Pediatrician’s Advice About H1N1 – Follow-up

Several weeks ago, I posted a letter from our pediatric office regarding the H1N1 virus, the hysteria surrounding it, and some advice about the vaccine. It got a lot of hits, so I thought I would post the follow-up letter that we received about a week and a half ago for your perusal. Hopefully, this will continue to take some of the edge off this relatively mild virus. As with the first time, the italics represent a direct quote from the letter written by Diane Holmes, M.D. and Kenneth Polin, M.D.

We are now into the seventh month of this outbreak, and fortunately, the overall severity of this infection has not increased.  The media reports the most severely affected patients without regard to the significant numbers who are not very ill and recover easily.  According to Center for Disease Control estimates, almost 6 million individuals have been infected, generating approximately 20,000 hospitalizations.  By those statistics, an individual with H1N1 disease has less than a 0.3% chance of even being sick enough to be hospitalized.  Please try not to fall prey to the media-based hysteria.  They are only giving the part of the story that draws viewers.

As we talk with our pediatrician friends in the area, we are all frustrated both with the lack of vaccine and the limitations of administration.  The entire H1N1 vaccine supply in the US is channeled through the federal government and subsequently through state and then local health departments.

Unfortunately, their efficiency is not always up to the standards we would like.   With all our staff working as hard as possible and with some of our nurses and doctors putting in extra time to just vaccinate, we have been able to give slightly more than 2,000 doses of the vaccine so far.  We understand your frustration if your child is not yet in that group.

Please understand that all pediatric patients are now considered in the priority group for the vaccine.  Even if we had enough vaccine for everyone (and we certainly do not) and our personnel did nothing but vaccinate all day, every day, it would still take more than 12 days to give the vaccine to everyone who wants it.  We absolutely want to vaccinate as many children as possible, but we need to also continue seeing sick children and give other essential vaccines.  One additional avenue to obtain the vaccine for your child is to bring him/her along with your other child’s scheduled visit.  We are happy to accommodate you if the proper vaccine is available that day.  Just ask the secretary to pull out the charts for the other child(ren), too, when you check in.

Another area of frustration is in trying to make practice adjustments keep in compliance with changing CDC guidelines.  This might result in inconsistent information at times being given to you by our staff.  We can only continue to try to do our best.

Please know that we take all pediatric illness very seriously.  Symptoms of flu (cough, congestion, fever, muscle aches, sore throat) do not routinely need to be seen in the office or the Emergency Department.  If at any point, however, you have concerns about your child’s illness (especially any fever lasting longer than 72 hours, any breathing compromise, child looking progressively sicker, child unable to drink) you should have your child seen. One frequently asked question is “What is the fever number that we should worry about?”  In children over 6 months of age, there is no “worry number.”  Always evaluate your child’s situation in context and trust your parental judgement.  A child with a 104 fever who is droopy but alert, breathing easily and able to drink is much less concerning than the child whose fever is 101 but is not alert, has respiratory issues, doesn’t have good color or is getting dehydrated.

Many thanks to those of you who have expressed appreciation to our office staff and our nurses recently for all their hard work during this very stressful time.  Your kindness and understanding is truly appreciated.

As always, we are trying to be as responsive to your concerns as possible.  Together, we will get through this.

Be Well!

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Toe Walker – First Follow-up

It has been three weeks since I wrote the article “Toe Walking – Not Just For Ballerinas Anymore” pertaining to toe walking in toddlers. Two office visits and more than 10 hours of exercises later, I thought I’d update you all to our progress, and perhaps get a little more conversation going around this surprisingly common subject.

First, let me say that I really like the doctors we are seeing at Children’s Memorial Hospital. They are knowledgeable, patient, and willing to crawl around on the floor walking like a bear or crab, and rolling large padded columns up and down inclines. They are also expensive, like much of our healthcare in America. Billing at slightly higher than $400 for 30 minutes of thoughtful and targeted exercise is very excessive in my opinion, but I will leave it at that for the healthcare topic. The point is that those weekly visits will not be weekly, but rather bi-weekly or even monthly depending on our feelings about Xavier’s progress. After all, the 30 minute sessions in the office aren’t going to correct the issue, our 30 minutes a day at home will, so other than to officially monitor progress or offer tips and additional exercise ideas, we will save ourselves and the (ahem) insurance company the cost of weekly $400 visits.

Xavier is progressing decently, though slow progress is to be expected. He is physically able to walk with a healthy heel-strike-first gait, a big advantage. His range of motion is normal, so whenever we remind him to “walk on flat feet” he immediately begins walking correctly…for a little while anyway. This is actually one of the more important things we have been advised to do is to constantly observe his walk, and remind him to get off his toes. It is both amusing and annoying to listen to us walk down the street having a normal conversation interrupted every couple of minutes or so with a “FLAT FEET” or “HEELS DOWN” reminder tossed the way of my little man. To his credit, he never complains, and drops his heels down every time, no questions asked.

The other important element of the treatment is the exercise routine. About 30 minutes of each day (not all at one time) we do fun little exercises to strengthen Xavier’s core muscles designed to make it easier and more natural for him to steer his balance back to his heels from his toes. Some of these exercises include:

  • Duck Walking – Stand with feet close together and bending at the knees, put hands just below each knee. Take small steps across the room or around the playground, quacking like a duck while walking. This is both the toughest exercise, but also might be the most effective according to the therapists. Done correctly, it is very difficult to do this without the body weight being centered over the heels.
  • Air Kick-Ball – Lay on back and try to grab a ball held above your chest with both feet, or instead of grabbing, just kicking is OK. Try this once yourself and it will be obvious that this is designed to strengthen the abdominal muscles making it easier to keep body weight balanced over the heels. Xavier actually thinks this one is really fun and will interrupt a regular game of kick-ball to do this exercise.
  • Squat Toy Pick-up – Stand with feet about shoulder-width apart. Keeping heels planted on the floor, squat at the knees and with both hands pick up a toy or small object placed between feet and slightly behind heels. Note that I personally have never been able to squat down with my feet flat on the floor, but can only do so on my toes with heels elevated.
  • Bear Walk – With feet as flat as possible and bending mostly at the waist (as opposed to the knees) place hands on the floor and walk across the room or around playground.
  • Crab Walk – Same concept as the Bear Walk, but with stomach and chest facing the sky as opposed to facing the floor.
  • Push Something Heavy – Push a short and reasonably heavy object along the floor keeping feet as flat as possible, or even better…
  • Pull Something Heavy – Same as above but pull while walking backward. This almost forces the heels to the floor first.
  • Superman (or woman) – Have child lay on stomach across your lap with most of upper body hanging over the side of your lap unsupported. Have the child reach for a ball or other object with both hands. The object should be held high and far enough away so that a good stretch up and out is needed to grab the object. This is designed to strengthen the lower back muscles and complements the abdominal core exercise above. The nice thing with this exercise is that you can easily touch the child’s lower back and feel it working.

There are a handful of others we have been given, but these are in the standard rotation. Xavier is showing progress, and will sometimes stand or walk on flat feet without prompting, but still has a long way to go. It is interesting to me how many people either have a child or know a child who has been through this and has had both success and a definite lack of success in correcting it, even with serial bracing. I am very hopeful our little dancer will be fine, but not without significant effort. I wish nothing but the best to anyone else who is working on the same thing, and would love to hear about your experiences as well.

Be Well!

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T.V. Or Not T.V. – That Is The Question

I love television! You love television too. C’mon, admit it, even if you think you spend too much time watching T.V., you love it. Television is an incredible invention and tool. It informs, entertains, passes the time, and creates loads of water cooler topics for us all to chat about while we aren’t watching T.V. Now, with the advent of first, cable programming, then satellite television, there are a seemingly endless supply of shows we can watch. Too many, in fact, for a single person to watch all of, so along came Picture-in-Picture, TiVo and DVRs, followed quickly by DVDs of television shows, webcasts, and iPod downloads. We watch comedies, drama, sports, documentaries, reality shows, then shows about reality shows, and awful “celebrity news” programs about the people on the shows about reality shows. Let me just sum this paragraph up by simply stating the following: TMZ? OMG!

I have also loved television for as long as I remember. I have very fond and vivid memories of watching “Sesame Street”, “Electric Company”, and “Zoom” on PBS back when I was four or five years old living on the north side of Chicago. I remember the intro music to the nightly news shows my dad watched religiously (and still does). I can still sing word-for-word the jingles for Empire Carpets, Aronson Furniture, and Townhouse T.V. and Appliances. I remember all those Saturday morning cartoons and watching sitcom after sitcom like “Welcome Back Kotter”, “Barney Miller”, and “Alice” after school every day. In recent years I was truly addicted to several shows including “Lost”, “Survivor”, “The Amazing Race”, and “CSI” (yes, the Vegas one – do the others even deserve the “CSI” name?). Finally, of course, I don’t let a Sunday go by without watching 6+ hours of NFL football, though I do try to get out of the house and be social for those.

Wow, sounds like I must have a rotted brain, obese body, high blood pressure, and a propensity for violent behavior, right? Nope. Aside from being a little softer around the middle, and perhaps a little less sharp than my interestingly television-free college years, I am a pretty healthy, happy, and good natured person with a good head on his shoulders, thank you. Does this mean that too much T.V. is in no way detrimental to human development? No way!

Many studies have been done that effectively demonstrate that excessive television viewing in early childhood leads to a higher risk of all the nastiness I listed above. Just to reinforce, that was obesity, high blood pressure, delayed or reduced capacity to learn reading and writing skills, and aggressive or violent behavior and mannerisms. I guess the key question is what constitutes “too much”? It appears as though the general consensus is that any television is worse than no television, but let’s be honest about the reality of a child growing up in America and never watching any television. From what I have read, it sounds like the scientific suggestion is that 4 hours or more daily is excessive, and progressively less than that is progressively better. So, now you know what to do with your children, just cut back that television time, right? Wrong.

Like almost everything else in life, that is simplifying the issue way too much. Let’s assume that children are going to watch television. In my case, the primary child watching television is my two and a half year old son, Xavier. Xavier likes a handful of television programs, and probably watches too much television. It is frustrating for both my wife and I as we would like to curtail his viewing habits more than we have, but between my money-making efforts and her caring for seven month old Hayden in addition to Xavier, television is a convenient distraction, and allows us to get the necessities done. You might think that makes us bad parents, and you have a right to your opinion, but there is more to it than that.

Here are some of the ways that we try to make the time he spends watching television effective, and hopefully less damaging to his development:

  • Avoid programming that includes commercials. Fortunately, we get the Disney Channel, Nickelodeon, and Noggin to complement our PBS channel. I know that Disney and PBS are commercial free, and I believe Noggin is as well. Commercials suck! They are well-produced and have a very definite objective to sell products and/or services to us. The benefit that they entertain us only makes their messages more powerful, and is in no way their primary objective. Children, toddlers in particular, can’t discern between commercials and regular programming, and can often immediately want the things they see on commercials. They can do the same with things they see on television programs, but generally the programs aren’t specifically trying to sell them something, so the impact is perhaps lessened.
  • Choose programming that encourages the viewers to be interactive, physically active, and thinking. Perhaps “Mickey Mouse Clubhouse” isn’t the greatest, but throughout that show, the characters ask questions directly to the “camera” and even pause so the child can respond. Mickey and his pals will also encourage the child to get up off his or her butt and march, dance, skip, and stretch. Other favorites of ours that at least try to be educational include “Word World” and “Sid the Science Kid”. I am not claiming that these shows will turn our young boy into a super-genius (his genes will do that), but they are relatively entertaining even for adults which helps us interact as well and ask him questions about what he watched, what he thought of it, and heap praise on him when he demonstrates having learned something during the show.
  • Get him actively playing and exploring outside the home for several hours each day, or inside if and outdoor excursion is either unmanageable or unaffordable. We utilize a local playground, the nearby train stations, and our very walkable urban neighborhood. Xavier has had the opportunity to explore some of the greatest museums our country has to offer, including the outstanding Children’s Museum on Navy Pier. FYI, if you live in Chicago, you can go to any local library and check out free passes to most of the city’s museums, pending their availability, of course.
  • Read to him every night before bed, and randomly throughout the day. During reading, it is important to keep the child engaged by asking questions about the story, what he thinks might happen next, what he would do in that situation, and other questions along those lines. We need to make more time to read to him, and encourage him to “read” alone as well.

With all that said, there are some weak points we need to correct, but struggle to balance. I have mentioned often in the past that Xavier loves trains. It is no surprise he would, they are big powerful machines that are ever present in our neighborhood as we live only blocks away from the two major commuter train stations in Chicago (Union Station and Ogilvie Transportation Center), and steps from the Green/Pink CTA elevated line (the “El”). Along with that love of trains comes a love for train videos and shows. Xavier will watch everything from “Thomas the Tank Engine”, to a DVD series appropriately title “I Love Toy Trains”, and a surprisingly gargantuan assortment of train videos available for viewing on YouTube.

While the train videos seem innocent, they have a few drawbacks that are causing us to become more strict about his time spent viewing them. First, while not commercials, they are selling us something…toy trains, imagine that! I have to admit that I have at times gotten swept into the collectible nature of the Thomas the Tank Engine characters, of which there are many more than you might imagine. We use the wooden variety (they also are available in die cast and a plastic motorized version), which cost anywhere from $10-$30 retail per character. The various buildings and accouterments are even more wallet-thinning ringing in for prices extending well into the $100+ range. Now that he has discovered actual “O” and “HO” scale toy trains I can only imagine how high the prices of his wish lists will climb.

These shows and videos can also be quite violent. Not in the shooting way that cop shows and war movies are, nor in the reality defying catastrophic injury manner of such cartoons as “Bugs Bunny” or “Tom and Jerry” are, but rather in the frequency and seriousness of the train derailments and other disasters that saturate the Thomas series. Even in the “I Love Toy Trains” series which features video of actual toy train layouts in various shops and basements, the “funny” moments involve trains crashing and derailing. I have no doubt in my mind that Xavier’s tendency to involve crashing in all aspects of his play come directly from our decision to introduce him to the “Thomas the Tank Engine” video series. Recently, I have found myself catching him in the midst of reenacting scenes from the videos, stopping him from completing the scene, and explaining that trains crashing is actually very far from funny, and that people get very hurt when train crashes happen (regardless of how incredibly powerful they are to watch).

So, I’m not so much looking for advice as much as sharing our experience with television, and wondering if others would be willing to share their challenges with this battle (and by battle, I men with the ubiquitousness of television more than the battle with the child wanting to watch it). This is something that is very difficult to avoid due to the demands on our time, and can’t be even close to unique to us.

I’d also love to know from the parents out there if and by how much having children has curtailed their own television watching habits. I have significantly reduced mine, and now will not even watch a single episode of a new show knowing my own propensity to becoming “hooked”. I still watch “Heroes”, will not miss “Lost”, and try to keep up with “The Amazing Race”. I still watch a lot of football on Sunday and most Monday Nights. I have lost touch with “How I Met Your Mother”, “Survivor”, and “The Big Bang Theory”. The only other show in the rotation is “The Biggest Loser” which, at two hours per episode is both way too long and easy to cut away from sporadically to get things done. Those people on that show are both inspirational and indicative of the epidemic of obesity in America, and it is something I like to keep up with.

Thank you, and Goodnight.

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The Nomad Dad

As I continue my evolution into a self-employed online entrepreneur, I run a never-ending gauntlet of new challenges for which I am just now becoming equipped. Some of these challenges include learning new technological skills, finding capital, hunting for great partners, and continually motivating myself to continue working, bypassing the amazing and grotesque story of the woman on Oprah whose boss’ “pet” chimpanzee mauled her beyond recognition. Alas, while these challenges are difficult hurdles to negotiate, the one for which I was least prepared is trying to work at home.

Working in “a home” is not the issue so much as working in “my current home”. My wife, 2.5 year old son, 7 month old daughter, and I all share a 1,280 square foot, 2 bedroom, authentic brick and timber true loft in Chicago’s West Loop neighborhood. If you are not familiar with a true loft, it means that the layout is very open with no doors and walls that do not reach the very high ceilings. We have been trying unsuccessfully to sell our place for about a year now, but the market is tough, and we happen to live in a neighborhood which is developing very quickly, with inventory saturating the market, much of it being sold off on the cheap at developer auctions and such. Our condo is extremely cool, the location is almost unbeatable, and the amenities are more than adequate. It was huge when Kerry and I moved in, and plenty of space even when Xavier came along. Hayden’s arrival earlier this year threw off the “tenant-to-square-foot ratio”, and in preparation for her arrival, we put our place up for sale.

To make a long story short (this isn’t an article intended to sell our condo after all), it still hasn’t sold. In June, I began working from home, and my ability to work in an environment free of not only daily temptations like T.V. and Xbox 360, but also regular interruptions from all three of my roommates has been severely compromised. To be fair, for the first couple of months I was home, my “work” consisted of spending several daytime hours surfing multiple job listing resources and networking, while the “Worldwide Pants” hours were spent working on my blogs. Late in the summer, however, it occurred to me that the world is changing in a profound way right now, and establishing multiple wellsprings of income while building my own personal brand is vital to my family’s future. To that end, I officially undertook other business building ventures, and my “work” has actually become exactly that…work. So, what to do about the home office situation?

Obviously, the best solution is also one that is more or less beyond my control, and that is selling our condo, and moving into a home where I can have a real office with a door dedicated to business activities. While ideal, a door alone will not completely solve the problem of interruption, so I looked to other sources of advice about ways to handle this underestimated challenge. One article in particular caught my eye, with simple and straightforward tips from a father of six who works from home. Yes, I live in a loft, but he has six rugrats at home with him, that gives him a degree of authority on the subject that I respect. It sounds like this is an issue for many Dads and also Moms, and the numbers of people working from home is growing every day, so I want to share Mr. Leo Babauta’s article, 10 (More) Tips on Doing Productive Web Work with Kids in the House, with others here.

Because Mr. Babauta does not specifically offer tips for my situation where a door, or even ten feet of separation exist between me and my potential interruptions, I thought I would add a personal touch by emphasizing the ability to work productively while “on the run”. Yes, for some a nomadic lifestyle is not the most productive, but I happen to live in the heart of one of the most populous cities in the world, so I have no shortage of locations where I can plop down with my backpack and laptop and get some work done. Today I sat in my nearest neighborhood Starbucks (I have four within a 3-4 minute walk), yesterday I did some work at Borders, and tomorrow I might visit Argo Tea.

Coffee shops and their ilk are also not ideal, often they are quite busy, and the music that the staff chooses to play can sometimes be overwhelming. Using these businesses like a biologically advantaged Cuckoo bird also comes with the delicate dance I will simply title “How-much-do-I-have-to-buy-to-be-left-alone-for-many-hours-on-end-and-will-this-Tall-Pike-Place-Roast-get-the-job-done?” tango. So far, so good. Usually I shell out about $2 for a hot beverage and the permission to commandeer my own little corner with electrical outlet for 3-4 hours, and no hassles whatsoever.

So, for now, this needs to be my top solution, though in the long run, it will not be sufficient. There are some things that must be done “in the office”, and for that I must either develop better techniques for blocking out the distractions, or give up some additional sleep. It is also a situation that requires a commitment from my wife, and she has been mostly good about it thus far. One huge benefit to working from home on my own business, after all, is the ability to spend more time with my family, so to some extent, my workday will always be “non-traditional”, it just demands a little creativity and dedication.

I’d love to hear from others who either have dealt with or are currently dealing with this same issue. What have you tried to better the situation? What has worked, and what has not? Oh, and if you think this story can benefit others, please pass it on, either directly, or by using the share buttons directly below this article.

Be Well!

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My Lil’ Kicker

This afternoon I officially registered my son for his first soccer “team”. We will be attending the Lil’ Kickers program here in Chicago. We are in the Thumpers division for 2-year olds, and start classes on December 2nd. I discovered that at the first class he would get his first uniform, and I openly chuckled at myself for how excited that made me feel.

From all I’ve read, it sound like a really nice program aimed at teaching children about soccer, yes, but also about listening skills, balance, coordination, and teamwork, the first and last of which Xavier could use a little coaching on. Lil’ Kickers is a franchise organization with 100 locations in 28 states and enrollment of over 237,000 kids! You can read more about Lil’ Kickers here.

If you have or had your own children in Lil’ Kickers, I would very much like to hear about your experience with them. If you haven’t, and you are interested in possibly signing up your own lil’ kicker(s), stay tuned, and I will post regularly about how it goes for us.

Be Well!

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The Halloween That Was

So, as we leave the three-day period known by the Catholics at Hallowmas, I can’t help but reflect a bit on one of the most fun, but also one of the most meaningless of all the holidays we celebrate today. Additionally, now that my son is beginning to understand some of the more entertaining elements of the celebration, i.e. getting candy, I wanted to understand at what point the candy element became part of the holiday. It struck me, like so many elements of the other major holidays, as just more American consumerism overwhelming the true meaning of a widely celebrated holiday. Finally, as I attempt to eat healthier and take better care of mine and my family’s diets, I wanted to see if there was some way I could start a movement to eliminate some of the candy overload we are all forced to participate in every year on October 31.

So, the consensus is that the modern celebration of Halloween originated with the ancient Celtic festival of Samhein (pronounced Sow-in). See, the ancient Celts lived in what is now Ireland, Britain, and parts of Northern France. What many people do not realize due to the climate moderating currents in the Northern Atlantic Ocean is that the United Kingdom sits as far north as cities like Calgary, Edmonton, Moscow, and Stockholm. The winters there, while not as cold as those continental cities in Canada and Russia, still hover near freezing, and the days in the winter get very short, and correspondingly very long in the summer. Imagine a winter there without the aid of electricity, heat, accessible food, modern plumbing, and pre-wrapped bite size chocolate candy…brr, gives me the chills just thinking about it.

Samhein for the Celts marked the end of the summer as they had completed harvesting their crops and were in the process of slaughtering their livestock for their winter stores. The Celts also lived in a time and place that was still unfamiliar with Christianity, Islam, and probably even Judaism. Their gods were those who controlled the elements around them, and their belief in an afterlife was of a spiritual world of the dead which existed separate from their world of the living. During Samhein, the Celts believed that the boundaries between the realms of the living and the dead became “ill-defined” allowing co-mingling with dead spirits both harmless and harmful. The Celts donned disguises during this festival often depicting the evil spirits that might do them harm. Sensibly, they believed that if they looked like an evil spirit themselves, perhaps the real evil spirits would leave them alone. Finally, in preparation for the long cold winter, the Celtic Druids would build massive bonfires upon which the Celts would burn crops and livestock as sacrificial offerings to the gods…so much for logic, eh?

The Romans finally arrived in the lands of the Celts around 40 A.D., bringing with them a couple of late-fall festivals called Feralia and Pomona that became combined with Samhein. The Roman festival of Pomona specifically honored the Roman goddess of fruit and trees, and its symbol was an apple. This symbol likely led to the tradition of bobbing for apples in later years. Later, the Catholic Church created the holidays of All Saints Day on November 1st and All Souls Day on November 2nd in order to bring a semblance of Christianity to the celebration known collectively as Hallowmas.

Not until the mid-1800s did the traditions of dressing up and going door to door asking for food or money emerge in America. Gradually, Halloween became more about community and big Halloween parties. Community leaders and schools gradually made an effort to remove the mischief and superstition from the holiday, and by the middle of the 20th century the holiday became secular and aimed primarily at the youth of America. Trick-or-Treating became the custom and flourished as a way for the community to “share” the cost together, and theoretically prevent “tricks” to their household and property by providing treats for the children. Halloween is now estimated to be a $7 billion industry, second commercially only to Christmas.

For a time, children would often receive apples coated in candy, toffee, caramel, and sometimes nuts. These homemade treats, while certainly scrumptious, provided fodder for hysteria as rumors of ne’er-do-well hiding blades and needles in these treats scared most parents into forbidding the eating of such treats in favor of well-sealed confections made by big candy companies. In fact, most unsealed candy and treats are now considered some of the most detestable of treats one can receive on Halloween, and may even subject the treat provider to some “tricks” for their audacity. Convenient circumstances for companies such as Hershey, Mars, Cadbury, and Nestle to swoop in with solutions for every American home.

So, what are the kids today celebrating? Instead of being frightened by spirits of scamps and rascals or stories of mischief and terror, we are more scared of other people surely intending harm. Most trick-or-treat parades appear populated with parents herding munchkins still dressed as vampires and pirates, but also as Teletubbies, Thomas the Tank Engine, and other popular icons of the day. While more sanitized, these aren’t too far off my own memories of Halloweens past.

Most of my candy-hauling took place during the early 1980s and involved loads of Snickers, Milky Way, 3 Musketeers, and Reese’s Peanut Butter Cups, but also way too much Good n’ Plenty, Necco wafers, Double Bubble, and those annoying Peanut Butter nougat chews in the Orange and Black wrappers. I was an unabashedly terrible costume creator, but loved the “thrill of the hunt”, and during my best years went with a handful of friends sans parental supervision. We would stop off at home from time to time to empty our load and head out to a different zone (or occasionally hit some of the “good” houses a second or even third time). By the end of those nights, I had undoubtedly collected a year’s worth or more of candy, and ate a good portion of it immediately after the mandatory sort-and-trade session. I was a big fan of Almond Joy and Mounds which I could score for a song from most of my friends.

Some of my most entertaining Halloween memories, however, were not of trick-or-treating, but rather the all too rare Halloween party involving those Taffy Apples, apple-bobbing, and various games. I wore some pretty cool costumes (mostly homemade) back when it was my mother, rather than me, choosing my disguise, and later admired the handiwork of my more imaginative friends.

I guess now, as a parent, I am hopeful that we can find a home in a place where those old-school parties of the past will take place, and my kids can have the same great memories of this holiday beyond just the brands of candy and fears of the dark strangers of the world to interfere. And here is a thought for all parents next year, how about being one of those “bad” houses and give away something other than candy for a change? How about shiny quarters, or dollar coins if you are able? Perhaps Clif bars if you must give a candy-like treat? If you already have made this change, what did you give out? I am just thinking in the spirit of helping our country be a little less obese, perhaps we can help delay the orgy of sweets that typically begins with Halloween and extends right on through New Year’s Day every year.

And please, if you absolutely must give out candy, just don’t, whatever you do, be the house giving out those wretched Black and Orange wrapped Peanut Butter nougat chews. If you do, may the trick be on you!

Happy Halloween that was!

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A Pediatricians Advice About H1N1

This is a direct paste of a letter sent by Dr. Kenneth Polin to my wife, Kerry, along with what I assume are many other parents today. Dr. Polin works out of Town & Country Pediatrics who operate three offices here in Chicagoland. The immunizations being provided by Town & Country Pediatrics are all Thimerosal-free, so are in limited supply and high demand. This is causing the offices to get swamped with calls throughout the day, making it difficult for actual sick children to get appointments to be seen. The offices have informed all parents this morning that they will only accept calls for day-of vaccinations for a single 30 minute period each morning…so a bit of a lottery system if you will. In any case, here is the letter…

Dear Kerry,

There has been a lot of information and misinformation regarding the current influenza as well as relating to the flu in general. We would like to inform and clarify in order to calm fears and help our patients cope with the current situation.

Influenza is an annual event caused by a virus which changes each year. That is why patients need to have a new influenza vaccine annually. The vaccines given in past year do not cover the new strains which appear. Most of the strains we see annually are somewhat related and can cause significant complications in the healthy population as well as in the population with underlying medical issues.

Every year, in the US, approximately 36,000 people die of the flu and related complications. This new flu which has been around since the spring of this year has taken a toll with about 1000 patients dying including 100 children (this is over six months time). The majority of these deaths have occurred in patients with other medical conditions however, this has not been exclusively the case and some healthy patients may have severe complications and even die. It is important to keep things in perspective and if your child gets sick, to be armed with information and not worry needlessly.

The signs and symptoms of the flu (all types) are a quick onset of fever with a dry cough. There are often accompanying body aches and many patients complain of eyeball aches. There may be vomiting also. Not all patients will have all symptoms. If your child has these and has no other medical issues, routine health measures for comfort are all that is needed. If your child is young (under two years old) or has other health issues we should discuss whether we should see your child or manage at home without a visit to our office. Additionally, if your previously well child appears to be compromised in areas of shortness of breath, significant vomiting, acting strangely, or you are just uncomfortable with his/her appearance, call us ASAP. The CDC no longer recommends the use of a flu test as the in-office test is not that reliable and better diagnoses are made using a history and physical diagnostic skills. The use of antiviral medications has also been discouraged in healthy patients in order to avoid development of resistance by the virus to these medications.

The best way to prevent the disease is vaccinating, but there is at the time of this writing only a limited supply as well as a limited resource availability to administer the vaccine. If you want the vaccine, consider all possible sources. Our office supply of seasonal flu vaccine was reduced as the manufacturers were told to shift their production from seasonal to swine flu. All of the swine flu vaccine was sent to the public health sector who in turn have distributed it to multiple sites including, to a limited extent, our office. We will be sending out information about what we have and what we can reasonably be expected to administer via email and on our website.

Keep in mind this is not a panic situation and with your help we can weather this storm together and not fall into the trap of fear that is not warranted.

As it relates to my previous post, The Drama is Deafening, this letter will hopefully show that both extremes are unwarranted right now, perhaps the hysteria about H1N1 even more so.

Be Well!

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Toe Walking – Not Just For Ballerinas Anymore

I know nothing about dancing. I’ve never been fond of dancing myself. Aside from some occasional thrashing about in nightclubs back in my early twenties, I am generally standing on the sidelines, or more likely, near the food/bar. From what I understand however, dancers, particular those in the ballet, work long and hard to build the strength and flexibility in their calves to allow for dancing on their toes. Apparently this makes movements more graceful and beautiful.

In children, toe walking takes on a completely different meaning. Many children walk on their tip-toes as they learn to walk, and will generally abandon that for a more typical heel-first walking style early on. Sometimes, children do not shake the habit, however, and despite its cuteness, can be pretty damaging both physically and emotionally. We have just begun officially dealing with this in our own little toe-walking son.

A neighbor of ours brought it to our attention over a year ago now. She told us about her own son’s toe-walking, and his need for a serial brace work for portions of every day in order to stretch out the tendons in the Achilles area to allow for a heel-first strike. Xavier advanced through most of his physical milestones early than average, and began walking just as he turned 10 months. Very shortly thereafter, he began running and kicking (I proudly share that he already has “mad” soccer skills). I must admit, it was tough to hear that my budding athlete might have an issue with his legs, but our neighbor’s warning was accurate, and after Xavier failed to shake the habit after more than a year and a half of walking, we decided to have a consultation with a physical therapist at Children’s Memorial Hospital.

The session was held in a typical doctor’s office, but the staff was a bit different. Instead of stethoscopes and tongue depressors, they came equipped with what appeared to be some sort of protractor, some toy cars, and a basketball. As far as Xavier was concerned, there couldn’t be a more entertaining doctor’s office to visit! They asked Xavier to do a series of things like squat down, lay on his stomach (so they could measure the angles his stretched tendons would allow), and walk like a duck. He behaved wonderfully, following every request and suggestion perfectly. Eventually, we made our way to a more gym-like room where other exercises followed.

The result is that while bracing is not necessary right now, we do have some exercises to perform daily with Xavier at home, and will be heading to therapy weekly for the next 4-6 weeks. The exercises are fairly entertaining, so Xavier doesn’t put up a fuss (for now), but it does take even more discipline and diligence in all of us to make sure we are doing them regularly and correctly. I have a high degree of confidence that we are taking care of this early enough that we will be able to correct his walking through exercise alone, but time will tell. Either way, it takes nothing away from his abilities or coordination (remember…MAD SKILLS), so I am not worried.

A word of warning, however, for other parents out there. We were told that though this could just be something natural that he was predisposed to do, some things can exacerbate the problem. Among those things are the family of “exer-saucers” and “walking aids” that seem pretty ubiquitous in children’s playtime rota. Before Xavier was walking, we would frequently let him play in his Rainforest Jumperoo by Fisher-Price. It seemed like an excellent toy to us – he loved it, it appeared to strengthen his legs, and it kept him occupied without crawling all over the condo like some drunken marine doing basic training drills. Come to find out that these toys encourage the child to brace their weight on their toes early on until they graduate to walking. Then, in an evil follow-up, the “walking toys” that seem to help the child walk actually force the child out of control, and that is exactly their problem. When used, the child is encouraged to walk with their weight forward on their toes in order to keep up with the rolling toy. Again, Xavier LOVED his “walker”, though due to frequent collisions with objects both inanimate (the wall or a pile of toys) and animate (my foot or the cat), we were less in love with this one, and will happily forgo its use with Hayden.

Rainforest Jumperoo by Fisher Price

Xavier in his Rainforest Jumperoo, a.k.a. Tendon Compactor

In place of these toys, the therapists suggest loads of “tummy time”. If you are a parent, you know what “tummy time” is, and if your not a parent…well, you can guess. Another problem that comes with toe-walking (or is it a cause – I can’t remember) is weak abdominal muscles. Strong abdominal muscles are developed during tummy time, and in turn encourage the weight to fall back on the heels when walking, standing, etc. You can actually see it on Xavier when he tries to perform a sit-up of sorts. A ridge running vertically down the middle of the stomach pushes up as he tenses his abdominals. This ridge, along with a noticeable flaring of the ribcage is the result of the two sides not yet “coming together” (again, I don’t know the scientific terminology). This too should be corrected with these exercises we are performing.

So, if you child, or soon to be child displays the toe-walking and abdominal ridge after 18 months of age, I suggest a visit to a good physical therapist to catch the problem before it becomes an impairment that needs correcting during school years. Kids can be cruel. We’ve all been there – probably on both sides of the teasing battlefield – and whether the child is forced to wear orthopedic shoes, or walk like a ballerina, chances are some taunts will be uttered in their direction.

If you have a very young child who hasn’t yet gotten into a Jumperoo-type or walking-assistance product, heed my advice, and stick with “tummy time”. Not only is it better for your child, but it will save you a few bucks as well.

Be well!

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The drama is deafening!

I am a history buff. Yes, I know…yawn, but alas, I am. So, having the historical education that I have, I should not be surprised by the drama that exists in this country right now (drama has existed throughout history), yet I find myself constantly amazed. I also expect that my posting of this article will cause a fair amount of drama among my limited number of readers, but I am going to post it nonetheless in the hopes that I am being logical, and that the vast majority of people will agree with my points.

On Thursday, we took Hayden into the pediatrician for her 6 month checkup. She is very healthy, growing well…all systems go. While we were there, we continued her parentally modified vaccination schedule with a couple shots (Pentacel and Prevnar). She is still behind in her Prevnar, but she will not get “more behind” going forward. As we did with Xavier during his first two years, we chose not to get Hayden immunized against either seasonal flu or the notorious H1N1 (gosh, it’s like uttering Voldemort). Much to Xavier’s chagrin, despite it being Hayden’s checkup, we shanghaied him with an immunization during the visit, as we were afforded the opportunity to get him the thimerasol-free H1N1 nasal mist (he also received the seasonal FluMist 6 weeks earlier). Neither Kerry nor I have ever gotten a flu vaccination.

Kerry has gone on record saying she has never had the flu in her life, and I can tell you that I haven’t had the flu in at least 17 years. Neither of us goes to a workplace, and actually spend most of our time among our own family in our neighborhood. Of course our “neighborhood” consists of something like 1.5 million people, but work with me here. Hayden is still only 6 months old, and in very good health thus far. Hayden (like Xavier before her) does not go to daycare, and is rarely in contact with anything that does not originate in our own house.

Xavier, on the other hand is officially a little boy, and regularly partakes in all the active socializing, and “gross” behaviors that come along with it. As an example, last week he and I walked over to the train station food court so I could try the enticing new “Black Taco” at Taco Bell. As I was waiting to pay, I looked down to spy my beautiful boy licking the front of the service counter! So, figuring that if anyone might bring home H1N1, or the seasonal flu for that matter, Xavier would, we decided to get him immunized for both.

OK, so to the point of the post. Upon returning home, I posted a status update on Facebook asking if our decision to immunize against “swine flu” made me a slave to the media or a responsible parent. I got several answers, and though most agreed we are responsible parents, there was more than one dissension. Being the person I am, and having some time on my hands, I decided to read more about H1N1 than I already had, and am blown away by what I have read.

So, unlike some of my posts, I am not intending to take a particular side of this issue, though it might end up sounding that way. Please remember that my intent here is to call out the unnecessary drama that we continue to create in our lives. Please also remember, we did not get Xavier vaccinated for fear he will die, but more because we would like to avoid him getting the flu because having a sick kid sucks. Additionally, my decision not to get myself vaccinated has nothing to do with fear of the potential side effects of the shot, but rather the laziness with which I take care of myself.

First, I’ll address the drama resulting from the fear of the virus itself. Listen, Influenza is no fun, and is prevalent in our society and the world. It is a nasty virus that attacks the respiratory system, and for most who get it, wastes about a week of their lives with high fever, coughing, and achiness. For too many others, about 3,500 per year in Illinois on average, it unfortunately ends in death resulting from complications associated with this virus, primarily pneumonia. Though a high number, this generally falls well behind heart disease and cancer (#1 and #2), and slightly behind other well-known culprits such as strokes, chronic lung diseases (emphysema/COPD/bronchitis/cystic fibrosis), accidents, diabetes, and Alzheimer’s…in Illinois at least.

H1N1 has been “around” since April 2009, or at least this strain of it. There have been H1N1 outbreaks in the past, the most recent of which was contained to a single military unit at Fort Dix, NJ, and killed only one soldier. So far, in Illinois, H1N1 has resulted in 542 hospitalizations and 22 fatalities. Only 5 of those 22 were children 18 years and younger, and only 1 was under 4 years of age. Even if we acknowledge that the major outbreak might just be gearing up, and we have only really experienced about a month of this nastiness, that trend is suggesting about 265 fatalities in the next 11 months. I understand that I am using grade school math here, and that the actual trends suggest this outbreak will be slightly higher than the 2008-09 seasonal epidemic, but even that suggests that if we take the simple preventative measures that are both being advised and should be common sense, most of us will not perish at the hands of this virus. So, cover your mouth, wash your hands often, and for the love of everything holy, if you are sick, sit your butt down, and don’t go to work, functions, meetings, recitals, or anywhere else where you think your are “needed” for life to move forward until you are over it.

On the flip side, of course, are those afraid or opposed to the immunization. Really, you are scared of the flu shot? What is going to happen? Flu shots do not cause the flu. Side effects of the flu shot are by all reports, rare (though I must admit I can not find any actual reported numbers, just the word “rare”). The worst is an illness called Guillain-Barre Syndrome which is associated with a swine flu vaccine developed and administered in 1976…yes, 33 years ago! Since then, studies have shown that only 1 in 1,000,000 people may be at risk of the illness associated with a flu vaccine. Science has done some remarkable things, and the development of vaccines to prevent illnesses is most certainly one of those things. It is easy to distrust things that we do not personally understand, but why is it so easy to trust those things that are so contradictory to them? I read somewhere that there is going to be an episode of “Sid the Science Kid” created by Jim Henson’s gang airing on Monday and will be about getting your flu shot. The writer was suggesting that the episode was evidence of Big-Pharma backed programming using propaganda to sell more immunizations, as if kids are going to all of a sudden enjoy getting shots.

So, as with so many things in life, I am suggesting that we all relax and attempt to fall somewhere in the middle of the two sides of this drama. This H1N1 is a virus that has, and will continue to cause fatalities among us. More often, it is going to knock people out of commission for several days leading to the usual wintertime decrease in productivity at offices and schools across the country. No doubt, the manufactures of the vaccines will push for more vaccinations as we still live in a capitalist economy designed to allow those corporations to profit from a demand. Take care of yourself, take care of your loved ones. Get the vaccines or don’t, but let’s recognize this for what it is (a respectable viral outbreak), and for what it is not (a conspiracy). So when I stupidly come down with either the seasonal flu or H1N1, the blame will only be mine.

Be Well!

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Actually…maybe.

I have heard it said on more than a handful of occasions that children are the toughest job and the greatest joy one can experience. While I am sure that isn’t exactly true for everyone, it is for me. One of the greatest challenges that I have had with my young children is understanding what the hell they are talking about.

Obviously, little Hayden at 6 months old isn’t talking yet, but she is definitely communicating. Her cries, whimpers, screams, giggles, and coos all mean something, and can often mean several things…oh, wait…maybe she is speaking Hawaiian?

Kerry seems to understand her better than I do. She seems to know that one kicking fit means Hayden is hungry while another means she is tired. For me she is either happy, sad, content, or asleep. While simple, it seems to work between Hayden and I, until it’s time to eat, of course.

Xavier’s speech, on the other hand, has exploded recently. Just 7 months ago on his second birthday, Xavier possessed a handful of words and could compose a rare, brief, and somewhat intelligible sentence to ask for water or to see a train. Today, he speaks primarily in sentences, and possesses a shockingly complex vocabulary (along with a word or two I wished he hadn’t picked up on – though sure to get a bit saltier in future years). According to one of my favorite “assistance books”, What To Expect, The Toddler Years, children about Xavier’s age should be able to carry on a conversation of 2 or 3 sentences, so he is right on target, but it still amazes me.

Among his favorite words of late are actually and maybe. Listening to him talk gives me perspective on what it must be like for immigrants to this country, suddenly trying to learn the English language. “Maybe” doesn’t so much mean that something might or might not happen, but rather acts as a lead in to a request for something…assuming a yes response, of course.

“Maybe us go see trains?”

“Maybe I can have juice?”

“Actually” is even more enjoyable to listen to. Xavier sounds like a wise instructor always correcting our sentences.

“Actually we are watching Nemo.”

“Actually us going to the park today.”

Every day brings new developments, and already the word maybe seems to be finding its’ more proper role as a frequently used adverb to express the possibility of something. He has thankfully picked up on “please” in the last few days, and now politely asks for things like water, or to see trains…unless we say no, that is.

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