Friday, March 27, 2020

Assessing our priorities in this time of quarantine

I know that many people are overwhelmed with too much to do and not enough time. This most likely includes most of you with young kids at home. Others have way too much time and not enough to do. I know that for myself, if I don't stay somewhat busy, I can dissolve into an blob and get absolutely nothing done. I am trying not to let that happen. If I stop doing these weekly posts, that will be one of the first signs that I have 'blobbified'! For now, I am doing daily walks (keeping social distance while I pay attention to the beautiful city we live in, playing piano (had to dust off the keys) and I even am following along with a friend's virtual tap dancing lessons. I am trying to make sure to make calls to friends and family who are isolated.

I hope these weekly emails are a virtual hug to all of the folks who take the time to read them. You are NOT alone. I read somewhere that seeing the empty streets is a form of global solidarity the likes of which has never been seen before.

As always, I try to gather pearls that might offer bits of support. This week I collaborated with my daughter Alana to offer everyone a bit of free therapy.

This week's topic
Assessing our priorities in this time of quarantine

People are struggling as we move into our second week of the lock-down here in San Francisco.

It feels like it is worth reminding everyone of an observation that I give to new parents. From my observations, the first few weeks with a new baby are completely overwhelming to 90% of couples; Only 10% of the time it is completely smooth sailing.
The mixed up thing is that the 90% assume that there is something wrong with them for having a hard time and that those lucky 10% take it for granted that they are having an easy time. If you are in the larger group, don’t be hard on yourself. There should be an element of comfort in knowing how normal you are.

In our current situation, there is a similar divide. Most of us are treading water. Kids are home from school. Many parents are adjusting to working from home. Most everyone is stressed and scared about this virus and the widespread impacts it may have on the health of their loved ones, and the economic impact. Having older parents or a family member with underlying health issues magnifies the concerns in a big way.
There are more questions than answers. It is especially hard to put on a brave face in front of our kids. I think there are probably a lot of people going into the bathroom for a good cry.

It doesn’t necessarily help to be inundated by posts from parents who seem focused on how to create nutritious meals, or limit screen time while at the same time managing to help their kids with their schoolwork. Of course this same family is also probably meditating and doing yoga together. They are riding the wave with ease.

Stop yourself from hating them. Negative energy is not good for you. These are the 10 percenters. If you are in the other group, well, you are running with the pack. Take some comfort in knowing that you are not alone. Give yourself a hug. We will get through this.

This is a good time to remind yourself to sort things into the "in my control/out of my control" category and to spend our energy on things that are in our control.

Here is a very abbreviated list to give you a sense of what I am talking about. You can control:

  • Washing your hands for 20 seconds every time you come in from outside. 
  • Making good choices about social distancing

You can not control:

  • How others are choosing to manage the quarantine
  • How much toilet paper is on the shelves at Costco

It would be nice if you can control who you are in contact with. Many can do this. Some people with first responders in the family don’t have that luxury.

Last Friday, I took a walk to Golden Gate Park and met up with my daughter Alana, who was taking a much needed break from her remote therapy sessions. We sat 6 feet apart on a bench in the rose garden and talked about the craziness going on. Alana told me about an exercise that she does for her clients and it resonated with me. She explained about a values assessment tool from ACT (Acceptance and Commitment Therapy.) Her blog post is here if you want to read it:


Take a look at this list of these 9 “life-domains” 

  • Employment
  • Intimate Relationships
  • Social Connection
  • Family connection
  • Recreation
  • Health/Wellness
  • Education/Learning
  • Spirituality
  • Citizenship/Community engagement

Now, ask yourself some questions.

Before the corona virus turned our lives upside down, how would you have ranked these in terms of what took up your time and energy? How has that changed? When things settle back to normal what would be your ideal?
 
Let's go back up to the "in our control/ out of our control" list and talk about some actions you can take. Alana and I put our heads together to come up with some ideas.

Perhaps previous ranking reflected employment at the top of the list, with time spent with the family lower than you’d like. Is there a short term goal you can set to help the current values align with the ideal values? For example, to shift employment lower, can you set boundaries around what time to stop checking work emails at the end of the day? 

-If we want to shift family higher, maybe turn off the TV and sit at the table for dinner without distraction, or create a short routine at the end of the day. Reading is always good, but this can also be an opportunity to try to answer a new question each night. Eventually this habit can open up possibilities for very real and important conversations.

-Shifting intimate relationships higher, how can we make sure that we’re setting aside quality time with your partner? Is there any way you can get some private time?

-Health and wellness: This might include a goal for meal planning, or making sure that you’re going for intentional walks throughout the day. When you do go outside, find the road less traveled so that you can maintain the social distance.

-Citizenship/community engagement: We can even do this during sheltering in place by donating extra canned foods to the food bank, or offering to help the community by grocery shopping. The Next Door app is really stepping up to connect those who are in need of assistance with people who are offering it.

-Right now we have to get creative with social connection outside our family. For many extroverts out there, shelter-in-place can be difficult, and this can be a good opportunity to reconnect over platforms like zoom or google hangouts or face-time with friends from near and far.

-Spirituality: This can include a meditation, mindfulness practice, or feeling connected to a religious community. Many religious organizations are offering virtual sermons for those who would like to remain connected.

-There’s a lot of overlap, find ways to get creative! Want family time and health and wellness to be higher on your list? Build this time in with your families, and you too can be doing yoga and practicing meditation as a family!

It’s baby steps, don’t get overwhelmed.. Take small actionable measures - this often helps us to feel much more in control than trying to enact a long term, large change overnight

Every individual and every family has their own unique set of values and priorities. Use this opportunity for reflection, to ensure that the priorities you set align with your personal values, as opposed to feeling pressured to meet some nonsensical societal standard.

Thursday, March 19, 2020

Managing the quarantine

It feels like something out of a sci-fi/horror movie. The kind where when the preview comes on, I mutter to myself, “nope, not going to go see that one.” But, we are living it. We are all in the position of having to figure out how to best navigate this new, hopefully temporary reality.
Schools are closed. Many people are trying to work from home while at the same time trying to entertain the kids and keep some semblance of education going. When we come out on the other side, I imagine there are a lot of parents who are going to vote to give teachers a hefty raise

These are stressful times, to say the least. Practicing mindfulness is essential. We don’t have a real choice so lets make the best of a very tough situation. Time is a precious commodity that we often don’t have enough of. Use this opportunity to slow down and savor it.

For those of you who are fortunate, please don’t take it for granted.

A home
Enough food, 
Good air quality
Time together.
Robust communication channels with our loved ones, even if we can’t be with them.

Cherish these things!
Do a gratitude exercise with the family. What are the things you have to be grateful for?

Is there something that you can do as a family to help others who aren’t quite as lucky? This could be something as simple as sending a letter or making a call. 

Every morning remind yourself what the date is. It is important not to let the days blend together. It is a good idea to stick to routines. Try to wake up at the normal time and keep the bedtime ritual intact. Getting enough sleep is essential. Get dressed every day (I wonder how many zoom calls are going on these days with folks wearing their pajama bottoms!)

Have a schedule of things that you need to or want to accomplish each day. With our normal life turned upside down for the next three weeks (at the very least), this may be easier said than done. It is important to get started on the right foot. Even if you try to put a schedule in place, with the schools closed, there is little doubt that your kids are going to have more time on their hands than they are used to. I suggest making a family plan for how much tech/screen time you find acceptable. Keep in mind that in 2019 The AAP and WHO updated their screen time recommendation. These are the guidelines:

Babies under 18 month 
As tempting as it is, screens should not be used as a toy or distraction.
Face time with family members is fine


Toddlers 18 months -2 years
Less than an hour of high quality screen activity is fine. Adult guidance and interaction should be part of this.

Preschoolers 3-5 years
An hour a day is fine. Make sure it is a high quality app or program. You can be in the room, but don’t need to be actively interacting with them

Elementary school aged 6-10 
Screen time should be limited to 1-1.5 hours/day. Be aware of what your child is watching or playing.

Middle school aged 11-13
Screen time limited to 2 hours/day. Your guidance on what children are watching remains important.

Regardless of how old you or your child are I would suggest taking a break after 60 minutes in front of a screen. Come up for air and give your eyes a little break.

The AAP has good reasons for placing limits on screen time. If we were facing just a day or so of being cooped up at home, I would typically be easy about bending the rules, but we are not sure how long this new normal will last. The risk for sliding into endless screen time is real. This blog post addresses screen time:


When you are making your family plan, you can divide the screen time into different categories.

Social
You might not count the social face time with friends and family as part of the allotment. That is up to you, but it is really important to stay connected with people, especially older relatives who are currently isolated.

Education
Do your kids have homework or school work assignments?  
Make sure the kids have a designated place where they can sit and do their homework. Having the television droning on in the background with the same COVID-19 and quarantine stories repeating over and over should be avoided. Figure out how much screen time is involved in their school assignments.



Enrichment/entertainment
There are so many rabbit holes to fall down on the internet. Make sure you go down the good ones and try to stay within the time limit. I was excited to see some of these options available!




Odd assortment of webcams and cool sites. Super tiny printing, so you need to enlarge it.

What can you do once you put down the screen?
I asked my daughter Lauren, who does theater and improv classes for people of all ages and abilities, and she didn’t disappoint! Some of her suggestion included:
Gift Giving: Take turns pantomiming giving unique gifts to each other. The only rule is that no matter what the gift is, the receiver must act like it is the best gift they have ever received in their life!! They must say thank you and try to come up with a reason why they love the gift. Then it is their turn to come up with a new gift to give. (I like to make the gifts very silly things, like pocket lint, or a chewed up pencil, and watch people try to come up with a reason why they absolutely love and need that gift.)

Art to Music: Have kids place the tip of a pencil in the middle of a piece of paper and close their eyes. Begin playing a song and with their eyes closed, kids begin moving their pencils in movements on the page that mimic the instruments or rhythms of the music pieces. (i.e. a drum solo might be penciled as a jagged heart rate monitor-like line). You can alter the music from style to style while the kids keep their eyes shut. Eventually (when most of the page is covered in lines) they can open their eyes and trace (darkly) all the penciled lines with a black pencil crayon (or find a shape in their scribbles and trace the shape to make it more clear). They can color each individual shape (that has been created by the penciled lines) in such a way that none of the same colors are touching each other, creating a unique piece of abstract art, or color a background outside the shape they created.
Click here for Lauren’s full list.


There are plenty of activities that are not tech related and more and more lists on line as creative parents figure out how to get through this quarantine without losing our minds. Here is a list that I compiled years ago


Going online to download an activity does not count as screen time.

Remember that the following factors can help balance stress levels

Nature: You are allowed outside! Simply make sure you stay more than 6 feet away from people who are not in your inner circle. Be aware of touching surfaces that might be contaminated. You can still walk, or run or dance! I would avoid play structures. Also, if possible use the restroom at home before you go out. Just to be on the safe side, have the hand sanitizer with you on your outing and scrub those hands as soon as you get indoors.


Exercise: 
The Department of Health and Human Services recommends that children and teens ages 6 through 17 do an hour or more of moderate to vigorous physical activity daily. Some of your kids are no doubt delighted to be released from their daily PE class at school, but it is important to stick some exercise into your daily schedule.

There are lots of free yoga, dance and exercise classes on youtube or online,
I am not counting those as screen time as long as your kids are getting up and moving.

Nutrition
There is no shortage of food. We are very fortunate about that. In order to minimize exposure to crowded stores, plan your meals so that you can limit your shopping trips and make them efficient, or have food delivered. Have the kids help you plan the meals and do some cooking. If you have multiple kids, this is a good opportunity for kids to take turns and have some one on one time with you in the kitchen.Do your best to focus on healthy foods.

Therapy 
My daughter Alana is a local therapist in SF. She wants to remind people that therapy is considered an essential service. If this situation is triggering anxiety in a level that you are having trouble coping with, many therapists are continuing to offer remote sessions.

The above tips are all important for maintaining a healthy immune system. There has never been a better time to pay attention to that.

I have vivid memories of power outages that lasted long enough to make an impact. One happened on my daughter Lauren’s birthday. We had to get back to the basics. We ended up making smores in the fireplace and had a musical evening of piano, guitar and singing by candlelight. We might have had some food spoil, but what we remember looking back are positive memories.

I wish this situation was as fleeting as the power going out. I am afraid that this is a marathon, not a sprint, but at some point we will look back at this period in our lives and reflect on how we navigated the challenge. Our goal should be that when we all sit around and recall the tale of the COVID quarantine, it won’t just be horror stories. We will remember how we successfully survived as a family and community and found beauty in togetherness, even as we stayed 6 feet apart.

Addendum.
My readers get my posts in their email every Friday morning
(If you are interested in getting on my list simply send me a note nursejudynvp@gmail.com)
This one got some response from the parents out there who are trying to work from home while keeping kids occupied.
It is easy enough for me to preach about putting down the screen. My kids are grown up and out of the house.
It is safe to say that if I had young kids at home, I would likely be allowing more screen time than the official recommendation.
But! If this situation lasts for more than a few weeks, I really don't want kids on screens for hours and hours.
Try to find a balance.
It is okay to eat extra carbs and binge watch the Hallmark channel Christmas movies.
It is okay to make lists and then ignore them. Do the best you can. Survive.
Success might be measured by not throttling each other.
Your comments are welcome here!



Friday, March 13, 2020

Is Your Medicine Cabinet Properly Stocked?

Is Your Medicine Cabinet Properly Stocked?
With all the talk of potential quarantine, I thought it made sense to brush off and update this old post. While it is important to have everything that you need, please no hoarding!

Even in the best of times, it is smart to have some basic medications at the ready. A little preparation goes a long way. Here are some suggestions of items to keep on hand.

Fever reducers/pain relief
Acetaminophen and Ibuprofen are the most common medications used for this. Remember that you never want to give actual aspirin to a child. Acetaminophen/Tylenol infant and children's liquid are the same concentration so they are actually interchangeable, but the infant bottle comes with a nifty little measuring system and a spill proof bottle which is great for accurate dosing. Acetaminophen also comes as a suppository, which is useful for a child who is vomiting or resisting medication by mouth. Keep those in the fridge. Mushy suppository??? Enough said. Ibuprofen is also known as Advil or Motrin. This medicine also comes in a more concentrated infant form. The infant and child dose are not the same. Make sure you understand your child's proper dose and can refer to these dosage charts.

Antihistamines
Benadryl and/or Zyrtec are the ones that I tend to recommend.

The generic name for Benadryl is Diphenhydramine HCL. There is no special liquid specifically for infants. Most of the bottles have a caution not to use for children under 4 years of age. In many offices, the physicians are comfortable going off-label and using these medications for younger patients if indicated. I do not recommend giving it to a young child without speaking to your health care provider.

These antihistamines would be given for general allergic reactions, itchy skin rashes or insect bites. While Benadryl will make most kids (and adults) very sleepy, it also can cause a few patients to be jittery. Zyrtec also comes in a liquid. Zyrtec typically has less likelihood of either sedation or the jitters. Claritin is one more antihistamine choice. It also comes as a liquid. It is fine for sneezy allergies, but perhaps not quite as effective for itchy rashes.

It is probably worth having both Benadryl and Zyrtec on hand. Local pediatrician, Dr. Hurd has a slight preference for Benadryl when treating her younger patients. There are many times when that sleepiness is a bonus.

Tummy issues
Pedialax or glycerin suppositories are worth having on hand If your child is prone to constipation. If days have gone by without a poop and diet enough hasn't helped to get things moving, these are often the next step. If it is the wee hours of the morning and you have a miserable, grunting and straining kid, getting the poop out is a good strategy.

If your child is vomiting, you will be glad to have an oral rehydration solution in the house. Options include:


Breast milk is also great for a baby who is vomiting, but not everyone is lucky enough to always have it on hand. Some of the oral rehydration solutions come in popsicle form, which is great for older kids. Most of the brands also come in convenient powder forms that you simply mix with water, These are great travel options. Dr. Hurd also counsels that it is worth having a box of saltines in the pantry just in case.

Colic
If you have an infant, have some colic remedies on handI find that the Simethicone products are safe and work quite well.

Mouth sores
If your child is prone to mouth sores or irritations, Glyoxide is very helpful and seems to help things heal up pretty quickly. You can also make a "magic mouthwash" by mixing a teaspoon of Maalox and a teaspoon of Benadryl and apply topically.

Eye issues
For young babies, breastmilk in the eye can cure a variety of issues. For older kids and adults, it is worth having Zaditor. It is an over-the-counter treatment for allergic conjunctivitis. It works quickly if allergies are the culprit. I also find that the homeopathic brand Similason is very soothing.

If eye irritation or discharge continues, It might be viral or bacterial. It is time to check-in with your doctor. Most offices will want you seen. Gooey eyes can be a signal of an ear infection, so a visit is the best way to make sure you are getting the care you need.

Respiratory symptoms
If your child has a history of wheezing, now is the time to make sure you have your asthma medications available. Please check the expiration date and see when they were opened. Many of them are light sensitive so you should always mark the package when you open them. If your child uses a nebulizer, the tubing should be replaced every 6 months. If you or your child use an inhaler, it should be rinsed out at least once a week. If it hasn't been used for more than a week it may need to be primed. Check the directions on your specific medication. Pro Air, which is one of the more popular inhalers, needs to have 3 extra puffs to prime it if it hasn't been used in 2 weeks. Flovent and Qvar are others that need to be primed if they haven’t been used recently.

For basic congestion, it is worth owning a humidifier and making sure it is cleaned properly.

For adults, the Neti-Pot or saline irrigation is strongly recommended by most experts.

Topical creams/ointments
  • Triple antibiotic ointment for cuts or scratches
  • Anti-fungal cream for yeast rashes or fungal infections
  • Hydrocortisone (HC) cream for mild itchy irritations. HC cream comes in a variety of strengths. You can get the weakest ones over-the-counter.
  • It is also worth having a basic barrier cream for diaper rash

If someone is asking my opinion on treating diaper rash, chances are good that I am going to play “paint by numbers” with a combo of the above ointments.

Please pay attention to this rather disgusting factoid:
It is easy for tubes of ointments to get contaminated. Think about it. If the tip comes in contact with bacteria from a finger or directly from the body...there you go. Yuck! One study that I read suggested that more than half of the tubes of creams and ointments that people have laying around are contaminated with staphylococcus (aka staph). The best way to avoid this is to make sure that you don't directly touch the tip to anything. Try to keep it sterile. Squeeze the desired amount onto a spoon and then use whatever applicator you want (clean fingers are usually fine).

Natural topical options
  • Arnica is great for bumps and bruises
  • Aloe is great for mild burns (moderate burns should be evaluated)

Basic first aid
I particularly like the self adhesive gauze popular brands Coban or CoflexThey come in lots of colors and are pretty inexpensive.
The advantage of these is that not only do they not hurt when you take them off, Your child can’t pull them off without help. Also, your little one can’t eat the band-aid!

Consider keeping a baggy with some gauze, Neosporin, and a roll of Coban in your diaper bag to take care of the little injuries that happen away from home.

Ice packs/warm packs
Invest in a child friendly ice pack that you can keep in your freezer. There are loads of adorable ones on Amazon. Holding a soft little penguin or bunny against the boo-boo might elicit a bit more cooperation. Having a microwavable hot pack can also be useful. If you don’t want to buy one, you can fill an athletic sock with rice and that warms up nicely. Another option for a warm pack is to pour some water in a disposable diaper and heat it in the microwave for a few seconds at a time until it is a good temperature.

Keep a bag of Epsom salts on hand. They come in handy for all sorts of things.

Equipment
  • Have a working thermometer that you have tested for accuracy before someone actually has a fever. As long as your baby is over 2 months, I am not one who is going to focus too much on the exact degree of the fever, but we do want to get a sense of how high it is.
  • Have a syringe or dropper on hand for much more accurate measuring.
  • Pulse oximeters have gotten very inexpensive. If you or your child is congested, you can easily check the oxygen level.
  • Have a good set of tweezers for removing splinters.
  • I also suggest having a special tick removal tool.

Pro tips
With any of your medications, put a strip of masking tape on the side of the open bottle and sign and date your doses. This will avoid the common incident of parents double dosing their babies. This also will help you keep track for those times when you are sleep deprived and frankly can’t remember whether a dose was given or not. I get plenty of frantic calls from parents who have inadvertently overdosed their kids by giving the medications too often.

If there is a concern your first call should be to California Poison Control: 1-888-222-1222

Make sure that all of your medications are stored in a safe, childproof location (a steamy bathroom is possibly not the best place). Don't underestimate the ability of a climbing child who knows where the gummy vitamins or yummy medicine is stashed. Even older kids can catch you by surprise at times. I recall a 7 year old patient with mystery tummy aches. He finally confessed to being in the habit of sneaking handfuls of gummy vitamins daily.

Expired medicine
Do a routine check for expiration dates. Even though I try to stay on top of this, I can be occasionally stunned by the old stuff that I find lurking in the back of my own medicine cabinet (it runs in my family).

Please don't randomly toss expired medication down the drain or flush it in the toilet. Medicine can pollute the bay and ocean, or be accidentally misused or abused. Wastewater treatment plants are not designed to remove medications or other chemicals in waste-water; so, after traveling down your drain, medicine may affect our environment.

In SF, you can take your expired medications here. When you visit one of the pharmacy sites, simply deposit your medicine in the green drop-box. If you visit a police station, take your medicine directly to the window. At police stations, you may be asked for your name and address. You are free to decline to give them that information.

What does that expiration date mean anyway?
In 1979, the FDA required that manufacturers include an expiration date on prescription as well as OTC products. This is the date at which full potency and safety is guaranteed, Usually, that date is roughly 1 to 5 years from the time of manufacture. 

The US military, which maintains large stockpiles of medications for both military and civilian populations for use during an emergency, became very interested in this issue following the 2001 anthrax scare. The cost implications were obvious. Throwing out large numbers of expensive drugs simply because they were past their expiration date was an enormous expense that could potentially be avoided if it was determined that the drugs were effective beyond that date.

To explore this, the FDA analyzed the potency of 122 common medications. The was called the The Shelf-Life Extension Program (SLEP). After vigorous testing of more than 3000 different lots of these drugs, almost 9 out of 10 lots were determined to have more than 90% potency at 1 year past the expiration date. The average extension of this degree of potency was 5 years.

So, while obviously if your child is ill, we don't want to take chances with medications that may be out of date, the bottom line is that in an emergency, expired medications are likely not dangerous. They may simply have lost a bit of their potency.

Friday, March 6, 2020

The importance of social support networks

The importance of social support networks


I am a problem solver. I can’t help myself. If I see something that isn’t working, it is a challenge for me to ignore it.
Admittedly this is not always a good thing. I am learning as I get older that not everyone wants to be fixed. Sometimes people need to talk and have someone simply listen. I try. Sometimes I succeed better than others.

Nevertheless it is clear that when I see a problem, my instinct is to roll up my sleeves and dive in looking for solutions.There is much that we have no control over. How can we focus on actions that are actually in our power?

My post a few weeks ago was about stress and the impact it can have on us. I know we can’t eliminate stress and trauma. Alas, we can’t manage the past. What we can do is to try our best to build our resilience as we move forward. Positive actions CAN make a big difference.

To follow up on my metaphor from the post about ACEs, there are several things we can do to mitigate the imprint from our past adverse exposures or current stressful situations. One of the most important protections or deposits in our “well being” account, and the one I will be focusing on in this post, is the act of creating and maintaining a positive support network. These are the friends, family, neighborhood communities, religious organizations, and local resources who you can count on. I am referring to the people who make you feel good about yourself. These are the people who make you soup when you aren’t feeling well, or come over to watch the kids for an hour so you can take a shower. Some just know how to listen.

At the same time recognize who the energy vampires and toxic people are in your life. These are the ones who tend to drain your account. It is the rare and most fortunate person who doesn’t have several of these folks in our orbit. Learning to have healthy boundaries is another essential lesson that we all need to remind ourselves of.

Parents, it is time to put your own oxygen mask on first. Please take care of yourself. Pay attention to your own needs. Not only does this give your child the sense of security that can come with having an intact parent, but it models positive actions for them and bodes well for their future.

Go out and make positive and supportive new friends. Wouldn’t it be nice if it was that easy. Unfortunately, finding friends and community can be a real challenge for some people especially with so many folks on the move these days.

Children have more natural opportunities in their lives to make these connections than most adults do. The earlier you start, the more natural it will be for them. Entering a new situation together can often help forge that initial connection. Kids have schools and camps among the number of opportunities they have growing up. They also have parents helping encourage the connections with other friends their age by making play dates as well as finding and signing them up for classes, groups and other social opportunities.

Beginning something at the same entry point is a bonding opportunity. The first day of a new class is a natural way for folks to meet. Someone coming in mid semester is a disadvantage. 

This tends to be true as we get older as well. When people start a new job there is often a special connection with the other folks that they go through orientation with. Most adults don’t have quite as many social opportunities without making an effort; if you move to a new town, grandma isn’t going to call your neighbors for you and help you make friends, (although I am sure she wishes she could).

Making new and meaningful connections can be done!
My sister-in-law moved to SF from Boston some years ago. She has created real and deep new friendships with people that she has met here as an adult. I asked her how she has managed to be so successful at that and she had a simple response. 

She made it her directive not only to meet new people, but to avoid social isolation. She joined some boards and found volunteer opportunities. One of her favorite activities is serving on the Board of Directors of San Francisco Villagean intentional community for older adults who support each other in navigating the challenges and opportunities of aging (and for the younger adults who care for their older relatives and friends). She was embraced by my friends immediately, and of course had the family here, but it was important to her that she make the effort to meet people independently as well. As Barbara says, "sometimes community just happens and sometimes you have to be more deliberate."

If you are someone who doesn’t easily meet people, becoming a new parent can change everything. It can make you feel lonelier or more isolated than you have ever been, OR NOT! If you take advantage of your new role, it can be one of the biggest social on ramps there is.  

When I hold my NewBie sessions (Newborn Information Essentials) I tell the parents that their new baby is the ticket to a brand new community of friends. Like many here in SF I am a transplant. A vast majority of my friends now are the parents of my children's friends.

In recognizing the importance of fostering community, a modern and effective way in which to do so can be through engaging in intimate, curated, digital chat groups. This is one of the things that the awesome new company I’m working for, Oath Health, is doing to build a supportive network for parents from the time they become pregnant. There will be weekly topics to discuss relevant to where you are on your parenting journey. At this time, our initial focus is to recruit moms who are expecting a baby or have a child under the age of 12 months. The goal will be to offer it widely at some point, but one step at a time. There will be guest experts (including myself) weighing in on the different topics. 

If you would like to sign-up to be a part of Oath’s beta chat group or know someone who might be, please click here. https://www.juno.health/
Understand that being socially connected is important. This doesn’t mean that you need to be on the phone for hours or go out all the time. Everyone has different needs.

Stress happens, things happen, life happens. Bolster yourself with connections so that if you are faced with a situation, you have resources to call on. As a parent, a support system in the time of need can keep you above water. Think of it as a gift to your children.