A day in Boyaca


in the colorful tourist town of Raquira

Big news dear readers.. It doesn’t entirely excuse my long absence but great news all the same.. After during a myriad of things during the last two years (like everyone else during this pandemic), I have finally received my Colombian visa. This allows me to stay in country for longer stretches. I am currently still back and forth quite a bit, while I supplement my income working in the USA, until my company can one day be self-supporting (if ever!) Right now, it’s still basically on pause – but hopefully that will change soon.

The pandemic has turned our lives upside down, but it’s also reminded us of what’s important. To me, it’s important for me to be here – and to continue to build my life here. Part of that is enjoying all the wonderful and beautiful things here – animals, flowers, nature, history.. and of course, FOOD. I’m not sophisticated enough to be a ‘foodie’ but I sure do like to try new flavors, tastes, fruits and vegetables.

I’d been feeling a bit hemmed in, with all the changes due to the pandemic, previous restrictions and missing my Sunday routine. So, I went on the internet and called a friend. Within a few minutes, we had booked a one day tour through several towns in Boyaca.

The tour we chose was through a group called Travel Experience VIP. Our tour guides were Nathalia and Alexandra and they were delightful and sweet. The trip cost 65,000 COP and included transport, snacks and a full day tour through several sites in the neighboring Colombian state of Boyaca. We had to pay for our lunch, a 5 mil trip insurance (for accidents etc.) and an optional nature hike (12 mil each). It was still a great deal – bus transport to Boyaca alone when we first looked at going on a trip to Villa de Leiva was 40,000 each way.

After we stopped for breakfast (included), we continued on to a dairy company. Boyaca is the home to the majority of Colombia’s dairy industry, so there were numerous dairy companies selling cheese, ice cream, milk and other dairy products. We stopped at this large well-known factory, to get some of the well-known cheese filled arapas. They were warm, and golden colored, and SO delicious that I was unable to get any pictures.

But I do have some more pictures of some of the cheeses and other products they sell. My favorite is a corn husk wrapped tamale style cheese filled delight called, “envueltos chavitos.” I like it because it’s not some greasy melted cheese mess. It’s made with a very dry crumbly style cheese that is so well mixed into the corn muffin tasting roll that you don’t see the cheese but it adds just a touch of sweet to what would otherwise be a plain corn muffin.

many of the dairy products made right on site -through the open door ,in the room behind the case.
this is the dessert case full of sweets..Bocadilla, araquipe, and my envueltos chavitos
a closer look at all the sweets you could ever want..

After we stopped to enjoy a delicious treat – back to the bus.. Now Colombian roads outside of major cities are really just rural lanes. Which is a nightmare if it’s a heavily travelled road – or a delight, if it’s a relaxing and sunny Sunday cruising in lovely rural farmland like our trip in Boyaca.. Green grass, farms, a small town here and there..

Then we were at our next stop, which was a sizable town, known mainly for it’s church.. Chiquinquira, I believe.. I am not a particularly churchy person, so I was happy to wander thru the small town square, and then get back on the bus. I later read about the poisoned bread incident back in the 1960’s, and well, that adds a bit more mystery to an otherwise kind of boring looking town..

The next stops were more fun..

ceramics!

As a middle-aged woman who likes to sew, crochet and take pictures, Raquira was definitely up my alley. (Did I mention that I have a cat, too?) Raquira is a totally cheesy tourist town, with cutesy little boutique hotels, coffee shops and romantic restaurants..

tourists shopping in Raquira

Now none of that particularly excites me.. But Raquira is also famous for artesanal crafts, particularly ceramics. And that does excite the craft loving part of me – the part that really really appreciates the effort involved in handmade goods – and Hecho en Colombia.. It’s also the me that is still trying to decorate my home – and doesn’t like that whole Ikea/ 2001 spaceship / antiseptic look. Ah, but limited space on the bus, so I mostly did take pictures, even though a lovely vase did follow me home.

yes, made in Colombia and painted by hand..

The streets were lined with shops, so there was plenty of different things to look at, admire or buy. We passed the ceramics factory, where large stacks of unpainted ceramic items just waited to be decorated.

a shopper’s delight

Unlike many tourist places, the prices were very reasonable – and much less than what you would pay for the same items in Bogota. Maybe I’ll go back one day – with folks with a car.. so I can pick up a couple more pieces.. maybe one of the handmade pieces of furniture I saw… Or a planter for my growing garden. My friend had the same dilemma.

in Sutamarchan – home of Longaniza sausage

After the shopping excursion, it was time for lunch – and it turns out that Sutamarchan, Boyaca is also famous for a specific type of chorizo-type sausage called Longaniza. Now long time readers know that I just love, love, love picada – or that delicious mix of potatoes, sausages and other meats. (It has the morcilla or blood sausage that I love!). I wasn’t a big sausage eater before I came to Colombia, but it’s definitely something that I enjoy now.

yes, I love picada.. and it’s part of my own Sunday tradition.

That huge plate is a portion for one – but it was more than plenty for my friend and I. After our bellies were stuffed – it was time to go for the nature hike.. and believe me, I was ready for a nice long walk about after all that food.

on a nature hike to see the “blue” lakes

The next big stop was the historical city of Villa de Leiva (Leyva). It’s famous for being a preserved Colonial town, with cobbled streets etc. and stringent building codes against modern construction.

Villa de Leiva plaza

The main plaza in the town is the largest cobbled plaza in Colombia. The city is full of restaurants and charming boutique hotels. For a tourist town, the locals remained surprisingly friendly and welcoming. (Which is pretty amazing when you think about all the tourists that pass thru Villa de Leiva, especially in December, which is peak tourist season.)

Then it was time to start the drive home. On the way – now that night had fallen, we drove by an amazing holiday lights display that just went on and on.. It was charming.

Then we stopped at one last place so we could stock up on arapas with cheese so they would be fresh for breakfast (which they were). On the way back, the bus stopped close to our place, so we wouldn’t have to travel very far to get home. I’ve even posted the link for the coupon we used for our trip with Travel Experience VIP. Now enjoy!

I added lots of links to make it easy to find more information about the places and things mentioned in my post.

**I have a whole series of posts on my Sundays here:

Sundays in Cartagena

Sundays at Parque Arvi

Sundays in la Candaleria

Sundays in Antioquia

Sundays in Usaquen

Sundays for your health

Sundays in Bogota

Readers may notice that this blog has changed over the years – to be more culture and life and less surgery. I still love surgery and I am still committed to everything I’ve always talked about here; patient safety, quality, and excellent care – I’ve just decided not to talk about it here anymore. It’s at a different site., dedicated to all things medical so I am changing the name – but slowly, so people will have time to get used to the idea..

Calling all fashionistas!


map Medellin

While many of you know that Medellin isn’t my favorite city in Colombia – it does have its own attractions.  I am not talking about the spectacularly breath-taking ride up to Parque Arvi on the metro cable or the Botero museum.

It’s the shopping – Medellin is the New York of Colombia and much of Latin America.  As home to Colombia Moda and the Colombian textile industry, the array of shopping opportunities are mind-boggling.  Most tourist guides will direct you to the upscale, brand name only shopping malls in the wealthier enclaves like El Poblado.  While these malls are worth seeing, I advise visitors to go in the guise of a museum-seeking tourist.

indoor flower garden at upscale mall in Medellin

indoor flower garden at upscale mall in Medellin (El Poblado district)

That is to say – go to look (at the sculptured gardens, majestic views and boutique brands) and maybe for a light lunch at one of the elegant eateries but save your cash for the real shopping mecca, in El Centro.  Wear comfortable shoes – and plan to finish shopping before 6 pm..

To get here:  Take the Metro (train) to Station San Antonio.  That will put you in the center of the shopping district.

Biggest Open Air Shopping District in Latin America

Don't worry, honey.. I stayed safely outside of this shop dedicated to crochet

Don’t worry, honey.. I stayed safely outside of this shop dedicated to crochet

At least, according to the banner hanging over one of the cobbled pedestrian streets.  But it seems pretty accurate as I wander street after street of an amazing array of goods.. If it isn’t here – than you won’t find it in Colombia.

photo (1)

Since it’s not Buenos Aires (Argentina), yes – they have sizes larger than SIX.

 

There are streets filled with row after row of sidewalk vendors selling a multitude of items.  A whole street devoted to shoes.. Sidewalk vendors selling ornamental sandals with adjacent stores sell every kind of shoe ever made..

sandals

Just one of the many, many displays of sandals in the shopping district of El Centro

Street after street with store after store of Shoes.. Appliances.. Clothing.. Cosmetics.. Electronics.. DVDs.. Porn…  Lingerie.. Hats.  Costume Jewelry.  Fabric. Ribbons.  Yarn..  Several stores filled to the brim with beads.  Pastry and cake shops.  Any kind of soccer (futbol) jersey you could ever want (and not because it’s the world cup – these stores are always here.)

Whole malls (centro commercials) for bridal wear.. Others filled with row after row of beauty salons.

Dollar stores for all the items you forgot to pack.. Luggage stores for extra space to bring back your fabulous finds..

About the only thing I didn’t see was a street devoted to mascotas (pets) but that’s probably just because I didn’t wander far enough.

You can find almost anything here!

You can find almost anything here!

 

Calling all Colombian travel agencies!   Fashion and textile guided tours

Add this to my wish list for Colombian tourism businesses –  or other ways to make Colombia accessible to tourists on a whole new level.  For people who are familiar with Colombia, the tours would just be a nice, relaxing way to have someone else take care of the details…  Not everyone lives in El Centro and has the ability to walk a few streets right into the commercial heart of the city.

But for first-time visitors; wives of travelling businessmen or people unfamiliar with this part of the city – a guided tour to the heart of Medellin’s fashion district would be absolutely essential, particularly as the area gets kind of sketchy after 6 pm.  Tours for fashion sewers, crafters and knitters along with general shopping and factory tours just sounds like a fun way to spend a day.  Throw in a typical Colombian lunch (not the enormous banda paisa but something featuring all of the great local fruits and vegetables) and a mixed group of tourists (Colombians, and foreigners from several nations) as well as a knowledgeable, bilingual guide  – and I think there would be a line of people ready to sign up..

I think it would go along with my dream trip to Bucaramanga for a weekend guided factory tour and shoe-shopping adventure.

Alas!  I am not a marketing genius – just a lover of fashion, sewing and crochet.  But just for fun – I am going to add a survey here where readers can let me know what they think of this idea..  If I get enough interested responses – I’ll pass it along to someone in the tourism industry.

Proexport advertises Shopping Tours but they are short on details..

If you are interested in a personal beauty consultant – and shopping.. a bit pricey but here’s the link.  (link is a bit short on details too..)

Fashion Tourism Survey

 Tips for Shopping in El Centro:

– Wear comfortable shoes

– Don’t bring extras: jewelry, cameras, smart phones.  (This is a high crime area).

– Bring mainly small bills: 2ooo, 5000 and 10,000 peso bills.  It’s problematic to pay for a 3,000 peso purchase with a 50 mil bill for shopkeepers and may be impossible for outside vendors.

– keep your belongings secure – I recommend a zippered purse.  Backpacks should be worn on the front.  Messenger bags work for me – so I can keep the strap across my chest, and the bag close to my body.

– Try not to be too loud and (gringo-ey) in El Centro.. While most Colombians like Americans, in this instance, you don’t want to attract too much attention.

– Be prepared to leave by 6 pm – and don’t stay in El Centro after dark unless you are with a native paisa (person from Medellin).  It is easy to get lost – and dangerous at night.

In general, use commonsense – have fun and good luck on your shopping adventures!

Is it safe to fly after surgery?


Long haul flights are a health risk for everyone

While the risks of prolonged immobility and pulmonary embolism with long distance travel are well-known, many potential patients are unaware of the increased risks of thromboembolism after surgery.

Increased risks in specialized populations

People with a personal or family history of previous blood clots (PE or DVT), women on oral contraceptives, and patients who have undergone orthopedic surgery are some of the people at greatest risk.

Increased risk after surgery + Long trips

The heightened risk of thromboembolism or blood clots may persist for weeks after surgery.  When combined with long-haul flights, the risk increases exponentially.

In fact, these risks are one of the reasons I began investigating medical tourism options in the Americas – as an alternative to 18 hour flights to Asia and India.

Want to reduce your risk – Follow the instructions in your in-flight magazine

Guidelines and airline in-flight magazines promote the practice of in-flight exercise to reduce this risk – but few have investigated the risks of thromboembolism in post-surgical patients by modes of transportation: car travel versus air travel.

airplane3

But, is it safe to fly after surgery?

This spring, Dr. Stephen Cassivi, a thoracic surgeon at the world-famous Mayo Clinic in Minnesota tried to answer that question with a presentation of data at the  the annual meeting of the American Association for Thoracic Surgery.

This question takes on additional significance when talking about patients who have had lung surgeries.  Some of these patients require oxygen in the post-operative period, and the effects of changes in altitude* (while widely speculated about) with air travel, have never been studied in this population.

Now, Dr. Cassivi and his research team, say yes – it is safe.  Mayo Clinic is home t0 one of the most robust medical travel services in the United States for both domestic and international medical tourists.

After following hundreds of patients post-operatively and comparing their mode of transportation  – Dr. Cassivi concludes that the risks posed by automobile travel and air travel after surgery are about the same.

Additional reading

For more information on deep vein thrombosis, pulmonary embolism and safe travel, read my examiner article here.

AATS poster presentation abstract:

Safety of Air Travel in the Immediate Postoperative Period Following Anatomic Pulmonary Resection
*Stephen D. Cassivi, Karlyn E. Pierson, Bettie J. Lechtenberg, *Mark S. Allen, Dennis A. Wigle, *Francis C. Nichols, III, K. Robert Shen, *Claude Deschamps
Mayo Clinic, Rochester, MN

Schwarz T, Siegert G, Oettler W, et al. Venous Thrombosis After Long-haul Flights.  Arch Intern Med. 2003;163(22):2759-2764. doi:10.1001/archinte.163.22.2759 .  This is some of the definitive work that discussed the risk of long flights with blood clots in the traveling population due to prolonged immobility.

*Most flights are pressurized to an altitude of around 8,000 feet – which is the same level as Bogotá, Colombia.  This is higher than Flagstaff, AZ, Lake Tahoe, Nevada, Denver, Colorado or Mexico City, D.F.  – all of which are locations where some visitors feel physical effects from the altitude (headaches, fatigue, dyspnea, or air hunger.  In extreme (and rare) cases, people can develop cerebral edema or other life-threatening complications at these altitudes**.

** Severe effects like cerebral edema are much more common at extreme altitudes such as the Base Camp of Mt. Everest but have occurred in susceptible individuals at lower levels.

Please be careful, my friends..


In the world of internet anonymity, I tend to think of my readers as my friends.  That’s probably because I started this blog – and my journey into medical tourism to be able to provide information for my friends and co-workers.  People who knew me well enough to trust the information I was providing.

The blog was a handy way to keep in touch with people while I travelled through Latin America – and it became a place where friends of friends, and loved ones could pass along inquires.  “Do you know a good plastic surgeon/ neurosurgeon/ cardiac surgeon?”  “Is Bogotá safe?”  “What are the hospitals like?”  “Are the people nice?” and so forth.

Along the way – it become something bigger – and I began to write more, so that people who didn’t know me personally could find more about me, my work and to know why they could trust my findings.  But just as I was writing about the good, the bad and all the different things I encountered – other wonderful kind strangers were reaching out to me.

Sometimes it starts with an email, other times a comment on the page.. and every so often – a ‘forward’ or a google connect.

Now, back when I was in Mexico – I had a pretty shady/ scary encounter with a large organization called Planet Hospital.

I figured it couldn’t be an isolated practice, so I looked around the web – but wasn’t able to find much about the company.  They are privately held – so they don’t have to disclose corporate information.

Since then – bits and pieces have emerged, which paint the picture of an extremely unethical organization but overall the company still stays ‘pretty clean’ as far as the media goes.

But recently, I received by google connect  a forward of a blog post by a young couple that just broke my heart.

The couple had contacted Planet Hospital for assistance in surrogacy – and well – I’ll direct you to her blog for the rest of the details about their long travail as they attempted to have a second child.

http://0kayintheend.blogspot.com

Since then, I have been following her posts – and by posting about the blog, I  hope to give her more exposure  but every post makes my heart sink just a little more for her and her husband.

http://0kayintheend.blogspot.com/2013/08/youre-only-as-sick-as-your-secrets_13.html

So, if you have a moment – take a look.  And, thanks, friends, for listening.

Overseas Radio Follow-up


As a follow-up for all the overseasradio.com radio listeners (and all my loyal readers) I have posted some additional information on the topics covered during the radio program with Ilene Little from Traveling for Health.com including contact information for several of the physicians mentioned.

in the Operating Room at New Bocagrande Hospital

Thoracic Surgery

Esophageal cancer – during the segment we highlighted the importance of seeking surgical treatment for esophageal cancer at a high-volume center.  One of the centers we mentioned was the University of Pennsylvania Medical Center in Pittsburgh, PA – and the work of Dr. Benny Weksler, MD.

Dr. Benny Weksler*, MD

Hillman Cancer Center

5115 Centre Avenue

Pittsburgh, PA 15232

Phone: (412) 648-6271

He is an Associate Professor in Cardiothoracic Surgery and Chief of Thoracic Surgery at UPMC and the UPMC Cancer Center.  (For more information on Dr. Weksler, esophageal cancer, and issues in thoracic surgery – see my sister site, Cirugia de Torax.org)

(To schedule an appointment via UPMC on-line click here).

We also briefly mentioned Dr. Daniela Molena*, MD at John Hopkins in Baltimore, Maryland.

The Johns Hopkins Hospital

600 N. Wolfe Street

Baltimore, MD 21287

Phone: 410-614-3891

Appointment Phone: 410-933-1233

(The link above will take readers to the John Hopkins site where they can also make an appointment.)

* I would like to note that I have not observed either of these physicians (Weksler or Molena) in the operating room.

We also talked about several of the thoracic surgeons that I have interviewed and observed numerous times, including both Dr. Rafael Beltran, MD & Dr. Ricardo Buitrago, MD at the National Cancer Institute in Bogotá, Colombia.  These guys are doing some pretty amazing work, on a daily basis – including surgery and research on the treatment of some very aggressive cancers.

in the operating room with Dr. Rafael Beltran

Dr. Rafael Beltran is the Director of the Thoracic Surgery division, and has published several papers on tracheal surgery.   He’s an amazing surgeon, but primarily speaks Spanish, but his colleague Dr. Buitrago (equally excellent) is fully fluent in English.

Now the National Institute website is in Spanish, but Dr. Buitrago is happy to help, and both he and Dr. Beltran welcome overseas patients.

Dr. Buitrago recently introduced RATS (robot assisted thoracic surgery) to the city of Bogotá.

Now, I’ve written about these two surgeons several times (including two books) after spending a lot of time with both of them during the months I lived and researched surgery in Bogotá, so I have included some links here to the on-line journal I kept while researching the Bogotá book.  It’s not as precise, detailed or as lengthy as the book content (more like a diary of my schedule while working on the book), but I thought readers might enjoy it.

In the Operating Room with Dr. Beltran

There are a lot of other great surgeons on the Bogotá website, and in the Bogotá book – even if they didn’t get mentioned on the show, so take a look around, if you are interested.

in the operating room with Dr. Ricardo Buitrago

Contact information:

Dr. Ricardo Buitrago, MD 

Email: buitago77us@yahoo.com

please put “medical tourist” or “overseas patient for thoracic surgery” in the subject line.

We talked about Dr. Carlos Ochoa, MD – the thoracic surgeon I am currently studying with here in Mexicali, MX.  I’ve posted all sorts of interviews and stories about working with him – here at Cartagena Surgery under the “Mexicali tab” and over at Cirugia de Torax.org as well.  (Full disclosure – I assisted Dr. Ochoa in writing some of the English content of his site.)

out from behind the camera with Dr. Ayala (left) and Dr. Carlos Ochoa

He is easily reached – either through the website, www.drcarlosochoa.com or by email at drcarlosochoa@yahoo.com.mx

HIPEC / Treatment for Advanced Abdominal Cancers

I don’t think I even got to mention Dr. Fernando Arias’ name on the program, but we did talk about HIPEC or intra-operative chemotherapy, so I have posted some links to give everyone a little more information about both.

HIPEC archives at Bogotá Surgery.org – listing of articles about HIPEC, and Dr. Arias.  (I recommend starting from oldest to most recent.)

Dr. Fernando Arias

Oncologic Surgeon at the Fundacion Santa Fe de Bogotá in Bogotá, Colombia.  You can either email him directly at farias00@hotmail.com or contact the International Patient Center at the hospital.  (The international patient center will help you arrange all of your appointments, travel, etc.)

Fundacion Santa Fe de Bogota

   www.fsfb.org.co

Ms. Ana Maria Gonzalez Rojas, RN

Chief of the International Services Department

Calle 119 No 7- 75

Bogota, Colombia

Tele: 603 0303 ext. 5895

ana.gonzalez@fsfb.org.co  or info@fsfb.org.co

Now – one thing I would like to caution people is that email communications are treated very differently in Mexico and Colombia, meaning that you may not get a response for a day or two.  (They treat it more like we treat regular postal mail.  If something is really important, people tend to use the phone/ text.)

Of course, I should probably include a link to the books over on Amazon.com – and remind readers that while the Mexicali ‘mini-book’ isn’t finished yet – when it is – I’ll have it available on-line for free pdf downloads.

Mexicali book update


The service is quiet so I am spending the day writing and working on the Mexicali book.  For new readers, I would like to explain that the Mexicali book is a little different from my previous offerings.  This is not an exhaustive compilation of surgeons and facilities in Mexicali, as frankly, I do not have the time or resources to accomplish such a task at this point in time.

Like all my books, it is a labor of love, but differs in that it highlights some of the best, and worst of Mexicali and medical tourism in this city.  So instead of interviewing and observing hundreds of surgeons, it highlights the limited number of physicians who agreed to participate in this project.

As such, no plans are being made to market this book commercially. Instead, I plan to offer it as a free pdf download for interested readers.  I will also be offering a full color soft-bound edition (at cost) for people interested in the many full color photographs of surgeons and surgery in Mexicali.  I will be placing the soft-bound edition on Amazon.com for interested persons.  Unfortunately, the cost of producing such a book (color photos) in limited runs is fairly expensive, so I apologize in advance to readers – but as I said – it’s a labor of love, and I won’t make a dime off of it.  I can only hope that if readers enjoy this book, they will consider purchasing one of my longer, more detailed books on medical tourism (such as the Bogotá book.)

More information will be forthcoming as I get further and further towards completion of this project.

Welcome to Mexicali!


As I mentioned in a previous post – here at Cartagena Surgery, we’ve decided to explore some of the border cities of our neighbor to the south, Mexico.  For many people,  Mexico is the most practical option when it comes to medical tourism.

For our first look at Mexico, we’ve decided to travel to Mexicali, in Baja, California.  It’s just across the border from Calexico, California and is home to around one million people – making it a large metropolitan area.

With the drastic increase in drug-related crime and killings plaguing many of the other cities in Mexico such as Cuidad Juarez “Murder capital of the world,”  Tijuana and even the smaller Nogales, Mexicali is the safer, sweeter option for border cities.

In fact, Mexicali is known as the most affluent of cities in Baja California – and it is certainly apparent during our visit due to the availability of a wide range of medical services.  While the entry from the central border gate leads to a bustling commercial district, the more upscale, attractive residential neighborhoods are only a fifteen minute walk from the border.

At the Mexicali - Calexico border

About Mexicali:

Travel and Tourism links for Mexicali:

Official Mexicali tourism page – has English version. Also has a health section promoting local physicians and hospitals.

Mexico Tourism Information

WikiTravel

Getting Here:

The easiest way to get for (for many people) is to walk.  After driving to Calexico, California – turn down Imperial Boulevard and head towards the border.  Turn right on second street – and cross the railroad tracks.  Immediately on the left – there is a secured parking lot.  It costs about three dollars to park here overnight.

Take your valuables with you – and as you leave, proceed back down second street towards Imperial.  Cross Imperial – and walk about two more blocks.   Turn left on Rockland, and proceed towards the Calexico government building.  On the front of the building – you will see a set of turnstiles (like at an amusement park.)  Walk through the turnstiles – walk another 40 feet to the second set of turnstiles – and you are now in Mexico..

the doorway to Mexico

You will then walk through a short underground causeway – filled with little shops, and money changers/ cambios.  (This is one of the better places to change money – the rates are surprisingly competitive, and beat anything on the American side.)  When you emerge from the short hallway – there are stairs on the left.

These stairs lead to one of the main streets in Mexicali for medical services – Maduro.

Update: March 2012

I will be living in Mexicali for several months – so look for more postings and information about medical tourism/ medical services in Mexicali in the future.

The App Store: Android Market


For anyone traveling to Bogotá or Cartagena, I have created some FREE mobile apps for Android phones. (Still working on iTunes versions).  These apps contain maps, local resources, travel links, and emergency information.  Where to go if you are experiencing chest pain?  Got you covered.. Where to stay?  also covered.. Cheapest flights – in the app..  Where to get a good meal – it’s in there too.. The apps will also keep you connected to the blog where I post all updates to the books, and news about the destination.

Bogotá Apps:
Bogotá Surgery – primarily based on the blog – for those who can’t stand to miss a post.

The Bogotá Companion– maps, travel resources and references, emergency information.

Cartagena app:
The Cartagena Companion – chock full of information, including short videos about Cartagena.

You don’t have to be a medical tourist to enjoy these apps – best thing is, they are all FREE..

Dr. Richard Eljadue Martinez, DDS


My readers may remember Dr. Richard Eljadue Martinez, DDS one of the dentists profiled in Hidden Gem.   He still maintains an active dental practice in the heart of Cartagena.

Dr. Eljadue also has a small hotel, Portal de San Diego in the middle of the historic district of the El Centro district.  (This is where I have been staying during my return visit to Cartagena – and as you should know by now, No – not for free – that’s not my style*.)

Portal de San Diego

Calle 2nd (segundo) de Badillo No 36 – 17

email: portaldesandiego@gmail.com

Portal San Diego is a charming hotel, a typical property with just a few rooms in the heart of one of the most interesting areas in Cartagena.  It is more than miles away from the high rises of Bocagrande and the modern, all access beach resorts lining the coastal highway – it is a world away.  The rooms are clean, comfortable and European in style – fast internet, hot water and air conditioning make it the perfect hideaway for a writer like myself with a myriad of nearby restaurants and cafes to supplement the complimentary breakfast.  It’s been such a nice place to relax and write while I’ve been here in Cartagena that it would be a crime not to mention it.

Since my first visit to interview Dr. Eljadue – he has added a small bar, Bar del Portal aside the hotel.  It’s a cozy, intimate sort of place, with a retro early 1960’s feel; everything is sparkling clean with crisp lines, and cool lighting.  Frank Sinatra or any of the Rat Pack would be perfectly at home in its relaxed atmosphere.  Normally the music is pure Colombiano – but for me, they’ve added a bit of Puerto Rican Reggeaton to the playlist.

One of the bartenders, Jesus (not pictured) looks a lot like the singer, Prince when he was younger and we joke about that as we sip Aguila and enjoy the evening.

Bar del Portal

*I do not accept gifts, payments or gratuities from any of the physicians or dentists profiled.  *

Liposuction in a Myrtle Beach apartment


Another case of sketchy plastic surgery reported – this time in Myrtle Beach, South Carolina.   Yet again, I would like to caution readers about seeking ‘cheap’ plastic surgery on the internet.  (I’m not saying don’t look – please do!  But look smartly.)  This doesn’t only apply to plastic surgeons, but to all surgeons, physicians, and healthcare professionals.

‘The internet’ is not all the same – the grade of information can vary widely from scientific journals (highly reputable/ reliable) to fiery but heavily opinionated blogs (unreliable/ unscientific) to frankly fraudulent such as in this instance (in the story above).  People need to use caution, due diligence and common sense when researching anything, but particularly medical information on the internet.  You need to do your homework.

There are a few things to consider when researching medical information/ providers on the internet.

1.  Is the information independently verifiable?  (and by what sources?) 

As a medical writer – this is a huge portion of my job – verifying the information obtained during interviews, etc.  But when you are looking to purchase goods or services – you need to do a little investigative work yourself.  Luckily, once again – the internet makes this simple.

The first thing you should investigate is – the person making the claims/ and what their focus is.  Use this website for an example, if you like.  So take the following information (below) – that is easily available on the site..

(If this information isn’t readily available on the site – that should make you suspicious.  “Anonymous” blogs or hidden author websites are NOT reputable.  People with valid, truthful information have nothing to hide, and are not ashamed to stand by their work/ writings.)

so you’ve gathered the following information  from the site:

Author – XXXX   credentials claimed/ authority source:  Physician (MD/ DO etc.)

Product or service advertised on the site:  surgical procedure XX

Use this information to answer the following questions:

1. Who is this person?

2. How do they know this/ what special knowledge do they possess?  (for example – a hairdresser shouldn’t be giving medication advice)

3.  Can I verify this?

– Medical personnel can be verified thru state licensing boards. 

Some states make this easier than others, but ALL states have this information available to consumers.  So go to the website of the licensing board (medical board for doctors, nursing board for nurses) and look the person up.

In this example, I am currently licensed in several states – so pick one, and do an internet search for the board of nursing for that state.  (Tennessee is particularly easy since they post educational information, license violations etc. on-line).  If this licensing information isn’t easy to find on the website, call the board.**

If the website (ie. plastic surgery clinic) lists an address – use that state for your search.

In another example – as seen below – we’ve looked up a surgeon at the Colorado Medical Board.

Looking up a medical license

Looking up a medical license

– All physicians should be licensed in the state of practice (where their clinic is.)  If they aren’t licensed in that state – STOP and find another provider.  Even if the doctor claims to be from another country, he or she is STILL required to have an active license in the state they are working in.**

Here is an example of physicians sanctioned by the Texas medical board (all of this information is freely available on the internet for your safety.)


Here is another example of a surgeon with multiple medical board actions against her.

licence details

license details

Many of the state medical boards will let you read the complaints, actions and disciplinary measures against physicians licensed in that state.  However, some states allow physicians under investigation to ‘surrender’ or inactive their license to avoid having disciplinary measures recorded.

– All surgeons, or specialty doctors should also be listed with specialty boards – such as the American College of Surgeons, or the American Society of Plastic Surgery(While membership is not mandatory, the vast majority of specialty trained surgeons maintain memberships in their specialty organizations.)  Other things to consider while investigating credentials:

Do the credentials match the procedure?  (Is this the right kind of doctor for this procedure?)

These credentials should match the procedure or treatment you are looking for: such as Plastic surgeons advertising breast augmentation.

This may sound obvious but it isn’t always the case.  (for example:  dermatologists shouldn’t be doing eyelid lifts or plastic surgery, primary care physicians shouldn’t be giving Botox injections, general surgeons shouldn’t be performing lung surgery etc.)
If you aren’t sure what procedures the doctor should be performing, look at the specialty surgery board – it should list the procedure.  i.e plastic surgery and liposuction.

4.  After verifying this information, it is time to do a basic internet search on the individual.  To do this – perform both a Yahoo! and Google search.   This should give you at minimum, 10 to 15 results.

These results should include several non-circular results.  “Circular results” are results that return you to the original website, or affiliated websites.   For example: Using the information from above – both Google and Yahoo! return several results that link directly to this website.  These results also return links for the sister sites.  All these of these are circular results – that return you to the starting point without providing any additional outside information.

However, if you scroll down the results:  outside links should appear.  These should include articles/ publications or scholarly work.  Other search results may include more personal information, social networking sites and other newsworthy articles.  This gives you a more comprehensive picture of the provider.

One of the things we should mention, is patient testimonials.  While many providers include extensive patient testimonials, I disregard these for several reasons:

– There is usually not enough information to verify the authenticity of these patient claims.  “I love my doctor. He’s a great surgeon.” – Gina S.  doesn’t really tell you anything.  In particular, there is no way to verify if there really is a Gina S. or if she is a fictitious creation of the website author.  (There have been several cases where people working for the doctors have created ficticious accounts including before and after photos talking about procedures that they never had).  Don’t be lulled into a false sense of security with patient testimonials.

– Some people use blogs, or message boards for the same purpose, and the same caveats apply.

– Another reason that patient testimonials are not useful in my opinion, is that patients (and their families) are only able to provide subjective information.  Several of the cases in the news recently (of fraudulent individuals posing as doctors) had several “happy patients’ to recommend them.  Patients, for the most part – aren’t awake and able to judge whether the surgery proceeded in a safe, appropriate fashion.  The testimonials are merely a comment on the physician’s charisma, which may give future patients a false sense of security.

I’ve finished my search – Now what?

   Use commonsense:

– Surgical treatments should be performed in an appropriate, sterile environment like a hospital or freestanding clinic.  A reputable surgeon does not operate in the back of a motor home, a motel room or an apartment.  (All of these have been reported in the media.)  If the setting doesn’t seem right – leave.  You can also investigate the clinic.

– Bring a friend.  In fact, most surgeons will require this, if you are having liposuction or another large procedure.  Doctors don’t usually drive their patients around (as was done in several recent cases.)  The exception to this rule is medical tourism packages.  These packages often include limousine transportation services but these services are provided by a professional driver (not the doctor, or ‘his cousin’).  Your friend/ companion is not just your driver – they are also there to help feel out the situation.  If something seems amiss – do not proceed.

– if the price is too cheap – be suspicious.  If every other provider in the same location charges a thousand dollars – why is this doctor only charging a hundred dollars? Chances are, it’s not a sale – and he/ she is not a doctor.

– Use reputable sources to find providers – Craigslist is not an appropriate referral source.

– Are the claims over-the-top?  Is the provider claiming better outcomes, faster healing or an ‘easier fix’ than the competition? (We will talk more about this in a future post on  “miracle cures’ and how to evaluate these claims.

I hope these hints provide you with a good start to your search for a qualified, safe, legitimate provider.  The majority of health care providers are excellent, however the internet has given criminals and frauds with an easy avenue to lure/ and trap unsuspecting consumers.

** The majority of cases that have been recently reported have taken place in the United States (Nevada, New Jersey, Florida and South Carolina.)  Many of the people perpetrating these crimes have posed as Latin American surgeons to capitalize on the international reputation of plastic surgeons from South America.  They also used these claims to try and explain away the lack of credentials.  A legitimate doctor from Brazil,  Argentina, Colombia, Costa Rica or another country, who is practicing in the United States WILL HAVE an American license.

Additional references/ stories on fraudulent surgeons.

(Hopefully this section will not continue to grow)

More on the Myrtle Beach story

Myrtle Beach – a nice article explaining why people should see specialty surgeons

Basement surgery

Article on unlicensed clinics in Asia (medical tourists beware!)

A truly bizarre story about unlicensed dentistry in Oregon

Additional references:

American College of Surgeons – lists doctors distinguished/ recognized as “fellows” in the academic organization, and provides a brief summary of specialties.

Bariatic surgery, revisited


In honor of the Latin-American Bariatric Surgery Congress, currently in progress in Cartagena – (since I couldn’t make time in my research to go) I am posting a brand new article about bariatric surgery and the severely obese. It seems American medicine is finally starting to catch up, and take notice..

It’s hard concept out there – and I still have trouble with it myself, sometimes.. In our society, it seems we are too busy blaming ourselves, and others for being overweight and attaching labels; ‘lazy’, to really see how fundamentally things need to change to improve our health as a nation.

From my perspective, down here in Bogota – it’s interesting, because I am seeing Colombians just beginning to start to struggle with obesity – as more and more imported snack foods, and fast foods replace traditional diets. Obese people are still very rare here – and after several months, I can still say I’ve not seen a single super-obese person here, but the ‘chubbies’ are starting to grow in number..

At the same time, by being in such a walkable city, and having access to (cheap!), delicious, ripe fruit every day, I’ve managed to lose over ten pounds with almost no effort.. I’ve been tracking my walking, and I walk about 6 to 10 miles a day with my various errands. But these are things that aren’t readily available – in the urban sprawl of American life.. A week’s worth of fruit for several meals for ten dollars? Not hardly, unless you gorged yourself on bananas every single day..

Surgery as a solution seems drastic to American healthcare providers, myself including.. Removing/ destroying a perfectly functioning organ.. But then – when you look at the drastic effects, and the desperate states our patients are in – Bariatric surgery really is as lifesaving as cardiac surgery for many people.. Until we change society as a whole (which may never happen), we need to help these individuals regain their health,and their lives..

Bariatric Surgery for the Severely Obese

In the meantime, everyone, stay away from soft drinks (all soft drinks, including ‘diet drinks’, juices and fruit drinks, sweet tea) and stick to water, plain tea. Coffee too – if you remember not to load it up with too many calories.. Try it for a month, and I wager you will be unable to go back to the supersurgery drinks you formerly enjoyed out cringing..

Today’s headlines: Obesity Kills


Everyone knows this already – but finally some scientists sat down and worked it out for the rest of us:  Obesity Kills!

Seems like a pretty timely article: Obesity Increases Risk of Deadly Heart Attacks – over on WebMD..

Here I am in Bogota, spending much of the week with Bariatric surgeons; discussing procedures, outcomes, meeting patients..