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[badwolf]

Hello fellow LL-candidates, LL-ers, and LL-alumni,

Tomorrow, I will undergo surgery for classic Illizarov in Saint Petersburg at MEDEM clinic. My surgeon will be Dr. Solomin, assisted by Dr. Kulesh.

I know it will not be an easy process, but I hope to keep a written account of the experience in its entirety. Please feel free to join in on this adventure with any questions or advice that you may have.

I would like to begin my diary with a quote from Joseph Campbell:

We have not even to risk the adventure alone; for the heroes of all time have gone before us; the labyrinth is thoroughly known; we have only to follow the thread of the hero-path. And where we had thought to find an abomination, we shall find a god; where we had thought to slay another, we shall slay ourselves; where we had thought to travel outward, we shall come to the center of our own existence; and where we had thought to be alone, we shall be with all the world.

Warm regards,
Badwolf

[Taller]

Congrats on starting your LL journey! I hope that it benefits you in many ways in addition to making you taller and more confident.

Cool quote by the way.

May I ask why you picked the username badwolf? Sounds like a heavy metal band or something

[Wintersleep]

Hey badwolf - I'm really grateful to you for starting a diary because I am planning on getting LL with Dr. Solomin in summer 2016 , I'll definitely be reading every post.

Would you mind asking a few questions:

1) Why did you choose external only over LON/LATN?

2) How easy was it to get a visa? - If you don't mind saying roughly what country you're from that would be cool too.

3) Have you already decided where you're going to stay after hospital? is it an apartment?

4) What's your goal?

Wishing you all the best with your surgery tomorrow and the entire process.

[badwolf]

Hi Taller,

It's an old username from the first season of the 2005 Dr. Who reboot... which gives you an estimate of how long I've been thinking about undergoing LL;p

[badwolf]

Hi Wintersleep,

I hope my experience can be useful to your own journey in some way.

In answer to your questions:

>>1) Why did you choose external only over LON/LATN?

While I don't intend to undergo LON (due to the prices of MEDEM clinic), I am still entertaining the possibility of LATN -- in which case I would undergo the nailing at Saint Elisabeth, as they are less than half the price of MEDEM. There are, however, several factors that may dissuade me:

1. One primary reason for considering nailing in the first place was due to the unpredictability of visa extension in Russia. However, it may be possible for MEDEM to extend my visa for as long as my treatment requires me to stay.
2. The thickness of my tibia will only allow me to place an 8mm rod inside. 8mm is hardly weight-bearing and its instability decreases the benefits of nailing.
3. I have a mild case of genu varum (bow-leg). If this is corrected during lengthening, there is a chance that the rod will not fit inside, due to my tibia no longer being straight.
4. The risk of deep bone infection, permanent knee pain, and the possibility of losing gained height after nailing.

That being said, I am still considering it, but will take my time reaching a decision.

>>2) How easy was it to get a visa? - If you don't mind saying roughly what country you're from that would be cool too.

I am roughly from the east Asians:) As, originally, I planned to go to a different hospital in Russia, I received my visa invitation from them. Unfortunately, by the time the invitation had been sent, severe price changes had been made and they were no longer a very viable option. I still considered them even after arriving in Russia, but ultimately I chose Saint Petersburg.

MEDEM offers visa support (invitation) as well, but plan in advance as these little slits of paper can take up to a couple of months to arrive.

>>3) Have you already decided where you're going to stay after hospital? is it an apartment?

Yes. I have already rented an apartment that's a few minutes walk from both Vreden Institute (from where Dr. Solomin works out of) and Saint Elisabeth hospital. There is an elevator and the room is fully furnished. Dr. Kulesh has, among many other things, helped me find this apartment and rent it.

>>4) What's your goal?

7.5 cm. Unfortunately, the optimal lengthening limit of my current height is 5cm, but I will see how far my body lets me go.

>>Wishing you all the best with your surgery tomorrow and the entire process.

Thanks! Whatever the outcome, I'm sure it'll be an unforgettable adventure;)

[growhigh12]

hope everything goes well, i am looking into dr Solomin in the summer 2016.. looking forward to more posts

[badwolf]

I spent most of today at MEDEM taking pre-surgery tests; one thing I can say is that they’re thorough! Preoperative examination, C-Reactive Protein Test, Complete Blood Count Test, Radiography, ultrasonic examination... I know their names because they’ve been considerately written on the bill that accompanies their costs;) This document itself, along with all contractual agreements are written in English, translation costs at around 37 dollars per page. (Totaling in about 262 dollars!) That being said, this is the only slightly outrageous cost and, all in all, things are turning out to be cheaper than I originally expected... for now.

Having visited both Saint Elisabeth and MEDEM, while MEDEM’s prices are a lot higher, it shows in the difference of quality.

However, without going into details, just a quick note concerning the obvious: Make sure you're well aware of what they're charging you for before you make your payment and also be sure to read the fine print of the papers you sign!

The first picture of their lobby is from their website, since I forgot to take one while I was down there – but it really is huge!

[doomsday]

can you tell us your initial height wingspan etc?

[badwolf]

My current height is 163 cm. Wingspan is 168 cm.

[Morgenst.]

What I'm also 163, did the doc advise you to not go past 5cm? That sounds terrible

[badwolf]

Just out of surgery! Will update later;)

[Medium Drink Of Water]

Hope you're feeling okay, badwolf!  Looking forward to reading what you have to write post-surgery!

[badwolf]

Hey MDOW!

I remembering following your diary. It was one of the things that made me consider China for the longest time until the prices went up. Good to hear from you!

My surgery was at 1 pm and now it is around 1 am. So far I've experienced close to no pain. The anesthesiologist seemed quite surprised! Once the pain increased (very) slightly, they hooked me up to a iv drip cktail of pain killers, antibiotics, and anti-swelling medication. The temporary effect of the antibiotics was a lot worse than the pain!

It's way too earlier to tell, but the accommodation here has been great. I've undergone surgery once in a fairly developed country, but the service and facilities here have been a lot more professional in general. Time will tell though.

I've yet to hear the details of how successful my surgery was and only caught a glimpse of my frames because right after surgery they bandaged it tight.

My mind is alert and wide-awake right now, but the nurse just came in and said I should sleep.

So, peace out;)

[badwolf]

Good morning. All seems well. Sleep is pretty much normal with still hardly any pain. The nurses came a couple of times and offered me painkillers, but I didn't take them. I seem to be getting the random bouts of hiccups though, which is odd;3

[badwolf]

What I'm also 163, did the doc advise you to not go past 5cm? That sounds terrible

They didn't advise me not to go over 5cm, but, according to the ratio of my current tibia length, under 5cm is the optimal length to avoid complications.

[microman]

im 164.5 so i sortof know what its like to be 163, but honestly 168cm is pretty normal, if you wear any lift you will be taller than alot of guys in the room so hopefully 5cm will get rid of the worst of your height problem, im assuing you are from a western country or maybe your indian in which case ignore what i said.

but yeah this is where i would have gone if mitkovic wasn't available, the only issue i had with solomin is that he is unknown and i was skeptical of the very cheap price.

if there was 4 more diaries like this and mitkovic wans't available id be very happy to have gone with solomin.

[badwolf]

im 164.5 so i sortof know what its like to be 163, but honestly 168cm is pretty normal, if you wear any lift you will be taller than alot of guys in the room so hopefully 5cm will get rid of the worst of your height problem, im assuing you are from a western country or maybe your indian in which case ignore what i said.

but yeah this is where i would have gone if mitkovic wasn't available, the only issue i had with solomin is that he is unknown and i was skeptical of the very cheap price.

if there was 4 more diaries like this and mitkovic wans't available id be very happy to have gone with solomin.

Hi, I'm from a typical Asian country where the average height is around 170cm. With lifts on I was pretty much average height there. Thus, the few friends whom I've told about LL were surprised that I would even consider going through with this.

I was also very cautious about Saint Petersburg, due to the lack of information and visa support. It was really after extensive communication with Dr. Kulesh and the MEDEM clinic that I felt comfortable enough to at least go for a consultation. That being said, I'll refrain from forming my ultimate opinion until after the entire process is finished.

My main reason for not going with Dr. Mitkovic was the limitations that the monorail frames seem to have:

1. Seems best suited for lengthening under 5cm.
2. I have genu varum (bow-leg) and this is best fixed with classic illizarov method.
3. Not related to the frames, but Dr. Mitkovic does not seem to offer nailing at the moment.

Other than that, he seemed like a very viable option and visa issues would've been less of a problem.

[microman]

yeah when people state their starting height if they are not in a western country where average is 177 they should probably say that 'oh yeah male average here is 170 (asian) or 165 (india) etc'

well okay then even if you do 5cm that will be you taller than half the men in the room assuming you wear a small 1cm lift of sorts so i guess you need not worry about the limitation.

and yeah i sent my passport to dr kulesh and he was preparing my letter but mitkovic said he would operate on me within 2 or so weeks so i jumped at that chance and i have had to do nothing visa wise at all in serbia.

[theuprising]

They didn't advise me not to go over 5cm, but, according to the ratio of my current tibia length, under 5cm is the optimal length to avoid complications.

This is a very rational approach that will serve both you and your body well. Seen too many guys do what they want rather than what their body can handle and end up with both mechanical and aesthetic problems. What is your starting ratio?

[badwolf]

Here's an update from yesterday:

I've been amazingly clear-headed today, one day after surgery. Once again, hardly any pain. Dr. Kulesh came and gave me an update on how the surgery went. Apparently, it was a success and certain alterations in the osteotomy were made to allow the possibility of implanting nails even after bow leg correction. Apparently, I have very hard bones and it took a lot of effort for Dr. Solomin to fracture them. I was told this is a good thing.

Just to make a few points clear:

As far as I know, I am the first patient to undergo limb lengthening surgery at MEDEM clinic. I chose MEDEM because they were an international private clinic that offered full visa support and only required me to perform surgery there and check-ups once a month.

In Russia (or at least Saint Petersburg), unless they have their own private practice, most doctors do not work solely out of a single hospital and it is possible for them to hold contracts with several different medical facilities. Both Dr. Solomin and Dr. Kulesh signed on as contract surgeons for my operation at MEDEM. While both doctors are highly experienced in limb lengthening and correctional orthopedic surgery (Dr. Kulesh spent hours openly showing me countless cases of his past patients, both the successful and the less so), they do not have much experience with international patients.

The nurses here have been lovely. And you never have to wait on them after pressing the call button. Today's physio-therapist spoke perfect English and Dr. Kulesh was blown away with how professional and skilled she was. So far he has been thoroughly impressed with MEDEM as a whole.

[badwolf]

Two days after surgery:

My lovely Svenska friend has kept me company on Skype video whenever she is not at work and I've never been too bored. Other time is spent writing, reading, and overall trying to be as productive as possible. Dr. Kulesh has told me with amusement on several occasions that most patients come for lengthening making bold claims about all the productive things they'll do during the lengthening/consolidation process and always end up just becoming couch potatoes, watching TV, and browsing the internet.

This is something that I want to avoid at all costs.

Other time I've spent talking with the nurses and staff whenever they come to visit me for administering medication, cleaning, and helping with my toiletries.

The young nurses are Anna, Ina, and Maria. None of them speak much English, but we've managed to communicate using iTranslate Voice and lots of eye contact and gestures. Maria is beautiful and especially communicative. She's only been in Saint Petersburg for seven days and I guess this is all pretty new for her as well.

The cleaning and cooking staff are more elder, but equally as gracious and interesting. Oxana does the cleaning and mostly helps me feel more human by providing face and body wipes, emptying my chamber pot (I've yet to use my bed pan yet and hopefully won't have to before I can walk to the toilet.) and setting up a system for me to brush my teeth and shave in bed.

Nina, the cook has pretty much shared her entire life story to me over the iTranslate app and she's been very affectionate and concerned about my well-being.

The chief of MEDEM clinic, Alexey, visited me today and said that my condition was very good. He told me that, if my condition remains stable, I may be able to attempting walking with support tomorrow.

The physiotherapist today didn't speak much English and, while he was nice, he was no where near as helpful as the lady from yesterday. In any case, I still remember most of the physiotherapy from yesterday, so I'll probably do it on my own.

I'd like to make an apology if you find this diary neither as entertaining or informative as some of the others on this forum. While I definitely hope this can provide all of you with information regarding the situation here in Saint Petersburg (and thus you are welcome to ask any specific questions you might have), I am writing this mostly in stream-of-consciousness and as Blaise Pascal once said to a friend he wrote, “I have only made this letter longer because I have not had the time to make it shorter."

So please feel free to skim through the bulk of it and find whatever information you deem relevant to your own personal journey.

[badwolf]

This is a very rational approach that will serve both you and your body well. Seen too many guys do what they want rather than what their body can handle and end up with both mechanical and aesthetic problems. What is your starting ratio?

I'll ask the doctor and get back to you regarding my starting ratio.

[badwolf]

Btw, last night I had some pain from my gauze foot holder support, so I asked for some extra painkillers (injection). Problem solved. Pain really has been a nonissue for the most part.

[KiloKAHN]

Sounds like you're having a really good start. Would be interested in seeing a full picture of your frames later. I bet they look similar to the ones I wore.

Will you be seeing much of Dr Solomin or do you see Dr Kulesh primarily? Does Dr Solomin perform the surgery on both legs or does he do one and Dr Kulesh the other?

[badwolf]

Hi KiloKHAN,

Dr. Solomin did the osteotomy on both legs, although, after considering your question, I would probably have felt comfortable with Dr. Kulesh performing them as well. I will see Dr. Solomin once or twice a month for a check-up and X-ray (one of these will be at MEDEM, per the conditions of their visa support).

Dr. Kulesh will come visit me regularly (around 3 times a week) and has promised to be on call whenever I need him. This was very surprising to me at first, but there is another patient from NY (that is an active member of this forum) whom I met before surgery and he has confirmed that Dr. Kulesh has gone beyond and above the call of duty to be there for him whenever he needed help of any kind. I was a little skeptical at first, but already I've experienced this first hand. Once again, this is only my current opinion of the situation and time will tell.

I've added a picture of my frames. The photo was taken from a lower angle with my feet tilted, so my femurs appear oddly short. From the start, I've been worried about ballerina foot as I've worn 6cm+ lifts for over a decade. With the doctors, I've gone over options of how we will deal with this when stretching alone will not suffice.

[doomsday]

Hey man

I'm glad you're doing fine, seems like Dr Kulesh is taking everything seriously. Btw would you be able to post some xrays, Id love to see if fibula if fixed to tibia and what technique has been used. Thanks.

Take care.

[Medium Drink Of Water]

Those are some compact frames, which also seem more securely attached than mine were (I didn't have any of those thick bolts going into the leg.)  Maybe you'll have better mobility and less pain when moving than I did.

[KiloKAHN]

Thanks for the info, badwolf. Those are some cool looking frames. I like the look of them more than Dr Barinov's or Dr Bagirov's frames as they appear more stable.

What was your consultation like with Dr Solomin? Was it easy to get your questions answered? How's his English?

[badwolf]

Sorry for the lack of an update. I moved to Saint Elisabeth Hospital 3 days after surgery to save on hospital fees and currently don't have internet. Saint Elisabeth Hospital is a municipal hospital and obviously the level of service here is no where near MEDEM's. That being said, one of my goals during this process is to be as independent as possible and so the changes have not affected me much (other than the lack of Internet access and maybe the quality of the food -- but Doctor Kulesh will buy me any food I request when he visits and one of the nurses, another girl that I met, and this one random Russian writer have been kind enough to bring me other food to eat as well.)

Today is my 6th day post surgery and I've started lengthening. Already, I can stand and walk (with some difficulty) on my own. My main issue is a low, throbbing pain (tension? pressure?) that I've started experiencing after intense training with my new trainer yesterday. Dr. Kulesh told me the Russian patients call this a "pressing" and it is basically the soft tissues being stretched/manipulated. This may or may not get worse as I lengthen. It would suck if it got worse, but already I am attempting to re-associating this feeling, in my mind, as a positive sensation. Seriously guys, after all the years I've spent waiting to do this procedure, only pain that I should perceive as undeniably permenantly damaging will stop me from entertaining any doubts or regrets.

I've started studying again since yesterday, something I have set my mind to do while lengthening. Once I get Internet access back, I'll start working again as well. I'll also try to upload my post-surgery X-rays:)

[Samuimw]

Hello badwolf , good luck with your journey. I'm also from Asia, my starting height was 164 and have been lengthening for two months now , I have reached 4.8 cm my target is 8cm. No problems so far only very little ballerina.

[microman]

does dr. solomin have a 6cm limit, it is implied in his FAQ.

what is your ratio anyway, i take it if you go above 5cm your tibia becomes longer than your femur?