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Posted on Sep 7, 2016, 5:17 am
#21

Thanks man. This looks like a valuable find, thanks for sharing it with the forum.

Luckily, this therapy is available in India/Delhi. Site: http://www.stemcellcure.in/

I reached out to them and explained my case. They've confirmed that they provide this procedure and asked me to provide latest X-ray to assess my case and suggest appropriate course of action.

I met Dr. Dhawan yesterday and asked him what his thoughts are about this procedure. He was totally against it and told me not to take short cuts.

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Posted on Sep 19, 2016, 10:13 am
#22

Status Update: Completed Lengthening and started consolidation.

Hi All

I haven't updated my diary in a while because I was going through some complications over the last couple of months. I was worried that I might say something in that emotional state, which I might not necessarily find true later. So I refrained from posting anything because I don't want to provide biased information or rant about doctors, which is not beneficial to anyone. I wanted to wait until the dust settles, look at the events objectively and provide my honest thoughts. I took note of critical events in a local diary so that I don't miss anything when I retrospect. For now, I just want to give a brief update as to how I'm doing now and what my next steps are.

As of now, all the complications are fixed and I stopped lengthening couple of weeks ago. I achieved 5 cm gain which puts me at 165 cm. I feel little sad that I didn't hit the sweet spot (6 cm) but I'm very happy otherwise because my complications are fixed and I'm ready to start the consolidation. I know 165 is still perceived as short by a lot of people but I have to respect the science of LL and biology of my body, and don't want to push too hard and end up causing irreparable damage. Moreover, I have a short torso, so lengthening any further would have taken a toll on my proportions. I'll provide a detailed post in coming days about what these complications were and the way they're dealt.

Even with just 5 cm lengthening, I have 1 inch ballerina. I'll be honest, I became little lethargic over the last few weeks and didn't exercise as much I used to. So I have to focus more and get this fixed.

Regarding consolidation, I was looking for any therapies that can speed up the bone growth. I got to know about Stem cell therapy (thanks to Oregonmade) and I researched about it. I have a consultation today with Dr. Ranyal to discuss about this. I'll update you more later today.

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Posted on Sep 19, 2016, 10:17 am
#23

2 inches is still a good gain with which you will have a great recovery. Congratulations.

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Posted on Sep 19, 2016, 10:38 am
#24

Thanks man. Yeah, I read many diaries that recommend almost full recovery at 2 inches. So I'm optimistic.

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Posted on Sep 19, 2016, 10:41 am
#25

Yup and TSF is very good, I am considering using that.

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Posted on Sep 19, 2016, 12:54 pm
#26

<WIP>

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Posted on Sep 19, 2016, 1:36 pm
#27

Consultation with Dr. Jaspal Singh Ranyal about Stem Cell Therapy
Profile:
https://www.practo.com/delhi/doctor/dr-jaspal-singh-ranyal-orthopedist?subscription_id=0

Services Offered:
General Orthopedics
PRP & Stem Cell Therapy
Prolotherapy

Address:
The Bone and Joint Clinic, G-44, Pushkar Enclave, Paschim Vihar, New Delhi, Delhi 110063

My consultation:
I called Dr. Ranyal last week to enquire about Stem cell therapy. I explained my case that I had limb lengthening surgery 5 months ago, and I'm looking for options to reduce my consolidation period. He told me to schedule an appointment. He said he cannot provide cost details over the phone as it's subjective, and he wants to examine my case in detail before commenting on options. So I scheduled an appointment for today, and visited his clinic. The consultation fee was 700 INR (11 USD).

Here is a gist of our conversation.

Me: Hello Dr. Ranyal.
Doc: Hello, Please come in.

Me: Should I pay the consultation fee at the reception ?
Doc: We can see that later, after consultation is over. Please come in.

I got my wheelchair, so I wheeled in. I didn't know that the clinic provides wheelchair. The clinic staff were kind and supportive. I told him that we talked over phone last week and he remembered me. He asked why I got LL surgery done at the age of 27. I just smiled and said my height was very short and I wanted to gain few inches. He didn't judge or pass on any comments/feedback.

Doc: Where did you get your surgery done ?
Me: In Gangaram Hospital, under Dr. Dhawan.

Doc: So you want to know if Stem cells can speed up your bone formation ? What do you know about stem cells ?
Me: I read some articles about Mesenchymal stem cells, which are taken from Iliac crest bone, that can help in healing bone fractures.

Doc: Let me explain in detail. There are three different types of stem cells available in the market.
1) Embryonic Stem Cells - Found in the mothers womb when the first zygote is formed.
2) Adult Stem Cells - Mesenchymal stem cells found in bone marrow or body fat. These are autologous, as in taken from the patients own body.
3) Umbilical cord - You know where these come from.

Each of the above stem cells have different characteristics. Let me explain them.
1) Embryonic stem cells have a tendency to multiply rapidly, and sometimes it becomes uncontrollable. So I don't recommend these to anyone, lets skip it.
2) Adult Stem Cells cells are the safest, but it requires a surgery to extract them, and the surgery can cost upto 2.5 lakhs (4000 USD), and you'll have to be hospitalized for couple of days.
3) Umbilical cord Stem cells are available from labs at the cost of 2000 INR per ml. I would need about 10ml per each leg, so the total cost will be 40,000 INR. These don't have antigens or antibodies, so there is no risk of body rejecting them. The only drawback of these stem cells is contamination, and inherent challenges. E.g. The lab may not have stored them in proper conditions which can contaminate the stem cells. When such cells are injected, it can lead to bone infection.


Me: (Interrupted him and asked) Do you think stem cells really speed up fracture healing ?
Doc: Stem cells help in accelerating bone formation. I have done it on other patients, but not on someone who had cosmetic limb lengthening, where the bone gap is so huge. So I cannot promise that you'll heal faster through stem cells. Did you ask Dr. Dhawan about his thoughts on stem cells ?

Me: Yes, I asked him but he didn't know much and he was totally against it. He was worried that I'm looking for shortcuts.
Doc: Yeah, Even I haven't done it on cosmetic patients. I have however done it on regular fractures and the results are quite good. I dealt with a case of minor fracture case which didn't heal since 3 months. I did Stem Cell Therapy along with PRP and he was able to get back to normal in 3-4 weeks. I'll give you his no. and you can talk to him.

Me: Okay sure. I read about PRP (Platelet Rich Plasma) as well, but I didn't knew it was that effective for bone healing.
Doc: Yeah, PRP works well too but not as effective as stem cells. PRP is also cheaper. For stem cells (Umbilical cord), the total cost would add up to 65,000 INR (1000 USD) where as for PRP the cost would be 40,000 INR (600 USD). PRP however is lot safer as the platelets are collected from your own blood, and there is no risk of bone infection.

Me: I want to take the safest route. My natural bone formation is also very good, so I don't want to take risks and want to tread cautiously.
Doc: Okay, sounds fair. So I've provided you with all the options, think about it and let me know how you want to proceed. Based on your psychology, I would suggest to go with PRP first. This is because we don't know if stem cells would work on you. So if you spend 2.5 lakhs (Adult stem cells) or 70K (Umbilical cord stem cells), and then if it doesn't work then you'll be terribly disappointed. So let's go with PRP first, look at the consolidation after 1.5 months and then see if we need a second PRP therapy or to go with stem cells.


We then talked about my personal life, and other stuff. He said that he used to Limb Lengthening back when he was in Libya. That was however on polio cases, which was pretty prevalent at that time in Libya . He told that he operated on lot of girls there who had crooked legs and leg deformities due to polio. He smiled saying that they used to come before marriage to get their legs straightened.  He then said I need to be positive and optimistic, and not to lose faith this will all be over soon and I'll start walking again.

My thoughts on consultation: I think it went well. I'm glad that he didn't sell it. He was honest that he didn't perform this therapy on cosmetic patients, and he didn't make magical promises that stem cells will magically fix my bone in 1-2 months. He gave me contact No. of another patient who has underdone this surgery, to get his feedback. The costing details for PRP or Stem cell procedure was reasonable. He was very attentive and patiently listened to all my queries. I'll meet other doctors and I'll wouldn't hesitate to go to him for PRP procedure.

Let me know if you have any questions.

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Posted on Sep 23, 2016, 11:16 am
#28

Hi fujitora,

i have been following this forum for about a month and untill now i tried to find the answers of my question from the posts. but i think i should ask you something about LL and bow legs correction.

Im 173cm and 73kg but my legs have been always thin and i have bow legs. so i have been considering about bow leg correction for a few years but i also read that its worth to get LL if i will have bowleg correction surgery anyway. so i thought it would be ofcourse great to gain a few extra inches...

My questions are,
1- Is it really worth LL+bowleg correction, or is only bowleg correction muuuuch easier?
2- Which methods can be used for LL+bowleg correction at the same time? is the only method classic ilizarov for it? or with LON method is it possible to do LL and bowleg correction at the same time?
3- I would like to gain 5-6 cm, and as i read your diary, it seems possible, but how long would it take to come back to normal life again. for example: walking without any support, riding a bicycle, swimming, dancing etc.
4- Would you get taller if you had just bowleg correction surgery? so as you wrote you gained 5 cm, but did you get it only from LL or did you gain any cm from bowleg correction as well?

i just want know your opinion and your answers about those questions..
thanks..

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Posted on Sep 24, 2016, 4:31 pm
#29

Hi Fritz

Happy to help. Here are my responses.


My questions are,
1- Is it really worth LL+bowleg correction, or is only bowleg correction muuuuch easier?
To answer if LL+bowleg correction is worth it, you have to take multiple factors into account - like your initial height, extent of height neurosis, amount of time you have, affordability, type of social life you have. I was very short (at 160 cm) and I have height neurosis, had 1 year time for this procedure, and not so active social life apart from my family. So I see so much value in it.

I don't think bow leg is easier than LL. In either cases, your tibia is broken. You go through almost same level of trauma albeit for less duration in case of bowleg correction. Bow leg correction is usually on one leg at a time, and required 3 months per leg with 1 month gap (so total of 7 months). You can insist the doctor on doing both the legs at once, in which case it would be over in 3-4 months. Also, the external fixator that Parihar uses for bowleg is much smaller and very convenient as compared to standard Illizarov. So you can say bow leg correction is more convenient than LL. However, I only felt inconvenience only for 1st two months during LL. Then your body gets used to it and time runs faster. I can't believe that I'm already 6 months past my surgery. Time really flies Bilateral Tibia Lengthening and Varus correction with TSF Anyways, I'm giving you the facts and my experiences to help you make the right choice. So if you have time, then LL is not difficult as compared to bowleg correction, but inconvenient for sure.

Only last thing that to consider is full recovery. During LL, your legs are not as active as they normally are. So you don't perform all the leg movements that you used to perform when you're normal. Your muscles forget those movements when you don't perform them for long time (like 6-12 months). It takes effort, persistence and dedication to train them and get back to normal, but it's not very easy. So if you want full recovery, I suggest you do only bow leg correction because you'll be in that dormant state only for 3-4 months, so your chances of becoming normal again are higher and faster.


2- Which methods can be used for LL+bowleg correction at the same time? is the only method classic Illizarov for it? or with LON method is it possible to do LL and bowleg correction at the same time?
TSF, in my opinion, is the best for LL+Bowleg correction. It's full weight bearing, and very convenient with just 2 rings. Full weight bearing is very beneficial - it allows you to walk with full weight on your legs, even during lengthening phase. This is very helpful to fight ballerina and callus formation. TSF is a bit expensive, around 15k with Dr. Dhawan. So if money is a concern, you can go with standard Illizarov frames where bow leg correction is done post lengthening using Hexapod struts. Dhawan doesn't do Hexapod anymore (just FYI), he only prefers TSF and I totally see why he made that choice.

LON is not possible if you have bow leg, because it's not possible to put in a nail. To put it simply, you cannot put a "straight nail" in "bent legs". However, it also depends on the extent of bowlegs. If you have very mild bow leg, then I think LON is possible. If you're worried about wearing frames during consolidation, you can choose to get plating surgery post lengthening but most doctors are against it (even Dhawan) because it's not considered as stable and sturdy as nail fixation. I've recently been reading about stem cell therapy to speed up bone consolidation, but there is no concrete evidence so far. But if it works, then I would think that's a much better option to go as compared to Nailing or Plating.

3- I would like to gain 5-6 cm, and as i read your diary, it seems possible, but how long would it take to come back to normal life again. for example: walking without any support, riding a bicycle, swimming, dancing etc.
I cannot answer this question correctly because I'm not back to my normal life yet. But, I'm in touch with Phoenix and based on his recovery you can start walking without support with in 9 months. Note, he was able to walk with out support but he still had frames on. His frames got off after 1 year, and he was able to go back to his normal life. You'll be able to walk but you'd have very difficulty in jumping, running or dancing. You wont have your previous strength in your legs, it can take up to 1.5-2 years or even more to be honest, to run/jump/dance.

4- Would you get taller if you had just bowleg correction surgery? so as you wrote you gained 5 cm, but did you get it only from LL or did you gain any cm from bowleg correction as well?
I don't know. Please ask "varusilizarov" - he has done only bowleg correction. He might be able to provide accurate answer. But logically speaking, yeah I think you would gain some height with bow leg correction and the amount you gain would depend on the extent of bowleggedness (I just made up that word Bilateral Tibia Lengthening and Varus correction with TSF). The more bent they are, the more you'd gain.

I hope I answered your questions. Let me know if you need any more info.

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Posted on Sep 25, 2016, 5:10 pm
#30

Hi fujitora ,

first of all thanks a lot for your detailed answers!

As i understood, it takes about min 3-4 months even if i have only bowleg correction but healing time will be shorter shorter than LL.
I live and work in Germany but im from Turkey. So if i compare the prices, LL is much cheaper in Turkey. So i was thinking of having bowleg correction (even maybe with LL) in Turkey and then come back to Germany and normal life(working etc). In this forum i found Muharrem Inan; who does LL in Istanbul and he uses classic ilizarov and LON..LON seemed to me better(i might be wrong though), thats why i asked about LON method..

Actually there no huge difference between 4 months and 6 months for me. Also for me the most important part is, when i can begin to work again, walk without support and when i wont need any physiotherapy?... Because when i come back to germany i dont want to visit any physiotherapist. I just want to walk without any support and to be able to work... (doing sports, jumping, dancing etc are important too, but for them i can wait 1-2 years). For example, you said 3-4 months for bowlegs if they are done at the same time... so after 3-4 month wont i need any physiotherapy anymore? or 3-4 months + phsysiotherapy?

and another part which i couldnt understand very well, do you mean that i cannot jump, dance etc anymore like before the surgery if i get LL? or do you mean that, i can jump, do any sports after LL like before the surgery, but it may take 1,5-2 years? 

I know i should  ask the doctor these questions but i dont wanna go to doctor without any idea Bilateral Tibia Lengthening and Varus correction with TSF

Thanks again for your answers
and Good luck! Bilateral Tibia Lengthening and Varus correction with TSF

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