Sunday, 1 June 2025

El Salvador - Medical Misery Part 2: “So I heard a click…”

May 25


Hello everyone!


Click here for Medical Misery Part 1


With Hannah having had surgery earlier in the month to repair a torn meniscus, it was my responsibility to…well, do everything. No issue with that - if you love someone, you do anything for them. It turns out I took that too far and really wanted to know how she was feeling…


My medical boot - find out why shortly!

That's a grimace, not a smile


Matt’s medical mishap


Every year a group of us head north to the town of Ataco to do a trail run. The last two years, I have run the 15km route. This time, all of us decided to go up a level from the norm. For me, that meant doubling up to 30km. With 1,150 metres of elevation to boot.


The route has some stunning views

There are quite a few crosses
in the hills around Ataco

I’d been training for this for months, albeit erratically and without a proper plan. This was going to be the furthest I had run in 11 years, and almost definitely the longest I had ever run in terms of elapsed time.

My last big training run, 2 weeks before the race


Some fools do a 55 kilometre run!

12 of us, as well as Mini and Maxi, headed up to the charming town of funky cat murals and a pretty plaza for the weekend. I drove our lovely new car in the knowledge that, for various reasons, hadn’t managed to be insured as yet (not for a lack of trying). Board games, cake, laughs, restaurants: a lovely Friday and Saturday.

Brilliant game if you've never played it

Our traditional pre-race stuff-your-face-with-Italian-food meal

Sunday comes around. Stunning sunrise. We saw this as I was off at 5:30am, with the rest of our crew leaving an hour later to do the 15km run. Short stretch, rules rattled off in Spanish (follow the orange markers), and away we go.

I was running in that direction. Not up that mountain, thankfully.

As you'll see, we couldn't follow the quadbike very far...

Positive vibes at the start line


The only aim I had was to finish. No time target, no position goal. I wanted to enjoy the new scenery and the challenge. Still, it was quite a frustrating start, with almost all runners getting bottlenecked as a gate hadn’t been opened, before being stuck in single file down a narrow, slippery, muddy path.


Quadbike wouldn't get through there...

Single file becomes very frustrating when the person at the
head of the line decides walking is appropriate for everyone else

Eventually the paths, and the field, spread. Lovely views, the freshest of air, insanely steep clambers. But all going well, and feeling good.

Lovely flowers helped distract from the inclines

Having a lovely time bouncing up the hills

I’m in a good rhythm on a flat section of trail just before 15 kilometres: halfway. Suddenly, I fall. Hard. I hear a click as I land just before I let out a yelp of pain. The front of my right foot has inexplicably clipped - well, nothing, there was nothing there - but the right side of the toe cap has clipped the floor first as I’ve gone to land my stride. The rest of my foot got caught and went right underneath my leg. Click.

Last pre-fall picture - men in military gear couldn't have helped

Obviously there is no media of me actually hitting the deck

Not a crack. Not a crunch. A click. Big click, admittedly, but my ankle does that sometimes. Heck, I can make it do that sometimes. Doesn’t normally have a searing pain shooting around my foot and lower leg, mind. I sit and breathe to compose myself. There’s no one around. I scan. There are no big rocks. It’s a flat bit of path. It’s dry. There are no excuses. Nothing to blame. What on earth happened?

A picture taken soon after -
notice the change in demeanour...

Still no one has passed. This felt like ages, though in reality it can’t have been more than a minute. I gingerly get up. I can put a bit of pressure on my foot. That’s good, I think to myself. If something was broken, I wouldn’t be able to put any pressure. I dust myself down, noting how filthy my right leg has become, and hobble along. I head down a slope - that hurts - and soon find a man directing runners. He sees me. His voice - he instinctively knew I spoke English - was flecked with concern. 

The undulating terrain
increased the difficulty

He asked whether I felt that I could reach the next checkpoint, about a kilometre away. There was a medical tent there, he said. I didn’t feel like I had a choice. Get there, get the damage assessed, decide what to do. Hobble on.

This path was rockier than
the one on which I fell


The ‘medical tent’ is the food and water stop, with a stretcher on the side. The man who was directing had radioed ahead so people knew I was coming. Onto the stretcher as a man who was sporting a Real Madrid baseball cap and loves Gareth Bale gave my foot a message - that hurt - and some magic spray. Foot down. Feels ok. There was no indication that I could be collected from here (not that I really asked). Grab some dates. Hobble on.


Gatorade, watermelon...and the man on the right

My Madridista inspecting the damage

On I hobble at a surprisingly quick pace - that magic spray really was magic. Going through a forest, I found three paramedics. They topped up my spray. Hobble on.

Lovely view. Hard to appreciate at this point.

There are others around now, as my route has joined that of the 15km. Both routes undertake the notorious ‘Escalera del Cielo’: Stairway to Heaven. 700 metres in distance, 160 metres of elevation. Last year I managed to run a fair bit of it. This time I didn’t want to consider doing that.

This year a sponsor made this section into a
competition - who could scale it quickest?

The winner did it in less than 7 minutes and bagged
themselves a fancy watch. I took a lot more than 7...

There’s a medic at the top. More magic spray. More dates. The hardest part of the run done and less than 10km to go. More dates. Hobble on.

More food and drink at the top of the escalera

The magic spray!

I intersperse hobble-running with walking for a while until reaching a viewpoint - a mirador - about 3 kilometres from the end. After appreciating the view, I started to move…and felt that I could put less pressure on my foot. This was also a downhill section: one that I normally fly down. Alas, this time I stuck to the edge as others got their final wind to zoom towards the finish.

A wonderful view - Guatemala can
probably be seen on a clear day

I soon found an ambulance with a driver inside. One more bit of magic spray, perhaps? No - didn’t have any. Any pills? Didn’t have any. “Do you have anything?” I asked. The reply was negative, with the driver’s finger indicating that any medication was up the hill I had just come down. My foot hurt a bit more upon that realisation.

Last year I sprinted this singing along to
Kelly Clarkson. Oh, the good old days... 

I walked almost all of the last section, high fiving little kids and telling the photographer at one point that I needed a doctor and a beer. “Eso!” was her reply. Probably more at the beer than the doctor.

I made her laugh. She took
this photo. Unbelievable.

I had sent messages to other running friends about what had happened. Turning the corner to the finishing straight, there was a huge noise. All of them - and many more - started cheering incredibly loudly. It was very heartwarming. Stupidly, I took those cheers and the adrenaline of almost finishing and jogged the last straight. Then realised there was one more corner. That hurt.



"Yeah, shouldn't have run that..."


The aim was to finish. I finished. Surprisingly, there was no medical tent to be seen at the end - it’s been there in previous years. Instead, it was time to shower, ice and get ready to leave.


Everyone else smashed their 15km runs

Of course, I had driven up to Ataco. It was my right foot that was injured. It is my right foot that pushes pedals. However, the car wasn’t insured, and it ultimately wasn’t fair for someone else to risk driving. I did a little test to see how my foot felt when driving and it felt fine - I was only using my big toe. So I dropped off friends, dropped off the dogs, then drove straight to the flavour of the month: Hospital de Diagnóstico.

It had been ten whole days...

I get wheeled around a bit: to a small room, to an X-ray machine, back to the small room. Eventually a doctor comes and explains in broken English that I have chipped a bit of bone off my ankle. That was the click. 

Very hard to tell on this picture so I've added one below...

There's a little bit floating below the bone.
That's the chip. Funny how something so small
can cause so much stress, though admittedly
this doesn't show ligament and tendon damage.

I am immediately signed off work for three weeks and strongly urged to buy a medical boot. The doctor actually tells me that there are two options - a cast or a boot - which he followed by saying, “Please get the boot!” Good decision, particularly as insurance was able to cover most of the cost.

Boot Boss

Once they eventually cleared everything with insurance (a different company to the one Hannah used, it’s a very complex system we have) and I had bought a variety of pills and gels, I was on my way home. Still the much more mobile of the two people in the house, but with a teeny tiny break in my ankle, and hoping that we won’t need Hospital de Diagnóstico for another reason for quite a long time.

"Smile so they can't see the pain!"

Unbelievably, I beat the average time...
with an ever-so-slightly broken ankle!


Love you all,


Matt

Friday, 30 May 2025

El Salvador - Medical Misery Part 1: the Maddening Meniscus

May 15


Hello everyone!



Hannah and I don’t think we’ve had the best of luck since moving to El Salvador. Cars breaking down, the house flooding, dogs getting sick. The one thing we’ve had is our health. Well, until recently…


Hannah in recovery after surgery

Internet picture. Been here a few times this month
but never thought to stop to get a photo...

That is a picture of Hospital de Diagnóstico. I have been to this area before as it is where many medical specialists have their offices. When I returned from the Dominican Republic in early 2023 with a large, strange swelling on my collarbone, I came to the dermatologist here to get treatment.

Quite a bit of pus!

The treatment room of the dermatologist - as you can
see from the poster, they also do plastic surgery

I have been here a lot in the last month. There are two chapters here: one for Hannah, and one for me.

On the phone pre-op - she wasn't allowed her
phone later on, which caused some problems

My new toy - note the large boot on my foot...


Hannah’s hospital hell

Whilst this visit happened quickly, it wasn’t expected until the final day of April. Hannah’s had a chronic issue with her knee for a few months. It turns out that the ‘issue’ was a complete meniscus tear. Surgery needed.

Novak Djokovic had a similar issue, then won Olympic
gold a few months later. That's what Hannah is clinging to...

One perk of being an international teacher is decent insurance. We set a date for May 15th. All that had to happen was for pre-authorisation to be cleared before then. Every necessary document was sent on May 5th. We were told it may take 3 to 4 days. So we waited…



…and waited…


…and arrived at May 13th with no news. Unaware as to whether Hannah’s major surgery was actually happening. I managed to find a WhatsApp chat number (very well hidden) and sent a message. This was the reply:


It wasn’t one hour. It was five hours, with me receiving the messages in the middle of a run. Having to stop every couple of minutes to send messages to try to find this mysterious pre-authorisation was frustrating (foreshadowing: not the most frustrating run of the month). A particularly joyous moment was being told that, without pre-authorisation being confirmed, the procedure would cost us almost $20,000. Oh, and that not enough documentation had been submitted, even though we had submitted everything that had been asked of us.




After confirming that Hannah was not a professional tennis player, it eventually came through later that evening. Push on as planned to a 5:30am visit to the hospital, with the surgery happening at 7am.


After waiting a while and other insurance elements needing to be sorted out (foreshadowing: not the only insurance issues to occur that day), Hannah went into surgery at around 8am. I was told it would take one to two hours. As instructed, I went up to floor 4 and waited. For 3 hours, with my only break being to get a Wendy’s (foreshadowing: not the only Wendy’s to be eaten on that day).

Wendy's is a short walk from the hospital

It gets to a little before 11am. Concerned and annoyed, I start ringing the reception bell ceaselessly until a receptionist the actual doctor arrives. In broken English, he explains what he did (it went well and he did some stitching and some trimming) before allowing me to enter the ‘recuperation room’ to see her. Hannah is high as a kite - she barely remembers me coming in. What’s remembered is that I’m not allowed to leave her phone with her or make a call in that room, and that I’m essentially told to leave the hospital and come back at 6pm; at this point, they’ll tell me whether she is able to come home that night.

Maxi knew something was going on,
so decided to hide in a cupboard

I return at 5:45pm to floor 4. A few people in the waiting room but no workers to be found. No light on in the reception. It gets to 6pm. That’s enough time, I think. Ringing the reception bell ceaselessly doesn’t work this time, so I do something I probably shouldn’t have done. I go to the imposing, silver doors of the ‘recuperation room’ and touch the doorbell. Not touch. Hold. Until someone comes to open it.

The recuperation room looked something like this - it's an internet picture

The door slides open to show a room…with no patients. Before I combust in horror, the worker is able to explain that patients have been moved to floor 5. Up I go, and they locate Hannah’s room. Of course with no phone, Hannah was unable to communicate with me that she had been moved. And of course, nothing had been communicated by the hospital. This seems…dumb.

The room looked similar to this - the first picture of the blog is
what it actually was like. It had a TV but they didn't give Hannah the remote...

After an interminable wait with a machine beeping every 10 seconds, the doctor comes in, inspects, says all is good and that we can go…as soon as everything has been cleared by the insurance company. Not this time, I think. I have their WhatsApp now. Remarkably, it took less than 5 minutes, rather than 5 hours, to be connected to an agent, who quickly asserted that they had given approval for Hannah to leave.


Only then we were told that the hospital’s local insurance needed to clear us to leave. Why, I don’t know. The one doctor who spoke decent English said this would take…1 hour. It’s already gone 8pm. I used this time wisely to go to Wendy’s to get my second substandard fast food meal of the day.

View of the hospital from the car park at 9pm. Parking was
free because of the scale of the procedure, which was nice.

After jumping through seemingly unnecessary and invisible red tape, we were able to leave soon after 9pm, with me ready to play nurse for the next couple of weeks until Hannah flew back to the US. Well, it started well…

The first night was tough for dogs, who had to be
kept away from Hannah and her knee

The morning after - I cycled to and from work twice to check on her
before deciding to finish for the day at lunchtime to stay home to support

Recovery will be slow...but I'm sure Mini understands...


Love you all,


Matt