Wednesday, April 27, 2016

Migraines in Brazil

I posted before about visiting the clinic in Brazil to renew my migraine prescriptions - ones I had obtained in the States after fourteen years of visiting different doctors, neurologists, being poked and prodded, EKGs, MRIs, experimenting with different migraine medications (including an experimental pain killer that led to a very unsuccessful English literature discussion followed by a special one-on-one with my professor to justify my weird behavior oh boy). Anyway, after a two hour wait, I finally saw the doctor and was able to get my prescriptions renewed. Excellent, right!?

Except, when I went to the pharmacy to pick them up, I was told my three month prescription for anti-seizure medication would only be filled monthly and I would need to return to the doctor each month for a new prescription. They would also only fill it for one pill a day instead of the required two pills a day. Oh, and it cost R$26 for the 30 pills. So to actually fill my 60 pills a month, it would cost us $52.

The other prescription I take is Imitrex, which you might be familiar with. It's an abortive for when the migraines actually hit. The pharmacist told us there is no prescription needed for Imitrex in Brazil; it can be purchased over the country. Score! I couldn't believe how great it was that Brazilians could skip the medical circus the States require for an Imitrex prescription. When my US supply of Imitrex finally ran out and the next migraine hit, I set off to get some more of my miracle drug. Except, it wasn't available at the first three pharmacies I went to. At the fourth pharmacy, one I try to avoid because it's quite expensive (although ironically its slogan is "drogaria mais barata do Brasil" aka "the cheapest pharmacy in Brazil), I finally found it. I almost jumped over the counter and hugged the pharmacist, except you know, the lights were blinding me and the sounds were deafening  to me and I was dizzy and nauseous and all that accompanies a migraine. Give me your finest drugs, sir! "Sure, that will be R$26." Yikes, R$26 again. Well, whatever, I thought, I really can't survive without it. And then I saw the box. Dois cápsulas. I'm sorry, come again? Two pills for R$26. I politely declined and left, the sun blinding me on the walk home. Have I mentioned how god damn close to the sun we are?

Let me break this cost down for you guys. I need nine pills of Imitrex a month (R$117) and sixty pills of the anti-seizure medicine a month (R$52). That means to continue my medication, the medication that took fourteen years to identify as the right medication for me, it would cost us R$169 and include a minimum of a two hour clinical visit every month. That's more that my husband makes in a week and extremely our of our price range.

Two nights ago a migraine hit me with instant nausea and sickening pain. It felt like the front and back of my head were being compressed; the pressure was unbearable. One of my big issues with a migraine is that one side my neck becomes very tense and no position, sitting or lying down, will relieve the tension. So I spent the last two days lying on the ground, intermittently making sure the littlest expat was fed, changed, and entertained, and welcoming relief in any form. My husband suggested asking the pharmacist what they typically dole out to Brazilians and with that I picked up 12 pills of Migraliv for R$15 (and no prescription). I will say it has dulled the pain enough that I can function, but it's no substitute for my prescription. So the current verdict is for clinical care and classic OTC medicine (for fevers, pink eye, etc) Brazil takes the cake with their free visits and in-clinic pharmacy. For specialized medicine and treatments, the States has Brazil beat by a landslide.

Saturday, April 23, 2016

Our Next House

I find that with every post I need to address the scarcity of my posts. I am really trying to post at least once a week, because there is so much to share and so much I want to say. But I've really been in a rut lately. My son is a "spirited child" which is a nice way of saying undiagnosed ADD. He was supposed to see a behavioral specialist before we left the States (via his pediatrician's recommendation), but it was one of those things we just didn't have time for. Anyway, it takes all of my energy/patience/sanity to parent him and the one year old all day. They are into everything and so full of attitude spunk. And the one year old has started the "I can do everything by myself/but I need your attention every minute or I will freak the fuck out" stage. Last night when my husband came home from work I sat outside by myself and checked Snapchat (jeanie.demelo) while eating the last of our cookies. He must have sensed my exasperation because he asked me if I was okay, gave my forehead a sweet kiss, and took care of the kids without bothering me. 

On to the post: although we'll be here for another five years or so, I find myself house hunting from time to time. Which is doubly weird because we own our home here and we likely will not purchase a home in New Jersey again. The taxes on our home were over $8,000/year when we left and I absolutely refuse to fall into NJ's tax trap again. But god do I love to take on and decorate a space.  I missed that with our current home because we remodeled it from afar while still in the States. 

One day when we do purchase a house again, I'm going to apply everything I learned from decorating our first home. Including:

1. I will paint and update before we move in. It is so much easier to spend a week or two working on an empty house than trying to work around furniture and appliances.
2. I will remove every outlet/switch, outlet/switch cover, and vent before painting. I chose to do our house one a room at a time and it took me the entire time we lived there to finish painting.
3. Once all the rooms are painted, I will install brand new (if needed) outlets/switches, outlet/switch covers, and vents. Again this is something I did one room at a time and it was tedious and I would hit the same issues with every room. It would have taken a lot less time and been much less frustrating if I had done everything at the same time.
4. Crown moulding and trim will be installed all at the same time, after painting. 

Really, breaking down the decorating into pieces like an assembly line would have saved me a lot of time and frustration. Slowly but surely, every room in our old 1940s house looked better and better. Those small, easy changes completely transformed the rooms. You don't realize how much a thrice painted outlet brings down a room until you install a bright, clean new one. I was nervous about updating the vents as well, but the ones that came with our house were rusted and broken. And again, the new ones completely made the room.

We'll see if I can convince my husband to take on another project house, but I am earning this "I lived in Brazil for five years" card. 

Thursday, April 14, 2016

Castelo Da Barra

Somewhere around Vitoria, a man built his family a castle from scratch. Apparently lots of tourists will stop to take pictures with the castle, because it's such a cool oddity compared to all the brand new houses built right there on the beach. We asked if he did tours and he said maybe one day when the castle was finished, but that he was still putting the final touches on it. He had been building it for 20 years. His son peered over the fence and my son asked him if there was a witch inside. His father responded, "Yes, my wife!" which of course got all the men laughing, while we women folded our arms. Maybe one day we'll get to come back and see the inside!

Thursday, April 7, 2016

New Year's Eve

He would dance all night if we let him

Baby expat was obviously thrilled by all the loud noises

I haven't posted in a while because I've been really, really sick for three weeks. I think I had a cold that turned into walking pneumonia. Or it could be bronchitis. I'm not sure. What I do know is that I'm coughing violently, my energy has been zapped, and I feel like a truck hit me. I haven't gone to the clinic, because I really don't feel well enough to sit around for two hours waiting to be seen while having to watch an energetic one year old at the same time. Whatever it is, they'll probably just give me some OTC medicine, which I already have at home anyway. 

SO, while I'm trying to get better, here is a quick, extremely belated post from our New Year's Eve in Vitoria. Most of our family went to church, but since we're heathens, we went to the shore. Here in Brazil, white is the color everyone dons for New Year's. There were fireworks everywhere. I don't think Brazil has any laws regulating their use, since we see them all the time at home (middle of the day, random 2 am shows, whatever). They were being let off all over the shore and I was a little nervous about how close we were to them. But no one got hurt, so it ended up being really cool, even if baby expat was terrified all night. The real fireworks show came from a few boats out in the water. There were tents set up all along the shore and people could buy food or alcohol, funny hats, and other party gear. We normally do everything with my husband's family (and extended family), so it was really nice that we got to count down the new year with just the four of us. All in all it was a great first New Year's in Brazil.

Friday, April 1, 2016

The Postal Service, a Necessary EVIL

Warning: a lot of ranting and use of bold text ahead.

Do you know about my extreme loathing for the USPS? Okay, let me tell you about it. Three times our boxes (going to Brazil) were lost in customs and never left the country. After going around in circles to fill out insurance claims, being told we need receipt after receipt to prove item values, and finally being told they won't process the claim because they can't prove that it wasn't lost on its way to Brazil and somehow then lost by Brazil and not them (boxes never left customs 😡), we were out the cost of the items AND shipping. This is somewhere around $500 for each box

There was the time our wedding rings (purchased in Brazil) were returned to Brazil by the USPS because we "never picked them up." Except.. We never received a notice to pick them up. This was at the apartment where our mail was constantly received with a handwritten note to the effect of "THIS IS THE WRONG ADDRESS! LEARN HOW TO READ! DO YOUR JOB RIGHT!" So I'm pretty confident that they delivered the notice to the wrong address. After all, they were adamant that a notice had been delivered. Of course, since the package was "unclaimed," it had to go back to Brazil and my mother in law had to re-mail it to us. It only took two months to finally get back to us. 

There was the minor annoyance every time we sent a box to Brazil and were told to do it a different way by every Post Office worker. 

  • You have to put your return address on the box/You don't need it because it's on the customs form (which covers it anyway)
  • Write the address on every side/Only write the address on one side
  • Put more tape on it/Don't put so much tape on it
  • Do a cartwheel while singing the alphabet/Do a headstand while reciting the Pledge of Allegiance
And now.. My mother sent a birthday present and I asked for the tracking number. We need to watch the shipping, because if the box is issued taxes, there is no notice from the Brazilian postal service (Correios). We need to follow the tracking to know 1) which Correios is holding the box and 2) that we need to pay the taxes. So the USPS informed my mother that "there is no tracking for Brazil." Except that every single time we've sent or received a box there has been tracking. What do they think this is? A third world country?? Well, actually.. Um, excuse me for a minute while I gather the patience of a thousand saints. 

On the Brazilian side of the nightmare: TAXES, TAXES, TAXES! A Republican's heart would jump out of his/her chest and they would collapse cartoon style if they knew how much we pay in taxes for "imported goods." I put that in quotation marks because the "goods" are usually our own stuff or presents. I have estimated that in the seven years my husband and I have been together, we've paid about R$10,000 in taxes for shipped goods. The taxes include:
  • Merchant Marine Renewal Tax (AFRMM) - (only applies to imports via sea)
  • Import Tax (II) - (about 20%)
  • Industrialized Product Tax (IPI) - (about 20%)
  • Merchandise and Services Circulation Tax (ICMS) - (a state tax and different for each state. In our state, Minas Gerais, the general tax is 18%, but certain items have different rates.)
  • Contribution to the Social Integration Program and Civil Service Asset Formation Program (PIS/PASEP)
  • Contribution to Social Security Financing (COFINS)
You can read more about what these different taxes are here. The link also has a good example of how those rates look when applied to a product. They use the example of $20,000 worth of golf balls being imported. The total sum of taxes on the product are $17239.88. 

The II, IPI, and ICMS are the ones that we're hit with every time, which mean we pay about 58% of the value of a box in taxes. And let's not forget how the value of a box is estimated. This is crucial. They scan the box and guess what's inside. Is that a box or a tablet? Doesn't matter, if they say it's a tablet, you're paying taxes on a tablet, and good luck fighting that. A tablet worth $100 or $400? Doesn't matter, you're paying whatever they value it at. So it's really frustrating when friends and family want to send, oh say, birthday or Christmas presents, and I have to respond, "Thank you so so so so SO much, but I need to know what you are sending, because we're likely going to have to pay hundreds of Reals to pick that box up." It makes me feel like an asshole and it makes me feel bad that my children can't receive presents without them passing the "are we going to be taxed to death" inquiry. 

Now for the political part: I understand why Brazil levies such high import taxes on products (or why they say they do).. they want to keep manufacturing domestic. Which was a great idea 50 years ago before we had a global economy. And to Brazil's argument, there are more small business here than I've seen anywhere else. It's also inspired a lot of auto manufacturers to open plants in Brazil so Brazilians can, you know, actually afford a car. But on the other hand, the products made domestically tend to be of very poor quality. And when we have China and other Asian countries as major players in the manufacturing industry, Brazilians can't afford PS4s and iPhone 6s because the exchange rate and taxes send them far out of reach. (Hello giant, functioning black market). You might have heard this before, but in some cases it's cheaper to fly round trip to another country and purchase a product than it is to purchase it in Brazil. Of course, if you're a rich Brazilian politician, none of this is a problem for you because you either have the means to afford everything from all your kickbacks or the means to bribe customs handlers. Uh yeah, we'll just leave it at that.