One worm too many

This post is about my intestines. I share this not to gross anyone out, but to cast light on some failures in our US diagnostic system. And, well, because I’m a traveler and that’s what we do. So if you can take it, or share frustration with our own health services in the US, then read on.

For a couple years now I’ve been struggling with some form of digestive trouble. It came on quite suddenly while I was traveling in France a couple years ago.  My bowel movements stopped. Entirely. For two weeks. I started experiencing a searing pain in the right arch of my foot that would come on with absolutely no warning and would paralyze me with pain. Though it would only last ten seconds at most, the pain was so intense I would often break into a sweat. It started randomly, and at long intervals, maybe once a day, then sped up, hitting more than half a dozen zings during our flight home. I was in agony.

Once home, the doctors ordered a stool sample to rule out parasites, then moved on to more frightening examinations and ultrasounds of my ovaries, my cervix and my entire abdomen. Nothing. I was sent to a podiatrist for the foot pain (no, not gout, or plantar fasciitis, or anything else anyone could identify). I became increasingly convinced that my foot pain had nothing to do with my feet, but moreso with my internal organs. More blood tests, more radiology. I was told I was simply getting older. I should drink more water, eat more yoghurt, buy some supportive, expensive tennis shoes, deal with it. Definitely not satisfying. Lessening my sugar intake helped my foot pain immensely. Still, I embraced suggestions: I ate more yoghurt, drank olive oil, chugged magnesium, ate apples by the pound, drank water and moved daily. Over the years, we stopped short of a colonoscopy, mostly because at the time, and just before leaving the country, I had to undergo unrelated surgery, and didn’t have it in me to add on a scope of my nether regions, as important as it surely is to reading my general health.

Over time, my foot pain mysteriously disappeared with only occasional flare-ups, and I had become almost accustomed to the other intestinal challenges. So I was pretty upset when, after several weeks in Mexico – and perhaps fed by the twice-daily ice cream binges –, my foot pain came back, with a vengeance. I needed to find someone who could look at my foot pain as being integral to the rest of my body, and not solely about my foot. I called on a doctor most often recommended in this Mexican town and told him my tale. He had no answers but said he too would start at the beginning: with a stool sample, three in fact, because “one sample is never enough. Any doctor who only performs one doesn’t understand parasites. Or stool samples.” Hmmm.

Well, you can guess what happens next, right? We were equally surprised when tests showed I had a rare parasite, one so rare that he had never treated this, and had no medication for it. It was so rare in humans, in fact, that treatment is to be reported to the CDC, one site informed me! The little fella may have been with me for years, and MAY be causing some of my distress. May be? We finally tracked down and ordered the meds from Guadalajara. I consulted with some Santa Fe doctors, one of whom said to go ahead, the other told me to run the other way fast as the side effects included suicidal depression. This doctor told me to keep the parasite, informing me that worms have been used to treat autoimmune diseases, decrease inflammation in the gut and that I should celebrate this infestation. Rejoice! She also insisted the parasite, otherwise known as a Rat Worm, couldn’t possibly have to do with my inability to go to the bathroom. But while researching, I learned that parasites very often cause constipation, which can’t be good for my body no matter how I looked at it. I mulled this decision over for weeks, but finally decided that if there was a chance this could help me in the long run, I couldn’t pass it up. So here goes, dosing on some of the strongest meds I’ve taken in a long, long time. Wish me luck.

As I write this post I am reeling from this powerful medication. I’m left to wonder at the costs of all the tests I have already undergone, and more importantly, at their accuracy. Do I actually know what’s wrong? Could this parasite be the cause of my internal distress? Were the docs and nurses who did previous examinations exhaustive? Or even precise at all? I can’t help but question. If only they had accurately done a stool sample several years ago, would I have suffered so long? Then again, no telling if this medication will treat all of my symptoms, or any of them.

The one message I’m left with is that I was right. Not that I know if this is the true cause of my distress; what I mean is that we so often know when something isn’t right in our bodies. And I definitely knew something wasn’t right, regardless of how many people told me I was just getting older, or wasn’t eating enough yoghurt. I had no idea it was a parasite, but I’ll take that any day over something more serious. And if this worm, which Aiden has affectionately named Fred, has helped me in keeping my, uh, girlish figure, then I thank him. More importantly, I hope that it has not been key in providing me with an incredibly strong immune system, from which I have benefitted for many years. Because by taking this drug, I’ve decided that Fred has been up to more nefarious dealings in my body. I am deciding to eliminate him with toxins I am not entirely comfortable with, all in the name of trying to answer questions about my health that have plagued me for several years now. So, Fred, be gone with you now. It is with much gratitude that I am asking you, telling you, and then letting you go. 

Leaving San Miguel and History as some know it.

Hierve de Agua with Zubin and Ciela

Hierve de Agua

Me and Captain Nibbles, my Xmas present

Mitla

Wall art, Oaxaca City

Hotel Delphinus seconds as a stray dog shelter.

Chahue Beach in Huatulco

My baby after a bath

Turtle release in Puerto Escondido

Textile Exhibit outside Oaxaca City

We left San Miguel de Allende in early December and en route to Oaxaca spent several days in the magical capital city of Mexico. With a population hovering around 21 million, it’s the fourth largest in the world, and the grayish stained skies remind us every day of the impact of growing populations everywhere. Yet Mexico seems to have an infrastructure that somewhat sustains the masses, and like New York, city segments are separated into boroughs or neighborhoods, where one can live in a small region with few reminders of the surrounding chaos.

Mexico City has beautiful architecture, and a main park several times the size of New York’s Central park. It has amazing food, museums, and dedicated art and creativity that extend through the city. It also has amazing wealth and poverty, and like so many big, metropolitan cities, a chasm between the classes that only grows.  We visited the murals of Diego Rivera at the Palacio de Bellas Artes depicting the history and struggle of Mexico through the ages. We visited the floating markets of Xochimilco, now a busy weekend draw for tourists and Mexican families out for a Sunday picnic. The miles of canals are bogged with brightly colored barges carrying families, young lovers, teenage drinkers, interested tourists, singings bards and vendors of random food items. Next day we made our way to the spectacular pyramids of Teotihuacan, whose fall is still little understood. Increasingly, our guide told us, its fall is thought to have been caused by internal conflict (and certainly not external domination by Spaniards) and climate disruption. Change of rainfall patterns certainly were impacted by cutting all the trees, but there’s more. Originally set near a lake controlled by smartly placed dykes that controlled annual flooding, the Spaniards didn’t understand the native system of flood control and nor did they like the floods. So with little foresight, they drained the lake. No water, no life.  Sound familiar? We’ve seen this evidence throughout Mexico.

The amazing Monte Alban

While we’re talking about history, here’s a brief aside: Outside San Miguel there are roughly 1400 archeological sites that have been registered but have yet to be excavated. There is no telling how many people once lived and flourished in this region but according to the new book “1491; New Revelations of the Americas before Columbus” by Charles Mann, there could have been more than 25 million people in the Central Mexican plateau alone, more populous than Spain and Portugal combined. Another way to look at it, writes Mann, is that by the time Columbus arrived, there were more people living in the Americas than in Europe, with epidemics wiping out a great majority. The book is amazing, by the way, and reminds how little we actually know about our own history, and how subjective (read: so very Eurocentric) that history is.

From there we flew down to Oaxaca city, very recently known more for teacher protests turned violent, including the death of a Mexican Journalist covering the protests. It’s also an extraordinary region divided into 7 different geographic regions with dozens of indigenous communities and languages. It’s know for food, traditional crafts and as far as I could tell, a deep sense of rebellion against authoritarian rule and corruption. It’s my kind of place. We spent a lot of time simply trying to connect with some other expat families, but mostly in vain, oddly enough. We befriended some Mexican families, but mostly wandered the streets of central Oaxaca trying to get a sense of what life might be like on a day to day basis. Despite it’s reputation as a food haven, I didn’t find a favorite spot, though we did find a great Italian ice cream stand where we spent many, many hours. But after a wonderful month, made far better by visiting friends from home, I left feeling isolated. I also felt that extended time there might increase that feeling of isolation, despite the warmth of the people we met. The high point was feeling clarity about my need for community and connection regardless the place. Anyone living abroad has to eventually form a community and has to feel confident that that community will be supportive and embracing. But I never fully felt that possibility. Despite it’s enriching culture and beauty, I’m not sure Oaxaca is for me long term.

Puerto Escondido

But perhaps its beaches are? We decided to actually take a “vacation” and head to the southern beaches of Mexico, along the Oaxacan coast. Highly recommended from our travel agent were the calm bays of Huatulco, known as a resort destination with some nods toward sustainability. I say nods because resort and sustainability do not mix. Ever. No matter how many little signs management puts up for guests to consider water usage before asking daily for fresh towels. That, while the gardener is pouring literally hundreds of gallons of water on a small patch of grass so guests can experience bright green upon entry. Sorry, but resort and sustainable do not go together.

I found our hotel by accident. I was surfing various option while discussing details with the agent. I tried to merely bookmark something that was remotely in my price range, and discovered the booking could not be cancelled. We were going to hotel Delphinus – wherever that was. It turned out Delphinus was a bit of both heaven and hell on the coast. Doubling as a dog sanctuary, we discovered a small room with 9 small but extraordinarily beautiful puppies set off the main entryway. We were indeed in heaven. Bless them for allowing dogs and for doing the work to help strays, but the owners had two devil dogs of their own who barked morning, noon and night. Every day. Every hour. Brutal. I changed rooms only once, and at least was able to partly sleep through the night before heading off. Still, it was worth it to be able to see those sweet little faces every day.  It also helped that the beach directly off our hotel was the finest, funnest beach around. In fact, had we not paid in full at our next hotel in Puerto Escondido, I would immediately head back for more. But alas, one decision always negates another. This, I learn every day. That darn road not taken… story of my life.

From Huatulco we took a taxi west. Aiden was feeling sick and I was feeling lazy and sick, so a taxi seemed a minor price to pay for comfort and speed.

Puerto Escondido is pretty much what I thought it would be – but bigger. I was hoping for a dusty, overrun surf town, where fruit smoothies and yoga studios dotted every corner. Instead, it’s a tourist-laden, messy place with lots of drinking and smoking and dangerous beaches. We’re set apart, having to walk or take a taxi to any restaurant, fruit stand or even swimmable beach. We’re blessed with a great hotel pool, but no internet access, and a growing feeling of being trapped. (How did we live before internet, I can’t recall?) Puerto Escondido, even moreso than Oaxaca City, is probably not for me. So process of elimination might be working well in terms of determining our next year.

But it’s all about decisions, and in this case, having too many. Choosing anywhere or anything possible—within financial reach, that is. And in the big scheme of things, considering the world’s poverty, our reach is far.  Which makes decisions all the more difficult.