Sunday, March 30, 2008

March 30, 2008 - Orosi Day Trip

We finally made it back to Orosí - it is almost unbelievable how long it took us to make the trip.

We first tried in the middle of December - we planned take the bus and stay several days with our Spanish School Family. When that didn't work out, we next tried in January - but that time, we didn't even get as far as details. So many things interfere - we were sick, I was trying to schedule surgery, life happened... We were stuck with this idea that we couldn't make such a long trip (and back) in only one day. Then you have to consider all the junk we have to take with us if we stay even one night - yikes! By March, we had gone on enough multi-hour bus trips that a full day didn't phase us as much, so we thought we would try renting a car for the day, and plan on a single-day trip. Well, the car-rental thing was a bust. This is the time that you really appreciate the culture here - Each time we called the family to plan a trip (and then when we called to re-schedule), they were unfazed. I could feel my whole body clench, but they were super-cool.

Here we were, running out of Costa Rica time, brains adjusted to the idea of a day trip, with a load of gifts (not something you want to take back to the states with you). So, we did it! We caught the 8:00 bus from Alajuela to San José, took a taxi to the Cartago bus stop, where we just caught the bus to Cartago. Ahhh. We recognized the right place to get off the bus - an easy half-block walk later, we are on the Orosí bus! Unbelievably, we were in Orosí just 2 hours after leaving Alajuela!

We had a great visit - my Spanish is getting better (but still very halting, and I don't really "hear" it well), and Rick's Spanish is *great*! There is a new baby, so we got to make a fuss :).

Since we got there so early, we had coffee while they had a late breakfast. They have been through some tough times - their oldest son was in the hospital with a bleeding ulcer. He had an attack while working in Guanacaste, then a stressful ride in the ambulance to Cartago - the ambulance driver from Nicoya didn't know Cartago, and so got a bit lost. The family had made trips to Nicoya to see him while he was in the hospital there (he had to stabilize before the ambulance ride), and they were talking about how long it took to drive there - they got home at 3:00 in the morning one time. But now he is in the Cartago hospital - it is the premier hospital in Costa Rica for stomach problems (and Costa Rica has a *very* high incidence of stomach cancer). They had put off visiting their son that day because we were coming to see them - yikes!

A bit later, José took us up to his family´s finca - it is a short (but steep and bumpy) drive up the mountain. No one really lives there, but there is a shack where people can stay overnight if needed. The views are amazing! While we were there, we saw a helicopter - José said that it was owned by a gringo who lives on the other side of the ridge - he can get to San José in 20 minutes. Talk about decadent!

The finca is in coffee country, but the coffee plants are in trouble - José showed us the damage caused by an insect infestation. The healthy beans are normally white inside...

We got back to the house and had a fabulous Tico lunch - Teresita cooked chicken soup (my mouth is watering just thinking about it). It is so rich!

Lunch just added to the feeling that could only be described as homesick. It seems strange to say it, especially since we really only spent 3 months there, but there is no more accurate word. From the time we entered the valley, past the coffee plants and the orange-blooming trees, recognizing friends´ houses, familiar restaurants, the rocky river, the soccer field - well, just about everything - I had a lump somewhere in the vicinity of my throat.

I thought again about living nearby - if we do end up close, I think I *will* talk to Teresita about getting cooking lessons from her...

Well, our return trip was not as smooth as coming to Orosí - it took us 3 hours instead of 2. We hit some traffic, but we also found out where a lot of buses leave from Cartago (about 4 blocks North of the Ruins / Central Park). All told, we spent 5 hours of travel for 5 hours of visiting - a pretty good rate I´d say!

OK, so this has been something of a ramble - I'm out of practice...

Friday, March 14, 2008

March 11, 2008 – Health Focus in Costa Rica

I’ve just passed my first year of retirement! It’s hard to believe that much time has gone by. One of the main things I wanted to do was to focus more on my health. I have found that my method for most of my life is to focus on one or two things at a time – everything else takes a back seat. I had been spending almost all my effort on work, often without leaving enough time in the day to even get a full night’s sleep (let alone all the other important aspects of life). Well, I was determined to change that. So, I spent the first few months just relaxing; downsizing my stress. We spent a few months in Costa Rica – learned some more Spanish and just lived. Then back to the states to work on our house – worked outside in the yard (and the sun!); definitely spent less time sitting at a desk! Then back to Costa Rica for a few more months. This time, we rented an unfurnished apartment within walking distance of downtown (no car). This meant we walked a *lot*! After 2 months, without thinking too much about it, or trying at all, I lost 20 pounds and knocked the bejeezes out of my blood tests - over 50 points off my cholesterol level, 40 off triglycerides, and almost 20 off glucose levels. Of course, doing the laundry by hand helped, and I can´t entirely discount the effects (beneficial?) of food poisoning

But I knew from past experience that I could only go so far, and at least a partial rebound was likely in my future – and I also had so much more to fix. So, we took the plunge, and I had gastric bypass surgery in Costa Rica. This is where your digestive tract is re-routed a bit – 90% of your stomach and the first part of your small intestine is bypassed. It makes you eat less, and digest more of your food lower, so you absorb fewer calories (and vitamins). It also means you have to let your stomach re-learn how to handle food – it has been about a month, and I finally get to try solid, near-normal food.

Rick was uneasy with the idea of my having surgery – let´s face it, it is a serious undertaking. But then he thought about this – our bodies have evolved to be efficient, and to store fat for the times when we need more fuel than we can take in. In these times, that is just not very often… So, if your body is not working the way you need it to, there is nothing wrong with changing your body. It´s still a bit scary, of course…

The long-term effects for most people is that you lose 80% of the excess weight. Some people gain some back, but not all of it. This is a permanent change, and basically forces a change to your eating habits. The other options for bariatric surgery were either not permanent, or were not as positive.

In the short-term, most of the excess weight is lost in the first 6 months. Something called ¨malabsorption¨ continues for 3-5 years – this is where the vitamins are not absorbed completely by the body (you need to take supplements).

One interesting side-effect of this surgery is that your glucose levels stabilize *immediately* - if you have Type 2 diabetes or glucose intolerance, 90% of the time the surgery itself cures this. This is because the section of intestine that triggers glucose over-production is bypassed – so no more triggering. This has led to a modified surgery for people who have Type 2 diabetes without a weight problem. They have been doing this in Costa Rica now for 5 years, with a high cure rate (~85%). The USA is a bit behind the times – the procedure is not FDA approved (yet). Cynics believe this is in large part caused by the pharmaceutical industry – diabetes is a real cash cow in the states, so why would they want it cured?

Some of the differences in health care here in Costa Rica are mind-boggling!

  • Everything happens at its own pace, so sometimes appointments take hours (much of it waiting). But of course, that has happened plenty of time in the states too. However, most of the time, appointments were spot on.
  • I had a consultation with the surgeon ($48), and left with his cell phone number – and instructions to call at any time. Over the course of the surgery and recovery, we must have called him over a dozen times – each time, he was happy to hear from us (really? Well, it seemed like it…).
  • Once we got the surgery go-ahead (passed all the pre-operation tests), we paid for the procedure. This included all the visits to all the doctors, all the tests, and over a week´s worth of prescriptions. It also included a follow-up endoscopy at 6 months.

The question of insurance requires its own entry…

March 10, 2008 – Renting a Car in Costa Rica?

We’ve gotten by pretty well so far in Costa Rica without driving a bit. For most places we need or want to go, we can walk, take a bus or taxi, and sometimes hop a ride with a friend.

But when we compared all the alternatives for a trip to Orosí, we decided to rent a car for a day and drive ourselves. We ended up driving ourselves a little crazy :).

We knew about some of the major “gotchas” - the car rental agency charges your credit card just over $1000 as a security deposit, along with the rental fee. Basic insurance is mandatory, and not always part of the quote. Optional insurance (as everywhere) is a *lot* and not part of the quote.

Here’s what we didn’t know. We had asked for a car for 10:00, and so were told the driver would come to us then. We didn’t exactly know what this meant, but it turned out that a van pulled up (almost half an hour early! Fortunately, we were ready to go.) and, after several more stops, took us to the car rental agency. We went in, and filled out a *ton* of paperwork. We each needed passports (copies were ok; for some reason, cédulas were insufficient), driver’s licences, and a credit card. At the end of all the paperwork, we were presented with three credit card slips – these had the imprint of our card, but were otherwise blank, and we were told to sign them (!!!). Something about not signing blank checks clicked, and we said no can do… Well, the upshot was that we ended up not renting the car. Fortunately, they did ask if we needed a ride back, so we were only stuck there a bit longer. However, it was an hour and half after we had been picked up, and the people who were in the van with us *still* didn’t have their car! We did find out that at least one other rental agency does not require you to sign blank credit slips, but most have a minimum rental period of 3 days. So our plan for renting a car for the day was canceled. Beside that, by the time you actually *get* your car, and account for *returning* it, how much of the day do you actually have left?

Recommendations –

  • Think about taking a taxi to and from the agency (you pay, but your time is your own)
  • Have a low-balance account just for car rentals and small miscellaneous items.
  • Don’t try to rent a car for less than 3 days.
  • When you book a car, ask if they require you to sign blank credit slips – if so, call the next place.
  • Check your credit card balance often to make sure the deposit has been refunded. If it hasn´t within 3 or 4 days, go to your bank (especially if you use a Costa Rican bank, like Banco National) and open a dispute – they will (hopefully) take it from there.

Note: If you have an account with a Costa Rican bank, you are responsible for all fraud committed with your credit/debit card. The law here is *not* like it is in the USA and Canada.

UPDATE April 11, 2008 - the $1045 security deposit (a hold on that amount in our account) finally cleared! Over a *month* without access to that much money is outrageous!