Sylvia's Journal

As I am progressing with my physical therapy, I am learning much about the intricate design of the human foot. My left foot, having been packaged for the last 3 months, is protesting about the sudden activity it is required to engage in; especially the many little tendons and muscles that have been inactive for so long and now have to compensate for part of the foot unable to move at all.

I started to do my PT exercises with too much enthusiasm which backfired as muscles protested, sometimes in unexpected places. That’s how I learned about how everything is connected to everything, foot, knee, hips.

This week I started to explore the commute to my new place of work. I am helped in this by the social navigation app ‘Waze.’ Based on input from 1000s of Wazers it computes the least obstructed way home or work; as a result every trip is different. Waze was celebrated in this month’s Fast Company as one of the top 50 innovators. It certainly helps me get home as fast as possible. My commute has greatly improved now that I work north of Boston.

Axel went out to the woodpile over the crusty snow in order to supply us with wood for a night of sitting around the fire. He had put on his snow shoes as the snow was knee deep. A few minutes later he came back into the house, without wood and with his thumb bent in a funny way. He had fallen through the upper and middle crust and caught himself with his thumb up.

Fifteen minutes later we were in the emergency room of Beverly Hospital where we spent the next three hours with various professionals attending to his thumb. At 10 PM his thumb had resumed its regular shape, albeit swollen and painful.

Our daughters, who were kept informed via text and pictures of our latest hospital adventures, are getting a little tired of these kinds of updates and wished us well.

We can only be grateful of this mishap not being more serious and of course having a health insurance card.

And so, on February 17, after months of being a care receiver, I became the care giver for a change.

I received my marching orders from my physical therapist: writing the alphabet in the air with my fused foot, a semi-squat side step with my feet tied with elastic and balancing on my left foot, first with eyes open and then, if too easy, with my eyes closed.

I slipped into my ortho boot to recover from the workout and we set out for Easthampton in a light snow. West of Worcester we could see the areas worst hit by Thursdays’s snowstorm, always quite beautiful in the aftermath with all the hard edges soften under a foot and a half of snow.

What a joy to see Faro. It was mutual. He kept muttering, opa, oma, opa, oma…and then we got to read and play and empty baskets full of toys on the floor. Faro is now stringing words together that start to look like sentences, like ‘books on the floor,’ or ‘where is opa now?’

I did my exercises once and then was sore for the rest of the day. I am on the mend but not quite as fast as I wished.

Jim cooked us a nice dinner which we shared with friends of theirs and then I hooked off when the evening just took off, to rest my foot and catch up on sleep.

Axel got up early to drive me to my new office for my first appearance there, but also my last for a while. I won’t be back until February 12 which seems a long way off. Next time I come here I should be walking without crutches which I plan to leave behind in Afghanistan.

Axel was probably as curious as I was about the new location, the new commute and my new digs. Still getting up early to commute someone else to work is pretty nice. He’s been the best nurse, cook and bottle washer one could imagine over the last 7 weeks. By the time I come back I should be able to take back some of the chores when I am two-legged again.

The office is nice for extraverts and a little challenging for introverts. It’s one big office garden with light coming through enormous windows from all sides – an artist’s paradise. I felt my spirits lifted the moment I stepped in. I am on the outer band (bank?) of cubicles, looking out over the Tufts Boathouse, just a few yards away and behind it the river. It’s a better view than from our Cambridge location because I had to standup to look out of my window there. Here light and view is a common good, everyone has it. Only one office has no glass walls – it will be our meditation room every Tuesday from 12 to 1. And I suppose the lactation room is a bit more private but I wouldn’t know where it was.

There are only a few people with offices, mostly the top 10 people and a few directors who need privacy because of their work. But even those offices are transparent, with floor to ceiling glass walls only the entrance door is not – there is no hiding, no unnoticed nose picking, yawning or playing cards – we preach transparency and now we practice it as well.

I unpacked two of my three moving crates – everything is on wheels so this was easy. One crate is left. It is full of 27 years of pictures and negatives documenting my MSH journey as well as many of my fellow travelers over the years. There are a few left of those I started with; they can be counted on the fingers of one hand.

I don’t know where to put these pictures. we were all given very little storage room which is a good thing in this age of electronic files. Most of my physical files are nostalgic remnants from my early years at MSH; documents that makes me realize how far we have progressed.

The limited storage space is intentional. We were supposed to have uncluttered ourselves before the move but I never got around that before the operation. It’s a chore for when I have nothing else to do – sorting through everything, to keep or not to keep. Such things are difficult. Sita gave us a book for Christmas that is written by an ‘unclutter coach’ – I had no idea that that is a coaching niche. Clever!

While I am getting used to my freed new ankle, the reality of my upcoming travel to Afghanistan has begun to set in – practical things so as how to carry things when on crutches and only allowed 50% of my (usual) weight on the left side.

The good thing is that business class travel has been approved and a ticket is being purchased. I should have no worries while on the plane – but it is the spaces and times in between that concern me a bit. I have asked for wheelchair assistance and trying to imagine if I ever saw a wheelchair at Kabul airport. And would I be parked for several hours in a wheelchair outside a gate? Would there be someone to push me to the bathroom if I need to go or leave my stuff with? And what stuff should I hand carry – not the usual heavy backpack probably. I have all these questions one never thinks about when both legs are working.

Packing for my trip is also going to be a bit of a challenge. Usually I make multiple trips up and down the stairs, carrying stuff this way and that. I have to be a lot more organized and, with this in mind, have started to make lists. It’s winter in Afghanistan, which is always a more complicated packing task and also makes for a heavier suitcase than usual.
I feel I am making some progress on the healing. Only occasionally does my ankle hurt, mostly my leg is stiff and weak. I am practicing walking, with 5 to 10% of my weight on the foot (presumably my level of comfort will tell when I am going over 10%). And each time I get up I have to decide, scooter or crutches?

We started 2014 with a whopping snowstorm which has left us 2 feet under. A front loader was needed to clean our driveway; ordinary snow plows attached to a truck no longer sufficient. It made for a cozy time inside and productive workdays thanks to the power lines holding the weight of the snow. The cove is a cauldron, waves of 4 to 6 meters and a very high tide submerged parts not usually submerged. We hope we didn’t lose more land – we won’t find out until spring, when the storms subside.

The pink cast was sawed off by what looked like a stick blender with a small circular saw. I couldn’t see any safety device that would keep it from going through the cast, the cotton layers underneath and then in my leg.

The young assistant who did the sawing giggled at my nervousness, assuring me that it was safe. But I was not convinced, especially when I could feel the pressure of the metal on the cotton, pushing into my leg. Her supervisor, I assume, came to check in on her and took over the job, maybe she was too careful. The supervisor pushed harder on the saw and I could feel more pressure on the cotton. I forgot to breathe, Axel discovered from across the room, documenting the whole process on his iPhone.

And then out came the shriveled leg with its skin looking like old parchment. The purple markings of where to cut where still as clear as they were on surgery day. The place that had felt like it was jabbed by an icepick for the last 6 weeks was unblemished – the jabbing had been done from the inside by nerves frantic looking for new pathways. The loss of sensation on the left side of my foot has diminished only slightly. We were told it was to be expected and would continue to diminish over time. I know the self-healing power of nerves from watching Axel’s limp left arm and hand come to life slowly over a year after the accident.

I have now entered phase 3 of the ankle fusion process: six more weeks in an orthopedic boot with increasing levels of weight bearing: 25% the next 7 days; 50% the week after and then gradually to full weight bearing.

This means the crutches and knee scooter are still important aids apart from the boot – no standing or walking without a boot until mid-February. It also means that I will have to travel with crutches to Afghanistan, 8 days from now. It was not quite what I had planned but it is too late to turn back, unless the business class upgrade that I requested is disapproved by our benefits manager. In that case I will stay home and continue the healing here.

Four more days, and soon I will be counting the hours till cast off. The last 8 days went fast, as expected, because of the Christmas distraction.

The day before Christmas Eve everyone arrived from Dorchester and Easthampton. Furniture was pushed to the walls to make room for the Christmas tree plus Faro and the two dogs, allowing just a little opening for me on my scooter.

We celebrated Christerklaas, starting at 11 PM on Christmas Eve, one hour earlier than usual. Despite last minute signs and groans about not being able to do much this year, everyone pulled through with poems (or prose in some cases), fantastic constructions as fake presents pointing to the real thing.

The gifts and poems this year were about cooking, knitting, and feasting the eyes this earth’s amazing landscapes, plus some chocolate on the side. The center piece for Faro was a shiny black baby grand piano, various trucks and books for opa and oma to read to him (we are currently quite taken with David Wiesner (Tuesday, Flotsam, June 29, 1999).

By 1:30 AM enough of us were yawning to suspend the festivities. We have exhausted young parents in our midst now – no matter how late they go to bed, Faro will wake them up at about 7:30 AM at the latest. We had only made a small dent in the pile of presents under the tree and the poems dangling from its branches.

We continued late the next day, Christmas Day, when everyone had emerged from their various quarters and Faro was fed and ready for his nap. Axel and I gave each other ‘non-thing’ presents – a massage and a two day trip to Maine with a visit to Axel’s favorite museum in Rockport and maybe a side trip, if we can swing it, to one of Axel’s Afghan student who came up from New Mexico to visit his American parents for the holidays.

Tessa, Steve and the dogs have returned to Dorchester, leaving us to enjoy a few more days of Faro and his parents before they too return to their home, after a visit to the New England Aquarium on Sunday morning. By then, I am sure, time will slow down again, but then I will be down to 48 hours.

In the meantime my office has moved from its prime Cambridge location on Memorial Drive to Boston’s northern suburb of Medford – a shorter commute for me in distance; no longer require traversing the Tobin Bridge into the city. Next week I will start experimenting with the best route.

Twelve more days was the first thought that came to mind when I woke up. The twelve days till cast off include some days that will go by very fast, like next week.

I continue to work full time from my command center, holding several balls up in the air – each ball requiring much reading, much thinking, much organizing.

Outside working hours I relax knitting and sewing things for Faro – it’s nice to have a small object like him for my projects – none takes long enough to get boring. All will be wrapped up for Christmas. Faro’s needs and non needs (non things) can be crossed off the list. My hunch is that most of his wishes are non things, like learning the alphabet, the names of birds and things in the sky other than moons and seeing his oma and opa on Skype.

I try to catch him on Skype at dinner time. We go over food groups and he gets to practice whatever new words his parents have taught him. His mind is like a sponge, with terabytes of space on his developing hard drive. On the outside I see him growing in height, weight and sprouting more hair every day. I can’t wait to see him in a few days.

In the meantime I am learning to navigate frozen ground and made a few outings in spite of the winter weather. I can in and out of houses and up and down steps with the help of strong helpers and my own hardening biceps. The left leg however is showing signs of atrophy – how quick the muscles lose their tone.

The plastic sleeve that is supposed to keep my leg dry under the shower, and is based on an entrance that should be (and was) narrower than my thigh, is no longer providing a waterproof seal. As a result I have to shower with my leg up against the shower stall wall, ballerina like.

I ventured down into the basement where supplies are kept that were no longer available upstairs and Axel was away. With the help of an old wooden lacrosse stick, serving as a crutch, I was able to hop across the cellar floor and get what I needed. It is amazing what one can do on one leg when there is a need.

I am working on my early spring travel schedule which kicks off with a month long trip to Kabul. Subsequent trips to Uganda and Malawi are somewhat in conflict and I am negotiating with various stakeholders that are not beholden to one another.

I have scheduled three PT sessions as soon as my cast is off in the first week of January. I will be on my own for over a month after that. Although I am familiar with the PT place in Kabul (they still should have my card in their files) I don’t think I will go there this time as my time is all accounted for by four different assignments.

I have just reached the halfway mark of my non-weight-bearing left leg condition. Every morning I calculate the days remaining till ‘cast off.’

The nerve action in my left foot is subsiding a bit which makes me think that the persistent nerve cells have found passages through the altered terrain of my left ankle. One particular point remains tender, as if an icepick is applied on it over and over again. It chafes on the cotton wads that protect my foot and leg from the unforgiving cast. But I don’t want to know what’s going on there – 18 more days and all will be revealed.

I have learned to be quite self-sufficient, showing once more our species’ resilience and adaptability. I can get up and down the stairs, dress and undress, shower, make meals all by myself. Still, Axel is doing double duty, especially when it comes to getting things for which one needs a car. I had had some illusion that by now I could drive myself to work, getting my scooter in and out of the car by myself – but that is not going to happen.

This working from home business has some nice side effects:

-I don’t have to get up at 4:30 AM three days a week and enjoy the luxury of sleeping till 7 every day and seeing my husband before the end of the day.
-I don’t have to do the Christmas commute from hell, which is the entire month of December, passing three major shopping centers to and from work with no alternative routes available.
-I can knit while listening to presentations or participate in teleconferences. As a result I have knitted a pair of socks for Faro to wear in his tiny Dutch clogs and nearly finished a sweater.
-I have been given several writing and review tasks which I have completed in record time as there are no distractions from commutes, in person meetings or walk-ins for gossip or chats with colleagues.
-I am not snacking on cookies, donuts and chocolates which are usually parked right outside my office.