Yes, that's right. I'm in Russia.
About MeI learned about cosmetic limb lengthening maybe a decade ago, most likely late at night, seeing what the internet can tell me about height increase. I found the old forum, and during those days it seemed as if every other patient was going to Beijing, as it was the affordable option at the time. I read into the surgery a bit back then, but not too much in depth since I was a busy student with a girlfriend. My mind was occupied and I didn't feel the need for the surgery, so I forgot about it for many years.
Fast forward to around 2017, and I was looking into increasing my height again. After a couple long (and one short) relationships, I was single. I've been at the same job for a few years, and while it paid well for the amount of work I had to do (there were weeks that I'd just surf the web), I didn't feel that I was growing professionally. I began to spend a lot of time on this forum, learning and planning.
I told my mom about it pretty early on. She was at first hesitant, but later agreed that this would be good for me. She's quite short herself at around 159 cm (4'11"), and confided in me that she too wanted to be taller--like her mom--when she was younger.
While planning, a couple things happened. First, I met a girl. She's beautiful, intelligent, ambitious, and thoughtful. Then I got approached for a job that would pay considerably more. I decided that if one of those two things worked out, I'd postpone the surgery. Obviously they didn't pan out, but I'm still in touch with the girl, so we'll see what happens after my journey.
Why Doctors Solomin and Kulesh?Let's get the obvious one out of the way: the price. The dollar is quite strong compared to the ruble right now, so it's an advantageous time to look across the pond. I'm not particularly wealthy, nor do I want to take on debt, so doctors overseas looked particularly attractive.
My shortlist for a time was Dr. Solomin/Dr. Kulesh, Dr. Parihar, Dr. Birkholtz, Dr. Giotikas, and Dr. Mahboubian. I didn't contact all of them, but their combination of experience, reputation, location, and price were what made them attractive to me. After exchanging emails, the expertise and punctuality had the most impact.
With a starting height of around 163 cm, I wanted to lengthen both tibias and femurs. Only a few offered cross-lengthening (
good primer on the method here), and Dr. Solomin's reputation both on the forum (specifically
Overdozer,
badwolf, and later
Jim_dabarber) and among his peers sealed the deal for me. He co-created the
Ortho-SUV hexapod (the "S" is for Solomin), wrote the book on external fixation, and the
forward was written by Dr. Paley. That was enough validation for me.
Contacting the DoctorsI emailed both Dr. Kulesh and Dr. Solomin for the first time in January 2018, with the same emails in the doctor information threads. For the most part you will be talking to Dr. Kulesh; in fact, I've yet to receive an email from Dr. Solomin, aside from the occasional out-of-office reply.
My impression is that Dr. Kulesh is punctual, to the point, and helpful. He seems to work late often, so I was surprised when he'd email me past his midnight.
After a couple dozen emails, Dr. Kulesh and I decided when the surgery would take place: late June. He asked me to remind him a month before I arrive and to ask any questions that I may have before then.
Sharing My JourneyI've told several people in real life about my journey. I've told my mom and around six friends. My mom has shared it with her closest friends as well, including her church pastor (who is surprisingly very positive about this idea).
I told my friends after my plans were in place, so it was matter of fact. I wasn't looking for direction, just telling them that my real reason for moving was for my surgery.
So far the reactions are at first surprise, curiosity, then support. No one has said that it's crazy (at least not to my face!), and they're looking forward to seeing the new me.
There are some people that I'm really close to that I haven't told yet, because I can't imagine their reaction being that great. It's harder for me to share with men, especially if they're about my height. I don't want to seem like a "traitor," as silly as that sounds. I haven't told my dad yet either, since he's a tough guy that managed to combat height neurosis with a strong--and sometimes abrasive--personality.
It won't be a secret for long, so I'll cross that bridge when I get to it!
Preparing to MoveI decided to stay in St. Petersburg for the entire duration of the lengthening phase to maximize the success rate. So I had to quit my job, sell all my things, and completely change my life. It was tough, but it wasn't too bad in hindsight.
As for the job, I told them half truths. I said that my mom's living alone in Japan, and I'm an only child, so I wanted to help her out in a time of need. All of that is true, except that she doesn't quite need my help so badly; she just wants me to help her create side gigs down the line. I liked my coworkers and didn't want to burn bridges, so this worked out fine.
The logistics of completely selling my accumulation of stuff was pretty stressful. I didn't start selling things until a couple months before the move, so it's really my fault. I used Facebook Marketplace (had the most success here), eBay (best for big-ticket items), letgo, and Craigslist (large furniture) for all my sales.
I was planning to sell my car, but my dad offered to fly to me and drive it back home. He's several states away, but likes to drive so it wasn't a big deal for him. It also allowed me to pack some things I wanted to keep for my eventual return.
PaymentThis was a huge headache, as both
Pope and
shortygirl already mentioned. I was naive and arrived without a ruble to my name, since I could use the ATM for small purchases and pay the doctors with PayPal, an accepted payment method according to their files.
But! PayPal has recently become more strict, and payments to Russian accounts are unreliable. My payment to Dr. Kulesh was blocked almost immediately, and he also got the failure message. I then tried to wire the money, but it takes several business days, so it's not ideal if your surgery date is soon after arrival.
So next I tried Western Union. I tried to send it directly to Dr. Kulesh, but I didn't have all the details (his address), so I had the bright idea of sending it to myself. Unfortunately that was blocked as well.
So then, ATMs! I found a few down the street, was able to withdraw 9000 rubles a few times. Then I got an error, so I hit another ATM. Got a few thousand more, then another error. Called my debit card company (Chase), and they informed me that I hit my daily $500 withdrawal limit. They allowed me to temporarily increase my daily limit to $1000 for a week, so I got some more rubles after the call. Be sure to only use a debit card, as you'll get a hefty charge for cash advances with a credit card.
However! I didn't have enough days to gather the required funds. So I tried Western Union again, this time for $2000 worth of rubles via debit card... And it worked! I walked to three banks listed on the Western Union site, and the doors even had the Western Union logo on it, but they turned me away. Found a place right across from MEDEM (the private clinic) called Alfa-Bank, and was able to transfer rubles on the same day. It's
inside this mall on the first floor, go inside past the escalators and it'll be on the right side (not the one right by the entrance!). Here's a business card:
This was a stressful few days. If the rates and fees are reasonable, I suggest transferring your home currency to rubles before you take off for Russia.
As for paying the doctors, I finally did this yesterday after all the consultations and tests. I hadn't paid a ruble before that. So far I've given only the advance payment of 240,500 rubles for step one of the surgery (i.e. putting the frames on).
Prepping for RussiaAs much as you think you're ready, you won't be.
For the visa I got it processed at a local Russian visa agency,
Rush In Documentation Center. It was quite easy, and it felt more secure than sending the passport myself. It cost about $500 for a
3 year multi-entry visa, which is only applicable for citizens of the United States.
Be sure to have the right power plug adapter for your devices. I bought myself a
compatible adapter, but it's pretty awful since the shape is all wrong for Russia; it's a square peg trying to fit into a smaller circular outlet, so the adapter keeps falling out. I'll need to buy better ones online,
like this one.
I asked my mom to get me a power strip (with USB ports if they have it), and she came through beautifully: no more adapters popping out with any small movement! I plugged my power strip from te US into it and it admittedly looks a bit crazy now, but it works. Quick note, I can buy things for myself, but asked mom since I'm in a hospital room now (more on that way below).
I brought my Nintendo 3DS, but the charger doesn't work even with a plug adapter! I found a couple stores selling the handhelds but not the charger, so I'll have to get it online (I recommend AliExpress). I recommend getting the USB charger cable if you have one, I unfortunately donated it during the move.
Only clothing I brought were shirts (around 10), underwear (5), socks (4), shorts (3), pants (1), and jackets (2). Brought one pair each of sneakers and sandals as well. Toiletries like toothbrushes and shavers are a given, but be sure you bring your favorites like toothpaste and deodorant since you might not be able to find one that you like. I had this problem, but luckily you can find Old Spice here.
I also bought some awesome pajamas from
Uniqlo called Ultra Stretch. They're extremely stretchy, so they should be able to accommodate frames. I'll probably need to cut the cuffs, we'll see soon enough.
SupplementsI was concerned about nutrition, so I stocked up on protein powder. First, I've been consuming
Schmilk (I like chocolate flavor) for a couple years now, which is a nutritionally complete meal in powder form; just add milk. I won't be completely replacing meals, but it'll be a good supplement.
Losing weight due to muscle atrophy is common, so I bought weight gainer protein powder as well:
Optimum Nutrition's Serious Mass. We'll see how well this works, I really liked Gold Standard whey while I was hitting the gym.
I bought some supplements for bone growth as well,
Vitamin Code's Grow Bone System. It has the nutrients that I was looking for, namely vitamins D, K, magnesium, and silica. I'm hoping that this helps in the long run.
Flight to RussiaPretty normal stuff, flew via Aeroflot. Food wasn't too bad. In-flight entertainment was extremely slow, I audibly and visibly saw a woman getting frustrated with it. Airport bathrooms were filthy!
Worthy of mention, wear a hygienic mask if you can. They're cheap, and Dr. Solomin & Dr. Kulesh won't operate on patients with influenza!
St. Petersburg, RussiaThis is a beautiful city, especially this time of year. June through July is what they call White Nights, in which the sky remains bright even throughout the night. Here's the city at 1 AM:
I picked a relatively expensive time to be here, since it's also during the FIFA World Cup. Silver lining is that the city is very lively now, and it probably helped restaurants prepare English menus. Not too common, but they're around!
Speaking of costs, this is a much less expensive city compared to Los Angeles... Even in the city! Draft beer can cost around $6-8 in LA, but it's under $3 here in SPb. I was worried that I'd dislike the food, but everything has been delicious (and affordable) so far.
ATMs are everywhere, so you won't be stranded for cash as long as you have a Visa or Mastercard debit card. Many restaurants take card, and they even bring their card reader machine to the table.
Tipping is sometimes included, so be sure to read the receipt first. Tipping isn't necessary, but it's becoming more common, so I leave 10% in cash (you can't tip via card). So be sure to get some smaller bills when you can.
Accommodation: Pre-operativeMy mom came with me, and will be with me a few days after surgery, so we had to get a place that we could share. Hotels are expensive right now, so I only stayed at one for a couple nights, since we landed past midnight; a bit difficult to find a 24-hour Airbnb.
Another merit to staying at a hotel is that they'll register your visa without breaking a sweat. Registration of a visa is strange: basically you have to register with your host within your first week of being in Russia, there's no cost to you. Be sure to do this, as failure to do so will mean fines and/or (though rare) deportation.
After that we relocated to a rental I found on Airbnb. It cost just over $1000 for two weeks, and it's in the heart of the city. It's also in walking distance to MEDEM, which made it convenient. This apartment was obviously newly created for short-stay users, since there were a few similar units next door inside a comparatively old building.
Getting AroundAt first I thought I'd be using Uber, but it turns out that the local market is more saturated with Gett. I had no idea what it was, but I saw ads in the airport and decided to give it a try.
If you've used Uber, it's pretty much the same deal. Gett is cheaper though, so I recommend using it if in Russia.
X-rays and TestsThe day after I landed, I went to RNIITO to get x-rays by Dr. Nikita, who works with Dr. Kulesh. This was about 35 minutes away (15 km or 9.3 miles) from where I was staying; this cost around 718 rubles ($11.40). I initially had some trouble on seeing him since the hospital staff didn't speak much English. After using Google Translate, showing emails, and of course name dropping, they managed to find Dr. Nikita for me.
Dr. Nikita spoke some English, so I had an easier time communicating with him. He walked me through corridors to get to the x-ray room, and I was asked to take my pants off. We took some long film x-rays while standing, and then I laid down for some tibial x-rays. Dr. Nikita said he'd email the results to Dr. Kulesh, then he walked me out. I think I was there for 30 minutes or so total.
Since I have a birth defect of the heart, I was recommended to see a cardiologist. Dr. Kulesh scheduled an appointment for me at MEDEM, so I headed back to the city. After some paperwork and waiting for a few minutes, I got a cardiogram and got the results right away. This cost me just under $25.
Consultation: Dr. KuleshThe very same evening I went to see Dr. Kulesh at St. George's Hospital. Very nice building, much newer than RNIITO. After some more Google Translate, I was able to find Dr. Kulesh's office, but there was another person waiting outside his door. There was already another patient inside his office as well, so I waited about an hour or more before being seen. Luckily they had Wi-Fi, so I was able to kill time pretty easily.
At last, meeting the man himself, Dr. Kulesh! We talked about my goals, method, timeline estimates, and recommendations. He showed me a handful of patient x-rays and photos to give me a better idea of what's to come, and the first patient was Jim_dabarber! He said that Jim is a good patient, and that he's doing very well with physiotherapy.
The doctor also shared stories of non-compliant patients, like a person who flew home one day post-op (!) and decided to lengthen 3 mm a day (!) because he was in a hurry. In the end the doctors were able to help him to recovery, but it was a tough one. Another patient lengthened 13 cm on his femurs and 7 cm on his tibias. Again, very tough recovery, and having joint problems.
He explained that they can only offer recommendations and guidelines, but if a patient is insistent, they will do it. But please, use some common sense. Those two guys mentioned above are not shining examples of good outcomes.
He also had a funny anecdote about patients wanting absolute perfection. One patient would scrutinize his x-rays, saying that one leg was 1-2 mm longer than the other. After correction, the nails were inserted since the method chosen was LATN; the meticulous correction wasn't fruitful, since jamming intramedullary nails will shift your bones a little bit. In the end there was minor discrepancy, but the mechanical axis was good, and the patient was happy with their result.
Another patient had curvature problems with their femur, which was not detectable from the outside. During lengthening the patient became concerned, Photoshopping the x-rays to straighten the femur, to say that is the result they wanted. Local doctors were also concerned, saying it should be fixed. However, the mechanical axis of the bones were good, so it was a non-issue. And again, it was undetectable from outside the body.
As for me, I currently have near-perfect mechanical axis, very slight valgus deformity (3-4 mm) at the knees. Right femur is around 47 cm, left within 4 mm of that. Right tibia is 36 cm, left is within 2 mm of that. I've tried to measure my own legs before and I was waaaay off, so keep that in mind.
We talked about methods a bit. He does not recommend LON at all, because of the higher infection rate. He had one patient with deep infection, and said "one is enough." Therefore he prefers LATN, but his utmost recommendation was conventional Ilizarov without intramedullary nails. Yes, the patient will have to wear the frames for a while longer, but it has the best outcomes. Unfortunately it's not a reality for many, especially for those who travel abroad on limited visas, so use your best judgement.
He prefaced this by saying that it's only his opinion, and that the final judgement comes down to the professor (Dr. Solomin), but that he does not think that weight-bearing during lengthening is beneficial. He was also inconclusive about the S (or Z) cut osteotomy, saying that there's more research required.
We started talking about potential surgery dates and location. At first I thought my only choice was MEDEM since it can take 1-3 weeks to get an appointment at the municipal clinic, St. Elizabeth's Hospital. However Dr. Kulesh said it's possible and that he'd get back to me on it after he talks to the professor. We made loose plans on when I'd get to meet Dr. Solomin.
Which Clinic?The very next day Dr. Kulesh let me know that they can book a room on Friday, June 29. I was mentally prepared for MEDEM, with its fancy architecture, hotel-like rooms, appetizing food, and English-speaking staff... But I originally asked for the municipal clinic, so I agreed.
Until then, I rounded up the advance payment, got an x-ray of my femurs, and met Dr. Solomin back at RNIITO. Dr. Kulesh was there as well.
Consultation: Dr. Solomin & Dr. KuleshAgain with the help of Google Translate and patient staff, I was able to find Dr. Solomin's office at RNIITO. This time my mom came along.
While waiting, Dr. Kulesh arrived. A few minutes later, I saw Dr. Solomin briskly walking down the hallway. He was very energetic, and offered us coffee or tea, which he made for us. He started off by apologizing, that he has a lecture that morning, so that he'll have to leave in a few minutes.
He mentioned that while he was quiet, he has been reading my emails. Dr. Kulesh pulled up x-rays, checked my mechanical axis/lengths/diameters, and said it looked fine for LATN.
He then disappeared for a while for his lecture, which was about fractures of the femur for about 16 other doctors.
When he came back, we talked about my goals. I said that my wish is 7 cm femurs, 6 cm tibias. He said his recommendation is 10% of the starting bone length, and I told him yes, that was just my wish. He added that after we start lengthening, we can see how my body responds. If the femurs can get to 7 cm, then to 8 cm, that's fine by him. Dr. Kulesh added that a patient once came in for lengthening, and a day after surgery changed their mind, saying that they just want the bone back in one piece; you really don't know how you'll react to such trauma.
As for when we could start the next set of legs in the cross-lengthening journey, Dr. Kulesh recommended a year apart. Dr. Solomin said as soon as the bones look consolidated via x-rays. Dr. Kulesh admitted that only one patient has ever taken his advice, adding that they had a great recovery.
I asked how many patients he has worked on. "Thousands. Perhaps finally, you will be my first successful patient!" Really, he was a charming guy. He talks very fast, and when he was lecturing, I told Dr. Kulesh that she had a hard time understanding since he has an accent too. To which he replied, "yes, he can be hard to understand, he talks just as fast in Russian!"
My mom asked if they sell or recommend special underwear for patients like me, to which they said "our patients usually just figure it out." So yeah, think ahead about this one!
They let me know that I'll be checked into the hospital on Thursday morning, then surgery on Friday. It's Thursday evening as I write this.
After the consultation, Dr. Kulesh walked us to St. Elizabeth's Hospital since it's close by. Beautiful day, perfect weather. Once inside and up a few flights, Dr. Kulesh left us with Dr. Roslan (not sure about spelling), saying that he'll help me get some tests done while I'm there. Did a blood test, urine test, and cardiogram once more. We were done in under an hour.
Accommodation: LengtheningFound a place a little north of the clinic which was affordable, just under $1500 for 91 days. Scoped the place out recently, there was a good restaurant downstairs that has free delivery until 11 PM. Score!
More about this place once I move in.
Preparing for SurgeryI was asked yesterday that I needed to shave my own legs, either the night before or on the morning of surgery. I have a lot of hair, so I decided to get a head start yesterday night.
Used my beard trimmer to chop away most of it, then used some shaving cream and a Venus razor to take care of the rest.
I haven't seen my nked legs in decades, it's a strange sight. It also feels very strange too. I'll admit that I've got some pretty legs!
Moving into St. Elizabeth's HospitalGot up early today and used Gett once more. I was asked by Dr. Kulesh to go to the emergency department and then call Dr. Roslan; it was a confusing few minutes for the staff since I came with two suitcases, a mother, and without an injury in sight. After a few minutes we saw Dr. Roslan, and we proceeded to my room.
I'll be staying here for two weeks, leaving around July 14th or so to the apartment I mentioned. So far I've had three meals, and while bland looking, I actually enjoyed them. I'm used to eating rice porridge, called
okayu, which they served twice today. They gave me some cheese for dinner, which was pretty exciting. Thankfully I'm a small eater so I actually got full eating this, but I also get hungry really fast so I'm hungry again after only two hours. Mom left me snacks, but I'll be a good boy and abstain since you don't want a full stomach before surgery.
The rooms are more than adequate. Door from hallway leads to a common room, with a kitchen and separate doors to the bathroom and shower. Then there are two connected rooms, one of which I'm typing this from. The beds aren't very soft, but I've fared worse. I brought a memory foam travel pillow, and it has served me well so far when I want to sit and type with my back against the wall.
There's an older guy in the other room, no apparent injury, but is on IV sometimes. His meals are different from mine as well.
Just took a shower, it's pretty cramped and outdated. The handle on the side of the wall is practically coming off the wall, so I won't be able to depend on that. The shower head holder is made of plastic and is also coming off the wall, so I've really got to be careful. Actually, maybe they'll replace it if I break it...
Closing ThoughtsThat's it for part one, while I'm still my old self. It's almost 11 PM and I'm getting pretty sleepy. Surgery after 9 AM tomorrow morning (June 29, Friday), still not sure when exactly really. Still pretty bright out, looks like dusk back at home.
Onward and upward!
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Topic: Android's Cross Lengthening with Dr. Solomin & Dr. Kulesh (2018) (Read 52193 times)