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Author Topic: One Step Closer - External tibias, femurs, humerus - Petersburg, Russia  (Read 68906 times)

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Alittletooshort

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I may have missed something but Dozer is just the new acount name of exclide? 
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microman

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for MEDEM the price is 350,000.00, about £4000 for me.

I think he has done about 10 international patients before, I don't know if it is MEDEM clinic but i would assume so since they speake english there apparently.

after being in hospital they rent appartments near Vreden, i think people come out to them, trainer, change bandages, housemaid etc.

i think with MEDEM they can send you visa support letter as well.
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microman

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okay got a new e-mail from him.

I talked to the representative of department of clinic, It was told that the clinic has good relations with consulate of Britain, For an additional fee they can issue the invitation letter.

I can ask several realtors to try to look for the apartment for you, I've done it for some patients, rent of the apartment will cost about 20-30 thousand rubles a month
the help of the realtor - 15-20 thousand

"and it is external yes, not LON/LATN." - O'k

you can go home for consolidation, It is possible to write out the paper from clinic with recommendations to perform an X-ray examinations every month

Is it possible to remoove the devices in your city? - you should ask about it surgeons in clinic in your city

so yeah seems okay, I just wish there was more than one patient diary really.
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Taller

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Microman,

So they don't offer LON?
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Taller

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Dozer,

Are you still considering lengthening your forearms?
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microman

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no they do, both LON and LATN, i just meant that I only wanted external.

he also said i should buy a wheelchair before the operation, maybe he means I take one with me in my own country, I don't know.

here is price run down of externals

Surgery medem clinc:     350,000.00/£4000
or
Surgery in St. Elizabeth:      230,000.00/£2700

Rent:                   30,000.00/£350 a month
Realtor help:               20,000.00/£235

Removal of device   40,000.00/£400

in medem clinic they speak English and can write invitation letter.

also dr. Kulesh mentioned about a 'trainer' coming in 3-4 times per week, is this a PT trainer, so does that mean I get assistance for that, if so that would be great.

I change bandages twice a week, the trainer trains them 3-4 times per a week and the housemaid comes once per 2 days.
« Last Edit: June 24, 2015, 06:34:35 AM by microman »
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microman

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Okay I have gathered all the information about the operation from Dr. Kulesh, here is what I have found out.

The MEDEM Clinic website is here    http://medem.ru/en/
Everyone speaks English there and facilities are much higher than standard, it will include single bed ward.
The clinic has good relations with consulate of Britain, for an additional fee they can issue the invitation letter.
Dr. Kulesh will show you the shop to buy the wheelchair from before your operation.
They can put various size of rings on your legs, so they can be thin/small.
You can discuss with the anaesthesiologist about general anaesthesia options.
2-3 weeks after operation patients leave the clinic in a wheel-chair, they rent an apartment near the Institute called Vreden.
You will choose apartment before operation, there you can specify what you want.
While in the apartment you will get a PT trainer; he speaks English to an okay level, he does PT with you 3-4 times per week, the housemaid comes every other day, she cooks and brings food.
Bandages are also changed in the apartment twice a week.
You are better to use a local bank to get Ruble or Euros out.
During apartment you can call Dr. Kuresh with pay per phone if there is an emergency.
For the removal of device, this can be done at MEDEM or Elizabeth, prices will be given soon.

To summarize, the cost of everything.

Pay via UK bank card
Surgery medem clinc:    ₽350,000.00/£4000

Removal of device   ₽40,000.00/£400   much later on

Pay with Russian Ruble cash or Euro where specified
Rent:                        ₽90,000.00/£1000    for 3 month stay
Realtor help:             ₽20,000.00/£235
Maid:                         €1050/£700       for 3 months of cook meals etc.
Bandage changing      ₽500/£144      £6 per session, twice a week, so £12 a week.
Trainer                      ₽900/£450      £10 per session, happens 3-4 times a week, so £40 a week.
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Overdozer

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Dozer,

Are you still considering lengthening your forearms?
Nope, I'll pass on that one. Too spooky for me and also I don't feel it's necessary anymore, and I've wasted too much time already. No way. I spoke about it with Dr. Kulesh however and he was willing to do it, although he warned me about bone regenerate being bad when lengthening forearms.



Good job, microman. I'm not sure, does the surgery cost include the stay in the clinic? Because the stay is quite expensive like 10 000 rubles a day. I'd consider St. Elizabeth hospital, it's not that shiny, but you won't be staying there for long anyways. Medem is just overpriced.
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Pre-surgery - 167 cm, Post-surgery - 181 cm
Final arm span - 177 cm, Sitting height - 90 cm

Lengthened 7.5 cm in tibias and femurs and 3.5 cm in each humerus. Surgeries performed all external by Dr. Kulesh, in Saint-Petersburg, Russia - http://www.limblengtheningforum.com/index.php?topic=1671.0

microman

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he said it includes 2-3 weeks stay, it was kind of hard to tell exactly from him.

but i can confirm i wont be charged any extra outside that amount, no longer how long I was going to stay there as long as it was within 2 weeks or something.

I was thinking maybe most of his international patients go to MEDEM, the operation is so cheap anyway it barely matters, maybe food, bed an medication is better, I don't know i can't asses that i haven't seen both places, its £1000 more but the whole thing is costing about £7000 anyway due to rent and flights, my LL budget is £10,000.

also what general anaesthesia options were you given, what was your recomendation.

where did you buy your wheelchair.

did you have a single bed ward when you were in elizabeth?

did you rent apartment, or were you lucky enough to have your home very near the hospital for lengthening. I would like to know what his PT and maid is like, are they attentive? does maid wath your clothes weekly as well?
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Overdozer

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also what general anaesthesia options were you given, what was your recomendation.
General, epidural and spinal. I chose epidural, they offered me some fancy pump-like thing. They leave it in your spine after the surgery and you can choose levels of pain-killing, so I didn't feel much pain after the surgery. I removed it 5-6 days later. But I had my surgery at hospital #4 and they don't accept international patients. However it's also goverenment hospital and the anaesthesiologist probably works closely with Dr. Kulesh. Not sure. Oh and... you sleep regardless of the method you choose, as they sedate you to sleep.

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where did you buy your wheelchair.
I don't use my wheelchair. But I bought it some years ago in an ortho shop.

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did you have a single bed ward when you were in elizabeth?
I had single bed, yes, but it was hospital #4.

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did you rent apartment, or were you lucky enough to have your home very near the hospital for lengthening. I would like to know what his PT and maid is like, are they attentive? does maid wath your clothes weekly as well?
I live very close to the hospital. Both hospitals and Vreden clinic also. And I didn't get a maid, I have relatives. PT also I didn't get, I do it by myself, as I'm a LL expert.
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Pre-surgery - 167 cm, Post-surgery - 181 cm
Final arm span - 177 cm, Sitting height - 90 cm

Lengthened 7.5 cm in tibias and femurs and 3.5 cm in each humerus. Surgeries performed all external by Dr. Kulesh, in Saint-Petersburg, Russia - http://www.limblengtheningforum.com/index.php?topic=1671.0

microman

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you are so lucky to live right next to a cosmetic LL clinic, hopefully one day that will be a reality for us all.

and yeah as it was mentioned elizabeth will prioritize russian patients I belive, so I think it would be best sticking to medem clinic for myself, i don't think you could compare elizabeth for yourself and elizabeth for me, they maybe put me in a worse hospital # you never know.

that pain killer thing sounds cool, I never heard of that before, is it a button you press or something?

great to hear about less pain after surgery, i hear the first few days can be the worst as in screaming out in pain!

Can you tell the difference between the anaesthesia, advantages and disadvantages.

General vs. epidural vs. spinal.

what do you do for washing durgin lengthening, I was thinking you just rub your body in with a wash cloth that had soap and water in it, do you avoid water on your frames.
« Last Edit: June 25, 2015, 11:52:53 AM by microman »
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Overdozer

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Quote
that pain killer thing sounds cool, I never heard of that before, is it a button you press or something?
I think they call it 'epidural pain pump' or 'patient-controlled epidural analgesia (PCEA) infusion pump'. You choose a pain killing level and the pump adjustes drug delivery rate. It's got a lot of pain killing potential, like you can make your legs completely numb. I don't recommend that though as your penis will also go numb and you won't be able to urinate unless you get a catheter. But ask Dr. Kulesh if they offer it in other clinics, I'm not sure.

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General vs. epidural vs. spinal.
General is when they completely knock you down with a lot of medications and insert a breathing tube in your throat. Then they can cut your arm off and you won't feel a thing.

Epidural and spinal are very similar. They both deliver some pain killing medications in your spinal cord, resulting in your legs going numb. Most of the time they're combined with general so you'll be asleep anyways, but the drug dosage is much lower in this case, just enough to put you at sleep.

Quote
what do you do for washing durgin lengthening, I was thinking you just rub your body in with a wash cloth that had soap and water in it, do you avoid water on your frames.
Yeah that's what you do. You also can put some bags on your externals to block the water from flowing in and take a bath.
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Pre-surgery - 167 cm, Post-surgery - 181 cm
Final arm span - 177 cm, Sitting height - 90 cm

Lengthened 7.5 cm in tibias and femurs and 3.5 cm in each humerus. Surgeries performed all external by Dr. Kulesh, in Saint-Petersburg, Russia - http://www.limblengtheningforum.com/index.php?topic=1671.0

microman

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okay thanks for that information, i guess the washing up advice would also apply to the consolodation period as well.

did you feel the pain level of external femurs was the same as external tibia.

overall how would you rate the difficulty of the whole process of external tibia and external femur, example

external tibia: 6/10
external femur: 9/10

i just hardly see external femur diaries, but sadly all the internal femur prices are 4x that of external tibia and i can't accept those prices for extra height if i want it one day.

exactly what is your wingspan as well, how do you feel about your proportions, I wouldn't mind seeing what someone looks like 10+cm taller than wingspan.

I myself am 164.5, wingspan 167, so i was thinking 174.5 would be my maximum choice given my wingspan, maybe you can show me that being much taller than wingspan wont look bad, in which i can think of 6+6 and not 5+5.
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Overdozer

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Femur is much worse for me in terms of both pain and discomfort. I'd rate tibia 2/10 and femur 8/10. Lengthening tibias externally is easy in my opinion, and rather comfortable also, well at least when compared to external femurs. If you can afford, do femurs internally. Lengthening femurs externally isn't a walk in a park. Have you ever played Call of Duty? You know it has a difficulty level called "You will not survive." - that's about external femurs.

My arm span is 170 cm and to be 176-178 cm after AL. No pics, sorry.
If you don't plan lengthening your arms, 174.5 cm would indeed be your maximum choice. It would also be safer, so I recommend sticking to that.
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Pre-surgery - 167 cm, Post-surgery - 181 cm
Final arm span - 177 cm, Sitting height - 90 cm

Lengthened 7.5 cm in tibias and femurs and 3.5 cm in each humerus. Surgeries performed all external by Dr. Kulesh, in Saint-Petersburg, Russia - http://www.limblengtheningforum.com/index.php?topic=1671.0

microman

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Wow, okay didn't realize it was so bad. sadly i will never be able to justify the expense of internal femur prices, i guess i wont be getting a 2nd LL then, i will simply have to accept that, or somehow put up with maximum difficulty in CoD hehe, if its only 5cm maybe it wont be as hard a journey as you had?

ah so you are 182 with wingspan 170!

I thought you said you weren't going to do AL now anyway?

yes i think 174.5 would be best for me, maybe one day interal femur would be a similar price to external tibia, but currently it's almost 4x the price!
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microman

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do you think femur lengthening could be made more tolerable if you do LON on them, and maybe did it one leg at a time, so when left femur is consolodating and the frames removed you then do right leg LON femur.

Obviously this would take longer than internal methods, but since its the difference is £5000 for LON femur and £40,000 for internal femur then id be okay for it to be longer.
« Last Edit: June 26, 2015, 08:33:43 PM by microman »
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microman

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it would be great if you could advise me on AL a little, just what solomin or kuresh has told you, what your mobility would be like, i can only imagine it would be much easier than LL but I can't really tell, maybe you could do femur LL and AL at the same time? i don't see why not they are not related at all but as i said i wouldn't really know.

if you could let me know what you think of my proportions in this thread that would be helpful.

http://www.limblengtheningforum.com/index.php?topic=2230.36

Thanks.
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Overdozer

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do you think femur lengthening could be made more tolerable if you do LON on them, and maybe did it one leg at a time, so when left femur is consolodating and the frames removed you then do right leg LON femur.

Obviously this would take longer than internal methods, but since its the difference is £5000 for LON femur and £40,000 for internal femur then id be okay for it to be longer.
LON will make it easier in the end indeed.

AL is easier than LL, but if you do it at the same time with LL it will obviously double the trouble. You need your arms during LL.

And you look better in 5 cm mockup.
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Pre-surgery - 167 cm, Post-surgery - 181 cm
Final arm span - 177 cm, Sitting height - 90 cm

Lengthened 7.5 cm in tibias and femurs and 3.5 cm in each humerus. Surgeries performed all external by Dr. Kulesh, in Saint-Petersburg, Russia - http://www.limblengtheningforum.com/index.php?topic=1671.0

microman

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oh okay, is there any disadvantage to LON for femur, i know for tibia there could be permanent knee pain, so that is why i avoided it.

oh right i didnt realise your arms would be completely incompasitated during AL, how do patients turn the screws then? do they just do one arm at a time.

maybe it would be adviced to do one arm lengthening and one femur lengthening?

ah yes well the 5cm mockup is more like 7cm as i am in 2cm lift, but yes i agree totally, with that said my AL mockup looks good!

any clues on prices for AL? does solomin or kuresh advice it or are they hesitant?
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microman

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just thought i'd add about possible scars left on the arms after arm lengthening, would scar revision get rid of these to a decent level, would you not be self counsious of the scars if it did not.

also after a lot of research i have only come across one cosmetic case of arm lengthening and that was internal, it apparently cost a lot of money, and it had to be one arm at a time, can you shed some light on these points?

would a monorail fixator like the mitkovic device on the femur be easier than external or LON?
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Overdozer

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oh okay, is there any disadvantage to LON for femur, i know for tibia there could be permanent knee pain, so that is why i avoided it.

oh right i didnt realise your arms would be completely incompasitated during AL, how do patients turn the screws then? do they just do one arm at a time.

maybe it would be adviced to do one arm lengthening and one femur lengthening?

ah yes well the 5cm mockup is more like 7cm as i am in 2cm lift, but yes i agree totally, with that said my AL mockup looks good!

any clues on prices for AL? does solomin or kuresh advice it or are they hesitant?
You can have knee pain also with femoral nailing: http://www.bjj.boneandjoint.org.uk/content/88-B/5/576

Someone turns the screws for them.

one arm lengthening and one femur lengthening - I guess you can do that lol.

The prices are probably the same. And no, they don't recommend it. Neither they recommend lengthening your legs and they'll warn about all the complications that may occur.

Monorail fixators cause misalignment so it's only to be used with LON or LATN.

You're right arm lengthening isn't very popular. Just like double LL surgeries. Or LL surgeries alone...
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Pre-surgery - 167 cm, Post-surgery - 181 cm
Final arm span - 177 cm, Sitting height - 90 cm

Lengthened 7.5 cm in tibias and femurs and 3.5 cm in each humerus. Surgeries performed all external by Dr. Kulesh, in Saint-Petersburg, Russia - http://www.limblengtheningforum.com/index.php?topic=1671.0

microman

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well I'd guess about 1000 people a year get LL, I say only 1 person has ever gotten AL.

but i will accept that i can only do 1 LL, no way will i end up like that other picture mockup, maybe if it was a future time i could get to 5 11 with 2 LL with affordable internal femur, and then get AL when AL wwould be a more common occurence, but in this day and age LL being relateivly new this is the best I can get so i will just accept that.

interestingly i read a diary of someone went from 5 2 to 5 7, luckily he had really long arms at 5 2, imagine if he had my wingspan relative to his height, he could only get to 5 4 i guess, seems fair i suppose i don't know.
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microman

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My arm span is 170 cm and to be 176-178 cm after AL.

is it possible to do AL at the same time as LL.

could you maybe do AL once you are consolidating the LL.
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Overdozer

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Sorry I don't update the diary... very often. Feeling really tired right now, can't get much sleep. The painkiller I'm using currently at max dosage (flupirtine) has two side effects. First one is that you feel drunk (200 mg), same as if you take two shots of vodka... or three. And the second one is it makes you tired.

Anyways, I've lengthened 3.5 cm on my tibia, no misaligment, good regenerate, so I'm done almost as I've lengthened 5 cm before, but shrank 1 cm (other doctor). Femur I've lengthened 5.5 cm, 5.8 cm on the frames. But I have a misalgment (antecurvation), but NP it will be fixed, when I finish lengthening, 100%. I'll upload all the xrays at the end of the lengthening.
« Last Edit: July 22, 2015, 05:08:19 PM by Dozer »
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Pre-surgery - 167 cm, Post-surgery - 181 cm
Final arm span - 177 cm, Sitting height - 90 cm

Lengthened 7.5 cm in tibias and femurs and 3.5 cm in each humerus. Surgeries performed all external by Dr. Kulesh, in Saint-Petersburg, Russia - http://www.limblengtheningforum.com/index.php?topic=1671.0

microman

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interestinly with mitkovic you don't use strong painkillers at all, its just off the shelf non prescription ones, many patients don't even take them.


check my diary if you have the chance, solomin was my 2nd choice but didn't want to wait for visa.
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Overdozer

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interestinly with mitkovic you don't use strong painkillers at all, its just off the shelf non prescription ones, many patients don't even take them.


check my diary if you have the chance, solomin was my 2nd choice but didn't want to wait for visa.
Well, I wasn't prescribed the painkiller, I bought it on my own (you don't need prescription to buy it in Russia). Also it hurts really bad this time, obviously I wouldn't use it if it didn't.

Yeah, it sucks for international patients because of visa. I do read your diary. Hope you'll be ok.
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Pre-surgery - 167 cm, Post-surgery - 181 cm
Final arm span - 177 cm, Sitting height - 90 cm

Lengthened 7.5 cm in tibias and femurs and 3.5 cm in each humerus. Surgeries performed all external by Dr. Kulesh, in Saint-Petersburg, Russia - http://www.limblengtheningforum.com/index.php?topic=1671.0

alex

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Anyways, I've lengthened 3.5 cm on my tibia, no misaligment, good regenerate, so I'm done almost as I've lengthened 5 cm before, but shrank 1 cm (other doctor). Femur I've lengthened 5.5 cm, 5.8 cm on the frames. But I have a misalgment (antecurvation), but NP it will be fixed, when I finish lengthening, 100%. I'll upload all the xrays at the end of the lengthening.

Hi Dozer

5.8 is good amount of lengthening, If I recall correct, you are going to length 7.5 cm of femur ?

How much degrees you can bend your knee (Femur side) ?

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Overdozer

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Hi Dozer

5.8 is good amount of lengthening, If I recall correct, you are going to length 7.5 cm of femur ?

How much degrees you can bend your knee (Femur side) ?
Yeah, I need to lengthen 7.5 cms.

I can't bend much, like 30-40 degrees. Well, it was the same the previous round. I worked it out after removing the frames. It's only a temporary problem.
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Pre-surgery - 167 cm, Post-surgery - 181 cm
Final arm span - 177 cm, Sitting height - 90 cm

Lengthened 7.5 cm in tibias and femurs and 3.5 cm in each humerus. Surgeries performed all external by Dr. Kulesh, in Saint-Petersburg, Russia - http://www.limblengtheningforum.com/index.php?topic=1671.0

alex

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Yeah, I need to lengthen 7.5 cms.

I can't bend much, like 30-40 degrees. Well, it was the same the previous round. I worked it out after removing the frames. It's only a temporary problem.

I can't bend so much as well, that's making me a little worry.

You can bend the previous femur 180 degrees ?
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Overdozer

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I can't bend so much as well, that's making me a little worry.

You can bend the previous femur 180 degrees ?
Well no one can bend 180 degrees, but I was able to bend it 160 degrees or so, close to the limit. Right now I have the tibia frame, so I can't bend it fully because of the top ring.
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Pre-surgery - 167 cm, Post-surgery - 181 cm
Final arm span - 177 cm, Sitting height - 90 cm

Lengthened 7.5 cm in tibias and femurs and 3.5 cm in each humerus. Surgeries performed all external by Dr. Kulesh, in Saint-Petersburg, Russia - http://www.limblengtheningforum.com/index.php?topic=1671.0

alex

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Well no one can bend 180 degrees, but I was able to bend it 160 degrees or so, close to the limit. Right now I have the tibia frame, so I can't bend it fully because of the top ring.
You did great work to regain full flexion. do you remember how long you take until you are able to bend 160 degrees ?
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