Costa Rica, Parte Uno (or "how Kelvin got over vacation PTSD")

Costa Rica is FABULOUS.

When K and I were deciding in December-January where to go for our March-April vacation, we were torn. Still healing from our October-November India vacation disaster which you can re-live here, we were a little gun-shy when it came to our next trip (esp an international one). We have always wanted to visit Costa Rica (a country about which no one has anything but great things to say) and my parents (who'd visited just before Christmas) encouraged us to give it a whirl. But it was kind of tempting to go somewhere a little less exotic and to "take it easy" or even take a "stay-cation."

When we had decided that we could probably handle Costa Rica, Kelvin tried to talk me into arranging a group tour (like riding on one of those tourist buses that we joke that "old people" ride and which we would highly recommend if you are thinking about visiting India). However, I always seem to think that, despite their making transfers and long-distance travel very easy, you end up overpaying for such tours and that we (particularly thrifty travelers, and even more thrifty in light of trying to save for the big day) could probably do things much more cheaply. We got a steal of a round-trip air deal from LAX, flying on a Monday, and (returning on) a Tuesday, booked a few hotels ahead of time, but are just "going with the flow," and it's been great. There have been absolutely no issues in getting around.

Here is a guest post from Kelvin, who kept exclaiming the whole way home from the international airport outside of San Jose, "I can't believe how great this is!" And it's just gotten better.

"Costa Rica #1"

Dear journal:

TINI (This is not India)!

Reasons why our Costa Rica vacation is not a sequel to India:

No honking during taxi ride.

Streets are cleaned.

No hassling by taxi drivers.

No one trying to sell us something.

We arrived in Costa Rica at 6 pm (on time), crossed Immigration, picked up our baggage, passed Customs, got a taxi and was on the road by 6:30 pm; reached our hotel, and got into our room by 7 pm.

During our car ride, we passed numerous restaurants serving MEAT!

We can understand and speak the language.

So far, not an ounce of stress crossed my mind. I have not tried to come up with a back-up plan in case we get stranded. I’m pretty sure I’m going to get a nice sleep tonight without nightmares of being tricked, mugged, or lied to.

This is what a vacation should be!

Sincerely,

CR #1 Fan" (pictured below).

As I wrote, it has only gotten better since we arrived, making this surely one of the most enjoyable and relaxing vacations I (we) have had in a while. In San Jose, we stayed at the delightful Hotel Aranjuez, which impressed us the morning after our arrival with a dramatic and delicious breakfast buffet including every type of fresh fruit you could imagine, juice, cereals, breads, cheese, meats, eggs, quiche, Spanish rice, omelettes-to-order, coffee, and tea. What a great way to start the day!

We took a hassle-free taxi ride (where the meter displayed the fairly-calculated price) to the bus station (the correct one; as there are several in the city), where we asked for and were sold the correct $4 one-way tickets to La Fortuna, with the reported departure time the same as that which signs specified and which we had researched ahead of time. Friendly Ticos (Costa Rican natives) conversed with us in line, without wanting or needing anything. We stored our luggage under the bus without fear that it wouldn't be there when we got off. En route, the bus driver stopped to pick up some children, walking home from school, just to give them a lift. We were not told we needed to get off the bus prior to it arriving at the station. We arrived a half-hour ahead of schedule. While we were greeted by several tour company representatives, they were only helpful in pointing us in the direction of our hotel and asking us to consider their packages (which we willingly did, later).

We checked into our hotel and enjoyed a lovely lunch of Arroz Cantonez (well, K did) and ceviche (guess who ordered that) before wandering a bit around the quaint town of La Fortuna, which sits not far from the base of Arenal Volcano, an active volcano which had its last major eruption in 1968 but which spews a little hardened lava here and there.

Charming La Fortuna

We took an afternoon-evening tour which offered us a chance to see some of the surrounding areas and experience some of our "Costa Rica firsts"

• The waterfall (Catarata in Spanish) where you can swim, or jump off the rock amidst the stream (I found the water too cold to swim, but K headed in).
  

• A chance to spot wildlife, including iguanas, and this toucan!
  

• Watching the sunset over Lake Arenal

• Soaking in some natural hot springs (a hot river!) outside of town. I had never been in a natural HOT river before! Sorry there are no pictures (non water-proof cameras were not deemed a smart thing to bring, as we had to slide down some mini-waterfalls to get to the springs).
  
  Today was filled with more new adventures:

• Spelunking
  

This morning, we took a trip to Venado caves, a series of caverns dating back over 7 million years, carved out of water (formerly the ocean) running through limestone. We were told not to bring our camera, for fear it would get wet, but I don't think either of us realized what an adventure we signed up for! Luckily, we had both a guide and a flashlight, but we found ourselves rock-climbing through crevasses (the movie 127 Hours came to mind!), army-crawling through some water-tunnels 40 cm wide, ducking so as to not smash our heads on hanging rock, dodging bats, and trying not to come across any of these:


(luckily, we didn't)

These, however, were fairly plentiful: (luckily, they don't eat humans)


Here are some stolen pictures of others doing what we were!

• 

• Segway riding!
  

K and I have both been interested in trying out Segways... apparently there is a city tour of Sacramento you can do on them. However, when we noticed a Segway brochure here, we jumped at the chance to try them out! The two ladies who led our tour of Fortuna were Americans marketing Segways here (both to sell, and for use in tourism-- as Costa Rica is a very eco-friendly country). We caught on fairly quickly (I feared that I would do a face-plant, which is actually nearly impossible to do; the machines just sense your weight shifts), and had a great time riding around! They are actually quite remarkable-- they apparently just need their batteries charged periodically, can be parked and not stolen as only the owner's "key" can make them work, and can be ridden in rain, sand, snow, and off roads!). We are both kind of "sold" on their functionality and Kelvin is currently plotting how we can get one (they run somewhere between $6000-7000).

• Baldi Hot Springs-- This resort, just outside Fortuna, boasts one of the world's largest pool complexes, a series of 20+ (hot) pools, of 12 different temperatures (the hottest being a mere 152 degrees Farenheit!). We passed a great couple of hours there, popping in nearly every different warm pool (but couldn't handle that 152-degree heat), trying out the water slides (I LOVE roller-coasters and just had to try all of the slides, which are the closest I've come in years!), as well as visiting the swim-up-bar for a Costa Rican pina colada. Can you believe that, until today, I had never had a drink at a swim-up-bar? Quite glorious, I must say.

Here is us with the "Baldi lady" at the entrance

And enjoying the pools...








AAAH!!!!!!!!!!!!!!!!!!!
THIS is what vacation should be about!
We head tomorrow to Monteverde (Cloud Forest) and then to the Pacific Coast.
Pura Vida, as they say here!

Breather(s) Needed

I am currently on "vacation." While I remember needing vacation very desperately during intern year due to feeling particularly run down, I don't think I have needed another vacation as much as I currently need this one.

I know it's probably been obvious from recent past posts, but I have been incredibly stressed out lately. It is not really stress while at work that has been keeping the anxiety level high. Even on OB, things seem quite manageable this year. FP clinic, including the millions of notes which seem to be piled up at the end of the day, is not as daunting as it has been. The bottomless EMR inbox is under control. However, it is the after work tasks cutting into normal down-time which are making me feel run-down and exhausted. Now having a job secured and with the end of residency in sight (just a mere trimester left!), I feel like I should be coasting, enjoying our last few months in the Sacramento area and spending time with friends; however, more than ever, I feel like a gerbil spinning my wheels in a cage, just trying to stay afloat and finishing everything that needs to get done.

It is times like these that I am just looking forward to the day (?post-wedding?) where I can go to work (or call), do my thing, come home and just relax, without having to plan or do anything (does this actually happen? Perhaps in a world without kids). I underestimated the time it would take to prepare for OB M and Ms (while one is done with, another one awaits me 2 weeks after return from vacation). I really underestimated the time it takes to plan a wedding. I underestimated how much insomnia (including nightmares) and poor sleep quality can affect your psyche in the negative. I am not sure I have ever been as tired as I have been in the past month.

This brings me to the question: are "vacations" periods where you are supposed to just let go of all of those things hanging over your head and truly just kick your feet back, knowing that a ton of work awaits you upon your return? (This is something that I have a lot of difficulty doing but which K does quite well). Or does it make sense to do some "work" (= wedding planning and other miscellaneous tasks, which are not very fun to me) while "on vacation," as it makes your life upon return incrementally less stressful? I'd be interested to hear your thoughts.

I have been able to let go a bit since Wednesday and, thanks to César Chávez (a Mexican-American civil rights activist), whose birthday is a holiday in California (among seven other states), we got to start our two-week vacation a day early.

Kelvin's sisters Theresa and Katherine flew up to Sac on Tuesday.

On Wednesday night, we (along with Kimie) all went to the Lady Gaga concert at (formerly Arco Arena; now) Power Balance Pavilion. While the show (main act didn't start until 9:30 PM!) didn't conclude until after midnight, which was way past my bedtime, it was really entertaining, as were some of the concertgoers' costumes!

Theresa was the only one of us who was inspired and fun enough to create a costume for the affair, which bought her a VIP entrance to the photo booth at front, as well as many photos with random strangers; her "telephone" hat was quite awesome, don't you think?!

(the rest of us-- Kim, Kat, Kelvin, me in boring attire)

On Friday, we drove down to Westminster and enjoyed some time at home with K's family.

We've gotten to watch some great college basketball games (although Richmond is out, fellow Richmond school VCU got its revenge over Kansas and now I am torn who to support in that final four game! I have fallen in love with Butler, esp with their heroic game over Florida!).

We have run on Sunset Beach, hung out with some of K's old friends in Orange County and enjoyed some rousing karaoke, as well as (as always, down here) great food, including Bruxie waffle sandwiches in downtown Orange, and Korean BBQ today.

Tomorrow, we head to Costa Rica for 8 days. Aah.

Life is fairly good right now, with about an extra 10-14 hours a day to myself.

Can't wait to sit down with a good book and do some leisure reading.

However, this vacation ends in 2 weeks and then it is back to the full grind.

What I am most excited for is post-wedding relaxation.

Today, we booked our roundtrip honeymoon tickets to:

and:

After the wedding, after boards, either before or after our move to Arcata, in late July we are headed to Bali, Indonesia, and then to Malaysia to spend time (per Hellen's recommendation yesterday) to visit the Perhentian Islands.

We can't wait for the *real* vacation :)

Under-arachnids

Back in the day, I was much more of an avid basketball watcher (and player) than I am now. Alas, residency has gotten in the way of much of my former sports interest (and partipication in pep bands and musical groups of the like); however, I just wanted to put out there how proud I am of the basketball team of my alma mater, the University of Richmond, a liberal arts college of ~3000 students.

I used to love to go to the UR basketball games, and remember the excitement after, one year in the NCAA tournament, the underdog Spiders (yes, the only arachnid mascot) upset a #2 seed, Syracuse. Yesterday, the team (#12 in their bracket) upset #5 Vanderbilt with an exciting final score of 69-66, to move onto third round tomorrow, where they face Morehouse State (who also had a big upset, beating Louisville 62-61).

Due to my inability to get any channels of TV at my apartment (for unclear reasons), it is unlikely I'll get to watch very much or any of the game (which may not even be broadcast-worthy); however, I will be cheering inside and will be looking for the final score.

Go, Spiders!

Lasts

It is March 17th 2011. The last day of residency is June 30, 2011, which is fewer than four months away (106 days, to be exact) ...

While I am still trying to stay motivated to keep up with patient care, diligent reading, and some required (albeit painful) tasks of residency, excited to move on to the "real world" and seeming "real life," I am also starting to realize that the time of "lasts" has started, and those "lasts" aren't all good.

I am seeing some of my patients for the *last* time. It is the *last* time I will do a well woman"exam on some of my young, healthy, continuity patients that rarely come in for other reasons. Yesterday, I told one of my favorite patients whose baby I delivered last September that "There is no rush, but you are due for a pap some time in the next year." She warmed my heart when she said, "Well, is it okay if I do it this June, just so that I can see you one more time?" And then there was the added, "Is there any way you could come down from Arcata for my next delivery?"

I am seeing some of my continuity babies for the *last * time-- now that some of them are over 18 months, they may not need to "return for next well child in 3 months." In the field I chose where I so much value continuity and relationships, the fact that I am leaving is rather depressing.

Tonight, I am on my *last* FP phone triage call of residency (let's hope it stays quiet).
This Sunday, I have my *last* FP wards call (I am praying that the team discharges some of their 20 patients before then ;)).
I have my *last* block of OB coming up in April, just after my *last* residency vacation.

This (well, once it stops pouring and we can actually get out there) is my *last* season of frisbee-playing at Curtis/McKinley park on Tuesday afternoons (although I hope the tradition will continue in our absence).

While I really like it here, I don't know where life will bring us-- this may be the *last* time I ever live in Sacramento. It will be the *last* time I have my own apartment.

It will be probably the *last* time I am surrounded by so many people of a similar walk and path, such good friends, and a built-in family in a place where, four years ago, I knew no one.

It is a season of lasts but I hope to make the memories last, too.

Revived

I have literally felt like an out-of-the-loop zombie for most of the last 2 months!

I am coming off a 6-week block of OB which is a time frame which far exceeds my attention span and patience for the L and D environment (I am not quite sure how the OB residents tolerate their 8-10 week blocks). I spent half of that time (including last week) as the chief on nights which always wears on both my spirits (mainly due to the ridiculous ER) and energy, as I tend not to sleep well during the day. And then, to top it off, there are the lovely post-call Friday AM clinics where I am annoyed by patients whose concerns, after 18 straight hours of working and pushing 80+ hours in a week, often just don't seem that important.

I don't really have much to say for "what I have done" in the last 6 weeks.
We shucked some oysters. K and I went skiing at Alpine Meadows one Sunday a few weeks ago, when our chains luckily did NOT break and we (well, I) had a great day on the super soft Tahoe snow (I think Kelvin got a rib contusion from snowboarding :( ). We watched the Oscars at Wai Kiu's house. We spent time at the Family Medicine Network Educational Conference last weekend. Today, we went to church and K dragged me to see a movie (Cedar Rapids; quite funny) because I literally haven't done anything "out of the house" in what feels like forever!! The wedding planning has basically been on hold.

This weekend, I mainly just slept. I don't know how it is possible to be so tired, but in the 36 or so hours from Friday afternoon until Sunday (this AM) morning, I was awake for about 12 total hours (1/3 of the time). It just is bad luck that we had to lose an hour this weekend...

So besides stressing about presenting OB M and Ms in a week or so and the never-ending wedding checklist, I am loving getting back to "normal hours" and "normal life" where I may be able to eat dinner at a reasonable time, get some exercise and, yes, sleep again...! Looking forward to Costa Rica in two weeks!