Saturday, October 27, 2018

GETTING READY TO CROSS THE BORDER INTO MEXICO: Completing Our Checklists and Heading Out!

😎We Made Our Lists and Checked Them Twice--Let's Head South! 😎
Blue Skies, Rugged Mountains, and Stately Cacti of Sonora, MX
     We made our lists (yes, multiple lists) and checked them twice—we were ready to head south in our RV to México! Well…we were almost ready. There were two important items on one list that were keeping us from crossing the border. How long would we have to wait to get them?
     We were so excited to hit the road, as we are each fall, after spending the summer in the United States. It was fun to spend time with family members, camp along the Oregon coast, eat lots of Dungeness crab cocktails, and enjoy fresh, baked parmesan halibut. But these days we are homesick. We can’t wait to return to Sayulita, Nayarit, our home now for the past three years.
     It takes quite a bit of preparation each August and September to ready our motorhome for the road trip, gather necessary documents, and stock up on supplies for the coming year. Is it worth the effort? What are these lists of things to do before heading south?
We Love Traveling in Our Class C Motorhome
     First of all, it is completely worth the time, energy, and money we spend to stock the motorhome and prep it for road travel. We sometimes feel as though we are early pilgrims readying our covered wagon to venture out on the Oregon trail. What will we need that we can’t find along the road? What will we want to take along from the United States that we won’t be able to get in our foreign home? That’s where our lists come in handy.
     Our first list, gathering our personal documents, was completed. It rarely changes so we keep these items with us, whether at home or in the RV.
Personal Documents- All Gathered
1.     Passports
2.     Mexican Resident Visas
3.     Oregon Driver’s Licenses
4.     Marriage Certificate (in case of death of one spouse)
5.     Birth Certificates
6.     Copy of our Wills
7.     Trust Document and Deed Proving Ownership of our Mexican Home

     Our next task was crucial to being able to drive our motorhome into México: 
Motorhome Documents Needed to Purchase Our 10-Year RV Import Permit
     This important step is where we got held up this year. Here it is October and we are still waiting for our title and registration for our newly purchased 2009 Triple e Class C motorhome, the two items needed to purchase our Mexico RV Import Permit. We couldn’t cross the border until we received these documents. When we traded our 2007 Southwind Class A motorhome this summer for our smaller, easier to drive Triple e, the dealership in Redmond, Oregon told us to expect our new RV documents from the DMV in about six weeks. That was in July.
     In August, Jon started calling. The dealership had not turned in the application for our RV documents to the DMV until five weeks after we purchased it! A call to the DMV in Bend, Oregon revealed that, yes, it would be another six weeks to process and mail out our title and registration. It could be September or October before we received our documents.
     We couldn’t face hanging out in smoky Oregon that long! After months of dodging acrid forest fire smoke this summer, we decided to head to Tucson, Arizona where the air quality is clear and the autumn weather is pleasantly warm. Our son, who lives in Bend, agreed to overnight mail our documents to us in Tucson when they finally arrived. As soon as we received them, we would head for the border!
     Why are these documents crucial when driving to Mexico? We needed to purchase a 10-year Mexico RV Import Permit for our new-to-us motorhome. We always buy our vehicle permits at the Banjercito located at KM 21 after crossing into Mexico at Nogales, AZ, so we know what documents we will need, but we still make ourselves a list. We’re glad we turned in the 10-year RV Import Permit on our Southwind when we came north in July, even though it still had eight years remaining on it. Since we decided on a whim to trade in that Class A motorhome and downsize to a smaller Class C rig this summer, we will need a new RV Permit and they are not transferrable. We had to wait.

Other Important Lists
     While we waited for the Oregon DMV to wade through their bureaucracy and the US Postal service to deliver our package, we worked on finishing most of our other lists. We had completed purchasing our:
1.     Mexican Motorhome Insurance online from Lewis and Lewis
2.     Prescription Medications—One Year Supply*
3.     Vitamin and Nutritional Supplements—One Year Supply*
4.     Over-the-Counter Medications—One Year Supply*
5.     Motorhome Oil Change and Repairs (Yeah! The electric step works now.)
6.     Clothing (pairs of shorts, Zumba shirt, OluKai Flip Flops, etc., items we can’t find in Mexico)
7.     My Zumba Instructor License Update (I took the English version of the class in the U.S. so I could understand the teacher. My Spanish is still pretty poor)
8.     12 Audiobooks from Audible.com for our road trip home (We can’t download from Audible.com once we cross into México)
Stocking Up On a 1-Year Supply of Vitamins & Supplements
     *We always purchase a year’s supply of our prescription medications, vitamins, and over-the-counter medications, such as ibuprofen and acetaminophen, because, surprisingly, generics in the U.S. are much less expensive than in México. In addition, some of our prescription medication is not available in México.

Exploring Tucson
     Once we had finished packing our boxes of supplies, we had more time to wait, so we explored Tucson’s old town, enjoyed beautiful sunsets, took walks, Zumba classes, yoga classes, and read. We learned the Tucson bus system and found out that health care in Tucson is high quality and efficient. We started to think about spending more time in Tucson next year. It’s great to be retired, to be able to do whatever we want, whenever we want!
Enjoying a Tucson Sunset from our Motorhome
An Important Doctor Visit
     Jon had an appointment scheduled with a medical specialist in Tucson, an exam that his primary care physician had recommended this year. Our hopes were that a simple exam would be all that was necessary and we could be on our way to México. But, the doctor ordered a blood test and an MRI. How long would he have to wait to be scheduled for the MRI? And how long before the physician would receive the results? And then, what if treatment was needed? We just needed to learn patience.
     We were thrilled that the Imaging Center could do Jon’s MRI two days later, on a Saturday. In addition, unbelievably, they claimed the results would be sent to the doctor in 24 to 48 hours. This was amazingly fast compared to our experiences in Oregon. Monday morning the doctor called Jon to say his lab test and his MRI showed no abnormality and “see you next year.” Our relief was extreme. One more hurdle cleared.
     We continued to wait for our Oregon title and registration to arrive in Tucson.

Licensing Our RV in Arizona vs. Oregon
     Here’s an interesting twist to the story: While we were waiting for weeks in beautiful Tucson, AZ, we realized that, because we were keeping our original Oregon RV license plates, our registration renewal would always come due in July, smack in the middle of summer. What if we couldn’t, or didn’t want to be in Oregon in July? Did we really want to play this 6-week to 3-month waiting game for our RV registration again next July when our tags expired? What if we registered our motorhome in Arizona in October instead? October is a beautiful month in Tucson, and it’s close to the Mexico border, so we could leave for home in Sayulita each year right after getting our RV registration.
     We had nothing to do but wait on the Oregon DMV and the US Postal Service, so we decided to stop in at a local Tucson branch of the Arizona DMV, the Academy of Driving Motor Vehicle Division on Broadway and ask what was involved with getting an Arizona RV license, registration, and title. Wow! In Arizona, we could walk into the office with the necessary documents, our smog test results, and $447, and walk out the same day with a new license plate, a tag, a new title, and registration.
     The day our Oregon title and registration arrived in the mail, we took them, along with our Oregon license plates, and drove straight to the Arizona Department of Environmental Quality (ADEQ). We paid our $12.50, passed our smog test, and received the smog certificate required by the DMV. Off we went to the Academy of Driving Motor Vehicle Division. An hour later we walked out with our new Arizona license plate (only one needed here), our new registration and title! All good until October 2019!

Ditching Our Last Two Lists
     By this point, we were anxious to get to México. Should we ditch our last two lists and just go? What was the worst that could happen if we skipped completing these:
1.    Shopping for American Food We Can’t Live Nine Months Without—Mrs. Renfro’s Habanero Salsa, Decaffeinated Orange Spice tea bags, Litehouse Chunky Bleu Cheese Dressing, a few bottles of California Cabernet and Pinot Gris wine… We decided we could live without these for nine months.
2.   Get a Health Certificate for Bella, our Dachshund—each vet I called was booked for the next three days. We always get Bella’s health certificate before crossing the border, either into México or the U.S. After the fiasco we went through at the Puerto Vallarta Airport last year with Bella’s health certificate, did we dare skip it this year? (See "Bringing Your Pet Into Mexico--New 2017 Laws Are Being Enforced") We’ve never been checked for it at the border when we are driving across, but… this could be the year they decided to ask for it. We decided the worst that could happen is that we would have to turn around and go back to Nogales, AZ and find a veterinarian to complete her health certificate. We were skipping this list for the first time in over twenty years of traveling to México with a dog!
Bella Is Tired of Dealing With Health Certificates
     Let’s head for the Mexico border! We fueled up the RV with diesel one last time, since gasoline and diesel are more expensive south of the border. A free night of camping in the Casino del Sol parking lot and some delicious sushi for dinner at their Ume restaurant, and we were ready to retire early. At 6:30 the next morning, we started our drive toward México.
     We soon arrived at the border, spoke to a courteous Customs Agent, and were waved through. No one asked for Bella’s Health Certificate. Whew—sigh of relief.

Obtaining Our Mexican RV Import Permit, Finally!
     We import our motorhome into México under my name, since I have a Mexican Temporary Resident Visa. My husband, Jon, has a Mexican Permanent Resident Visa, so is not eligible for an RV Import Permit. I gathered the following documents, plus a copy of each, to purchase the RV import permit:
1.     My Passport
2.     My Temporary Resident Visa
3.     Original Arizona RV Title
4.     Original Arizona RV Registration Certificate
5.     My Oregon Driver's License (I’ll get my Arizona license next October)
6.     My Credit Card (no copy is needed of this)
7.     Certificate of canceled import permit for any prior temporary import permits (We just keep this handy in case they request it)

     I was so sure I had everything correctly prepared for my walk to the teller’s window at Banjercito, all copies and originals in hand. But, no, I had made one error that required me to gather my documents, leave the bank window, and go to the copy center for two copies, before I could return to the bank teller and start from the beginning.
     I had inadvertently grabbed an old copy of my previous Temporary Resident Visa, now expired. To me, the copy looked identical to my current card—same posed photo of me with no glasses, no earrings, and my hair pulled severely back from my scowling face. But the teller was sharp. She noticed that the copy was of my expired Temporary Resident Visa.
     Fortunately, the copy center’s copier was functioning this year and for 10 pesos (50 cents US), I was quickly able to get two readable copies, one of each side of my visa. Returning to the line at Banjercito, I was relieved that there was only one person ahead of me. It turned out that 9:30AM on a Wednesday morning was a good time to purchase my 10-year RV Import Permit.
Mexico: Pemex Gas Stations, Mexican Flag, & Beautiful Backdrop
     Another 247 miles and we would arrive in beautiful San Carlos, Sonora, on the Sea of Cortez. Soggy Peso Bar, here we come! We love the blue skies, rugged mountains, sparkling water, and stately cacti of Sonora, MX. Retirement in México is always an adventure. Never a dull moment.
View From the Soggy Peso Bar

     Check out my Amazon.com Author Page to explore more of my stories about "Healthy Living and Traveling in Mexico".
    
                                                  Terry L Turrell, Author  
             In Canada: Amazon.ca
                                                       Mexico: Amazon.com.mx
                                                       United Kingdom: Amazon.co.uk
                                                        Australia: Amazon.com.au *
     I invite you to SIGN UP for my "Healthy Living and Traveling in Mexico Newsletter", published monthly with stories about our latest adventures, my recent blog articles, and news about my books.
     Thank you for reading my books and blogs. I look forward to hearing your comments and reviews.
    Terry L Turrell

Thursday, October 11, 2018

DEALING WITH H. PYLORI STOMACH INFECTION: Is Mexico Getting the Blame?

Stained Helicobacter pylori on Stomach Lining
Epidemiology and Diagnosis of Helicobacter pylori Infection ) 
     Helicobacter pylori (H. pylori) is a type of bacteria that can infect your stomach and small intestine. Surprise! My doctor decided to test my blood for it this year and the results were positive. I really wasn’t that surprised.
     I knew H. pylori infections are common, though usually do not cause symptoms. As a pharmacist (recently retired), I dispensed prescriptions for many patients who had been diagnosed with H. pylori and their doctor had decided to treat the infection. According to the CDC, H. pylori causes more than 90% of duodenal ulcers and up to 80% of gastric ulcers. Patients with ulcers often develop symptoms that may include severe or persistent abdominal pain, difficulty swallowing, bloody or black tarry stools, and/or bloody or black vomit or vomit that looks like coffee grounds. 
     But I didn’t have any of those symptoms. So why did my doctor decide to test me for H. pylori? Did she think that because I had lived in Mexico for over three years and traveled there extensively for more than twenty-five years that I was a high-risk candidate for an H. pylori infection? My blood test results came back positiveI did have H. pylori bacteria living in my stomach. How long had I had that?
     It turns out, my risk of having H. pylori in my stomach is fairly high based on statistics. Over 50% of the world’s population has this gram-negative bacillus growing on the mucous lining of the stomach. In fact, according to the Centers for Disease Control and Prevention (CDC), two-thirds of the world's population is infected with H. pylori, so the odds that I am one of those who has acquired it isn’t all that strange.
     “It is not known how H. pylori is transmitted or why some patients become symptomatic while others do not. The bacteria are most likely spread from person to person through fecal-oral or oral-oral routes. Possible environmental reservoirs include contaminated water sources,” according to the CDC’s fact sheet. We always dine out at reputable restaurants and drink purified water, wash our hands well, and disinfect our vegetables and fruit at home. So why me?
We Dine at Reputable Restaurants in Mexico & Drink Purified Water
     It is not entirely clear how H. pylori infection is acquired, nor why ulcers or cancer occur in so few of those infected. It is believed that the exposure usually happens during childhood. Now, this surprised me. The more I read about H. pylori, the more I understand that it is commonly contracted at a young age, sometimes from family members, and often remains in the stomach undetected for the person’s entire life. H. pylori could have been traveling along with me for sixty years!
     H. pylori infection is more prevalent in developing countries such as México and those in Central and South America, as well as Asian countries including China. Since I have been traveling to and living in México, as well as Costa Rica and Ecuador, for over 30 years, the odds are that I picked it up somewhere along the way. Of course, H. pylori can be contracted in the U.S., Canada, or any country, so who knows where I picked it up, but living in Mexico is not necessarily to blame, though it could have been the source. Add to that, my 20-year history of GERD (Gastroesophageal reflux disease), sometimes severe enough to cause prolonged vomiting, and it must have occurred to my physician that I was a good candidate for the H. pylori blood test.
     Why was it important for me to be treated for H. pylori? Many people carry these bacteria in the stomach their entire lives and never undergo treatment. Most infected people (more than 70%) are asymptomatic, without symptoms. But there are risks of leaving it untreated, especially once symptoms begin.
     When signs or symptoms do occur with H. pylori infection, they may include:
·       An ache or burning pain in your abdomen
·       Abdominal pain that's worse when your stomach is empty
·       Nausea
·       Loss of appetite
·       Frequent burping
·       Bloating
·       Unintentional weight loss
     Since its discovery in 1982, H. pylori has been known to be a principal cause of peptic ulcer disease and as the main risk factor for the development of gastric cancer. About 15% of infected individuals will develop peptic ulcer (duodenal or gastric) or gastric cancer as a long-term consequence of infection. I already have a genetic risk for gastrointestinal cancer, so, yes, I’m going through with the whole, nasty treatment process.
     What’s so nasty about the treatment? Well, have you ever heard of an infection that requires treatment with three antibiotics at a high dose plus a proton pump inhibitor, all administered simultaneously for two weeks? That’s what it takes to eradicate the resistant H. pylori bacteria and allow the stomach ulcer to heal. There are various FDA-approved treatment regimens. My doctor prescribed amoxicillin 500mg, two capsules twice daily, plus clarithromycin 500mg, two tablets twice daily, plus metronidazole 500mg, one tablet twice daily, plus omeprazole 20mg, one capsule twice daily, all taken for two weeks. I was not looking forward to this course of therapy!
     The side effects of the medications were worse than the symptoms I had been experiencing! The stomach upset, even when taking all pills after meals, and the diarrhea this therapy caused were enough to make me seriously consider stopping the medications after the first week! The horrible metallic taste in my mouth from the metronidazole was one of the worst side effects. At least it didn’t alter the flavor of food. I powered on, determined to complete the treatment and eliminate this nasty bacterial infection.
No Alcohol During Treatment for H. pylori Infection!
     The hardest restriction during treatment was NO alcoholic beverages for 17 days—the two weeks of treatment plus 72 hours! I was well aware, as a pharmacist, that even the amount of alcohol in a cough syrup would interact with metronidazole, causing an Antabuse-like reaction including nausea, flushing, low blood pressure and dizziness, headache, and other symptoms. Though I typically enjoy two glasses of wine each evening, I refrained completely from ingesting all forms of alcohol. Boy, did I get tired of drinking root beer, ginger ale, and grapefruit flavored Perrier while Jon enjoyed his Cabernet Sauvignon!
     One of the most serious potential side effects of taking this much antibiotic for two weeks is developing a Clostridium difficile (C. difficile) intestinal infection, which usually presents as watery diarrhea three or more times a day for two or more days with mild abdominal cramping and tenderness. I know how serious C. difficile infections can be, so I began taking the probiotic, Culturelle, a high-strength lactobacillus, three times a day, beginning as soon as I was diagnosed with H. pylori. This helped build up the good bacteria in my stomach and intestines before bombarding my system with multiple antibiotics. I continued taking Culturelle three times daily during antibiotic therapy plus one more week, then twice daily for another month. So far, I have escaped the horrid C. difficile intestinal illness. I plan to continue taking Culturelle once daily from now on, in addition to eating yogurt every day, usually my own made from Yogurt Starter Mix containing live culture Lactobacillus acidophilus.
Sources of Lactobacillus for a Healthy Stomach & Intestine
     What also surprises me is that when I tested positive for H. pylori, my doctor decided to test my husband, Jon, for it, too--but his blood test was negative for H. pylori. Logically, he would be likely to have acquired it either from me or from the same source that I did since we have lived together for over twenty-five years. In fact, he is at a higher risk than I am because he grew up in the developing country, Ecuador, from the time he was 3 months old, over 68 years ago. But, he was not infected with H. pylori. Lucky guy!
     Well, I survived the treatment for H. pylori. I’ll have to return for another blood test to prove that the bacterial infection has been eradicated. Maybe in a year…my gastrointestinal system needs some time to heal from the antibiotic treatment.

     I invite you to check out my Amazon.com Author Page to explore more of my stories about "Healthy Living and Traveling in Mexico".
    
                                                      In Canada: Amazon.ca
                                                       Mexico: Amazon.com.mx
                                                       United Kingdom: Amazon.co.uk
                                                        Australia: Amazon.com.au *
     I invite you to SIGN UP for my "Healthy Living and Traveling in Mexico Newsletter", published monthly with stories about our latest adventures, my recent blog articles, and news about my books.
     Thank you for reading my books and blogs. I look forward to hearing your comments and reviews.
Terry L Turrell