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Diary 16
March 25
For the past 10 days there had been no major change in my status. Now my first leg is lengthened by 2.7 cm and second by 2.0 cm. I am doing little stretching on the bed everyday and other times I watch TV or do internet or so on. A day is so long on the bed! I take bath everyday and can go to toilet on my own.
Legs are sometimes uncomfortable which seem to come mainly from the knees. It may be because the clicker sometimes touches the patella and push it. Anyway clicker is obviously one of the major source of discomfort. And it is especially annoying at night, when I always wake up several times due to the knee discomfort. Recently I started to feel muscle tension on the calf muscles of the first operated leg in certain position with bearing weight. But it does not bother me on bed.
Another minor issue(certainly major to me!) that I have not mentioned before is that I am really home sick. I started to have difficulty eating Ukrainian food three times a day from right after the first operation. I am just sick of it!! Now I am eating the same thing almost everyday. I want to go back to my country as quickly as possible.


Diary 17
April 2
Over the last several weeks, the weather in Kiev has become much warm. It seems the spring has truely come.
Today we took the follow up X-ray of the shins. The Tibias were lengthened by 3.6cm for the first leg and 3.1 cm for the second leg. Although the speed of lengthening is different everyday for both legs, I have taken memo of the number of clicking everyday. It is interesting to find that the actual length is slightly larger than theriotical length...(true for both legs last xray and xray today)
As confirmed by actual measurement of the lengthened tibia, the shins looks much longer now, which makes me feel good. Actually it looks great now and I am getting scared how it would look if I have lengthened 6cm, it probably looks rather disproportional.
There have been serious concerns over the past 10 days. That is the knee is gradually losing its range of motion, and now my knee would not extend from 90 degree flexion (sitting position). Maybe this is nothing to worry about because it is obviously caused by the clicker, which is to be taken out at the end of lengthening period. This really bothers me because, it interferes with the quality of life in the apartment which makes me difficult to move around or sleep. This is a major thing to me and yet I had no good explanation before the operation. In fact, they gave me an impression that I could start practicing crutches sometime after the operation. But this will never happen unless clicker is taken out. Just before I leave Kiev!
The range of ankle motion has drastically decreased in the past several day too. It is worrisome because now I can barely put my sole flat on the floor. As I recall recommendation of some other doctor that the limit of tibial lengthening could be influenced by the restricted ankle movement, I also take this seriously.
Tomorrow we ( Drs, me, and translator ) are planning to discuss the date of my leaving Kiev as it will probably be at the end of this month or early May. So soon!! I am planning to make all my concerns clear and seek for the optimal choice (including reevaluation of the lengthening extent).

Diary 18
April 5
Today we had a long discussion on my current concerns and the lengthening plan.
The first concern about the knee motion, they told me that is was caused by much too fast lengthening speed (which was done upon my strong request), but that progression will stop at a certain point soon and it will reverse after removing the clicker.
The second concern on the ankle motion, they told me that I should not worry and that it would also reverse.
Before the operation, I had told the Drs that I am planning to do gain 6 cm on the tibia to correct my short shins and that my wish is not to be as tall as possible. As I was planning to shorten the lengthening period upon satisfaction of my body proportion, we agreed that 5 cm extension is enough for my goal.
We decided to keep on lengthening till clicker is surgically removed on 4/18 and leave Kiev on 4/26. I was so happy everything went so quickly..
But soon after, I realized a huge misunderstanding!!!
As I asked the doctor when he thinks I can start walking without crutches after I go back to my country, which for some reason I was expecting 1-2 months, they answered 3-4 months.
WOW wait a minute! I have already planned to go back to my carrier in July 1! I cannot possibly make it! I was in a big big trouble! What am I to do?
Drs were sympathetic to my situation and told me that if I work very hard on rehabilitation I will probably be able to walk without crutches by 7/1 even if I went for 5cm, as my bone regeneration speed was very fast and they had no doubt that bone regeneration itself would not be a problem (meaning more of a functional problem). They also told me that if I become lazy about the rehabilitation after I go back, I have little chance to make it by 7/1.
Another option discussed was to stop lengthening 1 week earlier (4/11) which would make approximately 4.2 mm of extension and start rehabilitation as soon as possible. In this case I do not have to take risks and maybe able to walk without crutches sooner than 7/1.
As I am already satisfied with my shin appearance to a certain extent, this is about if I should be greedy at a risk of my future carrier, a difficult choice to make.
I have promised to make up my mind by tomorrow..

Diary 19
March 11
Yesterday, I went back to the hospital to receive the required exam (urine, blood, electrocardiogram, and Xray) for the operation. Yes! I have decided to stop lengthening and remove the clicker, as I thought I have achieved my goal. At this time, due to the extensive exercise, my ankle was able to bend over 90 degrees, even better than a week ago, but my knee was able to extend approximately 90 degree (cannot extend the knee from sitting position) though I was able to bend it fully. As for the ankles, the cause is probably relatively short leg muscles compared with the lengthened bones. I can feel the muscle tension or pain as I bend the ankle. But the knees may be more complicated, as I can feel and see the clicker pushing the patella with knee extension and the extension stops when the clicker and the patella are tightly bound together. Both clicker and muscles seem to be the cause.
I was not at all comfortable being at the hospital because I really did not have a good time before, it reminds me of the post surgical period (right after the surgery).
And today, I finally had the clicker removed from both knee. The anesthesia was performed intervenously, painless procedure. The actual surgical procedure was about 10 minutes. The final result was 4.5 mm of lengthening for both tibia, 36 days from the operation for the second leg. Tomorrow I will go back to my apartment..
Now I am very relieved to have completed all the surgical procedure for this trip. Yes! No more lengthening! I can now concentrate on the rehabilitation!!
Diary 20
April 18

It is now night before departure. Early tomorrow morning, I will leave Kiev to my home. Though my stay of two months is not a very long period, I still felt it pretty long probably because I was watching TV, doing internet, or sleeping all the time. Despite of my plan to do more productive things, I just could not concentrate and gave it up long time ago.
After the surgical removal of the clicker, I was working on rehabilitation. At first, unlike my expectation that my knee should be much more mobile compared with preop, my knee gained only little motion. The reason is because there is still a part of the internal device sticking out of the tibia towards the patella, which was to touch the patella upon knee extension and of course, tight muscles. But the general knee discomfort has reduced considerably.
The intensive rehabilitation improved my knee motion everyday. Though rehabilitation is a little bit painful, it is so relieving to see my knee recovering its motion. Now my knee can extend close to strait but I have the feeling that the gaining the remaining motion is most difficult. It may still take some time. I can now bare my full weight on the legs with standing. But the internal device sticking up the patella is very uncomfortable, so I cannot stand for very long. Surprisingly, there is only little discomfort on the osteotomy site. Now I am learning to use crutches.
Oh, by the way, stitches have been removed today.
Though the surgical scar is not my major concern, I think it will take years for it to become unrecognizable level, provided that it would be left this way (I am hoping Drs would do something about it when they remove the internal device). Most scars are pigmented and small scars are oval in shape. Some of them are bumpy in shape forming dimple, which stands out a little. It may not be even recognized as a surgical scar, as some of them look more like a small gunshot wound.
All the people that I got to know in Kiev were super nice!! Probably much nicer than the people in my country. I was able to feel strong hospitality from them, which I thank them from my heart. And drs were caring, comprehensive, and responsible.
Financially, the total money that I spent for this surgery was approximately 23,100 USD (21,000 surgery, 1,100 airplane ticket, 200 transportation to the airport in my country, 800 in Kiev). Of the actual 800 USD I spent in Kiev, hotel stay for the first three days after the arrival in the beginning cost 240 USD, and 300 USD for calling card for international calls were the main expenditure. As for calling card, 15 minutes call everyday to USA for 2 months will cost the same (sorry, if there is a cheaper way). Other foods, apartment rent, and wage for the person who came to my apartment everyday to take care of me (from 8:30 am to 6:00 pm) was all included in the surgical fee.


At this point, I cannot comment on whether I am satisfied with taking the surgery because the procedure is not over yet. I may be unhappy if I end up having some complication. And as I can barely stand with slightly bent knee, I have not yet experienced the joy of being a 4.5cm taller than before, though I am happy that my shins look much longer than before. The conclusion would only be drawn after I recover the full function of the legs. But if on assumption that everything went well, I am super happy that I have had the surgery. The surgery was obviously worth it for me.
And to be more realistic, you may never know until you get old and fragile, when you have more chances of falling and breaking bones.

I will add a little more to the diary after I return to my country.


Diary 21
April 29

It is nearly 10 days since I came back to my country. Everything is so nice here, including foods! I found I had lost 18 pounds during the 2 months in Kiev….but now I am rapidly gaining the weight. Both of my legs can extend to almost strait now and I can stand without holding on to anything. I can also use crutches which has been kindly provided by the Drs in Kiev. I am mostly on wheelchair that I borrowed from some volunteer group in my country. The most serious problem is that I have trouble climbing the stairs…..

About my trip back to my country, Drs has asked the Aeroflot Russia to help me get on and off the plain. After the Drs had dropped me off at the Kiev airport, the Aeroflot staff took over and did everything for me. I just sat on the wheelchair and followed their instructions. This service was great because I had very little trouble getting by the immigration office and tax office. The staff carried all the baggage and even helped me to mail it after I arrived in my country. And this service did not require additional fee!!