Alligators 'n Roadkill
On The Road
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Sunday, February 19, 2012
“Who’s Sorry Now?”, or, How I learned to stop worrying, and tolerate the PT’s……….
"Man is the only animal that laughs and weeps, for he is the only animal that is struck with the difference between what things are and what they ought to be." -- William Hazlitt
I may have had a small epiphany here……….I have long railed against what a lot of us here in Costa Rica call the Perpetual Tourist (often shortened to PT). I have said things – and believed them – like it was disrespectful to this nation to ignore the legal route to residency. I said that it was unwise to ignore the legalities because of the very real risk of detection and deportation, with the loss of whatever assets one might have here. And, I am sure that a good part of my feelings on this subject had to do with my own decision to do things per the legal requirements of the nation, and the need for others to validate that decision.
But, you know what? I have now lived here for more than two years, and it has slowly dawned on me that Costa Rica does not care about me, not even a little bit. Moreover, they certainly do not respect me. Sure, the local Ticos all call me Don John (but not, unfortunately, Don Juan). And, they gave me this plastic card, all gold, that looks like a credit card. This makes me officially a Ciudadano de Oro, but that is all it does. There is nowhere up here where I live where I can present this card in the expectation that it will gain anything at all for me. Not only that, but whenever I have dealings with any official agency (including that stellar group over at my favorite utilities place, ICE), I am referred to as a stranger (extranjero). Even the official numero de cedula (cedula number) differs from that issued to natural born Ticos, thus ensuring that I am instantly identified as a foreigner the moment I whip that puppy out.
The immigration folks require that we join their health system, and pay a monthly cost for the privilege, and we couldn’t wait to do so. However, I have recently blogged in regards to a problem my wife has, so if you follow that blog, you already know how that works. As for myself, I have had a problem with my left eye for nearly three years now, and have seen the Ophthalmologist who is supposedly the best in the whole province, in Liberia, first as a private patient, and later, under the Caja (I found that the cost was too much to see him as a private patient). It made no difference which way I saw him. He still has not resolved my problem. Both of us finally realized that we had to go back to the states so that we can obtain proper care for these problems.
So, ultimately, I am left with this question, the one that is always posed by those PT’s: at the end of the day, what difference does any of it make? Whether you are legal or not, whether you cross every single t and dot every single i, Costa Rica doesn’t care. They’re too busy promoting their BS line about Pura Vida, and carbon-neutral, ecologically friendly, Green tourism, etc., etc., blah, blah, blah, yada, yada, yada………
To make matters worse, I have long spouted that standard Libertarian line about “I support your right to do whatever you want to do as long as it does no harm to me or mine, because that is your right.” Well, what harm does a PT do to me or mine? Their actions make no difference to the government of Costa Rica. Their actions make no difference to the manner in which we gringos are seen, treated, interacted with, or even victimized by, Ticos. So, to all those folks who may ever have felt the least bit slighted, or offended, or in any way, hurt by my written words on this subject: I apologize. Y’all do whatever the hell you want, and good luck to you!
Monday, January 23, 2012
Oh, my aching back
"There are more fools in the world than there are people." -- Heinrich Heine
(This is an excerpt from an article that appeared on August 24, 2011, at the link found below this piece):
Is that MRI for back pain necessary?
Back surgery is one of the best documented examples of expensive medical treatments that drive up health care costs while not always helping patients, and sometimes even hurting them.
And the latest Medicare data show that doctors frequently order MRI back scans for patients who haven't tried recommended treatments such as physical therapy. An MRI often prompts surgery.
I saw this article when it first appeared, and just had to save it for the opportunity to add my commentary. I guess it has had ample opportunity to ‘age,’ so maybe it is time to add said commentary.
This is a rather strange factoid to see jump up as suddenly as it did, because the basic conclusion of the article is the exact same thing that I, and many other professionals, have been saying for many, many years! There is and has long been, a tendency to over-diagnose (as in, running too many expensive diagnostic scans and tests) and over-treat back complaints (as in, entirely too much unnecessary surgery, too soon).
The results of these two things are really frightening, if you look at the big picture. Too often, diagnostic scans are misread, misinterpreted, or outright ignored, and serious diagnoses are given to relatively benign conditions. A very wise Orthopedic Surgeon, who I knew many years ago, said that the wisest course of action with back complaints is to do nothing. When there is any need for something to be done, he said, the wisest course was to keep treatment simple and minimally invasive. Physical Therapy, along with some education in how to cope with back problems, in general, in his opinion, went farther, caused fewer problems, and cost less money. Time, he said, was the greatest healer of back problems.
And, you know what? I did not need this latest study to know that he was right. Anecdotally, I can tell you I have talked to many people over the years who reported back problems – hell, I’ve got a ‘bad’ back, myself. And, I have come to realize that they generally fall into one of two camps: those who did not receive much beyond PT, some rest, some education, maybe some muscle relaxants; and, those who underwent CT Scans, MRI’s, EMG’s (with Nerve Conduction Studies), and whose treatment all too often included surgeries.
Guess how many of those who had back surgery had bad outcomes, and guess how many of those who did not have surgery are still going strong. Worse, I remember an investigation I did some years ago into multiple complaints (not to mention multiple malpractice actions) against one particular back surgeon in Texas. Now, this was only one guy, in one city, and he was not even the worst of the bad guys. What I remember most clearly is that I obtained and studied the case histories of a good number of patients who not only had bad outcomes, but whose medical records totally lacked any objective diagnostic information to suggest any need for surgeries.
Worse, I remember a situation where a physician – who was not even an orthopedic surgeon, by the way – convinced a large number of patients, diagnosed with “Intractable Pain,” that they needed to let him place an electrical device into their spines, the purpose of which was to somehow stimulate the spine into ignoring their chronic pain. These patients were a mixed bag of “failed back surgery” and/or other types of pain patients whose reported pain could not be controlled by other, more conventional methods. Most of them happened to be individuals who had reportedly been injured at work, and had not been able to return to work due to their intractable pain.
At that time, orthopedic protocol required that patients undergo a full psychological workup prior to undergoing surgeries, or the placement of such implants, in an effort to provide some indication of whether they were suitable candidates for invasive procedures. Turned out that, while all of them were indeed referred to see a psychologist, the testing rendered, without much personal interaction between this psychologist and the patients, was mostly leaning towards identifying these people as poor candidates for this implant, because they were mostly identified as being chronic complainers of pain, regardless of what interventions were attempted (in short, very close to being outright malingerers).
The ‘Surgeon” went ahead anyway, at a cost of many thousands of dollars per patient, and none of them were ever able to return to anything resembling a normal life. Most were disabled for real, after months to years of questionable ‘care,’ that ultimately did affect their physical abilities. What can I say? The ‘Surgeon’ was a good salesman.
Ultimately, even though a good number of patients’ lives were irretrievably damaged, nothing was ever done to the physician, even though we made a great case against him. Part of the problem is that these patients allowed him to do what he did, willingly (for whatever motives), and they had to assume a portion of any blame.
My point? Obviously, never allow your doctor to go straight to MRI’s or other expensive diagnostic studies, until time has had a chance to work, along with mild therapy and treatment. Below is the link to the article that got my attention: http://www.npr.org/blogs/health/2011/08/24/139923555/hospitals-have-got-your-back-maybe-a-little-too-quickly?ft=1&f=1001
Monday, January 2, 2012
Price Reduced!
This two year old 2 bed, 2 bath cement block home sits on a secluded plot (2166 sq meters, or about ½ acre) on a very quiet road that actually runs all the way down to the water’s edge of beautiful Lake Arenal. (The water is just 500 meters from the front door).
This is the last house on the road down to the Lake. There is a heavily wooded, deep gully on one side (the Ticos refer to this as a montaƱa, or a quebrada), with a little stream at the bottom. This ensures a nearly constant, fresh breeze. Water is paid once a year, and currently is only about $72.00 per year, with no meter. The water is cold, and crystal clear, with nothing added. There are two septic systems (aguas negras, for toilets, and gray water, for washer, showers, and sinks). The house is available with Kenmore washer and electric dryer, Whirlpool Gas Range,
Maytag refrigerator, and a 2005 Suzuki Grand Vitara, XL7, with current Marchamo and Riteve would be included with the sale (pictured below). Also included will be one queen size bed, with frame and one King size bed, with frame. Additional furnishings are negotiable, including wall-mounted Samsung Plasma TV, Sharp Surround Sound system, and small appliances, including Sharp Microwave.
Part of the Living Area is pictured above. |
Front of the house features a recently completed and oversized carport, and there is an enclosed (screen, metal, and wooden bars) garage cum workshop attached to the back of the house.
| This is the workshop/bodega, at the back of the house. |
Solid wood doors, and beautiful wooden kitchen cabinets are featured. Windows are all protected with iron bars. The ceilings throughout are high, with beautifully stained wooden beams. Reduced Price: $175,000.00. Monthly rent is negotiable, with renter being responsible for all utilities.
Wednesday, December 14, 2011
Walmart: A (quick) study in Love/Hate
“Everyone is entitled to be stupid, but some abuse the privilege”. - Unknown
Why are some folks so upset with Walmart? You know, I get so tired of these whining idiots who make claims like, “Walmart has ruined many small towns,” or “Walmart is responsible for making China what it is today.” Where do they get these silly ideas? Are they totally ignorant of modern history? Where were they during the sixties, seventies, and eighties?
First, let’s keep in mind that each and every generation, from the beginning of time, has seen change of one kind or another, and pinned responsibility in the wrong places. More recently, while folks my age pretty much agree that growing up in the fifties was an idyllic period in history, we are just as wrong as all the generations that came before us (‘cause we all know that the ‘Good 0l’ Days’ only exist in the memories of us old folks). And, as for the death of small town America, that was written way back at the beginning of the Industrial Age, and anyone who continues to deny it today is simply foolish.
The death of small town America was starting to be obvious as early as the sixties, and the death of Downtown America was evident at the same time. But, what really caused this? You certainly cannot blame Walmart, because they were not only not the first store of this kind, but the first Walmart did not open until 1962, the same year as the first Kmart and the first Target. At the same time, we saw, across the country, the establishment of a myriad of similar stores – Govmart, Globe, Fedmart, Grants, Woolco, and many others. These stores took over the retail spot earlier occupied by variety stores, such as Woolworths, S. S. Kresges, and so forth.
Variety stores, also referred to as ten cent stores, ‘the five and dime,’ or simply ‘dime’ stores, got their popular name because most of the items for sale in them only cost five or ten cents. They had much more class than today’s ‘dollar’ stores, but their merchandise was much the same quality, and variety. If one wanted clothing, one went to J. C. Penney, or to the local department store (another dinosaur). Auto parts were found (at least in my part of the world) at Western Auto, a great chain, also an extinct species. Groceries were purchased at the local food store, or maybe at Safeway (wow, I think this chain still exists).
What killed off all those dinosaurs? Competition, plain and simple. And, it was not Walmart alone. Here’s how it happened, and how it keeps on happening:
As for Walmart selling nothing but stuff made in China, I’m not going to cite any facts or figures for you, but I am going to tell you this: (applying logic, here’s how it goes) – you, the American consumer, demand decent quality for a fair price, no? Walmart, as a purveyor of goods, for a profit, realizes that they need to be able to offer you what you demand, right? How the hell are they going to stay in business if they don’t show a profit? And, how are they going to show a profit if they cannot provide you, the consumer, with what you demand?
So, they search the world over, looking for good products at a fair price. Actually, for Walmart, they no longer have to do much searching, since most decent manufacturers now bring their product to Walmart, hoping that it will be acceptable to their buyers, who after all, are looking for whatever you demand.
Now, don’t try to tell me that you disagree with any of this, because you know this is how it works. It is most certainly not the fault of this particular retailer (or any other retailer, for that matter) if the best products, for the best prices, happen to come from China. If you must blame someone, blame the Republican Party, the GOP, and big business (as in the owners/stockholders of major brand names). They are the ones who decided, beginning way back in the sixties and the seventies to start exporting work, from first our heartland, to our southern states, and borders, and then, overseas, first to Mexico, and then, very quickly, to Asia. Read your history!
I remember this happening and watching it happening right in front of all of us. We lived in El Paso, Texas, from 1970, until 2004. First, in the late sixties and very early seventies, large American manufacturers began to relocate their factories to places where they could find cheaper labor than they had in Indianapolis, Sheboygan, St. Louis, Erie, Gary, Rolling Hills, or wherever plants used to be. They found cheaper labor, and all kinds of tax breaks and other incentives from communities and even States located along the U. S./Mexico border, and in many southern states. I remember the excitement as Hallicrafters (a major supplier of radio communications equipment during WWII) came to El Paso. (I actually worked in their factory for more than two years, as an electrical technician). Then, Tonka Toys, then many apparel manufacturers came to town to join those who were already there (Farah had one of the world’s largest manufacturing facilities right along I-10). Lee Jeans, Levis, Wrangler, and many others also set up shop.
But, a funny thing happened. Once these big names arrived along the border, it did not take long before they realized that even cheaper labor was right there across the border. So, one by one, those who were able to do so, began to move their manufacturing to Mexico, and today El Paso, once a major manufacturing center, is nothing more than a great big warehouse for all the finished goods that cross the border from Mexico every day. And, of course, once these big names set up shop in Mexico, it did not take long before they heard the call of even cheaper labor over there in Asia, and guess what? Mexico has a good number of empty factories, now also, just like we do.
Who is to blame for this? NOT Walmart, folks. They, and others like them, only try to make you, the consumer, happy. We can’t hope to successfully boycott them (and, frankly, the very idea of trying is absurd). Hell, they even have their own subculture today. Haven’t you heard of, and seen those pictures of ‘Walmartians?’ Of course you have.
Wednesday, November 30, 2011
Ramblings on turning 65
NOTE: (I began writing this on June 25th, my birthday).
“Now some of you may encounter the Devil's Bargain, if you get that far. Any old soul is worth saving, at least to a priest, but not every soul is worth buying. So you can take the offer as a compliment. He tries the easy ones first. You know like money, all the money there is. But who wants to be the richest guy in some cemetary? Money won't buy. Not much left to spend it on, eh gramps? Getting too old to cut the mustard. Well time hits the hardest blows. Especially below the belt. How's a young body grab you? Like three card monte, like pea under the shell, Now you see it, now you don't. Haven't you forgotten something, gramps? In order to feel something, you've got to be there. You have to be eighteen. You're not eighteen. You are [65] seventy-eight. Old fool sold his soul for a strap-on. Well they always try the easiest ones first. How about an honorable bargain? You always wanted to be a doctor, well now's your chance. Why don't you become a great healer and benefit humanity? What's wrong with that? Just about everything. Just about everything. There are no honorable bargains involving exchange of qualitative merchandise like souls for quantitative merchandise like time and money. So piss off Satan and don't take me for dumber than I look”. - - - - Wm. S. Burroughs
Well, today’s the day. I am now 65 years old. There were times when I did not expect to reach this point. There were times when I thought I’d be truly decrepit when I reached this point. There were fewer times when I naively thought today would be just like any other day. But, now it’s here, and I hardly know what to make of it.
On the one hand, I do not feel all that well. But, part of that (I hope) must have to do with the fact that the doctor put me on anti-hypertensive medication for the first time just one week ago, and I think I am still adjusting to what the medicine does to me. At any rate, I feel very sleepy most of the day. Hopefully, this will ease over time.
Meanwhile, today is very muggy, we’ve already had a pretty good rainfall, and I’ve been sweating, as I worked to prepare some ribs. That’s right. Honest to Gawd, an entire rack of Pork Spareribs. - - - And, of course, right there, we have a side issue. I paid ₡3,500.00 per Kilo for said ribs. That’s like $7.00/Kilo, or $3.50 per lb. I brought back some newspaper grocery ads from our recent trip to Texas, and HEB (one of the best supermarket chains in the world) featured Pork Spareribs at $1.57 lb. - - At any rate, I did a brine soak overnight, and then made up a rub, with those ingredients that I had on hand, which I applied just before I lit the fire.
Now, I know that many will argue as to the best way to get good ribs, but this is what I know: Using local charcoal, which is not very good, but adequate, I made a very hot fire (shop vac helped here). I seared the ribs to black, on both sides. Then, just like always, I banked the coals, all around the sides of the grill, and placed the rack in the middle, closed all vents and the lid, and walked away. I returned to the fire after two hours, and turned the ribs over, and left them again, for two more hours. They were good! Really, really good. We had friends over, plus sent a couple of plates up to another neighbor, who was feeling under the weather, and all that was left at the end of the day, were a couple of small pieces. - -
Where was I? Ah, yes, reflections…………
We are blessed this summer to have three of our grandchildren staying with us. Yes, we brought Tristen (13), Aislynn (9), and Bryan (18, and a brand new High School Graduate) back down with us from our trip to Texas. We did get to see most everybody while we were there, and Blanca and I got to experience some of those good things to eat that we never can find down here (Long John Silver’s Fish & Fries, Der Weinerschitzel’s Chili Dogs, Rudy’s BBQ, a couple of decent burgers, and, of course (and just for me), DQ.
We came back to find that the oven has not fixed itself, and we really have no clue where to find someone who might be able to get it working again. We ask everybody we encounter, but no one knows who can really work on a gas stove. I suppose we could call the people that came to look at it when it was under warranty, but I was not really impressed with what that guy did when he came. Plus, I shudder to think what they might cost for a house call that I have to pay for.
I did find a choke cable repair kit at an auto parts in Arlington, and brought that back with me. Bryan, our grandson, helped me to put that in, and then, I bought a new battery for the Torito, so it is back on the road, after months of not being able to use it.
Electrical consumption was minimal during our absence, but now, with three more bodies in the house, I know it is going to jump way up there. Even though I know we did pay for a lot more than we ever used in the past, I know that with the exorbitant rates ICE charges, our bill will soar again, and the difference this time is that it will be due, at least in part, to some actual use.
As to being older, inside me is that same skinny young kid who was drafted way back in 1965, but now, he finds it hard to push his way out, past all the accumulated poundage, not to mention the years of experience and the scars that the years have laid on this old body.
I wish I could say that I am wiser for it all, but I think the only outward appearance of wisdom is that sometimes (rarely) I do know enough to stay silent when an opinion is asked for by some family members. That would be situations where I know one or the other of my kids or grandkids is not going to listen to me anyway, or more likely, those situations where I know my wife is going to ignore me altogether.
This thing started out to be titled as ‘reflections,’ but I have wisely (I believe) decided to call it ‘ramblings,’ since there is no one topic, and little of what I have written so far really applies to achieving this new age. I certainly do not feel wiser. My wife will happily tell you that that is for sure.
Life does, apparently, go on. I am just trying to take it one day at a time. We have been working our way through some TV mini-series, and movie series, with the grandkids. We have watched things like “Band of Brothers,” “The Pacific,” the “Back To The Future” movies, “The Lord Of The Rings” trilogy, and are now most of the way through Harry Potter. Yes, we know that we cannot yet see the final Harry Potter movie, nor can we see the latest “Pirates of the Caribbean” yet. But, we struggle on.
We did get the oven fixed, and I am still mystified as to what was wrong with it in the first place. At the cost of about $110.00, a technician came to the house late Tuesday afternoon, with his wife and child in the car. He didn’t spend ten minutes here, and all he had to do was make an adjustment to a valve at the very bottom of the oven. He claimed that it likely gets clogged with grease (I can personally vouch for the fact that there is no grease anywhere near the oven itself), and that is why it needs to be adjusted. I haven’t a clue as to what it is, exactly, that he adjusted. I did get down there myself, but only saw the one main orifice, and the air vent that may be adjusted. So, now, I guess I need to find another valve (the tech said that there is a brass screw down there somewhere that can be adjusted), so that I can save the bucks next time around. The problem that I am having here is that we have had mostly gas ranges for all of our married life, and never, ever did we have any problems with one until we came here, and, bought this stove!
Here’s some food for thought. We have, as I said before, had the pleasure of our grandkids visiting this summer. I know that I have long groused about the poor quality of public school education in the U. S. But, I have been very pleasantly surprised to learn that our 18 year old grandson, the one who just graduated from high school, has a surprisingly large store of information packed away inside that late-teen-age head. He needs to work on his vocabulary and English language skills (too much texting?), but he is able to converse intelligently on a wide range of topics. So, maybe there is hope for the future, after all.
Our granddaughters, meanwhile, are as delightful as always, being very sweet young ladies, with inquiring minds. We now count less than a month until they all depart. Bryan will return to Texas for a sort of farewell tour, with plans to go to Austin and spend time with some of his uncles before he heads back to El Paso to report for active duty with the Army in early October. The girls, of course, are very anxious to get back to Arlington, where they will first meet their new baby brother, Julius, and then get ready for the start of another school year.
Grandma will stay in Arlington until at least November, to help out with that new baby, while I will stay here to hold the fort down. Meanwhile, our property is for sale, if you’re interested…….oh, and, uh………I have reduced the asking price.
Quick update: as of today, Nov. 30, 2011, I am in Texas myself, along with Blanca and the grandkids. I seem to have an eye problem which was being improperly treated by those stalwart Tico docs of the Caja, and am hoping to get it fixed while here. We are set to return to Costa Rica on Jan. 9, and I feel time pressing in on me, since I got here on Nov. 8, and have had nearly three weeks wasted by a doctor here in Arlington. I am to see another eye surgeon on Friday, the 2nd, and hopefully, he can get me on the right path.