Important Breaking News from Namibia…

We are now out of Africa and look forward to sharing our experiences in town and on safari in subsequent articles, but first, some breaking news from Namibia…

Oops, I did it again 🙁

As you may be able to infer from the title of the post, I once again had a major injury in Africa, this time in Namibia. First, Africa has more than its fair share of rough rocks set in cement as walkways, post supports, etc. We had returned from our first game drive of the day to our lodge in Etosha National Park in Namibia. I had already gotten out of the safari truck at least three times that day, but now it was dark, and the truck pulled close to the entrance of the lodge. I stepped off the truck onto the ground but made the mistake of taking another step backward. Unfortunately, my foot came down on a bell-shaped sloped structure holding up the porch post. I quickly fell backwards onto the raised rocks that seemed to come up to meet me.

Mike helped me to stand and walk into the lodge, but things went downhill from there. I knew I broke something in my leg because I couldn’t put any weight on it, and I was incredibly nauseous. I had to lie down, ASAP. The staff used an immobilization board, like you see for injured football players, to get me to our cabin, and it was already dark out.

A Really Bad Night for Both of Us

Boy, was that an unpleasant night and the following morning. Mike had to carry me around my ribs to the bathroom at least four times. The first two times, the pain in my ribs was so bad I passed out before he got me back to bed. By the next day, I was convinced he had broken my ribs in the process, but it turned out I had broken a rib in the fall, which accounted for the extreme pain.

I traveled with strong pain pills left over from previous surgeries, but nothing could kill the pain that night. We planned to contact our travel insurance provider in the morning to figure out what to do. The people running the lodge were really helpful, getting a doctor’s referral and contacting our travel insurance guys. But the ambulance didn’t show up until about 1:00 pm. I was told it would take me a few hours to a place where a doctor could stabilize me, and then we would continue on to Windhoek, the capital of Namibia. The triage doctor suggested an orthopedic surgeon and a private hospital, so that was where I was going.

The Unpleasant Ambulance Ride

The first thing I asked the ambulance guys when they arrived was if they had strong pain medication, and they assured me they did. They immediately started the first of what turned out to be five IVs in as many days. They hit me with Fentanyl, and I was definitely in less pain. The next challenge was getting me to the ambulance. They used some kind of weird metal contraption for transport, but when they tried to move me, I was screaming in pain. That prompted the first dose of Ketamine. OMG. I can’t adequately describe the feeling of that drug other than being shoved into some other universe where I was hallucinating, and I thought I was dying. And that is putting it mildly.

I awoke in the ambulance, thinking I was out so long we were already in Windhoek. Then the ambulance guy said, “Do you remember the last 5 minutes?” You can’t imagine my disappointment.

We already knew that 90% of the roads in Namibia are gravel because we had been driving around Namibia for the prior week. However, I didn’t know the plan was to drive me in the ambulance over gravel roads all the way to Windhoek. I can honestly say that ride was the longest six hours I think I have ever spent. In the middle of the ride, I complained about pain and was given another dose of Ketamine. The second drug-induced trip was just as bad as the first, and I felt like I had fallen into a hole. I told the ambulance guy that he couldn’t give me any more Ketamine, ever!

What We Did Next

It was full dark by the time I reached the hospital emergency room. Next followed the X-rays. Once they viewed the break in my leg, I was admitted. Thank goodness.

The Surgery

I met the doctor the next morning, and he explained he had to replace my hip, which I already knew from my previous broken femur experience. He said it should be about 1 pm when he could start. I could hardly wait as I was so thirsty, as I’d had no water since midnight. I was finally taken to what they called the theater around 2 pm. The room was very modern and reassured me that I was in good hands.

After surgery, I was taken to what they called high care or Intensive Care for recovery, because my blood pressure was too low. But they gave me lots of great painkillers. At some point between 6 pm and midnight, I remember screaming. The doctor wanted a post-surgical X-ray, but the technicians mistakenly rolled me on my side to do it. In the process, they badly dislocated my new hip. At this point, all I can think of is water; it’s been almost 24 hours. But the nurses said no water because I was going back to the “theater” so the doctor could fix the dislocation.

At least after the second round, they gave me some water. I tried explaining about ice chips, but they got me a cup of ice cubes. At this point, I wasn’t going to complain.

Post-Surgery Experience

I remained in high care for the next three days because my blood pressure wouldn’t go up, and my oxygen saturation was below 90%. Both of these are common for me after surgery, but I had been drugged up since Friday, and it was now Wednesday. I just had to wait for the drugs to clear my system. I was finally able to have the PT person get me up on a walker so I could go to the bathroom. That was as far as I got that day.

I noticed in South Africa six years ago that all of the patient records were recorded manually. At the end of my bed was this giant piece of paper that they were recording all the drugs, all my stats, and who knows what else. It was the same in Namibia. And like South Africa, the nurses are called sisters. The manual recording seems strange because the hospital billing was electronically generated item by item, and the surgical procedure and implant were the same as here. It was an odd mix of old and modern methods.

Another thing that surprised me was that while the staff does speak English, they had a very difficult time understanding me and I them. I think they must have thought me quite odd asking for things like ice for my hip, lip balm, and a shower. The result was that I finally got a shower on Wednesday, but the sister helping me didn’t really seem to know how to go about getting me in and out of the shower with a walker that didn’t fit. On another note, the food was awful, so I didn’t eat anything but fruit for a week.

Getting Out of High Care

Finally, they transferred me to a regular room where I could do PT two times a day and start walking on crutches. Stairs on crutches have to be mastered before they let you out of the hospital. So that was my goal as soon as I could stand up without being super dizzy. The downside was that they pretty well ignored me once I got to a regular room, but they wouldn’t let me out of the hospital until Saturday. I was there for an entire week.

It wasn’t until Mike took me to our hotel that I realized I hadn’t ever seen an ice pack. No wonder there was so much swelling. I started icing immediately, and I stopped taking pain pills.

The Insurance vs. Cash Payment Dilemma

It started when we arrived at the hospital. Mike was given a quote for the X-rays before they took them. He said ok, but asked them to confirm they could bill our insurance. This became a theme. We should have been dealing with my international medical insurance carrier as primary and our travel insurance policy as secondary. However, in reality, it was much more complicated because there were additional reps on the ground for each company. The first thing we needed before surgery was a guarantee of payment. While the GoP should have come from my medical, it was Saturday night, and they wouldn’t answer us until Monday, so it was the travel insurance that provided the guarantee of payment. That created additional issues on Monday, but we worked through it.

Then we had to keep paying cash for all of the services, and everything was separate. For example, each of these items was quoted and billed separately: X-rays, hospital admission, operating room, hospital time, the surgeon bill, anesthesia bill, intensive care fisio, regular ward physio, and crutches. I’m not sure what the guarantee of payment was about because these people didn’t want to bill our insurance, like we wanted; they wanted payment with cash or a credit card.

Things got even more complicated between emails with attachments that were too big to send and quotes via WhatsApp. Since we had only seen quotes in some cases, we had to beg for the final invoices so we would have enough information for the insurance to pay us back. People came into my room every day asking for payment.

Costs

So what did this cost? I’m sure you are wondering. I have both international health insurance and I bought trip insurance because a 30-day safari is expensive. Overall, the medical, hospital portion was about $14,000, most of which Mike just charged. I expect to get all but $1000 of that back. The ambulance was completely covered by the travel insurance. I am also trying to recover $20,000, which is the policy limit for the safari portion. In addition to forfeiting the safari, we canceled the rest of our summer plans, and in airfare and hotel, we probably lost another $4,000. Not too bad.

Return to Playa

I will admit that the 36-hour, three-flight return from Namibia to Playa del Carmen wasn’t as bad as you might think. The worst part turned out to be getting into the van in Cancun for the ride home. I twisted my knee when my first attempt failed. Then once I reached the seat, I realized that the pain in my leg was pretty bad, so I took some pain meds.

I can’t say how nice it was to come home, we went a long time without a home. The air conditioner had been on since morning, and I was able to crawl into my own bed. It was heavenly. But we both still had jet lag, my hip was still swollen to twice its normal size (no joke), and I was carrying at least five pounds of extra fluid around my hips.

Starting Rehab Right Away

My trainer came over the next day and we started the difficult rehab process. She and I had both researched the exercises recommended for a hip replacement. We also discussed the timing for the various exercises and the three specific movements I couldn’t do for at least three months. There is no cement around the prosthesis because the goal is for bone to grow into the implant in my femur, so it is nice and solid. We have to be very careful until that process is done. I have done so much physical therapy over the last six years, and I definitely know the routine. I also found my really large clay ice pack and started using it frequently.

Mike also reminded me that I had my own TENS (muscle stimulation) machine for pain. It works pretty well. That said, after a few days at home consuming loads of fluid and protein, everything was still really swollen, so I found someone to come to my place and give me a massage. I was hoping she could help my leg drain and reduce the swelling. A little tricky, I admit, because I couldn’t lie on my stomach, but she was able to work on my back from a chair and on my leg while I was on my back.

The next two days I felt awful, but on the third day, the swelling was down and I felt like myself again. My theory is that the prolonged use of pain medication caused me to store some of it in my tissues. The massage released them into my system, making me feel bad, but it helped clear the drugs from my system.

How I’m Doing Today

It is now two and a half weeks after surgery, and I finally feel like myself again, except for the metal hip. I’m working with my trainer almost every day on range of motion, strength, and upper body, so I don’t lose what I spent the last 6 months working on. With this procedure, there are milestones at four, six, and twelve weeks. I plan to work hard on my rehab for the next six months so I can get back to doing everything I want to do, including returning to Africa, d*mn it.

If this had happened to you, would you go back to Africa?