In about three short weeks, I'll be returning to East Africa to live and work for a few months.

I've been there before, of course, and feel like I'm returning to my other home and family in Africa.  It's interesting, and incredibly frustrating, that my arthritis seems to always become more active at the most inopportune times -- of course, I guess, there really isn't a "good" time.

Since BOTH of my knees are now "gone," I was concerned that this trip would not be possible.  Luckily though, I have an orthopedic specialist who has worked with me before and understands my passion for my work in Africa.  To ATTEMPT to alleviate some of the knee pain, my surgeon has been giving me weekly injections of Synvisc in the knee joints.  The purpose of these injections is to build a temporary cushion in the joint so my bones are not rubbing against bone. When I return from Africa, I will again have more surgery and will need to have both knees replaced.  My surgeon said that there is an additional product available (Synvisc  I) which is a single injection that provides six months of relief, but at this time he doesn't recommend it because it is a very large shot and he doesn't feel it's as effective for most people as smaller and more frequent injections.  He admitted when we started this regimen that he couldn't guarantee it would help, but it was the only treatment we could try at this limited time.  I normally don't take pain meds because of the side effects, but he's also working with me, trying to find one to keep with me as a back-up in case the pain reoccurs while I'm abroad.

But I can't take my surgeon or the pharmacy with me to Africa. It's a challenge because like most Americans, I've become spoiled by the relative convenience and availability of over-the-counter and prescription medications to cure or soothe those aches, pains, rashes, and a myriad of other symptoms.  We can open that cabinet at home, or drive to the nearest Walgreens.  If we don't cure ourselves immediately, we can grab a phone, call our favorite doctor, and be "fixed," or at least working on a solution quickly.

As much as I love Africa, however, these things simply aren't available most of the time. Although I have an IDP (International Driving Permit), I don't have a car.  I am only aware of one "pharmacy" of ANY kind in our area with very limited medications.

If I need to be seen by a doctor, I must go to a hospital-type facility after arrangements have been made for me (gee, I can't call a doctor, because I don't have a phone)!  The reality is that I pretty much need to be self reliant, medically, while I am in Africa.  Since I've been there several times, I've learned to keep a list of things I must ALWAYS take with me on each trip.  I have also learned to look at things as having more than one purpose. Yes, I've used dental floss to sew!  Because of all of the joint replacement surgeries I've already had, my doctors have me always carry my wrist, knee and ankle braces. Such simple things as Band-Aids, moleskin, topical antibiotics, disinfectant towelettes, diarrhea meds, allergy pills, eye drops and even cough drops are all great ideas.  I've found the best way for me to decide what to take is to stand in front of my own "medicine cabinet"-and think-why do I have this, and what would I use if I didn't have it?  I also pack a "multi-tool" and often a small pocket knife too.