Tag: hospital

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Surgery Scheduled for Monday Evening

Monday 30 July. Yep! That does seem different, evening instead of morning, but that is the way it is (and maybe when an operating room was available at the small private hospital). And the doctor said the sooner we do it, the less damage will be done to the tendon and the sooner I will be without pain. And instead of using the main Hospital Metropolitano in downtown San Jose we are going to one of their 4 suburban campuses, the only one with an operating room. It is in the Lindora barrio of Santa Ana which is on “my side” (west) of San Jose just off our “freeway,” Ruta 27, and about 30 minutes closer than the downtown hospital campus, especially during rush hour, thus easier and quicker for both me and my driver whom I’ve already scheduled.

I am to be there at 5PM, with the surgery scheduled for 7PM to 8PM with one hour in the Recovery Room and return home soon after 9PM. That should be a good way to get sleepy for bedtime!  Ja, ja, ja, (español for ha, ha, ha)   🙂 though the anesthesia is only local.

He says my activities can be normal in a week to 10 days though I will have 5 weeks of physical therapy (2X a week), the hardest part one U.S. friend said. But I did cancel or postpone my August trip to Sarapiqui, which I now have rescheduled for next May. Before then I will be a new man who will try harder to not fall off the bed or on the rough sidewalks of Alajuela! It’s just that time of life!   🙂   No cane yet and hopefully not soon! But maybe needed someday?

“Getting old is not for sissies.”     ~Bette Davis

¡Pura Vida!

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Orthopedic Surgeon Today

Because my right shoulder has been hurting now for more than two months I decided I needed to see a specialist and to do it faster use a private doctor who is in the Medismart Group I am a member of (Medical discounts!) The public medical system might have led me to the same results but at a much slower pace.

I chose Dr. Dario Lungo with Hospital Metropolitano in San Jose and rode the bus there after Spanish class this morning. I took with me the x-ray of my shoulder my local general practice doctor, Dr. Candy, had me get at a local radiology clinic. Candy also recommended that I see an orthopedic specialist and let me choose one in my discount plan.

Dr. Lungo looked at my x-ray and had me move my arm in various ways and said it is definitely a rotator cuff problem and then pointed out on the x-ray that the collar bone above the ball joint of my upper arm was touching or did not have the gap between them that they should have. “We need an ultrasound.” Ultrasonido Hombro Derecho  Another 3 hours because radiology  was backed up with jobs! But it paid off! Photo is UltraSound equipment.

SUMMARY REPORT

US muestra ruptura completa del tendón supraespinoso derecho Leve bursitis secundaria y derrame alrededor del TLB. 

US shows complete rupture of the right supraspinatus tendon, slight secondary bursitis and effusion around the TLB.

The full radiology report is much lengthier with lots of detail, but that is enough to share here with the big serious thing being a rupture of the main muscle/tendon in my shoulder, caused by my two falls in the past two months.

TWO OPTIONS

(1) I can do nothing (like our grandparents did) and in 2 to 3 years the pain might subside with a little natural healing, but never the same. (2) Surgery to repair/rebuild the ruptured tendon and other minor repairs that takes at most an hour and a half with local anesthesia as a hospital outpatient. Cost is $4,200 which is a hugh junk for me! This is called “Rotator Cuff Surgery” in the states and the USA National minimum price is $8,400 (twice our cost) and the maximum allowed is $56,200 with a national average of $21,800 (More than 5 times my cost here.) And of course I could get it for free if I waited for public health coverage but afraid to wait.

DECISION TOMORROW

I will consult with Dr. Candy tomorrow and probably go ahead and schedule it in the next few weeks, if she thinks it best, meaning I may have to cancel my August trip, though Dr. Lungo said I could travel two weeks after the surgery.

AN ASIDE STORY: NICE PEOPLE HERE!

On the bus ride back to Atenas from San Jose our full bus broke down (only the 2nd time that has happened to me) in La Garita. The return bus from Alajuela stopped and all of us got on that also-full bus, standing room only from front to the back! As soon as I stepped into the bus a young man popped up out of his seat and made me take it ( I tried to refuse). The respect for the elderly here is simply amazing! But of course that means I look old!  🙂

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Quiet Roberto – An Imitator of Christ

Occasionally the behavior of people calling themselves Christian saddens me, while on the other hand being around someone like Roberto causes my heart to swell with joy and love and motivates me to be a “follower of Jesus” rather than just a “Christian.”

Roberto was one of us 6 men in the hospital room this week for two nights and as the healthiest looking and the only one who was mobile, he became “a little Christ” among us, walking humbly and quietly from bed to bed to comfort each of us any way he could, listening patiently to the overly talkative man, emptying the urinal of the overweight man, cranking beds up or down, talking quietly with the wife of the dying man, and generally being the presence of God’s love in our little 6-bed hospital room. To watch a man imitate Christ in front of me for parts of 3 days was pure joy!

Then today as I returned to hospital simply to make a follow-up appointment with my cardiologist (no, you can’t do it everywhere by phone) I got to try being like Roberto or Christ. A special needs adult in front of me in line dropped a hand full of papers that scattered on the floor. I got down on my good leg’s knee and picked them up. As I handed them to him the radiant smile on his face was another moment of blessing among loving Costa Rica people. 

¡Pura vida! ¡Gracias a Dios!


Philippians 2:3-8
Do nothing from selfishness or empty conceit, but with humility of mind regard one another as more important than yourselves; do not merely look out for your own personal interests, but also for the interests of others. Have this attitude in yourselves which was also in Christ Jesus, who, although He existed in the form of God, did not regard equality with God a thing to be grasped, but emptied Himself, taking the form of a bondservant, and being made in the likeness of men. Being found in appearance as a man, He humbled Himself by becoming obedient to the point of death, even death on a cross.

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My first free prescription!

Waiting in line for my “free” prescription
at the local government Clinica Farmacia.
The right line is to give them the prescription & left to pick it up.
Depending on work load, 1 to 3 hours wait. I just left and returned later.

My local private doctor diagnosed me with heart arrhythmia and through an expensive private cardiologist in San Jose I was given an expensive beta blocker at about 60-80 bucks a month. My local private primary care doc found a generic version at about half that price, but I talked to my government primary care doctor anyway. As reported earlier, he sent me to a cardiologist at the Alajuela Hospital where I would go with emergency heart problems on the government plan. And the really nice, 30-something cardiologist checked me out and said he could give be a prescription at no cost but it would be different from what the private doctor gave me (a 3rd brand of beta blocker). It is Atenolol and after researching it online I discovered that it is the most used med for arrhythmia in the U.S. or all around the world right now. So I am just now experiencing one of my big savings through CAJA, the government health plan.

As I think I explained earlier, I am keeping my foot in both doors “just in case” because some hospitalizations, surgeries, or other procedures have long waits in the government program unless an emergency. i.e. Hospital Alajuela will be my government hospital where I have a cardiologist already. Next Monday I have a consultation at Hospital Metropolitano San Jose which will be my private hospital of choice when the public hospital is not available. I joined a discount program with them and will save up to 80% off many services there compared to other private hospitals. At my age, regular private insurance is just too expensive, so this is my self-made plan and I plan to use the public services as much as possible as in this case with heart medication, but if needed, I have a private option that I hopefully can afford. 
When you are an immigrant in another country, it takes time to get all the details worked out. But it feels good when you do!  🙂

And after stirring up people on Facebook with a comment about Trump, I’m going to stay focused on BEING an immigrant and not telling people how to solve the immigrant problems in the states!  🙂

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Cardiólogo hoy

Cardiologist today (cardiólogo hoy) for the appointment (1 pm) I started making 4 months ago.

10:15 – Left the house walking to bus station
11:00 – Bus to Alajuela then taxi to Hospital Alajuela
12:15 – In line to check in on 4th floor Cardiology Department (cardiólogia)
12:30 – Behind the gray screen for weight and blood pressure
12:35 – Wait in front of Door 8
1:00 – Called into Door 8 where she asked questions in español of course. Then created an EKG (ecg) and then sent me to Door 4
2:00 – Dr. Hernandez calls me in behind Door 4. My first and only person of the day who spoke English. We mixed it up, Spanish/English, as he created a little heart-related medical history of me to begin my cardiology file. At one point he had me both sit and lay down on the examining table where he listened to my chest and back and then felt around in my abdomen. He read and wrote notes on the reports I brought from the private cardiologist I had seen earlier and the medication she had prescribed. He told me he would have be back for an ecocardiogram along with blood and urine workup to give him a total picture of my health to help him better monitor my heart. I feel very good about making this young (30-something) cardiologist my primary heart doctor with the government healthcare program generally called CAJA here.
2:50 – I go back to the front desk with really nice young adults who only speak Spanish to make my appointments (citas). The young man had to use his phone to translate to tell me I must first go to the first floor to a desk and have them make a file on me, mi experiencia, which took a while to find the right desk where I took a number and waited.
3:20 – I took my beautifully created large folder for all my medical records there back to 4th floor where the young man called me past the line and put everything in the folder except my two appointments for March 24 & 25 and multiple copies of my prescription for a different but similar treatment of my arrhythmia.
3:30 – Got a taxi to bus station
4:00 – Bus to Atenas
5:15 – I’m eating one of Chef Dan’s Meatloaf Dinners before watching ABC news.

Now all of this cost me exactly $0. The prescription is good until my March visit and it too is FREE! While the prescription from the private doctor even in generic form costs me between $40 and $50 per month.

Yeah, this first visit cost me most of the day and I had to wait a few months for it, but my heart will be monitored and cared for until I die at no other cost than the required $100 a month CAJA cost which is required if I live in Costa Rica, use it or not. I’m going to use it! Save money! And I like most of it even if rather slow! 🙂 Later I will explain how I plan to work the free government system with some limited private system healthcare and a great little local insurance for a private hospital if or when ever needed for just $12 USD per month! Later!

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San Jose Hospitals Today

Entering Hospital Mexico, the largest in Costa Rica
and a public hospital
MRI at Public Hospital Mexico

Hospital room at small boutique private hospital, Clinica Unibe.
We saw another similar one called Hospital Metropolintano.

In and out of the van at about 5 hospitals

Clinica Biblica, one of the two largest private hospitals along with CIMA.
We also visited Hospital Catolica, just a little smaller.

An absolutely wonderful Senior Adult Apartments with all levels of care,
great views, and near the second largest mall in Costa Rica.
Verdeza Apartamentos
I would love for this to be my final home before death! Great program!

More tomorrow as we head for San Ramon, a town a little larger than Atenas to visit more of the local healthcare facilities and hear more from Paul and Gloria Yeatman and eat lunch at their house.