Calic - External Tibias - Dr. Sarin - 2013 - My LL Experience

Since my diary on old forum  seems to be gone and I got myself banned I will continue my diary here since I think there is still a lot of interest in how things are post LL. My experience with Dr. Sarin was positive with little pain and no major complications. Sweden has done an excellent job with his post-LL updating so I will try to do the same. I am still at the guest house for another month since I decided to stay longer to recover more.

Zip of my old forum  dairy in HTML format
https://docs.google.com/uc?export=download&id=0Bx9uEct5EovhTDlxenBHNGQ2aUU

Here is a quick summary:

Info about me
From: USA
Age: 24
Armspan: 180 cm (5’11”)
Sitting height: 90 cm (35.5”)
Weight before LL: 73 kg (160 pounds)
Pants: 30”x30”
Height before LL: 170.8 cm (5’7.3”)
Height after LL: 178.4 cm (5’10.25”)
Lengthened amount: 6.5 cm (2.56”)

I found this a bit odd. I am guessing the additional height is due to spine decompression from being in bed for so long every day at the guest house.

Frames were put on 4/19/2013
I had two minor pin site infections.
I had numbness in a part of right leg and could not move my big toe and had difficulty moving my small toes so Dr. Sarin had me stop at 6.5 cm instead of 7 cm.

Frame removal on 7/26/2013
After frame removal I weighed 57 kg (125 pounds) and had about 5 cm (2”) of ballerina foot as well as some knee bending in my left knee.
I started standing 3 weeks after frame removal, walking using a walker with wheels at about 4 weeks, crutches at 5 weeks, hand crutches at 6 weeks, and at 7 weeks I could walk unassisted slowly and painfully with shoes on.

Right now I am 61 kg (134 pounds) and my ankles have a little bit above 90° range of motion.

Hospital video


Lengthening video


Walking upstairs is easy but going downstairs is quite difficult. I lack the ankle range of motion and thigh strength to walk smoothly.


Walking barefoot feels okay and walking with shoes is easier with the slight lift of the heel.


Guest house
The living conditions at the guest house are all still good. I am satisfied with the food, power, Internet, and having concerns addressed. Aftercare has significantly improved from a couple of months ago.

Current status
It takes a couple of minutes to get my feet flat in the morning or after not standing for a while. I can walk long distances unassisted upstairs or on a flat surface but I do not walk completely normal. Walking downstairs unassisted is still quite difficult. Right now I am focusing on exercises to build size and strength of thighs and gain further range of motion of my ankles.

X-ray from August 17th, 3 weeks after frame removal. The lengthening estimate on the gap is wrong, I did 6.5 cm


X-ray taken September 16th, 7 weeks after frame removal.


Proportions photos – I feel my torso looks a bit short but other than that I am happy with how I look. Tibia looks like it is about equal in length to femur so it is at the limit between looking normal and not normal. I am happy with how my tibia and femur look so stopping at 6.5 cm was just right.












Photos of scars – Tibia and Fibula osteotomy sites look good. My Tibia osteotomy site is 2 lines and Dr. Sarin told me if he did not do the C shaped cut because it might have splintered my whole tibia bone. The inner knee, middle pin site, and IM nail insertion scars look the worst. My IM nail insertion scar developed into a keloid so it looks extra bad – I see other patients with scars that look much better.






To the nked eye my alignment looks okay; my legs are straight as they should be.


Thoughts on a 2nd Surgery

I have mixed feelings about doing a 2nd surgery for an additional 4 cm. Some tell me to just go for the height if it means something to me and the amount I want is reasonable and is not going to be enough to matter and many others say I should not bother and I would be stretching my currently good proportions to the limit and be risking disproportion.

My gut feeling is to not do it. I think the sacrifice in proportion would not be worth the additional gain in height. Everyone says I look good as is, my tibias look good in relation to my femurs, and 5’10” is a good height. Personally I think my tibias look a bit longer than I would like but I think I still have a lot more muscle to build back before I can accurately judge. I still probably would have lengthened to 7 cm if I was able to. My tibias are longer than everyone else’s at the guest house who was near my starting height and I still think they look okay so I would recommend others to lengthen between 6 and 7 cm and not be worried. Perhaps later in my life I could top off my femurs with an additional 2.5 to 4 cm to even out my tibia and femur proportion and gain a tiny bit of height.

I am open to any questions or requests for photos or videos.

Wow. That is awesome. You look great. You dont need a second procedure.

Tell us about how it was working with Dr Sarin. I think many here would appreciate an honest assessment from a guy who got a real surgery with him.

Was the guest house clean ? Were the staff responsive? Tell all!!!! 

Your proportions look good as they are.  If you feel comfortable with this height, there's no real need to go for 2nd Surgery.  But if you do continue, you should do at least 5cm or it may not be worth the expenses and time.

Btw,  don't do external on Femurs.  Results of patients who did that is not good and it's alot of pain.

Speaking of that, how would you describe the level of pain you had?  When do you expect to be walking without crutches?

That's amazing. Walking unaided already and heels to the ground. I can't barely still do that when I wake up.

You think your tibias look longer bc your used to your old ones. It took me a couple of months to not think like that.

If you're going to do your femurs then at least do minimum 4,5cm.

@TomD
I feel Dr. Sarin should spend more time with patients. I am sure a lot of the time problems are not severe but he should spend a bit more time explaining things and make patients feel like they are cared for. He almost always answers his phone and will be here if you have a problem you really think needs to be checked out right away. All of the patients here currently are doing okay and have no major problems.

The guest house is clean and the staff are responsive. Bed sheets are changed regularly, floors are swept and cleaned, pee bottles and trash emptied, and food trays removed.

The caretakers live here and have cell phones you can call to request anything you need done - being moved up and down stairs, laundry, retrieve items from the fridge, clean up messes, buy stuff from the market, or whatever.

@Carter
I would definitely do internals if I choose to do femurs. I am pretty worried about proportions so I will need to wait until I get my muscle back and do some mockups before I feel comfortable doing 5 cm more.

My level my pain was low throughout the whole process, I almost never took any painkillers. Physio, pin site infections, and moving around after 1st surgery did cause me substantial temporary pain though.

I no longer use crutches.

@Sweden
I am sure I will get used to them soon. I often wonder how much I could have lengthened and still been okay. My tibias are longer than everyone else's at the guest house so that had me scared to not lengthen too much.

Quote from: Sweden on October 06, 2013, 09:16:53 PMThat's amazing. Walking unaided already and heels to the ground. I can't barely still do that when I wake up.

You think your tibias look longer bc your used to your old ones. It took me a couple of months to not think like that.

If you're going to do your femurs then at least do minimum 4,5cm.

Hey Sweden.

I hope the ballerina is getting better. We are all rooting for you. I miss your Hockey mask photos lol

Quote from: Calic on October 06, 2013, 09:43:47 PM@TomD
I feel Dr. Sarin should spend more time with patients. I am sure a lot of the time problems are not severe but he should spend a bit more time explaining things and make patients feel like they are cared for. He almost always answers his phone and will be here if you have a problem you really think needs to be checked out right away. All of the patients here currently are doing okay and have no major problems.

The guest house is clean and the staff are responsive. Bed sheets are changed regularly, floors are swept and cleaned, pee bottles and trash emptied, and food trays removed.

The caretakers live here and have cell phones you can call to request anything you need done - being moved up and down stairs, laundry, retrieve items from the fridge, clean up messes, buy stuff from the market, or whatever.

That is good to know. So we can feel secure that the facility is good. If I am reading you right, Dr Sarin's 'bedside manor' needs improvement.

I want to try to confirm and dispel as much gossip as I can about Sarin. I know your story is only 1 guys opinion but its a first hand opinion. 

Did he seem like he cared about you? Did he ignore your concerns like you were an idiot?

Did Dr Sarin try to up-sell you? With hold or try to charge for pain killers or other meds? Would he refuse x-rays as nonsense even though you were very concerned? If there was a complication, was he willing to fix it for free or did he try to haggle?



p.s. Did you meet Sysop in India ? If so PM me please.

@TomD

I felt Dr. Sarin genuinely cared for me, he would always answer my calls or text messages right away or within a day. He never ignored any of my concerns but I never had any major concerns come up during my lengthening.

Dr. Sarin did not try to up-sell me anything and he stayed true to the package price including everything you need while staying here including fixing complications. Pain killers and meds are always available free to anyone who needs them. I do not think he refused x-rays to me or anyone and everyone goes for x-rays every 3 or 4 weeks anyway. Perhaps if you wanted more frequent x-rays you would need to convince him of a reason why.

Dr. Sarin fixed complications for patients for free without any haggling, I have seen many patients go to the hospital again for frame or pin adjustments or other issues with no trouble.

I did meet Sysop for about 5 minutes when he came to my room but I did not know at the time he was Apotheosis.

Calic

Did the staff give you any special cream for your scars? They dont look bad at all . I have seen others who fade to the point where you would have to be looking at it to see it.

Are you still at the guest house?

Thanks, I still think the scars don't look so good right now though. I have not been given any cream or anything for the scars and I have not done anything personally to try to improve them. With enough time they will fade and with the hair on my legs they probably will not be noticeable and I will not care. I might have the keloid scars cosmetically fixed up after I get my IM rods removed.

I am still at the guest house and will be here until the end of the month.