Teens

“It’s Just a Cold…”

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Adorable child dressed as doctor playing with toy over white

Happy cold and flu season! How many times have you taken your child to the doctor and been told, “It’s just a virus. Rest, push fluids, and they’ll feel better in about 10 days”?

Sadly, it’s true. There are hundreds of different viruses that cause colds, from the most common rhinovirus through the ever-unpleasant adenovirus to the rather pretty coronavirus (it has a crown…).

We can’t fix any of them.

All of them are contagious. All you have to do to catch one is breathe around someone who has one, or touch a surface that someone infectious has recently touched and then rub your nose or eyes. After a 2 or 3 day incubation period you will wake up to a scratchy throat and headache and you too will be infectious (mostly for the first 3 days).

Children catch an average of 8-10 colds during the first two years of their lives; they average 6-8 colds per year during their school years. Since most colds occur from October through March, this means 1-2 colds per month, lasting 10 days each. If it seems like your children are sick all the time, it’s because… they are sick all the time.

Symptoms of a cold include fever, red watery eyes, congestion, cough, tiredness and decreased appetite. Your child’s ears might feel plugged up. Watery nasal discharge can turn thick and green after a day or two (this doesn’t mean they have a sinus infection, it’s just part of what a virus does).

So how do we keep them as healthy as possible? You probably already know the basics:

  • Wash their hands frequently. Keep those hands away from their eyes, nose and mouth! No nail chewing!
  • Cover their mouths when they sneeze or cough. Elbows or facial tissues work.
  • Disinfect surfaces.
  • Look for small daycares and classes whenever possible (I know, but we can dream).
  • Do what you can to boost their young immune systems. Breastfeeding your infant will make me poor–all that wonderful grown-up immunity transferred to your little one. Never smoke in air your child will inhale. Really. Never. It will destroy their immune system. And yours, by the way. Take probiotics like Acidophilus (in yogurt) or Lactobacillis.
  • Make sure they get enough sleep. If they are sleepy during the day, move their bedtimes up. Tired people get sick.
  • Offer them healthy food, and throw out all the unhealthy food so they will have fewer options when they get hungry.
  • Have lots of fluids available, because hydration is necessary for your body’s defenses to work. And no, I don’t mean soda. Water, dilute juice or milk please.

When your children get sick, treat their symptoms so that they will feel better. We have nothing that cures colds–antibiotics do not kill viruses. Salt water (saline) nose sprays are safe. Tylenol or ibuprofen will help with fever and pain. Over the counter cold meds will suppress some of the symptoms in children over 6 years of age, although they’ve never been proven to work for younger kids.

Call your doctor if the fever lasts more than three days, if your child is lethargic or unusually cranky, or if they have an earache or breathing problems.

Make them rest and drink fluids, and they’ll feel better in about 10 days.

Domesticated Momster

Back to School: Time for Homework!

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girl with books-01There are more than 2000 school days in your child’s life, most of which will end with homework. Over time that means you need to inspire your children to do about 4000 hours of schoolwork at home, when video games are calling their names.

I have a few suggestions on how to get that mountain of homework done with less argument and frustration.

First, establish the habit of homework long before they actually have any. When they are little, assign time in the evening when the TV is turned off, activities are done, and you as a family can sit and read, build things, or play games that involve a little brain work. Do this during the two hours before bed and the kids will also sleep better.

Why do we need homework?

Consider the goal of homework: what do we want our child to gain from doing it? Of course, we want them to learn the material. More importantly, we want them to learn how to learn, and to love doing it. We want to furnish them with skills that will prove useful in real life. If homework can teach your children to examine facts, explore knowledge, organize and take personal responsibility for their work, and manage their time efficiently – what might he or she accomplish in life? These are the very skills that form a foundation for success.

Where?

Choose a place. There is no “right” place. If your child does better in a quiet environment, a desk in his room would work well. If she needs a little supervision, the kitchen table might work better. Wherever you choose, turn off the TV, videogame, and cell phone (quiet music is usually fine, and sometimes can even help children concentrate). Make sure they are comfortable and the lighting is good. Have the supplies they need – pencils, paper, calendar, dictionary? – nearby. Get rid of any distractions.

When?

Pick a time. Again, there is no “right” time. Some kids will do better right after school; some will need to blow off steam and may do better after dinner. Choose the time that works best for your individual children, involving them in the decision. Then make this schedule a routine, because children’s brains accommodate habits well. Kids don’t argue over something they have done every day for years; they argue endlessly over change and unpredictability.

Give your children a warning a few minutes before their free time is ending, so they can finish whatever they are doing before you drag them away.

Keep your expectations appropriate for your child’s age. As a general rule of thumb a child should have about 10 minutes of homework per grade level. Children in elementary school will need help organizing their work and staying on task; teenagers should be able to do their work without supervision. If all goes well, somewhere in middle school they learn to take responsibility.

Start the hardest subjects first; position assignments which require memorization (spelling, math?) early and repeat after breaks.

Since you as parents won’t always be around to supervise, let your teenager fail in high school when they make poor choices. Summer school is cheaper and immensely less life altering than flunking out of college; repeating algebra is torture, but less traumatic than loosing a job. To paraphrase: give a child an organized notebook, and he will pass one test; teach him how to organize and he will have a skill for all of his life (sorry, couldn’t help myself).

Expect problems; they give you a subject of conversation to share with your child! Approach problems with diplomacy and respect for the person who is your child. Label the problem: “You get distracted by your cell phone.” Don’t label your child: never “You’re lazy.” Be wiling to compromise with your child to solve the problem. “If you will turn off the cell phone while you do your work, you can have 5 minute breaks between subjects to catch up, call and text.” Agree to the compromise; it is a contract with your progeny. If you need to, write it down and both of you sign it. Read last week’s blog on How to Fight with a Child.

Rewrite this contract when the first one flops, until you find an arrangement that enables your child to learn and you to not run screaming from the room.

Allow the child’s input as much as possible. Let him decorate his workspace up to the point where he puts in distractions. Let her decide subject order, as long as it works. Let them choose their break activity, up to a time limit.

Reward success.

We as humans are hard wired to respond better to rewards than to punishment. How long would you go to work if you did not get a paycheck?

Sadly, it is not realistic to expect a better grade to be your child’s only reward. That grade is too far into the distant misty future, over a mountain of hard labor.

Rewards work best if they are small, and given for small increments of good behavior. A hug, a smile and pride in their accomplishment is all they need when they are small. When they are a little bigger, take time to read a book together or play a game. Keep rewards simple, small, and frequent.

Older children also need small, frequent rewards, though probably not as simple. They always have items that they want, but don’t need; these items make great rewards. Study time, completed homework and test grades can all earn them points toward a goal. There is no need for an argument when he or she doesn’t do their work before picking up the phone; they just won’t get that essential point.

Homework is training for life. Choose the place and time, working with your child to fit it to your family routines, your child’s personality, and his or her age. Endeavor to teach self-discipline, time management and responsibility equally with reading, writing, and arithmetic. Reward success. Keep in mind that the goal is not to learn how to spell that list of words, but rather to inspire a love of learning which will propel your child to succeed, now and into the future.

Domesticated Momster

Parenting: How to Fight with a Child

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kidsfightingThe most basic principle of conflict resolution, that both parties in the conflict have to be treated as equals, flies out the window when that conflict is with a child or between children.

Equality is a tricky area in parenting. Yes, this child is in every way your equal in humanity and way ahead of you in potential. He or she is undeniably not your equal in size, power, or – for a while – intelligence and experience. If we allow a child equal power in a conflict what we get is a spoiled, obnoxious child who will put his or her own future in jeopardy by making bad decisions.

Equality is likewise tricky between two children, because we cannot count on children not to take advantage of their greater size, intelligence, or experience. A referee is needed.

When we are in conflict with our children, or they are in conflict with each other, we must treat them with respect as the complete human beings they are, while we decisively withhold the power they are grasping for.

The standard steps to conflict resolution apply, but they must be adjusted for the relative sizes of the combatants.

First, listen. It is all too easy to dismiss a child. You are the parent, you know what they are going to say, and you know what your decision is going to be, so why waste the time, right?

How did that attitude make you feel the last time you were on the receiving end of it?

Take a moment to listen to their side, even if it is ridiculous, because just knowing they are being listened to is a win for a child. This is much easier to do when your 4 year old is explaining to you why she thinks she should have ice cream for lunch, than it is when your 13 year old is explaining why it is not a problem that you caught him smoking. Give them the time to speak, no matter how tempting it is to cut them off.

Actually focus on them and pay attention to what they are saying. Don’t let your mind wander into thinking about what you will say next, or the errands you have to run.  The prize you get for listening is a better understanding of your progeny; as a bonus, they then have to listen to you, to be fair. Another win!

Sometimes it helps to set a timer prominently between you and give each person a minute to speak without interruption.

After one contender has their moment to speak, their opponent should repeat back what they heard. Sometimes what we mean to say is not what comes out of our mouths, and sometimes what we hear is not what was actually said.

Communicate, and insist that they communicate. Don’t fling insults and accusations. Don’t bring up past history. Don’t yell, because yelling looses it’s power quickly. Don’t threaten with ultimatums – they backfire. Never denigrate your child and never label them: labels stick, and children sometimes try to live up to them.  Sit down at their level, look them in the eye, speak at normal volume, and stick to the subject.

Don’t make assumptions, or jump to conclusions. Slow down and give yourself the time to fully understand, or mistakes will be made.

Summarize. After everyone has had a chance to make their points, sum them up. Name the problem, list the arguments on each side.

Start with areas of agreement. In every discussion there are points of agreement. Start with those points, and work from there. We agree that ice cream is delicious, and it does have calcium in it for your bones, but…

In the end, you are the parent and must make the decision that you feel is best. Listening to your children along the way does no harm, strengthens relationships, will make them feel valued, and will nourish their self esteem. Understanding their thought processes and point of view may also help prevent later conflicts. Avoid the pitfalls – jumping to conclusions, towering over your child, name calling – and you will not have damage to repair later.

The experience of being treated fairly and with respect will carry forward and encourage your children to demand respect as they become adults. And learning how to argue without destroying a relationship? Priceless.

Domesticated Momster

Parenting: How to Fight Like a Grownup

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CinemaUsher-01Children thrive in a home where they feel secure: security that is based in large part on their parents being sane and reliable. It can be terrifying when parents argue. If Mom or Dad act crazy when they fight their daughter, watching from around the corner, or son, lying in bed with a pillow over his head, will believe their world is falling apart.

As a result, an important part of parenting is learning how to discuss and resolve differences of opinion without devolving into screaming insults and accusations.

The goal of any parental conflict is to reach a compromise with which both parties will feel that they have won something, and both parties feel that they have given up something to the deal. If one party wins everything the compromise will not hold, because the other will have nothing to loose and will either keep fighting or just give up. We are looking for a win-win.

Parents are individuals first, with unique histories and priorities. There are bound to be disagreements over the decades it takes to raise a child. (Last week’s blog outlined common areas of disagreement; after this is how to fight with a child.) Since these disagreements happen between two people, the personalities of those people will impact the process. A little self examination is in order before we move on to how to fight like a grown-up.

There are three common personality styles that can negatively affect – umm- discussions:

  • The avoider: this person will not bring up the problem, will change the subject when they can, try to make jokes, deny that there is a problem… The problem will not get solved unless they can be brought to ground. (My husband is nodding and pointing at me.)
  • The nice guy: this person will give until they can’t give any more and then they explode. They will yield all points and agree to whatever their partner wants. Said partner will be completely blindsided when the divorce papers come.
  • The competitor: this is the person who will argue for points they don’t even care about, because they just want to win. Sometimes they can go over the line and and get nasty, flinging insults and accusations.

Parenting is too important to allow personality style to impact decisions. Figure out how you and your partner argue, and realize that your child is important enough to force yourself out of your comfort zone and let go of whatever habits you have indulged in until now. Face whatever the issue is, stand up for what you think is right, but don’t steamroll over your partner. Discuss the issue with the goal of compromise and cooperation.

People smarter than me have studied how to resolve conflicts in politics and business. The same principles work for relationships and parenting. The process can be divided into steps:

  • Listen. This means not interrupting until your partner in life, that person whom you love most in the world, has made his or her point. So hush! If you have trouble staying quiet, place a timer prominently between you and give each person a few uninterrupted minutes. Listening also means hearing and trying to understand what their words actually meant. This is difficult to do when all you are thinking about is your own point of view and what you are going to say next. You need to know how your partner in life sees the problem in order to fix it.  Sometimes it helps to repeat back what you heard, because what one person says is not always what the other person hears. “I’m frustrated and angry because we can’t pay our bills” can sound like “I want out of this marriage” if you are not careful.
  • Communicate. Talk about the actual issue. We want the best education for our child, but we can’t agree  on priorities. Don’t detour over to how you feel, other issues, or past history. Don’t try to assign blame. We never should have moved, or You should have taken that other job, won’t help.
  • Summarize. After you’ve both had a chance to make your point, sum it up. Name the problem, list the points on each side. Write it down if it helps.
  • Start with agreement. In every discussion there are points of agreement. Start with those points, and work from there. We both value education, but we know we cannot afford the private school we love… You want to work more so we can come up with the money, I want you home more and think we can teach them by reading, traveling, going to the library.
  • Don’t make assumptions, or jump to conclusions. Slow down, give yourselves the time to fully understand. Don’t let emotions and the thrill of drama get the better of you.
  • Realize that you must come to an agreement, there is no other option. We can work a little more to pay for math camp during the summer, and carve out extra time to hit libraries and museums.

Both sides must give a little and both sides must win a little, because you are in this together. One partner cannot overpower the other, or the partnership will not last, and your children need your partnership to last more than they need whatever you are arguing about.

In a conflict between parents either both parents win or both, in the end, loose.

Domesticated Momster

Conflict Resolution in Parenting: Prevention

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CinemaUsher-01A good friend of mine, not realizing how complex a subject it was, and how much work it would be, asked me to write a blog about conflict resolution.

He may no longer be on my good list (coal for Christmas, you!), but for the next few weeks I will be blogging about conflict resolution because he got me thinking. This week is for the groundwork: exploring the issues that are at the root of many conflicts between parents. Next week will be about the most (and least) effective ways to fix those conflicts; after that we can expand into parent-child conflicts and those between children.

The first, most important, and absolutely non-negotiable concrete foundation of conflict resolution between parents is that parents are equal partners, and have to respect each other as such. You chose to have a child together. It is the privilege and responsibility of both to parent. It does not matter if you are married, partners, or single, or if one parent is taller, stronger, richer, smarter, more talented…. That child belongs to both of you and needs both of you. I once saw a child in the post office with a parent on either side holding onto an arm and pulling. Don’t do that. Your child is not a rope in a tug of war.

Conflicts can only be resolved by compromise. If one side wholly wins, the other has no choice but to keep fighting. Both sides have to give a little; both have to feel that they have won something. None of us are always right; we can afford to be flexible. In the end it is far more important that your children see that their parents respect each other, can listen to each other and discuss problems, and are able to compromise, than whether or not their bedtime can be changed, or they can go to a party.

If parents cannot respect each other as equals, that is the lesson their child will absorb, and someday he or she might accept something less than respect from their partner.

The structure we build on that foundation is agreement on common goals. It seems, going into parenting, that we should all have the same obvious goals. We want our child alive, healthy, happy, self-confident… Obvious, yes? It’s amazing how much variation there is within these bounds. Ideally, parents discuss and agree on goals for their children before they actually have any. In reality, many parents discuss religion and not much else.

So, ten things to talk about with your partner before things go ka-BOOM:

  1. Where you will live: Having a child is a lifetime commitment, so this means 20 years of where you will live, not just right now. Talk about location, type of home, whether you want to be near family, if you will move for a better job…  whatever is important to you. Things change, and it is nice to know where your partner stands on the subject ahead of time.
  2. Finance: Children need security to feel safe enough to explore and grow. Financial worries can plant their lives on shifting sands. Sit down together and figure out how much money you make, what you will spend it on, and how you will save for an emergency and the future. Make a budget. Your child does not want to loose a parent over the electric bill.
  3. Diet: You want them to be healthy, right? Not to have diabetes at 12, back pain at 15, and heart disease at 40? That means agreeing on what to feed them, and on being a good example yourself. It also includes not using food for emotional support or rewards. And don’t get me started on using food so that your child will like you better than the other parent.
  4. Routines and schedules: How obsessive are you going to be about homework, meal times, and bedtime routines? Routines can be incredibly helpful: kids don’t argue over something (like bedtime) that is a habit. On the other hand, routines can become rigid and squash all random opportunities and creativity. Where do  you put that balance? Routines work only if both parents are in agreement on them, so talk.
  5. Sleeping arrangements: I have seen more than a few marriages end in an ugly divorce over this one. There is really no moral right or wrong on it, but you must both agree. Just don’t co-sleep with a baby under 6 months. I’ve lost two small patients that way, and never want to lose another. Just don’t.
  6. Education: How important is school? (Guess which side I took on this one) Are some subjects more important than others? Do actual grades and the particular school matter, or is it learning and inspiration that is important? How about learning technical skills versus book learning? How about “useful” skills versus not so obviously useful? Did I mention that I also have an a degree in anthropology? I am married to an engineer. We have discussions.
  7. Careers: Which career choices are acceptable, and which are not? You might want to write these down and then switch lists – surprise! When I was a child, my options were nurse, teacher, or housewife. My mother had crossed “nun” off the list and not replaced it with anything. I was a big surprise.
  8. Athletics: How important are sports? Life ending? Or just done to be well rounded and get exercise? Any particular sport in mind?
  9. Criminal behavior: This is a biggie. Children start out as small barbarians, travel through self-involved, and wander into insecure before they become adults. They will try out hitting, biting, lying and stealing along the way. How will you react? What will you do to discourage this behavior?
  10. Privacy: Children have no legal right to privacy. They have what you give them, and they deserve your protection from their own … lack of insight, so their privacy cannot be absolute. Where is that line? How much do you trust before you verify?

So, I have managed to write a blog on conflict resolution without ever discussing how to resolve a conflict. Hmm. We will do that next week. First and foremost: respect your partner and set common goals. Once you have that foundation and framework, everything else falls into place more easily. With a little nudge. Or two.

Build that foundation. If parents endlessly argue and fight, marriages self destruct; if parents cannot treat each other with respect and decide on common goals, children self destruct.

Have that conversation before you need it.

Letting Go: Being a Parent

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boy with baloon2-01Many parenting issues seem to be all about control. Parents make rules and then enforce them; cook food and convince the children to eat it; educate young minds and teach them right from wrong. Being a parent brings with it a mountain of responsibility, and the authority needed to do the job.

I’ve been thinking lately about the other side of the coin. What role does letting go of that control play in parenting?

When we are pregnant or our progeny are small, we are completely responsible for those small creations, and we make all of the decisions about their lives. Remember the terrifying responsibility of holding a tiny, fragile new being in your arms? At least that small person didn’t argue with you over the necessity of being in a car seat, or sleeping on their back! Later, we put their small arms and legs into clothes we like, and hold their hands as we walk them to the dance or art class we choose. We choose the home in which they grow, the religion they practice, and the school they attend.

Somewhere along the line that absolute control begins to evaporate, we loosen our grip and our children begin to choose their own direction.

Perhaps it starts with that first strident “No!” to the clothes we have chosen, or evolves later with a demand to take a course in auto mechanics instead of ballet. Perhaps they refuse to study in a class they hate, or ask to go to their friend’s church instead of yours.

They become increasingly independent, take on more responsibility for their own lives, and our influence wanes.

Life itself has more of an impact than we would sometimes choose. Disappointments and loss are inevitable, and possibly essential for normal development. Nothing can make a parent feel more powerless than when a child is injured or sick. Heartbreak strengthens our souls and allows us to appreciate real love later, but it is hard to watch it happen to the one you never wanted to see hurt.

Worse, how do you manage when your child is simply not built in a way that coincides with their dreams? When they are not tall enough, or pretty enough, or talented enough, and they have to realign their futures to a different reality? How, when random chance throws them sideways? There is sometimes simply nothing in your parenting arsenal that will help.

How do you manage when, in order to build their future, they have to leave another part of their lives (perhaps the part in which you are standing) behind?

They will never know who they truly are and be able to choose the direction of their lives if we dictate all of their decisions. So we as parents need to learn to step back and empower them, rather than holding all that power close ourselves. We need to allow them to risk hurt, while we place the weight of their lives on their own shoulders, so that they can become our equals rather than our dependents.

Over time, we assume more of a supporting role. We are there if they need love, if they ask for help, or if they want to bounce ideas, but we no longer determine and fix their lives. Powerlessness is proof of successful parenting.

So, letting go.

Perhaps we start when we hold up two outfits and ask them which one they want to wear. We keep control of the things that keep them safe, making them wear seat belts and bike helmets, locking up guns, making them get their shots – but let them choose which sport they want to play, what they want to learn, and who they want to associate with. We let them fail a test or loose a friend, even though we can see it coming and they cannot. We protect them from choices that will destroy their future (drugs, sex, destructive relationships…), but accept their decisions in other areas. It is their life, not ours.

We force ourselves to let go, and step back. We will no doubt be angry, or sad, over some of  their choices. We may feel guilty when they fail and we could have helped. We will have trouble finding where the line is, where that point is that we need to step back.

I have no clear answers, no surety of right and wrong. The most important thing is simply to be conscious of what we are doing, and why we are doing it – to realize that our impact as parents is as great for what we choose not to do as it is for what we do.
Domestic Momster

How to Nurture Self-confidence in Your Child

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skateboarder-01In the last several weeks I have seen a mother trying to make her daughter look prettier (she was beautiful without the make-up), a father pushing a son better built for track into football, and a parent making fun of a son’s drawings.

These parents might someday wonder why their children did not have the self-confidence to achieve more in life.

Let’s not do that.

So… top ten ways to nurture a confident child

  1. The most important single factor in building a child’s self esteem is unconditional love from their parents. Children need to be certain that no matter what dumb thing they do, or how badly they fail, you will love them. You may not always like what they’ve done, but you will always have their back. They will have the courage to try, when they are sure you will catch them if they fall.
  2. Give your child a chance at success by laying out clear expectations; they need to know what success is in order to achieve it. Nothing will destroy self-confidence more quickly than trying to shoot at a moving target. What do you hope to see in your child: honesty? hard work? creativity? Be consistent. If you want them to be honest, then you need to be stringently honest in your own life, and require it of them in every part of theirs. No telling your child not to lie, then suggesting a fib about their schoolwork! Expect hard work? Work alongside them, and let them know how much you appreciate their labor.  Exhibit, and reward, the behavior you want to see.
  3. Make your expectations something at which your individual child can succeed. Any child can give their best, work hard, be true to themselves, and be honest. Not every child can be a football star, brilliant musician, or great artist. If your expectation is that your child try new things and do his or her best, then they can succeed at putting paint on canvas, and they will feel pride in their accomplishment.
  4. Find activities in which your child will thrive. You may have to try a few new things; break out the ballet classes and art lessons. Learn to throw a ball. Read books, tour a museum, travel… Explore the world in which your child will live his or her life. Nothing will build self-esteem like success, so seek out and encourage activities they love or for which they have a talent.
  5. Be interested in what inspires them. It’s impossible not to be: you are interested in their hair color and their height, how could you not be interested in their minds and talents? In the end, if mom or dad is interested, they will know that their accomplishments – and they themselves – have value.
  6. Allow time for free play and creative activity. Children do amazing things when they are allowed access to their own imaginations. Freedom will allow them to get in touch with their innate abilities, so that they can discover their best future. Self-confidence thrives when we do work at which we excel.
  7. Examine your own mind. Any left over preconceptions that might injure your child? Your small human is new. He or she embodies a combination of mind, talent, and ability that has never existed before. If you think science is the most important subject, but gave birth to a poet, you need to make sure that small poet doesn’t get the idea that you would have been happier if he or she could grasp algebra.
  8. Expect them to fail: the only people who do not fail are those who do not try. Show them with your own behavior that failure is a learning opportunity, so they will not think that they have less worth when they, in turn, fail. Let them watch you try new things. When you fail, make sure they see you accept that failure and learn from it, so that you can succeed next time. When they fail, tell them it was great that they tried, and redirect them to what they can do differently next time, so that they will get better. No defeatist talk, for the entire duration of their childhood!
  9. Spend time with friends with like interests, and friends who are completely different. Friends who value the same things your child does will reinforce his or her worth; friends who are very different will teach your child that every person has equal grace, whether their talents lie in building an app, a home, or a business.
  10. Be true and honest. Your children know you, and will know when you are not being real. Children do amazing things every day: there is no need for fake, meaningless praise. You love this child, therefore you love and will value the things that he or she is good at, even if you never thought you would before you became a parent. True praise builds healthy self-confidence.

While you’re at it, work on your own confidence. The world has probably battered it a bit. Children will always follow our example. If that example is self-confidence, courage, and honesty, how far might they go?

Ten Tips from the Doc: Summer Vacation Success

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skateboarder-01School’s out! Time for the Family Vacation. So how do you have fun without going insane? I, of course, have my top ten!

10. Pack a simple medicine kit: don’t waste a day of vacation at the doctor’s office, refilling the prescription you forgot at home. Take:

  • any prescription meds your child sometimes needs, even if they haven’t used them in a while (asthma and allergy meds come to mind)
  • frequently used over-the-counter stuff: acetaminophen or ibuprofen, an antihistamine, insect repellant with DEET (the other stuff really doesn’t work, and insect borne encephalitis is unpleasant), sunscreen, and hand sanitizer
  • basic first aid supplies (band aids, gauze pads, tape, antibiotic ointment, cortisone cream, alcohol, tweezers, scissors, thermometer)

9.  Write out a budget before you go. I know, I am a fun sucker, but it has to be done. Know how much money you have and where you plan to spend it. Give the kids an allowance for souvenirs. They will be more careful with money they consider their own, and they will not be constantly asking for things. “Can I have that?” can be answered with “Sure, it’s your money. But are you positive that is where you want to spend it? There might be something better later…” Also, knowing how much you yourself have to spend will save you stress and regret later.

8.  Keep to healthy foods most of the time. (Here I go, sucking out the fun again!) Kids will have more energy, feel better and have a better attitude if they are nourished. And it’s cheaper. Have a basket of fruit available, some whole grain crackers, cheese, peanut butter, popcorn – food with nutrients. Don’t waste valuable vacation time sitting in the drive thru line and arguing over food.

7.  Keep to established routines when you can. Bring along a book for that bedtime story, keep bed time the same, set aside time for their bath. Kids don’t always deal well with change, and vacations are all about change. A few familiar routines will help them feel less stressed. And a full night’s sleep is an absolute necessity if you don’t want an emotional wreck for a kid.

6.  Keep an eye on the little ones. You are in a different environment with new dangers. Distractions abound. Kids on vacation get lost, or get into Grandma’s meds or the local pool. Check out my summer safety tips.

5.  Find interesting things to keep their brains busy. Bored kids whine, and then they find their own version of interesting things. Have a stock of books, games and videos for the car. Bring a journal for them to write in, and art supplies. Explore the area you travel to – Google it before you go. See the sights, hit the museums, find the local artists and craftsmen. Check out ideas to abolish summer boredom.

4.  Keep your own mind open to new and different ways of doing things, so that your kids will do the same. Kids internalize their parent’s judgments, and they will close down their minds and wipe possibilities out of their lives if that is the example you set.

3.  Keep them physically active as well. A tired kid is less stressed, sleeps better, and is not sitting around thinking of ways to get into trouble.

2.  Keep stress to a minimum. Use a GPS if you’re driving: arguments with the navigator have ruined many a vacation. Keep your expectations in line with the actual possibilities, to avoid disapointment. Don’t overschedule – leave time for that relaxing hike and to have a conversation over dinner. Stay within your budget – your hindbrain will know you are overspending and your stress will mount. Stressed out people snap at each other and cannot enjoy time or family.

1.  Align your vacation with your priorities, then toss out the rest. What are the goals of this vacation? Relaxation, family time, memories, enrichment, joy? Plan the vacation and activities that will get you there, and don’t let exhaustion, stress, and fear get in your way. Don’t stop at Uncle Joe’s house if you know he will stress you out; don’t vacation with those friends who overspend or forget to pay their half of the bill. Don’t worry if the kids are getting dirty or if your Aunt Judy wouldn’t approve. Just say no, open up, and relax.

And have a fantastic vacation!

My Rant: It is not Malpractice to be Tired

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kidsfightingFair warning: I am on a rant. Skip this one is you don’t want to hear me whine.

In the last few days I have seen doctors in the media picked on because they fell asleep (“Doc, there are patients who need to be seen!”), because they were burnt out, and because they didn’t smile, explain things thoroughly, and ask about the patient’s home life while checking for an ear infection. Doctors fought back with comments about their long hours, intense work schedules, and exhaustion.

It didn’t work. The comments just changed to: “Well, fight for better hours!” Or: “Be willing to make less money!” (umm, I did go into pediatrics…) One person was actually so narrow minded and idiotic as to tell us we were harming patients by working too hard, and that it was sheer laziness that kept us from improving our schedules. That we “were keeping our heads buried in the sand” so that we did not see the important issue: that the business of medicine was as important as the practice of medicine. That what we were doing was “not good enough,” and that doctors never fight for anything. How that person knitted all those ideas together in one head is beyond me, and I don’t believe that I, or any other doctor, deserved it.

First, no one was harmed in any of the situations. The sleeping doc got up and went back to work, probably better for the quick power nap. The child whose doc did not smile and ask about their home life nevertheless fit that child into her already full schedule and took excellent care of her. I have in thirty years never harmed a child because I was exhausted. I did once tell a mother that I was too tired to care for her child and would find them another doc, after which I walked back to the office, sat down, passed out and had a seizure. Doctoring is a different sort of job.

Second, doctors have been fighting far longer than I have been one. We fight with insurance companies every day. Through the AAP we fight in the legislature for pediatric issues. We fight for universal vaccination. We fight for neglected kids, for abused kids, for healthy foods in schools…

Last, our heads are about as far out of the sand as they can get, as we care for children whose parents have poured boiling water over them, for teenage girls gang raped at parties, for gay children who are thinking of slashing their wrists…

There are a limited number of hours in the day, and every single time the kids matter more than how overworked we are.

The one thing that I am never willing to compromise is the care of my patients. Jumping from “doctors are overworked and stressed” to “doctors are harming patients because they are overworked and stressed” is a leap. The data actually proves otherwise.

Presuming we can simply work less and everything will be fine is naïve.

One of the biggest problems right now is that there are simply not enough docs, and fewer of them are going into and staying in primary care. Those of us in the trenches cannot do less when there is no one to take up the slack. Legislation can not fix this problem, and the fact that we are judged and condemned at every turn just puts another nail in the coffin of primary care. The doc above fit an extra patient into her day, took care of the acute problem, and was spat upon because she didn’t smile and answer questions that weren’t even asked. If burnout is a concern, then stringing us up for target practice just because we are doing our jobs is a problem.

So here is my fight for the day, because I do not want to be accused again of not fighting enough: please appreciate the 11 or more years we spent in school and worked for free, accumulating debt while you were already earning a paycheck. Please appreciate the fact that when you call at 2AM, we answer. Please appreciate the times we miss important events in our children’s lives because we are helping someone else’s child. Please appreciate the fact that we carry the responsibility inherent in our jobs on our backs every minute of every day.

A simple “Thank-you for fitting my child into your busy day,” will go much further toward keeping doctors in primary care than any change in our work hours or income. We are not the enemy; we became doctors because we wanted to help people. Please let us do our jobs, and don’t snipe at us because we are tired. The fact that we are tired and overworked is not a good enough reason to fault us. We do not deserve it, and we have earned at least that much respect.

Whether or not the insurance company pays that $35.00 is always going to be at the bottom of my priority list, as it should be. The business of medicine will never and can never be as important as helping that little boy in room 2 to breath better.

Your Daughter’s Vagina

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marilynThis week my amazing daughter handed my son-in-law a daughter. This brand new person has lots of silky dark hair, deep blue eyes and 2 dimples. She is a 7# 8oz miracle.

In the last few days my son-in-law has heard endless versions of “You’re in deep trouble, man,” “You’ll need a shotgun,” and “The boys will be after her!” My son-in-law is a deep thinker, so he gave it some deep thought and said, “Why?”

Assuming we want our daughters to have joy in life, fulfillment in their chosen work, family, and love: why then do we not want them to have sex? It seems an essential part of the picture.

When we actually consider why we feel this way, it comes down to the unfortunate fact that we equate a woman’s value with her sexual appeal, but devalue women when they actually have sex. No sex? Virginity and a pedestal. Sex with one man? Mother and Madonna. Sex with more? We have a direct line of descent into whoredom, where your daughter can be given a monetary value.

Then we confuse this scale by judging a woman’s value by how sexy she is. I once heard a med student say about the best kid cancer doc I knew, “What else could she do? She’s damned homely.” We want our daughters to be sexy, but not to have sex.

The valuation for men is perhaps equally harsh, but diametrically opposed. Virginity brings snickers and derision. Faithfulness to one women is sometimes thought to be gullible and foolish. Sex with many women is part of the admirable macho stereotype: men have conquests and “sew their wild oats,” admire James Bond, Casanova and Don Juan, and slap each other on the back as they carve notches into their belts or acquire trophy wives.

Math works, and these numbers do not add up.

There are of course other problems with these assumptions: not only are we devaluing our daughters, we are also making life difficult for our sons. We want our boys to have self respect, good long term relationships with their partners and the maturity to hang around to see their children grow up. Herpes, AIDs, and serial shallow relationships devoid of respect will not bring them this future.

So what is the solution?

We need to give our own values serious consideration, and then evenhandedly teach those values to both our sons and our daughters. We cannot tell our boys that it is OK to get a girl drunk so that she will have sex with them, and then tell our daughters that if they drink too much and have sex they are whores. We cannot tell our boys they are not manly if they choose to wait for love, and our girls that they must wait, or they are trash. It does not work to dress our seven year old daughters in spangles and teach them to hip thrust to sexy music, but then insist they remain innocent.

We need a coherent, honorable, human plan. Consider the future you want for your child, give thought to how sex fits into that future, be fair, be stringently honest, and build rules consistent with that future.

Some simple rules might be: we don’t want you to have sex until you are fully mature; we want you to be in a relationship built on love and mutual respect when you do; we want you to be safe and responsible.

Follow your own rules. Start when your babies are brand new, behave honorably, and be consistent throughout their childhoods. “Do as I say, not as I do” has never and will never work, because in the end your children will know you very well indeed.

  • Watch what you say, both to your own partner and about the other people in your life, because words and judgments will worm their way into your child’s mind and later poke holes in his or her self worth.
  • Keep conversation open, so that when they hear something at school or at a friend’s house they know they can ask you about it. They need to be able to come to you when they have questions. Give them knowledge so that they will be able to make good decisions.
  • Monitor what they see on the internet and on TV. Much of what is on screens these days will need explanation.
  • They will probably make mistakes. When they do, it is perfectly all right to discipline them, because they did break your rules (aren’t you glad you made those rules beforehand, and made sure he or she understood them?) Do not, however, add judgment to the mix. Give them time and space to think and consider the consequences of their actions. Allow them the chance to do better next time. Everyone makes mistakes, and it is hard enough to forgive yourself and go on, without the ones you love adding to the weight of regret in your heart.
  • Never throw labels at them, because labels will leach onto their brains forever. They will never forget that their parent, who should love them no matter what, called them trash, or a slut. They might even feel that they have to live up to the label.
  • Sex is a powerful weapon. If handled well it can bring joy, deepen a loving relationship, and create life. A parent’s example provides the model, good or bad, for their child to follow; thoughtless words from that same parent’s mouth can echo in their brains and make them bleed.
  • Society’s views, as seen in your neighborhood or church, and on the screen in everything from commercials to movies to music, have an impact.
  • How we think about sex, our behavior, and the inner judgments of our own actions effect everything from our relationships to our health, our self esteem to our future.

Sex can be a natural part of a fulfilled life, or it can injure your child’s mind, body and soul, up to the point of self-injury, depression, and death. It is important. It is deserving of respect and careful consideration, and an absolutely equal and consistent application of those conclusions to the parenting of both our sons and our daughters.

My son-in-law is brilliant, you know, and he was right.