Healing with Pawpaw

Wow. It's been a really long time since I updated this blog. Sorry!

The reason is above.

I've recently been able to type using both hands again. Added over 10,000 words to my latest manuscript over the past five days, plus catching up on correspondence that went quiet whilst I was recovering. Loads of other things have been happening, but I'll try and stick to the most relevant.

So, the arm is doing very well now.

It wasn't doing well for a long time. A couple of weeks ago it wouldn't stop leaking bright yellow gunk. Two months and none of the antibiotic creams were closing the wound. In desperation, I poured raw honey over it. It stung like a bee's bum, but within two hours the entire wound had closed. 

I was seriously amazed. 

I put more on overnight, wrapping it in a bandage, but things were back to gunky in the morning. When I went to the clinic to see my miracle man, Moses, he explained that they use honey in traditional medicine too, but that the best thing was only to apply a small amount and to leave it uncovered. Following his advice, all of the gunk started to scab up really well.

 

The problem with the scabs is that they were really thick and dry. They started pulling the skin in tightly. At first, I thought this was a good sign - certainly better than yellow goo - but then I realised it would probably lead to scarring. 

Everything I read suggested wet dressings result in scar-free healing. The problem was that any of the medical creams I applied just turned it gunky again, and even the gentlest moisturisers were too harsh and started burning. 

Again, in desperation (necessity is the mother of invention), I went into the garden and clubbed a papaya (pawpaw) from one of my trees. In my research, I'd stumbled across some articles that suggested papaya was extremely good for wound healing. Most articles suggested that green (unripe) papaya milk was best, but I had two problems with that. To get the milk, you have to score the skin of the fruit, or the tree, and collect the sap. Firstly, my trees are really tall, I couldn't get up there, and secondly, it's the middle of the dry season. We haven't seen rain in two months, and it felt a little unkind to drain water from a tree that needed it more than I did.

I tried making a pulp from one green fruit and used it to wash the wound, but that didn't work so well.

As it turns out, ripe papaya is just as good, and much easier to work with.

Take a fork and mush a bit of the fruit up. You only need a small amount, and I keep it in the fridge as it's nice when it's cool. Simply plaster it over either the open wound or the scabs. It will sting a little, but nowhere near as badly as raw honey.

Then leave it to dry. This takes about twenty minutes in a warm climate, maybe forty-five in cooler climates.  It's really weird stuff. The fruit exposed to air will dry really quickly, whilst the fruit touching your skin will remain moist for a long time. As the outside dries, it'll glue itself to you. It makes a superb natural wet dressing, you can move about and it won't fall off.

Be warned - this is a pain in the bum on an open or scabby wound, but it is absolutely worth the discomfort. Firstly, it eats away at the gunk - which is good. Secondly, it sticks to you when you remove the dressing, taking all the crap with it. This is painful and unpleasant, but ultimately also very good, because it helps to thoroughly clean the wound.

I changed my dressing three times a day: morning, noon, night. Nighttime was uncomfortable. The fruit can completely dry out and this becomes painful because it pulls on the skin. On an open wound, this can really ache. It woke me up a couple of times. You will need to soak it off in the morning with tepid water.

After three days (nine applications), the scabs had almost completely gone and I didn't feel the papaya was helping much anymore. I gave the wound a wipe, but couldn't get all of the papaya off. Note - if you have this problem (it can set pretty solid), don't damage yourself trying to get it all off. It won't go rotten or cause trouble. Your body, or the aloe gel, just seems to deal with it.

I switched from using papaya to a tube of 100% aloe vera gel which a friend had sent me. Again, I refrigerated this. I applied at least three times a day, generously. On the third day, I got out of the shower to find that the edges of the scabbed area were peeling. It looked as though the aloe and the papaya residue had merged to create a thick film. I picked at it to see what would happen and the entire scabbed area lifted off in one sheet to reveal perfectly smooth skin underneath. This photo shows my skin after another couple of days of aloe. No scarring at all.

I'm still moisturising with aloe and also unrefined shea butter. Shea is brilliant for skin once it gets a bit further down the line. If you put it near an open wound it'll sting.

So, going by my recent experience, I suggest a three-fold process for troublesome burn or wound recovery:

1. Honey for emergency use if you have an open, leaky wound that refuses to close or scab. Apply minimally, leave uncovered, and expect it to hurt. Personally, I think it killed bacteria faster than the antibiotic cream, with none of the side effects.
2. Once the wound stops weeping and either goes closed but soft, or scabbed, switch to ripe papaya dressings. This will clean the scab out and keep the wound moist to help prevent scarring. This will also encourage skin growth and help to fight infection and inflammation.
3. Once the wound is close to healed, or you no longer feel the papaya is offering much benefit, clean the area, let it dry, then apply aloe vera.

I'd love to know how this goes for others. I was truly amazed at the results. Like I say, nothing had managed to close the wound for two months. Honey, papaya and aloe did it in about ten days.

One up-side to this is that I've made a new friend. A guy also called Moses, like Nurse Moses, but who runs an amazing massage centre near my old place in Kagugu. I knew him before, but only really got to know him because of this injury. I'm helping to redo his website at the moment, in return for help with my hand. He trained for two years in Japan and is just amazing. Even though my skin isn't strong enough to withstand physio yet, he showed me ways to massage the tendons in my arm and shoulder to help relax the muscles and get things moving better. His centre is truly beautiful and I will post more about it later.

Meanwhile, can anyone tell me what these ants are doing? 

I found them on the side of my couch. At fist I thought it was mold, but when I got closer, I realised it was a cluster of tiny, tiny ants. They were just standing around, not moving. I blew on them and they still didn't move. I've never seen ants behave like this before.

I went back later and they'd all disappeared, leaving these strange scales behind. I have no idea what they are?

Anyway, the up-shot of my hand starting to work again is that, not only can I type, but I can just about - almost - chop vegetables. I'm able to cook basic food. Huzah! 

Made this nommy sausage stew. Real comfort food.

The only thing I can't do yet is play the tin whistle. I've given a couple to Sande (my name for Moses II, so this doesn't get confusing). His brother Jeff plays the traditional flute. When I'm better, I hope he'll make me one and teach me to use it. Sadly, that may be a while. I'm healing well except for my ring finger, which is not as sensitive as the others and is developing a callous which is a strange shape. It means that when I try to cover the holes of the whistle, all the air escapes, and I can't tell how hard I'm pressing. I'm due to see the dermatologist on Monday, so hopefully there's something can be done about it.

Papaya ikivuguto (natural yogurt) with tree tomato and passion fruit for pudding.

My wonderful new housekeeper, Shania, has been a real blessing. She makes my bed, washes the dishes and tidies the house for me. She has a little boy, Bon, who came to visit, luckily on the same day my friend delivered my writing desk, along with her little girl, so they watched movies together.

 

My gardener came to tidy the hedges the other week. He chopped down the tree with my washing line attached, so I now have a really nice new line. I'll take a picture soon. My landlord put it up with a metal pole, so hopefully he won't be able to cut it down again.

What else has been happening?

Oh, the African Union summit was held here. Lots of beautiful flags flying all around the capital. 

And I was bumped by a car yesterday. Ironically, as I was leaving the hospital! A few years back Kigali introduced traffic lights and pedestrian crossings. Whereas drivers seem to have gotten the hang of the lights, pedestrian right of way is a whole other issue. It's like playing chicken with the traffic every time you want to cross. I was halfway across the road yesterday when someone just drove his car into me!

In one way it was okay, because he was going very slowly. In another, it was dreadful, because that meant his foot was actually over the brake, he just didn't use it!

I stood in front of his bonnet and made a very theatrical display of pointing to the stripes on the road. I think I've embarrassed him into obeying the highway code.

Still, they're talking about pedestrianising the whole of the city centre. I think that's a wonderful idea.

Deliverance

 

Bug pic! I'll update if I get a response from /r/whatsthisbug. 

Well, interesting week. Little stressful. Couple of those days where I should probably just have pulled the sheets up higher and stayed there.

First disappointment - the dressing didn't come off. My wrist was still a bit weepy, so another round of bandages. Moses assures me they will come off tomorrow instead. I believe him, because what choice do I have? But it's also dawned on me that I'll probably still wrap up in public, so as not to put people off their dinner. I thought my hand looked fairly normal, but a few people have wrinkled their noses, and I've had one audible 'eeewww'.  I've ordered long gloves from the UK. 

I'm still under instruction not to type or touch anything. Apparently I only have one layer of skin, and I need to grow two more before I can start that sort of shenanigans. Otherwise, I have been told, there is a chance that 'blood will come out of my fingers.' I don’t think I like the sound of that too much.

Had a sad moment when I picked up my whistle to see if I could play a simple tune, and realised there wasn't a hope in hell. I have no idea how long this is going to take, but things are slowly improving. I can put my bra on like an adult again.

Second disappointment: my gardener 'trimmed' (err, demolished) the tree with my washing line attached. But it's okay, my landlord used a pole to put it back up...

Need to grow two layers of skin and an extra three foot of armage.

And, final disappointment - well, you can probably guess.

'Back at the weekend,' translated to 'back on Monday, five hours before my flight,' for chap in a cassock. Having no prior warning, I'd booked a Nakumatt delivery and a meeting with a UK client - neither of which I would have done had I known. Ended up not seeing him. Not because the delivery was late, or the meeting overran, but because of this yucky feeling I had. I felt disproportionately pissed off. I really did like this guy. I was looking forward to seeing him, and I don't mind if business overruns and you're late - but I do mind a total dearth of communication followed by an expectation that I can drop whatever I'm doing last minute because you want to see me.

It's really nobody's fault.

Monochronic people cannot date polychronic people.

Just a fact of life.

It irked me because the last time I felt so bent out of shape by a bloke was D, for exactly the same reason. It was this flashback that froze my fuzzy warm feelings. That titanic wave of former frustration and irritation. 

I'm not sure I can ever look on this guy as 'just' a friend. I like him too much. But I dislike this feeling more than I like him, so time to put it in a box under the table. I'll work with him in a professional capacity, but I won't be out socialising. I'm done with that train of thought entirely.

But, the week hasn't been all doom and gloom. The delivery was fun. I now have somewhere to store my dishes, herbs and spices.

 One-handed flatpack assemblage? Leave this to me.

Earlier in the week, my friend Maia (different to Maja) dropped off a small desk I intend using for writing. I went and bought a proper office chair - the other half of the delivery. I've positioned it in front of my bedroom window with a (limited) view of Kigali and my papaya tree. I think of it as the glowing window of inspiration.

Old habits die hard. I had a little ritual tonight to imbue it with inspiration. Although I can't type fast with one hand, I feel I should attempt to make some progress. I'll begin with some editing, which only requires me to scowl at the screen, muttering to myself. 

Consider this writing desk activated!

Confusion Girl

Girl With Bounce

WARNING: This is another post with pictures of a fried hand.

Just had a lovely meal out with Jo & Zubes. Both a bit knackered - me with my hand and Jo with a bad cough. Decided to cheer ourselves up with pizza at the best-lit bar in town. I knew it as Ogopogo, but apparently it's Terra-something (Terra Nova?) nowadays. Whatever, it's pretty. 

Pizza Oven

On the hand front, progress is being made.

For the morbidly curious, this was my hand the day after the physio fucked up.

I wrote to the head of Rwanda's Physiotherapy Unit explaining what had happened and very politely asking for a refund towards the extra medical costs of fixing the damage. He never responded. It's a typical outcome to most things regarding money here - having the same problem regarding a fridge warranty and the manager of Nakumatt. 

Still, Nurse Moses is my miracle man. I will never forget him for as long as I live. He prompted a gushy Facebook post last week:

A massive 'You're utterly amazeballs' to all my nursing, medical and healing friends. Over the past five weeks I have been entirely indebted to an incredible man called Nurse Moses. He's seen me in extreme pain (three hours of skin-stripping surgery on an infected wound), we've laughed a lot despite sharing no common language (there's a splodge on the wall that looks like Che Guevara), and he's forgiven me for fucking up a month of his work by seeing a psycho physio on the side. He's managed to fix every mistake I've made and still manages a smile when he sees me. He is, quite simply, amazing. As are all of you who have the stomach, patience and dedication to enter such a profession. I don't think we ever realise just how wonderful you are until we need you.

Had a bit of a scare last session. Nobody told me that Flamazine, the cream used for burns, turns black when it oxidises. My hand was flapping in the breeze on the moto home, so when I looked at it, I almost passed out. Thought it was rotting or something, until I ran it under a tap!

Anyway, really good news: all of the dressing is scheduled to come off 7 p.m. Saturday. Would have been Friday, but y'know, it's the Wimbledon semi-finals. Tennis or hand - priorities, people.

Here's what it looked like today. We've had some complications with the wrist, it's been slow to heal and was showing signs of infection, so I agreed to Fucidine. This is another cream they use, which is an antibiotic. Unfortunately, I have a bit of a reaction to it. An hour or so after use, I can't keep my eyes open. It completely sends me to sleep and can make me a bit emotional. Think it also had something to do with a bout of conjunctivitis. I feel much better when we don't use it, but it's the only thing that gets the skin healing, so it's worth a bit of discomfort. 

The fingers are shiny because they're coated in shea butter, which I think is some sort of miracle ointment. A small amount of scarring is occurring, so it didn't quite prevent that, but I do think it's helping with colouration and skin repair. Moses reckons all of the red will return to normal over time.

Zuba very astutely asked 'How did you burn your fingers and wrist but not the middle of your hand?' 

I have no idea. My best guess, looking at it now, is that I landed on the side of my arm, then attempted to push myself up with my fingers. My fingers were in a really bad state, so I guess, with my weight behind them, they were pushed down into the hot embers. Or perhaps I landed on my fingers and went down onto my arm.

I cannot express my sheer level of amazement that, in the space of just six weeks, I have managed to regrow everything. I expected it to take three or four months, and to be horribly scarred. It's kind of funny now when I meet people who heard what happened - they're expecting a big ugly mess, and all I have to show them is a fairly normal looking hand. 

I have my own macabre fascination with the process. I certainly wouldn't recommend trying it yourself, but I suppose at least there is hope that if it does happen, and you're young and relatively healthy, it's not world-ending. Your body has the power to regenerate.

The new skin is really stiff, and the scars are still forming so we're yet to see how that turns out, but there are options for physio and dermatology, which Moses (who I trust implicitly) assures me will get everything back to normal.

He tells me to be patient, but I'm not very good at that, so I've done the next best thing - I bought super fast wifi to watch Wimbledon. That's two weeks of lying on the couch not attempting to touch anything. It rally is doing wonders for my recovery.

We have this super cool contraption called Alcatel OneTouch. It's a small box about the size of your palm. You plug it in at home like a router, and you can link up to ten devices (laptop, mobile, Kindle etc.) to it. Then you can unplug it, pop it in your bag, and take your wifi connection with you. Lasts for up to five hours before it needs charging. Unfortunately, it only comes in pink or orange, but the concept is very cool, and you can change your SIM to use a cheaper 3G provider, as 4G is stupid expensive so I'm just treating myself for the duration of the tournament.

So, despite the hand, life is pretty good right now. 

Having some minor confusion, in that my favourite priest is back in town. He called me when he landed, but I was really run down at the time - struggling with the physio incident and a bad cold. Didn't get to see him before he buggered off to Goma to check on their project. Then one of his trustees flew in from Italy, only his flight between Kigali and Goma was cancelled, so LB got in the car and drove all the way to Kigali to pick this guy up.

We went out for drinks, and the trustee jokingly said 'You know he didn't drive all this way to collect me.' *nudge, nudge, wink, wink*

Anyway, he's back in Goma now - they've both gone to check on the project. He says he'll be back at the weekend, but he's flying out Monday, and he's so Congolese when it comes to timing. 'The weekend' probably means ten-to-midnight on Sunday. 

I promised myself after my last crush, that I would never again sit in silence wondering whether to say anything. Life is too short, you never get that time back, and it's twice as painful if the answer you've been waiting for is 'no'. So, before he flies out this time, I intend to separate him from the pack (he's really sociable, knows a lot of people, never alone) and just come out with it. If I don't, it's going to be another four or five months before he's back in town and I get the opportunity again.