Walking in the rain

My pick-up for the BioFit Center had been moved up to 7:30 am on Tuesday for my interview and appointment for nutritional counselling prior to my physical therapy session. John went with me today and Bill Cortright, the founder, greeted us and ushered us into his office. He is also the Green Bay Packer fan that I talk football with occasionally during my PT sessions. We began by going through a form where I answered questions about my medical history and that of my family. Then we talked about my existing diet. I went on the MS Recovery Diet about two months prior to coming to Panama and I felt like I was on the right track in that regard, but as Bill talked and explained the science behind nutrition and how it varies for each individual and even varies within each individual by age, new insight into the world of nutrition opened up to me. The BioFit Center uses bloodwork and a stress test to determine what types of food a person needs to be consuming throughout the day. Bill went through a presentation that showed how the body uses food to create energy and he demonstrated several ways that the wrong diet might lead to disease.


I then met with the nutritionist who took my height and weight and my neck, shoulder, waist, hip and upper thigh measurements. Then she hooked me up to sensors that measured my body mass index which is the percentage of body fat. She had to wait for my bloodwork to be completed from the sample that was taken from me yesterday and then they will then work up my ideal diet plan. This diet is about the quality of food you eat not the quantity and it's about spreading your nutrition out throughout the day.


I then went into the gym area and began my workout with Ivan. John stayed and talked to Bill and one of the other counselors about setting up a program that he could follow. My energy level was up and I enjoyed the therapy session. We worked on balance and coordination. John finished his interviews just as I was doing my final stretches.


On the way home we asked the driver to drop us off at a Mexican food restaurant we had been told about that wasn't too far from the hotel. Even though this is a Spanish speaking country, Mexican food and/or spicey food isn't very popular here. We arrived at the restaurant a few minutes before 11:30 and they were not open yet. We wandered around a few minutes looking at the nearby shops and businesses and waited for the doors to open. The restaurant decore was classic Mexican to the max. The walls and woodwork were painted in classic Mexican colors and everywhere you looked there were Mexican trinkets or paintings or dolls. We ordered and I walked around and looked at all the items that garnished every conceivable space. In the entrance there was an old carved bench with a sunflower backrest and heavy wooden seat. On the bar was a large set of old balance scales and looking down at our table from a shelf high on the wall were skeleton dolls dressed in traditional Mexican garb.

I don't know if it was because we were the first customers of the day or if it is always like this, but it took forty minutes to get our food. Good thing there was plenty to look at.  I asked the waiter if he spoke English and John said, "Of course he does," and as he was walking  away we asked for water and the decorously dressed Spanish man said, "Okey dokey." The food was okay, but not spicey enough for John and it was no less expensive than the Mexican restaurant we frequent in Hawaii.

We left the restaurant on foot and walked over to Rey's supermarket and bought fruit and eggs and then started walking home. The sky was noticably darker as we left the supermarket than when we went in. We crossed the overhead walkway that crossed the busy road, Via Espana, and went into the shopping center and stopped at the Post Office and Radio Shack. When we emerged from the stores it was raining. We managed to walk under the overhang of the storefronts almost all the way back to the hotel and it wasn't until we came to the intersection between the Veneto Casino and the Torres de Alba that our cover ran out. We waited a few minutes for the rain to let up but it only came down harder. We were within fifty meters of the Hotel entrance so we just walked the rest of the way in the rain.

The double whammy tripple stinger

Monday caught my ride to the BioFit center for my workout.  It was nice working out and stretching for an hour because it took my mind off of the treatments to come later in the day. I saw Bill, the director of the BioFit center, and I mentioned that Dr. Paz had told me about meeting with a nutritionist. Bill said, "Great, let's set it up for tomorrow."  There have been so many questions regarding optimal nutrition and diet to help with the stem cell therapy that the Stem Cell Institute has decided to go ahead and implement this program. I think that in the coming months the stem cell program will get refined and more organized and that I'm benefiting from some of the new refinements here on my visit.

They moved the afternoon pick up from 2:00 to 1:30 and I guessed this was because they were giving me my second double whammy and I complained so much last Friday that they wanted an extra half-hour with me. In the van John asked me how I was doing and if I was ready for the upcoming treatments. I told him I wasn't and felt kind of dazed. John told me to be strong and get through this but I certainly didn't like the idea of getting stuck twice again. When we arrived at the Royal Center Dr. Hernandez was there and he told me they needed more blood to make more serum to use with the interthecal injections. I really didn't like that! John asked Dr. Pichel if she could use the same needle for drawing blood and injecting the autologous stem cells. She said she could. I made Dr. Hernandez promise that this would be the last of the blood letting. On Friday we had talked to Dr. Paz about doing a blood panel that included hormone and cortizone and John asked Dr. Hernandez to take enough blood now to do that work up.

It was all set. I went into the little room they always use for my injections and sat on the table while Dr. Pichel readied for the shot in the back.  Today I really didn't feel up to this, but I knew I had to get through it. It stung and I complained a little when she shot me with the the anesthetic, but it was not as bad as I had anticipated and the interthecal injection went fairly smooth and fairly quick. I felt the pressure of the large needle being inserted but didn't feel the long skinny needle sliding silently through the barrier of my central nervous system. Just a note about anatomy, the central nervous system is a closed system and the nerves are encapsulated in a membrane that shields it from the rest of the body's fluid. When Dr. Pichel began injecting the stem cells I felt pressure radiating into my left hip and shortly thereafter my left foot became cold. Then it was over and I was half done.

I felt a little weak, perhaps carried over from the feeling I had in the van and Dr. Pichel said I could lay down for the intravenous injection. John asked for a blindfold but they thought he was kidding. Dr. Pichel played around with the veins on my arm and told me she was going to use a baby needle. I squeezed John's hand and prayed that it would be over soon. The needle stung going in and John said that they hooked up the vacuum tube for the blood but that the blood didn't flow. I could feel the needle moving around inside my arm as Dr. Pichel tried to get the blood going to no avail. The needle was withdrawn and I asked if it was over but it hadn't even begun. 

The first puncture was in the crook of my elbow and now she moved down on my forearm. John said the vein was visible where Dr. Pichel inserted the needle, but again no blood would flow into the vacuum tube. John said they tried injecting saline solution but that didn't help and they tried hooking up a large syringe and drawing the blood out with the plunger, but that didn't work either.  I had been holding John's hand and had his thumb between my teeth.  He said later that he was hoping that they didn't hurt me too bad since he really liked having the use of his thumb.

John said they broke out more needles and decided the next size needle was too small and went with a larger one. They picked another spot at my elbow but more towards the upper side of my arm. I gasped when they inserted this needle. Dr. Pichel kept cooing and telling me it was alright but I was complaining and biting on John's thumb again. John said this time they injected saline solution then the stem cells then more saline solution, then they withdrew the blood. He said they used the large syringe and pulled the blood out of me with the plunger. When the syringe was almost full Dr. Pichel diconnected it and withdrew the needle from my arm. Dr. Hernandez took the syringe and screwed a steel needle then injected my blood into three vacuum tubes and dissappeared.  Dr. Pichel said it was over and cleaned up my arm and put small circular band aids over two of the three puctures. I asked her if the vampire had gotten enough of my blood.

One of the things that causes outbreaks in Multiple Sclerosis patients is stress and here I am trying to get relief from the symptoms of MS but I'm having to deal with the stress of getting injections. People might think that I'm a baby and that my phobia of needles is unwarranted, but I believe you should beware of doctors who want to inject foreign substances into you. I was in the National Guard for over nineteen years and I had all kinds of vaccinations. Every year they would require us to get flu shots and every year I would get sick from the shot. Often I would be sick for a month. The flu doesn't even last that long. I recieved the Hepatitus vaccinations and that could very well be the trigger that brought on the disease. There have been more than one case where a person started having symptoms and came down with MS after receiving the Hepatitus vaccinations.

No one knows what causes the disease but there is a connection to a mechanism that allows T-cells to pass through the membrane of the central nervous system. There is a lot of information out there about adjuvants used to deliver the toxins in vaccines into the body and also about food adjuvants. The science is too complex for me to go into on this blog but you can use the two links above as a starting point. My innate sense of survival compels me to abhor the thought of injecting foreign substances into my body. By nature we are not designed to live that way.

John and I went back to the hotel and I laid down on the couch to let the stem cells do their thing. John went down and worked out at the hotel gym then came back in time for Monday Night Football. The Cowboys added to my stress for the first half then came back out for the second half and took care of business. I went to bed relieved that the intravenous injections were over and that I only had to endure three more interthecal injections.

Lazy weekend

I felt a little tired on Saturday and had a slight headache. We didn't do much other than lay around all day and watch the ever changing clouds of the Panama sky. In the afternoon John and I went down to the hotel gym and rode the stationary bikes for about half an hour. I felt listless but my headache went away for a little while.  John went to the pool and swam and I watched. If someone has a hard time walking or is in a wheel chair, getting to the pool will be a challenge here at the Alba de Torres Hotel, but the pool is clean and well maintained.

It hasn't rained much since we've been here, but on Sunday I woke up to overcast skies. I went down to the gym and worked out on the treadmill, bike, and elliptical trainer doing five minute sessions on each for two circuits. Then I worked out my upper body with five pound weights. When I was done the rain had begun. Back in the room I watched the lightening show and made breakfast. It rained all day and John and I were content to just watch and relax. We watched Phil Mickleson win the Tour Championship and Tiger Woods win the FedEx Cup. Then we watched American football with Spanish announcers. Around six in the evening the rain let up and we walked down to the little store in the hotel building and puchased water, bananas and batteries for the camera. We crossed the street to the Pomodoro Cafe and John ordered a pizza to go. Back in the room John had pizza and I had cold chicken. The pizza smelled good, but not on my diet.

When I went on the diet I made up my mind that I would give it a year to see if I was getting results. I miss pizza and chocolate chip cookies and tomatoes but the diet isn't near as bad as the needles. The MS diet is basically no gluten, no dairy, and I cannot consume tomatoes, sugar or legumes of any kind and limited red meat. I subsist on fruit, vegetables, rice, chicken and fish. Lucky I live Hawaii. Panama has pretty good fish from what I've experienced so far, but I have lived on or near the ocean my whole life, and there is nothing like the fish we get in Hawaii. I was in Hawaii for twenty years before I tried to eat sashimi. Now it's one of my favorite things.

John and I watched the Colts beat up the Cardinals on Sunday night football then went to bed. They broadcast the Sunday night game with English announcer. Why they use Spanish announcers on some games and English announcers on others is beyond me. I hope the game tomorrow is in English.

The double whammy

Went to the lobby early Friday morning to be picked-up for my  physical therapy appointment but the driver wasn't there. I called the Stem Cell Institute from the cell phone they loaned me for the duration of my stay and they said that the driver was stuck in traffic. He was a new guy and not only was there a lot of traffic but he was also confused as to where to go or how to get there. I arrived 10 minutes late at the BioFit center. Ivan went right to work and we did balance and upper body exercises. I enjoy my workouts and feel they are one of the best things to try to get my neurons firing again to my weak leg.

For some reason the damage to my nerves seems to be effecting my left arm and right leg the most. Until last January I still had good control over my walking, but since then my right leg has gone down fast. It is noticably skinnier than my left leg and the muscles seem to be withering away. I have a case of what is known in the MS world as foot drop. No control over the muscles in the foot and it just flops where ever it wants with each step unless I focus on placing it correctly as it hits the ground. I have to look at the ground as I walk because I cannot feel when my foot is touching down and if I don't watch with each step I loose my balance.

My left arm is also weak and I have diminished feeling in my left hand. I can touch things with my left hand but cannot feel them and if I pick something up with this hand I have to look at it or I will drop it. It was the tingling sensation in my left hand that caused me to go to the doctor so many years ago that eventually led to the diagnosis of Multiple Sclerosis. If stem cell therapy does anything to relieve the symptoms in my left hand, and more importantly, my right leg, I will be eternally grateful. Multiple Sclerosis seem to be such a prevalent disease and so many people are doing research on it that from what I have learned I believe they are close to discovering the cause. If they figure out the root cause of the disease I believe a cure would be forthcoming. In the meantime stem cells are showing great promise in repairing the damage caused by the disease so that people with Multiple Sclerosis as well as many other diseases can have some or all of their ability to function restored.

At 2:30 in the afternoon John and I went down to get picked up for the ride to the Royal Center where I've been getting my injections by Dr. Pichel. Dr. Hernandez and Dr. Paz were there when we arrived and we had a nice talk. I told them about the pain and tightness I was still experiencing from the lipo surgery and Dr. Paz examined me and said that it looked like the healing process was going well and told me to be patient. I told him that I wish they had done a physical evaluation prior to the lipo so that they would have a base line of where I was when I arrived to compare it to where I am when I'm done. He agreed that should be done and could be worked in. He then explained that they would be moving their offices into another building and would be attempting to consolidate all the activities in that one place. It is evident that they will be growing exponentially. After Dr. Paz left John grilled Dr. Hernandez on their patient capacity and the types of things being treated. They have a rather large program for autistic children and Dr. Hernandez says that they have good results and that for the most part the earlier the person gets treated the better the results. This seems to be the case with MS patients also. Jimmy, who was just diagnosed last year leaves today after four weeks of treatment symptom free.

I received my fourth interthecal injection and it was relatively painless. Dr. Pichel is spraying the injection area with a numbing solution prior to administering the anesthetic. I only feel pressure in the area when she inserts the larger shorter needle and more pressure when she injects the stem cells. Almost immediately when the stem cells go in I feel pressure in the area of my tailbone and my feet get cold. The whole process now takes about three minutes.

Next came my first intravenous injection. For some reason I do not like the idea of having needles stuck in my arms. I didn't watch but John said Dr. Pichel found the vein easily then injected saline solution into my arm. I was cringing the whole time and squeezing John's hand. Dr. Pichel then switched syringes and injected my own stem cells grown to over twenty-six million in number. Dr. Hernandez told us that they have a new lab process and they are now able to increase the number of autologous stem cells up from the eighteen to twenty million they had been able to propogate in the past. The intravenous injection process took about three minutes also but it wasn't over soon enough for me. When I looked at my arm there was blood everywhere. John said that when they switched syringes that blood poured out of the needle connection. Dr. Pichel cleaned me up and put a small band aid over the puncture and we were done.

The driver took us back to the apartment where my job was to rest and drink lots of fluid and that's what I did.

In search of Ruth's Cris

The driver, Lionel, was early for the pickup today and I was able to warm up on the stationary bike for 15 minutes before Ivan went to work on me. Jimmy came over and did his cool down for the last five minutes of his workout and we talked.  He said the reason he had such a hard time with his last IV injection was because they couldn't find his vien. He has large arms and he said that he had lifted weights regularly prior to coming down with MS, but when you look at his arms now there is no discernable veins that show through his skin. They shouldn't have that problem with me, I have veins visible everywhere and they said they would be sticking the needle in the back of my hand. I'm dreading the IV tomorrow, at least I can't see the shot they give me in the back but the one in my arm is in plain sight. Dr. Pichel promised she was going to use the baby needle.


Ivan worked on upper body strength and balance and began easing into some ab exercises to try to get my stomach loosened up. My stomach muscles feel good after they get stretched out and start working, but getting them to that point is painful and then if I sit down for five minutes they seem to tighten up again. We did one circuit on the leg press and leg extension machines before cool down. Today Ivan had me cool down on the eliptical trainer. Of all the machines the eliptical trainer seems to burn up the most energy the fastest and I feel it is the best machine for my weak leg and foot drop.


On the way back to the hotel I asked Lionel about going to the Multiplaza Pacific Mall. He told me how to negotiate with cab drivers and what to ask before getting in their vehicle. He said we shouldn't pay more than five dollars to get to the Mall and that for Panamanians it would only be three dollars. The cabs here do not have meters. 

I was energized after the workout and I talked John into getting out of the apartment and maybe catching a movie at he Multiplaza, so we readied and headed out travelling light, no purse or backpack or camera. John said that Multiplaza sounded like something out of the futuristic movie The Fifth Element.


We walked outside and hailed a cab or rather a cab hailed us. I've never seen a city with more cab drivers. We went to the closest intersection and cabs were coming at us in two directions. They probably would have been coming in all four directions except the corner where we stood was the intersection of two one way streets. I had told John what to say to the cabbie and he opened the door and asked, "Quanto cobra Multiplaza?" The cabbie said, "Three dollars," and John replied, "Bien," and we slipped in the back seat. John said, "Vamanous," and we were off.  John's accent must have been so good that the cabbie mistook us for locals.


The mall was new and spacious and had many upscale stores. John said it was close to the kind of malls that he saw when he was visiting Dubai. It was certainly as nice if not nicer than any mall in Hawaii. It reminded me of the Fashon Show Mall In Las Vegas. The Multiplaza is located in a newer part of town and right next to the Punta Pacifica Hospital where the Stem Cell Institute has their office. We wandered around the mall looking for the theaters and the Ruth's Cris steak house. John wanted to see if he could find another $40 dollar steak. No one seemed to know anything about Ruth's Cris, but we eventually found the theaters. Four of the ten or twelve theaters were designated VIP which meant they had full reclining leather chairs and the ability to order food and drinks while you watch the show. We didn't find a movie that interested us so we continued our search for Ruth's Cris. After covering most of the mall we finally found someone who told us that Ruth's Cris was coming soon and still under construction.


I was wearing down from all the walking and we decided to go to the food court and get something to eat. On the way we stopped at a location that had massage chairs and for a dollar we received a three minute massage. In the food court we found all the fast food restarants you might expect to find in the US and then some. We selected a place that cooked steaks to order and that had a nice salad bar. We ordered a single filet, twelve dollars, and two salad bars and we had to ask for a to-go container for most of my salad and most of the steak. The girdle prevents me from eating very much at one setting. We worked our way back to the entrance from which we arrived. John stopped and picked up a Cinnabon, not on my diet, and two bottles of water.


The cab ride back to the hotel was again three dollars. I was worn out, but it was nice to get out of the apartment for awhile. Tomorrow is going to be a big day. I will get my fourth intrathecal injection of allogeneic stem cells and my first intravenous injection of the autologus stem cells. The intrathecal stem cells they have been injecting into me have been extracted from donated umbilical chords of newborn babies and the autologus stem cells are the cells that have been extracted from the extricated fat tissue of my mid section. I'm apprehensive about the multiple injections tomorrow but I so desire that the microscopic cells being injected perform their miracles.

Shopping in a sauna

I had another good workout at physical therapy on Wednesday. I felt energized and ready to go after the session but, back in the apartment, after sitting on the couch for just a short while I cooled down from the workout and lost all the energy I had. I rested through mid-day then we decided to walk down and find the post office and go to Rey's, the large supermarket about a quarter mile away. We stopped and purchased sunglasses from a street vendor. He had name brand glasses selling for $7 each. We found the post office through a maze of shops in a three level shopping complex. I purchased stamps and mailed a card. Rey's was across the street from the shopping complex and the street is a six lane thoroughfare but instead of crossing the busy road through the traffic this time, we discovered a walking bridge that we were able to take to the other side safely.

Picture above left is the colorful walking bridge. I struggled up the steps going and returning. The picture above right is the front of Rey's supermarket. Inside the store it was cool and modern. Throughout the store there are various tables set up with an employee offering product samples much like they do at Costco in Hawaii. Although I found it interesting that here they would have samples of wine or rum or some other libation at one or more of the tables. We purchased fruit and a cooked chicken and loaded it into my backpack, which then became John's backpack.

It was extremely hot out and I was having a difficult time walking. The heat was exacerbated by the multi-layers of clothing I was wearing. I had on the shirt I was using as an undershirt with the girdle over that and then another shirt on top of that to hide the girdle. On the way back we would walk through shops to cool down and I was looking for a Panama tee shirt that I could use as another outer garmet over my girdle. We returned to the Hotel and it took all my remaining energy to climb the steps up to the Hotel entrance. In the picture I'm posing on the steps. The parking garage driveway in the foreground leads up to a side door in the lobby and I suppose wheel chair patients could get in and out of the building using this ramp. Navigating the sidewalks would be an additional concern.

The airconditioned apartment felt good after our trek. I took a long shower and discovered that it feels much better when I have John put the girdle on me than when I try to do it myself.  He is able to stretch the elastic nice and tight and that helps with the pain and soreness. We watched a little tv and went to bed.

A good looking day

Tuesday I woke up feeling sluggish. I was moving so slow it took me all of two hours to get ready to go to physical therapy. The driver was waiting for me when I stepped into the lobby of the hotel and I was five minutes early.  I think I was five minutes early, but it seems that every clock in Panama is set to a different time varying by as much as fifteen minutes. The driver was one I haven't seen before and his name was Eric. He took me to the bio-fitness center and escorted me upstairs. I went into the gym area and asked Ivan if I could warm up on the stationary bike. He told me to go for it. Ivan was working the Jimmy another of the MS patients and Jimmy was lifting weights. I hopped on a bike and started peddling. Jimmy joined me on an adjacent bike for his cooldown period.  I asked how he was doing and he said that yesterday was a very painful day. He said that he screamed like a little girl when Dr. Pichel gave him his intrathecal injection. I told him about the problem Dr. Pichel had with my injection. Jimmy told me that he was doing great otherwise. He has regained all of his sense of touch and he has no noticable effects from MS. He told me how strange it was that he was the oldest of seven siblings and he was the one that never smoked or drank and always took care of himself, yet he was the one that ended up with MS. We talked about the stress of being in the restaurant business and Jimmy gave me the low down on all the drivers and which ones are lazy and which ones are on the ball.


Jimmy finished his cool down and left, and I peddled until Ivan came for me. We repeated much of the routine from yesterday but Ivan added in an exercise where I sat on a large ball and rotated my trunk left and right holding a smaller two pound ball in outstreached arms. At the far end of each rotation I would bounce the ball on the floor and catch it, then at the center of every other rotation I would do a chest pass to Ivan. Although this exercise was painful at first it felt good to use and stretch my sore core muscles. I know that every patient that comes to physical therapy will be in a different condition and will be given different exercises but physical therapy and/or exercise is a very important part of the recovery process. The old addage - use it or loose it - has never been more true and I think the tendency is for many of us with degenerative disease is to just give up and succumb.


I was working my way through a grid exercise Ivan had set up when I heard, "There will be absolutely no wearing of Cowboy jerseys in this facility." I turned and saw Bill, the director of BioFit watching me exercise. I told him he would have to deal with this tee shirt for the next three weeks.  He is a Green Bay Packers fan and we talked football for a couple of minutes.  Bill named his first born son after Brett Farve and I told him that it was too bad Brett defected to the Vikings. Bill said I was doing really well with the exercises and told me it was going to take time, but that he has seen improvement with all the MS patients that have come through there, even the ones in wheel chairs.


Eric, the driver, was waiting for me in the BioFit lobby when I finished and took me back to the Hotel. John was making breakfast when I walked in the door. I felt invigorated after the workout and John commented on how good I looked. I ate and we watched the rain clouds turn the sky black as they moved toward us across the city. There was a nice thunder and lightening show to keep me entertained for the afternoon. It is the rainy season here in Panama, but we have had very little rain. The first few days it rained briefly in the afternoons and for a few days there was no rain at all. This was the first day that it rained hard for a couple of hours. After the showers passed I walked with John to the little store in the bottom of the hotel and we purchased a watermelon and bottled water. We then went to the hotel gym and rode the stationary bikes for almost a half hour.


I suppose most people are interested to know if I've felt any improvements at this point of my treatment. I hesitate to post anything I think I feel and it's difficult to determine if any of the MS symptoms are lessening due to the overall pain and soreness from the lipo surgery. I still don't feel that I'm at the point of physical ability that I was when I arrived in Panama. One thing I have noticed is that the chronic pain that I've had in my lower back for many years has dissappeared.

A difficult injection

Monday I ate breakfast and dressed in my workout clothes then went downstairs for my 9:30 am pick-up. The driver wasn't waiting on me again and I called the Stem Cell Institute to find out if there was a problem. Ana told me that the driver was running late and would be there in about five minutes. She also said that there were schedule changes and that she would fax the changes to the hotel. The driver showed up about 9:45 and took me to physical therapy. John and I decided that he doesn't need to go with me for the therapy sessions.  It's an hour of shear boredom for him and I'm busy working out with the trainer. The driver dropped me off in front of the building, unlike the other driver who had escorted us up to the therapy center. The elevator system in this building is quite confusing and luckily Jimmy, the other MS patient undergoing therapy here, was leaving as I arrived and he showed me how to punch in the codes and work the elevator. Ivan was waiting for me and I explained that the driver was late.

Therapy today was quite a bit different from the first day, and as I thought, the first day had been an evaluation day. First Ivan stretched me out then we worked on coordination and balance doing walking exercises. We then did leg strenght exercises using a step and more balance exercises where Ivan pushed on me while I stood on two squischey half-ball like things. Next I did leg presses and leg extensions on their weight machines. I did more walking exercises carrying a two pound ball then did a five minute cooldown on the stationary bike and then more stretches.  The driver wasn't around so Ivan escorted me down to the lobby and found the driver waiting in front of the building. Ivan told the driver that he had to escort me up to the bio-fitness center and pick me up there and couldn't be lazy and just wait in the van.

When I got back to the apartment John had a smoothie waiting for me and I rested while John worked on the computer. At 2:30 we went downstairs for our pick up. Again the driver was late and I had to call Ana. She said the driver was stuck in traffic and she would call Dr. Pichel and Dr. Hernandez and let them know we were on our way. I picked up the schedule changes Ana had faxed at the front desk.

We arrived at the Royal Center where I get my Intrathecal injections. Dr. Pichel was waiting for us in the reception room and asked how I was feeling. I told her I was feeling okay but still sore from the lipo. She took me right into the exam room and made preparations for the injection. Dr. Hernandez and John along with Dr. Pichel's assistant were in attendance. The picture above is Dr. Pichel's assistant hooking me up to the blood pressure monitor. Dr. Pichel examined my skin and the rash had diminished since I had been wearing a shirt under the girdle. She swabbed my back with bentadine and I steeled myself for the injection of anesthetic. The anesthetic needle felt more like a bee sting this time. Dr. Pichel said she used a baby needle for me. She waited until the area was numb then John said she began trying to insert the short larger needle though my backbone. John said she was having problems and kept pulling the needle out and reinserting it. A couple of times she had it in over an inch deep and once tried inserting the long skinny needle to no avail. John said she was poking me so many times that he began to get queasy. All I could feel is the pressure of the needle being inserted and at times pressure going all the way down to my sciatic nerve. Finally she shot me with more anesthetic a notch higher in my back and John said the larger needle went in almost effortlessly. She then inserted the long skinny needle and began injecting the stem cells that Dr. Hernandez provided from his cooler. I was scared and crying, but I tried to just relate what I was feeling rather than screaming. This time I felt pressure only in my right hip and I was much relieved to be done with the third injection. Just five more to go. OMG.

I felt a little queasy and they had me lay down on the table for a few minutes. John asked Dr. Pichel why she had so much trouble inserting the needle this time and she said that it might have been inflamation or muscle spasms from the previous injection. She explained that she could inject anywhere along the spine but that the higher she went the narrower the spinal column became and the harder it was to put the needle in the proper place without hitting a nerve.

They had thrown a blanket over me and John was rubbing my bad leg. I decided I had to get up and get out of there because I was nice and warm and cozy and began feeling like I could spend the night on that little table. On the way back to the hotel in the van I experienced a warm sensation in my lower body almost like I had stepped into a hot tub up to my waist. Back in the apartment John gave me juice and I laid down to rest. John went down to the hotel gym and I lay in bed until Monday night football started then I ate some watermelon and laid on the couch. It was a good game but I fell asleep in the fourth quarter.

A $40 steak on a two-bit street

Sunday was a day to recover from our Saturday excursion. John did laundry and we watched some football and lazed on the sofas most of the afternoon. It is nice having a washer and dryer in our apartment.  The Torres de Alba is referred to as an apartment hotel and our accomodations are more like a one bedroom apartment than a hotel room. For the most part the accomodations are quite functional with few defects. It's nice being on the upper floor because the city noise is fairly constant and sometimes quite loud. I hear a good deal more of it than John does. The windows do not seal well and as this might lend an avenue for noise to enter it certainly lends an avenue for the air conditioning to escape.  Electricity is included so it's of no consequence to us. It does look like they are remodeling the other tower of the hotel and I do see them bringing in new windows almost every day. The biggest flaw is the walk-in shower. Although it's large, big enough for two people comfortably, the floor is the same grade and level as the rest of the flooring and there is no slope to allow the water to flow towards the drain. As a result there is always a puddle of water in the bottom of the marble tiled shower and I have to be careful when I step in so that I don't slip. All the flooring is marble or granite and it's quite cold.  I would recommend a nice pair of warm slippers to future guests here.

We went down to the hotel gym for a light workout then showered and dressed for dinner.  There is a nice steak house in the Veneto Hotel and Casino next door that we thought we'd try out before the Cowboy game began. In the picture to the right we are standing at the corner of the block where our Hotel is located shooting down the street. The building with the flags in front is the Veneto Hotel and Casino. There are older apartment buildings with shops on the first level across from the hotel. 

I've lived around and worked in some of the nicest resorts in the world for the last twenty years and I have never seen a $40 steak. I was tempted to get one to see if it was dusted with silver. We ordered fish which was much more reasonable. The restaurant reminded me of my stint in fine dining many years ago. But instead of pristine beaches and beautiful sunsets outside there are small shops and shoddy streets and uneven sidewalks amidst a combination of new and old high rise and low rise buildings. In the picture above we are standing under the porte cochere of the Veneto shooting more of the street scene. You couldn't shoot an arrow and hit the ocean from here and even if you could it would not come close to the clear blue water surrouding Hawaii with pristine beaches often within view of the restaurant inwhich you're dining. John learned that the minimum wage here is $1.38 an hour. Most of the workers in the hotel are making about $12 a day. The $40 dollar steak just boggles my mind. Oh, and side dishes were extra. For the price of that steak per week you could have a live-in maid at your beck and call. We probably won't be eating there again. My diet is so restrictive it is actually difficult to go out and eat. I've been getting by making most of my meals in our apartment.

After dinner we walked back to the sportsbook area and watched the Dallas/New York game. Dallas lost and that always puts me in a bad mood. John tolerates me. Tomorrow is going to be another big day, physical therapy in the morning and more stem cells in the afternoon. I went to bed and tried not to think of the game or the coming pain.

The Panama Canal

We had scheduled a Canal tour for Saturday earlier in the week and had to be at the marina at 7:00 am to check in.  I had a restless night and the alarm went off early. We readied and were in the lobby of the hotel at 6:30 and had the front desk call a cab. The traffic was light at this time on Saturday morning but the marina was quite a ways away. It was located on an island connected to the mainland by a man made causeway that was created by using the material dug out of the canal almost one hundred years ago. The causeway also serves as a breakwater for the canal entrance. We checked-in and moved to the end of the long line of people waiting to board the tour vessel. It seemed like we sat at the dock for quite awhile before finally getting underway. As we approached the channel that leads to the first lock a large refrigeration ship steamed across our bow. John said we'd probably be going through the locks with that ship. We had to wait for a canal pilot to board us. Any vessel over 65' must have a pilot on board and in control of the ship. Once the pilot came on board we pulled into the channel and made our way under the Puente de las Américas or Bridge of the Americas (in picture above) then motored to the first lock and queued in behind the refrigeration ship and two tug boats. Tug boats are another companion that all large ships must have to navigate the canal. The cost of going through the canal is based on displacement and the cost of the tug boat and canal pilot are extra. The canal master determines if a ship needs a tug and how many. The average cost of a canal transit is about $200,000.00.

Once the four boats had cozied into the first lock they closed the gates and flooded the lock with water from Gatun Lake and in eight minutes we rose about twenty feet. The Iron gates in front of us opened and we moved into the second lock. This pair of locks are called the Miraflores Locks and after another eight minute flood we were 20 feet higher and the front gates opened and we motored out into a man made canal.  Picture above are the gates to the first lock closing behind us. After a short transit through the man made canal we arrived at the third set of locks called the Pedro Miguel Locks. There are a nice series of pictures at the preceeding link and in some you can clearly see the new larger canal that is being dug parallel to the transit we just took. The expansion scheduled for completion in 2014, the canal's one hundreth anniversary, will allow for the larger more modern ships to take the short cut through the Americas.

I'm watching the lock fill with water in  picture to the left. The water roils as it floods the locks from large underground pipes. After leaving the locks we motored under the Puente Centenario or Centenial Bridge. It is a classic beauty of sleek design that resembles a racing sailboat speeding across our path.

That's me on the stern of the tour boat with the bridge behind us. Click on the link to the bridge for better pictures. John wisely opted for the half day tour when we signed up. I was thinking that it would be nice to go through the whole canal, but after taking about three and a half hours to get from the harbor through the Pedro Miguel Locks I was quickly using up my energy reserves.  It was nice being outside and on the water, but the heat and breathing in the diesel fumes from the refrigeration ship in front of us took its toll.  I spent most of the transit through Gaton Lake in the air conditioned space below decks. There were windows to take in the sights and we could still hear the narration of the tour guide.

The transit from the last lock to the town of Gamboa, our disembarkation point was only about an hour or less. Gamboa was a worker village during the time of canal construction then it became the headquarters for the canal dredging operations and is one of several villages in the Canal Zone. There is a hotel called the Gamboa Rainforest Resort located here and John and I may try to spend a weekend there if I feel up to it. For most of our journey there was arid or semi-arid land along the west side of the canal and thick dense rain forest along the east side of the canal.

We boarded a bus at Gamboa and took the only access road to the town back to Panama City and the island where we met the boat earlier in the day. We hailed a cab to take us back to the city. The afternoon humidity and heat were sweltering and the cab was well worn with an air conditioning system that functioned best when travelling over 40 miles per hour.  We hit a traffic jam coming into the city and the air conditioner started spewing out warm air. I was sitting in the back seat with the sun behind me and I thought I was going to pass out. To our right were the slums of the city. Someone had told us about this place, hundreds of tenement buildings in terrible repair. They had told us the police would not even go in there. After a few minutes of sitting almost motionless our cabbie took a sudden right turn into the slums. John said, "Ah, the senic route." The cab dodge in and out of back roads and passed by discheveled buildings and the gaggle of the downtrodden loitering along run down storefronts. We emerged unscathed onto a less busy road back in the safe zone. I was thankful the air conditioning was putting out cooler air.

We arrived back at the hotel and I was thoroughly worn out and my body was hurting. I took my last pain pill and John and I both laid down and took a short nap. Around 5:00 pm we went down to the hotel gym and worked out. I'm a little more mobile but my mid section still hurts from the surgery. This night I slept like a baby.

Gyms, Jims and a thick pair of socks

Friday and Mondays are the two days of the week with the most activity as far as treatments go. Tuesday, Wednesday and Thursday I have physical therapy in the mornings then nothing for the rest of the day. This Friday we went down for our 9:30 am pick up to go to physical therapy but there was no van or driver there to greet us. Usually they are there waiting. I called the Stem Cell Institute and they said the driver had vehicle trouble and they were sending someone to get us. The driver that picked us up was Amitt and he was the first driver that we've had that spoke English. I think he picked us up in his personal vehicle. Amitt drove us to the modern high rise building where the bio-fitness center is located.  There are few street signs here in the city and there are many one way roads so to try to navigate with all the crazy traffic would be a nightmare unless you know the streets very well and all our drivers so far seem to have a good handle on that.

Yesterday John had talked to our friend Rhody who lives in Boquete, Panama about six driving hours away and whom we will visit the weekend after my last treatment. Rhody told us of a supermarket called Riba Smith's that was well stocked with many things you cannot find anywhere else including lots of organic and health foods. We asked Amitt if he knew where one of these markets were and he said he did and he asked if we wanted to go there.  We said we would like to after physical therapy if it wasn't too much trouble. 

The bio-fitness gym was new and spacious and not very crowded. I had the feeling that they mostly worked with rehabilitation clients. There were only two other people working with individual trainers while I was there. My trainer was a young handsome latin male by the name of Ivan. That's Ivan with me in the picture.  I think today was mostly an evaluation day as far as physical therapy goes. Ivan checked my flexibility by stretching me out, which was painful due to my lipo, then he tested my strength using a weighted ball and step platform. He then tested my balance then my mobility level. I wish the Stem Cell Institute had arranged for a evaluation day prior to my lipo. With my core muscles still sore from the surgery I am not as physically capable as I was before surgery and there was plenty of time for an evaluation session on Monday afternoon. It would have been nice to have a pre-lipo base line to determine the level of improvement during my time here. Perhaps they will work that in for future patients at some point.

After physical therapy Amitt took us to Riba Smith's. It was a very nice store but I wanted to get in and get out and John wanted to shop. I was worried about keeping Amitt waiting and John wasn't. I finally saw Amitt and told him we were trying to hurry and he said no problem. I asked him if he could help me find a card for a friend and he did then he went and purchased an ice cream cone and patiently waited. John was off like a kid in a candy store. By the time we left we'd packed out about $85 worth of food. We are now well stocked.


We returned to the room and unpacked the groceries. John was just about to make something for lunch when the phone rang and they said the driver was downstairs to take us to my afternoon appointment. My scheduled pick up was at 2:30 but the driver had arrived at 1:30.  We were late so we grabbed our stuff and headed out. Downstairs there were two other gentlemen waiting in the van. They were father and son, and Jimmy the son was here receiving stem cell therapy for multiple sclerosis. This was the end of his third week and he was reporting great results. The one setback he suffered occurred the night before after taking his weekly Avanex shot. I'm not sure why the doctors here in Panama recommend that patients on a drug regimen remain on the drugs while taking stem cells. From what I understand the doctors in Costa Rica recommend just the opposite. I will ask Dr. Paz about that the next time I see him.

At the clinic Dr. Pichel came in and greeted us then asked who wanted to go first. I told Jimmy he could go first. I desire the stem cells but dread the injections. John and I talked about things that needed to be included in the blog while we waited. I had mentally prepared myself for the initial injection of anesthesia. Just had to endure that little bee sting. However this time it wasn't a bee sting, it was more intense like a centipede bite. I complained loudly and John said Dr. Pichel pulled the needle out of my back and massaged the area some then stuck it back in.  Again the pain was intense and I cried and complained. John was telling me to hang in there until the anesthesia took effect but all I could feel was the centipede.

A minute, which seemed like an hour, passed and the pain was gone. John said Dr. Pichel repeated the proceedure of inserting the larger shorter needle then the longer skinnier needle. The picture above is the long skinny needle being inserted and the picture to the right is the injection system with the short larger needle, the long skinny needle and the syringe. By the time she put the short needle in my back all I could feel was pressure. After inserting the long needle she injected the golden fluid containing the stem cells and almost immediately I felt pressure in both hips.  The fluid going in definitly impacts nerves and sends sensations to my brain. Over the next half hour the pressure in my hips dissipated.

Dr. Pichel and Dr. Hernandez examined the bumpy rash on my midsection and said I should try wearing a shirt under the girdle. I left the girdle off for the ride back to the hotel and that wasn't such a good idea. With every bump the van hit it felt like someone was hitting me in my mid section.

While waiting outside for the van to come back and get us we talked with Dr. Hernandez who waited with us, his little red and white cooler constantly in his possession. We talked about his crazy ex-girlfriend and about the plans for expansion and improvement of the Stem Cell Institute.  That's me and Dr. Hernandez in the picture sitting on the bench in the warm humid Panama City atmosphere.

The van arrived with Jimmy and his Dad inside. Jimmy asked the driver to drop them off at a restaurant on the way back to the hotel. Traffic was terrible on this Friday afternoon. The automobile's horn is an intrical part of the driving system here. There are surprisingly few accidents, but we did see a minor one on the way back to the hotel. Back in the room I lay down and prayed for the stem cells to do their thing. About five hours after the injection both my feet felt as if they were freezing cold. I borrowed a pair of John's socks and put them on then took a pain pill and John tucked me into bed. When I woke the next morning the sensation was gone.

Off day

Thursday was an off day. I was still very sore and really didn't feel like moving. John went down to the small store in the lower level of the hotel and purchased water, eggs and bananas. He made scrambled eggs for breakfast and that was the first meal we cooked in the apartment. The pots and pans that are in the unit are well worn, but the dishes and utensils are nice and in good condition. The kitchen is appointed with a gas stove, a microwave, a relatively new blender and a toaster. It also includes a refrigerator, washer and dryer.

Later in the day John walked to the larger supermarket called Rey's about a quarter mile away and across a busy thoroughfare.  He returned with groceries and a new frying pan. We went down to the small hotel gym and worked out.  Well, John worked out and I attempted the stair master but ended up on the bike because sitting was easier on my stomach than standing. I gently peddled while John lifted weights. There was another american in the gym when we arrived. Nice fellow with with the DOD in some capacity who is down here for training. He had been stationed here for several years in the past and said he was planning to retire here.

After the workout it was time for my first shower since the lipo.  The girdle had caused a mild rash on my midsection that had itched most of the day and it felt good to gently wash that area.  My incision was covered by a clear bandage and after the shower John removed it and applied anti-biotic creme Dr. Crespo had given us. John rubbed aloe cream on my rash and strapped me back into the girdle. The pressure of the girdle actually feels good on my sore muscles.

John made rice in the new frying pan and I cooked up some stir fry with rice and salmon and vegetables. I watched a little TV then it was off to bed. Dr. Crespo had also given me pain pills and I was using them sparingly. I did not take a pain pill prior to going to bed, but at 3:00 am I woke up hurting so I took a pill and went back to bed.

My first stem cells

Day three, Wednesday, there was nothing scheduled until the afternoon, so the morning was spent recouperating from the lipo surgery yesterday.  My fat has been sent to the lab to have the stem cells removed where they will be cultered and grown in super concentrations before being injected back into me intravenously. I had an appointment at another clinic in the afternoon for my first dose of mesenchymal stem cells. These stem cells are donated from the umbilical chords of newborn babies. After donation they are seperated and screened and I assume cultered then they are added to serum derived from the blood they took from me the first day and injected into my spine. We met Dr. Helen Pichel, in photo with me above, at the clinic and she explained the proceedure and covered many details. Unlike most doctors I've had to deal with the doctors here seem willing to explain everything about the proceedure the anotomy the physiology and what to expect as far as results as well as covering the complication that could arise.

I would be the center attraction at todays event. Dr. Pichel and her assistant would be administering the injection and Dr. Hernandez would be there with his little red cooler that contains my concoction of stem cells. There were also two other doctors there to observe, one was from China where they have been doing stem cell therapy for years. From what I understand Dr. Pichel has developed an injection technique that so far has been free from complications. John was also there taking pictures.

After I had been prepped and was girding myself for the injections to come John said Dr. Pichel was even going to show me the long skinny needle she would be inserting into my back but he interviened and told her that wasn't such a good idea. John said that it was about five to six inches in length but very thin. He said they first injected a local anethesia and that felt like a bee sting. John said Dr. Pichel then massaged the area and waited a couple of minutes then inserted a shorter thicker needle, I assume to get through the cartlidge in the spine, then she inserted the long skinny needle through the center of the thicker needle.  Dr. Pichel told us earlier that getting the needle into the proper location was done by feel and technique. I did not feel that needle at all but once it was inserted and the doctor injected the stem cells I could feel a tingling sensation in my lower back and down the top of my left thigh and the top of my left shin.

Part of the prep process was wiring me up to a computerized heart and blood pressure monitor. After Dr. Pichel removed the needles and said, "That's it! How do you feel?" I began to have several sensations and reactions. First I felt pressure on my tailbone and middle back area which are the two locations that I have cronic pain as a result of an injury that occured when I was 17.  I then began to have a queasy feeling in my stomach accompanied by a full body hot flash and I thought I was going to throw up. Dr. Pichel and Dr. Hernandez noticed that my blood pressure hand dropped and they had me lay down.  I was prone for about a minute and my blood pressure returned to normal.  Dr. Pichel asked me what I had to eat pior to the visit and I told her I hadn't eaten since breakfast. She advised me to eat fruit prior to the next injection to get my carbohydrate levels up.  Dr. Hernandez explained that the brain needs carbohydrates to function properly.

My condition was complicated by the fasting two prior evenings and the lipo surgery the previous morning. I had not felt like eating mainly since my stomach was sore from the lipo and I had become use to eating sparingly.  Lesson learned.

The driver took us back to the hotel and I spent the few hours before bed resting and drinking lots of water per the doctor's orders.

In the ring with Sugar Ray

If they ever figure out how to acquire stem cells without doing liposuction stem cell therapy will be a simple and an almost pain free process. I feel and look like I just went eight rounds with Sugar Ray Leonard where he delivered nothing but body blows. Perhaps it is because I was so thin that in order to collect the 500ml of fat tissue they needed they had to suction a wide range of my midsection.  I have a single entry incision along my bikini line but I have bruising from just below my breast down across my pubic bone and the bruising seems to be migrating down along my left thigh. The bout with the plastic surgeon began early Tuesday morning with a 6:15 pick up.  We hopped in the van and drove about three blocks from the hotel to the surgeon's clinic.  Had to wait a few minutes for the staff to arrive and unlock the doors.  I made the comment that we could have walked to this appointment but I would soon learn that walking back from the appointment would not have been possible. I filled out some paperwork and the anesthesiologist, Dr. Javier Jelensky, came out and talked to us. The Dr. was very nice, originally from Cuba, who had an interesting sense of humor. He asked me about past surgeries and told us how simple the process was going to be. I related to him that I didn't like needles and wasn't thrilled about being knocked out and he went on to tell us about the drug being used and how mild it was then in the same sentence told us that it was the same drug Michael Jackson had been given just prior to his death. He clarified that Michael had been on other medications and was converting from one sleeping agent to another and that ended up compounding complications that lead to his demise. He said this would be the best sleep I've ever had and that when I woke up it would seem that only five minutes had passed.

An assitant, Lily, took me and and prepped me for surgery, which was mainly having me disrobe and put on a hospital garmet that would not even be appropriate for the beach. She also stuck a needle in the back of my hand for Dr. Javier to use for his anesthesia. They let John come in and be by my side one final time before surgery. Dr. Luis Crespo came in and told us what to expect and I asked him if he would be able to find enough fat in my stomach area or if he would need to go elsewhere.  He pinched around my stomach and said that he should be able to get enough with one puncture wound. He went over what we should watch for after the surgery and told us about the girdle that I would be wearing for three weeks and he said he didn't expect any complications. After all, this was just a mini-lipo. All I can say is that I would hate to have a full-on lipo and can't believe anyone would do this type of thing electively. Now having said that John explained elective surgery from a different perspective and I guess I do understand it, but given my phobia of needles and doctors in general it would have to be dire circimstances before I would ever have it done.

They kicked John out and wheeled me into the operating room.  Metal arms swung out from the table and they strapped my arms down to them.  I'm so weak I was helpless to fight back. Dr. Javier connected something to the needle in my hand and Dr. Crespo asked me where I was from and that was all I can remember until I woke up five minutes later. Lily set me up and dressed me and I lay back down feeling very warm and comfortable and as if I had just had the best sleep of my life. I see why Michael was addicted to the drug that helped him sleep. John came in the recovery room and talked to me and laughed at me. I guess I seemed a bit intoxicated and that is something I've never been before. Lily brought in a wheel chair and they eased me into it, then she put on my shoes. They wheeled me off into the van and toward my own devises for heeling. A minute later we at the hotel and the pain began to creep in. Sugar Ray Crespo had done a number on my stomach. I discovered that with almost every movement except perhaps the movement of a hand, requires the use of core muscles and every time a core muscle worked there was and additional pain on top of the dull pain that is with me all the time. The pain killers they gave me helped a lot but I would not have been able to manage anything without John there to help. He may be putting on my shoes for me for a week.

The pictures below are 24 hours after surgery. Dr. Hernandez examined me a couple of hours later and said that I looked really good but that more bruising would show up in the coming day or two.

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The suction wand Dr. Crespo used was about 12 inches long and he had the whole length of it inserted into the puncture wound that's visible in the picture on the left. My five minute nap actually lasted about two hours and I was being lipoed for about 45 minutes. The girdle is a wide elastic band that wraps my midsection and velcros to itself. The girdle is laying underneath me in the pictures. I can only hope they took enough fat so I do not have to go through this again.

A glimpse of the future

The alarm went off early on Monday. For me Sunday night had been fairly sleepless. We readied ourselves and met the driver downstairs for our trip to the Stem Cell Institute.  It was the same driver that picked us up at the airport and we later discovered that they try to keep the same driver with us for our entire stay. I had to fast for five hours prior to 8:00 am which I discovered in an e-mail rather than the information packet that they gave me at the airport. Good thing I checked e-mail yesterday or I would not have been aware of this requirement. As it turns out there were lots of errors in the information packet and it was not organized very well for MS patients who tend to have cognizance problems.

The ride to the Institute took 15 minutes and we arrived about 15 minutes early.  Dr. Paz came out and talked to us and I was able to ask him lots of questions regarding the therapy and results. That's me and the Dr. in the Picture. He seemed impressed that I had refused to take disease modifying drugs and had choosen to combat the disease all these years using suppliments and even more recently diet. My concern about being thin and having enough stem cells was alleviated when he informed me that thin people have a higher concentration of stem cells in their fat.  I told him what I had learned about the narrow vien in the neck theory. He said that if that was the cause of MS that stem cells would do what they could to repair the damaged vein as well as the damage in the spinal column. He also agreed that getting healthy was more than just taking stem cells, that it ran the gamut from diet to the right mental attitude and he talked about his vision of growing the Stem Cell Institute into an organization that would encompass all of those things.

I met Ivonne the administrator and Dr. Maria Tribaldos.  Everyone was very nice. Even Maria when she had to take like eight vials of blood. That's Maria taking my blood to the right. I squirmed a bit, but it turned out to be the most painless needle I have ever had stuck into me. Did I tell you that I hate needles. I could tell stories about needles...  like the time I locked my mother out of the car at the Dr's office and refused to let her in because I didn't want to get poked...  and the time I gave the anesthesiologist a right hook when he tried to put me under for my wisdom teeth extraction...   but I digress.  Where were we?  Oh yeah... I really hate needles. I had to overcome a lot to pay so much money to come down to Panama and get stuck with needles so many times.

We went over the schedule and Ivonne corrected the anomolies in the paperwork that I was given at the airport. They gave us a cell phone to use while we are in Panama along with all the numbers to call if we had a question or problems. Dr Paz did a few physical tests and took my MRI's and medical info that I brought with me. In all the appointment lasted less than two hours. The driver took us back to the hotel and we had the rest of the day off. 

John and I walked down the street and stopped in a local restaurant for lunch then went back to the hotel for a siesta.  Later we went down and worked out in the nicely appointed workout room and then went for a swim. Tonight I begin another fast and we have to wake up early and go the plastic surgeon for liposuction.  I guess that could be an added benefit of stem cell therapy, but I understand it is the most painful part of the process. I did not confirm this, but I believe they freeze some of my stem cells. If I need to come back at some future date for a follow up treatment they will have stem cells on hand and not have to do the lipo again.


Today they took my blood and tomorrow they take my fat. I will be glad when tomorrow is over.