4 weeks time to start dynamization - loosening of some of the pins on the frame to transfer more weight to the bone. He said from the x-rays it looks like I'll only have to wear these for another two months, and after frame removal he'll want me to wear some walking braces for an extra month or so for added protection. He also referred me for a consultation to a phsyiotherapy department. I have to call tomorrow and arrange my sessions. I'll be charged a co-pay at the beginning of each physiotherapy session, but the price is yet to be determined. It'll surely be less than the $80 co-pay I make when I get my x-rays and ortho appointment, however.

Last time I sent my x-rays to Dr Parihar he e-mailed me back saying that there were changes at the knee indicating that I haven't been doing enough exercises/weight bearing. I assumed that meant my knees looked like they've atrophied, but when I told my local ortho what Dr Parihar said, he showed me the x-rays and explained what Dr Parihar was talking about. Apparently if you don't do enough weight bearing for a while, your x-ray then starts to show small pockets in the bone where the color isn't as solid white, indicating that not enough pressure is being put on them. It's something to look out for when you get your x-rays.

My local ortho is fine with following Dr Parihar's recommendation as he's the one who performed the surgery on me, so before I allow any frame manipulation from the local ortho I'll wait for approval from Dr Parihar.

I've been doing a lot more standing since the last x-rays and now my feet can go completely neutral, although there is still a good amount of tightness in my left calf muscles which makes walking a bit painful and leaves me with swelling in the calves for a couple hours after doing so. I have to force myself to walk more and push through it though, especially since my ortho wants to start loosening the frames. I can lift both legs during leg raises and my right leg can go completely straight during leg extensions. The left leg is still lagging behind at halfway up, but I think it's due to the pain I still get below the knee on the left leg.

I'll post my x-rays after I receive them. I suspect it will be on Tuesday.

start dynamization after 4 weeks ...hmmm  .. are you worry that you may lose some mm during that .. I remember Dr naveen said once that you shouldn't lose any significant amount of your height gain if you would do so ( I think 2mm at top) , but like I still  sometime think that what caused my height loss , or maybe monorail is different case .. I don't know ..
 

[KiloKAHN]

Looks like you have some substantial callus. Congratulations!

im jealous of your callous very nice

Thanks. I was quite surprised at how much callus formed since the last x-ray. Hopefully it continues.

start dynamization after 4 weeks ...hmmm  .. are you worry that you may lose some mm during that .. I remember Dr naveen said once that you shouldn't lose any significant amount of your height gain if you would do so ( I think 2mm at top) , but like I still  sometime think that what caused my height loss , or maybe monorail is different case .. I don't know ..

That's something I've considered. I think you compress less if your callus is more developed once you start dynamization, but if it does compress I'm not really bothered by it. I lengthened 0.2 mm over my lengthening target so if it compresses 2 mm that will bring me right to 6 cm exactly. I've e-mailed Dr Parihar my latest x-rays and told him of my local ortho's plans to see if he agrees. If he suggests to wait longer before we dynamize the frames then I'll go along with his suggestion.

[LowerVilliers]

Hey KiloKhan

Regards to supplements, did you buy any vitamins or protein while in India?

[KiloKAHN]

Hey KiloKhan

Regards to supplements, did you buy any vitamins or protein while in India?

The doc prescribed Shelcal for calcium and vitamin D and Zevit for zinc. I got my proteins and other nutrients from ordering fish , mutton, chicken, mushrooms, and other veggies on the hotel menu. The supplements prescribed are very cheap at the hospital pharmacy, unlike the gauze.

[just_me]

@KiloKAHN, What kind of tests did you have to take at the hospital before your surgery? And what kind of questions did you have to answer and sign at the hospital before your surgery?

[KiloKAHN]

Update: 3/2/2015
Today I had my first session with the physiotherapist. The clinic was about 15 minutes from my office in a very nice medical center. Very thankful for the insurance my office currently provides. My physiotherapist is very friendly and he asked a lot of questions about the frames, what I'm able to do as far as walking and stretching, how long ago I got the surgery, etc. We chatted a bit about games and wrestling and I told him that I had had the surgery for cosmetic purposes because 1) I'm going to be seeing this guy a lot so no need to lie and 2) all my half-siblings are huge and I'd get a ton of crap from others when going out with them after they found out we were related (i.e. "Omg, what happened to you?"). He was cool about it and didn't criticize me for doing it. He's very tall and said himself that he's 6'5, so perhaps he understands the advantages that extra height provides. What was funny though is when I told him I wrestled in high school and college he said I should have taken down whoever gave me crap about my height with my wrestling moves.

Anyway, I had a belt wrapped around my torso and I wheeled onto this platform in between two bars that I had to grasp while standing up. He held onto the belt from behind to make sure I didn't fall down and had me walk forwards and backwards while grasping onto the bars for a while. He then brought out a walker and had me walk around the room. After doing all the walking he measured my ankle dorsiflexion, which I found out is -25 for both legs. A solid improvement from before as I can touch my heels to the ground (though with my body still slightly bent forward while walking even though standing against the wall I go completely neutral) but still requiring a lot more work. I was told that my equinus should lessen in severity even faster as I start walking more and that removing the frames would possibly help because I won't have wires sticking through me near my ankles. I was shown some exercises to reduce swelling in my feet after walking. There are more stretches he'll have me do once my frames are off but he said that the best thing I could do at this point is walk as much as possible. I will now have physiotherapy sessions once a week for the next few months, meaning they'll continue even after the frames are removed.

One other thing I got from this session is that I should probably invest in a walker that has wheels in the front. Mobility is so much easier with them than with the walkers that don't have wheels, especially in areas with heavy carpeting. I was actually quite surprised with how much my walking has improved within the last month. Looks like there's light at the end of the tunnel.

[KiloKAHN]

@KiloKAHN, What kind of tests did you have to take at the hospital before your surgery? And what kind of questions did you have to answer and sign at the hospital before your surgery?

I just had to get blood work done so Dr Parihar could go over the results. Aside from that, a series of measurements had to be taken. The forms you sign aren't atypical for this sort of thing. Just consent forms authorizing the hospital to perform surgery as well as a questionnaire about your medical history and allergies.