Kilimanjaro/Tanzania/Zanzibar

At the summit

 Since we had to invest the time to train and get in shape in order to hike the Inca Trail, we decided to attack Kilimanjaro as well before we became lazy slobs again.  So, 2 months after Peru, we all hopped onto a plane and made our way to Tanzania.  Taylor came along this time.  No FOMO for him on this trip.

As we got closer, the peak got bigger and bigger

One of my co-workers hiked Kilimanjaro last year so I had an expedition company that came well recommended.  They outfitted us in similar fashion as Peru with a guide, cook, porters, bathroom and people to set up and take down our tent.  We decided to hike up the Machame Route.  This is a 7 day hike that provides an extra day for acclimatization.  Our group has 2 people that are especially sensitive to the elevation (Tom and Nick), so the extra day provided everyone with the best chance for success on summit day.  The entire hike is 32 miles with top elevation (Kilimanjaro Peak) 19341ft.  Kilimanjaro is an extinct volcano so there were volcanic formations, obsidian and ash all along the trail. Nick tried to take some obsidian home but it got confiscated at the airport.

Walking above the tree line

Glacier at the peak

At the beginning of the hike, we were all raring to go and the pace set by the guide was frustratingly slow.  Pole, pole (pronounced poh lee, poh lee) is what everyone would say, this means slowly, slowly in Swahili.  However, as we got further and further up in elevation, the pace remained the same but our group began to appreciate pole, pole.  We had brought a pulse oximeter with us to keep track of how everyone was doing.  On the day before summit day, Taylor, Isaac and my readings were >90% (normal is 100% at sea level) with heart rates in the 80-90s.  Tom and Nick were in the 80% range with heart rates in the 90-100s.  Genetics!  I wish I had known about my superior mountain climbing ability 30 years ago.  

We were all doing well and our guide was pretty sure we were all going to make the summit on summit day when, on day 4, two days before summit day, I slid down some loose scree and hurt my ankle.  It really hurt a lot but I could bear weight so I thought it was likely just a sprain. I made it to camp but had to use my hiking poles to hobble to the food tent and to the bathroom.  In the morning, Tom taped up my ankle, soccer injury style, and we hiked to the next camp.  It was painful but doable.  On summit night, our guide was very encouraging so I retaped my ankle, took some ibuprofen and proceeded to hike to the summit.  I was so happy that I actually made it!  On the way down, some porters got dispatched from our camp and they helped me slide down the ash hill back to camp.  In fact, those porters helped me hike all way back to the exit gate.  I am sure I would have had to be airlifted out or our 7 day hike would have turned into a 10 day hike if they had not been there to help me. I did give them extra tips.  

One of our camps, Kili in the background

We started hiking to the summit at 10pm and actually got to the summit at 7:30 AM.  That is how hard it is to hike 3 miles at that altitude (19341ft).  We were able to watch the sunrise over Moshi.  Take a look at the nearby glacier and take pictures of us all at the top.  The whole time I was up there I felt like I had been running and just needed to catch my breath.  But even when sitting and resting, I never could catch my breath.  That is when I realized that it was probably time to descend.  Even without my ankle injury, this was a much more challenging hike than to Everest Base Camp.  

Cool tree that we saw on the way down to the exit gate

Stage 2 of the trip was a safari/game drive through the Serengeti.  This was like going on an off road trail for 5 days.  We brought our binoculars so we would be able to see the animals, however, our driver was able to get us up close to everything so we only had to use our binocs to see the black rhino.  We were able to see many lions, lionesses and cubs up close as well as giraffe, hippos, elephants, leopards and water buffalo.  We saw so many zebra and wildebeast we were bored of them by the end.  We watched one elephant herd for a long time.  There was a baby elephant that kept trying to run out between the adult legs, so cute.  We saw some lionesses stalking a zebra, but when all the other game drivers came over to check it out, they got spooked and stopped.  Oh well.  It was fun to watch as much as we did.  The Serengeti is very flat and dry and despite the Toto song, you cannot see Kilimanjaro from it.  I was glad that this part of our trip was mostly driving as it was pretty painful to walk, even with the tape.  

We couldn't get out of the car but they had tops that popped up so you could see out.  We were so close, we didn't really need to get out to see the animals

Stage 3 was a trip to Zanzibar.  Beach rest and relaxation after our hiking week.  Our plan was to go scuba diving in the Indian Ocean so we stayed at a dive resort.  Unfortunately, I couldn't swim because the pressure of the water on my foot when I kicked or when a wave went by made my ankle hurt.  I couldn't even think about putting on a fin.  It was at this point that I began to suspect that my injury was more than a sprain.   We drove past the African hospital and thought about getting an xray but I was pretty sure I had broken my fibula and there really isn't anything to be done other than pain control and time so we skipped the African ER.  Luckily, our hotel room was right on the beach so I could sit on the veranda with my foot up and watch the waves while the rest of the family went diving.  I did get to do a little snorkeling while the tide was in and there was minimal current and wave action.  Taylor dragged me around since I couldn't kick.  (Having grown sons is so nice).  I saw a lot of eels, more than I have ever seen while snorkeling before.  Everyone else said that the diving and snorkeling at that area was incredible.  I guess I will just have to go back...

While in Zanzibar, we were able to tour the old town that was basically built in the 1600s.  There were slave markets, mansions built by trade barons and Persian Baths to discover.  Walking around the town was pole, pole.  We all had lots of time to contemplate what we were seeing.  

This whole trip took 3 weeks.  Isaac and Nick's teachers were very good and provided homework for them to do while we were gone.  Isaac did really well but Nick had some trouble finishing his work.  I guess that means no more trips during the school year for him in the future.  He will have to stay with Miriya or Taylor instead.  

When we got home, 2 weeks after my ankle injury, I was still having a lot of pain walking so I went to see my favorite orthopedist.  Sure enough, the xray showed a distal fibula fracture.  The doctor laughed and wryly observed that I have proven that the break is stable.  He put  me in a walking boot for 8 weeks.  It is gradually getting better.  Pole, pole!

Peru

 As our family has gotten older, we have come to realize that life never stays to the same.  Kids move away, health problems creep up, age begins to take its toll.  Bucket list items are becoming more important to us.  Memories are the legacies I want to leave for my kids.

Peru November 2022

I had to wait for one year after my transplant before the doctor would allow me to leave the country.  We found a great deal to Peru at almost the year mark.  Good enough, right?  Hiking the Inca trail has always been on my bucket list.  

Tom, Isaac, Nick and I flew into Lima and then immediately flew to Cusco to begin acclimatization.  Peru can be a wild place plus we needed a tour guide and permit to hike the Inca trail.  So we deviated from our usual mode of planning our own travel and booked this trip with a tour company.  

In Cusco we visited several Inca sites.  It turns out that Cusco was actually the capital of the Inca nation.  I had no idea, I guess I thought it was Machu Picchu.  We learned that Machu Picchu was actually a sacred city and was hidden from the Spanish which is why it has survived as well as it had.  The main cathedral in Cusco was actually a converted Inca temple.  So fascinating. 

The Inca trail is a beautiful hike.  It took us 4 days to hike 26 miles with a max elevation of nearly 14000 feet.  We had a team that included our guide, a chef, porters and people that set up and cleaned up our camp.  We even had our own private toilet in the wilderness that followed us from camp to camp.  Sound like glamping?  Well, I guess it was, but this was a pretty typical set up for this hike.  The food was delicious and the chef even made Isaac a birthday cake as he celebrated his birthday while we were on the hike.  The trail is actually a pilgrimage route taken by the ancient Incas from Cusco to Machu Picchu and you literally walk on the ancient steps made by the Incas

We got to hike in and around many ancient Incan ruins and we saw monkeys, llamas and alpacas in the wild.  Visiting Machu Picchu at sunrise before the crowds hit was amazing.  Of course we took the obligatory picture with the city and the mountains in the background.  When we returned to our hotel, we found that the steps that were so difficult when we initially arrived were now pretty manageable.  Thank you acclimatization.  

Once done with Machu Picchu, we rode a train to Lake Titicaca.  I loved this train.  The countryside is so cool.  The elevation is so high, you are above the treeline for much of the trip.  Lake Titicaca is the highest freshwater lake in the world and is higher in elevation than Cusco.  The coolest thing we saw here was the floating islands made out of lake reeds.  The ancient people made these islands to protect themselves from the war monger Incas.  The people living on these islands allowed us to look around their houses and community sites.  We tried not to be too intrusive, I wouldn't want strangers snooping around my house either.  

From Lake Titicaca we flew back to Lima and were supposed to take a bus to see the Nazca Lines.  Here is where we ran into some trouble.  Just after we left Cusco, the president of Peru was deposed and a new government was formed.  There were many demonstrations about this and the population used the major highways to announce their displeasure.  This made the busses stop running.  We weren't able to get to Nazca in the way that we had planned.  We could either skip Nazca or we could hire a private car to take us.  We already had the airplane tour and penguin tours booked and no one would be giving our money back.  Plus, we figured we weren't likely to return to Peru, so we sprung for the private car.  This turned out to be a great investment in the end because it made it very easy to visit the nearby National Park after we were done with Nazca.  

I loved the Nazca lines.  I was even able to get over my fear of weed hopper airplanes to enable our family to see these mysterious decorations from a civilization older than the Incas. The lines are best viewed from above and the airplane would fly along one group of geoglyphs with one side tipped so one half the plane could see, then it would turn around and do the same so the other side could see.  We would then move to another group of geoglyphs. Tom and Nick were DONE with the airplane by the time we landed (Nick actually barfed) but all agreed it was very cool and worth the effort.  

After the Nazca lines tour, we took a boat out to some islands and saw actual penguins that live there in the summertime (our winter).  That is the first time I have ever seen penguins in the wild.  The nearby national park was on the beach and we took a great hike over the cliffs while also learning about the makers of the Nazca Lines.  These people were precursors of the Incas and likely traded with them as the Inca's empire was building and Nazca was declining.

Luckily there were no demonstrations at the Lima airport and we were able to exit the country without difficulty.  The tour company took great care of us and we never felt like we were in danger despite the unexpected political instability while we were there.  

Tahiti 2022

Right after my most recent transplant Tom wanted to start planning vacations.  After the last transplant failed and we had to cancel a trip to Hawaii, I just couldn't handle the disappointment and was vaguely worried about angering the Gods again, so refused to even plan more than 1 month ahead.  Tom was very patient with me and finally, after we passed the point where rejection and blood clots and infection were concerns, I found a great airfare to Tahiti.  We snapped it up and were super excited because we haven't been able to go on a beach vacation for the past 2 years.  

We arrived in Papeete on the island of Tahiti Nui and took a ferry over to Moorea.  We looked at going on to Bora Bora, but it had the same things as Moorea and was considerably more expensive so we skipped it.  On Moorea we stayed in an overwater bungalow at 2 separate resorts.  Since it was Easter, hotel availability was low and we couldn't get a string of nights at one single resort.  This was actually a blessing as our bungalow at each resort had different amenities which resulted in different experiences.  

Our first bungalow was the Hilton and we looked out over the bay to the mountains in the distance.  We loved watching the sunset in the evening and the moonset in the morning.  The water was about 4-5 ft deep off of our deck and we could snorkel and swim in the early morning before anyone else was up.  We had a glass window in the floor that looked down on the fish.  It was very cool to see the different fish from night and day.  We also used our flashlights to look down in to the water at night.  We were able to spot crabs and octopus as well as sea urchins moving around.  

While at the Hilton, we attended a Tahitian music and dance show.  I love the Tahitian percussion, probably hearkening back to my headbanger days.  At the end of the show, one of the dancers picked Nick for a partner.  He went up and danced with her while we all watched and took pictures.  He had a lot of fun.  

I got to dance too

We went hiking a few days.  The trails are pretty poorly marked and overgrown.  I don't think the native Tahitians do much hiking.  When we reached the viewpoint, I understood why as I was completely drenched in sweat.  I mean, dripping, and we started hiking before sunrise. The next time we went hiking it was rainy and then began to pour.  We were again drenched, just in a different way.  Isaac decided to do a mud hike up to the top of a hill using ropes.  He was covered in mud and had to shed his rain jacket afterwards and so was cold.  He later admitted it probably wasn't worth it...

We were able to go scuba diving.  We had scheduled a 2 tank dive in the  morning but both Isaac and Nick were vomiting over the side of the boat after the first dive.  Tom's seasickness gene is still going strong!  Surprisingly, neither Tom or I were sick.  Anyway, we cut the dive short and went out again the next day.  That dive was awesome and no one got sick. We were able to see eels, sharks and turtles on our dives.

At the next resort, we again had an overwater bungalow that overlooked the ocean.  The area off our deck there was very deep.  We could see many fish that liked deeper waters when we snorkeled off that deck.  It was deep enough that we could also play the "push each other in 100 times" game. This is a favorite of my teenage boys.  I was happy to play as well, wink wink.  

We visited some Tahitian temples.  It was hard to envision how they were used as the Tahitian history is all oral so modern interpretation is sparse.  They do let you walk around on the stones and pretend to sacrifice your brother or shoot arrows at competitions.

Tahiti is a beautiful place and was a sorely needed vacation for our family.  After a rough 2 years of sickness, disappointment and life limiting drain, it was so wonderful to be doing our old activities again.  

Liver Transplant, part 2

From my previous liver transplant post, I was hanging out with a biliary drain.  This pesky drain remained in place for 9 months.  Finally, 1 year and 1 week after my first transplant, I was called up again with another liver offer.  I was actually at work when the call came.  I only had 2 hours left of my shift and begged to come in a little late as I couldn't immediately leave.  They were very understanding and I drove to OSU straight from my own hospital.  Tom was traveling and had to meet me in the hospital after he landed.  I went to surgery the next morning and received a pristine liver that came from within the hospital so only a small amount of ischemic time.  The post transplant liver biopsy showed very little tissue damage.  It is as though I received a completely new liver.  

The post operative period was very difficult.  I had cdiff 3 weeks after transplant.  I never want that experience again, and I have new empathy for patients suffering with this ailment.  I also kept having recurring, low grade fevers and right clavicle pain.  Initially, we attributed the clavicle pain to irritation of the diaphragm during surgery as there had been extensive adhesions.  But when the fevers started and the pain never resolved, a CT was obtained.  This showed an abscess in the area between the liver and the diaphragm.  Ugggh, this meant another drain.  Life is a cruel mistress!  This drain was placed in the right back and was so painful.  Lots of bloody fluid drained out on the first 2 days and the fever resolved.  I could hardly move due to pain and after 3 days inpatient without any further drainage I begged to have it removed.  It was removed and I went home thinking everything was better.  

Wrong!  One week later, I began having pain in the right clavicle again.  Repeat CT showed not only an abscess but also an aneurysm in one of the liver arteries.  This explains the bloody drainage.  Now I required embolization (coils placed in the aneurysm to prevent leaking or rupture) as well as replacement drain.  I ended up with the equivalent of a heart cath but instead of cannulating my coronary arteries, they accessed by liver artery.  Post procedure blood tests did not show any liver damage.  I cried and thanked the interventional radiologist profusely.  The drain was also replaced and this time remained in place for 3 weeks.  The pain improved but I was still very relieved to finally have it removed 3 weeks ago.  

Up to this point, 4 months post transplant, the liver remains healthy, I am fever and pain free and so thankful to be able to go swimming, climbing, mountain biking and hiking.  I am also going back to work.  

I cannot express the profound gratitude I have for the grieving family of my donor who selflessly give me the gift of life at Christmastime.  I am also so thankful for my family.  I know I would not have coped with all of the setbacks without their loving support and prayers and blessings.  

My life has been richly blessed by the gift of a new organ.  Please consider donation to help someone else in need.  

#DonateLife  

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