Be the bearer of good news over the holidays

The holiday speak is all about the “seniors” this year – and their limited choices for lifestyle.

Throw out a life-line to family members

Check out the new Google interactive map on our home page where you can see at a glance popular places where others, like yourself, are living better lifestyles requiring less income and enjoying better healthcare benefits sometimes as cheaply as $22 a month.

Use what you see on the map as a conversation starter at gatherings of extended family over the holidays.

Typically four generations are being affected by the retirement decisions of people in their 60’s.

You can be the bearer of hope in this daunting economy.  Introducing topics that offer more “choice” will lift the spirits of an entire gathering.

“Light at the end of the tunnel” conversations

That old cliché is true, “you have nothing to lose and everything to gain” by starting a dialogue that will at least reveal a base-line of what family members think about their own or their elder’s retirement.

At best, you will plant some positive seeds of thought that will bear fruit for great grandparents, grandparents, parents, and for the grandkids.

Don’t know where to start?  Click Here to read some topics for discussion recommended by retirement consultants.

The Fresh Face of Change

I get to write and search for other people who have answers to the questions we all have regarding living a full life in our 50′s and beyond.  And that excites me and gives my life meaning.

Let me know, by clicking on this virtual “show of hands” if you get excited by the idea of being part of our team exploring retirement hot spots for your individual needs and to help others.

I find it interesting that I’m seeing a lot of “hands up” from medical and health care professionals.

For example, in an email I received yesterday, a U.S. surgeon asked:

“I wonder if you’ve come across resources for USA trained, USA citizens to become licensed, practicing physicians in other countries?  I believe this will be a topic of great interest in coming months and years (for obvious reasons) and I am considering writing a guide myself if I can’t find one.  I personally envision living aboard a boat and practicing in Chile or Malta.”

Fun on Medical Vacation to Costa Rica

Medical Tourism in Costa Rica – Dental Tourism in Costa Rica -Medical Vacation in Costa Rica

Why not take a vacation, meet some great people and tour some of what Costa Rica has to offer?

Costa Rican Medical Care (CRMC) is again working with PROMED the Council for the International Promotion of the Costa Rica Medicine to promote the Medical Travel Conference April 23-25, 2012 in Escazu, Costa Rica.

Costa Rican Medical Care is one of the select few medical tourism facilitators recommended by Traveling 4 Health and Retirement.  We know the company’s principals and have talked with a number of their satisfied patients who have shared reports on their experiences and the services provided.

My husband and I have fond memories of our trip to Cost Rica for the 2009 conference when we were hosted by Tim and Viki Morales, President and Patient Coordinator of Costa Rican Medical Care.  It wasn’t just what we learned at the conference, it was what we learned at the beach and over lunch and dinner listening to Tim and his wife Viki, who have years of experience to share.

Conferences are a great place to gather information, browse the booths and talk with professionals about what you want.  But how often do you get the opportunity to spend enough time with providers to get to know the people behind the company?

This year’s host hotel will be the beautiful five star Inter-Continental Hotel located in beautiful Escazu just outside San Jose.  The hotel is conveniently located across from the recently-expanded Mutiplaza Shopping Center, a true international shopping mecca.

Your Early Bird Price is only $500 for Single or $600 for two attendees double occupancy sharing a room.  Room cost for the 4 nights alone from the hotel’s website is $976!

I encourage people to take advantage of the hospitality and knowledge Tim and Viki have to share.  It’s refreshing to get to know a company’s philosophy and practices and investigate an industry while building a relationship with industry leaders rather than being held at arms-length, which is certainly more often the case at conferences.

Add that to having a chance to tour medical facilities of interest, and you are now much better prepared to make a decision based on not only on cost and but also on quality considerations.

What you’ll like about the Medical Travel Conference in Cost Rica is that there are no “added costs” for tours of facilities or access to seminars and workshops.  As attendees at other conferences can attest, that’s not always the case.

Perks of being hosted by Costa Rican Medical Care

I can assure you from first-hand experience, that this is a company that does a first-rate job of hosting.  You will hear honest opinions, get to know personalities and philosophies and come away with trusted resources to call for your or your company needs.

The following story was told to me by Tim Morales:

“In August, an employee benefit advisor along with his wife contacted CRMC about offering their services. They flew down to Costa Rica to visit the medical and dental providers and decided to each get complete physicals while they were there. During the booking process, his wife mentioned that she had just had a Mammogram in the last 60 days and did not need that included in the physical. Because the physical included a breast ultrasound, Viki urged her to take advantage of having the test as a second check.  This test showed two spots that were not seen with the Mammogram. Within 90 minutes, she was seeing a specialist for biopsy and removal of the two affected areas. They could not believe the prompt and caring service they received from the hospital and doctors and said that if this had happened in the States, it would have been weeks to get an appointment to see the specialist. They were very happy that they had taken Viki’s advice, as the problem would have gone undetected.

If, like many people, you think of Costa Rica as a third-world country with antiquated health care, I urge you to take advantage of this conference and the special early bird pricing available to find out the real truth about the care and facilities in Costa Rica.  You’ll come away with a new perspective and appreciation for what’s available to the medical tourist.  And you’ll have the added benefit of a five-star stay added bonuses at a big discount.”

Whether you’re an individual curious about treatment abroad or a company representative interested in benefits for your employees, this is a unique opportunity.  For more information, please visit www.costaricanmedicaltourism.com.

A New Understanding of Jet Lag, photo credit to Virginia.edu

Sleep on Medical or Wellness Holidays

- by Becky Mackay, special to Traveling 4 Health & Retirement .

Whether you are travelling by coach for just a few hours or embarking on a longer international journey, travelling on medical or wellness holidays can disturb your natural sleeping pattern and cause a number of problems. Without adequate sleep you may find yourself irritable, frustrated, or simply unable to enjoy the new sights and attractions found at your holiday destination. Here are a few ways that your sleep may be disturbed while on a holiday and how you can fix the situation.
Uncomfortable Seats: Whether you have a red-eye flight or an overnight train journey, you may be unable to sleep thanks to seats that won’t recline, don’t have adequate legroom or are simply too small. When you do fall asleep, neck or back pain can wake you up. To avoid this problem, considering travelling with a small neck pillow, which provides a way to relieve pressure when sleeping in a sitting position. A small cushion from home can easily do the trick, or for light sleepers, a specialised half donut shaped pillow, which wraps around the neck, providing both support and comfort. To ease the whole body bring another pillow to prop behind the back and drift off into uninterrupted sleep.

Snoring: Falling asleep on a plane while feeling uncomfortable is one thing, falling asleep on a plane if you or a partner are prone to snoring is another. Embarrassment can ensue regardless of whether you or your other half suffers from snoring, but there are ways of avoiding these noisy, embarrassing moments. Sleeping on your side and avoiding coffee, alcohol and cigarettes before and during the flight are all easy methods to decrease your chances of snoring. If these haven’t worked then try one of the over-the-counter remedies, including nasal sprays and strips. If you have found no luck with these treatments then a visit to your doctor may be in order and they will be able to provide you with simple medical procedures for the treatment of snoring.

However, if it is a stranger’s snoring affecting your travel sleep, it is always a good idea to take earplugs with you, just in case.
Jet Lag: Once you have arrived at your holiday destination, you may face one of the most frustrating travel inconveniences-jet lag. By travelling long distances over various time zones, your body clock becomes confused. The best way to avoid this is to prepare in advance. If you are travelling to the East go to bed later and wake up later to adjust to the time. If you are heading West, do the opposite, sleeping and waking up early. Once you arrive begin eating the meal of the day according to the current time zone and spend some time in the sun to align your body with the natural circadian rhythms.

Whether your sleep is disrupted on a plane, train, or even in your own hotel room, losing sleep can really put a damper on your holiday. By following these tips you can make the most of your trip and resolve any sleep disturbance issues you may face.

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Becky Mackay is an online writer, with a keen interest in health and lifestyle. For more top tips visit her twitter page @FreshHealth11.

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Related article:  A new understanding of jet lag
Study explains why biological clock is slow to reset after transmeridian travel.

Entrance to Bumrungrad Hospital, a private hospital in Thailand catering to medical tourists

Medical Malpractice in Thailand – Medical Tourism in Thailand – Medical Tourists in Thailand

It is rumored that Thailand is actually considering legislation that would make it less complicated for both Thais and foreigners to sue for medical malpractice.

A T4H member’s post on our page Understanding Medical Malpractice in Foreign Countries informed our readers of pending legislation with a link to a Thai law firm, Chaninat & Leeds.  And although the firm has not responded to my inquiries about the law, I was able to find credible sources with opinions on the implications for medical tourists in Thailand.

The new law appears to offer indigenous and traveling patients compensation for malpractice.  It has been prepared under the principle that patients suffering as a result of medical error deserve compensation and treatment without having to wait for any inquiry or the need to bring the case to court.

“Although the main purpose of the draft is to help poor and middle-class Thais, if the law is enacted with such details as the draft now carries, the law could end up benefiting foreign patients, who could file charges against private hospitals which cater to wealthy Thais and foreign clients”, said Dr Vithoon Eungprabhanth, an academic at Thammasat University’s Health Laws and Ethics Centre, (source:  Bangkokpost.com, 7/29/10 “Compensation for malpractice: a boon for patients”).

There is, of course, opposition with valid concerns.

“We have opposed the bill not because we don’t want to help patients,” Dr Methee Wongsirisuwan insisted, “We just object to legal clauses in the bill because they will benefit no one”. (source:  “Angry doctors say parts of Malpractice Bill benefit nobody”, nationalmultimedia.com, 8/20/10 by By Chularat Saengpassa).

T4H member, Dick Atkins, specializes in assisting companies and individuals on legal issues in foreign countries.  He is the author of “Chapter 12:  Legal Rights Affecting the Medical Tourist” in the book “How to Plan A Successful Medical Tourism Trip.

Atkins provided the following opinion on the law:

“I have mixed feelings about this [law]. It is interesting that Thai hospitals are among the best in the world for Medical Tourism and complaints are few compared to other places.  Lack of a remedy if the procedure goes wrong does not appear to be an important reason for not getting such treatment in Thailand.  It is important to see how the fund will be funded.  Will the extra costs be tacked onto each procedure and make them too expensive?  Probably, the amounts to be disbursed will be modest, reasonable by Thai standards, but not high enough to make much of a difference in the selection of a country for treatment process.  But that is an educated guess.”

“Overall, I think that it is a responsible idea and a positive move and that a well worded law and well funded compensation fund should attract more medical tourists to Thailand and give those seeking treatment there peace of mind.  Also, the availability of that compensation may lower the costs of the US policies which compensate for errors and their medical costs. So, that is my preliminary view,” said Atkins.

Dick Atkins, owner of Dick Atkins, Esq. is a Philadelphia lawyer and owner of International Recoveries, LLC.  Atkins lectures at travel insurance conventions.  He is on the Board of Directors for the United States Travel Insurance Association.

Curious about medical tourism in Thailand or what it’s like for non-Thais to live in Thailand?  Read more here.

Arnon Krongrad, M.D., pioneer of minimally invasive prostate cancer surgery

Prostate Cancer Treatment–Chronic Prostatitis –Laparoscopic Prostatectomy

When you’re good, you’re good; and this surgeon is one of the best – if not the best in the World at treating chronic prostatitis.

Prostate Cancer Surgeon, Arnon Krongrad, MD emailed me the following summary of the trials and tribulations of patient Jeremy Prinz of Oklahoma City, OK.  Krongrad is a member of Traveling4Health Community, and the founder and CEO of The Krongrad Institute in Miami, FL.

Because prostate cancer and chronic prostatitis is a life-altering threat to many men in the World, I am reprinting here the information for the benefit of Traveling4Health members and their loved ones.

Says Krongrad, “Patients with severe, chronic prostatitis may receive extensive, but often ineffective, treatment.

The exact extent of treatment is captured in this recent story of one patient who consulted:

• 1 internist
• 4 urologists
• 2 psychiatrists
• 3 chiropractors
• 1 pain specialist
• 1 hypnotherapist
• 2 acupuncturists
• 3 physical therapists
• 4 orthopedic surgeons

This patient did not find relief with procedures ranging from prostate injection to spine surgery.  He also found no relief with these medications:

• doxycycline
• ciprofloxcin
• amoxicillin
• levaquin
• bactrim
• flomax
• quercetin
• saw palmetto
• parafon forte
• pyridium
• prosed-ds
• elmiron
• lyrica
• celebrex
• ibuprofen
• tramadol
• lortab

As graphically shown below with his post-op Chronic Prostatitis Symptom Index (CPSI) scores, this patient did find relief with laparoscopic prostatectomy.  At 2 years, this relief appears complete and durable. You can click here to read his story in his words and click here for more information about laparoscopic surgery for severe, treatment-resistant chronic prostatitis.”

This U.S.-based surgeon should be on everyone’s list of global medical resources whether you’re traveling from Europe or cross-country U.S.A.  It saves you money and time to find the best doctors.

Expensive executive physicals done inexpensively overseas

Health Travel – Health Care -Health Savings Accounts

Heads-up for small business entrepreneurs

Running mean and lean in this economy, this cost-savings tip is for you!

An article published today on foxbusiness.com explains, in dollars and cents, how you can deduct a medical expense as a business expense.

Wow – the difference in the amount you can write-off was an eye-opener for me.

The article author, Bonnie Lee, is the owner of Taxpertise in Sonoma, CA and the author of Entrepreneur Press book, “Taxpertise, The Complete Book of Dirty Little Secrets and Hidden Deductions for Small Business that the IRS Doesn’t Want You to Know,”

Says Lee, “You better be pretty sick if you expect to be able to benefit from deducting medical bills from your taxable income.  If your adjusted gross income (AGI) is $100,000, you need in excess of $7,500 in medical expenses before you can deduct a dime.

On the other hand, if you deduct the medical bill as a business expense, not only do you enjoy the full amount as a write-off, but if you are a sole proprietor filing a Schedule C or a partner in a partnership, you will enjoy a reduction in the amount of self-employment tax you pay, specifically a 15.5% savings.”  Read more: http://www.foxbusiness.com/personal-finance/2011/08/04/tax-enigma-is-it-medical-expense-or-is-it-business-expense/#ixzz1UBH6hd3z

I’d say, forward the full article to your accountant/ bookkeeper, and plan accordingly.

Save even more money using two other strategies for reducing cost of health care for you and your family:

Health Travel

Traveling for surgery or medical tourism, as it is often coined, makes it so that even cash-starved entrepreneurs can win for their bottom line.  Most small-business entrepreneurs are not insured or under-insured.  They feed the baby first, before taking care of their own health.

As a result, it’s not unusual for small businesses to show so little AGI that there’s no room for deducting medical expenses.

So here’s what you can do:

Be smart — bundle your business trips abroad with scheduled medical treatments, and write everything off as a business expense.  For example, add a few days onto a trip out of town for a business convention in Panama, Mexico or Costa Rica.

Or if a business trip overseas is not an option, then bundle family vacations with getting needed dental and medical treatments done in some idyllic destination.  In this way, you can stretch your health care dollars to pay for family vacations.

Tip:  We’re talking light dental, cosmetic or diagnostic services; treatments that don’t take up more than a day of your precious vacation time.  It’s just amazing the thousands of dollars you can save.

Health Savings Accounts

Here’s how health savings accounts (HSA’s) help stretch that medical dollar.  You can use the funds to pay for your airfare, accommodations and the medical procedures done overseas.

If you don’t know what a health savings account is (HSA), do a little research, and I recommend you read “Every Penny Counts …”

Even though everyone’s “bottom-line” mindful these days — It’s not always about the cost – it’s about finding the best doctors.  It’s always less expensive in time and money to get procedures done by the best!  As a business owner, taking care of your health is #1 — Read about executive-level physicals.

If you have specific questions about how to find those best doctors, we’re here to serve you.  Just join the Traveling4Health Community (it’s free) and post a question in a forum or send a me a private message.

Hospital Punta Pacifica in Panama Central America

Hospital Punta Pacifica – Centro Medico Paitilla – Clinica Hospital San Fernando -

Great Reasons Why You Should Visit Panama, Central America, for Your Health

Combining healthcare with leisure travel, which is also known as “Medical Tourism”, is a wonderful option for those that wish to integrate caring for their health and tending to their soul.  Panama, which is often overlooked by the leisure and medical traveler, has emerged as an optimal destination for both.

Read “Best Hospitals in Panama”

Read “Best Doctors in Panama”.

It all boils down to quality care, and Panama is a safe medical destination. International Triage, a medical tourism company recommended by Traveling4Health and Escape Artist, is positioned as a friendly gate keeper to the best doctors and hospitals.

Shai Gold, CEO of International Triage, has managed some 3,000 cases and $150 million dollars in international medical services, and is the former founding Vice President of the International Medical Services Department at Jackson Memorial Hospital in Miami, Fl.

Through a collaborative partnership with the Bern Hotel Group, patients of International Triage and their families can choose from a wide variety of leading international hotel brands, or rent a condo with maid service on a long term basis, to provide you and your family only the best quality care.

How to Schedule Your Trip with International Triage

To get information about scheduling a procedure, contact International Triage to initiate a phone call and consultation for free.  For your own peace of mind, get the advice you need before you go:  Ask about a 2^nd medical opinion, or get helping planning your medical tourism trip.

Limited Face-Time For Medicare Patients

Health Care – Medicare – Medical Tourism – Baby Boomers

How to navigate the New Medicare and protect your quality of life

New Medicare affects everyone you know, no matter what age, because the looming storm of health care changes creates a high-pressure assault that will radiate out to effect cost-shifting mechanisms and reduce patient customer-service.  Read:  The New Medicare

Is a 15-minute appointment really enough to treat you as a whole person or just barely enough to treat a symptom?

The pressure on our health care system will rain on everyone’s parade and throw a wet blanket on everyone’s quality of care and challenge your quality of life.  Overworked doctors are putting us all at risk for more medical errors.

According to the Institute of Medicine, between 48,000 and 98,000 Americans die each year due to preventable medical errors.  New research shows how these medical errors are more likely to occur when doctors are overworked or depressed. (Source:  http://www.kivitv.com/story/11179590/your-doctors-health)

Is the best way to fight a storm to ignore it, to expect someone else to change the weather?  That’s not what you do in face of a tornado warning, and it’s not what you should do with it comes to taking personal responsibility for being your own health care advocate.  You should have a “safety” plan so that you don’t get left behind medically or financially.  And that’s your personal responsibility.

Be Your Own Best Health Care Advocate

Like they say on an airplane, put your own oxygen mask on first, so that you can then help others.  You may not be the pilot of the plane, but if you want to survive, you do need to be proactive.

If you have no one to turn to for advice on medical tourism, perhaps you should be the maven of medical tourism for your family and friends.  You can start by becoming a member of the Traveling4Health Community to meet people who have experience as medical patients, subject experts and medical providers.  At least do the research for your own medical needs.

Just as a weather system can be tracked across the globe, so is it possible to see that you are in the path of negative changes in Medicare.  The changes are unavoidable.  You can’t stop the consequences any more than you can stop aging — so best to prepare for the storm in order to survive and even thrive.

That takes some personal responsibility; and that’s what we see happening.  Health care is becoming consumerized.  People are taking a fresh look at the high-value options and managing their own health care options.

Health Care is Globalized – Take Advantage of The Benefits

Consumerized Health Care is, by necessity, on the grow.  Get used to traveling for high-value care; and by that I mean better patient service and equal or better quality patient care.

If that’s a big, scary jump for you, start small (most people do).  Don’t wait until you are faced with a major surgery like a heart value replacement to start your research.  Most people start with dental tourism.

And if traveling out of the country is too ambitious a step for you, then start researching where, within the country, you can travel when medical needs arise.  Since orthopedic and heart surgery are high risks for many Baby Boomers, I suggest you read about where you can get affordable hip and heart surgery in the U.S.  Read about a U.S. hospital catering to medical tourists.

If the idea of traveling outside your community is anathema to you, you can spend more to increase your access to high-value care.

Tips for increasing your access to care:

1)      Travel for cost and quality care.  Plan ahead for trips to include light-dental, elective and wellness procedures.  If planning for major surgery, do consider your destination choices carefully and the consequences of long flights and healing time.  (Read: How To Plan A Successful Medical Tourism Trip ).

2)      Spend more out-of-pocket for better access to care.  For example:

• Buy supplemental or gap health insurance.  Paying more increases your chances of being accepted as a patient by the doctor of your choice.  However, it doesn’t automatically mean you will get more face-time at appointments.

• Pay for concierge care.  For example, MDVIP.com.  President Mark Murrison says, “The issue of conveyor-style care is one reason people are looking for other ways to get better care.”

• Access to care add-on plans.  For example, telemedicine; myhousecallmd.com, and ringadoctor.net.

3)      Retire abroad for lower cost of living and access to high-value care.  For example, in many destinations doctors make house calls.  Retiring overseas, full or part-time,  you can save money and live where heath care is remarkably affordable and quality of care is equal or superior to health care in the States.

Don’t put all your eggs in one frail basket by relying on living where your cost of living is high and your health care experience may not be the best.

Evaluate all destinations on proximity to health and wellness services and quality of physicians and hospitals.

Cash in on Medical Tourism

You’ve got questions.  What is Medical Tourism?  Who Can you Trust?  Where Should You Go?  How Much Will You Save?  What About Insurance?  By reading our patient advocacy book “How to Plan A Successful Medical Tourism Trip”, you can get your questions answered and contact the patients, doctors and subject experts directly.

Dental Tourism – A Good Place to Start

Many people start with traveling out-of-country for dental needs.  It’s hard to find anyone these days who doesn’t know someone with a good experience with dental tourism.

Interestingly, we get more complaints from patients about dental tourism than any other medical specialty; the reason is simple.  People don’t do adequate research to find the doctors with the best reputations.   You can avoid that pitfall with a little education.  Read:  Find Best Doctors .

What About The Travel Cost of Medical Tourism?

Definitely consider the cost of travel and accommodations into the overall cost of traveling for treatment.  That’s why people combine vacations to exotic destinations with light-dental and wellness trips.

Tips:

1)      Working with a medical tourism facilitator will often save you money on your overall trip; not just on your procedures. Check the reputation of the facilitator as well as the reputation of the medical provider by talking to other members of the Traveling4Health Community.

2)      You can use your Health Savings Account (HSA) funds to pay for your travel and accommodations, as well as prescriptions and your procedure.  However, not all HAS insurance agents are created equal – Read “HSA Insurance Agents Manipulating Employers and Employees”.

Tips on Executive Health Management

Read about:

1.  the “Trifecta of Executive Health Management” described in this article as:

• A Health Savings Account (HSA)
• Customized physicals
• A trip to Costa Rica

2.  Private Health Screening – Why Choose An Executive Physical?

Authors Roberta Taylor and Dori MintzerDiscuss Retiring Abroad

Baby Boomers Living Abroad – Cost of Living Overseas – Health Care Abroad -

Authors discuss the risk of isolation when retiring Abroad

Traveling4Retirement articles provide members of the Traveling4health Community insights on healthcare and medical resources in other countries, but also “body and soul” wellness guidelines for people preparing to retire abroad.

Living Abroad

Deciding what’s right for you will probably take some research and many conversations involving some thoughtful self-analysis of what you want to do with the rest of your life.  Not only do you want to consider financial needs, but also how your destination of choice affects your wellness and relationship with family and friends.

Read:  Living Abroad in Your Encore Years.   Finding your next tribe.

Authors Roberta Taylor and Dorian Mintzer are valuable resources to introduce to our community.  Their book, The Couple’s Retirement Puzzle, focuses on 10 must-have conversations for transitioning to the second half of life.

The conversations in the book are meant to help each partner clarify what’s important to them, then work together to develop a shared vision around these topics.

This is an extremely beneficial book for baby-boomers, 42% of whom plan to move upon retirement and 7% of whom are considering moving out of the country according to a study quoted in the Wall Street Journal. (Source:   “He Says Maine. She Says Florida” WSJ.com, March 21, 2011).

Cost of Living Overseas

Statistics list cost-of-living as the number one reason people choose to make a move when they retire; and certainly the cost-of-living advantages of moving out of the country are impressive.  You can have that better home and live with less financial stress.

Examples of purchasing power: Compared to the U.S., purchasing power is 59.17% lower in Panama, 47.32% lower in Mexico, and 50.59% lower in Costa Rica.

Examples of property markets: Compared to the U.S., to buy an apartment costs you 21 to 23% less in Panama, 35 to 50% less in Mexico, and 23 to 67% less in Costa Rica.  (source:  http://www.numbeo.com/cost-of-living/comparison.jsp)

Health Care Abroad

Retirees cite the number one reason they hesitate to retire outside their home country is the unknown quality of health care.

The Traveling4health Community provides you with ways to establish relationships with foreign-based doctors and communicate with other Americans living abroad so you can know before you go, what awaits you in terms of doctor relationships and available medical services.  The unknown of medical services becomes known.

Health Care Risks When Living Abroad

According to feedback from people recently moved abroad, one of the least understood consequences of moving abroad is the risk of feeling isolated; a stranger in a strange land.

Do We Stay Or Do We Go?

Excerpt from The Couple’s Retirement Puzzle: Talking together about where to live is an important part of retirement transition.  The decision is usually based on lifestyle choices, geographical preferences, proximity to family and friends, health issues and needs and, of course, financial considerations.

I asked Taylor and Mintzer about retiree’s fear of isolation, and shared with them the feedback I get from Baby-boomers living abroad.

Ilene Little (IL): You have a chapter in your book that cites a story about a couple who did not have a good experience retiring to a destination they had previously only experienced on vacations.  In your workshops, do people ask you questions about retiring abroad?

Roberta Taylor (RT):  We had a couple in one of our workshops who talked about moving to Costa Rica where they had vacationed several times.  They wanted the experience of living in another country, but were concerned about adjusting to a new culture and community. The fear of isolation is so great – how do you integrate into another community where you don’t know anybody?

Fear of Isolation Living Abroad

(IL): The word “unfamiliar” is the key word here.  The Baby Boomers  most likely to retire abroad are well-travelled and especially those retirees who own 2^nd homes abroad.  These people have crossed the bridge of isolation and have experienced a level of comfort that only comes from time spent in a new community environment.

Upon retirement, many of these 2^nd home-owners do the “switcheroo”; the home in the U.S. becomes the 2^nd home, and they spend more time living abroad.  The reasons are varied, for example, cost of living, climate, and in many cases a more relaxed lifestyle in an idyllic location.

By the term well-travelled, I mean people who have worked abroad and have made friends in expat communities or have established themselves with special interest groups like artists, recreational vehicle clubs, and sailors.  San Miguel, Mexico and Lake Chapala, Mexico are two excellent examples of retiree artisan communities.  I believe Lake Chapala boasts more single women retirees from American and Canada than any other destination in Latin America.

(DM):  What’s so interesting is that when you’re younger, children and work are usually the bridge to how you meet other people.

At a later stage of life when children are grown and identity is not so tied to work, it’s not as easy to meet new people. Men often have more difficulty with this issue than women, although it can be a challenge for both.

(IL): Aren’t the two of you great examples of people embarking on a new phase of life and overcoming the barrier of meeting new people?  As I understand it, you had never met before starting to collaborate on this book.

Dorian Mintzer (DM): We actually had met and knew a little about each other through a New England-based network called Life Planning Network, a community of professionals from diverse disciplines dedicated to helping people navigate the second half of life.

The Mintzer and Taylor Story – New Friends, New Life Purpose

(RT): The idea for the book grew out of an awareness that friends, colleagues and clients were beginning to express concerns about retirement but often hadn’t talked with their partners. My husband was retiring and I was just beginning a new chapter in my work life. I had no idea how this might affect our relationship.  It occurred to me that there were many issues in addition to finances that couples needed to be dealing with as they were going through this major life transition. The topic seemed both important and timely.

Although Dori and I didn’t know each other well, I knew that she had started the Boomers and Beyond special interest group, and I felt somebody who could do that was clearly creative and could match my energy.

I called her and said, “I have a great idea.  I think you might be interested. We met for coffee, brainstormed ideas and there was no turning back.

The Couple’s Retirement Puzzle.

(IL): You just published this book recently, didn’t you?

(DM): We did, on April 5^th.

(RT): We call it a three and a half year gestation.

(IL): That’s encouraging for people to hear.  When you’re embarking on a new project in a new stage of life and with a new partner, it’s easy to feel frustrated if you don’t see results within a short time frame.

As Bill Gates says, “We always overestimate the change that will occur in the next two years and underestimate the change that will occur in the next ten; don’t let yourself be lulled into inaction.”

New Partners on a New Life Path

(DM): One of our friends commented that our writing partnership was like a quick marriage because we didn’t really know each other. Focusing on communication as the foundation of the book, we discovered that we really had to work on our own communication issues. When you’re collaborating, you may have different ideas and different styles.  Just like couples, you have to negotiate where the middle ground is.

(RT): This has been an incredible learning process for both of us.  We had to learn how to “walk the talk”.

Walking the Talk Together

(IL): That’s what I call establishing a track record of trust with people, and it’s particulalry applicable to people looking to retire abroad.  For trust to exist, you have to become predictable to one another.  I started the Traveling4health Community so that people could bridge the culture gap through a common interest like medical care.  When you find people you can trust, you can do many things together whether in business or socially.

I believe it was you, Dori, who said in one of your video interviews, that “You teach what you need to learn”.  That’s been my journey, as well.  I was looking for options for my own retirement, and I took the time to become an expert in medical resources abroad because nobody else was doing it.  I didn’t want to rely on Medicare or Supplemental Insurance Plans that would limit my ability to live where I wanted to live.

The Road Ahead

Excerpts from The Couple’s Retirement Puzzle

The traditional notion of the “golden years,” with Social Security and a condo in Florida, is becoming a thing of the past. In the 21st century, we are being challenged to redefine retirement and reinvent ourselves in order to live our version of “the good life”—having financial security, access to adequate health care, and enjoying a sense of meaning, purpose and belonging as we get older.

We are experiencing personal change and questioning how to continue to grow as individuals and as couples in this new life stage. The question for each of us is, “How do I want to live the next part of my life?

Beginning the conversation before you get to a decision-making place can help pave the way for an easier transition.

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Roberta Taylor is an experienced psychotherapist and her website is www.pathmaking.com.

Dori Mintzer is an experienced psychologist, and her website is www.dorianmintzer.com.

The Couple’s Retirement Puzzle website is www.couplesretirementpuzzle.com.

Exclusive Interview - Medical Tourism Report on Cali, Colombia

Medical Tourism Cardiac Surgery in Colombia

WHY in the world should patients consider going to Colombia?

Traveling4Health asked that question of Shai Gold, CEO of International-Triage, LLC., and a subject expert on medical care in Latin America.

Gold’s background and expertise make him uniquely qualified to answer this question.  He is the former founding Vice President of the International Medical Services Department at Jackson Memorial Hospital in Miami, FL.  Currently International-Triage maintains a presence in Florida, Colombia, Costa Rica, Panama, Dominican Republic, Bahamas and Venezuela.

Over the course of his career, Gold has managed over 3,000 international cases and 170 million dollars in international medical services.

Read:  Medical Breakthroughs in Cali, Colombia, by Shai Gold

Why Consider Colombia as a destination for Heart Surgery?

Gold responded to the question first by addressing what is unique about Colombia’s medical infrastructure.

Shai Gold (SG): “50 medical schools in a country of 45 million people results in an endless stream of medical talent, “and the private hospitals are world-class; well-equipped and supported by private foundation capital.

Seasoned physicians and surgeons practice their professional with the aid of great support teams.  Low cost environment (50-75% savings compared to USA) and proximity to the USA (3 hours from Miami), make for an optimal destination.

As a senior healthcare planner and hospital executive in the USA, I spotted these trends and decided to bank on Colombia as our key destination in the Caribbean Region.

Traveling4Health (T4H): Most people are afraid of going to Colombia due to concern for personal safety. Isn’t this an issue?

SG:  Up to five years ago it was an issue.  Colombia of the last five years has changed.  Political stability, national determination to eliminate internal conflicts and US aid have combined to result in drastic improvement in the level of safety and security.  Previously unruly places, such as Bogota, Medellin and Cali, are now booming with foreign investment and business opportunities.  Colombians are returning home en mass to help the rebuilding process and partake in the economic opportunities.  Today’s Colombia is NOTHING like the Old Colombia.

Read why a retired surgeon from Florida chose Cali, Colombia for his own heart surgery:  Surgeon Chooses New Technology For Own Heart Surgery .

Cost comparisons of Heart Surgery – U.S. to Cali, Colombia

T4H: Can you give people an example cost savings?  Let’s talk about the very expensive cardiac surgeries likely to be needed by baby boomers.

SG: Although heart transplants are not available to international patients in Colombia, what is available is a very good pre heart transplant stabilization procedure (LVAD) that in the United States cost a fortune.”

Savings of 77% or more on Heart Stabilization Surgery

SG: Cardiac stabilization procedures are required for people with very limited heart output.  A left-ventricular assistance device is implanted by a highly-skilled surgeon who is supported by a seasoned nursing team and state of the art cardiac intensive care unit.

In the United States, this procedure at a good teaching hospital will run (inclusive of the device and the lengthy stay of 30 days in the hospital) around $400,000.  In Colombia, we get that done routinely for approximately $90,000.

T4H:  What do you mean by “routinely”?

SG: It means that this procedure is performed routinely by the medical staff for local patients.  The team is very experienced and, while it is a complex procedure, it is not an anomaly-type procedure for the surgeon.  In a nut shell, experience makes for better outcomes.

T4H: Wouldn’t the need for a heart stabilization procedure be an emergency situation?  Would there be time to plan ahead for a trip to Colombia for this operation?

SG: It’s interesting that you mention that.  It is an astute observation.  “People are on wait lists for a heart transplant as a result of very protracted declines in heart output and performance.  Technically, you could be an outpatient with less than 35% or 40% cardiac sufficiency for a long time at the expense of your quality of life.

You have a poor quality of life because anything you do is an exertion that takes a toll on your cardiovascular system and on your pulmonary system.  But as long as you are managed and you are stable, and you don’t have too much accumulation of water in your lungs, you’re good to be at home.  You have time to plan to take advantage of price and quality of life considerations.

T4H: That’s an excellent example of both quality and cost comparison.  So, you’re saying that Cali, Colombia is one of the places you recommend as a destination for this procedure?

Cali, Colombia – Centers of Medical Excellence for Cardiac Surgery

SG: I happen to like Cali both objectively and subjectively.  Objectively, Cali is the beneficiary of terrific cardiovascular physicians.  There is an aggregation of many good cardiologists and cardiac surgeons in Cali in a region that 30 years ago didn’t have a single cardiac surgeon.

T4H: Wow.  What happened to affect that change?

SG: It was a planned approach.  About 30 years ago, an affluent patient and visionary Cardiologist physician by the name , Dr. Waltenberg crossed paths.  The patient was shocked to find out that he will have to be sent to Bogotá  for treatment, as it was not available at any local hospital.  He asked Dr. Waltenberg “what is needed to provide Bogotá  quality cardiac care in Cali” and gave the good doctor a large tract of land to build the best hospital in Cali.

Today, Valley de Lilli Foundation Hospital is the largest Cardiac Hospital in Colombia, offering world class services.  It has become a focal point for training new generations of cardiologists and surgeons who remained in the community and enriched the choices available for patients.  Our medical director in Colombia, Luis F. Rivas, M.D., was the second Chief of Service in Cardiac Surgery and critical care at Valley de Lilly Foundation Hospital, serving 18 years in that capacity.  Dr. Rivas cultivated and shaped many generations of young cardiac surgeons in Cali.

Over time, the number of qualified surgeons proliferated, and today there are five or six hospitals in Cali that perform excellent cardiac surgery.  The surgeons have excellent interventional cardiac skills, and the hospitals have wonderful cardiac intensive care units.

T4H:  What is the name of the center of excellence you recommend for this particular procedure; or would you rather provide a list of all of the hospitals?

SG: I knew for many years about the Valley de Lily Foundation Hospital as a center of excellence, so that is certainly a place that people should strive to go, but they stopped dealing with international patients.  So, I looked for a small boutique hospital that is very efficient and effective and safe, and I settled on a place called Clinica Dimé.

T4H:  Why Cali for heart surgeries and not Bogotá?

SG:  Bogotá is at 8,500 feet of elevation.  High-altitude destinations can be very challenging for patients with pulmonary or heart problems.  For people who can’t deal with the very high altitude of Bogotá, Cali’s low elevation represents the perfect solution.

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Visit Shai Gold’s Blog

About the author:  Ilene Little is CEO of www.traveling4health.com.  She is a reporter in the medical tourism business  and she does all of the content reviews for the EscapeArtist Medical Tourism Blog.