Many may enter, but only one may leave . . .

Okay, so parenting isn’t exactly a gladiatorial event, but some days it feels pretty close. I think it’s funny sometimes that they call it the “terrible twos” since our 26 month old has been having temper tantrums since she was 10 months old (with the full throw-down, leg kicking, fist pounding, shrieking accompaniments – fun stuff). She’s temperamental and mercurial in the best of times. One minute, she’s sunshine and song, dancing and prancing and being the funniest, most magical creature I have ever had the privilege to know. The next, she’s in full lock-down, siege mode where I am the castle and she’s the rampaging, invading forces.

It’s usually instigated over something really important, like I put a cap on a bottle for the 3rd time without asking her first although she was fine with the first two times, or I sat down when I should have known that I needed to stand (all day long, for no reason), or I wouldn’t lift her for the 10th time with her wrapped around my standing leg (try doing dead lifts of 30 pounds on one leg while standing on the other leg and not holding on to anything – seriously, try. I double dare you), or I wouldn’t give her a sip of my wine (which I now needed because of the aforementioned episodes).

And forget “choose your battles,” every single little thing with her is a battle. Whether or not we change her overly wet diaper (for some reason she’s very attached to keeping that used diaper on – or more likely, she just doesn’t want to bend to our will), whether she has anything decent to eat for dinner that isn’t another piece of chocolate, whether she has to wear clothes rather than run around naked, whether she gets to play with our electronics (remote controls, phones, computers, cameras, etc. – and yes, she perfectly well knows the difference between the real thing vs. toys vs. ones that no longer work), everything is a confrontation between her agenda and ours. In trying to get her to explore a tree house at the Arboretum last weekend, I told her explicitly that she could NOT go in the tree house and I swear, five seconds later, she was running towards that thing with full determination (luckily, she is still too young to fully grasp reverse psychology, sarcasm, or irony – the latter two of which keep me sane).

I think what astounds me is how these personality quirks are genetic rather than environmental, because she is basically the worse parts of my husband and myself. She gets her grumpiness and quick temper and quick boredom from him, her stubbornness and impatience and opinionated, fussiness from me, and she’s only two years old! While I know we will be grateful that she’s such a –strong– personality later in life, it’s difficult to envision such a future on those days when you feel defeated by your toddler and it’s only 7:05 in the morning.

This probably makes me a bad parent, although I think this just makes me an honest parent, but there are days when I despair. Sometimes I feel like all we do is argue and wrestle (literally and figuratively) and compromise grudgingly, but somehow in such a way that neither of us really wins. Despite the fact that I would never, ever lay a finger on her and have never done so, there are times when I just want to wring her tiny, beautiful neck or scream in bloody frustration. But of course, we do none of these things. We may scream and fling our limbs in sheer fury and exasperation on the inside, but on the outside, it’s business as usual: setting the rules and explaining the consequences and being consistent with quick judgment, time and time and time again.

Sometimes, I want to just walk away and check myself into a hotel somewhere with room service and housekeeping and a pool and basically have the ability to read a book and eat a meal in peace and quiet and sleep in past 6:30am. But as someone once so very nicely pointed out, parenting is the job without sick days or vacations or holidays. Part of what is so difficult is the relentless nature of it all. I will always care about her health and safety. It’s not like I’ll just give in the 50th time she asks to play with the scissors or not yell at her the 100th time she tries to shake off my hand and dart into a parking lot or off the sidewalk into the street. It is a war, not a battle, an unceasing war where the primary objective will never, ever end. But it is also the most important war in which anyone could ever engage. And the reward, the victory, is the mental and physical and emotional health of an individual. My individual, the one I adore.

I should mention in all fairness that we are also deeply enthralled by her and that she is enchantment and light itself. She is also funny and smart and adorable and loving and quirky and creative. No one can make me laugh or seize my heart so quickly and thoroughly like she does (excepting my husband of course). And there’s no one in the world I want to give my very best to, every moment of every day, like her. But there are days when “grin and bear it” is more than just a phrase. I imagine it’s a bit like special forces training or completing a triathalon or surviving torture. Because some days, I swear, experience in all of those with a liberal dose of child development psychology couldn’t hurt. In the meantime, we try to cherish the good moments, bear the bad ones, and know there’s a glass of wine waiting at the end of the day.

The Mean Girls

Like most women, I was neither the popular nor the outcast at school. I was fortunate enough to have a group of close friends I could be certain of and who shared interests with me. Junior high and high school were fine. Not great, I have no fantasies of ever returning, but nonetheless, no worse than a season of “Survivor.” I had hoped though that over time the “mean girls” would somehow grow up, mellow with age, and in general, have that karma-botox that somehow smoothes out their sharp edges.

Well, recently, I have been proven wrong. Two separate instances have reminded me that the “mean girls” still exist and in full force. Some are the “mean girls” of my youth (literally), all grown up. They are still catty, they are still spiteful, they still believe they own the world. And I compare them to myself and my friends who seem perfectly “normal” and nice to me and I see very little differences in the circumstances of our current lives. No significant differences in income or neighborhood or access to the luxuries of middle-class parenting. But their sense of entitlement continues to wrap them in a safe cocoon of superiority. I wonder if this is what it’s like to be born into nobility – to know from birth that you are somehow better, brighter, prettier, stronger; or at least to be raised with these beliefs.

What baffles me though is when I encounter the new breed of “mean girls,” the ones I have only met recently as an adult. Maybe they were someone else’s mean girl in school and it is only that they are out of context for me that I am baffled by them. I compare them to my circle of friends and again, I fail to notice any differences in attractiveness or intelligence or education or income or neighborhood. If anything, they seem to fare worse than those women that I am closest to both locally and from afar. Is it then a symptom of insecurity? Is it the slight failure to keep up the the Jones’ that inspire such cattiness from otherwise lovely women who are grouped together to support one another? Are cliques, although perfectly natural and understandable, a necessity of all social interactions? But it’s not the cliquey nature of the interactions, but the seeming superiority of a particular group within the group that continues to baffle me.

Perhaps this is the result of observation and that to some other person, I was a “mean girl” once. If this is the case, my sincere, humble apologies. But somehow I doubt my book wormish, music loving, poor dancing, cultural embracing self would ever be cool enough to be a “mean girl.” And I can only hope my daughter will follow these every so nerdy footsteps. Good friends are the bunkers we have in this battlefield of female interaction. May her friends be as true and steadfast as mine.

Red pill or blue pill?

There was an article this morning in the newspaper (online) regarding overmedication and over diagnosis of young children, even infants. The profiled child had received multiple diagnoses before the age of 3 including autism, bipolar disorder, hyperactivity, insomnia, and oppositional defiant disorder. As a result, he had been prescribed an increasingly greater number and potency of medications originally developed for adults. Finally, after years of bouncing around from one medical practice to another, he was weaned off of these meds and given a much simpler diagnosis: attention deficit disorder. Or in other words, he’s a kid. An active little boy, to be fair, but a perfectly healthy little boy.

There are many aspects of this case and the other cases like his that are frustrating and worrying. The over diagnosis of our children, and our infants for that matter, causes an inaccurate estimate of the burden of disease in our society. Do we really have an increased population of children with attention deficit or are we more quick to label a child who will grow out of this phase of hyperactivity and mellow with age? How do we distinguish between an active toddler and one with a real, treatable disorder? Many of these drug therapies were originally created for adults. What are the long term effects on the developing body and mind of a child? Several drugs prescribed to children have side-effects. One side effect of some of these drugs is insomnia, so a sleep aid is prescribed. If a side-effect of that sleep aid happens to be constipation, then do we also prescribe a laxative? Is this a pharmaceutical merry-go-round without an exit? Is it better to develop novel behavioral “therapies” for children or to medicate them to the point that they are blank, vacant automatons, albeit more easily handled?

The questions are far more troubling than the responses. As parents, it’s important to ask the questions. Ask them frequently, ask them more than once, keep asking until the answer makes sense and is consistent. Don’t be afraid to ask for a second opinion. Doctors are also human, some are parents, some are more prone to diagnosis and prescribing drug therapies. But in the end, none of them are the parents of your child and thus have different priorities than you regarding the health and welfare of your child. And regardless of all the schooling and training, none of them are an expert on your child like you are – you know best what is “normal” behavior from your child. What is the regular energy level and appetite for your child or affection level. Doctors are here to help, to be a source of information and a safeguard against real health threats for your child. But they are not perfect. If something feels wrong, it might very well be – or it might be the best therapy and you just need more information. Therefore, ask, ask, and ask again until it makes sense to you.

Are there children who have real medical disorders? Of course. Do they need the attention and care of doctors? No question. But is there also a spectrum of childhood behaviors and activity that encompasses hyperactivity and diminished attention span? I believe there is indeed. Our 26 month old toddler is incredibly active. She has a difficult time sitting still for a meal let alone all day long. Her preferred activities are to run around the median of the house, dance, play ring-around-the-rosy, enjoy the playground with swings and slides, and practice throwing and catching objects. She also likes to read and draw and impress shapes into playdo, and she loves to climb her parents like a monkey gym. Does this mean she has attention deficit disorder? I doubt it. Her doctor thinks she’s a perfectly healthy little toddler as well.  She may be very active, she may hate to sit still or lie still (e.g. diaper changes) when she is forced to stay still, but I attribute that to a battle of our wills and her increasingly stronger desire for independence and control. I’m also fairly reassured that at this rate, the risk of childhood obesity and its related conditions are fairly low for her.

I also feel grateful every single day for her health, for her love, for her very existence. I know without question that we are one of the lucky ones and we are blessed to have her in our lives. Would I move heaven and earth to find a cure if anything ever happened to her? Of course, without doubt, no question. But I would question every step of the way, I would find second and third opinions, I would assemble a team of doctors and experts who believe in her and her holistic health, almost as much as her father and I would. And no matter what, I would love her for who she is, the totality of her, screaming tantrums, opinionated assertions, and refusals of kisses and all. Bring on the terrible two’s – I’m just grateful I have a munchkin I can hold and kiss, even if it is against her will sometimes when she would rather be at play.

The ugly stepchild – childhood vaccinations

There has been a lot of attention in the media about autism. Celebrities have taken up the cause; childhood vaccinations have become the hot culprits. While autism is an extremely heartbreaking condition and more research is strongly warranted to identify the causes, in research, it is just as important to understand what does NOT cause a condition (e.g. negative associations) as it is to understand the risk factors. Multiple national, international, large and small population studies have been performed and an association between childhood vaccinations and autism does not exist.

There are two main arguments against vaccinations causing autism. The stronger argument is one of causation. If the accused preservatives in vaccinations do cause autism, than the eradication of thiomersal (the preservative) almost ten years ago should show an associated decrease in autism diagnoses 3-5 years after removal from vaccination production. However, this is not the case. Unfortunately, autism diagnoses continue to rise even as the “cause” has been eliminated. The second argument is temporality, or timing of vaccines and autism. Diagnoses of autism tend to occur in toddlers, right about the same time that they are given the bulk of their childhood vaccinations. So one day they receive another set of vaccines and shortly thereafter, they are diagnosed with autism. What if those same children were diagnosed first and then were given routine, childhood vaccinations shortly thereafter. Would we blame autism on giving the children vaccinations?

My heart goes out to anyone who has been affected by autism, and parents most of all. But mass hysteria regarding the (unfounded) causes and potential risk factors of autism will not help the search for a cause and the greater search for a cure. Wherever the research may lead, we know now that childhood vaccinations are not the culprit.

Decreased vaccination rates among children however have indeed caused outbreaks of measles and whooping cough. Vaccinations and antibiotics are two of the greatest medical advances of the last century. We live in a cosseted time where we no longer see the ravages or graveyards of the great scourges of measles and mumps and rubella and polio. We no longer have outbreaks that will cripple a generation, both literally and reproductively. We rarely see the types of fatalities that an epidemic of tuberculosis or diptheria or plague may cause, at least not here in the United States. But the stronghold against these epidemics, the safeguard for our children, lies in the vaccinations that we provide for them. As those vaccination rates decrease, we infer upon the entire population a vulnerability to the return of these agents.

Some may argue that vaccinating your children is a private, personal issue and parents should have the ultimate choice in whether or not to vaccinate. My main problem with this argument is that “herd immunity” (protection of the entire population) depends entirely on the high rates of vaccination of all eligible members of the population. Some will be unable to receive vaccines (e.g. compromised immunity, allergy to the ingredients in vaccines, too young, etc.) and we rely upon the immune status of the those who are vaccinated to protect the most vulnerable among us, as well as the population as a whole. When a family decides not to vaccinate their children, they not only put their children at risk, but all children in the population. This is similar to the argument against second hand smoke. While it may be a personal freedom to choose to smoke, you are robbing someone else of that same freedom when you expose them unwillingly to your decision to smoke when you share an environment with them.

Let’s not let the emotional fear of vaccinations causing autism (which has been shown by good research to not be true) cloud the very real threat of childhood infectious diseases that can seriously harm a child when the prevention is readily available and whose safety and efficacy has been shown for several generations. Any serious side-effect of vaccinations (called adverse events) are immediately reported and investigated by multiple agencies. Vaccine production and research commissions far less actual monies than pharmaceutical research, development, and production. There is no financial incentive to pushing vaccines on an unwilling population except for the prevention of future medical care costs when children fall ill from preventable diseases. And surely the desire to keep children healthy and safe should be the priority of both parents and doctors and the nation as a whole?