Marissa's Special Elbow

I hope I'm not alone in wondering when to seek medical attention for my kids. When is it appropriate to tell them to "buck up" and when should you seek an expert's advice? I have the privilege of having two kids for whom every ache and pain is deemed worthy a trip to the emergency room...at least in their minds. I cured one of my kids of that by finally taking her. After six hours of sitting around, she was given two ibuprofen and told to go home, they couldn't find anything wrong with her. 

About six weeks into the school year, Marissa started complaining about her elbow hurting. She was careful about bumping into anything, as any touch caused her pain. Eventually we ended up at Tria's urgent care for it, where she was fitted with a partial splint to protect it and keep it somewhat stationary. 

There, the doctor took a look at her record and her many trips to Tria for this same elbow, and said, "Hmmm....we've seen you a lot for this, but we've never taken an MRI. Let's do that." 

The MRI indicated something surprising — Marissa has an extra muscle in her elbow! Only about 4% of people who have elbow surgery have this, and the percentage of people who have elbow surgery is quite small, so let's just say it's pretty rare. 

They did more testing and an ultrasound which showed that as she moves her arm the muscle impinges on her ulnar nerve. A-ha! The source of her pain. Thankfully they could do an outpatient procedure to remove the tissue that was compressing the nerve.  

She was cleared for surgery and we were able to get it scheduled in a week. Dr. Bohn (pronounced "bone," which I thought was ironic considering she's an orthopedic surgeon), was highly recommended and had an opening on Thursday, November 5th. 

Marissa barely slept the night before surgery. She was anxious about the coming day, as anyone would be, especially a 15-year-old. She and I stayed up together from 2 a.m. to 4:30, entertaining each other with stories and laughing. Pretty soon her mind was relaxed enough that she could get a couple of hours of sleep before we had to go to the surgery center. 

Marissa was amazing through all the pre-op. She got an IV with no issues, chatted with the nurses and asked a lot of questions. They gave her a nerve block for her arm, which deadened all feeling in her arm and made it feel like it weighed 100 pounds. She said her arm felt like it belonged to a stranger.

Finally Dr. Bohn came in to greet her before surgery. She said, "Let me check to see how this arm is doing," she picked up Marissa's arm and let it go. It dropped like a rock onto the pillow below. Dr. Bohn laughed and said, "That cracks me up every time." 

Marissa did great and the surgery went well. Dr. Bohn had to transpose Marissa's nerve to another area of her elbow joint, so it will take some extra time to heal. It took Marissa a while to wake up, but eventually she did and we headed home for recovery to begin.

The day after surgery all of the nerve block had worn off and Marissa was in a lot of pain. The meds she had been prescribed made her sleep and she slept most of the day, but whenever she was awake she was in a lot of pain, so we got a different medication that would help more. 

It's been a few days now, and every day is better than the day before. Hopefully no more trips to urgent care for elbow pain for her. 

There Are No Emergencies During a Pandemic

My sister is a floor nurse at a local hospital and is on the front lines of the COVID-19 epidemic. Mom and I keep checking in on her, knowing that, right now, work isn't just physically draining but also emotionally exhausting for her and everyone she works with.

The hospitals protocols are changing almost daily, with new information and as they prepare for the onslaught of COVID patients. One of the things that's in the news right now is the need for ventilators and for N95 masks. N95 masks are a certain kind of mask that keeps out the smallest particles and are the recommended personal protective equipment (PPE) to keep health care workers from getting sick while treating COVID patients. They are in short supply right now. And then there are the ventilators — hospitals want to have on hand significantly more ventilators than they usually own for this epidemic. This has been a point of much discussion in the news, with people speculating why hospitals would need so many more ventilators. I mean, other flu varieties don't require this many people to be ventilated, why now?

Kristi explained in a phone call with our mother and I, and here's the reason:

There are no emergencies during a pandemic. 

Nothing, not your loved one being unable to breathe or having a heart attack, is worth risking the lives of healthcare workers who are there to save them.

During normal times, if someone presented to the hospital in severe respiratory distress, they would be put on a bipap machine. It's like a c-pap machine that people use for sleep apnea, only with pressure on both the exhale and the inhale. Patients can be in a regular hospital room if they are on a bipap machine.

Except...

While someone is on a bipap machine their breath is aerosolized, airborne in the room for others to breathe in. Without enough N95 masks to protect health care workers, chances are high that those treating these patients will contract the virus.

If the person's breathing continues to worsen and their oxygen levels don't rise, then they are put on a ventilator, which is a much more serious intervention. The patient is heavily medicated because a tube is shoved down their throat. Without sedation, patients will try to grab at it to remove it,  possibly damaging the airway. During the intubation procedure of someone who has COVID, everyone in the room is highly at risk for being exposed to whatever virus or bacteria the patient may exhale, so personal protection equipment is essential. After the intubation, a machine breathes for the patient and they are typically in the ICU so their medication and oxygen levels can be closely monitored. It is not pleasant.

During the coming epidemic, hospitals are skipping the bipap stage and going straight to the ventilation stage. Why? One, because they don't want to expose their caregivers to the disease by aerosolizing the virus with bipap machines. Two, if the patient worsens, the care team will be frantically donning their protective equipment outside of the room while the patient is in distress, unable to breathe. By the time the care team is able to enter the room, the person may be unconscious, suffer irreparable brain damage from the lack of oxygen, or have died.

From a nurse who was on the front lines of fighting the Ebola epidemic: There are no emergencies during a pandemic.

There is no rushing into a room during a code blue, nurses and therapists surrounding a patient and providing life-saving care. There is no treatment without first taking precautions that the patient may — MAY — have COVID if any symptoms are present. Right now hospitals beds are being taken up by people who are waiting for test results to rule out COVID, since it currently takes 48 hours to get results back. Until a patient is known to NOT have the virus it is assumed they do, meaning that each time a nurse enters the room they must gown up appropriately. It takes much longer to care for patients now than when a pandemic isn't going on.

So yes, there is a shortage of ventilators. There is a shortage of N95 masks. And scientific data is behind all of the changes that hospitals are making to reduce mortality during this pandemic. Science and facts.

*NOTE: This was published with the input of my sister. It is not a reflection of her opinion or that of her employer, only mine.

Cooking During a Pandemic

Our house is out of chicken. I was low before the whole coronavirus/hoarding thing happened, and now all of the stores are out.

It is a main staple for me in my cooking, it is so versatile in all the ways you can prepare it. I've shopped multiple Cub Foods locations, my local Lund's, Wayne hit Costco, and no one has any. We are not dark meat eaters, all those chicken thighs can just sit in the case.

I'm so bummed. And yet...my kids couldn't be happier.

"Chicken this, chicken that," they would say. They are thrilled. No chicken during the entire quarantine! Hooray for them!

Both Wayne and I picked up cuts we normally wouldn't pick up. Pork tip roast. New-to-us cuts of beef. Turkey tenderloins.

And tonight, I roasted a pork tip roast with a dry rub recipe I selected from Allrecipes.com.

As it roasted the house filled with its aroma. It drifted from the kitchen through the entire lower level, up the stairs and finally to the closed bedroom doors of the two teenagers. They finally came downstairs wondering, "What smells so good?"

This stuff, oh yeah.

Even my non-pork eater ate two slices of this roast at dinner, it was that good.

Later this evening, at a virtual happy hour via Google hangouts, my friends and I kept looking for silver linings in what's going on right now.

• More acceptance from corporations to accommodate work-from-home arrangements.
• Insurance companies finally accepting and paying for telehealth appointments. (Yay progress!)
• Unity across our entire country regardless of party.
• Universal focus on what's important in life: Family. Relationships. Love.

These are crazy times. The last pandemic of this size was in 1918. The Spanish flu took 50 million lives worldwide — its mortality rate was 10%. The coronavirus has a mortality rate of 1%, nowhere near as deadly. And yet, if 70% of Americans get it, 2.5 million people will die.

Let's not go there.

So please, stay safe, stay home, love your family, and eat all the random sh*t you can buy. Except this stuff. I would be hard pressed to buy this, even with the enticement of bacon.

Good Minnesotans never take the last one. Anyone? Anyone?

We Interrupt Daily Life for This Important Message

• Don't touch your face.
• Stay at least 6 feet away from everyone around you.
• Do not shake hands or hug or touch anyone else.
• If you feel sick, stay home.
• If you believe you've been infected, call the Covid-19 hotline at 800-HOLYSHT.

The past two weeks have been unprecedented in my lifetime. I've never seen such a fearful response to a virus, to the point that we are indeed in a pandemic, complete with panic-buying and supply hoarding.

It started in Wuhan, China, moved to London, then to Washington State. Now it's in 39 of our 50 states.

It's the flu.

It's a respiratory sickness, one that is worse than usual, and people who are immuno-compromised or have respiratory issues in general are at high risk, as are the very old and the very young.

Markets have crashed. Whole industries (cruises, travel, airlines) have been practically shut down. Grocery stores have been emptied.

Local retailers at kiosks closed their businesses at Southdale Mall. National retailers still open but mostly empty. 

Our local Walgreens, all paper products and hand sanitizer are out of stock.

Local grocery store. No onions? I think we can live without onions...

And as of today, Marissa's school is closed for the next THREE weeks. Three — two for quarantine time and one for their regularly scheduled spring break which they can't possibly cancel in case some families still plan to make the trips they had planned previously. Which is not advised, but you can't stop people from going.

No word yet from Lindsey's online high school, which, I suspect, will be business as usual since it's 100% remote anyway. Wayne's company is asking everyone to work remotely starting tomorrow as well.  And I, well, I work for myself part-time out of the house anyway, so there's no change there.

Which means...we're gonna have a full house. Except Wayne volunteered to be the only person physically in the Minneapolis office, to bring in the mail and what-not. He will be there by himself, because, as he told his boss, they would have to "pry my cold, dead hands off my office to get me to work from home." That's how much he was looking forward to attempting to be efficient and work while at home with his family.

I've never seen a societal response of this kind to a flu warning. Don't get me wrong, I'm not downplaying the illness, but the human response to it appears over-the-top. As public health officials say, if we do our jobs in hindsight it will look like over-reaction. If we don't, well then, buckle up, we're all in for a ride.

I mean...why are people just NOW buying hand soap? Don't we all normally have hand soap in our homes? Do people not normally wash their hands often? To make sure a family doesn't run out of hand soap for a three-week period you may need three, four bottles of hand soap tops. So...why are people buying cases of it? Don't get me on the toilet paper hoarding. That seems like such an American response.

One family meant to purchase 48 rolls of toilet paper through Amazon but accidentally ordered 48 cases, so now they've got enough toilet paper for a small village. Or for their family for the next 3 years, however they choose to use it.

I went grocery shopping this past Monday and got everything I needed for the week. I bought toilet paper at the grocery store (which I usually don't do) because Costco was out the last time I was there; I hadn't thought anything of it at the time. By Friday, grocery stores were emptied, their shelves silent witnesses to the scramble of the early morning crowd who had emptied them of their contents, snatching toilet paper and disinfectant wipes from each other's hands in a frenzy.

Here's the most frustrating part for me. We have two beautiful, wonderful, amazing daughters whom I love dearly who both also have mental health issues. Lindsey has thrived in her Normandale College classes. She's back in a traditional classroom, interacting with "real" people and loving the social engagement. She is always more excited to work on those classes homework than her online high school courses because she has to be prepared for the next class discussion. Now, one of her college classes is moving online for the rest of the semester, and there's a strong possibility that her other college class will as well. Her spring break was last week, but classes are suspended this coming week as well due to the coronavirus.

Most college students would be thrilled — YES! No more slogging to class, sitting in classrooms, having to work on group projects and talk to other people. Lindsey, on the other hand, is incredibly disappointed. This was her only social interaction outside of family, her only necessary trip out of the house three times a week. She enjoyed talking with the other students, she loved the debates and discussions. And now they are canceled.

And then there's Marissa, my social butterfly. The thought of not seeing her myriad of friends in person for three weeks is devastating to her. What will she do when she can't joke with her friends between classes, chat at lunch and give hugs? She loves to hug her friends. She is an incredibly genuine, kind-hearted girl who is always thinking of others. She is going to wither under three weeks of distance relationships.

I, in the meantime, continue to work away at my various projects, do housekeeping duties and guide my girls in their daily lives. I can understand why Wayne wouldn't want to be at home when everyone else is home. When he's working, he is 100% focused on work. I rarely call him at the office, he is there to be efficient and get things done so he can get home. He will probably have an amazing two weeks at work with no one else there! Such an introvert.

We'll see how all of this develops. In the meantime, stay healthy, stay away from others, and cough into your elbow, not into your hand.

Physical Therapy: A Memory

I had the misfortune of being in two car accidents this year in which I was rear-ended. Twice. One occurred in late July, the other in late September. The one in late September did the most physical harm to me even though it was at a lower speed, because I had my neck craned all the way to the side looking for oncoming traffic. My head was nowhere near the headrest, so I had the full effect of a whiplash-like movement.

Within a day I was hurting and going to the chiropractor. Getting adjusted two or three times/week wasn't making a difference. I'd feel fine after the appointment but by the next morning my neck was stiff and painful. One Saturday I was in so much pain that I moved the entire day like a mannequin — I could not turn my head in either direction at all, and instead of looking down at things I had to bend down to see things below me.

Through a series of appointments and visits with various health care professionals, I found myself in physical therapy (PT) at PDR Clinics. I've been going twice a week for four weeks now.

I learned that while I had been doing neck stretches correctly, I hadn't been holding them for long enough for my muscles to actually benefit. I'm strengthening my muscles using their MedX machines to isolate muscles. Those difficult-to-exercise neck muscles are actually getting the workout they need to get stronger.

I've heard and know of many people who've had to go to PT for various injuries, and I'm so grateful for this area of care. It's important to put the work in — when the therapist says they want you doing stretches every day, they mean it!

All of this reminded of a time when my dad was sick. He battled colon cancer for 7 years before it finally claimed his life. During much of that time he was able to live life normally, and other times he was in so much pain and could not control his bowels, which makes living life pretty much impossible.

My dad and stepmom Terry in happier days. 

One time he was hospitalized for three weeks after a bowel resection surgery. He did not recover well, anesthesia always threw him for a loop, literally. He was out of his mind delirious for nearly five days before they realized that the painkiller they were giving him was doing that to him. Once they got him on a different painkiller he got back in his right mind and the healing could continue.

Recovering from one of many surgeries, April 2015. Grandkids Sam and Presley, wife Terry by his side.

He was so eager to get home that he convinced the doctors to release him even though he had hardly any strength after being bedridden for three weeks. In order to get into the house he sat down on the front steps and slid his butt up each stair; he could not even lift his legs high enough to climb a single step. I don't remember if the hospital bed was in their house at that time or not, but if he was able to make it up the stairs to the bedroom he probably didn't come down for several days.

Weeks went by and my stepmom-angel took care of him. He was getting a little better every day but still was very weak. I am not sure how it came about, but a doctor or someone finally convinced him to meet with a physical therapist at their house to help him build his strength.

I talked to him the day of the therapist's first visit. Dad was angry. "That was the stupidest thing ever," he grumped to me over the phone. "She had me sit in a chair and straighten my leg, hold it for a few seconds and then put it back down. It didn't do a damn thing." My dad was a big man, accustomed to being strong and active. The fact that he had weakened to the point that straightening his leg was considered "exercise" frustrated him.

The next day I called again just to see how he was doing. He was even more frustrated and annoyed because he was sore from the "supposed exercises." I think he felt even more defeated at how weak he had become.

I don't know if he ever kept up with the therapist, she may have come a few more times. And knowing how frustrated he was by the experience, I don't think he kept up with the exercises they told him to do.

After that particular hospitalization, my dad slowed down. He was never able to get back to the level of activity he'd had before, and he was incredibly slow at walking. My sister and I had a hard time walking as slowly as he did. I would literally hover a single foot in the air to make my steps as slow as his. One time Dad and Terry were in Minnesota visiting us and the four of us were walking to a restaurant. Kristi and I absentmindedly started walking at our regular pace and within a few minutes found ourselves nearly half a block in front of Dad and Terry. God bless my stepmom, she assured my dad that she was feeling "tired" and needed extra time as well so that she could walk beside him. She did that everywhere they went.

I'm missing my dad this time of year. His birthday is on Christmas Eve, this whole experience of going to PT for my own injury is reminding me of his experience.

How's the No Drinking Thing?

I was overwhelmed with the responses I got from my post about my sober curious journey. Thanks to everyone who reached out! I received a lot of texts, messages, phone calls and so forth.

I heard things like, "I've never liked the taste of alcohol so I've never taken up drinking. Because of that I am excluded from invitations to happy hour from co-workers. Ouch."

Ouch indeed. Just because someone doesn't drink alcohol doesn't mean they don't enjoy getting together socially.

Some people told me about their own journeys into and out of sobriety, and how drinking (or not drinking) has changed their lives. These stories were so educational to hear, sometimes tragic, other times hopeful. From this I've learned that alcohol truly affects the lives of so many people in this country, whether you drink or not.

The weekend after that post I hosted a happy hour at my home. I was so grateful for those friends who brought interesting sparkling lemonades and water and had recommendations for concoctions to mix with sparkling water to make it tasty. And I found a local restaurant has a "mocktail" menu with many delicious options for alcohol-free beverages. Yum!!

Am I still alcohol-free? No. I was sober for a month, which was a great experiment. During that time I had happy hours with friends, experienced a P!nk concert and had nary a drop, enjoyed better sleep most nights, and woke up more energized earlier in the morning than I typically do. Did I enjoy these things any less because I wasn't drinking? Not at all. Did I enjoy them more? Not really, to be honest.

The one thing that did NOT happen during that month is I didn't lose a single pound. I would like to lose a little weight, and I was wondering if the calories from alcohol were impeding my ability to lose weight. The good news is that I apparently don't drink so much that just cutting out drinking would make me drop 10 pounds. (That would have been concerning.) The bad news is...I didn't lose any weight after not ingesting any calories from alcohol for 30 days.

I celebrated my 30 days of sobriety with a glass of red with a grilled steak at our house. Mmmm....steak....can't have a bite without a glass of cabernet!

And since that experiment I find myself drinking less, primarily just on weekends and in lesser amounts. I do enjoy a refreshing glass of white wine on my patio in the late afternoon, and it seemed ridiculous to deny myself that pleasure when there was no reason.

This little experiment has led to my next experiment, which is that I have begun using the weight loss app Noom. If drinking less did not help me lose weight, then I needed some real guidance to help me trim the pounds that I want to drop. More on that in another post, for those who are interested!

Thanks again to everyone for your support through this journey. I feel like 2019 has become a year of discovery and growth for me, and I'm excited for what's to come!

Writing a "To Done" List

I have started using an app called "Noom" to start tracking my nutrition and exercise, in an attempt to get healthy and lose some weight. "Noom" is all about the psychology of why we eat what we eat, what triggers us to make unhealthy decisions and help us counter those. The goal is to help people make better choices moving forward so users can maintain a healthy weight the rest of our lives.

This week the coaches at Noom had us do an exercise and create a "to-done" list, and I thought it was too good to not share with others.

We all have a "to-do" list, right? Be it a for work, home, family or just you, we've all got a running list of things we need to do. Mine often consists of stuff like: get groceries, make a dinner menu for the week, run kids around to appointments, make various phone calls for house projects, et cetera. That doesn't include client projects or other things that make their way onto that list.

The coach at Noom asked us to make a "to-done" list. List all of the things that you've accomplished this past week or month or whatever, those things that were most important to you. Your "to-done" list could look something like this:

1. Had a successful project launch at work.
2. Finally made it to the dentist which I've been putting off.
3. Spent time with friends at a happy hour.

Review that list, and now ask yourself, "What of these things is important and will be remembered?" 

This became really poignant when one of my group members posted her list, which consisted of many enjoyable activities like gardening, spending time with her grandkids, finally seeing a friend she hadn't seen in decades. She had this to say about her list:

"I've been retired for 13 years, and I've told myself that there is so much I want to do in retirement. I thought I would have less stress, but I still have stress and have more health issues than ever. Making this list have made me focus on the most important things in my life...my health and how much time I have left to enjoy it. Today is a new day with opportunities and I am going to make the best of it."

Wow. All that discovery from a weight-loss app? Yes.

Before reading her post I had made a list of my own. As expected, it consisted of many things that had been on my "to-do" list that were now done: Grocery shopping. Cleaning. Running kids around to appointments.

I made a second list after I read hers, and it read a little differently:

And then I had this epiphany: Those things that are on my "to-done" list need to start by being on my "to-do" list. I need to make room in my life for those things that bring fulfillment and happiness to me and to those around me. My kids probably won't know or care about how much grocery shopping I did, but Marissa will definitely remember going paddleboarding on a beautiful summer day with her mom, and Lindsey will have memories of learning how to drive with me in the passenger seat. (Hopefully not traumatic memories.)

Now I ask you: What things do you need to put on your "to-do" list so they make your "to-done" list?

No More Wine Time

I am setting an intention, which means you, dear reader, get to be a part of this.

I have decided to abstain from alcohol for...well, for a yet undetermined amount of time.

Lately several reports have come out talking about how the emerging "mommy drinking" culture has normalized alcoholism for women. The blog post I linked to above is a perfect example of how it happens. And our retailers have helped this along.

These are some photos of a display at PaperSource, a store that specializes in paper products; invitations, greeting cards, gift wrap, and customized invitations for special events. Plus, of course, gifts. This was the majority of the gifts available in the store yesterday, outside of the Easter display.



If I were looking for a gift for a girlfriend for her birthday, I can either refer to her addiction to prosecco, mixed drinks or wine. This is not what I would expect at PaperSource.

But really, it's not their fault. They are just jumping on the bandwagon of jokes about how our kids drive us to drink, right?

I find myself craving a glass of wine around the time I would start cooking dinner. I truly embody Julia Childs' quote about cooking with wine. During the week I used to ignore it, but then the days I would cave and open a bottle went from weekend nights to Thursday through Sunday nights.

Then I would have a glass with dinner. And then a titch more with a piece of chocolate or something for dessert, and the bottle that my husband and I had opened together was gone.

But then...what will I drink with the movie I plan on watching later on?

That is my true downfall — I enjoy having a drink while watching a movie. And sometimes I stay up late to watch a movie all by myself. After all, some days it's the only "alone time" I get. Before I know it bottle #2 is empty or nearly empty.

All without feeling any effects of the alcohol until the very end of the movie.

There are an average of 635 calories in a bottle of wine; by the end of the evening I would have had nearly 900 calories worth of wine. Do that several nights a week and suddenly the weight I'm trying to drop won't drop. Shocking.

Plus the fact that I can drink two glasses of wine with no effect is concerning. It sets a bad example for my kids.

So...I've decided to abstain entirely for a time, to give my body a break from having to process all that poison. I'm paying attention to my "critical moments," those times when I really crave a glass of wine, when they happen, who I'm around when they happen, and choosing a different behavior instead of opening a bottle. Sparkling water and limes will always in my house, so I can get a refreshing drink without need the alcohol to make it taste refreshing.

We'll see how this goes. Who knows, maybe I'll reduce my alcohol tolerance and be able to return to having just a drink or two at special occasions. But for now, this is the intention I am setting and I appreciate all of your support in this endeavor.

My Mental Health Education: A Tutorial

Since my eldest was diagnosed with severe general anxiety disorder nearly 5 years ago, my family has learned so much about resources available to help those with mental health issues. The good news is that there is more available today than there were then. The bad news is that there still aren't enough resources for everyone who needs help, leading to long wait lists for specialized services, hampered further by insurance companies' unwillingness to pay. Try telling your suicidal teenager to hold off on acting on those feelings until a bed opens up.

Unlike services for physical ailments, the kinds of options available for mental health care are not widely known to people until they need them.

Develop a weird rash? See a dermatologist. Have a strange skipping heartbeat once in a while? See a cardiologist. Develop life-stopping anxiety? See a...psychiatrist? Psychologist? Therapist? All of the above? Do I need cognitive behavioral therapy (CBT)? Dialectical behavior therapy (DBT)? Eye movement desensitization and reprocessing (EMDR)? Most people have an idea of the kind of specialist to go to for physical ailments; even if they didn't, they could go to a general practitioner who would steer them in the right direction. But for mental health care? Better start educating yourself.

I have recently helped steer a friend through a mental health crisis for her daughter. She is grateful because if she didn't have a friend to lean on, she wouldn't have known where to turn, and the hospital where her daughter is right now is not about educating her, just getting her daughter healthy enough to leave the hospital.

So I thought I'd share some of the education that I've learned for those who may need it. My disclaimers:

1. These are the terms as I've defined them through our family's experience. They're probably not the "right" ones, but they work for my understanding as a parent and advocate trying to get resources for my children.

2. I'm not intentionally ignoring other mental health conditions like schizophrenia, bipolar, manic disorders and others. I just have no experience with them, so I only speak to those resources that treat depression and anxiety/OCD.

Inpatient care is almost 100% reserved for those whose condition has deteriorated to the point that ending their lives is a viable option to them. Both of my kids' primary diagnosis is anxiety, but at that point in their lives their anxiety was so uncontrolled that it caused suicidal thoughts. Just because your kid does not have depression does not mean you won't encounter these programs in the course of his/her treatment. I have learned that depression and suicidal thoughts can be and often are completely unrelated.

First, the basics of who's who:

Psychiatrist/Psychologist/Therapist: The psychiatrist is the only one who can prescribe medications, the other two can't. We honestly have never used psychologists in our daughters' care, only therapists and psychiatrists.

If your child is in an inpatient program, the psychiatrist is the head of the care team. All decisions regarding your child's care will be run by and approved by him/her. Connect with this person daily if possible for updates and discussions on treatment.

For outpatient care, the therapist tends to head up the care for your child and the psychiatrist is one of the members of the care team.

Kinds of treatment programs:

Inpatient: This is when the child is in the hospital 24/7. There are different kinds of inpatient care, though. We've had experience with two.

Acute or Lock Down Units: This is for children and adolescents who are actively suicidal, meaning they have the thoughts, plans and intent to end their lives. These units have extremely limited visitation hours, limited contact with outsiders, restrictions on clothing and other items that can be used for self-harm. If your child is not actively suicidal, this is not the right fit for him/her. For both of our children, if they have been on a lock-down unit it would have made their anxiety so much worse.

Sub-Acute or Intensive Treatment Unit (ITU): This is a step down from a lock-down unit, still has some restrictions on clothing allowed (no draw strings, no shoe strings allowed) but much fewer restrictions in other areas.

Both of these provide the reassurance of 24-hour care to ensure that patients are safe. Parents of kids who have ever been suicidal know the fear of falling asleep at night and hoping that their children don't do anything to themselves while they're sleeping. Ready for bedtime? Not tonight, thank you, I'll sleep after my kid's gotten help.

These programs also provide group therapy, one-on-one therapy, family therapy and psychiatric care on a daily basis.

Outpatient: Outpatient means that they do not stay overnight in a facility. Both of my kids started with outpatient, went to inpatient briefly, then back to outpatient. Some kids start at inpatient because their mental health reaches a crisis point. Either way, they will go back to outpatient care. These are the kinds of outpatient programs we've learned about.

PHP (Partial Hospitalization Program):  This is an outpatient treatment program that lasts 5-8 hours of a person's day, making attending work or school difficult. Most people take a leave of absence while in a PHP. PHPs can sometimes be in a hospital, but many now are in clinics that are fully outpatient based and look nothing like a hospital. PHPs have daily one-on-one therapy, group therapy, time for patients to do whatever "assignments" they need to do for their mental health, and psychiatric care, as well as family therapy as the family is able.

"PHP" is the biggest misnomer of the entire mental health care system. This term has been around for 50 years or more, it needs a new name.

IOP (Intensive Outpatient Program): This is a program that lasts between 2-4 hours per day. It has many of the elements of a PHP but in shorter spurts. Not every element occurs every day; group therapy may occur once or twice a week instead of daily. It's another step back to normalcy, when mental health treatment no longer takes up a significant portion of each day.

Therapy: The last and usually longest step in returning to full mental health. For my daughter who recently completed an IOP program, she went back to her therapist on a 3x/week basis for a short time, then stepped down to 2x/week, hopefully back to 1x/week at some point. There are so many kinds of therapy, I'm just going to point you to a WebMD article that I think does a great job of summarizing all of the different kinds of therapy available. Click away.

Depending on your child's condition, your child may need to go from an inpatient program to a PHP program to an IOP program. And...the inpatient hospital may not always make the best recommendation. We wish we had known what a PHP program and IOP were back when our eldest was in the hospital. (Although there were very few if any IOP programs in the area at the time.) PHP programs existed then; the hospital she was in had one the floor above her! But they never recommended it for her, they said she would be good going back to once-weekly therapy. I believe she would've had a quicker road to recovery had she received intensive help right after hospitalization.

We also learned that lapses in care are extremely detrimental. We've had gaps in therapy for our oldest, once when her therapist left the practice and it took us a few months to find a new one, another time when the second therapist we connected her with was not a good "fit" and we didn't make her go until we found yet another. Like strength training, if you don't do it, you lose what you build. She regressed in both time periods and because anxiety is an invisible illness, we had no idea how badly her mental state had gotten until another crisis occurred. Now we are paranoid about making sure there are no gaps. If her therapist ever has to cancel we find another day within the week to replace the session, and for the holidays we schedule around days off far in advance, especially because her anxiety is highest around the holidays (like it is for many).

For some, maintenance care means therapy on a consistent basis for years. THIS IS TOTALLY OKAY AND DOES NOT MEAN A PERSON IS CRAZY. I see my chiropractor every two weeks if I want to avoid getting migraines. Why would I ever judge someone for seeing a therapist consistently for decades? Do it if it keeps you healthy.

And there you have it, everything I know about mental health resources in a nutshell. Of course, I wouldn't know ANY of this if I hadn't been open with others about what my kids were going through. Once I started telling friends and neighbors about what was happening, I learned that they had gone through similar challenges and I got educated from them. Many people had struggled with advocating for their child's mental health and no one ever knew to help! My point is...we can't solve the problem when we don't talk about the problem. I hope this guide helps even once person navigate the system.

When NOT to Tell Someone You're Doing "Well"

The year I turned 40 I was diagnosed with Hashimoto's disease. Oh My God!! you say, are you okay?!

I'm so okay I forgot to mention it to some members of my family.

Hashimoto's is an autoimmune disorder in which your body attacks your thyroid, reducing the amount of hormone produced naturally by the body. The treatment? Take safe and common hormone replacements to bring the body into balance. But also see your endocrinologist often for a simple blood test in which your hormone levels are monitored so your doctor can determine when you need to step up the hormone replacement dosages, because your body keeps attacking your thyroid until you need full replacement hormones.

For six years I have been seeing my endocrinologist, and once had him bump up my dosage. And then, two years ago happened.

In fall of 2016 at my regular check-up, I reported that I was feeling tired and run-down. I could nap every day, was tired every afternoon, stopped working out because I couldn't get myself up at 5 a.m. anymore to fit it into my day. My chart indicated that I had gained 7 lbs in one year, probably a combination of fewer workouts and more sleeping. But, my dad had also just passed away, which added a new level of stress to life, making all of the above explainable as well.

They drew blood for the blood test, and a week letter I got a letter that my levels were within normal range, and that based on my report the doctor did not see a reason to make an adjustment, see you next year.

I found myself back the following November, giving the same report: I'm tired. I sleep a lot and could sleep more. I don't have the energy to work out. And my hair was falling out in copious amounts. I could see my scalp through my hair and it was devastating. Others said they couldn't tell, but I could and it bothered me.

I had also read the book "Hashimoto's Protocol" by Izabella Wentz, a pharmacist who self-diagnosed her own Hashimoto's in her late 20's. When she reported to doctors that she had no energy she was told that "people slow down as they age." She retorted, "Really?! 29-year-old's slow down?"

This time I had the blood draw done in advance so we could discuss the results at the appointment. But the doctor (and truthfully, I) forgot that I'd done that so we didn't check the results. The doctor walked into the room and said, "Hi how are you?" To which I replied, "Well." Because, as the CEO of a company I used to work at says, replying by saying "good" is not proper grammar. (I partially blame him for my two-year mistreatment.)

I then proceed to tell the doctor of my woes. I'm not sleeping well and can't sleep enough. My hair is falling out. I lack the motivation to work out. My thinking is fuzzy. I am sluggish and can tell I've gained weight. This year's report? Another 11 lbs, 18 lbs in total in two years. I have never gained this kind of weight in my life in such a short period of time. Does this sound like me? No.

He informs me that hair loss is not a symptom of Hashimoto's, nor is the kind of insomnia that I experience.

Really? It's all over in the support groups, the book I'd read, anecdotal stories others with the condition had told me. Well, he informed me, RESEARCH indicated that it wasn't, despite all of that "other" evidence.

He does a blood draw, because I stupidly forgot I'd been there the week before for a blood draw (it was an early morning appointment), and a week later I get the same form letter: levels are within range, no change needed.

Did he not hear a word I said?

Turns out, he didn't. I called the clinic several times and when I didn't get a return phone call I drove down unannounced and had a confrontational face-to-face with him about it, both about the missed blood test and my oral report which he ignored. He finally agreed to make a small adjustment to my dosage, and within a week I felt improved energy.

After this experience I changed from an endocrinologist to a whole health doctor, who informed me that my endocrinologist never tested my T3 hormone level, a key indicator in treating Hashimoto's. I had read in Izabella Wentz's book that this was a common oversight—most endocrinologist's only test the T4 hormone.

My new physician and I also got a chance to review my endocrinologist's notes from the last two visits. In both reports, he wrote "Patient reports feeling well." He noted the weight gain, but not a single word about how I was actually feeling.

I realized that my very automatic greeting of  "well" after hearing the words "How are you?" is what he wrote in his report, and he hadn't listened to a single word I said.

So...word to the wise: if you are talking to your doctor, make sure s/he is clear if what you are saying is a GREETING or a REPORT. There is a real difference.

How am I doing now?

Great. My new doctor, Dr. Richard Sinda, is fantastic. I feel listened to. I am feeling better. He and I review my results together, because he knows I'm a data geek and like data, even though half of it goes over my head. He adjusted my hormone replacement dosage and started a new one because, now that we're testing my T3 level, we learned that it was also low and needed support. I also started a bunch of other supplements and vitamins to improve my overall health. As he says, "I don't want to know how much Vitamin C a human needs to prevent scurvy, I want to know how much Vitamin C a person needs to be in optimal health. There is a different between a lack of sickness and optimal health."

As for the weight, well, I now have the daunting task of losing it. I know what I need to do, I just need to do it. Move more, eat less (and better food choices). Hopefully it will come off as quickly as it went on, I'm giving me two years because that's the healthy way to do it.

So that's the latest. For anyone who is diagnosed with Hashimoto's, I highly recommend Izabella Wentz's book. I did not follow the protocols she recommends, though I am sure that if I did the weight would just fall off. Her dietary changes and supplements were a bit daunting and seemed overwhelming to implement, which is why I sought a whole health doctor who helped me implement the ones that made sense for me.

One more lesson learned that the person who can best advocate for your health is YOU. My health languished for two years; it could have been longer had I continued with my same doctor and hadn't advocated for myself. I'm glad I finally made the change needed for my own health.

Marissa's Bionic Teeth

Marissa had chronic ear infections the first year of her life. Her nose was constantly running, her ears always aching, and she was a downright miserable kid. When she turned one she got ear tubes, which drained the nasty infectious stuff so at least she could sleep at night, but ironically it didn't prevent the infections. (I will not describe the scene to you of waking her up many mornings with ear drainage smeared across her face, her pillow, and making her hair stick up. Okay, I guess I kinda just did. Plus...it smelled and she needed many, many baths. Her sheets were washed nightly.)

This pattern continued despite the ear tubes. Her nose ran constantly. We stopped wiping it all the time and considered the initial layer a protective coating that kept her skin from rubbing off with every wipe of a tissue. None of the other parents at daycare would set up play dates with her, they thought she was always sick. And, she was.

She would get a cold which would turn into an infection. We would go to the doctor who would prescribe antibiotics. It would clear up eventually, but the minute the antibiotics stopped, it started all over again. She needed stronger and stronger antibiotics, which also did a number on her tummy. Poor kid.

We finally sought the opinion of her ENT who suggested that removing her adenoids may help. He had barely said the words and we scheduled the surgery. He wanted to do one more round of antibiotics "just to see if it would clear up," but she'd practically been on them her entire life, what would one more week do? We were tired and frustrated of having a cranky, unhealthy kid.

Around her second birthday she had her adenoids removed; the change was immediate and dramatic. By the evening of the surgery, she was smiley and playful. I didn't want to put her to bed when it was bedtime, it was such a treat to see her so happy. In the morning she woke up singing! Or babbling. Or something other than the howl we heard most mornings. Looking back, it must've been like waking up with a full-on sinus infection every single morning of her life. Such joy she must have felt awaking without a headache and a clogged skull.

Her nose cleared up, her ears cleared up, and any cold she caught after that stayed exactly that: a cold. No more drainage, no more nastiness, and we had a super happy baby. Yeay!

She grew and grew, and at age 6 began losing her teeth. One of the first teeth she lost was replaced with a tooth of the most unusual yellow, almost chalky white around the edges. Her dentist murmured something about "malformed enamel," and that was that.

Then another tooth came up with an interesting pattern of clear and white enamel. And another. We changed to a pediatric dentist who first used the word "hyoplastic enamel." Thus began our education.

Hypoplastic enamel is enamel that malformed while the adult teeth were maturing in her head during the first years of life. I learned a lot about tooth maturation. Ever see the skull of a child with the dental cavities exposed? It's creepy. I can see where the director got the idea for the creature's mouth hole in "Alien." You are born with adult teeth buds in your skull, and during your first few years of life they grow into the adult teeth that eventually push down into your jawbone once your head is big enough for the fully grown teeth. It's quite an extraordinary feat of human anatomy.

A child's skull with dental sinuses exposed. Creepy!
Especially that canine tooth way up there.

So why do some people develop hypoplastic enamel? Recent studies have pointed to chronic antibiotic use in infanthood as a probable cause.

Let me say that again: Chronic. Antibiotic use. In babies.

My death stare. Is it as intimidating as my kids say it is?

At age 12, Marissa already has 3 fillings, one crown and a capped baby tooth. The baby molar needed a cap because the enamel all around the edge of her gums literally disintegrated. It was like a cavity encircling her tooth; there was no way to "fill" it, and no point in anything more than a cap since it was a baby tooth and was going to fall out anyway. She recently lost that tooth, and we joked about her "cybergenetic" or "bionic" tooth.

Marissa's "bionic" baby molar.

When she had the crown done recently, the dentist told me that as she began to file down the existing tooth it literally crumbled under the slightest pressure of her tool. Her current crown will need to be replaced when she's 18, and eventually she will probably need an implanted tooth because the dentist isn't confident that the root of the tooth can hold.

Remember my last blog post, about my phobia of bad teeth? Marissa is going to face a lifetime of expensive dental work, filling, repairing and replacing her teeth through the years.

I'm angry that her permanent teeth were permanently ruined. all because she had a runny nose when she was a baby. Had we known then what we know now we would have insisted on more aggressive intervention earlier to reduce our antibiotic use.

It's Not Dental Phobia

I have a permanent retainer behind my bottom teeth, and I loathe how it captures food and I can't get it out. I brush, floss, and have even bought cheap dental tools to pick at this retainer.

Then I got the best advice ever — a friend of mine who has the same issue has her teeth cleaned every 4 months. Sure, you pay for an extra cleaning a year out of your own pocket, but it's all of $85 and it's worth it to me.

Yesterday was my cleaning, and I got into an interesting conversation with the hygienist. Or, I should say, she had a lot of interesting thoughts that I agreed with by making odd sounds with my mouth wide open.

She talked about seeing patients who finally came in for a cleaning for the first time in 15 or 20 years. They have such dental phobia that they never see a dentist. Some have no issues at all, just really, really dirty teeth, while others end up with a mouthful of cavities and future crowns and bridges.

Upon thinking about this, I've determined that I don't have dental phobia, I have a fear of bad teeth. Our teeth are made of bone; once they're gone, there is no substance in the world as strong that will replace them. Crowns need to be replaced, bridges fall apart. Our natural teeth are the authentic manufacturer-installed parts; once they are replaced, the fit isn't quite as tight, the holding as deep or strong.

I have dreams (nightmares, really) where my teeth suddenly start falling out of my mouth at random and I am devastated. I worry that my teeth will start wiggling and coming out like baby teeth. I fear the day that I'm told I need a crown, because I loathe the idea of filing down two perfectly good teeth just to put a false one between them.

And so I go to the dentist often not because I'm afraid of the dentist, I'm afraid of bad teeth.

It's been working out well. About a year ago my dentist noticed that one of my molars that's had a filling in it since childhood was starting to crack. He recommended that we remove the old silver filling and put in a new one made with material that would flow down into the crack and seal it, hopefully saving the tooth from cracking further. It's been a year now, so far so good.

Every dentist I've ever had as an adult has commented on how good the fillings I had put in as a child are. Thank you, Dr. Nyder, our next-door-neighbor and dentist, for your awesome work 40+ years ago!

Well now, this was a completely random post, I can't believe you made it to the end. Thanks for reading my rambling thoughts. It's leading me to another post about my daughter Marissa's dental woes, stay tuned for that if you actually read this one.

A Pause for a Health Update

Lindsey behind the lens of my Dad's camera, in Michigan.

So...how's Lindsey?

She's fine.

She went through quite a health spell this past winter/spring, missing 6 weeks of school, missing many more days after she returned, and having a not-great end to her 8th grade year.

What we discovered, through many tests and trials, discussions and theories, is that her anxiety was so high that it was affecting her physical health. It caused such severe stomach cramping and nausea that she lost 5 pounds in four weeks, the girl who doesn't have a pound to spare.

Yes, a mental illness causing a physical illness. A true, real, physical pain that has no expected, typical cause.

We already knew that Lindsey has anxiety, which we thought was under control. We learned a lot of things about nutrition, the digestive system and her anxiety triggers.

Smiling mouth, pained eyes.

We learned that eating small meals four to five times a day seems to work well for her. Sugar in excessive amounts really whacks out her system for a good 24 hours. (No desserts. No pure juices.)
While she does not have celiac disease, gluten really does a number on her system, so gluten is still off limits.

She is under the care of a team of physicians who are working together, between her nutrition and her mental health needs, to get her back on track. And now, at the end of August, I feel like she is finally back to herself.

In the meantime, her dad and I wonder...how much of what's going on is related to her anxiety and how much is related to her being 14? We have no idea, we've never parented a teen before. Poor firstborn, gets to be the first to trial-balloon every parenting technique we have.

We are grateful for all the parents who have shared their journeys with us, who have broken the code of silence to let us know what they've faced behind closed doors.

We are grateful for our friends, for Lindsey's friends, for our family who have supported us through this. And we are grateful to live in a city that has such incredible resources for health care. While it took us a while to navigate the system to figure out who to call or who to talk to, there was always someone there to help, in specialties we never knew existed.

At the end of the day, Lindsey will be stronger. More resilient. Amazing, at anything she chooses to do.

And we will be her loving parents.

Struggling in Secret

Overwhelmed. That is the only word for all the emotions I'm feeling.

Overwhelmed by the issues facing Lindsey. Overwhelmed with the amount of information I'm learning about GI conditions, about natural treatments and cures, and the impact diet may have on a person's digestive system. Overwhelmed by thinking of the possible causes of Lindsey's issues, be it a physical ailment or an emotional one that affects her physical body.

More wonderfully, overwhelmed by the support and advice of my tribe.

Here's what I've learned through sharing our family's story: lots of people have been through this. Many parents told me stories of their teenage children struggling with digestive symptoms for which no "standard answer" was found. Each of them went down different paths of doctoring, diet, supplements and therapy. Most of them eventually got to an answer, but for some, the answers took years. Years. That might be fine for adults, but for teenagers, that's their entire adolescent experience.

My question is this: Why are we all struggling in secret? Let's share our stories, pool our knowledge, and find the quickest and surest path to health. Yes, the causes are different, the ultimate answers are different, but the symptoms are the same. How are families getting their children to school when they are struck by random bouts of diarrhea? What diet changes did they find worked? What didn't work?

Keep in touch, keep talking, share knowledge to help those coming down this path after you. I can guarantee I will do the same for you.

Leave of Absence

One thing that always brings a smile to Lindsey's face: Beauty.

Nothing has yet solved Lindsey's GI issues. Not the detailed food diary she's been keeping that we are pouring over, looking for potential food triggers. Not eating small, bland meals every two hours. Not the GI specialist, with whom we had probably the absolutely worst visit with a physician that I've ever experienced. Not a daily dose of Zantac, herbal teas, probiotics and other medicines.

Of the four full weeks in February, Lindsey missed school for three of them. She missed two straight weeks, went back to school for a week, then the stomach issues came back again full force.

I felt guilty leaving Lindsey home alone for hours at a time while everyone was at work or school. And I know she wasn't taking the best care of herself. We would come home to see the doses of medication still sitting on the countertop, herbal tea packets unopened, and for lunch she had a bag of gluten-free chips. Yes, she's a usually a mature, responsible girl, but when it comes to caring for her health, she is still 13.

The stress for our family became apparent when what was supposed to be a "quick" run for a blood draw over my lunch hour turned into a 4-hour ordeal. We ended up waiting in the emergency room for a blood draw, because that was the only place in the hospital that would use a "j-tip" for the procedure, which makes it completely painless.

Guess what waiting for a procedure you're already nervous about does? Yep, it increases your anxiety.

Lindsey nearly passed out during the procedure. It's a good thing she was already prone, or we would have been picking her up off the floor. She actually doesn't remember much of it because she was so out of it.

Instead of going back to work, I ended up stopping in the office to pick up my laptop so I could work remotely for the latter part of the afternoon. I missed a strategy meeting that I was looking forward to participating in. Lindsey apologized to me for taking so long for what should be a simple blood draw.

My child, apologizing to me, for having anxiety around a condition that is causing her pain. This was too much.

That evening Wayne and I decided that I would take a leave of absence from work to manage Lindsey through this, whatever "this" is. I was trying to work a full-time job while working another full-time job as Lindsey's healthcare and education manager. It wasn't fair to my employer, to Lindsey, and especially to me.

Unfortunately the timing is bad at work, with a couple of people having recently left the organization. I was willing to work some hours at home to keep projects moving along, so we arranged it so that I am working part-time on a temporary basis, able to come back to more hours when things get better at home. I am so grateful to work at a place that is so understanding and accommodating.

And so this week our new reality begins. We are all hoping that we can get to a diagnosis and a solution for her soon. I do not wish for this to become our "new normal," I'd rather go back to our old normal, thank you very much.

What Now?

How ironic that I just posted about solving Lindsey's tummy troubles and trying a dairy-free diet. I wrote in such hope that perhaps dairy-free would be the answer, while also wishing that it wouldn't be because this Wisconsin girl finds dairy-free cooking/eating to be exceedingly difficult.

What's more difficult is taking the day off work to spend 5 hours in the ER with your daughter who cannot eat a thing without pain.

She missed school on Monday due to diarrhea and a stomach ache. She didn't eat all day, ate dinner with us that evening, and spent the evening curled up in a ball in agony.

I was hoping that a good night's sleep would help (now I ask myself, "help what?"). She awoke late Tuesday morning groggy, having not slept well due to a stomach ache all night. I couldn't coax her to eat until 11:30 or so. She had a brunch of a fried egg, gluten-free toast with jam, and a small side of potatoes. Granted, not the most balanced meal, but not the worst thing I've seen 13-year-olds shovel in their mouths.

She went up to her room and 20 minutes later I checked on her. She had beads of sweat on her forehead and was rolling in her bed in pain. She probably would have thrown up had it not been for her fierce aversion to vomiting.

We were in the ER by 12:30 and discharged around 4:30, not bad for a major metro emergency room. After an X-ray and a blood draw, they determined that she has no blockage, no inflammation, no other exceedingly obvious problems that would cause these issues. We already had an appointment with a pediatric gastrointestinal specialist (which is pronounced "expensive"), but not until late March.

The good news? All the scans the GI specialist would want are already complete, and Lindsey's anxiety around a blood draw doesn't have to be dealt with in the near future.

The bad news? She went home from the ER still uncertain as to whether or not she could eat without pain. Sure enough, about 30 mins after her gluten-free, dairy-free dinner, she had a stomach ache and diarrhea. But she managed to keep it down and isn't losing weight.

I suspect we have more tests and screens in our near future. And, I'm hoping, answers and relief.

Tummy Troubles

Lindsey has been dealing with on and off stomach aches for several years. When she was younger, we chalked them up to what most parents think -- nervousness or a desire to miss a school day.

In the past couple of years they've become more troublesome and frequent. Lindsey noticed that she was often feeling bloated after eating pasta or breads. One evening I watched her gobble a plate of spaghetti and not even 10 minutes later she was groaning with a stomachache.

I recommended that she try cutting gluten. The stomachaches had finally gotten bad enough that she was willing to cut out her favorite food; pasta.

We found a decent gluten-free pasta, and I started substituting GF flour for regular flour in my cooking. It took a few tries but we found a decent GF bread. Her stomachaches got better, fewer in frequency and not as severe.

She's been gluten-free for 18 months, and for most of it her stomach troubles have been better. That is, until recently.

In the past six months or so she's been having issues again. One day she stayed home due to a bout of diarrhea in the morning. She felt better by noon so she went to school, only to have an accident at recess. I felt so badly for her.

Once again, we wondered if the stomachaches were due to stress or anxiety, but the very real physical symptoms were not at the same time as her stress. She would be working on a big school project, complete it and turn it in, and the following week be out with terrible tummy troubles.

I took her to an integrative medicine physician, who recommended that she take probiotics and switch to whole milk from 2% milk. (Really?) I took her back to the pediatrician recently who weighed her and measured her, and determined that she is gaining weight and growing, which is all good. By the time of this appointment Lindsey reported to her that she was getting a stomachache every afternoon after lunch. Every single day. I would think that knowing that you're going to be in pain after eating would keep you from eating at all.

The pediatrician recommended that we try cutting out dairy as well, knowing that Lindsey had a milk allergy as a baby. On our way home from the doctor's office we bought almond milk, vegan butter and a new probiotic to try.

It's been one week, and Lindsey's had one episode, but for the most part has been feeling well. In the meantime, I am struggling to create gluten-free, dairy free meals the entire family will eat. I made mashed potatoes the other evening with almond milk, and while everyone ate them, they tasted gritty to me. A favorite recipe of ours of chicken with a white wine and sour cream sauce turned out too tangy because there was no dairy to cut the acidity of the wine.

I am hoping that this will be the beginning of the end of her GI troubles. In the meantime, we're all eating healthier, less processed foods.

Nine Grams

Marissa joined me in grocery shopping the other day. At this age, shopping with one of the girls is fun. We get silly, we look at foods we have no idea what they are, and we laugh.

I nearly bought this cereal, even though I knew no one would eat it, just because Marissa and I had a good laugh over it.

Marissa will pretends or actually sneak food into the cart that she knows I don't allow in the house, then run-walk down the aisle with the cart so I can't see what she put in it.

This sneaking of food into the cart tends to happen most in the cereal aisle. I thought back to when Lindsey and I did our sugar-free challenge and how difficult it was to find cereals with no sugar in them. I picked a random number and told Marissa she couldn't buy a cereal that had more than 9 grams of sugar. In the meantime, I was also scanning for a new gluten-free cereal for Lindsey to try.

I had no idea how challenging this would be.

Marissa brought me the "Dory" cereal which had 11 grams of sugar per serving, only two grams more than my limit. Surely only 2 games doesn't make a difference, right? She held her hand over the corner with the picture of the cereal while she asked for it, so of course I said she couldn't have it. The picture was of a cereal with marshmallows in it -- really, only 11 grams? I'd been reading ingredients lists of 17 grams, 23 grams and more. If that's 11 grams, how sweet and sugary are those other ones?

I decided to start looking at the "healthy" cereals vs the ones that I would assume would be more sugary.

First I checked out the Chex cereal choices. I looked at the GF "fruit and oats" variety, then happened to see the chocolate Chex next to it.

Guess which one had more sugar? Yep, the Fruit & Oats one.

She asked for the S'Mores cereal. Lucky Charms (which makes both girls crazy). Choc-O something-or-other. No. No. Nope.

Finally we got tired of studying cereals and saying "no" and went for a long-standing favorite in our house, Cracklin' Oat Bran.

It wasn't until we brought it home that I saw what the sugar content was -- 17 grams per serving. Guess we're crossing that one off our list, too.

Sleepless No More

I am sitting in a darkened house with a cup of coffee, looking out at a winter wonderland, piano music softly playing from our living room speaker. I am finally doing one of my favorite activities that has been absent for too long: writing.

These quiet moments are rare.  For years I have suffered from insomnia, which means that on weekends I "sleep in" until 8 or 9 sometimes, catching up on the sleep I missed earlier in the week.  Weekends I finally get a full 8 hours of sleep, even though it takes me 12 hours to do so. Usually by the time I'm up the girls are up and the day's activities have begun.

Today, they are still in bed and it is quiet. I began writing at 6:30 a.m.

I had been in a slump this summer and part of this fall, though others couldn't tell. My Fitbit that I got for my birthday in the spring informed me of how very little sleep I was getting, yet at the same time how much. I would awake in the morning thinking I'd barely slept 3 hours, only to find that I had slept more than that but hadn't thought so.

But really, what's the point of knowing you got seven hours of sleep when you feel like you got three? Knowing that I'd gotten more sleep than I thought would energize me for a time, until physical fatigue set in. I'd convince myself that I really should be able to function; after all, I got seven whole hours of sleep! But I still felt exhausted because the sleep was so disjointed. I would wake up around 2:00 most every night. Some times I fell right back asleep, but most nights I would lie awake until at least 4:00 if not 5:00. Occasionally I was up for the day.

Morning meetings are a bitch when you've already been up for 8 hours by the time they occur, much less afternoon meetings. People at work thought I was a morning person, but that was only because morning was actually my afternoon considering the time I got up for the day.

My wise husband, who has talked to me over the years about my sleeplessness, finally convinced me to do something different about it than what I'd been doing before, which was, really, nothing. I had read every resource about getting good sleep, followed every recommendation. I went to bed at about the same time, have a bedtime routine, used lavender,  tried melatonin, insert well-intentioned person's advice here. I had tried over-the-counter sleeping pills but they made me groggy upon waking. Despite all attempts, like clockwork my eyes would pop open at 2 a.m.

My doctor informed me that if I hadn't been waking up in the middle of the night previously that I would start to do so, as women in "my stage of life" often have hormones fluctuate mid-sleep cycle and for some it causes insomnia.

What kind of walking zombie was I going to become?

I finally tried something I had never done before, something that was always a last ditch effort for me: a prescription sleeping pill.

What a novel concept, right?

Sleep aids are one of the most commonly prescribed medications, and I only finally decided to consider them.

My mother has always been hesitant to take prescription medications. Her life's experience led her to have no trust in pharmaceutical companies, and her skepticism is not unfounded. Just like any parent/child relationship, her values have rubbed off on me.

My mother expressed concern that sleep aids cause long-term memory loss and confusion. But guess what else does: lack of sleep. And here I was, wasting hours of my life attempting to sleep while not having the energy to get my exercise in, being cranky with my family, masking my fatigue at work, and never trying a sleeping pill.

After discussing options with my doctor and expressing my hesitation at taking Ambien, which was his recommendation, he finally convinced me to try it with one caution: Never, EVER take it if I've had any alcohol at all. Yes, sir. (And then he and I compared our favorite wines.)

The first night I took one I let my husband know to be on the look out for any weird behavior, and that if the kids needed something in the middle of the night he was on-call. I dutifully took a sleeping pill and went to sleep.

I woke up with my alarm at 6:30.  I was refreshed, not groggy. I cannot describe to you the feeling of having a full night's sleep for the first time in what felt like eons. All day I walked around with a giddy smile on my face. I couldn't believe how good I felt!

It's been a few months now since that first experience, and I am a changed woman. I sleep through the night. If I awake in the middle of the night I fall back asleep usually within 30 minutes.

I started doing my fitness routine again, first just on weekends (when I used to get my catch-up sleep), and then rising earlier during the week as well. I'm back up to exercising three times a week, and I feel AMAZING. Exercise gives me strength and energy, and I'm thrilled to be getting the rest needed to be back at it.

I feel like my life is back on track. It's incredible what sleep can do for a body.