Archive | February, 2016

No Medicine is the Best Medicine Sometimes

26 Feb

“Oh, she’s the doctor who doesn’t give medication,” our family friend said when she realized who our pediatrician is. It amused me to hear her reputation described as such, but the good news is that it’s true- in all the right ways, anyway! We have a radical, thoughtful, socially-minded doctor for our kids now. This has been revolutionary for our life.

A while back I mentioned in a blog post that my parenting anxiety was more extreme because of not having a doctor that we had trust and confidence in. (You can read about that here: https://exiletomexico.wordpress.com/2015/01/25/just-keep-breathing/  ) But then- ta-dah!- we found our ideal pediatrician, Dr. Anja. And as we recover from another bout of Lucia’s asthma, and bask in a reassuring check-up for Khalil, I thank my lucky stars yet again for her existence in Puerto and for us finding her.

You guys just don’t know how novel it is to have a doctor who has a file on our kids, a doctor who wants to see them for check-ups. I can quit referring to old Facebook posts to check on their previous weight. I can ditch some of my excessive notes from every illness ever- because now their doctor has that info. I can ask questions and get advice on what to expect, what to watch out for, how to keep my kids safe and healthy- information specifically for my child, not generated by parental desperation, academic websites and parenting books! Her information comes from medical school in Germany, residency in New York, experience in a public hospital here in Puerto, plus her own practice here. It is a much, much wider range of experience and education than most doctors around here. (Not to mention her credentials are much, much better than mine; I don’t even have aspirations for being a doctor, guys! I just want to be healthy and informed.)

And that reputation for not giving (useless) medication? Perhaps it’s frustrating for people who believe you always need medicine, but that’s not us. For us, it’s a miracle to find a doctor here in Puerto Escondido that doesn’t want to inject a patient with antibiotics every time they cough. “It’s an infection,” they tell you, as if infection were a synonym for bacterial-problem-requiring-antibiotics. Or else it’s something like, “When they have a fever they do need antibiotics.” Really? So, the flu now requires antibiotics? Mosquito-borne illnesses, too? Give me a break, doctors. Even when they don’t give antibiotics around here, they always give you some kind of medicine to buy. Of course, if you go to one of those doctors that works in a pharmacy (which costs about a tenth of what a non-pharmacy doctor charges), they pretty much have to sell you some kind of medicine. But even when we took Lucia to a different pediatrician, he still prescribed us some symptom-relieving medicine for her virus (which I didn’t give her because he didn’t resolve my questions about it, and because I’m a mean, mean Mommy). But our pediatrician has the same philosophy that I do about medicine: You don’t need medicine that’s not going to help. Revolutionary, right?

Before finding Dr. Anja, we also had the medical establishment* here telling us that my healthy, in-the-normal-weight-range daughter is underweight and malnourished. I think they told us that because Lucia’s tall and thin now, and thus out of the very limited “healthy” range for Body Mass Index here in Mexico. I mean, they were working with limited information, bless their little hearts. They certainly couldn’t check her growth over time, since they didn’t keep files on her. By using those same limited standards, she would have been considered overweight as a baby, and they probably would have advised me to breastfeed her less or some other such insanity. I suppose the plus side of not having well visits for her as a baby here was the lack of opportunity for them to tell me she was too fat.

By the way, I did not resort to violence, thank you, and I didn’t even laugh in their face at the word malnourished applied to my healthy, often voracious eater. Both times I nodded politely and left as quickly as possible, before they could suggest I feed her chips or something to fatten her up. Yes, that is plausible; a doctor told me I needed to eat more sweets because my blood sugar was a bit low during pregnancy. If doctors prescribe candy to pregnant women, then why not chips and donuts to “malnourished” children? Sigh. The saddest thing is that these 2 different doctors didn’t recommend anything at all for Lucia. They told us she’s underweight with no suggestion as to how to remedy the supposed problem (not that I would’ve listened, but that’s beside the point).

But all that is in the past! Now we have our doctor. And did I mention that my kids like going to the doctor now? Lucia’s always excited to go there. “Are we going to my doctor? The one with the toys?” she asks. You guessed it, Dr. Anja has a waiting room with toys and books and puzzles! There are colorful things hanging from her walls. There’s a giant stuffed animal in the exam room that Lucia likes to hold during asthma treatments. Her walls are painted and her space is inviting. As an added bonus, there’s always soap for hand washing available (you can’t say that about every health center, unfortunately). We haven’t been to any other medical place with this kind of kid-friendly (or even just friendly) environment.

dr anja waiting room 1

The waiting room- You wish you had this doctor, too, don’t you?

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There are even more toys than what you can see in this picture.

Even if she had an ugly, boring office, though, her awesome manner with the kids would still make up for it. The first time we took Lucia there was the first time she wasn’t scared of a doctor. Our doctor knows how to get kids to take a breath before they understand what taking a breath means. She is friendly and talks to them in a respectful way, but on kid-level. She tries to be as noninvasive as possible while doing her job, not making them sit still for more time than they have to, distracting them with toys while she does some things. Of course, I’m sure it also just helps that she’s not trying to give every kid shots of antibiotics every visit.

Dr. Anja explains things to us, the parents, as well. She wants us to understand and be part of our child’s health and care, instead of assuming that we’re completely ignorant about all things health-related and that we need to be protected from ourselves.

She is also trying to reach out and make her adopted community a better place. She now has a bus she uses to take her important services to smaller towns, places where they might never see a pediatrician otherwise. (read more about it here: https://www.indiegogo.com/projects/pediatric-mobile-clinic-in-mexico#/ ) She is also interested in maternal health and promoting more options and information about pregnancy and birth, which is another desperately needed service down here. (What’s that? You guys can sense the future collaboration happening between us? Here’s hoping!)

Being from the U.S., of course it makes me feel at ease knowing that our doctor is familiar with best practices and protocol on an international scale. It’s nice to be able to talk about health issues in my native tongue, too. But it’s not her being foreign and trilingual, or her having experience abroad, that makes her our ideal pediatrician. There are great doctors around here who are from here; for example, my gynecologist is home-grown on the Oaxacan coast, and he’s brilliant and ideal for me, too (someday I’ll write a gushing post about him). Likewise, you can find plenty of doctors in the U.S. who are just as willing as most doctors here to give you antibiotics for your virus. I’m sure Europe also has its share of doctors who think all patients are idiots because they didn’t go to medical school. So it’s definitely not her being foreign. It’s her attitude, her way of doing things, combined with her knowledge, that make her the perfect pediatrician for us.

So amen again for the peace of mind that comes from having a great doctor available. Now we just need to find a good general practitioner for us grown-ups, so the whole family can get sick whenever we want, without the stress of relying on Google and tea to cure us. Meanwhile, y’all who don’t live in Puerto can hope you find your own Dr. Anja. Good luck!

 

*I’m sure there are plenty of good doctors around here. I’m not saying other docs are all awful, but we’ve had some unpleasant consultas, and I am saying that the other doctors that we’ve visited are not a good fit for us. And, okay, I am talking bad about the many, many doctors everywhere who don’t want you to ask questions. They are bad doctors if they don’t want the patient involved in his/her own care, in my humble opinion. For more examples of the madness, you can read about my fight with my insurance company doctor during my pregnancy here: https://exiletomexico.wordpress.com/2015/02/01/me-versus-the-insurance-company-doctors-a-saga/

The Camote Conundrum

22 Feb

I never really understood the difference between yams and sweet potatoes, despite the internet’s wealth of information, but I damn sure know the difference between sweet potato and, say, potato. I definitely can taste the difference between the smooth sweetness of a sweet potato and the starchy blandness of yucca. Or so I thought, anyway.

If you’re from the U.S., you probably don’t really know the difference between sweet potatoes and yams, either. According to the Huffington Post- and several other websites*-, the USDA (U.S. Department of Agriculture) long ago decided to label some sweet potatoes as yams based on their color and texture, even though yams are actually a different plant. (´Merica. Sigh.)

When you add Spanish language and American cultures into the mix, things really get messy. Here in Oaxaca, it all gets called camote, the word used here for sweet potato.  However, some of the things that are called camote look and taste to me like yucca (the term used in Cuban restaurants in Louisville) aka mandioca (the term used in Paraguay where it’s a diet staple), which apparently is called cassava in English. I think. Confused yet? Great. Me, too.

Since I’m not a botanist, perhaps all these multicolored roots are all camote, and I just can’t wrap my little gringuita head around so many types and flavors of sweet potato.

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Just a few of the many kinds of camote I run into in the market

They don’t all taste the same, either, so occassionally I buy something and am unpleasantly surprised by its flavor. It happened to me the other day- I found myself with a whole kilo’s worth (2.2 lbs.) of boiled camote that tasted bland and sticky and starchy like yams (cassava? yucca? mandioca? Whatever it’s called- the semi-flavorless one.) Now, according to what I’ve since read on the grand internet, cassava requires more processing or it can be poisonous. Since we didn’t die of cyanide poisoning, I suppose it really wasn’t cassava. But geez was it dull!

But as any good cook knows, really bland food is an artist’s blank palette. Did you know, for example, that tapioca comes from that boring old cassava root? So I set out to make it taste like something a little jazzier. I used my typical tactic of blending about 5 different recipes with my own ideas. Here’s the recipe I came up with, in case you ever find yourself in a camote conundrum like mine:

Camote Patties

Ingredients:

2 cups camote, boiled and mashed (perhaps 1/2 – 3/4 lb.raw)

1/4 lb. ground beef, fried with 1/2 an onion and 2 cloves garlic (could be omitted or substituted for soy, with extra spices)

3/4 cup corn kernels

handful of cilantro, chopped

very generous sprinklings of salt, pepper, cumin, paprika

garlic powder and hot red pepper (cayenne or other) to taste

2 eggs, beaten

breadcrumbs

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my mixture… the purple part is the camote

Instructions:

  1. Boil the sweet potato / potato / other root vegetable (I bet turnips would work nicely, too) until soft. Mash with potato masher and set aside.
  2. Fry the ground beef with onion and garlic and the spices listed above. Set aside. (I did this in steps- one day I cooked the camote. The next morning I cooked the meat. In the afternoon I actually finished cooking the meal. It’s no big deal for things to be refrigerated while you’re getting it all together if needed.)
  3. Mix in all the ingredients for patty mixture- camote, meat, corn (thaw first if frozen), cilantro and more spices. Form into patties whatever size you want. Dip in egg and then in bread crumbs.
  4. Fry for 5 minutes on one side and 3 on the other (disclaimer: that’s an estimate. I didn’t actually time it- I just eyeball it.) on medium heat, until a little browned on the outside.
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frying the patties

Alternately, you can mix the egg and breadcrumbs into the patty mixture and fry from there. I opted for this dipped version to cut down on the amount of egg and breadcrumbs I used, but I made a couple the alternate way at the end and they were really good. Regardless, my kids devoured these, and Conan and I both enjoyed them as well. I plan to use this recipe next time I accidentally purchase the wrong kind of sweet potato. Enjoy! Buen provecho!

*This website had the clearest explanation: https://www.loc.gov/rr/scitech/mysteries/sweetpotato.html

Or here’s a funny flowchart if you’re still baffled and need to know:

http://lifehacker.com/this-flowchart-shows-you-if-youre-eating-a-yam-or-a-sw-1472702569

This Post Brought to You by Nina Simone and Pollyanna

14 Feb

At the end of every semester I have a couple of weeks of sitting around the office doing office-y things (grading, paperwork, planning, etc.). It always starts as a nice change of pace, a much-needed break from the normal teaching schedule. On day one I’m like “Yes! No students! Finally I can respond to all my emails!”

By day three I’ve answered all my emails and googled some important matters, such as “why does my 3 year old want sandwiches all the time?” and “lyrics to Beyonce video.” In addition I have most of my grades calculated, half of my paperwork completed. I’ve done some online shopping (did you know I can get cashew butter sent to Mexico!?) but then discarded the items before paying as I calculate how many pesos that is. I’ve congratulated and scolded students on their grades, and made my first trip to the dreaded vending machines.

By day six I’ve read more news than my optimism can handle, know 300 more useless facts about childhood development, and have gained 3 pounds from sitting around snacking all day. My anxiety’s up- between the news and the extra coffee I’m drinking, my eyes are red and strained, my body’s cramped and bloated and I’ve driven all of my coworkers crazy by roaming into their offices to chat constantly. I’m like, “When do classes start again? Where are the students?” Even when I have plenty of office work to do, I can’t stay focused on it for eight whole hours, staring at a screen, alone in my cubo.

2d886f1177bc9ea8853cdc65fc62de7c I ask myself, “How can anyone be productive for a whole 8 hours a day, while sitting the whole time, 5 days a week?” Y’all who do so are obviously made of stronger stuff than I am.

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Yoga time at the office when there are no students (this is not really me, but it could be!)

 

But I’m trying not to be like this:

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I mean, complaining about this is a bit crazy anyway. “Woe is me, I’m getting paid to sit down and work and still have some time to surf the internet!” And after I hit my news website, the idea of complaining becomes not just absurd, but also callous, offensive, and self-absorbed.

“I’m sitting in an office while other people are having babies with underdeveloped brains, thanks to Zika virus. Woe is me!”

“I could be getting deported to a home country where I’ll probably be killed, but no, I’m stuck at the office all day!”

“I could be fleeing war and death, watching my family suffer or die on the journey, but instead my butt is going numb in this chair. Damn!”

“My only venture out for the day is going to the snack machine, while folks in some places get to spend all day running around trying to procure safe water. It’s not fair!”

“Other moms are praying that their kids can stay alive if they’re stopped by police, but I’m forced to sit around googling about positive discipline for toddlers instead. Alas!”

You see what I mean.

Thinking about others doesn’t make my butt less numb, but it does change my perception about it. This semester’s end, I’m all about the reframe. “It’s so great that we normally have students!” I exclaim. “We’re so lucky to have a job where we can sit some and stand some, be introverted and extroverted, think and talk and move, all in the same eight hours!” I enthuse to my coworkers (on one of my many trips to annoy them in their office). “I love my job!” I shout, especially when I’m leaving at the end of the day.

I’ve been applying this reframe to other areas of life, too, with pretty sweet results. Here’s another example.

Before my reframe: “Getting up at 5AM is the pits! And it only nets me 20 measly minutes of exercise! I only squeeze out 10 minutes of me-time while I drink my coffee! I’m so tired! When am I gonna not be tired?”

After my reframe: “Getting up at 5AM allows me to have 20 whole minutes where I can feel the power and strength of my body functioning.  I can appreciate my fully-functioning body. I also get a few minutes for quiet, child-free reflection with my locally made, delicious Oaxacan coffee. And I get to see a beautiful sunrise every day. I’m going to be tired for most or all of these child-rearing years anyway, so I might as well make the most of it.”

When I’m mumbling curse words about my children and my bad luck in having children who hate to sleep, I can take a step back and remember that moment 15 minutes ago when one or the other of them made me laugh or knocked something over in their excitement over seeing Mommy (Me! That’s me! I’m a Mommy! Already a win.). I can remember that they fill me to the brim with joy more than they fill me with frustration. The moments of frustration and Mommy-rage are worth it. The fog and delirium of early mornings is worth it. The days at the desk are worth it. My life is freaking fabulous!

Of course things aren’t perfect, and they’re not supposed to be. Everyone has their own struggles, and even when they’re not dire, sometimes you need to vent about them sometimes to get it off your chest. However, I don’t want to spend more of my life entertaining thoughts about the negative than feeding thoughts about the positive. I’m working to stop and think before I complain out loud, to decide if it’s something worth complaining about or not. I don’t want my main conversations (with myself and with others) to be full of complaints. It makes me so much lighter to reframe my complaint in my own head meanwhile and see if I can’t find the upside.

It works a little like this: I think something like, damn dirty dishes! But instead of saying that I cancel it out and say “That was a great meal!” Never ending laundry? I’m still so happy that we have electricity and a washing machine! Sweating like a pig? I’m not cold! I love the sunshine! Screaming children? We have screaming children! (That’s good right? They’ll be vocal and opinionated like me.)

And when that doesn’t work, I can listen to this Nina Simone  song and dream of one day being as vibrant, brilliant, beautiful and alive as she was.

 

 

 

An Empirical Study in Parenting a Three Year Old

5 Feb

Banging your head against the wall is not an effective parenting tactic, as it turns out. Even if your walls are made of concrete and you do it repeatedly, your survival instincts appear to be too strong for it to put you out of your misery. It also does not make the children behave in the manner you’d like. It doesn’t make the baby sit still during diaper changes. It doesn’t make the three year old take her damn nap. Nothing. Sad but true, folks. Sad but true.

Screaming the f word at the top of your lungs is another tragically ineffective tactic. If you scream loud enough, it might scare them and make them pause for some miniscule amount of time. We’re talking a few seconds, here, though, not the 10 minutes or 3 days of break from the madness you were hoping for. In fact, it’s liable to make little ones cry, which means you’ve just made the problem worse. You’ve gotta soothe them and you now feel guilty on top of it. And the baby is heading straight back to the cat’s litter box meanwhile. Crapola.

Corporal punishment is an equally ineffectual technique for me. First of all, there’s that pesky little voice in my head that says, “we don’t hit people,” and damned if it’s not my own, real, non—psychotic voice saying that very thing to my kid. I spanked Lucia once in an instant of shock and rage over her purposely hitting the baby hard when he was itty bitty, and I’m pretty sure it was, indeed, worse for me than it was for her. Later that night she said, in this sad little voice, “Mommy, don’t hit me anymore,” like it’s this regular abuse I dish out to her, and that totally sealed the deal on keeping that out of my parenting repertoire.

 

I also can’t use corporal punishment because when she pushes my limits, I occasionally have the urge to shake some sense into her. Like when she refused to help me during clean up time, then proceeded to dump on the floor half the toys I’d just picked up, I had a brief moment of rage so strong that my reptilian brain encouraged me to fight back against this mutiny, to show that brat who’s boss! Immediately after that urge, I thought, “Whoa, who the hell are you, Julia, and did you know this is your tiny child who you love more than chocolate?” Alas. Violence is not an option for my parenting strategies.

 

The worst thing, though, is that my go-to parenting tactic for the 3 year old is totally the most insane: Reasoning. I try to implement things like rules and routines, positive and negative consequences, rational discussion. Have you ever tried to reason with a three year old? Have you even interacted with a three year old?? Reasoning can’t work, because the three year old mind is the antichrist! Errr, I mean, it’s antilogic! They are completely irrational savages! In case you’re not intimate with any 3 year olds these days, let me give you some examples. Let’s call this my little case study in treating your child like a small but reasonable human being, and you can see for yourself how effective it is.

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This is known in our house as: “I’m really tired so I can’t go to sleep because I’m too tired”

Evidence #1: Rules, Schmules aka “You can’t see me because my eyes are closed.”

 

“No, Mommy,” my daughter scolded me. “I’m going to hide over here first, and then you go in the kitchen and count,” she said, explaining to me how hide and seek works in her world, showing me exactly where she was going to hide. Then when it was my turn to hide she indicated exactly where I was to hide. (In another instance of her incidental wittiness / rule-breaking, when her Papi told her to count to seventeen, she counted, “1, 2, 3, 4, 5, 6, 7, teen.”)

 

It’s not limited to hide and seek, either. These monsters will snatch your Memory card right up when they see it goes with the one they had in their last turn. They stick whatever foot they want in the middle during the hokey pokey. They just don’t care about your rules.

 

Or you take the time and energy to set up rules and routines only to have them broken repeatedly. “Play time’s over now,” you remind the savage, for example. “This is clean up time.” But to them that means they can remember what they were doing with these toys a couple hours ago and start it up all over again. Shower time means time to clean the bathroom floor with Papi’s bath sponge. Nap time means they’re starving and need to finish the lunch you didn’t want 30 minutes ago. Need I go on, folks? There is no logic and no respect for the establishment!

 

Evidence #2: Panic Attacks aka “The sky is falling! Even if it’s only rain, it’s still the end of the world!”

 

Saying that a three year old can’t regulate their emotions is the understatement of the year. These people haven’t seen my kid have super freak-out/tantrum/panic attacks over things like cutting the wrong shape for her sandwich: “I wanted a rectangle, not a triangle!” or the baby touching something she thinks he shouldn’t: “The baby’s gonna get the apple! The baby’s gonna get the apple!” she shrieks, even when you tell her that it’s not a problem. Other dire moments for her include “The video’s on and nobody’s watching it!” and “But I can’t see with my eyes closed!”- her favorite freak-out during an attempted nap time. Getting food stuck in her teeth, me sitting in the blue chair instead of the white chair (or vice versa the next day), her forgetting to put the cereal bowl on her head before I put the cereal in- all of these things and so much more can bring on shrill screams, panting, crying, full-out thrashing attacks until the crisis is resolved.

 

Evidence #3: No Impulse Control aka “But I really wanted to color on the baby’s head”

 

Three year olds have a lot of ideas about right and wrong, which is good. But they can’t quite talk themselves into doing what’s right or not doing what’s wrong, consistently. Her impulse control is certainly better than when she’d say, “no milk floor” while pouring her milk on the floor, but she still has a lot of slip-ups. She has not yet learned to lie, so when I ask her, for example, how the baby’s head got marker on it, she tells me proudly, “I colored on it.” She proceeds to tell me that we only color on paper (aka yes I know I done wrong) but she just colored a little bit on his head because she really wanted to. Oh, well, okay then.

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Repeat after me: “We only color on paper, we only color on paper” (this picture is from the internet, but you should see my nice sheets and this precise look on my 3 year olds face)

Evidence #4: Negative Consequences are the Best aka “I want to do it the hard way”

 

I try to set up logical consequences to convince her to follow the game plan, only to have her laugh in the face of consequences. For example, I tell her that if she showers with me right now when it’s time to shower (and not with 10 minutes of coaxing and nagging) then we’ll have time to read an extra book for bedtime. Usually her response is something like, “But I’m playing with my blocks. I just need to make this house.” Or, “But I’m taking care of Lucia (her kangaroo/big sister child). I have to put her to bed first.” Then at bedtime she still thinks she gets an extra book!

I can either coax and nag or break out the big guns- “Do you want to do it the hard way?” The hard way, of course, is not pleasant for anybody. It involves forceful lifting of the savage, lots of tears, some screaming, the whole dramatic routine. Sometimes the threat of the hard way (and the counting up to it: 1, 2, 2 and a half…) encourages her to get with the program, but sometimes she busts out her future-13-year-old defiance and yells: “I want to do it the hard way!” (Geez, she is so my child.) Then we do it the hard way, and she hates it and screams and yells about how she doesn’t want to do it the hard way. Three year old logic.

 

I try to explain to her about logical consequences. “You know that Dora DVD that doesn’t work anymore because we didn’t put it back in its case and now it’s all scratched up? Or that chicken puzzle that’s missing pieces?” I ask her, and she nods. “That’s why we need to take care of our things. That’s why we need to put our things back where they go when we’re finished.” I tell her, foolishly believing this will enlist her in clean up time. “But I’m playing. You do it.” She told me the other day. She even told me the other day I could give away all her toys to someone else, that she didn’t want them anyway, just to avoid cleaning them up. The other night I told her that if she didn’t help clean up I was going to put her toys out in the shed. She didn’t care until I told her that included her “Lucia” and the tent she was currently “living” in. “But we don’t put people away!” she insisted, explaining why her kangaroo doll (a person!) couldn’t possibly apply to this. And then she says, “Just put the tent where I can’t reach it. If you put it outside in the shed, the ants are going to eat it.” Once again, I wasted more time having this conversation than what it was worth to acheive the end result of her picking up approximately five blocks. Obviously, though, my three year old has lots of reasoning happening in her brain. It just doesn’t happen to be reasoning that helps me in any way.

 

Analysis

Let’s review our parenting tactics and their effectiveness: head-banging and screaming curse words- counterproductive; spanking- personally incompatible; reasoning, discussion, consequences, routines, etc.- results variable, could be equally attributed to chance alone, or to children raised by wolves. More studies are needed. We are now nearing the baby’s first birthday, and it appears we’re keeping the three year old despite all evidence against her, so we’ll have plenty more opportunities for this important research. Please keep us informed about your own studies as well.