Ollytaytambo to Cusco - 16th to 21st Jan 2018
This post should have been an account of the trials and tribulations of a 4 day hike through the Andes on the Inca Trail, coupled with amazing descriptions of the mystical Machu Picchu - and the fulfillment of a dream of mine for 20+ years. Instead it will tell a very different story. An adventure, for sure, but nothing close to what I had planned, or ever imagined might happen....
I had a bad night, coughing a lot, and preventing both me, and Dee, from sleeping much. But the fun really started for me in the early hours, when I got up to go to the loo. Dee has been in and out of the bathroom all night with tummy trouble, and when I erupted at 4am, it became a revolving door between us. (If you are at all squeamish, stop reading NOW. It's about to get a lot worse...) Diarrhea like I have never known before. My bottom turned into a fountain - albeit not a very pretty one. The amount of water gushing out of me was simultaneously unbelievable and very worrying: I knew I didn't have that much water in my body, it was that bad. It didn't ease up and by 7am at it was clear that there was no way I could do the Inca Trail. Dee popped some Imodium and, trouper that she is, decided she was going no matter what.
As she set off with SJ, Bill and Krystal at 8am, she let Dennis know that I would go back to Cusco with Mike and Kristen later on in the morning. I dragged myself together at 10 o'clock, with constant, urgent dashes to the toilet. Dennis suggested we set off on the planned tour, which wouldn't get us back to Cusco until the evening, and if I couldn't manage the day, he and I would take a taxi directly back to Cusco medical centre.
Off we went. Within 10 minutes of our journey, I started suffering immense stomach cramps and shooting pains through my groin. I tried to hold on, keep calm and silent, but within minutes my vision started blurring - white splodges were appearing in front of everything. "I'm losing my vision" I said a couple of times. Kristen shouted to Dennis in the front seat, who told the driver to pull over. (He told me later that when he asked the driver to stop, the driver didn't want to because the police would get him for stopping on the kerb, so Dennis said "If you don't stop, she'll s**t in your van!" We pulled over immediately.) They slid open the door to the van and sat me down in the doorway. I still couldn't see properly, and the next thing I remember was hearing voices. "Jenny, Jenny, can you hear us?" Dennis and Kristen had caught me as I fainted unconscious into the van. Coming to, I needed to go to the loo - I was such a mess. I squatted down by the van, only to find I'd lost control as I'd fainted. I didn't care, nothing mattered and anyway there wasn't anything except mucus left in me to come out. As awful as it all was, at least it wasn't smelly! Kristen helped me, trying to preserve any shred of dignity I might have had left (although at this point I really don't think I had any...) as she found some clean clothes for me to change into.
Dennis meanwhile had gone chasing after Mike, who, suffering from stomach problems of his own, had raced into a local farmer's cornfield to have a poo! It was like a scene from a bad holiday movie (I'm thinking Inbetweeners...); tourists relieving themselves all over the place, doing wonders for Anglo-Peruvian relations.
We pulled ourselves back into the van, and proceeded on to where Kristen and another group would leave for their tour. Dennis, Mike and I taxied straight to Cusco, an hour's drive away. We made it with a few stops, and thankfully no more accidents.
Dennis arranged for the doctor to come and see me at the hotel, so I waited in his room (I was supposed to be on the Inca Trail, so had no room of my own). An hour later there was a knock at the door. By now my diarrhea looked like a watery spinach soup - what the h*ll is going on?!?!
Dr Eduardo Luna didn't need much time to examine me. My ashen face, diarrhea, and now, vomiting, fever of over 40 degrees, blood pressure (80 over 40) and the gurgling in my lungs was enough for him to say "hospitalisation" pretty quickly. He mentioned pneumonia (which worried me) and told us to get to the clinic within 20 minutes, with all of my things. Little did I realise that this was to be the last I'd see of Hotel Puma or Cusco city.
At the Mac Salud Hospital, I was shown to a private room and immediately the tests started. Bloods, blood pressure, temperature. The results were back within the hour: I was anemic, had the lowest levels of electrolytes and potassium the doctor had ever seen, was severely dehydrated, white blood cell count of 14600 (normal = 10000), very low red cell, hematocrit low (36%). I was sent for an electrocardiogram (ECG) and ultrasound on my heart and a chest x-ray.
The cardiologist and Dr Luna talked a lot - in Spanish, so I was clueless as to what exactly they were saying - and when they started asking whether I'd experienced any chest pain, whether I'd had chest pain the past and what my parents' heart history was, I knew things were not good. Apparently my heart was not functioning properly and the abnormalities were so severe that they thought I might have had a heart attack. Scare number two. Finally they concluded that I probably hadn't, but there was definite cause for concern.
The third scary word - and moreso than pneumonia or heart attack - was ''sepsis'. Dr Luna mentioned this one based on my blood results and, even through the fog of fever, I knew by now that I was in a bad way. I just had to trust that the doctors and nurses could fix me. I was concerned but calm: all the doctors were being so thorough I had to believe that they would figure it out. I was in good hands.
The chest x-ray confirmed severe bronchitis (not pneumonia - thank God) and Dr Luna figured that , my heart problems were probably due low potassium caused by severe dehydration, rather than sepsis. He turned out to be right. Thank God again.
I barely went back to my room. Within minutes I was transferred to the intensive care unit (ICU). Hooked up to intravenous drips, heart monitor, blood pressure monitor, oxygen feed and monitor, the ICU nurses started pumping me with drugs through the multi-valve system running into my forearm. I only remember surrender: to my fever, to the nurses, to the treatment. Dennis had come back to the hospital by now (having tended to Mike), and was with me until I fell asleep, giving my hand a squeeze as he left...
I woke to some good news - my fever was down. The heart monitor still showed uncomfortable irregularities and my heart rhythm dropping too low on the wiggly line above my bed. (Hypokalemia, caused by low potassium, increases the risk of an abnormal heart rhythm, which are often too slow, and can cause cardiac arrest.) However, it was distinctly better than when I was admitted, just not quite right yet. My blood pressure, which had dropped to 70 over 35 yesterday, was hovering around 90 over 50. So the concoction of re-hydration, antibiotics, altitude pills, aspirin, electrolytes and potassium was working. Yea.
Another ECG showed improvement in my heart function, but my T2 was still irregular. My breathing was still fluctuating and fast, my oxygen levels better - but then I was having it piped into my nose! On the plus side, my skin had colour and my stomach cramps had gone. In their place I had some serious growling and gurgling going on. In fact less of a growl, and more of a herd of miniature bison, stampeding from one side of my bloated belly to the other. Back and forth they'd race for 10 to 15 minutes, and then they'd quieten down for half an hour until they got restless and went on the rampage again. Needless to say, the green spinach soup was still flowing - and a stool (if you can even call it that) test confirmed amoebic parasite. With bacterial infection, just to jazz it up a bit.
So there it is. I have amoebic dysentery with bacterial infection, severe bronchitis and acute mountain sickness just to make it all a bit worse. Oh and let's throw thalessemia minor into the mix to exacerbate the effects of the above. Joy.
The next day the bison quieten down - no more stampeding, only trotting around and in a small group. They seem to have lost at least half the herd - I think I've farted them out! I kind of miss them, although I know it's good that they're going. More drugs and more blood tests. The daily - or twice daily - ritual is taking its toll on my arm. I have track marks that would get me access into any crack house in London. But it's the arterial blood tests that I've begun to dislike. Really quite painful and messy.
My white cell count has gone up, and my red cell percentage down - neither of which is good, but my heart rhythm is normal and blood pressure 110 over 70 - my usual. :)
I had another ECG and all were happy that my heart had returned to normal - but just as I'm about to relax there was another small panic around higher than normal coagulant markers in my blood, so off for another ultrasound. Femoral arteries all OK. Phew. But anticoagulants get added to my cocktail of drugs.
Around 2pm a porter comes with a wheelchair. I assumed another scan of some sort so I duly got in it, with nothing but my hospital gown and slippers. No-one speaks any English, so generally I just go with the flow. Although this flow took me downstairs, outside and into a waiting ambulance. No nurse chaperone, I was driven off into the streets of Cusco, with no clue where I was going, no phone and with a driver/porter who spoke only Spanish. We stop on a street corner at what looks to me like a dentists. And he asks me to get out. I have a major meltdown - Dennis had told me that Cusco is the rapist capital of South America and here I am, in a flimsy see-through gown, blanket and slippers, being asked by a strange guy to walk across the pavement and go into a dentist shop! Objections! Tears! Lots of confusion! A phone call to the hospital administrator, Melissa, who speaks English, apologises and sends a nurse over. (I learnt later that they had had an emergency in ICU which was why no nurse had been able to accompany me originally (the emergency died)). So in I go - besides the dentist on the first floor, the ground floor has an ultrasound clinic and thus my abdomen is examined to check that the parasites haven't torn any holes, and abscesses haven't formed. They haven't. Thank God again.
The nurses welcome me back. They are all so lovely to me, trying to communicate in pidgin English or Google Translate, while still looking after everyone else (I think 4 or 5 of patients) with great care and attention. I'm called either Jennifer, or more frequently, Lady. And, for my part, my hospital Spanish is coming along slowly. They are my angels.
They put me to bed around 8pm and it takes a while to fall asleep. Dennis is away with Kristen and Mike to meet the others at Machu Picchu the next day, so I have had little contact with anyone today, other than the nurses and through the phone. It's very quiet at night and I am more aware of the movements of the automatic blood pressure band wrapped around my right arm. Every half hour or so it inflates and in the still of the night, and maybe partly because of the oxygen tank bubbling like an aquarium quietly behind me, I pretend it's a giant octopus's tentacle, gently wrapping around my arm to give me friendly squeeze. I like it. It's comforting in the still darkness. I imagine it bigger, squeezing my entire torso; Duncan curling up to me to give me a cuddle. I cry silent tears. I miss home.
Day 4. Friday. Things are finally improving; heart, blood pressure, oxygen and breathing are all normal. No diarrhea (or even poo) for 24 hours. White cell count has gone up to 17,000 though, so there's still a war going on inside. It's not quite over yet.
I was well enough to read, learn Spanish and chat to the UK. We had another death in ICU (I found out later that it was very suspicious and possibly the family had tampered with the patient's medication). The doctors also advised me today that I cannot continue on the trip. They want me to go down to sea level once I am discharged, not up to Lake Titicaca (4000m) and La Paz (3800m) where higher altitude, worsening hygiene and fewer medical facilities could reverse my progress with scant options for assistance. I cannot deny that I'm disappointed. It's bad enough missing the Inca Trail and Maccu Picchu, I wasn't expecting that this would effectively end my Peru trip completely. For me it's a double-edged sword. I'll be missing all sorts of exciting stuff, but I want to be well. So I understand and my insurance company, who have arranged all payment for my treatment, are supportive in getting me back to Lima and into a nice hotel to recuperate. And let's face it, I'll be coming back anyway - Macchu Picchu still beckons...
On Saturday the gang (well, the girls) came to visit - my first real visitors besides Dennis, who has been a rock through all of this ordeal. It was great to see them and hear all about the Inca Trail and I'm so glad they all made it, despite their own tummy troubles. It sounded as amazing as I'd imagined. They all left as the nurses prepared for another potassium infusion. My heart had gone a little wonky again, so I needed a top up. New intravenous (the old one was bent and painful) and 3 to 4 hours on a drip. Eugh. Just as I though I was free from needles!! It finished at 9pm and I was bundled into a wheelchair and into my own room. I'm out of ICU!!! 5 days. I'm done. I may even be discharged tomorrow...
And indeed I was. Lungs clear, good to go. It took another day for insurance to sort out flights, medical escort and a check up in Lima, but at lunchtime on Monday I said goodbye to the girls, the nurses and my new dear friend, Dennis. As he said, when I shed a tear on this shoulder, "I'm quite sure we'll see each other again". Switzerland - when he moves there to be with his fiance and daughter. I am sure too.
I had a bad night, coughing a lot, and preventing both me, and Dee, from sleeping much. But the fun really started for me in the early hours, when I got up to go to the loo. Dee has been in and out of the bathroom all night with tummy trouble, and when I erupted at 4am, it became a revolving door between us. (If you are at all squeamish, stop reading NOW. It's about to get a lot worse...) Diarrhea like I have never known before. My bottom turned into a fountain - albeit not a very pretty one. The amount of water gushing out of me was simultaneously unbelievable and very worrying: I knew I didn't have that much water in my body, it was that bad. It didn't ease up and by 7am at it was clear that there was no way I could do the Inca Trail. Dee popped some Imodium and, trouper that she is, decided she was going no matter what.
As she set off with SJ, Bill and Krystal at 8am, she let Dennis know that I would go back to Cusco with Mike and Kristen later on in the morning. I dragged myself together at 10 o'clock, with constant, urgent dashes to the toilet. Dennis suggested we set off on the planned tour, which wouldn't get us back to Cusco until the evening, and if I couldn't manage the day, he and I would take a taxi directly back to Cusco medical centre.
Off we went. Within 10 minutes of our journey, I started suffering immense stomach cramps and shooting pains through my groin. I tried to hold on, keep calm and silent, but within minutes my vision started blurring - white splodges were appearing in front of everything. "I'm losing my vision" I said a couple of times. Kristen shouted to Dennis in the front seat, who told the driver to pull over. (He told me later that when he asked the driver to stop, the driver didn't want to because the police would get him for stopping on the kerb, so Dennis said "If you don't stop, she'll s**t in your van!" We pulled over immediately.) They slid open the door to the van and sat me down in the doorway. I still couldn't see properly, and the next thing I remember was hearing voices. "Jenny, Jenny, can you hear us?" Dennis and Kristen had caught me as I fainted unconscious into the van. Coming to, I needed to go to the loo - I was such a mess. I squatted down by the van, only to find I'd lost control as I'd fainted. I didn't care, nothing mattered and anyway there wasn't anything except mucus left in me to come out. As awful as it all was, at least it wasn't smelly! Kristen helped me, trying to preserve any shred of dignity I might have had left (although at this point I really don't think I had any...) as she found some clean clothes for me to change into.
Dennis meanwhile had gone chasing after Mike, who, suffering from stomach problems of his own, had raced into a local farmer's cornfield to have a poo! It was like a scene from a bad holiday movie (I'm thinking Inbetweeners...); tourists relieving themselves all over the place, doing wonders for Anglo-Peruvian relations.
We pulled ourselves back into the van, and proceeded on to where Kristen and another group would leave for their tour. Dennis, Mike and I taxied straight to Cusco, an hour's drive away. We made it with a few stops, and thankfully no more accidents.
Dennis arranged for the doctor to come and see me at the hotel, so I waited in his room (I was supposed to be on the Inca Trail, so had no room of my own). An hour later there was a knock at the door. By now my diarrhea looked like a watery spinach soup - what the h*ll is going on?!?!
Dr Eduardo Luna didn't need much time to examine me. My ashen face, diarrhea, and now, vomiting, fever of over 40 degrees, blood pressure (80 over 40) and the gurgling in my lungs was enough for him to say "hospitalisation" pretty quickly. He mentioned pneumonia (which worried me) and told us to get to the clinic within 20 minutes, with all of my things. Little did I realise that this was to be the last I'd see of Hotel Puma or Cusco city.
At the Mac Salud Hospital, I was shown to a private room and immediately the tests started. Bloods, blood pressure, temperature. The results were back within the hour: I was anemic, had the lowest levels of electrolytes and potassium the doctor had ever seen, was severely dehydrated, white blood cell count of 14600 (normal = 10000), very low red cell, hematocrit low (36%). I was sent for an electrocardiogram (ECG) and ultrasound on my heart and a chest x-ray.
The cardiologist and Dr Luna talked a lot - in Spanish, so I was clueless as to what exactly they were saying - and when they started asking whether I'd experienced any chest pain, whether I'd had chest pain the past and what my parents' heart history was, I knew things were not good. Apparently my heart was not functioning properly and the abnormalities were so severe that they thought I might have had a heart attack. Scare number two. Finally they concluded that I probably hadn't, but there was definite cause for concern.
The third scary word - and moreso than pneumonia or heart attack - was ''sepsis'. Dr Luna mentioned this one based on my blood results and, even through the fog of fever, I knew by now that I was in a bad way. I just had to trust that the doctors and nurses could fix me. I was concerned but calm: all the doctors were being so thorough I had to believe that they would figure it out. I was in good hands.
The chest x-ray confirmed severe bronchitis (not pneumonia - thank God) and Dr Luna figured that , my heart problems were probably due low potassium caused by severe dehydration, rather than sepsis. He turned out to be right. Thank God again.
I woke to some good news - my fever was down. The heart monitor still showed uncomfortable irregularities and my heart rhythm dropping too low on the wiggly line above my bed. (Hypokalemia, caused by low potassium, increases the risk of an abnormal heart rhythm, which are often too slow, and can cause cardiac arrest.) However, it was distinctly better than when I was admitted, just not quite right yet. My blood pressure, which had dropped to 70 over 35 yesterday, was hovering around 90 over 50. So the concoction of re-hydration, antibiotics, altitude pills, aspirin, electrolytes and potassium was working. Yea.
 |
| Not exactly looking my best! |
So there it is. I have amoebic dysentery with bacterial infection, severe bronchitis and acute mountain sickness just to make it all a bit worse. Oh and let's throw thalessemia minor into the mix to exacerbate the effects of the above. Joy.
The next day the bison quieten down - no more stampeding, only trotting around and in a small group. They seem to have lost at least half the herd - I think I've farted them out! I kind of miss them, although I know it's good that they're going. More drugs and more blood tests. The daily - or twice daily - ritual is taking its toll on my arm. I have track marks that would get me access into any crack house in London. But it's the arterial blood tests that I've begun to dislike. Really quite painful and messy.My white cell count has gone up, and my red cell percentage down - neither of which is good, but my heart rhythm is normal and blood pressure 110 over 70 - my usual. :)
I had another ECG and all were happy that my heart had returned to normal - but just as I'm about to relax there was another small panic around higher than normal coagulant markers in my blood, so off for another ultrasound. Femoral arteries all OK. Phew. But anticoagulants get added to my cocktail of drugs.
Around 2pm a porter comes with a wheelchair. I assumed another scan of some sort so I duly got in it, with nothing but my hospital gown and slippers. No-one speaks any English, so generally I just go with the flow. Although this flow took me downstairs, outside and into a waiting ambulance. No nurse chaperone, I was driven off into the streets of Cusco, with no clue where I was going, no phone and with a driver/porter who spoke only Spanish. We stop on a street corner at what looks to me like a dentists. And he asks me to get out. I have a major meltdown - Dennis had told me that Cusco is the rapist capital of South America and here I am, in a flimsy see-through gown, blanket and slippers, being asked by a strange guy to walk across the pavement and go into a dentist shop! Objections! Tears! Lots of confusion! A phone call to the hospital administrator, Melissa, who speaks English, apologises and sends a nurse over. (I learnt later that they had had an emergency in ICU which was why no nurse had been able to accompany me originally (the emergency died)). So in I go - besides the dentist on the first floor, the ground floor has an ultrasound clinic and thus my abdomen is examined to check that the parasites haven't torn any holes, and abscesses haven't formed. They haven't. Thank God again.
The nurses welcome me back. They are all so lovely to me, trying to communicate in pidgin English or Google Translate, while still looking after everyone else (I think 4 or 5 of patients) with great care and attention. I'm called either Jennifer, or more frequently, Lady. And, for my part, my hospital Spanish is coming along slowly. They are my angels.
They put me to bed around 8pm and it takes a while to fall asleep. Dennis is away with Kristen and Mike to meet the others at Machu Picchu the next day, so I have had little contact with anyone today, other than the nurses and through the phone. It's very quiet at night and I am more aware of the movements of the automatic blood pressure band wrapped around my right arm. Every half hour or so it inflates and in the still of the night, and maybe partly because of the oxygen tank bubbling like an aquarium quietly behind me, I pretend it's a giant octopus's tentacle, gently wrapping around my arm to give me friendly squeeze. I like it. It's comforting in the still darkness. I imagine it bigger, squeezing my entire torso; Duncan curling up to me to give me a cuddle. I cry silent tears. I miss home.
Day 4. Friday. Things are finally improving; heart, blood pressure, oxygen and breathing are all normal. No diarrhea (or even poo) for 24 hours. White cell count has gone up to 17,000 though, so there's still a war going on inside. It's not quite over yet.
I was well enough to read, learn Spanish and chat to the UK. We had another death in ICU (I found out later that it was very suspicious and possibly the family had tampered with the patient's medication). The doctors also advised me today that I cannot continue on the trip. They want me to go down to sea level once I am discharged, not up to Lake Titicaca (4000m) and La Paz (3800m) where higher altitude, worsening hygiene and fewer medical facilities could reverse my progress with scant options for assistance. I cannot deny that I'm disappointed. It's bad enough missing the Inca Trail and Maccu Picchu, I wasn't expecting that this would effectively end my Peru trip completely. For me it's a double-edged sword. I'll be missing all sorts of exciting stuff, but I want to be well. So I understand and my insurance company, who have arranged all payment for my treatment, are supportive in getting me back to Lima and into a nice hotel to recuperate. And let's face it, I'll be coming back anyway - Macchu Picchu still beckons...
On Saturday the gang (well, the girls) came to visit - my first real visitors besides Dennis, who has been a rock through all of this ordeal. It was great to see them and hear all about the Inca Trail and I'm so glad they all made it, despite their own tummy troubles. It sounded as amazing as I'd imagined. They all left as the nurses prepared for another potassium infusion. My heart had gone a little wonky again, so I needed a top up. New intravenous (the old one was bent and painful) and 3 to 4 hours on a drip. Eugh. Just as I though I was free from needles!! It finished at 9pm and I was bundled into a wheelchair and into my own room. I'm out of ICU!!! 5 days. I'm done. I may even be discharged tomorrow...
 |
| View of Cusco from my room |
And indeed I was. Lungs clear, good to go. It took another day for insurance to sort out flights, medical escort and a check up in Lima, but at lunchtime on Monday I said goodbye to the girls, the nurses and my new dear friend, Dennis. As he said, when I shed a tear on this shoulder, "I'm quite sure we'll see each other again". Switzerland - when he moves there to be with his fiance and daughter. I am sure too.
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