CCSVI Diagnosis and Treatment Log Entry #10 – Results of My Ultrasound Examination

Image by meironke via Flickr

It is only possible to live happily ever after on a day-to-day basis.
  - Margaret Bonnano

Now that Kim and I have travelled to New York City three times in the past five months, for CCSVI related reasons, I find myself growing negligent in my sworn duty to hate the Big Apple. New York is beginning to grow on me.

I was raised to loathe New York City, primarily because our Boston sports teams competed with theirs. I not only hated the Yankees, Jets, and Knicks, but by extension the Empire State Building, Central Park, and musicals (both on-Broadway and off). Evolution has favored the human trait of “in-group loyalty.” Unfortunately, this trait naturally gives rise to “out-group hate.” Why? Maybe it’s because by denigrating outsiders, if we don’t entirely love the circumstances into which we are born at least our condition seems favorable by comparison.

Although New York City continues to grow on me, I won’t be moving there anytime soon. And don’t worry Red Sox Nation, there are some absolutes in this world after all. The sun will rise in the east tomorrow, a bear will shit in the woods tomorrow, and I will still hate the Yankees tomorrow (and musicals).

In March I was diagnosed with and treated for a condition called CCSVI, which is believed to be related to multiple sclerosis. This occurred at Brooklyn's Kings County Hospital Center, under the direction of Dr. Salvatore Sclafani. That was NYC trip #1.  To read about my CCSVI experiences, click here.

In late July of 2010, Kim, Zach, and I traveled to New York to attend Dr. Sclafani's CCSVI symposium. More precisely, I went for the symposium and Kim and Zach went for the sightseeing. They learned a lot about the New York City subway system that day - some good and some bad. This was NYC trip #2.

I thoroughly enjoyed the symposium. I was able to listen to and even rub elbows with some of the top CCSVI physicians and researchers in the world. I also met with several of my online MS/CCSVI buddies, and spent time with members of CCSVI Alliance, the non-profit organization that I volunteer for.  I had hoped to combine the symposium trip with an ultrasound examination at Kings County Hospital, but unfortunately the doctor who was trained in that procedure was unavailable on that day.

So, just two weeks later, Kim and I made NYC trip #3 for the aforementioned ultrasound test. Dr. Zamboni, the Italian physician who coined the term CCSVI, developed a specific doppler ultrasound protocol to determine if a patient does or does not have CCSVI. In order to meet the diagnostic criteria for CCSVI, a patient must demonstrate two or more of the following five criteria during the ultrasound:

1. Reflux (blood flowing in the wrong direction) in the internal jugular veins, in the vertebral veins, or both.
2. Reflux in the deep cerebral veins, and/or in other venous segments of the intracranial compartment.
3. Evidence of internal jugular vein narrowing (stenosis).
4. Blood flow not detected by doppler in one or both of the internal jugular veins or vertebral veins.
5. The cross sectional area of either internal jugular vein is wider in a sitting position than in the supine posture.

I met none of these criteria. Well, at least I don’t think I did. The examining physician, a colleague of Dr. Scalfani’s who was trained just a few weeks ago at Dr. Zamboni’s clinic in Italy, still considers the test somewhat subjective.  I am grateful that he was frank with me about that. He’s doing his best, but it’s not a straightforward task by any means.

How do I feel about the results of this latest visit to Brooklyn? Should I consider it good news that I don’t have CCSVI anymore, or should I consider it bad news that there is nothing more that can be done for me right now? Excellent question- I wish I had an answer. I wish I had a lot of answers.

What, then, is going on with my CCSVI and my MS? Here is where things stand:

• It’s still too early for me to say with certainty whether my disease progression is the same, slower, or non-existent. Stay tuned.
• It is not too early, however, for me to state that I’ve definitely not improved, as many others have (although not everyone).
• Based on what Dr. Sclafani saw in the March venogram, I almost certainly had CCSVI in my internal jugular veins and possibly in my azygos vein. He ballooned all three for good measure.
• Based on the ultrasound test this week, I likely no longer have CCSVI type problems in my internal jugular veins. We can’t know about the azygos, as this ultrasound test does not look at that vein.
• I may or may not have flow restrictions in various other central nervous system veins such as the lumbar and vertebral. Even if I knew that these veins had restrictions, we couldn’t know yet if this would affect my MS. Furthermore, even if we knew it could affect my MS we probably couldn’t treat those veins. Much more study is needed.
• There is nothing further that can be done for me right now relative to CCSVI, although as we learn more about CCSVI there may be procedures I can undergo later.

What, then, is going on with my general sanity?  Here is where things stand:

• Going forward, I need to keep my finger on the pulse of CCSVI research while not obsessing over it.
• I will try to heed the words of Margaret Bonnano (at the top of this post), and “live happily ever after on a day-to-day basis.” It will not be helpful for me to long for the healthy days of my past, or worry too much about my uncertain future.  I need to stay in the moment.
• I am alive; blood is coursing through most if not all of my veins; and despite everything I am still Enjoying the Ride.

Media Coverage

First, CCSVI Alliance, the 501(c)(3) non-profit organization that I volunteer for, had some good media coverage.  Check out this link.  Doesn’t their president, Sharon Richardson, look soooo presidential? 



Second, my friend Marc Stecker, aka Wheelchair Kamikaze, is featured on the cover story in the Fall 2010 edition of Momentum magazine, seen here. If you’re one of the few individuals in the MS world who has not yet visited his website, click here. 

Taking the iBOT to Bar Harbor

Check out my latest iBOT action video.  To see my other iBOT videos, look on the right-hand sidebar of my blog.  Enjoy!

The Crap That Runs Through My Head

Such as...

“What if this weren't a hypothetical question?” 

And, stuff like the following little conundrum.  On Wednesday I took my handcycle for a ride. I felt strong. I covered 2.6 miles with only a couple of stops. This is a very modest distance for a healthy person, but trust me, for a person in my condition it was impressive. The ride invigorated me, and set the stage for a relatively energetic day.

Then I went out Saturday morning and only covered 2.1 miles, and had to stop about 10 times. The ride did not invigorate me.  In fact, I never completely recovered from it until the next day.  What changed?

As I was finishing up Saturday’s ride, I started to ponder that very question. What changed?  I approached the problem in a systematic fashion. The cause of my weak handcycling performance could have been due to differences outside my body or differences inside my body. Let’s consider the outside first.

Was the course different? No, I followed the exact same course (a little shorter on Saturday though).

Was the weather different? No, it was sunny and about 70 on both days, with light winds.

Was the bike different? I don’t think so, although I didn’t inspect it closely.

Time of day?  Nope.  9:00ish on both days. 

Overall, it doesn’t appear that any external factors were responsible for my disparate performances.

So what was different inside my body? Two possibilities come immediately to mind: what I ate and how I slept.

On Tuesday night, before my Wednesday morning ride, I slept about 7 hours, which is my average. On Friday night, before my Saturday morning ride, I slept 8.5 hours, which was very unusual.

On Tuesday, I consumed 1,722 calories. Remember, I’m counting calories these days to try to lose weight. On Friday, I consumed 1,976 calories, which included 2 lite beers in the early evening.

Was it my menstrual cycle?  Nope.  Last time I looked I have only male reproductive parts.   

I can’t think of anything else that I did differently on the days before my morning rides. Was the combination of more calories and more sleep on Friday the difference?  Did Friday's modest alcohol consumption have such a profound effect on Saturday's handcycling performance? 

Another possibility is that there were changes inside my body other than diet or rest. The obvious candidate is MS. Remember though, I have PPMS, which means that my health doesn't change much from day to day. I don't have those classic good days and bad days like people with RRMS do.  But maybe having a chronic, disabling disease causes me to constantly walk a fine line, where even the slightest changes in variables either external or internal to my body have a profound impact on my ability to function.

Or maybe I just need to stop thinking so much. A less analytical person might consider the same experience and say, "hmm, I wasn't nearly as strong today as I was on Wednesday. Oh well, it's probably nothing."

What do you say?

Have you ever seen a Black Swan?

The answer is yes. You have seen many black swans. Allow me to explain…

Most of us embrace the illusion that the things we plan for will actually happen, and that the events that so-called “experts” predict will likely come to pass. We behave as if we live in a world that is stable, predictable, and follows some set of rules. This couldn't be any further from the truth.

I recently read a compelling book on the subject, called The Black Swan, by Nassim Nicholas Taleb. He describes black swans as earthshaking events that are not anticipated, and that have far-reaching effects. Black swans can be public, like 9/11, or private, like a surprise pregnancy or a cancer diagnosis.  Black swans can be positive, like winning the lottery, or negative, like the financial crisis we are still recovering from.

Taleb explains that the events which have the most impact on our lives are not the day-to-day occurrences that we spend so much time thinking about and preparing for, but rather those catastrophic or wildly fortunate, completely unexpected events that we never see coming. This is not to say that we should ignore the little things that we can control, and wait passively for the wheels of fate to turn either in favor of us or against us. We need to be concerned both with the routine events of the day and the black swans.

So if unpredictability, chaos, and pure luck rule the day, then why even spend time shopping for groceries a week ahead or completely filling your gas tank? The answer is, because we just never know how long it will be until the next black swan, or what form it will take.  It is difficult to prepare for specific black swans, but we can take into account their existence. Taleb's advice is to exert effort to minimize exposure to big, negative black swans, and increase exposure to big, positive black swans. Examples of minimizing exposure to negative black swans would be purchasing life insurance (for your spouse) and not buying a house in a flood zone. You can maximize your exposure to the positive black swans by looking for opportunities. Taleb says:

“Seize any opportunity, or anything that looks like an opportunity. They are rare, much rarer than you think. Remember that positive black swans have a necessary first step: you need to be exposed to them. Many people do not realize that they are getting a lucky break in life when they get it. If a big publisher (or a big art dealer or a movie executive or a hotshot banker or a big thinker) suggests an appointment, cancel everything you have planned: you may never see such a window open up again. I am sometimes shocked at how little people realize that these opportunities do not grow on trees….Work hard, not in grunt work, but in chasing such opportunities and maximizing exposure to them…you gain exposure to the envelope of serendipity…Diplomats understand that very well: casual chance discussions at cocktail parties usually lead to big breakthroughs- not dry correspondence or telephone conversations. Go to parties! If you're a scientist, you will chance upon a remark that might spark new research. And if you are autistic, send your associates to these events.”

Consider my own situation. I played by the rules. I got a good education. I worked hard in a variety of jobs. But what defines me more today than anything else is the fact that I have MS. This was a big negative black swan, that couldn't be avoided or predicted. I experienced another negative black swan when I found out that the iBOT, my advanced mobility device, was no longer being manufactured. On the other hand, my mother’s passing almost two years ago was not a black swan. Although it was tragic and had far reaching effects on me and others, it was not a complete surprise.

If the discovery of the connection between CCSVI and MS proves to be a key to understanding this damn disease, that discovery will, in retrospect, have been a positive black swan. I’ve exposed myself to that potential by undergoing CCSVI treatment, while not even knowing for certain if it will work.

(Photo credit: Wikipedia)

I’ve spent a lot of time avoiding negative black swans, yet I can’t elude them all. My point isn’t that we should forsake college educations or refuse to draft five-year plans. I’m not advocating that we avoid buying the groceries a week ahead. But I wish that we would admit to ourselves that as a species, the most sophisticated and intelligent species on earth, we still have very little control and very little understanding of the complex ways of the world. It is simply beyond our grasp.

For me, this discussion about black swans is not at all troubling.  It represents an enrichment of our understanding of the world, even if that new understanding is that we don’t understand, or control, nearly as much as we thought we did.  I find this concept, and the truth it reveals, to be strangely liberating. 

The bottom line- spend enough time on the mundane tasks to stay above water, carrying on as if the future is predictable. Spend the rest of your time avoiding negative black swans and exposing yourself to positive black swans. And most of all, try not to be shocked if the completely unexpected happens. In fact, be shocked if it doesn’t.

The Evolution of Friendship

(Photo credit: Wikipedia)

It's the year 2000. My wife and I have decided to move three hours away from the only town my kids have ever known. It’s time to break the news to them, and we dread it, partly because “moving” was one of my great childhood fears, right up there with the boogieman in the closet. But our 8 year old, Zachary, didn’t inherit that phobia from me. I remember exactly how he responded to our news. "That’s OK, because I'll get to meet a lot of new friends, and I’ll be able to keep my old friends."

What Zach said is true. Well, sort of. Well, not really. Every time we have a major life change, like switching jobs or moving to another town, we welcome new people into our lives, but we leave other people behind. It’s as if we have a fixed number of friendship slots. If new ones come in, old ones must go out.

Some of our friends just gradually drift away after a major life change, not because they weren't important to us, but because the relationship succumbs to the erosive effects of time and distance- victims of the zero sum game I describe above. It’s rarely a conscious decision on our part. It happens outside of our direct control. That was the case after I stopped working a little over a year ago. I stayed in contact with some former coworkers. Others have begun to fade away, and I’ve also gained new friends.

Who are these new friends? I'm not working anymore, so how is it that I’m meeting people and building relationships? I’ve gone from interacting with dozens of people every day and traveling all over the country, to sitting at home most of the time. Thank goodness for the Internet. If I had gone on disability retirement 20 years ago I think I would've gone crazy from the boredom and loneliness.

In just the last decade or so, an entirely new type of human interaction has evolved, and the subsequent relationships often become meaningful, fruitful, and enduring. They start out as “virtual” relationships, but they can become very real over time.

I am active with several online groups having to do with multiple sclerosis and more recently with my iBOT wheelchair. My relationships with these people are like the close relationships I used to have with some of my coworkers. We share common goals. We get to know one another’s life stories. We talk “business” while sprinkling in conversations of a more personal nature. We support one another. We learn from one another. My life is tangibly better for having fostered these friendships.

Technology helps. I communicate with my online friends over the telephone, though email, texting, Facebook, Skype (perhaps the most intimate online communication platform), and several other methods. Last night I had my wife take this photo with my phone, and I emailed it to my new friend Michelle, with the caption, “Summer has begun at the Old Port.” I knew she’d appreciate the photo.  It took me about 20 seconds to make that quick connection to somebody three states away.



One of the advantages of online relationships is that they are not constrained by geography in any way. My friend Herrad, in Amsterdam, is an example of that.

I’m grateful for my online friends, and I appreciate the blessings they provide. It’s a particular thrill, though, when I get to meet any of these friends in person. Online communication is a wonderful substitute, but nothing replaces personal contact.

me with virtual friends turned real 

By the way, my son Zach didn’t keep any of his old friends from ten years ago. We kind of expected that, but there was no way we were explaining the realities of life to him on that fateful day in 2000. Childhood ignorance can be bliss.

Save the iBOT

Imagine for a moment that you can’t walk.  Don’t worry- it’s just pretend.  Then, imagine that one day you discover a device that gives you a higher quality of life and greater independence. Because of this device you once again go places and do things that usually only walking people can. You became re-integrated into the fabric of society, the everyday comings and goings of healthy people.  How would this change your life?

Then, imagine that after only a few years, the device no longer exists.

When we discover something that reduces human suffering and makes the world more accessible, it should not simply fade away because of red tape and bad government policy. But that’s exactly what is happening. The iBOT is fading away.

But there is a group of people working to change that. How can you help? First, join the Facebook group called Save the iBOT, which was founded by my friend Max Burt, an iBOT user from the UK. Soon, this group will be launching a website with more information about how you can join the effort. Once the new website is up and running, you’ll see announcements on Facebook and here at Enjoying the Ride.

Help us save the iBOT, because shouldn’t humanitarian progress be a one way street?

To read about my iBOT experiences, click here.

Soldier Gary Linfoot

Alan T. Brown, iBOT user and activist.

iBOT inventor Dean Kamen

Two videos of me in my iBOT:

 

CCSVI Diagnosis and Treatment Log Entry #9 – 12 Week Update

Everyone wants to know how I’m doing after my CCSVI procedure. The answer is…I feel exactly the same as I did before my visit to Dr. Sclafani.  That may sound like bad news, but maybe it is, and maybe it isn’t.

Some people are personally invested in my outcome because they know me and care about me. Others are following my story because I represent another data point in what has become a global, open laboratory experiment. Our collective lab notes can be found at CCSVI websites, on Facebook, Twitter, YouTube, TIMS, and at a place we affectionately call the Blogosphere.

So I sit here and wonder- have the blood flow characteristics in my central nervous system improved enough to alter the course of my MS? Unfortunately, I have no answer today. As soon as I do have a clue, one way or the other, you’ll be the first to know (well, right after I tell Kim).

Before trying to evaluate the success or failure of my CCSVI procedure, I decided to re-read my earlier blog posts, so that I could be reminded of what my expectations were. I’m glad I wrote them down, because expectations are notoriously fluid over time. Here’s some of what I wrote, from the oldest post to the most recent:

“…people like me who have already suffered significant damage to our central nervous systems will not see much, if any, improvement in our current conditions. We would simply stop getting worse. I need to stop getting worse, like, yesterday. Getting better can wait.”

“This concept has such upside potential that I find myself temporarily disinterested in all other MS research. For the moment, everything else is just so much background noise to me.”

“Given the speed at which my MS is progressing, patience puts me at more risk than taking early action does.  CCSVI remains my best chance to halt the progression of this disease before it completely consumes me.”

“Although I am very encouraged by the possible connection between CCSVI and MS, I have to be realistic about the chances that this will make a difference in my life. In other words, I am managing my expectations. This is how I operate. Others, in a similar situation, might effuse optimism. To each his own. Perhaps this will slow down or stop the progression of the disease. Maybe it won’t help at all. But one thing is certain. If I do nothing, then I know where this thing is headed.”

“No miracle changes on the operating table. It may take me many months to assess the impact. No matter the final results, it was a most interesting experience.”

“How am I doing, you ask? I’m doing just fine, thank you. Ask me again in six months or a year, and I may be able to tell you if this procedure had any positive effect on my disease progression.  Wouldn’t that be something?”

“Because it may be a long while before I know if this CCSVI treatment helped my disease progression or not, I’m unsure of how to comport myself. Should I carry on as if I’m cured or as if I’m still sick?

That’s a trick question. Forgive me. The answer is the same no matter the outcome of my CCSVI treatment. To the best of my ability I'm going to live my life one day at a time, hope for the best, prepare for the worst, and treat each day as if it could be my last. I encourage each of you to do the same.”

Several themes stand out in these earlier posts. First, I had modest and realistic expectations. Although there have been many accounts from CCSVI patients about immediate improvements, as a person with advanced PPMS I had no expectations in that regard. I only hoped to stop the progression. Second, before I had CCSVI treatment I felt that it would take six months or a year to assess its impact. It’s only been twelve weeks. Third, even if I see no benefit from CCSVI treatment, I will not regret having tried.  

Since March 17^th, I have seen no improvements. I expected none. Over the same time period I have experienced no disease progression. I expected none.  Twelve weeks is simply too short of a period to notice disease progression for me. 

There are two potential story lines, either one of which may be playing out right now:

1. The procedure had no positive effect on my disease progression.
2. The procedure slowed or stopped my disease progression.

A third scenario may be overlaid on either of these though, just to complicate matters. It may be that the repair was not permanent. The stenosis that was opened using angioplasty may have returned (restenosis). I expect to have a follow-up visit with Dr. Sclafani at six months, which will be September of 2010, to determine if the areas of stenosis have remained open. I'll have this exam whether or not I believe my disease progression has stopped.

For me, then, it remains a waiting game. Is the uncertainty difficult to bear? Sure it is. However, it’s preferable to the grim certainty I would have faced if I had tried nothing at all (and 'nothing at all' is exactly the recommended course of action by many physicians and other experts, none of whom walk in my shoes).

My Disabled Cruise Story - Chapter 6 – Home is Where You Hang Your Swim Trunks

After four consecutive days of visiting magnificent ports of call, we were looking forward to a full day at sea, just us and our faithful ship (and the other 3,800 passengers and 1,400 crew). Kim had been eyeing that rock climbing wall all week, and conquered it on Saturday.

By the end of any vacation week, I’m always ready to go home. I come to miss my simple life with all its little routines, all the familiar people, and all my own “stuff.” But this vacation was different.  I didn’t want it to end. 

Saturday was difficult because we were saying goodbye to all the friends we met, all the wonderful staff who had taken such great care of us, and the incredible ship itself. We were also saying goodbye to cruise Kim and Mitch. We liked cruise Kim and Mitch. They were such a cool, happy couple.

There was a party atmosphere on the Freedom of the Seas that Saturday night, and we joined in. We were determined to squeeze every ounce out of our dream vacation.

that’s Cuba just over the horizon, honest

farewell stage show

last dinner – world’s best waitress Marianna

For the first time that week, we arranged for a wake-up call the next morning. We needed to be ready to leave the ship by 7:30 a.m. on Sunday, according to the cruise schedule. We contemplated hiding somewhere on the ship, so we could be stowaways on the next cruise, but we feared that my iBOT might give us away.

We enjoyed one last buffet breakfast on Sunday, and then departed the ship on time. At the baggage claim area in the terminal we loaded up the manual wheelchair with our bags and headed out for the buses that were waiting to transport us to the Orlando airport. We had plenty of time. Our flight wasn't leaving until 3:30 in the afternoon. Weeks earlier I had prepaid for our transportation from the ship dock to the airport, and I had let them know that my bus would need to be wheelchair accessible. I was told that it would not be a problem.

last buffet breakfast

This is when things started to break down. Nothing much went right on our journey home, but I was unbothered by all of it. For months I had worried that something would go wrong on the trip to the ship. A bad trip from the ship back home was of little concern to me. But that's exactly what we got -- a bad trip home.

The first problem was that the person in charge of the buses didn't have my name on their list. I convinced him that this was an error. Second, since they didn’t expect me in the first place they definitely had not taken my wheelchair into consideration. Eventually they found an accessible bus, and sat us on it for a couple of hours before filling it with other passengers.

About an hour into that two hour wait, I had to empty my bladder. The wheelchair space was mid-bus, and the bathroom was in the rear. I stood up and held on the seat tops and the overhead bins. Kim moved one of my legs at a time until I reached the bathroom. When I came out of the bathroom I plopped down in the nearest seat, and just stayed there until we arrived in Orlando. We then did the dance down the aisle again to get me back to my wheelchair (after everyone else had already departed the bus).

We arrived at the Orlando airport in plenty of time for lunch, and checked in three hours ahead of our flight, or so we thought. There were thunderstorms in Chicago, so our departure was delayed from 3:30 to 5:30. Kim worried that we would miss our connection in Chicago, but I’ve travelled enough to know that if incoming flights are delayed due to weather, then outgoing flights are almost certainly delayed at least that same amount.

When we landed in Chicago we found out that our connecting flight had indeed been delayed by two hours. Therefore, we would still have the planned layover, but we’d leave O’Hare at 9:30 p.m. instead of 7:30. 9:30 came and went- so did 10:30 and 11:30. Finally, wheels were up at about 12:30 a.m. local time. No problem. The 7 hours we spent in O’Hare helped us shed that nagging feeling that we didn’t really want to go home. After all those travel delays, we couldn’t wait to go home.

The flight from Chicago to Maine was uneventful. As usual, my iBOT made the round trip without a scratch or dent. We pulled out of the Portland Jetport (not a mere airport, mind you) in our own mini-van and headed for home at 3:30 in the morning- long day.

For Kim and I, this vacation was everything that we hoped it would be. In fact, I'm cutting up my previous Visa rewards credit card (there are not that many items at Cabela’s that I can take advantage of anymore), and we now buy everything with our Royal Caribbean credit card. We'll get free stuff on our next cruise. Yes, we're hoping there will be a next cruise.

This was an ideal vacation for a wheelchair user. The accessibility on these large, modern cruise ships is as good as it gets. The ports of call leave something to be desired regarding accessibility, but if you have modest expectations then you are not disappointed. It is my understanding that the Eastern Caribbean islands have better wheelchair accessibility than the Western Caribbean islands, where we went. But that itinerary just wasn't available to us on the ship we wanted, on the week we wanted. Maybe our next cruise will be to the Eastern Caribbean.

I'd like to recommend two resources that worked well for me. First, Candy Harrington's books on travel for wheelchair users and slow walkers are fantastic. She also maintains a blog for more current information.

I used a travel agency out of Kansas City which specializes in cruises for disabled passengers. Jeanie was very helpful and a joy to work with. She responded promptly to all of my questions, and guided me through the entire process. Working with someone who understands your unique needs is invaluable. They can be reached at: Snail’s Pace Special Travel Services

If anyone has any questions for me about cruising in general or more specifically about cruising in a wheelchair, I’ll be glad to tell you what I know. Just click on the email button on the top right-hand corner of this blog page.

I hope you've enjoyed reading about and seeing the pictures of our dream vacation. I encourage everyone to do what they can to stop and smell the roses once in a while, no matter how difficult your journey. I know that a Caribbean cruise is not practical or even possible for everyone, but almost anyone can find some way to relax and enjoy themselves. No doubt you deserve it.


cutting loose in Cozumel

My Disabled Cruise Story - Chapter 5 - You CAN Drink the Water in Mexico

On Friday, the mind games began.

Sometimes it’s like there are two people inside of me. No, I’m not schizophrenic. On one level I was still having the time of my life, and I needed to concentrate on enjoying the day ahead in Cozumel, Mexico. On another level I was starting to feel a creeping dread that this vacation would soon be over. Despite this dark cloud on the horizon, I did manage to stay in the moment and thoroughly enjoy the remainder of the cruise.

As I did in Jamaica, I prearranged for a wheelchair taxi tour of the island. The deal was $175 for 4 hours. We departed the ship and ran the gauntlet of vendors on our way to the taxi stand. Per the plan, our taxi driver was waiting for us holding a placard with my name on it- already much better than the situation in Jamaica.

The van appeared modern and in good shape. The driver opened up the rear doors exposing a nice power lift. I positioned myself on the lift, and the driver raised me up. When we got to the top I noticed that there was neither a lowered floor nor a raised roof in the van. Damn, vertical space would be at a premium. As I inched forward the top of my iBOT seat hit the top of the van door opening. Progress stopped.

My wife and I have encountered so many access obstacles over the years that we’ve become proficient and creative at solving them. I wish I had pictures of the time we drove the iBOT onto a dock at my brother’s lake cottage using two planks over the water. Probably we could have solved this taxi challenge as well, but our hearts weren’t in it. My wife’s reluctance was based on her opinion that $175 was too much money to spend. For me, I feared that I would not be able to sit up straight during the 4 hour tour. So, even though our driver urged us to try to squeeze into the van, we played dumb. I apologized to the driver, who barely understood any English, and asked him to lower me back to the pavement.

The walk into town from the pier was 2.5 miles, and we decided to go for it despite the Mexican heat. The stroll was neither scary nor particularly interesting. The sidewalk quality was below Grand Cayman standards, but still passable for me in four wheel drive mode. By the time we reached downtown we were hot, tired, hungry, and thirsty. A gentleman beckoned us into his restaurant with the promise of air conditioning. It worked (both the beckoning and the air conditioning).

walk into town

drunkstore bar

After relaxing and refilling our tanks in this authentic, quaint, affordable Mexican restaurant, we were ready to take on Cozumel.

We wandered the clean and safe streets. Although the vendors were vocal, they didn’t bother us. I don't know if they were less aggressive than the Jamaicans, or if we were we simply getting used to that game. Throughout the city, the Spanish speaking vendors had a common English phrase for, I assume, all wheelchair users: “free parking inside”…”free parking over here”…”come on in, free parking.” Ugh. It was only funny the first dozen times.

downtown Cozumel

downtown Cozumel

back up just a little more…

bars with clowns, what an idea!

I had managed to avoid using the bathrooms in Haiti, Jamaica, and Grand Cayman- just good timing. But because we took advantage of the beer and margaritas in Cozumel, there was no avoiding it. They say not to drink the water in Mexico. I say the water is OK, just don’t use the bathrooms, well at least the handicapped accessible ones. They were not clean, and they didn’t always have grab bars. The stalls were just a little bigger than the standard ones.

But other than that we had a great time in Cozumel. The food, drink, and souvenirs were plentiful and inexpensive. Eventually, we had to return to the ship. But there was no way that we wanted to make that 2.5 mile trek back to the pier in the afternoon heat. We found a taxi driver and asked him to call us a handicapped accessible taxi. It seemed that the ratio of cabs to tourists was about 2 to 1, and there were three large cruise ships in port that day. Tough way to make a living.

Besides the bathrooms, the other third world-ish aspect of Cozumel was the occasional soldier or group of soldiers toting automatic weapons on the streets.  I just don’t see that very much in Portland, Maine. There is a serious war in Mexico these days between the government and the drug lords, and even the tourist towns are not exempt from it.

When the wheelchair taxi arrived, because we were highly motivated, we found a way to squeeze me and the iBOT into the back of the van for the short ride to the pier. I had asked another tourist earlier in the day what the cost of the taxi ride from the ship to downtown was. The answer- $7. But because this was a special handicapped van, he charged me $14. That kind of discrimination is just something you just don’t experience in America. I took it in stride though.

Unfortunately, I repeated a mistake from earlier in the cruise. I was having so much fun in Cozumel that I had not been careful, and had overheated, although not as badly as in Haiti. I rested in our stateroom with a cold cloth on my forehead for an hour or so, and then I was good to go.

That night we enjoyed dinner with Pablo and Melissa, went to a production show in the ship’s massive theater, and partied a bit more. I lost $100 of my $112 blackjack winnings (of course).

I hope I don’t come across as too critical of Cozumel. I liked the island, and we had more fun there than any other port-of-call that week. The best word to describe Cozumel- festive.

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view of Cozumel from our ship