Sorry. Even although it’s perfectly legal in Washington, available in pot shops everywhere, and in the Beatle’s next line in the song, we don’t get high.

We appreciate the thoughts and prayers from everyone. Both of our daughters, despite their own very busy lives, have been wonderful. And even although we are brand new to this tiny community, our neighbors have brought food and wanted to help out. So we’re getting there. My pacemaker is doing fine, as am I, and hopefully in a few more weeks I’ll be able to drive which will simplify life a lot. Nikki’s orthopedic doctor is pleased with her progress and her breaks are healing a little ahead of expectation. She’s managed all kinds of moves and challenges. The mayor’s wife of one of our kids’ towns has loaned us a wheelchair. Unfortunately I can’t lift or push it, but when one of my daughters is here to load us into a car and push the chair, we can take some beautiful walks. And Washington is abloom with azaleas and rhododendron and the weather is changing … warming up and some sun. The days are getting much longer and I will miss the uniform days nearer the Equator in Panama.

I’m scheduled to go back to work on board PEARL MIST August 20 on a Great Lakes Cruise and then doing the fantastic fall foliage cruises on the St Lawrence and New England through mid-November. Right now everything is a go. We pushed going back on the ship until August 20 so I would have plenty of time to fully recover.

What I probably won’t recover from is sticker shock. The fire department ambulance treatment and ride was $1,410, but then again there was an ambulance with trained EMTs who were able to shock me back to life twice. So far, and you all know how hospitals keep finding more stuff to add to the bill, the hospital bill from Skagit Regional Medical Center, what they billed the insurance/Medicare is $76,000 for emergency room and a two nights stay. The estimate is that our out-of-pocket cost will be around $1,000. Whatever, I’m grateful for the care and to be alive, and grateful for insurance and Medicare.

People always want to compare medical care in the US with Panama. When it comes to emergency/911 response if it is available in Panama (and it wasn’t where we lived) there is no comparison. When we lived in Boquete town and Nikki went into anaphylactic shock due to a medication, the first question the ambulance folks asked was “Do you have money for gas.” The kid who accompanied the ambulance had to wedge himself between the side and the gurney on which Nikki rested less she slide out the back doors which wouldn’t close.

So we knew there from experience there was a certain amount of risk living in Panama. Back then we were willing to accept some risk, but as we’ve grown older for us now the risk is no longer worth the reward.

Regarding prescription medicine: it depends. First, not all medications are available in Panama. Panama’s medical establishment, like the CDC in the States, doesn’t necessarily approve or allow sale of some medications which may be available in other countries. If you have essential medications you need to check this out before you move. For a while we were able to order medications in the US and have our kids send them to us in Panama using one of the forwarding operations in Miami. Then Panamanian customs got wind that expats were doing this and started opening and inspecting packages and prohibited sending most prescription medications into the country.

Life is more simple in the US even with the hassles of insurance company reviews. You simply pick up what you need at the local Walgreens. Since most of my medications are available in generic form. most are covered by my Medicare Advantage plan. In Panama I would be paying at the local drug store for every medication. Granted some were half the price of what I would pay if I was just buying them myself in the US and they weren’t covered by my insurance. But some of those pills were $12 each when I had to buy them in Panama.

So it depends.

Don’t go with easy answers or generalizations regarding medical care and medicine. This is an important consideration if you are thinking of relocating to Panama or anywhere else. Do the research first regarding your specific situation.