Friday, June 14, 2019

Day 1060 to 1119 of the Third Voyage: In which we tried to leave El Salvador and yet here we are…again.

You know what a mulligan is, right? It’s when your first attempt at something goes unexpectedly awry so you get to try it again in anticipation of a better outcome. Basically, it’s a do-over. We don’t get mulligans anymore.  After you’ve had two or three or twenty, your mulligan rights get revoked. We no longer get do-overs; we just get do-agains. As in, “Swell, the engine died…again; or great, the transmission blew a seal…again; or, awesome, this thing that has always worked has decided not to work just when we need it most…again.”  Yet despite our track record, we really thought this was our moment. This would be the time when everything would go in our favor. So when the inevitable happened, the disbelief was profound—a punch in the gut that sent us to our knees.  

We don’t get mulligans. We get Kerrigans.

So what went wrong?  Well, first off…let’s talk about what went right.  To say that this was the best prepared we’ve ever been for a passage would be an understatement. Over a month before our departure window, we printed out a list of everything that needed to be done and posted it in a conspicuous place in our cabin so that it stared/slapped us in the face every day and twice on Sundays. It ran the gamut from oil changes and systems checks to provisioning and stowing charts—a full two pages of to-dos—and damned if we didn’t cross every item off the list. We even took the boat out of the slip and put her through her paces, running up and down the estuary testing gears, speeds, temperatures, and loads. We wanted to leave the last week of March but ended up pushing that out two weeks for an optimal bar crossing. And then, just for good measure, we talked our friends into going with us because we were so sure we’d have the perfect cruising experience that we wanted to share it with fellow Boaters-With-Engine-Troubles to prove to all of us that it could be done.

We were set to depart on April 15th, but I woke up nauseas, head-achey, and loathe to get out of bed so we opted to wait until the next day so I could get some rest. At the time, I chalked it up to multiple days of toiling in the extremely high heat and humidity, not enough sleep, and pre-voyage jitters. An excessive amount of drinking due to all the going away parties that we threw/were thrown for us probably didn’t help. But looking back it was probably a premonition. Kind of how animals can predict earthquakes before they happen, maybe I’ve developed a sixth sense that things are about to go terribly wrong. Or maybe it’s just because things always go terribly wrong. But at any rate, we pushed off around noon on the 16th, rendezvoused with the pilot boat, made it over the bar safely and in one piece, and turned the pointy end toward Mexico. With no wind to sail, we settled in at a motoring speed of about 7 knots and there wasn’t much to be done except sit back, look for fishing pangas and long lines, and contemplate the 30-hour voyage ahead. And for four hours, it was awesome. Until the engine died. And then it wasn’t so awesome.

We put out the sails, but the light afternoon winds did us no favors and our speed dropped down to an excruciating three knots.  So the decision had to be made…do we cut our losses, turn back, and hope we can get the engine working long enough to get us back over the bar? Or do we push forward, hope for some wind, and pray that the Mexican navy can tow us into Marina Chiapas should it come to that? I think had we been anywhere near the half-way point, we would have gone with the latter, but four hours after leaving Bahia del Sol we were barely out of the state of La Paz, let alone the country of El Salvador. Because here’s the sucky part of boating. It’s amazingly, incredibly, agonizingly slow. Even on the good days. One knot is roughly equivalent to 1.15 mph. When the engine is working, it’ll hum along nicely at 7-8 knots which, given wind/wave/water resistance coupled with the gross tonnage of the boat and all that other physics stuff, is considered quite a good speed until you realize that you’ve been chugging along for four hours and you’ve only gone 25 freaking miles.

Had there been wind in the forecast, we probably would have just said “screw it” and kept going, but the forecast called for winds of 2 mph. Two. Miles. Per. Hour. I’m pretty sure Otter farts with more velocity than that. And here’s another sucky thing about boating. When you have no means of propulsion to flatten out the ride, you’re at the mercy of the waves and the swell and all the up and down and bob and sway and side to side that comes with it. And if you were already a little unsettled to begin with (like I was), it’s very easy to get seasick (like I did), and that just adds to the fun quotient right there. Because why be depressed when you can be queasy and lethargic as well.  It made the most sense to turn around, so that’s what we did. And because no good deed goes unpunished, our reduced speed meant that it would now take over eight hours to go back those 25 freaking miles.

It was close to midnight by the time we got to the “anchorage” which is in quotes because it’s not really an anchorage so much an okay-ish place to set an anchor while you wait for the next bar crossing opportunity which in our case was the following afternoon. The last time we were in this “anchorage” we had just come off one of our more hellish journeys and no sooner had we set anchor than we were met by a panga full of mechanics to slap a Band-Aid on the engine so that we could at least get over the bar and into the safety of the estuary. Amongst all the people and commotion, I hadn’t realized how roly-poly the anchorage was then, but I sure got to experience it now—over twelve hours of bobbing and weaving and swaying in the heat and humidity and not a breeze to be found. Because why be depressed, queasy, and lethargic, when you can be miserably hot as well.

Now on a positive note, the engine had decided to work again. A couple hours in to our return trip the night before, we tried the engine and it turned over and for a split second we thought about turning around and heading to Mexico after all, but we erred on the side of caution which was a good thing because approximately four hours later, it died again. Out came the sails and down went our speed. A couple hours later, as we approached the anchorage, we tried the engine again and it started right up so at least setting the anchor was easy. It started again the next day after having been off all night. We were starting to see a pattern. But at least it was working now for this, our third time across the bar. The first time—going in—was totally anticlimactic. Of course, after the voyage we’d had, we could have ended up on the beach and it would have been the least of our many ordeals. The second time—going out—was a bit more of a ride as we got on a pretty good outgoing tide and surfed our way out at a blistering 14 knots.  This third time was a bit more dramatic. Just as we were making our approach, we got caught by a big wave that got up under our stern, buried the bow deep into the water, and then swung us hard to starboard while surfing the wave at over 15 knots. It was such a sharp veer that at first I thought the Captain was aborting the crossing, but he stayed calm, corrected our course, and got us over the bar in one piece.

By now, you’ve probably figured out that this bar is not something to be taken lightly, and you’d be right. We’ve been over plenty of bars. Most were straightforward, a couple were on the scary side. You hit them at the right time—some at high tide, some at slack—and in the right conditions, and you generally don’t have any problems. This one, however, requires “local knowledge” which is an ominous term describing anything that will kick your ass unless you were born, raised, and reside within 100 yards of said obstacle. This bar shifts and changes on a daily basis and is subject to the tides, swells, waves, and whims of the Pacific Ocean, so you must be guided in by a pilot boat that gives you instructions over the VHF in terms of where to steer, when to throttle, and what’s coming up behind you. And if you’re really lucky, they take your picture while you’re doing it…
This is us being pushed SIDEWAYS toward the bar. If they’d had a telephoto lens, you’d see four people, one dog, two cats, and a small child with “Oh Shit!” looks on their faces. All except the Captain. His just says, “Screw this. Nicaragua is just down the coast. I hear it's nice.”

Overall though, we were lucky. Some things went flying down below when our bow went down, but nothing was broken. We’ve seen other boats come in with broken stanchions, bent davits, loose rigging, and overwrought gears. Some didn’t close hatches before they came over and ended up with more water in their boat than under it.  One couple was towing their dinghy (big no-no) and it overturned and got ripped up on the way in. And in one heartbreaking case, a rogue wave came down on top of a catamaran, swamping the cockpit, and flattening a little dog before a second wave lifted him up and out. Despite an exhaustive search of the surrounding beaches, he was never found. Now obviously these are not the norm and most just experience a high-speed surfing sensation, but the potential for hazard is there and must be respected.

Tail tucked firmly between legs, we limped back into the marina where friends gathered to grab lines, Leo was on hand with extra-strong welcome back beverages, and the Port Captain was there to record our arrival. The Immigration Officer also met us on the dock. Why? Because our visas had expired the day we left and as we had not made it out of the country, we were now officially illegal aliens. Because why be depressed, queasy, lethargic, and overheated when you can run afoul of a country’s immigration policy as well?

Back at his office, he went into a lengthy discourse in Spanish regarding our situation in which the only words I caught were “problema”, “mucho problema”, and “penalizacion” with a look on his face that could only mean a very large fine. But this mess was our own doing, and we were quite willing to (literally) pay the consequences. We asked him how big of a fine and he very sheepishly said, “$11.43… por persona.” And then immediately winced as if he was fully expecting one of us to throw a chair at him. But we’re calm, and thinking “Okay, $11.43 per person per day. Even if it takes us a month to repair the engine, we’re looking at about a thousand dollars. That’s cheaper than flying out of the country, especially since it was Easter week and flights would be difficult to find and ten times more expensive even if something was available.” And that’s when he clarified that no, the fine was $11.43…regardless of how many days we overstay our visa accompanied by a look that said, “I can’t believe you’d think that of us. We’re not total monsters. And thank you for not chucking a chair at me.” This was confirmed by others we spoke to (the one-time fine of $11.43, not the chair chucking.) Of course, rules and regulations change as frequently as the honchos in many of these government agencies, so I guess we’ll find out when we attempt to leave again.

In the meantime, we think we identified the problem with the engine and once again, it’s related to fuel delivery. The fact that the engine would run perfectly fine for four hours then quit, only to start up again after a couple of hours and run for another four, got us to thinking that there must be a small air leak in the fuel line. How I understand it is that air gets in the hoses, gets caught somewhere, slowly forms a bubble, fuel can’t get around it, the engine starves, the engines quits, the engine cools down, the bubble dissipates, fuel gets through, the engine works, lather, rinse, repeat.  It makes sense, right? And when the Captain found some dodgy fittings that were absolutely letting air in, it just seemed to validate the theory.

So the engine was fixed and has been tested twice (the first time for 15 hours in gear while tied securely to the dock and a second time for four hours tied loosely to the dock and maybe in gear but who knows because we lost all those brain cells from huffing in diesel fumes from the first go-round.) We’ve been ready to go since mid-May. Yet here it is June, and we’re still here. Why? That damn bar. Bad weather on the other side of the fricking globe has wrought havoc all the way over here in the form of huge waves and swell that effectively closed the bar. Because despite thousands and thousands of leagues across vast expanses of ocean dotted with myriad land masses between here and there, a storm in Indonesia means there’s no leaving an estuary in El Salvador. And perhaps we’re taking it all too personally, but when you’ve been someplace for a really long time and all your previous plans to leave have been thwarted and you’re so ready to go you can taste it, it’s quite disheartening to hear things like, “The bar has never been closed for this long! It’s gotta be some sort of record!” and you begin to wonder who you screwed over in another life. And what were you doing in Indonesia in the first place?

And that brings us to now in what feels like Day 2,743 of the “Great Wait” in which the boat sits in a perpetual state of readiness…nothing has been unstowed; boxes and bins are still tucked away or crammed Jenga-like into cabin corners; bungie cords are at the ready to secure moving items; passports and paperwork are near at hand; and any foodstuffs eaten or provisions used are immediately replenished. We don’t venture too far from the boat—a reprovisioning trip to San Salvador or a jaunt up the coast to Cadejo in La Libertad is as far as we like to go because you never know when the time will come and the next favorable bar crossing window will not catch us unawares. We are resolved to be within two hours of shoving off at any given time. So if the storms on the other side of the world suddenly subsided, the swell settled down, and the bar became calm, we would be ready in the time it would take for the Immigration Officer to come down to the marina, collect his $11.43 per person, and wave us off with his white hanky.

At this point it seems weird—to me at least—that we’re so anxious to leave when we know what’s waiting for us out there. But I think deep down it’s more that we are determined to make it back to Barra and whether we motor, sail, bob, limp, or tow ourselves with our own dinghy, we will get there. Something will inevitably happen…it always does, but better to get back out there and let it do what it’s going to do rather than sit here and fret. Because we’ve been “ready” for a long time and we’ve been stuck in “set” for what seems like ages. It’s time to “go” and do it again.  The big question is when. And who knows? It could be tomorrow…

Saturday, April 20, 2019

Day 1014 to 1059 of the Third Voyage: In we which we take 2,335 steps forward and 849 steps back, but we’re not ready to give up just yet.

We’ve been in El Salvador just shy of one year now which just blows my mind because it seems like only yesterday that we were flailing about helplessly off the coast sans engine, sans steering, sans generator, and apparently sans sanity and/or any common sense. But I guess a year is about how long it takes to forget the crappy parts about being on a passage and start to think that maybe it’s not that bad. So, I guess what I’m saying is that it’s time to leave—time to hit the open ocean and see where it takes us. That and our visas expire on April 17th and we do not want to go through that bullshit again.

Of course, we do know where the ocean is (hopefully) going to take us only it’s not where you think it may be and—up till a couple months ago—not where we thought it would be, but…we’re going back to Barra de Navidad. I know, I know… it seems like a huge step back, but we have our reasons. Specifically, we have a list, but here are the highlights...

Reasons to go back to Barra:

1…Mexico is infinitely less expensive than pretty much everywhere else. Taking the cost of moorage out of the equation (because it’s going to be either “are you joking?” high or “okay, what’s really wrong with the place” low, depending on the season), living in Mexico is just so much more economical. If you shop where the locals shop, the staples (meat, dairy, vegetables, fruit, bread, etc.) are about 30% less than what we’re paying here (and half of what we’d pay in the States) whereas most other goods can be found for less because Mexico manufactures just about everything—including drugs (of the pharmaceutical variety) where we figure we’ll save well over $150 per month on our prescriptions between the three of us. An added bonus is that we won’t have to pay a driver or rent a car to procure said goods and staples because things are more accessible in Barra. Looking to the south, things won’t get much better from a cost and/or convenience factor. Costa Rica is frightfully expensive and much of Panama isn’t much better. And as we can all agree, saving money is a good thing because we’ll need all that extra dough when the next system on the boat goes kablooey. As for moorage, we’re negotiating a rate with Marina Puerto de la Navidad that should make us all happy. The harbor master there loves the Captain because he designed the invitations for his daughter’s quinceanera so that practically makes us part of the extended family. That and I’m pretty sure we singlehandedly kept their bartenders employed during the slow season so we’re good for their bottom line.

2…Medical care is more accessible in Barra. So a scary thing happened about two months ago and by scary I mean that it started off as an “oh shit!” moment but then turned into an “oh shit…” moment and yes, there is a difference. One morning—about a week after she had returned to the boat after her knee replacement—the Deck Boss greeted me by saying, “I think I had a mini stroke” which 1) is NEVER preferable to “Good morning” and 2) is NOT something you want to hear before you’ve had your coffee. Cue the “oh shit!” moment. Her symptoms had included numbness, dizziness, and vision changes which according to WebMD (our primary physician) might be indicative of a mini stroke. Upon further research, these same symptoms also fit the description for someone who has just ended a regimen of post-surgery anti-coagulants aka the more likely diagnosis. After everyone was satisfied that she was not dying and after two cups of strong coffee, came the “oh shit…” moment as in “oh shit…what if this HAD been a stroke? What would we have done?” Because as the medical establishment likes to stress, the difference between having a bad day and having a catastrophic, life-changing, horrible bad day comes down to how fast you can get treatment. Had she had an actual stroke (mini or otherwise), we’re at least an hour away from medical attention—and only if someone here has a car. Even an ambulance would need thirty minutes just to get here. In looking ahead at some of the marinas and anchorages in Costa Rica and Panama, we’d be in the same boat (no pun intended, though technically true.)

Now broken bones, gaping wounds, animal bites, allergic reactions, and the ilk can (generally) be tended to using the first aid we have on the boat until proper treatment arrives or can be obtained (witness the events of Day 883-909.) But strokes are a whole other animal and the one that got me thinking that we need to be someplace where time is taken out of the equation. There are doctors within Barra—only 10 minutes away by water taxi; 24-hour emergency clinics in Melaque and Cihautlan (half hour by car); and, better yet, there’s an on-call doctor at the Grand Bay that will make “boat calls” (as described in the events of Day 457-557) and also has an ambulance on the property at his disposal. Also in the immediate area:  dentists, eye doctors, dermatologists, and a really good vet.  More specialized doctors can be found in the city of Manzanillo about an hour south by car. Given age and accident proneness (Deck Boss), propensity for odd maladies (Captain), and susceptibility to a complete mental breakdown (First Mate), these are all advantages.

3…We really miss the food! Growing up, I didn’t eat a whole lot of Mexican food. The Deck Boss broke out in hives every time we drove by a Mexican restaurant so Chinese became our family’s go-to ethnic fare. There was the odd school outing to Casa Bonita in Denver, but even at that young age I knew that much like the restaurant was supposed to resemble a Mexican village so, too, was the food supposed to resemble Mexican cuisine. In other words, it was all an illusion crafted from plaster and paint, and just about as tasty. In college, I was introduced to Taco Bell—which I love like a junkie—but have since been informed it’s about as Mexican as apple pie. In Seattle, the Captain and I used to frequent several Mexican restaurants. At least I think there were several—could’ve been the same one. The food all tasted the same from location to location, only the name of the establishment changed. The Captain said it’s because most of the chain restaurants get their stuff from the same food distribution companies, so it’s not so much “Las Palmas” as “Los Sysco”.  But that’s all in the past now, because we’ve seen the light and it’s covered in mole. The food in Mexican is as varied as the country itself, and after having sampled everything from a simple street taco to pozole to a molcajete mixto simmering in a volcanic bowl, we’ve come to really appreciate how lively and full of flavor even the most basic food is.  And yes, there will always be dishes that aren’t quite to your liking, but at least it’ll never be boring. Here in El Salvador they have the mighty pupusa which is a thick tortilla (either rice or corn), stuffed with beans, cheese, and whatever else you want, and fried on a griddle. Good ones are delicious and satisfyingly filling—the Salvadorean comfort food you didn’t know you were missing. Bad ones taste a little like paste and sit like an adobe brick in your stomach. But whether good, bad, or somewhere in between, the flavor is enhanced when covered in a hot sauce that we picked up in Mexico. So, there you go.

But beyond that, we miss our favorites in Barra…our pollo asado guy across from the Ixtapa Tienda, the fresh tortillas just down the block from him, the carniceria that stocks the best smoked pork chops and cut-to-order bacon anywhere, the flan man that sets up his dessert cart by the Malecon in the early evenings, and the fresh fruit vendors that come to the Thursday market, to name a few. And, of course, there’s Pipi’s, Manglito’s, and our regular haunts. Editor’s Note: When we get back, we’re going to try the home-made tamales that the lady sells out of a cooler across from Loco Loco Pizza. We never got there in time and she was always sold out. Fresh tamales are the best! Back in the States, I used to make those tamales that came in the can. It took a couple of dinner disasters before I realized that the paper should come off BEFORE you cook them. It’s definitely not Mexican food. It’s more like “what shall we do with the leftover ravioli paste at the Chef Boyardee factory?” food and “I know! Let’s fashion it into tubes, wrap them in repurposed can labels, and slap a Mexican flag on the lid!” And speaking of individually wrapped food, the first time I bought hot dogs in El Salvador I was surprised to find that each weenie came in its own wrapper. At least I think it was a wrapper. If you took it off, the whole thing fell apart. But if you left it on and cooked it, you couldn’t bite through it. It’s like they wanted us to question our food choices or something. But we weren’t deterred, because sometimes you just want a taste of home and few things are more American than hot dogs, apple pie, and Taco Bell.

Of course, there is one thing that the Deck Boss does not miss about Mexican restaurants. She’s not a fan of mariachi bands—specifically ones with horns…which is all of them. She thinks they’re deafeningly loud, earsplittingly loud, and just overly loud in general. I don’t know if she’s always had an aversion to them or if this is something new since her hearing started going wonky, but she’s pretty convinced that a) mariachi bands never had horns back in “her day”, b) the only reason mariachi bands added horns was so that people would give them money to stop playing, and c) the restaurants that employ mariachi bands with horns only do so to compel people to eat faster and thus create higher table turn-over. So imagine her surprise when a mariachi band showed up at our favorite restaurant in El Salvador—horns and all—and proceeded to play the entire afternoon, even after it started raining and they had to take refuge in the swim-up bar.

"Don't look over there. You'll just encourage them." Deck Boss

4…Barra will be better for Otter. He doesn’t get a whole lot of off-leash time here (reference blogpost Day 697 -782), but he sure did in Barra. Every morning we did a big 3-mile walk up, down, and around the hillside surrounding the marina—all of it off leash which means that he did twice as much walking as I did due to the constant intreat to, “Get back over here!” which would require him to trot back toward me before pulling a u-turn about five feet shy and taking off again. Add to that the frequent trips to Barra (where there are an abundance of dog-friendly establishments) and he was getting in some damn good exercise and on a consistent basis. We all were, truth be told. Here…not so much. And it’s starting to show. The Labrador Retriever in him means he is predisposed to “lab flab” as it is and let’s just say I can’t let his harness out any more. Editor’s Note: Change “lab flab” to “land lubber blubber” and “harness” to “shorts” and I could also be talking about myself and the Captain. We try to keep him (and us) active with regular trips to the beach, but the circumstances of our surroundings coupled with the extreme heat of the day makes additional exercise challenging. I think Barra will be good for him in this regard—more opportunities to be more active. That goes for all of us really.

Reasons to continue the voyage south:

Well, there’s only one…but it’s a doozy. Namely, there’s a whole world out there that we haven’t seen and, technically, the point of the odyssey is to travel, have adventures, and live a less conventional life. There’s no telling what’s out there. And it’s quite possible that we’ll find another Barra somewhere along the way.

So perhaps we’re doing ourselves a disservice by not moving forward, but sometimes there are reasons as to why it’s best to go back, if only to just stand still. Because in truth, it was a tough year. Besides the usual parade of shit going wrong and the health challenges and the hip replacements and the knee replacements and all the things that happen in the course of living that you just deal with because that’s what you do, there was one event that was wholly life changing and one which has not been touched on in this blog because it is not my story to tell. But Neil lost his brother last April and I think when the rug has been pulled out from under you, sometimes it’s best not to have the floor moving as well. He needs—we need—some stability. A place to feel like home. At least for a while. And Barra is our happy place.

So, what does this mean for the odyssey? Well, it’s not over. The Third Voyage only ends when we reach the Panama Canal so while it’s very possible that it will take another 1,283 days to get there, we will get there. The world isn’t closed to us; we’re just doing some backtracking until we find our footing. And there are still new places to see and adventures to be had—we just might get there by car or plane instead of boat. I guess what I’m saying is that I’ll keep blogging as long as you keep reading. Besides, there’s still 849 miles of ocean between us and Barra. And as we all know, shit is bound to happen—especially to us. We could experience a catastrophe between here and there that would fill a thousand blog pages. It could be such an adventure that only a blockbuster action movie starring Jason Statham, Olivia de Haviland, and the Taco Bell spokes-dog could possibly tell the story. Who knows what will happen? Besides…the nice thing about journeys and adventures and less-conventional lifestyles is that you can change your course almost as easily as you can change your mind.

Saturday, March 16, 2019

Day 946 to 1013 of the Third Voyage: In which I think I speak for all of us when I say we’re totally over hospitals and definitely done with hoops.

The new year brought a new knee. The Deck Boss was admitted into the hospital on January 7th and went into surgery the next morning. Everything went according to procedure with the exception that her knee had become so pronated over the past few years that Dr. Zeledon had to shorten a tendon which had become stretched and straighten a nerve that had become pinched. But after two hours of surgery, the new hardware was installed, the kinks were worked out (literally and figuratively), and her leg was the straightest its been in probably ten years.

Now the doctor had warned us that the first two days after knee replacement surgery could be the worst from a pain perspective so not only did the nurses duly administer pain meds on a regular schedule, but they were administered via an epidural going straight into her spine. Which sounds awful except that it did the trick and she was not in any terrible pain. She was also rarely conscious. As per hospital regulations, I was required to stay with her, so for two days I got to look at this…

On day three, they started easing back on the neural blockers and she was encouraged throughout the day to stand up, put weight on the knee, and take a step here and there to get the juices moving so to speak. Of course, with the epidural, she had zero feeling below the waist so during these little exercises, she had to be assisted by myself and a nurse—not an easy task (anyone who has ever tried to manhandle a mega large bag of dog food into a shopping cart that keeps rolling backwards should know what I mean.) I’m still feeling the effects of it and will most likely return here in about 10 years for a back replacement. But things continued along uneventfully until the evening of the fourth day when the vein that the IV administering the antibiotics and anticoagulants was in collapsed and it was necessary to find a new one pronto-like. The first nurse did her best, but after 45 minutes of trying different veins in the arm, wrist and hand and with the Deck Boss in pain and in tears, she gave up and called in one of the emergency room nurses. This nurse came in and over the next 45 minutes tried all the tricks of the trade to get a vein…clinching, rubbing, slapping, etc. At one point, she even filled a latex glove with hot water and placed it on her arm in the hopes that a warm vein would rise and I will never look at hand-turkeys quite the same way again. When everything failed, she prayed. Literally. She readied the needle, looked towards the heavens, said a few words in Spanish, eased it in, and hit pay dirt. A minor miracle and one that elicited much whooping, hollering, and hugs all around.

The next day the epidural was removed, and the nerve began to crackle back to life. This part was decidedly not fun but at least now she could feel her legs and, as you know, it’s way easier to do physical therapy when you can physically feel what’s being therapied. After another day or two—and once the doctor was satisfied that she could walk a few steps (i.e. to the bathroom and back) —she was released to the small, hospital-owned hotel across the street which, because this is San Salvador and you can’t get there from here without going 16 miles out of your way, took one hour. One hour in the back of an ambulance winding our way through the various neighborhoods because all the two-way streets are so narrow that oncoming traffic creates an impasse and all the one-way streets outnumber the way you need to go by about three to one. And when you do finally reach the main street, there’s a big nasty median in the way so you have to travel the opposite way of where you want to go until you get to one of the many traffic circles (all built around a massive monument to liberty, freedom, and/or the end of the civil war) in order to go back to where you really need to be which, in our case, was literally across the street from the hospital.

The hotel (for lack of a better word—we heard it referred to as a hotel, hostel, and hospice so I guess it’s all things to all patients) was typical of a lot of places in El Salvador in that from the street it looked like an austere, windowless concrete building surrounded by a high wall crowned in barbed wire—not unlike a mini-prison—yet on the inside, it was bright and airy and the back opened up onto a large patio overlooking a lush, tiered garden with a green belt beyond that. I spent a lot of time out here because the room—while large and comfortable—did not have a lot of natural light. The lack of large windows not only kept the whole place cooler, but more secure (important given the amount of medications on the premises) and quiet (important because many of the 15 rooms were occupied by recuperating patients and the rest by families with loved ones across the street in the hospital.) We opted to stay here because the Deck Boss was scheduled for daily physical therapy along with follow-ups with the orthopedic surgeon and here, at the hotel, they make house calls. Add three meals a day and on-call assistance (if needed) and all-in-all it’s an absolute bargain for $50 per day. Even more so when you factor in its secondary function as an immersive language course because with the exception of one of the day managers, no one spoke a lick of English. Editor’s Note: I’m not sure they spoke Spanish either. I once asked for some milk and they brought me corn flakes and I know my Espanol isn’t THAT bad. At any rate, I really had to up my game and came out all the better for it.

And there was another nice little perk…it was within walking distance of The Coffee Cup which is a Starbucks-like chain of cafes with the added bonus of not serving Starbucks coffee. Now, yes, we lived in Washington State for 25 years, most of that time in Seattle, but that doesn’t mean we’re required to love Starbucks by default (or, for that matter, the Seahawks, the Mariners, and long walks in the drizzle. But Costco? Costco rules!) But, yes, we do love coffee. And yes, we were those people that stopped for coffee every day—sometimes twice if it was a rough morning, and often times at happy hour (yes, that’s a thing at a lot of the coffee stands—half price drinks after four pm.) Add that to the urn at the office and that’s a lot of coffee. And if you ever wonder why microbrews, wines, and artisanal spirits are so popular in the Pacific Northwest it’s because we need all those depressants in the alcohol to counteract the caffeine so we can sleep at night and start the whole cycle over the next day. Of course, it’s easy to get caught up in the coffee culture when it’s absolutely everywhere. Besides the ubiquitous chains like Starbucks, SBC, and Tully’s, there are the countless independently-owned roasters, and the approximately 50,000 drive-through coffee stands found on every corner, most vacant lots, and in any parking lot with a little extra room. We frequented a lot of those. You know those plastic sleeve things you put on your car visor to hold your CD’s?  Ours held punch cards for all the different coffee stands we went to with small stars on the ones that gave out really good dog treats (because Otter was a regular, too.) The stands were also great for giving directions because in a place where something can literally be at the corner of NW 85th Place SE and W 4th Ave NE, it’s much more helpful to say, “Take a left at ‘Coffee Caboose’ like you’re going to that coffee stall at ‘Abe’s Auto Body’ and you’ll see it next to ‘Joltin’ Joe’, but if you pass ‘Hey, Joe!’ then you’ve gone too far. And while you’re there, can you pick me up a triple Americano?”

Once we got on the boat, our coffee consumption went way down—and not just because there wasn’t enough room in the galley for our urn. Rampant availability was at the core of our addiction (because the best coffee is impulse coffee!) and as we made our way down the west coast of the US, the fewer coffee stands we encountered and when we would go to a “destination” coffee place it was less “hey, let’s get a latte!” and more “buy something so we can use the wifi.” Good coffee could be found in San Diego, but bars of the juice, beach, and dive varieties seemed more prevalent. Mexico, of course, is all about the tequila, cerveza, and margaritas, with coffee and coffee drinks being relegated to page four of the bar menu. El Salvador is about the same (just change tequila to rum and page four to the small print on the back.) Starbucks, however, can be found everywhere--especially in all the larger cities and tourist towns. And, much like any other American chain operating anywhere in the world, you know exactly what to expect when you walk in…same layout, same décor, same merchandise, same food items, and same crappy coffee. There, I said it. They have crappy coffee. I know they start out with good beans. El Salvador produces some of the finest coffee beans in the world—shade grown in rich volcanic soil—and I was told that they sell an awful lot of them to Starbucks. So why Starbucks feels the need to turn around and roast these primo beans over an open dumpster fire is beyond me. And they obviously let the beans “age” in a dank cellar somewhere beforehand because that “old dirt” aftertaste has to come from somewhere. Blonde roast? Medium roast? Strong roast?  I’m pretty sure that’s just determined by rate of decomposition. Editor’s Note: Of course, this is just my opinion, and is most likely unpopular. But then I’m used to that because I also think that football is boring, In-n-Out Burger is overrated, and the only good part in that Titanic movie was when the ship finally sank and put us all out of our misery. So it was really nice to find The Coffee Cup—a Salvadoran chain that roasts its own beans (and “roasts” in the sense that the natural coffee flavor is released and nurtured and not beaten to death with a tire iron, buried out back in the septic field, disinterred with a back hoe, and blackened over a flaming tire)—and get my perc/Americano/latte fix on a daily basis. All this being said, we do go to Starbucks when other options are limited (i.e. no options and/or wifi is required), and I do enjoy their teas, smoothies, and various fruity quaffs. But if caffeine is a must and it has to be coffee, it’s best to stick with a Frappuccino or macchiatto-type concoction of some kind because nothing offsets the taste of burnt beans like 2000 calories of camouflage.

But I digress…

During our stay at the hotel, we didn’t spend the whole time staring at the wall. We also got to stare at the wall at Immigration, too!  Unlike Mexico, where a visa is good for 180 days, the maximum stay here is 90. That’s why we HAD to go on that cruise last July—we had to leave the country in order to reset our visa (it was tough, but sometimes sacrifices must made.) When it came due in October, we opted to get an extension through the Department of Immigration in San Salvador because we really thought we would be leaving in November (early December at the latest), had projects to complete, and didn’t want to lose days/incur the expense of flying out of the country. Editor’s Note: Driving to Guatemala, while only a few hours away, was not an option. Guatemala, El Salvador, Honduras, and Nicaragua have their own little European Union thing going on in that they form a four-country visa zone—to reset your visa requires leaving the zone. Now applying for an extension through Immigration should have been straightforward, but of course you can’t have a good bureaucracy without hoops, headaches, and a whole lot of paperwork. On our first visit, we met with the agent, got all the paperwork, and procured a list of everything that needed to accompany said paperwork (waiting-in-line time and agent time = two hours.) I spent approximately six hours getting the documents in order which consisted of translating the forms and applications into English so I knew what I was filling out, filling them out, writing an essay on why we needed to extend our stay, translating that into Spanish, procuring bank statements (to show we could pay our way), having our photos taken, and scanning/printing copies of passports and various boat documents. This had to be done three times: one packet for each of us. We also needed references from a Salvadoran so our friend, Ernesto, filled out forms that stated he knew us, we were okay people, and that to the best of his knowledge we weren’t up to any mischief. We returned to Immigration to hand in our paperwork along with our passports (waiting-in-line time, agent time, fingerprinting = another three hours.) A few days later, we returned to pick up our passports and new visas and were informed that there was now a new head of Immigration and that we’d need to fill out the paperwork again because the old paperwork had the previous honcho’s name on it (no waiting this time around but agent time and the three of us frantically copying the info from the old forms onto the new = two and a half hours.) When all was said and done—and factoring in the three-hour round trip to Immigration each time—we had over 24 hours into the process; but we did procure our 90-day extension—which would have worked out perfectly had we actually left in November or December, but when the Deck Boss decided she wanted a new hip and a new knee for Christmas, that all went by the wayside. The hip was done in October, but the knee wasn’t scheduled till January—approximately two weeks before our visas were set to expire…again. Now I guess in hindsight, we should have bundled up the Deck Boss’ knee in about five yards of Ace bandage and spent some time in Mexico, but after coming off the hip surgery it just seemed too much at the time and we had been told that medical waivers were fairly easy to come by. Yeah, right. Now one would assume (yeah, yeah, yeah “you”, “me”, “ass”, whatever) that since we were already in the system (paperwork, references, fingerprints, photos, et al) that all we’d need to do is provide a letter from the doctor, have our fingerprints scanned for verification, and pay our fee, right? Wrong. So very wrong. Not only did we have to fill out all the paperwork again; we had to procure new references (thank you, Santos!), submit new photos, produce updated bank statements, get fingerprinted again, provide a letter from the doctor, and bring copies of the hospital invoices. The agent then called me to say they also required a letter from me explaining why we needed to stay even though this was answered in essay form as part of the document pack. The fun part of this process? Between the time limits as to how soon you could apply for an extension and the office closures over the holidays, our window fell the week after the Deck Boss’ surgery which meant we had to spring her out of the hospital and bring her in by wheelchair—all nice and drugged up—to sign the paperwork and be fingerprinted.  I wish I could say that was the last hoop, but there was one more. And they set it on fire. But first I must backtrack a bit…

On the day the Deck Boss was due to be released from the hospital/hotel, I had planned everything out perfectly…Santos would drive to Bahia del Sol and pick up the Captain; when they got about thirty minutes out, I would head over to hospital administration and take care of the bills; once they arrived, we would pack up the Deck Boss and all our stuff and head over to Immigration to pick up our passports; we’d stop for a quick bite to eat, then head back to Bahia before the Deck Boss’ pain meds wore off and she cratered from all the activity. Did it go down as planned? No, it did not. The Captain called me first thing in the morning to tell me he was not feeling well. And not in a “just feeling blah” kind of way; but in a “stomach is cramping, heart is racing, losing feeling in my limbs” kind of way. But not coming was not an option. For one, if he did need medical attention, he wasn’t going to get it in Bahia. The nearest clinic is over an hour away, AFTER you procure a ride (which can take up to an hour.) Santos was already on his way and since they were picking us up across from the hospital, it made sense for him to endure the long ride just in case a doctor visit was required. And two…Immigration had already insisted we bring a semi-conscious woman into the office to sign paperwork; anything less than death would not be considered an excuse for not picking up a passport. But the closer that Santos and the Captain got to San Salvador, the more apparent that something was really wrong, and not ten minutes after paying the hospital bill to get the Deck Boss out of hock and secure her discharge, I found myself in the emergency room looking at this…
I think I've seen this show before.

Over the next few hours, the Captain was poked, prodded, and pried. They ran tests on blood, urine, stool, and every other bodily fluid that could be drawn, coaxed, or just plain induced. In between tests—while he was less conscious than not—I ran back and forth to the hotel to help Santos get the Deck Boss and all our stuff loaded into the van so they could make the hour drive to where we were in the ER across the street. And once they finally did arrive, we all waited…and waited…and waited…for the lab results. Four hours later, the results came back and the winner was…” Something you ate.” Or, more specifically…” Bacillus Cereus” aka “Fried Rice Syndrome” aka “Yes, that’s what they call it and that’s exactly how he got it.” Because a couple days before, the Captain had come out to visit us and he and I went to a Chinese restaurant for lunch. He took the left-overs home but didn’t put it in the refrigerator right away. Suffice to say, if you feel the need to nosh on some fried rice that’s been out on the counter for a few hours, the MSG will be the least of your worries. He was pumped up with medications, given a prescription, and we were sent on our way. Next stop…Immigration. Now picture this:  I’ve got the Deck Boss high on pain meds on one side of me and the Captain spaced out on antibiotics on the other side and the agents should be wondering what I’m doing to these people (and probably check those references again), but what they’re really concerned about is the letter I wrote and how very wrong it is. And what I’m hearing from the agent is, “A medical waiver is a very serious thing and must be handled absolutely correctly and this letter is just not acceptable, and your passports will not be returned.” And I’m wondering if Google Translate pranked me when I was creating the letter and turned my text regarding surgeries, physical therapy, and extensions into a manifesto to overthrow the government, and the conversation is starting to get a little animated in a frantic kind of way, but then through my feeble Spanish, the agent’s so-so English, my phone’s translation app, and lots of pantomime, I finally realize that the problem wasn’t with the content—it was with the formatting. But not all the formatting—just one part. Solution? I procured my laptop out of the van, opened the document in Word, reformatted the letter so that the text was justified, and copied it onto a thumb drive so the agent could print it out and have me sign it. Once that was done, we were given our passports, and sent on our way. So l guess the take-away is this… it doesn’t matter if your paperwork is a little off, your intentions are somewhat dodgy, or your references are a bit sketchy—Hell, it doesn’t even matter if you’re 
100% lucid—as long as your text is flush with both margins, it’s all good. Also, next time…just go to Mexico.

Postscript:  For those of you keeping track at home, here’s how much it costs to get your knee replaced in San Salvador:

The surgeon: $2500
The anesthesiologist and OR nurses: $1500
Body parts: $2563
Everything else (tests, labs, meds, hospital stay, nursing services): $3215.60
Twelve nights at the hotel/hostel/hospice:  $616.50
Grand total:  $10,395.10

And if you’re thinking of visiting the ER:  Exam, labs, meds:  $102.20

Sunday, January 13, 2019

Day 910 to 945 of the Third Voyage: In which we explore another aspect of the Salvadoran healthcare system and end up with more than we bargained for… but in a good way.

I think it’s safe to say that between the three of us, we have had a lot of experience with Mexican/Central American healthcare. In the past three years we have darkened the doorsteps of three orthopedists as well as an internist, cardiologist, radiologist, dermatologist, ophthalmologist, otolaryngologist, audiologist, and a dentist. We nearly added a gastroenterologist to the list, but luckily that cleared up on its own.

With animals on board, we’ve also been to the vet a time or two (a petologist?) but this has always been for vaccinations and parasite prevention and never for an emergency. Cue the music because…dun dun dun…we found ourselves with a pet emergency of the feline variety. Now here’s the thing about cats—and I read this on the Internet, so you know it’s true—they will never let on that they’re not feeling well. It’s a defense mechanism going back to their pre-domestication days when it wasn’t a good idea to show weakness because that would put you at the top of the menu. Of course, with Edgrrr, he will also never let on that he’s well-fed, well-cared for, and reasonably content. His defense mechanism is that he only cops to two moods: pissed off and not pissed off. The former means that his food bowl is empty; the latter means that you filled it before he had to start bitching about it. But for all his primal instincts, even he couldn’t hide the fact that he was limping and leaving bloody pawprints everywhere. We don’t know when it happened—or how—but there was no denying that his paw was severely messed up.
Guess which paw?

It’s times like this when you can really feel helpless. You can’t just hop in a car (because you don’t have one) and scurry to the nearest vet (because who knows where that is) and even if you could, there’s the language barrier (although a messed-up paw is pretty self-explanatory.) We’d had one experience with a vet a couple months ago when we rescued a pelican from the water with a severely broken wing. An expat called in a vet that came out to the dock to examine it and through a bartender/translator advised us that the wing could not be saved, and as it was now unable to survive in the wild, the humane thing to do would be to put it down. So the vet took the pelican to a secluded part of the docks, pulled a vial out of his tackle box, and gave it an injection. He cradled the bird in a blanket until it drew its last breath, after which we gave it a burial befitting a mariner. Bummed us out for a week. Unfortunately, we couldn’t get hold of this vet, but I doubt there was anything in his tackle box that would have put a paw back together and, even though there was nothing he could have done, I still harbored a little resentment that he couldn’t save the bird I’d prematurely named “Lucky”.

So instead I called Santos who had his son come pick us up while we tried to find a vet online that wasn’t two hours away in San Salvador, and it was Freddy that suggested we go to the vet in his hometown of El Rosario that had saved his dog’s life. Forty minutes later and we’re here…

At least it's well ventilated.

It’s obviously in the construction stages, but when it’s done this will be the first animal hospital in the area. But more importantly, this facility (even in its current state) provides the community with affordable pet care. Because pet ownership in El Salvador is on the rise—for companionship, protection, and (rurally) varmint control—but “responsible pet ownership” as we know it in the States is often out of reach for the average family. Because when you’re only bringing in $600 a month, travelling (most likely by bus) to a vet in San Salvador and forking over a hundred plus dollars to have your pet neutered is not an option. Neither is $50 plus for shots and $30 for two months of parasite control meds. That’s one of the reasons why there are so many unwanted litters and high mortality rates. But here, you can get your pet fixed for $35, all their yearly shots for $10, and flea/tick/worm prevention for less than $5.  Editor’s Note: If you find yourself in the area and in need of a vet and can afford it, please consider paying a little more for their services. All extra money goes toward the building fund.

But back to Edgrrr’s paw. Dr. Alberto Vasquez Guardado and his assistant/wife were both caring, thorough, and genuinely dedicated to their profession (they are building a hospital after all!) They were also old school, because they had to be. As you’ve probably guessed from the photo, there’s not a lot of clinic yet. And what is there is extremely bare-bones, because this is El Salvador and little things like walls, electricity, plumbing, and anything else that requires a permit is subject to the whims of whoever is currently in charge at the planning office that day and what is a valid permit one day may not pass muster with the guy manning the desk the following day. As a result of the start/stop construction process, they currently have one room for procedures, labs, and convalescing patients while everything else (exams, vaccinations, grooming, etc.) is conducted on tables in a part of the clinic still open to the elements. There is no power (see aforementioned blurb on “permits”), but syringes, tools, and surgical items come sealed until use and whereas our vet back in the states would have probably used some knock-out gas on Edgrrr prior to any procedures, here in rural El Salvador they have “the bag” which is exactly what it sounds like. Now at first, I was taken aback—and for a split second thought it was just a weird attempt at vet humor (like “ha ha…but seriously, here’s the knock-out juice.)—but after seeing it in action, I realized it’s actually low-tech genius. Because Edgrrr is not the most cordial of cats; he has a nasty swipe and a sharp bite to go along with that “charming” personality of his.  It would normally take two people to hold him down so that the vet could do their thing, but the bag eliminated this need. It acted like a firm hug around his entire body, holding him still yet allowing him to breath comfortably. Once he was situated, the vet cut an opening and pulled his bad paw out for further examination. There was growling, but there was no carnage.

Pictured: Cat in the bag. Wonder if it comes in blue to match the boat?

Like I said before, we have no clue how he did it or what he got in to, but it took over twenty stiches to put his paw pad back together—in fact, the doctor pretty much had to remove the pad, clean out the wound, stitch the pad back together, and sew it back on. The procedure took about thirty minutes (with only the bag for containment and a local anesthesia for the pain) and then Edgrrr was returned to us with a small baggie of antibiotics and some topical cream. The vet also showed us a phone video of the procedure which was as gruesome as you can imagine, and when he asked if we wanted a copy my immediate response was, “No, gracias. I think that’ll be fueling my nightmares long enough.”

Ten days later we returned for a follow up. Edgrrr went back into the bag and Dr Vasquez took him into the back room. About five minutes later, he returned and, without saying a word, put a tiny black furball into my hand and disappeared again into the back room. As I’m standing there completely stunned, my first thought is, “Holy shit. Did Edgrrr die? Is this to lessen the blow? Is this my condolence/replacement cat?” but then my next thought was, “Oh my God! This is the cutest thing I have ever seen in my life!”

Prepare to say, “Awwwww!!!” in three, two, one…

This incredible bit of adorable was found wandering—malnourished and anemic—in the field beside the clinic. Its mother was nowhere to be found. The vet took him in and nursed him back to health, and if the kitten was once lucky to have been abandoned right next to a vet then it was twice lucky that a gringa that’s gaga for gatos should happen into the clinic right as he was ready for adoption. Not that we rushed into the decision. We do live on a boat and we are travelling (albeit at a very, very slow rate), but when you’re in our situation and you already have animals, one more (small one) really doesn’t affect your lifestyle, just so long as it doesn’t become a habit. So we talked about it, slept on it, and the next morning returned to the clinic and adopted our newest member of the crew. And we named him Cadejo.

Now at this point you’re probably wondering what the heck is a Cadejo? Well, in Central American folklore, a cadejo is a supernatural creature with glowing red eyes that looks like a dog with a little deer thrown in and comes in two colors. The white cadejo is a benevolent protector (one who, according to legend, will ensure that drunk folks get home safely), while the black one is malevolent and likes to lure people into questionable situations (like an open bar serving nothing but tequila.) The good and the evil; the dark and the light; one pushing, the other pulling. They say that the two cadejos represent the duality in us all. Pretty heady stuff, huh? Very yin/yang. But before you go thinking we got all mystical on you, the fact of the matter is that our Cadejo was named after this place…

Less yin. More yeast.

This is Cadejo Brewing Company, our go-to place in San Salvador for really good beer, excellent food, and the best wings outside of the States. We come here a lot. How often? Let’s just say that the servers start pouring the preferred brews as soon as we arrive in the parking lot:  El Suegra for the Captain, Belga for the Deck Boss, and Hija de Pooh for me. We have other places we like to eat in San Salvador, but it’s just so nice to go to a place where “todo el mundo sabe tu nombre.”  We’ve had a lot of good times here and that coupled with some pretty cool folklore, made it seem very fitting to name our newest family member after a brewery. That and they have the world’s most kick-ass growler…

Of course, one of their slogans translates as “Not suitable for cats” but we’ll just ignore that for now.

So obviously we are head over heals for our nuevo gato and it’s all we can do to not spend every waking moment watching him bumble around in exploration, play like it’s his job, devour his food like he’s in a pie-eating contest, and sleep like it’s his other job. We’re curious to see how big he’ll be. The vet said he was two-months old, but he was still so tiny that he fit in the palm of my hand. Over the next three weeks he grew six inches from tip of the nose to tip of the tail but seems to have stalled out since then although he has gotten slightly taller. He still doesn’t register anything on the scale. So you can imagine the spectacle of Cadejo next to Otter who easily clocks in at 85 pounds. I’d post a picture but it’s black on black in bad lighting. 

On second thought....

In case you’re wondering, Cadejo and Otter get along just fine. Otter is curious, but he forgets how big he is and one sniff of the nose sends the little guy tumbling, but overall he’s very gentle and tolerant. Of course, Otter is the farthest from alpha as a dog can get. Edgrrr bullies him constantly—swatting when he passes by, hissing when he steps too close. When I’m feeding Otter, Edgrrr will run underneath him and between his legs to get to the bowl first leaving Otter to stand there with a hangdog look on his face. When Otter and I return from a long walk, Edgrrr immediately gets in front of him at the water bowl just to be a jerk. He sleeps in Otter’s bed, muscles in on his treats, and sticks his butt in his face (and not in a polite way.) If Otter had lunch money, Edgrrr would be waiting by the swing sets each day to take it from him. In fact, I’m pretty sure Edgrrr think’s Otter’s name is actually “Uncle.” Editor’s Note: As I’m writing this, I’m realizing that Edgrrr pretty much treats us all this way. So I guess that makes me “Patsy”.

And speaking about Edgrrr.  He responded favorably to the treatment and made a full recovery. And how does he feel about the new addition? Well, there hasn’t been too much drama. Edgrrr was still in recovery mode when we brought Cadejo home so it was a couple of days before he even realized he was there. Then one night he jumped up on the bed, saw the kitten, widened his eyes, and gave us a look that said, “WTF, dudes?! What, did you think I died? What’s with the condolence/replacement cat already?” And since then there has been some posturing, some displays of dominance and what have you on Edgrrr’s part but now that he’s established the pecking order, we have actually caught him playing (?!) with the little fuzzball. But what Edgrrr really likes about Cadejo is that he’s on a soft food diet. Edgrrr has always been a kibble cat by choice. He was never into canned food and whereas he liked the idea of treats, he would usually just lick it a couple times and call that good. But sometime during our stay in Mexico, he got a taste for pollo asada (grilled chicken) and his culinary tastes began to expand. And now, at 14 years of age, he’s decided that canned cat food is far superior to anything he's eating and insists on having some with every meal and if he doesn’t get it, he muscles Cadejo out of his. So I guess what I’m saying is, that diet he’s been on for the past year? It's pretty much gone by the wayside. Not that it seemed to do much good. From the time the vet in Barra looked at him and said, “Muy gordo!” to Dr Vasquez lifting him up a year later (and five pounds lighter) and saying, “Muy gordo!” it’s kind of become apparent that gordo is as gordo does and if you’re going to be fat, you may as well be happy or at least, in Edgrrr’s case, not pissed off.

Thursday, December 6, 2018

Day 883 to 909 of the Third Voyage: In which while normal people buy a t-shirt to commemorate their travels, the Deck Boss collects body parts.

Lest you think that all we do is fix things in the morning, huddle in front the AC during the heat of the afternoon, then stand around in a swimming pool from four to six imbibing in two-for-one cocktails while bitching about boat repairs and the heat, we do in fact engage in other activities.

For instance, the Captain and I volunteered to “teach” English-conversation classes as part of a program started by some local expats. I use the term “teach” loosely because basically all we did was follow a weekly themed curriculum (on topics such as work, food, travel, health, etc.), help the students with their pronunciation and comprehension, and then banter back and forth to get them comfortable speaking English in a social setting.  We were a bit nervous at first because A) as noted above, we’re not teachers and B) our (and by “our” I mean “my”) Spanish skills leave a lot to be desired. Case in point…I’m constantly mixing up “vacio” and “vaca”, but by now our water-delivery guy knows that when I say, “the tank is a cow” what I really mean to say is “the tank is empty.” You know, that kind of stuff. But I think the kids got a kick out of the fact that most of the volunteers had minimal (aka “just enough to get by”) Spanish-speaking abilities. They liked correcting our pronunciation or helping us find a corresponding word in Spanish and I think it helped them to realize that it’s okay if you’re not fluent so long as everybody sort of understands one another. Proficiency comes later. (And with some of us…much, much later. If at all.)

Most of the kids ranged from tween to early twenties and you had to admire their dedication. Although the classes were free of charge, attendance was required in order to graduate, so they came after school, before work, in-between jobs…rain, shine, or monsoon, all desiring to learn English to improve their employment prospects. These were kids whose aspirations ranged from teachers and pilots to professional chefs and charter boat captains. One 12-year old boy, dressed in neat jeans and an ironed white shirt, said his dream job was to be an “agricultural engineer” and that he planned to own a farm with a sizable field, a barn, eight cows and two horses by the time he was 20.  Given his determination, I don’t doubt that.

At the end of the 10-week program, we held a graduation ceremony at the Rosy Mar restaurant that had so graciously allowed us to use their space for the classes. Each student got up in front of the crowd of family and friends, introduced themselves, and gave a short speech in English on a topic of their choosing before being presented with a certificate and an English-Spanish dictionary. They all then sang the CCR song, “Have You Ever Seen the Rain” (apropos given that it was rainy season and we had just come off of a week where we got 30+ inches) before it was time to dig into papusas and cake.

Pictured: First graduating class. Future president of El Salvador is in the first row, second from the left.

Most all of the cruisers were there, and we brought along the Deck Boss so she could meet the kids and see first-hand what we had been doing with our Wednesdays. As the festivities wound down around seven, we put her in a car to go back to Bahia del Sol and, as there was limited room in the vehicle, the Captain and I walked the mile or so to the estuary to catch the panga back to the marina. It was in the middle of the mooring field, dropping off some of the other cruisers, that the message came through on my phone saying that “Jan had fallen” accompanied by this picture:

Deck Boss Down.

By the time we got to the marina and up to the hotel lobby where they had taken her, a couple of the other cruisers had gotten her cleaned up and two others—one a nurse by trade and the other in construction (aka a trauma specialist)—were on their way to assess the sizeable gash above her forehead. Technically, she should have gone to the emergency room for stitches and to be thoroughly checked out. And had we been back in Barra or Puerto Vallarta, we totally would have. But here, the nearest clinic is in the town of Zacatacaluca—about an hour away—and, unlike the tourist towns of Mexico, the likelihood of someone speaking enough English to fill in the gaps of our meager Spanish made this course of action extremely daunting. So when Lucy, the nurse, determined that some butterfly tape and bandages should suffice until we had time to assess the damage, we went with it. In hindsight, this was a good decision.

Besides, she looks okay. Right?

Now when she fell, she fell hard. She sustained the gash on her forehead, a nasty cut on her hand, and was experiencing some pain in her right leg, which makes sense when you choose to fall on some sharp rocks and not, say, on a grassy lawn.

Pictured: The opposite of a soft landing.

The hotel lent us a wheelchair to get her down to the boat and with the help of our fellow cruisers, we got her up and onto the boat. Moving around inside was easier because if there’s one thing a boat has, it’s lots and lots of handholds. The next day, she was stiff and sore. By that evening, she was starting to experience pain in her leg. By Monday it was obvious that the pain was getting worse. On Tuesday morning, we took her to Hospital Diagnostica in San Salvador, arguably the best private hospital in the city, and awaited Dr. Pablo, who is technically a cardiologist, but is unofficially the go-to physician to the gringos. While she was being examined by the emergency room staff and having her head stitched up, Dr Pablo arranged for an orthopedist to come check out her leg.

Now pretty much from the get-go, the Captain kept saying, “She’s broken her hip.” The Deck Boss was inclined to believe him, but I kept holding out. She was getting around okay, nothing seemed to be protruding or otherwise looking weird, and the pain was to be expected given that she had fallen into a rock garden. But he kept insisting, and when I asked him why he thought this, he replied, “All old people break their hips. It’s just what they do.” And I’m thinking, “Well…that’s just a cliché. Next you’ll be telling me that all cruisers do is fix shit, stand around in swimming pools drinking two-for-one cocktails, and bitch about the heat. Oh, wait. Shit.”

And damned if he wasn’t right.

According to the x-rays, it was evident that something had cracked and/or the ball had fallen out of the socket and/or whatever it is when hips break. I don’t know; my mind was going a million miles an hour, but it came to a screeching halt when the orthopedic surgeon, Dr. Zeledon, announced, “She has to have surgery to replace the hip. I’ve scheduled her for this afternoon.” Wait. What? Next thing I know, she’s being wheeled off for blood tests, an EKG, and additional x-rays, and I’m being whisked away to sign papers and put down a deposit. And here is where healthcare south of the border differs from the US. Back in the States, the patient fills out a complete medical history, a list of medications, insurance forms, privacy statements, record release forms, etc. etc. etc.  And if the patient is really lucky, they get to go through the same rigamarole at the hospital prior to the surgery. You know what they had for the Deck Boss?  Her name, date of birth, a copy of her passport, and the Captain’s cell phone number. The 3-page form I initialed and signed was all in Spanish and to the best of my knowledge stated that I was her representative, that we gave the surgeon full authority to do what needed to be done, that we understood the inherent risks associated with surgery, and that we would pay the bill prior to her being discharged from the hospital. Aside from asking if she was allergic to any medications, no other information was asked or given. Editor’s Note: Such are the dangers of limited Spanish skills. I guess if she went in for a hip replacement and came out with an extra leg and a bionic arm, I’d have no one to blame but myself.

And at precisely three o’clock that afternoon—four hours after having arrived at the clinic—they wheeled her away for surgery. After an hour in surgery and two hours in recovery—they wheeled her into her private room where we were waiting. And about this room…it was large—200 square feet I’m thinking—and in addition to the hospital bed, was furnished with a recliner, flat screen tv, daybed, large bathroom with a walk-in shower, tons of storage, individually-controlled AC, mini-fridge, and private access to a balcony overlooking San Salvador. Seriously. The Deck Boss was, understandably, completely out of it, and unable to appreciate her surroundings, but the Captain and I were impressed. At this point, an orderly came and asked when I’d like the daybed made up with sheets and this is when we discovered another way that healthcare here differs from outside the US. Namely, a member of the family is required to stay with the patient as a caregiver. Wait. What?

Twelve years ago, at a hospital in Everett, WA—back when the Deck Boss destroyed her leg for the first time—she came back from surgery, was pumped up full of morphine, then the nurses sent me on my way and told me to come back the next morning during visiting hours. That’s not the case here. Here, the nurses make their regular rounds to check vitals and administer the scheduled meds, but a family member is expected to watch over the patient and alert the staff if any additional care is needed, which, in my case, consisted of frequently contacting the nurses’ station to request more pain meds. Because there’s no morphine here to speak of, only Tramadol. And whereas Tramadol is a narcotic in the oxycontin family, it doesn’t pack the punch of what they give you in the States. On the one hand, it means that El Salvador doesn’t have the opioid epidemic like the one plaguing the States. But on the other, it’s probable that that first 24 hours after major surgery will be a little uncomfortable. Luckily, the nursing staff was very accommodating and didn’t even laugh at me when I called to tell them that the IV bag was a cow and needed to be replaced with a full one. Because did I mention that none of the nurses spoke English? Not that I expected them to, but as I had no way of knowing that morning that I would be spending the night in a hospital, I didn’t have the basic necessities like warmer clothes, my glasses, and a phone charger. The latter being the most important because of the translation app on my phone, which by midnight had gone completely dead. So, by two in the morning, I’m thoroughly exhausted, wearing the Deck Boss’ street clothes over mine to combat the chill of the hospital room, painfully squinting through calcifying contact lenses, and trying to conjure up enough Spanish to supplement the frantic pantomimes I was using to communicate. By four in the morning, I could easily have been mistaken for an escapee from the psych ward. But my discomfort was nothing compared to the Deck Boss’ as it took several hours to get the pain meds dialed in to where she could finally sleep.

But true to the doctor’s word, by the next morning she was able to put a little weight on her leg, and by mid-afternoon—roughly 24 hours after surgery—was discharged. We spent the next week with our friends, Lin and Lou, at their house up from the marina so that the Deck Boss could recuperate where the rooms weren’t so bouncy, then it was back to the boat after a positive follow-up with the doctor. A week later, the staples were removed and that was that…with one exception. Dr Zeledon explained that she shouldn’t have any problems with the new hip, provided she doesn’t fall. So, she is now the proud owner of one of those rolling walker things with the handbrakes and the seat for when you get tired. We got her one in blue (to match the boat) and were pleasantly surprised to find that the storage container below the seat will comfortably hold a six pack. All it needs now is a cup holder and she’ll be set.

Now I’d like to say that that was the end of our adventures in orthopedics, but I’d be wrong. Because when she fell, she also landed hard on her bad knee and effectively undid all the good that the stem-cell procedure two years prior had accomplished. So, it looks like she’ll be adding a new knee to her collection right after the holidays, and it looks like we’ll be extending our stay in El Salvador until next spring. Which is okay really. Because if something else goes wrong, I think she’ll qualify for a bulk discount.

Postscript:  For those keeping track at home, here’s how much it costs to get a hip replaced in El Salvador…

The surgeon: $2500
The anesthesiologist and OR nurses: $1400
All other doctors and specialists (Dr. Pablo, ER doctor, X-ray techs, etc.): $658.5
Body parts: $1012.92
Everything else (tests, labs, meds, hospital stay, nursing services): $2057.19
Grand total:  $7,628.61
I had to put down a $3,000 deposit prior to the surgery and pay the balance before her discharge. All in all, not a bad deal. Even without the third leg and bionic arm.