145. A Heat Exhaustion Adventure

Previously in Costa Breeze:

If you didn't read our prior blog post 144. More Firsts: Some Good, Some Bad, I strongly recommend that you start there.  Otherwise, you won't follow what is going on here.  

To be brief, on Friday 1/26, Ramie over-worked himself helping our friends at the shipping company unload a container, and found himself in the Emergency Room at about 9pm and suffering from extreme heat exhaustion, and was required to spend the night to get pumped full of IV fluids and monitoring.  The hospital that we brought him to was a public hospital, not a private hospital like we went to when he had the problem with his knee, and instead of putting tonight's patients in the shared hospital rooms, Ramie found himself on a gurney, bunked out in the main hall of the hospital along with 3 other guys.

Saturday 1/27- Having his bed right in the middle of all of the commotion of the nurses station, Ramie slept like crap and only got to sleep in cat-nap style. The nurses were laughing and talking all night, playing music, and tending to other patients, not to mention he was in the hallway so the lights were on all night. Around 5am there was a shift change and, being in the hallway next to the nurses station every time a new staff member walked by they would greet everyone in the vicinity with a “buenos dias”, including the patients. Ramie just laid there with his eyes closed, still very tired and trying to rest more, but every time he heard “buenos dias” he would just say it back. There was no point trying to sleep any longer. At around 5:30 I got a text message from him saying that he was awake, which was ok though because I was awake at about 5 and also laying in bed trying and not succeeding to sleep some more. He told me that he was still exhausted, but he was feeling significantly better than he had been last night and was ready to come home and relax in a more comfortable place later on today.

Around 6 am a nurse came and to take his blood but didn’t try to talk to him at all about the plan for the morning, and at about 6:45 am he got breakfast, which consisted of the typical breakfast mix of rice and beans with a slice of cheese and a fried plantain and coffee. 

Mmm, coffee sounded great after the crappy sleep, but it turns out that they put sugar in it. Ramie is NOT a fan of sugar in his coffee, but he choked it down for that little kick of caffeine. By 8:30 here were still no signs of any specialists or doctors around, the nurses had spent the morning tending to patients but they seemed to disappear as well, so we had no new updates and were just on hold until someone with some authority showed up at the hospital. I got a message from Loren who was ready to drive me back down to the hospital to pick up Ramie and had to let him know that so far there has been no forward movement and we don’t know when we’ll be able to pick him up. Loren insisted that he had no important plans for the day and to just keep him in the loop whenever it’s time to go get Ramie, and he’ll be on his way.

It’s been almost 3 years since I’ve drove a car so the joke is, do I even remember how to drive anymore? I think I would do just fine, but I’m not 100% certain where the turn off of the highway is since it was dark and raining last night when we were down there. Loren was willing to help us out and once again, I wasn’t going to argue with him. Finally, around 10 I got a message from Ramie saying that they hooked up another IV bag, but they still haven’t tried to talk to him about anything yet. Communication is NOT a strong suit down here whether at the hospital or anywhere else for that matter. At one point Ramie did try to talk to the nurse about what was happening and she just told him that it would take about 6 hours to get whole bag of electrolyte fluid, but that’s all of the information he could get. Right around noon lunch was served, he got some more rice and beans (this time separate and next to each other on the plate instead of mixed together), with a small fish filet and some steamed veggies. 


Ramie and I were chit chatting back and forth all day while he was still parked in his hospital gurney near the nurses station. He said that at least he got to do some people-watching for entertainment while he was stuck here. 

Finally, around 1:30 pm Ramie got to talk to an actual doctor who explained that Ramie’s levels were getting better but that he still needed to finish this bag of IV fluid which was only about half gone. He asked the doctor how long that would take and was told that it probably wouldn't be until around midnight. The doctor also wouldn’t say whether Ramie would be released in the middle of the night but hinted that it would probably best to spend another night and get released on Sunday morning. The doctor did mention that this electrolyte concoction that they are giving him in metered doses is helping to help get his Kidney test numbers back to normal, but sine they were so high last night it will take time to get them back down to levels that they want to see.

Sometime mid-morning when we realized I wouldn’t be picking Ramie up early in the day I decided to make the day productive by putting in a few hours of work at the tax prep job as well as continuing to do some chores around the house. Oh, and I should mention here, I have been remembering (with the help of strategically set alarms on my phone) to continue to water the concrete so it wouldn’t crack since the project manager (Ramie) who would have been in charge of this task was out of commission. 


Spotted this little beauty on such a gloomy occasion

 
It wasn't long after Ramie talked to the doctor this afternoon that the hospital started to get busy. They must have needed the hallway space for all of the new patience and our guess is that since it was decided that Ramie would be spending another night, they finally brought him into a room. With the upgrade to a shared room with a curtain, they also gave him some soap to shower and a fresh change of hospital clothes. After Ramie telling me all day that he didn’t need me to come down and bring him anything, at about 2:45 we decided that I’d bring him some supplies for another overnight, including another change of clothes, his toothbrush, some snacks, a water bottle (because they aren’t very good at refilling his little cup of water by the bed), and a phone charger because his phone was on the verge of dying for the last 2 hours and he would get too bored if he couldn’t use it, especially now since they took away the people watching of the hallway.

I also decided that this would be a good way to have Loren bring me down to the hospital, I could see where the turn off the highway is, and then insist to Loren that I’d be able to go pick Ramie up tomorrow morning myself. I messaged Loren the new plan and he was on board and ready to go in no-time. So quickly, in fact, that he once again showed up at the house while I was still gathering the supplies that Ramie requested. Loren came prepared this time, though, with a pillow and his computer and told me that I could spend as much time as I needed in the hospital with Ramie while Loren waited in the car. I didn’t plan to spend long but it was nice to know that Loren wasn’t in a rush to get back home. Ramie and I spent probably an hour talking, trying to stave off the boredom, and it was close to 4:30, when I left. I was able to convince Loren on the drive back to let me take the car home tonight so that if I felt comfortable tomorrow, I could drive down to pick Ramie up. Loren insisted that he would have been very happy to drive us again, but I insisted that I needed to be a big-girl and get comfortable driving again so that I can I am confident that I can if the need arises. It truly was a very easy drive, a straight shot down the highway for about a half hour. I assured him that if I didn’t feel comfortable tomorrow when the time came, I could just stop and pick Loren up from their house and he would drive me.

He looks so much better and has color back.

Around 6:00 they brought Ramie his dinner of more rice and beans, potatoes and veggies. No meat with it this time, boy would I suffer on my diet in one of these public hospitals!! (I would definitely be sending Ramie out to smuggle in some food that wouldn’t make me continue to feel like garbage!!). 

I would be spending another quiet overnight by myself, and I know that Skye was missing her rough play time with dad since I just don’t do it the same as he does. 

Mom, that's not how we play this game!
 
Sunday 1/28- I Woke up Sunday morning with a text from Ramie saying that they hooked up another IV bag around 5:45 this morning. Ramie told me that his only words to the nurse were, “Oh no, mas!” (oh no, more). We didn’t have a great feeling about the start to this morning because the other 2 bags seemed to take about 12 hours each to finish. I want him to get healthy again, but isn’t there a way that he can do something from the comfort of home!?

Around 6:45 they drew blood for another lab test and I think we were both settling in for another long day of waiting for the next doctor to make the next decision. They also brought him breakfast. You guessed it rice and beans. He also thought yogurt, he took a big bite and realized quickly it was mayo. 

All of a sudden, out of the blue at about 8am Ramie sent a text saying “come get me”. Wow, that went quickly! Ramie said that he finally got to talk to the doctor who told him that his kidney levels that should have a “normal” level around 200, that started at 1500 on Friday night and was still over 1000 on Saturday was now down to 500. Clearly, you can see that this is an improvement. The doctor gave him some prescriptions to take during the rest of the week with strict orders to take it very easy for at least a week, probably more, and stay out of the sun. Ramie made sure to ask if he should be concerned about any long term damage to his kidneys and the doctor said that everything will be ok.

After getting Ramie’s text I was out the door in under 10 minutes and had a half hour drive ahead of me. Remember when I mentioned that I’ve only driven the truck once here in CR, well, I didn’t mention that the prior drive was only about 1 mile from town to our house, and last night’s drive from Lorens house to ours was only about 2 miles. This would be the first one of any length. The drive was so easy though, it reminded me of MN county roads, just much curvier & hillier and I had no problems at all driving or getting used to our truck. When I got to the hospital Ramie was already waiting outside in the shade. As I expected, Ramie hopped in the driver's seat and drove home from the hospital. I took a look at the prescriptions that he left with and it turns out that it was Tylenol and electrolyte drink powder. Well, I guess they wanted the patients to leave prepared.

Oh, I don’t think I’ve mentioned it yet, but since we are now residents, and this was a public hospital, none of this cost us anything out of pocket. Not the ER visit, not the 2 nights hospital stay, not even the prescriptions that he got to take home. As residents, we pay into the system every month, and this is one of the things that we get the benefit of in return. You can visit regular clinics for free too, but that is a whole different process. From what I’ve heard, getting an appointment can take 6-12 months to get in, even longer if it’s for a specialist. You can also just show up for one of the walk-in appointments, but unless you are there early in the morning and get in line, chances are you might not get seen today. It’s great that none of this costs any extra, but if time is of the essence, you’re better off paying out of pocket at one of the private clinics.

We were home by about 9:15 and ready to start taking care of things that needed to be done around the house. One of the things that we had to do today was to cut up the big chunk of beef loin that we bought on Thursday when we went to San Isidro. You see, steak is very expensive here, but we found good quality beef loins at the restaurant supply store, and we cut them into our own steaks. I always let him cut these since he knows exactly how thick he likes them, so I didn’t take care of that chore while he was not home. We quickly discovered that now, or at least today, he is very temperature sensitive. He thought the meat felt like it was nearly frozen and thought something was wrong with the refrigerator, but when I checked it, I found that the meat was not extra cold, it was just regular fridge temp, and Ramie just had the sensation of extra cold. Hopefully this isn’t a side-effect that sticks around long-term, but I have heard that suffering from a heat injury is much like suffering from frostbite, and that you might have lasting effects. Fingers crossed we have no such long-lasting problems. 


Monday 1/29-Friday 2/2- We didn’t have much going on this week, which was very good for both of us. The concrete is cured enough we no longer have to water it and we can park drive on it. Tax season is kicking off, so I have some work coming in from the tax prep job, but I was starting to dig in some more on the new job as well. As you can imagine, since it’s a new company, everything is still a learning process since every company does things just a little bit differently. I’m learning how they do things, they’re learning what I know, and there’s a lot of trying to figure it all out.

Ramie started the week off very gradually. On Monday he was still pretty wiped out. He hung the laundry out on the line and was sweating and tired by the time he was finished with that. As the week went on, by Wednesday he was feeling well enough to dig in the yard and move some dirt now that the concrete was done, but only for about 45 minutes. He could tell that he felt worn out much more quickly than he had before, but this was absolutely understandable because he truly was still recovering.

Friday 2/2- Little by little, the rest of the week Ramie increased his activity level and by Friday he was feeling much better than he had a week earlier. Even though the doctors at the hospital never mentioned a need to have additional lab work done to see where his levels were at, we wanted to know how he was recovering and decided that he would go to a private lab nearby to have the levels that were so elevated in the hospital re-checked now that he had been recovering for a few more days. There is a lab in Dominical that Tracy has used before for tests, so that’s where we went. Ramie had exchanged messages with them previously to determine what tests he needed and to make sure that they offered them. When we got there the whole process took less than 15 minutes: he walked in, they drew some blood, and we were on our way. Later the same afternoon he got an email with the results, and we were very happy to learn that the high levels were all were they are supposed to be or very close to it. 

Well, now that this is behind us, I am very skeptical about ever letting Ramie go work for the shipping company again, this is the 2nd time he’s hurt himself there and I just don’t trust that there won’t be a 3rd. We shall see what happens the next time they ask him to come help…

Pura Vida!



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