Another Illness

If you read through the 3-year blog history, you'll find that illness is just as much a part of the Indonesia experience as anything else.  In the first fifteen years of my professional career, I probably missed two weeks of work due to illness.  In the three years I've lived in Indonesia I have missed nearly a month.  We're sick more often, and with harsher illness.  Last week was yet another example.

When I arrived home from work on Monday, I told my wife I felt "odd".  My skin felt raw and I was warmer than usual.  Thirty minutes later I was shaking with chills and skipping dinner.  Ninety minutes later, after the kids are in bed, I'm curled up in a ball on the couch burning with a 102 (39) degree fever and trying to stay warm with a blanket.  Medicine isn't bringing my fever down.

I fell asleep at 10 PM.  My wife woke me a few hours later to make me take more medicine.  I was burning up.  I was surprised when she told me I'd been asleep only two hours.  I would have sworn I'd been asleep at least six.  It was a rough night after that.  Between fighting the fever and frequent trips to the bathroom, I hardly slept.

At  8 AM the next morning, after all the kids were at school, I went to the medical clinic.  I was able to see a doctor within twenty minutes.  She took my vitals, asked my symptoms, and walked me to the ER.  I spent the next several hours in the ER hooked up to an IV under observation while they ran some tests.  They were trying to keep me hydrated and bring down my fever.  They were able to keep me hydrated.

Around noon they gave me my diagnosis:  Amoebic Dysentery.  Ugh.  Same thing my daughter had last year, though our symptoms were slightly different.  They gave me three different pills, one to kill the amoeba, one to help the issues that pill would cause in my stomach, and a third pill to fight the nausea caused by the other two.  I would be taking 750mg of Flagyl three times a day for the next five days.

The medicine alleviated my symptoms almost immediately.  My fever disappeared within hours, and the other symptoms began to improve.  However, the medicine was brutal.  Flagyl has a list of side effects and I experienced every single one of them.  The worst for me was the headaches and the nausea.  They left me incapacitated and in the fetal position for hours at a time.  I kept trying to play with the kids but did not have the energy to do it.  Being light headed didn't help either.

I stayed home from work on Tuesday, Wednesday and Thursday.  I went back to work on Friday simply to honor a family rule:  We do what we have to do so we can do what we want to do.  I had a farewell party to attend and was hosting a poker party Friday night.  If I didn't go to work, I wasn't going to do either of those events.  Toughest day of work I've had in recent memory.  Several times I doubled over to catch my breath.  I did make it through the day, however, and attended the farewell party and the poker game, though everyone commented I looked very ill.

It's now Tuesday, a week after my trip to the ER.  I took my final dose of Flagyl on Sunday AM and I still have the side effect of a sour taste in my mouth, though it's not as bad as it was yesterday.  For the most part, I feel better, but I'm about 10 pounds (4 kg) lighter and don't have my full energy back yet.  My appetite is slowly returning.

I went back to the medical clinic tonight so they could run more tests to confirm the amoeba is gone.  They said it would take an hour, but realistically I don't expect to hear anything until tomorrow.

The worst part for me is knowing that my daughter went through this.  She's a tough little kid.  She had a lot more energy than I did!

Return from China

Monday I flew back to Jakarta from China.  I knew I'd have a late night Sunday, so I planned ahead and booked an afternoon flight.  This meant a late arrival into Jakarta, but Tuesday was a holiday (Buddhist New Year) so I knew I could sleep in.  The only interesting part of the trip occurred on my Singapore to Jakarta flight.  I'm sitting in my business class seat when an enormous Indonesian sits in the seat next to me.  He was so big I was tempted to ask if he held a job that was responsible for his size.  When he started sleeping the moment after he sat down, I thought it better not to wake a sleeping giant.  While waiting for baggage, several airport staff, including security, rushed up to have their picture taken with him.  He exited the airport shortly before I did so I asked my driver if he knew who it was.  He informed me it was Ade Rai, the number one body builder in Asia.

Tuesday morning I didn't sleep in as long as I had hoped.  We decided to make a return visit to Taman Safari.  We do this with all our guests...did I forget to mention my cousin arrived?  She is the solution to our Singapore nanny dilemma.  She'll be with us until 1 July when my mom takes over.  Anyway, we decided to take her to see the animals.

I was quite impressed with the strides my daughter has made with her fear of animal encounters.  In prior visits, the idea of being close to the animals was always more appealing than actually being close to them.  This time, the fear was gone and she fed everything, including the elephants.  My son even got in the act of feeding the large beasts.  He knew exactly what to do when I gave him a mango and walked him to the elephant.  He put that tiny green fruit directly in the gaping maw, only to see it fall to the ground.   I would say there is no fear in that boy, but we also finally had the opportunity to ride the elephants...and my son wasn't exactly happy about it.

 

 

 

On our return to Jakarta our son gave us the scare of my life.  It is a long drive back from the zoo and I was making the most of the opportunity by taking a nap.  Our nanny calling our son's name in a panic woke me like a bullet firing in the car.  I turn around and my son's eyes are open and rolled in the back of his head.  I touch him and he feels like food fresh from the oven.  I pull him out of his car seat and onto my lap and he is as limp as a rag doll.  I thought I was holding my dead son.

I steeled my nerves and was preparing myself to give artificial resuscitation.  I checked his breathing - it was shallow, but there.  His heart was racing.  Our nanny said she had watched him have a seizure and that his lips had turned blue, that's why she started calling his name.  Our daughter starts freaking out whining:  "I don't want my brother to die, I don't want my brother to die."

My wife retrieves the fever reducer from the diaper bag and I instruct our driver to pull over as soon as possible at a gas station.  I want ice.  Minutes later we're pulling into a rest area that happens to have a Starbucks.  Despite the efforts of the staff, I was able to procure some ice and napkins, and, in addition to the fever medicine, we were able to bring his core body temperature down.  After twenty minutes of rubbing his chest, neck, back and head with cool water, our son became responsive and started voicing his displeasure.  He then proceeded to vomit all over himself and my wife who had the bad luck of just taking him from me.

I called ahead to the emergency clinic and asked if there was anything else we could or should do while we traveled there.  They said to just keep doing what we were doing.  Ninety minutes after holding my limp son in my arms, we arrived at the ER.  Ninety minutes after giving him fever reducing medicine, which did definitely reduce his fever, the ER nurse reported his temperature as 103.6.  I can only imagine how high it was when I picked him up.

We spent a few hours in the ER and left with five different medicines to give him.  The doctor said the seizure was likely a result of the fever and is common in young children with fevers.  No long-term damage is expected other than the reduction in years of my own lifespan for having the scare of my life.

Indonesia....you give me fever

Spent 6 hours in the ER today. I woke up with a temperature of 39.6 (103.1). They ran blood and stool tests and gave me three IV's. They were not able to reduce my fever below 38.1 (100.5). I've had a fever over 37.7 (100) for three straight days. It's difficult to stay awake, move, etc.

The test results indicated I have a bacterial infection. Doctors have given me antibiotics. I have until Saturday to break the fever or they want me to go back again. 1000mg of Tylenol isn't cutting it.

A few things I have learned:

1) Fevers from 37.7 - 38.8 give you teeth chattering chills.
2) Fevers over 38.8 make you sweat like you are in a sauna
3) Phlebotimists here must not get proper training. She pricked my vein to draw blood and attach the IV and my blood dripped all down my hand and onto the sheets. I did not like her after that.
4) Bacteria suck.

I have a fever

I woke at 3 AM shivering with cold. I wrote it off to being directly under the air conditioning, and just bundled up. When my alarm woke me at 5 AM, I was still cold, and now I had a stomach ache. I decided to go to work anyway.

At work, I took Tylenol every 4 hours - which is about the cycle of chills I was having - and felt fine while the medicine worked. At 3:30, when it was time to take it again, I decided not to. I went to my physical therapist for a cyatic nerve issue, and was absolutely freezing. She said my body was hot to the touch and that I probably had a fever. After the session, I went to our medical clinic.

Diagnosis: unknown, but NOT H1N1. Fever was 102.3. No other symptoms - respiratory, nasal, stomach, etc. Just the fever. So, they told me to go home and stay home for 3 days and wait. If I get new symptoms, I have to go back. If the fever is still around after 3 days, I have to go back.

Last night, I fell asleep after dinner around 7:30 and woke at 9 AM this morning. Fever was gone, but is back - much lower - this afternoon. I'm able to keep it down with medicine, and I no longer have chills, just heat. I think I'll be better by Friday.

I'm disappointed because I finally just got back to work. This is really annoying.

A need to feel productive

I spent only three hours in the office this morning before returning home sick. I've been sick with a head cold for a little over two weeks. My wife and daughter have both caught it, fought it, and moved on while I'm still fighting it. Struggling to speak finally did it for me. After three solid hours of meetings: 6 AM - 9 AM, I called it a day. When I arrived home I took a single Benadryl, and then slept for 5 hours straight. I'm updating my blog so I feel productive.

JOB

I'm two months into the job and I already feel like I've accomplished 80% of what I need to in my two year assignment. The remaining 20% requires repetition and time. Recognizing that I may be overly optimistic on the progress, I'm still pleased with what the team has accomplished in the last three months (I officially took over one month before my arrival). I knew this team was better than they were performing.

The big question that usually follows such a statement is: "what did you change?" The honest answer is: "Not much". To borrow terminology from the book "From Good To Great", we already had the right people on the bus, we just needed to point the bus in the right direction. I made three changes:

1) I modified the roles and responsibilities of the three section leaders. We were too matrixed in how we managed resource assignments and we were underutilizing one of the best analytical minds on the team. I made each section lead responsible and accountable for the resourced in their area of focus, and I put the person who was managing that effort in charge of solving our production support issues. The net result - less resource churn, higher productivity, and a 20% reduction in production support backlog.

2) I changed the focus. Demand management is one of the most difficult jobs a technology manager faces. We support every department in the business, who all report to a different VP, so negotiating which projects take priority often falls to the IT department - and at least one VP is always upset that they are not considered a priority. When I arrived, we had 35 people working on 30 projects. We were trying to do everything and really accomplishing nothing. Something needed to change. As we began finishing projects and starting new ones, we allocating two to five resources per project, instead of one. Over a 6 month period, we'll complete the same number of projects, but we will complete each individual project faster, so the illusion is higher productivity, and the team feels like they are accomplishing more. Delaying the lower value projects will provide the additional benefit of them dropping off the list as people find other ways to accomplish their objectives without technology.

3) I changed the measurements. We were very focused on delivery and schedules. The end result was releasing non-functioning product on time and creating a mess for the production support team to clean up. There was talk of implementing a "project warranty" - a period of time that the project team would support any issues. Instead, I borrowed from Deming and built quality into the process - better estimates, better design, better testing - and started holding people accountable for the quality of the product, not how fast they completed it. At this point, we are delivering a few weeks late (our estimates haven't included the learning curve associated with better quality), but our applications do not generate production support issues after they release. I'm willing to face my management, and my customers, with delays if I can guarantee a quality product at the end.

FAMILY

This is my daughter's final week of school. End of school in Jakarta, for expats, means return to the home country. For us, it means everyone we met has already or is planning to disappear for the next two months. Per my contract, I don't get a vacation for my first six months, so we won't be going anywhere. It will almost be like our first day here all over again where we didn't know a soul.

Next week is my daughter's birthday, and we've been concerned that there would not be anyone around to attend her party. My daughter even expressed this concern quite poignantly the other night when she lamented "I'll be in my princess dress and there will be no one here to see it." Hoping to avoid that emotionally scarring trauma, we decided to celebrate her birthday this Saturday, betting that her classmates would not be leaving the day immediately following the last day in school.

Our bet paid off - larger than we had anticipated. We went from thinking we'd have no one, to an event that looks like we'll have over 40 people including about 25 kids. We still have not received the majority of our belongings (though I did receive word they are in Indonesia's customs), so we're a little concerned we won't have enough in our house to keep everyone entertained. We have hired Gymboree to host the party, so hopefully that will be enough.

JAKARTA LIFE

In 2000, I had my first job that allowed me to connect to the company network from home. In order to do so, I had to contact the host computer and provide my credentials and a security token. The token was a randomly generated number that changed every 30 seconds. I had to carry a small, pager-like device that would provide me the appropriate number to use based on the time I was attempting to gain access. Today, technology has advanced to a degree that instead of randomly generated tokens, we use SSL or VPN or a reverse-proxy server. Well, except for here in Jakarta.

I have utilities to pay in Jakarta - cable, electricity, water, cell phone. I don't have checks, the utilities don't do auto-deduct, and none have the ability to pay online. Thankfully, much like my bank back home, I can do online bill pay through my bank. I registered with my bank - BCA - to have this feature (which cost me 10,000 Rupiah - $1) and they gave me....a token generator. Yep, in order to pay bills online I now have to use a randomly generated token like I did over 9 years ago to access a network. I guess SSL was too difficult to implement on their website.

Online banking isn't the only financial service that required me to take a few steps back in time. I'm finding that for many of my transactions, cash is the only acceptable form of payment. This is especially true of services - the Gymboree party, tennis lessons, many restaurants. Often, business that do accept credit cards pass on the 3% transaction fee to the consumer - so, cash is the cheaper way to buy goods. I prefer the US approach of including the 3% fee in the list price and charging the dinosaurs that use cash more so that I can have the convenience of my fraud protected credit card.

Finally, while service levels in general are superior to those in the US (or any western country, for that matter), repeat service is not. I like to be a regular. When I find a restaurant, a barber, a mechanic, a brand, even a car dealership, that I like, I give them all my business and am very reluctant to change - my econ professor would say I'm a 'sticky' consumer. In exchange for my loyalty, I expect them to recognize me, throw me a freebie now and then - basically, reward my loyalty. In the US, businesses do that. One place I frequented for lunch ended up buying every 3rd meal for me - so I went there a lot (until my wife said I was not allowed to be a regular at Hooters).

We've been to the Hacienda restaurant every Saturday for dinner since we found it - the last 5 Saturdays in a row. We arrive before most people have dinner (around 5 PM), so we're often the only people in the restaurant. I would think by this point they would be saying "welcome back", or at least know that we always like extra chips (that they charge us for). Nope - we're like any other bule to them. It's the only place in the city to get our Mexican fix, so I don't see our habits changing anytime soon. For now, I'll just have to live with my disappointment.

Lingering cold, Immigration, and the Perfect Mess

The cold I have has lingered longer than I had hoped. Yes, you can just catch a simple cold in Indonesia. It isn’t SARS, or Dengue Fever, or any of the other exotic variations available in this tropical environment. I don’t have a fever, or a head ache, or a body ache – just a very stuffy nose and a mild cough. So, I did what any normal, rational human with an acute upper respiratory infection would do - I spent 30 minutes in the gym.

It better be gone when I awake in the morning, though. Tomorrow night we are doing a team building event and I am kicking off the whole occasion with my “what does it mean to work for me” presentation. I need to be able to speak for the presentation, and have the energy to help my team win at bowling.

Sunday was much like Saturday, only I spent more time awake. There is an expat grocery store nearby, and I took the brief walk to see if I could find some familiar medicine that wouldn’t put me to sleep. I didn’t find any medicine at the grocery store. I did find Kellogg’s cereal, Jiff Peanut Butter, fresh fruit, and juice. I only bought the fruit and juice as I wasn’t sure where I would find a bowl or where I could store the milk for cereal.

Above the grocery store was a pharmacy. Nobody spoke English, so I bought medicine based on the picture and waited until today to confirm with my colleagues that it was worth taking. Glad I waited. The one that would have treated my symptoms had expired. I had lunch at a pizza restaurant and went back to the hotel for a four hour nap, then woke up, watched a little TV, and went to bed for the night.

I forgot to mention that on Thursday last week I went to the immigration department. I had to sign and initial about 15 different documents – none of which I could read – and have my picture and fingerprints taken. The place was a zoo. We couldn’t park in the parking lot and the inside of the building reminded me both of the trading floor on Wall Street after they announce the crop reports, and a Central American police station in a movie from the 1970’s starring Nick Nolte as a photo-journalist covering rebel insurgencies. Luckily, my company is thoroughly prepared for the expat experience at immigration. They made an appointment for me, so when I arrived, I walked right up to the counter to sign the documents, walked right over to take my picture and fingerprints, and walked right out. Total time at immigration was about 15 minutes. Some people looked like they had been there for days.

Also, I’m reading a fascinating book that I think should be required reading for anyone in management – especially those charged with process improvement, process control, records management, or any other profession where fastidiousness is encouraged. The book, “A Perfect Mess”, posits, quite cogently, that the cost of cleanliness often outweighs the benefits and, moreover, the benefits of messiness often are incalculable. For example, we never would have found penicillin if Fleming’s lab had been as meticulous and sterilized as today’s research environments.

To put the argument in perspective, the best analogy is that of a deck of cards. I give two people a deck of cards and inform them I will be timing how fast they are able to find four cards I name at random. One of them, in preparation, sorts the deck numerically by suit. The other does nothing. I name four cards. The person who sorted the deck can find those cards significantly faster than the person who didn’t – 6 seconds vs. 16 seconds, on average. When I advise them to put the cards back, the ordered person puts them back exactly where they would be in his defined sort, while the unordered person puts them back on the bottom of the pile – 6 seconds vs. 0 seconds. So, the act of finding and replacing four cards is 12 seconds vs. 16 seconds. On the surface, it would seem that order is preferred. Of course, if you add in the 90 seconds, on average, it takes to order the deck, it took 106 seconds for the ordered person, and 16 for the second person. At what point does the benefit of order surpass the cost? Well, assuming that order is consistently maintained – which, in reality, it seldom is – it requires 23 repetitions before adding the order is cost effective.

If that were the end of the analogy, the meticulous, fastidious and OCD crowd would walk away crowing. Unfortunately for them, the real question is – how often do you need an ordered deck? When you want to use a deck of cards, what, typically is the first action you take? You shuffle it, to create disorder and a useful randomness. So, an ordered deck really has no utility. This analogy applies to many other aspects of life. Quite a fascinating book.

One week into my stay I finally upgraded to the club level. My frugality extends to my role as a consumer of company funds. As I mentioned in an early post, I wagered that the $45 daily rate would be cheaper than eating elsewhere. I avoided the hotel restaurants and instead visited their buffet. Breakfast buffet was $19, dinner buffet was $35 - $54 total. Internet in the room is $72/week. Dry cleaning is expensive - like $5 per item. By agreeing to pay $45 a night, I get breakfast, dinner, free Internet and two items pressed each day as part of the fee. Plus, I get unlimited drinks (when I'm not sick). I think of it as the "all-inclusive" plan.

Side note - the spell check on my blog engine doesn't recognize contractions. Very odd.

Interesting thing, life

I recognize I have been remiss on timely updates to my blog. These last few days have been a whirlwind of activity.

Thursday and Friday were both long days at work. Recognizing that my driver's day begins before mine and ends after mine - making his Wednesday closer to an 18 hour day - I changed my work arrival for Thursday to 9 Am. I ended up staying until after 8 PM. Friday was not much different. We've been struggling to resolve some issues on our Help Desk application, and I'm trying to impress upon the team the importance of fully testing the application before publishing it for release. Thursday night, after seeing the results of our testing, I was highly confident that our code was ready for production release. To my surprise and frustration, there were two bugs - closely related - that prevented us from going to production. So, we spent Friday attempting to reproduce these issues - one of which we were unable to duplicate until 4:30 in the afternoon - and then resolving them for another release. I had high confidence in our code once again when I left late Friday evening.

At this point, I have no idea if my compatriots in Phoenix updated production with the new version. I made a conscious decision to not check my work email until tomorrow morning. If we did not release the new version, it would only upset me, and there is nothing I can do about until Monday morning, so no use getting upset over something I can do nothing about.

Friday afternoon my nose started to run. It's been itchy, on and off, since I arrived, but it really started bothering me Friday afternoon. I completed my work out Friday evening and ordered a massage (loving these $25 1/hr massages!!) for 8 PM. I've always known that a vigorous massage helps release toxins from your body. It's one of the reasons they advise you to drink lots of water afterwards, to help flush it out. After this experience, I'm a confirmed believer. About half way through the massage, as the masseuse was working my arms, my nose opened up like a faucet. I actually had to ask her to stop and bring me some tissue. At the end of the massage, I was so congested it was like trying to suck air through a straw clogged by a piece of ice. Luckily, ever since my first trip out here, I've carried medicine for food allergies, cold, and travellers diarrhea. Unfortunately, the only cold medicine we had at home was Sudafed PM, which knocks me out. I think I was awake for a total of 5 hours on Saturday.

Despite my Rip Van Winkle impression on Saturday, I did find an opportunity, in my medicine induced haze, to make the obligatory DVD shopping trip. I was on a hunt for Bolt and Wall-E, two movies for my daughter. They had both of them. I picked up a number of other Disney movies, too - Peter Pan, Alice in Wonderland, Pocahontas and a few others.

To change gears a bit - when you travel for business, or spend time abroad, it's always tough to be away from family. Communication technology - email, phone, webcam, etc - helps shorten the distance by helping you keep in touch and stay connected. This works well when everything is fine. When there are crises, or when someone close to you is in pain, the distance seems even farther.

This week, a great person died. She lived well into her 90's and I think we all thought she would live well into her hundreds. She was vibrant, full of life, and spread joy everywhere she went. I'll remember playing cards with her at the lake, and hearing stories about her undying support for Michigan State football. I did not know her well, but I do know well the impact her life had on those around her. She will be missed.