Vaccination talk

My cousin asks me once, why do doctors say, “This will only hurt a little?’ when they give a shot.

I thought about it. “It’s a matter of scale. Picture this: in room one, I have a woman who thinks her lung cancer is back and it is. In room two I have a mother and daughter crying because the daughter is pregnant and frightened. In room three, I have a well adult who needs a vaccination. Scale their levels of pain.”

Room one is very high, room two is very high, room three barely registers on my pain scale.

I would give out a health department vaccination information booklet by 24 weeks to my pregnant patients, especially the first pregnancy. I previously had given it later, but then I had a woman who refused the child’s vaccines at visit after visit after visit, saying that they were still doing research. The child still had no vaccinations at 9 months.

Remember the woman who refused vaccinations for her children? She had more than four children. They all got whooping cough, pertussis. They whooped for months and were on quarantine. They were not allowed out of the household, any of them, until they were no longer infectious. The mother said she now was for vaccines and got them vaccinated.

I have seen adults with pertussis. Adults do not whoop but they cough. They can cough until they throw up or until they break a rib. For months. It is not fun at all. The adult Tdap stands for tetnus, diptheria, and acellular pertussis. I have never seen a case of diptheria and I don’t want to. It sounds horrible and can kill.

Have I seen a complication of a vaccination? One in 30 years of practice. And I know a person who had a complication, but they were not my patient.

The illnesses cause way more damage and disability than the vaccine. In residency I care for a young man in a group home. He can’t talk and has an odd skull shape. His mother got measles during the pregnancy. Measles is one of the infections that can cause severe birth defects. Get vaccinated before getting pregnant, though half the pregnancies in the US are “unintended”. That usually means “unbirthcontrolled”. I do not really understand that, since the risk of pregnancy in a fertile woman is one in four every time. Twenty five percent seems a pretty high risk to me.

I’ve written about my response to my last Covid-19 vaccination. It’s not a complication. It is an antibody response and it means that my immune system is WORKING, though admittedly it is weird and annoying. I don’t like the muscle dysfunction, but I will get the vaccinations anyhow.

I have a very alternative young woman in for prenatal care once. I give her the vaccination booklet. “Oh, my child is getting every vaccine there is,” she says.

“May I ask why? I was not expecting you to say that.”

“I was in the Peace Corps in Africa. I have seen kids die from every single one of the diseases we vaccinate for. My kid will get ALL the vaccinations.”

I said, “Please would you talk to my other moms?”

She smiled at that. “Maybe.”

I hope she did and does.

The extroverted feeler and responsible behavior

My son is an extroverted feeler and my daughter is an introverted thinker.

When he was 12 and she was 7, their father and I were working out the details of a divorce. Their father moved out for a year, moved back in for a year, and now was out again. It had taken me two years of couple’s counseling to decide that yes, we did need to get divorced. Now we were in the year of hammering out the details.

One day he came over and was obnoxious and rude. I got angry and yelled and threw him out. I slammed the door after him. I didn’t usually do that and it felt both good and bad.

The kids were conferring. I wondered if I’d scared them, losing my temper. They both came to me.

“Mom, we don’t want you to yell at dad and make him leave.” said the EF, arms crossed. The IT stood beside him. “And no slamming doors.”

“But he was rude first!” I said, realizing as I said it, uh, lame. And where have I had this conversation before?

“We know that he was rude. But we aren’t talking about him. We are talking about your behavior. We don’t care what he does.” They both looked stern and fierce.

“So I have to behave no matter what he does.” I said. They nodded. “You are right. I apologize for yelling at dad, throwing him out and slamming the door. I need to behave anyhow. That’s what I tell you, right?”

“Yes, mom.” And then they both hugged me to comfort me.

I felt sheepish for behaving badly, but mostly proud. Proud that my kids felt comfortable confronting a misbehaving adult and the one with whom they were living, me. Right after a yelling tantrum, too. And proud that they were giving me back the message that I’d given them for years: I don’t care what the other kid did, that is not acceptable behavior. And overall I felt pretty good that I really had not yelled and slammed doors very often: we’d done the majority of our fighting in the counselor’s office and had tried to make it very clear that it was not the kids’ fault.

The photograph is of my son in Thailand. He was a Rotary Exchange Student, to Trang. I don’t know who took the photograph.

Previously published on everything2.com.

 

Stepping out

For Mindlovesmisery’s Sunday Writing Prompt: “Take a walk“. Writing from another’s point of view.

Stepping out

We’re trying to get our steps in today. Mother thinks we’re too high too much and wants us to practice being more grounded. Silly mum, but we’re trying to humor her. Down to the beach, no shoes, keeping track. Step counters, we’ll walk all day…

DSCN2146.JPG

 

Ooooo, what has my sis got? I am heading over. Dang! She ate it already! I don’t see anything in the water. Bit murky here.

DSCN2184

 

 

Wait, but who is that? We agreed to walk, but if that one comes this way! No way! I am out of here.

DSCN2096

 

 

Rats, mum is still watching. She’s got her fierce look on, don’t mess with her.

DSCN2770

And look, people! And those awful four legs. It’s not that I’m scared, mind you, but their mouths give me the creeps. All those stalagmites in there. No smoothness and their faces have all those expressions!

DSCN2157.JPG

And there goes dad, heading by, checking on us. Jeez.

DSCN2119

Ok, ok, we’ll walk.

DSCN2177.JPG

 

 

young alone

I have a double lot, L shaped, because the 1930s garage extends 5 feet into the second lot.

I don’t mow the second lot. It is in the center of the block and has an apple tree, a plum tree, a maple with a tree house, wild roses and weeds.

The deer leave their young to stay. Intemittently there are young alone in my lot. I went to go in the tree house this weekend, but this small one was alone. I don’t like to scare them into the streets or more exposed yards, so I backed off.

sleepy head

This is a story my mother told. When we were little, my sister and I lived with our parents in a small house near Ithaca, NY. We each had a bedroom downstairs. Our parents had their bedroom upstairs. We were not allowed up there, because the stairwell came to the middle of a hall and there was no railing at all. They were afraid that we would fall down.

I am three years older. I’m not sure I was always a good sister.

One weekend morning, my parents were lying in bed in their room, quite early. Suddenly a very round three year old face popped up at the end of the bed, with a wicked gleam, and spoke:

“Boodie with a yellow bill
hopped upon my windowsill
cocked his shining eye and said
“Ain’t you shamed, you sleepy head?”

And then my sister raced out of the room and down the stairs.

My mother said that when they got over their stunned laughter, they came downstairs to talk to us. I had coached my sister until she could recite perfectly, aside from the missing r. I think we got a mild scolding about the safety of the stairs, but since they were still laughing, I don’t think we took it seriously.

previously published on everything2.com, a slightly different version

At what age should we talk to our kids about drugs?

I am a rural family physician and my recommendation: before age 9. Before third grade.

WHY? Your eyes are popping out of your head in horror, but my recommendation comes from surveying my patients. For years.

The biggest drug killer is tobacco. However, it takes 30 years to kill people. It is very effective at taking twenty years off someone’s life, destroying their lungs, causing lung cancer, heart disease, mouth cancer, breast cancer, uterine cancer, stomach cancer, emphysema, heart disease….

I ask older smokers what age they started smoking. This is informal. This is not scientific. But most of my male older smokers say that they first tried cigarettes at age 9. I think parents need to be talking to their children about cigarettes by age 9.

And then start talking about alcohol and illegal drugs and the terrible dangers of pills.

“My innocent child would never….” Unfortunately my daughter said that as a senior in high school in our small town, there were 4-5 kids out of the 120+ that were not trying alcohol and marijuana. But there are kids trying far worse substances. We have methamphetamines here, and heroin, and pain pills sold on the street.

The perception that pills are safe is wrong too. Heroin is made from the opium poppy and it’s rather an expensive process, not to mention illegal and has to be imported from dangerous places. But teens take oxycodone and hydrocodone, bought on the street, to get high. And now drug sellers are making FAKE oxycodone and hydrocodone and selling that on the street. It contains fentanyl, which is much much stronger. If the dealer gets the mix wrong, the buyer can overdose and die.

Talk to your children young! NEVER take a pill from a friend, never take someone else’s medicine, never take a pill to party! YOU COULD DIE! And if you have a friend that is not making sense, that you can’t wake up, DON’T LEAVE THEM! Call an ambulance. Your friend may have used something illegal, and may not want you to call an ambulance. But if you think they are too sleepy….. don’t take a chance. People can get so sleepy, so sedated, that they stop breathing.

And parents, you are the ones that have to set a good example. Don’t drink alcohol every night. Don’t use pot every night. Take as few pills as possible. Pills aren’t necessarily safe because they are “supplements” or “natural” — hey, opium and heroin are plant based! Stop using tobacco and if you have a hard time doing it, tell your children you are struggling. It takes an average of eight tries to quit smoking. Get help.

Lastly, we talk about childhood innocence, but we let kids babysit at age 11. That is the Red Cross youngest age. My daughter took a babysitting course at age 11 and babysat. If we think they are responsible enough to do CPR, call 911 and do the heimlich maneuver, shouldn’t we also be talking to them about addictive substances by that age?

Talk to your children about addiction young… so that they can avoid it.

I am submitting this to the Daily Post Prompt: calm. I am not calm about this topic, but the photograph is calm…. and if we can help more children and families…..

Mergansers

These are some of the creatures that I saw last summer at Lake Matinenda. A whole family of mergansers swam around the point in the early morning. I was drinking tea and writing in the very early morning. Suddenly they startled at something in the water and all rushed up on the rock ten feet from me. I froze and when they didn’t notice me, I slowly picked up my camera.

What were they scared of? There are pike and lake trout and otters…

Weathering emotions

Just before Christmas, I was describing the present I had gotten for a friend’s son.

“Wait,” she said, “I’m not sure he’ll like that. I want him to be happy.”

……

Oh, I thought. I reassured her, “I think that he will like this a lot.” and he did.

But… I don’t want my children to be happy.

WHAT! HORRIBLE MOM!

No, wait. Let’s play with the idea.

Say that your goal is for your child to be happy. You want them to be happy, as much of the time as possible.

Your child will pick up on what you want. Your child wants to interact. Your child loves you. So your child will try to make you happy. Even when they aren’t happy. Then you are in a vicious circle, with you wanting your child to be happy and your child valiantly attempting to be happy or at least act happy whenever you are around until finally they hit the teen years (or possibly age 3) and scream at you, “Go away and leave me alone!” Then they will be sullen and guarded and only show up when they want food, transportation and money.

My goal is NOT for my children to be happy.

Are adults happy all the time? Well, don’t be silly. Of course not.

So why do we want children to be happy all the time?

I want my children to be able to handle the full spectrum of emotions. Happy, sad, grumpy, confused, brave, scared, apathetic, all of them. I want them to be able to name each one and tolerate it. Because my children will be adults and they have to be able to handle all of those emotions. I strongly suspect that they will encounter each and every one….

How do I model this? I tell them how I am feeling AND they don’t have to fix me. My sister died in 2012. I was very sad. I cried a LOT. Sometimes I would be sitting in the kitchen crying and my daughter would wander through the room and stop and hug me. She is not a natural hugger but she knows that I am and that I find it very comforting. She wouldn’t cry with me. She had her own emotions.

I came home from work once and said that I was furious and hurt. Ok, more than once. But once I described a meeting which turned out to have me on the agenda. The other five people knew that and I didn’t. I felt jumped and attacked. It hurt.

My son said, “Five against one?”

“Yes,” I said.

“Then they didn’t have enough people, did they?” He grinned at me and I felt much better. Still mad and hurt, but he was so funny. We went out for pizza because I didn’t want to cook.

Our US Constitution includes the pursuit of happiness. We are free to pursue it all we want. But I don’t ever think we will catch it. We will and we should still have times when we are sad or afraid or feel confused or hurt. I would go to work and tell my nurse, “I am in a really bad mood because something in my family is a mess. My mood is not about anything at work.” She would nod and then through the day I would cheer up, because I had to think about work.

Emotions are like the weather. We don’t control them. My mother died fourteen years ago. I see an ornament on the tree that reminds me of her and I feel sad and miss her. Next morning I change from writing Christmas cards to writing Valentines and I am using a stamp set and stickers and it reminds me of her and I think it’s funny. I am happy then remembering her. Let the emotions come in like the weather: name them, acknowledge them, don’t try to control them, let other people know you are in a storm, accept help, and let them pass. And let your children have their full range of emotions as well.

The photo is me and my younger sister, in 1965.