Biopsy Report: Common Old Man Skin Cancer

You have to click the image at least 2 times to get an enlargement.

Yesterday afternoon I saw my Dermatologist who presented me the lab’s very detailed report with color microscope photos and the diagnosis en español:

“Carcinoma epidermoide bien diferenciado, invasor, de al menos 4 milímetros de diámetro mayor, que alcanza los márgenes de resección.”  Or in English according to SpanishDict.com translation:

“A well-differentiated, invasive epidermoid Carcinoma of at least 4 mm greater diameter, reaching the margins of resection.”

The Doc assures me he can cut it all out by going a prescribed mm distance all the way around it (a big chunk of flesh!) and with several stitches will heal that part of my right forearm back to normal. That’s a $600 surgery or for $4,000 he can do a much tinier section removed while a separate pathologist is testing (continuous biopsy) every little bit of skin to make sure they get all the cancer without taking as much of a chunk! He recommends this for a growth on the nose, etc. where removing more is more obvious. Of course I’m doing the cheaper one which he assures me has always been successful for him and what he recommends. Just a little scar on my right forearm. It is scheduled for 19 November after my next trip which is to Palo Verde National Park 10-15 November. My doctors work around my trips and not vice-a-versa.   🙂

It is interesting that Dermatologists here say the same thing they told me in the states, that these growths that keep popping on my body in old age are caused by getting too much sunshine when I was a little boy. No one told us that back then!  Or maybe I was not paying attention when Mom wanted me to use sunscreen?      🙂     The young are invincible and us old ones just smile at our little problems.   🙂

Since this is a retirement blog, I guess this kind of gory medical report is appropriate. Anywhere you live in retirement you must deal with these things and the medical services in Costa Rica are simply great and so much more affordable that I’m just using a private doctor again instead of the free public ones, which are slower but just as good and free!  🙂  I still use a public doctor to monitor my heart arrhythmia, but other things I’ve been happy with the quick responses of private doctors, like this Dermatologist, Dr. Gamboa.

¡Pura Vida Medico!

Reduce Pollution!

Some youth in the city of Alajuela left a sidewalk chalk message for pedestrians the other day: something like “Be aware of the city and REDUCE pollution!”

¡Pura Vida!

Breakdancers in Alajuela

While in Alajuela the other day I heard music in the gazebo of Central Park and found local teens breakdancing with a boombox in the gazebo. I tried to get a couple of shots with my phone and they aren’t very good, but an interesting part of culture here as especially the young adapt cultural activities and music from other cultures & countries around the world.  Truly, it’s a small world!   ¡Es un mundo pequeño!

Central Park Alajuela with the big white gazebo on the other side.

 

Breakdancing in Alajuela

A nation’s culture resides in the hearts and in the soul of its people.

~Mahatma Gandhi

P.S.   World Surfing League in Costa Rica This Week

New Hospital Adventures

Hospital San Rafael de Alajuela, Costa Rica

Adventure 1: New Cardiologist Scheduled

It was time for my one-year checkup with my public hospital cardiologist yesterday, 27 Agosto, made by the doctor one year ago, Dr. Hernandez. In the meantime I heard around June from someone else with the same cardiologist that Dr. Hernandez (whom I really liked) had gone to Spain to study heart surgery and I would be getting his substitute whom the other person also liked very much, especially because he spoke English! So I was already expecting a new doctor, whom I learned today is Victor Andres Garcia Rojas (called Dr. Garcia) – and I will do another article below on Spanish Names using his.

Adventure 2: I Forgot Pre-appointment Blood Tests

Yeah! No good excuse! It was on my calendar that I wasn’t watching and I forgot that appointment a week earlier. The results were to be with the doc by yesterday so they would be part of his evaluation of my heart. I rationalized and said, “oh well, he will reschedule that and add to my file later. No big deal! Pura vida!”  Well, it is a big deal! Hospitals are very serious!

So I wait in the adultos major line (for old people & shorter than other line) for about 30 minutes. When I get to the desk there is suddenly a computer problem with a bunch of supervisor types coming in to explain something on the computers to all the clerks. Then finally my clerk takes my cita (appointment paper) and my cedula (ID card) and starts to check me in and I casually tell her about forgetting the appointment for blood workup. She stares at me, shakes her head and tells me she is sorry (this is all in Spanish of course) but “the doctor cannot see you without the blood tests.” Thus she makes a new appointment for me with Dr. Garcia on September 5 (Whew! I leave Sept. 6 for my Caribe trip!) Then, with multiple attempts, she explains to me that I must go down to main lobby (photo at top) and wait in line at the laboratorio for a new appointment and show them that it is needed for a Sept. 5 doctor visit. By then I remember waiting in that line a year ago for the missed appointment. My punishment for living a pura vida life!  🙂

So back downstairs to that crowd in top photo and actually the laboratory line was not as long as some of the others. I had my new lab appointment for this Friday in less than 45 minutes! This girl was not as slow a speaker or as patient with my bad Spanish and so she used her phone translator some with me, though I was understanding more of her Spanish than she thought. Language is all part of the adventure!

So now, (with all the complaints about slowness in public healthcare), I’m doing blood workup this Friday (just 4 days later!) and I see the doctor next Wednesday! Pretty fast I think! And this delay is the fault of my forgetfulness or not setting the phone calendar alarm on my lab appointment! Now I get to go back to the hospital two more times (More adventures!). And I will remember to fast 12 hours before my 6am appointment Friday!  Aren’t I lucky?    🙂

Adventure 3: Spanish Names – Why 4?

Be aware that this can be slightly different from country to country, but for the Costa Rica explanation I will use Dr. Garcia as my example:

Dr. Victor Andres Garcia Rojas

Victor = First Name;     Andres=Second or Middle Name;

Garcia=His Father’s Last Name;     Rojas=His Mother’s Last Name (maiden name)

Most people go by their father’s last name, thus he is “Dr. Garcia.” But on legal documents and other places they use all four names, like on the Cedula (ID Card) and in the hospital. Since I have only 3 names, the hospital or national healthcare program has given me a fourth name that is on all my hospital records = “Noindicaotro” as a replacement for my Mother’s last name. Interesting since it is not a word in my Spanish Dictionary!   🙂

Adventure 4: Talkative Old Man on Bus

On the bus ride back to Atenas (45+ minutes) I sat next to a very talkative man who did not stop talking and even singing the entire trip. It was mostly in Spanish with an occasional English word or phrase to show me that he knew some English. I had a crick in my neck when I got home for having my head turned to the left the whole trip. And no, what he said was not very interesting, but I appreciated his friendliness and I guess he appreciated me listening attentively.   🙂

 

¡Pura Vida!

 

 

Surprising Vista at Xandari

By using my new 600mm telephoto lens instead of my usual Samsung Phone Camera for a vista from the hilltop resort Xandari, I zoomed in on the Alajuela Cathedral with Central Park to the right and the bigger surprise, at top edge of photo is an American Airlines plane landing or taking off at the San Jose International Airport in Alajuela! Luck of the timing on the plane and sorry that the blog template crops off part of the plane, not so in my original photo (see in gallery).

Below is another shot in same direction from the same restaurant with my phone camera to help you see how much I was able to zoom in and crop a little!  🙂  The cathedral is on the left side of the city that you see between the restaurant and the mountains. My last day at Xandari, Wednesday, Walter picked me up and we got my internet order package 5 blocks east of the Cathedral, ate lunch 2 blocks north of the Cathedral, then drove 24 km (15 miles) west to Atenas where I live. My small world!   🙂

Looking south over Alajuela, Costa Rica (& San Jose Airport) from Xandari Resort. I stood in this same spot for the Cathedral-Airplane photo, just zooming in!

 

¡Pura Vida!

See my Trip Photo Gallery:  2018 Xandari Resort

Xandari costa rica   (their website)

Retired in Costa Rica

Xandari Gallery is Ready!

There are so many good photos of flowers, architecture, the farm, public art and one very surprising vista! (I may share here tomorrow.) And I decided not to fill another week’s worth of blog posts with them. So I encourage you to check out the 2018 Xandari Resort Photo Gallery. This was one of my most photogenic places to visit yet!

I just love every little corner of Costa Rica!

 ¡Pura Vida!

Xandari costa rica   (their website)

Trails & Sidewalks at Xandari

If you count the unofficial paths and trails there are possibly 5 miles of walking/hiking ways within the Xandari property. And I think I have walked over every portion except a little section that dead ends along the river. Around the villas and through the gardens is paved while through the farm and to the waterfalls is dirt paths, sometimes muddy this time of year! I came back to my room with muddy shoes every day! Just a sampling of trails and I did not include some grass-covered paths. Trails are a great way to immerse yourself in nature!

This slideshow requires JavaScript.

 

¡Pura Vida!

See my Trip Photo Gallery:  2018 Xandari Resort

Xandari costa rica   (their website)

Butterflies and Other Bugs – Xandari

Xandari is like any place in Costa Rica, there are lots of bugs, but I don’t think as many here as some deeper forests I’ve been in. And this is butterfly season! Here’s a little slide show of 6 butterflies and 2 other insects photographed at Xandari Nature Resort. Enjoy!

This slideshow requires JavaScript.

 

¡Pura Vida!

See my Trip Photo Gallery:  2018 Xandari Resort

Xandari costa rica   (their website)