Dental Tourism in Costa Rica

My journey to becoming a dental tourist began somewhere off the coast of Nicaragua in 1993 when the crown on a molar broke.  Our next landfall would be much further south, so I cautiously chewed on the other side for a couple of weeks until Yankee Rogue was safely moored at the Costa Rica Yacht Club in Puntarenas.  (Note:  anchoring out was our normal routine; however, in the fast-moving waters of the estuary, a mooring the prudent option; besides, I had fond memories of the Yacht Club serving $6 filet mignon dinners back in 1989.)  We dined (me gingerly) that first night at the club with one of the club board members & his lively wife, & my very first question was "Who is the best dentist in Costa Rica?"

The next morning I called the recommended dentist's office in San Jose, & a couple of days later caught a public bus to the capitol, & then a taxi (necessary in the city because there were no street addresses then; more on that later) to a modern dental office.  I met the dentist, who spoke perfect English & who had gone to graduate school at the University of North Carolina at Chapel Hill.  The work was done efficiently in a couple of visits, with a great deal of concern for my comfort.  I don't recall the exact cost of my replacement crown, but remember that I thought it very reasonable.  I was even given some local anesthetic for our ship's medical kit in case of an accident in which one of our crew had to be stitched up by the other (we'd both taken Medicine at Sea classes in California & had practiced suturing raw chicken breasts).

We were in Puntarenas a while for a semi-overhaul, so I returned to San Jose a couple of times for some more dental work, once seeing a specialist for a complicated root canal.  A decade & a half later, my U.S. dentist somberly informed me that I needed some major work that would require more money than my first house had cost, three different dentists & several months of appointments.  I immediately flashed back to the chat I'd had earlier with her assistant about how her friend had just bought a cheap ticket to Costa Rica.  "Umm, I'll have to think about this," I mumbled to my nice local lady dentist before dashing out the door to go home & check on flights to San Jose.

I did more than check on airfares.  Thanks to the internet, which had matured in the years since I'd crewed in international waters, I was able to conduct thorough research, making what I considered the best choice of dentist for the work I required (my old dentist was no longer in practice in San Jose).  My new dentist of choice was Dr. Telma Rubenstein, who works with her husband Dr. Josef Cordero at their clinic, Prisma Dental.  They specialize in cosmetic dentistry, including implants, & their office is the most complete & professional I have ever seen.  Their x-ray equipment, including a panoramic machine, is much more modern than what I've ever seen in the U.S.  Their lab is right next to the dental office, so work is done quickly, & if there is ever a problem it can be resolved almost immediately.

Dental tourism is described in detail in Wikipedia, but basically it has flourished in many parts of the world during recent years as the prices for dental work in some countries, like the U.S., have skyrocketed.  Not only are traveling dental patients able to save a great deal of money, in many cases more than enough to cover all of their travel expenses, but they are able to receive excellent care that can exceed that available locally.  General anesthesia is often available for complicated work or for those for whom the dental chair is traumatic.  Tranquilizers & pain meds, including shots, have been offered me at various times to ease the experience.  Antibiotics have also been prescribed when appropriate.

No matter what dentist I have seen over the years in Costa Rica, the commonalities are concerned patient care, quality work, & efficiency.  They are all aware that time is critical for tourist patients, & it is not unusual for office visits to be extended to whatever length is necessary to ensure that the patient's work is completed in the shortest amount of travel time.  In my experience, U.S. dentists schedule lengthy & complex work in relatively short segments, seeing many patients in a single day.  In contrast, at Prisma Dental as much work that can be completed in a single day is done, even if it means sitting in the chair most of the day or well into the evening.  I've even had a driver from the office meet me at the airport to make sure I got started right away on my work.  This may not appeal to everyone, but I'd much rather have one long semi-miserable day & get over it instead of having to confront my dental fears over multiple visits.  Note that implants will require two separate trips, one for the installation of the metal posts, & the second, after six months of healing, for the finishing crowns.  Last time I checked, general anesthesia for the post(s) installation (my recommendation) was $500, which includes the services of an anesthetist.

If you are having crowns or bridges made in the lab, you are then free to play tourist for a few days until your final installation visit.  (I recommend staying an extra day or two just in case your new work needs a final adjustment).  As an alternative to touring in-between dental appointments, many visitors opt to use the in-between time for cosmetic or other surgery.  A single round-trip ticket can take you home again improved literally from head to toe.  It is not uncommon for couples to travel together, getting whatever medical and/or dental services each of the partners needs or wants (his & her facelifts are more common than you might think.)  Watch this site, as I'll be posting more soon on medical tourism & where to stay during your visit.

Your primary motive for visiting Costa Rica the first time might be to save money on your dental work, but please take the opportunity to savor this incredible country while you are there.  Sample the amazing geology, the diverse flora & fauna, the culture, the delicious food, & most of all the joyful people you will meet.  Dental frugality may be your initial motive, yes, but don't miss the serendipitous experiences available while you are there.

Chances are good you'll want to return to Costa Rica again & again.  Just think of the great souvenir you can bring home--your new beautiful smile!

Time Travels

Some travels don't take time in space, but in time.

This was recently brought home to me when I was contacted on Facebook by someone I didn't recognize.  When I clicked on her page I saw that she had gone to college in California, where I had lived most of my teen & adult life.  I wrote to her, confessing I did not recognize her, but asked if we had gone to school together.

Her reply stunned me.  No, we did not actually know each other, but she had been long-married to someone with whom I'd had a penpal fling back in the 1950's when he was in prep school & then the Air Force Academy.  He was from my hometown in Illinois, where I'd spent the summer of 1958 with my grandparents.  After his mother had died her husband had found some of my mail to him, along with three photographs I had sent.  She & her husband decided that perhaps my children & grandchildren would get a kick out of seeing my letter & photos from so long ago.  Not having any information other than a 1958 postmark & my maiden name, this persistent lady used her computer to track me down, starting with the alumni site for my high school.  There she discovered my married name, & found me on Facebook.

What a trip down Memory Lane the three of us had!  We all emailed back & forth, & I mentioned the names of two of my girlfriends from times gone by in my home town, & almost immediately I received their current phone numbers.  I had terrific phone reunions with both women, & I reminded one that I had been the culprit in the first grade who'd spilled the beans about Santa not being real.  I remembered that her mother was irate with me, but fortunately my childhood friend forgave me.  In fact, she didn't even recall the incident, & we senior ladies then giggled together about our teen exploits.  Oh, the cokes we had drunk, the afternoons we had danced along to Dick Clark's American Bandstand, & the boys we had kissed!  We caught up on loved ones lost & counted up children, grandchildren & great-grandchildren.  I had thought I didn't have anyone left in my hometown, but now I have reasons to return.

Then just a few days later in my post office box there was an envelope in which I discovered the mail I had sent on 13 October 1958, nearly 55 years after I had sent it.  Enclosed were three photos of me from my early teens.  A couple days after than my long-ago penpal, who is now long-since retired from the Air Force, called me & we had a wonderful chat.  Not only had he & his wife utterly charmed me with their thoughtfulness in returning my mail, my friend told me how much my letters had meant to him when he was away from home for the first time.  I wasn't the love of his life, of course, but our naive mail exchanges had been important to each other at the time.

On 28 February 1958 I attended my second-ever dance, the annual high school Sadie Hawkins.  The photo was taken while I was waiting for my date to arrive, & my dad & I developed it in our bathroom darkroom.  My date had had been my biology lab partner from the previous summer.  We'd had great fun in class, & I still had a crush on him.  I don't remember much about the dance, but I continued to date him off & on through high school & some college, until I got caught also dating his roommate (yes, I am appalled at my teenage self).  His sister is still a friend of mine, though my date & I lost contact a couple of decades ago.  However, his well-reviewed books are available on Amazon, & he is a Distinguished Professor at a prestigious university, & recently received a grant to research what is sure to become a major work.

A couple of months later, my dad took the second photo, just before I left the house with a friend to see the same boy play the lead role in his school production of the Gilbert & Sullivan operetta "The Mikado."  The performance was spectacular, I think much better than the one I saw 30 years later by the legendary British D'Olyly Carte troupe.  The high school group definitely performed with more gusto.  I remember well this dress, made by my mother, as were all of the ones in my closet.  I recall even the iridescent ball buttons down the front, as well as the pleated cummerbund that matched the pink cotton satin of the floral stripes.
 
Note that the dress was supported by petticoats.  They were always too long,  so I'd have to wear a belt under my dress to keep them up. I usually wore three at a time, starching them with sugar water every night & they would drip-drip-drip in the shower until morning. My father used to tell my best friend (then & until her death 56 years after we met) & me that we looked "like two bells going someplace to ring." Quarreling with my sister was our morning routine as we battled over who got to wear which petticoats.  It got so bad one spring morning in 1960 that my father decreed that no one would get to wear petticoats again, so that was the end of my full-skirted style statements (except for my hoop-skirted strapless gown, which would soon cause an embarrassing incident at prom).

This final photo was taken in June 1958, when I was was 15-1/2, in my grandparent's yard in Greenview, Illinois.  My girlfriends from grade school & I spent long summer days reuniting that year.  I'm sure the primary topic of conversation that summer was B-O-Y-S, & I learned what the word "parking" really meant.  Every time I hear the songs "One Summer Night" or "Lazy Summer Night" I am taken right back to that sultry summer.  Our primary transportation was an ancient car belonging to the grandfather of one of the girls.  It kept flooding & I still remember my friend's bare foot constantly pumping on the pedals.   Oh, the times we drove it all the way into a Springfield drive-in for Green River drinks & our favorite pork tenderloin sandwiches!

I learned how to get my heart broken for the first time that summer, & one of my friends taught me how to make pizza sort-of from scratch that summer.  I still have that first pizza pan, with 55 years of criss-crossed lines from all the pizza cutters over time.  It is the one I've used to teach three generations of offspring how to make pizza.  (Note to self:  add pizza pan to will.)

I look at this final photo, & remember the exact turquoise color of the plaid dress my mother had made.  I know exactly how the matching leather belt felt when I wore it, & I can smell the
freshly cut grass in the yard.  On the other side of the fence lived a horse named Tony, & my little sister, gone 19 years now, & I would feed him sugar cubes & apples.   I know when we teen girls weren't busy chasing boys that summer I spent hours reading books lying in my grandfather's green hammock.  There would be chicken fried steak for dinner, along with mashed potatoes never served without gravy, creamed corn & red Jell-O with sliced bananas.  We would all pass around a small plate with a big onion that had been scored on top & a paring knife, & we would each cut off tiny chips of onion to top off the gravy on our mashed potatoes.  There would certainly be a pitcher of iced tea on the metal kitchen table & a plate of freshly sliced tomatoes.  I would sprinkle sugar, instead of salt, on mine with a spoon taken from the spoonholder that was always on the table.  Two kinds of pies, maybe one of them my favorite gooseberry, would be served for dessert.  My grandmother would hardly eat a bite because she, in her cobbler's apron printed with tiny sprigs of rosebuds, would be constantly jumping up & down, trying to get more food for everyone.  My grandfather would have left his cap on the back porch, but surely he was still wearing his overalls as he ate a full plate, making jokes & teasing the girls in between bites.  The nearby window sill held sweet African violets planted in coffee cans, & all the girls would chatter as we washed the dishes with water my grandmother heated on the big gas stove she wouldn't let anyone else light.  The years have fallen completely away, & I am home again.

My thanks to my long-lost penpal & his lovely wife for their thoughtfulness.  In a bit of serendipity it turns out they live only a few miles away from my elder daughter & granddaughter.  We are planning a reunion during my next visit.

During my recent journey down Memory Lane I have seen, tasted, smelled & touched my past just as surely as I have anything on a trip that began at an airport.  Despite the creaks in my bones & the evidence in my mirror to the contrary, inside I still feel like the 15 year-old girl in the photos.  All the same feelings, hopes, dreams & uncertainties are still there, along with the knowledge tomorrow will still bring something new & exciting.

To what time in your life would you like to travel?  Do you enjoy visiting often?

What to Wear--10 Tips on Basics

So you are conforming to airline regulations & planning to pack light, but what in the world are you going to wear without looking like the proverbial Ugly American?

Tourist in Paris, Heat Wave 2013

Comfort is a key component in traveling, but there are definitely places & situations that courtesy requires some spiffing up.  We love our jeans, but they aren't appropriate everywhere.

Here are a few basic travel clothing tips:

1.  Unless your travels take you on an archaeological dig or off on a stint on a farm in the hinterlands (& they well might, 'cause I've done both), any jeans should be unfaded & in good repair.  Colored (e.g., white, black, lavender) or very dark or colored jeans, even though identical in cut to your everyday britches, make a dressier appearance. Women can wear them with heels & a nice top to make them acceptable many places, & men can even wear good jeans with the right jacket for a relatively dressy look.

2.  Given a choice between jeans & khaki, I prefer the latter for pants most of the time.  Khaki goes with almost any color, including that traveler's standby, black. You can dress up your khaki-based outfit, but if you are off for dusty activities, khaki also hides the grime better than any other color (which is why it is the color of choice for safaris, & why it will be in my suitcase for Mongolia next year).

3.  Appropriate headgear for your destination climate is important, to protect from sun or cold.  Choose white to reflect heat, or a dark color to retain it.  A brim can help shade your eyes from relentless sun, & if dips low in the back, will protect your neck, too.  Wool will keep you warm, even when wet.  Make sure your hat is packable so you don't have to risk leaving it in the overhead bin.

4.  Scarves, for both men & women, can perk up a light-traveling wardrobe, & are practical for hair covering when riding in the open air, if you need sun protection on your shoulders, or fashionable warmth when the sun dips low.  A large onecan become a cover-up sarong on the beach.  Scarves take up little room & give you an instant wardrobe change.

20-yr Old Shower Clogs with Gripper Soles

5.  Although men can sometimes get by with a single pair, women usually at least need two pairs of shoes.  One pair of shoes should be comfortable for extensive walking, with the other pair also comfortable, but suitable for dressier occasions.  Depending on climate & time of year, sandals with good may be the best choice for the second pair (caveat:  don't try to put a lot of miles on sandals, even those advertised especially for walking).  Everyone also needs a pair of good shower clogs with non-slip soles for the beach, hotel room use & safe showering.  Recent trips to Iceland & a planned expedition to Machu Pichu required hiking boots, so I searched for the very lightest available.  By watching for online off-season sale I was able snatch up an easily packable pair that weighs mere ounces for a truly bargain price.

 6.  A water-repellant jacket with hood that can be layered is a traveler's classic, but a lightweight, perhaps disposable, hooded poncho will take up less room in your daypack & may be more suitable for rainy season in the tropics.  If heavy rain is likely at your destination, a folding umbrella is a good idea, though make certain it is a sturdy one that won't blow inside-out in a stiff breeze.  Do remember that even in the tropics it can get quite cool in the highlands, which is why I pack a jacket & slacks for Costa Rica.

Layering was the key to comfort in Iceland in June 2013.

7.  It's a rare trip that I don't carry a simple black swimsuit.  Even in northern climes swimming or public bathing is a common activity, & a hot tub in Reykjavik is the perfect place to view the Northern Lights.  I like a lightweight cover-up for modestly getting to & from the water.  Depending on the itinerary I might pack a hand towel or old thin bath towel that I can either pass on or throw away before continuing on where I won't need it.

8.  Skirts are my frequent choice for travel because they are comfortable, & in hot climates they are cooler to wear even than shorts.  Tops that don't have to be tucked in make the entire outfit comfortable, plus they cover
your money belt.

A skirt was my cool choice for a cruise to Isla Tortuga.

9.  Synthetic fabrics travel well, but are hot in tropical climates, so sticking to natural fabrics is a good idea (especially for undies).  Breathability is the key to comfort.  A loose linen blouse or shirt is tops for comfort in heat & humidity.  A few on-the-go wrinkles are acceptable, & hanging clothes in the bathroom while you shower will smooth them out a bit.  A portable steamer works well, but I leave mine at home to save precious luggage space.

10.  Don't forget a belt that does not contain metal.  Look for one made of webbing with a plastic closure so you don't have to remove it during airport screenings.  Remember that even though those new or freshly laundered pants had a snug fit when you leave home, they are bound to stretch out as you go.  You'll be climbing, stretching & bending over more that you think, & droopy drawers are less than flattering.

If you take the right articles of clothing you won't have to carry too much.  What tried & true must-take clothing items do you pack?  Feel free to post your recommendations below.

Isla Tortuga, Part I: Overboard in Paradise

The day was tropical gorgeous as our 42' ketch, Shannonigans, dropped anchor just off the deserted beach of Isla Tortuga, an island, that is part of the Costa Rica National Park Service in the Gulf of Nicoya.  It was 1989, & a friend & I were crewing from Costa Rica to Panama on the boat, which was owned by a former student of mine & her husband.  Their Lloyds of London insurance policy required additional crew members, so my travel buddy & I had filed our sailing resumes with Lloyds. We both had been accepted as crew so that the vessel would be insured for the passage, which would include a transit through the Panama Canal.  We were a crew of four, the husband & wife owners, my friend & I.

The only inhabitants we discovered on the beach were coconut crabs, busy breaking into the numerous coconuts lying on the perfect sandy beach.  There were lots of shells, some quite large, & the sun was bright. quickly tanning our November-white bodies as we splashed along the shore, relishing our recreational anchorage just prior to making passage.  We four frolicked in the surf & shore as if the rest of the world didn't exist.

The morning passed quickly, & all too soon it was time to take to the inflatable dinghy for a return to the boat for lunch.  I was third up to grasp the rope boarding ladder, & was half-way up the side of the hull when all of a sudden, & without a clue how it had happened, I found myself underwater.  Silly girl, I thought, as I surfaced, my face red in embarrassment, but I quickly reached the ladder, which descended a couple of feet into the water.  I placed my right foot on the first PVC rung & attempted to lift myself to the next rung.  No go.  My weight had caused the flexible ladder to hug the underwater hull like a second coat of bottom paint. Although still in my 40's at the time, still I hadn't the upper body strength to pull myself out of the water with the ladder at a near 45 degree angle.

So on to Plan B.  Okay, I'll just climb back into the dinghy & scramble up the ladder from there.  The physics of hanging off the side of the Avon with most of my middle-aged body in the water soon became apparent.  There was no ladder on the inflatable dinghy, so no purchase for my feet.  Once again I was unable to hoist myself out of the water.  The skipper gave me an assist, Plan C.  No go. Another lift attempt & it was clear this wasn't working.  Geez, I could be in the water a long time.  I looked around for Plan D inspiration.  The sun-kissed beach wasn't that far away & I could have swum myself aground where I could have been easily picked up. However, the skipper decided to try Plan C-and-a-half.  Crouching in the dinghy, he grabbed me under the arms, & gave such a final mighty pull that he ended up flat on his back in the bottom of the Avon, while I popped up out of the water like a cork & he managed to haul me over the side.

By the time I successfully scrambled up the PVC rungs & over the side of the sailboat, all four of us were laughing so hard that I swear it wasn't just water dripping down from our swimsuits. This was a time before cellphone cameras so all we carry to this day is a visual memory of my escapade, though had this happened later in time surely I'd have ended up on YouTube.

It was a funny tale in the retelling, but by the time I was back in the States I was having second thoughts about the entire experience.  The conditions had been perfect for my clumsiness.  At no time had I been in any real danger.  Wet, yes.  Embarrassed, of course.  However, I hadn't even lost a contact lens, let alone experienced anything life-threatening.  But what would have been the outcome if any of the variables had been different?  What if I had taken the dinghy ashore alone & fallen without the knowledge of the rest of the crew?  What if there had been sharks nearby or rough weather?  What if it had been dark & the water cold, or if my skipper hadn't been young & strong?

It's always a good idea to learn from one's experiences, so I did a little research.  An amazing 90% of man-overboard drownings occur during calm weather, & only 26% of the victims were actually sailing at the time of their accidents.  Half the time, even when the overboard victim is right by the boat, he/she is unable to be rescued because it is not possible to get back aboard.   Not long after I got back to Southern California there was an incident where a sailboat owner on a daysail date fell overboard a few miles from shore.  His inexperienced companion was unable to assist him back aboard & he drowned right in front of her by the side of the boat.  I also have a friend whose nephew disappeared one night off a commercial fishing boat, so I am all too aware of the potential consequences of a boating misstep.

What had been an amusing, if embarrassing, story on myself soon became an opportunity to better prepare myself & my boat.  I  installed up-to-date man-overboard equipment & bought individual lifelines for the crew to wear on deck & on watch.  We practiced man-overboard drills.  My own Avon inflatable was soon sporting a non-flexible boarding ladder that could be dropped a couple of feet below the surface so a swimmer could have foot purchase instead of just relying on upper body strength to haul oneself over the side.  A custom stainless-steel boarding ladder was manufactured for Yankee Rogue, our 35' cutter-rigged sloop.  It folded well down into the water so anyone in the water could just step up onto it for boarding safely & easily.  I wrote an article for a boating magazine so that others could learn from my experience.

Happily I haven't fallen overboard since 1989, & no one ever had difficulty boarding Yankee Rogue. Amazingly, the new custom ladder actually saved the life of my beloved Devon Rex cat, Shadow, a couple of years after my own in-the-water experience.  Look for that post later, as well as the story of my return to Isla Tortuga earlier this month , more than two decades later.  (Note that you can subscribe to this blog so you don't miss any posts.)

Did you ever learn an important lesson while traveling?  Please share your tale below--

Mal de Mer

Just started to read a Huffington Post article on preventing seasickness.  "Avoid ocean crossings," the author advises.  Good grief, to my way of thinking, you'd miss the best part of sailing.

When living in California I made many pleasure trips to Catalina Island without feeling the slightest bit woozy.  My government marine archaeology position required countless trips on various work boats in rough waters, many in the violent waters around Point Conception, where the decks were relentlessly awash, making the journeys from bunk to workstation to galley hazardous indeed.  I thrived, even on those days when it was too rough to leave the bunkhouse bolted to the deck.

Years ago I interviewed Sir Robin Knox-Johnston, CBE, the first person to do a solo non-stop circumnavigation & author of A World of My Own: The First Ever Non-Stop Solo Round the World Voyage, for a sailing magazine.  He regaled me with tales of his near year-long voyage, & recounted his meeting with Queen Elizabeth II when he was knighted.  "She asked me what I did about seasickness, so I told her the best cure for seasickness I'd found was to spend a good bit of time sitting under a tree."  My understanding is that Her Majesty was amused.

I've never truly been seasick.  What I do get is cranky the first 3 days when bluewater sailing.  Except for stove duty & head calls I never leave the cockpit.  At the beginning of a passage, when I'm not expending energy on crankiness, I am totally lethargic.  Once, making passage from Panama to Colombia, my skipper informed me that we were taking on water.  I reluctantly lifted my head from the cockpit cushion for a quick look below.  Indeed water was sloshing over the floorboards in the salon.  Oh well, I thought, that's okay because I can lie down in the liferaft just as well.  Fortunately, my crewmate found the wooden plug I'd stowed for just such an occasion, & he was able to staunch the gushing seawater, & the bilge pump drained the overflow.  I'm not sure I even rolled over during the crisis.

But, oh, how glorious the fourth day & those ever after, when making passage.  I wash my hair & resume basking in the glories of life at sea.  Dolphins race alongside the boat, & I whistle & play Jimmy Buffet music to keep their company as long as possible.  Both galley & cockpit are my domains, & I bake bread & pizza on top of the stove.  I stand extra-long watches under the star-bright skies so my skipper can sleep through the night.  I delight in the phosphorescent wake of our stern, & imagine the magical seaworld beneath our passing keel.  The rising sun gives promise of another glorious day without the travails of civilization, & I revel in the rocking bosom of Mother Nature.  The sea renews, & I am reborn daily.