This may sound a bit stupid, but have you ever realised that invalid (meaning someone made weak or disabled by injury of illness; pronounced /ˈɪnvəlɪd/) is the same word as invalid (meaning not valid; pronounced /ɪnˈvalɪd/). How horrible! The reason for this startling revelation is because I, myself, have been invalid for the last 2 months (feel free to use whichever interpretation you choose).
Yes, it seems that in one of my typical moments of death-defying extreme action (I was chasing our pet parrot), I slipped on a small step and hurt my ankle. Given that I sprained my ankle in the exact same place a year ago, I assumed this was just a repeat injury and carried on.
Insurance, however, insisted I get an X-ray “just to be sure”. So off I hobbled to the local doctor. He sent me to the hospital for the X-ray, who then sent me back to the doctor to get the X-ray interpreted. To my surprise, I was told I had a fracture of the fibula. I was surprised, not only because my sprain was not just a sprain, but also because the local doctor managed to pick it up! I really must give the health workforce here a little more credit.
With this diagnosis, I was then sent back to the hospital to see an orthopaedic specialist. I was sure that all this to-ing and fro-ing couldn’t have been good for my ankle, but thankfully I had the most patient chauffeur (who, thankfully, got his licence only a couple of months ago).
Back at the hospital’s fracture clinic, I was seen to by the head of Division who cracked a few jokes (see what I did there?), and then presented me with a moon boot to wear for four weeks. In case you are not aware what a moon boot is, all I can say is that it is very aptly named after what you would anticipate an Isabel-shaped astronaut would wear while walking on the moon…. on one foot. At least it was removable in this tropical heat – unlike a cast – and at least I could continue to put weight on my foot and “walk normally”.
Walking normally. Yes, I would just like to say that there is nothing “normal” about walking in a moon boot. Imagine one of your feet doubles overnight, and is covered in hard plastic armour. Not only do you inadvertently kick everything around you, but having one foot a few centimetres higher than the other also causes you to limp somewhat dramatically, causing shooting pain in the knee and hip of your other, supposedly good leg. The lovely nurse from insurance had a very comforting story for me when I made her aware of these troubles, “My sister wore a moon boot for a small fracture, and then slipped and broke her other leg. I thought it might make you laugh”. Laugh isn’t quite the word I would use, but I appreciate the effort.
With Solomon’s technology, it took me a week to get a copy of the X-rays to insurance. They very quickly called me back to let me know that, in fact, I did not have a fracture. Rather, the bone was minimally displaced. I think that means it was broken…..but only a little bit. There goes my thinly-veiled faith in the Solomon’s medical elite. This new diagnosis had insurance very worried, and they gave me very stern advice NOT to wear the moon boot, not to put any weight on my foot, and to go on crutches immediately.
So, back I went to the hospital. For the princely sum of SBD$30 (about AUD$6), I was issued with a true piece of art: hand-made wooden crutches. For all the faults, it does amaze me what people here are able to do with so few resources. Speaking of faults, the remarkable and rudimentary, all-wood crutches lasted about 30 minutes before imprinting black bruises in my armpits and bestowing big blisters on my hands. Fortunately, my patient chauffeur is also rather handy, and fashioned a very comfortable leather-bound padding on my crutches at the cost of one of our couch cushions (don’t tell the Landlord!).
About a week later, I received a call from an orthopaedic specialist in Australia, who had been contacted by insurance to offer further advice. His advice was this: “Don’t use crutches. Wear a moon boot and put weight on it”. Sigh. While this third piece of advice in as many weeks left me rather relieved that I didn’t have to bother with crutches anymore, it also made me rather frustrated.
This mixed messaging, coupled with extreme concern from those around me who had experienced the same thing and strongly recommended immediate physio, finally led me to demand that insurance arrange a proper assessment in Australia.
Back in Australia, everything seemed so easy. I had an MRI, which almost sent me to sleep with its repetitive clunking sound. A few days later, I had an appointment with the specialist – who had an awesome nespresso machine and herbal tea selection free for client consumption (it’s the little things). He sent me to get an X-ray, which was just down the hall and took 15 minutes. After a 30 second glance, he advised me that: a) the bone was healed – Yay!; b) I had a lot of ligament damage but not enough for surgery – okay; c) it would be six months of physio before I could run again, and 18 months for the ligament to be fully healed – sigh; and d) that I should avoid walking on sand, hills or uneven surfaces for a little while – in other words, don’t walk anywhere in the Solomon Islands. I guess it was as good a diagnosis as I could expect.
The real challenge in Australia was the cost. Even with insurance covering most of it, I was responsible for the Medicare gap, which still left me a few hundred dollars out. Perhaps the most bewildering thing was getting the ankle brace. I remember back in the day when you would just head to your local pharmacy, go to the rack, choose your size, and then go on your merry way. Not anymore! This time, I had to have an appointment with a specialist orthotic company, pay an AUD$25 consulting fee for someone to decide whether I needed a small or a medium size, and then hobble out $100 poorer.
The one positive from this whole experience is that I am now far more acutely aware and observant of disability inaccessibility wherever I go. It may not surprise you that Solomon Islands is a disaster for this – pervasive slippery tiles on the floor; steps that are so steep and spaced so far apart that they would be better suited as a climbing wall; no railings……anywhere; no ramps; and just lots of sand, hills and uneven surfaces.
However, I was also surprised by things in Australia. I was pleased by the buses that drop down to allow you to easily step on them. I was pleased by the lifts, railings, ramps and automatic doors. I was less pleased with the numerous escalators that didn’t work (so many! And way worse than steps), slippery paint used for pedestrian crossings, long distances between bus stops, and sloping footpaths (great to rain runoff, bad for people with feet at different heights). My conclusion is that it is almost impossible to cater for every form of disability everywhere, but having more than one option for getting to/from, in/out of a place is good.
Now to end with some good news. Back in Solomon Islands, I have managed to find myself the most amazing physio ever (excluding my physio friends who have not had the chance to woo me with their mad clinical skills). In the space of a week, I have managed to regain almost all movement, and am beginning to get strength back in my foot, thanks to a lengthy and slightly painful daily exercise regime. I am walking without a hobble, and have just made my first venture back into the field where I am preparing to tackle the extremes of sand, hills and uneven surfaces. Wish me luck!