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Posted on Jul 8, 2014, 5:45 am
#111
Thank you for the fantastic dairy! These are definitely some great pictures you took No More Mal-Kahn-Tent - External Tibias - Dr Parihar The beginning two weeks are very painful. I hope you are feeling better now. In terms of the crust you see around the pin site, don't worry, they are normal. If the discharge is yellow and clear then it's just regular bone discharge. However, if the color gets opaque and you are in pain then it's infection. For me, I on purposely leave these dried discharge on my pin site, they seem to help stabilizing the wound to the pin and cause less pain from movements.
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Posted on Jul 8, 2014, 5:51 pm
#112
kilo... do you have an email for dr shah??? i have to get release for my equinus
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Posted on Jul 9, 2014, 3:36 pm
#113
How is the air quality like there?
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Posted on Jul 9, 2014, 7:51 pm
#114
Is that weight of muscle or fat?
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Posted on Jul 10, 2014, 12:34 am
#115
Lol i thought i was fat. i guess i don't have to tighten up anymore then. Pizza order incoming..
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Posted on Jul 10, 2014, 9:16 am
#116
Quote from: Blackhawk on July 08, 2014, 12:50:47 AMThat's a lot of weight for someone your height!  I am about 167 and my highest weight when I worked out a lot was about 85kgs.

Do you think you might have too much muscle and resistance to lengthening on your legs?  I remember reading captain Americas diary and he had a lot of muscle and he had problems.  But maybe Sarins frames were just weaker.

I'll have to ask Dr Parihar tomorrow about whether or not he'll think muscle resistance will end up a problem for me later down the line. As of now I haven't noticed any particular tightness or resistance to the turning. Fortunately my frames aren't bending like Captain America's did, though it's because exfix only frames are more sturdy and full of more components than frames you wear for LON.

Quote from: BilateralDamage on July 08, 2014, 04:03:05 AMSo glad to hear you're doing well Khan.  The nights get lonely, I definitely know this, but once you start standing next to people and realizing you're almost average height, it makes it all worth it.  Stay strong!

Btw, I envy your starting weight.  You're built like a brick man!  You're going to look great post lengthening.  No More Mal-Kahn-Tent - External Tibias - Dr Parihar

Yeah, one of the downsides of doing lengthening here is that not only am I the first international cosmetic patient (Dr Parihar has done 10 cosmetic cases all for locals), but nobody in this hotel is international. Actually since I've been here I'm the only Westerner I've seen. I saw one guy from Africa and a Chinese family at the Foreigner registration office and that's it. Not quite used to Indian cuisine either so there's that hurdle.

Hah, well my build definitely helped when I was on the wrestling team. I was often wrestling people much taller than me as nobody my height was close to my weight. It was awkward for them and it resulted in a lot of wins for me. No More Mal-Kahn-Tent - External Tibias - Dr Parihar

Quote from: Classical on July 08, 2014, 05:45:37 AMThank you for the fantastic dairy! These are definitely some great pictures you took No More Mal-Kahn-Tent - External Tibias - Dr Parihar The beginning two weeks are very painful. I hope you are feeling better now. In terms of the crust you see around the pin site, don't worry, they are normal. If the discharge is yellow and clear then it's just regular bone discharge. However, if the color gets opaque and you are in pain then it's infection. For me, I on purposely leave these dried discharge on my pin site, they seem to help stabilizing the wound to the pin and cause less pain from movements.

Yeah the first two weeks seem like they'll have been the worst. I'm just over that and despite continuing distraction the pain has lessened with more physiotherapy and increased standing. From what both you and Dr Divya described about infections, I think I have an infected pin near my ankle. I'm going to check on it tomorrow and see if I can get antibiotics for it. By the way, do you change your dressings every single day? I change them each day and clean them by soaking sterile gauze in boiled water. Is that the same procedure you were given for cleaning the pins?

Quote from: yugiohja on July 09, 2014, 03:36:15 PMHow is the air quality like there?

Air quality is similar to what I'm used to, though I lived in downtown Los Angeles so I guess I'm used to bad air. It seems clean enough, but there are definitely areas of Mumbai where you just get this sewage smell that's not at all pleasant. I've found that Mumbai is very similar to Shanghai in a lot of ways.

Quote from: KirP1 on July 09, 2014, 07:51:51 PMIs that weight of muscle or fat?
Well when I was at my peak level of fitness on my university's wrestling team, I weighed 84 kg (185 lbs) and had very little body fat. I've done weight training for mass gain since the age of 13 so most of that weight was made up in solid muscle. However, after two years of being forced at a desk job for 10 hour days and slowed metabolism, I packed on the fat. Pretty much all of it was concentrated on my abdomen. Judging from my wrestling team body weight and level of fitness, I would guess that I have around 30 lbs of fat that I could stand to lose.
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Posted on Jul 10, 2014, 9:56 am
#117
Nice diary KK, i think you have chosen the best doc for this procedure in India. From looking at your pic i think you could go down near 80 kilos. Man Indians are "funny".
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Posted on Jul 13, 2014, 5:22 pm
#118
Update: 7/13/2014
The other day I went to see Dr Parihar. For some reason I was out of breath every few steps on the walker and I had to rest for a bit. It was very odd because each day before I had no breathlessness. Getting on the auto rickshaw was a pain and it took me probably ten minutes to walk to the ATM. It was raining outside and one of the hotel staff had to cover me with an umbrella. I arrived at Mangal Anand Hospital and had to wait downstairs a bit for the x-ray guy to arrive and get the updated x-rays of my legs. After that I went to the second floor and walked slowly and out of breath toward Dr Parihar's office. He was standing at the end of the room with a concerned look and asked me how long I had this issue. He had me get a chest x-ray immediately after moving me to a wheelchair, but fortunately there was nothing wrong with my lungs. He supposed that my tiredness was due to putting too much weight on my arms while moving with the walker and not enough on my legs.

I was led into one of the doctor's offices and had my osteotomy staples removed. They were taken out with pliers but I hardly felt it at all. Dr Divya then changed all my pin sites and looked at the ones I thought were infected, but he and Dr Parihar both said it was normal discharge. A few of the wires near the knee and ankle have larger holes surrounding them than the others, which was done intentionally by Dr Parihar. He cut the skin around them because there's naturally more movement in those areas and doing so would reduce pain and skin tearing. The issue with this is that more discharge tends to get stuck in those areas and I have to work harder to clean them.

You can see in the photos below that the fibula osteotomy is a lot larger than the tibia osteotomy. Dr Divya told me the reason it's much longer is because there's a blood vessel right behind it as well as muscle blocking the bone. They don't do a fibula osteotomy similar in size to the tibia osteotomy because the smaller it is the more blind the surgeon is getting to the fibula and the risk of damaging something is further increased. The tibia osteotomy can be very small because the bone is right underneath so there's no real risk involved.

I was given antibiotics and more pain medication. I had to pay for them so any further medication you get is not covered by the original surgery cost. You also have to pay for your own dressings, which are 500 INR per box.

I had to have a physiotherapy session downstairs after seeing the doctors and this time I had to do 15 reps on all the exercises. I was also given new exercises for arm strength in addition to breathing exercises.

The last couple days have been very uncomfortable and I've had a hell of a time trying to get to sleep due to discomfort from the pin sites. Dr Divya said he'll get me some sleeping medication to help with it.

Photos
 No More Mal-Kahn-Tent - External Tibias - Dr Parihar No More Mal-Kahn-Tent - External Tibias - Dr Parihar No More Mal-Kahn-Tent - External Tibias - Dr Parihar No More Mal-Kahn-Tent - External Tibias - Dr Parihar No More Mal-Kahn-Tent - External Tibias - Dr Parihar No More Mal-Kahn-Tent - External Tibias - Dr Parihar
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Posted on Jul 16, 2014, 2:00 am
#119
Hi Kilo, glad that you didn't get pin infection! I don't dress my pin site everyday. It's either every other day, or every three days. What I do is I use iodine swaps to clean the sites. After letting them dry for 5-10 mins, then I wrap them tightly with gauze.

Looking at your picture of the fibula scar, woo, they do look quite long. I am looking at mine now. Yes, mine is also longer than the tibia scar, but not by much. Also, it seems quite interesting that doctors in India like to use surgical staples to close scars. Mine is done with surgical glue.

Have tried to take Melatonin to go to sleep? For me, that world even better than sleeping pills, plus it doesn't have much side effect. I usually take 10gm. Hope you feel better!
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Posted on Jul 16, 2014, 3:05 pm
#120
Responding to ShortyMcShort's question from Dr Dhawan's page:

Quote from: ShortyMcShort on July 15, 2014, 12:04:45 AMI read your other posts Kilo and Im not sure if it was you or another poster who said add another $15,000 or so for accommodation, food, physio and etc. So another $15,000 and its at $25k, and it could even reach $30k. My question is why did you choose going to India  with Dr Parihar over say Dr Birkholtz in South Africa who has a package for $30k externals and $35k for LON/LATN, yes I understand Dr B is still more expensive, but no hassle of having to find accommodation and etc. And the hospital and accommodation seems really nice in South Africe(based on the pictures of course) and clean, which is the complete opposite of India

Genuine question by the way, not trying to discourage you or anything like that and I hope it doesnt sound that way. Very curious about your journey as it could help me to decide on my decision soon when Im ready. Thanks

With Dr Parihar I think everything will total around $25,000 USD maybe a little extra. For Dr Dhawan it might be closer to $15,000 + depending on the hotel you stay in (generally cheaper in Delhi than Mumbai) and how lucky you are with finding cheap flights. You might save even more with Dr Dhawan if you can arrange a flat and a caretaker.

One of the reasons I chose India was because I have a little extra security over here. I have family with a lot of personal connections in India and valid visa status, so should anything go wrong I could have some trusted people come to assist me at quick notice. Finding accommodation here wasn't really difficult. It could be if I wanted a flat or apartment in Mumbai, but I preferred to stay at a hotel anyway because the hotel staff takes care of so many things that there's no real need for a caretaker. Plus it's just way more comfortable, so I don't mind spending the extra money. The hospitals themselves may not be fancy but they have what you need for the surgery and the brief stay at the hospital. I wasn't able to be all that mobile so even if the hospitals were fancy I don't think I could have made much use of it. Being seen by a doctor who was trained and recommended by Dr Paley but also in my price range was a huge plus as well. Dr Parihar is very active in workshops teaching Ilizarov and is probably the most famous Ilizarov surgeon in the country. If you look online he's attended a lot of ASAMI conferences that Dr Paley, Dr Guichet, and others have attended too. So there's that extra layer of confidence that my surgery was done well.


Quote from: Classical on July 16, 2014, 02:00:12 AMHi Kilo, glad that you didn't get pin infection! I don't dress my pin site everyday. It's either every other day, or every three days. What I do is I use iodine swaps to clean the sites. After letting them dry for 5-10 mins, then I wrap them tightly with gauze.

Looking at your picture of the fibula scar, woo, they do look quite long. I am looking at mine now. Yes, mine is also longer than the tibia scar, but not by much. Also, it seems quite interesting that doctors in India like to use surgical staples to close scars. Mine is done with surgical glue.

Have tried to take Melatonin to go to sleep? For me, that world even better than sleeping pills, plus it doesn't have much side effect. I usually take 10gm. Hope you feel better!

I slept so hard with the sleeping pills I took the night before that I slept all throughout the day and didn't change my dressings. I was worried a bit but reading that you do yours every other day or every three days is comforting as you don't have any pin site infection issues. Yeah the staples were fun to look at. It made me think I was put together like a Frankenstein creature lol. I'm feeling better now but I've got a lot of sensitivity on the osteotomy site on my right leg and on the back of my left calf muscle.
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