Home alone. Ron left on Saturday morning to travel back to Colorado to visit his Mom and family members for the next week, leaving me and the cats, lying around like melted butter. Yes, it is hot and just going to be getting hotter here in La Paz. We haven’t even hit the really hot months yet, which I believe are July through mid-September, but it has been hovering around 100° for days now, and that appears to be the plan for the next week or so. Luckily we are at a marina that has a couple of pools and a beach, although we haven’t taken advantage of the beach yet. They have warning signs about the stingrays that inhabit the area, encouraging you to shuffle your feet when entering the waters, to warn the little beasties, I guess. It seems stingrays here are the color of the sand and it is easy to step on one if you don’t watch it.

I have to be in “take-it-easy” mode while Ron is gone, as I have injured myself. Yes, this month’s blog should actually be titled, “How We Spent Our Summer Vacation Injuring Ourselves and Visiting La Paz Medical Facilities and Farmacias.” Without medical insurance. Actually, we are lucky in many ways, to be able to afford the excellent and financially reasonable care we have received. But let’s not jump the gun, and no, no guns were involved in any of our medical calamaties…

Ron and I were visiting friends on Saturday, May 24th, and to make a long story short, he fell down some rocks/small boulders when leaving their dock. (Our gate key didn’t work, so we climbed over a railing to cross some rocks and go around the locked gate. I made it, but the first rock Ron stepped on tumbled out from under him and he went right down with it, almost into the water. He hit several rocks on the way. I helped him back up and we hobbled back to the boat, which was probably a quarter of a mile away and across a sandy beach). We didn't realize he was injured that badly until we had a doctor come to the boat two days later on Monday. You might recall from a previous posting, we have met a doctor here who does “boat visits.” Ron had been in pain and had some problems breathing, and kept saying he felt a “clicking,” as if a rib had become dislocated, but he didn’t think it was more than that. Ron asked the doctor to push his ribs back in place. She listened first to his lungs and felt his chest and said immediately, you need x-rays. You have air bubbles in your chest. Thank goodness she didn't do what he asked of her. She sent us in for x-rays and we were told he had 4 broken ribs and a punctured lung! He was sent right to the hospital from there, where another doctor was waiting with a wheelchair as soon as we got out of the cab. (Our boat-visit doctor kept in touch with us and the doctors she sent us to by phone, coordinating everything. She was a gem and didn’t charge us anything for this care.) The doctor with whom she had arranged for us to meet at the hospital wheeled Ron away, while I filled out some paperwork and when I got to his room, the doctor introduced himself and another doctor. They then proceeded to operate on Ron in his hospital room - in my presence! They put a tube into his lung to expand it, and then to drain blood and air out of his chest cavity. He spent two nights and three days in the hospital. All in all it was a good experience, although there were certainly some surprises and challenges, having come from the U.S. system of medical care.

Thoughts on Medical Care in La Paz
The hospital was a small, older hospital, which doesn’t necessarily cater to American or Canadian tourists, so there were more locals there, and supposedly it is less costly than the newer institutions. It also meant the care was more personal, kind and more humane overall; even to me, when I was so shaken up checking in. The woman at the front desk told me not to “worry. Everything will be ho-kay.” (in her broken English). They didn't pester me with financial questions AT ALL. They gave me two remote controllers and told me Ron was in room 8. I was confused and asked what I was to do with the remotes. “Are you going to call me on these, or what?” Shows how clearly I was thinking. She slowly explained "No, this one is for the television… This one is for the air-conditioning…" Duh. Guess I was kind of out of it... Ron and I hadn't realized how injured he was, and how dangerous it was. This was all on top of me coming back from caring for my dear friend Steve for a week and then him dying; the same evening Ron injured himself.

Most of the nurses and nurses aides spoke no English, but the primary doc and "chief nurse" did, as did one or two of the administrative staff. So trying to explain to the nurses what Ron needed with our limited Spanish became a challenge. It certainly forced me to start carrying my English/Spanish phrase book everywhere with me. After the initial 24 hours Ron needed to go to the bathroom, but was constipated from the pain meds. Nor could he get up due to the chest tube. (Sorry Ron, TMI??) We stated “no baño,” showing them his extended stomach, and finally they said, "Oh, no poopie?" It was rather funny – if you weren’t Ron, that is. His doctors were also amazed that he could have gone for three days with a collapsed lung and broken ribs, and kept saying he was “Strong like Bull.” They were very available and communicative, unlike what we have known to be the case in the U.S.

Another interesting aspect was the “hospital cafeteria.” It turned out to be a little café next door, where I went to get some lunch, but also discovered that they prepared meals there for the patients. My lunch was 75 pesos - including three chicken tostadas and a bottled water. That comes to about $5.78 US dollars. They had a daily special where you got a good soup, rice, entree, desert and drink for 105 pesos. $8.10 U.S. for more than you can eat, but not obnoxiously so. It was a cute little place with cloth tablecloths, napkins, flowers on the tables, colorful bright paintings and place settings. The staff sort of brought you out what they thought you should have in some cases, rather than what you planned to order, like giving me a bowl of vegetable soup the first time I went in.

I had been nervous about the cost of his hospitalization, with “emergency surgery,” since we don’t have any health insurance down here yet. (I have since been investigating it, although it might end up costing us more than actual medical care each year, even with events like this one). His total cost for the three days at the hospital, including doctors was about $2,370 US. Not bad; probably the cost of a day in a U.S. hospital, not counting the doctors. I also got a 10% discount on the hospital bill with my Sam's Club card! Weird.

Another difficulty of being on our/my own in another country is having to take taxis everywhere. I had to take a taxi back and forth to the hospital to visit Ron, which was on the other side of town. So I would end up negotiating with the driver – improving my Spanish (!), to find the best deal. It took me a while to become comfortable with that, although in general, the drivers have been very helpful and kind. In fact we have found a couple we stick with. One of them has very limited English so he brings his friend who speaks better English, and if his friend is unavailable, he calls him on his cell phone (yes they can do this in Mexico while driving) and hands the phone to me to help translate any questions or to let me know what is going on. One day I asked him if he had had a busy day, but I apparently used the incorrect word and he called his friend, handed me the phone and the friend said, "He wants to know what you ask him."

The other driver, who is the all-time-best-taxi-driver-in-La-Paz is Elias. He has repeatedly refused tips at times, handing me back money when he thinks I have given him too much and even bought Ron and I some bottled water the other day when we were running around town visiting farmacia’s (pharmacies). He waits for us when we have to make stops and is always so gracious. I told him he was sweet the other day (for getting us water) and I clearly used the wrong word, as he did not respond until I looked up the work for “kind.” I probably called him a pastry or something before.

My Own Medical Stuff! Again...
I twisted my knee somehow and ended up injuring it again, despite the success of the cortisone shot I received in PV, back in February. I talked to our boat doctor, as we refer to her now, and she researched a good, economical place in La Paz. She made an appointment for me and told me that I needed to call the Doctora once I was in the cab, and to hand the phone to the cab driver, and he would get the directions to her clinic. Ok... Not the US norm, certainly. So I called once I got to the Cathedral in the center of town, where all the taxis hang out. The driver spoke to the Doctora and off we went. We ended up going to the outer area of town, to dry pale dirt roads and dusty houses and cars. At one point Ron said, what have we gotten ourselves into? Even the taxi driver wasn't so sure. But we found the Clinica, which turned out to be a "Sports Med Clinic," behind an iron fence. The waiting room was packed!

I met with the bilingual doctora and she spent an hour assessing my knee and decided it was my IT band, not the actual knee. I brought along my x-rays (from February), and really, would you do this in the US? She looked at them, felt my knee and leg, manipulating them this way and that, and said she would not give me a cortisone shot, but put me through a physical therapy regimen, for the next 7 days, giving me electrical stimulation, hot and cold compresses, and ultrasound treatment. When I asked about the cost, she said, “oh, very reasonable, 170 pesos for about an hour.” Well, that comes to about $13 U.S. per session. By the way, the sessions lasted about 2 hours minimum, not one hour. I had the same physical therapist each day, who spoke no English, but we were able to communicate as I brought my Spanish-English dictionary each day. By the end of my treatment there I had discovered that she has 3 children, the oldest being 30, and she is only 42. Yes, do the math. She also works two jobs, one as a physical therapist from 8-6, then 7-10pm as a massage therapist in a spa. She gets no days off. She said having a child at age 12 is not "normal" in Mexico, and that she works hard because she is a single woman, helping her 30 year-old son go to medical school.

After a couple of weeks of physical therapy, which also now included muscle strengthening exercises, I noticed one evening that my left leg below the knee had become swollen, like a sausage. Eewww. Ron and I were off again to Fidepaz, the hospital he had gone to with his broken ribs. They did an ultrasound and found out that I have Baker’s cysts containing bits of cartilage floating around inside. Not 1, but 3, probably due to torn meniscus. So I am to undergo an operation once Ron is back, to have them drained, removed? And to repair the meniscus. Ron and I swear that we have had more medical issues in the past 7 months than we have ever had in our lives. Either it is our age, or our lifestyle, or I guess a combination of both. Yuck. At least we are alive, and have these kinds of things to worry about – I know, it could be a lot worse.

So we are safe and sound, tucked into Costabaja Marina in La Paz. We will be here for the next few months, to wait out hurricane season. We hope to make some excursions out to the islands in the Sea of Cortez, but come back here if we get notice of any concerning weather systems approaching Baja Sur. We will probably be in the La Paz area until mid-October or so when we have to return to Mazatlán for our next step in our visa process. By that time we will have been in Mexico for a year - October 28th!. So that is it for now. Hasta la Vista!