One Shy of Seven

Ode To Northern California

Some of you may gag when you read this blog post. I won't go on forever and ever on the subject. I arrived back in my native San Francisco yesterday to beautiful sunny blue skies and a warm mid-seventies temperature. I couldn't have had a larger s*it eating grin on my face! Stepping out of the doors at San Francisco Airport I filled my lungs with the cool eucalyptus filled air and felt all of my frustrations and fears of the past six weeks melt away. There is something to say for the cleansing feeling of knowing your place.

And that is exactly what I cannot stop thinking about today. This is MY place. I keep saying it. This is MY place? My home? My life? Today I woke up and headed over to the presidio to meet with my physical therapist. My tail was between my legs when I left the house and by the time I got into the presidio that grin was back on my face again. I bust through the doors at Presidio Sport & Medicine and was greeted by one of my trainers, Andy. He could see how excited I was to be back. Now that I think about it this might be the most "excited" I've been since I've been back in the US! This wasn't really an "exciting" detour if you know what I mean.

Anyway, so I rip through some preliminary exercises and am transported back to the four or five months I spent at PSMT prior to the beginning of this journey. I was working through some recurrent sciatic nerve pain. That experience wasn't only physically beneficial to me but also mentally beneficial. When you're surrounded by professionals who actually care about their patients and invest themselves into their work its hard not to have some therapeutic benefits from taking time to focus on your body and in turn your mind. As a quick side note, Erica Moody, at PSMT is one of the most talented Physical Therapists I've worked with over my tenure of knee, spine and now shoulder injuries. She not only understands her job but she understands people. It is the combination of her advanced therapeutic skills with her personal touch and approach that makes her stand out in my mind. If any of you ever need someone to look at an injury or work on physical therapy in the San Francisco bay area I'd highly suggest you stop by and see her.

Well that was a tangent. But a necessary one.

So where was I? Oh yeah, my love of San Francisco! Well lets just say I've spent the better part of my twenties traveling. Through my former position I spent time in every major city in the continental united states along with a trip to Istanbul and Athens. As I departed and started exploring Asia & the Pacific I found myself looking fondly back on my time in San Francisco. While I was away I chalked a lot of my emotions around San Francisco with my friends. I had for the first time in my life since college developed a social network of friends in a city. I had close friends, work friends and family friends to rely on.

It wasn't until I got off the plane yesterday and kept smiling this morning as I drove around that I realized this place feeling has just as much to do with the actual city as it does the people within it. I can't put into words what I'm trying to express but surmise it to be something magical about what this city does to me.

I'm lucky to have found this at my age in my life. I'm not necessarily ready to settle down and lay deep roots in any one city but I now know the one thats at the top of the list.

Below are a few of my favorite places from my travel the eighteen months prior to me leaving for my trip.

Frogs Leap Vineyard

Ocean Beach

Chrissy Field Beach

Lake Tahoe

Marin Headlands

Apre work

AT&T Field

Angel Island Camping

View of Tiburon from Angel Island

Golden Gate Bridge view from Angel Island

Napa Valley

Alicia and I @ Marin Headlands

Napa

Point Reyes National Seashore

Once upon a time in Sihanoukville, cambodia I separated my shoulder...

How bout that ride in. I guess that's why they call it the windy city. Ha ha ha. You guys might not know this but I consider myself a bit of a loner. I tend to think of myself as a one man wolfpack. But when Paul and I started our around the world journey I knew he was one of my own. And my wolfpack, it grew by one. So there were two of us in the wolfpack. I was alone first in the pack and then Paul joined in later. And five days ago, when I separated my shoulder I thought, wait a second, could it be. And now I know for sure that I am once again alone in my wolfpack. One lone wolf, running around the desert tundra in the Chicago suburbs....

Okay, enough of the hangover references. Yup, I"m back in the good old US of A. This past week has been an unbelievably trying and humbling experience.

Lets start with the "trying" part. So I'm on a sick beach on Bamboo Island in Cambodia. I decide to join in a friendly game of soccer with my new mates from my Intrepid group. Like the grizzly bear that I am I tend to be slow yet intimidating on the field. I decide to up my game and go for a goal. In the process of going for the goal, I get my foot stuck in the sand and come crashing down on my right shoulder. I immediately hear a CRUNCH sound and know I must have broken something. Thankfully when I sit up I'm not in a lot of pain but notice a HUGE bump on my shoulder (as if a bone is about to break through the skin) and can't lift my arm. I'm having flashbacks to last winter when my buddy Craig dislocated his shoulder up in Tahoe while chasing down a rogue saucer. Just like in that experience I'm far away from medical attention and I need to scramble to get myself to a doctor or clinic. Thanks for putting me through that experience Craig so I was more prepared for Cambodia!

First of all let me say, this is why I booked myself on an Intrepid trip while traveling in a country that doesn't speak English as a first language. My local guide Sky jumped in and helped me sort the entire ordeal out. Sky called for a "fast boat" to take me back to the mainland. It took us about two hours on our little rickety boat to make our way to the island for lunch and snorkeling. I find out that the "fast boat" to get me back is actually a jet-ski. I can't get on a jet-ski with my shoulder the way it is!? So Sky calls the boat off and arranges for a slower bigger boat to take me back. Thankfully he was able to negotiate the boat price down to fifty USD. Keep in mind I paid $6 for the entire day of boating, snorkeling and hiking. While we're on the boat back to the mainland Paul is talking me through the process and he's helping keep me calm. I couldn't have done this without my wolfpack.

When we get to the mainland Sky has his friend pick Paul and I up in her personal car and drive us to the local beach clinic. I love this part of the story. A motor scooter pulls up alongside our car as we're pulling out of the harbor and Sky arranges for a mid-drive hand off for water bottles and fruit to keep me hydrated and my blood sugar up. I was seriously amazed at this feat!! What is this James Bond in Cambodia!? Sky could have been MI6 at that moment.

Paul and I make it to the clinic and I proceed to the x-ray room. This room could have been built in the 1920's and updated in the 1940's when the x-ray machine was installed. The x-ray machine looked like something out of 2001 space odyssey. As the x-ray tech was about to pump me full of radiation I ask for a lead vest. She rustles one up and thankfully I protected my future children b/c with the look of the machine I could have come out sterile. Paul has to use the facilities while we're there and as he's going into the WC Sky suggests he hold it as he explains Cambodian clinic squat toilets tend to be very gross and full of sickness. Paul doesn't flinch and holds it the rest of the day.

I'll never forget looking at the X-ray for the first time. I actually started laughing b/c it looked like I had cleanly broken my Clavicle bone. The doctor explained to me that nothing was broken but the space between the two bones should be much smaller and has a stabilizing ligament in it. I was relieved but relatively confused. He explained to me that this injury is not an emergency and I should keep my arm in a sling for a few weeks until the pain goes away. He did also however suggest I head to Phnom Penh to have an MRI taken to assess soft tissue damage. He asks if I want help finding pain and anti-inflammatory drugs. In a moment of hilarity Sky tells me never to buy medicine in Cambodia. I almost bust out laughing as Sky is "mr. Cambodia" and has been talking up the great things of his home country since we met him but he finally admits to something you SHOULDN'T take there. The look on his face was the most serious I'd seen him throughout the entire journey. He explains once we leave that Cambodian pharmacies are notorious for making mixtures of drugs and diluting them but selling them as name brand. Thus, I stuck to the Aleve I had brought from home.

Paul and I signed ourselves off of the Intrepid Trip and again Sky came up big time by arranging for us to take a taxi to Phnom Penh for only forty US dollars. That is a five hour public bus ride in a private Mercedes taxi for only forty American. If I had tried to arrange it myself I'm sure it would have cost me three times the amount. When we arrived in Phnom Penh that evening Sky had his friend, Mr. Ny, pick us up in his Tuk-Tuk. Mr. Ny was priceless over the next three days with helping us make our way around the city. He was so careful with pot-holes and speed bumps to make sure my arm wasn't too painful. Sky also helped arrange a hotel room for Paul and I to stay in. Can you get the picture as to how helpful Sky (representing Intrepid Travel) was in the situation?

That night Paul and I headed over to the S.O.S. Medical Clinic (with Western Doctors!) to get a second opinion. We had another Cambodian doctor (it was after hours and the western docs needed their sleep) and this guy was hilarious. He put me through some basic, painful, range of motion tests and told me exactly the same thing the clinic doctor from the beach told me. Basically its not an emergency but come back tomorrow because our Chief of Staff from South Africa will be in during the day and he specializes in sports injuries. This was GREAT news. Finally he insisted that I stop drinking beer and that I needed to get my Uric Acid tested. Of course what he was hinting to, as he patted my belly, was that I was a bit overweight and it was probably the beer that was causing it. This was a fair answer and really I wish more doctors in America could be that blunt with their comments. It might do us a lot of good. I didn't want to tell him I had lost 20 lbs since I started traveling three months ago... then he really would be concerned!

Paul and I retreated to our hotel for the night and were up early to take the Tuk-Tuk back to the S.O.S. clinic. We met with Dr. Alan Kourie from Cape Town, South Africa. He was a really great young guy with a positive attitude and a thick sports medicine book on his desk. This at least was a start to getting a western opinion of the situation. He put me through a pretty extensive range of motion examination. His opinion was that I had a grade II or grade III AC shoulder separation. He told me I should probably get an MRI done to see to what extent the tissues were damaged but that the MRI machine in Phnom Penh was pretty old and I'd be better off getting it done in Bangkok. We took further non-1940's x-rays to make sure I didn't have any smaller fractures in the parts of my shoulders that didn't come out clearly in my 1940's x-rays. Thankfully I didn't have any other broken bones. He didn't point out that I needed a Uric Acid test and invited me to come out drinking with him that night to watch the cricket. Hilarious!

It was after his opinion that I was thinking I'd carry on my travel. I was told to keep my arm in a sling for a few weeks and as my strength came back I'd start moving my arm again. He suggested I get some physical therapy suggestions from some of my contacts back home and start doing them on my own. He referred me to a local physiotherapy guy in Phnom Penh who I could chat with before I moved onto Siem Reap.

After a long Tuk-Tuk ride over to the local Physiotherapy office in Phnom Penh I found myself in front of a very fit looking Swiss gentlemen. I told him about my accident and his advice was a bit different than what I had been told up to this point. He pointed out that physical therapy for an injury like this shouldn't be taken lightly. I should really rest and immobilize the shoulder to give it the best opportunity to heal and that the exercises you do to rebuild strength usually are very hands on from a therapy point of view. Thus, I'd need to work regularly with a physical therapist for a few weeks before I could do the exercises on my own.

This was really the first time during the process that I realized I was probably going home to get this looked at. Up until then I was thinking I'd get a travel dolly for my backpack, Paul (along with help from other intrepid travelers) could help me get my gear from city to city. I really was thinking I wouldn't need to interrupt my travel.

That late afternoon I had an hour or two to just think about the situation I found myself in. As I looked at all of my options I began to realize what was most important to me. I want full range of motion. I want full strength back. I wanted to know I did everything I could to ensure my body would be in the best shape possible for the rest of my life (minus the Uric acid test). I wanted to be able to swim freestyle again. I wanted to be able to serve a volleyball overhand. And then I realized, not that I wanted but I needed to go home. I needed to give this the attention it was due.

This was a tough decision as it meant I'd be headed home and Paul would continue traveling. It wasn't that Paul couldn't handle solo travel for a while, it was that I didn't want him to have to. I wanted to experience Nepal and India with him. I wanted to stick to our itinerary and I didn't want to go back to dreary gray Chicago in April! But Paul helped by confirming my decision. He told me he'd do the exact same thing.

So I booked a one way ticket on Asiana Airlines from Phnom Penh to Seoul, South Korea and then from South Korea to Chicago. It was a total of 29 hours of travel with a 10 hour layover in Korea.

I'm home now and have a doctors appointment this Tuesday at Lutheran General. I'll start my process of figuring out the game plan moving forward. Hopefully I can be back on the road in a few months. For now I'll try to enjoy time with my mother and father in my old home town. I'm trying to take things one day at a time and find the positives in this situation. Thus far I can see a few positives because I get time with my family as a young adult that I wouldn't otherwise have had. I'll get to see my girlfriend a few more times in 2011 than I would have otherwise been able to and hopefully I'll be stronger and wiser after this experience.

Now the humbling part of the experience. I'm so completely thankful to have the means available to me to have this injury properly examined and repaired. Along every step of the process over the past week I kept reflecting on how lucky I was. I was lucky I could afford the fifty dollar boat from the island to the mainland in southern Cambodia. Lets keep in mind that most of the population of Cambodia makes less than fifty USD a month. So I spent a months salary of the average citizen of Cambodia just to get off the island!! At the clinic I saw first hand how basic the medical options are for most people in the country of Cambodia. I was fit with a basic sling in the operating room and after spending the last four years in some of the best operating rooms in America from the east coast of NYU, Mass General, Northwestern in Chicago and UCSF in San Francisco I was thankful I never had to go under the knife in rural Cambodia. How blessed and spoiled am I that I have these options available to me? Why me? What makes me so lucky to have been born in America. What gives me the opportunity and so many other people less opportunities. I'm thankful to be in the situation that I am in but am humbled by seeing so many people who don't have that luck.

The clinic doctor basically said if this was a local he wouldn't have charged them the $45 for 1940's x-rays b/c they couldn't afford them. He wouldn't have done X-rays at all, he'd assess their shoulder and tell them to take it easy for a week or two but then get back to work to support their families. They'd have recurrent pain and problems for a long time but they couldn't afford any other treatment options. Meanwhile I shell out more cash to get back to the capitol city but decide not to have an MRI done there b/c its sub-par to what I'd receive in Bangkok or better yet the USA. I spent more money on my flight home than most Cambodians would earn in a year... I don't mean that in a bragging way, I'm just processing how different our lives and perspectives are. It definitely put life in a different light.

I decided to come home because of exactly one thing, I had the option to. Many other people have much fewer options, if any. I'm thankful to have options but I'm humbled by it. It makes me wonder how I can be more involved in the future to make a difference in peoples lives who have fewer options.

Last note: I couldn't have asked for a better tag-team to help me while I was injured.

Thank you Sky for everything you did over the past week. Thank you for smiling and helping to keep me happy throughout the painful process. Thank you for sharing your insider knowledge of Cambodia and welcoming me to your country. Thank you for sharing your friends with me during this event. Mr. Ny was amazing and I hope to come back and see him again in the future. The restaurant owner who drove us to the clinic was amazing. I hope to come back and see her again - her Amok was the best dish I had on my entire three months away from home.

Paul saw me through everything this past week and never once flinched. His patience and care, although not surprising, is something I'll never forget. I'm thankful to have had him by my side and hope to repay the kindness and love he showed me over the rest of my life throughout our friendship. Thank you Paul, you'll never know how much you mean to me.

Now the pictures: