OUR PANAMA ADVENTURE

January 10, 2012 – Update for Days 5 – 6

Monday morning started at 6:00 on the top deck, forward, as we glided past many anchored freighters waiting for their scheduled entrance to the canal. We were following Windstar, a four masted passenger cruiser. Quite pretty. As the moon set and the sun rose, a myriad of pilot boats descended upon us. We ended up with 2 canal pilots and 14 line handlers coming aboard. One of those vessels took our photographers ashore at the locks to document our passage.

We were entering from the Caribbean on the northwest side of the canal and heading southeast toward Panama City. It is really hard to come to grips with those directions when we are moving towards the Pacific Ocean. But so it is.

It has been 12 years since our first passage through the canal. This one was every bit as intriguing. The lines from the towing engines, mules, were brought to the ship by two men in a row boat. Other methods have been tried over the years, but none have proven as effective as this. The mules do not actually propel us through the canal. We advance under our own power, and the mules keep us from hitting the sides of the locks. They did a great job for us.

Exiting the Gatun locks brought us into Gatun Lake. This is the water source for the operation of the locks. Each vessel uses 52,000,000 gallons of water for the complete transit. 35 ships a day transit the locks. You can do the math.

The canal is in operation 24 hours per day, and still cannot meet the demand. It is expected that the new wide locks, scheduled for completion in 2014, will remedy that. The canal is under the control of a separate Panamanian Agency, not the Panamanian government. It is self sufficient and very efficient. Each vessel must have its transit fee paid 48 hours in advance by a direct bank transaction or it will be barred from entering. The Prinsendam’s fee exceeded $350,000.

We sailed through Gatun Lake, transited the second set of locks and entered another, smaller, lake. That is when our real adventure began. I noticed that the shore line seemed blurry. I cleaned my sunglasses, but that did not help. My cataract surgery only corrected my left eye to 20-25, so I assumed that was the problem. When I blocked my right eye, my vision was very blurry and much worse than normal. I returned to our cabin to check the hours for the medical center. Alice and I went right down. It was 3:30 and the doctor did not come on until 5, but his nurse was there. She did some paperwork and started to give me what she said was an “emergency room” eye test. Right eye was perfect. Left eye had deteriorated to the point where I could not even see that there was an eye chart on the wall. OOPS!  She paged the doctor.

He arrived and did some quick tests only to conclude that I had probably suffered a detached retina. I needed immediate medical attention ashore. He called the bridge and learned that we were exiting the last lock. We had 5 minutes to prepare me to go ashore. Alice went to the cabin for my meds. 


Denise, the ship’s medical disembarkation officer, joined us upon Al’s return. She said she would help Alice pack necessities for a stay ashore. Denise would disembark Alice 30 minutes later. She also brought our passports. 

By now I was “blind” in my left eye, and a bit frightened. The doctor led me to the gangway where he turned me over to the paramedics. The trip across the gangway to the side of the lock was an adventure. I could see nothing to the left of center. The Holland America port agent met me at the ambulance. Since I could sit up, we decided to take his vehicle to the hospital in Panama City. At five o’clock we were met by a doctor at the emergency room door.

Vision had not improved.


Alice left Prinsendam almost an hour after I did. She was put aboard a small boat along with the Canal narrator. They had traveled some distance from the Canal in that time, so the ride back to Panama City took a while. A port agent met her and took her to a first immigration office where she waited 45 minutes in a lunch room while her papers were processed. Then she was "handed off" to another agent who drove her to another immigration office deep in the bowels of the container port. His wife and child were with him. None of them spoke English. After processing here, they drove to the hospital.

At about 7 o’clock, while the doctor was away getting forms completed, I started to see vague images with my left eye. 


At 7:30 Alice arrived. They had drawn blood, admitted me and we were on our way to my room. They apologized that they only had a couch for Alice to sleep on. They fed us, and we went to sleep knowing that they now felt that the retina was probably not detached or only partially detached. That was significant comfort compared to thinking I might no longer have left side vision.

January 10, 2012 - Day 6 - Panama Adventure 2

Today, Tuesday, I got a visit from a neurologist, had an MRI of the brain, an MRI of the arteries in my neck, a consult by the cardiologist with a pending echocardiogram and a complete eye exam by an ophthalmologist. The consensus is that I suffered a small blood clot that impacted the vision center in my brain. There is no lasting optical damage, and although my vision is not clear enough to read now, it should return to almost normal in a few days. The cardiologist believes that my atrial fibrillation triggered this event, so he wants the echo done to make sure the left ventricle is OK. He agrees with the ophthalmologist that I am safe to travel. They will confirm that tomorrow after the echo.

Holland America has been outstanding. HAL called me first thing this morning, and they called our travel insurance company. They will assist us in rejoining the ship as soon as possible, if I get clearance from the ship’s doctor after, he reviews the local doctors’ reports. Hope this can happen tomorrow. 


In response to HAL's call, a woman from our travel insurance company's claims department called. My incident is on file, and they will contact me, when we get home, to assist me in filing my claim.

It is now 6:30 PM, and we just received a visit from a new doctor on my team. He came to our new room to report that both MRI’s show no damage. It furthers the belief that my afib led to throwing a clot. They will continue to monitor my coagulation levels until we leave.

Our new room is a beautiful suite with beds for each of us, a lovely seating area , room to dance, and a huge bathroom. It overlooks the modern downtown skyline through 15 feet of windows. Cabin 350 will be small by comparison.

They finally came to get me for the echocardiogram, which went well, at 7:10. They do not use technicians to do the echo here. Instead a cardiologist administers the test. This is great because he provides an immediate interpretation. I have a slight thickening of the ventricular wall, but no sign of thrombosis in the heart. He said he will report this to the cardiologist on my team, but has no concerns about my ability to carry on.

He wheeled me out into the hall to wait for the transport person to take me back to our room. While waiting there, the Neurologist found me. He had been looking for me because he wanted to tell me that, although the MRI’s showed no signs of thrombosis, he was convinced that I had experienced a TIA (mini-stroke). He was going to recommend that I go home, not to the ship.

Alice and I were devastated. We so badly wanted to complete this cruise. All of our things were on the ship, including Al’s jewelry, her  computer and our winter clothes. We had not even begun to use our shipboard credits, the welcome aboard champagne was still in our fridge, and we were only 2 bottles into our 24 bottle wine package. We still had over 60 days to go. BUMMER!

Shortly after returning to the room, the lead doctor on my team paid a visit. I started to lobby him for a favorable report to the ship’s doctor, based on the fact that his cardiologist and ophthalmologist approved me for travel. He said the neurologists report could not be omitted, and that the ship’s doctor would have to decide, after he received their reports by email tomorrow. In the meantime my INR levels were too low so my blood was clotting too fast. Not what you want in TIA territory. He wanted me to take some coumadin immediately, and they would check my blood in the morning.

Will keep you posted, but we are both doing very well, all things considered.

January 11, 2012 – Day 7 The Beat Goes ON!

It is Wednesday now. Seems like we have been here forever. At eight o’clock they drew blood for the INR. Dr. Gabriel, the team leader, was here. He said the results would be back in an hour. He also said they were getting the reports prepared for transmission to Prinsendam. There was no change in their position since last night. The cardiologist came in and, again, said he believed my afib had tripped a clot that caused the problem. He also reiterated that he saw no reason to go home, but he recommended that I speak to my cardiologist when we got home. He suggested that I wear a Holter Monitor to recheck the regularity of my heart rhythm. They left.

Alice and I were still down. I decided to become proactive, and called Holland America. I explained the situation to the lady handling my case, and, again, told her how badly we wanted to return to the ship and how inconvenient it would be to have to go home with only the few warm weather things we had with us. She repeated the party line that it would be up to the ship’s doctor. She did say she would start looking for flights to rejoin the ship in Peru on Saturday or Sunday, but made no promises that I would be cleared. She just wants to be ready. She really is great.

After that call a nurse appeared. They had received my INR results, which were way too low. I was to immediately take a double dose of coumadin. After I did, she injected an anti-coagulant directly into my stomach. Ouch. I never had this experience before. They will check INR again tomorrow morning.

The phone rang . It was a woman from Clinica Einstein, the doctors' office. She apologized for being sick and away from work for the last 2 days because it is her job to support the patients’ families and keep us informed as to costs and payment methods. She told me how much the bill would be. Yikes! This would include all of the doctors, the hospital, canal disembarkation fees and all testing. This would need to be paid in full by credit card before we left. Yes, she understood that our insurance would reimburse us, not pay upfront. These are the rules, so I should start to make arrangements with my credit card company. GULP!

Then she told me that she would be coming to the hospital at 1PM to take Alice and me on a city tour. She would bring along the office person who handles credit card payments. We would then drop that person at the clinic as we started our tour. All of this occurred as indicated. We had a delightful tour of Panama City with this lovely lady. She even made photo and souvenir stops. She returned us to the hospital at 5PM, and said she would come by tomorrow morning with some immigration documents we would need to leave the country.

We no sooner sat down in the room than the phone rang. It was Leslie from Holland America. “I have good news” she said. “You are going sailing.” Alice and I almost cried. We have been up and down like yo-yo’s. Now the stress is waning as we know we will get back to the ship on Saturday in Trujillo. That will only have been 5 days away, but it seems like an eternity. This also means that we will completely miss visiting Ecuador and our first two shore excursions.

Best part is that Alice is really anxious to get back to the cruise. She has really gotten into it.

Sorry to be so long winded, but this is really a great stress buster.