I’m into an almost-three week cycle of escalating upper back pain, which reached an all-new level of agony about five days ago. I woke up around 3 AM with some of the nastiest pain I’d felt in my life, centered around two points. These roughly correlated, from what I see, with C7-T1 and down through T7. (I have a known bulging disk at C4-5, plus degeneration at C5-6-7 and T6-7-8). What set things off, I don’t know, but I’m going to chalk it up to being sedentary for a couple of weeks, prolonged driving, and sleeping in a different bed over the holidays.

Everyone wants to know…”What are you doing to help this? Did you know stretching/yoga/incense/tai chi/medication/walking/heat/ice/meditation/yak milk from Uruguay can help?”

Yes. People with back problems know chronic pain and what helps their particular pain. My pain is nociceptive, not neuropathic, a result of spondylosis (arthritic changes in the spine) and degenerative disk disease. It’s due to structural changes in my spine and muscles that result in inflammation. In 2008, I got significant relief from epidural steroid injections until I could no longer put off an anterior cervical diskectomy and fusion in 2009 for two herniated disks. It did wonders for me (C5-6-7 were fused with cadaver bone and covered with a plate), and I had no symptoms of problems again until early in 2014. A new round of doctor visits (initial with a new PCP, first ortho, second opinion ortho, and follow-up with PCP—so, about four  months of appointments) and fighting with insurance to get an MRI (after spondylitic changes showed up on x-ray). It showed the new C4-5 disk bulge, acquired cervical spinal stenosis, and degenerative disk disease in the upper thoracic spine. Luckily, my lumbar spine seems fine. I say that because most people do have lumbar troubles, and they are hard to fix.

What does the pain feel like? First of all, let me list some terms. Acute pain is the type of pain that is short-lived. For example, the pain you have after surgery or while passing a kidney stone is acute. It may last a few weeks to a few months and fade away. If it lingers for three-six months or longer, though, it could become chronic pain. I am in no way diminishing acute pain. It can be horrible; most people have either had a kidney stone or know someone who has, and many describe it as the worst pain of their lives. Labor pains can be similar. This is a good review of pain: http://www.merckmanuals.com/home/brain_spinal_cord_and_nerve_disorders/pain/types_of_pain.html and http://www.spine-health.com/conditions/chronic-pain/types-back-pain-acute-pain-chronic-pain-and-neuropathic-pain

Chronic pain is, frankly, misunderstood by many. Thankfully, fewer people today than 10 years ago consider it purely in one’s mind. It may come and go without warning. It may “flare up” and be a problem for several days or weeks, then wane, but it never leaves for good. My chronic pain on good days is around a 1-2 on a 10 point scale (the universal pain scale, which is most commonly used, calls this “Hurts a little bit”). It’s never completely gone, but I would say 60 days out of 100, it’s bearable, and I can walk, swim, write, knit, and cook without too many problems. I even jogged a bit this fall.

Of the remaining 40 days, about 20 are at a 4-5, or “Hurts little more/hurts a lot more”. Those are the days I take over-the-counter mid-day pain meds, instead of just AM and PM, and have a hard time getting things accomplished at home and work, but I do get them done. As I write, this is a 4-5 day, by the way. In fact, it’s taken me two days to complete my post, since I’ve been trying to stretch and be good to my back every half hour, attend two meetings, and deal with increasing pain.

Twenty horrible days out of a 100, or about 5 days every month, I have what some call “breakthrough” pain. This is pain that’s 6-7 or maybe an 8. I’ll tell you that for me personally, labor pain without medication was an 8; a kidney stone was a 9, and the worst pain ever, a 10, as in “I’m truly going to die” was about 12 hours post-op from a total abdominal hysterectomy. I was receiving acetaminophen and ibuprofen for pain, which was brutally insufficient. I told my family I loved them, I’d see them in the afterlife, and I was dying because no human being could survive that kind of pain, ever…except I couldn’t choke out the words. It was more an “Ughrwaghhh ahhohhhh eehs” than anything coherent. A good friend who is a nurse got the point across, and finally, I received something more appropriate for post-op pain following abdominal surgery.

On these breakthrough pain days, I sometimes have to miss work. I can’t drive. I take whatever over-the-counter and prescription medication I can, strictly according to the doctor’s instructions, but more often than not, I just have to lay flat on my back and wait for it to pass. Heat packs and hot showers help, but they are usually not sufficient to stop the pain once it starts. I worry about what people might think of me, just lying there, when there is “stuff to do be done” at the house, at my office, and for the holidays.

What does the pain feel like? Imagine someone takes a red-hot stiletto or sharp, thin knife, and then, the person slowly pushes that knife through your upper back, just above the bra strap or slightly higher. The pain explodes in a starburst pattern outward from the initial knife entry point, up to your skull, wrapping around your ribcage, and into your shoulders. The pain doesn’t stop; the knife keeps constantly stabbing you. The pain is intense enough to take your breath away. The muscles across your upper back yank themselves around in an effort to realign and help the pain, but of course, this only makes things worse. Your whole back dissolves into muscle spasms. The pain then starts extending into the lower back, which hadn’t been hurting before. No matter what you do, the pain…won’t…stop.

Now…during a flare-up, imagine this pain going on for days. You can’t sleep (and this perpetuates the vicious cycle because your body needs deep sleep to recover). You can’t use your arms because it hurts your back (for cooking, daily chores, driving, pain-distracting crafts, and so on). You can hardly communicate. It’s difficult to use the computer. You desperately want to do things, but you can’t—the pain is so intense, you can’t concentrate. You get snappish and irritable when your family can’t read your mind (yes, I know that is a totally unrealistic expectation, so take this with some gentle sarcasm). People’s feelings get hurt, and you try to explain your pain to them and apologize for being miserable and angry and depressed about feeling useless and why your house is a wreck, but you just dissolve into tears because not only can you not think straight, you can barely talk. This round, I’ve had so much pain, I’ve felt nauseated, which hasn’t happened in a while. (No, it’s not my meds causing this—it’s the pain. The nausea was there well before I even saw the doctor, and it has a very different “feel” than the nausea you have from a stomach virus).

I know pain is bad for everyone. I do not want to say men’s pain is easier than women’s. It’s not. It’s pain, and it’s horrible. However, for good or ill, in many homes (NOT all—I am simply making a generalization based on the several dozen families I know personally), the women hold the glue together, and they make the choice to try to keep on doing through pain crises. They sign the school notes, plan the day-to-day activities, and organize the chaos. They may have careers of their own, and yet they still pull a “second shift,” as Arlie Hochschild describes it, while also dealing with pain (http://sociology.berkeley.edu/professor-emeritus/arlie-r-hochschild).

If that works for your family, it’s great; I am not criticizing. All I am saying is that among my circle of friends, most women I know put their health concerns last (whether they are single or in a relationship doesn’t seem to affect this). They continue to work while sick, they shuttle their kids and their kids’ friends while hacking up a lung, and often, they have to do the stuff on their lists that needs doing, or else it won’t get done. Mind you, I’m not talking about frilly holiday decorations; I’m talking about paying bills so the lights don’t go off. They take care of their animals, their job obligations, and anything else that may come along, putting themselves and their well-being low in the priority list. I don’t know if this is an American phenomenon or not, but it seems omnipresent.

I do not want to dismiss what partners and friends do for those in a pain crisis, either. My spouse was so desperate to do something, he drove 90 miles to get my ortho records for my PCP when a fax would have sufficed. He did this, I think, because he a) wanted to help so badly and b) couldn’t bear to see me writhing in pain while we waited to go to my PCP (and he drove me another 70 miles there and back; did I mention rural health care options are challenging?) So, kudos to wonderful, helpful partners and friends—but ladies, really, it’s okay to give yourself a break. Feel guilty if you must (I did), but do take a day or two to recuperate if you can (and by that, I mean if you have sick leave. I spit on the corporations who make employees work while sick). I took two days of sick leave this week, but I kept my phone on, and I checked email from home. Thankfully, everyone is so focused on finals, I was able to rest most of the time. But I was angry I couldn’t work on holiday gifts or email my students or reorganize the bathroom, like I wanted.

Of course, the best thing to do is stop the pain before it escalates, if possible. Here is a list of things I do routinely/daily to manage pain. I want to make the point that I really have tried all the things I can:

  1. Stretching and not sitting too long. I try to get up and do basic stretches every 30 minutes. It sounds like a nutcracker is in the room.
  2. Heat packs and hot showers, a couple times a day. I always have an extra heat pack on hand, ready to go.
  3. Monthly massage. Massage therapy isn’t all pretty spas and woowoo music. My massages hurt, but then they heal, and I made sure my massage therapist and my orthopedist have seen each other’s notes.
  4. Take my medications regularly. I take 2000 mg of Tylenol, divided into two doses (AM and PM), 50 mg of Tramadol (one in the AM, and one in the PM), and 1000 mg of Naproxen divided into two doses (AM and PM). I also take calcium, a multivitamin with extra vitamin E/D/calcium, flax oil, fish oil, red rice yeast, and niacin. I keep both my PCP and my ortho up to date on all the things I take, including supplements.
  5. For this particular flare-up, I’ve also been given 5% lidocaine patches (great, but cost a lot), Robaxin (it’s okay—I’d call it “better than nothing”), a steroid dose pack (6 days of a tapering dose), and 50 mg amitriptyline (PM only, for sleep). These are just temporary measures. I am fortunate in the only side effect I have from prednisone is some insomnia, so I take it early in the day. I got Toradol and Decadron at my PCP’s office (wonderful stuff, but Toradol has the potential for kidney and gastrointestinal side effects, so its use is short-term only), which did help break the cycle for a few hours.
  6. Deep breathing and meditation a few times a week. I have a yoga program for my Wii, but many of the positions are, in fact, painful. I do some basics when I stretch.
  7. I just got a gel mat for the kitchen, and it has been helpful for times when I stand and cook.
  8. Voltaren gel: While only available with a prescription in the US, you can buy this on the shelf in Canada for about $8 a tube. I’ve found it’s good at bedtime, especially for aching joints.

Here are things I’ve tried that either did not help or did more harm than good (and remember, I am just a sample size of one):

  1. Ice: I know it helps some people, and that’s great. Heat/warmth is the better option for me.
  2. Neurontin (Gabapentin) and its cousin, Lyrica (Pregabalin): These are anti-seizure medications, used for treating nerve pain, post-shingles pain, and diabetic neuropathy. For some people, they work miracles, and I am glad we have them. I tried Lyrica in 2008 for a month; I was dizzy and gained some weight, but it did nothing for pain. I took Neurontin (300 mg, twice a day) for six days this past November, and I was a crazy person. I had hallucinations, I thought worms were crawling out my nose and ears, and I could hardly stand up. I cried, I laughed, and by day 6, we were all scared to death of how I was behaving. Our pharmacist helped me cut back the dose and stop it over a 48 hour period. Some researchers at the University of British Columbia published this article several years ago (http://www.ti.ubc.ca/letter75). Use of Neurontin and Lyrica for nociceptive pain (like my spondylosis) is still not well understood, I think. While I noticed slightly less pain on the Neurontin (possibly 20% less), I noticed a marked increase in pain when I stopped taking it. That was, in fact, about the time the current pain cycle started, but I can’t prove causation—there are too many variables, like holiday travel.
  3. Curcumin: I was so hoping this would help. I tried it for two months, and I noticed no changes at all. Again, it does seem to work for some people, and I have had good luck with supplements like fish oil and slo-niacin (e.g., I am open to trying supplements).
  4. Glucosamine chondroitin: Ditto, same as the curcumin. I tried it for almost six months and noticed no difference.
  5. Chiropractic: I used a chiropractor for hip pain after pregnancy, and I do believe it helped realign things. However, two years-worth of treatments (and a lot of out of pocket money) did not improve my upper back pain with lasting effect. My orthopedist actually said it was counter-indicated for cervical problems like mine, though he routinely suggests it to his patients for whom it might be appropriate.

I have two treatments that I use (or have used) which sometimes help and sometimes hurt or have no effect. These are:

  1. A TENS Unit: A TENS (transcutaneous electrical nerve stimulation) unit sends mild currents through electrodes that supposedly erode the transmission of pain from the nerves. It sort of redirects and rechannels the pain, or otherwise “tricks” the nerves into “distraction.” On certain days, it has been helpful. For this current flare-up, it made the pain worse, so I stopped using it after one 10-minute session.
  2. Epidural steroid injections: I’ve had three, total, over a 1.5 year period. It’s been almost five years since my last one. The first two helped tremendously. The last one didn’t really do anything.

Are any readers wondering why drugs like Vicodin or something similar are not listed here? Major law changes in 2014 restricted how opioid drugs are prescribed. Moreover, the DEA has dealt harshly with doctors who prescribe these medications and pharmacies that fill them. Rightly or wrongly, they created a lot of fear among doctors, pharmacists, and patients, even those who were judicious and used them for appropriate reasons.

I guess I don’t need to say that I am filled with loathing for people who abuse these drugs (both those who steal and sell them, as well as those who improperly prescribe them), and the media that makes them more frightening than they need to be (i.e. the “don’t ever take these because you’ll absolutely become an addict!” sort of panic). I do not want my pharmacist or physician being targeted in any way, but I can’t help but wonder if I’d gotten something in this class of drugs for a short period (twice a day for a couple of days), would I be feeling better now? As an informed consumer, I simply don’t know what to think. I found opioid pain relievers worked very well after my back surgery, and I only took them for about two weeks as my doctor instructed (i.e. one tablet every 4-6 hours for the first five days; then, cut that dose by half; then, lengthen the time between doses; and finally, at the end of the second week, take half a dose at bedtime if needed). I had no addiction or withdrawal symptoms, following those instrctons. TIME has this to say: http://time.com/3445728/painkillers-opioids-dangerous/ while Johns Hopkins says this: http://www.hopkinsarthritis.org/patient-corner/disease-management/benefits-and-risks-of-opioids-for-chronic-pain-management/, which is more pros/cons than scare tactics.

This leads me to things I’m either trying or want to try:

  1. More green tea. I drink a cup full daily at the present time and enjoy it.
  2. I’m looking into acupuncture, but I want to make sure I have a qualified practitioner—and we live in an isolated, rural area where I only found a couple of names within a 60-mile drive. I don’t want to end up in Smith’s Acupuncture, Fresh Vegetable, and Coffee Shop, if you see what I mean.
  3. Gin-soaked golden raisins. I know, isn’t that crazy?! But people swear by it. If you are in enough pain, you’ll try nearly anything. The People’s Pharmacy has a good article about this here: http://www.peoplespharmacy.com/2013/10/17/gin-soaked-raisins-for-fibromyalgiareally/

I normally write about 1000 words an hour, and I’ve been working on this off and on for about two days. It’s been hard to focus. As I close the first draft, I’m glad the day is almost done, and I’m going to see my massage therapist, hoping she can help (well, not as much as I’d hoped, turns out).

Does the internet hive mind have any further, reasonable suggestions, backed by studies and data and/or reliable sources? Andromache wants to know. But now, she’s going to do some more stretching.


Asperger’s Syndrome: It’s Not “Cool”—It Just “Is”.

Asperger’s Syndrome: It’s Not “Cool”—It Just “Is”

Watch network TV for 30 minutes in fall 2014, and chances are, you’ll see a show with an “Aspie” character. Some writers actually have their characters formally diagnosed with Asperger’s Syndrome (AS), but more often than not, they’re content with just having the person show “tendencies” of the disorder. People put all kinds of spins on AS—from using it to “celebrate not being neurotypical,” like that’s some sort of shiny toy, to excusing rude behaviors. Unacceptable! Among the best articles detailing this entertainment phenomenon is one that appeared here in the New York Times online: http://nymag.com/news/features/autism-spectrum-2012-11/

First of all, you don’t know if you have Asperger’s Syndrome unless a trained medical professional, such as a psychiatrist, has made a formal diagnosis. Anybody can be an asshole or have weird habits. Just because you are an introvert doesn’t mean you have AS. Second, AS is now lumped in with a range of conditions across Autism Spectrum Disorder [299.00(F84)] in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Some people may have a formal diagnosis in the Autism Spectrum Disorder (ASD) and little outward sign of it. For others, ASD affects every moment of their life to the point they will need daily assistance with a range of activities, including eating and speaking.

We have a teenager who has a formal diagnosis of Asperger’s. Yes, it came from a bona fide medical doctor who did a residency in pediatrics and psychiatry. There’s a comorbidity (fancy talk for an accompanying condition) of attention deficit hyper-active disorder as well. Our teen takes medication to help focus on schoolwork and other activities. Having had the diagnosis and quality treatment for seven years, which includes cognitive behavior tools in addition to medication, has made a huge difference in our family life. The teen, given that many of them are secretive, surly creatures, is fun most of the time (not all the time). He loves travel and can navigate his way around a big city as well as a rural back road. Yes, he’s quite smart and is working ahead of his peers in a couple of subjects. He’s also tender-hearted when it comes to animals and his family, even if he doesn’t always know how to show it.

Case in point: I dutifully got a flu shot and had known, typical side effects—mild fever, bone aches, and a raging headache. He wasn’t sure what to do to help, so when I asked him to find out about how long the side effects might last, he visited the CDC website and made the following pronouncement: “You’re having a robust immune reaction. Your T-cells and B-cells and natural killer cells are helping produce antibodies, and that’s why you have a fever. You do not have Guillain-Barre syndrome, in my opinion.” I think he said something else about a sort of mystical cell that was related to the Enigma machine, but it got lost in my delirium (Natural killer cells? Isn’t that a Woody Harrelson movie?) Fifteen minutes later, he presented me with a bowl of ramen noodles (something I secretly love but avoid due to the calories and sodium) and gave me a hug. Now, that’s some serious affection from this kid.

Yet for every sweet moment like this, there’s a pile of awkwardness. Forget team sports—although he’s quite competitive at board games. Out in the community, sometimes people talk about him right where I can hear them (so can he), especially people who are older and who have “traditional” views on parenting. “I can’t talk to [that kid]. He’s odd.” Or they keep prodding him to interact with them by asking rapid-fire questions, shaking their heads or interrupting when he doesn’t respond quickly enough. He’s honestly trying, and if he gets something out, it’s usually polite. But to fill the awkward silence, the people often answer their own questions. The teenager is utterly perplexed. (To be fair, I find small talk tedious myself).

Dating issues haven’t gone so well, either. After writing an email to ask her mom’s consent, he finally got the gumption to call a girl he met at camp and liked. He suggested they use their iPads and Face Time—except that she forgot to ask her dad’s permission to use his iPad. Dad comes onto the scene and yells at his daughter, who hangs up in embarrassment. My teen is left confused and hasn’t mentioned trying to call her back. We reassure him he’d done nothing wrong, and that perhaps he could email her, but he’s now gun-shy. Thanks, Super-Strict Dad—I know you are nervous about your daughter talking to a boy, but let me assure you, my son has no bad intentions with a damn phone call from 40 miles away.

One late Friday night, after watching the show Scorpion, which tries to make being super smart yet socially awkward seem like a hoot with perks (it’s totally not), he asked me, “Why am I different?” I took it literally and responded with the usual platitudes of we don’t know, we don’t have an explanation for what causes ASD, but it’s probably some unknown combination of genetic pre-disposition and environmental factors, blah blah blah.

“No,” he said. “Why do I see and feel the world differently? Why do I think in multiple dimensions at the same time? Why can’t I turn off the rational part of my brain and just accept the abstract?” Whoa. That was heavy for 11:30 PM, after I’d had a full week at the office. Why was his dad in bed already when this metaphysical discussion arose?

“I still don’t know the answer,” I replied slowly, “because although I’m a visual thinker like you, it’s not hard for me think abstractly. Part of it is age, education, and experience.” I paused. “But the bottom line is that I think you can use that type of thinking to your advantage, if you work hard at it, and do extraordinary things. It’s not going to be easy because the people who run the country, the corporations, and the education system don’t think like you. They’re going to put up barriers, like the stupid, badly written standardized tests you have to take at school. But hang in there. College is coming, and there, your ways of thinking will eventually be a boon.” That seemed satisfactory to him, particularly since he’s decided to emulate the Flash/Barry Allen as a role model. (We told him that Sheldon Cooper, Magneto, and Gollum were absolutely off the table).

Take this blog post for what it is: one family’s experience with having a teen on the autism spectrum. We strongly believe that Asperger’s Syndrome does not need to be the new “in” thing. So, let’s not make it the characteristic by which we largely identify people’s “hipness factor.” Would you tell someone, “Oh, you have epilepsy! That’s really awesome! I’ve always wanted a friend with epilepsy.” Or, “You’re bisexual—that’s so cool! I wonder if I’m bisexual, too? It seems like the ‘in’ thing to be right now.” Crap like that would make a lot of people beat you up, deservedly.

The bottom line: Asperger’s Syndrome isn’t “cool” or “trendy”…but neither is it “uncool” or somehow “wrong” to have it. It’s just a state of being. Don’t single out people with AS, either positively or negatively. Don’t try to tell parents of these kids how to “fix” them. Just let it be—and let them be. It’s all good…67.831% of the time.

My class reunion is coming up this weekend. I went to the last one–it was okay. Not much had changed about how people acted or treated one another. I stay in touch with the people I like and not the ones I don’t, so there was no real need to go to this next one. Besides, my buddies weren’t going, and I sure could use a free weekend to write. Or do laundry.

The other day, my spousal partner heard me talking to our teenager about how much I had loved chemistry in high school. (The teenager is a complete math/science nerd and extremely proud of it, though getting him to write is worse than pulling molars). We had a good teacher–she was funny and she knew how to teach, a winning combo. I especially enjoyed the study of atoms–how they were made and stuff of that ilk (I’m sure there’s a name for that sort of thing, but I don’t recall it). My spouse asked me why I’d never taken more science in college, aside from the required 2-course sequence (biology) if I loved chemistry so much. “Because of my high school trig teacher,” I promptly answered. “She taught me a bad lesson–that I couldn’t do math.” Now you see how this links to the high school reunion. I’ve been seeing pictures on various social media making quips about that math class and its “quirky” teacher. They’re not a bit funny to me. Having that teacher was, in fact, more than a bit traumatic.

See, here’s the deal. I was good at math and science. Maybe I wasn’t destined for a career in chemistry, nor was I any kind of math genius, but with the right person guiding me, I not only was decent at math and science, I was quite good at geometry. And I did fine in biology, though I liked chemistry much better. The spouse said, “I see a lot of stories about ‘the teacher that most influenced me’ in a positive light. Why not write about a negative experience?” So here it is.

I had a particularly superb 8th grade math teacher (I took algebra a year early) as well as an inspiring 8th grade science teacher (earth science–weather and oceanography–it was wonderful). I remember her setting a glass of cold water down in front of our lab group. Condensation formed on the exterior of the container. “Tell me what is happening and why,” she said. “Explain to me what’s going on when the water forms on the outside of the glass.” We came up with some wild theories, but eventually figured it out by working through the problem in front of us. Damn, talk about a teachable moment! And it was low cost! I ran into her about 15 years later at a conference and was delighted to see she’d gone on to teach college science education to future teachers, after a long career in the middle school classroom. My algebra teacher began on the first day of class with the books open on the desks. She could be fun, but she stressed to us from Day 1 how serious we had to be about our studies. I got pneumonia in 8th grade and had to stay home five days of school. When the doctor looked at my chest x-rays and delivered the bad news, I panicked. “I can’t miss algebra!” I cried. “Please, can I just go to school for that one period?” He looked at my mom and said, “No patient of mine has ever complained about getting to miss school.” I think he thought I was nuts–or very odd. I got As for all but one 6-week grading period that year.

So, in high school, as a freshman, I was in Algebra II and Biology, both of which were sophomore classes. I wasn’t the #1 student, but I was still a strong performer. I enjoyed the classes a lot. Even dissection, which I found pretty gross, was bearable. I knew absolutely and utterly that I would never have a career in any kind of medical setting–ever. I took a second year of biology–challenging but interesting–and followed up that second algebra with geometry, which I adored. I was considering a career in law, with a major in classics or English, so doing proofs was kind of a breeze.

As a junior, I went into the next math course–college algebra (aka algebra III) and trig, a two-semester combined course. And things fell apart. No matter how much homework I did or how many hours I spent studying, I rarely got scores above a C. And I really tried. I got help from friends. I spent hours trying to understand the stuff. But when the teacher’s idea of “teaching” was showing one problem, saying “you don’t have to understand anything but the formula,” and getting students to do problems on the board (sometimes incorrectly) without any follow-up explanation…well, that was an issue. Remember that this was long before things like Khan Academy or YouTube; even the Internet was quite young. My parents, who had no idea what to do, called the district office to see if any kind of tutoring was available–nope. I squeaked by with a C in college algebra, but when it got to trig, I couldn’t even get a D. So, I just completely gave up. I spent that last 15 or so weeks of school writing scripts for a TV show my bestie and I had created. The teacher never noticed since I was quiet and didn’t move the chair out of its tile squares; she had a real fixation about that. My writing skills developed nicely. Meanwhile, I was doing fine in all my other subjects, and I’d discovered a passion for history, thanks to a teacher every bit as gifted as the math teacher was terrible. It was probably the only thing that kept me from falling into a serious depression. For the first time in my life, I had genuinely failed at something. My demanding mother, who never interfered in school because teachers were always right, saw how hard I’d worked and didn’t skin me alive for bringing home a report card with the letters A, A, B+, A, A, F.  (The B+ was in chemistry, back in the days when an A had to be a 94 or higher). Something look weird about those letters to you? Yeah, me, too. If I had a student with those grades, I’d talk to them and find out what was going on. Only one teacher of mine did. All students had the same homeroom teacher, all four years of high school. Near the last day of school that year, she took me aside. Mind you, she hadn’t ever had me for a class, and other than seeing her for 15 minutes a day, she barely knew me…or so I thought.

“I just wanted to tell you….” I remember her awkward pause. “I wanted to tell you that the same thing that happened to you in math this year happened to my daughter, too.” I recalled that her daughter had graduated a year earlier, a popular honor student. “And…please don’t worry. She got into the first university of her choice. She’s doing great there, and she’s not having any trouble with math on the college level.” That was all she said, and probably all she felt she could say without speaking ill of a colleague. I wish I’d thanked her more for saying what she did. It meant a lot. Flunking that math class seemed to cost me a lot in the short term–not graduating in the top 10 of my class, not taking any more math or science (despite wanting to be in advanced chemistry), possibly missing out on some scholarship money, and definitely destroying my confidence in my math/science abilities. I never considered any kind of career in science after that point…because I’d been given the clear message that I would fail.

I exempted all but one math class for my undergraduate degree; I took logic for that one required math and got a B, which was fine since it was actually sort of boring. I took one statistics course in grad school and got an A. I became a successful social sciences faculty member with a Ph.D., a tenured associate professor (for the moment). I thought I’d never have to worry about math again aside from averaging grades. But then, we had this aberrant child who was some kind of math/science whiz. When he was in 5th grade, I saw that unless I refreshed my math skills, I wouldn’t be able to help him before too much time passed.

We are lucky enough to be able to take one or two classes as employees of our university system, free, each semester. I’d been out of high school a long time; heck, I’d been out of college a long time, other than as the instructor. I knew I was both wiser and able to tell whether or not a teacher knew how to teach. I took a chance and enrolled in college algebra. Parts of it were challenging (logarithms, shudder), but I got an A. In fact, to everyone’s utter shock, I found out I sort of liked math, for many of the same reasons I took and liked foreign languages. I got a thrill out of the deciphering and problem solving. I enjoyed it enough to enroll next in pre-calculus, and there was another shock: I loved trig. LOVED it. The whole earth opened up, and angels sang as my mind started seeing unit circles in everything from the window panes to the ceiling of the Sistine Chapel. It blew me away. But let me quickly give credit to the professor, who used videos, practice tests, homework with a program that walked students step-by-step through how to work problems, and other techniques aside from throwing a random question on the board and expecting students to do math through magical osmosis. He answered any questions, promptly and thoroughly, no matter how “stupid” they may have seemed. I recommend him all the time, and most students have agreed with my assessment of his teaching skills. The ones that don’t are usually those who don’t bother to take advantage of all the practice and extra credit he offers (probably the same ones who botch my classes, too).

Thus–an example of how a teacher influenced me. No, let’s be honest–that’s a story of how a teacher royally screwed me over. She was a crappy, awful teacher who had no idea how to convey her subject. She may not have intentionally set out to mess with my mind and confidence, but she did, and she never displayed any empathy or compassion to her students. Let’s just say that I was fortunate enough to a) have other teachers that were a positive influence on me (the ones I’ve already named, plus my Latin teacher), and b) possess the metacognition to know how to master a subject I once thought I was absolutely incapable of understanding.

What’s next for me? Well, if I get the time, there’s calculus. And heck, maybe I’ll even give chemistry a try. I’m too old to change careers, but I’m living proof that you are never too old to learn…and master…something new.

Now, back to that novel I’m writing….

I’ve actually got two novels in my hopper–and for some reason, Chapter Six always breaks me down. I don’t know why I always get stuck there. The current one, though, is coming together better than the one I’d been messing with for a few years (which was a bildungsroman cum Dark Percy Jackson; I felt like I had a cool idea, but I sure didn’t want to compete with such a great guy as Rick Riordan, even if my stuff was much, much meaner). The present novel has a general outline and a detailed concordance that is proving to be a useful tool. I have one more chapter of ‘setting up the world.’ and then I can get down to the crime(s) that pull in the main characters. I even have an ending planned, and the critter is doing a nice job of writing itself in many ways. I don’t want to say too much because I know people steal like crazy off the Internet. Suffice it to say, I am playing to my strengths…writing what I know. It’s a mystery set just before World War I involving  an interesting female protagonist and her lady’s companion (who is proving to be an unexpectedly fun character to write). And yes, there’s a love interest, but he’s more of a friend for quite some time. The crimes are not too heinous, but I hope they are ‘clever,’ and I am trying to be quite historically precise on every…tiny…detail. That’s involving a lot of reading and research on the time and place (1913 Vancouver), which turns out to be quite the hotbed of plot threads. How did we write before the Internet?? I guess we just made crap up and hoped no one checked too thoroughly on our work.

The concordance is vital to my writing. Since it’s historical, I needed to develop ‘mini-bios’ for all the characters with things like their dates of birth and any important events during their lives, along with a timeline that covers the year before the start of the novel. I got my hands on train schedules, immigrant records (for names), period house plans, 1913-era dress patterns, and even articles on how the earliest hospital x-rays machines worked. I’ve reviewed where missionaries worked in China, and on my last visit to Vancouver, grabbed all the materials I could on the police during that time period. Will I get an agent? Will I be able to sell this? Who is my target market? I’m trying not to worry about those things and simply write well. I’m thinking this is going into ‘historical mystery’ and hoping the current fascination with World War I’s centennial will give me some selling power. But…that means getting it written quickly, and that’s not happening just yet. I’m cranking out, on average, a chapter a week. I’ll post general updates here. My best friend is a superb writer and editor, which is good for me, and I have a few friends in the business that may give me a hand if I beg. All I want right now is to have the complete manuscript, sitting on my lap in hard copy, before the end of January. That’s my goal, folks, and I’m sticking to it.

I’ve hopefully concluded a 3-month contretemps with Choice Privileges. I redeemed some points back in June for an Amazon gift card. I waited the requisite 4 weeks–no card. I called and got the run-around, but was advised to wait 4 more weeks to be certain, and someone would follow up. It never happened. I finally called back again (waiting about 6 more weeks), got a bit more of a deflection, but finally, they agreed to reissue my points. However, they were quite grudging about it. “We’ve decided to reissue your points,” said the rep, “but only if you understand that this is a one-time only courtesy on our part, and that if you do use those points for a gift card that never arrives, we will not re-issue them again.” No thanks to me for being a customer. Nothing.

I told him that while I knew it wasn’t his fault personally, his script was terrible, and he needed to let his supervisor know that. A better response would be: “Ms. Andromache, we are sorry about the loss of your points and gift card. We are re-issuing you the gift card, now that we’ve investigated the missing points, and you’ll receive a tracking number so it won’t get lost. Our company policy is that unfortunately, we are not responsible for any losses in the mail, and I regret that it happened. I hope this card arrives with no problems. Again, we apologize for the inconvenience and appreciate your patience resolving this issue. We look forward to your next stay with us at a Choice hotel property.”

So, that’s a second hotel chain knocked off my list. I used to LOVE Holiday Inn Express…until they botched a very important reservation, where it was not just me involved, but a group of about half a dozen people, with no remorse, no apology, and no concern shown. I haven’t stayed at one of their properties in almost five years now. (The manager would not return my phone calls, and some poor desk clerk tried his best to help–it was the manager who incurred my wrath when she lied and said she’d talked to me and resolved the situation when I went higher up. That was nasty icing on the cake).

I’ve had the best luck with Hilton and Marriott properties for ‘regular’ travel (hello, I can’t afford to stay at Omni or Fairmont too often, both of which were amazing)–and both the Marriott and Hilton loyalty programs have thus far earned me rooms in some very nice places. Returning from a long trip a few years ago, a Marriott employee went out of her way in rural West Virginia to help us when my son got suddenly very ill; she contacted a local drug store and got us numbers for the emergency clinic, making sure we had ice brought to our room, and was just a genuinely nice person (it was one of the worst cases of strep throat the PA said she’d ever seen when we got to the clinic the next morning). Hilton/Hampton employees were particularly nice after the death of my father and during the settling of his estate. We got to know each other quite well since I was there for about a week. (I also need to say that the one time I did have a special need/request, it was honored, even if it was a bit odd–no feathers).

I probably should have been more polite to the poor guy on the phone (I didn’t yell; I just told him I thought their resolution wasn’t particularly customer friendly)–I realize this is beyond his control. But–his tone had no empathy; rather, it was perfunctory and blunt. Again, there wasn’t a single variation of “I’m sorry for the inconvenience.” Even if didn’t make any real difference in relation to the missing card, it would have been nice to hear. His script was more to the tune of “I have to reiterate to this lady that if a second card goes missing, there’s nothing further we can do.” I do think there is a way to say both–or at least sound like you are sincere. So–for the price of a $50 gift card, they’ve permanently lost me as a customer. Because I travel so much, people often ask me for my opinion on hotel chains. Wonder if he/they realized that I will be passing on their lack of customer empathy to all those friends and co-workers who ask me where I stay on my travels….Bazinga!

As an educator of 20 years, mostly in higher education, people often ask me what I would change about our current education system in the U.S. Five years ago, I would have said it’s fixable. We can reform it within. I can no longer say that. Those of us who teach college are seeing problems that we cannot fix. Here are my top picks for ways to make the U.S. education system a much better one, or at least start the process of change.

1. Treat teachers like the professionals they are. This includes a salary comparable to other professions that require a four-year degree and a professional internship. Ideally, as part of their professional development, all teachers should be encouraged and supported in obtaining a master’s degree as well—not for the increase in pay, but for the intrinsic increase in knowledge.

2. By the same token, make the standards for teacher education and qualification rigorous. Raise the GPA for admission to candidacy, add a fifth ‘supervised’ year of training under a mentor teacher (i.e. the new teacher is autonomous in his/her classroom, but has an experienced guide who can help them with the common problems of first-year teaching), and create a set of meaningful certification criteria that has reciprocity across states. Have yearly evaluations that include periodic observations, portfolios, and interviews rather than putting so much emphasis on students’ test scores or a once-a-year observation. If a teacher is to be considered an ‘expert’ in a specific academic discipline, he or she should hold a master’s degree in that subject as well.

And here is an addendum to colleges of education or other institutions who grant teaching degrees: Make your teacher education candidates work for it. Don’t ignore your undergraduates in favor of your research or grad students. Make sure you focus on giving students in teacher education in-school experiences plus sharp thinking and problem solving skills. Encourage their growth and creativity. Be picky about who you allow into your programs. Do not allow teacher education to be the major people choose when they can’t get into nursing school (sad, but true). Make it be the major that your best college students actively seek out…and if there is competition for limited spots, that’s not necessarily a bad thing.

3. Catch the weakest K-3 students early in the education process. Get them help sooner, not later, and be willing to compensate the educators for the after-hours time they spend with these students. Provide a dedicated special education teacher, as needed, to every classroom, rather than one for every four or five classrooms. Additionally, a well-trained aide should be a part of every classroom at least through 4th grade.

4. Get over the concept that all children are destined to go to a university. They aren’t. We need qualified, energetic, and dedicated professionals in the service industry. For whatever reason, America often attaches a negative stigma to students who want to be plumbers, electricians, and bricklayers. This is unfair. Personally, I could not perform any of those tasks—and I am very thankful to have skilled men and women I can pay for their work. (My plumber is a lady, by the way).

5. Stop using a business model in education. This means getting rid of NCLB and Race to the Top, cutting back on the high-stakes testing, and abandoning ideology like Lean Six Sigma, which was great for engineering and nuclear power plants, but lousy when applied to people.

6. Find a way to equalize education spending across the country. The system is broken when children in more impoverished states are given X dollars per pupil, while in wealthier states, the spending is 3X dollars, for example. Education, for whatever reason, usually gets the ‘cut’ when a state has budget issues. Education should be the last thing from which funds are ever cut.

7. Create a balance between national and local standards. No one is saying that children in South Carolina need a year-long course in the history of Idaho, or that you must teach physical science in 7th grade and life science in 8th grade. But have some broad national learning objectives for all subjects; then, allow states to determine how they would like to structure and teach those objectives, making them specific and applicable by and on the local level.

8. End social promotion—and by the same token, stop holding back children who are capable of working ahead in a given subject. Add some flexibility to the ‘age/grade’ system, such as letting the 2nd grader who is reading on a higher level spend ELA time in a 3rd grade classroom, or the 3rd grader who hasn’t yet mastered 2nd grade math concepts, but is doing well in other areas, drop back for just that one given subject.

9. Quit promoting bad teachers to administration just to get them out of the classroom, and end the practice of nepotism in promotion. A good educational administrator must first and foremost be a good teacher. Learning to lead and administrate is a skill acquired after several years in the classroom as a teacher.

10. Lower the student to teacher ratio, and regardless of the budget, do not eliminate art, music, PE/recess, and foreign languages from the curriculum. Overwhelming evidence shows that exercise, creativity, and studying a second language are good for the brain and the body.

11. Encourage faculty to engage in creative teaching techniques and collaborative teaching. Offer incentives to teachers who lead these endeavors.

12. The love of standardized testing is so deeply ingrained in U.S. culture, it will be impossible to eradicate it completely. But cut back on it. Consider a nationally-normed test given across a span of time, such as 2nd, 6th, and 8th grade, not every year.

13. Get parents deeply involved–in education. Not just in extracurricular activities, but in supporting their children getting homework done, reading their heads off, and being responsible (according to age and other logical expectations).

14. Finally—whatever new system is put into place—allow it time to thrive and adjust before claiming it doesn’t work or is ineffectual. The most touted educational system in the world, from Finland, took 30 years to perfect and had a lot of bumps along the way.