PhysicianMom.com

Boston

noreply@blogger.com (Dr. Ellen) — Sat, 20 Apr 2013 04:18:00 +0000

Wow. It's hard to find any words to say regarding the whole Boston marathon bombing. Boston will always have a special place in my heart as I spent seven years living there... I really grew in my relationship with my Lord and Savior there... I met my husband there... in fact, he ran the Boston marathon as a "bandit" the year I met him (it was a college thing to do).

It's been surreal reading all the updates on all the happenings up there. Instead of google or cnn I've just been reading friends' updates on facebook. I am glad for the safety of my friends up there. However, my heart does break for the those who lost their lives and those seriously injured.

Hats off to the MIT cop. Crazy... he was shot at my old college campus near building 32! (All MIT buildings are numbered... we never called them by names)

As a mom, the story of the eight year old boy especially tugged at my heart. It reminded me of all those other children who lost their lives not too long ago... also due to violence. Life is fragile and unpredictable. I would be a very nervous and anxious mom if it weren't for the hope and faith I have in my Savior.

One of my favorite verses that reminds me of what's to come is from Revelations 21, promising no more crying or pain.

Then I saw “a new heaven and a new earth,”^[a] for the first heaven and the first earth had passed away, and there was no longer any sea. ²I saw the Holy City, the new Jerusalem, coming down out of heaven from God, prepared as a bride beautifully dressed for her husband. ³And I heard a loud voice from the throne saying, “Look! God’s dwelling place is now among the people, and he will dwell with them. They will be his people, and God himself will be with them and be their God. ⁴‘He will wipe every tear from their eyes. There will be no more death’^[b] or mourning or crying or pain, for the old order of things has passed away.”
⁵He who was seated on the throne said, “I am making everything new!” Then he said, “Write this down, for these words are trustworthy and true.”

I also really like this Keith Green quote:

“You know, I look around at the world and I see all the beauty that God made. I see the forest and the trees and all the things. And it says in the Bible that He made them in six days, and I don’t know if they’re a literal six days or not. Scientists would say no; some theologians would say yes; it doesn’t matter to me. But I know that Jesus Christ has been preparing a home for me, and for some of you, for two thousand years. And if this world took six days, and that home took two thousand years, … this is living in a garbage can compared to what’s going up there.”

And I truly believe... as Stephen Curtis Chapman's song says, there's "More to this Life"

Work/Home Balance for Mom

noreply@blogger.com (Dr. Ellen) — Tue, 16 Apr 2013 01:58:00 +0000

Today's post is actually a guest post from Summer Blackhurst. It is that time of year again where we are looking for a new match with another au pair for the next year. So far we've had two chinese au pairs and have had two years of overall very positive experiences. I'll share more about this in a later post.

=============

Some days I am up until 1 a.m. tying up loose ends in the home and with my job. Often by the time I lay my head down to sleep, I am promptly visited with my baby’s first cry to be nursed or my toddler’s call for comforting

Finding the right work/home balance has brought me to the brink at times (and as much as a 36-hour day would be just the right fit - extending out the solar system to make this possible just isn’t in the cards). With all the demands on moms in the 21^st century, kids are getting caught in the middle of the madness. They don’t have to suffer though. With a little ingenuity moms can have kids, and if they choose to, pursue career dreams.

In these cases get creative and look for more flexibility at work, telecommuting or working less than 40 hours if possible. Talk to your hubby about stepping it up as much as possible. Train him to give you a night off from the little ones whenever he sees that “crazed” look in your eyes.

What about childcare? Have you ever thought about bringing in an Au Pair for a little extra help at home? I know with live in childcare it’s scary trying the find the right fit for the family. Finding childcare that doesn’t break the bank is also nerve racking. Au Pair childcare might not fit your needs, but it might. The State department set up this program for “foreign nannies” to come here and receive an invaluable cultural experience. Their job will create opportunities back in their own country for them, and US families leverage the live-in help and culture exchange to restore stability at home. Au Pair care is real time - live in help. An Au Pair keeps the family from being tied down to specific day care schedules and is typically a lot more affordable than using a local nanny.

In the swaying winds of home and family culture, our children need a steady hand more than ever. The more time I spend as a working mom the more I’m convinced too much is on my plate, it isn’t possible to do it all without help. So while we can have it all, we don’t necessarily have to do it all! Finally, I’ve found no matter what I might be going through at the time, I’ve never regretted pushing my little peoples needs the front of the line.

Summer Blackhurst writes content for Go Au Pair. She is the mother of two beautiful boys under three-years-old. She’s been writing for more than 15 years and worked in the childcare field for 20 years.

Toddlers in the Throwing Things Stage

noreply@blogger.com (Dr. Ellen) — Wed, 03 Apr 2013 21:18:00 +0000

Our little E is now nearing two years old. Just like his older two sisters, he has reached a stage where he likes to throw food on the floor. It is a frustrating stage to go through since things can get messy. However, it is a normal part of development and he will eventually grow out of it.

Why do they like to throw things so much?
Simple answer is because they can. This is a rich stage of new discoveries and growth both with motor skills as well cognitive skills. In a simple sense, they have discovered gravity. Things always fall down and never up! They also realize they have power to do certain things. Perhaps it is interesting and fun to see all the reactions they get from doing certain actions.

How best to respond as caregivers?
Tough but it is always advised to stay calm. In fact if your response is calm, collected and consistent every time they may get over the novelty of throwing food faster. You can try to convey to them what is ok to throw and what is not ok to throw. During play time, they can throw balls or soft objects as long as it is not towards anybody. During mealtimes, praise them when they do not throw food on the floor and put it in their mouths instead. Depending on the age and maturity of the child you can try giving consequences... like having them pick up the food or giving them a short time out. Patience is required and at the end of the day, the phase has to run its course. There is an end.

Three Year Olds and Fear During Bedtime

noreply@blogger.com (Dr. Ellen) — Wed, 13 Mar 2013 02:54:00 +0000

Our second child has recently started sleeping with the night light. She never was afraid of the dark before but turning three somehow turned on the "fear" button in her. She has always been such a good sleeper but a few times now we hear her crying out after we put her down. "I'm scared" she would sob. Thankfully, she is easily consolable. A hug, a kiss and word of comfort usually does the trick but recently I added changing the sound machine to little birds instead of the usual white noise and adding a little night light so she is not in complete darkness. We have not resorted to bringing her in bed with us as I know some may be tempted to do. No... once you cross that line, it will be hard to ever cross back! Plus, it gives the wrong message that their room is not a safe place.

So what is it with three year olds being afraid of the dark? During this developmental time their young minds do not quite know how to differentiate fantasy and reality. Their little brains are absorbing so many things from day to day... both from real life but also from things they see on tv or even read in books. So it is best to limit these exposures to "scary" movies and books. It is actually hard to find anything that is "not scary" since most all the Disney movies have a frightening villain. At night when there are few distractions, the child's imaginations run wild.

Of course personality plays a part as well... but in general, fear at night is a common thing. So what to do?

Stay calm when you talk to them about it
Show understanding but don't support or build up these fears
Don't dismiss their fear
A stuffed animal or favorite blanket may help
Keep bedtime routine consistent and soothing, not overstimulating

When our older child went through this, we started playing music from an ipod as part of her bedtime routine We'd set the timer to 30min so it would play music for that long then stop. This helped her get her mind off of "scary things". She also started praying every night for "good dreams" as part of the routine. One of her favorite songs to sing is "When I am afraid, I will trust in You...I will trust in You..." by Steve Green.

Finally, need to watch out for stresses in life that may be causing the child more anxiety which can display itself as fear at night. So things like...

divorce
death of a pet
birth of a new baby

Whenever unsure about how to handle a situation, can always bring up with child's physician to explore whether more help is needed.

So below is the Steve Green CD where that "I am Afraid" song is from. Every song on there has scripture set to wonderfully catchy easy to sing music. My kids love it!

The Ultimate Childproofing Guide (Infographic)

noreply@blogger.com (Joseph Kim, MD, MPH) — Wed, 13 Feb 2013 00:00:00 +0000

The Ultimate Childproofing Guide (Infographic) from HomeInsurance.org

Making Sweet Rice Balls with my Preschooler

noreply@blogger.com (Dr. Ellen) — Mon, 11 Feb 2013 07:33:00 +0000

Happy Chinese New Year, everyone! It is the year of the snake. Click here to read my post from last year explaining this popular holiday celebrated in many parts of Asia.

So here was a fun activity I did with my five year old... we made "tang yuan" or glutinous rice balls... which is a chinese dessert that is yummy and so easy to make.

Ingredients:
- sweet rice flour (or glutinous rice flour) which can be bought at an Asian grocery store
- water
- optional - food coloring (or we used pink sprinkles... the kind you can put on cupcakes)
- brown sugar
- you can also make these balls larger and put other things inside like red bean paste or even fruit etc. but we didn't this time...

In a bowl, we spooned about 1 cup of the sweet rice flour. Then I had my five year old spoon in water with a teaspoon until the consistency is just right... (comes out to be about 4 oz total). Basically, you want the dough to be sticky so you can roll it into tiny balls. We made some white balls and some pink balls by just adding pink sprinkles... she sprinkled and I mixed with my hand until we liked the color of the dough. Just for fun since Valentines Day is around the corner we made some into a heart shape... My daughter was specifying who she wanted each ball was going to be for.. so she made some real small (like the ones for her little brother or her baby cousin) and some she made real big... as you can see below... she likes pink so we made more pink balls =)

To cook just drop them into a pot of boiling water.

They are done when they float to the top! (about 5-10 min)

So add brown sugar to the water and then you have a sweet dessert soup...

You can also add these glutinous rice balls to other famous chinese desserts like red bean soup...

or green mung bean soup...

Anyways, this was fun, easy to make, and yummy... and an activity I could do with probably all my kids... even the one year old if I can stand the mess! I didn't this time... maybe next time...

Food Poisoning vs Stomach Bug

noreply@blogger.com (Dr. Ellen) — Wed, 06 Feb 2013 03:49:00 +0000

So many families around us are coming down with the "stomach bug" that I figured it is only a matter of time before it hits us... especially since I'm exposed to so much of it from treating patients.

Well, Miss A threw up at least five times tonight. Poor little thing, it is so heart wrenching to watch her small body writhe and retch and I'm amazed at how so much can come out of a such a tiny tummy! I am not feeling so well myself even as I write this so I fear I'm going to be #2 on the hit list. Unfortunately, if this is truly the bug and not some bad food she ate earlier today or yesterday... then it will likely go through most if not all of our family since the stomach bug is so contagious.

So how does one differentiate between a stomach bug and food poisoning? It is not always easy to tell which is which since a lot of the symptoms overlap. Here are some main differences:

Cause

food poisoning is due to bad food (usually something like potato salad)
stomach bug is usually due to a virus (rotavirus, adenovirus, norwalk virus etc)

Onset

food poisoning usually starts within 2-24 hrs of exposure
stomach bug can take from 1 to even 10 days of exposure before symptoms start

Duration

food poisoning usually lasts 24 hrs
stomach bug can last 3-5 days

Symptoms

pretty similar between the two with nausea, vomiting, abdominal pain, and sometimes diarrhea
if notice blood, should get evaluated by a physician

Treatment

again pretty similar between the two with rest and hydration being main focus
better to push small amounts of fluids more frequently than large amounts

Click here for a site that actually has a pretty good flow chart and you can click here to take a quiz to see which you likely have.

Prayer Sticks

noreply@blogger.com (Dr. Ellen) — Mon, 28 Jan 2013 22:01:00 +0000

I like crafts but I seriously do not have the time to gather the materials and do them. That is why I love it that we can do crafts from time to time at my MOPS group. A while ago we made these prayer sticks that I love. It has been a hit with the kids. They love to shake it up and pick a stick before every meal. Then they get really excited when they get to pray for someone they know whether it is another member of our family or a friend. Every now and then they'll pick a stick that I'll have to explain to them a little and help them pray... like the president =)

I have a long list of missionaries and friends that I want to pray for but don't always find the time to do it. This way, they are all written on sticks and every day before every meal I'm praying for one of those folks on my list. Actually, since each member of the family get to pick a stick, we are praying for 4 or 5 folks on the list every meal.

Any other fun family traditions out there? This toddler/preschooler age is such a fun time! Exasperating at times... yes... but overall lots of fun. I want to just freeze my kids and stop their aging!

Which reminds me of this crazy story about a twenty year old who stopped growing and has a two year old body! You can read more about it here. Kinda crazy..

Happy Monday, everybody!

Extended Families and Such

noreply@blogger.com (Dr. Ellen) — Mon, 14 Jan 2013 05:33:00 +0000

I’m back on the plane now flying back home. The big difference between travelling with kids versus travelling alone is I have the option to sit here and blog or sleep the entire way if I choose! I do miss my kids, though. When I found out that my flight was delayed and I’d be getting in past my little one’s bedtime, I was sad. I miss holding and hugging my children and I especially feel bad that I’m not there to help them feel better since two out of three got sick. The other was recovering and better by the time I left. Kudos to daddy who held down the fort while I was gone!

Well, it has been a productive couple of days. Not only did I get a chance to help my grandmother get set up for a bunch of benefits that they had no idea she qualified for… but I also helped my youngest aunt move. I really thought I’d be getting a lot of rest and time to myself but instead I felt pulled in many directions trying to meet different needs and navigate through family dynamics. There is usually quite a lot of drama when it comes to interacting with this side of the family!

Overall, I’m glad I was able to come out and spend time with my uncle, three aunts, and my grandmother who turned 96 today! Extra bonus… I also got to spend time with a cousin from the other side of the family (in case you cannot tell I have a huge extended family).

Growing up with lots of uncles, aunts, and cousins, I’ve always thought how great and fun it is to have a large family. Having only one sister, I was determined to have more than two kids… so here I am with three. Now, we’re getting ready to have a pretty huge cousins reunion with all our kids this coming summer. That should be a lot of fun... and I think a lot less drama.

Elderly and Falls

noreply@blogger.com (Dr. Ellen) — Thu, 10 Jan 2013 14:06:00 +0000

I’m actually on the plane right now writing this. I'm on my way to see my grandmother in Houston. She is turning 96 years old this weekend!

Part of the reason for my visit is to spend time with her and celebrate her birthday, but the other part is to be there when the home health agency sends a nurse to evaluate her for home physical therapy. My grandmother has had three falls in the past year and fortunately did not break a hip. Falls in the elderly are very common and more times than not result in hip fractures which then leads to a fast decline in health. The rate of deaths associated with hip fractures and falls in the elderly is extremely high. Therefore, it is very important to try to prevent falls.

Here are a few things that can help prevent falls in the elderly:

Routine physician visit to screen for things that can affect balance such as:

vision screening
hearing screening
going over medication list for interactions and medicines that impair mental function
taking vitamin D may help with prevention of fractures

Maintenance of strength, agility, and balance

daily exercise is key
sometimes physical therapy is needed

Making the home environment more safe:

remove rugs and other items that can trip patient – often home agencies can send nurse to evaluate the home and make suggestion
avoidance of stairs – best if can be on one level instead of having to go up and down stairs often throughout the day
adequately light walkways

Using assistant devices

install hand rails
raise toilet seats with arm rests
grab bars for showers and tubs
plastic seat for shower and handheld shower head for washing
use of walkers and canes

To take antibiotics or not?

noreply@blogger.com (Dr. Ellen) — Tue, 08 Jan 2013 04:23:00 +0000

Happy New Year, folks!

It has been a busy past few weeks with extended family visiting. Plus, I've been sick with a nasty upper respiratory infection which started out like a regular cold with sore throat and congestion. I actually thought I beat it after a few days and was getting better, but then I came down with a cough that worsened and kept me up all night. Finally, after a week of symptoms that did not seem to be resolving, I took antiobiotics. Even then my cough lingered and only two nights ago did I finally sleep through the night without waking from coughing!

I was pretty miserable and probably took so long to recover because my immune system is stressed from the hustle and bustle of this season. Since I've been with my kids all week 24/7 I really worry that I transmitted my germs to them. It is probably inevitable and I'm dreading the sleepless nights ahead.

So how do you know if your sickness is viral or bacterial requiring an antibiotic? This is a busy time of year for our practice and we get a lot of requests for antibiotics. Unfortunately, most upper respiratory infections are viral and antibiotics would not help at all. It may just be coincidence that someone starts to feel better after they start taking the antibiotics prescribed.

Usually antibiotics are prescribed if there is clinical evidence of an ear infection or strep throat. It would be indicated for sinus infection if there is significant facial swelling/pain or has lasted for more than 10 days. Otherwise, most sinus infections will resolve on its own with supportive care. However, most people cannot wait that long and come to the office after only a day or two of symptoms. Most claim they fear a worsening of symptoms if they do not "nip it at the butt". Therefore, most doctor offices will give in and prescribe more antibiotics than really necessary. This in turn can lead to resistance where antibiotics will become less effective.

My rule of thumb is to at least give it a good week to see if there is improvement. If no improvement after one week or if symptoms are worsening, then perhaps antibiotics is warranted.

The most important rule of thumb is to wash hands frequently and adequately!

When Tragedy Strikes

noreply@blogger.com (Dr. Ellen) — Mon, 17 Dec 2012 04:54:00 +0000

My heart has been very heavy... and honestly when my husband and I paused to pray for the tragedy in Connecticut the other night, I did not really know what to pray. I didn't want to just pay lip service. I was gripped with such grief and can only imagine what those 20 moms might be feeling...

This poem caught my eye today and I thought I'd share it:

twas' 11 days before Christmas, around 9:38
when 20 beautiful children stormed through heaven's gate.
their smiles were contagious, their laughter filled the air.
they could hardly believe all the beauty they saw there.
they were filled with such joy, they didn't know what to say.
they remembered nothing of what had happened earlier that day.
"where are we?" asked a little girl, as quiet as a mouse.
"this is heaven." declared a small boy. "we're spending Christmas at God's house."
when what to their wondering eyes did appear,
but Jesus, their savior, the children gathered near.
He looked at them and smiled, and they smiled just the same.
then He opened His arms and He called them by name.
and in that moment was joy, that only heaven can bring
those children all flew into the arms of their King
and as they lingered in the warmth of His embrace,
one small girl turned and looked at Jesus' face.
and as if He could read all the questions she had
He gently whispered to her, "I'll take care of mom and dad."
then He looked down on earth, the world far below
He saw all of the hurt, the sorrow, and woe
then He closed His eyes and He outstretched His hand,
"Let My power and presence re-enter this land!"
"may this country be delivered from the hands of fools"
"I'm taking back my nation. I'm taking back my schools!"
then He and the children stood up without a sound.
"come now my children, let me show you around."
excitement filled the space, some skipped and some ran.
all displaying enthusiasm that only a small child can.
and i heard Him proclaim as He walked out of sight,
"in the midst of this darkness, I AM STILL THE LIGHT."

Written by Cameo Smith, Mt. Wolf, PA

When Jesus spoke again to the people, he said, “I am the light of the world. Whoever follows me will never walk in darkness, but will have the light of life.” - John 8:12

For God so loved the world that he gave his one and only Son, that whoever believes in him shall not perish but have eternal life. - John 3:16

Christmas Traditions

noreply@blogger.com (Dr. Ellen) — Fri, 14 Dec 2012 04:10:00 +0000

Long time no write! This time between Thanksgiving and Christmas is pretty crazy. I try to avoid all the hustle and bustle by doing a lot of my shopping online. However, even so there seems to be an endless list of things to do.

Thankfully... at least this year... my kids are not focused on gifts. Since my oldest is five years old this year, I really hope to share and instill in her the true meaning of this season. I've gotten so many great ideas from the last MOPS meeting I went to last week. I wish I can do them all! I plan to try some ideas this year and maybe some other ideas next year and see what goes.

I'm excited because I don't remember too many set traditions growing up other than a great time of gathering with family and cousins. The focus was mainly on just family, fun, and presents. I remember how all us kids would put together little shows and skits and perform for our parents. I also remember going to Atlantic City almost every year on New Years Day! Haha... those were the "traditions" I grew up with.

Therefore, I am excited to set some traditions now for my kids... but instead of focused on just family, fun, and presents... though that should probably all still be a part of it... I want the focus to be on Christ.

Here is a list of some ideas I got from either my MOPS group or online or some other source...

Advent Candles and Wreath
We never did advent candles at home growing up though I remember our church would light them the Sundays leading up to Christmas. I'd like to try the advent candle idea this year with my kids and see how it goes. Oops.. we missed the first two Sundays but I figured we'll just catch up this Sunday and go from there. Click here for a pretty good explanation of the meaning behind the candles and wreath.

Advent Calendar
I actually found an advent calendar that I started to do with my kids from the beginning of December. My kids are excited to do this everyday because they get to open up a little compartment which has a verse for the day and a surprise chocolate treat inside.

Truth in the Tinsel
This is highly recommended by many and it truly intrigues me. I don't think I can manage it this year but it is on my list to try for next year. Click here to read more about it but apparently this is an e-book and there is a daily lesson, craft and verse leading up to Christmas.

Jesse Tree
This is also a daily devotion starting on Dec 1 that starts with creation and ends with the birth of Christ. The idea is you read a verse and hang an ornament a day on a small tree leading up to Christmas. I've heard some families use a quilt instead of a tree. Here is one link that has the list of verses and ornaments... there are many online. Here is a link on Amazon where they are selling a variety of ornaments/books related to this.

Nativity Interactive Set
So after hearing about this at MOPS, I ordered "What God Wants for Christmas Interactive Nativity Kit". This is for the week leading up to Christmas where the kids get to open up a gift box a day which six of them contains a character in the Christmas story and the seventh a mirror. Going to try it this year and see how it goes.

25 Jesus-Centered Christmas Books
I've heard about this idea from different sources and love it. However, this year we'll just read these books during nap or bedtime without the wrapping part. Perhaps next year I may try to wrap them up. Realistically we'll have to see because wrapping up 25 books would take some planning during the month of November when we have Thanksgiving and two birthdays to celebrate. Here is a great list of Christmas books from Vanderbilt Wife blog.

Tinsel Box
I hope I got this one right but my understanding is that every "service" or "act of kindness" done in the month of December or all year round for that matter... gets written on a sheet of paper and slipped into this box. Then the box is opened on Christmas day and the family can read and go through all the slips of paper put in there. “The King will reply, ‘Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.’ (Matthew 25:40)

Christmas Caroling
I really want to do this. I love singing and think it would be a lot of fun for the kids. I'm just not sure if there is any specific etiquette. I googled and didn't really see anything too earth shattering. Hmm.. maybe we'll try it with one or two neighbors that we are more familiar with and see how it goes. When I mentioned the idea to my kids they thought the door to door part was similar to trick or treating... ha. Well, I want to give cookies or baked goods or something when we do this instead of asking for candy.

Cookie Exchange
Not sure if this is so much a tradition... but most people probably bake or eat cookies around this time. I'm going to try a cookie exchange this year so we'll have more variety to choose from.

Alright, what else? Any other traditions out there?

Terrible Three

noreply@blogger.com (Dr. Ellen) — Fri, 30 Nov 2012 03:50:00 +0000

My middle child just turned three years old this past Tuesday. Many of you may agree with me that the three year old stage is far more challenging than the famous "terrible twos" stage. It definitely does vary from child to child, but this was certainly true with my older one and several parents I've spoken to have agreed with me.

What is it that makes this stage so hard?
It is all related to development and how their little minds are learning new things, their wills are earning to be independent, yet their emotions are difficult to control. They get frustrated easily when their little hands and bodies can't keep up with what their minds want them to do.

Now our middle child is fairly mild and even though this stage is a challenging stage for her, we are not experiencing the all-out body thrashing tantrums that our older child use to throw. No.. with this one it is more of a stubborn and silent defiance. She will sometimes have a scowl on her face if she is not getting her way but she does not melt down nearly as much as our first.

I wrote this entry when my oldest was in her two's... her three's were actually much harder to deal with. Now that she is five, I think it is safe to say that she has outgrown the tantrums. She will always be my emotionally sensitive one, but she is learning to control her feelings better...

Now, my third child was starting to throw mini tantrums after turning one. We are already bracing ourselves for when he turns two then three... too bad they don't stay this cuddly and compliant!

Ok.. so some practical things I've learned to deal with tantrums:

try to stay calm while child is freaking out (this is not always easy but important)
we may both need a time out to calm down
physical hug and assurance of love
don't give in to the demand or they will learn that tantrums can get them what they want
avoid triggers that will set off tantrums (routine really helps)
make sure getting enough sleep (tiredness definitely leads to more emotional breakdowns)

Five Years And Counting...

noreply@blogger.com (Dr. Ellen) — Fri, 16 Nov 2012 04:21:00 +0000

Yesterday was my first child's fifth birthday. Five years ago, we brought home our teeny little baby and began this adventure called "parenthood"... did we really know what we were getting ourselves into?

There are so many books out there... but really... until I actually stepped into this role of "mommy" I don't think I ever could have imagined all the highs and lows that come with mothering.

It has been such an intense journey... filled with lots of giggles, sweet kisses and cuddly hugs... but also has its moments of agonizing frustrations and exasperated explosions. Sometimes I feel inadequate and defeated and worry about how my reactions and actions will affect this little being.
Those are the times I look up to my loving, patient Father in heaven in desperation and plea that His grace covers over the multitude of my mistakes.

But he said to me, “My grace is sufficient for you, for my power is made perfect in weakness.” Therefore I will boast all the more gladly about my weaknesses, so that Christ’s power may rest on me. (2 Corinthians 12:9)

Counting Blessings

noreply@blogger.com (Dr. Ellen) — Fri, 02 Nov 2012 20:12:00 +0000

November is here! Which means Thanksgiving is just around the corner. Many blessings to count for this year... especially with the recent aftermath from Hurricane Sandy, I'm reminded of all the things I often take for granted (like lights and hot water). We were very fortunate to gain back power so quickly and to sustain little loss. Here is a photo of the only damage from the storm really that I can see in our backyard. Pretty impressive that the winds picked up these ceramic tile pieces and smashed them. Oops.. we had put away the chairs and didn't think to put away this little table as well...

My prayers and thoughts go out to all those who have suffered much more loss and damage to their homes and those still without power and heat.

No Power During Hurricane Sandy

noreply@blogger.com (Dr. Ellen) — Wed, 31 Oct 2012 02:38:00 +0000

We just got our power back! Hurricane Sandy hit us yesterday and we lost power for about 24 hours. I actually spent all afternoon cooking up perishables and trying to come up with a food plan since we were anticipating power loss. We lost power during Irene, too, but we were definitely more prepared this time. However, if this hurricane thing is going to become a common occurrence, we better get ourselves a generator! Actually, I was mostly just worried about the food in our refrigerator and freezer spoiling. For it was actually nice to be without any electricity, to spend some good family time bonding without tv and computers!

So how did the kids do?

Well, the power went out last night after we had already eaten dinner, bathed, and brushed everyone's teeth. So the transition was not too bad. Little E was already fast asleep when it went out. My two girls wondered why it seemed darker than usual and my older one is used to sleeping with some music playing. However, since she didn't nap earlier, she was pretty tired and went to sleep without too much drama (she is our drama queen).

The rain had pretty much stopped by the morning but there were still some pretty heavy gusts of wind throughout the day today. I actually really enjoyed the day because everyone was home with no where we needed to be. So the morning was filled with some music time, writing time, finger painting... We even attempted to play a game of Candy Land... this lasted about 5 minutes with my almost 3 year old. The almost 5 year old probably could have played to completion but the 3 year old grabbed all the pieces and started running around giggling and daring her sister to catch her. Maybe we'll try again during Christmas break.

We bathed everyone early (before naps) because I was worried we'd run out of hot water and we'd all have to take cold baths. Who knew how long we'd be out of power! Bath time was actually a blast because we stuck all three kids in the tub with some washable bathtub paint / soap. Idea is you make a mess with it and then just wash in it then wash everything off.

I needed a nap so I took one during my kids' nap time this afternoon. This is a luxury I don't usually get especially in the middle of the workday because of work. Even on weekends, there are usually too many activities to consistently be able to take a nap. I probably could have slept longer but I wanted to get dinner figured out before it got too dark... so my husband had our camping stoves fired up in the garage so he can help boil water. We basically used a large pot of boiling water to heat up leftovers by steaming! We all ate pretty early at around 5ish but it was already getting dark so we had several candles as well as flashlights pulled out. My girls enjoyed eating under candlelight. I liked it, too... maybe we should do this even if when we do have lights!

So just as I was snuggling with my two girls under a blanket to read a bedtime story by flashlight, all our lights came back on! We read the story by flashlight anyway and then tucked them in for the night. It has been an adventurous kind of day!

Cruising with Little Kids

noreply@blogger.com (Dr. Ellen) — Sat, 27 Oct 2012 00:48:00 +0000

Many may agree that vacationing with little kids is not really that "relaxing" and can be more "work" than just the normal weekly routine at home. When you are in a different environment, sleep schedules can get thrown off which can add a layer of fussiness. Plus, being around the little ones 24/7 may take some adapting to especially if one or both parents are usually at work during the day. It can lead to some stressful moments where parenting styles may differ or issues not dealt with before may arise.

I think cruising is an awesome option for parents with little kids who are planning a family vacation. These are some of my reasons why:

Economical
When we add up the rooming costs as well as food and entertainment, cruising can be a very economical way to take a week long vacation. Of course, it depends on what you are comparing to (camping will probably be less expensive)... but especially if you get a great cruise deal (like sometimes Disney has a 'kids cruise free' deals), it can totally be worth it.

Avoid Airport Hassle
At least for us, there are several drivable cruise ports (NYC, NJ, and MD) It is such a pain with little ones to go through the whole airport check-in fiasco with carseats, toddler bottles etc. and if still nursing the whole nursing bag etc. Cruising is a great way to get to a far place (like a remote island in the middle of winter) and not have to fly there!

Break from the kids
Yes, we do want to spend time with our kids when we are on vacation. However, it is *huge* to have a few hours here or there where you can leave them with kid friendly crew for kiddie activities while you spend some quality time with just your spouse. Even just a few hours away gives me a refreshed spirit and extra patience to deal with the physical needs of my little ones. Plus, the kids have a blast (at least they did on Disney... but I'm sure they would on other cruise lines as well).

Mealtime convenience
I love how we do not have to figure out what we are going to eat every night... or breakfast or lunch for that matter! Sometimes figuring out food is the most stressful part of vacation. Plus, if you travel in a large group it is not always easy to get everyone to agree on cuisine and it can easily become very costly if you eat out every night. On a ship there are a multiple options. You can sit down and be served every night (which is nice when you have little kids) or you can choose to do a buffet or just grab fast food or even stay in and get room service! There are plenty of options for picky toddler eaters and the staff is usually very accommodating and can even puree food for babies. On the Disney Cruise lines, there is the option to leave the kids in the Oceanear Club where they get fed dinner while the parents enjoy mealtime alone. I believe this option may be available in other cruise lines but you may have to pay for it.

Options for entertainment
If you pick the right ship, there are a multitude of activities for adults only, kids only, and both. We usually like Royal Caribbean because they have more physical outdoorsy and sportsy activities (like rock climbing walls and ice skating rinks). Recently, we went on a Disney Cruise which was awesome for the kids but didn't have as many choices for activities for my husband and I. However, we are pretty active and prefer more sporty type of activities. I'm sure they have plenty of entertainment on board for other adult folks since there were many adults on the ship... even adults without kids! But regardless of cruise line, it is nice that there always seems to be a movie theater on board as well as plenty of lounges and places to hang out. So once the kids are asleep (which is usually pretty early if they are young) you can either take turns going out or travel with grandparents who are more than happy to watch the kids sleep while you slip out together for some late night movie or something. Some cruises will even have in-cabin babysitting for a nominal fee. It is much harder to arrange this type of night life when you are in a hotel or house somewhere. Plus, you'd have to drive somewhere rather than just take the elevator up or down a few floors to get to your entertainment.

So those are just a few of the reasons that I can think of why I like to cruise. Things to consider when choosing a cruise include:

Destination and Ports of Call
You save a lot of hassle and money if you pick a departure port that you don't have to fly to. The other issue has to do with seasickness. Usually, the ship is big enough that you do not really feel the rocking. However, the rocking also depends on time of year and where the ship is going. So for those who get seasick, it would be worth it to do more research and go to ports during times of year where there is minimal ship "rockiness".

Length of Cruise and Type of Ship
The larger the ship, the more activities and options there are. Usually the larger ships are reserved for longer cruise nights. So it is possible that if we cruised with a larger Disney ship there may have been more that my husband and I would find fun to do. 7 nights is probably a pretty average time frame where you get the larger boats. We had chosen a 5 night trip which seemed plenty because our third child was only 14 months and we weren't sure how the kids would do sleeping all together in the same room. Given the extra cost of cruising with Disney versus other cruise lines... we are probably leaning on just sticking with Royal Caribbean in the future. Carnival is supposed to be very good for kid friendly activities in addition to being the most economical. We just have not tried it yet because of previous bad reputation for food. However, I believe the new lines have really improved in this area.

Well... I'm already looking into and planning our next cruise trip. In another blog I'll spell out the differences between going to Disney with little kids versus cruising with Disney on a ship!

Dropping Naps

noreply@blogger.com (Dr. Ellen) — Wed, 24 Oct 2012 22:06:00 +0000

I love nap time! Best is when all three kids fall asleep around the same time and stay asleep for at least 2 hours. However, in our household…this does not happen often.

So when do kids start dropping naps? Sleep and the amount of sleep needed per child may vary slightly but in general toddlers require around 12 to 14 hours of sleep in a 24 hour period. They require less as they get older, thus will eventually drop their nap.

So the pattern of sleep goes something like this...

Newborns
They sleep most of the time, waking up mostly to eat every 2-3 hours, after which ideally they should be awake and "play" a little before falling back asleep so to not associate eating with sleeping.

Infants
They fall into a nap pattern where they sleep about 3 times during the day… usually about an hour in the morning and early afternoon then a shorter 30 min nap in the late afternoon before going down for the night (ideally 12 hours). They may then drop the late afternoon nap and sleep consistently maybe a little longer once in the mid morning and once in the afternoon and again about twelve hours at night.

Toddlers
By around 18 months, they will likely lose their morning nap and only nap in the afternoon. Sometimes when this happens, the afternoon nap gets longer which can be nice. However, the transition from 1 to 2 naps is sometimes tricky and not always smooth. Kiddo #3 is around this stage… and I still can’t remember exactly how we did it with the other two.

Preschoolers
Eventually, they lose the afternoon nap and no longer take daytime naps. When this happens can vary from child to child. About 70% of children will be done with naps by kindergarten. However, this is probably more due to their schedule and what their body becomes used to and may not necessarily mean they wouldn’t benefit from that nap.

Both my girls (ages almost 3 and almost 5) are still taking afternoon naps. Well, let me rephrase to say that we still put them down consistently every afternoon for a time of “rest” and usually they will both fall asleep. There were many occasions after my oldest hit 3 when we thought she was “losing her nap”. However, as we kept “quiet time or nap time” consistent she still will nap for us more times than not.

Sometimes you can really tell a huge difference in behavior with kids who are not fully tanked up on sleep. This was especially true with our oldest. She would totally melt down and become an emotional wreck if she skips her nap. Plus, she would have terrible night terrors at around 11pm on those nights. We do not notice our second child being this way.

I actually just read a very interesting article describing a recent study that suggests daytime naps reduce risk of mood-related problems later in life. Click here to read.

So this is what I do:

Try to keep nap time (or quiet time) regular and consistent
Try to keep their sleep environment not too stimulating and not too bright
Even if the child skips his or her nap for several days in a row, I would keep trying for a while because it may be a phase and they may nap again
Even some quiet time in the afternoon is better than nothing

I want my kids to nap so I can have some peace and quiet and sanity in the afternoon… but good to know that it may help their emotional health!

Meningitis

noreply@blogger.com (Dr. Ellen) — Fri, 12 Oct 2012 19:47:00 +0000

It has been a busy week with hubby being away on business trips. I was trying to get to bed before midnight this week so did not get a chance to blog. However, I've been wanting to talk about meningitis since it has been in the news lately.

I'm sure you have all heard about the crazy outbreak of fungal meningitis that has been linked to tainted steroid injections. You can read about it all over the internet (most recent story I found is here). Main things:

cases linked to tainted steroid injections manufactured by NECC in Massachusetts
most patients involved received this steroid injection in their spine for back pain
so far 170 cases with 14 deaths
very slow growing so more cases will probably arise
this is not contagious and only those who received the steroid injection are at risk

So what is meningitis?

Meningitis is inflammation of the membrane that covers the brain and spinal cord

What type of meningitis are there?

Viral

caused by viruses like enteroviruses or herpes simplex virus
this is the most common type
symptoms are far less serious and often it mimics the common flu

Bacterial

caused by bacteria like Neisseria meningitidis and Streptococcus pneumonia
rare but can be life threatening if not treated
we have vaccines to prevent some forms so talk to your doctor and get vaccinated

Fungal

caused by fungus like Cryptococcus and Histoplasma
even more rare and more challenging to treat
usually patients with certain medical conditions are higher risk of getting this

Parasitic

caused by parasites in contaminated food, water, or soil
less common in developed countries

Noninfectious

caused by things like cancer, lupus, head injury, drugs, or surgery

What are the symptoms of meningitis?

(here are a few common symptoms...)

fever / chills
severe headache
stiff neck
nausea / vomiting
confusion
seizures
difficulty waking up
sensitivity to light

How is it treated?

It really depends on the type of meningitis. Antibiotics are given for bacterial meningitis and antifungals for fungal meningitis. Most cases of viral meningitis are treated with fluids and supportive care. Sometimes, hospitalization is required if the symptoms are severe. Call your doctor if you have any of the symptoms above. Since meningitis can be serious leading to even death, it is a good idea to vaccinate for the types that can be prevented.

Medifast Weight Loss Program

noreply@blogger.com (Dr. Ellen) — Thu, 04 Oct 2012 04:54:00 +0000

I'm doing it! Just last week, I decided to offer the Medifast Diet Plan to my patients. Thank you, Dr Lee, for telling me about this!

You can read more about it on my medifast website here, but in a nutshell it is a very low calorie, no brainer method of weight loss. I like it for several reasons...

No brainer - so good for the patients who don't want to count calories
Meals are designed to be very low in calories yet satisfying...
I will be the health coach walking alongside and helping my patients stick to the plan
After weight loss is achieved, there is a transition period and then maintenance
Cost to the patient is only for the meal replacement foods they are eating and comes out to about $10/day... and you should really only need to do this weight loss phase for 1-3 months before transitioning back to "real life" food and then maintenance

Initial weight loss is fairly simple and most people can achieve this if they follow any diet plan. However, the trick is to keep it off and with the coaching that goes along with Medifast Diet Plan, I'm excited that I can offer something to my patients that can be lasting. The goal is to develop healthy eating habits and to achieve optimal health. Haha.. I sound like an ad on tv but I truly am excited about this and want to see my patients get off of their blood pressure, diabetes, or cholesterol meds! Will keep you posted...

Appendicitis

noreply@blogger.com (Dr. Ellen) — Wed, 26 Sep 2012 03:56:00 +0000

We had a recent scare where hubby tells me he has abdominal pain and thinks he might have appendicitis. Picture him laying on the floor of our kids' playroom in the midst of toys spread about and I'm palpating his abdomen trying to determine if it is serious enough to go to the emergency room! At the end of the day... it is not his appendix... whew! His symptoms have not completely gone away but we're hoping it will soon.

I figured this is a good topic to give a short 101 on because it is actually the most common cause for emergent abdominal surgery in the US.

What is it?
Appendicitis is when you get inflammation of your appendix. Appendix is a finger shaped pouch that protrudes from your colon on the lower right side of your abdomen.

Who gets it?
Anyone can get it but it is rare under the age of 2 and is most common between 10 and 30 years old. It is estimated that 1 in 15 people will get it in the US.

What are the symptoms?
Usually, you will experience dull pain that starts around the belly button and eventually shifts to the right lower side of your abdomen. Associating symptoms may include:

nausea
sometimes vomiting
sometimes diarrhea
lack of appetite
low grade fever

Pain is usually worse with movement. If the appendix ruptures you may even feel better for a little while. However, once the lining of your abdominal cavity becomes infected, the pain will be worse and you will be more sick.

What causes it?

Obstruction from food waste may block it and cause inflammation or an infection can cause it.

How do you test for it?

It is important to get a physical exam. Your doctor may also order blood tests looking for infection and imaging like a ct scan or ultrasound.

How do you treat it?

Usually treatment involves surgery to remove the appendix. Sometimes you have to drain the abscess around the appendix if has already burst.

You can get really sick really fast so it is important you call and see your doctor if you suspect appendicitis.

Working Moms

noreply@blogger.com (Dr. Ellen) — Tue, 18 Sep 2012 04:45:00 +0000

It has been a long time since I've blogged! We actually just got back from a Disney Cruise which I'll write about in another post.

I read this great article from Focus on Family that has been a great reminder / motivator for me and thought I'd share it. It talks about "working moms" organizing their day, but I can see it applying for "stay home moms" as well. Click here to read the entire article.

My main take away point is to get organized! I need to make a list of important household contacts and their numbers and it would be nice to have a big family calendar. Now if only I have time to get organized...

Stranger Anxiety vs Separation Anxiety

noreply@blogger.com (Dr. Ellen) — Tue, 28 Aug 2012 04:43:00 +0000

I just re-read this post I wrote 2 years ago when my second child was going through separation anxiety. It is funny because now I'm going through it with kiddo #3 and for some reason, I don't remember the other two being this bad. My kids sure do have a set of lungs!

I figured I'd clarify the difference between Stranger Anxiety and Separation Anxiety in this post. Although, a lot of times they do go hand in hand.

Stranger Anxiety

this is a normal part of development that usually occurs earlier than Separation Anxiety and may start around 5 months and last to around 18 months (some get it worse than others)
child can get upset when he or she sees someone other than their primary caregiver and even if their primary caregiver is still nearby (can be relatives or close friends)
child will cling or hide between legs or cry when stranger approaches to interact
symptoms seem to peak around 12-15 months

Tips?

reassurance to the child
consistency in schedule
slowly introduce new faces (may need to be around a few times before leaving child alone with new caregiver)
explain to family members or friends so they do not take it personally
patience (this will eventually pass)

Separation Anxiety

again a normal part of development that usually occurs around the same time as stranger anxiety but maybe peaks a little later and resolves by 24 months
child gets upset when separated from their primary caregiver (this is around the time when they realize that there is only one mom or dad and that if they don't see you, you are not there and since they have no concept of time they don't know when you are coming back)

Tips?

can practice separation with short amount of time / distance
separate only after naps and feeds so child is not tired or hungry
keep surroundings familiar or make new surroundings familiar
develop "goodbye ritual" but do not linger or stall

So how do I get little E to not scream his head off at the nursery every Sunday? He does fine with different caregivers at home. Unfortunately, I think E has developed a bad association with the nursery because he starts to cry when we approach it from the hallway. Therefore, I'll have to spend some Sundays with him there to get him used to the room and remove the negative associations. In the past, we've attended early service on Sundays which was smack in the middle of his morning nap schedule, so that could have triggered this whole separation thing. We'll have to consistently go to second service until he drops this morning nap. Then maybe, slowly as he gets older and as we consistently introduce him to the environment, he will get over this. My other two did! Let's see how long it takes this time...

Bumbo Chair Recall

noreply@blogger.com (Dr. Ellen) — Sun, 19 Aug 2012 00:54:00 +0000

This news is a few days old but thought I'd throw in a blurb...

My husband got an email from Babies R Us that the Bumbo Chair we got as a baby shower gift in 2007 is being recalled. Apparently, babies are able to get out and are even getting seriously injured falling from high places like table tops and counters. They actually did a recall in 2007 which resulted in a new warning label to not put the chair on high surfaces. I admit we've placed our bumbo on the kitchen table to feed our kid. Thankfully, none of our kids have gotten hurt. I actually really like the chair and have even given it as gifts to others!

For more on the recall you can read or watch a clip about it here.

So now, they have this new seat restraint that is supposed to keep kids on the chair. We just ordered it. Will let you know how it goes once we get it but the thought of having to install it is already not attractive to me. I usually just leave those kind of projects for my husband to figure out... too much time and energy for my tired brains these days. I guess it would be too chaotic for them to have folks go and exchange our old chairs for a new chair with the restraints already installed. They say 4 million chairs are being recalled.

This is what the new chair should look like: