My Big Fat Cajun Wedding

On December 8, 1990, I got married. It was my first trip to Louisiana, and my staid protestant family met my new loud, fun catholic in-laws. Like the movie My Big Fat Greek Wedding, my stiff northeasterners got swallowed up in merry-making, and had a blast. First, the rehearsal dinner speeches started with the restauranteur welcoming everyone with a dirty joke. Wary looks were exchanged, but fortunately none of my family understood his thick Cajun accent (enhanced by a few drinks). Except it had something to do with ducks and condoms.

For our 30th Anniversary this month, there’s no Big Fat Events. COVID in Acadiana’s hospitals is up to apocalyptic volumes, added to our usual winter big numbers of patients. This new bump started with pre-Thanksgiving gatherings. For example, some parents rented party buses for Homecomings, finding the distancing, outdoor events planned by schools too nerdy. Those unmasked teens spread the virus to each other, then on to their families. Then Thanksgiving happened, and it’s a bump on top of a bump.

Fortunately for children, they aren’t getting as sick as adults with Coronavirus. There’s some coughing and fever, maybe a headache, and recovery in a few days. Many fewer children get as gravely ill as adults do.  Unfortunately, Emergency Departments, Intensive Care Units, regular beds, and even ambulances are clogged by the sheer numbers of very sick, even dying, grown-ups.

It doesn’t seem to be the schools’ fault. They’ve been careful with their protocols,  enforcing mask-wearing and distancing. It’s parents not following the basic containment rules: teaching kids to wash hands and wear masks properly (cover BOTH nose and mouth). Their violation of distancing rules in allowing, even arranging, spreader events, has been responsible for the current calamity. Maybe enough of them and their elderly parents have gotten sick now, that we’ve all learned our lesson.

So please, from all of us working at hospitals, please plan a Quiet Christmas: no parties, no big family events. Just you and your kids at home opening presents, virtual church, and grandparents at a distance, preferably on facetime. Thus we can have as merry a Christmas as possible.

Another event during my Big Fat Cajun Wedding 30 years ago was the Thursday Gumbo. My family of stiff protestant Northeasters wondered, what’s “A Gumbo?” A gathering? Brown soup? But they were swept up in the milling, laughter, and noisy chatter, and even calling for seconds on the brown soup. I get misty-eyed watching the video; so many of our parents and family have passed on.

Also when I watch that video, I first wonder “Why is everyone so close together?” Then I remember: oh, that was life before COVID. Hopefully, no one’s planning any Big Fat Events for this Christmas. Too many friends and family have been in the hospital, in ICU, or died, to risk making more Christmas tragedies.

As mentioned above, Coronavirus cases have ramped up since October, with too many kids and adults having big risky gatherings. Acadiana’s hospitals are clogged with cases, adding to the usual winter high volume. Being careful, not succumbing to “COVID fatigue”, is key to survival. It’s a sneaky virus, being so contagious and spreading through asymptomatic kids and adults. We’ve got to cinch up on the mask-wearing, distancing, and hand-washing; to get through the next few months as the vaccine rolls out. Fortunately for us in Louisiana, we get to go back outdoors in February or March. My unlucky Northern family will still be shoveling snow.

As for vaccine safety, I’m not worried; I’ll happily start mine in the next few weeks!  The vaccines have been carefully studied and well-scrutinized. Mythbuster: there’s no microchips in the injection. Nanotechnology is amazing, but just isn’t there yet, so don’t worry that Government will track you through the vaccine. Like they want to watch me anyway: “Hey, look, Scott’s driving to work. Now he’s napping. Wow, he’s mowing the lawn.” If they really wanted such information, it’s much cheaper and doable to spy on us through our phones.

So again, plan a Quiet Christmas. Fewer people, no parties, fewer presents. Just you and your kids at home, and visit other family on-line. That way next Christmas can be a happier one, with no melancholy watching of this year’s videos.

Island of Misfit Toys

This week’s guest columnist is Dr. Matthew Morgan, a Family Practice resident at the University Hospital and Clinics here in Lafayette.

I have fond memories of Sunday dinner at my grandfather’s.  We followed the same routine: mom brought the potato salad, grandmother made fried chicken, grandfather made the coffee.  And we’d play games: dad liked horseshoes, my brother… lawn darts.  Remember lawn darts?  They were comically-enlarged versions of traditional darts with a weighted end, to be tossed in the air at a target on the grass.  You may not remember them because of the Consumer Product Safety Commission, a government agency that banned them after several children were injured, some critically.

Many toys have been removed from the market over the years.  Some people think “they’re taking childhoods away from us!” Perhaps, but lawn darts had a proven record of hazards, and some toys prior to the Safety Commission’s founding were just flat-out ridiculous.  Look up the Gilbert Atomic Energy Lab, a toy marketed in 1950 by Alfred Gilbert (inventor of the more popular, and safe, Erector Set).  This set contained actual uranium ore which, besides producing cool effects, brought low levels of radiation into the household, and could cause radiation burns if handled improperly.  One play suggestion: secret the ore somewhere in the house, and play hide-and-seek with the included geiger counter.

Another obvious benefit of this agency was the removal from the market of Aqua Dots, an arts-and-crafts toy with beads manufactured in China.  After several toddlers were hospitalized with comas after ingesting the beads, they found that their chemical coating contained GHB. Popularly known as the “date rape” drug, GHB is particularly toxic to children.

A more routine responsibility of the agency is assigning age ranges for toys.  There’s a common misconception that the age suggestions are based on intellect or maturity level.  Thus parents buy the toy or game for their child who’s younger than the age range, thinking that their kid is advanced enough to enjoy it.  However, the age range is actually for safety’s sake, particulary for kids under age 3.  It’s decided by rigorous testing to assess the choking risk of small parts.

I recall when my brothers and I got our go-kart.  Back then, a go-kart was a glorified piece of sheet metal with wheels bolted on each corner, one of which attached to a small motor.  I vaguely remember a steering mechanism, but we ran into trees and dirt piles so much I can’t be certain.  It’s easy to remember the safety features though, because there were none.  Of course our parents didn’t make us wear helmets either.  I carry a reminder of that go-kart on my right elbow, a shiny white scar from when I jumped off while riding on the back, one thing mom did specifically warn us not to do.

Things have changed since then.  Go-karts and other motorized toys have become more complex.  While there’s been some focus on safety, they’ve also gotten more powerful, with new and different dangers.  With advancement in battery technology, there’s even electric dirt bikes for kids, though their size and speed don’t necessarily correlate with age-appropriateness.

Like we discussed above, the Consumer Product Safety Commission sets age levels for toys and games.  Though they base these assessments on proven algorithms, the science is still evolving concerning motorized riding toys.  For example, many of these are intended for use on dirt roads and isolated driveways.  They are unsafe on paved streets, particularly top-heavy and overpowered ATVs.  Another consideration is use of these toys by children with Attention Deficit Hyperactivity Disorder.  These kids have  decreased attentiveness and a penchant for risk-taking, so it’s important to keep in mind your child’s potential for accidents.  And bad injuries happen with these toys to any child, ADHD or not.

Parents can limit the use of these devices, ensure safety measures, and purchase them with their child’s capabilities in mind.  Helmets, elbow, knee, and wrist pads, and boots are helpful.  Designate safe areas for play, keeping kids off roads where they’re hard for cars to see and avoid.  Set use hours with the best visibility, for kids to see hazards and the hazards (cars) to see them.  Be there when your kids are riding or using potentially dangerous items.  We see castastrophes all the time in the Pediatric ER; don’t let your child be one of them.


Merry Christmas/Happy New Year!

This week’s guest columnist is Dr. April Weliever, a Family Practice resident at the University Hospital and Clinics here in Lafayette.

In the past weeks Dr. Hamilton reviewed Christmas safety issues.  Christmas must be pretty dangerous, because there’s more to talk about this week!  Dr. Hamilton talked about choking hazards with toddlers putting things in their mouths, and last year he saw a toddler who put a Christmas tree light bulb in his mouth and chewed it up!  Fortunately the baby didn’t get cuts in his mouth or swallow any glass.  But toddlers like to explore with their mouths, and bulbs look pretty tasty, all smooth and brightly colored.

Christmas also comes with fire hazards.  Natural trees look and smell great, but if the needles become dry, a spark can start it aflame.  Add hot lights, an overloaded power socket, and your risk increases.  If you get a natural tree, stand it with the trunk sitting in water, and keep that water replenished.  Your tree will suck the water up and need more, to stay hydrated and fire-resistant.  Keep space heaters and other hot sources (time to upgrade to LED bulbs?) away.  In the old days, people used to put lit candles on their trees, and not surprisingly, fire departments had busy Christmases.  Don’t try this at home!

Fireplaces are another hazard.  In many homes they’re dormant until the family wants a Christmas eve fire in the grate.  If you light a fire, have your chimney inspected beforehand by a chimney sweep.  Birds can nest there, old soot can build up, and these can either catch fire in the chimney or block the flue, filling your house with smoke. Also have a fire screen, so that sparks and flaming logs don’t roll out and set carpets, presents, or trees alight.

Last Christmas tip, and it’s those pesky toddlers again!  Keep holly, mistletoe, and poinsettas out of reach.  Kids rarely eat enough of these to get poisoned, but don’t chance it!  If your child does ingest something potentially toxic, call Poison Control (1-800-222-1222) to see if he needs to get seen.  Don’t leave alcoholic drinks lying around either- toddlers love to imitate their parents, but you don’t want them emulating you that way!

So if you’ve gotten safely through Christmas with no conflagrations or toddler poisonings like we discussed above, now it’s time to talk about New Year’s.  New Year’s is traditionally a time for reflecting on the year past and planning for the year ahead.  It’s also a time of year for family and friends to get together, drink a lot, and then attempt to blow some fingers off with fireworks.

Seriously though, many celebrations will include fireworks displays in the community, and also in many backyards.  Though fireworks are lots of fun, festivities can get out of hand, and every New Year’s we see several kids with burns and blast injuries.  According to the National Fire Protection Association, Emergency Departments treated nearly 12,000 individuals for firework-related injuries in 2015 alone.  Over 3000 of those were kids.

Drinking and fireworks make a bad combination.  Have a “designated shooter” who is not drinking, to handle the fireworks and matches or lighters, so that safe decisions are made, and kids are well watched.  Light only one firework at a time, and have a bucket of water or ready garden hose to put out flames.  Never try to re-light duds, or light broken fuses.  Stick those guys in a bucket of water and forget about them!  Avoid buying fireworks packaged in plain brown paper.  These can be commercial-grade fireworks, and maybe too hazardous for backyard use.  Nothing spoils New Year’s like a house fire.

Sparklers are another child hazard.  They seem safe enough, but the hot tip actually gets to 1200 degrees, hot enough to melt glass!  And when they throw sparks, little kids’ arms are too short to keep them far enough away, and can get a spark in the eye.

New Year’s time is terrific for kids to zip around on the cool toys they got for Christmas- bikes, scooters, skateboards and ripsticks, dirt bikes and ATVs.  Make sure Santa also brought the helmets!  And for those skates, skateboards, and ripsticks: wrist guards.  Don’t start the New Year with a broken wrist- it hurts a lot, and puts the toys back in storage until the cast comes off. 

Christmas Out Of Control

When I was growing up, my Christmases were chronically overbooked.  Mom was a violin teacher, and since I played too, I got roped into every pageant, every church program mom could sign us up for.  It paid some bills for our family, but it wasn’t exactly peace on earth, barreling through the snowy county to the next gig.

My wife has her own version of holiday spiraling-out-of-control.  Early in December she starts buying gifts for our three kids, determined to hold the presents to a sane amount.  Then about two weeks before the big day, she realizes the crucial gift ratios are off: one kid getting 3 presents, the other 5, the other 7.  So more agonizing about how big the piles will look on Christmas morning, more spending.

When you make Christmas crazy, not only does it stress you, but it stresses your kids.  When kids get stressed, they get sick.  Then they come see us in the Emergency Department.  For our sake, for your sake, and for your kids’, here’s some tips for keeping a lid on things.

First, kids don’t care about Christmas volume.  Few children worry that their house is more decked out than the Griswold’s, or that their stack of presents exceeds the GDP of Botswana.  Kids typically want only a few presents, but they care that they are the right ones!  They know what they want, will let you know, and then you need to shop early, before things sell out.  Now’s the time (as you’re reading this!) to get their Christmas lists and get the shopping done.  Then later, if you need to even out the piles, you can get the “secondary” presents (clothes, socks,etc)

Also, more pageants, more shows, more activities won’t amp up your childrens’ Christmas spirit.  Too much running around can exhaust them, make them grumpy, and make them prone to getting sick.  Kids would rather spend time alone with their parents, than in crowds.  Good family holiday activities are things like hikes, kayaking, playing games together, cooking together, watching movies at home.  These are where kids’ favorite holiday memories are made, not at the Christmas Spectacular for $50 per ticket.

Here’s a not-so-heart-warming Christmas story.  Last week we saw a baby with a month of coughing, occasional vomiting, but otherwise looked well.  My colleague seeing the child decided to do a chest x-ray, given the long-standing cough, to be sure he wasn’t developing a pneumonia.  While the x-ray showed no pneumonia, it did show the quarter lodged in baby’s esophagus!

Occasionally babies and toddlers will grab an object when no one’s looking.  Since their mouths are their most sensitive parts, they’ll put new things in there to explore them.  And occasionally swallow the object.  Kids swallowing “foreign bodies,” as we call them, is especially a concern at Christmas.  More toys strewn about, ornaments on trees, spare tree bulbs, are temptations toddlers can’t resist.

As we discussed above, keeping Christmas low-key and simple helps decrease holiday stress for you and your kids.  It also decreases the amount of foreign bodies they can ingest.  However, you will want to decorate some, so it’s a time to be extra vigilant.  Small ornaments that baby can fit in his mouth should be high on the tree, out of reach.  After decorating the tree, put all the boxes away and crawl around the area yourself, like a toddler, searching for anything she may be able to reach and eat.

Buy only age-appropriate toys. Toys will have an age category on the box, so you know if there’s lots of pieces that could be ingested.  Keep the little ones away from the older one’s toys with small parts. Be especially careful to not leave out any magnets, button or disc batteries, or balloons- these can be deadly.

Finally, as always, it’s better to give than to receive.  Studies have shown that people are happier the more they give, and not just presents.  One really good giving idea this holiday is to donate blood.  There’s always a shortage of blood in December, as people are so busy they feel they don’t have time to give.  But we always need blood, for premature babies, for heart surgeries, for accident victims, and more.  Making time to give blood will bring you a whole lot more holiday cheer than spending that time looking for parking at the mall.

‘Twas The Night Before Christmas- AAUGH!

According to the American Academy of Pediatrics, Christmas is only slightly safer for kids than riding bikes no hands, eyes closed, on the roof.  The AAP website has a three page list on avoiding flaming disaster in the living room.  To be fair, their are some extra hazards in the season.  However, my experience in Pediatric Emergency is less about Ralphie shooting out his eye with a Red Rider B.B. Gun, and more about toddlers chewing Christmas tree light bulbs.

Toddlers love putting brightly colored, shiny objects in their mouths.  Decorative light bulbs have thin glass, easily cracked when bitten. Fortunately, the curious kids get only a few minor cuts in their mouths and quickly heal. Occasionally we see more traumatic ingestions when toddlers get a tiny bit of Christmas lodged in their airway or esophagus and need surgery for removal.

No matter how well your house is toddler-proofed, with cabinets locked and choking hazards swept away, Christmas undoes all that.  It’s impossible to police boxes of decorations, toys with tiny pieces, things hanging off Christmas tree branches. Thus one more holiday stress: having to watch your cruising babies extra carefully with all that stuff around.  Best advice: keep decoration ambitions small and manageable.

The next realistic Christmas safety worry is kids and dogs.  Kids and dogs interact more during the holidays, either with new dogs as presents, or visiting friends and relatives with dogs.  Trouble starts when kids want to meet the pooch, poochie gets nervous about approaching strangers, and bites them in the face. Best advice: don’t get a new dog until your children are 5 years-old, when they can learn to treat animals safely. Closely supervise interactions between your child and others’ pets.

Fires are another seasonal worry.  The Christmas tree tradition started in Germany, with candles on them for illumination.  My dad lived there in the 1950s and told of proud Germans who eschewed electric bulbs for old-fashioned candles, and the busy Fire Brigades racing from one tragic house fire to another.  Even with electric bulbs, trees fires are possible. Trees dry out easily, are covered with flammable ornaments, kindled with paper wrapped gifts, and stand next to overloaded power sockets.  Keep tree water filled, and unplug lights overnight.

Besides physical risks for kids at Christmas, the season is emotionally stressful. Parents get overwhelmed, and kids too.  We’re looking for Peace On Earth and Good Will among men, yet find ourselves cutting each other off for parking spaces at the mall.

One source of stress is that during Christmas we are supposed to be happy, and are disappointed when the season isn’t any happier than usual.  The disappointment is even more acute when we become less happy due to seasonal hassles.

The list of things that drag on us at Christmas continues: overeating, driving through traffic to shop in mad crowds, dragging decorations out, extra cooking.  And while visiting family is usually a good time, you also visit some you don’t like (you moved so far away for a reason).

Kids get stressed too. They overeat, and eat too many things that cause stomach-aches. They stay up too late, and are exhausted the next day.  They get sick- it’s the cold and flu season after all.  And parents aren’t paying them enough attention because we’re too busy on a regular day, and adding a Christmas list makes that worse.

Besides the safety cautions from above, you need a strategy to minimize holiday hassles for you and your kids.  Most importantly, keep it small.  When it comes to decorations and shopping, small and tasteful beats big and garish.  Make small amounts of special Christmas food and involve the kids when you do, so cooking becomes more of a positive for you both.

Second most important: keep the kids’ routine.  Make bedtimes and meal times pretty normal.  If things get chaotic, kids get more stressed.  Again, make sure your kids are mostly eating a regular healhy diet.  And like we say in almost every column in this series, everyone’s should wash hands- that’s the best prevention for illness.

Humorist Dave Barry wrote: “No matter how hectic it gets, you need to remember what the holidays are all about…exactly how much can you charge on your credit cards before going to jail?”  Don’t be that Christmas parent; keeping it simpler equals Peace On Earth.