Thursday, February 24, 2011

Confessions of a PCV

The contrasts between lifestyes still overwhelms me from time to time. I get bombarded with reflections, comparisons, judgements, different reactions.

You keep a PCV locked up in a wealthier Central American city's hotel room for 3 weeks, a few of these stronger fits are bound to burst forth.

When I went shopping at one of the three HUGE multiplex malls in the city the other day with Nga, for example - QUITE the experience.

My reaction:

Massively overstimulating consumerism set to tones of chic/tacky music AND strategically-placed objects that serve little purpose in the big scheme of things, all within the square acreage of a small town. Which is, not to mention, beset with multiple locations of several different fast food, fast dining and snack shops that collectively set out to demand your attention, pilfer your wallet & waistline and condition you to repeatedly favor the indistinct 'right now' over the unique and rich 'in moderation' election when it comes to the high calorie, money-absorbing treats such as those, should be. Lastly, with the need to simply convey/purchase your elections, be they clothes, acessories or food, the act becomes a mountain of details you are propulsed to shuffle through whether you want specific or general (and you find yourself wondering if in fact you really need so much detail in your selections to begin with.)

(Which reminds me of a quote about the subject of people and their choice-making that I adore: "The whole purpose of places like Starbucks is for people with no decision-making ability whatsoever to make six decisions just to buy one cup of coffee. Short, tall, light, dark, caf, decaf, low-fat, non-fat, etc. So people who don't know what the hell they're doing or who on earth they are can, for only $2.95, get not just a cup of coffee but an absolutely defining sense of self: Tall. Decaf. Cappuccino." - Joe Fox, You've Got Mail

(Whew that paragraph was fun to articulate - the positive out of this shopping experience; it gave me a muse for philosophical thought amongst all the mucking about in fabricated dronage and my current medical self-absorbtion. That, plus I did find a casual, comfortable dress for only $2.95.)

Wednesday, February 23, 2011

Life as a Medevac

I sit in my hotel room in Panama City. Music channel on the TV, typing on my new netbook, tanktop and jeans on, long frizzy hair hanging over my shoulder. Empty cup of batida de chocoalmendra (chocolate almond milkshake) on the counter next to me. Georgie and Nga, my fellow medevacs, are in rooms on either side of me, we knock on each others doors and discuss our medical developments and issues, check to see who wants to go up to the pool on the roof and what we'll have for dinner.

Nga JUST got word that her test results came in and were sent to the doctor and PC office. Georgie has finally gotten cleared to go back to site; she'll leave tonight. We're happy for her.

Today, after the lab appointments at the hospital, and a walk across the street to a small local outdoor cafe that sells a platefull of local food for $2.50, we went to a bookstore that had books in both Spanish and English. We bought some young adult books in Spanish for the practice and entertainment. It reminded me of going to Borders or B&N or Half Price Books with Brittany back in KC. Books and Spanish, two mutual passions of ours.

The cleaning ladies putter around our hotel floor and we tell them if we want our room cleaned today or not. Today, the dog that a guest has in the room across the hall from me surprised the ladies. We all chat with them about it in Spanish.

Oh good gosh, this scene is getting a little too enduring...

Three Peace Corps Volunteers, from Guyana, Peru, Nicaragua, all accustomed to the outdoors, to taking care of ourselves with the minimum and knowing how to work work with our local community vibes, we all sit in a hotel room in Panama City for days/weeks on end and wait for any new developments on our health status, and when, just when, we can return to our homes, our jobs.

Sit. Hotel room. Wait. Not words that bode well with PCVs, I'll tell you. Welp, who's up for another batida de chocoalmendra?

Monday, February 21, 2011

Urological. -No, I'm quite logical, thank you, I just have kidney issues.

The urologist I was sent to in Panama City, Panama did a CT scan and found two stones in my left kidney. I don't know if the ultrasound in GT was wrong, or if maybe I passed some stones without knowing it. He said my kidney was getting pretty roughed up, and wouldn't delay the surgery (a catheter search and rescue, and then maybe a cut into the kidney if necessary) for mom to be there in time.

Walking into the hospital that day, little by little, I gave up my freedoms, mobility, independence. It started with the wheelchair escort to my room. I was not allowed to transport myself where I needed to be. The abandonent of my clothes and undergarments for a gown. Nurses putting on the stockings for me, and then tucking me into bed to await the surgery. "Tengo que quedarme?" I asked them ("Do I have to stay (here)?") I was interrupted by another nurse coming to put in an IV. After he left, I returned to my task of hanging washed clothes in the little closet to dry, now toting the IV rack behind me. I lay, vulnerable and out of control over myself, on my hospital bed as they wheeled me to the operating room. They injected sleep stuff into my veins, and then gas. I was guided on when and how to lose consciousness.

Coming to, not being able to remember or control what had just happened to me, I was unable to wake up when I wanted to. I was unable to talk, as I tried to do, at first. I reached my room, and I was unable to move onto my own bed, nurses did it for me. I awoke to tubes coming out of me; all I could do was lay there, as even trying to infiltrate my betraying body had to infiltrate my self, too. I couldn't move, get comfortable, try to function on my own. I was foreign to myself.

I felt so helpless, as I lay there, drifting in and out of sleep, waiting for mom to arrive. At least she was still the same; her love, too. The next morning, as my body lay, still incarcerated, my reign over what happens externally was still obliterated as the nurses came to begin my day. It was bathing-time, and I quickly learned to let go of modesties and accept reliance upon others (strangers, mothers), however coerced. After that voyage into the sponge bath, my new challenge became sitting up, standing up and relocating to the chair. How do you move with tubes all in you? With attached baggage to look out for? I, who used to be unable to blow my nose in front of others, had my liquids seeping out of my body into clear bags that I and others had to carry around.

There are 1,001 little stories like this that came out of my 5 nights in the hospital, but the point was, I had to humble myself and open myself up to manipulation, scrutiny, weakness, facts of life, assistance. I had to hold onto the feeling of differences with my body on the outide, as we attempted to get rid of the differences with my body on the inside. Continually aware of the catheter poking out of my bad, even when the bag was detached. The doctor wanted to be able to put it back in if my kidney didn't seem to be draining correctly. I had a tube in my back. I couldn't lay too harsh on it, I certainly couldn't move onto my side, I couldn't sleep on my stomach, either.

Once the catheter was removed, I noticed an immediate change in comfort and absence of pain, though still aware of the gaping hole in my back. As a kid (and adult, even), I was so fascinated and engrossed by my littlest of wounds, scraped knees, cut fingers, blistered feet - as something different was happening than supposed to. I really enjoyed employing the use of Band-Aids.

These experiences were significant to me because they were infrequent.

I had to wait 26 years to spend some time in a hospital, which is pretty darn lucky, I'd say. Praise God for my mostly healthy body, because I'd rather experience the newness of this kind of vulnerability than the prevalence of continued vulnerabilities, limitations and immodesties of other health issues that many others do.

Thursday, February 17, 2011

Urological. -No, I'm quite logical, thank you, I just have kidney issues.

How often have you woke up and glorified in these facts:

Yay, I get to wear underwear today!
Yay, I get to wash myself today!
Yay, I get to pee today! I get to pee in a toilet today!
Yay, I get to walk around, unencumbered!
Yay, I get to use my body how it's supposed to be used!

These proclamations, and millions more, I fear, do not get glorified enough.

I'm healthy and I'm young. A person can get used to that. Get used to the freedoms that health gives you. Come to expect stability from your body, no matter what happens. This can lead to underappreciating your body, or pushing your body too far, or being lax on upkeep of it.

At the very least, it can lead to impatience when something does go awry. And alarm and fear at this new development. A sensation of betrayal of yourself by your body.

This is how I've felt with these kidney stones, at least. It started as abdomen pain I couldn't really pinpoint. It went away, only with time, on it's own schedule. When it left, I forgot it, until it happened again. A few sleepless nights over a month or so, while I tried to change my diet a bit, maybe it was intestinal. It happened during the day once, and I had to go home from work I was so sick. I cried at this confusing, painful thing happening to my body.

It made me feel like I didn't want to move, like I wanted to arch my back to relieve the pressure within my abdomen, an ache that went from my lower back down to the soles of my feet. It hurt to breathe deep, it felt like muscles were tensing and never relaxing, like someone was jabbing me slowly and thoroughly with a butter knife in my sides. It didn't matter what kind of food I ate, how/where it was cooked, or if I drank alcohol. I couldn't figure it out.

The ER in KC found a slight kidney infection and gave me antibiotics. Was I being a wimp with the pain? Because it didn't feel like a slight anything, and certainly not for a problem so ongoing. I couldn't properly describe what my body was doing to me, and the problem did not get solved. After returning to my site, the pain came back, less intense, but more frequent. I ignored it until I had to take strong pain killers to feel ok. I knew I couldn't ignore this any longer. I'd have to interrupt my life, put all my attention on my body, to figure this out.

After a day of travelling to GT to get to the PC doctors and the worst pain I'd experienced yet, I finally got an ultrasound that finally found something tangible and foreign in me that was causing the pain.

And that's how I found myself in a hospital bed in Panama City, hooked up to two different catheters, an IV, a sore throat from intibation and those circulation stocking things.

Undiagnosed physical pain is one sort of corporal trumping and impatience; being a hospital patient is a whole other story...

Wednesday, February 9, 2011

A Ritual

On my coffee cup of vanilla latte I got at Rituals Cafe as I waited for the flight from Trinidad to Panama City, it read:

"The Perfect Cup. There is much to be said about the ritual of preparing a good cup of coffee. What is your ritual?"

This is my ritual.

I heat some water in a smll saucepan to boiling - just enough water for one cup - and turn off the stove and throw in Marata, Brazilian brand coffee, into the pan to steep a few minutes, probably more than 2 tablespoons, but definitely enugh to cover the top with color and leave a significant mound above the water.

While water steeps (covered by some lid) I make some milk - one scoop of powedered milk to make about a 1/4th cup of milk. I make it a little richer than regular milk. At this time, I also prepare my coffee cup and strainer, which is my 2nd biggest plastic strainer with the coarser-holed mesh, the one that fits right over/in the cup, and I put half a napkin into it.

I get some tap water in my coffee cup, remove the lid fro the pan and splash the cooler water over the steeped coffee, to get the grounds to settle at the bottom. After putting the strainer over the cup, I pour the coffee into it, the combo of the napkin and coarse mesh make it go pretty fast.

I add the milk and raw sugar, amounts depending on my prefernce of the day - for a Real Coffee wow, I use a spalsh of milk and one scoop of sugar, for a warm, smooth, coffee-ish beverage, I use ´nuff spashes of milk and two scoops sugar. Mmm.

Its best if had with toast and in a hammock. The quiet, cool, newly sunkissed morning never felt so good.

What´s your ritual?

Friday, February 4, 2011

The Unknown

So, while waiting in the horrific queue to get an ultrasound done at a Guyanese Emergency Center/lab/pharmacy, I was reading this short story by Edgar Allan Poe called “Spectacles.” This guy happens to glance at this woman in an opera box during a performance and declares it love at first sight and he pursues her, and she returns the affection and within the first night of actually meeting each other, they agree to marry. He is slightly vain and she seems to be older than he by what she calls a significant amount. He doesn’t care, and when her only stipulation to their marrying so quickly be that he wears these pairs of spectacles, he readily agrees. At this point, knowing Poe the amount I think I do, I was thinking “ok, she’s like a witch who’s preserved her look as a young woman, but really is ancient and the glasses show her for her true age and he’s forced to stay married to her and suffers the rest of his life!” or something like that. It didn’t end like that, but it was still Poe-ish and hilarious – when he agrees and puts on the glasses, they perfect his sight and up close, he sees rotted teeth, ugly make up and she’s OLD! He was the heir she was looking for, and when she realized that he was enamored by her, she decided to mess with him, so it was en elaborate joke on him, and then he ended up marrying her younger relative whom everyone thought he was into to begin with. Hilarious, suspenseful, weird but not sinister as I expected Poe to be.

So yeah, the Clinic. We have a doctor and nurse with Peace Corps, but their exams are limited, so they send us out to other specialists in the Town to get exams, then send the results back to the PCMOs. I was there for an abdominal ultrasound, me and about 40 other people. People I don’t know, a procedure I don’t know, the dynamics I am unclear on….in pain and worried about my health…. Not good. This pain that’s been intermittently been plaguing me for 3 months has finally come to a climactic head, and all without my mom, 911 and a hospital procedure I know and trust in. The culmination of all of this was enough to push me over the edge early early Tuesday morning, and leave me haggard late Tuesday morning while I waited. Luckily, once I was seen by the doctor, a Dr. Anand Joshi, relief was the primary emotion.

I’d seen him in and out of his little office/exam room during the morning and he seemed abrupt and impersonal. As it was, he called me into the room, told me to lay down and pull up my shirt, as he continued to talk to the nurse. But as soon as he started examining, he started rapidly and matter of factly talking to me and asking questions that somehow seemed aware and personal at the same time. “What am I looking for?” was the first one, which struck me as odd – even referrals in the States would have files sent over and the doctor would know the basics beforehand if not at the moment. But, all that I came with was a paper with the words “abdominal ultrasound” on them. I told him we’re looking for mostly kidney stones, but described the pain and how it was happening. He asked more questions, quickly and skillfully to figure out what he could that’d help him with what he was doing, also asking me about being a PCV. He is a doctor from Bombay, India, and mentioned the fact that volunteers who leave home miss out on those years of income and work experience, to which I countered that most of the volunteers don’t really have work experience, and this is giving them cultural and developmental experience that can benefit them later.

He asked if I have a history of kidney stones in my family, I said not that I know of, and he says, “Well you must because I see here a good set of them. You have at least 3 in your left kidney….. and one in your right. I can’t imagine you living down there like that because you must be in a lot of pain.”

Tears of relief start coming as I choke out “Yeah!” This busy, matter of fact doctor from India working in Guyana who knows little to nothing about me, was able to quickly find the problem, make me feel at ease and sympathize with me, all in the period of 5 minutes. He cannot follow up, he cannot treat me, he cannot know what I will do with this information he’s given me. I do not know how these stones will come out, I do not know how serious it is, I do not know if my time with Peace Corps is over. I don’t know that it will be all right. But, at the moment, it was all right. It was the appropriate conclusion for the manner of medical issue.

We know what it is now, at least. There’s a name for it, a valid reason for my pain and discomfort. I wasn’t beyond diagnosing. I am so scared to be walking around with this – I’ve never had such a major medical issue before – and scared to go have surgery without my family around – hell, even a good friend. But I am relieved that it is treatable, easily recoverable, and in essence, minor. It will not affect my Peace Corps service, and when they’re out, I will be ok. Dealing with this is just another way that I am learning to deal with the world, on my own. I can do it, I can do it, I can do it...

Please for your prayers though. I leave for Panama on Sunday or Monday to get the surgery.