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Back to where it all began!
Darrell
03/19/2013, Tenacatit, Jal, MX

The ride from Barra to Tenacatita was not pleasant. There was a 15-20 knot wind on the nose which made for a very choppy ride. Marcus put on a brave face, but we could tell he was very uncomfortable. As we rounded the point and headed down bay the ride improved and by the time we anchored Marcus was doing much better. Unfortunately we where only able to push about 4 knots so it took a good 4.5 hours to arrive, but we did set anchor just before dark.

The first day was odd, we had expected to catch up with everyone who helped us out and give a full account. What we found is that almost everyone but Legacy had left already, including Dr. Nava who went back to Guadalajara. The boys did school that morning on reefs, so we went snorkeling at the mini-reef here. This was Marcus' first excursion into nature since we where here last. He did great, but the water is getting cold here and he has no body fat so he went for about 15 minutes. I did get some interesting shots and he found 3 kinds of coral for his assignment. Even Curtis bailed early, to go surf with Colton. Later we went in and played Mexican Train (or Cuban Dominoes locally) with the cruisers.

The next day I talked Marcus into going in and playing some badmitton and learning horseshoes with Jim from Sweet Dreams. It's good to see him getting about again. He is still lacking strength so we have to pace our activities. My knee had swollen to the size of a grapefruit so I decided it was time for a break. Yesterday was nothing more than hanging out and reading Isaac Asimov. Curtis went in to surf and take the dog.

Today is better for everyone, which is good as we are preparing to depart for Chemala tomorrow (Wednesday). I am still trying to work with Slalom to get a 30-60 day contract for April/May. If that happens then we will get to Paradise Village and I will leave the family and boat here and go back home. If not, then we have to decide if Marcus is really ready to head up the coast or if he and Nicki need to fly home while Curtis and I get the boat back. If anyone needs a SharePoint expert or .Net developer for 30-60 days, please let me know.

Cheers, Darrell KJ6WER, sent by HAM Radio

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Back to where it all began!
Darrell
03/19/2013, Tenacatit, Jal, MX

The ride from Barra to Tenacatita was not pleasant. There was a 15-20 knot wind on the nose which made for a very choppy ride. Marcus put on a brave face, but we could tell he was very uncomfortable. As we rounded the point and headed down bay the ride improved and by the time we anchored Marcus was doing much better. Unfortunately we where only able to push about 4 knots so it took a good 4.5 hours to arrive, but we did set anchor just before dark.

The first day was odd, we had expected to catch up with everyone who helped us out and give a full account. What we found is that almost everyone but Legacy had left already, including Dr. Nava who went back to Guadalajara. The boys did school that morning on reefs, so we went snorkeling at the mini-reef here. This was Marcus' first excursion into nature since we where here last. He did great, but the water is getting cold here and he has no body fat so he went for about 15 minutes. I did get some interesting shots and he found 3 kinds of coral for his assignment. Even Curtis bailed early, to go surf with Colton. Later we went in and played Mexican Train (or Cuban Dominoes locally) with the cruisers.

The next day I talked Marcus into going in and playing some badmitton and learning horseshoes with Jim from Sweet Dreams. It's good to see him getting about again. He is still lacking strength so we have to pace our activities. My knee had swollen to the size of a grapefruit so I decided it was time for a break. Yesterday was nothing more than hanging out and reading Isaac Asimov. Curtis went in to surf and take the dog.

Today is better for everyone, which is good as we are preparing to depart for Chemala tomorrow (Wednesday). I am still trying to work with Slalom to get a 30-60 day contract for April/May. If that happens then we will get to Paradise Village and I will leave the family and boat here and go back home. If not, then we have to decide if Marcus is really ready to head up the coast or if he and Nicki need to fly home while Curtis and I get the boat back. If anyone needs a SharePoint expert or .Net developer for 30-60 days, please let me know.

Cheers, Darrell KJ6WER, sent by HAM Radio

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Barra for a dock break!
Darrell
03/15/2013, Barra de Navidad, Jal, MX

So we left Santiago Bay with Sweet Dreams for Barra. It was a motor sail the whole way and the only consolation was a 22 inch Bonito. We anchored in the lagoon and called a Panga to take us in for laundry and some provisions. After that it was a pretty quiet night.

The next morning we decided to pull into the marina. This is the first dock Rubber Duckies has seen since the end of November. It was nice to be able to have hot water on demand and not worry about battery state before sundown. I messed up my knee pretty bad and it was getting worse but I just had to pressure wash the boat and the dock line, 30 days alone in Las Hadas had pretty well done both in. Marcus was also up to going to the resort and playing in the pool (hot tub really, the pool was too cold for him). Sweet Dreams came in as well so we invited them over for Sashimi and Tempura vegetables (another bonus for shore power).

Thursday was low key. We prepped the boat for another transit and finished some clean-up chores. Sweet Dreams left for Tenacatita around 2pm, so the boys insisted we have a 'date night' so they could play on computers and whatever... We decided to check out the resort establishments and walk around. What a fantastic facility, we have used the pool on many occasions but never anything else. The lobby is on the 7th floor and overlooks the bay as well as downtown Barra, its a breath taking view. The lounge is there as well, which is where we ran into the couple that plays music in the lounge. Unfortunately I cannot recall their names, but they where very nice and invited us to dinner with them. We first met them at Echauri when Marcus was admitted and they asked us to look them up if we got back to Barra, so there we where. It was nice to catch up and find out more about them. After dinner we headed to the lounge to hear them play, it reminded me of our dear friends Jim and Jannette of VYC, and had a nice evening all around.

Now it's off to Tenacatita, where this whole mini-adventure started.

Darrell KJ6WER posted via HAM Radio

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03/29/2013 | James Pecorella
Darrell,
Again, I took it for granted that everything was going well and didn't realize your predicament until I finally got into facebookl So sorry to hear of the continuing difficulties. Abdominal surgery is very tough and usually takes 9 months to a year before you start feeling like your old self. So, hang in there. This, too, shall pass. In the meantime, if you still need the condo, its yours. There isn't any furniture in it, but I imagine you still have stuff in storage to help fill it. There are a lot of great hospitals in Sacramento: UC Davis, Sutter, St. Joseph's, Kaiser, etc. and they are all close to the condo. So, let us know if you need any additional help. I also posted on facebook to be sure you got this. Safe journey.
First Week
Darrell
03/10/2013, Santiago Bay, Jal, MX

Well these first few days on the boat have been a whirlwind of activity. It started with Jim, Colton, Curtis and myself diving on the boat to clean what was clearly a Japanese buffet on the hull. But I have to say that we all love the Micron 66 that the Boatyard at Grand Marina put on (thanks Neil!). It was nice getting back in the water after a month as well. We moved Sweet Dreams and Rubber Duckies from Las Hadas to Santiago Bay the same day we moved back aboard. Something about having enough of the Macarrana and Gungam Style ;-) The first couple of days here where pretty quiet. Jim and I took what ended up being an 8 mile walk into Santiago to look for some boat and fishing supplies, we have been doing movie nights on both boats.

But last night was a highlight for Marcus. His friend Isaac and our friend, his mother, Nancy came out to visit on the boat. We had the crew from Duckies and Sweet Dreams and it was a very nice evening. Nancy introduced us to a local liqueur, Cola Blanca, made from Peanuts and Almonds. It's quiet scrumptious. Marcus even got out for a dinghy ride. The boys got the surfboards out and did some dinghy surfing and Isaac even got up for some nice rides. Marcus sat on the deck of Duckies with score cards!

Today Jim and I are going to scuba Elephant Rock and see what that has to offer. Tomorrow is the big day for Marcus, it is hopefully his last checkup. If we get back to the boat soon enough we are going to sail down to Barra de Navidad on Monday, otherwise it's Tuesday morning. Well, no internet, no photos sorry. Hopefully when we get to Barra and I connect at the Sands Hotel and upload some new content.

All in all, Marcus' recover is moving along spectacularly.

Cheers!

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03/10/2013 | Verena
So glad to hear things are getting back to normal for your guys! All the best to Marcus!
Verena & Mike, pacificsailors.com
03/12/2013 | anneke
more data on Marcus!!!!! glad that things are back on track, apparently, you are always on our minds!
Our Experiences with Mexican Healthcare
Darrell
03/06/2013, Manzanillo, Colima, MX

It's hard to believe that this all started over a month ago. It's been a whirlwind of emotions and too much like a 9 o'clock movie. Through it all we have had the best support of friends, family and the cruising community that anyone could ask for. Through it all there has been a resounding undertone of doubt about the Mexican Healthcare System, albeit mostly from those that are not down here. Having just spent the last 30 days under the auspices of said system I feel that we have a much better understanding of that system. And here are a few of my thoughts for those that are curious.

From the moment of Marcus' first diagnosis from Dr. Jose Armando Nava to what will be his final checkup next week from Dr. ? He has had first rate care from the attending and surgical physicians. The hardest part of the ordeal has been a communication and cultural issues. I feel it was divine intervention that Dr. Nava replaced the doctor at Blue Bay Resort in Tenacatita. Having just rotated out of a 2 year stint at a trauma center in Guadalajara he nailed it on the head when he felt that Marcus had internal bleeding. Dr. Nava even went so far as to drive Nicki and Marcus for an hour looking for a center that could perform the blood test to rule out appendicitis. This little adventure lasted for over 4 hours and until midnight. He remained with them the whole time acting as translator when necessary. Then when his condition did not improve he found the center in Manzanillo and helped them arrange transportation. We still owe him dinner on the boat! This is where many will consider Mexico a third world country in truth. There are few medical centers that have much of the equipment that we take for granted. For example, finding an ultra-sound machine meant making a 3 hour car ride.

The Hospital Echauri was our real indoctrination into Mexico. Nicki and Marcus arrived early afternoon and they swept into the CAT Machine. Within 30 minutes they determined that Marcus needed surgery and Dr. Rivera stepped in. It was the day to day care that our Spanish, or lack of, really became the issue. The nursing staff tried to communicate, but there where details that could have helped us with the care of Marcus that did not get articulated. Echauri, being a private hospital, meant that we had a private room and it included a couch for a family member to sleep on. Nicki spent most of her time here during the 7 days that Marcus was a patient. When Marcus' condition deteriorated and our funds started running low Dr. Rivera suggested we move him to Hospital General (Civil) since he is also an attending surgeon there as well. The Civil hospital also had the benefit of easier access to blood (he would later need a second transfusion), and the ability to give Marcus IV nutrition while his pancreas had time to heal and his hematoma (which was still very large and causing problems in his GI tract) shrank.

Speaking of blood, there was a lot of concern (even internally) about getting blood from the Mexican Blood bank. It was not helped by the fact that Echauri we would need to make the 1 hour drive to Colima to retrieve the pint of blood ourselves. Mexico recently underwent a change in their blood supply for the better. It was privately managed for years, unsuccessfully, and recently the government took control. It is now required that a family needing blood has to arrange making a donation. If no donation can be made then a letter of inquisition explaining why is submitted along with a hefty 'monetary donation'. Echuari did not have facilities to take a donation and due to timing having us donate in Colima was not an option. Due to Marcus' age some strings where pulled and we had a 'minor monetary donation' along with the car ride. Of course since the center does not handle money that meant a drive across town their accountant and then returning with a receipt... At Hospital General they were pleasantly surprised that not only Nick and I were ready to donate, but our good friends Jim and Gina from Sweet Dreams where ready to donate as well. They only needed two donors so Gina and I were eliminated due to a small reaction to Sulfur based Antibiotics, and that was after a pretty serious questionnaire. Nicki and Jim where selected. At this point they perform a blood screening to check for certain things and have you come back. Upon their return Nicki discovered that she was slightly anemic, go figure, but Jim was a good donor so at least we had one! I illustrate this only to demonstrate how serious they are about the supply.

The move to Hospital General was another level of indoctrination into the Mexican culture. The public hospital is exactly that, for everyone. And there is a resounding mantra from the staff, 'The same treatment for all'. This was a bit of a shock at first. Marcus had gone from a private room with a TV to a wing of 8 beds and curtains, and no facility for family to stay and a strict (militant) policy of only 1 visitor period, and no kids. Dr. Martinez arranged an expection twice for Curtis to visit. We also learned that a parent must be with the child at all times as they will not treat a minor without a guardian present.

The treatment also changed, and the first 24 hours where a bit of a roller-coaster as well. Marcus went from 1 doctor and 1 nurse to 6 doctors and a team of nurses giving constant care and supervision. There was a bit of turmoil at first with doctors suggesting treatments that ranged from a second surgery to transfer to Colima and the Pediatric Intensive Care Unit. Boy, good Spanish could have saved a lot of bent feelings here. Thus introduces our best hope for success, Dr. Thomas Martinez, the Gringo resident. Thomas was brought in to interpret Gringo to medical Spanish and back and ended up staying with the case throughout. I really think that without him things would not have gone as well with Nicki and I. The Medical notes from Echauri had not made it back to the surgical unit and there was some confusion regarding the 600ml size of the hematoma (which greatly concerned them until they realized that it had in fact shrank considerably at this point).

Marcus was moved to the surgical wing and the nursing staff took over. A primary difference between the private and public hospitals was the attention and methods in place by the staffs. Where Echauri's nurses may ask if Marcus had gone to the bathroom, at the Public hospital they gave him a container and measured. They also had a more reliable tracking mechanism for medication and other statistics. Overall we were much more pleased with the level of care and professionalism at the Public Hospital, even at the expense of much of our personal comfort and privacy. Many of the families that stayed slept in chairs and blankets provided by the hospital, which didn't have much. None of the patients had pillows and there was no hot water. We later learned that both of these are purposeful to decrease the chance of infection and not cost related.
Overall the hospital was kept very clean.

When Marcus was released under strict guidelines to allow his Pancreatitis to subside we went home and thought we were out of the woods. However, after 5 days he began to experience increased pain and nausea. On day 6 he threw up and we immediately went back to the Urgent Care wing. When they got the paperwork he was immediately seen and then as quickly re-admitted. I have never gotten this kind of care at either a public hospital or Kaiser in the states. After a series of x-rays(in house) and ultrasounds (which are done by taking you by ambulance to the private hospital Echauri, since the public hospital in Manzanillo does not have this equipment) they determined that he had an intestinal blockage.
Through it all we consulted with many medical professionals back in the states from Surgeons to Nurses, the overall consensus was he was getting the same level of care here and there was no reason to evacuate based on medical reasons. There was some internal debate about getting the right information for Nick and I, we managed to pull Mary Lou in at Echauri and at the Public Hospital it was Dr. Martinez so there we were blessed.

Marcus also made a new friend, Isaac. His mother is Nancy, she is the office manager at Echauri and has been actively involved with Marcus since his arrival in Manzanillo. They visited Marcus on several occasions at Hospital General (I think Nancy pulled some strings!) and it was a highlight for Marcus to see others not involved in his recovery. We have invited them out to the boats (Rubber Duckies and Sweet Dreams) for the day to celebrate.

As we pack up to move back onto the boat after 33 days it amazes me at the help we have received through this. Especially to Dwight and Mary Lou Davis for putting up with us in their house for 30 days!

Others I would like to mention that where involved (and not limited to, so sorry if I failed to mention anyone):
• Uncle Darrell
• Jane & Russ
• Harmony (Alameda)
• The gentleman who acted as ambulance dingy in Tenacatita (I can picture his face, but not his name)
• The woman who came along to translate P?
• Everyone who offered us meds when I put out a call to fill a prescription from Dr. Nava in isolated Tenacatita
• Margarita and her husband
• Legacy
• Kia Ora
• Moon Tide
• Ojo Rojo
• Nikia
• Relentless
• Sweet Dreams
• Dr. Ibara, head of Surgery at Manzanillo General(sp?)
• Dr. Nava
• Dr. Martinez
• Dr. Rivera
• The staffs at Echauri and Hospital General, Manzanillo

The next week will be waiting for the last check up on 3/11. Between that and how Marcus does staying on the boat will determine our next steps.

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03/06/2013 | James Pecorella
Holy Mackeral! I finally sat down to ready your blogs and was totally unprepared for the medical ordeal you related. Thank goodness that Marcus made it! I'm so sorry I have taken so long to sit down to the blog. I just wanted to have some quality time to read about your adventures. Little did I know that you guys were under such stress. You know we have the condo in Sacramento that is unoccupied-it's at your disposal if you need to come back to the states for follow-up treatment. But it sounds like things are under control; so, you probably won't need it. Just keep iit in mind though.

Tell Marcus that we are so happy that he has recovered. When I told Austin, he was really upset. As they say, when you hit bottom there's not place to go but up. So, I'm sure you guys will have nothing but good times from here on.

Hast la vista!
03/07/2013 | anneke
that is all great news about Marcus!, remember that we are ready to help!
btw, you should forward your evaluation of the medical scene to Latitude: they will be very interested in that.
hang in there!
03/07/2013 | Legacy
Glad to hear that Marcus is well on his way to recovery and glad that your experience with the Mexican medical system was generally positive. We always urge cruisers to join Divers Alert Network (http://www.diversalertnetwork.org/) as their reasonably priced membership - $55/yr/family - includes medical evacuation insurance any time you are more than 50 miles from home, and it is NOT restricted to diving accidents. We know of a couple of cruisers who have used the service, and even if evacuation isn't necessary DAN can help with medical care logistics.
03/08/2013 | Julie and Ken on Kia Ora
Glad to hear the good news! We think of Marcus often and are happy to hear that he is on the mend.
03/09/2013 | Armado Nava
hello, im surprised of all the events that happend to marcus, i had to leave the hotel and im at guadalajara atm, but its good to know that marcus its getting better, and im glad to read this, if u need anything just let me know. and dont worrys for the dinner :) and was nice to meet u, ill stay on touch and hope all goes ok
03/10/2013 | Steve Cook
Glad Marcus is doing good. I met you guys in Barra around Christmas and have been following Marcus's progress. Your blog on the Mexican health care system was splendid. I'm wondering how the cost compares to the US..if you have an idea.
Steve Cook
S/V Si Bon
Marcus recovery - Day 1
Darrell
02/28/2013, Manzanillo, MX

Today was Marcus' first full day home. He has been doing great, his appetite is back and he is walking more stable. The crew from Sweet Dreams came up with Sandwiches, Guac and chips for a really nice lunch and visit. The kids went swimming and took a tour of the place. After lunch everyone ended up on Marcus' bed watching 'Fail' vidoes on YouTube!

Tom, thanks again for all you translation and medical advice throughout... You will always be welcome on Rubber Duckies. And congradulations on your new arrival this Saturday. Es miho o miha?

Now I am smilling!

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03/06/2013 | Grandma Colleen
Wishing Curtis a Happy Birthday today. I remember well the day he was born.... my first "unofficial" grandson.

Also hoping that Marcus continues to improve and will be his old self soon,

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