Read Unbiased Cosmetic Surgery Reviews

The majority of clients who contact Blue Morpho are medical tourists who want to have cosmetic surgery. Tummy tucks, breast augmentation, nose jobs, and face lifts don’t seem to be taking a hit from the downturn in the economy! I just found a great website, RealSelf, which provides reviews of plastic surgery procedures and cosmetic treatments by real people. You can read about their experiences as well as learn what they paid, giving you a good idea how much you will save when you travel for surgery. The website also has a plethora of advice and information from US doctors about the many procedures available to improve your appearance and meet your cosmetic surgery goals.

I am posting my own, somewhat biased, comments on the site about medical travel for plastic surgery in response to posts from people who have had less than stellar experiences abroad. One point to remember… you get what you pay for! If a $2000 breast job in a Mexican border town sounds too good to be true, it probably is. Medical tourists should work with accredited hospitals to ensure commitment to patient safety. Using a medical travel service such as Blue Morpho saves you the time and energy of doing the research on your own, and it doesn't cost you a thing.
If you are considering plastic surgery, take a look at the RealSelf website to find out what others are saying. And contact Blue Morpho when you are ready to plan your trip!

Hospital International Patient Safety Goal: Patient Identification

On the Blue Morpho website I frequently reference Joint Commission International (JCI), the top accrediting body for international hospitals. Blue Morpho works exclusively with hospitals that have either achieved this accreditation or are actively working toward it. You might ask what’s the big deal about accreditation? As you may know, almost all U.S. hospitals are accredited by the domestic arm of The Joint Commission. This stamp of approval is necessary for hospitals that bill Medicare and most private insurance companies.

JCI surveys all areas of hospital operations, and I think one of the most important things they have done in recent years is establish International Patient Safety Goals (IPSG’s), similar to the National Patient Safety Goals in the U.S. There are two reasons why I want medical tourists to know about the IPSG’s.

1. Planning travel to a foreign hospital for medical care can be scary, especially if you don’t know what to expect. Knowing that the hospital you will visit has shown dedication to patient safety through JCI accreditation and implementation of the IPSG’s offers reassurance.
2. Research shows that patients and their companions who are actively involved in the safety of their medical care actually DO receive the safest care. Education is the first step to becoming an active participant your care. (And this is true for anyone entering a hospital in the U.S. and abroad!)

Let’s start with the first goal: Identify Patients Correctly. The JCI standards manual states, “The intent of this goal is twofold: first, to reliably identify the individual as the person for whom the service or treatment is intended; second, to match the service or treatment to that individual.”

What this boils down to is that before providing any treatment to a patient, the nurse, doctor, lab tech, etc. must verify that you are indeed the person for whom the care is intended. This happens best through the use of two identifiers. The first is your name, and the second is most commonly date of birth; your room number should never be used. Generally you will be asked for this information, and your answers compared to the written documentation on the medical record, medication, lab order, etc. This simple step prevents errors. For instance, you may be in the room previously occupied by Mr. Smith, and it ensures you don’t get Mr. Smith’s medication rather than your own!

So what is the patient and companion’s role in this? First off, it is OK to remind the caregiver to verify your identification. You may even ask to see your name on the medication or treatment order to make sure it is intended for you. Answers to your questions will reassure you and make you feel safe while reminding your hospital caregiver that you want to be a part of your care. Rather than being off put or challenged by your questions, medical caregivers will appreciate the opportunity to reassure you that they are doing the right thing the right way. After all, medical professionals don’t want to make mistakes any more than you want them to.

Education about patient safety is in no way designed to frighten, nor is it uniquely targeted to medical tourists traveling outside of the U.S. for care. In my role as a U.S. hospital Patient Safety Officer, I always advised nurses to educate patients on the steps they take to ensure patient safety. Further, I encouraged patients never to hesitate to ask questions and always speak up if they had concerns.

I’ll cover more about patient safety in future posts. Feel free to leave a comment here on the blog. I am interested in knowing what you think.

More about Costa Rica: Recovery Accommodations for Medical Tourism

Medical tourists have many options for recovery accommodations in San Jose and surrounding areas, ranging from the luxurious Intercontinental Hotel to more budget-friendly B&B’s such as Costa Verde Inn. On my recent trip to Costa Rica I visited two hotels specifically designed for medical tourists that cater to patients recovering from surgery.

Las Cumbres Inn and Paradise Cosmetic Inn are both located in Escazu, a suburb of San Jose. The facilities are similar in many ways. Both are private, enclosed facilities with 24-hour security and are designed with recovery in mind. Three meals, transportation (two round-trips for airport and hospital), daily nursing care, internet access, and cable TV are included in the costs. The common areas have attractive and comfortable furnishings, and of course the gardens are lush.

Both facilities are surprisingly economical, ranging from $75 to $115 per night for a lone traveler to $115 to $185 for a patient and companion; rates include three meals a day for each guest. Costa Rica’s hotel tax is around 16%, so be sure to account for this in your budget. Interestingly, these hotels will accommodate two surgical guests in one room in case you and a buddy want to experience surgery together.

I expected that after visiting the two hotels I would make a recommendation based on my assessment. Frankly, I’m having trouble deciding which one I like best. My visits to each were unannounced, and the English-speaking staff gladly gave me a tour and explained services. I got the impression that in either hotel the staff will go the extra mile for guests.

In the end, if I was making a personal choice I would go with Las Cumbres. Las Cumbres is close to town, making taxi rides cheaper for easy access to outside shopping and restaurants. It also has large rooms, modern furnishings, and big TV’s. Nurses make daily rounds but are not on-site at all times; I was told medical assistance is available 24/7. Below is a photo of one of the common areas at Las Cumbres Inn; warm and cozy! Check out the studio-deluxe room at Las Cumbres as well. It is around $135 per night for a surgical guest and a companion.



























Paradise Cosmetic Inn has a beautiful panoramic view of San Jose and the Central Valley that is stunning at night. The owner, Raul, and head nurse, Rose, are outgoing and friendly. Paradise has a nurse on site 24 hours a day. The photo below shows the afternoon view from Paradise Cosmetic Inn; imagine it lit up at night.













If you are a medical tourist planning to travel alone, you must consider staying in a dedicated recovery hotel. Especially during the early post-operative days, it is important to ensure that you get care and attention from another human; you don’t want to go it alone! They will accommodate a travel companion as well and will likely make the trip easier for both of you.

Whatever your budget and personal preferences, Blue Morpho will help you make arrangements for post-op recovery accommodations. Get in touch with us any time to talk about the options: email info@bluemorphomed.com or check out our website at http://www.bluemorphomed.com/.

Stay tuned… next up in Blue Morpho’s medical tourism blog we’ll begin a discussion of what you need to know about the International Patient Safety Goals for hospitals.

Getting Back to Normal after Surgery

Although Elena would not describe walking hunched over like an old woman her “normal” state, she did start to seem more like herself following the really bad day. She resumed some activities independently and took a brief but tiring walk outside. She started emailing friends with updates on her progress, and her sense of humor came back to life. Six days after surgery Elena was ready to get into a taxi and venture out into the world. It was an exhausting outing, but she did appreciate the opportunity to eat a good restaurant meal and pick up a few groceries. (Costa Rica is not known for its food, but there are some great restaurants in Escazu!)

Nine days after arrival, it was time for me to head back to Texas on an early morning flight. That afternoon, Elena saw Dr. Lev and had her stitches removed. It was the first time she was able to check out his work in front of a full-length mirror, and she was pleased with what she saw. Any lingering buyer’s remorse disappeared.

So ends my story about what it’s really like to have surgery in Costa Rica. If I left anything out or you have questions, shoot me an email at info@bluemorphomed.com or check out our website at www.bluemorphomed.com.

Keep reading the blog! Soon you will hear all about my upcoming visit to El Salvador, a little known hot spot for medical tourism, plus details about a stunningly beautiful hospital in Guadalajara, Mexico.

And remember, when you are ready to embark on your own medical tourism adventure, let Blue Morpho help you plan wisely so that you travel safely.

Day 5 – Buyer's Remorse

As Dr. Lev warned, the 2nd post-operative day was the worst. Ever overdone a work-out and felt the worst soreness on day 2? This is definitely what Elena suffered. We called it “buyer’s remorse,” kind of like buying a lime green pair of platform shoes that seemed just right in the store. Unfortunately, you can’t take surgery back to the mall for a refund! Elena expressed thoughts of, “why did I do this to myself?” and “oh, what have I done?”

We discovered on this day that yes, I needed to wake her up during the night to keep the pain medication on schedule. Otherwise, she woke up feeling terrible, and it is far easier to treat pain proactively than to wait until it takes hold. Even her appetite suffered a bit.

I left the room to make phone calls and returned every 15-30 minutes for check-in. On a side note, the best way to call home from Costa Rica is with Skype if you are traveling with a laptop. Skype is easy-to-download software, and you pay 2.1¢ per minute to call to the States using a credit card. You will need a headset with microphone (I bought mine for $9.99). Other options include renting a cell phone for about $10 a day or using an international phone card from a land line. If you use your US cell phone, you will pay a whopping $2 + per minute! Most of the hotels and recovery inns have a computer for guest access if you don’t plan to travel with a laptop.

Fortunately, tomorrow is always a new day, and The Day of Regret soon faded into history.

Day 4 – Recovery Begins

I asked Elena if it would be OK to candidly post my thoughts on the role of a caregiver, and she gave me permission to say that the first two days were kind of like taking care of a puppy. Every hour she wasn’t asleep involved walk, water, potty, medicate, feed, and fluff the bed. The aides at the hospital made helping her out of bed look so easy. Since I was unable to pick her up and carry her, it took several tries for us to work out a system that was comfortable. I wrote out a medication regimen and provided regular snacks and meals to avoid stomach upset. Elena helped by never losing her hearty appetite.

Not to overstate my role in this process, here is where I advise medical tourists that traveling with a caregiver is ideal, if not necessary. Particularly in light of the extensive surgery Elena underwent, she would have had a tough time the first few days had she been alone. Preparing meals, getting in and out of bed, showering, and figuring out the medication schedule would have been an extreme challenge without assistance. Even with a close friend, Elena’s dignity suffered a bit of assault when I had to help her with basic needs.

Day 3 – Hospital Discharge

Between 3:00 and 6:00 a.m. Elena and I managed to get some sleep. Dr. Greenwood arrived promptly at 6, which in Costa Rica is full daylight, to check on our patient. He gave a recap of the surgery and told us that Elena was awake and talking by the time she arrived in post-op recovery. Again, he entertained while he educated… truly a gracious and caring man.

Soon after, Dr. Lev visited our patient and inspected his work. He gave Elena the option to spend another night in the hospital depending on her pain level and comfort. Although this would have cost only $250, Elena opted to head back to the hotel. Dr. Lev carefully explained the aftercare instructions and wrote prescriptions, which I was able to fill in the hospital pharmacy. Dr. Lev gave us his pager, cell, office, and home phone numbers with instructions to call any time. Elena ate lunch and we packed up to leave.

The amazing thing was that Elena was able to pay her entire bill by credit card prior to leaving. If you have ever been in a US hospital, you might recall that it can take months for all of the bills to roll in… separate bills from the surgeon, radiologist, pathologist, hospital, etc. CIMA provided a simple, itemized bill that we were able to review on the spot, and the total was several hundred dollars less than the original estimate.

Once again, Angela arrived to help get us ready and explain any additional questions about discharge instructions. She called a cab and wheeled Elena down to the entrance. The taxi driver, without request from us, drove slowly and apologized for every pothole! The folks at Costa Verde helped Elena from the cab to the bed, unloaded our luggage, and provided extra pillows to help Elena get propped up in the bed at a 45-degree angle per Dr. Lev’s instructions.

Now it was time for my work to begin.

Day 2 – Surgery

As a resident of Costa Rica, Elena made her own contact with her doctor and all pre-op arrangements such as blood work and hospital pre-registration. She chose her surgeon, Dr. Alejandro Lev, through referral from a friend. We arrived at CIMA at 8 a.m. and were greeted immediately by Angela, the International Program Coordinator. Elena completed the registration process while an employee of the hospital delivered our bags to the room. Then it was off to the pre-operative area.

One thing that struck me is that physicians, not nurses, provided most of the bedside care prior to surgery. Dr. Greenwood, the anesthesiologist, greeted Elena and me with a kiss on the cheek and proceeded to entertain throughout our interaction, which included starting the IV himself. (I know this happens on TV all the time, but in my experience nurses normally do this task!) Dr. Lev spent a great deal of time explaining what would happen in the operating room. As a former U.S. hospital Patient Safety Officer, I was particularly attuned to physician and staff compliance with safety initiatives. It was clear that CIMA takes the standards seriously. (More on this to come in future posts.) The procedure started a bit later than scheduled, but we were kept up-to-date along the way.

Once Elena was wheeled off to the operating room, Angela gave me a tour of the hospital and showed me to our room. I worked for nine years in an Austin hospital that is well known as a beautiful, hotel-like facility, and I am convinced CIMA San Jose was designed by the same architect. The resemblance in design and layout, right down to the fixtures, is incredible. During the lengthy procedure, I took advantage of the wifi access to surf the web and watch movies on my laptop. I had lunch in CIMA’s impressive restaurant – no, not a cafeteria – with table service and a full made-to-order menu including homemade desserts. Dr. Lev and Dr. Greenwood each called me during surgery to give updates.

Elena made it to the room around 6:30 p.m. and Angela was there (still!) to make sure we settled in. I asked Angela if it is normal practice for her to provide this level of attention to her patients, or were we getting special attention because of my role as a medical tourism facilitator. She assured me that patients are her top priority and that she always sticks around to make sure all goes smoothly. She proved it by rolling up her sleeves to step into her nursing role, checking the IV, and educating me on what to expect during the night.

As is typically the case in hospitals, we got lots of attention but very little sleep that night. I learned that Anabelle, our night nurse, trained in East Texas and worked as a nurse in Houston. I slept on the companion sofa – granted, not the most comfortable place to sleep – but it allowed me to remain at Elena’s side.

Day 1 – Arrival

This is not a typical medical tourist scenario. As a medical travel facilitator accompanying a resident of the destination country, I did not go the normal route that includes transportation arrangements and concierge services. However, my goal in the coming posts is to document my observations and experiences to give medical tourists an insider’s perspective on the process.

After arrival at the airport in San Jose and a breezy trip through immigration and customs, I hailed a taxi to drive me to Costa Verde Inn in the Escazu suburb. It was much like any drive from an American city to an outlying suburb: we passed car dealerships, McDonald’s, strip malls, business complexes, middle class neighborhoods, condos, and sprawling estates.

A striking difference, however, was the lush green and blooming foliage along the way as well as the mountains on the horizon. Within 15 minutes of the airport, we arrived at Costa Verde Inn, an unexpectedly quiet, tropical retreat, and one of many in the Escazu area. Our room was huge, with two king-size beds, a full but miniaturized kitchen, and a shower big enough for four. The inn’s common areas are open to the outdoors, complete with a pool, palms, and mango trees.

There is a covered outdoor dining area that serves a full breakfast every morning. The reception staff is friendly and speak fluent English, and the free internet access is faster than I get at home. All this and we are paying around $65 per night.

Awaiting Elena’s arrival in San Jose, I ventured out in the evening for dinner and a trip to the supermarket. A $4 taxi ride delivered me to a mall much like one in any large city. It was not exactly the exotic experience you might expect to find in Costa Rica, but the familiarity helped allay anxiety about our big day tomorrow.

A few things to note about Costa Rica: unlike other parts of Central America, you don’t see people living in poverty. Frankly, there are fewer panhandlers than in any American city I have visited, including my hometown of Austin. The locals maintain a moderate lifestyle: kids go to quality schools, homes are small but tidy, and residents have access to free medical care.

Elena has arrived, so we’re off to bed to prepare for an early arrival at CIMA in the morning.

What’s it like to have surgery in Costa Rica?

My personal experience in Costa Rica began as a bittersweet experience. Two of my closest friends from my hometown of Austin, Texas bought a hostel in Costa Rica, packed up, and moved far away. As much as I miss seeing them regularly, my son and I were blessed with the opportunity to travel to places we had never been. Needless to say, we fell in love with the country and have returned numerous times to enjoy the cloud forest, canopy tours, white water rafting, secluded beaches, and volcanoes.

This trip, however, is a whole new experience. My girlfriend Elena, now a resident of Costa Rica, is having surgery tomorrow at CIMA Hospital in San Jose to treat battle scars of childbirth.

Elena has never had surgery, and to my knowledge has never even taken pain medication other than Tylenol. She is one of the fortunate women for whom childbirth came quickly and relatively easily. Naturally, she and her husband are quite anxious about the extensive surgery that is scheduled for tomorrow! So that he can remain home in the cloud forest to care for their children and business, I am on my way to San Jose to accompany Elena through the process.

Thus begins my journey to tell a firsthand story of what surgery in Costa Rica is all about from the perspective of companion, caregiver, and friend.