Random Musing About My Life in Ghana

We’ve been living in Ghana for two years and four months, but who’s counting?? Ever since my accident, I’ve found living in Accra a little more challenging. I’ve thought about this a lot, because nothing has dramatically changed in terms of living conditions, although Dave seems to be working even more than ever, which I never thought would be possible. So, after putting much thought into it, I’ve decided that what is getting to me is two-fold; loneliness and the uncertain future.

When I was laid up, there were so few things for me to do. Even working was cumbersome with a cast.  Exercise has always been my lifeline to sanity. Even during some of my worst days, if I could just exert a little energy, I always felt a bit better. After my ladder incident, my activity level greatly diminished. Doing leg lifts is not what I would call aerobic. They were just little things, but they felt bigger as I could feel the depression setting in. Being in the house all day long by myself, was often torturous. Dave continued to work long hours, and many of my days drug on and on. I encountered small, but frustrating situations. Have you ever tried to shower, do your hair, open a jar, or a number of other trivial tasks with one useful arm/hand?

When we first moved to Accra, I made a concerted effort to keep myself busy. I joined the North American Women’s Association (NAWA), and through that organization joined a small group of women who enjoyed golfing. Through golf I met women who played cards every Friday morning, and I was invited to join their group. I briefly joined a Book Club, because I missed my Elko group so much, and of course, reading is universal. I went to monthly NAWA meetings, not for the content, but rather for the socialization or networking opportunities.

For me, a documented introvert, all of these things (with the exception of golf) take a lot of mental energy. I have no difficulty doing things with those with whom I am comfortable – i.e., going to lunch, the beach, bike riding, etc. Active participation with people I don’t know, is one of my least favorite things to do, but I forced myself to do them in an attempt to get as much out of this experience as possible. I think I have done a pretty decent job of that until recently.

Book Club – I went to four get togethers and just never really felt like I belonged or clicked with anyone. I am probably not the easiest person to get to know, but I did try to contribute to the discussions, receiving very little feedback. Many of these women had been meeting for two years or more, and so they already had an established connection. When we weren’t discussing the book, I was sort of lost, as they would discuss things they had been doing together or people that I didn’t know. I can’t remember one person asking me about myself.

Cards – I have to begin by saying that all of the women were very, very nice. I was welcomed into the homes of many women, and since I actually enjoy playing cards, I was happy to learn a new game. However, just as in Book Club, I never established a connection with anyone. Many of the women were either from Europe or South Africa. A number of them socialized outside of the card group, primarily because their husbands worked either at the same company or, at the very least, in the same industry (predominately oil).

One Friday I was waiting for Michael to come get me. The remaining three or four women were discussing a new movie showing at the theatre, and made a date with each other for the following week. I just stood there, sort of waiting for an invitation, but none was forthcoming. I knew then that this wasn’t really the group for me, but I continued going for several months because I was desperate for company. I even hosted a Friday game once. I gave this group a full year before I finally decided that it was time to find something else to do. I sent an email to all of the women, thanking them for teaching me the game and their kind hospitality. Not one person responded to my email. Not one. So, I guess I made the right decision.

To be honest, I don’t think any of these ladies are unkind. Rather, I believe that they are experienced expats who can’t relate to what it’s like to be a “rookie expat.” I guess one could argue that I’m also no longer a rookie, but many of these women have lived their entire lives overseas as an expat, and so they have learned, or are just naturally capable, to survive – and being social is one of the most important survival skills.

Through golf I also met my friend, Tanya, who introduced me to the Boot Camp world. While I was cussing her under my breath, during our hour and a half together, I secretly looked forward to going to her house once a week. Not only did I participate in one of the most challenging workouts of my life, but I was surrounded by other campers….and we had something in common. When I got hurt, Tanya continued to reach out to me – checking on me, inviting me to lunch. I greatly appreciate her friendship. But, as I was sitting there all banged up, I just wondered if I would ever be able to get back to her class. In fact, even Tanya wondered as she suggested she refund my money for the unused sessions. I quickly told her no, and that I had to have something to work for.

My stepdaughter is in a similar position. She gave up her teaching position to follow her husband across the country to Philadelphia where he is enrolled in a three-year veterinarian residency program at the University of Penn. She has chosen to stay home with her children, and like many young mothers, she’s finding it tricky to find a balance. I get that. You want to support your husband, but you can’t lose yourself. A person has to feel wanted and valued. I’m fortunate, as I maintain a contract with the school district, so I do have a few hours daily where I am mentally stimulated. We are both in the last year of our three year commitments, and looking forward to what is next.

I think what I miss the most about a job is the daily interaction with people, which I find strangely peculiar, as I am not a real social person. However, going into an office every day is much, much different than working online. Almost exclusively, my interaction with others is virtual. About once a month I skype with one or more of my co-workers, and I always look forward to those sessions.

While we were in the states in June and July, we were asked countless times what we were going to do when Dave’s contract ends in April 2014. As if we weren’t thinking about it enough already, now we had constant reminders, which obviously got us thinking even more. I suppose some feel like we are being coy when we say we don’t know, but it’s the honest truth. We just don’t know. One of the risks of accepting an overseas assignment with Newmont is the uncertainty that comes with it at the end of the contract. The company does not promise the employee a return to their previous position. In fact, the employee is not even guaranteed a job within the organization. We knew and accepted the risk when we made our decision, but now that our time in Africa is coming to a close, that decision seems a bit impulsive.

So, as I sit here feeling sorry for myself, the most important question I’m asking is “how can I make this better?” Intellectually, I know what I must do. I have to continue trying new things, or even repeating experiences. Emotionally, it’s hard to rack up the energy to put forth the effort. However, looking around me, I know there are others who are dealing with events much more difficult than mine, and I need to buck up and make a choice to make things better!

Here are some ideas:

·        Golf. While I’m not fully recovered from my injuries, I golfed twice (although not well) while in Elko. It’s time to get back to it. Unfortunately, the golf course that I (and my fellow golfers) played every Tuesday has closed down, temporarily, for reconstruction. There is a golf course right around the corner from me, so that’s an option.

·        Boot Camp. I will join back up in September when I return from the states. I might not be my old self yet, but at least I can join in on the “fun.”

·        United Way. I reached out to the local United Way back in February to offer my grant writing services. I finally received a response from the executive director while in the states rehabbing. Since I’m doing very little grant writing for the school district (it’s primarily financial functions I’m performing), I’m anxious to actually put my skills back to work.

·        Write. I enjoy writing, and have been encouraged to write a book based on my experiences. I’m not sure that’s what I want to write about, but I will set a goal to write at least twice a week.

·        Friends. If you are reading this blog and thinking….oh man, this lady needs a friend, don’t fret. I have several of them. I just need to do a better job of reaching out to them. I am one who would rather wait for an invitation. Instead, I need to be the inviter from time to time.

·        New stuff. I need to continue trying new things here in Ghana. Once I leave, I suspect I’ll never return, so I need to take advantage of it while we are living in country.

OK, I’m feeling a little better now that I have some written goals. I’ll check back in and let you know how things are going!

 

 

Let's Get Physical

Wow! It’s been quite the ride since my infamous ladder accident on March 12^th.

After having my cast removed by an ISOS doctor here in Accra, I entered into physical therapy for my stiff wrist. Dr. T set me up with two physical therapists from 37 Military Hospital, which is right down the street from our complex. Initially they came to my house to provide me with the PT.

Emmanuel and Richard were very kind, and we had multiple and varied conversations over the next several months.

Emmanuel is a bit older and is a civilian. He seemed to be more knowledgeable about anatomy and injuries. He grew up in the Volta Region, has three grown children, and is devoted to his family.

Richard was born and raised right here in Accra, and has three children; the youngest being around 7. Richard is a member of the Army. He often wanted to discuss the places to which I had travelled, as he was very proud of his opportunity to travel as a result of his military service. Most notable was the time he spent in Liberia and couldn’t believe I had not yet been to that country. Honestly, I’m not sure why he wanted me to go there, as he always complained about hot and miserable it was.

 

When I asked Richard where he had been trained (i.e., University of Ghana, perhaps), I was surprised to hear, “37 Military Hospital.” Uh oh…..

PT was very, very basic and consisted of about three flexibility exercises and Emmanuel massaging my wrist and hand with some concoction that smelled vaguely like Icy Hot. He squeezed the liquid out of a small Johnsons Baby Oil bottle, but it contained some “secret” ingredient. In those first couple of weeks, my home PT appointments lasted approximately 15 minutes a day.

My wrist was slowly, slowly making progress. Although I’ve suffered two other broken arms, they were as a child, and I never underwent any type of PT after the removal of the casts. Unfortunately, I was beginning to experience intense pain in my hands, especially at night when trying to sleep. I would wake up with my fingers numb and a burning sensation running throughout my hand. The only way for me to make the pain subside was to sit or stand up and hang my arm at my side. A couple of weeks after the cast was removed, I also began experiencing pain in my shoulder, and in particular on the outside of my shoulder in the deltoid muscle. I couldn’t recall doing anything in particular to hurt my shoulder. Frankly, I had been favoring that arm so much that I’d hardly even been moving it at all, a move that was going to eventually haunt me!

One day Richard came to the house by himself. When I told he and Emmanuel about the pain in my shoulder at the previous appointment, they decided it was time for some electrical stimulation. If you’ve never experienced physical therapy before, you might be surprised to know that in many cases patients are treated to high voltage pulsed galvanic stimulation to reduce muscle spasm and/or soft tissue swelling, which is what the PTs suspected was the issue with my shoulder. I’ve had electrical stimulation plenty of times in the U.S. as a result of two foot surgeries. However, the equipment here in Ghana leaves much to be desired.

As Richard pulled out the machine from his backpack, I noticed the cord first and foremost. Whereby an average cord would just be plugged into the wall, this piece of equipment had two wires sticking out at the end of the cord. Richard fiddled around  with it for a while, stood up and said, “I’ll be right back.” I watched him through the front window as he sifted through my flower bed on the front porch. He returned with a small stick, which he promptly pushed into the top hole in the outlet and then inserted the two wires into the remaining outlet holes. I was pretty sure I was going to get electrocuted right there in my own house, and yet I said nothing!

Richard proceeded to put the pads on my wrist, elbow and shoulder. It’s really hard to explain how different it all was here in Ghana, but suffice it to say that everything was a bit more primal….meaning the pads were strapped onto my wrist and arm with cellophane tape, rather than having some sticky solution that adheres to the skin. Richard then cranked up the electrical currents so that my head started twitching. I implored him to reduce the current.

Another PT strategy is to use ultrasound and heat to get to the deeper tissues. My shoulder was not getting any better; and in fact, was getting worse so the boys decided to use the heat approach. Again, from within his backpack, Richard pulls out this enormous infrared heat lamp. I wish to hell I would have taken a picture of it, but alas, I did not. Here’s a picture of one I found on the Internet. (picture of a similar one).

Unlike many of the lamps I found out on the Internet, this one had no stand, so Richard plugged it in (with a REAL electrical cord), and then stood and held the lamp close to my shoulder. Let me tell you, this puppy put out the heat. More than once I had to tell Richard to back off. I don’t know how many times between March 12^th and May 20^th that I said to myself, “I can’t believe this is happening to me,” but I can assure you that many of those times were during PT!

More than once Richard would fall asleep on my couch while Emmanuel was massaging my arm, or affixing the electrical stimulation paraphernalia to my arm. You have to understand Ghanaians. They are the most amazing sleepers. They can sleep anywhere; on the bus, in the restaurant, in the car, on the side of the main road, and evidently on my couch. I swear I was talking to Richard one moment and in the next he was sound asleep.

One day I asked him why he was so tired. He told me that he must get up at 3 a.m. in order to get to work on time. I then asked him what time he went to bed to which he replied, “About midnight.” Why in God’s name would you stay up so late when you have to be up so early, I queried? He told me that in the evenings, after everyone goes to bed, he listens to the radio. In Richard’s defense, I never asked what he listens to, but I’ve heard the radio programs in Ghana, and they are anything but relaxing. They mostly are people yelling about the topic of the day. Regardless, I reminded Richard that if he would get to bed earlier, he would get more sleep, and would, therefore, not fall asleep on client couches. J

Richard also told me that he sings his wife to sleep every night. He informed me that he was a very good singer, and then proceeded to give me a demonstration; leaning down into my ear and softly singing to me. It was very, very weird.

Emmanuel was fairly quiet and only talked if I asked him questions. Richard, on the other hand, was nosy. He noticed a picture of my family on a table and started asking me about them. I explained who everyone in the picture was; my husband, my son, my stepchildren.

Him: “What?”
Me: “What do you mean?”
Him: “You are divorced?”
Me: “No, actually I am married.”
Him: “But, you have been divorced?”
Me: “Yes.”
Him: “Oh, I am so sorry.”
Me: “Oh, don’t be sorry. It all worked out for the best. My ex-husband and I are on friendly terms and I have an awesome son that resulted from that marriage.”
Him: “You are friendly with your ex-husband?”
Me: “Yes. He is one of my Facebook ‘friends.’”
Him: “Do you ever talk to him?”
Me: “Yes. From time to time – like when we are discussing our son; Christmas or birthday presents, his schooling, etc., Are you surprised?”
Him: “Yes. That would never happen in Ghana.”
Me: “Why not?”
Him: “A black man can never be trusted.”
Me: (laughing) “Oh Richard! Give yourself some credit.”
Him: “No madam! I could never sit and have coffee with my ex-girlfriend. I cannot trust myself. Does your husband know you chat with your ex-husband?”
Me: “Well, I don’t mention every single time I ‘chat’ with him, but in general he knows we speak because I’ll relay a conversation we’ve had.”
Him: “You need to tell your husband tonight.”
Me: “OK, Richard. I will.”

That evening I told Dave about our conversation, and he just sort of shook his head asking me if the PT was working. As you can see, this white woman CAN be trusted.

The pain in my shoulder refused to go away and was intensifying. I had noticed that my range of motion was becoming very limited and Emmanuel felt it best for me to come to 37 Military Hospital for more intense PT.

37 Military Hospital is probably one mile from my house, but with the Accra traffic, it took 15-20 minutes to get there. The first day I arrived, Emmanuel met me out front and led me through the open aired hallways to leading to the Physiotherapy Unit. There were many Ghanaians sitting in the lobby, but of course we walked right by them.

PT at the hospital was exactly the same every day. First, I was taken into a private room for the heat treatment. Almost always there was another patient in the room. This day was an exception, which is why I was able to take a picture of the room.

 

I’m not sure which heat lamp was worse – the hand-held one or this one. Take a look.

 

I call it the Foreman Grill. Heat did radiate pretty intensely out of this contraption, but the lever system was broken; meaning, the machine was sitting on my sore shoulder. After about 3-4 minutes, I could no longer handle the weight and had to have it removed.

I was also quite concerned about the frayed (and I do mean FRAYED) cords. Check these pictures out. There were signs on the wall indicating that no cell phone pictures were allowed, but I tempted fate.

 

 

Next, I was moved across the hall to the room in which I was to receive the electrical stimulation treatment. Not what I would call a "tidy" room.

 

There was no cellophane tape used here, but rather these very long straps that were wrapped around my arm to keep the pads in place. The pads used in the U.S. feel like rubber - the best way I can describe them – and they are a bit sticky, which ensures they stay in place. When the pads are removed, they are immediately cleaned and sterilized. The pads at 37 Military Hospital are made of fabric. I can only imagine how many people they have been adhered to prior to me. And trust me….they were not what you would call clean or sterile.

Another disturbing item in the room was this air conditioner.

 

 Well, let me be a bit more specific. It wasn’t so much the air conditioner, but rather the large blue bowl sitting on the floor collecting the water dripping from the air conditioner. Notice all of the cords on the ground? As a reminder, I was hooked up to an electrical machine. Yes, many, many things crossed my mind.

 

After I took the picture, Richard implored me to take it back to the U.S. and show everyone. I said, “Why?” He said, “Tell them that this is how our hospitals are over here and that they need to help us.” I very quickly responded, asking, “Why doesn’t maintenance just fix the leak? Why do the Americans have to fix it?” He had no response to that one.

My final treatment was in the paraffin wax room. I had no idea what I was in for; this was one procedure I had not been exposed to previously. The paraffin wax vat is about 24” x 12”. It looked as if there was dirt lying at the bottom of the container.

 

Emmanuel told me to just dip my fingers into the wax, which I did. “Holy crap!” I yelled. It was unbelievably hot. “And you want me to dip my entire hand into that?” I asked. Yep, he said. I shook my head, took a very, very deep breath, as Emmanuel took hold of my arm and dipped my hand into the paraffin wax past my wrist. Not once. Not twice. Not even three times. EIGHT times he dipped my hand into that scalding vat of wax. He then placed a plastic bag over my hand and wrapped it in a towel for the next three minutes at which time he peeled off the wax.

 

Unbelievably, my skin was intact. I was sure I would have multiple burn marks. Did I mention how hot the wax was??

I turned to Emmanuel and asked if that was it, to which he replied, “No. We will do it again.” “WHAT?” I shouted. Every day Emmanuel would submerge my hand into the paraffin wax as I would count to eight.

One day he said, “Why do you count?”

“It is a mental thing. It is so painful for me to put my hand in the wax, it’s my coping mechanism.”

Emmanuel laughed, shook his head and said, “Only a white woman.”

After six weeks of “therapy,” I was not progressing as expected (at least as I expected) and discerned it was time for an intervention! I had already scheduled a trip back to Colorado in late May for my niece’s graduation, and had two medical appointments arranged with orthopedic surgeons in Loveland and Ft. Collins for evaluations of my elbow, wrist, shoulder, and knee. Dave and I agreed that it would be in my best interest to move up those appointments.

Richard asked me if he could come with me….he would just hide in my suitcase. He just wants to visit America for two weeks. I asked him what he would do when we landed and he informed me that he would work; doing what he does in Ghana. I asked him what he would eat and he said he didn’t need to eat. He would just enjoy America.

I met with my elbow doctor first. Dr. Chamberlin’s nurse had obviously relayed my story to him, because when he walked into the examination room he said, “Wow! You have had an interesting couple of months since I last saw you.” I laughed and agreed telling him that my elbow had been the least of my worries.

His nurse had gotten a fresh set of xrays of my elbow, shoulder, and wrist, and he quickly went to work studying the scans. He asked me if anyone had told me that in addition to breaking my arm, I had also broken the scaphoid bone in my wrist. Of course not. The scaphoid is located between the hand and forearm on the thumb side of the wrist, and is one of the most common bones to be broken in a hand, particularly in a fall.

Dr. Chamberlin told me that all of the post-injury problems I’d been having (pain and numbness in my hand) were typical of a scaphoid break. He did, fortunately, tell me that the bone was healing nicely, but that if the previous doctor(s) would have seen the break, they would have likely kept me in the cast longer as it takes a while for that particular bone to heal. He told me that it is oftentimes difficult to see a scaphoid break in the first two weeks of the injury. As luck would have it, I just happened to have the very first xray taken of my injured limb. Dr. Chamberlin quickly pointed out the injury, and was surprised that the other three doctors had not spotted the break.

Because I was having difficulty using my hand after the cast was removed, I was not using my shoulder. This resulted in a what is termed “frozen shoulder” (medical term – adhesive capsulitis). According to Wikipedia, this is a “disorder in which the shoulder capsule, the connective tissue surrounding the glenohumeral joint of the shoulder, becomes inflamed and stiff, greatly restricting motion and causing chronic pain.” In researching the condition, I was experiencing the classic signs. Very restrictive movement of my shoulder, pain was constant, and exacerbated at night as I tried to find a comfortable position. The most excruciating pain would come when either my shoulder was bumped unexpectedly, or when I would trip or stumble and I would reach my arm to regain my stability. These actions would almost cause me to fall to my knees in agony. I would just hold my breath and wait for the pain to subside.

Dr. Chamberlin explained that frozen shoulders often take months to heal. He offered three options:

1)      Old lady approach. Do nothing. Eventually (1-3 years) the pain would subside and the motion in my shoulder would return.

2)      Physical therapy. He would start me on a fairly aggressive regiment of physical therapy. Recovery is still slow (9 months – 1 year).

3)      Surgery. He would put me on a table, knock me out, and manually manipulate the shoulder; basically breaking up the tissue. This would be followed by a very aggressive round of physical therapy.

I chose option #2. I wanted to avoid surgery at all costs for several reasons. First, and foremost, if I underwent surgery I was pretty sure Dave wouldn’t be with me, and that did not appeal to me at all. I would have to remain in the U.S. that much longer for the therapy. And of course, anytime one undergoes the knife, there are potential complications and my history with surgeries has not been necessarily kind.

I began therapy just days later with Julie and then later with Nick, an Australian, who took over my case when Julie went on vacation in Italy. I have been dedicated to my physical therapy, only skipping a 3-4 days in the last nine weeks. Several times, while on a Caribbean cruise, my sister would come to our cabin looking for us….and there I would be….doing my PT.

A few days later I was seen by Dr. Rocci Trumper, another ortho doctor in the same practice specializing in knee injuries. I absolutely loved this doctor. He was so personable and completely engaged in the appointment. After quickly scanning the MRI and conducting an examination of my knee, he ascertained that I had probably ruptured my ACL back in 2005 when I suffered a basketball injury. He said that based on my description of what happened in the fall and the subsequent level of pain I endured (which was nothing compared to the 2005 injury), he strongly suspected I had merely dislocated my knee in the fall due to the lack of an ACL. He told me that if I had been happy with the way my knee had been performing up to the day of the injury, he would not recommend surgery. I wanted to hug this man! He had just made my day. Dr. Trumper only had one bad quality – he serves as the athletic doctor for the Colorado State University Rams. I guess everyone has their Achilles heel. J

I am happy to report that although I’m not at 100%, I have regained about 75%-80% of movement in both my wrist and shoulder. Both are a bit painful, but I now have the tools needed to move towards 100% recovery. Every day I work on strengthening the muscles around my knee, and am back to doing low impact cardio. My goal is to get back to my boot camp class in September.

As I very often say when I return to America, “I love the United States of America.” This has never been so true as now.

 

 

A Ghanaian Healthcare Adventure

Michael safely transported me to the ISOS Clinic, a facility that provides primary healthcare to Newmont employees and their family.

I was met there by Dave and Dr. T, resident physician. After my meltdown with my husband, I sat down and answered a series of questions. Dr. T then had me get up onto the bed where she examined my wrist and leg.

 

My arm was swelling quite badly by this point, and it was very painful. The doctor did the usual tests on my knee (this is not my first knee injury). Based on her examination, she didn’t think I had torn my ACL. She felt the joint was pretty stable and wasn’t displaying the classic signs of an ACL rupture.

She then gave me a sling with which to wear to help hold my arm still and gave me a brace for my knee. Unfortunately, she only had two knee braces – large and small. The large was enormous, and the other, although too small, would work in the short-term. She had me move to a different room where she proceeded to give me a shot of pain medication (yea!). She was very careful administering the medicine as she said patients can react much differently. I quickly felt the medicine and the relief was fast. Unfortunately, it only lasted about 5 minutes, and then I was back to hurting pretty badly.

The IOSO Clinic is small, with very few employees. Dr. T served as both doctor and nurse. She arranged for transport to Lister Hospital where my wrist would be x-rayed and an orthopedic surgeon had been called. The ride to the hospital remains pretty much a blur to me, but I don’t think it was too far from the clinic. I was more concerned with keeping my arm as still as I could, while we drove over the always rough Accra roads.

I was about to find out how valuable Dr. T was going to be in this healthcare journey. Lister Hospital is fairly new, having been built in 2004. The waiting room was quiet when we arrived, with only a few other people waiting.

Dr. T had me sit down, got me the paperwork I needed, and went down the hallway to get the process moving along. As soon as I completed the necessary forms, I was taken to the x-ray room. Now, I’m guessing most of you have had an x-ray at one point or another in your life. This room was about as big as a walk-in closet. The walls were not filthy dirty, but I wouldn’t call them clean and sterile either.

Dr. T asked the x-ray technician if she should begin removing the brace and sling, but he didn’t want to discuss it with her. As Dave said, “He just wanted to be in charge.” We’re not even sure he realized she was a doctor. Dr. T and Dave finally went outside and he helped me to remove the brace and sling. Usually, when a patient gets an x-ray, they are covered (in part) with a lead apron, reducing the exposure to radiation. But, even more so, I would expect the technician to be wearing an apron – neither of us did. The room was so little he was basically standing right next to me when he took the x-rays.

I was then taken into a second room where there were two nurses sitting at a desk.

One of the nurses took my vitals and asked me a few questions. The most disconcerting thing was the way in which she “cleaned” the thermometer. She pulled out a tube that was filled with cotton balls. She took one of them and wiped off the thermometer. This was done without soaking the cotton ball with any kind of disinfectant. I was in a lot of pain and wasn’t thinking clearly, but I knew that I was NOT going to let her place that thermometer anywhere near my mouth. As it were, she put it under my armpit. I couldn’t help but wonder how many underarms that thermometer had been without a proper sterilization.

Next, I got into a wheelchair and was planted in the hallway in front of a door. Dave finally moved me out of the way as workers were running into me. I was then wheeled into a different part of the hospital.

We had to go up a ramp, which was outside, but covered. I was taken to a private hospital room, and was tended to by 2-3 nurses (I was getting personal attention, for sure). The smile was all for show. I was not what you would call happy.

The one nurse made a point of showing me how to turn the TV off and on, but I had no interest. She returned a few minutes later, and when she saw I had not turned the TV on, did so for me.

Dr. T had called a local orthopedic doctor to meet us at the hospital before we left the ISOS Clinic. Dr. Ocloo (oh-clue) was located at Korle Bu (core-lee-boo) Hospital and because of traffic would take anywhere from 1-2 hours. It wasn’t long before he came in, however, and affirmed that I had fractured my radius bone. Just this morning we heard about Louisville's Kevin Ware. He is the basketball player who suffered a compound fracture in yesterday's Elite 8 game against Duke. We didn't see the actual injury, as our TV did a WAWA thing, but we did hear about it. I am feeling more and more like a big wuss, and I can only imagine the pain that poor man is going through.

But, enough about him....back to me and my wrist fracture. Dr. Ocloo said that he would cast it the next morning at Korle Bu. A Lister doctor was in the room at the time and told him that they would be happy to cast it that night. Dr. Ocloo turned to him and told him that they didn’t have the proper materials. The doctor assured him they did, but Dr. Ocloo didn’t want to discuss it further.

Dr. T had evidently been corresponding with ISOS doctors in Paris (ISOS headquarters), and based on the x-rays she had sent coupled with the recent diagnosis of medial epicondylitis in my elbow, they recommended the cast be placed above my elbow. They also suggested the cast be in place for six weeks. Dr. Ocloo strongly disagreed with the Paris doctor’s recommendation saying that he would not cast the arm above the elbow as that would be cruel. He also said that the arm only needed to be in the cast for five weeks.

He then went on to examine my knee, moving it this way and that. He told me, “There is nothing wrong with your knee,” to which Dr. T said, “Do you think we should get an MRI just to be sure?” “No,” he answered. He told me that I could stay in the hospital overnight to which I emphatically said, “NO! I want to go home.” We were then wheeled back to the entrance in which we had arrived and Michael took us home. I think it was about 8 p.m. when we arrived home.

It had been a very long day for all of us, but mostly me. I had woken at 6 a.m. MST on Monday, March 11th. I stayed with my brother in Brighton, Colorado, and he dropped me off at the airport that morning. From Denver I had a direct flight to JFK in New York City, where I had a lengthy six hour layover. I was flying economy comfort overseas, and while I get a whopping four additional inches of legroom, sleeping is still not easy. I can usually get 4-5 hours of sleep, but for some reason had a more difficult time on this trip and estimate getting more like three hours of sleep. The last leg of the trip from JFK to Accra is approximately 10 hours in duration, so when I got home, all I wanted to see were the insides of my eyelids. As is typical for us, we only take short naps upon arrival, otherwise getting to sleep that night is difficult.  

As you can imagine, I was exhausted by just traveling. Add on the entire emotional and painful last few hours, I was hoping to get some good sleep. I took a pain pill and got into bed a bit later, but really couldn’t get comfortable all night long. If my arm didn’t hurt, my knee did. If my knee didn’t hurt, my shoulder did from being in a sling. Every time I felt myself dozing off, I relived the accident. I got up several times, and went out onto my recliner, hoping to pass some time by surfing the Internet or playing solitaire. It was one of the longest nights of my life.

The next morning Dave encouraged me to take a shower, even though I had no energy or ambition to do so. I was emotionally and physically spent. He reminded me that once I had my cast on, taking a shower would be a lot more difficult. As usual, he was right. Have you ever taken a shower with just one arm? If not, I challenge you to try it just once. It’s not as easy as you might think, especially when you have a bum knee and are nervous about falling and further injuring your as yet uncasted fractured arm.

Dave was a huge help in getting me in and out of the shower, drying me off, and in helping me put my clothes on (including my bra….try that one with one arm). However, he was sorely lacking in the “let me help you dry your hair” task. He tried, I’ll give him that.

Dr. T called Dave that morning and told him that the ambulance would be by to pick me up at 9:30 a.m. Dave assured her we did not need an ambulance and that Michael could get us to the hospital. Dr. T insisted, and would not take no for an answer. Right on time (VERY unusual for anyone or anything in Ghana), the ambulance arrived. In fact, they had to wait for me to finish getting ready. As I was climbing into the ambulance I was saying, “I can NOT believe I am getting into an ambulance.”

As I mentioned before, we found ourselves very grateful for Dr. T and her advice. What we didn’t know was that Korle Bu Hospital was located in downtown Accra. We were not only going to the heart of the city (the worst traffic ever), but we were also going in the morning, during hours long rush hour traffic. The ambulance driver turned on his lights and sirens. Dave got in the car with Michael and followed behind. We arrived at Korle Bu in a matter of about 20 minutes, opposed to what may have taken 1 ½ - 2 hours.

When I got into the ambulance, I laid down on the gurney, but was not strapped in. As we were weaving in and out of traffic, the gurney slid back and forth slightly. I knew that if he took a sharp corner, I would likely go tumbling. I sort of hooked my right foot under a bar to keep me from moving too much. Also, since I was lying flat on my back, I had no idea where we were going and what was going on outside. I’ll let Dave provide an account of the ride to the hospital.

Riding through traffic in Accra is normally an exercise in patience and frustration.  Not this time; it was time for Nascar; Accra style.  Usually, cars mosey along in the regular travel lanes with others moving around you into any available open area looking for any flat spot to fill hoping to get into the flow until traffic becomes completely jammed and comes to a grinding halt.  Occasionally, a military or police car will plow through everyone honking his horn and flashing his lights.  If he has a siren, he’ll use that too.  Everyone squishes up against the side ditch or car next to them to make a small opening for the “emergency” vehicle to pass and move quickly to wherever they are going (pastry shop or dropping kids at school most likely).  Ghanaians are very calm about this imposition and only get angry when the military car has a trailing vehicle that’s just taking advantage of having a guy with a siren in front of him.  I often kid Michael that he should flash his lights and honk his horn when the traffic is particularly bad; now was his big chance and he was clearly relishing the idea!  Putting Beth in an ambulance turned out to be a good idea; trying to keep up in a trailing car…not so much.  This was a nail-biting experience with lots of honking and near collisions as we bobbed and weaved through traffic behind the ambulance.  I never realized how quickly traffic closes in behind these emergency vehicles; especially when everyone assumes you are “taking advantage” and tries to cut you off.  We got lots of angry honks and finger pointing trying to keep up.  At one point, a police car started chasing us with his lights and sirens blaring.  Fortunately, he got cut off and we lost him in Accra Central traffic.  Smokey and the Bandit got nothin’ on us.

Ha Ha! I completely forgot Dave telling me about being chased by the police car! There were a lot of quick stops and starts.

The ambulance, like most vehicles on the roads here, had a standard transmission. So, as you can imagine, the stops and starts were that much more pronounced. I could see the tops of trees, and sometimes the blue skies. Mostly I noticed the mosquitoes flying around me.

When we arrived at Korle Bu Hospital, Dr. T told me to wait in the ambulance while she went inside to find the doctor. She wasn’t gone but a few minutes, at which time I exited the ambulance. Korle Bu Hospital is a public hospital and is located in Accra Central. There were lots of people milling around outside in the heat. As we entered the hospital, the first thing I noticed was the lack of air conditioning. Next, I couldn’t help but lay my eyes on all of the injured. There must have been 10-15 gurneys haphazardly scattered in the room. I don’t know if this was the waiting room, or what. Mostly, it appeared to be men on the gurneys. One guy looked as if he had been in a fight. His face was swollen and blood was everywhere. One patient, in particular, sticks out in my mind. He was lying on the gurney with his right calf all bandaged up. He had about ten 4” pins sticking straight out of the top of his leg, and the underneath part of his leg was soaked in blood. None of these guys were really moving, and many were sticking out in the walkway, so we had to walk around them. I would not consider this hospital sterile and clean, by any means. Dave told me that he wouldn’t have let me do anything but cast my arm here.

As Dr. T guided us through the hospital, we must have passed 100 people sitting in chairs, or standing in line waiting to be seen. I felt two things: 1) a tremendous amount of guilt for moving ahead of all of these people who had likely been waiting for hours; and 2) a tremendous amount of relief for being able to be seen quickly.

The area in which Dr. Ocloo was located was air conditioned, and it was full of young children and their mothers. He apologized and explained that it was “Baby Wednesday.” I saw several babies with casts on their arms and legs. There were three “bays,” and as soon as we walked in, Dr. Ocloo had his staff remove a mother and her baby from the middle bay and escorted me inside. Again, I felt much guilt and relief.

A number of hospital workers descended on me, all under Dr. Ocloo’s direction. They quickly (and roughly) cast my arm (boring old white one). As I was lying flat on my back on that gurney, all I could think was, “I can NOT believe I am here.”

 

This is the back part of the room. I didn't even notice it, but my trusty photographer did!

It was very painful, and tears were leaking out of my eyes. However, once they were done I felt instantly better as the arm was now stable and protected.

He had someone check a calendar and said that the cast would come off five weeks from that day. Dr. T asked Dr. Ocloo if he would be x-raying the arm to ensure that it had not moved in the hours since the last x-ray, and he refused….twice.

We walked out the same way we came in, and again guilt and relief were about all I could think about. As we were getting into the ambulance, Dr. T told us that she wanted to get an x-ray regardless, so she said we would be going to the Diagnostic Center, which is in East Legon, completely on the other side of Accra. The good news was we were still in the ambulance, so off we went. This time Dave drove with me. That's Michael behind us trying to keep up!

When we walked into the Diagnostic Center, it was full of people waiting….again. Dr. Tatyana did her “thing” and I was quickly taken back for an x-ray. The center is much cleaner than Korle Bu, and the x-ray was completed efficiently.

Next, Dr. T wanted me to have an MRI, against Dr. Ocloo’s recommendation. We waited for about an hour, and it was a long hour for me. I began to feel nauseas and hot. I was also SO tired, I could barely keep my eyes open. Finally, I was taken into the MRI room, where I expected to immediately change and begin the scan. However, there was already a lady lying in the MRI machine getting scanned. Dave, Dr. T, and I sat in the room with the MRI technicians and basically waited for them to finish. At one point, the two technicians got up and completely left the room, for about 10-15 minutes. In the meantime, the machine continued to make noises and the lady remained in the machine.  You can see the lady in the background in the MRI machine.

The technicians returned, got the lady out of the room, and told me it was my turn. The thing I was most grateful for at this point was simply a place to lie down. I didn’t care if it was noisy or uncomfortable, I just wanted to close my eyes, which I did for the next 25-30 minutes.

We got back into the ambulance and made our way back home (another quick trip through Accra traffic). As soon as we got home all I wanted to do was sit on my recliner, take a pain pill, and maybe sleep a bit. That night I slept at least eight hours, and would have probably slept longer except Dr. T called. She told me she had gotten the radiologist’s report on my knee. According to him, I had a torn ACL, MCL, meniscus, muscle, and significant fluid on my knee.

Dr. T recommended I travel to Paris to follow up on both my arm and knee. I told her I would have to discuss the issue with Dave, and that I would get back to her (he had gone to work). She told me, in no uncertain terms, “You are the patient. You must take control and make a decision.” I was taken aback, but then said, “I am mentally and physically exhausted and I am in no way capable of making a rational decision by myself. I will discuss this with Dave and get back to you.” I think she got the picture.

Dave and I were really not so much concerned with my arm as we were with my knee. Both Dr. T and Dr. Ocloo did not observe any obvious problems with my knee when conducting their examinations.  I partially tore my ACL about eight years ago while playing basketball, but had chosen not to have surgery. Rather, I rehabbed the knee through exercise. When I hurt my knee the first time, it was a much different experience than this injury. The first time I heard a pop, and when I was lying on the basketball court, my knee just burned. As I tried to walk to the sidelines, I had the sensation that my knee was going to fall off of my leg. When I fell off the ladder I heard more of a crack, not a pop. I watched my knee move to the left and then to the right. There was pain, but no burning sensation. It didn’t swell excessively, I was able to bend my knee almost completely, and the knee didn’t feel like it was going to fall off my leg. I could tell that something was not right with my knee, but I was not convinced it was my ACL.

We had a decision to make. Stay in Ghana and hope everything would be ok, or travel to Paris to get a second opinion. I always thought that going to Paris would be romantic….not painful.

Careful What You Wish For!

Sometime between our April 2012 Seychelles trip and our May 2012 Laguna Beach trip, I injured my left elbow. I can narrow it down to those two events as I don’t remember it hurting while golfing in the Seychelles, but distinctly remember it bothering me at the Aliso Golf Resort.

After several months of the pain, I did some research online and was convinced I had what is commonly referred to as “golfer’s elbow.” My symptoms aligned exactly with what I was reading: pain in the tendons connecting my forearm to the elbow. The pain was centered on the bony bump on the inside of my elbow and sometimes radiated into my forearm.  

Why? Well, that also made sense after my research. Golfer’s elbow is usually caused by overusing the muscles in the forearm that allow you to grip, rotate your arm, and flex your wrist. Repetitive flexing, gripping, or swinging can cause pulls or tiny tears in the tendons. Since moving to Ghana I have golfed more than ever as the local weather accommodates the sport nicely. In addition, I have probably spent a record number of hours in the gym trying to pass the time.

I also read up on cures – the number one being rest. As hard as it was to do, I didn’t golf for two months. It started feeling better, but as soon as I picked up a golf club, the pain returned. I also read an article that suggested I needed to strengthen my forearm muscles. Did that, but it only hurt. Mostly I just kept working through the pain.

The pain was sometimes so bad that I couldn’t lift a pan from the stove, or shut the car door with my left arm. In January I decided enough was enough and made an appointment with an orthopedic surgeon in Loveland, Colorado in February as Dave and I would be back in the states.

As I expected, after getting an x-ray, Dr. Chamberlin informed me that I had classic symptoms of medial epicondylitis, better known as golfer’s elbow. After hearing that I lived in Ghana he realized a more aggressive course of action (i.e., surgery) was not going to be my first option. He decided to go the conservative route and recommended placing a cast on my arm for 4-6 weeks so as to immobilize the joint. I cringed just thinking about it, but felt a bit better when he told me it would be a removable cast. He strongly suggested a round of physical therapy after 4-6 weeks, and I was frantically wondering how that would work in Ghana. We scheduled a second appointment for late May when I would be back in Colorado for my niece’s high school graduation.

Dr. Chamberlin’s nurse then took me to the “casting room.” There were two other people in the room that day (among several others) that made an impression. The first was a 14-15 year old kid who had a broken arm. He had been playing in a high school baseball game, was at the plate and got hit by a pitch. Brought back vivid memories of the day when Benjamin broke his arm playing football. I was hysterical; he was calm, asking me why I was hysterical.

The second patient was an older man who had evidently had his toes cut off. Seriously, the guy was lying on the table with his right leg straight out. I was looking straight at the bottom of his foot….there was not one toe left. When his doctor left, the nurse proceeded to take out the stitches, some 100 of them I heard her say.

Right about now I was feeling a bit like a baby. All I was getting was a removable cast as a result of having so much free time on my hands.

At any rate, the nurse started to cast my arm. This was a regular plaster cast, similar to the two I had gotten when I was a child (one on both arms). After the plaster dried, the nurse cut off the cast and then fashioned it in such a way that with a bit of effort I could remove the cast.

For the next week I faithfully wore the cast 24 hours a day, except when I showered. My friend Tanya would have been impressed as I even wore it while doing plyometric exercises. I continued to go to the gym and just did exercises that didn’t involve my arm. It was something I could live with for the next few weeks. I desperately wanted my elbow to feel good again.

On Monday, March 11^th, I began my 20+ hour trip back to Ghana. People were kind and helped me with my bags often. So many people asked me what had happened, and I constantly found myself saying, “I wish I had a better story to tell….”

On the long overnight flight to Accra I finally relented and took off the cast after trying for two hours to get comfortable with it on. After an uneventful flight (something I always pray for) I arrived home and the first thing I did was crawl into my comfortable bed for a short nap.

At 2 p.m. I woke up, took my cast off and jumped into the shower, removing my cast. After getting ready I started to unpack the three bags I had hauled back. I was tired, but felt better after the rest and a shower.

While I was getting ready I heard a loud noise outside of the bedroom and had assumed it was Doris, our housekeeper. Well, when I opened the bedroom door I saw what had made all the racket. The door to the attic was wide open. Now…if this is the first blog of mine you have read, you can’t imagine my horror, and I recommend you go and read about Steve McQueen and his friends.  For the rest of you, I'm sure you know what was going through my mind. Rats! Larvae! Cockroaches! Small children!



Now that I've taken a picture of the door, I can see how filthy it is, what with people opening and closing it.
I can assure you I have no intentions of getting on a ladder and cleaning it!



My reaction, of course, was to shut the door as quickly as possible to insure NO animals, insects, or other disgusting creatures ventured into my home. I went downstairs and got the ladder, set it up under the door, climbed onto it, and quickly shut the door. It flew right back open. After several attempts at jamming the door shut, I realized I was going to need some help. I have experience with the door as the pest guy has been to my house numerous times. I knew that the guards have an allen wrench which is used to open and close the door. So, down to the guard station I went. They could not find the wrench, after looking multiple places. He suggested I contact ATS (our maintenance provider).

It was late in the afternoon, and I knew that if I initiated a call to get ATS to my house, it likely wouldn’t happen. As I walked back to the house, I was devising a plan in my head. I would call Dave and have him (or someone who works for him) call ATS. I just couldn’t imagine the attic being wide open all night long, and was anxious to get it resolved.

I went back into the house, up the stairs, dialed Dave (never thinking he would answer) and climbed onto the ladder. Looking back at my cell phone log, I initiated the call at 3:27, a mere 4 hours after I had landed. Yes, I was on the ladder, phone in my right hand, flip flops on my feet, using my left arm to again attempt to close the door. Unexpectedly, Dave answered the phone and the door seemed to shut. As I began to tell Dave the problem, the door swung open, startling me. I slipped and fell backwards and to the left. When I hit the ground, I heard a crack in my left arm and then watched my left knee twist first to the left and then to the right. It was as if it all happened in slow motion.

As my sister calls it, "the scene of the crime." The door is just above the table and the cross.

The cell phone had fallen out of my hand, and for a second I was just stunned. I picked up the phone, which was lying to the right of me and heard Dave said, “What are you doing?” I told him I had fallen off the ladder while trying to shut the attic door. I was lying flat on my back staring up into Steve McQueen’s world. I looked at my arm and knew immediately that it was broken and started to cry. Dave said something like, “Maybe you just twisted it,” but I assured him it was broken. It had an obvious deformity to it, and was not the first broken arm I’d had or seen. I was blubbering about how a rat was going to fall on me. Dave told me to forget about the attic and to focus on the important thing….me!

If I didn’t know it before, I certainly do now. Dave epitomizes the phrase “grace under pressure.” While I lay on the ground crying uncontrollably, he was already formulating a plan of action. He hung up and by 3:34 p.m. he had arranged Michael to come pick me up and transport me to the Newmont Clinic, had our friend Julie calling the clinic to let the doctor know I was on my way, and was searching for a ride so he could meet me.

As I gingerly stood up and carefully held my left arm to my chest, I moved towards the stairs. I contemplated walking down them, but with not knowing what was wrong with my knee I chose to move down the stairs on my butt, ensuring I wouldn’t fall and further hurt myself.

I had visions of falling down the stairs and breaking my other arm!

As I sat in the living room waiting for Michael, I thought about the fact that I hadn’t eaten a bite of food since I had eaten at Burger King in the JFK airport the previous night. I was desperate for something to take away the excruciating pain, and knew that soon after I got to the clinic I would be receiving pain medication. Evidence exists that I was thinking clearly at some level, as I then hobbled into the kitchen and got myself a soda and a granola bar. After all, you are never supposed to take narcotics on an empty stomach.

I sat back down and decided it would probably take Michael 30 minutes to get to the house. I needed something to distract me, so I called my sister. She answered tentatively and I just started bawling. It’s a wonder she could figure out what the hell I was saying! I felt like we only talked for about 2 minutes, but in looking at my cell phone log, she successfully kept me distracted for more than 17 minutes. It would have been longer but then it occurred to me that I don’t have call waiting (Ghana, people, Ghana) and that Dave was probably trying to call. Just minutes later Michael pulled up and I made my way to the car. Dave called just as I got into car, worried that I hadn’t answered my phone.

Ghana traffic is terrible, so I almost always plan my excursions around the pattern. I rarely ever go towards Dave’s office after 3 p.m. otherwise it will take me an hour to arrive, rather than 20 minutes. Unfortunately, I didn’t have the option. We would be going with the afternoon traffic, and it wasn’t good. I was sure it would take me an hour to get to the clinic.

Looking back, I have to laugh. Michael was so quiet the whole way. I told him I had broken my arm and he would just stare at me and then at my arm with his eyes huge. He didn’t say two words to me the whole way to the clinic. Fortunately, the traffic thinned out after a bit and I arrived at the clinic in about 30 minutes.

I had not seen Dave since March 1^st….12 days. I walked in, saw him, and just started crying (again). He gathered me into his arms and assured me everything was going to be ok.

I was about to embark on more than a week long health care journey. Be careful what you wish for!

To be continued.....