There’s a price to pay for living outside the US…Disappointing day…

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The view from the veranda at the holiday home we rented in Madeira ten years ago.

Yesterday, I was enthused about the physical therapy appointment at Wellspring Wellness Center. With exercise physiologists on staff, I felt confident they could help me improve my mobility while awaiting my future appointments at the end of August and subsequent open heart surgery at Cleveland Clinic in Ohio.

How little did I know that I’d be turned away? Based on the fact they had no record of me having treatment and tests in Minnesota, after consulting with their medical director, they all agreed it was too risky to treat me. They feared my heart condition would make such treatment too high risk and, let’s face it, the potential of liability if something went wrong during such a course of treatment.

I walked out of the facility disheartened and frustrated. They suggested I see a cardiologist (I’ve already seen three in the past year) for the type of treatment that would be suitable for me. With countless tests upcoming in August, I wasn’t about to go through the uncomfortable and time-consuming process of going through a litany of tests here in Minnesota, especially when Cleveland Clinic does its own tests.

The risk of a lawsuit is driving influence in medical care in the US. This is not the case in most other countries where medical malpractice lawsuits aren’t nearly as common as in the US.

But this was only the beginning of the day’s frustrations. I’d made an appointment at CVS Minute Clinic, which I called and assured me I could get prescriptions for my high blood pressure meds, which I am running out of. Remember, I got 13 months of prescriptions from Doc Theo in South Africa before we left at the end of April last year. Now they are running out and I have to figure out how to get them. They won’t accept written prescriptions from South Africa.

When CVS stated they’d write prescriptions for tourists running out of medication, I quickly made the appointment for yesterday at 5:00 pm, figuring at least this would be out of the way.

Alas, when we drove to the CVS for my appointment, and after waiting several minutes for my appointment upon prompt arrival, after filling out forms and signing privacy documents, I discovered, once again, that they couldn’t help me. They couldn’t find any record of any doctor prescribing any medications for me, nor was there a record of any tests or medical appointments to substantiate the necessity of my taking such medicines.

The PA agreed to give me a one-month emergency prescription as a tourist, but one month didn’t do me any good. I am not going to CC until the end of August, a full 3½ months from now.

I walked out empty-handed, frustrated and wondering what I would do. My only option, so I thought, was to book an appointment with a cardiologist or, in the worst case, a primary care physician and see if they’d write the prescriptions without having a litany of tests. I could run into the same scenario, and if I refused to take tests, I could walk out empty-handed again.

Deciding I’d think about this for a day or two since I had enough pills left to get me through two weeks. When I awoke in the middle of the night, I checked my old account at ProgressiveRX and found an old prescription in their records that could supply me with the meds I need. I had looked earlier, but I looked under the US names of the meds when, in fact, they are named differently in India, where most of the world’s drugs are produced anyway. They have everything I need.

Today, after posting, I will order the meds and have them in three weeks at the latest. After digging through my pill bag, I found the same unopened pills that could get me through until the shipment arrives at our mailing service, which in turn will mail them to me. What a relief!

This explains why living outside the US for the past almost 12 years has left us with no medical records to rely upon for future medical care in the US. We are left without medical records when we have had no US health insurance all these years, only carrying health insurance suitable for people outside the US. It’s another fact of life for world travelers. Any medical care we’ve needed all these years, we’ve sought outside the US, mostly paying out of pocket.

Thus, I’ll be able to get the meds I need, and yesterday, after all of this, I started working out, once again, in the upscale fitness center in this hotel. I will carefully monitor my heart rate and perform ECGs on my Fitbit each time I work out, being as careful as possible. Despite my current condition, all three cardiologists I visited explained that exercising is good for the heart muscle.

In less than an hour, my friend Chere is stopping by for a visit. We’ll hang out in the lobby and catch up.

Be well.

Photo from ten years ago today, May 15, 2014:

No photos were posted on this date due to a travel day.

A must-watch mongoose mania video…Shocking drug prices in South Africa!…

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Yesterday, when I arrived at the pharmacy to pick up the 12-month supply of medications prescribed by Doc Theo, the pharmacy was busy and hadn’t put the entire order together. However, about half of it was ready to go. After waiting in the queue for about 15 minutes, I told them I’d go to Spar and come back in another 15 minutes if they thought they’d be ready. They assured me they’d be ready.

I had dropped off the prescriptions last Friday, but they didn’t have enough of some of the meds to complete my order and assured me they’d have everything by Tuesday. They did, and I was grateful for their efforts in getting it ready as much as they did. It’s a very busy place.

By the time I returned 20 minutes later, the order was ready to go in several large plastic bags I had to take to the check-out counter to have the staff member check off every single item, one by one, to ensure nothing was missing. I waited another 20 minutes until she was done, but I could tell she was working diligently to complete it as accurately and quickly as possible. I didn’t complain.

We are always thrilled to see the mongoose stop by. They are cute, funny, and anxious to see what meat treats we may have in store for them. They love it! See the above one-minute video of them receiving their bits of paloney, a soft roll of baloney.

When I checked out, I cringed a little over the total of ZAR 12599.21, US $700.11, which also included a few toiletry items totaling about ZAR 225, $12.30. Let’s ignore those items for illustrative purposes today and go with the total for this post.

When we returned to the house, I looked online to see the pricing in the US for only one of the medications to use as an example. I visited Drugs.com at this link and was shocked by what I discovered. Only one of the multiple drugs shown in the bulk photo below included today is Premarin 0.3, a hormone I’ve been taking for years. I take one tablet each day. Here’s was I found:

“The cost for Premarin oral tablet 0.3 mg is around $715 for a supply of 100 tablets, depending on the pharmacy you visit. Quoted prices are for cash-paying customers and are not valid with insurance plans. This price guide is based on using the Drugs.com discount card, which is accepted at most U.S. pharmacies.”

This young Big Daddy couldn’t resist eating the bird seed off the feeder ledge.

Ironically, the 100-tablet cost for this medication is comparable to the entire bill I paid yesterday for multiple prescriptions for one year, not only 100 tablets of one drug. If I did the math for 365 tablets a year with the cost of 100 tablets, the total cost for the one drug would be as follows:

3.65 X US $715 = $2609.75 (ZAR 4753.66)

I could buy all the drugs for the 100-day supply and subsequent cost in the US for one drug. Wow.

No, I am not factoring in what a co-pay might be with insurance in the US. But since we have no health insurance in the US other than basic Medicare, which doesn’t include drugs, these figures are relevant to us. At that point, I didn’t start looking up prices for the other medications since my curiosity was satisfied by this one example in the lot. Surely, if I wanted to take the time and effort to research pricing for each drug, I’d find a similar scenario.

Now, it confirms the logic for us to purchase my meds in South Africa whenever we visit and perhaps even warrant future trips in years to come, let alone the enjoyment we glean from spending time in the bush with friends and wildlife.

Here is the receipt for the 12-month supply of prescriptions I picked up at the pharmacy in Komatipoort, totaling ZAR 12599.21, US $700.11.I also purchased nail polish and a battery-operated toothbrush included in the total.

The task now is to minimize the packaging as much as possible since, due to humidity in South Africa, most meds are individually plastic wrapped. It can take forever for me to pop out each tablet and put them in a container which I am doing with a few of them, which is why three large empty containers are shown on the right side of the photo.

Of course, I am bringing along the prescription Doc Theo wrote with all of these meds if questions are asked as we enter any country along the way. Also, I am including the more detailed receipts from the pharmacy to substantiate the excessive amount of tablets further. Hopefully, we won’t encounter any issues along the way, especially since the majority of these items will be in my carry-on baggage.

We’ve never had problems bringing large amounts of medication into a country, but one never knows, as we learned from losing our bags most recently when it hadn’t happened in the first eight years of our world travels. One can never take anything for granted.

Here is my 12-month supply of medication, three I regularly take, while many of the others are for allergy symptoms should they arise, as they did here in South Africa, due to dust, dander, and pollen.

Today, I am busy organizing the meds and also baking two cakes for tomorrow’s farewell party, one keto chocolate cake, and one regular cake, Tom’s mother’s delicious oatmeal cake with broiled coconut and almond frosting, which is exceptional. It’s baking in the oven now. When it’s done, I will make the chocolate cake but might leave the frosting to make tomorrow.

That’s it for today, dear readers. Thanks for joining us in our less adventurous posts as we wind down the time until we leave South Africa in 11 days.

Be well.

Photo from ten years ago today, April 19, 2013:

The cruise line-owned beach is set up in Grand Turks and Caicos, with “pay for” cabanas. We didn’t care to bake in the sun in the sand and stayed behind on the ship to enjoy the quiet time. For more photos, please click here.

Off to Komatipoort for our final teeth cleaning, trip to Spar and pharmacy…

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Broken Horn’s tongue when he notices cut veggies on the ground in the garden.

Our teeth cleaning appointments begin at 11:00 am this morning. We’ve already had breakfast and taken our walk. The walk continues to be painful for me, but it improves a little each day. Walking on rocks is hard on my legs, and every five minutes or so, I have to stop for a minute or less and stand still to recover. This issue is due to the surgery I had twice on both legs after heart surgery and my unstable spine.

Following is the bill for today’s two teeth cleaning appointments in Komatipoort:

Today’s ZAR teeth cleaning bill for each of us was ZAR 640, US $71.06, for a total of US $35.53 each. What a deal!

Each day when we return to the house, I am glad we did it, and I got through yet another walk on the rocky dirt roads in Marloth Park with many potholes. Over the many years we’ve lived here, I always hesitated to walk on these roads for fear of falling. Once we get to Florida and we can walk on smooth paths and paved roads, I will have built up endurance after walking on these hazardous roads. I am looking forward to that.

Last night, I spoke to my dear friend Karen (and Rich) in Florida, and we planned a time to get together in early May. They will stop for lunch or dinner on their way to see Karen’s mom Donna who lives a few hours from The Villages. It will be wonderful to see them again after an entire year since we last stayed at their home in Apollo Beach, Florida.

Now, as we head to Komatipoort, we’ll not only get our teeth cleaned but also head to the pharmacy to pick up my year’s worth of prescriptions and then to Spar for a few more essential grocery items we need to make the cakes for our upcoming farewell party on Thursday. Dawn is doing all the side dishes, and guests bring their meat to braai, a popular tradition in South Africa.

With lots of wine left from my birthday party, we plan to bring a box of wine to set up for the guests to enjoy at the party, which starts at 4:00 pm, 1600 hrs., and will continue well into the evening, knowing this lively group of friends. We expect about 20 guests, including Dawn, Leon, and us. They only have so much room poolside, so we kept the number of guests small for this event.

Kudu foreplay. It looks as if Big Daddy has been digging in the mud.

We just returned from our trip to Komatipoort. Tom filled the little car with petrol while I headed to the pharmacy to pick up the 12 months of prescriptions which included some drugs “just in case” that we may not use during those 14 months we’re away. A few items had to be specially ordered, but fortunately, everything arrived in time for today’s pickup. It took quite a while for the pharmacists to put the entire large order together.

It will take me several hours to go through all of it and remove much of the unnecessary packaging. Some tablets will have to stay in bulky plastic packages since humidity can deteriorate certain drugs. In Florida and South America, plenty of humidity will inspire me to keep them in bulky packaging.

When arriving in certain countries, it can get tricky at some security check-in areas. I got a copy of the prescription Doc Theo had written in the event I am questioned about carrying so many drugs, none of which are narcotic or mood-altering. When arriving in certain countries, based on the fact that our checked baggage had been lost several times in the past few years, I will be carrying all of these prescription medications in my carry-on bags.

In tomorrow’s post, I will share the unbelievably low prices of the medications we picked up today. You won’t believe the prices compared to prices in the US and perhaps many other countries. It was mind-boggling. It’s unreal! For us, it will be worth it to return to South Africa for the enjoyment of the wildlife and the people and the low prices of all these medications.

Jasmine, the mom, was standing in the garden while her son, Little Johnny, was lying by the fence.

We stopped at Spar for a few last-minute items we needed for our remaining 11 days in Marloth Park. We won’t need to shop again. I’ve started doing a few organizing tasks toward getting the packing done, including handling the prescriptions and toiletries we’ll be bringing with us as opposed to items we may leave behind.

We’re allowed to check two bags each at 23 kg, 50.6 pounds. We’ll be weighing everything as we go along in the packing process.

That’s it for today, folks. We’ll be back with more tomorrow.

Be well.

Photo from ten years ago today, April 18, 2013:

Parrots posing for us as we walked along the boulevard in San Juan, Puerto Rico. For more photos, please click here.

You won’t believe the prices!!!…

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I dumped four medications for six months in this pile on the bed to illustrate how inexpensive drugs are in South Africa.

Yesterday, we headed to Dr. Singh. The high-tech dentist is Malalane, who patients visit when they need more than fillings, cleanings, and basic dental care, which Dr. Luzann provides in Komatipoort. There are other dentists in the area, but we’ve been delighted with the combined care of these two dentists.

Since an old crown was replaced by Dr. Singh many months ago, the discomfort I’ve felt was entirely self-imposed. He explained I have been brushing too hard and applying too much vigor when flossing in an overly enthusiastic attempt to keep my teeth healthy. Yep. I can be that way.

Dr. Singh didn’t charge for the appointment, and I learned my lesson: moderation and gentle treatment are more appropriate for teeth. I don’t generally do much of anything in moderation. I either go “all the way” or not at all. This doesn’t always serve me well, and in this case, it became apparent. I will temper my teeth cleaning vigor.

With our eye doctor appointments out of the way a few weeks ago, resulting in new prescriptions for both of us and our teeth cleaning done, all I had left to tackle was an appointment with Dr. Theo in Komatipoort to refill enough of my basic three prescriptions and as a safety measure, an asthma inhaler to use needed. My appointment with him was this morning at 11:00 am.

The total bill for the doctor visit was (without insurance) ZAR 675, US $44.77.

No more than about five minutes into my appointment with Dr. Theo, load shedding started, and their generator kicked in with ample service for lights but insufficient for air-con. The building heated up in only a few minutes, but Dr. Theo and I were so busy chatting neither of us minded.

He’s not only an excellent primary care physician, but over the years I’ve been seeing him, he’s become a good friend. He promised he and his wife would attend my 75th birthday party at Jabula next February. I mentioned how fun it would be to have him there. Most of our close friends are his patients. Through our friends, we chose him as our “family physician.”

In 2019, Theo discovered I had heart disease, and his first diagnosis ultimately saved my life. He arrived at his office on a Saturday, wearing shorts and flip-flops to give me an exercise stress test. From there, you all know what transpired, emergency open-heart surgery due to three 100% blocked major arteries. Yes, Dr. Theo saved my life.

He wrote prescriptions for six months. In addition to what I have remaining on hand, I have an ample supply to last until we return in December. If I run short of anything, I can always order online from ProgressiveRX. It will all work out. As an alternative, I could have gone to a doctor in the US and paid out of pocket for the appointment and the pills. I can only imagine how costly that would have been.

The receipt from the pharmacy for all of the drugs plus a few toiletries that were only 10% of the total. The total bill was ZAR 4015.64, US $266.27

As shown above, in the photo, the doctor visit was (without insurance) ZAR 675, US $44.77. The six-month supply of meds was well under ZAR 4015.64, US $266.27, when 10% of the total pharmacy bill included a few toiletry items. For example, from a US site:

“The cost for Premarin oral tablet 0.3 mg is around $676 for a supply of 100 tablets, depending on the pharmacy you visit.”

As you can see, it paid for me to obtain my medications in South Africa rather than from the US. In the UK, there may be no charge for tablets due to their universal healthcare system, but its nearly impossible to get an appointment unless its a dire emergency,

We could submit the doctor bill to our global health insurance company., SafeTrip, with United Healthcare. But for two reasons, we do not; one, we haven’t met the US $250, ZAR 3750 deductible, and two; we’d prefer not to enter any claims for small amounts.

Before we leave, the only other appointment I need is a pedicure at the local spa, which Dawn and I plan to do together next week.

That’s our news for today, folks. We’re off to Jabula on our own tonight for the first time in a long time. Have a pleasant Friday evening and weekend.

Photo from one year ago today, March 11, 2021:

No photos were posted on this date, one year ago. The text-only post may be found here.

Stuff happens…The cost of medical care and prescriptions in South Africa…Astounding facts…

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In South Africa, prescriptions are dispensed in plastic packs in these boxes, not in bottles.

“Sighting of the Day in the Bush”

Is this a white-crested seedeater?  Please correct me if wrong.

Over the past week, I had an odd discomfort in the front of my right shin, but I didn’t notice any insect bites or injuries. It wasn’t itchy, just painful when I wore anything touching it.

Yesterday morning I awoke to added pain and noticed a raised red circle-like bump the size of a small lemon. I wondered if it was an infection or, more problematic, some blood clot. One can’t be too careful when finding such a thing.
 
I didn’t give it much more thought until we were on our way to the grocery store in Komtipoort while wearing shorts and noticed the redness had increased in a few hours. Since we were heading to Komatipoort anyway, Tom suggested we stop at Dr. Theo’s office and see if he could see me without an appointment. It was close to noon.
This is the receipt for yesterday’s doctor appointment, total cost ZAR (rand) 565 (US $38.24).

After waiting about only 20 minutes at most, Dr. Theo brought me into the exam room. I so appreciated him squeezing me in. Their office with several physicians is bustling, with appointments booked as tight as possible. These quality physicians have quite a following.

After carefully and diligently checking my leg, he assured me it was definitely not a blood clot and most likely an infection. If treated early enough, it could avoid the necessity of taking antibiotics. He prescribed a cream that was to be applied twice daily.  

In the past 24 hours, after only three applications of the cream, its already begun to improve, although there still is some redness. If it doesn’t continue to improve over the weekend, antibiotics may be necessary.

It’s dirty here…lots of dirt and dust constantly flying through the air, especially when the wildlife kick up more and more land from the garden when they visit.  Even the slightest scratch could become infected under these conditions.

The ZAR 49.95 (US $3.38) listed on this receipt was for the two tubes of cortisone cream the doctor prescribed.  The ZAR 1224.49 (US $82,68) balance was for the entire batch of prescriptions, enough to last for four months.

While visiting with Dr. Theo, I asked for prescriptions for the three medications I take and have for years. Here in South Africa, many drugs can be purchased over the counter in small amounts. But, for a several-month supply, a prescription from a local doctor must accompany the purchase.

None of my three medications are narcotic, thus making it relatively easy for a doctor to write a prescription. As mentioned in yesterday’s post describing “what to bring for an African safari,” we breezed over drugs. If you missed that post, please click here.

We were both thrilled over the low cost of the doctor’s appointment and the costs of the prescriptions. Next week we’ll return to the pharmacy for two more month’s supply for the three medications. They had to order them. Then, I’ll have enough for six months.  

Itemization for the three prescriptions, sufficient for four months.

Before we leave South Africa, either in November or February (depending on our immigration status), we’ll try for another six-month supply even if we have to go back to the doctor for the required appointment. At only ZAR 565 (US $38.24) for the appointment, it’s undoubtedly worthwhile.

I become frustrated when medical issues arise and sometimes hesitate to mention them here. But I do. Many of our worldwide readers are traveling or contemplating traveling, and any information we can provide when “things go wrong” may be helpful.  

It’s all a part of our continuing transparency and commitment to our readers to “tell it like it is” with no fluff, no minimizing, no exaggerating…plain and simple, the facts, keeping in mind we do tend to get excited when nature unfolds before our eyes.

Speaking of nature unfolding before our eyes, I need to wrap this up. We’re getting ready to head out for our daily drive to see what more treasures we can encounter in this magical place.

May events in your life bring you excitement and enthusiasm.

Photo from one year ago today, September 14, 2017:

This mom and her calf are our neighbors in this gated community of Roco Verde in Costa Rica. For more photos, please click here.

Final expenses for 31-nights in a hotel in Buenos Aires…We’re off to Ushuaia!…

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Due to the poor signal in this crowded Wi-Fi cafe in Ushuaia, we cannot upload any photos.  As mentioned in earlier posts, we’ll continue to make every effort to maintain our usual style of posts.  Would you please excuse any typos and formatting issues?
Yesterday was quite a busy day, and today won’t be much different. By the time you see this post, we’ll be at the airport getting ready to leave Buenos Aires to fly on a chartered plane to Ushuaia, Argentina, where we’ll board Ponant’s Le Soleal to begin our expedition to Antarctica.
We’ve been excited about this for a very long time. The situation with my knee put a bit of a damper on our enthusiasm. Still, now that I am on meds to hopefully alleviate the discomfort, we’ll be able to settle in on the cruise and enjoy this once-in-a-lifetime adventure.
Getting out the door in the middle of the night wouldn’t be my preference. For Tom, after 42.5 years on the railroad, he was used to getting up and out the door at all hours of the day and night. But, now after retirement, even he cringed at the early hour.
Today, we wanted to share two important aspects of the 31-nights we spent in Palermo Soho Buenos Aires, Argentina; one, the reasonable expenses we incurred staying in the Prodeo Hotel, a fine boutique hotel two, a short review of the hotel itself.

First, let’s start with the expenses we incurred in total for the 31-night stay in the Prodeo as shown below: (Due to a poor Wi-Fi signal, we’re experiencing formatting issues):
 Expense   US Dollar   Argentine Pesos 
 Hotel – 31 nights $                  2,480.00 47,076.69
Flight – Round trip- inc
in cruise 		                  –               –
 Taxi   $                       65.31 1,239.75
 Groceries & Dining
out- inc tips 		  $                     987.87                     18.752.28
 Laundry  $                        56.00 1,063.02
 Tips for hotel staff   $                     158.05 3,000.19
 Pharmacy & Misc.   $                     477.52 7,157.48
 Total   $                  4,224.75 59,537.13
 Avg Daily Cost    $                     136.28 1,920.55

We’re thrilled to have spent this amount while staying in a hotel and dining out every night, the exception when we purchased groceries for Christmas Eve, Christmas Day, New Year’s Eve, and New Year’s Day when most restaurants were closed or only offered outrageous prices on fixed price meals, not suitable for our budget or, my dietary restrictions.

This was surely a bargain compared to the cost for groceries, rental cars, and vacation/holiday homes. And we imagine that a traveler desiring a month in this fascinating country could even do better with proper planning and careful spending.

Would we return to Buenos Aires in the future? Possibly, with our plans to return to South America in the distant future for some specific sites we’d like to visit such as Machu Picchu, the Galapagos, and the Pantanal. 

A contributing factor to our enjoyment in the area has been the quaint and charming Prodeo Hotel, a contemporary boutique hotel, architecturally interesting in a fantastic location, staffed by some of the most OK people in the land. We generously tipped all of the staff members who made this stay memorable.

During this less-than-busy summer season in Buenos Aires, there were many days we were the only hotel guests. However, whether it was a whole house or the only guests, we were always treated with the utmost kindness, generosity, and attention.

As shown in the above expenses, we booked the hotel through a corporate rate at US $80 (ARS 1,532) a night, a reasonable rate for this busy city with many other hotels twice as much or more. No doubt, our extended stay helped us with pricing, but the competitive nature of boutique hotels does allow for some special pricing from time to time. It never hurts to ask.

Any issues while we were here? The power went out four times when the city was having problems.  Our bathroom sink wouldn’t drain, but after a few hours of bringing it to staff’s attention, it was repaired. 

Housekeeping was inconsistent at times, but our room was always clean and well-kept. The complimentary breakfast was repetitive, most of which we don’t eat (fruit, granola, cakes, bread, etc.). We appreciated the daily sliced ham, cheese, and hard-boiled eggs. Tom enjoyed the coffee while I sipped on my turmeric tea concoction each morning. 

The atmosphere is pleasing, comfortable, and inviting.  The bar has many types of beverages from fine wines to eclectic beer and serves some traditional Argentine empanada and other types of local food (none of which I could eat).  We never dined in the bar/dining room but enjoyed drinks from time to time.

The intimate hospitality by far surpasses what one may find in a large hotel, and we’ve discovered we mainly have found smaller hotels tend to suit our needs. We highly recommend Prodeo Hotel for your next visit to Palermo, Buenos Aires.

Small did OK getting up at 2:30 am and getting out the door in time for our 3:15 taxi to the airport. Check-in was a bit challenging and time-consuming, but Aerolineas, an Argentine airline, was seamless. Moving right along, we’re currently sitting at a tiny table at a tiny little bar with Wi-Fo in Ushuaia.

We both watched a free movie, Hacksaw Ridge, a stunning film on our individual monitors during the flight while the 3.5 hours passed quickly. Once we collected our bags, we were off to the bus with our Ponant group of passengers.

After a ride through the gorgeous town of Ushuaia, recognized as the most southerly city in the world or “the bottom of the world,” we headed to a local Accor Hotel for a magnificent buffet lunch with many foods I could have.

At our assigned table of English-speaking passengers, we met two fun couples and had a taste of the lively conversation yet to come with our cruise mates, most of whom are serious world travelers.  Not necessarily like us, but world-traveled, nonetheless.

We’ll be back with more as Wi-Fi allows, hoping to be able to stay in touch with all of you!

Take care until then!

Photo from one year ago today, January 23, 2017:

Andrew and Ian Smith, father and son and innovative owners/managers of Willie Smith Organic Apple Cider and Apple Shed, including restaurant, cider shop, and museum. (Not our photo). For more photos of this popular landmark in Tasmania, please click here.

Traipsing around the town…Why visit Atenas?…

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This morning when I perused through our photos to see what to post, I stumbled across this funny photo showing my hands and camera in the rearview mirror while taking the photo of this rug vendor walking along the street. Vendors don’t pester passersby, asking only once if interested.

“Sightings from the Veranda in Costa Rica”

Cattle sheltered under the shade of a massive tree during a sunny morning in Atenas.

Walking through the town of Atenas is quite entertaining. The endless array of shops lining the streets, many worn and tattered on the exterior but bustling with energetic business on the interior, creating a fascinating peek into the daily lives of “Ticos,” the acceptable and unoffensive nickname for the locals.

Few tourists are to be found when walking through the town although it’s reported there are about 1500 expats in Atenas of its population of about 5000.

Although an older comment, this quote from a contributor on TripAdvisor provides a reasonable explanation about Atenas. We can’t imagine it’s changed much over the past six years. (See selection below this photo).

A sign was announcing at the Patron Saint Festivities from October 14 through 24. 
Re: Things to do around Atenas
Oct 07, 2011, 11:43 AM
Atenas is a quiet town, authentic Costa Rica, and it could be used as a home base.
Many “well-to-do” Ticos who work in San Jose choose to live there and commute. Kind of like folks living in CT and commuting to New York in the USA.
No crime to speak of, lots of farms, some great locally grown coffee. The area produces five different varieties, only 3 of which are exported (they save the best for local consumption)
I dig it. I used to live in a bustling tourist town here. When I left the coast, Atenas is the town I moved to for a time. I was looking for a city that had zero tourism and found it. I then bounced over to Grecia, but now live in between the 2.
IMO an interesting choice but a good one. No tourist crowds, down-to-earth pricing compared to towns more tourism-oriented. Not much in the way of local attractions, Poas mentioned by ex-beachers is probably one of the closer ones, the metal church in Grecia is something to see and not far away, also there is a great little central park full of green parrots in the town center of Atenas. 
If you are looking for an authentic Costa Rican experience, then it is a good choice.
Cheers”

This is our kind of town, quiet, attractive, friendly and filled with a variety of treasures that easily keep us entertained and engaged (including many birds) during this extended 113-night stay. 

In almost every case, when we chose an extended stay over 90 days, we encounter visa issues.  We’re inclined to avoid such extended stays when possible. But, when we opt for an extended stay, we do it for a reason, often to accommodate the next leg of our travels.

However, the time spent here has definitely been worth the hoopla of having to leave in nine days to fly to Nicaragua to get our passports stamped. Besides, with our five-year anniversary on October 31st, we’ve usually done something special to celebrate…a mini vacation…a special night out, etc. The two-night stay in Managua will fill the bill.

Don Juan Pharmacy where I purchased a bottle of contact lens solution for US $20, (CRC 11,401) usually priced at around US $7.95 (CRC 4,932).

We’ll be back at the villa on the 30th, most likely staying in and celebrating here at the estate on our actual anniversary date on October 31st. It will be easy to celebrate in this outstanding property which far exceeds any five-star hotel we’ve seen to date. 

Would other travelers be content in this small town? Yes, in many ways. Its central location makes it a good base for sightseeing and if one enjoys traveling on mountainous roads the scenery is exceptional as we’ve shared in many posts. 

Atenas is conveniently located near the airport. There are seven hotels listed in Atenas, at this link with more in surrounding areas, some modest and unassuming and others more deluxe (none are five-star rated). Most are well under US $75 (CRC 42,752) per night. 

We’ve heard parrots may be seen in the trees in the park.  We’ve visited several times to no avail.  We’ll keep trying.

There are 39 restaurants listed in Atenas which may be found at this link. These restaurants don’t work for my way of eating but for most, they’ll be ideal with fresh local ingredients and flavors commensurate with local tastes and customs.

Of course, for those interested in the privacy and convenience of a vacation/holiday villa, nothing can beat this exceptional home with three large bedrooms, each with an en-suite bath, plenty of storage space, ceiling fans, and ultra-comfortable beds and bedding. We love the “screening room” with a large flat-screen TV, surround sound, and comfortable seating.

The granite and stainless steel gourmet kitchen with a second “clean up” kitchen is over-the-top with every imaginable amenity and kitchen tool and gadget.  Well, I could go on and on but most of you have read our comments in past posts about how much we’ve loved this property and location.

Nothing is as pleasant as a blue sky during the rainy season.

The downsides are few in this area. However, if dancing until dawn is your “thing” you may be better off staying in the “big city” of San Jose which has every type of nightlife one can imagine.

Although there are a number of clothing, souvenirs and “sports” shops in town in the area, if shopping is high on your list of priorities, a trip to San Jose would satisfy even the most enthusiastic shopper. Atenas lacks in this area.

Also, for the more extended stay, one must consider that its best to arrive in Costa Rica with every possible item you’ll need during your stay. Prescriptions cannot be mailed into the country, although non-narcotic items can be purchased at several pharmacies without a prescription. Keep in mind that brand names and many ordinary doses for many things are impossible to purchase.

There are many tall trees at the central park.

Shipping supplies into the country will result in long delays due to customs with high tariffs on items that may not be worth shipping into the country with the added expense. From what we’ve been able to perceive to date, Costa Rica is very protective of what enters their land for a few primary reasons.

One, they don’t want any hazardous products entering their country possibly affecting the delicate ecological system. Two, they prefer to sell locally grown and manufactured products offered by their vendors. Three, they can collect taxes on locally sold items.

As a result, expats, used to shopping on Amazon, for instance in their former lives, may become frustrated knowing they have to return to the US or their home country to load up on supplies. 

A water fountain at the park.

We particularly understand these restrictions when we realized I’d run out of my one of my regular prescriptions (I take three) while we were here when unable to purchase an alternative in any close proximity to the original dosage. Thus, I am spreading what I have left, missing one pill every fourth day to no ill effects so far. This plan will get me to Florida where my prescriptions will be waiting in our box of supplies at the hotel.

I could go on and on about Atenas and add more information over our remaining days in Costa Rica until we depart on November 22nd. For those considering moving to Costa Rica, we’ll discuss more on this topic in future posts.

Have a lovely day! 

Photo from one year ago today, October 19, 2016:

In Bali, a large visitor came to call after high tide during the night. Check out those eyes! For more photos, please click here.

Warning to all tourists taking prescription drugs…Could result in a Costa Rica nightmare…

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Yesterday we shared a photo of an Owl Eyed Butterfly, and today, we have a winking Barn Owl.

“Sightings from the Veranda in Costa Rica”

Ulysses was creating a perfect trim on the hedges at the villa.

After yesterday’s scathing tongue lashing on Monday’s less than a pleasant attempt at renting a car, we hesitated to go down a somewhat negative path two days in a row.

For the majority of tourists, today’s post will have little significance. You book a vacation/holiday in Costa Rica, staying at a resort for a week or two. If you take prescription meds, you bring along a sufficient amount for your entire stay. If innovative, you bring enough for an additional few weeks in the event of some mishap or delay in returning to your home country as initially planned.

Creatures in Costa Rica are colorful, including this massive spider in her web.

However, suppose travelers like us plan to stay for an extended period. In that case, it’s an entirely different scenario when no prescription drugs (including non-narcotic meds) may be shipped into the country. Also, no vitamins or supplements may be shipped into Costa Rica and will also be confiscated.

Why is this? These are stringent drug laws, coupled with Costa Rica’s intent to create a revenue source from selling their prescription medications in the local and chain pharmacies. As a result, other than prescribed narcotics, mood-altering, or brain function medications, most medicines are sold over the counter without a prescription.

I take low doses of three non-narcotic meds for the following conditions (bad genes); hypertension, thyroid, and a hormone…fairly innocuous items, all typically requiring prescriptions from a doctor in the US.  (Other country’s laws may vary).

It was frustrating, taking photos through the fences, but these birds weren’t ready to return to the wild after their rehabilitation.

When I noticed my supply dwindled these past months, I decided to purchase over these next few months from ProgressiveRX, where I’ve been buying refills regularly over these past five years through their online service, comparable to buying from any online pharmacy in Canada.  

Easy as always? So I thought. This has never been an issue in any country in which we’ve lived over these past years. So I’d make the online purchase well before I needed them (slow delivery times) and have them shipped to wherever we may be at any given time. 

Although one shipment was lost while we were in Italy, the company happily replaced the lost items at no additional charge. Luckily, I’d planned the shipments months before I needed the pills and never missed a dose through the lengthy process of replacing the lost items.

Three Barn Owls at Zoo Ave, the bird and animal rescue facility in the Alajuela Valley.

While in Australia, for the sake of convenience, I received new prescriptions from a doctor we’d visited for physical exams while in Trinity Beach. But, unfortunately, I couldn’t get more than a six-month supply, which is typical, even through online pharmacies. 

Thus, again with a several months supply on hand, I ordered more from ProgressiveRX, which we had shipped to us in a box of supplies from the US from our mailing service.

I’d also considered making the purchases of a few month’s supply while here in Costa Rica since both of us must have physical exams no more than 60 days before the upcoming cruise to Antarctica. So we’d have the necessary exams and purchase my meds while here at any pharmacy.

Three Barn Owls were sharing a tree branch.

On Monday, the day of the rental car fiasco, I’d brought along the pills in the bottles with clearly marked labels to the Walmart Pharmacy. As it turned out, I’ll run out of two of the meds before the time we leave on November 22nd, thinking they could easily be replaced by some Costa Rica versions of the same frequently prescribed drugs for these conditions, common throughout the world.

Oh, foolish me. Walmart could not supply me with any of the three meds without changing doses and brand name components. One of the meds required the brand name when I tried alternates to no avail in years past.

After the pharmacist and I counted what I had left, we discovered I’d run out before leaving. “Local pharmacies don’t carry what you need,” explained the kindly pharmacist. So it’s a lost cause. I contemplated my options which included taking wrong doses and wrong meds and decided against it.

These birds were too high up to get clear shots without a tripod.

During the last month, when I’ll run out of two of the three meds, I’ll take doses every other day.  Doing so should not be life-threatening, although it may create some unpleasant symptoms. I’ve experienced worse. I’ll be fine.

In the interim, I’ll place an order from ProgressiveRX to arrive at our mailing service in September or October (at the latest) and have them shipped in a box of other supplies we’ll be sending to our hotel in Miami, where we’ll stay one night before boarding the 30-night cruise to South America.

How will we ensure the proper timing? We’ll have the shipment arrive from Nevada to Florida at least two weeks before our arrival on November 22nd. The hotel will hold the package for us until we arrive. 

Parrot sitting atop a perch at Zoo Ave (Ave means “aviary” in Spanish).

At that point, I’ll have enough to hold me for a few months until I place another order for a shipment to South Africa. That will work. We received a shipment while we were in Marloth Park in 2014 without incident.

The result…bring enough medication with you when you come to Costa Rica unless you’re confident you can purchase refills from a local pharmacy of the products/brands/doses you typically use. You are allowed to bring a regular supply into the country commensurate with your stay, plus extra for unexpected events.

Did I learn a lesson? I suppose regarding Costa Rica, I sure did. And, of course, in the future, I will check if there will be an issue receiving medication by mail from countries where we aren’t quite sure. But, after five years of world travel, this is the first time we’ve run across such a situation. 

A bit blurry from afar but a pretty parrot nonetheless.

But, like the rental car situation (BTW, we did get a refund from rentalcars.com for which we’re relieved and pleased), one never knows what may be encountered in unfamiliar territory. Neither of these scenarios would be an issue for a typical short stay by most travelers. 

Our unique nomadic lifestyle can be challenging at times. And we continue to learn as we go.

Be well.

Photo from one year ago today, August 30, 2016:

Shorter than he’d usually prefer, Tom’s buzz cut in Phuket Thailand held through the 33-night cruise, which began on October 31st. For more details, please click here.

We figured out how I became ill…See our many photos below in the second half of this post…

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Views across the Huon River.

There’s no doubt we’re running low on photos. Having been increasingly ill over these three months, I wasn’t feeling well enough to go sightseeing once we arrived in the Huon Valley, five weeks ago. I’ve barely been well enough to do much of anything. 

Tom makes the bed, does the laundry, washes the dishes, and helps make dinner. The cleaner comes once a week leaving us with not much more than tidying up after ourselves. 

I had mentioned that I wouldn’t continue to discuss this health issue. This was prior to having a diagnosis anticipating that our readers would tire of my whinging. But, now that I have the diagnosis of Helicobactor Pylori (the bacteria that causes ulcers and gastritis, we both felt it was important to share this information with other travelers. 

These conditions may become prevalent for travelers to certain countries and after eating certain foods. After all, to the best of my knowledge, I may only have exacerbated this condition while living in Bali for four months. 

These comments are by no means intended to criticize or berate the two lovely cooks, the property, or the diligence of the owners or managers. They were very conscientious to ensure our visit was safe and sanitary. 

Rolling hills in the Huon Valley which apparently were bright green in the spring, before we arrived.

However, certain climates with ultra-high humidity and rampant insects and ants may be a breeding ground for illness.  Also, one never knows the handling conditions when purchasing produce, fish, meat, chicken, and eggs from vendors in farmer’s markets which we’ve done regularly.

We often hear of infectious disease as a result of bagged lettuce and other produce purchased in the US and other highly developed countries in traditional chain supermarkets where one may easily assume everything is safe to consume, only to discover it is not, in some circumstances. 

When looking back and discussing where we’ve been these past few years and when in fact this illness may have started we reviewed many of our past posts. Most of us carry the H. Pylori bacteria which may be activated over a long period of time, often exacerbated by certain conditions.

Sailboat on the Huon River on a cloudy day.

When we received the diagnosis a few days ago, we both racked our brains trying to recall when, in fact, some of these symptoms began. Without a doubt, the symptoms started with an outrageous and uncomfortable sense of fullness after eating a normal-sized meal, once we arrived in New Zealand where we lived for three months on an alpaca farm.

Most of our meals consist of medium sized portions of protein, one or two cooked vegetables and a salad.  Eating none of this foods should or previously caused any intestinal distress. 

Previously while in Fiji, where we spent three months living on the island of Vanua Levu we literally cooked every meal.  During this period we didn’t consume a single portion of seafood when we’d discovered all local fish was caught close to the shore.  See this photo below and our post from December 29, 2015 for our mention and fears of eating fish in Fiji.

Photo and caption from December 29, 2015:  “We’d been warned against purchasing locally caught fish when its often caught close to the shore where bacteria is heavy in the waters from sewage disposal.  As a result, we never purchased any fish during the past four months (in Fiji).  I’m looking forward to cooking fish once we arrive in New Zealand.”  Eventually, I did eat the fish.  See text below for details.

At the end of the three months we left Vanua Levu to fly to Viti Levu where we stayed for one additional month.  This was during the busy holiday season that we dined out a few times, once on Tom’s birthday on December 23rd and again on Christmas Day.  On each of these occasions I ate shell fish and/or squid both of which meals were consumed in a five star hotel. 

Here’s my dinner on the night of Tom’s birthday in this photo below with more seafood.  Here’s the link to that meal:

My fresh plate of food on Tom’s birthday on December 23, 2015.

But, here’s the one that tops it all from Christmas brunch December 25, 2015:

This is what I ate for Christmas brunch at the five star hotel in Vanua Levu, Fiji; baby octopus all of which are caught close to the shore.  Please see this link for these facts.  Those heads were a bit tricky to chew.  I ended up eating four of them, less one head, never giving it a thought since we were dining in an upscale environment.

Once we left Fiji on January 4, 2016, we cruised from Sydney, Australia to Auckland, New Zealand where we lived on the alpaca farm for three months. It was during this period the bloating symptoms began, most likely the onset of full blown H. Pylori.

On January 11, 2016, I posted this story with a seafood photo on a cruise, here again exacerbating my condition by eating bottom feeding, caught-close-to-the-shore seafood.

This is the entrée I ordered for four evening meals in a row on the cruise to new Zealand, seafood on a bed of cooked cabbage and vegetables.  Here again, more high risk seafood.

How many times did I mention the risks of eating seafood caught close to the shore which is often infected with a wide variety of bacteria, including Helicobactor Pylori?  More times than we can count. 

Any yet, foolishly, I continued to eat squid and bottom feeding fish which seems to be the biggest culprit in causing my illness as shown in these photos. At the time, I made the assumption that dining in upscale restaurants and aboard cruises would eliminate these risks.  How wrong I was!

Today, as I experience some side effects of the massive doses of two different antibiotics, one of which includes 2 grams  (2000 mg) of Amoxicillin per day, twice the recommended dose for strep throat or penumonia.   The other antibiotic is Clarithromycin at 1 gram (1000 mg) per day.  The third drug is a PPI (proton pump inhibitor) always taken in combination with these two antibiotics is intended to reduce the acidity of the intestinal tract during the treatment and for two months thereafter (by continuing the PPI).

The course of treatment ends next Monday at 7 pm.  Thirty six hours later we’ll board the cruise in Sydney.  I can only hope I’ve learned something here:  that the cosumption of squid and other close-to-the-shore and bottom feeding fish will now be forbidden in my diet, eliminating one more of the foods I’ve enjoyed over the years. 

We’re grateful for our almost 1700 daily posts.  Through researching our photos, we were able to piece together why, when and how I developed this bacterial infection.

However, no food(s) is ever worth a serious health condition of any type.  We hope this post may have provided some insight into what may be recommended to eliminate from one’s diet while traveling.  One can never be too cautious, a lesson I’ve learned the hard way.

Be well.

__________________________________________


Photo from one year ago today, February 22, 2016:

These foals in NZ were hard to get close for more detailed photos when they’re very shy  If you click on this link, it will take you to last year’s post where, if you scroll to the bottom on the page, you’ll see a hysterical horse photo we’d taken in Hawaii.

Dealing with life’s everyday challenged while traveling the world…

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A billy goat tied to a tree.

Finally, Tom is on the mend. After considerable research, we speculate that the abscessed tooth he had pulled may have resulted in the gastrointestinal infection that began to plague him 48 hours after the extraction, lasting for almost a week.

He suffered from severe gastric symptoms, fever, chills, body aches, and weakness. He took over-the-counter medications to alleviate the fever every four to six hours for the first few days until the fever subsided, sleeping most of the day on the sofa in the living room.

A bubbling brook.

The simple fact is that pulling the tooth released bacteria from the abscess in his bloodstream and stomach, resulting in what appeared similar to the bacterial infection I had in Marrakesh, Morocco after eating raw vegetables in a restaurant the first day of our arrival. 

After traveling for 17 months at that point, I should have known better. Now, we’re more cautious than ever in less developed countries. I had waited three weeks before succumbing to a three-day dose of Cipro which we’d brought along for exactly this reason.

Recently, we read a study that discovered the depth of the intellect of horses and their innate ability to connect with humans, even reacting to expressions on a human face.

Within hours I began to feel relief. In Tom’s case, we didn’t want him to take antibiotics a third time since his first dose for the abscess was in November, the second in January, on two occasions when the abscess flared up. Thus, he waited.

It wasn’t until he started feeling better yesterday that we conducted research to make the connection to the abscessed tooth extraction and the gastric. Had we suspected this earlier, calling the dentist to inquire, most likely he’d have recommended antibiotics, which we didn’t want Tom to take once again unless it continued for more than a week.

A creek we encountered on a drive.

Its in these types of scenarios that not having a “regular” doctor and dentist puts us in a tough position. In our old lives, if we were sick for more than five days we’d make an appointment to see the doctor often having tests and leaving with a few prescriptions. 

We don’t have this luxury now, 40 months after leaving Minnesota. For those family members and friends who are reading today…please don’t worry…if one of us exhibits life-threatening symptoms, we’ll immediately find our way to an urgent care facility or hospital. 

Even on cloudy days, the countryside has a special charm.

It may seem as if we’re often sick as we share the details of our daily lives. Most likely it’s no more than most of our readers. The difference is that few document each virus, infection, injury, and days of being under the weather. Most likely, twice a year we experience a malady of one sort or another.

After considerable discussion, we’ve come to the conclusion that moving from one location, one country to another, we have little time to build an immunity to local viruses than those who live in one location occasionally traveling who seem to build an immunity.

Stopping to admire cloud-covered Mount Taranaki.

On cruises, passengers are exposed to a variety of illnesses from living in tight quarters for a few weeks.  Luckily, we’ve never had Norovirus even during periods when there’s been an outbreak.

Although on four of our past cruises either one or both of us has developed the common “cruise cough,” the worst of which was on the cruise from Hawaii to Sydney with horrible symptoms lasting three weeks after the cruise ended. By far, that was the worst illness either of us has experienced since we left the US. 

Horses we encounter are animated and friendly.  Check out the cute pink spot on his nose.

When the ship disembarked we were so sick with a fever and a cough neither of us hardly recalls the time we spent picking up the rental car at the Cairns airport and finding the house in Trinity Beach.

We caught this awful virus toward the end of the cruise when a woman coughed on me in the elevator which, once my symptoms manifested, Tom was infected developing into the same whirlwind of awful symptoms.  

We each spent the last few days of the cruise in the cabin (it was an 18-day cruise) in an attempt to avoid infecting others. Otherwise, this was one of the most enjoyable of our 12 cruises to date, making many new friends with whom we’ve continued to stay in touch.

Another creek we crossed on a drive.

Most recently with Tom’s abscessed tooth, we ask ourselves what we may have done differently once the symptoms manifested. We were living in a remote area of Fiji. We visited a dentist within days of the first symptoms, taking antibiotics as prescribed. 

His second bout of symptoms occurred on the day we boarded this last cruise from Sydney to Auckland. The only solution was another round of the same antibiotics. As required in the case of antibiotics he continued with the full course of the medication. 

Once we arrived in New Plymouth, within two weeks of arrival, we were in the dentist’s office when at that time, no new symptoms were present. We feel we did everything we could. Then, he developed the awful gastrointestinal infection plaguing him for almost a week. 

A winding country road.

Now, he’s able to eat again, is feeling well and life will continue on as always, always, stress-free, filled with simple daily pleasures and the comforts of living in the countryside in this beautiful country. Soon, we’ll head back out to tour more of this exquisite location, sharing new photos along the way.

We feel blessed and grateful for each and every day of our lives. But, no one “said” life of world travel would always be easy.  It’s not. And, it’s the times it’s not easy that make us appreciate greater periods of good health and simple pleasures. Overall, we were very fortunate during these last 40 months.

Thanks to all of our readers for sharing this journey with us during periods of both excitement and the mundane events of daily life.

Be well.

Photo from one year ago today, February 13, 2015:

Thousands of feral chickens populate the island of Kauai. It is speculated that Hurricane Iniki in 1991 blew away hundreds of chicken coops, letting them loose to proliferate. It’s quite a sight to see! For more Kauai photos, please click here.