As I keep writing, I do not respond to personal messages because doing so requires duplicate work. If you have a question for me, please post it here.
I received the following PM:
QuoteHi sir. Did I understand correctly that you went for a 9 cm surgery split between tibia and femur with dr kulesh? How was your experience 1/10? What was your starting and end height? Any complications? What was your impression on the doctor and clinic. Was it modern? Dirty?
Please answer truthfully. I am thinking about this surgery but I am scared as fking hell to do it. I really need to find a proper doctor. And I am willing to pay around what you did.¨
Almost all of these questions are already addressed in my diary. Please read my diary for your answers.
The only question I see that I do not recall answering previously is "How was your experience 1/10?" Answering this question would grossly oversimplify the experience. Moreover, my experience will not be your experience.
Next, all of my input on this forum has been factual and frank--read it if you like and draw your own conclusions.
Last, if you are fearful of any elective surgery; then, you should not do the surgery. Instead, continue to work to gather information and understand options until you feel informed and comfortable to go forward. Leg lengthening surgery is not for everyone.
St. Petersburg Lengthening -- DISTRACTION COMPLETED
I have on question: I believe it's possible to do a second surgery right at the moment of the frame removal (all in same surgery), correct? Do you know if Kulesh approved of this?
I encourage you to discuss your question directly with Dr. Kulesh.
I think the question is not whether something is possible; rather, the question is whether doing something that may be possible is wise.
Many folks who are considering two surgeries on the same segment or lengthening both the tibia and femur on the same leg do not fully consider the impact of these procedures.
Whether you lengthen tibias or femurs, you stretch the tissues from ankle to hip. Tissue can only stretch so far. Think about folks who keep trying to put larger and larger rings in their ear lobes. Eventually, the lobe tears because all of the available stretch is used up.
In the same vein, perhaps you can safely and successfully stretch either your lower leg or your upper leg by 15%. This does NOT mean you can stretch both by 15%.
Consequently, if you want to do multiple lengthenings; then, most folks are advised to wait for a couple of years between lengthening.
However, perhaps you have a good reason to do what you want to do. If so, I encourage you to discuss in detail your idea with your surgeon.
Quote from: California2 on January 21, 2020, 03:53:14 PMI encourage you to discuss your question directly with Dr. Kulesh.
I think the question is not whether something is possible; rather, the question is whether doing something that may be possible is wise.
Many folks who are considering two surgeries on the same segment or lengthening both the tibia and femur on the same leg do not fully consider the impact of these procedures.
Whether you lengthen tibias or femurs, you stretch the tissues from ankle to hip. Tissue can only stretch so far. Think about folks who keep trying to put larger and larger rings in their ear lobes. Eventually, the lobe tears because all of the available stretch is used up.
In the same vein, perhaps you can safely and successfully stretch either your lower leg or your upper leg by 15%. This does NOT mean you can stretch both by 15%.
Consequently, if you want to do multiple lengthenings; then, most folks are advised to wait for a couple of years between lengthening.
However, perhaps you have a good reason to do what you want to do. If so, I encourage you to discuss in detail your idea with your surgeon.
Thank you very much for your detailed answer I appreciate it a lot.
Glad you are doing fine and accomplished your goal, even at your age (no offense), well done!
Was it really hard to go out on shopping? going to the groceries store, cooking, cleaning, showering, etc, while on the wheelchair and on frames? I still picture it extremely hard for oneself to do all that...any advice would be gladly appreciated.
Finally, where did you stay and did surgeries on? clicnic #1 #2 or #3?
Thank you in advance California2
Regarding cooking, cleaning, shopping, showering, etc.
I find that most challenges in life can be overcome with proper mindset, preparation, discipline, and strength of will.
As to cooking and cleaning--I had no problem cooking in a wheelchair. In fact, I got much pleasure from preparing elaborate meals for my neighbors from time-to-time. Doing so also provided an opportunity for social interaction. As for cleaning, I could push around a vacuum or mop but had a cleaner in twice a month.
As for showers--no showers until frames are removed and wounds are healed. Sponge bath only.
As for shopping--I tested my wheelchair and route before my surgery to identify problems and develop fixes. I had no real problems--not easy or convenient but doable--unless it was snowing. Wheelchairs do not work well on snow or ice. When the snow came, I had to plan my outing to the store for right after the pathways were cleared.
As for clinic 1, 2, or 3--I don't know what you mean. My initial appointments and x-rays were done at the Vreden Institute and St. George's Hospital. My first surgery was done at St. Elizabeth's Hospital. My nail insertion (LATN) was done at the Medem Clinic in downtown St. Petersburg.
Vreden and St. Elizabeth's are next door to each other--St. George is about two miles away.
Thank you very much California2.
The number of clinics is in regard to how Dr. Kulesh points it out on his document (the one he sents when you ask about prices, etc).
Any advice on how to buy food (and other stuff) online? I am sure going shopping with the frames cant be nice 
Additionally, I would also appreciate if you could advice on how to use the bathroom (pee and poo) when on frames at home, etc... 
Most accommodations in St. Petersburg are large high-rise apartment buildings. These often have central courtyards with outdoor gym equipment and child play areas. All have a variety of stores and shops on the ground floor--groceries, restaurants, barber shops, nail salons, etc.
Consequently, going shopping involves little more than going to the ground floor. Similarly, you can order food online for delivery from some nearby shops--I ordered both pizza and sushi a few times. Some websites (like Domino's) are in multiple languages--otherwise, Google Translate worked well enough.
Last, you can hire an aid to come once a week and help you do things if you want. 1000 Rubles is about $15. You can get a lot done for 1000 Rubles in St. Petersburg. Also, from time to time I asked my MD or physical therapist to swing by Burger King--they have coupons online to get a Whopper and a Big Burger and two small fries for 200 Rubles--about $3.
As for the restroom--first, make sure your chair can get into the unit's bathroom. Get a bottle urinal or a quart milk bottle for urine. So long as you can get your chair into the bathroom, you will be able to move from the chair to the commode when necessary. You will also be able to empty your bottle in the commode and rinse it out in the sink for next time.
Thank you very much man you are very kind to share your experience in a very detailed way. Also glad you are recovering!
I am planning on going in June this year, I hope all goes smoothly as I will also travel alone and I know zero Russian.
If you allow me, the last 2 questions that came to my mind was, why did you mention the intramedullary nails are usually left there for life? wouldn't that be a problem? why can they just remove it at a later date when consolidation is 100% done?
St. George's Hospital is the municipal hospital? the one that is the cheapest option to do surgery, please correct me if I am wrong.
Thanks again and I hope you can forgive me for asking so many questions 
The intermediary nails used in LON and LATN are just pieces of stable and inert metal. They contain no magnets or other potentially harmful material.
You can remove these nails if you like. However, most people only remove the screws that hold the nails in place.
Once the screws are removed, the nails become completely encased in what would otherwise be a hollow space in your bone. Most people become essentially unaware of the nails after the screws are removed; thus, they do not remove them.
If you are bothered in any way by the nails; then, you can always have them removed. But that is a decision to make a couple of years from now.
Best of luck with your procedure! I am confident you are in good hands.
As for municipal clinics--St. George's and St. Elizabeth's are both municipal clinics; thus, the least expensive.
When I had the surgery, Professor Solomin was at odds with St. George's administration so he did not do surgery at St. George's; however, Dr. Kulesh used St. George's for x-rays.
I do not know which hospitals they use for surgery today--it was St. Elizabeth's and the MEDEM Clinic downtown when I had my surgery.
Frankly, while St. Elizabeth's was less modern and showed more wear and tear (as might be expected at a municipal clinic), the rooms were much larger and included a kitchenette, and the staff seemed more friendly; thus, I preferred the municipal hospital all-in-all.
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