Bone Isotope scan!

Well, today was the day of my bone isotope scan.
I was a little nervous, but grateful that after this scan i would know for sure what needed to be done to me!
The bus dropped me at the private clinic where i was to have my scan and i headed up to the doctor...sorry, correction...nuclear physician's office, for my scan.
I was asked to lie down and they injected me with the substance in my right arm. It was luckily only a needle full and didnt hurt too much.
I was asked to return in a couple of hours, so i headed off for sum breakfast down the road.
When i returned, i lay down in a machine not dissimilar to an MRI machine.
I lay still while the machine slowly spun around me and took images of my lower body.
The whole procedure took about an hour, and then i was on my way.
Or so i thought.
I had the bus drivers number to call when i was done, so i gave him a call and he said that he was on the road back to where i had come from, 2h away, and that he would get another bus or ambulance to pick me up.
After 3 more phone calls over the next couple of hours, he eventually returned back to pick me up 3h after my original call!
Then i was off to the provincial hospital to get my file. They had to phone up to the orthopaedic section to let them know i was coming as it was already so late in the day.
When i got upstairs, i sat and waited another 2 hours before the specialist i had been seeing all along came walking up to me with another man. He introduced us, and he turned out to be the head of the orthopaedic department.
We went into the consultation area and he pulled out my scan results and put them up on the xray viewing machine.
The scan showed up that there was still action around the fracture sites, which meant that the bones were still healing. He told me that bones can continue to heal for up to 2 years, so based on the scan, he would not recommend another op before that period is up. This would only be in October next year. And obviously only if the bones still weren't grown back together by then.
The other area of the scan which was just a big blotch of activity was the knee!
He said that this indicated that the knee was extremely unhappy, which is why i am experiencing a lot of pain in that area.
He said that until they go in and see what is the matter they would not be able to do anything about it.
So, with my knee scope already booked in for March (thank God, as the new date had it not already been booked earlier, due to demand, was only in May!), all that was left to do was strengthen the quad muscles as much as possible before the op.
He told me that normally he would want the affected legs quad muscle to be 120% of the good leg's strength. At the moment i can just about lift my leg straight form a bent position, but i am sure i could lift more were it not for the pain in my knee.
He said that it was a bit of a catch 22 i was in as i needed to exercise the quad muscle even though the exercise meant hurting my knee!
We also checked my blood tests and they were perfect. He said that he had never seen an infection reading as low as mine. Everything was great.
So, basically what needs to happen is that over the next 3 months up to the 5th March, i need to work on my atrophied quad muscle as much as possible in order to get it ready for the op which will immobilize it again for possibly another month or more.
I have done a bit of research online and have found that an electric muscle stimulator might be very helpful for my quad muscle as it could exercise the muscle without the need for me bending my knee.
I have found one online and am in the process of ordering it.
So, another visit to the hospital and another different diagnosis!
At least this one is based on the scan, and not some doctors hearsay.
Apparently the recovery period after the scan is 3-4 months, so this would mean that all things going well, i will be walking by June/July 2013...
But i wont know for sure what the outcome will be before the scope in March. I am still very optimistic that the scope will rectify the problems with my knee, and that come the middle of next year i will finally take my first steps!

Round & round we go...!

So, today was meant to be the fitting of my orthotics.
So i thought.
It was another long day, but at the end of it, i hope, a faint light at the end of this tunnel?
It all started with collecting my file and heading up to see the orthopaedic section.
Wednesdays are crazy days at the hospital! About double the number of people i have been used to on a thursday.
Eventually my name was called and i headed in to see the guys for my fitment.
The first thing the doc said to me was to ask me why i was wearing a knee brace?
I replied that it was for lateral support for a torn LCL ligament. He asked when the accident was, and i told him, 14 months ago. He shook his head. Then he asked me how long i have been walking for. I told him i haven't been able to put any weight on my left foot for the entire 14 months because of the pain.
He was astonished.
He said that this was impossible. I should have been walking after 6 months!
He asked me to get up on the bed and take off the knee brace.
He preceded to push and pull and twist my knee in all directions, causing a helluva lot of pain! I am pretty sure the other side of town could hear my screams!
He tested the knee for lateral laxity in the MCL and LCL ligaments, and told me that they were normal. The LCL was a little lax, but this was still acceptable.
So, what this basically meant was that the LCL ligament was ok. It had repaired itself over time. The problem lay elsewhere...!
He told me that often he would get people come see him complaining of knee pain, and the result of the pain was the hip or somewhere else.
He said pain transferal to the knee was a common thing.
He asked his colleague to come in and make sure of his findings, and he went thru the same procedure of twisting and pushing and pulling!
More screams of pain!
He was amazed at how much pain i was in from even the slightest touch.
He immediately booked me in downstairs for a full set of xrays from head to toe.
So off i hobbled down to radiology.
2h later i was sat back with the othro guy and we were looking over the xrays...
Neck - perfect.
Spine - pristine.
Hip - brilliant. Very happy with the fracture healing. Perfectly mended.
Femur - erm....not great...possibly a non-union...!
Knee - looks fine.
Tibia - wow...what an ugly job! Possibly a bone infection as well!!
Lovely news!!
So, what it all boils down to is that my femur may not be grown back together where it was repaired, which could be resulting in pain when the leg is limp and the muscles arent supporting it, which seems about right.
Also, the tibia bone didn't look very healthy. It wasn't nice and white and solid. It was looking a bit like a piece of cheese! A bit mottled! Not good at all!
And the repair job on the tibia apparently was not good either!
I was sent for blood tests to ascertain whether or not i had an infection to the tibia, and was told that he wants to operate on the tibia again. He would need to open up the knee again and move it over, bang the nail out, clean out the infection (if there is one), ream the inside of the tibia, and then insert a new nail down the shaft of the bone.
The femur would need to be done in the same way if a non-union was found! They would need to cut my hip area open again, bang the old nail out, ream the bone, and insert a new nail.
I am booked in for wednesday next week for a bone isotope scan, where they inject a mildly radioactive substance into you intravenously, and a couple of hours later, once the substance has distributed itself throughout your body, you are gamma scanned for abnormalities.
Basically though, it will tell if there are any problems with the bones, including non-union and infection.
Based on this scan and on my blood test, i may have to undergo surgery to both the femur and tibia fractures all over again!
I will know for sure on wednesday what the prognosis is, so will update again then...
I cant believe that the specialist i have been seeing until now could have missed this?!
Thank God the guy i saw today knows what the hell he is doing!
So, after 10 months of wondering why i am not walking yet, i now may find myself under the knife again for a complete do over of the original op 14 months ago!
Not exactly the news anyone would want to hear, but i consider it a step in the right direction (excuse the pun) nonetheless!
Here's hoping for positive news next week...

Ligament Tears, Orthotics & Scoping!

To say it was a fantastic visit to the hospital today would maybe be a bit of an exaggeration.
I suppose that i can say that i walked away at the end of the day with good news, but still not completely over the moon just yet...
The day started with the customary trip to the physio first, and he told me that i needed to add a few more exercises to my routine now.
I spoke to him about the instability in my knee, and that, after some research online, i thought that it may be related to the tear of the LCL that i sustained.
I asked him if there were any exercises that i could do to strengthen the LCL, but he explained that the LCL is a ligament made up of fibrous tissue, and therefore it cannot be strengthened like a muscle can.
The only way to fix it would be to strengthen the other muscles in the leg, notably the quad muscle, in order to take the strain off of the LCL and let it repair itself over time.
These kind of tears (mine was a Grade II, a severe tear, but the ligament still intact) can take years to completely repair themselves, as they grow back very slowly.
I also asked him about the difference in my leg length, which has been a bit of a worry of mine as well.
He got out the tape measure and measured from the tip of the hip joint, to the inside of the ankle, in a straight line. He did this both sides, and told me that i have a difference of 3cm. 2cm is the accepted difference, and anything over that would necessitate getting orthotics so as not to mess up the spine, hips and knees in normal walking posture.
He told me to chat to the orthopaedic specialist about this as well.
He also told me that it was possible that a knee brace might help in the lateral instability that i was feeling in my knee.
Then it was off to the ortho specialist to see what he had to say.
Unfortunately it was a pretty busy day and i could not see the guy i normally see, so it was a new doctor today.
I explained what the story was, and he took a look at my file.
He sat me on the bed and also did the leg length measurement, and told me that he would book me in to the orthotics clinic they held every 3 months at the hospital, and that they would custom make me some inserts for my shoes.
I told him that i was experiencing some popping and grating noises in my knee whilst i was doing my exercises, and he told me that he would have to do arthroscopic surgery in order to ascertain what the problem was. More than likely it was due to the tear of my meniscus though.
In the MRI i had, it was indicated that i had a small medial meniscus (the schock absorber material under your kneecap) tear.
He said that they would do keyhole surgery, and drill 2 small holes in my knee, 1 on either side of the knee.
They would insert a camera in the one side and the tools in the other side.
I will have to stay over for 2 days, as there is apparently a lot of bleeding involved wit this type of surgery, and they can only release me when the bleeding subsides to an acceptable level.
I asked him about the LCL tear, and he said that even if it was a level III, which is a complete rupture of the ligament, they do not do the surgical repair on the national health system. I would have to have it done privately!
He said that even professional rugby players have recovered from severe tears to the LCL by strengthening to the quad muscle to such a level that it takes over the function of the LCL and lets the ligament repair itself.
So the diagnosis for recovering from the pain i find myself in, and being able to walk again, is to strengthen my quad muscle to super strength.
I asked him how long he would expect this to take, bearing in mind that i can only just lift my leg from bent to straight at the moment. 6 months minimum was the answer!
Some more prescriptions of pain killers and anti inflamatories, and i was on my way again.
The orthotics clinic is booked in for the 5th December, and the next available date for the keyhole surgery is the 5th March.
So until then, its gonna be the usual exercises, with the new ones added by the physio, and a lot of quad exercising.
On a personal note, it was disappointing to be told that i will have to exercise for at least another 6 months before i can hope to be walking again, but if i look at the positive in my visit, i will be getting inserts for my shoe that will make the walking process better, i will also be getting surgery to repair the tear to my meniscus, and i now know exactly what i need to do in order to relieve the pain to the lateral part of my knee.
So, like i said, all in all, today was a pretty good day....!  8)

ITB Treatment...

For any of you reading this who might be wondering what exactly those stretches and strengthening exercises are for the ITB, i attach a copy of them below. I hope you can read it ok?

1 week into my new program, and i am happy to report that no new delayed muscle pain has arrived!
However my knee remains painful to lateral movements and weight bearing.
I have noticed muscles appearing in the Vastus Lateralis area, the lateral side of the lower quad muscle. This muscle seems larger from doing the Figure 4 exercise to strengthen the Hip Abductors and Lateral Rotators.
It is a hectic schedule of physio, as i have added in hamstring strengthening, quad stretches, Vastus Medialis strengthening, calf exercises, and ankle/achilles stretching as well as the exercises listed.
The entire session takes me about an hour to get through, and i have set myself a program of doing mornings, after lunch, and again before bed in the evenings.
A 6 day exercise week, and a sunday to rest.
I'll report back how things are going in a week or so.
Good luck to all of you in the same boat. Not much fun, but there is always light at the end of the tunnel...eventually...
;)

Physio physio and more physio...

The last month of rest started off frustratingly, as the injection that i was given did nothing to relieve the pain, and the sensitivity i was experiencing was exactly the same as before.

In fact, i didn't notice any improvement until 3 weeks after my last visit!

Slowly i started to feel as though my leg was a bit more stable and my knee a bit more "solid".

The pain was still there, but at least not with every little movement!

I did try and do a few strengthening exercises towards the end of last month. Literally only 5 minutes or so.

2 days later i was in agony with muscle pain!

My quads were SO sore, and even standing up or sitting down was extremely painful.

2 days on and i awoke to a pain free quad! Very strange indeed!

So, last thursday my next appointment with the hospital arrived.

Just for interest sake, wednesday was the 1 year anniversary of my accident!

I caught the bus through, and by the time i had collected my file from reception (a 3h queue), it was time for my physio appointment.

I spoke to my physio about feeling a bit stronger, and also about the quad pain i had experienced.

Apparently it is called delayed onset muscle pain. Appears around 24h after doing strenuous exercise and lasts for about 48h!

He told me that he had just done a course and in the course they discussed ITBS!

He printed me out some sheets from his course explaining ITBS and also exercises for it.

I was surprised to find out that ITBS is not a repetitive strain injury as previously thought, but is caused by other muscles acting or not acting on the ITB.

Your Gluteus Maximus and Minimus and various other muscle groups influence how your ITB is stretched by acting on it depending on how strong they are. If one or more of these muscles are weaker, then the pulling forces are incorrect and create pain in the anterior part of the knee.

The remedy is to strengthen all of the muscles associated with the ITB to the correct degree, and the pain should go away.

On the memo were 3 exercises on stretching and strengthening the Gluteus Maximus, Hip Adductors and Hip Abductors.

Apparently doing these exercises 4 times a day, 6 days a week, for 6 weeks, is considered the minimum time period to strengthen them all sufficiently to relieve the pain.

I asked him to make a rough estimate of how long he thinks it will take me to walk again. He said a conservative estimate would be 6 months!

So, armed with this information, i headed off to the orthopaedic specialist to see what he had to say.

We discussed the injection and he decided against giving me another.

He said that another month of rest for my knee was to be had, but told me that various areas of my leg were very weak and needed strengthening.

My ankle also had nowhere near enough range of motion in it for walking, so i was given stretching for my achilles tendon as well.

He told me to do all my stretches and strengthening and return in a month to see where we are at.

So, now its down to me to get busy with a LOT of exercises to try and sort my knee out.

There have been times in the last year where i have been adamant that i needed another operation to fix the pain in my knee, and there have been times where i have gottten angry and cycled my ass off to try get there quicker. But all, to no avail.

I have now kinda made peace with the fact that a lot of hard work is necessary on my behalf to physio myself back to health.

I (hopefully) now have a list of exercises that if i stick to, will give me some relief and hopefully get me walking again.

The next month will be a telling one...

1 Year Anniversary!

Today is exactly 1 year on from the accident....

2 steps forward, 1 step back (excuse the pun)!

Well, another month has passed now, and i find myself back to rest, rest, rest...

The cycling went as i wanted it to, pushing my rides up to some days, 15km in a single cycle. Around an hour on the bike. My knee would start off sore in the first few minutes, and then warm up and i was able to get into a nice rhythm, but then usually, the pain would return and the knee get really sensitive around about the 45min mark.
In the end, after 3 weeks, and 240km cycled, i was forced to abandon the bike as my knee became really sensitive and painful even when not on the bike!

It was a big blow to my hopes of what last month could possibly hold in store for my recovery, but also forced me to go back to resting my leg again and see if i could relieve the pain.
This turned out to be somewhat of a blessing in disguise.

After a week of icing my knee and resting it during the day, with no exercise at all, i found that the pain was slowly dissipating. I decided to try some of my physio exercises on strengthening the knee. This once again sent my knee backwards in pain-ville, and i abandoned this as well and returned to total rest.

I decided to give the hospital that had been treating me a call and set up an appointment for yesterday. It was a month earlier than when i was supposed to be heading through to see them, but i needed some clarification on what was wrong, and how to proceed.

I have done a lot of research online throughout this adventure, post op, and i found a girl on an injury blog that was experiencing much the same symptoms that i was. I got chatting to her, and it turns out that after 2 years of exploring possibilities, a specialist diagnosed her with Iliotibial Band Syndrome, or ITBS for short.
It is a repetitive strain injury usually causing pain around the fibula head and anterior part of the knee. It can also be brought on by high impact injuries to the tibia/fibula/femur/knee.
The normal treatment is RICE - rest, ice, compression, and elevation.

I had long suspected that this might be the cause of the problems, but had been told repeatedly by my physio that i just needed to strengthen the surrounding muscles and i would be fine.

After my correspondence with her, and my personal experience on the bicycle, i was now more convinced than ever that this is what i was experiencing.

I called the hospital and setup an appointment to see the physio and also the orthopaedic specialist.

Yesterday was my visit, and i arrived and collected my file from the reception and headed up to see the physio.

He lay me on my back and checked range of motion and twisted and turned my knee, which produced quite a lot of pain. I chatted to him about what i thought the problem to be, and he seemed to agree, but stated that i needed to stretch out my quad muscles as they were very tight. He said that they were a bit better from when he last saw me, 5 months ago, but that they still had a long way to go, and that until i had them fully stretched out, there was no way i could exercise them properly.

He told me to use a hot water bottle on my quad and outside of the leg, where the ITB runs down from the glute muscle to the side of the knee. I was to warm the area up, and then to take a hard ball, like a tennis ball, and run it up and down my muscles and ITB, trying to release the tension in the muscles.
After i had done this for a while, and i could feel that they were more pliable, then i was to do stretches on them.

The best stretch for me for my quad area with the pain associated with my knee, is to lie on my stomach, and bend my injured leg as far as i can towards my backside, and then to take my good leg and wrap it around my injured leg, and force it as far as i can, further towards my backside. This produces a stretch in the quad area of my injured leg. Hold this for 30s, and then release to both legs lying straight out on the floor. Then repeat this another 2 reps at least.

For an ITB stretch, the best method for me is to sit cross legged, or as close as possible to this position as my injured leg allows, with my left (injured) foot over my right knee, and then to lean my upper body forward , and at the same time use my left hand to push gently down on my left knee, towards the floor. This produces a stretch that you will feel in your left ass muscle (gluteus), and possibly down the side of the left leg as well (which is where the ITB runs).

He heated up a bean bag in the microwave, and put it on my leg, and after it had warmed my muscles up, he did some deep massage on my quad and ITB. It hurt like hell when he pressed in with his thumbs, and this was without much pressure even being asserted! I realised that it is gonna take a while to totally stretch these muscles out.

Then it was off to see the orthopaedic specialist.

I chatted to him and told him about the continued pain in my knee and the biking i'd done, etc, and he sent me off for xrays of the knee to see if he could see anything unusual.
The xrays came back and we sat and looked at them and he said that my knee looked perfectly healthy. He was very happy with the healing of the bones, and also mentioned that he would not recommend taking the tibial nail out, as it was seated perfectly in the tibia, and would only cause a lot of damage to my knee were i to remove it.

He told me that he thought that possibly i might have ITBS. This was brilliant to hear, confirming my unprofessional opinion on things.

He said that he would give me a cortisone injection in my knee to relieve the inflammation, and help with the pain, and that for the next month i was to take it easy, and not do anything too strenuous on the knee.

So, like i mentioned earlier, i am now back to rest and recuperation.

In a months time, i have another physio and doctors appointment, and they will reassess the situation and see if the ITBS treatment has worked. If so, we can then move on to strengthening exercises again, and hopefully walking in the not too distant future! If the treatment has not helped, then they can at least cross ITBS off the list of possible causes of the pain, and we can explore things further.

I dont think that i could of hoped for a better visit to be honest. I am just a bit frustrated that it has taken 5 months of struggling along, only to find out that i need to go backward in order to possibly go forward again! At least all the strengthening exercises have not been in vain. I can certainly feel that i have a lot more muscle tone in my leg, so therefore more to work with when i do finally get back to strength training.

For now, stretching and rest.

And hopefully good news in a months time.... 8)

Biking my way back to health...

Well, its almost 2 months further along now, and not a lot of progress unfortunately.
I suppose i blame it mostly on the exams i have been studying for...I've been pretty much housebound, studying and going over past exam papers for about 6 weeks leading up to my final exam on the 31st July.
So, not a great deal of exercise for my leg.
On the way back from my final exam, i picked up an exercise bike that i found cheap on the internet. Until now, i had been doing sporadic rides on a bike at my grandfathers retirement village, but this had dwindled to less than a ride a week.
Since the 1st August i have ridden over 70km now, with training rides of 10min to start with in the mornings, and then again in the afternoon.
I did this for the first few days, and have since upped the time spent to 25min rides in the morning and afternoon. Trying to keep an average speed of around 16km/h or so.
My knee is sore still during the cycle, but i just push through it, knowing that in the long run i cant be doing myself any harm.
The other day on one of my rides i heard a loud squeaking coming from the bike under me, so i decided to open her up and see what was wrong. The bearings were short of grease, and after a thorough service, she was back to new again!

I've gotten back into a routine of doing my physio exercises i researched on the net, as i had stopped this about 2 months ago due to exams, etc...maybe laziness...?
It is hard sometimes to push yourself to go through the exercise program as it takes about an hour, and you don't feel like doing it every day!
But, i've gotten back into it now, and that, coupled with the cycle twice a day, and also walks in the car park, and around the block when i need a change of scenery, are seeing me slowly getting stronger.
It is a very frustratingly slow recovery from these injuries, and i constantly see the amazement on people's faces when they ask me how long ago the accident was, and i tell them, and they ask why i am not walking yet?
But i have come to terms a while ago with the fact that it will take as long as it takes, and i just need to get on with it and make it happen.
I still think that in 2 months time when i go back to the hospital for my 1 year post op visit, i will ask them to get this rod out of my shin and see if that improves the pain in the lateral side of my knee.
It is something that seemed to go away to a large extent for the last 6 weeks or so, but also i had not been doing much exercise in that time.
Once i started exercising my quads and other muscles again, the pain returned, sometimes as bad as it was 3 or 4 months ago!
I am putting this down to the fact that as the other muscles work to get stronger, and are sore after their workout, they relax a bit more than usual, and this leaves the knee more susceptible to lateral movement, and hence the pain returns.
I'm not a doctor, but this seems to be the case anyway.
I have set myself a target that i will be walking with a cane at the least by the end of this month, but i am not sure if this will be attainable?
I will see how the rest of this month goes, and give it my best efforts, but, at the end of the day, it is what it is. It's baby steps all the way...

Leaps and bounds (excuse the pun)...

Another 3 weeks on, and another physio appointment later.
The last 3 weeks i have not been in a regular exercise pattern as i have been helping mates with work, and also studying for some exams i am writing the end of next month. Maybe coupled with a bit of laziness, but the amount of exercise i am getting when i am up is quite substantial anyway.
My knee is a lot more stable now, and the sideways movement is not as painful as before. My leg is also a lot stronger too. I am easily able to lift my leg in all directions now. Sitting on a chair, i find it easy to lift my leg to straight out in front of me and hold it there for half a minute or more, whereas before i was battling to lift it at all.
I am really encouraged by how far i have advanced in the last month and a bit since my last physio visit, and i know that give it another 5 weeks or so and i will see another leap forward in strength and mobility.
My knee flexion is now at about 100 degrees, so that is good. It seems that as the quad muscle and hamstrings are strengthening, the range of motion is also coming back.
I am still not load bearing without crutches, but that is only because of the pain in the anterior part of my knee. The same place i have had pain all along. Around the head of the fibula.
Today at the physio, i asked her about this, and she told me to sit with both my legs straight out in front of me, lifted in the air, and to try point my toes as high as i can. To try pull my toes towards my shins to paint a picture.
This pulls the shin muscle and it runs all the way up the outside of the leg, past the head of the fibula.
Well at least it does on my good leg. Not quite on my left leg yet though. The muscle in my left leg is a lot bigger and stronger, but apparently the lack of muscle in this area is the reason that i am still getting knee pain here.
So i have been given exercises to strengthen this.
As mentioned, to try pull my toes upwards towards my shins using just the muscles, not with my elastic bands or anything else, and to hold it stretched in that position for a count of 10 or 15, until the muscle burns. Then to release, relax, and then repeat for a set of 15.
Another exercise i was given to strengthen the knee and get it ready for weight bearing, is to lie on my back and bend my knees so that my feet are flat on the floor as well, forming a 90 degree bend.
Then to push my hips upwards, off the floor, and to hold that position for a count of 10, then relax, and repeat 15 times.
When this becomes easier, to do the same exercise, but to cross my right (good) knee over my left knee, and lift the hips then, so that all the weight is now only on my left leg, and repeat as before.
This will strengthen the knee and also the quads.
I have also taken to riding an exercise bike now. It is good to get the knee going through its range of motion, and will help strengthen my quads and calf muscles as well.
So, back to the exercises for another 5 weeks or so, and we will see how i am feeling then.
Not too much longer now and i will be able to say goodbye to my crutches for good!

Ups & Downs

Well, its another 3 weeks on now, and i am starting to feel a little bit stronger.
One thing that i wasn't aware of with my recovery process would be the pain involved as the muscles started to come back.
After my last trip to the physio, i was told that by the 2nd week of June (5 weeks later), she wanted me full weight bearing on my injured leg. She also said that i would start doing lunges and standing on 1 leg and balancing.
So, armed with this information, i went back home and did twice the amount of exercise that i would normally do in a day.
The following day also happened to coincide with a bit of work that i had to do, running through for the next week.
When i woke up in the morning, i could feel that my leg was pretty sore. The muscles were screaming at me, and were very tight.
I soldiered on through the day, hoping that the following day the muscle pain would lessen somewhat.
It didn't.
I stopped doing all my exercises, and just tried to rest my leg each day when i got in from work. I was also on constant pain killers throughout the day in order to make it to the evening.
The pain was located mainly in my quad muscle, and felt like a torn muscle. Very sensitive to the slightest movement or question being asked of it to do some exercise.
Even rolling over in bed was so painful that it woke me up, which made sleeping through the night impossible.
The last 2 weeks has been without exercise now, but i am finally at a point now where i have begun my walking exercises in the car park again.
My knee certainly feels a bit stronger, and the muscle pain is still there, but bearable to do light exercise again.
Tonight i will get back into my exercise routine.
The range of motion of my knee has remained constant at about 90 degrees, but i have not been stretching for the last 2 weeks, so i haven't tried to extend that as yet.
My quad muscle is still very tight and knotted, and i have bought sum Arnica oil with Deep Heat infused in it, for massage every evening to try and break down the muscle tightness so that i can start stretching it again.
It's only 2 weeks til my next visit to the physio, but i certainly wont be at the point she suggested by the time i see her.
But, although i have been through a lot of discomfort over the last few weeks, the extra strength and stability i can feel in my knee gives me great encouragement that i will be back to walking again before the end of the year...

3 weeks in...

Well, its been about 3 weeks or so now since i officially started my physio program.
Lets get this straight though....my use of "physio program" involves me doing an exercise program that i largely put together on my own from info on the net.
I suppose the normal use of the word would involve going to a physio and actually having a professional go thru a program with you for about 45min to an hour each visit.
Anyway, i dont have the cash for a physio program in the true sense of the word, so let it just mean "home exercise" from now on...
In the last 3 weeks there have been ups and downs in my workouts.
In the beginning i was struggling a lot with some of the exercises. Simple things like lying on your stomach on the floor, legs straight, and lifting my injured leg off the floor keeping it straight, and holding it for 2 sec before returning it to the floor.
It sounds really simple, but the Gluteus muscles involved were so weak that i could not even lift my leg no matter how hard i tried or focused.
Now, i am happy to say, i can do this exercise with relative ease.
My knee is still giving me a fair bit of pain, but i think that either i have become accustomed to the pain and am taking it more in my stride, or it is not as acute. The frequency of pain is still around about the same, but i am beginning to realise that this is certainly not going to be a short term thing to get back to full health again.
Where my leg was giving me pain only in the exterior/lateral side just below the knee, at the top of the fibula, before, it is now painful just about everywhere, especially in my quad muscles.
This may sound like a bad thing, but i have concluded that it is actually very good news!
Just like exercising any muscle in the body, after a gym session, possibly a day or so later, the muscles are sore and stiff. This is the same pain i am experiencing in my left leg.
But this makes a lot of sense, as i am exercising muscles that had 5 months of non use in them. In order to get them back to full strength, there will have to be pain and stiffness!
Like i said before, my leg is certainly feeling stronger after the first 3 weeks or so, but there is sill a long way to go.
The instability i felt in my knee is still there. I expect that to be the same for some time yet. I am beginning to realise the massive role that the upper leg muscles play in the overall stability of the knee and leg.
As i mentioned, my quads are pretty sore and stiff, but it seems clear to me that these will be the most time consuming to get back to full strength. And until i do, i wont be able to hold my body weight up on my leg, so walking will be out of the question.
We have a fairly big car park area at my parents complex that they stay, so i have been going out for 2 circuits of the car park on crutches every day as well to train my leg into walking normally. It takes me around 15min to complete the 2 circuits. I find that it is a bit painful in the knee area when i start, but once i am going it clears up and i can push a little harder. If i stop to rest for a minute or more, then i have the same pain at start up again. As before though, this goes away once i start walking again.
This is definitely helping me with overall fitness of the leg, and along with the stretching and strength training, i am really pleased with my progress.
My eyes are still firmly set on xmas time as a deadline to be walking again, and i believe i can achieve this with a lot of hard work.
According to internet research i have done, it is mostly the case that recovery from muscle atrophy takes a lot longer than the actual period spent in inactivity. My period of inactivity was around 5 months, so, i should be looking at around 10-12 months to recover fully. The docs said 12-18 months, but i am sure they give you a worst case scenario, as otherwise you would be very upset with them when after a year you were still not walking!
Well, thats the exercise part of things so far...
As far as the DR is concerned, my cases that i had over there seemed to have dissolved, or maybe were never put into motion in the first place? I think the latter to be the more realistic verdict!
I have heard nothing in the last 3 weeks from my "lawyer" back there, and have asked a friend to make a call to the insurance company to find out if there was even a case lodged with them.
She phoned them, and got thru first time! Apparently, my lawyer said for 4 months repeatedly that he could not get hold of them!
Unfortunately, i do not have the surname of the insured, the wife of the driver that hit me, otherwise i could inquire further. They cannot help me without this information.
It is a pity, because i would like the hospital to get their money. It may be a lot of money, but they did save my life, and i am on the road to recovery because of them. Unfortunately, i do not have this money, and without an insurance payout to cover it, they will probably never get paid!
I do not feel responsible for this though. I have tried my utmost over the last 6 months to find a resolution to my situation, but have come up empty handed. At the end of the day, the Dominican Republic has screwed me over with its corruption, and as such, have screwed their own.
It is a vicious circle that does not seem to have an end as far as the tourist or foreigner is concerned, but i am just a statistic in this country. One of many that has seen an ugly end to their experience there.
A great pity indeed, as it is a fantastic place to visit...

Stretching & strengthening...

It was my first trip to the physio in the township just up the road from us, today.

My mom dropped me off at 7.30am for my appointment, but with the usual administration system and then the wait to get seen, it was only around 11am that i finally got thru to see the physio.

She prodded and poked and we chatted about what the MRI results were, and what exercises i was doing.

And that was about it.

She booked me in for a return visit in 2 weeks time, and just said to keep doing my exercises at home.

To be honest, i cant see much good of even going to the physio, as it is basically up to me now how well i progress.

I have been researching all the muscle groups of the upper and lower leg, and also exercises that i can get thru with my limitations i have, and have built up a program of stretches and exercises to do each evening.

Stretches are done every night of the week, and strengthening every day except for thursday and sunday.

So, we'll see how well i progress on my program.

I am setting myself a goal of walking again by xmas. So, lets see how things progress.

As far as the insurance payout in the DR is concerned, it is not a happy picture.

I received a mail from my lawyer in the DR 2 weeks ago, demanding another $400 from me in order to make my case with the insurance company!

A case that has apparently been made for the last 5 months or more! I was told that i have a "good chance" of winning the case. I am not quite sure why it is only a "good chance", as i was totally innocent in this accident, and the driver was totally in the wrong. This should be cut-and-dried!

So, he has requested another $400 in order to take my case further otherwise he will drop the case entirely!

Something that i find very strange indeed, as the case is for 4 000 000 peso, roughly about $100 000!

Take from that the lawyers 30% share, which gives him $30 000, and it boggles the mind as to why he cannot invest another $400 of his own money into the case?!

So, this is where i stand at the moment. In no man's land. I do not have the money to send him, which i have told him in a return mail, but he only replied with a deadline to send the money over Western Union style or else!

It sounds like a damned Nigerian scam!

At this point, i am just concerned that the hospital receive their money for saving my life and fixing me up. If there was ever going be anything left over for me, it was going to be a big bonus.

2 weeks on, and no further contact from him. Another lawyer getting rich off of the pain and suffering of a foreigner to the DR. The vicious cycle continues...

Post MRI comments...

Well, today was another long one.
A 6am start and the usual pick up of 7.15am, then the drive thru to the clinic in George to get my MRI done.
I was expecting it to be much the same as a CAT scan, but whereas a CAT is done in a few seconds, the MRI takes around 40min.
After the scan was complete, i phoned the bus service, and they picked me up outside the clinic, and i was taken back to the hospital.
I only had about 20min before my physio appointment, so i spoke to Pieter, the quality control manager, and he phoned thru to my physio, and he came down and helped me jump the queue in order to obtain my file.
Then we headed up to the physio rooms, and he set about examining me to see what we had to work with.
He has taken a few of the exercises off the list of one's i was doing, as he said they were a bit too advanced for me at the beginning stages, and has given me a couple of alternative exercises to do to the one's that were giving me pain in my knee.
My next physio appointment is booked in at the township just up the road, so at least i wont have to be going all the way back to George anymore.
Then i was off to sit in the queue to see the specialist with my MRI results.
They were all out on lunch, and i sat and waited about 3h to be seen.
I saw a different doctor this time, a woman specialist, and she told me that she had looked thru the results and found that the only problems they were showing was a small tear to the miniscus on the inside of the knee, and that the titanium pin that was inserted in my tibia, was a bit shallow.
She said that the miniscus tear would never heal itself, but that it was quite possible to carry on a normal life with the tear that i have.
She also said that the tear was not the reason i was feeling pain in my knee.
The shallowly inserted titanium pin may possibly be, coupled with a slight misalignment of the hip fracture changing the dynamics of the leg and putting excess strain on parts of the knee that normally would not have any.
The pin could not be removed until 1 year after the operation, so i will have to wait until October this year in order to have it removed.
Possibly it too may be contributing to the pain, as the head of the pin may just be catching on the knee when it rotates.
But, even with the MRI, they could not pinpoint the exact problem.
So, the prognosis is 12-18 months of physio, and an expected return to functionality of around 80% at best!
Not exactly the news that i had wanted to hear, but then again, it is what it is, and doctors only make educated guesses on these things.
It is very much down to the individual how long the recovery process will take.
So, back to the physio exercises then, and we will see what the future holds in store...

Playing the game...

It was an extremely long day out, but, no complaints here. All part of the process.
I was picked up at 7.15am after about a half hour wait at the local clinic. Thereafter it was a couple of stops along the way to pick up others, and we arrived at the hospital around 9am.
The last few times i'd been thru with my mom, we'd been in the queue at 7am, so i was expecting it to be a long wait.
I was not wrong.
3h later i reached the front of the queue and collected my file and headed up to the orthopaedic section to wait to see the specialist.
An hour or so later i was sat in front of him discussing my ultrasound on monday.
He checked the results and read the docs notes from the visit, and said that he would sign off on the MRI that i needed.
This MRI costs over R8000 if i was to have it as a private individual, so i am very fortunate to have finally gotten it signed off.
I can fully understand the system involved, and the expenses incurred in the entire process that i have been thru, and as such am very happy to have finally gotten my visit rubber stamped.
My investigation on the internet whilst still in the DR led me to the fact that i would need an MRI to fully ascertain what was wrong with my knee, but i was aware that there would have to be a process that would need to be followed in order to get to this point.
The ultrasound had detected some fluid build up in a few places which could not be explained, that indicated that there were underlying problems. Also some irregularities on the surface of the patella (kneecap). So i am very happy to be booked in next thursday to see what needs to be done.
After my visit, i went and waited outside for our transport to return.
Being Easter weekend, our driver had collected a lot of traffic on his runs up and down the Garden route, so was the last bus to arrive back to the hospital around 6pm.
The hospital runs a policy of dropping everyone at their doors if they are later than 6pm, so i was dropped off outside my front door around 7pm. The entire transport system for the day was for free! Like i said before, no complaints here!
In the meantime i continue with my exercises, some evenings having to cut them short because of the pain, but most, managing to get thru my entire routine.
5 more days until i find out what lies ahead...

Happy Birthday Dad!

Today was my dad's birthday, and he decided to join us on the trip to the clinic.
After the clinic we had plans to go out for a birthday lunch.
So, with a midday appointment, and a later start, we headed off to the clinic to see what the scan would reveal.
I signed in at the reception desk, and was taken to a room which had dimmed lighting, and was asked to sit on the doctors bed thing that you sometimes have to lie on when you visit the doctor.
After a 20min wait, the doctor arrived and we chatted for a while.
It turned out the scan was an ultrasound one.
So i sat and watched fascinated as the doctor ran a little scanner over my knee that he had just covered in a KY jelly stuff, and the ultrasound showed pictures of my knee and the muscles attaching the various parts together.
I asked him a lot of questions, and he compared the 2 knees in various places, and at the end of it all declared that the scan had been inconclusive, and that the only real way to see what was wrong, was to undergo an MRI scan.
So, he wrote a letter to the specialist in George, and suggested an MRI be the way to go.
I have an appointment with him in George thursday to set a date for my MRI now.
After the scan, we headed off to the waterfront area for lunch.

Thursday i have to be at the pick up point at the clinic in town here at 6.30am. I get taken, along with a taxi full of others, to all the stops along the way, until we arrive in George, and then when everyone is done for the day, we head back again, arriving back around 5pm tomorrow evening.
It is all provided by the hospital as a free service, which is quite brilliant really.
George Hospital is setting standards of excellence in South Africa, and has been chosen as a pioneer in a new NHS type system that the UK currently employs.
Lets see what tomorrow holds in store. I am praying that my next appointment with a certain MRI machine, will be in the not too distant future.
In the meantime, its exercises 6 days a week, slowly strengthening my leg muscles and knee.
The range of motion in my left knee is now about 110 degrees, a massive improvement from a month ago when it was only around 70 degrees!
As directed by my physio, i have been trying as much as possible to make a normal walking motion using my crutches, with my injured foot touching the ground with as much weight as is comfortable.
My quad is very stiff most of the time, but i am sure this will diminish over time.

Another scan...

I was up at about 5.45am again this morning for the next installment of my hospital adventure.

My mom was once again the designated driver, and we hit the road with a flask of coffee for the 1.5h drive through.

It was the usual 2h wait in the queue system in order to get my file from the admissions desk, and then it was off upstairs for my visit with the specialist.

I spoke with him, and showed him the letter from my physio, and he told me that he was pretty certain that whatever injuries i had to my knee would not require surgery, but that he would sign the forms and send me for a scan of my knee.

I was very happy that finally i was getting a scan and someone would be able to tell me exactly what was wrong with me.

I thanked him, and headed off to find Pieter, the guy who i had been liasing with from before i left the DR.

He was in his office, and i chatted to him for a fair while, and commented on how impressed i was with the service i had so far received from the hospital.

He told me that the hospital offered a shuttle service between the town where i was staying, and the hospital, so that when i needed to return, i could use the service instead of my mom having to drive me through every time.

He also told me about their physio service at the hospital if i needed it.

He walked me up to the physio department and i chatted to the head physio there.

It turned out that she knew the lady physio that was serving the area where i lived. I told her that i had been told that the physio service in the area had closed down.

She said that this was not true, as her friend still did the physio there. She phoned her friend and made a first appointment for me on the 18th April.

This would be perfect for the future, as it was only a 10min drive from my house to get to physio each week, and would be done on the public system, so would save me a lot in physio fees, which i dont have.

My appointment for my scan was made for the private clinic in George, for the following thursday.

My mom pointed out that there was another branch of this same clinic closer to home, and we headed to the George one to see if there was any way we could get the appointment changed to closer to home.

We were in luck, and after a chat with the receptionist there, we managed to change the location and the date for monday!

Another step further into the process that was hopefully going to tell me what was wrong with my knee...

Back to hospital

On tuesday i spoke with my physio, and she said to me that if i was still having the same pain, even with the brace, then i should possibly consider getting a scan of my knee to see what the problems are.
I contacted the guy at the hospital i had been in contact with previously, saying that i was still in a lot of pain, and was there any way that i could get seen again by the specialist, and possibly get a scan of my knee.
This morning, he replied saying that he had spoken to the specialist, and that i had an appointment booked in for tomorrow! All i need is a letter from my physio recommending further inspection of my knee.
So, i went back to the physio, and she has written me a letter to take to the specialist tomorrow.
I am quite surprised at how quickly things are moving along with regards the hospital here, as this is on the government system, and it just seems extremely efficient to me.
I must say that i am pleasantly surprised!

Braces and exercises

Finally managed to track down a knee brace.
A woman in the same town had an accident a while ago, and has finished using hers. So she was prepared to rent it to me.
I went through and picked it up this morning. I figured out how it was supposed to fit on my leg, but just to be sure,  went back to the physio for a quick visit so that she could fit it professionally for me.
It was only a 5min job, and soon i was crutching my way back towards the car with my new bionic leg, confident that now the pain in my knee would be alleviated.
This evening i went through my exercise routine, but only managed about half of it before the pain in my knee once again stopped me short.
I decided to stop for the evening, and speak with my physio in the morning.
Its extremely frustrating, as, if it wasn't for the pain in my knee, i would be a lot closer to walking again.
Ah well...will see what the physio thinks in the morning...

Toilet troubles...!

After an extremely restless night of waking up every 1.5h to go to the toilet, every time with a full bladder, i was a little concerned as to what this change in sleeping habit was caused by?!
I did a bit of research on the internet and found that the antacids i had been told to take 3 times a day have certain side effects.
One of them being a need to go to the toilet a lot more often.
I delved a little deeper, and found that these antacids, although high in calcium content, are not ideal for calcium intake.
It was originally thought that the calcium would be absorbed into the body and help bone growth in this manner. But scientific tests have disproved this theory in that the stomachs natural acids play an important role in absorption of the calcium. And the fact that the antacid is cancelling out the stomach acids, only results in the kidneys having to process all the extra calcium out of the body. This can lead to kidney stones in long term use, and various other problems too.
So, i decided to stop taking these tablets.
I am using a calcium supplement anyway, so do not think it necessary to carry on using the antacids as well.
And since i stopped taking them, i am back to sleeping a full nights sleep, and have reverted back to normal toilet sessions.
I find it very important to know what you are taking in the way of supplements, and have researched all of the tablets i have been told to take.
Normally i would not be taking any tablets. I only take herbal supplements if needed, but for now, i am relying on the extras to get me back to fighting fit, having been satisfied by my research that all is good.

Aqua-size!

Today was a luvly sunny day, and i headed out to the swimming pool to get some sun on my skin, and do a bit of aqua exercises.
I had been told to walk up and down in the pool at about waist depth, so as not to put too much weight on my injured leg, so that i could simulate the walking motion.
This was important to teach my muscles in my leg the correct procedure for walking, as i needed to relearn all of this again.
I found that i needed to be at around about armpit level depth to relieve enough weight from my leg to make walking possible.
I did about half an hour of walking back and forth, with a bit of pain occasionally in my knee.
Then it was a bit of suntanning and catching up on the latest news in the world of surfing in the local Zigzag magazine.
For those interested, exercises include:
* Standing straight up with my crutches for support, and slowly transferring my weight from right to left and back again, as much as i can withstand.
* In a sitting position, doing leg raises.
* Using an elastic band, hooking it around my toes, and pushing against the band, stretching out my calf muscle.
* Using the same band, with the foot pulled away from me, try to pull it back towards me against the resistance, basically the opposite of the above exercise.
* Standing in an upright position, with the elastic connected to my injured leg from the front, try to pull against the band, and flex my knee in a reverse raise to 90 degrees.
I have a whole list of exercises to perform, which are taking me an hour or so every day to go thru.
I have also been told that it is necessary to get hold of a brace for my knee asap as i need to start load bearing on my injured leg, and this brace will facilitate that without the pain.
I also got a call back from one of the South African newspapers that i had contacted while still in the DR. They had been following my progress, and wanted to do a telephone interview with me now that i was finally home again.
Here is the article that was published in the Cape Times newspaper...the details a little misprinted, but the gist of things is there...

Physio

Today was my physio appointment, bright and early at 8am.
The first time in my life i've ever had to have physio and i was a bit apprehensive, but at least i knew a few questions would be answered once i was done.
I was explained all about the muscle and ligaments in my knee and how they work together to achieve the functionality that you require to walk normally.
She tested all of the range of motion of my joints from my hip down to my ankle and toes, and asked me to do certain lifting and bending exercises to see how strong my muscles were.
She was generally satisfied with most things tested, but was a bit concerned about my knee pain that i was having.
She told me that my knee had a bit too much lateral movement, and judging by where i was indicating the pain was, that i more than likely had a ligament tear to the lateral collateral ligament.
Unfortunately, this ligament could not repair itself over time, and required surgery.
She told me that it was possible to strengthen the rest of the leg and knee, but that the knee would always be susceptible to collapse laterally due to the injury.
She said that she would suggest to the specialist at the hospital that i undergo an MRI scan in order to ascertain the extent of the injuries to my knee.
I have a return visit to the hospital scheduled for the 23rd of April, so i am guessing this is when the scan would take place?
She gave me a list of exercises to do at home in the meantime, and suggested that i get hold of a knee brace to stop the lateral movement in my knee.
Unfortunately, the braces cost about R2500, so this is not really financially possible at the moment.
I think i will soldier on without it for now, and if i need an op in the future, i will then have to obtain one of these, as post-op it is vitally important to stop this movement until the knee has recovered.
The physio treatments are not on the health system here, and therefore not for free, and are not affordable to do on a regular basis, so i will carry on at home, and visit the physio every couple of weeks to see how i am improving.
No harm in strengthening my leg for now. Will have to wait and see what the MRI reveals in a months time.
If i need the op, then i will have to get it, no matter how long i need to wait in order to have it done, as my mobility is very important to me as someone who leads a very active and sporty lifestyle.
Once again, time will tell what the future holds in store...for now, exercise and patience...

Hospital -- Take 2

A nice early start of 4.30am in order to get to the hospital and join in near the front of the queue...or so i thought...
The wait in the queue was a 2.5h one, and i gratefully received my file from the admissions window, and was then sent upstairs for my appointment with one of the orthopaedic specialists.
It wasn't a very long wait and i was seen to.
The doc looked over my xrays which i had brought with me, and said that he needed to send me to get more recent xrays before he could make a proper diagnosis, but that looking at the xrays i had brought in, he was reasonably happy with what he saw.
So, off i went, back downstairs, to join the queue for the xrays.
Another hour later and i was sat outside the docs room once again waiting for my next appointment.
In i went and he looked at the new xrays.
A broken drill bit inside my hip, which is apparently quite a common occurrence.
A broken titanium screw in my hip, which is apparently near impossible! The doc even requested he could keep the xray to show his peers cos they didn't believe him when he told them!
He was very happy with the job on my femur. He said it was a complicated operation, and was well executed.
He was happy with my hip, even though it did contain some broken equipment in it.
And the tibia was a decent enough job too. The fibula which was not repaired, he said was common practice to be left as is, as it was not an important bone, and was frequently used if bone grafts were needed.
So, that just left my knee.
He said that i should visit a physio to see what my limitations were, and that he hoped that with physio alone, i would be able to get myself back to somewhere near my former self...
Then it was back downstairs for a 3h wait for my medication - vitamin A, loads of pain tablets, and a box of calcium based antacids to supplement my calcium intake.
Then it was the 2h drive back home again.
A successful day, and a good start on my road to recovery...

Police stations...

If you had mentioned the words "police station" to me 2 weeks ago, i would have been terrified, but now they were a happier place to start my journey to hospital.

I needed a police affidavit to say that i had no job and no income, which i needed to take with to the hospital in order to receive my treatment on the public health system.

A reference letter from a local doctor was needed, and then i was set to go.

A trip to reception to get my file from the hospital, and then a meeting with the guy who i had been liasing with over the internet, and then to join the queues of people waiting to get seen.

A wait i was certainly prepared to do, after all the waiting i had been doing in the DR!

1 week til i find out exactly what the prognosis for the future is...

Until then, to try and lead as normal a life as possible, with as much time spent in and around the swimming pool as my untanned skin can handle...

Plettenberg Bay...

It was fantastic to see my parents again, and almost a little surreal to be back home again after such a long time in the wilderness full of worry and problems.
The short drive back from the airport, was greeted by the familiar sight of the Plettenberg Bay lagoon as we came over the rise into the town!
There was a tear in my eye as i finally realised the dream that had started 2 weeks earlier in a cabana in the Dominican Republic...

Sunny South Africa...home at last!

The time with my brother and his girlfriend seemed to fly by all to quick, and then i was on the way back to the airport again.
I checked in with SAA, and once again was greeted by super helpful staff at check-in, who provided me with a wheelchair and also someone to help me with my bags thru immigration and customs and onto the plane.
Unfortunately it was another lengthy delay waiting onboard the plane, as there was really bad weather on our intended flight plan, and the pilots had to wait for the revised flight plan to be sanctioned and loaded into the flight computer.
Unfortunately, i had a friend meeting me in Johannesburg at 7am, and i had no way of letting her know that i would once again be delayed!
The flight was only about a third full, and while i was being seated in economy, the lady in charge of the hostesses approached me and asked me if i would like to sit in business class!
I have never flown business class before, and gratefully accepted!
WOW!
The luxury was immediately plain to see! There was loads of space between seats, and the seats converted all the way into beds to sleep on.
There was even a button that set into motion a 20min massage, with balls rolling up and down your back while you lay or sat in the seat!
My foot was once again swollen, so the ability to be ale to put my feet up and sleep was very much appreciated!
The menu was to die for.
Starter was salmon and cream cheese, followed by fillet mignon with veggies. Then a dessert of cheese and biscuits, all washed down with a couple of glasses of merlot!
After this, i was definitely ready for bed, and collapsed into a deep sleep. My first ever sleep on a plane!
In the morning i woke up to a breakfast of orange juice and muesli, followed by spinach and egg, and a platter of fruits.
Then it was time to land, and once again i was helped with all my stuff into a wheelchair and bags collected and pushed thru to arrivals.
A few days in Joburg, where i was very well looked after, and then it was the short, 2h flight, to George, to see my parents for the first time in almost a year...

Lima

The flight was a good one, and the staff were very helpful and attentive to any need i had.
I did start to think about the delay, and whether i would be able to still connect with my onward flight, as it was only an hour or so stopover in Lima...
My questions were answered when i landed in Lima, and i was asked which onward flight i was to be taking?
I was told that my connecting flight had already left and that i would have to stay the night in a hotel before leaving the following morning and only arriving in Sao Paulo now at 5pm!
My poor brother would be waking up at 3am to start the 2h drive to the airport to meet me, and i would only be arriving 12h later now!
I had 1 free phone call provided me by the airlines from the hotel, so i would be using it when i arrived.
It was about a half hour drive at midnight to get to the hotel, and when we arrived i was greeted by the famous signage of the Sheraton group!
Wow! A hotel that i could never have dreamed of affording. This should be quite a treat!
It was!
I was prepared a hamburger and chips from the kitchen, and it was delicious. Served with an orange juice while i used my 30min of free internet connection to send an email letting my parents know of the delay and also to my bro, although i suspected he would not be checking emails at 3am in the morning!
Then it was a hobble upstairs on my swollen left foot, and i was greeted with 2 dbl beds in a large room with ensuite shower and bathroom.
It was immaculate, and super comfortable!

I had my first hot shower in almost a year of travelling, and just stood under the water, feeling the weight of the last 5 months slowly wash off of me and disappear down the plughole.
I finally managed to extract myself from the shower, and dried and phoned my bro to let him know of the delay.
Unfortunately i had gotten the time differences wrong, and he was already on the road for an hour!
He was not best pleased, but said he'd see me later on.
And then it was bed.
It was a crying shame that i would only spend the next 4h in the most comfortable bed i had ever slept in, but i had no choice, my taxi would be here to collect me and take me back to the airport at 6.30am!
I decided to forego the incredible spread that was breakfast at the Sheraton, and get the extra hour or so's sleep instead.
Beep beep, beep beep, went the alarm on the clock radio next to the bed, and it was already time to get up.
I lay there thinking about what had passed, and what was still to come, and slowly managed to drag myself away from the comfort i had only briefly known.
I went downstairs, hoping to grab a coffee before my taxi driver arrived, but he was already there, a full 20min early, and i climbed in and said a very grateful goodbye to the best hotel i have ever had the pleasure of staying in.
Back to the airport, and an ontime flight for a change, and we were on our way to Sao Paulo.
I would just like to state for anyone reading this blog, that if you are ever in South and Central America, then the airline of choice has got to be TACA airlines. I flew both legs of my journey to Sao Paulo with them, and was blown away by the helpfulness and professionalism of this airline. They also happened to be the cheapest airline to fly with!
Upon arrival, my bro was nowhere to be seen, and i was once again helped off the plane by a member of staff, and pushed in my wheelchair to baggage collection, and my bags collected and brought along with me to the arrivals area.
The guy who had helped me went off to make a phone call to my brother to ask when he would be arriving, and then returned to stay with me the 20min or so til they did.
He helped me load the bags in the car as well, and off we went.
The 36h or so i spent in Brazil was amazing.
We were in Ubatuba, a coastal area just south of Sao Paulo, and it was incredibly beautiful.
It was great to see my brother, who had been by my side via email and telephone through my entire ordeal, and between him and his Brazilian girlfriend, had been a massive help to me.

The last 2 weeks...

Ok, here's the information from the last 2 weeks or so...
I'll date order it as it happened anyway...

The long road to recovery...

Everything starts with a few small steps.
Whether it be literally, or figuratively speaking...
And so began my journey to a decent hospital and knowledgeable doctors...
It had been about 2 weeks in the planning, but my return to South Africa had begun.
I had been in contact with a local hospital in SA, and had arranged an appointment with specialists on the public health system for the 19th March.
It gave me just under 3 weeks to get myself back to SA.
I had sat in the DR for almost 5 months waiting for sum favourable news from insurance companies, and had gotten close to nowhere. This was not my driving force behind wanting to get out of the DR though.
It was my health.
For a long time i had been insistent on getting something out from my suffering, so that i could pay back some of the cash invested in me by friends and family.
But after all this time, my health was not getting any better, and i needed to get myself back on my feet. There was no way i could even think about paying back any of this money if i could not work. Health was my number 1 priority.
So...
I had contacted immigration in the DR, and they had told me that i was free to leave the country. There was no impediment to me leaving.
The hospital had confiscated my UK passport, but i had my SA passport on me still.
Never before did i think an SA passport could be useful outside of South Africa.
But i was being proved pleasantly mistaken...

Airports -- Take 1

On wednesday i had hired a car and travelled up to Santo Domingo airport to speak with immigration themselves and find out what was required in order to leave the country on my SA passport.
The reason being that my entry stamp was in my UK passport, so i was a bit worried that they might stop me, or charge me a lot of money on my way thru immigration...
I had looked for hours on the internet on tuesday, and even phoned a few numbers to find out, but no matter who i phoned, or what info i found online, it always seemed to be contradictory, or incomplete.
So, i found myself in a hire car with a mate, on my way to the airport to find out from the horse's mouth, so to speak...
After a bit of lunch in the airport while we waited for the lady at immigration to return from hers, we asked some questions and got some answers.
It seemed like all i needed to do was to to pitch up at the airport with my SA passport, a photocopy of my UK passport, which i had in my possession, and pay the 1000 peso fine for staying over my initial 30 days, and i was free to leave.
It seemed simple, but after 5 months of hell, it was certainly not a simple thing in my mind!
Friday could not come soon enough...

Airports -- Take 2

After what seemed like forever, friday arrived.
My ticket had been booked with the last of the money from my family they had available, including a very generous contribution form my grandfather for my birthday, donations from my mates off of this website, and a little help from my previous dive company as well.
It was a 5pm flight via Lima in Peru, arrriving in Sao Paulo the following morning at 5am. I needed to change flights in Lima, but there was only a 1 hour stopover, so that wasn't too bad.
We arrived at the airport around 2pm, and went over to the check in desk to hand in my bags.
I was asked for my passport, and after a minute, the person helping me disappeared with my passport. She was chatting to another lady further down the row of check-in attendants.
She returned and told me that there was a problem.
My heart skipped a few beats!
Apparently i needed my onward travel documents in order for them to process my booking!
I had specifically asked my parents to hold off on paying for my date change for my return ticket from Sao Paulo to Joburg, as this was emergency money in case anything went wrong at the airport, and i didn't want it wasted in paying for a flight i could not catch if i was held up in Santo Domingo for any reason.
For this reason, it was not a confirmed flight as yet.
It was only for the following tuesday, as i was planning on spending 2 days with my bro, who happened to be visiting his girlfriends parents in Sao Paulo at the time.
But, without this ticket, i was not going to be boarding the plane!
I went thru to their offices in the airport and checked online, but all i had in my email was the old ticket, and an email from the SAA representative confirming the date change. I did not have the all important e-ticket that i needed to present to the airlines!
So, with a bit of fuss, they changed my ticket to the next day, saturday, for the same time.
They were very nice to change it for free, as this was, essentially my mistake.
So, off we went, back to Bayahibe, a 2h drive away.
On arriving back in Bayahibe, my place i was staying, had already been filled by new tenants, so i was effectively homeless!
Luckily a mate had just moved out of their old place and still had 24h left on his old lease, so i moved in there for the night...

Airports -- Take 3

Saturday morning arrived, and another car hire later, and another trip up to Santo Domingo with my mate loomed large.
This was our 3rd trip in the last 4 days, so it was with a little bit of mounting frustration that we climbed in and started the 2h drive back to the airport.
I went to check in, with the ticket that my parents had now paid for, in my possession, and they accepted my bags and asked me if i required a wheelchair and someone to help me thru immigration?
I asked for some help, and a guy from the airlines arrived with my wheelchair.
My mate gave him instructions in Spanish as to why i had photocopies of my UK passport, and what to tell the immigration officer.
I was extremely nervous because if there were any altercations, then i would be stuck in the DR with no accommodation and more importantly no more money, as it had all been sunk into getting me back home!
It went thru without a hitch, and i was wheeled into the departure area to wait for my plane.
After an impossibly long 2h delay due to technical problems, i was off down the passage to board the plane.
I was first on the plane, which was a first for me.
After another 30min of everyone sitting on the runway waiting, we were finally into the air, and i breathed a huge sigh of relief as i watched the tarmac, and the DR, disappear into the distance!
I was free!
I was going home!
The nightmare was finally coming to an end...

On a more positive note....??

Just received a call from my lawyer.
Sounds promising.
He said that he has made a case against the insurance company for taking so long to even get back to us about a meeting. The case against them was delivered on tuesday, and they have 10 days to respond to us before we can take them to court about this.
The original figure requested for when we made our initial case against them was for 5 000 000 peso, so lets hope that when we sit down with them we get a fair bit of that as a payout!
Time will tell, as is always the case here...
Lots more info to add. Updates in about 10 days time. Keep watching this space...

The never ending story...

Weeks drag by and nothing changes here.
Not just my situation...the Dominican Republic in general.
Certainly somewhere to just come and watch the days and weeks pass you by.
But not the best medicine when you have broken bones that still need mending, and are sitting around waiting for lawyers and lawsuits!
Same story every time i manage to get hold of anyone to give me some more info.
Battling to contact the insurance company. Cant go after the driver yet...
Blah blah blah...
Back to my hammock. A happier place.
Thats all i'm afraid.
More of the same...

Birthdaze...

HAPPY BIRTHDAY TO ME!

And my birthday wish is......

Haha...thats a tough one to guess hey?!

Much love to all my friends and family. Miss you guys!

The perfect system...!

Managed to get hold of my lawyers on tuesday.
Didn't post any more news because it was just the same sad story being repeated all over again!
Except it has changed a little again from the previous time.
I was told that the insurance company wont answer the phones or return the calls of my lawyers once again!
This from one of the biggest insurers around. And after they apparently told us just 1 week ago that they will sit down and talk with us this week. Again. This is now the 3rd time they have said this since the beginning of the year!
I'm beginning to feel as though i am being taken for an idiot here!
Well, maybe past the point of that to be honest!
Apparently the only way we can get hold of them, is if my lawyer drives up to Santo Domingo, the capital, 2h away, and demands to be seen.
Well there is a solution then! So i asked him please to do that?
No can do. Too busy with other cases. His partner, who apparently has the time, wont go, even though he has asked him to...??!
This totally puzzles me. My lawyers are on a 30% commission, paid to them once these cases get resolved. So, surely there's the incentive to take a day to drive up there and sort this out??
Apparently not!
So, here we sit...waiting for something to happen while i quickly run out of funds to survive here!
Great system here. Really looks after the people who need it!
And that is all i have to say about that...

Same old story...

Another week of nothingness...
I really hope i am not just getting strung along here with no end in sight. It certainly feels like it most of the time!
Tried to phone my lawyers yesterday, but no answer, and no reply, so I am once again clueless as to what the week held in store?
We were supposed to have a date by now as to when we can talk to the insurance company, but like i said, no news...
Money is getting really tight now too. My parents are stretched to keep supporting me month after month, and i have had to ask my mates to please help out with whatever they can afford.
I hate asking anyone for help, especially financial help.
I just want my life back. Want the opportunity to support myself!
Its not that much to ask is it?
Apparently, so far, it is...
Got a bit of flu the last few days, but have been overdosing on Echinacea tablets. If you ever have cold or flu symptoms, get hold of some of this natural plant extract. Boosts your immune system and helps you fight off infection naturally. Works a treat! Back to normal after just 3 days!
Gona try get down to the beach this week and get some tanning done. Have gone nice and white after not having been in the sun for the last 4 months!
On a positive note though, a South African newspaper agreed to publish my story, so am hoping that it might gain some support for me back home? Will see what happens there.
Hoping for happier news this week this side as well...

News...of the good kind...!

Finally, today, i got a call from my lawyers, to say that they had some good news for me!
They were in court for another case today, and they phoned the insurance company again to try set a date to sit down with them.
The insurance company were evasive as usual, so my lawyers did a bit of threatening to try get them to meet with us. They agreed that we could set up a meeting within the next week!
Then, the driver's lawyers contacted us as well, and said that they were willing to meet all of my medical expenses since leaving the hospital if the insurance payout wasn't enough to cover everything.
This is a start at least! Definitely good news.
The best news of all, is that my doubts over my lawyers can be put to rest.
With a lot of time on my hands, and not many answers to questions over the last 3 weeks, it has been difficult to stay positive about events, so it is reassuring to know that i do still have someone on my side out here!
But, i wont get too excited just yet. I have had good news in the past, and nothing has come from it, so i will wait and see what the next week holds in store.
I feel like i have said those few words a lot over the last 3 months..."wait and see..."
Hopefully we have reached a turning point in all this now?
Exercises are going well.
My ankle is 60-70% back to normal already, after only a few days out of the cast. All the constant moving it around when i had the cast on has definitely helped.
If anyone reading this wants a hint, do as many small little rotations inside the cast as you can. I was constantly doing this for the 3 months i had mine on. The movement was small, but has made a difference i think.
Still moisturizing my foot every day too. The skin is still new, and dries out within a day if not treated.
Soft too. Gonna have to toughen up a lot before i can walk comfortably again one day.
Well, thats all for now...

The waiting game...

Yesterday morning i got a call from the lawyers.
They have been very busy the last week so they couldn't get chance to speak to me...
According to them no-one wants to talk to us at the moment. As in, neither the insurance company or the drivers lawyers.
Apparently we need to make the case with the insurance company first because we need to know how much they will pay us before we can recover the difference from the driver's case.
So, it is still a waiting game...
I have contacted South African Airlines and asked them to please postpone my trip back home by a month. I hope that they will be able to do this for me...
Looks like i am stuck here for the foreseeable future.
I suppose there could be worse places to be stuck huh? Caribbean...doesn't sound bad.
Just wish the circumstances were different.
Anyway, we blessed with sunshine every day of the year here, so, from this week i will be heading to the beach in the afternoons with a friend, to get some sun-tanning done.
It'll be a nice bit of practice on the crutches too every day!

For those interested in my exercise regime, I am now doing 2x sets of 25 dips in the wheelchair, followed by a final set of as many as i can. Around 40-50. Repeated morning and evening.
Also still doing a set of 30 raises with the 5kg water weight on my right leg twice a day.
Also been doing 30-50 situps each evening before bed.
Flexing my ankle throughout the day as much as i can. It does get sore after a while, so i need to take a break before carrying on.
For my knee, i am sitting in the wheelchair, and trying to put my left foot flat on the floor. At the moment, I can only just manage this. With my right leg, I am putting it over my left leg and pulling it into a bent position as much as i can. Doing this twice a day, morning and evening. While my knee is bent at its maximum, I am massaging the muscle around the knee, and also the quad area.
Sundays is my day off from exercise to give my muscles a rest.

Home improvement!

Well, 4 days on, and nothing much has changed...
I haven't heard anything from the lawyers this week yet, and the week is half way through.
Obviously some extremely important news that needed be told??
I did try yesterday to get hold of them, but they didn't get back to me yet...very strange behaviour?
I was waiting on my doctor to let me know whether i could get the cast off as well, but no answer there either...
Good news is that on monday i got myself a pair of crutches.
Monday night i headed out, my first "walk" in over 3 months!

It felt great to be in the upright position again!
The crutches did cause some bruising under my armpits, but this is totally normal. After a while i will get used to this. Also my forearms got tired real quick, but this too is normal, as i am using muscles that i haven't used in months.
Today, after another newsless day from the specialist in SA, i decided to take matters into my own hands.

Cast Removal 101 :

I think it went pretty well, and can safely say to anyone in the same situation, this can be done by yourself in just a few hours.
My leg was pretty dirty inside, but mainly from dead skin, as you can see in the photo's.
With the lack of movement, obviously blood flow has been restricted, and as such all the skin has died.
But i cleaned my leg up ok with some soap and water, and after, some surgical alcohol to protect it from bacteria. I also rubbed some moisturizer into my foot where i had removed all the dead skin.

Exercises are still going well. My upper body is getting nice and strong now. Just the fat around my waist to cardio off when the opportunity arises!
My ankle is really stiff after 3 months, so i am doing slow rotations of the ankle, and flexing up and down. So we will see how that goes...