Another Gauntlet of Doctors

This happened the week before my cancer surgery and now it has started again two weeks before the beginning of my radiation treatments – tiring – hard to keep up with – but necessary!

1. Today, First of 3 Dental Appointments

Those who have experienced radiation know that you cannot have any dental work done after radiation for a long time, especially no tooth pulled because the radiation does something to keep the hole from a pulled tooth from healing. Hopefully none will need to be pulled! 🙂

  • Today (Monday) – teeth cleaned and checked out with two tiny cavities found visually that she will fill this Friday. She also ordered a panoramic X-ray of my teeth from the Dental Radiologist one block away where I went next to make my appointment.
  • Thursday – Teeth X-rayed when I will take the resulting X-ray back to Dr. Karina for her to study and see if there are other problems we should take care of before radiation.
  • Friday – I return to Dr. Karina for the two known fillings and anything else she finds on the x-rays.

2. Tomorrow, Tuesday – Appointment with Ophthalmologist

This is Dr. Raquel Benavides whom I saw in the hospital and Dr. Hernandez (my oncology surgeon) recommends to see if anything can be done to help my eyelid that will not close now or blink. He thinks she can “stich” the eyelid mostly closed to a sort of squint so that I will not have to keep it covered and can still see with it. Hmmm, I’m not convinced of that yet but maybe she will convince me or have some other solution other than an eyepatch. I’ll find out tomorrow and expect almost anything to come after radiation is completed.

3. Tomorrow, Tuesday – Appointment with Oncology Surgeon

This will be my 3rd “follow-up” or “post-op” visit to the surgeon, Dr. Christian Hernández. He wants to check on the healing of the long incision and the swelling on my left face and neck. Plus he said he wants to hear what the Ophthalmologist says. 🙂 He must not have a mouth specialist friend who can fix one-sided smiles! 🙂 He encouraged me earlier to go ahead and shave on the left side, but because it is tender and sensitive I only lightly run the electric razor over the left cheek and even more lightly on the left side of my neck which is more swollen and more sensitive. So I am not back to normal yet, skin-wise. The pain is less now in the ear and jaw, but still some and I’m now taking an over the counter acetaphetamine locally popular called Panadol.

4. Wednesday – Seeing my Dermatologist as Pre-scheduled

The last time I saw him, Dr. Roberto Gamboa, was when he sent me to Dr. Hernández to take care of the tumor which I will now have to tell him came from that skin cancer he removed in MOHS surgery which is supposed to mean they got it all. Well . . . cancer roots go deep! At that last visit he also treated a little skin cancer on my upper lip which was a black spot on my lip in some of my cancer selfie photos. (I was putting a very expensive anti-cancer medication on it once a day for 20 days.) That scab is gone now and supposedly the little cancer there. Of course he will be checking for any more and he often burns bumps off my skin with nitrogen. He is also my “traveling buddy” who likes nature lodges all over Costa Rica like me. He is the one who recommended Bosque del Cabo Lodge where I’m going the first week of July and earlier got me hooked on El Silencio Lodge I’ve visited twice now! Hopefully he finds no new skin cancers this visit. And maybe the best thing is that he is located in nearby Alajuela rather than far-away San Jose! 🙂 A much quicker and easier drive!

5. Next Monday – MRI at the Lindora Campus of Hospital Metropolitano

This MRI is for the Radiotherapists to help them target the cancer cells in my head, especially in the nerves since the cancer was in the left facial nerve. The best thing about this is that it is in a suburb on this side of San Jose, Lindora, and secondly in the only hospital that takes my Medismart Card for a big discount, as does the Radioterapia Siglo XXI I’m using and thus they are sort of Medismart partners. 🙂 It will take only about an hour with a little less than an hour each way traveling, so not as tiring as going to San Jose.

6. Next Tuesday – CT Scan and Mask-making at Radioterapia Siglo XXI

I assume that the MRI and CT Scan show different things that they need, thus I’m getting both in preparation for the radiotherapy. Both of these will be in San Jose at the Radioterapia Siglo XXI building where I will spend a lot of time the next month and a half.

7. Begin Radiotherapy in San Jose

This is the long-haul treatment of cancer, radiotherapy 5 days a week for 6 weeks and they guarantee that you will be tired at the end – enough so that they encourage you to plan no activities for the following 4 week or in my case, the month of June. It will take place in central or north-central San Jose at Radioterapia Siglo XXI, the only private radiation company in Costa Rica with only one place for the public healthcare patients to get it at Hospital Mexico. I chose to pay for private because it could be quicker, with often very long waits in the public healthcare system and because my oncologist strongly recommended it because of the size of the cancer.

As I shared in an earlier post, I am now planning to travel to San Jose each Monday and return to Atenas on Fridays, staying in a hotel near the therapy location. Even though someone else will be driving, I dislike the long, high-traffic drive that at peaks can be 2 hours between Atenas and San Jose. As long as I feel like it, I will even add a tour or two each week to something of interest in San Jose like some wonderful museums and parks plus history and architecture that interests me and may give photo ops, though many museums restrict photographs. Otherwise I will be pampered with all meals, room cleaning, Wifi, and hotel gardens to relax in between treatments. I will try to turn radiation into a relaxed and colorful, tropical vacation in the center of Costa Rica! 🙂

¡Pura Vida!

Dental Emergencies Only

Monday I returned to my dentist to see if the infection was gone so they can finish my root canal, stuffing it with something they get from a tropical tree. Unfortunately it still had infection though improved a lot and not painful, but I need more antibiotics and time. I wait 2 more weeks for it to be completed. Patience!

And when I arrived I witnessed this new sign (feature photo) taped to the front door that they now accept only emergencies, but they assured me that my infection is included in what the government accepts as “emergencies.” So I do get to go back in 2 weeks for what I hope is the last time!   🙂

Everything is different now with Coronavirus! The whole world is in a state of change!

They must often change, who would be constant in happiness or wisdom.


¡Pura Vida!


And if the virus caused you to cancel your Costa Rica vacation, try this very short 1 minute “Virtual Vacation”  video clip. ¡Pura vida!

Home Business Sign: General Medicine & Dentistry

Home Business Signs: General Medicine & Dentistry
 It appears that husband is dentists & wife the general doctor
 Atenas, Costa Rica

We are still getting the rains from the big Pacific storm that hit the southern Pacific coast of Costa Rica around the little town of Uvita where the “Whale’s Tail” beach is located. Here’s an article about the storm with a beautiful photo of the Whale’s Tail beach made on a sunny day. Also article about the weather closing Manuel Antonio National Park.

My photo of “Whale’s Tail” Beach is not nearly as good during rainy season in May:

Home Business Signs: Dentist

This is just two of several in-home dentists in Atenas.

I guess 24 hour service is easier from your home!  🙂
Atenas, Costa Rica

With Dental Tourism big in Costa Rica, we have many dentists!
Atenas, Costa Rica

And the photo gallery of Home Business Signs in Atenas

Dentists are medical professionals 
who help you put your money where your mouth is. 
~Author Unknown

Doctor Visits

Monday I had my first follow-up visit with my CAJA (government healthcare program) at Alajuela Hospital where my cardiologist did another EKG and a ultrasound of my heart. Then he personally monitored a treadmill test of my heart followed by another ultrasound he monitored. It was amazing to me that I was in and out of there in 45 minutes. He told me that the only other test he would like to have on me is an angiogram which he could not order until he consulted at least one other cardiologist there in the Alajuela Hospital because there is not much indication that I would have any blockage. He said he would call if it was approved and then I would have to go to Hospital Mexico in San Jose, which is the only one with the equipment to do an angiogram. It is the primary or main hospital for Costa Rica CAJA or government healthcare.

Well, his technician called me today y hablando sólo en Español. We both struggled through but basically I have to go back anytime tomorrow and get some “documentation” or paperwork from them in Alajuela to take to Hospital Mexico for an appointment for the angiogram. If I understood her correctly, my Mexico appointment is April 10 at 10 AM, but not clear yet if that is when I get the angiogram or, if like most things here, I may just be making an appointment for one much later. I should find out tomorrow.

This is how “single payer” or government or what Americans like to call “socialized medicine” works with priorities given to more serious things, emergencies, etc. It took two months for my first appointment with my cardiologist. No problem for me to wait for this as I don’t believe I have a serious problem. Best of all: No more cost for me now that I have a CAJA card, even if it led to the unlikely case of heart surgery.  I will keep you posted. Dr. Hernandez is basically building a file on me and my heart for any future needs and trying to be responsible for my heart. I appreciate that!

Today I visited my dentist who also speaks only Español and we managed fine for my annual teeth cleaning and checkup by the dentist herself and not a technician. She says once a year is fine and not the every 6 months U.S. dentists request to increase their income. She found the need for one tiny filling which I’m scheduled to get next Tuesday. And that is it for a year! And cheap! Many Americans come here for dental work to save thousands of dollars in what is sometimes called “medical tourism” or even “dental tourism.” A friend in Tennessee has come here twice for his dental work and saved a lot more than his plane ticket and hotel bill. That is for big work like bridges and caps.

Someday I will think about taking a photo at one of these places! It just hasn’t been on my mind with everything else to do like getting there and communicating!  🙂

Doctor & Dentist in 2 Days

Well, I keep meaning to ask Dr. Candy (my primary care doctor) to recommend one of the many

Oficina de Dra. Karina Valerio Rodriguez

local dentists or dental clinics. How do I choose? Some have shiny new offices, speak English and most of their patients are expats and dental tourists – yes, that is what they are called. Americans and Canadians come here to get dental work done at a fraction of the cost in the states even with insurance. And do a little tourism while they are at it! There are many more in San Jose but there are some here. The English-speaking clinics charge a lot more than the local Spanish language dentists. So how do I choose?

I finally got another excuse to see Dr. Candy since I seemed to have bruised my right heel walking around town in sandals. I just walked in without an appointment thinking her assistant could probably help me with both needs, but she was there and I walked right into her office. They check my vitals, feel of my heel and she says I have some inflammation and gives me 7 anti-inflammatory capsules to take one a day for a week then come back in to see her. In two days my heel quit hurting, but I’m taking all the med and will see her next Wednesday. No charge for anything because I am a member of her clinic now at $42 a month. I have unlimited visits with all meds and supplies included and ambulance service. Her assistants are both EMTs and they have their own ambulance. 🙂 I’ll have to get photos and show her office later.

Then I told her that it was time for a dental check up and teeth cleaning. Would she recommend someone? She said, “Sure!” (She treats me like she’s my mother and is quite direct about some things.) “I think you should see Dr. Karinna just around the corner.” That dental clinic is just a half block from Su Espacio where I have my main Spanish lessons and David, my Spanish teacher, was delighted when he learned this. Dr. Karinna is a dentist the locals use and she speaks only Spanish. “And,” he said, “She charges half what the English speakers charge.” David is not only very price-conscious, but is always trying to put me in situations where I have to speak Spanish (like the barber he sent me to). And that might have been part of Dr. Candy’s motivation for the choice. Candy speaks good English but knows I’m studying Spanish and need to learn and use it.

So, I walk down to the dental clinic and walk in, ask for an appointment and get it for the next day at 1:00. It was a delightful experience with only essential communication needed in Spanish, but then one can’t talk much at the dentist anyway!  🙂  A complete checkup (no x-rays) and a very thorough teeth cleaning by the dentist herself in maybe 45 minutes at a total cost of 18,000 colones which at today’s conversion rate is $33.97 USD. Not bad!  🙂  I told her I would return in six months, Retorno en seis meses. So, one more routine is now transferred to my new country and culture!  I’m settling in!  🙂  And I got her email address for my Nashville dentist to email her my records. Pretty cool!

Telling more briefly about my new dentist in Spanish on Aprendo Español en Atenas.