Saturday, August 13, 2011

Less Sick!

Even before leaving the Netherlands to visit family, my mother ambushed me with the suggestion I go to a naturopath while in Seattle. I complied, picked one that had cardiovascular experience from the clinic she and my aunt go to, and we made the appointment for a few days after my arrival.

That went surprisingly well. Apparently naturopaths are the "real" doctors to go to if you have a complicated problem that isn't easily compartmentalized into one of the traditional medical specializations. It sounds like the underlying concept of naturopathy is to look at the body as a single system (albeit with complex interactions), and to treat underlying causes/conditions instead of throwing a handful of pills at it. As such, treatment with supplements, vitamins, life style change, etc, is generally preferred, though there's no ideological opposition to treating with prescription drugs.

So my new doctor spent an hour and a half in the appointment (nice change from the 10 minute standard appointment in the Netherlands or the US with regular doctors), finding out about my symptoms, onset, current concerns, etc. Then he suggested we look at adrenal function and neurotransmitter function, as these are what ultimately control cardiovascular/circulatory issues. So I did a urine test and a 24 spit test at home and sent the samples off to the lab.

A couple weeks later he got the results, and I came in to find out what they are and what comes next. My noradrenaline (aka norepinephrine) was low, and glutamate and glycine were high. My cortisol starts out too low, then levels out, and ends too high, instead of having a nice high-to-low curve over the course of the day. My dopamine and serotonin are somehow managing to stay in range, though the other out-of-range substances should be throwing them out of whack a bit. But I'm quite glad those two are normal, as they can result in anxiety or depression otherwise.

My naturopath's suggested course of action is to try to raise my inhibitory neurotransmitters to try to bring them into balance with my high glycine and glutamate levels, then bring everything down to a normal level together. This two-step approach is supposed to avoid problems caused by imbalances that might result with a one-step approach (ie, bringing down the glycine and glutamate directly). He prescribed a couple house-blend supplements from their office.

Well, so far they're working quite well. Prior to starting on them I was semi-housebound. I could go out a few times a week, but only if very little walking and standing around was involved. Now it feels like walking a few blocks is no big deal at all. I'm still not running around in circles, but I can amble a bit. My heartbeat is feeling a lot steadier too ... no more palpitations if I lean forward a while when using my laptop, etc. And stairs aren't wiping me out anymore!

But I'm still not back to normal. Basically we're treating one of the highly disabling symptoms of M.E. rather than the underlying cause. But that's the best that can be done when the underlying cause isn't certain, and there's no known cure for it. I think my functioning on the Bell Disability Scale (designed for M.E.) has gone from 40% at the start, down to 25%, up to 40% with higher dose B12, to 50-55% now with the new supplements.

It's made a huge difference with regard to mental alertness and processing especially. I can do witty verbal repartee again! Maybe I can go back to Dutch classes or work part time, if this keeps up :-)

Oh, another development regarding M.E. ... I'm not calling it CFS (Chronic Fatigue Syndrome) anymore. A large group of M.E. (myalgic encephalomyelitis) experts got together and agreed on a new definition, that clarifies a decent earlier one, but is adamant about calling it plain M.E. Anyhow, I fit the definition perfectly, so I'm sticking with M.E.! Though it's a little awkward for patients in the US, where a diagnosis of M.E. officially doesn't exist.

The new International Consensus Criteria:
1) Require that you have PENE (post-exertional neuroimmune exhaustion - replacing an optional post-exertional malaise), meaning your body and brain become very dysfunctional after relatively minor exertion, sometimes resulting in days of being pretty sick. It has to reduce functionality by at least 50%. It's Severe M.E. if mostly bedbound, Moderate if mostly housebound, and otherwise it's Mild. Without supplements, I'm Moderate, with Severe looming rather close by.
2) Require 3 neurological symptom, out of: memory/processing problems, brain pain/muscle pain, sleep problems, sensory/motor problems. For me that includes difficulty processing input, memory problems, headache (relieved by fish oil of all things), muscle pain (relieved by B12 and doing less), waking up a lot because the shoulder I sleep on hurts, and muscle twitching. Sensory dysfunction is pretty infrequent for me.
3) Require 3 symptoms out of: chronic or exercise triggered flu-like symptoms, frequent and prolonged viral infections, GI problems, urinary problems, and food/medication/odor/chemical sensitivities.
4) Requires a cardiovascular, respiratory, body temp, or temp intolerance symptom. For me that includes light-headedness, orthostatic intolerance, neurally mediated hypotension, palpitations, low body temp, feeling feverish, and ice cold feet.

Wednesday, July 13, 2011

Still Sick :-P

So nothing much has changed health wise since the last post. Still waiting for an appointment at Lelystad, and my huisarts still thinks CFS is a psychological disease. Bleh :-P

I had an appointment with my inburgering coordinator recently, and she'd heard about me having ME/CFS from the volunteer work coordinator, and seemed to know what it is and how badly it messes people up. We even had the meeting in the big room on the ground floor instead of trekking up the very steep stairs to one of the little rooms :-)

She told me about classes in Amersfoort, since traveling to Utrecht and back is way too much for me now. They looked alright, but I think traveling to classes at all right now is mostly pointless. Even taking one bus to volunteer work leaves me exhausted, and I literally do pretty much nothing for half an hour after arriving, except chatting and drinking water. I don't think I have the mental focus and processing speed after traveling that I'd need to process much of anything.

So I told her this, and asked about classes or tutoring online, but that's not an option with NWA. Though I think some other agencies in other cities might allow it. Not sure. But she is going to look into finding someone with some experience in teaching Dutch to the NT2-II level, which would be totally awesome if it happens. If not, it might just be someone coming by to help me practice my Dutch chatting.

Anyway, last month was very bad from a CFS standpoint. I've discovered one of the more lovely aspects of it, thought to be the primary contributor to the "fatigue" aspect. Basically varied circulation problems, causing blood pressure, pulse pressure, and heart rate irregularities, resulting in light-headedness. I went back to a much higher dose of B12, and it seems to be helping somewhat. Just needing to lay down once a day instead of every hour or two now :-)

I'm making good progress reading the first Dresden File in Dutch, still picking up a lot of words I think. I also want to start working on learning the word list for 5 year olds, to get my vocabulary into better shape. Very basic stuff that I just haven't come across before.

Wednesday, June 15, 2011

Neighbors!

We have new neighbors, though they haven't moved in yet. They're doing the traditional Dutch new-house remodel first. It's a young couple moving in, maybe 5 or so years younger than me and Jan.

They put a new fence two weeks ago, under the direction of one of their father's, which is great since the old one was ready to collapse into a pile of soggy dust. Jan and his dad helped with taking down the old one and getting the support structure installed. It's nice having a real fence instead of a pre-fabricated thing from a hardware store that people usually put in.

Their other neighbors are less pleased at the prospect of a new fence. They refused to cooperate at all, so the new neighbors pulled off all the planks in their own side of the fence, and put in new posts right next to the old ones, then attached new planks. It must look extremely stupid from the other neighbor's side, having half the planks gone with a solid layer of planks right behind it. :-P

Jan chatted with the uncooperative neighbors a couple days ago when dropping off their package. They got back after the three day weekend to see the new fence looming there. Now they're complaining that the fence is too high - well, it is a bit, but they'd long ago built up part of the old fence to include an overhead trellis, which is actually higher along the fence line that the fence itself :-P They're probably just annoyed because their backyard with an extra shed is now even more claustrophobic with the previously very low part of the fence no longer being very low.

I stayed inside for most of the festivities, since I burn like crazy and it was a hot sunny day. Me and Jan's mom chatted a lot, which is getting easier as my Dutch improves. Jan thinks my Dutch is about as good as his Mom's English now :-) But while talking about the fence (a privacy fence with your neighbors is a "schutting", and "hek" is only used for pasture-type barrier fences), I had a light-bulb moment where I finally realized the difference between the "g" and "ch" sounds"

Both sounds are guttural, being produced in the throat. My 'g' sound has always been very good, but my ch sound not so much. Well, while discussing the "schutting" it clicked with me that the "ch" is produced lower in the throat, while the "g" is made near the top. They still sound exactly the same to me, but at least it'll be easier for other people to understand me :-P

Oh, and I STILL got sunburned, even though I didn't stay in the sun long. Bah!

Things are slowly progressing, healthwise. The supplements I mentioned in my last post have been helping a lot. I've gone from about 25% of normal functioning to 40% or so. No more constant pain, though I still have to be very careful with how much I do. I tried 15-20 minutes of weeding on Sunday and crashed. I hadn't fully recovered by work on Tuesday, and a doctor appointment to walk to the same day, so crashed yesterday too. Blech.

Well, getting sort-of-diagnosed by the internist I was sent back to my huisarts to coordinate my further care. Unfortunately, there is a clinic in the Netherlands that defines CFS as a psychological condition (hey, how else can they justify using the "treatment" they developed), and that was the information my huisarts got when she went looking for it. She started describing the CFS treatment at the Nijmegen CFS center, starting with pacing. I responded that I think I'm already doing a good job of balancing resting and activity within my current limits.

She then went on to describe CBT (cognitive behavioral therapy), though without saying the name. Well, I'd known what I have for over a month at that point, and knew that CBT is a treatment based upon a theory by some British psychologists that CFS is the result of faulty cognitive processes and inappropriate behavior. Basically they say that people with CFS are NOT physically ill, but may have been in the past. Due to that past illness CFS patients have developed the incorrect belief that exercise will make them ill. So to cure us, we just need to close our eyes and believe REALLY HARD that we aren't still sick.

...

Well, I informed her that my cognition and behavior are just fine, all things considered, and that CFS has many physical signs that can be observed by doctors in bloodwork and such. I asked if she'd heard of the CFS clinic in Lelystad, and she hadn't. I said I'd be more interested in going there, since they treat CFS as a physical disease. She asked me to look at the Nijmegen center's website, and offered to write me a referral to Lelystad or Nijmegen if I wanted it.

So I went back for that referral yesterday, to Lelystad, of course. After hearing about Nijmegen, I did a lot of research into it online, and it is indeed quite bad. They assert CFS has no physical component, yet their own research study say that their counseling only improved feelings of fatigue, with no resulting increase in physical activity. Yet they keep touting CBT as -the- treatment for CFS. At least in the Netherlands I already know that they must be smoking too much of :-P

I'd hoped my doc might do a little more reading in the CFS area, but at my appointment yesterday she still acted as though the problem is "tussen de oren" or "between the ears." The cute Dutch way of saying it's all in your head. She doesn't approve that I don't want to see the psychologists, but doesn't seem to care much either. I confess that I was somewhat tempted to try Nijmegen, just so I could argue with the therapists :-P Must be the lawyer in me.

The CBT bunch annoy me a lot, I must confess. Not only do they marginalize CFS and make proper diagnosis and treatment harder, they just don't make any bloody sense! There's literally thousands of studies documenting physical abnormalities in CFS, and they insist it's all psychological. And some idiots keep listening to them! Conspiracy theories abound on the CFS forums, but I think the simple explanation is that they identify CFS in a way that is central to their careers, and are better at getting the ears of policy-makers. It must sound nice to a politician to hear that millions of whatever currency can be saved if you label these people as malingerers that just need to exercise more and stop giving them any sort of benefits.

Sorry for the rant :-P I signed up with the Lelystad clinic online yesterday, and spent about three hours filling out a questionnaire regarding symptoms, medical history, and the SF-36. It took about three hours, but I had to copy and past to Google Translate. Then I got an automated response with a brochure, and another email this morning asking me to fill out the online journal for a baseline. Really just selecting 1-10 for various symptoms each day.

I did more research on them, finally wading into a Dutch CFS form to see what patient experiences were. It looks good over all, though they're not as thorough in testing as the Amsterdam clinic. I decided to try Lelystad first anyhow, since Amsterdam has a months' long waiting list. But at least it should result in a firm diagnosis, and referrals to deal with any problems generally resulting from CFS, such as digestive problems. Hopefully I can get a prescription for the supplements that have been working so well so far, and get costs reimbursed by my insurer.

So I'm still not doing much regarding inburgering, aside from 3 hours of volunteer work per week and learning a lot of medical Dutch words. I've been making steady progress on reading the Dutch translation of the first Dresden Files novel, and am understanding stuff pretty well again. Picking up words is SO much easier when I can process thoughts quickly!

Sunday, May 22, 2011

Off Topic?

It feels a bit weird blogging about my health so much instead of my adjustment to life in the Netherlands ... but dealing with my health is pretty much all I'm doing now. I haven't been able to do much studying, due to it being pretty impossible to concentrate much and process information. Even typing tends to get painful after a few paragraphs.

Our garden is doing great. Jan's been watering it as needed, though we finally started getting some decent rain over the past week or so. He's done enough watering that he doesn't want to do more of it, and we're looking into hiring someone to install a faucet outside. It's one of those things I take for granted back in the US, since houses always have them! After that's installed I can put in a low-pressure sprinkler system with a timer, so the garden can stay alive when we're out of town.

Another thing I took for granted in the US - window screens! I've read cases where tenants took their landlords to court for not providing them, whereas here most people don't have them at all. We bought two yesterday for our bedroom upstairs, and Jan installed them from outside on a ladder while I passed him tools through the window. Screens are different here as well. They don't really have normal pre-made ones at the stores. Either kits to make your own to fit, or rollable screens you have to adjust and install yourself. We got the rollable ones, which required a little sawing to get the right height, and some drilling while up on the ladder. I can see why the rollable ones are so popular, despite the extra work ... they can be rolled up when not in use, removing them as an obstruction from the view, then pulled down and locked in place when the windows are open.

We made our first Ikea trip in months yesterday too. We broke a glass, and another one was crusty and smelled like Jan-shampoo, so we through out those two and got 12 more. I also wanted a thick mattress pad, since I can only sleep on my sides, and that's been very painful lately due to the Chronic Fatigue Syndrome. So I got a nice foam pad, which is helping a lot. I tend not to like the bed TOO soft cause it tends to make my back a bit sore, but the CFS pain has made it hard to sleep well, since I keep waking up with things hurting and having trouble falling asleep again.

One bit of good news is that my mega-doses of B12 and carnitine arrived yesterday, and seem to be making a huge difference already. I was very active yesterday, yet had minimal pains once I started taking the supplements, and NO crashing. For reference, I crashed a bit both Monday and Tuesday after working 3 hours sitting in an office, followed by several days of feeling like I had a nasty flu. But I did fine yesterday with no naps, lots of standing around, trips to 2 hardware stores and Ikea, and going up and down the stairs 7 or 8 times. Usually one trip up the stairs causes pain, and two causes muscle twitching. So I'm very hopeful that I can get functional enough to get out and start doing (Dutch) stuff again!

We have new neighbors moving in, and actually ran into them at the hardware store. They're younger than us ... mid to late 20s? They seem very nice and cheerful though. They were doing the painting thing, and probably aren't living there yet. The other neighbors had a marriage announcement party yesterday, which is apparently pretty typical here. Marriage seems a lot rarer here than in the US, at least before living together for many years.

Enough typing, arms hurt :-P

Tuesday, May 10, 2011

Health Update

I didn't notice til today that it's almost a full month since my first appointment with the internist. Well, the doctor confirmed today that I have Chronic Fatigue Syndrome (CFS), though if I'm lucky it might not be too chronic. Apparently there's decent hope for recovery when people have had it less than a few years.

Again the visit was very short, but he got straight to the point and told us that next he'd inform my GP (huisarts) of the diagnosis, and she would coordinate my future treatment. He mentioned physiotherapy I think (in Dutch), which looks like it focuses on managing symptoms and preventing deterioration instead of trying to "cure" CFS.

I did my volunteer work yesterday after a three week vacation due to Easter Day 2 and the boss going on vacation. I was able to handle it alright, but had to do too much walking to get there and back. The good bus stop is still closed, and now a couple blocks around the building are fenced off, and I had to walk even more to get around it. I woke up twice last night, first with a leg cramp and then with a shoulder cramp. I didn't even know shoulders could cramp, much less while sleeping :-P

I've been too wiped out to go to the library, so I've been looting my fiance's collection of Dutch books. I started reading his old Garfield books, which use Dutch in a more informal and conversational way. They're still fun :-)

Friday, April 29, 2011

More Books

I've had a lot of free time lately and 0 energy for doing anything physical. So I've been reading when I get bored doing other silly stuff and have the mental focus to handle it!

DE SHUILKELDER by Tomas Ross (44 pages)
This is mostly in the present tense, but has a few pages in the past tense. The past tense words are the simpler verbs though, so it's quite readable even if you only know a little about past tenses. The title literally means "The Shelter Celler", but I guess we'd say "The Bombshelter". This is a short story, not a novel (and doesn't try to be a novel or feel like a shortened novel).

It felt like I was reading a Stephen King short story, which I think is a good thing :-P It had a similar dark and twisted aspect, and seemed very well-written, despite the linguistic constraints. This story left me wanting to read more by Thomas Ross.

DETECTIVE ORHAN EN HET VERMISTE MEISJE by Sadik Yemni (108 pages)
It means "Detective Orhan and the Missing Girl". Another great read. I lucked out, getting two in a row! This one is more of a novel, and all in present tense, aside from characters talking about the past. I understood almost everything while reading it at B1 level.

The author is a Turkish born Dutchman. Almost all of the main characters are Turkish, but the chicks aren't stupid passive foreigners. It was refreshing after some of the books I read earlier :-P I think it was also interesting in that it briefly addressed cultural issues of non-Western immigrants and their Dutch-born children. And that basically they're just Dutch people that happen to have foreign grandparents and cousins.

The plot was good and interesting. Some parts were a bit unrealistic, like the detective running around with guns all the time and shooting up neighborhoods (and bad guys) without being noticed or caught. But overall a solid murder/disappearance mystery with a plausible yet non-obvious ending.

Wednesday, April 20, 2011

Book Review!

I love reading, and have found it to be a useful way to get accustomed to Dutch grammar, and even to pick up a few new words. But you can't just pick up any Dutch novel, grab a dictionary, and go for it. Believe me, I tried it :-P

"Normal" books often have abstract and colorful phrases. Even if your dictionary has all of the relevant words, you'll still have no idea what the hell the author just said. Another problem is that dictionaries don't conjugate verbs. Even electronic ones, unless you want to shell out 500 euros or so. And even then maybe not :-P

One solution is to read books designed for very young children. But those can be a bit boring, even if they do have pretty pictures, not too mention that they're rather short. The other solution is books written or adapted specifically for people that can only read simple texts.

In Amersfoort, the main library branch (Zonnehof), and a smaller one (Kruiskamp), both have "NL Punt" sections with books we can handle! The main branches at Hilversum and Utrecht have similar sections, though called differently. If you need help finding the section, ask a librarian. Not only do they usually speak fluent English, they tend to be very good at understanding (and speaking in) simple Dutch.

NL Punt includes translation dictionaries, text books for learning Dutch, useful guides telling foreigners how to bath themselves and clean their homes, and novels. Most of the novels at the Kruiskamp branch are targeted at teenage girls, but Zonnehof has a much better selection of novels for adults. The NL punt at Zonnehof is up on the 2nd storey (3rd floor for us Americans) with the childrens' books. After coming up the central stairs, take a left into a little alcove.

Once you find the section, picking a book is pretty easy. Find one with a cover that doesn't look like it's targeting teenage girls, flip it open, and see if you can understand it. Some books (A-level) will only use the present tense, which is great if you haven't learned much conjugating yet. Most of the novels won't use a normal paragraph format, and will only use short sentences.

HITTEGOLF by Rene Appel (61 pages)
The title means "Heatwave" and it's an adaption of a popular novel written by a Dutch author. It's a crime thriller written in the present tense. It's the first book I read, and I got it when I was at about A1 level. I didn't use a dictionary even though there were a lot of words I didn't understand. I was still able to follow what was happening pretty well.

I liked this novel a lot - I'm looking forward to reading the original one of these days! The author managed to make the present tense sexy and intense, instead of weird and awkward. It's a somewhat typical murder mystery, but the protagonist is the primary suspect. It was a little annoying that he was in a bit of a stupor for most of the book.

KIND VERMIST by Sylvia Vanden Heede (175 pages)
The title means "Missing Child". And don't be scared off by 175 pages - there are very few sentences per page. I think these books may also be used for dyslexics or similar, which might explain the odd formatting. This one is also a crime novel - trying to find out whodunnit, with a protagonist that is a suspect. It's written at about the same level as Hittegolf, so understandable at A1 level, if you're not bothered about understanding every word.

But I didn't like this one much. It was the first (but not the last) Dutch Book For Stupid Passive Foreign Women I read, and after Hittegolf it was a huge disappointment. The author didn't make the present tense work very well, so it came across as weird and awkward. And the main character is a woman that is not intelligent and very passive. She doesn't do stuff - stuff happens and she cries and things miraculously work out at the end. This book's saving grace was an interesting plot with a twist at the end.

NACHT by Anton van der Kolk (110 pages)
This one is actually a normal book but written for younger high school students in the easier track. It uses the past tense, and has normal paragraphs, but it was surprisingly easy to follow. I read this at about the A2 level.

It tells the story of a teenage girl trying to explore her grandfather's past during WWII. Aside from that, the primary theme is family relationships and dealing with growing old. And, for fun, a little side jaunt into incest with a cousin! I'm not sure where that came from, but I think it detracted from an otherwise interesting book. It also provides some historical context for WWII in the Amersfoort area, and the concentration camp on the outskirts of town.

TWEESTRIJD by Rene Appel (123 pages)
The title means "Two-Player Game", more or less. Another adaption of a normal novel, but I didn't like it nearly as much. Again, I (think) it was present tense, and it worked well. It was pretty readible at A1 level. But it suffered from having a useless female protagonist that I wanted to stab in the face before anyone else could.

It's another crime/relationship thriller, and the redeeming feature is that there are competent female characters - just not the main character :-P The basic plot: Nice Stupid Girl meets Bad Stupid Boy, things go wrong, Stupid Girl is helpless, Stupid Girl is miraculously rescued. A huge disappointment after Hittegolf.

KOMT EEN VROUW BIJ DE DOKTER by Kluun (168 pages)
Definitely a chick book. Uses the past tense, was pretty readable at A2.5. This is a pretty famous book, and has had a movie made. Primarily I'd class it as an emotional read, with a lot of medical and sex vocabulary.

Basically a scum-sucking philanderer (the author) finds out his wife has cancer, and keeps screwing everything in sight. But apparently this is sorta okay because he really loves his wife. You might enjoy this book if you like watching train wrecks and their emotional aftermath. I don't :-P

DE VOORLEZER by Bernhard Schlink (87 pages)
The title literally means "The For-Reader", which we don't really have a word for in English. It's someone that reads a book aloud for someone eles. It's an adaption of a very famous German novel by the same name. In fact, I'd seen the movie a year or two ago, and enjoyed it. I was a bit past A2 level when I read it, and it was an easy read, although it uses past tense.

The protagonist starts as a 15 year old boy having a somewhat complicated affair with a much older woman. Years later, in law school, his law school class is observing a trial for WWII war criminals, and she is one of the defendants. During the course of the trial, the protagonist comes to understand his former lover's previously inexplicable behavior. I liked this one a lot.

Thursday, April 14, 2011

Doctor Visit and Studying

The doctor visit yesterday went fine. They tried to call to see if I could come in a bit earlier, but I was already napping :-P I barely woke up before Jan came to pick me up, and going out was a major effort.

At least getting to the hospital was easier this time, even though the GPS kept trying to mislead us. There were probably some two-way one-lane roads she wanted to explore. Finding our way around the hospital was slightly confusing. There's letters indicating which area you should go to, like "P" but on signs they like to add a little "s" or something after them just for fun. Fortunately P is P, even when it says "Ps".

First we went to the internal medicine area in the basement, and the doctor was very friendly and started speaking English right away. I was surprised by how big his office was. Very spacious, with a separate little room for getting naked and lying down. Ooer. He hadn't received the electronic records from my neighborhood doc. Apparently something isn't working right with the technology. So I recapped: "My doctor say she has no idea what the problem is. Possibly Lyme disease?" He already had the lab results at least, and affirmed that they rule out a lot of serious problems. He ordered a chest x-ray since I have been coughing a little bit, urine screening, and blood tests. It sounded like he's mostly looking for viruses, though the urine test was for everything. And testing for Lyme disease :-P All of the x-raying, peeing, and blood drawing was done very quickly, and by even more friendly english speaking personnel. I even managed to tinkle on demand without making a mess! I got skillz.

The whole visit took about an hour, with short waits for the blood drawing and x-ray. The doctor will call next friday with results, or sooner if there's something scary going on. In fact, he got a call from the lab people while we were seeing him, and quickly made a call to a patient that had some bad test results, to let her know she needed to come to the hospital immediately. My next appointment is May 10 - the internal specialists do seem too busy. I'm not sure if that's from a funding problem at the hospital or simply too few internests in the country. But I'm confident that I'm not going to die while waiting to get diagnosed at least.

Now that I have a better time frame for my medical problems, I'm quite certain I won't be starting the refresher course at James Boswell Instituut. So I made a list of things I most need to improve, and brainstormed ways to work on those.

For vocabulary I can read "actively" - taking the time to completely understand everything. I haven't been able to do that much over the past 5 or 6 weeks due to being sick. But hopefully I can concentrate more if I avoid any tiresome physical activities. There's also free online lessons using the Delft Method, which is supposed to be quite good for vocabulary though less so for grammar. And apparently it's boring :-P I can also try to do more writing for fun - like a Dutch journal or something. Then I'm looking up the words I use frequently, and immediately using them, which should reinforce my memorization of them. Of course, this requires someone (Jan!) to correct my mistakes :-) And there's always English TV programs with Dutch subtitles.

For speaking I primarily need to practice with Jan. Again, inability to focus has prevented that, but might be clearing up soon. I could also try reading aloud to myself - then I get used to grammar structure maybe? Dunno how useful that is. I got started again on livemocha.com this morning. They actually have some Dutch lessons now, though they're a bit too basic to be useful for me. But they do let people submit spoken texts, primarily for pronunciation feedback.

My listening could use improvement too. I can go to the websites associated with my textbooks for a lot of that, as well as using the CDs and DVDs. And of course, there's Dutch TV. I could also try books on tape (well, CD) from the local libraries.

And although my grammar is passable when I have enough time to write it and check it over, I want to keep that going well too. Writing a journal, etc is good for that, as well as livemocha and reading books. I also need to work on my past tense verbs, which I can do with my "201 Dutch Verbs" book.

And if being sick looks like a long term thing after the tests are done, I'll go on to the B2 course book.

It feels good to have a plan at least. And after spending most of the day tracking down information and using livemocha, I don't feel too exhausted yet. Maybe tomorrow I won't feel exhausted at all! Maybe I can study! And learn! And grossly overuse exclamation marks!!!!!!

Tuesday, April 12, 2011

Gezakt

"Gezakt" means "failed" if you're wondering :-P My class had our final exam for progressing to B2 classes on Thursday and Friday. Monday we received emails saying if we had passed or failed. I passed the writing test and failed the spoken test. Only 25% of the class passed, which seems a bit ... off. It wasn't like in A level where a few students were slacking, one didn't know how to study very well, and another had pronunciation problems. Everyone in B1 was studying a lot, and I was probably the closest thing we had to a slacker in class, since I missed a third of the classes due to being sick. From what I heard, most people that failed the class had also failed the written test, so grammar was the main problem.

Our teacher spoke briefly about problems with the course itself on a couple occasions. Apparently the average pass rate for B1 intensive classes at James Boswell Institute is under 20%. So our class was actually above average! Her opinion is that we're too rushed in A level and the grammar doesn't really have the time to sink in, though just enough for a lot of us to barely pass A. Then we're in B1 and need to progress to a certain level, but just don't have enough time to do it, even if we're doing everything we need to be doing. The biggest indicator of who passed and who didn't was how well they were doing prior to starting to B1, which was generally based on how much Dutch they know prior to starting A level.

If I'd paid for the class with my own money, I'd be a bit ticked off to know that my odds of passing were less than 1 in 5, regardless of how much and how efficiently I studied. One student mentioned today that failing was unexpected, and a bunch of us agreed ... we'd been doing the right things and making fast progress. But it simply wasn't possible to make fast enough progress. The teacher told us she focused on giving encouragement during the course because students usually give up if told they aren't doing as well as they need to be, such as one in our class who was having very basic speaking problems and stopped going to class when the teacher spoke with him about it.

Hopefully JBI will re-evaluate the course and make some changes. If B1 or A need to be longer, then they need to do it. Or label the class to make it clear that it's only going to work for people that have been in the Netherlands for a while and already picked up a lot of the vocabulary and basic grammar.

Well, I was upset at first, and cried - mostly from frustration at being sick so friggin much. After thinking about (justifying?) it a bit, I reached the conclusion that I don't want to start B2 next week anyhow. I can barely make it to classes as it is, and suffer through them with physical exhaustion, pain, and mental fatigue. I can't understand half of what people are saying and can't actively read in a learning context at all. My brain is just not processing things well. I already have the B2 course book, so my plan for now is to study at home and make Jan grade my homework :-) Hopefully if I'm not exhausting myself just by getting to classes, it'll be possible for me to actually focus and study.

My next doctor appointment is tomorrow, but it'll probably take at least a couple weeks just for a diagnosis. And then it might take much longer to treat the problem. There's a review class all the other failing students can take (400 euros, 15 lessons over 5 weeks), but it's only two weeks til that starts, and I probably won't be physically ready for it. The blood tests came back normal. Even my cholesterol and triglycerides had improved from a year or two ago :-P So no electrolyte imbalance, no anemia, no diabetes. My huisarts (general practitioner) asked if I thought it might be Lyme disease, but I haven't had a rash or been frolicking in the fields with ticks. My primary problem now is muscle weakness, resulting in pain, shakiness, and cramps (in that order) if I overuse them. The appointment tomorrow is with an internist, and I suspect more tests will be following soon.

In better news, I started with volunteer work yesterday. It was pretty enjoyable, though I had to take the bus instead of riding my bike, and the closer bus stop was closed because the street was closed, and I had to walk about a kilometer. Currently that's enough walking to cause me some suffering, even if I do it at a leisurely pace. But I had plenty of time to rest after I got to work, even though I was just barely on time. Everyone spent about half an hour drinking coffee (water for me) and chatting. I participated quite a bit, but they didn't feel awkward about chatting with eachother when I couldn't really keep up, though were happy to explain words I asked about. I processed the incoming mail, which included some reading and writing, checked some numbers against each other, and recorded and printed out the weekly energy usage and such. I was also shown the ins and outs of the copy machine, which is pretty nifty.

It was a slow day, so after doing all that with a lot of random chatting interspersed, they gave me a little magazine discussing housing laws and such to read, which was pretty interesting. I used my elite copy machine skills to make a shrunken copy of the magazine to take home to read some more. They asked how long I'd been here and said I was doing very well with my speaking for being here 7 months. Maybe I should ask them to talk to my teacher :-P

We did more gardening over the weekend prior to the previous one, and got the front area sorted. The ivy was trimmed back, the cement block around it removed, bricks dug up where the roots had burrowed between them, and the roots pulled out or deeply cut. I HATE ivy :-P I got a fuschia, carnation, and white hyacinth to plant in the cement block, and transplanted some purple pansies that were in a plastic pot. Then we got a tall black squarish pot to put in front of the trash area, with a small climbing rose, a colombine, and a little azalea. We also got two smaller pots for the backyard against the gray brick shed wall, one with an camellia and one with a climbing hydrangea.

It's been pretty exhausting but the garden is finally DONE. Everything is growing very well, except the purple basil which really didn't like the sun as much as it was supposed to. It's transplanted to a less sunny area now and looks like it might be recovering. The blueberry bushes look so leafy and healthy, with some new upward growth as well. The roses have lots of leaves starting, and the fuchsias are just gorgeous. The heavily pruned hibiscus tree is looking good too, with lots of little twigs starting to grow from the main branches and trunks. Even the sad little beet I kept stepping on is growing vigorously :-)

We got a little birdhouse to attach to the shed wall. It was the only one we saw that looked like a birdhouse, instead of abstract industrial art :-P We also have a little bird feeder hanging in the hibiscus tree, but the birds are still more interested in the peanuts and seedballs we hung in the tree a week or two earlier. I doubt we'll get birds this year, since most had already started nesting when we put it up, but there's two of the cute little yellow ones in the garden next door that spend a lot of time in our garden, and two really stupid little brown birds that are nesting in a neighbor's roof gutter. When it rained the first time after they started their nest, both were standing right outside the nest and looking at it in a puzzled birdy manner. But they keep adding to the nest there, so ... not very smart birdies!

Tuesday, March 29, 2011

Spring

We set our clocks forward a couple days ago, so I guess it's really Spring now. Over the weekend we finished getting plants for the garden, and Jan is almost done hauling out bricks and rocks. There was a big wooden fan on the shed that he removed as well, since it was extremely rotten. We also got a bird house to attach to the shed, close to the bird feeder in the tree.

This weekend I mostly got shade plants and some flowers for the sunny areas. We also tracked down a 2nd blueberry bush! We tried the nursery in town first, but it sucks and the employees believe that "self-pollinating" blueberry bushes won't benefit at all from having a 2nd variety nearby. Everything I've read online says otherwise, ranging from "my self-pollinating bushes produce no berries" to "they produce about twice as much when cross-pollinating". Maybe the don't have teh intrawebs in Dutch nurseries and believe everything the manufacturer tells them :-/ The new bush we got will only hit about 4 feet, instead of 6 like the other. But both should have blossoms around the same time, and happily cross pollinate.

After getting the new plants in, I dug up the dense patches of tulips, crocuses, and those little purple things and put small clumps of them between the other plants, distributed around the garden. No idea if they'll survive a transplant at this time of year, but it's worth a shot. All that's left to do is taking a look at the front little garden area. It has a small plum tree surrounded by white pebbles, a small slow-growing hedge, and a nasty mound of ivy growing out of something that it completely obscures. I hate ivy :-P

The visit to the doc went well last week. She asked some questions and ordered some blood tests, basically checking for indications of the causes of my exercise intolerance problems. Most neighborhood clinics don't have a lab, so she marked a scantron sheet with the applicable tests to run, and I picked up an envelope from the receptionist on the way out, which had the addresses and hours of the hospitals and other clinics where I could have blood drawn. She suggested I make myself sick prior to getting the blood drawn, so that whatever was happening might be captured in my blood when it was drawn, versus going in when I was feeling fine. Very sensible! Though getting sick again (and an purpose) really sucked.

Jan took a couple hours off work to drive me to the hospital, since I'd have to take two buses each way otherwise. Catching and transferring buses is not good when my body is trying to shut down and insists on taking a nap. So I went to class in the morning, and walked nice and fast to catch the bus afterward, and just barely made it. Jan got home half an hour after I did, and we left for the hospital just as I was starting to feel icky. The main hospital is pretty easy to get to, but parking really sucks. Unless going to the emergency room, you have to park a 5 minute walk away, which wasn't much fun for me. Stairs were involved :-/

We weren't sure how to get to the lab for having blood drawn, so stopped at the reception desk to ask. Which turned out to be a good thing, because the first time someone goes to a hospital, they get a card created that contains all their data. The card itself is pretty similar to a credit card, with raised numbers, but also all the other data in raised type, like my name and my doctor's name, etc. It's all white, including the raised type. When we got to the lab, I gave the scantron from my doc and the white card to the receptionist, and she did something with the card and put the scantron into a little machine, not for scanning but for automatically printing the info from my card onto the scantron. Sweeeeet, formless hospitals!

I only had to wait a minute or two to get blood drawn. Both nurses (the first was newer and intimidated by my reclusive veins), were very nice and happy to chat in English when they realized my Dutch wasn't so hot. Everything was pretty fast and easy, but the biggest surprise was how relaxed and happy all the hospital employees seemed.

I should get results back in a day or two. My doc told me to give her a call then. In the meantime, I made myself sick again over the weekend with too much gardening :-/ Either I wasn't being careful enough, or my threshold of how much exercise I can tolerate is decreasing. Ick.

Tuesday, March 22, 2011

Volunteer Work

So last Monday I had a meeting with the volunteer agency, Ravelijn, that works with the inburgering agency, NVA. It went well and I was very impressed with how organized and focused they are. We talked about my future plans, as they put a lot of emphasis on finding volunteer work that will be useful for either experience useful for getting a real job, or networking for future jobs. But the primary objective is always to be getting practice speaking Dutch. They are very firm on that :-P

From what I could gather, Ravelijn deals largely or only with immigrant female volunteers. As a result, most of the non-profits they deal with regularly have positions for uneducated women, rather than over-educated Americans. But Ravelijn did an awesome job of finding a possible position for me with a organization that offers assistance to low-income renters in dealing with the organization that provides low-income housing in Amersfoort. I love rental law, so it would be great, even if I'm just stuffing envelopes and chatting with the other office workers. I had a meeting yesterday with that organization and Ravelijn, which seemed to go very well. The only concern is that my Dutch might not be good enough for me to be very useful. I'll hear back by Monday.

Over the weekend we did more gardening, clearing out the rest of the bricks and Stupid White Pebbles of Doom. We visited a large nursery in Leusden, which is really close enough to think of it as part of Amersfoort. It's still pretty early in the season, so we didn't find squash or brussel sprouts yet, and only one variety of blueberry bush, so we'll probably make another trip in week or two. Also to get non-edible plants :-) We gave the hibiscus tree a major pruning, which looked like it was about 5 years overdue. Hardy ones should get a hard pruning every year, apparently, to avoid becoming huge messy bushes and make nice big flowers. The top foot or two of the branches were completely entangled with a vine that had snuck in from the neighbor's yard. The plum tree out front also got a mild pruning.

We also finished up the downstairs bathroom this weekend. We painted it last weekend, though I think the color is too light. Jan fears paint any darker than the pastel shades, so we keep ending up with ... pastel shades :-P Anyhow, it looks a lot better with yellow/cream walls (depending on the light source), instead of a white wall over white wall tiles over white floor tiles. We also got up a small mirror, towel hook, and TP holder. The old TP holder was flimsy ugly yellow plastic, and the towel hook was a metal stick poking out of the wall.

Over the past few weeks I've been getting sick a lot, and I finally noticed a pattern. Exercise is making me sick! Basically any aerobic activity results in me getting intense chills and exhaustion 2 hours later, which lasts for about 2 days. I'd been having this problem every day lately after getting home from class, and I kept thinking I had the Neverending Dutch Flu For Immigrants or something. But over the weekends I usually feel better. After class I walk pretty fast for 10 minutes to catch a bus. I push myself hard enough that my breathing accelerates and my calf muscles start burning. Then I get sick. But if I walk slowly (like I did for the A level class, catching a bus that gets me to school 2 hours early), I'm usually fine. Gardening has also been fine, so long as I go slow and steady and don't carry around bags of bricks and such. Cycling to the volunteer work meeting yesterday made me sick again. Even riding slowly takes a lot more effort than a slow walk.

So I called the doctor today and made an appointment for this afternoon. Yeah, still no problems getting in to see a doc with socialized healthcare :-P I hope they can figure out what's going on ... there's quite a few things that can cause exercise intolerance, and some, like electrolyte imbalance and blood pressure problems, can be easily fixed. And if the cause is something not so easy to fix, hopefully I can get a better idea of how to deal with it. Hopefully I can go back to walking fast, because walking slow annoys me to no end.

Sunday, March 13, 2011

Gardening

Spring seems to finally be here. At least, temperatures have been above freezing for about a week, and should stay there for at least another week. Woohoo!

Last weekend we went to the library and got more easy Dutch novels, but I also started reading a "normal" novel in Dutch and have been able to make good progress. We had our speaking midterm a few days ago, and I didn't do very well. No one else did either, really. The teacher attributed that problem to the short amount of time we have at A level Dutch ... we learned the rules, but didn't really have time to get comfortable with applying them. She suggested speaking Dutch at home, and doing volunteer work. I already had an appointment scheduled for the 14th, so that works out well :-P I'm also speaking Dutch at home now (when I remember to and can sufficiently express myself), but Jan has been banned from speaking Dutch since he tends to use a lot of words I don't know yet, and it's too annoying and frustrating. Anyhow, I can understand Dutch sentences pretty well, but just need to get more comfortable using the correct word order. I'm learning enough new vocab as it is :-P

We have the writing midterm on Tuesday, and I think I'll do much better on that.

Jan's parents came to visit yesterday (and get computer help), and helped out a lot in the garden as well. Jan and his dad fixed the wiring in the shed, and took out most of the lights. Apparently it was set up to be a marijuana grow operation at some point, hence 10 lights in a small shed :-P Plus a timer for the electricity! Now we just have two lights, one right by the door and one at the opposite end ... plenty for good illumination.

Jan's mom and I worked in the garden. I got caught up on the weeding and removed some of the bricks from the yard. Basically it had a big patio area and a wide path to the shed and gate, despite being a fairly small yard. And half of the non-bricked area was filled in with little white rocks :-P Basically there were bricks in the most useful spots for growing plants, and dirt where there's partial to full shade from the shade. Brilliant :-P So now the patio is being trimmed around the edges, as well as the path, and the white rocks have been removed to a fully shaded corner around the base of the tree. Jan and I did more garden work today, pulling out more bricks and laying down some fresh soil to fill in the empty bits.

Next week we'll probably get plants. I suck at garden design, so I'm going with a practical use of the space, centered on food bearing plants that are also attractive. Then I'll fill in the spaces around those with decorative plants, tentatively aiming for a cottage garden look. I'm thinking about getting 2-3 highbush blueberries for along the north fence (lots of sun exposure), one or two small squash varieties to grow on trellises, a rosemary bush, and strawberries, brussel sprouts, garlic, and rhubarb. All things we like to eat which should do well here. And I'm pretty sure we'll have good spots for all of it :-)

No more trees since we have so little space and they create a lot of shade. But the blueberry bushes should be tall enough to break the monotony of the fence. Oh, and the house came with a nice little plum tree in the front of the house :-)

Right now there's just remnants of prior owners growing: the big purple hibiscus tree by the shed, and small clumps of tulips, crocuses, and something else that hasn't bloomed yet - probably mini daffodils.

Friday, March 4, 2011

Inburgering Progress

We just finished our third week of B1 level Dutch class. Which means just 5 weeks til B2 starts. Eek! If I look at all we're learning and supposed to be learning, it seems hopelessly overwhelming... but somehow it's sticking pretty well. Just yesterday I got a "heel goed!" on a grammar quiz :-P

The main thing now is sorting out the rules, and picking up as many new words as I can. One nice thing about Dutch is that a lot of words get recycled. One verb might have one of 5 or 6 different prefixes added to it that create a different meaning while still being related to the basic verb. And nouns can be stacked to form new nouns that are longer than the English alphabet. They're scary to look at, but easy if you break them down into their basic parts. Dutch word formation is actually pretty logical. Too bad the grammar is so complicated :-P

I'm still a lot more confident with reading and writing than I am with speaking. Our teacher spoke to the class about it today, and listened to our concerns regarding why we don't speak Dutch much outside the class. Some had problems with Dutchies getting snobby toward their bad grammar and switching to English. I mentioned that it's hard to express myself fully in Dutch. She suggested persistence and finding nice people to talk to (and implied that the mean ones shouldn't aren't worth being upset by), as well as speaking Dutch as much as possible at home, and switching to English for the complicated stuff. I'm scared, but I think I'm ready to give it a try.

She also suggested getting in touch with a volunteer outreach organization, since that usually involves speaking with Dutchies. I've already got an appointment for that, in a week or so. I had a pre-appointment last week with my integration person, and filled out a form. I needed some help with that still, since it wasn't the sort of form we practice with in class :-P Anyhow, she'd printed out a list of different volunteer opportunities, and there were probably around 30 that were fairly diverse. I think the one I'd like best is teaching computer skills to immigrants that don't speak Dutch. It's typically one day per week, which should work fine with my schedule.

A bit of trivia: The Netherlands is the country with the highest percentage of its population contributing money to charity or doing volunteer work ... 77%! Volunteering especially seems far more common than back in the US. Granted, people don't work 50 hours per week here, and part time work is very common for women.

Tuesday, February 15, 2011

Politics

I've been here a bit over 6 months now, and have been noticing a bit of trend. With some elections around the corner and ramped up political grandstanding, some issues have too obnoxious to ignore.

I said in an earlier post that the Netherlands is much more supportive of immigrants, in helping most of them pay for classes to learn the language and the culture. The flip side, of course, being that non-European Union immigrants are required to learn the language and culture.

Despite this (mostly) helpful approach, there are some political parties advocating a less helpful and more punitive approach to immigration in general. The more (in)famous is the PVV, the party of Geert Wilders. The PVV was the third most popular party at the last general elections, and is part of the coalition government currently running the country, along with the two most popular parties. The major platform of the PVV is anti-Islamist - in fact, it was originally formed to oppose Turkey being admitted to the EU, due to being a largely Muslim nation.

Wilders is currently on trial for discrimination and inciting hatred (a crime here) against Muslims, basically for saying that Islam is facsist, Moroccans are violent, and advocating banning the Koran for being comparable to "Mein Kampf". His defense is that his statements should be protected as free speech. In addition to wanting to ban the Koran, he wants to remove the constitutional promise of equality under the law, replacing it with the cultural supremacy of the jewish-christian tradions. Some other gems he's proposed: no non-Western immigration for a while, preaching only allowed in the Dutch language, no new mosques or islamic schools, and special ghettos for "undesirable" people (and their families) to be forced to live in for a while. He thinks the primary focus of Dutch foreign policy should be the eradication of Islam.

The PVV has also come out strongly against non-Western immigration, more recently including Western European members of the EU in that category. He thinks unemployed Eastern European migrants that are legally in the country should be deported if they become unemployed, even though they have been paying unemployment taxes just like everyone else.

Unfortunately, there is a common Dutch perception that even the Dutch-born children of Dutch immigrants with full Dutch citizenship are still "immigrants" and not really Dutch - they are seen as outsiders. This causes some of the more idiotic Dutch to treat the children of immigrants as second-class citizens, something which those children know is wrong, but is still happening and mostly allowed. As a result, these children tend to either 1) rebel and get in trouble or 2) become highly educated and move to a country where they can get a job. Both results kinda suck, according to the politicians always talking about attracting and retaining highly educated immigrants, and the politicians complaining about people whose parents were born elsewhere being a bunch of useless criminals.

One way this discrimination against "outsiders" is expressed is by silly job requirements - frequently a native level of Dutch speaking is listed as a requirement in job listings, even though there are no interactions with customers and fluent Dutch is sufficient.

As an English speaker that hasn't looked for a job yet, I haven't been discriminated against. In fact, strangers assume I'm Dutch until they start talking to me and I ask them if they speak English. But I have an Egyptian friend from class that has co-workers get upset if him and another Arabic speaker use Arabic to explain something work-related that they can't handle in English or Dutch. He was honestly upset about this - his co-workers had hurt his feelings by demanding that he only speak Dutch in their presence at work.

With that sort of thing happening, and all of the political bullshit bouncing around, I can easily understand why even the highly educated migrants want to go elsewhere. Who wants to contribute to a society that constantly tells you that you have less worth than they do?

Wednesday, February 9, 2011

Boodschappen Doen

"Boodschappen doen" is the Dutch equivalent to "running household errands" or "doing household shopping." It's the title of the post because today is the first time I went grocery shopping on my own :-) I suppose I cheated a bit by using the self-checkout option, but it's still a first for me.

I started my next level of Dutch classes yesterday. The book moderately sucks though, and has to be supplemented by 70-ish pages of worksheets. At least B2 goes back to the same format we had for A. There's 15 people in this class, all from different countries. Very diverse! A couple are from Indonesia and Belgium, so they speak enough Dutch to skip the A level. Everyone seems to be at about the same level, except one guy who consistently got inversions wrong.

I have to admit, it's easy to get word order wrong in Dutch, especially if you're accustomed to speaking a language where you can speak while you're still forming the thought. If you try that in Dutch, odds are your "extra" bits (referring to time or place) or verbs and subjects will end up in the wrong order somewhere. But it's also hard to keep track of the whole sentence you want to say, if it's more than 10 words or so. I guess we should focus on shorter, concise sentences when speaking spontaneously :-P

Even though the work is harder, using more grammatical rules in combination with each other, the pace seems slower now than it was for A level Dutch. Not a lot of homework, and we just cover 5-8 pages per day, but the stuff we do cover needs a lot of practice to get it to stick.

The class I'm in now is in the morning, which is much nicer. I can stop at the shops on the way home (like today!) and get stuff done without trying to cram it in during the evening when everything is super crowded. Stores close very early here ... the grocery stores aren't so bad, staying open til 8 usually, but the special food stalls all close at 6pm. With the craptastic traffic, that makes it impossible to shop at the stalls after work. And I like cooking fresh, healthy dinners. It's so much harder to eat right when coming home hungry with no chance to shop and little time to cook. It's also more fun being able to shop every other day, and get really fresh stuff, instead of loading up once or twice a week.

The stalls here are something I'm not used to in the US. Although there are supermarkets with a bit of everything, there's also smaller shops around specializing in a certain type of food: cheese stores, fruit & vegetable stores, fish stores, meat stores, poultry stores, bakers, etc. Although they exist in the US, they're far more common here, and pretty essential if you want anything atypical. The supermarkets tend to have a limited selection of everything, though will have 10-20 different varieties of each popular item. It's annoying :-P

Sunday, January 30, 2011

Dutch Classes

Well, I passed the A level Dutch exam at James Boswell Instituut, and can now continue onto B1. This is a good thing, since I already signed up for B1 and I think the city has already paid my tuition for it :-)

I went into (and out of) the final exam quite confident that I would pass it. I'd gotten the highest score on the written midterm. Then we found out Wednesday that half the class had failed, and I only passed by a few points. It felt like I'd dodged a bullet without even knowing it was there at the time. Sheesh. I think the main thing I learned was to stay within my realm of comfort on the written test. If I'm not sure what preposition to use, I should think of something else to say :-P

It's given me incentive to improve my study habits in B1, realizing how hard the A test was. The B1 test to advance to B2 will be even harder. Class starts in about a week - we only get a 4 day weekend between A ending and B1 starting. But after 2 weeks of class we get a 2 week vacation, which I really do feel like I'm going to need.

3 people who rarely (if ever) did homework failed the exam. One of them missed enough classes to fail on the attendance criteria of attending 80% of classes. But she also failed the exam. 2 more barely failed, which was something of a surprise, since those two had been doing homework and trying hard. It sounds like grammar was their main problem.

Dutch grammar is hard! And we learn most of the rules for it at the A level, which makes it difficult to keep all the rules straight. The dutch love to change word order in various ways depending on whether you're using a main clause, a dependent clause, a question, a modifier at the beginning of the sentence, past tense, future tense, command tense, reporting what someone else said, using a modal verb (can, shall, may, must), etc. It gets confusing. Presumably we get more comfortable with all of that in the B levels.

Tuesday, January 25, 2011

Healthcare

Well, I'd heard all sorts of things about the quality of mandated health coverage. Ranging from "It's just as good as in the US" to "you die while waiting to see a doctor" to "god hates government mandates".

I definitely didn't die while waiting. I signed up Friday morning with the local doctors' office, and was able to make an appointment to come in that afternoon. Both visits I waited about 15 minutes past my appointment time, which is pretty similar to the docs in the US, except they don't automatically have a nurse checking blood pressure and such, followed by another 15 minute wait.

My doctor speaks good english, at least in a medical setting, and seemed to know exactly what to do to check me out for pericarditis (and any lung problems while she was at it). I was given the all clear on that account, and she suggested that intercostal muscle soreness from the flu and a bit of coughing was making it a bit painful for me to breath normally. As a result I was compensating for that by breathing abnormally, and basically hyperventilating a bit, causing the excessive light-headedness. She suggested breathing "lower", which actually helped. Still having the usual asthma crud, but that's manageable.

She checked out my jaw pain a bit and decided it's probably muscular in origin. Told me to come back after the weekend if things haven't improved, or call their emergency line if needed. Well, the jaw pain didn't get better, so I went in for another appointment today. I could have gone in yesterday but would have to miss Dutch class and a final exam, so I opted to wait.

The doctor poked and prodded a bit more, ruling out teeth grinding, etc, and pinpointing the likely misbehaving muscle (the masseter) and prescribed a high dose of ibuprofen (advil) for 10 days, to be taken even if the pain seems to be getting better. And to make another appointment if it's still a problem. So I'm taking a pain killer and waiting for my chewing muscle to heal. And she also told me to avoid very hard foods.

The doctor's office is located on the south end of our neighborhood, and is in a small medical complex building. Downstairs is the doctors' office (4 doctors working each day on average, closed on the weekend), and an apothecary. Dutch apothecaries should not be confused with American drug stores - they only have drugs and medical paraphernalia in apothecaries. Upstairs is a dentist, and some other medical type offices. It looks like registering with a neighborhood doctors' office here requires living in the same neighborhood, unless that's impossible. So most people probably live within walking distance of a general practitioner, which is pretty awesome.

Picking up the drugs was also very easy. My doctor sent the order to the apothecary via computer, and I just walked across the hall and picked it up. It was so WEIRD not getting charged anything for it. I half expected to get tackled by (the non-existent) security personnel as I left, for not paying. Also no line waiting for the drugs, very fast. The employee I spoke to spoke "a bit" of English well enough for everything to go smoothly.

So in my experience, the Dutch health system works quite well for visiting a GP, both in quality and in speed. I've never been impressed with all the whining back home against government mandated healthcare, and I'm even less impressed now after seeing that a big chunk of it works just fine over here.

Thursday, January 20, 2011

Tussentoetsen

I love the way that word sounds :-P It just means midterms, though in the case of our language class it's not used in grading. Just assessment, so we know what to work on. I passed mine with flying colors. Woohoo! Now we have another test today, just one week later. Today is writing, and Monday is speaking. I'm pretty sure it's just another progress test (our schedule is a bit weird because we started later that the other classes), but there's no final test on the schedule anywhere.

I made it to class yesterday, but skipped Thursday, Monday, and Tuesday. Pretty sure I have pericarditis again. Ick. Sometimes when I get a virus, it gets into my joints and pericardium (sac around the heart) and everything gets inflamed. In the joints it mostly just hurts like hell, but in the pericardium it causes extreme physical exhaustion. Like, I get out of breath if I stand up. Seriously. I've stocked up on Aleve and taking a big dose for a week or so, which seems to be helping a bit now - it's supposed to remove excess fluids. But my jaw really hurts on one side and is getting worse, so going to try to go to the doc tomorrow. Need to get signed up with the local clinic first :-P

Just 2 weeks of class left! Can't believe how fast it's gone, and how fast we're learning. Sometimes my head wants to explode, but things seem to be sticking pretty well so far. My book for the next level arrived. I leafed through it, then showed the author names to my fiance: "Are these girl names?" He said they were, and asked me why. Well, the primary color in the book, other than black type, is pink. Ugh :-P It seems like a good book though. No word lists, but it has a compilation of grammar tables in the back, which is something I wish our current book had too.

Thursday, January 13, 2011

Flu :-(

I gots it. I had it yesterday too, but I also had 2 of my midterms yesterday. I went to class anyhow, though it was made more exciting by my first bus arriving 7 minutes late, and my train leaving 2 minutes early. WTF.

I missed the train, but found another one going to central Amersfoort 15 minutes later. From there, I found a 2nd train going directly to central Utrecht. I ended up in a different part of the Utrecht train station, but tracked down the bus area, and managed to catch a bus and get to class only 15 minutes late. Fortunately the speaking exam was first, and we were doing it two people at a time. I arrived when the first pair was still in the class room taking the exam.

I think I did fairly well, given that our topic was "clothes shopping" versus easy stuff other people got like "talk about yourself" and "talk about your family." The writing was a lot easier than the speaking, and I finished with 10 minutes to spare after checking over my answers.

I'm skipping class today, on account of feeling like crap due to flu and the lovely asthma that always comes with it. The flu part isn't too horrible (yet?) but the asthma is pretty bad. I get exhausted from sitting upright for too long :-P Fortunately I have a nice couch to sprawl on while studying.

We went to 2 libraries on Saturday. The first (closer) one had a good selection of non-fiction for inburgerers, but the fiction was all angsty teenage emo crap. We chatted with the librarian, and she told us the more central Zonnehof branch had the biggest selection. So we went there, and that library is huuuge. A ton of novels for adults learning Dutch up on the 2nd floor (3rd floor if you're American). I only went through 1 of the 6 or so bins before finding three novels that looked good and declaring the mission a success.

I started reading the shortest of them, "Hittegolf" (Heatwave) by Rene Appel. It's 60 pages, but is written with nearly every sentence on it's own line (though organized into paragraphs), so would be about 30 pages if written in a normal format. It's based on a best-selling Dutch novel of the same name, but with very simple language and all in the present tense (except when people speak/think about the past). Present tense has the potential to be annoying, but it works very well in a mystery/thriller of few words ... it's actually pretty sexy. I don't understand all the words, but enough to understand what's happening at each point.

Saturday, January 8, 2011

New Year, New Post

New year's eve in our neighborhood reminded my of the night videos from Operation Desert Storm. Like, non-stop lights and explosions and smoke so thick we couldn't see across the street. It lasted at that level for 2 full hours. Some of our neighbors decided to burn the fireworks boxes after using them ... I'm glad there's idiots here too, not just in the US. Fortunately the box that exploded was in an upright position on the fire, and the fireworks went up instead of, say, up the nose of one the idiots.

I started back to newbie Dutch class last week, and it looks like the Russian girl dropped out. She's missed more than 20% of the classes now, so can't pass. I'm still making good progress with my speaking and listening. I went to the library last night with Astrid, and didn't have any problem. The librarian mention she had a British colleague that managed to learn Dutch in 6 months, and both her and Astrid thought I was well on my way to doing the same. Woohoo!

There's a lot of people that stay here for years without learning Dutch (EU still people don't have to until applying for permanent residency), which I just don't understand. Sure, you can speak English at your job and most shops and talk to family and fellow ex-pats, but it seems so limiting. Like you're only living half the life you could be living. I don't get it :-P

So I got signed up with the Utrecht province library system, which just involved showing a photo ID and a random letter from the bank with my name and address on it. And 42.50 euros for an unlimited yearly subscription (and 3.50 for a waterproof satchel with shoulder strap). But that includes up to 10 books borrowed at a time, and free CDs, DVDs, and Blu-ray. I could have gotten it free through the city because I'm inburgering, but it's a small price so I'm not bothered about it.

The library closest to me is less than half a mile away, though it's a smallish one. There's a huge one south of downtown Amerfoort that has a huge selection, including a decent amount of novels for adults learning Dutch. I checked out three this morning. There's a closer library with books for Dutch learners, but all the novels were for children and angst-infested teens. Ugh.

I signed up for B1 lessons at James Boswell Instituut last week, after emailing my inburgering contact to get the info needed to have the NVA billed instead of me. It was easy ... also ordered the textbook. I'm taking the morning class, since I can get a ride with Jan and get there just a bit early, then take the bus and train home quickly afterward. I'll be home in time for an afternoon nap, and making dinner will be waaay easier. I had to get a new OV (public transit) card, since the regular one can't handle off-peak discounting on the trains.

Riding the train sounds pretty easy. I just put my card near a reader when entering the train station or on the platform before boarding, then do the same thing after I get off. Apparently conductors have a card reader to make sure card-using passengers have swiped in, when they walk through to check for tickets. I'm going to give it a try on Monday. A classmate living nearby is be taking the same train at the same time, so it shouldn't be too scary :-P