Barefoot in the Kitchen

The first time a scorpion stung me, it was almost a relief. My being stung seemed all but inevitable, given the number of stories my jungle neighbors told about their encounters with the bug. I was anxious to get it over with, just so I’d know how my body would react.

I got my answer early one morning while walking barefoot into the kitchen. A piecing pain suddenly shot through the big toe on my right foot. I turned on a light, saw the scorpion on the floor, and bolted for the bathroom where I had stashed a bottle of antihistamines with this occasion in mind. After gulping a couple of the pills, I sat and waited for a reaction.

It was a short wait. In a matter of seconds, beginning with my now hot and throbbing big toe, the pain rolled up my right side like a wave and left nerves numb in its wake. I felt nauseous. My throat constricted but only slightly. Not enough to warrant a trip to the hospital. Besides, that might have meant missing our “girls’ weekend” in Guadalajara; a friend was picking me up in an hour.

I wobbled a bit the first day of that shopping trip. But three days religiously swilling liquids and I bounced back. Three months later, I regained feeling in the big toe.

Since then I’ve been stung twice more. The third time I acquiesced to my children who told me I looked green and drove me to the hospital, where seasoned staff put me on an antivenin IV drip.

“We do this routinely,” they said. “Don’t hesitate because you think your case isn’t serious. We rarely see a case that is. Just come in; you’ll appreciate the quick relief.”

Two hours and 250 pesos later, I walked out feeling fine. My kids were right; that’s the way to go, I now advise. That and don’t go barefoot, not even in the kitchen.

The Librarian: Lonely No More

Was it only a year ago that I, the “lonely librarian,” sat on the floor in the library at entreamigos surrounded by boxes, tape and markers, packing books for storage? Last April the future of our small community organization seemed bleak. Staying in the building on the main street that entreamigos had occupied for three years was not an option. Its location near the beach was prime real estate; the landlord had other plans.

A large abandoned warehouse at the other end of town had been given to entreamigos but renovating it into useable space was overwhelming. First, it would take a massive effort to clear the building of years of debris and garbage. Then, even with the possibility of a $36,000 grant from The Three Swallows Foundation, the San Pancho community would have to raise twice that amount of money to begin construction.

Did the community care enough to make the effort? When larger cities, including my home town of Evanston, Illinois, are closing their neighborhood libraries, could a project of this size in our small town possibly succeed?

The answer is a resounding “yes.” Having a library and community center did matter. Today entreamigos has a brand-new home; in cash, more than $100,000 was raised. The dilapidated warehouse was restored inch by inch into a completely “green” space through hundreds of hours of volunteer labor and donations of supplies.

A few months ago I sat on the floor in the new library at entreamigos and unpacked all of the old boxes. The newly painted wooden shelves, recycled tires and crates, were ready to be filled. The large, airy space with brightly-painted tables and chairs and comfy pillows beckoned eager readers. It had been a labor of love for all of us, a commitment to libraries and to education that San Pancho was willing to make.

In Evanston, news of a $10 million deficit in the budget sounded the death knell for the neighborhood libraries. Closing the two branch libraries was not a new threat; in fact, it was almost an annual event at budget time. But this year was different, and the end of the neighborhood libraries seemed imminent.

There was one possibility. The Branch libraries received a six-month reprieve to raise $200,000. Could the Evanston community raise that amount to keep the Branches open?

To date, 1000 volunteers have raised $65,000 with more commitments of support daily. But a “For Rent” sign in the window of the South Branch library has added to the pressure.

Come on Evanston. If we can do it in San Pancho…

Our Mexican Medical Adventure

“I thought he seemed pale.” That’s what our San Pancho friends said later. Probably out of politeness no one said anything at the time. I thought he looked pale, too, but we had just arrived from overcast Connecticut, and I chalked it up to lack of sun. We had no idea that a serious medical problem was brewing.

During the next ten days Skip felt tired, then lightheaded and dizzy. We called his internist in Connecticut. “Better get him evaluated,” the doctor advised. Though we didn’t know what was wrong, we suspected the problem might be more than the small hospital in San Pancho could handle. AmeriMed in Puerto Vallarta advertises that they provide “full medical services based upon U.S. standards of health care” and that their staff is bilingual, so off we went.

Lab work revealed that Skip’s blood count was dangerously low. He needed a transfusion immediately. The doctor ordered two units of blood and called in AmeriMed’s gastro-intestinal specialist to do an endoscopy, on the hunch that intestinal bleeding might be causing the blood loss. He discovered stomach ulcers we hadn’t known about and showed me the images on his monitor. He even gave us a DVD of the procedure.

Medicare doesn’t cover anything outside of the U.S., the out-of-pocket costs were mounting, and we wanted Skip to be treated by doctors who already knew him. So we decided to return to Connecticut. After lots of blood work, more transfusions, another endoscopy and other tests, the Connecticut specialist had no conclusive explanation. “I question whether those small ulcers could have caused so much bleeding,” he said. Nevertheless, after a month Skip was fine: no symptoms; blood count normal; no more pallor. The doctor cleared him to return to Mexico, and we booked the first available flight.

Health problems will inevitably arise for expats in Mexico, especially those of us who are of Medicare age. Sometimes the solution is clear. For minor problems we can go to the hospital in San Pancho or to one of the English-speaking doctors in the area. The time I nicked myself with garden shears I got a free tetanus booster in five minutes at our village hospital. If one of us had to be hospitalized for an emergency, we would use our MedJetAssist plan to cover air medical transport to a U.S. hospital.

However, there is a confusing middle ground, as in our situation. The problem isn’t minor, and yet it doesn’t require hospitalization. We have asked ourselves many times, "Did we do the right thing?" We wish we had noticed Skip’s symptoms sooner, but sometimes they take awhile to crystallize. Language becomes a factor. The doctors at AmeriMed spoke English, but the nurses and technicians typically didn’t. We muddled through, because a lot of medical words in Spanish are the same as their English versions, but pronounced in Spanish.

In the U.S. we are accustomed to a large university teaching hospital minutes from our home. In the midst of the crisis we were comparing AmeriMed to Yale New Haven Hospital—not a fair comparison. AmeriMed wasn’t world-class, but the staff was resourceful and they got the job done. The transfusion pump, for example, didn’t work and neither did the replacement. After a lot of tinkering, the nurse improvised a solution: He tied a blood pressure cuff around the bag of blood to prime the pump, blood began to flow, and the transfusion proceeded. When Skip had another transfusion in the U.S., the pump was the same type as AmeriMed’s, but in that high-tech, expensive hospital I noticed with some relief that a sign was attached: STOP! If pump fails for any reason: REMOVE from patient immediately; TAG unit as “out of order”; CALL Clinical Engineering Department.

Since this episode occurred, I examine Skip for signs of pallor, and I ask intrusive questions about bodily functions. But, except for noticing symptoms sooner, we would not have done anything differently.