Based on United Nations statistics, a group ranks countries on the amount of good they do for the people living there, called the Good Country Index. You can see on the list that though not at top (like those Scandinavian countries) Costa Rica is the highest ranking Latin American country and of course ranks higher than the United States. 🙂 Photo above is one of my shots from the 2018 Oxcart Parade, Atenas.
I learned about this recognition from Christopher Howard’s newsletter/blog in his article More Accolades for Costa Rica.
“Twenty years from now you will be more disappointed by the things you didn’t do than by the ones you did do. So throw off the bowlines. Sail away from the safe harbor. Catch the trade winds in your sails. Explore. Dream. Discover.”
-Mark Twain
And many of you know that Mark Twain’s spirit is my spirit. I have visited more than 60 places in Costa Rica and intend to continue until I have visited every park, refuge and reserve along with lodges and hotels that offer birding and nature adventures. The feature photo is my cell phone shot at the Beach Break Hotel in nearby Jaco Beach when the Nashville FBC Group was here.
And what is different about this week is I am going close to home, an hour’s drive away to Hotel Punta Leona with their own private nature reserve and they promise many birds including the Scarlet Macaw they provide nesting boxes for (like Tambor Tropical Resort I’ve already visited). As long as I have the promised WiFi connection I will be doing nightly posts from Punta Leona the rest of this week. Get ready for adventure near my quiet town of Atenas!
I finally figured out how to copy Google Maps via a PDF file converted to jpg. This shows the 1 hour drive from my house to Punta Leona. CLICK to enlarge. Note that I will pass by Tarcoles River & Carara National Park, both good birding places that I can visit from the hotel if desired.
And I have three more similar nature hotels scheduled close to Atenas this year with Macaw Lodge in June, Villa Caletas in July along with a repeat of nearby Xandari Nature Resort. There is adventure close to home! 🙂
This article is about what you get for what you pay for in healthcare. Though not #1, Costa Rica is in the top 25 countries for efficient healthcare (based mostly on our public healthcare) while the U.S. is next to last with only Bulgaria being worse. Some rich expats here from the states still swear healthcare is better there and fly back for every little thing, since money is no problem for them.
The closest public hospital to me is in Alajuela. I spent 2 nights here for my angiogram. Español es necesario!
The rest of us expats have found excellent healthcare here at a fraction of the cost of the states when using private doctors/services (maybe averaging around 1/4 the cost of stateside) and some of us save even more by mixing public healthcare (free though I pay a required tax for it) and private healthcare for which I must pay cash since I dropped my expensive private health insurance here. Yet it is quicker and sometimes more expedient than public healthcare. As shared in earlier posts I use a mixture of both and for private care I belong to a medical discount group called “MediSmart.”.
-o-
The most popular Costa Rica Made Cookies are called “Chiky” and come in many flavors and styles from the most popular chocolate cream-filled to strawberry, lemon, banano and even the tea-time crispy wafers. Mmmm good! The Link above is to Christopher Howard’s article and here is the English-language website of the cookie company here in Costa Rica:
OK – not a happy thought! So for those who don’t want to think about it, I have another post today on why we are happier in Costa Rica! 🙂 This is one of those articles for readers planning to retire here. Since I expect to spend the rest of my life here, I should plan for death here.
First, most expats living here will need two wills, one in Costa Rica and one in their home country. I already had a very detailed will in my home country, the United States, but now I am in the process of a slight update of it (I got rid of all my stuff.) AND creating a Costa Rica Will (which I should have done earlier). Since I own no property or even a car here (just personal effects in my house), my will is simpler than most expats living here. A house, a piece of land, a car, etc. located here must be covered in a Costa Rica Will, not your stateside or home country will. As the Boy Scout motto says:
“Be Prepared”
I keep a notebook in my house with all the instructions for what to do when I die or am disabled with copies of my 2 wills, powers of attorneys and other important documents. If someone finds me dead in my house, they will hopefully also find this notebook and follow the instructions.
MY COSTA RICA WILL covers everything in this country including: FIRST, MY BODY which I am donating to science at the University of Costa Rica Anatomy Department (easy for everyone else). 🙂 SECOND, ANY BANK ACCOUNTS here which for me is just one where my SS Check is deposited for housing expenses. A Costa Rica Bank account needs a Costa Rica Will. Any other money accounts a person has here would be the same. THIRD, MY PERSONAL EFFECTS here will be handled by Costa Rica law and I’m giving my son or sister 30 days to come here and claim anything they want (computer, cameras, artwork, photos, books, clothing & very little furniture). Hogar de Vida (a local children’s home) gets what my family does not claim (in person here) and/or Hogar de Vida is 3rd in line for all personal effects. They can use the stuff or sell in a yard sale as they wish. FOURTH, AN APOSTILLE DEATH CERTIFICATE(S) will be sent by my CR Attorney (or in some cases by the U.S. Embassy?) to my attorney in Nashville who will need it to execute my will there. Standard procedures.
MY UNITED STATES WILL covers everything related to me in the United States: FIRST, MY BANK ACCOUNTS there SECOND, MY RETIREMENT ACCOUNTS THIRD, MY ONE TINY LIFE INSURANCE POLICY FOURTH, DISPERSING ANY BALANCES ACCORDING TO THAT WILL
If I owned property in the states, it would be included above also. I don’t. I have greatly simplified by life in my final years. I have two attorneys (Costa Rica & Nashville) in touch with each other now so they have a plan to handle my death. When I die, it is all up to them in their respective countries. In my case they are also Executors of my two wills and Powers of Attorney, for me in their respective countries.
As a well spent day brings happy sleep, so life well used brings happy death.
~Leonardo da Vinci
The above featured photo by Charlie Doggett is of the Bribri Watsi Waterfall in the South Caribe of Costa Rica. The latest international report to place Costa Rica as the happiest place on earth lists some of the reasons. See the full article at World Economic Forum or here is my brief summary:
Seventy years ago we did away with our army and now spend 8% of GDP on education while the rest of the world (including the U.S) spends only an average of 4.8%. So our strength is human talent, human wellbeing.
Not spending on the armed forces also allows this country to protect the environment. Costa Rica generates more than 99% of its electricity from renewable sources.
The Costa Rican government has used taxes collected on the sale of fossil fuels to pay for the protection of forests. “We saw in the eighties that the forest coverage was reduced to 20% due to animal farming and timber. We’ve managed to recover all this and we’re back to forest coverage of 50%. By this we are combating climate change.”
Costa Rica hosts more than five per cent of the world’s species, despite a landmass that covers just 0.03% of the planet. “Many people say that to protect the environment goes against the economy. Whereas it’s the complete contrary. Our tourism has grown precisely because of this,” says Alvarado.
As a result, Costa Rica is the happiest and most sustainable country on Earth, according to the 2019 Happy Planet Index (HPI).
See my photo Gallery of happiest, most sustainable country:
is what the Dermatologist says about the cause of skin cancer. But he also says if I continue to get too much sun it will make it worse, so my two wide-brim hats and 60 SPF Sunscreen, called El Protector Solar here or informally protección de sol. I dislike it but when I know I will be in the sun much, I use the sunscreen now and wear my big hat everytime I go out!
SKIN CANCER SURGERY ON MY FACE THIS TIME
The only other skin cancer removed was from my arm a month or two ago and it was comparatively easy with a lot more skin on the arm. Sorry if the photo below grosses you out, but I was really surprised at how much this facial growth had grown with this big of a scar or “more than 15 stitches” said the doctor, though I counted more like 20 or 21 in the photo. My eye is partially swollen and partially closed but it will get back to normal soon. I went back to the doctor the day after surgery (Wed) and he changed the bandage which I will permanently remove Thursday. Air helps healing. And he prescribed a cream I put on it twice a day for at least two weeks when I see him again for a checkup, after my next photography trip of course! 🙂 I have to keep my priorities straight you know!
MOHS SURGERY
It was Mohs surgery Tuesday which the link describes or basically it is a pathologist there with the surgeon doing biopsies on every bit removed until there is no sign of cancer. With this he is now more certain he got all the cancer and didn’t remove too much “good skin” which is more limited on the face. He was prepared to graft a piece of skin from my cheek if necessary, but thankfully it was not. And in two weeks or so I will be back to normal with a noticeable scar on my face. No problem! Just call me “Scarface.” 🙂
Surgery day bandage
The 15+ stitches
That’s Life! – ¡Así es la vida!
¡Pura Vida!
And tomorrow I will go back to sharing more from my great trip to Maquenque Eco Lodge!(Link is to the Gallery)
And oh yeah, that sunset photo above is one I made at Arenal Volcano National Park. After all, this article is mostly about the sun! 🙂
My dermatologist (after 2 skin cancers) says I have to wear a wide-brim hat everytime I go out along with sunscreen. Bummer – but here’s my first one (a Dorfman Pacific Safari Hat) which is like what a neighbor wears everyday, so I won’t be alone! 🙂 Then with a Christmas gift certificate I ordered a Panama Jack Safari Hat which might be more stylish. The price you pay living close to the equator! ¡Pura Vida!
My prayers go to the Bush Family in their loss . . .
. . . a truly great & humble man!
George H. W. Bush
Humility is not thinking less of yourself,
it’s thinking of yourself less.
~C. S. Lewis
REPORT ON MY BIOPSY: After removing the 10 stitches from my arm (where all that cancer was confirmed removed) and the two stitches from my face for the biopsy, Dr. Gamboa gave me the facial biopsy report:
In brief, it says I have another carcinoma cancer on my face which is a smaller and slower growing type than the one on my arm. No problem waiting until January to remove the rest of it (the biopsy took most of it). Because of the delicate and thinner skin location next to my eye, we will be doing a more complicated and more efficient (more expensive) “Mohs Surgery” with two doctors doing it with a pathologist standing by to make sure they get all of the cancer as he examines each layer as removed (continuous biopsy). It will not be in his office this time but in a clinic, hospital-like, operating room, but still out-patient. He is checking on availability of other doctor and the clinic for the week of 21 January – after my Boca Tapada trip. Remember — the doctors work around my trips! 🙂 Important! That is where I sleep in a tree house 5 nights!
Dr. Gamboa also “PRESCRIBED” wearing a wide-brim hat instead of the ball caps I’ve been wearing and of course sunscreen every day when out. I sure love sunny Costa Rica, just 673 miles north of the equator, but with the value of the sun also comes with some potential dangers for someone like me who loves the outdoors. I have already become more careful, even though the doc says these current growths and cancers were probably caused by sun I got as a child or teen, more sun now can make it worse, so I must be cautious.
As I continue choose between the free government healthcare (with monthly payment like states do with Medicare) and the mostly affordable private doctors using my MediSmart discount card I have so far been well cared for in my various medical needs and either free or at very reasonable private costs.
In earlier reports I have explained how the public system includes a cardiologist I like and I feel well cared for. When my various “tags” and other skin growths began to increase, I decided to try a private dermatologist and have been equally pleased with his services and prices.
One growth on my right arm he suspected and did a biopsy which proved positive for a melanoma cancer, Tuesday afternoon he cut a chunk out of my arm and is pretty sure he “got it all.” His guideline is to take 4mm to 5mm all the way around the growth. That meant 10 stitches in my arm, but that will heal. I decided that a photo of it would be too gross. He also took a sample from a growth on my face that has not healed from an earlier nitrogen treatment (freezing it off). So when I go back for my stitches to be removed in 2 weeks I will get the biopsy report on that. Hoping for no more malignancies, but we do what we have to do and I’m still enjoying my monthly adventures with doctors working around my travel schedule! 🙂 And by the way, my rotator cuff surgery has healed very well, thanks a lot to the physical therapist Andres! Pretty much back to normal use, though now I have 10 stitches in that same arm! Sigh.
I walk regularly and eat reasonably well if not maybe too much! 🙂 So my overall health and heart condition is great, just this little skin cancer bother that is caused by too much sun when I was a kid or teen, says the doc. I’m more careful about the sun now!
The Grand Feast
Tony & Rose Mary, the couple who plan our expat trips almost every month put together a group eating traditional American Thanksgiving Dinner at the Baron’s Resort on top of a hill here in Atenas with beautiful views. It was delicious in every way and the turkey was cooked perfectly – moist not dry! And they even had pecan pie! (My favorite if you don’t know.) The resort is now owned by my local attorney, Cecelia Tristan, and she is doing a lot of extras to make their restaurant appealing to locals. I will eat there again from time to time.
And no excuse for not snapping a cell phone photo – just didn’t!
You have to click the image at least 2 times to get an enlargement.
Yesterday afternoon I saw my Dermatologist who presented me the lab’s very detailed report with color microscope photos and the diagnosis en español:
“Carcinoma epidermoide bien diferenciado, invasor, de al menos 4 milímetros de diámetro mayor, que alcanza los márgenes de resección.” Or in English according to SpanishDict.com translation:
“A well-differentiated, invasive epidermoid Carcinoma of at least 4 mm greater diameter, reaching the margins of resection.”
The Doc assures me he can cut it all out by going a prescribed mm distance all the way around it (a big chunk of flesh!) and with several stitches will heal that part of my right forearm back to normal. That’s a $600 surgery or for $4,000 he can do a much tinier section removed while a separate pathologist is testing (continuous biopsy) every little bit of skin to make sure they get all the cancer without taking as much of a chunk! He recommends this for a growth on the nose, etc. where removing more is more obvious. Of course I’m doing the cheaper one which he assures me has always been successful for him and what he recommends. Just a little scar on my right forearm. It is scheduled for 19 November after my next trip which is to Palo Verde National Park 10-15 November. My doctors work around my trips and not vice-a-versa. 🙂
It is interesting that Dermatologists here say the same thing they told me in the states, that these growths that keep popping on my body in old age are caused by getting too much sunshine when I was a little boy. No one told us that back then! Or maybe I was not paying attention when Mom wanted me to use sunscreen? 🙂 The young are invincible and us old ones just smile at our little problems. 🙂
Since this is a retirement blog, I guess this kind of gory medical report is appropriate. Anywhere you live in retirement you must deal with these things and the medical services in Costa Rica are simply great and so much more affordable that I’m just using a private doctor again instead of the free public ones, which are slower but just as good and free! 🙂 I still use a public doctor to monitor my heart arrhythmia, but other things I’ve been happy with the quick responses of private doctors, like this Dermatologist, Dr. Gamboa.
Every day I do a few simple, light exercises to regain the movement in my right arm toward recovery from the rotator cuff damage and surgery. (Up to 3 times a day.) Thanks to Andrés for loaning me some of his tools to use at home! Photo captions explain the use of each one.
While in the Caribbean next week I will continue to exercise but may not take all of this equipment. 30 pound baggage limit on the small plane.
The dish towel is for polishing the table top. Remember in the movie “Karate Kid” polishing the car? I have several movements with the broomstick, the good arm does the work but gets the other one moving! And the big rubber band is for strengthening.
2.5 lb. weight is for mild strengthening.
The rope and pulley is similar to the broomstick, good arm doing the lifting work.
I use rope and pulley on a door.
“And will you succeed? Yes indeed, yes indeed! Ninety-eight and three-quarters percent guaranteed!”
– Dr. Seuss
