I have been living in Ecuador for 15 months! A difficult year on many levels that began a healing journey after falling foul to a ‘perfect storm’ of circumstances that started with a small knee injury in France and led some painful months later to a diagnosis of polymyalgic arthritis and recovery in Ecuador. I write now early in March enjoying full recovery, pain free, meds free and mobile (yaaah!). This is the story of that journey.
For some of you in Europe where I had just moved with my sons after spending their whole lives and my past 25 years in Asia, or the Middle East or South America (most recently we lived in Yangon, Myanmar), in December 2020 I disappeared off the family map, remaining there only virtually. After 15 years of being the stay at home parent for my boys I was suddenly not where they were any more and this bears some edification because I know many of you have no idea what happened, or why I am still away.
It began in mid-October 2020 when I stepped off my bike on uneven ground in a field in France and injured my long-problematic left knee. We had arrived in mid August, the 6th country the boys have lived in, for them to start school in Switzerland (that journey is documented here!) and where Cécile (their Maman, my partner in co-parenting) had secured a post at the HQ for the UN Refugee Agency in Geneva. As it turned out she had to return to finish up her engagement with UNHCR in Myanmar until late November so it was me and the boys for the summer and much of the fall adjusting to our new reality after most of their lives had been spent in Asia and the Middle East. Anyway that day in October something slipped in my left knee and it became painful and inflamed.
This wasn’t the first time; I injured my knee initially in 1983 and had a surgery then to fix my posterior cruciate ligament, these small mishaps had happened a few times over the years, but this time, a week or two of rest and anti-inflam/pain killers, just didn’t work to get me mobile and pain-free again… maybe age had something to do with it; I’m 58 yrs on with many hard miles on the knee, from the Canadian Rockies to the Himalayas, the Alps and the Andes! In the ensuing two months as things really got worse I went to three doctors in France each one amping up the pharmaceuticals and none really helping. Between doctors two and three I was given a referral for imaging which showed a knee with little cartilage remaining to cushion the articulation between bones. Then I had lab tests, more imaging and an orthopedic surgeon who wanted me to have total knee replacement surgery (just shave 5mm off here, 7mm there, put in this cushiony stuff and sew you back up) in which ultimately they disconnect your leg at the knee and then reconnect it with some new bits inside and offer a 65% success rate.
I wasn’t very keen on TKR surgery nor that there was a long waiting period for the surgery- and that the ski season would soon be upon us and I wouldn’t be able make a turn for the whole winter so I’d be immobile, cold and miserable, and without an income.
To make a long story shorter (but not by much), over those 2 months I became like the tin man left out in the rain; stiffening in more joints particularly my hips and knees. This made walking, sitting, standing up, going up and down stairs all so painful, then my shoulders got in the act and then my hands. Not nice and blood tests were not revealing much, except that I didn’t have rheumatoid markers which was a relief of sorts. Temporary relief came only from a hot shower in the morning.
I have reflected long-time about what got me into this situation, the perfect storm. Certainly the knee thing was where it started and just today I recall also how body-damaging scooters are (those 2-wheelers now popular in European capitals for ‘scooting’ around) and I had been a scooting fool around Geneva. It had become my main and preferred mode of transport. So, my lower back was compromised from over-scoot, that one-foot-lower-than-the-other-backward propulsion is not at all good for the lumbar/sacral spine. I had felt this before at some point scooting around London with the boys when they were little (a great tip for parents btw, kids too big to stroller love it and you can whizz around cities with ease) my back was killing me afterwards. The nerves that serve the knee exit the spine in the upper lumbar (L5 to be precise) and to confirm involvement at the spinal level the entire big toe nail on my left foot (the irony doesn’t escape me), innervated from the same location in the lumbar spine, turned black as if I had dropped a brick on it. I liken the ensuing inflammation to a slow algae bloom the way it started in one joint and spread to the others supported rather than suppressed by the anti-inflammatory pharmaceuticals.
As winter approached and it got colder with humidity where we were not far from Lake Leman and Geneva, the cold got into my bones making matters worse. Nutrition played a role. It was part of the storm. Cécile had been there when we arrived in August and I continued cooking for two veggies and our two boy meat-eaters so once she returned to Myanmar in September I reverted to meat eating also to bulk up a bit for winter (or so I thought). I surmise that my diet changed too radically without the softer tropical fruits and veg I had been used to for 8 years and this change in my internal flora contributed to my troubles.
Along with these physical changes (the climate, the nutrition, the inflammation, the meds) there were emotional and mental stressors; a relationship that had ended 3 years earlier far from a ‘conscious uncoupling’, logistics and lobbying issues around the school where Kasem was in one and Zaki in another (for the first month), problems getting a driver’s licence transferred (that in itself is a story) meaning for a while I was driving on a Myanmar driver’s license all the while daily crossing the border between Switzerland and France as you do as a ‘frontalier’ (cross-border dweller). Stress is a killer and I carry it in my lower back, the water element, the seat of emotions, the element of balance, potential and flow… ebb and flow so why be surprised when the nerves and I was not getting the reinforcement of a better perspective from community and so with everything else going on, I fell foul to my own lassitude, we are indeed our own worst enemies.
To add to the problem, Brexit was reaching it’s writhing twisting finale for Brits residing in Europe. British people (am a Brit by birth) who could prove they resided in France by the end of 2020 had to apply for residency pronto. Cannot express enough how I loathe the ‘rule Britannia’ media driven bullsh*t that warped that appalling decision. There is a Catch-22 in many countries, where to get a bank account you needed a fixed address and to rent a place you need a bank account. Fortunately with foresight my name was on the tenancy agreement for where the boys and Cécile were to live in France (they have now moved to Switzerland). In France you can’t work out of your house so you need to join or set up a ‘cabinet’ (clinic), you can’t work without liability insurance, you have to register as a business; a minefield of administration and bureaucracy. And really I have a very strong aversion to bureau-crazy. I had registered and then applied to become a French resident just before the final deadline on 30 June, 2021 and still haven’t heard back from the French, I’m told it could take years.
Unable to manage well and in such a declining condition in France with my status uncertain and sadly UNHCR and all it’s concern for ‘family reunification’ of refugees doesn’t extend that concept with visa facilitation to it’s staff in ‘blended’ families. I was at a loss and dependent on one particularly supportive friend (thanks again Joe) to get me to appointments with labs and doctors. And then I spoke with another friend in Myanmar who suggested I needed to ‘go home’, and I am forever grateful for this advice (thanks Christina). And to her question ‘where was home’ I easily answered… Vilcabamba in Ecuador. Don’t be too surprised dear reader who may not know me well, it is in Vilcabamba between Afghanistan missions 22 years ago that I established a presence (coming and going, sometimes for weeks, and sometimes months) in this little town of the southern Andes, building community, centered now around two houses and a project called the Pyramid on Mandango. The boys have been multiple times to Vilcabamba, a respite in nature’s harmony. It is also Ecuador where friends in Vilcabamba had had success with more heinous knee problems than mine, through stem cell injections, a much preferred approach than hacking the knee apart, so going to Ecuador was not such a long stretch and though I haven’t yet, it could still be that I have stem cell injections into my knees.
23 December 2020 I left for ‘home’. This was a very difficult moment; my definition of home is where your family lives and my sons are my family, as their ‘at-home parent’ their entire lives my departure though planned to be only 3 months, was still heart wrenching. Over a year later my return to France or Switzerland where the boys are in school and living with their mother is pending a full recovery. Over this time it has been thwarted by the covid restrictions overlay (at the time of writing these are ebbing) that would require me to get vaccinated (against medical advice having an auto-immune reactive system) and make working as a therapist nigh on impossible in Europe. I am very grateful the boys are with their Mum, they moved from France across the border to Switzerland last year and very close to their school, they are 15 and 17 yrs old, young men.
I made my first mistake early on stopping cold turkey the anti-inflam meds the minute I set foot in Ecuador. The trip had been alright, I was coked up on pain-killers and for the first time in my life I wished I had checked in as ‘needs assistance’ because the walk first through Schipol airport and later after a 11 hour plane ride, transiting Quito airport nearly killed me; but I survived. Arriving in the evening I lapped up the hot humid night air of Guayaquil my final airport. In the morning I went immediately to see the stem cell doctor, who straight away told me I was not a candidate for stem cells in my current ‘inflamed’ condition. He did a round of unexpected and very painful neural therapy injections (injecting procaine under scar tissue to stabilize the autonomic nervous system), well-based in science but doesn’t help alleviate the pain at least not immediately. All in all my knee has seen more action than your average knee and is full of scarring. Said doctor sent me off with liver and kidney support homeopathics, and prescriptions for vitamin injections and advice to adjust my nutrition with the aim to reduce the inflammation.
I had arranged for a taxi truck to drive me to Vilcabamba, no flights these days to the nearest airport at Catamayo (LOH), it is a 9 hr drive east, climbing dramatically up into the Andes arriving at Ecuador’s third (and most beautiful) city of Cuenca at 2400m and then south along a stunning road, running the spine of the Andes to Vilcabamba at 1600m. I was glad I paid the expense to do this as I am not sure I could have managed the bus. As it was by the time I got to Vilca after 3 days of travel, I was stiffening up big time, and within that first week when I was ensconced in my the guest room of my tenant’s house I could hardly get out of bed on my own.
Those early days of pain are a bit of a blur, my memory is befuddled. I was hoping that following the good doctor in Guayaquil’s protocol to support liver and kidney function and boost my immune system, this along with enzymes to try to reduce the inflammation and a transition to an organic dis-inflammatory and alkaline diet would reduce the pain. Alas I learned, that isn’t how these things work, at least not as quickly as I needed it to. It was a good learning. Diet/nutrition adjustments and the appropriate supportive supplements can be mitigate the symptoms of many ailments, but they take time. I was in so much pain and while I had great care and compassion from my friends here, especially my friend and tenant (for 10 years) Rebecca who (put me up in her spare room, then cared for me until I could move into the small guest house, the Casita right next door). She brought me food and made nutritious smoothies for weeks after I arrived.
By February 2021, my spirit had spiraled so low due to the ongoing pain and loss of mobility and independence and also because I was acutely missing my sons, I had thought I would be away from them for 3 months which would be the longest period in their lives, yet here I was no further ahead and no end to this process in sight. This emotional stress did not support healing at all. I got a prescription for prednisone from a locally based Egyptian doctor. Prednisone is a steroid anti-inflammatory and by all accounts it is miracle drug for many. I could move freely and nearly pain free for the first time in months, within 2 days of starting the steroid… wow it was amazing. I kept on with an anti-inflammatory, alkaline diet hoping it would yield results given the chance to return balance to my system. I visited a reputable homeopath who diagnosed gout but neither did my profile fit nor did the diet changes and supplements give any respite, so it wasn’t gout which would have made a fix easy. Then with the supportive counsel of a dear friend on Vancouver Island (thank-you Amanda), I saw a rheumatologist who diagnosed me with ‘polymyalgic arthritis’ a dubious condition that some say is lifelong and he advised me to take prednisone, a steroid anti-inflammatory that is to be honest quite the miracle drug.
Among many things I have learned is that despite medical diagnosis and prognosis who will tell you differently, this kind of affliction is not permanent, and the medical diagnosis is self-defeating. The treatment does not serve to support a curative ethos, instead it prolongs the ailment and promotes the mind-set of a life-long illness and drug dependency. If the whole approach quite distasteful.
I had made that initial mistake of stopping the anti-inflammatories, and made several more along the way and in my own defense note also that I was without a ‘guide’ and advocate. This is a role I play for wellness clients in my occupation as a therapist. I knew I needed someone who had followed my process as close to the get-go as possible and who could give me advice as to ‘what next’. Who could that have been? I needed someone aware of the pitfalls when a medical diagnosis for something not really explainable is only a description of the condition. I strongly recommend a health advocate if you are facing an illness that is characterized as ‘chronic’. It happens to many folks, and they end up relying on their doctor who may not have the depth or breadth of knowledge to consider different approaches from the western medical model (or they are sold out to pharmaceuticals as the only solution). Diagnostics are tricky, finding a treatment plan that gets to source, explores all options and solves the problem, is even trickier.
‘Arthritis’ is a modern-time conundrum, more and more people become arthritic and it is thought nowadays to be an inflammatory response to an auto-immune trigger. In my case I discern that my trigger (the source) was a ‘wrong’ immune response to streptococcus bacteria; one of the first blood tests I had when things got so bad I couldn’t get out of a chair without help (and a lot of pain), showed high levels of this streptococcus antigen (ASTO). So if I let a scratchy throat progress, my body thinks I may be getting strep, antigens are produced to fight off the bacteria but they get carried away (an over-response) and lead to an arthritic inflammation. Thinking back as I have over these months it is quite possible that I had a sore throat when I had that knee incident in the french farmer’s field or soon thereafter, but these things never happen in isolation and this ‘man from Asia’ was not used to the chill breezes of autumn in the Jura mountains. The perfect storm set the stage, created the fertile field for illness, how to regain wellness became the question and the challenge.
I mentioned stress earlier and as a causal contributing factor it is pretty clear that at least in my case, going deep into this and finding where it comes from needs to be a big part of the healing. Here in Vilcabamba, there is an incredible menu of traditional and alternative healing modalities available from some very talented therapists. People from all over the world come and live here, holding workshops, seminars, classes and sharing therapies most of which are out of the western medical model, and that work. I benefited from many of these treatments, and from the easy availability of organic food, of amazingly clean air and water, and importantly the acceptance and support of community.
I made some blunders on the way, suffering set-backs too painful to mention here, but all part of my path. I have seen a holistic chiropractor, had heart-centered therapy, muscle testing, worked on the question ‘am I fit for Love’, worked with RIFE technology, hypnosis, massage, taken courses, attended seminars, embarked on plant medicine journeys, and I have had a deep dive into my dark side. I realised that likely I was suffering delayed PTSD from a few incidents in Afghanistan, and had deeper scars likely originating even before I was born, and then adopted. With great gratitude I have been able to exchange craniosacral treatments for many of these therapies. I know this inner work has been essential and integral to my healing, and with the intention of preventing future ‘calamities’ of this sort.
Part 2 of this writing gives you a break, and will reveal some of what worked on this journey and where I am headed next.