Caregiver expertise...what does it require?...

Mom and Babies hanging out by the recently cleaned cement pond.
"Sighting of the Day in the Bush"
Her attention and love of her offsprings have been unrelenting since we first saw them in August.
There's never been a time in my life that I required a full-time caregiver.  Although I had surgery a few times, I recovered quickly and only needed help lifting heavy objects or grocery shopping for a week or so.  In all likelihood, this is the case for most of us.

But now, I strive to recovery from this dreadful and complex surgery with my sternum cracked, chest cut wide open and numerous incisions running the length of my legs, all of which is painful making moving about difficult.

In addition, I've had two painful chest tubes since removed, that have stitches to be removed tomorrow when we return to Nelspruit for an appointment with the surgeon.

No doubt with only 16 days since the surgery, there is still a lot of pain and discomfort.  It takes six to eight weeks for the cracked sternum to heal as would be the case for any broken bone.  

In the case of most broken bones, the patient is wearing a cast during this healing process.  It's not possible to stabilize this type of break with a cast and thus, I must move gingerly to avoid further injury.

Thus as described above, this is the time I am needing a full-time caregiver, namely my husband Tom who's had no major experience in this area throughout his life.

I can do a number of things for myself; bathe, bathroom, getting in and out of bed (where I spend little time during the day as recommended by the doctors).  I cannot use my arms for any tasks such as folding towels, chopping and dicing vegetables or performing many household tasks.  

Thank goodness we have Zef and Vusi (included in our rent) who come each day to make the bed, wash floors and clean the house.  With all the animals kicking up their heels in the dirt garden, there's more dust in this house than one can imagine.  Here again, one more bit of serendipity that proves that this was the best place in the world for this to happen to me.

As a result, Tom as the caregiver doesn't have to spend time cleaning the house, other than doing dishes and picking up after us after they leave, his attention is not divided in my full-time care.  This is another huge benefit for which we are both very grateful.

One of his biggest jobs in getting those darned compression stocking on my legs each morning.  As tight as they are, it's an athletic event.  But each day it goes a little more smoothly than the prior day.  It's not easy putting on these tight knee-high stockings when I have awful incisions in both of my legs and he's trying desperately not to cause further the pain.

Over these past five days, since he took over as my caregiver, after my release from the hospital, there are a few things I've observed that truly define the quality of a caregiver beyond the basic tending to bandages, stockings, and mobility.

Let me add here, I requested an early release from the hospital.  Once I moved (after eight days) from the ICU unit to the regular hospital, it didn't take more than a few hours to realize the quality of care went from a 10+ down to a zero.  At that point, I knew Tom could and would take better care of me.  As a result, I only spent two days in the hospital ward, in a room to myself. 
During this period of high temperatures, some warthogs avoid cooling off in the cement pond when the water has become warm.
Most patients spend from three days to a week in the hospital ward after being released from the ICU unit.  In my case, I spent eight days in the ICU and as mentioned above, only two days in the hospital ward.

Back to the points that I've found have been most helpful in addition to basic caregiving tasks have been the following, in order of preference:
  1. Caregiver's attitude: Nothing could be more distressing than having a caregiver who wasn't encouraging, upbeat and optimistic.  A negative resentful attitude could, without a doubt, have an impact on the rate of recovery.  Regardless of how difficult this may be, never attempt to make the patient feel guilty for putting them in this position.
  2. Willingness to prepare special meals:  After bypass surgery, many patients have a diminished appetite and desire to eat.  Healthful, familiar meals are a real boon to the patient's recovery.  
  3. Replenishment of cold fresh beverages can be instrumental in recovery: The medications may cause extreme thirst and a dry mouth. Drinking plenty of fluids is required for recovery.  Having stale water or beverages hardly inspire the patient to drink to replenish their needs during the healing process.
  4. Participation in the rehabilitation process:  This type of surgery (and most others) require a committed and diligent walking program.  By encouraging and gently reminding the patient as to this process is crucial in making a complete recovery.  If the caregiver walks with the patient especially if they're fearful of falling, the patient grows more and more confident.
  5. Medication distribution and monitoring:  Many times patients find themselves taking eight to 10 new prescriptions, some of which are taken at varying times of the day and night.  A conscientious caregiver will oversee this process to ensure correct dosages to avoid over or under medicating. Some pain medications cause drowsiness and result in the patient becoming forgetful.
  6. Encouraging rest periods: Instructions after surgery may include certain activities based on the patient's level of progress.  Type A personalities may easily become overjealous in performing such tasks.  As much as the patient believes "more is better" a good caregiver will monitor such activities encouraging rest periods and following doctor's orders.
  7. Creating a comfortable sleeping and napping arrangement:  If the patient is uncomfortable sharing a bed with their caregiver/spouse and if the space is too small for comfort, an extra bed in the same room might be suitable. Air conditioning in hot weather is a must, as is appropriate heat in cold environments.  Avoid extreme temperatures to aid in healing.  Ensuring bedding and pillows are placed for the utmost in comfort is a must, even when the patient is out of bed and seated at a table or in a chair.
  8. Escape time.  When going through a difficult recovery, everyone needs a period of time each day when they can escape from worrying thoughts and pain. Watching fun TV shows and movies, games to play or other such activities reduces the time the patient is feeling stressed, here again aiding in recovery.
  9. Encourage feelings of self-esteem:  Let's face it, having one's body mutilated from surgery is a difficult thing to face for some patients.  Only the caregiver will know if this is an issue and will provide realistic encouragement during the recovery process and in times to come.
These points became obvious to me over these past several days and I only have Tom to thank for making this trying time tolerable.  Besides, a little laughter throughout the process can easily lighten the load for both patient and caregiver.  There's no shortage of that in this household.

Tomorrow, we'll cover the responsibilities of the patient in order to aid in their own recovery process and the willingness of the caregiver to carry on with love, support, and excellent care.

Be well, dear friends and thank you all for "coming back."
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Photo from one year ago today, February 28, 2018:
Nearby at another tree, we spotted a rhino mom and her baby, born this season and still closely attached to the mother. For more photos, please click here.

When all is said and done, what will it really cost????


The boys are especially handsome with their budding horns.

"Sighting of the Day in the Bush"
The kudus give us "the look," which means "more pellets please,"
Note:  Please bear with us for a lack of innovative and exciting photos.  Stuck on the veranda and with only a few visitors each day, our photo ops are limited right now.

As mentioned in yesterday's post, whether we like it or not, whether it's fair or not, we are faced with a monumental financial loss due to my recent triple coronary bypass surgery.

Having to cancel all prepaid venues over the next three months results in a financial loss for which there is nothing we can do that we haven't already attempted.

On top of the incurred losses is the fact that we had to pay for the holiday rental of the "Orange" house from February to May when we'll depart for Ireland for the upcoming three-month rental in Connemara by the sea.  This booking will remain in place.
Two female kudus stopped by this morning.
We're looking forward to the summer months in Ireland but the realities of what it will have cost us to get there is quite a sting.  Once again, I'll reiterate, we are immensely and eternally grateful to have discovered my severe heart condition while in South Africa for several reasons:
  1. The cost of health care in this country is very reasonable
  2. The quality of medical care in South Africa is exemplary
  3. South Africa is known for its advancements in heart disease as compared to other countries throughout the world
  4. The cost of living while recovering is as much as 50% less than in many other countries throughout the world
We couldn't have been in a better place when discovering this life-threatening condition.  Oh, gosh, had we gone on to Kenya we would have been in dire straits trying to find the quality of care required to "right" this condition.  We are so grateful for being here in South Africa.
Soon they were accompanied by a young male, most likely an offspring of one of the females.
Now we are faced with bearing the entire cost of the operation, doctors and follow-up care when our insurance company is looking for any possible "out" to avoid paying the claim, only adding to our worry and stress.  We are talking about a lot of money.

Today's post is presented with the intent of sharing these losses but may not be exact to the penny.  The time and energy required for the exact numbers aren't quite where I'm at during this recovery period. But, the numbers we present today are within 5% of the actual costs.  I'm still not quite clear headed enough to be as precise as we'd usually strive to be.

So, here's an overview of the losses we'll have incurred as a direct result of this dire medical emergency.

  • Flight to Kenya from South Africa (non-refundable) ZAR 15752, US $1135
  • Kenya Safari Tour (non-refundable) ZAR 199688, US $14,400 with a promised refund of ZAR 69336, US $5000 for a total loss of ZAR 130352, US $9400
  • Hotel in Santiago Chile (non-refundable) ZAR 20440, US $1474
  • Cruise from Chile to San Diego, CA (partially refundable) ZAR 22174, US $1599
  • Flight from San Diego, CA to Minneapolis, MN (non-refundable) ZAR 6330, US $ 456.60
  • Cruise from Fort Lauderdale, FL to Copenhagen, Denmark (partially refundable) ZAR 12480, US $900
Total losses: ZAR 207523  US $14,965

Plus, we must include any and all medical expenses for hospital, doctors, and medications.  We'll report back on these as they become known in the near future.  With these totals included, we will be looking at a total loss, in excess of ZAR 1040040, US $75,000.
Such cuteness...
Also, ironically, we received a notice from Expedia while I was in the hospital that the flight from Nairobi, Kenya to Santiago, Chile was being canceled and we'd be refunded the entirety of this expense (not calculated in above costs). This credit hasn't been reflected on our credit card as yet but we're watching for it.

As we review these losses they are meaningless when compared to the fact that my life has been spared and in time as we recovery physically, emotionally and financially, we'll move into the future with excitement, hope, and fulfillment for that which is yet to come.

Thanks to all of our readers/friends and family for their loving support and prayers during this challenging time.

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Photo from one year ago today, February 27, 2018:
I had the opportunity to feed tiny Doc who slowly nibbled on the teaspoon.  For more details on bushbaby rehab, please click here.

ATM card hell...The consequences of not leaving South Africa as previously planned...

This is our Basket, the Bully, who was thrilled to see we'd returned to the bush.  Many weeks ago he appeared with a bloody right ear which now is but a stubble of an ear which appears to have healed nicely.
"Sighting of the Day in the Bush"
Wildebeest Willie was so happy to see us he didn't bother to eat a single pellet for several minutes after Tom tossed them his way.
It wasn't as easy as canceling a few planned flights and tours and losing the money associated in doing so.  We had carefully planned every step of the way in our upcoming itinerary to ensure a seamless transition from South Africa to Kenya to South America to a cruise to the US and a flight to Minnesota from San Diego.

Now, all of these plans are dashed and we reach to the future to make new plans with affordability as a key issue after losing tens of thousands of dollars in non-refundable fares and fees.  One might say we should have had travel insurance.
But in the real world of non-stop travel, this type of "trip insurance" doesn't work.  We don't have a home and any travel we do is not considered a "trip." In order to acquire such insurance, we'd have to lie about our lifestyle and that's just not our way of doing things.

Besides, it's difficult to be reimbursed for any claims for a valid trip, let alone trying to file a claim for an untruthful application. Even now, we struggle to get our medical policy to pay for my heart surgery, as they claim I had an undisclosed pre-existing heart condition (not the case).

Of course, we are grateful I'm am alive and imply no complaint or sense of unfairness.  The fairest thing in the world that ever happened to me was this condition being discovered in time.  For this, we are eternally grateful.

None the less, there are consequences we must bear for these last minute change in plans.  Fairness is not an issue. Reality is the issue and as much as we'd like to bury our heads in the sand, we have no such option.  Life continues on with or without our approval for such consequences.

In tomorrow's post, we'll share some of those consequences and the financial effects and burden they have placed upon us, not as a warning to potential world travelers but as a revelation of what worst-case scenarios which may transpire while choosing a lifestyle such as ours.  

We always knew this day would come but life seldom provides an ample enough warning to make us better prepared.  No doubt, we were thrown for a loop and work diligently now to muddle our way through many of these.

One seemingly minor issue that never crossed our minds during these past two weeks since the surgery was our debit/ATM cards.  With mine expiring on February 28th and Tom's on March 31st, we faced quite a dilemma on how we'd easily access cash. 
Basket has the biggest side warts of any warthog we've seen in the garden in over a year.
When we made our original world travel plans, we choose five credit cards that would best serve our purpose.  Since we'd never used PIN numbers on credit cards since we didn't want to access cash from the cards, we didn't give it another thought.  Thus, we never requested PIN numbers.  We each had ATM/debit cards we could use at a relatively low cost to access all the cash we'd ever need.

Perhaps this was an error on our part.  We should have ordered the PINs.  But, once we left the US and began using a mailing service, we didn't want PIN numbers coming to the postal service although the company is bonded and highly reputable.  

One short term dishonest employee could wreak havoc on our cards if they perused our mail.  We felt totally safe and in control using our bank ATM cards for all of our cash needs.  Little did we know that we'd be unable to collect the renewals cards, arriving in our snail mailbox in Nevada, USA.

With the former upcoming original plans, we'd be in the US on April 8, 2019, and could collect our renewed cards at that time leaving only a short gap in time without access to the cards.  Tom's card was good until March 31st during which time we'd have been on a cruise with no need for an ATM card.  This only left us with an eight-day gap.  We never gave it much of a thought.

But then, life happens and the blur of the past two weeks brought us to these past few days realizing we wouldn't have a working ATM card until we received them in the mail from the mailing service.  Mail service is not ideal in South Africa.  It's possible they'd never arrive.  Plus, Tom's card had yet to arrive in Nevada with its 3/31 expiration date.

In the interim when Tom tried to get cash from his card yesterday, it wouldn't work.  Some convoluting security block had made use of his card impossible.
This morning we spent 90 minutes on the phone with Wells Fargo attempting to get the situation resolved.

Much to our relief, after the call dropped several times, they are sending us two new cards via FED EX International.  They removed the block on Tom's card which we can continue to use until 3/31 while the new cards arrive within two weeks.  Situation resolved.  Fiasco averted.

This is only one of many issues we'll have had to maneuver during this challenging period.   But, we'll continue to chip away at each obstacle as we face them head-on.  Then, of course, there are immigration issues, more flights to be canceled, more cruises to be canceled, the hospital insurance claim and my many months of recovery to tackle and... it goes on and on.

But, above all, I am alive, if not blissfully so, temporarily fuzzy-headed from the somewhat mild pain relievers and a plethora of heart-related medications slowing me down but...I am alive.
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Photo from one year ago today, February 26, 2018:
A foam tree frog nest, made overnight by the female frog awaiting up to one dozen males to fertilize it.  We've been watching for the males but have yet to see them.  In this post four years ago, we had the opportunity to see the males fertilizing the nest. After an incubation period of a few weeks, the tadpoles will drop into the pool of water to complete their growth cycle.  For more details, please click here.

First post since February 11, 2019...Life after heart surgery...A heartwarming stroke of appreciation...

This was the scene that rolled out before our eyes this morning.
"Sighting of the Day in the Bush"
A baby wondering what this green crunchy stuff could be.
Our last full post was uploaded two weeks ago today.  I can't tell you how many times I longed to be able to write but after the triple coronary bypass surgery of February 12th, it was impossible.  With all the medications, the pain and the associated brain fog I could barely sign my name, let alone write a post.

I spent eight days in ICU and a few more days in the regular hospital.  With the diminished nursing care in the hospital ward, after the excellence of the ICU nurses, I felt Tom could take better care of me and thus, on Saturday, February 23rd, I asked the doctor to release me to return to Marloth Park.

This decision proved to be right.  Tom's exemplary care and attention to detail with nary a moment of frustration for being assigned caregiver, we both knew this was the best thing we could do to aid in my recovery.

No, it hasn't been easy by any means.  Tom, bless his heart, painted a picture on Facebook of me being "a trooper" and handling this so well.  This has hardly been the case.  I have suffered as much as any recipient of this life-saving surgery and hardly consider myself as brave or courageous in the process.
There were three little ones in this dazzle of zebras.
Being unable to move about freely for fear of dislodging metal parts in my chest, the pain when trying to perform the simplest of personal tasks and the knowledge that long term recovery is surely in the distant future, makes day to day living somewhat of a challenge.

The long drive back to Marloth Park in the little red car was easier than expected. Tom avoided any herky-jerky maneuvers.  The pain medication made me sleepy enough for the time to pass quickly and before we knew it, we were back in Marloth Park.

Louise had two massive bouquets of flowers, the fridge filled with enough food to last for days, the bedroom cooled down with aircon (before the power went out that night) and the house in spic and span condition.

In no time at all, Tom unpacked our bags, made piles of sorted laundry for the boys to hang outdoors today and began to prepare a perfect dinner of chicken "flattie" and salad, all that either of us cared to eat.  
Tom had cut several stalks of celery saving the scraps for the kudus, bushbucks, and zebras, all of which love celery. 
Now, the real recovery would begin.  But, on Saturday night when the power went out, thrashing in bed, unable to get comfortable in the hot still air, I attempted to remove the hot compression stockings when my feet and legs felt as if they were on fire. 

In doing so I tore something in my chest near my right arm that has left me in even more pain that today has finally begun to subside.  I couldn't conceive of driving back to Nelspruit to see what I'd inadvertently done to myself when we're already scheduled to return to see the surgeon this Friday.

Then, on Saturday night, prior to the power outage, I showered only to have one of the major incisions in my thigh, start bleeding profusely.  With all the blood thinners I'd been taking, the blood wouldn't stop running.  Again, last night it happened after the shower.  But, we can deal with this.

In essence, Dr. Theo Stronkhorst, located at Rissik Medical Centre, 71 Rissik Street, Komatipoort, 1340, (phone 
013 793 7306), the warm, kind and knowledgeable general practitioner in the small town of Komatipoort saved my life. Plain and simple.

The little ones showed little interest in pellets or vegetables.
When I had an appointment with him on Thursday, January 31sr to get my three prescriptions refilled in preparation for heading to Kenya for the amazing upcoming multi-faceted safari, beginning on February 22nd, I casually mentioned a recurring pain in my lower jaw on both sides, mainly occurring in the mornings upon awakening and then again in the evenings at bedtime.

Normally, when we hear about women having jaw pain as an indication of angina, it's on the left side of the face, closer to the heart. Somehow, this sharp and conscientious doctor knew that he needed to check this out further in order to give me peace of mind for our upcoming travels to Kenya.

He told me to be at his office on Saturday morning, February 2nd for an exercise stress test.  I thought I sailed through the test without incidence.  I was a little stymied when he had me lay down on an exam table after the test in order to give me a dose of nitroglycerin.  

By Tuesday, February 12th, I was prepped for open heart surgery at Mediclinic in Nelspruit, South Africa for coronary bypass surgery with three of four coronary arteries 100% blocked.  I shouldn't have been alive.  

Two youngsters hanging out as their parents savored the breakfast,
First, we saw cardiologist Fanie Fourie for tests including an angiogram, CAT scan, and ultrasound.  But it was the angiogram that painted the full picture.  I was a walking time bomb.  Dr. Fourie explained, during the angiogram while I was wide awake that my arteries were impossible to "stent."  Open heart bypass surgery was my only option.

Tom and I were both in a state of shock with this news.  How was it possible that health-nut me was in such a dangerous state of being?  But, the bigger question for me will always remain, "Why was I spared?"

Yesterday, in a thank you letter to my immediate family for their love and support during this ordeal, I mentioned that I may spend the rest of my life trying to figure out why I was spared.  Surely, there's a bigger purpose here that I will continue to explore for my remaining years. 

But one thing I know for sure is that Dr. Theo Stronkhorst saved my life and this I will never forget and never fail to appreciate day after day. I will always recall a vague recollection that I spent my 71st birthday in ICU surrounded by some of the most loving and diligent nurses on the planet. (They are called "sisters" in South Africa).
The youngsters are indescribably adorable.
They sang the birthday song that night, presenting me with a gift and through my medication fueled blur, I had tears in my eyes.  Grateful.  I will always be grateful for each and every day of the rest of my life to those nurses, to those three doctors and anesthesiologists who participated in my care, for Dr. Hannes Naude, who performed the surgery and most of all, Dr. Theo Stronkhorst who gave me another shot at life.  

Sure, it's painful.  Sure, it takes months of recovery, much of which will be my responsibility to enact and sure, it has required the attention and loving efforts of my dear husband Tom who has given me this extraordinary life of love, healing, renewal, and exploration which for this final chapter of my years, in many ways will have just begun.

A special thank you to our readers/friends throughout the world for their continuing love, encouraging messages and endless prayers.  

We'll continue to post daily as we gradually work our way back to a life of world travel and the blissful lifestyle it provides.


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Photo from one year ago today, February 25, 2018:
An apparently happy oxpecker on the hide of a kudu we spotted on yesterday afternoon's drive in Marloth.  From this site: "Oxpeckers graze exclusively on the bodies of large mammals. Certain species are seemingly preferred, whereas others, like the Lichtenstein's hartebeest or Topi, are generally avoided. Smaller antelope such as lechweduikers, and reedbuck are also avoided; the smallest regularly used species is the Impala, probably because of the heavy tick load and social nature of that species. In many parts of their range, they now feed on cattle but avoid camels. They feed on ectoparasites, particularly ticks, as well as insects infecting wounds and the flesh and blood."  For more photos, including "Movie Night in the Bush" please click here.

Power outage due to storm....

No post today as planned.  Power has been out for almost 12 hours.  Very hot, still in lots of pain.  Will write when we can.

Our last post for a week or more...

Ironically, we arrived in South Africa, one year ago today. Its been a fantastic year and we're both grateful for the stunning experiences we've had in the bush.  Now, let's see if South Africa can deliver me good health!

This will be the first time since March 2012 that we'll have been incommunicado on this blog for a week or longer.  However, we're so looking forward to sharing the good news that my recovery process is in place and all is well after tomorrow's triple coronary bypass surgery.

Tom will be posting notices on Facebook that are open to the public so feel free to check there if you'd like.  I'm easy to find my name with a few clicks. 

As mentioned in yesterday's post, we decided to leave Marloth Park to come to Nelspruit one day earlier than planned.  The water and power outages weren't something either of us felt like dealing with especially in the hot weather.

As it turned out, the power was out all last night.  That would have been one tough night. We are glad we left.  We spent the night at the lovely Leaves Lodge and Spa, a few minutes drive from the hospital, giving us peace of mind for being so conveniently located.

Today, at noon I'll check into the hospital for the prep required for this type of surgery which includes x-rays (for placement of the heart), blood tests (as a baseline) and a litany of other pre-op procedures you can well imagine.

This morning we headed to a Vodacom store to purchase a SIM card for Tom's phone.  During this past year in South Africa, we never had a need to call one another since we were always together making the SIM in my phone sufficient. 

But, now with him living at the hotel and me in the hospital, we'll need to be able to phone and text one another although he'll be with me most of the time.  Once I'm out of ICU, he'll bring dinner some nights since I'm certain the hospital food won't fit my way of eating. 

When I stayed overnight in the hospital last week after the angiogram, after not having a morsel of food all day, they brought me one chicken leg and a cup of plain spinach, not quite enough nourishment for this patient.  We'll see how that goes.

Now, the waiting game is on regarding the insurance company coming up with the money on time.  With a two-hour time difference between here and the UK, they may only be getting into their offices now and, it takes a few hours to process the funds.  I won't be admitted in time for the noon pre-op until after the insurance provides the funds.  We wait.

And so, dear readers, I wrap this up now again thanking all of you wonderful people for your thoughtful and kind well wishes and prayers.  Please keep an eye out for a post in about seven days or, if I'm healing quickly, perhaps even sooner.

Take care...


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Photo from one year ago today, February 11, 2018:
Due to a poor wifi signal, I'm unable to add the year ago photo.

No water in Marloth Park...Electricity teetering...The insurance challenges...

Due to problems with the electricity supply from the provider, Eskom, the water processing plant in Marloth Park is unable to function.  They are working on a solution but it could be days.  Also, it is possible we'll lose electricity as well over the next few hours.

Today is a scorcher, well into the 37C, (99F) range, with high humidity and tonight could be another one of those impossible-to-sleep nights without any relief by taking a shower without the water supply. TIA (this is Africa).  It's the way it goes.

I won't say, "thank goodness' we're leaving here tomorrow morning at 9:00 am for the hospital for triple bypass surgery.  That's not exactly how we feel.  Fortunately, we were able to take quick showers this morning using some of the remaining water in the tank.  Thank goodness that yesterday, I'd done all the laundry for items to bring to the hospital along with clothes for Tom for the week or more ahead.

As I was writing the above few paragraphs the power went out and came back on. about an hour later.  Subsequently, with no water and most likely no power we decided to spend the night in Nelspruit instead of heading out tomorrow morning.

Now back at the lovely Leaves Lodge and Spa who so kindly, have provided us with a discount for the long term stay, we have power, water, and good aircon.  We're set for the night.  Tomorrow, we have to check into the hospital by noon to begin the prep for Tuesday's surgery.

Somehow, I feel better being in Nelspruit three minutes from the hospital.  Now that I know that three of the four main arteries to my heart are 100% blocked, there's a smidgen more peace of mind until tomorrow.  Plus, I'm on medication to prevent a heart attack and, I have an ample supply of nitroglycerin in case of an emergency.  Wow!  Who knew?

Now aware of my situation it makes all the sense in the world to me.  In the mornings when I'd shower and dress for the day, I found myself feeling tired from these simple tasks.  At times, merely walking to the laundry room with an armful of dirty laundry made every step feel as if it were a chore. 

When we had dinner parties, I found myself wondering how my energy would hold up with all the cooking, prep and serving required for such an event.  Now I know and yes, I am grateful but none the less, a little terrified.  This is big surgery and I'm not any stronger, braver or tougher than the rest of us.

As for the insurance...on the day of the angiogram, at a cost of ZAR 80,000, (US $5871), the insurance company turned us down claiming I had an undisclosed pre-existing condition which was not the case. 

At the time we applied for the insurance over six years ago, I provided our 20-year family physician's contact information and copies of our medical records as requested including the three prescription medications I was taking (Tom takes no medication), one of which is a low dose hypertensive mediation.

The rep at the Nelspruit Mediclinic worked very hard with the insurance company, along with the doctor to no avail.  They wouldn't approve the claim before the procedure.  As per the hospital requirement, payment must be made in advance of treatment with or without insurance company approval. 

We paid out of pocket using our debit card since we wanted to avoid using regular credit cards.  We use credit cards to pay for all living expenses and future travel costs.  We didn't want to put such a large charge onto any of our cards.

Once we paid, we began the six-hour wait for our turn for the angiogram.  When the doctor discovered the magnitude of the blockages, he knew he couldn't do any stents.  The only option was triple bypass surgery. 

I stayed in the hospital overnight and in the morning before we left the hospital we met with the wonderful billing rep Trudy, to see how much the bypass surgery would cost and, ultimately how much money we'd have to come up with.

The estimated cost for the surgery was ZAR 700,000, (US $51,370) including some but not all of the doctor's fees. (We see how that rolls out).  With the rejection on the angiogram, we certainly didn't think they consider this added cost and again, we were declined.

Our only option was to liquidate assets immediately to ensure we'd have the funds in place by Tuesday morning.  The financial institution has a three business day turnaround in releasing funds. 

We called and spoke to the rep and for the first time in our lives stated, "This is a life-threatening emergency. We need the funds to be available immediately." By midnight Friday, the money was in our account.  Whew!

In the meantime, Friday night, Kathy and Don, had invited us to dinner at their lovely river view home in Marloth Park with friends Linda and Ken also in attendance. 

Before we left the house, I decided to call the insurance company one more time as well as write a letter I'd consider one of my better uses of the English language.

At this point, we were on pins and needles waiting for the money to come through in time but we had a good evening together with our dear friends while they all fussed over me, more than I'd ever imagined possible. 

Toward the end of the evening, I checked my phone as I had several times, and there it was...the insurance company instructed me to log into our account to find a letter waiting for us...they approved the bypass surgery!  They included a claim form for which we could file for reimbursement for the angiogram.

Sharing this news with our friends, as we sat around a bonfire in their garden, only added to our sense of relief.  Last night, the six of us went to Jabula Lodge and Restaurant for dinner and once again it was a celebratory occasion in support of my upcoming surgery on Tuesday. 

They presented me with gifts, hugs, and kisses, as did Dawn and Leon, owners of our favorite restaurant who provided a bottle of champagne and Amarula shots. I enjoyed a glass of champagne while the others tossed down the sweet shot.

Again, this morning before we headed to Nelspruit, Kathy, Don, Linda, and Ken stopped by to offer more support and love.  How did I ever get so lucky? Couple this with Tom's love and attention and zillions of comments and email messages from our readers, family members, and friends, I couldn't feel more loved.

May these warm wishes and prayers result in a positive outcome and I will be the happiest and most grateful person on the planet.  The pain and discomfort afterward will pale in comparison to my joy.

Thank you everyone... thank you with all of my heart!


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Photo from one year ago today, February 10, 2018:
After all the whale watching trips we'd done on tours these past years, to finally see plenty in Antarctica was a dream come true.  For more photos, please click here.

Finally a diagnosis and..we don't like it...Oh, my!..

Ms. Bushbuck always appears to have a smile on her face.  Love her and her offspring!
"Sighting of the Day in the Bush"
The four piglets certainly have grown over the past six months.  They are so fun to watch.
Sorry I didn't post yesterday.  With the news from the doctor on Thursday after the angiogram, I just didn't have it in me to sit down and write on my phone's small screen.  My laptop was in a repair shop in Nelspruit while I stayed overnight in the hospital.  Thankfully, they got it working again. There was an issue with the electrical plug-in.

I'll get to the bad news first, to avoid drama and anticipation.  I have three 100% blocked coronary arteries including what is called the "Widow Maker" (in this case, the 'Widower Maker).  Basically, I am a walking time bomb. I need coronary bypass surgery and I need it fast.

It's scheduled at the hospital with a thoracic surgeon that works with the cardiologist I've been seeing.  They both will perform with the surgery.  I feel as if I'm in good hands based on the number of positive comments from locals who know them well.  I have no choice. At this point, I cannot fly on an airplane or even be active for that matter...too risky.

We are both shocked.  How did this happen? The doctors say there was nothing I could have done to prevent this situation.  Heredity is the driving force and as hard as I've tried to stay healthy my entire life there was no way I could have prevented this outcome.

Of course, we are very grateful a diligent doctor, Dr. Theo Stonkquist, a GP in the little town of Komatipoort had the insight and expertise to insist I have an exercise stress test at his office last Saturday when I complained of intermittent jaw pain which was later described as angina. 

Although I breezed through the stress test with relative ease, barely out of breath, the printout didn't look good.  Dr. Theo immediately contacted Dr. Fanie in Nelspruit on "Whatsapp" and sent him the report.  He was adamant we get to Nelspruit to the Mediclinic first thing Monday morning for more tests.

For the early morning appointment, we booked a hotel near the hospital and stayed two nights. On Tuesday I had a CAT scan of my arteries and failed that test and others miserably.  An angiogram was scheduled for Thursday. 

We returned to Marloth Park, spent one night and called Dr. Fanie the following morning at 9:00 am.  He was short and to the point.  I definitely needed an angiogram promptly when the CAT scan showed one artery had a 100% blockage.

In the cath lab the next afternoon, after a many hour wait for my turn, I was told I'd be awake for the angiogram with only a mild sedative placed under my tongue.  Actually, it was quite interesting watching all the monitors showing my heart and its arteries.  The doctor, anesthesiologist and about seven support staff were informative and supportive.
Ms. Bushbuck's baby has sure grown over the past many months as well.
We'd hope he'd insert a stent and I'd be done.  But, not the case.  The angiogram revealed, before my own eyes, that three of my coronary arteries are 100% blocked. If I'd had a heart attack, he explained, I wouldn't survive it.  I'm so grateful this was discovered before we left for Kenya, known for not-so-good medical care.

Toward the end of the hour-long angiogram, the doctor explained (and showed me) why stents were impossible to place.  The only alternative was a triple coronary bypass which is scheduled for Tuesday next week, a mere three days from now.

I'm on medication in the interim and was told to avoid anything strenuous or stressful.  The strenuous part is a breeze.  The stressful?  Well, I can't imagine anyone on the planet not feeling a bit stressed over such a thing as open heart surgery, including striping arteries from their legs to replace those blocked in the heart. 

However, we are both so grateful this was discovered in time and pray for a safe and good outcome and speedy recovery.  As they say, "we may be down but we're not out."  Hopefully, six weeks from the time of the surgery, we'll be boarding our ship from San Antonio, Chile.  No pressure, just wishful thinking. 

No doubt, I will be a good patient and do everything I can to recover as prescribed and we'll continue on with our world travels.

As for the posts??? We will continue tomorrow, Sunday and again on Monday while I staying overnight in the hospital for Tuesday's surgery.  As of Tuesday, February 12th the posts will cease for five to seven days until I'm well enough to report.  I can't wait for that day!

Tom will be regularly posting updates on my Facebook page which is open to the public.  Please start checking back here by next Sunday.

Tomorrow, we'll be sharing the news on how this situation has been handled by our annual international health insurance company which information may be helpful for those traveling the world, expats and those contemplating traveling.

No words can describe how grateful we are for the outpouring of love and prayers from family, friends, and readers from all over the world.  We simply can't keep up with the email messages, comments, and texts.  We'd love to respond to each and every one of you but there simply isn't enough hours in the day.  We can only be humbled by your love, prayers, and kindness.

A special thanks to friends Kathy, Don, Linda, and Ken for inviting us for dinner last night (which was the originally planned night of our going away party - since canceled) and making the evening so filled with caring conversation, love and laughter.  Tonight, we all meet up again at Jabula, our usual Saturday night out.

Thank you...from the bottom of my "heart."

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Photo from one year ago today, February 9, 2018:

A sea of penguins.  For more details and final photos, please click here.

Sorry, no regular post today!

Tom and I are patiently waiting for my turn.  Tomorrow will be a new and brighter day and we'll post the outcome of today's findings.

Again, .thanks for all the prayers and we'll wishes!  Astounding!  We are so lucky to have all of you rooting for us!

Back to you no later than 24 hours from now.
Be well. 

The medical saga continues...The news isn't so good...



Ms. Kudu, Willie and Mike, and Joe.

Willie and warthogs, all getting along.

Wildebeest Willie, he's quite a guy!

Willie, six kudus, and a few pigs stopped by last night.


Basket stopped by last night.  His right ear has healed but is mostly gone. 




"Sighting of the Day in the Bush"

Bushbanies

It's almost 2130 hours, 9;30 pm, Wednesday night and we're back in Nelspruit at the Leaves Lodge & Spa.  The conversation with the doctor this morning was short and to the point, "You have a 100% blockage in the artery in front of the heart (the left anterior) and you need angioplasty immediately, or possibly open heart surgery."

My mouth dropped open.  I can't believe this.  Nor can Tom.  How did this happen?  Of course, we're both wrecks.  Now, we wait in Nelspruit for the approval from our insurance company.  If they decline, we must pay the entire bill out of pocket, a huge unexpected expense. 

If we miss the window of opportunity for tomorrow's procedure, the angioplasty, we'll have to wait until next Tuesday.  The doctor only goes to surgery on Tuesdays and Thursdays.  We won't make our Thursday flight to Kenya, nor will we make our one-week hotel stay (prepaid) in Kenya.

If open heart surgery is necessary, oh dear, that will be at least six weeks during which we'll have to stay in South Africa.  We'll lose tens of thousands of dollars in prepaid future travels, flights and a cruise back to the US.  

But, its the way it is and we have no choice but to figure this out.  In reality, we knew a day like this would come.  We just didn't think it would be now.  My laptop died tonight.  I am writing this on my phone.  Oh.  

I couldn't move photos around.  Will fix at later date.  Will be back as soon as possible with updates.

Thanks for all the love.  Too many to respond to but will keep tryimg.  You people are wonderful! Thanks so much.olio
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Photo from one year ago today, February 6, 2018:
The seas were wild through the Drake Passage in Antarctica as we headed back to Ushuaia, Argentina.  It wasn't as wild as it could have been.  But, as usual, Tom and I felt fine, free of any seasickness.  For more, please click here.