Friday, December 30, 2005
Grandma has lost her hearing. It happened almost overnight, and though the doctor says one ear is better than the other, the overall effect is dirt poor hearing. Bud's hearing deteriorated slowly, over many years, and Carolyn served as his back-up ears. Hearing aids have helped Bud quite a bit but they magnify every sound and it is not the same or nearly as good as normal hearing.
Carolyn is adjusting. Some friends are coming from Juneau and they will bring Bud's old hearing aids for her to try. When they return to Alaska in April, she will see an audiologist and see what can be done.
But what a loss! Many things are missed: undercurrents in conversation, overlapping dialogue, asides and nuances. Sometimes, even with the best circumstances, comprehension is poor. We speak louder and make sure they are looking at us when we talk but some voices are particularly hard to decipher. We have a new acquaintance with a soft, gravelly voice and a hint of a Scottish brogue - Bud and Carolyn have a real hard time hearing him.
My friend, Josh, had a cochlear implant in August. He is 35 and has been "sort of" deaf since he was 3. He had sound magnified as much as possible with hearing aids and learned to sign fluently. He also got through Yale without much effort and learned to speak more Bemba in Zambia than any other Peace Corps Volunteer in his group. If there are obstacles to overcome, it definitely helps to be brilliant.
So now Josh hears better than he ever has. Insertion of the implant required brain surgery and the implant requires programming and reprogramming to optimize its performance. It is a great big deal, a lot of pain and expense and uncertainty but now he can hear. Josh writes of the blessing of hearing a bus accelerate, something we gripe about every day. He can hear now, just like most of us. What a gain!
Wednesday, December 28, 2005
Sunday, December 25, 2005
We were fed in someone's backyard, bought cookies at a house with no sign and looked for fresh cheese at two different houses but failed to find any that was ready. Josfel wouldn't admit it but I know those women were giving him a hard time for not calling ahead. He tried to charm them but he left empty handed.
Saturday, December 24, 2005
Wednesday, December 21, 2005
Tuesday, December 20, 2005
Joanne, another ex-patriate, lives in Bucerias full time where she and her partner run a small hotel, massage studio, bakery and bookstore. Cecelia, in pink, lives and works in Bucerias as well. She is a dentist/orthodontist and has made a large contribution to the success of the cleft lip/palate program in this city.
Rosario Guadalupe's job is to exercise her lips and mouth to improve her speech.
Sunday, December 18, 2005
Yarn: Silky Wool (Elsebeth Lavold), color 35, petrol, 6 skeins
Needles: US 5
Pattern: Scallops Cardie
I eliminated the yoke detail and changed the button and neck bands, but otherwise followed the pattern. It fits fairly well, the armhole length and the overall length are a bit short but I haven't blocked it yet. I liked the yarn a lot and the pattern was easy.
Oh, and it looks sort of like a sweater I made for my sister a couple of years ago.
Here is a picture of the sweater I just finished, version one. I didn't like the pattern on the yoke so I ripped it all out. The simpler style seems better for the yarn. Pictures coming later today.
Saturday, December 17, 2005
Fourteen people were scheduled for surgery on Thursday, but two were canceled. One teenage boy was anesthetized and an abnormal heart rhythm was seen on the cardiac monitor. He was awakened immediately and will see a cardiologist before surgery. Risks and benefits, heart vs. lip, it wasn't a hard decision to make. Another little boy had his surgery canceled because a necessary piece of equipment wasn't available. His burn reconstruction required a tissue expander and there wasn't one. I didn't learn exactly how it happened that he was there and the tool wasn't, but someone somewhere dropped the ball. Unfortunately, it happens everywhere sometimes, and it is always hard on the patient and the family.
Otherwise, it was a very good day. We did twelve cases in two rooms, with one anesthesiologist and two surgeons. The local hospital is a nice facility, generally spacious, well equipped, well staffed and air conditioned. We started surgery at 10:00 am which is a little late by American standards but we worked until 7:00 pm to make up for it. The cases turned over quickly, under 10 minutes, so a new patient was usually on the table shortly after the previous case had finished. I spent most of my time in one room, often watching the patient's status while the anesthesiologist was in the other room, and helping as the patients were put to sleep and awakened.
The atmosphere was always upbeat and relaxed. The team of doctors and the scrub techs from Guadalajara were experienced and efficient. They did without a lot of fancy equipment that we take for granted and still did great work. Latex gloves were used as tourniquets, Q-tips dipped in ink served as skin pens and a scalpel did what a dermatome does. Once when the laryngoscope light didn't work, the anesthesiologist yelled "Niña!!!" for the circulating nurse to find him one that did. Rather than wait, though, he took a look down the dark throat, and the headlight-wearing surgeon cocked his head, shining his light down the airway, and boom, in went the tube.
I liked the lively banter and how the surgeon would sing Mexican love songs as he worked. I liked the friendly atmosphere and the teamwork. I liked working with an organization that is lean and mean, where they make good use of the donations they receive and the time offered by volunteers. I liked seeing all these things in Mexico, like I saw them in Ecuador and like I have seen them in the U.S. To me, it means that there is a lot of good in the world, that people everywhere are caring and loving and giving.
But most of all, I loved the kids and their brave parents. I loved the terms of endearments that we all used to put them at ease when they were scared and to comfort them when they cried. Mi amor, chiquito, hijo, mamita - the warm rhythm of soothing Spanish. Some comments were made about how it is good of me to help, but always, for me, I get more from it than I give. Way more.
Friday, December 16, 2005
The first day of the cleft lip/palate clinic in Puerto Vallarta is the consultas. This is when all of the children in the program are seen by the surgeons, dentists and orthodontists. Decisions are made about who needs surgery and when it should be done. Progress is noted and interventions and treatment plans are adjusted. It is also a time when families reconnect and share their stories. They can be tremendous support for each other.
We saw 84 children in las consultas on Wednesday. Fourteen were scheduled for surgery on Thursday. The others will be seen again in February and many will continue with regular orthodontic and other medical and dental visits in the meantime. Some will be lost to the program, sometimes for reasons we will never find out about. And there will be newcomers every 3 months as well, babies, of course, but also people who just finally seek help. One girl had her open palate repaired yesterday at age 18. Usually this surgery is done at or around one year of age. Who knows why her family waited so long to seek treatment.
There were two children on Wednesday that affected me deeply. One little seven year old boy was born without ears. He had scars on each side of his head. He was there with his sister, a young adult, who told me that he couldn't hear at all. The dentist spoke to her at length, in Spanish, so I didn't understand some of it. The boy is not in school, has had no sign language instruction and can only signal a few words with his parents and other siblings. One can easily see that he is a bright little boy and it is sad to think of him all alone in there. Dr. Cecelia, the dentist, assured me that there are plenty of resources in Puerto Vallarta to help deaf children. What I don't know, though, is the rest of the story. What else does that family have to deal with?
Little Efrian came into the world three weeks ago. He was born with a bilateral cleft lip and palate defect which severely interferes with his ability to suck. His mother had a bottle of breast milk with her so she was trying her best to feed him, but this baby was skin and bones. At a glance, I was afraid for his life. He is in grave danger of dying from malnutrition.
Dr. Cecelia gave Efrian's mom a special nipple for his bottle and showed her how to use it. He showed great interest and hopefully he will learn quickly how to eat with this new device. There wasn't much time for teaching and a lot depends on the mother. I saw her talking later to another mother who had a chubby, healthy looking 5 month old. She had told me how scared she was the first two months. These babies choke a lot and it can be frightening to feed them. These are courageous people, the parents and the kids. I hope we see little Efrian again in February.
Wednesday, December 14, 2005
Tuesday, December 13, 2005
Last November, on Thanksgiving Day, I flew to Ecuador to volunteer as a PACU (recovery room) nurse with an American surgical team. Most of the 93 surgeries in our two weeks of work were cleft lip and palate repairs of children. Interplast is a California based group that has been sponsoring surgical missions for almost 40 years. It is not religious or political; it is health care. I felt fortunate to be chosen for a trip and was impressed with Interplast staff and volunteers every step of the way. From the very first contact, every interaction I had with this group was well organized and professional. I kept saying to Dave, "It is as if they have done all of this before."
This year, we are living in Mexico and I have found out about another group here in Puerto Vallarta that is doing similar work. Tomorrow I will volunteer with other members of the International Friendship Club at a local hospital for a three day cleft lip/palate surgery clinic. The surgeons come from Guadalajara and that is about all I know at this point. I may work in the operating room but I really won't know until tomorrow (or Thursday). This group is a little more laid back than Interplast. Not having surgical scrubs or a copy of my license was not a barrier. Just show up, was the reply. We can use your help.
Sunday, December 11, 2005
Neighbor: That barking dog on the stairs is driving me nuts. We were up at 3:00 am this morning throwing rocks at it trying to shut it up.
Dave: Yeah, it doesn't like the cats.
Neighbor: I tried getting it to drink antifreeze but it wouldn't drink it.
Dave: You did?
Neighbor: Yeah, and I went down to the poison store last week but the dog wouldn't eat the poison either. Smart dog.
Dave: The what? The poison store?
Neighbor: Oh, yeah, there's this place that just sells poison. Insects, rodents, whatever. I told the guy I wanted to kill a dog and he asked how big. Then he put a box on the counter and I bought it.
A day or so later, we saw our neighbor at the dog's house with a police officer. He told us that the owner of the dog wouldn't answer the door so the officer wrote up a warning and pushed it under the door. He also said the dog just had puppies.
Friday, December 09, 2005
It would be possible to live here and avoid Mexican food entirely. Everything a gringo could want is available in this town, at one store or another. There are 10 or 20 large grocery stores, including a Sam's Club and WalMart. There are specialized stores for natural foods and ethnic restaurants of many varieties.
But I never get tired of Mexican food. In the summer, when it was too hot to cook, we ate fajitas about five nights a week. Tamales are available at a nearby market, pork, chicken or chile with cheese. You can reheat them in the microwave. Taco stands are on every corner. Limes and juice oranges are plentiful year round, delicious and very cheap. Chiles rellenos, ceviche, guacomole, salsas, corn chips, fresh tortillas, fresh shrimp and tuna and red snapper - what a cuisine! Great tasting and most of it is easy to prepare. Yum!
Time for lunch...
Thursday, December 08, 2005
Wednesday, December 07, 2005
The exchange rate has hovered between 10.4 and 10.7 pesos to the US dollar since we arrived last August. Usually we get pesos from one of many ATMs, using our debit card. Most transactions, like rent, are paid with cash, although credit cards are accepted at many places, including large grocery stores.
We are both retired and have medical coverage for ourselves and the kids through our former employers. Medical care here is generally very good. We haven't looked into whether our insurance will pay for hospitals or doctors here. Hopefully, we won't need to. We have needed antibiotics a couple of times. One bottle of pills cost $9 and the other cost $2; prescriptions were not necessary.
Banking and bill paying is done online and we don't even need to look at our snail mail. We have a friend at home who gathers it up and throws it in a box. Our townhouse is rented and the tenants have deposit slips, so money just appears in the bank. It is like magic!
Restaurants are reasonable, not dirt cheap but cheaper than Juneau by far. A typical meal, say, chiles rellenos, will cost about $6 a plate at an average restaurant. Shrimp is about $9. Another few bucks for drinks and a tip add up to about $30-$35 for Dave, Ray and I to go out for a meal. Taco stands are cheaper and, of course, there are very expensive, elegant restaurants if you want to spend more. Even when we go to the pool or the beach, we end up spending about $25 for drinks and snacks for the three of us.
Tuesday, December 06, 2005
1. Crismas list 1 and 2
2. Questions 2
3. Extra 2
1. Crismas list
Hi santa, this year I am 8 years old and I would like: A Detective Kit, The complet Calvin and Hobbes books 1,2 and 3, A 100 page book on science, A spy Kit inclueding Movment sensors and layzers and more, three tickets to Harry Potter and the Goblet of fire one child and two adults, all the books of Garfield not one, two and three, two scary books, 50 more Yu-Gi-O cards and The Harry potter and the
Monday, December 05, 2005
Now, we are the tourists and we are the ones changing the landscape and the economy. Americans and Canadians number in the thousands in Puerto Vallarta and the surrounding area. Some live here year round and many more come down for the mild winter months. We buy property, we fix it up, our friends come to visit, they buy property... on and on it goes. What was once a fishing village is now a base for large scale resorts and a huge market for second homes. Prices keep rising. People keep pouring in. It is such a great place to be.
So, nothing stays the same and I really do not bemoan change. It is inevitable and some people will be happy and some will not. A few will become rich and many will be unfairly displaced, either legally or economically. A man wrote a local letter to the editor of the English language newspaper outlining the construction of a new harbor in front of his million dollar beachfront home. His point was that proper procedure was not followed and that his property would not be what he bought anymore. But he failed to describe the place as it was 10 years before, when his home and the homes of his fellow Americans did not exist. Surely there were Mexicans who lived there. Do you suppose they are happy that he arrived?
We spent the weekend in Lo de Marcos. It is a town up the coast, beyond Sayulita. It is like hopscotch. Puerto Vallarta gets too big for the quiet beach life. People move to Sayulita. Now Sayulita is crowded, expensive and gentrified so Lo de Marcos will be next. On it's web page, Lo de Marcos says it is "waiting to be discovered". Yep. Get in on the ground floor.