And in non-Amal center related news



We moved house 2 months ago, and I just have to say, alhamdulillah, the view from our roof is amazing.  Every day I go up there to check on the mountains.  Yesterday this is what they looked like after a fresh snow.



And for a few moments before it set the sun lit up the snowy peaks with the most striking rose color.DSC_0245


And here is our family according to Yousef.  Karima’s crutches!  Funny that he is surrounded by these boxy concrete houses and yet he draws ours with a slanted roof.  Why is that so universal.  DSC_0242


Why we were at the clinic…

If you have a million hours to kill and love to read about other people’s surgeries, then I invite you to read this post that turned into a mini-book.  It’s about my daughter’s surgery to treat a unicameral bone cyst in her femur.  Or just scroll down to the end and see what all the fuss is about.  Wish I were better at real-time blogging.

So Karima was scheduled to have her first medical intervention the following day.  We were all nervous and excited, it would be the first time anyone of the five of us in our nuclear family would “go under”, although Karima’s grandmothers have had LOTS of surgeries.  She was excited about everything, the clinic, having a swanky hospital bed with flat screen tv all to herself.  The clinic itself looks like what people in the 70’s might have imagined the future would look like, everything is white, glass and rounded.  It’s a brand new, state-of-the-art clinic with the prestigious sounding name Clinique Internationale de Marrakech.  I assume with the word Internationale they are referring to their clientele, a mix of Moroccans and Europeans.  Morocco is just getting into the whole “medical tourism” scene in a big way.  This place has all the latest equipment, I myself got an MRI there a while back, a few friends have had surgeries or delivered babies there.

When it was time Karima was wheeled away, we weren’t allowed anywhere near the OR.  It was our first experience of watching her being taken away, all in a white, like a little angelic being.  We felt we wanted to be there with her til the last minute, because she’d be surrounded by a team of medical personnel.  But that’s not how people in Morocco think about it, here connections are made quickly and everyone is either “auntie” or “uncle”.   The doctors and nurses would not treat her much differently than they would any child, including their own.

Hamza and I went for a little drive, prayed in the Kasbah mosque, and had some lemonade at a trendy little café overlooking the Kasbah square.  When we returned, after about an hour, Karima was already awake and enjoying some tea and toast.  We were all thrilled that she was not in pain at this point, things had gone well.  She told us what it felt like to be put to sleep (like blinking and when you open your eyes it’s already over).  The doctor didn’t come see us, I suppose within his range of procedures, this one was so minimal as to not require much discussion or explanation.

Karima started her life on crutches.  As expected, her friends and teachers made a big deal out of her.  They brought her lunch in class so she wouldn’t have to hobble downstairs to the cafeteria.  They made sure she was comfortable and helped prop her leg up on some jackets.  I said to Karima, “the good thing about being on crutches is that you won’t get detention”.  Her school is big on detention.

She adapted to her crutches very quickly, I was amazed at how seamless the transition was, and also saddened in a way at how fast disability had made a home with us.  But she wasn’t beat by it mentally or emotionally, in fact navigating life with a handicap just another challenge that she wanted to excel at.  This was in the beginning.  Before her body started to get very sore.  By three weeks into it everything ached, her wrists, elbows, and most of all her “good leg”.  Her good leg got really strong but tightened up, while her hurt leg got weak and skinny.  One night she had to get up really fast and couldn’t find her crutches.  She hobbled on her hurt leg, and the next day she was in so much pain that we had to go get her from school by 9 a.m.  We went to the doctor and he re-took the x-ray.  We were hoping there would be some change, even the slightest, although three weeks isn’t really enough to make a difference.  Normally we were going to take the x-ray at 6 weeks.  It was still disappointing to see the x-ray with no change. The bone cyst was just a dark mass of nothing.   At this point the doctor re-iterated to Karima that she shouldn’t put any weight on the hurt leg.  This was also the first time he talked about surgery.  He said that if she experienced great pain we’d need to go the surgery route.  This was a scary thing to hear, especially since all this was discussed in Karima’s presence.

I realized that until this point I’d been trusting that the cortisone treatment would work.  On the side, I’d been doing research online, going to forums and message boards to see what other people had done.  There were several promising minimally invasive procedures, besides the cortisone injection.  One was to pack the bone cyst with either bone graft or synthetic bone material.  I brought these options up with the doctor, but he said that the cortisone injections were the standard approach, the most likely to give results, and that beyond that there was little hope except surgery.   Hamza and I were frustrated that there wasn’t any energy here in Marrakesh around the idea of new or alternative therapies.

We moved house during all this.  To a new neighborhood with lots of outside space.  The boys immediately took to riding their bikes every minute they weren’t in school.  The youngest, Yousef, learned to ride a two-wheeler a few days after we moved in.  I had this idea that riding a stationary bike would be good for Karima, it would give her hurt leg some gentle, much-needed movement.  Then she said “what about riding a real bike?”  And we both said “nah”.  What if she needed to stop real quick and jarred her hurt leg on the ground?  Still the idea kept coming back and Karima said, “Let me just try it”.  We had never wanted to hold her back or keep her on bed rest.  We’d always tried to let her have as much freedom as possible while on crutches.  She was so tied to those crutches, I didn’t want her to start identifying with them.  They weren’t a part of her body.  The bike idea seemed worth a try, so she got on very carefully, propped her hurt leg up on the pedal, and started to pedal with her good leg.  It worked really well.  She circled around the empty lot that is in front of our house and she just laughed to feel so free.  It was beautiful to see her move so fluidly after about 5 weeks on crutches.  Plus it felt really great on her hurt leg, it got gently bent in that way that felt so good to her.

The bad news is, Karima had a fall.  One of the neighbor boys was walking his rather feisty dog, and the dog lunged at Karima while she was on the bike.  She tried to make a u-turn real quick and her bike tires slipped in the dirt.  She fell directly on her left side, the side with the bone cyst.  After that she started to have a lot of intermittent pain, it would come on real strong, like a contraction during labor, then pass.  We were majorly set back, she and I could no longer do the simple physical therapy moves we’d been doing, like bending her hurt leg at the hip.

The doctor ordered another x-ray because he suspected a hairline fracture or fissure.  Nothing showed up, but we saw once more that the cyst was the same size, in fact if anything it seemed larger.  The doctor said that if the pain kept up we’d have no alternative but surgery.  We started scrambling to find a specialized clinic abroad, we looked at Spain and France.  Our hope was to find an orthopedic pediatric specialized team.  We had complete faith in the doctor in Morocco, he was widely known and had performed many successful surgeries on some of our friends and acquaintances.  Still our hope was to find someplace that performed some of the less invasive therapies we’d read about, the bone marrow transplant, or packing the cyst with bone graft, inserting cannulated screws in the cyst to drain it continuously…anything to avoid a painful surgery that might have long-lasting repercussions.  Our good friend in Spain was married to a doctor so she was an obvious choice to ask for help.  Sure enough she and her husband started to research the question for us.

In the end though, the choice was taken out of our hands.  On Saturday the 12th, Karima hurt her leg again.  I suppose this was inevitable.  She was starting to get tired of the crutches and sometimes stumbled because she was being careless.  She’d almost slipped a few times.  On that Saturday, we had a few kids over and although she had said she didn’t want to play with them and she was going to stay in her room, in the end she couldn’t help it and went outside to be part of the action.  Somehow it happened that one of the kids stepped on her hurt foot, and as she tried to pull it away, she felt something snap.  More intense pain, she went to her room and got in bed. It was worse now than before.  I thought it might pass if she stayed in bed and didn’t move it.

But by night time, the pain had only gotten worse.  Now she was crying non-stop and none of our meds worked, even paracetamol with codeine that we kept around for those special (painful) occasions.  Nothing could cut through the pain.  It was an awful feeling for me, to watch her shrieking in pain, and I had to think quickly in a situation I’d never been in before.  I texted my husband to come home quick, and then called the doctor and explained the situation.  It was obvious by now that Karima needed emergency pain relief.  Karima was saying “I want the surgery right now, I don’t care, I’ve been patient all this time, too patient!  That’s it! Make them fix me mama!”

We rushed her to the clinic in the middle of the night, calling some good friends to come spend the night with the boys, Amin and Yousef.  Karima was still in a state of agony when we got there, but somehow after about an hour, she relaxed a lot.  The resident on duty was another student of my husband’s, and once Karima had relaxed, they were discussing how it makes more sense for medical students to write their theses in English rather than French, since all the reference material is in English.  My husband teaches English and so people often want to have these types of conversations with him.  We also found out why the x-ray appeared to show that Karima had a fractured hip bone, totally unrelated to the bone cyst problem.  We’d seen these x-rays and they left us really perplexed (and googling “children hip x-ray”).  Well it’s because there is a layer of cartilage in the middle of the bone, that’s where the bone grows from, and on x-rays the cartilage shows up blank.   It looks exactly like a fracture, but it’s not.

Karima seemed to relax even without pain meds.   She and I went to her room, by this point exhausted because it was 2 in the morning.  But she couldn’t sleep, the pain would come on in waves, so we had to call the nurse in, who gave her the first (but not the last) very diluted morphine shot.  I didn’t know that morphine really burns when it’s being injected.  But it sure knocked that girl out.  I was surprised that such a swanky clinic was “out of blankets”, luckily we’d grabbed two on our way out.   They were going to charge for each person that stayed the night with her, and there was only a thin couch to sleep on, so we decided that I would stay with her that first night.   Finally by 2-3 in the morning we were both able to pass out.

The next morning was pretty mellow, Karima was excited to be in the clinic and have it be such a big deal.  The surgery was scheduled for the afternoon so she was instructed to eat a light breakfast and then nothing after that.  Her dad brought her just about all of her favorite breakfast things including Moroccan donuts, French cheese bread, msemn fried bread with eggs, chocolate milk and a Crunch bar.  Although at this point she didn’t have much appetite (maybe the morphine).  We all gladly helped her out though.  That morning she was still “enjoying” the “thrill” of being in the hospital.  She asked her dad to get a wheelchair and wheel her around the place.  When I look back on that morning and her innocent excitement I’m so sad.  Nothing could have given her (or us for that matter) any inkling as to what was about to happen to her, I mean going through the door of surgery and coming out on the other side.  To prove how clueless we were for about the post-op, we actually had this plan to re-unite our family (the five of us) and celebrate over happy meals in the evening (her special request).  That was her big wish,” I want a happy meal waiting for me”.   Note that we don’t eat at McDonalds ever, except in circumstances of major duress.

The day dragged on and finally by 3 pm they came for Karima.  We gave her big hugs and she was wheeled off.  We didn’t even know which type of surgery she would have.  The doctor had told us there were two options: the first, and least invasive, was having 2 titanium pins inserted into the bone (intramedulary) near the knee and those would go from the knee to the hip (this is the option we were hoping for obviously).  The second option was to have a metal plate inserted directly at the site of the cyst, fixed in with screws.  This was going to be the more invasive of the two.  The doctor said that after Karima was under anesthesia, he would study the bone under a machine called fluoroscopy which is like a big x-ray.  If he found it was too fragile he’d go with the second option.  So he told us it would all take some time, because he couldn’t actually decide which surgery to go with until she was under.  The prep work would take about 1.5 hours even before the surgery began .

We sat and did some prayers, prayers for mercy and healing.  There’s a way in which being in a hospital room is a lot like being in a retreat.  There’s not much to do except be very present with what is.  It’s a very focused and refined space.  I think I actually tried to sleep at that point, I was in that soldier mode where a mere 20 min of complete and deep relaxation can keep you going another 8 hours.  Some people came to visit, thinking that Karima was already out of surgery.  A few co-workers  of Hamza’s.  Around 6 pm I started to get anxious and restless, I went down to ask at the front desk if they’d heard anything.   They said that there was usually no communication from inside the OR, so they didn’t know any more than I did.  After that I went down about every 10 or 15 mins, just to feel like I was doing something, each time they said, we’ll let you know as soon as we hear something.  I had awful moments thinking of all the bad things I’d heard about people not getting up from anesthesia.  Because overall, we weren’t “worried sick”, up to this point we hadn’t felt like Karima had anything life-threatening or debilitating, so although it was a major shock to even find ourselves there, we didn’t have a feeling of desperation.  But of course, with the surgery taking so long, the mind wanders.  Finally around 7 they said that the nurses had left the OR.  The first sign of life from in there.

Then all of a sudden the doctor was in the room with us, dressed in his everyday clothes, which was a little disorienting.  It’s like he was ready to go home and we didn’t even know what was going on.  He’s a very calm guy, for someone who deals with so much responsibility, he never rushes or gets worked up.  I learned a lot from seeing how he is, he just deals with what is in front of him and he gives it all his attention and intelligence.  We didn’t even know what questions to ask.  He said the operation went well.  I had the wits about me to ask which of the two surgeries he’d done, and it was the second option, the metal plate.  Masha Allah, not the news we were hoping for.  I don’t know why I was still in the mindset that it was going to be the first options (titanium pins).  Later Hamza said he knew it was the second because it took so long.  At this point, everything was so new and constantly changing that we were beyond reacting to each individual development.

He took us down to see Karima, she was still in the OR.  He had us put on some disposable gowns.  We went in, it’s an intense space, there were people in their cots with curtains pulled across, in various states.  Lots of machines and beeping.  Very high tech and state of the art.  We saw Karima in her bed, asleep.  Her face pale and somewhat swollen.  She opened her eyes slowly, saw us, and a tear rolled down her temple.  She just said “it hurrrrts” and she slipped back into unconsciousness.  That is when it hit me, what she’d gone through, how big this all was. She opened her eyes again, and again that look of pain came across her face.  I wished she wouldn’t wake up, and sleep through the worst of it.  We tried to think of something positive to say, so we said “Salma is here”.  Salma is a really good friend of hers, and Karima had asked that she visit.  It was clear to me at that point that Karima was in no shape to see anyone that night.  I remember touching Karima’s face and she relaxed and went to sleep.  It was like seeing a newborn.  But she kept waking up, each time she was in pain, and I think too at this point, the shock of her new state was settling in.  Before she had thought that when she woke up from surgery she’d just be all better.  And I had similar delusions too, I didn’t expect to be set back this far.  I stayed with her, while Hamza went out to tell people that she wouldn’t be seeing any visitors that evening.  Salma and her family, and a few others visitors had kindly shown up and I was so grateful that people cared enough to do that.

They wheeled Karima up to her room and transferred her to her bed.  She was so groggy and she was suffering.  The nurses settled her in and then left, and Karima promptly threw up.  I was mad at the nurses for not anticipating this and leaving her something to throw up in.  I cleaned her up, called them to change the sheets, and I found a bowl in the bathroom that was meant to collect water from a dripping faucet.  I put this near her.  Then she went to sleep, and I remember thinking, “great, she’ll probably just sleep through the night and through the worst of it”.  I settled down on the couch but didn’t go to sleep, I think I was checking internet on my phone or something.  Then Karima threw up again, I helped her, rinsed out the bowl and brought it back.  Poor thing she was exhausted and the throwing up was so violent.  She proceeded to throw up every half hour or hour, all night long.  Every time she drank a little water, she’d throw it up.  We tried some 7up too because it “has electrolytes” and I wanted her to have fluid in any form possible.  The nurses came in a few times, but mostly we managed on our own.  The general attitude in Morocco is that throwing up after surgery is a really good thing because it purges the body of the anesthetic, so they actually saw Karima’s all-night barfing binge as something great.  She got a lot of encouragement from the nurses about that.  I got sleep in two shifts that night 12-2 and 5-8 or so.  Karima was exhausted and only wanted to sleep, but her body’s reactions wouldn’t allow her to.  She dozed on and off.  I wonder if they didn’t give her a dose of anesthesia that was too much for her body weight, or if she is just particularly sensitive to it.  I remember getting up each time to help her, and each time I was more groggy and confused, til I couldn’t talk, I would just go through the motions and collapse again.  It was like having a newborn, except with a newborn you don’t know what they need, and with Karima, she could tell me exactly how much her body hurt, how dizzy and nauseous she felt, and there still wasn’t a whole lot I could do except exert myself to the maximum to relieve her suffering.  It didn’t make me long for a newborn, truth be told.

At 8 a.m. I was so ready for Hamza to come and take over.  I wanted to go home, have a shower, change, maybe catch some sleep.  I figured he’d come in with new energy and shift things.  Then he called me and croaked “I’m very sick, I’ve been up all night”.  He was having chills and fever and had lost his voice.  He was in terrible shape.  Because it seems that we have a rule in our life that we never just have ONE thing going on, it’s always two or three major things at once.  So.  It reminded me so much of my first post-partum days with Karima, where it was something like this: I draw from the well of patience until I feel like I’ve reached the bottom of it, only to find that bottom has gotten much deeper.  I draw on that deepest well of patience and strength.  I haven’t done this, to this extent, in a long time.  Life has not recently tested my physical and mental limits in such a real and raw way.

That morning was horrible.  Karima started really freaking out.  I don’t know if it’s fair to blame it on the morphine, although I’m sure that added to her delusions.  She started sobbing and saying things like “Save me mama, I’m going to die!”  “Why would they do this to me, tell them to fix me right now” “It’s TOO MUCH” and also “It’s not fair to do this to a 10-year-old girl”.  Pain is a big teacher, and I could see that Karima had gotten a taste of her mortality, at a very young age, and it scared her.  A friend said “the good thing about impermanence is that suffering also will pass”.  Alhamdulillah that’s true.  And from my perspective, the good thing about suffering is that it reminds us of our impermanence.  For Karima, the fabric of safety and normalcy was ripped open for a while and all of our efforts combined couldn’t protect her from experiencing that.

My parents came and that helped a lot.  At this point I was very bonded with Karima.  We hadn’t spent this much time with other continuously, in years.  I had that “can’t leave my baby with anyone because no one can take care of her like I can” instinct kicking in.  I couldn’t leave that day.   We spent a lot of the day like this: Karima would say “My foot, it’s too out”, so I’d pick up the whole leg, adjust it by turning it either in or out, about  1 cm, then I’d lay it down very carefully, prop it up with her favorite red fuzzy blanket.  Then I’d gage by her face whether that was bearable or whether I needed to readjust.  We did this a lot.  It was the least I could do to help make the pain bearable.  The nurses started to give her morphine (actually albuphine a close relative of morphine) sub-cutaneously instead of intravenously.  Her veins are thin and they’d used up both arms and both hands.  She was all bruised and bandaged so they just gave up on the IV.  The morphine really burns when it goes in.  Then Karima would get really distant and within a half hour she’d pass out.  But after an hour she’d wake up and be miserable.  The morphine made her really dizzy and nauseous.  So it was a balance between managing her surgical pain with morphine, and then managing her nausea with something else.  The entire day was spent like this.  Karima was too dizzy to watch tv, draw, talk on the phone or play on Gramma’s ipad.  Yeah, that’s how bad it was.  When people came to see her, they’d make her dizzy.  So when they came, I’d let them come and visit for a minute or two, but then if they wanted to talk we’d go out of the room and hang out in the waiting areas.

That evening the doctor came to see Karima.  He took out that scary looking drainage tube from her incision.  He had Karima turn on her (good) side, which was very challenging for her and she was crying. He took off the bandaid and I got to see the incision for the first time, it was about 5 inches, and long black line. It looked better than I expected, it was swollen or bruised.  Karima wouldn’t look at it.  Then the doctor made Karima get up, she was very dizzy and weak, she cried that it hurt and that she couldn’t do it.  The doctor had her get out of bed, walk around to the other side then get back in there.  She was exhausted.  I was pretty surprised that she could already do it, because we had spent all day adjusting her leg one cm this way or that way so that she had the least amount of discomfort, and then all of a sudden the doctor comes, turns her on her side, and then has her get up.

Meanwhile, Hamza was really sick, he was suffering from a bad flu. So we had medical drama roaring on two fronts.  The next morning, my parents came again pretty early which was just wonderful.  They were there for us throughout, taking care of the boys, bringing food and, as usual, my mom would show up with exactly the things we needed, without us having discussed them beforehand.  That’s how she is, she just knows.  A new calm descended over the room, a new energy took over.  Grandpa read to Karima a story he had been reading to her called “Wayside school” and she wasn’t too dizzy to follow.  My mom brushed Karima’s hair, gave her a sponge bath, made things tidy in the room.  As soon as I felt that Karima was in a good place, I took off, I had a lot to take care of.  It was strange to head from there straight to the little stores near our house.  I was pretty shaky from not having slept.  I grabbed a huge load of groceries…there I was asking the price of carrots, as if it mattered again.  And I desperately wanted to tell everyone I met that my daughter had just had surgery, that that was where I was at.  But I also desperately wanted to get home, so I kept my story-telling for later.  When I got home with the groceries, Hamza was resting, and I gave the supplies to Malika, our housekeeper and savior in times of trouble.  It’s a wonderful feeling to know that no matter how crazy things get, she is there to keep the mess in check, and to cook the best Moroccan food in town.  I took a much needed shower although at that point we had just moved into our new house and our shower was so funky that in order for the hot water to work you had to turn on some cold water in another tap, then you had to not have the light on because the light and the fan were both connected to the same switch and the fan would suck out all the warm air.  Nevertheless, showering and changing clothes was bliss for me.  I hadn’t packed anything to go to the hospital and things got so crazy with Hamza being sick that there was never a chance to bring more things.

That afternoon, Karima was ready to leave the hospital.  It’s not very restful being in the hospital, there’s always sure to be someone walking in just as you are about to doze off.  I’m talking for me as much as for her.  She was off of morphine by then, amazingly, so we were no longer tied to the hospital for that.  So I called the doctor and asked him to have the clinic release her that day.  Hamza was able to come over even though he very weak from the flu.  He is really good with the kids and I’m always happy for him to step in.

So now we were waiting for the bill.  The girl in accounting told me that if we stayed past 6pm we’d be charged for the night.   All of a sudden I was really done with that place and the last thing I wanted was to be charged for another night.  I hopped in the car, raced home, got some cash and drove back.  I paid the bill and left the insurance forms so that we could file them later and get reimbursed for some of the cost.

We drove home in the night, the same way we came.  Since then, Karima has gone through a lot of phases of healing.  For the first two weeks she was home, she couldn’t bend her leg, so there always had to be someone on hand to hold her leg and keep it very straight.  It was a big milestone when she could finally bend it and get up on her own.  Then she slipped and had to put her weight on her bad leg, and after that she couldn’t bend it again.  All in all she was in good spirits, but when that happened she broke down, crying and saying that she felt she was never going to get better.  It is hard to imagine that one day she’ll really be off crutches…unfortunately, it has become part of lives and something we adapt everything around.  Going outside was another big milestone for Karima, as was her first slow walk around the block.  Her school is one block away, so I had her walk to it just to reconnect with it and start visualizing going back to school.  Last week, Karima started physical therapy, and that’s been transformational.  In the first session, it was almost as if Karima didn’t consider her leg a part of her body anymore.  She was scared of it and if she needed to move it while she was sitting, she’d move it by picking it up with her hands.  She also couldn’t lift her leg more than an inch off the bed.  She couldn’t bend her knee hardly at all.  Amazingly, by her 4th session, Karima was riding away on a stationary bike, she can bend her knee past 90 degrees, and she can lift her leg up as high as she wants.  Every time she comes to physical therapy, a layer of stiffness and disability is lifted off.  Having the therapist right there helped her get over this idea that she might hurt her leg or break it if she moves it too much.  She’s not afraid of that leg anymore.  She needs to rebuild her strength in it to get ready for the next phase which will be 6 weeks of walking with one crutch.  After that, insha Allah, she’ll be off crutches completely, just in time for her 11th birthday. 


Why we are at the clinic: part 1

It seems life’s been full of steep learning curves and new challenges for me these days.  Since November I have: gotten the ball rolling with the women’s training center, moved house, and dealt with a major health challenge concerning my daughter.  I’m going to go into that because…I’ve explained it a lot in the last few days and I’d like to have the full version down on “paper” while it’s all fresh in my mind.  If you like a good story about medical procedures, and who doesn’t, then read on.

It all started sometime in late October/early November.  My husband took the kids with him to the gym, for a fun bonding time.  There’s hardly anyone there so they had the place to themselves.  Our daughter Karima got on the treadmill and put it on as high a speed as she could and challenged herself to run a full minute.  That’s the kind of thing she does, she loves quantifiable goals.  Practice piano for 20 minutes, read 1 chapter…Anyway, they were all happy when they came home.  The next day, she said she had pain in her left thigh.  I figured she must have pulled a muscle because she got on the treadmill cold.  Over the next few days she continued to talk about the pain, halfway down between her hip and knee.  I reassured her it would go away soon.  Well, it didn’t go away.  It didn’t seem to be getting worse, but it wasn’t getting better.  She continued like this for a good 3 weeks.  I suspected she was exaggerating, or that she didn’t actually know what pain felt like because she’d never experienced anything intense.  So I would often say to her, “oh come on Karima, it’s not that bad, don’t overdo it”.  Well the 4th week she started to limp, and wince with almost each step.  I tried to observe her in secret to see if she was only doing it for our benefit.  Some pre-teen scheme to get attention.  She wasn’t.

At the same time, life was so full because I was getting things going with the women’s non-profit which is a huge project for me, we found a great house that we were going to move into, my husband works long hours, and plus she was away at school for 8 hours a day so she wasn’t right there as a reminder.  It was so obvious that she needed help and yet I just didn’t get it together.  Finally I had this big realization that I needed to be a lot better at holding all these things in my consciousness at once: the family, the everyday running of the house, the women’s project, and moving all needed to be equally important.  In a way, having more things to do has forced me to be more aware and efficient than I was before.  My husband and I agreed that taking Karima to a doctor was an immediate priority.  So we went the next day.   As I saw it, mainly to reassure Karima that “it was all in her mind and there was nothing wrong with her so she could knock it off already”.  

The doctor, a traumatologist who knows our family well and was my husband’s English student, examined Karima, found the exact spot where it hurt, and then took an xray there, so of the middle of the thigh.  When he saw the xray, he took another one, this time of the hip.  He showed it to me and Karima, and point to an oval dark place in the extremity of the femur (thigh bone).  I saw it and immediately knew it wasn’t normal.  The first thing that ran through my mind was “am I looking at bone cancer?”.  Then he explained that this is something called a bone cyst.  Perfectly benign, a bone cyst can occur in children during their peak growth years, between 5 and 15 years old.  The cyst fills with liquid that can’t get out, that liquid puts pressure on the bone.  In Karima’s case, the bone was bulging, and very thing.  The biggest fear with a bone cyst is that it will weaken the bone and cause it to fracture.  Karima and I looked at each other and it was so bizarre to hear all this that we laughed with each other.

“You weren’t faking after all!”  I said to her.

“You see!” she said, vindicated.

Then she cried a little because it was new and scary, and now she had something in her bone that made it very weak.

The doctor said that she couldn’t walk on her leg anymore, and basically she had gotten to the point where it was so painful to walk on anyway.  He got out this pair of little kid crutches with colors on them and handed them to Karima.  She was so excited.  Crutches!  She tried them on and took a few bounds.  She walked in there without crutches, and walked out with them, not knowing that she would have them for many months to come.

In the car she was all bubbly and excited, “I just can’t imagine how everyone will react” she said.  All she could think about at that point was how surprised people would be when they saw her with crutches: her brothers and father at home, her friends and teachers at school.  She got home and the boys were so excited about the crutches.  Everyone wanted to have a turn and we had to keep adjusting them to fit little Yousef then readjusting them back for Karima.  For a brief moment, both boys were very helpful to her, Amin said he’d be her “crutch assistant”, hand them to her whenever she needed them.  It was the big news, as we called family members and told them about it.

I forgot to say that the doctor had told us that the standard treatment for a bone cyst is to drain it and inject it with cortisone.  And that Karima would have her first such procedure the following day, in a clinic, under general anasthesia.  Karima was really excited about that, about being put to sleep, and having all sorts of medical procedures.  Oh yeah, and the doctor also said to me that I should have noticed that the pain wasn’t improving.  He said, any pain that stays the same for a week needs to be checked out.  Lesson learned!  I’m so glad that Karima didn’t fracture her bone, can you imagine me telling her it’s all in her mind and then her leg actually breaks.  She and I joked that I just barely missed out on the trophy for Worst Parent Ever.

The next day hubby and I took Karima to the big shiny new clinic (we didn’t know then that we’d become quite familiar with that clinic later on…in fact that’s where I am right not, but I’m getting to that part).  In fact, as much as I’d like to finish the story, I’m too tired now and I’ll just try to post this and write the rest of the tale tomorrow.  I’ll say this much, Karima is doing well now, praise God.

Eid, Drink, and be Merry

In the weeks leading up to Eid I was in a kind of fog, I couldn’t wrap my head around the fact that it was Eid again.  Life has been busy and I felt unprepared to shift into this other mode.  Buying a sheep, buying enough supplies to last us through the 10-day souk hiatus that follows Eid, tracking down something bright and happy to wearh (times 5), giving some thought to decorations and presents (again?), making plans to see tribe members (in our case, other than family our tribe is an ever-shifting crew of family-less souls that share our lives at the moment).  But amazingly, we managed to do these things, and they didn’t do us in.  It flowed busily but peacefully into this blessed day.  And I have managed to shift into that other mode, because you just can’t help but emerge into full consciousness at the sacrifice of an animal.  Oh, I remember now what this is all about!  I’m always amazed at how the most powerful spiritual experiences come from pattern interruption.  This Eid reminds me of the ultimate pattern interruption, death, only a breath away.

But as much as I like to ponder symbolism, Eid is no time to daydream.  It’s time to roll up your sleeves and get to work.  Today I felt like we were a pioneer family, all of us working to do our part.  Even the children were eager to help with the skinning, the gutting, etc.  When I saw my five year old chopping liver with a butcher knife I got this feeling like, yeah, maybe we could survive in the wild after all.  These kids are not squeemish.

A beautiful morning that brings the promise of rain.

I know we had some other kids somewhere…I’ll just have to photoshop them in later.

Veggies on the grill, on Eid?  Psych!

The little assembly line I set up for myself: marinating the liver and wrapping it in fat to make kabobs with.  It sounds awful but it’s such a big hit with the kids.  The fat keeps the liver from drying out on the grill.

He leaves the rest of us no excuse, methinks.

Entertainment for the night, a light saber show.  Feeling the force today.

Natural highlights with henna and spices

A few months ago my daughter begged me to put henna in her hair.  Not just henna, but the full works, a mysterious blend of herbs and spices that strengthens hair and leaves it a coppery hue.  Our friend Lalla Khadija is one of those people who knows what to buy and how to use it.  She has her own family henna recipe and helped us purchase the right ingredients from a spice shop down near Jema el Fna.  I love the way that Moroccan women view such indulgences as henna, the hammam, and natural beauty remedies as necessities rather than luxuries.  That’s just how they roll.

This hair henna recipe contains 4 major components: the spice mix shown below, a red mineral called “lakar el fassi”, about half a gram of saffron, and of course freshly ground henna.

Can you spot dried roses, pomegranate peel, cinnamon sticks, lavender and cloves? These ingredients help darken the henna effect and scent the hair.

Boil it in water until, as Karima says, it looks like eyeballs. It smells so good though, edibly good.

This is "lakar el fassi" (translation: lipstick from Fez). I think it's pulling the real weight here, as far as color longevity.

When we added "lakar el fassi" to water it turned bright reddish orange. We also added about half a gram of saffron. See the cool gold flecks from the mineral?

We strained the "eyeball" mixture keeping only the nice burgundy colored water, added "lakar el fassi" and saffron brew, then stirred in the ground henna. It got too messy after this to document...

But what we got is a bright red goo, like clay in texture, that I smeared all over K’s hair.  It took a while, it was messy, we survived.  She kept it in for an hour then rinsed (also messy).  Her hair is normally dark brown, but it turned dark orangey red.  She was kind of shocked in the beginning, but after that wore off she grew into the look.  We’ve all been there, right ladies?  That’s just what we do.

Beware, henna does dry out hair, so if you already have frizz going on it’s not a good match.  It also has a strong smell…the rose petals and lavender help but the henna has a very distinct smell.

Voila. Natural highlights that have lasted for months, much longer than expected.


The Adventures of Aisha, Fahd and Farid in Beirut

Yes, the title begs some explaining.  You see, I have once again hit the trails, the blog-workshop trails that is.  As I call it, seeing the world, one blogging workshop at a time.  This time we are in Beirut, Lebanon.  The city is so vital, chaotic, engaging…and I’m sure I have some very deep and interesting things to say about it…but these are not those things.  This is a fun post for my kids.

Before I left my kids made some paper dolls for me to take to Beirut.  The idea was that I would take pictures of the dolls in different places in the city.  In case you forgot, I have as many kids as there are (distinct) dolls in these pictures.  So three.  The dolls (not my kids) are named Aisha, Fahd and Farid.  They’re part of something called Flat Stanley.  As for my kids, in this post I will refer to them by their nicknames Sousou, Moonboy and Meemers (you know who you are).  Apparently you are not supposed to blog your children’s real names.

For Moonboy who loves music….here is your guy “Farid”, he joined the Wailers band, what instrument should he play?

And Meemers, the girl who may be a great lawyer some day…can you read the sign next to Aisha?

And for the little acrobat monkey Sousou, do you see the monkey shaking hands with Fahd?

How about this monkey, do you know how they made it?  Who else do you see in the glass?

Oh look, now Aisha wants to be a monkey too!  She’s swinging from the trees.

Ok now Farid is being a traffic policeman.  They really need those here in Beirut, the traffic is awful.   I bet you can read the sign in Arabic and English Moonboy.

Sousou, do you remember when we go to the bank and you press all the buttons for me?  Now Fahd is helping me.

They made the signs for this cafe from license plates.  Pretty cool huh.

Kids do you remember Christina?  She’s with me here in Beirut too (she’s a blogger too, remember?).  She wants to give you kids a big hug, but she can’t, so she’ll just have to give the dolls a hug instead.

Aisha, Fahd and Farid are so hungry now. They’re going to eat Lebanese food, mmm, this one is called Koosa Mahshi, it’s like zuchinni with rice and meat inside.  Sahteen!  (that’s how they say besseha here, bon appetit).

Aisha is showing the most beautiful mosque, very different than Moroccan mosques isn’t it?

Thank you kids for making these dolls, they made me think of you often and of all the things I wanted to show you from Beirut.


Mobiles for Morocco, and other projects

Peace and blessings of Ramadan to all readers!

  1. Good and wonderful things are happening…a few people are in fact interested in homeschooling in Marrakesh.  Whaddya know.  When this seed first planted itself into our consciousness, I prayed that God would send the right people and resources if this were meant to be.  And alhamdulillah, things are in fact coming together.
  2. Amanda (blogger Marocmama) is running a wonderful charity campaign called “Mobiles for  Morocco”.  She is collecting mobiles for the babies at a home for abandoned babies here in Marrakesh.  Read more about it at  (she lives in the US by the way).  The babies spend so much time in their cribs, mobiles with interesting shapes and soft music would be very stimulating to them.  Please send Amanda your new or used mobiles, or a cash donation.
  3. The next step in the cooking classes project (cooking classes for poor mothers here in Marrakesh) will be, inshallah, to equip these women’s kitchens!  They are learning how to cook, but what good is that when they don’t even own fridges or ovens (for the most part).  Most do their cooking on little camping style burners and even with such meager equipment, they manage to whip up amazing Moroccans goodies like tajines or fried bread (mesemn).  We are hoping to buy the necessary fridges, ovens, pots, pans and appliances that would push these women into another category of cooking.  For Moroccan women, their kitchen is their pride and their creative outlet, and we want to encourage that.  Eventually they may be able to turn their cooking into a side business, cooking for special occasions in the neighborhood.  If you’d like to contribute to this project, please contact me.  We already have a generous donor from Germany who has gathered 500 euros towards this.  Yay!
  4. In other news, our littlest child is not so little now.  He turned 4 last month!  No more toddlers in the house (but still plenty of crying).  The other day Amin (his older brother) got a cut on his toe, so I gave him a little foot bath to soak it in.  When little Yousef saw that he said “Can I have a bloodbath too?”.  When he got better he said “Ok!  I’m back on my foot”.  He cracks us up, and I am glad his brother and sister are old enough to also appreciate the cute things he says and does.
Here is a photo taken at a recent visit to the home for abandoned babies:



















Ladies cooking:

Birthday boy with the birthday tarte he requested:


My Nikon, my friend

Since these pictures did not find their ways into their own blog post, here they are grouped together.

The Mosque and the Church  (Marrakesh, Morocco)

mosque and church in Marrakesh Morocco

Amin picking out carrots (Marrakesh, Morocco)

Amin buying vegetables

Double Rainbow (Taos, NM, USA)

new mexico rainbow

Filling my eyes with sky (Taos, NM, USA)

cloudy sky in Taos New Mexico

Yousef  filling his cup from the endless source (Imam Jazuli’s tomb, Marrakesh, Morocco)

tomb of imam jazuli

A perfect moment (Ocamora, NM, USA)

yousef in archway


Eid: thoughts, teachings, snapshots

“These are days for eating, drinking and remembering God”.  That is a description of Eid, which we celebrated this past week.  And that sums it up pretty well.

Eid comes as the celebration marking the end of each year’s pilgrimage season.

Some of my favorite things about Eid are…

…thinking about those who have made the pilgrimage, their stories, their light filled faces as they return.  Thinking about the year that my husband made that journey, as I stayed home 7 months pregnant with Karima.  That is a story worth its own blog post.

…Eid prayer, a special communal prayer held outdoors.  Normally we go to the one on the road to Ourika, with tens of thousands of people.  This year we had the good fortune to be out in the countryside, where a gathering of the entire community means a couple hundred people.  As we arrived and settled onto the straw mats, we were greeted by the most peaceful singing “dear Lord, make us among the thankful”.

…the beautiful teachings related to the slaughter of the Eid sheep.  As part of the celebration, it’s traditional to slaughter a sheep (or goat, cow or camel), feeding family, friends and giving away a third to charity .  It’s a very real experience, that puts you face to face with your own meat-eating.  Certainly for me there is a heaviness associated with it.  I’d much rather just grab some meat at the store, but as Barbara Kingsolver put it, you can’t run away on harvest day.  The Islamic teaching is to accompany the animal through the door of death in the best possible way.   That is, to speak softly and soothingly to it, to not show it the knife, to not slaughter it in the same place as another animal so that it won’t smell or see blood, to use a well sharpened knife and to make the slaughter itself as quick as possible, and finally to utter a prayer a the moment of death.  One of two things will happen if you witness or participate in this event, either you will become a vegetarian, or you will come away with more gravitas, a much deeper awareness of the responsibility we have as meat eaters.  Where does our meat come from?  How was the animal raised?  How was it killed?  The answers to these questions are so directly relevant to our own humanity.

…family time, food time.  See pictures below.  What I love about this set of pictures is the light, notice the light.

1-On the way to Eid prayer.  My son and my father.

Walking to Eid prayer, Marrakesh Morocco

2-Planting feathers.  An ambitious endeavor.planting feathers

3-Let the feasting begin.  Moroccan tektouka salad, made with roasted red bell peppers and tomato.
Moroccan tektouka salad

4-My plate.  Spinach artichoke dip, the famous liver brochettes of the first day (meat needs to wait till day 2 to taste better), guacamole, broccoli (a treat in Morocco, trust me on this), and tektouka.  I didn’t actually eat the liver brochettes, sorry, not a fan.  But my kids love them, and broccoli too, contrary to the common kid stereotypes.  Moroccan food on Eid

5-This is my identity expressed via the medium of cookies.  One one hand, the all American fave, chocolate chip (chip here is singular).  On the other hand, Moroccan “slipper” cookies (shaped like a belgha), which are, incidentally, filled with peanut butter.  I had an “I am baker, hear me roar” moment when I baked these and they actually came out looking and tasting as good as store bought.  I always thought Moroccan cookies were well beyond my scope.  chocolate chip cookies and Moroccan slipper cookies

6-Last food pic I promise.  Indian carrot pudding (much, much more heavenly than the name connotes).  And Moroccan tea.

gujarella and Moroccan mint tea

7-My daughter is wearing a dress that my sister, and later I, both wore as girls.  I think it was used to begin with.


8-Just the light.  It almost made me cry, all day, it made the simplest things so beautiful.

Olive orchard, Ourika valley, Morocco

9-That night we stayed in one of the few houses in the area still without electricity.  Candle light is also so peaceful and lovely.candle in moroccan lamp

A tooth puller, literally!

I had a wisdom tooth out yesterday.

Here are the stages of mental preparation I went through.

1-Realization: when I connected all the dots and realized that the intense migraines I had been having the last few weeks were caused by wisdom teeth that looked like this:

2-Denial: the dentist set the date for the surgery, but I still didn’t fully internalize what was going to happen.  Denial is bliss!

3-Sheer terror: I decided to learn a little more about the procedure.  A certain youtube video showed me a little more than I needed to know.  After a few seconds of watching it, I was in shock, tears rolling down my eyes, and scared out of my mind.  So much cutting with the scalpel, the SCALPEL!  In my mouth!  I am not prone to swearing, but in this case, it was appropriate.

4-Getting my zen back together: as the day and the hour drew near, I needed to build my mental fortress.  I explored all the things I was afraid of: being cut, possible long lasting nerve damage, the trauma of a medical procedure to the body, those first few seconds in the chair as the dentist is laying out all manners of needles, knives and drills…I needed to go through each of these things in my mind, fully accepting each fear, accepting the reality of what I was going to go through.  Only then could I get to the stage of mental fortitude that I knew I needed.

5-Focus: as the hour drew near, I settled into a deeper level of being.  More quiet, more serene.  Ready for battle.

6-Surrender, and patience: in the chair, all I had to do was open my mouth and surrender.  I focused on breathing and relaxing.  After all, I have given birth to a few babies, and that required a bit more courage than dental surgery.

45 minutes of work by two amazing Moroccan dentists.  They did an awesome job.  I felt more sorry for them than for me, they had the really tough job.  I managed to open my eyes after a while and watch what they were doing.  But thankfully I couldn’t see into my own mouth.

The best part of all is that I was able to come home to an empty house, the kids were over at my mom’s.  If that’s what it takes for me to get some alone time, then so be it!  I have not been home alone for a day in years!  Well, maybe a day here and there.  Hubby is also planning to take the kids to the beach this weekend, so I can rest some more.  Thank you honey!

Now I just need to rest, which is always the part I am worst at.  The pain is manageable.  I can’t open my mouth or chew much.  There are stitches in there!  The medication helps.   It’s a strange irony that now that I have some actual TIME to blog, I am kind of loopy and so this will not be my best writing.  However, I am well versed in the art of compromise, so please indulge me in my medicated mediocrity!