My name is Olga Komendova. I live in the Magadan region, in the small town of Seimgan. I raise four children all by myself. Two of them are my own sons (Victor, b. 1988, and Sergei, b. 2000), and two are adopted (Sasha, b. 1988, and Maria, b. 1990). Sasha Karmanov is a friend of my son Victor. Sasha had serious trouble three years old: his legs were paralyzed, and now he cannot walk and has to move in a wheelchair. And then Sasha's mother suddenly died. Their grandfather became the person-in-charge, but he was a heavy drunkard and threw the children out when it was -50 C outside.
I took Sasha and Maria to my home. Now I am their official trustee, and we are a large family.
It is very difficult to live with children in the far North. No doctors, no home improvements. The boiler house often interrupts its work, and it is cold inside. This winter, the school didn't work for three months, because it was just too cold in the classrooms. But the main problem is that Seimgan is very far from any civilization.
My parents, who lived in Samara, died in December 2004. I inherited their house, and now I want to take the children to Samara, because the sad circumstances have made it possible. But I had barely started to think about moving there when Sasha received an invitation to hospitalization at the RCCH. I had always though that Sasha was incurable, but here it turned out that he had a chance. We postponed all our plans and went to Moscow with Sasha. I left three children at home. My salary is our only source of income.
Here, at the hospital, everybody shows a very good attitude to Sasha and me. Sasha gets help and gains new friends. I hope that finally he will walk.
But we badly need help in moving from the Far East to Samara. Tickets for the family and a railway container for all our belongings will cost 100,000 roubles (about $3500).

Olga V. Komendova

The doctor's comment:

- The child has a spinal trauma, and also some signs indicate that there was also an inflammatory process of unclear etiology. In any case, Sasha's problems began after a trauma: he jumped off the roof of a shed, felt some pain, then weakness of his extremities, and then developed paresis of lower extremities and malfunction of pelvic organs. His condition has somewhat improved in this respect, but further treatment is impossible if we don't resolve the most pressing problem: healing of neurogenic trophic ulcers on his foot.
Earlier, in 2002, this boy was admitted to our hospital. We implanted a neurostimulating device in the spinal region, in the lumbar enlargement. It stimulates the spinal cord and promotes healing of trophic lesions. However, at that time the child didn't arrive in hospital again because of tragic events in his family. More than two years passed. The device was out of use for a long time, because neither Sasha nor his adoptive mother knew how to handle it. So we didn't observe any significant effect. Now we have repaired the device and arranged normal stimulation. As a result, one of the trophic ulcers has already ñlosed.
Presently we plan to continue stimulation of the spinal cord and simultaneously perform combined treatment of the remaining trophic ulcer using pluripotent stem autocells and Collost, a novel and very promising drug. However, it is rather expensive; one pack costs $50, and Sasha will need at least ten packs. It is produced in various forms, and we will apply it in the powder, film, and gel forms.
Soon Sasha will have an operation. We will have to resect the necrotic tissues, clean the wound and prepare it for implantation of cells and application of Collost. Stem cell therapy is expensive, and in Sasha's case it will cost at least $1500 (the exact sum depends on the size of the wound). Here, at the Russian Children's Clinical Hospital, we will take Sasha's cells, purify them, and then isolate and cultivate the fraction that is of interest to us. In this case, the fraction will consist of fibroblasts and blood vessel progenitors. Cell cultivation is performed at the Laboratory of Cell Technologies of Transplantology Institute. Cell cultivation is the most expensive procedure; it requires many different reagents and complex equipment for preservation and proliferation of cells.
When we cope with Sasha's chronic ulcerous process, he will have an additinal examination. On its basis, we will decide how we can make the boy stand on his legs. But now, until the ulcers are healed, no corrective orthopedic operations are possible. Yet orthopedic correction and rehabilition will be the primary problem at the next stage of treatment.

Head of Center of Microvascular Surgery
Alexander V. Bystrov, Ph.D. (Med.)

2002

Sasha Karmanov, my son, is 14 years old. He had a great trouble in April. Oh boys, boys! You never listen to your parents' warnings. You always want to have some extreme experience. Same with my Sasha: this spring, he jumped into the snow from the roof a garden shed together with his friends. The result is a spinal trauma and completely paralyzed legs. Before this trauma, Sasha used to fish, play basketball, cycle, and ski. And now all these things are impossible for him. He spent the spring and summer at the hospital, in a wheelchair. The doctors are doing everything possible in this situation. But, to start walking again, my son needs an operation with an implantation of an expensive stimulator. It costs ca. 1500 USD. But I have no such sum.

I am asking all kind people - please help us if you can! We live very far away, at a village near Magadan. Getting a job is very difficult in our region, and so I am unemployed for the time being. I bring up two children all by myself. There is nobody around who can help. My only hope is that somebody will respond to this plea. My son has a whole life to live - please help him!

Irina Ivanovna Karmanova

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