Journey towards third surgery
A few weeks went by. And I was limping and limping more. Developed ankle pain on the right. Had valgus on the left. People started asking me questions what really happened to me.
'You seem to be bending your legs in awkward angles'. You coul deasily figure out that I was totally in s*it. By the time I heard from Majid that his left nail was also broken. And that the Boston girl was in emergency unit.
That girl in the neighbouring room had complications. I heard from another fellow patient (the guy staying in the opposite room) that Motallabe used my images on mi tv in Iran. And he claimed that I was doing very well and very happy about the results. This really really infuriated me.(Here I was suffering from infection on my right wound area (wound had healed but still pus was coming out of the top surface). I couldnt believe my state. I had cleaned everything 3 times a day. Was on antibiotics every single moment. Is it deep infection?) I called Motallabe and was crying out to him. I yelled at him saying he destroyed my life.
He said he would send the invitation to come to Iran the very next day. He said I didnt have to pay anything and this time he would fix the problem and do everything properly. And the infection can be fixed by one month of injections.
I went to another third world country at this point. (I am not going to reveal for protecting certain information). There that doctor had promised a very cheap price. He was shocked to see my xrays I had sent over email. But he said he could exchange nail on the left and put autograft. That is a straightforward procedure. But I have to go to Dr Paley or someone like that for correcting right leg. That was his advice. I hadnt told him about the pus coming out though. I was in his office and he saw the pus on the right leg. He asked me to go get standing xrays and other specific images. He put me on a culture test. I went through isotope test. Isotope test was inconclusive. It showed that the legs had severe activities. But the culture test indictated that the infection was only on the surface. So I didnt know what to make out of this.
The doc said that the right nail had to come out if its deep infection. And he wasnt sure if that was the case. He said that only during surgery he could confirm. I called up Dr Fragomen, And he said that when I visited him it didnt look like infection. But he had to see me to tell anything. I flew back to New York. On the way back at London airport, I saw this prettiest of girls and she talked to me nicely and by surprise she was sitting next to me on the flight from Heathrow to NYC. I finally thought of ignoring the monetary issues that would arise from this mis-adventure and just fix me for good. Went straight to HSS. Had another series of tests.
In Fragomen's office I suggested him a particular solution and he also agreed that would be the best course of action. The right nail would be removed and tested for infection. If I pass the test, osteotomy would be performed and the leg straightened. This would tell us what length is actually recoverable. Then reduce the left side accordingly and exchange nail there and graft it. Sounds like an adventure???
.
Only one glitch. Fragomen said he wouldnt let me do both legs in one shot. (in case of no infection) This is to make sure I recover on time and the right way. In hindsight this might not have been the right solution money wise but it really was the best solution recuperation wise.
Third surgery and recovery
Lot of my friends and my brother gave me lot of money towards the next two surgeries. They didnt even ask me what really happened to me.
Anyways, regarding HSS, this is one hell of a hospital with all sophisticated instruments and a gamut of great doctors. The only problem is they really really charge a lot. They are very scientific and methodical in whatever they do. The doctors are flexible. But the hospital gives you all kind of bills. I had just one surgery here and like 100 bills some of them I dont even know the purpose.
I was in the waiting room and first Fragomen came and talked to me. He took pictures of my legs and stuff. And then another girl came she noticed suspicious area in the right leg and she took a picture of that. Then the anasthesiologist came and talked to me. He was a great person. Then another doctor came and talked to me. I dont know his role. He asked me if I understood what was going to be done.
Then they put the drips on. Slowly I was passing out. I remember being taken inside a tunnel kinda thing and I was in the OR and I saw the doctor and a whole lot of people setting up things. I have pictures of all of that. But I am not sure if I can even share them. Then I passed out. When I woke up I was not in post surgery care unit (different from the recovery room). I woke up in pain and threw up a couple of times.
Then in 3 more hours I was moved to the recovery room. I stayed in HSS for 4 more days and then I discharged myself (yes its funny). Basically my infection was only on the surface. SO my biggest worry was over. The doctor told me that there was very very minute development of gram negative bacteria in the culture. But we are talking about really negligible amount of development. He said that they provide ample environment for the bacteria to grow in the culture tests. but the nail itself was negative.
So the canal was clean and he also cleaned the canal as well as anyone could. His words were 'If more infection comes out of that, he would be surprised'. On one side it sounds good. But the next 3 or so months I would still live with that inner fear that its still not ruled out 100%.
They use pins and not regular sutures. This actually helps in faster tissue merger. But it pains as hell when they remove it. (especially if someone who is not experienced removes it). Another good thing is it doesnt leave significant scars. I would say I liked this technique. The day I came back home I was changing the dressing and found yellow patch in the dressing that was coming out. I was worried if that was infection.
To date I dont know what that was. But it never happened again. I was allowed to take bath and stuff but only on running water (shower). By this time I decided not to go to work at all. I wanted to recover and get the next surgery done and then go back. I stayed back home watched NFL network, Worldcup soccer over the next few months. Ate a lot of chicken wings and started gaining weight. I would say I consumed a lot of calories. (Why should I talk about these insignificant things? I think they might have made some difference and I want people to take note of that).
It took 8 weeks for the right leg to join completely. It was quick enough I suppose. I had gained 5-8 mm. Thats right. Anyways I stated this for all those people who asked me if I gained anything at all. I have decided to move on from this height neurosis.
I mailed Motallabe and asked him to give me back my money. As it would help me pay for my upcoming surgery. He said he has talked to nail company and they have agreed to pay. He asked me to send all the picutres and stuff. I sent him the xrays after the third surgery. He kept saying, he can not cover for the stupid decisions by American doctors.
He said my condition was due to not wearing the braces. I wore the braces right through. It was a painful experience. I told him I would report to this board and would appear on TV interviews. He would resort to a semi-aggressive and semi-delaying tactic. I had to find a way to get the second surgery done. I had no money after all. He was pissed at the fact that the length was not retained.
But this was done because the other side wasnt improving. I cant go on like this in my life being a limp and waiting for miracle to happen. This one time he told me that HE WOULD SHOW THE VIDEO TO PEOPLE WHO MAIL HIM. IT SHOWS THAT I WAS VERY HAPPY WHEN I LEFT IRAN. I was so pissed at losing my privacy.
Fourth surgery and there after
Now I hit a point where HSS refused to let me in for the next surgery without clearing previous bills or pay everything upfront for the next one.
It sucked. But the doctor was willing ot operate me anywhere in NYC area. I went around shoping for a hospital. I squared in on NYH Queens.Its better than the Iran hospitals after all.
And I am with a good surgeon. I somehow managed most of the cost. I still have huge bills left from both surgeries. But I guess I will get through them in months.
The only thing at this point I wanted from Motallabe was to give me some money instead of the surgeries he offered me for free. And he said he wouldnt do that.
He was very angry at the fact that I went to another doctor and shared information about his procedure. He has great respect for Paley and Rozbruch and I had been communicating with them about my case.
So he was pissed and he stopped mailing me back or taking my calls. He repeatedly asked me in one of the mails why would I go to another doctor. I replied saying his procedure sucked.
I had to wait a long time for the fourth surgery because I was finding it hard to get ready with the money and HSS was still on my mind. But all the bills from previous surgery impeded me from choosing them. I went to NYH Q instead.
By this time my understanding of the procedure was very good. I knew that when the nail is exchanged and OP-1 graft is done my legs would be equal (8 mm more than they were before LL) and no valgus or any ****. I promised to enjoy my life.
Fragomen exchanged nails and grafted me with OP-1. He asked NYH for OP-1 just before entering the surgery room. (As if showing it was used in case of emergency. And since this was not part of the initial deal with NYH I didnt pay for this at the time of surgery. But they shot back later after a month by sending me a bill for 28K for the 'Materials used in surgery'. I am still fighting this bill.).
I stayed in NYH only one night after this surgery. I consider that as a proud moment. This was a fairly complicated surgery. But I had become so hardened by my surgeries I came out of the hospital with all the pain in the world. I saved money like that.
.
I returned home and in one more month I threw away my crutches and started walking. You could see me limp a little bit. But I was getting better. The XRays were strange. Bone joined on 2 of the 4 sides completely. In fact it started putting more and more callous in those regions.
In 3 months I started walking perfectly. (That is now). But I take the stairs carefully. Now I do everything. Except carry weights or jump around. My finall xray was yesterday. I still have a gap on one side. But its not that serious. My bone (s) are one single piece. Fibula is stronger than before. Tibia has joined but the gap still worries me. There is callous formation though around that area.
Overall my left leg (tibia especially) has been very slow in progress. But once the nail was removed (the first nail) it showed callous which means its the nail which caused non union. There are other proofs also. Many other patients still suffer from non-union. I am not. I got it linked. I am healthy now. One day I will run like I used to. Right now its a wait game. Even my friends said I am walking better. If they watch closely they can still say that my left leg has no strength.
I am still fighting with Motallabe and his horror. I intend to show all the emails I exchanged with him (with personal info removed) and images. I also intend to answer any question/concerns.
He still says he is going to distribute the video if I write anything about him in the internet. But I think I am past that stage where I was worried about his empty threats.
