Unpleasant Strangeness

It seems my bicycle is not the only thing breaking down. Apparently I am falling apart as well. This past week has been a weird one.

It started during my ride back to Stone Town from the northern beaches on Zanzibar. I felt a little pain in my upper back. I just thought I had slept funny or strained it slightly. But as the day wore on it got worse. By the next morning it was painful enough to see a doctor, who prescribed some anti-inflammatory drugs. They did not help. That night I was in agony. A constant pain was shooting into my upper back by the spine. It felt like a knife was sticking into me. I also had numbness in my hand and arm.

First thing in the morning I went back to the doc, who gave me some different drugs then sent me to the government hospital to get x-rays. An African hospital is pretty much what you would expect: dirty, unorganized, people laying around or waiting to see a doctor. It was awful. I did not stay long; the x-ray machine was broken. But while I was there the nurses could see that I was in pain (I was doubled over, keeling on the floor and wincing.) They took me to another doc who gave me injections of painkiller and more anti-inflammatory drugs. But he said there was not much more he could do without an x-ray. He suggested I go to Dar es Salaam.

Returning to my room, I felt helpless. I could not possibly pack up my bike and take the ferry back to Dar. I could barely walk without excruciating pain. Then I realized there were small planes that flew to Dar. So I checked into it and managed to get on a flight that afternoon, leaving my bike and almost all my belongings in my hotel room. It’s only a 20 minute flight so I was in Dar by 4:30pm. I took a taxi directly to a clinic recommended by my guide book.

I almost collapsed as I was filling in the admission form. I had to kneel down on the floor and was grimacing with pain. The nurses took pity and shot me again full of painkiller. Finally I saw a real doctor (from South Africa I think). He said I should get an MRI but the only MRI machine in Tanzania has been broken for 5 months. So he told me to get a CT scan instead, which they arranged for 9:00 am the next day.

Meanwhile he gave me more pills (Tramadol and Olfen) and a neck brace. A taxi took me to a nearby hotel. It was 8:00 pm by this time. I had not slept much the night before, nor had I eaten or bathed all day. But the drugs seemed to help and I slept more that night.

The next day, after my CT scan I saw the doc again, after a 3 hour wait. He said I had bone spurs on the spine in my neck and swelling of some of the discs which were impinging on the nerves, causing the pain. How did this happen? Well it could be normal wear and tear, it could be from riding, he did not know. Here is the official results from the CT scan. Don’t mean much to me but a Schmorl’s node can’t be a good thing.

1. Cervical sponylosis with posterosuperior osteophyte at C5 impinging on the C4/C5 intervertebral disc

2. Diffuse disc bulgings at C4/C5, C5/C6 and C6/C7 intervertebral discs with indentation on the thecal sac.

3. Schmorl’s node at the inferior end plate of C4 vertebral body.

The doc was not optimistic. He said I should fly to South Africa and get an MRI. Based on that I might need surgery. Great. the last thing I want is spinal surgery in Africa, even South Africa. But if I go back the USA, it effectively ends my bike trip.

So I returned to Zanzibar and am now just holed up in a small hotel room (at least it has A/C and a TV). I am just trying not to exert myself too much. I want to let my body heal itself if possible. I am taking loads of painkillers and they work pretty well but I don’t know how long I can or should just sit here. I have travel insurance and need to check with them to see how much I am covered. I know they will fly me back the USA if I need to but surgery is a last resort. I’ve had back problems before and they managed to clear themselves up over time without surgery. I’ll keep you posted.

Anyone else ever have this problem? Was it the most painful thing ever, or am I just being a wimp?

20 thoughts on “Unpleasant Strangeness

  1. Capt. Don Kilpela Sr. June 5, 2009 / 1:32 pm

    I can empathize with you totally for I had back spasms a few years ago and spent four days in the hospital. They finally subsided with IVs of liquid valium. I have never in my entire life had such pain. They took me from my bed in a stretcher. It was excruciating pain that came in waves like electric shocks every few seconds or sometimes longer, maybe as long as a couple of minutes. I was in bed at home for two nights before they took me out. I did nothing but bed rest and later mild exercise but my back has never been the same. In fact, I asked for a prescription of valium which I keep with me when I travel just in case. Never had to use it yet but still carry it.

    Kevin, the body has a way of telling you that the strain is too much. Knowing how determined you are, perhaps it would be a good thing to truncate the trek and rehab here in the states. You are still a young man and as Jim has demonstrated, you have many years of challenging cycling ahead of you.

    I am quite certain that with a year’s rest and time to recoup funds you will be back on the road. Your feat has been nothing short of amazing (people shake their head in awe when I tell them about you and show them your blog) but like any athlete, you need time for the body to heal itself.

    Knowing you, however, I am certain you will make the best decision for yourself for only you know the total situation. We all support you come what will.

  2. Capt. Don Kilpela Sr. June 5, 2009 / 3:15 pm

    Addendum: Kevin, I’m not certain that even you realize what an incredible thing you have done for the past nearly two years: the hardships you endured were sometimes beyond endurance; the food at times almost inedible and yet you had to get protein and sustenance for the effort you were expending; the occasional fear from the unkown and unexpected (and there was probably more than you ever revealed); and the aggravations of simple living from day to day and keeping your vehicle operating; and that’s not to mention the hundreds of time you had to find and set up a complete camp in all kinds of weather. Need I go on? Why the simple day to day living for most of us is trying at times…well enough said. Be good, take care, and make the best decision you can with the advice of your doctors.

  3. Jim June 5, 2009 / 5:27 pm

    I, too, can relate to your back problems, but, being a fellow cyclist, I think that I can offer some hope as well.

    My “disc” problem started when we lived in Ann Arbor some 40 years ago. Excruciating pain…I couldn’t sit in a chair for very long. In those days, they prescribed a metal back brace that I wore for several months. That worked pretty well and got me over the pain without meds.

    Then, around 1988, I had another occurrence that struck me at work (lifting heavy materials no less)…I crawled from my office through the parking lot (no kidding) to my car and went to the ER. The doctor prescribed pain killers (great stuff) and complete bed rest (and I mean complete)….I stayed in bed for 2 weeks. This took care of it…I could hardly believe that surgery was not needed.

    Well, here I am pain free after 20+ years and after close to 20,000 miles of cycling (knock on wood). I believe that cycling stretches out my back and has certainly helped me stay pain free. But, who knows….

    But, again, I have never cycled in the extreme conditions that you face and, like Don, I think that your body is sending a message pleading for rest. Like many of us, you’re not 20 years old anymore.

    We all wish you well and hope that your condition improves quickly.

  4. Bénédicte y JC June 5, 2009 / 10:49 pm

    Kev, just translated your diagnosis to Juan carlos. His first impression from the way you describe your pain and the scan diagnosis is that yours is a benine pathology that you have probably had for many years but that exacerbated with the great efforts you have been making since you began your trip. The position of your hands on your bike handlebar and the constant road vibrations you have been experiencing while riding transmit directly to your upper spine. and the repetition of these small and repetitive traumas lead to inflamation, edema and irritation of your upper body’s nerves (neck, shoulders and arms). all of this leads to a very common pathology in traumatology called cervicobrachialgia that is characterized by intense pain, numbing of your upper limbs, probably more dominant on the side that is most affected and muscle weakness (lack of strength while grasping). It’s considered a profesional pathology among cyclists and mountain bikers. When it comes to treatment, steroidal and non-steroidal anti inflamatory drugs are efficient and should be taken during several weeks. There are several possible treatments that do not require medication such as acupuncture, diathermy, laser and phisiotherapy. The most important at this stage is to avoid repeating the trauma, in other words stop riding. If you get back on your bike, you will make things worse with possible edema de la medula, monoplegia (arm paralysis) and emergency surgery… bottomline, frombased on what we have read in your post, you are still in time to stop further damage if you put an end to your trip and start medical treatment, get some rest and then start physiotherapy… the ball is in your camp, but that was our two cents worth of thoughts… hope it makes sense, it’s late here and medical translations are not my forte… but hope it helps. Take care.

  5. Katrina June 6, 2009 / 12:43 am

    Oh Kev.
    All I can say is, what can I do today to keep so busy that I don’t think about you?

    You have proved yourself…stop pushing it. Like Unc, Don says, rest, and finish it up later. call me.


  6. Michael Brady June 6, 2009 / 2:15 am

    Hey Kevin

    I’ve had back pain, lower back pain, and it doesn’t get better by being really active. Give it a few days but if it doesn’t get better….

    You can always pick up where you left off at a later date. From what I know about you, you probably will. But you need to be in a place where health care is really expensive… 🙂

  7. Ira June 6, 2009 / 4:05 pm

    You’re being a wimp. Eat some bugs and get back on that bike. Remember – nobody likes a quiter.

  8. DAD June 7, 2009 / 10:29 pm

    Post pone the bike trip for now and come home and take care of the problem before it gets worse and puts you out permanently. Let me know your plans.

  9. Nicole June 8, 2009 / 7:49 pm

    Unless you want to be riding a Hover-a-round or find yourself sprawled out in the middle of Collins Ave screaming “I’ve fallen and I can’t get up”, I suggest you take care of this problem asap. Don’t listen to Ira. Do you think he’s gonna be there to wipe your butt if you end up too crippled to do it yourself? I’m sure he’ll help you raise your glass of Capt. Morgan. But, applying a moist towelette to your backside is another story.

  10. Kevin Koski June 10, 2009 / 9:26 am

    Thanks for all the advice and condolences everyone. Bene, you offer some plausible and sensible explanations. But then again I have never been too sensible so I plan to attempt riding again in the next day or two. The sharp neck pain has dissipated to a dull ache whenever I sit or walk. I also still have numbness in my left hand and arm. I have not tried to get on my bike yet.

    It’s been a depressing week. Laying down watching TV for several hours a day gets boring real fast. Then I picked up some kind of infection in my left eye so I had to go back to the doc and get more medication. On top of that I acquired a bad case of the shits. Maybe I should hang it up.

    I am way behind schedule now, both in mileage and my budget, so I will take a bus part way across Tanzania and then attempt to ride into Malawi in the next week or so. We’ll see what happens; maybe I’ll eat a few bugs.

  11. Jim June 10, 2009 / 7:25 pm

    I hope that you will re-think your decision, before you do permanent damage. Plenty of time in life to continue later, Kevie. Time to come home and connect with friends for awhile.

  12. Kevin Koski June 11, 2009 / 10:07 am

    Jim, I may have to give up. I tired riding yesterday and got about 100 yards before the pain overwhelmed me. It is interesting that the pain manifests itself in my left arm. Apparently although the pinched nerve is in my neck, it is the nerve that goes to my arm and hands that is affected now. Obviously I can’t ride in this condition. Even with pain killers it would be tough. I will take the bus for a while and see what happens. If things don’t improve in a couple weeks I will have to end it.

  13. john kilpela June 13, 2009 / 2:19 am

    Kev, all the best, I can relate as well had some lower back troubles back in the early 90’s. It really took about a year for it to clear up. And a lot of trips to the chiropractor. You’ve done an amazing thing with this trip so far, no reason why you can’t postpone it for a while. Come home, come on up the the harbor for a spell, alittle R and R with family will do you wonders. Besides, what else do you have to prove. YOU ARE THE REAL IRONMAN!!


  14. Steve June 14, 2009 / 3:54 am

    Kev, Google Earth has a clear picture of Stone Town. It looks like a horribly dense and confusing mess, particularly to the east (around 6:10:33.22S, 39:14:23.68E) with hundreds, maybe thousands, of dwellings all connected by a seemingly random network of dirt trails. Lots of identical-looking approx. 30’x30′ dark brown square features, too. Any idea what those are? What are the coordinates of the place in which you are holed up?

  15. Kevin Koski June 14, 2009 / 7:52 am

    Yes Stone Town is a maze of small streets. It is impossible not to get lost. But as it is not very large, you end up sooner or later at the sea or a major road. It’s a fun place to explore.

    Not sure what the sqaures are. Houses or shops probably. I was staying in the Vuga district, not far from Shangani in the far west part of town. Don’t know the coordinates.

  16. JoJo June 16, 2009 / 6:46 pm

    Just talked to the Doc I work with (orthopaedic Doc) and he said you’ll need a disc fusion, in other words surgery. Pack it up and head home before it gets worse.

  17. susie q June 22, 2009 / 7:04 pm

    wishing you safe travels home!

  18. Dirk August 11, 2009 / 10:24 pm


    You did the smart thing, head home and and get it taken care of . This is an amazing & impressive trek thing you have undertaken, your not done, so get healthy and resume when you can. Excellent blog, great to find you after all these years sir

    best regards, say hi to Nicole

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