Africa: A Calamity

Not good

We thought with Caty’s lost luggage we had had our trip disaster. Well, not quite.

Our last night at Karongwe Private Game Reserve, we came back late from our game drive and rushed to the Lodge for dinner. When we got there, we discovered that the dinner was going to be outside in the Boma (a boma is a livestock enclosure, stockade or corral – basically a round area with stick walls).

The chairs were somewhat wobbly and I was deeply concerned about my cameras falling or getting dirty. Just after I placed my cameras at one of the extra chairs at our table, Caty’s camera fell off her chair. So, I decided to run my cameras back to our tent.

Bad plan.

Caty gave me one of hers. I had my full-frame with the shorter lens in a bag and the other two on straps on my shoulders.

I took off in a hurry because I knew dinner was starting shortly.

At Karongwe, you are not supposed to walk to your room at night without an escort (there are wild animals around). But, the escort was not at the reception area or the beginning of the sidewalk and my tent was very close (I could see it easily).

So, I headed up the sidewalk, which went up and then down a slight (very slight) rise before the trail to my tent. As I was barreling along (watching the sidewalk), I was wondering if I should have waited for the escort and I looked up briefly to survey the area for animals. That’s when my foot caught the lip of the sidewalk seam.

I started pitching forward and – I guess because of the decline in the trail and the weight of everything I was carrying – I started gaining rather than losing momentum as I tried to stop. I was certain I could stop, but I just keep going faster and then I pitched forward. I twisted to the side to avoid hitting the sidewalk and I hit the ground – hard. I landed on my bag and Caty’s camera went flying out of my hand. I screamed – mainly in surprise and anger that I had fallen.

This is a daytime view of the scene of the crime from my tent balcony

I was panicked about the cameras (and spiked with some adrenalin). I raised up and as I touched the back of my left hand, I felt what I thought was a flap of skin on the back side of my pinkie finger (I assumed it was a cut). I looked down at my hand, which was a bit bloody and it looked as though I was missing about a half inch of my finger. Then, I saw that it was bent backwards at a 90+-degree angle and it appeared that the bone was sticking out.

For some reason, my panic manifested itself in a need to get to my tent. I rapidly gathered up everything and started running toward my tent.

I had fallen right behind Guillaume’s tent and he rushed out immediately (I think he thought I was being attacked by an animal). He was in his tent because he had come down with bronchitis (I felt bad to disturb him as he was trying to recuperate). I kept saying that I had broken my finger, that I needed to go to the hospital and that I was worried about the cameras.

When I got to the room, I sat down and started shaking as blood dripped (not gushed, just dripped) from my pinkie (the gashed and broken one), my ring finger (which looked like it might be sprained and was bleeding around the cuticle) and my pointer finger, which had a small cut. My rib hurt and my knee hurt slightly, but neither was scraped. Later, I also had a sore jaw with a big bruise on it. My knee still hurts a little.

Guillaume left to get a first aid kit and tell the group I was injured. While he was gone, I did the smartest thing (maybe only smart thing I did in this) – I took off my wedding ring. I figured if I waited any longer, they would have to cut it off. It will be interesting to find out if it will ever fit again.

Becca got there first and, knowing she is squeamish about blood, I wouldn’t let her look. I wouldn’t let Caty look, either (and that’s odd because she isn’t squeamish) and I couldn’t bring myself to look.

Linda and Caty arrived and Guillaume splinted my finger and started preparing to go to the hospital. Then, Linda suggested we check to see if there were a doctor at the lodge (game reserve … doctor … makes sense). Becca when to check and there were actually three! 

Bandaged

Turns out the one who came to treat me was an 82-year-old psychiatrist! 

But, he washed my finger (in South African water -- and I had been brushing my teeth with bottled water!), splinted it and said he didn’t think it was broken (he thought it was an evulsion) and that I didn’t need to rush to the hospital. I didn’t really want to go to a Bush hospital, so we agreed that we’d got to a doctor the next day when we got back to Johannesburg.

In retrospect, the psychiatrist must have had a diagnosis about me – I spent the entire time he was taking care of me apologizing for hurting myself.

As for the cameras – I broke the hoods on both of my cameras, but there didn’t seem to be any other damage. They are still working fine and I have replaced the hoods (sort of -- the new one on my small camera keeps falling off). Caty’s card door had popped open and may have gotten dirt in it. But, she got it cleaned when she got home and everything seems fine. Whew!

We also discovered that I broke my prescription sunglasses (actually the frame, but the lens wouldn’t stay in).

I iced my hand, took some Ibuprofen and slept (somewhat). I thought I would have terrible pain, but I didn’t. I thought I would have to miss the morning game drive, but I didn’t. 

Gotta keep going

I just cut down to one camera – which I regret because we saw the Leopard and I might have been able to get some better pictures. 

Leopard!

I also started worrying about infection, so I took one of the Cipro tablets I had with me.

I made it through the day pretty well. I was a bit sore, but not too bad.

After the game drive, we left and headed to Johannesburg, which is about a six-hour drive. Guillaume called Soeki and made arrangement to go to a clinic she recommended as soon as we got there.

We drove quickly back to Johannesburg and went straight to the clinic rather than going to the guesthouse first. We were supposed to be staying back at the Malikana, but they had a large group there, so we were staying at another guesthouse.

The Medicross Medical Center Clinic was in a mall. Linda and Guillaume came in with me and the rest of our group stayed in the van. Guillaume seemed a bit worried about their safety and instructed them to stay in the van with the doors locked! Unfortunately, no potty break after the long drive.

The “sisters” (they still call nurses “sisters” in South Africa) saw me first and acknowledged that it was a nasty wound. Then, I went X-ray and the doctor came to see me. He showed me the X-ray... 

X-rays

...the entire end of my finger was broken clean off (I was right and psychiatrist was wrong) ...

Snapped off

What he said next floored me!

He suggested that I change my plans and immediately fly home to get my finger attended to. He said that if I didn’t treat it right away that I could get an infection, perhaps a bone infection that could endanger my health or lead to amputation. What???? It was a broken pinkie.

I really didn’t want to fly home immediately. 

Victoria Falls

Well, actually, I didn’t want to have to deal with British airways to change my ticket. I mean, those people are difficult. 

Plus, we were supposed to go to Victoria Falls the next day and Victoria Falls was supposed to e spectacular. I hate to miss any chance for spectacular.  

Plus, I knew it would be distracting for the rest of the group if I had to change may plans.

So, we discussed it further and decided that we would go to the hospital and have an orthopedist look at it. I decided that if surgery was needed, I would rather go ahead and get it in Johannesburg. Then, I could skip Victoria Falls, stay in Johannesburg until the rest of the group got back and then fly home on my original flight. We also agreed that Linda would stay with me if I needed surgery. I felt pretty rotten about it.

Guillaume arranged for us to stay at the Malikana if I had to stay for surgery -- at $40 per night! I told you South Africa was inexpensive.

So, we rushed to the guesthouse and dropped off the girls. I packed an overnight bag (Guillaume said that, in South Africa, you stay overnight before day surgery -- so, is it really day surgery???).

The hospital

We drove about 30 minutes over a super highway (I got to see the modern city that Johannesburg is) to the huge, exceptionally busy Unitas Hospital. 

I figured that I would be in for a long wait (I mean, when is an ER wait ever short?). 

And, poor, sick Guillaume had driven all day and was miserable  with his bronchitis – what a trooper.

But, I hardly waited at all. They took me back almost immediately and Dr. Neville Vlok (young, red hair and beard, blue eyes, very handsome) came in to see me.

I told him that my ideal scenario would be for him to fix me up so I could go on to Zimbabwe and my second-best scenario would be surgery in Johannesburg. He said that I would be fine to go to Zimbabwe. What a relief!

Then, he anesthetized my hand and cleaned out the wound and glued the nail base (he said there wasn’t enough tissue left for stitching). He gave me prescriptions for antibiotics and pain medication, which we picked up at the hospital.

Before we even left the pharmacy, the anesthesia started to wear off and it hurt. That’s about the worst pain I have had so far.

Back to the guesthouse and then we went on with our tour.

Nice!

And, now, I will get political. South Africa has government-assisted healthcare. My total cost for the visit to the clinic, the X-ray, the procedure at the hospital and four prescriptions was $221. Yes, $221! And my travel insurance paid for it. In the U.S., the X-ray alone would have exceeded that.

It just gets worse

Now, then, what’s the rest of the story? Well, it ain’t over!

I asked Scott to set up an appointment with an orthopedist for as soon as I got back. Instead, he set up an appointment with my regular doctor’s office (he thought they needed to refer; they don’t). It was supposed to be at 8:00 a.m. the Monday after I got home with “Carolyn.”

Anyway, we got back on a Saturday night and I thought it was odd that the appointment did not show up on my healthcare portal, but there was nothing I could do. 

When I got there Monday morning, they had no appointment on the books and they told me that Carolyn no longer works there. We still have no idea who Scott talked to.

At this point, it had been almost a week since I broke the finger and I was getting worried that it wouldn’t be reparable. They got me in at 11:15 a.m. and the doctor I saw told me that I needed to see an orthopedist right away (duh!). He also told me that my ring finger needed to be splinted immediately because it had a mallet fracture – the thin tendon that straightens the end joint of the finger was torn. Notice the injury on that finger (it's just a little blur) ...

Two bad fingers

This kind of injury is also known as "baseball finger," and happens when an unyielding object (like a ball – or, in my case, the ground) strikes the tip of a finger or thumb and forces it to bend further than it is intended to go. As a result, you are not able to straighten the tip of your finger or thumb on your own. Treatment is splinting for 6-8 weeks.

They told me that the only orthopedist who could see me right away was Dr. Karl Larsen and informed me he was out-of-network for my insurance. I thought my insurance paid a lower rate for out-of-network. Turns out they pay nothing and do not apply anything to the deductible! That’s what happens when your policy changes every year.

I was on the phone with Blue Cross the entire time between my appointment with my regular doctors and my appointment with Dr. Larsen. One person said I just needed to prove it was an emergency; another said no way; a third said that she only handled California. Most of the time I was on hold. Later they denied charges and now I have appealed that decision. Luckily, Dr. Larsen gives substantial discounts for upfront payments. Had things gone as expected – it would have cost me less out-of-pocket than had insurance covered it because I have a high deductible.

But, things haven’t gone as planned.

The very next day, Dr. Larsen operated on the finger, putting a pin down through the top of the finger to hold the bone together.

The pin

For a short time, I had a massive bandage/splint.

Big bandages

It didn’t hurt too much, but it was kind of freaky to have  ¼” of pin sticking out of my finger. 

My insurance company called me to discuss my options as I was leaving surgery. That was timely!

Ewwww

The doctor gave me antibiotics, but two days after the course of medication was completed, my finger started to look infected. 

So, I went back in and they took another X-ray, which showed significant bone erosion, suggesting bone infection. The South African doctor was right!

Dr. Larsen removed the pin (just pulled it out with pliers – that was weird).

The next day, I had surgery again and they took cultures. Turned out that I have MSSA (Methicillin-Sensitive Staphylococcus Aureus), a serious but, fortunately, treatable infection.

So, next, I had to see an infectious disease specialist (Dr. Elizabeth Kleiner). The treatment – six weeks of daily intravenous antibiotic infusions. So, I had to go to the hospital to get a Mid-Line put in my arm (the other arm!). Then I went for two weeks of daily infusions. They took the Mid-Line out Oct. 24 and put me on oral antibiotics for my trip to Europe. When I get home from Europe, I will get a PICC Line (larger than a Mid-Line) and have four more weeks of antibiotic infusions.

That should fix the infection! Then, I have to wait a few months and have another surgery to fix my finger (which is just wobbly right now because the bone isn’t attached). It will probably require a bone graft.

Sooooooo ……. There you have it.

Oh, and, so far, this has cost me (actual cost) over $6,000. Yep, more than the trip to Africa!

Did I say I support universal healthcare?

Or that I go on Medicare in five months. Too bad this injury couldn’t wait. 

Addendum: Completed the IV antibiotics and am in physical therapy. Spent $8,200 so far.

Plus, turns out my lens was broken, just took awhile to fall apart. Not repairable. I got a full refund and just ordered a new lens for a couple of hundred more dollars and a new insurance policy on the new lens.

NEVER FALL DOWN!!!

Trip date: August 25-September 9, 2017