Sylvia's Journal

It is very cold, just one degree above freezing. Coming back from Africa, this is a new experience. It is also a new experience for my foot which takes longer too limber up in the cold. I am trying to fall back in my old routines but it’s hard. I am getting up too early and having more trouble than before the accident in getting myself organized. My desk is still a mess and I have a hard time concentrating. I don’t think I ever had a concussion but I act as if I did with this being a delayed reaction.

The accident and our recovery have been dominating our life the last four months. Everything had orbited around it, including our daily schedules of exercises and therapy. In Nairobi my life was organized around the needs of the task at hand, which filled each day and evening. Now, without this focus, I am feeling a bit lost. I am no longer incapacitated, having proven that I can do the work as I did in Nairobi; yet on the other hand I am not yet ready to get in the car three times a week and head to work and complete the forty+ hour week with two days working at home. But something is shifting.

I think my dreams of last night carry some clues even though it is hard to find them in my nearly undecipherable pencil scribbles on yellow Post-it Notes next to my bed. This is the text I found when I woke up this morning: “Something about (health) services – it is easy to render lots of them of dubious quality or outsource them and no longer pay attention.” There were more scribbles about a feeling that came with the words, a sinister and ominous undercurrent that combined two topics with which I occupied myself: Rwanda’s genocide and coaching. I read the chapter in State of Africa on Rwanda and with my colleagues Lourdes and Barbara I discussed the revision of a forthcoming publication on Coaching. I can only think, at this early hour, that there is some tension between an inner-directed self-centredness (Rwanda) and an outer-directed attention to others (coaching). I have a hunch that this week is going to contain some turning point for me in my recovery and return to normal life.

I started the day with a badly needed massage from Abi. Later I went to physical therapy. In between there was one work-related call (on coaching), an a few tasks such as writing my assignment report and completing my expense report in addition to a half-hearted attempt to organize myself and plan my week. If I apply my work standards from before the crash I was singularly unproductive.

My physical therapist was curious to hear about my PT experiences in Nairobi and announced that she, too, will get more aggressive as the swelling of my foot subsides (which it hasn’t). She worked hard on mobilizing the ankle joints and gave me a new set of exercises to build up the weak and tight muscles around them.

Axel also had his appointment for OT/PT in Peabody to which he still needs to be driven. He found himself in some bureaucratic mess-up related to re-activating his driver’s license that may require weeks if not months to sort out. It appears that someone inadvertently checked a box that should not have been checked on his application for a handicapped parking sticker. He was placed in the category of high risk drivers who are either post-stroke or epileptic. Given our litigious society we fear that no one is willing to take the risk of calling him fit by placing a signature on some form or another. It is a bit of a nightmare of which the end is not in sight. The fees required to pass each barrier (hundreds of dollars) also undo the benefits of the handicapped sticker which absolve us from putting quarters in parking meters. We’d have to park entire weeks at parking meters for the next few months to offset the re-instatement fees.

I am sitting in my bed with a pillow as desk and the computer on that pillow; much like I have done since July 21st minus the last two weeks. It is very early in the morning.

My dreams were many and mysterious. I was doing exercises with my foot on a raised platform on a square with lots of people looking on. At some other point I gave directions to someone to a hotel in Kathmandu. The directions were so precise, with street name (Khatra or Khadra street)l, that I could check with my Nepali friends whether it really exists. I also dreamed about being with people who push boundaries and who innovate and in some context or other used the terms innovation and denovation. I think in my dream state I invented a new word. I suppose innovation and denovation are opposites. Maybe coming back to one’s own house, hearth and loved ones is denovation, as in: going back too what was before.

It is wonderful to be home again. This is the best part of traveling after all: coming home. This homecoming was a bit different from all my previous homecomings. I used to be full of energy, no matter how far I had traveled, bring my suitcase in, unpack it, distribute gifts and goodies, have tea, dinner and whatnot, take a shower, put the laundry in the washing machine, clean off my desk, and have everything ready for a new workday. I would go to bed at a normal US time and everything looked as if I had never been away.

Not this time. My suitcase is still sitting on the floor, unopened. The Dutch cheese did not even make it into the refrigerator. I was completely exhausted and went straight to bed for an uninterrupted 8 hours of sleep. That woke me up at 3 AM.

I am stiff beyond belief. Once more I wonder when and if I will ever be limber again. I am curious what my physical therapist will say about my foot; it doesn’t feel like there was any progress and possibly even regress. My neck and shoulders are sore and my range of motion feels limited. I was allowed to travel business class but even there it was a challenge to keep my leg up and get comfortable. I don’t think I slept more than one hour on all the flights combined.

Nevertheless it was wonderful to be out in the field again and do the work I love so much doing. It was worth it and I’d do it again if the opportunity would present itself. But not right away. I think I am going to take it easy for a little bit.

All our aches and pains were overshadowed by a call from a sobbing Tessa yesterday morning. Her pet rabbit Nijntje died, suddenly. Tessa was inconsolable. Axel and I cried along with her on the phone, wishing our arms could reach all the way into London to hold her. Her pain was made worse because she couldn’t locate Steve at first and there was no one to console her or simply be with her. Tessa had poured all her love in this little creature which she got on her 18th birthday and which had been so much a part of her life after high school. And now it is no longer there. Our hearts are aching for her.

Later, after we had hung up, it occurred to me that we got a glimpse of Tessa’s reaction when the news of our crash finally reached her last July. Not that rabbits and parents are the same, but when it comes to being the object of love, maybe they are.

This sad news colored the day, which was already sad because of our imminent parting; add to that the early nightfall, the leaves falling and hurricane Noel racing up the coast to soak the Northeast. It could easily have added up to a sense of foreboding and depression. But it did not. I was excited and looking forward to the trip while Axel knew that this going out into the world was another important milestone for me on my path to recovery. My excitement was matched by a most glorious sunset over Boston as Sita and Jim drove me to the airport. Axel watched it from the cove. The sky was lit up with brilliant orange and pink streaks of clouds against a dark background. I think the storm was announcing itself in full Technicolor.

Navigating the airport was a different experience than I had expected. I travelled with my plastic boot which helped me avoid a significant part of the security line which snaked for a long distance. I could not see myself standing in line that long and asked for a short cut. A couple of Brits were standing right where I was let into the line and got upset. When I pointed at my boot they softened a bit. They asked what happened to me. When I said ‘a plane crash’ all the women in the group crossed themselves and the men asked whether I was flying on Virgin. They seemed to think that I would be a liability on their plane. I told them I wasn’t planning on crashing ever again in my life and that I was going on Northwest which therefore would be the safest choice of airline.

Later, after security I discovered the stresses of being handicapped when the line in back relentlessly pushed forward while I was still trying to collect all my belongings and put on my boot. I know that travel is stressful, even for the totally fit. Security adds more stress and it becomes hard to see other people’s needs. We’re all in our own little balloons, trying to get wherever we want to go, in one piece and with all our stuff. That’s when the truly kind people stand out, like the young man who took my handluggage and said, hey, I’ve been waiting in this line for so long, I can wait this little longer, take your time.

I am posting this entry from Amsterdam. My next post, if there is anything to tell about a whole day of travel, will come from Nairobi, incha’allah. Please hold Tessa in your thoughts and prayers. She needs them.

Today will be entirely focused on my departure. There are no therapies and nothing to cut up the day. The suitcase is open on the bed downstairs and I have been throwing things that will need to travel with me in and around it. I have checked the weather in Nairobi and Holland so I know which clothes to bring. On the Nairobi end of the trip my friend and colleague Ida is securing airport assist, plastic tubs for my daily foot soak, a massage therapist and maybe even a physical therapist. I will be wearing my plastic moonboot for protection and comfort on the way from here to there. Not surprisingly, my dreams were all about travel. They were good dreams.

Yesterday was another very low energy day. It is as if my body has known, this entire week, that it needs to save up all its energy for the trip. I was never very good at being with low energy. Some people just take a nap but that is too radical for me. Before the crash, when I felt low I could go for a walk or a bike ride and get my energy back up. Now such physical activity is out of the question and I have not yet discovered other means to change things around. I did my foot soak, which helps a bit because I can walk better afterwards, and then I made a pumpkin pie, which made things worse because I stood on my foot too long (but smell and taste were worth it).

I had my orthopedic check-up yesterday. I first saw a physician assistant for about 5 minutes. He looked at my foot and asked a few questions. When I mentioned the continuing numbness and hypersensitivity of my foot (sole/toes respectively), he suggested the nerve might have gotten squished (not his words) in the tarsal tunnel. I did not know there was such a thing in my foot. It is like the carpal tunnel in my wrist. No one had ever mentioned this. It can take as long as a year to get better, or never at all. I was really taken aback by the way he said ‘never at all.’ There was a little hint of sadism in the expression on his face, as if he was still in Haloween mode. I figured he was a butcher or Freddie with the chainsaw. These things take a few days to wear off.

Then I got to see the real doctor for a couple of minutes. He wiggled my ankle and asked about pain. Good, good he nodded, this will take time. I discovered there is a formula. I love to hear about formulas; it is something I can hold on to, count off days, stuff like that. Recovery of muscle strength and soft tissue damage takes twice as long as the period in the cast. That would be 4 months. The next time I will see him, January 3, all should be well. Let’s hope the formula applies to me. These visits to my orthopede are very short. I think I am not an interesting case, since he took over from another orthopede and never got to operate on me.

Axel went by train to Brookline for his therapy session with Paul who could not make it to Manchester this week; a big undertaking. He took advantage of his time in Boston to meet up with Phil Karber for coffee and talk about adventure travel (without capital letters), a stop at the Paper Source for his card project and then back to North Station where he joined thousands of commuters for the return trip to the North Shore. He returned in great spirits and full of energy and participated in the cooking and clean-up while I marvelled at is energy (it is usually the other way around) from the comfort of my recliner chair.

I woke up to a glorious sunrise with brilliant pinks meeting the brilliant oranges and yellows from the trees in an explosion of color. I tried to gather evaporating dreams but they slipped through my fingers like sand. I hung on to some pieces about a community construction event, people sitting together and having a good time after hard work. This is probably another form of advertisement for the event that Diane is organizing at the Manchester Community Center on Sunday and which I will miss, unfortunately.

There was also something darker in the dream but it slipped away. This is fine. I was going to bring all the dark stuff into my EMDR session with Ruth but she just got another grandchild and the session is cancelled. I won’t be seeing her until I get back from Kenya. I’ll put all that stuff in storage for now; a closet that is already pretty full.

Yesterday we went to MGH for a consultation with a doctor who stands on the top of the health care pyramid. The orthopede from Salem hospital called him quadernary care, since tertiary has already slipped into the suburbs (Salem, Beverly, etc.). We got up early to beat the traffic and had a hard time getting out of the house in time. These things remain stressful, especially with our forgetfulness. We had to return once to retrieve a missing piece of paper. I particularly don’t do well with such stress and there were a few tears on the way. But despite the traffic, and there was much, we made it on the dot and saw the doctor for a few minutes and his assistant (intern?) for a few minutes more. He gave us some good news and some bad news. The bad news was that he considered the movement that Axel had seen last week and about which we were so excieted was pretty meaningless. The good news was that the distance that the nerve has to cover as it is reinventing itself is much shorter than we thought; the muscles that govern the extension of his wrist and fingers start fairly high up, close to the injury. He ordered another EMG in 6 weeks. If there is a positive change then the healing is progressing well and nothing needs to be done. If there is no change he will want to do an operation and help the nerve along.

Axel went to OT in his pirate outfit: hat, patch and hook. He was the only patient who showed up in style. You’d think that a Muscularskeletal Center would take full advantage of its name at Haloween (they had a few skeletons up here and there but that is part of their normal decorations). At my PT office things were a bit more playful. My therapist was dressed up as a gypsy with lots of necklaces, bangles and scarves, making for a noisy session. The secretary greeted me with wings on her back; there was a cowboy, a Red Sox player and the most adorable little cat person (3 years old) who came by each treatment room sticking out his candy basket to us patients, lying on our backs, ill prepared for ticking treating. I had no candy to give.

We were both too pooped to go out in town and see the tricker treaters go from house to house. We finished the lobster pie and went to bed early. A trip into Boston, with all the emotions attached, was a bigger deal than we thought.

Today is Halloween. If all things would have been normal I would have gotten up very early in the morning or stayed at Ann’s house to set up the annual MSH Halloween display, a tradition that is at least 15 years old. Last year’s Haloween display at MSH included lots of hospital Johnnies. Little did I know that I would have my own hospital Johnnie a year later plus many other patient paraphernalia. We are entirely equipped to go as accident victims this year: Axel’s body brace, a neck brace, a walker, several splints, crutches and our Johnnies. If we add some bandages and fake blood we could be very real. We got the walking bit down pat. But I feel no excited about such a costume and little energy for dress up. So this will be the first year that Haloween will pass me by, alas.

My dream life was very active last night; dreams about letting a wild thing loose followed a dream about being stalked by the monster-of-having-too-much-to-do that was trying to drag me down into something that looked like quicksand; bizarre, frightening and very real. After the fist dream I woke up and quickly scribbled down what I remembered while still expecting arms to pull me into the muck. I was not able to distinguish Axel’s arms from the dream arms and pulled over to the side of the bed. I remember falling asleep again; no longer afraid but angry, about these arms. Poor Axel!

The good news from yesterday is that my cervical spine is fully aligned again. The vertebrae (C2, 3, and 4) have been coaxed back in line over the last 6 weeks or so. This does not mean the pains are gone. The muscles still need to be retrained but the tender spots are smaller now and massage calms things down easily. In fact, yesterday I woke up with my left shoulder and neck totally pain-free. It took a while to register this. Such a luxury!

The process of realignment is mysterious. The physical therapist only used very subtle movements. The exercises she gave me are hardly exercises: minute movements of my head that are easy to do and cause no pain. If there is any stretching involved I cannot feel it. I can do these exercises without anyone noticing. Before this experience I always assumed that getting vertebrae back in line required force, as one would yell at a soldier or kid who is not standing in perfect alignment with the others. Maybe this is what chiropracters do. The end result certainly shows that this subtle coaxing into position works and that my spine prefers straight over crooked.

We went for our weekly massages to Abi’s office in Gloucester this time as she could not make it to our house. This meant it took the entire morning. We emerged so relaxed that on our way back we both forget all sorts of things we had intended to take care of while in Gloucester. But we had not written things down. This forgetfulness is a little worrisome and we haven’t found a way to cope yet other than writing things down. It is when we forget to write things down that we are in trouble.

The parents of Sita’s friend Brian sent him to our house with a lobster pie which we ate last night. We are in charge of our own meals now but this was certainly a treat. Sita and Jim left for Western Massachusetts to make music with their friends and so we have the place to ourselves. Axel promptly served himself about a half inch of white wine. I protested faintly and then had an inch myself. It was the Lobster Cove Chardonnay (“Life is a Beach” says the label with a lobster in a beach chair) that Ted and his brother Gus brought back from Illinois.

This morning, for the first time ever, I got very busy (coffee, hot pack, toast) before I started writing. We’ll see how this new routine affects the creative process (not so great).

I went to bed very early after Sita, Jim and I returned from serving a lasagna dinner with our Quaker meeting in a church in Beverly to about 70 down-on-their-luck or very low income income folks. It is usually a bit of a feeding frenzy. People come primarily to eat and they do it fast. Panera had donated various breads and pastries that would have filled a few bathtubs. Much of that went too, although we helpers also got to take some of that home. We will be in full carbo celebration for about a week I estimate.

That was about the most strenuous activity of the day. For the rest it was a very low energy day. I felt I got nothing accomplished other than checking email and sending a few out. I struggled a bit with that feeling as I counted the hours of work and non-work. It was rather lop-sided. Much of the day went into recovery work anyways.

In the morning Axel accompanied me to the surgeon in his Beverly office. We waited one hour in a small and dreadful waiting room (painted in grey – what were they thinking?) with the TV blaring at us. The surgeon explained that my abdominal fascia were probably sutured with fishline (no kidding, Axel recognized the name from his fishing years) and that the sutures from below and from above came together just about at my belly button and that was the knot with its sharp ends I was feeling. He explained about the risk of snipping these off (hernia) in the early months of healing but that the intervention was easy and that it was up to me. Later in the day he called me back. He had obtained the report from UMMC and the sutures were of the kind that gets absorbed. He counseled patience and told me that the discomfort would probably go away. Axel and I had already decided to wait it out.

Axel was dropped of by Ted for his OT and PT and picked up over an hour later by Diane and her husband Dr. Curt Prout, the oldest practicing doctor I know. I am sure Axel had another consultation from him on the drive home, a multi-purpose drive. Axel is anxious to get his driver’s license renewed and start driving again so he doesn’t have to call on people all the time for these rides. His eye sight is improving quite remarkably and not being able to drive is starting to annoy him big time. But Sita is more cautious and is not that anxious to see her dad behind the wheel.

My physical therapist took measures again of the range of motion of my foot. She does it when I feel that I am not progressing much. She proved me wrong and told me that I had made huge progress, more in some directions than others. I have held off on many of my exercises fearing a tendinitis. I don’t know whether I have been successful yet, so I continue to take it easy. The sole of my foot appears to be awakening and although it is a good sign, the discomfort has increased.

I am still waking up several times a night. I have gotten used to it and have come to accept it, as much else. I have now a much higher tolerance for discomfort and pain. For the physiical aspect I am relying on heat- and ice-packs, exercises and going to bed early as ways to manage this condition. Psychologically I can live with all of this simply because I can (and because things turned out as well as they did). I remember some years ago getting all upset about the pains in my knee and having to stop playing squash. It was the worse thing that could have happened to me, I thought at the time. Now I know better and I can smile. How little did I know then.

Although I cannot remember my dreams of the night, I did wake up at one time with words on my lips. I have come to pay attention to these as they have nearly always triggered insights or provided a key to something I needed to know or contemplate. There was ‘Track changes!’ which I believe was a command. There was ‘stacked right’ which reminded me of the importance of facing danger and threat together. But this morning the meaning is not that obvious. I am really puzzled. The words came to me in two languages and mean different things but they are both legal terms, and somewhat related as a search on google quickly proved. One was ‘ward of the state’ and the other ‘voogdes’ which is Dutch for female custodian (of a child). The google search led me to a whackie site about Indigo children and the god Wodan. I think I’ll save it for my next EMDR session.

Yesterday was the last day of our OBTS Board meeting. In the middle of the day we walked the Babson Campus to see the various buildings where the conference will take place. It turned out to be a walk that lasted 45 minutes or so and I was truly exhausted. I did not bring my cane or anything to help me walk, not realizing how long it was going to be. It was the longest (time and distance) walk since July 14 and it took the wind out of me. After lunch I sat with my heat-pack on my shoulder and a cold pack on my ankle and managed to hang in there till about 4 PM. I left before the meeting was officially over, in the middle of a series of motions from the president. I arrived home about 5 PM.

I found the flowers that had expired on the birthday chair much as I had expected. I could see how festive it had looked before. All the animals were still standing on the table, looking a bit tired and lonely. I was lonely too since everyone had gone shopping for the evening meal (tacos). I did my hot/cold water foot soak routine and collapsed in my comfy chair. Sita’s friends Brian and Tim came for dinner but not after Tim had gotten stuck on the beach at the exact place where Annette’s taxidriver had gotten stuck a couple of weeks ago. We had a lovely dinner together and discovered that when Axel eats spicy food now only the left side of his forehead sweats. The part on the right side of the scar is totally dry. This is funny because his right side feels ‘woody’ and you’d expect that part to be on fire.

Bedtime (for me) was early and sleep came quickly.

I wrote about patience on August 10. I looked for the entry (because I am impatient this morning) so I could take some of my own medicine. I have been suffering from the kind of impatience that is expressed with the words “are we done yet?” Re-reading my journal, in search of that one entry was indeed the medicine I needed: we have probably covered a good part of this recovery marathon and we are now in the last quarter. It’s like I imagine the last quarter of a marathon to be: painfully slow and tedious.

My foot is developing a tendinitis and I was told to hold off on exercises for a bit. One can be too enthusiastic. It may have something to do with walking around the house on slippers; I am told to wear shoes with lots of support and to give myself ice massages (done by tiny Dixie cups with water frozen in them and then peeling back the paper as I massage my unhappy tendon). Since I already have a tendinitis in my right shoulder which is painful and incredibly slow to heal (months and months and months) I hope to nip this one before it gets as bad as the shoulder.

I also asked the physical therapist what do to about my hands that wake me up several times during the night because they are so painful. She told me to experiment with pillows around my body and this seemed to have worked last night. So here we are, both hugging pillows instead of each other, as we try to support muscles and tendons that give us a hard time if we don’t. This is how Axel combats lower back pain in the morning. We really still have a distance to run.

I recovered from the long and intense workday of Wednesday and put in about a half day of work. Much of the work is responding to the increasing number of requests that come in to write this, review that, or fill in a form. It doesn’t feel like very productive work but it helps others do theirs and it does show up as a check mark on my to-do list. And every day there are emails or Skype calls from family, friends and colleagues from around the world who are inquiring about our recovery.

One of such emails came in yesterday from Ummuro, a colleague from Kenya. He is pleased that my first venture outside the US is to Kenya. He stuck a little gift into his email by quoting his grandfather who was a very wise man: “don’t look for meaning in life……human life is pretty meaningless without a sense of the sacred……the answers to your troubles may in fact lie in your own shadow.” I wish I could remember such a quote from my grandfather. I suppose this is the advantage of coming from an oral tradition, you remember words so much better. We end up with journals in hard-to-read handwriting that get stored in some closet. There is a lot to say for an oral tradition and learning things by heart.

Today I am getting ready for a two-day Board meeting at Babson College of the Organization Behavior Teaching Society. It will be another stretch, two days in a row. I will stay over two nights in their Executive Education Center which will be nice so I don’t have to drive back and forth. It will be my first two nights away from home since I came back from the hospital. I will go armed with ice packs, heat packs and my flex band. It’s like a practice heartbreak-hill as I am gearing up for the real thing in another 9 days.

Axel will be in good hands with Sita and Jim who are in a very good mood because the Red Sox won big time last night; a punishing victory as Axel calls it. I of course did not watch (which nobody here understands) and was refueling in Tunis with Antoine de St. Exupery on his way from Paris to Saigon, falling asleep just before something bad happened to him somewhere over the desert (and from which he recovers of course, as the lucky ones always do).