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[Bohemia]

Greetings fellow lengtheners,

Originally, I had flown to West Palm Beach, Florida, and underwent consultation with Dr. Paley. Despite his excellence, I declined on the $110,000 total rate, and instead contacted Dr. Alejandro Monegal, and selected him for less than half that of Dr. Paley.

ESSENTIALS
Who: Dr. Monegal
What: Bilateral femur surgery
When: August 25th
Where: Barcelona, Spain
Why: Lengthen 8cm
Me: 29 years, 165cm

RATE TABLE

Procedure:	$40,100
Residence:	$1,467 per month / $4,401 for 3 months
Physiotherapy:	$34 per hour / $3,060 for 3 months
Summary:	$47,561

Note: the doctor has required me to give him his share of the rate (20k-ish) in cash in person to avoid the 20% tax fees on sizable bank transfers. I consider this a hassle, because I will need to carry an absurd amount of cash, and declare it to customs. However, I blame the Spanish government for that, not him. Regardless, everything else has transpired very seamlessly, and friendly. Both he and the residency have answered every question courteously and timely.

LINKS
Hospital: http://www.clinicadiagonal.com/en/
Residency: http://www.barcelonadisability.org/en/
Interview: Click here

The residency, MCI Sant Jordi, specializes in disabled care, and every room and feature of the facility supports handicapped folks, which lends itself to our situation.

INQUIRIES
What type of pants can I wear over my healing legs for the 3 months? i.e. sweat pants, shorts, leggings, etc.
What type of shoes can I wear? I literally only wear leather boots; I do not own a pair of sneakers (not athletic).
Will I need to order food in every night for dinner?
How will I occupy my time, rather than lie on my back for 16 hours per day?

I do not currently feel very social about it; I almost prefer no one to interact with me in person while I exist in such a poor state. But then again, many insist that socializing helped their lengthening. According to Dr. Monegal an individual will also undergo the same surgery on the same day! I believe he utilizes the name "glenn" on here, or similar.

I vow to myself that I will enact the full 8 cm, barring an unexpected medical emergency. However, I do not wish to remain in Spain for a full 90 days, so I may do 60-75 days instead, although I would prefer the doctor locally if a health issue arises.

Be Well,
Bohemia

[axelf]

Hey,

what is your age and starting height?

I'd say: Try to learn a new language!

Anyway, please keep us updated on a regular basis! :-)

ps: what's your impression of Dr Monegal in comparison to Paley?

[glenn]

Hi Bohemia!

Yes, I am doing my surgery on the same day with Dr. Monegal. Can you believe it? After all these years, it's only about 22 days from now! The feeling is surreal...

Let's share notes:

What type of pants can I wear over my healing legs for the 3 months? i.e. sweat pants, shorts, leggings, etc.

I think I will just bring some shorts/swimming trunks. MAYBE I will bring one pair of jeans, but I'm not sure how that will make my life easier.

Here's the historical temperatures for September and October in Barcelona:
http://www.barcelona-tourist-guide.com/en/weather/weather-september.html
http://www.barcelona-tourist-guide.com/en/weather/weather-october.html

What type of shoes can I wear? I literally only wear leather boots; I do not own a pair of sneakers (not athletic).

I will fly to Barcelona in my flip flops and just wear those the whole time I'm there. Again, I don't see how bringing a pair of running shoes will make my life any easier. (Does anybody else know if Physiotherapy requires running shoes? Or can I do it bare feet?)

Will I need to order food in every night for dinner?

This is what I wrote on my diary. You can check it out here:

I asked about groceries as well; apparently online grocery shopping and home delivery is prevalent over there. Dr. Monegal recommended www.mercadona.es . It's got good prices, and English, but the only thing that irks me is that there's no pictures. You have to buy based on the description of the product. I looked further and I prefer the interface for this grocer: www.alcampo.es . The site seems more polished and easier for English readers to navigate. Another one I thought might be ok is www.carritus.com .

Also, I haven't explored the options mentioned on this page yet. But I have a feeling I will find this page useful in the future.

I don't exactly know how I will get stuff delivered to MIC Sant Jordi, but I'll figure it out once I'm there. I'll let you know when I know.

How will I occupy my time, rather than lie on my back for 16 hours per day?

youtube.com, coursera.org, ocw.mit.edu, khanacademy.org.... You can also think of it as a chance to read all those books that you've always wanted to read but never had the time. Also, as Axelf said, it's the perfect time to learn a new language!

I have a question for you:

...I will need to carry an absurd amount of cash, and declare it to customs.

I am bringing cash, too. What happens if I "forget" to declare it and they catch me?

[Bohemia]

RECORD LOW EXCHANGE RATE

The doctor gave me the exact fees and bank specifics to wire the funds. If you would like this procedure, then I strongly encourage you to book it now, or soon, because the Euro to Dollar exchange rate has fallen to record lows. For example, today, it hit 1.1 Dollar to 1 Euro, as opposed to last year it reached 1.4 Dollar to 1 Euro. To calculate, the whole surgery costs 35,510 Euros (26,010 to hospital, and 9,500 to Doctor personally), thus today it equates to about $39,000 only, whereas last year it would have costed $49,700.

In other words, you will save over $10,000 if you schedule now at the bottom, in comparison to the average rate.



AIRFARE

Route: Philadelphia-Barcelona nonstop round trip
Schedule: August 23 - November 3 (72 days)
Rate: $1,250

I think I will just bring some shorts/swimming trunks. MAYBE I will bring one pair of jeans, but I'm not sure how that will make my life easier.

I will fly to Barcelona in my flip flops and just wear those the whole time I'm there. Again, I don't see how bringing a pair of running shoes will make my life any easier. (Does anybody else know if Physiotherapy requires running shoes? Or can I do it bare feet?)

Dr. Monegal sent me an email that said verbatim:

---
Bring training clothes:
- running shoes
-shorts
-t shirts
- swimsuit

PT protocol includes:
- stretching
- Knee function recovery
- cycling/elyptic
-pool work
- parallel bar walk
---

I suppose the physiotherapy will include a degree of athletics.

[ouroboros]

Congrats on your upcoming surgery, wish you all the best!
I was just wondering what device are you going to use for your lengthening?

[axelf]

hey bohemia! how did it go?

[Bohemia]

I underwent all the physical measurements (blood, chest, xrays, etc.) and also the procedure all in the same day, on Tuesday August 25th. I remained utterly resolute to do this, and never once considered otherwise.

Dr. Monegal surprised me at how down to earth and and ordinary he is, yet very devout and sober toward his craft. He explained that he does surgery every single day of the week, and specializes in careful, precise treatment.

I awoke in the post-surgery area, and felt very alive and happy, albeit a tad kooky due to sedation. They wheeled me in my bed back to my room, and I texted friends about my condition. You retain decent lucidity once you awake. The epidural eliminates all pain whatsoever, and instead a bone-level pressure ensues, like if a person squeezed your thighs in their hands at half-strength.

Every day at 8:45am a food personnel enters the room and asks what you you like to eat for breakfast, lunch, and dinner. As a matter of judgement, I consider the meals below average, regrettably. For example, the first day they gave me a 5-inch green and black banana. I literally laughed at it, took photos, and showed my friends. LOL I explained to the food person that I would not accept that, and she apologized but seemed confused, because apparently they eat green bananas. Besides this, the meals consist of staples and will suffice for the 7 day duration at the hospital.

At 9am, two nurses come in, sponge bathe your whole body with soap, and give new sheets and pillows. You will need to become content with letting staffers gently wash your genitals, because they will each day.

Then at about 12pm and 7pm they give you additional meals.

If you elect for the epidural, which I recommend, you need to acknowledge that three cords will enter your body:

• Epidural in spine—which you forget exists
• Catheter in penis or vagina—which you do not forget, but spares you from urinating manually
• IV in arm—for nourishment, analgesia, and anticoagulation

It does seem a little artificial and disconcerting once you realize the number of wires in your flesh, but you remain moderately mobile in bed, despite their placement.

Today, day 4, Friday, they removed my epidural, and now employ only an IV analgesic. In fact, at the moment I type this, the bag has become empty, and I sit here on a chair next to my bed without any chemical support and feel pretty normal.

As encouragement, not a single time have I considered this an unwise procedure, and have not once suffered in any pain. I would grade the discomfort level at under 5 the entire time so far. In other words, you can do this.

As others have echoed, I suspect the crux of any dislike would be the boredom of lying in a bed for 16 hours straight, days upon days. However, watch your laptop, chat on your phone, do whatever, and it will pass.

All in all, the nurses have treated me extremely kindly and carefully, and Dr. Monegal is a truly world class surgeon.

I can safely recommend this to people so far!

[TrueSpartan]

Thank you for keeping us updated Bohemia. How are you doing now? How is the pain level and scars?

[Bohemia]

I need to revise a previous item. However I could not modify my post, so I will do it here:

I said falsely:

Note: the doctor has required me to give him his share of the rate (20k-ish) in cash in person to avoid the 20% tax fees on sizable bank transfers. I consider this a hassle, because I will need to carry an absurd amount of cash, and declare it to customs. However, I blame the Spanish government for that, not him. Regardless, everything else has transpired very seamlessly, and friendly. Both he and the residency have answered every question courteously and timely.

I wired 26,010 Euros to the hospital, and gave 9000-ish in cash to the doctor personally for he and his staff—not 20k.

In other words, I safely carried the cash in my carry on, and passed customs without any declaration.

I clarify this to avoid any confusion.

[Bohemia]

I have hit Day 6 now, and would like to update about my condition.

Frankly, the experience has underwhelmed me. In fact, my legs have remained under a 5 in pain level at all times. I had hardened my resolve to the reality that I may need to bear a 7-9 at certain points, but it never materialized—however I have not commenced stretching yet. I attribute this to two factors: my preexisting leg muscle strength, and Doctor Alejandro.

1. I played ice hockey from childhood through college, and my legs became utterly impervious to pain. Perhaps this caused my tolerance for discomfort in my lower appendages to rise.

2. The doctor explained that he utilizes a particularly gentle and careful procedure, as opposed to other doctors who may hammer harder or less tenderly on vulnerable areas, which exacerbates trauma.

So I will rate the factors so far:

Surgeon: 9.5 / 10 — very available, down to earth, and caring; the opposite of Dror Paley in terms of personality
Nurses: 7 / 10 — consistent in their duties, friendly, but a bit clumsy and scattershot at times
Food: 5 / 10 — boring and strange, i.e., they gave me two chicken wings for dinner one night WTF?; that said, I did not expect fine dining

Thus, as an average, I give a total of 7.1 / 10.

As a matter of a severe criticism though, the urologist required me to remain on a catheter for six full days; that is, three days beyond the epidural. Honestly, it became almost nightmarish by day 6 (today). Yesterday, I shat for the first time on the toilet, whereby I attained the trifecta: (1) my penis bled (2) my pee sprayed outside the catheter tube all over my thighs (3) tears dripped off my eyes—blood, piss, and tears in one moment.

If the cruel and unusual catheter requirement never occurred, then I would have considered this a nearly flawless experience.

So in fairness, I possess both a love and hate of what has taken place here. On one hand, I wholeheartedly recommend the procedure so far due to the seamlessness. On the other hand, sadly I cannot recommend it if you would need six days of catheterization.

(They had difficulty inserting the catheter tube into my penis at the time of surgery, and called in a urologist who implemented a special one for me. All the while I had no idea I have a particularly thin pee hole.)

Anyway, the doctor and Claudio the physiotherapist, helped me to stand up on my feet upright and unaided for the first time!

[Bohemia]

Day 8: I reside at MIC Sant Jordi until November 3rd.

The physiotherapist, Claudio—who also acts as a radiologist at Clinica Diagonal—stretched me this morning. I followed up and stretched in my bed too several hours later.

A restaurant and cafe sits on the ground floor of the apartment facility, and carries food to the rooms of patients, or anyone including the general public can enter and eat. I commend the dining! They serve it on fine plates, with metal dome lids to preserve the hot food.

Furthermore, the 24-hour nurses of this place will voluntarily pick up essentials and medications at the pharmacy for you upon request; so for example I needed ice packs, bandages, prescriptions, etc. and they retrieved them all for me, and declined my tip!

At the moment, due to the alternate factors of this, I will update my previous rating:

- Dr. Monegal: 9.5
- Physiotherapist: 9.5
- Food: 9
- Nurses: 8

Total = 9 / 10

Fairly impressed so far. Not a single person in Barcelona has ever been rude to me in any way; quite the opposite.

Also, I stood unaided for the second time today (under monitor of Claudio), and also rode the bicycle machine!

[Bohemia]

View of stitches on left leg


View of black and blue on left thigh


View of three-course meal the restaurant gives

• Spaghetti in mushroom sauce
• Chicken leg
• Chocolate cake
• Side of bread
• Bottle of water

View of me seated in wheelchair (covered for discretion)

[Bohemia]

How are you doing now? How is the pain level and scars?

I feel content. Pain remains low, although a bit annoying when lying down for extended periods of time. I have no real idea about the scars as of yet.

[Bohemia]

Extremely impressive meal today:



- Rice with tomato sauce and a fried egg
- Sausage and beans
- Bread
- Cheesecake

I literally eat better dishes here than in the US.

[aspirant185]

Man, you are in fking BARCELONA !!! This is like the best and most amazing city in Europe. The food is amazing, I guess, just google some stuff on tripadvisor, from time to time, like once in 3 days, order some nice meals from outside, the food is really good...
Do not miss a chance to visit a game of F.C. Barcelona and witness the best player in history of soccer - Leo Messi, who is, ironically, only 169

[Bohemia]

Man, you are in fking BARCELONA !!! This is like the best and most amazing city in Europe. The food is amazing, I guess, just google some stuff on tripadvisor, from time to time, like once in 3 days, order some nice meals from outside, the food is really good... Do not miss a chance to visit a game of F.C. Barcelona and witness the best player in history of soccer - Leo Messi, who is, ironically, only 169

Authentic Catalonian food has no comparison. The restaurant in this facility has genuine chefs—not generic cooks—and they whip up very cool dishes. To be honest, I eat better meals here than when back in the U.S.

I hit 1cm today, and I can both feel and see the mutation in the composition of my legs. My knees appear further away according to my eyes.

I can stand by myself once stretched, and walk about 40 foot with hand support on the parallel bars. I ride the stationary bike for at least 10 minutes each day now, and my degree of flex hits 90 degrees.

No complaints, although I will confirm that I wake up in the middle of the night, and need to re-configure my legs in multiple ways to finally fall asleep again.

I would like to commend both Claudio and Dr. Monegal, who both reply to text messages within 15 minutes any time of day or night.

One other thing, for those of you who consider Spain a location for your procedure, or for those of you who do *not* consider it so—I will say that virtually every person here speaks English to a certain extent, they play American music in cabs, on radio, on television, the hospital clinic seemed cutting edge and modern, etc., furthermore, they possess almost the exact same goods and services that you would find in a normal American city.  In other words, undergoing the treatment in Spain sort of mirrors undergoing it in the United States, and in many ways it becomes indistinguishable. Besides England, Spain may be the nearest locale for an experience tantamount to the U.S.—if that matters to you!

[axelf]

hey bohemia,

if you fancying the meals at MIC that much....how much do they charge for it? and how can you get groceries to your room?

[Bohemia]

if you fancying the meals at MIC that much....how much do they charge for it? and how can you get groceries to your room?

Full three course meal for about 14 Euro. They create a new menu of dishes every single day, so they print it off and translate it for their English patrons. Then a nurse will shuttle it to your room at any time you request between 9 am - 5 pm.

Also a nurse will shop for anything you like within walking distance (pharmacy, supermarket, etc.); or you can wheel your own ass down to the grocery—which I did today and will not do it again, because it requires crossing streets, and pushing up inclines and such, only to discover the grocery lies underground and requires a downward escalator which I could not utilize.

Wheelchair hands


Papaya, banana, milk smoothie in the cafe

[aspirant185]

Can you ask Dr. Monegal, whether he would do what dr Paley is doing - femur and tibia within one month ?

[Bohemia]

I underwent both femurs at the same time, and will remain here from August 25 to November 3, which amounts to about 2 months and a week.

For split segments (femur/tibia) he lets you travel back once you discharge from 7 days in the clinic (as far as I know), but for both femurs or both tibias he would require two months in Barcelona under his care.

I encourage you to email him any questions; he usually replies swiftly. And I would prefer not to misspeak for him.

[aspirant185]

I will do that .

I am interested in doing 5 cm Femur and 3 cm tibia with him and would be curious how much time after the Femur he can to the tibia .. I have relatives living in a french village just 30 miles from Barcelona, so I wouldnt have to pay for accomodation and food and stuff

[Bohemia]

I am interested in doing 5 cm Femur and 3 cm tibia with him and would be curious how much time after the Femur he can to the tibia

He does not like to discuss a second round until the first has completely fully. I already grilled him about that. But shoot him an email and he will probably give his counsel.

I am currently suffering insane cabin fever, and cannot pass over this experience soon enough. Days have blended into each other and I have lost orientation to day of the week.

[Bohemia]

In a weird mood, created this...

Photo in the gym where I stretch three times a day. The black and blue appears strong, but looks less in person.

[Bohemia]

[chsn]

Keep it up Bohemia, you re doing great! Soon you will no longer be a Hobbit!;)....How fast are you distracting?

[Alittletooshort]

Great diary so far!
I have a question and perhaps you can help me out on this one. So far I have saved up slightly more than 30 000€, I'd love to get this done for not more than 40 000€ in total. Do you think this is possible If I wanted to get something 5-7cm's with Dr. Monegal and a 2 months stay.
Greetings!
Edit: In a shared appartement to save money, which is about 800-900€ per month If I remember correctly.

[determination]

Great diary so far!
I have a question and perhaps you can help me out on this one. So far I have saved up slightly more than 30 000€, I'd love to get this done for not more than 40 000€ in total. Do you think this is possible If I wanted to get something 5-7cm's with Dr. Monegal and a 2 months stay.
Greetings!
Edit: In a shared appartement to save money, which is about 800-900€ per month If I remember correctly.

With that budget you have lots of options in Europe.
Do you want to do internals? Did you consider externals too?
5-7 cm are an easy target I guess.

[Alittletooshort]

I don't have the time and will to endure externals and Dr. Monegal seems like a highly skilled surgeon so he'd be my favorite choice.

[Bohemia]

I created a generic Youtube account, and posted this video of Dr. Monegal removing my stitches last week:

Keep it up Bohemia, you re doing great! Soon you will no longer be a Hobbit!;)....How fast are you distracting?

Haha! I extend the Fitbone between .81 to 1.08 cm per day, according to how I feel.

Dr. Monegal emphasizes that the week of lengthening between 1.5 - 2 cm acts as a tipping point—he calls it the snap—where the tension culminates, and once you pass it the soft tissue finally gives in to the extension and tension diminishes greatly. I currently am at 17.6 cm at exactly Week 3, so I wake up in the middle of the night in utter discomfort, punch my bed in frustration, curse the world, and rearrange my legs to fall back asleep.

Both Dr. Paley and Dr. Monegal referred to a tipping point—Paley said 2 weeks, Monegal said 3 weeks. I side with Monegal on this, as I can feel a climax of aching tension at the moment, but also feel it passing.

Great diary so far!
I have a question and perhaps you can help me out on this one. So far I have saved up slightly more than 30 000€, I'd love to get this done for not more than 40 000€ in total. Do you think this is possible If I wanted to get something 5-7cm's with Dr. Monegal and a 2 months stay.
Greetings!
Edit: In a shared appartement to save money, which is about 800-900€ per month If I remember correctly.

Snapshot of my receipt


Procedure/Hospital/Fitbones: 35,510 Euros = 40,148 USD.
MICs Sant Jordi: 1,450 Euros = 1,639 USD per month, or 3,278 USD for 2 months (for a double room, not a single)
Total: 43,426 UD

This does not include food for your apartment. The restaurant in MIC cooks quite amazing authentic Spanish dishes, and will roll it to your room in silver dome lids, like a room service in a hotel. That costs about 15 bucks for a three-course meal.

To reduce those figures, you could select a "single" room whereby you receive one bed in a lesser-sized apartment. I elected for the double, and they pushed the two beds together for a king size.

I would like to compare Dr. Monegal and Dr. Paley:

- Dr. Monegal: 40,000 USD
- Dr. Paley: 80,000 USD

Paley costs about twice the rate of Monegal. As you witness in the receipt, Monegal takes 7,000 Euros for this treatment. I can only imagine that Paley takes about 30,000 at least. I recognize that Paley sort of innovated the field of internal lengthening, but I cannot conceive of any reason why I would accept that rate, when Monegal can do it for a fraction—they both know each other, have met at conferences, and reside in the same league in terms of talent.

Another thing—very few folks on this forum discuss Fitbone in comparison to Precice. But, little does everyone know, that Fitbone has quite a community of surgeons in Europe and the United States. These doctors all convene yearly to discuss their experiences, resolve complications, share counsel, and define best practices. I personally consider Fitbone an equal alternative to Precice in almost every day. They only differ in that Precice utilizes magnets, and Fitbone uses electricity. In regards to weight-bearing, my physiotherapist (who also does radiology at the hospital) has me standing, walking in the pool and with the parallel bars. Weight-bearing has not given me any hassle at all, in my estimation.

Me typing this post in the cafe:

With that budget you have lots of options in Europe.
Do you want to do internals? Did you consider externals too?
5-7 cm are an easy target I guess.

I wished to do femurs, so I could only do internals. I am not opposed to externals on tibias, but holy crap I cannot imagine how annoying that would become—I literally have no idea how a person could do the very long 5-12 month program. I could not stand it myself.

I don't have the time and will to endure externals and Dr. Monegal seems like a highly skilled surgeon so he'd be my favorite choice.

Me neither. I can confirm he does extremely careful and gentle surgery. I will have very little scars.

[Bohemia]

Walking between parallel bars

[Bohemia]