Posted on by bethanypasma · 1 Comment

Just Your Typical Day of Online Classes

Before devotions, I look over my schedule and carefully pack all of the day’s necessities. Even though I have a nice office space, the wifi on the elementary side where my office is located is so bad that through experience I’ve learned that, unless I’m willing to hotspot my computer and use up all my phone data (even the extravagant 13 Gigs a month that I can get for $16 CAD), I need to move over to the high school side. (The high school side is equipped with better wifi since teachers generally teach their online classes from that location.) I pack everything I’ll need into my backpack, and I head over to the “hallway” of the high school. (It’s an outdoor space that is covered by a roof but open on the sides. I think North Americans would call it a porch in any other circumstance.) I set up at the table that my Spanish teacher Gladys and I refer to as my “second office” – laptop, binder, textbooks, pencil case, AirPods, phone – everything out and ready so I can begin classes as soon as devotions are finished. 

As far as views go… can’t complain about this one! It’s just a little breezy…

After devotions, I come back out to my workspace. I send the link for the class through the WhatsApp group that we use to communicate with students when they’re at home. I join the Google Meet myself, and I begin to welcome the students as they enter the online classroom.

“Good morning, Eunice!” 

“Good morning, miss!” I hear in response. 

“Good morning, Jazmin!” 

“Good morning, Miss Pasma!”

I greet each student by name as they enter the class. As I greet each student, I check off their name on my class list, the best way to keep track of attendance and to know that we’re ready to begin. But really – more important than the attendance is the connection with students individually and not just as a homogenous group on my screen. Students spend 6 hours in front of their computer or phone on days of online classes, and how much of that time is authentic connection? I have a feeling it’s not much. 

In fact, it’s this lack of authentic connection that is my most frequent frustration when teaching online. It’s very easy for students to stay muted unless I call on them. I finish teaching a concept, and I ask, “Do you have any questions?” Students stare blankly at me. Maybe one or two students will bother to shake their head to indicate that they do not have any questions. I have commiserated about this lack of authentic communication with Seño Gladys, my Spanish teacher, on a regular basis. She told me that sometimes her students stare at her, staying so still, that she will say to them, “Students, breathe!!! Are you still alive???” It makes us laugh when we tell each other the stories of our experiences, but obviously we both agree that the best classes for students (and teachers!) would have students at school in person every day. 

If I turn my head and look to the side, I have this beautiful view from “my second office” 😍

My students have come a long way in their ability to use technology and to use it well for their online classes. My grade 11 students received classes exclusively through Zoom last year, so they are well used to this format. My grade 10 students, who were in middle school last year, only had videos posted to a Facebook group that they watched asynchronously, doing worksheets to show their understanding. Of course, there were some benefits – students could watch a video multiple times if they were having trouble. They had extra flexibility in their schedules – easier to share a phone between multiple family members. If they had internet issues, they could watch the videos later. Synchronous online classes are a whole new ballgame for them this year. And wouldn’t you know it, their very first online class of the year was English.

I did have an in-person class with my students on the first day of school, and I tried to prepare them for their first online class. “I’ll send you a text in WhatsApp with the link to our class,” I told them. “Even though students aren’t at school, teachers still meet together for devotions. And think about today. Did we finish devotions exactly at 8:00?” A few of my students shook their heads no. “We will not start class until after devotions, but devotions often finish at 8:10. So don’t worry if I don’t send you a message until 8:10, or 8:15 or even 8:20!”

The next morning, I indeed sent them a text around 8:10 with the class link. I only received one frantic text before that from a student saying (in Spanish, of course), “Miss, I can’t connect to the class! I don’t have a link!” The students successfully joined the class, and by 8:20 – yes, a full ten minutes to get everyone connected to their first class 😂😭😂 – we had begun class. 

And then we tried to do English class online – a totally new forum. It was PAINFUL. I discovered quickly that I could not ask a question and wait for someone to volunteer an answer, a technique I can easily employ in an in-person class. If I didn’t choose a person to answer, students just stared at me, all deer in the headlights. Each time I asked a question and then asked a specific person to answer, we had to wait through an uncomfortable 20 to 45 seconds of silence waiting for the student to figure out how to unmute in order to give the answer. I asked students to type answers to a question in the chat so that they could all participate. Two students out of 15 typed something in the chat. That concerned me so much that I looked up “chat” to see what the Spanish word was – maybe students just didn’t understand the English terminology in an online class! Since the Spanish is “el chat”, I knew that wasn’t the problem… 

Thankfully students have come a long way in their ability to navigate technology. Students can easily type answers or questions in the chat, and they can use the “raise hand” function to let me know that they have a question. Now we never have to wait longer than 5 seconds for someone to unmute, unless their internet connection isn’t great and they’re having trouble hearing. That is the more continuous problem – poor internet. As I teach, I can often see a student or two “leaving” the meeting only to re-enter immediately, a sure sign that their internet is so weak that they lost connection to the meeting. Occasionally I’ll get a text from a student as we are working on a workbook page saying, “Sorry, Miss, my internet failed and I didn’t hear the instructions. What are we doing?” 

Of course, teaching online does have a few benefits. Students are not allowed to bring any technology to school when they’re here in person, and I don’t have the projector that I’m used to from my classroom in Canada. We do almost everything “old school” when we’re in person. When we’re online, I’ll take advantage of the tech tools at our disposal. One day we were playing a Kahoot (for those of you not in school yourself, Kahoot is a fun competition-based game platform. We use it to practice or review grammar concepts or vocabulary), when suddenly the electricity went out at school. That, of course, meant we lost our internet signal, and I got kicked out of my own class. By the time I set up my computer to hotspot internet from my phone and rejoined the class, I was greeted by the faces of only six students, all waiting patiently. The other nine had also been affected by the electricity outage. As we continued the game, students slowly trickled back into the class and rejoined us in our game. 

Basically any response to these experiences is one part shrug emoji (🤷🏻‍♀️) and one part flexibility in figuring out what will work in the moment. For the past week, we’ve had all of our classes online as we await an inspection from the ministry of health to ensure that we’re practicing all the pandemic restrictions required. I’m so tired of only online classes and can’t wait to return to our hybrid method. My Spanish teacher told me just yesterday in our Spanish class that on Thursday, she had to cover another teacher’s class, and she had no free periods, spending literally the entire day from 8:00 to 1:30 in classes with the short recess break as her only reprieve. She said she has a whole new appreciation for how students experience their online days. 

I fervently hope that mandatory online classes are very soon a thing of the past in both Canada and Guatemala. By the time I’m back in Canada, I hope to never need to teach an exclusively online class. But I hope that when we use digital tools, I’ll remember the joys and frustrations I’ve experienced here and have a little perspective. In other words, I won’t complain about poor internet again!

Posted on by bethanypasma · 3 Comments

Two Years after My Adrenalectomy

March 13, 2020. 

Friday the 13th, no less. I still remember the hint of uncertainty in the voice of the surgeon’s administrative assistant when she called me to tell me the date that my surgery had been scheduled. There are probably a fair number of people who would have turned down a surgery scheduled for a Friday the 13th, but I was desperate to get rid of the tumour that had turned my life upside down, and I had no such superstitions.

I’ve written in various places about my life with pheochromocytoma, my journey to diagnosis, and how my life changed afterward. But it’s still a topic that I find myself thinking about regularly, a topic I have more to write about, and a topic I want to keep writing about. One reason is that my pheochromocytoma posts receive regular visits from Google searches literally around the world. I have a feeling that they’re being read by people searching for their own diagnosis, people who have just received their own diagnosis, people who are wondering what’s going to happen next. 

That’s certainly something I did. The night I got the first lab test results that indicated that the underlying cause to everything was in all likelihood a tumour in my adrenal gland, I Googled the heck out of all things pheochromocytoma. By the next day, I could have told you what diagnostic imaging was available and what was preferred by doctors to confirm the diagnosis, how an adrenalectomy was performed, and what studies said about the correlation (or lack thereof) of tumour size to symptoms. But while I did my fair share of Pubmed reading, I also read every story that I could. How were people’s symptoms similar to mine? How were they different? How did people get diagnosed? Did they also have such a hard time getting a diagnosis? (yes, they did.) What had been their experiences in surgery? What was their recovery like? 

Today, two years after a life-saving and life-changing surgery, here are a few of the reflections I’ve had recently. 

One: I’m one of the lucky ones. My surgery was completed laparoscopically and went incredibly well. Don’t get me wrong – I felt like I’d been hit by a truck afterwards. Laparoscopic surgery is still surgery. But I was left with three small incisions that healed well. Pathology and post-operative monitoring left no reason to suspect a malignant tumour. (With pheochromocytomas, it is notoriously difficult to discern a malignant vs benign tumour, and really, the only reliable sign is metastatic cancer that has begun to grow elsewhere in the body.) Follow-up genetic testing so far hasn’t revealed any genetic cause, which is incredibly fortunate because it reduces the likelihood of my remaining adrenal gland developing another pheochromocytoma. Following other pheochromocytoma patients through social media has given me a window into the experience of living with a malignant pheochromocytoma. Sometimes when I read their stories, I can’t believe that I got to have surgery and never look back (except reflectively). I can’t imagine what these patients go through day after day, year after year. 

Two: I know I’m lucky. Really, really lucky. But I don’t always feel lucky. I wrote in my very first blog post about pheochromocytoma that my journey had started four years previously. But it became really obvious once I started losing symptoms that I had actually been living with the tumour for something more like ten years. Facebook memories continually remind me of just how much my life was disrupted by constant, ever-evolving, and ever-increasing-in-awfulness migraines. To think about ten years of life affected in this way – it really sucks. It’s great to have good health to enjoy now… but what would my life have been like without those ten years of awfulness? And that’s just the physical side of things. I have done a lot of emotional healing post-surgery. But I’m still not completely healed from the trauma of this experience. I keep a very close eye on points of data that might indicate a tumour recurrence. Sometimes when my resting heart rate is high, I need to take some deep breaths and remind myself that I just had Covid, or that I literally didn’t get a chance to sit down during the day. (My resting heart rate dropped 30 points after surgery. Since my watch gives me this data daily, it’s easily accessible to monitor.) After years with headaches happening almost daily, the change to being headache-free was shocking. But it makes it hard to have a headache now without wondering what’s causing it. I also have bloodwork done annually to monitor my metanephrine levels. It’s hard not to worry while waiting for these results. I am working hard at living in peace and not in fear. But it’s hard work. 

Three: I wanted a story to be able to explain things. I had been so sure that I would receive news from genetic testing that the cause for my tumour was genetic, that it was very unsettling to receive the news that there is (so far, at least – genetic testing for pheochromocytoma is still a relatively nascent field) no genetic mutation that explains my tumour. My surgeon had been quite sure I was a genetic case. My age alone made it likely. I was so unsettled after speaking with my genetic counselor that it took me a little while to realize this was actually good news. A genetic mutation would reveal the cause for my tumour, but it would also point to likely recurrence or future follow-up needed; it would plot the path for monitoring. Instead, I need only the most basic – my annual metanephrines test. No fear of another endocrine system failure in the future (à la MEN 2, definitely the scariest possibility). Definitely not von Hippel-Lindau – very good news. Et cetera, et cetera. Go down the list of mutations and their scary consequences… and I was glad to have avoided them. So why was I so set back? It took a while for me to realize that the genetic mutation story was a story that I could tell to make sense of my experience. Yeah, it would suck. But the tumour would have had a cause, and I had received the treatment, and we could all wrap things up with a nice bow. But now I have no origin story. My body grew a tumour just because. And can you ever really trust your body again after that happens? 

Four: I am indeed learning to trust my body again. I’m still working on trusting that I won’t grow another tumour. But there was another area that I needed to learn to trust my body and the messages it was giving me. For more than four years before diagnosis, I had gone to my doctor again and again with new symptoms and irregular blood work, and I was shrugged off each time. Yes, your platelets and white blood cell counts are high, but they’re not that high. That shaky feeling? It’s not blood-sugar related. No need for any further follow-up. By the time that I was visiting the emergency room, I was given the message implicitly that I could not be counted on to explain what was happening, or that I was exaggerating, or that I was wrong about the severity of what was happening. Sometimes the message was explicit – like on one visit where three different medical staff members told me that perhaps I was just experiencing a panic attack. One side-effect of these messages were to make me stay home from the hospital when I had a pheo crisis. It was so miserable to be in the hospital and not be believed, and they didn’t do anything to help, anyway! It was the belief that I might not actually live through the episode that finally sent me back to the hospital the time that I finally met the right doctor who made his miraculous diagnosis. 

Years of learning to ignore my body’s truths isn’t undone overnight, but I’m working on it. It’s helpful when I have a headache to be gentle with myself, to treat my body with kindness, to believe the message it’s giving, and to be curious about the cause, which of course helps with the fear of recurrence anyway. In many ways, the physical healing was the easy part. Remove the cause of the extra adrenaline in my body, and my hormones all normalized, and the cascading consequences of their imbalance slowly (or quickly, in some cases!) disappeared. The emotional and mental healing require more time. And I think it’s okay to take my time. My body will always bear three little scars along my back, the only outward signs of the surgery from two years ago. What emotional and mental scars I will always have yet remains to be seen. Just as my physical scars have lightened month after month and are continually less noticeable, so too will my mental and emotional scars continue to grow lighter and less noticeable.

Still one of my favourite graphics about the symptoms of pheochromocytoma