Chin muscle repair after genioplasty

[kavan]

OK, so  the guy probably toots his own horn a lot over the net for a broader base of patient recognition outside of India. But I was reading some of his professional articles (published in legit venues) and those seems OK. As to how many surgeries a doctor does, there is really no way to cross reference it. What's clear is that he's very confident in his abilities and wanting to be recognized outside of India (medical tourism) and making direct appeal to patients. That's the new trend with younger doctors. Just to say, I find published papers something in his favor but have nothing against his horn tooting seeming suspicious.

[InvisalignOnly]

The article talks about PROFIT INCENTIVE in medicine. I mean profit incentive also plays a big role in US medicine too as does extreme difficulty for patients to pursue malpractice cases. Of course, there are differences between medicine in India and in US but both share some similarities in venue of profit incentive and difficulty in suing. So, VERY DIFFICULT for patients to sue US doctors. Anyway, this Indian doc looks to have a private hospital and most likely would have a board of directors involved. But I have no idea about Indian gov monitoring or quality control of private hospitals or even for public ones. I guess I would attribute a lot of vigilance to OMAN though and he did practice in their hospital.

Although I've been to neither Oman nor India, I can't imagine Oman having some things you will find in India. eg. the RAT TEMPLE where thousands (millions?) of rats are revered

I see - I didn't know it was difficult to sue in the USA, I really don't know anything about their system except for what I read in newspapers. In India, the additional problems are the court system and the fact that it's easy to bribe or intimidate people including police, other doctors, witnesses etc. It's considered normal for cases to drag on for many, many years, even decades, so it does not make sense for a potentially disabled client (who already lost a lot of money) to spend even more money and several years of his or her life attending court hearings.

Re: rats, obviously the 'rat temple' is an extreme example and there are a lot more interesting things in India than that. It's a great country with a fascinating culture and history, but not a typical destination of choice for elective medical treatment. I have visited Oman and other neighbouring countries several times for business, I'd say that it's about equally common to see rats on the street in India and the Middle East (it's not super common but it does happen from time to time). It's not uncommon in London either, and I hear it's the same in New York City.

It's an interesting suggestion you made about the OP visiting the doctor in Oman instead of India. I think it's a great idea if OP can afford it (Oman would be way more expensive in every ways). It's closer to him, it would be much less of a culture shock, it's a beautiful country with generally nice people and personally I'd feel much safer in a private hospital in Oman. Once he is in Oman, he could then fly to India for a holiday and just enjoy the country instead of worrying about medical treatment there. India is way, way more interesting for a tourist than tiny, boring and safe Oman

At the end, I guess it's all down to luck. I had emergency medical treatment in a government hospital in India and am eternally grateful to the doctors that treated me (for a ridiculously low amount of money), they did an excellent job. On the other hand, I had a minor elective surgical procedure with a Western European doctor at the best and most expensive hospital in a Middle East country, and the doctor messed up big time and I have an ongoing problem ever since (I could have sued but can't face the stress, decided to just live with it). So you never know, but you still want to make a choice that seems best and most rational in the circumstances.

[Post bimax]

s**t stirring from US covert operations.

This made me think - you spent some time at MIT right?  Did you ever run into Chomsky?  I know he was there pursuing his theory of Universal Grammar in the Linguistics and Philosophy department and (somewhat ironically) doing research for the DoD.  He's also a Professor Emeritus there now

[kavan]

This made me think - you spent some time at MIT right?  Did you ever run into Chomsky?  I know he was there pursuing his theory of Universal Grammar in the Linguistics and Philosophy department and (somewhat ironically) doing research for the DoD.  He's also a Professor Emeritus there now

Of course I did. He was active professor. Courses were very popular and filled up fast. He was friends with another Grand Wazoo professor of mine and came to brunch at our dorm.

[Post bimax]

Of course I did. He was active professor. Courses were very popular and filled up fast. He was friends with another Grand Wazoo professor of mine and came to brunch at our dorm.

Dang.  That's awesome.  Depending on one's opinion of him I guess lol

[kavan]

Dang.  That's awesome.  Depending on one's opinion of him I guess lol

Even though his courses filled up fast, I still could have gotten in ('strings' via the house master). However, TBH, in venue of psychology, I liked the Harvard professor, BF Skinner better (behaviorism) about whom Chomsky was critical. For 'humanities', I took Fine Arts at Harvard and considered 'vacation' to be away from institute. Besides, a lot of his political theory was 'coals to Newcastle' to me at the time or it just came through via 'osmosis' because most of the dorm was taking his course(s).

Counter-Gov stuff was in venue of 'fun' hobbies or extra-curricular activities including but not limited to screwing with the secret service on campus. One 'sunny day' prank included intercepting their lines and asking; 'Do you think it's going to rain today?' (They wore overcoats/raincoats.) Another was for a bunch of people from the dorm to don rain coats, dark glasses and ear pieces and just walk around near the agents and pretend to be talking to each other. House master who was pretty good friends with Chomsky found the pranks funny. So, not something he would reprimand the dorm residents for. Nor would Chomsky be type to reprimand for either.  In fact, at the time, running joke was that the 'I' in CIA was an oxymoron.  The dorm was a bastion for magnetizing certain types who were 'groupies' or protégés to a select collection of professors. The institute always had a problem with it. President would be hit with complaints. Complaint would go to house master about certain activities/proclivities of the occupants. It would be laughed at as a request for us to DUMB DOWN. The attitude at the time (not by prez though) was that if any of these 'intelligence' guys had any issue with being spotted or pranked with, they would need to smarten up. Later,in recent years, the institute decided to DEMOLISH the dorm.

[Post bimax]

in venue of psychology, I liked the Harvard professor, BF Skinner better (behaviorism) about whom Chomsky was critical

It would make sense for Chomsky to be critical of behaviorism given his linguistic theory.  In his view, consciousness (and language acquisition) are made possible via inherent 'schematics' that exert strong behavioral influence.  I'm not sure where the present literature stands on the question.

Counter-Gov stuff was in venue of 'fun' hobbies or extra-curricular activities including but not limited to screwing with the secret service on campus. One 'sunny day' prank included intercepting their lines and asking; 'Do you think it's going to rain today?' (They wore overcoats/raincoats.) Another was for a bunch of people from the dorm to don rain coats, dark glasses and ear pieces and just walk around near the agents and pretend to be talking to each other. House master who was pretty good friends with Chomsky found the pranks funny. So, not something he would reprimand the dorm residents for. Nor would Chomsky be type to reprimand for either.  In fact, at the time, running joke was that the 'I' in CIA was an oxymoron.

Sounds like a blast

[kavan]

I see - I didn't know it was difficult to sue in the USA, I really don't know anything about their system except for what I read in newspapers. In India, the additional problems are the court system and the fact that it's easy to bribe or intimidate people including police, other doctors, witnesses etc. It's considered normal for cases to drag on for many, many years, even decades, so it does not make sense for a potentially disabled client (who already lost a lot of money) to spend even more money and several years of his or her life attending court hearings.

Re: rats, obviously the 'rat temple' is an extreme example and there are a lot more interesting things in India than that. It's a great country with a fascinating culture and history, but not a typical destination of choice for elective medical treatment. I have visited Oman and other neighbouring countries several times for business, I'd say that it's about equally common to see rats on the street in India and the Middle East (it's not super common but it does happen from time to time). It's not uncommon in London either, and I hear it's the same in New York City.

It's an interesting suggestion you made about the OP visiting the doctor in Oman instead of India. I think it's a great idea if OP can afford it (Oman would be way more expensive in every ways). It's closer to him, it would be much less of a culture shock, it's a beautiful country with generally nice people and personally I'd feel much safer in a private hospital in Oman. Once he is in Oman, he could then fly to India for a holiday and just enjoy the country instead of worrying about medical treatment there. India is way, way more interesting for a tourist than tiny, boring and safe Oman

At the end, I guess it's all down to luck. I had emergency medical treatment in a government hospital in India and am eternally grateful to the doctors that treated me (for a ridiculously low amount of money), they did an excellent job. On the other hand, I had a minor elective surgical procedure with a Western European doctor at the best and most expensive hospital in a Middle East country, and the doctor messed up big time and I have an ongoing problem ever since (I could have sued but can't face the stress, decided to just live with it). So you never know, but you still want to make a choice that seems best and most rational in the circumstances.

Well, to be more precise, anybody can sue.  The matter with malpractice claims is prevailing which is contingent on expert witnesses which in turn is a lot of expense for the patient. Doctors have malpractice insurance which basically pays their legal defense bills.

A patient could have medical insurance to pay for an operation. So, if they sue the doctor the insurance paid to do the operation and the patient wins, the insurance plan could demand the part to most of the winnings. That is example of plight of poor in US who have insurance by state or gov.

As to India, doctors there are often wanting private pay medical tourism. So more incentive for them (I would think) to do good job. Clearly the OP got in touch with another who went to the Indian doctor and had good things to say about him. So, it's like that and maybe more so than all the self horn tooting you spotted on Richardson's promo material. He would have incentive to do good job on OP because that's a way he gets referrals from patients outside of India.

I was looking more at R's website. Some of the things he does are 'quick' things like mole removal or skin fixes. So, small stuff could be part of high number of 'procedures'. Notable ones (which, of course will be longer) would be fixing facial deformities, birth defects, things that cause speech defects, accidents etc. So, for that sort of thing, there would be nothing but satisfied patients. Can't imagine any complaints.

Background in fixing facial deformities; maxillo-facial, cranio-facial will also include some plastic surgery because the deformities would also be found in soft tissue. Hence, he does rhino. Also, sewing up lip in cleft lip patient is soft tissue work and stitching technique is PS and. I'll also mention again what I said in one of my earlier posts. India, as an ANCIENT culture had medical advances where the first rhinos (and I'm talking fixing noses that were chopped off) came from there. So, I would imagine that there would pride involved with some Indian doctors as it relates to a culture with history of medical advances. I mean North America  doesn't arise from any advanced civilization. I would not be surprised (nor something I personally would fault him for) if he drew from cultural history as it relates to medicine to consider himself even better than NA doctors.

[kavan]

It would make sense for Chomsky to be critical of behaviorism given his linguistic theory.  In his view, consciousness (and language acquisition) are made possible via inherent 'schematics' that exert strong behavioral influence.  I'm not sure where the present literature stands on the question.

Sounds like a blast

For linguistics, I admired professor Harald Reiche. http://news.mit.edu/1994/reiche-0817
He was extremely cultured, impeccably dressed urbane and a classicist. This set him apart (and to me 'above') in my eyes, from Chomsky and other MIT pros who had large followings.

Yes, some stuff was fun. But on the other hand, people were jumping off buildings and hanging themselves in the basement due to competition of getting straight 'A's.

[Post bimax]

For linguistics, I admired professor Harald Reiche. http://news.mit.edu/1994/reiche-0817
He was extremely cultured, impeccably dressed urbane and a classicist. This set him apart (and to me 'above') in my eyes, from Chomsky and other MIT pros who had large followings.

Yes, some stuff was fun. But on the other hand, people were jumping off buildings and hanging themselves in the basement due to competition of getting straight 'A's.

Well, I'm sure nobody would accuse Chomsky of being either "impeccably dressed" or "urbane".  Could be an endearing quality to some though.

Interesting window into that world.  Sad to hear about the suicides.  I have some friends that have gone onto Hopkins for med school.  Apparently it's a tough transition to go from being a big fish in a little pond to being surrounded by sharks.

[kavan]

Well, I'm sure nobody would accuse Chomsky of being either "impeccably dressed" or "urbane".  Could be an endearing quality to some though.

Interesting window into that world.  Sad to hear about the suicides.  I have some friends that have gone onto Hopkins for med school.  Apparently it's a tough transition to go from being a big fish in a little pond to being surrounded by sharks.

After the suicides came the humor parody magazine special 'Suicide' edition. Best buildings and bridges, how to tie a noose and sample notes to leave behind for all responsible for not giving you an 'A'. Although not well received by the institute admin either, the sad part was grading was on a curve where to get the A, one needed to be way on the other side of spectrum of the average where TESTS were designed for that. The jumpers or 'ropers' had a meta-program going on in their heads (from parents) of; 'Get all A's', 'Be a doctor.' 'Get into Harvard med.'

[ODog]

I got the hardware removed. I noticed the familiar stiff feeling right under the lower lip immediately post-op, and was disappointed. Now I have to go through another recovery for nothing.

And no it’s not “too early to tell.” I’ve come to know this stiff feeling and I can differentiate it from the other temporarily stiff areas induced by the surgery/ incisions.

The more I look into what IAN nerve injury entails, the more I’m seeing that Richardson may be right, that stiffness as a symptom is not supported in the literature or in his clinical experience. In fact, even my surgeon said the same, that the literature doesn’t support stiffness as a symptom.

For instance, right now I have completely numbness on one side of my upper lip. But there isn’t a strong sensation of stiffness or tightness when I scrunch the lip. So numbness does not equal stiffness.

As to why Richardson knows all about this and the surgeons here do not, he says he sees more complications in India. Fair enough. I should also clarify that by muscle incarceration, he simply means a muscle that isn’t functioning properly. Doesn’t have to mean “entrapped.” That’s why I was swapping the word “damaged” in there in my descriptions. 

I probably will have to get another revision done with him... I don’t like to accept things until I’ve tried everything.

The problem for me is I still don’t understand what the heck he would attempt to do as a treatment. He says he doesn’t know until he accesses the “mistake.” But he could give me examples, like “for one patient I noticed they had X problem with the mentalis and so I did Y and it improved the symptoms” etc.. but none of that.

[Post bimax]

Sorry to hear the hardware removal didn't work out.  That sucks.  I agree you should pursue every lead you have.

I should also clarify that by muscle incarceration, he simply means a muscle that isn’t functioning properly. Doesn’t have to mean “entrapped.” That’s why I was swapping the word “damaged” in there in my descriptions.

Entrapment is literally a synonym for incarceration, so I'm hoping this is something that just got lost in translation and he's not bulls**tting you

[Dogmatix]

The problem for me is I still don’t understand what the heck he would attempt to do as a treatment. He says he doesn’t know until he accesses the “mistake.” But he could give me examples, like “for one patient I noticed they had X problem with the mentalis and so I did Y and it improved the symptoms” etc.. but none of that.

I think you should think about this. Nerve damage is not something that you just fix with a surgery, if that was the case it would be a major break through for paralyzed people etc. Selling hope is a very good business. Look at the weight loss industry, it's the easiest theory in the world, eat less and exercise more, but still selling magical fixes is a big business. Sure, seek advice, but also make sure you know exactly what he's going to do before buying anything. Doing another surgery on the nerves may not only not help, but also cause more damage.

You say you know it's not too early, I can't argue with that. But the body and nerves are amazing. They find new paths and there are stories where it suddenly happen after 2 years. I've recently become interested in vitamin B complex, I talked to one patient who was told by the doctor that they give this in high dosages to people who've had their finger cut of and reattached. I also talked to one patient who had problems getting the feeling back after orthognatic surgery, but the day after starting treatment started getting some buzz. Sure, it's anecdotes and case studies, but on the other hand totally harmless and can be done while consulting for other things.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4904479/

[ODog]

I think you should think about this. Nerve damage is not something that you just fix with a surgery, if that was the case it would be a major break through for paralyzed people etc. Selling hope is a very good business. Look at the weight loss industry, it's the easiest theory in the world, eat less and exercise more, but still selling magical fixes is a big business. Sure, seek advice, but also make sure you know exactly what he's going to do before buying anything. Doing another surgery on the nerves may not only not help, but also cause more damage.

You say you know it's not too early, I can't argue with that. But the body and nerves are amazing. They find new paths and there are stories where it suddenly happen after 2 years. I've recently become interested in vitamin B complex, I talked to one patient who was told by the doctor that they give this in high dosages to people who've had their finger cut of and reattached. I also talked to one patient who had problems getting the feeling back after orthognatic surgery, but the day after starting treatment started getting some buzz. Sure, it's anecdotes and case studies, but on the other hand totally harmless and can be done while consulting for other things.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4904479/

The problem as I’m trying my best to lay it out, is that it may not be nerve damage. I DO have nerve damage but it’s not really a bother. It’s the stiffness that’s a bother. Nowhere in the literature does it mention this as a symptom.

So let’s say my nerves do recover eventually, that doesn’t mean the stiffness will go away. Richardson believes they are separate problems.

He made it clear before I got the hardware removed that it wouldn’t help my main problem, but may or may not relieve the numbness some.