Monday, January 27, 2014

Seven Things That Make Me Happy Today

1. When Alex leaves me hot coffee in the morning.

2. Hearing the Bean say "happy" and sport her squinty-eyed-shit-eating-grin while we eat breakfast together.
3. Dropping the Bean off at daycare without a hitch.
4. Finding the last open parking spot at work. Even when I'm running 15 minutes late. After a productive a.m. Target run.
5. Researching a topic I'm passionate about and finding a new cache of empirical studies.

6. The satisfaction of having booked Full Circle Speech's first client.

7. Looking forward to a dinner that has already been prepped and watching Burn Notice with my main man on our epically comfortable couch.

Monday, January 20, 2014

22 Months

My greatest brag of the last month is that the Bean learned to say that she loves me, rather than just sign it. It sounds something like "I'll mama," rather than "I love mama," but I'll take it. She also says "I'll daddy/Beebee/Mimi/Papa."

Other Things She Says:
Her speech and language development continue to amaze me. Then again, I'm an SLP for a reason.

She's had a few multi-word sentences, but they are usually a bit punctuated - "Daddy. sit. right there."

She says plurals and possessives correctly - "Mama's bed" and "cows."

This, that, there ...

She says orange with a bit of a French accent like "ohwanjjjjj."

"I'll bosth" = like a boss.

She sometimes says "shy" before talking on FaceTime to anyone, or going over to play with friends.

"Picpuh" = show me all 1,000 pictures in your photo stream at least two times.

Orders Alex "right here" and points to the exact spot she wants him to sit while she takes her bath.

Tells Alex "get" when she wants him to chase her.

Reliably says "poop" when she does indeed have a poop in her diaper, but then fights a diaper change 50% of the time. That girl can wiggle.

"Popo" = let me grab at our ponytail.

Insists "song" in the car. I now understand the beauty of a solo work commute - alone time to listen to music rather than provide it

The other day she shouted "hey baby!" while I was driving her in the car. She said Daddy taught her to say that, but he denies any such claim.

Things She Knows:
Alex and my first names. She just picked up on someone calling her Daddy "Alex," and then found herself saying it, which made us laugh. Then we taught her my name, although she mostly still thinks my name is "mama."

She knows the names of most colors, but is not reliable with what they represent. Most things are still "purple," but a lot of her clothes/shoes/accessories actually are purple, so she's got a good chance of being correct. She knows that school buses are yellow and snot is green and the light is red if we're stopped and green if we go, but if presented with just a color swatch, would perform only slightly better than chance.

She's learning her letters, but I think she's more interested in dancing to the alphabet song than learning the alphabet itself. A neighbor gave us this LeapFrog talking magnetic letter thing the other week, and when my dad babysat he spent a lot of time playing with the letters. She can reliably identify the correct letters for Mama, Daddy, Beebee, Francie and Papa. She seems to associate the letters more with the names they represent, rather than actually knowing the letters themselves.

I continue to be amazed by what she knows, especially when  I know we didn't teach her, like when I said the word "yoga" and she proceeded to do a downward dog, or when she shouted "hey!" at the right time in Jingle Bells, or when she pointed and said "Gas. Daddy." at the gas station where I happen to know they filled up together a day or two before.

Things She Does:
Takes naps by herself at 12:30 on the dot at daycare, and goes on strike when at home with both parents.

Does "Cheers" with her cup.

Insists on attempting to dress herself.

Successfully puts on her own boots.

She likes to sit on the potty for just a few seconds, then say "try!" and clap for herself. She did go pee on the toilet once this month, but I think it was just luck. She's still very interested in all things potty, and wants to sit on the stool next to the toilet and hold my hand while I pee. Weird. So far she thinks getting to "wipe" or "fush" is a reward for peeing on the potty. We haven't had to resort to candy yet.

Nurtures any and all humanoid or inanimate objects - she gives pat-pats, shushes, rocks and covers everything with a "blanket," even if it's just a bottle of travel shampoo when the blanket is a Kleenex. She has also taken to giving me and Alex pat-pats and covering us with blankets. And I kinda like it.

Pretends to change Baby's diaper, using what we've come to call the wiggle-and-drop method, as in, "I will wiggle this poop off of you and then drop you on the floor before I put a new clean diaper on you." Baby doesn't seem to mind.

Now hates my car. Insists "daddy's" when we go to leave the house. The one time we had no choice but to take my Volvo, she threw a bit of a fit.

Continues to experiment with hitting me, and we continue to experiment with discipline. So far we've used "time outs" - which equals about 20 seconds of sitting on the stairs, then complying with our requests for an apology, and a brief re-explanation of her wrongdoings. 

Beebee babysat a few weekends ago and it actually went well? "Well" being that she cried hysterically for "mama" and "home" for 15-20 minutes before settling in to look at photos and play ABCs for the rest of their evening together. She even woke up the next talking and asking about about Beebee.

She still cries at daycare drop-off 95% of the time. Her teachers tell me she usually stops in just a minute or two after my departure and carries on just fine the rest of the day, only occasionally asking for one of us.

She loves to drink the leftover milk in her cereal bowl.

And yes, there are tantrums. They don't make it too high on this recap of the last month because they really are a blip on the radar. She's clearly emotionally dysregulated, but I figure she's just a normal toddler. I'm surprisingly patient with this "misbehavior," and just let her work it out on her own, or try to distract her. Unless it's a matter of safety, which it so rarely is.

And, as always, I have to note that I think she's the coolest and just the bee's knees. We got lucky, I believe.

Other favorite photos from recently:

We finally made/finished/hung a growth chart for her, and marked her length/height at birth and her first birthday, and included our own heights as well. We welcome any and all guests to measure themselves as well!

I repurposed the frame frame that I used to hang out Christmas cards into a decoration for the small hallway between Francie's and our rooms. I had these Instagram photos printed via Print Studio almost a year ago - a few of my favorites from her first year of life - but never had any ideas on what to do with them. The Bean LOVES looking at photos.

Daddy and Bean reading together. Makes my heart happy.

Wearing the new tie-dye shirt Jess/Hunter made her, and trying to do that thing where you put your fingers upside to your eyes like some sort of goofy owl - my dad was trying to teach her and this is what we got.

A terrible picture but good memory of our attempt to get the Bean's passport photo. I think the postal worker had an IQ of 7, and was frustrated that when Francie looked directly at the camera as she asked, that she smiled. "Tell her she can't smile." Right, like we can make a nearly-2-year-old do anything.

And the final shot. She looks like a baby bank robber.

Girlfriend likes apple pancakes from Original Pancake House.

Rockin' her yellow one-piece at the SWCC pool, where she went down that waterslide in the back no fewer than two dozen times. Maybe she's a shy adrenaline junkie?

Shooting some hoops. Definitely not court-approved attire.

Saturday, January 11, 2014

Bridge City

I finally finished embroidering the Portland bridges for Alex. I was originally thinking it would be a cool wall hanging.  Then I was thinking a quilted pillow for our new couch. But now I'm thinking I want to make an Oregon-themed quilt. I copied the idea from something on etsy, so I can't take credit for the design. I am pleased with everything but the missing Sellwood Bridge. I wonder what Chris Christie would have to say about my piece this week?

Thursday, January 9, 2014

Flu Shot Frenzy

Flu Fascination

Alex finally got his flu shot yesterday. He said it was more than an hour wait at the Beaverton Kaiser, and he tried not to breathe in for the entire visit because of all the sickies at the clinic. Not really, but kind of. For the record, the Bean and I got our flu shots in September and didn’t have to wait even one minute. Alex complained of a sore arm that night, and then today he told me he didn’t feel that well. Pansy. He would never go as far as to say that the flu shot made him sick, because he and I both know better than that, but I’m suspicious a part of him believes this to be true. People say it all the time.

I’ve had several conversations lately about the flu vaccine and the flu in general, in part spurred by emails I’ve received at the VA reporting increased flu diagnoses, amplified by recent news coverage of this season’s early outbreak, and out of curiosity about whether or not our daycare has any policies on the flu vaccine. In the interest of having not just An Opinion but An Informed Opinion, I began researching influenza and the vaccination via the CDC, Wikipedia, major players in the world of health and medicine (e.g. NIH, Mayo Clinic, etc.), the actual research studies referred to in the articles, and even anti-vaccine blog posts.

To start, let’s talk about risk in general. There is a huge misperception about what is risky or “scary,” and what actually poses true danger to our wellbeing. I’m a good example here. I am afraid of flying. In 2012, only 794 people died in plane crashes (in aircrafts carrying 6 or more people). Contrastingly, more than 34,000 Americans died in motor vehicle accidents in the same year. Statistically, as the story goes, I’m more likely to die on my way to the airport than en route to my final destination. I, however, have the self-awareness to know that my fear of flying is essentially unfounded and that, statistically speaking, it ain’t that risky. (Besides, I’m actually more afraid of having some sort of mid-air crisis than dying per se). So I don’t stop flying just because I’m afraid.

Let’s take a look at some more stats, just because numbers are fun. And it serves as a good reference point.

Cancer. In 2010, approximately 41,000 US women died from breast cancer. In 2012, they estimate that 160,000 Americans died from lung cancer, which is more than breast, prostate, and colon cancers combined.

Drugs. In 2010 more than 38,000 people died from drug overdose in the US, with 60% of those related to pharmaceuticals.

Murder. The homicide rate last year was about 15,000.

Drunk driving. Last year just over 10,000 people were killed in alcohol-impaired MVAs.

And then there’s influenza – the CDC reports that, on average, 32,000 people die each year from the flu.

So you’re saying, statistically speaking, all other variables aside (age, health, gender, etc.), any given person is MORE likely to experience death related to influenza than to drunk-driving and murder combined?!? They should do something to help us! To prevent that! Like a medicine or an immunization or something!

Flu Facts

-        The “flu” = influenza – a contagious respiratory illness caused by viruses that infect the nose, throat, and lungs.
-        The flu does NOT equal a stomach virus, although we often refer to puking out of our mouths and butts as the “stomach flu.”
-        Healthy adults can infect others beginning one day prior to development of symptoms and up to five to seven days after becoming sick.
-        Flu is unpredictable. The severity can vary widely and depend on several factors including: which influenza viruses are spreading; vaccine variables such as when it’s available, how much is available, how many people get vaccinated, and how well matched it is to the virus causing illness; the age, health and exposure of the person infected.
-        Complications of flu can include pneumonia, ear infections, sinus infections, dehydration, and worsening of chronic medical conditions e.g. CHF, asthma, DM.
-        To test for and confirm actual flu, doctors use nasal/nasopharyngeal swabs; these rapid tests are more than 90% specific and 50-70% sensitive (meaning that false negatives are more common that false positives; in other words, it’s more likely for a person with the flu to NOT receive a flu diagnosis than a person withOUT the flu to test positive).
-        At the VA hospital where I work there are more cases of flu so far this year than in all of last flu season:
-                          50 of the 52 cases of confirmed flu this year are H1N1
-                          34 of those patients required hospitalization
-                          More than 50% of those patients are between 20 and 30 years old
-                          And the majority had not received their influenza vaccine

Flu Vaccine

According to CDC reports and the research papers referenced, the influenza vaccine is the most cost-effective counter-measure to seasonal flu outbreaks, per controlled studies and rigorous scientific review of those studies. In order to evaluate the influenza vaccine (and in all good research), both efficacy and effectiveness are explored. Efficacy is the extent to which the vaccine reduces the risk of disease in controlled conditions. Effectiveness is the observed reduction in risk after the vaccine is put to use, or the actual prevention of the illness in real-life vaccinated populations. The general consensus (save for the anti-vax bloggers who usually fail to cite actual research articles or whose logic has major holes) is that the vaccine provides moderate protection for healthy adults, and children younger than 2 years. Adults over 65 years of age are considered in the higher risk demographic, and while they are always recommended the vaccination, the evidence to support the efficacy/effectiveness here is mixed.

Let’s look at some actual numbers (sidenote: because I blog and I’m not practicing good science in my personal life, I’m not providing any citations of the research papers I actually perused, because, who are we kidding, most people who read this wouldn’t care):
-        Recent randomized controlled trials (RCTs) of inactivated influenza vaccine among adults under 65 years of age have estimated 50-70% vaccine efficacy during seasons in which the vaccines' influenza A components were well matched to circulating influenza A viruses.
-        Another analysis determined that flu shots were efficacious 67 percent of the time; the populations that benefited the most were HIV-positive adults ages 18 to 55 (76 percent), healthy adults ages 18 to 46 (approximately 70 percent) and healthy children ages 6 to 24 months (66 percent).
-        A 2012 meta-analysis showed that in adults, vaccines show a three-quarters reduction in risk of contracting influenza (4% influenza rate among the unvaccinated versus 1% among vaccinated persons) when the vaccine is perfectly matched to the virus and a one-half reduction (2% get flu without vaccine versus 1% with vaccine) when it is not, but no significant effect on the rate of hospitalization.

And let’s talk “herd” immunity, or community immunity. This is defined as when a critical portion of a community is immunized against a contagious disease, so that most members of that community are protected against the disease because there is little opportunity for outbreak. In other words, when there’s some nasty contagion out there, the chain of infection can be disrupted when a certain, large proportion of the population is immune or less susceptible to said nasty contagion. As I heard one doctor say, the best way to protect your 85-year-old grandmother from the flu is for your family and her caregivers to get vaccinated. (To those who don’t “believe” in herd immunity, one of the most accessible explanations and accompanying research I encountered was regarding the rotavirus vaccination). And for the sake of numbers, here are some examples I came across demonstrating herd immunity with flu vaccines:
-        A study looking at New Mexico's 75 long-term care facilities found that as vaccination rates of health care personnel rose from 51 to 75 percent, the chances of a flu outbreak among patients in that facility went down by 87 percent; the study demonstrated that vaccinating health care workers provided more protection to residents than vaccinating the residents themselves.
-        Japan once required school children to receive annual flu vaccinations, as they are a likely population to both catch and spread the disease. Their data showed a positive effect of vaccinating children in reducing mortality among older adults from flu – they report one life saved for every 420 children vaccinated.

Obviously, I’m pro-vaccination – I work in healthcare, I’ve read the reports, and I generally have faith in science. I’m happy to do the simple things that research supports to better the environment for all of us. All that said, there are, of course, no guarantees. The flu vaccination isn’t perfect. No vaccine is. Science isn’t perfect. Nothing is. Theoretically, you can get the numbers to tell you whatever you want them to. What’s that saying, “If you torture the data long enough, it will always confess”???

Reasons People Might Give to NOT Get a Flu Shot, and How I Might Respond

You: “I’m allergic to eggs.”
Me: “That sounds like it sucks. I love eggs. And baked goods. Especially chocolate chip cookies, which you need eggs to make. Anyway, I think they make egg-free vaccines. Have you asked your doctor about it?”

You: “I heard I could get Guillain-Barre Syndrome from getting the flu vaccine.”
Me: “Yes, technically that’s a risk. And it said so on that waiver I had to sign before they stuck me and the Bean. But research shows that your risk of acquiring GBS from a vaccine is lower than acquiring it in conjunction with the actual flu. (The estimated frequency of influenza-related GBS was four to seven cases per 100,000 people, compared with one case per million persons following vaccination).

You: “Flu vaccines always give me the flu.”
Me: “No they don’t. Your flu vaccine probably wasn’t even a live virus, so that wouldn’t make sense anyway. There is zero evidence that the flu vaccine causes flu. You probably already had the flu. Or it’s not the flu anyway and you just have a cold. Don’t be such a pansy. It is winter after all.”

You: “I could have an allergic reaction.”
Me: “Yup, you could. But you could have an allergic reaction if you eat peanut butter, or shellfish, or get stung by a bee or a jellyfish. Do you carry an epi-pen just in case any of those things happen? Probably note. The good thing about experiencing anaphalaxys post-vaccine is that at least you’re already at the doctor, so they could probably get your treated really quickly.”

You: “I don’t want my kid to get the flu vaccine because of the heavy metals, like mercury.”
Me: “I don’t know enough about the quantities or risks associated with mercury, but I doubt it’s the only environmental exposure. You eat fish don’t you? Are you telling me you want your kid to get the flu? Because old people, young people, and immuno-compromised people have the highest incidence of flu-related complications.”

You: “Shots hurt.”
Me: “Don’t be such a pussy. It hurts for, like, a second. Taking the bandaid off hurts worse. And maybe your arm will be sore like from a good charley horse or an intense workout. Besides, the flu hurts worse.”

You: “I’m a healthy person. I eat well, I exercise, I never get sick. ”
Me: “Well lucky you. You have a lot to be thankful for. So pay it forward – help your family, friends and neighbors by getting vaccinated so that you don’t potentially transmit the virus to anyone else. And keep practicing your healthy habits. I could use some of your self control.”

You: “The flu shot doesn’t even do anything. I know people who get vaccinated still get the flu.”
Me: “It’s true, you can get the flu shot and still get the flu. But the research is pretty convincing. If you are otherwise healthy and you get the flu shot, you’re not very likely to get the flu. But if you do, you will more likely have milder symptoms. Maybe instead of wanting to die for a week you only feel like ass for 3 days. I wear a seatbelt – it doesn’t guarantee I won’t get hurt in a car accident, but it reduced my chances. I’ll take the extra protection.”

You: “The flu isn’t that bad anyway. I mean, it would suck, but I’d survive.”
Me: “Maybe you’d survive okay, but what about your baby? Or your grandpa? They might not fare so well if you pass your nasty virus along to them. Then wouldn’t you feel like an asshole? What if they had to be hospitalized? Or died from complications? You’d wish you’d gotten a wimpy little shot.”

You: “How do we even know the flu vaccine is for the correct strain?”
Me: “We don’t. But I have more confidence in the virologists to wisely predict the correct strain of influenza than I do in my own ability to avoid said strains at work, in the Target bathroom, or when buying my Starbucks chai skinny latte. Plus, there’s evidence of cross-protection, meaning that the annual flu vaccine provides some protection against flu viruses it wasn’t designed for. And there’s evidence that people who get immunized but still get the flu experience more mild symptoms. My vote, if I have to be sick, I’d rather not be too sick.”

You: “You can’t trust the government. They’re probably lying about the research. It’s all to benefit big pharma. They make a profit off all this shit.”
Me: “Sure, you might be right, to some degree. I’m as much a conspiracy theorist as the next GenXer. But I have a good deal of confidence in the medical professionals I have worked with, even if I’m not so trustworthy of “the man.” I’ll save my conspiracy theories for the food manufacturing industry and the environment. From what I can tell with the information available, the science in favor of influenza vaccines seems pretty sound.”

Final Thoughts

The bottom line: there is far more/better/faster/stronger (Daft Punk anyone?) evidence in support of the influenza vaccination. So even if it doesn’t work perfectly, and it saves only a few lives and a little bit of money and time, isn’t that better than the alternative? And because it’s clear a flu shot is no guarantee, you should still practice good health habits such as washing your hands regularly (I see you fakin’ it in the public restroom –  sing the full ABC’s, people), eating healthfully (alcohol overconsumption lowers your immune system), sleeping well (>7 hours/night), and exercising regularly (get your heart rate up, like, every day). That much we really do have control over, so protect yoself before you wreck yoself. Or your herd.

Monday, January 6, 2014

Potty Party

The Bean peed on the potty! And she even looked cute doing it. Her reward was getting to wipe, flush, and wash her hands. And praise, lots of praise. It was just circumstantial, I'm sure, but we are proud nonetheless. We aren't "potty training" yet, but she has a potty upstairs and a special toilet seat downstairs that she likes to sit on occasionally. Today she just happened to actually pee while sitting! Well, after she peed a bit on the kitchen floor during neked time post-bath, Daddy scooped her off to sit on the potty to finish the job. Great first toileting, girlfriend. 

Year in Review

It's hard to summarize a year. But you know what makes it easier? Having written this shit down. On my blog. As it happened. That's the point, after all. Sure, I'm supposed to be some sort of an expert in attention, memory and cognition, but let's be real for a minute, I can't remember anything unless it's photographed and written down. So here's my few minutes of reminiscence about 2013. From what I can tell, it was a great year, full of good family time, sprinkled with some friendly celebrations of marriage and babies, and punctuated with fabulous holiday celebrations and a kick-ass new couch. Here's the year in review ...

We rang in 2103 with good friends, including the Franzke’s staying with us a few nights.
I met up with my WR ladies in Yakima to celebrate Baby Girl Shine’s pending arrival.
The Bean (finally) started crawling.
I was offered the part-time Polytrauma SLP job at the VA, specializing in working with veterans post-TBI. Essentially, I secured my dream job.

Fleas. We had fleas.
My besties and I celebrated the Future Mrs. May at McMenamins Edgefield.
Alex was told he needed surgery to repair his torn ACL from skiing with coleagues in January.
The Bean’s first word was “dah," referring to the dog, Gizzy.

Baby Vivian Shine was born 3/10/13.
Francie turned 1! We celebrated with a red balloon party a la Goodnight Moon.
Gizzy "went to a better place." She was serrendipitously re-homed with a friend of my dad's.
Alex built a front fence over Spring Break with the help of the dads/grandpas.

The Bean finally started sleeping all night regularly.
Baby Max Menne was born 4/5/13.
TThe Bean and I took a trip to Denver to meet the beautiful Baby Vivi and organize her nursery closet.
Alex survived ACL surgery.

Uncle B visited.
I started my new job at the VA. Chris watched the Bean.
All three of us attended WR 2013 with hubbies and all 5 babies at a fabulous rental house in Hood River.

Alex and I ate vegan for a month after watching Forks Over Knives.
Alex wrapped up his first year at WLHS.

We took our annual visit to Tahoe to celebrate the 4th, and the Bean went for hikes, played in the sand and learned to walk fully on her own!
The three of us flew to SoCal to celebrate the May wedding, and we got a week of vacation at Newport Beach with my BFFs.
We took our first family camping trip.
The Bean started daycare.
Alex started coaching JV2 Boys sccer at WLHS.
We crashed the Franzkes for a summer Bend visit.

The Bean, Al and I flew to Indy to celebrate Laura + Garret. Alex met us there.
We tried to prioritize finances, including tracking, spending, and budgeting.

We kept our adventures local, and were blessed with beautiful weather – punkin patches, HS football games,  walks to April Hill Park, Fruit Loop.
Francie dressed as strawberry, trick or treated at a few neighbor houses, and helped to pass out candy.
We had fleas. Again.

We hiked at Multnomah Falls, and Francie actually did a fair amount of hiking herself.
Uncle B visited with his girlfriend, Zahavah.
I completed my first full-size quilt – a “jelly roll race quilt” - for Laura & Garret.
We spent Thanksgiving with the Flynns.

“What does the fox say?” dominated the radio waves at our house.
We cut down our Christmas tree, Francie sat (and cried) with Santa, and she experienced her first hot chocolate and roasted marshmallow.
We finally purchased and received our fabulous new couch!
The Bean got her 1st haircut.
We spent a wonderful Christmas in Tahoe with my dad and all the Close Family. The ratio was 7 adults to one very spoiled child.

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