Flying around the world with a broken leg

As I exited the swimming pool I thought to myself: “Better watch out, you don’t want to slip on these tiles and break a leg. That would suck.” Seconds later after I had stepped down from the ledge I was on my back in severe pain. It wasn’t a slippery surface that was my demise but rather a hole next to a garden stone. One of those flat stones you’re meant to step on. A combination of simple sandals without a lot of friction and an uneven surface and my foot had bent in a way that it’s not meant to. After a sleepless night and a swelling the size of a small banana above my ankle my adventure began.

This is the tale of how I injured myself in Indonesia, got treated in Bali and flew home to Germany to recover.

It’s text heavy because you’re not really in photographer mode when injured. I hope it serves someone as a guide in case the same things happens to others. If nothing else it’s a reminder for me unforeseen accidents also belong to being a digital nomad. Coping with these situations is a life skill as any other. I am writing this about one week after the accident from my parent’s home in Munich. I will attempt to include as many details as possible.

I was happy that my room was only ten meters away from the place of the accident. On one leg I managed to get into my room, put the leg under a cold shower and then lay on my bed. After a short while a pulsating pain appeared – I assume this was due to the shock wearing off. I applied tiger palm to the affected area and bound my foot with a bandage I always travel with. I couldn’t sleep very well. A couple of hours into the night I opened the bandage to reveal a large swelling underneath. It was now that I assumed this was more than a simple bruise. I tried my best to get some sleep.

The morning after I was up early and began research on hospitals in Bali. For this trip I was insured via my VISA credit card. Best possible medical care was so my top priority. On the island there are two hospitals operated by BIMC. Both have accreditations, english speaking staff and good reviews online. I posted into the Kumpul coworking group and most people agreed they had a good reputation. Some cited cheaper alternatives but I chose the newer (and more modern) facility of BIMC in Nusa Dua.

bimc-nusadua-page

At about 9am I called an Uber to the accomodation and took the roughly 45 minute trip.
After arriving I filled out the usual information and signed a couple of documents. I was in the waiting room for about 20 minutes. After a nurse asked some basic questions and took my vital signs I was seen by Dr. Samantha. She tested my foot, explained her diagnosis very well and gave me my options. The X-Ray was optional but the only certain way to know if I had fractured any bone. The extra cost was negligable so I opted to do it. In hindsight it was the right decision because a small fracture at the bottom of the leg was the final verdict. Finally I received a splint (a half open cast) and a pair of crutches.

All in all the experience was very good. The staff was very responsive to questions. Even though treatment was swift I felt everyone took enough time to treat me. The total cost for the treatment was under 6M IDR which is roughly 400 EUR. More than half was for the splint itself. The consultation with the doctor was 650.000 IDR and the X-Ray about 430.000 IDR. In a local hospital some elements might have been cheaper. But since my insurance should cover it I would do it again.

diag

Interesting side note: the crutches which I had to buy were only 250.000 IDR per piece.
I returned to my accomodation with Uber and put some thought into my next options. Exploring a new place is already challenging enough without a disability. So I was not keen on continuing my intinary as planned. Staying put was also not an option. My recovery was going to take about six to ten weeks and my visa for Indonesia was going to run out in three. Returning to Europe was the only real option and to my mum was a very comfortable one as well.

invoice

Qatar was going to bring me home with two legs via Doha. The longer eleven hour flight being at night and second shorter six hour flight. I chose wheelchair assistance when I booked. Because long distances such as in airports are a daunting task on crutches.
My flight was 2 days after my hospital visit. The staff at the accomodation where very helpful and helped me get as comfortable as possible. I ordered breakfast with them and used Go-Jek to deliver my a late lunch/early dinner. I packed my bag at a very slow pace since I had enough time.

The flight home

The hospital had requested I come in for an anti thrombose injection about four hours before my flight. So I asked the driver that works with the accomodation to pick me up about six hours before departure. Total time at the hospital was very reasonable again.
I arrived at the airport about 3 hours early. The driver organised a porter to assist me to the check-in counter. There were no wheelchairs available outside so I had to use my crutches to get there. It was exchausting and once I got to the check-in counter a wheelchair was available. Since I was so early I had to sit there for about an hour, but passed the time by reading.

As soon as check-in opened the staff interviewed me about what had happened. The supervisor came to have a look at the medical record. They changed my ticket to the first row on both flights which was a real help.

I was then taken to the gate. Because I was so early though I sat there for some hours. They tried to clear the area I sat in for another departing flight but I was able to convince them to let me stay seated. My only challenge here was going to the toilet which was quite far away from where I was sitting. The first leg of the flight went without a hitch. The cabin crew was very caring and I slept peacefully for most of the flight.

The second leg (no pun intended)

On arrival in Doha the airport staff took me through security and into a waiting area. My flight had a delay. Unfortunately this caused some difficulties. The delay caused a change in aircraft type. So my seat was not first row anymore. I realized this at the gate together with a family who had booked first row. Out of the 8 front row seats six were occupied by families with infants. The remaining two were middle aged couple that didn’t want to give way to my disability. The supervisor came on board and thanks to a lovely gentlemen who moved one row back I got two seats in the second row. This allowed me to keep my leg stretched out during the flight.

This aspect was not solely for my comfort but also to combat thrombose. I take from this experience that I will not hesitate to give my seat to someone who needs it. Even though I am at discomfort with my height in the non aisle seats (see Post mortem for an update on this).

2017-01-28 15.17.04.jpg

On arrival in Munich I only had to cope with the 40 degree drop in temperature. Two gentlemen from the ambulance service wheeled me right up to the doors of our car. That was the end of my one legged flying adventure.

Conclusion

My conclusion from the whole experience is this. Flying today with a disability is a viable option. Of course it requires some preparation but it’s nothing to fear. Here’s my short list of recomendations:

Pack as little as possible in your carry on bag. You’ll have it on your lap in the wheelchair most of the time. But those 1-2 times you have it on your back and hop to places like the toilet you’ll be glad it’s light.

Have your medical report with your passport ready to show at check in. Kindly ask if there’s anything they can do. I’m not lucky with upgrades, but you might be.

Post mortem

I’m currently in Munich recovering from the injury and getting treatment. Coming to Europe for treatment was the right decision. In the end the fracture was diagnosed correctly but treatment in Germany involves a more modern “boot” which is a big step up from the simple splint.

2017-02-02 07.29.04.jpg

About 3 days after the flight I had intense pain in my left calv which is a symptom for thrombosis. A colleague had a similar experience just a year ago and I opted to immediately visit the doctor. Unfortunately their diagnosis (pressure tests) did not result in the right diagnosis. It took a further doctor to ensure blood work was made and since that was positive a deep vein sonogram was done to identify that I had indeed a thrombosis in my leg. I am now on blood thinner tablets for 3 months and all should be fine, but it does once again show that it helps to research yourself, ask friends and colleagues (thanks Martin if you’re reading this) and get second opinions. Medical issues are simply to important.

I also decided to update my list of recommendations for such situations:

  • In future I will insist on thrombose injections (blood thinners) immediately. There may be an increased complication if you have (or get) Dengue fever ** but if your flight is a couple of days after the injury and you are staying inside (with A/C) I would still take them rather than risking a thrombosis. Don’t underestimate how little you are able to move in the aircraft. Especially when on crutches.
  • Once landed take the next possible opportunity to get a second opinion from a local doctor. I was lucky in that I asked for the optional x-ray otherwise my fracture would not have been identified. Other than that my splint was uncomfortable but it was a valid short term treatment, but imagine I had just got some pain killers and walked around without crutches (hindering the healing).
  • Prepare a zip lock bag with everything you might want during the flight like: headphones, kindle, phone, tissues. You don’t want to waste time searching through your bag when boarding.
  • Ask to be taken to the toilet before boarding. The airport facilities are a lot more comfortable than on the airplane.

** By the way this is also the reason why you should not take Aspirin in or to Asia as a pain killer. Always go for Ibuprofen or something similar. If you do get Dengue and take a blood thinner it could actually worsen your situation (IANAD, ask your doctor for information).

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