Home Thoughts From Abroad

When you get to the age that Pam and I have reached, you are going to have parents that are not well. This is true for most of the friends that we have; parents who are old and infirm who need care, with tough decisions to make regarding that care. In this we are not alone.

The situation is somewhat more complicated in that we live on the other side of the world from our remaining parents. My Mom is in England, Pam’s Dad is in Canada, and both are more than 24 hours away by plane, even if you make all your connections. Pam made that trek over the last few days, taking some 28 hours to get from here to there. Fortunately her trip came close to the end of the school year, so the cost was borne by the company I work for as my contract calls for them so fly me and my wife home once a year.

Pam’s Dad has not been well for several years, but his health took a decided turn for the worse in February of this year when he suffered a heart attack and underwent emergency surgery to have a clot removed near his heart. That attack seems to have triggered a new and alarming deterioration in a pre-existing condition known as tic douloureux. He has been in decline ever since.

The attack came as Pam was in Thailand, presenting the results of her work in Cambodia over the last two years to a new group of doctors and community health workers in this part of the world. Their response to what she had been doing was enough to convince her that the time had come to put together a new partnership to deliver Christ-centred health care to the myriad of villages that dot the Cambodian countryside.

She returned to Malaysia to face a tough decision: whether to go back to Canada immediately to care for her father, or remain in Malaysia to put a conference together that would capture this momentum of support for Cambodia’s needy people. Anyone who knows Pam knows that this decision was agonizing.

For a while it looked as if her Dad’s situation had stabilized, so after much prayer she decided to go ahead with the planning for the conference, an endeavour that required the coordination of specialists from Singapore, Papua New Guinea and Phnom Penh, all of whom had prior commitments. This had meant that Pam had to make numerous trips to Singapore and Cambodia and many conference calls on Skype. Meanwhile her Dad’s condition continued to deteriorate.

Finally last week the conference went ahead as scheduled, and the Lord brought all the elements together, and others that Pam had not been aware of, resulting in a new initiative that promises to be a huge blessing to the people of Cambodia. The work is clearly not done, but a map has been plotted for the road ahead, and commitments made that if kept will see a Christian witness throughout Cambodia.

With this major hurdle behind her, Pam was now free to fly home to be at the side of her Dad as he faces surgery in less than two weeks. My prayers go with my faithful wife, who with her every breath seeks to do what is pleasing in God’s sight, though it may cost her. I know that her presence will be a blessing to her Dad, and a comfort to her family who have borne the burden of caring for Dad for many months.

Pam left for Canada early yesterday morning, starting the long trek that is our annual pilgrimage to see family and friends at the end of the school year. I will remain in Kuala Lumpur for another five weeks, which means that some of these posts, like this one, will originate from Malaysia, and those that Pam writes will originate from Canada.

Regular readers of this web log will know that Pam’s Dad has not been well. He suffers – and that is the proper word in his case – from a condition known as tic douloureux, a severe, stabbing pain to one side of the face. It stems from a branch of the nerve that supplies sensation to the face, the trigeminal nerve. The pain usually lasts from a few seconds to a few minutes. It may be so intense that you wince involuntarily, hence the term tic. There is usually no pain or numbness between attacks and no dysfunction of the muscles of the face.

Most people feel the pain in their jaw, cheek, or lip on one side of the face only. Pain is usually triggered by a light touch of the face or mouth on the same side as the pain. The pain is so severe that people can become afraid to talk, eat, or move during periods of attacks. It is considered one of the most painful conditions to affect people.

The cause of tic douloureux is unknown. There are a number of theories as to why the trigeminal nerve is affected. The most commonly accepted theory is compression of the trigeminal nerve, usually by a blood vessel, causing it to become irritated. This irritation causes the outer covering of the nerve, the myelin sheath, to erode over time. The irritated nerve then becomes more excitable and erratically fires pain impulses. Tumours and bony abnormalities of the skull may also press on and irritate the trigeminal nerve. Trauma, infections, and multiple sclerosis can also cause damage to this nerve.

People with trigeminal neuralgia become plagued by intermittent severe pain that interferes with common daily activities such as eating and sleep. They live in fear of unpredictable painful attacks, which leads to sleep deprivation and undereating. The condition can lead to irritability, severe anticipatory anxiety and depression, and life-threatening malnutrition. Suicidal depression is not uncommon.

Her Dad has been taking Tegertol, an anticonvulsant that keeps the pain impulses from firing. It also causes her Dad such shortness of breath that he feels like he is suffocating. As the myelin sheath surrounding the nerve continues to erode, the Tegertol has become less and less effective, requiring the use of morphine to control the pain. For the last three weeks her Dad has been hospitalized in an effort to stabilize his medication and the pain.

There is a new surgery that promises relief in about 85% of cases. The operating procedure requires part of the skull cap to be lifted back and the nerve exposed and cauterized. It is a six hour operation and not without risk for someone who is 86 years old. But medication is no longer an option, and surgery has been scheduled for May 27. Pam has gone home to assist her family in the preparation for her Dad’s surgery. She would appreciate your prayers.

I know that there are many of you who have been praying for my Dad so here is the latest news. Following several weeks of almost constant, excruciating pain and trials on medications that left him as limp as a dishrag- but mercifully pain free, he did get to see the surgeon last Tuesday.

The good news was that the MRI clearly showed the nature of the problem, a blood vessel is sitting against one of the intercranial nerves and it is correctable with surgery. Although the surgery does involve going into the skull, the surgeon was pretty confident that it is a straight forward procedure with minimal risk. There is some risk from the general anesthetic, especially given his recent heart attack so he will need a pre-op assessment by the cardiologist and anesthetist. A decision was made to book him for “urgent” surgery.

Today came the bad news. Given the state of the health care system, the wait for an OR for “urgent” surgery is four to five months. Randy and Syl are however developing some advanced skills in the titrating of medication doses and in monitoring the care he is recieving. We now have some hope that they may have found a drug combination that will allow Dad some freedom from pain and yet be able to breathe, alert enough to eat, be safe and even get a bit of pleasure out of life while he awaits his OR date. Last night was the first night in several weeks that my family felt it was safe to leave him alone overnight in the retirement home.

We know that God is in the details and are trusting that the wait is the best for Dad as at least it will give his heart some time to recover. He would appreciate yours prayers that during this time he would have some measure of pain relief and freedom from the overwhelming fear that an attack will happen at any moment. Pray for my family at home as they seek to look after Dad and for us a we make decisions about when I need to return to Canada.

It is very difficult to be away at this time but I know that the amount of time I can spend at home will have limitations. I would love to be there now to help with his care but I also want to be there through his surgery. We are now in the process of booking flights home immediately after graduation on June 19th and although Steve will need to be back to start teaching on July 15th, we are praying that I will be able to stay on until his surgery is over.

Our lives are busy these days, and not without their share of grief and responsibility. But we do make it a point to celebrate opportunities to see and do new things, for that is what continues to keep our lives in balance. This weekend I had the chance to see the Malaysian Grand Prix, the first Grand Prix I have seen live since Dad took my brother and I to see the first Canadian Grand Prix in 1961. (Just in case you were thinking that I was over-indulging out here).

The tickets were a gift, as was the invitation to the Mercedes party on Saturday. I did end up spending about 30 bucks on these neat little handheld monitors they rent these days. They not only show video of the parts of the race track you can’t see, but give you updated track times, leaderboard and even onboard video views of whatever driver you select – great for close-ups.

I caught a ride out to the track on the back of a buddy’s motorbike, and spent two days at the track, seeing everything from practice, through qualifying to actual race. The whole experience was fantastic, and the level of driving by these guys is really something to watch.

On Saturday there was a fair bit of rain for qualifying. Here is an uncharacteristic view of Lewis Hamiltion, spinning out on the hairpin entering the grandstand straightaway. Button did worse, and neither McLaren or the two Ferraris made it to the front of the grid.

On race day Hamilton sliced through the field like a hot knife, but ran into a very stubborn Sutil and had to settle for sixth. Considering he started at 20th, he did very well indeed. Provided his car continues to perform, he should do well this year again.

On Saturday evening Pam and I had tickets to the Mercedes Benz party, and had a lot of fun munching on canapes and dancing to some very decent live music. With a number of colleagues from the college along for the affair, it made for a very pleasant evening. Today it is back to work and responsibility again.

Being firstborn in this part of the world has mythic proportions. You inherit not only the family name, but the fortune and all the responsibility for looking after your parents, not only in this life, but in the afterlife as well. The sense of earthly entitlement and an eternity of responsibilty are not conducive to healthy children.

In North America that is less of a problem, although firstborn’s do share some of the same baggage. Expectations and smothering come high on any new parent’s to do list, despite the best of intentions not to go there when you are making preparations for this new entry into your family. Second borns have a much better chance of being normal. Not only are the expectations lower – “s/he is going to learn to talk eventually and then we won’t be able to get him/her to shut up, so what’s the rush?” – but there is the modeling that an older child provides; a much surer teacher than any parent could ever be, no matter how well intentioned.

Our grandaughter, pictured here in her Mommy’s duds, is the perfect example of a second born: bright, lively, outgoing; no sense of entitlement, just happy to take whatever comes her way. With her older brother there to test out everything in advance, she gets to see how it is done before she even knows that she didn’t always know it. Our only problem with this delightful child is that she is 15,000 kilometers away from us and we only get to see her once a year. That is the price we pay for serving the Lord where He has called us. Every once in a while we have a pity-party for ourselves and cry a little.

Today our little girl turns two. We hope that there are no tears on her special day, and that she receives back from others some of the wonderful joy she gives with her innocent loving spirit. Happy Birthday Abi. May God richly bless your young life, and may you grow to know the One who created you to be such a blessing to others.

Pam and I never used cell phones much in Canada; much too expensive when land lines were so cheap. But here in Asia it is the other way around. Landlines are very expensive for expats, and require a $400 deposit to install. We did get a landline, but almost never use it. I couldn’t even tell you what our phone number is. It supports our intenet access, that’s all.

Our cell phones – they call them handphones here – are our lifeline. When Pam is in Cambodia or Nepal or Thailand, as she was last week, we text each other regularly to stay in touch. When I call my mother in England, as I do once a week, I often use my handphone, as the reception is better and she is a little deaf these days. I have a hundred names in my phone directory and I text and call throughout the day. I have over a 100 ringgit of credit on my phone and I can’t ever seem to use it up.

The cost for all this service is staggeringly cheap. When Pam went to Thailand I had 110 ringgit worth of credit on my phone. After a week of burning up the lines with text messages and the ocassional call I had 106 ringgit worth of credit. That means I spent 4 ringgit texting and calling Thailand all week; about a buck and a quarter – a medium coffee at Timmies. You remember that we live in Malaysia right? When we were home last June, Bell wanted to charge me long distance charges for calling Cambridge from London!

Oh, but don’t they get you on  the contract? What contract? We’ve never had  phone contracts; strictly pay as you go. But what about the price of the phone or the SIM card? Funny you should ask. My three year old Sony Erikson cost me $50; it does everything I need a phone to do. As for the SIMs, feature this: when Pam walked through the terminal in Chiang Mai, Thailand, she was handed a promtional package from a phone service provider that included a free SIM card and free air time. That’s right folks, in this part of the world they give those things away.

But what about dead air, weak zone coverage? No such thing. Neither of us have ever lost a call or been unable to get service anywhere in Asia. Even texting Pam in the Himalayas last year posed no problem. Face it, Canada: when it comes to cell phone service, you live in a third world country! Call your service provider. Tell them you expect them to give you a decent phone for $50 and the SIM for free and you want to pay no more than $10 a month to call and text anywhere in North America as often as you want while your credit just continues to pile up month after month. Let me know what they say.

I don’t know if the last post made it clear, but Pam is off again this week, this time in Thailand, where she will attend a conference and deliver a presentation on the work in Cambodia. She is also going to be doing some important newtworking among missionary colleagues to keep the lines of communication open. The conferencing and the networking are vital if the work of Christ is to remain connected to the people who need the services and support that these missionaries provide. Pam and I both know this. I have plenty to keep me busy in KL this coming week, and the phones in this part of the world have fabulous coverage and cheap service costs, so we are able to stay in touch with each other.

But I definitely feel the pressure of holding the fort when a crisis develops, as it did yesterday when we heard that Pam’s Dad had been taken to hospital having suffered a heart attack. Fortunately Pam’s brother Randy was home and got Dad to the hospital quickly. The emergency surgery was effective and the clot in an artery near the heart was removed in time. Dad is now on the road to recovery, although we are still waiting to hear if there has been damage to other organs.

For a while there it was touch and go acting as liason between Pam and her sister-in-law, Sylvia, as Pam was all for trying to get a flight out of Chiang Mai back to Toronto. But thanks to sms and skype I was able to get Pam some accurate information that allowed her to make an informed decision, and she has chosen to see the conference through, provided that Dad remains stable. I would ask for your prayers for Pam’s Dad that he would have a full recovery, and for Pam that she would have the peace of God this week as she serves Him in being an encouragement to others.

Pam and I have always had a bit of an unusual relationship. Although we had a few things in common – both our fathers were orphans, for example; both of us are extremely driven individuals – there are wide differences in our backgrounds. Pam was raised in a large, raucous family with a myriad of social connections in the boonies of south-western Ontario; I was raised in a small nuclear family with almost no social connection in the heart of Canada’s largest city. She gave her heart wholly to Christ when she was six, and has always lived a life of quiet devotion to Him, I accepted Christ when I was 27 and only after I had exhausted all other options.

We both shared a conviction that having children would be the most important thing we would ever undertake, and devoted ourselves to the task. Pam gave up her profession for five years to bear and raise them when we were young. We gave up our first house in the inflation crisis of the early 80s rather than have her go back to work. We read widely on childraising, and read constantly with our own children; exposing them to everything we could to expand their knowledge base at an early age.

We insisted on a proper bedtime each night, often giving up our social activities in the evening to do so. We refused to let them go to daycare, even after Pam went back to work, though it meant sometimes she would work all night and then take care of the children all day until I got home. When they were older and went to school, Pam would work evenings and nights when I could be home with them and slept days when they were at school.

It was an exhausting and sometimes alienating schedule. Because of our insistence on tithing, because we self-financed two years of overseas missionary work, because we opted to send our children to a Christian school, because we put aside a monthly amount for our children’s post secondary education, we were a lot poorer than many of our peers. To compensate we bought older houses that I would then spend years renovating. The renovations allowed me to be near to my children and be productive in the long hours that I would be looking after them while Pam was at work. Selling these renovated houses allowed us to provide a lifestyle for our children that was in no way inferior to that of their friends.

The egalitarian nature of our relationship did not go unnoticed by others. Pam came under scrutiny and criticism from her female peers for maintaining a profession instead of retiring to raise children. I was under constant pressure to ‘go out with the boys,’ something that my modified working/househusband role would not allow. The renovations, missionary service years and childraising responsibilities also meant that I had no opportunity to pursue any positions of added responsibility in my own profession. I remain what I was when I began this career 35 years ago, a simple classroom teacher.

As our eldest son pointed out in a recent blog (http://www.jonandnic.com/topics/faith-ministry/et-ducit-mundum-per-luce), the Lord’s purpose for our lives needs no special direction to maintain. Pam and I have simply done the things that lay before us to do, asking the Lord only to bless and correct us. This is what has led us, at our age, to Malaysia. This week Pam flies to Thailand for a conference on community health evangelism. She has just completed another level of training in that field, and just finished writing a 10,000 word proposal to the Dutch government for community health funding for Cambodia. I continue to be virtually her only financial support for all of this good work. Ours is an unusual commitment to Christ, and one that many do not understand, not even in our own church.

But we remain convinced that this is the path the Lord would have us walk. We are not especially strong Christians. We fight and complain, argue and grow frustrated. We question the Lord’s compassion and doubt our own decisions. But we remain committed to each other and to the Lord, and are doing all that we can with our limited resources to serve Him where he has called us, in the way that He appears to direct. If that makes us a little bit strange, then that must be what He intended.

The first two years here in Malaysia went by in a kind of blur. There was so much to learn, so many new projects and courses to get started, so much to see, so many new people to meet and cultures to understand. We are grateful to the folks at TWR Canada who have so supportive of Pam’s work here. But there was a lot to learn about her responsibilities, traveling, how to access reimbursement for expenses. Steve is still teaching new courses for which new lessons have to be prepared.

In addition there was a lot back in Canada that we had to learn to manage from afar. We are grateful to Sarah and Milan who look after our wee apartment, our friends who still drop by our website from time to time and especially our family who have been rock solid while we have been out galivanting around Asia. If we can ever get Canada Revenue sorted out we will consider ourselves to be well and truly adjusted to life on the other side of the planet.

In all that uproar, there was never much time for television. We would watch a show maybe once or twice a week, but we never subscribed to cable, and never saw Western news except when we were staying at a hotel. That changed this week when we got cable. I guess that is a measure of increased confidence in our ability to manage our responsibilities here that we feel that we finally have time to actually watch television in the evening.

This morning I watched the Toronto Maple Leafs and Vancouver Canucks play. What a treat. Especially as Toronto had an outstanding first period and were leading three-zip when I last looked. I even got to see Coach’s Corner. I can’t tell you how comforting it is to see a period of hockey when you haven’t watched a game in nearly three years.

The Olympics are coming up in just two weeks. It will be Chinese New Year here in Asia and we have a week off school. We can’t afford to go anywhere as we are still paying off our little jaunt to the Land of Oz, so we plan on seeing a lot of telly that week and soaking in all that gorgeous Canadian landscape. Go Canucks!

Despite not having family around, Christmas was pretty good this year, perhaps because we stayed busy seeing new things. We were thankful to be able to get internet long enough to contact our closest family: kids, grandkids and parents. However, a few days after I called my Mom, I heard from my sister that she had fallen in the nursing home and broken her hip.

Back in KL I tried to get through to Mom at her hospital, but to no avail. Her ward didn’t allow patient phones, and the reports from the nurses were brief in the extreme. I was able to gather that Mom would not leave her room and was refusing physio. Because she would not move, her body closed down and they stopped feeding her by mouth.

Today we were to find out if they would take her back in the nursing home. My sister and I feared the worst. Her home is not equipped for the level of care that Mom’s condition would require. We didn’t know what the ‘Plan B’ would be, but we were sure that we would have to consider it.

We needn’t have worried. Lorna from the home came around this morning and welcomed her back to the home this afternoon. Mom had put on quite a show. Apparently when the physio team left the room, other staff reported that Mom had been up, moving around quite nimbly, practicising, as it were, for her ‘performance’ to Lorna. Like the old trooper that she is, she knew she could come through with the goods when she needed to; so why waste her ammo on the rehearsals.

Mom has always been like that. She was singer/entertainer in the war, that is, when she wasn’t manning the radar, and has been fighting some version of the Nazis ever since. It is never a nice feeling to realize that you have been duped once again by a consummate player, but you can’t help admiring the spunky old thing, and I do wish her a full and complete recovery back in the safety of her snug little apartment.