Sunday, August 29, 2010

First Trip to the OB in Nepal
I am very thankful that I already had a connection here to someone Tom & Alana knew who is a doctor at the local private clinic at the Patan Hospital. He set up an appointment with one of the OB's so that I can continue with my prenatal checkups while we're here in Nepal. I knew that this recommendation was a good and trustworthy one, but I was still very curious as to what the experience of going to the doctor would be like here. And, after my first appointment today, I can say that it went well but definitely was an experience.
The private clinic is within the Patan Hospital, and there was a significant lack of clear signage to figure out where to go, but we (Alana went with me) found it relatively quickly. We went to one side of the front desk to check in for the appointment. He gave me a form to fill out that involved no medical history or insurance information (as opposed to the thick packet you get in the States whenever you go to a new office) and only really contact info, for which they didn't seem to mind if there were gaps. He handed the paper to the guy at the other side of the table, and so we shifted over there. We were waiting, but lines are not really much of a cultural concept here, so someone else just went closer up to the counter ahead of us. As we waited, I noted a binder setting on the counter labeled PAPSMEARS and filled with papers. Not sure what the contents actually were, but it seemed an odd thing to have on the sign-in counter. Suffice it to say that the rigidity with which medical info and records are guarded in the States is not really a factor here.
We shifted closer to the counter, and the guy handed me my paper and another paper and told me to go to room 7. Room 7 seems to be a communal pre-exam room, which contained a desk with a guy sitting at it, a household-type scale, a blood-pressure cuff, and probably some other general use stuff. I handed my paper to the guy at the desk, and when it was my turn, he took my weight and blood pressure. Mind you, "turn" only means I was the one being measured at the time. Everyone is standing around waiting and watching each other, so I had an audience for these prep items. It's a different scale with a bit less precision, and I had to convert from kg to pounds, but it would seem I have lost about 6 pounds since my last appointment at Dr. Bickman's office 3 weeks ago.
Anyway, after this part was done, the man told me to wait outside Room 6. Oh, I almost forgot the best part of Room 7! As I was getting my blood pressure taken, another woman came in to hand her urine sample to the man at the desk. That is obviously different procedure than I'm used to in the States, but the truly notable thing was the bottle. You know those travel-sized bottles you can buy of things like Tylenol that hold about 5 pills? Yeah, that's the size of bottle she was holding. I couldn't help but wonder how on earth she got anything in there without peeing all over her hand. Perhaps she did not. Anyway, it was rather extraordinary! :)
As we were waiting for Room 6, I looked over and noticed a hand-written sign in both English and Nepali next to the door of the "Toilet" (bathroom): "Please keep all urine, stool, papsmears in orange box." There was an orange box setting on top of a metal cart right below it. I have to admit that I was a bit morbidly curious to peek inside the orange box but thought better of it. Alana and I were both a bit baffled by the sign. I mean, urine samples I can sort of understand, though I have a new appreciation for those secret little doors behind the toilets at office in the States. Stool samples seems an unfortunate thing to have setting out in a box in the waiting room...not to mention that I REALLY hope the containers for those samples are bigger than the one I saw for urine! But, the truly baffling one was papsmears. Is that sign really necessary for the nurses? If it's for the people getting the paps, why are they carrying it themselves? Alana was imagining a scenario where you have to go into the bathroom and give yourself the pap. Pretty sure that's not the case but can't quite make the pieces fit!
The waiting room is totally clean but so much different than a clinic in the US. The furniture was all purely functional (basic plastic or wood chairs, which actually seem like they would be much easier to keep sterile), there were no decorations or magazines to read, the walls were all plain white, and the signs were largely hand-written or printed on plain white cardboard and taped to the wall.
The portion of the appointment with the actual doctor was pretty void of interesting cultural bits. There are two parts to the room. I got called into the room by the doctor, who stays in that room. She was sitting at a desk, and there was a dividing curtain, behind which was the exam table. The exam table is not nearly as cushioned as the ones in the US, and there was just a normal pillow (not those odd paper like ones). Dr. Alka was very good, as I assumed she would be. I didn't get to hear the heartbeat or anything, which was a bummer, as I get used to that little reassurance at each appointment in the US. She did say she'll do an ultrasound at 20 weeks, and I'm supposed to go back in one month for another appointment.
After the time with the doctor, I took my chart out to the cashier where you pay in cash (roughly $12 US). Then I took it back to the sign-in desk to set up the next appointment, and then I walked out with my chart in hand, presumably for me to bring back with me next time. :)
All in all, a good but colorful experience!

Monday, August 23, 2010

Sorting Thoughts

So, my head has felt like it is spinning now for a few weeks. Wrapping up jobs and seasons of other roles we've invested in deeply, trying to clear our apartment to make space for someone else to live there, packing up stuff for four months for our family, leaving dear friends and familiar things in Los Angeles, and making the long journey to be here in Kathmandu for four months...There has been a lot to sort through in thoughts and emotions. There have been moment of clarity and a lot of muddiness to wade through and many things to reflect on more and try to express to share. So, as I find myself wide awake since 2 a.m. for the second night in a row, I figured I might as well jump in on starting to make note of a few.

While we are only gone for four months for now (and will see what God has for us beyond that), it has still been a season of major transition for us. Even when we return to LA, life will be different. Things as we have known them for the past season won't ever be the same. In some things we have had a sense of closure, and in some, there are still things we had to leave without seeing them all neatly wrapped up and made clear. It has been an intense and often overwhelming season, and as the time drew closer to depart, I felt myself detaching emotionally. I was feeling so drained emotionally and mentally, and with a new pregnancy, often even physically. I kicked into "to do" list mode with time running short and so much left to do. After a dear friend asked me about how I was interacting with her, it made me realize how much I had slipped into this functional detached mode, partially out of practical reality but also partially out of self-protection to avoid engaging the hard emotions of leaving.
If anyone had told me within my first year or two of living in LA that I would have such a hard time leaving it, I never would have believed them! But, I have put in roots. I have invested deeply, and many amazing people have invested in me and in my family! I have shared my life with dear friends and a community. On one of the last nights in LA, our church council prayed for us, and one of the things Brad shared was about the leaving that came in the calls God gave people TO something.
In Genesis 12:1, the Lord told Abram, "Leave your country, your people and your father's household and go to the land I will show you." When Jesus called the first disciples, they left everything and followed him (Luke 5:11). In thinking about what we were heading toward, I think I forgot about the leaving that is involved in being called into something new. I had avoided it, but as the last week in LA unfolded, I felt the impact of the leaving. Of leaving dear friends that I have shared life with, of leaving a home that might not be much but has been home, of leaving what if familiar and comfortable to head into what is unknown and new and sometimes scary.
And, as we are here, I still feel that impact. I know God has good things here for us, but the leaving is hard.

Monday, August 16, 2010

New Title

Oh, and in honor of our new adventures, I've changed the title of my blog! :)
So, I'm obviously a bit behind with updating this blog! We are three days away from leaving for Kathmandu, Nepal, so there is much going on for us to prepare practically, mentally, emotionally, spiritually. My brain is feeling a little fried tonight, so I won't try to start capturing it all now, but I wanted to actually make a recent post to get me back on track so that I'll get back into updating during our adventure ahead!