Friday, December 5, 2008

A Day Tour in Costa Rica

 

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A large coffee plantation on our way up the mountain

So finally with my dental work about done and school over, I signed up for a tour to get out of town and do some sight seeing. I had try' d to do one the first weekend I was here but the bus was an hour late and I ended up going home. The following weekend was just rain, and now I had to try to at least get out and see something before I left. I would have done more tours but the weather has just been rain, and more rain. This is the rainy season for the Caribbean and the Central Valley where San Jose is, but the locals say they never get rain like this, and for them, very cold. Sometimes in the 40's (Fahrenheit) at night.

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This was our first stop on our way up to see the Volcano. A gift store with this farmer and his oxen who charged $1 a photo (I didn't pay)

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One of the reasons I wanted my bike down here was to be able to do day tours. But because of poor weather, being busy anyway with school and the dentist, the heavy traffic and poorly marked roads, not to mention it being dark by 6:00 every night, it seemed easier and safer to sign up for some tours. I think if the weather would have been better I would have got out more then I did, and did some exploring. But still finding your way around down here when there are no street signs and your right in the middle of a big city does tend to make the most routine trip become an adventure.

So I signed up for what is called The Highlights Tour. An 11 hour bus ride originating in San Jose that included a trip up to Poas Volcano, a visit to a Butterfly farm and Botanical Gardens. Also the La Paz waterfalls and then down to the lowlands to take a boat ride thru the Sarapiqui Jungle.

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I forgot the name of these common flowers , but they were all over the back yard at our first stop.

The bus picked me up at Intensa (my school) about 6:30  am. After about 3 or 4 more stops at local hotels we were on our way. We had a pretty full bus and our guide spoke both Spanish and English. In fact everything he said, he said twice, once in each language. Our group included five younger kids from the Houston area , though they were really from all over. Argentina, Syria, Japan and the states. With couples from Connecticut , Florida and El Salvador. There was also an 84 year Finland man who immediately after stepping on the bus introduced himself as "Elja from Finland" to the whole bus. That out of the way, he sat down. I noticed he had a Harley Davidson signea on his sweater and I wondered if he maybe was a fellow motorcycle traveler.

As we wound our way out of the Central Valley as its called, the big valley that runs thru the middle of the country and has San Jose, Costa Rica's largest city in it, we immediately began to get really great views of the valley. We made one stop at a tourist shop which was owned by the coffee plantation, got some photo's of a farmer and his oxen, and then continued on our way. Soon we stopped at another shop and had breakfast. Here I would get a chance to talk more with Elja, and also to talk to the couple from Connecticut.

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A traditional Costa Rican Breakfast of Rice and Beans, scrambled eggs, bread, fried banana's and coffee

It turns out Elja was planning on buying a Harley Davidson in the states and then driving it down to Argentina. But one of the things about buying a bike in many countries and then trying to take it out is you have to have owned it for 6 months, something he wasn't planning on. So after arriving in the states and finding that out he decided to just travel the whole way on bus, plane and boat. After arriving in Argentina he was planning on trying to get a cabin on a freighter heading back to Europe, or there a bouts, a month and a half trip.

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This Tree Sloth was on the side of the road as we rode by. Its was so wet, like everything else up here, it looks like it never gets a chance to dry out.

Elja kind of reminded me in ways of Bob Able, a guy many of us in Alaska met when we first moved up there. Legend had it, or at least Bob did anyway, that along with his wolf dog they both had walked the entire length of the Alaska Highway. This was back in the 70's, and there was even a write up in one of the local papers about it. Bob himself smoked and drank, and there were times he would dance the night away with us youngsters, sometimes clutching at his heart when it became too much. Sometimes we really thought it was going to be "Bob's last dance". His wolfdog "Lucky" would always be waiting for him outside the bar. Bob would often tell us that wolfs don't make good sled dogs because they don't have enough breadth in their chest and lung capacity. One of those things I always remember, probably because of the person who told me... Anyway, Elja wasn't exactly Bob, but I think they're both adventurers who always will be, regardless of their age.

I asked him if he had family and he told me he had two daughters living back in Finland. At 84 to try and take a Harley all the way to Argentina, and not speak Spanish either, I had to kind of wonder. Yet here I am doing close to the same, just a little younger. It left me not knowing what to think. On the one hand isn't it great someone would not let their age stop them and here he was at 84 traveling the world. On the other hand I had to wonder if he really knew what he was getting into and his limits. If nothing else, at least buy a smaller bike and learn Spanish, and always have an emergency plan, which he may or may not have had. I did want to ask him what his daughters thought of him traveling alone like this, but never got the chance.....

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Elja from Finland. Traveling alone at 84, I had respect for him, I also feared a little for him.

The couple we had breakfast with were from Connecticut and were just down for the Thanksgiving weekend. They both seemed to do a lot of traveling having been all over the world. She was from the Philippines and was going to law school and writing a book (as she traveled) about accounting for lawyers. I'm not sure what he did. It seemed they just traveled whenever they had time for it, just sort of fitting it in with their days off, study, or whatever. It was like it was a priority in their lives as much as school, work or any other activity was.

Our first goal was to reach the top of Poas Volcano, while not active with lava, it never the less sends out a lot of steam and sulfur dioxide creating acid rains that affect a lot of the surrounding area. It also has one of the largest craters of any volcano on earth, nearly a mile across while lying deep in a cloud forest, something it probably creates for itself by holding in the clouds. Its kind of like trying to see Mt. McKinley (Denali) in Alaska, there are no guarantees of seeing it when you visit it, or any of the volcano's in this country when you go on the tours. 

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The Poas National Park Visitor Center, and the trail leading to the crater.

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Our guide leading our group (he's ahead of the group on the right)

The farther up the mountain we got, the cloudier it became. The road was very winding and it had steep drop offs to the sides. To not be able to see anything up here was a little unnerving. Our guide talked about the "acid rains" that come from the volcano itself and effects so much life, vegetable and animal, around the summit. Some of the huge leaves of plants up here had built such a resistance to the rain that they were a quarter inch thick, and like rubber. As we continued on the walkway to the crater it continued to mist and rain. It reminded me of the Pacific Northwest Rainforests, except here was warmer. It also like there, at times looked like the place doesn't actually ever dry out. Everything just looks like its continually wet. In fact the rainy season is about 9 months long here, kind of like the winter in Alaska, just a different type of extreme.

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Here I am at the crater, I don't know what I"m grinning about, its raining and you can't see a thing.

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Here's the view of the crater, completely clouded in, its down there somewhere!

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The jungle was so fertile, humans seemed to be sprouting out from underneath the foliage.

 So as we made our way down from the Volcano and got on the bus, we headed for out next stop, the La Paz Butterfly farm and Botanical Gardens. The rain and mist wasn't letting up, and we could barely see as we drove thru the clouds again.

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The path thru the La Paz gardens

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The screened in bird area in the gardens

Arriving at the gardens we did a walk thru the bird area (a big fenced in area that houses several species of birds, which is also next to the fenced in monkey area) and I got some photos of the Macaw's and Parrot's that are housed there. After that the path led us into the Butterfly farm and housing area. This is a big glassed in area, filled with many species of butterflies, everything from Monarchs to the famous Blue Maroth's (don't know if I got that spelling right). Also there were rows and rows of cocoons in various stages of their molting cycle. The guide said it was too cold for them to come out of their cocoons, but on a sunny day they would hatch, or come out into the warmth as butterflies.

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Part of the Butterfly farms enclosure

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The butterfly nursery

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The infamous, Blue Maroth

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Another one of our "butterfly hosts". Their were hundreds flying everywhere.

After we left the butterfly farm it was time for lunch. This time I sat down with Elja, the couple from Connecticut and the 5 kids from Houston. While most of them seemed to be just living in Houston, not going to school as I thought, they were still from all over. Mo Mo was from Syria and was very interested in my trip. He himself wanted to take the overland route to India thru the middle east, and wanted to know where he could find information about the trip. He apparently had refused to go into the army in Syria (a requirement for all male citizens I guess) almost 10 years ago and was considered a deserter. He had not been back since though apparently after 10 years he could return now if he wanted to. I told him that was pretty rough, but he said he didn't hardly know anyone there anymore anyway.

There were the two Asian ladies, and the guy from Argentina and the other one that I really didn't get a chance to talk to. They were all traveling together and had to leave to go back to Texas on Sunday.

The lunch was all you could eat and had a variety ranging from hot dogs and pizza, to salad, roasted chicken, of course rice and beans, and a really good rice pudding for desert. Elja had a couple of beers while he was there, he wasn't doing all the hiking we were, he was getting rides ahead of us and meeting us at different spots. He told us he had been trying to talk to the table full of nuns sitting next to our table but they all spoke Italian and he wasn't getting anywhere! He said he wasn't sure if they were from Italy, but they sure spoke like it!

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These Rhinoceros Beetles are native to Costa Rica as well, they are about the size of your hand.

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This whatever it was, was over a foot long. Costa Rica has more of a variety of animal life then any other place on the planet, over 600 different species live here.

So after a really good lunch, and a walk thru the reptile and insect house, we began the long hike down to check out the La Paz water falls. The day was only half over and we had already seen quite a bit, or like up at the volcano in the clouds, saw a lot of nothing!

See you Monday (Lunes) for more jungle adventures...

Wednesday, December 3, 2008

El dentista

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My dentist office in San Jose, you can see my bike and its security guard patrolling outside the building

So finally, the reason this whole adventure started to begin with, my dental work! I went to the Dentist for my first appointment the Friday after my arrival in San Jose, but first a little history for those who don't know.

About four years ago I went to a dentist in the states with the idea that after years of either neglect or simply not having the money or insurance to keep up on my teeth, I was going to do what ever it took to get them up to where they needed to be. I was working on a very good case of periodontal disease that I didn't even know about. Mainly due to not going to the dentist enough, getting my teeth cleaned regularly, and other bad habits like diet and smoking.The amount of money just for a crown, let alone a root canal or an implant, as most people know in the states is very expensive. To look at having to get several, well, it seemed not even worth looking at for where I was at during that time in my life.

So I started my journey back to trying to recover my teeth and have a healthy mouth once again. And while dental insurance which I now had would help, with up to 50% of $2000 a year of covered things, like fillings, teeth pulled, partial dentures, ect. There is a lot it won't pay for including implants. Still a thousand dollars a year, spread out over 14 months and 3 different years adds up to be a lot of money, especially if your looking at 6 or 7 thousand dollars worth of work. Throw in partially covered cleanings twice a year and and a tax free flex medical spending account thru work and I felt I did have the means to put a dent in the work that needed to be done. The thing now was to find out what and how much the work was going to be.

The first dentist I went to looked at the amount of bone loss that had occurred from the periodontal disease and recommended me having all my teeth pulled and getting full dentures. The cost about $6000. My insurance would barely touch this, and I didn't have the money anyway at the time to do it. This was not the diagnosis I was hoping for. Plus I was attached to my smile.... I ended up going to his brother who is a orthodontist for a second opinion. Not a good choice since not only was it his brother, but without great evidence to the contrary, what Dr. is going to go against the known diagnosis of another Dr. He concurred, all the teeth needed to come out.

Then I made another error. I went to another orthodontist who had worked on a friends teeth, and told him of the two previous diagnosis. Well of course he wasn't going to go against two of his colleagues. In his opinion the periodontal disease and bone loss were so bad, having all my teeth pulled and getting dentures was the only option. Or he said full dentures fixed to implants would work, the cost about $40,000. The news wasn't getting any better after seeing three doctors. For me I simply could not believe since I still had most of my teeth and they were functioning fine, why they would have to come out. I argued that if the periodontal disease could be eliminated, and then proper hygiene used, why should I have to lose any of them? He said that the pockets formed due to bone loss were too deep, and it would be impossible to keep them clean enough so the periodontal disease wouldn't come back. Again I didn't agree, and knew I needed more information.

So onto another dentist for a fourth opinion.While his news was better it still wasn't what I was looking for. He suggested I leave a few bottom teeth in for the partial dentures to attach to, but all the top teeth would have to come out. He wanted to start pulling teeth that day. I said I needed to think about it. I still didn't get why teeth that aren't rotten or falling out on their own have to be pulled? Even if a tooth is lose, that doesn't mean its going to come out, or is not healthy. There had to be a way to not only stop the periodontal disease, but also keep up on it so it wouldn't come back.

Reading a Mother Earth news one day I came upon an ad for a book which tells you how to save your teeth using the " Smile Method". A way to treat deep pockets around your teeth and stop periodontal disease from coming back. It was just the book I needed. Used in conjunction with an "open minded" dentist here was a definite way to work on what was going on with my mouth, progress. Now I just had to find a dentist that was opened minded enough to work with me. I contacted the last dentist I saw and he said he had given me his diagnosis, if I wasn't going to follow it he wasn't going to see me, or work with me. I don't remember if I contacted the others or not, but they too had already given me "their diagnosis".

At this point I was sort of running out of dentists in the area, and at $150 a diagnosis it was costing a lot just to have them tell me what I didn't want to hear. So the 5th person I saw, a women dentist told me, not only had she seen the book I was talking about, but there was an antibiotic that would knock the periodontal disease out, and then with regular periodontal cleanings and good dental care in between, I should be able to save most of my teeth. More progress, I was and am so grateful to her for not only what she knew, but also her willingness to work with me and have an open mind.

It was not all good news though. She said seven of my back teeth would have to come out. Some of them were simply too far gone to do anything with, and another one was just hanging in there. And my periodontal disease was very advanced. My gums and teeth were all badly effected with deep pockets. It was going to take a concentrated effort to not only knock the disease out, but also to not keep it from coming back. As she told me, I had to quit smoking as well. Smoking constricts the blood vessels in the gums and prevents the flow of blood to those areas. It would be hard for them to recover if I continued to smoke. I knew if I was going to put in all this time, effort and money into my mouth, then I needed to quit. Without a real reason to quit smoking I don't know if I would have been able to. I have smoked for almost 30 years of my life.

I went on the "patch" for about two months, took my antibiotics to knock out the periodontal disease, bought an electric tooth brush, later an irrigator to treat the deep pockets and really worked on flossing and keeping all my cleaning appointments. After so long without cleanings, the dental hygienists really had to work, and I thanked them. The first cleanings were the hardest, It took two appointments just to get everything done. But I was on my way, and I knew this was, and is a life time commitment. For there were times in my life where I had put a lot of money into my teeth and got them where they needed to be, only to let them go for a number of years and pay the price, which is what I was doing now.

My mom had lost all her teeth when she was young and she always said, "whatever you do, take care of your teeth". The first time I went to the dentist I had like seven cavities as a kid. In a way it seems I have always been playing catch up with my teeth.

So next up would be having the seven teeth, two wisdom and four molars and maybe a bicuspid pulled. I didn't like that either but I guess I had to listen to my dentist at some point, having seen 5 of them now. The plan was to save all the front teeth, remove the weak or broken teeth from the rear, and then go with partial dentures for the rear. Not only would I be getting rid of useless teeth in the rear, I would be improving the health of my gums.

At this point we had not seriously talked about implant work yet, mainly because of the cost seemed prohibitive. But cost or no, I do want to know all the options available to me at all times. Because as things change I may be able to address those problems later, and I don't want to burn any of those bridges now. For the most part I think we did do what needed to be done for the present and future health of my mouth. Of course I just hated losing any teeth unless I absolutely had to, but some of them were basically just roots anyway.

Its been 3 and a half years now since the two orthodontist's and two dentists recommended me having all my teeth pulled out. And while the final analysis with all this is far from over, it seems a reasonable assumption, verified by at least as many specialist since, if I continue to properly care for them that I should be able to keep the rest of my teeth, the rest of my life.

In some fairness I don't blame the first doctors and their recommendations .Given the severity of my case, and the chance that I wouldn't make any changes or use any treatments to be able to effectively keep the disease away, It looked like having all my teeth pulled was the only option. But, having said that they should have at least given me possible options. The well, "this is what would have to happen for you to save most of your teeth, and if your willing we can try this approach".

The thing is they either didn't consider all options, didn't know about all options, or just didn't believe they would work. Or they didn't want to go against a colleagues diagnosis, and take any sort of risk themselves. If they didn't consider all options, then they were passing on a limited amount of knowledge to me to be able to make an informed decision for myself. In a sense they would be making a decision for me. A decision that once done, I would never be able to undo. If they didn't know about all options then that is sort of unforgivable. As a professional I think you need to keep yourself abreast of all new information coming out (and believe it or not, a lot of this was old information and not that new), especially with something this important, or if your not going to keep up, you should refer me to someone who is, or at least consult with them. I don't feel this was done either, especially by one of the dentists. To not believe different treatment options will work is a judgement call. And for the most part I believe they were making the best decision for the circumstances influenced by the factors at hand, their own present level of knowledge, and probable (but not certain) progression of the disease unchecked. And also I believe to a big degree by the diagnosis of the doctors before them. Which I know I set these evaluations up wrong to begin with so it is partly my fault. I've heard that when seeking a second opinion one should travel at least 50 miles from the first one to get an unbiased opinion. I certainly didn't do this, not only did I tell the other doctors what the previous one had said, I even went to a brother of the first dentist! Its like a trial where the jury already has a preconceived idea of whether the person committed the crime or not. Either way they owed it to me to present all the available options and maybe approach the whole thing from a more open mind. And as I said, the 5th person I saw, thought immediately I would be able to save most of them, so I don't think this was a wild flight of fancy I was on. But I still had a ways to go to prove I hadn't just found some one that told me what I wanted to hear.

After I got my partial dentures made I realized I was probably not going to like them. Losing the feeling of the roof of my mouth while eating, or talking was hard to get use to. They were not all that comfortable, and in fairness I probably never gave them a chance. But even other people I talked to who have used them over long periods of time said they never really have gotten use to them. I felt bad in ways for my dentist because this was sort of our plan, but I really didn't like them. I think she understood. In fact she told me she knew one guy who didn't like his so much he had thrown them into a lake or river or something!

So that was that, my dentist recommended an implant specialist after I asked her about getting an estimate for them. It seemed the only option left. Even if I couldn't afford it, at least I would know what it would cost and even if they would work in my case. The man who did the diagnosis and estimate was a specialist, having studied under the guy who pioneered implant therapy. Its all he did. He confirmed that I did have enough bone left for the implant work to proceed, (the good news). And it would all cost about $28,000 (the bad news).

At one point I had talked to the author of "The Smile Method" and he had suggested looking at getting dental work done over seas. He said he got his done in his home country of Greece for much cheaper then in the states, and the money he saved even paid for the trip. Even my dentist admitted that the reason dental work was so much more expensive in the states is because "that is what the market will bear here". Hmmm. Is that why we were paying so much for gas six months ago? Or maybe why insurance won't cover implant work here? I appreciated her honesty. If all those prices are due to the fact that that is what the market will bear, what happens when people can't bear the market? It can come down in price for one.....

So this started my global search to find the cheapest quality implant work. With technology this was made so much simpler. I just went to another dentist office that did Panoramic X-Rays, got a set of those, went online to find implant specialists and started sending the implant treatment plan with the digital x-rays to them all over the world. And the dentist's office that took the x-rays did this for me. Ironically they were also the one's who gave me my first diagnosis for complete dentures. With them at least, I felt their diagnosis was sincere, if not completely informed.

I had responses from Thailand and Argentina at first. Then I found a company out of Colorado that helps from the states find specialists in other countries for their health needs. They do a lot of the foot work for you and thru them I got doctors names in Panama, Costa Rica and Mexico. Maybe just as important they have references on those their sending you to. So again aided by technology and emails I could contact many doctors at once, get their references, treatment plan and costs all within a week or so. What would have cost so much money and time 30 years ago to do, now could be done at a fraction of the cost and in a fraction of time.

The doctors I found here in Costa Rica to do the work were the ones who got back to me the quickest and had the easiest references to check. In fact the doctor who did the restorative work studied at the University of Michigan. As I spoke to more and more foreign dentists I began to realize that many of them had studied in the U.S. In fact one guy who called me for a reference on my doctor in Costa Rica told me he had extensive work done on his mouth over the years at the University of Michigan, and every dentist that had ever worked on him there was studying from another country, everyone of them. He also said that he had gotten the most outrageous quotes for implant work as well in the U.S. and he was ready to seek help elsewhere (one specialist quoted him $30,000, just for work on the top of his mouth, and they hadn't even talked about the bottome. He later told me he had gotten all his work done in Costa Rica for about $10,000 and was happy with it).

Its also worth noting, and this goes hand in hand with my last posting on part of the U.S.'s problem being how we view the rest of the world, that so many people I spoke too thought one, you couldn't get as good of work done outside of the U.S., and that when I said I was going to see a dentist outside of the U.S. they thought I would be crossing the border into Tijuana or something to have it done in a back alley. I have to admit on this trip I have continually had to confront my own prejudices and preconceived ideas as well. With everything from how I expect people to live and act to what they eat and do for entertainment. I'm continually reminded while things maybe done a little differently then in the U.S., that doesn't always make it any better or worst, just different. I think, like all people, I would be offended to be stereotyped as well. When I got to my home stay I was surprised to find out there was Wi-Fi in the house for our computers. I was surprised more because the owners are both older people from that generation that doesn't use computers as much. Their son when I seemed surprised that there was Wi-Fi in the house seemed to take offense, like "of course we have it, we have everything you do". That wasn't what I meant, but his sensitivity to what I seemed to be insinuating was well taken. The reality is his parents have it for people renting here, not for themselves.

Its hard to not make a point here with our own health care system in the U.S. While viewed by many to be the best in the world and certainly it is where some of the best training is, this in itself as my experience indicates does not mean you will receive the best care. There are many factors here, the biggest maybe being what you can afford. If I had walked into those first offices with a hundred thousand dollars to spend and told them that, I may have had hundreds of options. For where I was at they only suggested one. The point of having to shop for your own care, and it being expensive to do so is a real problem in our system. Too many times we just go along with what is being said and never seek another opinion. Or more importantly, and I think its the number one thing you can do, is do the research yourself. Find all possible solutions and in a tactful way discuss them with your doctor. Too many times its their way or the highway. They have all the knowledge, don't question them. Their is a certain attitude that is as big a problem with our health care system as anything. And its the attitude coming from the Dr. that "I know what's best for you", and coming from us the "well you must know, your a doctor, I'll do whatever you tell me". Kind of the same problem we tend to have with our government! And its not to say we should all suddenly think we're doctors, but we should with the help of a doctor, make informed decisions based on what they tell us, our own research, and hopefully the opinions of several, not just one if you feel it is warranted. I could go on and on about my experiences with our health care system, but suffice to say our number one problem and solution lies with ourselves and taking care of ourselves to begin with, and then taking care of ourselves once we feel the need to cross the threshold......and into the realm of the health care system itself.

After figuring I would be able to afford the work down here, and after multiple calls and emails to the dentist here, I flew down to Costa Rica in July of this year to have the seven implants put in. That was the first step of the procedure and it would take 4 months before those healed well enough to have the abutments (I think that is spelled right) and crowns put on. My first visit I was here for a week, had the surgery, had to stay in my hotel room most of the time, and then flew out. I rented a car to go over to the Pacific Coast for a day, but that was all the touring I could do. My dentist told me I was brave for braving the roads here..... Little did he know I would be driving back down in 4 months!

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Hotel El Esteseo, where I staid my first time in San jose

So somehow the adventure part of me surfaced and I began to think seriously of driving my motorcycle down. In my head I thought it would be like driving thru Florida, only maybe a little more rougher........ Well it has been a little rougher then Florida for sure!

Another contributing factor to my driving down was the fact that I was establishing residency in another county for school reasons, and I couldn't take more then 5 credits anyway in the fall semester or it would mess up my financial aid. If I was going to take a semester off and take a trip like this, this was the time to do it. Even if I did take classes, I still had to come down for 2 weeks of work in the middle of a semester which would mess up my classes anyway. So the decision was made. I couldn't get my college Spanish class to coordinate with my classes at Intensa, my school in San Jose, so I decided to take the whole semester off and do this trip instead. It would also give me a chance to work on my blogging site.

So now that your caught up, like I said, my first appointment was Friday, and in typical fashion it lasted three and a half hours. First the implant doctor had to reopen my gums to check on the implants. Then the restorative doctor had to attach small abutments to the posts and take x-rays and impressions for the teeth themselves. They also did a color test so the new crowns would match my present teeth.

The doctors here treat a lot of people from the U.S. At one point over half the people in the waiting room were from the U.S. There was a couple from New York State who spend their winters down here, and have for 26 years. Another guy was from Hollywood and another couple from California. The doctors have to work long hours and get people in and out as fast as they can. A procedure that could be spread out over several months in the states has to be fit in in a couple of weeks here, because most people are only down here for a limited time. Production Dentistry is what it feels like. Getting out of the chair at 7 p.m. was not all that unusual.

Its good and bad. The good part is your getting a lot of work done in a short time. The bad part is three to five hour days, while not the norm usually, were not rare either. I had five appointments that ended up being about 15 hours total. And this is without travel time. Going out on my bike in San Jose is always an adventure. While my house was only 10 miles from their one office, it could easily take me an hour to drive across downtown San Jose with all the traffic and one ways. For one appointment I was literally two blocks from the office, only to be forced into one ways and pushed into traffic and out of town and into another traffic jam. It took me an hour to get back to where I was, only two blocks from their office to begin with!

At times there were 10 to 12 different people in the office. Two doctors, a hygienist, an x-ray technician ( I had 8 to 9 x-rays total which made me nervous getting x-ray'd that many times), and a host of assistants. It truly is like production dentistry. I had my teeth cleaned as well, another savings of roughly a third or more. The total cost of everything including travel and lodging came to about one half of what just the dental work would have been in the states. And of course the downside is if anything goes wrong it is a long trip back, but the implant specialist does guarantee his work for life. I asked him well what if you retire or something happens to you? I think he got a little annoyed and said he's only 38 and he's not planning on going any where!

Overall the care has been good, the long time in the chair the only real downside to trying to get this much work done in a short time. Most people in the office spoke at least some English, the doctors of course speak it well.

I have one more follow up appointment but all the implants are in. I have to admit they really look natural and real. And more important having the implant work done should stop the bone loss that occurs when you have a tooth removed (another apparent down side to dentures and having all your teeth removed is the continual loss of bone even after the teeth are gone). And also having them to be able to chew with, will relieve the front teeth that have been doing all the work since I had the back teeth pulled. They like dentures will take a little getting used to, and I already noticed food will now get caught in places it wouldn't before when there was no teeth there, and I do have to floss and care for them just like regular teeth. It is early, but it seems like everything has gone about as well as can be expected.

I am grateful to Dr. Anglada, Dr. Castro and all their staff for all their good work. Including Melisa, who wants to be a dentist herself one day and I really hope she makes it. She has such great enthusiasm for her work and would be wonderful at it. Her father Memo, also was very helpful thru out as a driver and at times a guide. Marisa Ryder from Bridgehealth International originally helped with the initial contacts and has followed my blogging site and the work from beginning to end, we both share a passion for travel, she having lived in Argentina for two years.

Also a thanks for you who may have read this and now know more then you ever wanted to know about myself and implant surgery! I can only say like the many different parts and subjects covered in this blog, every part may not be of interest to everyone. I received a lot of calls from people interested in all of this because they were like me, wanting to have extensive dental work done, and were not able to afford it in the states. To those people this post will hopefully be informative and provide some useful service which are both goals of this site. Eventually as noted previously, I would like to set this site up in different categories and make it easier to access information people are looking for. making it more user friendly. For now though its just going to be posts coming out more or less in the order that they occur, tying in with the story as a whole. Like I said, I am hoping this site will continue to evolve and grow, and that by having readers who follow it and give their input as well, it will in a way be useful to all of us.

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It was a real biker jam at the dentist office

Monday, December 1, 2008

San Jose, Spanish Classes and Mrs Einstein

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Intensa, one of their three schools in the San Jose area

I started my Spanish lessons the day after I arrived. Originally I was was suppose to be here for 4 weeks total, but having arrived a week later then I thought I would set everything back. I was hoping to maybe get enough of a grasp of the language studying 20 hours per week, and doing some additional tutoring in the afternoon to be able to partly test out on it when I get back and get some credit for it. A semester of Spanish in college is about 60 hours, or equivalent to about 3 weeks here. Intensa really focuses on teaching thru oral skills, as well as immersion. The three weeks that I'm going to be here will probably not be enough to cover some of the things the test will have on it. The combination of losing a week, and also not necessarily wanting to spend all my time here studying (6 hours a day) means I probably won't learn as much as I was hoping, but still I know it is a really good start to learning the language, and will certainly help me in my travels.

An advantage I have here is since I'm the only person starting at my level, I'm the only person in my class, so I get great attention! They rotate teachers so I get a new one each week. And so far while my learning is slow, and my teachers have the patience of saints (they have too!) I am getting it. In Spanish Poco by Poco, says it, little by little.

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The courtyard at school

Everyone at the school has been great. Intensa has 3 schools in the area, with literally hundreds of students, They teach morning, afternoons and evenings, generally 3 to 4 hour classes. A lot of their students are Costa Rican's studying English. In fact one of their goals is to earn a Certificate in English, as established by the University of Michigan. But you also get a sense that their are many people here of all ages and for all reasons. From people wanting to learn Spanish for business reasons, to students, to people like me who maybe are just traveling and want to learn the language better. And as mentioned before, to do a home stay, with lessons and have your meals included is a very economical way to go. Costa Rica like many places in the world, see English as a very important second language. It is one of the main languages used in international business.

The School has helped me with everything from cashing my travelers checks, to changing dollars to colones (the local currency), making sure I'm settled in at my home stay, while finding a bank that will take my debit card. They also make reservations for tours, which we get a student discount for, have helped me with faxes that I had to make to the U.S., let me use their phone for long distance phone calls while selling me the card to make the call. I have been able to make all my zerox copies while also using their place as a pick up place to send packages back. They even called my house here to make sure I remembered my cooking class I signed up for. and finally they invited me to their staff Thanksgiving day dinner.

All the teachers have told me how much they love working here, and you really get a sense that they do. You can tell when people are comfortable with where their working, the fact that they have time to offer so much help tells you a lot. Like their priorities are not just about production, or making money and every moment has to be accounted for. The fact that they have three schools says their doing ok in that area anyway. Usually what all that means is that their getting good management from the top down.

Intensa and Homestay

Vera Cordero, Robert Patterson the administrator, and myself. Vera's patience with all the emails and the help to get me here and set this all up was amazing.

My first day here I got to sit down with one of the original founder's of the school, Robert Patterson, also the present administrator. Being somewhat of a celebrity myself, having driven my motorcycle down I have seemed to have attracted some attention. And of course I still give out by card with my blogging site for those wishing to follow the trip. We hit it off easily and ended up talking well into the afternoon. It was very interesting talking to him.

Originally from the states, in the 70's he had worked for different companies all over the world. Everywhere from South America to the Middle East. Eventually in the 80's he ended up here in Costa Rica where he and a partner started the school. Eventually he bought his partner out and for the last 25 years or so has run the school. He is in ways a very unassuming man, but speaking with him you get the sense, or maybe I imagine it, that having lived so long outside of the U.S. he has a different perspective on it, as well as the world. I guess this was something I was after to learn from him, and partly why I'm drawn to international travel.I think for him he was interested in the perspective of a guy who would jump on his motorcycle and travel 4000 miles to Central America. And maybe also the perspective of a fellow "American". Or maybe he just wanted to check me out to make sure I was safe!

Like so many I've met down here he was very interested in what I thought of Obama. For the most part I have gotten pretty good feed back on Obama from foreigners. Not everyone though, but many in the world, and myself included I think felt a sense of relief. Like this is really is an opportunity for change, like a younger person who really knows what he wants to do and how to do it. Not someone who was scrambling to find a place to stand from, a position that was more popular then his opponents, just so he could get elected. I guess I feel like so many "Americans", I just can't handle another 4 years of Bush's policies, or anything that remotely looks like them. As I said in my last post, there is just way too many countries that either hate us, or at best are annoyed with us and our policies. And I think I do in a lot of ways understand Bush's concerns and the vision he has for the world, but the ways he goes about getting there has been disastrous in so many ways. And often his decisions are based in fear and the go it alone attitude which has done just that, left us alone. Robert wasn't so sure about Obama either, like many people probably are, he is taking a wait and see attitude. But I reminded him of what Einstein's wife said when asked about her husband, and we both laughed.....

When someone asked Mrs. Einstein if she understood her husbands theory of relativity, she thought for a moment and then said "no, but I know my husband, and he can be trusted".

At some point you have to trust someone, and you have to trust someone new if the old one isn't working. Personally and I don't think its going out on a limb at all to say, Obama is from the right background, he understands the depth of a lot of our problems, and his motivations are right. He's not afraid to surround him self with the right people who may not agree with him. He's not threatened by people who differ with him, in fact he's smart enough to know he needs all those experienced people and that no one could possibly know everything, and personal conflict gets you nowhere. Its not as important that things get done your way, its more important that they get done the right way, regardless of who does them, or who's idea it is. As soon as I saw his motives, his intelligence, his focus, professionalism and reluctance to gravitate towards negativity in the campaign, and not get rattled no matter what tactics his opponents used against him, I began to realize this is a very special man, at a very special time. He will make mistakes and he is not free from all the powers that be that often define our two party system, but I still think he is the best hope we have right now for where we're at, and the fact that much of the world seems to agree, is a sign of relief indeed.

Of course Ralph Nader see's it differently. To him the two party system is and its all inclusiveness is the problem to begin with. The inherent weaknesses of our system. The governments reluctance or inability to really level with the American people, or conduct business honestly and continually come up with "band aids" to long term problems is historical. Its hard to ignore his arguments, but I always reach the point of yes, but if I vote for you, none of the changes I want will occur, none of them. Because you won't win and our votes will be fragmented....... His argument, if you don't really vote for change, and tell the government what you think and stop being slaves to an ineffectual two party system paid for by special interests, nothing will change. Again Its hard to argue with him, for me it is easier to vote for Obama, because this might be the only realistic avenue to change right now we can hope for.

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Marcela, another teacher who showed "divine patience" with me

I am somewhat cautious too as Obama puts together his "Super Team" and they move forward with the ooh's and ah's of followers that the same thing happened with George Bush when he was first elected. His "Super Team" of George Schultz (I believe), Colin Powell as well as others from the Reagan and his dad's administration, plus majorities in the house and senate all had the Republicans glowing, and promising big change, much like the Democrats now could be. So we will see. George Bush couldn't keep his super team together, apparently couldn't lead them, and lost support of people like Colin Powell who realized like with the Iraq war and the weapons of mass destruction theory he was being used it seems, to fulfill some personal agenda of Bush. A big difference from now and then is one, I think Obama has the ability to lead all these big ego's mainly because he is not threatened by them (we'll see), but also by him not having a personal agenda as much as having an American agenda. This is huge, because with a personal agenda it has to come into conflict to some degree with others in your cabinet. To have a more open flexible agenda that depends more on the circumstances and finding the best solution on a day to day basis instead of being locked into a this way or the highway philosophy can make a big difference in the longevity and cohesiveness of a team. Added to this the enormity of all our problems right now, two wars, the economy, the perception of us abroad, there really isn't any time for gloating or saying we did it, nothing has gotten done yet, and it maybe years before there really is any solid signs that things will improve. There are some subtle, but important differences here, and where we're at today is quite different then where we were at 8 years ago.

With Bush in the end doing things his way no matter what anyone else thought was one of his strengths, but also a great weakness. I almost got a bumper sticker for my car when we invaded Iraq. It would have read, "just because you believe in something doesn't make it right, Bush is wrong". I guess that makes me a liberal but I saw no reason to start a war, we couldn't pay for, in a country that had nothing to do with 9/11 when Afghanistan needed so much help and the world was with us there, but not in Iraq. Maybe history will judge the decision differently and I wouldn't want to tell people in Iraq that they were better off with Hussein then they are now, but their suffering without him seems to have been no less in ways then with him.

In Costa Rica the upper half of the television stations are English speaking and generally U.S. stations. The lower half Spanish speaking and are all Latin American produced. All the U.S. stations like CNN, TNT, HBO, Cinemax Fox News as well as many others are here. Big shows like David Letterman, Jay Leno, all the late night talk shows, can be found. They have the NFl and NBA with even their own version of Sports Center and ESPN. Some are dubbed in Spanish, some like TNT have one in Spanish and one in English, both playing the same show at the same time. With such a large population of U.S. citizens down here, there are not only t.v. shows for them but English newspapers as well. In fact that was one of Roberts criticisms of the "expatriot's" (as their called down here, Americans who have retired or decided to move down here) that they tend to live in their own community's and don't necessarily get outside of them enough. This sort of "segregation" is still quite prevalent in the states as well, while in general cultures and nationalities do tend to stick together, living in either their own countries or communities abroad, it is too bad and a tremendous waste of cultural richness that we don't share more with each other. When we make a connection with someone by making an effort to learn their language, or one of their customs, the feeling is very rewarding. Again to quote Greg Frazier from his travels around the world five times, the thing he remembers most, was "the people, and the sharing".

From my travels in Europe and Morocco to Canada and living in Montana and Alaska, there is nothing like travel to reinforce the bonds of humanity thru shared experiences, not necessarily coming from the same culture or even speaking the same language. People all share the same values, expressed in different ways and rituals. When this is first understood, it goes a long way in how we define ourselves in relation to others.

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Yami, one of my "devoted" teachers

We ended our conversation when Roberts son Bernie came into the cafeteria needing something signed. For me being around people who not only know the U.S. but know so much of the rest of the world as well is just such a valuable perspective. Like noted, a more balanced view of one's self within the context of the world community is so important. Like when I meet Europeans and having been raised in a geographical area that encompasses so many different countries and cultures they just seem to naturally have a perspective of the world. Like their not the only ones on the planet. And worldwide travel with so many of them is taken up so easily, like yes, of course your part of a bigger world, why not partake in it. I happen to share this perspective with them. I think it is so vital to so many of our problems on this planet. Gaining a sense of a global community and working towards common goals is what's going to save us, not tying to separate ourselves and become the mightiest country on the planet. And guess what, again, like the inner city problems that migrate to the suburbs, its also the 3rd world countries problems that migrate to our doorstep because we didn't deal with them effectively to begin with...or better yet, fully understand our role in creating them to begin with.

There is no doubt that there are very real threats out there that need to be acknowledged and dealt with. How they are dealt with and in what manner is the question. When you go to war you naturally start a chain of events that you lose control of. All the ugliness of war seems the unavoidable by product of waging it to begin with. From listening to technicians in the Pentagon joke about blowing people up from satellites based in space, not even knowing who they were in Iraq, to not working with the rest of the world, and waging wars you can't pay for, when the economy is already so bad, going it alone, it goes on and on, holding people in Cuba we may not even be aware of who they are, taking your anti-terrorism measures to the point they infringe on the civil liberties your suppose to protecting to begin with, all done in the name of what is right, and what you believe in, or maybe worst, fear. Its sort of hard to believe, but is It any wonder we have a new president and the Republicans are scrambling to find out who they are. No the old ideals wont' work anymore. You can't just believe your way out of a mess, you need to figure out what created it to begin with and come to terms with what really needs to be done to change it, without extreme reactions (though sometimes those are even preferable to doing nothing). That is where I see us today environmentally, politically, every way you look at it, like Bob Dylan said, "The times they are a changing". They always have been, though now they just seem to really be coming to a head. I know I sound like I should run for office, sorry I guess Adventure Logs has temporarily turned into Political Logs!

"Does not tomorrow begin today?" Quai Chane Cains teacher in the t.v. show Kung Fu. If so our problems have been heading in this direction for awhile.

Intensa and Homestay

Miyera one of my three teachers who patiently guided me thru my lessons, and someone I would call a friend

As I had another long talk with one of my teachers, one of the basic challenges with the U.S. seems to be we're having an identity crisis. Our old models and believes, how we define ours selfs, doesn't seem to be working anymore. We're not the only super power anymore, people are struggling right along with the dollar. Today's world is not the same one my father and mother grew up and grew old in. Its not to say mom and dads values aren't needed or their wisdom, if anything we could use a good shot of those values. But to bring someone in, just because they represent old recognizable values, or have a seemingly hip and modern hockey mom as a side kick, who in an emergency could end up running the country, to me is not only irresponsible, its an old game of politics that we just can't afford to play right now. We probably never could. That's the reason there was probably a large collective sigh of relief that might have been heard across the world as the election results came in. In ways the conservative movement has been a disaster in this country, but I'm not convinced having the far left in control would be any better. And maybe the biggest illusion of all is me commenting on my perceptions of what I think is going on...... hmm

Well I have spoke my peace again, sorry if it offends anyone, the thing with travel is you just never know what your going to run into, attitudes and all. I just think this is such an extraordinary time for all of us, with so many challenges on every front, its hard to imagine anything quite like this, but we know our country and the world has been thru darker times. I just hope we can gain some sense of the need to do it together, and put our at times huge ego aside. And this doing it together is not the same as having a world wide democracy in the world, a vote with the majority winning. A vote between conflicting lines of thought, the one getting the most votes wins, regardless of whether its wrong or not (an inherently flawed system one might argue). But more of a lets all put our heads (or hearts) together and instead of coming up with something we've already tried before, lets thru a group conscience approach, arrive at a solution we could not have arrived at before thinking alone. Here in maybe lie the best solutions to our problems and also maybe the secret to Intensa's success. I don't think Robert the cofounder and current administrator, would argue with that at all, in fact I think he's very aware of it......maybe their best kept secret. Maybe a secret uncovered, one that leads us to think, maybe their teaching more then just Spanish and English at that school.....

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Here I am on graduation day, graduating with full honors , obviously the best in my class..

Namaste', A Hindu greeting or goodbye that means I acknowledge the divinity or godhead in you..........before taking any action with or against another, we need to acknowledge this connection first.