The Mexican Pipeline: Surfing Medical Emergency in Mexico
By Danielle Rivet
Medically Reviewed by: Melissa Conrad Stöppler, MD
As I packed my bags, the excitement of a surf trip to Mexico filled my mind. A good friend's birthday celebration and the X Games surfing competition being held with predictions of a large south swell were just some of the highlights I was looking forward to. Puerto Escondido, Mexico was the destination. It would be my first time venturing down to this particular part of mainland Mexico that has such powerful surf; it is known as the "Mexican Pipeline" because of its similar treacherous conditions to the famous Pipeline on Oahu's North Shore. Despite the tales and warnings I received from other surfers about the place, I was ready for an adventure. Little could I have predicted that I would receive more "adventure" on this surf trip than I had anticipated.
With three boards in tow and a week's supply of bikinis and clothes for hot humid weather, I set off to catch my flight to Puerto Escondido, Mexico. After a full night and half a day's journey, I exited the Puerto Escondido airport. The cab ride with other surf travelers, including even some pro surfers coming in to compete in the X Games, only took a few minutes to reach the hotel that faces the infamous beach break. As the luggage was unloaded, the sound of eight foot surf turned my head, and I found myself in perfect viewing distance of hollow beach break waves spitting surfers out right and left like baseballs in a batting cage.
After registering at the hotel, in no time I found myself in a bathing suit grabbing my biggest board and heading out front to conquer the heaving Mexican surf. Moments later I took a few minutes to sit on the sand and watch the waves; the way they were breaking, to plan how I would paddle out, and to catch my breath and work up the courage to surf in such demanding conditions. Knowing the longer I sat on the beach the less likely I would get into the water, I grabbed my board and charged into the surf. The feeling was much like that of being on a first date; excitement and nervousness all at once causing that gut-wrenching experience mixed with adrenaline.
After taking a few waves on the head and sensing the power being dealt by a sizeable south swell, I made it into the line-up. The next battle would be paddling for a wave. A few sets passed and finally a smaller wave looked good. I charged, got a little hesitant and I went over the falls helplessly - with enough time to know what was in store for me. A hard hit on the bottom of the shallow ocean floor, a few more waves on the head, some long hold downs underwater, and then finally a break that let me catch my breath and paddle back out. A few more poundings, and finally one perfect wave came through and I caught it, pulled in, and got my first Mexican barrel just before the sun slipped past the horizon! I decided to call it a day and proudly walked off the beach; luckily unscathed and with a little more experience than when I first arrived.
The next morning was the same mission, take on the beach break and get some good barrels. This time it was a little easier, yet still nerve-wracking. The Mexican Pipeline is all about give and take. You have got to risk taking a beating in order to get some of the best barrels of your life. After a couple of hours in the morning mustering up all of my courage, I decided to reserve the rest of my afternoons and evenings to surf "The Point." The Point is a left point break that is only a five minute taxi ride from the main beach break. It is much less treacherous and offers a really fun left hand wave that occasionally barrels to provide a fun, yet less challenging surfing experience.
It was here that I would least expect to get injured, especially after coming out of the beach break's treachery each day unharmed, but I guess one rule of travel is to expect the unexpected. After four days of continuing on the daily routine of waking up, surfing the beach break in the morning, and heading to the point for the afternoon, I was starting to feel at ease with my surroundings and was having even more fun. However, that fun was interrupted on one of my last waves of the day at The Point. I dropped into a wave and was enjoying the view of being in the Green Room-getting barreled. I looked up and slightly ahead of me I saw the nose of a board paddling into the wave. No sooner did I see this, and the board and its pilot dropped right in front of me. With rocks beside me, and the back of the surfer's feet and board in front of me, I only had one option - and that was to pull out and give out a, "hey!" and let him know I was there and hope he would exit just as swiftly as he had arrived.
What happened next was far from what I had expected. The surfer looked back at me with complete surprise. He jumped forward, punching through the wave with his body, and springing his board back toward me with the push-off of his feet. I had little time to react and instead just kept going on the wave only to feel a hard hit on my back left leg. I finished the wave not wanting to look down at the damage caused by the impact of a board fin on my leg. At first it looked like I had made it out unharmed, but a second glance left me feeling weak in the knees. A four inch gash was showing yellow tissue, evidence of a deep wound, and blood was slowly oozing out of the wound. I knew I had to act fast to avoid infection and a large amount of blood loss (and hey, let's not even think about sharks!).
Once I got to shore, I wrapped my leg with my sarong to keep pressure on the wound, prevent bleeding, and keep the sand out. I hobbled to the road to catch the next taxi back to the hotel. Once arriving at the hotel, it was complete chaos. Everyone was concerned, but no one was quite sure what to do. There were suggestions of going to the hospital, which was about twenty minutes away, but the overall response was to go to Doctor Pepe next door. With a high recommendation from the hotel staff, I decided to avoid the hospital and take myself to Doctor Pepe.
As I walked down a narrow cobblestone street, my next obstacle was to climb the terrace of narrow winding stairs that led to his front door. A few times on my journey I had to wonder if this was really happening. It seemed like a scene right out of a movie. As I entered the doctor's office, it appeared seemingly empty and quiet except for a few buzzing flies and a TV showing a Mexican soap opera. I rang the bell to the office, and a nurse who barely spoke English greeted my friend (who would serve as a translator) and me. I showed her my wound, and she seemed very welcoming - like I had come to the right place. I was apprehensively led through a series of airy and minimalist-looking medical rooms before reaching the very back room that had a metal patient's table and surrounding medical supplies.
I was instructed to climb up on the table, and the nurse told me in her best English that "what she was about to do would hurt a little." As she began, "little" wasn't the word I would have used to describe the level of pain. She put all sorts of antibacterial solutions on the wound and then proceeded to scrub it. I am guessing the scrubbing was to get any sand or debris out, but all I could wonder was when it was going to stop. Ouch! She finally finished, and the infamous Dr. Pepe entered the room. He was a tall, older Mexican man with curly greying hair and a large yellow-toothed smile - he seemed like a nice guy. He took one look at the wound, and I agreed with his conclusion that I would need stitches, but I wasn't excited about it. He administered a shot to numb the pain and proceeded to do the stitching. I couldn't watch - I just gripped my friend's hand and the side of the table trying to hold back the tears, not because of the pain, but because the shock of the incident - and the vulnerable feeling of being in foreign place - and not fully knowing if coming to Dr. Pepe was the right decision.
The procedure was quick, and before I knew it Dr. Pepe had me all sutured up and bandaged. He gave me a packet of pills for the pain (I think - it was a packet of pills in a foil strip), and a prescription for antibiotics. The fee was only 300 pesos which amounts to about 30 US dollars. I could only think of what this would have cost in the US! I was instructed to come back the next day as a follow-up and stay out of the water for at least a week. I left the office, thanked Dr. Pepe, and headed to the local pharmacist to get my prescription filled.
As I limped away, I looked at the receipt and my prescription paper. On the top of the papers were Dr. Pepe's full medical name, which translated to Dr. Pepe Medical Gynecologist. I had to take a few glances just to make sure I was reading correctly. Had I really just gotten stitched up by a gynecologist? All I could do was laugh; this was turning more comical by the minute. I figured he must do a lot of suturing in his line of work, so I was confident I had received good medical care in Mexico, from Dr. Pepe the gynecologist.
When I got to the pharmacy I received one antibiotic. I am not sure if it was a misunderstanding due to a language barrier (lost in translation), but I was sure only one antibiotic pill would not be enough to prevent an infection. Thankfully I only had one day of my trip left, so I resigned myself to sit by the pool to nurse my wounds and thought that I would see a doctor when I returned home. The following day was when I was supposed to leave, and of course the day that I remember being in the most pain. The stitches were tight, it hurt to walk, and there was a little bit of swelling. All these things worried me because redness and swelling are the first signs of infection. Before I left I went to Dr. Pepe one last time to get the bandage changed and to get the wound checked. He said the wound was normal and looked good considering it had occurred just one day ago. So I packed my bags and headed for the airport to catch my flight back to Orange County, California.
The next day after my return home I went to an urgent care facility. The doctor took one look at my leg and looked perplexed at the Mexican stitch job. He asked me what Dr. Pepe had done, and sheepishly I shrugged my shoulders, I really had no idea. I told him I couldn't watch, so I wasn't sure. All I knew is that I had six stitches and that it was done by a gynecologist. The doctor laughed and asked a few sarcastic questions, but when the final analysis was done it was determined that I had received a variation of a type of suture called a mattress stitch. He gave me a prescription for cephalexin (Keflex) (that contained more than one pill) to prevent infection and instructed me to return in seven days to get the stitches removed. Also, I was instructed to keep the area as dry as possible, to not use band-aids, to keep topical antibiotic ointment on the wound, and not to do anything but walk until the stitches were removed.
I left the urgent care facility with mixed emotions. I was relieved that I was going to be okay (but not happy about no activity for a whole week). I also was still unsure of what a mattress stitch was, so I decided to look it up online. I found out that a mattress stitch is a type of suture that is used for areas with high tension (meaning, areas on the body where a wound occurs and is more likely to pull apart). A mattress stitch is extra strong to reinforce the area while healing. This made sense to me because the wound was on the outside of my leg about five inches from my ankle. This portion of the leg supports a lot of weight while standing, walking, or any other upright movement. So, with all my new understanding all I could do now was rest and wait for the cut to heal.
Each day the wound got better. The swelling went down after about four days, but despite the lack of infection the redness remained. After day seven, I went back to have the stitches removed. I was really apprehensive about the procedure. The wound area was healing, but still really sore. The doctor assured me though that it wouldn't hurt - he was correct. The stitches were removed in less than ten minutes, and already the skin that was raised due to the tightness of the stitch started to relax. The following day the redness started to decrease, and the pain decreased. After two weeks, I could return to my normal exercise routine. I kept the wound very clean and made sure to keep antibiotic ointment on it to prevent dryness and infection. A month later and the wound is almost completely healed.
While I wouldn't want to repeat the accident, I did learn two things:
- I know what a mattress stitch is, and
- I should ask what kind of doctor I am going see before I get any medical procedures done in a foreign country.
Overall it was a good experience. Some people bring back hammocks, sombreros, or jewelry as souvenirs from Mexico. I have a four inch scar that reminds me of surfing in Puerto Escondido, and learned that the waves aren't nearly as treacherous as that one loco bandido surfing The Point that day.
Danielle R - aka Shark Girl
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