I chose the Solomin/Kulesh team in St. Petersburg for good reasons.
However, I do not think it is fair or accurate to discount every limb lengthening surgeon in India.
Limb lengthening is neither an easy nor a quick process.
Do real research, make an informed decision, and maintain realistic expectations.
Quote from: California2 on March 12, 2020, 08:31:24 PMI chose the Solomin/Kulesh team in St. Petersburg for good reasons.
However, I do not think it is fair or accurate to discount every limb lengthening surgeon in India.
Limb lengthening is neither an easy nor a quick process.
Do real research, make an informed decision, and maintain realistic expectations.
can you please explain this process of making a decision especially when you are in a different country?
doctor's education matters? see dr M. he produces one of the best results but his education is quite poor. he is not a MD. He went to schools which shut down due to malpractice. he has also had a history of tying up with old forum to get patients. even now he runs these cringey ads and promo tricks. But his results are excellent. i have yet to hear a single patient say anything bad about him. should one go to him inspite of his education background?
guichet on the other hand had excellent reputation and is known as a pioneer. But until one diary from that woman patient came out every one had thought he was a god.
seriously how can make a decision like this about a doctor for such a serious operation in a different country? in India there are a few docs like Suhas Shah who have great education, (trained with paley and catagni) but he has done horrible things to patients even crippling an international patient. there is also one Milind Chaudry who is again extremely well qualified to do LL but no one wrote any experience of him.
and consultations are not quite useful. unless the doc is really incompetent and stupid or careless ("you can lengthen 20cm no problems" type) you will never be able to weed them out. guichet offers a very sophisticated consultation. after consultation you would think nothing would ever go wrong under his care.
I don't know that there is much difference in selecting a surgeon based on the surgeon's qualifications whether the surgeon is next door or across the world.
When considering a surgical team that is geographically distant, you would naturally consider additional factors such as cost and logistics.
I addressed both of these concepts in prior posts. You are welcome to read through my prior posts if you think the information may be useful.
Quote from: California2 on March 13, 2020, 03:06:03 PMI don't know that there is much difference in selecting a surgeon based on the surgeon's qualifications whether the surgeon is next door or across the world.
When considering a surgical team that is geographically distant, you would naturally consider additional factors such as cost and logistics.
I addressed both of these concepts in prior posts. You are welcome to read through my prior posts if you think the information may be useful.
i went through your posts and found this
QuoteIn general, that the surgeon performs leg lengthening regularly (or exclusively); that is, that leg lengthening is a primary focus of the surgeon's practice. That the surgeon also conducts research regarding leg lengthening and is published (books or peer-reviewed articles). That the surgeon performs both medically necessary and elective leg lengthening. That the surgeon has no public record of discipline or gross malpractice and is regulated by a professional body. That the surgeon employs a team of qualified professionals. That the surgeon practices in a first world country with modern facilities.
my observations
1. medical qualifications are not in your list as per this post. someone who went to a bad uni, is not MD (MD requires u to be a better student than others like osteopathy) are not major reasons for you to drop a surgeon. ironically you have also praised dr Solomin for being an MD and phd holder and for having written an important book. pls note I'm not attacking you or anything. You have no obligation to respond or to back up each one of your previous posts, i Understand that. I'm just trying to understand how past patients chose their surgeons and why not other surgeons
2. India is a not a first world country. so I'm not sure why India can even be an option because its not a first world country (referring to your last line) any wrong choice made in India can be more dangerous than in europe or US.
As for what difference whether surgeon is next door or not? the difference is if the surgeon is next door but not super qualified but literally everyone in your neighbour hood has nice things to say about the surgeon then you can drop your qualification requirements
as for cost and logistics, they are very important but completely unrelated to surgeon quality . They are also very easy to evaluate unlike surgeon 
Thank you for finding my prior post. Near that post is another post with discussions amplifying my comments; however, I do not specifically recall what I wrote so I leave it to you to find and read those amplifying posts.
Reviewing my post regarding criteria for selecting an MD that you shared, those criteria still seem valid and appropriate to me.
Medical education is important; education creates a foundation for experience. However, once educated, experience becomes a far more important criteria in my opinion. That is, I would rather be defended for murder by a guy who went to night school and challenged the bar exam but won 100 murder trials than be defended by a Harvard valedictorian on his or her first murder trial.
Mohoubian is a more pertinent example. He is a DO rather than an MD; yet, he has significant experience in limb-lengthening. His experience should vastly override any concern about his education.
I did not choose a surgical team in India because, in part, India is not a first world country. However, one should not generally extrapolate to conclude that a quality limb-lengthening result is not possible in India. India has first-world surgical facilities and first-world surgical teams even though the country in general is not considered a first-world country.
If you want to rely on your neighbors' opinions regarding professionals in the neighborhood; then, you are free to do so. I am not a fan of testimonials unless I can support such testimonials by objective evidence.
I do not agree that costs and logistics are easy to evaluate. It is plain that using the MD next door is easy. It is far from clear how complicated using a geographically distant MD may or may not be.
Whichever path you choose, I wish you all the best.
So under an experienced and well qualified surgeon, LON might be a good choice for us who cant afford internals?
"LON" is a subset of external lengthening.
So, it is more correct to say that "external lengthening" is an option for folks (like me) who do not want to pay the cost for internal lengthening.
If you choose external lengthening; then, you also choose whether you will do: a) purely external lengthening; or b) lengthening over nails (LON); or, c) lengthening and then nailing (LATN).
Purely external lengthening remains the safest way to lengthen; however, it leaves you in frames for the longest time.
The frames serve two purposes: first the frames are the tool that pull apart the bones; second, the frames support your distracted bones until your bones heal enough to bear your weight.
LON and LATN significantly reduce the time in frames. In addition to frames, nails are inserted inside your bones. Once distraction is competed, the frames are removed. The nails hold your bones apart and can bear some weight until your bones heal enough to bear full weight.
If you want to do LON or LATN in connection with external lengthening; then, you will discuss with your surgical team which process is best for you. Via LON, the nail is inserted at the initial surgery. Via LATN, the nail is inserted when the frames are removed.
Internal lengthening does not use frames so you can look and be more 'normal' during the process; and, you can bear more weight earlier so recovery is generally faster but it can costs four times as much as external (depending on where you get external done).
Quote from: California2 on March 13, 2020, 09:25:18 PM"LON" is a subset of external lengthening.
So, it is more correct to say that "external lengthening" is an option for folks (like me) who do not want to pay the cost for internal lengthening.
If you choose external lengthening; then, you also choose whether you will do: a) purely external lengthening; or b) lengthening over nails (LON); or, c) lengthening and then nailing (LATN).
Purely external lengthening remains the safest way to lengthen; however, it leaves you in frames for the longest time.
The frames serve two purposes: first the frames are the tool that pull apart the bones; second, the frames support your distracted bones until your bones heal enough to bear your weight.
LON and LATN significantly reduce the time in frames. In addition to frames, nails are inserted inside your bones. Once distraction is competed, the frames are removed. The nails hold your bones apart and can bear some weight until your bones heal enough to bear full weight.
If you want to do LON or LATN in connection with external lengthening; then, you will discuss with your surgical team which process is best for you. Via LON, the nail is inserted at the initial surgery. Via LATN, the nail is inserted when the frames are removed.
Internal lengthening does not use frames so you can look and be more 'normal' during the process; and, you can bear more weight earlier so recovery is generally faster but it can costs four times as much as external (depending on where you get external done).
thank you for the information sir.
and yes i do know the differences between lon/latn and purely internal methods like precice and stryde.
the thing about lon that is appealing to me is, the external device stays on your leg only during the lengthening period. this is so good for me because, lets say i'm going to lengthen my femur by 8 cm, it will stay on my leg only for 80 days which i can bear.
and when the lengthening is finished, they remove the device and leave the nail inside so that your bones can consolidate. if i am not mistaken.
from my point of view i really really dont think it wouldnt be as successful as the pure internal methods, since i'm more interested in the outcome, rather than the process being comfortable.
just the infection risk that i'm aware of, around the pin sites. but that risk can be avoided if treated carefully.
these are my thoughts
Quote from: California2 on March 13, 2020, 04:26:36 PMThank you for finding my prior post. Near that post is another post with discussions amplifying my comments; however, I do not specifically recall what I wrote so I leave it to you to find and read those amplifying posts.
Reviewing my post regarding criteria for selecting an MD that you shared, those criteria still seem valid and appropriate to me.
Medical education is important; education creates a foundation for experience. However, once educated, experience becomes a far more important criteria in my opinion. That is, I would rather be defended for murder by a guy who went to night school and challenged the bar exam but won 100 murder trials than be defended by a Harvard valedictorian on his or her first murder trial.
Mohoubian is a more pertinent example. He is a DO rather than an MD; yet, he has significant experience in limb-lengthening. His experience should vastly override any concern about his education.
I did not choose a surgical team in India because, in part, India is not a first world country. However, one should not generally extrapolate to conclude that a quality limb-lengthening result is not possible in India. India has first-world surgical facilities and first-world surgical teams even though the country in general is not considered a first-world country.
If you want to rely on your neighbors' opinions regarding professionals in the neighborhood; then, you are free to do so. I am not a fan of testimonials unless I can support such testimonials by objective evidence.
I do not agree that costs and logistics are easy to evaluate. It is plain that using the MD next door is easy. It is far from clear how complicated using a geographically distant MD may or may not be.
Whichever path you choose, I wish you all the best.
Thanks for the thoughtful reply and addressing all my concerns.
asking neighbours is indeed not objective. but the only completely objective way is to find evidence of malpractice in public records. even dr Paley who is considered god like has these. dr M probably doesnt (couldn't find any). but more the surgeries a surgeon does, more the chances of something having gone wrong at some point
it's all the more hard to find these records in other countries. guichet probably has some in france but Ive not found any documents. betz, some patient had taken him to court once. in India, I dont think anything like this would even surface up. courts are not for normal people in developing countries like India.
there is at least one patient of dr rozbruch who claims he abandoned them after a surgery didnt go right and no doctor would taken them. there are some youtube videos on this. This seems to a strange problem in US. Surgeons abandoning their patients and other surgeons being hesitant to take up such cases.
other than that, diaries on the forum, google reviews and other website reviews can be easily faked or mis represented. that's why I felt a good surgeon would have good reputation locally and that could be a good way measuring his (or her) ability. please suggest any other objective ways (not counting educational, writing books, getting phd etc)
This is a very complicated problem to solve
Quote from: Fox on March 13, 2020, 11:03:16 PMthank you for the information sir.
and yes i do know the differences between lon/latn and purely internal methods like precice and stryde.
the thing about lon that is appealing to me is, the external device stays on your leg only during the lengthening period. this is so good for me because, lets say i'm going to lengthen my femur by 8 cm, it will stay on my leg only for 80 days which i can bear.
and when the lengthening is finished, they remove the device and leave the nail inside so that your bones can consolidate. if i am not mistaken.
from my point of view i really really dont think it wouldnt be as successful as the pure internal methods, since i'm more interested in the outcome, rather than the process being comfortable.
just the infection risk that i'm aware of, around the pin sites. but that risk can be avoided if treated carefully.
these are my thoughts
There is this device called salameh fix which is more conevenient to wear but it's not used by any other surgeon apart from dr Salameh. I have no idea about whether he is good or not. It just looks much cooler and socailly acceptable to wear salameh fix which is tiny than full external fixators.
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