Sylvia's Journal

I returned to work this morning, from my armchair. My computer is set up as if I am in the office, no one would know, except my office mates. But many of the people I work with aren’t in the Cambridge office anyways, so no difference to them.

After two meetings and some review work I noticed my flagging energy half way through the day. I had set myself some goals, things to complete, emails to read, to send, documents to read and phone meetings to attend, as if I hadn’t had a significant operation; funny how I fooled myself.

Axel has returned to his usual schedules of errands and doctors’ visits to deal with the various body parts that need expert attention and so I spent a good part of the day alone. I am well equipped now to take care of my needs, with my scooter and its basket full of necessities: a phone, a cup of tea or coffee, a water bottle, Tylenol or a piece of fruit.

The crutches are retired except for duty once I am upstairs where there is no knee scooter and I hobble around the old fashioned way.

I have requested a handicap placard for my car so I can park in handicap spaces or at parking meters for free, at least for the next few months. With icy winter weather coming our way I don’t want to be parked far from indoor spaces or scoot long distances. Traveling with my scooter is the next challenge, one I will tackle on my birthday 8 days from now.

I am settling into my new dependent lifestyle. I need help with just about everything as I can’t carry stuff from one place to another, nor get up and down the stairs without someone spotting me. I settle into a chair and then make my wishes known: an extra sweater, a book, my computer, a cellphone, food. Axel collects everything I need and tries to make me comfortable; a most wonderful personal attendant!

Yesterday my knee walker arrived which is giving me great freedom. I scoot around the house with great ease. The handy basket below the handlebars allows me to transport some stuff from one place to another and be just a tiny bit less dependent.

I took my last pain pill before I went to bed and hope that indeed it was the last one. Progress. I also had had my first shower this morning – the long road to normalcy has started: 12 more days with the clunky temporary cast. I will get the slimmer full cast as a special present on my birthday. I hope I get to choose a design. Then 40 more days till that one will be taken off. It seems long but the days go fast. I am hopeful.

Every morning I have to inject myself with a liquid that keeps my blood from clotting. I religiously follow the 7 AM ritual: hand washing, alcohol rub, stab myself, press and release the plunger. Axel’s cousin Erik died of a blood clot after ankle surgery some years ago; we were the same age then, early fifties. Once I have my full cast on I can switch to aspirin. I look forward to that milestone.

I took two full days off from work and left an automatic message to that effect. But still, colleagues ask me when I will answer my email again. Monday I go back to work, from my armchair.

Friends have visited, bringing books, food and puzzles. I completed the fun part of the 1500 piece puzzle and then folded the whole thing up when only black and white pieces, hundreds of them, were remaining. I am doing this for fun, no point in doing the not so fun part. Now I am free to prepare for my coaching exam in 2 weeks and pick up my rusted Dari for my upcoming trip to Afghanistan.

And now it is the eve of my surgery, scheduled for tomorrow morning 8:30 AM. I walked through the house looking for things that required me to be upright on two legs and that had to be completed. Ah, the Christmas mustard making. Two bowls of mustard seeds marinating in wine and vinegar demanded attention – if not processed now they’d marinate into slime I feared. It’s a job that no one else in our family has even attempted to finish. I processed those batches and am good to go for at least a first distribution next month.

Our friend Isabella the Reiki Master will join us to get me utterly relaxed into the operating theatre. She has done this some 4 years ago before my rotator cuff surgery with great success.

At home everything is ready: the crutches by the door, my knee walker/scooter procured on eBay and on its way, the pain pills and the blood thinner in pre-dosed injection needles on the counter, the recliner upholstered and tested, and, a present from Axel, a cute little bamboo lap desk to hold my iPad mini. All that’s left is a healthy meal (chard with lentils) and a good night sleep.

A fungus infection on my left foot is jeopardizing my ankle operation. The to-be-operated-limb has to be without any blemishes, punctures, infections and what not. The nostrils also have to be free of staph bacteria. Infection control in hospitals is a big deal. Stories about flesh eating and uncontrollable bacteria that roam around hospitals are also real and very scary. Occasionally one makes it into the news and everyone talks about it. I don’t want to hear anything about these things, not in general and especially not now.

My pre-op nostril swab proved positive but not with the resisting kind. An antibiotic cream should have killed the invader by now. The nurse told me that many people walk around with these bacteria in their noses, sometimes for years, until a hospital admittance procedure finds them and roots them out.

Several visits to three different nurse practitioners and finally the doctor himself let to an aggressive campaign to get rid of this fungus that’s been living on the bottom of my left foot for months now. I am taking antifungal pills to combat the affliction from the inside and a cream from the outside. The program seems to be working and I cross my fingers that the remaining 4 days will do the trick so I can show an unblemished left foot to the surgeon on Wednesday.

Plan B, if I get rejected for surgery, is not very appealing – requiring a postponement of surgery to deep into spring because my travel agenda is full until mid-March with trips to Afghanistan, Uganda and Malawi. Postponement will complicate my life big time. Shoo fungus shoo!

The blurry week is over, finishing with my pre-op visit to New England Baptist Hospital, located in an elevated part of Boston we never knew about. The views are magnificent if you are lucky to be on a top floor near a window.

It was the most thorough pre-op examination I have ever had, including nose swabs that detected unwanted bacteria – part of an aggressive infection control campaign I have not seen in other hospitals. “We were the first to do this in Boston and our infection rate has gone way down ever since,” said the nurse proudly. I like that; hospital infections scare me.

Our stay in 167 Water Street B&B was part of a barter arrangement for Axel’s graphic design services. It included a three course meal at David’s and, after a good night sleep, a full breakfast with the other B&B guests, visitors from Vermont.

A glorious long weekend allowed for some yard clean up – putting the asparagus bed to bed, pruning the raspberries and removing the frozen tomato and basic plants. But the kale, pak choi and chard are still going strong.

I finished the upholstery project and my recliner chair is now ready for my post-operative period. I am checking things off my to-do list that require two legs.

I also handed in all my course requirements for my coaching certification – awaiting word for my final exam in the next few weeks that will, if passed, earn me the title of certified professional coach. The real coaching work of co-workers will start soon after. It’s been a very demanding and fulfilling journey that I started a little less than a year ago. At the time I was not sure I would be able to manage the 225 hours in training.

After landing at Logan, and completing my Pakistan trip, I have been busy. First there were Sita, Jim and Faro, surprising us wit heir presence for a night. What better homecoming than that! I got to hang out with Faro for a couple of hours, and distribute gifts: for Faro the Pakistani oil tanker truck and pointy Aladdin slippers and for Sita a block printed table cloth. I tumbled into bed around 9 PM (6 AM Pakistan time) and sunk into a deep and dreamless sleep.

No one but me understood why I got up at 4:30AM and drove to work, to hand in my reports and then meet Axel later in the day to close on a home equity loan that will help us pay for a oil-to-gas conversion that will hopefully pay for itself in the end.

Then off to an MSH event at the Institute for Contemporary Art to take advantage of the nearby American Public Health Association Annual meeting and showcase our organization. Axel and I took advantage of this event and Sita’s job in Boston to celebrate her 33rd birthday that we all missed, including Sita herself, on assignment in Edmonton. Tessa had reserved us a table in a nearby restaurant. Dinner started at 9 PM, another late night. Axel drove me home while I slept in the car and transitioned barely conscious to my bed around midnight. A late night well worth it. I have come to love those family dinners where I can be generous from my unused food allowances from the trip.

Wednesday was another blurry day with required attendances in and out of the office: meetings, phone calls and a mid afternoon pre-op education session at the doctor’s office that was utterly wasteful of my time. The long wait in a depressing waiting room full of morbidly obese men put me back on the road in a bad mood, exactly at the hight of the rush hour. By the time I came home I had logged more than three hours on the road, coming and going.

The plan had been for Axel to drive us both back to Cambridge to celebrate the presence of a former colleague from Japan who was attending the public health meeting. This time our good judgment prevailed – we sent our regrets, put on our Jammie’s and settled down in front of the TV. I drifted away before the movie was over and went to bed at a decent hour.

And now I am in DC for all day meetings which will mean another late night what with my plane landing in Boston at bedtime tonight. Tomorrow more pre-op stuff requiring another trip into Boston at rush hour to make sure I am fit for surgery. Only then, it seems, can I finally land for a restful weekend that includes a stay at our friends’ B&B in Newburyport. Hallelujah!

More than a week has passed; a week that was too full for taking time out to write. I am losing my habit of writing but something has to give. I intend to make this a rare occasion.

The free sidewalk chair has been stripped from its upholstery, each and every one of the 1000s of staples removed, ironed, measured and the copied on the new fabric that we bought yesterday. A soft easy-drape red-brick material that is perfect for beginners – no patterns or lines to match up. I am putting the chair back together and only occasionally can be seen staring at a piece of fabric and muttering ‘how the heck…?”

I have been chugging away at two major tasks. One was producing the ‘good-enough-for-now’ organizational assessment tool that is part of a larger assessment a Johns Hopkins colleague and I will be using with a local reproductive health group in Pakistan next week. We will cover organizational functions (my part of the job) and health communication/behavior change communication practices. We will spend five days with our Pakistani colleagues, helping them introspect and figure out how to serve their clients better. I have been contemplating to study a bit of Urdu, imagining that I will recognize a bit from Dari and will be able to read the script.

The second big task is completing the requirements for my coaching certification, plus an additional certification for one the central tools that my coaching school uses. I had been a little discouraged by that second certification as it added about 17 more hours to the more than 200 hours I have nearly completed. But as it turns out it has been very interesting and it no longer looks like a hurdle. I think I have about another 20 hours or so to go – some of which can be taken care of during my long trip to Pakistan.

In the meantime Axel has received his sleep apnea machine. Sleep apnea has been identified as the culprit for many of his ailments. It is quite complicated to put all the pieces in the right place. For the first week it includes something that looks like a muzzle to keep his mouth closed. I couldn’t quite stand to watch it. Luckily I fall asleep easily and didn’t have to witness the whole thing. One night we met on the way to and from the bathroom and it looked as if an alien had invaded our house – the contraption, the tubing hanging from his nose – or one of those horror movies where government officials in white suits with masks on tell you that you have been invaded and everything you own is now available for ransacking.

The highlights of our time together – times when we recover from all the work and medical hooplala – is watching series together that we missed out on when it was shown on TV. We completed the five seasons of Mad Men which I found encouraging since it showed we have evolved as a species in only 50 years. Now we are watching Brideshead Revisited, the series from the 80s. It makes us happy that we did not grow up in a rich British family and, once again, it made us realize we have evolved, at least some of us.

That brings me to the US government crisis which shows, to the contrary, that in some places there has been no evolution at all.

On Saturday we picked up a recliner that was sitting on the sidewalk with a sign that said ‘free.’ We made a U-turn and loaded the chair in the car. At soon as we got home I started to remove the dog-haired upholstery – a major job that gave me blisters and a sore shoulder from pulling thousands of staples pounded into crappy wood. I dismantled the recliner mechanism to get at the tucked away corners. I took a course at least 2 decades ago and re-upholstered a couch and an armchair under the watchful eye of an upholstery master at a local vocational school. I had forgotten that the biggest part of re-upholstery is removing the old stuff. I have no idea whether I will be able to actually do the upholstery and put the chair back to together – it would need to be ready in 6 weeks.

Why? Because I have finally taken the step to schedule surgery (6 weeks from now) and have chosen for fusion over total ankle replacement. What got me off the fence were phone calls with three people who had considered both options and decided for fusion. All three said they wished they’d decided this earlier. They could walk again without pain. That clinched the deal for me. November 20 is the day that my talus and tibia bones will be fused together, forever. I feel as if a weight has lifted off my shoulder. When every step up or down the stairs or even down the driveway is painful I now know it is not forever. Light at the end of the tunnel – assuming the surgery goes well.

Faro and his parents came over for the weekend. When Faro is at our house our living room turns into a playpen – all the furniture is moved to barricade something he is not allowed to get into or touch. Plastic containers are strewn across the kitchen. We have started to teach him that he can only open two drawers in the kitchen and not the one with the measuring cups, the wooden spoons and definitely not the knives (he can just stretch that far up). He walks up to the drawer and lightly touches the forbidden ones while looking at us, waiting for the ‘nee.’ That is one word in Dutch he knows well and copies. He shakes his head and says, nay, nay, nay. Other Dutch words he knows are ‘vliegtuig’ (plane), ‘appel’ and ‘auto.’

At Faro’s toddler school they have a ramp. He has discovered ramps and cars zooming down them. Axel’s wedge, which is supposed to help him sleep without getting acid reflux, turns out to be a great ramp, as does Axel’s Achilles tendon stretcher, a smaller version but still a ramp. It is amazing that toy manufacturers manage to sell us all these kids toys when our houses are already full of things that can be repurposed without much effort into the most amazing playthings.

I am getting up in the dark again, and most of my morning commute is in the dark again. It’s fall and getting colder in the morning and evening. I have used the remote starter already once. But during the day it is Indian Summer time – one of my favorite times of the year.

I missed the staff outing to check out our new offices, a place further north, where we will move in January. I have heard mostly complaints about the move as it is inconvenient for many of my colleagues who live in Boston or in the southern and western suburbs. But for me it means I won’t have to put up with the Tobin Bridge, its traffic jams and its tolls. Since I joined MSH in 1986, the office has been slowly moving in my direction.

Today we are celebrating Steve’s 30th birthday. He is entering a decade that is about settling down and moving into middle age – ha, he doesn’t like to think about that I am sure. I think it was Jung who declared that this is the decade that bridges the first half of life with the second; a decade of shifting priorities and developing other parts of oneself. That certainly was true for me.

Steve’s favorite food is pierogies; it is convenient that he lives in Dorchester’s polish triangle. The place is awash in sausages, pickles and pierogies. It is not quite our WeightWatcher’s fare but we’ll join in on the fun anyways.