Surgery, US, and the blues.

I've been working on this post for quite some time and have finally had the time and internet access to finish it...

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

The picture I almost got with Tony Kiedis

I only had a couple of hours to pack since someone had already been dispatched from Tarija to pick me up in our site when I found out I'd be flying to San Diego to meet Mark.

One of our first days in San Diego, we decided to participate in the US economy. We took the bus from our hotel to the Old Town Transit Center, from where we could walk to lots of places to shop. We were looking for the Target in particular, and we knew where it was in general, but couldn't see it. So we started walking the right direction, cutting between buildings that got in our way. We stumbled into a courtyard that had very prominent video surveillance and realized where we had found ourselves.

If you are unable to zoom in to read the sign, it says: "San Diego Psychiatric Hospital."

Getting around without a cell phone sucks. At the Transit Center, the first payphone I tried had no dial tone. The second had a tone but also a background noise that covered up the voices on the other end of the line. Both were suspiciously sticky. Who cleans payphones, and how often? Finally I found another bank of phones that worked. We had purchased a 7-Eleven prepaid phone card, but it lasted way fewer minutes than it advertised.

I'm really impressed with all the readily available technology, lots of people with blackberries in particular. I have a 3X5 spiral notebook with important phone numbers and lists that I was referring to as my palm pilot until someone politely mentioned that palm pilots are like, SO, out. I prefer mine because it doesn't have to be charged or sync'd. I almost lost it during a trip to Target where I put it down underneath some DVDs I'd been looking at. I freaked out briefly but found it by retracing my steps.

My parents and Mark's mom arrived in San Diego that weekend because we weren't sure how long we'd be in the states. My brother and his wife and kids also came down from the OC, so I got to meet my niece for the first time and spent some time on the beach with them. After that day, Mark and I decided to make the trip north to get to see our moms more. Since we had no vehicle (and my driver's license had expired) Mark and I decided to take public transportation as much as possible. Our adventure began at the Old Town Transit Center in SD where we took the Coaster to Oceanside and then the Metrolink to Laguna Niguel, both trains. My sister-in-law picked us up at the station with the kids and took us to their house where we had our first home-cooked meal of the trip. We hung out and talked, I hit a home run with my nephew's whiffle bat (losing the ball to a storm drain), and then my brother took us to a drop off point where our good friend Evan picked us up to go to his house in Cerritos. In LA, we got to spend time with Evan and some other friends, including the maid-of-honor and best man from our wedding, who live on opposite sides of the 405 freeway from each other. We all met up at Lara's house, played Rock Band on the Xbox 360, and ate italian food. On July 2, Mark and I celebrated 3 years of marriage by buying ourselves bagels and professional massages- two things we can't get in Bolivia. If you'd asked us a month ago, I don't think either of us would have imagined we'd be celebrating the anniversary that way.

Before I left our site, I had been working 2-3 hours a day on the mural and this is how I left it:



The white circle in the upper right corner is going to be the moon. The Peace Corps symbol is in the lower left corner, since they're the ones who funded the paint for the whole project. The emblem of the school will eventually appear in the lower right corner and a compass rose will be in the upper left. The names of the countries have not yet been added, as well as some revisions of national borders and black in-fill around the globe for contrast.
These are closer up shots of the 3 national symbols that I painted on the Bolivia map. The first is a flower called the Kantuta, which actually grows on a bush near the mural (not shown). The following flower is called a Patujú (pah-too-HOO) and grows in the tropical regions of Bolivia.
Finally, the escarapelo badge, which we were adorned with when we swore in as volunteers back in April 2007.

We were invited to attend a quinceñera. It was hosted at the local evangelical church, so we sat through a service first, and then the ceremony began. There were 14 pairs of children of various ages- each pair represented a year of life and walked down the center aisle dramatically before taking their place in a human tunnel for the birthday girl to pass through. The church was decorated with toilet paper, in the way that we'd use colored streamers, bows, and ruffles everywhere. After the ceremony, we were invited to share cake with the other 100 attendees. The cakes were made in true Bolivian fashion- they looked great but weren't that tasty. Bolivians rarely use butter in their baking. Instead they use lots of baking powder and egg whites.
I was able to be in El Puente for the 24th anniversary of the high school there, Colegio San Miguel. The night before the anniversary, the students paraded across town with candle torches and performed traditional dances in costume. Below is a picture of the senior class of CSM in their Caporales uniforms. Yes, that is velour.

There are a couple new political offices that have appeared in our site: The autonomia office showed up just prior to the June 22 vote, and the MAS office (friends of Evo) appeared leading up to the August 10th recall vote.
Here is some graffiti that appeared in the main plaza of Tarija. My favorite part is that they spelled Evo with a B, a common mistake in a language where the letters sound very similar. I've gotten into specifying that our last name is spelled with a B grande as opposed to a B chico.
I took a self-portrait with Roque before I left since Mark hadn't seen him recently.

Here's Roque "helping" me with the laundry.
When visiting my best friend Lara in Brentwood, Southern California, I met Anthony Kiedis. He's the lead singer for the Red Hot Chili Peppers. He was sitting outside the Peet's Coffee about 2 blocks from Lara's apartment with a couple of 12-year old blonde groupies. I embarassed the begeebers out of Lara and Mark by dragging them down there to try and get a picture with him. I walked straight up to him and said, "I'm really sorry, but would you mind taking a picture?" He said, "wait a minute... what is your name?" and shook my and Lara's hands before admitting that he wouldn't feel very human if he started taking pictures with just anybody. I mentioned that we were home from the Peace Corps and he asked where we are serving. When I told him we are living in Bolivia, his eyes lit up and he asked, "So, have you smuggled in a bunch of cocaine?" I bet if I had, I would have gotten his picture. I got a little (more) nervous at this point and started spitting out random coca trivia such as where he should visit in Bolivia to see the plant growing and how many kilos of leaves it takes to produce a kilo of the powder. Answers: the Chapare, 900. After that I'm not sure what I said but the conversation ended pretty soon after. Mark had run away earlier and Lara was relieved that I had finished violating the number one rule of living in LA, that you don't get excited about meeting celebrities. We got something to drink and sat at a table out of ear and eyeshot of him and that was it. Mark told me that he saw Anthony check me out as I walked away. I'm just a little obsessed now but I'm managing by reading his autobiography. He's had a pretty crazy life, and it now makes a little more sense why he asked about cocaine so frankly.

We had already noticed the slower pace of life in Bolivia compared to the states. What I've been told is that the concept of time in Bolivia is based on the Incan idea that time is circular. Any event in time occurs somewhere on the circle, and if the event is missed it can be recaptured on the following trip around the circle. This is much different than USA time, which is more linear, thus the appearance of efficiency, punctuality, and difficulty letting go.

The last time I'd been in the states was late August 2007. During that trip I pretty much bottomed out in the depression rut I was in at the time. It is comforting to notice that I feel 200% better on this visit. So what has changed? Since the first trip, I have learned enough Spanish to understand what people are saying 85% of the time and also enough for me to express myself in Spanish. When I couldn't do either of those things, it was very frustrating. I've made friends in our little town with whom I share baked goods and tea, women who I will miss when the time comes for us to leave. And I've found projects that I enjoy and feel capable of working on.

We took the greyhound/crucero bus from Norwalk to LA Union Station, then on to Stockton via Coalinga junction. Compared to the bolivian bus system, greyhound was way disorganized although once we were on the bus it was ok. They seem to not keep track of the number of tickets sold for a certain route relative to the capacity of the assigned bus. Therefore, the bus that arrived at Norwalk was full, leaving us to miss our connection bus in LA since we had to wait for a backup bus. The next bus arrived an hour later, took us to LA Union, where we had to wait another 3 hours. Since there are no assigned seats and there is uncertainty about there being enough seats, everyone waits in line as soon as a gate is assigned to a certain bus line. It was a colorful group hanging around, not excluding us. I'm pretty sure we ran into multiple people recently released from the psychiatric hospital, who seemed to be comfortable talking to us because of Mark's hair. In general, the population of greyhound riders were mentally or physically disabled (thus unable to drive themselves) or of lower socioeconomic status. The only reason anyone would ride the bus is because it is significantly cheaper than Amtrak or flying. The inherent cost is the loss of many hours of your life, waiting for greyhound to get their act together. We saw no businessmen traveling on the bus, but most people had cell phones. We were having to use the payphones to update people on our location. The bolivian bus system is used by people of all walks of life. Busses are frequent and relatively reliable. When you buy your ticket, you reserve a particular seat and you know it's yours. You get a claim ticket for any luggage you place under the bus. All this comes for 2-3 dollars. We paid $50 each to get from LA to stockton.

Mark's dad, Matt, picked us up at the station in Stockton and took us out to dinner with his family. It was dollar taco night at the restaurant where Matt's son David works, so we grubbed there. After dinner, Matt was kind enough to drive us to Cameron Park where Mark's mom lives. We spent the 4th barbecuing and watching TV, the first down-time we'd had on the trip so far.

While we were in Sacramento, we broke Luna out of the boarding resort, took her to the vet for vaccinations and a nail trim, and then took her to Folsom Lake. She and Mark hiked around for an hour while I took a nap in the shade of a tree and then we ate a picnic lunch. Luna's gained about 10 lbs since her surgery last spring, so she was looking a bit barrel-shaped. Once she's back in our care, we'll be able to get her diet and exercise worked out to get rid of that weight, which is bad for her mildly displasic hips.
We were also able to get a glimpse of Maya, Mark's Mexican calico, who is living with an aunt and uncle in Sacramento. She keeps to herself, spending the night in the basement and coming out to bask in the sun during the day. Finally, there's Javier, the grey tabby living with my parents. He's living the good life and looks very healthy. SACRAMENTO:
We had dinner at El Navillero, a family owned and operated mexican restaurant in south Sacramento. Mark's been going there for years. It was so much food! We also went to the Leatherby's creamery, a family ice cream parlor that was one of our favorite Sacramento dining establishments. Luna's not the only one who has gained 10 lbs lately.

Debating with Republicans. One of Mark's relatives claims that if Obama is elected, he will make the white man pay. I reminded her it's a good thing she's mexican.

Mark left a week before me to return to Panama. He was checked out by his knee surgeon and cleared to return to Bolivia for two more weeks of physical therapy. I had only been booked a one-way ticket to the states, so when I called to schedule my return flight, there weren't many flights available. This enabled me to stay with my parents for an additional week during which I was able to visit friends in the bay area and to be moral support for my mom's surgery.

Being back in the states left me feeling self- conscious about certain things. I think my sense of what was socially acceptable was a bit altered. For example, I noticed that people weren’t talking about their general digestive health as much as PC volunteers do. My nephew was talking about how he enjoyed swimming in the pool, but it sounded like he was saying “swim-in-poo” so I discussed with him how gross that would be. My brother was not amused- fair enough. When we were traveling on public transportation, I noticed that I’m used to it being okay to strike up a conversation with a perfect stranger. Also, blatently staring at people for extended periods of time is perfectly fine in Bolivia. In the US, not so much. As far as getting around town, I’m totally used to making judgment calls at intersections and I’m sure I could’ve been ticketed for jaywalking multiple times.

In closing, I'd like to thank American Airlines, for waiving my checked baggage fees. A 65lb rolling suitcase and a 55lb duffle bag- pretty far over the normal person's baggage weight.