Bushamy is right. Less expats in estelli, jinotega, and matagalpa, but the weather is much cooler there and the wind is blowing constantly when u get up in the higher elevations.
Don't worry about fitting into a community. They will love u. I meet new Americans here every week. Lots of groups coming through now as well. The rainy season is over now and people are starting to come back down.
Medical care is another thing. Pharmacies here have everything u need cheap. I can walk right into a pharmacy and get whatever I need. The meds here work awesome as well. About two months ago I had a cold and runny nose. I walked into a pharmacy and told the girl. She gave me a nasal inhaler and I laughed out Loud at her. I bought it any way for about $2. I took it home and used it and within 15 mins felt 100% better. Worked like a miracle. Over the years I have gotten sick here on occasion and they always have something that works quick. I go to a dentist here and the price for a filing is around $20. In NYC it's about 2k but that's nyc. You can find and afford a private dr to treat you for whatever. I have one and a private eye dr as well. I scratched my eye last week and paid $20 for a visit and then another $5 for the rx drops. People are very friendly and you will meet expats and or locals easily.
2. Open mind
3. Good cookbook
4. Some type of music device that plays music u like, ie iPad, Walkman etc
5. Good towel. Hard to find a big towel here.
6. Baby wipes as you can't flush paper down the toilet
7. Tootsie rolls
8. Thermal water bottle
9. Hair gel, they only sell one kind here
10. Really great walking shoes.
If I had to prioritize this list I would put tootsie rolls first. Chocolate u can buy here is snickers, twix, and a Hersey bar. Everything else is almost non existent. They do have M&M but this is hardly considered chocolate.
If you get pulled over by police, a $4 tip buys your innocence. Hope this helps.
One last tip, don't pet dogs here ever! Little ones bite much more than the big ones. I always have a water bottle to spray them just to be on the side of caution.