Friday, May 21, 2010

Tracie’s travel thoughts after our IVF Vacation in Costa Rica and Panama:

Tracie’s travel thoughts after our IVF Vacation in Costa Rica and Panama:


Things to be aware of: everything takes longer, more money, and more hassle than it does in the US.

“Pack half as much stuff, and bring twice as much money. “

Hindsight –

Hotels: I would have splurged and stayed right near the hospitals in a nice hotel. We don’t usually travel that way, but in this case, the stress of traveling from hotel to hotel, and navigating the roads, tolls, and simply trying to find the clinic, lab, pharmacy, etc… was too much stress. (and we are usually “stay in a cheap clean hotel and forage for food ourselves” kind of travelers.) Take a shuttle or cab from the airport, skip renting cars, and just enjoy your time there. Most tours will pick you up. I’m not kidding about the roads – they are truly horrible. And it’s HOT there. You won’t feel like being outside unless it’s in the water. Make no plans prior, and just do what you feel like. We actually did very little “touristy” things, but we had a toddler in tote.

Money: Costa Rica is very expensive. Even buying groceries, expect twice what you pay in the USA for some things. Denny’s for 3 adult burgers and two kid’s meals was $68. Most tours are around $100 per person, and expect to be gone all day, as most are 2-4 hours from San Jose. Most tours are not appropriate for young kids. Rental cars will be at LEAST twice what you are quoted, for insurance. Even if you have insurance thru your credit card. Our quote was $210, and the final cost was $479. Cars are smaller there too… a whole class or two smaller than you’re used to. Mark the previous damage carefully with the agent.

Panama was very much like the US, cost-wise. Some things are much cheaper. The nice resorts are at least an hour out of town, traffic sucks.

One thing we did that I do suggest: we traveled to Puntarenas, CR… to the Double Tree (all-inclusive) resort, during that 1st week stimming. (although you really could start stimming at home and just come to Dr. Perez by day 6) Taking the new toll road the drive is about 90 minutes, and the resort is lovely. We booked about $129 a nite per person (remember AI) and it was well-worth that money. The upgrade to high end booze or building three is not worth it, IMO.

If you want to escape to Jaco for a few days, the ride back to San Jose is about 90 minutes via that same toll road, and I have VERY nice condo to recommend near it all. $90 or so a nite, 2BR, kitchen, pool, etc. from a very nice American couple. I also have an acupuncturist/massage lady in Jaco that I adore. She’s willing to travel to San Jose if more than a couple of you “hire” her.

Knowing simple Spanish will help a lot. Some English is spoken, but not as much as I had hoped. Dr. P’s nurses speak very little English, but I did not need them at all. Remember you are in THEIR country, and they are not required to speak English just because you do. Speak slowly, with simple words to get your point across. We did have a couple times where we felt Dr. P’s English was not sufficient enough to understand what we were saying. When in doubt, ask him to repeat it, or say “tell me again what you mean, please.”



Money:

Bring lots of USD $20, no larger bills if you can help it. CR will take USD, and Panama uses them as their currency. Tips are usually included, check the menu for details. We used our credit card (that does not charge a conversion currency fee) and small bills. Save all your small colonies (local currency) in one handy place if you’re driving, there are many highways that have tolls of 200-500 colonies ($1-3) each. (be aware that there are “quick pass” lanes on the far right, avoid them since you’re paying cash.)

Petty theft is HUGE in Costa Rica – watch your wallets, cameras, anything left on your table as you eat, and turn your head away… but we felt very safe. But we are “seasoned” travelers. Most neighborhoods, resorts, and even the stores, have lots of security guards. When in doubt, just ask the front desk or a local. Lock your doors when driving, and know where you’re going.



Doctor:

Dr. Perez was very pleasant. According to a local (who moved from Chicago 5 years ago with her husband) Dr. Perez is “thee” doc to see in CR for IVF. His walls are filled with tons of piks of the babies, and his schedule is booked SOLID 8am to 7pm six days a week. He is VERY busy. He is very straight to the point, and does not use extra words in any way. You may feel rushed in your appt, although we often waited 60-90 minutes past our appt. time to see him. Ask your questions in a simple way, straight to the point. NO EXTRA WORDS. There was a language barrier to some extent. Make sure he understands what you are asking. (I have found working thru Mark Semple, Passport Medical, MUCH easier, in a huge way, but keep in mind, he won’t butt in your personal doc-patient relationship. That’s not his role.) Dr. P is a perfectionist, and his office, the way he does things… it’s all done with precision and attention to detail. Not my style in a buddy, but for a doctor, I’ll take it! A sense of humor gets lost in translation. Don’t even try. Het het.

All said and done… this way is great if you’re looking to do a standard antagonist protocol IVF, and don’t have anything too far outside the box. It’s a bit of a “one size fits all” approach to doing it, which he seems to pull off amazingly well. I personally think he overshoots the moon to get you pregnant, and didn’t seem worried for one second about putting in too many. He even made the comment – “do not worry, many die early anyways.” Um, not what this momma wants to hear. I got the feeling he cares very little about your history, diagnosis, etc. Just do A, B, C and he’ll get you D. I can’t really say this is “bad”… but it’s different. There will be no coddling. Sorry. None.

The ER & ET office is tiny. You literally get knocked out while laying on a small table under a shelf. It was kinda funny. You do not get a fert report, he does not see what you have until you are standing there on day 3 outside the glass. We insisted on a few minutes to discuss (alone) which he willingly gave us. I’m actually questioning the “extras” like embryo glue, assisted hatching, etc. but can’t make claims. I just suspect those are fluff words. He says he’ll go to day 5, but we didn’t have that luxury. (nor did anyone we knew) I wore a tank top under my paper robe. They are very small. I am not. Ha. I was in a LOT more pain than I planned on. Ouch. He says you can swim after ER, but not after ET. It was so hot, I did swim in pools, not oceans, post-ER. I stay dry post-ET. DO NOT GET SUNBURN. You’ll be miserable.

We paid the $2450 in cash to him (or you can wire the money) and the clinic the (3) u/s appts by credit card. ($75 each?) Other costs unexpected were: estrogen patches to help my lining $90, E2 bloodtest $40, and the progesterone he offers, $100. (be aware it’s 17P, and once I did my homework, I found that to be a dangerous form of p4 to take in my case. It’s been taken off the market in the US, and only used to prevent PTL, later in pregnancy, and there are many issues I take with it. But do your own homework, or just bring a couple bottles of PIO with you from home. )

All in all, I am happy I did it this way. Like I’ve said all along… a $20K failed IVF would have been too much to swallow. I think this trip cost us under $7K. (we had hotel perks, however).

If you have any additional questions, I am more than willing to help.

-Tracie

5 comments:

  1. Thank you very much. This is really helpful! We are excited to see your outcome!

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  2. Any suggestions on where to stay while in Panama?

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  3. How often did you have to go in for ultrasounds, blood work and to visit the doctor while in Costa Rica? I am thinking of doing this option in September and am trying to figure out how often I need to be in San Jose.

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  4. Thank you so much for this blog, DH and I just found out about this potential opportunity and are interested in learning more.

    Most likely we will have to use donor eggs, which after speaking to Mike at Medical Passport, we understand the donors typically come from Columbia. We'll need to do 2 days in CR, followed by 6 days in Panama for the transfer.

    My question concerns the estrogen and progesterone they prescribed. Is that something I can have prescribed by my own doctor, rather than the doctors in Panama/Costa Rica?
    Thanks!
    Jen

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  5. Oops "Mark from Passport Medical".

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