Showing posts with label Health. Show all posts
Showing posts with label Health. Show all posts

Which Lifestyle Would Cost Our Family Less - Oregon or Costa Rica? - Part 1: Taxes

Gringo expats decide to retire in Costa Rica for a wide variety of reasons. Topping many expats' lists of desirable advantages would be maintaining their living standard at a lower cost or enjoying a higher standard of living for the same cost. That goes for adventurous, frugal younger expats as well as older expats such as myself stretching their retirement dollars.

Costa Rica can certainly offer terrific savings, especially in the areas of health care and housing. Many other daily expenses, however - automobiles being the most egregious example - are higher than what most norteamericanos are accustomed to. Depending on your financial status, lifestyle choices, goals and ability to adjust, the comparative financial equations we all go through at some point before moving here will each have their highs and lows.
calculating living expenses in Costa Rica and Oregon
Taking Stock of Expat Living Expenses


One Constant Is That Things Change

As we approach a new phase in which our own income will shift to primarily U.S. Social Security, our calculations are changing. In fact, just in terms of cost of living, we find that it may actually be cheaper for us to reside in our previous home state of Oregon. I'm not going into all the gory details of that calculation, but this two-part article does hit the high points. Hopefully, it provides additional food for thought to those considering moving to Costa Rica

Mouthwatering Free Fruit in Costa Rica

One of the things most people savor about summertime anywhere in the world is gleaning wild fruit whether it be wild blackberries, salmonberries, apples, pears, cherries or nuts. I loved gathering tart apples, plums and cherries in Oregon from roadside trees. They were rarely hybridized, grafted, fertilizer-fattened specimens, but they were just as delicious as those in the supermarket bins if not more so.
Various citrus fruits in Costa Rica
This morning's juice fruit selection

Most of our roadside fruit here in Costa Rica is of the citrus variety, though there are varieties of vine berries and occasionally other tropical tree fruits to be had. Most of the latter, such as water apples or guanabana, come from neighbors' trees, which they readily share with us.

The past week, Tamara and I have been collecting various citrus fruits on our neighborhood walks and this morning I clambered down the steep hillside below our balcony, thick with six-foot tall coffee plants to add some sour mandarines  to the growing collection.

Despite a similar appearance, these are not the same as the Mandarin oranges one finds on store shelves in the States. These possess a bit thicker peel and are very sour (or ácido in local parlance). Locals claim these provide more health benefits than other citrus fruits such lowering cholesterol and cleaning your liver of toxins.

In the picture upper right, starting from the left side are these fruits: sweet lemons, mandarines, sweet oranges, grapefruit and a few sour lemons.

Tick, tick, ... it's that time again in Costa Rica

We have observed that in Costa Rica soon after a summer rain or at the beginning of the Emerald season that the local tick population exhibits a marked rise of activity. This year seems no exception. Whenever there is a rain day in summer, we are sure to find more ticks on the dogs. 


The ones pictured above I recently extracted from our Border Collie, Buster. They're enjoying the Big Sleep in a bit of naptha (lighter fluid).

Though it may be old hat to folks who have pets and live here or another area of the world where ticks are common, I think it's worth repeating: Ticks carry diseases, so it's important to check your animals regularly and use preventatives and repellents. It is not uncommon here for pets to contract something lethal from ticks, such as erlichia.  Tick inspection is not an easy job for dogs with thick coats like Buster, but we can usually find them by feel. It's important to check less obvious places such as the ears, between the toes and the tail and anal area.

There really is only one good way to remove them, especially if they've been in long enough to embed their mouth parts into the skin. That is, to use some twisting device, such as pictured below. There are some of these that are more like tweezers that will work in really tight places (one time we had to extract one from our puppy's nostril!). Always twist counter-clockwise.


You can pull them out with regular tweezers or your fingernails, but you risk leaving mouth parts embedded in the skin, which can infect the animal. If you pull on a tick, you can easily put pressure on its abdomen, which risks injecting the pet with even more disease-carrying organisms the tick is carrying.

All the hearsay remedies for tick extraction (covering with oil, kerosene, burning, etc.) are not always effective and at any rate take a long time during which you could have just taken the beastie out mechanically.

We also apply Revolution monthly on our pets and during bad tick periods we spray their coats with a dilution of Bañol (Amitraz) about twice a week. This repels as well as knocks off any ticks that are already on.


So, keep those pets healthy! Give them a check-over today.     - Ciao cacao

Firm ranks Costa Rica amongst safest countries in Latin America

Firm ranks Costa Rica amongst safest countries in Latin America (via http://insidecostarica.com)
March 25th, 2014 (InsideCostaRica.com) Consulting firm, FTI Consulting has published its 2014 Latin America Security Index, ranking Costa Rica as the safest country in Central America and one of the safest countries in the whole of Latin America.  …

A Typical Visit to the Farmacia Doctor in Costa Rica

Here's a simple, real-life story about how part of Costa Rica's approach to healthcare works. It's pretty typical in our experience. It's too bad that the U.S., with its struggle to provide decent healthcare for its citizens, cannot adopt something along these lines.

thermometer aspirin and water glass
Being sick is no fun but at least the doctor's free

Nearly two weeks ago, all three of us came down with the flu. The usual symptoms were present: fever, nausea, diarrhea, and so on. Two days later, the worst was over. In fact, Sean was back to normal and back in school.

Tamara and I, however, still were not quite our chipper selves. We had a lingering fatigue, a vague nausea that came and went, an upset and gaseous digestive system. We limited our diet to bland foods, drank a lot of green tea, and kept hoping for the best, but each day was about the same.

At the end of the first week, I decided it wasn't flu at all, but probably some sort of Costa Rican parasite we had all picked up from bad water or food or who knows where. I researched that topic and found it's not unusual for young people, with their strong immune system, to overcome such an infection, so that could explain why Sean recovered so quickly and we did not. Tamara took a ... ahem, ... sample into one of the local labs to get it checked out along with a small jar of our drinking water. The latter test I'd been meaning to do forever anyway.

Costa Rica's Blue Zone and How to Make Your Own

Nicoya Peninsula seen from space (false color)
Nicoya Peninsula seen from space (false color) (Photo credit: Wikipedia)


Recently, the International Business Times posted an article about the extraordinary lifespan of residents of Costa Rica's Nicoya Peninsula. The Nicoya is Costa Rica's northern peninsula, a place hosting fabulous white sand beaches and the driest climate in the country. It's home to about 75,000 residents.


According to Dan Buettner, who has studied so-called "blue zones", which are areas where it's common to find people over 100 years of age, "A 60-year-old in Costa Rica has more than a four-fold better chance of making it to 90 than a 60-year-old in America".

Top 10 List of What I Like Best About Living in Costa Rica

toucan
I was driving my son Sean into Pedregoso today so he could play video games with some of his friends. On the way he asked me what I missed the most from our former life in Oregon. I recalled having thought of something just a few days ago along those lines but couldn't bring it up at that moment (his was Dr Pepper). Maybe it's because there is so much to enjoy here in Costa Rica that I don't fret over comparisons to the "old life" that much. Be here now, right? 

So, I thought I'd make up a quick list of those things I enjoy about retiring here in Costa Rica. The order is not important. It's tough to say which features are better than others. It's not so much their presence individually, but the synergy of them taken together that makes me smile, relax, and want to share the goodness that we've found living here.

Is Costa Rica The Happiest Place On Earth? Maybe Not for the Reasons You Think.

tropical ocean beach
In a walk across the web, I stumbled over this article about how Costa Rica is again the Happiest Place On Earth, and my stubbed virtual toe is still smarting a little.

A lot(!) is written about how Costa Rica is an undiscovered paradise (mostly by the Tourism bureau and real estate agents methinks), and this Happiness Index thing keeps popping up every year. 

This particular article, however, seemed more over-the-top than most, so I couldn't resist dissecting it a bit - tongue-in-cheek - based on my own experience in "paradise." Yes, I've cherry-picked for brevity's sake, but 80% of the article is intact below. I'm going to use my own scoring, +1, -1 and 0 for neutral. Let's see what my "happiness index" comes up with.

Having just been voted the single-most happiest place to live on the planet, Costa Rica has grabbed the attention of many. But the question burning up the Internet is, "why is Costa Rica ranked the happiest place on Earth?"
...
First off, the country is ideally located in Central America between  Nicaragua to the north and Panama to the south.

I have no idea why that positioning would be considered an ideal location and the article doesn't say, either. I think a happier location would be between, say, France and Spain, or elsewhere on the Mediterranean. Will give this the benefit of the doubt, score 0.

One Gringo Family's Experience with Universal Health Care in Costa Rica, Part 2

cat scan
Not the actual machine at Clinica San Lucas (sorry, could not resist!)
Part 1 is here.

Tamara was pretty happy to leave the Caja hospital after halfway through her third day there. The doctor wrote up the orders for the tests, and we were on our way after a short check-out procedure. 

Contrary to my usual procrastinating tendencies, we went right away to a nearby clinic to schedule the exams. First up was a CAT scan, then the colonoscopy within a couple of days.

Unfortunately, the gastroscopy couldn't be scheduled sooner than 8 days away, so we had some down time. The CAT scan was done at the only place in Pérez Zeledón that has the machine, Clinica San Lucas. I won't go into all the gory details, but the typical preparation for all the tests was fasting and usually a purgative besides. Believe me, she was pretty worn out by the time we finished all the tests.

One Gringo Family's Experience with Universal Health Care in Costa Rica


Seguro Social Logo for Costa Rica
Logo of Costa Rica's Social Security
Everyone, Ticos and Gringos alike, love to kick the Caja, especially when it's down, which it is pretty much all the time. Caja Costarricense de Seguro Social (CCSS) is the Costa Rican government's universal health care system implemented after the 1948 civil war, which resulted in the abolition of the Costa Rican Army and the government refocusing its resources towards social programs.

No question about it, there is plenty to dislike about the system. In general, it's underfunded, understaffed, overcrowded, and slower than a sleeping sloth. Worse, the resources that it does have are scattered about the country unevenly. While in Cañas there is a state-of-the-art clinic, here in Pérez Zeledón the hospital is an awkward maze architecturally and in terms of process. The only thing holding up the building appears to be the umpteen layers of paint on the walls.

That said, the Caja does provide access to health care for millions here, health care that citizens could simply not afford otherwise. Monthly premiums are minuscule (update: were miniscule, now 13% of income for new residents) and cover literally everything, all clinic or hospital visits, doctor appointments, procedures, exams, surgery, and prescriptions. Though there are always horror stories, there seem to be an equal number of stories about folks who have accessed the system, gotten superb care, and walked away without a bill. Obviously, one's mileage can and does vary.

Do You Want The Good News Or The Bad News First?

If you already follow my personal Facebook page then you know the latest, that my wife, Tamara, had surgery yesterday to remove a tumor surrounding her left ovary. The surgery went great and the patient is doing fine, thank you all for your kind wishes for her speedy recovery. She should be going home today to rest. We still need to await the biopsy results, but everyone thinks it will prove to be benign.

I didn't write about this situation before because Tamara wanted me to keep a lid on it until it was over. It's been a hectic two months running around getting exams, more exams, more tests, and dealing with the Caja here (the government healthcare system). In the near future I'll be writing in detail about our intimate experience with the health care systems here, which I'm sure many of you are curious about. It's one thing to hear about it in the abstract, quite another to learn about a real-life experience. Suffice it to say, in this case we went private, but that doesn't mean we wouldn't use the Caja in the future.

Now, so that this post isn't a downer, here's something on the lighter side. On my other blog, Cloud Warmer, I have the same little, blue, floating Twitter Bird as on this blog. If it's driving you nuts, you now have an outlet for the annoyance. Someone over there mentioned in a comment that the bird is "creepy", so I put up a poll to decide its fate. That poll will likely decide the fate of its twin on this site. So, you can see just how important this is and you really should pay attention!

So, if you can't stand that little innocent-looking bird, vote Yes, if you like it, vote No, and if you don't care one way or the other, please vote, "Don't Care". It's high time that you expressed your deep apathy!

Costa Rica's Place in Medical Tourism

photo of globe, passport, stethescope
The term coined for traveling outside your home country to obtain health care is medical tourism. The primary motivation of such travellers is to take advantage of lower medical costs with an equal or at least acceptable level of care. In some cases, other countries may have treatments that are not offered in the home country because they are too new or don't have approval by government regulation or by one's insurance carrier. Even if they are covered in your home country, there may be an unacceptable wait time for the procedure.

Those goo-goo googly eyes!

Light on!
This guy (gal?) came to visit one evening, laconic and seeming a bit lost. Harmless enough as long as you could look past the homeliness as he plodded along our floor. 

Then he wandered into a less lit area under the stairs and I thought I saw something strange, a faint glow from those dots on either side of his/her head. 

Light off!










Maybe we should dub it the Clapper Bug? Vertical headlights, which I suppose are for attraction of the opposite whatever, since he'd need a serious re-alignment if he wants to use them to see where he's going. 


Not much else going on at the moment. I've been busy with yet another ham radio project (YAHRP!) and Tamara is in sort of a lull between jobs, though there's always gardening and socializing to catch up on.

Our residency renewal is just a couple of months away so we went, with the help of a couple in the know, down to the new Caja (Caja Costariccense de Seguiridad Social - CCSS) offices in Pérez this morning to apply for health insurance, which is a new requirement for residents. Tuesdays always seem a good bet when doing the bureaucratic thing and this one was exceptional. We were first in line (for those applying, not for those with some other issue) and out of there in pretty short order, including one hurried trip to a nearby copy shop for some extra xeroxes. After that one must go to the hospital to get the "carnet", which, along with your latest payment receipt gets you medical attention there or at your local clinic. 

One glitch (of course). They wanted proof that Tamara and I are married, which is not something I ever carry around, and if I did it wouldn't be in Spanish, so completion of her final step is pending finding such a document. Cost? $62.50 per month for the three of us. For that you get free (as in no co-pay, 100% covered) doctor visits, hospitalization, and prescriptions. For small stuff we'll very likely depend on the free doctor advice at the pharmacies, for stuff that we need done quickly, private doctors, but if we're pinched for cash or it's really big, the Caja is there for backup. 
 

Berry, Berry Tasty

Our Norte-Norteamericano friends are on the cusp of Spring now; hope is on the way. So, I reckon that they won't think I'm being overly fiendish with this posting. It won't be long until they'll be telling me about the gorgeous summer in Oregon during our "green" season here.


Summer here, as in Oregon, is my favorite time of year, and that's especially true now that our wild berry season is starting up. 

We have three kinds of sweet berries on the property in various places. I'm careful to avoid hitting them with the gas trimmer knowing that it won't be long until they bear fruit. 

 
Two of the berries are a type of raspberry, though unlike the ones we had in Oregon. One is red, the other is black (but it's clearly not a blackberry plant). The red ones have small, light leaves, akin to a rose leaf, and a very delicate, slightly sour flavor (see top picture). 


The black variety, pictured at the right, has a much stouter, white stalk with large thorns and as you can see the berries grow in tight, grape-like clusters. They ripen far too slowly for my impatient self. Their taste to me seems rich and wine-like. I think these are the best of the three and the ones that I would like to actively cultivate.



 
Just like in most areas of the world, we have the wild blackberry, too (called mora here in CR). 

This variety doesn't appear to be so invasive as the Himalayan blackberries that are gradually taking over the Pacific Northwest, which is a little surprising given the year-around tropical weather. Their stalks are nasty, micro-thorned and tough. The berries are small, hard, and scrumptious.

 

 When we get in the mood for some berries we take a hike around the cleared spaces on the finca and in about 15 minutes we've gathered enough for a few bowls of cereal with some leftover for the next fruit salad. Not only delicious, they are an excellent source of Vitamin C and other antioxidants. This is just the first picking so as the weeks go by we should be hauling in a lot more of them.  

Summer's End?

Two things happened yesterday that make me think we're seeing an early close to our summer here. Sean called down to me while I was working on the cottage to look up into the sky. Above was a swirling cloud of large birds, flying in random circles, maybe 200-300 birds. Sean confirmed with binoculars that they were vultures. As I watched them I noticed a small stream of more birds joining the swirl from the east. Before they started to blend into the clouds above there were probably around 500 birds up there. Once the eastern line joined in they all streamed off towards the coast. I'd heard of large migrations of vultures and other birds that happen down here and I think we were watching one of the tributaries of one of those super-large migrations in progress.

Then there's this:
 

It's a frame up I tell ya!

Since the work crew finished the floor and columns (see picture a couple of posts back), I’ve been working on the framing of the cottage by my lonesome. It’s been slow, not helped by the unusual frequency of rainy afternoons this summer, although when I look back at the old picture and then this one, I feel a lot better! I’m hoping to finish the framing for the lower roof and get a waterproof skin up within the next couple of weeks. This summer seems to be closing up on us fast, so there’s no time to waste.



My Trip to Peru, La Canicula, Swine Flu in Costa Rica

Anecdotal testament to living in a healthy clime: We finally came across the bathroom scale. Tamara's lost 5 lbs. and I've lost 10 lbs.! No dieting (that is no intentional dieting, just adapting to a new diet overall). Yay!

Wednesday, I returned from a one week vacation in Perú where I visited my good friend Evan. He has two daughters whom I’d never met before, one of which lives there in Lima, the other in California. His brother from California was also there visiting. Though it was a bit crowded in his apartment, it was great to meet his family and spend time with all of them. 

The Train to Huancayo


Lima to Huancayo Train Over Trestle
The grand highlight of the trip was a weekend trip by train to the city of Huancayo, high in the Andes. The trip is about 13 hours each way and rises from sea level, through the highest passenger station in the world (over 15,000 feet above sea level), and ends in Huancayo a little over 10,000 feet elevation. We left Friday morning and got back in Lima early Monday morning.

The scenery along the way is nothing short of spectacular, not only for the geography, but also for the views of Peruvian life and the marvel of engineering, which is the railroad, built at the turn of the 20th century. The line took over 30 years to complete and features 6 switchbacks (zig zags where the engine has to decouple and re-couple at the other end for each leg of the zig zag), 53 bridges, and 69 tunnels. It reaches it’s highest elevation (15,830 feet) at the Galera tunnel before heading down to Huancayo.
Open air market in Huancayo goes for several blocks

The train runs about twice a month and has very nice accommodations including a bar car, and open viewing car and hot meals included. I didn’t take my camera, but Evan took a lot of video and photos, so when he sends those up I’ll post some pics.

 

 

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