Q & A

It’s been a busy year so far at the Chula Vista Resort and Spa. We’ve had illnesses, cancer scares, and various and sundry other medical issues that needed treatment.

I  had the Mexico City Flu, and a couple of precancerous lesions by my right eye that were removed in January. At the same time, our roommate, Todd, had a Shingles outbreak around his right eye. It took about three weeks, but that has resolved, so things are getting back to normal for both of us again.

Our kit-tens, Mollie and Mika, are doing great. Mollie is helping me type right now, so this could take a while. Kit-tens are apparently immune to the flu. And Shingles. They’re still the cutest kit-tens ever.

* * * *

We’ve had visitors in February. Our beautiful and talented oldest daughter, Gwen, and her husband, John, were here for a week. While they were here, we had a major plumbing problem with the kitchen sink. It started leaking. And then it stopped draining.

I can usually fix most simple plumbing leaks on my own, but this is Mexico. I’m not sure if there are any construction codes in Mexico, and if there are, they’re probably viewed in the same manner that traffic laws are. They’re more like unto suggestions than anything else.

The pipes under the kitchen sink are a perfect example of that.

traffic jam

The plumbing looks something like unto this…

So I called Jaime Mendoza, our property manager, and he called Tacho, our general fix-it guy. Tacho looked at the weird configuration of pipes and started swearing in Spanish.

“Now you know why I wanted you here.” I said.

It took Tacho two weeks to fix the leak because he would fix one leak, and another one would mysteriously appear. After the first week, we were pretty sure that dynamite would be the best solution because houses in Mexico are made of concrete. But Tacho preserved, and he eventually fixed all of the leaks and cleared out the huge clog from somewhere under the kitchen floor without having to resort to explosives.

* * * *

We also had a couple of issues with our swimming pool. The solar heater stopped heating, and there was a leak in one of the pumps. Those problems took closer to a month to fix because the replacement parts had to be ordered from Guadalajara, and then the repairmen had to be reminded that they had to come back to install the new parts, even though they had the parts that needed to be installed.

There was a defective valve in the solar heater. Once that was replaced, it worked better than it ever has. Our solar heater isn’t the top of the line model, so we ordered five solar heating lilly pads to augment the heater from a guy named Rodrigo. He owns a garden store that sells a lots of pool equipment. We’re going to pick them up later today. The total cost on those is less than $50 US.

And the leaking pump was sorted out with a new gasket.

Mischief. Managed.

* * * *

The heat shields on my propane grill needed to be replaced because they had more or less disintegrated in the eleven years that I’ve been using it. Finding replacement parts for your grill isn’t a big deal in the States. It’s a huge deal in Mexico. The easiest way to replace the three heat shields here seemed to be to buy a new propane grill, and while a lots of things are way less expensive in Mexico, propane grills aren’t one of them.

And then I met Ed and Kat. Ed is grizzled-looking gringo who kind of retired down here, but still wants to work for some unfathomable reason. Kat may or may not be Ed’s wife. She’s a very attractive Latina, probably thirty years younger than Ed. She has really big eyes, so she’s a lots of fun to talk to.

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I love the Google Image Search!

Ed opened a shop called Baja Grills that sells propane grills and smokers. And fishing bait and supplies. And hot tubs. And fireplace inserts. And stuff…  He didn’t have the replacement heat shields I needed, so he made new ones for me. They probably cost me $60 US. 

Winter in the Lakeside Area lasts about a month — from the middle of December to the middle of January. It doesn’t get freezing-ass cold here, but there’s about a ten degree difference between the outside temperature and the temperature inside of the cavernous gringo mansion we’re renting.

It’s colder inside of our house than it is outside. We have three gas fireplaces at the Chula Vista Resort and Spa, but none of them have the requisite inserts that make them functionable. Probably because propane fireplace inserts are outrageously expensive down here, too. 

We have three portable propane heaters that we use during the coldest month of Winter. But one of Ed and Kat’s fireplace inserts might work perfectly in our living room fireplace. Lea and I are going to go take a closer look at it later today…  It’ll all depend on what kind of deal we can get.

* * * *

And there’s been golf. Todd and I play at least three times a week, sometimes more often depending on how we feel. So far, we tend to take turns having reasonably decent rounds of golf. Last Sunday, we played 36 holes of golf. I beat Todd by three strokes on the front nine with an 89. We both shot 88 on the second 18.

Yesterday, we both sucked.

I started playing golf back in my thirties because it was the only way I could talk with my dad. He loved to play golf, and he was a wicked good golfer. My favorite part about golf back then was I could drink beer and smoke cigarettes while I golfed. And there was that whole hitting the shit out of a little white ball thing…

The more I golf, the less it resembles what I thought it was in my youth. “Good golfers hit the ball as hard as they can. Great golfers hit the ball as hard as they need to.” I can’t remember who said that, but he was right. I would add this: Good golfers have a strategy. Great golfers are able to execute it. 

Golf is like unto playing chess with an opponent that never moves any of its pieces. Hitting the shit out of a little white ball has become the least important part of my game anymore.

Strategy was something I had no concept of until I started playing in the Go-Go tournaments at my country club. Go-Go is like unto regular golf, except with a twist. Or two. And that’s where all the strategy comes into play. I would like to take this opportunity to thank Dave Naisby and Bill Merrell. They’re the guys that organize and coordinate the Go-Go tournaments at the Country Club de Chapala.

I can’t say they’ve made me a good golfer, but I suck a whole lots less than I did three years ago.

And then there’s that whole balance thing. I need to be physically relaxed when I hit a golf ball because my fucked up back can take only so much abuse. If my swing isn’t relaxed and fluid, I’m going to be in for a long and very painful day. But my mind has to be laser-focused because half of this game is 90% mental. And trust me when I say this: I can be too relaxed when I golf sometimes, and that’s not good.

It’s an odd set of contradictions that I have to manage every time I pick up a golf club. Sometimes it works very well. And those are the days that keep me coming back for more abuse.

It’s kind of like being a psych nurse, except the pay is worse. But you meet way fewer assholes.

* * * *

I’ve spent a few days trying to imagine this post as a question and answer piece about my nursing career. Or just a question and answer thing about anything. There’s one major obstacle to this concept. No one ever asks me anything about being a nurse. Come to think of it, they don’t ask me about much of anything else either.

So if I’m going to do this, it’s going to be all my imagination.

There’s one compelling reason for me to go down this road. A couple of my former patients have been on my mind lately. And I’ve learned not to ignore those things when they happen.

* * * *

What was the most heartbreaking thing that happened when you were a nurse?

The suicides. I was a psych nurse for thirty years. I couldn’t tell you how many of the people I had a role in caring for killed themselves after they were discharged from the hospital. There were dozens of them. In 1990, twelve Vietnam veterans at the MVAMC took their lives in one month.

I remember my first patient who took his life at the Minnesota State Hospital in Anoka. He drowned himself in the Rum River. I remember the last one, too. He was at St. Luke’s in Phoenix. He had had a stroke, and the day before he was discharged he met with everyone on the evening shift to thank them and say goodbye. He shot himself two days later.

And I vividly remember each of the five patients that killed themselves while they were still in the hospital. Those are things you never forget, no matter how much you try. If I exclude the suicides, there’s one person who jumps to the top of the list. That said, I probably have a hundred stories similar to hers.

* * * *

Her name was Audrey. I met her at the Minneapolis VAMC. She was a sweet woman in her forties. She was admitted for depression, and if I remember correctly, a lengthy list of somatic complaints. She was a cancer survivor, so one possibility was her cancer had returned.

As I’ve said before, diagnosing is essentially a process of ruling out all of the things that aren’t wrong with you until your doctor figures out what’s left. The first thing her doctor did was order a full body CT scan.

One of the great things about working at the VA was the ease of doing consults with other specialty clinics. Sometimes the consulting physicians would come to the unit, but usually we had to transport our patients to the various departments, then return them to the unit when their consult was done. 

I was transporting Audrey in a wheelchair to Radiology for her CT Scan. And she told me this story:

“I remember when this began. I had just turned 30 when the pain started. I went to see a doctor. Hell, I went to a lot of doctors. And none of them could find anything wrong with me. One of them said my pain was a figment of my imagination. You know, like I was crazy. After awhile, my friends all started thinking I was crazy. It went on for months. After about a year, even I started thinking I was crazy.

“It was so frustrating. There was nothing wrong with me, but the pain was unbearable. I couldn’t work. I couldn’t sleep. I didn’t have a life. All I did was go from one doctor to the next, only to hear the same fucking thing: All your tests have come back negative. We can’t find anything physically wrong with you…

“And then I was diagnosed with cancer, and this is going to sound really crazy, but I almost felt happy! I think I cried genuine tears of joy when I heard that! I was so relieved because it wasn’t just all in my head. There really was something wrong with me! I wasn’t crazy!! That’s just so fucked up, isn’t it?”

I couldn’t answer her. She looked back over her shoulder to see if I was still there. I was trying unsuccessfully to choke back my tears. 

* * * *

What’s the weirdest thing you saw in your nursing career?

There’s a lots of competition for this one. Lesbian encounters in the night. Guys accidentally getting foreign objects stuck up their asses. Guys jamming foreign objects into their penises. The list goes on. And on…  But the hands down winner has to be the guy that drove his girlfriend from Arizona to Michigan. It doesn’t sound that weird, except she was dead for most of the trip.

I don’t have any other stories like unto this one.

Her name was Christine. She was 31 years old, and was a frequent flyer at Aurora Behavioral Health in Glendale, AZ. She was a dual diagnosis patient, meaning on top of her psychiatric issues she was also chemically dependent. In layman’s terms, Christine was a trainwreck. She was one of the most exhausting patients I’ve ever met, and I wasn’t her nurse. Now that I think about it, she wasn’t even on my unit, and I probably spent more time interacting with her than I did with all of my patients combined. 

Christine lives forever in my Top Five Patients From Hell List.

In June of 2014, Christine was discharged from the hospital. She was picked up by Ray, her 62 year old boyfriend, and Ray’s 93 year old mother. We cheerfully waved goodbye as they all climbed into Ray’s van and headed off to Michigan. We prayed that they all made it there safely and never returned to Arizona again. Ever.

Christine probably accidentally overdosed on her discharge medications by swallowing the entire contents of a bottle of OxyContin on purpose, and then died to death somewhere in Oklahoma. See? I told you she was a trainwreck.

And then the weird part happened. Rather than stop and report what happened to the police, Ray put a pair of sunglasses on her face, placed a teddy bear on her lap, and kept on driving.

Across hot and humid Oklahoma to steamy Missouri, through sweltering Indiana into Illinois — you get the picture– stopping only for gas, fast food and bathroom breaks until he made it to Michigan. And then Ray decided to notify the police that something had happened to his girlfriend. It didn’t take the police long to figure out what was wrong because Christine’s body had begun to decompose. 

Police chose not to press any charges against Ray. Or his mother.

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This is Ray. The story of his road trip made National News. You could look it up on the Google…

* * * *

When I first envisioned this post, I had imagined a lots more questions and a few more stories. And then I realized most of my stories bear a lots of similarities to each other, so there’s that.

It might explain why no one asks me a lots of questions.

Skin Deep

“Beauty is in the eye of the beholder.” ~ Margaret Wolfe Hungerford

“Beauty is only skin deep, but ugly goes clear to the bone.” ~ Mark Edward Rowen

“Love between the ugly is the most beautiful love of all.” ~ Todd Rundgren

* * * *

I went to see a dermatologist for the first time in my life last week. I’m a guy, and guys think about their skin about as often as they think about making a souffle. I was in high school the first time I ever had any appreciation for skin. Even then, it wasn’t my skin that I appreciated. That skin belonged my girlfriend, and what I appreciated most was that she let me touch it.

Women have silken skin, mostly because they think about it all the time and go through great pains to enhance their skin. In 2018, worldwide sales of skin care and other beauty products was in excess of $300 billion. There’s a simple reason for this. Life, if you live long enough, will make you old. But no one wants to look old.

Depending on the study you look at, genetics plays a huge factor in whether or not you have great skin. Or maybe it doesn’t. But it does play a huge part in determining what color your skin is.

I’m not going to elaborate on skin color. I know as much about being non-white as I do about rocket surgery, which is clearly nothing at all. My Muses might have something to say about it someday, but they never submit any of their ideas to me for pre-approval.

* * * *

Possible Little Known Fact About Skin: Your skin is the largest organ of your body, and is the major component of the integumentary system. This system plays multiple roles in maintaining homeostasis.

All body systems work in an interconnected manner to control the internal conditions essential to the function of the body. Your skin is your body’s first line of defense against infection, temperature change, and other challenges to internal balance and equilibrium. 

There’s a reason for that. Your skin is primarily an external organ. Because it’s on the outside of your body, it’s exposed to a plethora of natural and unnatural environmental conditions.

Sun. Wind. Cold. Heat. Biting insects. Bears. Bullets. Paper cuts.

If not for your skin, you probably wouldn’t survive any of them.

* * * *

This is all really cool and stuff, dude. But aren’t you going to tell us why you went to see a dermatologist? I mean, it kind of seemed like that’s where you were headed with this, weren’t you?

Um, yeah. I probably was. So, thanks for getting me back on track.

Right around Christmas, I developed a crusty patch of skin in my right eyebrow. Just about the time I was on vacation from being retired and came down with the Mexico City flu, it started itching. I’m a nurse, so I have an impressive array of ointments for just about everything. I put a dab of this on it, then a dollop of that. And a strange thing happened. The itch didn’t go away. It got worse.

That’s when I became convinced that I had skin cancer.

* * * *

Nurses have a vast array of superpowers, not the least of which is the ability to put up with an endless supply of bullshit from doctors and patients simultaneously. Nurses are poised to assume the worst about almost anything. So when something goes wrong with our bodies we tend to think we’re going to got dead.

Granted, we’re not always correct with our diagnosis of imminent death, but doctors aren’t always correct either when they tell you there’s nothing seriously wrong with you, so there’s that.

I think this penchant for assuming the worst thing has something to do with nursing school. Being a nursing student makes you almost totally paranoid. Not everyone is designed to be a nurse, so a good portion of nursing school seems to be designed to cull out those individuals. When everyone really is out to get you, it’s not paranoia. It’s just good thinking.

Before you become a nurse you might have a vague idea about some of the things that can go wrong with your body and kill you to death. However, by the time you graduate and become a nurse, you have an extensive knowledge of not only deadly infectious diseases, but a few hundred other killer conditions and fatal processes that you didn’t even know existed. And one of the things we learn is almost every killer disease or ailment starts out looking or feeling like something totally harmless and innocuous.

Nurses are trained to be compassionate and caring. We tend to identify closely with whatever our patients are experiencing. Almost everyone I went to school with was convinced they had whatever their patients had. When I was going through my OB/GYN rotation, I was pretty sure I was pregnant.

* * * *

I actually told that to one of my instructors. Not my OB/GYN instructor. That was Sister Mary Hitler, and we weren’t that close. It might have been Kathy Ohman. She once told me that I intimidated the hell out of her, so I felt very comfortable around her. She told me her theory about the caring, compassionate nature of nursing students. And then she said this:

“Almost every one of my students has believed they’ve come down with whatever illness their patient has. But you don’t strike me as being an overly caring guy. Don’t get me wrong, I think you’re one of the best students I’ve ever had, but you don’t fall into the same category as most of young girls that become nurses.”

“So, what category do you think I fall into then?” I decided to ask.

“Oh, that’s easy.” she replied. “You’re just crazy.”

* * * *

Skin cancer is one of the most common types of cancer, and it’s most commonly caused by overexposure to ultraviolet light. Our sun produces three different types of UV rays. Coincidentally, there are three types of skin cancer.

I’ve never been one of those people who laid in the sun trying to get the perfect tan. For one thing, I don’t turn a luscious golden brown in the sun. I burn, baby, burn, and look like unto a boiled lobster. Only worse.

PROD-Sunburn

See? I told you

However, I have become person who wanders around a golf course looking for a little white ball in the bright light of day. I don’t always use sunscreen, but I always wear a hat when I golf.

Altitude and proximity to the equator increase the intensity of the UV rays. The Chula Vista Resort and Spa is 5000 feet above sea level, and about 1400 miles north of the equator.

I don’t know how that compares to wherever it is that you might be, but I can tell you this: the sun here is very intense no matter what season it is.

* * * *

I made an appointment at the Dermika Centro Dermatologico Ajijic with Dra. Tania Sánchez Tenorio. I almost wished there was a lots of stuff wrong with my skin so I would have to see her more than once. She’s a tall, skinny, young supermodel that just happens to be a doctor. 

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But she doesn’t wear a bikini at the office, which is a shame because she has great skin

Dra. Tania listened to my assessment of my problem, then did her own examination.

“You actually have two lesions by your right eye, but they’re not cancerous, they’re precancerous. I can burn them off with liquid nitrogen. The entire procedure will take five minutes and will cost one thousand pesos.”

* * * *

Contrary to popular belief, the healthcare system in Mexico is very good. The doctors here are excellent, and most of them actually listen to their patients. But probably the best part about it is it’s actually affordable.

Getting those two lesions burned off my eyebrow cost me fifty bucks.

Dra. Tania told me to always use a sunscreen with an SPF rating of at least 50 when I golf, so I’ll be adding that to my pre-golf routine. Before I left her office, I asked her what the best treatment for spider bites was.

The previous morning, our roommate, Todd, woke up with what appeared to be two nasty insect bites near his right eye.

She wasn’t at all annoyed that I was hitting her up for free information, and agreed that the treatment I had already suggested to Todd was the best course of action. And then she said this: “But if he doesn’t get better in a couple of days, have him make an appointment with me. Sometimes it’s not a bug bite. It could be Shingles.”

* * * *

Shingles is a viral infection caused by the varicella-zoster virus — the same virus that causes chickenpox. The hallmark symptom of Shingles is an extremely painful rash.

I didn’t think Todd had Shingles. The eruptions on his face looked similar to spider bites that Lea and I have both experienced since moving here. And they looked like that for two days. But on the third day, Todd’s face kind of exploded. So, yeah. He really did have Shingles, and my already high level of esteem for the beautiful Dra. Tania climbed even higher. Which I didn’t think was even possible.

HunchbackOfNotreDameCharlesLaughton

Todd looked like unto Charles Laughton in The Hunchback of Notre Dame

On the rare occasions that he left the house last week, people couldn’t help but stare at him. I tried to reassure them when they asked me, ¿Que pasó con Señor Tadeo?”

I told them, “Creo que tiene lepra.”

* * * *

Leprosy, or Hansen’s Disease, is an infectious disease caused by a slow-growing bacteria called Mycobacterium leprae. Leprosy results in disfiguring skin sores and severe nerve damage, usually in the arms and legs. Eventually, it kills you to death. Leprosy has been around since ancient times, and was once the most terrifying disease in the world.

There’s a reason for that, too. Leprosy was once thought to be very incredibly highly contagious. It turns out that it isn’t, but no one knew that way back in ancient times. As a result, lepers were expelled from their communities and sent to live out the rest of their lives in leper colonies, like, the island of Molokai in Hawaii.

Possible Interesting Sidenote From My Nursing Career: one of my patients at the Minnesota State Hospital was on an obscure medication called Orap (pimozide). When I looked it up to learn more about it, one of its indications for use was the treatment of leprosy.

It’s weird the things you remember sometimes…

* * * *

In closing, love the skin you’re in. Unless you were Michael Jackson, there’s nothing you can do to change its appearance. The older you get, the more fragile your skin becomes, so be good to yourself. Use a good sunscreen if you’re going to be in the sun for an extended period of time. And drink a lots of water. Your skin will love you for that.

And watch out for paper cuts…