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Posted on Jun 16, 2018, 2:04 pm
#1
About Me

Leg lengthening has been something I’ve considered for years (Which is the case for most people). I was actually arranged to have this surgery done last year. I had already purchased my plane ticket, gotten my visa, paid for an (non-refundable) apartment through Airbnb and even scheduled my surgery date but unfortunately, I backed out last minute. In some ways it was actually a good decision for me to wait a year later because I learned so much since the
. Honestly, even now, I’m learning more as I actually undergo leg lengthening.

A little about myself, I’m a 22 year old male from US and I just recently graduated college in May (Had to make sure I was able to walk at graduation lol). So of course I rewarded myself by breaking my legs a couple weeks later. I co-own a landscaping company which is how I can afford to go to school and pay for this surgery. I do well on my own but I think it’s quite obvious that my company doesn’t do well enough that I can go to Paley. I still have graduate school to become a physical therapist but I’ll be taking a gap year to (obviously) undergo cosmetic leg lengthening. I’m 165 - 166 centimeters (5’5) short but have worn uncomfortable 2 inch lifts since high school. My wingspan is conservatively 170cm. I’m very athletic and my reason for this surgery is because I’m insecure about my height. I have no issues with women at all, I know I haven’t lived out that many years, but I’ve always been in some type of relationship for the most part. So for readers who are considering leg lengthening solely for women, I would recommend improving yourself in other ways first before concluding to leg lengthening.

Wearing lifts was my way of coping with my insecurity. Being at roughly 5’7 - 5’8 with lifts on was good enough for me. However, there’s so many instances where lifts would be a huge inconvenience. Such as taking really long walks for an entire day or having to reveal my true height when shoes have to come off in places such as the beach. And it doesn’t help that I live 5 minutes away from the shore lol. I have several other personal reasons but everyone has their own reasons to why they want or believe that they need this surgery. Whether a persons reasons are justifiable to undergo this surgery or not is so subjective that it’s such an abstract topic that I’d rather avoid.


Traveling Tips to St. Petersburg

Luckily, traveling and visiting foreign countries is something I’m already familiar with. Not many Russians in my experience speak English so you will definitely need a translator, have an offline application on your phone if you don’t plan on getting a SIM card.

The prepaid phone services are so cheap and having a working phone is extremely helpful that I’d recommend just getting it. Don’t forget that your phone needs to be unlocked. The phone service I use here is Beeline and I pay 650 Rubles per month (~$11USD) for 32GB. There’s other plans with minutes and SMS but those were useless to me.

The phone plan I use:
https://imgur.com/a/V3g8QWk

Examples of other phone plans:
https://imgur.com/a/yiStm0T

If you’re not from Europe, make sure you bring a universal power adapter, this is the one I’m currently using:
https://www.amazon.com/dp/B075JFPC42/ref=cm_sw_r_cp_api_IFljBbX9SRRBW

Here is the website where I got my 3 year multiple entry visa. You’re only allowed to stay for 6 months max in one visit with this visa. It cost me roughly $500. It was very easy and took about a month for them to send back my passport with my visa:
http://www.russia-travel.com

When you get to Russia, you have 7 business days to register your visa. If you stay at a hotel or the hospital, they’ll do this for you. But if you stay at an apartment where the owner may not be willing to register you at the post office or police station, like in my situation, you can go to this hotel that offers registration services (They charge 1500 Rubles for one month which is about $25 USD):
Piterskaya Hotel
Address: Liteinyi lane, 63
Phone: +7 (911) 266-3268/ +7 (951) 673-8980
E-mail: [email protected]

One of the reasons why having a phone with internet was so useful was that I could use Uber. You set your pick-up location and destination and you’re done! No communication issues in trying to explain where you want to go. The Uber rides here were very cheap, here’s a few rides I took (Uber doesn’t save the distance or duration of the ride):

-Ride from apartment to St George hospital, one of the hospitals Dr. Kulesh works at (~$3 USD):
https://imgur.com/a/ZBDIJYQ

-Apartment to St Elizabeth municipal clinic where I am currently staying and had my surgery (~$3 USD):
https://imgur.com/a/9Y0ciWW

-Apartment to Piterskaya Hotel where I registered my visa (~$5 USD):
https://imgur.com/a/BJPnqnh

Getting money over here is also a bit difficult. What I did was have one of my friends send me my money through Western Union. But it’s not that simple, the first time we tried, Western Union took my money and we received a tracking number that said pending, which was strange because the site said it would be ready to pick up within minutes and they already have my money. It was just stuck like this for the entire day and we just gave up that day cause they kept my friend on hold for half an hour:
https://imgur.com/a/gmVAo6W

We make another call the next day and turns out we have to call Western Union first so they can verify the transfer which was so odd because they took my money before telling me this. They said they do this because there’s a lot of fraud, especially in Russia. They were making sure that the person my friend was sending the money to (me), was actually me. So if you are going to use Western Union to receive money, call this number before you attempt to transfer money (This number is for US customers):
1-800-325-6000


Consultation with Dr. Kulesh & Dr. Solomin

I had my initial consultation at Vreden institute. Dr. Nikita, one of Dr. Kulesh’s assistants first took my X-Rays here:
https://imgur.com/a/Fg2pNF7

Afterwards, I met with Dr. Kulesh who accessed my x-rays and biomechanics with this program on his computer. He explained the surgery to me and whether or not LON or LATN was even possible. He measured my bone lengths, measured my medullary cavity, measured all these angles regarding my biomechanics and then adjusted my X-Rays to see how my biomechanics would be if I added 7cm on my femur. A couple minutes later, Dr. Solomin comes in. We discuss what I wanted to do and how much I want to lengthen. They were suggesting against doing both femurs at the same time but I insisted. They definitely aren’t here just to make money. They answered all my questions, and gave me a few days to make a decision. They weren’t trying to push me to do the surgery at all. They gave me the details I needed to know and left me to decide for myself. If anything, they actually had me thinking twice if I actually wanted to go through this. Dr. Solomin seemed shocked when I said 7cm on the femurs and said that it was a lot. They suggest up to 10% of the original bone length. But that going over 20% would be way too much. The length of my femurs (measured by the x-rays) were 43cm, so by numbers a 7cm increase for me would be between 16%-17%.

Each person is different and these numbers are just based off of previous cases. One patient may do well lengthening 20% while another patient might have have trouble even doing 10%. I prefer not to look at us like were machines or computers because everyone will have a different experience, especially with this surgery. My goal is to lengthen 7cm but I plan to stop distraction as soon as my body tells me to.

At the end of this consultation, I chose to go with external lengthening or lengthening and then nailing. I still have not decided which of the two. I won’t have to decide until after lengthening. But I personally preferred LATN over LON because with LATN, you can get better alignment during the correction period, the nail will be longer and more stable, and complications are generally easier to fix without the nail in the bone.


The Surgery

I arrived at the St. Elizabeth municipal hospital and was immediately taken to my room. It was the day before my surgery and I had an electrocardiogram and several blood tests done. My anesthesiologist came in the afternoon and explained to me how she was going to put me under general anesthesia and how I had to curl into a ball for her to see my spine. She then said I had to stop eating and drinking at 10:00pm and left.

Here are some pictures of the room:
https://imgur.com/a/yJI3sXA
https://imgur.com/a/IbzyTTe
https://imgur.com/a/oIHcmM2

The next day, I shave my legs for the first time and wait on my sofa thinking about the worse that could happen. I was mainly concerned with going under a coma because of the general anesthesia. This would be my first surgery ever. I know I was being over dramatic but I was extremely nervous.

The nurses came at around 9am, told me to undress, and had me lay down on a stretcher then covered me with a blanket. I can still remember being wheeled into the operating room. From my bedroom, going down the hall, up the elevator. I was really comfy wrapped in the blanket, just enjoying the ride and at that point my mind was somewhere else. My mind was blank, I wasn’t scared, I wasn’t nervous. I accepted reality.

In the operating room, there were- if I recall correctly, three connected rooms in which surgeons can operate in. In between each room was a window. To my left I saw a woman who was completely still. To my right there was a man, I couldn’t see him completely through the window, but people were going in and out of that operating room so I assumed his room was being prepped for surgery as well. There were about 5 nurses around me preparing the room, hooking me up to things. Every few minutes the blood pressure monitor would go on, that was really the only thing that was uncomfortable for me so far. I was still just laying there relaxed, probably for around half an hour. Soon, I saw Dr. Kulesh, Dr. Solomin, Dr. Nikita, and Dr. Roma walk in.  I was so glad to see familiar faces, not long after though, my anesthesiologist put me under and the last thing I saw was having the catheter put inside me. This was actually one of my bigger fears but at that last second before I was out, the drugs had already kicked in and I didn’t feel a thing.

The next thing I know, I was awake with frames on my femurs in the operating room. I woke up smiling, I was just happy I was alive lol. Getting wheeled back to my room was a completely different feeling than getting wheeled to the operating room. I was excited and really looking forward to gaining the height. I looked forward to when I no longer had to wear my lifts or worry about taking my shoes off at the beach.


Test of Patience

I felt no pain after the surgery, but of course that’s because I’m still on anesthesia. I was hooked on to this machine for about 5 days which would administer the anesthesia at the rate the anesthesiologist sets it to. Every time it would run out, the pain would get worse over time. The pain at its worst was maybe an 8/10, but that only happened for about an hour or two because my anesthesiologist was busy that day and the nurses aren’t allowed to dispense it. For the most part however, the pain was sitting at 1/10.

Here’s the machine that was administering the anesthesia:
https://imgur.com/a/d5TsBh7

Sleeping straight through the night was (and still is) a bit difficult because I would wake up extremely uncomfortable and would have to reposition my legs. It’s not so much because of pain but the discomfort. After I got off the anesthesia, the pain stayed at a 1/10. At night, it wouldn’t go anywhere above 4/10.

Here are my frames:
https://imgur.com/a/h2jjEQa

Here’s the upper part of the frames:
https://imgur.com/a/SARqfFc

My catheter was removed around the same time. I was glad that there was finally nothing sticking inside me. I graduated from the catheter to peeing in a plastic container. Dropping a deuce was a different story though. I knew I wasn’t going to use that damn bed pan. The nurses said I had to if I couldn’t get to the bathroom so I did everything in my power to learn how to walk (using my walker). It was difficult to walk at first, but eventually I got the hang of it. I’ve been wearing the frames for about a month now and it’s still hard to walk but I’m happy as long as I don’t have to take a   on my bed.

I think the hardest part of this is just sitting around all day and doing nothing. I wake up, eat, stretch all day, turn the nuts on my rods, sleep, and then do it all over again. I watch movies and/or shows but I have to use my phone’s internet since there’s no WiFi here at the municipal clinic. It’s no big deal for me though since it’s so cheap but- just a heads up for anyone who planned on WiFi being available to you here.
 
The food isn’t all that enjoyable either. I email Dr. Kulesh things I want/need from the store and he has one of his assistants buy the food/items for me. The meals at the hospital usually has some kind of potato in it (Potato soup, mashed potatoes, chopped potato, etc). Then there’s also other types of soup, oatmeal-like breakfasts, sometimes rice, and then the famous macaroni and hot dog dinners. Most meals come with bread and you get breakfast (9:30AM), lunch (2:30PM), and dinner (6:30PM). Haha, I’ve been here for way too long.

https://imgur.com/a/BF8lrRi
https://imgur.com/a/H9CdH1T
https://imgur.com/a/Atq2bpO

Just to give you an idea on cost of food (If you stay at an apartment you can actually use this site to have them deliver you your groceries):
https://www.okeydostavka.ru/spb2

There’s a lot of time to fill while you’re here. So make sure you have something that will keep you occupied. I really wanted to stay productive while I was here, so I’m studying to take my test to become ACSM certified in exercise physiology. I dreaded the first few days I was here. But now days just go by really fast, I feel like my concept of time has really changed. Being stuck here makes you appreciate simple things that you wouldn’t have thought of before. Like simply walking outside to get fresh air or being able to have decent conversations with someone. It gets lonely sometimes because Dr. Kulesh and Dr. Solomin are really the only people that visit who know enough English to actually have a conversation with.


Distraction & Schedule

I started distracting on May 25, exactly a week after I got the initial surgery. I distracted 1mm per day for 20 days and today is my third day lengthening 1.5mm per day. So at the end of today, I would have lengthened 24.5mm (2.45cm) on paper. Ever since I got off the anesthesia about 5 days after the surgery I haven’t had the need to take any painkillers, so I’m hoping it stays that way.

X-Rays 9 Days After Distraction:
https://imgur.com/a/YdNlzqO

X-Rays 20 Days After Distraction:
https://imgur.com/a/CtojCLL

After initial surgery, I was getting shots under my skin every night near my stomach, I was told it was blood thinners. After about a week, I went from that to taking Pradaxa once a day.

I get bandages changed 3 times a week, X-Rays about every 10 days and have physical training 1-2 times a week with a trainer. I stretch all day (every day) and train on my own when I’m not with the trainer.

Price

These are prices most relevant to me right now. You can contact Dr. Kulesh if you want a much more detailed document regarding prices. It’s extremely detailed and has everything you need to know on it when it comes to money.

Dr. Kulesh’s e-mail is: [email protected]

As I mentioned earlier, my 3 year multiple entry visa (6 months stay max in one trip) cost roughly $500 USD

One way plane ticket cost about $350 USD

Consultation plus X-Rays with long films: 6.000 Rubles (~$95 USD)

To install frames: 166.000 Rubles (~$2630 USD)

Price for a single room per day at the municipal clinic: 4.400 Rubles (~$70 USD)

Each bandage change by doctor: 1.500 Rubles (~$24 USD)

Each 30 minute session with the trainer: 1.500 Rubles (~$24 USD)

X-Rays with 4-short films: 3.000 Rubles (~$48 USD)

Installation, calculation, and removal of reduction modules for corrections: 27.000 Rubles (~$430 USD)

If I decide to go the LATN route, removal of the frames and installation of Russian nails cost: 126.000 Rubles (~$2000 USD)


A Little Taste of St. Petersburg

https://imgur.com/a/rbkNGEM
https://imgur.com/a/Gt3d5n0
https://imgur.com/a/l1kZFRw
https://imgur.com/a/O9PM3Uv

Anyway, this is my experience so far. I’ll do my best to keep my diary updated and try to respond to everyone, please don’t take it personally if I don’t get to you.
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Posted on Jun 16, 2018, 2:15 pm
#2
lol i got quoted at 25k for very similar but I had wanted to stay at the private clinic and housing for 150-200 days. Yours is extremely cheap and I don't know why.

I'll also mention that this was extremely detailed and well done and I wish you the best of luck seems you're in good hands. This is a great example of how ideally detailed each log should be so far.
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Posted on Jun 16, 2018, 2:26 pm
#3
Very detailed, good luck. So what amount of money you recommend to save if you want to do the surgery in Russia?
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Posted on Jun 16, 2018, 2:40 pm
#4
Quote from: Johnson1111 on June 16, 2018, 02:15:36 PMlol i got quoted at 25k for very similar but I had wanted to stay at the private clinic and housing for 150-200 days. Yours is extremely cheap and I don't know why.

I'll also mention that this was extremely detailed and well done and I wish you the best of luck seems you're in good hands. This is a great example of how ideally detailed each log should be so far.

Well the surgeries are a lot more expensive at the private clinic. Everything is more expensive there including rebandaging, IM nails, physiotherapy, etc. For example, the initial surgery to install frames are 299.400 Rubles in the private clinic and 166.000 Rubles in the municipal. Swiss IM nails cost 274.000 Rubles in private and 129.000 in municipal. To stay at the private, it’s 11.340 Rubles per day for a single room and 4.400 at the municipal. These are just a few examples but it all adds up.


Quote from: lucindaris on June 16, 2018, 02:26:03 PMVery detailed, good luck. So what amount of money you recommend to save if you want to do the surgery in Russia?

If you’re going to stay at the hospital for as long as I am then getting the nail installed after lengthening, and while also taking possible complications into consideration, I would say $15K USD minimum. Im not saying you’ll have to spend all this money but you’ll definitely need more if you’re staying in the private clinic and/or staying in the hospital even longer for externals (consolidation phase). Also I want to bring up the possible things you’ll have to pay for when you get back home such as x-rays, nail removals, physiotherapy, etc. Things most people don’t consider after they’ve gained their height.
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Posted on Jun 16, 2018, 2:51 pm
#5
Wow, thanks for the detailed diary and all the pictures. I really wish you the best during your LL. External femurs are so difficult based on all the diaries I've read.

Solomin is very experienced and I'm hoping it will show during your stay in Russia.

QuoteThey answered all my questions, and gave me a few days to make a decision. They weren’t trying to push me to do the surgery at all. They gave me the details I needed to know and left me to decide for myself. If anything, they actually had me thinking twice if I actually wanted to go through this. Dr. Solomin seemed shocked when I said 7cm on the femurs and said that it was a lot. They suggest up to 10% of the original bone length. But that going over 20% would be way too much. The length of my femurs (measured by the x-rays) were 43cm, so by numbers a 7cm increase for me would be between 16%-17%.

Thanks for sharing that. I already knew that was supposed to be their protocol (recommendation of only a 10% increase over initial bone length), but it's good to hear it happened in private too. They could just claim it online to look like the ones who want to risk the least for their patients, while the actual practice was different.
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Posted on Jun 16, 2018, 2:56 pm
#6
QuoteThey were suggesting against doing both femurs at the same time but I insisted.

It's good this happened too. Did they give you a good picture of how difficult bilateral, external femurs are?
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Posted on Jun 16, 2018, 3:24 pm
#7
Quote from: myloginacc on June 16, 2018, 02:51:48 PMWow, thanks for the detailed diary and all the pictures. I really wish you the best during your LL. External femurs are so difficult based on all the diaries I've read.

Solomin is very experienced and I'm hoping it will show during your stay in Russia.

Thanks for sharing that. I already knew that was supposed to be their protocol (recommendation of only a 10% increase over initial bone length), but it's good to hear it happened in private too. They could just claim it online to look like the ones who want to risk the least for their patients, while the actual practice was different.

I really appreciate it, thank you! I was well aware on how difficult bilateral external femurs would be even before Dr. Kulesh and Dr. Solomin warned me. I feel that it’s more a psychological endeavor than it is a physical. And this LL route is definitely not for everyone. I like to think that I have a lot more psychological endurance and willpower than most people. Based off the other bilateral external femur patients Dr Kulesh has told me about, I feel like I’ve been doing a lot better than all of them. But in addition to that I also want to consider myself lucky that I’ve had no complications so far.

Trying not to be bias, I feel that Dr. Kulesh and and Dr. Solomin are competent surgeons. My opinion comes from my experience so far and I’m not here to promote them because I’d rather have each person determine how capable these doctors are on their own. I’m just here to tell my story and for everyone else to form their own opinions. But I was also glad that they not only suggested the 10% limit on their file, but in the consultation as well. I felt that they were so much more realistic unlike some of the consultations I’ve read about in other diaries where doctors say “Oh 7cm? Yeah, of course that’s easy.”

Quote from: myloginacc on June 16, 2018, 02:56:57 PMIt's good this happened too. Did they give you a good picture of how difficult bilateral, external femurs are?

Yes, they showed me a picture of one of their patients from last year wearing these bulky frames to give me an idea. They also explained to me a few things he struggled with such as walking and doing things for himself. Since I kept insisting other alternatives such as doing one leg at a time, Dr. Kulesh recommended I stay at the hospital for the entire period of lengthening. I’m still not sure if I’ll be staying here the entire time because I actually already paid for an Airbnb for two months with Jim_dabarber. (He’s coming to have the second part of cross lengthening done). I can already walk with a walker (with difficulty) but I definitely won’t leave the hospital until I’m 100% sure I can handle being on my own.
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Posted on Jun 16, 2018, 3:42 pm
#8
Thanks for sharing such a detailed diary. I have been waiting for you diary since 17t May  Bilateral Femur Lengthening with Dr. Kulesh & Dr. Solomin I thought you will not visit here until you finish lengthening period. I am happy that everything has been successful so far.
As I said before, I am also thinking about external femur, but my main fear is fat embolism rather than discomfort.  And I think your frames look a little bit compact compared to Jim"s femur frame. Maybe they are the same I am not sure.   
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Posted on Jun 16, 2018, 4:09 pm
#9
Quote from: Tiger9898 on June 16, 2018, 03:42:20 PMThanks for sharing such a detailed diary. I have been waiting for you diary since 17t May  Bilateral Femur Lengthening with Dr. Kulesh & Dr. Solomin I thought you will not wisit here until you finish lengthening period. I am happy that everything has been successful so far.
As I said before, I am also thinking about external femur, but my main fear is fat embolism rather than discomfort.  And I think your frames look a little bit compact compared to Jim"s femur frame. Maybe they are the same I am not sure.

I actually almost chose not to write a diary at all. But I’d be happy if anyone could take anything from my experience. I don’t want to be the guy saying everything will be fine, everything will go well. I’m optimistic but I can’t even say that for sure in my case until I’ve recovered to the point I’d like to be at. Fat embolism is definitely something to consider especially with bilateral femur lengthening. I believe my doctors are skilled and I feel safe under their care but the truth is that complications can occur no matter how good your surgeon is. You probably won’t die but complications definitely will make your experience much worse.

The ring I’m wearing is supposedly the largest size but maybe you’re comparing my frames to when Jim had his reduction modules for correction installed. Those make the frames look huge! Luckily those only need to stay on for about a week.
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Posted on Jun 16, 2018, 4:13 pm
#10
The first couple weeks how did you get around with both femurs operated on? What was your strategy and how did you do it?


You're right about the private clinic being much more expensive and I also had 20 days there listed which is alot. I also was doing 3 surgeries with LATN opposed to 2 (Not sure if that factors in)
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