Sixteen days postop today.  My arm movement has improved considerably.  I’m doing things I have been unable to do since my accident in February: like touch my nose.   The daily Occupational Therapy sessions however are painful ordeals that must be endured if any progress is to be made.  I am fortunate to have a terrific therapist, a Hand Specialist who is one of the best in the business.  Tony Dao keeps his patients focused and motivated as he works through the pain with a sense of humor urging you to commit for yet another pull or push on the muscles before finally turning you loose.  For me, the exercises continue at home every two hours until 6PM (only I’m a tad more gentle).  Only to begin again at 9 in the morning.  This is what my life is like these days.  One looming possibility keeps me working as hard as possible: another surgery.  If so, it would be the last, and I hope it is done right away, if that is what they decide.  I have a doc’s appt to take out the sutures Monday, I’ll learn more then.  I continue to be in touch with my colleagues in Honduras and learned that the personeria juridica has finally been aprroved by the federal government.  The nun is so happy.  Now we must maneuver through the local bureaucrats to finalize the legal documentation.  One of my fondest desires is to be back in La Paz when the ground is broken on the new building.

xx

On this date we traveled to my daughter’s mountain cabin in the North Cascades to get away from crowded city life for the weekend.  Hiking the rural country roads and steep mountainsides helped me clear my brain for the rigors of further surgery.  Nothing however can really innure one to the pain accompanying medical treatment that requires slicing deep into muscle and tissue and manipulating bones and nerves into a hopefully healthier alignment.  I thought I had lost these pics and is why they are out of sequence.

Each week that goes by, each month that goes by, leaves me feeling more and more helpless and out of control.  Uunimaginable bureaucratic obstacles have become a way of life and each one after the other seems to be competing for inanity.  During my convalesence I have become addicted to the movie “Avatar.”  A feeling of lonliness and despair that I have never before experienced has transported me into a fantasy world where I yearn to go home, trying to avoid time-consuming idiocies continuously thrust onto my path.  Honduras has become my Pandora, my home planet, and like Jake, I want to go home.  My surgery has been rescheduled from May 18th to May 25th and most recently, again, to June 1st.  What can I do….  Turuk Macto will fly again!

I will be going under the knife again on May 18th.  The orthopod doing the surgery is the premier ‘locked elbow guy’ in the Pacific Northwest.  He tells me I’ll be home in Honduras in four months: August.  I believe him.  To stay in contact with my friends and colleagues in La Paz I call home frequently; I am still after all a member of the Health Project team there and merely on medical convalescence leave.  Improvements continue at the Hogar San Jose.  Sor Edith tells me a new roof on a large room designated as a classroom is being constructed by the soldiers from Palmerola Air Base who occasionally come to build things, like our chicken coop.  The quest for the personeria juridica continues to be just that, a quest.  Edith told me our lawyers are still mired in bureaucratic negotiations with the government.  The children are well but a few are coming down with the sniffles; the rainy season has started.  I am fortunate to be recuperating in Seattle surrounded by family whom I love dearly.  We are preparing a gift box with clothing and toys for the children, everyone contributing something.  My next post will most likely be after my surgery and three-day hospital stay.  Wish me luck.

I really have no photos of my frenetic two-week journey on pain’s highway from Honduras to Seattle.  Other than those seared into my mind.  It’s best to forget most painful moments in life.  One must think positive thoughts after all.  Which I am struggling to do after seeing the orthopedist at Harborview Medical Center last Thursday.  Heterotopic Ossification, he said.  That is the complication my Occupational Therapist suspected I have when, after a month of three-times-a-week Occupational Therapy exercises, we both noted a sudden decrease in progress.  Multiple surgeries and minute pieces of bone from the comminuted fracture set the stage for the growth of boney spurs into the surrounding soft tissue causing an internal blockage.  The result is a locking of the elbow joint into a 90 degree angle that can only be relieved by another bout of surgery.  Yes, the doc said, confirming the diagnosis, adding that I would be scheduled for additional surgery after a consultation with the ‘locked elbow’ guy.  I am thinking positive: this will only delay my return to Honduras by two or three months.  I continue to be in contact with my friends and colleagues in Honduras concerning the status of my projects and I will continue to post comments.  The pictures above are from our deck overlooking Puget Sound with the Seattle ferry to Whidbey Island in the distance and three shots of the U.S. aircraft carrier U.S.S. Abraham Lincoln making a port call at Everett Naval Station on its way to Norfolk Naval Station for a three-year refitting.

I don’t remember bouncing down the concrete stairs head first from my second-story apartment to the first floor landing.  Only later did I remember that I had got up to pee ’bout eleven.  I went to bed Wednesday night around 9PM after teaching a late-night English class.  Took a shower, brushed teeth, took a benadryl for my allergies.  The light bulb had burned out in the bathroom near my bedroom, so half-asleep I maneuvered through the dark to my second bathroom, contiguous to the stairwell.  I came to in pitch black. Head against the bottom entryway door, feet sprawled behind; when I could think I first thought I had tripped in the bathroom and fallen in the shower. When I tried to move intense pain shot through my body.  After a few minutes I managed to inch my body around and crawl up the stairs to a light switch.  The bones in my right arm had bent into an obvious unhealthy profile and there was blood everwhere. Crawling out of the stairwell, I stood and staggered to my first aid kit, took out an ace wrap and wrapped my bleeding arm the best I could to help staunch the bleeding.  Then I took the pillow off my bed and molded it to my arm’s contour to help splint it; pressing the pillow against my abdomen it immediately became saturated with blood.  After several minutes reclining on my sofa, fearing going into shock,  I called the PCMO about midnight.  Thus began a chain of events that took me by ambulance from La Paz to a hospital in Comayagua where X-rays confirmed a serious compound fracture of the radius and ulna at the joint with the humerus.  Immediately transported to Tegucigalpa with IV antibiotics started I reestablished contact with Dr. Claros who treated my plantar fasciitis in 2009.  He reduced the fracture and debrided the open wound that same morning after my having arrived by ambulance at 5AM.  The next day I was med evaced to Panama via Costa Rica.  Panama’s medical facilities are top notch and the country receives medical referrals from all over Latin America.  After three surgeries, however, it became apparent that they were not equipped to deal with the severity of my case.  The third surgery there was an external fixation of a metal brace to the bones of the ulna, radius and humerus to keep them from moving while I was transferred by med evac to Seattle, where the premier trauma center in the country is located.  And fortunately my home of record.  Surgical procedures in Panama are not allowed to use pain meds like morphine, dilaudid, demerol, or even codeine because of the country’s drug problems.  I survived three surgeries there, the third being most memorable, experiencing the worst pain I have ever felt in my life.  I awoke in the recovery room the third time thinking I had somehow been transported into the depths of a 15th century torture chamber Inquisition, my entire arm on fire, delirious my mind screamed how in the 21st century anyone could be allowed to suffer such pain.  My accident happened the night of 9 February 2011.  I arrived at Harborview Medical Center in Seattle on the 19th of February.  My fifth surgical procedure was done on 22 February 2011.  I was discharged from Harborview on 25 February 2011 to my daughter’s home to begin intensive 3 times a week Occupational Therapy.  It has taken me this long to post a comment due to the extreme pain and treatment regimen.  And of course there is the never-ending paperwork.  My goal is to devote myself entirely to the rehabilitation process and be ready to return to work in Honduras by the end of May.  I will post photos next entry.

When we started our Peace Corps training two years ago, fifteen H-14 Health Project aspirantes (trainees) arrived in Tegucigalpa, Honduras on February 24, 2009 on a flight from Washington D.C.  One person was lost right away.  Arriving at our Field Based Training site in La Paz, La Paz we numbered fourteen: thirteen were proudly sworn in as Peace Corps Volunteers at the American Embassy by the Ambassador of the USA on May 13, 2009.  Over a period of months the Health Project PCVs posted to every corner of the country began shedding more and more Volunteers until after a year there were only six of us left.  Various explanations were mulled over as to why so many Health Project Volunteers were ETing (Early Termination).  There was a major earthquake May 28th 2009.  Then there was the coup that ousted the country’s president on June 28th 2009.  Who knows why persons make the decions they do.  Six of us made it.  And my friend Jen from New Joisy took it upon herself to have made a hand-stitched banner for each of us remaining six Health Project H-14 survivors.  Saludos to Jen, Tara, Katy, Matt, Iljeen, and me!  In two weeks I will be traveling to Seattle for my first visit to the States in two years to visit my family.  I will be there for three weeks and will return home March 12, 2011.  For you see, I have extended my term of service until June 2012.

I’m proud of this ordinary-looking diploma.  With six years prior military service when I was but a kid, I have now served my country with two years in the U.S. Peace Corps as an old dude.  And I’m staying for another year.  We remaining 26 of 50 initial H-14 trainees who started this adventure back in 2009 met as a group for the final time in Valle de Angeles for our COS Conference last week.  Every six months a new 50-strong group enters service.  They alternate: Business; Water and Sanitation; and Health comprise three projects.  Next cycle comes Youth Development; Community Development; and Resources Management.  Most make it, some don’t.  Ours was a 50% success rate.  We were the survivors.  As you can imagine, our last conference, which focused on administrative separation duties, was filled with nostalgia and excellent memories.  And a little bit of booze (or maybe a lot, I forget).  But it was fun.  Three of my PCV companeras and I will be extending for another year.  The rest will scatter to the far corners of the States and the world, forever friends and companeros and very special folk.  We have experienced an adventure that will remain in our collective memories forever.  Adios amigos!

 This is where the kids have been playing for almost the past two years.  A dirt and rock sanctuary.

The Palmerola Air Base asked me if we could use a few bags of cement.  Hell yes, I replied.  How many do you want?  How many do you have?  We ended up with 50 one-hundred-pound bags of donated concrete that I and insufficient but available help unloaded over two days.  Next came a donation of sand by a local colegio.  All this activity happened around the holidays.  Finally the President’s daughter came to visit and negotiated with the alcaldia the labor of prisoners from the centro penal who were working off their court penalty.      And this is now where the children will play until our new building is constructed sometime at the end of 2011.  We are confident that the Personeria Juridica will be approved.  If not, we have Sister Edith’s unbridled confidence to proceed siempre adelante.

It appears that the monolithic bureaucratic entity is endemic to civilization, no matter the country’s development status.  A word about the Personeria Juridica: a Honduran legality conferring a status to an organization similar to incorporation in the States.  Sister Edith has been engaged in a bureaucratic battle for six years.  Her first two attorneys meant well but accomplished squat and ended up at odds with each other, the process at a dead stop when I became involved in March 2009.  A new attorney expressed interest and then a friend of hers joined the campaign.  Over the past year we have jumped hoops and organized folk to get to the point of completing and getting the required paperwork to the capital city for approval.  We have been in an approval situation since the first of December that is so stereotypically bureaucratic.  The Tegucigalpa governmental bureaucracy is asking for corrections to the tramite (legal paperwork) that have already been submitted.  Our lawyer told me she has completed all the requested modifications but she does not have the influence to move the tramite through the bureaucratic maze.  I have contacted folks to enlist the assistance of a diputado (similar to a congressman) from Comayagua; a lawyer assigned to Governacion y Justicia which is a governmental office, a staff person recommended by the President’s daughter; and the governor of the departamento of La Paz.  There is nothing more I can do.  It would seem that every country has its bureaucratic labyrinth that is impervious to common sense and whose squeaky, ponderous wheels are greased by who you know, power, and pure luck.  The tragedy, of course, is that the construction of a new building for the Hogar San Jose is contingent upon the approval of the Personeria Juridica.