SAN JOSE CR: SECOND TIME AROUND

NEARBY PARK

LOOK!!! I am starting with a photo.  I love this park, which is just ten minutes walk from where I am staying, on the way to downtown San Jose.  Parks dot the way to downtown and the central area abounds with them.

They say, 'Man proposes and God disposes.'  Before I came down (nice trip, local airport to Chicago, then direct to SJ, arriving early afternoon), my expectation was that I would have a first appointment with Costa Rica Dental Team last Monday for a new impression and a tooth cleaning and that, maybe Thursday, I would have the crowns fitted (the 'teeth' you can see).  In between, I hoped to be the regular tourist and venture forth to see more to the country.

This was not to be.  Jessica, the dentist who supervises all that happens to me, wanted to be sure the molar next to the implants was free of caries.  Capped by a metal crown,  it was the survivor of the original bridge.  I agreed to have the crown removed.  Alas and alack, what did she find, do you think?  I will spare you the details (do I hear huge sighs of relief?), suffice to say that two other specialist dentists became involved so that I managed to enjoy the chair for five days instead of two!  What fun (actually bummer)!

On the other hand, I was once more impressed at how appropriate the name of this practice that displays its emphasis on 'team'.  Especially how, when another specialist was attending to me, Jessica would appear to all was going to plan.  Again, when we ran into a problem with one of the crowns, not only did Jessica have the technician doing the work in the Lab across the passageway come in for a consult but the Lab boss (part of the practice) later came by to make sure that the necessary adjustments would ensure a proper result.  How good is that?  Especially being picked up by Paul and later returned returned to my BnB...not something that your local dentist does for you!

On the principle that 'the devil you know is better than the devil you don't know', I have once more stayed at Casa 69, run by Donna, a native of Toronto.  Her pets all seemed to have remembered me, and it was great to be greeted by (more or less) the same old gang.

Despite the daily spell in the dental chair, I have managed to get to know SJ better, by dint of considerable peripatetics.  I have met folk from far and wide, either at Casa 69 or at the practice.  My pick would be Ray, a long time client of CRDT.

Ray is from Alaska, where he is a gold miner somewhere near the little town of Nenana (about three quarters along the road from Anchorage to Fairbanks), but up in the back country, well off the grid. Back in 1992, I spent a week near Nenana on the only tree farm in Alaska, owned by a retired teacher who came up from Pennsylvania years before to do two years teaching.  Such is the charm of Alaska that he stayed on, married a lovely Inuit lady (also a teacher) and spent the rest of his life flying to remote communities to conduct class!  That was quite an experience, of which I may write another time.

Ray's year looks like this:  eight months of working at the mine, drive down to Washington state, fly to SJ to have any necessary dental attention, then fly to Jackson Hole to ski four months, pick up his car and, finally, drive back to his log cabin to recommence the cycle once more.  A lovely man but somewhat taciturn.  Maybe because I know a little of his home territory, he was willing to talk awhile about what he loves to do...extreme back country skiing!  For the first time I got to hear from such a 'crazy' exponent of what seems sheer madness; what it is like to descend precipitous slopes, fall off slope edges to the next descent, having to hold one's breath (to avert drowning in snow) as one sinks into deep powder,  ski blindly through deep powder for several seconds, then burst forth to instantaneous assessment of the line to pick byond, and continue the mad course down to the bottom. Imagine all that!  A skier since his boyhood, Ray sort of fell (forgive the phrase, if you can) into this madness when very young.  I suspect that this is what he lives to do.

Good and all as it might be to come here for cost effective dental work, where else might I have heard an expert skier disclose the absolute joy of his passion?

Today it is rain showers but I may venture forth with my 'pop up' brolly.  Early to bed this evening as the taxi comes at 4:30 AM to take me to the airport.  A long day's travel with five hours of stopover at Houston before continuing to Chicago.  At last, around midnight, Elmira regional airport where Uma will pick me up for home.  Quite a week!

LITTLE SNOW HERE!

AUTUMN/FALL HAS RUN IT COURSE.

Luckily, I do not live in Buffalo.  The good folk there are having a hard time.  A Winter's worth of snow in two days...unimaginable!  And now all that snow ( seven to ten feet of it) threatens flooding as it melts.

My daughter called me to ask if I was OK.  When she called I had no idea of what was going on to the NorthEast of me.  About an inch of snow overnight but the sun was out and the snow mostly melted when she called.  Up around the Lakes they get 'lake effect snow'.  This happens when there is a steady cold wind blowing from the NE across the relatively warmer water of the lakes.  As it does so, it picks up water vapour.  If it traverses at least 50 miles the moving air picks up enough such that, as it rises on reaching the shore and the higher ground beyond, given sufficiently cold conditions,  it dumps the moisture as snow.

If you draw a line on the map from the NE through Corning you will see that it will cross over the lakes region at the narrowest point (less than 50 miles across).  In this narrow band little snow falls. The result is that, despite getting very cold here, we get little snow.

How cold does it get in Corning?  Most mornings this last week or so the temperature outside on my rear deck is between 7 and 15 degrees F (-10  to -5 deg Cel), rising to about freezing or just above during the day but some sunny days sends it higher.

Usually, we do not get snow until after Thanksgiving, into December.  I suppose we can expect another long, bitter Winter.  This Fall I had snow stoppers fixed to my shiny, slippery steel roof.  Last Winter I go a little tired of shovelling wet-concrete-like snow that had avalanched from off the roof. Now the snow will remain on the roof and act like a blanket, helping to keep the house snug; and the snow shoveling work will be significantly less.

Last Winter's bitter cold and wind prevented my new trees from waking up in the belated Spring. Arbor Day foundation guarantees its trees for Fall planting.  They come through the mail and I was expecting the replacements any day.  This year I determined to plant them all in a more sheltered location.  Along my neighbor's fence, on the west side is quite protected from wind and gets the early sun.  In the Spring, they could be replanted to their proper places.

Most of you know that I make compost out of leaves and lawn cuttings.  Not having any mature trees as yet, I have to beg leaves from my neighbors.  They very kindly obliged me with bags of leaves.  This year I got ten or so bags...but what to do with them?  As I was digging the soil in preparation for the arrival of the new trees, a bright idea struck me.  Why not line up the bags of leaves along the trench running parallel to the fence.  This would make a cosy place for the young trees, protecting them from any wind from the East, would it not?  As you can see, this seems to have worked out very well.  I planted them the day after their arrival; it was warm and sunny.

The next day it snowed!

Since I have mentioned the composting, here is this year's pile (still in the frame) with remaining pile from last year just in front, nicely
surrounded by dark red leaves from my neighbor's Japanese maple.

Next week (first in December) I will be off to Costa Rica to have the work on my three new dental implants completed.  This entails removing the healing caps and attaching the abutments to which the crowns will be fixed.  This will be done on the Monday and the Friday, so I will at least two days midweek when I can go on some tours to see other places in Costa Rica, like the rain forests, jungle and volcanoes.  Also, I am looking forward to the wonderful fruit and the amazingly delicious food. There is virtually no 'factory food' in Costa Rica so everything tastes 'soo good'.  No wonder the Costa Ricans are among the happiest and long-lived people in the world.

So I am glad to report that I am safe and well.  And getting on with it!

THE YEAR SO FAR...

SUMMER HAS HAD ITS DAY; although it did try to hang on for a bit.  Now I am listing all the Autumn/Fall jobs that have to be in hand before the really cold weather sets in.  Feels like a good time to review the year.

Without doubt the weather has been a little weird.  I thought it would be a good idea to see out the entire Winter here in Corning. NOT a good idea, as it turned out.  Seems I took no notice of my forecast that it would be a long, severe Winter.  If I had really thought that I maybe would have headed off for warmer climes for a week or so.  As it was, for those of us who stayed here the whole season, Winter was very depressing, even a little crushing.  A new experience for me.

The really good thing about Winter, so to say, is the coming of Spring.  Suddenly, everything speeds up.  One's energy returns with a rush and the spirit soars.  This year, all that was just plain delayed too long.   Of course Summer did not languish in the queue, further shortening Spring.  But...lots of rain this Summer and not many really nice, hot days.  So here we are, the beginning of Fall.

Why all this going on about the seasons?  Perhaps I am really thinking how everything interacts and it is not just the seasonal changes.  With the Winter hanging on, I discovered a strange sinusitis; not the sort that has you thinking all your upper teeth are in danger of falling out...just one upper molar sensitive to sideways pressure.  This along with a persistent cough.  This seemed just like a condition I had in the middle of last year (same time, around my birthday).  Off to the clinic I went, returning with a prescription for antibiotics, eventually twice repeated.  Sort of worked.  Being a little obsessive about the causes of conditions, I had developed a theory that these two were connected.  My Doc disagreed, referring me to an Allergist (last Spring was a killer for allergies).  To my surprise, it turns out I have more than one or two.  The Allergist started me on a nasal spray and that seemed to help a bit.  Not much progress with the tooth. My dentist referred me to an Endodontist who was of the view that I had an incipient infection at the molar root (ergo: root canal needed).

The last thing one wants when one is ageing is a persistent low level inflammation somewhere in the body, especially to do with teeth, (bad consequences for vascular disease), so by now I was a little worried.  Enter 'dental tourism ', brought on by the need for implants to replace the collapsed bridge.  Down in Costa Rica, I had the root canal done.  The result has been quite wonderful...almost like the coming of Spring.  The tooth/sinusitis feels much improved, my lethargy has gone away and I am finally 'getting on with things' (aided, of course, by better weather).

The other complicating factor was that, early in Spring, my belle amie (Uma) was diagnosed with advanced breast cancer.  My first real brush with this cancer thing.  Until now I had never really understood or appreciated how fearful this can be.  I have been supporting her every way I can, including going  with her for the surgery and subsequent chemotherapy, which has the most dreary effect on the sufferer.  It has been hard on me too.  I am a 'fix it' person and cancer is not something easily fixed. However wearing, it is nevertheless a precious thing to be included in all that is going on for her.

So the lesson for me thus far is that life is complicated and not always easy or pleasant.

What else I have learned is the importance of  the company and support of friends, maintaining fitness and health, and getting out into the outdoors.

Another surprising finding this year has been the importance of our musculature for health.  From midlife on we begin to loose muscle mass, men more so than women. After age 70, this loss accelerates.  As well, in age, the more muscle one has the less one gets sick.  Until recently, I had not realized that the musculature also functions as an important part of our immune system, so better muscle mass could be a factor in preserving wellness in later age.  Just over three years back, my friend Richard introduced me to the concept of 'slow burn'.  When visiting with him he showed me the series of exercises he does once a week.  This is indeed a minimalist approach and I was excited to follow it up.  Last year, I discovered that one of the trainers at the gym was actually involved in the original research in this approach, so I now have someone to keep me in the groove.

It seems a little exercise often is the way to go.  As well, I have discovered the High Intensity Interval approach to exercise.  This takes care of the aerobic side and, wonder of wonders, does not take long.  With these two approaches, I have reduced my time at the gym to about 25 minutes each visit.  It seems to be working well.

Sorry...no photos this time.

SJ CR III

HERE IT IS...FRIDAY MORNING
and I am free of the dental tourism bit.  All I have to do is to comply with the follow-up instructions (pills, mouthwashes, diet rules, and etc.,)  The procedure went really smoothly, and was much easier than I had anticipated.

I had my first implant done by my brother who, until several years ago, had been the first Professor of Prosthodontics at Sydney University School of Dentistry, and was largely responsible for the introduction of implant practice in New South Wales, Australia.  That was 28 years ago and that single implant has given not trouble through all that time!  He must have been OK at it as he recently received one of the high honors from the Australian Government for the work he has done with Veterans in this area. Certainly, not just by doing that work but by keeping me up to date with his professional interest, I have great confidence in this aspect of dentistry.  Much thanks to him!

So I knew generally what to expect but things went even better.  Dr. Wong, the oral surgeon, did not however sing to the music although he did hum along occasionally. Also, he took some nice photos and sent two on to me.  If you do not mind looking into my mouth, here they are.

Implants 

This one shows the three implant about to be screwed down into the holes drilled into my jaw.  Dr. Wong did this using a surgical guide to ensure accurate position.  The drilling requires several passes, each a little wider, using a slow drill irrigated with chilled water.  This to prevent heating and destroying the surrounding bone.  Once they are fully inserted the bone will begin to heal around them, treating the titanium of which they are constructed as if bone.  The surface of the implants is specially treated to encourage this process so that, in about four or so months' time, each implant will have become integral with the surrounding bone.  Very cool indeed!

Healing Caps

Once properly in place, he then screwed on healing caps to protect this process. In December, I will return for the final work.  This involves removal of the caps, attachment of special abutments means of screws. Crowns, to make it all look like regular teeth, will then be glued to the abutments.  All I have to done is to take good care of the site to ensure no infection of the wound.

I had thought that it would have been two implants and a bridge. However, the local oral surgeon surgeon who extracted the tooth next to the incisor had done such a good bone graft that good bone density was assured. Although the extra implant adds a little to the overall cost, I consider that this will be cost effective and a sounder restorative approach.

So there you have it. I am forced to confine myself to eating icecream, yogurt, smoothies, and the like for today and soft solids tomorrow.  No alcoholic drinks until tomorrow evening (had to forego the Jamesons last night), so that is when I will truly give thanks.  In the meantime, many thanks Costa Rica Dental Team.

SAN JOSE CR II: A pleasant surprise

WEDNESDAY:  CHOOSING A GOOD PRACTICE at a distance might seen somewhat of 'pig in a poke' exercise.  I did the best I could (more details later) with two practices in mind, one I was fairly sure of and the other, also promising, as a backup.  Imagine how it might feel to travel to a distant county and not to like what one discovers.  With governments backing dental tourism there is room for lots of hype and possibly practitioners of dubious competence but gifted with advertising elan getting into the market place.

As it turned out, I liked what I saw at Costa Rica Dental Team.  Paul, the client coordinator, did indeed pick me up in good time to take me to the offices.  As everywhere, there were forms to fill in at the outset. Then it was off to the first examination consisting a detailed examination that included using a special camera to take several views of each tooth.  This showed up some questionable shadows at the margin of two crowns, one of which seemed serious enough to take preventive replacement of one crown.  The  molar that might have needed a root canal did not yield any more information and we agree that the endodontist due to visit the next day would provide the final opinion (which was that a prophylactic root canal would be in order).  Over that last two days I have been moving through a maze of replacement of crowns, root canal, cleanings, consultation with the oral surgeon about the implants, x-rays, and various other stuff.  All very boring, no doubt, but altogether an impressive demonstration of how a dental team can go about providing excellent service.

There are quite a lot of women dentists in CR and I think they bring quite a different approach to care.  Mike, the owner of the practice, has a preference to employ women at all levels and I think this is a good strategy.  He is an American trained as a Dental Technician who, for much of his early career, ran a laboratory for a large practice.  He had opportunity to acquire clinical knowledge through working alongside the dentists and to see the connections between clinical and technical aspects of advanced dentistry.  The next step was to set up a laboratory of his own, eventually in Florida although he originates in Michigan.  He received work from all over the US and finally moved his laboratory to San Jose, the distribution center remaining in Miami. The laboratory is his main business stream, serving 800 US dental practices.

Prosthetic and cosmetic dentistry is more an add-on, using a core team and bringing in specialists according to patient needs.  He stands behind the work, giving a 10 year guarantee.  The oral surgeon has his own practice, where Paul took me for the necessary imaging.  Altogether, I think this is a neat way to package professional services.  Permanent crowns are to be fitted this afternoon, leaving the oral surgery and placement of the implants for tomorrow.

To date, I have been very busy with the dental stuff but yesterday I had enough free time to walk do the down town area...about a half hour's distance.  Recall that SJ is at almost 4000 ft elevation and quite hilly and it is enough to say that I have learned a respect for the macro terrain. At the more micro level one must watch the steps and the unevenness of most of the sidewalks and smaller streets.  These seem to have been in constant repair for the last century or so and lagging the wear and tear.  More importantly, watch out for the drivers who have scant, if any, respect for pedestrians!  The streets are narrow and traffic thick, so their eyes are not focused on people trespassing the road.  To give the drivers their due, pedestrians seem singularly unconcerned about risk, most often just stepping out into traffic with nary a glance.

At town center pedestrian conditions improve, better pavements and good use of pedestrian malls.

How to describe SJ? An old city becoming  new with vestigial traces of the old and the interim all around. Of course, the people are wonderfully friendly and helpful. Very few know English so do some work on Spanish before you come here.

I am just back from having the final crowns fitted.  They have done an excellent job of preparing and fitting them.  Jessica, my dentist, sang along with the music a good part of the time....there's added value for you!

This evening, I plan to go down to the corner to the Irish Pub for a glass or two of Irish whiskey.  Tomorrow, they drill the sites for the three implants and screw them in.  Not looking forward to this.  More on this in the next posting.

SAN JOSE: Day 1

RELAX, FRIENDS...I do not plan a posting  for each day.

Overnighting at IAH turned out to be something of a bummer due to that Texans just looove their air-conditioning.  I did not actually shiver but I found it difficult to doze.  All the nice lay about places were taken by...yes: lay abouts!  How nice it might have been had I the foresight to pack a light jacket.  However, I managed to read most of the latest Jack Reacher book.

San Jose (henceforth SJ) is set in hilly surroundings.  The pilot of the UA 737-800 executed the approach with commendable elan, air brakes out and rapid descent, managing to cope with an impressive cross wind just before touch down.  'Good job' said I as I stepped off.

At almost 4000 feet elevation but just under 10 deg North, the weather is very like Corning and we can expect thunder storms tomorrow.  The days are longer just now up near the Canadian border while here we have the relatively brief twilight of the tropics.  Really very pleasant, all in all.

My accommodations are very acceptable.  Casa 69 is not too far from downtown.  I ventured out and had Pizza at the eponymous Hut just up the road and found the ambiance much more 'up scale' than any I have encountered in the US, more stylish than many a restaurant I have visited. 

 Just hereabouts the environ is a mixture of the run down, gentrification, and modernity.  For example the side streets are somewhat cobbledied with pot holes matching those one might encounter around Corning, whereas the street up the hill has about five inches of new blacktop.  Of course, the city is hilly but with some very nice parks.

In the line waiting to pass Customs, I asked someone who seemed to know CR well why it is that Costa Ricans live so long, are so healthy, and so happy.  The reply?  'Because they grow all their own food on small farms.'

Well, it is off to bed for weary Roberto.  Tomorrow, three dental appointments.  The CR Dental Team will send a car around to pick me up...don't get service like that in Corning!

WHERE DID HE GO...THIS ROBERTO?

I ADMIT IT...A LONG TIME since my last posting!

Winter hung on, then Spring caught us all by surprise but with little of that rush of energy, so depleted were we all from that overlong and penetrating cold.  'The worst we have had for some years', was the complaint on every side.

For we humans, that is.  As for the plants, they simply took off while we green finger pretenders lagged far behind.  I managed to get sort of 'sick' with a weird low grade sinusitis, partly due to allergies it would seem.  Later it became clear that another villain in the piece has been an incipient abscess in one of my upper molars, possibly affecting the sinus on that side.  Several courses of antibiotics helped somewhat but what can be worst than such in the Winter.  All I wanted to do was eat chocolate!  Supposed to be an natural antidepressant but excellent at adding fat. What is that saying, things that taste good must be immoral, illegal, or fattening?  Seems I am too moral and collected the residual possibility. Maybe the allergist is right...at least the nasal spray he recommended has fixed most of the symptoms.

Please forgive all this going on about overstated illness.  It has been a matter of grinding away at the gym and riding the bike and gradually my trousers have become a little less tight around the waist. To admit to the truth, the fact is that I passed my annual physical with flying colors.  Things cannot be all that bad.

What is prompting this dreary chronicle?  Here I am, sitting out the night at Houston International Airport, on my way to Costa Rica.  Do I hear you asking, 'Why on earth is he going there?'

For the last decade I have marveled at the long life of a bridge' in the right side of my jaw, constructed some 30 years ago and taking the place of two side by side extractions.  Finally, it felt rather loose and then fell out.  The problem was a decayed tooth and the front end.

My dentist effected a minor repair on the tooth at the other end and then pronounce that I would need to have two implants supporting a new crown.  How much would this cost, including the necessary root canal and crown?  Looking at me seriously, he pronounced a total of some $15,000!!!

'What do you think?' asked he.
Me: 'I think, Dental Tourism.'

So, dear friends, I researched this topic from Thailand, Turkey, and finally Costa Rica. In San Jose there are lots of fully qualified dentists doing this work and I expect all this to be done for around $6,000 including travel and accommodation.  Plus I get to go to CR twice, apparently a very nice country to visit.

So watch this space...I will write a brief posting at each stage, beginning Monday.

I was going to have the work done in Turkey, in combination with cycle tours there and, later, in Israel.  But meanwhile came the news that my dearest friend was diagnosed with the dreaded breast cancer; a very aggressive type, Stage III.  So I have been caught up in supporting her through the surgery and chemotherapy.  This next week is a lull in her treatment regimen so it is Dental Tourism for me this week.  Turkey and Israel will have to wait.  It turns out this might not be a good time to go to the Middle East so it seems to be working out.

More shortly.

BRIEF UPDATE FOR INITAL 2014

A COUPLE OF MONTHS SINCE my little rant about Australia's weird stance on the 'boat people' or 'illegals'.

Now to bore you with an update or two now that 2014 is under way.

What is so good about the weather is that, when nothing else makes life a little grim, it can step in to fill the gap!  Three words sum it all up...'Damn cold here'.  Night temperatures rarely get up to 10 deg. F and twice have fallen to minus 16F.  I have this neat wireless outside sensor so that, when I get up, I can see at a glance how cold it is outside.  What a joy!  It also gives the room temperature so that the outside/inside temperature difference and be as much as 80 deg. F!  That explains why the furnace is lighting up so often.

We have a bit of snow and, until the rain of the last two days, I have had a foot or so hanging about due to repeated falls and the low temperatures preventing melting or sublimation.  I know you love to have a photo or two every so often, so...

 how do you like these apples?  We have had another three or four inches since these were taken.

This meant some great skiing on local golf courses and the park up the hill a bit from me, that has a very useful hill on which to practice downhill skills.

That nice slippery metal room means that a lot of snow can come off in a hurry once the sun warms it a bit.  What was fluffy powder turns to a wet concrete mix once it falls.  Next year...snow stoppers to keep the snow up on the roof, you bet!

It has been a real test for my heating system and I am glad to report that it, according to the gas company's data, is running very much more efficiently compared with like houses round about.  However, I definitely plan to put in sub-floor hot-water driven radiant heating for the upper floor.  Easy to put in the piping and I have a very helpful manual on how to plan and install.  What has convinced me is the excellent job the radiant heating does in the sun-room you can see lower right in the top photo.  During the winter months this is my rear entrance and it never falls below 50 deg F and the floor is ever wonderfully slightly warm.  I hang out my washing there and it drys overnight!  Think of stepping out of bed onto a warm floor.

So much for the house. 

Not much skiing to date, other than as described already but I do plan to go on a couple of trips further North, into the Adirondacks and perhaps into Quebec Province.

To while away the winter hours I have taken up learning to write in the italic style with my right hand and now have a passable style.  Very like meditation.  For my brain, I have been teaching my left hand to write.  Very weird at the outset but now feeling more normal and a passable hand, if not yet easy or stylish.

For the rest of the time, I have followed a friend's advice (he has written several books) that, if you want to understand a subject, write a book on it.  This will be followed in another blog ('beliefaccordingto') as I am writing about the 18 or so 'missing years' of the life of Jesus.  This is primarily for myself.  However, now well into it, I am finding that it does require a lot of reading and research and that the writing has quite taken over.  Hence the daily stint at the computer putting this idea into words is at the point where I am no longer in control, the plot seems to be running itself; I quite look forward to finding out what will be written each day!  The only problem with this is that I being driven crazy by the excessive typing mistakes I have been making.  So, back to improving my touch typing.  The Google 'Type Fu' happens to be just excellent for that ($4 well spent).

That's it...have a good weekend!