Packing For School Survival

When I was in third grade, one classmate, Jack, was incessantly bullied.  Jack was heavy-set and wore thick glasses.  Even worse, when he got teased, he shrieked at his harassers, rewarding them with a show disrupting the whole class.  The teacher seemed unequipped to deal with Jack and his teasers, wringing her hands every time Jack was set off.  This went on for weeks before Jack moved to a different school.  40 years ago episodes like this were rare, and few teachers knew what to do.

It’s time to get the kids ready for school- uniforms, backpacks, notebooks, etc.  It’s also time to get kids ready in their heads.  I was always excited for the new school year; September and fall weather still make me happy, but I loved school.  Many kids don’t, and dread another year of bullying, isolation, and drudgery.  The unluckiest kids are those starting a new school, becoming “the new kid” without friends.  Also unlucky are those with underlying anxiety, mood, or behavior issues.

When those psychologically vulnerable kids get bullied, particularly if they are new in school, sometimes these kids become suicidal.  They begin to think that anything is better than this, even death.  Suicide is on the rise, including Lafayette parish.  Our suicide rates are comparable with those of New Orleans and Baton Rouge.  This fall more unhappy children will come to our Emergency Department, their parents seeking help before it’s too late.

Thus it’s time to get your child back into counseling, before the offices also become flooded with the September rush of stressed kids.  Sometimes kids who are on anti-depressant or mood stabilizing medication stop them over the summer, because things have been stable.  First, you shouldn’t stop these medications without talking to your doctor.  Going “cold turkey” on them can be medically or psychologically dangerous.  Second, with school starting, now is the time to really be on them, before the perfect storm of depression, isolation, and bullying begins.  Finally, good mental health starts with getting enough sleep.  Time to walk back bedtimes until your kids are going to bed around 8 pm, for a 6 am wake-up.

Willie Geist, co-anchor of the Morning Joe show on MSNBC, discusses parenting in his book Good Talk Dad: The Birds And The Bees…And Other Conversations We Forgot To Have. Sometimes when his kids behaved badly, Willie would take them to the local New York Police precinct.  He’d made friends with the desk sergeants over the years, and enlisted them to scare his kids straight.  Playing their part, the officers would stare down at the child and in stereotypical Brooklyn accent, say something like “Hey, whaddya wanna act like that for anyways?”  This got them to behave, for a little while at least.

This episode highlights opposite poles of parenting styles.  One end theorizes that kids need respect for authority, and a little fear of adults helps them behave.  The other end is parents who feel that children need to learn behavior themselves, with the parent as co-raiser with the kid himself, rather than the all-knowing authority.  In this scenario, the parent is more friend than disciplinarian.  Willie Geist gets to have it both ways, delegating the fearsome adult role to his local cops, while remaining his kids’ friend.

Some think the increasing child depression and suicide that we discussed above is due to this more recent “child-centered” parenting, and a waning of the older, sterner method.  The nicer parent style lets kids make mistakes, and then maintains their self-esteem when they fail.  The kid learns from mistakes without the emotional trauma and depression that might ensue from failure (as the theory goes).  The older method holds that kids aren’t the emotional center of the universe, that there’s people more important than them (like parents and other adults), and the sooner they learn this the less disappointing life will be.  Some ego bruising is a good thing in this model, since recovering from failure leads to emotional resiliency.

I’m with the old model.  As a perennial little league disaster, I spent a lot of my childhood feeling like Charlie Brown, not measuring up.  I rarely got an award for achievement.  Perhaps this has given me emotional stability in a career where death and tragedy are constant worries, and occasional outcomes. If this parenting style doesn’t suit you, perhaps look to your local police precinct for help!

Back To School- Get It Right!

Schoolteacher Jane Anderson Lemoine has lots of back-to-school stories- kids falling asleep in class and drooling all over their desks, a boy accidentally going to two social studies classes per day for a whole week and not telling anyone, and one five year-old who was so scared it took three adults to coax him into his first day of class.  Yes, getting back to school can be exciting, but given the swarm of deer-in-the-headlights kids (and teachers and parents), there’s goof-ups too.

August 8 is the first day in Lafayette parish, so when reading this you’re already behind!  First things first- get your children into their doctor.  They’ll need physicals for school and sports, and maybe vaccines.  Some need medications for school, like asthma inhalers or ADHD meds.  Many kids must have these things, so appointments are tight.  Make that call now!  Some walk-in clinics provide some of these services, but NOT the Emergency Department.

Your child may also need a new backpack.  If so, this isn’t something to skimp on.  Though the jury’s out on whether they contribute to kids’ back pain, you’ll want a comfortable one.  It should have wide, padded shoulders, and a waist strap.  The waist strap is very important, because weight is best carried on the hips, not the shoulders.  Whatever the current school fashion, heavily-loaded kids should have both shoulder straps on, and the waist strap buckled and cinched.

As the 8th approaches, it’s also time to get children back on a school sleep schedule.  Start walking those bedtimes back from midnight to something more appropriate- 8 or 9 pm for elementary kids (at the very latest!), 10 pm for teens.  They also need to start waking up sooner.  A week before school starts, wake them at 10 am instead of noon, then 9, then 8, and so on.  Bedtime also means phones and other screens off!  Leave enough time for breakfast before school. Kids don’t learn or behave well on an empty stomach!  Finally, you should always be reading books with your young children at bedtime.  They learn to read, acquire more words, have family time, and wind down for sleep.

Besides the physical preparations for school we discussed above, you’ll want to prepare your child psychologically too.  Kids are nervous- is my new teacher nice?  Can I handle the workload?  Who’ll be in my class?  Some kids are also terrified of being bullied.  Worse than hard homework or frowning teachers, is the prospect of public humiliation and violence.  No wonder some kids stay home with “stomachaches.”

Bullying takes a toll.  Many ruminate on their victimization for years after.  A significant percentage of school shooters were loners, outcasts from school cliques, picked on for being different.  Prepare your child to not be victimized. Shy kids need to rehearse what they’ll say and do if bullied, so that they confidently deflect attempts at humiliation; practice where to go, where not to go, which friends and school personnel will help.

Besides victims, bullying also requires bullies, and passive bystanders.  Don’t let your kid be either one!  Teach them that bullies are the bad guys.  Before school, be clear that there’s firm consequences if they bully- grounding, detention, phones and video games revoked.  Don’t threaten them with violence, since this begats violence in them.  Also talk about how bystanders who intervene on behalf of victims are the brave ones,the good guys. Encourage them to sway crowds to protect victims- there’s safety in numbers for victims and bystanders.

Fortunately, most kids only have the usual nerves- new teachers, new classes, new classmates.  The best preparation for this- meet your teacher!  Jane Anderson Lemoine, our schoolteacher from above, tells of a kid who went a whole week going to two social studies classes, wandering from one to the other, hearing the same lesson twice.  When she discovered this, he hadn’t said anything to anyone about it, and the parents were clueless. If only someone had double-checked his schedule.

Meet the teachers, so you become allies in your child’s school experience.  It’s better to get to know each other in the beginning, instead of later when you’re irate about bad grades or conduct notices.  Know how they communicate, with students and parents.  Email, text, school website, phone?  If your kid takes the bus, meet the driver too.  The driver is a VIP, taking your child through traffic, twice daily, for all year!

Teach Your Kids To Wash Their Hands! Now!

In the past weeks the news has reported on stomach virus epidemics in several states.  More than the usual amount of kids and adults have had vomiting, diarrhea, and fever.  Though Louisiana wasn’t listed, we in the pediatrics business in Lafayette have been seeing more of these viruses too.

Now with school starting, we will see even more vomiting and diarrhea in kids and their families.  Why is that?  First, stomach viruses are most often caught from other people.  People who already have the virus and are vomiting and having diarrhea, get the virus on their hands and in their saliva.  When they touch others, or others drink after them or kiss them, the virus gets into the next person’s body.  Viruses can be left by the contaminated person on surfaces like door knobs, kitchen counters, and faucet handles.  When someone touches the contaminated surface they pick up the virus.  Then they touch their face or lick a finger, and the virus gets inside and sets up shop.

Now you can see why hand washing is so important.  Soap and water are great at washing viruses off your hands to keep you from picking up and ingesting viruses, and to keep you from passing a virus you might have to others.  And touching your face?  It turns out that the average person touches their face about 300 times per day, usually unknowingly.  So keep those hands clean so they don’t bring viruses to your face and your body’s “intake” (mouth and nose).

If you want to see a great blockbuster movie about virus spreading, watch Contagion, starring Matt Damon, Laurence Fishburne, Gwyneth Paltrow, Jude Law, and Kate Winslet.  It is a thriller about a new influenza virus that spreads around the world causing widespread panic and death.  The possibilities in the movie are all too real.  And throughout the movie I saw many instances where I said to myself, “If only that character had washed her hands.  Then she wouldn’t have died.”

But what exactly is a virus?  What are these things that cause so many illnesses like vomiting and diarrhea, or colds, or fevers?  Simply put, a virus is a microscopic particle that acts like a tiny robot.  It is a crystal-shaped chemical machine that injects its own DNA into a person’s own cells.  The viruses’ DNA takes control of a cell and turns the cell into a virus-making factory.  The cell eventually swells with so many viruses inside and then bursts, spewing those cells to swirl around the microscopic environment of your body.  That next generation of viruses takes over more cells.

Fortunately, we have an immune system.  Over a matter of days the immune system recognizes the viral invasion and counter-attacks.  It cleans up the virus and the body’s healing ability repairs the damage by replacing the destroyed cells with new ones.  The body also gets rid of viruses by ejecting them from the body- through sneezing, coughing, vomiting, and diarrhea.  This is good for our bodies but bad for those around us.  Others pick up those viruses with their hands and mouths as we talked about above, and get sick too.

One of the great inventions of the 1800s was the idea of hand-washing and public health.  Before then, one of every five infants died of an infection before they reached 12 months of age.  Children and adults died much more often of infections too.  Armies, with their troops crammed together in camps, lost many more men from disease than from battles.

Then science discovered that “cleanliness is next to godliness.”  Clean hands became popular.  Cities and army camps started providing clean water and sewage management.  Death rates from infection dropped dramatically.  Many more lives have been saved by hand washing and city sewer pipes than by antibiotics or vaccines.  What better disease prevention could there be than moving massive amounts of germs away from where people live, eat, and drink?

The lessons are clear- wash your hands!  Teach your kids before school starts to wash theirs.  Wash them after blowing the nose, touching others, using the bathroom, or touching a possibly dirty surface.  Show your kids how to keep safe, from Contagion!


Back To School, Not The ER

My kids and yours are heading back to school in the next few weeks. They’re going to get new teachers, new class mates, new books. They are also going to get some new germs too, if they are not careful.

We in the pediatrics game are bracing for the onslaught of sick kids that happens every year after the kids have been in school for a while. Kids share the latest germs by wiping their noses and then touching their classmates, coughing and sneezing on each other, and little ones sticking their fingers in each others’ mouths. Older kids share drinks, and of course teenagers kiss (gasp!).

How do we protect our kids from the contagious-disease-factory known as school? First, we need to remind them about good hygiene- hand washing, not sharing drinks, covering mouths when coughing and sneezing. Second, we need to take them to the doctor if they need vaccines or refills on preventative medicines, such as those for asthma kids. Third, if there are no sinks handy for handwashing at school, think about equipping your kids with a bottle of hand sanitizer. DO THESE THINGS NOW! WRITE YOURSELF A REMINDER NOW!

Finally, one of the best preventions for illness is a healthy diet. Vitamin pills just don’t cut it near as well as good food. No fast food. No junk foods or soda in the house. A fruit with every meal. High fiber breads and cereals. Milk or yogurt two to three times daily. Veggies with lunch and dinner.

Please make life easier for me and my overworked colleagues- follow this advice. And if your child does get sick, be sure to use the emergency departments only for EMERGENCIES. Long wait times in emergency rooms are caused by too many people clogging the system with minor illnesses like coughs, runny noses, fevers, sore throats, ear aches, and rashes. So use your family doctor and the ER wisely. And wash those hands!