bad case of the mondays

February 23rd, 2009 Posted in Uncategorized | 1 Comment »

this weekend was a great one, very hard to come back to the clinic this morning… on saturday erin and I went canoeing up (yes up) the Macal River. It separates the twin cities (san ignacio and santa elena)….  our guide (and steerer) was an older man named Raphael. The river was calm, the sun was beating down. erin and I were a little worried about getting burned, since we’d been spending most our weekends holed up in caves. Our nervousness intensified, Raphael said to me, “you gonna get red”, I told him I had sunscreen and he replied, “doesn’t matter, you gonna get red”…Raphael did a nice job of getting us in the shade now and then. Something I have noticed about other locals and particularly about Raphael: they know (in depth) the flora and fauna of their land. Generalization, yes, but it doesn’t seem our flavor of Americans are so in touch with the local foliage (ummmmmm, missouri state tree: dogwood? thanks fourth grade)… everyone here knows about the wildlife, they can name them, know if they are poisonous, what they eat, etc. Raphael was amazing. Because he’s spent his life intertwined with the land, his eyes see differently. He was spotting iguanas, bat gangs, fish left and right. he’d point them out to us, and finally, our eyes would see what he was pointing at. We saw probably 10 iguanas, two turtles (I spotted one of them, somehow), an emerald tree snake (asked him if it was poisonous, he said, “little bit”, whatever that means), several toucan nests (haven;t seen one yet:(, tons of heron (great blue, great white, and others), kingfishers (bird), vultures. Raphael enjoyed splashing his oar in the water to freak the bats and make them fly over us… Raphael was an incredibly peaceful man. I really enjoyed his presence in our canoe. that night, while erin and I laid in bed, we felt like we were rocking. Yesterday, sunday, we went sailing off the coast. my first time in a sailboat. it was a blast. I slathered on 15spf and 36spf round the clock, and managed to only get burnt, of all places, inside my bellybutton. We sailed about 17 miles away from Old Belize, toward a tiny Caye (key) called Goff caye. we’d heard that it was very picturesque, and it was. so strange, this tiny, tiny island out in the middle of the ocean, (which had about 40 other people on it). to get an idea of the size of this thing. It would take probably 1 minute to walk the width of it, and 2 minutes to walk the length). we pulled up to it and dropped anchor probably 100 yards from the beach. erin, dalheart (a guy who works at the hospital doing maintanence, our age), and I then got into the dingy and attempted to oar to shore. Dalheart and I were paddling, took us awhile to get the hang of it and stop drifting out to sea. historically I’m a little freaked out by being too far into the ocean (I blame ‘JAWS’), but this was okay… plus, the water was only about 10 feet deep at the deepest point while we were in the dingy. We eventually made it ashore. The last time I was in the ocean, it was ocean beach in san fran. lauren, matt, chris, julien, and I all got in that cold, cold water and played around… couldn’t have been warmer than 70 degrees in that agua. the water off goff caye was the exact opposite. so clear. so warm. because of the nearby reefs, the sand is very coarse, and has little flecks of red in it. we had some snorkel equipment. erin and dalheart ventured off and saw some reefs and exotic fish, including a barracuda. I on the other hand, saw a rock. i couldn’t get my mask to stop leaking (because I had the snorkel in it wrong)… I gave up… it was a little anticlimactic to say the least. Instead, I parked myself in 1/2 a foot of water and attempted to skip rocks (it was actually coral, and my best was 4 skips). It’s so fun to play, really play, like back in elementary school. I buried my legs in the sand and called it prehistoric sunscreen. Dalheart and erin made a (very intricate) face and turtle in the sand, respectively. I went back in to get all the sand off me, and out of my bathing suit, and saw something translucent white in the water that I assumed was either trash, or a jellyfish… and made my way away.  erin came out to rinse off, just as I remembered what I had seen in her vicinity, she had already been stung twice on her right leg… the same leg she hurt in the caves branch waterfall climbing… that leg has really taken a beating. we rowed back to the boat… her leg was burning pretty bad, there wasn’t anything on board to help the pain, dalheart said pee is supposed to help. she was willing to try anything… I offered mine up (and dalheart’s) but she opted for her own. I was hoping to take pictures of her pouring her own urine on her leg but she informed me she’d be doing it in the privacy of the bathroom. darn. she said it helped “a little, placebo if nothing else”. we headed back to the mainland, caught some serious wind, and were going 9+ naughts/knots/nots (i dunno)… this was pretty freaking fast. we were tilted WAYYYYYYYYY up on the right. we got some pretty funny pics of me down in the kitchen/dining room area trying to stay upright. it was crazy… I was a little scared but figured our captain, Grant, wasn’t just gonna let his boat tip over. he didn’t. we survived. and saw a great sunset on the ride back. 

lost in translation

February 20th, 2009 Posted in Uncategorized | 2 Comments »

only had one patient in clinic this am… an english speaking local woman with two weeks of pain in her right calf when walking…. doctora measured her calves and found that the right calf was a centimeter larger in circumference than the left… suspicious for a clot.  In the states, the next step would be to do a duplex doppler ultrasound on the leg, looking to visualize the clot, and perhaps drawing D-dimer, a chemical, when elevated in this setting, would have pointed us toward a clot, but not with 100% certainty (because other diseases can elevate the d-dimer)… no duplex doppler here at la loma luz… no D-Dimer to order at la loma luz… in the states, if she were in fact found to have a clot, she would be admitted to the hospital… the danger of the leg clot is that it can travel to the lung and cause a ‘pulmonary embolus’, bad news, especially if it’s big (can cause sudden death)… so the way to deal with the clot is with anticoagulants (blood thinners)… in the states, she would be admitted and started on heparin (probably a drip?) and simultaneously on warfarin, both blood thinners… she would eventually be discharged from the hospital on warfarin only… warfarin inhibits clotting factors, but before the inhibiting starts, warfarin first inhibits ANTI-coagulant chemicals, actually predisposing the patient to more blood clots… that’s why heparin is necessary in the beginning along with warfarin… (following this?)… so back to the patient… she wasn’t admitted (I’m not sure why and the language gap between me and doctora makes it difficult to ask her complicated questions in english, and my spanish isn’t good enough to get the question across)… doctora made a comment that she needed heparin, but then said that the hospital doesn’t have it available for out-patient use… so, she prescribed warfarin.  in the states, particularly at truman medical center, there is an clinic called ‘warfarin clinic’… warfarin is a potent medication, it has to be carefully monitored… that’s the warfarin clinic’s job, to draw the necessary labs to know how thin the blood is… too much warfarin can cause serious bleeding… so in the hospital, it’s necessary to start the dose out very, very low and titrate it (increase the dosage) until just at the perfect level of blood thinning… daily labs are checked, dosages are adjusted, and when the magic number is reached (2-3) the patient continues the heparin for a couple more days and then goes home, just on warfarin… well… this is belize, things are different, technology and resources are limited. Doctora explained what the diagnosis and treatment would be and started writing her notes in the chart… she wrote a prescription for 7.5mg of warfarin to be taken daily (a large dose for a tiny woman) and told them to come back in two weeks for the labs to be checked… I sat there, my mind racing…I had the overwhelming feeling that the patient and her husband didn’t understand what was going on at all, why she had to take the medicine, etc… I was sure that doctora would eventually explain the possible side effects, but I didn’t know how well her english would be understood… I didn’t want to step on her toes, but I finally interrupted her writing and said, “doctora, es OK yo digo las cosas about Warfarin” (bad, bad spanish, spanglish really… “doctora, it’s ok I say the things about warfarin”) she said “side effects?” and then “Yes!”.  so I started in, made sure they understood that she had a clot, that the medicine would help it to decrease in size, prevent it from traveling up her leg, prevent another one from forming… I warned them that if she should start to bleed from her mouth, or nose, or get large bruises anywhere, especially on her toes, she should come back to the emergency room immediately.  they understood. I asked them if they eat many green vegetables… (Warfarin basically inhibits clotting factors that use vitamin K in their production… dark leafy vegetables have lots of vitamin K in them, and eating them erratically interferes with warfarin’s job)… they didn’t eat them much, I told them to just continue to NOT for the next three months while she’s taking the medication…. I told them it was very important that she take the medicine EVERYDAY, at the same time, and very important that they come back in two weeks for the blood tests…. Things are quite different here… My role here at la loma luz is much less ‘important’ than my role in the states (and even still, in the states, I frequently feel like a little monkey following people around, bothering patients with one more physical exam, another barrage of questions, no power to change medicines, order tests, make decisions… can you tell I’m ready to assume the role of real physician:)?)  Anyway, today I felt like I contributed. I felt like this patient actually benefitted from my presence… not a common occurrence in my role as “student-doctora”.  

BIG PHARMA, in Belize?!?!?!?!?!?

February 19th, 2009 Posted in Uncategorized | 6 Comments »

before I get into the meat of this blog… I’d like to point out that in the internal medicine doctora’s office, I sit right next to a old blood pressure device that has mercury in it. AHHHHHHHH!!!!! When I was on Peds in the states, we had an entire lecture about the hazards of mercury… it is a bad, bad element, should it escape from that machine… I accidentally bumped it with my arm a little bit ago and freaked out… so after my brush with near mercury poisoning, a drug rep came in… it was very, very theatrical. He was speaking very rapid spanish, so I could only pick up a word or two every few seconds… he was like a magician, pulling brochures, handouts, and med samples out of the bag… levaquin for pneumonia, ketoconazole/itraconazole for vaginal yeast, topamax for migraine prophylaxis, tramadol for back pain, paracetamol for whatever (I think it’s like tylenol)… He kept handing me samples too… what was I going to do with them???  it was a crazy site in that room for those 10 minutes he was there. he had this handout flow chart for vaginal discharge: which is usually either Bacterial vaginosis, yeast infection, or the STD tichomonas… anyway, I asked the nurse what the word grumoso meant under the candida yeast section… she didn’t know… then the pharm rep and doctora started talking about it in espanol… they kept saying leche-something… I finally figured out they were talking about the discharge consistency and I piped in, “in english we say ‘cottage cheese’”. apparently medicine of all languages, not just english, loves to compare and describe disturbing physical findings to food.  gotta go, time for lunch:)

childhood phobias and dislikes… dispelled. for now…

February 19th, 2009 Posted in Uncategorized | 1 Comment »

In psychiatry and psychology, there are many techniques for helping patients to work through phobias… one technique for example is desensitization. It works like this… say I’m scared of, um, flying. the doctor might (over time) have you look at a picture of a plane, then hold a model airplane, then sit in a plane without its engine on, then with the engine on, then taxiing on the runway, then eventually flooding.  Another technique, quite the opposite, is flooding. it’s just like it sounds.  If I were afraid of swimming pools, the therapist would push me in. If I were afraid of small spaces, the therapist would make me lay in a coffin… you get the idea… By way of flooding, my time thus far in Belize has helped me to rid (or at least temporarily suspend) some old fears and aversions… 1. bridges made of wood with space in between the slats… these were a HUGE problem for me as a kid. At this park we frequented (Par Hill for all you Joplinites), there was a wooden bridge of this kind that was no more than 2 or 3 feet off the ground at it’s saggiest point. I was terrified of it… I may have even cried (did I mom?). there was also a bridge at George Washington Carver that also invoked this sort of horror in me… I think we have that episode on video (don’t we mom?). anyway… that fear has been broken five-fold. there’s a large wooden bridge that separates santa elena from san ignacio, I’ve walked on it many times now (at least three) and have gotten to the other side without much ado. then, at the area named “iguana park” we crossed the ‘hammock bridge’… I have great pics of this bridge… it’s very shaky with wooden slats… in the middle of it, some of the boards have broken and others have been nailed haphazardly and perpendicularly to the damaged areas… I was a little nervous on that one, but crossed it, twice. then there was the bridge at the resort Blancaneaux… this one was high, high above a river and shook from side to side (albeit subtly)… I didn’t even look down to watch my footing on this one!!!! 2. the dark. I have been scared of the dark for all my life! I used to sprint down the hall from my bedroom to my parents room when I was little… I was sure there was something waiting to snatch me up from behind (usually in the form of a giant tarantula… yet another fright dissolved) in the dark. well, I think being in 4 caves, some of them, a mile or so from the light, qualifies as a resolution to my darkness fear.  Especially the last cave… We were with one of the locals, who volunteers to take visiting hospital personnel to little known Belizean wonders. he took us down in twin cave, without helmets, without headlamps… instead, we held candles… it was crazy… and very dark. 3. bugs. I think the tarantula encounter is proof enough… we had these weird bugs we called ‘hoppers’ in the basement of the house I grew up in… they were a mix of a spider and a grasshopper… my mom and dad used to ask me to go to the basement to get things for dinner, etc (invariably a 2 liter of diet, caffeine free pepsi for mi padre)… I’d get to the bottom of the stairs, spot one within say 5 yards of the fridge and would stand there, paralyzed with fright, for a long long long time before I’d finally race to the fridge and race back… Sometimes I would have to psyche myself up for 15 minutes or so before I could enter the hopper zone. 4. cantaloupe. never liked it… not one bit… especially after seeing the way my grandma babe would eat it… she’d cut it up into pieces, put it in a bowl, and pour a bunch of milk over it… YUCK!!! I never liked it and never gave it a real chance, until now. I have it 2-5 times a week for breakfast or lunch and have really come to appreciate the choice, quality melon. Flood on!

case of the tuesdays

February 17th, 2009 Posted in Uncategorized | No Comments »

the clinic is very slow this afternoon… the hospital is very, very small… 8 rooms, 3 of them with patients this am… one of the patients is a 70-something year old woman who has been in and out of the hospital for months… she isn’t doing well. her kidney function is deteriorating, she is extremely swollen because her circulation is failing… she is bleeding inside her GI tract…she has some kind of ischemic (no oxygen) disease in her left lower leg… the skin is sloughing off and revealing pale, pale epidermis underneath (she is of Latin descent)… I could barely find a pulse in her left foot, and the foot itself is very cold to touch: a bad sign. she only moans in pain, does not talk… although she is overloaded with fluid, none of it is where it should be, in her vessels, so she is actually very dehydrated… because her veins are flat, and she is so swollen, it is very, very hard to start IVs on her… she desperately needs IV fluids, though they will likely third space (go out of her vessels and contribute to her already massively swollen state)… the nurse put a tourniquet on every extremity this am looking for a suitable vein to try an IV in… she didn’t find one. it was incredible to see the indention that the tourniquet produced in her arms and legs… the doctora tried twice to get a central line on her (a large IV in a centrally located large vein in the anterior chest {subclavian vein} or neck {jugular vein}… doctora, until two years ago, practiced for 20 years in cuba (she is actually russian…. very interesting story)… she is not accustomed to the central vein kits that are used here… typically to insert the line, you insert a large needle into the vein, then slide a guide wire into the vessel, remove the needle, and slide a catheter over the guide wire, then finally remove the guide wire and voila, you have a central line…. anyway, she had no problem getting into the vein but three times, she could not get the catheter to slide into the vessel over the guide wire… she was very, very frustrated… this situation is complicated by the fact that this patient is terminal, she will die, when we don’t know, but she is going down hill and there is no guidance from the family as to what should and shouldn’t be done to prolong her life… eventually (on the fourth try) the anesthesiologist got an IV in her hand… she is now getting fluids… how much they will help remains to be seen… 

happy hallmark creation day everyone!!!

February 14th, 2009 Posted in Uncategorized | 1 Comment »

erin and I are off this am to Actun Tunichil Muknal cave (I practiced memorizing it for about two minutes yesterday), or ATM for short… old mayan ritual cave… sacrificed body inside! eeek. the tour company is providing lunch, and they are catering nicely to my vegan ways, corn tortillas and veggies for me!!!!  should be a little more relaxed inside this cave… I think… but, will still be spending many hours inside… hope everyone’s vday is all they hoped for… erin and I have a hot date to the pizza place (Mr. Greedy’s) down the hill for some vegan pizza (already inquired as to whether the crust has eggs/milk/butter, and hooray, it doesn’t) and sangria!!!! I might even shed my sporty spice daily attire and bust out a skirt… it’s gettin crazy down here!!!!!

mom, read this!

February 13th, 2009 Posted in Uncategorized | No Comments »

I;m planning on calling you between 6 and 7pm this sunday!!!! will you be available???? I’ll call the house phone. lots of love. 

just when I thought things were quieting down

February 13th, 2009 Posted in Uncategorized | 2 Comments »

wednesday we moved to the ‘nicer house’ on the property…. we had been living in the house that is farther away from the hospital and not as ‘nice’ because the nicer one didn’t have a hot water heater (yes, I’ve been taking warm showers, except for the first night). anyway, we dragged our stuff down the hill and started to move in.. the house didn’t really seem that much nicer… there are cabinets in the kitchen (instead of open slots), there is a non-functioning stove, the bathroom is a little bigger, someone put a conch shell next to the tub for ambiance…. this house has 4 bedrooms, some of which have queen sized beds in addition to bunk beds. two bathrooms. I opted for a bottom bunk, so I could keep my mosquito net in working order… after much scrutinizing and wandering from room to room, erin and I decided to continue sharing a room. we’re used to it by now, and it seems a little weird to be all alone at night. safety in numbers. so anyway, after Marta cleaned up the bathroom and we made the bedroom our own, it did seem to be nicer…… the first night passed without much significance… the mattresses on the beds are better than at the other house. and we can get internet from the “front porch” (i.e. slab of concrete). so last night came, I was settled into bed reading ‘my own country’, starting to get sleepy (been going to bed around 9 everynight)… erin went out in the living room/kitchen/dining room (without furniture). I  heard a gutteral sound coming from the direction of the kitchen followed by, “oh my God!” and then “Lindsey there’s something out here”. There are three creatures we have yet to see in Belize, though we know they are lurking in the shadows (steve the xray tech is always trying to freak me out, telling me they’ll be in my bed, etc). 1. scorpions. 2. tarantulas 3. snakes… I ran over the list in my head as I started to mobilize my sore legs and said with excitement and fear, “WHAT IS IT????” erin grunted, “TARANTULA!!!!!!!!!!!!!!!!” I jumped out of bed, grabbed my camera, and raced cautiously down the hall into the big room. There it was, crawling along the interior wall: black, fuzzy,  bigger than my hand, slowly walking toward the kitchen. I was simultaneously overcome by curiosity, a sensation similar to nausea, and a huge rush of adrenaline… As I watched it slowly crawl along the floor, change directions and start coming toward us, I was sure of one thing: I DID NOT want to kill this creepy thing…. I got close enough to snap some pretty good pics, while squealing, squirming, and  jumping around with itchiness. the tarantula started to move close to my tennis shoes… I got a broom and diverted it back to the wall (without touching it)… we opened the front door, and from 12 or so feet away, the pipe-cleaner looking legs started in that direction. when it started to change course, I put the broom on the side I wanted it to go away from. this strategy worked well and half a minute later, it slowly crawled out the front door, off to it’s rightful home, the wilderness. we stood there in shock and awe for the next 20 minutes, trying to figure out how it got in (we decided optimistically to assume it had been in the house the whole time, that way, feeling a little safer). I said I was relieved that it happened… it wasn’t that horrific… it left without a fight…. now we didn’t have to fear it anymore… so that leaves the snake (apparently the scorpions don’t really like to come inside)… I decided we should come up with a contingency plan if a snake were to come into the place and be between us and the exit. we decided to put the broom right outside our room, next to a trash can that we could trap it under… we decided to keep a set of keys on the bar, ready to be used in the event of emergency. if the snake should be too big to fit under the trash can, we would (in one great swing) sweep it across the floor, and high-tail it down to the hospital to find the security guard… at least now, thanks to that fuzzy, nauseating guest, we are “prepared”.  erin admitted that she didn’t want to name the tarantula, unlike our lizard friend… he wasn’t a roommate we’d like to keep. To me, it shall forever remain, “He Who Must Not Be Named”.

waterfall cave: not a spectator sport

February 12th, 2009 Posted in Uncategorized | 3 Comments »

wow.  yesterday we got to skip work to go with the two american nurses on this waterfall seeing adventure through the adventure company, “Caves Branch”.  this is what i knew about the excursion prior to going on it: we’d be hiking a little, seeing some waterfalls and a cave might be involved.  so, we got there and had to sign waivers… I actually read the document… “cave’s branch is not a guided tour company, it is an adventure company”. “cave’s branch cannot be held responsible for any bodily harm including DEATH.”  ”By initialing below I understand that DEATH IS A POSSIBILITY.”  my heart rate increased as my pen scribbled lrs.  there were 11 of us total: a family of two sons and dad from canada, a couple in their late 20s also from canada (the guy had just finished his residency in fam practice), the four of us, and our two guides Ching and Alex.  following a 20 minute bus ride through an orange orchard, we arrived at the edge of dense, dense rainforest.  A small, inconspicuous trial was pointed out and we started up the trail, after a pep talk including the subject of sleeping snakes on the path.  As I climbed higher and higher into the jungle, I realized that Ching had made no mention as to what we should DO if we encountered a snake.  luckily, we didn’t. along the way Ching pointed out a spiny tree that they refer to as ‘give and take’, it looked like the tree equivalent of a porcupine, so it ‘gives’ you pain if you touch it and get the spines stuck in your hand, but it ‘takes’ the pain away because the sap has analgesic properties. we arrived at the large mouth of the cave… I had been so focused on staring where I was stepping on the hike, that when I looked up at the ceiling of the cave, the mass of hanging stalagtites appeared to be moving, like they were on a conveyor belt. For a second I thought I was about to have a mystic spiritual experience (perhaps culminating in bursting into a beam of light) but my eyes eventually adjusted and I started taking pictures… they had given us backpacks. we were instructed to pull out the hard hat inside and put it on…. “the cave will be completely dark, the only way you will see is by the light on your helmet. watch where you are going at all times, and periodically look up to make sure you’re not about to smash your head into low ceiling. we will get wet. at times we will have to crawl, we will be going to the halfway point of the cave, about 2.5 kilometers in…” I strapped on my helmet and noticed some sort of harness in the backpack…. nothing was mentioned about the harness… perhaps it was for another sort of excursion, I thought.  into the cave we went. ching pointed out large holes in the ceiling, about a foot wide by a foot and a half deep, we looked in, and saw the homes of bats, usually one bat per hole. Ben, the fam practice doc, found a hole that had about 10 bats hanging upside-down from the top…I thanked dios many, many times in that cave for having my hiking boots on: we walked over sand and small pebbles around huge limestone formations. Then came the river which has carved the cave over millenia. wet, wet boots, wet pants, large stones.  And then we began to really maneuver on, around, and under HUGE boulders.  sometimes I was walking on limestone ridges reminiscent of a tightrope with nothing but shallow river to my left.  the water rose, and I was wet up to just below the crotch, I silently thanked the gods for my height. I had to use all muscle groups to traverse this place, scratching my shins, knees, hands, and fingers at times on less than smooth rocks.  I took out my camera to take a few shots of a particularly cool formation, tripped on a rock in the river, spared my camera, rammed my knees against the bottom, and drenched myself to my waist.  erin held my camera in her dry backpack for the remainder of the experience.  we came to an indistinct area where there was a large flat topped rock. we were instructed to take out our harnesses and put them on. Being inexperienced at donning this type of attire, Ching dressed me, cinched me, secured me, fastened me.  we were to leave our backpacks there. “ARE YOU READY?  now comes the fun part, the waterfalls, there are seven of them. the second one is the largest at 15 feet, we will rope you in to climb that one” Ching was excited. I was flabbergasted. What??? Climbing waterfalls? harness? rope? seven? 15 feet?  before we got to the first waterfall, we had to go under an area with ceiling so low that we had to crawl in the water, getting soaked up to the clavicles. and then, we had to swim. the water was cold.  not so cold it took my breath away, but cold enough. we got to the first waterfall, probably 4-5 feet high and maneuvered up it one at a time. not too eventful, very wet though. completely wet at this point. As I trudged through knee deep water, two bats whizzed by my head. Then came the second and biggest waterfall. I was scared, and I was about 4th in line. I had to pee, ching said to do it in the water, but no pooping. Alex the guide had gone first to secure the ropes, he’d be belaying us up (not too savvy when it comes to climb talk, but basically, a clip was attached to the harness {which was only up to the bellybutton} which was attached to a rope. we would climb, while alex pulled the rope so that there was no slack and if we fell, we’d stay at that height and not plummet into the water below). the three people in front of me made it up. amanda, the third, did well until the very top, she lost her footing, and was pummeled by the waterfall, until she collected herself and climbed the rest of the way. now it was my turn. First I had to jump off a rock into the pool below, making sure to not jump in at the sides, where pointy rocks were waiting to snag me. I jumped. Then I swam over to the rocks where Ching was waiting to clip my harness in. I secured my footing on the jagged rocks, he clipped me in.  I think of myself as having the upper body strength of a toddler, so, I was nervous to climb. I slowly found footholds and hand holds and began to gain height.  I was up about 10 feet pretty quickly, on the ledge where amanda had fallen. only five feet to go. there weren’t any obvious places to grip and I ended up slipping, falling (about an inch thanks to the harness), and hanging. I hung there for what seemed like an eternity with the waterfall assaulting my face… I couldn’t breath. eventually I pulled myself up and was vertical again, and climbed the rest of the way up. when I got to the top I wanted to pee, but was so full of adrenaline from my fight with the waterfall that I just had to stand there, shivering, while my blood palpably pumped through my body. I eventually peed and erin made it up behind me, only to fall in a hole and scrape up her knee pretty badly. we talked over what we thought would happen on the way back down… we figured we’d repel down. waterfalls 3,4,5, and 6 were traversed without the drama of #2… the last waterfall was 8 feet tall, we climbed it without a rope.  scary. made it without falling or hurting myself. now it was time to go down… we quickly found out that we wouldn’t be repelling, we’d instead be JUMPING off numbers 7 and 2.  When it was my turn to jump, i was given instructions by ching to jump where he was shining his headlamp, making sure to bend my knees, and keep my arms at my sides. out in front of me, the wall of the cave that provided the opening, jutted into my path. I asked how I was supposed to avoid hitting my head it, I don’t remember what the answer was, but it satisfied me enough, I jumped, tucked and landed in the cold water without any major trauma, I had hit the bottom with one of my feet, but as far as I could tell, all was well. back down 6,5,4, and 3… my anticipation growing, growing, growing for the number 2 jump. for this one, they roped us in as we climbed down to the ledge where I had fallen. I made it down with the help of alex’s superb belaying skills.  (keep in mind that neither of the guides wore harnesses… bad asses.) he had me sit down on the waterfall to prepare to jump. “see that rock a couple of feet below you?” I saw it. “don’t hit that”. I’ll try. I flew through the air and sank like a rock into the water. I wave of relief flooded my body as I swam away from the waterfall. I made it. no more waterfalls. I was euphoric. we made our way back to the flat topped rock, where ching and alex spread out a table cloth and topped it with plates of fresh-made tortillas, cucumbers, carrots, cabbage, tomatoes, green pepper, and other animal products I shall not name. I felt apathetic as they spread out the lunch, I wanted out of that cave… it wasn’t until I put the leading edge of my burrito into my mouth that I realized I was famished. I engulfed it. made another, inhaled it, and ate another tortilla drizzled with hottest sauce. I felt like it was the first meal in a while that I had actually earned. lunch ended, we stripped our harnesses off, and made our way out of the cave, which took approximately another 45-50 minutes. at one point, we had to crawl for what seemed like a block, and I understood for a moment what claustrophobia must feel like… I felt panicky wondering when we were gonna get the hell out of there, then brought myself back to the task at hand, putting one foot in front of the other. at times, when I ceased all thought, I glided effortlessly, smoothly, and gracefully over, around, and under the boulders. when I thought about where my foot needed to go, I was shakier and more clumsy. I splashed through shin deep water and saw the first sign of natural light in the past 4 hours.  As we silently neared the mouth of the cave I let out a loud ‘whoop-whoop’.  I asked ching later if anyone had ever died in there, or on any of the excursions, he looked at me with a smile and said no.  I felt overwhelmed and enormously appreciative of ching and alex’s expert skills as we hiked back to the bus. I had made it, we all made it.  had I known what I was getting myself into, I would have never gone. I wouldnt’ve thought I had the strength/tenacity/courage to do something like that. I won’t underestimate myself again, nor will I go back to that cave. 

XUNANTUNICH!!!!

February 9th, 2009 Posted in Uncategorized | No Comments »

chris and ju, thanks for the comments, and yes, please knit me a mu sweater!!!! yesterday erin and I took public transit to xunantunich, mayan ruins about 30 minutes from san ignacio/santa elena.  we then hiked about a mile up to the ruins.  very peaceful there! we climbed up to the top of the castillo for a breathtaking view of belize and guatemala. there is no way that anyone would be allowed to climb up to the top of the castillo in the US. lawsuits, lawsuits, lawsuits. the rocks of the building were slick, it was drizzling, but we made it up there after a ridiculously cautious ascent. it had been a while since I’d been up to heights that soaring, forgot that they make me a bit squeamish. I kept getting this strange physiologic sensation watching other tourists venture over to the edge of the top platform (there are no guard rails, safety=the individual’s responsibility). Needless to say, I stuck close to the middle, as far away as possible from the edge.  there were armed guards from the belizean army up there, i asked if anyone had ever fallen off, they said no. we made our way down slowly… erin made sure to capture forever on film my strategy of decent when it involved going down on my butt… just getting back to my toddler roots. we waited forever for a san ignacio-bound  bus, and passed the time talking to an artist from the czech republic.  The world became significantly smaller when I ran into an acquaintance on the bus.  (for the inquiring minds who want to know: a girl named serena who is my ex-boyfriend erik’s ex-girlfriend, how convoluted… we met once, two years ago, in san fransisco). we passed the rest of the afternoon sitting (sans hiking boots) on a south indian restaurant’s patio, enjoying cold belikins (the local brewsky of choice), delicious dosas, a nice breeze, and a sense of accomplishment. Santa elena is feeling more and more like my momentary home, and you’re right chris, my homesickness has dwindled down to nothingness. we have a new and semi-permanent reptilian roommate, a gecko we named floyd who’s been living on the windowsill in our bedroom.  by the by, no new mosquito bites to report!!!! Hasta luego MIS amigos! 

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