Deviations From Course: Sailing Homeward Part 3

Everything was great until it wasn’t.

I thought it would be smooth sailing after we braved the Tehuantepec.

The voyage from Chiapas across that notorious patch of water was relatively uneventful, except for the unlit fishing net that we snagged when entering Ensenada de la Ventosa in the dark to wait out a blow.

That mishap turned out to be the calm before the storms that life would cast as we sailed our remaining 1500 nautical miles homeward.

The first of these formed the morning after we’d arrived in Zihuatanejo.

It came with a thunderous bang when the Captain lost his footing on the companionway stairs and slammed into the navigation table, ribs first. After two days of failing to ease the pain with the contents of our medicine chest, I set out to provision something more substantial from a local doctor. Morphine did the trick.

Within 24 hours, we were able to get Fabio into a dinghy and on-shore for an X-Ray to confirm that he’d fractured two ribs. The doctor prescribed 10-days of pain-management with bed rest and a full-month without heavy lifting.

Thankfully, our friend Steve, who’d last sailed with us from New Zealand to Fiji after the Captain’s 2015 liver resection, agreed to help us navigate through another medical challenge. He arrived from Florida the day before Italy closed its borders in their effort to contain their coronavirus. Still, cases were tapering off in China, so we hoped that the rest of the world would soon follow suit, departing Zihuatenejo for La Paz, dreaming of the anchorages we would visit along our way.

After a three-day sail, we arrived in La Cruz de Huanacaxtle to whales breaching and news of toilet paper hoarding in the US. As the Captain and I had planned to store the boat at the US-Mexican border with me returning Stateside for work, we’d depleted most of our onboard provisions. Given the rising pandemic tide, we decided to replenish provisions in nearby Puerto Vallarta as a precautionary measure. While the vibe was changing in Mexico, store shelves were still full, and tourism remained incredibly strong.

Border closures were rapidly increasing by the time we set sail from La Cruz de Huanacaxtle, leaving cruising friends stranded across the globe. We felt blessed to be sailing Mexico’s Pacific coast but decided to skip the dreamy anchorages along the way and head straight for La Paz.

The day we secured our dock lines at Marina Palmira, The US State Department announced a global Level 4: Do Not Travel Advisory, urging citizens to return home.

Steve booked a return ticket to Atlanta on what we thought would be one of the last outbound planes. Before boarding in Mexico, he was socially distanced and had his temperature taken. When he arrived in Atlanta, he was cattle-herded through customs cheek-to-cheek with hundreds of other travelers; no fever checks.

Rather than proceed with our original plans, we opted to remain south of the border until the coronavirus situation stabilized, with me pursuing job opportunities remotely. Marina Palmira was filled with boats, but almost empty of people, as most had returned home to Canada or The United States.  

The Governors in Mexico began to get serious about containment. The protective facemasks couldn’t hide the fear. Visits to big-box grocery stores were limited to one person per household. School & and small-business closures were enacted.  

Rumors abounded on the coconut telegraph, some accurate, causing us to vacillate on whether to remain in La Paz after the Captain fully recovered from his rib injury or venture onward up into The Sea of Cortez. We’d heard of cruisers being denied permission to exit or enter ports, of prohibitions against anchoring off the islands, and of hurricane-protected marinas being fully booked.

In a short time, La Paz had become our new comfort zone, offering us access to hypermarkets and comprehensive medical facilities, but with little to excite the eye during the lockdown and a perceived higher exposure to hurricanes in the coming season.

The Sea of Cortez offered us a magical place to float surrounded by beauty with better hurricane protection closer to our final destination. But access to provisions and healthcare would be limited. We chose the magic and sailed onward.

The trip up to the mooring field at Puerto Escondido was freeing and filled with jaw-dropping landscapes the entire way. We were able to tuck into the few remaining unrestricted anchorages, avoiding small villages and shuttered national parks.

Our arrival at Puerto Escondido was a bit unnerving. While the staff followed all protective guidelines, many of the patrons were congregating in close quarters, sans facemasks. In La Paz, socializing with the few cruisers that remained was done at an appropriate distance, if at all. Now, I was face-to-face with humanity again and found myself looking at the ground rather than meeting gazes and failing to greet anyone with a smile. I’d gone from being an open, social butterfly, to avoiding face-to-face encounters.

We stayed at Puerto Escondido just long enough to replenish our stores, do a bit of boat work, and secure a mooring ball for the hurricane season in case we needed it.

Then we set out on our first tour of the Loreto area, calling in at the San Juanico, Isla Coronados, Isla Carmen, and Isla Danzante. The seascapes dazzled us, and we managed a few hikes in the more secluded anchorages.

But the battle between rainbows and storm clouds continued given a growing number of COVID cases at my mother’s supportive living facility; two staff and three residents. Thankfully, there have been no additional in-house cases since May 7. 

After ten days resting on anchor, we returned to Puerto Escondido so The Captain could repair some stitching on the bimini and sails and then set out on a second tour.

Our intent was to buddy-boat with our friends Rob and Linda on Cat-N-About to explore another hurricane hole further north at Puerto Don Juan near Bahia Los Angeles.

We called in at several lovely anchorages along our way with me feeling guilty about our good fortune to be able to wait out the pandemic surrounded by such glory.

But the Captain started to feel unwell as we neared Bahia Concepcion. There were no noises after we dropped the hook at the cactus-lined anchorage at Playa Santa Barbara except birds cooing, fish jumping, and the Captain wincing in pain from intestinal cramps every 20-30 minutes.

Rob and Linda from SY Cat-N-About brought chamomile tea, and Jacomine and Roel from SY Tara brought fennel and Panadol suppositories. That eased the Captain’s stomach upset and the cramps allowing him to sleep.

I went out for a solo dinghy ride around the anchorage, feeling nothing but Fabio’s absence.

While his pain lessened with a good rest, Fabio and I thought it wise to visit a doctor in Loreto. After day-hopping the 100 nautical miles back to the mooring field at Puerto Escondido, we rented a car and scheduled an appointment with Dr. Salinas.

The local police took our temperatures as we entered the town of Loreto, and then sent us onward without question. In addition to the doctor’s office visit, we were able to buy a new cell phone to replace a non-functioning one and load up on groceries. It was just like any other day.

Dr. Salinas recommended medications used to treat a typical stomach ailment, but Fabio became progressively unwell overnight. The next morning, the doctor ordered an ultrasound that revealed a partial bowel obstruction. Dr. Salinas prescribed a bland, liquid diet, and medication to clear the blockage. If that didn’t work, a nose tube would be required to drain the liquid or, worse, surgery.

I was surprised by the extent to which this illness overwhelmed me. I had sailed through Fabio’s metastatic liver resection, chemotherapy treatments, double-hernia surgery, skin cancer surgery, and semi-annual PET-CT scans, always optimistic that everything would be okay, armed with a Plan B if it wasn’t. Perhaps this latest illness was just the straw that broke the camel’s back, or it seemed more challenging to come up with actionable plans in the time of coronavirus. 

With no relief after five days, we returned to the doctor in Loreto. The Captain received an IV with fluids and anti-spasm medication to rehydrate him and ease the pain. Fabio’s illness had exceeded Loreto’s diagnostic capabilities, so Dr. Salinas advised us to return La Paz for a CT scan. Given all the hotels and Airbnb’s were shuttered until June 15th due to the pandemic, we opted to motor-sail for twenty-four hours on an unseasonably cold evening, bashing our way into 2.5-meter seas with 25-knot winds on the nose; almost twice than forecast. The Captain docked the boat, caught a few hours of sleep, and headed to the hospital for a CT Scan.

He was admitted upon arrival on May 29 and operated on the next day. The surgery was more complicated than expected, taking three hours instead of one. The large intestine had moved to the cavity left open from the 2015 liver resection and adhered to the diaphragm. The medical team needed to deflate Fabio’s right lung and drill a small hole in the membrane to separate the intestine and clear the obstruction. According to the surgeon, Dr. Tarazon, the organ had become completely blocked and would have burst in a few days without surgery.

Fabio struggled post-surgery. The lung expansion machine used to inflate his right lung was showing progress, but not as much as expected. An infection had manifested in his left lung, and his oxygen levels were worryingly low. Fabio was moved from a standard room to ICU to stabilize his oxygen levels, and a COVID-19 test ordered.  By the end of the day, things were looking up; his COVID-19 test results came back negative for coronavirus, his right lung had inflated and the chest tube was removed. I left the hospital late in the evening, feeling optimistic.

But overnight, his right lung collapsed again. The medical team installed a new chest tube to inflate it, but Fabio was unable to maintain his oxygenation levels. The doctors intubated and sedated Fabio, placing him on a ventilator and feeding tube for seventy-two hours. Fabio, who is fluent in Spanish, verbally gave the medical team the go-ahead beforehand, and I signed a bunch of papers, having a vague idea of their contents because of my weak command of the language. 

Finally, Fabio’s vitals stabilized. Dr. Tarazon said he had the bloodwork of a teenager. I snapped images of the monitors and test readings and sent them to our friend, the sailing gastroenterologist Dr. Charlotte Dacker in New Zealand. She posed a few more questions to ask the doctors, and when answered, reassured me that while Fabio’s pre-ventilator readings were scary, Dr. Tarazon and his team were taking the right course of action, and the Captain was on the mend.

During my first visit with Fabio after intubation, he moved his head and arm as if he recognized my voice and knew I was there. But he did not respond at all during subsequent visits. The medical team did not know whether Fabio could hear me but encouraged me to keep talking to him.

After seventy-two hours, Fabio came off the ventilator with vitals remaining stable, intestines operational, his right lung inflated, and the left lung nearly free of infection. But I wasn’t prepared for the ICU delirium.

When I walked into the room as he was emerging from sedation, Fabio said, “I don’t want to see you”. The doctors said to me that this was not unusual behavior for patients coming off mechanical ventilation and not to take it personally. I was too busy taking it personally to hear them.

The following morning, while he still did not recognize the doctors or nurses, Fabio knew me as I entered the room and shouted ‘leave, leave.’ I asked whether he wanted to speak on the phone with any of his friends, and he said no. I asked him if he wanted to have our friend Rob, a trained paramedic, visit. He again said no.

Thirty-six hours after the ventilator was removed, Fabio’s confusion began to clear. He knew where he was, why he was there, and who the doctors were, but when I attempted to visit him, he cried, “they’ve hacked my computer, go check yours, leave, leave.”

It took Fabio a total of seventy-two hours to emerge from the sedation fully and the resulting in ICU-delirium. When he finally agreed to see me, he was still hallucinating black holes and floating computers, confident that the nurses were evil spies. But within a few hours of our meeting, he was sitting up in bed, speaking with a few friends via WhatsApp, and joking around with the doctors and nurses.

Since then, the trend has been positive. Fabio’s vitals remained stable when the chest tube and oxygen mask were removed, and he began to ambulate with a walker. After 17 days in residence, including six in ICU, he was released from the hospital, initially with round the clock nursing support and house calls from surgeon Elmer Tarazon, physiotherapist Jesus Terapeuta, and respiratory therapist Marcos Dominguez Rico. We’ve rented a charming casita in the center of town through the beginning of July to allow Fabio to fully heal.

The road to recovery is not an easy one. Every new round of medical treatment eats away at Fabio’s spirit, and he struggles to find the energy to get his strength back. I feel more like Nurse Ratched than Florence Nightingale as I push him to work with the physiotherapist and ambulate around the house. But he’ll get there.

I am so thankful that the Captain has weathered yet another medical storm. Amandla and I are looking forward to having him back at the helm.

Click these links for Part 1 & Part 2 of the story.