Oaxaca, The Beatles and Knee Replacement

For the past two weeks that I have been in North Carolina, I have made the rounds of orthopedic surgeons first to get a diagnosis, then to hear second and third opinions. Consensus: knee replacement. Question: What type?  Answer: Read on. Bottom line? It’s essential to get a second and third opinion!

It all started on July 5, 2014 in Teotitlan del Valle when Michelle threw a Beatles Birthday Party for Mary. There were Dr. Z on percussion and Kaszt on electric guitar, with a Beatles play list that would take any Beatles fan back to Twist and Shout.  The tasty veggie and meat lasagnas were plentiful.  The red wine flowed and three decadent cakes waited patiently on the side table for consumption. We were among mezcal and good friends.  We’ve got a loosely knit small group of ex-pats who live in the village and from time-to-time we know how to party-on, just like our Zapotec neighbors.

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As we shouted out our favorites, Dr. Z and Kaszt played them, and of course, we all took spins on the dance floor, which was really the terrace overlooking sacred Mount Picacho and the Rio Grande.  And, then, the next day I could feel it in my right knee.

My sister brought me a brace when we saw each other a couple of weeks later in Mexico City. I needed it for our non-stop Looking for Diego Rivera and Frida Kahlo Art History Tour. Then, I started a regular regime of ibuprofen. Not much helped. In New Mexico I was icing and limping. In California I got a cortisone shot.

In North Carolina, the first orthopedic surgeon I saw showed me the x-rays and said, You need a total knee replacement.  I said, are there any other options. You can wait, he said, and it will get worse. I scheduled the surgery.

Friends said get a second opinion. The second surgeon I saw said I was a good candidate for a partial knee replacement. Who was I going to believe? So, I started to read surgeon bios, scheduled a third opinion and investigated the medical research literature.

Here’s what I found out:

Total Knee Replacement (TKR) involves a large incision, maybe 9-12″ inches long, removal of the knee-cap, reshaping the tibia, tibula and femur, and removal of the anterior cruciate ligament (ACL) — a crucial muscle for knee stabilization.  This surgery requires a two-day hospital stay, at least six to eight weeks of intensive physical therapy, and a post-operative recovery time of two to three months. It is major surgery.

I thought, geez, I’m going to have to cancel my winter workshops and I don’t want to do that.

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Surgeon #2 recommended a Unicompartmental (Partial) Knee Replacement (UKI), told me recovery time could be halved and that their robotic technique was very successful and advanced.  Wow, great, I thought. This seems to be the answer. Plus, he graduated PhiBetaKappa and went to one of the top U.S. medical schools. What I loved about him is that he prescribed an anti-inflammatory (meloxicam) and gave me a better brace on the spot.  I was ready to cancel the first surgeon and sign on with this one.

Then, a friend said, it doesn’t matter where they go to medical school.  What matters is where they did their fellowship program.

But, oh, what the heck, I kept the appointment with Surgeon #3, even though I was tempted to cancel it since I had already made up my mind that the robotic partial knee replacement was for me.

What I found out from Surgeon #3 just blew me away.  He told me there are two types of UKIs:  fixed bearing and mobile bearing, that the fixed bearing is done by robotic surgery, and he suggested I read about the differences.  You have to be your own patient advocate to get down into the medical device details to know the complete story.

According to the literature, the advantages of the mobile bearing implant is less wear and tear on the artificial part and that it “feels more like a real knee.” But, the surgery technique is more complex and requires precision. Failure rates are related to surgeon error.

Here’s an American Academy of Orthopedic Surgeons discussion of the two surgical techniques, if you are interested.

Right now, I’m leaning toward Surgeon #3.  He did 600 knee replacements in his fellowship year, has been in private practice for six years, and uses the Biomet Oxford partial mobile bearing implant.

What do you think about this choice?

Now, my plan is to return to North Carolina for this surgery just before Thanksgiving, then return to Oaxaca before Christmas in time for all the workshops scheduled to start in January.  Meanwhile, when I go back to Mexico next week, I won’t be dancing the night away.

Questions to Ask Before Deciding

  • What is the pre-and post-surgery process?
  • What type of anesthetic do you use?
  • Is there medication I can take for pain relief? How long can I safely take this?
  • Are there non-surgical remedies to help me?
  • If you recommend a TKR, what implant do you use and why?
  • If you recommend a UKR, do you use fixed or mobile implants and why?
  • If you do not perform UKR, why?
  • What brand medical device do you use and why?
  • Where did you do your fellowship?
  • How many of these knee replacement surgeries do you perform  each year?  How long have you been in practice?
  • If you go in and find the cartilage eroded and the knee cap damaged, what do you do? Do you do a TKR then?

Seek at least three medical opinions.  Then, go online and research the doctor’s experience and credentials. Compare where they did their fellowship and the ranking of that program for the surgical practice.

Anybody in Oaxaca know if there is a great orthopedic surgeon for knee replacement medical tourism?

 

Pre-Hispanic Women’s Clothing Design: The Huipil Endures

Years ago, after I first arrived in Oaxaca, I discovered an incredible small book by Mexico City fashion designer Carla Fernandez. Taller Flora: Indigenous Dress Making Geometry of Mexico, Pre-Hispanic Origin (2006) is now difficult to come by. But, it has become my bible for easy-to-make, easy-to-wear, comfortable, flowing clothing  that is versatile and beautiful.

The book is also my inspiration because it tickled an idea to develop the             Felt Fashion Workshop several years ago.

During the week-long workshop, January 17-24, 2015, we use naturally dyed merino wool to make wet-felted cloth.  Then, we sew it using the simple  geometric patterns to construct the garments. Our instructor, Maddalena Forcella, is internationally-known for her work.

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The results could be a jacket, a blouse, a shawl or scarf, a dress or a poncho. The quechquemitl is one of my favorites.

I was recently in Santa Fe, New Mexico, where I saw jackets, blouses and dresses made with felt, sewn and blocked, selling for $500 to $800 USD and more.  And, United States clothing designer Eileen Fisher uses variations for many of her patterns including the asymmetrical merino poncho priced at $248 USD.

There is more to the huipil than an article of clothing. It is a symbol of womanhood, female creativity and personal experience.

In ancient Mexican culture, each community created identity by weaving a distinctive pattern into the cloth.  And, there were different pattern variations for important life cycle events like weddings , births and baptisms. The woven cloth told a story about the village and the woman who created that particular garment.

Art of the Huipil: Mixed Media Workshop

Scheduled the week before the Felt Fashion Workshop, set to start on January 8, the Art of the Huipil is a hands-on experience taught by artist Lena Bartula. During the five-day session, participants create a huipil based on their own personal stories, using found objects and those we collect during visits to local weavers and markets. The result is a piece of art suitable for hanging, if you wish.

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In January, Oaxaca days are warm and mild.  Evenings are cool and comfortable. We offer a perfect getaway from winter that is safe and affordable.

You do not have to be an experienced artist or seamstress to attend. All levels are welcome.  This is about having fun and opening yourself up to the possibilities of creative self-expression in an encouraging, friendly place.

Questions? Contact Norma Hawthorne.

Blogger’s Dilemma: What To Say and How Often

Perhaps I’ve been traveling too long and have run out of things to say about Oaxaca, and what would be interesting to know, see and do there. I left Mexico on August 19, 2014, not scheduled to return until early October, another two weeks from now. I am not there, so daily life is not out there in front of me.  I fear there’s not much to say that is current or relevant.

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I miss Oaxaca.  The suitcase life does not suit me. Since I left Mexico, I’ve visited family and friends in Los Angeles, San Francisco Bay Area, New Mexico, and now, I’m back in North Carolina.  These visits are more than satisfying. They are essential touchstones. There are many more people around the country I want to see and can’t.

In the works are new eyeglasses and a possible knee replacement surgery — a surprising diagnosis. I’m getting three opinions on this surgery. Then, there is getting Rx’s refilled, seeing my dermatologist for the six month skin scan, changing my permanent address for my driver’s license and voter registration, and updating my computer technology — the essentials of life maintenance.

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Search Engine Optimization (SEO) advice says it’s important to post a blog at least three times a week to keep readers interested.

I hope you forgive me that I’m not able to do this now.  If I think of anything relevant to say, I’ll keep you posted!

I am inviting guest contributors!  Contact me. 

Viva Mexico! Viva la Independencia! September 16 Independence Day

On September 16 each year, Mexican Independence Day, the president of Mexico stands on the balcony above the entrance to the National Palace in Mexico City facing the huge Zocalo filled with people.  He recreates Father Miguel Hidalgo’s famous shout Viva Mexico!  Viva la Independencia! that Hidalgo made from the church in the town of Dolores in the state of Guanajuato, on September 15, 1810.

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Thus began Mexico’s war of independence from Spain which was not fully realized until 1821.

Known as El Grito de Dolores, the cry is the most important symbol of Independence Day.  Each year at eleven o’clock in the morning, mayors and governors of cities and states throughout Mexico echo it as citizens gather to join the shout.

 

Some think that Cinco de Mayo is Mexican independence day.  It is not.

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Mexico’s General Iturbide rode into Mexico City in 1821 to decidedly end the War of Independence. The Puebla nuns, also known for their mole poblano, created the red, white and green  Chiles en Nogada in his honor. He’s the man who designed the Mexican flag.

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The other Mexican revolution started on November 20, 1910. Also known as the Mexican Civil War, the ten-year conflict succeeded in ousting the thirty-year dictatorship of Porfirio Diaz.

Travel every city, town and village in Mexico and you will see streets named for the revolutionary heroes and the dates of independence.

Viva Mexico! Viva la Independencia! Give a shout out!

Food Alert! Guzina Oaxaca Opens in Mexico City

Casa Oaxaca is one of our favorite go-to restaurants in Oaxaca.  Sit on the roof. Overlook the spectacular roofline of Santo Domingo Church. Indulge in a tamarind mezcalini. Follow this with a perfectly prepared seared sea bass or duck tacos. Each sauce that accompanies is an art form in its own right. Finish with something made with Oaxaca chocolate and then walk down the Macdeonio Alcala to walk it off.

Now, when you are in Mexico City you can enjoy Oaxaca food at is finest.  Chef Alejandro Ruiz has opened Guzina Oaxaca in the upscale Polanco neighborhood where Quintonil and Pujol share addresses.  Guzina, which means kitchen in Zapotec, the predominant indigenous language of Oaxaca, showcases some of Oaxaca’s finest ingredients, include mole and mezcal.

It is also pricey.  Entrees are about 350 pesos or $25-28 USD. But if you have an appetizer, a cocktail, wine, entree and dessert, you could spend about $70 USD per person. But, then, Mexico City is one of those places with European ambience and style, a bargain if your economy is the dollar.

Food writer Leslie Tellez tells her story about Guzina Oaxaca. And, you can read more on Trip Advisor and El Chilango, too.

Chef Ruiz is not the only Oaxaca entrepreneur to make a foray into Mexico City.

Remigio Mestas Ruiz, textile curator, promoter of indigenous weaving and textile traditions ,and a man with a social conscience, opened Remigio’s at Isabel la Catolica #30 several years ago  His Oaxaca gallery, Baules de Juana Cata in the Los Danzantes patio, is where Oaxaca textile lovers go to find the very best backstrap loomed garments created with Thai silk and Egyptian cotton by the finest weavers.  These are all available in Mexico City, too.

More good reasons to come to Mexico City, don’t you think?

Looking for Diego Rivera and Frida Kahlo: Art History Tour in Mexico City, November 13-17, 2015.  

Oh, and did I mention that Mexico City is safe?

This restaurant tip came from one of my readers. Got tips about Mexico and Oaxaca you want to share? Send me an email.