After a lice scare at my daughter's preschool, I thought to myself - this is the glamorous life a pediatrician! Nit combing random kid's hair - Wow!
Next time I will do this with while wearing a tiara and opera gloves - because my life is THAT glamorous! I also found a lot of misconceptions about lice and lice treatment exist. So I pulled an old article I wrote for Dermatology Central in 2007. Enjoy! http://dermatologycentral.typepad.com/resource/2007/03/dr_austins_lice.html
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So the big mommy dilemma.... I know you experience it too. Is my kid actually sick or is she faking? Usually this is easy, even predictable. Not wanting to go to school because of a test, a fight with a friend, doesn't like gym, playground bully, it's Thursday and not Friday.... the list is lengthy, but with a little prodding the answer usually becomes obvious.
My tight-lipped 7 yr old can be an entirely different matter. School avoidance has been the name of the game since her first day at day care at 14 months old. She has run away from daycare more than once. But she has a tough mommy and sick kids don't wait. So often, she gets a cursory exam and is deemed fine- by yours truly- and deposited at school. Unlike your average mom- doctor mom (DM) can check ears, throat, chest, and belly. The usually cause of fake complaints. Doctor mom can also ask pertinent questions of little fakers to catch them in a lie. Faker: Mommy it hurts went I pee? DM: What color is it? Faker: I don't know, pee colored? DM: Does it glow? Faker: Yes! DM: You have to tell me if it turns purple? Faker: It is purple - but a very faint purple Okay, gotcha! Urine doesn't glow and since I doubt my kid took her pee outside for a porphyrin test, it'snot purple. Faker caught with purple glowing pee! Now you never let on that you've caught them. But you absolutely should quietly revel in the satisfaction. Now just this week Miss Faker complained of right sided abdominal pain and nausea. At 7, she's getting better at her faker form. I quickly ran the list of faker reasons to skip school - but none seemed applicable. I even reminded her this is Wednesday and she gets a day off with me on Friday. Still, she's sticking to her story. She picked a good one, because just about every doctor has a story about sending their kid to school with appendicitis. Ok, kiddo. Let's see how this goes. How would she know about appendicitis - she's 7. Maybe she's not faking. She is hobbling around with her hand over McBurney's point. But, she doesn't have fever or vomiting. But, she won't eat breakfast either. Crap! Instinct tells me she looks too healthy to actually be ill - but I just can't catch her in fake, faker symptoms. So she gets to stay home. Because I know if she goes to the nurse with right sided belly pain - the nurse is gonna call me anyway. The nurse knows my rule with Faker - don't call me unless she's puking or has a temp >100.5.But everyone freaks about right sided belly pain. Did I mention, since I'm covering another docs office due to sudden illness, it's also my only day off to run errands- and we 're almost out of toilet paper? I mean THIS is an emergency! Oh yeah, and Daddy Dear, is out of town. DM: Okay, can we go to the store for 2 minutes? Faker: No mommy, I'm too weak. DM: Good grief! DM: Speaking of toilet paper- when did you poop last? Faker: I don't remember- DM: huh? A day, week, month? (Since faker is 7 I'm no longer privy to her toilet routines.) Faker: Few days ago DM: Was it normal? Faker: It wasn't purple and it didn't glow DM: Shit, she's on to me Well then, I guess we'll be having a quiet day on the couch doing school work. She puts up a quiet fight - but we muddle through Then Faker asked to watch TV. She looks ok- so I leave her to the TV and I take refuge in my bed. An hour later - DM: How are you feeling honey? Faker:I threw up (nonchalantly) DM: Huh? When? Where? Faker:In the toilet while you slept? I flushed it So she threw up and no tears and didn't wake me and cleaned herself up? LIAR!!!!! Faker: So do we go to the ER now? In my head I'm thinking well yeah now I'll be spending the next 8-24 hours in the ER with you. Gotta find someone to take little baby faker for the night til Daddy Dear comes back from Texas. And just when I find someone to take a 3 yr old for a sleepover ......(God do I have good friends!!!!) I notice what Faker has been watching- Untold Stories of the ER on Discovery Health. No wonder her acting was so good - she got some professional coaching. Oh, it's coming together. DM: Faker, are you curious about the ER? Do you want to see it in person? Faker:Um yeah - DM: Did you ever really have a bellyache? Faker:Yeah, but I farted around 9 and felt fine since.So can we still go to the ER? DM: Well, how did you know about appendicitis? Faker: Remember Madeleine? DM: Madeline who? Faker:The book, Madeleine (The Ludwig Bemelmans' classic) Oh crap, that's how she learned - Madeleine had her appendix out and we must have talked about anatomy and right lower quadrant pain. She's even got a Madeleine doll with a scar there. I had a feeling reading to my kid was overrated! So for all you non- doctor mommies out there, don't feel bad. With all my fancy education, I still get bamboozled too. And we have to accept it. Any time your child will go to such lengths to stay with you rather than go to school - means (for whatever reason) they really, really need to be with you. So as frustrating as it may be, hug them tight, and remember the time will soon come when they want nothing to do with you. And tomorrow, they go back to school! Because Dr. Austin says so! So each year in I think, right around this time, Fall back - Daylight savings time is ending. A blissful extra hour of sleep. And then I awaken from my daydream of Autumns past to
remember I've got 2 small kids. I'm about to enter HELL! From delightful musings of sleep I start running about the house in a full on panic. You'd think the house was on fire - but no. Its time to get wonderdad up to strategize how we will deal with the onslaught of screaming, overtiredness, not tired enough for bed and strange scary darkness at 4PM to get them sleeping again. So that, perchance, we may also sleep again.So, Dr. Austin, why do children react so horridly to time change? Well the answer is simple. Toddlers react horridly to ALL change! My 3 year old had a tantrum this morning simply because her sock was inside out - in the draw. It's what they do. Break the routine and suffer the consequences. Anything from stool witholding on vacation, to refusal to eat certain foods which were your go-to solutions. Anything a kid can control to get the upper hand, they will. That's their job. Now I could tell you all about disruption in circadian rhythms and the pulsatile inputs from the suprachiasmatic nucleus. The neuroscience is fascinating, trust me, but more to the point is my kid wont go to sleep, stay asleep, wont stay in bed, wants breakfast at 3 AM, wakes up cranky and the list goes on and on. And you know- jet lag feels yucky! That's what kids are experiencing, but without any context. The best I can tell you is you're not alone. Sometimes this time of year we try to re-frame it as a positive. For the child who can not yet tell time - now we can start getting her to bed an hour earlier because its dark outside. Of course, this wont work if she's memorized the order of the programs on the "Goodnight Show" and knows that Caillou (that horrible little whiny bitch) comes on before lights out. But, I'm always hopeful to find a way for an extra hour of sleep here or there. BTW - if your'e wondering- this plan never actually works. The next best thing is to stick to your routine. They may start waking you at the butt crack of dawn (4:45AM), but that is what my husband is for. (I don't think he knows it - so shhhhh, don't tell). Watch the naps! Kids can catch up on hours lost during nap time so now they're going to bed at 11P and still getting you up at the butt crack of dawn. This is when you start offering them money to go to sleep. My oldest nearly got a TV in her room during this period while I was pregnant. Because I would have done ANYTHING to sleep more that 4 hours a night. So watch it. A good negotiator vs a sleep deprived mommy is a recipe for a room full of As-Seen- On-TV crap, at best. But honestly, I'd have given her matches, roman candles, a blow torch, ANYTHING...to just sleep. Be ready for some extra whiny, tantrum-y behavior. Knowing what's coming and that it will eventually pass can help you cope - so can chocolate and wine- so stock up! Also, if you're truly at your wits end with a crabby kid and no sleep - I always think now is a nice time for an extended trip to Grandma and Grandpas. I suggest dropping them off at Halloween and picking them up at Thanksgiving. While I'm sure Daylight Savings was a super duper idea when Ole Ben Franklin dreamt it up, with the advent of the electric light it seems rather silly. Getting dark at 4:30PM limits the time a child can get outside and play. Less light means less Vitamin D. We know that's not good for growing bodies. While I think I read that this practice somehow saves energy, I already do that (we're buying a Prius !) And basically, I'd be up for slashing and burning a jungle if if gave me an extra hours sleep. Sorry nature lovers. So get your copy of "Go the F^&% to Sleep" and a bottle of wine, let them cry it out for awhile and snuggle by the fire for long winters night. Why? Because Dr. Austin Says So |