So back in February while descending a local peak with my friend Dan I slipped a little and felt a strange sensation in my right knee. My knees usually hurt on decents and I didn´t really think it was anything out of the ordinary. I was wrong. I would find out a few months later that I had a grade II meniscus tear and a slight ACL tear. Damn.
My knees were sore for a few days after the hike, but again I thought it within the realm of normal. The soreness went away and I thought everything was fine. About ten days after the hike, my right knee started to swell up and became warm to the touch. It hurt pretty much all the time and was even uncomfortable to lay in bed. Strangely, at the same time I was having a weird thing going on with my left thumb. It's hard to describe, but basically every morning my thumb would be "stuck" in an extended position. I could bend it, but it was painful and felt like it needed to pop. I could feel and see the knuckle "jumping" every time I flexed my thumb. After about an hour or so it would gradually loosen up and work normally, but then be sore later in the day.
I have arthritis in my family and at first we thought I was just experiencing symptoms at a young age. I was a little bummed out at the thought of arthritis at 32 and hoped it was something different. We also thought maybe gout since I was experiencing symptoms in multiple joints. (Another member in our group was diagnosed with gout during training.)
The first week of March I went into Tarija for tests. I met with an orthopedist, had X-rays taken of my knees and hands, and blood tests to check for gout. Unfortunately, there was no MRI machine in Tarija. Everything came back negative. The X-rays showed no bone damage, the blood test revealed no gout. The doctor diagnosed my thumb as "pulga agitado" -- stuck thumb -- and tendonitis in my knee. He prescribed me 14 sessions of physical therapy.
The PT was almost a joke. It was in a beauty-salon-type-place where I received a vigorous daily massage of my knee and thumb, a mud/herb wrap, ultrasound, and a donut shaped "healing magnet" placed around said joints. My therapist, Rene, had treated many PC volunteers over the years and knew much more gossip than I had ever heard. Oh yeah, the place was located on the fourth floor of a building with no elevator. So after the two weeks of PT neither my thumb nor my knee were really feeling any better. Luckily, we were about to attend our one-year medical checkups in Cochabamba where we could see specialists and have a more complete physical.
In Cochabamba I was diagnosed with a cyst in my thumb and authorized for an MRI on my knee. The docs said I had a cyst growing on the tendon that moves the thumb back and forth. The cyst was preventing my thumb from extending and my options were minor surgery or a cortisone shot to shrink it down. The cortisone shot would be a temporary solution and the docs said it would be painful but would restore full movement to my thumb. I had the cortisone shot, it hurt, and like magic one day later my thumb was back to normal. Erica and I took our Costa Rican vacation and after we returned to Bolivia I had the MRI completed in La Paz. It was exciting having an MRI, my first, and feeling that I would finally understand what was going on with my knee.
Two weeks later the PC doctors called from Cochabamba and confirmed the injury to my knee. They told me that I would be authorized to have surgery in either Washington DC or Panama. Within a week I found out I would be medi-vac'd to Panama for knee surgery.
Because PC has the policy that we must always fly on US based airlines whenever possible I was to fly to Panama via Miami. I spent a few hours in the Miami airport for my first time in the US since January 2007. I had a Caesar salad and visited the Starbucks while generally being in awe at the cleanliness and efficiency of the United States.
I arrived in Panama late on a Wednesday night and was met at the airport by PC Panama medical staff who drove me to the hotel I would end up staying in for a month. Friday I had a new MRI done, since they said the Bolivian MRI was "horrible."
I went to the mall and saw some movies over the weekend. I was awed at the size of the mall and the bus station. I also went to see the wreckage of a helicoptor that crashed in the city the first day I was there.
I met with the surgeon the following Monday and was scheduled for arthoscopic knee surgery on Thursday. I had never had surgery before and was pretty scared. I asked many questions and talked as much as I could with Erica who had stayed behind in Bolivia. I was a little upset at the discrepancies that were coming up between the medical info I received in Bolivia and the new info from Panama. In Bolivia I was told the procedure would only require local anesthesia, I would only spend one night in the hospital, and all my rehab would be done in Bolivia. In Panama the doctors told me I would be placed under general anesthesia, I would spend multiple nights in the hospital, and my weeks of rehab would take place in Panama. We tried during the last days to have Erica make the trip to Panama, but it just did not work out.
I checked into the hospital with the help of Ricardo, the PC Panama medical assistant. We became friends during the month I spent there and he was wonderful in getting me to appointments, visiting me in the hospital, and just providing support. PC Panama alternates between two hospitals and I had the fortune of being in turn for the new, lujo (luxurious) Johns Hopkins hospital.
(PC Panama office, Ricardo and I, Johns Hopkins hospital)
I checked in and that same say had my surgery. It was a quick procedure and everything went well. I was pretty out of it the first night but felt OK and was able to receive calls in my room from Erica, my mom, and Erica's mom. They all helped me to feel better and were relieved to know the surgery went well.
(My surgeon, Dr. Samuel Edwards, and me just after the surgery)
I felt much better the second day and began my PT in the hospital on day three. I had crutches to get around the room and had to use this funny chair for my first showers.
The nurses were all very nice and helpful and were attentive to any need I had. I ended up spending four nights in the hospital and was discharged Monday around noon. Ricardo was there to pick me up and take me back to the hotel. My first few days back in the hotel were difficult. I no longer had the help of the nurses, or three meals being delivered to my room. I also had to get myself to the hospital complex for my continuing PT. I used crutches for the first week, then a cane for the next ten days. The PT in Panama was excellent. I had ultrasound, electric muscle stimulation, and multiple machines to use to begin strengthening my leg and knee.
(View from roof of hotel)
When I was just about finished with the PT, after a month in Panama, I received the news that my brother had lost his battle with cancer. Steve was diagnosed with intestinal cancer in December of 2006. Erica and I traveled to San Diego to visit with him and his family before we left the country in Jan 07. My sister Rebecca kept me up to date via email and ocasional phone conversations while we were in Bolivia. Steve had multiple surgeries, chemotherapy, and some holistic medicine. Throughout his illness he improved at times and always kept an incredible attitude and fighting spirit. He passed away on June 24, 2008.
PC Washington received the phone call from my sister and within 24 hours I was on a plane from Panama heading for San Diego. PC Bolivia also sprung into action and within six hours had sent someone to pick up Erica from our little town and she was on a plane 36 hours later. I arrived in San Diego a day before her and we met up at the San Diego airport after being apart for just over a month. The unexpected trip home was surreal. I was grateful that we had spent time with Steve before we left the country but incredibly sad that I was not there during his hardest time.
We spent a few days in San Diego with family and attending Steve's services. It was a very emotional time for us.
In San Diego Erica and I stayed at a Best Value Inn. It was by far the nicest accommodations we'd had since we first left the US.
In San Diego I spent time with my sisters and was treated to a great birthday dinner complete with an ice cream cake.
Erica and I left San Diego and traveled north to spend some more time with our families and see friends. We did not have a car or a cell phone so we used all sorts of public transportation and pay phones. Riding the train from San Diego to LA was quite nice as it was right along the coast.
Riding Greyhound from LA to Sacramento was not quite as enjoyable. We visited with some friends in LA and I got to drive my truck around. It was a bit surreal to be driving again after a year and a half.
(Fun with Greyhound)
We had a dinner with my dad and his family in Stockton and then he drove us up to my mom's house in Cameron Park. We settled down for a few days, celebrated the 4th of July, and got to spend a day with our dog Luna at Folsom Lake.
Erica's parents picked us up in Sacramento and we headed to their house in Livermore. We had a few more days with her family and saw some friends in the Bay area.
Since I had come to the US while on medi-vac status, I had to return to Panama to receive the "all-clear" from the PC doctors. I left the US July 9th and returned to Panama to complete the medical clearance process. Thankfully, the PC Panama staff was aware of my desire to return to Bolivia and get back to my work. They expedited the process, I met with the doctors and was medically cleared on the 11th. I spent the weekend taking in some of the sights of Panama city and Sunday July 13, my 33rd birthday, I was on my way back to Bolivia.
Because PC Panama worked quickly my flight plan was a bit crazy. I left Panama city at 3:00AM, arrived in San Jose, Costa Rica at 5:00AM, had a four hour layover, then on to Lima, Peru, where I had a 10 hour layover. Finally I arrived in Santa Cruz, Bolivia just after 2:00AM. I was exhausted but happy to be back in Bolivia.
During my birthday on the planes I felt like quite the experienced South American traveler. Since Erica and I had recently been to Costa Rica and we had taken our honeymoon in Peru a few years prior I felt comfortable in both places. I passed through customs in both countries and went into the cities for food. In San Jose I knew there was a Denny's a short walk from the airport and went there for breakfast.
In Lima, Erica and I had discovered a wonderful Chinese restaurant and I was able to successfully navigate the city buses to find it again. I enjoyed a dinner of spring rolls and stir fry beef noodles and walked around the historic city center. The food was as tasty as I ever remembered. By the time I cleared customs in Bolivia I had stamps from four countries in 24 hours.
It took another day for me to fly to Tarija where I was finally able to see my friends and feel like I was home. The docs in Panama had prescribed me another week of PT to be done in Bolivia so I spent the week in the city and was able to meet Erica at the airport when she arrived from the US.
A few days passed and we found out that all the volunteers were being moved to Santa Cruz in case violence broke out during national elections. We had a multiple day conference, got to meet new volunteers, and were again reunited with friends from our group who we rarely see. Finally we left Santa Cruz, flew back to Tarija, and headed back to our real home of El Puente.
I was very excited to get home as I had been gone for almost two months. Our first few days back in town I realized again the joys of living in such a unique environment. In the 500-person town of El Puente we are close with only a few families, yet I would guess that everyone knows who we are. I had many people greet me, welcome me back, ask about my knee and wish me well. I felt missed and appreciated and proud that we had succeeded in becoming part of their community.
I got back to my routine of reading, exercising, meditating, cooking, and working. I also had picked up a harmonica and some books and began teaching myself how to play. I helped Erica with the mural and got back to assisting the high school english teacher with his lessons and skills. Our friend Dan came out and visited and we worked on the mural and hiked a mountain I had been eyeing for some time.
I was eager to test out my knee and my new treking poles that my mom had bought for my b-day. What a great feeling it was to hike another 10,000 ft mountain and have absolutely no pain in my knee. Thank you Dr. Edwards for fixing my knee!
(The mountain)
(Views from top)
Dan is a great guitar player and while he was visiting I had my first chance to play harmonica with some backup. We also went over to the house of a local family that we are close with. The two boys had asked me in the past to help them learn to read music. They have an electric bass and guitar, and keyboard, and a full drum set. When I had visited before I had my trumpet and it was difficult to play with them. This time was different. Dan and Erica took turns on the guitar, I played harmonica, and Erica even played set for a little while. Before long Dan had taught the older son, Reynaldo, the basic blues bassline and we were off. It was amazing. I doubt they had ever heard the blues and most certainly had never played them. Dan also showed the chords for Wild Thing and we took turns soloing and backing each other up. The younger son, Leopoldo, is quite a good drummer and he was able to keep up and add some of his own style. The mom and dad came in and were speechless. She brought us some of her fresh baked bread and tea and we shared a very special evening. They had never seen a harmonica and I encouraged them all to try it. The younger sister, Elida, was the most curious and she had a great ear and was able to play along. Unfortunately we did not take any pictures, but we did videotape a bit of the jam session. I think it will prove to be one of our favorite moments captured on film.
Erica and I spent two more weeks in El Puente, playing the blues almost daily and loving our new hobby. We had been in site just over a month when the political atmosphere began to rapidly deteriorate. There were marches and protests in the main cities and bloqueos throughout the country. We experienced our second bloqueo in El Puente complete with dynamite and we watched a frightening rock fight between opposing groups. A few days later the US ambassador was expelled and then PC called us all to Cochabamba for safety and possible evacuation. You are probably already aware of what happened next.
We will write about that experience in a separate post. I'll close with a picture of our neighbor and friend Dementia and her son who had come to visit a few weeks before everything changed.
Hasta luego,
Marcos
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