Kids and Nosebleeds

The other night, while husband was away on business trip (always seems to happen when he is away)... oldest daughter had a coughing fit in the middle of the night that resulted in throw up and a massive nosebleed all at the same time!  These are so much fun to clean up as you can imagine...

Daughter is not sick but she gets coughing fits in the middle of the night due to a combination of allergies and reflux... and may even have a component of asthma in there... poor child. I have to say this used to happen much more frequently when she was younger.  We seemed to have things pretty well controlled with an air filter in her room and combination of allergy and reflux meds.  So it has been a while... but prompted me to put together this post on nosebleeds.

Nosebleeds are very common in children but can can seem alarming.

Common Causes of Nosebleeds Include:

• nose picking
• dry air
• allergies / sinusitis / colds
• aspirin use / blood thinners / cocaine use
• side effect of nasal sprays
• trauma to nose / foreign body in nose
• deviated septum

How to Stop a Nosebleed

• stay calm and reassure the child
• keep child upright and tilt head slightly forward
• pinch soft part of nose with tissue or washcloth
• keep pressure for 10 minutes (try not to check too often)
• sometimes can add ice to bridge of nose
• avoid rough play or nose picking/rubbing/blowing immediately following

When to Call a Doctor

• not stopping after 30 minutes of direct pressure
• losing more blood than expected
• any difficulty breathing
• occurs after direct trauma / car accident
• has frequent nose bleeds
• bleeds from other places like the gums or bleeds heavily with minor cuts
• has something in the nose
• has recently started new medication

How to Prevent Nosebleeds

• use vaporizer (warm mist) in the room
• moisturize with saline mist nasal spray
• apply vaseline or lanolin ointment to tip of nose twice a day
• apply antibiotic ointment to red sore areas twice a day
• may need to see ENT to get exposed vessels cauterized

Starting Public School

Last week, my oldest daughter started her first day of public school.  There was much excitement and anticipation the night before.  The actual day did not disappoint and was filled with shouts of glee and boundless energy.

“Mommy, you can leave now,” she announced to me when she got to her bus stop and was surrounded by other kids from kindergarten to sixth grade.  It was a small crowd of eleven or so and the parents gathered in front to take bus stop photos.  I was a little nervous for her because I remember my own bus experience as a first grader and missing my stop coming home.  My mom had to run after the bus and pick me up at the next bus stop, which thankfully, was only 1 or 2 blocks away.  I was glad to discover that another little girl would be taking the same bus with my daughter and would even be in her same class.

Sending my daughter to public school reminded me of my own experience growing up.  I actually really loved school and going back to school after summer vacation was always a favorite time of year for me.  It was fun to discover who my teacher was going to be and which new classmates were going to be in my class.  However, it had its challenges, especially during the early elementary years because English was not my first language.  

As I attend these back to school welcome meetings and navigate through my daughter’s school computer site, I am struck by how much more challenging this must have been for my own parents when they had to send me to school for the first time.  Well, they did not have emails and websites back then that they had to log onto for information, however, I’m sure they still had to figure out how to get me to school and what I needed on the first day.  Being immigrants from Taiwan, my parents understood the English language some, but were nowhere near fluent in speaking.   

So this post is a “shout out” to my parents and to all immigrant parents out there who place value in education and sacrifice time, energy, money, and comfort… etc to get their kids through school!  Despite the disadvantages of not having fluent English speaking parents who were heavily involved with school or could help me with homework every night…(except for math.. they were brilliant with math)… I think I turned out okay =)

Pre-Boarding When Pregnant

Long time no write!  We just got back from a week long trip to San Diego for a cousins' family reunion.  They were all my cousins on my dad's side of the family and their little kids.  So all together we had 13 adults and 10 kids... of which 9 adults and 7 kids stayed under the same roof in a large vacation home rental.  The kids who were under the same roof were all under the age of 6 with the youngest being 1 month old!  So you can imagine, it was quite the adventure and never dull.    I have so many memories growing up of interacting and playing with my first cousins.  I loved that my kids got to meet and play with their second cousins.

As an extra plus, a couple of my mom side cousins live in San Diego so we got to meet up with my cousins on my mom's side as well.  My dad is one of six kids and my mom is one of eight kids... so I have a ton of cousins!  All in all, the trip was especially meaningful to me... I hope it was also for the rest of my family.

Being 3 hours jetlagged, it took us some time to adjust back to normal East Coast time.  The first morning back we all slept in to close to 11am!  I'm glad for this week before school starts up again.

So!  Different things I can blog about... but first I just want to throw in a plug for pre-boarding planes while pregnant.  Note to self and to readers out there travelling with small children who plan to fly while pregnant... ask airline if they will allow pre-boarding for being pregnant.   Especially if you are going to fly on Southwest where there are no assigned seats, it makes a world of a different to get on the plane first so that the kids can sit with you.  Plus if you are bringing a bulky carseat... you don't have to hold up the rest of the line trying to buckle it in.

Here's a glimpse of our airport experience.

Thankfully my mom dropped us off at the airport so I didn't have to be alone with the luggage and kids waiting for my husband to longterm park the car.

What we had to manage before we checked in bags:

• large roller suitcase
• large roller dufflebag 
• large carseat bag (filled with 1 carseat, 1 booster, and bunch of diaperes and other stuff we can stuff)
• stroller (where we strapped 2 of our 3 kid)
• older child with her bookbag that we had to carry or give back to her everytime she took it off
• larger bookbag that dad had full of electronics (mainly to entertain the kids w for the 7 hr flight)
• diaper bag

We checked the first three items (yay for no bag fees with Southwest) and was left with the last four items above to get through security and to our gate.

They changed the rules and we no longer have to take off kids shoes if they are under 12 years old... this saves time!  Can you imagine travelling on a business trip and being the annoyed adult who is behind my family in line?  I have to say though we have done this so much that we are pretty fast now and have a system down.

Now whether or not the security folks care to wave a stick over the sippy bottles that we brought depends on the airport and maybe person working security.  In our case... Phillly airport did it but San Diego did not.  I'm just thankful I did not have to bring a pumpbag this time around!

So back to the issue of pre-boarding while pregnant.  I did not know and did not ask about this.  Therefore, even though Southwest allows families with small children to board "early"... "early" means after all the pre-board folks, elite folks, and then all of the folks who are in zone A to board!  So by the time we were boarding, there was already a ton of folks ahead of us.  The challenge is folding up the stroller to check in at the gate, then to put the bags overhead... then finally to get the carseat buckled in place... all the while making sure the kids do not get into trouble or get hurt or lost.  Being 28 weeks pregnant just makes it harder for me to do a lot of the lifting so pre-boarding definitely would have helped my husband.  Too bad the agent didn't just allow us to just board with the other pre-boarders... instead she just commented to my husband that we could have pre-boarded if we had asked and gotten a blue slip.  Why follow the letter of the law instead of the heart of the law?  Anyways, I was annoyed and would have rather not known that fact... but I guess now I know.  So here's a tip to you other pregnant or pregnant to be mothers out there because I do not plan on flying anymore while pregnant!  No more pregnancies for me!

The actual flight itself was not that bad because the older two kids can be distracted with coloring, sticker activities, ipad stuff and movies.  The youngest had his own carseat and snacks was probably the number one distraction for him... I think I was much more stressed making this same flight out to San Diego 3 years ago when I only had two kids but under the age of 3.  I blogged about flying after that trip here.

So yes, it was a little nuts travelling cross country with three kids ages 5 1/2, 3 1/2, and 2... but personally I think it was worth it.

Hey cousins... let's plan a future family reunion in the East Coast please =)

The Seriousness of Peanut Allergies

Here is a sad article about a 13 year old girl with peanut allergy who dies after ingesting a snack that contained peanuts in it.  She died despite spitting out the snack right after tasting it and despite benadryl and multiple doses of epipen injection.

Food allergies have become more prevalent in this generation and as this article demonstrates, allergies to certain foods, especially peanuts, can be extremely serious.  

Thankfully, none of my kids currently have any serious food allergies but it is wise to be aware of the potential.

Dr Joann Lin, board certified in both Adult and Pediatric Allergy and Immunology and General Pediatrics shares some important facts:

1. Peanut allergy is separate from Tree nut allergies because peanuts are legumes and do not grow from trees.  People can be allergic to only peanuts, only tree nuts, or both.
2. There is high cross reactivity amongst tree nuts so it usually recommended that if you are allergic to one tree nut, avoid all tree nuts.
3. The likelihood of outgrowing a peanut or tree nut allergy is only about 20%.
4. Peanut and tree nut allergies can be acquired suddenly in adulthood.
5. It is recommended that an epinephrine autoinjector should be carried at all times.  They now come in 2-packs.  It is recommended that the packs stay together because the first injection might not work, or the reaction is persistent, and you might need the second one.
6. There are currently three types of epinephrine autoinjectors in the market: Epipen, AuviQ (provides audio instructions), and generic epinephrine autoinjector.  Each device works differently.  Physicians should "dispense as written" and train patients with the appropriate trainer because at time of emergency, people are usually in panic mode and don't have time to read the instructions.
7. If epinephrine autoinjector is used, seek immediate medical attention. The autoinjector basically "buys you time" to get to a doctor.  There is a risk of a persistent allergic reaction and the epinephrine does wear off in a few minutes.  Epinephrine is basically adrenaline so the biggest side effect would be a little jitteriness.
8. Any organ system can be affected with a severe allergic reaction. Skin = hives and swelling of lips, face, tongue, throat, Lungs = wheezing, cough, asthma attack, GI = vomiting, diarrhea, stomach cramping, Cardiovascular = headache, fainting, weakened pulses.
9. Use epinephrine autoinjector when there is more than a little rash - ie rapidly progressing rash, if you're not sure, or other organ systems are affected; Liquid Benadryl orally works the fastest, but it still takes 15-20 minutes for it to work. No one will ever fault you for using the epinephrine "too early."
10. Most at-risk population for bad reaction and possible death - preteens/ teens/ young adults.  Because they have "forgotten" how severe the reaction was and may forget to ask about foods, because they are now becoming more independent and doing sleepovers, and because they "want to be like" everyone else
11. Most peanut allergic individuals tolerate products cooked in peanut oil (think Chick fil a) because it is highly refined. Peanut oils that are cold-pressed, expelled, or extruded, however, still have the peanut allergen.     
12. Currently there is no cure for peanut or tree nut allergy.  Oral desensitization is mainly done in academic centers; it is still dangerous and should be discussed with your allergist.  
13. Great resource: Food Allergy Research and Education: www.foodallergy.org

Dr Joann Lin has a private practice in Texas.  You can read more about her and her office here.

Best Kept Secret Amusement Park... Knoebels

For those of you who have never heard of Knoebels... it is a true hidden gem in Pennsylvannia!  Shhh... don't tell too many folks because it is not super crowded and we want to keep it that way!

During 4th of July weekend, we went there with our three kiddos and even camped.  Yes... with my prego belly and all, I decided to brave the heat and discomfort and just do it for the sake of the kids.  They loved it and had a blast.

So Knoebels is an amusement park that is extremely family oriented.  There are many positive things to say about it but I'll just list a few here...

-  There is no admission fee!  You only pay per ride and most of the kiddie rides are around $1.  This is a huge money saver because most of the time, my husband and I are not riding any rides anyway.  In fact, this trip my husband and I went on zero rides.  Most other parks, adult tickets cost more than the children tickets.  So paying close to one hundred dollars per adult to just walk around the park and watch the small kiddos ride their small kiddie rides is pretty silly.  Maybe when our kids grow older, we can go on rides again.  Either that or we somehow find a way to take turns going on adult rides by ourselves but how fun is it to go on a rollercoaster alone?  

Next time we go, we need to go to a Weis Market where you can buy a $20 ticket book for $16!  They also have something called Bargain Nights where certain Wednesday and Friday nights, you can go on unlimited rides after 5pm for $7.50 per kid and $10 per adult.  We just bought for our kids and watched them have fun.

-  There is hardly a wait to get on rides!  At least this was the case for the kiddie rides that my kids went on (ages 5, 3, and just turned 2).  This is a gigantic plus... especially if you compare with Disney where you have to sometimes wait half an hour or longer.  Little kiddies (at least my little kiddies) are impatient and have a very hard time waiting in general.

-  The park food is great with very reasonable prices.  In fact, they are the 13 time winner of Amusement Today's Golden Ticket Award for Best Food.  I got a tip to try their perogies and hash browns.  $3 per order and very delicious.  They also have very yummy home made ice cream.  In addition to the food being pretty good and reasonable, this park allows you to bring outside food in.  I don't think I've ever been to any other amusement park where you can do that.  They all seem to want you to buy their overpriced food!  Knoebels also has lots of waterfountains where you can bring your own water bottle to fill instead of buying overpriced water bottles that you'd expect at other parks.

-  They have plenty of rides and even free entertainment.  Currently, the park has 60 rides and my kids love that they have so many little kiddie rides that they can go on by themselves.  Even little E who just turned two was having a blast riding by himself.  While waiting to go to dinner at the Alamo (the one sit-down air conditioned restaurant in the park) we were able to watch some singing/dancing shows.  It was all very entertaining.

-  The waterpark was great on a hot day.  They charged $4.50/child and $6.50/adult for full day of access to their pool and kiddie splash area.  My kids had a blast.  It was a great way to escape the heat.  In fact, we spent the majority of the day in the water park area and then did the bargain all-you-can-ride after 5pm.  Was a wonderful tiring day...

-  Camping at the park was icing on top for the kids.  My youngest was probably too young to really enjoy it, but the two older girls had fun sleeping in a tent and doing the whole smores and campfire thing.  Sure, it was hot and noisy... but overall the kids were so tired by the end of the day, they slept through the night.  I loved that we picked a site so close to the bathroom.  However, I did not love that other campers would constantly walk through our site to get to the bathroom.  We'll have to be more strategic next time and camp next to or diagonal to the bathroom or something instead of directly across.  Also... next time, I think we'll go in the fall.  Weather would be cooler then.  So in terms of campgrounds, this is not the nicest we've been to since it is so crowded and loud but it is fairly well kept and walking distance to the park.  We will likely make this a tradition and we'll be back!

Oh... I forgot to mention... parking is free, too!  I love this park.

Protecting kids' skin from the sun

How are you protecting your children from the sun this summer? This is from CNN where Holly Firfer reports on the measures parents can take to minimize sun damage to their children's skin.

Bug Phobia

Guess what daddy did with the three kids while I was away on my health conference in Boston?  Apparently, he was on a mission to desensitize them to bugs!  They went on a bug hunt around the house.  My oldest even had a magnifying glass and all three were very involved in searching, finding, and even touching them!  Bugs they found and touched included silver fish, stink bugs, and even spiders...  Well, daddy said they wouldn't touch the stink bugs but they touched all the others.  Ugh.

So I'm afraid of bugs.  I realize now it is probably because I was never really exposed to them in positive light when growing up.  So it's pretty ridiculous but there would be times where I would be standing 10 feet away with a shoe in my hand trying to swat at a little bug.  I realize that if I don't want all my kids growing up completely paralyzed and fearful of these little critters, I need to minimize my "freak out" response when I see them.  Between my au pair and myself, we are probably causing my little ones to fear and hate bugs.  So husband decided to take it upon himself to get them to like bugs!

Yuck... I'm having a hard time even looking at these pictures without feeling panicky... 

The treatment for phobia is actually exposure in a controlled setting with positive feedback.. something called "flooding".  Not sure if it will work for me unless I go through intense therapy but for the little kids since they are still young... probably easier to desensitize them.  We'll see...

Daddy actually has been catching all sorts of critters in our backyard for them to touch... frogs, a little turtle... he even considered bringing in a garter snake!  Reptiles... bugs... not really my thing...