Friday, July 25, 2014

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.

Wednesday, July 23, 2014

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.




Sunday, July 20, 2014

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!

Saturday, July 19, 2014

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.


Friday, February 21, 2014

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!

Wednesday, December 11, 2013

AUSTRALIA, AN INTERESTING PLACE BUT...

WHAT STRIKES ME FORCIBLY when I return to the Land of OZ is the amazing ethnic diversity, especially in the cities (where almost 90% of folk live).  Since arriving here in the United States almost 19 years ago, I have made the trip to my homeland almost every year.  Over this last decade, there seem to be more and more Asian and Chinese faces.  Consider that, in a population of some 23 million, folk have arrived from almost 40 countries, currently at the rate of about 350,000 per year.  Some 200 languages are spoken by people living permanently Down Under; twenty percent were born in other countries and another twenty seven per cent are the children of people born elsewhere; and almost seventy per cent of Australians acknowledge upwards of 300 different ethnic traditions.  Equally amazing is that virtually all speak and read English, a benefit of government programs to encourage and fund learning this language.  Matched to this tough line on the lingua franca is cultural encouragement to preserve ethnic language and customs.  For example, the education system allows children of immigrants to take special subjects relating to to their original language and culture at the public examinations.

Another huge benefit is the culinary diversity that has made no concessions to what might be 'Australian tastes'.  If one goes into a Greek restaurant, for instance, Greek food is what you get.  In Melbourne, where I lived for a decade, a favorite street of mine boasts some thirty different ethnic cuisines; you can eat in many countries just by walking up and down the street!  If there once was an 'Australian identity', it has been long since lost in ethnic diversity.

How very different from the Australia into which I was born and grew up.  Seventy years ago the population of Australia was about 7.45 million and there was hardly a 'foreigner' to be seen.  Then we had the 'White Australia' policy. In 1942, the then Prime Minister (John Curtin) laid it out very clearly,
"This country shall remain forever the home of the descendants of those people who came here in peace in order to establish in the South Seas an outpost of the British race."

When I started school, in terms of migration, rather more people were leaving Australia than arriving.  By the time I was about to attend High School, all that had begun to change and at fast and furious pace.   By then, the population had increased to 8.4 million, mainly due to immigration. Now the population is over 23 million, 60% of this increase being due to immigration.

These waves of immigrants from the Baltic states, the Mediterranean states, the Middle East, Asia Minor, Asia, China, and so many individual countries (including the United Kingdom), completely overwhelmed and obliterated the sense that Australians had of themselves when I was but a lad.  Then we thought of ourselves as British; England was our real home and many of us made our pilgrimage by ship to this homeland when we became of age, taking the long sea voyage this ancestral land.

Not that every ordinary Australian welcomed these new arrivals, these 'DPs','Baults', 'Pommies', 'Wogs', 'Wops', 'Slope Heads' and 'Slant Eyes'.  We did not like their food, their customs, their energy, or much at all about them.  We considered that they would eventually take over and diminish our opportunity.  In a way something like this did eventuate because this process radically transformed the country, absorbing much from the old and the new to produce something very much better.  Now our racial memories encompass the whole world, even North Americans migrate Down Under.  If Australians have any sense of what it is to be an 'Aussie', it surely entails a sense of being from many places and supporting one's "mates" regardless of from whence they came.

BUT...then came the Boat People.  Folk making their way across the sea from Indonesia, a way station in the long journey from places like Iran, Syria, Iraq and Afghanistan, all refugees seeking a better place, fleeing a home land that had become impossible for them, selling all they had and even borrowing much to make the journey the last leg of which was a perilous sea journey in small, un-seaworthy boats designed more for small scale off-shore fishing than to transport human cargo.  Many boats have sunk and at least a thousand men folk, women, children, and infants, have died making this hazardous way to freedom and what promised to be a better hope.

This exodus had begun just before I came to the US.  I was living in Darwin and occasionally one of these boats would turn up, the people on it arrested and the craft set then set to fire.  The Australian defense forces became adept at finding these boats in transit so that, over the years, the smugglers of people have come to depend on being 'rescued' at sea.  For me, and many expatriate Aussies, this unfolding drama, now drawn out over almost two decades, was off-stage.  In Australia, these folk who were refugees of various sorts became transformed into 'illegals' without rights and interned under conditions often approaching in-humane.  No one knew much of where these 'boat people' came from, the financial and physical cost or the nature of the journey, the perils they faced, and the conditions endured, or the treatment they received at journey's end, should they have survived.  If they were barely 'above the radar' for Australians they surely got little notice in other countries.

THEN...two intrepid journalists living in Afghanistan, one a writer and the other a photographer, risked their lives to insert themselves into this harrowing experience.  Eventually, they reached Christmas Island surviving to tell the story we all ought to hear.  Last month it was published, of all places, in the New York Times Sunday Supplement.  I came across the article, The Dream Boat, quite by accident and was appalled by what I read and saw.  You can enter into the journey yourself by reading the story by clicking on the highlighted title above.

Many who read this blog live in Australia.  I hope this NY Times story will stir you to serious consideration and action.  Others of you, who live elsewhere, have friends in Australia.  I hope that you will send the story on to them.

If you read the comments of my fellow expats that appear below the article, I think you will see that mostly we are shocked and chagrined at what we have discovered.  Australia is very much a melting pot filled with locals, displaced persons, refugees, and good old Brits that have come to live together to make Australia a 'Lucky Country', releasing inestimable benefits, adding quality and energy, and enriching our culture.  It almost unimaginable that with our experience of immigration, we should treat refugees in this way...except that we have.



Sunday, November 24, 2013

12 Degrees F...MUST BE ALMOST WINTER!!!

IT HAS BEEN COLD...All of a sudden, the sun gets up just before 8 AM and sets around 5 PM.  Here in Corning, we sort of had two "Indian Summers", periods of several days when the day temperatures reached the mid-70s.  Now we have the cold weather in earnest, overnight lows of 15 to 20 degrees F.  I wonder if today was a taste of life to come.  As the sun rose today (Sunday) I noted 11 degrees on my deck, where I have an outside thermometer wirelessly transmitting the data so that I do not have to step out to see how cold it really is.  As I set off to walk to church around 9 AM...20 degrees.  With the wind at 20 mph whistling down the river at 20 mph, my ears fairly froze as I crossed the bridge. Note to me: get a hat that covers your ears, Robert.

I had some jobs to complete over at my dear friend Uma's home.  'Better get these done before Winter sets in", I have been saying to myself for weeks.  Just as I was finishing these up yesterday, in swept a swirling fall of light snow, demonstrating remarkable timing.  Today the temperature never got above 24 and, as I write, is back to the low of this morning.  What can one say but..."Brrrr".  I managed to get outside to dig three holes for planting my new trees (I have six to plant) before retreating.  These arrived in the post from Arbor Day Foundation.  They are all certified 'dormant' so can be planted in this cold weather in order to get a good start in Spring.

This is Thanksgiving week and I will spend the afternoon before Turkey Day peeling potatoes for the free Thanksgiving Dinner the church hosts.  Not sure what I will do on the day, maybe go over for the dinner to help out and have some turkey and whatnot.  Maybe dig three more holes for planting; it will be a little warmer.

I managed to get myself out of that 'corner' (A Christian Atheist: an Oxymoron?).  The talk was well received.  The gist of it is in the last two postings in the other blog (BeliefAccording...).  I was also to read a book to the children and chose 'The Little Engine that Could'.  A modern version of the story we know as The Good Samaritan, and between the lines, 'When the going gets tough, the tough get going'.  I admit to having a great time with them!  Would you believe, they have invited me back to do a short series so another 'corner' is in the offing, this time along the lines of inquiring into a modern basis for spirituality and morality.

The shortening daylight hours and standard time surely bring a change to the ordering of the day.  A case of getting the work done while you can; 'work for the night is coming', as an old song reminds.  Not much room for procrastination either.  This Winter, my focus will be bringing the downstairs area up to guest accommodation standard and making the entire house 'shipshape'.

Soon enough the snow will be covering the ground.  I have the snow tyres (tires) on now and even got my skis out the other day.  Three times a week I have taken to quick walks including the local park that has a nice slope at the northern when where I can do my 'hill bounding' and other skiing related training.  Will there be snow, I wonder?  Never mind, I am very happy to go exploring for snow trails and plan a trip up into Quebec Province to Mont Tremblant National Park, and some other trips into the Adirondacks.

If you are in the US...happy Turkey Day and safe travels.
If elsewhere, have a great week.