How to Test Your Kids’ Vision Before They Can Read

You might be wondering how your three-year-old could possibly sit still for an eye exam, let alone read one. Here’s how.

The US Preventive Services Task Force recently recommended vision screening for all children between the ages of three and five.
If you’ve logged a good amount of time trying to distinguish “C” from “O,” you might be wondering how your three-year-old could possibly sit still for an eye exam, let alone read one.
Childhood vision screening generally takes place in a pediatrician’s office. Here’s what your child’s pediatrician is looking for and what you can expect during the visit.

What your child’s pediatrician is looking for

Unlike your eye exams, which may include testing for glasses, your child’s vision screenings are generally looking for warning signs of future vision problems.
Your child’s pediatrician is specifically screening for evidence of amblyopia, which occurs when one eye is unable to communicate properly with the brain. The risk of amblyopia is low: according to the USPSTF, between one and six percent of kids under age six will have either amblyopia of a risk factor for amblyopia.
In its review, the USPSTF found there to be small but permanent improvements to vision in three- to five-year-olds when amblyopia is identified and treated. Because the tests for amblyopia and its risk factors are non-invasive, the USPSTF has determined that the benefits of vision screening outweigh any harms.

What to expect during the visit

A pediatrician may use many different tools to examine your child’s eye structure, coordination, and acuity. The following three tests are among the most common.

Tool 1: Red Reflex

What it measures: Your child has likely had a red reflex test before, as many kids have them before two months of age. The test helps identify any physical abnormalities in the back of the eye, ranging from cataracts to retinoblastoma.
The red reflex test is named after the color healthy eyes give off when viewed through an ophthalmoscope from about one foot away. That red color is easier to see in the dark, which is why your pediatrician may turn the lights off for this test.
The phenomenon is the same as the “red eye” you try to edit out of photographs. In fact, photographs featuring a single red eye have been used to identify serious eye conditions.

Tool 2: Cover/Uncover Test

What it measures: You’ve probably seen your child’s pediatrician do a fix and follow test, in which your child is instructed to look at the pediatrician’s finger and follow it around the room. That test examined how well your child’s eyes function together.
The cover/uncover test works a similar way. Your child will be asked to focus on an object in the distance, then the pediatrician will cover one of your child’s eyes. While your child is still looking at the object, the tester will uncover the eye and watch for movement.
The test is observing for strabismus (incorrectly aligned eyes), which is one risk factor for amblyopia.

Tool 3: Lea Symbols Chart

What it measures: You may have not spent a lot of time thinking about how the letters at your optometrist office get made. They are optotypes, specially designed tools for testing vision. The letters in an optotype are designed to all blur equally under the same conditions, which give examiners a better understanding of a patient’s visual acuity.
Pre-readers get their own special optotypes. Instead of letters, they’ll likely have four symbols: a square, a circle, a house, and an apple. Those symbols, called the Lea Symbols, have been shown to get more cooperation from kids than other eye tests.
The Lea Symbols test works much like the eye charts you see (or don’t see!) at your optometrist. The test measures kids’ visual acuity, and can determine whether or not your child may need glasses.

When Food Is Medicine

This is a submission in our monthly contest. November’s theme is Gratitude. Enter your own here!
One night, after the results of my son’s routine blood work showed scary-high levels of phosphorous, an effect of his kidney disease, anxiety fluttered inside my chest like I had swallowed a hummingbird. Anxiety about his health, the new medication I’d have to force down him, the disease’s progression, his eventual transplant, school, life, friends … I clicked on the TV to take it away, to lose myself in some gorgeous, rainy, heavily-accented series on the BBC. I landed, somehow, on the “Great British Baking Show.”
I ate through the first season like it was cake, watching home bakers whip together sometimes beautiful, sometimes disastrous creations in their bowls and mixers and ovens. What struck me was how real – how average – these people were, baking for the simple pleasure of creating something, of feeding their families. I thought: I could do that.
My first loaf of bread came out lumpy and awkward but delicious. My three children ate it smothered in butter as I spoke to my son’s doctor and nutritionist on the phone. We needed to start him on a grainy, awful-tasting powder – a phosphorous binder – which would be his ninth daily medication. But something in me refused. They said I could sprinkle it on his food, or mix it with water – but I knew, and they knew, it wouldn’t be as easy as that. He was three-and-a-half, very particular, with a history of eating issues. There must be something else we can do.
They relented: We can try to make changes to his diet first, they told me. No cheese, no milk. Limit whole grains, meats, nuts, the list went on and I scribbled notes as the hummingbird fluttered inside me. Really? For this boy who spent the first two years of his life nearly unable to eat solid food? Who would spit out (or vomit up) a single Cheerio? Whose crackers I’d break into grains of sand and set with something like a prayer on his high chair? This child whom I’ve been spoon-feeding for far longer than is good for either of us? For years the message was always FEED HIM, in alarming capital letters. FEED HIM or we will we will write failure-to-thrive on his chart. FEED HIM or we will thread a feeding tube down his nose and into his belly and do it for you.
Now you want me to take the food away?
But my son, like my two healthy children, ate my bread and butter and something clicked. I went to the supermarket; I read ingredients. What I thought of as “good bread” with the label from a fancy Los Angeles bakery wasn’t just flour and water and yeast; it was a science project of chemicals and preservatives, even a phosphorous additive. I put it back.
I started keeping bread dough in the fridge, ready to bake when we were running low. Then on to other things: carrot cake, corn muffins, zucchini bread, forgoing the nuts and doubling the vegetables; French toast with pasture-fed eggs; from-scratch pancakes, waffles, everything with almond milk instead of cow’s. I baked at night, when my family was asleep and everything was quiet and dark, which was better anyway because summer days in LA were just too hot. I kept batches of waffles and French toast in the freezer to warm-up in the mornings. I joined a CSA and looked forward to Wednesdays, when a giant box of organic fruits and vegetables, sometimes with the farm dirt still kissing the heads of lettuce, would land on my doorstep.
Baking turned to cooking. Roasted delicata squash in coconut curry. Pasta with burst cherry tomatoes and garlic and kale. My littlest one now eating spoonfuls of (almost) dairy-free spinach pesto for breakfast, and why not.
Meat quickly took a backseat to fruits and veggies, but chicken from the farmer’s market, lightly pounded and pulled through sesame seeds could save the world. Soups, stews, sauces, and after too many years of spoon-feeding, my son started to use utensils on his own. Rosemary shortbread cookies. He’s feeding himself. Cucumbers and avocado with balsamic vinaigrette. Not just feeding himself, but feeding himself a salad.
I’m lucky to live where the produce is so bountiful. I’m lucky that my children (and husband) are good sleepers, so that I have my nights alone in the kitchen. I’m lucky that I enjoy the quiet miracle of turning ingredients into food. Some things take time, so I save them for when I have time. Good produce, meat, and eggs – it’s expensive, but hey: I serve expensive food on cheap plates.
Sometimes my cooking is beautiful and sometimes it’s a disaster, just like the bakers on TV, but watching my son’s phosphorous levels stabilize without medication, and watching my healthy son and daughter eat their veggies (and their cookies) with pleasure, makes the effort, and the expense, entirely satisfying.
 

The Highs and Lows

We learned the management of diabetes is an art form. Her little fingers became paint brushes of red expressing her glucose levels.

This is a submission in our monthly contest. October’s theme is Determination. Enter your own here!
 

The storms of life move us in unexpected directions. Sometimes they hit us simultaneously. One spring our family survived a nor’easter where hundred-foot oak trees swayed like reeds of grass on a beach, rain hammered our windows, and power lines whipped to the ground causing  power loss for a week. Incredibly, the winds of this nor’easter paled in comparison to the gales blowing in my life.

My concern for my five-year-old daughter, Sophie, grew as she became more tired, cranky, and was drinking more water than ever before. I thought I was overreacting due to my emotional and physical exhaustion from attending graduate classes, working at an internship, parenting three girls, and struggling financially during the Great Recession. In order to appease my fears, I called the pediatrician and dreaded driving to the office in Friday rush hour traffic.

Sophie’s blood glucose level was 535 and very high. My motherly instinct was right.

How could this be? I don’t know how many times I have gone to the pediatrician’s office with a sick child and have been told they are fine. I looked at the doctor with an expression of uncertainty.      

The nurse brought Sophie into another room to get stickers and the doctor touched my shoulder. “Do you know what this means?”

I felt like the world was closing in on me. “I’m not sure.  What do we need to do?” My voice was eerily calm but I was barely breathing.

“Type 1 diabetes is a result of not enough insulin being made in the pancreas. It is an autoimmune disease and the insulin-producing cells in the pancreas are destroyed. Normal blood glucose levels in children range from 70 to 120.1. You need to go to the hospital and stay for a couple of days to learn about the disease and how to manage it.” His kind eyes spoke volumes.

“This can’t be happening. Can we go home first?” The churning feeling in my stomach was building.

“Yes, but you have to go to the Emergency Room tonight.”

On our way home, my husband called to find out about the doctor’s appointment. I could no longer hold back my tears and struggled to share the diagnosis. Verbalizing the reality of our daughter’s chronic disease weakened every part of me.

“Mommy, what’s wrong?” Tears started welling up in Sophie’s eyes.

I took a deep breath and looked at her. “Nothing is wrong, Soph. Don’t worry. Everything is going to be okay.”

There is no parent handbook to tell you how to handle every situation. I wanted to take care of Sophie but I didn’t know anything about Type 1 diabetes. I focused on giving her my love and calm reassurance. When we were in the ER, Sophie allowed the nurses to put an IV in her hand and check her blood glucose levels every 30 minutes.

“Do you really need to prick her finger again? She doesn’t like it,” I asked.

The sympathetic nurse replied, “Let’s just check her glucose level one more time.” Later, I realized this compassionate nurse didn’t have the heart to tell me Sophie would have to prick her fingers six to eight times every day for the rest of her life.

I didn’t sleep the first night in the hospital room. Feeling overwhelmed and afraid Sophie’s blood glucose levels were too low or too high, I asked the nurse numerous times to check her. Eventually, I cried myself to sleep.

The next day we were questioned multiple times about why we were in the hospital. I was exhausted and frustrated. In between these interrogations, a nurse gave me a 45-page guide titled, “What You Need to Know When Newly Diagnosed with Diabetes.” She showed me how to inject insulin using a syringe and an orange since I’d have to give Sophie three injections every day. My thoughts of attending classes, writing papers, working, and paying bills were non-existent. How was I going to take care of Sophie?

In the hospital Sophie and I were on our own personal journey. We learned the management of diabetes is an art form. Her little fingers became paint brushes of red expressing her glucose levels. Her small voice cried several times, “Is this the last time I have to prick my fingers?” My heart broke. I knew there was no other choice. Love and hope would be our guiding light.

Sophie’s resilience during this challenging time gave me courage to be strong. She was still an active and vibrant five-year-old who liked to swing and swoosh down a slide. I knew we would have many more highs and lows and nothing would crush our spirits.

Why I Don't Worry About the Small Stuff Anymore

When your child is born with a heart that’s broken beyond full repair, you learn what you can and cannot control.

This is a submission in our monthly contest. October’s theme is Determination. Enter your own here!
I used to have a recurring, panic-inducing dream about an underground parking garage. The garage lies beneath the children’s hospital where my son receives ongoing treatment of his heart defects and other serious medical conditions.
Picture incredibly narrow parking spots with load-bearing columns scattered about everywhere, creating an obstacle course that even the most compact of vehicles must navigate carefully. Scuff marks with glimmers of auto body paint litter the sides of every single one of those load-bearing columns: a reminder that many who have gone before me have failed to make it out unscathed.
I’m a horrible parker, hence the nightmares.
Thanks to my poor depth perception, visuospatial tasks have never been my forte. I’ve hit more than a few stationary objects in my nearly 15-year-long driving career.
Throw in the previously unfathomable level of sleep deprivation that accompanies the job of parenting a medically complex child (which exacerbates my depth perception problems), and I stand no chance against this parking garage.
For the first several visits, I have my husband park the car, or I give up and drop it off out front with the valets. But this arrangement eventually becomes unfeasible. Sometimes my husband and I need to arrive separately, and the valet booth has limited hours.
I realize I’m going to have to learn how to park the car in that hellish garage so that I can always be there with my son while he’s in the hospital. There’s just no way around it anymore.
I take the scholarly approach, as I tend to do. I make diagrams of the precise angles necessary to maneuver my way into one of the spots without scraping a column or a neighboring car. I visualize the garage and imagine myself parking. I even ask my husband for pointers, but he’s not much help since he’s been graced with a natural gift for this sort of thing: “I dunno, I just turn the steering wheel and park the car?”
After all that preparation, I get a chance to put it into practice at the next scheduled appointment I must take our son to by myself. I meditate on (that’s my code for “obsess over”) the task at hand the whole drive to the hospital, and I briefly contemplate saying, “Screw it, I’ll just do valet parking” before turning into the garage.
I choose my target. I take a hard pass on the spot between two huge SUVs that are barely within the lines and decide on one with well-behaved neighbors instead.
Much of the elegance of my diagram was missing in this real-life attempt, but I managed to get my car in the spot. Never mind that I’ve wedged myself into a position that will require a nine-point turn to exit. That’s a problem for “Future Me,” and it’s beside the point.
When your child is born with a heart that’s broken beyond full repair, you learn what you can and cannot control. I can’t control whether the cardiac surgeon I’ve handed my son over to will return him in a better condition than he was in before – or if I’ll even get him back at all.
I can’t control the fact that I’ll probably outlive my child.
But I can learn how to park the damn car. I can conquer that fear and make that nightmare go away. I can let go of all the anxieties that used to plague me, the worries about issues that seem so trivial in retrospect.
Now I know that if the worst-case scenario in a situation is a scraped fender or having to file an insurance claim, that’s not something worth worrying about. Those are problems we can solve if the worst should happen.
It’s the unsolvable, uncontrollable, life-threatening types of problems that are the real stuff of nightmares, anyway.

Surviving the Common Cold: What the Research Says

While everyone has a cold treatment they swear by, scientific research has its own favorites. Here are a few therapies the data does (and doesn’t) support.

As soon as you touch the door handles in your child’s classroom, you can almost feel the germs latch on. Your partner mentions her secretary has the sniffles, and you immediately notice the back of your throat starting to scratch. Your cousin posts to Facebook his kids are just getting over a bad cold, and even though he lives across the country, you know it’s coming for you anyway. Getting sick is nearly impossible to avoid when you’re parenting youngsters with underdeveloped immune systems.

But at the very least, you can avoid ineffective cold remedies. While everyone has a cold treatment they swear by, scientific research has its own favorites. Here are a few therapies that the data does (and doesn’t) support.

Elderberry

Elderberry is the most recent trend in cold and flu remedies, but don’t overlook this newcomer. A small study of flu patients found that those who took three teaspoons of elderberry syrup four times a day for five days were symptom-free four days sooner than those who took a placebo. Another small study found that air travelers who took elderberry supplements were less likely to contract colds, and those who did had less severe cold symptoms.

Zinc

Zinc won’t stop a cold in its tracks, but it’s still one of your best bets. Research has shown that taking zinc within the first 24 hours of symptoms, and continuing through the length of the cold, can reduce the length of a cold by an average of one day. Sure, one day might not be much, but if it’s the day that you have to coach your kid’s basketball game or nail a big presentation at work, it might be worth it. 

Other studies have even found colds to be reduced by as much as 35 to 40 percent.The downside of zinc is a potential for bad taste and nausea. Be sure to take zinc on a full stomach.

Echinacea

Echinacea is often touted as a way to prevent colds but the jury is still out on this one. A study found that taking 900 mg of Echinacea a day did not reduce the likelihood of contracting colds or the severity of symptoms. Other studies, however, found the opposite. A meta-analysis from University of Connecticut claims that Echinacea can reduce the chance of contracting a cold by 58 percent, and reduce the duration by an average of 1.4 days. Echinacea is ineffective for children.

Nasal irrigation

Your sister-in-law swears by it. Your mom keeps calling you to ask if you’ve tried it yet. But it’s just so dang gross. Can you really shoot water up your nose to make the gunk come out, and is it even worth it?

Yes, yes it is. Researchers believe nasal irrigation, often referred to by the brand name “Neti Pot,” may help relieve symptoms of acute respiratory tract infections with minimal side effects. If you can get your child to do it, it’s effective for them also.

Over-the-counter medicine

For children, the dangers of over-the-counter medications likely outweigh the benefits. Several studies have found that antihistamines and decongestants are no more effective than placebos for treating coughs or promoting sleep in children, but are in the top 20 substances leading to death in children younger than five years of age.

For adults, cough medicines with dextromethopran modestly decrease cough severity and frequency compared to a placebo.

Honey

The easiest remedy to convince children to take might also be one of the best. Buckwheat honey is more effective than placebo for reducing coughs and improving sleep for children, but should not be used in children younger than one year due to the risk of botulism.

Vitamin C

Put down the glass of orange juice. If you are already sick with a cold, it’s too late for Vitamin C to do you much good. Research has found that taking 200 mg of Vitamin C before getting sick can help reduce the duration of cold symptoms by an average of one day. For most people, however, taking the vitamin did not reduce the likelihood of getting a cold.

Essential oils

Peppermint, eucalyptus, teatree – when it comes to cold and flu season, are these potions essential or another brand of snake oil?  Unfortunately, research on the effectiveness of essential oils remains pretty weak. Eucalyptus and peppermint oil, however, have long been used as decongestants. Neither should be used on children younger than two; in fact, peppermint oil can cause life-threatening breathing problems for infants.

If sleeping with Vicks VapoRub and socks on your feet sounds like a sweaty and sticky torture, feel free to skip this remedy. There is no evidence to suggest that it works. A study in the journal Pediatrics, however, notes that parents have found it effective in helping their children get a better night’s sleep when applied to the chest. However, camphor oil – a main ingredient in vapor rubs – can be toxic to children under two and should not be used on infants.

Sleep

“When you’re sick, rest is best, rest is best,” our friend Daniel Tiger loves to remind us. Of course, for a parent, resting is far harder than taking a vitamin supplement. But research shows that sleeping six hours or less a night can makes it four times more likely an adult will catch colds compared to those who slept seven hours per night. Those who regularly slept less than five hours of sleep had a nearly a fifty/fifty shot at catching a cold when exposed to a virus, compared to an one in six chance for those who slept seven or more hours a night.

Antibiotics

Quite simply, there is no way an antibiotic will help the common cold. Colds are viral infections, and antibiotics treat bacterial ones. Research backs this claim up. The Centers for Disease Control (CDC) also cautions that antibiotics are not needed for sinus infections caused by viruses.

If your favorite remedy didn’t make the list, don’t discount the placebo effect. Snuggling up with your favorite tea or your grandmother’s chicken noodle soup will do you good even if they don’t decrease cold symptoms by a statistically significant amount.

Illness and Family Dynamics: What Happens When We Get Sick?

It’s what we do as a society when we or our children get sick that highlights a lack of flexibility in our lives.

It’s inevitable that, at some point while raising children, you will be used as a tissue substitute, thrown up on, or pooped on. But it’s what we do as a society when we or our children get sick that highlights a lack of flexibility in our lives.

Lack of sleep never stopped anyone

Everyone has a sick kid tale to tell. My mother tells me about staying up all night with my ill brother when he was a baby. She talks about standing in the shower with him as he coughed, the endless checking of his temperature and the worry for my sister sleeping in the next bedroom.
My mother didn’t sleep that night. By the time the sun had risen, her temperature was rising, too, and she felt that familiar thumping in her head that precedes influenza. That same morning, she drove to the next camp where my father was working, not so he could take over – he was busy building a road and couldn’t take time off – but because it was the agreed upon plan, and illness doesn’t stop motherhood.

What are the options?

Whilst I never drove cross-country with a fever, a sick baby, and an excitable child, I certainly know what it feels like to wake up ill and have that sinking feeling that it can’t make any difference to my day. I’ve begged my husband to stay home, citing a thumping head and a stomach-ache that turned out that night to be appendicitis.
He went to work. He had to, and I understand that. People rely on him, and his work requires a significant amount of notice to enable him to take a day off. This is not about who should or shouldn’t take a day off, or who deserves to be cared for when they’re ill, or exactly how ill you need to be to justify staying or leaving. This is an examination of what we all do, what I’ve done myself, and how I wish we could do better.
Because it feels awful to watch your loved one leave and know that you have to get through at least nine hours without throwing up on your child. It feels awful when you’re the solo parent and you can’t even count down nine hours until you see another adult and have some help.
It feels awful to leave your loved one behind, knowing they’re going to have a terrible day, but that money or your boss’s goodwill just can’t stretch for a day off. It feels awful when your kid says they’ve got a sore throat on the day you’ve got back to back meetings. Dosing them with medicine and sending them anyway becomes a viable choice.
These are all options people routinely choose. Yet, none of them are ideal.

There is no illness!

Many parents have made the choice to ignore their symptoms and just get on with it. In two parent families where one parent is at home, most of the time the other parent will still go to work. Currently, there are no legal requirements for paid sick leave in the U.S. Families are entitled to unpaid sick leave instead. This forces people to choose between leaving their child with an ill care-giver, relying on a support network (which may or may not be available), or losing a day’s wage.
We would never let our children stay with a caregiver who could barely walk, so why do we consider it acceptable to care for our children ourselves when we’re so sick? We do it for two reasons: lack of flexibility in the workplace, and cultural expectations. Our culture is entrenched in the idea that sickness is weakness. We power through. Advertising for medication isn’t about getting better; it’s about masking symptoms and getting on with your day. Stay-at-home parents put a movie on and hope for the best, because really, what other options are there?

I’m not sick, it’s just pneumonia

This ‘powering through’ isn’t limited to stay-at-home-parents. When working parents get sick, they go to work. Time off for illness is rarely available. Given the nature of sickness, it’s not as if you can book a sick day a fortnight in advance for a head-cold. Illness takes us by surprise and often leaves us with the choice of going to work or missing a day’s pay.
Unsurprisingly, research shows that people in low-paying jobs are the most likely to go to work even when they’re sick. This is likely because the consequences of missing that day of work are monetarily more severe than for workers in high-paying jobs. However, 45 percent of people in high-paying jobs still go to work when they’re ill, but they more frequently cite reasons such as letting down co-workers.
The culture of the workplace has a big impact on whether workers come in if they’re sick or not. Companies who have procedures and policies in place involving back-up staff and the flexibility to work from home are less likely to have sick staff in the workplace. Interestingly, companies who have better policies also have workers who take less time off overall.
Families who have found workplaces with flexibility surrounding illness want to keep their jobs, so they work harder even when they’re working from home with sick kids watching a movie. Flexibility is they key to providing families with viable options.

They’re not sick, it’s just…pneumonia

When kids get sick, guess what happens? They still go to school or childcare or wherever they usually go. Four out of 10 working parents say they might send their sick child to school. Six out of 10 do this because they fear they’ll lose their jobs if they take time off to care for their child. Clearly, workplaces hold some of the power here.
Families with children will get sick more frequently throughout the year. A study found that, in childless households, viruses were present four to five weeks in a year, whereas households with children had viruses present up to 45 weeks in a year – that’s 87 percent of the time. We all know that once one person in a family goes down, it’s inevitable that everyone will.
Perhaps the best thing to do is to have a solid plan.

Make a plan, and make it good

Talk to your spouse about what you’ll do when you or the kids get sick. Find out how you both feel about illness and responsibility. Figure out who will do what so you’re not left simmering with both fever and resentment as your partner drives away to work.
Also, find a really good takeaway place, stock up the freezer, or sweet talk Grandma into watching “Moana” on repeat with a sneezing toddler. Try and strengthen your immune system in preparation for flu season. Build up your support network. Even if your friends or family can’t watch your sick children, maybe they could leave a lasagne by the door?
Perhaps most importantly, talk to your workplace about flexibility. We all deserve to know that we’re worth receiving care when we’re sick, whether that’s from a partner, a parent, or an employer.
Planning for sickness will pay off. The way we do things now? It’s a bit sickening.

Determination

This is a submission in our monthly contest. October’s theme is Determination. Enter your own here!
What a mundane word: determination. Used so casually to describe the driving force behind menial tasks. “Sure took a lot of determination to carry all those groceries in by yourself.” To me, determination means so much more. Sometimes determination is all you have.
Daylight breaks, warm rays of sun fall on your bed and face. Your eyes open and, for a moment, just a moment, you feel at peace.
Pain. Pain hits you like a truck. It doesn’t trickle in from a tap, it pours in from a waterfall. You can feel it everywhere. As it sinks in, saturating your hopes for the day, your ambitions, your solitude, it meets a wall. This wall is my determination not to let chronic pain steal my day.
Lists and lists of things that must be done…. Doctor appointments to book, parent and teacher interviews to arrange, bills to pay, a house to clean, dogs to walk, cats to feed, an Individual Program Plan to review, exams to study for, Low Vision and Autism information sites to read, and I will probably have to pee a few times.
Did I take my meds? Give my son his meds? I must have. I do it twice a day, every day.
There is the pain, still there, eating at me.
Eight things off the list. Have I sat down yet?
What can I postpone? I will get through this day. My pain won’t destroy me. I have unending determination.
Made it. Sort of. I am behind on my chores, phone calls, studies, writing, marketing, health, and organization of a future for my little family. Me and my boys. We have a happy place in this world. We are finding our way.
There are extracurricular and volunteering activities to attend to. That’s fun. Busy, but fun. We have colleges to look at, plans to make, and upcoming holidays. Terrifying, but fun. I can fit in my medical appointments, surgeries, and exams. Somewhere. As long as my son’s shunt doesn’t malfunction, as long as he doesn’t have a seizure, or my truck doesn’t break down, or….
I am determined to not let those things happen and have even more determination to handle them when they do.
The day is moving quickly. A few new symptoms. What’s that about? My son had a headache at school and his aide was being “mean.” But hey, we are down to four headaches a week. That’s great news. No homework? Even better. Let’s cook together. Life skills for the future, boys! Plus, it’s fun.
A bit hard to peel sweet potato when your back feels burned by stabbing hot pokers and your foot is half dead. Even more difficult to cook, make lunches, feed and walk dogs, deal with paperwork, and organize showers when you have more knots in your muscles than a lobster trap and the pain-induced nausea drowns your thoughts.
Let’s do this. My determination will see me through.
Finally, time to sleep. I hope I can sleep. The hours before I drift off are for reflecting, clenching the pain aside, taking mental inventory of coping resources: I kept my temper, didn’t lose my patience, listened to stories of grand dreams, computer games, Sci-fy books, girls, and heard a bit of bickering, of course.
Smiles, laughter, stories, that’s what its all about. Goals, dreams, ambitions, that’s what it’s all for. Maybe I will get my degree, go back to work full time, become an accomplished author. Maybe my son will become the biologist and fabulous family man that he hopes to be, and possibly my other son will receive all the external supports he will require to be an independent adult and marry a movie star….
We will have bumps along the way. Chronic illness does that to you. But we have made it this far. We know a little determination goes a long way.
And it carries all the groceries in, too.

How My Relationship With My Father Influenced My Tenacity

Maybe he was never home because his work was the main thing putting a roof over our heads. He didn’t speak English, nor did he have a college degree.

This is a submission in our monthly contest. October’s theme is Determination. Enter your own here!
It’s almost eight months since the day my father passed away. By that point, we weren’t really speaking to one another. We were more like neighbors under the same roof. Two weeks before he died, my growing tumor turned out to be curable. It was also his birthday.
Who knew two Tuesday’s later he wouldn’t come home?
That’s the thing. No one knows why people die. Death just happens. What you take from it is what matters, because the grief will always be there.
The day he passed, I struggled to eat. I wasn’t hungry. I didn’t cry. I was just numb. I still feel numb.
How do you differentiate between the determination to do nothing but prove someone wrong and the determination to carry out someone’s legacy after he passes away? I didn’t have anyone to speak to about this. I found myself in a unique situation. I was angry at my father but wanted no one to forget his name.
He had a machista type of attitude. He was a guy’s guy who, while not the best husband, was a good father. Watching the dynamic between him and my mother throughout my childhood and after moving back home affected my view of him. He never showed emotion other than pure joy, so I sympathized more with my mom. Also, as a workaholic, he often wasn’t home.
I never cared to consider that maybe he was never home because his work was the main thing putting a roof over our heads. He didn’t speak English, nor did he have a college degree. He had diabetes and his leg had been amputated. But he was a man’s man, and he took on everyone’s burdens anyway, including my mother’s fifth and most recent battle with cancer and my two-year journey to find a cure for my health troubles.
I saw how hard he worked. I saw how much pride he took in every little thing my siblings and I achieved in our academic and professional careers. Even though I have a completely different personality than his, it is all based on things I learned from him.
I always called my father out on everything. I never took no for an answer. I always spoke my truth, which was different from his. That, in itself, is where my tenacity comes from.
Left with so many unanswered questions after his death, I sometimes get angry for not being angry with him anymore. There are so many things he could’ve done better. As much as I prayed for our relationship to get better, I think there was always some ray of sunlight that shined through its cracks.
I am not a parent yet, but I know the invisible shield of confidence that comes from a parent reminding you of your worth. There is no such thing as saying “You can do it” or “I love you” too many times. As tough as things may get, your kids remember everything.
Because of my father, I work hard. He not only shaped my career ambitions, but my personal ambitions as well. I’ve made myself a promise to not get married or bring a child into this world  until I can do everything my father did for me as a child.
My goals are big. I can thank my father for that.

A Good Reason for My Sleepless Nights

I have a motherhood confession. There is a child (or two or three) sleeping in my bed more nights than not.

I have a motherhood confession.
There is a child (or two or three) sleeping in my bed more nights than not. With four total, and all of them still relatively young enough to wake up in the middle of the night sick or scared or wet or thirsty or just alone, it’s a nightly event that at least one and sometimes more pad into my room, holding a blanket or a stuffed something that has seen better days.
I roll over and look at the clock. Inevitably, there’s a moment where my stomach sinks at the math of how much more sleep I might get if I am lucky. But I always make them some space.
I know it’s a controversial subject, and I know (and respect) that it’s not for everyone. I know the parenting magazines would probably frown on it. Perhaps more importantly, I know the lack of sleep has likely taken years off my life or, at the very least, made me look like it has.
And yes, I’ve read the sleep training books and talked to the doctors and let myself fantasize about what it would be like to just once sleep wholly through the night and let me tell you: the prospect is absolutely lovely.
But I feel like this is something I need to do, and there is a good reason. It’s this:
When I was 16, I stopped eating.
It wasn’t that simple, and it wasn’t all at once or even a conscious decision. Not at first. But I was no longer a kid, and me and my life were both getting big fast, and I knew I needed to do something to try to make us small again because the bigness felt too new and frankly a little bit scary.
But pretty soon, as these things do, the not eating itself got too big – bigger than I could easily handle myself. I lost more weight than I ever meant to, although somehow it still wasn’t enough. The anxiety problem that had been a manageable hum in the background of my life before became a loud and constant scream that I couldn’t ignore.
Nighttime was the worst because I stopped sleeping. I would toss and turn for hours, trying to convince myself I wasn’t hungry and I wasn’t sick and I wasn’t falling quickly into a hole that was too big for me to pull myself out of alone.
My mother and I were not in the best place then. Neither of us was healthy independently, and together, we were worse than the sum of our parts. But I knew she saw what was happening to me and I knew she was worried as well.
One night, when it all got to be too much, I did something out of desperation that I hadn’t done since I was maybe six and scared of thunder: I crept into her room and climbed into her bed.
She didn’t say anything, and I assumed she was asleep. But I pulled the covers up and settled my head on her pillow and closed my eyes. And then I felt it, so light I thought I imagined it at first: her hand resting on my back. I’m sure it was the first time we had touched in months. Maybe years.
Sometimes I think that hand saved my life. Or it was the bridge that got me into the next day, which got me into recovery, eventually. At the very least, I know I fell instantly asleep.
For a short while, it became a routine of sorts, one that we never spoke about in the daylight. I don’t know if she appreciated those small moments of togetherness we had there like I did or if she just tolerated them because she knew I was sick. She’s gone now, so I can’t ask. When she died and I found myself unable to sleep again, I was grateful for the memory. I was also grateful for its lesson.
You see, most days I’m not a great mother – not like the ones you see on TV or read about in those same parenting magazines that say my babies should learn to self soothe. My temper is shorter than I’d like, and I make more boxed mac and cheese than anyone should ever admit to.
I am terrible at braiding hair or remembering to sign the thousands of papers that come home every day stuffed into four different backpacks. I’m much too distracted and I’m tired and I make so many mistakes daily that I usually lose count before lunchtime.
But at night, this is still something I can do, what my own mother did for me all those years ago. I can make space. I can let them in, rest my hand lightly on their backs, feel their soft breath as they settle next to me, and – if only just for that moment – help them rest easier in the knowledge that they don’t have to be alone.
I know it’s not forever, and their need – big now with little-kid troubles, night terrors, bed wetting, things under the bed – will evolve into bigger-kid need and likely then into the not needing at all. It’s a prospect that both gets me through my tired days and terrifies me.
But for now, I know this: For as long as I can, I will help them sleep, even if it means that, tonight, I don’t.
This post originally appeared here on the author’s website.

One Moment at a Time

This is a submission in our monthly contest. October’s theme is Determination. Enter your own here!
Giving up isn’t an option today. One mistake, one wrong decision, one moment of indulgence in self-pity will rip away everything and everyone who brings meaning and love to my life. To an outsider, my life may seem bleak: I live paycheck to (one week before) paycheck in a condo that is too small for my three children and me. It is not out of the norm for me to not know how I will put gas in my car or food on the table. My credit score is a whopping 450. I am divorced. I borrow money from my 70-year-old mother, who also helps me with laundry and other household chores. At 39, I am only at the beginning stages of my first career. I have no husband and I don’t go on vacation. I am scraping by one day at a time, but I am overwhelmed with gratitude.
No one wants to visit the depths of emotional and physical pain that I have. My story is as sad as they get. Every alcoholic mother cliché is true. I am a low-bottom drunk. My final years of drinking were spent chugging vodka straight out of the bottle just to calm the shakes and nausea. My final drink ended with me driving in a blackout at 10 a.m. after disappearing from my place of employment unannounced. My visits with my children were supervised by court order. They still loved me and I can’t comprehend how or why. They still had hope for me. They saw through the sour breath and the phony smile, and they knew the person I am today was hiding in there. They waited for me.
I was full of broken promises and empty apologies. I missed birthday parties, and I passed out in front of my children. Hangover after hangover, alcoholism told me I could drink today and not get drunk. Just a few to keep the shakes at bay, then I will stop. This is a disease that lies. This is a disease that takes over mind, body and spirit and grabs hold of families and innocent children. This disease held me so tightly, and I danced with it for so long, believing the lies and forgiving its betrayal.
I was unemployable, undependable, and (I thought) unlovable. Alcohol was my everything. My best friend and lover. My courage and fear. My entertainment and bedtime story. My motivation to live and desire to die. Alcohol came before my kids, relationships, health, and sanity. I wanted so badly to want to stop drinking, but I still longed for alcohol to run steadily through my veins every waking moment.
During my final months of drinking, I began to sense the end was near. I didn’t make sense of it at the time, but I grew so scared of myself. I would enter a package store, and as I left I would think, something terrible is going to happen tonight, and then wake the next day thanking God nothing terrible happened. This became the beginning of the end. The disease was dying. I no longer felt invincible. I no longer believed the lies of alcoholism.
I bought a gallon of vodka knowing I would drink the whole thing that night. It scared me. I was preparing for my final surrender. Surrender came on February 3, 2014. I did not want to die. I knew I would lose my oldest daughter forever. I saw it in her eyes, in the way she was beginning to pull away from me. She would not be fooled by this disease much longer. I prayed for help in my own desperate way, and God answered my prayers.
Detox. A six-month inpatient rehab an hour and half away from my kids. AA meetings. I learned to like some things about myself. I learned to do things sober. I relearned how to do everything sober. I danced sober, I laughed sober, I cried sober, and I felt things I had been numbing my entire adult life. I embraced a new way of life, and I made a commitment to God and to myself to stay sober at all costs, just for today.
I have caused pain to those I love that I cannot take away. I don’t do that today. My children waited for me, and I am going to make sure their wait was worth it. Today I don’t care how much money is in my bank account or what my credit score is. Today I am sober and God is my provider. I now live in acceptance, self-awareness, and gratitude, including gratitude for my darkest days because they made me who I am today.
Through dedication to God, to the program of Alcoholics Anonymous, and to self-love, I have accumulated 1,347 days sober, one moment at a time.