And So it Ended…Goodbye Belize. Adios.

Things had been a little more quiet at work for a few weeks.  I was not complaining about ending my time at Saga Humane Society on a less hectic note.  However, now that the final days were winding down, it was like they could smell that I was leaving.  Everyone was in a panic to see the vet before she left the island for good.

CAUTION, SOME MILDLY GRAPHIC PHOTOS

On Thursday we lined up a nice final snip day.  Thursday is when we did the majority of our free spays and neuters.  Secretly, this was one of my favorite days.  Not because it was all surgery, but because it was mostly human-free.  Merari in reception knows that unless your dog has a leg hanging off or an eye falling out, Thursday is not for appointments.  I could have a break from the regular stress most vets face in dealing with a variety of clients, questions, and personalities.  On this Thursday one of the staff went out into the community to do some errands and to look for any additional animals that might need spay/neuter.  She returned with an owned dog that was already neutered, but clearly was having trouble walking.  I took a look and thought, “What in the H#@*!??”  This dog had a tumor that I had never seen the likes of before.

Foot Mass

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I wasn’t really in the market for new challenges, but as a solo vet you don’t always get to pick and choose. I decided to try using the cautery machine (one of the items purchased for Saga with my fundraiser before I  moved to Belize) to help me to remove it, then suture it closed.

Mass Removed from Paw

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What a relief for this dog!

We also had a fun goodbye lunch that day at one of the beach resorts.  Sitting out looking over the ocean with the whole staff and a few friends.  We never usually had the opportunity for time like this and I cherished it.

Lunch Out

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Friday was my last full day at Saga.  Twenty animals would be looking for medical care (not a record by any means but enough to keep us on our toes). Eight of these needed an exam with deworming and vaccination, simple enough.  One was an anal gland abscess, yes, this is as horrifyingly gross as it sounds, thank you vet gods for deeming this necessary on my second to last day.  We rechecked a recent adoption with a little hair loss and a lot of itch, performing a skin scrape to identify demodex mange and get him on the road to better health.  One dog was losing weight with a good appetite and we sent off some blood work to Belize City on the airplane.  We tested another with one of our quick snap tests to diagnose him with both heartworm and ehrlichia (tick fever) and start some treatment.  I diagnosed one dog with neck pain and sent home medications and strict instructions, while another complained of bloody diarrhea with muscle wasting.  I rechecked a healing leg wound (doing great) and a broken toenail (needed heavy sedation for full removal and cleaning).  The staff brought in an underweight dog that members of the public had been complaining about due to it’s thin appearance.  A very large dog that was rescued from our sister island of Caye Caulker a month prior came in for a recheck.  Although it was amazing that she had gained significant weight, I also noted that her mammary glands looked huge.  We had no way of knowing previously if she was spayed and really she was not an ideal candidate for surgery at the time.  Now it was obvious that she would need surgery the next morning before I left.  As it turned out, which I suspected when I felt her belly, she was in fact NOT pregnant.  She was having pseudopregnancy (where a dog’s body thinks they’re pregnant and makes milk), so once spayed she went on to do well.  We also picked up a really cute friendly tomcat with a swollen leg.  We got him neutered and on medications so that eventually he could go back to ruling his neighborhood (without  making more kittens!).

So, that leaves just one more case.  A dog who had been in a fight with another dog in it’s home a few days earlier.  The owner thought it was more fresh, but after shaving down the neck I would have had to disagree.  The dog had a thick coat and so a wound could easily go unnoticed for awhile.  I suspect the odor eventually gave it away.  Under sedation we shaved some of her face and most of her neck.  There were some old tooth puncture wounds and just a lot of skin infection, like a big bad hot spot.  She went home looking like a mess but I knew that in a few days it would be a lot better.

Friday night I went home.  It was bittersweet knowing that Saturday morning would be my last regular trip to Saga for work, by lunch I would be done.  I put on my pyjamas, got myself a treat, and sat down on the couch.  Then the phone rang.  Sigh.  It was of course Ingrid, it was an emergency.  She told me hesitantly that it was the same dog, bitten again.  The same dog I just fixed up that same day.  I put on a scrub top and biked back to work alone.  There she was, an even bigger mess than before.  The owners looking embarrassed and exasperated.  Although they had gone home and separated them, the other dog had grabbed her through the small slats in the fence.  I let them know how much I didn’t appreciate fixing up the same dog twice in the same day, but they already knew that there would need to be a change at home.  I took the dog and sent them away for the night.  The wound was in the same area and even though there was a lot of blood, it looked small.  A  tear on the back of her neck.

Dog Bite Wound Surrounded by Skin Infection

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It would have been easier with help, but I didn’t really want any.  I just wanted to do it alone.  Once she was under anesthesia it was strangely peaceful.  Just me and the dog.  I needed to shave a little more fur, and not having any sharp clipper available left I tried to channel my inner Ingrid and get it done with a straight blade.  I flushed and explored the wound and found it to be huge under the skin compared to the small tooth hole visible from the outside.  I carefully opened up the whole thing.  Even some of the neck muscles were torn apart.  After flushing and flushing and flushing to clean it, I finally put it all back together like a jigsaw puzzle. Placing dozens and dozens of sutures in multiple layers, finally getting to the skin.  Trying to learn from the results of previous cases, I also immediately placed a drain, hoping that all of the tissues would survive and that no abscess would form.  I gave her pain meds and antibiotics and carried her to a cage to tuck her in so I could go home.  I was tired out when I got back on my bike and pedalled home.

Neck Wound Sutured with Drain

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The next morning would be my last.  I would stay on call for multiple days of emergency but I would not go through my regular work routine again.  I came to Saga and spayed the Great Dane with the milk in her mammary glands from the previous day.  The surgery on this giant breed dog went off without a hitch.  My neck wound dog looked great and was up and about.  I tended to a few appointments and that was it.  At noon I said goodbye, I hugged the staff that had made all this possible, I tried to hold back the tears, and I rode away.  I knew how thankful I was to have had this year in Belize.  How almost no one in my profession would ever get to experience the type of year I just had as a real part of the community of San Pedro.

So many people have thanked me so many times, but it is I who was the lucky one.

 

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“Doctora, You Have an Emergency.” A Year of Waiting for the Phone to Ring.

The voice on the other end of the phone was always calm.  Sometimes too calm.  I often couldn’t tell based on the tone whether she meant that someone had called about a broken toenail, or whether a dog had been run over and now it’s skull was hanging out of it’s scalp.  Honestly it could go either way.

How many times could it happen?  During almost ten years as a veterinarian in Florida I had not spent even 1 minute on call.  I moved to Belize and started a year of being on call 100% of the time.  Only when I left the island was I potentially safe, otherwise all bets were off.  Sometimes I was already at Saga in my time off (bonus, no travel time) but often I was in the shower, on the couch in my pyjamas, scuba diving, running, on my bike, or in the gym.  Sometimes I was asleep in bed. Many times I was eating breakfast at Estels Dine by the Sea on a Sunday morning and once ended up pulling bones out of the business end of a dog then saving a chihuahua from hypoglycemia (low blood sugar) back to back while my visiting friends packed my pancakes into a takeout container.

When I look back, I was pretty lucky.  When I got called out on a weekday night it was rare and usually serious.  Most people (and their pets) let me go about my evenings in peace.  It was much more likely to get called in on my days off, between Saturday at noon and Monday evening.  It was also likely to be a dog, as I saw only six cats and one parrot for an after hours emergency.  I looked back at my log to see how the year panned out.  Some of the cases I will never ever forget, others I could barely recall even seeing it on paper.

Types of After Hours Emergency Visits

C-section (the very first emergency, of course!): 1

Dog Bite (never ending): 11

Intussusception (telescoping intestines requiring major surgery): 1 – Hi Mango!

Sick Young Puppy (many reasons): 6

Abdominal Exploratory (oh Ingrid): 1

Injured Parrot (sore leg): 1

Lame/pain (musculoskeletal including spine, legs, etc.): 12

Fractured Limb (some amputated): 3

Post Surgical Complication (don’t act wild after your neuter): 1

Health Certificate for Travel (the best non-emergency emergency): 3

Distemper (not good): 1

Hypoglycemia: 2

Vomiting +/- diarrhea (includes parvovirus): 11

Acutse Allergic Reaction (can you save hives?!): 1

Dead on Arrival (respiratory, very sad): 1

Euthanasia Requested: 4

Urinary Tract Infection: 1

Decreased Appetite (without much other excitement): 2

Hit by Car: 2

Toxin (don’t let your dog eat marijuana, topical medications like creams, plus some unknowns): 4

Bones stuck in the colon/rectum: 1

Gun Shot (drama): 2

Eye Concern (always emergent): 3

Collapse with Fever: 2

Cough: 1

Needed Injections (after hours): 5

Ruined Bandage (I said keep dry): 1

Cat Bite (to the butt of course): 1

Broken Nail: 1

Pyometra (uterus infection – please spay your females): 1

Liver disease (and yellow): 1

As you can see, some were short and easy, some were terribly complicated and took hours.  Most of these types of cases also came up during our regular clinic hours as well.  In the early days the technician attended all the emergencies with me.  As I got more comfortable in the clinic I would try my best to let her stay home, but not only did Ingrid field almost every call, I often needed her help for surgical cases.  There were cases where her teenage daughter ran for towels and opened my suture, and others where I instructed my boyfriend Mick on how to hold off for me to place an IV catheter.  I could never have gotten through all those cases without periodic help.  I remember recently being alone with an owner and her small dog who had been recently attacked by a large dog.  As I started my exam and pain meds she started looking a little faint and I told her, “Ma’am, deep breath, you’re going to have to hold it together because right now it’s just you and me!”

Some concerns were very popular, like dog bites, others thankfully were more rare.  Only four of my emergency cases ended in euthanasia when it was not the original intention of the owner bringing it in (ie. I had to recommend it).  Three died while I tried to save them (1 uterus infection, 1 gunshot, and 1 toxin).  Of course those are the types I never forget.  Some are very satisfying, like sending a momma dog home alive to her nine puppies after a C-section was done to remove her one deceased puppy.  Others are heartbreaking, like staying up all night and having the dog die despite me.

I will say, that when coming in after hours most people are in a more vulnerable position.  They are often panicked at the condition of their dog.  Sometimes the fix was easy and so it felt good to alleviate their fears and send the dog home for what would likely be an easy recovery.  Other times their severe concern was warranted and I knew it would be touch and go.  Some wounds started as a three hour procedure, but then required a month of aftercare to finally resolve.  Either way, clients were always thankful, grateful, and respectful.  Every single person who hauled me out of bed late at night apologized, even though they didn’t have to.  It was appreciated.

Various After Hours Wounds

Foot pad laceration from yard, machete wound sutured, gunshot to abdomen (did not survive), gunshot to head and neck (partially healed), left front leg amputation due to dog bite.

It always feels good to see these pets feeling good with happy owners later on down the road and know that for some of them, we literally saved their lives.

So, to answer the question of how many times could it happen…ninety-one.  I attended ninety-one after hours emergencies.  It was great experience and honestly was much smoother and less scary than I had envisioned before my arrival.  I learned a lot.  I stretched my abilities.

Who needs sleep and free time anyways?

Run to the End of the World and the Zoo Too!

Twelve weeks had come and gone so fast.  In my spare time I had been training, running, getting read for the End of the World half marathon in Placencia, Belize.  This country’s only half marathon/full marathon.  I love to run, but I knew this island was not really designed for it, so I dedicated my exercise time to my other favorite, Crossfit, and ran but only once or twice each week.  As the year went on though, I really wanted to train for a distance race.  So, back in September, through impossible heat, then rain, through mud, and puddles the size of lakes I ran, tiptoed, and waded my way to my 13.1 mile (21 km) goal.

So the day before the race, we were up and off to what is the beginning of all trips, the ferry.  Somehow we scored a big covered boat and I tried to sleep my way to Belize city.

Ferry Ride

It was then into a rental car for the three and a half hour drive south.  Along the way we stopped in the tiny capital city of Belmopan and finally got to try the infamous Farmhouse Deli for lunch, and it did not disappoint!  Best carrot cake in a long time for sure. I hear they are soon coming to San Pedro.

Farmhouse Deli

The drive down the peninsula into Placencia was also the route for the half marathon, a point to point course starting to the north and ending in the village to the south.  Those running the full marathon would need to start in the village and turn around where I started, then run all the way back again.  We checked into the hotel and settled in for the night.

My alarm went off at 3:55 am on race day.  After eating the breakfast I brought along and double checking that I had everything I needed, I was getting out of the car at the start line before 5 am.  Enough time to check in, use the porta potty, and warm up.  My legs felt good.  Nervously I stood in the dark amongst the strangers at the start line, this would be the fourteenth time that I had lined up for a race of this distance or longer, but still I had the jitters.  Would it be hotter than I thought? Would there be enough water?  Did I run fast enough in those speedwork sessions?

Then we were off.  Immediately I was passed by the majority of the 167 runners in the race.  I was tempted to chase, but of course I knew better.  There was plenty of time for that.  For now I needed to stick to my goal pace.  I was not aiming for a personal best, I didn’t feel that I was in my best running shape.  But I didn’t come to play either, I came to do the best I could without the wheels falling off by mile 9!  Once the dawn broke I could start to see the views.  I soon ran past a private community that looked nothing like the real Belize, houses worth more than entire communities.  I then started to see the ocean on both sides of the peninsula with the sun rising on the left and little mountains behind the ocean on the right.  After having trained on cobblestones and pot holed dirt roads and hard cement slab, the asphalt felt like soft heaven under my feet for the first time in a year.

Race Course Views 

Slowly but surely I began to pass other runners.  I often ran with two young Belizean guys that were near my pace.  Without really knowing it, they helped me a lot by providing a mental distraction to the physical pain.  Soon we were entering the gritty little community of Seine Bight.  The kids were up early on a Sunday morning to cheer us on.  I caught an american tourist from Denver there and stayed with her for a few minutes.  It was still a little too early to push hard if I had to, plenty of miles left for that.  She let me know she thought she was in 4th for the ladies and that made me 5th.  She told me she went out hard to run as far as she could before the sun came up but now she was hurting.  Then I pulled away and she didn’t follow.

Running

Seine Bight

I could see the guys that I was trying to keep up with just ahead, and keeping my same pace I overtook a young Belizean woman who had stayed far ahead of me for about 10 miles but was clearly slowing now in the heat. As we approached the air strip I was feeling good.  The sign here cracked me up, luckily I did not have to pause for a takeoff!

Placencia Airport

“STOP.  All vehicles must give way to aircraft landing and taking off.”

I also ran over at least twenty of these!

Speed Bump

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Soon I could see the finish line, I could hear “Go Sam!” and I sprinted to the end, finishing just a little faster than my goal with an official time of 1:53:15.

This race was not chip timed, it was done the old fashioned way by hand.  So, we had an awards ceremony later after the full marathon finished and up until then the placings were a bit of a surprise.  There was a little drama and a discrepancy and then the disqualification of a runner that had tried to cheat the system.  When all was figured out I was awarded 3rd Overall Female.  A result that I was very satisfied with.  My legs told me that I had tried hard.

Awards

After the race was over, I had a little time to explore and experience Placencia.  The village is an odd configuration of little shops, beach front hotels, and original homes.  The views are spectacular and the people are friendly.  I thought it was a great place to spend a weekend.

Placencia

The following day, I woke up sore.  I had plans though to see one of the last things in Belize that I wanted to do but had not, the Belize Zoo.  We were in the car and headed back north.  The Belize Zoo is a small zoo with a big heart.  They have goals of education, conservation, recreation, and research.  They house only species that live here in Belize and end up with a lot of injured or non-releasable wildlife that would otherwise have nowhere to go.  The zoo and enclosures were heavy in plant life, most being full of natural trees, plants, and flowers.  I got to see and learn about many of our most famous creatures.

Tapir, Belize’s National Animal

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Keel-billed Toucan, Belize’s National Bird

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Harpy Eagle

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Margay

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Jaguar

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Jaguarundi

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The whole weekend was a great experience, but I had a clear favorite memory.  As I sprinted to the finish line of the half marathon sweating and out of breath, the announcer yelled into the megaphone, “Samantha English, San Pedro” and for just a moment I was a Belizean representing my little town.

I couldn’t have been more proud!

The Smile Says it All!

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The Wild Wild West

It started on a quiet Saturday night.  I attended a dinner with the staff to say goodbye to one of our own.  We enjoyed food, drinks, and laughs.  I went home smiling and soon put on my PJ’s and headed to bed.  I awoke at 1:30 am and I was already on the phone.  Somehow I had answered while still asleep.  I quickly recognised those most familiar words, “Doctora, you have an emergency.”  It of course, was Ingrid.  She sounded far too chipper, and I soon found out that she was still awake, having not yet been to bed.  Within five minutes she was at my door, picking me up in the golf cart to drive me to work.  Biking around in the middle of the night would not likely be perceived as “safe”, even by me.

As we arrived I immediately recognized the male owner.  He is a well known local that makes one of my favorite unique island drinks.  He and his wife had returned home from a late night shift to find their small friendly dog having difficulty using its hind legs.  After a thorough exam, I gave an injection as well as some medications and home care instructions and we were all headed home once again.  By 2:30 am I was putting my head back on my pillow, having difficulty falling asleep after all of the excitement.

CAUTION: Some bite wound photos.

At 6:20 am the phone was ringing again, this time I looked at the screen before I answered, a number was listed with no name that my phone recognized.  As I said hello, the voice at the other end sounded panicked.  I knew her right away.  She quickly explained that her neighbor’s dog had been attacked by another larger dog.  I instructed her to send them to the clinic and rolled out of bed.  Pulling a scrub top over my head and exercising my self imposed special right to wear flip flops after hours, I hopped sleepily onto my bike and headed to town.  The owner met me minutes later with a small fluffy dog having bite wounds on both sides of her abdomen.  All I knew was that the dog who bit her dog was not her own.  I quickly realized that I would need help, and so as I sent the owner home, I called for assistance.  The dog was soon under anesthesia in order to clean and better assess her wounds.

Bite Wounds on Right Side

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When it comes to bite wounds there is often more than meets the eye.  On both sides although it appeared like small punctures, they connected to each other with extensive damage to the underlying tissues.  This needed to be opened up and flushed out before being sutured closed.  After a few hours we had everything squared away.  The dog was resting quietly in a cage and I was heading home by 10 am.

Closed Wounds on Left Side

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I stopped on the way to pick up a few groceries, and as I stood in front of the freezer trying to find affordable bacon, the phone began to ring.  I searched my bag and glanced at the screen, Ingrid.  Sigh.  I answered jokingly, wondering what could possibly be wrong now.  “Gunshot”, she explained sounding concerned, “The other dog involved in this morning’s dog bite has been shot.”  I quickly paid my bill and headed back to the clinic.

I arrived back at Saga to evaluate this large dog.  By all reports from all peoples I met, the shooter was yet a third party, but of course that was for the police to sort out, not me. Unfortunately, many hours had passed since she had been injured and no one had noticed until now.  She had been given an injection for pain and we now started emergency IV fluids.  Her heart was racing and she was covered in blood.  We began washing her down to find the location of her wound and soon found a single bullet hole entering her abdomen from the side.

Bullet Hole into Abdomen

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This was obviously not an ideal situation even in the most advanced of clinics.  This was a dog who desperately needed a blood transfusion and surgery and  was not likely stable enough for anesthesia.  We got her to a point where we thought it was best to open her up and explore her wounds.  As I cut her belly open from the midline I was greeted by a sea of blood.  Not having any suction here we began to use sterile towels and gauze to find the source.  Quickly I identified a dramatic hole in her small intestine, but could still hear air escaping and smell a foul odor.  Eventually I found a second area with multiple holes where the small intestine meets the colon at the area of the cecum (a small organ that dogs don’t have much use for now through evolution, but animals like horses and rabbits need for digestion).  This meant that mixed in with the blood in her abdomen was feces.  I took a moment to evaluate the entire situation in my mind.  I took off my gloves and asked for the phone.  I explained to her owner the extent of her injuries and my recommendation for euthanasia.  As he agreed with me to go ahead and let her go, sadly, she died on her own.  Although my decision was vindicated, I felt saddened at what she had been through.  What we had all been through.

Finally I arrived back home after 2 pm and put myself back to bed.  Over the next week the fluffy dog with the bites returned to the clinic for a recheck and although her right side was healing perfectly her left side was forming a draining abscess due to the bacteria in the dog’s mouth that bit her.  Despite antibiotics right from the start there was infection and some of the skin was dying.  We decided to hospitalize her for care, using additional antibiotics and honey bandages as well as removing dead tissues as we went along.

Healed on right, Infected on Left

I continued this type of treatment for a week until I felt that I could again make an effort to close the wound.  Soon we went back to surgery and I opened up any remaining pocket, placed a drain to allow the fluid to escape, and closed her up again.

Wound Closed Again, Now With Drain

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After five more days of maintaining the drain we were able to remove it.  Eventually her stitches were also taken out, but frustratingly a small area in the middle of the wound was open. I started honey bandages yet again to encourage it to heal in on it’s own.  It had been three weeks since the bite happened.

Wound Almost Healed

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Finally She Can Go Home!

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In the end, two dogs survived that day of emergencies, one did not.  As I conferred later on with one of the ladies involved on that fateful morning, she said to me in reference to the day’s events, “It’s like the wild west.”  Indeed.

Oh Belize, It’s Almost that Time

It’s hard to know even where to start, but my time in Belize is coming to an end.  My year of crazy adventures and even crazier medicine and surgery has almost come full circle.  Working for a non profit shelter in what is technically a third world country does not take care of things like student loans and retirement, and so I knew that this ride would not last forever.  It’s hard not to get emotional, because despite the lows, there have been immeasurable highs.  Despite the sweating, the muddy feet, the endless stream of dogs who can’t seem to keep their bandages clean and dry no matter how many times that I swear their leg will fall off and I pull out my hair and….I digress.  Like I said, it’s going to be hard to say goodbye.

Belize is this tiny country that has taught me so much.  The things I have learned have ranged from medical, to language, to cultural/local, to so much about myself.

Medical

When I think back I’m not even sure what I thought this would be like.  I knew what I would have to extend myself medically and be pushed to my limits.  As it turned out, after a short time, I was left as the only vet on an island of 13,000+ people for the next six months.  If I couldn’t do it, it wouldn’t get done.  So I tried.  Hard.  I learned how to spay dogs much more efficiently than I had ever before and got good at this.  I learned how to remove legs and toes without wanting to run and hide (almost).  Over time I realized that tick fever (ehrlichia) has about twenty different and unrelated presentations (note, when Ingrid whispers tick fever, listen).  I started to recognize ringworm from across the room.  I attempted to perfect my physical exam, as many times it was the only “test” available.  I learned how to do house calls, how best to perform home euthanasias, and did the first of many after hours emergencies of my career.  I figured out how to heal bite wounds, hit by golf cart wounds, gunshot wounds, run over by taxi wounds, machete wounds, and unknown wounds.  I bandaged and sutured and bandaged and sutured through work days and evenings and weekends.  I learned to “make do” times a million and to never waste even a single gauze square.

Language

The short version is that those of us that only speak 1 or 2 languages basically suck.  I would strongly advise all children of the world  be exposed to multiple languages, because we North Americans are sheltered and deficient in our multi-lingual skills. Officially Belize is an English speaking country.  This used to be a British dependency.  Most born and bred Belizeans will speak Criol to family and friends and are fluent in English and many speak Spanish.  Some know Garifuna and Mayan languages as well.  Many islanders, however, are first or second generation immigrants from other nearby latin countries, all of whom speak Spanish.  I grew up speaking English and French.  I started to learn the basics of Spanish online before I arrived, and I mean very basic.  I quickly realized that at least eighty percent of my clientele would prefer to, or only could, communicate in this language.  I got Ingrid to start teaching me, we made a list of three words or phrases on the clinic white board right next to the list of patients and who needed their bandages changed.  Once I had mastered them we changed the list.  I listened carefully every time clients and staff were talking to each other, and I started trying to use my new words intermixed with English words in sentences until I could start to string multiple words together.  I got laughed at, I laughed at myself, I made lots of mistakes.  But people noticed, they smiled, they appreciated my efforts and encouraged me to continue. By month eight I was able to travel through Central America with my non-spanish speaking sister and get by.  Learning a new language as an adult is hard, my grammar is terrible, but I feel proud for trying.

Cultural/Local

Things in Belize happen in their own time.  I had to let go of my frantic need to be on time.  One of the most common phrases here is, “Right now.” This actually translates to, “I’ll do it in a few minutes when I have a chance but not immediately.”  Life got easier when I figured that out.  It turned out that the world does not spontaneously combust when things happen in a more relaxed timeframe.  Many things have to be done by hand or in person, and that means waiting.  Get used to it.

Belizeans are friendly, you just have to try.  In my experience the people who live here are more reserved and private at first,  but always extremely respectful of the doctor.  After a few visits once clients got to know me, they got more relaxed, saying hello and joking with me.  I learned while on many outdoor morning runs that if I smiled, they smiled.  If I said good morning, I got lots of kind responses.  At my Crossfit gym I soon felt like one of the group.  It just took a little time.

Buying food here is not a one stop shop.  It can take visits to 3-5 stores to finish buying eggs, bananas, meat, vegetables, and dry goods, depending on what you need.  I also learned not to often go out looking for a specific fresh item, it’s better to keep an open mind and buy what looks good.  Living on an island means that sometimes nothing looks good.  I have eaten more wrinkled vegetables than I can count.  Things that I would have thrown out in the past are mostly fair game.  Expired items mean half price, and that’s like finding gold!

My favorite Belizean food is conch ceviche. Conch is the big pink shell that you place to your ear to hear the ocean…and it’s delicious mixed raw with lime juice, tomato, onion, cilantro and spices, scooped up on a tortilla chip.  I’m going to miss rum punch too.

I can go anywhere and do anything on a bicycle.  Enough said.

Myself

Hmmm, I think this will take more reflection once my time here is done.  I know I can be a lot braver than I thought.  I can live in a tropical climate with no a/c.  I can easily go without real shopping, fast food, going to movies, and buying “stuff” for months on end.  I learned to appreciate side trips to Mexico.  I can get a chain back on a bike and bathe without running water as needed.  Perhaps I have more skills in areas both veterinary and otherwise that I never gave myself credit for.

I think as vets, most of us can be pretty hard on ourselves.  Wondering if we are making the right decisions or doing a good enough job.  For me, being left to my own devices for a year with close to no input on thousands of cases was a challenge.  Ten years of experience came in very handy.  I am so thankful to my colleagues back home who answered my pleas for help from time to time.  It also turned out that emergency on call was not as awful as I supposed it might be and I could survive it.  The positive feedback from the community fueled my  energy to continue on.

So, I know that I will look back on my year in Belize with fondness and amazement and laughs.  My blog has been a way to keep track of many stories and events, much like a diary.  I have a few more blogs to write and post in my remaining time here, and then I will take a break.  I plan to visit my homeland of Canada for the upcoming holidays, and then I will move on to my next opportunity as a small animal vet in Doha, Qatar, a tiny oil rich country in the Middle East.  I have had a few people ask me to continue on writing even after I leave Belize, so I will see where things take me.  I am so grateful for those who have taken the time to follow along.

 

resumepic

No Rest for the Well Rested

During a couple of weeks away on vacation I was lucky to have a visiting vet as well as technician Ingrid holding down the fort.  This meant that I returned to only a minimal number of disasters, which was great.  My visiting sister departed on a Sunday morning and then the calls began.

My first day “back” was Sunday on call for emergency.  It started in the morning with a dog who just wasn’t acting right.  Often times these cases with strange behavior and undetermined pain relate to a back problem.  I treated this dog with some non steroidal anti-inflammatories (x-rays are not even an option on a Sunday) and sent him home to rest.  After returning home I was called back again in the afternoon for emergency number two.  This was a senior aged chihuahua who had never been spayed.  She had not been feeling well earlier in the week when I was away and was on antibiotics.  I quickly determined that this dog likely had pyometra, a life threatening infection of the uterus.  She would soon die without intervention.  We proceeded to an emergency surgery (the only effective treatment) and were able to send her home alive, happy, and spayed.

Back at work on Tuesday I inherited a complicated medical case that was suffering from low platelets (a type of blood cell that helps you to form clots when needed).  With a very worried owner, it was necessary to perform a few more blood tests on this friendly senior dog.  Here in Belize, most dogs with low platelets are suffering from a type of tick born disease called ehrlichia, that is why tick prevention is so important.  In North America most dogs with this problem have an autoimmune disease.  After a few weeks of treatment and testing it appears that this dog has both.  An interesting but difficult case.  She continues to be under my care.

That afternoon a man walked in with a blue pitbull who was obviously pregnant.  She had been having some bloody discharge for about three days.  A dog is pregnant for sixty-three days.  He had no idea when she had been bred, as this dog had been left to him by a friend who recently moved away.  I did not like the look or the smell of what I saw.  We decided immediately on an afternoon emergency c-section.  Unfortunately it was soon obvious that her puppies were not likely full term but were already deceased.  Her uterus was infected and starting to turn purple.  She needed an emergency spay.  Luckily we were able to save her life, but her new owner declined to take her back as she could no longer be bred.  She became a Saga dog up for adoption.

Terra

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On Thursday morning Ingrid and I headed up north on the golf cart for a few house calls.  Sometimes it’s nice to have a little adventure outside.  Our first stop was to do an exam for a health certificate for a dog to travel to the U.S.  This was over seven miles north of the bridge and was the furthest north I’d ever been by land!  It was a beautiful day with the ocean sparkling blue every time we caught a glimpse.  Next we headed back south to recheck a great dane I had seen a month prior.  This dog weighs just over 200 pounds and is very friendly.  He is easily the tallest dog I have ever seen; he’s more like a pony.  He was doing very well and we headed back to the clinic.  In the afternoon I had a scheduled surgery with one of my favorite pitbulls, Max.  Max was born with a problem called “entropion”.  His eyelids curl in so that his lashes rub is eyes, causing pain and corneal ulcers.  He had this corrected in the spring with a visiting vet but one side was again causing him issues.  I decided that a revision of the surgery on just one side would help.  Max has a head like a basketball but he’s a gentle giant.  At his recheck his ulcer was gone and his eyelids were already looking better, still needing more time to finish healing.

Max’s Entropion Before and Surgery

Max After, Just Before Suture Removal

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I also had another dog for mass removal that afternoon, which turned out to be a small hernia.  This dog was spayed years ago and had never had an issue, but her owner was concerned that at this older age she had developed a mass on her belly that seemed to be growing.  On careful exploration of what had appeared to be a fat tumor, I found that it was really fat from inside her belly protruding out through a small hole.  I removed the tissue, freshened the edges, and sewed the hernia closed, hopefully never to reappear again!

On Friday and Saturday I was left to my own devices.  Ingrid was away at a Crossfit competition in Mexico.  This always makes me nervous, but I have the rest of the support staff to help me out.  Luckily it was a very quiet two days and I hardly even had to use my make due spanish to get by.  Saturday night was a big Hallowe’en party at a hotel in town and I did my best to make a costume.  It was a great time.

Bride of Frankenstein

Then despite being out way way way past my bedtime I was up early Sunday morning for a training run up north, followed by a great afternoon at the Saga Hallowe’en party fundraiser.  I was asked to be a judge in the doggy costume contest.

Saga Hallowe’en Costume Contest

After all that I was indeed ready for a nap!  What a great week.

 

Habla Ingles?? My tour of Central America.

Living as a vet in Central America is not all dangling legs and tick fever!  One of my non-veterinary goals of moving to Belize was to see all of the countries of this vibrant continent while I was here.  A few months ago I started contemplating how I could make this happen.  Who would be a good travel partner and have the time to go on this journey with me?  I decided excitedly to contact my sister Alissa in Canada, and after much discussion she said yes!  We spent months planning our budget tour.  Between my work and her family we decided on sixteen days.  Due to our time constraints and my previous visit to Tikal, we decided to forego Guatemala so she could see my home country of Belize. Belize is also technically an English speaking country, but for this trip I would need to try to get by on the spanish I have worked so hard to learn over this past year.

Panama

We began our trip at the southern most country, Panama.  We flew separately, meeting up at our first hostel in Panama City around 11 pm on a night in early October.We chose to save money (Belizean vets are, shockingly, not rich!) by staying in hostels.  Instead of staying in big loud dorm rooms, we booked a private room with our own bathroom at each stop, which is a great tip for budget travel.  I was second to arrive, and asked my sister if everything was ok.  She replied “Yes, but our toilet has no door!”  And so our adventures began.

Our first day in Panama was spent visiting the Panama Canal, an engineering marvel.  They provide a short movie to explain the history of the canal (in which we accidentally ended up in the spanish showing…did I mention Alissa speaks zero spanish?) as well as a very interesting museum.  Many products we use and buy every day come through the Panama Canal.  We did not get to see a boat pass through, but it was still pretty great.  We were at the Miraflores locks on the Pacific side.

Panama Canal

We got our hostel shuttle bus to drop us off at Ancon Hill in the afternoon and we walked to the top to see some great views.  We then walked through the oldest area of the city and made our way home on foot.

Views of Panama City

On day two we were up what we thought at the time to be “early”, which turned out later to be practically sleeping in.  Our pre-booked tour arrived to get us at 5:30 am to head to the San Blas islands.  These tiny islands are still inhabited by the indigenous Guna Yala people, and although you can visit, they do not allow any modern development.  We took a wild ride in a van (one co-passenger was able to hold on until we pulled over for her to vomit), followed by transport by small boat.  The day was spent with a mom/daughter from Peru hanging out on the beach and swimming in the warm waters.

San Blas Islands

The next morning we were off to the airport to take a 1 hour flight to San Jose, Costa Rica.  This allowed us to avoid wasting precious time trying to bus out of Panama.

Costa Rica

We arrived by plane not fully sure of what we would do for most of the day.  Our plan was to take the afternoon bus to the town of Monteverde/St Elena.  We were dropped off at the bus station early in the morning to first buy our tickets.  It was then that we found out that the location had changed.  We managed to find a taxi, who tried his best to trick us into thinking that the buses were on strike and we needed a very expensive shuttle that he could arrange.  This of course, was untrue.  He dropped us off at a mall where we found the buses and easily bought tickets (and by “easy” I mean I used my best spanish to get by and hoped for the best).  We decided that based on the safety level of San Jose (about zero) and the interesting things to see (also zero) that we would stay in the mall and read until our bus came.  I also managed to unknowingly drop my wallet in the bathroom, and although I realized it quickly and got it back, I unfortunately lost all of my Colones (local currency) which I had just obtained at the airport.  Rookie mistake, take note, don’t drop wallet!!

The bus ride to the small town of Monteverde was relatively short (about 4 hours) but required lots of Dramamine (for motion sickness).  We were happy to finally arrive.  Our B&B/hostel was amazing, more like a hotel room.  We were high up in the cloud forest (higher than the rain forest) and so it was much cooler, and of course, raining.  It was so humid that anything you hung up to dry out actually got wetter.  Our first day was spent ziplining through the forest.  Alissa had never been, it was my second time trying this out.  Although we were soaked from head to toe and all the way through, we had a blast flying from treetop to treetop.  We went tandem twice in the pelting rain, with me yelling “Tell me if he signals to slow down!”, and her yelling, “I can’t see anything!”.    That same day we booked a night walk to try to spot some of the local wildlife in the dark.  We reluctantly put our wet clothes (we each brought 1 pair of pants on this trip) back on and headed out in a group with a guide.  Without him we would have been stumbling around in the dark seeing nothing but trees.  With him we saw a kinkajou (really cool), sloths, toucans, a green viper, an orange kneed tarantula, and more!  It was amazing.  We forgot about our wet misery.

Ziplining and Night Hike

The next day we decided on a self guided tour of the Monteverde Cloud Forest Reserve. We caught a local bus to the reserve and got a map.  We spent 3 hours walking the trails and managed to see an agouti (very very big rodent), coatimundi (related to raccoons), and about 8 different local species of hummingbirds that they feed near the gift shop.

Cloud Forest

Getting out of Monteverde affordably is not the easiest.  We had already purchased a bus ticket from Liberia, Costa Rica to Granada, Nicaragua, but we needed to get to Liberia by 9 am first. The local bus leaves Monteverde at 4:20 am.  Yup.  You read correctly. We knew that we had to get off somewhere along a highway called La Irma and then stand at the side of the road and flag down a bus to Liberia. It turned out to be easier than it sounded and by mid morning we were on the Tica bus from Liberia to our next country, with leg room and air conditioning included.

Nicaragua

We arrived successfully in Granada, the oldest colonial city in Central America.  This was our most affordable stay, paying $10 US each per night for a private room with a fan and bathroom.  This was also the first hostel that didn’t even pretend they might have hot water, there was just one tap in the shower. Our first morning was spent on a guided walking tour of the city.

Granada

 

That evening we used the same tour company to take us as part of a group to the Masaya Volcano, a short drive from town.  This is an active volcano and one of the most amazing sights of the trip.  Each vehicle waits at the entry to the park at the base of the volcano, then they allow a certain number to drive up at a time.  Once arrived we had twenty minutes to view before rushing back down.  It was amazing, very rocky, and the lava looked like waves in an ocean.  Although it was bright orange, you could not feel the heat.  It was mesmerizing.

Masaya Volcano

The next day was for relaxing, a massage, trying the local dish “quesillo” with tortilla, crema, and onions, and enjoying the constant happy hour 2 for 1 drinks.  The average price for a cocktail was $1 US.

Our next day would be our longest of travel.  We needed to get from Granada to the capital city Managua in time to catch a bus that would travel through Honduras and into El Salvador.  We were up at 2:55 am.  WHAT?   Yes, you read correctly.  I longed for a day we could sleep in until 5 am!  We boarded another Tica bus for the long haul, with multiple border crossings.  I tried my best but couldn’t always understand enough spanish to know exactly what was going on.  We also learned that you may need to show proof of Yellow Fever vaccination to get into Honduras if you’ve been to Panama, luckily we brought that along!  Borders were also where I saw some of the worst cases of dogs with injuries, broken legs, missing feet, big scars.  It made me realize how lucky we are here in San Pedro to have Saga Humane Society.

Driving to El Salvador

El Salvador

We finally arrived in San Salvador, the capital of El Salvador, after dark.  It was too late to catch two more local buses to our destination, so we gladly hopped in a cab to the tiny beach town of El Zonte. Our spacious room was a bit like a tree house.  We were ready for bed.

Although we wanted to start enjoying our short stay, we were detoured by the realization that there was no bus out of El Zonte on the day we needed to leave.  How were we going to get to our next location?  We decided to catch a ride to the neighboring and larger tiny town of Playa el Tunco to see what we could come up with .  Indeed, no shuttle or bus.  We did speak to an operator however, who taught us how we could do it by a taxi and multiple buses and we decided to try it.  As a side note we enjoyed the beach, the food (love papusas), and a little shopping before returning back.

Unexpected Side Trip to Playa el Tunco

Now, how to get back to El Zonte without a taxi?  We asked around and found that a local bus would pass at 12:30 pm on the main road, just wave and jump on for $0.25 (El Salvador no longer has their own currency and uses US dollars). Side note: All the $1 coins that the US mint made that Americans refused to use ended up in Central America.  So, this was a true chicken bus minus the chickens, and 15 minutes of our life that will not likely be soon repeated.  We stood up and held on for our lives while people got on and off, sometimes jumping in and out via the back emergency door of this green school bus.  We didn’t understand how to pay, we got our feet trampled, and we laughed the entire way.  Finally we jumped off as the bus slowed down near our road.

We came to the beach in El Salvador to see the black sand beaches, they did not disappoint.  Everything that looked like mud was really black sand and it dried to the colour of asphalt. These beaches are for serious surfers, but I tricked my sister and signed us up for a surf lesson, her first time trying.  With the help of our local pros we were bruised and battered but we had a blast.  This was a beautiful surf hostel.

El Zonte 

After only 1 full day in this beach paradise we were up early and off to try out our instructions to getting to Honduras. We headed back to the capital via taxi to catch a big bus into Honduras.

Honduras

After a slight mistake with being led to the correct bus company at the wrong location we were on the bus towards Honduras.  To our surprise we were served some breakfast, chocolate strawberry crepes, soon after departure.  The bus was headed to the big city of San Pedro Sula but we were to get off before that in La Entrada.  After many hours we were dumped off at the side of the road with our packs in tow, in search of a local bus to our destination of Copan Ruins.  We were soon crammed into a small shuttle van with 15 locals (including many men in straw cowboy hats) and our packs strapped to the roof for the 1.5 hour drive.  After 1 quick switch to another van we arrived.  The little town of Copan Ruins is located just a few minutes from the Mayan ruins site themselves, and this is why we came.  After asking around we found our hotel on foot. The streets were real cobblestone and very steep.  We had a delicious local dinner.  Our “hotel” was quite old and a little musty, but the best part was showing my sister how to use one of these.

Shower Head Heater

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How these are legal I don’t know.  But the look on her face was priceless.  The tape, the string, the wires, the slight electrocution, awesome.

The next morning we were off and walking to the ruins.  I have seen quite a few of these in Belize and Guatemala but every site is very different.  A guided tour is always best, but our budget was to wander around by ourselves with our travel book.  There was also a program to reintroduce the native Scarlet Macaw to the area.

Copan Ruins

We loved all the Mayan architecture and the birds, but we actually had to get back on the road the afternoon after we arrived.  You can see us riding in a local crazy taxi/scooter to get to the bus.  This next bus was not quite a “local bus” as everyone had a seat, but far from luxury.  We were headed for the big city and stopped dozens of times to pick up more people with one man hanging out the door to entice them on to ride with us.  One of us whispered to the other giggling, “Should I ask when they are serving the crepes?”.  Hmmm, maybe not.

Finally we arrived at a huge bus station in San Pedro Sula, often referred to as the most dangerous city in the world.  How welcoming.  We came here only to sleep the night and catch a plane.  We quickly caught a taxi to our hostel and found it to be in a safe neighborhood (as planned) and very friendly.  This was our most expensive stay at $25 US each for the night.  We had an amazing room and another scary shower head heater (that worked).  Ahhh, hot showers.

The next morning we were off to the airport, and after a quick stop and search by the police for unknown reasons we were up in the air and off to my home country of Belize!

Belize

Alissa would soon have to go home, but I wanted her to get to see where I live and work.  After she hopped on a borrowed bike to accompany me on a training run down south (a great way for her to experience our rainy season giant puddles) we were off and riding our bicycles up to visit the weekend farmers market and explore up north. We made time to tour my workplace Saga, to eat local BBQ, and to walk the beach front.

San Pedro

After 16 days of fun our trip had come to an end.  I got to add four new countries to my passport and my sister got to add six.  We experienced so many exciting locations and adventures.  We collected a bracelet from each country as a memento, but we collected tons of memories to last a lifetime!

What a Great Trip

We went to places we’d never been in a language we barely speak and had a great time doing it.