Precice 2: Bilateral Femur With Dr Mangal Parihar

Hello Guys!

I got precice 2 devices implanted on 19th April at Mangal Anand Hospital, Mumbai, India.

Just like most of you, I have been researching for the last 10 years and have been in contact with most surgeons across the globe. I was supposed to get the surgery done in 2019 but it couldn't happen. I happened to read patients' diaries here on the forum and each diary does give you a lot of information on LL surgery aspects. I must thank all of you for providing significant information. I was thinking to write about my experience but I had to decide on the surgery date first. Here I go... I hope my journey with the team at Mangal Anand Hospital will be smooth.

I assume only 1-2 Dr Mangal Parihar's patient diaries are on the forum. The reason for writing about my journey is to help future LLR patients.  Again, am not brave enough to write the diary the way razaldazal & heightjourney2021 did with daily videos and images. I'll prob keep it brief & precise.

Basic info:

I am a non-smoker male in my 30s from the UK
Starting Height : 164cm
Weight: 61kg (134 lb)
Medical History: None


Why India and not the UK

 Stryde issue was found in the UK and MHRA UK will be the last one to re-issue the licence/allow the use of Stryde.  Precice device family is still not allowed in the UK for both NHS and private Hospitals. Precice got available in India and more importantly Dr Mangal Parihar and Dr Divya Ahuja agreed to operate on me.

Day 0

A day before surgery, I got admitted to the hospital. I was already asked to get blood reports and chest x-ray done beforehand. Consultants (Three Ortho surgeons doing their fellowship under Dr Parihar & Dr Ahuja) came to see me. They briefed me about the surgery and how the post-surgery journey will be for the first 7 days. 

In the evening, the Anesthesiologist came to see me and I asked him wot sort of anaesthesia he will be using on me. He said epidural pump as it will be easy to control the pain even after the surgery. He assured me that pain will be minimum. Then Dr Ahuja spent 20 mins answering all my questions. Lastly, Dr Parihar called me and asked if I hv any questions. I was like I don't have any as most questions were already answered by Dr Divya Ahuja. Dr Parihar asked me where will I be staying during the lengthening and I replied that I'll be staying in Gujurat. He asked if I can stay in Mumbai for a week after discharge from the hospital. Dr Ahuja wished me a good sleep and to see me in the morning around 11.

Day 1 Surgery Day

wow, It is happening. Woke up around 7.00, took shower and got ready. I think I was a little nervous when the nurse came in with an IV and also took blood samples.

Entered the operation theatre/surgery room at 11.30 am. I remembered Dr (Anasthesiologst) greeting me and asking if I am feeling ok. He then said he will give me a pain injection first and then insert a catheter. I was half awake and half sleepy. I remember some music (soothing or healing music) playing. Not 100% sure wot kind of music tho. Next moment, I was in ICU. For the first night, I was constantly on IV fluid as my BP was very low. Again, Anaesthesiologist came to see me and asked me about my pain level. I was like I can't feel anything. This was due to anaesthetic effect. Dr Rajul, Dr Mehul and Dr Anurag came to see me and asked me to move my feet. I couldn't. One of the Dr tried touching my feet but no sensation. They then decided to reduce the epidural dose. Supposed to move from ICU to normal hospital room but they kept me in ICU. Felt sorry for the nurse who was keeping an eye through the night. Taking Oxygen, BP level aswell as keeping IV fluid. Nuvasive/Cure surgical rep came to see me but I didn't speak much coz of drowsiness.

Day 2

Nurse woke me up, and gave sponge bath and medicines. I was completely taken off from Epidural dose but the catheter still remained intact. I had breakfast in bed and my BP was getting back to normal which was quite hearty. Thank god. I was moved to my room at 10ish. Physio came in and showed some stretching exercises wasn't able to do much of them as I was still recovering.
I should mention my pain level for day 1 & 2. First day it was zero pain due to anaesthetic effect, 2nd day was not that bad. Evening Physio came at 5ish. I was like wow two physio sessions in a day. Was able to do some exercise but again it was all done in the bed.

Day 3 - 7

Same routine and pain level (controlled) as I was taking Nimesulide twice a day and patches. Two physio sessions every day. Started ordering food from outside. According to Physio my leg movement was very little. I guess I need to focus more on physical therapy as advised. Let me just brief you about the medicines and supplements I was prescribed.

For Pain: Nimesulide 100mg BD (Cox-I Inhibitor), Ketoprofen patches
For stomach: Pantoprazole
Supplements: Vitamin D, Calcium & Methyl cobalamine.

I was also carrying paracetamol, co-codamol and Adcal D3 from the UK.

On day 3, Dr Ahuja visited and examined both my legs. He was like I should try and wake up Qudracep group muscles and start stretching/lifting legs up slowly.  I told him about no bowel movement since surgery. He asked me to drink plenty of water and eat food with more fibre. I was also given lactulose. Still no bowel movement on day 3 but luckily it happened on day 4 which was quite a relief. Dr Parihar came to check on me. He said we will start distraction on Wednesday (27th).

I had regular physio sessions in beds and was given more exercises to do on my own. On days 5 & 6, I really felt that my right leg is going dead as I was having difficulty stretching. I asked my physio and she said she can muscle spasm there. She asked me to use an Ice pack and also showed me how to break the muscle tightness. I tried cold pack but didn't improve much. I was having a headache. It was more like tension headache with neck pain. I took painkillers and called the nurse for help. All three doctors used to visit me for a regular check-up. One of them advised me not to be stationary and spend some time sitting up.

I realised one needs upper limb strength to move around. Having strong arm and wrist muscles helps a lot. I spent the whole week in bed 24/7. This first week post-surgery was challenging in terms of mental capacity as you can't operate on your own and needed help for everything. Nurses and Mousi (support staff in Marathi) were available 24/7 to assist me.

Day 8: Nurse came in at 7:30 am, checked my blood pressure and reminded me to take medicines. On day 8 I had fewer headaches but muscle spasms on my right thigh wasn't improving. Had a good Physio session in the morning but it wasn't the case with evening physio. Evening physio was like I got to really work on stretching as my distraction starts I need to work more on flexibility.

I forgot to mention about DVT pump which was taken off on day 6 or 7, don't exactly remember.  Started on Aspirin 75mg EC daily.

will update on Day 9 (first distraction) - Day 18 (Distraction week) very soon.

Great to read this fitness2022. I had heard of another patient getting this done with Dr. Parihar.

Are you going to be on Aspirin to prevent DVT throughout the lengthening period or will it be Xarelto?

Aspirin alone is not sufficient to prevent DVT according to current guidlines... It is either paired with LMWH or not taken at all.

Yes, there was one more patient who got it done just a week before me. I asked one of the Dr if he is doing well and he said he is doing well. Also, if your recovery is slow then Dr Ahuja prefers you to stay longer than usual just to make sure you're comfortable (with no complication), then only they will discharge you.

Yes, I'll be on Aspirin from now onwards. I am not taking any NOACs.

I was a bit concerned about it. I was thinking to carry either Apixaban or Rivaroxaban with me for a month. I did ask Dr Ajuja and he said he will use DVT Pumps and then Aspirin. He also mentioned not being stationary all the time. Again, the risk of DVT is highest for first 7-10 days (I was on DVT Pump) and then straight to Aspirin EC. I'll speak to Dr again about going for NOACs. I try not to be stationary for longer and do some movement. Finger crossed.

NICE Guidelines say to use NOACS for 4 weeks. I think UK surgeons prescribe you NOACs only for 4 weeks.

You're in really good hands. Good to know Mousi is still there, too. Congrats on taking the next step toward getting taller.

I got my surgery 1 week before you. How's the pain situation for you?

Quote from: KiloKAHN on May 08, 2022, 08:05:07 PMYou're in really good hands. Good to know Mousi is still there, too. Congrats on taking the next step toward getting taller.

Mousi is not a name it's a designation. It's like saying good to know the nurse is still there.

Quote from: KiloKAHN on May 08, 2022, 08:05:07 PMYou're in really good hands. Good to know Mousi is still there, too. Congrats on taking the next step toward getting taller.

Thanks you KiloKAHN. You're so rite. I am definitely in good hands. Oh yes, Mousi is still there.