Advice from the Doc

As long as Silas and I have spent some time with our respective doctors lately, i thought i'd share some useful and interesting tidbits we picked up along the way. Silas and i both came down with colds near the end of last week. I thought i was getting ahead of it and felt like i was doing about all i could by going to bed promptly at 8:30 every night and resting during naptime on the weekend. But alas, it turned into a sinus infection and by Monday i knew i was done for and headed off to the Dr.

One of the things i like about my Doctor is that he gives you printed specific information for ailments that you've had a zillion times-- and it doesn't just say to drink fluids and rest.

Well it does say that, but then it has several specific medications listed for various symptoms and he circles the best ones for me. He told me to take aleve for any body aches, to take Mucinex D for the congestion, and at night to take benadryl. This time it was all in my head but in the past when it's gone to my chest he's prescribed an inhaler as well.

I thought the Mucinex was just for your chest but he explained that's the Mucinex DM (umm, i think they need to work on their product differentiation strategy!) but the guaifenesin in Mucinex D helps break it up wherever it is-- sinus or chest. I asked what i could do to avoid a cold always turning into an infection. He said the usual supsects of rest and fluids are important and that some people are more prone to getting infections, but to throw the medications at your symptoms at the first sign. Not only can they help you feel better but they can prevent mucus from forming and holding on becoming a breeding ground for bacterial infections.

All day Monday i was feeling guilty and wondering if i had made the right decision to send Silas to school. He definitely had a cold (primarily head congestion) but from his temperament you wouldn't know he was sick really. That night his mucus was green which is always described as the warning flag and i guessed the fluid was still in his ear. So, i called and managed to get him in for an evening appointment. Turns out he doesn't have an infection (so i guess the green mucus isn't so reliable after all) but she unhelpfully told me that of course with the fluid there it could turn into an infection at anytime. Great-- so i get to keep being paranoid.

She did help me understand why there's basically no medications you can give to toddlers even with severe congestion like Silas has. She said that repeated studies have shown adults' symptoms being reduced by medication but similar studies in children showing no effect. And i know our regular Doctor told me last time that there were some studies that showed an *increased* incidence of ear infections in infants and toddlers given benadryl. So, at least i have the medical literature backup. But it still doesn't feel right with an arsenal of meds at my side and only saline solution, humidifiers and warm baths for Silas.

Stay tuned. Now that we're recovered and almost caught up on laundry and dishes, i hope to get some pictures of Silas' haircut. You were too polite to say but you'll note that his hair had become epic in the pictures from my last post.

Perfect Weekend

Not that everything went perfectly but the structure of this weekend was truly perfect-- two normal weekend days, a bonus holiday with the kids and JT to go to the museum and a super bonus day just for me to get all the stuff done around the house that was in no way going to happen during the other days. This makes me think that from now on after a vacation or trip i'm going to send the boys back to school and plan one extra day for me to just to get everything back in order.


I think it's time for a general update. It seems to go in spurts but we enjoyed an awesome weekend of 8 am + wakeups for the whole family. That meant we didn't make it to soccer class on Saturday, but we sure did enjoy our extra sleep.


Silas went to the Doctor for an ear check today and he still has fluid in his right ear. We have to go back in another 4 weeks. At that point if he still has fluid we have to go to an ENT and i'm guessing that means ear tubes. So, we'll just have to wait and see. There's a few upsides, although Silas has had a few colds since his last ear infection, none of them have really stuck around. Which is actually great because not only does it delay any visit to the ENT, but it means Silas isn't in pain. We also had a speech update and we're doing well. Silas is up to about 25 words, a handful of signs and he's starting to "parrot" language. He needs to be up to 50 words by 2 but at least we're making some really good forward progress.

What about when they swarm you?

Somehow in the last few weeks the boys had converging phases of difficulty that managed to overwhelm all our parental patience and skill some evenings. Henry continues to be defiant and sassy and we were struggling with epic MAD meltdowns that were just spiraling out of control. Even though we were setting timers, giving him warnings before transitions, he just couldn't handle it when a favorite activity was curtailed. We finally decided that a serious contributing factor was video games before bed. He just seemed to be unable to control himself when he got upset about having to stop and we endured a few hour long tantrum/meltdowns before we banned video game to weekend afternoons. He's no sweet angel all the time but so far so good on the utter meltdown messes we had endured. He's been doing well at school and he got "twenty thumbs up" from his babysitter last night so i know he saves the really juicy bits of naughtiness for us.

Silas just about did us in there for a bit. We got locked in an epic power-struggle over seating arrangements for meals. As it turns out Silas is possibly more stubborn (hard-headed as they say at school) than any of the rest of us. He very clearly did not want to sit in his booster seat to eat meals anymore. He wanted to sit in the regular chairs which he can get himself up and down from on his own now. This would be all fine and good, and we do let him sit in the chairs to read books or play at the table, but he's constantly standing up in them testing us and has fallen off more than once. It's essentially impossible to let him eat dinner in the chair without him making a serious mess and most likely impaling himself on a plastic spoon.

As the days wore on i tried to make a tea party with stuffed animals in all the other seats, i switched the placement of his seat with mine, nothing worked. The first night he got so upset and couldn't calm down that he just asked to go to bed-- sans dinner. The second night he finally did calm down and sit in his chair but only after we gave him his pacifier and baby. On the third day JT had the idea of resurrecting the little table and chairs. It's not been a perfect solution-- we now have to constantly get Silas to sit back down until he's done eating. But at least for now we're not losing our minds over the iron will of someone that doesn't reach our knee caps.

Trytobe Athlete

There's something about certain occupations that leaves lots of folks intimidated. I guess because they aren't credentialed and accredited. You know if your a Doctor because you have a medical degree, ditto for lawyers and bus drivers. But aside from professional athletes, there is a whole class of people that aspire to be athletes and fall somewhere on the scale of declared amateur athletes to tentatively aspiring athletes. Lots of people say they're a wannabe runner, swimmer, triathlete, insert activity here. I've decided to be a tytobe athlete. I'm just doing my best, working my training as a priority into my life but not taking on goals i can't handle.

After running an exhilarating 8K race on Thanksgiving i decided to sign-up for Chicago's March 8K Shamrock Shuffle race to try to improve my time and then for the sprint distance (half) triathlon in August.

I'm a very disciplined sort of person. It doesn't take me paying for an expensive gym, a personal trainer or a boot-camp to get out there and exercise. But, I have found that i do push myself further and prioritize my workouts more when i have an actual race to prepare for. First of all it's a definite time period, i.e. here's my 8 week workout plan. Also, i've been signing up with friends so there's a little peer pressure to respond to if i wimp out.

For now i just know that i'm out there doing my run in 28 degree weather because at 6 degrees tomorrow is going to have to be my gym cardio day. And when i work up to my longer runs in weeks 5-7 i'll have to schedule them during naptime on the weekends-- sacred time. It's worth it because i feel awesome and look forward to introducing the boys to race culture when they're a little older.

Holidays with Small Children, grand and exhausting

We were lucky enough to rap up another year with family visiting for Christmas and then a week-long trip with friends to a house in nearby MI for New Years. Both were fun and exhausting and i can't tell you how much more relaxing going back to work Monday morning felt. This is the first year that being off the boys' routine seemed to be a real factor to contend with.

I don't know if it was just coincidental or what but Henry has entered a very defiant phase in which he frequently says no to whatever is being suggested and often breaks down or gets mopey at the slightest hint of things not going his way. It takes a significant amount of parental effort not to lose it on an hourly basis and to balance funny and cajoling with "i mean it" discipline. It was hard to tell how much of his meltdowns over Christmas were due to being over stimulated and what was just this phase he's in. Anyhow the extra hands were appreciated and it was of course fun to see everyone open their gifts together. Unfortunately our visiting family took turns being sick during their stay but we all amazingly stayed well for the most part.


We spent New Year's week with three other couples with kids. It was mayhem and after all the kids were asleep a ton of fun. We had a few outings to the outlet mall and lots of games of hearts as well as a favorite ice cream treat called chunky monkeys. The boys had a short outing to the lake where they enjoyed tromping around on the snow covered sand and throwing stones into the snow.

Now that we're back to our routine we almost have our sleep schedules back to normal and the house somewhat put back together. I got a promotion at work that took effect Monday so i've been feeling my way through a job that's mostly known to me with some new challenges and JT is working on a case that looks slotted for trial. So we're busy and doing well and just hoping we have only light snowfall for a bit!

Sleep Training- A Response

I have a good friend that is embroiled in sleep-training her little one. We had our fair share of sleep-training with both Henry and Silas (who were difficult in different ways) and I've managed to become somewhat of an expert on some different techniques for the grueling process. Lots of people don't agree with any version of sleep training but we do. JT and I believe that you're teaching a child how to sleep well for the rest of their lives. Tammy posted some sleep training questions and i thought i would use this post to provide my answers to them. For the record there are two sleep books i would absolutely read: The first is Weissbluth's Healthy Sleep Habits Happy Child and if you happen to have a non-colicky baby the book 12 Hours Sleep in 12 Weeks.

1. Do we set up our pre-training “bedtime” environment? Do we turn on white noise, let her turn on her crib aquarium, leave music playing, dim lights? Or is now the time to simplify our sleep “crutches”? (we left our set-up the same)

You need a routine for bedtime. It can be very simple. If you already have one continue to do it. If you want to inject one additional thing (i think the white noise would be great especially given question 7) but i wouldn't add any additional steps before you actually put her down to sleep.

2. What if she poops/pees?
I thought she had pooped one night so I changed her. It turned out to just be pee, but it probably was good to wake her up a smidge after the feeding anyway.

If she poops you need to change her. No worries if it's just a wet diaper. It's nice not to have to change her but if you do you do and it's not a deal breaker. Unless you have reason to suspect she's got a dirty diaper after you feed her, i would change her before you feed her so that she's already drowsy and ready to go back to sleep after you feed her.

3. What about naps? Do we do sleep training for her daytime naps? We can NEVER get her to take naps. Still completely unresolved.

If she's having a hard time with naps you will most likely want to sleep train her with naps as well. Speaking from personal experience, i would wait to work on naps until you've got the nighttime ironed out pretty well. Weissbluth offers sleep research to indicate that daytime and nighttime sleep are neurologically different. Therefore using sleep training techniques at night and not during the day isn't actually confusing. Based on some of the same research though, daytime sleep is more difficult to "train." Ideally you will be healthy and have some good nighttime sleep under your belt before you attempt nap training. You must read the Weissbluth book before you get started because you will have many questions about how to do this.

4. Does the method recommend that you go completely cold turkey with no feeding at night? Or do you ease into sleeping through the night?

I've actually not read Ferber's book so i can't attest to his method. Depending on the age of the child and if there are any weight gain issues i think it's a choice about what strategy works best regarding night-time feedings. My personal preference and what i think is easiest to implement is to follow the steps that are outlined in the 12 weeks book and that i shorthanded below to lengthen the times between nighttime feedings and then work on phasing them out all together.

5. How to extend the period of time between feedings? What if she falls sleep during these nighttime feedings?

The 12 hours sleep in 12 weeks book offers step by step guidance for how to lengthen the time between nighttime feedings and eventually work on phasing them out all together. First she tells you to keep a log for a few days of at what times she's eating now and for how long. Then you work on a two-pronged strategy to lengthen the time between the feedings and shorten the feedings until you've eliminated each one.

From your post i think she's eating twice a night roughly around 1 am and 4 am. You set those as your new goalposts and you never feed her earlier than that. If she wakes up earlier you use your toolbox (could be letting her cry, giving her a pacifier, patting her, etc.-- see the book for a complete discussion of different techniques), to get her to the goalposts you set. The idea is to always move the ball forward and not let them creep backwards. If she wakes up and eats at 1:30 am tomorrow that becomes your new goalpost. Basically the idea is if she did it once she can do it again.

You also note how long she's eating. If she eats for 15 minutes at each feeding you start there. Every few days you reduce the amount of time by 2-3 minutes. If at any point she eats for less than that (and doesn't wake up with some gentle prodding) that's your new "time limit." There's something i'm forgetting about the order with which you phase out the feedings. So you're just going to have to read the book!

6. Is it ok if they fall asleep while you’re nursing them, then you wake them back up when they’re in the crib?

Weissbluth argues that it's fine if they fall asleep while they're nursing. It's a normal response to a totally soothing and relaxing ritual. You don't have to undergo any shock treatments to fully wake them up while putting them in the crib. Just lay them down normally so if they wake up they wake up but you're not setting out to arouse them from their peaceful slumber.

7. Should we be “extra quiet” in the rest of the house? We live in a small 1 bedroom floor-thru apartment, and I know Sadie sleeps at daycare when there are toddlers screaming about. So, should we get her to sleep with our standard-noise-level, or do we just need to learn to turn our standard-noise-level down? (we put headphones on to watch tv and tip-toed around the house)

No, you shouldn't be extra quiet. I would recommend the white noise machine (or waves or any other kind of soothing sound machine) to give her some buffer but she needs to be used to sleeping with normal night noises. This will help in the long-run if you ever want her to be able to sleep if it's not perfectly quiet. This won't help if you want to have friends over, and it also won't help if she's at camp sharing bunkbeds and the crickets are too loud.

Finally-- in addition to telling you that you really need to read the books, i'm also going to suggest that you try moving Sadie's bedtime up by 15 minutes and see what happens. Especially if she's struggling with naps i have a feeling she's overtired which makes getting them to sleep that much harder. Reach Weissbluth and we'll talk some more.

Finally, finally from one parent that has gone through this to another: this is hard. It's hard because it's terrible to hear your baby cry, it's terrible to know that the situation before wasn't good and there's no going back, but to not be able to see clear to the other side. It's terrible because as you noted, all the crying and the not knowing and the wondering and the questions sets you on edge, and your partner on edge. Call for support when you need it, read some books so that you've got an expert weighing in with the advantages of a good sleeper, and take breaks from the sleep training. You can take turns walking around the block or running to the drugstore just to get some distance from the crying.

Christmas Prep

From December 2008

We're getting ready to welcome our families for Christmas and involved in prepping for that as well as helping the boys celebrate the season.

Henry has been really into the advent calendar that i made last year. He gets to put up a new felt ornament on the santa calendar every morning. He's been doing a great job remembering and we use it to count down the number of days to Christmas-- which showed me he can reliably count to 15 for example.

Tonight we made snowflakes and this weekend at our friends' annual Christmas party we're going to do a gift exchange and the kids get to make gingerbread houses which we've done most every year since Henry was born. It's fun to have these traditions with friends and family because it's a great way to mark time. When we first started the gingerbread houses i think there was Carys, Henry and Helen. Last year Silas was too little to participate and this year baby Walker will be sleeping nearby if i had to predict.

We've decided the keys to success doing "gingerbread" houses with very little folk is to a) use graham crackers (who has time to bake gingerbread), b) give each kid a baking sheet covered in tin foil, contains mess, is a nice base for the house and enables you to transport them back home when you're done. While Tab and i construct the houses and glue them together with icing we give each child a few graham crackers on their tray to ice and decorate. They can eat what they decorate and when they're done the house is usually dry enough to decorate.

From December 2008

By the way, we made some progress with soccer. Henry is still usually at the back of the class but he's loving it and i saw him make a goal right at the end when they each get to practice kicking the ball into the goal. We staved Silas off from his baby until after class and even though he whined through most of the games he asked for more after each one. I predict he'll tolerate more and more each week until he decides it's actually fun.