Posted on May 20, 2013 in Destinations, Underway | 17 comments

Once an eye on the horizon, with its discoveries and challenges beyond; reading the skys and the seas for changing conditions; charting the reefs and shallows; choosing an anchorage for its natural beauty and shoreside communities; and keeping an eye to the sea in watch for the abundant sealife of the Baja that was always nearby. Now we have an eye on medical results of chemotherapy for Non-Hodgkin Lymphoma, and our minds on the necessary course adjustments from our dream of continued cruising throughout Mexico to the healing to send us to sea once again.

Just a week ago, Monday 06 May, with a visit to Hospital de Loreto, and several subsequent visits, and lab reports later, we learned that there was something amiss in David’s blood and spleen. Counts were down, and the spleen was enlarged to something beyond twice its normal size. Critical decisions at hand? Pursue treatment in Loreto or return to the US? It did not take more than our subsequent visits to the Loreto clinic; consultations with the doctors in Mexico; and the recommendation of those back home, especially our good doctor friend Ken Fabert who confirmed the urgency of our situation, and thus confirmed our decision to return to the US.

Our Medical Care Experience in Mexico
Medical care in Mexico is a common topic among cruisers since most are of retirement age or beyond. Ranging from good to dubious, the stories shared have been positive and have focused on quality care and low cost. However, each situation is unique and the decision is a personal one – seek treatment in Mexico, or return to the US.

Our decision was based upon the nature of the medical facility where our initial diagnosis was revealed, and our perceived experience of the doctors as they assessed the lab reports and physical changes that prompted our visit to the clinic. Our understanding of the issue was also hampered by our lack of Spanish. Unfortunately doubt and concern continued to surface.

The Chronology of Events

    Monday: First clinic vist. Labs ordered, xray and visit to lab.
    Tuesday: Second vist to lab for second blood draw to confirm low count. Afternoon visit to clinic to review lab results and meet with internal specialist.
    Wednesday: Ultrasound and confirmation of serious issue. Contacted DAN and initiated evacuation planning.
    Thursday: Moved Zoë into the Puerto Escondido Marina and prepared her for life on her own for a while. Met with George and Ruth who would be looking in on Zoë.
    Friday: Departed Loreto International Airport to San Diego.

What was the cost of our medical services in Mexico?
Yes, the cost of care was less than what we might have found in the US and did provide what was needed to suggest the potential diagnosis allowing us to determine if it was necessary to return to the US.

    Initial consult with Dr. Tomas (GP) $350 pesos (US$28.00)
    Lab Work $860 pesos (US$70.00)
    Consultation with internal specialist $800 pesos (US$65.00)
    Ultrasound: $746 (US$61.00)
    Total Expense: USD$224. (With the exception of the rental car that was necessary to make the trip from Zoë to Loreto each day.)

Medivac Out
Our decision to go prompted a call to DAN (Divers Alert Network). The call was placed over the Internet from the restaurant/bar at the marina, the only place where we could pick up wifi. Background noise, and reading the lab reports, which were of course in Spanish, to the DAN rep confirmed the urgency of the situation; most notably hemoglobin at 6.0, (less than fifty percent of norm). With this the evac planning began with coordination by DAN partner Travel Assist.

Anxiously awaiting word of departure day and time, we moved Zoë into a very weather-secure marina in Escondido. Likely one of the better hurricane holes on the eastern coast of the Baja. Nearly 40 emails and just 36 hours later, we boarded the Lear jet for the flight to San Diego. Most interesting was the trip to the airport. An ambulance was summoned to convey a sense of urgency to Mexican authorities and expedite customs and immigration procedures at the airport. It is unclear if this really helped, and as an example a tarmac parking fee was levied against the ambulance which we had to pay.

The Nature of the Problem
Here in San Diego at Sharp Memorial Hospital, our diagnosis turned up Non-Hodgkin Lymphoma, sub-typed as Mantle cell lymphoma.

So Many People to Thank
This is a list that will continue to grow as the days and weeks pass. From the cruising community; Jim and Chrissy aboard Loomba Loomba for their support and introduction to Ruth and George Woodhouse who are looking in on Zoë; John of Swagman and John, Deb and Pep Eh of Scot Free IV for being at the dock to assist in safely securing Zoë to her new slip and extending their optimistic support and offers of help. And most of all the wonderful couple on Sea Flee, Ruth and George Woodhouse who are looking after Zoe while we are in San Diego. Plus, so many others that have offered help and support; Chris and Chris of Scintilla, Paul and Janet of Talos IV, and Rob and Nancy of Shindig, and Val and Don of Distraction who have kindly offered their home and support while here in San Diego.

Our appreciation goes out to others that made the course change easy to navigate, while providing the confidence we were in the right hands; Tiera from Hertz who helped navigate the clinic’s procedures getting us to the right check-in window at the right time; the volunteer ambulance staff that transfered us to the airport who helped with customs and immigration; and the flight team onboard the Lear jet that ensured our comfort and medical well-being during the flight to San Diego; and finally to the teams at DAN and Travel Assist who worked diligently together to coordinate our evacuation.

And a Very Special Thanks to Kirsten & Emil
Remarkable good fortune has befalling us with a daughter and son in-law who put their lives on hold to help. Traveling from Seattle, Kirsten spent four days with us to lighten the burden of the news, and to lend a hand. Moments can come at any time, and seeing Barbara and Kirsten sharing a blanket and a nap was a moment that will last in the memory of this uncertain time. Emil has made the trip from LA twice, and most recently to shuttle Barbara about town in search of temporary accommodations where his insight was invaluable, and of course there was a stop at Trader Joes for the goodies only TJ’s can provide. We want to give everyone a huge thank you for your prayers, calls, emails, concern, words of encouragement, research into helping our future and love. We can feel it.

What’s Next?
HEALING AND TREATMENT, and it looks to be a six month regimen. Find a place to live. And determine how Zoë is to make her way to San Diego. Decisions are hovering and we’ll cover the details in the next post.