Assuming there is something Homeric about our voyage, I would have thought it would be taken from The Odyssey rather than from The Iliad…
A little disclaimer: This is not a “proper” Team Bouchon Sailing story as can usual be read on this blog, but more the unfolding of an injury that occured to me (Marie) during our time in Costa Rica, and trying to navigate, on my own at first, a foreign health system. It is also a story of incredible support from other human beings from Costa Rica.
Yalçın had left in the morning for LA. After accompanying him to the San Jose airport, I still had until the beginning of the afternoon to return the rental car in Puntarenas and I was determined to make the most out of having a car. Extra groceries at Automercado (the Wholes food looking chain of supermarket which had a lot of international items), a stop by an auto store to get engine oil and coolant and finally driving back and stopping at a couple other supermarkets to see what our local options would be once we’d leave Puntarenas, one month from now. Needless to say, the trunk of the small economy rental was full when I arrived in Puerto Azul marina: bags from the land vacation, groceries, oil, coolant and even a bucket I’d gotten at one of the closer stores. I still had two hours before they’d come pick up the rental, more than enough time to unload everything at my pace. Taking a couple of items with me, I went back, opened the boat (understand the main door but also all the hatches to air out) and changed to a swim suit and skirt to adapt to the warmer weather here compared to the capital and considering to squeeze in a swim in the appealing swimming pool of the hotel before unloading… I should have, as unfolding events would prevent me from using this pool ever again. Instead, my gaze followed someone else from the dock to the place where marina carts were kept. I saw him take the only plastic cart and walk to another boat. I could use a cart too, that would make my life easier instead of going back and forth many times for unloading. The blue metal carts that were left were bulky and heavy, I couldn’t see myself walking on the shinny floor of the reception with that massive thing. No big deal though, there was a side path that lead directly to the parking lot. It was kinda hard to maneuver the bulky cart on the gravel and I had a bad feeling about it: would using this heavy cart even make my life easier? I now had to move the car to that part of the parking lot, otherwise I would still have to move the many items back and forth on a comparable distance to reach the cart from the car. So I left the cart under a little roofed shelter and drove the car to that area of the lot. A parking spot even had a Rental Adobe sign, a commercial for the company I rented with (the only one in Puntarenas), and I figured they could probably pick it up from there. That was perfect! I got out of the car, walked the 20 meters that were between me and the cart, reached for it and enthusiastically pulled it behind my back. I can’t tell precisely what happened, despite trying to replay the scene for many doctors in the following days. Perhaps the cart took a while to start rolling as it was in the gravel and sprang rapidly to my foot, or perhaps the arms of the cart were just too short for me walking that enthusiastically with the cart in the back, or who knows? The result is the same: the bottom of the cart caught the back of my right foot, and the sharp metal cut deep into my flesh. Under the pain, I collapsed on the gravel, I was feeling dizzy, it was almost lunch time and had only had a donut in the morning at the airport with Yalçın. Then, someone passed by, said ‘hi’, I think I might have replied and as the man walked away, it occured to me that calling for help might be a good idea: ayuda ayuda, por favor! He helped me reach a sitting position and told me he would get someone from the hotel to help me. Holding on firmly to my ankle, above the bleeding cut, I saw a gap right above it, with a little bump on the upper side. Fuck, the tendon! I was sure it had been cut. Of course, I have no medical training, but it was really making sense. Despair.
The hotel staff arrived with a first aid kit and someone went back to get a wheelchair. As they installed me on it, I started to faint again, so they took me inside, in the air conditioned interior. Maria, the receptionist who was there when we came to check out the marina before Yalçın left and with whom I had exchanged phone numbers, was very helpful as always: she went to get a strawberry smoothie to increase my sugar level, as I hadn’t had food since the morning. As I explained what happened, people reassured me that I would be fine. We put a little bit of spray on the wound, which was still bleeding on the floor. It was deep. They said they would call an ambulance and that, very likely, they would take me in for stitches. No one seemed to believe my tendon could have been hurt but, in my mind, if I was to go to the hospital, there was little chance I would come back the same day and that made me worry about many things: the boat, the rental, the groceries. Luckily, the hotel staff was the most helpful: they unloaded the car for me and agreed to handle the return (Maria even called in advance to see if me not being there was fine), moved the groceries to the boat in order to refrigerate the items that needed to be (I was worried they would have difficulties with finding where to put things on the boat, but I found my groceries nicely tidied up on the table when I was back) and got me the bag that contained my documents. Soon, an ambulance of the Red Cross arrived and I took off with Francisco. He disinfected the wound and was reassuring about the tendon when I say I was worried. We reached an urgent care clinic, where, after hoping in a wheelchair and presenting my passport, I was set in an outdoor corridor to wait for my name to be called. I was grateful the place was outdoors, since the pandemic was going on on top of everything else. I was lucky to have my N95 mask with me from my excursion at the airport in the morning. Still worried about the boat, I had asked Max, the only other boater I knew in Puntarenas, to have him close the boat. He was working at the Costa Rica Yacht Club on the next block and instantaneously went to Tire-Bouchon. He confirmed the groceries were in, and that the hotel had closed the boat’s companion way, but informed me that the hatches were all still open and since it rains pretty much every afternoon around here, I gave him the code and he closed everything. He was very concerned about my injury and kept checking on me and offering support throughout that entire period, which was invaluable. At first, he had thought I had a car accident as I had asked him for directions on where to find engine fluids in the morning, stating I had a car. By now, Yalçın had landed and read my alerting messages too. He had also feared about a car accident before getting the details. But at that point, the latest was that I was waiting, at an urgent care clinic in Puntarenas, to see a doctor.
I first got directed to the nurses for admission. With my broken Spanish and precious help from Google translate, I explained what happened. They put me back outside to wait for the doctor. After waiting some more, my name resonated on the speaker. Not exactly sure about what to do, I used my valid leg to move my wheelchair to the admission table and said that my name had been called. Another patient, visibly trying to help but quite aggressively (he seemed to be having some mental issues), showed me where to go. Hesitant to follow his directions given his state, I only started going half-heartedly until a staff from the hospital took over and brought me to the door of a doctor, actually where the guy has been pointing at, and after checking-in inside, the staff told me to wait for a bit. Less than 5 minutes later, a young doctor informed me that they were going to stitch my wound and send me home. I was feeling myself fainting already at the announcement, given my legendary fear of needles (imagine stitches!); yet, when he asked if I had any questions, I stated for the second time that I was worried for my tendon. This time, he bent down to look at the foot and palpated the tendon in question. The verdict came right after: it was cut, they were going to send me to the hospital to have surgery. Alright, no big surprise! But still a little panicked: surgery!!! That probably involved a whole bunch of extra needles…
They installed me on the exam table, lying face down. The first nurses came back and I understood that everyone was quite surprised at the diagnosis. How could have I hurt myself that way with a “carrito”? Maybe my Google translated word wasn’t the best translation, yet I’ll realize later that I would have a hard time to explain it in French as well… I was waiting for the dreaded stitching procedure on the table when the nurse just bandaged me: no stitches here since I was going to the hospital. Relief! Then everything went fast. I was sharing the diagnosis over the phone with Yalçın and Max. The latter told me he didn’t recommend to go to any hospital in Puntarenas, especially with Covid and especially if surgery was required and he offered to drive me to a private clinic in San Jose. But everything went so fast from there that I didn’t get a real chance to accept, or even consider, the offer, which, it turned out, would have been the right choice, as embarrassing as it can be to have someone you’d met only a couple of days before, drive you for two hours while you’re bleeding in their car. Instead, I was put in the back of an ambulance, with a patient on oxygen, a worried relative sitting next to me, nurses and the doctor who had examined me earlier. I had strict instructions not to put my foot on the ground, but my worries were somewhere else. Covid and the fucking Delta variant, which was spreading quickly through Puntarenas… Did the man have Covid? I tried to open the little window at the back of the ambulance but was soon asked to close it as there was AC. At least I have the N95 mask I was trying to reassured myself, but I had to admit the situation was by far the worst I had experienced, in the whole pandemic probably. We had been particularly careful (and lucky to be able to!) in avoiding any sort of shared transportation so far. I talked to Yalçın on the phone to feed him with the latest information and also, distract myself from the present moment. We hung up as the ambulance parked since I wanted to be ready to handle what was coming next, with my full attention on a language I barely understood. The main patient went out and then, we waited in the ambulance with a nurse, as the new hospital was apparently struggling to find a wheelchair for me… During the wait, I asked the question that was on my lips all along. The conversation went as follows: I asked the nurse if the other patient’s condition was serious; she replied he had been having convulsions; then I couldn’t help but asked if it was Covid since he was on breathing aid and she answered, almost laughingly, that, if it had been Covid, there would be no one else on the ambulance, except for medical staff fully dressed in protective gear. I smiled back, half reassured, but still uncertain they had time to test anyone who came in with such an emergency… Finally, a wheelchair with an almost entirely torn seat came – I guess that was better than nothing… – and the nurse rolled me around: first to the check-in, where the discussion went with a funky mix of broken Spanish and English to gather my information; she then rolled me inside a way too crowded waiting room, despite some seats here and there closed for social distancing. Since I had lost the ability to move around by myself, I was pretty close to someone else… Well, fate was all in this N95 mask now and I tried to relax myself noticing that I was already privileged to be wearing once of these… The nurse had explained that my number would appear on the screen to go to the admission room she had pointed at before leaving me. I felt a bit abandoned in this entirely new place, afraid to have to restart the entire process from scratch: explaining what happened, waiting, getting a diagnosis and finally treatment. Yet, I had a paper from the first hospital, so very likely, they had transfered some information too. After updating both Yalçın and Max, it was time to call my health insurance to see how to handle the hospital expenses, especially if surgery was on the schedule. Explaining the situation, in French (still more comfortably than English, not to mention Spanish) and speaking (and not texting) on the phone, had a double effect: it made it more clear what the right thing to do was (get the surgery in San Jose) and made the situation more real (I had to refrain surging tears on the phone). The “calling a French number” part had been challenging though and made me realize that I had annoyingly left my wallet in the boat! My Costa Rican number didn’t seem to want to call abroad, so I had decided to go with Skype paid but cheap option to call phone numbers worldwide. One: I didn’t have my credit card to reload my account; second: my PayPal account really wanted to confirm my identity using my French number (unusable in Costa Rica – very nerve-wracking as so many online services, for the precise reason that I was abroad in Costa Rica, wanted a phone identification: Guys, phones, unlike internet, don’t work well internationally!!)… In blend terms, I was screwed. Luckily, Yalçın saved me from another part of the planet by loading his own Skype account with 10 dollars and giving me the login and password: I was now able to call the insurance. As usual, they would need as many medical reports as possible, but I could be reassured that given the circumstances they would likely cover everything; they would contact their medical team to confirm and also check about the hospitals in Costa Rica as I mentioned that I had been advised to go to an hospital in San Jose instead if surgery was on the table. I hung up and patiently waited for my number to show up on the screen. When it did, I started rolling myself (still with my valid foot) towards the nurse admission door. A hospital staff came to help. Once in, I started explaining that my tendon was broken thinking they would know I already got a diagnosis. That was the error! They asked me what happened instead, which I re-explained as best as I could, before being dismissed with the information that I should wait in front of the “light surgery” door.
I waited for some more, looking at the screen that diffused a bunch of Covid safety messages in Spanish, including a social distancing clip with bear candies that I was sure I had seen in the US as well. When my number eventually appeared on the screen followed by the “light surgery” I expected, I tried to go in but the inside arrangement of the room wasn’t wide enough to let me in. The metal bed and metal light stand were blocking and the staff inside were on the other side and couldn’t really help. A young man than had seemed agitated, going in and out successively with his girlfriend, came to help me and manage to move the furniture and my wheelchair around in a way that the door could close. I felt grateful. When you feel that lonely and vulnerable, any little piece of help is disproportionately appreciated and heart-warming. Inside, a woman and a man listened to my story again. I explained the diagnosis I had received and said people had recommended me to get the surgery in San Jose and still thinking about the phone call with the insurance, that I would need a paper from them if surgery was necessary. The doctor was speaking a little English and with her assistant, they seemed happy at my little Spanish interested to talk to me and learn what I was doing and thinking of Costa Rica. They asked me to explain what happened again. The doctor gave me a list of recommendations for hospitals in San Jose to get the surgery from. The fact that I hadn’t had food since early in the morning also came in the conversation, probably when I explained I almost passed out when the injury happened, to which the doctor offered that I get the hospital diner at 5:30. It was only 4 and I was hoping to be out by then, so I politely declined. She sounded offended for a minute and apologized for offering, and the tone of the conversation changed. They came to examine me and concluded there was no tendon rupture. What about the diagnosis of the previous doctor? I asked. It had been wrong, they replied. She asked me to move the foot which I could barely do and recorded a video with her phone. I assumed she WhatsApped it to the orthopedist, which accounted for the visit they would later bill and that it would turn into the “normal mobility” that would appear in the medical report I had to ask for the insurance. They announced that they would stitch me and I would be good to go home. The dreaded moment arrived, they numbed me and stitch me. Aside from the anesthesia and a needle sensation that might have been right at the edge of the numb zone, I didn’t feel a thing. I was still lying down, when they explain that I should feel better in two days, that I should take it easy tomorrow and not exercise, like “not go walking in the park”. I was still absolutely not convinced by their diagnosis and replied that I would be really unable to go walk anywhere as I couldn’t stand on my foot at all. “No, no, no. I should be able to walk.” The assistant tried to help me to a standing position and I started fainting again. They attributed that to the effect of the stitching, reassured me it was normal especially since I hadn’t had food recently and they gave me a tissue soaked in alcohol, an habit in Costa Rica which proved out to be quite effective despite making me feel even more sick, as if I was hangover! Sadly, the whole fainting thing distracted us from the important fact that I couldn’t walk or even flex my foot. When I explained no one was here to take me home, the assistant said he would personally drive me back in an ambulance, another mistake on my part. After insisting on getting a print out of the medical report that I needed for the insurance to cover my care, getting my medications and the hospital bill accompanied by a bloody paper (literally, the entire top part had blood on it) which would allow to pay by wire transfer (or so it said… To be continued…) since I didn’t have any form of paiement with me, I waited and waited for this ambulance. After an hour or so, I started asking the admission door man of the ER, who told me to relax that he would call my name. Several hours passed, I was starting to loose what was left of my composition: I just wanted this day to end, to be back on the boat and to eat and rest. I thought to myself that I should have accepted the diner at that point. Night was falling. I started to be scared, what if the ambulance never came, how would I go back to the hotel without my fucking wallet. I asked Maria over message if the hotel had shuttles, she said no and gave me the taxi company number. I explained the situation, I had no money, could someone help me at the reception when I’d come back? She said she’ll do what she could. An old woman in the hospital had started to pity me and to regularly ask the ER doorman when my ambulance would arrive as well. He wasn’t replying to her but coming back to me saying “tranquila tranquila”. I was happy to relax but now I needed to go home, dude! I eventually told Maria I would take a taxi and manage the paiement once I was back at the hotel, to which she replied instantaneously “no no no, wait for me wait for me, I’m coming to get you”. An immense relief. I informed the door man to cancel the ambulance and that someone was going to pick me up. He seemed to understood but 5 minutes later, the ambulance arrived (I had the uncomfortable impression that the dude was making fun of me!). The supporting woman was surprised I didn’t take it and the door man pretended to be as well. I was outraged and hoped I had made the right choice to wait for Maria now. It started raining in the night and I was waiting outside of a Costa Rican hospital, without money, for someone who I barely knew to take me home. Every car that arrived came with a hope but they were either picking someone up or letting someone out. Where was Maria? She had said it would take her 15 minutes. I texted again. She replied right away: she was finally on her way and had to wait for her cousin to come with the car. Good! I hadn’t entirely screwed myself over! She soon arrived in a white SUV driven by her cousin. She helped me limped in the back of the car (they hadn’t given me crutches or anything in the hospital) and her cousin drove back to her work, the marina-hotel. Luckily, it was a short ride. I felt so grateful at these people to have interrupted their life to make mine a little easier, Maria’s cousin who had answered her call and Maria herself and her kid, Matteo. That compensated all the uncomfortable wait at the hospital in the balance of this bag day. When we reached the hotel-marina, Maria picked up my backpack from the room I had been waiting for the ambulance several hours earlier and helped me walk back to the boat in the night. Matteo was shy but patiently lended me his mom for a moment. Thanks to them, I had made it, back home, such a relief!
Once in the boat, I found my groceries nicely organized on the main table and the cold items (and more) stored in the fridge. Another rush of gratitude! I finally had food: instant noodles were a quick enough fix for my hunger unsatisfied since morning and while having dinner, I talked with Yalçın on the phone. All this time, he had researched the possible outcome and tests for an Achilles’s tendon rupture. I was exhausted, we would look into it tomorrow but I still registered some of the information. Incredibly relieved to be home after a day like this (it would be a whole different story if I had been staying at a hotel for example), I took my meds and went to bed, with a firm intention to take it easy the next day.
The next day, I talked to my family, which was, understandably worried about my tendon too, I talked to Yalçın again who informed me about a medical test to assess whether the tendon is ruptured or not and that our nurse friend Mariya confirmed as well during our couple hour long WhatsApp call at night. I accidentally worried Yalçın’s mom too by answering “the foot is alright” when she asked me how I was in the morning, without knowing about it. I treated myself with a nice lunch and talked to the insurance on the phone, they were going to bring my case to their medical team to see if further examination in San Jose, the capital, would be required as I asked. Max and other marina staff and boaters stopped by to say hi and ask how I was doing, it felt like a little local family. In the night, the insurance emailed back: the medical team agreed, I should see an orthopedist in San Jose, they would contact me the next day to organize the visit after things opened up in Costa Rica. By the next day, I had resolved myself to do the rupture test and the result was unmistakable: compared to my left valid leg, the manual contraction of the relaxed right calf wasn’t actuating the foot at all (a nicely controlled experiment when you think about it from a scientific perspective, since we have two feet!), sign of a full rupture. The insurance worked hard to find me an appointment that same day and organize a transport to bring me to the capital. I waited at the reception for more than half an hour before resolving myself to call them back: the taxi hadn’t come and it wasn’t realistic that we could make it in time for the appointment in San Jose even if the taxi showed up right now, as the friendly tour operator at the reception had confirmed. The insurance told me not to give up but soon got back to me confirming what I already knew: they were sorry it hadn’t worked out and would make sure to find me an appointment on Monday. I had to call back Antonio, the marina manager, who picked me up again and drove me back to Tirb in the hotel’s wheelchair. I was feeling guilty to have an older person roll me around, but despite the language barrier, he was very helpful. I was sort of relieved to have more time at home to gather mental strength if I needed surgery. Yalçın was relieved too that I wouldn’t see a doctor on a Friday at 6PM, in a rush before they start their weekend. The only annoying part was that I had no crutches to go anywhere and the insurance wouldn’t pay for them unless I could get a prescription beforehand. I sort of understood but that was a bummer nonetheless, in particular since I couldn’t get a prescription on Friday as the taxi had been late. Anyway, as long as I remained on the boat, I didn’t have to walk much and had handholds everywhere to help me jump around, so it could have been worst!
During the weekend in Puerto Azul hotel marina, there is loud music by the pool, with a Caribbean ambiance (or at least the idea I have of it) and an animator that drives the day offering discounts on ceviches and organizing karaokes for the guests. It kept the mood up as well as other visits, like Luis, a marina worker, who came by with candies and throughout my time in the marina always had kind advice and attentions, as well as stories for me, with an incredible determination to exchange despite him speaking no English and my Spanish being quite scarce for the extend of things he wanted to explain. I took the weekend easy, talking with Yalçın and family, making some handlaundry and chilling in the deck at sunset – my ultimate treat to see the bright side: I was still on my boat, in pretty Costa Rica, with time for myself. On Sunday, going back and forth by email with the insurance, we organized a visit to San Jose for Monday with safety margins for the taxi ride this time, and an appointment with an English-speaking doctor at 1 o’clock. I made a bag for a couple of days the day prior, but was still borderline late on Monday to get the taxi. An American number (that I ignored at first) called me to announce the car while Antonio was rushing me on the wheelchair with my bag through the back door of the hotel. Quite surreal of a scene when I dropped the boat compost trash as we were rushing by a bin, while I was trying to explain to someone on the phone in Texas that I was getting close to the taxi car in Costa Rica! Things calmed down as I settled in Sergio’s black SUV, which was way beyond the comfort of cars I usually ride in. Sergio asked about the injury, explained that today was a holiday in Costa Rica and we genuinely talked about Covid, vaccination, the company he works for, Costa Rica in general etc. I was rediscovering the instant kindness and openness of people when you are traveling alone. Once we reached the hospital, he made a point in asking for a wheelchair for me at the reception, locating the doctor’s office and driving me all the way to the fifth floor in my wheelchair. The floor was empty but I was one hour early. He left me there after giving me his phone number and telling me not to hesitate if I needed anything. I was still hesitating about whether I would go back down the building to have my sandwich or not, when the doctor’s door opened, preventing me to intake any food and allowing me to have surgery later in the day, because indeed, the diagnosis about to come was total rupture of the Achilles tendon. The doctor was calm and comforting. He listened to my story and after a careful examination as well as the famous calf contraction test, took his time to announce the outcome. He recommended to have surgery as soon as possible. The recovery process would be long but it should be 100%. He explained a ultrasound would be necessary to see how apart the two edges of the tendon were, he presented me with the principle of the surgery: he would stitch the two ends together with a very strong wire that would eventually be degraded by my body in a year or so. The stitching pattern was stickingly close to what we do when we splice lines – sharing this idea with Yalçın cheered both of us up! I would be a pirate with a splice! The surgery could take place later today, or at most tomorrow, if we proceeded through the emergency room for the hospital services to take care of the logistics around my insurance. Alright, let’s do this!
A woman rolled me all the way to the emergency department in an other building. After giving my passport and emailing a copy of my proof of health insurance, I was admitted. Compared to the hospital in Puntarenas, every nurse was very kind and spoke good English. I was informed that they needed to wait for my insurance to be approved for the major tests and the surgery, but that they could get me started with the IV and the Covid test. Aaaaaarg… needle time! I started to explain that I had a phobia of needles and hoped the IV could be installed only right before the surgery. The issue was I also needed a blood test so they gave a choice: they could put the IV right away and use it to draw the blood, or just draw the blood right now and postpone the IV. No good alternative, really! I started to panic and my eyes became watery. The nurse left without waiting for my answer and, thankfully, nobody came back with the request before the surgery was ready to happen. It was a relief since, it took a while for the surgery to be ready to happen! An administrative battle was going on between my insurance and the hospital, which was already stressing me out and made me scared the blood draw and other needle pleasure (irony!) could be for nothing: The ER admission secretary had gone back to me saying the hospital didn’t accept my insurance. Luckily, the insurance was on it and got in touch with Nathalie, the administrative person whose phone number I had been given. After too long of a wait and a Covid test that I took without any complain, trying not to upset the medical team too much this time, the insurance came back to me saying they had found the reason of the refusal (a name discrepancy between “AIG travels” and “AIG international”) and that they were able to provide the document the hospital expected and everything should unlock. When the secretary came back to me, I welcomed her with a large smile and a “I’m glad it all worked out” when she explained that it still wasn’t good. Apparently, the insurance was asking for the bill to offer proof of coverage and the bill wouldn’t be ready before tomorrow, so they need a little sum from me to make sure I would pay in case the insurance wouldn’t, only until the solution unlocked tomorrow. The “little sum” was $2,000, or half of the surgery! I was stunned! I explained I didn’t understand since the insurance had just call me to say it was accepted, it didn’t make sense, it was a large sum and it almost sounded like a scam! I emailed the insurance again but loosing my cool while waiting for the answer, I tried to call them again. Sadly, my phone, still using Yalçın’s Skype account, started complaining about too weak of an internet to reach anyone. When the secretary came back, I was on the verge of tears, I explained the situation didn’t make sense, they already had taken a photocopy of my credit card specifically in case the insurance didn’t pay, that was too much and I couldn’t even reach the insurance. She agreed to let me use their phone to call, drove me back to the entrance, dialed the number and passed the phone under the Covid glass installed in front of her desk. When an English speaker replied on the insurance line instead of the usual French speaking staff, I lost my cool again “No, I didn’t speak English. Yes, I had a case number and I needed to speak with Lanka (who was taking care of my file today) and it was urgent!.” When she replied he was on the phone and could call me back, I exploded in my fluent English that “there was no calling back, I had been waiting for the surgery for hours now with no food no water, they were asking me for 2k and I was using the receptionist phone, so there was no calling back! I needed to speak with Lanka right now!”. I’m not proud of this moment but it really felt like I was trapped in a bureaucratic absurdity at a time where only getting care should have mattered. Of course, Lanka wasn’t more available because I yelled at the poor woman on the phone. In fact, it turned out he was on the phone with Nathalie again and called me back right after. He had understood the reason of their reluctance and had sent a document that stated the max amount the insurance would cover which should be way above the scope of the surgery and should solve the problem this. If it didn’t, there was no other way, I would have a pay the $2,000 advance and they would reimburse me as soon as possible. We had to wait for the verdict of Nathalie’s superior. I was grateful at his honesty and felt he truly tried everything in his power. There was no point in arguing anymore, there was a path to this damn surgery. I felt relieved. The approval came soon after, I was so happy and the secretary seemed sympathetic as well. She drove me back inside the ER where a nurse promptly picked me up for the ultrasound.
The hospital corridors we zoomed past were decorated with framed pictures of the incredible wild life of Costa Rica, that I would have to wait for a while to meet in person. The nurse left me in an exam room where a doctor soon joined. She didn’t speak much English but my Spanish was enough to understand that the gap between the two ends of my tendon was 4 cm. She was encouraging about the outcome of the surgery and wished me the best for the recovery. Another nurse walked me back to the ER ward. It was now time for the worst: the IV and blood draw. But first, I needed to change to the green (my favorite color!) hospital gown, then the secretary saved me by coming to pick up my belongings, including “precious items” for which I had to provide an extensive list, including the total amount of money in my wallet – with no exception for the 10 Turkish lira note I had gotten from Yalçın! Parting with my phone was a hard one as I had been chatting with Yalçın during the long and stressful wait and giving it away would basically mean being alone, really alone… But I wasn’t going to go to surgery with my non-sterile phone, right?! So I let go of it. In the meantime, the surgeon had showed up and confirmed it wasn’t too late to operate. In a fatherly fashion, he checked I had put the gown in the right way and encouraged me for the IV. He then left to get himself ready. The nurse who had been standing by for quite a while now came to me. I explained I wasn’t a big fan of needles and that I tended to faint when blood was drawn etc. With kindness and understanding, he explained he was the same before becoming a nurse himself. It sounded like a story you tell to make patients comfortable but the way he told it felt sincere. And he started his business like all the other nurses, “don’t worry, I’m not using the needle, only putting the rubber band” and I know by experience that’s once it’s on, there’s no going back as the blood accumulating in the arms gets too painful if you wait for too long. I had to be strong and go for it. Another nurse joined and took my other hand and we chatted the three of us while the nasty needle business was happening. I did feel dizzy after and earned my alcohol coton to recover! I was now ready for surgery. But wait, had my Covid test come back negative? I should have shut up as it took a little while for the staff to locate the results, but I guess it was as I was driven to the anesthesia waiting room through the colorful corridors. Note for every medical staff, having concentration camp movies in the waiting room isn’t the best way to relax surgery patients… The anesthetist came introduce herself. She was friendly and even offered that I use her phone to send a message to Yalçın since I didn’t have mine. I mentioned the little bubble I had noticed in the IV tubing (that’s how you kill people in movies!) but she didn’t seem concerned. I mentioned it again to the surgeon when he came to check on me and he told me I watched too many movies! Alright then, I guess, I’ll have to trust them… 5 minutes later, I was brought in the surgery room, where the anesthetist explained they were going to inject the epidural and sedate me. And then, boom! Nothing. I woke up with a gray boot on my right foot in a white room. I would never know if we did listened to music during the surgery as the doctor had offered in the morning – any music except reggae tone! He came by to explain everything had gone smoothly and showed me the boot, I still couldn’t feel my legs but the sensations were coming back slowly. I was the only patient in the white recovery room. One of the nurses talked to me for a little bit, another occasion to use my Spanish, and showed me her vacation picture in Paris. It was friendly.
I eventually was brought back to my room and after some observation time. I was allowed drinks and got a wide variety ranging from juice to tea. They then bough back my precious (and not so precious) belongings including my communication with the outside world device, and finally, when my food interdiction was lifted, I ordered a chicken sandwich to finally eat after another full day of starvation. It was late in the night already and time to sleep, but it didn’t go as smoothly. The night was incredibly painful, and, if the couple of shots of morphine through the IV did relax my entire body, the pain was hard to control. Until the morning. By morning, I guess they had figured out a cocktail of meds that was more or less taking care of the pain. The breakfast and lunch were quite gourmet compared to French hospitals, with pancakes and ice cream, quite good for the moral! A team of nurses came to clean me in the morning, and after the surgeon stopped by, another team was instructed to show me how to shower with the boot on the foot that I was not supposed to take off nor put weight on. Spoiler: with a plastic bag and a seat! The surgeon also explained how things would unfold with future appointment, what to do and not do until I see him within 10 days and proudly showed me pictures of the open surgery. Not quite something I was ready to look at, but glad these pictures existed I guess. He left, after giving crutches and checking I was okay walking with them. The insurance called him for medical reports and instructions while he was in the room, and he stated I was ready to go home this afternoon and that a regular taxi would be fine. I packed my things, the nurses helped me dress and made me realize the boot prohibited any long pants until it was removed, the pharmacist brought me the medications and I waited for the taxi to arrive. Between two and three, a nurse drove me downstairs to meet the taxi driver that had been looking for me for a while. The insurance had sent a team of two in a mini bus. Again, the driver was very friendly and helpful, and his accent reminded me the one of Juan from Huatulco, maybe he had Argentina origins as well? I didn’t ask as the two men chatted together for most of the way, pleasantly allowing me to update family on the phone and rest during the nearly two hour way. The driver still took care of bringing me all the way to the boat and said he wouldn’t before he sees me in the cockpit, having been mandated to bring me home safely. He wished me the best for the recovery and left to drive back to the capital. I was home, I just had to wait patiently for the tendon to fix itself, Yalçın to come back and the control visit with the surgeon.
The first days went fine, with the now usual visits from other marina users. Max even sent his friend whose boat he was fixing to check on me and I met Alessandro who was also pleasantly speaking English. I was taking my treatment of opioids for the pain and a strong antibiotic to fight against infection. When the pain receded after a couple of days, I decided to stop the opioids and replace them with paracetamol. I lost sleep, which is apparently quite common when you stop after even a few days. The days alone started to feel less bearable and the side effects of the antibiotic was making paranoid that something was going wrong. We moved the control visit with the surgeon earlier to a week after the surgery: to the next Monday, instead of Friday. Yalçın was also coming back on that day and it would be a relief. Tired of spending days in the hot boat, I decided to spend the weekend in a hotel in San Jose, close to the hospital in case anything when wrong. The insurance failed to find a taxi again for the Saturday but I decided to go nonetheless. The hotel staff helped with finding a taxi, which actually turned out cheaper than the companies the insurance goes through and the two days in comfort were, well, comforting. The Holiday Inn in Escazu had handicapped rooms where I was able to take a relaxing bath and watch French TV. I even was able to get croquetas and a Poki ball, a perk of having access to the food diversity of a capital and a relief not to have to cook for myself. All in all, Monday came and I had survived and managed to sleep some more. Yalçın met me in the hotel and we went to the control visit together. Everything was looking good. The doctor removed the stitches, a painful process. It was still early and we decided to stay in San Jose one more night, to allow Yalçın to arrive and get a little more comfort before going back to Tirb. After the visit, I had a little bit of a panic moment when I felt a weird sensation in the calf. My anxiety came back. It felt quite similar to the sensation in the muscle right after the rupture. After an hour of self-deliberation, I decided to call the doctor in the afternoon. He kindly offer to see me again right away. Unsurprisingly, everything was still fine. He explained to Yalçın how to feel the tendon, in case this happened again to check that everything was alright and reassure me. I felt a little embarrassed, but relieved we had been able to double-check: at least, I wouldn’t be going home with broken tendon to be discovered two weeks from now. The taxi came the next day in the morning, late, which allowed us to have a quick breakfast. We were back on Tirb by noon with my foot for two more weeks in the boot with a total immobilisation and Yalçın back. We got quite a rush of adrenaline finding Freddie the engine gone when we got back, before realizing one of the line holding it had been coiled in a very careful way, for sure thefts wouldn’t have taken the time to tidy up so thoroughly. It turned out the marina had taken on themselves to saw the lock in order to make sure our outboard wouldn’t get stolen and had stowed it safely in a room of theirs. Only, they had forgotten to tell us! Relief! Yalçın went shopping right away to beat the afternoon rain, walking all the way to the downtown and back. An endeavour he would repeat a couple of times to get us groceries and parts for the engine (we rebuilt the blowby). We ate a lot of good Turkish food cooked with love and I tried my best to patiently wait with my foot and mood up.
After close to two weeks, on the Friday before the weekend we had to leave, we made another trip to the capital for another control visit. Everything was still looking good and the doc had made me optimistic I could start taking the boot off and walking in 2 more weeks. We waited for the ride back (we did the round trip in one day this time) in a bakery and treated ourselves with French pastries. At the verge of the weekend, the ride back took a while, but since it was the last time from Puntarenas, we couldn’t complain. We spent the two following days getting as ready as possible to take off again, after a long and eventful month in the marina.
Events from July, 28th 2021 to August, 21st