Hi everyone,
My flight is departing this Sunday May 6th. Just thought I would start my diary off early. I am having my consultation and surgery with Dr. Sarin possibly next week.
Details:
Age: 21
Weight : 132 lbs or 60 Kg
Current height: ~5’5” or 164.5 cm
Wingspan: 175 cm
Target height: 170 - 172 cm (might change based on my condition)
Type of surgery: LON
Location: New Delhi, India
From: US
Ethnicity: Indian
Cost break down:
Surgery: $10,000
Stay: $1000 per month (inclusive of food, medications, etc.)
Plane tickets: $1200 two way (600 per trip). Studentuniverse.com has the cheapest flights to India but idk if you need to be a student per se.
Emergency cash: ~ $500.
I will try to keep it as informative as possible with lots of pictures.
Update:
My surgery is scheduled for this Friday: May 11, 2012.
India: It is really hard for someone to imagine what 106 degrees feels like until you are in India. lol. Its literally like a sauna where it HOT and DRY. May and June are the hottest months of the year and then the monsoon season starts. Luckily there's a/c EVERYWHERE.
Sarin: I met Dr Sarin yesterday evening in his clinic. He is very down-to-earth person. He answered all my questions and cleared up all my doubts about LL. He's been doing this for more that 20 years now and clearly knows what he's doing.
Sunny: He is one of the caretakers at the guest house. He also escorts people from the airport, the hotel, the hospital, and the guest house. He is very laid back and knows English very well. He even took me around the city because I had some stuff to take care of.
Guest house: I visited the guest house today afternoon and met Dryani. He is painless as of now. Just like what Dryani mentioned the guest house is a big apartment with multiple rooms and a common (living) room. All rooms have TV, A/C etc.. Food is the last thing one has to worry about here. I saw pizza hut and Mcdonalds right down the street, dominos isn't very far either.
Kaizen: I bought my ticket with insurance, which is like 30 dollars extra but it lets you change/cancel your trip anytime. Right now I feel like I'll be done by September 1st. but we'll see
To all: Thanks guys. I will keep updating.
Deus Ex: I will not be engaging my ankles since I am only aiming for 5.5 -6 cm. No one should dread having their ankles locked since Dr Sarin will give you the option to have them on or not. If I somehow develop BF later on, he would just lock my ankles then. Dryani has his ankles engaged because he is aiming for 7.5 cm and he, in no way, regrets having that, because he has the option to remove the ankle locking pins whenever he wants. Dr Sarin also explained how the calf muscle lengthens along with the bones. Here's a brief summary of this very complex process:
As the calf muscle gets stretched over time, the individual muscle fibers stretch to their full length. When the fibers are overstretched, the motor nerve connecting the muscle "yanks off" due to the excessive stretching. This, in turn, causes the muscle fiber to die. The beautiful thing is that your body can regenerate new muscle fibers that are longer to accommodate for stretching. This process keeps repeating until you've reached your final lengthen and the stretching of the muscle stops. Idk if your tendon can lengthen but I do know that the muscles can and will. This process takes much longer than the bone lengthening if you do not have your ankles under constant stretching and it is also a reason why getting rid of BF takes a lot of perseverance and time. Not surprisingly, having your ankles engaged speeds this process up since your muscles are constantly stretched vs. if you don't have them locked you will have to to work really hard and stretch religiously to avoid it.
The reason why I am not locking my ankles is because I have a narrow window of time to consolidate my bone faster. And walking and some weight bearing heals bones faster. If I develop BF later on, I will have the option to lock them.
I agree with Dryani, Sarin doesn't care about money at all. He cares more about his patients and their comfort.
Dryani: Thanks buddy, I will see you in about 6-7 days. We are gonna have a fun summer living there and in the process we will get taller! I was so caught up in thinking about how I will be living for the next 3-4 months and how much fun I'll be having that I almost forgot I am pursuing my dream of becoming taller. lol
Dookieman: yea man, I am very excited for this surgery. I can't even sleep at night because of all these thoughts racing through my head. well, partly because of my f***ed up sleep cycle. haha. I am very thankful to have found this forum.
Kaizen: I will make a list of things that you must bring after I am at the guest house. hopefully, that will help you.
If you guys are curious, this is what I brought with me from US.
http://i.imgur.com/tpoAl.jpgTwo 5lb bags of whey protein
Calcium supplements
Multivitamin
Zinc
Iron
Vitamin D
Finally at the guest house!!
I will post an update soon with brief description of each day of my experience at the hospital.
I have NO pain as of now and starting lengthening tomorrow.
My sleep cycle's still screwed up, so ill try getting some rest
Right now I do not have an internet connection in my room. Sunny said it'll be there by the end of today but I am currently using crazy+6's WIFI. I would love to upload some pictures but I don't want to use up too much of Crazy's bandwidth. So I'll just wait.
Day before the surgery:
I went to the hospital and met the other two patients from US. Both of them already had their surgeries done and were recovering. One of the patients got diarrhea from eating the hospital food so I decided to stick with Dryani’s routine, lol. From then on, I just ate the double cheese pizza and Ice cream.
Surgery day:
I woke up around 6 am, took a shower and got ready for the surgery. They brought the stretcher in to take me to the OT. It was fairly cold in there but they put a blanket over me. They started me on the iv drip, I started feeling drowsy and I was gone in about 10 seconds. After I woke up after the surgery was over in the recovery room, I started feeling pain in both of my legs. This pain was the real deal. I called the nurses and doctors over and mumbled some things to try to get the message across that I was in pain. The pain felt like there was a lot of pressure on my legs or something heavy is trying to crush my legs. But soon after that I was knocked out again. I was knocked out again. I woke up in my room around 6 pm and this time there was no pain. A similar type of pressure pain came on and off during that night but the nurses did a good job taking care of that. They put me on epidural with fentanyl at 8 ml/hour (which is pretty high) after the surgery. I made it through the night and was off to a good recovery. One thing I learned was that the pain I felt in my legs was nowhere close to what I expected bone pain to feel like. I was expecting sharp pain that one might feel with a sensitive tooth or something, but it’s more like pain caused by pressure on the legs which is more tolerable, in my opinion.
Day One:
I had on and off pain throughout the day. I don’t remember much of this day.
IMPORTANT: Best part about this surgery is that due to the fact that you have so many drugs in your system and you have that constant feeling of drowsiness, the memory of having the intense pain starts to fade very quickly. Right now I do not have the emotional memory of suffering pain or what the pain felt like after the surgery, I just have the factual memory that I had pain. So, having no memory of what that pain felt like is basically like having no pain in the first place.
Day two:
I was taken off the fentanyl this day and started on tramadol on iv drip. Keep in mind that fentanyl is administered through the epidural. This day I was able to move about in my bed but it was still a little painful. My appetite slowly returned to normal and I started eating regularly.
Day three:
NO PAIN. Started watching Dexter on my laptop. The day went by fairly quickly as I finished watching Season 1.
Day four:
I did some physiotherapy on this day. It felt good to finally hang my legs off the bed and touch the ground.
Day Five:
I was anticipating being discharged from the hospital but I found out that they were still fixing up my room back at the guest house.
Day six:
I got discharged from the hospital and arrived at the guest house.
BTW, Hilltop came in yesterday to see us. I was surprised to see him walking without support since its only been around 5 months
Arche: its not so much of indian food. A lot of the meals basically contain chicken and rice
Update:
Amount lengthened - 3 mm
Today I started feeling some pain in my left leg around my knee and where the cut was made. The pain seemed to get worse as I made my turns throughout the day. From 6 pm to 9 pm the pain was extreme and unbearable. I resorted to taking a muscle relaxant and ultraset. When I was having that pain I called Dr Sarin to ask what was happening and he explained that my bone just separated today and that I had nothing to worry about. so for the past 2mm my bone had consolidated a little and it never actually made the separation and today it separated all together. The pain disappeared completely around 10 pm. May be my age is the reason why it might have consolidated. Right now I am just relieved to know that I just avoided pre-consolidation and as long as I keep lengthening its not gonna happen again. My right leg is cruising along nicely as we speak.
Steve1987 -Nice buddy, we'll be waiting for you! Idk if you can recover quickly enough to start playing sports but i do know that if you played sports before in your life your bones will be really dense and vascular. so you will have no problem forming a callus and heal faster than someone who hasn't been physically active. I also did track in high school and played football and basketball recreationally. Just like you I have the same concerns about being able to enjoy my favorite hobbies. The reason why you might not return 100% to playing sports is because of the ballerina feet and not the bones. But BF is curable, it just takes a lot of time and diligence.
Iskd is not available in India as of now
Update + xray:
I haven't had any significant pain for the last few days. Everyone at the guest house got their x-rays done today. Here's a picture of my x-ray:
to STsacrifice4LTgain: I will keep that option open for me if the ballerina starts to get worse but I don't think I will need it since I am only going for 5-5.5 cm. But I recommend that option to anyone doing more than 6 cm since Dryani didn't have too much trouble with them.
I am able to walk but I try not to. I know that walking helps with bone growth and everything, but that's the problem. I am trying to avoid pre-consolidation which is a high possibility for me since my bone density is already high, my age is 21, and the cut is made really high at the end of the diaphysis. If you've watched Dr Paley's lecture on Limb lengthening then you may recall that the further away from the middle of the bone the cut is made, the faster it heals. so I am taking no chances for the first 2 cm. After I reach that mark and the X-rays show no joining of the bone then I'll go crazy with exercising and all that.
Update:
Progress: 1.3 cm or 1/2 inch
I still continue to have pain sometimes during the night. I refrain from taking painkillers and try to tough it out with only muscle relaxants. Dr Sarin bought me a wheelchair so that I can move around the guest house pretty freely. He wants everyone to come out of their rooms and congregate in the common room. The food is a non issue now that we have a deep freezer full of microwaveable stuff that we can eat anytime we want.
Okay everyone, here is something that my room mate, cooldoc prepared for the guest house regarding the concerns about the medication. Note that he is a physician as well as a tibia patient.
PLEASE READ THE DISCLAIMER BEFORE ASKING ANYTHING. I will not be answering any questions about the following unless it is really important.
DISCLAIMER: I am a patient, but also a physician. I do not claim to know everything, but I would like to contribute to my future predecessors here in the house by sharing my knowledge and experience regarding the medication we have for pain.
IN ORDER TO MANAGE PAIN, WE NEED TO UNDERSTAND WHERE IT’S COMING FROM.
The pains that we have after the surgery mainly involve (I kept the explanation below as simple as possible so if I insult anyone, please forgive me.):
1. Inflammation- your body’s natural response to surgery, to the pins and to foreign material in you, the constant stretching, rips, spasms, and opening of the pins. THIS INFLAMMATION WILL BE A CONSTANT WAXING AND WANING PROCESS.
2. Spasms- originate from inflammation and injury, so even if you do not lengthen, you will have minor spasms that you may not feel. The point is that many things cause spasms, and this is not avoidable. Some spasms you may feel and others you may not. Some are jerky and others are dystonic (meaning it stays contracted and you feel less flexible.)
3. Bone pain- the bone has a periosteum- a layer of covering outside the bone, that contains all the nerves. Any manipulation of this layer will cause pain. The initially cut, the initially pins going through, but no pain should come after that. EXCEPT if your bone cut is jagged or irregular and the periosteum rubs against each other as you separate or lengthen, which would eventually go away once the bone separates completely OR if you started forming callus or consolidate early whereby again the periosteum is manipulated, than you will again have pain.
4. Pins cuts- your skin (dermis particularly), muscles, soft tissues are all innervated by nerves and as you lengthen, they will rip and you will have pain. This is a gradual process, which some of you will grow tolerance to more than others.
5. Nerve pain- this is difficult to define as nerve pain presents itself in various ways from tingling, to numbness, to shooting, burning or sharp pains. This will occur as you lengthen as the nerves are being stretched and injured, but somewhat tolerable as the process is gradual. HOWEVER, nerve pains that are sporadic and ranked the worse spontaneous, lightening pains you have, than something may be compressing on the whole nerve and this is something YOUR DOCTOR NEEDS to know. Especially if the pain is localized to a region or you find it impossible to move a toe for example.
6. TO SHORTEN THIS CATEGORY- EMERGENCY PAINS OR PAINS THE DOCTOR SHOULD KNOW should include PAIN THAT IS “excruciating” AND “not relieved by medication” OR “keeping you awake” OR comes with physical findings of “swelling, redness, blue toes, complete rigidity or fevers that does not go away.”
AS THESE PAINS MAY REPRESENT: an infection (cellulites, necrotizing fasciitis, abscess), tendonitis, blood clots, etc…
Medications we have available to our disposals, including their limitations, safety dosages and side effects. (REMEMBER ALL THESE MEDICATIONS CAN KILL YOU IF NOT TAKEN APPROPRIATELY)
1. ULTRACET (TRAMADOL 37.5 mg and Acetaminophen 325 mg)
2. TRAMADOL (50 mg)
3. FLEXURA D (metaxalone 400 mg and diclofenac potassium BP 50 mg)
4. MOBIZOX (Chlorzoxazone 500 mg and paracetamol 500 mg and diclofenac 50 mg)
5. PROXYVON (paracetamol 400 mg and dextropropoxyphene napsilate 100 mg)
6. FENTANYL
BEFORE I START TALKING ABOUT THE MEDICATIONS, I WOULD LIKE EVERYONE TO UNDERSTAND THAT CERTAIN MEDICATIONS WILL HELP WITH ONLY NERVE PAINS OR INFLAMMATION OR INJURY OR BONE PAINS AND SOME MEDICATIONS WILL HELP WITH ALL PAINS DEPENDING ON WHERE THEY ACT AND HOW THEY ACT. MANY MEDICATIONS HAVE A MIXTURE OF THINGS IN THEM, SO MAKE YOUR DOSAGE CALCULATIONS WISELY.
Acetaminophen or paracetamol (WORKS all pains above except spasms)
Is non-opiate, centrally acting analgesics (LAST ING ~4 hours). It is a week anti-inflammatory (through COX 2 pathway), antipyretic (fever reducing) and analgesic (pain reducing). It reduces pain by blocking TRPA receptors on the dorsal horn of the spinal cord. MEANING THIS MEDICATION WOULD WORK FOR ALL PAIN AS IT IS BLOCKING THE NERVE ROOT. Unfortunately, it is weak, WHICH MAKES IT DANGEROUS AS WE CAN TAKE TOO MUCH. It is a medication that is broken down by the liver. TAKING >4 grams per day can lead to liver inflammation and failure. IF alcohol is consumed or if the liver works too hard breaking down alcohol than taking <4 grams can lead to liver issues. LOW ADDICTION AND TOLERANCE RATE.
Tramadol (WORKS all pains above except inflammation, or spasms) (Has added effect of helping with depression)
Is non-opiate, centrally acting analgesic (LASTING ~6-8 hours). It is analgesic (by selective u-opiod receptor agonist)- the same site as opiates, but selective and causes increase serotonin release (like anti-depression meds). BECAUSE THIS MEDICATION WORKS ON U-OPIOD RECEPTORS IN THE BRAIN- it works on all pain. BUT it has no anti-inflammatory or spasm affects directly). MAX dose is 400 mg a day. It is digested by the liver and so liver damage is a major concern. (SO BE CAREFUL MIXING THIS WITH ACETAMINOPHEN OR PARACETAMOL and AVOID ALCOHOL). HIGH ADDICTION RATE IS TAKEN AT HIGH DOSE BECAUSE OF OPIOD RECEPTOR SITE.
Metaxalone or skelaxin (works on spasms)
Is a muscle relaxant only. Mechanism of action is unknown. LOWEST SIDE EFFECTS OF THE MUSCLE RELAXANT. 3.2 grams (or 800 mg 4 times a day is MAX). Lasts about 4-12 hours. It is digested by the liver. (SO BE CAREFUL MIXING THIS WITH ACETAMINOPHEN OR PARACETAMOL and AVOID ALCOHOL). LOW to MODERATE ADDICTION AND TOLERANCE PROFILE.
Chlorzoxazone (works on spasms)
Is a muscle relaxant. Works to relax muscles by acting on SPINAL CORD by depressing reflexes, so this is a great muscle relaxant for those with spasms related to nerve irritation. 2 grams or (500 mg 4 times a day) is MAX dose. Last 6-12 hours. It is digested by the liver. (SO BE CAREFUL MIXING THIS WITH ACETAMINOPHEN OR PARACETAMOL and AVOID ALCOHOL). LOW to MODERATE ADDICTION AND TOLERANCE PROFILE.
Diclofenac (works to decrease inflammation and pain, but not spasms directly)
Is an anti-inflammatory (NSAID). Works on COX-2 receptors to decrease inflammation so it has less damaging effects on gut. BUT LIKE all NSAIDS, it is damaging to KIDNEYS, LIVER, HEART IF TAKEN OUT OF PROPORTION. THERE ARE MANY ADVERSE THINGS TO THIS MEDICATION, and took a while for it to be FDA approved. MAX dose is 150 mg a day (so 50 mg 3 times a day is MAX). Last >12 hours. . It is digested by the kidneys mostly, but also in liver. (SO BE CAREFUL MIXING THIS WITH ACETAMINOPHEN OR PARACETAMOL and AVOID ALCOHOL). NOT ADDICTIVE, but HIGH SIDE EFFECT PROFILE
dextropropoxyphene napsilate
Is an opiate. Dextropropoxyphene acts as a mu-opioid receptor agonist. It also acts as a potent, noncompetitive α3β4 neuronal nicotinic acetylcholine receptor antagonist, as well as weak serotonin reuptake inhibitor. SO IT PRETTY POTENT OPIATE. HAS BEEN TAKEN OFF US AND AUSTRALIA MARKET DUE TO FATAL CARDIAC ARRYTHMIAS AND COMPLICATIONS FROM THIS along with its HIGH ADDICTIVE PROFILE. MAX is 600 mg a day or (100 mg 6 times a DAY). TAKING MORE WILL CAUSE LIVER DAMAGE AND RESPIRATORY COMPROMISE and DEATH. TAKEN 100 mg a day can build addiction, tolerance if taken for prolong periods of time. EARLIER WEAN from this medication to other analgesic is preferable. LAST ~6 hours, this is the reason for addiction. It is digested by the liver. (SO BE CAREFUL MIXING THIS WITH ACETAMINOPHEN OR PARACETAMOL and AVOID ALCOHOL). LOW to MODERATE ADDICTION AND TOLERANCE PROFILE.
Fentanyl
Similar to tramadol, but more potent agonist at the μ-opioid receptors. 100x more potent than morphine regarding this receptor. Only minutes to 1 hour of pain relief with injection. Usually started at lowest dose of 25 mcg/ml (concentration) and titrated up by minute or hour depending on pain relief. Careful monitoring required as respiratory depression can occur leading to DEATH.
A FEW WORDS ON ADDICTION AND TOLERANCE,
THIS IS REALLY DEPENDENT ON THE INDIVIDUAL. WHY? PEOPLE WHO GENERALLY ABUSE ALCOHOL AND TOBACCO ARE AT HIGHER RISK BECAUSE THESE PEOPLE HAVE A KNOWN TENDENCY TO DEVELOP MORE RECEPTORS FAST WITH ANY USAGE AND DEVELOP TOLERANCE EASIER THAN OTHER PEOPLE FOR EXAMPLE. SO WHO DEVELOPS RECEPTORS FASTER AND TOLERANCE REALLY DEPENDS ON THE PERSON. YOU COULD DEVELOP TOLERANCE IN A FEW DAYS AND OTHERS IN A FEW WEEKS.
THE KEY IS TO KNOW WHY YOU HAVE PAIN AND SELECT THE APPROPRIATE MEDS. TO CHOOSE YOUR MEDS WISELY AND GO SLOW AND THAN ADD ON THE BIG GUNNERS LATER WHEN YOU REALLY NEED IT. REMEMBER YOU ARE EXPECTED TO HAVE SOME DEGREE OF PAIN CONSIDERING THE SURGERY U DID.
Update:
Progress: 1.6 cm
My pain levels fluctuate between 2-4 out of 10 through out the day. Sometimes it peaks to about 6 or 7 for a very short period of time. Dr Sarin takes good care of the pain levels though.
For those of you who are in the dark how the process goes, here's a quick breakdown:
-You arrive at the airport
-Sunny(caretaker) picks you up from the airport and takes you to a hotel, (this arrangement is made after you email Sarin your flight details)
-Next day you have your consultation with Dr Sarin at his office which is right in front of the Hotel,
-If you decide to go through with the surgery then Sunny will drop you to the hospital the day before your surgery
-5 days after the surgery, you will be brought to the guest house.
All of this is included in the Surgery fee which is $10,000.
Update
Progress: right leg: 17.5mm; left leg: 17mm
I have been feeling extreme pain under my left knee which is preventing me from bending my knee. I have pinpointed that the pain is caused by a pin that is going through a tendon (either through Sartorius muscle or one of the hamstrings). The pain is unbearable in the night and really interferes with sleep. I stopped lengthening for a day to see if it would improve but so far its been the same. My right leg on the other hand is pain-free and I hope its stays that way. Dr Sarin has agreed to come look at it today and decide what to do with the pin.
Kaizen came in yesterday. He is sleeping on Dryani's bed for the time being.
@kaizen: Lmao, you really need to catch up on sleep!
6ftby2014: Basically everyone doing externals have pins going through tendons. the top of the tibita is covered in tendons. it's unavoidable. Even in the Beijing diaries I read about pain under the knee and stiff knee problems due to tendon problems. The thing is that it's supposed to get better after the first couple of weeks but somehow it has gotten worse for me. Sarin has told me to wait one more day to see if it gets better. I have 2 options to fix this; either he gives me a local anesthetic and cuts around the pin to relieve the tension which might be the cause of this pain. or he would remove the pin all together and I would be left with two pins on the top ring. The problem with the second option is that it would be unstable if i wanted to extend my knee outward but I am confident that those two pins combined with the IM nail are more than enough to stabilize the tibia.
Update:
Progress: 1.925 cm left leg; 2.1 cm right leg
The pain under my left knee has been subsiding for the last few days. Now the only pain i have sometimes is minor pin cutting pain. Although I am a little jealous of 'Cooldoc' since he is already at 3.2 cm and when I started lengthening he was only 3mm ahead of me. He hasn't had any major problems lengthening 1.25 mm/day most of the way. He has no ballerina, no nerve pain, no pain in general besides the traveler's diarrhea of course, lol. I guess it really depends on the person. I feel very happy with my progress as of now and feel like beside from the minor bumps along the way, it has been a smooth ride. This is all thanks to Dr Sarin. He has the ability and the experience to deal with and resolve any complication anyone might have within the span of 1-2 days. He even re-assures everyone that during any SOS situation (extremely serious pain), he has the "strong stuff" to relieve any pain and he lives only a minute away.
The Common room: this is where everyone congregates almost everyday. Today Dr Sarin was here and we had a mini party in the common room and we really enjoyed ourselves.
Ilike8cm: X-rays I believe, are taken every 15 mm and yes they are included in the 10000 charge. my next one should be when I reach 25mm. I will take some pics as soon as the pin situation improves.
Sarin: As Kaizen would agree, a lot of us have developed a new respect for Dr Sarin. He came to visit us today and we talked to him for a while. His views about LL is not what I expected. He mentioned that he would never raise the price for the surgery but rather he is considering some discount options. He does not think of this as a business but instead he says that he is doing it for a 'cause', perhaps to help people like us.
Here I am standing at 5'6" and not even half way there yet.. I am now starting to notice my new height.
The long arm-span really shows up in this picture.
stevie - the picture quality is crappy. lol. but my feet are actually touching the ground and they can go beyond 90 degrees when i stretch them. anyways im not too worried about ballerina and I think it's over hyped. Crazy+6 is here living with us and he has no ballerina problem after lengthening almost 9 cm.
To all.. i will update my situation soon. I am usually busy socializing in the common room most of the day. days seem to go by very fast.
Update:
Progress: Left leg - 2.6 cm, Right leg - 3.1 cm
Pain: Nope
I had a lot of pain on my shin caused by an irritated nerve for the last week. This is the reason why I slowed my lengthening on the left leg. The pain would only last 15-20 mins after I turn the rods but it was very annoying and disruptive. Sarin took a look at it and asked me if I wanted to remove the pin and I said yep. The pain went away as soon as he took the pin out. I was so relieved. Right now I have two pins going through my left leg, which is more than enough to weight bear. Dryani has similar nerve pain with his leg as well right now, but he is scheduled to remove and replace his pin tomorrow, so he'll be fine.
I have no pain in any legs since the last 3 days.
Sleep: I don't know about other people who have been through LL but my sleep has never been better. I usually sleep around 3 am and wake up around 12:30 pm. I get a solid 9-10 hours of continuous sleep every night no matter the pain level.
Days seem to go quicker and quicker because I keep myself busy all the time. Usually making round to different rooms and talking to Dryani, Crazy+6, Kaizen, Cooldoc, etc.. Being around this many good people and being in a safe environment really helps you to stay motivated in reaching your goal.
and finally update on Cooldoc (my roommate)
Cooldoc: MMT meet Cooldoc. This guy has balls of steel. He has reached 5 cm yesterday and it took him a 1 month and 1 week. He has been going at 1.25 mm/day the whole time. As I mentioned before, he is a physician and has done his research. He has been having aching pain due to this fast lengthening rate and also pin-cutting pain but its nothing he can't handle and surprisingly enough, he doesn't take any opiate painkillers. not even tramadol, he only uses muscle relaxants. Dr Sarin came to check on him yesterday and checked his callus and he said it was good. every morning he checks his pulse on his feet to make sure there's proper blood flow. He didn't have a single complication till date. Before I had the nerve pain I tried lengthening at 1.25 mm/day but had too much achy pain, so i stopped and plus i'm not in a rush. I guess it really depends on the person.
Craig49 was here a couple days back. He is a true inspiration to all of us and we really enjoyed talking to him.
Pictures of the guest house.. Coming soon...
lol kaizen, lets hope weight lifting helps you sleep better.
soapey: thanks man,. I am outside my room most of the day. mainly visiting other patients or being in the common room. We are allowed to go outside (only with a caretaker) but India this time of the year is scorching hot. so we mainly stay indoors.. Idk about part time work in India but you can work online if you want to.
stevie1987: great, we'll see you in a month then! Dryani uses skype for his work so you can ask him about the quality. all I know is the speed is 2mbps and it's enough for youtube videos in 480p
Soapey: since I have hairy legs, im not too worried about scars or anything. If you are worried about scars you can always do a scar removal procedure which, in India, shouldn't cost that much.
STsacrifice (can I call you ST from now on, lol?): thanks. don't worry about not being able to sleep too much. it all depends on the person and how much sleep you need. see you soon. make sure you visit us while you still have working legs. lol
LL complications: After doing a lot of research I have found that pin infection is the most common complication with this surgery. But not with Dr Sarin. No a single LL patient of Sarin here has gotten any pin infection. On exactly how this works, he prefers to keep this a trade secret until may be he publishes it. Don't worry it's not some 'radioactive' cream or some secret potion that he uses to keep infections away.. lol. but something that he discovered in his 20 year experience of doing this surgery.
Braden: yes it is normal. Dr sarin answers emails very directly and concisely. don't take it personally but that's just how he answers emails.. if you are serious about this surgery then I recommend calling the number on his website to get more information. you can also shoot a personal message to me or any one of us living at the guest house. I hope that helps
Update:
Progress:
left leg: 3.4 cm, right leg: 3.5 cm This is confirmed by my recent the X-ray measurement.
(New) Ballerina: NO ballerina yet. During physiotherapy, my feet are able to stretch beyond 90 degrees. So it think i may be able to come out of this with less than 2-3 cm of ballerina which is easily correctable.
Pain: Still nope. It's been two weeks since the pin removal and its been the best pain-free experience ever since before the surgery. I've been spending most of my time socializing outside of my room. Talking to other patients who also are going through the same journey helps keep my anxiety low.
Pictures:
Sunny gave everyone these slippers to help prevent ballerina. you might be able to recognize the person in the blue frames, but surprisingly, half of Sarin's patients are not active MMT members 
This is Cooldoc after he crossed 5 cm
This is my sleeping position most of the time. Side sleeping is still possible with these frames.I have a really funny picture of how Dryani sleeps. I'll upload it if I get his permission. Adlerta: My distraction rate was 1mm/day till 3 cm and then .75 mm/day after that. It really depends on the person. Right now I haven't felt much pain for the last two weeks so I might try to go .866mm/day. In my opinion .66mm/day is too slow for initial lengthening and should be done after crossing 3.5 to 4 cm.
Dookieman: the guest house and the culture is very similar to college dorms.
Arche: I brought my PS2 here so that I can play games with other patients, but so far there hasn't been much interest from other patients.
Dryani's sleeping position:
LMFAO. Apparently he has a very flexible neck
Here's my excel sheet on my lengthening rate and my pain levels till date:
Update:
Progress: 4.1 cm
Pain: On the scale of 1-10. It's usually 2 during the day and between 3-5 at night. I started taking a Proxyvon before sleep. I still sleep a lot but it is more interrupted because of the pain.
adlerta: I suggest you bring Protein powder and vitamins with you since they are more expensive in India than in US. There is a kitchen at the guest house and the food you get can be adjusted based on your needs.
Braden: Thanks.. I wouldn't know anything about the visa process since I have dual citizenship of US and India.
Krazy4: That does seem like a good idea but I usually have achy pain in both of legs at once.
Update:
Progress: 4.6 cm
Pain: My pain levels fluctuate around 4-5 most of the day and flares up to 6-7 during the nights. It is getting difficult for me to sleep due to the pain. I don't think there is anything Sarin could do the fix the pain besides giving pain killers since is general achiness due to my current lengthening rate of 1mm/day.. My goal at this point is 5.5cm on the left leg (due to preexisting leg length discrepancy) and 5 cm on the right leg. My reasoning behind the relatively fast lengthening rate is that I would rather suffer through 8-9 days of moderate to high pain and then to get these f***ing frames removed than go at a slower lengthening rate and feel moderate pain but for a longer period of time.. and besides 8-9 days of opiate painkillers wouldn't do me any harm.
Ballerina: My left leg is starting to drop recently. It takes a lot of stretching and some time to bring my foot to 90 degrees. But my right leg still manages to stretch beyond 90 degrees. I feel that I might be able to walk away with no ballerina on my right leg and about 2-3 cm of ballerina on my left leg.
Update on Cooldoc: Cooldoc went back home 2 days ago after finishing 6.8 cm in his tibiae. He now holds the record for fastest LL journey of all time. His average lengthening rate was around 1.25mm/day.. He took a really big risk by finishing his journey within 2 months and a week and only time will tell if he consolidates or not. One thing is for certain, he is very intelligent physician and he knows how to balance out the risks and benefits. His muscles were also very flexible due to his experience with martial arts. I am sure he will recover fast. And being a physician has its perks especially with hospital equipment and pharmacy.
Disclaimer: This, in no way, should make people think that its easy to go through LL and be done within 2 months.(Let 'em know Kaizen).. Cooldoc took a risk and he suffered through a lot of pain only because he had a very small window of time to do this procedure and had done his research and planned his recovery. I just wanted to update his condition and I will not answer any questions related to him.
Update:
Progress:
4.8 cmrick116: I actually don't know who could have replied back to you from the hospital. But if you are trying to get in touch with doctor Sarin you should email him or call him from the information given on his website.
http://www.drsarin.in/height-gain.html .. He currently has a patient at this guest house who is also not native in English and she manages to go through this just fine. I hope that helps.
Mdragon, Dookieman, AL4N: Thanks guys, I appreciate any kind of encouragement.
Ilike8cm: Thank you. I am still shocked at how fast this journey has gone by. But going slow has its own advantages as well when it comes to pain and ballerina.
Here's my recent spreadsheet:
Dan J: Thanks. My time here in India has definitely passed quickly. Dookieman was spot on when he said that the guest house is like a college dorm life. I spent most of my time in the common room or socializing with other patients. I can't say the same for the people living at the hotel right now but it is only temporary. But I hope that we can establish the same type of dorm culture at the new guest house. I can't think of things that I could change if I were to go back and do it again but I'll think and get back to you on that.
Arche: I could take a picture of the kitchen and post here but it wouldn't matter because we're moving to the new guest house in 2 days. I swear man, either me or ST, we will take a video tour of the new guest house and post it here... I think that'll satisfy your need for pictures! lol.
To all: I'm nearing the end of my journey. I have set the frame removal date to July 30th and I will set/confirm my return ticket to around August 9th. If I missed your questions please repost them, I'll be happy to answer them. I have learned a great deal about this procedure and a lot of its medical aspects through doing research and I was lucky to have a roommate like Cooldoc (a physician) teach me everything about LL. I had a pretty smooth ride up until the last couple of days with only some minor speed bumps. Honestly, just having the knowledge of why/how something is occurring the way it is, reduces a lot of stress and anxiety from LL.
Ilike8cm: Ahhh, Dr Chaudhary. Heard some horror stories about him. lol
Here's one:
http://www.makemetaller.org/index.php/topic,845.0.htmlRockieo: That is a very reasonable question. I suggest that you save 15K for the whole Journey. That'll cover your plane ticket, the cost of living and the surgery and some other things here and there such as supplements. Personally I got by fine with $ 14,400 which included my $1200 plane ticket
To anyone who is curious about the current situation in India:
Update: PICS! PICS! PICS! My frame removal date is tomorrow on Tuesday, July 31st.This is what I have lengthened so far:
I wont know until after the surgery exactly how much I've gained, but I will be over 5 cms. These are some pictures that I was able to take. The guest house has 3 floors. I'm on the middle floor and I'm living in a triple room sharing with Kaizen and Dryani. This is a panoramic shot of my room: 
Here are some more normal pics:
This is for you Arche:
Here's a picture of my legs at the end of my LL journey. Notice I have written stuff on them with a marker to remind Sarin to keep my left leg 0.5cm longer than my right. On my right leg it says, "x" (meaning whatever unknown length it has), and the left leg says,"x+.5cm" (meaning add .5cm to the length of right leg)
My Final Height was
Left leg: 5.5 cm Right leg: 5 cm
I am extremely satisfied with this height and hoping to have full recovery.
Maybe planning femur surgery in 3-4 years........
More Pics
Just to be clear, the .5 cm difference between both legs was intentional so I could correct my leg length discrepancy that I had before LL.
hotdawg: I don't see any problems with going back home for some time in the fixators considering you don't have any complications during the time. I would say one thing though, Dr Sarin's expertise with tibia lengthening is primarily with ilizarov device and I don't know if he would be the right doctor for putting monorails on tibiae. Even if he agrees to that, you would be the one of the first persons to try it if you are willing to take the risk with your legs. Other than that it wouldn't be an issue to go back for a week or two. The quality of a patient's LL journey has significantly improved since I came here mainly due to the experience and knowledge of the veterans being passed down to the new patients to help them avoid or cope with any complication that may arise. So by the time you get here, you'll be in good hands...
shadow45: I am following mmt's advice on not going over 5cm per bone segment because after LL I still want to be able to retain 80 to 90% of my athletic ability. With that said, I know I'm bound for femur surgery in the next 5 years or so. Just waiting for cheaper Internal option.. I f*&king hate Kaizen right now because he's going for femurs in 6 months from now.
Click Here!
