Saturday, January 21, 2006

Dispatch #7 Mexican Medical Adventure and Other Stories

Dec 18, 2005 to January 15, 2006

When last we left our story we were heading north to La Paz from Cabo San Lucas. We had an uneventful journey compared to some of our fellow boaters. The winds blow from the north this time of year and sometimes they get to blowing really hard from the north and are called “northers”, catchy, huh? These can blow 35 or more knots for several days non-stop and make heading north virtually impossible against them. While, several of our fellow boaters were either pinned down in an anchorage or beat against these winds on the way to a protected anchorage on their way up to La Paz, we had quiet passages but moved quickly to take advantage of the predicted calm weather window and were glad for our decision.

La Paz is a little city we really have come to enjoy. It is a “real” Mexican city in that its livelihood does not depend on tourism and there are few really touristy things about it. There are stunning islands just north of here that are likened to “mini Galapagos” island with some of their own unique species. Some local operators lead tours to the islands to snorkel or dive, fish, picnic on the beach, swim with the sea lions, etc. There is a huge collection of hammerhead sharks about 30 miles from here that are a big diving draw, but we have passed on that experience. What we’ve found to like about La Paz is the fish taco stand for 10 pesos/taco (about a dollar) with all the sauces and condiments out in front, the organic ice cream place with flavors like guanabana, mango, limon crema and, one of our favorites, petalo de rosa (with actual rose petals in the ice cream), the 2 open air markets, the friendly people, the many places to get great food. We’ve walked the streets endlessly discovering new shops and delights. There is a stunning huge cathedral near the main square, an anthropological museum and many everyday shops including a mind boggling number of shoe stores and watch stores. We (Betsy) practice our Spanish on the vendors and enjoy the really friendly and accepting atmosphere here.

There are at least a hundred other cruising boats in and around La Paz. Many have come and never left the area they like it so much. Others like us are transient but enjoy the city enough to stay for a while (more on why we have stayed later, stay tuned). A “yacht club” has been formed of these cruisers with membership of $10 per person per year. The money goes to a lunch program for local school kids and the club organizes events including an auction for the kids before Christmas. There is a tiny clubhouse that receives mail and deliveries for member (and non-members), collects mail to be posted in the US when someone is heading that way, has a coffee hour each AM at 10-11, sells t-shirts and hats, and serves as a book exchange. As to the latter, I must admit I had never seen the full collection of Danielle Steele, but it takes up a large area—suffice to say, literature is too kind a word for these books. Every morning at 8 AM is a radio net on VHF. All the cruisers turn on their radios and tune in to get news, weather, announcements of deliveries, mail at the clubhouse or various marinas, hazards, announcements of events, swap and trade and local assistance (where can I find a muffler for instance).

The radio net can sometimes be very efficient and informative. Other times, it is like getting one’s teeth pulled without anesthesia. For an example of the latter, I will quote extensively from a fellow boater’s blog which we laughed out loud reading.

"We’re back in La Paz! Home of the La Paz Cruisers Net, a radio “info” hour, with lost and found, who’s coming and going, weather, tides, stuff for sale/trade, etc. Every so often the net gets taken over by the chatty mcchattersons and degenerates into gossip or specific snarking about this or that and we of course never miss it if we can help it. This morning was dominated by the epic saga of Raoul’s sore throat. Blow by blow details of the progression of this extremely rare and unique variety of strep throat, heretofore named Streptococcus Raullius, which doesn’t respond to any normal antibiotic, nor does it respond to any run-of-the-mill doctoring. No no. Raullius requires special $80 (US!) antibiotics (did he mention they must be very very strong and not any normal antibiotics?), which may be obtained by only one very special doctor in La Paz (additional personal anecdotes and the doctor’s name, spelling of name, and telephone number is now given about seventeenthousand times for everyone who didn’t quite get it the first time; this takes an additional fifteen minutes) who was thankfully astute enough to identify the important nature of this illness. Betsy from Qayaq (a doctor, unfortunately for her this morning) I knew must be pacing up and down the walls of her boat near the start of the antibiotic “advice” and it took about 20 minutes for her tortured voice to come on offering clarification on a few points.

Now we’ve degenerated to, “Is today… Wednesday? Or Thursday?” Luckily the highly contagious Raoul knows that it is Wednesday (because he knows he does the radio hosting on Wednesdays). I would make fun of the question, “Is sweetened milk the same as evaporated milk,” if damned if I didn’t ask the very same question a week or so ago when sifting through all our weird cans left over from the apartment departure and which we ended up bringing along."

We had planned to stay in La Paz for Christmas which we did. Then we headed up to the islands north of here to enjoy an amazingly beautiful week. We assembled our kayaks and kayaked nearly daily along stunning rock formations. One evening out in the kayaks we saw 4 blue-footed boobies which apparently nest near where we were anchored. There was no mistaking them with those blue feet—sort of like the Microsoft blue screen of death. Frigate birds, ospreys, and pelicans wheeled around us at anchor, and one anchorage was loud with the frequent splashing from the pelicans diving for fish. While there are rumored to be ring-tailed cats on the islands, they are nocturnal and we didn’t see any. We snorkeled one day among tropical fish and various interesting rock growths, but it was so cold that 20 minutes was more than enough. We ended up seeing lots of fascinating underwater and shore life from the relative warmth of our kayaks instead. We walked a couple hours up an arroyo to the other side of one of the islands and were treated to gorgeous views on the other side. We also didn’t see the rattlesnakes and scorpions that are rumored to be on the island—we were not disappointed in this. All in all it was a wonderful week with beautiful weather.

We returned to La Paz on New Year’s day intending to visit with my brother and his family who arrived on New Year’s eve. Due to some confusion about rentals in their vacation home, we only got to see my brother and his youngest son for a few hours when they drove up to visit from Cabo. While it was disappointing to spend so little time with them, we hope we can connect again later in the spring as we think we’ll be back up this way then.

During that first week of January, Richard also discovered a lump that he was worried about, thought it was new and over the week it seemed to increase in size. I agreed that we ought to have it evaluated. I had made the acquaintance of a local Mexican family doctor at Christmas and made arrangements to tour the hospital with him and talk to him about his practice here. When we met with him at the hospital I also asked him for a specialist referral for Richard. He graciously called and made us an appointment for the following day with the specialist.

Here is where the Mexican health care system starts to look pretty good when compared to ours. The next day was Saturday and our appointment was at noon. The specialist didn’t even get Richard’s full name because the family doctor didn’t know it. We not only saw the specialist but got an ultrasound that very day on Saturday. The ultrasound was actually performed by a radiologist and the specialist popped in to look at it between his other patients. The report was typed up within 10 minutes of the scan and we were back in the specialist’s office going over results with him. The lesion was indeterminant and he suggested that it be removed so that we could determine what it was. He offered to schedule the surgery for Monday but we wanted some time to decide whether to go forward with it. We paid cash for the visit and the ultrasound before we left. Suffice to say that those costs were somewhere between 1/5 and 1/10th the comparable costs in the US.

Luckily, one of our good friends is the same kind of specialist in the US and we immediately e-mailed, then called him once we knew the ultrasound findings. He concurred that the lesion should be surgically removed and told us that the surgery was not very complicated and that it should be easy enough to do in Mexico. Since the specialist here spoke good English, I had felt pretty comfortable that we were getting good advice and good medical care so I encouraged Richard to go ahead so we could put this whole thing behind us. Monday AM I called the specialist and we scheduled surgery for the next day and he asked us to come that very morning for pre-op evaluation including labs, x-ray (I argued but he insisted) and ECG, most all standard in the US. He had us see an internist for a pre-op exam and the ECG, the internist also spoke very good English and I enjoyed that visit very much as well as receiving another invitation to visit to observe his medical practice. The labs, etc. were all completed within an hour or so and we were cleared for surgery as well as clearing the cost accounting as we went along (these costs were also well below the US equivalent except for the blood tests which were maybe half the cost).

The following AM we caught a taxi at 6:15 to the hospital. The taxi driver told us to pay him later (although initially we misunderstood and thought he was waiving the cost) so we wouldn’t worry about money with our other concerns. We checked into the hospital and Richard had an IV started and got some sedating medicine and was carted off, all done by nurses who spoke no English at all. This was quite disconcerting although my Spanish was rudimentary it was good enough to ask what the medicine was and the names are close enough to the US names that I recognized what he was being given. He was in surgery for about an hour and then I was called to the OR door where the surgeon, expansive and in the good mood that surgeons seem to get from the conquest of surgery, showed me the “lesion” that he had removed assuring me that it looked quite benign. As the wife as opposed to the doctor, I was rather stunned by the unexpected show and tell experience, but happy to know that everything seemed to go well. We spent the rest of an agonizingly long day waiting for Richard’s anesthesia grogginess to wear off and not being able to communicate much at all with the nurses. The only nurse we felt any kind of relationship with was the darling probably 19 year old student nurse who was sent (as a challenge or even a punishment?) to deal with the gringo non-Spanish speakers when Richard’s wound bled after he got up to go to the bathroom. She very sympathetically removed the tape from his wound and gave him new dressing and a choice of tape or no tape (NO TAPE THIS TIME PLEASE) all basically in charades. I went to the cafeteria for lunch feeling very lonely and stressed and had an awful lunch (it was comida corrida, a preset menu like “le menu” in France including soup, main course, drink and dessert). I returned to Richard’s room where he had just finished his lunch which he thought was wonderful. As I looked through the things leftover on his tray I realized we’d had exactly the same lunch—of course he was in an altered state of consciousness and had missed breakfast so was hungry…

At last at 6 PM the doctor returned. We had asked the nurses if we could go home and they had told us to wait for the doctor. The doctor agreed we could go home and made sure I had the antibiotics Richard needed (in my expedition first aid kit? Hey are 100 pills enough?). Then we paid our bill and left. The hospital bill was a bit startling and we’ve since found out that this is the most expensive, but best quality, hospital in La Paz. It is all private pay. The big cost was the doctor’s charge and I guess that’s reasonable (don’t I have to say that?) although they did charge us for every little thing that was used just like they would in the US (guess we saved money on that tape though, huh?) We were just relieved to be heading home rather than spending the night incommunicado in the hospital.

Richard is recovering as best can be expected, we learned a couple days ago that the biopsy was indeed benign much to our relief. We’ve had some wonderful people drive us to appointments and back and have been hanging out at the marina for convenience and enjoying what can only be likened to a vacation for us boaters: at the marina one can walk right into town, use showers as desired, hook up to electricity and water, have a wireless internet connection 24/7, walk to restaurants and generally relax compared to anchoring. The down side is you are 5 feet from your neighbor, you can’t come and go without running into other boaters that want to know what’s up, the noise is less controllable and it costs money. We look forward to being back at anchor soon when Richard’s closer to fully recovered.

I took advantage of our enforced shore time to take an intensive Spanish class at a local continuing education school for almost 2 weeks, 4 hrs/day. I certainly have learned a lot and tuned my ear a bit better but I’m still a long way from sitting down with anyone and chatting about the news for instance.

We still plan to move to the mainland, specifically Puerto Vallarta, by early February to meet my parents and then head south some more and visit some anchorages we’ve heard wonderful things about. Then we are beginning to think we will return to the Sea of Cortez to visit more of these beautiful islands in the spring and early summer, then put the boat somewhere safe for hurricane season here in Mexico before beginning our journey south again at the end of the year and head to Central America and across the Pacific next year. Plans are made to be changed, so we’ll let you know as they do.

Take care all and keep in touch. We enjoy the e-mails we receive.