Screamin’ Down The Road- Part III

In previous installments of Traveling With Children, I’ve discussed avoiding disasters  like plane crashes or hotel fires.  Traveling With Children now has a new dimension: avoiding getting COVID on road trip potty stops.  Yesterday our cousins with three little girls sent us pictures of their driving supplies while they head out west.  They included a five-gallon bucket with a toilet seat, filled with kitty litter. The picture’s caption: “This helped us avoid at least 24 interactions in public spaces.”

When little kids use the potty, they touch everything: the toilet seat, the walls, you, their own mouths. Gas station bathrooms are nightmares keeping track of their hands and staying sanitary. Now add the risk of breathing in COVID-laden aerosol from fellow travelers. The Centers for Disease Control (CDC) recommends not traveling at all during the pandemic. Traveling means increased interactions with other people, at gas stations, restaurants, and the vacation destination itself.

However, many are craving their summer vacation and like our cousins above, heading out. The great outdoors is a popular destination this summer.  Open air seems to greatly decrease your risk of breathing in someone else’s Coronavirus, as opposed to being indoors and breathing other people’s recirculated air. Hiking is good exercise, and a welcome change of scenery from your home’s yard and four walls. And being outdoors lets you avoid crowds.

I find giving advice about vacationing is like giving advice to ATV riders.  People put kids on ATVs no matter what I say, so likewise here’s how to minimize your risk if you must go on vacation. First, don’t travel to COVID hot spots, like California or Florida, where your odds of catching it are increased. Second, minimize interactions enroute to your destination.  This means not eating inside restaurants. Using drive-thrus is safer, but three drive-thru visits per day still increases your interactions with potentially infectious strangers.  Best to pack your own food, which is also less expensive and can be healthier.

As far as that potty stop, good luck!  One friend mentions that she and her kids will go “over the side of the road,” but her kids are teenagers.  With three little girls, our cousins went with the home-made port-o-potty.  Maybe just stay home?

While many are hitting the road for summer vacation, those lucky enough to have boats are hitting the water. NPR recently reported on boaters in Washington State sneaking across Canada’s closed borders to visit. Locals at one coastal town complained about an American yacht with teens and adults “wandering the dock…no social distancing, no masks, and went through the store as if…shopping at Walmart.”  To avoid detection, US boaters switch off their transponders, which are required by international law to avoid collisions, particularly at night or in fog. With so many American boats “going dark” when they cross the border, the Canadians know they’re not all sinking.

For places that rely on tourist dollars, allowing vacationers in is a two-edged sword.  While their livelihoods depend on visitors’ lodging and eating, those visitors also bring disease. Canada decided that American dollars aren’t worth the risk of more Coronavirus.  Our National Park system decided the opposite.

The citizens of Jackson Hole, Wyoming, were expecting a quieter-than-usual summer, with the warnings against traveling. Jackson Hole is near Yellowstone and Grand Tetons National Parks, and has the region’s airport.  Instead, Jackson Hole is experiencing even more visitors than previous years, particularly at campgrounds and RV parks. People figure that camping and wilderness vacations are “safe-cations,” where they can breathe free of COVID-laden crowds. I’m sure the staff of the town’s only hospital, St. Johns Health, have eyes bugging out like deer in the headlights.

As we discussed above, the CDC recommends not traveling during the Pandemic, since this increases your odds of catching the virus.  Even the great outdoors’s wide-open spaces, with record visitors, is now less wide open.  If you must vacation, staying away from National Parks, sadly, is a smart move. Also stay away from any COVID hot spots like California or Florida.  Avoid crowds, where even outdoor air may not dilute all the aerosolized virus that’s exhaled.

Again like above, if you’re driving, minimize stops for gas, food, and the bathroom.  Sanitize your hands after using gas pumps, and wear those masks.  While flying is much safer than driving as far as avoiding crashes, personal interactions in the airport or airplane may increase your risk of catching Coronavirus. Maybe stay home, or at least stay south of Canada.

Screamin’ Down The Road- Part II

In 2014, I wrote about traveling with kids.  I had just read a book about disasters, and piled on stories of surviving plane crashes and hotel fires. Friends gave me more practical advice for this summer . Jane Anderson Lemoine of Lafayette told about while at Disney, her 3 year-old son was constipated.  One morning she gave him a laxative before heading out.  “Within an hour it started to take effect….in front of the Swiss Family Robinson tree house he’s pulling down his pants, in the middle of the Magic Kingdom, because when you gotta go, you gotta go.  I’ve never seen my husband run so fast…”

The moral of the story: prepare for bodily function disasters.  Pack medications, like for pain or fever, some bandaids and ointment- you decide on the laxative.  I’ve looked for pharmacies at night in unfamiliar cities- it’s no fun.

Besides meds, pack extra clothes for your kids, and you.  Jane always packed more for her kids, anticipating spills and vomit.  However, she didn’t pack for when her son barfed on her at the beginning of a plane flight.  While he had fresh clothes at hand, she wore his vomit for 5 hours, even down her back and into her pants.  Extra grocery bags to store those soiled clothes is a good idea too.

Speaking of airliners: tray tables, armrests, seatbelt buckles, and airvents are all touched by multiple people, and don’t get regularly cleaned between flights.  They can harbor more bacteria and viruses than the flush button in the airliner’s toilets- and at one toilet per 50 passengers, that’s saying something!  So pack disinfectant wipes and and hand sanitizer, and clean those surfaces as you settle in.  You and your kids don’t want more bodily explosions when you get to your destination.

Kids can be embarrassing on the road, especially sitting close to strangers in restaurants and airliners.  Jane’s son loved to chat up those around him.  Loudly.  At first she and her husband were mortified, until they realized that most strangers love kids, no matter how deafening.  Kids can be fun for other folks, distracting them from their own traveling woes.

Tina Kelley of Maplewood, New Jersey, wrote me about camping vacations.  Once she put her baby in the car for the night, in case of bears.  That didn’t stop a park ranger from yelling at her, though the evening was cool.  He’d probably seen too many kids left cooking in cars during the day.  Her story reminds us of traveling safety, though car crashes are way more likely than grizzly attacks.

Make sure everyone, even the backseat passengers, are buckled in carseats or seatbelts.  Identify your exits in planes and hotels, before you need them.  If you go to a waterpark, don’t drink the water!  Keep mouths closed and hands clean, and shower off before and after a visit.  Think about all those other bodies, and diapers, you’re sharing the water with.

Besides safety, plan entertainment for your kids.  Sure, phones and tablets are distracting, but there’s healthier options for childrens’ brains.  Books on tape work great, for parents and kids.  When mine were young, we listened to Harry Potter books on long drives.  Everyone was so enthralled that even after an 11 hour drive, we’d sit in the car, in the driveway, until the chapter finished. 

Books, board games, and coloring are fun too.  Save the screens for when kids are tired of those things.  Jane Anderson Lemoine, from above, only allowed screen time at night, after the non-electronic distractions.  This was a treat for her kids, since screens were limited at home.  

There’s generally two kinds of vacations.  One’s the relaxing trip, where otherwise busy parents get to lay on the beach or by the pool.  Then there’s Disney- dashing about miles of tarmac in the heat to get ahead in line, followed by standing in those lines.  Then a brief rest on the ride before heading back into the rush.

Often your kids will have opposite needs of yours.  If you want to relax, they’ll want to be busy. The things that work in car rides also work then- books, board games, saving screens for later.  If it’s a Disney-Death-March vacation, you’ll ALL need a rest.  Plan downtime in your schedule- an afternoon of napping and poolside rest in the middle of the park frenzy.  Have fun! 

When Vacation Follows You Home

This week’s guest columnists are Drs. Michael Johnson and Sam Defigarelli, Family Practice residents at the University Hospital and Clinics here in Lafayette.

The family returns from a cruise ship holiday in the Caribbean.  Everyone, including 10 year-old Gavin, had a blast.  He loved snorkeling, going down the waterslide on the ship, and even the exotic food at ports-of-call.  But even before the bags are unpacked at home, he says “Uh-Oh!” and runs to the bathroom, just in time for the watery explosion from below.

Traveler’s Diarrhea is a condition that develops soon after returning from trips to resource-limited countries.  Gavin has three potential whammies in his scenario.  These countries often don’t have sewage treatment, and snorkeling is a potential contact with contaminated run-off.  Cruise ships and water-parks are known risks for catching diarrhea.  And improperly prepared food could make him sick as well.

The biggest concern with diarrhea is dehydration.  Most only have a day or two of loose stools, but some also have nausea, vomiting, cramps, fever, or bloody stools.  When there’s lots of vomiting and diarrhea and worries about dehydration, kids should get seen.

Most kids only need home treatment- plenty of clear fluids like pedialyte for infants, sports drinks or dilute juices for older kids.  Avoid full strength fruit juices- these can worsen diarrhea.  For copious diarrhea, rehydration solution packets are available at pharmacies, to mix with clean water.  If kids aren’t having cramps, nausea, or vomiting, they can eat and have milk.  Bland starchy foods are best- fast food and other heavy greasy food can prolong symptoms.  We say ”feed through diarrhea;” don’t restrict food if they’re hungry!  The sooner they eat, the sooner their guts get back in balance.

You’ll want to control the spread of infection to you and your family, so that you aren’t cleaning up after multiple kids and feeling rotten yourself- a total nightmare!  Wash your hands frequently with soap and water- better than hand sanitizers.  Make sure kids aren’t touching or drinking after each other.

Prevention while traveling is even better.  Only drink from unopened bottles.  Avoid ice- it could be made with contaminated water.  Eat food served hot, and avoid salads (ingredients washed how?).  And parents, alcohol won’t reliably sterilize water or ice, so avoid having your cold one on the rocks.

Here is a different scenario than above. It’s June, the annual family reunion picnic, with all the aunts, uncles, and cousins . The grills are going and the sides have been put out: coleslaw, potato salad, macaroni salad.  There is a lot going on: pick-up football, pets running about, tables knocked over, umbrellas and chairs being set up, conversations all around.  The hamburgers are late getting on the grill and the sides have sat in the sun.  Everyone’s hungry so the burgers are a little under-done, but so what?

Any dangerous situations in this story?  It’ not the football- it’s the mayonnaise-based sides warming in the sun, incubating bacteria like Staphylococcus.  And undercooked hamburger can contain E. coli, a potentially disastrous infection.

Food poisoning is all too common in children.  Usually it’s just some diarrhea for a day or two and maybe some vomiting if your unlucky.  However, food poisoning with certain bacteria can have worse consequences.  Staphylococcus (a.k.a.”Staph”) often has a quick onset, within hours of ingestion, and can lead to dehydration and fatigue, especially in younger children.  There are many strains of E. coli too, the worst of which can lead to Hemolytic Uremic Syndrome, a deadly disease involving kidney failure and coma.

Treatment of these bacteria infections isn’t just giving antibiotics.  In fact, sometimes antibiotics can make the symptoms worse.  There’s no treatment besides fluids and rest, and for the really sick kids, hospitalization.  So better to prevent infections than have them!

Safe food handling is paramount.  Always cook meat thoroughly, particularly ground meat.  Be careful of your meat source- meat from a single farm, ground in the store, is much safer than meat from multiple feed lots, pre-ground and packaged when it gets to the store.  Never leave mayonnaise-containing food unrefrigerated for more than one hour.  Be sure to wash vegetables and fruits thoroughly- they might be from fields fertilized with manure that contains E. coli.

So be careful when you travel, and when you cook at home.  An ounce of prevention is worth several pounds of diarrhea, when vacation follows you home!



Screamin’ Down The Road- Traveling With Children

On January 13, 1982, Air Florida Flight 90 crashed into the icy Potomac River in Washington during take-off.  Joe Stiley, one of the few survivors, saw the crash coming, seeing out his window how the plane was falling to the river.  He tucked into the “brace” position and told his secretary sitting next to him to do the same.  The plane crashed into a bridge and then into the Potomac.  Joe blacked out and awoke with the cabin full of water. He methodically unbuckled his seat belt, undid his secretary’s, and they swam to the exit and to the surface.  Joe was one of the few people who bothered to read the safety card every time he flew, note his nearest exit, and count how many seat rows to that exit.

In disasters like these, surviving comes down to following safety instructions to the letter, immediately.  When you are flying, read that safety card every time.  Look up and find where your exits are.  Read how to open the emergency doors.  If the oxygen masks come down, put yours on first so you don’t black out before you can get your child’s on. Leave your luggage behind- trying to take it with you slows down everyone else’s exit.

However, don’t be put off from air travel.  My family and I love to fly and it is as safe as sitting in your bedroom.  Disasters like above are very rare.  In fact, the most dangerous part of any flying trip is the car ride to the airport.  Most of us drive more when traveling with our families and cars are much, much more dangerous than airliners.

So wear those seatbelts and buckle your kids into car seats properly.  Check your tires before long car trips.  And here are a few tips to keep your kids happier so they don’t distract from your driving.  Let them drink only water.  If kids drink soda or juice, they will have to take more bathroom stops.  With water, they only drink if they are truly thirsty. Have snacks and entertainment for them- DVDs, games, books.  On long drives my family loves books on tape.  We so enjoyed Harry Potter that even after an 8 hour car ride, we would sit in the driveway at home just to hear the end of a chapter.

Hotels are another safety and comfort consideration.  At 5am one morning in a hotel in Mobile, the fire alarm went off.  Being well trained by their Emergency Dad, my family popped immediately out of bed and headed for the exit.  In fact Mr. Prepared was the last out, having a little trouble getting my shoes on.  We were all the way down the stairs before all-clear was called.  On our way back up, we were surprised how few other guests had even peaked out to see what was going on.  In a real fire, I sure like my family’s chances better than theirs.

In her book The Unthinkable, Amanda Ripley shows how people survive disasters.  In airplanes it means following your safety card like Joe Stiley above.  In hotels it means practicing finding your exit, crawling on your hands and knees under smoke. Count the doors to the stairwell.  Go down the stairs- it’s fun to pop out and find yourself in some forgotten alley and make your way back.  Don’t stay above the fourth floor- that’s as high as Fire Department ladders reach, in case fire traps you in your room.

Again, keeping your kids comfortable in hotels makes traveling more fun.  Use that hotel pool!  Exercise after sitting in a car all day will help them sleep.  Keep your usual routines- eat together, read bedtime stories, be calm and unfrustrated.  Bring comfort medicines- ibuprofen or tylenol for aches, cough drops for dry throats in dry hotel air.  Searching for a pharmacy at 11pm in an unfamiliar town is a real drag!

So when traveling, be prepared.  Review and follow all safety tips.  Buckle up.  And don’t forget your bathing suits!