ear infections and antibiotic controversy

Parents out there, I have something for you to read about ear infections and antibiotics.  It's an easy read, but it is a bit long.  Nonetheless, I think every parent should read it.

80% of all ear infections clear up on their own.  Back in 2004, new guidelines were given to doctors regarding the treatment of ear infections. The article below lists the guidelines.  I think it's important to be familiar with them.

Despite these new guidelines, American doctors still over prescribe antibiotics for ear infections, at alarming rates.

Why?

I believe they want and need parents to like them, in order to have a thriving practice.  If they follow conservative guidelines, they risk gaining a reputation for rarely giving out antibiotics, and consequently, too many parents would avoid their practice.  When babies and toddlers are screaming in the night and waking frequently, parents want answers and treatment, usually in the form of antibiotics.  Doctors feel compelled to acquiesce.  Also, it would take too long to explain why a prescription isn't needed.  Time is money.

Today Peter went to the doctor for a routine ADHD check up, to obtain another prescription for his Strattera.  The doctor always gives him a complete physical exam at these appointments.  He looked in Peter's ears and found infection in the right one.  I said that Peter was three days into a mild cold.  Doc asked Peter if there was any pain, and Peter said no. Doctor was surprised at that.

He wrote a prescription anyway!

I am not going to fill the prescription, unless Peter develops severe symptoms after three days.  If he remains symptomless, I will have his ear rechecked at his next ADHD check up, in two months.

I learned that children over 4 tend to get asymptomatic ear infections--no pain or fussiness or fever.  Often it isn't known that an infection is present until a child fails a school hearing test, due to fluid behind the eardrum.

Last December I took Paul, my seven year old, in for a flu shot.  Doctor checked him over first and found an ear infection, which either started because of allergies, or from a cold in late November, or both.  Again, there was no pain or symptoms.  Doctor wrote a prescription, and I filled it. I had little experience with ear infections.  My kids aren't prone to them, so I never had to do any homework.

In January I took Paul for his yearly check-up, and to get the flu shot he couldn't get in December, due to being put on antibiotics.  Clear fluid was present--not infected.  The doctor put him on the same antibiotic, saying it would probably clear up the fluid.  My husband and I were scratching our heads.  With no infection present, why another round of drugs?

However, we filled it, because the doctor explained that Paul would have to get ear tubes if the fluid did not clear up by three to four months from onset. It had been nearly two months since the initial infection. We figured the doctor must have reason for believing that antibiotics would clear up fluid. We wanted to avoid surgery at all costs.

Well, we went back in March to have the fluid checked.  It was still there! Clear, not infected.  Paul had failed a hearing test at his yearly check-up (Jan), and again in March at this appointment, due to the fluid.  The doctor gave us a referral to an ENT.  The appointment is in late April.  I plan to fight the use of tubes, based on my research, especially if the fluid is still clear and not gel like.  The hearing difficulty is not an issue in terms of Paul's learning, and I feel the fluid will drain on its own when the weather is warmer.  Fluid tends to hang around longer in the winter months.

They now know that even in very young children, the tubes don't improve speech and language development, as was thought for many years. They also don't decrease the number of infections, necessarily.  Ear tubes, like antibiotics, are overused in America.  Having them put in causes scarring, which is a factor in long-term hearing loss in kids who need them more than once.

It is true that chronic ear infections can also cause scarring, but ear infections tend to become chronic when antibiotics are overused!  Ear infections treated with pain relief, and no antibiotics, clear up with fewer complications than those treated with antibiotics.

And studies show that treating with antibiotics only decreases pain by one day, compared to not treating with antibiotics.

I feel angry that I wasn't given better information.  I wouldn't have filled any prescriptions, had I known these guidelines, given by the AAP back in 2004!  The information is still current today.

Doctors:  Skip Antibiotics for Child Ear Infections - shorter article
Dr.Greene.com - Antibiotics and Ear Infections - new guidelines

When the enemy threatens your day, take it back!

Peter had plans this morning.  Big, glorious plans.  He'd made eight dollars in chore money over the last two months--enough to buy another bird feeder.  Plexiglass, he told us, like Mr. Joe's.

Our neighbour, Mr. Joe, has a very popular bird feeder.  Birds make quick work of the seed, emptying it in 36 hours.  Peter naturally reasoned that if he had a plexiglass feeder, we'd get more birds.  And if not, "do you think we could ask Mr. Joe to stop filling his?  He's stealing all the birds."

"Peter!  Of course we can't ask that.  There are plenty of birds to go around."

I turn away, hiding my smile.  I know I should be dismayed by his selfishness, but somehow, I'm not.  The boy loves his birds.  Loves them! He checks his feeding station a good fifty times a day, praying to see this or that bird.

Daddy awakens.  The plan is to quickly go to Walmart for the bird feeder, then back home so Daddy can leave for work.  He has seventeen hours of work to do between Friday night and Sunday night, and he arranges his schedule based upon the family's needs, as much as possible.

Peter gets dressed and ready.  He's as excited as a baby toddling across the room for the first time.  He worked hard for the money, and now, his prize is within reach.

But Daddy can't find his glasses.  Peter can't find Daddy's glasses. Mommy can't find them, nor Paul, nor Mary.

Slowly, Daddy unravels.  He utters his favorite line: "I'm so glad there'll be no glasses in Heaven!"

Peter takes it well for the first fifteen minutes, then he unravels.  He's as mad as a coach yelling at a referee over a really bad call.

My own stress level climbs, as it always does when Daddy or Peter unravel. Their anger, fueled by a low frustration threshold, is rarely directed at any of us.

Nonetheless, it steals our peace.

Fifty minutes pass, and no glasses.  I stop looking, deciding my time is better spent keeping Miss Beth and Miss Mary out of trouble.  With their help, I get breakfast on the table.

After clearing the table, I ask husband if I can get in the shower (as in, will he keep Beth alive for me?).  He says yes, and I enjoy the relative solitude of the bathroom, asking the Lord to help me take back the day.

I say relative solitude because someone always finds reason to enter the bathroom when I'm showering, to check up on me or give me commentary.

While I enjoy the water, husband finds his glasses on the floor at the foot of the bed.

Peter, relieved he can get the feeder, doesn't quite recover his equilibrium. He's punchy.

Husband is aggravated at the unexpected change of plans. Now, he will not be able to get all his work done before night church, necessitating going out again, to clean one more bank, after church.

They proceed to Walmart, also picking up bike tire paraphenialia, to fix both boys' tires.

Once home, Peter fills his feeder immediately, and will Daddy please hang it?  And Paul wonders if his tire can be fixed today?

The day already shot, or so it seems, Daddy decides to do these things before leaving.

Nothing goes smoothly.  Time passes.  Angers resurges, escalates.

My own resolve to stay calm amidst the storm, falters.  But the Holy Spirit whispers.  Call them to get their Bibles, and open to Isaiah. 

I quickly clear the lunch things, and call Mary and the boys to the table for Bible reading and prayer.  Miss Beth hangs out a few minutes coloring, then wonders around, sometimes watching the birds.

Daddy is outside, working on bike tires.

"What Psalm are we on?", Peter asks as he opens his Bible.

Not Psalms this time, I say.  This is an extra, emergency devotional time, to get our joy back from the Enemy.  

I open in prayer.

Turn to Isaiah 51.

Why I said 51, I don't know.  It just came out.

Excerpts from Isaiah 51:1-11:

The Lord will surely comfort Zion and will look with compassion on all her ruins; he will make her deserts like Eden, her wastelands like the garden of the LORD.  Joy and gladness will be found in her, thanksgiving and the sound of singing.

Lift up your eyes to the heavens, look at the earth beneath; the heavens will vanish like smoke, the earth will wear out like a garment and its inhabitants die like flies. But my salvation will last forever, my righteousness will never fail.

Awake, awake! Clothe yourself with strength, O arm of the LORD; awake, as in days gone by, as in generations of old. Was it not you who cut Rahab to pieces, who pierced that monster through? Was it not you who dried up the sea, the waters of the great deep, who made a road in the depths of the sea so that the redeemed might cross over?  

The ransomed of the LORD will return.  They will enter Zion with singing; everlasting joy will crown their heads. Gladness and joy will overtake them, and sorrow and sighing will flee away.

Daddy enters halfway through, and grabbing his sandwich, he joins us.  He gives us commentary on the history contained in the verses.

He closes us in prayer.


And then I hear it.  His heart.

It isn't the glasses, or the bike pump, or the tires, or hanging Peter's feeder. Or even getting a later start with his work.

He wants more time with his family. He wants at least one day off a week--one entire day.  He pleads with the Lord for that, and for a better job, and for time to study for certifications, or for a computer internship--all things that still elude him.

Husband has been reading Ann's book, intermittently, as I've left it on the end table, or on the computer desk.  He's fighting the concepts, I can tell. I haven't mentioned that I know he peeks at it.  I don't want to spoil the work of the Holy Spirit.

He wants to be grateful, thankful, but it's foreign to him.

Ann lost her little sister years ago--her blood splattered on their gravel driveway by a delivery truck driver.  Grief shattered the family, and Ann, for years.

It never occurred to me that he would pick up the book and be intrigued.  It's the Holy Spirit.

Husband lost his mother at sixteen, her blood splattered by a truck driver on a Delaware country rode.  His life didn't turn out well, though he loves us, his family. He is grateful for us.

All the rest is hard, as it was for Ann.

She started with a list.  A list of everyday gifts, everyday blessings.  And through her list, she found more than thankfulness.  Thanks-giving bore fruit--joy, peace, freedom from fear, a heart to give back, and profound intimacy with the Lord.

I want all that, and more, for my husband.

May it be so, Lord.

parenting through Him

I wanted to take some time to thank you, Terri, for praying about the reading issue!  Many times I've found that after posting about a difficulty in our lives, the issue resolves itself in a few days time.  When this happens, it always makes me wonder if someone out there has prayed.  Thank you!  I appreciate you!

My Peter made a miraculous recovery! (wink)  He still had symptoms, but not so bothersome.

It wasn't a particularly nice day; we had wind and temps in the forties.  But my grace for today--husband was gone 9:30 AM - 6:00 PM--was the hour the older ones spent outside playing football and using tennis rackets and balls.  I liked seeing them so happy--so blessed by each other.

The boredom issue came up later--like last Saturday--probably because they don't do school on the weekends.  Again, I told the Lord that I didn't want any videos or computer on.

"Help me, Lord!  I'll do whatever you say."

Now, I don't like board games.  Don't ask me why, though maybe it's the sitting and waiting?  When someone suggests a board game, I've always inwardly rolled my eyes.  "Must we?", I'd think to myself.

Lately, God hasn't let me get away with that.  He reminds me that parenting, at its best, is sacrificial.  That means not doing what we want to do, and doing what we don't want to do.

So I found myself playing "Go to the Head of the Class", a game I highly recommend.

There are two dice in the game.  The red one you roll to find out which of the six subject categories your question will come from.  The black die is rolled to move your player once you've correctly answered your question. The questions are wonderful opportunities to challenge your kids, and cement their learning in mathematics, language, history, geography, science, and art and music.  Since there are three levels of difficulty (student, scholar, graduate), there are plenty of questions parents are challenged by as well.  It's marketed as a whole-family game.  The recommended age is 7+, but when four-year-old Mary plays, I make up her questions myself and she's perfectly happy with this.  The questions are numbered and in order of difficulty, but you don't have to go in order; I peruse the list in each category until I find a question that is challenging for my children, but reasonable.

Over the last several weeks, as I've played more board games, I've realized how good they are for my children.  Children need to learn how to win and lose with grace, how to joyfully let someone else go first, how to take it in stride when they fail at something.  Social skills are taught by parents, not by other children or by teachers (teachers don't have time, truthfully).

By the way, this is precisely why I feel the whole socialization and homeschooling issue is ridiculous.  Just being among peers doesn't teach social skills!  Often, it teaches mob mentality instead--especially when you consider that on the playground, in the lunch room, and on the bus, no adult has time to listen to every conversation, or monitor every aspect of a game or activity.

Anyhow, I've come to feel that few arenas are as good as family board games, in teaching children many of these skills.

I had a great time and the rewards for obeying my Lord, as usual, were many fold!  When I parent my children through Him, and not in my own strength or wisdom, I'm always at peace--and my children are as well!

a fresh perspective

The Lord blessed me!  Peter started the day reading the rest of his Boxcar Mystery.  An hour later he finished it, announcing that it really wasn't scary after all. He read it in a day and a half.  Since we weren't due to go back to the library for another week, I knew that at this reading pace, we'd run out of grade 3 and 4 chapter books. Before husband left for work, I ran to the library and checked out seven more Boxcar Mysteries.

We're back in the reading business!  I'm so utterly thankful!

That was the highlight of my day.  Soon after Peter came down with a full-fledged cold--Daddy's cold.  As a mother, one of the hardest things for me to endure is this:  whining.  When Peter is sick he whines; he has no patience for illness.  About every ten minutes he reviewed for me--for us all--the discomfort of every symptom, and asked continually when he would be well again (we haven't had colds here since late November).  Along with that question, he asked me at least twenty times when the two goldfinches would come back to the feeder  Ughh!  It was a long day.

After the kids went to bed, I was more spent than usual.

Then I read something humbling, beautiful, at the end of Ann's book (quote below).  I don't know what you have planned this weekend, but being a mother, it probably entails a lot of service to little people--a lot of laundry, dishes, meal prep, diaper duty, wiping up wet messes, vacuuming dry ones, sweeping crumby ones.

I quote Ann Voskamp's  One Thousand Gifts ( pp 193-195) below...for you, for me. No matter how long, how rough, our days are, by switching our focus, we can serve our families with the joy of the Lord.

Jesus is about to let flesh be broken with nail, heart be broken with rejection, the chains be broken with bleeding love.  And in His last hours before His earthly end, He doesn't run out to buy something or catch a flight to go see something, but He wraps a towel around his waist and kneels low to take the feet of His forsakers gently in hand and wash away the grime between their toes.

At the last, this is what will determine a fulfilling, meaningful life, a life that, behind all the facades, every one of us longs to live: gratitude for the blessings that expresses itself by becoming the blessing.

Eucharisteo is the hand that opens to receive grace, then, with thanks, breaks the bread; that moves out into the larger circle of life and washes the feet of the world with that grace. Without the breaking and giving, without the washing of feet, eucharisteo isn't complete.  The Communion service is only complete in service. Communion, by necessity, always leads us into community.

Eucharisteo means "to give thanks", and give is a verb, something that we do.  God calls me to do thanks.  To give the thanks away. That thanks-giving might literally become thanks-living.  That our lives become the very blessings we have received.

I am blessed.  I can bless.  Imagine! I could let Him make me the gift!

I could be the joy!

Scratching a stubborn pot furiously with a wire scrubby, I remember it again, what I once read of liturgy.  That liturgy has its roots in the Greek word leitourgia, meaning "public work" or "public servant."  The meaning!  This life of washing dishes, of domestic routine, it can be something wholly different.  This life of rote work, it is itself a public work, a public serving--even this scrubbing of pans--and thus, if done unto God, the mundane work can become the living liturgy of the Last Supper.  I could become the blessing, live the liturgy!  I rinse pots and sing it softly, "This is my song of thanks to You.."

In the moment of singing that one line, dedicating the work as thanks to Him, something--the miracle--happens, and every time.  When service is unto people, the bones can grow weary, the frustration deep.  When the laundry is for the half dozen arms of children or the dozen legs, it's true.  I think I'm due some appreciation.  So comes a storm of trouble and lightning strikes joy.  But when Christ is at the center, when dishes, laundry, work, is my song of thanks to Him, joy rains. 

Friday's Gratitude:

* A boy's eyes lit up at the sight of more chapter books

* Goldfinches at the feeder--the first since March 12th.

* Squirrels taking a mesh bag of discarded meat fat (for the birds) off our tree and running behind the shed with it.

* Quiet reading time, reflecting time, for Momma.

* Sick bodies, reminding of the miracle our bodies are.

* Tulip shoots surviving the snowstorm (all has melted).

* Girls playing in the mud.

* Sending an Amazon copy of Ann's book to a friend in need, keeping the blessing going.  (A friend sent one to me.)  Please pray for my friend?  She and her husband and three girls embarked on a trailer park ministry to the poor and needy, resigning a children's pastor position at a church in Wyoming.  They planned to live on their savings while the ministry got up and running, until a salary could be generated via ministry donors.  They are down to the last few hundred in their savings account.  Big miracles needed. People come regularly to their home offering garden veggies and eggs, so my friend has faith that God will keep providing.  She homeschools her three girls, one of whom, at eight years old, was just diagnosed with ADHD and OCD; she is on medication for the OCD and receives counseling. While my friend's faith is strong, she is obviously going through a lot.  She is on my mind daily now.  Please pray?  Humbly thank you.

* Husband's cold mending quickly.

* Mopped floors, vacuumed carpets--the blessing of hard work and a body that is up to the task

out like a lion - March

These red-winged black birds seemed to know we'd get a few inches of snow.  (Peter learned that some birds can predict the weather.)  They came in droves just before a heavy snowfall began.  You can see the snow starting to collect on the ground.

On Monday the children enjoyed a homeschooling playdate at a park, where Peter found this salamander.  He's thrilled to have a second pet.  Come summer, we'll have a full house of various creepy crawlies.

Paul loves to create and Momma doesn't always have time to put projects together.  More often than not, he comes up with his own ideas.  This will be a ladybug.

Two days in a row Miss Mary created beautiful paintings, along side Miss Beth.  For some reason Beth ruined both of Mary's paintings, by balling them up like a piece of trash.  The first day I gave a mild scolding, but on the second I tapped her hand lightly and told her she needed to treat Mary's work nicely and this better not happen again.  

She was remorseful today and reached over to kiss her big sister and say sorry.  I wonder if she was jealous, because her own paintings are a bit of a mess?  I praise her work as much as I do Mary's.  

Anyway, Mary was so touched by her little sister's kiss, that she immediately forgave her, despite having spent about thirty minutes on the painting.   

I tell my kids frequently that one of the reasons God gave them siblings is to help them learn to love more like Christ.  When squabbles happen, I suggest to them, they need to work peaceably through them and each person must confess their part and be humbled.  They do seem to come to resolution quicker when I give this reminder.

We made brownies yesterday, and though Beth couldn't taste the batter containing four eggs, I did let her sample the frosting we made.  She licked it right off the beater utensil.  Warmed my heart, I tell you, to see her enjoying it so.  

We got a steady, heavy snow on Wednesday, lasting most of the day.  It was breathtakingly beautiful--the biggest snowflakes we've seen yet!  I do fear for the tulips and other bulbs, just coming up in this bed.

  

What made me think I could start morning glories in the house?  Tonight I had to put popsicle sticks in with these, attaching them with bread ties.  I hope we can come up with another solution before long. I didn't realize they would need to climb right away.

Miss Mary was so smitten with her Paul, that she put her arm around him while he read to her.  Oh, how that touched my Momma heart.  Then she kissed his baby soft cheek.

Is not a cardinal in the snow one of God's greatest gifts?  Breathtaking!

Thursday gratitude:

* For sibling kisses

* For husband hugs

* For whole-family cuddling

* For picture books shared all together on the couch

* For brothers who read to little ones so Momma can keep the pancakes from burning

* For a husband who always insists on taking the burnt ones, no matter how much I protest.  He lays down his life for us daily, in these little ways.

* For listening to Peter read while I nursed Beth in the rocker next to his.  He still reads aloud, for now, but he didn't repeat anything or stutter, as he read a Box Car Children book.  God heard my heart on this OCD complication! This is the first time in a while he was able to read peacefully, something other than the Bible.

Later tonight though he had trouble falling asleep because of some details in the book concerning a cave and a monster (not a real one of course, just part of the mystery).  Frustrated, he told me he wasn't going to read these books any more and why don't they write more Magic School Bus Chapter Books, because those are his favourite?

Last time this occurred, he told me he was only going to read these books in the morning--definitely not near bedtime.  This one he found particularly interesting though, because he read for pleasure about four separate times today.  I will be in prayer that this gets resolved soon, somehow, because like holding his hamster and watching his birds, reading calms him.  I had him make a list of self-soothing techniques and he listed the hamster, the birds, and just today, he added reading to the list.  It's something he can choose to do when his temper begins to flare.  Unfortunately, we still have difficulty finding material that doesn't aggravate his OCD in some way.  Tonight he asked me time and again if a monster was going to climb in his window.  It has been years since monsters were an issue.  The OCD makes him terribly skittish about many things. While I'm frustrated over finding something he's completely comfortable with, I'm so very thankful he's reading again!