Hospital

I did not plan on writing this episode. But sometimes life happens, and not always according to your plans. I’ve got an 11-day opportunity to get to know how it goes in New Zealand hospital. Now I’m at home with my left leg in a cast and with a walking frame, and because I have plenty of time, I’ve decided to put my hospital experience into a blog post. But first:

TL;DR

Since Sunday of May 26th I had troubles with cramps and swelling of my calves. It was getting progressively worse. On Wednesday of May 29th I was admitted to Waikato Hospital in Hamilton with acute rhabdomyolysis. After two days of various examinations I was diagnosed with compartment syndrome. In nutshell, this means that muscle swelling causes more and more pressure in the muscle, which then run out of oxygen and eventually start dying – this causes rhabdomyolysis, which literally translates to “muscle breakdown”. Protein and multiple other substances from the broken muscle gets to the blood, which is not good for kidneys, because protein is not supposed to be in blood in such quantities. So it is absolutely necessary to stop this cycle as soon as possible: “open” the calf, so the muscle compartments have a space to breathe (this is called fasciotomy), remove dead muscle tissue and also continuously apply IV fluids to reduce the load on kidneys. Which is exactly what doctors did.

Following my diagnosis I had 3 surgeries: first the doctors opened the calf, then they removed dead muscle tissue and at last they cleaned up and stitched the wound. My left leg has a cast from below the knee down to toes. My right leg turned out completely OK, kidneys did as well. What does this all mean to me? Because they took my “shin” muscle, which does mainly the foot lifting, my walk will be rather silly in the coming months. Will I be able to run again? Maybe. Maybe not. At least not anytime soon. However, I will be able to do all the other sports, which don’t involve running – e.g. biking, swimming, etc. :-) And because the worst outcome was kidney failure, dialysis and leg amputation, it ended up almost perfectly. There is really nothing to brag about – there are much, much worse things in life. This hospital experience is just one of many happy little accidents on my life journey. Shit happens sometimes. So I’m just going to accept it, shrug, chin up and go on with life.

Marathon training

I love running. It is my way to clear my head after a long day at work, and a way to remain somehow fit. I started taking it seriously when I signed up to a 10k race 2 years ago. I ran over 1000 km since then, and I participated in two other races (both were half marathons) and a Taupo relay run. And because I love challenges, marathon was always my “holy-grail” milestone. I was not signed up to a marathon race – I just wanted to prove to myself I can run such distance. Just a training run, you know. So when I arrived to New Zealand, I created myself a five-month training plan and started following it by running 4 times a week.

It was easy in the beginning, as I was running just about 10-20 km per week. One day it was a slow-paced “recovery” jog, the other day it was an interval training – multiple short-but-fast sprints divided by short breaks to catch up breath. As the time went on, the distances were slowly creeping up, so I eventually ran a few “training” half-marathons. The longest run I did had 33 kilometers. I ran over 450 km and I felt prepared for the marathon. The week before the marathon was a recovery week – I did barely 14 km. I thought to myself: “all right, let the body recover, and for the next week let’s do two light sprints and one medium-distance recovery run, and then let’s do the marathon on Sunday”…

The plans are changing

Then the “race” week started and I had a short run planned for Monday in my training plan…just 7 km “recovery” run, nothing wild. But there was no run this day. My legs started swelling in the morning and I started getting leg cramps. But I could walk, so I just walked to my job as always. It’s just 1.5 km, so why would I bother taking a car? I knew my cramps. I had them many times before, and I hoped that I’m just missing electrolytes and that it will get better overnight. “I will do my training run tomorrow”, I thought. However, the cramps were much worse on Tuesday. My legs were so swollen that the morning walk to work was not an option. So I used a car to get there, and with the help of a few bad words here and there I was able to overcome the pain and crawl myself to the office. I was fortunate enough to do the same thing in the evening.

However, overnight my calves turned to stones, and my ankles looked like big swollen balls. I tried to walk, but I was not able to bend the legs. An whisper in my head told me an obvious news: “no, you are not going to work today”. I used whatever was left of my power and flexibility to crawl to my car and drive to Victoria Clinic in Hamilton. I was there before due to Work Visa health check, so I thought they would have my records. I gracefully paid the health check fee and then I got a whellchair. An upgrade to my mobility, indeed. I also messaged my colleagues at work that I unfortunately can’t come that day…

The doctor checked my calves and declared that it must be a deep vein trombosis, and that I need an ultrasound check. But they don’t have an ultrasound there, so I have to visit River Radiology clinic about 1.5 km away. He also told me that using my car is not the brightest idea, because of my limited ankle mobility, so that I should use a taxi. That was a fair point, so I had to swallow my pride, install Uber and use it for a 1.5 km ride.

UBER premiere

I have used taxi maybe once or twice in my life, and I have never used the taxi-revolution called “Uber”. “Well, at least you’ll get a new experience”, I told myself when I was installing mobile application of said company, which managed to lose over billion US dollars last year. Taxis aren’t probably the best business out there. However, I have to admit that their system works pretty well.

It did not even take four minutes until a shiny white Prius parked in front of the clinic. My driver’s name was Harpal and he was very nice. He asked me how my life goes, so I took the opportunity to cry myself out. It had no impact on him. He drove me straight to the entrance to the radiology clinic and wished me good luck and a nice day. So I gave him a five star rating and a tip. In the end it was a very pleasant experience. But I would still prefer walking there.

It was only 50 meters from the taxi to the radiology clinic reception, but the legs were swollen even more than in the morning. I was able to barely crawl there, and I immediatelly asked for a wheelchair. I had to wait 4 hours, because they were busy and there was no timeslot left. These 4 hours felt like eternity. At least I had a brilliant idea in the morning to take my phone charger with me, so I could charge my phone…and try to google the diagnosis.

However, the ultrasound brought no answer – the veins are all right, no blood clot. Well, what’s next? Let’s use UBER again to get back to Victoria Clinic! My second driver had a nice new Honda Accord and was as nice as the first one. When we arrived, I immediatelly asked for a wheelchair and went straight to the toilet, because I did not have a chance to use it during the day. Though I was not prepared to see my Coca Cola colored urine. I told my doctor about it, just as a “by the way” fact. He was already nervous from the ultrasound result, but this fact made him nervous even more. He told me that I should go to hospital, and that he’ll arrange my admission there. And he asked me whether I want to go by taxi again or whether I want an ambulance.

It was 6 PM. Darkness outside. My calves were so swollen that I thought they are going to explode in no time. I could not even crawl anymore, I was tired and didn’t know what the hell is happening to me. Just thinking about myself trying to find my way to the right clinic in the hospital maze in this state seemed so unappealing to me that I thought $70 is a great price for a direct route. Besides that, I haven’t ever been in an ambulance before, so there goes another life experience…

Hospital

After 20 minutes, two nice hospital medics welcomed me to the ambulance. One of them interrogated me thoroughly as we were cruising through Hamilton evening traffic jam. Everything happened so quickly after leaving the clinic. I did not spend even a minute on emergency, as they took me straight to the hospital room. Then I got a dinner – a sandwich with an apricot yoghurt. I was not hungry though, so I saved it up for later. They gave me IV fluids immediately – 1 liter per hour – to hydrate me quickly. I got four other fluid bags in the coming hours…

After a few hours they took me from the shared room to a new, beautiful, single room with a stunning view. The room was just above the heliport, so I could see the rescue helicopters taking off and landing. Interesting fact: Waikato Rescue Helicopter project is 50% community-financed! The ward was called “A3”. I felt great, if not counting the crazy pain in my legs. I was trying to fall asleep, but my legs were burning as hell. They gave me Paracetamol and Codein, but nothing helped.

Next morning, about 6 doctors and two students of medicine surrounded my bed. They were asking a lot of questions – mainly about my marathon training. They told me I have rhabdomyolysis and left the room. Rhabdo. A.K.A muscle breakdown, often the result of overtraining. I’ve heard about it before – in relation with fitness phenomen Crossfit. Many crossfit gyms and coaches followed the “excercise until it kills you” mantra, which, indeed, led to a few kidney failures here and there. But…this is not my case, right? Besides that, I was not running much in the last 7 days, so why is this happening to me today and not straight after the workout?

Hospital life

Perfect hospital shall have its perfect order. A day in the Waikato hospital starts at 7AM, when nurses hands the patient administration to their colleagues when changing shifts. Then a breakfast follows – typically cornflakes, muesli or porridge, and toasted bread with butter and jam…and sometimes even fruit or yoghurt. Then the doctor visits begin – usually individually, not in “herds”. Lunch is at 1PM and offers a soup, toast bread and some kind of sandwich (e.g. with ham and cheese). The shift changes again at 3PM. At the beginning of each shift, nurses check the blood pressure, temperature and pulse of all patients. Dinner happens around 7PM and it’s the main meal of the day. It offers soup, main course, side salad, fruit and a dessert. The food quality was hospital-like…not a Hilton hotel, but it was kind of balanced. However, some of the roommates were not happy about it, so they just threw it away and ordered a McDonalds delivery instead, with a pack of Doritos and Mountain Dew. I’m not sure if it’s a better choice, but I’m not here to judge…just to observe :)

The last shift change is between 10PM and 11PM, and then a calm, peaceful an uninterrupted night begins…right? Well, as long as you don’t have a roommate that does snores like a giant bear. During my stay in the hospital I was in 5 different rooms. Three of those rooms were shared, and in one of the rooms there was a gentleman, whose average snoring intensity easily exceeded 65 db. However, his record was 73 db (measured by my phone just next to my ear)…this can be easily compared to a chainsaw! Yes, I indeed downloaded a mobile app just to measure the snoring intensity of this random man in my room. But what would you do yourself at 3AM after five hours full of desperate attempts to fall asleep, only to be interrupted by loud “ChhhhhhhrrrrruuuuUUUUUUUPPFfffuuIIIIIiiiiiiii” each time?

I have identified at least five types of employees in the hospital: nurses had a dark blue outfit and their job was mainly administration. Orderlies had red outfits and they did most of the other stuff – they served food and hot drinks, drew blood (VERY efficiently – fast and painlessly) and did everything to make us patients feel comfortable. Doctors had no specific outfits, but their common trait was business – they usually stayed just for about a minute and disappeared before one could take a breath and ask a question. Janitors had black (or dark green?) outfits with “ISS” logo, so I assume they were outsourced from an external company. I need to credit them however, because the hospital was really clean. And then there were the ladies and gentlemen in light blue outfits – they were the “bed taxi” drivers. Their job was to take patients from point A to point B. They were always extremely chatty…I remember going through the whole Brexit thing with one gentleman who was originally from Britain…

The hospital staff was from all over the world. From India, China, Sri Lanka, South Africa, Europe and even the US. I remember when I was on x-ray check…there was a young man who introduced to me as Giuseppe. I had to ask him whether he’s from Italy…and he indeed was! We had a nice talk about Naples. Everyone asked me where I’m from, and everyone wondered why I came to New Zealand just by myself. When I told the anesthesiologists before my surgery that I’m from Czech Republic, they told me they were there and that we have a good beer…but that beer in Belgium is better. They put me to sleep before I could disagree with them. That’s not fair!

Diagnosis

And there was Friday – day five of pain. The right leg started to look, feel and work like a normal leg – the pain, cramps and swelling went away…but the left leg was getting worse and worse. So they took my blood again and took me to ultrasound, x-ray and MRI. It was my first (and hopefully last) MRI in my life. My legs went into the tunnel and a I got a big noise-cancelling headphones. They did not help much though – the MRI machine is loud as hell. I thought I’m there for eternity, and I was indeed really happy when the scanning ended…it took just about 40 minutes.

I just got into my room from the MRI scan, when a doctor rushed into my room. He told me the thing: “You have an acute compartment syndrome in your left calf. We typically wait with a surgery for a few days, but you need it now. We need to open your leg to let your muscle breathe. If we don’t do it, the calf muscle will die and we will have to amputate your left leg. The only possible complication is infection, but you are going to get strong antibiotics, so the probability of infection will be less than 1:10000. You are going to theatre in an hour. Please sign this paper here and there. Any questions?”

I asked him what I did wrong and if I could prevent this. “No, you couldn’t. You did nothing wrong. Your training and nutrition were on point, you are otherwise completely healthy. It seems that you were just unlucky.” Well, this was not what I expected. But I had no other choice, so I signed the paper, and by doing so I felt instant wave of huge relief. “They know what is wrong with me and I’m getting surgery now, that’s neat!”, I thought. From that point onward I decided to accept everything as it goes. Then they took me to the theatre waiting room, from where I quickly let everyone know – my family, flatmates, colleagues and friends. Then an anesthesiologist came in and asked me if I have any allergies or any problems with anesthetics, and to sign a paper here and there. He had a long dark mustache and huge eyebrows, so he looked exactly like the Italian plumber from the popular videogame Mario. He was really chatty, as were all his colleagues. I wonder if they continue in conversation when their patient falls asleep under the power of anesthetics. It must happen all the time…they are talking to someone and suddenly realize: “oh, he’s already asleep…” :D

“The wakeup room” was my favourite hospital room. When I woke up there, I had my left leg in a cast. But I felt no pain…in fact, I felt like in heaven. Morfin was pumped into my blood, and the nurses there were the nicest nurses in the whole hospital. Their job was to wake up all the patients that were coming from the theatre. Dream job, if you ask me. So wholesome! They gave me a lemon ice block and drove me to my room, where I fell asleep under the power of pain relief medication…

First “steps”

In my room I met my new “friend” – the morfin “pain relief” button. The instructions were clear – if it hurts, press the button. However, there was a side effect – when I pressed the button, I started to feel reeally sleepy. So I was not using it much. Nurses told me that it’s a good thing, and that there are patients so used to it, that it has no effect on them…no matter how hard they press it.

Then they moved me to another room. There were three other patients. One older gentleman who soon went home. One gentleman who snored incredibly loud. And one guy in my age, who had both his hands wrapped in bandages and was holding them up all the time. When he walked somewhere, he looked exactly like a zombie…or rather a mummy. Later I got to know that my ward “M7” is also for patients with burns. And that his both hands are seriously burned, because a gas-leaking canister exploded in front of him.

Then a doctor visited me and told me that I need two other surgeries. During the second surgery, they took away the muscle that did not withstand the pressure and died. And during the third surgery they cleaned up the wound and stitched it. Then I got a new, “final” cast and a walking frame, so I could start to move around. It was not easy in the beginning – the first day after my surgery I could barely stand. The next day I started walking here and there, and I could finally have a proper shower.

I used my time in hospital mainly to chat with family and friends. Some friends and many of my colleagues – in fact my whole office – came in to see me, which really boosted my mood and caused the time to fly fast forward. And because I was already able to move around with the walking frame, the time has come for me to get discharged home. My great flatmate Lubos took me there all the way from hospital, which helped me in a big way, so big thanks to him! The instructions until Monday are: rest, stay at home and leave the leg lifted as much as possible.

What’s next

On Monday – June the 17th – I go back to the hospital to get my cast and stitches off. I can’t wait, I’m counting down every hour. I hope that I’ll be able to start using the leg, but I have to be patient – I won’t be able to walk straight away. I got no further information from the doctors, but I suppose I’ll need some form of physiotherapy. I’m not sure how well will my leg work – there are four muscles in a calf, and I was told that one of them was almost entirely removed, because it did not survive. The said muscle is the “shin” muscle – it lifts the foot up. Because it’s absent now, I will probably need some kind of special shoes, which will make the foot not drop all the time. But it’s not a problem. Good hiking shoes are typically solid in the ankle, so they can provide a certain degree of support, so eventually I’ll be able to hike.

I want to get back to normal life as soon as possible – go to work, go shopping, go out with friends…I’m starting to get bored at home :) The biggest hurdle for me now are the stairs – I can’t climb them up yet, because I can’t put any weight on my left leg yet. Driving a car will not be a problem, because my car has an automatic transmission, so I don’t need to use my left leg at all. My employer is doing their best to assist me in getting back to work – from offering me to park my car straight in front of the building, to offering me a home office during my recovery. I don’t know how I earned this, but let’s just say I have an awesome job and that I’m very grateful for that.

Speaking of gratitude…I want to take a moment here to thank everyone who messaged me, emailed me, called me or just liked my Facebook posts from hospital. The hospital stay was long, but thanks to you it was enjoyable and it flew by quickly. I want to thank my parents and relatives and my friends from Czech Republic, New Zealand and elsewhere in the world. And I want to thank everyone who came in to visit me: my flatmates, my friends and especially my colleagues. My whole office came in to visit me…can you imagine that?!? You guys are awesome!

No, I am not planning to mentally break down from this, or return back home because of it. This is just a happy little accident on a life journey, and many more will come for sure. I am happy and I accepted how everything ended. What doesn’t kill you…you know that one, right? My New Zealand travel backlog is still very long. I want to eventually clean it up a bit, and I want to share everything with you. So thank you for reading and see you in the next blog post!