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 Magical Costa Rican Jungle

As I hung up the phone after setting up a kayak tour with Omar from Bucus Condos and Tours, he told me he hoped I was feeling the magic of the jungle and sending it my wishes to be fulfilled. This is the kind of lovely energy that is here among the people.  I truly have been sending the jungle my wishes and my intentions each day.  They are to release the inflammation in my knees and to continue to practice mindful presence.

Just down the road from where we are staying I discovered a beautiful yoga retreat center that has daily classes (Tierra de Sueños).  I decided that I have been resting, elevating and taking ibuprofen long enough.  It is not good for my body to continue with the ibuprofen and I need to change my mindset about these knees.  Yoga kept calling to me and so I decided to listen.  The retreat center has a sort of open air yoga platform a few meters down a twisty path through the jungle, from the reception office. It is made of dark wood planks on the floor and walls that continue up to form a high ceiling.  Immediately upon ascending the stairs I knew I was in the right place.  The peaceful, meditative energy was palpable. I sat facing the teacher who had a backdrop of palm trees, red flowers, flitting butterflies and hummingbirds.  Seriously.

The instructor began the class with a breathing meditation and had us set an intention for our practice. “Release”. That was my word, throughout.  As I followed her instructions for the various poses throughout the class, I definitely released a lot of sweat.  Ho-ly cow! I have never sweat like this in my life, my shins were sweating and not just a little, visible drops ran down my legs. It amazed me.  There was a gentle breeze that blew through the space. This did not help me one bit.  I quickly glanced at my neighbor to assess her sweat factor.  Nope, she was just fine, no sweat not even a glow. (I realize this might be my paranoid, introjection or irrational comparison but I don’t think so).

“Ok”, I thought, “I’m gonna go with it.”

Blast, I forgot to bring a towel though.  It has been awhile since I have attended a yoga class so I am sure the sweat was also due to the fact that yoga is no joke. You use every muscle.  Gratefully, I made it, my knees did great. I walked home feeling joyful for having used my body, wondering if I overdid it, but hopeful that my intention worked.  As the week went on I came back for another class and to that word “release” in my mind. By the end of the week, I found that I had my range of motion back and less inflammation. Huh, maybe the magic of the jungle is working.

So, now I have done a total of three classes (sweat not so overwhelming, remembered a towel) and my knees are so much better.  I think Jacob has stopped worrying about me so much and we are feeling more free to go on excursions. Little did I know that the coming excursions would all hold the theme of life in balance with the earth.  We met Omar at the restaurant called Maxi’s in Manzanillo and he took us on a boat to Punta Mona. There we picked up some kayaks and went further down the coast to the Gandoca Canal which boarders Panama.  He led us down the river; the jungle towering above us.  We saw Spider monkeys, caymans, blue herons, tiny King Fisher birds that look like hummingbirds and “Jesus Christ” lizards.


I think the lizards were our favorite.  When the water is smooth, no ripples from the wind, these small prehistoric looking lizards are able to run on their back legs across the water.  We quietly paddled up to a log holding one of these lizards. Omar waited for just the right moment to scare the lizard into doing its trick which was followed by squeals of joy from the girls, that was the best part.  Nature is truly amazing; that peaceful lagoon holds so much life. One can’t help but be in awe.

After the great upper body workout paddling back upstream, the wind had now kicked up,  we ended our day with lunch at a sustainable organic farm (which Jacob referenced in the last post).  Omar led us through a jungle path to the main structure which is two buildings their top floors connected by a swinging bridge and contains an outdoor kitchen on the first floor and sleeping quarters upstairs.  Little did we know that there was a group of about 15 people who had spent the last 10 days together at the “Awesomeness Fest” on the Pacific side (really, I’m not making this up) and were ending their trip with an excursion to the Caribbean side and stay at the organic farm.  As we walked up they were all standing in a large circle about to eat the food prepared by the staff at the farm. The owner of the farm opened up the circle for us to join; we shared our names, favorite fruit and a blessing of love that was baked into the food we were about to eat.  What? My hippie side felt very happy.

IMG_1644This theme of reverence and respect for the sustenance that the rainforest provides continued with the next two tours we took.  First, we went on a tour to meet some of the indigenous people of Costa Rica, the Bri Bri, to learn about their way of life and process of making chocolate. We spent about an hour with a Shaman who talked about the spiritual ways of the tribe and the medicinal uses of  vegetation from the jungle. During our experience learning about chocolate, we discovered that it too is seen as medicine and a symbol of  love, life and solidarity.

Next, we spent time on a jungle hike with a tour guide from the La Ceiba preserve.  This preserve is connected to the Jaguar Rescue Center and is “step two” in the reintroduction of rescued animals back into the wild. Fabian, our guide and conservationist, was one of the most joyful people I have met.  His love of Costa Rica was very evident and he, too, spoke about the medicinal properties available in the rainforest.  Something he said stuck with me in a very impactful way,

“Everything we need is here, we have only to understand”.

Our hike led us to the La Ceiba tree or Tree of Life.  This tree was HUGE. Its roots roped out in several directions and where they connected to the trunk they were over 6 ft. high.  Fabian explained that this tree is seen as a “mother” tree because her roots go deep into the earth and stretch out in many different directions. She takes in so much carbon dioxide that she feeds the forest around her.  She feeds the animals and people around her too, with the oxygen she supplies.  Powerful.P1020175

Sadly, this balance with and respect for the land has not always been the theme in Costa Rica.  During our visit to the Bri Bri people, our guide shared with us how much their culture has been lost.  It started when Spaniards came to the country. The introduction of Spanish language caused the Bri Bri people to slowly forget their own as well as the ways of living in balance with the rainforest.  Large crops of cacao and bananas were planted and more people immigrated to the Caribbean cost from Jamaica and China to work on the plantations. However, the Costa Rican government realized something very important.  People wanted to visit. To see the wildlife, meet the native people.  They realized tourism could be another big part of the country’s  income; therefore, large scale conservation projects were started which included preserving a large part of the land for the Bri Bri and other indigenous peoples, in the place they had naturally settled. Thankfully, this has allowed them to sustain, still participating in chocolate and banana production but in the balanced way they know.  The shaman’s knowledge is still being passed to the next generation.  And yet, outside of that preserve, there are banana plantations as far as the eye can see along the hour drive from Limón to Puerto Viejo. Chocolate production is dying out because people are making more money on bananas.

Still pondering the theme of living in balance and the rich resources the rainforest provides, I was saddened by a video I watched this morning, about the millions of acres of rainforest that are burning in Indonesia. The people of Indonesia have found a profitable solution to caring for the needs of their family, through the production of palm oil.  The government is capitalizing on this as well.  The reporter was encouraging a boycott on palm oil.  It got me thinking, is this the answer to saving the rainforest? Is it as simple as refraining from buying unsustainable products?  Perhaps the boycott will make them stop burning the fields, but I think the boycott is only part of the solution, there are larger social issues at play. Burning the fields has more to do with a cheap way of “resetting” the land than it does the crop that is planted on it.  Indonesia is not the only place where monoculture happens.  It is not the only place where the negative impact of monoculture to the earth is evident.  My intention isn’t to get political, my thoughts only bring me to the awareness that we are headed to Indonesia at some point on our journey.  How will the rainforest there compare to here? Costa Rica is all about conservation.  What is conservation like in Indonesia?  The people of Costa Rica seem to be striving to find a balance between large production of goods and respect for the land.  Is that a value there? 

I have set a new, or additional intention for my meditation and yoga practice.  I intend for this journey to not only be an education in culture and respect of diversity but also for the girls to develop a respect and reverence for the earth.   I have always been connected to nature and often seek it is a place of refuge. Our dear friend, family member, and my colleague Kris Abram posted this to Facebook today:

“A revolution needs to happen and it starts from inside each one of us.  We need to wake up and fall in love with the Earth.  Our personal & collective happiness & survival depend on it” – Thich Nhat Hanh

My wish to the rainforest is not only to help support the healing of my knees and release whatever I am holding there but to also help me become clear about how I can live a balanced life in my unique way and how I might take the next step in my career of impacting social change.