health

Quinn in a swimsuit stands in front of a pool with arms crossed a smirk on her face

The Vitamin Showdown

Scene: The famous whistle music of the classic western movie plays in the background as mother and young daughter stand on a dirt road, staring each other down, guns cocked and ready for the other to make a move. Dusty wind blows through their hair and tumble weeds roll and bounce across the space between them. Mother’s thoughts play over the scene: “I will win this stand off with my youngest daughter over taking her vitamins even if my legs are starting to shake and arm is cramping”.

One Month Earlier

Mom and daughter in the kitchen. Mom is holding a bottle of chewable multivitamins:

Quinn: “I don’t like raspberries”

Mom, speaking flatly: “you don’t know that until you try it, Quinn.”

Quinn with a note of attitude: “I do know, mama”

Mackenzie who had been standing by watching the interaction pipes in with a brown-nosing quality to her voice: “I love them Mama!”

Uuuuhhhg, ok, I decided, I’ll play along one time. I agreed they were crunchy vitamins instead of the chewy type of which she was more familiar. Fine. Jacob said he would grab a new kind when he went to the store that afternoon and brought home bear shaped vitamins of the gummy version. Quinn conceded, tried one and immediately spit it out.

Damn our family rule that says one must try something before forming an opinion and if you don’t like it you can spit it out! We need an amendment to that rule that says, ‘except in the case of vitamins’! Over the next week we tried all the typical bribery, but Quinn used savvier methods. She perfected a dramatic gag reflex to powerfully highlight the amount of torture and abuse she was experiencing by our forceful demands of vitamin consumption. “Fine! If you won’t take these then you will need to use your own allowance to buy more and you can pick them out!” (I’ll be honest, I tried one and they were gross but hell if I tell her that)

This new solution seemed to appease her. She bounced home with Jacob one afternoon (I actually don’t think Quinn has another way of walking) and proudly presented her new strawberry and vanilla flavored selection…We only got one willingly down her throat.

Mom, face turning red: “If you don’t take your vitamin, then you don’t get to have treats later in the day and you just don’t know what those will be so you might as well set yourself up for success now”.

Quinn with a power voice: “I don’t want any treats”

Mom with sing-song sarcasm:  “Ok, we will see how you feel later”.

We all had milkshakes that evening except her. She appeared unaffected. For the next two weeks we fought with her, pleaded with her, offered rewards, and helped her plug her nose all with about a 50% success rate. Jacob grew tired of the nose plugging drama and told her he wouldn’t help her anymore and into the deep mud she dug in her heels and then poured cement on her feet.

I made cookies the other day (really my purpose wasn’t to torture her, but I secretly hoped it would tip the scales in my favor). She saw me eating one and asked me if it was one of the cookies I had made. “Mmmhmph” I nodded a confirmation with a mouthful of cookie. “humph” she said as she shrugged her shoulders and walked into her room clearly communicating with her body her complete disinterest. Who is this six year old and when did she become a teenager? I was sure to send her the same message back with my own nonverbal communication, but she was already gone. Score one for Quinn. However, it dawned on me that my little one prefers salty treats to sweets. Ha ha ha! This will get her. I have now restricted her fry and chip consumption. No cheese cubes or crackers in her lunch for snacks she gets double helpings of veggies and fruit. She is still unaffected in fact asked if she could pick out new veggies at the store.

Ok, I’ll admit the fact that double veggies in her lunchbox is not a bad side effect of this vitamin showdown but that’s not really the point is it? Jacob is now on her side, begging me to let it go. This morning Quinn said to me, “Mama, did you know there are nine vitamins in each cornflake? I’ll eat those, I love cornflakes”.

Blast! Who taught her how to read? Now I have to take away her books.

Silver elephant in the green brush with a stormy sky

This Side of Amy: Decisions, Decisions, Decisions

Over the last six months of travel to six different countries, it has been one decision after the next. Some days I wish more than anything we had a pocket travel agent. A little tiny person we carry along who finds the best housing, the best flight for the best price, the best transportation, the best restaurant complete with food my children will eat and so on. As anyone who has ever planned a vacation knows, travel requires many decisions, and sometimes once you get to where you are going, as they say, the best laid plans go to waste. That means you are required to make new decisions on the fly, which can be overwhelming, especially when hunger, exhaustion and hyper kids cloud the access to your rational mind. But hey, this can also be part of the fun, right? Sometimes the new plan works out even better than you could have imagined.

We’ve been doing great so far, with all these choices in front of us. However, in the last two months not only have we been faced with the above list but also with big journey altering decisions.   Our choice to make a long stop in Cape Town was really made by my knees, which created more complicated decisions to be made in a hurry. Decisions about my health, treatment, continuing on after treatment, finances, long term car rental in a location that absolutely requires a car to get around, a long term apartment we can afford. Should we find a school for the girls so they don’t have to sit around with my knees, and me? Then, which one should it be, will it work into our budget? Which doctor do we listen to about surgery, which physical therapist do I go to? Do we apply for an extension on our visa in case I need more time to heal or do we trust 3 months will be enough, what if it’s not and we didn’t extend our visa and I do need surgery? What if what if what if what if what if!!! The whole of the last 2 months has been based on what if….

Calgon take me away.

Someone else tell me what to do, what is the RIGHT way? I need The Universe to send me a real sign, I mean a literal sign that says, “Amy, if you do a. b. c. and d. all will be wonderful and all your dreams will come true”. Like a frickin’ fairy godmother to sing a bit of bippity boppity boo and poof it’s done. Why doesn’t that happen anymore? What has the human race done to chase off sweet cuddly godmothers with rosy cheeks and magic wands?

And then, my sweet daughter comes in the room with a card in her hand from her game, the kind of game that has cards with only pictures and you make up a story, and she tells me, “this is your card mama”. Guess what the picture was? It was a picture of a green field with a stormy sky and the sun starting to break through the clouds. Just like the sky we saw this morning as we came down the mountain pass on the way to see the second-opinion-doctor. The sky had giant thunderhead clouds with beams of sun bursting through in beautiful yellow rays shining down on the houses below. Oh, you mean that kind of sign?

The other day, we stood on the top of Signal Hill, a vantage point to see the whole of Cape Town, Lion’s Rock and Table Mountain. As I took in the experience of seeing the massive, sheer rock wall of Table Mountain, I was washed with a knowing that I will heal in this place that this mountain and the whole of the area is emanating with radiant, loving, healing power. All along our travels, we have been to places like this. Places that filled me full with energy from the earth. So much so that I could neither catch my breath nor articulate my words. The Valley of the Gods in Utah, Machu Picchu in Peru, the La Ceiba jungle in Costa Rica, the brush with the elephants in Namibia and now I get to add Table Mountain in Cape Town to my list of power places.

In these places, I can literally feel the planet radiating energy. It buzzes in my veins, tingles in my hands and feet and fills me a sense of connectedness to myself, to other humans, to the earth, to The Universe. I bet you have felt these kinds of places too. Maybe you have felt the resonance on a mountaintop when the view and wind take your breath away or on a quiet walk through the woods smelling the herbaceous, earthen path. Perhaps when sitting on a beach feeling the sea spray and warmth of the sun on your skin or in your own home when your kids or grandkids crawl up on your lap and give you a kiss on the cheek for no reason.

Tonight, as my head is spinning consumed with the unknown, with the decisions that are still left to make. I remember how I felt up on Signal Hill and I remember that my fairy godmother is right here, right inside of me. If I can quiet myself for just a moment, get out of my own way, really take in the energy of these places and these moments and listen, the best decision will rise up from my intuition. It’s the quieting the self that is tricky. My head is so damned chatty. My pleaser persona scrambles up my true emotions and needs. It creates fear instead of love but I’m learning…I’m learning. Therefore, I leave you with this snippet of a tune to sing for the rest of the day:

“All we need is love, love. Love is all we need. Love is all we need” ~The Beatles

 

(By the way, I’m still working on the pocket travel agent; so far Google will just have to do.)

 

Shadow of Amy and Quinn reflected on the red dirt of the Soussusvlei desert in Namibia

Musings from Muizenberg

In three days, we will have been on the road for six months. First, I want to thank those of you who are following along and sending us messages of encouragement and support. I have received a lot of loving questions about “the knees” which makes me feel cared for and grateful. I was never much of a “Facebooker” until we began our travels. It has now become my lifeline to our many friends and family members. If you love or even like a little bit of the blogs you are reading, please share them with your own circles on Facebook or forward our website to your friends who boycott Facebook. We would love more followers.

I thought I would take a moment and give you all a real time update on our whereabouts. We are currently in the city of Cape Town in beautiful South Africa.  As you know, I have been battling problems with my knees since we left Colorado. While in Namibia, the swelling gave way to a lot of pain and so we searched with spotted internet service, and found an orthopedic surgeon in Cape Town. After undergoing MRIs on both knees (wow that was intense, who knew how difficult it would be to stay perfectly still for 20+ minutes/knee?), his assessment is that I have broken up cartilage that is irritating the knee joint and causing the inflammation and pain. I must have a piece in my left knee joint that is preventing me from fully straightening it. His recommendation is arthroscopic surgery to “clean out” the cartilage in both knees. Apparently the right knee is the worst and I am even missing bits of cartilage on that side. Because of this news, we have opted to stop here in Cape Town to receive the needed treatments. The long flight from Spain to Namibia (10 hrs) taught me that when inflammation is running amuck it will fill up your whole leg, is really painful and takes several days to subside. In my case, the swelling in my knees has been ever present for the last 5 months. Traveling back to the US is not only very expensive on such short notice but it is also a 35-hour journey.

Here in Cape Town, I will be able get treatment and proper rehabilitation. Our visa allows us a 3-month stay and we have found an apartment to rent for that time. We can even apply for an extension if needed (which I am pushing for so we can explore the many nature trails and mountains of the Cape once I am healed). We have found a very sweet Montessori school called Auburn House School where the girls are enrolled and will start the new term with the rest of the students on April 5th. This was at their request and they are very excited. It will allow me time to catch up on writing and Jacob to continue to work on his plans for his own career goals.

That is the Real Time update for today March 19th, 2016. Happy Birthday to my nephew Roarke who turned 12 on St. Patty’s day. We are sending so much love to Jacob’s family as they celebrate Shirley Martin’s life at her memorial service today. She was a kind, hilarious, beautiful woman, mother, sister, daughter, grandmother and friend to many people.

Keep watching your inbox for our blogs. In queue are more words from Mackenzie and Quinn, my take on Sevilla and our amazing experiences in Namibia.

As they say here in Cape Town,

 

Go Well.

 

Travel with Kids: Health

Keepin’ It Real: Travel with Kids

Installment #3: Medical Mishaps

….and so I sit on the red twill couch in the sunny living room of our apartment in Sevilla, Spain. My knees propped up with pillows obeying the instructions of Dr. Ruiz from Hospital Universitario Virgen del Rocio, who, after painfully draining it, told me I was not allowed move my knee for at least 24 hours. Jacob took the girls to their art and theater class for me instead of going to his Spanish class this evening because the girls deserve to get out of this house and do something fun. Sitting quietly and obediently at a busy hospital for two hours is a lot to ask of an 8 and 6 year old.

The growing pain and inflammation in my right knee had been haunting the back of my mind since we arrived. Each time we travel to a new destination, my knees seem to get a little inflamed but then it subsides and I am able to keep up with our adventures. So, I thought this is what would happen here too. I ramped up my yoga practice trying to be gentle on my knees, not over tax them. I found an English speaking Physiotherapist/Orthopedist/Eastern Medicine practitioner nearby and made an appointment. I surfed the Internet for an Acupuncturist as a treatment supplement. All while the inflammation grew and grew. The increased walking here could have been the cause or maybe over the last 5 months I have not properly rehabilitated my knee. Whatever the reason, two days ago I could no longer walk without looking like Igor from the movie “Young Frankenstein.” My knee was so inflamed it looked like an over full water balloon ready to spring a leak at any moment then burst.

Jacob immediately relegated me to the couch and instructed the girls to push me around on a rolling office chair if I needed to use the bathroom. He went to stock up on food and walk by an Acupuncture clinic whose website made it seem like they were still in business; however, their email bounced back and the message I heard when I called could have said it is no longer in service but it was in Spanish and so I wasn’t sure. He returned half an hour later with food and news that the clinic was indeed closed down. We spent the afternoon trying and failing to figure out options for English speaking doctors in the area. When that proved difficult, Jacob took to consulting with Dr. Google instead and determined that:

a. I have some strange disease I have never heard of

b. fibromyalgia is causing the inflammation

We decided those weren’t the most hopeful of prognoses and went back to seeking an actual doctor. After a couple of phone conversations with receptionists, the Physiotherapist I had an appointment with later in the week, texted me at 10pm to tell me he could see me at his office at noon the next day and included the address. “Wait”, I thought, “this address looks different than the one on his website, better consult Google again.  Hmmm, it isn’t showing me Sevilla, there must be a mistake”. I sent him a text explaining my confusion about the location and thanked him for rearranging his schedule for me. Alas, his clinic was NOT in Sevilla it is in Madrid. He hasn’t practiced here in over 4 years. Great. That’s only a 4-hour car ride or 2 and a half hour train ride away! I immediately started to cry. The pain was getting worse and the fear growing that our broken Spanish would not be sufficient to get treatment and we would have to go home. However, now here I am less than 24 hours later, relishing the relief from the pain caused by pressure in my knee and feeling more hopeful that with proper rehabilitation we can continue our journey.

A Keepin’ it Real blog post about health has been bouncing around in my head for a while now. What better time to write it than after seeking and receiving medical care in a foreign country?? I must admit, I sat in the waiting room of the hospital looking around at the mass of people awaiting their care and witnessed myself experiencing many different emotions. I felt a lot of trepidation about the quality of treatment I would receive immediately followed by a feeling of shame for that thought to come into my mind. I felt relief that we were in Spain and not in Panama or Peru when this happened. There was a sense of hilarity at the situation. For instance, about every five minutes or so, Jacob and I immediately stopped our conversation and strained to understand the name and instructions being said over the loudspeaker. When we were finally called to “Rayos numero dos”, Jacob pushed me in my wheelchair, out into the hall around and around a pole, the girls following behind like obedient little ducklings, trying to determine what the instructions meant since all the doors in the hallway were closed. OH! Of course, silly. It means x-ray! At the moment of our realization, the x-ray technician opened the door to “Rayos numero dos”.

Finally, after the x-ray and initial consultation with a nurse, I lay on the treatment table in the third and final room of our medical adventure and I felt the feeling of vulnerability. No matter the country, no matter the facility, lying on a treatment table in an unknown place is vulnerable; however, I also felt trust. Trust that this man was doing exactly what his education and training had taught him. In fact, looking back, it seemed they were actually more careful about sterilizing my knee prior to the treatment than the fancy sports medicine doctor I saw in the States. I even got a little numbing spray on the injection site prior to being stuck with the giant needle.

Knees aside, the biggest unknown about long-term travel for me is health. How do we stay healthy? If we get sick, how do we get the medications and treatment we need? All blog posts I have read say everyone at one time or another will get travelers diarrhea. So, when Quinn came down with it in Lima I was scared we would be unable to keep her hydrated. Happily, that was not the case. Common sense was our best ally. Even the common cold can foul up plans for exploration. As everyone knows, if one member of the family is ill it is likely to get passed to all.

We battled this type of illness beginning in Urubamba, Peru. It was our first stay in a hostel and there were three other petri dishes, a.k.a. kids, staying there as well. One of which already had a cold. So, you can imagine the cold found its way into everyone in the house then followed us around through the Sacred Valley. Airplane travel is another kind of petri dish so we likely picked up another bug traveling from Peru to Spain. All told, at least one of us was sick for a full month.

Even with all the precautions and immune system boosting protocols, the risk of catching a parasite, virus or bacterial infection is very real. Up to this point in our travels, our experience has showed us that in Costa Rica, Peru, Spain and Paris, one does not buy medications at a grocery store but instead at a pharmacy. Usually, you have to speak to the pharmacist to explain what you need and she/he gets it from behind the counter, even ibuprofen and vitamins. In fact, in many of these countries a trip to speak with your pharmacist is your first course of action.  Doctors are reserved for emergencies or when the pharmacist is stumped. One time, in my broken Spanish, I asked the pharmacist for fish vitamins instead of fish oil…oops what’s the word for oil again?? How about the word for fish when it is swimming in the ocean and not in lemon juice on a plate?

Trust is a big factor when it comes to medicine in a foreign country. Can I trust the pill, treatment or advice I receive is the same or as good as what I would find at home, where I am more familiar? I think this speaks to so many issues of diversity. Can I trust the unfamiliar? Can I trust that another culture is as good as or even better than my own or that I just might learn something from that other culture? More aptly can I accept this as a possibility? The experience at the Hospital in Sevilla taught me that yes, I can and at times I must.

The only thing we have to fear is fear itself. – Franklin D. Roosevelt.

Our strategy moving forward is of course, mindfulness and preventative medicine. I need to accept that I have some sort of problem with my knees and listen to them, seek out rehabilitative advice and do it.  I don’t want to avoid travel because of the fear of getting sick. I don’t want to make judgments based on secondhand knowledge or assumptions. I want to ask questions and research to find out what is available so I can negotiate treatment in a way that feels safe.  Otherwise, I am allowing my fear to grow and fester to an unnatural size and creating a self-imposed barrier to potentially amazing experiences and people.

Some tips to stay healthy:

  • Listen to your body and rest when needed.  Traveling is tiring and when you are tired your body has less energy to fight off infection. The girls are perfect, at times loud, little gages of when we need to rest.
  • Vitamins are important.  We are now taking daily multi and “fish vitamins”. Every little thing you carry has to be weighed according to its importance and cost.
  • Eat more vegetable soup. We thought we could get our nutrients through eating healthy foods and follow the advice of smart travelers ahead of us, only eating fresh veggies we have washed and peeled ourselves. However, when you are bouncing around a lot preparing your own fresh veggies can get tricky and in some places the risk of parasites on those fresh veggies is very real so you end up skipping it.
  • Carry hand-sanitizer everyday.  More often than not, there is no soap (or toilet paper) in the bathroom; therefore, I carry around a natural hand sanitizer made from essential oils.

 

The story of the knees

I hate being injured. I am not a good patient. This is the first time since before I gave birth to Quinn that I have been injured. When I was pregnant and sprained my ankle, I wasn’t really doing anything strenuous anyway so it was easy to rest but now, it’s different. My knees started hurting around 9/10 or 9/11. We were scheduled to move furniture with Jacob’s mom and step dad that next Saturday; still so much to do before our closing on 9/16/15. Both of my knees swelled up beyond recognition and I was barely walking.

Of course, I kept pushing myself. I couldn’t stand watching Jacob’s parents move our stuff for us even if they were buying a bunch of our furniture. It was a mistake. By that evening, I was in terrible pain. Jacob was so stressed. Worrying about all we still had left to move and what the heck was going on with my knees. I called in reinforcements to help with the rest of the stuff (thank you Crissey and Conor) on Sunday and tried to sit as much as possible. Still not really taking it as easy as I should have. Even though we finished the bulk of the move and give-away-purge, we still had so much left. Jacob was still working. Ahhh. I don’t know how we accomplished it, a lot of arguing and high emotions. Fast forward….we got all of our stuff out by closing. The last bits dumped in Crissey’s garage to be dealt with later.

I went to the doctor and was directed to get x-rays to rule out stress fractures in both of my patella. My good friend Kevin Vernon is a talented Physical Therapist and insisted on seeing me the next day. With x-rays in hand I went to his office. His diagnosis was amy's broken kneessevere bursitis but still some concern I had injured the joint in my left knee somehow. With a lot of pushing we got my PCP to prescribe oral steroids to bring the swelling down immediately. I was instructed to continue to elevate and ice. Of course that weekend I was scheduled to go to a wine fest with all of my close girlfriends. The last Girls Weekend for at least a year. Damnit! All I could do was sit while they went on walks. I sat at the festival. They took good care of me, didn’t allow me to push it. Told me to sit. My knees got better fast with the steroids but still my range of motion on the right need was very limited, still hobbling.

On Sunday evening, we said goodbye to Jen and Ben and drove to Monument to spend the next couple of days with my parents. I had made a “just-in-case” appointment with my Dad’s orthopedist for that next Monday. Good thing. He took a look at my x-rays, made me get more (the cost of this is now skyrocketing, I am sure) and then determined I needed to have the right knee drained and shot with cortisone in addition to blood work to rule out rheumatoid arthritis (negative, whew!).

So, fast forward another week, I am sitting at our campsite at Natural Bridges National Park in Utah. Jacob and the girls are hiking to the amazing bridges and I am stuck resting. My right knee feels great, left, still swollen. Better, at least I am not limping but still feels puffy and hard to bend all the way. I know this is best for me; I will miss many amazing sites if I keep pushing myself but DAMNIT! My dear friend Carrie, says the knees are connected to the root chakra which is your sense of prosperity and security. I have definitely just taken a HUGE security blanket away, it makes sense that on an energetic, psychological level that insecurity would manifest in my body in this way. So, just as I meditated on this morning, “My sense of security is within” “I am ready to move forward and accept change”. I will continue with this mantra while I cut up watermelon to bring back to the thirsty hikers.

What are We Doing About Health? …the details

Staying healthy can be a challenge no matter where you are.  Maintaining your health on the road presents it’s own unique challenges.  Here is the list of items we considered when looking at a year long trip.

Medicine Kit.
I have a friend who has used essential oils for years and now sells dōTERRA oils. She has many stories of times she and her family have used essential oils either topically or ingesting them to cure everything from diarrhea to achy muscles. So far I have peppermint, lemon and lavender. I think lavender will be useful to soothe bug bites and inhale for motion sickness, lemon added to honey to soothe sore throats and when used with peppermint, to cleanse our toothbrushes. Peppermint will be useful for upset tummies, mouth rinse when used with the lemon, and to soak our feet after a hot day. I am also planning to get Oregano essential oil, as it is a natural antibiotic and immune booster. My friend recommended the book Modern Essentials as a comprehensive, travel friendly guide to using essential oils.

We will try to eat yogurt in each place we stay to get the local good bacteria as well as take a daily probiotic. I anticipate one or all of us will get sick at one time or another but at least these things can help give us a fighting chance.

We are bringing a travel medical kit that is stocked with Band-Aids, ointments, pain medicine and such. We liked the kit itself because of the pockets and storage uses.

** update**
I ended up purchasing the Physicians Kit from dōTERRA. It came with a slew of digestive aids, immune boosters, sore muscle concoction and many more. I have been testing them out. I woke with a headache one morning and put a swipe of peppermint oil across my forehead and it took the headache away. I have used the muscle rub and that has also helped. I am becoming a believer. I purchased some liquid coconut oil to use as a base and plan to get a few small bottles to dilute the oil to use in ways that were recommended. Such as oregano oil diluted in the coconut oil to rub on our feet as a way to start boosting the immune system.

Travel Clinic:
We went to the travel clinic and had a 3-hour appointment with the travel physician. She spoke to us about travelers’ diarrhea, mosquito borne illnesses such as malaria and Dengue Fever, vaccines, and health clinics abroad. She gave us a list of travel references and a website to locate “Certified Travel Health” physicians around the world. Here is what we chose to do:
• Yellow Fever Vaccines for all (ouch, those are not so fun) many countries will not let you enter without it.
• Typhoid pills for me, Jacob, and Mackenzie (getting Mackenzie to take a pill for the first time is a whole other story. Not by best mommy moment)
Quinn got the Typhoid shot because of her age.
• Hepatitis A/B vaccine for me and Jacob. We will not have time to finish the Hep B vaccine (it is 3 shot series. Second shot a month after the first and the third 6 months after the second) in the US so we will figure that one out later.
• I had to update my TDap vaccine
• We were given prescriptions for an antibiotic, preventative malaria medication and medication if anyone shows signs of malaria.
• Japanese Encephalitis: we held off on this one for now. It will cost about $600 each if we get it in the US. Our travel doctor said if we wait till we get to Bangkok we can get it much cheaper there and it will be just as effective. We will need dental cleanings by then anyway so we will take care of that then too.

Health Insurance:
Jacob researched health insurance that will cover us in case of an emergency. It seems to have all kinds of bells and whistles. It covers everything from emergency evacuation to trip insurance including lost luggage insurance. He found it through World Nomads.