Sylvia's Journal

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.

It is that day again, departure day. There is stuff strewn across my office, an open suitcase and a nagging feeling that I have forgotten something important. Even lists can’t help. Years ago I made packing lists. I had one for every country I traveled to because each has special requirements. Like malaria prophylaxis for countries around the Bay of Benin but not for Afghanistan; winter clothes for Afghanistan but not for any of the other countries I usually travel to; electrical plug types etc.

The lists were made in the early 2000s and show how much the technology has changed our lives. On my lists featured items such as a phone-flashlight-music player- handheld (remember the Ipaq?) – camera, with different charging devices for each; now a tablet or smart phone will do all of that and so much more. We also had paper tickets which sometimes made for some exciting last minutes, waiting for a DHL or Fedex envelop with either my ticket or my passport with visa stamp, or both. Now, except for the visa part, these days are far behind us. Today I crossed off all these superfluous things; I happily crossed off theTampax as well, I am way beyond that now.

Travel was relatively simple then. There were three classes, First, Business and Economy, with Business only a few hundred dollars more than economy. Our travel policy included a rule that allowed B-class for trips longer than 14 hours. Alas, these days are long gone yet my trips are often closer to 24 hours. I am ecstatic if I get an Economy Comfort seat but by the time my ticket is purchased these are usually long gone.

I also used to travel with toys, gadgets to entertain people or give away as prizes, stacks of quotes printed on large colored papers, poems and what not. All this filled half my suitcase – I brought very few clothes and without all that stuff could have travelled with hand luggage only. I invested a huge amount of effort and energy in creating a ‘space for learning.’ It is not that I don’t think this is important but I am lacking the energy and create the learning space psychologically only.

After a flurry of activities, compressed into a three day week full of meetings, inbox assaults, deadlines met and not met, I activated my out-of-the-office message for Friday and headed out to Marlborough for the third and last 30 hour face-to-face workshop in my coaching training that is nearing its end. Not counting the time spent writing reports and filling in worksheets and reading required books, this will complete 200 hours of study. It seemed daunting at the time I started back in February, and it is still a little daunting since there is an exam still to be taking, but I do feel a sense of accomplishments and feeling tremendously enriched.

We learned some new techniques today and I applied one to the question whether I wanted to be a vegetarian or a mixed animal/vegetable eater. The tool probes for pain and gain (or costs and benefits) of change versus status quo. The answer was quite clear at the end of the exercise: I will remain a combo eater, light on the animal side but not without. This turned out to be a good choice: I was invited along to dine in a Brazilian diner where, had I made the other choice, I would not have been able to eat.

Back at home Fall is approaching. Tonight Axel had a fire going again, barely three months after the last spring fire in June. Our summers are short indeed, but our apres-summer is one of the best seasons of the year.

The vegetable garden is full and ripe. I pulled up the leek and braised them as suggested by Julia Child; the last fingerlings were consumed tonight by Axel – we have been eating those for weeks now. The beans keep producing as if there is no tomorrow and the kale keeps coming back after we cut it bare. The Sungold cherrie tomatoes also keep producing but their skins are more and more fragile and burst before we can even get to them – burst or not burst, they are still delicious. We are in a state of vegetal abundance.

And in the cove there is marine abundance. With a little bit of luck we will be able to harvest oysters in the not too distant future; the mussels are indeed reproducing, and the sea urchins are coming back. We have been a bit lax with the lobster traps, leaving them baitless in the waters where they fill up with the red invasive seaweed, an abundance we are less happy about.

The return to the grid meant an avalanche of emails. I noticed my sense of despair mounting as the emails kept coming in. All this stuff I need to read and many to act on in the next 10 days made me a little nervous, yet I didn’t want to cut my vacation short by getting a head start. All would have to wait until Tuesday.

This week and the next will be short weeks. On Friday I am off to Marlborough for the last of my three coaching face-to-face intensives, 30 hours in 3 days. And then, on September 11 I resume my travel, with Entebbe as a first stop and Jo’burg the next. By the time I come back it is fall; that too depresses me.

All this anticipation drains me and so I am trying as hard as I can to live in the present. This is something I am learning from my grandson, who is so very much present to each moment. His future, at least in his mind, does not yet exist (he’s right on that account) and his past extends only minutes back. Oh, to be able to wander around the world like he does, being enchanted by everything he finds on his way: a leaf, a rock, a puppy, a sea gull, even sea gull poop.

After we said goodbye yesterday we re-arranged the furniture that had been used as a barrier to the non baby-proofed places in our living room and moved all the baby paraphernalia upstairs. Axel cleaned the Small Point mussels and I read the Sunday NY Times, nearly from cover to cover.

In the evening we motored in and out of Gloucester Harbor on a sunset and evening cruise to celebrate the 50th wedding anniversary of friends. We calculated that we have 17 more years to go before we get to celebrate our 50th. Our friends told us happily they plan to be there. They will be close to a 100, which will be, by then, the new ‘old age.’ And so we think they will.

And now Labor Day is upon us. It is morning and everything is possible still, leaving me with so many delicious choices: knit, read, bake, a harvesting trip into the garden? We are now awash in produce and fruits, the blackberry bush heavy with juicy black fruit and the garden full of red tomatoes and greens that call out ‘harvest us please!’ It rains, making for an easier easing in and one less chore, the watering of the garden.