sv evi

It’s our one year anniversary in Cuenca and I wake up in the hospital. Quite different than our planned celebratory dinner as a family because as we all know…shit happens. There was no regular path to this moment, instead a series of accidents and bad luck. The good news is the surgery is behind me and now the slow healing process begins.

It all started over a couple of months ago when I had a planned adventure for the kiddos while Hannah was away at her weekly afternoon of playing bridge. Getting outside is imperative because the three wee ones trapped in the house can be a challenge. The week before I had ridden my bike a couple of hours out of town, up a valley road to this visible summit on a ridge. Guaguazhumi (pronounced Wawashumi) seemed like a good way to spend an afternoon with the kids.

That nipple on the ridge is the summit.

We took a ½ hour taxi ride ($6) to the trail head. We were a determined team with Luz in the chest carrier, my backpack full of rain gear, hats, water, snacks, a change for Luz, camera and a couple of small toys, and Tomu and Jade hiking. They are very experienced for their age and keen to explore.  We were prepared…after all, what could go wrong?

The trail immediately began with a steep ascent and would continue for the duration of our hike. I picked the more direct, steeper, shorter route with the intention of having a longer leisurely descent with the sights of Cuenca and Cajas always in our view.

Trailblazing Jade the Fearless

There wasn’t a soul in sight for our hour climb and near the summit we had to push through some overgrown brush and criss-cross through a gully….challenging for anyone, yet Tomu and Jade were excited to push for summit. I stepped up a small slope and suddenly, without warning my foot slipped downward a couple of feet. I instinctively put my left hand up to protect sleeping Luz’s head and my right hand out to catch my fall.

THWACK…my foot went down with my arm extended, stretched over my head immediately dislocating my shoulder. I knew it right away when I stood up and checked on Luz. She was crying as this woke her and I noticed my right arm was a few inches longer. The pain was intense though with the adrenaline pumping I remained calm, telling the kids we had to go down and wouldn’t make the summit. They knew something was up even though I downplayed my injury. We walked back to a flat spot where I took off the heavy pack (OUCH), took Luz out of the carrier (OUCH), took off my shirt (OUCH) and evaluated the situation.

Clearly dislocated as I could see the odd shape of my shoulder and the ball of my humerus bone in my armpit. Made a small attempt to reset it by holding onto a tree and pulling backwards….like in the movies. No luck. Checked cell phone…no service, not that I could really call anyone to help me though speaking with Hannah would have made me feel better. I knew we had to get to the remote dirt road, an hour down a steep trail with the 3 helpers.

I explained to Tomu and Jade that I was OK but hurt and they would have to help themselves to get down. Tomu valiantly offered to help Jade down the tricky parts of the trail and he assisted in getting Luz back in the carrier and the pack on my back (OUCHY-OUCH). I thought about ditching the pack and returning for it later but since I had to carry Luz regardless I thought the pack would provide counter-pressure to Luz’s carrier…kinda holding my shoulder together….but not really.

We managed to get down fairly quickly and the sun came out blazing when we reached the road. It was no surprise that there were no cars in sight so we started walking. I thought about knocking on a door of one few houses for assistance but decided against it. Luckily within a few minutes a mixto (taxi pick-up truck) passed and agreed to take us home. 

Happy to be off the mountain I had a moment to let it all sink in and the pain came on strong as well as many emotions during the very bumpy ride home. I was mad at myself for putting the kids in a potentially bad situation, for getting hurt and realizing the consequences of it all. Injured, unable to help around the house, the slow recovery….crap.

I finally got ahold of Han and she was going to meet us at the house to watch the kids and I would carry on to the hospital to get my arm reset. The best thing about this day so far was the kiddos and their attitude. They all were beyond helpful by listening and acting accordingly after the accident and before with their eagerness to do some crazy exploring with Papa.

Han arrived at the house and the second phase of this debacle began. Figuring out which hospital to go to and how to progress with emergency care and long term help. I couldn’t really think about anything except putting my shoulder back in the socket. The pain had intensified as it had been a few hours since the accident by the time I reached the hospital.

They immediately put me in a room and gave me a lot of attention with questions, blood pressure, x-rays, etc. but no indication of getting my shoulder set. After an hour and much struggle with the language, calls to and from Han and many different people coming in and out we heard the trauma specialist was on leave (he just had a baby). More confusion and delays, saying I would have to go to another hospital, finally they informed me a doc would come and help me.

Hours more passed before he actually arrived, during which I had been admitted, prepped for surgery, IVed, lightly drugged (not enough) and left alone in a room while I writhed and tried to get a comfortable position to relieve the pain…no luck. Han arrived as the doc was trying to manipulate my arm back in the socket, without success. It was an extreme anterior dislocation that was difficult to reset so they put me under and minutes later it was in place.

When I awoke the pain had all but disappeared. After more x-rays, paperwork we were free to go. The prognosis was it would take awhile to recover but with time and rehab it should heal fine.

Fast forward a month. After rest and a couple of rehab sessions things had gotten better for the first couple of weeks then much worse for the last couple of weeks. I sought a second opinion and subsequently third opinion, got an MRI and the diagnosis was two major tears in the supraspinatus (top shoulder muscle), and the labrum (shoulder socket). Surgery was scheduled for the following week. We found out later, while performing surgery there was a 3rd major tear on the subcorpularis (shoulder blade muscle).

As happy as I was to finally know what was happening with my body, the actual news itself was pretty grim. A month had gone by since the dislocation which set recovery back. I had been relatively active during the month while my shoulder was barley attached with activities like biking daily, playing ball and roughhousing with the kiddos…all the normal stuff. There was some pain but compared to when it was dislocated for 5+ hours and after it was reset it seemed minimal.

The afternoon before surgery I went to a 90 minute relaxing massage to loosen things up before I was laid up. It was a brilliant idea and upon leaving my session I felt better than I had in a couple of weeks. I pedaled my bike home from the other side of town on one of the designated official bike lanes just like the ones in Seattle with the little bumps separating it from the road and painted with that red, textured, rubbery coating and the familiar bike logos stenciled on. Also, all intersections have the pedestrian crossing lights except changed to show a rolling green bicycle when we have the right of way.

From experience I know there is no established formality for ‘right of way’ in Latin America and I often say when urban riding “I don’t want my epitaph to say ‘But I had the right of way’”. The nice smooth lane I had to myself combined with the gentle downhill or the post massage, semi-euphoric state of mind or the lack of traffic on the one-way road…I dunno but I was riding fast with my perfectly connecting lights flashing the rolling green bicycle and that bliss quickly ended.

In the distance I saw the small white car approaching my clear intersection and prepped to brake (even though I had the right of way) and I saw it stop before turning into my lane. Perfect, they are waiting for me and I continued my fast pedal cadence when at the last second they turned and crossed my path. It happened in slow motion in my mind and by slamming on the brakes I managed to scrub some speed before the bike collided with the drivers front bumper and I flew cartoonish over my handlebars, over the car hood and landed some meters away, tumbling into the bike lane.

FUCK, FUCK, FUCK I yelled, more scared about further damage to my shoulder than anything else. It hurt…really badly and consciously I had managed to not land directly on my existing injury….the night before my morning surgery.

Many people gathered and the woman driving the car came over crying (I think she thought she killed me). Soon the police and ambulance arrived even though I called no one except Hannah. It was difficult to dial with shaking hands and the service wasn’t good so many dropped calls later she left Jade at Tomu’s soccer practice and arrived with Luz in tow to find me in an ambulance.

We talked for a minute and I assured her I was going to be sorta OK. While I received suspect care in the ambulance, Hannah was negotiating the compensation with the woman who had no insurance but had the backing of a dozen colleagues from where she worked across the street. Hannah had the backing of Luz who was bawling due to all the commotion. I was useless and no help.

After much debate we agreed the ambulance would transport me to the free, public hospital for x-rays and evaluation. The woman and some entourage, including Hannah and Luz would follow and pay for the x-rays. I did confess that I was previously injured and was getting surgery the next day…it seemed like the right thing to do. We creeped through rush hour traffic, listening to the driver and EMTs argue about the best route and Hannah and Luz followed in another car.

When we finally arrived at the hospital later I was frustrated and done with everyone and the last thing I wanted to do was spend hours waiting for x-rays the night before my surgery. I stepped out of the ambulance in front of the emergency entrance and said “adios…I’m going home”. I got in a taxi and picked up Tomu and Jade who were patiently watching the next soccer practice. They are on their best behavior when things are at their worst…they really rise to the occasion.

So happy to be home, Han soon arrived with Luz after riding with the woman and her entourage. The police had been following but were released en route when we agreed, via recorded video, that the $50 cash compensation was sufficient…which it wasn’t but what can we do?

The next morning, lying on the operating table, I was surprised by the large size and sparseness. It was virtually empty except for a couple of metal shelves, a garbage can and a free standing closet. Staring at the two huge, modern octopus-like lights which hung from the ceiling above me I witnessed people slowly filling the room by rolling a dozen types of electronics, scanners, computers, monitors, drills, and a cart with all the ominous looking sharp things…one by one over the next hour.  The anesthesiologist came in and sent me to dreamland.

So back to the start of this blog…our 1 year anniversary and when I awoke in the hospital I was happy to see Han and the kids. I got some sweet homemade cards and they all wanted to climb on the robot bed. Lovely to have my main support group in attendance. Our dear Cuencano friends Lore & Juanito came by as well. Unfortunately the doc made me stay overnight…ugh. They came in frequently to wake me and ask how I was doing?!?

The doc came by late and gave me the news of the surgery. From the MRI he knew about 2 of the damaged areas but was surprised by the severity once he was inside. He also found a 3rd major tear that didn’t show on the MRI and took care of that as well. My new internal hardware includes 4 composite screws anchored into bones to give extra support for the sutures which repaired the severed tendons. Overall he said it went very well and eventually, with proper therapy, I should be 100%.

After a difficult night of sleep…the first of 100+ in a row to date, we finished up some paperwork and final check up and I was ready to go home. I had to go downstairs and pay before they would officially release me and remove the IV. I settled my tab, about $3900, not including the screws which we arranged to buy direct from the supplier to avoid the hospital mark-up as advised by the surgeon to save some $$ since this was all done without insurance. My research shows the similar extensive repair in the US may have cost up to $30,000 or more.

As I write this I am 6 weeks post-op and progressing on schedule while seeing 2 different physical therapists per week not counting Libby who was my in house therapist while she was visiting….Thanks Wub!  Their styles differ and I’m benefiting from the variety with Jose and his specific exercise regimen and Carla and her stretching and shoulder manipulation. The loss of strength and complete atrophy of my upper body is shocking. I stepped on a scale yesterday at rehab and I weighed 144 pounds! I haven’t seen those numbers since middle school football. I couldn’t lift my arm for weeks and have recently began using the smallest dumbbells made…and seeing progress which is so measurable at this stage. I’ve started riding my bike this week which changes my attitude immensely. I did enjoy the leisurely walking pace to experience my neighborhood and the city these past few weeks…but nothing like biking in Cuenca, which I love.

My first goal was to be ready for our 3 week Bolivia trip which departs in a couple of weeks. Patagonia trip in January will be more demanding as we are backpacking and camping with the kids and I think that’ll be OK as well. Lastly I hope to resume the annual Squamish, BC trip to rock climb with Han when we return to the PNW next summer. With every painful stretch and struggle with every rep and grunt I close my eyes and imagine climbing that big wall again.