ALONG CAME A SPIDER

This will be a brief post as I have not been very active for the last month. At the end of August, after being at my site for three months straight, I took a long weekend off and relaxed at a lovely bed & breakfast in Polokwane, “Olivia’s Place.” Gorgeous surroundings and wonderful people sum it up. While there, I got word from PC Medical that I should come on down to Pretoria to meet with the orthopedic surgeon to talk about options for my knee. It had not noticeably improved despite 8 weeks of good effort at Physiotherapy at home, so I added a couple more days away from my site to talk at length with the surgeon and the PC doctors about having arthroscopic surgery to repair/trim my torn meniscus. The surgery was approved and a date set the following week on the 12th of September. I went back to rural Limpopo to finish up some work at the office, pack for an anticipated 2 week stay in Pretoria while my knee would be healing and rehabbed and to say good bye to all the folks there.

Sometime during that trip back I got bitten by a spider. It was one of the kinds of spiders with necrotizing venom that I have learned are fairly common here. Best I can figure, it was hiding in a chair or couch in the crease between the seat and the back when I sat on it. Even though I started antibiotics while still at my site, the bite was well abscessed by the time I got to Pretoria for my pre-op visits on the 11th. The Orthopedic surgeon took one look at it and informed me, quite rightly, that there was no way he would operate until the abscess was completely healed. He also said that the ulceration looked particularly bad to him and he marched me down stairs to a general surgeon. He agreed and scheduled me for surgery to “clean out the abscess” for the next morning. I ended up having surgery at the same time on the same day and in the same hospital as planned, but a bit up river from my knee.

To remove the abscess, the surgeon had to take a chunk out of my seat a bit bigger around than a US nickel and almost an inch deep. The wound cannot be sutured or the abscess is likely to return and there would be a very noticeable scar even if it didn’t. The wound has to be left open and cared for with special dressings and kept immaculately clean so that it heals slowly from the inside out (if I said bottom up that would also be accurate but confusing.) I have the unfortunate experience of being well trained in wound care as a result of Linda’s failed cancer surgeries, so the day to day dressing changes was left to me. Thank goodness for all the years on the farm backing trailers into tight places as otherwise the mirror views necessary to the task might have made it impossible. What was not possible was for me to return to my site and my work there. Not only would that have made my biweekly doctor appointments for wound checks impractical, but the lack of clean running water and a shower would just make avoiding reinfection a miracle. So here I sit at my usual Pretoria backpackers (though in a single in suite room rather than a dorm) waiting for my clearance to go back to work.

I have been able to get almost all of my quarterly PC reporting done and have updated the GET THE MESSAGE materials to incorporate some new information of ART as an aid to prevention that gained general acceptance at the World AIDS conference in July, on Medical Male Circumcision (MMC) which is being pushed hard in SA right now and to address some of the observations that came out of the last session. However, as I enter my third week here, sitting is getting a little boring. I have offered to help out at the PC office, but as yet nothing has been found that needs doing. If I had any pain or disability, the inaction would be more palatable. I think that I am not alone among volunteers in having embraced an active life style, physically and mentally. It is addictive and I miss it. Good news is that the medicos think I should be ready for a return to third world Africa by the first of the month. I’m certainly ready in my own mind.

As for the knee, I anticipate that the complete healing process for the spider bite will take a little longer before that surgery is an option. I want to try to get one more GTM workshop done and then will see if I can reschedule the work on the knee for the end of this year or the first of next. I will just hobble on ‘til then keeping a weather eye out for our little eight legged friends.