Wednesday, August 6, 2014

Dear Friends and family,
It has been 8 months since I posted a blog.  Many have written Leland to ask in a round-about way if we are still alive.  I have started many blogs, finished none.  I intend to post this today….!

On December 21, 2013, Geoffrey Musyoka and Gladys were married in Machakos.  It was a beautiful Kambaa wedding with processions (about 3), flower girls strewing rose petals and blowing bubbles, one lady spraying artificial snow (December is summer in Kenya), all of which we enjoyed tremendously.  Gladys was beautiful in her white dress; Geoffrey looked a bit nervous but very handsome in his suit.  Although the wedding was to have begun at 10 am, the processions began about 1:15 pm and the vows were exchanged around 3:15 pm.  Leland and I were the only wazungu there; several other staff from BKKH attended.  Leland and I had to get back to Nairobi before dark since we have decided to limit our travel on the roads to daylight hours (dark comes about 6:30 pm in the summer), so we missed the reception (in fact, left just after the exchange of vows—I think there were about 45 more minutes to the ceremony).


I mention that day because, by the latter part of December, I realized that my hearing was so poor that I could no longer work safely and effectively in Kijabe.  By October, I had stopped participating in rounds—I could not hear what was discussed and found it very exasperating for me and all the others to have everything repeated.  I tried following the team and reading the notes in the medical record to get the plan for the day—but as in the US, the notes often did not reflect the extent of the discussion.  On the drive to Machakos, Leland suggested that I reconsider having a cochlear implant—by the drive home from the wedding, I had decided to do just that.

Because of the new health care requirements, I was able to enroll in an insurance plan that covered pre-existing conditions—including my hearing loss.  Before the ACA, I could not get coverage for an implant—at least not until I qualified for Medicare.  I was able to make appointments with two implanting surgeons and acquire a PCP via the internet while still in Kenya.  I left Kijabe on January 9, had my left cochlear implant on February 13, and had my first programming session on February 24.  After my implant was “activated,” the audiologist went behind me and said three colors.  She asked me to tell her what I heard—I replied, “Orange, yellow, purple.”  We all burst into tears—even the surgeon had tears in his eyes.

It is truly life-changing to be able to hear again.  At first, sound was very electronic; people sounded like Munchkins in the Wizard of Oz.  I heard noises that I could not identify—one day I heard a strange sound all day; then that evening realized that what I had heard was two plastic bags flapping against each other in the breeze through the window.  After 5 months and several programming sessions, I can hear and understand almost all speech, even at very low volumes.  I hear birds chirp, rain patter, water splash, doorbells and phones ring.  For several months, I practiced daily listening exercises on-line—after Leland came home on April 30, I have simply engaged in daily conversation.  He still is amazed at how much I can hear and understand.  My kids joke that they can no longer talk about me when I am present.  My daughter says the biggest change is that I now can stay up late and talk—before the implant I would be exhausted by 8 pm.  My son-in-law thinks it is fantastic that I can now talk with him in the car.  For the first time in 5 years, I can engage in conversation with my 5-year-old granddaughter.  It is truly an amazing, almost miraculous experience.  Every day, I realize what a gift I have been given.

Evelyn and Alex reading together
Leland came home to be with me for the implant, then returned to Kijabe.  Although he had many visiting neurosurgeons to help since his partner left in September for a 6-month fellowship in Germany, Leland was the only BKKH consultant who was continuously there until early April.  During that time, he became exhausted and had several episodes of illness.  So, it didn’t take too much encouragement from me for him to agree to come to the States for a 4-month break from May through August.

In the weeks after Leland’s arrival in the Chicago area, he had increasing exhaustion and proximal muscle weakness (upper arms and upper legs).  He was evaluated in Madison and was found to have chronic fatigue syndrome as a result of an Epstein Barr viral infection he had in Kijabe in March.  Over the past 3 months, he has had a few weeks when it seemed that he was slowly improving but over the past week, his muscle weakness has again worsened.  We really don’t know if he will be strong enough to return to Kijabe.  For that reason, we have deferred our departure to Kenya until late October.

We have tremendously enjoyed being back in the USA.  We continue to marvel at the roads, the signage, the running water (hot and cold, and without sediment).  I found an apartment in La Grange Park and moved in there on February 1—within walking distance to my son’s house, restaurants, the bike shop, a drug store, a hardware store—and most importantly, 0.7 miles from Grace Lutheran Church and 0.1 miles from the grocery store. 

For the first 2-3 years in Kijabe, I felt comfortable and happy about not having a home in the US—I would joke about being homeless and unemployed.  After 3 years though, I missed having a place to call home—our furniture and clothes that we had not given away or sold were in storage, we had no address that was ours.  So when Leland became ill, we thought seriously about where to settle in the US if we couldn’t go back to Kijabe.  Since both of us like the walkable communities here in La Grange/La Grange Park and love being near to Michael and Marisa, we started to look at houses and neighborhoods.  On May 30, we saw the house where we want to “age-in-place.”  We closed on our bungalow on July 15, moved in on July 18, and will start the renovations that will allow us to live completely on the first floor in mid-late August.  Both of us have a real sense of peace about this decision and are very grateful to have this house as our own.

Our little house
We spoke of our work in Kijabe in Charlotte NC at a BKKH board meeting and twice at our church here in La Grange. Leland was a keynote speaker at the Bethune Conference in Hamilton, ON in June and a visiting professor in Charleston SC in August.  I continue to work on the BKKH database; Leland has made revisions to several papers and submitted them for publication.  He continues to work hard to recruit visiting neurosurgeons to go to Kijabe for 2-week commitments to help his partner, Humphrey Okechi.  We hope that we both will return in late October—but if Leland is not able to do so, I will return for 2-3 months in order to train someone to take my place there, and to pack up and say goodbye to the many people who are our community in Kenya.

The summer months are usually lean ones for NGO’s.  This summer is no different.  There is consideration of limiting admissions at BKKH; this will require hard decisions not only by BKKH administration but also by all the Kenyan staff.  For that reason, I ask for your prayers for wisdom and guidance, your donations to provide for care of the children, and your efforts to tell others about the work that God is doing through BKKH in Africa.

I’d like to close with some thoughts on poverty and poor people.  Most of us here in the US have little appreciation for how deeply poverty impacts every facet of life for many people in the world.  Herman Melville said, “Of all the preposterous assumptions of humanity over humanity, nothing exceeds most of the criticisms made on the habits of the poor by the well-housed, well-warmed, and well-fed.”  Leland’s sister Mary said, “I just watched and listened to your talk at the Bethune round table conference. Wow. What an eye opener. I am afraid you ‘hit the nail on the head’ about most PNS's [pediatric neurosurgeons] not being committed to treating the poorest of the poor because they are or will be disabled.  The big question to most of the PNS's re treating the African kids is, ‘why bother’?  That makes them uncomfortable and squirm in their chairs. Answer being, ‘I'm comfortable where I am, and to commit to that would take me out of my comfort zone, salary income, etc, etc.’ Unfortunately, it takes a Christian commitment that is missing in most of them. Why would anyone want to work in such conditions as no funding, used/broken equipment, strained living conditions, and lack of support? That's because they are looking at the big picture. You have to look at, and really see, the soul of the little person inside that disabled body. Then, how can you say no?”

Take care, God bless.
Susan


Links:



fhs.mcmaster.ca/surgery/isd/brt2014.html (Bethune Conference, Leland’s presentation)