Friday, July 24, 2009

Do you ever wonder if the pre-vacation stress is worth it? yeah, me too.

So much to do! We are going off the grid for ten-- ten! ten!!-- days tomorrow and I have so much to do! We have a ferry reservation and we have to leave by 9:30 AM to make the ferry or else sit around all day in Horseshoe Bay, and I know it will be all day because half of Metro Vancouver is going on vacation this week and I doubt any of them are heading East because there are fires all over the Okanagan. So they will all be trying to get on the ferry with us.

Fortunately one of the things on my List of Things to Do is "write Booland post." Much more fun than the other seventy bazillion things left.

Here are the crises we have endured this week:

1) On Monday, fortunately *after* I dropped off MG at camp, a tire blew out on the van, which is our only vehicle during the summer. Turns out that because our van is crazy old, replacement tires are very hard to find, so we've been driving all week without a spare, and phoning hither and yon trying to chase down suitable tires to replace our now-mismatched set. We finally located some an hour's drive away, and that is what RW did this morning.

2) On Wednesday, because her tooth was hurting and she didn't want to have to have emergency dental surgery on vacation, RW went to the dentist and ended up having half a root canal. Ever since then, her tooth has been hurting even more, which apparently means it's infected, so today she started antibiotics. She is miserable and sick and in pain and went to lie down for a power nap at 7:30 tonight and is still asleep.

3) Also on Wednesday, we had a childcare crisis when the person we'd lined up to pick up MG from her camp, which this week is not close to either our home or either of our workplaces, suddenly that morning remembered a conflicting appointment. RW heroically found alternate care via the cell phone on her way back from the dentist.

4) Last night, my elderly cat had another seizure. This is the third one he's had in the last few months. After the second one, I took him to the vet, who ordered a bunch of tests, which determined that there is nothing wrong with his kidneys or liver or brain. So, you know, that's good. But what it means is that he just has mysterious seizures every once in a while, which freak us all out and also necessitate some cleanup. Also afterwards I revised my detailed instructions to the cat-sitter to include directions on what to do if the cat has another seizure. Also, while I was at it, I wrote down what to do in case the cat dies while we're gone. Which is a sobering, if unlikely, prospect.

So we are all fairly strung out over here. MG is still awake, mushing clay around on her floor because she says it helps her feel better. Turns out she is extremely anxious about going on boats. Who knew? Not us! She always seems to enjoy being on ferries but she just told me she's worried because of the Titanic. I told her soothing things about lifeboat laws and never being more than an hour from shore and no icebergs here, etc., but she said she's just still anxious about boats. I said, well, I guess a cruise wouldn't be a relaxing vacation for you, then, and she looked horrified and said Absolutely NOT!

Oh, well. We'd been thinking about trying for an Alaska cruise with family members next summer, but maybe we will have to come up with an alternative plan. Or else maybe she'll be over the Titanic by then.

Okay. Here are the GOOD THINGS that happened in the past week:

1) Vancouver Folk Music Festival! It was last weekend. Little Latke, now 4, and her parents came up and stayed with us and we heard much music for two days solid.

2) MG's camp this week, which was The World's Smallest Performing Arts Camp. Six kids. One counselor. This afternoon they did their performance for the dozen or so parents and relatives who showed up: a ten-minute extremely abridged and adapted version of "Newsies." My kid has been singing the songs and practicing her lines all week, and telling us the back-story on her character and about the theatre games they've been playing and how nice the other kids are and like that. Also practicing her accent, which according to her is how orphaned newspaper sellers in New York during "the Depression" (actually the show is set in the 1890's, but well, you know...) talked, but sounds more like Dick van Dyke's Cockney accent. She's been in performances before, but this is the first time she's been in a musical (aside from the all-school "holiday" pageant) and as an old performing-arts camper I found it unexpectedly affecting.

3) I learned to play "Uncle John's Band" on the ukulele.

4) I keep getting these great e-mail notifications of comments on my last post. If you did comment, thank you so much and I hope you come back and see this. It's been so very heartening to read everyone's good wishes about MG's sleep issues and headaches. I will keep you posted.

Thursday, July 16, 2009

Melatonin Melodrama

A couple of months ago, the Mermaid Girl started complaining of headaches. Since these complaints mainly came when it was time for her to go to school, we pretty much blew them off, until one day school called and said MG had a bad headache that hadn't gone away even after she lay down for a while, and could we come pick her up?

So we made a doctor's appointment. Almost two years after our move, we have yet to find a pediatrician or primary-care doc who 1) we like AND 2) is taking new patients. I have a good dermatologist, but for most of our ad-hoc medical needs we go to the clinic down the road, where the bedside manner tends to be rather...brisk, and the quality of care varies wildly depending on who you get.

MG's doctor-of-the-day was predictably to-the-point. She asked a barrage of questions about the circumstances of both the headaches and MG's life in general: When do the headaches come on? Where in the head do they hurt? How much sleep does she usually get? What does she eat? etc. etc. I was bristling that she persisted in addressing me rather than MG herself, who was increasingly fidgety and monosyllabic: she didn't like the doctor, she was anxious about the outcome, she didn't like being pulled out of school where they were having a party. All in all, not the most auspicious of appointments.

I was fully prepared for--and halfway convinced myself of--a diagnosis of Dramatic Child Syndrome, but the doctor said she thought it was migraines, even though MG doesn't throw up or get dizzy and sometimes the headaches are only a few minutes in duration. She prescribed--rather scoldingly--more sleep and fewer additives and dyes in MG's diet. The main thing MG got out of this experience was that the mean doctor said she couldn't have any more chicken nuggets. I was similarly freaking out because even though the doctor seemed more concerned about orange dye than the cheese itself, cheddar cheese, a common migraine trigger, comprises about 90% of my child's protein intake.

We went home and calmed down a bit. The Renaissance Woman suggested that rather than dramatically changing MG's classic Picky Kid Eater diet, and putting the whole family through a morass of power struggles and behavioral and sensory challenges, we focus on cutting out dyes where we can (like, getting white cheddar rather than the orange variety) and on sleep.

Ah, sleep. Like her parents, MG is a night owl. She has had terrible insomnia for years, and it seems to be getting worse as she got older. I blogged a while ago about our decision to start giving her melatonin at bedtime, but I have to say now that this was pretty half-hearted and occasional, because we were afraid of her developing a tolerance and of unknown long-term effects. So it didn't make that much difference.

But in the face of possible migraines, and of the brusque chicken-nugget-hating doctor's assurance that MG would not develop a tolerance, we doubled her dose of melatonin--to 1 mg, still pretty low overall--and started dosing her religiously every night about an hour before bedtime. We figured if sleep deprivation was triggering the headaches (as well as the overall crabbiness, jumpiness, morning agonies, and circles under the eyes that we already knew it was causing) then that would be enough right there.

There followed a month of relative bliss. Every night, MG willingly popped two melatonin sometime between 8:30 and 9:30 PM, and, about half-hour later, fell over as if klonked on the head, begged to go to bed, and was asleep almost immediately. No more pleas for glasses of water and cold cloths on the head. No more plaintive calls from the bedroom at 10-:30, 11:00, 11:30, long after lights-out, asking for someone to change the disk on her nightly (and, theoretically, soporific) book-on-CD. No more irritable confrontations with a restless child who insists that she's TRYING to go to sleep, really TRYING, but her body just won't LET her.

And no more struggles in the morning with a pathetic lump who pulls the covers over her head and begs for just a few more minutes of sleep, just one more minute, she's so, so, so sleepy, she feels sick...Nope! Instead, we suddenly had a kid who popped out of bed at eight, often on her own without benefit of parental alarm clock. She was even on time to school sometimes.

The headaches didn't disappear entirely, but they lessened, in both duration and frequency. I started keeping a headache log, and determined that they mostly happened when MG was hungry (or at least when she hadn't eaten for a while-- she didn't always recognize it as hunger).

Then, suddenly, the night before last, just as RW and I were settling in to watch our nightly DVD episode of "Big Love"...we heard it. The dreaded cry. "Mommmmm! I can't sleeeeeep!" Despite the doctor's assucances, the melatonin had stopped working, just like that. In the morning, we had to drag MG out of bed, just like old times. Last night, since she was exhausted from the night before, she went to sleep easier, but this morning was just as hard.

I was surprised by how upset I was-- to the point of crying. We'd gotten so used to MG's struggles with sleep that they just seemed normal, until we didn't have them any more. Sure it's easier for us grownups when she goes to sleep quickly and easily and gets up on her own in the morning, but I also had a chance, in the last month, to see what MG was like with enough sleep, something she hasn't had on a regular basis for years. It wasn't a total personality transplant--she was still very much recognizeably herself-- but her temper was mellower, she was more willing to laugh at herself, she could deal with frustrations and challenges with more equanimity, and she seemed sunnier overall. Her life was better.

I'm not sure what to do now. Oviously we need to find another--better--doctor, to deal with both the headaches and the insomnia, and we're working on that. I also consulted Dr. Google (and his/her/its friend, Dr. Facebook) and determined that it's not unusual for melatonin to stop working after a few weeks, and that many (better!) doctors suggest running a schedule that's some variation of two weeks on, one week off. So we're stopping the melatonin for now, in hopes that it might be effective again for a while when school starts.

One of my favorite parenting bloggers, whose son has autism, used to have a tag line on her blog that read "Our special needs are just more obvious." And while I knew that was true, intellectually--everyone has quirks, needs, differences, no one is cookie-cutter "normal"--after the last few months I feel like I get it a little more.

MG needs enough sleep. I mean, she won't die without it, but for her intellectual and emotional and physical well-being-- and ours!-- she needs more sleep than she's been getting until this past month. We've been avoiding sleep specialists, partly because we've had the impression that the conventional medical wisdom holds that Bad Parenting (late bedtimes, lax routines, late TV-watching) is behind most childhood insomnia, even though that's not our experience, and we're not interested in being scolded or spending months on "solutions" that have nothing to do with whatever the causes really are. We'd been sort of limping along, figuring things would work out.

But when I frame MG's sleep issues as a genuine Special Need, suddenly it looks different. I find myself geared up to advocate for her, to brave the lax clinic pediatricians and the imagined sleep specialists and the contradictory recommendations and whatever is out there.

I feel like I should have some rousing finish for this, but I don't. Just hope that we'll all get a good night's sleep tonight.

Tuesday, July 14, 2009

Random Somethings of Midsummer

*Hello hello! Happy Bastille Day! I mean, happy, I guess happy, I always think of Bastille Day as more violent than happy, what with the extreme bloodiness of the French Revolution and all, though I guess the 5 or 6 guys who tottered out of the Bastille (did anyone else ever hear that? That there were actually only a few prisoners in there by 1789?) were pretty happy.

*Okay. Happy Tuesday, anyway.

*Tuesday is my short day at work: only 4 hours. Since Monday is 5 hours and also crazy busy lately, I always feel like a Lady of Leisure on Tuesdays.

*Especially since MG has started walking home from camp on her own.

*Camp--at least this week-- is at her school, with her last year's teacher, and runs from 9 AM to 3 PM. So basically, from a parent's perspective, it's JUST LIKE school.

*Except, no homework! Woo-hoo!

*And also, according to MG, it is actually TOTALLY DIFFERENT from school, because basically all they do is art and P.E.

*On the Growing Up front, MG is now taking showers instead of baths.

*Yesterday she finished her shower, turned off the water, and asked me to hand her a towel. I reached out and touched her hair, which made the fuzzy, bubbly sound of a head with a fair bit of shampoo on it.

*I guess taking showers is a skill not acquired all at once.

*Yesterday, when I was feeling crappy, MG made me a plate of cinnamon-sugar toast, and even cut it in half for me. I was very touched.

*Then she said, as she says after every action evidencing a modicum of self-sufficiency, "Is this getting me closer to earrings?"

* I was a little less touched after that.

*More news: MG now has a trampoline!

*It was an early birthday present, a joint effort between some grandparents (who provided the cash), RW and I (providing the legwork), and our neighbor, who came over and helped us put the thing together last week.

*I have been nonplussed at how many people, on reading/hearing this news, react by warning me or RW about the dangers of backyard trampolines

*So I have become kind of defensive about explaining that we know the dangers, there is a net enclosure, MG has learned trampoline safety for years in circus class, we have a number of rules in place, etc. etc.

*The Vancouver Folk Music Festival is this weekend!

*This will be the third year in a row that we're going as Vancouver-area residents, not tourists up from the States.

*It's wild to think how different our lives are than they were about two years ago at this time.

*Kind of puts my recent job complaints in perspective, doesn't it?