El Salvador - Medical Misery Part 1: the Maddening Meniscus

May 15

Hello everyone!

Click here for Medical Misery Part 2

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

Colombia - Paddling around Palomino

April 22-24

Hello everyone!

Following our gruelling four day hike to Ciudad Perdida (The Lost City) Following our escape into the hills in Minca, we headed to our final destination on our Panama and Colombia adventure. Back to sea level. Back to the heat.

Our beach, just outside Palomino

A ghost crab - I love their eyes!

Vibes

We headed east. This involved:

• Hauling suitcases up a steep, rocky path from our Minca guesthouse to the road;

• Taking a rickety taxi, complete with Bukele-loving driver, from here to the edge of Santa Marta;

• Getting on a small bus, which blasted reggaeton almost the whole way, to the town of Palomino;

• Shoving suitcases and ourselves into a tuk tuk to take us 5 kilometres from town to a building that looks like something from the old game show Blockbusters.

Possible in an hour in a car, but almost two hours on a bus

The bus from Santa Marta to Palomino was about $3

I'll have a P, please, Bob

Or a honeycomb. Either way, a funky eco hotel with its own private beach, with a strange name - Uuttaaka - that apparently means ‘mangrove’ in the indigenous Arhuaco tongue. 

View from our honeycomb

No other hotels around and rocky outcrops at each end of the
beach meant the only people ever on the beach were guests

Those mangroves mean we had to cross a bridge. From that bridge,
we saw a long, bright yellow snake. Not my favourite thing, that.

This was very much a place to unwind, switch off and do little. It was thus a shame that you can’t swim in the enticing Caribbean Sea, owing to strong currents and waves. I channeled my inner King Canute to try to tame them, but to no avail. Not that he really thought he could do that, anyway…

Red flags were on display across the coast

Those of you who know me will be aware that I can’t do a sitting-around-doing-nothing holiday for very long. Probably two days maximum. Lucky for me then that nearby Palomino is a bit of a backpacker haven, albeit one that felt eerily quiet at times.

Barely a soul to be seen

Irish-ish bar on Palomino's main street

One thing that broke the strange silence was the presence of some birds, like this delightful creature that we found in a tree above a hostel near Palomino’s excuse of a beach. I think it’s a red-and-green macaw. It was difficult to get a picture with the lighting and its constant movement, but it was lovely to see.

Red-and-green macaws are monogamous

These are larger than scarlet macaws

The beach at Palomino is almost non-existent. As for the town, I think it’s a common stopping point for people doing a more in-depth trip around Colombia, or for people who have completed the Lost City trek. People who have finished that hike will probably want to do nothing more than lie in a plastic tube, drinking a beer as they float down a river towards the sea. That is what is advertised as Palomino’s main ‘activity’.

Not much space to lie down!

Tubers are on the right. To be clear,
Hannah was not drinking and paddling.

We decided to be a little more active, opting for kayaks and paddle boards. The current allowed us to paddle leisurely down the Palomino River. After a rocky drive up in a 4x4, we were dropped off at the entry point of the river. After making sure that we actually could kayak and paddle, our guide seemed content to let us enjoy the sights and sounds of peace.

Somewhere behind the clouds are the Sierra
Nevada de Santa Marta mountain range

The river's mouth is at the Caribbean Sea

He did occasionally intervene, for good reason. He spotted one turtle and a few birds on our way down. There were also a few early tubers. Quite a few of them were enjoying a beer at 10am. No judgment. 

The area is a major nesting ground for Hawksbill turtles, but this is
more likely a Red-Eared Slider, an invasive species often kept as a pet  

Flamingos can be found on an island further east -
Google Lens has suggested that this is a Roseate Spoonbill

The river run was a chilled way to spend an hour, and spending a few days at Uuttaaka Lodge a chilled way of ending our trip through Panama and Colombia.

2 of the 3 days at the honeycomb were gloriously sunny

Food at Uuttaaka was brilliant -
this fish was actually the least best meal

Mojitos: quite strong

Sun setting on our Easter break

Love you all,

Matt