Meeting with Dr. Cavallini

Monday February 25 continued....it has been a long day!


 Finally, they called for Bakty again, and we were off to have our consultation with Dr. Cavallini.
Bakty has given me permission to let y'all know this; he was pretty scared about the whole implant thing!  The whole idea of having something screwed into your jaw is pretty intimidating, not to mention he was anticipating major pain from the whole procedure.  That is another reason (other than the tanning thing ;-) ) that I came along, spousal support! 

I borrowed these photos from Dr. Cavallini's website- It seems my camera somehow lost my photos of these.

3D X-ray

Garden Area Near Front Waiting Room

   Dr. Cavalllini's office is to the right of the waiting room at the front of the office. He has a big comfortable office filled with books, photos, trinkets and his degrees posted on the wall.  He is very pleasant and personable, I can't imagine anyone not liking him.  He loves to tell jokes!  He didn't start our conversation with "well here is what we are going to do", he took his time and got to know us a little first.  He asked us where we were from, and where Bakty was from originally.  He looked at me and ascertained that I had a bit of English decent in me and insisted I speak with a British accent, I do Southern so much better and easier. He wanted to put us at ease and get to know us better.  He has clients come to him from all over the world, and being as Bakty is originally from Indonesia, we had to discuss languages. Dr. Cavallini makes a point to learn as many phrases from all different languages that he can.  He keeps a little book with the most popular phrases in it and we discussed quite a few of them.  He gave us a lesson in Turkish, Thai, Polish, Arabic & Italian.  After discussing languages and where we had traveled in the world and if this was our first time to Costa Rica, he then asked Bakty what he was wanting to have done with his teeth.  We explained what we thought needed to be done as he pulled the x-rays, that they had taken earlier that day, up on the large computer screen on his desk.  We had said originally we thought Bakty needed 4 implants, but he said there was no need for 4 and that 3 would do.  Bakty was actually only missing 2 upper back molars, but thought he was missing 3.  One more of  Bakty's other teeth needed to be extracted before the implant could be done on it, this was the tooth that prompted us to leave for Costa Rica as quickly as we did.  Bakty was ready for it to be out so the pain would go away.  We asked if that tooth could be taken care of first and Dr. Cavallini said that it could. 

  Bakty's next question was "So, what is the process going to be tomorrow?".  In a most serious expression, Dr. Cavallini explained that, " First we are going to call the funeral home, and then we are going to pick you out a nice casket, we'll be sure you have a nice funeral, then we are going to make sure we find your wife a good husband."  I was laughing, Bakty, not so much. He confessed to me later that he wasn't sure just how to take that statement, it had him a bit unsettled.  I understood Dr. Cavallini's personality and the humor, but Bakty was already nervous and apprehensive about the whole ordeal and didn't find it quite as amusing as I did.  Bakty eventually overcame the apprehension of the whole ordeal.   

  Dr. Cavallini explained further about the implant procedure and the fact that due to the infection in the lower tooth, that would be extracted, it would be necessary to do a bone graft as well.  Also because of the area of infection, the size of the implant would be pretty large. He asked if we had any further questions, and the only one at that point was, what time did we come back to get started.  We didn't need to know what this was going to cost, as we had already received an email estimate of charges for the procedures before we had left home.  $2,000 was our approximate total for this time around.  3 implants and a bone graft for less than the cost of 1 implant in the U.S. !  We would have to return to Costa Rica again, anytime after 3-4 months to have permanent crowns put on the implants.

  I have to interject here for a moment and say that both Bakty and I felt very good about the amount of time that Dr. Cavallini spent with us.  There hasn't been any physician, dental or otherwise who has ever taken so much time to get to know us and try to put us at ease before a procedure.  We weren't the only people who felt this way about Dr. Cavallini, and Dr. Marcos (his son), as well as the rest of the staff.  They all want to make you feel as comfortable and at ease as possible. We heard the same sentiment over and over again from the people we met.  Rest assured it is all well worth the wait!

  He said Bakty would need some pain medicine and antibiotics and he then scribbled out his prescription and walked us out to the back of the office to the pharmacy.  We paid for the prescriptions and headed back to the front office. We then went to schedule with Diana. She looked at her schedule book and told us to be back in the office by 11:00am the next morning (Tuesday).  It is now about 7:15pm, dark and still a bit rainy.  We asked Diana to call for a cab, we figured we would tackle the walking thing tomorrow, after all we weren't' really sure how to get to our hotel.  We met the taxi within a few minutes outside the office and asked for Hotel Cristina, although I believe Diana had already given him this information.  He didn't talk much and we were tired anyway, it had been a long day! I was watching the meter in the cab to see how much the ride was going to cost us.  The meter didn't move for quite sometime and then it quickly started to rack up the colones.  Traffic was bad and the closer we got to the hotel the worse it seemed to get.  We were almost to the hotel at the intersection of Pan American Highway #1 and Boulevarde de Rohrmoser when traffic was stopped in all 4 directions.  There were 2 large buses that seemed to have ever so slightly collided with one another and behind one of them was another bus, all in the middle of the intersection.  We needed to go straight which meant that we would have to squeeze through the 5 feet of space that was between the latter 2 buses.  Everyone else was doing it, and so did our driver.  Finally on the other side of the traffic jam we quickly made it to the hotel.  The taxi ride came to a total of 2,000 colones or $4 U.S., which the driver gladly accepted.

  Upon arriving back at the hotel we stopped at the front desk to get our bags and head to our room.  Remember our room wasn't quite ready when we first arrived.  It was just around the corner to the right.  Our room layout was very nice, just flip the kitchen and sitting room and that is what we had.  We were starving by now and threw our bags into the room and secured the necessary items in the safe and off to the Chinese restaurant, Flor de Loto, down the street from the hotel.  We had been told it was good, we would soon determine if that was so.

  It was the only close, within walking distance, restaurant open, except for the Italian one in the hotel, but we didn't want Italian.  We entered in and seated ourselves near several other tables of people.  We ordered 2 bottled waters, tofu soup, fried rice, mango chicken.  We were not very impressed with it at all, where was the mango with the chicken?  All we got was a sauce and fried chicken strips, no veggies, nothing.  The fried rice was equally absent of veggies. The soup was okay, not very flavorful.  We asked for a to-go box, there was at least enough portions to have left overs for the next day.  We paid our $32 check and left, vowing we would not return.  The next morning confirmed that for me...
  
Next Post: The Implants Are In-

Tico Time

Monday February 25, 2013 continued...

 If there is one thing we have learned from our travels abroad, it is, the U.S. runs on a totally different time warp than most of the rest of the world.  I would say we (U.S.) are probably in hyper-drive most of the time, if not all the time.  The fast paced society that we live in detracts so much from the things that are really important in our lives.  Especially quality time with family, friends and other things that are more relaxing, like beach time for example.  Anyway, there is something to be said for a slower, more relaxed approach to life, rather than trying to hurry everything along so much that we miss the moment.  In Indonesia it is called jam kerat "rubber time", and it is very flexible "rubber".  Nothing will ever happen in the time you think it should, so just sit back, relax, enjoy and spare yourself the heart attack, you never know who you might meet.  For Costa Rica it is Tico Time, not sure if that is the official name or not, but a friend of ours says that is what he has heard it called, so Tico Time it is!

  As we got settled in to the waiting room at the front of the office and Bakty worked on filling out his paperwork, there were several people discussing the process of being seen.  One man was not too thrilled at his wait time and he was very vocal about it.  These folks had been here waiting longer than we had, it was past 3:00pm and the office reopens in the afternoon at 2:00pm, so I figured they had been there at least since then..  I anticipated that we might have hours to wait as well, not knowing what the exact procedure would be.  As it turns out, we were sitting there for probably 25 minutes, just enough time for Bakty to get through most of the paperwork, before his boredom of form filling finally set in and he turned it over to me to finish, when one of the nurses called his name, "Yon Barber" (John Barber). We figured John would be easier to pronounce than Bakty, and it is his first name, which he adopted upon becoming a U.S. citizen.  We could see the astonished look on  some of the waiting patients faces, thoughts running through their minds must have been, "Wait, I was here first! I have been here for more than an hour and a half!", and so on. 

 Part of the fun, for me, in the waiting room was listening to the nurses call out patient names and the patients having to tune their ears to the Costa Rican accent to figure out if their name was being called.  I love different languages!  Don't get me wrong, I am not making fun of the nurse's accents, I actually find it very interesting to see how tuned-in other people, who don't speak the language, are.  Once again, I think we are too conditioned and too much in hyper mode to slow down and pay attention and listen closely. 

  We got up, followed the nurse as she led us down the hall to a room on the left that contained their 3-D X-ray machine, complete with a hookup directly to a laptop.  (More modern than some of the U.S. dentist offices we have been in!) She got him settled down and positioned just right and she stepped out of the room, pushed the button, and the machine revolved around his head and took the necessary shots.  She then directed us to the room directly behind that one where they proceeded to take impressions of his jaw.  While he was having this procedure done, I finished his paperwork and double checked it.  Hmmm, what is this form about, $150 for a 3 Yr Warranty?  A fantastic thing actually, cheap, cheap insurance!! More on that later. Once his impressions were done and he had finished spitting out the last of the residue from the casting, we were told to go back and have a seat.  I turned in his completed paperwork and we sat and waited.

Bakty waiting in the nice comfy chair!

  Fortunately we had brought the laptop with us, so this gave us time to Skype to family at home.  Bakty had also brought a book to read.  Dr. Cavallini's office is complete with WiFi, large screen TVs, water, snacks, free phone to the U.S. (just ask to Diana to make a call), cell phone rentals at about $5 per day, outlets to charge your electronics (all 110V-120V so no need for a converter, this was the case throughout where we traveled in CR)  There are actually 4 separate waiting areas dispersed throughout the office, 3 with a TV and separate A/C. Sometimes the very front office, due to the glass windows, became a bit warm, even with the A/C.  There is also a lovely atrium in the center of the office, filled with plants and light flooding in from the skylight above.  All around the office posted on the walls are photos and poems and letters from people around the world who have expressed their gratitude for the work that Dr. Cavallini and his son have done.  It was very encouraging to read these while waiting.

  The sky had steadily been growing dark as we sat and waited.  Then it began to rain, and rain hard!  The office staff was shocked by this as it is the dry season and very unusual for it to rain like this.  We will definately get a taxi for the ride home!

  By now it is close to 5:00pm and we have Skyped our sons, my mother, Bakty's brother in Indonesia and anyone else who was online that we could talk with, to let them know that we had arrived safe and sound. We had checked our emails and our voice mails through Google Voice.   We hadn't eaten since the sandwich and cookies that we were given on the flight and we were getting hungry. (Remember, 5pm CR time is 6pm our time).  Thank goodness I had brought the bag with supplies in it! We had brought some Larabars, raw almonds, cashews and Pirates Booty for snacking in the airport and on the plane.  We always carry some type of food with us, just in case.  Now was the "just in case"  and we were prepared for it. I went to the desk to ask how long before our consult and was told 40 minutes which eventually became about 1 and a 1/2 hours.  Thinking it was 40 minutes kept us from running out to get a bite to eat...so we snacked, waited and got to know our fellow waiting room companions.

  There were people from all over the U.S., Canada, Russia and Costa Rica waiting in the office. It was comforting to know that this wasn't the first time for many of them.  Some were back for their 3rd or 4th office visit because of the extensive work they were having done.  For some it was their first time (day), like us.  For others, they were returning to have corrections done to failed implants.  It concerned us when a few of them were telling us how their implants had failed and they had to return to Costa Rica to have them redone.  We then wondered whether or not this was the right thing to do, was that going to mean we had to pay again to have the implants done if they failed?  Why did their implants fail?  Was the work not being done properly?  Was this going to be more costly than we first had anticipated? Not really the time to be having second thoughts!  However, we were committed and there was no turning back now, and as we talked more with them, we found the overall attitude from everyone was very positive. (Much good news later regarding all of our questions!)  You see, unlike the dentists in the U.S., if your implant fails, you pay them again to redo it.  If you don't have insurance and even if you do, this can get expensive.  Implants can and do fail, for various reasons and most of the time it is probably due to the health of the patient and the way they take care of their teeth (my analysis from discussion with people who were there for that reason). It seems that having considerable bone loss and gum disease adds to that statistic of failure.  I will say if you are considering implants and have lost teeth already, don't wait to get the implants!  The longer the time period lapse is, the more bone loss and the higher probability of implant failure.

  I am going to take a momentary respite from our experience to comment on the U.S. dental fees.  I am sure that if there are any dentists reading this they may have some disagreement in my recommendation to have work done in CR or anywhere else other than the U.S.  Some would say the work is inferior, or the equipment is outdated, etc. Is this true? Or is it all so they can charge you anywhere from $3,500 to as much as $8,000 for an 1 implant? Or, how about $1,200 and up for a crown?  Or $900 and more for a root canal?     Maybe..., or maybe they are just misinformed as to the dentists' education (U.S.), quality of work and high tech equipment & materials that are available.  And yes, I also realize that in the U.S. there are other factors that increase the cost of any medical procedure.  These U.S. cost figures came from our own experience, as well as everyone we spoke with from around the U.S. and Canada.  

Which is why we were all there in Costa Rica for dental work!  

Some of these people had gone back to their dentists and were told the work wasn't good and they were going to be sorry they had done it in CR (which they weren't), some of their dentists even said they wouldn't do anymore of their dental work.  On the flip side there were a few dentists who commended the job that had been done on their patients' teeth by Dr. Cavallini.

 Back to the waiting room, it was now pushing 6:30pm and we had been talking with several of our waiting room friends and watching it rain.  Bakty even shared his snacks with a young lady who sat down next to him. Despite the fact that we had to wait as long as we did, it really wasn't so bad.  It was raining, so it wasn't like I had missed much sun, and we got to talk with some really great people while we were sitting there.  Everyone has a story to tell and to me they were all interesting.  Many of these people we saw over the next few days and had even greater conversations with them.  Remember we need to slow down, there are terrific people out there that we just haven't met yet.  It was wonderful getting to know them and learning about their dental experience as well as their life experiences.  We met people from Canada, California, Texas, Virginia, West Virginia, Pennsylvania, Florida, Arizona, Tennessee, New Mexico, Ohio, Illinois, Georgia, Alaska, Maryland. Had we stayed longer than our 2 weeks, we just might have met people from every state in the U.S.  

  After all of these discussions, we now know that our fears were unsubstantiated! The praises from our fellow waiting room friends have confirmed, that they would do it again. The work is done to the highest quality and the guarantees are better than you could ever imagine. 

  They called Bakty's ("Yon") name again, now time to meet with Dr. Cavallini.

Next Post:  Meeting with Dr. Cavallini
 
   
 
 
 

Arrival in San Jose

Monday February 25, 2013

  Sunday evening, we spent the night with our son and his wife since they live closer to the airport than we do.  That way we wouldn't have to fight morning Atlanta traffic and probably an hour or better drive. Not to mention how stressed out we would be by the time we got there.  We don't want to be late!  We arrived in plenty of time at the new International Concourse for the airport, the place was pretty empty. Passports & boarding passes in hand we check our one large suitcase and continue on to security with our carry on luggage.  It wasn't too much of a hassle to get thru security, although we did opt out of the body scanner and went through the ever so pleasant "pat down".  They didn't find a thing on us, imagine that!

Getting Settled in for the Trip

  Anyway, we finally board the plane and get settled in to our seats, it is a full flight.  We are dressed in layers since we are leaving freezing weather and headed to a much warmer climate.  This time of year it is the dry season for Costa Rica.  Mid November thru May/June and then the rainy season starts, so we expect lots of sun and warm breezes.
  We finally arrive safely in San Jose after a bit of a delay in Atlanta, remember it is a full flight.  Well, they asked for volunteers to give up their seat before departing and we had to wait for Delta to find, then unload the volunteer's luggage before we could leave.  Amazingly enough we arrive only 20 minutes behind schedule, we must have had some great tail winds. 

  Arrival in San Jose airport was pretty easy, we went straight to immigration where we stood in line for probably 30 minutes before we finally got our passports officially stamped. 
 

We're Officially In Costa Rica!

  Note:We were given a slip of paper written in Spanish with a triangle and exclamation point in the middle.  This was to inform us that beginning April 23, 2013 should we stay over our limit, we will be fined $100 for every month we have exceeded it.

$100 fine per month you overstay your allotted time in Costa Rica

   There wasn't any sort of major suitcase check, we just ran our bags thru a scanner and went on our way to meet Carlos, our driver.
  Dr. Cavallini's office had prepared us, in an email with instructions, for pickup at the airport.  We were told Carlos would be picking us up and to look for him at the right of the exit outside.  We were given his phone number as well, just in case we couldn't find him.
  We made our way through the masses of people trying to find rental cars and taxis and stepped out into the Costa Rica air. The weather was wonderful!  Somewhere in the high 70's with a slight breeze, there was a bit of overcast sky near the airport but further off in the distance the sun peeked through the clouds. The warm weather was wonderful and I couldn't wait until we got to enjoy this beautiful country. 
  Just as they had said, there was Carlos, with our names on his sign, standing &  waiting for us to exit.   Carlos was very talkative & spoke excellent English, having lived in the U.S. for several years.  He took us to his car, loaded our luggage and then proceeded to the Cristina Suites Hotel.  Along the way we asked lots of questions, where to eat? (local sodas), what about grocery stores? (AM/PM which is more of a mini mart or the larger grocery store Mas X Menos), why did you move back to Costa Rica? (for a better life, great climate, good food)... It took approximately 20 minutes or so to arrive at the hotel.  Traffic was crazy and the motorcyclists were even crazier!  Thank goodness we hadn't chosen to rent a car!  They zip in out between cars and buses taking advantage of every opening in traffic they could get.  Although at least the cars, buses and trucks stayed between the lines, where as in Indonesia and several other countries we have visited, they make their own lanes, as wide as the road will go. We asked Carlos if he had time to drive us to the dentist office and he said, if we could be quick with check-in he would be happy to drive us.  It was about 2:30pm at this time.
  Before leaving Georgia I had asked Edward what the schedule was for us once we arrived in Costa Rica.  He said to be at Dr. Cavallini's office sometime after 2:00 for the initial consult. 
  Upon arriving at the hotel we were greeted by Elizabeth, who speaks perfect English as well.  She was very pleasant and greeted us with a big smile.  We told her that we were in a hurry because our ride was waiting on us, she said no problem, this will be quick.  We filled out a small amount of paperwork and gave her our credit card for security.  She said our room wasn't quite ready yet and that we could leave whatever luggage we wished with them at the front office and they would keep it safe until we returned. We were a bit apprehensive, but since we had locks on the luggage anyway, we figured we didn't have anything to lose (it was only clothes), if that were to be the case. We took the important stuff with us laptop, money & passports. So, we hopped back in the car with Carlos and headed to Dr. Cavallini's office.  We asked Carlos about walking from the hotel to the office and he said it would be no problem for us, about 15-20 minutes, but not to walk the way he was driving us.  There are several one-way streets in San Jose so he had to drive in less than a direct route to get to our destination.  We arrive at the office and Carlos dropped us off outside, as he has someone else to pickup at the airport.  We push the doorbell to be let in, it is securely locked at all times, and unless someone releases the lock you don't get in.  Once in the building you can use the stairs or the elevator to get to the reception/waiting area. Don't expect that this office or clinic, as the name reads on the outside of the building, is anything remote to the environment you might be used to seeing at home, at least in the U.S. anyway.  There is a small hotel called Cacts on the left next to the office and what looks to be someone's resident on the right.  As in most countries like Costa Rica you will most certainly find homes intermingled with all sorts of businesses, some of them even live over their establishment.
  Upon arriving in the office, the reception desk is to your left.  This is where you will find Diana, who is almost always at the front reception desk.  You are instructed to sign your name on the check-in sheet and you are given a clipboard full of papers that need to be filled out.  These are the standard, medical history & release forms. We found a  couple of seats in the waiting room, which was pretty full, and Bakty began working on filling out the forms.

Next Post: Tico Time

More Questions

There are a lot of things to consider when deciding to go to a foreign land for vacation, even more when it is for dental work.  We still had a few questions that needed to be answered and things to consider and double check before we left so that we were prepared or as prepared as we thought we should be. 


Passport, Visa or Both
  For citizens of the U.S. at this current time there was only a need for a passport.  No visa necessary, however, before entering Costa Rica, you must have a round trip ticket or a ticket to another country.  Your passport should have 6 months minimum left on it from your date of entry.   Once in Costa Rica you only have 90 days to stay before you must leave for a minimum of 3 days and then you may re-enter again for another 90 days and so on.  Also, note there is an exit fee that you pay when you leave the country ,currently it is $29 U.S. per person.  If you are coming to Costa Rica you might want to consider trip insurance.  This is especially true if you will be here for medical reasons.  You never know if you will have to extend beyond your allotted time or not.  You can go to this website for more information: http://www.costarica-embassy.org/?q=node/72

Diseases
  Did I consider the possibility of some disease?  No, actually I didn't. We have traveled all over the world and for most of those places we visit, we have never worried about what we might catch.  We try to watch what & where we eat/drink, and really haven't had too much of a concern of getting a deadly illness.  We have picked up a parasite or 2 in our travels and have managed to rid ourselves of them.  Would I consider vaccinations?  Probably not, and that is a whole other issue and I am choosing not to delve into it at this time.  :-)  
  However, If you tend to be the worrisome type or you feel that your health is not as good as you might wish and that you may be susceptible to illnesses, before you go you can check with your physician, local free health clinic, as well as this website, http://www.who.int/ith/en/, to determine what you might need to protect yourself against while traveling in Costa Rica or any other foreign country.  The choice is completely yours.

What to Pack
  This is going to be primarily determined by what you plan to do while in Costa Rica.  As I said before, I am the ocean, sun, beach loving girl!  So for me, a couple of bikinis, flip-flops and a cover up would have worked just fine, except we wouldn't be at the beach the whole time we were there, so I had to consider other articles of clothing.  Bakty on the other hand would have gone with soccer & tennis attire.
  We would be in the city and walking, so comfortable walking shoes were a must.  The temperature in San Jose, which is pretty much a city in a valley, is cooler than the coast.  Although cooler, the temperature still ranged from the low 70's to low 80's during the day.  It was very comfortable weather, a bit breezy and almost always sunny for most of our visit.  We packed sleeveless & short sleeved shirts, shorts, and an extra pair of long light weight pants. I packed 2 pair of dressier capri pants, sleeveless casual/dressy shirts and a lightweight dress and we wore jeans on the way to San Jose. We had our personal toiletries, minus shampoo and lotion, a few pair of socks, underwear, sandals, a light jacket for the cooler evenings (sometimes low 60's in San Jose), 1 set of workout clothes for both of us and a beach towel. 
  We filled 2 carry-ons and 1 large suitcase.  We over packed!!!   Hard as we tried not to, we did.  I could have done with 2 less pairs of shorts, 2 less pair of capris, 1 less pair of long lightweight pants, and 4 sleeveless shirts.  Bakty only wore half of what he brought as well, so we could have gotten by with just our carry-on bags.  When we travel we aren't usually looking to dress up a lot anyway so we tend to be a lot more casually dressed. Note to self:1 carry-in is all you need, no matter where you are going!  If we didn't have to worry about the larger suitcase we probably could have traveled a little differently than we did. But, having the large suitcase did give us that extra room to bring back lots of Costa Rican coffee!
  You might also want to bring your own washcloth or extra towel depending on what type of hotel you will be staying at.  Both of the hotels we stayed at had towels and washcloths, but I understand that some hotels are bare minimum in that area.  If that seems too much to bring, you can always buy them if you find the need. Costa Rica is very environmentally conscientious and they don't want to wash more than necessary so you need to hang your towels out to dry and not just dump them on the floor.  They will replace them about every 3 days with clean ones. Also note that you have laundry service available in most hotels or depending on your hotel, you may have a laundry available for use.  We had washers and dryers available at the Cristina Hotel, it was $6 U.S. to wash and dry 1 load of laundry.
  If you are traveling during the rainy season or plan on trips to the mountains & volcanoes, you will want to be sure you have packed items that will keep you warm and dry.  When up in the higher altitudes and the dampness it can be a bit cooler.  So, bring a jacket, some light weight water proof clothing, a compact umbrella, and some good shoes for the wet slippery environment. 
  You will want to have sunscreen, if you like hats bring one, and insect repellent. We didn't bring any of these and just purchased what we needed from the local store.  We never saw one mosquito the whole time we were in Costa Rica, that doesn't mean they weren't there, we just never got bitten or saw one anywhere we were. If you just can't live without them, bring a hairdryer and/or your flat iron.  One of our hotels didn't have a hairdryer in the room. You could have one if you asked, but we were at the beach and I like beach hair, so I didn't ask. Check with your hotels if you are not sure.  Bringing them certainly expands the need for more luggage. 

Next Post: Arriving in San Jose and the Dentist Office

Know Before You Go

Questions, Questions and More Questions

I did a lot of research via the web and friends who had traveled to Costa Rica. Some of our many questions:
What is the official currency used and the exchange rate?
Where was the best place to exchange our currency? 
What was the best way to take money?  
What did it cost for ATM usage and credit card usage?  
Do they speak any English? 
Are the locals (called Ticos) friendly? 
Could I use our cell phones and if so what charges would we incur? 
What kind of internet access will we have? 
What clothing would we need?  
Should we rent a car?  
Where would we eat?  
What would we eat? 
Can we drink the water?
How safe is it in San Jose (the city) & outer areas of the country? 
Do we need a visa or just a passport? 
What diseases should we be concerned about? 

And, finally, the most important question of all; 

Where is the best and closest beach?

Below are some of the answers that we have since confirmed-
Please note that I will answer all of the above questions and more as I progress through this blog. Not all questions will be answered in this specific post.  Also, remember, this was our personal experience and interaction with people we met.  Which leads me to say that your experience could be different from ours. I am only trying to give you the best observations from our point of view.  For your Costa Rican experience (whether it includes the dental or not),  I hope that it will be equal to or better than ours! Pura Vida!

Currency

One Side of Currency

Other side of Currency

  The official currency is the Costa Rica colón (CRC) and at the time of our travel the exchange rate was about 500 colones (plural for colón) to $1 (U.S).  That makes calculation fairly easy.  Say that an item costs 1,000 colones, all you need to do is double that (2,000 colones) and drop the 3 zeros.  That item just cost you $2 (U.S.)   Also, don't get confused by the fact that is says mil on their bills, this is Spanish for thousand. The best place to exchange our currency was at the casinos.  Before leaving we went to our local bank and exchanged our worn out bills for brand new, crisp 100's, 20's, 10's & a few $1's.  If you have ever traveled outside of the U.S. this tends to be the best option if you are going to exchange cash.  The reason is that other countries value the bills that are newer and in excellent condition and they give you a better exchange rate, and it is the most current currency, so they feel better about it not being counterfeit. Though they still check for that as well.  The casino gave us a 500 to 1 exchange when the hotel only gave us a 486 to 1 and the bank was 490 to 1.  We actually never did an exchange from the ATM with our debit card, so I am not sure what exchange rate that would have been.  We also didn't choose to use our credit card to obtain cash because of the high fees associated with cash advances.  If you don't wish to exchange any of your currency at all, they will take U.S. dollars and it seems that most places rounded to the 500-1 exchange, but some would be a bit lower rate, just be sure you don't care about the loss of a couple of dollars if you choose this route.  

  Keeping our money safe, we never took more than we thought we would need on any of our excursions.  Certainly never more than $100 (in colones) at a time.  We had a very secure hotel in San Jose and a large safe in the room and that is where the remainder of our money stayed.  We could have used traveler's checks, but didn't want to have to go to the bank and wait in line, plus you have to have your passports with you as well. The less we had to risk losing the better. Cash was easy for us.

  When we booked our hotel we had a choice of  2 options.  We could pay in cash, U.S. dollars or colones, and there would not be any difference in the 500-1 rate of exchange.  Or, we could pay with credit card and the cost would be higher.  Here was our example: We had a rate of $73 per night if we paid cash, if we paid via credit card it would be $83 per night.  Both of these prices included taxes and fees. We paid in U.S. dollars and that just saved us a trip to the casino, which was just around the block, so really not an inconvenience.

English or Spanish, Friendly or Not?
  The local people, Ticos as they are called, are very friendly and willing to help if they can.  Some of them speak a little English, while others can speak fluent English.  Most of the drivers we had could speak English as they had either learned from the radio and television or they had actually lived in the U.S. We could speak a little Spanish and we learned more everyday, so we had no problems, and a little bit of sign language/hand gestures doesn't hurt either. The tourism literature is in English as well as Spanish.  At both of the hotels we stayed at, English is spoken by the reception staff. So you always had someone to help translate, call a cab, make excursion reservations, etc. But, as always, if you are in a foreign country, learn their language!  It makes communication so much easier and they appreciate your efforts of trying to speak their native tongue.  Even if you don't speak fluently, at least you are trying and that goes a long way. Remember don't be an Ugly American, not all of the world speaks English.

Cell Phones and Internet
  We have AT&T for our cell phones, I called them to find out what the fees would be if we used our phones in Costa Rica.  AT&T charges based on the minutes you think you will use and you have to pay for voice minutes, then extra for text messages and additional charges for data usage, way more than I wanted to pay for no more than we would be using our phones. If we didn't want to purchase their package options we could always just use the phone and pay the ridiculously high fees associated with per minute usage.  Needless to say, we didn't use our phones while we there, we didn't need to.  We had excellent WiFi connection in both hotels, as well as Dr. Cavallini's office.  Because of this we were able to use Skype to talk to family and friends and the connections to the U.S. were great.  However, we did have issues connecting to family in Indonesia, not sure why. Before we left home I set up Google Voice accounts for both of our phones so that we could receive notice and listen to messages via email as well as texts (Bakty's phone # only, mine had issues with the text feature).  Using Google voice we were able to send texts to cell phones in the U.S.  If we had wanted to, we could use the phone at Dr. Cavallini's office to call for free to the U.S. or we could rent a cell phone from them for about $5 per day.  We also had free phone calls to the U.S. at the Las Brisas Resort and Villas, when we stayed at the beach.  One note regarding Google Voice, we had to search Google U.S. and bookmark it to enter the GV option.  When you are in Costa Rica you get Google Costa Rica and it works a bit different for things that are U.S. accounts, so we had to be sure we were in Google U.S. to utilize the Google Voice Feature. 

Renting a Car
  We chose not to rent a car because of the unknown time period that we might use it.  But, not only for that reason.  During my research it seemed apparent that driving a rental car could be opening oneself up to theft.  One of our friends friends had an incident where she had a flat tire and when she stopped to change it some men offered to help, despite the fact that she watched them closely, they still managed to make off with her camera.  The flat tire may or may not have been their doing as well.  The rental cars are marked, possibly in different ways, I don't know for sure. Some of the people that we met in CR did rent a car and they had round green stickers on their windshield. Their experience was that it was cheap to rent the car, but the insurance was expensive.  It seems that the rates ran around $500 U.S. for 5 days, but you can check that for yourself as prices change from season to season.  It seems that U.S. & Canadian insurance would not cover that part of the rental for these folks, so they paid the CR price for insurance.  Here again, check with your insurance company and the car rental company before you go.  For these people renting, they had a great experience driving and exploring the country of Costa Rica, stopping whenever they saw interesting sites or at the many fruit stands and souvenir places along their way.  Some by way of accident got to see beautiful tropical rain forests because of wrong turns, others faithfully followed trucks hoping they would be led back to civilization from their dark, foggy, rainy, one lane mountain roads, (did I mention no guardrails and long drop offs down the cliff) and others just stopped to ask for directions in their best Spanish possible, "Donde" (Where is...)? Another note for car rentals in CR is that if you plan to go to bordering countries, Panama or Nicaragua, you have to stop at the border, cross on foot, rent your car for the next country.  They do not allow rentals to cross any borders.  Also, you will always have to have your passports with you at all times when driving the rental car, there are frequent police stops to check for identification.  There are major highways which tend to be the best for traveling to and from unless you are adventurous.  If you are going to be in San Jose only, you may not want to drive around town as it is very crazy and congested. Choose from taxis, buses or foot instead. See the next section below for more on that.

  Overall, use common sense, all the people we met were very nice and helpful, but as anywhere you go there are always a few bad apples.  If you need to stop be sure that it is a place that police or some type of security persons are present, they seem to be everywhere, and that it is very well lit if traveling at night.  Don't stop out on the road just because someone is trying to flag you to pull over by flashing their lights or honking their horn.  Continue to a safe spot, as referenced above, before pulling over.

  For our next trip to CR, (Yes, there will be a next one definitely!) if we have the time, we will probably rent a car so that we can explore more things between San Jose and whatever beach we are headed to.

Taxi, Bus or Walk
  Taxi drivers for the most part speak a lot or very little English.  Only use the red taxis with the yellow upside down triangle on the door and an ID#.  This way you know you won't be paying more than you should for the fare, at least for a gringo. (More on that in a later post).  From my observation there is apparently some mystery about the way a fare is calculated even though it is metered, the price changes for the same transport by as much as $2 (U.S.) I watched the meter like a hawk and it stayed the same for about 8 blocks, then all of a sudden it started counting up the CRC quite rapidly.    Speaking with fellow travelers they had the same experience, but if it only varied by $1 or $2 then, so be it, we got where we wanted and didn't have to walk in the rain. If you use taxis (called piratas or pirate taxis) and not the red ones with triangles then you will definitely pay a higher fare, so we were warned.  Also, these taxis are usually not regulated or insured and they can sometimes be red. The  taxi ID# normally has the same driver (so we were told by one of our drivers), so if you find one you like, you might look for him or make a request to see if he is available. They take either U.S. dollars or CRC.  

  Bus travel is used quite regularly by most Ticos in the city.  It is the least expensive way to get around the city and its outer-lying areas.  You must be careful that you speak enough Spanish to find out exactly where the bus will be taking you to, I can only imagine the nightmare of getting lost on a bus, probably something similar to the nightmare of going to school in your pajamas for those of you who may have had that dream. We didn't have a reason to use the bus while in San Jose, but a fellow traveler from Canada said that he regularly took one that went to Jaco (pronounced Hocko).  He said his fare was only $5 U.S., not bad if you are traveling light with a backpack, but I had a nightmare before we went. This nightmare was way before we ever even decided to go to CR, but I remember it vividly.  I was standing at a bus station with our suitcases when someone asked me a question.  I turned to answer them and when I turned back around, the bus was pulling away and my luggage was gone!  Laptop, passports, everything!  I couldn't speak enough of the language to find someone to help so I was left to wander the street in a country where I didn't know the language.  This was enough to deter me from wanting to do a long distance ride on a bus with more than just a backpack.  In relaying my dream story to some of the people we met, they said it was actually a common occurrence, so keep your eyes and hands on your stuff at all times!  Especially at bus stations.  Here again, there are always bad apples wherever you go.
  
  Walking. We did a lot of it.  It was a good 15-20 minute walk to the dentist office from our hotel, depending on the pace.  We walked it everyday except for one when it was raining really hard, which we were told was very unusual for this time of year.  We walked to the park, we walked to the grocery store, we walked just to explore. It is great exercise for one, and it saved us money on taxis.  It is safe to walk during the day, but do not go out walking at night unless you feel the need to be charitable to those who might want what you have. You get to see more of the local culture when you walk as it slows you down so that you can better observe your surroundings. Be sure to wear comfortable shoes if you plan on walking more than a few blocks.  I was amazed to see the shoes that the local women wore, 6 inches heels for instance!  I realize they work close by, but I know some of them had to walk a couple of blocks to get to the bus stop. I used to wear heels like that at work, but as soon as I got home it was bare feet all the way!  Comfort over style for me!  I did wear sandals a couple of times we walked to the dentist office, we walked at a slow enough pace that I didn't get blisters, except for the very first day and we were practically speed walking so I did have one blister to contend with.  Also, be aware that even though there are sidewalks, they are in very poor condition in most places.  Tree roots break them up and cause upheavals of the concrete, holes from work that had been done but never filled in, missing sidewalks altogether with just loose gravel in its place.  I can't tell you the number of times that Bakty or I tripped over the same piece of concrete sticking up, and we knew it was there!  Just be careful and watch your step and enjoy your walk.

Next post: More Questions Answered

Researching Costa Rica for Dental Implants

   On February 25, 2013 my husband, Bakty and I boarded a plane to Costa Rica.  It was a fairly quick decision on our part to do this, 2 weeks to be exact and we were off.  However, it wasn't without some consideration that we chose to go to Costa Rica to have dental implants done for Bakty.  

    We had discussed the option for at least a year before we made the decision to go. We knew about medical tourism from friends & friends of friends who had gone to other places for different medical needs. They were satisfied with their results, but most importantly they were satisfied with their cost!  Imagine getting professional, safe,  high tech medical care and a vacation at the same time all for a fraction of what it would cost in the U.S.! 

   Bakty had lost 2 teeth (back molars) over the past couple of years and had one additional tooth that was in dire need of being removed.  He had done everything to try and save the tooth, but it was infected and had a cracked root and it had to come out. Bakty was in pain and it was at this point we started to weigh options for replacing it and the other 2 lost teeth.  I had already called our dentist to find out the cost of extracting the painful tooth, $250 or $350 depending on the way it had to come out.  Uggh! Bakty had had enough of the pain and the apprehension of the costs to have implants done.  He was going to need 3 implants and an additional crown for another tooth.  Total starting cost in Georgia for this-$12,000.00 Implants start anywhere from $3,000 to $4,000 per tooth in the Atlanta area.  This doesn't include all the additional costs, xrays, crowns etc.  Plus, if your implant fails you have to pay all over again for a new one.   Even with the insurance it can be costly!

   The decision was made, find a dentist in Costa Rica.  So the search was on.  I researched the internet to find the best possible dentist in San Jose.  There were several to choose from and after talking and research we decided on Dr. Marco A. Muñoz Cavallini.  

Here is his website: http://www.aestheticdentistrycr.com/meet_the_doctors_costa_rica.html

  Please note that I am not paid by Dr. Cavallini nor am I given any compensation by him or his office for this information.  I am simply relating our experience so that others can benefit and have more information available from someone with first hand experience.  After all, for some it can be scary just to go to a dentist in the U.S.,  so I can just  imagine the apprehension of going to one in a different country! 

  We are adventuresome, so what the heck!  We decided to be the test pilots for all of our friends and family and anyone else that would be interested in the experience.

  After talking for at least an hour with Edward, the coordinator/overall go-to-guy for initial questions, it was settled, Dr. Cavallini was our dentist.  I had already reviewed his website and found out  he had served over 21,000 people and had read as many reviews online of him as I could.  I had a good feeling about the whole thing. I  told Edward that Bakty had a tooth that had to come out immediately and he said that would mean we needed to get to Costa Rica as quickly as possible, because if we pulled the tooth here in ATL, not only would we be paying for it, but Bakty would have to wait at least 3 months for it to heal before an implant could be done.  Edward said if Dr. Cavallini pulled the tooth there would be no charge and the implant could be done at the same time. No Brainer!

  Now to find flights... Best price $632. RT- Delta, straight 3.5 hour flight directly into San Jose!  Yea! Flight booked, leaving in 2 weeks -February 25, 9:45am (EST) arriving in SJO 12:45pm (CST).

Lots to do before we leave-
 
  In between the time that I first spoke with Edward at Dr. Cavallini's office and our departure day, I sent an email of our current dental x-rays so that they could evaluate them and give us an estimate of what might need to be done and the overall cost involved.  I got general pricing when I first spoke to Edward and was able to get a rough estimate before booking the flights and I made sure I over estimated our cost so I wouldn't be sticker shocked.  I had also decided that I would see about having some of my crowns replaced.  I received several email correspondence from Dr. Marco, Dr. Cavallini's son.  The emails contained quite a bit of information on procedures. pricing and what to expect as well as a map of their office location. 

Next a place to stay-

  Not having any idea of the best hotel to stay in and what was a reasonable price, I went to Edward again for help.  I had already done research online, pricing was anywhere from $120/night and up.  The clinic has a hotel right next door but it was booked. At $73 a night, no wonder!  The clinic is owned by Dr. Cavallini and it is very convenient especially for people who might have a considerable amount of work to be done and/or that don't want to be too far from the clinic. He suggested a few hotels,  and I gave him my criteria.  First and foremost it had to have a nice pool, I wasn't traveling all the way to Costa Rica and beautiful 80-ish balmy weather and not getting a tan! We wanted the hotel to be within reasonable walking distance to the clinic, and a kitchen would be great.  Edward made arrangements for us at The Cristina Hotel and matched the clinic hotel nightly rate as well.  

Here is their link: http://www.apartotelcristina.com/ 

  Things were coming together quickly over the next 2 weeks as I prepared for us to leave Atlanta's 30 degree weather and head on our new adventure, knowing we were headed to warmer weather made it even better.  

  But arrangements for animals, house and son had to be made, after all we will be gone for 14 days.