Happy Birthday to my Father/Daddy/Grandpa/brilliant physicist/musician/Quirky/Sweet/Missed

 My dad would have turned 98 on June 21st. His birthday was always right around Father's Day; some years they fell on the same day. We lost him back in 2007. Time plays tricks and it feels impossible that it was so long ago.

When I wrote the first edition of this post, I put the call out to the family for their input. There were some classic stories like the time dad tried to calculate the width of a canyon based on how long it took for a sound to echo. In the same vein no one in the family can help but to think of dad during a thunderstorm. We all find ourselves calculating how far the lightning strike is by counting the seconds between the boom and the flash.

Dad strongly preferred back roads to the highways. We never stopped teasing him about one trip from Pittsburgh to New York, where we went miles out of our way because he was following the moon, rather than looking at a map, and had grossly miscalculated.

The lock for my high school locker was Kr Cr Ar -- If anyone needs help figuring out the code that would be 36 Krypton 24 Chromium 18 Argon. My dad had us remember combinations based on the periodic table. Yep, he was a nerdy scientist.

This had its pros and its cons. The first time my poor husband Sandy visited my house (at the vulnerable age of 18) my dad handed him a Scientific American magazine and asked about alternative approaches for addressing the problem posed in the article. Deer in the headlights would probably be an accurate description of Sandy at that moment. My mom rescued him “Robert, leave him alone.”

One of his passions was music. He was one of the rare people with perfect pitch. One night, I was sitting next to him at a large group dinner. There was the sharp clink of a fork hitting a wine glass. I heard him quietly ask,“Hmm what note was that?” He tuned out the rest of the conversation for a moment and then proclaimed “B Flat.”

I couldn’t help myself. I ran to the piano to see if he was right. We clinked the glass again. It was indeed B flat.

He played his violin until his last days. Certain pieces of music bring him right to me. We had a couple of Beethoven’s Violin and Piano Sonatas that were ‘ours.’

He came from a large family. His maternal grandfather, Michael Weiss had 14 children, so he had cousins everywhere. Family was tremendously important to him and he made the effort to stay in touch with people. He also created a system in which all the members on that branch had an identifying number. I was 2-4-2 — My grandmother was the second eldest, Dad was the 4th and I was the second. The extended cousins still use that at family events. The ‘Weiss’ number system lives on (my grandson is 24211).

He loved animals. When we were growing up he unhesitatingly welcomed the parade of stray cats that my sister Marjie brought into the family. To round things out, we also had an assortment of fish, gerbils and birds.

One of my all time favorite ‘dad stories’ was when one of the finches suddenly died. Dad had a cousin who taught veterinary medicine at Cornell. (Family number 14-2). Cornell happened to be where Sandy was in school. I got up there to see him as often as I could. Dad thought it would be interesting for me to bring the dead bird with me on my next trip so that cousin Richard could do an autopsy and ascertain the cause of death. He put the bird in the freezer to wait until my next visit.

I did NOT think this was a good idea and after a back and forth, strongly declined to take the frozen bird. Here is the thing, No one is quite sure how long the bird remained tucked away in the freezer.

He was curious about everything (why did the bird die?) and brilliant until Alzheimer’s dimmed his mind. If anyone had a question, before the days of google, the obvious choice was to “ask Grandpa.”

He also figured out a Back Scratching hack with a handy grid system. ABCD going down/12345 going across. If you had an itch you could easily instruct the ‘scratcher’ where to go. B3 is usually right in between the shoulder blades.

(I-3 was off limits)

Dad was game to do anything. We were always on the go to fairs, concerts, bowling, sporting events (Go Steelers, Pirates and Penguins) or even just to go watch a bridge being built. My mom was delighted to have quiet evenings with the rest of us out of the house.

When we weren’t actually going anyplace, we had a stash of board games including chess, Mastermind and Racko that he was always willing to play.

I don’t remember him saying no.

He was recycling and composting long before it was fashionable. His optimism that anything could be fixed or repurposed was overshadowed by his full schedule. Tools and willingness lost out to the fact that there were only so many hours in the day. This meant that his workbench in the basement became a veritable cornucopia of broken toys and unfinished projects, where it remained virtually untouched until we cleared out the house. That was a project that took us several years.

My dad didn’t tell a lot of jokes, but he was the universal recipient and appreciated any humor that was directed his way with a broad grin and a big laugh.

One of the traits that I got from him in spades and am most grateful for was his problem solving ability. Like my father, my default is to go right into problem solving mode. The truth is, sometimes people just need to kvetch, vent and have someone simply listen.

Learning that not everyone wants to have someone “fix” them is something that I continue to work on. This would have been a foreign concept to my father. If he saw something that could use some correction or fine tuning, he would dive right in. In some cases this might have been total strangers. A man limping? Let's evaluate the physics of his gait. An off-key singer? (his favorite) He invented a method to teach anyone to sing.

His kids and grandchildren coined the verb “to Grandpa someone,” which translated as constructive criticism, or instruction that was more than likely unasked for. He was pretty sure that anyone could learn anything, and he was ready and eager to teach.

My dad had a remarkably even temperament. It is possible that he never once raised his voice to me. I would like to think that this was mutual, but every time he tried to teach me the error of my bowling technique, I would lose control of my temper (I should have listened, I am a terrible bowler.)

It was no fun being mad at him. He would simply get sad and say something along the lines of “I am going into the backyard to eat worms.”

He was a family man who loved his wife, children and grandchildren with all his heart and we knew it. He started with girls only, three daughters, followed by five granddaughters. The switch flipped. The next two grandchildren were boys, followed by five great grandsons, who he never got to meet but would have been so proud of. One is a budding chess enthusiast who gets exasperated with his mom for making bad moves — she wishes she could travel back in time with him so he could play against his great-grandpa!

To all the parents out there, my memories of my dad center around the gift of time. This was the most valuable thing my father could and did give to me. Spending time with your kids is something you will never regret. If you are not getting enough, make this post a spark to have your see what you can shift around to get more quality time.

Here is a simple activity that my dad loved. Find an “inclined plane” (otherwise known as any board or piece of cardboard that you can lean on a slant.)

Roll things down

Watch your kid laugh

Here is a bonus story about my dad, for people who like the inexplicable

Thanks to 2-4-1, 2-4-2-2 and 2-4-1-1 for your help!!

Strep Throat

 Strep throat is a bacterial infection most commonly caused by the Group A streptococcus bacteria. There are other strains of strep bacteria (Group D, Group G, to name a few), which can cause sore throats, but typically heal on their own without treatment and do not lead to serious concerns.

While you can catch this illness no matter how old you are, classic strep throat is most common in school-aged kids. Due to the growth of receptors on tonsil tissue, kids between 5 and 15, seem to have a much greater affinity for the strep bacteria than at any other age.

It is quite unusual for babies under 2 years of age to have it (they don’t generally have the receptors for strep on their tonsils), but there are always exceptions.

Symptoms

Someone with strep throat will usually present with one or more of these:

• Sore throat

• Fever

• Body aches

• Headache

• Stomach ache

• Nausea

• Dizziness

• Smelly breath

• A red sandpapery rash all over the body that starts in the armpits

• In kids under 5, the primary symptom might be more congestion than sore throat

• NOTE: Typically the strep throat 'package' does not come along with a lot of congestion. If an older child has lots of coughing, clear mucus and sore throat, it is more likely viral.

Strep with the rash may be referred to as Scarlet fever...sounds scary right? Indeed it used to be. Now that we have antibiotics to treat it, strep throat with Scarlet Fever is not much more alarming than simple strep.

Get out your little flashlight and do some checking. If you are lucky enough maybe they will actually open their mouth; most of the time the throat will look quite red. You may see red or white patches in the throat or on the palate (the back part of the roof of the mouth).

The tongue might also have red and white patches. This is referred to as strawberry tongue for obvious reasons. Feel around the neck and see if the glands or lymph nodes feel swollen. Sniff the breath. Often parents call and say that it smells like their kids swallowed a 'swamp creature'. The breath smells gross.

Symptoms are not always straightforward

Be aware that children under 6 often say that their "mouth" or “neck” hurts, but they are talking about their throat.

Some folks don't even complain about a sore throat and some cases don't present with an elevated temperature.

Complaining of tummy and headache with sore throat should significantly increase your suspicion for strep throat, especially in the absence of cough and congestion.

While nausea and tummy aches are quite frequent with strep, add diarrhea to the mix and we are no longer as suspicious. Nausea plus loose stools is usually more of a tummy bug of sorts.

Contagiousness

Strep throat is quite contagious, but it is not uncommon for some family members to have it, while others escape. Remember the difference in tonsil tissue by age? Because of this, some parents might not automatically get strep throat infections from their kids. (The minute someone in your family gets that sore throat we would suggest sucking on a zinc lozenge and some Sambucol; maybe you will get lucky).

Some patients also seem way more susceptible to strep than others. Nurse Judy used to get it all the time until she had her tonsils out. That is not an uncommon story.

The incubation period ranges from 1-5 days but most of the time folks show the first symptoms about 2-3 days after exposure. You can catch it from being in close contact with someone else who has it. If you treat with antibiotics (which is recommended) you are not considered contagious once you have completed 24 hours of the medication (hence the 24-hour policy from many schools). If you don't treat it, you remain contagious and can spread the illness for about 3 weeks.

How to avoid strep:

Strep throat, is very contagious in school-aged children, but the transmission may be minimized with good practices. Since it lives on surfaces, good old fashioned hand hygiene is very effective at decreasing spread.

• Wash hands well with soap and water

• Wipe down surfaces, especially in the bathroom, kitchen, doorknobs, and cell phones.

• Don’t apologize for wearing a mask in a crowd

• Avoid swapping spit, sharing drinks, etc

• Replace toothbrushes for household contacts with strep

Testing for strep:

Many doctor’s offices will test with a rapid NAAT test that is very reliable (it’s like PCR). With this technology, most offices are no longer sending swabs out for culture (the 24 hour result), although that would be recommended if testing within 2 weeks of another positive test.

If your child hates the swab there are 2 things you can do to help.

1. First is to have them lift their legs when they are saying AAAAH. The brain gets confused by this and forgets to gag.

2. Another tip that we learned from a 3 year old patient is to growl like a lion. The growling is the perfect way to open up the throat and the mouth for that swab to sneak in.

Most in-office testing is specific for Group A strep. There are different strains of the strep bacteria that can cause various infections. If the in-office test is negative, and you’ve had chronic (more than a week) symptoms, it is sometimes possible to test for other forms of strep bacteria by asking for a special test to be sent out to a lab called an “upper respiratory culture.” Ask your provider about this.

A note on strep “carriers”:

Some folks are carriers. This means that they have a small amount of the bacteria living in their body all of the time and it doesn't make them ill. Those folks may be chronically positive on testing, even when they feel well. This gets confusing, because they might separately catch a virus, go to the office, get tested for strep, turn out positive, but the strep bacteria wasn’t causing their symptoms.

Unless you know you’re a carrier, it’s usually worth it to simply treat a positive result.

Are antibiotics necessary?

Given enough time, strep can resolve by itself, but the antibiotics absolutely shorten the severity and duration of the illness, decrease the infectiousness to others, and significantly decrease the risk of complications. Untreated strep throat can lead to complications later on, such as rheumatic fever and heart valve problems.

It is impossible to have real statistics about this. Most folks don't jump into the doctor's office every time they have a sore throat. There are likely millions of untreated cases of strep out there at any given time and of course most of them will have no issues in the future.

It’s worth noting that in Europe, not all cases of strep are treated right away with antibiotics. They reserve treatment for those with significant or prolonged symptoms. However, in the US, we feel better safe than sorry. If we know you have a case of strep throat, we will strongly advise that you do a course of antibiotics to avoid the above complications. This has resulted in slightly lower rates of rheumatic fever in the US.

Current medication protocol

There are two most common oral antibiotics, and a shot is available for children that are unable to tolerate oral antibiotics.

• Amoxicillin: great taste, and can be given once a day every day for 10 days (much easier than two or three times a day like it used to be). Some doctors will still choose to do twice daily dosing.

• Penicillin: vile tasting liquid, so not recommended for little kids. In its pill form, it needs to be given 2-3 times per day, but has a more “narrow spectrum” aka can preserve the gut microbiome better than amoxicillin, ideally resulting in less side effects. Be aware, the urine might smell funky during treatment.

• Penicillin injection: one and done, but it’s large and painful. Best for kids that absolutely cannot tolerate medicine or are vomiting.

• For people who are allergic to penicillin or amoxicillin: azithromycin can be given daily for 5 days, but please note that it’s at a higher dose than what is used for ear infections or pneumonia.

• Once your kids can swallow pills it can be a game changer. For tips on giving meds check out Nurse Judy’s blog post

If you do end up being treated with antibiotics, it is important that you finish the entire course. If you are not seeing an improvement within 72 hours of starting the medication, make sure you check in with your doctor. It is rare, but strep can lead to serious complications including abscesses on the tonsils, ear infections as well as kidney problems.

Some studies conclude that if you do end up on antibiotics, taking probiotics can help keep a healthy gut.

Symptomatic treatments until the antibiotics kick in

• Tylenol or Motrin (we are treating pain, not necessarily fever)

• Lozenges

• Tea with honey (no honey for kids until one year old)

• Gargling with salt water

• Popsicles

• Cold fruit nectar

• Humidifier at night (if the air is dry)

• Check out Manuka honey if you can find it. It has proven antimicrobial properties and 1-2 tsp per day is safe (although it can’t replace antibiotics).

Severe (and uncommon) complications

There are some exceedingly rare complications of strep throat that should not occupy your mind but are nonetheless good to know about in case some of their unique symptoms appear after strep:

• Abscesses: shortly after or during infection, pus can collect in the spaces behind the mouth and throat in the neck. This is serious and often requires an emergency room visit. These children will have extremely high fever, a “hot potato” voice (very muffled), and an inability to close their mouth or turn their head. They are often drooling excessively.

• Rheumatic fever: a serious fever that develops 2-4 weeks after strep throat infection. It has an autoimmune cause, and can be associated with joint pains, involuntary movements, and heart valve problems. Treating the initial strep infection with antibiotics will reduce the risk of this by about 70-90%.

• Post-streptococcal glomerulonephritis (say that five times fast): an extremely rare condition in the US, it’s characterized by decreased urination about 2-3 weeks after infection. The urine that comes out is very dark, possibly bloody. There may be puffiness in the face and arms as well as headaches. This is not typically associated with a fever.

• PANDAS (Pediatric autoimmune neuropsychiatric disorder associated with group A streptococci, say that ten times fast): an even more extremely rare disorder, this is an autoimmune condition characterized by the extremely abrupt exacerbation or onset of OCD disorder or tic disorder symptoms. The timing can be weeks to months after strep infection, and treatment remains poorly understood. Time seems to improve symptoms, but pediatric rheumatologists and infectious disease doctors can use steroids or naproxen.

Strep throat is very common and severe complications are very unusual, so while it is not our intent to scare people, but knowing what to look out for can save lives.

If you are one of the families dealing with strep throat, don’t forget to change your toothbrush 3-4 days after starting the antibiotics so that you don't get re-infected!

Nurse Judy’s Substack is free. I have no current plans to add a payment option. But feel free to pass these along and share.

Say Yes when it's an option/ A pillow, a new suitcase and Happy Father's Day

 Last week, we were in Boulder for the wedding of one of Alana’s oldest and dearest friends. Alana flew in on Wednesday. After her first night there, she reached out to Sandy asking if he could bring her one of our good pillows since the hotel pillows were not to her liking (she fully admits that she is high maintenance when it comes to bedding.)

Sandy tends to say yes and this was no exception. So, when we flew in on Friday he brought a larger suitcase in order to fit the pillow. Obviously this meant that he had to now check a bag rather than carrying one on for free.

I brought my little suitcase through to the gate. It was a full flight, so when they asked for volunteers, I didn’t think twice about checking mine. I knew that we would be waiting around for Sandy's anyway.

When my suitcase arrived on the carousel we immediately saw that it had a large crack in it. I brought it to the counter and the customer service person recognized that it was too damaged for further use. She walked us to the end of the terminal where behind a locked door, there was a huge room filled with brand new suitcases. This was not a lost and found. We got to choose any one we wanted that was of a similar size.

So thanks to Alana not liking her pillow, I now have a new suitcase that is much nicer than the one that got broken.

It does make me wonder how often United destroys luggage.

It also reminded me of an old post that Sandy had written for my blog many years ago.

It was all about saying yes instead of no. Thirty four years later, in Alana’s case he is still the dad who says yes.

With Father’s Day next weekend it felt like a fine time to rerun it.

Warning, Have some tissues handy. The first time I posted it, dozens of my patients told me that it made them cry.

____________________________________

In honor of Father’s Day, Nurse Judy has invited me to pen this week’s column and share some of my thoughts about why I have, and believe you can have, the absolutely greatest relationship with your kids through all stages of their lives. I believe that inherently, mothers are more nurturing, protective, overtly emotional, physical, and “maternal” in their instincts, beliefs and behaviors towards their children. But from the moment I first saw Lauren, a day that all who know me recognize as the most impactful day of my life, I knew I was going to give Nurse Judy a run for the money. I, like many of my generation, had an ok relationship with my parents. But it was not the one I wanted with my kids, and that became immediately obvious that day Lauren was born.

I have been called a lot of things over the years. I am frequently referred to as Mr. Nurse Judy. After years of taking our golden retriever to the park up the hill in the afternoon when the local elementary school let out, I became known to a few generations of kindergarteners and first graders as Java’s daddy. I was known as a business executive. But the grandest name I treasure is that of daddy (or father or papa bear or now Papa…) Why? Because after building a relationship with Lauren for 28 years, and with Alana for 25 years, I continue to have new and grand experiences with them, experiences that are direct descendants of the beliefs I had in raising them. And now I have a daughter who jumped at the opportunity to go on a daddy/daughter cross country road trip when she left for grad school, where we got to eat yellow (yes, there’s a story there) in Indiana, and simply cross a bridge into Kansas, make a U-turn, leave and say “we’re not in Kansas anymore.” And I have a daughter who is still my roller coaster buddy every August, and is accompanying me on what may be the stupidest thing I ever try – climbing Kilimanjaro. So how did I get here?

First of my early parenting philosophies was simply make time. I’m not talking about the “I’ll play with you when I get home and I’ll read you a bedtime book” type of time. I’m talking about the “take a morning off to hear your 2nd grader say one line in a play; use vacation days to chaperone school outings; play Barbie for hours on end; and supervise a cabin full of 5th grade boys on the school trip” kind of time. A typical dad probably spends more time away from their child than the mom. So take advantage of the time that you can have! As soon as my kids came home from the hospital, I never missed an opportunity to be with them. Each night, when an infant would wake up and cry, I went in. It was pickup and delivery to Judy to nurse them. Judy thinks I was doing this for her but she was just a benefactor. I picked them up, sang softly or told stories to them as I cleaned them up, and then brought them to our room. And then back to their cribs. Every night. We built up quite the relationship. Bath time? That was mine too. Nightly bedtime ritual? Well we both had one. But much of my daughters’ love for the great rock and roll of my youth comes from that time we spent every night. As they became toddlers, every weekend I took them to Miz Brown’s diner in Laurel Village. So Judy could get more sleep? Hmm, ok, but not really. It was completely selfish on my part. Want more time? Be the home that welcomes the gathering of the friends. While perhaps not directly involved in your child’s life at that moment, the benefits are extraordinary in what you get to witness, the welcoming environment you’re modeling for your kids, and the lifetime of relationships with your childrens’ friends, who consider you an extra dad. (2023 update - as a result of this, I have officiated three times at the wedding of one of my extra daughters!)

Next on my list of dad-parenting beliefs is “don’t look for a reason to say yes; assume that’s the answer, and instead force yourself to look for a reason to say no.” It’s simple but at least for me, it was initially uncomfortable and unnatural. But once I grew comfortable with this practice, it was an epiphany! Saying yes to as much as you can say yes to, is so much easier than saying no. And it has such wonderful benefits. Questioning, exploring, learning, experiencing…and you get to be a cool dad! Talking about going on a family camping trip when you’re asked if they can try camping in the house? Say yes, and set up the tent in the living room, light the fire, roast marshmallows, and sleep in sleeping bags. We can all think of valid reasons not to do this and I’m certain my instinctual reaction was “too much time; too much effort, and then I have to clean it all up and put it away.” But saying “no” wasn’t going to lead to the magnificent shared family memory we now have 20+ years later, and I certainly don’t remember anything about setting it all up or taking it down. “Dad, can I help?” Of course there are reasons to say no; it will certainly take more time. And you may have to watch your language. Unless it’s urgent, so what? Invite your 3-year-old to crawl under the car with you. Rub some dirt on their nose to make it official! And let them help! “Can I go someplace?”; “can someone sleep over?” Yes. And yes. Unless something is a threat to their health and well-being, be quick with the yes! Might some of these yeses have less than ideal implications to you and your free time? Probably, but that’s not what you’re going to remember! Only after saying yes can you then figure out if there is a “no” reason significant enough to change your mind. The more you say yes, the more they will ask you. As school children. As teenagers. And now as adults.

You will recognize my last pearl of wisdom as a modification of the Peter Pan syndrome. Let them be kids as long as possible! While it may be cliché, as we all know and live every day, once that’s gone, it’s gone forever, and I know that I, and maybe you, wish you could get it back! So don’t take it away from them. Don’t be in such a hurry to “help” them see things as you see them, through adult eyes and perceptions. They are emotionally, physically, and intellectually naïve – it's a wonderful time so don’t rush to take that away from them. In fact, for a truly wonderful relationship, force yourself to see the world as they do! That’s why I once found a pet/fish store open till midnight so I could go out and replace the fish that had died when Lauren was asleep (and yes, I brought the dead fish with me to try to get a match!) Of course she would have to learn to deal with the death of a beloved pet, and eventually beloved humans. But she didn’t have to learn about it that day, and it let her be a kid a little bit longer.

Don’t try to explain why work is so busy, that you need to do it to pay the bills that benefit them, and thus you don’t have time to play Chutes and Ladders for the 5th time in the past 2 hours. Instead, see it through their filters – why would anyone want to deal with things that are drudgery and frustrating when you can have fun playing a grand game? They didn’t ask to be your child – you decided to make them your child. I hope that decision was made with an appreciation for the fact that this responsibility instantly became the single greatest responsibility you have ever undertaken. The consequences of that decision are literally life changing for all involved. If it’s not your greatest responsibility, then something’s awry and you will miss out on immeasurable joy.

In the summer of 1988, my family of 3 (Lauren was 1) was invited to a swimming party at the home of my then senior VP. He had 4 adult daughters. While everyone was subtly vying for his attention, I spent the greater part of the day with Lauren in the pool. Late in the afternoon, the VP’s wife found me and pulled me aside to tell me that her husband had spent much of the day watching us play in the pool. Why? As she explained, he had been the wonderful corporate soldier. Moved all around the country when he was asked to. Frequently traveling. Successfully moved up to senior VP of one of the world’s largest companies. And she told me that if he had to do it all again, he would rather have spent the time in the pool with his daughters, because now he was here, envying me and the relationship I was already building with my child. Over the course of my career, I was often asked to make those same sacrifices, but by then I had already learned my golden rule – I worked to live; not lived to work. And while I had a satisfying and rewarding career, I never reached for those corporate stars that were dangled in front of me. Because one day I was hoping that I would have the type of relationship with my children that allows me to eat yellow with one of them and climb a mountain with the other.

Now most of the time Papa is busy saying yes to the grandsons.

Once upon a time/ I made up a fairy tale

 

My grandsons Coby and Elliot were visiting this last weekend. I was doing some bedtime snuggles with Elliot. “Can you tickle my back while you tell me the story about the king and the 3 sons that go on a trip and one is nice and the others are in a rush” “A story about a king?” I asked “And one prince stops to help the bee” Oh for heaven's sake; now I remembered. A few months ago I found an old notebook of my mothers. It is full of pages and pages of handwritten shorthand and prompts for story ideas. Unfortunately her handwriting is challenging to say the least. (I can fully blame my terrible penmanship on her). It feels like a treasure waiting to be explored. While I hadn’t successfully deciphered any of her actual stories, it encouraged me to try to create my own cockamamie fairy tale and the last time I was visiting the kids in LA I had tried it out on Elliot. I had followed one of mom’s basic templates, Good deeds would generally be rewarded with some type of good karma. Her heroes generally had the superpowers of kindness and curiosity. Her villains were mostly self-important, selfish and grumpy. It was a fairly safe bet that goodness would triumph over evil. Elliot evidently remembered the story I had made up and wanted to hear it again. Once upon a time, there was a king. He gathered his three sons and told them that he wanted them to complete a quest. They needed to travel across the kingdom. He was going to pick who would be the next king. The first son started out in a rush, certain that he would be the fastest. The second one was close behind. To summarize, the two princes hurried along and wouldn’t stop to help the various creatures along the way who needed some assistance. I barely remembered the specifics but EJ was able to prod my memory. Elliot is four. I was surprised and a little impressed that he remembered it. The first critter that needed assistance was a bee that was stuck in some honey. He called for help, but the first two princes rudely rushed by without stopping. The third prince had been enjoying his journey. He was looking at the lovely countryside and listening to the birdsongs when he heard a call. “Can someone please help me? My wings are stuck in the honey!” The kind young prince immediately stopped. “ Let me see if I can get you unstuck, but please don’t sting me if I get close” “Oh, I certainly won’t sting you, I am grateful to you for trying.” The prince used a little dry leaf to get the bee unstuck and the happy bee flew away. The next encounter was with a squirrel who couldn’t remember where he had hidden his nuts. He was very hungry. The prince helped him dig around and found his stash of acorns. I couldn’t remember the third, but there was EJ recalling all the details. “It was a snake! He needed help shedding his old skin, it was stuck” “ Oh, of course, you have such a good memory!” So eventually the youngest prince arrived at the destination. His brothers and the king were waiting for him. The brothers started teasing him about how slow he was, when suddenly lots of bees, squirrels and snakes showed up to thank him for saving their friends. The bees brought lots of honey as a gift. Then the king told everyone that the winner wasn’t the one who got there the fastest, but the one who was the kindest… The snake offered to bite the mean princes, but the youngest prince told him not to. And of course, they all lived happily ever after. At this point Elliot said, “I love you Grandma and I will always stop to save you.” and he turned over and was fast asleep. Goofy fairy tale for the win. The fact that Elliot had held on to this silly story reminded me of how much kids are taking in. I love thinking that the gentle messages from the story somehow linger. Take your time enjoying the journey. Getting someplace the fastest isn’t necessarily the win. Be kind. For more about the power of storytelling, check out this old blog post.

Mothers Day Musings/My goal is to find something about the day that everyone can celebrate

 For many people, Mother’s Day is one of those made up Hallmark Holidays that can hit a wide range of emotions. For lucky families, it can be a special day of joy and celebration. But for some, it can go from being moderately uncomfortable to downright painful.

It isn’t hard to figure out who might be having a hard time with it; people who never had a mother in their lives or people who have lost a mom. Moms who lost a child, women who couldn’t have children, or women who made the choice not to have kids but perhaps feel a twinge every once in a while.

There are also so many wonderful families with no mommy but two amazing daddies. How about immigrant families who are forced to be separated? The list goes on and on. Ouch!

My mom died in March of 2017 and I remember absolutely dreading Mother's Day that year. Maybe I was just more sensitive because it felt so raw. Every time I turned on the TV or the radio, there it was, Mother’s Day, Mother’s Day, Mother’s Day. What are you going to buy your mother this year? Where will you take your mother? Show your mother how much you love her. Newspapers, magazines, Muni signs. I couldn’t escape it.

My goal is to find something about the day that everyone can celebrate

Make it a Mother’s Day tradition to tell your kids or people who are important to you, stories about your mothers, grandmothers, and great grandmothers. Did they have some favorite pieces of wisdom? Share them! Did they have some favorite songs? Sing them! Did they have a favorite cookie recipe? Bake it.

It doesn’t need to be biological.

Who are the maternal figures in your life? Reach out and give them a little acknowledgment .

If you are lucky enough to have a mom to celebrate, simply knowing whether or not flowers are something mom would like or not is a statement all on its own. Don’t make assumptions. If you haven't done it already, make this year the one where you fInd out what they actually want.

Maybe go on a special outing or just spend some quality time together. Take lots of photos. Memories might be more valuable than jewelry.

But then, consider that for some moms with young kids, having a bit of alone time may be just as valuable. Give that mom the opportunity to take an uninterrupted nap! Or a candle lit bubble bath (remove the bath toys!)

I have an additional offering for all of the moms (or dads) out there who are celebrating. Here is an update of an old post where I list some of my hall of fame failures.

Nurse Judy the Mom

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

Um, not likely.

What you may see on the outside is not always accurate.

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

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

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

Dare me? Silly girl.

I caught up with the Lion and made the song request.

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

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

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

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

But the hands down winner is the time I drugged Lauren and then put her on a horse. Yes, you read that right.

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

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

She managed to keep it together for the several hour experience, but just barely. She could hardly keep her eyes open. I was concerned that she was really coming down with something worse than a cold. When we got back to our cabin, I figured out what the problem was. I had not taken the time to read the box and grabbed, and gave her, the nighttime cold/ cough medicine instead of the daytime one. The poor girl was sedated! Since fortunately she didn't fall off the horse, we can laugh about it now.

Alana claims that a runner up might be the time I sat back and let my kids and some friends scamper around Alameda beach collecting jellyfish.

No one got stung, not all jellyfish are toxic, but I fully admit to questionable judgement.

I am now starting my list of “Grandma screw ups”. I have been fairly well behaved, but there was a time when I was taking baby Elliot for a walk and I let him smell a beautiful yellow flower. Somehow the center of the flower stained his face yellow. It took days to fade. Lauren was not amused.

Trust me. Most parents have done some dumb stuff, the photos on Instagram are usually just showing the better moments. If you are human, take it easy on yourself as long as you gather wisdom and learn lessons. (read the labels, be careful when you practice punching, avoid handling jellyfish and be aware that some flowers can stain)

Happy Mother’s Day to all who celebrate.

To everyone else, be grateful that all the commercials will soon be over until next year. Of course Father’s Day is just around the corner…..

Do you know how your grandparents met?

 After my mother died, when we were at the family house sorting through old letters, I came across a pile of correspondence between my mom’s parents. These were love letters, filled with personality and pet names; sweet and funny treasures. As we were reading them I was struck by something. Somehow, I didn’t know the story about how the two of them had met!

How is it that my sisters and I didn’t know that story? The loss of my mom pierced through me with the stark realization that there was no one left to ask.

There was something nagging in my brain and fortunately it came to me. Back in 1987 my grandmother had done an oral history project with the National Council of Jewish Women. I had started to listen to it shortly after she died in 1995 but her loss was too fresh and hearing her voice got me too emotional. Life happened and the existence of those tapes was forgotten.

But now I remembered! I did a quick internet search and there it was. There are two hours of grandma being interviewed. The story of how she met my grandfather was included.

Fast forward.

As some of you know, I am writing a book. It is NOT the Nurse Judy collection about fevers, poop and rashes. Instead it is a collection of weird stories, spooky serendipity and a shout out to my quirky family. Messages from beyond? Maybe.

One of the stories in the book is about my grandmother. She was born in downtown Pittsburgh. Her name at birth was Gertrude, but we remembered her telling us about how her name was changed to Flora. To us, she was Grandma Fuffy.

The story goes that when she was young, disease struck the family. One of her older sisters perished and Grandma was very ill. As was the custom at the time, her family changed her name in order to fool the angel of death. (It worked?)

Recently, my sisters and I were trying to see if we could remember what illness it was; we were split between possible Typhoid or Diphtheria (Hooray for clean water and childhood vaccinations, I can’t imagine the horror of losing children to those illnesses)!

That week I had a vivid dream. My grandmother was telling me that the information that I was seeking was available to me.

I decided to listen to her interview again. This time hearing her voice surrounded me like the coziest of sweaters and filled me with warmth.

Once again my question got answered. It had been Typhoid.

Of course I listened to the full two hours. What a treasure. It stops abruptly in the middle of a story, the cassette tape was over. I wanted so much more, but am grateful for what I got.

It is possible that many of you have quick little videos of parents, grandparents and older relatives and friends,

But do you have the stories?

Make it happen. Most folks are delighted to take a trip down memory lane with you. Even people with diminished memories often can happily recount tales from when they were young. Capture the history.

Being able to hear my grandmother's voice feels like a gift from the universe.

Don’t wait.

Here I am on Grandpa Asher’s lap. Marjie is sitting next to Grandma ‘Fuffy’

(shockingly…and I kid you not, this is only about 14 years before I met Sandy)

Thanks for reading Nurse Judy’s Substack!

Crib Safety/AAP guidelines for SIDS prevention

 

The American Academy of Pediatrics has clear guidelines reviewing the best safe sleeping practices for babies. It is hard to believe that it has been just about 30 years since the ‘back to sleep’ recommendations were first instituted. That change made a measurable difference and cut the SIDS incidence by roughly 50%. The annual number of sleep-related deaths has remained steady since then. Unfortunately that case count is still too high. There are still approximately 3,500 infant deaths every year here in the US.

These incidents usually occur when an infant with an intrinsic vulnerability to SIDS is placed in an unsafe sleep environment.

The most common risk factors include:

• Male sex

• Prematurity

• Low birth weight

• Genetic factors (There is some preliminary research that has found a link between certain enzymes and SIDS, but it is in the very early stages)

• Race (non white babies tend to be at higher risk)

• Under 4 months

• Prenatal exposure to drugs, nicotine or alcohol

• Second hand smoke

Obviously, aside from the smoking, most of these are not in your control. So, what is in our power? That is what the guidelines are all about.

Here are some considerations for creating the safest sleep situations.

Back to sleep is basic.

Generations ago, kids were put to sleep on their tummies. Grandmas knew that they slept more soundly that way. Here’s the thing. It is actually better for infants to be having lighter sleep for the first couple of months. Because the sleep isn’t quite as deep, babies can rouse more easily if they have unmet needs. Believe it or not, the goal at this age is not to get your baby to sleep through the night. They need to wake up to feed. Ideally a baby wakes up periodically and then can settle themselves back to sleep without too much assistance. The safest position is on their back, not on their tummy or their side.

Some parents worry about choking being more of an issue in that position. In fact, healthy babies naturally swallow or cough up fluids. It is an evolutionary reflex. Babies may actually clear such fluids better when sleeping on their backs.

Infants don’t have very good head control, so another benefit of them being on their back is that they are less likely to smoosh their little faces into the mattress.

Make sure they are getting some regular tummy time.

That head control will improve more quickly with your help. You can start this within the first couple of days. Even having them lay on top of you, for several seconds bobbing their little heads up, counts. The amount of time per session can increase gradually. This supervised time is so important for strength and development. It also can help you avoid a flat head (positional plagiocephaly). Here is one of my blog posts on that topic.

Once they can roll, it is common for parents to stress because all of a sudden babies have the ability to flop onto their tummy. Please note, it is not reasonable for you to stay awake and keep flipping them onto their back. Your job is to place them on their backs and make sure the crib is safe. Keep doing plenty of tummy time and floor exercise. This will help them work on the skills so that soon they have more control.

The AAP recommendation is for babies to sleep in the room with the parents, preferably for at least the first six months. They want you in the room but not the same bed.

The guidelines are clear about co-sleeping. The AAP gives that a big no.

I understand that this is a tough one, I know that in many cultures folks sleep in a family bed. Unfortunately the statistics are jarring. The risk of SIDS is 10 times higher when sleeping with someone who is impaired because of their use of sedating medications, drugs, alcohol or simply exhaustion. Show me a new parent who isn’t exhausted…

It isn’t just a risk at night time. The risk of SIDS is up to 67 times higher when sleeping with someone on a couch or soft armchair or cushion.

By all means snuggle them to pieces when you are awake, but when you are at risk of dozing off, they are safer in their own little bed.

The guidelines also advise parents to take steps to ensure that the baby doesn’t get overheated.

They are not hothouse flowers. A cooler room is better than a hot one. It is interesting that the risk for SIDS is higher during colder months. This is likely because in the colder weather, caregivers might be tempted to use extra blankets or clothes. Over-bundling may cause overheating, which elevates an infant’s risk for SIDs. The ideal temperature for babies is between 68 to 72 degrees fahrenheit or 20 to 22 degrees celsius. Of course, having said this, keep in mind that babies all over the globe with less resources live in much hotter climates without AC and do just fine. Don’t freak out if the room reaches above the ideal temperature. Focus on things that are in your control.

It is common for infants to start off in the smaller infant bassinets before moving into a full sized crib. The safety consideration for bassinets and cribs are the same.

Some of the infant beds, like the snoo, have movement and sound to help soothe them. There are no safety issues with those, just make sure that any infant sleep product is JPMA certified (Juvenile Products Manufacturers Association).

When it is time to move into a full sized crib, you want to look for that same JPMA certification. Older models might not meet the current safety standards. It is essential to get one with stationary sides. The older cribs used to have rails that you could lower. This was easier on your back, but no longer considered safe.

If you do have an older model, double check with the cpsc.gov to make sure there are no recalls associated with it:

https://www.cpsc.gov/Recalls?combine=cribs

By law, the production date of a crib must be displayed on it and on its shipping carton. Take a photo of that so you have it for your records. Check for any obvious safety hazards. Slats should be no wider than 2 & 3/8 inches wide. If you buy a crib online, get your ruler out and measure any openings immediately when it arrives at your home. Check for sharp edges and protruding screws, nuts, corner posts, decorative knobs, and other pieces that could catch your baby's clothing.

The mattress should fit tightly in the crib with no gaps. If you can place more than two fingers between the mattress and the crib frame, the fit isn't snug enough.

Here is one list of best mattresses for that is updated regularly

Use a tightly fitted sheet. There is nothing wrong with a quality hand-me-down sheet as long as the elastic at the corners is still strong. Test the sheet, whether new or used, by pulling up on each corner to make sure it doesn't pop off the mattress corner.

There should be nothing else in the bed. No stuffed animals, pillows, blankets or crib bumpers. I confess that my kids had a crib full. Lauren used to have long conversations with her Winnie the Pooh bumpers. Those days are gone.

Infants can be kept cozy in a swaddle until they start to roll. At that point I would switch to a sleep sack. There are many good brands that meet the current safety criteria. There are several good brands, such as the HALO or Woolino, which aren’t too hot or too cold. The weighted swaddles, including the Merlin, are not on the AAP list for safe sleep products.

The mattress should be a firm, flat surface. If they are at an incline they can slide down and there is a risk of suffocation.

The new guidelines specifically state that devices such as car seats, strollers, swings, infant carriers and infant slings are not recommended for routine sleep, especially for infants younger than 4 months. These infant seats and carriers are fine if you need to have the baby hanging out in the room with you during a wake window.

I am going to permit a loophole and say that for a closely supervised nap these are still okay, just not at night. Supervised means that you are keeping an eye on the baby as they sleep, not completely engrossed in another activity or taking a nap yourself.

Flat is best, but if you have been reading my blogs these past years you know that if your little one has a cold or congestion, I have always suggested putting them on a little bit of a slant. You can still do that by putting a little towel under the mattress but now it needs to be more subtle. The angle should be no more than 10%.

The new guidelines also suggest avoiding the use of home cardiorespiratory monitors as a strategy to reduce the risk of SIDS. The concern is that they might provide a false sense of security.

Breastfeeding is ideal. Being a good parent is NOT about how you feed your baby. Not everyone is able to nurse. But, data shows that breastfeeding reduces the risk of sleep related infant deaths. During the first 2 months, feeding at least partial human milk has been found to significantly lower the SIDs risk. If your baby got any at all during those early attempts, that might make a difference. If you do produce enough milk and can manage to nurse at least for the first 6 months, that is consistent with the AAP recommendation. Of course, if you can make it through the first year with some breastmilk as part of their diet, that is even better.

Pacifier use is associated with reducing risk.

I have no issue with a baby falling asleep with a pacifier in their mouths. I would not force it, if they don’t seem to want one. I would also try hard NOT to get into the habit of replacing it every time they fall out.

As kids get older, there are fresh safety issues to consider. Make sure the mattress is at the lowest level so that your little one can’t climb out. Make sure the crib isn’t near any wires, lamps, window shades or cords that they can reach.

The good news is that once they are a year old, I am fine letting them have a little comfort object in the crib with them like a lovey.

You might feel like you are in the dark tunnel of sleep deprivation right now, but babies grow fast. I know it can feel overwhelming and a bit terrifying when they are little and at their most vulnerable, but there are actions listed above that can help keep them safe. Blink and they will be asking for the car keys, Then you will have a whole new set of things to worry about!

Nurse Judy’s Substack is free. I have no current plans to add a payment option. But feel free to pass these along and share.