A couple of weeks ago I wrote about the accident I had 10 years ago, and mentioned that it changed my life. If you haven’t read it, the short version is that I tripped over when I was walking down a mountain path in South America, fell onto my knee, sprained my right ankle and fractured my tibia. So why did this have a long-term impact on my life?
Four weeks of travelling on crutches with a cast, then a ‘space boot’, resulted in many amazing memories and photos, but really wasn’t great for healing my leg properly. This was followed by ten days of sitting in a house and doing almost nothing, then seeing a doctor in Paraguay for another X-ray and gradually coming off the crutches. Luckily I got the money back for at least some of this treatment because of my travel insurance, though not all of it as the bag with all the receipts in was stolen!
Lesson 1: Make sure you have insurance.
Before this, I didn’t know anybody who’d broken a bone, and I had no idea that you were supposed to do physiotherapy exercises to build up your muscles again once you’d had an accident like this. In the short term, this meant I couldn’t kneel down for a few months, and I also soon noticed a cracking/popping sound in my knee. In the whole process after the accident, nobody ever examined my knee. Over the subsequent ten years, I have seen numerous doctors, physiotherapists, and even a podiatrist, in the UK, Czech Republic and Poland and have discovered that as a result of tripping over:
- …the muscles around my right knee are weaker than those around my left knee, especially the IT band which goes from your spine through your bum down to your knee.
- …my kneecap is slightly out of alignment, perhaps up to 5mm.
- …my talus (a bone in your foot) is in the wrong place (discovered in August 2015, moved to the correct position in December, moved back again in May 2016 and still there now!)
- …the meniscus of my knee is damaged (discovered in August 2016).
- …my pelvis is slightly twisted, and I get pains in my hip sometimes due to this.
- …my ankle is now much easier to sprain – it’s happened twice more due to falls, one in May 2011 in the Czech Republic, and another in May 2016 in Poland – and takes much longer to heal than for a first sprain.
- …I also roll my feet inwards when I walk, which is probably something I’ve always done, but it puts more pressure on my kneecap, and means I’ve worn inserts in my shoes since August 2012.
All for the sake of a few seconds of inattention, and not knowing about physio!
Lesson 2: If you fracture or break a bone, get physio!
Different medical professionals each seem to have spotted one new aspect to what is a very compounded problem, and each new point moves me a step closer to being more healed, though it’s unlikely ever to be completely better. One of the things I currently need to organize is an MRI scan, which should confirm the damage in my meniscus and perhaps result in an operation that may stop it from cracking if I’m lucky – I’m sure this will be much appreciated by many of my friends and acquaintances!
Lesson 3: If you think there’s a problem, do something about it, and don’t give up until someone can help you. You know your body best.
The real point of this post, however, isn’t to bemoan the problems caused by my accident. Instead, it’s to tell you what I’ve learnt from my ‘medical tour of the world’. Because as those of you who’ve been following the blog for a while will know, it’s not just my knee. I also have ulcerative colitis, which was initially diagnosed in Sevastopol, and has subsequently been treated in Thailand, Canada, the UK and Poland, and I have asthma and nasal rhinitis. As well as dealing with my own medical problems, I’ve also been an informal interpreter for a handful of hospital visits in France for guests on the campsite I was working on way back in the summer of 2005.
So what else has it taught me?
In the UK medical system, I had to push and push to achieve anything. At one point I was told my knee cracked because I was overweight. I was, but my left knee didn’t crack and I didn’t know anybody else whose knees did either. Some doctors didn’t seem to want to take into account the accident I had had. Other people I know who have been diagnosed with illnesses like colitis or Crohn’s have had a very long process in the UK, as much as two years in some cases, with lots of waiting. One doctor told me that my repeated diarrhoea was probably caused by a urinary infection (!) I didn’t really help myself though, because I was never around for long enough to wait for appointments to see specialists.
Lesson 4: Stay in one place (!)
Thankfully, I’ve been incredibly lucky with the helpful people I meet as I’ve moved around. I arrived in Sevastopol and almost immediately had to go to the doctor because I was getting blood in my stool. With the help of Olga, the Director of IH Sevastopol, who I’d only just met, and some of her friends who were or could recommend doctors, I was diagnosed with ulcerative colitis and put onto the medication I needed to get it under control within eight days of the first appointment. Again and again over the next year, she was there to help me out. I also got a lot of support about my diet from Katie Slater, who I’d met a few years previously, and who happened to be training as a nutritionist at that point (and who now has her own business and blog). Now that I’m in Bydgoszcz, friends and colleagues have again recommended doctors so I am able to see a physio regularly, who is the person who diagnosed the damaged meniscus in my knee. I am also an outpatient with a gastroenterologist, who is going through the process of trying to get me off needing steroids multiple times a year to control my colitis.
Lesson 5: Ask for help.
When I lived in the Czech Republic, I noticed that I was starting to have problems with my right hip and back, which I suspected were a side effect of the original knee injury. A friend recommended a local clinic to go to and helped me to get an appointment, but I decided that my Czech was probably good enough to see the doctor by myself. The first experience was slightly traumatic, as although I’d managed to explain what had happened with the accident thanks to rehearsing it before I went, I hadn’t anticipated a couple of simple questions: “How tall are you?” and “How much do you weigh?” This resulted in the doctor, who didn’t speak any English, adopting the traditional ‘speaking to foreigners’ approach of slowing down and shouting at me, presumably in the hope that I would understand.
Lesson 6: Don’t forget to practice answering the simple questions too.
I did get there eventually, but later on in the same appointment, I found myself lying on a bed having acupuncture needles stuck into me, without knowing that it was coming. Presumably she’d given up explaining and decided to just go ahead with the treatment anyway, and although I didn’t mind, it was my first experience of acupuncture and I would have appreciated being asked. I should have figured it out as the walls of her consulting room were covered with posters of acupuncture points and similar.
Lesson 7: Expect the unexpected.
The whole appointment traumatized me a bit, and when I had to go back to the same doctor over a year later I was shaking before I went in. Of course, she didn’t seem to remember me at all and the second time around was absolutely fine. Luckily, my Czech was good enough for the very helpful physiotherapists at the same clinic. Unfortunately I missed one of the appointments though as I misunderstood the time. I arrived an hour late because I forgot that time in Czech uses ‘half to’ instead of ‘half past’ i.e. 5:30 is ‘half to six’.
Lesson 8: Always get somebody to write down the time of appointments for you!
The doctors’ surgeries, hospitals and clinics I’ve been to were all very varied in character. In Thailand, the hospital in Chiang Mai had the latest equipment and was very high tech – I’m not sure if it was the ‘foreigner hospital’ as everyone seemed to speak English.
In Sevastopol, the paint was peeling off the walls in quite a lot of the hospital.
I had to take my own towel and sheet for the colonoscopy and to buy everything I needed for blood tests and IV drips from the chemist and take it in myself, including the needle and the bandage for my arm afterwards.
In the UK, my local doctor was very patient when it came to explaining the long and complicated history of my colitis, of which all the written proof I had was in longhand Russian, in order to be able to prescribe me the medicines I needed.
Despite these vastly different conditions, the treatment I got in all these places was just as thorough and the doctors were just as likely to spend time listening to me.
Lesson 9: Medical professionals around the world are dedicated and want the best for their patients.
I’ve been extremely lucky to be able to afford private treatment when it was difficult for me to access public health systems in some places, and it has even occasionally been covered by my health insurance or the wonderful European Health Insurance Card if I’ve been within the EU. I estimate that I’ve probably spent at least £2000 on my health over the last three or four years, between appointments and medicine, but when it’s a choice between not spending the money or being healthier, I know which one I would pick every time.
Lesson 10: Use the medical system – that’s what it’s there for!
I wish you good health and hope you never have a need to compare and contrast so many different medical systems!