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[shortygirl]

Hi!

I am currently lengthening my tibias in Saint Petersburg with Dr. Solomin and Dr. Kulesh, I thought I would write about my experience as maybe it will be useful to other people who want to have this surgery here and you can ask me any questions. I will try to organize my thoughts below and probably write way too much!:

Pre-Surgery
I arrived to Saint Petersburg on May 14th with the intention of potentially having the surgery on May 19th. I met with Dr. Solomin and Dr. Kulesh, had some X-rays and discussed my goals and the details of the surgery. I was obviously really nervous about having the surgery but Dr. Solomin and Dr. Kulesh immediately made me feel comfortable and very confident about having the surgery with them. They are both extremely kind and I really feel that they are absolute experts in limb lengthening. After meeting with them I felt really confidant about going forward with the surgery and that I was in the best hands. My goal is to lengthen 5cm-6cm, I would like to lengthen more but it seems like the majority of competent doctors recommend not exceeding this amount for good reason so I think it is wise to take this into account. LATN was the only option for me because with LON they do not make a nail that is small enough to go into my small bones (I have skinny girl legs), so that is what I am doing. I had my first surgery at the Medem clinic because I needed Visa support which they offer but I will have my second surgery to remove the frames and insert the nails at the municipal hospital because it is about half the cost.

Thoughts on Saint Petersburg
I was a bit nervous coming to Russia because in North America and I guess a lot of the world there is a lot of negativity about Russia everyday in the news. I really like Saint Petersburg, it is a really beautiful city and it just seems like any other European city like Paris or Berlin. For the most part it has all the same things that we have in North America, I went shopping at a really nice mall, went to McDonalds a lot, used Uber to go everywhere (Uber is super cheap here like $4 to go anywhere)

Paying for the Surgery
Paying for the surgery was more complicated - my plan was to pay for the surgery with paypal which I thought would be really easy but when I tried to send a paypal tranfer it wouldn't work - I called paypal and they told me that because I was trying to send such a large amount of money their security restrictions wouldn't allow me to send the transfer and there was nothing they could do. Then I went to a few different banks and tried to use my debit card and credit card to purchase rubles but their machines wouldn't accept any of my cards. As a last resort I was able to pay with a combination of western union transfers and taking out cash from ATMs so it all worked out but it was really difficult. I guess the best thing would be to just get the Rubles in your home country before coming here (or bring a large amount of your currency to exchange for Rubles) but I really didn't want to be carrying around $10000 in cash worrying I would lose it. Anyways it all worked out! I don't really feel the need to go in to detail about the costs, if you email Dr. Kulesh he will send you a comprehensive guide to the costs.

Surgery at the Medem Clinic

http://medem.ru/

I chose to have the surgery at the Medem Clinic and am staying there for the duration of my lengthening. The surgery itself went fine, nothing out of the ordinary. After the surgery I had pain killer injections for about 3 days but the pain was really not that bad. The frames are so uncomfortable and annoying though, I am counting the days until they are removed.

The Medem Clinic is really nice and luxurious, it is kind of a combination of a top hospital with amazing facilities and a 5 star hotel. Most of their cliental seems to be wealthy Europeans that come here for various surgeries. Here are some pictures of my room, it's really nice and has a beautiful view:
https://imgur.com/a/iVQ9V8a
https://imgur.com/a/jHdM61n
https://imgur.com/a/oYdJcFb
https://imgur.com/a/1b1pdDS

I definitely feel really spoiled here, the doctors and nurses are very kind and eager to assist with anything I need, at least twice a day a doctor comes to check on me to see how I'm doing and if I want any medication for pain or sleeping. I've been in nice hospitals in Los Angeles and Chicago but this is definitely better. There is a resident orthopedist who comes to check on me and a neurologist who comes to talk to me about any pain I have and he prescribed me some medication that is pretty good for managing the pain.

The food is really good, gourmet style spa food (although the menu repeats every 7 days so now I am starting to get sick of it a bit!)
Here are some pictures of what the meals are like:
https://imgur.com/a/GqvzEdZ
https://imgur.com/a/CxDttKY
https://imgur.com/a/AcNWS7W
https://imgur.com/a/YPditZC
https://imgur.com/a/ZBbN1c0


Pain
So far the pain is not THAT bad but I am definitely a baby about pain so I am taking pain killers. I am taking celebrex which is an NSAID similar to ibuprofen and lyrica a painkiller specifically used to treat neuropathic / nerve pain (like the pain you feel from stretching the skin and nerves) and I also take ibuprofen as needed. During the day I am very comfortable but during the night sometimes the pain gets really bad, it's different every day. For instance last night I had this very severe nerve pain when I moved my left leg, it was one of the worst pains I have ever felt but later it just disappeared, hopefully it won't come back. I asked the doctor about having some stronger painkillers but in Russia painkillers are strictly regulated - I brought some oxycodone from home and showed the doctor the bottle to see if I could have some (typically in North America doctors prescribe opiods like this after surgery which really take away every bit of pain) and he said it's not possible because it's restricted here. If I had known I probably would have brought more oxycodone to take at night. So anyways the pain comes and goes, I just try to remind myself that the pain is temporary.

Sleep
Sleeping is really hard because of the frames and on nights when the pain is bad (it is an option to have an injection of strong painkiller at night I think Tramadol but I so far have avoided asking for it because I don't want to become dependent on it, it's so addictive and if I were to have it everyday for 30 days while I am here and suddenly not have it anymore the withdrawal would be pretty bad. I usually sleep for 3-4 hours during the night but I also have naps during the day so I feel ok / rested. My activity level is so low that I don't think I need that much sleep.

Walking Etc.
I can walk and stand for a pretty long time but I am not walking too much really. I have a wheelchair and a walker which I use. It seems like some doctors recommend that you walk a lot during the lengthening while others recommend that you avoid walking so I am not sure which is better but my walking is minimal. I am doing a lot of stretching throughout the day as well as low impact exercises to keep my legs moving and strong like leg lifts etc. I think it would be useful to have an exercise bike, I have one at home that I think will be really good for getting back the strength in my legs. One thing that I really noticed is how much my other muscles are being used to compensate for the lack of strength in my legs - my abdominals and upper body. I think it is really beneficial to build strength in your upper body / arms before having this surgery.

Other random thoughts
The Medem clinic has really fast wifi so that's good. My phone works fine here I didn't get a Russian phone or SIM I mostly just use imessage over wifi. You can have things delivered to the clinic - my cord for my macbook broke so I ordered one from the apple store and they delivered it right to my room the next day.

So far I have lengthened about 36mm 3.6cm, if everything continues to go well I plan to have my nailing surgery in 18 days (July 6th) - I am counting the days lol

My legs already seem sooo long with only 3.6cm - it's hard to picture because 3.6cm doesn't sound like a lot but I really notice the length. They also feel really stretched out, I feel it would be so difficult to lengthen more than 5-6cm, I can't imagine how anyone would do it I just don't think my legs would let me.

I can't really think of anything else to write about but feel free to ask me any questions.

[Tiger9898]

Happy to see another diary from Dr Solomin /kulesh s" patient.  Thanks for sharing us such a detailed diary.  I hope everything will be excellent and you will have good recovery. 
May I learn how much money will you spend on accommodation there? I think you should pay too much money to stay at MEDEM during whole lengthening process. And do you know the opinions of them  about safety limits in tibia lengthening?

[shortygirl]

Happy to see another diary from Dr Solomin /kulesh s" patient.  Thanks for sharing us such a detailed diary.  I hope everything will be excellent and you will have good recovery. 
May I learn how much money will you spend on accommodation there? I think you should pay too much money to stay at MEDEM during whole lengthening process. And do you know the opinions of them  about safety limits in tibia lengthening?

Thanks!! The accommodation situation was actually really complicated - initially I had rented an apartment on airbnb for the duration of the treatment which I returned to for about a week after the surgery BUT because the Medem clinic had immigration officials coming in to make sure the patients they got visa extensions for were actually in the hospital they told me that I would have to stay at the clinic for the rest of the treatment or they could get in a lot of trouble. Russia is sooo strict aboust visas I've never been to a country that is so strict. They only charged me 1000 euro for this (to stay until July 19th, after I would pay more I guess but it doesn't matter because I won't stay that long anyways) The normal nightly rate for the room I am in (Luxury room) is really high like $300 a night...I am not sure if they will have this 1000 euro price for future patients or if it is just a one time thing. At first I was annoyed because I had prepaid for the apartment for a few months but I got most of it refunded from airbnb and I actually really like being in the clinic I think the time passes faster when people are visiting everyday etc.

[shortygirl]

And do you know the opinions of them about safety limits in tibia lengthening?

Dr. Solomin recommends to lengthen no more that 10%-20% of your initial bone length. For me that would be about 4.5cm (determined with X-rays). That being said they don't have strict limits they just give you a recommendation, he told me he has had patients that lengthened even 9cm.

[Tiger9898]

I think it is just one time thing.  According to the file that dr Kulesh sent me,  staying at MEDEM costs around 135$ per day. So,it has been the way so cheaper for you so far
Yes, they say we recommend lengthening 10% of initial bone, but we consider admissible to lengthen 20% of inital bone.  I thought maybe they said something different in face to face consultation.  May I learn your starting height?

[shortygirl]

May I learn your starting height?

About 165cm

[Dylansaga]

What has been the total cost so far? including surgery price and hotel/clinic cost. Ty and good luck.

[patientprivacy]

Did you have ATL? Thanks

[PAGrb490]

what was your reasoning for LL? 165cm is an average height in the US for a  female.

aksing cause I am a female too and consider doing LL, so just curious to hear a female perspective.

how about your age?

[shortygirl]

What has been the total cost so far? including surgery price and hotel/clinic cost. Ty and good luck.

I think in total about $6500 USD including flight here / everything. There are a few remaining costs including the surgery to remove the frames and insert the nails which will be about $4000 USD.

[shortygirl]

Did you have ATL? Thanks

No I didn't have this. There is a possibility of having this surgery (at additional cost) if you lose too much ankle flexibility but so far my ankles are ok. The other option is to go home after lengthening and regain ankle flexibility over time with physio, I would choose this option. I was very flexible before doing this although I have noticed a decrease in my flexibility now. When I read about people's experiences with ATL it sounds like it creates a lot of long term problems and would add a lot of time and pain to my recovery so I would really want to avoid it personally.

[PAGrb490]

padron my ignorance, what is ATL?

[Muller25]

So who's going to Solomin this year?

[myloginacc]

padron my ignorance, what is ATL?

Achilles Tendon Lengthening.

So who's going to Solomin this year?

Please make posts like this outside of someone's diary. Make a thread in meetup & travel.

[shortygirl]

what was your reasoning for LL? 165cm is an average height in the US for a  female.

aksing cause I am a female too and consider doing LL, so just curious to hear a female perspective.

how about your age?

I will send you a private message just because I don't feel like sharing publicly

[PAGrb490]

pls do, many thanks!

[shortygirl]

A few more pictures::

A picture of where they made the cuts to break my bone, the scars are healing really well and are nearly faded, I hope all of the scars will heal this well:
https://imgur.com/a/BaPKeyW
These are the only scars besides the ones from the pins and screws of course.

Scar gel that I really recommend!! You can get it on amazon it works really well to fade scars:
https://imgur.com/a/uSxoFps

When I first started lengthening Dr. Kulesh marked on the frames with white out so I could see the progress which is cool. As you can see it is almost 5cm, although on the X-rays it is always a bit less of actual lengthening, maybe 4.5cm instead of 5. I'm not sure why this is but that is just how it is:
https://imgur.com/a/1Ut5Aii

I had x-rays yesterday so when Dr. Kulesh sends them to me I will post them.

[Thequietone]

We need an updatr, shortygirl!

[shortygirl]

Hey Everyone,

First of all, sorry for the delayed update to my diary, I planned to do an update a lot sooner but when I got home I just reallllly didn't feel like thinking or talking about everything, was so exhausted etc. but I think it's important to do an update for people who are considering surgery with Dr. Solomin / Kulesh.

First of all, I can definitely say after everything I am so glad I chose to do the procedure with Dr. Solomin and Kulesh, in thinking about the entire experience I really feel they are some of the top doctors in the world when it comes to LL and I have no regrets about choosing them as my doctors. I will try to summarize everything below:

I completed lengthening 5 cm and spent about 3 days in the "corrections" phase, where Dr. Kulesh and his team spent hours meticulously calculating adjustments to my frames to make sure my legs were perfectly straight. I was really impressed by their perfectionism when it came to this, over this period I had about 12 X-rays and recalculations using special software to make sure that everything was perfect. I'm not sure if all doctors are so meticulous about this as when reading other people's diaries I don't remember reading so much about corrections. One of my bones had become very misaligned during lengthening and that leg hurt quite a lot to correct. Dr. Kulesh explained that when doing the correction period over only a few days it hurts more, you could choose to do it slowly over a week or 2 and would probably experience no pain, or he said they could even do the corrections in 1 days but the pain would be severe.

July 13 - I had my frames removed and nail insertion surgery at the municipal hospital. Everything went well. I was expecting more pain than the initial surgery to attach the framed because Dr. Kulesh said inserting the nails is harder on the body but I didn't find the pain to be worse. I had an epidural anesthesia in my back, it was uncomfortable so I actually asked to have it removed the day after surgery and managed with mild painkillers alone.

July 16 - Feeling pretty good, scheduled to fly home today (12 hours to New York) Dr. Abdulah accompanied me there, this is where problems arose. I originally came to Russia with a 30 day tourist visa, but I paid for a visa extension through Medem Clinic (in fact this is really the only reason I chose to have my first surgery at Medem which cost a lot more because they offered visa extension) The visa extension cost about $1000 and supposed to be valid until July 19th. I found it odd that I never got a new visa in my passport or any official documentation to prove that my visa had been extended, I asked Dr. Kulesh about this at least 4-5 times and he said not to worry about it, I had been registered with immigration and they would have a record of my new visa. Of course, when I went to check in for my flight, they checked my documents and said there was no way I would be getting on the flight because I do no have a valid visa and am technically in the country as an illegal immigrant. At this point I was pretty upset. It was a long ordeal but eventually I managed to get an emergency transit visa in order to leave the country (only granted because I was "injured") if I had been in perfect health the gate agent said I likely would have spent about a week in Russian court and paid a lot of fines. I missed my flight, had to purchase a new flight for 12 hours later. Although this was a difficult situation, Dr. Kulesh paid for my new flight and any of the expenses I had due to the visa problem, which was really great and really made me feel like he is a genuinely good person (I don't know whose "fault" it was, maybe Medem or the Russian immigration system but I don't think it was Dr. Kulesh's fault) He also came and waited with me at the airport until my flight so from 8pm until 4am the next day to make sure i got on the flight okay, I told him he really didn't have to and I would be okay because they had really great staff at the airport helping me but he insisted on waiting which was very kind, I don't think a lot of doctors would have done this.

Rapey Doctor - All of the doctors that I met during my time in Russia were great and very professional except for Dr. Abdulah. While we were in the airport he kept touching me, it made me uncomfortable. When I missed the flight he insisted that we go stay at a hotel near the airport (as in we both stay in the same room) until my new flight. I got such a bad feeling about him that I refused and said I would wait at the airport. There was no way I wanted to be alone in a hotel room with him. Later, when we were alone in an elevator at the airport, he tried to kiss me on the mouth "to say goodbye to me" (this isn't a custom in any country I've heard of especially Russia). I had given him my phone number because we had to separate at the the airport while he sorted out my emergency visa and later he sent me so many inappropriate text messages, kissing faces, basically saying creepy inappropriate things. Anyways if you are a girl and have surgery with Dr. Solomin I would avoid Dr. Abdulah.

Plane Trip Home - Everything went smoothly flying home, the airline helped me get to my seat and through the airport etc. Even though it was only 4 days after the surgery I felt fine, I didn't take any painkillers on the plane, took blood thinners to avoid DVT. Got home and basically slept for a week I was so exhausted. I didn't sleep very much at all during the entire time I was in Russia and especially during the last week so I was really so tired when I got home.

July 24 - After resting for a week and eating a lot I felt like I had my strength back so I started gradually standing / doing some walking with a walker. When I first started walking my walking was terrible, I was just so weak and wobbly, I had about 1cm of ballerina foot so of course because I couldn't place my foot flat on the ground walking and even standing were difficult.

I felt stronger everyday, pushed myself to walk more and after about 3 weeks things improved dramatically. My ballerina foot is pretty much gone, my calf muscles are still tight but I can stand and walk almost normally now (although my walking is slow and careful). I tried physiotherapy but frankly didn't find it to be very helpful, the only thing that really helped me stretch out my muscles and get back to walking was actually walking, even though it was so hard at first. Dr. Kulesh had suggested that I have Achilles Tendon Lengthening to improve my ballerina foot but I didn't want to, and in my case I'm glad I didn't because I was able to resolve the ballerina foot pretty quickly (I'm sure everyone is different though).

August 15 (about 1 month post nailing surgery) - Went for a short walk maybe 1/2 mile without a walker or crutches. My walking is still slow / muscles still tight but in general feeling pretty optimistic about recovery, when I first got home I didn't feel that I would progress to walking unaided so quickly (Dr. Kulesh didn't really give me an estimate and I didn't ask him because of course it is different in every case - for example before I decided on Dr. Solomin / Kulesh one doctor I talked to estimated 3 weeks post surgery, another 4 months, obviously a vast difference. I kept 4 months in my head as a "worst case scenario" . I also had X-Rays and an exam with an orthopedic surgeon here to confirm that everything is going well with my healing. Dr. Kulesh follows up with me as well by e-mail. I haven't got my full range of motion back in my feet yet (doriflexion in particular) but it's improving every day.

Scars - I was initially really concerned about how scarred my legs would be after the two surgeries but I'm pleasantly surprised that the scars are very minimal. Based on pictures of other peoples scars that I have seen I think Dr Solomin / Kulesh take great care to minimize the appearance of scars (maybe because i am a girl lol). I thought I would probably want to have laser scar removal surgery after the procedure but now I think that after a couple months the scars will be so faded I won't even need it.

One last thought - 5 cm / 2 inches, really does feel like a lot now that I'm standing. I really notice the difference in height so I'm really happy about that. Although it was a great challenge and very painful at times, I don't have any regrets about doing the procedure, sometimes I feel down still about not yet being as mobile as before but most of the time I'm just so happy to be have achieved my new height, it is the greatest feeling in the world to have accomplished this and be able to put it behind me after thinking about it for years!!

Hopefully I have remembered and summarized everything okay!

[csherpard]

Hi shortygirl, thanks so much for updating your diary - i am currently going through lengthening and its very encouraging/inspiring to read updates like the one you've just written. Quick questions if you have the time:

I was amazed to read that you walked 1/2 a mile unassisted a month after nailing surgery! I am having the nailing surgery done in a month and (as you say) there seems to be a wide range of opinions on how long it takes to walk after nailing. It was my understanding that you couldn't fully weight bear on the nail till the bone was pretty much fully consolidated. Is there not a risk of the nail bending ? Is the point where you are given the green light to weight bear pretty much straight after nailing or is a certain level of bone consolidation required ?

[Bob]

How is the food in muncipal hospital?

[AR]

shortygirl,
I wish u speed recovery, and i want to add that dr kulesh personaly is a great dr and can't leave the patients in troubles, he is very gentle and its not only because he paid for ur new flight, which reflects how responsible he is and he is not a money seeker like some LL drs. I was in ur situation luckily my visa extension from the MEDEM clinic went well but when dr kulesh went with me to the airport we forgot my walker, i told him its ok no problem he siad he will give me the walker money because now i don't have it. Unfortunately we faced a problem in the airport. The flight company didn't alow me to check in because if i'm only using a wheelchair and can't go to the bathroom they can't accept me on the plane. Dr kulesh talked with them and they agreed to accept me if i only have walker or crutches, he went to the pharmacy to buy me crutches but he didn't find. So he told me to wait 1 hr and went back to the clinic to bring my walker, this is a surgeon who has some assistants to help patients but he himself will do anything to help his patients. I respect him.

[shortygirl]

Hi shortygirl, thanks so much for updating your diary - i am currently going through lengthening and its very encouraging/inspiring to read updates like the one you've just written. Quick questions if you have the time:

I was amazed to read that you walked 1/2 a mile unassisted a month after nailing surgery! I am having the nailing surgery done in a month and (as you say) there seems to be a wide range of opinions on how long it takes to walk after nailing. It was my understanding that you couldn't fully weight bear on the nail till the bone was pretty much fully consolidated. Is there not a risk of the nail bending ? Is the point where you are given the green light to weight bear pretty much straight after nailing or is a certain level of bone consolidation required ?

I was surprised too, especially considering how weak I was after the nailing surgery but I just felt stronger every day that passed. As fas as I was told the nails I have are fully weight bearing (up to a certain weight I suppose but I only weight about 100 pounds) I think certain internal only nails like ISKD are not fully weight bearing maybe this is what you are thinking of? Dr. Kulesh didn't warn me about a risk of nail bending and he was generally very informative so I think he would have told me if it would be a potential concern.

[shortygirl]

How is the food in muncipal hospital?

It is really the worst food ever lol. It seems like food that they would feed prisoners in a Russian jail. Not only is it bad tasting and bland, it just wasn't enough calories to sustain a healthy body weight, I lost at least 20 pounds while I was in Russia. Even the orderlies that brought the meals looked so skinny and sickly with dark circles under their eyes. No fruits and vegetables. If you are staying there for an extended period you could ask one of Dr. Kulesh's assistants to go grocery shopping for you though as the rooms have a kitchenette.

[shortygirl]

shortygirl,
I wish u speed recovery, and i want to add that dr kulesh personaly is a great dr and can't leave the patients in troubles, he is very gentle and its not only because he paid for ur new flight, which reflects how responsible he is and he is not a money seeker like some LL drs. I was in ur situation luckily my visa extension from the MEDEM clinic went well but when dr kulesh went with me to the airport we forgot my walker, i told him its ok no problem he siad he will give me the walker money because now i don't have it. Unfortunately we faced a problem in the airport. The flight company didn't alow me to check in because if i'm only using a wheelchair and can't go to the bathroom they can't accept me on the plane. Dr kulesh talked with them and they agreed to accept me if i only have walker or crutches, he went to the pharmacy to buy me crutches but he didn't find. So he told me to wait 1 hr and went back to the clinic to bring my walker, this is a surgeon who has some assistants to help patients but he himself will do anything to help his patients. I respect him.

Thanks, yes I agree Dr. Kulesh is a very caring doctor and 100% agree that profiting from patients is not his interest at all. For example he told me that he turned away a potential patient while I was there because he didn't think she was a good candidate for the surgery when he could have just taken her money and done the surgery.

That's so odd the airline treated you this way, did you make prearrangements for special assistance? With my airline there was no requirement to have crutches or a walker on the flight, if I needed to use the bathroom they would have taken me on the small wheelchair that they used to get me to my seat. Sorry that happened to you.

[6'2_dream]

hello no more ShortyGirl haha
You should move to Tallergirl now that you're taller
 hope you're happy it's a great achievement
 
 I hope you are well speak more as this your recovery, already walking? Was it 5cm?You're with 170cm now   ?

[177cmm]

Haha she wasn't short even with 5'5 at all, average of USA :p
Can I ask u about one thing? How much u spent total in Russia

[shortygirl]

hello no more ShortyGirl haha
You should move to Tallergirl now that you're taller
 hope you're happy it's a great achievement
 
 I hope you are well speak more as this your recovery, already walking? Was it 5cm?You're with 170cm now   ?

hahaha thanks!! I will definitely keep updating about my recovery, progress is sloooow lol. Today I walked up and down a flight of stairs in my house (15 steps) unassisted (but holding the railing for safety) so thats some progress.

[shortygirl]

Haha she wasn't short even with 5'5 at all, average of USA :p
Can I ask u about one thing? How much u spent total in Russia

lol true. To be honest I'm not sure of the exact amount I ended up spending (just that it was more than originally planned but within my max budget so I didn't stress about it too much) Dr. Solomin really itemizes every cost ie. bandage change 1,500 rubles, adjustment to frames, 2,000 rubles, taxi service 1,000 rubles (unlike many doctors who seem to just charge one amount inclusive of everything) so to calculate out the exact amount would probably take an entire day of accounting. I would estimate around $15,000 USD including everything flight and accommodations.

[177cmm]

I will try to close everything in 10000$. I think it's possible.

[BK524]

He's upped the prices though.