Travel Health: Limping Through Latin America

If you’re into active travel and especially if you’re not 24-years-old anymore and maybe you have a few well-earned aches and pains or even injuries along the way, you will be able to relate to this. For the past five years Karen has been on a quest to manage or even (gasp) banish the pain in her right leg. This has has led us to different kinds of adventures in Latin American including visits to country farmers, non-FDA approved supplements, extreme acupuncture, and a final realization that active nomads like us have to take pain management into their own hands while on the road.

Karen vs. the volcano

It started about mid-way up the climb to the flanks of a ridge adjacent to Santiaguito Volcano in northern Guatemala. We were part of a small group hiking up to a flat vantage point disturbingly close to the action. We planned to spend the night there to watch the volcano toss out white-hot boulders, spew red-hot lava, and burp scalding steam and ash.

Karen during the Guatemala hike that started it all.

It had been more than a year since we’d huffed up a nearly vertical trail carrying 30+ pound (14 kilo) backpacks and we were definitely feeling the altitude and the exertion. Then Karen felt something else, a kind of muscular refusal in her right hip punctuated by pain that was sharp enough to make her stop walking.

Then the pain passed and we started walking again without thinking much of it until a few days later when Karen could barely get out of bed. That was almost five years ago and part of that time has been spent exploring Latin American medicine trying to find a way to manage or banish the pain so that we can return to the hiking and trekking we love. That search has led us to some incredible people, experiences, and realizations.

Is there an upside to a bum leg?

Ask any traveler what the best part of travel is and you’re likely to get some vague, clichéd reference to “all the wonderful people you meet” or “the unexpected personal experiences.” What they’re really saying is that when you put yourself out there in the world, at the mercy of the strangers all around you, almost everyone turns out to be pretty generous, supportive, and cool.

What other possible explanation is there for the fact that the majority of travelers leave their homes and then return to them not only unscathed, but better for it. It’s certainly not the suntans or the souvenirs that make them better. It’s the people they left behind and the interactions they carry with them. Turns out, a bum leg in Latin America is to travelers what an adorable little dog is to single men in Central Park.

If there is a silver lining to Karen’s injury it’s that it’s led to these adventures in Latin American medicine including unforgettable interactions with amazing people and, um, methods.

Adventures in Latin American medicine: What a watermelon will get you in Guatemala

Karen’s hip was particularly bad in Guatemala after too many nights spent on the ground. Before we’d fully agreed, a good friend of ours had us in his car and on our way into the countryside in the northern Peten region. We were going to see Don Ramon, a farmer with a talent for adjusting bodies in ways that alleviate pain.

Our friend swore he’d seen Don Ramon work near miracles on other people in pain but we were still nervous as Karen lay face down on a burlap sack on the damp ground behind Don Ramon’s humble home.  As his family gathered around, Don Ramon proceeded to stretch and manipulate Karen’s right leg and hip in ways that were downright painful. She even hollered a few times, not that Don Ramon noticed or changed his tactics. After about 15 minutes he was done and Karen’s hip actually did feel looser and slightly less painful. Or maybe it was just numb. Or paralyzed. We paid Don Ramon with a watermelon.

Adventures in Latin American medicine: High tech in Honduras

Juan Carlos Paz, wunderkind behind Jungle Expedition tour company in San Pedro Sula, Honduras, really, really wanted to show us his favorite part of Cusuco National Park. After a day of hiking in the park and a night of sleeping on the ground it was clear that Karen’s leg was in no condition to make the hike to his private oasis. We contented ourselves (sort of) with a shorter walk, and then returned to San Pedro Sula in Juan Carlos’ vintage land rover.

Karen on a consolation walk in Cusuco National Park in Honduras after her bum leg made it impossible to do the hike we’d planned on doing.

For the duration of the drive Juan Carlos slyly made it known that his father was a radiologist. Before we knew it we had an early morning appointment with Dr. Carlos A. Paz Haslam. Carlos’ father had shoe-horned us into an already packed schedule in order to make an MRI of Karen’s hip using state of the art machinery. Dr. Paz then spent half an hour going over the detailed images with us. He refused to take any payment at all.

Adventures in Latin American medicine: Supplements in San Salvador

Miguel Huezo, owner of Suchitoto Tours, had already helped us out with everything from restaurant recommendations to road condition updates during out time in El Salvador. When Karen’s pain took a turn for the worse it seemed natural to ask him if he knew any good doctors. He immediately referred us to a doctor who had gotten his mother back on her feet after she broke her back at age 70.

Dr. Sara Maria Alfaro, trained in the US as an orthopedic surgeon and now practicing in San Salvador, performed a fairly routine exam and looked at Karen’s MRI from Honduras. Instead of reaching for her scalpel, however, Dr. Alfaro wrote out a stack of prescriptions for joint health supplements including glucosamine, bromelines, and amino acids plus Wobenzyme, a legendary 40-year-old supplement created in Germany, and drops made in Argentina that include cow cartilage and are not even available in the US.

The total cost of the office visit was US$33. Three months worth of the supplements set us back about US$600 and may or may not have resulted in a small reduction in pain and greater range of motion in the joint.

Adventures in Latin American medicine: Watery relief in Costa Rica

As Karen struggled through a yoga class at Pura Vida Retreat & Spa in the hills above San José, Costa Rica, the instructor suggested a Watsu treatment. We’ve never done Watsu but the instructor convinced us that the weightless, stretching-centric experience done in a small pool full of body temperature water would relieve the pain and promote healing.

Basically, the therapist holds your body and gently places you in positions which allow slow movement through the water to produce gentle resistance which stretches muscles and opens up joints. All you have to do is relax and turn off. The effect was like getting a massage in a sensory deprivation tank and Karen now has a new favorite treatment, with or without pain.

Adventures in Latin American medicine: Random act of pain management in Panama

Dr. Mark Sobor introduced himself as we sat next to each other in a small wooden boat speeding from Isla Colon to Al Natural Resort on a nearly deserted corner of Isla Bastimentos in the Bocas del Toro archipelago in Panama. Over evening cocktails that night Dr. Sobor explained that he is a family physician and pain management specialist from Chicago.

We mentioned the chronic hip pain and that was that. Despite the fact that Dr. Sobor was on vacation he spent hours over the next two days treating Karen with his own aggressive form of acupuncture plus electro stimulation and very deep tissue massage.

Karen undergoing electrified acupuncture in Panama.

Afterward Karen felt like she’d been trampled by a cranky Billy goat but as the soreness subsided she realized that the underlying pain was actually greatly minimized. She could even climb stairs (if not a volcano) and sit cross-legged without cringing. Yoga classes and horseback riding seemed like possibilities again. But the good times didn’t last long once we were back on the road and unable to continue treatments with Dr. Sabor.

Adventures in Latin American medicine: Manipulation in Medellin

In Medellin, Colombia a wonderful friend of a friend took one look at Karen’s limp and insisted we make an appointment with her acupuncturist whom she credited with near miracles. Dr. Roberto Moreno Zuluaga was a successful orthopedic surgeon, then he trained in homeopathic pain management and acupuncture and has since renounced surgery. After an initial evaluation he said he believed the hip pain was caused by a muscle injury which had compacted the hip joint wearing down the cartilage.

This was the first time a diagnosis had “felt” right and so we started a course of deep (and often painful) massage, stretching, and acupuncture to release the injured muscle, increase the space in my hip joint, and give my body room to replace the cartilage. Every treatment brought a reduction in pain (as did his advice to ride a stationary bike) so we extended our stay in Medellin by renting an apartment for a few months so treatment could continue. After six visits (US$30 per visit) Dr. Moreno said he believed Karen was good to go and would likely heal on her own if she could keep up the routine of stretching and stationary bike riding.

We made one last appointment with Dr. Moreno before we had to leave Medellin, just to be sure. That was nearly six months ago and in that time, with no stationary bike or acupuncture at our disposal, Karen’s pain has, unfortunately, gotten worse. Now she’s added intense therapeutic massage with a talented therapist from California named Florence Bannout. This hurts like hell but seems to be getting to the deep-seated heart of the problem.

Florence also referred Karen to Mike Carey who says he can read your “cellular memory” which allows your body to tell him what’s wrong so he can fix it. This may be the oddest approach to Karen’s leg problem (so far).

Karen sat across from Mr. Carey while he asked her body yes-or-no questions from an enormous list. Her body answered, electronically, and Mr. Carey registered the responses through his fingers. He ultimately diagnosed her with a slipped occipital bone (for which he gave me a tincture which he said would electrically stimulate this small bone at the base of the skull, back into place), heavy metal poisoning (for which he told me to blend cilantro with water and drink a small amount for seven days), and suggested I start taking something called Barley Gold to promote regeneration of the cartilage in my hip.

Taking pain management into our own hands

As wonderful and eye-opening as all of those experiences have been and as grateful as we are for all the generous, caring help we have received the fact remains that nothing has done much for the pain on a permanent basis so far. One of the major reasons for that is the fact that we are never in one place long enough to commit to long-term treatment. It’s clear that because of our nomadic lifestyle we have to take pain management into our own hands.

The latest addition to our portable pain-management arsenal is Arnicare. Karen’s been using it on her hip, leg and knee for the past four months and it produces an almost-instant reduction in the daily pain.

Karen taking pain management into her own hands on the road with Arnicare.

Other plusses?  The gel formula absorbs fast, there’s no old lady smell (it’s odorless), the metal tube travels well and is easy to get every last drop out of so there’s no waste, the screw cap stays on so there’s no leaking in our luggage and there’s no need to keep the stuff cool.

Arnicare also comes in fast-dissolving pellets which taste great and come with a nifty top which accurately dispenses the right number of pellets. It’s also tiny and super lightweight so the pellets can be slipped into a pocket or pack.

We’ve also used Arnicare beyond Karen’s chronic pain. For example, it saved both of us during three days of intense horse back riding at Hacienda Zuleta in Ecuador. After more than a year of not riding we were expecting to be limping but after judiciously rubbing Arnicare into the major muscle groups even Eric, who gets saddle sore just looking at a horse, felt so good he said “this stuff might be magic,” and he was only partly kidding.

Riding through the high-altitude paramo at Hacienda  Zuleta in Ecuador.

Arnicare rescued Eric again after he spent hours working under the truck in positions that normally leave him with extremely sore shoulders. Are we pain-free travelers? No. Have we found a new way to take pain management into our own hands while on the road? Yes.

Ultimately Karen had the bad hip replaced and we’ve been up and running ever since.