Sunday, January 30, 2011

Making the Call: How a snow day becomes a Snow Day

Somewhere in the clouds last Tuesday night, high above the houses and apartments in which little girls and boys slept, small changes in the atmosphere caused:

“...the greatest weather surprise in the last 10 to 20 years,” according to meteorologists at one local TV station.

This unexpected first wave of Wednesday's snowstorm came to my neighborhood around 6:30 a.m., early enough for six cars to slide off a road into a ditch and for a school bus to lose traction on a hill and remain stranded. But the storm arrived late enough in the morning routine for the absence of something just as significant: a snow day.

There was snow—buckets, inches, gobs of it; but there was not, a Snow Day.

“Timing is everything,” a local police chief told me when I asked him how an official snow day, or cancellation of school, is declared.

Unless the snowstorm hits early in the afternoon or evening, it’s a waiting game.

Midnight.

1:00 a.m.

2:00 a.m.

3:00 a.m.

4:00 a.m.

Some of us, awake for various reasons, peek out the window at this hour to see if a dusting has spread across the roads, but most people are sleeping.

Not so, of course, if declaring a snow day is part of your job.

“The process begins around 4:00 a.m.,” the website for the Princeton Regional Schools states. It’s around that time that administrators down the road in Hopewell Valley call the police headquarters.

The dispatcher checks in with officers in patrol cars.

How are the roads?

Whatever they report is passed back to the superintendent, who then considers the conditions in surrounding areas and the ability of teachers and staff to get to work on time, too.

By 5:30 a.m., a decision must be made.

Once it is, dispatchers at a bus company hear from the transportation coordinator.

“We get a phone call...a human calls us.”

The dispatcher then calls her drivers, one at a time---relating the news if there’s a delay or cancellation.

If there is, said one administrator at an independent school, the director of communication updates the school's website. Then, the administrator puts out a message through Call One that is automatically sent to parents and staff.

After that, he calls the TV and radio stations.

"I have a code I punch in.”

Why?

“Otherwise you’d have students calling the local TV station and saying school is canceled.”

When snow accumulates at night and it is clear school will be called off the following day, he's got another way to outmaneuver the strategies of students sniffing out a snow day: the announcement is never made before 10:00 p.m..

“We wait until after study hall...we learned that the hard way.”

Back to the early morning hours, administrators at smaller independent or nursery schools follow the lead of the districts they are a part of.

“I watch the local access channel,” the director of one told me, lamenting the Muzak. In the dark morning hours, waiting for reports from other schools and districts, she just hopes the drone of early morning television doesn’t put her to sleep. She somehow stays awake, and then sends messages for parents and staff through an automated service called Blackboard Connect.

Many years ago, on winter days in Maryland, my brother and I would sit by a transistor radio hoping to hear the announcement that Montgomery County schools would be closed. If they were, our morning would include the luxury of eggs and toast, reruns of "I Love Lucy", sled runs down the “hill” in our backyard, and a bit of Swiss Miss hot chocolate before I'd eventually set off to fashion another regrettable hair cut for my Cabbage Patch doll.

I had no idea what went into the decision of determining a snow day, and no sense of the work it might mean for the parents whose schedules were suddenly altered.

5 loads of laundry, 1 batch of cookies, 2 loads of dishes, 1 homemade pizza, 2 trips outside, 1 snow fort, 1 sled trail, 1 awesome batch of sloppy joes...

Banana bread, play dough, a movie, breaking up a squabble between siblings.....

These were a few of the things I heard from moms who, because of Thursday's snow day, had gotten the day "off"  from work.

The next time I get a message announcing a snow day, I'll probably think a bit about the people who spent the lonely hours between 4:00 a.m. and 5:30 a.m. determining that call.

"On days like that," the assistant to one superintendent I spoke with said, when I asked her if her boss ever looked tired after a night monitoring the weather, "he comes in a bit bleary-eyed."

The other side of this story is what might happen if there are several more snow days this winter. As a story in NJ.COM reported, some districts have used up so many, they may have to make up the days on "school breaks, such as Presidents Day weekend and spring recess. After that, there’s school on the weekends." Announcing that decision to constituents sounds almost as painful as listening to Muzak at 4:30 a.m..

Sunday, January 23, 2011

One Week Later...

After last week, the question now is: why am I writing a post this week instead of sleeping?

When more than 200 people tell you, in no uncertain terms, that the first step to dealing with the exhaustion incurred when a child does not sleep is to find ways and moments for you, yourself, to sleep, that’s a fair question.

And I have been sleeping—downstairs while my husband takes the night shift, during "Dora the Explorer", while my two year old pushes through other children’s nap time, and in pockets here and there, whenever I can. Still, when friends, readers, and total strangers reach out in response to a question—or plea—for advice, I thought I’d write enough this week to at least say: I heard you.

I really heard you.

Lisa Belkin at The New York Times responded to my post by putting it in greater context and including it on her Motherlode column, a stroke on her part that, to me, felt like both a journalistic and magical act. All of a sudden, what had been a solitary and isolated experience became part of a larger conversation with people who, even in my most rested state, I might never meet in person. I printed the 154 comments, just as I did the comments posted on this Lunch Box Mom blog itself, and the notes sent to my private email. I put the pages in a folder, and carried it around to read while eating, or at pick-up, or before heading to bed—a collection of essential information, stories, warnings, admonishments, and support, that came at the right time.

First, there were those men and women who wrote to address the physical depletion a parent feels when he or she has experienced prolonged sleep deprivation. These were cautionary tales. The women who eventually developed seizures; a chronic disease (believed to be linked to the stress of the experience); others who had panic attacks while eating—and choked; one with neurological problems lasting longer than the child’s sleeplessness; and a dad who related three-fender benders.

There was the emotional pain--marriages, friendships, familial ties: broken.

These stories stopped me in my tracks. They were, as much as the empathy expressed alongside them, enough to wake me up from whatever pattern I was creating.

For that, I looked at the other advice sent in those emails, or posted in comments. Nap while the kid watches TV, enroll her in more (than we were already doing) daycare, trade off nights with my husband—and sleep somewhere else when I do so; get the ball rolling to find longer term escapes (a night nurse, or nanny). Co-sleeping had not gotten us much more sleep--but I was glad to know it worked for many. And, there were the wonderful and beautifully not paradoxical sentiments: to give in to the circumstances and have fortitude.

Most of the comments—and every single email sent directly to me—included a story about the writer’s child (or relative) who experienced sleep problems. Many, but not all, included a specific path towards progress, or a diagnosis that made a world of difference. Sleep apnea, sensory processing disorder, dairy protein intolerance, autism, the 1 in 20 million case of being born with liquid in the inner ear, or the unique case of an adopted child whose body contained excessive amounts of a heavy metal—needing to be cleansed; others with iron deficiencies discovered only when taken to a hospital for a comprehensive sleep study. Fixes included craniosacral work, crying it out with a lock on the door, melatonin, boring the kid with Masterpiece Theater, or exhausting them with running the stairs of an apartment building.

There were the comments posted from the other side of the spectrum—the readers who were bad sleepers when they themselves were children, or who knew people who were. The young woman who learned to swaddle herself and those who eventually used their hours of wakefulness to be highly productive. Along those lines, there was the advice to help Ava be as independent as possible, chiefly, through books and the ability to read. And, with our work with Ava now, it seems the stories about children with active imaginations, who need both intense interaction and physical exhaustion during the day, and specific coping strategies to unwind at night, children, who with age and ability, become better sleepers, were consistent with what we’ve seen in our own staggered progress.

I was struck with a deep sense of connection to the readers who wrote to say they’d “been there” that “it will get better,” and in the meantime, to find ways to sleep and “hang in there.” I laughed out loud as though I was separated from birth from the woman who wrote to say that her first thought when she felt dizzy and disoriented from sleep deprivation was to think she was being poisoned from carbon monoxide. And, I thought about what it meant that one woman, whose pre-teen now sleeps at least nine hours a night said, “I still remember that light-headed, walking on eggs feeling only too well—I suspect it will haunt me to the end of my days.”

I am deeply grateful to the people who posted comments or sent emails. They didn’t have to, and certainly what they recounted were either hard-won strategies, or memories that would have been easier and less painful not to revisit. Still, they reached out—they wrote, they helped.

Becoming sleep deprived is like walking into a forest at dusk. One bad night becomes two bad nights; two bad nights become a week; a week becomes a month, and months become years. By the time you realize you are alone in the dark, too disoriented to find your way out, it’s too late to look for a map. I wonder what parents might be given before their child is born (even if it’s their second, or third) that could establish benchmarks and strategies in the event they find themselves in this part of the woods. Something that takes the subjective, emotional part out of assessing one’s own level of depletion and makes it as much a part of our discussion of child rearing as post-partum depression. Six months, nine months, 18 months, 24 months in—how are you doing? How much sleep are you getting? If it’s less than x, then here’s what we do. Not for the kid—but for you.

Along those lines, as I’ve drifted off to sleep, I’ve had a version of a Utopian dream. Some people already live in communities that might offer this, or have a network of friends who “care-share” or belong to churches that have something similar, but as far as I know, it’s not popular in my area.

In our conspicuous age of parenting, when we have classes for every age and interest, and gadgets for every need, why don’t we address the physical and emotional needs of parents and have buildings—parts of a hospital, a church, a gym or center like those built for seniors or teens—designed specifically for parents or caretakers that is free from the distractions of home?

Here you could drop your kids off at the child care center and then retreat to a room with cots. You could sleep for two hours, or go to the library and read the paper, or to the cafĂ© and eat a meal sitting down, or go to the auditorium and hear a lecture. Then, at the end of those two hours, you’d pick up your kids.

And, life would go on.

And, now, because I heard you and I listened, I am going off to bed.

Sunday, January 16, 2011

Hitting the Wall: What it Feels Like

If you've already read this post and are looking for an update, please click here.


Having had two panic attacks in the last ten years, I am no expert, but I have learned two golden rules:

 1) It’s better not to take yourself to the emergency room of a New York City Hospital when you can pop a Benadryl and berate yourself in the comfort of your own home.

 2) When pulling your jogging bra off in a panicked effort to get more air, it’s best to check your proximity to the men’s locker room first.

The panic—or sensation that I could not breathe and was near death—occurred last Sunday a few minutes after I had the very real feeling that I was about to collapse or pass out. It turns out that after two and a half years of bad sleep, and four months of really bad sleep, at the hands of a clinically diagnosed “bad sleeper” of a child, a mom can lose it.

The first thing I’ve lost is the feeling that I am sleepy. I am so chronically tired that I am no longer tired.

The second thing I’ve lost is my appetite.

I’ve also lost my patience, at times my optimism, my concentration, and my “free time,” but losing my appetite is probably what led to the loss of a third thing in my life—equilibrium. Equilibrium in the literal sense—I got dizzy and almost collapsed. And equilibrium in the emotional sense---the dizziness made me panic and I lost my peace of mind.

All this manifested in the last five minutes of my beloved Zumba class, during which I was dancing to one of my least favorite songs, the kind of tune that, even on the best of days, makes me want to leave the room.

On this day I fled.

I grabbed my kids from the child care area, made my way to the front desk of my gym and sought out the most maternal and competent looking person I could find.

“I feel like I am going to pass out and I want you to know who I am,” I told the woman.

She suggested I take a seat, calmly handed me a chocolate covered LUNA bar and a cup of water and searched for my file.

I didn’t know if I was actually going to faint, but if I did, I wanted someone to call my husband and look after my kids until he arrived. My oldest knows our home phone number---a relic my husband never answers, much less checks messages on, and my youngest knows that she is “2 years old” and is in love with Tyrone from the Backyardigans, but when it comes to identification, I’d say that’s about as far as it goes.

“Two a’s and two f’s” I muttered. The bane of a woman married to a man with a Dutch last name, I realized, was that I was going to waste my last moment of consciousness doing what I do in the more mundane moments of my life: explain to some poor listener the key to correctly spelling Vander Schaaff.

The woman found my file and I moved from feeling faint to feeling like I could not breathe.

We called my husband, who hopped in his car. She called 9-1-1 and got an ambulance on the way. In the meantime, I sipped water, tugged at my shoes, and apparently, at the annoying tank top clinging to my chest.

“Why don’t you put this t-shirt on?” another woman said, handing me a loose fitting t-shirt from behind the counter. “You’re sort of....exposing yourself.”

So, that was why the men sitting in the chairs near their locker room had put down their copies of US News and World Report.....

I put the t-shirt on overhead and slipped my jogging bra off beneath. As much as I breathed, I felt like I was getting no air and that the next breath would be more restricted than the first. My hands shook, my stomach felt queasy, and even as I continued my slow conversation with the helpful team who had now surrounded me, I felt lost in another place.

The EMTs arrived before my husband.

They checked my blood pressure; my chest; my lungs.

“When was the last time you ate?”

I’d had part of a muffin walking through the grocery store at 8am that morning.

Then I remembered I’d not had lunch the day before. Or the day before that. Or the day before that.

“I haven’t been sleeping much,” I said.

“Since when?”

It’s been particularly bad since August of last year, but it all started......oh, I don’t know.....shortly after I went into labor on June 18, 2008.

I sometimes wonder what it would take to start to chip away at the deep fatigue I feel. An article in Scientific American on accumulated loss of sleep, something called sleep debt, suggests that it would not take a single night or two of sleeping well. You have to look at the larger deficit, which since Ava’s latest bout began in August is at least 270 hours.

It would take more than ten days of consecutive sleep to make up for that, or nine months of napping for at least an hour. Even if it were humanly or logistically possible to do either of those things, I'm not sure I would.

I am, in my own way, as stubborn as my child who does not want to sleep. I have been told that I am the “goose that lays the golden egg”, that I must take care of myself so that I can tend to my children, and that I should find a way to catch up on sleep even as I figure out a way to help Ava with her own problems, and not wait until it’s all “fixed.”

But there is a part of me that has not believed that I am vulnerable or can be tired out to the point of passing out; that does not accept that while working towards the solution with Ava, that I need a compromised, messy, imperfect coping system to make up for the losses in sleep I’ve incurred.

And partial solutions only make me more frustrated that something so simple, so essential, so basic as sleep, is such a horrendously difficult proposition in my house.

Sometimes, because I am conflicted about acknowledging the severity of our problem and because I used to teach public speaking, I like to recite to myself a passage from Lincoln—completely out of context and appallingly out of proportion:

“The world will little note, nor long remember...” .....the fact that Ava doesn’t sleep.

But, the body does.

We’ve made some baby steps, with the help of a second specialist, but until the problem is consistently solved, we have to make do with the frustrating, maddening muck of being in the middle. I have to accept an element of failure—that we are failing—and therefore, what do we do until we succeed?

It’s no longer a question of “what do we need to do to succeed?” It’s a question of “While we are trying, what do we do?”

One reader and friend, whose own child exhibited similar sleep issues until the age of 5, suggested that I end this post by posing a question to you, the reader, that can be the subject of next week’s post. What have you done? Before a solution clicked, before a child outgrew a phobia, or a problem reached a long-hoped for solution, or you decided there might not be one--What did you do to persevere while you were in the “middle?” Send your stories to me at this email.

"Fifi" the comfort object french poodle, low wattage light bulbs, relaxing music and narration, box full of treats and rewards for "good sleep" and a chart to mark our progress.

PS: The other stories this week, of course, are the painful ones coming out of Arizona, which made me turn to the insightful Gavin de Becker for perspective. He is out of the country and unable to answer the questions I sent him, but for a clear headed assessment of the world in which we’re raising our kids, his book, Protecting the Gift, is one of the best.



Photo credit: Boxing Gloves:

Sunday, January 9, 2011

Drug: Resistance

For a generation that grew up with Nancy Reagan’s “Just Say No” campaign, it is interesting that the biggest obstacle between us and the drugs many of us crave is the American Academy of Pediatrics.

But, as we head into the lion of winter, noses dripping, coughs hacking, and our little ones sharing germs more freely than they do their toys, there is a noticeable grumbling among some parents who have finally cracked and asked, as only a Kleenex-hoarding, humidifier-using, orange juice-buying parent can: “What do we have to do to get some antibiotics around here?”

Amoxicillin, cefdinir, amoxicillin/clavulanate-- any one of the cephalosporin antibiotics that are more precious than gold for the parent whose main concern is the health of her child and the sanity of the family and not the “emerging resistance of the common pathogens” and that nitpicky distinction between viral and bacterial infection. Ah, science, that realm of specifics.

Although it’s true that many of us sit in the examination room with our children and pediatrician wondering what it would take to get her to pull out a prescription pad, to say we’re on opposite sides of the situation is not actually the case. It just often feels that way.

Dr. Robert M. Siegel, in a January 2010 article in PEDIATRICS, (Acute Otitis Media Guidelines, Antibiotic Use, and Shared Medical Decision-Making) describes the medical community’s response to the 2004 guidelines set forth by the American Academy of Family Physicians and the American Academy of Pediatrics for the treatment of the most common problem sending kids under five and their parents to the doctor: ear infections, or more specifically, acute otitis media or AOM.

The guidelines advised practitioners to be more careful in diagnosis, select narrow-spectrum antibiotics, use analgesics such as acetaminophen, ibuprofen and Auralgan instead of antibiotics unless the infection failed to clear, and endorsed an observation option. Siegel cites a study that showed a decrease in antibiotic use for AOM from 1994-2000 (before the new guidelines) which he credits to better accuracy in diagnosis, as well as another study that looked at behavior after the guidelines, showing an increase in the use of analgesics and the narrow-spectrum antibiotic amoxicillin (the type recommended in the guidelines.)

Still, the endorsed practice of “watchful waiting” and observation of the infection translates to one thing for parents: no drugs. Not the kind we think we want, anyway.

A fact that Siegel says requires more parental involvement and input, not less.

“Several groups have examined watchful waiting for AOM with a rescue or safety-net antibiotic prescription if the symptoms do not resolve. In office and emergency department settings, more than 60% of parents chose not to fill an antibiotic prescription when the child was given adequate pain control. ”

The choice not to fill the prescription is part of a larger agenda to educate parents on the risks and benefits of antibiotics and he writes, “If the use of antibiotics is to be decreased when treating AOM, physicians must immediately address the main concern and reason for the visit: ear pain.”

If you’re typically respectful of your doctor’s opinion, and the greater mission of the AAP and their guidelines, then it takes a leap of confidence or desperate anguish to finally say, “What do I have to do to get some antibiotics around here?” Especially when you have not been given the safety-net option, or when AOM is not the issue.

One reader found herself in such a position. Never, she said, in her multiple visits over the years to doctors in both New York and New Jersey, would a pediatrician prescribe an antibiotic. Finally, she sent her husband to the pediatrician with her young daughter instead of going herself.

“He’s got an MD and a Ph.D in neurobiology. We were pretty confident he could get a prescription.”

Her doctor, a brilliant and well respected practitioner, who like many in his field has stickers of farm animals on his stethoscope and does magic tricks with tongue depressors, is not so avuncular when it comes to parents’ desires for antibiotics. Did sending in Dad, a heavy-weight who can pronounce and spell Streptococcus pneumoniae and Haemophilus influenzae with the best of them, do the trick?

No dice.

The only time the reader has gotten a prescription was after failing to get one from her primary pediatrician and taking her sick child across the country to visit her family. They went to an urgent care clinic in a strip mall somewhere in Montana.

“We got an antibiotic. The improvement in her child’s condition was, “dramatic.”

I found myself in a similar situation over the Christmas holiday when my daughter was on day 28 of a sickness that had vacillated in intensity but included: five days of fever, two days of bloody ears, a fortnight of grumpiness and at least a lunar cycle of runny nose. The illness had, essentially, followed our Advent calendar in terms of length, but had given us far fewer chocolate surprises.

I’d taken her to the doctor three times that month, called twice with follow up questions, and then, before heading in for my fourth visit in as many weeks, was able to speak with the doctor on the phone once more.

“Here’s the thing,” I said, getting my courage, “you’re going to check her ears and find nothing. But, I want an antibiotic.”

I brought her in. He examined her. He asked her about sinus pressure. (She’s two and a half—it was an interesting exchange.) He looked at her throat. He double checked her chart—a long, well documented history of the last month.

The risk, he explained, reaching for his prescription tablet, was that we would give her medicine and it wouldn’t help. It could still be viral.

That risk, a large bottle of amoxicillin in all its bubble-gum flavored glory, was one we were more than willing to take.

Whether we needed 31 days to beat a viral infection, or the medicine combated what was in fact a bacterial one, I guess I don’t know. And, I admit, the fact that we are given antibiotics so rarely is the thing that makes them so effective whenever we are.

Sunday, January 2, 2011

A Sign of the Times

As I write this, I am looking at a well meaning magazine story about the Modern Stay-at-Home Mom. I am modern, by virtue of the fact that I live now, and I am a mom who stays home with her kids, so I suppose I fit the bill.
But I don’t identify with the piece.
Because layered in the story’s presentation—kicked off with a photo spread featuring a woman first dressed in a 1950’s styled silk dress and pumps, clutching a nearly naked babe and fully clothed vacuum cleaner, and then pictured in present-day jeans and sunglasses, pushing a trendy stroller and presumably a child, is the implication that that those of us who are SAHMs now are doing it because we have reached a more enlightened place than those who stayed home with their kids—or did not stay home---in generations past.
Should I feel superior to my grandmother who raised four kids, worked in a factory during World War II like Rosie the Riveter, read more books in a year than I can hope to in my lifetime, and subscribed to MS Magazine—in her late 70’s? I may be contemporary, but in her beliefs and actions in the name of equality, she was modern.
I stay home because I have reacted to an imperfect situation—work/family/childcare---by joining my generation’s “opt-out revolution.”
I admire my peers, both those who head to the office each day and those who join me in the bullpen of domestic negotiations. And I know that in an economic sense, I am excessively and exceptionally lucky to be home with my kids.
But being called Modern implies that my predecessors were old-fashioned. The times may have been, but many of the women were not.
Certainly moms who stay home now can more easily have parallel lives in other spheres, especially because of the technology of our particular era: we can write blogs, sell creations on Etsy and run philanthropies from home offices during nap time. Some maintain the contacts they built before they left careers, and many have partners who are uniquely good at understanding and respecting their contributions and versatility.
But am I more modern than the complicated but ambitious stay-at-home mom of another century, Elizabeth Cady Stanton? Or the moms of more recent times who never became famous, but raised a generation of men who have had the confidence to become Stay-at-Home Dads or support SAHMs?
In her essay, "A Mother of a Year", Stephanie Coontz cuts through the distractions of the time and gets to the heart of things. She writes of a child-care crisis, imperfect work and family leave policies, outdated and impractical school vacation and class schedules--- and the fact that “the woman who stays home faces the frightening prospect that if she gets divorced, she and her children are far less likely to regain their former income than a mother who went back to work within the first year.”
She wrote that in 1998.
I finished graduate school that year. A coincidence that makes me think that the group of women finishing college or grad school now, and the ones who couldn’t afford to go, are poised to be the next cohort to find themselves called “Modern Stay-at-Home Moms".
I know these young women because they are my daughters’ baby sitters. They are the education majors, the mechanical engineers, the graduate students in psychology, who arrive at my house and look at me---my kids running circles around my legs, my dog barking, and my eyes still droopy from a night of little sleep, and are welcomed by a, “I am so glad you’re here,” as I hand my kids off and make my escape.  
I imagine they are thinking, “That is not going to be me.”
The big secret is, “Yes, it will be. You will inherit the chaos of child rearing. But, you’ll do it in your own way, and hopefully, with a little less chaos, and paid sick leave.”
Which brings me to the other side of the misnomer Modern.
To the generation of women starting their careers now, or finishing up a women’s studies class, we "modern" SAHMs are part of what has already been—lives and choices to study, observe, emulate or reject.
I know our stories are far from over.
But, it seems to discount the past, and shortchange the future, to call us modern, as if that, in itself, were a destination.   
We are just one stop along the road. And, looking around, this place appears to be called 2011.

Painting by: Mary Cassatt