Forgiveness and Atonement 2023

 

This week's post is an update of one from several years ago.

It has been a hectic week and I haven't had the bandwidth to create anything new.

My husband Sandy had a total knee replacement on Tuesday and I am busy trying to stop him from overdoing it.

Of course, hours after we were home from the hospital the kitchen sink clogged. Yes indeed, there he was, one day post op, trying to clear the clog, so that is who I am dealing with!

But now that I have chained him to the bed and the plumber is here, all is well.

I have forgiven myself for rerunning an old post.

Forgiveness and Atonement

"Forgiveness is a strange thing. It can sometimes be easier to forgive our enemies than our friends. It can be hardest of all to forgive people we love. Like all of life's important coping skills, the ability to forgive and the capacity to let go of resentments most likely take root very early in our lives."

Fred Rogers

Being angry is like swallowing a spiky and potentially poisonous stone. It can do no good inside of you...poop it out and flush it away

Nurse Judy

Last Monday was Yom Kippur. This is considered one of the most important days in the Jewish Calendar. 

It is a Holy Day, rather than a Holiday, unless you consider fasting and deep introspection something you celebrate.

I am not a classically religious person. My friends and family have heard me say that my belief system is simple:

1. There is ‘more to it than this’, we just don’t get to know exactly what that is
2. Be kind

So while I am skeptical about an all powerful being with a white beard judging my every action, there is something about Yom Kippur that has me treat the day with a bit of reverence.

The message around Yom Kippur is twofold: forgiveness and atonement.

I will address forgiveness first.

I am not saying that you shouldn’t get angry at someone who has done something wrong. By all means, feel those feelings as much as you need to. But then take a moment to do some thinking. When we feel a strong emotion we can ask ourselves what this particular feeling is trying to communicate to us. Perhaps something has been threatened or a boundary has been crossed. Once you have identified the purpose of the emotion it has done its job. Now it is time to let your head take over.

It might seem like I am going off topic, but bear with me for a moment.

When I was working at Noe Valley Pediatrics, it was not unusual for kids to vomit, poop or bleed on a surface or the floor. People who work with kids know that this is simply part of the job. Bodily secretions are considered biohazards. We had to have a system for dealing with these messes.

Fortunately we had these nifty little kits designed for exactly this purpose. The amazing medical assistants who I was lucky enough to work with would spring into action. They would put on some protective equipment and proceed to sprinkle a special substance on the mess. This chemical turned whatever yucky stuff we were dealing with into a gel form that created a blob that was easily cleaned up and disposed of. These clean up kits were a valuable tool.

Anger and grudges directed towards someone are like a biohazard. Those negative feelings can actually impact your health. You need tools for learning how to change something potentially toxic into something more benign and easily dealt with.

Talk to a therapist. Meditate. See what you can come up with that helps you let go of stuff. One technique that I like is to turn mad into sad. Turn anger into disappointment. Those are potentially heavy feelings, but they are less toxic to you.

Don’t forget to forgive yourself! None of us are perfect and we all have lessons to be learned. You will be amazed how much lighter you can feel when you let go of all that negative energy.

The next aspect of Yom Kippur is atonement. This day is actually called the Day Of Atonement, so maybe this should have come first.

The day involves fasting, and for many observant Jews, solemn prayer asking for forgiveness from God and people in our lives for any possible sins or wrongdoing that we may have committed during the past year. There is a lovely ritual called tashlich, where you toss breadcrumbs into a body of water as a symbol of casting off your sins.

I remember one year, I took my young daughters out in a boat on Stow Lake to do our own version and toss bread to the ducks (ducks actually shouldn’t eat bread, but I didn’t know that at the time. I have forgiven myself.)

https://friscolibrary.com/blogs/post/the-dos-and-donts-of-feeding-ducks/

 We did our own little ritual. 

“Is there anything you have done that you feel sorry about?”

Lauren went first and did it with a gusto as she tossed piece after piece to the eager ducks. She had an absolute laundry list of confessions.

“This is for the time that I …….

And this is for the time that I……"

She went on for several minutes confessing to all sorts of little misdemeanors that I had been clueless about. Yikes!

Finally she was done. Her conscience was clear.

“Alana, it’s your turn, Is there anything you feel regret about?

“Nope”

“Nothing at all?”

“Nope..”

 Okay, well then. 

Shake your head if you must as I did, but knowing Alana it is quite possibly accurate.

When I think about atoning, I think it is imperative to point out the difference between intent and impact. While good intentions gone awry happen frequently, It is the impact that is what matters.

If you accidently knocked over a glass of milk, pointing out that it was awfully close to the edge of the table is not an appropriate part of the apology. 

“If someone hadn’t left that glass there, this would not have happened” (try again)

“Oops, I should have been more aware of my surroundings, let me help get that cleaned up” (better)

If you said something hurtful, it doesn’t matter all that much if you meant it or not. If it caused pain, make the apology a clean one, don’t muck it up with the defense or reason. Simply be sorry, learn the lesson and try not to repeat.

Parents, caregivers and people who are role models to children - Your kids are watching you! If you can learn to forgive, they will notice. If you learn to admit mistakes and try to do better in the future, they will notice. 

As the amazing Mister Rogers noted in the quote at the beginning, these behaviors take root early on.

There is nothing easy about this. Especially these days when it is so easy to be angry at people who are making horrible choices. I wish it was actually as easy as tossing crumbs into the lake.

Have I completely forgiven the people who stole the catalytic converter out of my 14 year old Honda a few years ago? Perhaps. Knowing that I cursed them with never ending pinworms, bedbugs and head lice took a little of the sting out of it.

Flu Vaccine information for the 2023/24 season

 

Flu Vaccine information for the 2023/24 season

Covid still seems to get the lion’s share of the attention, but the flu is not something that should be ignored. Influenza is one of the deadliest vaccine-preventable diseases.

Each year, the flu kills more children in the United States than meningitis and whooping cough combined. Flu can lead to serious complications such as bacterial pneumonia, ear infections and sinus infections. It can also worsen chronic medical conditions, such as congestive heart failure, asthma or diabetes.

The flu is no joke. Even a mild case can be completely miserable. The aches, the coughing, the chills, that horrible feeling that you don’t want to be touched…nobody wants to get this.

In the heart of the Covid pandemic, we had a couple of years where the Influenza season was lighter than usual. It isn’t rocket science. When people avoid crowds, wear masks and wash their hands, things don’t spread as easily.

It is clear that once people relaxed cautious behavior, things went back to normal. Between October 1, 2022 and April 30th 2023 the CDC estimates that there were

27-54 million cases of flu. This led to 12-26 million doctor visits, 300,000-650,000 hospitalizations, and 19,000-58,000 deaths.

All of those positive behaviors such as handwashing, masking when in crowds... etc. are still important, but your best protection is to get a flu shot!

Getting the vaccine is not just about keeping you or your children from getting ill. It is also about minimizing spread within your family and community. It means protecting people who are vulnerable, including infants under 6 months who are too young to get the shot.

In addition, flu vaccines can reduce the burden of flu illnesses and hospitalizations, on our health care system. All of those health care workers need a break!

Kids can start getting the flu shot at 6 months. If you have a baby at home who is too young to get vaccinated, please take extra care to make sure that all the household contacts are protected so that you don’t bring the virus home. Pregnant and nursing moms can and should get the shot. Double check that you get the preservative free if you can.

Anyone who is under the age of nine, and is getting the flu vaccine for the very first time, needs to receive two doses of the vaccine in order to be considered fully protected. The first dose “primes” the immune system; the second dose provides immune protection. The two doses need to be separated by at least four weeks. Over the years I have seen patients who have had only their first shot come down with the flu. One dose will not fully protect them.

If your child has ever had more than two previous doses of any flu vaccine, they only need one this year. It takes about 2 weeks for the shot to take effect.

Every year the disease trackers do the best they can to predict which strains of the virus will circulate and try to match the flu vaccine to the anticipated strain. Some years have better matches than others. The experts are optimistic that this year is a pretty good match for avoiding severe illness.

A couple of things are different for the 2023-2024 influenza (flu) season:

The composition of flu vaccines for the U.S. 2023-2024 season will contain the following:

• Egg-based vaccines
• an A/Victoria/4897/2022 (H1N1)pdm09-like virus; (Updated)
• an A/Darwin/9/2021 (H3N2)-like virus;
• a B/Austria/1359417/2021 (B/Victoria lineage)-like virus; and
• a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.

The flu mist is another option that is approved for healthy, non-pregnant people between the ages of 2-49

When should you get the shot?

The flu shots usually become available in August. As soon as a baby turns 6 months old you can get them started with their first dose since they need two doses to be fully protected. 

For older kids and adults, late September and October are ideal times to get the shot. The protection lasts about 6 months. Most years the flu starts to really circulate in the winter months but be warned, Dr. Ted has already had some of his patients test positive!

In past years there have been some supply issues, but this year it seems that there is plenty to go around so far. Because it is impossible to predict possible delays and shortages with the supply, the safest way to prevent having an issue with a potential shortage is to get the shot by November.

Dr. Sophia Hurd, A UCSF physician at the Laurel Heights location says that the flu shot visit is a great time to get caught up on any other vaccines that your child might be missing. Most offices require appointments for shot visits.

Can you get the flu shot and Covid vaccine at the same time?

There may be a small benefit to separating them by at least several days, but if your busy schedule needs to get them taken care of at the same time, that is fine. Just make sure you get them in different arms (or legs).

What are the typical reactions?

Some shots are more painful than others. The flu shot is one that usually doesn’t hurt too much. When I worked at Noe Valley Pediatrics, I gave thousands of them and more often than not, the babies didn’t even fuss. Afterwards is a different story and soreness at the site can last for a few days. Every year, my own arm is always sore from the shot.

It can vary a bit from year to year, but most of the time the reactions to the flu shot are quite mild. It is common to have a low grade fever. Remember that a day or two of aches and a bit of fever is still better than a full-blown case of the flu.

What if my little one already has a cold?

A mild illness does not affect how well the body responds to a vaccine, so a mild illness is not reason to put it off.

What about egg allergies?

If your child has a mild to moderate egg sensitivity it is still considered okay to get the standard shot. 

Beginning this year with the 2023-2024 season, additional safety measures are no longer required for flu vaccination of people who have egg allergies. Of course, all vaccines should be administered in a setting where personnel and equipment needed for rapid recognition and treatment of allergic reactions are available.

It is important to keep a close eye on your child for at least 30 minutes after the shot. If they seem to be having any breathing issues or exceptional fussiness they should get checked out immediately.

If you have someone who has actually had an anaphylactic reaction in the past, talk to your doctor about some new options.

Tips for the immunization visit.

As I mentioned in last week's post, a little preparation ahead of time with either method can make a world of difference.

The flu mist is a nice option for kids over 2, but to tell you the truth, getting a 2 or 3 year old to cooperate with something being squirted in their nose can be more of a challenge than the 2 seconds it takes to do the injection. If you can practice with a little saline in the nose at home, you will have a much better chance for success. If you can’t get them to do this in the safety and comfort of your home, save yourself the trouble of trying in the office and just opt for the shot.

For the injection, get out the doctor's kit and do a little playing. There are also loads of little videos that you can watch in advance. I have one link here - Daniel Tiger gets a shot, but do some homework and see if you can find one that might resonate with your little one.

Make sure you give appropriate choices, such as which arm they want the bandaid on, or what kind of treat they might get. Dr. Hurd pops a gummy or piece of chocolate into her kids mouths right after the shots and they are a big fan. No fussing at all.

Be clear that whether or not to get the shot, is not one of the choices.

When you go in for the appointment it is helpful if your child is wearing short sleeves or clothes that will allow them easy access. Perhaps bring an ice pack with you and give yourself a bit more time for some icing in advance. 

You might also order a product called a Shot Blocker from Amazon and bring it with you. These little gizmos have helped a few of my ‘shot haters’ have an easier experience.

I have found that there is no age limit to people who are terrified of shots. Some parents are so upset by the sight of a needle that they can’t be in the room when their kids get vaccinated. If you are one of those, see if you have the option of having a partner be the adult on duty.

Wishing you all an influenza free year. Now call to make an appointment!

For frequently asked questions, here is a great resource from the CDC.

How to get the most out of your doctor's appointment

 

How to get the most out of your doctor's appointment Our medical system has some challenges (understatement). If you are in the position of looking for a provider, assuming you have choices, here are some things to consider: What is the process for asking follow up questions or non urgent questions in between appointments? Is there an advice nurse? Do they use email or a patient portal? What is the expected response time? Is the office convenient? On a Friday afternoon (when all the kids get sick) it is better to be able to avoid crossing a bridge. Is there parking? If you are managing a baby and stroller, this can be a bigger issue than you think. How long are the appointments: acute care as well as routine check ups.These can vary significantly from practice to practice. What is the practice’s vaccination policy?  Is there a separate waiting room for sick and well children? Spoiler alert, most practices do not, but they might schedule sick and well appointments separately. What are their urgent care options for after hours? What do I do when my kid has a fever at 3am? What is their comfort level with trying complimentary or natural treatments (this may be more important to some of you than others). If it is a specialist, is there a nurse practitioner that you can address questions to? Do they take your insurance? What hospitals/specialists are they affiliated with? Does the pediatric practice visit newborns in the hospital? If they don’t, what is the best way to let the practice know that the baby has been born to schedule the first appointments? Does the practice have recommendations for: Managing visitors to the house after the baby is born? Hepatitis B vaccination in the hospital or at the practice? Vitamin K (...just get it!) Cord blood banking? It is a challenge for many parents to figure out what to do with all the little concerns that come up. If something has you really worried, then by all means call your doctor, but for so many things, you probably don’t need a special appointment. I’m talking about the things like the strange shriek that seems to happen every night at 2:41 am, or that little red spot on the back of the thigh that has been there for a while but doesn’t seem to be changing or bothering anyone (but you). But keep a ‘shopping list’ of sorts. I suggest creating a little document that you share with all caregivers. This can help make sure that when you do have a scheduled appointment, you bring all of these things up. I also strongly recommend doing your homework and taking a look at these common questions/discussion points that come up at many of these routine appointments. Go ahead and flag anything that feels like it needs to be focused on and add it to your list. Even the best and most caring doctor has limited time during routine appointments to often do a comprehensive exam while addressing all concerns that you have. This makes it even more important to maximize the time that you have. While you have the right to have questions answered in a way that you understand, it can be helpful to be organized. That is where that little list comes in. Let the doctor know at the beginning of the appointment what is on your mind, rather than an “oh by the way” as they are heading out the door. Even better: Dr. Ted likes it if patients send their lists the day before the appointment, so that he might have an opportunity to answer those questions virtually before you get there! What to bring with you to the doctor appointment Your list of questions and discussion points Updated insurance card Any forms for school or camp A change of clothes, count on the fact that they will pee or poop all over the place, and a plastic bag to pack out poopy diapers if those occur. If cold/ flu season bring some activities from home so that they aren’t touching the communal toys. For older kids: shot blockers, simple little items to decrease the pain of injections. A little cold pack to put on the injection site prior to the shot (some offices will offer that). Preparation and some playing before the appointment can go a long way towards making the appointment easier. Don’t stress if your little one starts screaming before you even park. I had one of those. You are not alone. There are things that you can do: Read some books. There are tons of good ones out there. Or tell a story about another child who was scared and talk about things that you can do to make it easier. A little toy doctor kit is a worthy investment for kids 18 months and older.  If you allow some screen time (in small doses some can be quite nice) then scope out some little videos that can help prepare your little one for an appointment. Tell the office ahead of time if you have a really doctor/shot phobic kid. When I was working at the pediatric office, my medical assistant Josie and I were the dream team and people would actually schedule appointments when they knew we would both be there. Josie was so good at giving shots that for years, even when she had aged out of the pediatrician, my daughter Alana would only let Josie be the one who gave her the annual flu shot. If you have an appointment for something more complicated... Forgive yourself for not knowing all the medical terminology. If you don’t know what something means or something doesn’t make sense, ask! If possible, have an extra adult with you. That extra set of ears can be really helpful. They can also be in charge of stopping the toddler from licking the exam table, so that you can be less distracted. I hope you all find excellent providers to help you and your family stay healthy.

Understanding Medical Terminology/How is your Greek and Latin?

 

How’s your Greek and Latin?

Years ago a physician friend of mine had a 13 year old female patient who presented with lower right abdominal discomfort. Appendicitis was ruled out and the diagnosis was Mittelschmerz. This simply is the name for the discomfort that can occur during the middle of the menstrual cycle.

It should come as no surprise that there is even a more complex medical term associated with this. The doctor reassured the patient that she believed that the discomfort was real. She shared the medical term and let her know that this condition wasn't worrisome. She also told her that while the discomfort would likely ease in a day or so, It could repeat monthly.

The young girl felt very validated that there really was something going on. She went back to school and proudly told her friends that she had a ‘ruptured Graafian Follicle’.

They all oohed and aahed and offered her sympathy.

What is a ruptured Graafian follicle? It is another term for ovulation.

This particular patient was delighted to have an impressive diagnosis.

How many of you remember being back in grade school and kids would tease each other… Uh oh, your epidermis is showing. Many kids would be upset until they figured out that the epidermis is simply the outer layer of the skin. It is notable how most of us are unfamiliar with the official names of our own body parts and functions.

I made a game with my kids when they were young. I would toss out a word and they had to decide if it was real or made up.

Uvula? Yep thats real (it is the little fleshing extension that hangs down in the back of your throat)

Flamichulum? Made up

I got a huge kick out of a video that Lauren recently sent of my 2&1/2 year old grandson Elliot trying to say “Medial Malleolus” after he calmed down from bumping his (ouch!)

The malleolus is the little bone that sticks out from the ankle). Hearing him trying to pronounce it? That was the cutest thing ever!

I actually enjoy looking at language and figuring out the roots.

Many of them are used quite commonly:

Natal: from Latin to be born

Prenatal means before birth

Postnatal means after birth

It is interesting to note that Natal is referring to the baby

Partum: childbirth

Postpartum refers to after childbirth

This refers to the mother as opposed to the baby

Itis refers to inflammation. Common examples:

Tonsillitis: inflammation of tonsils

Pharyngitis: inflammation of throat

Sinusitis: inflammation of sinuses

Otitis : inflammation of ears

Dermatitis: inflammation of the skin

Here is a silly tiktok video I did once upon a time.

RRHEA: refers to flow or discharge. Common examples:

Diarrhea (really?)

Rhinorrhea (runny nose)

"A" in front of a word often means without:

Afebrile: without fever

Asymptomatic: without symptoms

Asymmetrical: Not symmetrical or even

Atypical: Not standard or typical

Acute: Not cute. Just kidding...

One more TikTok

Pathy: This comes from the Greek word ‘pathos’ which means suffering or disease:

Naturopathic: a system of treating disease naturally

Idiopathic: a disease of unknown cause (the ideo is NOT from idiot, which was what I was guessing; instead it stems from the ancient Greek Idios, meaning one’s own.)

So, with an idiopathic illness there is no external cause.

Oma: a growth or tumor

Not all ‘omas’ are dangerous. For instance a lipoma is an overgrowth of fat cells. Annoying but usually nothing to worry about.

Here are some common terms related to medication instructions. If your doctor tells you to take a medication PO BID, it is important to know what they are telling you to do.

PO (per os) Oral or by mouth

NPO (nil per os)  Nothing by Mouth

PR (per rectum) suppository

QD (quaque die) daily

BID (bis in die)  twice daily

TID (ter in die) three times a day

QID (quater in die) four times a day

QHS (quaque hora somni) nightly

A.C. (ante cibum)  before meal

PRN (pro re nata) as needed

It's all well and good to have fun figuring out all of these terms, but when you are tired and worried a complicated word that you have never hear of can stress the *&^% out of you!

For instance if your doctor tells you that your baby has Infant Dyschezia, take a deep breath. This is also known as grunting baby syndrome. The infant appears to have difficulty pooping, but they have no signs of constipation. You know, they grunt and groan as if they are about to pass a football and then you have a giant, soft poop. 

This usually improves as their muscle coordination improves (8 months or so).

My biggest message is that it is perfectly fine NOT to know all of the medical terms that you come across. Here is the key: Always ask if there is something you don’t know.

Nurse Judy Post: There is no such thing as a silly questions

What Would You Do If.....?

 

Many kids are heading off to school this month.It is a big adjustment for everyone. When you are no longer with your child 24/7 you want to make sure that they are prepared to deal with unexpected situations. Today's topic is about an important activity that you can do with your child that teaches them to be "problem solvers".

The What Would You Do If......? Game I lived in New York back in the early eighties. It was a different city back then. At one point there was a rash of home break-ins and burglaries. A friend of mine who was an actress obsessed quite a bit about this. She went as far as rehearsing made up scenes for any given situation to avoid being frozen by fear. Go figure, one day someone did break into her apartment. She went right into her pre-rehearsed mode. Figuring that acting a bit cuckoo would get any 'bad guy' off balance, she immediately broke into the character that she had prepared. In a loud, shrill British accent she yelled, “Welcome!!! Would you like to stay for tea?" She would have made the Mad Hatter proud. She went on with a list of options. "Would you like herbal or black? I have delicious honey from local bees!" As expected, the intruder was completely caught off guard. He mumbled something, turned and ran. Brilliant. Not that I am recommending that particular course of action, but it highlights the value of advanced planning.!    Years ago, the concept that everyone would carry around an individual cell phone seemed as futuristic as the communicators on Star Trek. Now, of course it is hard to imagine how we got along without them. It was, however, the lack of the cell phone that prompted me to create a game that became a favorite in our family. It must have been 1994 and I was on my way to pick up Alana from preschool. She was about 4 years old at the time. It was one of ‘those days’. I was uncharacteristically running late. Then I got stuck in terrible traffic. To compound things, I took some random turns to try to make my way around the congestion and ended up utterly lost. (Remember that this was also before Google maps or GPS.) My stomach was in a knot and I wondered what my younger daughter would do when mommy was late picking her up. It turned out that she was calmly waiting for me in the office, but that was the day that the "what would you do if" game was created. It was all about building on the concept of planning in advance for an assortment of situations. It went something like this: I would ask a question such as, "What should you do if mommy is late picking you up? What are some of the choices? Which is the best one?" Getting a teacher or trusted adult to wait with her or take her to the office was clearly the right answer and I praised her for figuring that out on her own. Alana loved this game. We created all sorts of situations: " What if we were at a store and you couldn't find me? Alana: " I would go to the check out and ask them to page you." We never made it too simple... Mommy :"What if they refused?" Alana :"I would demand to talk to the manager" Our scenarios covered any number of little emergencies including earthquakes, fires, and getting lost or separated. The better you are at problem solving, the easier it gets to improvise. This game came in handy more than once. The shining example that comes to mind happened after years of playing this game. Alana and I were walking the dog on the beach one day. I had donated blood earlier that morning and didn't realize how foolish I was for doing anything strenuous. I got very light headed and ended up down on the sand trying hard not to completely pass out. Alana was ten at the time and she went right into problem solving mode. We did have cell phones at this point. She got the dog on the leash, patted some water on my forehead and calmly called daddy. I could vaguely hear her talking. "Mommy fainted...I think she is okay." The game was such a success that my sister taught it to her kids. Hers had an interesting spin because they lived in Alaska at the time: "What would you do if you saw a bear?" "What would you do if a moose wandered into the yard?" There were actually times when these things happened, and my nephews were able to act calmly and appropriately! Topics can range from handling a bully to getting separated on Muni. Being prepared for unexpected situations can be invaluable. If your child finds themselves without you and in need of assistance, finding a grown up wearing a uniform is often a valid option for some of the difficult situations. Finding a parent who has a child with them and asking them for help, might be another safe option. This game is meant to empower. It is wonderful for some kids, but could be terrifying for others. You need to assess your child's temperament before playing. Either way, identify a problem or situation. Start with simple, less scary ones. Discuss all the possible solutions and then agree what the best plan should be for any given situation. Stressful situations happen. Teaching your child to take a deep breath and use their problem solving skills is one of those things you can do now that can have lasting implications for them when they grow up. Even teaching a very young child to dial 911 in an emergency can be life saving! You have to figure out if this will be empowering for your child as it was for Alana. My daughter Lauren was NOT a fan. In fact, I remember one day when Lauren and I were taking a walk, I tripped on something, stumbled and fell. I was perfectly fine, but Lauren's reaction was to start screaming. As she says, "mommies aren't allowed to fall". Every kid is different. As your child grows, the situations that you might want to bring up will increase in scope. It saddens me that we have to be prepared for things other than losing track of our kids on Muni, but that is the world we live in. Have a family plan in place in case of an emergency. In an extreme situation, if someone other than one of the regular people is going to pick up your child, consider having a family “safe word” so that they know they were sent by you. Do you have your earthquake/emergency kit ready? Does it include adequate diapers, medications, pet food? Where will everyone meet up if home is not a safe option? Find out from your school what kind of emergency plans they have in place. Teach your kids to get in the habit of looking for emergency exits, especially for your older kids who are at a concert, theater or a club. (sigh…can’t keep them in a bubble no matter how tempting that might be) Here is another thing that you may not have considered. What if you lost your cell phone or it ran out of batteries and you don't happen to have a charger? Do you know important phone numbers, or do you count on speed dial? Having a list of important numbers in an accessible place is a good idea for everyone. Adults need to learn to be problem solvers also. Some people are much better at this than others. For instance, if you got in a fender bender, what would you do? Many folks would just freeze and panic. What should you do? Assess for injury; call 911 if needed If you are on a highway, wait for assistance. Getting out of the car is often dangerous! Do you have an AAA membership? Know where the card is. Know where your insurance info is kept (make sure you have a copy accessible) Take a photo of any damage Take a photo of the other driver's insurance card and driver's license...etc. Always have a charger in your car for your cell phone so that a low battery is never an issue. I think that the "what would you do" exercise is actually something that you might want to do with a nanny or caretaker. Training to keep calm in any type of emergency situation is essential. Having a plan in advance could help most people keep from panicking. Preparation is power!