Tuesday, January 31, 2012

Missing in Action

I haven't been holding up my end of the blogging partnership lately and I apologize. I wish I could say that my schedule has been overwhelmingly busy but in truth, I'm still just nursing my ankle back to health. Two weeks down, one to go before I can start physical therapy and the long rehab process. I did just schedule my first PT appointment for next week, can you tell I'm anxious to get going?

That aside, life has been chugging along. I have yet to nail down a home yet but have a couple options lined up. One of which is bound to work out. I've also been researching my transportation options. Apparently important tax for a foreign car into Laos is 100%. Is that not incredibly insane? Even more so, is just how many foreign cars are on the roads here. Where do these people find the money to pay such an insane tax?
Just another of the many quirks of Laos.

A quick recap of my last week. Lots of reading, Ian bought me a new kindle book about Buddhism that I've thoroughly been enjoying. We also took a trip to the local movie store and bought a handful of pirated films to keep me entertained. In truth, probably the most exciting aspect of my last week has been culinary.

I've been eating like a queen here. It's just too easy. Options are plentiful, dirt cheap, and oh so convenient. The fresh squeezed juices and smoothies are pretty epic too. My favorite thus far is a Laos coffee and coconut milk smoothie; a delicious sugary, caffeine infused concoction to keep you buzzing all afternoon!

The pho and Vietnamese sandwiches have been pretty amazing as well (cheaper and tastier than at home). I've also had lots of tasty curries, noodle dishes, sushi, the list goes on and on. I'm pretty sure I'll come back to the US about 30 lbs heavier.....unless I get off these crutches soon and back to the gym. :)

Massages, tasty food and beer Lao.....who needs a functioning ankle, right?

Massages fix EVERYTHING

Today felt like my first true Saturday in Laos, if for no other reason than I seem to have filled the day with weekend type activities and only let my ankle slow me down slightly. I went to brunch with some friends at Stickys (a local expat institution). After a leisurely brunch and a sweat inducing stroll downtown, we went shopping at the local home goods store, where everything is dirt cheap, comes from china and will likely disintegrate in 2-4 weeks. This was quite an endeavor on a bum foot and took far longer than anticipated.

So in reward for my valiant shopping effort, I experienced my first ever Laos massage. For a whopping $6, I was given a wonderful full body massage (minus one injured ankle) which involved a small Laos lady bending me in various positions and at one point standing on my thighs to allow full use of her body weight. It was quite amazing and I will likely be back every week for the next 53 weeks or so :).

After the massage, a brief nap to help collect myself and then dinner with some new friends at their beautiful Laos style home. I took a Napa Valley wine I found in the local expat market just to make sure and represent a little bit. However, I was well outdone by the French woman who brought a delicious Champagne which went quite well with a tasty fish stew our hostess made.

All in all, a successful Saturday....complete with Sunday morning hangover.

Monday, January 23, 2012

Downhill from here

It seems that this adventure of mine has been off to a bumpy start. First, the trip getting here wasn't as smooth as it could have been. Then this bizarre ankle injury and now I've spent the last two days struggling with a fever, headache and the stomach bug from hell. So I'm banking on the fact that things inevitably change and its bound to turn around at some point. My recent sickness has at least kept me off my feet for a few days and thus sped along my ankle recovery. The swelling has gone down a great deal and the bruising gets more spectacular every day.



The problem with being laid up in bed is that I don't have much of any consequence to write about. Unless anyone is interested in hearing about old espisodes of American tv series such as Gossip Girl, House, or Dexter....I haven't been up to much lately. One thing I did learn is that there is a great little shop in town that sells any pirated movie, television series, etc. that you could ever want for a little over $1 a piece. It makes up for the fact that all the cable here, while free in most apartments and homes, is completely in Laos.

I have also been brainstorming some way to repay the wonderful woman (essentially my boss) who has taken me to the hospital in Thailand, played doctor to my ankle and stomach, and taken me into her home where she cooks and takes care of me. Not sure if I will ever find anything appropriate to repay that steep debt but if you have any thoughts, I'm all ears.

Hopefully life will get more interesting when I'm back on two feet!

Saturday, January 21, 2012

Life goes on

Back to work today, at a snails pace of course. Having never been on crutches before, I never appreciated just how life altering they are. Luckily, I have a wonderful housemate (at least temporarily) who makes sure I'm fed and comfortable. She also has a cat named Tom Collins, who is absolutely insane. He's still a kitten and insists on chewing on my bandaged foot at every opportunity. You can see the crazy in his eyes, don't you think?



On the upside, I went sinh shopping today with a woman from work. Sihns are traditional skirts that women wear in Laos. They can be quite beautiful and I'm excited to go to a tailor next week to have mine made. I purchased five different fabrics, and I'm sure I'll buy a great deal more over the next year. They are a neat foldover design that allows you to ride a bike, motorbike, etc. without flashing everyone around. It's also a very cultural thing, and I think the Laos people appreciate the effort of falang women to wear them. All the men compliment me when I do wear them :)



As for my foot, it's getting uglier by the day, but I am certainly appreciating that while my injury looked horrible, it could have been much much worse. It was a subtalar dislocation meaning not the actual ankle joint but the joint just below that. This means that my ankle joint was still intact and also means there is less chance of an associated fracture or the need for surgery to stabilize things. I do plan to followup with an orthopaedic surgeon with my xrays just to be sure but if the internet is right (and it so often is) then my prognosis looks pretty good. Three weeks nonweightbearing, then physical therapy and I should be right as rain.

I've even cheated some and put a little weight through the foot and it seems tender but not overly so. I've also been doing some nonweightbearing motion and have decent range of motion already, so hopefully rehabilitation will be a breeze (famous last words). I must admit that in a city where motorbikes are the main transportation, life with an injured leg isn't easy. I'm basically stranded unless I call a cab (there are only a hand full in town) or hop on the back of someone's bike crutches in hand. Needless to say, I won't be purchasing my own motorbike any time soon.




I did make it out of the house today to see an apartment. I'm sharing with an Australian woman I met since being here. Two bedroom, one bath for $500 a month....and prices have basically gone through the roof lately. That of course includes aircon, internet, water, etc. It also includes a guard at the front gait, a maid who cleans daily, does the laundry and dishes. Basically I will be paying $300 for a housewife/mom and an apartment. That's a long way from San Francisco prices. You can see why people get spoiled living here.....now if only I could higher someone to carry me up and down the 3 flights of stairs :)

Wednesday, January 18, 2012

And my world crashes to a halt

Never in my life have I been in a hospital as a patient, until last night. My new project coordinator/boss invited me to attend a weekly netball game she attends on Tuesday nights. Apparently, netball is a cross between basketball and ultimate frisbee and is played on a basketball court. A group of ex-pat women get together and play once a week here in Vientiane. Kerryn, my boss, assured me it's not competitive and really more of a social thing and a chance to get a little exercise. I readily agreed to join.

Now I don't blame netball in any, way, shape or form, but I'm pretty damn sure you will never catch me playing that idiotic game again, ever. Long story short, I was running to defend my opponent and my foot stopped but my body kept going. I took a hard fall and looked up to see my foot rolled under me at a 90 degree angle, a very abnormal, inhuman, and sickening angle. I assumed my leg was broken as I had felt some kind of snap, pop, as I hit the ground. I swore and cried, cursing my damn bad luck.



Luckily, the women I was with were fantastic. They called the local French clinic emergency line and got the French doctor and PT to meet us at the clinic just around the corner. A couple of them managed to scoop me into Julie's (one of the women, who before then I had never met) SUV and pull together my passport (for the inevitable trip into Thailand) and health insurance. The French doctor and PT took one look at my foot and suggested making haste to Udon Thani and the hospital there (2 hour drive). The PT asked if my foot had been normal before this accident (which goes to show just how awfully abnormal it looked). I was then mercifully given a shot of morphine.I can't describe the feeling of seeing one of your bodyparts headed in the wrong direction. Somehow it is quite difficult to wrap your brain around it. It seems to send your body into a state of shock.

So with Kerryn supporting my leg on her lap, Julie driving and another wonderful woman, Sang (who speaks Lao) accompanying us, we made the 2+ hour drive to Udon Thani. The first hour wasn't so bad, as I was high on morphine and the pain was a persistent but background noise. However, the morphine faded and an intense burning that I could only guess to be nerve pain took over. I began breathing like a woman giving birth and sobbing uncontrollably. I have been lucky enough to have few serious injuries in life, and this pain was like nothing I had ever felt before.

I can't imagine how that last hour felt for the poor women in the car with me, but I remember it as being the worst of my life. Somehow, we made it through the bordercrossing with only minimal complications, and I eventually found myself being wheeled into the emergency room at Auk International Hospital. I begged for more pain killers as they removed my shoe and sock. I admit I could not bring myself to look at my foot at that point but someone managed a picture that I will share soon, it really is rather mindboggling. The ER doctor consulted "the" orthopaedic surgeon who was currently in the OR.

I was taken to xray and the morphine began to once again numb the pain. From my hospital bed I could see the xrays, showing no fracture but a dislocation of some kind. Turned out my talus (the bone that articulated with the tibia and fibula) had dilocated laterally (to the outside of my foot) and the rest of the foot moved in, hence the odd, inhuman angle.

Given this information, the ER doctor informed me that they would need to straighten my foot "some" and immobilize it to prevent nerve damage while we waited for the orthopaedic surgeon. I would then need surgery. So I couldn't eat or drink water although apparently morphine makes you crazy thirsty. The straightening of the foot wasn't exactly enjoyable but as I heard and felt the loud pop of the talus reducing, I knew things were headed in the right direction. Kerryn assured me my foot was back to where it should be and I could move my foot again, something I had been aching to do for the last 4 hours.

So, we booked the VIP2 hospital room (medical tourism :) ) and after an xray to confirm a reduced ankle and no need for surgery, we all attempted to get some sleep. I spent the next few hours feeling relief like I have never felt. Seeing you foot in such a horrible position is quite traumatizing and scary. I had been sure surgery was in my future. Instead I am in a splint for 3 weeks non weightbearing on crutches and then starting physical therapy and rehabilitation. Not looking forward to the next few months but counting my blessings for how much worse it could have been.

It's been an emotional and scary last 24 hours. I am moving in with Kerryn to her spare room for a temporary solution to my homelessness and lack of manueverability. Then hopefully I will get some decent sleep and start to recover. I must say that my compassion for my patients, especially those in the hospital, has increased exponentially. Crutches are no fun, and I'm so happy my one leggedness is only temporary!

Tuesday, January 17, 2012

Never thought I'd own a motorcycle...

and I don't yet, but soon. I bought my motorbike helmet today. I've been borrowing them as needed but now I officially have my own. So at least my head is protected....and I look pretty badass too. My assistant is taking me motorbike shopping tomorrow as well. The one thing is that it's too damn hot to wear a good jacket to protect from roadrash....drive defensively right?
Good look for me, right?

Monday, January 16, 2012

The sense of relief that comes when...

the fear of a new adventure drops away and you find yourself settling in for what looks to be an amazing ride.

I ended my second Monday at work with that brilliant feeling.

 Our program coordinator returned from Holiday today and went to straight to the task of getting me oriented and put to work. I have to say that I'm quite excited about this new position I have and the general work prospect in Laos. The organization I'm working with is pretty amazing, has some great funding sources and smart philosophies about working in a developing country. I enjoyed getting a better understanding of how the organization works and my place in all of that.

Apparently, Laos culture has some very specific aspects when it comes to work and prosthetics and orthotics. First of all, we work 8:30 to 4:30 with an hour and a half lunch break....not bad :). Secondly, things go very slow. Every item of business takes multiple people and lots of bureaucratic stamps of approval. In fact, since our director passed away last week....everything is on hold until we get someone from the ministry of health to sign off on everything we're doing. I guess it's a lot like the university setting in that way...

I'm looking forward to spending some quality time with the prosthetic and orthotic team tomorrow and seeing how they do things. So far, it's mostly been lots of paperwork, planning trainings, etc. With the idea of sustainability and being locally run, I won't actually have much patient contact over the next year, except for consults now and then. I play the role of mentor, evaluator, and development. I will be spending most of my time developing methods for things to run more efficiently, introducing new materials, methods and technologies, and reporting back to the funding sources about what I'm up to. I look forward to the experience and while I'm sure there will be lots of frustrations, have high hopes for the next year.

Also, just a disclaimer that almost every expat I've met in Laos only intended to stay a year.....and is still around. As one person said "people seem to get stuck here.....in the best possible way."

Saturday, January 14, 2012

Random photos


I love this buddha carving. It's about
three times as big as I am.

Cool old car and beautiful hotel down the road.

Cute little munchkin.

So many amazing temples all over the city.

And monks are all over the place. I love the orange robes.




Beautifully ornate, some of the temples are just breathtaking.



Offerings at Impeng temple.


The Laos Way

My first week is in the books. I can't say it's been all fun and games but it has definitely been memorable. Work has been slow to start, primarily because the Expat team I work with has either been on holiday leave or on work trips to the provinces. Speaking of which, I just read the statistic that 70% of Laos is inaccessible via road! Apparently the beautifully paved roads of Vientiane lead a few kilometers out of town and then abruptly end....I plan to confirm this, once I purchase a motorbike.


This is a statue at my work, made completely out of unexploded ordinances, a major cause of death (200 annually), amputation, blindness, etc. in Laos PDR.

Thus far, I've been using the COPE bicycle to commute to work. I figure I'm easing into the motorbike thing. The roadrules or lack there of are quite interesting. Primarily, Laos drivers don't EVER look behind them. You are responsible for the people in front of you, end of story. That may take some getting used to. Also, while they drive on the right side of the road here, it isn't uncommon for motorbikes to cruise along the left when it's convenient. In general, road rules seem lenient at best....
investing in a good helmet for sure :). And just about everyone in town rides a motorbike, young women, old women, babies, falang, monks, everyone.

This is the casket covered in an elaborate display. 
I spent much of today recovering from a beerlaos hangover....the downside to making new friends and saying goodbye to the former director of the National Rehabilitation Department who passed away last Tuesday. The funeral was quite beautiful and quite the cultural experience for me. The director was quite an important and well loved man in Laos and the funeral directly reflected this. There was a crowd of probably three hundred people including many government officials.

The process of saying goodbye to a loved one in the Buddhist tradition is quite complex. There are a number of rituals I didn't fully understand and many prayers spoken in Laos that I can only guess at the intentions of. The director died while away from his home, so his body was brought to the gymnasium at the National Rehabilitation Center rather than taken home. The last week has seen a continual vigilance by the deceased's family over his body, with it being essential that someone sits near the casket at all times. A number of my coworkers stayed until early morning, keeping company of the family, cooking food, and playing card games. I don't quite understand the vigilance, but I believe it has to do with the deceased's spirit which is later released when the body is burned.



The director served in the military and was well decorated,
hence the uniformed pallbearers.

This morning, the monks from the director's temple came, blessed the body, dressed the family in monk/nun robes and accompanied the procession of the body to the temple. The whole process is quite laborious due to the large amount of flowers, offerings, etc. that people have placed over the last week which accompany the body and are burned along with it, including suitcases of the director's clothing and possessions.

The family, dressed at monks and nuns, leads the casket to the temple via a long white sheet. The immense display is then re erected at the temple, followed by speeches, blessings, and finally the burning of the entire display.

The final act of the funeral, burning the body and releasing the spirit.

Tuesday, January 10, 2012

A First Time for Everything

Today was a day of firsts. It started out with me finding my first mosquito bite....the first of many I'm sure. It's the dry season now and apparently come wet season, you can't tell the raindrops from mosquitos....care packages of deet anyone?


Tuk tuk - local taxi cabs....much safer than my motorbike or bicycle.

I am apartment hunting currently and thus have been doing more of that than work. So my assistant/translator took me on the back of his motorbike this morning to view a couple of places. Luckily traffic is light midday, I managed to keep my skirt out of the exhaust pipe, and my hands are only slightly sore from hanging on. Soon, my boss' son will be giving me motorbike lessons and then unleashing me on the road....that's a scary thought. Especially since I also managed to ride a bicycle home from work today and am thanking my lucky stars I'm still in one piece. Given the number of tourists on motorbikes and bicycles around here, I like to think the locals are use to them and give us farangs (foreigners) a wide birth.

I also had my first instance of helping tourists. A sweet couple from San Diego struggling to read the map and finding no help from the non-English speaking locals.  I talked them into visiting the COPE visitor center (my new place of employment)....which you should check out the website and maybe consider a donation to their wonderful cause :). http://www.copelaos.org/. It felt good to have the ability to help someone out and gave me a little boost since lately I am the stupid tourist making mistakes and looking silly.



Sunday, January 8, 2012

Wandering Vientiane


Currently I'm living out of The Day Inn, a little hotel near "downtown" Vientiane. It works for now, but the plan is to find a house or apartment shortly and settle in a bit more. Having lived in SF for the last 5 years, I'm having reverse sticker shock here in Laos. Most apartments in the city are $250-300 for a 1 bedroom.

I spent today wandering around Vientiane, stumbling into Buddhist Wats (temples), and soaking up the sunshine. I will admit to getting lost, although only slightly, and with the Mekong river as a southern border, it's hard to get too distressingly lost. Somehow it seems that getting lost is often the best way to orient oneself to a new city anyway. I stumbled upon a number of restaurants, food carts, and bars that I will surely seek out again in the near future. I also happened upon my new place of work, to which I will be formally introduced tomorrow.

I also found the local hospital, which the ex-pats joke about viciously....aparently not somewhere you ever want to have to visit. Luckily, I've been told that there are a couple of clinics at the French and Australian Embassies that are quite good, should healthcare be required. With that in mind, I still think I'll invest in a bicycle helmet for scooter and bike riding purposes.


Saturday, January 7, 2012

The Journey

The last 33 hours have been some of the longest of my life; 18 hours of flight time, a 12 hour layover in Vietnam, and nothing resembling decent sleep or a shower of any kind.....but for those of you considering coming to visit at some point....it was an absolute pleasure, you'll love it. :)

I feel like I've already discovered what undoubtedly will continue to be a recurring theme for this journey I'm on; Humility. There is nothing more humbling than being the idiot gringo who can't speak the language and knows next to nothing about the culture. Good practice at letting go of my ego.

My journey was going well until I arrived in Seoul, Korea and was asked for my visa for Vietnam. My stomach dropped as I realized I never even considered that I might need a visa for my layover in Vietnam. Luckily, I'm not the first (nor likely the last) ignorant American to make this mistake. Having an overnight layover in Vietnam wouldn't be such an issue, except the airport closes at 1 am, and I can't leave the airport without said visa. Luckily, the Korean flight attendant was very helpful, if not a little condescending as he tried to rectify my f-up. The compromise was that they would let me on the flight as long as I promised not to leave the airport and signed a form accepting full responsibility if Vietnam didn't take kindly to my lack of visa.

Long story short, I'm not in a Vietnamese jail.....but I did spend the longest night of my life sleeping on cold metal seats in a freezing, eerily empty, and dark Vietnamese airport. Luckily, I had stolen the blanket and pillow off my last flight knowing I would likely be crashing on the floor somewhere. However, the Vietnamese apparently don't believe in heat or insulation, and I spent much of my night putting on layer after layer of clothes trying to get warm enough to fall asleep. Apparently I did drift off at some point, as an airport security officer prodded me awake around 2 am to interrogate me about why I was sleeping in his airport after hours (closest I have ever felt to being a bum).

All in all, it's been an exhausting couple of days...but the little I've been able to see of Laos so far has me very thankful to be here and looking forward to my adventures ahead. Right now, it's time for some much needed sleep.