A special journey to Isla del Sol

On Saturday, August 30th, our 2nd day in the world without Terry's vital presence, Christen, Hollice, Brad and I, along with our new dear friend Andrea ("Ari") from the US Embassy and a fellow American took a full day excursion to Lake Titicaca. On this very day, Terry, our dear friend Colleen, and I were to have gone exactly where we ended up going ...

We had a private van tour from our hotel to Copacabana on the lake, then took a 1 hour boat ride to Isla del Sol. It was a gorgeous day. So fitting to be on the water ... a day that would have so been enjoyed by Terry ...

Our guide gave us a little hiking tour of the island, including some Inca ruins. The sun shone down on us and kept us warm at this high altitude of almost 13,000 feet. Toward the end of our hiking tour of the island was the Sacred stream that flows into Lake Titicaca. That is where we chose to scatter a small portion of Terry's ashes. We really felt it was right to leave a bit of Terry behind in this country where he chose to end his stay on planet Earth.

The boat ride back was even better than the ride there; as I had figured (Terry's training) we had the wind and small seas going with us so it was a warm and pleasant trip aboard the rooftop of our private boat. It was an incredibly personal day. A very special day. A day we will always remember and treasure.

Terry is still loved; we will treasure all those incredible memories forever. Love, Tammy

Follow this link to see just where we chose to scatter Terry's ashes: http://maps.google.com/maps?f=q&hl=en&geocode=&q=-16.0393,-69.1442&ie=UTF8&z=12&om=1

Also, fittingly so, Terry made the Latitude 38 website one last time:
http://www.latitude38.com/lectronic/lectronicday.lasso?date=2008-08-29&dayid=161

The day after

It's after 9pm already here in La Paz. Christen, Hollice, Brad and I managed to get through our first day without Terry in our lives. We of course had heavy hearts, still do. But, we managed to have a productive day and even fit in some sightseeing. We had a 10am appointment with the hospital administrator, a nice lady named Maria Luisa, to go over the final hospital bill and get wire transfer instructions. She also had copies of Terry's basic medical records and x-rays for us to take with us. We also had to deal with the mortuary people.

After that, we caught a taxi to the US Embassy - certainly a first for us all, to visit a US Embassy. But, we have friends there now and they were expecting us. When an American citizen dies abroad the Embassy is a big help in obtaining legal death certificates and mortuary arrangements and many other things. You would be amazed at how huge a help they can be (they were at the hospital with us all afternoon yesterday). We will be forever grateful. Anyway, we got through security okay (they held our phones and cameras, not allowed) and found our friend Lourdes who helped not only with the paperwork details but also with gaining us access to an embassy phone to call the USA (no charge) which was fabulous. You know, we were on US soil today for like 2 hours! I have to say it felt GOOD. It had been awhile for me! Lourdes and her husband and daughter all work at the embassy. They invited us to stay for lunch, and treated us to lunch in the embassy cafeteria. The ambassador was there too (we didn't meet him though)! After lunch we used the restroom - and it was just like a restroom in the USA! Nicest restroom I've been in since, well, the USA. Toilet seat covers, we could flush the TP down the toilet, oh the list goes on. Pretty silly, I know - but what a treat in this third world country.

From the embassy the four of us taxied to central La Paz so the kids could see a bit more of the city and do a little shopping. That was pleasant, and a great distraction. Lourdes' daughter Andrea met up with us around 4pm and we went and arranged for a day trip to Lake Titicaca tomorrow. Terry, Colleen and I were supposed to have gone to Lake Titicaca today ... Sorry, I digress. We have a private tour booked for the 5 of us (Andrea is going with us), and that will be a great way to get through the day. I'm sure it will be a great day ... sadness underlying it all, but a great day nonetheless.

It was a bit of a hassle, but we finally now have all of the paperwork required to take Terry's ashes home with us on Monday. I am sitting here looking at Terry's urn and I have to say it is somewhat comforting in a strange and sad way. Terry was cremated this afternoon, in accordance with his wishes. We plan to scatter some or most or all of Terry's ashes in Puget Sound as soon as we can arrange for us all to be together to do so. Maybe in October? We'll see. We are considering taking a small portion with us tomorrow and scatter at Lake Titicaca. We'll see.

Brad flies home to Colorado on Sunday, the rest of us on Monday. It will be nice to be home and amongst family and friends. My dear friend Holly is organizing an open house next Saturday 9/6 for friends and family to take time to remember Terry and share in our grief. If you would like to join us, please contact Holly directly at hserdy@hotmail.com . I will be there ... God willing.

As I write this, we (the kids and I) are going through Terry's personal belongings. It still feels very wrong that this has all happened. I miss Terry terribly and feel so bad that his life was cut short when we had so much more to do and see. I really appreciate all the love and support of family and friends. And Terry's kids, they've been terrific. It's been really special to have this time with them.

Please drop me a note any time, I'd love to hear from you. I think I am going to make this my last installment of the Terry updates. May he rest in peace and be sailing away to a better place ...

Love, Tammy

Boat Transporting Advice Needed

Tammy and the kids would like to get Secret O' Life (a Union 36) back to the US, or at least further North and closer to home. It's currently in Bahia de Caraquez, Ecuador. If anyone has advice or suggestions on the best way to do this, please email me at leeanne@writecraft.net.

Thanks,
LeeAnne Egge
Blog Editor

In Loving Memory of Terry Alan Bingham

I am incredibly sad and heartbroken to report that at 1pm today EST Terry left us. We were not well prepared for this event today; we have been blindsided. At 7am today his doctor was talking to Terry and he was fully alert and okay. At 7:20am Terry went into sudden and complete cardiac arrest. It took them 30 minutes to get Terry's heart working again and during this time there was significant brain damage.

By noon things were looking mighty grim; the kids and I all went in to ICU to see Terry and be with him. The doctors did try to reverse the brain swelling and perhaps the damage done, but alas it was not to be so. In accordance with Terry's wishes, we all agreed and the doctor also agreed that it would be best for Terry if we removed all life support. As the doctor suspected, it did not take very long for Terry to stop breathing. We were all with him the entire time and it was very peaceful. Terry is in a better place and not in pain.

Of course, our hearts are breaking. We are trying to be strong but we do break down quite frequently. We are here for each other and oh thank God for that. I cannot imagine if I had been alone. The kids are doing great, get lots of strength from their Dad. We will all miss Terry's presence in our lives so much.

Some or all of the kids and I are talking about getting to the boat asap; hopefully over the weekend. We are not sure of the flights and all but will figure it out (no, we are not going to bus there). The Embassy folks are of course here for us; they have been at the hospital since before noon. They are helping with arrangements, including cremation which will happen tomorrow around noon our time. We have an appointment to pick Terry's remains up at 3pm tomorrow.

We might leave here as soon as Saturday but it is too soon to know. I am unsure at this time as to when I will return to the USA - I have a scheduled flight from Ecuador on September 20th so I would say that would be the latest I would return. There is so much to absorb right now, we really were not prepared for this. The doctor's also were very surprised by this turn of events, Terry was doing so well. I'm so glad I had the quality time with him yesterday ...

With love and thanks for all your prayers and thoughts,
Tammy

Terry is gone

Terry passed away after a sudden heart attack this morning. Our thoughts and prayers are with Terry's family and Tammy in their tragic loss.

Critical Update -- Major Setback

Just got word that Terry had a severe heart attack this morning and is in critical condition. It took about 30 minutes to restart his heart, and his brain is swelling. Please continue to pray for Terry.

Please leave comments here by clicking the 'comments' link at the bottom of each post. I know Tammy, and Terry's kids, would love some words of comfort and encouragement during this very tough time.

Wednesday night update

Just a quick note to say thanks for all your prayers and thoughts! Terry is doing well, continuing to progress. Tonight the doctor says we take out the ventilator tomorrow. We'll see, not going to get our hopes up too much and we don't want it removed sooner than he is ready. He was a little tired tonight, but still very alert. He is very much with us mentally -- and just two days ago the doctors were concerned about that -- so good job Terry! He is very anxious to be able to express himself with more than nods of yes or shakes of no. He is a real trooper ...

It looks like we are going to be here awhile, unfortunately. But, there are much worse (and more expensive) places to be stuck, so we will just count our blessings. We hope to get an idea sometime next week as to how long we will be here. Hard to say now! Certainly a slow recovery so far, but he has been very sick. Not out of the woods yet, but doing better!

Thanks again and please keep up all those prayers and positive thinking, there is a lot of power in both. I am certainly trying hard to do both!

Lots of love, Tammy

Tuesday Update from Tammy

Terry is still very awake and alert (perhaps too much so) and very anxious to have the ventilator removed. Unfortunately, he is not yet strong enough - he tires out after being off the ventilator for awhile. We were so hoping that it would be today ...

It appears that there are two main factors why Terry is not yet off the ventilator. One is his lungs are slightly impaired from the 15 years he was a smoker (he quit in about 1975). The other is the Sepsis/blood infection. Then throw in the 11,000 foot altitude and I think we can cut Terry some slack.

We all feel that Terry has a lot of questions to ask and I'm sure some things to say; he is very frustrated not being able to communicate. We have a feeling that he is taking his situation to be more dire than it is. It is a bad situation he is in, but perhaps he thinks he is even sicker than reality. So that is going to be our goal tonite, to try to give him a better perspective on what has happened to him and how he is now compared to just a few days ago.

If Terry had his way we would be with him all the time. That's also what we would like but as long as he is in ICU that is not an option. This afternoon when I said I had to leave he adamantly shook his head no ... it just breaks my heart to have to leave him like that. My heart goes out to him ...

Please continue the prayers and positive thoughts. Terry needs our help now. Thank you so much!

Love, Tammy

Background -- Dealing with complicated Acute Pancreatitis in BOLIVIA

For those of us interested in the medical details of Terry's condition, Tammy asked me to post this. It's from an email Tammy sent to the USC Center for Pancreatic and Biliary Diseases in LA on Saturday. She hasn't heard back from them yet, so if anyone has some pull there, feel free to rattle their cage! Or, if you know of another group that might be more responsive, please leave their name in the comments for this post:

Dear USC Pancreas Disease folks,

I am in La Paz, Bolivia, while my significant other/¨husband¨ (Terry Bingham) is in the ICU unit at Clinica del Sur fighting for his life. I found your email address on the Internet and was hoping that you might be willing to do a long distance consult with us.

As you can imagine, this is a very tough situation all around. I would like to give you some background:

Terry woke around 4am Monday with a stomach ache. At 8am he took his vitamins and within minutes was in severe abdominal pain. I have never seen him in such pain, he was doubled over and no position provided relief. He was near tears - and he is a VERY tough guy. Within 2 hours we were admitted at the best private hospital in La Paz, Clinica del Sur. He was quickly diagnosed with acute pancreatitis.

They put him on IV fluids, Demoral and on oxygen due to the high altitude here (11,000 feet)and his difficulty breathing due to the pain and distension. The rest of Monday and through Wednesday around noon his condition just seemed to deteriorate. Monday afternoon he developed a fever (38.9 centigrade) and they put him on antibiotics which did take away the fever.

They did an ECRP scope procedure Tuesday around noon and found nothing much. His blood pressure dropped precariously low at this point and they took him to ICU after the procedure. Tuesday night he was taken to surgery because of the severe distension. They first did a laprascopic (sp?) surgery but then had to proceed to full blown surgery and they found nothing wrong other than a very distressed pancreas, a lot of fluids, including puss, and I would assume blood but am a little unclear here.

They told us that he had a sepsis infection that was very bad. He is on three antibiotics still at this point: Ciprofloxacino, Meropenem, and Metronidazolin (Spanish spelling, of course). He is on Norepinefrina, I can´t remember what that is for but you´ll know. Maybe for the pain?

He is on the ventilator of course and is fully sedated, although they seem to be ready to allow him to wake up. It is my understanding that they have been gradually dialing back the ventilator assistance.

We have a bit of a language issue as you can imagine. We have the US embassy involved and they are helping in many ways including translation. They took blood cultures during surgery which results came back just yesterday as totally negative for any infection. However, after surgery they told us that he had a sepsis infection, a very bad one.

He had a small fever on Wednesday but has not had one since. All of his lab reports are coming back with very small signs of improvement. His kidney function is still not normal, but it too is slowly improving. They have now started giving him plasma and platelets.

His arms and legs are quite swollen with water retention and he still has some distension of course.

So far we are dealing with an unknown cause. The doctors say there was no parasite involved. We have been in Latin America off and on (mostly on) for the past few years, cruising on our sailboat from Seattle to Ecuador. Terry´s main doctor´s name is Dr. Ibanez. He seems to be highly respected and we are very impressed with him. While he does seem to be in good hands we are feeling a bit helpless here. We get a little misinformation or there is miscommunication at times, which leads us to feel a bit insecure about whether everything that should be done is being done.

Terry is overall in very good health, although we suspect now that he has been having some mild symptoms for at least a month that maybe attributed to this. Occasional loss of appetite/mild nausea, occasional mild diarrhea, last week some mild heartburn a few times which is not normal for him, and maybe some general malaise.

We have been traveling via bus through Peru so these were all easily explained away as due to travel in a 3rd world country. The possibility of medical evacuation has been discussed off and on. We have the impression that while on the ventilator that is not much of an option. To complicate things, evacuation from La Paz requires an air taxi from here to a lower altitude where a medical evacuation plane would be waiting. Not the best circumstances!

We are writing to you in hopes that you might be able to assist us. I´m sure this is a bit unusual, but as you can imagine we are a bit desperate. Terry´s children have flown down from the USA to help us through this. We are in very good hands with the embassy folks, in fact they have taken charge of making sure there is a source of plasma and platelets for Terry - he is type A positive which is not common here in Bolivia.

I am hopeful that we will hear back from you and thank you so much for taking the time to read this long email! We will look forward to hearing what you have to say!

Sincerely,
Tammy Woodmansee
from Seattle, WA, and a US Citizen

Terry's Troubles -- La Paz, Bolivia

On and off for several years now, Terry Bingham and Tammy Woodmansee, of Seattle, Washington, have been cruising and exploring the West Coasts of Central and South America aboard their boat, the 'Secret 'o Life', a Union 36 cutter. This summer, they've been visiting Ecuador, Peru and Bolivia, leaving the boat now and then to take excursions inland by bus. They hike, sight-see, and visit with other tourists and locals they meet along the way.

Early on Monday morning, August 18, Terry and Tammy were in La Paz, Bolivia, when Terry started experiencing severe stomach cramps. Terry is normally a hale and robust fellow, and very tough, so they knew something was very wrong. After getting to a doctor, Terry was admitted to the best private hospital in La Paz, Clinica del Sur, where they quickly diagnosed acute pancreatitis and started treatment.

Even so, he continued to worsen until he was taken into surgery on Tuesday night. They found infection and bleeding, and his pancreas was in very bad shape, although they could not track down a cause. He has a blood infection (sepsis) and is struggling to breathe, in part because of the altitude of La Paz (11,000 feet). He was very close to death's door for several days and any setbacks could have been fatal. Luckily, he has Tammy, good doctors, and his strength on his side.

Today, a week later, he is only now being weened off the respirator. In the last couple of days, he has finally regained consciousness and awareness. He still has the blood infection, although his vitals and labs are gradually improving.

Through it all, Tammy has been his rock, juggling all the details of his care in a foreign country with an unfamiliar health care system. This weekend, Terry's (adult) children Hollice, Christen and Brad arrived to help, which was a great boon to both Tammy and Terry.

Terry is doing better, but his recovery is likely to be a long and expenses high. We created this blog to help spread the word and allow people to help if they wish, and to keep people informed as Terry hits the road to recovery.

In a short while, we will add a PayPal 'Donate' button so donations can be made directly to Terry's PayPal account. Please check back for that soon.

Your prayers, good wishes and donations would be greatly appreciated!