Tibia Lengthening with Dr. Solomin and Dr. Kulesh in Saint Petersburg

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.

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?

Quote from: Tiger9898 on June 18, 2018, 07:47:37 PMHappy 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.

Quote from: Tiger9898 on June 18, 2018, 07:47:37 PMAnd 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.

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?

Quote from: Tiger9898 on June 18, 2018, 08:31:55 PMMay I learn your starting height?

About 165cm

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

Did you have ATL? Thanks

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?

Quote from: Dylansaga on June 18, 2018, 10:08:24 PMWhat 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.