Tale of Two Surgeries


“If I save my insight, I don’t attend to the weakness of my eyesight.” ~Socrates

 

For six months, I lived in a blurry world. Although it was difficult to attend to the visual world due to weakness of eyesight, I gained an accurate and deeper intuitive understanding of people, places, and things. Instead of relying on outsight, I gained a better appreciation of my world through insight. 

Since I had my first eye operation in the United States and my second eye operation in Nicaragua, I thought it would be interesting to compare the surgeries in two vastly different countries. Both surgeries were similar. I will try to withhold judgment, but I can guarantee that if you are concerned about having a delicate or major surgery in a developing country, I will put your worries at ease.

A Tale of Two Surgeries Through The insightful Observations of an Expat 

A look at my island from the taxi window as I was on my way to the hospital in Managua.

Surgery in the United States

1. Facility

The facility where I received my vitrectomy in the U.S. was modern with all of the latest equipment. Johnson City Eye Clinic Website

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Let’s Play Ball!


“Never allow the fear of striking out keep you from playing the game!” ― Babe Ruth

It should also be noted, never let the lack of a proper field or uniforms keep you from playing the game. Baseball is revered in Nicaragua. Our La Paloma team just received new uniforms and they look so jazzy!
Ron and I donated money for two uniforms and they put our names on the back. Ron’s name means rum in Spanish and when they showed us our names to be printed on the back of the uniforms, they wrote “Rom” instead of Ron. It took me a minute to realize that they were trying to spell “Rum” on his shirt. Haha!
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Gypsytoes or Stickytoes


This says it all about our lives on Ometepe Island. We want the best of all worlds. How does one decide to stay or go? Is it possible to have Gypsytoes and Stickytoes  together? If so, how does that work?

Here are some of our considerations in deciding to stay or go.

Financial

 

We grow a lot of our fruits and vegetables.

In 2016, we traveled to Colombia, Fiji, New Zealand, Las Vegas, Tennessee, and Pennsylvania. We accounted for all of our expenses and income for 2016, and we actually saved money and came out ahead when we balanced income vs expenses.  We own two homes, we have no mortgages and no expenses for our home in the states. Our trusted friends live in our house, collect our mail, and they even took care of our old cat, Tokyo, until she passed away this year. The small amount of rent goes into a special account which we use to pay our property taxes, rental insurance, and for repairs on the house.

If we were to sell our house on Ometepe Island, we would be free to travel the world, but it would come with a price. We would continue to live only on our monthly income, and try not to dip into our savings, yet it would be difficult because we would have to pay a monthly rental fee, which we don’t have to now. Traveling is expensive. We aren’t backpackers anymore, and we like to stay in Airbnbs throughout the world. It is doable, but will take some work to stay within our budget.

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Weekly Photo Challenge: Sticky Gecko Toes


Weekly Photo Challenge is Texture

Last night two geckos were outside clinging to my kitchen window mating. This may be the best gecko porn I have ever photographed! I wondered how they pulled off their gravity-defying feat.

A little research led to the discovery that geckos can stick to surfaces because their bulbous toes are covered in hundreds of microscopic hairs called setae. Each setae branches into even smaller hairs called spatulae.

When the tiny hairs contact a wall, ceiling, or glass surface the van der Waals force kicks in. This physical bond happens when electrons in the molecules of the tiny gecko toe hairs interact with the molecules in the surface, like the glass. They create an electronic attraction. Who knew?

The balance of the forces and the angle of the hairs allow them to scurry across surfaces quickly. So, they really don’t have a sticky substance in their toes, it is all due to the physical forces of nature. Isn’t Physics amazing?

Weekly Photo Challenge: Textures of Tzintzuntzan


The Weekly Photo Challenge is Texture.

Tzintzuntzan was the capital of the Purépecha Empire when the Spanish arrived in 1522. Situated on Lake Pátzcuaro, Mexico the character of the indigenous people is clear in every archeological remnant and rock of this fascinating archeological site.

The main attraction is the five yácatas or semi-circular pyramids that are well organized and face out over the lake area.
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Random Rants about My Country of Birth


Random ranting is always good for the soul. It is like a pressure cooker value releasing steam. A good rant is cathartic. Sometimes ranting keeps me sane. And living in Nicaragua as an expat, I have some frustrations about my country of birth. It has been a while since I’ve ranted, and Anita of the blog No Particular Place to Go inspired me with her rant-a thon, so here are a few of my random rants.

U.S. Health Care Rant

Don’t get me wrong. I appreciate having Medicare, but we can’t use it abroad! With my first eye surgery in the states, single payer was quick and easy. I paid 20% of the total cost of the doctor, facility, and anesthesiology. When I told my doctor that I needed to fly back to Nicaragua, he said he would have to replace the vitreous in my eye with silicon oil, which necessitates a second eye surgery to remove the oil.

“I am going to see if a doctor in Nicaragua can remove the oil in my eye,” I said to my surgeon. “Good luck with that,” he responded. “I doubt that you will find anyone as competent in Nicaragua as eye surgeons in the states.”

What is it with doctors’ arrogance? Waiting for surgery in the gurney, I watched as a train of gurneys were moved in and out of the operating room. “How many retina surgeries do you do here in a day?” I asked the attending nurse. “Usually 15 per doctor per day,” she said. I quickly calculated that the doctors each made $1750 per surgery X 15 surgeries a day = $26,250 a day!!! That is just the doctor! It doesn’t include the facility or anesthesiology fees.

I made an appointment in Managua at Vivian Pellas Hospital to see a retina specialist. Dr. Juan Rivers gave me a through exam and patiently answered all of my questions. When he said my eye was still extremely swollen, he asked, “Why didn’t the surgeon give you steroid shots to reduce the inflammation before injecting the oil?” I said that the doctor told me oil and water don’t mix, so he couldn’t put steroid shots in my eye. “Well, that is what we do before we inject the oil or gas,” he said kind of irritated. He shook his head and said that I would have to keep the oil in my eye for three months, which could have been avoided if they reduced the swelling first.

Through my tears… in only one eye… I thanked him for his patience and his TLC and scheduled another eye appointment for the end of August. His initial consultation cost $160.89. The surgery to remove the oil and replace my corroded lens will cost $3,000 for everything. Since we have international health insurance, we weighed the cost of airline tickets, a rental car, and at least two weeks of expenses to repair my eye in the states in a train of gurneys vs the cost of surgery with Dr. Juan Carlos Rivers at Vivian Pellas. I opted for a competent, caring doctor in Nicaragua. I can file claims with my international insurance and get some of my money back.

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