Therapy & Buses - June 30, 2011

Physical Therapy:

Last night again we did not sleep well.  Last night Eric's leg was twitching for an hour, which it normally does not do, so maybe that is a good sign.  Then this morning the construction next door started bright and early at 6:30am.  We tried unsuccessfully to sleep through it.  After the free breakfast at the hotel, we headed to therapy. 

At BioFit, Alexis stretched Eric's legs then made him do 200 crunches.  The workout portion focused on pushup type exercises. 

First Eric did pushups.  Then he did single arm raises from a pushup position.  He held himself up in a isometric position on his forearms.  He rolled himself back and forth lifting an arm at each side.  Finally he did one arm "superman's" laying down and lifting an arm which works on lower back extensions.

Panama City Buses:
After returning to the hotel, Tracy went to try to take pictures of the colorful city buses.  These are old U.S. school buses shipped to Panama.  Local people buy them and some paint them with exquisite drawings.  Our understanding is that Panama is going to put in a metro service and these buses will go out of service and be replaced with standard (boring) buses and the same drivers will be hired to drive them.

At night this bus lights up in multi color LEDs that change from green to red to blue.  It is super cool looking.

Therapy & Injections - June 29, 2011

Our van picked us up at 10:30am to go to BioFit.  At the BioFit waiting room we met another stem cell spinal cord injury patient.  He was injured at his T6 / T7 in a rodeo 6 years ago.  Three years ago he received a single stem cell injection in Mexico and did gain some improvement.

Eric's therapy began with stretching and range of motion with his legs.  Here are pictures of the daily stretches.

 

 

After stretching it was time for 200 crunches.  We were both pretty tired today from not sleeping well and I do situps along with Eric so we both kind of groaned when we started.

Today's exercises were focused on shoulder workouts.  First was a single arm shoulder press with the added bonus of sticking the other arm straight out holding a weight.  Brutal!  Then Eric held a weight with two hands and rotated it around his head in both directions.  He did three sets of those.  

Next was fun exercises that still worked the shoulders.  First he  bounced a huge ball on each side lifting it over his head for transfer to the other side.  That was followed by a game of volley the medicine ball with Alexis. The ball was aimed head high and over each shoulder.

A little after noon we left in our van heading back to the hotel and on our way we got stuck in a traffic jam. Since we were supposed to be picked back up at 1pm for a 1:30pm injections, we were eventually rerouted to go directly to the Stem Cell Institute.  We got there early so we had to wait a long time.  Because we had not gotten to go back to the hotel, we did not have books for the wait and Tracy did not get to grab a jacket which is needed for the ice cold air conditioned facility.  Eventually Eric got brought back into the small clean room for his spinal injection.  Then suddenly there was a huge boom of thunder.  The sky opened up and it down poured rain flooding streets outside and continued to thunder and lightening.  Eric's spinal and IV injections went smoothly.  This is his first of two bone marrow stem cell injections.  

Because of the flooding and increased traffic, we had to wait even longer to get our ride home.  We eventually got back at 3:45pm starving from lack of lunch!  We debated going straight to dinner but decided to go eat snacks in the room so Eric could lie down and we will go eat dinner later.

Standing Exercises - June 28, 2011

BioFit physical therapy today began with the standard range of motion stretching of Eric's leg's then 200 crunches with a medicine ball.  

Today's exercise focused on standing exercises trying to remind Eric's body how to stand up.  Eric was unable to push himself into a standing position.  He needs something to grab onto to pull himself up.  Alexis used a cross hand grab and partially pulled Eric up while Eric tried to remind his body what it should be doing.

Schedule for the Final Week - June 27, 2011

Here is the schedule for this week:

   Monday :          BioFit in the morning.  8^th IT injection in the afternoon

   Tuesday :         BioFit in the morning.

   Wednesday :   BioFit in the morning.  1^st IT & 1^st IV of Bone Marrow stem cells in the afternoon.

   Thursday :        BioFit in the morning.

   Friday :             BioFit in the morning.  2^nd IT & 2^nd IV of Bone Marrow stem cells in the afternoon.

   Saturday :         Fly home !!!

Today’s update:

The BioFit therapy began with range of motion stretching for Eric’s legs.  The workout portion focused on balancing exercises from a sitting position.  This included catching a ball and holding a ball and moving it various ways without losing balance.  Eric did pretty well, though did occasionally lose his balance.  We got back to the hotel and only had 30 minutes until our pickup to go to the Stem Cell Institute.  

This was Eric’s final spinal cord injection with the umbilical cord stem cells.  Eric was done within 5 minutes and we spent most of our time waiting to be picked back up again.  Back at the hotel Tracy went to buy a Subway sandwich so we could eat and then Eric could lie down for a few hours.

Driving Tour - June 26, 2011

Osvaldo, Eric & Scott overlooking Panama City

At midday our hired driver, Osvaldo, came to pick us up.  He drove us up to the highest hill 300 meters above Panama City.  This hill used to have American military housing.  There are still very nice houses there mostly owned by and rented by Americans.  

 

 At the top of the hill on one side is a view of Panama City and the Casco Viejo peninsula.  

Panama City

Scott and Eric above Casco Viejo

The other side is a view of the American bridge and Pacific side entrance to the Panama Canal.  The views were fabulous.

American Bridge at entrance to Panama Canal

 

Pacific entrance to Panama canal leading towards the Miraflores Locks

Next we drove through Casco Viejo where our driver pointed out some of the historic spots and restored buildings.  We drove through a very impoverished and run down area to get to the nicer restored area.  Next we went to the Amador Causeway to have lunch overlooking the ocean.  We debated quite a while on which restaurant and eventually settled on a nice Italian restaurant which had indoor seating because it was extremely hot and humid out today.  After we returned to the hotel.

Panama Flag

Time to relax and prepare for our final week of treatments before heading home next Saturday.  We are looking forward to going home next weekend!

Walk Adventure - June 25, 2011

Usually on Saturday's we venture somewhere new.  This weekend we decided to wait until Sunday, where we are hiring a driving to take us a few places in the city.  We have done most of the local touristy things already.  It turned out to be a good decision to wait until Sunday because not long after breakfast it started pouring rain.  So it was supposed to be a lazy get some rest day anyway.  We spent the morning reading and relaxing then had lunch in the room eating food that we snagged from the breakfast buffet in the morning.  By the afternoon it had stopped raining and Tracy had the itch to get out of the room.  Eric eventually, begrudgingly, agreed to go on a walk (roll). 

 

Panama City and our favorite spiral building

Determined to make it to the ocean seawall, Tracy directed them through the streets and sidewalks.  We almost got stumped at two chains blocking a throughway that had not been there the day before.  We had to go that way because the sidewalk was under construction.  Eric got under the first one without issue.  The second one was in the middle of a down sloping ramp which was wet from the rain.  Ugh!  But we were almost to the destination and we were not turning back.  Soooo Tracy held on for dear life trying to keep him going really slow downhill while her feet slipped along the pavement.  When Eric got to the chain, he lifted it over his head and proceeded to start falling backwards.  I held on and just barely squeaked under the chain myself and kept him from hitting the ground.  It was a scary moment for both of us!!!  From there we only had to get to a crosswalk and a walking overpass to get to the ocean front walkway.  We rested for a while staring at the ocean and view before heading back to the hotel.  

Cargo ships waiting their turn to enter the Panama Canal

On the way back we took a different route.  Overall we fared pretty well except for another intersection with sidewalk under construction.  We were forced to go through some dirt which turned into a really muddy sticky mess.  It was red mud that stuck to Eric's chair and would not come off.  Since he pushes his wheels with his (gloved) hands, it got on his hands, spread to his pants and shirt and legs.  Yuck!  So back at the hotel room he not only had to shower himself but also his chair.  I guess we should just consider it another lesson learned about being in a wheelchair and the types of things we have to deal with.  Overall I was really proud and exhausted that we had made to the ocean and back.  I think Eric was just exhausted and dirty.

Pretty church we pass every day

A local statue at the ocean front park

     

Bio-Fit & Injections - June 24, 2011

The Bio-Fit therapy started with stretching and range of motion with Eric's legs.  Next was abs.  Alexis increased to sets of 50 for a total of 200 crunches holding an 8 pound medicine ball.  Today's workout was upper body and Alexis showed Eric some new methods for bicep and shoulder workouts using cables. 

We met two new patients with spinal cord injury that started their treatments this week.  Joseph was injuring diving into the ocean and hitting a sandbar and injured his C4/C5 resulting in paraplegic condition.  Chris was injured when when he was clearing trees in his backyard and a tree fell on him injuring around the T6 leaving him paralyzed from mid-chest down.

Tracy & Eric, Joseph & Kelsey

After finishing physical therapy today, Eric returned on the van back to the hotel and Tracy went for a walk. The Pacific ocean is only a few minutes from Bio-Fit and there is a walking path that goes along the ocean seawall.  There are no beaches near Panama City; I think the closest is an hour away.  Within 15 minutes I was over enjoying the fresh ocean breeze, looking at the cargo ships in the ocean waiting to go through the canal, and enjoying looking at the scenery of Panama City.  The walk back took 30 minutes and I evaluated whether or not I thought I could get Eric all of the way from our hotel to the ocean front in his wheelchair.  

When I returned it was time for lunch, then back into our van to go to the stem cell clinic for injections.  Today Eric had a lumbar puncture in the spine and an IV injection.  They has some issues finding his vein in his arm and eventually used a vein in his hand for the IV. 

Upon returning Eric is supposed to lay down, but that only lasted 30 minutes today because by the time we got back we were hungry for dinner.  Scott had found that we could order Pizza Hut pizza and have it delivered to the hotel.  So we had the front desk order us pizzas and they guys laid down briefly while it was delivered.  It actually did taste like a Pizza Hut pizza, unlike the local pizzas which are very thin and have a miniscule amount of sauce.  After we enjoyed the pizza together in our room, Scott returned to his room and Eric did laid down.  He never got a headache, though his lower back was sore from the injections.

Bio-Fit and Dinner - June 23, 2011

 

Eric had a very full therapy session today.  The session started with standing exercises, which I think is good practice for Eric, especially since he does not have a standing frame here to use like at home.  Next he sat in his chair and performed exercises focusing on abs and balance.  He held a weight in his hands and moved it side to side and up and down.  He reached for an object (forward, sideways and up) and pulled himself back trying to use his abs, and finally he bounced a huge ball on each side, catching it then moving to the other side.

  


In the afternoon we had light snacks because we were going to an early dinner with Julie, Scott, Abul and Dhoha as tomorrow is their last day here.  We went to Bennihana, a restaurant I have not been to since I was a kid.  We had fun watching our cook and enjoyed the food and company together.

Bio-Fit, Injections & Lightening - June 22, 2011

On days Eric has Bio-Fit therapy and injections it is a busy day.  


Therapy started with stretches and abs.  Next Eric worked through a bunch of exercises from a kneeling position.  These were to focus both on abs strengthening, balance and upper body strength.  He performed arm lifts, push ups and a military exercise.

After therapy I picked up a Subway sandwich to eat back in the room later.  A few hours later we were picked up and taken to the clinic where Eric received another lumbar puncture (in the spine).  Back in the room Eric rested and read for a few hours.  

Tonight was the big Panama vs US futbol (soccer) game now in the Americas tournament semi-finals.  Last week Panama beat the US but both teams moved onto the semi-finals.  Eric, Scott and I went to Scott's favorite restaurant around the corner.  It was very quiet tonight because most people were watching the games in one of the two casinos across the street.  Our restaurant did have a TV though and we stretched dinner and dessert to watch the whole game.  This time the US won and advances to the finale against Mexico.  While I am proud my country won, I feel bad for the Panamanians who are really, really into their futbol.  Back in our room that night we were entertained by a magnificent lightening show with ligthening shooting across the sky in the distance.  It went on for several hours.  There is frequently lightening in the evenings which we enjoy watching.

Bio-Fit Therapy - June 21, 2011

Today at Bio-Fit Eric went straight into an upper body workout.  At the end of the session Eric performed the standing exercise where he pulls himself up and the trainer locks out his knees.  It was nice to see him tall again.  It was a good workout and the hour went quickly.  Here is a picture of Eric and his trainer Alexis and Scott and his trainer Arnando.

All day Eric had a minor headache.  He has also been suffering some hip pain, a problem which he had before he came to Panama and the pain comes and goes.  We are also both a little discouraged that Eric has not seen any changes that would indicate the stem cell injections are working.  With all that, Eric did not want to do anything today so we spent the afternoon in the hotel room reading and watching TV except for a brief trip out for dinner.

This Week's Schedule - June 20th, 2011

Here is the schedule for this week:

   Monday :          BioFit in the morning.  5^th IT and 3^rd IV injections in the afternoon

   Tuesday :         BioFit in the morning.

   Wednesday :   BioFit in the morning.  6^th IT injection in the afternoon.

   Thursday :        BioFit in the morning.

   Friday :             BioFit in the morning.  7^th IT and 4^th IV injections in the afternoon

Today’s update:

The first half of the BioFit physical therapy was stretching and abs.  For today’s workout Eric sat and got to have fun punching.  He put on boxing gloves and then had to keep his balance while going through a series of punches: both hands punching forward together, right hand punching to the left while holding the other arm out for balance, then switching to the left hand cross punches holding the right hand out, cross punches right – left – right – left, side jabs, then upper cut front punches.  Eric was very focused and had fun.

 

In the afternoon Eric went for his injections.  He had his 5^th injection in the spine and 3^rd IV injection with umbilical cord stem cells.  His last two injections next week will be with his bone marrow.  We are now back in the hotel room and Eric is laying down for a while before dinner, though luckily he has not experienced any headaches or extreme exhaustion that some patients feel after the injections.

Adventure Day - June 18, 2011

It is the weekend and our day to see more of Panama.  Today we decided to go see some native wild monkeys and challenge ourselves to get Eric and Scott onto a little boat.  Should be exciting!  Our guide took Eric, Scott and I on a nice drive to the to the Gamboa rainforest.  The drive took us further along the Panama canal and through some rainforest.  At our destination, my challenge was to get each of the two guys transferred onto low fiberglass tourboat.  With a little help from the tour operators, I got each guy down into the boat and seated.  Phew!  Hmm, not sure how we will get them back up, but we can figure that out later.  

 

The boat took us into the Panama Canal lake portion.  We passed several huge container ships which are soooo amazing and impressive up close.  Our destination was Monkey Island.  The driver was quickly able to locate Howler monkeys taking a siesta in a tree.  

 

Next he found the White Faced monkeys.  They are very active and love eating bananas, mangos and baby alligators.  One banana was offered and two monkeys rushed the boat.  We were told not to move and don't try to touch them.  One jumped on top of the canopy then leaned over and looked down at Eric; pretty cool!  

As we continued cruising the lakeshore, the boat driver found a baby alligator sitting on a log and later we saw an adult alligator, who quickly descended under water.  The guide pointed out several iguanas, but they were very hard to see in the trees.  Just riding in the boat was so relaxing and we all agreed we enjoyed the trip.  

Back at the dock after everyone else unloaded, I put together the wheelchairs and brought them back over.  Two men helped lift each guy and I lifter their legs and they were quickly back in their chairs.  YEAH, not too bad with help!

For dinner tonight we ventured to a new restaurant that supposedly served Mexican cuisine.  We walked/rolled through a slight rain dodging cars to get there.  The menu was confusing but we eventually found the Mexican food and ordered.  Scott went for a appetizer of Oysters Rockefeller, then he and Joe ordered chicken fajitas, Eric ordered carne asada and Tracy ordered green and red chicken enchiladas.  The wait was long and no chips were offered.  Eventually the Oysters came out and they were surprisingly good.  Our meals were served and while prepared differently than you would get in the US, it was all very good.  Yum yum!!!  We walked back to the room stuffed and happy.