Injuries and Surgery Overseas

What a week...  After all these years, I have never gotten injured or sick while on the road.  Considering my latest experience and how unprepared I was, felt that this would be a great way to kick off the new year with an informational piece on how to not die abroad.  I first want to outline questions to address in case you’re in an emergency, then jump into my experience in Cambodia where I almost lost my leg!  Here are the first couple of questions I would ask myself on my way to the hospital:

  • Do I have travel insurance? If not, buy it!
  • Which hospital in the area has the best ratings? Are they acceptable?
  • Have you asked locals about their preferred hospital for these sorts of injuries?
  • Do the doctors at the hospital speak English?
  • Does the hospital accept my travel insurance, or will my travel insurance even cover this injury?
  • How much will the visit cost if your insurance doesn’t cover the injury?
  • Do you have a place to rest if needed? (A hostel is not the best place to be after surgery)
  • Do I have a travel companion with me in case I’m bed ridden? If not, you should consider the severity of your condition and decide if you should head home.
  • If you decide to stay, how will you get food and water? How long will this put me out for? If a long time, it may be better to cut your losses and just head home.

How it all began:

If you can’t tell from my site, I love to travel.  Whether good or bad, I love the unexpected occurrences that come up day in and day out.  I strongly feel that what doesn’t kill you makes you stronger, or at least makes for a good story.  On my most recent trip to Cambodia, I feel that I have a little bit of both.

Throughout my travels I have been very lucky to not experience any major injuries.  I always purchase travel insurance in case of a remote injury, but up until now have never had to use it.  Funny because a few weeks ago I considered not renewing my travel insurance as a cost cutting measure.  Luckily, I took the smart route and renewed!

After living in Koh Tao for the past 8 months, I was pumped to be back on the road again.  My 4-6 week trip was to begin in Cambodia for two weeks to see the temples and dive, then wrap up in northern Thailand and Laos to see the countryside.  I felt young again, completely refreshed from my time on the island.

Although I would have preferred to fly into Siem Reap or Sihanoukville, we opted for Phnom Penh due to the pricing and efficiency of travel.  If we were to fly into either of the other two destinations, we would minimize our travel time on the bus.  Given it’s supposed to be a pretty see to see, I’d rather spend more time on the bus than in the airport.

We arrived in Phnom Penh quite late, grabbed some food and packed it in for the night.  Our first stop in the morning was the Tuol Sleng Genocide Museum, or as we call it S21 for the school name.  My toe began to throb as we were walking around the museum, but given my stubbornness continued to push through.  So much to see!  Towards the end of the tour the pain was becoming unfathomable, so we decided to swing back to our hotel to grab sandals before heading over to the Cheung Ek killing fields.  My thinking here was that I haven’t worn shoes in so long, if I switched to sandals the pain would diminish. 


On our Tuk Tuk ride to Cheung Ek, the pain subsided and all was good in the world.  As I was thinking about my victory, I realized that my toe was very swollen.  Crossed my fingers it wasn’t serious and decided to give it a bit more time before jumping to any conclusions.  This was my first day on the road, not a chance I wanted this to become an issue.

Throughout the tour I was continually looking down at my foot, becoming frustrated that this was distracting me from the rich history of Cambodia.  That is when everything took a turn for the worst, my toe cracked open and started oozing puss.  That’s it, now I’m freaking out and ticked off.  I’m in a third world Asian country a billion miles from home, what the fuck am I going to do now!

Given our circumstances, we asked the Tuk Tuk driver to take us to the hospital.  He gave a nod and began to drive.   Arriving a few moments later, I stumbled into the hospital to realize that not a single person in there spoke English.  Not to say that I was surprised, but this didn’t alleviate my frustration. After fumbling around with Google translate for a few minutes, I realized that this was not going to work.  I had no idea where I was going or how to receive medical treatment in this country, needed to go back to my hotel and regroup.

When the driver got us back to the hotel, we decided to sit down and have a chat with the receptionist.  She was extremely helpful and guided us through the different international clinics in the city.  They were expensive and all had horrendous reviews, but at this point I didn’t care.  I needed to see someone, and don’t speak Khmer so my options were limited. 


Made another trip across the city to the Naga Clinic, which was recommended by the gentleman working the bar.   Always trust your bartender, right?!?  Now by no means was this as clean as a US hospital, but I was pleasantly surprised of the look and feel as well as the English-speaking nurse greeting me as I walked in.  I was seen by the doctor right away, who went through a list of medical questions.  He then sat me down on his table, examined my foot, and determined that I had a serious infection growing underneath my toe nail.  He stated that the only way to rid myself of the infection was to cut out the toe nail and the infected area (I.E. ingrown toe nail surgery).  All I could think was “that’s it, this trip is over before it even began…”.  After asking questions on recovery, he reassured me that I would be back up in no time and this shouldn’t ruin the vacation at all.  I was to come back in the morning and have minor surgery and be done with it.

Next morning headed straight to the Naga Clinic for this “minor” surgery.  Don’t want to pretend I was all cool with it, I was actually shitting myself.  I’ve had surgery before, but never like this.  There were so many unknowns, like who the hell my surgeon was.  What does the surgery entail?  I realized all I knew was that they were removing the infection, but I didn’t even know how much of my toe was infected!

Walked into the clinic as soon as my panic attack went away and met the surgeon.  He looked like he had been to war and back with his limp, maybe should have retired 20 years ago.  All that was going through the two of our heads was “you’ve got to be joking”.  He shook my hand, was very professional and walked me back into his operating room.  It was dark, old, and honestly not the cleanest.  Exactly what I read online, but it’s too late now, I’m committed. 

As I was sitting on the operating table we began chatting and I found that he was a surgeon for the Khmer Rouge back in the early 80s, operating on both the Cambodians and Americans.  We spoke about the history for a bit and how he became a doctor.  All of this helped ease me into the anesthesia, as I wasn’t nearly as nervous as I was when I first walked in.  Always say that looks can be deceiving, but I didn’t apply them to this situation which made me feel bad for negatively judging him in the beginning. 

Surgery flew by in less than an hour, the doctor confirmed that everything was taken care of.  I was not to dive or be in the water for minimum of two weeks, but the following day was able to walk around town.  He felt that it would be smart to come back in two days for a follow-up, which we both agreed and adjusted our travel plans. 

We hung around the city the next two days, I mostly laid in bed but did take the occasional stroll around.  All was looking good, in no time we’ll be full throttle again.  When I returned to the doctor, he gave me a strange look.  “Did you go in the water” he asked.  I was positive that the bandage never got wet and that I was nowhere close to water, explained this to him but he wasn’t having it.  “This looks bad, very bad” he complained.  Apparently he felt that the bandage had gotten wet and the incision was now infected.  Fuck my life…. 

We began reviewing everything that he told me on the day of the surgery, how I was able to walk the day after and no water.  He confirmed this but said that everything has now changed.  I now was not to get out of bed for 5 days, no walking no nothing.  He amped up my dosage to more than double from before, and even added additional pills.  What concerned me the most was his statement that followed.  “If this infection doesn’t get any better, we may have to amputate your toe.  If you wait too long as it continues to spread, it may cost you your leg.”  Now understand, I don’t know shit about the medical field or third world infections.  I haven’t the slightest clue if he’s telling me the truth or just being dramatic.  All I know is that I’m losing my shit knowing there’s a possibility that my doctor may want to amputate one of my limbs.  In Cambodia.    

We went home and I made a swift decision, it’s time to consult professionals whom I trust and take the next flight back home.  Picked up the phone, called United Airlines and jumped on a flight that evening. 

Arrived in NYC 28 hours later and my first stop was the ER.  Actually, my first stop was Burger King, but hey, a man has priorities…  Had to wait a few hours to see the doctor, but at this point I was feeling comfortable that I was home and that nothing serious would happen. 

Doctor came in, took a look at the toe and established that everything was going to be just fine.  There was an infection but nothing the antibiotics wouldn’t cover.  Added a few more pills to my arsenal, and away I went.  He said that what happens in many of these hospitals is that they want your money.  They know that you’re far away from home, so make you more nervous about the situation so you continue coming back in for a checkup.  To this he had a point.  The entire surgery cost me $55, yet they charge me $60 for the follow-up?  After looking this up online you’ll find that many people complain that they overcharge for visits and lie to get you to come back in. 

So here I am, home after four days and able to walk around effortlessly.  Really ticked off that my trip ended early, but let’s summarize this situation.  I’m not a doctor, nor do I pretend to be.  If I could do it all over again, I would have done it the same.  There is no way that your first time getting surgery overseas will be seamless, and I’m glad that I’m healthy with everything attached for the future. 

Now moving forward, how would I handle new situations?  First, I would do more research on the doctors not just in the city but in the area.  I found that most Cambodians fly to Bangkok given the better treatment facilities.  It’s also cheaper and a cleaner city.  Second, don’t jump to conclusions.  I now know how their system works and they want my money.   This is the same everywhere in the world, but the reality is not many people are threatening you with life changing decisions.  Finally, make sure that I’m careful with my body.  Even if a doctor says it’s ok to walk around the day after surgery, is it smart?  Phnom Penh is not a clean, city, it’s filthy.  If you have an infection, it will most likely get worse.  Next time if I required surgery and don’t opt to move to a better hospital, I’d stay indoors for a few additional days to heal up.

On a side note, I’d like to thank my travel companion Amelia for accompanying me on this journey.  You came with me to the hospital, for all the visits and even hung around through the surgery.  Changed my bandages on my gross toe, picked up food, and ran errands.  Instead of touring around the city, you kept me company inside knowing that this was eating me up.  You did all of this without making a peep that I completely ruined 4 days of your vacation.  Offered to stay in hotels over hostels so that I could get more rest, even though you’d spend more money.  Thank you again for being a warrior!