Surgery Type: External Tibias with TSF Frames
Doctor: Dr. Manish Dhawan
Location: New Delhi, INDIA
Diagnosis: Bow leg Correction and Limb Lengthening
Age: 29 yrs
Pre-Op height: 165 cms (Night) , 167 cms (Morning)
Target height: +5cms
Cost Of Surgery: Rs 9.5 Lakhs / $15000 (approx) (For surgery and stay in hospital for a week)
Date of Surgery: April 16th 2015
Distraction Start Date: April 26th 2015
Special Thanks to itzRammi for the tremendous support during this crucial phase of my life.
Also, I want to thank KiloKhan for his diary, which helped me in choosing the doctor, and giving me the confidence that India is a good destination for LL.
Finally I want to thank the Admin and creator of this forum for giving me a platform to share my experiences and get help in turn.
Phoenix.. Rising !! External Tibias with TSF Frames @ Dr. Dhawan, New Delhi
From my childhood, I knew there is something wrong with my legs. I always wondered why my knees don’t touch each other, like many of my friends’. When I grew up, I came to know they are called bowlegs, and studying about it a bit more, I could now understand the reason for all the leg pain I have every night, knee pains if I walk a lot, why I couldn’t do skating for long when all my friends were doing it easily, and why my friends used to comment on my crooked walk.
After doing a lot of study, I went to a local doctor to determine if my bowlegs are severe, and if there is any other way of correction. He confirmed my doubt that my legs are a bit crooked, and I will need a correction surgery, and as I don’t really have any big immediate problems with my knees, I could delay the surgery, but ultimately that might lead to knee replacement surgery or other issues if untreated. So, I decided to go ahead with the bowleg correction surgery before my knee turns completely useless.
If I go with bowleg correction, generally it is done one leg at a time; 3 months for each leg, and a month break in between. So, It will be 7 months all together and I will be partially crippled most of the time. And I am sure I will not go out and work, or be active in that period, with a frame on my leg. I was not really ready to go through all that hell of breaking leg and all, just to get straight legs.
I figured, the better way is to do two legs at the same time, and also lengthen 4 to 5 cms in the same 7 to 8 months. This way I have some kind of incentive to go through this procedure, and still be happy at the end for doing it.
From the time I have mentally decided to do CLL, my life is on hold. Every decision I take, every path I go is affected by a possible future LL. I cannot reveal my personal matters, but my decision to do LL will also decide my complete future, whether or not I will have my life as I planned from long back, or possibly go back to square one, which I have to rebuild. This made my decision more difficult.
But I ultimately decided it is now or never, and started to wait for the right moment. From a couple of years I was tied down due to family commitments and my own inability to take a firm stand. A point came, when the frustration peaked, and in a moments decision I just left the job, booked the tickets, and I was at the doorstep of my parents’ home. Yea, they were surprised and happy to find me there. My friends too liked the surprise. Then came the question from every one.. “WHY?” For which I don’t have any answer.
I just got rid of my professional life commitments, but it’s hard to put my personal life on hold. I knew that, so I wanted to make sure none of my personal life needs me during my CLL hibernation. I was not going to tell about my CLL to anyone. So, I waited, just waited for a month at my parents’ doing all the stuff, tying loose ends, planning my CLL, working on the possible doctors, devising strategies to hide my career break from others, and make it as convincing as possible. Once I am sure my personal life will wait for me for a year, then it started.. My LL Journey.
I took off to Mumbai on March 14th. Felt a bit emotional when I was leaving my parents. I used AirBnb to find an accommodation, when I went to the apartment, it was on 3rd floor, and no lift. I had 2 big Bags; I had to carry them upstairs. That was when I realized, how crowded Mumbai is, and how small the apartments are. Apartment was good though.
As it was not really planned ahead, I did not take Dr. Parihar’s appointment. So, next day early morning, I went to the hospital directly. I came to know he comes only in the evening, and the next day he is going out of country for a week. It happens to me all the time, I am generally lazy, so I am used to such last minute surprises. I did what I do best, knocked all the possible doors and managed to get an appointment same day evening.
Evening, I waited outside, and initially I was called into Dr. Divya’s cabin. He was a nice guy. I told him about my bow leg, and why I need CLL. He tried to correct me saying bow leg correction and CLL are two different things. I said I know, and I came here to know the extent of my defect and if surgery is the only alternative. If so, I am ready for it, If not, I am OK to think about the alternatives too.
He checked my legs, tapped them on the knees and around, to see extent of existing damage, then asked me to walk across the room, to see if it is crooked, then requested me to take few X-Rays.
I went downstairs to get the X-Rays, this is the first time in my life I ever got an X-Ray, and he took not one, but in 5 or 6 different positions (My legs and knees in multiple positions). After that, I waited, they called me in again, but this time into DR. Parihar’s cabin. Dr. Parihar was sitting in the chair, and he offered me a patient chair. Sitting before him, I realized, he was towering over me, he should be really tall. He again asked me everything and I repeated what ever I told Dr. Divya. Dr. Parihar had a soft copy of my X-Rays on his computer. He looked at them, and confirmed I have Bowlegs, but he was pointing to the fact that both my legs are not equally deformed. My left leg has 8 degree curvature, and my right leg has 5 degrees. That explains the fact that I have more pain in right leg than the left, may be because I tend to put all my weight on my right leg when I stand, due to its lesser deformity.
Ultimately, he suggested me to go through the surgery, but he didn’t give me a deadline. He asked me to do it when I am ready, and only after I tell my parents about it, as he explained, LL is not a very easy journey, and we need loved ones through ups and downs.
I was already decided not to tell my parents or any others about my LL, and want to do it alone, so I didn’t ask him if he will allow me to still do it without my parents. If it comes to that, I just wanted to keep that option open to just lie to him that I informed my parents, but they cannot come here during my surgery dates due to some blah blah reason.. 
After that I went back to the apartment. Next day I wanted to meet LowerVilliers from this forum. He was in Mumbai at that time, and we had a chat before, and I told him I will meet him when I come to Mumbai. But as we all want to be anonymous, we didn’t really exchange names or contact numbers. He informed me before that he is in a hotel nearby the hospital.
But, I couldn’t contact him from the time I came to Mumbai, he didn’t respond to my messages, so I thought of giving it a try. I went to his hotel, and tried to talk to the hotel staff, to find me a foreigner… LOL. I explained them how I am Dr. Parihar’s patient, and I am here to meet another patient, and I don’t know his name or contact number or his room number. As expected, it was a flop. . I couldn’t meet him.
Next day, I started figuring out what to do. I was determined to do the surgery. I had confidence in Dr. Parihar, he was going above my budget, but I was still ok to do my surgery with him, especially after reading kilokhan’s diary. But, I was somehow not so comfortable in a very big city like Mumbai. I wanted to do it together with some other LLer, and LowerVilliers was the only one planning to do his surgery in Mumbai then, but he was not responding to my messages, and I was not comfortable doing it all alone.
I started checking for Hotels or apartments for stay during LL and the cost of living is too much, as I wanted to stay near doctor for the whole lengthening and consolidation.
Because of these multiple issues, my own undecided mind, and on itzRammi’s suggestion, I decided to meet someother doctor too, before taking a decision. I ruled out Dr. Shah, So I decided to go to Delhi to meet Dr. Dhawan.
Again, overnight, I booked air tickets to delhi and landed in the airport next day morning. Didn’t yet decide on accommodation, so I booked a hotel online. It was a bit far from Sir Gangaram Hospital, where Dr. Dhawan works. I then tried to take Dr. Dhawan’s appointment, and called on his mobile directly. As usual, no surprise, He said he is away, and so I have to wait two more days to get his appointment. Great!! History repeats.
I took the opportunity to look around the city. I liked Delhi instantly. It is not as big and crowded as Mumbai, and there is a feel of history where ever I go. Lot of parks, lot of activity.. Not that I will be able to enjoy any of them during my LL phase.
Next day morning, I contacted itzrammi and he came to meet me at the hotel. He was very excited to meet a fellow LLer. I was happy too, as I was feeling lost and alone in my LL journey already, and I just got some one who can understand my issues. He is very silent at first, but quickly we became friends. You will know in future how lucky I am to just stumble upon him.
I shifted from the hotel, and moved near the hospital, and itzrammi helped me with the luggage, and also took me around the city, I was happy to use the Delhi Metro, and visit places like cannaught place, palika bazar etc.,
March 25th morning, I took an appointment with Dr. Dhawan. Waited for itzrammi, and after meeting we went to consultation together. It is a very big corporate hospital, with lot of blocks, that made it difficult to find Dr. Dhawan’s cabin.
Unlike Dr Parihar’s hospital, here Dr. Dhawan is one among many doctors, so there are thousands of patients; there is always a line outside Dr. Dhawan’s cabin. We waited our turn, and we went in. We sat down before Dr. Dhawan. He was looking at someother patient, then he came to us.
Dr : Tell me what is your problem?
Me : bow leg correction and lengthening.
Dr: where are you from?
Me: I answered him.
He was surprised ..
Dr: Why did you come this far? And how did you get to know about me?
Me: I told him about the Forum, the ASAMI Board, etc, and how I shortlisted Dr. Parihar and him.
I showed him the XRays taken at DR. Parihar’s clinic. He checked them, and asked me to come with him. We went to a different room which was a bit spacious. He ordered everyone else to go outside, and after closing the door, he asked me to take off the pants and walk across the room. I kept walking. He stopped me..
Dr: your walking pattern is crooked, and your legs need correction.
Me: Is there any alternative other than surgery? I don’t want to go through the ilizarov surgery if there are any alternatives.
Dr: No, Correction surgery is the only way. We put frames around your leg one at a time. Each leg takes 3 months to heal, and there will be a 1 month break in between. So all together it will take 3+1+3 i.e., 7 months.
Me: If that is the case, I will go with leg lengthening too, and do both the legs together, so I can get some height too in the same time period.
Dr. OK, that can be done. We use Hexapod frames in that case. They use software to get proper angular correction, so they will be accurate. In your case externals is the only possible way.
Me: How much will it cost?
Dr: It might cost around 4.5L.
Discussion again went towards forum. He was happy to know that there is a forum, and something good is written about him in it. He enquired about other doctors on forum. I told him about Dr. Talwar, Dr. Parihar, Dr. Milind Chaudhay, Dr. Sarin, and Dr. Sringari.
As expected, many of Dr. Sarin’s and Dr. Sringari’s patients came to him with issues, and he knows enough about their business model. He is not happy about them. Apart from that he made no comments on other doctors.
Later itzRammi too told him about his issue, and Dr. Dhawan immediately confirmed that his height can be increased easily.
We went back to the hotel. By now LowerVilliers had confirmed his surgery is delayed, so there is no fellow LLer in Mumbai, and I was hesitant to do LL in Mumbai alone as it is a big crazy city and people are too busy to care about one another. But I was Ok with being alone in Delhi during LL as the city is comparatively small and people are a bit nice. And itzRammi would be here for a month or so, so he will be around during my surgery, which was crucial for me. Apart from that, I was comfortable with both Dr. Dhawan and Dr. Parihar for externals.
I thought for a while and decided to go ahead with the surgery with Dr. Dhawan, as my situation is now or never.. In the meanwhile, I informed my younger brother about my decision, and asked him not to tell anyone else. He laughed at first, thought I was crazy, then he realized I am serious, so he tried to convince me not to do it now, or at least inform my parents, but ultimately he realized that this is a done decision, and he cannot change me, so he agreed.
I did not want to live in a hotel during my LL, I wanted a freedom of my own apartment, So I spent the whole next week checking apartments and talking to dealers, seeing the apartments. Every dealer was giving me good offers, but on second or third floor, without elevator, which doesn’t suit me. I had to explain my situation to everyone, so that they can understand my problem, and show apartments accordingly.
Finally I finalized on an apartment, which is on the ground floor; No steps what so ever. Rent was Rs 20,000 per month and electricity extra. Rent is more considering the location and the facilities offered, but I didn’t have many choices. Also, the owners’ family was friendly and they offered to help me in any way they can during my LL. That was a big thing in itself for me.
Next, I moved-in to the apartment, and then purchased an orthopedic mattress, a TV, and some kitchen utensils. Also, went around the locality and collected contact numbers of all the restaurants, pharmacy stores etc., which offer home delivery. Also I hired a maid for Rs 3000 per month, who cleans the apartment daily, washes my clothes, and do the dishes, and cook food for me. She will also go get groceries if needed.
Once I am settled–in, I called Dr. Dhawan to setup a surgery date. He gave me the date on April 16th. Also he asked me to come and meet him at the hospital. I went, and he asked me to give my X-Ray. He checked it again, and asked me if I am willing to go with TSF instead of Hexapod. He explained me the pros are, immediate full weight bearing, less rings, compact and strong. The only issue is it will be costly; the total might come to Rs. 6.5 Lakhs. That is 2 Lakhs more than Hexapod. But, I didn’t hesitate and confirmed that I will go with TSF.
On April 15th, a day before surgery, itzRammi and I went to Sir Gangaram Hospital, to get admitted. It is a very big corporate hospital. They made us wait for 2 hrs before allotting a room. The room was clean, all the facilities are top notch. We just waited for them to come and take blood and urine samples for a lot of tests which are mandatory before the surgery.
Once it is done, I got a feeling that I will not be able to walk again properly for a year or so, and I wanted to go out and roam on the roads for one last time. I am usually not that kind of a person, but something happened, and I want to go out at any cost. As I was admitted, and I am the patient, I am not supposed to go out technically till I am discharged. But, as I am still in my regular clothes, I first tried to sneak out, but the guard somehow suspected, and stopped me, then I tried to talk to nurse, to let me out, which she didn’t allow. I got pissed off, and called Dr. Dhawan, he said I can go out if I want. But nurses were clearly not happy at me for putting them in that position, which require taking a decision on their own. They clearly follow the rulebook, no free will. So she found an easy way out for herself; I can go only if the duty doctor for that night allows me to. I waited, and when duty doctor arrived, I told him all the stories I can, with a fair bit of emotions and compelled him to allow me to go out. At last he gave me permission, and we went out. I was so happy to be out there, I walked a bit on the roads for an hour or so, and came back to the hospital. Immediately after coming back, they gave me the patient clothes, and they put a band around my wrist so that I can’t try to sneak out again.
On Surgery day, they woke me up early in the morning, for an X-Ray. Though I could have walked there myself, the ward boy insisted I go in a wheel chair. He is just following his rulebook; any patient should be taken in a wheel chair. I felt funny, but I obliged. itzRammi came with us too. The guy took an X-Ray of my chest. I was confused, and I was sure he took a wrong X-Ray. I told him I have a leg surgery and not a heart surgery. He smiled, and told me this was required for giving Anesthesia to me. I felt like a kid, who doesn’t know anything. After the X-Rays, we returned to the room. At around 10:30am nurse and the ward boy came for me to take me to the operation theatre. They put me on a stretcher, and took me to the waiting room, where we came to know my surgery is still 2 hrs away, I was asked to wait. I used the time to go to the restroom and clear my stomach before the surgery. Then I waited, almost slept for a while. Then a guy came and checked my reports. I figured he came to knock me out before surgery. I was right. He just took me into a room, it looked nothing like an operation theater which I only saw in the movies. I was still admiring the beauty of the room; when he suddenly held my arm, put a strip around it, something like they do for BP check up. Then he took a pipe from the nearest machine, and put it under my sheets, and then held my wrist, found a nerve, and inserted a needle, which was connected to a bottle with some mysterious liquid in it. No idea what it was, but in hardly 10 mins I felt dizzy.
I opened my eyes, and I was no longer in that room, I was back at the same place from where the anesthesia guy took me. I didn’t understand at first, but I know the only way to check if my surgery is already done, or I am still waiting for my turn, is to check my legs. I immediately removed the sheets from my body, Vola!! The first thing I notice is I am nude waist down! Great! I immediately covered my self again, as fast as I could. My reflexes made sure I didn’t loose my modesty in front of a room full of patients and nurses. Also I still didn’t get a peek at my legs. Now, I removed the sheets from my legs instead. Its like what they show in movies; the slow motion shot. There they were, in all their glory, black and shining, around my legs. They looked good in fact, but I knew they are not jewels, but very expensive leg cuffs. I am unable to move my legs or toes. That seems to be my fate for an year or so..
Next thing I noticed is the Urine Pack. Upon some groping I found a tube hanging from my precious private part. That made me really annoyed, some one doing that to me when I was unconscious, without even letting me know before hand. Now I know it is a part of the surgery, but then at that moment I felt like I was abused.. ☺
Also, I was not able to put my legs properly due to those rings, there is no good way, my ankle was in air and it was paining. I had to call the nurse, and she did fold some sheets, and put it under my ankles for support. It was better after that.
After they brought me back to the room, at 6:30pm, I found itzRammi sitting there. From him I came to know that I was away for 8 hrs, the surgery itself was for 6 hrs. itzRammi was sitting in the room all that time, as the nurses told him to be in the room just in case they might need him during surgery. He was even ready to give his blood if needed during surgery. Thankfully extra blood was not needed, But the fact that he was ready to give blood made me realize how lucky I am and how much I owe him. You will see this is just the beginning, and I cannot repay all that he has done to me in the next 15 days. I didn’t see Dr. Dhawan the whole day. But the nurses started giving medications 4 times a day.
My left ankle was stiff and painful, and few of my pinsites were bleeding. They said its normal.
Second day (17th Apil), liquid diet was given, while continuing the medication. No sign of Dr. Dhawan, but many doctors who are part of Dr. Dhawan’s team are coming to me regularly to check my status. But I am getting a feeling that they are just coming out of curiosity to know my story and check my frames. I am becoming more like a caged animal in a zoo for all the patients, ward boys, attenders, nurses, and everyone to see.
Finally Dr. Dhawan came to me. He was so happy looking at me, and said my surgery is a grand success. He suddenly pulled off the sheets from my legs. My reflexes again saved my modesty, I was still not wearing anything waist down. I did purchase few loose fitting shorts before, but I am sure they will not fit over those rings, and I was not in a position to move my legs, let alone wear anything. He checked the legs, and with one finger around the ring, he suddenly lifted my whole leg, to show how light-weight the ring is. My leg is in air, and I am like, what the F**k! And before I realize, he just left it from there, and my leg fell on the bed. I was so angry, but surprised that I didn’t get any pain. Then he went to my ankles, and started moving them in all the directions possible, with all the pressure he could apply. It pained a bit, but not really as much as I feared. Next he told me, a physiotherapist will come to make you walk now. I said no way I am going to walk today, I am not ready for it mentally and physically. He told me not to worry, and said, TSF frames are tough enough to handle your weight, and you should walk as much as you can daily, else if you are just bed ridden, you will be like that for the rest of your life. I am sure he did all that just to give me confidence to walk and show that my leg is lot tougher than I think. It actually did help! I was not even moving my toes till then, and after that visit, I started moving my leg a bit, and folding the leg at the knee. Later, a physio came to make me walk, but I just lied to him that Dr. Dhawan asked me to walk from tomorrow (Dr. Dhawan did say if you are not really ready, walk from tomorrow, but you should start walking ASAP! so technically its not a lie). He went away, and I was happy to have averted that walking thing for a day!
From morning I was not so comfortable. First I wanted to go to the toilet, but they wouldn’t let me. They offered a bed pan instead, But I declined, not ready for such a thing. They had a mobile potty kind of thing, a chair with a potty attached to it. I said I just want to use a real toilet. Nurses were worried if anything happens while helping me to the toilet, they will loose their jobs. A ward boy came forward to help, but once he saw my frames, he never came back. Taking a sh*t was not the priority, the main problem was with the Urine Pack. The feeling of having a Urine pack is itself very unnerving, you loose control on your piss and it becomes involuntary, over that, it was kinda getting messy, sticky around private parts, and I had to clean the area with water. The whole day nothing else was on my mind. I even tried to check if its possible to pull it off, but was afraid of doing it without permission.
Slight bleeding in pinsites continued, but ankle pain resided, but still it was stiff.
Third day (18th April) onwards normal diet was given to me. I was getting used to my frames, and I was able to move my toes, and legs a bit. itzRammi was helping me a lot in arranging support for my ankle, moving my legs when ever I misplaced them, pay the hospital bills with my card, do all the other stuff required.
First thing I did in the morning was I called Dr. Dhawan, like a kid in a day care, I asked him permission to go to toilet, and also complained about the nurses for not letting me use, what seemed like my basic human right.. He just laughed, and said he is giving me all the permissions in the world to do everything I want. He is so confident on my frames. But still nurses and ward boys were not helpful. Infact they were even avoiding me. So, I decided, I don’t need anyone’s approval for it, and I should do it myself. Discussed the plan with itzRammi, and as he was looking at how desperate I was from two days, he agreed.
Then came the physio again, now with a beautiful girl, she is a trainee I suppose. I kinda hated them for coming so early, but seriously, I was very afraid to walk. As I told you, I am not wearing anything except a shirt, so I put a towel around my waist and tied it together before they came. So, when they asked me to get up, I removed the sheets, and tried to sit on the edge of the bed, but couldn’t really move my legs all the way. So, the physio helped me put my legs on the floor, helped me wear some slippers on. Then both of them on each side held my arms, and lifted me. I was holding the walker. I was standing with their support on both sides. Now I realized my towel was slipping slowly, and the knot I made was apparently loose. I suddenly left the walker, and held the towel in place. If they were not holding me properly, it would have been a disaster. The physio told me not to worry about the towel, and said it’s a hospital, so that’s nothing, just leave it, or if I wanted he will hold it for me. Apparently, he was asking me to walk nude, as no one cares if a patient is wearing anything at all.. lol
I asked him to just hold my towel in place. Then I held the walker again. They made me stand properly. Legs were paining, but I managed. With the whole body weight on my hands, they made me take my first step. It was very painful. I couldn’t do it, but some how I managed two steps forward, then two steps backwards and some steps side ways, and then sat down on the bed. It was like I went to a war and won. It drained all my energy away, I couldn’t do anything else for atleast a couple of hours. I just slept.
Dressing is done today, and they showed me pinsite care. We paid hospital bills, as nurse gave my discharge date for tomorrow.
In the meanwhile Physio came again in evening. This time I made sure my towel doesn’t need any external help. I used a pin to hold it together. but realized its too early to be able to walk all the way to the toilet, so got back and sat down on the bed. I sat there fo 15 mins, with foot on the floor. After that I forgot about going to the toilet, and was just happy at my new found ability to walk.
But later Dr. Dhawan visited me, and told me he needs to take an X-Ray on Monday, which will be used to feed information to the TSF Software, and get distraction sheet. So, effectively my discharge date was delayed by 2 days. We didn’t understand why there was a misunderstanding.
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