I firmly believe that I am not the only one to find herself in this predicament.
     I use this story to illustrate. I remember fighting for my life when diabetes first reared its ugly head. It's been almost 20 years, but at that time, my first indication that something wrong was loss of sight. I literally looked down at a menu in a restaurant one evening and NOTHING was there. No words. No images. I could see the menu in my hand but nothing else. I could not order. "I'll have the same" was all I could utter.  I felt a tinge of heat go from my head to my toes. I was more afraid in that moment than I had ever been in my entire life.
     The next day, I was in the doctor's office. After an 8-hour glucose test, it was confirmed that I had diabetes.  At that time, not the kind where you could watch your diet and it be okay. This kind required meds and injections. So I learned how to shoot needles of insulin into my stomach so that I could live. I hated all the changes I had to make, but I wanted to live. Oddly enough, I felt better, so how could I argue with this twice daily horrible stick. With more extreme measures necessary, I had a gastric bypass, plus breast reduction and tummy tuck. All making me a better person. All, with the exception of the tummy tuck, was  paid by insurance because the excess weight was comprising my life. All of these saved my life. My insurance coverage saved my life.
     Would I have had these procedures without insurance? No and no. There would have been no way to tackle these without insurance. I suppose the first lesson is to do your best to have medical coverage; the second lesson, if that isn't an option, find one that can work for you. Do it by any means necessary.
     Most insurance companies look at dental procedures as cosmetic and elective rather than routine or necessary. I have never understood that mentality, especially as I watched my mother shell out thousands of dollars in the course of my lifetime to attempt to save the teeth I would eventually lose. If dental insurance covered issues as extensively as medical insurance, I and thousands of others wouldn't find themselves in situations where they have to look elsewhere for care. Care and money would remain in local dental offices, making it easier and more convenient while supporting local dentists and their businesses.
     Len carries the basic dental insurance at his work, the same coverage that most people in the United States carry. It covers preventative visits, cleaning, x-rays. NOT implants, crowns. It's cheap coverage and pays exactly what it should. But what do I do? I need more.
     All that to say that I'm looking to save my life again. Although my quality of life is not comprised, its hard to do eat or smile. My self-esteem has taken a dive, and gumming my food is not an attractive attribute for anyone. As a travel writer, first impressions with sources make the difference between getting a story and losing one. As a photographer, my personal image portrays my self-worth to my clients and their ability to put their trust in me to capture beauty. I'm not on my game lately. I have to fix that for there lots more stories and images to capture. I have to fix me first.
     With the population aging, health care (especially dental insurance which might cover implants, etc.) growing astronomically and travel becoming easy, why not look for options and answers. Medical tourism continues to be big business throughout the world - with countries like Costa Rica, Europe, Asia becoming destinations for procedures - people are finding alternatives when none are presented in the United States.
    As we continue our journey, I hope to find more information for you. Education is a powerful thing. It takes us places you never imagined . . . namely, Costa Rica.

This weekend, we go to the bank.
     We will be wiring our full payment to Costa Rica. Wow! Again, that trust thing is taking center stage.
     If that isn't enough to get your sweat pouring, not sure what will.
     The checklist is getting smaller. To do: submit patient forms, submit my medical doctor's form, send money. Three things. Then, I go.
     But first, I must wait.
     No excuses, I promise, but my calendar looks like a war zone. I have about two weeks to prepare for the seasonal launch of my photography business, finish fine-tuning a new website, prepare for two upcoming weddings, pitch my story to various outlets, complete a photography and editorial deadline for a chamber magazine, reach out to writers and sources for the winter issue of Georgia Connector, put out all fires at home, order dog and cat food home delivery (by the way, this is the best thing EVER - CHEWY.com) call Ken and get round bales arranged for delivery . . . breathe.
     This adventure has been about three things: economics, health and fear. I fear dentists more than snarling tigers. However, I do love to eat; I do love to make money; I do love to be a success at my business; and I do love to see my husband look at me with adoring eyes. I haven't seen those lately (although he will say that is not true); I'm not sure how it could not be true. And, I haven't looked in the mirror with intention or motivation in a long time. I honestly can't remember when I looked into the mirror and actually liked what I saw.
    Leave it to a millennial to find a guru who will put my life in perspective. As my son says, "kick that fear in the ass." He's right, but you know me - a woman, a hardheaded woman. A woman whose fears have often dictated my course of actions. What is unraveling in my head is far worse that what reality will offer. I know that. Still, I fall for these thoughts.
     These are the facts.
     I will be in debt up to your eyeballs for the next three years, BUT, I will smile again, eat again, find joy again. More than anything, I will find me again. I will smile, not simply because I can, but because I want to.
    Here's Ty's take on it all . . . thanks bud.

With the stormy trail of #IRMA barreling up through Georgia, the distraction was welcomed. I had a couple of days without making a decision. In reality, I had already made the decision to go through with the procedure; but, until dates are made, flights booked, checks sent, it's still a dream.
      Well, no more putting off.
     We received the new estimate from Meza yesterday. Through communication with Len since I had been out of power for a couple of days, they explained the changes and additions due to the one lost tooth in front, the broken post in another, the chip in another. With this comes the first lesson of this experience. The 2016 estimate - granted there was less to do - was about 10K less than the estimate we received today. Never put anything off to another day; it never comes to any good.
     Okay, so now we're talking more money, but it is still considerably less that having the work done in the states. From a financial and economic standpoint, there is only one choice. The work needed is just too extensive to approach any doctors here. I have had four implants, each one costing a minimum $5,000 each (office visit, x-rays, extraction, sedation, implant, crown). Each tooth. I have more holes than I have teeth and they will have to be replaced with an implant.
     Nothing is debatable here.
     Since we tackled financing first, we borrowed according to last year's estimate. We need more. We told Jose at the dental clinic,  and in order to get us to where we need to be, they offered a 10% discount if we pay via wire transfer. We are now within budget.
     This morning, I forwarded an email to Jose, the patient coordinator to confirm October 1 as our arrival date. Gasp.
     More papers are coming including a list of hotel partners that are particularly adept at working with medical tourists. We are booking Suites Cristina which we figure will provide us with space for me to recoup and work and Len to work remotely. Plus, a kitchen. And, Meza Dental books everything for us. 
     It's amazing how most hotels that we looked at before we received the list from Meza has as special page on their website for medical tourism. Medical tourism is big business in Costa Rica, and they embrace this fact. Not only for necessities like dental or vision or hip replacement but also for elective procedures that would not be covered by personal health insurance. According to International Living, more than 700,000 Americans make annual visits here.
     Another patient questionnaire this afternoon. Medical history and the like. The same you would see at your local GYN.
     I have forms to complete and a calendar to adjust. I'm going to Costa Rica.
    

It's Sunday afternoon, and we are glued to the TV coverage of Hurricane Irma as she is barreling down on the Keys. It does nothing to steady my nerves that are building for what is about to happen. We keep busy by fiddling with the old Chevy, writing blog posts, editing images, cooking "butt" for BBQ all day long.
     Len is wacko - yes, I love you, but wacko - when travel arrangements are as fluid and unpredictable as Irma's path, he tends to get a little antsy. We are thinking that we will travel in less than two weeks. I am missing a tooth, and I'm not sure the solitude of my house is a good idea. A two week window for booking flights and securing hotel accommodations gets dicey, to say the least. We are prepared for the cost of the airfare, but we'd like it not to be astronomical. Booking this close to departure always is scary. That's why we always tell you to plan ahead. For us, two weeks is all the "ahead" we have. So, I'm wacko, too.
      We're wacko together. 
     I spoke with Jose at Meza Dental Care on Friday. He is the patient coordinator and is working to make sure everything runs smoothly. From the current x-rays of my mouth to the hotel accommodations to the photography spots we hope to explore, he's doing it all. When I explained to my dentist in Oconee about all the information and forms they require, she said, "They are quite thorough." I liked hearing that for sure. I also liked hearing the x-ray technician feel excitement for what is about to happen. Granted, they aren't the ones receiving the money, but she understands the scope of the work. "I can't wait to see the results," she said. I simply nodded and silently whispered in my head, "Me, too."
     Although Jose was not the one I initially corresponded with last year, the communication with Meza has been the one thing (thus far) that has impressed me most.
     I send an email; within 15 minutes, I have a response. Every question has an answer, and if it takes lots of explanation, he's on the phone with me.
     I like that. Very much. I call it my test of professionalism - the courtesy to respond to my email or calls within a specific time. It amazes me how many professional organizations, businesses, outlets, editors - ignore requests or even a confirmation of acceptance of an email or call. As an editor and a small business owner, I have found that nothing rattles my cage like lack of acknowledgement. And then of course, there's the "it's not my job" or "I was away from my desk" and a multitude of others excuses. There's no room for excuses in business. I don't make it a practice in mine, and I expect the same from others.
    So with my x-rays on their way to Costa Rica, new estimates and a course of treatment should be decided upon the first of this coming week. I expect a call from Dr. Meza, and at that point, we'll give the go-ahead and talk dates. 
      This thing is about to get real.  
     

It's been over a year since I wrote the first post.
     Today, I sit here missing another tooth, and as I stated before, circumstances have decided my fate. I can no longer wait. I can no longer make excuses. I can no longer hope that things will get better, for I know, I'm on a downward spiral and rocking my hillbilly roots is not the look I'm going for.
     I opted out of the choice for dentures. So, now it becomes my responsibility to find a suitable alternative that is right for me, my family and my budget. As a travel writer, I have heard the term medical tourism batted around lots. Stories abound where individuals, even businesses and industries, travel to foreign countries for needed or elective procedures, many paying a quarter of the cost in the states. It makes sense financially. I makes sense for me. Since dental insurance is almost non-existent for baby boomers - granted we have a policy that covers cleaning, x-rays, but not implants or crowns - we must consider the expense and how it will affect our family.
     Counting on my expertise in research to carry me through this, it's Meza Dental Care in San Jose', Costa Rica, that I will be putting my faith in. Dr. Alberto Meza to be exact. He's a graduate of UCLA and fully accredited through the American Academy of Cosmetic Dentistry (a must for all who seek international care). Reviews are impeccable and patient stories are nothing less than extraordinary. Correspondence is almost immediate, and at this point, this impresses me most.
     For the type of treatment I require, cost in the United States ranges from $50K to 80K. At Meza, around $25 plus travel expenses. The cost of everything is less; the professionalism the same, if not greater - at least from a distance.
     Yesterday, I was approved through their preferred lender, lendingusa.com. Today, I begin juggling schedules and responsibilities.
     Here we go . . . andiamo . . . we usually say when we're hitting the road for travel. Yes, Costa Rica should be amazing but forefront on my mind, pain and fear. Still, andiamo.