Oma had a few coughing fits during the night, which some cough syrup and hot tea just barely controlled. With our relaxed plan in the next few days, I looked up what getting back to the States would look like and cost, or what our other options were. Consulting with my parents, we decided that finding a clinic when we got back to Cusco that day would be the best option.
Oma and I got to the train with twenty minutes to wait. Our seats were in completely different cars now, and, after we loaded, I realized that the hallways between cars were for employees only. I sent our car steward to her car with a note and some soles so she could buy a snack or drink if needed, and then I relaxed in my car.
This was the lowest class of train that went to Machu Picchu City, and it was still just fine. Only got served drinks, no sandwich or disappointing brownie, and there was no guided tour coming through the speakers, but we still had windows in the roof to see the receding mountains.
It was only a 90-minute trip, since we weren't going all the way back to Cusco, so I got to Oma's car to help her out and she was incredibly hoarse after talking to a German couple all the way back. They were about four weeks in, had done many of the activities along the coast that we had, but had also been waylaid by a stomach bug for a few days, as well as going further into Peru to see Lake Titicaca. Of course, Oma had to see if they had been to many of the places she had lived any visited with Opa in the '50s.
Our driver showed up with a hand-written sign that said Oma's name, and we piled the two Germans in to give them a ride to their hotel another 30 minutes up the Sacred Valley. We did some chatting, but once they left, Oma's coughing, lethargy, and hoarseness all started catching up with her.
We were close to Cusco, I told the driver to skip taking us to the hostel to pick up our bags and head to a clinic instead. I had found the name of one recommended in forums and travel books, but he asked if "clinca touristica" was where we wanted to go. Sounded as good as any, so we had him drop us off there. I used nearly the last of my cash to pay him.
Oma got into the clinic (which was now high above sea level again in Cusco) and sagged into a chair. They got a selection of insurance cards from her, then took us up to a room on the fifth floor to check her out. An English-speaking doctor heard her symptoms and scheduled an x-ray and fluids. The x-ray (which we took in the basement) showed a lot of fluid in her lungs, both from pneumonia and from altitude. Her oxygen levels were in the 80s instead of the upper 90s, so she got an oxygen tube. And liquids are always good, so she had an IV put in, with some antibiotics to help her fight. Her cough and sore throat got some cough syrup and cough drops, but, after perking up after a few hours on the IV, she was still most irritated about that. Her diagnoses of bronchitis, pneumonia, and altitude sickness causing edema in the lungs were all scary, but all treatable and being dealt with.
Talking to the doctor, it sounded like they were hoping to get her oxygen levels up and fluid down before our flight from Lima to Miami on Wednesday night. We weren't going to make the Tuesday flight to Lima, and instead look to get to Lima midday on Wednesday to give her more time at the clinic.
We spent the night with the IV and oxygen (and some not terrible hospital food), and I got the double bed next to her hospital cot.
On Tuesday, her recovery was not as quick as they had hoped, so we were moved into the intermediate care unit, and they added a heart rate monitor with metal sticker-clips on her chest as well as a blood pressure cuff to the tubes and wires coming off of her. I took a cab into the city to cancel our flight and pick up our bag from the hostel where we had left it before heading to Machu Picchu, and I found a bookstore to get some new titles to supplement our waning stock. I was back before lunch.
It was an afternoon of watching Animal Planet and trying to figure out how to fix the wires when they started beeping. Oxygen? Breath deeply and slowly, and move it around on her finger. Heart rate? Roll over a bit and try each of the five different connections to make sure none of them fell off. I wasn't impressed that the nurses never came in to help with the beeping unless we hit the call button. They did schedule her flight for Wednesday, the next day, to Lima with a doctor and supplemental oxygen for the plane.
The night, Tuesday night, was arduous. Oma would shift in her sleep, one of the monitors would start wailing, and I would get up to start moving and pressing things to get it to stop.
Wednesday morning, we asked for a sponge bath before our leaving time of 9am, and we were ready with Oma in the wheelchair with a mask when it was time to leave. I had been going back and forth to the front desk to call insurance and credit card companies about travel insurance, and so they wanted me a final time to get all the paperwork to take to the next clinic (including some very large x-rays) as well as a final payment.
It was an ambulance ride to Cusco airport, where we relaxed in the small medical room there before heading to the boarding area and climbing the stairs up to the plane. We switched seats with someone (who probably didn't feel very excited about sitting next to someone coughing with a mask on) so I was between Oma and the doctor. We had some empanadas to snack on, then, after landing, the doctor arranged the taxi and accompanied us 45 minutes to INCA Clinic, which specializes in cardiovascular and respiratory diseases. (They were so good that, in the middle of Oma telling them that it was hard to draw blood from her veins, they had already finished when many others had struggled.)
It was a rollercoaster few hours. We got there at 3pm, and the first thing I heard was that they wanted a minimum 8-hour observation window for Oma. Our flight to Miami was at midnight - it was going to be close. We were not given many positive signals until about 5pm when Oma's oxygen was staying at normal levels without her nose tube in and the x-ray showed an 80% decrease in the liquid in her lungs. Her white blood cell count was still (understandably) elevated, but if she could walk back and forth down the hallway and keep her oxygen count at above 95%, they were willing to release her and we could head to the airport.
The wireless oxygen measurement device on her figure read "96", both rightside up and upside down. I could start making plans to get her back to Milwaukee and see a doctor there as soon as possible. I booked up an evening filght from Miami to Chicago (which was as close to Milwaukee as we could get), then booked myself an even later flight from Chicago back to Baltimore (which was as close to DC as I could get).
All told, that part of the trip went ok - the wheelchair attendant was ten minutes late picking us up from the lounge in Lima (where we had had a midnight snack before the flight), so making me anxious about missing our boarding time. The overnight flight wasn't the most comfy, but sitting up, Oma was only coughing, not feeling short of breath. Landing in Miami on Thursday morning, a lot of hotels were sold out, but we found a Fairfield Inn and Suites that had a room that we might be able to get into before noon for a morning nap. They let us have breakfast and tea from the buffet before our room was ready at 9:30. It was a five-hour nap before getting a shuttle to airport, with wheelchair service to the gate.
Landing in Chicago, we met my uncle at baggage claim, handed over the novel's worth of medical paperwork and x-rays, gave the detailed instructions for the inhaler, cough syrup, pain meds, and - most importantly - the antibiotics, then hugged goodbye before heading back through security to fly to BWI where my fiance lovingly picked me up for 18 hours at home.
I missed out on a meal or two of ceviche, but Oma was home and on the road to recovery.