JET LAG and DAYLIGHT SAVINGS TIME

Have you experienced jet lag?  It is not a friend of mine!

We recently made the cross-ocean journey from Delhi to the United States (for the process of renewing our visas) and wowzas ... it knocked the energy outta me!

From the all-knowing internet ::

Jet lag is a temporary condition. Signs of it appear one to two days after air travel across at least two time zones. How severe it is and how long it lasts depends on the number of time zones you cross. It is also related to the direction of travel. Flying east tends to be harder to adjust to than flying west.  

Estimates are that it takes one day per time zone for your body clock to adjust to the local time. 

Crossing more than six time zones can require even more time for your body to adapt. Some people are able to adjust more quickly than others to rapid shifts in time zones.

Yikes.  It takes one day per time zone for your body clock to adjust to local time.  

Which means that flying from Delhi, India to the midwest in the United States gives us NINE days of jet lag recovery time.

When we left, we flew out from India at midnight on a Thursday night.  We landed in Chicago at 4:30 am (waited on the plane for 30 minutes since the customs folks don't start work until 5am) .... then boarded another plane and ending up somewhere in Kansas at 9:30 am on Friday morning.  If that doesn't screw with your internal clock, nothing will!

Add Daylight Savings Time into the fun of a family of five trying to adjust to severe jet lag and you end up with several dazed and confused folks. 

The rest of you all in the United States love Fall Back time because you get an extra hour of sleep.  For us though, it meant that we have an extra hour to suffer through trying to keep everyone awake just a "smidge" longer.

If you haven't experienced jet lag before, here's a short recap on what we experienced ::

1. The littles falling asleep -- HARD -- at 4pm local time.  
2. The littles waking up -- WIDE AWAKE -- at 2am local time.
3. Mama and Daddy being overtired, a bit short on patience and just plain exhausted.
4. The whole family wants to eat pancakes, bacon and toast at 8:00 pm, and craves spaghetti and garlic bread at 5:30 am.
5. There is alot of "shhhhhhhhhhh!!!!" going on in the hotel room since everyone is functioning on 100% energy levels between the hours of 2am and 6am, when the rest of the guests are trying to sleep.
6. When we go downstairs for continental breakfast at 7:30am, we've already eaten "breakfast" in the hotel room and two snacks.
7. Lots of tears.
8. Somewhere in the middle of the late morning (11:30am or so) we start to see yawns, and shoulders start to slump and chattering voices start to wane.

There are not alot of cures or solutions for jet lag.  Many people suggest melatonin or other homeopathic or herbal remedies.  Many agree that exercise and exposure to the sunlight is the best option.

(Updating this post to let you know that we finally slept "through the night" on Night NINE of our travels to the United States, just like the experts said!)

SEEING IS BELIEVING

Since winter time is coming (a/k/a the time of year when it's smoky, hazy and just downright BAD news for contact wearers), I finally crossed off "see an eye doctor" from my list.

We received a recommendation from a friend and set out for our appointments.

What a great experience.  

Terran and I ended up needing new prescriptions, so I got some "funky glasses"

. . . which was a change for me since all of my life, I've chosen more discreet frames (although I have to add that the second frames are actually a dark red, not orange like the photo suggests).

The littles had a "beginners' exam" and the results were that they have perfect vision.  Great!

Too bad they both desperately want "cool glasses" !!

WHEN A COMMUNITY COMES TOGETHER

The Delhi expat community is grieving the loss of an extremely bright light this week.  A fellow expat (who has lived here quite awhile with her family) passed away on Sunday and the school community, American community, military community and expat community as a greater whole is remembering her memory, her amazing smile and her willingness to help out and make everyone feel welcome.

I had an opportunity to help out a bit during her memorial service yesterday, and when I was getting ready to leave, Tony asked me where I was going.

I simply said "to school."  To which, he responded "mom, school is out today."

I debated sharing the details of my visit to school (where the memorial service was being held).  When you're 7 years old, sometimes the details are too heavy to handle and sometimes emotional issues such as death are better gingerly handled.

I decided in the end to share with him the basic facts of the situation ... that one of the mothers from his school died on Sunday.  The following was our discussion,  I wanted to share it with you for several reasons.

(this took place over about 45 minutes' time as he was busy playing a computer game)

T : So why are you going to help him? Doesn't he have a dad still?

N : He does still have his dad, but when things like this happen, he and his dad need all of their friends to show them that everyone cares about them.

T : Maybe I will need you to introduce me to her son.  I could be his friend when he's lonely.  I could also tell him it's ok to cry even though he's a boy.

N : That would be nice of you.  What's neat is that they've lived in Delhi for quite awhile, so he does have alot of friends.

T : Wait, what grade is he in? 

N : 5th grade, babe.

T : Oh 5th?  Then maybe I will be too young for him?  But I am friends with Ali.  He's in 5th grade.  Maybe I should introduce Ali to him?  What's his name, mom?

When I mentioned the boys' name, he lit up and said "Oh he DOES have good friends.  I know who he is."  Then he got teary-eyed and said "but I know who he is and that makes me sad."

A long pause happened while he continued to play his game.  About 10 minutes later,

T : You know how I want to be an inventor?  I think I need to make an invention that helps doctors know how to make a heart beat again.  That would be a good way to help, I think.  It would have helped Grandpa too.

I then got ready to leave (choking back the tears) and said goodbye to the kids (with an extra long hug thrown in).  Tony ran to me at the door and said :

T : Are all of the moms going? (to which I responded "yes, there will be alot of the moms there") Ok, then when you all get there, will you give him a hug, because he really needs his mom, I think.

Her life was celebrated during her memorial service and memories flooded the room.  The service was live telecasted to her family and friends around the world and it was amazing to see everyone come together, write words of encouragement and memories for a book that will be created for her family.

As one of the speakers said, it is moments like this that allow you to realize that this community of strangers, that have come together in a country that is not their own, really do create a bond and a support network that has strong threads of love, family, shoulders to lean on, friendship, comfort and encouragement.

To all of her friends here in Delhi that are missing her this week, hugs and love to you all.  To all of MY friends that have become my family here in Delhi, I appreciate and love you!

THE PATH OF LEAST RESISTANCE

Sometimes the "path of least resistance" can be one of the best attitudes to adopt when living overseas.

Instead of fighting that which you cannot change, it is sometimes healthier to simply adapt ... go with the flow and chant "ohm."

The situation that I'm NOT sure this new mantra applies is when it comes to my immune system.  IT decided to take a huge hit in the ass and I've been all but laid out for the last seven days.  Apparently the path of least resistance when it comes to your immune system is NOT a good thing!

What seemed to be all of the classic symptoms of dengue are apparently just a random and very nasty virus, that simply MIMICS the chronology of the dengue illness.

It all started with very swollen lymph nodes in my underarms (very visible to the naked eye and extended in a grotesque fashion) and a horrid back ache (hearkened me back to the days of back labor, for those of you who have experienced that joy of pregnancy) that lasted for several days.  

This was rapidly followed by an intense fever (104 for the better part of a day, finally subsiding to 102 for the day following).  Thank goodness for the ladies that work for us, as they took one look at me and took good care of me for a two day period.

I think the thing that did me in the most though last week was the fact that my bones and joints literally felt that they were breaking.  They felt on fire, brittle, pulsating and just wretched.  There were moments that it took every ounce of mental strength I had to get myself up and out of bed to use the restroom.  It hurt just to push my body weight up and off of the couch, since my wrists and elbows felt they would break if I applied any more pressure.

Since then, I've experienced nasty sores in my mouth, ridiculous eye pain, and now my body is covered in a rash.  A rash that is so itchy, I'd prefer to just trade in my skin for new. 

Blech.

I haven't sat still this much, or for this long in years, I think.  I do the bare minimum of activities for one day's time and still feel completely exhausted when I get home from school pickup.  

Even though two doctors tell me that there is nothing to worry about, I still wonder how long this will take to recoop from.  I am definitely not used to being laid out like this.  

We will be doing some follow up work with the doctor once I feel back to normal ... to investigate and make sure that my immune system is giving its all ... and work through some vitamin supplements and such so that I'm keeping myself as healthy as possibel!

Thanks to those of you who wrote to ask if everything was ok, as it'd been awhile since a post from me.  All is well ... relatively speaking ... and I'll be back to 'normal' postings soon ... promise.

OF MOSQUITOS, DENGUE & CITRONELLA

The latest buzz word all over Delhi is "dengue."  It seems everyone has it, just recovered from it, or is fearful that they have it.  

Transmitted by mosquitos who bit an infected person, who then in turn bites a healthy person, its symptoms include high fever, severe headaches and body/joint aches that can last up to 10 days.  A person's platelet count can be horribly affected, requiring that the platelet levels be checked daily to monitor whether transfusions are needed.

The above photo shows our daily "prescription" of hopeful dengue fighting choices.  

All-Out (plug-ins, much like what you might be used to that would dispense air freshener)

Odomos (a very pleasant mosquito repellant cream, that as long as the contents are potent as they are supposed to be, is very very effective), 

Good Ole' Off from the United States (we keep a can in the car for pre-drop-off spray downs before school)

Hit (a "good smelling" outdoor spray, also used for inside when we want to pre-treat a room before bedtime) and 

Bees Wax Balm - which I swear by.

I found this article interesting (from Bloomberg) ::

Delhi's Richest Areas Hit By Dengue as City Prepares for Games

By Mehul Srivastava - Sep 13, 2010 4:52 AM GMT+0530 Sun Sep 12 23:22:09 GMT 2010

 

What makes southern New Delhi more susceptible than the slums and crowded settlements in the north is its continual supply of fresh water.

The tree-lined neighborhoods where New Delhi’s executives and entrepreneurs live have become prime breeding grounds for a deadly scourge.

A dengue outbreak in the city has been concentrated in areas with rooftop tanks, lotus ponds and flowerbeds as mosquitoes lay their eggs in the standing water, doctors say.

India’s health ministry confirmed 1,438 cases of dengue in a city more commonly afflicted by diseases endemic to the poor such as malaria, tuberculosis and diarrhea. The outbreak may be fueled by the city’s $4.6 billion preparations for next month’s Commonwealth Games, as the heaviest monsoon in 15 years leaves pools of water at construction sites.

“In Delhi, dengue is a disease that spreads best in the kind of neighborhoods that only the upper-middle class and rich live in,” said Sandeep Budhiraja, a doctor at the city’s Max Institute of Medicine. “I’ve treated at least five CEOs this week alone.” 

Symptoms

Dengue causes sudden fever, severe headaches, and muscle and joint aches lasting up to 10 days, according to the WHO. It can trigger a potentially fatal drop in white blood cells and platelets, leading to excessive bleeding.

The disease is spread by female mosquitoes. The insects contract the virus when biting an infected person, and then they transmit it when feeding on a healthy person. 

About 3 percent of cases are fatal, according to the Centers for Disease Control and Prevention in Atlanta. Indian newspapers reported as many as five deaths in the latest outbreak. The health ministry told Bloomberg News it didn’t have any data on fatalities.

Budhiraja and other doctors said the health ministry’s number of cases likely was too low. He said he has seen 1,500 cases in his hospital alone since July.

“And this is just the beginning of September,” he said. “Just wait for a few weeks.” 

What makes southern New Delhi more susceptible than the slums and crowded settlements in the north is its continual supply of fresh water. Bloomberg News contacted eight hospitals in the southern part of the city, and doctors and spokesmen estimated a combined 2,442 cases of dengue. Seven hospitals contacted by Bloomberg News in the northern part of the city estimated a combined 923 cases.

“Unlike for other diseases, as tropical countries become wealthier, dengue does not tend to decrease in incidence,” said Peter Ryan, head of the mosquito control laboratory at the Queensland Institute of Medical Research in Australia. “Instead, the problem often exacerbates.”

New Delhi’s efforts to spruce itself up before the Commonwealth Games starting Oct. 3 also are creating favorable breeding conditions for mosquitoes carrying dengue. Government preparations for the 71-country sporting event include digging new subway routes, refurbishing or building from scratch 20 stadiums, and rebuilding roads and bridges.

“Construction sites with tarpaulin that collect rainwater, pipes lying around, lift shafts or even buckets are perfect for dengue,” said Scott Ritchie, a medical entomologist at the Tropical Public Health Unit in Cairns, Australia.

Fear of dengue infections prompted the United Kingdom, Canada, Australia and New Zealand to issue travel advisories to its athletes competing in the games and ask them to wear protective clothing and use mosquito repellants.

Greater Kailash Enclave resident Anjum Khan, 19, her skin pale and her breathing shallow, sat in a hospital room waiting to be discharged after a week of receiving platelet transfusions and painkillers for dengue. The fashion-school student switched hospitals twice because they ran out to platelets.

“I am not sure where I caught it,” Anjum said as her mother packed her belongings. “It was very painful.”

here we go again ... attempt no. 1,325 ... day one

Blurry picture of my vice.

STILL ...

I've written about it before and I've tried to quit before.

I'm posting a picture of the thing that I clamor for when I need a breath of fresh air.  Yes - I know how twisted that sounds, but mentally, IT is the activity that I have associated with 'taking a break' for many, many years.

IT is my sanity

IT is my refuge.

IT is my peace and quiet.

IT is my moment of clarity.

IT is often what I choose over time with my family.

IT is my 'sigh' at the end of a day.

IT is what comforts me when I'm having a whiny expat day.

IT is the excuse I use when I don't want to man up and quit being a wimp.

IT is the thing about which people constantly say "oh, I had NO idea!"

~ ~ ~

I'm not going to keep track of the days that I'm smoke free.

I'm going to put a patch on every morning until I run out of the stock I brought with us from the United States.

I'm going to buy a crapload of gum.

I'm going to send text messages to my circle of friends and say things like "I WANT a cigarette" or "please tell me not to buy a pack" because I know they'll text back and say things like "suck it up, you can do it" and change the subject to talk about when we're going to get together to roll sushi or to ask how many tshirts have sold on that particular day.

I'm not going to promise myself a reward at the end of completing this attempt, because removing this crutch from my life is reward enough.


I'm choosing to write about IT because whether your IT is cigarettes, sugar, internet, alcohol, shopping or a whole other host of addictions ... we all have an "IT" ... something that takes on a life of its own and steals valuable moments of our lives.

What's YOUR "IT" ? Man up and share them.  Even if it isn't a physical thing.  What holds you back from being 100% healthy, or 100% effective, or 100% motivated?

Emergency Room 101

The vitals ... of my teenage son last week at the emergency room.

After some of his classmates urged me to PLEASE take him to the doctor, I sent him on his merry way.  I truly assumed that it was nothing more than a simple virus, and went on MY merry way to a reception.

Halfway through that reception, the doctor called and said he was sending Terran to the Emergency Room, and could I please go with him.

I rushed home and made arrangements for Shanti to stay with the kids.  Phoned the Husb and he immediately set out to booking a return flight home from his business trip.  The doctor feared a bout with appendicitis, and the ER staff immediately set to prepping him for surgery ... 

... right next to the Resuscitation Room (which has an ominous sound to it).

IVs were stuck, liquids and all food were banned and paperwork was filled out.

After an initial check and once-over and a phone call with the doctor who would be administering the surgery, I started in on the paperwork.

(It took over an hour to get the paperwork filled out ... during which time I was asked what country I was from.  When I answered United States, a different file was pulled out - from which I was read the price list for the various room options (single bed, double bed, quadruple bed, etc.))

The gal helping me chatted on her phone, the guy helping HER chatted on his phone.  The printer was out of ink, the computer wasn't working so we had to walk to a different wing to finish the admittance process.

I was a nervous wreck.  But you wouldn't have known it.  Inside my stomach had fallen and my blood pressure was rising.  There was a metallic taste in my mouth and my palms were clammy.  Terran was somewhere getting an ultrasound and bloodwork done, possibly being scheduled for surgery ...and I was sitting idly ... waiting for paperwork to be finished.

I tried my best to stay calm and not completely freak out that I was a 15 minute walk from wherever Terran was ... and kept telling myself to be glad that he was at least "old enough" to be by himself while I was mindlessly waiting for the printer ink to be replaced.

After the determination was made to admit him, the Husb made arrangements to fly home from a business trip and my dear friend offered to come and sit with the littles (actually several friends offered to help - which was so appreciated!).

We got settled in his room, and the ER surgeon and the bariatric surgeon both came to see Terran.  Finally, after what seemed like an entire day of waiting, based off of the ultrasound, it was determined that he should undergo a CT Scan to rule out appendicitis.

During the next couple of hours, the Husb made it back to Delhi, the littles fell asleep and we still waited for the CT Scan.  Husb and I swapped out at the hospital and I headed home to relieve my friend and get some sleep ... and the Husb did night-time duty at the hospital.  Finally at 2:00 am, the results from the CT scan came back and the surgeon determined that Terran did not  have any issues with his appendix and instead had a "severe intestinal infection."

More antibiotics were administered via the IV, and they ordered him to get some sleep and continue not to eat (a hard order to follow when you're a strapping teenager like Terran!).  If all went well, they'd release him two days later.

Long story short (or maybe this is already too long a story?) ... two days later, he was released from the hospital and besides battling another strange virus this past week, is back to feeling normal.

The whole point of this post is to discuss medical care in India.  Sure, our family has the luxury of choosing the best of the best when it comes to Emergency Rooms and Hospitals.  We are selecting doctors and physicians who are happy to take personal calls on their personal cell phones AND make house calls.  I know that this is not the case for every resident in Delhi.

But when I compare our previous experience with medical care in the United States (and boy, did we LOVE our doctor in Ohio) ... with our experience so far here - pickles to pickles - we really have no major complaints.  Paperwork takes quite a bit longer and the process of filing for insurance reimbursement is a bit tedious, but overall, we are completely satisfied.

What I have a beef with ... or questions about ... is how a nearly 48 hour hospitalization .... in a room with only a single bed ... with an ultrasound, bloodwork, CT scan ... tons of IV antibiotics ... ER doctor consult, bariatric surgeon consults (several times over), etc. can ONLY cost us .... TOTAL ... with no insurance contribution ...  

was not that much more than our ER copay ALONE would have been based on our last insurance policy.

What is up with that?

I will be completely honest.  I haven't done much research on the newly passed healthcare reform in the United States.  I did get a "HCR for Dummies" website link sent to me by a friend, which helps a bit -- but I still feel like I'm pretty ignorant on the subject. I won't pretend to be an expert on insurance policies, the business of insurance or how an administration of a healthcare organization functions. 

What do you think?  Is it all the insurance companies?  Will the healthcare reform fix things?  Change things?  Mess things up?

Do you feel like "cheap" healthcare means sub-par treatment?  Does it only feel like you're getting good treatment if it costs a fortune, or if you have to show an insurance card before being treated?

The un-insured

[Note : I'm still in my funk and even my camera is not being cooperative.  Not sure why the blur exists, but I'm too unmotivated to retake the pics ... ignore please]

While we were state-side, we had occasion to visit our old pediatrician.  Everyone at the office remembered us and it was a breath of fresh air to have a doctor's visit happen the way we are used to. 

In short order, we had some meds prescribed and then in even shorter order, realized we'd have to pay out-of-pocket because of our new "global" insurance.

No worries.  We'll just file a claim when we get back to Delhi.

The friendly pharmacist produces the bill ...

$168.48 -- for one bottle of ear drops and one tube of ear cream for a recurring skin funk. The bottle of ear drops was $138 all by itself.

So I thought ... it might be an interesting experiment to see what they same meds would cost here in Delhi.

I walked into the neighborhood chemist and presented my wee bottle of ear drops and tube of cream.  I asked if he had the exact same thing for me to take home.

He pored over the ingredients, wrote some things down and after yelling upstairs in Hindi, cupped  his hands and readied himself for the medicine to be dropped down.

I took my turn in poring over the contents.  Yep, the same medicine.  Same percentages of all of the right healing combinations to fix our little Mia.  Appropriate expiration date and an exact match to what I'd carried on the plane from Ohio.


The chemist wrote up a bill.

The total for the exact same two medicines?

Rounded up, it's Rs. 63 ... or $1.38.

Now, I won't pretend to know the ins and outs of medicine, insurance and the medical profession - but the huge price difference just strikes me as more than just a bit bothersome.  That, and the fact that I've yet to hear from our insurance company about my efforts at filing a claim for reimbursement.

When ailments knock.

Yep ... that's what the lab tech looked like that came to collect a swab sample from Mia's mouth about a month ago.

She hasn't really felt good the entire time we've been here ... and there's a reason most of you don't know about the details. There isn't any reason to alarm you about our health ... and we are *basically* ok ... but Mia has had a hard time.

H1N1 recently made its rounds and seemed to knock on the doors of nearly every family at the school.

Mia has had difficulty breathing, many nights of fevers and constant ear pain.

After a pretty scary experience at a pediatrician's office (whereby she wanted to hospitalize her and ordered her to be nebulized for 30 minutes before being released) ...

... we were instructed to get a H1N1 test. The pediatrician insisted that we not go to a clinic, where everyone else would be going and Husb's assistant set up a home visit before we even reached back home.

The above-mentioned lab tech came and without belaboring the experience, spent nearly 40 minutes preparing himself in the hazmat getup ... only to spend 12 seconds swabbing her mouth and then running out the door.

We dubbed him "the moon guy" and got the results of her test 48 hours later, via their website (negative).

A couple of weeks later and after a recent weekend of much pain, labored breathing and sleepless nights, I took her to see an allergist. She is now on a nebulizer with three different meds (3 times a day), an oral steroid and we are awaiting blood tests to see if anything major is at play.

Husb and I often say that while we may be enjoying this experience, it will end the day we feel our health is in jeopardy. I don't think medical care is sub-par in any way compared to the States, but I definitely feel a bit uneasy when it comes to the care of my babies, mostly because of the language barrier.

Having said that, there are some great things about living here. The ability to stop by a chemist on the way home and simply purchase a nebulizer machine with a prescription ... and quite honestly, the ability to walk into a FULL allergy/asthma clinic waiting room and be seen instantly.

There aren't many occasions when I'll pull the trump card (which happens to either be based on the color of your skin or the amount of money you're willing to flash [in my experience]), but when ailments knock on MY door, you'd better believe that I'll do whatever it takes to make sure my babies get better.