Tuesday, January 24, 2006

Medical Care in San Felipe

They were speaking Spanish as I woke up and I thought about joining in on the conversation. I must have imagined that I was lucid enough to communicate even with my limited Spanish vocabulary, but the conversation was one sided, try as I might words just wouldn’t come out. I attempted to reposition my body and realized that my hands were restrained. In my drug induced haze I was content to silently be a part of the conversation. more.... After twenty of listening to them talk among themselves they removed what ever had been covering me and declared the surgery complete and successful
This little saga began nearly a week ago and I now have first hand experience with the emergency health care system in San Felipe. Before I chronicle the chain of events that got me to this place I’ll say the approach to medical care in Mexico is different than that in the US but the care I received was good and my providers were compassionate and efficient.
I crashed my motorcycle a few days ago, just as I was about to hand the bike over to the buyer, our local Federal Police Office (like our CHP). He had seen it parked in my garage when he and his wife had attended a party at my house a few months earlier. It’s a large powerful sport bike that was perfect for riding the California Coastal highway at speeds nearing insanity but of little use to me here in San Felipe. He knew that it was a special machine and decided that he wanted to buy it from me. We had gotten together a few times over the course of the last few days to discuss his purchase and he had showed up unexpectedly this evening and wanted to pay for and take the bike. It was dark but before I handed it over to him I tried to impress on him how this was no ordinary bike and that if not treated as such it was easily possible to screw up and get hurt, even in first gear from it’s hare trigger throttle and it’s massive torque & horsepower. Even as a professional driver who claimed to have motorcycle experience, I felt obligated to drive this point home before he would ride it. I was going to reposition the bike for his virgin voyage to allow him a straight test drive removing as many unnecessary obstacles as possible for him, I choose to take the bike up the street and turn it around. On the way up the street I grabbed a handful of throttle to show him what was possible and predictably as I have done thousands of times the front wheel of the motorcycle lifted a couple of feet off the ground and floated in the air as the fierce acceleration allows it to remain airborne. I shift into 2nd gear and as the bike reaches 60 mph and I back off the throttle the front wheel again predictably starts to return to terra firma. The front wheel touches down with the routine chirp of a tire spinning at 20 mph making contact with the road at 60mph. Without any warning the front end of the motorcycle is ripped from my hands as it takes an abrupt left hand turn and throws itself and me to the ground. The bike and I, now side by side are sliding up the road at about 60mph. Since my youth, I have been a stickler for wearing my safety equipment when riding motorcycles and own the best equipment that money can buy. As I am sliding down the street scraping the side of my head and a number of other parts of my body against the asphalt I can't believe I don’t have any of my safety equipment on. I chose to make this last little show without even a helmet or gloves let alone my armored leather racing gear. I am in shock as I tumble and flip, flailing my body down the street waiting for the physics involved that allowed me to travel 25 yards body against pavement to scrub off the released energy & some skin…. ahhh friction. When I stopped I couldn’t wait to get on my feet to get my head away from the pavement and to take a quick inventory of the rest of me. In shock and scraped up I am standing, arms & legs are where they are supposed to be and In the few instances where I have crashed a motorcycle in my 35 year history of riding the biggest & fastest machines available I had never had my head dragged on the ground before even when protected by a helmet.
Fortunately the bike hadn't done any flips and just slid on it's side, minimal damage a broken mirror, a broken brake peddle and some scratches on the plastic. Some metal on the handle bar slider and exhaust pipe was ground away as was some skin from my body but no broken arms or legs. A gathering of spectators righted the bike for me (it weights 450lbs). It started with a push of the button and I rode it the hundred yards back to the house and inspected it for damage. I washed my wounded hands off in the kitchen sink and after a little while the Federal Trooper drove me downtown 10 blocks to one of the local medical facilities. I have to admit that the service is much better when you are escorted into a medical facility with/by the Federal Police. The doctor seemed more concerned at the time by my blood pressure than my injuries. After explaining to her (the Dr. on duty) that I was pretty much in shock from my unexpected trip across the pavement in addition to the anxiety of damaging a machine that I was in the process of selling what kind of blood pressure did she expect. After agreeing to take something for my blood pressure she cleaned up the road rash on my hands, arm and head and sent me to the X ray room where they took an picture of my noggin which confirmed that it wasn't broken, but proved that it surly didn't contain as much brain power as was needed to have kept me from needing to being there in the first place.
The following day the Federal Officer returned to complete our sales transaction with a few hundred knocked off for the new scratches, broken peddle & missing mirror.
The missing skin on the back of my hands and a little swelling on the side of my head took most of my attention a few days later I began realizing that the pain in my side was increasing indicating a possible fractured rib or at least a very bruised rib. A bruised area on my hip the size of a serving plate developed a palette with more colors than a Gay Pride Parade.
Realizing I was beaten up a bit and having plenty of writing work to do as I continue to develop my blogs, I spent the next few days mostly in bed writing on my laptop with an occasional outing to spend some time with clients who were in town for the weekend. I scored some Tylenol with Vicodin from a friend. They seem to prefer over the counter pain medications and I found them to be useless, I figured I would be good to go in a few days, of course the injured rib would probably be a continues reminder of my stupidity for weeks to come.
The next few days were colder than usual in San Felipe and working on my laptop from bed (a luxury item I had acquired during my years owning “The Back Shop” a Back & Neck Care business. Custom designed & built by me, in various levels of firmness for different areas of the body from premium Latex. This mattress sits upon a European adjustable suspension foundation, and the whole thing is built on a hospital style adjustable bed frame), add to that an electric blanket in a house with no heat during a cold snap that was breaking local records and working from bed was a no-brainer…I easily rationalized both working & healing, and of course run on sentences!
The bruising & swelling on my hip was beginning to get more painful while the road rash on my hands, arms & head was healing very fast. I had expected it to hurt, after all I hit the pavement pretty hard, and so I spent another day working from bed licking my wounds. 5 days after the initial trauma of the accident I was awakened by a bad sensation in my thigh. Attempting to swing my legs out of bed I was quick to recoil as a searing sharp pain radiated to the front of my thigh. This pain was magnitudes beyond what I had experienced in the days before. I took the last of the 10 Tylenol with Vicodin that I had been given and went back to sleep for a few hours. Next time I awoke I attempted to move my leg and the pain exceeded my threshold sending a shockwave through my body. Intense sensations of heat, clammy skin all over my body and my head was spinning and in disarray from processing very unfamiliar data being sent from all over my body… I had to fight to remain conscious. Every little movement of my leg triggered a pain response that was too much for me to bear.
It was obvious that I need to see a doctor now. I nixed the idea of me taking myself to the Doctors office as my room was on the second floor and I couldn’t even get out of bed. I called my friend Glenda who has lived in San Felipe for years and knows most of the medical staff in San Felipe. I explained to her that I had a special problem and that lacking much of a Spanish vocabulary I couldn’t call the emergency number and expect to be able to get what I thought I needed.
With the amount of pain I was experiencing in my thigh the idea of being put on a gurney and carried down the U shaped staircase in my house was unacceptable. (Some of the tile staircases found in the local Mexican architecture have bitten me a couple of times already…once to the point of bleeding and each time I was going up the stairs…sober) What I wanted/needed was to be medicated, to have the site on my thigh compressed, and to be strapped to a rescue gurney/back board, that would allow complete immobilization of my torso & legs…providing they didn’t dropped me.
Glenda called the Dr. Victor Abasolo’s office in San Felipe and explained to him what I was experiencing and requesting. He arranged an ambulance crew who showed up shortly (sans siren thank you)
Raul the ambulance crew chief arrived on the scene first decked out totally in white right down to his perfectly non scuffed white shoes and carrying a large soft red bag filled with his emergency supplies. Raul spoke a lot more English than I spoke Spanish, but with my desire to get this right we had each group of sentences describing what was happening and what needed to be done, translated through all four of the accepted languages spoken in Baja, English, Spanish, Spanglish and pantomime .
Raul asked if I was allergic to morphine. The thought of an allergic reaction to a pain medicine never entered my mind, but I’ve never had Morphine in my 51 years on the planet. “Lets not find out the hard way the last thing I needed was a complication on top of my complication…can you just give me a little? Put it in real slow and see what happens?” Raul called the Dr. several times to let him know my concerns, each time he confirmed that it was understood and what the next step would be. Raul’s assistant appear back in my room with a sleeve/splint type device to immobilize a leg, we would use that to apply the compression I was requesting. At 6’ 2” I am taller than the average San Felipe local but we managed to get enough compression high enough on my thigh to immobilize the muscle to help control the pain and safeguard whatever was going on in there. With the help of my 2 adult sons they managed to load me onto the rescue gurney and strap me down. The four of them took me down the stairs. I use my arms against the stairwell to help balance myself, they had to lift me up and over the banister in order to round the corner of the U shaped stairs. They managed to get me down the stairs with hardly any pain. They loaded me into a nearly new red squarish fire rescue type ambulance and headed for the clinic to get me X rayed. For some reason the clinic wasn’t able to get me into their X ray room right away and I was loaded back into the ambulance and transported to the local “American” hospital, Formerly the Saint James Infirmary now the San Felipe Hospital (see more on the ups & downs at the hospital) for X rays. At this point after being placed on the X ray table the most pain I was enduring was my pelvis where it was in firm contact with the hard plastic rescue gurney…Then the X ray technician palpated my hip and the pain and my reason for being there came rushing back tome like a red hot branding iron burning into flesh & nerves. Several X rays revealed that due to my immobilized position he wasn’t able to get the X ray shots at the angle he needed so he had the ambulance crew and a few orderlies pick up me and my new appendage, the rescue board and held me at the angle they needed while he took a few more X rays. Not long after he handed me a large envelope with the developed X rays. I was loaded back into the ambulance and headed to the Dr. Abasolo’s private clinic. By the time I was rolled into the Dr. Abasolo’s examination room the Morphine had finally taken effect and the pain was replaced, largely by anxiety over my situation. After a few minuets of examining both the X rays and my distorted hip the Dr. announced that there were no broken bones and he was sure that this was all just soft tissue damage, hematoma, blood clot etc. I was relieved to be assured that neither my pelvis nor hip was broken. At that point I nearly expected him to send me home with Vicodin, anti inflammatory meds, and ice packs….no such luck.
“This is going to require some surgery” he told me…ahhhh dreaded words!!! Other than having a few teeth pulled I have never had surgery in my life…I’ve never even had stitches. Dr. Abasolo told me he suspected that there could be a liter & a half of blood between the layers of muscle in my hip & thigh area; he was going to have a local surgeon come over for his opinion. Dr. Daniel Reynaga Morelos arrived in less than 10 minuets. They confirmed with me that this wasn’t to be considered elective surgery and that it would be best to do the surgery right away and in Mexicali, a two hour drive from San Felipe. They wanted to handle this in Mexicali in order to have blood available just in case I should require a transfusion and for other issues that I wasn’t privy to.
It was now about 2:30 in the afternoon, he made several phone calls and announced that he had secured an operating room and everything they would need for an 8:00 surgery that evening. I could pay to have the ambulance take me to Mexicali or he was confident that I was stable enough that I could get myself to Mexicali anyway I wanted. I had already had the services of the ambulance for half the day and decided that I didn’t need anymore of their services. I sent my sons to prepare their Mothers Mini van for use as transport by removing the seats and inserting my latex mattress. I guess I could have taken the bus or any other form of transportation….It was good to have options.
While waiting for my sons to return with the van they began pre-surgery prep, blood work and an EKG. I’ll assume that I have a whole lot more chest hair than the average Mexicans. The nurse kept sticking new sticky electrode tags on my chest and was unable to get a reading on the EKG machine. The language barrier was in full swing. I tried to get through to the nurse that I had had an EKG before; they had shaved a couple bare spots on my chest to get a good contact. After several replacement sticky electrode patches I figured sooner or later there would be a hairless area…I finally got the nurse to bring me a pair of scissors and I cut enough chest hair away so he could get the electrodes to stick allowing a reading. The Dr. shot me full of Valium before we left… the drugs allowed me to sleep most of the way to Mexicali which was wonderful as the increased levels of tourist and construction traffic has had a rather negative impact on the road surface…I was happy to sleep and not have to endure the bumps & potholes.
My room for the evening was painted a relaxing pale blue; the doors and wood work were gloss white enamel. It was very clean and had a spot of one visitor to sit & also a visitors sleeping area. The mattress however even though it was on an electric adjustable hospital bed was reminiscent of the hard plastic rescue gurney I had spent much of the day on.
I was visited by a Dr. of Internal Medicine who spoke perfect English and asked me health history & life style questions while referring to my blood & EKG reports. He announced that he found me fit for any kind of surgery…”Lets just keep it to the surgery that’s needed…OK?”
Both Dr. Abasolo and the surgeon Dr. Reynaga had already been to my room to confirm that they were there and ready for me and that I was in good hands.
In the operating room I was greeted by the Anesthesiologist who told me that he would be administering a spinal block…That was both good & bad news…I was never very excited about the thought of standard anesthesiology where they drop you body functions to just a hair above dead while your life is in the hands of someone who’s job it is to make sure you are breathing…This is an especially frightening thought to me while South of the border. On the other hand I had experienced a Spinal Tap when I was a child and my memory of being held down by half a dozen staff while they tapped me like a keg of beer, searching for the answers to a sleeping illness that was never diagnosed. That experience had resulted in frightening memories and an odd sensation in the small of my back that remained for over a decade. I was a little frightened of the Spinal Block, but fortunately the drugs I had been given were controlling my anxiety levels and I realized that these people where helping me with an issue that was out of my control. The young Anesthesiologist administering the spinal block did a fabulous job inserting whatever it is that he stuck into my spine with no pain at all. I never noticed them preparing to put me out or if I just fell asleep but the next thing I remember is that they were speaking Spanish as I woke up.
Back in my room the most uncomfortable part of my whole time in the hospital was waiting for the Spinal Block to ware off. The bizarre feeling of not being able to feel large parts of my body was disconcerting.
12 hours later I was showering in preparation for being released. During the surgery the Drs. had inserted a drain in my thigh, a 5 foot long length of plastic tubing with a Tupperware like fluid collector at the end to collect any residual drainage. They told me that during the surgery they had removed over a liter of blood & fluid and that they were very happy with the outcome of the surgery. I was pretty surprised that the bruising colors in my skin had been drastically reduced nearly back to normal and the saddle bag that had developed on my hip and waist was gone…had I known I would have asked for a little off my gut while they were in there.
15 hours after the surgery I was walking and dragging around my new 5 foot long red tail …the only outward physical evidence of my distressing 28 hour ordeal.
In general I was pleasantly surprised by the level of compassionate care that I received. As a cash paying patient I really appreciated the option of getting myself to the hospital in whatever way suited me best, & knowing that they would have handled it if I wasn’t able to. I liked the fact that they didn’t keep in a hospital setting any longer than necessary racking up charges. It’s been five days since the surgery and I am recovering well with no hospital related infections (a common complaint even in the best hospitals in the US.
My Doctor used to work out of the American built hospital in San Felipe and my understanding is that they are capable of emergency surgery there. I had toured the hospital a few times during the last three years with clients who were interested in knowing the capabilities of the health care system in San Felipe as an integral component of their decision to invest or move to San Felipe. Within the last year the founder of the “American” hospital has sold it due to age & health issues and the hospital has been through some gyrations. I will be writing more on the San Felipe Hospital as I learn more about their current capabilities.
For now I am pleased to report that quality, compassionate medical care is available.

Thursday, January 5, 2006

Welcome to My San Felipe

Welcome to My San Felipe

San Felipe, should I even try to explain this place? Only a few years ago a sleepy fishing village with excellent Sports Fishing and a sustainable Shrimping industry. Today; dreams of becoming the next Cabo San Lucas as Golf Courses, Custom Homes & High Rise Condos begin to dot landscapes & beaches. Silver Jewelry...tasteless Tee Shirts. Sport Fishing is still great. An occasional hot day...an occasional cool day. Better than average sewage systems keep the Shrimp industry sustainable. Old guys with white ponytails, dark tans & huaraches sandals....Shakers & Movers investing millions of development money in pristine beach front property. Regular Carnivals & Circuses...Lions, & Tigers, & Bears..Oh My! Fire works, Mariachi Bands, Fish Tacos, Cerveza, & Tequila. More

The annual average rain fall wouldn't wet the eraser end of a pencil stuck in the sand...ample water supply in underground aquifers. Papa Neutrino Floating Garbage Ship. Earth Ships coming.
Arnold Palmer Signature Course. Shade...Sun Screen. 60 thousand folks invade town for Easter week...Days when you know everyone you see. Sea of Cortez gently laps the sun drenched sandy beaches. Fine Dining...Pole Dancing. Have your name written on a grain of rice (so who would know) Roadside fruit & vegetable stands. Solar Power. Fire Works, Mariachi Bands, FishTacos, Cerveza, & Tequila. 1/4 mile monster swing between low & high tides...watch out for Sting Rays! Jack Nicholas Signature Golf Course. Wind Power. Swimming & Sunbathing.El Dorado Ranch is building out. November Shrimp Festival. Sandy beaches to explore. UFOs. Fractional Ownership coming to La Hacienda. Christmas Eve announced by every siren in town...and fireworks. Goofy trinkets made from shells. Just a few Kilometers from the beach,towering mountains thrust out of the desert 10,000 feet and touch the sky...an undeniable awe inspiring presence. Playa Paraiso is going up. International Airport. 300 year old Cardón cactus tower to 50 feet. Sand Dunes. Shrimp Tacos. Pesos or Dollars ..locals often speak enough English to keep us Gringos from getting fluent in Spanish. 9 Holes Sand Trap. Fisherman's Pangas on the beach at the Malacone. Marina Development overlooks great Shrimp season. Pickups trucks that you seriously wonder what's keeping them rolling down the road, dune buggies, ATVs & Hummers, and the odd million dollar Baja off road race truck share the roads. Community Festivals draw thousands to beach front Malacone. Mariachi Bands, Fish Tacos, Cerveza, & Tequila. Police trucks even have bad mufflers Natural Healers...state of the art hospital. Coconut Shrimp. Harrison Ford raises a toast to National Enquirer. Beautiful houses built from old tires. The Baja 1000. Moonless nights away from the lights of town assures you that we are silently screaming through the solar system, you can almost touch the stars. Banana Boats. Aqua Marina has movie history. Young people listening to Tuba & Accordion Bands. Flour or Corn? Local club scenes pumps out the newest hip hop chart buster at decibel levels reserved for the Space Shuttle...until 3 AM...quite restaurants on the beach. The haves & have nots. Garlic Shrimp. Marlin Brando. Shorts & Tee Shirts. Fire Works, Mariachi Bands, Fish Tacos, Cerveza, & Tequila. Been in town for more than a few days? You will recognize someone you've already met..and they'll recognize you...You will stop to visit. Midnight drives through the desert are actually encouraged. Babies....Retirees. Dirt roads... High Speed Internet. "HOT Peppers". Multicultural. Getting dressed up...NOT! Fishermen making their nets. Shacks, & Villas...Dive Bars & Fillet Mignon. Fire Works, Mariachi Bands, Fish Tacos, Cerveza, & Tequila. Barking dogs and noisy roosters... silent Sunsets & Sunrises...Full Moons. Powered Hang Gliders over head. One crazy place....lower Blood Pressure: These are just a few of the subjects I intend to play with in my posts. I hope you find the San Felipe I describe as I am getting to better know and love it is an interesting place you to read & learn about. It will be my pleasure to be your virtual & interactive guide. Welcome to My San Felipe, I hope you consider making it Your San Felipe... Did I mention the Fire Works, Mariachi Bands, Fish Tacos, Cerveza, & Tequila?