Monday, July 31, 2006

Our Day of Days....

I'm enjoying my time with Mick. He's not as accustomed to this kind of travel as Jason and I are. The frenetic pace is more familiar to me through working with my friend Joseph when we do the Middle East tours. This is actually much easier because I NEVER have to get dressed up or represent some barely-caring institution. Mick's about ready to get back to Columbiana. Makes no difference to me. I'll never feel at home there again. Maybe I'll never feel at home anywhere.

So we get up early to catch the San Jose-bound bus back to Liberia in order to snag the connector to Playa Tamarindo. The landlady hits us for 36 bones. Seems the price was PER PERSON, not per room. Which means I had to cough up and extra 12 for Jason who had left at 3AM for San Jose.

Anyway, we got to the busstop in plenty of time. Arrived in Liberia right at 9, or so we thought. We had just missed the 8:10, but another was scheduled for 10. Maybe we had time to hit the Papa John's or Burger King we had passed by a few blocks away.

We bought two tix, and just to be sure asked what time the next bus left. The ticket lady said 8:10. 8:10? How could that be? I had 9:05. She CAN'T mean PM!! Then she says "You have five minutes." How the Heck can THAT be? I thought all of Central America was on the same time zone. Turns out we had picked up an hour crossing into Costa Rica . How had we gone for two or three days without time mattering? Guess that's the beauty of it.

Oh well, two and a half hours to Tamarindo. MUCH more built up than San Juan del Sur or Coco. They had Subway, Pizza Hut, TCBY, condos, mucho Americanos...the works.

We snagged some breakfast and walked around til we found Cabinas Doly. Simple room on the beach, private BR, fan and that was about it. Twenty-five bucks per night for the room.

We laid about and read for much of the day. Took a walk and found another book store mentioned in Lonely Planet. Off loaded the finished and much-despised "Condo," the Whitman book of poems and a Spanish book I had ill-advisedly picked up in Manaugua. The owner, a California ex-pat, actually was happy to get a spanish book. Got two bucks for it for a net loss of $3.50.

Picked up a Thereaux (The Family Arsenal) and Elmore James "Tishomingo blues." If I could finish "Chaos" soon enough I would be back for more trades. There was a Michener book on the writing process for his novel "Mexico" I would have liked to read. It never happened.

Around six Mick and I walked up the beach. In the waning sunlight we ran a barefoot mile together. Walking back to the room we made plans for dinner. There were some interesting looking restaurants around.

I showered and sat out on the balcony outside the room reading.

I heard Mick calling to me from inside the room. He is a self-admitted hypochondriac, always worrying about this spot, that mole, this perceived rash and, of course, the ever popular balding. Always fearful of some dread disease. I once had to find pictures of him from five years previous to show him a freckle he had just noticed. He gets it from his mother. Therein lies the rub. After years of worrying about having every newly discovered disease or catastrophic illness, one day it came to pass.

So anyway I entered the room to see what was afflicting him this time. He was laid out on his bed, ashen from pain and fear. He was absolutely white.

"Dude, I went to piss and just about passed out. I've NEVER felt this much pain." Mick was hurting bad. Appendicitis? Kidney stones? Cancer? Our minds ran the gamut.

Ever so slowly the feeling ebbed. He got up and walked around a bit. It felt a little better. Maybe it was a muscle cramp. I suggested we walk around outside. The Costa Rican weather was stifling. Mick has always perspired like a faucet and he was dehydrated.

He kept talking about the fierceness of the pain. Mick is a tough SOB. I've seen him many times take a fastball (lean INTO a fastball to be precise) without a flinch. This thing dropped him.

We bought water, decided against dinner and headed back to the room. It was dark and the street was fairly busy with tourists and locals. Out of the shadows what should appear but two local guys with stethoscopes draped around their necks. One spoke no english, the other some. Turns out they were medical students.

With Mick interpreting we described his symptoms. The one with the english skills told us it was common with tourists in this area. Dehydration and heat combine for a knockout punch. He didn't think it was kidney stones. "Drink lots of water. You'll be fine." They offered to take our blood pressures (both normal) and asked for a donation for a local children'sclinic. For easing our minds it was worth the eight bucks we dropped on them. Money well spent, we thought. Didn't even care if they went out and drank it.

Then came his next tentative, fearful attempt to whiz. Squatting to avoid falling over, Mick gave it a shot. Again the sharp lightening bolt of pain drew him up short.

We obviously had a situation on our hands. There was nothing to do but get Sra. Doly (the proprietess) involved. She spoke NO english, but after initially assuming I was the one with the problem, we got the point across. A short call to the local clinic contacted a doctor who spoke some english. At this point I was wondering how I would get Mick all the way to San Jose. The capitol city would have a major hospital facility. I couldn't think anything anywhere else here would be sufficient.

The doctor, a young woman, arrived in an ambulance, lights flashing, about 20 minutes later. After checking his vitals, all normal, she gave him a morphine injection for pain and an IV drip to dilate the ureter. Mick was at wits end, fearing morphine addiction, questioning appropriateness, worrying, worrying, worrying. I did my best to reassure him, but to no avail.

We were faced with two options at this point. The doctor was thinking kidney stones. We could sit it out overnight and see what the morning would bring, estimated cost $60. Or take the ambulance to Liberia to a clinic where ultrasound and ultrasound treatment was available, $680. We were going to take a ride.

I dashed to an ATM. Had to talk my way to the front of the ATM line and cashed out $600 to add to the $180 I had in hand.

The run to Liberia was an hour and a half over washboard dirt roads. I hadn't noticed the rotten condition on the drive from Liberia to Playa Tam. To be on the safe side we checked out of Cabinas Doly. It was a good call in case we had to stay in Liberia. Wouldn't want to make that same trip twice more.

Got to the clinic around 9:30PM. It was closed. Locked up. But, soon a black Hyundai pulls up and out stepped Dra. Monica Guardia Caldera. AND she spoke excellent english. Turns out she had once worked in Miami. She was quick to reassure Mick. And me.

The ultrasound showed two healthy kidneys and no stones in the ureter. "You already passed the stone. That was the pain." Mick wasn't buying. She wanted a urine sample. That prospect had him pissing his pants. Figuratively.

He braced himself against the wall while a male nurse held his arm in support. The water flowed freely. No pain. I knew he was feeling better when he came out quoting Seinfeld's Kramer, the most famous fictional kidney stone sufferer in history.

Naturally the worrier in him would not let Mick relax (One month later he's still fretting). "Maybe only the morphine allowed me to go without pain." But, though approached with trepidation, each subsequent piss was without incident.

After having his urine and blood analyzed at another nearby clinic (which had to open for us), Dra. Guardia was more than certain the problem was a passed kidney stone. She even called the local Best Western to have them hold a room. She wanted us to return the next afternoon for a follow-up. The ambulance took us to the hotel. That will NEVER happen in the US.

By midnight we were watching HBO in our air-conditioned room. Out of pocket expenses for the ambulance ride, the doctor coming out on a Sunday night, the Med Tech coming out on a sunday night, all the blood and urine tests and the follow-up doctor's office call was less than a thousand dollars, all payable by credit card.

All things considered it was better than what ine could expect in the States. Mick's insurance said we could submit the bills for reimbursement.

In the end it was a good day. Just another stop along the way to Ithaca.

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