My friend and business partner Chhiring Sherpa has been wearing one of these 216 bead malas for years.  I always ask him about it and this time when he returned from Nepal he brought 20 of them hand made by his wife Karma with beads sourced in kathmandu.

The mala is twice the regular numbe of beads, is strung with tiny beads (5mm) on a stretchy cord.  This wy it can be worn around the wrist 4-5 times and fits everyone. 

handmade in the USA 30 inches around on stretchy cord, 216 rosewood beads.