family life « Random Thoughts Today and Tomorrow

{January 26, 2010} Back in the US, Jetlagged with two kids

I’m back! I don’t know why but my blog was blocked again in the last few weeks of my stay in China so I couldn’t write any random thoughts.

Anyways, we’ve been back for a couple days now and eegh! – it is always a pain to adjust jetlag coming this way. It’s just harder. My husband and I debated how to do it again, like we do every year. Do we adjust backwards or forwards? IE: do we let them sleep later everyday, or wake them up earlier everyday. So I point him to my blog entry that I wrote last time about adjusting jetlag: http://pj.moretang.com/2009/02/09/adjusting-your-babies-jet-lag/ and we agree to do it my way. We’ll wake them up one hour early each day and pray they sleep an hour early that night.

So far it’s going pretty well. I think partly because we know what to expect and partly because the kids are older now. First night my 2 year old slept from 2 am until 10 am. My 1 year old son has not done as well, waking up in the middle of then night for several hours and breaking up his sleep patterns into several long naps. Finally I decided he needed one long sleep cycle, a good 9 hours and made sure he got that.

I think because I’m not as worried about them not adjusting, I’m also letting them sleep more during the day. I remember part of the worry before is “what if they sleep too much and don’t sleep at night?”. And we push off their nap and push off and push off, until either 1) they can’t take it anymore and crash too early just to wake up in the middle of the night or 2) they are too jittery to have a good nights sleep. So this time it appears they are sleeping the right amount and still sleeping well at night.

A fun chat I had with my husband this morning:

me: i have no problems falling asleep before 12

after 12, after our son wakes up

i have insomnia

until my hunger goes away

there is probably a quick solution for that

my husband: lol

i don’t know if the word for that is “insomnia”

you should start eating our son. two birds, one stone

{December 7, 2009} Update from China – Notes to Self for Future Trips

I made it to Shenzhen, yet again with my two little kids. I think everybody including myself were expecting this to be the worst flight so far. It’s been extremely tiring on all of us in the past. I was expecting it to be hard on me because of my son, who is now 14 months and just such a boy.

Instead, surprise, surprise! It was such a refreshing flight. They both slept remarkably well. My son didn’t want to wonder the hallways too much. He did a little bit in our first-class cabin, but didn’t have to chase after him into business class or economy or anything. And he took a 2 hour nap after wards. And fell asleep as we landed. I got breaks to eat. I got breaks to watch a little bit of TV. It was amazing.

My daughter slept well too, and had a long nap all the way until the landing.

Adjusting the two kids jet lag is an art that I like to think that I have mastered. This time it is going well beyond my expectations. My son usually sleeps at 9 pm Pacific time and wakes up around 8 am. That is 1 pm and midnight China time. So that is what we are working with. The week prior to leaving, we started trying to let the kids sleep later and later. It was a bit tricky since no matter how late I slept with my son, I would still have to wake up early the next day and I had interviews.

In China, they usually would go to bed around 2 pm and wake up a little after midnight.

This time it was just amazing. First day they both slept around 5 pm. We were in aww. Even more in aww that they both woke up 3/4 am. Second day they slept around 6/7 pm. Both still woke up around 4/4:30 am. But it does look like this time it will only take a couple of days to adjust.

Now tips to myself for the future. We always mail clothes and we mail summer clothes. Just in case it is soo hot and we can’t buy any summer clothes locally. And we bring little winter clothes thinking we can easily buy all the winter clothes we want.

This plan has been fairly backfiring. We end up with loads of summer clothes, fell rushed to go buy winter clothes.

I think in the future it is to mail winter clothes. What they ultimately need is long-sleeve t-shirts and medium thickness sweat pants. Don’t need that much shorts, or tanks, or dresses, or skirts.

Looking at the weather pattern is will be in the mid 60s to 70s for this week in ShenZhen. Very comfortable.

We did mail summer clothes in the case we go to Sanya – which is in the mid 80s. So it might work out this time in that sense.

I also brought one thick set of winter clothes for the possibility of going to Nanjing – which is unlikely as it is raining all week and it is in the mid 40s to low 50s.

For myself – the main thing is to have two pants that I love, two shirts I can easily interchange. And one comfy cardigan. I think I did well this time packing. Just not as much long-sleeves shirts for daughter (only two) and socks for son.

I’d just like to see it go easier next time. Mail more clothes that we need, and less that we don’t. And we can always adjust as the weather gets colder.

All this might be moot, since I don’t know when is the next time we will do such a trip. And in April we will be going to Nanjing and the weather will be completely different.

Addendum: For the past few days here in Shenzhen, it has been a lot warmer. It gets to 85 in my room. The t-shirts and shorts have come in handy. Can’t go outside in shorts, yes in T-shirts. I think it would still be best to mail some t-shirts, not as much, and just of couple of shorts for son, none for daughter. A good thing to remember is that the clothes dry a lot faster when it’s warm, so we don’t need to worry as much about laundry backing up.

{October 30, 2009} Got H1N1 Vaccines?

I’m not here to discuss whether people should or should not get the H1N1 vaccine. I think there are plenty of good reasons to get it, IE patients with chronic medical problems where getting H1N1 would really knock them out. And there are good reasons not to get it, IE most patients I’ve seen with active H1N1 do just fine.

Either way, my husband and I made a firm decision to get it for our kids and me. I was really hoping to get it before my ER rotation started. And as both my kids are under 5 and need two shots each, we were really hoping to have them get it before we head to China again for the holidays. Not that they are at increased risk of getting it in China, it would just be an extreme inconvenience to be sick while traveling.

Once we’ve made our decisions, next came the hard part. Where in the heck can we get the H1N1 vaccine? We kept calling our doctor’s office (Woodland Healthcare), and they always have the same answer “no and don’t know when.” We called all the pharmacies in the area and got the same response.

Kaiser had both the H1N1 injectable and nasal vaccine for 1-2 weeks prior to anybody else. However, you have to be a Kaiser member. We were willing to pay or even join, but got rejected. It seems to me this was poor planning to distribute a large amount of vaccines in high demand only to a subset of population and not allow any access to other parts of the population that would really need it. What can you do, it’s a private organization and it will take care of its own. (I have my own biases against Kaiser as I have in the past applied for medical insurance when I first got pregnant, obviously for the pregnancy. And I was DENIED for having a medical condition such as pregnancy. My nanny recently broke her collarbone, and while broken collarbone typically don’t need surgeries her Kaiser FP and orthopedic doctor decided she did. One would assume on the basis that her’s might have been more emergent until I heard it was scheduled for a week later.)

Back to the H1N1 vaccine status:

We started following the news and calling county health departments.

Where we live we are close to three counties: Sacramento, Yolo, and Solano.

Sacramento was the first we heard that had the nasal H1N1 vaccine. My daughter qualifies for it but not my son. We decided to wait for the injectables so that they can get it both at the same time and it would be easier to track for us.

Then Yolo County Health Department got their shipment of nasal H1N1 vaccines. My mother-in-law, my husband and I must have called multiple times that day to confirm that I, a medical student, would qualify as a health care worker. I get off work early to drive 50 minutes out of my way to be turned away. They were only giving it to children ages 9 and younger and pregnant women and women with children less than 6 months of age. I was a little annoyed that they answering service was so unprofessional and uninformed, I wasted my time going up there. However, I was okay with being turned away as long as they were prioritizing. I don’t want bad karma following me just because I took a vaccine that belong to a little kid.

Solano County Health Department gets their shipment of nasal H1N1 vaccines and the day before they start their clinics, they also get their injectables. The best part about them is that they have an amazing phone line to call for information. Their website was constantly updated. And a very awesome person that worked in the department that deserves so much kudos, took down my husbands and my names and numbers. She called us every time with updates on the vaccine clinics.

Their first clinic they only had nasal H1N1. I decided to go myself to check it out. I got there maybe 5 minutes after they were supposed to start. It was a very cold and windy day. The line was already maybe 100 people long. I’m very happy I didn’t bring my kids that day, if they weren’t sick, they would have been sick afterwards from just the wind. The clinic got started a little bit late, however, they were extremely efficient once they opened their doors. I got my nasal H1N1 vaccine in about 1 hour. Instead of actively screening like Yolo County was. They were passively screening. They had on a form that listed the criteria for getting the vaccine and this time it included health care workers and specifically said emergency personnel. And it asked that people who do not qualify – please do not ask for a vaccine. Otherwise they did not ask anybody or turned anybody away, except for technical details like getting the nasal seasonal less than 4 weeks ago, etc.

The next day, Solano Health Department was hosting another H1N1 vaccine clinic, this time with both nasal and injectable form. We decided to bring the kids this time. I thought that the line would be perhaps the same, not much worse. I was very wrong. The line outside was very long. My husband went to wait in line while the kids slept in the car and then when they woke up, I took them to a local park. It took maybe 1.5 hours to get to the front of the door. Once inside we got a number, we were 133. They were calling number 85. There were people coughing and sneezing all in the waiting area. So once again we took turns taking the kids outside. This wait wasn’t too bad, maybe 30 minutes.

Our number gets called and we’re thinking, okay very soon now. We go inside and there is yet another line for the injectable vaccines. It is a short line, maybe 20 people, but it was a good 1.5 hour wait. It was hot and stuffy. There was a mother in front of me with 3 kids. She had an older daughter around 6 or 7, a toddler in her right arm and an infant in a carseat in her left arm. She was amazing.

Total time wait for H1N1 injectables would be 1 month by the phone and then 3.5 hours in line. I kept thinking, these poor infants/toddlers waiting so long just to get poked by a needle and this is a good thing?!

Now then next step is to just hope that when it comes time around for their boosters, there will be enough left.

And how ironic is this. My son also needed two shots of the seasonal flu vaccine, being this is the first time he is getting it. I had originally decided to wait to try to get them at the same time – nobody wants to go to the doctors multiple times just for shots. Of course, now, we cannot find seasonal flu shots anywhere. My doctors is out of them, tells us to call local pharmacies. We called every singly pharmacy in the area and many don’t have them, if they do, they do not do pediatric seasonal flu shots.

My husband and I had another heart to heart talk at this point and decided the seasonal flu shot – not as important this year.

Good luck to all those this season dealing with H1N1 madness!

{May 7, 2009} Posting on Craigslist for a Babysitter

I decided to post on Craigslist for a babysitter for the summer. I’m going back to school next Monday. Some of the responses I’ve recieved has just been amazingly unprofressional. What are these people thinking? Why would I trust them with my kids?

Here are some examples:

From LuVnYa4Eva (loving you forever): is this job still available? i love children but i do not speak mandarin chinese only english, although my boyfriend does even though that doesn’t count but im really intersted let me know thanks.

- This was the whole email. Did not even provide a name or contact information or any background. Yea, sorry so not leaving my kids with you.

From a Boy GaGa who’s email is crazed3009@

- Yea, sooo not hiring someone who goes by Boy GaGa or calls himself crazed….

And I don’t understand these’s people where their email name and their real name doesn’t match. I’m not going to write her name, since it might be her real name, who knows. But…

dangerwoman81@whatever.. So not letting my kids hang with a dangerwoman81, sorry, but no.

{April 2, 2009} How to find a Chinese Nanny – Craigslist!

I’d like to think I’m an expert at this, now that we’ve gone through sooo many nannies. I’ve done a lot of searching on what’s the best way to find a good Chinese nanny. The advice in the past have to post in the Chinese newspaper (Renming Ri Bao). Now I say, post on craigslist! It’s cheaper and pretty effective.

We’ve had nannies that came from nanny services. There’s about 6 main companies in the Bay Area. They are for the one month post-partum period and cost about $2600 for 26 days. Each company have their on niche, like basing their practices from Taiwan, and etc.

Those nannies are expensive and don’t make good long-term nannies. It’s hard work being a post-partum nanny, but they do it for the money. And when they are done with the 26 days, they can take a break for as long as they want before they decide to pick up the next contract.

I used to think they were the super-nannies and that they should know a lot about everything. But now I realize that they really are the most opinionated and probably know the least. They are great for that one month old baby, but don’t have much experience in doing much else.

Posting in the newspaper you can find nannies from $1200 to about $1600 and of course even more. The problem is that I live about 2 hours from the Bay Area. When I post, I can get about 20 to up to 50 calls. But as soon as they learn where I’m located, they aren’t as interested. It’s also really hard to to interviews over the phone. Most of them don’t drive. It doesn’t help listing my city, because most of them don’t read English or wouldn’t know still where my city is.

I’ve read before that posting on Craigslist is useless. Since most of these nannies don’t read English. Well I have to say that whichever website I was at then was very wrong.

It is true that the nannies don’t read English, but their children do or their friends.

I’ve been very successful at finally finding a nanny that lives close enough to us that she’s here Monday through Friday and gets a break on weekends.

So try Craigslist!

{April 2, 2009} Fever and Vomiting solved

She broke out in a rash. Whew. Thank goodness.

What disease could it be when it’s high fever for a couple of days. Fever leaves and rash comes?

Roseola infantum!

I’ve never been so happy to see a rash. If she hadn’t had two episodes of fever before this, I wouldn’t have been so frantic up to this point.

{April 1, 2009} Fever and Vomiting?

Since coming back from China at the end of January, my daughter has been sick 3 times (currently on her third time). I’m getting more and more frustrated each time and I’m running out of theories.

She’s never been one to have high fevers, typically gets low fevers for a couple of days to a week and then starts to get better.

Remarkably in China, she never got a fever. She did have a very serious watery diarrhea for a week, but that resolved on its own.

The first episode since coming back was definitely due to a viral URI. She had low-grade fevers and had all the upper respiratory symptoms of cough and runny nose. Lots of stuff running out her nose. It went away in about a week or maybe two.

She was a week symptom free when all of the sudden the fever returned. Not super high, but not super low either. She didn’t have any of the URI symptoms anymore, JUST fever. And of course feeling very crappish. We had to give her Motrin just to perk her spirits. She was EXTREMELY irritable without it. That went away in a couple of days and we thought, maybe she just never got over the first episode.

But now, I want to say it’s been closer to 2 weeks when her fever came back again. She even had her 2 year old checkup and was very happy with the doctor. Her only shots was a PPD and a hepatitis A vaccine. Both very safe on the side effects of things. Had the shots on Friday. Fever came Sunday night, started low in the 100-101s. Monday night it was all high fevers the whole time, above 103s and Motrin was barely bringing it down to 101. Brought her into see the doctor on Tuesday.

It’s frustrating, because I agree with the doctor that there are no localizing physical signs. This time she was also still a happy kid even with the fever. So we decided to bag her urine. My husband was the one that brought it in and he said that the lab found no evidence of infection, but there might be some trace of blood? I have no idea what that means in terms of “might be?”?

She’s been vomiting, but mostly milk and only when her fever goes past 103, so we are pretty sure it’s due to the fever. She’s not dehydrated. Doesn’t have any other symptoms. It’s really starting to be extremely worrying. I have no idea what’s wrong and it’s very frustrating.

Anybody have any suggestions or clues for us?

It’s Wednesday and if by Friday she’s not perking up, it might be time to draw some blood.

{February 23, 2009} Babies Sick

My babies are sick, both of them. Started with a cough. Now it’s a cough and a fever. The older one is also vomiting. The younger one is doing better, maybe because he’s still breastfeeding.

It’s one of those things where my medical knowledge starts to conflict with everything else in my brain.

When do I give acetaminophen? Some website say over 100, some say 103. Who came up with the arbitrary number? Didn’t my school give a lecture about how fevers are really not dangerous?

And then when do I call the doctor? When do I go to the doctor?

If I hadn’t already done an ER rotation, I would probably be at the doctors. But now that I’ve worked in a ER, I know the kid should be really really sick or else we would be waiting around for hours just to be kicked out. On my ER rotation, I pretty much had to kick out all of the pediatric cases that I saw.

Now, why isn’t the doctor calling back?

It’s going to be a couple of long nights…

{February 9, 2009} Adjusting Your Babies Jet Lag

My first born is under 2 years of age and she has already been back to China three times. Dealing with jet lag is always a pain, especially when coming back to the US. However, I believe my husband and I are really getting better at it.

This last time was different, because now we have two babies. We’ve looked up the internet on this jetlag issue before and the advice is always to adjust them early, even before you get on the flight. But most of the advice is assuming people are traveling between states, not halfway around the world.

This time, we followed the advice. We let the babies sleep later and later everyday so that they were going to be around 11:30 to midnight. We did this because our flight to China was leaving at 12:30 am. So we figured it’s better that they can stay awake until the plane takes off.

Going to China is 15 hours, coming back is 12 to 13 hours.

Going to China – our bedtime is their afternoon (around 2 to 3 pm). So it’s not that bad. We just go to sleep around 2/3pm and wake up around 2/3 am. And we move that back by 1 to 2 hours everyday. It’s actually kind of nice to finally be an early bird for once.

Coming back is always the hard part. Because now, our bedtime is like 8 am in the morning. It really doesn’t help to go to sleep at 8 am in the morning and then wake up 8 pm at night and just be awake all night. In the past, we’ve also tried to adjust backwards where we made our daughter sleep an hour later each day. That really took a long time to adjust – almost 3 weeks. And it was painful. This time, we adjusted forwards. We would wake our daughter up and hour early each day. This worked so much better. She adjusted pretty much in a week.

We really couldn’t apply the same strategy to our son – the younger one. So that was the tough part. As my daughter got adjusted and he didn’t – I found myself being up all the time. As soon as she fell asleep, he would wake up.

Either way, it hasn’t even been two full weeks and they are both adjusted now and I’m just happy I can get 6 hours of sleep per night.

I think this experience is preparing me for residency.

{October 23, 2008} One Stuffy Nose, One Vomiting Baby

Is two kids too much? Especially so close in age? 18 months apart to be exact. I wonder how my parents did it. My sister and I are 2 years apart. It’s almost like going one on one, parents to kids, but not quite. It really is more like the kids over power us.

My newborn baby boy has a chronic stuffy nose. It started about 3 weeks of age. Then it went away for a week and now it’s back. Most of the time is just sounds nasty, and he feeds okay and as long as you prop him up, he sleeps okay too. Other times, it’s very frustrating. It’s a lot of bulb suctioning and nasal drips. And those vaporizers. I made an appointment to see one of my professors and for some OMT and I can’t wait.

My older one recently has been very pukey. Three times today she’s puked up formula. Yes she’s still on it. She was down to one bottle a day. But today, she was calling for it, and not too long after she has it, she pukes.

It’s stressful. What’s more stressful for me, is the other adults in the room freaking out. Gotta maintain control. And not scare the kids.

I guess it’s from my ER rotation I get this from, but I ask right away to myself – “Sick or healthy?” She’s well-hydrated, not feverish –> she’s healthy. Okay, let’s not go to the ER. What would one of my preceptors say if they saw a patient like this. “Keep her hydrated, it’s okay if she doesn’t eat for a couple of days. Use a syringe to feed little bits of gatorade at a time if you have to.” So maybe a trip to the clinic is not necessary as well?

But I’ve decided a long time ago that I don’t want to be the doctor of the family – too much responsibility mixed in one. I just want to be mom.

So we’ll still call the doctor tomorrow just to be safe.

Of course, just to be safe, I threw away the newly opened formula can, just in case there’s preformed toxin sitting in there. And we opened another can. It would really suck though is those cans were packaged together.

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