Friday, May 31, 2019

Bath Time Tips for all ages

Bath Time Tips for all ages


I can still remember the first time we put my daughter Lauren in the big tub. My husband was in the other room tackling his first solo messy diaper. The episode was a big learning experience that got referred to as 'Poopageddon'. He had neglected to fold over the poopy diaper and Lauren managed to get her feet right in there. Poop was everywhere including the walls.

“Jude? Can you come in here? I need an extra hand”.

There was no way a sponge bath was going to do the trick. Fortunately her cord was off so doing a full bath was an option.
If I remember correctly, at this point Sandy needed a bath as well. He got in first and I handed him the baby. Our bath routine was created. Both of my kids learned to love the bath in the security of daddy’s lap. (If you don't have two willing partners I would usually use a big sink until the babies are good at sitting.)

I have patients who swear by the blooming lotus bath aid

As you bathe them, I would start with the face and head.......then do the body and end with the tush (going from the cleaner areas to the dirtier areas). You can use a warm, wet cotton ball to clean the eyes. I suggest cleaning from the outside of the eyes in towards the tear duct/ nose.

There is not one bath routine that works for everyone. Tub and sink sizes, babies temperament and willing partners will vary from family to family.

Until the cord is off and any circumcision is healed, the babies should not be submerged in a tub. This is usually around 10 days to 2 weeks. Until you can do that first bath, you can simply do some gentle sponging off. Babies are not terribly dirty. As long as you get the face and tush you are fine.

Safety review

Once you are ready to submerge the baby, safety is key.

NEVER LEAVE THE BABY FOR EVEN AN INSTANT

  • Remember that babies can drown in even an inch or two of water

  • Have all supplies at hand (towel, wash cloth, cup for rinsing)

  • Make sure there are no electric cords or tools nearby ( like shavers or hair dryers) that can get pulled into the water

  • Wet babies are squirmy and slippery! Wearing a terry cloth robe will help keep you dry as well as offering traction to a wet slippery baby.

  • Have a rug on any tile surface to keep from slipping.

  • Watch out for faucets. There are faucet covers to keep from getting bumped

As a safety precaution I would have you turn down your hot water heater to 120 degrees. Many hot water heaters come from the factory set to 140 degrees. No one needs it to be quite so high. Check the water temperature in the tub to make sure it isn't too hot. Grandma did just fine by testing with her elbow, but there are all sorts of floating bath thermometers that will take the guesswork out of it.

A good water temperature range would be between 36-38 Celsius or 97-100 Fahrenheit. Some infants have a little trouble regulating their body temperature so water that is either too hot or too cold can make them uncomfortable. The normal body temperature averages 37 or 98.6. Too cold is no good, but too hot is probably worse. Babies have very sensitive skin that can burn easily.

While I don’t ever advocate keeping the bedroom too warm, 68-72 is fine; it is nice to have a cozy environment for drying off right after a bath. Making it a pleasant experience from start to finish will help keep bath time from being an ordeal. Many folks use a little space heater for this. Make sure any appliance is kept well away from the water.

How Often?
Babies don't get too dirty and usually don't need to be fully bathed more than 2-3 times a week.

Faces and diaper areas should be washed at least daily. All skin-folds also need to tended to DAILY as well. Don’t skip this or you will be the one sheepishly calling me to tell me that you discovered some nasty areas on your baby. Common areas are under the arms, in the neck, thighs and groin. The area behind the ears also can get gross. You can proactively avoid this with a routine skin fold check, spread the creases, wipe with cetaphil cleanser (no water needed) and then add a layer of aquaphor or cerave ointment.
If your baby loves the bath and it is part of your routine, it is perfectly fine to do one daily. Make sure you moisturize your kids after the bath. This is especially important for anyone with dry skin.

Other considerations
It isn’t uncommon for kids who used to like their tub time, to become “bath phobic.” One of my patients had an issue when a couple of siblings were having their routine bath time together. The younger one had a large poop in the tub. The older one freaked out. There was no fixing that. He ended up taking showers for a while. In the case of Dr Elizabeth’s son, their tub has some jets. He hit a button, It made a horrid noise and it took a month before he would get in without a struggle.

One slip in the tub, or shampoo in the eyes can make kids who used to like the baths reluctant to get in. Having one parent in the tub is usually my best suggestion.

To protect the eyes, using a cup to rinse the hair usually helps. A sports bottle can work well for this. There are also lots of little specialty bath items with spouts on the market.

Having your child look way up for the hair rinsing can help keep the eyes from getting shampoo in them. If you can, perhaps stick a little sticker or decal on the ceiling of the tub for them to look at.
Some kids feel empowered if they are holding a dry washcloth that they can hold over their eyes for the rinsing.

Find a nice gentle baby soap. There are a lot of good brands. Watch for any rashes or irritation when trying anything new.
It is worth being a careful label reader. There can be ingredients lurking in some products that you want to avoid. Parabens and phthalates can be hidden under the ingredient ”fragrance;” these can potentially disrupt the hormone system.

If you are local, you are safe getting any product from Natural Resources on Valencia. They don’t let any product in the door unless they have carefully vetted all of the active and inactive ingredients. The lines that they like to carry are Earth Mama and Think Baby. EWG is another source to checking on product safety

 
Bubble baths can cause urinary discomfort in some sensitive little girls, so I I avoid them except for very special occasions. Some kids can get irritations from simply sitting in the soapy water so if you have an older baby who enjoys the bath, let them play in the clear water and then do the soaping and rinsing right before they get out.

Things you can add to the bath
Adding a splash of apple cider vinegar to the tub seems to be useful at preventing some rashes. It is hard to give an exact amount since the tub volumes vary so much, but I usually suggest between ½ to 1 cup.

Baking soda is also a popular thing to add. For babies use about 2 tablespoons; for older kids you can add up to a cup. This is a good one for an itchy rash like poison oak. Believe it or not, it can also help with constipation.

Do NOT mix the vinegar and the baking soda unless you are doing a science experiment and want to create a volcano.


Bleach baths are good for eczema or any potentially bacterial rash.
If properly diluted and used as directed, a bleach bath is safe for children and adults and believe it or not, this is a standard recommendation from many dermatologists. The directions are to add ¼ - ½ cup of bleach to a standard tub that is filled. Don’t do this more than 3 times a week, and only soak from the neck down.

Oatmeal - Aveeno makes a nice product that is good for dry itchy skin.

Bath toys are fun, but can get gross! Make sure you clean them regularly. The get quite moldy and slimy

There is nothing quite like the scent of a clean, sweet smelling baby. Enjoy the moment!

Friday, May 24, 2019

Tylenol/Motrin/Advil: What is the best choice/Dosage charts

Pain and Fever reducing medications/ How to choose the right one


It should go without saying that none of us want to give our kids medication unless it is necessary. If your child is fussy or feverish for more than a day or so, I would prefer to figure out what is going on rather than just masking symptoms. I also always like to see if there are some natural remedies that can help us out. Many low grade temps will resolve with some cool compresses and a tepid bath. If your child is teething, it is important to find some other comfort measures, because those symptoms can linger for weeks at a time.

There will be the time for most of us that we need to go to plan B and get out the pain/fever reducing medications that are on the market.
 
There are several fever reducing/pain relief medication options currently available for infants and children. Acetaminophen is most often found under the brand name Tylenol. Ibuprofen is commonly found under the names Motrin or Advil. Generic brands are perfectly acceptable. Below you will find a dosage chart to refer to as your child grows. The charts tell you how many milligrams of each medication your child needs. This is calculated by your child's weight. The different concentrations can be confusing. Let's go back to school for a moment for a quick review.

If you take a 500 mg Tylenol tablet, crush it and then dissolve it in a teaspoon (5 ml) of water, you will have 500 mg of Tylenol. If you take the same 500 mg tablet and dissolve it in a cup of water (240 ml) you will still have 500 mg...simply in a different concentration.

Once you know how many milligrams are appropriate for your child, your next step is figuring out what volume of fluid will deliver the proper dose. That will depend on the concentration of the medicine.

Infant and Children's Tylenol have the same concentration of 160 mg/5ml. The infant bottle comes with a handy syringe for accurate dosing, but there is no other difference. The infant Tylenol used to be more concentrated but that formulation is no longer on the market. It is still important to read the label to make sure you know exactly what you are giving. Acetaminophen also does come in suppository form. This is a terrific option for an uncooperative or vomiting child.

Acetaminophen is usually dosed every 4-6 hours. Too much Tylenol can be toxic to the liver, so it is important not to exceed the recommended dose.

Ibuprofen still has both infant drops and children's liquid that areNOT interchangeable. It is important to know which medication and dose you are giving. The infant formulation is about twice as concentrated. Ibuprofen is usually dosed every 6-8 hours and should be given with food when possible.

I don't have a strong preference between acetaminophen or ibuprofen. Ibuprofen does tend to last a little longer which makes it a good choice for a night dose, but on the other hand, if it is given repeatedly on an empty stomach it can cause irritation. This is challenging for sick kids with poor appetites.

I often suggest alternating the medications if you find yourself needing to use these for more than a few days in a row.(Remember that mystery fevers or fussy kids should be checked out!)

Both medications come in a variety of chewable tablets, or standard capsules for older kids and adults. My favorite compounderEddie,from the Feel Good Pharmacy, can also offer some options that are not readily available in typical drug stores:

  • ibuprofen suppository
  • acetaminophen or ibuprofen gummies
  • dye free/ preservative free suspensions

All of the compounded forms require a prescription even though the medications are over the counter. If you are not in the Bay area, check with your doctors office to see if they are lucky enough to have a trusted compounder that they work with.

It is not uncommon for me to get calls from worried parents letting me know that their kids inadvertently were given a double dose of their medication. Consider putting a piece of masking tape on the bottles and mark off times and dates of dosages. This can help sleep deprived parents keep track of when they gave what. It also alerts partners if a dose was recently given by another caregiver. This is a good habit with antibiotics as well.

When it comes to medicine, some folks are under the assumption that less is better and try to give partial doses. This doesn't usually do the trick. I like to use an analogy here. Imagine that you are trying to fix something on the roof. In order to get up there you need to climb a ladder. You must climb high enough to get on the roof. Climbing halfway gets you nothing. With medicine, you need to give enough to be efficacious (enough to get you all the way up to the roof.) Some kids are certainly more sensitive and a smaller dose may help, If that is the case, by all means give the smallest amount that you can get away with, but understand that most folks will obtain the best results by following the guidelines for weight.

Keep in mind that neither of these medications work instantly. It is common to have to wait at least 30 minutes or so before you notice any relief or decreased fever.
 
Both acetaminophen and ibuprofen are safe to give in conjunction with other medications like antibiotics and antihistamines. Be careful if you are giving any of the multi-symptom cold remedies. Many of these already have the fever reducer as one of the ingredients; you don't want to double dose.
A little bonus tip is that the benedryl dose is generally the same volume as Tylenol.

If your child is under 3 months of age, and you feel that they needany medication, check with your doctor's office. Any young infant with an elevated temperature needs to be evaluated.

Friday, May 17, 2019

Sunscreen 2019


This week's Topic
Sunscreen 2019

Sunscreen has been in the news lately. It is time once again to be a careful label reader. There are currently 16 active ingredients allowed in sunscreen! The new announcement proposes that only two of these 16 ingredients, zInc oxide and titanium dioxide have earned the GRASE acronym (generally recognized as safe and effective.)

Two of the ingredients, PABA and Trolamine salicylate, are no longer recognized as safe. The FDA will be investigating the remaining 12 ingredients and has indicated that they will have more conclusions for us in November. The concern is that recent studies have found that the ingredients in some sunscreens are being absorbed at a higher level than previously thought. The fact that an ingredient is absorbed through the skin and into the body doesNOT mean that the ingredient is unsafe, but it makes sense to do further studies. Of course, summer is coming and we have to protect ourselves and our kids now. We aren’t going to wait until November to decide on a good sunscreen. All the experts agree that unprotected sun exposure is a hazard.

I reached out to a couple of fabulous dermatologist for their wisdom on the topic. Dr. Lawrence Cheung provided the following bullet points that confirm how important this is

Skin cancer facts:

  • Skin cancer is the most common cancer in the U.S. (Skin Cancer Foundation)

  • Over 5 million cases of skin cancer are diagnosed in the U.S. each year, more than all other cancers combined. (Skin Cancer Foundation)
  • Most skin cancers are a direct result of exposure to ultraviolet (UV) rays. (American Cancer Society)

  • Multiple sunburn events during childhood double a child’s risk of developing skin cancer later in life. (skincancer.org)

Ignoring the need for sun protection, unless you live in a cave is simply not an option. Even in San Francisco with our foggy days we have to pay attention.

Obviously your best bet for preventing sunburn is to stay in the shade when possible and also wear a big floppy hat and loose protective clothing. Dr. Jennifer Sorrell, a popular local dermatologist had some great advice about hats. If you get your kids in the habit early they are less likely to object to having something covering their head. Set a good example and have the adults in the family wear hats as well.

Not all hats are created equal. Choose a wide brim that gives the neck some protection. Make sure the fabric doesn’t have spaces. A straw hat would not be as good as one with tighter fabric. Letting your child pick out a cute hat that fits the parameters might ensure more cooperation.

Have a parasol or a shade umbrella over strollers and baby carriers. Pay attention to babies in backpacks; they might be getting more exposure than you are aware of. Umbrellas are not foolproof. You can also get sun exposure through glass. Kids sitting inside a car can get burned.

Remember that eyes can also get damaged from the sun. Do your best to get your child used to wearing sunglasses. The lighter the eye color, the more sensitive they are likely to be, but everyone should wear eye protection.

Don’t forget about lips! There are lots of chapsticks with SPF protection.

Sun can do the most damage to our skin between the hours of 10 am and 4 pm, with the most intense rays between 10 am and 2 pm. Reflection from water and/or snow can make any exposure more intense. The link below will lead you to a great little site that can tell you what the UV risk is on a particular day depending on where you are:


Location matters. If you are traveling to someplace like Mexico or Hawaii you have to be even more careful than you would need to be here in SF. If you know you will be out in the sun, check out some sun protection clothing! Options and technology are increasing all of the time. There are even some sun protective, light weight blankets that some folks swear by.

Even if you are very careful, if you are out enjoying life, it is very difficult to eliminate all sun exposure. If your child is under 6 months old and the choice is sunburn versus sunscreen, choose the sunscreen every time! Keep in mind that some of my preferred products are zinc based. Zinc in the common ingredient in many diaper rash creams that we start applying from day one. It is completely safe.

Some medications including some antibiotics such as Bactrim can make someone especially sensitive to sun exposure. Make sure you are familiar with any medication that you or your children are taking to make sure this isn’t a factor.

Sunscreen considerations
Sunscreens are either mineral or synthetic/chemical.
The mineral ones contain zinc or titanium dioxide. These work by reflecting the sun's rays like a mirror to protect the exposed skin

The synthetic sunscreens absorb rays in a chemical reaction that dissipates the heat back off the skin.

SPF or Sun Protection Factor is a measure of how well a sunscreen will protect the skin from the UVB rays. Quite a few studies state that it is not worth getting any SPF that is over 50. 
These studies suggest that the higher SPF doesn’t offer a significant increase in protection, just more chemical exposure and a false sense of security. The cost does not necessarily correlate with the better choices. The UVB rays are the kind of radiation that causes sunburn, damages skin, and can contribute to skin cancer. The UVA rays are connected to aging skin and wrinkles, They may also have some cancer links. It is important to protect against both so you want to look for a product with broad spectrum protection.

If you are using a sunscreen for the first time, do a test patch on one small area on a thigh or wrist a few hours before sun exposure. If you slather your child with a new sunscreen, spend a day out in the sun and then they break out in a rash, we would have to figure out if it is heat? sun? sunscreen? Doing a test patch first assures you that it is not the sunscreen that is causing the rash. For older kids, the use of a sunscreen should be routine. Nurse Jen had a great idea that works with her little girls. They apply a daily sunscreen to their face with makeup brushes. What used to be an ordeal has turned into something fun. Great habits now will avoid wrinkles and potentially serious skin problems later on.

If you can plan appropriately, apply the sunscreen at least 15 minutes before going out. Ideally put it on before the clothes go on to make sure you don’t miss a spot. For significant sun exposure, sunscreen needs to be reapplied at least every 2 hours, even if they claim to be waterproof. Don’t forget the feet, the ears and the top of the head if you have thin or no hair up there.

Sunscreens come in several forms. I don’t love the sprays. It is easy to miss spots and inhalation can cause problems. The biggest concern for me though is that they can be flammable. With the mineral powders, try to contain the application so that your child doesn’t breath in the particles. Lotions and sticks don’t have those issues. The Environmental Working Group has listed their best kid sunscreens:


Click the link If you are interested in supporting the EWG and checking out their safe sunscreen sampler pack

While we need to be a little more protective of our fairest kids, regardless of the skin pigment, everyone should be wary of sun exposure. If your child is out with a nanny or friend, don't hesitate to remind them to be on the "sun protection patrol". Trust me, sunburns are just as painful for the grown up who lets it happen on their watch!

If you or your child does get burned Dr. Cheung suggests that you forgo the aloe vera and instead apply the 1% hydrocortisone cream that you can get over the counter. Apply twice a day until the pain is gone. Ibuprofen (with food) can also help decrease the pain and inflammation. I have seen some sunburns so severe that they cause blisters. If a larger surface of the body is impacted, it is worth seeing the doctor.

I forbid you to stress out if you have been haven’t been using the better sunscreens. Sunscreen ingredients have been used for several decades without reported side effects. Take this new information, and pick good brands moving forward.

One more thing to keep in mind when picking sun protection is the environmental impact. If you are simply hanging out in the park, it isn’t an issue, but if you are swimming in a natural body of water, (especially the ocean), some chemical sunscreens that contain ingredients like oxybenzone and octinoxate are believed to contribute to coral bleaching, and damage the reefs.

Friday, May 10, 2019

Nurse Judy the Mom


How many of us feel inadequate when we look at other parents who appear to be super mom or super dad. These magical beings seem to manage to handle whatever life throws at them with ease? They never ever make a mistake or lose their temper. Their children think they are perfect.

Um, not likely.

What you may see on the outside is not always accurate. As a Mother’s Day gift to you and I going to share an inside look at Nurse Judy the mom, including the story of one of my more epic 'mommy fails'.

For the most part, I am blessed and my kids have made it easy for me to look pretty good. The truth is though, that we all have our moments. If you ask my daughters for the lamest mommy stories, I certainly have my fair share of times that I did something that they didn’t appreciate or a time I embarrassed them.

Lauren recalls an incident at a zoo night when she was around five that still makes her grimace. That evening there were costumed characters roaming around the zoo dressed as animals. Some had instruments.

“Mommy, I dare you to ask that Lion to sing 'The Lion sleeps tonight'”

Dare me? Silly girl.

The Lion’s response was, “Only if you sing with me”

Much to Lauren’s chagrin, the guitar toting Lion and I created a lovely duet of Weem-a-Wopping ‘In the Jungle’ as we wandered all through the zoo.

I think the only time I actually embarrassed Alana was the first time I discovered Lemon Drop Martini's at a friends Bat Mitzvah Party and danced the night away with a large group of tipsy moms. Those things are dangerous!

There was also the time that Lauren and I were practicing our karate moves. She practiced some punches on me and then it was my turn. She had a pillow up to her belly for protection but wasn’t standing properly, I did my move and she went flying across the living room. I was horrified. She was furious. Moral of the story, check your stance.

But the hands down winner is the time I drugged Lauren and then put her on a horse.

We were doing a family vacation up at the Russian River and scheduled a horse back riding session at beautiful Armstrong Redwood state park. My girls and I could count the number of times that we had been up on a horse. Sandy, the New York City boy, was actually an experienced rider. Lauren had a mild cold and her allergies were bugging her, so I gave her a little something to help dry her up and we were off on our adventure.

We were in a guided group along some pretty steep trails. Lauren’s horse had a mind of his own and didn’t want to stay with the others. To compound things, Lauren was feeling really quite out of it and was having a hard time staying awake. Sandy held back on his own horse to make sure she didn’t get left behind.

She managed to keep it together for the several hours, but just barely. She could barely keep her eyes open. I was concerned that she was really coming down with something worse than a cold. When we got back to our cabin, I figured out what the problem was. I had not taken the time to read the box and had grabbed and given her the nighttime cold/ cough medicine instead of the daytime one. The poor girl was sedated! Since fortunately she didn't fall off the horse, we can laugh about it now. I promise that I never did anything so careless moving forward.

Trust me. Most parents have done some dumb stuff, the photos on Instagram are usually just showing the better moments. If you are human, take it easy on yourself as long as you gather wisdom and learn lessons.

We all have fairly different parenting styles. Alana (who I never punched across the room) generously offered to let me share a glimpse of mine. Because I actually kept (and still keep) a journalof milestones, I recently reread the letter that I had written to her as she left for college. She was the baby moving out. This was a big milestone for me as well. I did need to make some mild edits and I have some explanations at the bottom for some of the more cryptic references. Warning This letter is not rated G.

Oh Goodness….Dear little Pooh of mine,
How is it possible that it is time for the ….letter. Just a blink ago you were my sleeping, spitty, very large baby.
First of all, you know (but I will tell you anyway) how very proud I am of you. I must have done something very wonderful and you are my reward. There is no one quite like you. You are a magical person. You never lose a friend, you just keep collecting them. You are fun to be with. You are kind. You are smart. You are wise beyond your years. Of course, no doubt, that is partly due to me (mommy takes a bow.) We will now review the mommy theories of life.
You know the pie theory very well. So we will simply discuss its relevance now.
Your pie is changing more drastically than it ever has before. You have pieces shrinking and other pieces dramatically growing. Brush off that student piece please…it has been fallow. Create a brand new…”let's do some laundry piece”
Just be aware that huge pie shifts are exhausting…if life seems overwhelming for a bit it is perfectly natural as the pieces settle into place and you achieve a new balance.
(My pieces will be shifting as well, but my mommy piece is always available to be a large as you need it to be)
Everything in life causes some amount of stress. Obviously some things have way more stress points than others.
Sometimes, though even the littlest thing can tip the scale and move you from mild stress to moderate stress or to completely stressed out (otherwise known as the straw that broke the camel's back.) Starting anything new is worthy of plenty of stress points. Make sure you get enough sleep, especially at first!!
Sex, Drugs, Rock and Roll

Sex
Make good choices…I do not expect you to remain a virgin until you are 30. That would actually be most unfortunate,
Just make sure that anything you do is something you will feel good about. You are worth a lot. Condoms are an unfortunate fact of life until you are in a committed relationship. Frankly I would insist that an experienced partner be tested before I did anything   *(remember the lollipop story) okay fine…let's quickly move on... Parting words, remember that you can always talk to me about anything and Lauren, I am sure is another fine resource if you want to bounce something off of someone other than your mom (even though she is remarkably cool.)
 
Drugs
easy….just say no,
Actually just be smart and safe. Alcohol is a drug, and lemon drops taste good…be careful. If you do drink a bit too much, the body can get dehydrated as well as hypoglycemic.
Orange juice and graham crackers are good things to eat/drink. Remember:
Vomiting all night…
Not fun!
Know your limit
Rock and Roll
That’s fine, just don’t start liking country or rap
Relationships
Remember that relationships are learning stations.
You will learn what it feels like to dump someone, you will possibly learn what it feels like to be dumped (or at the very least lied to.) You will learn what characteristics you like in a partner and what things you don’t want to put up with.
Never regret anything. Cherish the good memories learn from the bad ones and move on.
And the very new theory…men are like shoes
Some you try on (have them tested first…just kidding; second thought not kidding…do it.)
Some you buy
Some are comfy,
Some just look good,
Some will give you blisters if you wear them too long,
Some get tight but can be stretched out and worn in
(This works doesn’t it!!!)
Happy shopping
QUICK LIST

  • French onion soup on a first date is probably not a good idea if you want to impress
  • Check your blind spot
  • Floss
  • Use sunscreen
  • Take viactiv
  • Don’t get a job where you need to wear a stupid hat
  • No reality shows (sorry I know this is a tough one)
Optical illusions
When you get in a disagreement with someone, remember that life is often like an optical illusion, People see what they see, and know what they know. There are indeed white arrows there, but they can’t see the black arrows as hard as they look. (Or they can only see the young lady and can’t see the old crone) Always try to see both images and feel sorry for those obstinate folks that simply can’t
Honesty
People lie all the time. They think it makes life easier. Lies are heavy to carry around and they often get complicated. It is wonderfully freeing to just tell the truth. It might be difficult for someone to hear, but oh well, they just have to deal. Don’t lie

Psychic stuff
Know the difference between the good spirits (which hover around you), the confused spirits (that you tend to encounter) and really icky things (that hopefully you never need to deal with.) Call upon those good ones to just weave the golden web around you whenever you feel the need. You are fairly powerful, keep learning to control it.
Encounters with the strange and wonderful (real people…not ghosts)
You don’t have a prayer actually. You attract the odd, the strange and yes the wonderful…Both your grandmothers and your mom have passed that lovely gene directly down to you.
May you always have fun, and great stories, but be wise and know that it is better to be safe than to have a good scary adventure story to tell.
Great saying
Love many
Trust Few
Always paddle your own canoe
Easy Mitzvah
Call or email your Grandparents.
Bambi
If the deer discover the magic of Alana (hey all other animals do) don’t feed them, and learn to check your body head to toe for deer ticks. They are tiny and black and look like raised freckles, you can check your scalp by just running your hands through your hair and feeling, you would feel a raised bump
(..I bet lots of moms send their kids with letters, perhaps mine is the only one with tick advice?)
Have a blast
Carpe diem! Seize the day!
You are about to start a great adventure. Enjoy every moment! Stop and look at the sunsets! Never ignore a “good sky”. Savor the gorgeous place you are in, Oceans, Redwoods, Deer, Brunch….How lucky are you?!?!
I love and adore you.
Mommy

************************************************************************************
Here are some further explanations to help make sense of things

Lollipop story
There was a story on the news about a teacher who ultimately was fired for an unorthodox approach to teaching about safe sex. He had started the class licking and sucking on a lollipop. After a few moments of this he told the class he was going to pass it around and have everyone in the class take a few licks and keep passing it around. The students all made expressions of disbelief and disgust. He went on to point out the obvious parallels of unprotected sex. I was happy to share this with my teenage daughters.

Psychic stuff
I come from a family where it is hard to to find rational explanations for the oddities and coincidences that abound. Whatever it is, Alana has it in spades, Lauren has managed to avoid it so far.

Mitzvah
A mitzvah is a good deed and I did my share of nagging to make sure my kids made a point of reaching out to their grandparents. I am proud to say that they were pretty good about it, and probably didn’t need quite the amount of nudging that I did.

Bambi/ Deer
Alana was at UC Santa Cruz, the day we dropped her off, there was a deer standing in front of her dorm as if he was waiting to welcome her. She is an animal magnet; my warning not to pet the deer was necessary.

Ten years after this letter, Alana has still never lost a friend and continues to collect them.

Friday, May 3, 2019

My Mother in-law/The amazing Nanya

My mother in law/the amazing Nanya
May 4th would be my mother in law's 92nd birthday. In honor of that, and with Mother’s Day right around the corner, I decided to take a break from topics like yucky viral syndromes or tick bites, and share some more personal stories about my children’s paternal grandmother.

In Law.
Just the word might make some people shudder and prefer reading about insects. It can make others feel warm and fuzzy. Regardless of who you get dealt in the in-law department, you have choices as to what type of relationship you establish with your partners parents. Some relationships are more challenging than others. Others are easy from the start. My married daughter Lauren couldn’t be luckier with hers.

Even if you are not close at first, bringing a baby into the equation is often an opportunity to deepen the relationship in a meaningful way. Some folks have turbulent relationships with their own parents, so making the assumption that it is only an in-law that presents challenges is flawed. Take a breath and if it is all possible hit the reset button. Having a child in the mix changes everything.

Before the kids came along, my dealings with Sandy’s mom were clearly going to be a bit interesting to say the least. When I met her for the first time, I was only 17 and I was outmatched from the start.

Elaine was the proverbial Jewish mother who was pretty certain that both of her children were perfect. Sandy was her only son. Being the woman worthy of him was something I was clearly going to have to work towards. One of the first battles of the ‘girlfriend versus the mother’ came when Sandy had to have his wisdom teeth out and asked me to come to NY to be with him. Elaine had already made vats of soup, and had purchased a new blender to make soft foods. “I am his mother and I will take care of him.” I did a wise, quick retreat; Mom was going to win this round.

After several years when it became apparent that this relationship wasn’t going away, we got to be more and more comfortable with each other, but it wasn’t until I had my first child (and the first grandchild for my in-laws) that our relationship became set. We united in the mutual love of the kids and ultimately had a close, enduring loving relationship until the end of her life in 2012. She was another mom to me, but without the same baggage that she had with her biological children.

Elaine may have had some challenging traits as a mother, but as a grandmother she was superb. She threw herself into the role with every ounce of her being. As soon as I became pregnant, Elaine started to mull over what she wanted to be called as a new grandparent. She didn’t want to be called something as common as grandma; even the mention of Bubby horrified her. She decided she would be Nanny. Lauren had other ideas and called her Nanya. It stuck and was perfect. Nanya she was.

Nanya belonged to Lauren. These two were soul mates, if you believe in that kind of thing. (Spoiler alert, I do.) When baby sister Alana came along, Lauren had to learn how to share. The first time Elaine held Alana, Lauren took one look and said, “Nanya, you need to put that baby down. Give her to someone else.”

Although Sandy’s parents had moved from NY to south Florida, they made a point of staying connected with visits to San Francisco every several months. It wasn’t always easy to have relatives come often and stay for several weeks, but having the open door policy is a choice I will never regret. My own mom instilled that value in me. When I was growing up, our vacations were based on grandparent visits rather than trips to more exotic locations.

If you are fortunate enough to have grandparents in the mix, make the effort to help foster the relationship that they have with your children. There are so many people out there who would give anything to have their parents alive to share the joy of watching the grandchildren grow up. Don’t waste this. (apologies to any of my readers for whom this might be a trigger.)

There was never a grandparent day at school that Elaine missed. She had a way about her and attracted all of the kids to her orbit. Everyone knew Lauren and Alana’s grandma.

Nanya was a brilliant and fiercely independent woman. When she was in town, she took the car keys, figured out the car seats and took the kids to movies, parks and museums. It was always an adventure. One story that is hard to forget is the time she spent several minutes playing catch with a gorilla at the zoo, until someone pointed out that she didn’t want to be handling the substance that the gorilla was tossing to her!

She gave money to people on the streets. She was quite clear that she didn’t care what folks did with cash. It was her choice to give. It was theirs what they ended up doing with it.

One of the lessons that Lauren cherished the most from her grandmother was that it is okay to crave and insist on some alone time. Lauren also inherited the travel bug. Elaine loved to visit far off countries, often by herself. She would pick a place and spend a couple of years researching and planning what she would see. She loved art and would have a list of museum exhibits to visit. She would also learn some important phrases in the new language. When we were clearing through her apartment after she died, We found a list of some quick translations in Turkish from a trip to Istanbul:

  • Where is the bathroom
  • How much does this cost
  • This is my hotel
  • Chocolate ice cream (Lauren used this phrase personally on her own trip to Istanbul!)

I admire her priorities!
She never took photos. She said that’s what postcards are for. She wanted to see things from her eyes and not behind the lens of a camera.

In 2014, Lauren packed up her sturdy backpack which she still has, and is called “ chocolate Ice cream”, and went to spend a year teaching English in Israel. She took advantage of being in that part of the world to take short trips during her breaks. The first trip she rather randomly planned was to Budapest and Prague.

When we told Uncle Bert, Elaine’s brother, that Lauren was going to those two cities, he paused for a moment and told us that those two places were the next ones on Elaine’s bucket list. We had no idea. She had started doing her research but age got in the way and she wasn’t able to go. We got the chills. Maybe not so random after all.

One of the last but important lessons she left us with was that everyone grieves differently. There is no such thing as a correct way to deal with loss.

Elaine had a framed poem that she treasured:

I’m not Here
Don’t stand by my grave and weep
For I’m not there, I do not sleep
I am a thousand winds that blow
I am the diamonds glint on snow
I am the sunlight on ripened grain
I am the gentle autumn rain

When you awaken in morning’s hush
I am the swift uplifting rush
Of quiet birds in circle flight
I am the soft stars that shine at night
Do not stand at my grave and cry
I am not there, I did not die

Indeed, her lessons and her love live on.