the hip post...

When you do a brief history of my postings {and I would wonder why?} you see a major portion of postings at the end of 2011. Hit Ano Nuevo and it’s a blank. Plenty of notes and thoughts at this end but no jump to sit down to the discipline of writing. Maybe the little blip at  the end of the Nicoya Penninsula, Montezuma, kept me too busy once I got into the throes of life there with beaches and bars yo.
When I first got there the Howlers would be a welcome alarm at 0520 and tea and writing was the start of the day. Then MZ got so many 'dias a playas' that it was a long and luxurious time with much for the head and body.
But it started with the Scorpion on Christmas Eve and has evolved into a total hip replacement. Looking at my pictures or profile comments  you get the impression that I‘m not living too bad a life in Central America.
 It’s been a good cover I guess, as the sting turned into an infection that needed antibiotics, diuretics and pain management and trust me it was por dolor no por jajaja. I also developed a limp which was a response to the swollen foot. For a shortwhile both legs were swollen and I not only had kankles I had grandma calves. Ruling out all other possibilities like gout, congestive heart failure etc. pointed back to the poor little bug that got stepped on and retaliated. Thank you Santa if I couldn't have my fucking pony when I was little why not a scorpion now?
Pain got to be the single focus. I was now aware of physical discomfort all of the awake times { I say awake instead of conscious as there were times when there was one but not the other} and anytime at night that I rolled on my right side or if I had to get up and pee{it happens }. I have always faced pain before by getting the biggest and baddest pain killers available and for a lot less pain than lives in my life now. It was warranted then and not abused {taken according to instructions except an occasional extra pink one} but a maintainense addiction to serious opiates had developed. It maintained my pain threshold and allowed me to be a lot more physical in life, alive but dependent on that freedom as well.
I came to Central America to live without pain medication that had a fifteen year presence in my life. I had to deal with my arthritic pain with a different mental approach and seek natural ways to treat the pain physically. I was comfortable approaching the mental aspect as I had started the weaning process before I left the States. I knew living in the Third World medical and pharmacutical availability was going to be an issue. I had made contact last year with someone who knew of a nele in the San Blas Islands who was an expert with the use of plants and woods of the bush. A nele is a spirit centered person, a shaman, who would connect with the spirits and understands the language of the plants and trees of the bush. Like the ayahuasqueros in the Amazon who drank ayahuasca to communicate with the bush, the neles use their knowledge to both treat common illnesses and communicate with the spirits. The nele I went to see was a 70 year old albino woman that I paid to spend time with and possibly find a bush medicine that would ameliorate my arthritic back pain but not be an addicting solution. Maybe some bark extract or flower would do the same as oxycontin or the usual menu of opiates and that was the major reason for the trip to see the nele. I know what you are thinking, that I'm also looking for the Panamanian version of ayahuasca and partaking of the local hallucenogenic. Nope, not the case. The nele asked the same thing but I was sincerely looking for something that would work for pain relief as well as learning about the Kuna Yala ethnobotanical pharmocopia. I told her I would like to explore the bush in her knowledge path. She said the ayahuasca has a sister in the Panamanian bush but I would have to come back again for more experiences. So that will be the first 7-10 days when I get back in September. I learned a lot from her and liked her quiet cranky style. She showed me some pretty cool survival plants, plants that would stem the flow of blood, ease my menstrual cramps, make me shit and arouse my "interest" as she said. But no big solution to the pain thing. She said to just trust the spirits and wear the amulet bracelets she put on my wrist and leave them til they fall off. Ask the spirits for patience and ask the spirits for relief. I'm working on it.
Her milk white skin and copper tinged hair made her stand out in the village of typiclly dark skinned indigenous peeps. I was told that the Guna Yala have the highest rate of albinism in the world. The Kuna people call them, "the children of the moon" and they are considered spiritually special. In the U.S. the rate of albinism is 1-30-40K. The indigineous people who make up the branches of the Guna Yala in the San Blass region have a rate of 1-165! Funny thing is that she was the only moonchild I met.
The scorpion's sting finally took it's toll as my ability to deal with the pain was almost gone.
I did finally get bilateral shots of the hips and the recent worst fear scenerio was being played out. Radiology was never a discipline I studied but I have read enough films related to cardiac surgery or my broken body to understand. Like an orthopod I’m looking at the functional left and defining the ball of the hip and how it is set in the socket. Then I look at the right and I could have been an idiot in Radiology to not recognize the hip issue. The next day I’m in front of one of the internationally certified ortho surgeons in Panama and uno doctore que hable ingles. He put  the shots up on the viewer and then just  said “ you have a totally destroyed right hip  and you need a total hip replacement.” Made me feel a little better when he gave me credit for being brave and walking around for 10 weeks with varying pain levels and then saying “Stupido!” for walking around for 10 weeks and not gettig x-rays 8 weeks earlier in San Jose.
I had incredable service at the hospital in Bocas the moment I walked into the session de urgencia. At $2.95 you get a doctor. $15.00 buys you bilateral pics and technician time. A final $2.95 for a MD consult and an injection of cortisone and lidocaine. All for less than $25. Another reason to love Panama.
Long back story but radical change in what’s going to happen in the short term of my life being forced off the road. Trust me not the end of the world but an immediate adjustment, a lot of quick planning and emergency exit stage left. Out of Panama, find a surgeon, call the bar and tell them you won't be available until June which means no gig which means try to find a gig, find another place in Bocas and figure out what is going back with me this time. Trying to go with the flow and be flexible with my expectations.
Do we hit a time when our flexability slows or is more difficult? I’m not talking about being able to bend over and lick your heels. I’m talking turning on a dime and getting shit together to make quick and correct decisions. This kind of shit would have made me a mad man and definitely un-Buddhist 10 years ago with a younger familia and a different attitude, but now it’s just the simple truth to deal with the need to remove my right hip and resurface the socket pocket. I think if you lose the ability to accept change you will not do well living on the road.

I left Bocas and flew back to Boston to get in front of an orthopedic surgeon recommended by a long time business friend. I could have had one of the best in the world if I wanted to wait four months til he had an opening but there was fat chance of that happening given the pain issue previously mentioned. It became a choice of the best guy in the shortest period of time and it worked out well. The ortho operating suite is a pretty violent place with sawing and hammering and cutting off the hip at the femur from the notes; "attention was then turned to the femur, which was opened with a cookie cutter "{WTF?}. Later, "the stem was impacted into place, the head impacted into place and the hip was reduced." Later in his report and my favorite part of medical gibberish, "Three drill holes were made in the posterior aspect of the greater trochanter reattaching the external rotator posterior capsular complex with an enhanced posterior capsular repair." Quite a mouthful of gibberish.
Four days in the hospital three of them on a morphine pump then a week in rehab {read nursing home} on oxycodone and then on to my friend Katie's house until I'm fully recovered with oxycodone as needed for pain. It all sounds like a recipe for a fall back to the old way of dealing with the pain in my body but I still hear the nele's voice, " Ask the spirits for patience  ask the spirits for relief." I do and I'm OK. Solo estoy diciendo. TmyO...