Your child has covid/ when do you need medical intervention?

 I was actually going to take this week off, but I know of multiple families who have had their kids test positive for Covid this week. This post is for all of you families who are actively dealing with a sick kid or who have been exposed.

When to worry!!!!

One of the hardest things for parents to learn is the very important basics of ‘When to Worry’ about an illness. Everything feels like it has higher stakes in this pandemic world that we are currently living in. Whether your child has Covid (any variant), Influenza, Rsv, Roseola, and/or any nasty virus du jour, there are certain things that I want you to pay attention to. Respiratory distress If your child is struggling to breathe they need to be seen, it doesn’t matter if they have a fever or not. When someone is working harder to breathe you may see the tummy going in and out more than usual. The breathing is more rapid. They may be making grunting or wheezy noises. The nostrils might be flaring. You also might see something called retractions, which is when the skin below the throat and around the ribs looks like it is sucking in.  Someone with breathing issues may look pale. For people of color, you can assess this by checking mucus membranes, nails or the palms. For a mild to moderate cough, see if sitting in a steamy bathroom brings some quick relief. If not, they need medical intervention. Warning sign: A baby having a hard time feeding and taking breaks for air Reassuring:  Feeding well What to do in advance: If you pay attention to what the baseline is, it will be easier for you to recognize trouble. If possible, before they are ill, get a sense of what your baby’s normal breathing looks like.  Actually look at their breathing, what does it look like when they are well? When they are calm, count their respirations. Fever If there is a fever higher than 101.5 give medication and wait an hour. You can also do cool compresses and lukewarm baths. Make sure they are not over bundled. If the fever has not budged, check in with your doctor or urgent care. These days if the fever is higher than 103, most practices will send you directly to the emergency room. What to do in advance? Have a thermometer that you trust. Before there is an illness, take everyone’s temp for several days at the same time of day to establish a baseline. Fever blog post Inconsolable If your child is crying inconsolably I am going to tell you the same thing I would tell the parent of a newborn. Is the diaper too tight? Do they possibly have a hair wrapped around a finger or toe? (that is more common than you might think), did they get an insect bite? Do a full body check to see if you can figure out the cause of the fussiness. If there is obvious source, even if there is no elevated temp, go ahead and give a dose of Tylenol or Motrin. Make sure you know the proper dose. Many times, fussiness can be caused by something as simple as severe gas pains. If you sense that this might be a possibliity, add a dose of simethicone to the mix. It certainly is not going to hurt and can possibly make a big difference. January looks like it might be a tricky month with so much illness making the rounds. Rather than feeling overwhelmed, try to focus on things that are actually in your control. What to do in advance? Get anyone who is eligible fully vaccinated. Have a stash of reliable masks. Make sure you are stocked with food and medications including pedialyte Make some soup and freeze it in reasonable portions Take steps to boost your immune system

Holiday Angst/Joy/ Traditions

 I hope that your holiday plans haven’t been impacted by the pandemic, but if they were, you are not alone. So many people I know are testing positive and cancelling their plans.

This year, I have potentially been exposed to COVID. I will not be celebrating in person with family and friends. Instead, I am isolating and hunkering down with my husband and our Granddog Bowie (who hates the rain).

Wishing you all safe, healthy and happy holidays

There is a reason that therapists need to work overtime in December. In many cases, the holiday season is the absolute set up for potential angst and disappointment. Holidays can feel magical for some lucky kids, but by the time most people reach adulthood, those same holidays can stir up a lot of powerful feelings. Not all of them are necessarily positive. Depending on the person and the family these feelings are often a mix of joy and dread. Hooray for you if you are an exception. Hallmark Christmas movies are an absolute treat, but the fact is, society sets a high bar for how it should be. Sparkling lights, delicious food, getting a pile of perfect gifts, family and friends gathering happily, What could go wrong? The sad thing is that for many people, if you end up having a perfectly fine day, that isn’t good enough when anything less than perfection is apt to disappoint. Writer Rebecca Solnit puts it well. “So many of us believe in perfection, which ruins everything else, because perfect is not only the enemy of good; it’s also the enemy of the realistic, the possible, and the fun.” It is a great time to focus on small moments of joy that we have within our grasp. Are you feeling low? Come on, there has to be something that can bring some cheer. Even looking at some sparkling lights, or being cozy inside on a rainy evening. If you are lucky enough to have your kids at home, can you do a family snuggle and tell stories? This is also a good time of year to remind ourselves to be clear on the difference between things we have control over and those that we don’t. Gifts  You have very little control over what you receive, but if you pay more attention to what you are giving, you can’t be disappointed. This is a great lesson for the kids. Start early focusing on how wonderful it is to give. A good gift doesn’t have to be something you buy. Give the gift of your time, or something you make. How about a foot massage to family members? Sign me up. Everyone has different wants and needs when it comes to gifts. This is the perfect time to remember those “love Languages”  You might also decide to give one big family gift, like an outing or a trip, instead of individual ones. There are no rules. Another enormous source of stress might be the timing of the gift. There are many things out of your control including shipping and/or availability of a desired item. The value of the gift should not be dependent on whether or not it ends up under the tree in time. Take a photo of whatever it is and put that in an envelope. The actual gift will get there when it gets there. Take a deep breath. Family If you are lucky enough to have a family that you want to be with, and it is the togetherness that is what counts, forgive me for this suggestion, but the actual holiday doesn’t need to be only one time of year that you gather. There is something very freeing from avoiding travel when the rest of the world is also fighting to get to their destinations and paying twice as much to get there. I know plenty of people who celebrate a week early or later. There is nothing wrong with that! (If you are reading this from a long line in a crowded airport, I know I am a bit late with this suggestion) Oath’s therapist, the amazing Brittany, adds that it is important to be cognizant. If this is the first holiday/Christmas since a loved one passed, or you have experienced loss, it is okay to initiate dialogue about how you miss the friends and/or family members who are no longer with you. Try to tell stories and share happy memories instead of avoiding their absence.  Traditions Take stock of your holiday traditions. Believe it or not nothing is set in stone. You get to choose which ones are achievable or not and which ones bring you joy. Is there something on the list that should no longer be on there for whatever reason? Cross it out! See if it is missed. Identify which things matter and which things simply cause stress and don’t add value. Talk to the kids and find out which things matter the most to them. You can also adopt new traditions. Have a virtual sing along with friends and family near and far, watch the Twilight Zone marathon. Reach out to people in your lives who may not have friends and family around. Food tends to be an important part of any holiday culture. Making a family recipe or special meal can make you feel close to relatives even if you are far away from each other. Bring the laptop into the kitchen and cook or bake together on zoom. Moving forward, forge traditions that feel great and are easy to achieve. Maybe your kids will be the ones who grow up without any holiday angst!

Travel Tips part two/Managing the flight

 Most parents have travel stories that stay with us, kind of like a battle scar. Here is one of mine.

Many years ago when my daughter Lauren was two, I got creative as I was planning for an upcoming flight as a solo parent. I had seen a craft in a magazine (long before Pinterest existed) where a necklace had been made of cereal and I thought that this seemed like a fabulous thing for an airplane trip. Unfortunately, not all ideas turn out to be good ones. Lauren and I strung some Cheerios onto elastic and she proudly wore her new necklace onto the plane. Soon after take-off Lauren decided to eat some of the Cheerios. I noticed with some dismay that as she bit off a Cheerio, some would go into her mouth while other parts would shoot off like little spitty projectiles. They were landing (unnoticed by anyone but me) on just about everyone within three rows of us. As soon as I realized what was happening, I tried to see if there was a way for her to nibble them off without making a mess. When that didn't work, I tried to take the necklace off to make it easier or to have her stop eating them at all. But as mentioned, she was two. My choices were clear - tantrum on the plane or unsuspecting fellow passengers having little pieces of spitty Cheerios in their hair. I opted for peace (besides, ignorance is bliss, right?)

Of course, now, in the days of Covid, those mini projectiles would have been viewed to be almost as dangerous as nuclear material. Fortunately, things were a bit more innocent then. A spitty Cheerio was just yucky, not infectious

My post this week is full of tips for managing your trip. Cheerios necklaces, understandably, didn’t make the cut. Hopefully the collection of tips that I did include are much more useful than the cheerio debacle!

Managing the Trip

"When is my baby old enough to fly?"  When I was working as the advice nurse at NVP, this was a very common question. There is no simple answer without considering a multitude of factors. Parents might make the valid choice to fly earlier than they might otherwise do in order to see an aging relative or deal with a family crisis. Consider this, adopted babies might fly within the first few days on their way to their new home. It isn’t always black and white. In ordinary circumstances, I would prefer to have the babies wait until they are at least 2 to 3 months of age and have had their first set of immunizations (keep in mind that the first shot does NOT give full protection against some serious illnesses, but it is a start.) The size of the baby as well as the time of year are also factors.  Even before covid I was always paying attention to what illnesses are circulating. During an active influenza season, I would think long and hard before taking a young baby on a plane. It isn't unusual for there to be some type of health alert circulating, so keeping current on the news is important. It is always worth keeping an eye on the CDC travel guidance https://wwwnc.cdc.gov/travel Regardless of how old your child is, if you are planning a trip here are some tips and things to keep in mind. One of my wise readers suggests that if you are traveling out of the country it is worthwhile to register your journey with the state department https://step.state.gov/step/ . Great idea! COVID If your child is at an age to get vaccinated for COVID, do it ASAP, it takes time for the immunity to take hold. Regardless of vaccine status, getting them used to wearing a mask is important. Do some work on this ahead of time. As soon as they are old enough to cooperate, do some mask wearing around the house for longer and longer stretches at a time. Find a reward or sticker incentive that might help. Poke around on the internet. There are some cute videos that help encourage mask wearing. Do some play with the teddy bears wearing masks. People often ask for my recommendation on the best masks. The answer is whichever one they are willing to keep on! It might take some trial and error to find a mask that works for your child. Of course a good fit and adequate filtration are what make any mask effective. Moms, Eliezah, says that her two-year-old has done well with Rafi Nova, Andy & Evan, and Cat & Jack brands that taper and have metal at the nose. Mom and author, Alexandra shared that her daughter Emma has been wearing the Evolve Together KN94s and with the ear loops tied they fit great. If you have a mask that you love, please let me know. Airlines are actually doing a pretty good job at trying not to be vectors for the virus, but it is a good idea to wipe down the areas around your seat as soon as you board the plane. Try to do as much snacking before the flight to avoid eating on the plane, but that being said, do not stress about it if you little one wants to munch on something. Staying sane during the journey is an important consideration. Managing the flight. Keep in mind that a car seat is the safest place for your child. It is worth checking with your carrier to review their guidelines. I remember a trip I took years ago. I was sitting next to a mom with a very young baby. She was so worried about the possibility of getting evil looks from the other passengers that she had actually brought ear plugs to hand out to the people sitting around her. What she didn't have was anything to soothe her baby in case of discomfort. Please always make sure that you have Tylenol or Motrin with you on the plane (not packed away in your suitcase). It is okay to bring small bottles of the medication through security. They need to be smaller than 3.5 ounces. I don't tend to give it ahead of time, but I am quick to medicate during the first sign of fussiness.   Does your child suffer from Motion sickness? Click to review my post on that topic.   I often get questions about the use of Benadryl. This is an option for a child who is over 8 months with a long flight ahead. It helps dry up any congestion and makes 90% of kids who take it deliciously sleepy. Aha, but what about the other 10% you might ask? It turns those little darlings into hyperactive, wild hooligans. You do not want to find out on the plane that you are the parent of the 10%. Look for children's liquid (generic name is diphenhydramine). There is no such thing as ‘infant’ Benadryl; Labels will not usually have directions for children under 4. Instead you are faced with that largely unhelpful “check with your Doctor” Here is a Hack. Benadryl dose is the same volume as the Tylenol dose. In my years of practicing, I have found that most pediatricians I have worked with feel comfortable prescribing it to younger kids, but I always suggest checking with yours own pediatrician for their opinion. Once you have the green light, you may want to give a test dose a few days prior to the trip to make sure it is a viable option for you. My goal is for parents to have the tools with them to deal with an unhappy child. Don't give any medication unless it is necessary. While I would usually err on the side of less medication, Benadryl and Tylenol/Motrin can be given at the same time. Ear issues Many babies and children may have trouble with their ears. For the younger ones, try to nurse or have them feeding during takeoff and landing. Sucking on a pacifier may be helpful as well. Have a lollipop or chewing gum for older kids. Ayr saline gel is a nice thing to have along. A dab at the base of the nostrils can moisturize the dry air and make breathing easier (use it for yourselves as well.)  If you have a child with a history of ear trouble, have some of the little gel heat packs in your bag. You can activate them as needed and the warmth feels great to a sore ear. You might also try bringing a baggy of cotton balls soaked in garlic oil. You can ask the flight attendant to pop them in the microwave for 5 seconds to warm them up (feel them to make sure they aren’t too hot). Make sure that baggy stays sealed or everything you brought with you will smell of garlic. For adults and older kids, you can equalize the pressure by holding the nose and gently blowing until the ears pop. Gently please.You don’t want to cause more trouble by forceful blowing. Supplies Take WAY more diapers with you than you think you need for the trip. I was on another flight once when we sat on the tarmac for three hours. There was an unfortunate family behind me who had planned on a short little trip and was out of diapers long before we even took off. It wasn't pretty. Plan accordingly. Many folks automatically bring a change of clothes for their baby. It is also worth bringing an extra outfit for yourself. If you have a long flight ahead of you with a child on your lap, it may come in handy (I learned that one the hard way and sat for several hours covered with poop.) Changing your baby on the plane can be a challenge. It is helpful to create little changing packs in advance. Pack up several individual gallon ziplock bags with a diaper, wipes and whatever else you use with a change. This will prevent you from having to take the entire bulky diaper bag with you into the tiny bathroom. You can't count on airlines giving you any reasonable snacks, so it is important to bring along enough provisions in case of delays. It is okay to give things that feel a little like a treat, but be warned, having your kids amped up on sugar during a flight is NOT what you are going for. Activities Download some activities or shows ahead of time for your laptop or tablet. None of us want to overdo screen time, but if you have managed to keep it special, a long flight is the perfect time to make use of this tool. Don't forget about the old fashioned low tech options! If you are visiting family, actually print out a bunch of photos of the people you are going to see (what a concept). You can use these for all sorts of art projects on the plane. Make a paper doll family by gluing the faces onto popsicle sticks. Besides keeping them busy for a stretch, this activity also can help your kids recognize folks that they don't see too much of. Wikki sticks are also a great activity to bring along. They are lightweight and not too messy. Reusable stickers will stick on the window. Don't bring anything that will make you sad if you lose it in between the seats. Which brings me to the next point. Protect the Lovey, blanket or stuffed animals that come on the trip! Deciding which security items come along on your travels is a big decision. If your child has a favorite blanket that they snuggle with, losing something on the plane or even in the hotel sheets can be a nightmare. Jet Lag Time zones are tricky. Staying hydrated and getting fresh air are essential. Sunshine is a bonus. My best suggestion is eat when you are hungry, sleep when you are tired and just do your best. Just know that even the best sleepers may have a period of needing a sleep training tune up when you get home. http://www.reflexandmore.com/en/articles-heb/25-english/articles/21-jetlag The link above has wonderful information for dealing with jet lag.  Melatonin https://nursejudynvp.blogspot.com/2019/06/melatoninis-it-useful-is-it-safe.html As long as it is really just a few doses, I would have no worries about putting this in your toolbox. You can have lots of fun while you are away and it is wonderful to see family. But, in my opinion, if you are traveling with children under the age of seven, don't call it a vacation. It's not. It is a TRIP (we used to call our visits to the various grandparents the "bad bed tour.")  A little preparation goes a long way and remember that some of the more challenging moments make for the best stories!

Travel Tips part one:safety

 

After almost 2 years of quarantine, so many of us have been missing our family and friends who live far away; lots of people are ready to accept some risks and do some traveling. This seems like an appropriate time to update and rerun my travel safety post. Next week I will give some management tips for the actual flight or trip. Both posts will include Covid considerations. My dad was a physicist who looked at the world from a unique perspective. How do things work? What is broken, what can I fix, but even more importantly what might go wrong and how can I prevent it? When he was teaching me to drive I remember him pointing to a boy with a ball on the sidewalk. “What could happen”? The ball could drop, fall into the street and the boy might rush into the street to follow it. Anticipating what could go wrong was the first step to prevention. My regular readers have heard me say that we can’t keep our children wrapped in bubble wrap. There are adventures to be had and loved ones to see. On the other hand, it is important to be aware of potential hazards. Knowledge is power and some accidents and harmful situations can be prevented. Others can be handled with less stress if you are properly forewarned. Health If you are traveling internationally, do you or your family need any travel vaccinations beyond the standard immunizations? Make sure you get these done at least a month before the trip if possible. The recommendations will vary based on where you are going and the age of your child. Make sure you have a copy of your immunization records with you on your travels. The CDC's Travel website is a great resource. This includes a list of COVID hotspots. No matter how much you miss people, I would be hesitant about traveling to a place that is running out of hospital beds. Covid precautions. If your child is at an age to get vaccinated for COVID, do it ASAP, it takes time for the immunity to take hold. As soon as they are old enough to cooperate, do some mask wearing around the house for longer and longer stretches at a time. It might take some trial and error to find one that works for you. People often ask for my recommendation on the best masks. The answer is whichever one they are willing to keep on! Of course a good fit and adequate filtration are what make any mask effective. One of my Oath Moms, Eliezah, says that her two-year-old has done well with Rafi Nova, Andy & Evan, and Cat & Jack brands that taper and have metal at the nose. Mom and author, Alexandra shared that her daughter Emma has been wearing the Evolve Together KN94s and with the ear loops tied they fit great. If you have a mask that you love, please let me know. Wipe down the areas around your seat as soon as you board the plane. Try to do as much snacking before the flight to avoid eating on the plane, but that being said, do not stress about it if you little one wants to munch on something. Staying sane during the journey is an important consideration. Getting care out of town If your child gets ill during the trip, it is important to know where to get care. I suggest doing some homework before you leave. This includes checking with your insurance if that is applicable, to see what will be the most cost effective choices. What local urgent care options are available where you are going? Do you have friends or family with a local pediatrician who will see travelers?  If your child has a history of wheezing, even if it hasn’t been an issue recently, take any inhalers with you on. Actually, bring them on the plane!  If they have ever had an anaphylactic reaction, make sure you have your epipen. That comes on the plane with you as well, along with your Tylenol  https://nursejudynvp.blogspot.com/2018/08/anaphylaxisepipen-options.html Be aware that your doctor's office can NOT call in prescriptions to another country! (Including Canada!) Gun safety? It might be awkward, but do it anyway - Ask your hosts if they own a gun. This might even be your own parents or siblings. Many people own guns and don’t give it a second thought if they are not used to having children in the house. It is essential to make sure that any guns are locked away, separate from ammunition. (This has nothing to do with the second amendment.) https://nursejudynvp.blogspot.com/2019/01/gun-safety.html Make sure that medications are child proofed. Grandma and Grandpa might have medications in areas that are easily accessible if they aren’t used to having young kids visiting. I had one little patient who got a dose of oxycontin right out of a nightstand drawer. Thank goodness she was okay. Is there a pet? Is the animal comfortable with kids? If animals are even the least bit growly, make sure they are kept in a different room. Some pets get stressed from having little ones around. I have dealt with more dog bite cases than I can count https://nursejudynvp.blogspot.com/2019/08/kids-and-pets.html Staying in a cabin/ Air B&B Make sure there is a carbon monoxide detector or bring your own. This is more important in the winter if there are wood burning stoves or space heaters https://nursejudynvp.blogspot.com/2017/11/carbon-monoxide-2017.html Most places have a smoke detector. Do a little test to make sure it has working batteries. Fire extinguishers are useless if you don’t know where it is and how to use it. Bed bugs...ugh Check the mattress before you unpack to make certain there are no bedbugs. The best way to do this is lift the sheets and make sure you don't see any red spots. Bed bugs are large enough to spot. https://www.bedbugreports.com/ In some cities like NY they are rampant. This is not a souvenir that you want to bring home. Crib safety Make sure your child's crib is up to current safety standards. If you are traveling internationally, be aware that cribs may not have the same safety standards that we have here in the US. General Holiday safety tips Are you staying somewhere with a Christmas tree? https://nursejudynvp.blogspot.com/2019/12/holiday-safety-checklist-2019.html Food safety This is often associated with international travel, but food can be contaminated anywhere. If there is vomiting, diarrhea and fever, this is likely bacterial and you should be seen. Making sure that you have clean water is essential. Make sure to avoid ice unless you are in a resort area that assures the safety of the water. It is worth asking the place where you are staying if the water is filtered. Street food, raw fruits and veggies, raw or under-cooked meats and fish, can all lead to trouble. Ask about poisonous plants https://nursejudynvp.blogspot.com/2019/04/keep-your-kids-safe-from-toxic-plants.html Swimming and Water safety If you are going anywhere with water nearby, appoint a water guardian. https://nursejudynvp.blogspot.com/2018/07/drowning-prevention-appoint-water.html Make sure there are alarms and fences around any pools, but there is no substitute for watching the kids like a hawk. Crowds Until we know more about new Covid variants that are making the news, I personally would suggest skipping any large crowds. But if a large crowd is part of your plans, take a photo of your child before the outing so you know exactly what they were wearing in case you get separated. Consider bright, recognizable colors. Write your cell number on their arm and cover it with liquid bandaid so that it doesn’t wash off. Make certain that your child knows the safety plan and where you should meet up if you get separated.  Hiking? Do a head-to-toe tick check every day. Winter isn't typically tick season, but with climate change, I never say never. The weather forecast is calling for much warmer than normal temperatures for most of the east coast this month, so if you are traveling on the east coast you might actually be able to enjoy some outdoor time. Altitude If you are above a certain elevation, it takes some folks a bit of time to adjust. You have to pay extra attention to sun and hydration.. https://nursejudynvp.blogspot.com/2018/03/dealing-with-altitude-2018.html I know I know, after reading all of this you are ready to curl up in a ball and call off the trip. That is not my intent. Do a little planning. When you call Grandma and or Grandpa with this very long and annoying checklist, just blame me. I can take it.

The Best Present is your Presence

 

I saw a bumper sticker some years ago that said:   Good parenting requires twice as much time and half as much money.   So true!   This is the season for gift giving, but we all actually could do with a lot less stuff (EJ spent 10 minutes giggling over several crunchy dry leaves, and another 10 cackling over crumpled up balls of aluminum foil)!! The best present I think that families can give to each other is the gift of self (otherwise known as time and attention.)   For kids who are old enough to understand, give a certificate that promises a special activity that you might do some time in the future. For older kids, escape rooms are a ton of fun (they now have some virtual escape rooms available if you don't feel up to going in person yet). A membership to one of the local museums or the Exploratorium is another good gift to give to the family.   It is great for families to do outings altogether, but one-on-one time is so important if you can manage it. Mix and match so that you make sure that everyone gets special time with one other family member. This includes one on one time for you parents as well.   The list of Nurse Judy's inexpensive and creative activities has some old and new ideas.   Collect and decorate rocks with colorful paints and glitter for a rock garden.   This is a great one to use as a reward for good behavior. When they see the pretty rocks, they will remember that they earned them.   Make a collage. Old magazines and old photos are great for this activity.   Make a musical instrument. Use your imagination: a shoe box with rubber bands can be a guitar; glasses filled with different levels of water make different tones; tapping different surfaces with chopsticks makes different sounds.   Go on a 'use all your senses' walk. What do they see, smell, hear, and feel? (This is also a great way to practice mindfulness, which everyone can benefit from!)   Make personalized place mats. Take some family photos, glue onto cardboard, and cover with clear contact paper. Kids will love to use these with meals.   Create a scavenger hunt walk. Plan a list ahead of time of thing to find...like a dog, an airplane, or even a girl with purple hair (or if you live in San Francisco you might be able to add some more unique items to the list -- a memory comes to mind of a younger Lauren loudly calling attention to the naked man painted gold, while Alana somehow managed to completely not notice him).   Go on an ABC hunt. Find things that start with all the different letters...or find the actual letters on signs and license plates. This is a great game in a supermarket or on a car ride.   Download free coloring pages from the internet. With a little searching, you can get a picture of just about anything.   Draw with chalk. Make a hopscotch board.   Make your own play dough. You can find the recipe online.   Make a fort using the couch cushions,   For a really special occasion, set up the tent and have a backyard camp out (or as we once did, set it up in the house!)   Write a story and illustrate it together.   Decide on a recipe and bake or cook something. Kids will often try foods more eagerly if they helped with the cooking. Let them help sprinkle in different spices and be the taste-tester.   Have a tea party. Invite the dolls, and get out the good china that you never use.   Trace your hands and feet and color them in.   Have some down time while watching a video or a special TV program. There are some lovely educational TV programs and videos out there.   Play a computer game. Don't be afraid of controlled use. Children that don't learn how to be comfortable with computers at a young age are at a distinct disadvantage in this high tech culture.   Okay, now put that screen away and get some fresh air! Families can play some sports outside. Find a patch of grass, a basketball hoop or one of the city tennis courts and get active.   Blow bubbles.   Playing board games with the family is the stuff that great memories are made of.   There is little out there that is as much fun as a giant box to get inside of . If you buy a new appliance or see a neighbor buying one, ask for the box.   Make a rain gauge and weather station (wouldn't it be nice if there was actually something to measure? If you build it, maybe it will rain).   Play dress up. In my opinion, every house needs a good dress up box, (after Halloween is a great time to pick up costumes and things on sale)   Read!   If you can manage to make it work, try hard to have at least one meal of the day sitting down with the entire family. Have everyone say a little about their day. Having one child help with cooking a special dinner, including making and decorating a menu is a great way to have one on one time.   Take advantage of where we live; there are always fairs, festivals and museums that are going on.   Make a scrapbook with keepsakes and photos of all the fun activities   Unless you are using the phone or tablet as part of the activity make sure you put them down and be fully engaged in what you are doing (emails can wait)   For Those lucky enough to live in or near the Bay Area, here is my list of quirky, only in SF things to do.   Fort Funston: Bring some dog treats and take a walk. You are pretty much guaranteed to see lots of fuzzy friends to pet. If you are lucky you will see hang gliders. (Free)   Take a ferry ride. The route from the Ferry building to Jack London square is super easy, and there are snacks and a bathroom available!   Turrell Sky dome: For this you need an admission to the De Young museum. Many folks have no idea that this magical place exists. Go out to the garden by the cafe and follow the path and signs down to the sky dome. Once you are in there, make sure you sing and listen to the acoustics   The camera below the cliff house: Lots of folks don’t bother stepping in there, but it is worth it. The Camera Obscura gives a real time 360 view of the surrounding area. It is only open when the weather is clear. It isn’t free, but it is reasonably inexpensive   The Wave Organ: This is an old exploratorium exhibit that remains at the end of a jetty behind the St Francis Yacht club. When the tide is right (good luck, I have rarely been there are the right time) pipes will play music. It is an enchanting place regardless, especially if you are there when no one else is out there. It is free   Musee Mecanique - If they love it there...consider earning points for future play there   Labyrinth down at Land’s End is worth checking out.   Walking tours are free and plentiful. These are a fun way to get outside and learn a little history of the city.   The Gingerbread house in the lobby of the Fairmont Hotel is worth a trip. It is only there until the New Year. This is free unless you opt to splurge on the very expensive tea.   I love the Stairway walks of SF book. If your child is old enough that they don't start asking to be carried half way through the walk, these are a great family activity. At the start of the pandemic, my daughter Lauren created a list of fun, at-home improv activities you can play as a family.   Sing-a-longs at the Castro Theatre (Thanks to JD and family for this addition)  Volunteer as a family. Groupon and Goldstar and great ways to find the deals out there! https://www.sftourismtips.com/san-francisco-with-kids.html   https://tripswithtykes.com/free-things-to-do-in-san-francisco-with-kids/     Happy Holidays...go out and make some wonderful memories! 

Covid Vaccines for kids 5-11

 

Covid vaccines for kids

It is shocking and sad that the topic of vaccinations has become such a divisive issue. I remember my mom telling me about how every parent she knew couldn’t wait to get in line to get their kids protected from polio and measles as soon as the immunizations became available. They saw firsthand how destructive these diseases could be. Vaccines save lives. Unfortunately for everyone, there is so much misinformation making the rounds. Disinformation is meant to cause harm.  Misinformation is generally not malicious, it just isn’t based in fact. It ends up causing plenty of harm in its own way. Please keep in mind, reasonable people really are on the same page. We all want our children to be safe and healthy. We also would like this pandemic to be in our rear view mirror sooner than later. Regardless of your stance on this topic, there should be absolutely no shame in asking questions. I want you to feel comfortable with the decisions you make regarding vaccination. Here is the essential thing. Please find a source (not your aunt’s gardener who gets most of his info from his cousin’s facebook posts). Your pediatrician is often an excellent source. Doing your own ‘research’ if it is not based on reputable data, can take you down a costly and potentially harmful rabbit hole. I have been trying to gather as much data as I can on this topic and one of the wisest statements I have heard so far was from Dr. Eric Ball, during a webinar hosted by the CDPH His point was, the choice you have is simple. Would you rather have your child get immunized or have them get the covid virus? The data speaks for itself. The Virus Kids do get covid. They might not all get terribly ill, thank goodness, but at the time that I am writing this, children 0-17 represent 17% of all cases nationwide. 6.4 million have tested positive (that is likely vastly under reported). 60,000 have been hospitalized and 600 have died. If you look at the top ten causes of death for children 5-11 during the past year, Covid-19 comes in number 8. And 5,200 have been hospitalized with multi system inflammatory disease (MIS). https://www.cdc.gov/mis/mis-c.html We are still learning about long term complications in patients. The impacts from the virus are continuing to show up weeks to months after the infection. Of course not all of them are as serious as the MIS, but pediatricians are seeing kids with what they are referring to as long covid. For these unfortunate patients, insomnia, fatigue, muscle pain and persistent cold-like symptoms are common. Some of these are not showing up for months after the initial virus. Frankly I am more concerned about protecting kids from potential long covid, than I am worried about the initial infections. Kids also serve as a vector. Not only can they spread covid to family members who might not fare quite as well, but the more ‘vectors’ the virus has access to, the greater the possibility that it can mutate into an even more terrible form. Immunity from the illness is not as protective as the immunity you get from the vaccine. Think of it like this, when kids are getting the flu vaccine for the first time, they need to get a series of two shots. The first one is a start, but doesn’t protect. The second one is what teaches the body to recognize and protect. Having had the illness is like having had the first flu shot. The vaccine First of all, all science to date has shown that the vaccine is safe. Billions of doses have been given. Kids' immune systems are indeed amazing. They are able to respond to a smaller dose than adults. The trials showed that they only require ⅓ of the dose that the older folks were getting. The schedule is similar to that of the adult series with a 3 week interval in between the shots. Certainly many people have several days of side effects. These might include aches, fevers and even some swollen glands, but once those fade, there haven’t been reports of any long term issues. Poor Sandy felt like he was hit by a truck for 2 days. I rubbed arnica all over my arm and was mostly fine after 24 hours. In any case we both said,” bring it on! Hooray that our immune systems are working.” Some folks have a much easier time than others. Either way I would suggest carving out some down time the day after the shot just to be on the safe side. Check out Dr. Teds section below for the scientific explanation about those side effects. Having a day or two of feeling yucky is much better than having actual covid. Even mild cases of the virus can lead to long term issues that we are just learning how to manage. The vaccine is not actually new. It has been in the works for more than 20 years. I am going to address a few of the common concerns that you may have read about. Myocarditis Post vaccination there have been 2 out of 100,000 cases reported. Aha...but guess what, there have been a reported 150 out of 100,000 cases of people who got myocarditis from having actual covid. It is nice to know that up until now there were NO cases in the 5-11 year old age range https://www.cdc.gov/mmwr/volumes/70/wr/mm7035e5.htm Fertility This is a non issue. There has been absolutely no documented impact on fertility. Oh yes , except for the well publicized case of Nicki Minaj's cousin’s friend’s enlarged testicles. Micro chips I hope none of my readers actually buy into this kind of misinformation, but just in case here is a list of some myths that have been dispelled https://www.cdc.gov/coronavirus/2019-ncov/vaccines/facts.html It is safe for kids to get vaccinated even if they have already had covid. In the clinical trials, 9% of the children had previous covid infections. These kids actually ended up having milder side effects compared with those who had never been infected. Is the vaccine perfect? Of course not. There are plenty of breakthrough cases, but the numbers are clear that the hospitalizations and deaths are overwhelmingly higher for people who have not had both shots. Although the risk is not zero, the incidents of Long Covid appear to be significantly lower in people who have already had the series of at least two shots We don’t always love our options. If you are a parent then you are familiar with this. Your toddler might insist on wearing their favorite shirt that is in the laundry because the dog peed on it. “I am sorry”, you tell them. That is not one of your choices. We don’t have time to wash it. You can choose between shirt A and shirt B.. Sometimes our choices suck. But that is the world we are living in. Here they are again. I will add a third option: Get Covid  Get vaccinated Stay in a complete bubble Unfortunately opting to wait and watch to see how things are going is essentially akin to picking door number 1. If I had a child in the 5-11 range. I would be getting them the shot at the earliest possibility, especially with the holiday season right around the corner. Dr. Ted’s Science Those side effects can be celebrated. Side effects from shots are a hard thing to watch. All of a sudden, your child spends a day feeling sleepy, feverish, or in pain, and "you did this to them" is all you can sometimes think about. But I put a positive spin on this phenomenon. When the body’s immune system is active and learning, it creates antibodies, along with a number of other inflammatory signals. These signals are what cause us to feel symptoms. We see this mirrored in the COVID-19 research: people with asymptomatic disease are more likely to make little or no immunity to the virus, whereas antibody levels are much higher for those with significant symptoms. So the day or feverishness after a shot could bring a sigh of relief: the body is stating the message was received. This doesn’t mean you should worry if your child doesn’t have symptoms or behave differently the day after a shot, they might just have a different experience of those feelings. But those short-lived symptoms do not leave lasting damage, only lasting protection!