Practical Truths

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Friday Night

Daughter comes into room at approximately 2 a.m.

 

“Mommy, my mosquito bite really itches.”

 

In the darkness, I slather anti-itch cream between her toes. I can’t really see but figure I’ve doused the bite and she’ll go back to sleep.

 

Ten minutes later, “Mommy, it’s still itching.”

 

I turn on the light and put more cream between her toes. We’ve been eating dinner on the back deck a lot. Boy, she sure got munched.

 

Half an hour later. “Mommy, it’s itching!”

 

I give her a Benadryl and she finally sleeps.

 

Saturday

 

Saturday morning, she sleeps in and comes down late in her PJs.  I don’t notice whether she’s still scratching her bites and have forgotten about our middle of the night itch fest. Husband takes the kids while I go for a hike and run errands.  

 

At 1 pm we meet in town to go to the beach together. I climb into the minivan, take one look at Daughter, and my eyes bug out. Her feet, legs, hands and arms are covered with raised, red welts. She’s scratching them terribly.

 

“She has Poison Ivy!” I exclaim, wondering if we should still head to the beach.

 

Husband has just picked up fourteen year old Niece, who’s staying with us for a week, and we’re all packed up and ready to go. So we circle the beach three times while hemming and hawing about what to do. I dial the pediatrician on call for the weekend but am cut off (poor cell service at the shore).

 

Finally, I declare, “It’s pretty cool out. Let’s get her in the salt water and see if that helps. If she’s uncomfortable, we can always leave.”

 

Fortunately, there isn’t a trace of humidity and the beach is cool so Daughter is actually much more comfortable once she gets wet and starts playing in the sand. 

 

I settle myself in a beach chair with my Blackberry and start Googling “itchy rashes in children.” In a flash, I’m flipping through full color photographs of big splotchy rashes, small bumps, blisters, clusters, you name it. One photo shows a child’s foot with bumps all over it. It’s labeled as…. Scabies. Yuck.

 

The phone rings. It’s my pediatrician.

 

“Hi, Heather. I just noticed you called and didn’t leave a message. What’s up?” she asks.

 

I tell her about Daughter’s condition and the photos I’m viewing on my phone.

 

“It could be Scabies, we’ve definitely seen that around here. But it also sounds like Poison Ivy. If she doesn’t have a fever and is feeling well otherwise, let’s see how she does. If she’s not better by tomorrow, call me.” She recommends an oatmeal bath and Benadryl to ease the itching.

 

Back home after a bath, which makes Daughter scratch more, I dress here in a long sleeve shirt, pants, and socks and that helps her keep from scratching. I give her Benadryl and wait to see what she looks like the next day.

 

Sunday

 

When Daughter wakes up, the rash has worsened and random bumps are moving up her hips and back. I give her another Benadryl and call the pediatrician. We agree to meet at the office at 10:30.

 

The minute Daughter’s clothes and socks are off, she scratches like crazy. Doctor still isn’t sure what kind of rash it is.

 

“It doesn’t look as weepy as Poison Ivy. It could be Poison Oak. It could also be from swimming in the Sound. Or Scabies.”

 

Mmmmm. I want a definitive diagnosis.

 

“Since it’s still spreading and she’s scratching so much, let’s put her on a steroid. We could also just treat her for Scabies in case that’s what it is.”

 

That involves putting a pesticide cream all over her body.

 

“I’d actually rather wait and know what it is.”

 

“Okay, the risk is just that it will clear up on the Prednisone and if it’s Scabies, it will come back and you’ll just have to treat her again.”

 

I truth, I’m not willing to accept that Daughter has Scabies (a tiny parasite that burrows into the skin – Yikes! Uggh! Ick!). Why would she get it and no one else? Why aren’t the rest of us scratching? If we just treat her for it, I won’t know if that’s what she really has. Or something else.

 

Monday and Tuesday

 

I spend the next two days obsessively trying to determine what type of rash Daughter has. It’s appearing symmetrically on both sides of her body. How can this be from a bug? I decide it must be something else and if Doctor doesn’t know, it’s up to me to figure it out.

 

Welcome to MomDiagnosis.com - my stint as a hyper Googling parent seeking answers to my child’s health mystery. (Husband does his best to ignore my bizarre behavior.)

 

I try to get an appointment with a dermatologist and wait for them to call with a cancellation. In the meantime, I spend every spare moment jumping on the computer to Google a new variation of my search theme.

 

Itchy rash on feet, legs, hands and arms.

 

Very itchy rash in child

 

Symmetrical rash in child

 

(There are about a dozen others but I won’t bore you.)

 

Monday afternoon I stop by a friend’s house to pick up some forms for a volunteer group and she remembers that Daughter had a fever the previous week.

 

“How’s she feeling?” she asks.

 

“Now she has a bad rash.”

 

“It’s Lyme Disease! I know it!” She is adamant that I have her checked for Lyme.

 

I return home and Google again.

 

Lyme Disease rash in children

 

Rocky Mountain Spotted Fever! It’s a tick-borne disease that presents with fever and rash. Later that day, Daughter says her elbow hurts. Joint pain! (No matter that we live in New England. My brother and his family visited us from Boulder, Colorado the previous week. At MomDiagnosis.com, a tick can hop a ride across country to satisfy my quest for an answer.)

 

I call the Doctor. “Should we test her for Lyme?”  Even in my obsessed state, I’m too embarrassed to suggest Rocky Mountain Spotted Fever.

 

“It’s definitely not a Lyme rash,” she says.

 

I Google again. The rash for Rocky Mountain Spotted Fever isn’t itchy. Oh.

 

Later that night, I remember that Son had Shingles when he was three and his reaction was similar to what Daughter is experiencing now. A very itchy rash covered his legs and moved up to his trunk. Or was it just one leg? How could both my children have the strange occurrence of Shingles as children after receiving the Chicken Pox vaccine?

 

I Google: Shingles in children

 

The pictures on the web for Shingles don’t really look like her rash. But a list of Comments about Shingles has some postings further down that name Oxyclean as the culprit in someone else’s child’s very itch rash on her feet, legs, hands and arms.

 

Yawn. I’m exhausted from my mad search for her true diagnosis. I don’t think it’s Oxyclean. It might be Shingles, or Scabies, or Poison Ivy.  And now it’s mostly cleared up from the Prednisone so it’s not even worth seeing the dermatologist I finally got an appointment with.

 

The real truth is that with the power of every medical site at my finger tips, I am hoping for some control over what ails her. Some ability to help her and not submit to the uncertainty of a doctor’s “I don’t know.”  

 

This is the third strange rash Daughter has had since birth. If something else is going on here, I don’t trust anyone else to dig as deeply as I will to get to the bottom of it.

 

A week later

 

Today is Daughter’s last day of Prednisone.

 

Will the rash come back indicating it’s Scabies and we need to begin extermination procedures?

 

Will another strange rash appear in a few months, driving me to diagnostic madness once again? (Husband will probably move out.)

 

Or will the last remnants of red dots fade away and we’ll never know what it really was.

 

Probably.

 

In the meantime, I’ve washed all her bedding in hot water. Just in case.

 

 

 

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Six year old Son has a girlfriend. They had a play date yesterday. At her house. Believe me, I was dying to see how their romance is unfolding  - or what six year olds who plan to marry do on a play date – but she’s afraid of dogs and well, our new puppy’s here to stay.

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Husband wooed me this weekend by cleaning out the minivan. I’m still not sure what possessed him to vacuum every nook and cranny with such vigor but it may have had something to do with the lingering odor accompanying us to the beach and a BBQ the day before.

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Yesterday, as news broke out about increasing cases of Swine Flu in neighboring New York City, I sent my pediatrician, Dr. Jen Gruen of Village Pediatrics, an email asking if they have adequate supplies of Tamiflu. She responded that they had already posted information on their web site about the disease. (See my earlier post about why I love my new pediatrician!)

 

I decided to follow up with Dr. Jen to get more information for parents on when to worry and how to think about caring for our children if the disease spreads closer to home. I’m glad I did since she was full of current, useful information including possible risks of Tamiflu in children and how to stay abreast of current cases in your state. I’ve added helpful links at the bottom so that you can stay informed.

 

 

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Kid Swap

During a play date a couple months ago, a mommy friend and I got to talking about the expense of childcare in this tough economy and ways to save. (I spent $200 to see an early movie and dinner recently – and that was on the cheap side.) Our solution? A Kid Swap once per month. On a Saturday from about 4 pm to 8 pm, one of us would take the other’s kid(s) for a play date, early dinner, PJs and movie. The kidless parents could use the time to see a movie, catch an early dinner, do stuff around the house, whatever…

 

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Why is getting out of the house on time in the morning with two preschoolers akin to herding one hundred cats through a small swinging door? Try as I might, I still can’t find the best way to encourage (or threaten) Son and Daughter to get dressed and out the door on time. It doesn’t matter how early we start to get ready, their silliness will find a way to delay our departure.

I call this magically disappearing time Mystery Minutes. And my rule of thumb is: Plan to leave 15 minutes prior to the actual time you need to leave.

In fact, plan 15 Mystery Minutes into all outings with children.

That’s 15 Mystery Minutes before you need to leave the playground, play date, etc. to make it somewhere else on time (or just because you want to leave). That allows for three “five minute warnings.” Which is where the Mystery Minutes come from: The fact that it takes at least three times longer than you think to herd children in your direction. Three times as long to convince them it’s a good idea, to assert your authority that they must comply, to entice them with a tempting enough carrot, or threaten them with a strong enough warning.

And, because no matter how carefully I’ve planned the steps to get us out the door, Son or Daughter will spring a surprise tactic or tantrum that sets us off course.

(This morning I cajoled Son into using nasal spray with a promise of two kitty cookies (one for each nostril). Well, of course Daughter then wanted some, too. What seemed like a good way to get him moving, turned into an all out tantrum when she insisted on five cookies.

“Just two!”
“Five!”
“We don’t eat cookies in the morning. Two or none.”
“None.”
None?”
“No, five!”

She was frustrated because she didn’t understand the rules. 1. We don’t usually get cookies in the morning so if we’re going to have two, why not five? 2. I usually negotiate on matters of little consequence. When did kitty cookies become a big deal?

So, I tell myself, if I’m going to break the rules, I should live with the consequences. And, if I’m going to break them, why not just give in all the way. More times than not, I realize later that whatever stubborn “rule” I held onto, was not worth my child’s tears.

And, next time, maybe I’ll plan for the full 30 Mystery Minutes so I’m not a crazed lunatic scrambling for snow pants and a second glove.

Now that we’re back to school, I can’t believe I lived without a regular weekly schedule. Last May I looked forward to the lazy, unstructured days of summer. I’m kind of a summer gal, actually, and relish beach time as much as my kids. I’m actually like a kid at the beach, happy to sit in the sand and help dig holes or bury feet.

But by around mid-July, I found myself short-tempered and calling my niece to help out twice a week. I kept harping on myself for not being able to hack it all day with my own two kids. But I see now how much a scheduled day and some simple structure helps keep my family in harmony. (Well, Husband goes off to work whether the kids and I live in harmony or not.)

And, the start of school inspired me to get off my butt and organize our mornings better, pack lunches the night before, even plan projects for after school. Oh, did I mention that I even set the table for breakfast last night and put out little bowls for an applesauce starter? Neither child touched it. But they did seem impressed with the whole set table thing and waited patiently for their scrambled eggs. A far cry from their usual pounding of forks on table while screaming, “Where’s my cereal?!”

Set Timetables
I also got smart and actually thought through how long it would take to get them ready and out of the house (hopefully, you’ve been doing this all along).

Here’s my morning schedule:
6-7:30 am Play or watch TV (I put out play dough when I made my coffee)
7:30 Make breakfast
7:45 Serve breakfast
8:00 Get dressed, brush teeth and hair, put on shoes
8:30 Get in car (remember the 15 magically disappearing minutes it takes to get the kids settled in carseats. Especially, if Son is buckling himself!)
8:50 Drive away to make 9:00 am drop off at school.

Of course, today I had the wonderful “Let’s not be late for our first day of school!” mantra to call upon. We’ll see how it goes tomorrow.

Recently a group of friends and I were lamenting the hassle of running errands with young kids. It’s a royal pain to unstrap them from the car seat, hoist them up and haul them in for a short stop at say, the dry cleaners or drug store. Witness my recent Nightmare in CVS episode to pick up Amoxicillin for two year old Daughter with ear infection:

“I’m sorry Ma’am, we don’t have it.”

“But I heard the nurse call it in!”

“Oh, here it is, but has your insurance changed?”

“Not since I picked up her fluoride vitamins last week!”

All the while Daughter is screaming in pain and lunging out of the cart or my arms. Put her down and she grabs candy from the toddler-height racks and cleverly rips it open. (Smart chick.) I vow never to return. Where is the new drive-through pharmacy in town?

Of course, the other secret solution is to leave your children unattended in the car for just a quick run into the store. Both illegal and dangerous, this option is only used in the most dire circumstances when your eyes can be on the kids from inside the store. And, anyone who’s ever tried this knows what a nervous wreck you are the entire time. First, in case Daughter or Son might be screaming even though you put favorite Barney CD on and opened books on their laps. But actually the greater fear is getting busted by a passerby who calls the cops. Even worse: a write up in the local paper’s Police Log that details said Irresponsible Mother who left children in car in the Store parking lot and claimed she was just “running in to get a few things.” Tssk Tssk.

The 2008 solution? Drive up service. Yep, my friend D. presented this ingenious solution at our girls’ night out. It’s perfect for dry cleaners and even her example, the liquor store! She pulls up front and dials the store:

“Hello, this is D. and I’m out front in the car with my kids. Would you mind bringing me two bottles of chilled Kendall Jackson?” That’s it. Easy as pie. She hands them her credit card or sets up a store charge. Works like a charm.

So, the other day, faced with sleeping Son and soon to be sleeping Daughter, I pulled up to a local vacuum repair shop. How am I going to do this? What if Daughter screams and wakes up Son? And then I remembered D.’s trick and decided to give it a try. I dialed the shop:

“Hi, this Heather Levy. I dropped off my vacuum the other day. Is it ready? Oh, great. Listen, I’m out front in my car with two sleeping kids in the back. Would you mind bringing it out?” He said sure.

And that was it. I handed him cash, he went in and made change and brought that out.

Now, I’m a convert. I realize my new trick’s only appropriate with certain merchants in certain settings, but imagine if stores starting marketing this service as a value added option? They’d corner the Mom market and keep our kids – and reputations – safe.

Uggggh, I’ve been holed up at home with my two toddlers for two and a half weeks while they’ve battled four (4!) illnesses. What a rough February! First, my son came down with croup. I though he needed to have a cold first but our pediatrician said the standard course is croup, cold, then possibly ear infection (yep, he got them all). When his cough wouldn’t subside after a week, she recommended children’s nighttime Triaminic. I balked. Weren’t children’s cough medicines banned recently by the FDA, I inquired? He’s old enough, she said. (The FDA banned them in Oct for children under two years. They are continuing studies for children ages 2 to 11 years.)

Contrary to my pediatrician’s prescription, I remembered warnings for children under six so I cautiously read the ingredients in all the childrens’ cough medicines at the pharmacy. Many had an anthistamine plus dextromethorphan or Pseudoephedrine (commonly found in Sudafed). I’m okay with the antihistamine. When the warnings first came out, a doctor told me it’s the safest choice since it’s natural. Plus, it’s recommended for bronchitis and is the only medicine that’s ever helped a bad cough of mine. I couldn’t justify the other ingredients. Sudafed makes me and most adults I know pretty crazed, how can I give it to a child? Plus, most reports have confirmed that standard cough medicines containing dextromethorphan simply don’t work. I left the pharmacy emptyhanded.

Instead, I tried honey. A colleage of my husband’s recommended a mixture of honey, oil (to smoothe it for stirring) and lemon juice. I tried honey and a little warm mater to mix it in the bottom of a sippy cup. Then I filled it with OJ. Both kids drank it down (by this time, S. was sick, too) and it seemed to work. I can’t be sure but a recent study reported in the New York Times indicated that a touch of honey makes a better cure than cough medicine. (Note: Do not give honey to infants under one year because of the slight risk of Botulism.)

Lucky me, their bout with croup, then double ear infections were followed by vomiting then diarrhea (from the antibiotic for the ear infection). I don’t have a solution yet for ailments of the gut other than lots of towels, laundry detergent, and patient motherly love. Here’s to a healthier March!

Disclaimer: Please check with your own pediatrician before giving your children any over the counter medications including antihistamines!