The Final . . . Spinal

Well, here we are not at the end of the journey, but the end of the treatment.
Not the beginning of the end but the end of the beginning.
We started the day rather uncharacteristically, with me getting up to have my coffee with my fellow ICM patients, only to discover La - AWAKE! and already up, showered, out and conversing with my compatriots.

The schedule was to start off with physical therapy at 1pm and then meander across the CIMA grounds to the "Cirugia Endoscopia" to get my injections. No, you read that right; yesterday did not qualify as the ultimate therapy session, today was more of a debriefing and physical testing session. I did well, by the way :) My therapist said I showed a marked improvement.

To further our good spirits, we got to the waiting room and were amongst the first let in - as opposed to the last, as our previous experience had been. Yeah, I know, we had oh, so many other places to be. As usual, the doctor started off with a shot of pain-killer which, contrary to his warning, was NOT a little prick. The spinal injection was less objectionable; in fact, as I braced myself for what I was sure was to be the impending 'jab' of the needle,the doctor said, "Okay, all done!" As had become the usual practice he showed me the syringe with my name printed on the label to reassure me that I had indeed gotten the correct shot. It reminded me of nothing less than the presentation of the wine cork by a sommalier. After that and the injection of my fat cells into my elbow IV, it was just a matter of lying on my back and doing nothing again.

After hearing that we would be in-country until the end of the month (a 'just-in-case' sort of thing) one of the doctors very graciously invited us to Thanksgiving dinner at at ICM.

This concludes the medical treatment portion of our programming..stay tuned for "Fear and Loafing in Costa Rica"........

Final Physical Therapy

So I had my last scheduled physical therapy session today, although I will be needing to continue various exercises on my own. I'm aware that there is not a phase of 'instant gratification' here, and I'm okay with that. Delay that gratification, baby! I'm just happy to be able to see a light at the end of the tunnel. With the kind of time I have spent 'down', I think that I'm a big enough boy to handle the a n t i c i p a t i o n .
I think that it may be more important to have it be right rather than to have it now - yes, of course, I would, in an ideal world, prefer that it was Right ... Now
- but, Hey! Welcome to the imperfect world as it is.
I do have to take the opportunity to compliment my fellow patients on the Huge amount of support - both physical and emotional - that has been gladly shared. It makes you feel good to be a human being.

Next up; my final injection tomorrow, Friday.

Today I Got Fat...

Today I went in for yet another spinal injection. This time I also got my first intravenous infusion of the cells that had been harvested from my abdominal fat. Many people claim to 'feel' the stem cells implant themselves into ones head at this point; unfortunately, I was not amongst them. Dang! Cheap Thrill missed...

Regardless, I spoke to the doctor about something I had noticed experiencing over the past couple of days. Whenever I would turn my head or change position while lying down, my head would begin to spin - a nasty case of the 'Whirlies' I had not experienced feeling since my early days with MS; this is not to bitch about this observation either about now or in the past, but to relate that this experience had resurfaced - perhaps on the conditions 'way back out?!?
What was it the techies used to say? "It's not a problem; it's a feature!" I'm excited.

Tomorrow, I have my final physical therapy, followed on Friday with my final injection & infusion.

Stay tuned for continuing observations and elaborations; Same Bat-Time - Same Bat-Channel!

HEY ALL!

I'm writing this on Tuesday, November 18th,2008.

Sorry that I didn't write Monday, but our plans to get injected yesterday were altered slightly.
We had to reschedule because the roads were all closed until late in the day. You see, the President of China was in town. He doesn't visit US, he visits Costa Rica. Anyway, we found ourselves battling near Los Angeles rush-hour traffic We started the procedure close to 6pm. The post-injection plan was for me to lay flat on my back, arms at my side, staring at the ceiling and doing nothing for, oh, about 4 hours. Around or about hour 3 I fell asleep and consequently continued on my heroic course of doing nothing.

Today (Tuesday) I found myself at physical therapy, working hard and reviewing my progress.
I pushed myself hard and learned a few new exercises. La wandered around aimlessly. Afterward we went to dine with Chris and Kaye at our new favorite place, Denny's..

Do You Know the Way to San Jose?

Good Morning, Costa Rica!

It's a lovely Sunday and as we have had nothing planned other than sitting around and waiting for the weekend to end, we rented a car (a manual Toyota Yaris) and my driver, La, started driving us to Los Angeles. No, silly! Not THAT Los Angeles, the one down here in Costa Rica! You have to travel through San Antonio, San Francisco and Santa Ana to get to it! ;)

Our mission? A trek to the Basilica de Nuestra Senora de la Virgina de Los Angeles in Cartago, about 14 miles away. In speaking to others who had come down here for this treatment and others to had already gone though it, the story was that drinking the Holy Water and being washed in it made for a near guarantee that total recovery was to be expected.

Now as many of you know me not to be the most pious person (although in my defense I AM a nice guy) but I am also not to be the one to ignore ANY possibilities - hey, it couldn't hurt! Plus there's always the ROAD TRIP factor.

So off we went boldly going towards Cartago when we realized a couple of things. There are no street signs or highway markers. And also that all roads seem to lead to San Antonio. Again and again. Sigh. It ultimately took us two and a half hours to get there (it took us only forty minutes to get back) Round and round and it goes; where it stops, nobody knows.

Part of our time in getting back was recognizing places we had seen before circling aimlessly on our way there and now with a near smug satisfaction muttering to ourselves, this way definitely leads almost DIRECTLY to San Jose!

Before the cart gets too far ahead of the oxen,I should talk about the Basilica. It's beautiful. It's HUGE. It's almost entirely handicapped accessible. We walked with a small line of faithful to the Holy Water springs. When we arrived, we both quaffed from the springs and proceeded to fill some bottles with Holy Water for me to drink later and La bathed my face, arms and legs with a touch of the water, all the while blessing me in Spanish. We sat for a while in the church admiring the incredible detail and listening to the services. Needless to say, La took pictures.

We headed back - after asking directions to San Jose from a flower-girl on the side of the road. She had amazing Poinsettias for less than six bucks. We only got almost lost a couple of times (I know RIGHT where we are . . . ACK! I didn't see THAT our the way out!) We soldiered through in record time. As we chuckled to ourselves that things couldn't get any better, what should show up at the side of the road but a shining Denny's sign. Now, yeah, I know that this may not seem to be a big treat, but the last time we found ourselves THIS excited about food from home when in a foreign land was probably as we were surrounded by thankful Americans at a Mickey D's in Hong Kong - laugh if you will, but know that there are times when is only proper and correct to bow down before the Altar of the Big Mac...

Tomorrow, poked again...

Currently in 'Cool your Jets' mode...

So it's Saturday afternoon, I'm continuing to 'recover' from my lipo & stem cell shots and generally am laying low, practicing my theraputic activities and doing very little else. There really isn't anything to report today so I will just sign off. Ta. Have an excellent weekend.

Otra Vez

Today began well, with a new hotel room opening up a bit away from the swimming pool. This was, for us, good because we generally don’t swim and others, often unsupervised kids, do like to, at often remarkably early times. These kids were apparently not blessed with ‘indoor’ voices.

Our plan for today was to visit CIMA Hospital for another spinal injection. We did so. ‘Nuff said. See ya tomorrow…

Once More Into the Breach, Good Fellows

Today, the ship well & truly left the safety of the harbor and we set sail for unchartered territories. After I had my first stem cell injection yesterday, I relaxed (as best I could) and waited for the next procedure, a liposuctioning of stomach fat cells to adapt as my own ‘stem cells’. And to be honest, I felt good about being able to lose the ‘love handles’. La was jealous.

We left the hotel at 5:10AM (!) to arrive at the CIMA hospital to do this . . . thing and I was changed by my ever-incredible La into my hospital patient greens and then laid down on the gurney. The anesthesiologist held up a syringe for me to see and with a smile proclaimed, “It’s your Pina Colada!” and then attached it to my IV. I smiled back and blinked my eyes…

Well, I closed my eyes - and when my eyes reopened, REALITY CHANGE! I was suddenly in a different room with an entirely different group of people. I was experiencing a mild discomfort on my stomach & that odd –minor- pain in my throat that inferred to me that I had been intubated. Cool. I was done! All that I had left ahead of me for the day was to kick back, relax and recuperate..except for the fact that the nurse who prepped me yesterday was coughing and sneezing and it appears that she has generously donated to the Cha and La Get Cruddy Colds in the Tropics phase of this trip...

Tomorrow…”This is Spinal Tap”, again……..

Stem Cells are Like Sea-Monkeys........

Today we went back to CIMA Hospital for my first treatment, an intrathecal injection of umbilical stem cells into my spine. I changed out of my civilian clothes into a glamorous green gown and waited for the doctor. A nurse came in and installed an IV lead, not necessary for the procedure, but a safety net "just in case". I thought that it was a good option, although I turned out not to have to make use of it.The doctor came in, had me sit up straight and cleaned my lower back with Betadine. He asked me to "make your belly button meet your spine".' He had me verify my name on the syringe that held the umbilical stem cells. He'd walked in them in an ice-cooler.He then injected the serum into my lumbar spine. The procedure was suprisingly painless!

After I had been injected, I was directed to 'lie flat on my back and do NOTHING.'
Ever the giver, I thought to myself,"I can do that!" As I lay there waiting for the driver to return for pick up, La & I discussed my next actions. Hey, big surprise! it was more of the same.

We drove back to the hotel to resume my activities i.e., another four hours flat on my back at home, staring at the ceiling and listening to the T.V. I did it and avoided the dreaded 'spinal tap headache'

Next up; having liposuction (as if I needed that!) to collect my own cells

And so it begins...

It’s a bright new day – okay it’s Monday, just about 7:30 + . Instructions had included to not drink dairy before the blood tests. Because nothing says ‘you’re up waaay too early on a Monday morning quite like not having coffee (cream and sugar; thank you!) while you’re in COSTA RICA!!! We were picked up and delivered by van to the Institute for Cellular Medicine for blood tests (don’t forget to study up!) meetings with staff of note and reviewing with my doctor what to expect in the coming weeks.

Oh! Of course, full payment by cashier’s check for services to be rendered.

We then returned to the base camp for a quick, well deserved cup of coffee and a bite of Costa Rican breakfast of Gallo Pinto (beans and rice), eggs, fresh berry and mango juices and some sort of corn bread filled with …potato, maybe?

Afterwards, we met up with some fellow North Americans with MS and their care givers/significant others/ patient, giving Angels. We all chatted, laughed and commiserated; making plans to be some sort of support for one another, perhaps dine and/or see some of the sights. Can you say ‘ROAD TRIP!’ Sure ya can; I knew ya could…

Then we were whisked to my first appointment for physical therapy. My first day was basically taken with giving my physical therapist, Jennifer, my particulars, and my range of motion capability was tested to see how well (or in MY case, not so much) I was able to perform.

Did you notice that subtle piece of self-deprecation? I hope that it brought a smile to your lips, because that is the last time you will see me say anything negative in regard to my condition. Once again I’m reminded to get over myself; that I am kind of blessed. Yes, I have my problems, but there are others that may have it worse.

Regardless, ::blithely waving his hand in the air:: we all were looking forward to what would be, at the very least, a net improvement. To say that we were all upbeat, positive and quite jazzed would not be an overstatement.

Today may have been the beginning of the whole torturous process, but it was effectively me being poked, prodded and having enough blood taken to feed a vampire Osmond clan.

We had lunch at a local “soda” (mom & pop diner), appropriated named Alexander’s. The Plato de Dia was fried fish, salad, beans, rice and some unknown greenish cubed vegetable. True to form, La did not eat her vegetables.

. . . Welcome to the Pregame Show

Tomorrow morning the ball finally begins to roll. I'm going to the clinic for the first time for meetings and blood work.

I'm reminded that patience is a virtue.

Hey! I can hang from my thumbs for a night.

“Bienvenidos a Costa Rica!”

Friday, November 07, 2008

Well, we have arrived in San Jose, Costa Rica, Centroamerica. .
We were picked up at Juan Santamaria International airport. and taken by our driver, Willy, to the Cristina Apartotel. We settled in and had dinner delivered from Los Olivos, the Italian restaurant next door. La & I are, if not delighted then very satisfied with our experience as it has unfolded. Any glitches that we have encountered has been immediately been addressed. So far, so good.

From what little we have seen thus far, San Jose looks quite pleasant and acceptably appointed with both American chains as well as local places, from large establishments to little Mama/Papa places. Greenery and pleasant weather abounding. .

It appears that we missed the rainy season by a hair; the first week is supposed to be relatively clear with the sky blue and the sun smiling.

Next up;

Marching ahead fearlessly (If to a different drummer) . . .

Living with Cautious Optimism . . .

Living with Cautious Optimism . . .

a blog.

Started today, on Wednesday, November 5^th, 2008

Hey, everybody! Welcome to my blog chronicling my trip from Los Angeles, California, USA to

San Jose, Costa Rica to undergo stem cell treatment for my condition (Secondary Progressive Multiple Sclerosis)

I feel that it MAY be a good sign to begin this on the day after Barack Obama was elected P.O.T.U.S. . Change, I believe, may just be in the Air.

Anyway, my thought and plan is to review how my trip goes if not day-to-day, then as close to it as may be possible from outside of the States.

Please bookmark and visit this page for updates.

Wednesday, November 5^th, 2008

I felt that today may be an appropriate day to start this blog because I saw my Neurologist, Dr. Tong Jiang at Kaiser Permanente. She was not only interested and intrigued with my declaration of intent to attempt this, but was excited to receive news on my progress.

We are leaving for Costa Rica Thursday, November 6^th.

Our flight leaves LAX @ 1:30a – we have to allegedly get to the airport around 2 to 3 hours early... Security, ya know.

Let us be honest. Can there be anything more potentially dangerous than an affluent, middle-aged white man in a wheelchair?!? LOL

Stay tuned for updates…