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Friday, June 11, 2010

Utterly Shattered in Quito

Just as we entered our second loop in Ecuador, chaos struck. We had a very long flight from Valparaiso starting with a bus ride in the morning stupidly arriving at the airport 2 hours and 55 minutes early, confusing the departure time with the Sky flight the afternoon before. We then had to wait three hours in the airport for a LAN flight that arrived in Guayquil, Christine's varicose veins began to swell up and when we arrived pretty tired, we found we also had a good round case of altitude sickness with the dry horrors at night and nausea at breakfast.


We are recovering from acute trauma at l'Auberge a delightful French hostel/hotel, which is a play on both aubergine and hotel in French I am told, with a Swiss restaurant serving excellent food at reasonable price.

After feeling somewhat better mid-morning, we set off into the Old City with its many diverse churches and traditional buildings, the markets and ladies trying to sell scarves adorned in Andean attire. I took a lot of views of the hilly streets of the old city and some sweet folk pictures of old ladies and street sellers and the interior of some of the churches. At the same time there was a big police presence outside the presidential palace because Hilary Clinton was visiting Raffael Correia. I always find the Latin American churches somewhat grotesque, because they have such bloodthirsty Penitente images of Jesus being crucified but suddenly I was thrown into a remarkable similar situation.

Just as we walked back to catch a bus to the hotel, a guy ran up out of nowhere, grabbed my Fuji camera and pushed me into the path of an oncoming bus which knocked me for six and drove off leaving me shattered and unable to move in the street. Some people called an ambulance which arrived and seemed to be more interested in videoing me than offering emergency assistance and dumped me on a gurney and I was ferried in acute pain through the bumpy streets of Quito to the International Emergency unit who promptly tried to x-ray me all over, so we made a break for a taxi, having found I had a compression fracture of my left hip, to try to decide whether to fly back to NZ (there are no direct flights) or have a major operation in Ecuador.

I couldn't get in or out of the taxi because my left thigh was completely disintegrated and any movement graunched the broken bones around causing internal mayhem. The guys in the hotel had to carry me up the stairs seated in a chair in absolute agony, set me in the restaurant (our room is up three flights of stairs) while I made desperate phone calls on global roaming and sent the x-rays to my brother Denis who is an orthopedic surgeon by e-mail to get advice and searched the internet to try to find the best hospital to go to. At best I could sit motionless with my left knee propped against the table but the whole thing was swelling up and getting more and more inflamed. Then I was carried in agony back down the hotel steps and driven to the Metropolitano Hospital (the only one I could get hold of with an English speaking operator and the best according to the hotel restaraunteur although the Voz Andes is also good), where on examining the x-ray, they told me they would either put in a plate and screws, or do a total hip joint replacement. They then did a computer tomography and decided on the plate. Meanwhile I had to try to get the insurance cover activated by global roaming. Nicely Christine was allowed to stay in a single ward room with me with a fold out mattress settee.

We then had to wait in sleepless agony for 18 hours with no clue as to how this would all work out and whether to continue, or can our journey, or reduce it to a recuperation followed by a quick trip through Europe later. After what seemed to be a sleepless eternity, I was finally operated on at 3 the next afternoon, where I was trundled into an operating theatre with rather hideous leather boots to hold my shattered leg up and told to breathe into a mask and promptly lost consciousness from a combination of intravenous and gaseous anesthetics.

A short time later, but actually three hours in real time, I awoke as they were shifting me on to another recovery bed and knew immediately that they had successfully set my leg and was overjoyed and congratulated them all heartily, telling them "hasta la vista". We then had another pretty sleepless night and Christine ended up with a racing heartbeat and a nasty knotty blue varicose vein, which looked like a thrombosis. So while I was trying to fend off multiple blood transfusions, which they insisted had no HIV or Hep C, and discovering that I could walk already with the help of a walking frame and could actually stand unaided on my broken hip one day out of major surgery, which isn't too bad for a man of 65, Christine ended up having an ultrasound scan which revealed she has a string of chronic superficial (not deep vein) thromboses, so she had to go out to get prescriptions for anti-inflammatory anti-thrombotics.

Just made it back to the Hotel after managing to get signed off only 48 hours after a major operation partly by determinedly getting out of bed and showing them I could do a circuit of the ward and having my blood transfusions like a good boy. The combined effects of the fracture and operation were pretty severe, in the sense that my thigh and upper leg is all swollen and my cock and balls are blue from bruising, my ligaments are shrieking, my muscles are cut (along their line of action) and my bones are broken albeit now stoutly screwed together, but it's great not to have head injuries. or be paraplegic, and not to have any brain damage from operative trauma like a clot to the brain (which happened to my osteoporotic mother from a similar crush fracture, causing an almost complete loss of ongoing long term memory - not something that made me very happy about the situation) and to be able to walk so soon!

Dr. Ernesto Mantilla (right) who led the team doing the operation signing me out.

Basically I found in the Metropolitano the absolutely best treatment in Ecuador and they have done a really great job of screwing up my thigh with a massive 110 ml plate and screws so that it is possible to stand unaided although I have to walk very carefully with crutches. Dr. Mantilla did a fantastic strategic job of setting the break expertly, while keeping me informed of all the possible options throughout. I tried to avoid a blood transfusion, but Dr. Yepez pretty wisely insisted, because I had lost nearly half my blood in the internal bleeding and operation trauma, so in the end I gave in because they have their own blood bank and their standard of care was way above anything I have seen in our National health service. And there is no sign of infection in the wound.

Dr. Julio Yepez who had to put the hard word on me to have two blood transfusions because I had lost nearly half my blood.

The insurance provider Travelguard has just sent a friendly confirmation the treatment will be supported. And we have postponed our COPA flight out of Cali Colombia for a week to get in better shape for surface and air travel.

And yes I am looking after the leg carefully, although I have learned to climb and descend a short flight of stairs in crutches with a day pack on only 72 hours out of the operation, without any undue stress.

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