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LL disaster in Iran - Diary

October 11 2006 at 12:54 PM
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ptr30  (Login ptr30)
from IP address 24.98.245.234

 
I am active in Random heros internal external board. But I decided to have the information in all active boards to avoid people going here. This is copy - paste from the other board.

I am formally opening my diary and putting it all together.
Background information: I will be 28 in a month. I was just over 5 6 and was suffering from height neurosis. After fighting this neurosis for over 4 years (on and off) I finally decided to put an end to this and undergo LL. I looked around and was not in a position to go to Germany or get it done her e in the states. I started talking to Motallabe through emails and through calls. (July-Aug 2006). Couple of my emails are already here in this board. Let me tell you he is an outright liar. He said that he had issues with his patients in the first two years and recently he had no issues at all and he had done over 90 LL surgeries most of them cosmetic. I wanted to talk to one of his recent patient and he gave me the contact of one of australian patient called Jason. I exchanged emails with him. I couldnt make anything out of his mails and in one email I asked him directly if I were him will he take the risk and he replied saying he had lengthened about 3.5cm and he wouldnt mind doing it but he would stay away from large amount of lengthening. I should have guessed from his emails. Here is his case information - He was about 174 cm and stayed in Iran for just over 2 months and got about 3.5 cm. After 1.5 months he was complaining about discomfort in one of the legs. He said the other leg was going fine. Ok another thing here - Tsui mentioned here in the board never responded to my emails. I know about his condition now. But god I must have known that before I left.

Well the doctor asked me to fax my passport and few other documents to get the visa done. He did not ask for any money which made me think he was genuinely a nice person as mentioned in Tsui's diary. And the fact that he admitted he had issues with some of his former patients in the initial years made me think he was a genuine person. He took about a week to send me an invitation letter from their embassy. I had to go to Washington DC to get the visa. (This is not an embassy but just some junk office).

Second week of september I flew to Tehran connecting through Amsterdam. There was one day of delay at Amsterdam for some strange reason. The airlines (KLM) provided overnight stay in a posh hotel. I could have just spent the night at the downtown and flew back to US. But I was tired I just slept the whole night and the next day flew to Tehran. There was an Iranian guy flying from the same city here in US and we became friends. He talked to the doctor and informed me that I will be flying a day late. And Motallabe had canceled my reservation at the hotel and pushed it by one day. Upon my arrival at THR, a taxi driver picked me up from the airport and put me in a hotel. At the hotel they took away my passport. The next morning I actually met Motallabe at the hotel lobby. He said that I can do 6-6.5cm in 50-60 days and I can go home after that. He said that walking maynot be perfect after that. With little bit of limp I should be able to walk. Then he asked me about how I intend to pay. I had cashier's check for 15K and 10K in cash. (The agreed amount was 15K). But he said that cashiers check wont be good in Iran. He took a xerox copy of the cashiers check anyway. The next day a lady called Mrs Rahimi picked me up from the hotel and took me for Xray and blood test. She was humble and didnt know much English and she said that she is a physiotherapist. All they had was lateral and ap shots of xrays and a simple blood test. No measurements of tibias or standing xrays and any other analysis. The very next day early in the morning same lady picked me up from the hotel to the hospital. I was sitting nervously in the reception room where I was asked to fill in a form which was entirely in parsi. They assured me it is all cool and I signed it. I KNOW IT MUST BE THE STUPIDEST THING TO DO. Here is my last chance to turn back but then I decide to move on. I was assigned to a room and asked to change clothes in that room. I had the cash in my backpack and I handed them to the doctor just before getting into the surgery room. He said that it would be like 3 hours. There were few girls along with the doctor in the surgery room and I went ahead with the surgery. When I got up I had my legs wrapped up and I just couldnt feel them. I wanted to move them and see if they were ok. The nurse asked me not to move the legs. Throughout my entire diary I am not going to talk about the pain levels and stuff. Growing up I have never faced severe pain until this experience. And in the last 1 year I have had 4 surgeries all hard core and so I dont know how to compare the intensity of pain. All I can say is it is nothing like I have ever experienced.

The nurse asked me to move the tows to see if everything was ok. And everything looked fine. I stayed in the hospital for 3 days and got good persian food. I would say the hospital care was good in fact it was excellent. The nurses were pretty, humble and very attending. Its not the best hospital in the world. But it certainly was good enough. They had a phone next to you so you can just call them if you need anything (from the bed moving only your upper body). They had male nurses too if you need catheter or anything. During all 4 surgeries I had a strange problem. My body reacts strongly to anaesthetics. I find it impossible to pee. And eventually I had to do catheter.

After day 3 I was taken to the room where I will be staying for the next few days. (on wheel chair of course). The pain killers provided are strange. You need to put it through your ass. And you are supposed to do it every 6 hours. Finally after day 5 they removed the clothing around the externals. God the external devices were so big and definitely not of this age. It had long strings and its an intimidating apparatus with screws and sturts and spokes. Now finally I know I made a mistake. But I think to myself its alright I will lengthen 4.5 cm instead of 5 cm which was my original goal.

The doctor said that I need to start lengthening from day 6 post surgery. Lengthening is done by turning 4 screws on the top by 180 degrees (which results in 0.25mm) for 4 times a day. You can do 1mm - 2 mm day of lengthening.
OBVIOUSLY this is not an accurate mechanism. You are just turning the screws and pushing your leg down without any proper measurement. The doctor left a bunch of pain killers (which are to be inserted through your ass) and a walker.
He introduced me to a neighbouring patient whos is a girl from singapore undergoing a complicated lengthening on her left thigh. She spoke decent english and she was accompanied by her brother who was going to attend med school. So he knew a fair bit of things.
There was another patient in the opposite room who was going through a cosmetic LL. Then there was a young chap who was like a maid. Basically to cook and take care of your needs. Before leaving my room doctor was boasting that his protocol was better than that of Dr Paley's.
Dr Paley does not let the patients bear weight even partially for 2 months. And that results in muscle loss. Little did I know how wrong he was.

Finally on day 6 I got out of the bed and took few steps on the walker. Mrs Rahimi was in that day and she immediately brought her digital camera and took some shots. She was praising me that I was a good patient.
I wouldnt complain about food. But it was routine which makes it hard. Morning you will receive milk + dates + eggs. Lunch you will get kababs and dinners you order pizza or something. I have had persian food before. So I wasnt complaining. You get OK food essentially. And I had packed lots and lots of protein powder packs which I was using.
I started lengthening and trust me its not fun. As I mentioned before I will not go into the details of pain. Its just unbearable. And it becomes harder and harder as you progress. Walking gets hard. You dont find it easy to get up and so on and so forth.
We were supposed to take xrays every second saturday.The first saturday I was in the room I went down for the xrays. Basically we stayed on 6th floor of a hospital. In the fourth floor the PT room was there and in the ground floor you had a general hospital and xray room etc.
I had my first xray and you dont make much out of it. (I had pretty much no knowledge of radiographic interpretation at that stage). The doctor had mentioned that the first two weeks the lengthening you do doesnt measure up on the xrays. But it is correct from then on. The next week I attended my first PT.
Its basically like raising your legs and pushing your leg against the Physio's palms for calf exercises. The doctor had newly bought some simple exercise machines. It is a very simple PT set up. Nothing fancy. But this where I met other patients and slowly started getting worried. But then I thought I am a self-motivator and a very healthy individual so things should be fine.
I met a patient called Majid who is the most interesting of characters I met. He was a rich chap who was some kind of freelance project coordinator with all oil companies. He used to do physiotherapy for hours and hours and carefully do lengthening and maintain good diet.
He was doing cosmetic LL aiming for 8cms. It sounded ridiculous to me. But he was almost at 5+ when I met him. He had fancy pants which would be easy to wear on top of the externals. There was a middle aged lady undergoing this surgery. I have no idea why would she do this at such a late age. Later I learnt she had several issues. Basically no one I know had a successful finish. Everyone of us have a ****ed up life right now. Thats the bottomline.

There was a little girl from Boston. She was like 15-16. She was a dwarf. She was too young to do this. I mean, how can you handle such pain at such a tender age.she was also tiny and thin. I would blame her mom for putting her through this. She is just below 5 ft. I mean we guys here are open for dating her right? ( I mean someone of her stature of our age. Dont mistake me ). Later she had several issues. She almost died. Whenever I ask Motallabe about the status of this girl he doesnt say anything. I was told that she went to another ortho to remove infection. If I do find out I will update you on that. I pray for her well being.

By the way I will try to get some of the patients onto this board. I will also get xrays to make you well informed.

There was a girl of our age doing LL and she was always in pain. I have seen her cry over dozen times. And there was tiny tiny girl doing LL. She was very brave. She used to use only crutches and not walker saying that will preserve the posture.
The former had problems immediately after removing the external and went through a bunch of surgeries. The later had reasonable union. But her rods were bent and she had bent legs and is suffering from knee pain. She was suggested to have two more osteotomy to correct the deformities. I have no idea what the current status is. I am going to pursuade as many patients as possible to contribute to this thread. The problem is Motallabe had been telling them that they need him for follow up.
In the middle of the process a guy who had done LL with Motallabe about 3 months before came back. He had lengthened 6.5 cms. He came back with infection. He was still on walker. He stayed there for a month and he left on crutches with an awkward walk even on crutches. He was a positive guy but the latest update I had on him was in january and he still had no bone growth on one leg and in the other there was fair amount of bone growth.

I slowly lost appetite and lost a lot of weight. When I returned to US I weighed only 110lbs that was a loss of nearly 30lbs. And I measured my weight well after 3 weeks after coming to US. In the mean time here in US I was eating well. So i might have lost more than 30lbs. Yes you heard me right.
My legs became thinner and thinner until only bone and skin were left near the thigh and the lower legs. I found it harder to get up and get around. You had to clean the pins twice a day and keep them covered. I had so much pain while taking even a single step. The pins going into the legs were piercing my flesh. That is a sign that the apparatus is failing. I learnt
about it only later on. All the time if I complain to Dr or Mrs Rahimi they never bothered to attend it. They used to say there was a guy called Tommy and he used to do so well. Shut up bitch. I am telling you about a problem and attend to it. Let me tell about Mrs Rahimi. She was the right hand of the doctor. She was so nice to me the first day I was in Iran. But after the
surgery I realized her true self. She will promise to come at certain hours for physiotherapy and patient care and she wouldnt turn up. Dr submits all money for our stay and care to her. But she always used to neglect us. The maid used to complain that Mrs Rahimi didnt leave him any money to bring dinner or anything.
I had to starve starting week 3. I wanted to use my dollars but the maid had no idea how to use it. Life was increasingly harder from week 3/4 once the HOLY MONTH started. People around you wouldnt eat anything until 6pm. I mean how can you do LL without consuming food. In fact you are supposed to eat a lot.
My appetite also became less and less. It is very hard to get sleep. You would be so tired and exhausted but the pain and discomfort wouldnt let you sleep. I started taking increased dose of antibiotics and pain killers. I called my parents and friends and pretended to be holidaying in Europe. I repeatedly lied to them. In the nights my life was a hell. I cried for the first time in so many years. I used to think if only my parents didnt conceive me I wouldnt be feeling that way. But slowly over the last year I have realized how much my parents love me.
Being short is not a sin and not something to be ashamed/felt bad about. Honestly if you are a dwarf yes this surgery is for you. If you are short (5 4+) you are still medically perfect.


Sometime during third week I fell down in the restroom. I used to pull onto the side bar while getting up. And it failed once. I fell down and hurt myself. Hearing the thunderous sound that girl's brother came out for help. Overall Iranians are kind hearted. Unfortunately except for Dr & Mrs Rahimi & few others. Only once did I even attempt to take a walk using the walker outside the hospital. And I remember a worker from the groundfloor helping me get around.

The doctor wouldnt show up at all. After the second xray I was concerned my bone growth was nonexistent in the left leg. I told this to this moron doctor. And his reply was as usual - we never had nonunion in our cases. And excess bone growth during lengthening is not good. It will make lengthening harder. While getting treatment in New York this year I learnt that how stupid he was. And he has had plenty of nonunions and all his cases ended with nonunion during my stay.
At 3cm I realized I cant take this **** anymore. I decided to stop. But the doctor said you had come so far spending so much and going through this pain you should complete the remaining 2cm. He persuaded me so much I decided to go on but slowly. I had surface infection during the later part of my stay and had to take injection every 12 hours. And Mrs Rahimi was supposed to do the injection. But she wouldnt turn up some time.But I used to get the injection and go to nurses downstairs. They were sweet and very helpful.

At3.8cm I totally decided to stop the lengthening. I told Dr of my decision and asked him to remove my externals and fix my internal rods. The decision was based on my observations. Every patient was suffering so much. And I lost faith in his methods. My walking was pathetic even in walker. And the external was just too much to take.
Besides the girl next door was basically having this procedure because of infection in her bone. I didnt want any such **** in my life. My surface infection had receded. And I thanked god and wanted to get out of the mess. I wasnt even able to do any of the physiotherapy stuff properly. I struggled and missed my real life.

At this time I still had to pay the remaining 5 Grand. I asked a friend of mine (confessing to him where i really was) to wire some money to the doc's account. The doc who pretended not to care about money and only about his results thus far refused to go ahead with the second surgery until the money is wired.
This is the first time I totally understood his nature. I mean, of course, no patient is going to run away with the external. Just get them fixed on the external. He has to give you money to remove them.

My friend failed to send money on time because of a glitch. Iran issues were just started to surface. And Iran was a blacklisted country to be sent money. Then my friend had to give an affidavit to release the money. I am sure he is right there at the top of CIA list right now ( ).

In the mean time I was supposed to get my visa extended. Mrs Rahimi took me in her car. God you should see how cooperative she was in getting me there. She would say 'Walk ,, Walk...' in an arrogant tone. I was like what the **** you stupid bitch???? I was so pissed that day. But I was like ok these sufferings are only until the externals are removed. Then i would be able to walk around. You can still see the flesh pierced region in my legs due to the pins getting into the legs.
I want to add that the pins break during the process. i had 2 pins breaking that way. And they change it using a tool and god that is PAINFUL. Majid had 7 pins breaking from his externals. Later I learnt that pins breaking indicates external devices starting fail (Improper fixation).

Once the money was shipped doc agreed to send me to the second surgery. The night before the second surgery I was taken for CT scan. I knew from my notes that my legs were off by atleast a millimeter. But Mrs Rahimi walking out with the scan said the legs were equal perfectly. I knew right there it was a lie. But I thought I would tell it to the doc the next morning before entering surgery room. I ****ing had to get out of THR asap.

Well I want to add that my right leg was longer by a mm or so compared to my left. (Just remember this). There is a shocking thing later to follow.

In today's diary entry I will start from the day of second surgery. Early on that friday morning (he was boasting that never had he
done a surgery on fridays. And he was accomodating my surgery date so that I can fly back soon) Mrs Rahimi picked me up early in the morning
to a different hospital this time. I asked her why wasnt I being taken to the earlier one. She said that this hospital has the instruments needed for the second surgery.
Ok I want to add something here. WITH THIS IRAN DOCTOR DO YOU KNOW WHO ELSE IS PRESENT IN THE SURGERY ROOM PERFORMING ALONG WITH HIM????? TWO OTHER PHYSIOTHERAPISTS. WHEN I WAS IN HSS I ASKED A DOCTOR ATTENDING MY RECOVERY
IF THEY EVER ALLOW A PT INSIDE THE SURGERY ROOM, HE STARTED LAUGHING AT MY Q. THE FACT THAT MRS RAHIMI IS DOING SURGERY ON YOU ALONG WITH MOTALLABE SHOULD TELL YOU WHAT KIND OF PEOOPLE WE ARE DEALING WITH. FOR PROOF YOU CAN VISIT THEIR WEBSITE AND GO TO 'ABOUT US' LINK and click
SPECIALISTS' YOU WOULD SEE THAT HE LISTED HIMSELF AND AN ANAESTHESIOLOGIST AND MRS RAHIMI AS PHYSIOTHERAPIST. AND SHE WOULD BE IN THE SURGERY SUIT. THAT PICTURE WAS TAKEN DURING ONE OF THE SURGERIES.

So I was taken into the hospital. I was struggling even to take a single step using the walker. And Mrs Rahimi would command in persian, faster faster. ****ing bitch do you know how it is to be this way????
I was put in a room and asked to change and get ready for the surgery. The doctor walked in to talk to me for a minute. I asked him, if I would be able to walk well after the second surgery. He said it is usual for patients to suffer during lengthening. And more so for me as no one was accompanying me.
So I was emotionally felt depressed. Otherwise I had done good progress. He asked me to feel happier. Then I mentioned him about discrepancies of lengths. He said they would be measuring it inside the surgery room and he would take care of everything. I was relieved for that moment. And all his speech made me think I am on course for a greater life.

Then he said some people will be seeing me soon and he asked me to try to walk well with the walker and show them my progress. Basically he was trying to show my case and get another patient. This was a dwarf girl and her parents. She was so stupid. She kept asking me if she can lengthen 10-12cms. I mean her entire
tibia would be only that long. duhhhhhh..

Then the most important thing. HE SAID HE IS GOING TO ASK ME SOME QUESTIONS AND TAPE ME. HE SAID IT IS ONLY FOR HIS INTERNAL USE. RIGHT FROM DAY ONE OF CONTACTING HIM I HAVE MAINTAINED THAT MY PRIVACY ON ANY ACCOUNT SHOULD NOT BE VIOLATED.I WAS RELUCTANT TO DO THIS INTERVIEW. BUT HE EARNED MY TRUST BY TALKING ME INTO THIS.ALSO HE ASKED ME TO SOUND POSITIVE. THEN HE KEPT ASKING ME QS AND ASKING ME TO INTRODUCE MYSELF ALL KIND OF THINGS. LATER HE AIRED
THIS INTERVIEW ALONG WITH MY IMAGES ONE WEEK LATER ON AN IRANIAN TELEVISION AND HE TOLD THE AUDIENCE THAT I WAS DOING EXTREMELY WELL. IN REALITY I WAS HAVING A BROKEN NAIL RESULTING IN MALFORMED RIGHT LEG AND A BENT NAIL ON THE LEFT LEG. EVEN NOW WHEN I THREATENED HIM THAT IM GOING TO SHARE MY EXPERIENCE ON INTERNET, HE SAID HE CAN PROVIDE COUNTER PROOF OF MY VIDEO SHOWING THAT IVE BEEN DOING GREAT. IN REALITY I DONT EXPECT ANYONE TO BE SO DUMB TO TRUST THOSE VIDEOS. EVEN BY THOSE VIDEOS I STRUGGLED SO MUCH EVEN TO TAKE A SINGLE STEP. YEA SURE YOU CAN SEE
ME PRAISING THIS DOCTOR. HEY I WAS TOLD TO DO SO. IF SITUATION ARISES I WILL BE GOING ON THE SAME CHANNEL AND ANY OTHER CHANNEL INCLUDING, SHOWING MY IMAGES FROM SURGERIES HERE AND ALL MY SUFFERING. IF ANYONE KNOW PEOPLE IN POPULAR NETWORKS PLEASE LET ME KNOW.

He is indeed a piece of work. I am going to quote an incidence I heard from a fellow patient just a month back. Before that let me answer your other qs. Yes I didnt gain anything. Well I lengthened 3.8cms. Then after returning to US my nail broke and lost most of the length on the right leg and the leg was deformed. I had nonunion on the left. I will explain entire situation in the diary. Just keep patience. I am working now so I dont really find time to do this diary in one sit.

I will be taking actions against him trust me. I was holding it back because he had promised me to file for the insurance and told me that insurance did say that they willl cover it. Basically he was buying some time and playing games.

Ok here is an example of how lunatic this guy is. There was a PT called Mrs Saraj working for him. She divulged the information about Tsui (you can see his adventures in this same board) to some of the patients. Basically Tsui supposedly had furthur surgeries and he had issues. If you look at his diary you would get an impression that he had LL surgery like a field trip and he was so successful. You wont find any info on what happened to him after 2 months. I dont have complete info so I dont want to misquote anything. And the doc was pissed at Mrs Saraj for talking about Tsui and he fired her. But he had backlog of some of her pay. She filed a case in a court and the court gave a verdict that Motallabe should pay her the remaining pay and some kind of benefits that he skipped for the last 2 yrs. After the verdict this moron was so pissed he yelled at her saying ' I WILL THROW ACID ON YOUR FACE'.

In reality out of all PTs (there were 3) Mrs Saraj was the most sincere. And I should really have picked up the clues when she used to keep mum whenever I asked her about will I be ok in a month or two. Her replies would be ' I pray for that '. Along that line. She helped me with the antibiotic injections when Mrs Rahimi used to miss appointments.

Anyways, he supposedly threw something on her car after the case was over.

But listen to this. When the case was going on I was having my surgeries here in US. And he was lying to me that Mrs Saraj was arrested in Tehran for spreading rumors against him. Basically he was portraying as if whatever Mrs Saraj divulged was wrong and he got her arrested. I confronted a month back why he lied to me like that. And he was like - no one was there when she was arrested. Thats why no one knows . And the civil case regarding pay dispute was not correct.

If there is a way to display all his emails without revealing my email Id/personal info I would certainly love to show them here. That would show what a bastard he is.

Cbick,

To answer what happened to that little girl. I can only state what I heard from others. When I saw her in Iran she used to suffer. She never took a step on her own. She always looked to be in pain. (I am sure by now you know that thats part of every day's life doing lengthening.)

After the apparatus was removed her sutures were exposed (just like what happened to several other patients). This resulted in infection of greatest magnitude. She was in bed taking antibiotics through drips. At the height of infection her mom decided to take her to another ortho as she lost faith in Motallabe.

Ok I am continuing my diary from where I left off.

After waiting for almost 3 hours in the room, finally they moved me into the surgery room. One thing I should admit, compared to the last surgery room this one was better. During this surgery they were going to remove the externals and the internal rods are already in there and they just have to fix the bottom two screws.
THE FUNNIEST THING IS, I WAS LYING DOWN IN THE SURGERY TABLE AND MOTALLABE ASKS ME ARE YOU HAPPY WITH THE ALIGNMENT AND EVERYTHING. DO YOU ASK PATIENT ABOUT THIS THING????????? IT SOUNDED TO ME LIKE ALIGNMENT IS LIKE PERSONAL PREFERENCE. AND THE WHOLE THING IS TRIAL AND ERROR. AND IN FACT WITH RESPECT TO MOTALLABE IT REALLY IS. YOU SHOULD SEE HOW THEY ANALYZE THE ANGULATION, KNEE POSITION, FLEXIBILITY AND EVERYTHING HERE IN US. THERE IS NO COMPARISON.
WELL JUST AS I WAS TALKING I BLOCKED OUT. AND I WOKE UP AND I WAS IN THE RECOVERY ROOM. They had assigned a dedicated nurse to me. She took good care of me. She was curious about why I had the surgery and she asked me in sign language. And I told her I wanted to be tall. She said im tall enough and good looking and didnt need this trouble. But before she left she wished me luck. There was a male nurse the next night. He helped me with the cathetar stuff.
While I was in bed Motallabe sent the PT named Amiri and Mrs Rahimi to make fiberglass covers. They made fiberglass covers when I was still wrapped up in band aids. I wasnt sure if that was the logical thing to do. Ok let me explain how this fiberglass splints are made. THey have green color fiberglass material which is like a fabric. They soak it in ice cold water and wrap it around your legs and leave it there for a min or two. It moulds into a solid. According to Motallabe you are not supposed to walk without them. And if you wear them you can somehow magically walk even without walking aids.

Late second evening post surgery Motallabe and Mrs Rahimi came to the recovery room to discharge me. They asked me to get up and walk with them.
I said I will wear the braces before putting my foot down. I tried to wear the braces and it was almost impossible to do. It doesnt sit right there. It needs to be
wrapped with bandaid clothes to keep it tight. Then I tried to put my foot down. I couldnt stand up. So they decided to put me in a wheel chair and take me home.
After great struggle I reached my room. (in wheelchair). And the doc was saying you can comfortably start bearing weight. You are just being paranoid to do weight bearing.


The next morning I tried to get up. But I hardly could. Ali, the next door girl's brother, helped me get to the restroom using walker. Third day after reaching the room, I decided to walk around. But I almost fell down. SO I asked Ali to get me
crutches. He went downstairs and bought me crutches. I tried to take few steps around the room with crutches. I looked ugly walking this way. You people have to see what I went through the next few months, to believe how hard life is, immediately after LL.
You cant get up from the chair that easily. This is true for LL of any kind - internal / external. Wipe off all those rosy pictures in your mind immediately after surgery. Tall or short you would look good just being energetic and running around. Tall or short you are ugly when you limp and walk like a loser.

Fourth day I went to KLM office in downtown THR to book my return flight. (This was on walker). The lady there said walker is not allowed inside the flight. But crutches are. How can he travel this way?
But I convinced her I will be on crutches. So the next two days I practiced walking on crutches. Oh well I can take few steps by now - ugly looking or not. But I avoided walking unless absolutely required and only on walker or crutches with someone besides me. (Just in case I fall down or something).

(^^^^) ONE MORE WEEK PASSED BY AND MRS RAHIMI CAME TO MY ROOM AND TOOK AWAY ALL MY XRAYS. I TOLD HER I NEED TO SHOW THEM TO OFFICIALS IN THE AIRPORT IF NEEDED. BUT SHE SAID I NEED TO TALK TO THE DOCTOR.
THEN I CALLED THE DOC AND ASKED HIM I NEED A LETTER SAYING I WENT THROUGH SUCH AND SUCH SURGERY AND THATS THE REASON FOR MY STAY HERE IN TEHRAN. HE SAID HE WOULD DO THAT BEFORE I LEAVE.

THE DAY BEFORE MY DEPARTURE I WENT DOWNSTAIRS AND TOOK XRAYS (WITHOUT MOTALLABE'S REQUEST). NORMALLY TO GET XRAYS YOU NEED HIS PRESCRIPTION AND YOU TAKE THAT DOWNSTAIRS AND GET YOUR XRAY. BUT BY NOW I HAD BECOME A GREAT FRIEND OF THE RADIOLOGIST. I WENT TOLD HIM I NEED TO HAVE XRAYS DONE AND I WAS GOING TO PAY HIM IN DOLLAR BILLS.
HE TOOK MY XRAYS AND SAID IT WOULD BE FREE FOR ME. THIS IS THE FIRST XRAY I AM SEEING WITHOUT THE EXTERNAL DEVICES. WHICH MEANS NOW YOU CAN SEE THE CAVITY, THE GAP AND THE NAIL CLEARLY. BUT I HAD THE BRACES STILL ON. SO THEY WERE CLOUDING THE PICTURE.

I SAW THAT THE NAILS WERE NOT STRAIGHT. THEY WERE HAVING AN ANGLE AND THE RIGHT NAIL LOOKED WIERD. THE NAILS WERE RIGHT ON THE SURFACE. I CALLED MOTALLABE AND TOLD HIM WHAT I SAW ON THE PICTURE. HE SAID I HAVE NOTHING TO WORRY. THE ALIGNMENTS ARE PERFECT AND THE NAILS WERE SUPPOSED TO BE BENT THAT WAY. THEY WONT BE STRAIGHT. ALL NAILS HAVE ANGLES.
WHEN I ASKED HIM WHY I CAN NOT SEE ANY CALLOUS AT ALL. HE SAID THAT IT TAKES 6 WEEKS TO BE VISIBLE ON RADIOGRAMS.


The night before I left, I had visitors. The same people (that dwarf girl and her parents who visited me hours before my second surgery) came and wanted to see how I am walking. The idiot doctor asked me to come to PT room. I said I am finding it hard to walk around and I want to rest. Then he sent Mrs Rahimi to bring me down. I told her I can not go down.
She is like 'No get up and get down'. I said I can get down with walker. She said you are flying tomorrow and you cant take the walker. So anyway I need to use the crutches. I was like what the heck. I felt so week. But I decided to go down. With great struggle I put the braces and took the elevator to the PT room. This dwarf girl can talk English. But her parents cant. She had a bunch of questions for me.
So did her parents and whatever they asked, the girl had to translate for me. While I was doing this, Motallabe taped me. This time around I was not answer as positively as I did in the waiting room of the hospital just before surgery. So obviously Motallabe was giving me this look. Why did I do so??? Because I wasnt walking properly as Motallabe had been claiming. At the end of the conversation she asked me if I could show her walking.
I said I am finding it hard and I wouldnt do so. But Motallabe was like 'you can do it'. Finally I got up and took few steps with the crutches. And the girl was like ' wow thats enough . If I can walk like that after 10 days of surgery I can do my job'. She asked me if I would advise her on doing 10cms.

I told her she doesnt need the surgery. She asked me if Americans were really that tall as they show in movies. I told her she is short and she is never going to be that tall. She asked me why I stopped just short of 4cms. I told her I am happy with that gain. In all reality I wanted to get out of potential issues. I didnt have faith on the doctor or the method or becoming tall and achieving things in life anymore.
Anyways, the girl offered me ride to the airport the next night. But I told her I will take a cab and she didnt need to worry. I had a feeling she was hitting on me. Oh well I want to be with someone close to my height so I can have taller kids.

The night I left was full of drama. The doc was supposed to come and see me before I leave and give me that letter he promised. But he didnt come 2 hours later than when he promised to come. I was getting impatient. Here I am 3 hrs before the flight time. Basically the whole thing was screwed up because the bitch Rahimi told doctor and others that my flight was at 4 am. But it was actually at 12am.
Seeing me being impatient she asked me to calm down and she had asked Majid and his brothers to drop me at the airport. It was getting late and I called Ali and asked him to get me a cab and accompany me to the airport. Ali's sister told me that Ali doesnt know much about international travel and she was sending her uncle along with Ali to the airport. Her uncle was just visiting her that day. He was more than willing to help. I was like screw that letter. I am going to leave. I didnt want to miss the flight. I thought I would be in better care once I am home. (I was going to stay with my friend who sent me money).
Ali brought me a cab. I took the elevator ( I was on crutches from this moment to end of July 06 - that is to say I was on crutches for 9 months post second surgery). When ali was loading my stuff in the cab, Rahimi was yelling at Ali for operating without her consent. She said I can not leave without the doc's arrival. Finally I cant leave now. I cant go up because I was tired. (Yes just after taking 50-125 steps only). So I stayed in the downstair hospital lobby without going up. (I had to come down again in that case. Why walk?????????). Of course I waling entirely using my arms. In fact all these days my triceps were bulging. My entire body was wasted. But my triceps were showing unbelievable form. Is this the best exercise for triceps or what?

After 15-20 mts, Rahimi came with the letter. She said doc can not turn up and he somehow gave the letter through someone else.
And in another 10mts Majid and his brothers arrived. They put me in their car and I was on my way home. I felt I was having this 'great escape' moment. I wasnt going to be depressed anymore.
After all I have gained 1-1.5 inches and I dont feel the neurosis no more. I am going to go home and spend my money happily.

While in the car Majid told me that Mrs Rahimi informed the flight timing wrongly. And they were waiting for Rahimi to call them up to turn up in the hospital. In the airport, the airport officials were not letting Majid's brother to get inside the international passengers area to check in my luggage. Majid and her brothers had to talk to the top guy to get his permission. Finally that took another 20 mts and they let him in. Me and Majid's brother were inside the area. God now I am beginning to panick. There was a huge line. May be 600-1000 people. And most of them were on my flight. And no time to check in. How could this be? I am used to walk right up to the air hostesses and check in luggage here in the states.
I was also blocking out. I couldnt take even a single step. I was going to collapse. I was so weak. An Iranian couple leaving to Chicago through the same flight found me struggling. They asked for a walker and offered to help me out all the way to Amsterdam. They brought me water and some orange juice. After having orange juice I felt better. I think it was out of lack of energy and I guess body is coping with all the antibiotics and stuff and also I am growing inside. So I thought its just natural this dizziness happened. From here to being loaded into the flight I was on walker. Then somehow managed few steps towards my seat in the flight. Of course I had been given a very comfortable seat.

Next morning I woke up at Amsterdam. I was helped using a walker to get to my gate. From there I reached here in US and it was so easy to get through all things here. My friend picked me up at the airport.

I will start today's diary entry with the most contentious issue - the external braces. Remember the braces were made
with the surgical cast still on my legs. So the casts are definitely definitely not of correct dimensions. And on top of that
it is held tight to your legs by wrapping band aid clothing. So I am never able to understand its purpose. We call it internal fixation because
it is supposed to give you complete stability from inside. Can these external braces do what the internal nails fail to do?????? Two days before I left Iran
they remade my right brace because it was pressing hard against my legs. I was always with braces on even when not walking. And the doctor was saying it is just for 'simple support'. After the disaster happened
he turned 180 degrees. Later about this.

The morning after I arrived I was changing the dressing. I noticed a small white stuff in the surgical area. I covered the wounds and went on heavy dose of antibiotics.I immediately called local hospitals and told them I need
appointment. The first doctor I visited, I had to lie to the front desk to get in. And when I was inside I explained what I did to my body. I felt ashamed. He took xrays to study my case. I was waiting in the room and he took like 2 hours and returned to me.
He told me that my legs were a mess. He gave me a very very sad face. It kinda bothered me at that point. He said that how can I be walking around when there absolutely no callous formation. It could take upto 6 months and I need to be on wheel chair in that time.
Also he pointed out that all the nails were going in from one direction and that is wrong. He also pointed out that the nail seems to be making angles and he fails to understand why it was done that way. Finally he tried to call up few other doctors who are in similar fields.
But he returned to me saying, he will not take money for my consultation. But he said he can not take this case. I emailed Dr Paley and Dr Rozbruch about the exposed metal part and asked them what can I do about this. I didnt get any reply from Paley. I got immediate reply from Rozbruch and his assistant Dr Fragomen.
They asked me a long list of questions. I was like I am just trying to find out if this can lead to infection and how I can cover up my wound. Why would they ask such irrelevant questions. I ignored those mails. Finally I was able to find a doctor locally who would take me as his patient.
He would cover my wound and just apply antibiotics. I asked him if he could stitch the wound and cover the exposed part. And he said he can not do that just need to wait for the area to cover itself. In the meantime I had mailed Motallabe about lack of bone formation and the exposed nail. He replied saying none of his cases developed infection or non-union. I was going to be fine. He suggested I go to some doctor and get it stitched and just keep taking a list of drugs.

But being a very cautious guy I managed to avoid infection around that area. I took my xrays after 3 weeks.(of getting back). I was shell shocked to see no bone on my left and only feeble bone formation on the right. I decided to consume lots of milk and eggs as Motallabe suggested. I started over-taking all the drugs he prescribed. I have summarized the drugs he prescribed in a separate post. I did that because that will show what a quack this guy is.
Anyways 1 week after my first post-op xrays I found another wound developing at the bottom screw of the right leg. It was causing me severe pain too. I visited my local doctor immediately. He looked at the wound at the top and the wound at the bottom. He said both looked suspicious. They were out of infection but looks like they are not healing. They seem to be widening. He was concerned. He said I need to go back to Iran or to another doctor here for consultation. The same day I had another set of xrays. (Thats right in one weeks time).

To my surprise the right leg had plenty of bone formation. But when I measured the gap it was lot lesser. I couldnt logically explain anything. The left leg looked very clean. But no bone inside. What is the deal with that? One side looks ugly but theres callous and the other side looks clean but no callous formation.

The next one week I had lots of pain (on and off) at the right knee whenever I took a step. And in the bed if I try to lift my right leg it had a sharp pain. I took plenty of pain killer and antibiotics that week. I also made sure I ate well and took all the drugs that he suggested me. But the pain was too much to take. I went for another xray on 7th day after the previous hospital visit. (You heard me right. I had 3 sets of xrays in 2-3 weeks).
Now the right side looked completely joined and the left leg was empty as hell. The metal part was completely covered. But the upper surface did not look like skin. It was all white mass. (Later I found out that thats the scaffold). By now my daily routine became cleaning the wounds and covering them up and just trying to eat as much as possible. I had lost 35 lbs or more by this time. After looking at the xrays in doctors office I was atleast pleased that the right leg had so much callous. I thought the body is filling one leg after another. (All self-reasoning ). But before I left that doctor's office, he asked me to leave the xrays with him. He said he needs to have a look at it. (Let me explain whats happening here. I went to the hospital only to talk to him about the new wound and the wound that looked ugly at the top. But I also happened to have my xrays done. The doctor was busy he only had a glimpse of it and gave a worried look. He asked me to leave it with him so he can have a second look. But I took the xrays with me to send it to Motallabe).
I came home. The same day Majid had replied to my earlier mail. I had asked him if he had removed his externals and how he was doing. He replied me saying he had 3 surgeries since I left. The first one was to remove the externals and the second one after two days of his previous surgery for covering an exposed screw and the third because his right nail broke. When I read the third one I was SHOCKED. I mean until then infection was my top worry. But now I am being told that the nail could break. I immediately replied his mail asking if I should be worried too. He replied back immediately saying, his case was unfortunate and all these nails have sufficient strength. I asked him if he was Ok and if he did some strenuous thing to break the nail. He replied me saying, he did nothing strenuous. He was just getting up from his desk and he could just not move his knee no more. And all 3 surgeries happened in a week's time. So he is totally down. He said his body was not able to cope up with this. I am hearing this from a guy who has the strongest will power among people I met in my life.

2 days after hearing the unfortunate incidence of Majid, I had pain in the lower screw of the right nail. (I had not done anything until this point). I was just on crutches walking around with the braces. But the right brace was only killing me. It wouldnt fit me no more. I decided to look at my xrays and see what the **** was wrong with my lower screw. AND THERE IT WAS. I SEE THE BROKEN RIGHT NAIL. THE THING IS IT WASNT CLEAR ON THE FRONT VIEW. ONLY THE SIDE VIEW SHOWS THE BROKEN NAIL AND THE LEG WAS MAKING AN ANGLE. I WANTED TO CONFIRM IT. I WASNT BELIEVING WHAT I WAS SEEING. COULD IT BE A MISTAKE ON THE XRAYS? IF THE NAIL IS BROKE HOW THE HECK AM I WALKING AROUND??? Majid only said that if a nail breaks you cant move your knee anymore. I sat on the floor and stretched my right leg and kind of confirmed my fears. The leg was not parallel to the floor. Was making a huge angle.

I immediately called Majid and tried to call Motallabe. Rahimi took the phone. 'hiii hii call after 6 hours'. Majid answered my phone. He asked me to send xrays to see whats happening. I asked him how can I scan the xrays. He asked me to use the digi cam and make the pictures. The two pictures that you see on this board were taken with my digi cam directly focusing on the xrays. I intend to publish all my xrays including the standing xrays and the xrays I took in Iran the day before I left.
I used those images and mailed doctors all around the world. I mailed Motallabe. I mailed Majid. I got late reply from Paley (about 3 days). I got immediate reply from Dr Fragomen and Dr Rozbruch. I got late reply from Catagni (3 days). I got very late reply from a doctor south of my city (7 days). I got an immediate call from Motallabe. He was shaking in his voice. He said he is sorry for my problems. He said I should walk with the braces on. And the length hasnt been lost. And he said the problem is not that serious. The knee can adjust with the new bend.
It irritated me when he said that. THIS WAS THE FINAL TIME I LISTENED TO HIM. I mean you are crying out to this guy saying the leg is bent and you are like a zoo animal on display and all he is saying is you can live with such deformity. What the **** he thinks? I decided to find solution outside of his treatment.

Well as I said Dr Rozbruch and Dr Fragomen had replied the very same day.Both of them had talked to each other seeing my mail and both left me a mail saying - 1) Had significant deformity on the right leg, 2) non union on the left --- and there could be infection too. They said that my case is extremely complex but I had come to the right place. They asked me to start with a consultation.
I mailed back Dr Fragomen asking if the nail is broken inside (still i was on disbelief) how am I walking around. He replied saying it could be MALUNION or STIFF NON UNION. I asked what those terms meant. He explained them in a mail. The same evening I tried to call him. But it was outside of office hours. So I made an emergency call. I could reach his cell phone now. (When you make emergency calls they call back on the number you leave). He called me back. He was at home I believe. He talked to me about the problems. He said the new bone is strong. So the right leg will be strong. And if the right leg feels good I dont need to come to New York. ANd in such case just need to do grafting on the left leg and plenty of orthos can do that in my city itself.
(I am protecting my identity here). He said that the films were very short and didnt show anything clearly. But he said he has some idea from all my descriptions.

2 days left. My mind was restless and I wanted to find whats the ****ing problem with my legs. Am I ok? Am I going to live with deformity? I lied to Dr Fragomen during the phone call about amount of bend I had while sitting on the floor. It was elevated upto 15cm above the surface. And I told him it was less than 5 cm. Should I call him and say that I lied about the angle??? I mailed him and wanted an earliest appointment. He asked me to come in on that monday morning. My friend drove me to NYC.

 
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Re: LL disaster in Iran - Diary

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October 11 2006, 12:55 PM 

In HSS ,New York

It was a fairly cold January day. (By this time there was no pus coming out of the top wound). I filled in a form at the lobby and was assigned to a particular room.
I was waiting in that room and the doctor came in after 15-25 mts. He was with another patient and discussing some XRays. He came in and he asked me maybe 300 questions. . I would say those questions were just to find out what the issue was. Right from why would I go for such a surgery. My age, My background, father & mother's height, what was my goal etc etc etc. What kind of medications I was on. I mean I can write a separate thread on how well my case was investigated.
He sent me for standing XRays. When I came back with them he took 1-1.5 hrs to get back to me. I was waiting in the room. I think I even slept for a few mts. I was so tired and exhausted. I was hoping that if I can do grafting I would be fine.

He came back and first showed me the left leg. He discussed what was going wrong on the left. The left nail was also broken. But it was not completely broken like the right. It was broken at the third screw (just like the right nail). But it didnt completely break away into two pieces. When I went for the XRays he was looking at my previous xrays. He showed me that the type of nails were wrong and the screws were going in as if the surgeon was trying to correct varus deformity.
And the nails were not nailed properly and that resulted in metal exposure. The breaking of nails were due to the bending forces. The left nail had permanently given me valgus deformity (not at the knee). I mean it looks like valgus but it is not knee valgus.He asked me to lie down and he was making sure I hadnt lost any sensation in any parts of the legs. He moved my leg around the third screw and it moved and he said there it is. As a patient you can distinctly feel that thing moving inside.
He showed measurements,angles and stuff and noted them all down.

He then discussed the right leg. He said it is almost near complete union. (2 of the three sides had closed in leaving the top front portion wide open). His measurements showed I had a bend 19 degrees more than medically allowed. But the mechanical axis was still going through the knee which means I was ok on that front. But I had to correct the deformity at some point in my life. I cant be walking like that. (If some of the terms are confusing you need to go back to your medical books and verify what I am saying. We are talking 3D here).
(I want to state something here disrupting the flow of this narration. I was totally dumb upto this point. But from this moment on I read a lot of resources and was sharp enough to understand a lot of things related to LL. I was constantly reading and discussing and exchanging emails). I told him about the infection I had on the top wound. He looked at it and said looks clean now. He also said Cipro that I was taking leads to slow bone formation and I need to get off that. I had lost 80% of length on the right leg. Now my left is longer than the right. Right is bent. Left has valgus. You name a medical problem that can happen on the legs I had them. Thank god my knee or the ankle wasnt affected. Those are the only worse things that can happen to a person.

I left his office deciding to find a place to kill myself. Well now I have destroyed my life, my parents hope on me, my frieds admiration for me, I am not even the short cute guy full of energy running around. The time frame for recovery quoted by Dr Fragomen was anywhere from 7-14 months. Wow isnt that good to hear. The solution suggested was to exchange nail on the left fixing the valgus and grafting that side. Once that heals perform osteotomy on the right and straighten it. But left needs to be reduced by 1.5 - 2cm. So I will finally have a gain of 2 cm or so. I laughed at myself. And the price of surgeries now is far greater than what I would have paid with Dr Guichet or someone else. (or doing LL in US itself).

I returned home and decided to go to a third world country again and perform surgeries and get rid of the length. 2 weeks passed. I didnt reply any of the mails from Dr Fragomens assistant. Yea I knew that I can not afford these surgeries. I had two options. Try to go with doctors outside of US one more time or kill myself. I decided to pursue the second one after attempting the first one and if it fails. Yes I am an optimist. .


 
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ptr30
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Part 3

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October 11 2006, 12:57 PM 

Next few weeks...

By this time I started being aggressive in my mails to Motallabe. I asked him specific questions. I asked him why would he insert nails that fashion. why would he put bent nails. Why were they not long and strong enough. He had lame defense for every ****. After a while he would avoid mailing you back. I threatened him saying I am going to die and before doing so I will report to this board. He said that he can change the nail on the left leg. But no need of graft. The bone growth will certainly happen over a period of time. I shot back saying how long should i be waiting for that miracle to happen. He pointed out Dr Fragomens analysis and said the non union is due to the nail. So if the nail is changed it should all be fine. But I shot back saying I will not settle for anything less than exchange of nails and graft. He said - 'ok I would do that for you'. But I wasnt going to settle for anything less than complete cure if I were to go back to hell called Motallabe's treatment.
I told him I will not live with deformity. In fact what inspired that was - I was really developing ankle pain by this time. That was due to length difference and the angle. I was confused there is no single way to fix a problem of this magnitude. I was depressed helpless and didnt even talk to parents. I told him in another mail I want to be cured completely. I suggested I need OP-1 graft because I dont want incisions unnecessarily else where in my body. (Besides autograft has its own issues). He realized I wasnt backing off. He said I can bring OP-1 graft myself when I come to Iran. I mean how ironic this is - Transporting a graft material that is going to be inside your body for possibly the rest of your life??????????? wtf. Anyways its Motallabe right? While these mails were being exchanged Dr Fragomen asked me to fix my problem asap and not wait until it becomes inevitable (after all left nail is moving inside remember?). Pus was coming out of right leg wound again. I was confused as to what should I be doing. I mailed Motallabe. And I told him I want my right leg fixed along with the left in the same surgery. I can not take a later surgery. He finally agreed to correct my right leg by performing osteotomy along the lengthened site and straighten the leg.

 
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Part 4

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October 11 2006, 12:58 PM 

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.


 
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