Perhaps this is slightly premature, but it appears (based on one data point, plus a fussy day today) that Thomas has another case of TD. This makes illness #3 in the past three weeks. I must say that I'm a little discouraged. It's already really hard work to keep him fed & reasonably safe, even with deciding to cut a few corners to maintain sanity (e.g., we lately have just been airdrying the jars we use to feed him rather than boiling them in the tiny batches allowed by our small kettle).
Part of the difficulty is that there are so many potential sources that it's hard to narrow down where we should focus. Is it the many (easily at least 10, often more) people who touch his hands and face any time we go out? Though we say no these days when people try to take him from our arms, it is essentially impossible to keep people from touching him without feeling extremely rude. Is it the not boiling of jars? Is it feeding him from our plates on occasion? Is it something in the way I prepare his food? (I try to be really careful.) Is it the way our clothes are washed? (In a river, if I understood correctly.) It's just hard to know.
Meanwhile, we have lots of azithromycin syrup, so hopefully that will do the trick if necessary. But I would also welcome any wisdom and/or prayer if you have any. I won't be hasty and don't feel urgent about this decision just yet, but part of me does wonder whether staying the full time is really a good idea for our little guy.
Saturday, January 30, 2010
Baby feeding, part 1
We came to India with a stash of ~20 assorted jars of Earth's Best organic baby food, one box of Earth's Best multigrain cereal, and a container of HappyBaby organic vegetable puffs. As planned, we went through most of the baby food jars during our two weeks of travel in Maharastra, and towards the end began transitioning to making our baby food on the go.
Baby-friendly foods that are readily available here:
Fruit - bananas, apples, watermelon, papaya, oranges
Veggies - carrots, potatoes, green beans (though they're sometimes tough), parsnips, eggplant, an green summer-ish squash, 1 orange winter-ish squash (called 'pumpkin' here, though not what we call pumpkin), beets, okra
Starch - white rice, 'idli' (a steamed rice cake, slightly sourdough-ish), a variety of flatbreads (naan, chapatti, paratha), pasta (in the international section of grocery stores)
Protein - yogurt, eggs, packaged cheese, and occasional fish or chicken off our plate if it isn't too spicy
Seasonings - garlic, baby onions, fresh coriander (i.e., cilantro), and other herbs I haven't yet identified. Salt and various peppers would be available too but I'm mostly steering clear of these!
Some of these stretch the definition of baby-friendly. We haven't yet fed Thomas everything on the list but he has taken quite well to some of the unusual stuff, including plain idli (Indians try to sweeten it for us, either with honey or milk with sugar & coconut), eggplant, and plain yogurt. Allergenic foods like eggs and fish were once considered off-limits for babies but recently it has been concluded that there is no evidence that delaying the foods prevents allergies, so we've given them to him -- especially since good protein sources are harder to come by than the other items. Dahl (lentils) would certainly be readily available but if bought/prepared for us it is very salty and often spicy, and I haven't yet tried making it in our electric kettle. I also still need to explore what other beans & legumes might be possible.
Aside from the few items that can be served plain (bananas, idli, rice, yogurt), here is the routine:
Step 1: Fruit & vegetable prep
Fruit and vegetables get washed in a three-step process. First, a soapy scrub to remove any dirt & debris. Second, a 20-minute soak with 1 tsp veggie wash (bleach works) in 5L water. Third, a rinse with bottled water. I generally wash enough fruit and veggies for a few days and then keep them in our produce bowl.
According to Stauffer et al (J Travel Med 2002), even raw, unpeeled produce can be considered safe for consumption after this process. We actually do boil and/or peel everything we give him for chewing and digestion reasons, so the three-step wash isn't strictly necessary for travelers diarrhea prevention for now, though it will be if we get to the point of any raw veggies while here. But I like to wash things to remove potential pesticides as well, and I just feel better having clean produce to work with.
Step 2: Food prep
The tools are shown, except that I forgot to include the vegetable peeler we brought from the U.S. We peel and then chop veggies or apples into small pieces, then boil them in just enough water to cover in our 0.5-L electric kettle. The kettle has an auto-shut off feature so sometimes we have to keep pushing the button in order to keep it (nearly) boiling. Then, if we want a puree we put it through the hand-crank food mill, or otherwise we just mash it with a fork. We generally do some of both: he seems to digest the pureed foods better, but he enjoys finger foods so we give him some small pieces at times as well. If we are making enough to store we put them in the baby food jars we saved from the beginning of the trip.
Step 3: Storage
One of the best items we found to bring was a small six pack-sized refrigerator. Without kitchen access there really would be no other way to keep from having to prepare food for Thomas at every meal, and there would also be no way to store breastmilk. The fridge generally stays stocked with a few boiled eggs and various jars of apples and vegetables. We haven't yet found a small enough container of yogurt to fit in here but hopefully we can include that as well. We tried to keep a carton of milk for late-night cereal for us, and it fits but it unfortunately doesn't really leave enough room for Thomas' stuff. The cereal here is mostly all very, very sweet anyway.
The only downside of the fridge is that when they come to clean our room they hit a switch outside the door that turns off all the electricity to the room. It is easy enough for us to turn back on, but we have to be aware on days that we aren't at home and make sure that we use that food immediately (it does stay pretty cool with the insulation of the fridge) or toss it soon after.
Step 4: Wash dishes
This happens in the same bucket used for washing the fruit.
Baby-friendly foods that are readily available here:
Fruit - bananas, apples, watermelon, papaya, oranges
Veggies - carrots, potatoes, green beans (though they're sometimes tough), parsnips, eggplant, an green summer-ish squash, 1 orange winter-ish squash (called 'pumpkin' here, though not what we call pumpkin), beets, okra
Starch - white rice, 'idli' (a steamed rice cake, slightly sourdough-ish), a variety of flatbreads (naan, chapatti, paratha), pasta (in the international section of grocery stores)
Protein - yogurt, eggs, packaged cheese, and occasional fish or chicken off our plate if it isn't too spicy
Seasonings - garlic, baby onions, fresh coriander (i.e., cilantro), and other herbs I haven't yet identified. Salt and various peppers would be available too but I'm mostly steering clear of these!
Some of these stretch the definition of baby-friendly. We haven't yet fed Thomas everything on the list but he has taken quite well to some of the unusual stuff, including plain idli (Indians try to sweeten it for us, either with honey or milk with sugar & coconut), eggplant, and plain yogurt. Allergenic foods like eggs and fish were once considered off-limits for babies but recently it has been concluded that there is no evidence that delaying the foods prevents allergies, so we've given them to him -- especially since good protein sources are harder to come by than the other items. Dahl (lentils) would certainly be readily available but if bought/prepared for us it is very salty and often spicy, and I haven't yet tried making it in our electric kettle. I also still need to explore what other beans & legumes might be possible.
Aside from the few items that can be served plain (bananas, idli, rice, yogurt), here is the routine:
Step 1: Fruit & vegetable prep
According to Stauffer et al (J Travel Med 2002), even raw, unpeeled produce can be considered safe for consumption after this process. We actually do boil and/or peel everything we give him for chewing and digestion reasons, so the three-step wash isn't strictly necessary for travelers diarrhea prevention for now, though it will be if we get to the point of any raw veggies while here. But I like to wash things to remove potential pesticides as well, and I just feel better having clean produce to work with.
Step 2: Food prep
The tools are shown, except that I forgot to include the vegetable peeler we brought from the U.S. We peel and then chop veggies or apples into small pieces, then boil them in just enough water to cover in our 0.5-L electric kettle. The kettle has an auto-shut off feature so sometimes we have to keep pushing the button in order to keep it (nearly) boiling. Then, if we want a puree we put it through the hand-crank food mill, or otherwise we just mash it with a fork. We generally do some of both: he seems to digest the pureed foods better, but he enjoys finger foods so we give him some small pieces at times as well. If we are making enough to store we put them in the baby food jars we saved from the beginning of the trip.
Step 3: Storage
One of the best items we found to bring was a small six pack-sized refrigerator. Without kitchen access there really would be no other way to keep from having to prepare food for Thomas at every meal, and there would also be no way to store breastmilk. The fridge generally stays stocked with a few boiled eggs and various jars of apples and vegetables. We haven't yet found a small enough container of yogurt to fit in here but hopefully we can include that as well. We tried to keep a carton of milk for late-night cereal for us, and it fits but it unfortunately doesn't really leave enough room for Thomas' stuff. The cereal here is mostly all very, very sweet anyway.
The only downside of the fridge is that when they come to clean our room they hit a switch outside the door that turns off all the electricity to the room. It is easy enough for us to turn back on, but we have to be aware on days that we aren't at home and make sure that we use that food immediately (it does stay pretty cool with the insulation of the fridge) or toss it soon after.
Step 4: Wash dishes
This happens in the same bucket used for washing the fruit.
Thursday, January 28, 2010
30 years
Mostly today I just feel incredibly grateful to be where I am: for an amazing husband and terrific son, for wonderful family and friends (yes, you!), for the opportunity to do work I enjoy -- in short, for all that God has done in the past decade. Life gets better and better, praise God.
Monday, January 25, 2010
Thank you, John.
Hand-washing cloth diapers is one thing. But hand-washing the batch from Thomas' bout with travelers diarrhea is another thing altogether. Talk about taking one for the team: I owe you, big time.
Sunday, January 24, 2010
Thomas updates
Here is what the little guy is up to these days:
- Crawling, for real now, though not particularly quickly yet -- but getting faster every day.
- Making the saddest, loneliest face and breaking into tears whenever Dad or Mom heads towards a door. If we actually go through the door, he crawls towards it, crying. This was especially sweet & sad when he was first crawling because he was so slow. Poor guy! And poor Dad -- home during the day and has to decide to let Thomas cry any time he wants to use the restroom.
- Getting from all fours to sitting. Which helps with . . .
- Pulling up, on chairs, suitcases, or whatever else we can find to keep his play area interesting.
- Laughing. Of note this week, Dad doing push-ups and seeing himself on top of mom in the mirror (i.e., on my shoulders) are both hysterical.
- Eating pretty much anything we give him. He has been quite an adventurous eater! But more on this later.
- Grinding his three teeth together (two lower, one upper). This gives me the willies.
- Babbling away, especially when other things are quiet. Early morning and during prayers and sermons at church are some favorite times.
- Smiling at strangers. He makes a lot of friends everywhere we go.
And, on health matters: Thomas was completely healthy for the first two weeks. Then, beginning in Chennai, he developed first an upper respiratory infection and then a little bout of travelers' diarrhea. The URI was most likely RSV: cold symptoms which worsened after a few days into bronchiolitis with development of a low-grade fever, and it's the season for it here. And the TD was worrisome, but never got too bad, and lasted for only a few days rather than the average 18-30 days it generally lasts in infants (!) thanks to a timely dose of azithromycin syrup. We did whip up a batch of oral rehydration solution and gave him a few sips, but it thankfully turned out to be basically unnecessary.
- Crawling, for real now, though not particularly quickly yet -- but getting faster every day.
- Making the saddest, loneliest face and breaking into tears whenever Dad or Mom heads towards a door. If we actually go through the door, he crawls towards it, crying. This was especially sweet & sad when he was first crawling because he was so slow. Poor guy! And poor Dad -- home during the day and has to decide to let Thomas cry any time he wants to use the restroom.
- Getting from all fours to sitting. Which helps with . . .
- Pulling up, on chairs, suitcases, or whatever else we can find to keep his play area interesting.
- Laughing. Of note this week, Dad doing push-ups and seeing himself on top of mom in the mirror (i.e., on my shoulders) are both hysterical.
- Eating pretty much anything we give him. He has been quite an adventurous eater! But more on this later.
- Grinding his three teeth together (two lower, one upper). This gives me the willies.
- Babbling away, especially when other things are quiet. Early morning and during prayers and sermons at church are some favorite times.
- Smiling at strangers. He makes a lot of friends everywhere we go.
And, on health matters: Thomas was completely healthy for the first two weeks. Then, beginning in Chennai, he developed first an upper respiratory infection and then a little bout of travelers' diarrhea. The URI was most likely RSV: cold symptoms which worsened after a few days into bronchiolitis with development of a low-grade fever, and it's the season for it here. And the TD was worrisome, but never got too bad, and lasted for only a few days rather than the average 18-30 days it generally lasts in infants (!) thanks to a timely dose of azithromycin syrup. We did whip up a batch of oral rehydration solution and gave him a few sips, but it thankfully turned out to be basically unnecessary.
What we're up to
Dec. 27 - Jan. 11: All Angels trip
We began our time here with a two-week trip led by the rector of our church, Milind Sojwal, who is from India and began his ministry in Maharashtra in the Church of North India. Our group of 14 flew into Mumbai and took an overnight train to Nagpur, city of Milind's former diocese. We worshiped with Milind's old parishes there and in nearby Chandrapur, and visited various diocesan projects, including a mission hospital, rural and women's empowerment programs in nearby the tribal villages, a boarding school for village kids, and perinatal outreach in the slums of Nagpur.
Another overnight train brought us to Pune, where we spent our time learning about the amazing work of Deep Griha Society, the organization founded and run by Milind's aunt. After earning her M.D., Dr. Neela Onawale began her medical practice as an outreach to poor patients out of her home. As deeper issues underlying her patients' medical problems became apparent -- malnutrition, lack of educational opportunities, the low status of women -- she gradually developed programs to meet the needs that she saw. Now Deep Griha works in three slums in Pune and has two rural projects; offerings include feeding programs, education, day care, HIV/AIDS outreach, and traditional medical clinical services. It is an impressive place, one which I would highly recommend for volunteering or charitable giving.
Jan. 11 - 15: Chennai
After the All Angels trip, John, Thomas and I flew from Mumbai to Chennai and stayed at the home of former All Angels parishoners Matt Scott and Sandra Seaborn and their children Sophie (3) and Stephen (7), recuperating from our Maharashtra leg's ambitious itinerary and gathering necessary supplies for the rest of our stay. January 14 was Pongal, a Hindu harvest festival and the biggest holiday of the year in Tamil Nadu. We celebrated by spending the day at a swimming pool with Sandra and her kids. Thomas loved his first pool experience!
Jan 15 - ?: Vellore
We are now in Vellore, in the southeast of the country, where Christian Medical College is located. I am working with endocrinologist Dr. Nihal Thomas on several projects, which I will describe in more detail later. Our plane tickets home are for May 1, but we only have housing reserved at CMC until March 1; we may extend our time in Vellore, or may head back up north when the temperatures go up in March-April, or may decide to go home earlier. John, meanwhile, is watching Thomas during the days and hoping to get some work done on his dissertation during naps, evenings, and weekends.
We began our time here with a two-week trip led by the rector of our church, Milind Sojwal, who is from India and began his ministry in Maharashtra in the Church of North India. Our group of 14 flew into Mumbai and took an overnight train to Nagpur, city of Milind's former diocese. We worshiped with Milind's old parishes there and in nearby Chandrapur, and visited various diocesan projects, including a mission hospital, rural and women's empowerment programs in nearby the tribal villages, a boarding school for village kids, and perinatal outreach in the slums of Nagpur.
Another overnight train brought us to Pune, where we spent our time learning about the amazing work of Deep Griha Society, the organization founded and run by Milind's aunt. After earning her M.D., Dr. Neela Onawale began her medical practice as an outreach to poor patients out of her home. As deeper issues underlying her patients' medical problems became apparent -- malnutrition, lack of educational opportunities, the low status of women -- she gradually developed programs to meet the needs that she saw. Now Deep Griha works in three slums in Pune and has two rural projects; offerings include feeding programs, education, day care, HIV/AIDS outreach, and traditional medical clinical services. It is an impressive place, one which I would highly recommend for volunteering or charitable giving.
Jan. 11 - 15: Chennai
After the All Angels trip, John, Thomas and I flew from Mumbai to Chennai and stayed at the home of former All Angels parishoners Matt Scott and Sandra Seaborn and their children Sophie (3) and Stephen (7), recuperating from our Maharashtra leg's ambitious itinerary and gathering necessary supplies for the rest of our stay. January 14 was Pongal, a Hindu harvest festival and the biggest holiday of the year in Tamil Nadu. We celebrated by spending the day at a swimming pool with Sandra and her kids. Thomas loved his first pool experience!
Jan 15 - ?: Vellore
We are now in Vellore, in the southeast of the country, where Christian Medical College is located. I am working with endocrinologist Dr. Nihal Thomas on several projects, which I will describe in more detail later. Our plane tickets home are for May 1, but we only have housing reserved at CMC until March 1; we may extend our time in Vellore, or may head back up north when the temperatures go up in March-April, or may decide to go home earlier. John, meanwhile, is watching Thomas during the days and hoping to get some work done on his dissertation during naps, evenings, and weekends.
Tuesday, January 19, 2010
Intro
Greetings, dear friends & family! Many of you have asked about being in contact during our time in India, and so I've decided, a bit belatedly, to start a blog. I have some reservations about blogging, in particular the time it can take away from other things, so we will see how things go and I make no promises as to frequency. But it seems that I will have some downtime during the days so I will try to post items of interest when I have the chance.
We are now in Vellore, settling in though still figuring out our routine here. We are currently staying at the CHTC (Community Health Training Center) guest house, one of the more modest accommodations of the Christian Medical College. We have two twin beds in a sizable room with a private bathroom, which has occasional hot water from the shower and continuous hot water (after flipping a switch) from a faucet. Tap water is treated and probably usually fine but, to be safe, not recommended for drinking, so we bought a stash of 5-L bottles of water, which we use for drinking, making baby food, sterilizing bottles and baby spoons, and doing a final rinse after disinfecting produce. Meals are in an attached "Mess," a Dickens-esque dining hall which offers quite good Indian food on steel plates under dim lighting. There are enough mosquitoes there in the evening that we have been avoiding it for dinner and either bringing food into our room or (on one unfortunate night) making do with our stash of curry-flavored Ramen, fruit, and peanut butter.
Vellore itself is actually a rather lovely town. We have been told that it doesn't have much to recommend it but from our perspective it is friendly, colorful, and easily navigable. For sightseeing there is a grand fort which we have driven through but not explored, and a "golden temple" which looks stunning in photos but which we also have not yet visited. Christian Medical College is Vellore's main attraction, and after five days in & around the endocrinology department there it seems to live up to its reputation as an amazing place. CMC really deserves its own post, so I'll refrain from saying much more for now.
And, what most of you have been waiting to hear about: Thomas!! The little guy has been an amazing traveler: full of smiles, content to be passed around, patient with the constant cheek-pinching he receives. At the moment he is sitting up, playing with the tape we used to tape bathmats to the marble floor to provide some cushion, and growling at us, his newest vocalization. I hope to post more info (and photos, perhaps video) as we go. He has had a bit of sickness in the past week (upper respiratory infection, then a come-and-go diarrhea in the past few days) but appears completely healthy and happy today, aside from a lingering cough.
I hope to fill in many more details along the way, but there's a start, at least.
We are now in Vellore, settling in though still figuring out our routine here. We are currently staying at the CHTC (Community Health Training Center) guest house, one of the more modest accommodations of the Christian Medical College. We have two twin beds in a sizable room with a private bathroom, which has occasional hot water from the shower and continuous hot water (after flipping a switch) from a faucet. Tap water is treated and probably usually fine but, to be safe, not recommended for drinking, so we bought a stash of 5-L bottles of water, which we use for drinking, making baby food, sterilizing bottles and baby spoons, and doing a final rinse after disinfecting produce. Meals are in an attached "Mess," a Dickens-esque dining hall which offers quite good Indian food on steel plates under dim lighting. There are enough mosquitoes there in the evening that we have been avoiding it for dinner and either bringing food into our room or (on one unfortunate night) making do with our stash of curry-flavored Ramen, fruit, and peanut butter.
Vellore itself is actually a rather lovely town. We have been told that it doesn't have much to recommend it but from our perspective it is friendly, colorful, and easily navigable. For sightseeing there is a grand fort which we have driven through but not explored, and a "golden temple" which looks stunning in photos but which we also have not yet visited. Christian Medical College is Vellore's main attraction, and after five days in & around the endocrinology department there it seems to live up to its reputation as an amazing place. CMC really deserves its own post, so I'll refrain from saying much more for now.
And, what most of you have been waiting to hear about: Thomas!! The little guy has been an amazing traveler: full of smiles, content to be passed around, patient with the constant cheek-pinching he receives. At the moment he is sitting up, playing with the tape we used to tape bathmats to the marble floor to provide some cushion, and growling at us, his newest vocalization. I hope to post more info (and photos, perhaps video) as we go. He has had a bit of sickness in the past week (upper respiratory infection, then a come-and-go diarrhea in the past few days) but appears completely healthy and happy today, aside from a lingering cough.
I hope to fill in many more details along the way, but there's a start, at least.
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