Sick and stuck in La Cruz (Puerto Vallarta) 1/21/2017
Ok, I say this with as much light hearted attitude as possible. Life tends to always throw curve balls whether you’re working the daily grind or sailing the world having a good time. Our’s in this case is being faced with Christian’s sickness and having to choose the best, safest option for him and our family.
Christian originally started feeling sick late October when he returned back to the States from a quick trip working on the boat in San Carlos, Mexico. At the time it just seemed like a normal sickness since everyone else around us was sick too. He recovered from the initial part, at least we thought he had, and went on his way back to the boat in San Carlos, Mexico with Nina and Taj early November. His energy was starting to get lower and his stomach frequently upset. Mid-November, they set sail to cross the Sea of Cortez and made their way south, down the Baja side. In the meantime I was up working in The States only having occasional text messages on his health report. Once it was clear that this “thing” wasn’t going away on its own, I told him to go to the doctor and take a poo (stool) sample with him to test for parasites.
He wasn’t near a doctor at the time, so he took this medicine that we keep on board called “Vermox“, which is normally a quick and easy fix for “non bloody travelers diarrhea” AKA “la tourista”. That didn’t work either. In the meantime he was still sailing down to La Paz, thankfully buddy boating with our friends aboard S/V Kenta Anae. They helped ease the parenting load off of Christian and helped with meals along the way.
As soon as he got to La Paz, after talking to other sailors who are practicing doctors from various locations, they decided that he probably got Giardia from the U.S. It made sense to us, because he had been drinking out of this spring and did so after a huge rain. So, he went to the farmacia in La Paz and got himself Flagyl for that, no prescription needed. Still no poo sample given to a doctor at this point (sense a little frustration from me?).
This is when I went down to La Paz to visit at the beginning of December. He was still on flagyl and seemed to be doing ok, if not a little better. We sailed, hiked a bit, ate out , and even surfed once. Nothing was screaming “get this guy to the doctor” yet. Then Nina and I left and Christian’s father, Gene Lauducci, hopped onboard to cross the Sea of Cortez with him.
With Christian, his dad Gene, and Taj aboard S/V Shawnigan they sailed away and across. Doing ok, but progressively getting weaker they made it across and to La Cruz anchorage. I only found out after the fact, when we made phone contact, how much he struggled with his energy and urged him to go to a doctor. He did finally! And the doctor in La Cruz wanted to just send him home on a 7 day course of Cipro without checking blood or poop. Christian had to ask for these. The labs were done, but limited (no blood culture and no stool culture). He did however order a specific test for Salmonella called the Widal Reaction Test. It showed that he had low-moderate levels of Salmonella of three different types. One of which was typhi (aka Typhoid Fever).
Phew, we thought we were on the right track now, but 2 days into it, the day Nina and I flew back in to Mexico, he started having negative and rare side effects from the Cipro and had to stop them immediately. I have never seen Christian like this. I have to admit it was a little scary.
The very next day we found a new doctor, after having a hard time contacting the previous one and not completely trusting him either. This new doctor took his own labs and agreed that it looked like Salmonella, and did a quick abdominal ultrasound mainly to look at the gallbladder, since it likes to harbor there long term. Based on the labs and apparently enlarged gallbladder, he said it seemed that Christian has had this for more than 2 years, not a recent infection. He started him on 5 days on IV Gentamicin and 10 days of oral Bactrim. After the 2nd day of treatment, Christian initially felt better but his energy was off and on and by the end of treatment and 4 days later he felt just as sick again.
He went back for a follow up and to ask for cultures. For some reason these doctors down here just don’t want to do cultures! He did do follow up Salmonella labs and found the level of one actually got higher! He suggested to Christian, without re-ultrasounding his gallbladder, that if he just wanted to get the Salmonella out of his system now and quickly he should just have him remove his Gallbladder. Can you believe it?! From one course of treatment to “let’s remove your Gallbladder” ?!?! Needless to say, we went and got a second, I guess this was actually a third, opinion.
We were referred to this doctor husband and wife team in Punta Mita through ours friends Richard and Doña on Profligate. They first used the collection of labs we’d already gotten and looked at the latest and started treatment based on that, but they interpreted it as normal values of Salmonella and raised values of Rikettsia. We asked for cultures again but they said he needed to get started on some treatment right away before waiting to see results. So again, Christian got three days of IM shots of a Cephalosporin and was asked to come back in a week for follow up labs and this time stool (poo) cultures using a really good reliable lab that the hospitals use. He was also sent to an ultrasound specialist for a full abdominal ultrasound. It was a good thing we did all of this. The ultrasound (which only cost us $20 USD) showed that his gallbladder was fine! And the 3 days of shots did not make Christian feel better. We were shocked when the lab results came back as still having Salmonella Typhoid, not Rikettsia, AND his stool culture came back as having multi antibiotic resistant E. Coli and no Salmonella (meaning the Salmonella is still in his blood, but he can’t spread it). Again, they did not do a blood culture because they don’t normally do them in Mexico and didn’t have the proper lab bottles for them in stock. URG! We found out the doctors around here hardly ever do them because it’s “expensive” and usually they don’t need to. To us, it’s worth it and in all my nurse training you get a blood culture first thing. Lesson learned, demand one in the very beginning, even if you come off as a crazy paranoid American.
So here we are currently finishing up the 1 of only 3 antibiotics that the E. Coli is susceptible to and hopefully the Salmonella as well. We go in on Monday to have both stool AND blood cultures drawn and Salmonella levels of course with a complete Blood Count as well. Christian has had a low white count through this whole thing. The labs should take five days for results to come through, which get emailed to us (pretty cool). We still have no idea where and when he got this nasty stuff.
We are keeping our fingers crossed. Christian is feeling better. The last three days he’s had a lot more energy. So far though, the one thing that all the doctors had in common was that they all said this Salmonella and now E. Coli might take up to a year to fully clear. So it looks like we are stuck here for in the Puerto Vallarta area for a bit.
Saying “stuck” really isn’t the correct word, since we are choosing to stay here until Christian is healthy, but at the same time it’s hard not to think about where we could be or want to be sailing now and in the near future. So for now, we are trying to stay positive and we’re ok with being here, because we are still here in Mexico and with the whole family together on the boat. Meeting lots of great people and other sailing families.
We are hoping to at least get healthy enough to cruise Mexico again and the Sea of Cortez again. We don’t want to push our luck in going too far off the beaten path. Safety and fun is better than an adventure unsafe and possibly life threatening.
I’ll try to update on the latest results next weekend. Hopefully Christian will be so healthy we’re out having fun!