I did external lengthening in volgograd this year.
it was a positive experience.
basic info:
external ilizarov
no intramedullary nail at start
starting length about 170cm
desired gain =10cm
price=12500 euros + about 200 euros for first consultation and bloodtest
clinic name=klinika da vinci, 7th floor
clinic address= ул. Социалистическая, 17 = sotsialisticheskaja street 17
hospital/surgery adress= autotransportnaya street 75 (still do not know the name of the hospital)
doctor name=alexander barinov
biggest problem=boredom, 2nd= few weeks insomnia,3rd bandage change.
smallest probem=the surgery, the frame
In the clinic complex/patient area there can be 8 patients in four rooms
other patients live in apartments.
food is delivered everyday.
breakfast at 10.
sun wakes you up at 4-5.
there is a washing machine right outside room. very noisy.
the common area is uncomfortably narrow. one person can comfortably move around on crutches at the time.
there is a physioroom but most machines are not safe for ilizarovpatients, like the rockclimbing simulator.
you do walking outside your room in the hall which is like 20 meters.
Involgograd:s diary. External ilizarov in russia, volgograd - Dr Barinov
first impression of volgograd:
brown, everything is brown, roads, ground, buildings etc.
not super clean, no trash really, just doesnt feel clean
the roads are not all asphalt
there are a lot of potholes
buildings are not maintaned that well, like tilecracking and paintcracking
grafitti
lot of mud around streets
messy
overcast a lot
it gets better towards summer when vegetation starts growing and the sun shines.
You will be in the clinic a couple of days.
Day before surgery you are sent by taxi on your own, which was worrying, to the hospital.
day of surgery
11.00 walk to surgery room with nurse
i feel calm. it is kinda strange. feels like i should be more nervous
most scaring thing was spinal anaesthesia. but, needle barely felt like anything..
nobody tells you anything about the surgery during surgery or even before it.
you get covered in lightblue gauze everywhere outside the surgery room.
you walk in and lie down on the surgery table.
a curtain of gauze blocks your view of your legs
anestesiologist talks little english but he tries talking with you the whole surgery.
words like bol, nyet, da, khorosho, are enough.
you have only one hand free
left hand is tied to the bed with iv drip in forearm and heartmonitor clip on left indexfinger.
you can use right hand freely.
they use a lot of antiseptic alcohol everywhere on your legs.
smells very alcoholly in the room.
you are injected in the spine with marcaine.
you are told it lasts from 12 to 18.
your legs get numb quickly, after 15 minutes they are completely numb.
you feel that the legs are there, but you cannot get any nervesignals to them.
it is kinda weird, funny, you tell your legs to do something but the signals stop at your stomach.
they poke your legs a couple of times to test the anestesia during 15 minutes.
12.00
the surgery starts, they dont tell you this though.
you can feel pressure when they cut your skin and when they chiselbreak your bone.
but no pain at all.
you hear banging hammering, drilling, screws tightening
you see little blood, stains on gloves, but no blood really.
you can feel these very small tingles in your legs feet etc., like nerve cells being numb and confused and tingling but they dont send any painsignals.
they listen to radio while operating, us songs, dance, pop, volgograd fm.
it gets kinda cold and you start shivering.
it helps breathing in deeply.
16.00 surgery finished
////
16.10 can move toes...still a little numb but toes are mobile and you feel touch. no pain really yet, but you feel pain starting to come.
stomach muscles are stiff and there is weird discomfort
16.25. pill of ketarol. 10mg
16.45 pain 1 of 100 under right knee in tibia
17:09 irina takes away drip...iv
17 12 pain right leg grows...7 of 100% under knee.
stomach feels softer now
can move legs side to side now
not able to bend leg
no nerve control
17.22 pain same place starts in left tibia. 3 /100% pain
17.30 right 10/100% left 5/100%
17.45 right leg 15% pain
18.00 ketarol 2x 10mg pills
18.44 30% pain
can feel legs, little numb
18.50 pain quickly escalating 35%
18.55 pain becomes like... heavier., like something hard pressing more and more on your skin, on your tibia. and whole leg feels heavier and heavier.
19.00 50% pain
19.05 ketorolac injection in right thigh. numbness spreads immediately
19.14 35% pain in right tibia. heavy pain. knee kinda feels painful.. numbish pain.
pain is kindof everywhere along the tibia...weirdish, like there is pain, mostly at the tibia cut, but the pain spreads up and down to bottom of knee and to ankle.
19.17 pain getting less heavy. at 22.00 the ketarol injection should be full effect....
19.30 little biting pain around pin insertion holes. 30% heavy pain on right tibia break site. 10% on left.
situation feels good.
19.40 cannot figure / plan how to move legs at all. still aneastestisized so... very awkward.
20.24 pain at 15-25 on right tibia. 5-10 on left.
20.35 pain at 30-35 both
20.40 ketarol 10mg pill
21.00 injection ketarol. numbness eats the area in seconds. no pain of injection, very quick injection, left thigh this time.
sleep. weirdly super sleepy. no sleep medication, just sleepy
about the surgery-room:
room is clean
room is square, like 30-40 m2 big.
there are machines like heartmonitor, oxygen machine
modern LED lighttube bulbs are used.
curtains are made of metal strips, bent and bad. should change those.
there seems to be one bulb broken in each of the two large round surgery lamps.
about the personnel:
there are 3 surgeons all from the clinic
3 nurses
2 anestesiologists
and some random assistants
advice:
plan immediately after surgery how to get nurse´s attention to give you ketarol before pain starts coming back
pain becomes 30-40 percent of 100 very soon.
these are the first days where the trauma will hurt very much before your body produces numbing agents around the area and you need medicine while this is going on during the first days.
take painmedicine in advance and immediately when pain grows.
surgery day 2.
3.03 wake up. 6 hour sleep.
no pain in left leg. 5% pain in right.
3.30 ketarol pill 10mg
4.10 pain is like a sleepy tired pain in legs. not heavy like yesterday. like when you are sleepy normal life and you feel your legs wanting to sit down or lay down. little biting pain under right knee. like 2% of 100 pain. nothing.
4.30 10% pain in both tibia fractures.
4.44 ketarol pill 10mg
6.00 pain is achetype. 10-15% both legs.
6.40 pain is still achetype. 20-25% both legs.
6.40 ketarol pill 10mg
7.00 21.00 30mgish injection ketarol...weird feeling. numbness eats the area immediately
9.30. doctor tsarkov tells me to walk back and forth in room 10meters. verdict: unsureness, unsteady, legs feel tied by rope, stiffness in all areas when walking, sometimes 5 of 100 pain, standing straight is ok no pain, walking 5cm steps with straight legs ok no pain. bending anything feels uncomfortable and 5% pain.
10.00 bandaging. wheelchair to bandage room. getting into wheelchair barely any problem. good. no pain. alcohol everywhere before bandage removal.
12.40 all ok. little numb heavy feeling in legs. 5 of 100 pain
13.00 workout. lift whole leg up down. heavy frames feel like 5 kg per leg.very stiff legs. stiff ankles. pins are blocking the calves. flexing calves is resisted by pins. much resistance when trying to bend feet. only max 90 degrees, but difficult to bend to 90. looks more like 100 degrees.
14.30 walk. terrible. crutches. have to stand vertically straight otherwise weird small pain. little twist, little wobble immediately 10-15 pain, but weird pain, like your legs are bound inside and round stones push your nerves. very stiff to move around. have to slide feet 5-10cm per step=then no pain at all. turning around is awkward and little painful. lifting feet is heavy and very insecure. too many things to handle. crutches, turning, keep balance, stand straight, heavy legs... no no nonono. just slidestep. too much stress and twist on other leg when lifting one leg to walk like normal walk. that is just too difficult. have to keep both feet on the floor. no pain when standing still.
14.45 lying down. legs are swollen. feel warm. moving toes works well.
15.00 all feels good when lying down. food. meatsoup and bread.
19.00 pain 10%. putting on footholders aligners to 90 degrees.
19.15. pain 20 on left tibia. 30 on right, biting pain at upper pin site on both outer knees.
19.15 10mg ketanol pill
20.00 pain at 2 of 100. ketarol works. also loosened the footalligners. too tight, numbed my toes.
20.05 new all russian doctor came in.asked if i needed ketarol. i nodded.
20.25 waiting for ketarol injection...
20.50 nurse gives injection.
sleep
Wow, I've never seen somebody do an amount this large on the tibias. Are you doing Latn or pure external?
Wish you all the best!
first consultation=
1
the doctor takes pictures of you and simulates your legs at 3,6 and 9cm distraction.
gives you an image of what to expect.
6cm looks at the max end of normal
9cm looks alien
although the calves looked a litte weirdly thin so....
2
dont trust the exchange rate if paying by card...it may become extra expensive
pay per bank wire if you can=exact amount.
day three
4.30 wake up. tingling weak stinging feeling in spine at injection site. hopefully nothing other than temporary sensation from raised legs all night
5.00 physio. air cycling
5.30 ache both legs at 10. warm tingly heavy stiff legs. full sensation. dont think any problem is here.
5.45 400mg ibuprofen. feels like a headache in legs. 15%-20%
6.00 physio. lift leg up down. wow. sitting still for minutes makes your ankles numb.interesting.
6.30 400mg ibubrofen.
6.40 legache 5%. thanks ibu.
7 00 physio. air biking
8.00 physio air biking 5 minutes
8.50 ache at 5-10%
9.10 nurse alina and other comes in checks on me. say food is soon.
9.30 nurse kirill checks temp with remote, 36,8degrees. all ok.
9.35 nurse ...did i get her name,larisa, matronly. takes my plate. who knew food would be catered..but seriously, get food on crutches.... that would have never happened. this should have been in the info though.... you will be brought food.
10:30 headachy feeling...like headache without the ache. weird feeling.
11 physio
12 physio
12.50 bored
13.40 took footaligners off. been numb in the ankles since wearing them all day. did physio with ankles up down. felt ankle pins after some minutes so i stopped.
14.00 left knee pin pain growing, 20-30% of 100 now.
14. ibuprofen 400mg. physio
14.35 pain 1 of 100.
15. headache without pain
15.30 less headache
17. physio. causes ache in knees, left. 19 of 100
18 physio. bending leg hurts in left knee pin.
19 physio
20 25% ache in knees.400mg ibup
21. 3% ache. nurse manager comes in, asks if i am ok, if i need pain relief, i say no thanks. physio.
22 physio
23 physio. legs have been swollen all day.
sleep
day four
2.30 wake.15 % ache. can feel outer ankle pins both legs, no pinpain
though, pressuretype pain 10 of 100 in legs
4 sleep
5. wake up physio
6. ibuprofen. should have taken the ketarol shot earlier. ankles still numb.
8. physio. legs feel heavy. numb. walking still is a mess weirdpain. 0 pain overall when resting.
9. 40 nurse gets breakfast,
12. nurse inna checks up. iv? i say no. need t o lay down/ i ask for more plastic bags..
13. constricted blooedvessels in neck, headachyish
14. physio. all ok. headache at 10%
14.40 nurse galina provides 6 plastic bags.... brings food
15. spinal anestesia site still sore...normal?
16.physio. tired today. like very low energy. no problem though
16.35 energy level normal
17. lay down
18. kitchen lady brings in food. i elevate legs on bedhead.
18.40 ache around knees, at 20/30%, ibuprofen.
19. three male nurses rudely open the door. reg checkup.
...same old
hospital food
in general=tolerable.
bring salt, they barely salt most of the things.
porridge, rice, wheat, crushed wheat, spaghetti in milk (ew...a russian thing)
cooked rice
cooked chicken
beef soup
vegetable soup
sweet fruit soups
tea
kefir
bread
butter
fried cabbage and beef
risotto of beef
cookies
potatosoup with stirred egg
potatomash
tuna-egg patties
salmon fillet
day of surgery
drip
leg length start
bandage change
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