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.