How to Keep Christmas from Making You Crazy

Cute girl thinking about ChristmasMy daughter the anthropologist tells me that celebrations solidify relationships between people within a community, give them hope for the future, and serve as rights of passage.

Keep that in mind as you enter into the holiday insanity. What you want this season to mean to your children throughout their lives?

Do you want them to be involved in your community with its rich heritage and history? Emphasize that. Tell stories, act out events and celebrate your history. Help out people who are less fortunate.

Do you want holidays to strengthen family bonds? Put family first. Limit the decorating and shopping and work events, and hang out at home. Make gifts for each other, bake cookies and play games.

If you want holidays to be about joy, be joyful. Foster realistic expectations, appreciation for what they have and genuine values. Develop traditions that are more about time together as a family and less about how much stuff they get. The memories they keep forever will be the little things: sharing a bowl of popcorn while watching an old movie; reading a book while Mom or Dad runs fingers through their hair. Few people remember what they received for Christmas last year. They do remember that walk on Christmas Eve admiring the sparkling lights, tasting cookies straight out of the oven, and the look on Grandpa’s face when he got that homemade penholder.

Gifts

It’s tempting to get your children all the things they want for the holiday just to see them smile, but where do you go from there? Maniacal happiness is not joy. It cannot be sustained over time. Add to that that you have created unrealistic expectations for all the other holidays in their future. And the storage needs!

Restrain yourself. If holidays are about family time, board games, and baking cookies it is possible for holidays later in life to be happy. If holidays are about how much money was spent and how many new toys they received, how can real life ever work out? Bigger and better toys every year? That was not the goal.

If you can afford it, get them one or two of the things on their lists. Make them the ones they can create with, the ones that make them use their brains and bodies and talent. Add on some little things that are fun to open. Let little ones play with the boxes and bubble wrap. Then focus the day on family.

The Insanity

Don’t let holidays overwhelm you. There are so many expectations that no one can possibly meet them all and have any joy left. There are special foods that need to be prepared, special clothes that need to be bought, decorations, gifts, traditions to be followed, parties, travel, family… eeek! Weed out the excess so there is room left for joy, relaxation and rejoicing in whatever you were celebrating.

Before you decide to spend money on gifts or travel, be realistic about what you can afford. What did you get for your last birthday? Don’t remember? No one does. What people do remember is the conversation, the hugs and the warmth. Those are free. Take dollars out of the experience as much as possible and you won’t end up with a credit card bill for a present that was discarded six months ago. Don’t try to keep up with the people who have that bill and you won’t be laying awake at night and fighting with your spouse instead of relaxing snuggled up with hot chocolate.

Tune down the stress. Not spending more than you can afford will eliminate a huge amount of stress. Next, stop worrying about what other people think; they’re too busy worrying about what you think to care anyway. Keep to routines as much as possible. Sit down for meals; take some time to focus on each other. Step back from the hysteria and think about whether your progeny will actually play with that new doll or just stuff it in a corner, and whether you really need to travel or attend all the parties. Take some quiet time and relax. The world will not collapse if you skip a party or miss the line for the “it” gift. It will collapse if your child is so exhausted and stressed that he or she has a melt dow

Health

Keep healthy. The week after a holiday is always busy at my office. I make lots of money from airplanes crowded with sick people and stores packed with germy carts. Get enough rest, and hydrate. Use hand sanitizer. Eat as healthfully as possible–avoid fast foods, throw in some fruits and vegies. Hide the caffeine and limit alcohol. Get a flu shot. Nothing can destroy a holiday quicker than a trip to the ER.

Avoid injuries. Most holiday injuries have nothing to do with the particular holiday, but everything to do with people being so busy that they are not as watchful as usual. Sports are more dangerous when we want to impress cousins. Teenagers tend to get more reckless during a celebration, and young children sneak away quickly. Most holiday injuries are from everyday activities and household objects made dangerous by the holiday craziness.

Chokings and poisonings are popular. The one I see most is an overdose on Grandma’s meds. At Grandma’s home they are left on countertops; at your home they are in her purse. A left over drink is a common way to poison children. A little alcohol can drop a child’s blood sugar and throw him or her into a coma.

Toddlers will put anything in their mouths. Unfortunately this means that everybody needs to pick up their stuff. Items over 1¼ inch in diameter are generally safe. Smaller items than that can go straight into their gut or lung. The most dangerous items to swallow are batteries and magnets; the most dangerous to choke on are grape sized (older children’s toys, hard candy) or stretchy (balloons, plastic bags, marshmallows). Clean up!

Holidays also provide a banquet of things to irritate children’s allergies. Live trees indoors, foods, cigarette smoke, wood fires and other people’s homes and pets come to mind. Avoid them if your child has allergies.

Fires and electrical injuries are especially common during holidays. Decorations can be flammable, old Christmas trees will be dry, and space heaters, candles and fires are commonly nearby. Frayed and loose wires easily start fires. Keep your eyes open for dangers.

Use your common sense during celebrations. If it doesn’t seem safe, don’t let people pressure you into it. Feel free to let watching your kids take precedence over seeing Uncle Joe’s trophy or Aunt Mary’s vacation photos. “He’ll be fine” doesn’t make him fine. Keep an eye on him, or her.

Feel free to be rude and head for home when the kids get tired, if a situation feels out of control, or if your child is being exposed to something you aren’t happy with. Use the munchkin’s youth or fatigue as the excuse for you to head home, relax and read a bedtime story.

Remember that the point of celebrations is to solidify relationships and give hope for the future. Get there by focusing on your history, rejoicing in your present and not sabotaging your future. Don’t go crazy with gifts: they don’t teach your children anything you want them to learn and the financial stress will eat away at that joy and hope you were dreaming of. Pick fewer things to do, and do them together. Be safe and stay healthy.

 

Summertime Injuries: Preventing the Scary Stuff

safety signSafety is not simple. There is no clear division between “this activity will be safe,” and “this activity will injure my child.” We could wrap our children up, keep them indoors, and not allow them to play with anything remotely dangerous—but then we would have a child who is lonely, overweight and really bored…who would get into trouble and injure themselves… Or not get in trouble and develop diabetes, heart disease and knee problems from obesity.

Kids need to be active, and summertime brings many interesting opportunities for exercise, adventure and injury.

Wouldn’t it be great if some doctor type person would tell you what activities were the most likely to bring ER bills into your life?

Oh, wait… That’s me! So:

The most common causes of accidental death are gunshots, motorized vehicle and bike accidents, drowning, poisoning, and fire. Drowning, MVAs, bike accidents, and trampoline accidents are all more common in the summer, when kids are out of school.

Water Safety

Drowning is every pediatrician’s worst nightmare. It is currently the fifth leading cause of accidental death. An average of 700 children drown each year: about 2 each day. Most are under 4; 80% are male. For every death, there are 5 more children who drowned but survived, commonly with irreversible damage to their brains.

Infants and toddlers drown in bath tubs, buckets, toilets – it only requires is about an inch of water, just enough to cover their nose and mouth. Older children drown in pools, rivers, lakes, and oceans.

Never leave any child alone for even a moment near open water, whether it is an ocean, a bathtub, or a water bucket. All it takes is one moment of inattention for a child to slip away. If there is open water, you need to be within touching distance and focused on your child. The story I have heard over and over is, “We were right there, just talking, but nobody noticed anything until we realized he was gone.” Keep your kids in sight, and don’t let yourself get distracted. Be especially careful at the end of the day, as the water empties and people are gathering up their belongings and leaving. Children will want to swim just a minute more, or will attempt to go back for that last toy floating in the water.

Pools should be fenced in and closed off with a self-latching gate at the end of the day, and all the toys should be put away. Life vests are fabulous for a parent’s mental health and relaxation (swimmies and floaties are not life jackets). Life preservers and a shepherd’s crook should be placed obviously nearby wherever kids are swimming.

Sign your kids up for swimming lessons, even if you are afraid. A middle schooler or teen will never admit to their friends that they don’t know how to swim. They will fake it, sometimes unsuccessfully. Don’t, however, trust a young child to remember his or her swimming lessons when they need them. If they are startled or scared, they will forget everything they learned and just sink to the bottom.

Know what to look for. In real life, drowning does not look like it does in the movies. It is possible to miss someone drowning right in front of you if you do not know what you are seeing. They do not shout for help and wave their arms. They tire, and panic. A drowning child might never make a sound, but quietly slip under the water. An older child might keep themselves above the water for a while, but their head might be low in the water, with their mouth at water level, or perhaps with their head tilted back. Their eyes might be blank or closed. They will sometimes hang vertically in the water without paddling their legs, or appear to paddle with no purposeful movement. A drowning person is very easy to miss if you are not vigilant; and easy to help if you are.

Somebody should know CPR—why not you? Your local fire department or hospital will have classes.

Swimming is a necessary skill, fun, and excellent exercise; it is also a time for close observation and care.

Motorized Vehicles

The other motorized vehicles—ATVs, dirt bikes, snowmobiles, and Sea-Doos—are also commonly out in the summer. They are the perfect storm: they go fast, have no outside framework, roll over easily, and the only things that keep them from crashing are your children’s foresight, common sense, and trained reflexes. The United States averaged 23,800 dirt bike crashes requiring emergency room visits every year between 2001 and 2004; these numbers go up as dirt bikes become more popular. Don’t. Really, just don’t. You do like the kid, right?

Bikes

Bikes come out of the garage when the weather warms up and the roads are not covered in ice. And yes, the dorky bike helmet is an excellent idea.

Thousands of children are injured or killed every year due to bike accidents, frequently right near their homes. In 2010 alone, there were 800 deaths, 26,000 traumatic brain injuries and 515,000 emergency room visits after bike accidents.

Asphalt is not soft, even right next to your house. When a car hits a child, the child flies through the air. The heaviest part of the child—the head—lands first.

Make them wear the dorky helmet, on top of the head please, covering the top of the forehead, and tied snugly under the chin, not dangling on the back of the head. Hang it on the bike handlebars when not in use so that it is the first thing on and the last thing off. Keep a big lock handy so that if you catch them on the bike without the helmet, you can lock it up and they can walk for a week. Sorry kid, that was the rule and you knew it. There is no need for any argument.

Please don’t buy a bike two sizes too big. Your child will fall off. Children should be able to place the balls of their feet on the ground while their rump is on the seat, and their whole foot should be flat when they are standing over the crossbar. An extra bike or two over the years is cheaper than a broken child.

Trampolines

Trampolines are a huge source of income for surgeons and orthopedists. If you would like to make them poor, don’t buy a trampoline. If you have one, please be careful. Most trampoline accidents occur when there is more than one person on the trampoline, especially when they are not the same size. The smaller one goes flying or is fallen upon. Safety nets and pads are better than no safety nets and pads.

On second thought, forget I said all that. Let’s go back to no trampolines. Kids break bones, damage their kidneys, and hurt their heads and spines.

Children will at some point injure themselves because they need to be free to run, swim, and climb monkey bars and trees. Try not to obsess over scraped knees, a goose egg on the forehead, or a few stitches. Everybody gets those, and your children will find a way. Concentrate on the risks that will kill them or seriously injure them: motor vehicle accidents, drowning, fires, poisonings, and gunshots. Don’t go out of your way to buy things that will hurt them, such as trampolines and ATVs. Make it so they have to get creative if they want to injure themselves. Creativity is good, right?

Domesticated Momster
The Blogger's Pit Stop

Top Ten Tips for Summer Vacation Success

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 tips:

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!

4th of July Safety: Tips from the Doc

safety signSunshine, water, and fireworks. What else could you need? To avoid the ER afterwards!

Oddly, most 4th of July injuries actually have nothing to do with fireworks, and everything to do with parents being so busy that they are not as watchful as usual. Sports are more dangerous when we want to impress cousins. Teenagers tend to get more reckless during a celebration, and young children sneak away quickly.

Most injuries are from everyday activities and household objects made dangerous by the craziness. So,…

Top Ten things that will land you in my office after the fireworks:

1.  Drowning: The 4th is all about water. Every year pediatricians see drownings and near drownings on the 4th. Never leave any child alone for even a moment near open water, whether it is an ocean, a bathtub, or a water bucket.

All it takes is one moment of inattention for a child to slip away. If there is open water, you need to be within touching distance and focused on your child. Pools should be fenced in and closed off with a self-latching gate at the end of the day, and all the toys should be put away. Life vests are fabulous for a parent’s mental health and relaxation (swimmies and floaties are not life jackets). Life preservers and a shepherd’s crook should be placed obviously nearby wherever kids are swimming. For more tips on water safety, check out my summer safety tips.

2.  Fireworks: I know, it’s obvious, but it had to be on the list. Please leave them to the professionals. It’s not worth months in the burn unit and doing physical therapy.  No-one thinks it will happen to their kid, until it does.

3.  Choking: Toddlers will put anything in their mouths. This means that everybody needs to pick up his or her stuff. Items over 1¼ inch in diameter are generally safe. Items smaller than 1¼ inch can go straight into their gut or lung. The most dangerous items to swallow are button batteries and magnets; the most dangerous to choke on are grape sized (older children’s toys, hard candy) or stretchy (balloons, plastic bags, marshmallows). Clean up!

4.  Allergic reactions: Holidays provide a banquet of things to irritate children’s allergies. Plants, foods, cigarette smoke, bonfires and other people’s homes and pets come to mind. Avoid them if your child has allergies.

5.  Fires and electrical injuries are especially common during holidays. Decorations can be flammable, candles and fires are commonly nearby. Frayed and loose wires easily start fires. I have had an astounding number of children run through banked campfires after dark. Block them off please!  Keep your eyes open for dangers.

6.  Poisonings: The one I see most is an overdose on Grandma’s meds. At Grandma’s home they are left on countertops; at your home they are in her purse. A left over drink is also a common way to poison children. A little alcohol can drop a child’s blood sugar and throw him or her into a coma.

7.  Alcohol inside the grown-up: does this really need explanation?

8.  Dehydration/Food poisoning: Watch their intake. It’s hot and the kids are running around in endless circles. Bring lots of water (the stuff mother nature made for you, not the stuff with caffeine and sugar added). Food left out in the heat for hours can grow things that cause vomiting and diarrhea. If you don’t know where it came from and how long it’s been there, don’t eat it.

9.  Scarce common sense: If it doesn’t seem safe, don’t let people pressure you into it. Make them wear that bike helmet! Trampolines and motorized vehicles (Sea Doos, dirt bikes) are never a good idea.  Feel free to let watching your kids take precedence over seeing Uncle Joe’s trophy or Aunt Mary’s vacation photos. “He’ll be fine” doesn’t make him fine. Keep an eye on him.

10.  Politeness: Feel free to be rude and head for home when the kids get tired, if a situation feels out of control, or if your child is being exposed to something you aren’t happy with. Use the munchkin’s youth or fatigue as the excuse for you to head home, relax and read a bedtime story.

The point of celebrations is to solidify relationships and give hope for the future. Focus on family, rejoice in the day and be careful.  Keep plans simple, pick fewer things to do, and do them together. Be safe and stay healthy.

Children in the Aftermath of Trauma

Sad child on black background. Portrait depression girlWe try to protect our children from as much as we can, but sometimes life has other plans.

The murders in Orlando have taken over our thoughts, our conversations at home and with friends, the internet, and the television waves. Our children are being bombarded by the nightmare in front of the TV at home, in conversations with friends, and with questions asked by their peers. It can be too much for a child to deal with.

Your child’s experience of an event will vary depending on their age,  personal style,  life experience, and  closeness to the disaster. A toddler will only care that his or her parents seem to be upset. Older children will hurt for the people involved, worry about friends and relatives that are not within their sight, and worry that it could happen to them sometime, at some other event. What seemed exciting to discuss with friends during the day becomes frightening after the lights go off.

Listen to them talk, and be patient when they ask you the same questions over and over. Reassure them, let them know that such things are extremely rare. Answer questions truthfully, at their own developmental level. Never lie.

Monitor what your child sees and hears – adult conversation and the media can magnify fear and confusion and increase their trauma. Repetition can intensify anxiety; pictures can get locked in their heads.

After the event symptoms of post-traumatic stress may appear, even in children not directly involved. They may be sad or moody, easily angered or irritable. They may be afraid to go to public venues. They may have trouble sleeping or sleep too much. Appetites may suffer. Your child may be anxious when his or her people are not all nearby, and wake from nightmares.

Children frequently have concentration problems after a trauma, and their grades will suffer. They may regress developmentally: your independent youngsters may become clingy, or need help doing things they had been able to do on their own. They may avoid activities they previously enjoyed, and withdraw into themselves. They may become anxious at the thought of going to school, or of being separated from mom or dad.

They can also develop physical symptoms like headaches and stomachaches. They may try to exercise more control on their environment, setting up their toys in a particular way, wanting their schedule to be predictable, or demanding activities they find reassuring. Teens may act out or try alcohol or drugs in an attempt to feel better.

Helping them may be as simple as listening. Be available and receptive but don’t push. A younger child may open up and tell you his story when you break out toys or art supplies; an older one may talk if you tell her a similar story about yourself, when you were scared or worried. Schedule time for just the two of you, and wait.

Children may try to hide their symptoms: they think they should be stronger, they don’t want to be a burden, or they think they are abnormal for having the problem. They may even feel that the disaster was their fault; children are not always logical. Allowing them to bury their symptoms will only erode their spirit from the inside.

Also, be a good example. Take care of yourself, eat healthy food, sleep, and discuss events calmly. Turn off the TV and stay off the web. Exercise. Take breaks to play, read a book, and do something unrelated to it.

Keep to recognizable routines– routine is reassuring and safe. Require reasonable behavior: if they still get in trouble for using that bad word, then everything must be OK. They may test you with bad behavior just to get that reassurance. Don’t spoil them with extra treats, because it will frighten them. Things must be really bad if The Parent gives me toys or lets me eat candy.

Lend a hand to other people. It will help to know that you have the power to help and comfort.

The traumatic symptoms may last quite a while. Triggers like parents going out at night or a security guard at a local festival may bring everything back. Fear of it happening again may linger. An anniversary will renew their anxiety.

If time passes and stress is affecting their lives, think about having them see a counselor or getting them into a peer group with similar concerns. We all need a little help sometimes.

My mom also used to say, “Time heals all wounds.” And with a little help from their guardians it always will.

Top 10 Tips for Successful Summer Vacations

little cute girl near the pool with a circle for swimming

School’s out! Time for the Family Vacation. So how do you have fun without going insane? I, of course, have a top ten from the Doc:

10. Pack a simple medicine kit: don’t waste a day of vacation at my 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!

How to Have a Stress Free Spring Break

little cute girl near the pool with a circle for swimming

Spring Break! 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. 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!

Lead, and the Children of Flint

Toddler-Playing-With-A-Chair-01In April of 2014 politicians in Flint, Michigan changed the city’s water supply from Lake Huron and the Detroit River to the Flint River, in order to save money. The water from the Flint River was more acidic and had more salt and chlorine in it, and it corroded the aging lead pipes through which it flowed, allowing lead into the water and poisoning the inhabitants of Flint.

The EPA allows 15 ppm (parts per million) of lead in drinking water. Water from homes in Flint tested as high as 13.2 thousand ppm. Lead levels in children’s blood doubled, then doubled again.

Nontombi Naomi Tutu said we “needed the people of Flint to remind the people of this country what happens when political expediency, when financial concerns, overshadow justice and humanity.”

Why do we worry about Lead?

Lead is a soft gray heavy metal that functions in our bodies as a neurotoxin–it poisons nerves. Acute lead poisoning causes headaches, stomach pain, clumsiness, agitation or drowsiness, convulsions and death.

Chronic lead poisoning is more insidious. Lead is most harmful to infants, children and pregnant woman, because it damages developing nerves. Kids who are poorly nourished will be more affected because deficiencies in iron, calcium and zinc increase their body’s absorption of lead. Babies are more at risk because they live closer to floors and surfaces and everything goes into their mouths. Exposed children:

  • can lose cognitive function and develop speech and reading problems.
  • can be unable to focus and organize their thoughts, and exhibit behavior problems.
  • have a higher school dropout rate, problems with aggression, and a higher rate of delinquency.
  • can have damage to their hearing.
  • will have problems growing because lead messes with their ability to use Vitamin D and iron.
  • become anemic, which leaves them less able to transport oxygen around their bodies.
  • can cause damage to their kidneys, giving them lifelong problems with hypertension and cardiovascular disease.

Where is lead found?

When I was a kid we wrote with lead pencils and had lead in our gasoline!

Nowadays, lead is used in some industries, found in deteriorating lead paint in old houses, and leached out of old lead water pipes and pipes with lead solder. We also occasionally run into it in old toys, old Christmas decorations, and jewelry, and in toys, ceramics and cans imported from other countries. Cosmetics such as surma and kohl can have lead, as can some home remedies and dietary supplements. A few years ago there were crayons with lead in them. The manufacturer said, “Kids weren’t supposed to eat them!”

Ideally, we prevent lead poisoning.

  • If you work in an industry that uses lead, take off your shoes when you enter your home.
  • Don’t give your kids old toys and jewelry to chew on.
  • If you have lead pipes in your home, run the water for 30 seconds before you use any of it to drink or cook, because lead will gradually leach from the pipes it is sitting in. Never drink or cook with water run hot from the tap–hot water leaches out more lead.
  • If you live in an old house, clean up peeling paint and household dust with a wet mop.
  • Check for lead paint before any home renovations.
  • If you have well water, test it for lead. Most well filters do remove lead.
  • Give your child a nutritious diet to avoid deficiencies in iron, calcium, and zinc.

Treatment for Lead Poisoning:

Pediatricians generally check children’s lead levels at 12 months and sometimes 2 years, and any time there is concern.

Treatment of lead poisoning varies with how high the level is.

Between 5 and 45 mcg/dl, treatment involves finding and eliminating the source and optimizing the child’s nutrition. Levels as low as 5 mcg/dl have been shown to have lasting effects on children, but chelation therapy at these levels has not been proven to have any effect on kids’ cognitive ability or behavior.

Kids with levels over 45 mcg/dl need to be treated with chelating agents, which can be quite dangerous. Chelators bind the metal in the blood and improve its excretion into urine and stool. Unfortunately chelators also bind minerals that your child’s body needs for normal growth and development. Also, kids can be allergic to the chelators, and the medicine can damage their liver or kidneys.

Far better to prevent the exposure.

I do not have words for how horribly the people of Flint were betrayed by their elected officials.

Some resources if you have concerns:

  • EPA Safe Drinking Water Hotline  800-426-4791
  • Poison Control 800-222-1222
  • Pediatric Environmental Health Specialty Unit Network (PEHSU) 888-347-2632

 

Domesticated Momster

What’s the Deal With GMOs?

little baby gardener lost in the moment with the sun shinning in

“GMOs” are genetically modified organisms.

Humans have been genetically modifying organisms since we stood upright and developed our big brains. We originally did it by selective breeding. That’s why my Golden Retrievers have that long, beautiful–constantly shedding–golden fur, why broccoli exists, and why that ear of corn you munch on isn’t 2 inches long. We pick the animal or vegetable with traits we want, and we breed or plant those rather than the ones with traits we do not want.

What is different now is that we can modify at the level of the organism’s DNA. We can take the gene for the trait we want and insert it into the DNA of the animal or plant to create an entirely new organism with the preferred traits.

The first genetically modified mouse was bred in 1981; the first genetically modified plant in 1983. Since then, GMOs have taken off. Between 1996 and 2013 GMO crops increased by 100%. Recent stats estimate that 10% of the worlds croplands are planted with GMOs. 94% of the soybeans, 96% of the cotton, and 93% of the corn grown today are GMOs.

Concerns about GMOs include unease about GMO’s effect on the environment and the economy of farmers, and worries about the safety of food products.

Environmental worries arise because GMOs are created to be more herbicide and insect resistant, give a higher yield, have more nutrients, and be more drought resistant. The non-GMO varieties can’t compete economically. Farmers have to grow the improved variety in order to survive. Then, if all of the wheat in an area is one variety, and something evolves that kills that variety, we have a problem. We have placed all of our eggs in one basket.

Another worry is that the GMOs are created and owned. To get them you have to buy from the company that did the work to create them. How do you compete if you can’t afford their product? If there is drift from their fields into yours (pollen travels) have you stolen something?

Will we use more poisonous herbicides because our new plants aren’t hurt by them?

Health concerns generally arise because the science behind the creation of GMOs is pretty extreme. We imagine scientists creating zombie corn that will poison our children. Corn grown on a plant that is more resistant to drought is still corn, with no difference nutritionally. Extra nutrients developed into a GMO plant are thoroughly tested and approved before they can be sold.

The one real issue when food crops are developed with new proteins is that kids with allergies may be effected. The FDA requires proof of safety when foods that are commonly allergic (milk, eggs, wheat, fish, tree nuts, and legumes) are affected. All of our safety standards still apply.

The positives of GMOs are my happy place, as a certified geek.

  • GMOs can produce food in areas of the world that are less fertile or have problems with insects, so children who might otherwise starve will have food. Those foods can also be developed to resist spoilage.
  • Food can be grown that is more packed with nutrients. For example, a tomato might be developed that has protein to help develop strong muscles.
  • Scientists have developed bacteria that produce biofuels that are safer for the environment.
  • A breed of pig now exists that can digest phosphorus, thus decreasing water pollution and overgrowth of algae.
  • Bacteria can produce chemicals that do everything from clot milk to make cheese, to break down starch to make sugar.
  • Bacteria have been developed that produce human proteins. Previously, insulin came from pigs, and diabetics could become allergic to the medicine they needed to stay alive. We can now treat children with hemophilia with clotting factors that do not make it likely that they will, in the end, die of AIDs. We can produce human growth factor to treat some forms of dwarfism. Research is being done that may produce treatments for kids with cystic fibrosis and sickle cell disease, and many forms of cancer.
  • A goat exists now that produces ATryn, an anticoagulant that decreases the chance of having a blood clot during childbirth, in its milk.
  • Scientists are developing animals that have organs that are compatible with human biology. This sounds questionable right up to the point where your child needs a lung transplant.
  • One I find particularly elegant: Scientists produced a male mosquito with a lethal gene, and released it in the Cayman Islands in 2010. The particular breed of mosquito was one that carried Dengue fever, and they decreased the population of that mosquito by 80%. Wouldn’t it be lovely if they could do that with the mosquito that carries the Zika virus–the one that is causing babies brains to not grow in utero?

In the end, GMOs are here to stay. There is no possible way to remove them from the planet even if we chose to. We enjoy the products of GMOs every day without even knowing geeks were involved, and the future possibilities are truly amazing. Gene therapy can cure diseases like cystic fibrosis, sickle cell, diabetes and cancer. Transplantable organs can come from pigs rather than dead children. Biofuels to help the environment–the possibilities are endless.

Opponents are pushing for products to be labeled so that consumers can choose, but even that is next to impossible to implement. A growing number of products contain one or more ingredient from a GMO. How many products have corn oil or syrup? Where do you draw the line–if a food product was grown on a farm near a field with a GMO product, and was possibly cross pollinated, might it not be considered a GMO?

Certainly we need to monitor the science to make sure what it does is ethical and safe, but we do that every day in medicine and science, under the watchful eyes of the Department of Agriculture and the FDA.

What matters is that the food is available, safe, and nutritious. Junk food, sodas, and pesticides on your fruit are a much larger problem. A GMO apple is, nutritionally, an apple.

Domesticated Momster

Top Ten Holiday Poisonings

Cute kid girl in glasses thinking about gift on Christmas holiday. Vintage portrait

or, “how to avoid visiting the Doc during the Holidays”:

  1. Tiny magnets: These aren’t really poisonous but they can get stuck in noses and ears, choked on or swallowed. Keep track of the big kid’s toys so I don’t have to make the little one cry digging something out of his or her ear. Worse, magnets that are choked on or swallowed can require surgery to remove. Two magnets in the gut will stick to each other and wear through the bowel wall.
  2. Button batteries: Same problems as above, plus they can leak and cause burns, eating holes through the bowel that can be fatal.
  3. Grandma’s meds: These are on countertop at her home, and sitting in her unattended purse when she is visiting yours. This is the most common poisoning that I see. Other people’s meds also count, of course.
  4. Household poisons: Both the usual suspects (cleaning products, bug sprays) and the holiday specific (liquid fuels) are more available and less monitored in the holiday craziness. Lock ’em up.
  5. Food: Avoid potato salad that was made on the counter where they just cleaned the chicken. Return leftover food to the refrigrerator quickly. Wash those hands! Pick up and throw out unfinished drinks–kids can drop their blood sugar and fall into a coma with a relatively small amount of alcohol. Throw away cigarette butts, because kids eat them and the poisons in cigarettes can actually throw small people into a seizure. (And we inhale these things on purpose. Blech.) Add e-cigarette refills to this list for the last couple of years. 1/2 tsp can kill a child.
  6. Decorations: It’s actually pretty hard to poison anybody with holiday décor. Antique items will sometimes have lead, so don’t let the little guy eat the metalics. Don’t breath in the spray snow, because it has either acetone or methylene chloride in it. And don’t hit Uncle Joe with that branch, no matter how tempting….
  7. Plants: Poinsettias are not poisonous. Promise. Neither is Christmas cactus. Holly berries, mistletoe berries and peace lily berries are, as are bittersweet and boxwood.
  8. Smoke and carbon monoxide: Very poisonous. Live trees and decorations can be dry and fires, candles and space heaters abound. Keep your eyes open and your smoke and carbon monoxide detector batteries fresh.
  9. Mind numbing toys: Boycott toys that don’t engage your children’s minds. Look for toys that they can create with, explore with, or build with. I know this is not strictly a poison, but it’s my list, so I can bend the rules. So,…
  10. Poisonous soul numbing holiday insanity: Back up and take a breath before you spend money you don’t have on stuff you don’t need. Defeat stress and exhaustion with a healthy diet, exercise and regular sleep. Celebrate your heritage, enjoy your family and friends and create joyful memories. Ditch the rest.