 - by Carmen Wise A relative at a recent family reunion asked me how my trip to Costa Rica and the surgery went. I answered, it was a breeze. We didn't go to Costa Rica to ride rapids, swim with sea turtles, cruise by canoe down jungle rivers, or fly from tree to tree on canopy rides. That's what a person does when visiting the lush gorgeous country of Costa Rica. And what we did on a previous holiday trip. Costa Rica occupies only a tenth of a tenth of the world's geography yet is host to more than six percent of the world's biodiversity. It is a haven for ecotourism. On this visit, however, we arrived as medical, not eco, tourists. Instead of exotic adventures, our sights and sites were limited to Hospitals, clinics, physiotherapists, Doctors, labs, and hospital cafeterias. Our participation was limited to watching the tropical countryside through the windows of vans taking us from medical appointment to medical appointment. How did it happen that we arrived in Costa Rica as medical tourists? I had suffered a rapidly debilitating shoulder injury and the Canadian (Albertan) medical system would not be able to address the problem for 18 months from the point of diagnosis. I couldn't wait that long for treatment. I am a professional violist and an artist and writer. My right arm is my dominant arm. My woes began about two years ago when I noticed my right arm ached after flinging the ball for my dog Sprite. Due to increasing pain, I found myself curtailing more and more activities. I dropped out of the community orchestra, turned away gigs with out of town orchestras, and dropped my weekly chamber music sessions. I found I had to limit my sessions on the computer to just a few minutes at a time. I found myself painting on smaller and smaller canvases as reaching aggravated my pain. I gave up swimming. Styling my hair was impossible as I could not lift either the dryer or a hairbrush. I couldn't tie my apron or pull my pants up. In the last few months before Costa Rica, I was not playing my viola at all. In fact I was in constant excruciating pain so that I hardly slept unable to find a comfortable position. Sleep was only a dream for me. Sometimes I would bump into something, or someone would bump me a little too hard, and I would go into paroxysm of pain that caused me to double over. People would run to me thinking I was having a heart attack. And the pain was becoming exponentially worse by the day. Throughout that time, I had seen physiotherapists, chiropractors, massage therapists, acupuncturists, and laser therapists. I faithfully followed a regime of exercises that did nothing to alleviate the pain or expand mobility. I visited my GP regularly during those two years. At first she suggested over the counter drugs then as time went on prescribed a stronger pain medication. In September, she saw that my pain was beyond a muscle sprain and requested an MRI. I waited seven months for this. The MRI report in April of 2007 showed that I had a 50% tears in my supraspinatus tendon, one of the rotator cuff muscles. There were also cysts and spurs. At that point my GP made an appointment with an orthopedic shoulder specialist. She received word it would be a 12 month wait. On her suggestion, I called the surgeon's office to see if I could get on their cancellation list. The nurse said there was little hope of that and indeed it would be 18 months on their waiting list. Eighteen months! I reacted with disbelief. 18 months - I hope my arm doesn't fall off by then. The nurse replied, I hope not. I began looking at alternatives. I wrote to the Cambie Clinic in Vancouver. They replied that the surgery would cost $ 11,000 and that everything else including the first exam and consultation would be extra. I then remembered that while in Costa Rica in February that year (I taught at a music Festival there), I had cracked my toe and was taken to a private hospital where I spoke with an Orthopedic Doctor. After he had bandaged the toe, I asked him to look at my arm. He moved it about and saw how restricted it was and diagnosed a tear in one of my tendons. This was one month before the official MRI in Canada. I wrote to my Costa Rican friends to ask about orthopedic surgeons thinking they could make an appointment for me. Three names came up. During that time, my arm was painful beyond belief. I was worn down if nothing else from the lack of sleep. My life has no real quality as all the activities that brought me joy were put on the shelf. I think the crowning blow was that as the wedding season approached, I had to give up all of my gigs as I could not play any more. It was now seriously affecting my income. When I received those names, I thought about how weak I felt and being in constant pain, I realized I would not want to impose upon my Costa Rican friends and that I myself, feeling weak and worn out, did not have the wherewithal to arrange for my transportation and for that matter lodging. I began to look into Medical tourism. I went on the Internet and contacted MedJourneys among other agencies. A MedJourneys representative replied immediately. He sent me information and testimonials and soon a price quote. For a little over eight thousand dollars they would deliver:
 Before anything was signed, sealed and delivered, MedJourneys arranged for me to speak on a long distance conference call with my surgeon, Dr Oscar Oeding, whose name was among the three my friend had sent me. He had been sent both the CD of the actual MRI and the report and had been able to study both prior to our conversation.
I asked him everything I could think of including did he think I had to have the operation. He made it clear that the situation would only worsen without surgery. I asked him if I would be completely free of pain after the surgery. He said this would be our unequivocal goal. Questions answered we approved the contract and a few weeks later went off to Costa Rica. My husband decided to come along as neither one of us were absolutely certain about how incapacitated I might be and how much help I might need. As much as I knew and loved Costa Rica and my friends there, it was still very far from home without my family, pets and familiar surroundings.
I very much appreciated his decision to come along. Expenses related to his fare and hotel stay were extra.
All went well right from the moment we landed in San Jose. Che-Tica, the recovery hotel, was beautiful, in the hills outside of San Jose, in a quiet and peaceful setting. Che-Tica ranch guests were housed in individual cabins, created in unique themes. We, for instance, stayed in the Taos cabin, done in Santa Fe style. The hotel guests took our meals in a separate attractive building which also served as a meeting area with hundreds of paperback books and DVD's to enjoy. Several computer terminals kept us in touch with our friends and family at home. Cars and vans were at our beck and call for appointments or shopping and tours. The Hospital, the Clinica Biblica, was huge, spotless and attractive. It had an International Office specifically created to facilitate medical treatment for foreigners. Bill, Darlene, Rogelio all spoke English fluently. My husband was especially grateful for this. They made sure we were accompanied at all times for tests, exams, appointments, and made sure everything was in place for the surgery and recovery. Someone was at our side at every moment. After the surgery, the surgeon explained what he had done. He had to shave off an arthritic spur as well as clean out the joint. All this was done arthroscopically so that all I had for scars were "two eyes and a smile", three little holes. When I woke up from surgery, I could tell I had complete alleviation from the pain that had plagued me in the past year. After the first night when I had a bit of a rough time with nausea due to the general anesthetic, I was up and around, making phone calls, sending emails, and eating delicious meals with gusto.
From Cartagos we rented a car and driver and drove up to Irazu Volcano. This was particularly fascinating for Mike who had worked with geo-thermal energy in the past. It is a stark yet fascinating scene. Buzz Aldrin, the famed moon lander, had visited the site some years before and had remarked how much it looked like the moon. The main crater which was filled with green water, there were two other pumice-filled craters, just like in all the sci-fi movies about the moon. Mike went home a week after we arrived and I stayed several more days.
Going home, as I checked in for my flight, I was informed that a wheelchair had been ordered for me. I felt very moved by this. MedJourneys had taken this precaution in case I might still be incapacitated. I was touched indeed as it showed the minute care this agency took with its clients. They had even made sure I had aisle seats by the bulkhead both ways to minimize bumps. There's no question I received full value for the money we spent. It is now several months since my surgery. In that time, I traveled to the Maritimes for my son's wedding. Then back to Costa Rica to finalize the property purchase. I now play and perform even more than before. I have painted several pictures. I am writing again. I continue with physio to strengthen and stretch those neglected muscles and have resumed my full scale of physical activities which include long walks with the dogs and visit to Curves. Much has been accomplished. A word about the Canadian or Albertan Medical system. In this case, it utterly failed me. As I share my experience with friends, I hear one sad story after another about long waiting lists. Even those with far more serious conditions, such as cancer, had to wait months for diagnosis and years for treatment. Some died while waiting. Many people do not have the resources to take a medical trip as I did. But we are not well off. We were able to find the money, but it meant sacrifices in other areas. it will take us a while to recover financially. My husband and I considered my situation carefully before stepping away from the socialized medicine that Canada offers. We made the right decision. My treatment in Costa Rica, a beautiful country with loving and caring people who welcome visitors with open arms, was excellent and efficient. I would recommend anyone to consider becoming medical tourists, even as they plan their holidays there. CHE-TICA RANCH The Hotel spread out over a few acres in the rolling hills about twenty minutes north of San Jose. There were two main buildings, one that housed the owners and their children, and another that served as the dining, recreation room. Guests were housed in separate cabins.
Ruben, our handsome Argentinian host, let his creativity flow as he designed his compound. Each cabin was decorated with a different theme. We stayed in Taos, which was Santa Fe in style with plaster walls and rustic furniture. Another was done in Alps style, with typical gingerbread décor. Another was a dream of a cabin that could have been perched on the Mediterranean its style Greek in appearance.
The Ranch was set in a tropical forest, lush greenery, brilliant flowers, orchids, and a view of the mighty Irazu volcano. When it wasn't raining we could enjoy such views everywhere. Horses grazed in the field adjoining the property. But my favorite attraction were the dogs, three lumbering golden retrievers who cam to life whenever we walked by. When the rest of us were licking our wounds and lying around, Mike often went off for walks with these beautiful animals. Overall it was a tranquil bucolic scene, ideal for rest, recovery and resuscitation. Lorena, Ruben's wife, was herself a trained nurse and she had an assistant Frances who attended to patients' needs such as changing dressings or bathing and kept track of medical appointments. Lorena supervised the meals. They were all delicious and she made sure they were highly nutritious. We of course always had fresh fruit anytime. Each cabin had a fridge and microwave so we could heat up snacks anytime. If anyone had to miss an evening meal due to feeling ill or being out, a meal was brought to the cabin. The Hotel was isolated and far from downtown San Jose but provided free shuttle service for medical needs. The isolation worked well with the type of patients who used the Hotel's services. Most underwent cosmetic surgery. Mike and I sat down to our evening meal with other patients in various stages of recovery. Face lifts in particular resulted in temporary disfigurement. Sometimes it was a gruesome sight indeed sitting across from swelling, bandaged, bruised, peeling and bandaged faces. But these patients were grateful to be able to stay in such a place where they would not have to suffer the stares of strangers and could commiserate with each other. Valery was a woman my age who had retired, felt lost, and obtained another teaching position in a private school. She thought that she would start things off on the right foot by looking younger and thus had submitted to all the cosmetic surgery she could get. Although she looked bruised and swollen, she did not have complications nor did she complain of pain. I asked her why she did it and she said the older you get the more invisible you feel. I know there is truth to that but not a state that I would identify with. I asked what her husband thought and his reply was "whatever makes you happy, dear". By the end of my stay, Valery had healed well but I thought looked a bit odd. Her breasts were too high on her chest and despite the face lift she looked every bit her age due to the grey cast to her skin and thin hair. Someone mentioned she had been a heavy smoker all her life. Jeanny had been in a horrible accident in Costa Rica about two years previously that had ripped half her face off. She had had several reconstructive surgeries and at the time I met her, was waiting for her replacement teeth. At the point I met her, she was strikingly beautiful. Both dentists and plastic surgeons had done a marvelous job in putting her face back together. Jeanny was a great source of encouragement and conversation with the others. Jeanny is a devout Catholic so we were able to share our faith with each other. Nels was a tall rather gallant-looking man who appeared to be in his forties but admitted to being 58. He said he underwent the face lift because his girlfriend suggested it. I told him to stay in Costa Rica and find himself a beautiful Costa Rican girlfriend who would love him as he is. He laughed about that. Nels also was a man of deep faith with interesting views on the Second Coming. A couple of us were as Jesus' disciples and hung on to Nels every word. He was a fine teacher and knew the Bible well. I would have like to have spent more time with him. Nels was in and out of the Hotel in just a few days as he healed very quickly. Jack came to Costa Rica for serious dental work. Juan hailed from Puerto Rico and also had a face lift although he seemed quite young, in his forties. His wife was with him of about that age. I think he wanted to improve his appearance for his work but not sure. Lori was a woman in her late fifties who truly looked much younger. She had extensive dental work done and sadly suffered infection. It was terrible to see her dragging herself around. Carole had been there the longest, going on her fifth week. Her story was that she had had a duodenal switch and lost more than a hundred pounds. At her age, 60, she had been left with loose skin. She had surgery for this and sadly, she also sustained serious infections. Someone said this type of patient often has infections due to the nature of their weight loss surgeries. They no longer had a natural immune system. She was very distressed and worried about going home and trying to work with the infections. Three other ladies, all in their sixties or older, left a few days after we arrived. They had talked each other into undergoing cosmetic surgery. They had been at the Hotel more than two weeks and when I arrived, were in a sorry state of pain and discomfort. I asked them now that they'd undergone this rejuvenation, what were they going to call their little club. Shirley said, "The idiots". Listening to their stories, except in Jeanny's case, I came away with mostly negative feelings about cosmetic surgery. I didn't think any of these people would gain much when compared with the pain and discomfort they endured. And the possibility of infection and complications seemed high. Many of the patients had weeks of recovery which meant they were away from their families, even those who had younger children, for long periods of time. Still, all things considered, whether there for reasons of vanity or from necessity, Che-Tica ranch offered solace, comfort and serenity at a time when we all needed it the most. |
On the second day, Mike and I toured the San Jose area, first to the InBio Gardens, a beautiful showcase of the natural climate regions and wildlife of Costa Rica. The third day saw us hop on a bus to Cartagos, a lovely little town that is dominated but a grand Cathedral that attracts hundreds of the faithful at all times. I had been there before and found it to be a serene peaceful visit. And so it was again.
My friend Shirley Guzman invited me to stay with her family. They treated me like an honored guests, taking me out for dinner, to the Pacific side to the beach, and to concerts. During that time, I took a bus out to the Caribbean side, visited a property development, and made a deposit on a beautiful three acre lot with a magnificent view of the mountains. More about that in a future article.
