One Year

Exactly one year ago today, I underwent surgery to remove my adrenal gland – and, more importantly, the tumour that had grown within that adrenal gland. 

I’ve written about life with pheochromocytoma, my struggle to be diagnosed, and how life changed afterwards. If you’ve been around for long enough, you certainly know most of this story. But please indulge me again, because this is easily one of the most significant events in my life within the last decade. 

I wonder how much we can appreciate our health until it’s gone. I think it might be one of the easiest things to take for granted unless and/or until it disappears. I might be a very strange case, because I didn’t realize that my health was gone until it was restored to me. That sounds crazy, I know. But it’s only in retrospect that I can see the long slow descent into poor health that took over a decade. I didn’t know it was happening at the time. 

By the time that I was going to the hospital emergency department, I obviously knew something was wrong. By that time, I was convinced I might actually be dying. But even then, I described myself as okay in between my crisis episodes. I just didn’t know that I wasn’t okay. 

I didn’t know. I didn’t know how much health was lost and what needed to be restored. I couldn’t remember. But God knew. God remembered. And God restored. 

One year ago, I underwent surgery to remove my adrenal gland and, more importantly, the tumour that had grown there that was producing extra adrenaline – sometimes 20 times the adrenaline my body should have had. I knew that I would feel better after surgery, but I just figured I wouldn’t suffer those awful life-crushing crises any more. I didn’t know what God had in store for me. 

Let me give just one example.

I used to wake up with a headache almost every day. A person just can’t actually take Advil every day of their life, no matter how much they may want to, so I would wait and see if this was the type of headache that would go away, the type of headache I could ignore, or the type where I really did need to take some Advil to make it through the day. Somewhere between 3 to 7 times a month, the headache would develop into a migraine. I am so thankful that I didn’t have some of the worst migraine issues – I rarely had photosensitivity or problems with noise. (When you often end up sucking it up and continuing to teach through the migraine, that’s really, really fortuitous.) But I did often have awful nausea accompanying the migraine, getting worse as the day went on to the point that I would just try to lie absolutely still in my bed so that I would just have the migraine headache to deal with. Migraines run in the family, so this was just an unfortunate genetic inheritance, it seemed. 

As the weeks after surgery went by and I kept feeling better and better, I stopped waking up with headaches. I was thankful not to have any migraines, but I wasn’t really holding out any hope that they were gone for good. I expected them to be a part of my life forever. But time kept passing and I just never got a headache, let alone a migraine. Over the summer, I flew to Alberta and stayed with my sister, taking care of my nephews. When the older one started school in September and came back with a cold, one morning I woke up with a bit of a sore throat and a headache. Just a headache, nothing more. But I was pretty miserable, wondering how did I do this almost every day for so long? 

The real benchmark for me was a week of lost sleep before coming to Guatemala. With variants of concern identified in Canada, I often lay awake in bed for hours, wondering if I would really actually be able to fly out of Canada and enter Guatemala. I never had the slightest bit of a headache. Previously, lack of sleep had been my number one migraine trigger. While getting a good night’s sleep wasn’t enough to prevent a migraine, not getting enough sleep pretty much guaranteed that I would pay with a migraine. We arrived in Guatemala close to midnight, and with the time going through customs and immigration, driving from the airport, and getting settled in at a new place, I fell asleep well after 2 am. With the time change, bright sunlight shining in, loud motos driving by outside, and dogs barking in the street, I woke up at 5. While I felt absolutely exhausted, I had no headache. No migraine. Nothing. I could only marvel at the goodness of God in the timing of this healing. 

It’s not just the goodness of not worrying about a tumour or about the next crisis. It’s the day to day goodness of good health. It’s the gift of being in a new country and a new job and new community and feeling good, every single day. 

I do not take this for granted. I literally thank God for my health each day. 

Bethany’s Life in Guatemala, Volume 7: Homeschooling

One of the things that I have really been enjoying about my work, as petty and small as it makes me sound, is that I can do all of it during the school day and I don’t take school stuff home with me here in Guatemala. If you read my earlier post about my routine of school work, you might be a little surprised by that. Preparing and teaching both online classes and in-person classes and then marking all of that work – it is a lot of time. But our jobs are designed to be done during the school day. And this isn’t “our” as in just the TEFL staff – this is “our” as in all the teachers here. We leave at 2:30, and we do not generally take work home with us. This is particularly helpful when a not insignificant number of the staff are also pastors in the church network and can do their pastor work outside of school hours. It also allows teachers to spend time with their families and have real lives. (I have to say, after the gift of such a manageable workload for a year here, heading back to a Certain School in Ontario will be a difficult transition! 😭)

If you read my last blog, you are now familiar with Julianna, the director of Global Shore Opportunities. Julianna is Canadian by birth, but she’s lived in Guatemala since 2004. As my TEFL director Beth put it to me, Julianna would say that she’s here by choice, but what about her kids? They don’t have a choice about whether to live in Guatemala or Canada. They’re all very happy to be living in Guatemala… but what about if they want to go to university in Canada in the future? So in addition to attending the school here and taking their classes in Spanish, these kids also do some homeschooling curriculum that ensures that they will be prepared for a Canadian university if they so choose.

This past weekend, the former homeschooling teacher returned to Canada. At the end of this month, our one Guatemalan TEFL teacher will return from her maternity leave and my roommate and colleague Eden will take over as the homeschooling teacher. But for the month of March, Beth and I have divided up homeschooling responsibilities as a sort of stop-gap measure. For the past week and for the next three weeks, I’ve taken over the homeschooling of two young boys. I’m only seeing them for a total of four hours a week – it’s not like actual full homeschooling would be, given the aforementioned stop-gap nature and, you know, the fact that I already have a job to do here. 

So, homeschooling. It’s quite fun! I have two young boys, grade 1 and grade 3, and we do a lot of reading together. We do Bible work and history work and language arts, and we always take a movement break. Otherwise it would be a lot of sitting! We race around the soccer field or have a jumping jack competition. I usually lose, but in the end when we go back to class and we’ve gained the ability to sit and listen again, I’m the real winner in the end. 

The homeschooling adds some more hours of work to my already busy week, but I feel like it does use my skill set very well. Seriously – taking a pre-planned curriculum that’s reading based and making it relevant and accessible to two kids? Easy. Coming up with comprehension questions on the fly (since the pages for our particular book are missing from the binder)? I feel like I could do that in my sleep after 15 years of prior teaching. Sprinkling in little mini-lessons to teach reading strategies and vocabulary? I’m a natural. 

On the workload front, it was a squeeze to fit in the extra responsibilities, but with a lot of very intentional focus and continuing to work while eating instead of taking actual breaks for food (teachers, I know many of you know what I’m talking about!), I did manage to fit almost all the work into my work day. I did head into school 10 to 15 minutes early most days, but that didn’t really feel like giving up much. The real challenge will be this upcoming week: we are heading to the city on Friday to renew our visas*. We still need to get all of the same work done… just in four days instead of five. We’ll see! 

*Visa renewal allows us to stay in the country for more than our allotted 90 days that the visa we entered with permitted. We’re already in March – how have two months already gone by?!

Bethany’s Life in Guatemala, Volume 6: The Director’s Message and Some Outtakes

For your heartfelt, very meaningful content today:

I have tried to share some of the importance of school here and what it means not to have students in school. In the Spring 2021 newsletter from Global Shore, the director, Julianna Konrad de Pelaez, does a much better job than I ever could. (That only makes sense – although we are from very similar farming family backgrounds in southwestern Ontario – even to the point of going to the same church, although not at overlapping times, Guatemala is now her home permanently. She lives and breathes this work that God is doing here. I get a glimpse into things; she sees things much more fully.) So to give you a much better glimpse, I offer you this link to the spring newsletter and encourage you to read Julianna’s words for yourself.

And on the much more lighthearted side:

Look. Sometimes you feel on top of your teaching game, and sometimes you wonder just how many mistakes you can make. It’s especially bad when you have to rewatch yourself make all of those mistakes and edit them out of your teaching videos. I’ve compiled several of them into a short video for your viewing enjoyment, should you so desire… I promise that I’m a better teacher than this in real life. (I hope!)

Nothing like watching all the mistakes you can make in a short time and thinking, “What is my in-class teaching actually like?!”

Bethany’s Life in Guatemala, Volume 5: Extreme Allergic Reactions

Look, some of my blog topics are going to be very serious, and some are going to be a lot more light-hearted. We will run the whole gamut of the human experience here. Today’s topic is definitely going to be on the more light-hearted side…

So as my family can attest, I have a history of reacting to bug bites. I remember that as a kid I would get huge lumps of mosquito bites. We’re talking reactions that were swollen, hot, hard, several inches in diameter. If I was unfortunate enough to be bitten right on the back of my knee, I wouldn’t be able to fully bend my knee for a couple of days. 

Thankfully that reaction has died down to a more tolerable “still react badly but no longer look diseased” kind. 

Well, naturally there are delightful things to react to here. There are teeny tiny little ants under our clothesline, and inevitably, every single weekend, when I do laundry, I get bitten. I immediately get a big swollen reaction about the size of a quarter, that after a couple of days fades away into a blister, that after about a week in total disappears just in time for me to do my laundry and get bitten again.

Then last week Wednesday afternoon, I discovered what I thought was a mosquito bite on my arm, up near my shoulder. It was itchy. I tried my best to ignore it and not to scratch it. 

Hours later, when I was lying in bed, I suddenly thought, wow, my arm hurts. I looked at the bite. It was a big red swollen reaction, much bigger than the usual quarter-sized ant reaction, but also way more than my typical mosquito bite. I revised my premise from mosquito bite to ant bite – after all, I had first noticed the bite when I was working out, and there are always ants crawling around on the floor in my workout location. (This kind of comes with the territory when most things are outside and inside spaces don’t really have doors that bugs can’t easily get through or screens on windows.) So, an ant bite… but definitely bigger than my typical “clothesline ant” reaction. I grabbed the tube of hydrocortisone cream that I just leave out on my night table here (no point in putting it away!), slathered it on the bite, and went to sleep. 

Wednesday night: “It’s not that big!”

On Thursday morning, my bite hadn’t decreased in size at all. I showed it to several people because it was quite impressive in size. But over the day, the swelling spread… and spread… and spread. By Thursday afternoon, my arm was swollen from armpit to elbow – literally. It was hot, obviously red, and noticeably swollen. I went home to get some Benadryl, and on the way stopped to show people how much it had grown over the day. They (very reasonably) suggested that maybe it was time to see a doctor. And yeah… that’s probably good advice. Except I am used to reacting to bug bites. And what is a doctor going to do? Give me antihistamines? I have some here, and I took some. Administer an epipen? If you catch up on my medical history, you will immediately understand why unless I actually think I’m dying, I don’t want to experience additional epinephrine running through my body. I took the Benadryl, took a regular antihistamine, slathered on some more hydrocortisone cream, went back to school, and tried desperately to stay awake for the last hour of work. (Thanks, Benadryl! You always make life so fun!) After school, I took a shower and finally drew a line around my reaction so that I could track the swelling and growth. 

It’s too bad that I didn’t turn my arm just a little more in this photo – the swelling goes even further, all the way down to my elbow, on the bottom side of my arm. You can *just* see the line curving out at the very bottom from this angle…

The swelling did seem to stop then. I think gravity was actually exerting its influence, since the only place that the reaction was outgrowing its line was around the bottom, by my elbow. Around 7:30, I deemed it late enough to take some more Benadryl. I took two and pretty much immediately fell asleep. When I woke up, the swelling still hadn’t grown any more. 

Thankfully by Friday afternoon, my arm was looking impressively better. The swelling had really gone down, and while it was still red, it wasn’t so hot any more. It took until Saturday afternoon for all the swelling and redness to actually go away. It also took another week (!) for the itchiness to go down.

Once the swelling had disappeared, you could finally see the location of the bite again. It wasn’t just one bite – it was actually three. I’m not sure if that’s what caused the extremeness of the reaction, or if it was also the type of bite. When I showed her my arm and described things, my very wise sister hypothesized that it had been a spider bite. 

“Don’t you think you should have an epipen just in case?” my mom asked when I talked to my parents that weekend. Again… I’m going to do anything I can to avoid the feeling of extra epinephrine. I also really don’t think I’m in danger unless I get bitten near on my face or neck. But also, in an abundance of caution, I do think I’ll go to a doctor much earlier in the reaction timeline next time! (And praying there ISN’T a next time!)

Bethany’s Life in Guatemala, Volume 4: Chicken Buses

Picture this: you’re in a school bus that’s painted garish colours, crammed in on all sides by other people and their purchases. There’s music blasting on a radio, and the driver seems to be driving like he’s making up for lost time, speeding around curves and over speed bumps and potholes alike. The driver is honking his horn as if it’s the only thing keeping the bus running, and his coworker is leaning out the door bellowing the name of a city at anyone, whether they look like they care or not. 

Where is this chaotic scene taking place? Guatemala, of course! You’re riding a chicken bus to get from one place to another, just like any other Guatemalan who doesn’t have a car or a moto. 

The famous chicken bus in its native habitat

Once a school bus has lived out its life in North America, it’s driven down to Central America where it gets to live a second life. It typically has some work done – I’ve heard that most buses get a manual transmission put into them, although I haven’t paid enough attention to know whether or not that’s true. Buses also get racks put overhead – key, because a lot of people riding the bus have a lot of stuff with them. They generally get a metal railing installed on the ceiling the length of the aisle. This is important because the bus will often start driving as soon as everyone is on, not once everyone is in their seat, and it’s helpful to be able to hang on while you head to your seat or while you get up to move to the front in advance of where you want to disembark. Additionally, some buses seem to have new seats installed – the seats are wider, meaning you can squeeze a third person in (and I do mean squeeze – have you been on a bus in a while?), although this means really squeezing your way down the aisle. And the seats are then also installed closer together, a key factor in being able to fit more people in your bus and maximize your income if you’re running the bus (although it makes it difficult for a taller-than-the-average-Guatemalan Canadian woman to fit her legs into the space comfortably. Especially given the bumps over potholes and speed bumps – sometimes the kneecaps take quite a beating!)

And, if you’ve ever seen any photos of a chicken bus in Guatemala, you know that the other drastic change to the bus is decorating the outside. Red, white, yellow, green, blue – buses are painted vibrant colour combinations. They can also then have fancy chrome added or sometimes decals added to the windshield (enough that sometimes one wonders how well the driver can really see the road!) The colours matter when you have an adult population with a relatively low literacy rate – even though the bus will say what route it is taking, that doesn’t matter much if people can’t read the sign. So the colours also indicate where the bus will go, and this way people know which bus to take. 

These chicken buses are the equivalent of public transit in North America, with a few key differences. Have you ridden a city bus lately? Even if you haven’t, I’m sure you know that they have route maps and schedules. And if you wanted or needed to ride one, you would check ahead of time to see where the stops are that you need in order to get on and in order to get off. And then you would check to see what time the bus would come by, and you would be at the stop a couple of minutes before the bus’s scheduled time, expecting it to arrive at that time. 

Meanwhile here in Guatemala, if buses have schedules, I sure don’t know what they are. And you can’t look up a bus time on Google Maps like you can in Canada. You just head to some location on the bus route, and you wait for your bus to come by. We’re actually fortunate that from home, a couple of buses come by and all head through Jocotenango (church location) and into Antigua (nearest city, where we generally do our grocery shopping). Once in a while we’ll come down the hill and just miss a bus and have to wait a while (like 20 minutes has been our longest wait time so far), but other times, it’s a short five minute wait. Today I crossed the highway just as a bus rounded the corner, so I hopped on and was in town in record time. 

Buses have some sort of standard stops, but you can also wait anywhere along the bus’s route and hop on, and you can also get off anywhere along the route – just go up and ask the driver to stop and let you off. 

Buses come in a variety of colours

Why are they called chicken buses? There are a couple of different stories to explain this name. Some say it’s because passengers are crammed in like chickens. My preferred story is actually that people take whatever they have to sell in the market with them, including live chickens. 

Besides the bus driver, there’s another staff person on the bus who stands in the doorway and yells the destination at people. Once in a while, he comes down the aisle and collects bus fare from people. These people have the most excellent memory for who has paid and who has not yet. I think I would be awful at that job, but every person I’ve seen has been so good at their job. 

Would you like to have a job where you lean out the front door of a bus? You need to be really good at hopping in once the bus driver has actually started driving. You also need to remember who has what stored inside the back door of the bus, because when those people get out, they expect you to get their stuff for them again!

I also have to say, given the picture that I painted early of people all crammed in, that perhaps the pandemic has been good for creating space on the bus, especially for a Canadian who likes her personal space. Capacity limits are technically in place (I say technically because I really don’t know how seriously drivers take them. I’ve never seen anyone turned away!) and temperature checks are done at the door of the bus (again – I’ve never actually seen someone read the thermometer, but it technically gets pointed at everyone!), but ridership also just seems to be down. I don’t mind having the additional breathing space and being able to get a seat. It also makes it feel much safer – much less worry over pickpocketing or theft when you can see everyone and not have people packed in close to you for long periods of time. 

Despite all my description here, I kind of think that you need to ride a chicken bus to really know what it’s like. I know that some of my friends and readers have done just that. From your experiences, what did I miss in my depiction here? 

Additionally, I don’t have too many pictures of buses, and I don’t have any really excellent ones. I also don’t have enough to capture the wide variety of bus colour. If you’d like to get some better visuals, do a Google image search for Guatemala chicken bus and enjoy!

Bethany’s Life in Guatemala, Volume 3: School Has Started!

I know. Last week was already about school. But I’m a teacher, so you should fully expect to read more about school over my year here, teaching in Guatemala!

I need to write about school this week. Because it was A WEEK. An incredible week. A good week. A hard week. So pretty much your typical week when it comes to school. 

On Monday, parents came to pick up packets of work for their children. One thing that is very different from Canada is that students need to pay for their photocopies here. That has been quite a different idea for me to wrap my head around. I’ve had several conversations with Beth, our TEFL director about it. Because my first instinct is to make sure I give the fewest number of pages possible, but giving nothing isn’t an option right now and besides needing students to do work that they then turn in to be marked so that I have grades, students also need to do work to learn. So I will balance thorough, thoughtful sheets with saving space. Beth also reminded me that students expect that cost. At many private schools in Guatemala, students are required to buy books and then don’t really use them, so this is also a way to ensure that students only pay for what they actually need. 

On Tuesday, the halls rang out with the joyful sound of children. Such few children, but what a joy to have children at school! The children of teachers and staff are at the school. Having them doesn’t violate municipal regulations for Covid, it means students can actually be at school, and it means students aren’t at home alone or requiring child care while parents work. 

We started Tuesday the way we always do – with a devotions time full of listening to God, worship, and prayer. I spent a lot of that time crying. I can’t believe how good it was to listen to children sing with gusto. I haven’t been in a space like that since February 2020. It was so good. 

On Tuesday, I also posted my first video in a Facebook group. Still kind of crazy to me that I am teaching and purposely using Facebook. I also received some very cute texts through WhatsApp from students asking questions about their work. 

I don’t have any pictures of students or school, so please enjoy this very cute text from a student! 💕

Tuesday through Thursday, I uploaded teaching videos to Facebook, answered questions through WhatsApp, and TAUGHT REAL STUDENTS IN PERSON!!! I have one student in person in my segundo básico class (grade 8), and two students in person in my tercero básico class (grade 9). It’s so helpful to have in-person students and get to have real interactions instead of just online, and it’s also really helpful to get one data point of information for where my students might be in their English level. 

In typical roller-coaster teaching fashion, classes went really well and really badly. When I finished my last class on Thursday, I came back to the staff room and told my TEFL colleagues, “I’m really worried about my online kids. When you can spend 3x longer explaining the concept in person and they’re still struggling with it… how are the online kids doing when they just have 5 minutes of explanation?” Sure enough, that has certainly been the class and activity that I’ve had the most texts about. When parents come next week Monday and hand in this past week’s work and pick up the next packet, it’ll be very interesting to see how students did. 

In addition to teaching, editing and posting videos, and answering questions, this week we also needed to plan our next two weeks of class. We need to turn in our lesson plans for the coming week by Thursday afternoon before we leave school. To give some context, remember that Guatemala is a country with a chronically underfunded education system. In November, the Congress literally voted to make cuts to education and the health care system in order to increase their stipends for meals. So when teachers aren’t paid a living wage, when no one checks in on their work, when they sometimes live long distances from school… why bother showing up on time? Why bother having lessons planned for the day? Global Shore is consciously different. Teachers must arrive on time for the day or they aren’t paid for that day of school. Their lesson plans must be turned in to be looked over. And those handouts… remember the handouts that get photocopied? You also have to give those to the secretary to make copies for everyone. 

This past week and next week, parents will come on Monday, and classes happen from Tuesday to Friday. But the plan is to change the turn-around day to Friday, so that classes will happen from Monday to Thursday, and on Friday parents will come and switch out materials. That means we actually need to have our lesson plans turned in by Wednesdays and get the copies done. In order to make that turn-around happen, this week we handed in lesson plans and handouts for two weeks. So yes, in our first week of school we had to write lesson plans and handouts for the next two weeks. Another crazy and fun factor is that we need to have 3 “midterms” throughout each quarter, each approximately 3 weeks apart. So I have already planned and made photocopies for a test for the end of week 3 and I haven’t even gotten any student work back yet. Literally who knows if students will pass or fail, if it’s incredibly easy work or incredibly hard work for them?! Not me!

I don’t tell you these differences to critique the educations system in general or the work that Global Shore is doing here. If you understand the cultural differences, many of the differences in how schools run make sense. But I hope that the stories give a little insight into my life in this past week and in the kind of work that I’m doing! 

Bethany’s Life in Guatemala, Volume 2: Online Education

Last spring, Ontario schools pivoted rather rapidly and unexpectedly from in-class to online at-home learning. Granted, I was actually off of work recovering from surgery during the set-up and first week of implementation, but I came back to work into a system that was functioning well. My students each already had their own Chromebook, and they were used to using them independently during class. It was a given that each home had wifi, and while connectivity might not always be strong enough for the whole family to have great internet access, I could generally see my whole class for devotions each morning and students were able to complete their learning online. It was a definite challenge for students to switch from in-class to online, but they were well equipped. 

My new students in Guatemala will be starting classes this coming week. We were very much hoping that students would be able to come to school in person – restrictions have eased from the very strict lockdown that stayed in place for much of 2020, and the Ministry of Education was requiring schools to submit a Covid plan to be approved before students began their school year. However, we received word this week that because our department (think province) of Sacatepequez is in the red (as determined by percent of Covid tests completed that have positive results), we will not have students coming in person. While we are in the red or orange, students must take their classes online. We anxiously await yellow or green. 

So just what does online education look like in Guatemala? 

My students in Ontario all had their own Chromebook. This is obviously not a given for all students – even in our younger grades, students didn’t necessarily have a device. But JKCS put together a plan to loan out school devices to families for as long as needed. Here in Guatemala, it is even less likely that students have a device. If they do, it’s almost certainly a phone. It’s much more likely that there is a phone or two that parents own and use. It’s already a significant difference to plan lessons and work that will be seen (and likely not done) on a phone. That phone might also need to be shared between multiple students. 

Next let’s consider wifi. I held out for as long as I could before getting wifi for my own home in Canada… and I think I got it back in 2015. It was simply not feasible to live without wifi in my home. Here, I am blessed to have regular wifi access – at home, and throughout a lot of the school. Of course, concrete and block walls mean there isn’t great wifi accessibility into each of the classrooms and offices, but my TEFL colleagues and I have been enjoying the sun and warm weather while working in the courtyard where we generally have great wifi access. Wifi is much less likely in the average Guatemalan home than Canadian. Many of our students simply do not have wifi at home. What they do have, however, are phone plans. My Guatemalan phone plan has 8GB of data a month, but anything that I access through Facebook and WhatsApp don’t count towards that 8GB – they’re basically free. (Let’s save the conversation about the ethical implications for another time… but that would be a very good conversation to have!)

It is quite ingrained in me from teaching in Ontario that students do not belong on a teacher’s social media. I let students follow or friend me once they’ve graduated, if they really want to by then. So please imagine my… culture shock to hear that our main educational resource is Facebook. It all comes down to that free data access. I’ve been added to Facebook groups with my fellow teachers and students. I’ll post my teaching videos there. I’m also a part of WhatsApp groups where students can text with questions as well as sending things like voice memos – a great tool for the English teacher! Parents are picking up an envelope with worksheets for the week, students will complete them, and they will swap out the old for the new on a weekly basis. Considering that my students might need to share a phone among multiple family members, and considering what we know about student engagement and attention span, I’m aiming for a five minute video, with a maximum time length of ten minutes. I don’t know my students, and they don’t know me, and I get approximately ten minutes of one-way video interaction with them a week (two classes), with worksheet feedback on how they’re doing and what they’re understanding. 

So it’s definitely going to be a fun challenge! 

And… if you’d like a little taste of what those videos look like, I’ve added one here for your enjoyment.

Bethany’s Life in Guatemala, Volume 1

I don’t even know where to start. How do you sum up a week in a new life in a new country in a new job with new friends and etc? I’m going to assume that over the course of ten months you’ll get an idea of what daily life is like here. I’m going to hit you with an overview of this past week and what school will be like. (If you have topics that you really want me to write about, questions that you have, etc, please leave them as comments here or on Facebook and I will address them in future posts!)

Last Sunday we had a whirlwind of an orientation. Breakfast together as a TEFL team, our first ride on a chicken bus to get into Jocotenango, church service, another chicken bus ride into Antigua, the purchasing of Guatemalan SIM cards and phone plans, lunch in a restaurant, a quick sight seeing, and a grocery trip in the famous (infamous) grocery store La Bodegona. La Bodegona is an experience and definitely deserves a post all to itself sometime. For now, just trust me when I tell you that it is An Experience.

My good ole beloved Antigua!

Monday and Tuesday were days with some TEFL orientation for us new teachers. Let me introduce the new cast of characters – they may show up in varying frequency in upcoming posts. Eden and Tegan and I are the new ones, and Max and Matthew are returning TEFL teachers, and leading the charge is our fearless TEFL director Beth. Eden and Tegan and I live upstairs in what is affectionately called Casa Canche, or “house of blondes” (think foreigners or light haired people). Beth and her husband Fred (director of communications for Global Shore) and Baby Ali (cutest little chubby cheeked baby you can imagine) live on the main floor of Casa Canche. Most of the ex-pats working with GSO in Guatemala have historically been Canadian, but with the new opening of GSO USA in 2019, it’s now easier for Americans to raise support and work here. So both of my roommates Eden and Tegan are Americans. As I’m sure you know Canadians love to do, they got quite the lectures and lessons about Canadian culture as we started working together.

I just cannot get over this view. I am constantly amazed by it… it’s what I see when I step out into our porch, or step out of school. It takes my breath away every time!

On Wednesday all teachers arrived. Most of the school staff is Guatemalan, and we had a LOT of people to meet and names to try to remember. We TEFL teachers also received our teaching assignments and curriculum and started lesson planning.

I’ll be teaching segundo and tercero básicos this year – essentially grade eight and grade nine. Básicos is middle school here, and it’s essentially grade 7, 8, and 9, and just like those can be challenging years for students in Canada, they can be challenging for students here. So even though classes are not too big, the students are divided into two sections. So I have four different classes that I’ll teach, two grade 8 classes and two grade 9 classes.

For the first time since my first year of teaching more than fifteen years ago, I have a whole new curriculum to learn and a whole new crop of student names to learn. I’m so used to teaching at least some of the same curriculum and usually know more than half of the students coming into my class. It’s so strange to have everything be new. Strange in a good way – I am up for the challenge! But you can pray for my transition into a totally new job and for my ability to quickly learn names of all my new students.

It’s been nice to have a weekend break. Yesterday, Eden and Tegan and I took the bus into Antigua ourselves – our first solo trip, successfully completed! – and enjoyed lunch in a restaurant, beautiful views of Antigua, and a quick stroll through a very empty artisan market (usually bustling with tourists). Today after church, Eden and I found a cafe and are enjoying some quality drinks while relaxing in the fresh air.

Tacos!

Next week will continue with similar work – staff devotions together each morning, then planning and meeting times. On Thursdays, teachers have to submit their lesson plans for the whole upcoming week, so I’ll be fine-tuning my lessons and starting to prep for the second week of classes.

And then classes themselves will hopefully begin on the 18th. I believe that we still need to find out if our Covid plan has been approved by the government, but the 18th is what we’re expecting right now.

Thank you all for your comments on Facebook and Instagram. It’s great to still feel connected with you! Please feel free to stay in contact with me through any of your favourite methods.

My Last ER Visit, or In Praise of the Right Doctor

The school year started the way it always does – first for teachers, then for students. I spent two weeks re-organizing my classroom, printing a few last pages from the unit I had rewritten during the summer, excitedly greeting coworkers as we saw each other for the first time after the summer, in meetings, in more meetings, frantically trying to get last minute details ready before the open house where I would welcome students and parents into my classroom before the first day of school. 

It was the whirlwind it always is. Seriously – it is never not a whirlwind. But things came together the way they always seem to, and I enjoyed meeting the new students I would be teaching. I went out for a late dinner with friends, even ran into a friend from church and stayed for quite a bit longer talking to him after my friends left while he was waiting for his food, and then went home to fall into bed, exhausted. 

I woke up the next morning feeling absolutely awful. I assumed it was a migraine. It wouldn’t be unusual after a stressful and very busy week where I hadn’t been sleeping well to end up with a migraine. I took some Advil and went back to sleep. 

I woke up an hour or so later and immediately realized with a sinking feeling that it was NOT a migraine. My hands felt shaky and I was jittery. I didn’t have any chest pain yet, but I knew after so many times through this routine that it was only a matter of time until my chest would tighten so unbearably that lying down would make each heartbeat physically hurt and would keep me awake no matter how desperately I tried to sleep. Then, sooner or later, the vomiting would start. It didn’t matter that I wouldn’t eat anything after the shaking started in an attempt to mitigate how awful the vomiting was. Something had set the symptoms in motion, and there was nothing to do besides wait them out. Wait in absolute misery. 

I decided not to go to the hospital. I was frustrated with my experiences with the health care I had received up to this point. I knew from experience that a visit to the ER would mean defending myself to various doctors and nurses. I wondered if I would be told yet again that I was probably “just having a panic attack”. I would be given numerous tests, none of which would reveal what was wrong. I would have to endure the time at the hospital miserably trying not to vomit in front of complete strangers, receiving nothing that actually helped the chest pain, until hours later it dissipated enough for me to be discharged and call a friend to come pick me up, taking with me a handful of referrals to give me some small hope for a future diagnosis. It was so awful being horribly sick in the hospital and not getting any noticeable benefit that I decided not to go at all. I decided I would rather be sick in the privacy of my own home and just hoped that the one specialist appointment I had lined up for later in the fall would provide the answers I so desperately wanted. 

By late afternoon, the vomiting had started. It was pretty early in the cycle for vomiting, actually. The symptoms seemed to be getting worse with each mysterious bout I had. I had thrown up for 16 hours the last time… how much more awful could it get yet? I sat down on my living room floor and cried. I absolutely despaired of ever finding out what was wrong and of it ever getting better. 

Half an hour later I was gasping for breath and brushing tears off my face yet again, these tears squeezed from my eyes by the sheer force of the vomiting. I tried to massage a cramp out of my ab muscles. I honestly wasn’t sure I was going to survive through symptoms that kept getting worse and worse. It was past time to go to the hospital, and I would just hope to end up with a doctor who a) actually listened and b) had any clues about what was wrong. 

And miraculously, that is what I ended up with. 

But not quite right away. 

Actually, I really can’t fault my first ER doctor at all. He was extremely compassionate, and he listened carefully and never suggested it was stress or a panic attack. In fact, he looked through  my bloodwork and enumerated my irregular results, explaining that while vomiting can elevate your blood sugar, it can’t elevate it that much. And while stress can cause some elevated white blood cell count, mine was way too high to be caused just by the stress of a new school year and a hectic two weeks of work. Etc, etc. 

By this point in my health journey, I was carrying around a file folder with every blood test I’d had that had been irregular, every hospital procedure, all referral paperwork, every test that had been run, all the files related to health. I also had a notebook where I had carefully recorded the dates of each episode, the symptoms I experienced, the notes from each doctor I had seen in the hospital or in referrals. I pulled it out to refer to when answering one of the ER doctor’s questions. He pulled up a chair beside my hospital bed and started paging through, asking me questions, flipping to the pages I would indicate. He looked and listened and asked for about fifteen minutes. He left to check a few of the tests he’d had run, and then he came back in and sat down again. 

“Something is definitely wrong,” he said. Tears immediately began to make their way down my face again, just sheer relief at being acknowledged and believed. “I don’t know what it is, though. We need someone smarter than me involved. I’d like to keep you here for a bit so you can talk to another much smarter doctor, is that okay?” 

I nodded, not excited about spending more time in the hospital, but happy to wait if it meant another doctor who would take me seriously and possibly have some ideas. I was prepared for an overnight in the hospital – over the last year of ER visits, I had started keeping a hospital bag prepared, waiting by my front door for the next time I would need it, sort of reminiscent of the hospital go bag a pregnant woman might keep, only to be grabbed with a whole lot less joy and anticipation. I had an eye mask, ear plugs, a portable battery for my phone, a book, sweatshirt, change of clothes. I was set for the night. 

Sunlight would have been peeking over the horizon by the time that I met Dr S, not that I got to enjoy it in the windowless ER patient room I was in. I assume that Dr S had been briefed by the referring ER doctor, and maybe he had already glanced through my charts. But he came in and listened to my story. Although I was used to telling it to doctors and could keep it as brief as possible to make it through without interruptions or losing attention, Dr S clearly didn’t need my abbreviated version. He asked question after question. He took thorough notes, looking at my notebook and carefully recording the dates of episodes that I had written there. He looked at my files and checked various test results, asking if I’d had this test or that procedure done. I told him how frustrated I felt so far – if I could get doctors to look at my bloodwork when I was in the hospital, each doctor would inevitably conclude that there was something wrong. But it felt like by the time that I felt better after each episode, the window had closed to figure out what was wrong until the next episode. Dr S reassured me that that was not the case, and there were, in fact, tests they could run when I was feeling fine that would still help us out. He told me he wanted to take a few minutes to read through everything else in my files and left for a bit. I dozed again. 

Dr S came back about an hour later. He had a few more follow up questions. Then he explained: “It’s Labour Day weekend. I have some tests that I’d love to run, but getting them done promptly on a holiday weekend won’t happen. You look like you’re feeling significantly better than when I first saw you. Would you like to stay and have tests run, or would you like to go home and come back for an appointment to see me?” 

It was true. At some point in the early morning hours, my chest pain had started to subside, as they always did, even without any treatment. The vomiting was successfully controlled by the medication the hospital had given me, and the IV was helping solve my dehydration. (The only two benefits I ever felt like I got from ER visits was to mitigate dehydration and get meds to help the vomiting end faster.) 

It was a holiday weekend. I was hoping to drive to my parents’ place to celebrate my dad’s birthday and be away from school before jumping into classes the following week. I was also exhausted. Despite using my ear plugs and mask overnight in the hospital, I had lain awake for a long time in an unfamiliar bed, was awakened when wheeled over to radiology for an X-ray, or awakened by the blood pressure cuff as it tightened on my arm every 15 minutes. I knew I would sleep better at home. 

“I see patients at the hospital on Tuesdays. Could you come in this next Tuesday and we’ll talk about how to move forward?” Dr S asked. 

I grimaced. Tuesday would be the first day of school. I explained how I would rather not miss that first day and asked if it would be okay to see him the following week instead. (This is a curious part of having my ill health show up in the pattern it had. As desperate as I was for an answer, I knew I would be more or less okay for at least a month since I had just had a major episode. Delaying a doctor’s appointment for a week was a risk easily worth taking in order not to miss the first day of school.) Dr S said he could understand how important it was to be at the first day of school and told me a delay of one week would not be an issue. 

A nurse came in to remove my IV. Dr S returned with a prescription he wanted me to start immediately. And he gave me a piece of paper with a word on it, a condition that he wanted me to look up to see if it resonated. Pheochromocytoma. 

After months of ER visits, tests, and specialist appointments, Dr S gave me the name of my condition the first time that I saw him. 

Of course, it still took a few more tests and imaging to confirm, but looking back, I am so impressed that he looked at the same clues that so many other doctors had seen and was able to put them together in a new way. 

I texted another friend to see if she was awake and could come pick me up and drive me home. Then I changed from my hospital gown back into my own clothes, this time opting to leave the heart monitor stickers on my skin until I got home. Despite the allergic reaction springing up under each sticker, it was easier to keep them on until I got home. I knew from experience that taking them off at the hospital would just mean that by the time I got home, my clothing would be covered with the sticky gel residue that coated each sticker. An EKG technician at the cardiologist had given me the helpful tip earlier that summer that oil – any kind, even vegetable oil or olive oil usually reserved for cooking – would help that residue come off. I had a bottle of bath oil in my shower just for such occasions. 

I got home and texted my parents to say I wouldn’t come home until the next day. I ate some applesauce that was regularly stocked in my cupboard for post-episode rehydration and some nourishment my body would be able to handle. I hadn’t had anything to eat in more than 36 hours, and I had lost 11 pounds in that time, at least before my hospital IV started my rehydration. And then I fell into bed and slept for some 8 hours. 

And that was my last ER visit for pheochromocytoma. By the end of the month, I had the first lab test results that indicated that Dr S’s hypothesis was correct. By the end of October, I had an MRI, and in early November I sat in a hospital exam room and cried when Dr S told me that the MRI revealed a small 2cm3 tumour on my right adrenal gland. I think he was a little concerned about my emotional state when I started crying, but I told him I was just so absolutely relieved to be reassured that we had a clear and definitive answer and clear path ahead now. 


That appointment was actually the last time I saw Dr S. He had already referred me to an endocrinologist who would refer me to a surgeon, and I was officially transferred from his care to the endocrinologist upon official diagnosis. 

My endocrinologist and surgeon are both excellent doctors and lovely people. But Dr S is the star of my story even though I was in his care for just over two months. He really felt like the first doctor to take me completely seriously and believe my story enough to investigate fully. I know my veterinary doctor sister would defend the other doctors I saw, saying that partly enough time is needed just to establish a pattern that a doctor can follow, enough evidence of the right kinds of symptoms. But Dr S was different from the other doctors I saw on my other visits. He is the kind of doctor that I hope anyone on their own difficult and mysterious health journey ends up with. 

Small things that he did made such a difference. On that first Tuesday non-ER appointment that I had with him, he asked me for my email address and sent me an email from his hospital account so that I could send him an email (and didn’t have to worry about misplacing a business card with his contact info). By the end of September when my lab test came back indicating high metanephrine levels, I sent him an email telling him that the results were in and were abnormal, asking what that meant for our next steps. He didn’t have an appointment time available that week and asked if we could talk by phone instead. I reminded him that I was a teacher and asked if it was possible that he call within a certain time frame when I wouldn’t actively be teaching my class (recess time and a prep period, if I recall). He was in a meeting until just before the end of that window of time but called me while walking back from his meeting, apologizing if I could hear the wind outside on his end because he was still walking back to his office. 


I am such a fan of universal health care. I know that our healthcare system is sometimes mocked by Americans as being inferior care for longer wait times. I would absolutely argue in favour of it, having gone through countless hospital visits, doctor’s appointments, tests, and a surgery and overnight stay in the hospital with a final bill of $0, paying only my insurance co-pay for my medications. I can’t imagine going through the stress of being sick while also worrying about how I would pay for my appointments, inevitably deciding not to go to the doctor because I couldn’t afford it. I also can’t imagine being sick and worrying about my illness interfering with work to the extent that I might worry about job security and therefore health insurance coverage. 

That said, I think some of my experiences with the health care system were because it is a system, not designed for individual cases. There are things that it is great at, and there are places where it needs improvements. Doctors are overworked, responsible for more patients than they can care for well. If I think about Dr S and what set him apart, it makes me think about the equivalency in my own work as a teacher. When I forgot to think about my students as individuals, each student created in the image of God with hopes, dreams, fears, abilities, and instead thought of my work as tasks to complete, systems to set up, things to get done, it was inevitably my students who suffered – and my relationship with them. In the system of health care, to many of the ER doctors I saw, I was an item on a checklist, a patient to see before going home, a set of tests to run, and when they were ready to leave and there were no answers yet, I was given a handful of referrals. I was an individual to Dr S. I was a person with a unique experience and story. 

May all of us, in whatever our work is, have eyes to see others as the individuals that they are, made in the image of God, with hopes, dreams, fears, abilities. Especially during a global pandemic when fear so easily rules our actions, may we see others as the humans they are. May we take the time to get to know them, to understand their hopes and fears, to celebrate their dreams and abilities. 


If you’ve made it this far in the story, congratulations! I feel like a lot of what I’ve written here and on social media lately has been pheo-related, but it has been a major, MAJOR part of my life, and writing about this experience has been hugely cathartic. If you’ve read my earlier post “Life After Pheochromocytoma”, then you have some idea of how drastically a diagnosis and surgery has changed my life. 

I want to end with something that might not apply to many people. But if you’ve stumbled across this story while in the middle of your own medical mystery, I want to offer some pieces of advice and hope. This advice can probably be found in lots of places online, but it might be helpful to read it in the context of my story, or hear it again, or it might perhaps even be the first time you’ve come across such ideas:

Advice

  • Be your own advocate. No, you shouldn’t need to be. But sometimes you have to advocate for yourself more strongly than should be necessary. Doctors are busy. They also aren’t experiencing your unique symptoms. You know yourself. Trust what your body is telling you. Insist on being listened to and taken seriously. If you are not taken seriously, find a doctor who will take you seriously.
  • Make documentation. It is so helpful to be able to refer to dates, records, and notes in order to be taken seriously. It is also helpful to look back at notes after an appointment or hospital visit because sometimes hospital visits are a blur. You’re not necessarily feeling your best. 
  • Take good care of your mental health. Not being believed is incredibly frustrating. Starting to not trust your own body is even worse. Do what you can when you can. Don’t feel guilty for the things that you can’t do when your body doesn’t let you. 

Edited to add:

If you would like to hear a conversation that encapsulates my ideas of different kinds of doctors and medical experiences, check out Kate Bowler’s conversation “Medicine with a Soul” with Victoria Sweet on her podcast Everything Happens.

Flight

There’s something so magical about flying. 

 

To think of this hunk of metal filled with people and weighed down with stuff as it hurtles down the runway, groaning as it heaves itself into the air, but then suddenly soaring…

It fills me with wonder. 

 

I am not one of those people who keeps reading during takeoff. No – a window seat for me, please. I press my nose against the glass and mentally gasp at all the sights. 

I don’t ever want to become one of those people who doesn’t press their nose to the glass. I don’t care about the opinions of others either, so I will continue to gaze about and gasp, sometimes audibly. 

While I was on jury duty, I was often in the corridor for air traffic on its way to the airport. Planes would fly overhead, not too high off the ground. One day I stopped at a nearby Shoppers Drug Mart on my way home. As I stepped back out of the store, I was suddenly engulfed in a shadow, and then a split second later, back in the sun. As my heart pounded, I tried to figure out what had happened. It was the shadow of a plane that had scared and then delighted me so. What a world we can live in, where we can experience this wonder and delight!

Sometimes when I fly, I think of that moment I experienced on the ground. Flying from Toronto to New York City a few years ago, the plane’s shadow was clearly visible on the ground below. I watched it for quite a while, racing along below us, as it temporarily engulfed houses, cars, boats in shadow. Did anyone down below feel that sudden flash of fear and then wonder? 

Right at this moment, flying anywhere feels like a far off dream, too dangerous and with nowhere I’m allowed to go. But I will still remember and smile at my memories of flight.