9/30/22: Tikal, Guatemala & Putting Humpty Dumpty Back Together Again!

 

As Steven and I strolled past the pastel-colored buildings in the island town of Flores, Guatemala toward Lago de Peten Itza, memories of the Mediterranean came to mind. Flores was founded on a peten or island by the Itzaes who moved here after being expelled from Chichen Itza on Mexico's Yucatan Peninsula.

We were so looking forward to discovering the town's charms and rooftop restaurants before touring more of the country and Central America in the next seven weeks. But a tour of the famous Maya ruins at Tikal National Park was our first stop as we couldn't resist the lure of walking amid temples, both uncovered and partially restored, beneath a dense canopy of the rainforest in northern Guatemala.

Peten translates to English as 'Islands on the Water.'

Lago de Peten Itza is the third-largest lake in Guatemala measuring 50 km long, 11 km wide, and 170 m deep. Viewed from above, it looks like a giant crocodile!

On the two-plus hour ride to the park, our guide, Ruben, mentioned that Tikal was located on a low hill away from the surrounding swampy ground. This high terrain and the abundance of flint may have explained why the Mayas settled here around 700 BC. The valuable stone was used to make tools, clubs, and spear points and was traded for other goods. Within 200 years, the Mayas, who
were the first to deforest the land, built first stone ceremonial structures, and then their cities at Tikal.

Tikal is located in a Biosphere Reserve with animals galore, according to Ruben. The Animal Crossing sign was certainly no joke as just moments later the driver spotted an anteater high in the trees. Don't know what that meant for his driving, mind you!

By around 250 AD, when Tikal had become an important religious, cultural, and commercial city with a large population, it was ruled by King Yax Ehb Xoc. He is considered to be the founder of the dynasty that ruled Tikal thereafter. Twenty million people lived in Mesoamerica at the same time.

Staying on the path and doing our best to ignore the crocodiles seemed smart as our tour entered the park!

The Ceiba pentandra or kapok tree was Guatemala's national tree and was known as the sacred tree of the Mayas as it stood at the center of the earth connecting the terrestrial and spirit worlds. Its branches represented the heavens and its roots, the underworld.

This was the first of four pyramids at Tikal we, or at least Steven, planned to climb that day. Since I broke both feet in separate accidents in less than a year about five years ago, I've left it to Steven to do climbs like this as I no longer trusted my balance. Each of the Tikal pyramids was symmetrical and all had flat tops.

Seeing Steven climb the pyramid to the top gave me the heebie jeebies.

Throughout the park, we spotted spider monkeys pulling their weight by their tails as they swung from tree to tree.

Ruben noted that 85 percent of the national park was like this. Archaeologists have agreed that it's better to leave the hills as is because the limestone is so porous and, after all, there are 300 other places to visit in Tikal!

Parts of the forest floor were muddy but I didn't pay much attention to that then.

We walked in the footsteps of the Mayas on the original Maya Road to the Gran Plaza.

The 45m tall Gran Jaguar or Temple 1 was the most famous and most excavated temple in northern Guatemala. Ruben said the temple had been built to honor and bury King Ah Cacao in the early 700s AD. Its tunnels had been filled with 180 jade objects, pearls, and 90 pieces of bone covered in hieroglyphs. At the top, was an enclosure or roofcomb with three rooms covered by an arch that crowned the temple. If we'd been there in the afternoon, we should have been able to see the figure of a seated dignitary illuminated by the sun!

South and east of the Gran Plaza where Ruben and our tour stood was the Acropolis Central, a maze of courtyards, little rooms, and small temples that some believe may have been a palace where Tikal's grand nobles lived. But based on the graffiti found, others believe the rooms might have been used for sacred rites and ceremonies.

Ruben emphasized there were no sacrifices in this ball court, just spiritual ceremonies, unlike other Maya sites where both winners and losers might be killed depending on the game.

We climbed a good piece to catch this view across the Gran Plaza and beyond the thatched rooves to the North Acropolis.

Maya Resistance Day is celebrated each October 12 in this sacred spot in the center of the plaza to commemorate when Spaniards invaded the Maya people in 1492.

At 70m tall, Temple IV was the highest temple in Tikal.

Coatimundis were everywhere. 

This one's for you, Janina!

We walked through the jungle to Temple Talud-Tablero which received its name from a horizontal panel or tablero above a steeply sloping wall or talud. This constructive system is normally used for the correct vertical and horizontal distribution of the load.

Even I climbed a gazillion stairs to reach the top of the viewing platform for stunning views of the Maya ruins in every direction!

At about 1, probably not ten minutes later when we were again walking on a jungle path did I slip on some mud, and down I went and was unable to move. I knew immediately something serious had happened when my left leg began to swell up like a balloon above my knee. Ruben, our guide, used his radio to call the national park office for an ambulance to be sent to our spot. When a pickup truck arrived 30 minutes later and I was asked to climb into its truck bed, I said, uhh uhh, no can do. Back it went to the park entrance and an 'ambulance' arrived a good while later. 

I literally owe my life to Ruben because he insisted I be taken to the private and not the public hospital in Santa Elena, Flores' humbler sister town on the mainland. Steven and a young man accompanied me in the ambulance for the almost three-hour journey on mostly rocky roads. Thank goodness, I didn't need an infusion or any immediate medical care as there were NO medical provisions or medical supervision at all in what passed for an ambulance.

However, I prefer to focus on the many ways I was truly blessed that day. I happened to fall in an area of the national park where the ambulance could reach me and not atop the viewing platform or in a narrow passage we had walked not long before. When we booked the trip to Tikal, we thought it was only a pick-up in Flores, dropoff at the park entrance, and a ride back later to Flores. Instead, Ruben was our tour guide for the entire time. That meant I had someone watching out for me from the moment I fell until I was transported to Santa Elena.

God was with me as the English-speaking hospital administrator, himself a surgeon, was there when I arrived and immediately made sure I had the best care available from then until the moment I left the hospital. After an x-ray determined I had a broken femur, we knew it required immediate surgery that night. Steven quickly notified our four children, one living in each US timezone, and also my four brothers in my hometown of Ottawa, Canada.

Steven and I remember clearly after the phone calls and WhatsApp messages were sent, his helping an aide push my gurney up a long ramp as if we were in a circular parking lot to outside the surgical room and seeing the surgeon and someone else just sitting on the floor with their backs up against the wall of a small room waiting for a long time. That was really nerve-wracking as you might imagine and didn't exactly inspire confidence in my upcoming surgery. Because of the language barrier, it took a while before we learned they were waiting for the medical instruments to be cleaned. The surgery entailed placing one rod from my hip to above my knee, my receiving two units of blood, and four screws to support the rod during the four-hour surgery. Because I didn't receive a general anesthetic, I was semi-conscious throughout. I NEVER want to hear the sound of a staple gun punching staples up and down my leg again!

It was bloody scary when the hospital administrator told Steven before my surgery he might risk his life from the gangs if he left the hospital in Santa Elena by himself to return across the causeway to our hotel in Flores. Once surgery had started, Steven did return to our hotel in Flores but only as the passenger in an ambulance to pick up his meds and a change of clothing before being escorted back to the hospital and sharing the extra bed in my room. He took a tuk-tuk the next morning when it was safer to retrieve the rest of our belongings. Not surprisingly, I was always very apprehensive when Steven left the hospital grounds in the next few days to go buy some pop or crackers at the store across from the hospital.

The next day, I obviously wasn't in too much pain as I was burning up the phone wires calling our children and my brothers to give them updates! Steven spent his time canceling all our upcoming hotel, travel, and tour reservations for the remaining seven weeks of our trip. What a huge pain that was for him. 

A few days later, the hospital administrator instructed the surgeon to personally remove my bandages and see to my wound care. I cannot even imagine any surgeon in the US kneeling on the floor by a patient to do that. I later joked that the surgery ruined my leg modeling career - oops, I never was a leg model! Again, Steven and I were incredibly thankful to have received the best care possible in the circumstances. Even Ruben, our guide, came in to check on me and say that the rest of the small group had wished me well!

The administrator/surgeon was beyond incredible in my opinion. He made it a point of popping in at least three times a day to check on me and tell us in English all that was happening. We made sure he knew he was always welcome to stay in our home if he was ever in Denver.

Once I was cleared to travel for no more than a five-hour flight, the administrator and Steven worked their magic with our travel insurance company and health insurance company for me to be medically evacuated back to a hospital in Denver right away. That was pretty imperative as post-operative care at the hospital was not the standard we're used to in the US. I had no access to the bathroom or commode the entire four days I was at the hospital nor any physical therapy, etc. But, and this is huge, I had been surrounded by the most loving of nurses and aides who treated me with such tenderness the entire time I was at the hospital in Santa Elena. 

Steven and I cannot begin to urge anyone who's traveling out of the country to buy medical evacuation insurance as that saved our financial hide. My new mantra is, if you can afford to travel, you must protect yourself and your loved ones by buying this type of insurance as the cost is extremely moderate. You might never need it but just in case you have it. Consider it like car or home insurance, please.

This was the only time we'd ever been in the jet and I can't say I'd recommend our version of jet travel! But the jet which had been dispatched from Mexico City arrived on the international runway in Santa Elena where a proper ambulance met the crew. They then picked us up in my room where Steven and I, and our bags, fortunately, were all transported to the jet and from there to an airport in the eastern Denver suburbs. Steven joked the jet was so small he could touch stretch out his arms to touch both sides!

Another ambulance met the jet and we were whisked to another hospital room - talk about door-to-door service! I was in the Denver hospital for almost two weeks because of medical complications and also to receive occupational and physical rehab.

Putting Humpty Dumpty back together again: Now, more than nine months later, I am basically back to where I was when I broke the femur in Guatemala. To make a very long story shorter, because my surgery was not done by the insurance plan's orthopedist, I was only ever able to see a physician's assistant or PA from the time I was discharged from the Denver hospital in October until I demanded in March to be seen by an orthopedist. That appointment didn't happen until late April even though beginning in December, my complications from the femur surgery included a stress fracture to my left tibia, bursitis in the left hip, a broken screw, and intermittent intense pain relieved by mega daily doses of acetaminophen. 

Physical therapy was never monitored and had to be interrupted for months with loosely goosey non-weight-bearing instructions because I was only under the care of a physician's assistant the entire time who never consulted with an orthopedist. When I finally did see an orthopedist, he confirmed the broken screw but said that happens. I saw the same orthopedist in mid-June for a follow-up appointment, still experiencing significant pain. Scans showed I had a bridge-to-bone issue which meant the femur bone wasn't aligned and there was a space between the rod and bone. 

Even with all this stuff going on, it's not like the complications 'kept us down on the farm.' With the PA's consent, we still flew out to see our son and family in San Francisco over Christmas, and our new granddaughter in Chicago in March, drove to San Antonio, Texas for three weeks in March/April, and went on a three-week cruise and self-driving trip of Alaska in May. Did family or friends think we were crazy - perhaps BUT the PA and later the surgeon both gave us the go-ahead for each trip. 

But, by early June, our daughter Natalie who works at a hospital in Chicago was finally sick and tired of my saying I wasn't getting better, was in pain, and not seeking other advice. She gave me the proverbial kick in the pants and told me in no uncertain terms to get a second independent opinion as it had been almost nine months and I still couldn't walk without a cane or wheelchair. I took her advice immediately to heart and within ten days, on June 12th, I received authorization to see the trauma surgeon I had chosen at the University of Colorado Health Sciences Center. I thanked my lucky stars I was able to see her on June 19th but because the accident had happened so long ago, she immediately referred me to the head of the university's Limb Restoration surgeon. His only goal is to put Humpty Dumpties like me back together again like new! Miracle of miracles and after almost immediate bloodwork and a CT scan, I was sitting with the limb restoration surgeon just two days later on June 21st. Considering patients come from all over the country to see this surgeon, I was honored to be his patient so quickly.

He confirmed my issues arose from a non-alignment of the bone and were likely due to the rod used during the surgery in Guatemala having been the wrong type. Friends had long asked if I thought the surgeon or the surgery in Guatemala was to blame for my issues and pain and I always said no. I couldn't play the blame game and the what-ifs. I still truly feel I am alive because of what transpired in that hospital. The surgeon, who only does limb restorations detailed the upcoming surgeries I'd likely need and that I'd be 100% non-weight-bearing in a wheelchair for up to six months. Poof - gone immediately were the long trips planned for Florida on June 29th and the trip to Asia this fall. But the prospect of getting back to where I was pre-accident was worth everything I and Steven would have to face.

After the June 19th bloodwork showed possible signs of an infection, I was under the knife for a deep bone biopsy of my left femur on June 26th. The surgeon and his team of sub-specialists, including plastic surgery, radiology, and infectious diseases (because I was diagnosed with something fairly serious back in October) are now all waiting for two weeks for the culture to reveal the path forward. Once the team at UC Health got me under their wing, they certainly proceeded with such lightning speed, my head is spinning so fast!

Getting used to making a meatloaf and vegetable dinner on June 29th, 2023 a little differently!

To say the next few months for both of us will be challenging is the mother of all understatements. I have always been incredibly active and busy on many fronts at once to the point friends refer to me as the Energizer Bunny! Gone are the days I can even use the therapy pool at the local gym, meet my mermaid friends for lunch, others for tea and knitting, or even run errands to help relieve the pressure from Steven. Being in a wheelchair in a home that is not in any way handicapped-accessible also provides other challenges we're trying to cope with. As you will read in the next post, Steven and I have together faced medical challenges before and we will face those ahead, too. 

We have both been so thankful for the delicious meals lovingly made for us and our son; for the Uber Eats card to treat ourselves at local restaurants; for the outpouring of calls from near and far, and for enough cards and flowers to make both the USPS and local florists profitable; for my Jewish friend who asked if she could come over to bake our family's favorite Christmas cookies on two weekends while I 'supervised' during one of my non-weight-bearing bouts; for friends who drove me to the therapy pool or to Mass every Sunday morning when I couldn't; to the retired orthopedist friend of a friend who willingly reviewed my medical updatess and suggested questions to ask of my new ortho team; to our son, Zachary, who has been an unwavering source of support by asking if he could please drive me to my therapy pool classes which kept me sane in body and spirit, his never failing to call during the day to see how I was doing and if there were anything we needed him to buy on his way home from work; for the understanding of fellow bloggers whose tales of their travel exploits I neglected to read and comment on; and to friends who pop in to say hello or just call and listen to the latest medical wrinkle. I shudder to think where we'd be without each of you to help us through this very long journey. To each, my most heartfelt thanks and love. To Steven, my rock - I know you didn't figure on any of this when we said 'in sickness and in health.' I love you always and forever.

Next post: Going back in time for the last time!

Posted very late on July 3rd, 2023 from our home in suburban Denver which we shall look forward to exploring for the first summertime in about 15 years - another ray of sunshine amid some tough days. Wishing each of you and your loved ones a fun summer whatever you do and wherever you go.