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My Inbox today – Via Lama Surya Das

Let none deceive another

Or despise any being in any state.

Let none through anger or ill-will

Wish harm upon another.

Even as a mother protects with her life

Her child, her only child,

So with a boundless heart

Should one cherish all living beings;

Radiating kindness over the entire world: 

Spreading upwards to the skies,

And downwards to the depths;

Outwards and unbounded,

Freed from hatred and ill-will.

Whether standing or walking, seated or lying down

Free from drowsiness,

One should sustain this recollection.

This is said to be the sublime abiding.

By not holding to fixed views,

The pure-hearted one, having clarity of vision,

Being freed from all sense desires,

Is not born again into this world.

~The Metta Sutra 

(The Scriptures of Loving Kindness)

Emaho! 

Lama Surya Das  

School can be fun!

The streets may not be paved with gold in DC, but my hometown elementary school will help the kids pave their own way.  We came for a visit, but decided to stay.

Now Karen is speaking English and Matan is close behind. When I would compare the children’s Israeli schools to the ones I grew up with, Israelis would tell me, “but that was a long time ago, I’m sure there too the schools are struggling”.

Sure, all schools systems struggle with budgetary challenges, but when children come home excited by what they’ve learned, and look forward to Monday when they go back to school, something is good is happening.

I can easily see the differences between the physical learning environment, but there is much more to being able to learn than simply a well designed building with bigger classrooms,  enough space and significantly smaller classes. Here, the focus seems to be much more on understanding the big picture, being able to read and analyze texts early on. But more than that, the educational culture is different. Learning in the US schools appears to be more experiential. The fact that there are only 22 children in a class rather than 35-40 also makes a significant difference on all children’s ability to remain focused.

Most importantly, here they will learn to speak, read and write English at mother tongue level. Maybe it’s just selfish of me, but I so want to share books and things I’ve read with Karen. Soon she’ll have adequate English to begin reading the books I so enjoyed at her age. For Matan, just being able to read and write English will help him get a decent job.

Lumbar surgery, the background

When I began having lower back pain last summer, I assumed it was temporary and would resolve with the help of some chiropractic treatments. But when I woke up on morning during the first week of August, and found myself unable to stand on my left leg, things got real.

Just a week earlier, I was driving on the highway through Tel Aviv when a siren sounded indicating incoming missiles from Gaza. Like everyone else on the road, I pulled over, exited my car and hunkered down against the dividing wall. I now realize that I never even blogged about last summer’s “Second Gaza War”. I was too wrapped up in managing a part time job with full time hours, looking out for our American interns whose parents wanted them home asap, and making sure my own kids didn’t freak out over the almost daily sirens and runs for the stairwell.

None of that mattered when my left leg became my worst enemy. Excruciating pain ran down my leg into my left ankle. I had 2 ER adventures where they made it clear that so long as I wasn’t incontinent, I was fine from their point of view. I had x-rays and bone scans, a CT indicated a herniated disc, and I figured the problem was pinpointed. After some nerve blocks that helped a little, I finally got approval for an MRI which took another 6 weeks to schedule. I had now been bedridden for more than 2 months. I was unable to drive and could barely make it out of bed much of the time.

The MRI was a revelation. I had a rare non malignant tumor in my lumbar spine, called a synovial cyst. It was huge and two surgeons and a neurologist who saw the results all said removal was the best option for returning to a fully functional life. I kept delaying. My husband didn’t want me to do it. He was afraid I would be in worse condition after the surgery. Conventional wisdom quoted me by ‘everyone’ was, “don’t touch your spine unless there are no other options”. So I took another month to think about it. The pain had become less intense, but more diffuse, spreading throughout my lower back and into both legs. I could walk and drive short distances, but by noon I had to lie flat on my back any chance I had in order to continue caring for the children. By this time I had lost my job. I couldn’t sit at a computer for hours at a time, and my mini iPad became my best friend.

I began researching options, and what surgery might entail. Since I don’t read Hebrew very well, I stuck with mostly American websites that provided information on surgical options for spinal synovial cysts. In most cases, it appeared patients required spinal fusion. Fusion surgery appeared to have a 95% “success” rate, from the doctor’s point of view. Most patients went on to experience severe pain along the spine since the fused area was no longer flexible, adding more pressure to the surrounding vertebrae.

In great trepidation, I went to an orthopedic surgeon who cheerfully told me that fusion wasn’t necessary, Yay!  He suggested an Israeli developed medical device that makes fusion a thing of the past in many cases. While thinking about this new option that I hadn’t found in my online research, I decided to get a second opinion from a neurosurgeon specializing in spinal surgery.

I had the good fortune to be referred to Dr. Uriel Wald, a leading neurosurgeon with expertise in spinal tumor removal. After looking at my MRI, he felt that even the TOPS medical device wouldn’t be necessary. He wanted to remove the cyst with a much less invasive laminectomy.

I am now several months post laminectomy. It went well. I was lucky. If I had done it in the US, most surgeons would have insisted on fusion. Dr. Wald spent a total of 3 hours operating to remove the cyst that was pressing on my spinal cord and some nerves at L4-L5.  TOPS would have meant much more invasive surgery. I still have some pain after a day with lots of movement, but much less than before surgery.

If I had to do back surgery again, or advise anyone else, I would tell them to get a second opinion from an Israeli neurosurgeon. Flight, lodging and surgery is less expensive than non-covered surgery in the US. For many Americans, even a co-pay could end up being more expensive.

 

 

Medical tourism – why Israel?

During years of IVF treatments, I discovered that Israel is a mecca for infertile couples. Fertility is state-of-the-art in Israel, with many world-class experts in the field to choose from. The Israeli government heavily subsidizes fertility research and treatments for women under 44, making it a popular option in a country where having babies is often a political issue.

Between 2009 and 2010, 4.1% of all live births were a result of fertility treatments. While Israeli citizens pay almost nothing for these expensive treatments, even self-pay medical tourists pay a fraction of the fees commanded by US clinics. According to IsraMedix, infertility treatment in the US can cost tens of thousands of dollars, while in Israel most cycles run approximately $ 3,500. More statistics on IVF in Israel this article from the Jerusalem Post.

But medical tourism isn’t limited to IVF. Most doctors began their profession in the military and as a result of Israel’s many wars, they tend to have extensive expertise in trauma and related fields of surgery such as orthopedics and neurology.

Surgeons gain extensive experience in complex procedures.  Many start ups develop innovative medical devices and procedures which are widely available to Israeli patients who benefit from universal coverage. The government further encourages advances in medical treatments and devices by offering incentives to enterprising researchers via the Chief Scientist’s Office and a range of biotech incubators.

While researching options for treatment of a benign lumbar tumor, I came to the unfortunate (for Americans) conclusion that most people will be much better off having back surgery in Israel than in the US. Aside from surgeon expertise, there are medical devices widely used in Israel, Germany and the UK, that aren’t available in the US because they have yet to receive FDA approval. I plan a second blog post about the incomprehensible differences in treatment and outcome, and why I would NEVER have back surgery in the US, given the option.

Israel is not the least expensive option for medical tourism. But the high level of professionalism and the ability to receive treatment from leading global experts makes it worth considering.

 

 

Now it’s time to say goodbye, and hello

It’s time to end the story of my childrens’ post-adoption development. Both are doing really well this year. Matan surprised us by learning to read. He exceeded expectations based on all reports from his kindergarten and preschool. Karen is doing well in all school subjects. She’s especially focused on English this year. After our visit in April, she doesn’t stop talking about moving there. She’s happier than I’ve ever seen her.

They’re growing up and deserve their privacy, so the focus of this blog will have to change. I may start a new blog at some point. But since I’m lazy, I’ll continue with this one in the meantime.

To be continued….

The end of summer

Sorry for the radio silence, but this has been a pretty action packed few months. We went from finishing up a challenging school year to looking forward with caution to see what the new school year, new classmates and starting school would bring. In the meantime we also had a war with Gaza during summer vacation which limited outside activities. 

Karen only spent three weeks in camp. The rest of the time she spent being really lazy at home, and staying with relatives to "help" out with younger cousins and babies. She really enjoyed being a mother's helper. She spent a couple of days with an aunt who had infant twins and a 5 yr old son. When an incoming rocket alert would sound, Karen was able to help her get both infants and the younger boy into the stairwell before the boom/s. Karen got to feel very useful and mature with her "responsibilities". 

I was waiting for the school year was to start, when an aching back suddenly turned into a full blown orthopedic disaster. I woke up one morning, tried to stand when an excruciating bolt of pain went down my entire left leg. I couldn't stand. I couldn't sit. I had a severely herniated lumbar disc which was inflamed and pressing on the primary nerve the goes from hip to foot. There was numbness and weakness, and a horrifying pain that nothing could blunt. After a month of tests, procedures and lying flat on my back per medical instructions, I hope to finally be able to work again, next week. It will be limited, but at least I'll start getting back to normal.

While I was debilitated, Dudu took more than a week off work and got the kids into the new school year. It was a really tough time for him too. But Karen had gone through a genuine metamorphosis, and was really helpful when I was in bed for most of the month. 

Next blog post will elaborate on the huge changes in both children, and the exciting new school year they've both begun.

An ideal visit home to DC

tokyo cherry blossoms (3)Just returned from our long awaited, with more than a little trepidation, family trip to Washington to visit Gramma and Grampa. The trip was a stunning success from my point of view, and I think the kids had a really good experience.

Things started off a little rough when we weren’t able to rent our car at the airport since the credit card didn’t have the same name as the only one of us who had a valid driver’s license. My Maryland one expired years ago, and I didn’t bring my Israeli one because I had planned to renew my local license and figured not having a license would get me to do it. Wrong, I never did get around to renewing my driver’s license. Apparently I need to retake the written test since mine expired more than a year ago. Ugghhh, ok, next trip.

But we soon put that behind us, when my  mom took my dear husband (DH) to rent the car in her name the following morning. From there things only improved. First, the house was huge, with plenty of room for the kids to play and sleep in various beds and arrangements. There was also a huge back yard with a deck for the grown ups to sit on, and a perfect area for playing soccer. When my sister and her family arrived the following night, my kids had already explored their new digs and marked some territory.  It was a great idea to rent a house together since the kids could play together anytime, and we didn’t need to plan and drive for them to just fool around with each other.  Of course, two very different families living in close quarters will invariably find areas of difference. Apparently I have a unique neurosis when it comes to laundering my family’s underwear with towels that have been used on the floor. I don’t mix any fabrics used to clean house, especially the floor, with my clothes or even with towels I use on face or body. Anything that goes on the floor can get laundered together, but not with cloth that touches our body. So now I’ve learned this makes me a little OCD with a slightly weird laundry fetish. Sometimes you need family since no one else will tell you these things.

But the house was great, even if it wasn’t particularly clean, and had a serious ant issue. Still, it had a nice deck, and we had great weather, making it the perfect place for the grownups to hang out while the kids knocked themselves out in the back yard. Once both our families were in place, we had Grama and Grampa over to sit on the deck and watch the children frolick. We got lucky since the grandparents brought over a badminton set, with net and extra ball that can work for hand ball over the net too. Or soccer. The kids seemed to find soccer balls everywhere.

The kids got along fine despite the language barrier. Poor Matan was just beginning to feel that people understood him in Hebrew, and suddenly he’s speaking and no one can answer him coherently. But after the first day or two, they got past language and had a really good time together. Normal sibling rivalry over new friends, but overall it was a very positive experience. Grama and Grampa also came over to babysit once, and on another occasion they even ventured out to the park alone with my two.  Both Karen and Matan began to bond with their American grandparents really nicely.

Once the first week was over, the kids were sad to see their playmates go, and sad to leave the big house (kids didn’t seem to mind the ant infestation as much as we did). We moved to a smaller, cleaner basement apartment in Takoma Park. It was a nice area, and we took some long walks down Sligo Creek trails. We spent more time with Grama and Grampa, and K even slept over at their house one night. She really wanted to, and we saw no reason not to let her, since my mom seemed ok with it. She called us once at night telling us she was a little afraid. We offered to pick her up, but she decided to stay. In the morning, they took her out to IHOP for a syrupy breakfast of pancakes and goo. Mom reported to me that K became very hyperactive by noon when she hadn’t gotten her meds. Mom saw a marked difference in K with and K without meds, at least when it comes to the hyperactivity. Then again, it could also be the sugar.

We had a relaxing last few days, mostly spent as a family. I was especially pampered since DH would wake up with Matan, and the two would go driving to find the nearest Dunkin Donuts so I could satisfy my craving for Bavarian Cream donuts. It was nice to also spend downtime with my mom, where she wasn’t worrying about preparing a dinner, getting something planned or in motion. We were able to just visit and spend time with her and her husband, in a very relaxed, non neurotic way. The first week they spent time at our house, enjoying the deck in the nice DC spring weather, and during the second week we visited them. It was quite nice both for us and the kids, who clearly bonded with Grama and Grampa!

 

The Tooth Fairy and a Trip to Washington, DC

Matan lost 5 teeth this week, three in one day. We’re travelling to the US in a few days, and his entire top gum is a gaping hole. A couple of days ago, when I picked him up at 4 pm, he proudly showed me one tooth that had fallen out during the day. About an hour later, we were in the shopping center and he brought me a second tooth in slightly bloody fingers. I knew I had to play tooth fairy and duck into one of the toy stores without him catching on.

Once we got home, he approached me with a third tooth, this one more than a little gross, but not quite as bad as his bloody grin. I felt a little ill, and not just because I had no way to supply the tooth fairy with THREE freaking gifts in one night. I told him I’d hold on to the third tooth so he could get another present later on. Both kids are already fully hyped for the trip, and talk of little else.  The next day, he lost a final tooth, but we stopped the tooth fairy after 3, telling him we’d put the rest of the teeth under his pillow once we get back. He already had 3 new gifts, so no loud complaints. Plus, did I mention, both kids are totally hyped for the trip.

Matan has been a little concerned, and has asked several times if planes can fall out of the sky. We told him it was like taking a train, which he’s done already. DH found some clips of the inside of planes on youtube, but strangely, it took some searching to find happy people inside a plane. We’ll be flying Turkish Air, mainly because they had the shortest total time from Tel Aviv to DC. Only an hour stopover in Istanbul vs. hours in any other airport. I’m just dreading the 10 hours from Istanbul to DC. Laptops and iPads won’t carry enough juice, even with a backup pack, so I tried to find a bunch of stuff for both of them. If all else fails, I have some sleeping pills…for me.

We’re renting a house with my sister and her family via airbnb.com and it should be a lot of fun. Her daughter and K are exactly the same age, and both our boys are also the same age. They’ll have live-in playmates for the entire first week we’ll be there. The second week the four of us are moving to a smaller apartment a little closer to my mom, and plan to spend more time with her and taking the kids to visit some of DC’s attractions. Top of our list is the Natural History Museum, Air & Space Museum and Zoo.

See y’all on the other side.

Thoughts of Ukraine

During this time of uncertainty and upheaval in Ukraine, I follow most of the news and think of how it could have affected my children had they remained in Ukraine, with birth families. I know, weird things to think about, but it does cross my mind. M is from Lugansk, a region which, along with Donetsk, is very pro Russian, and regions that may be up for grabs by Putin. Russian troops may already be nipping at the border regions. Apparently, they really hate Americans in these areas. I’m glad I didn’t know during the 1.5 months we spent in Lugansk for M’s adoption. I was always so worried we’d be tagged as Israelis, and therefor Jews. But apparently it’s much less healthy to be an American in Donetsk than a Jew. See what happened yesterday to an American film crew doing a documentary on orphanages, here and here.

We haven’t yet done a birth parent search for M’s biological family, and if the region is in upheaval, or changes countries, it can make it much harder to find records. That aside, we feel close to Ukraine and the stoic Ukrainian people we remember so well. They are the original Cossacks, and very tough. Everyone is asking why Ukrainian forces in Crimea didn’t fight the Russians. Well, in addition to it being a pretty good way to die really quickly, apparently they never received orders from the Ukrainian government in Kiev. They didn’t fight and they didn’t give up their arms. They just stood by and watched the Russians take over their bases, ships and sub. I’ve been following events there closely and The Interpreter  has a really good daily update I’ve been reading ever since events began on the Meidan.

Cha-Ching, another job offer via Facebook

Yep, while everyone is trawling LinkedIn for that new job opportunity, I posted exactly what I was looking for on Facebook, and for the third time in a row, received an offer, this time for a very exciting start-up.

Interestingly, all three positions have come from some of the great people I worked with at Zend, almost five years ago. We had a great team there, and everyone I worked with has gone on to various interesting companies. Each time I’ve wanted a new position, I’ve posted to Facebook that I’m looking for something that is part time, with flexible hours, and each time, I’ve been contacted for a position in sales, marketing and/or business development by former co-workers from our Zend sales and marketing team.

This opportunity is by far the most compelling. The position may involve occasional travel to the US, which will be a challenge, mostly for DH who will need his mom come and help him out. But management said it would probably only be once or twice a year. I think we can handle that frequency. I hope to be able to post a few more details once I start, but the company is still in semi-stealth mode, so no details about the amazing management team and their very desirable technology quite yet…