Saturday, July 20, 2013

First chink in the armor...


Wow.  What an epic 36 hours we have just been through!  Very, very stressful. The good news is that all seems to be in order and everyone is OK.  The compelling details:

We reported earlier on how idyllic we found Salento to be.  Fantastic mountain biking, hiking, and horseback riding.  Also a sublime and relaxed atmosphere at La Serrana eco hostel made the stay memorable.  Fantastic. 5 stars.  It was with some sadness that we departed Salento around 4 days ago for new sites in Colombia. 

Our first stop was Villa Maria, which is a suburb of Manizales.  Still in the coffee region.  Our objective was to hire a guide service to take us up high into Los Nevados National Park.  The park has some of the highest concentration of peaks in the Colombian Andes.  They top out at just under 6000m  - nearly 20,000 feet! 

We had no illusions about getting up any of the peaks. We simply wanted to see the high country and do some trekking.

The guide service came by our hostel in Villa Maria and gave us a briefing the night prior to our departure.  One of the things that caused my Spidey Senses to go on full alert was the plan itself. It involved a 3 hour Jeep ride up a rough hardscrabble road, not too dissimilar from the same type we have in the San Juans.  This would deliver us to 4000m (13,200 feet) whereupon we would go for a 4 hour hike.  We would set up camp that night at 4200m and then go to 4500m the next morning to the toe of the glacier.  This seemed to me like a very aggressive gain in altitude in a short period of time.  Things like Acute Mountain Sickness and HAPE were certainly something that Joanie and I discussed.

The drive up was beautiful and uneventful.  Our hike was hard due to the thin air. I had a low-grade headache.  Rock was suffering the most. No headache, but really dragging his feet.  After the hike, we told the guide that we wanted to camp near the car just in case.  He suggested we could do one better and drop down 300m to a nearby ranch and camp there at 3700m.  We agreed that would be the best plan.

We erected tents, etc and everyone was pretty well knackered so we passed on dinner and just rested in the tents. Essentially, we went to bed at around 17:30. At around 19:30 that night, Rock developed a cough. This progressed for the next couple of hours. It got wetter and wetter.  At 21:30, I went into his tent, listened to his cough and distressed breathing and decided to pull the plug.  I am not an MD, but felt that it was classic signs/symptoms for early onset of HAPE (high altitude pulmonary edema). The wet lung sounds indicate fluid building in the lungs and if left untreated can lead to rapid loss of conscious and eventually death. He had to go down. Right now.

We broke camp in the dark, waking people up, disassembling tents, etc.  We loaded the truck and down we went those same rough 3 hours down the mountain road. We made the hostel in Villa Maria (1800m) at 1:00 AM.  Whew!  His breathing improved significantly during the descent.  He had only a dry cough in Villa Maria and slept well the rest of that night.

We were satisfied to have made the right call and made it quickly and decisively.  You don’t mess around with that stuff, at all.

After a healthy dose of coffee and relaxing, we eventually got a cab and made our way south to Santa Rosa de Cabal.  It has a fantastic hot springs. Really cool. We will post some images later. Well worth the visit.

Rock was 100%. We were patting ourselves on the back.

After a lovely visit to the hot springs and a nice dinner, we retired to our hostel.  I stayed up late doing our first machine wash laundry since Paris, 30 days ago.  It had been hand washing in the sink that entire time. We needed it.  I went to bed at around 2:00 am and Rock was coughing badly. Not a wet cough, but a bad cough. 

The cough persisted ALL NIGHT LONG.  None of us slept, Rock especially. His breathing was labored and rapid.  At 6:00 am we decided we needed to get him to a hospital. I had plugged in some signs/symptoms on www.webmd.com and one of the possibilities that matched his presentation was Acute Respiratory Distress Syndrome.  Whether he had it or not does not matter. What mattered is he was having a very, very difficult time breathing. I counted his reps at 50-60+ inspirations per minute and very shallow.  He was like a Cheetah recovering from a chase.  Almost panting.

Rock and I grabbed a taxi to the hospital 15 blocks away. English was just about bereft at this hospital and my Spanish is only just passable for getting food, lodging, and directions, but not for describing medical conditions. Let’s just say that the hospital desktop computer with Google translator was invaluable. 

The doctor's initial diagnosis was larynx.  I was calm, but firm. I said no way. He was 100% yesterday. No ill effects.  He does not cite pain in the throat. We think he likely has a secondary infection and needs antibiotics (which we carry and which we would have administered if needed).  I basically was not going to leave the office without a blood workup. Period.

His saturated O’s measured on the pulse Ox were 78. Yuck. They got him on O’s and also some antihistamines in the form of pills and the inhaler.  Then they took the blood sample.  The care was prompt and professional. And clean.  I checked on the computer each item they wished to administer.  It was all in Spanish, of course. 

About an hour later, the blood work came back with elevated white blood cell count. Possible bacterial infection.  Big surprise.  The last thing they gave him was a load dose of dexamethasone. A steroid to reduce inflammation.  His breathing was improving, but was still 30-40 per minute. 

We got the antibiotic script as well as some other anti-inflammatories and cough medicine. His saturated O’s were at 91 when we left the hospital. Mine were 98-99. 

He responded vey well to the steroids and his breathing continued to improve.  When we got back to the hostel, we were thrown into full-blown Chinese fire drill mode. The day prior we had arranged for a cab driver -that we had been using for the past 10 days -to come pick us up and take us back to Salento at 12 noon.  We missed the activities and relaxing atmosphere.  This is a 1 and ½ hour cab ride.  On July 20, Colombian Independence Day no less.  We tried to cancel the ride, but he was not happy with that idea. Can’t blame him. He was nearly in Santa Rosa and had passed up on other business. I was all for just eating the fare, but we decided that we could rally and stay on our plan. So we scrambled to pack up the gear, gave Rock some food to help his tummy with the steroids, hustled to the pharmacy for the script, administered the meds, paid the hostel in Santa Rosa, yadda, yadda, etc etc.  It was CRAZY. 

We arrived in Salento at 13:00 (4 hours ago). Rock is still doing well.  We unpacked back into our favorite hostel in Colombia and I made some coffee and I had my first food in a long time.  Rock seemed to be A-OK.

Our concern, of course, is when the steroids wear off. He is sleeping now and has been for the past 2-3 hours. His respirations are still 30+ but no coughing, etc.  The antibiotics should chase out this infection pronto and we are confident that we have dodged our second bullet in 36 hours. 

8 ½ months on the road and nary a common cold or diarrhea for just about the whole group. I had a cold the first few days in Thailand that I probably caught on the flight over from Hawai’i.  Joanie got over one a week or two ago.  We have been super healthy with no burglaries or car accidents to report. Knock on wood. This episode dished it out to us in spades. Wow. 

Please be patient with us on individual emails. Things are busy. We will post blog updates on Rock's condition as we have news to report. Remember, no news is good news. Bad news always travels fast.

Thanks.


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