Tag Archives: children

10 things to remember if your child breaks a bone and you are nowhere near a hospital

How’s that for a light-hearted title? I bet you’re well cued that this is going to be one of those laugh-out-loud posts.

Or maybe not.

Most of you probably won’t be in the position of having your child break a bone and being thirty hours and an international flight away from good medical care, but if you’re a parent thinking this topic through can’t hurt. Presumably, for example, some of you go camping. So today I’m going to share some of the lessons we learned or put into practice last week when Dominic broke his femur. Some of these things we learned the hard way as events unfolded, some we already knew and came in very, very handy.

 1. This doesn’t strictly count because it’s prevention, but we all know that prevention is infinitely better than any cure, so … Sit down with guests when they arrive and specifically warn them about any hazards in your house. Staircases and swimming pools are always significant hazards (visit this website to review other common hazards). Briefing guests will not prevent all accidents, but it can’t hurt.

2. After an accident happens, do not assume that the people involved are able to relay a complete and accurate account of events. Accidents happen fast – those involved may not be aware of everything that unfolded in that instant. They will also be shaken themselves and may be in shock. Assume that your child is seriously injured (and handle them accordingly) until you are reasonably certain that nothing is broken and that they did not hit their head.

3. If in doubt, get it X-rayed. We were fortunate that the X-ray machine here in Luang Prabang was working last week and the technician was in work. When local doctors examined Dominic’s leg it was the only time all morning that he didn’t scream when it was moved. The doctor seemed very confident that it wasn’t broken but we had it X-rayed just to be sure.

4. Use your friends. This is not time to be shy about calling in favors from your medically trained friends. Get on your phone or get on skype and call a doctor. Even if you think you have things under control, you are also very stressed and outside observers may be able to provide helpful input on something you’ve missed. (In our case our friend, Asha, a pediatrician, got on skype with me at 10pm her time, walked me through appropriate pain relief and provided advice on how to make Dominic as comfortable as possible during the night).

The pharmacy near our house

5. Have a variety of infant pain medication on hand. We already had children’s paracetamol in the house but nothing else, and it is not advisable to administer more than four doses of paracetamol in 24 hours. Apparently, when treating breaks and fractures, one good strategy is to alternate doses of infant paracetamol with doses of infant nurofen. Luckily, when Mike got on his bike at 6:30pm and made an emergency dash to some of the local pharmacies, one of those stores had infant nurofen in stock.

6. Have a medication dummy/pacifier in your first aid kit: We don’t have one of these (yet) but I’ve since learned of their existence. It works by loading the medication into a reservoir that then flows through the dummy teat. Apparently they can sometimes work better than syringes when it comes to getting babies to swallow medicine they don’t like the taste of (orange-flavored infant nurofen, for example).

7. Breastfeed upon demand. Breastfeeding apparently reduces distress and lessens pain, and so does proximity to mum (or dad, if dad is the child’s primary caregiver) so stay close by.

8. Splint the limb to hold it stable and reduce your child’s pain. Our insurance company’s doctor told us over the phone how to splint the leg. We used packing box cardboard and a gauze bandage. Cardboard turned out to be a good choice because it didn’t have to be removed for the X-rays in Thailand. I taped the cardboard edges with gauze tape so they wouldn’t scratch him, but another thing I wish I had thought to do was slip a soft pair of my cotton socks over the cardboard to make it marginally more comfortable against Dominic’s skin.

9. Move your child as little as possible. This one is common sense – anyone who has broken a bone knows how much it hurts when that limb moves – but make sure you think creatively about how you can minimize movement. We were assuming we’d put Dominic in his travel cot as usual during the night until Asha pointed out that we could just leave him on the change table mat to sleep for the night rather than trying to maneuver him into that small space. And to that end…

10. Sleep your child somewhere where you can get to them to comfort and/or breastfeed without having to move them. The change-table mat on the floor by my side of the bed worked for us – I was able to feed Dominic by kneeling over him.

Finally, a bonus number 11: If you take up yoga while you’re pregnant, don’t quit after you give birth. You never know when you’re going to find yourself on an airplane having to breastfeed a baby who is strapped into a carseat.

Any tips to add? Leave them below to help out others who will read this post.

Feeling much better in hospital in Thailand

Share on Facebook

Advertisements

T’is The Night Before (A Children’s Story)

It’s 8, and Mama Bear gives a yawn
She’s very tired, she’s been up since dawn
All day Baby Bear needed loving and feeding
Up and down he set emotions stampeding
She goes to bed, she begins to count sheep
One, two, three, four… Mama Bear is asleep

It’s 10, and Mama Bear wakes in the dark
Drums and cymbals and music, hark!
These are sounds she is daily dreading
The loud late strains of a Lao wedding
She lies in bed, she begins to count sheep
One, two, three, fifty… Mama Bear is asleep

It’s 12, and Mama Bear wakes in the dark
Papa Bear’s snoring sounds not like a lark
She tugs his arms down from over his head
Papa Bear sighs and rolls over instead
She lies in bed, she begins to count sheep
One, two, three, eighty… Mama Bear is asleep

It’s 1, and Mama Bear wakes in the dark
This time she hears a familiar dog bark
Zulu has chased a cat up a tree
And is leaping around in a wild frenzy
She lies in bed, she begins to count sheep
One, two, three hundred… Mama Bear is asleep

It’s 2, and Mama Bear wakes in the dark
Baby Bear moans, stirs, and lets out a sqwark
Mama Bear leans over and hands him his dummy
It’s a 24-hour job, this being a mummy
She lies in bed, she begins to count sheep
One, two, four hundred… Mama Bear is asleep

It’s 3, and Mama Bear wakes in the dark
“It’s morning! It’s morning!” the roosters remark
Mama Bear thinks about chicken pot pie
And how she wishes the roosters would die
She lies in bed, she begins to count sheep
One, two, five hundred… Mama Bear is asleep

It’s 4, and Mama Bear wakes in the dark
She hears a buzz, the mosquito trademark
Little legs brush her cheek like lace
She swipes, misses, and hits her own face
She lies in bed, she begins to count sheep
One, two, eight hundred… [beep beep beep beep]

It’s 5, and Mama Bear wakes in the dark
It’s Baby Bear again, a wee hungry shark
She rises and reaches for her little boy
He gives a sudden, toothless, grin of joy
She picks him up, she kisses his head
She thinks, “this is almost, maybe, better than bed.”

Share on Facebook

Inflection points

Yesterday morning, right after we got up, I did my weekly weigh in. Apart from one ultrasound in Thailand, taking pregnancy vitamins and stepping on the scale every Saturday morning has pretty much been the sum total of my prenatal care. I suspect that my return to Australia tomorrow is likely to mark the inflection point on this issue (though I must say I haven’t minded avoiding some of the tests that sound like they’re a routine part and parcel of the first 28 weeks if you live within, oh, 500km of good medical facilities).

After I stepped off the scale and Mike stepped on, it quickly became apparent that this weekend would mark more than one inflection point. Yup, I am now officially half a pound heavier than someone six inches taller than me.

That was only the start of yesterday’s fun and games, for we spent much of the day packing, with Zulu following us mournfully from room to room. We couldn’t tell whether he recognizes now that suitcases invariably mean departure or whether he was just soaking up the prevailing mood.

After I laid out all my clothes on the bed I asked Mike to look them over with me. We’re going to be tight on weight both going out and, particularly, coming back, and I wanted to make sure I was traveling as light as possible (which, in practice, I will admit translated to: I wanted Mike to tell me exactly what I wanted to hear with regards to the decisions I had made).

He did not.

And when I got surly after he told me that he thought I should cull some of what I’d selected he had the gall to laugh and then come over for a kiss.

“I know you don’t like me very much right now,” he said, “That’s fine. I don’t always like it when you think differently than I do, either.”

“Yeah,” I said. “But that only happens when you’re wrong. I used to get to make all my own packing decisions without any disagreements with anyone.”

“Mmmm,” Mike, now busy putting my shoes in plastic bags, chose not to engage on this topic. He also chose not to point out that I used to have to do all my packing by myself too, instead of sitting on the bed and watching him fit stuff into my suitcase.

Inflection points. There have been a couple of them lately.

Three weeks ago the belly started to swell faster than a desert cactus after once-a-decade rains. Two weeks ago I suddenly got ravenous (mostly for junk food – can anyone say nutella and ice cream?). Last weekend we transitioned from the second to the third trimester. Tomorrow Mike and I go from together to apart, from hugs to skype, as we separate for ten weeks. I will go from summer to winter as I cross the equator.

At Mum and Dad’s place even my dinnertime conversation will change. In Australia we may not spend an entire meal trying to work out itineraries that might get Mike to Australia in time for the birth if I go into labour more than two weeks early. Then again, that might be because Mike and I have researched this equation every which way and figured out that unless I have a hellaciously long labour, there are none.

There are some silver linings to this whole situations – I am quite looking forward to winter weather, and spending the most time in Australia that I have in a decade. I’m also very glad I have a beautiful and happy home well staffed by my parents to go hang out in for months on end (fully a dozen years after my poor Mum and Dad must have thought they were safely past the risk of having one of their daughters turn up on their doorstep alone and pregnant).

Empty dinner table overlooking the Khan

But there’s grey this weekend, too – a great big cloud of it. I don’t like this whole separated for the third trimester thing. I would quite like Mike to be with me for pre-natal classes and for us to be able to discuss things like birth plans across the dinner table instead of the equator. I would quite like to be with him when he’s procuring things like cribs and change tables and figuring out where to put them. I really don’t like the fact that Mike is sitting across the table compiling the results of last night’s exploration of every conceivable flight route out of here into a document called, “Flight info-Mike to Aus in emergency.doc”

Sigh.

Many of my friends tell me that all of these inflection points will pale in comparison to the one that’s about to hit us when the baby arrives. Of course, some of my friends have also suggested that it will make a far better story if I go into labour the night before Mike flies to Australia and he skids, sweaty and disheveled, into the delivery room just in time to catch the sucker as it pops out.

Nope… as much as I love stories, I think I’ll be far happier if Mike arrives well before that particular inflection point.

I’ll keep you posted. Catch you from Australia.

Back at Home are Mike and I: Jottings on art, parenthood, and home

Well, we’re back from Thailand and we hit the ground running this week. Although, after a full week of looking at this on Koh Tao…

And this on Koh Samui…

And strolling through resorts…

And buying satay off the beach…

And dining in lovely seaside restaurants as the full moon rises over the ocean…

Well… let’s just say I wouldn’t expect any sympathy from anyone if I tried to complain that we’ve had some re-entry shock with getting back to work. So I shall just say that we’re well and truly back at work.

Mike returned to scores of emails and the usual collection of unruly work-related campfires needing to be tended (and, in some cases, extinguished). I have returned to a new schedule of memoir work in the mornings and consulting work in the afternoons.

I’m jotting this down in between switching from memoir to drafting a distance learning chapter on personal resilience. I have ended this morning’s memoir work without much idea about how to fix a tricky chapter transition. Or, maybe more accurately, how to fix a tricky whole chapter.

That would be chapter, uh, two.

Sigh. I hope something shakes loose on that front this week as I am determined to finish this edit before the baby arrives. Because, of course, after the baby arrives my life as I know it now will end. I will never again find the time or energy to write anything worth reading, and Mike and I have probably just gone on our last truly relaxing holiday and enjoyed our last meal out at a lovely restaurant.

OK, so maybe I’m being just the tiniest bit melodramatic. But I have to admit that stalking my genuine happiness about this coming baby is no small army of fears – fears clothed in thoughts similar to those above. So, as I get into a serious creative writing rhythm again, I was particularly delighted to stumble across a great article recently called The Parent Trap: Art After Children.

Frank Cottrell Boyce writes:

There’s a belief that to do great work you need tranquility and control, that the pram is cluttering up the hallway; life needs to be neat and tidy. This isn’t the case. Tranquility and control provide the best conditions for completing the work you imagined. But surely the real trick is to produce the work that you never imagined. The great creative moments in our history are almost all stories of distraction and daydreaming – Archimedes in the bath, Einstein dreaming of riding a sunbeam – of alert minds open to the grace of chaos.

Writers have produced great work in the face of things far more stressful than the school run: being shot at, in the case of Wilfred Owen; being banged up in jail, in the case of Cervantes or John Bunyan. Yet that pram is lodged in our imaginations, like a secret parasite sucking on our juices.

While I would argue that it may, in fact, be easier to write while locked up in prison than while trying to get kids ready for school every day, I loved this article for standing in opposition to some of my fears. Well worth reading if you are an artist with a family, or thinking about having one.

In addition to all things babies I’ve also been mulling on all things home as I start to pick up the threads of my memoir once again. I stumbled across this poem by Emily Dickinson recently and it intrigues (and baffles) me. Anyone want to help me out by offering their thoughts on it? I am particularly confused by the last two lines – about feet retiring and faces remaining.

Away from Home are some and I

Away from Home are some and I —
An Emigrant to be
In a Metropolis of Homes
Is easy, possibly —

The Habit of a Foreign Sky
We — difficult — acquire
As Children, who remain in Face
The more their Feet retire.

Thanks for dropping by!

Lessons learned about Laos, parenting, and development work, in Phonxai

On Monday, Mike and I plus the friends we have in town at the moment (Mum, Dad, and three little boys aged six, three, and 8 months) traveled up to Phonxai so that Mike could inspect a school in progress. This was an all day endeavor that involved renting a landrover and spending more than six hours traveling – about five of them on dirt roads.

As always when I travel up to the villages here in Laos, it was illuminating. In no particular order, here is a summary of things I learned or relearned on Monday.

1. Northern Laos is lush with mountains and winding dirt roads dug into the side of steep slopes.

2. Water is life – the rivers paint the valleys a vivid green, even when the hills are a dusty and parched brown.

3. In Lao, X is pronounced S (Phonxai is pronounced “Ponsigh”)

4. If you spend five hours in a landrover on dirt roads when you are four months pregnant you’ll end up feeling well frothed on the inside. Also, you should not drink a great deal in advance of this trip, and you should definitely wear a sports bra.

5. British kids will find even the cool season here in Laos uncomfortably hot.

6. Boys who are three and six years old have an incredible capacity to repeat the same observation or question numerous times (e.g., “gosh, it’s very bumpy, isn’t it?” and “are we nearly there yet?” and “why not?”)

7. If you let these same two little boys sit in the back-bench seats of the landrover together (even with two adults back there as well) trouble will erupt roughly every thirty seconds as long as they are both awake. You will find yourself repeatedly saying things like:

  • “I said, bottom on the seat! If you can’t stay sitting down you’ll have to come sit in the middle seat with mum.”
  • “Leave your brother alone! Don’t touch him! Not even one finger!”
  • “Stop singing that song! I mean it, you have until the count of five!”
  • “Try not to throw up, OK? Take deep breaths, look out the front window, and here’s a plastic bag just in case.”

8. If you want to make little boys deliriously happy, all you have to do is get in a landrover and drive back and forth across rivers – stopping every so often to let them walk across a bamboo bridge adjacent to the crossing.

9. Little boys will be quite enamored with squat, bucket rinse, toilets and very probably decide that they’d really rather have this type of toilet in their own home.

10. People all over the world are fascinated by each other’s babies. If you are a mother carrying a baby, you don’t need a word of the local language to effectively communicate on this subject.

11. Lao children in the classroom are remarkably well behaved, despite being packed onto backless benches. If a strange adult walks into the classroom they will leap to their feet and greet you with a polite sabaidee in unison.

12. It is a lot easier for non-profits to raise money to build schools than it is to fund teacher-training programs, but many rural schools suffer from a shortage of good teachers.

13. Rice banks (a village-run storehouse of rice that village families can borrow from during the hungry months and then repay the loan plus five percent interest after harvest) do great things in helping to reduce food insecurity. In one village we visited, of the 93 families in the village more than 60 borrowed from the rice bank every year. The rice bank had been started with an initial, donated, “fund” of two tons of rice and now had a total fund of about six tons of rice.

    Mountains in Northern Laos

    Water is Life

    Bamboo bridge across river in Northern Laos

    Fun at river crossings

    An old school building in Laos

    Children in a new school building in Laos

    Even Lao children find it too hot sometimes

    Learning about the village rice bank

    Inside the rice bank

    Great moments

    On Monday I wrote a post about a bad day – a day when fatigue and noise came together in a perfect storm. These days happen. They would happen anywhere, but when you’re living overseas it’s particularly easy to externalize bad days and begin to dwell on all the things about your new home that grate on you.

    Living in Laos (as anywhere) is a mixed bag, and I write about the bad days along with the rest because I am striving to be honest with myself and with you about my experiences – those that are fun, and those that aren’t. I do this because I think there are almost always important lessons buried somewhere in honesty – for me, if not for you. And I know I’ve said this before on the blog, but it bears repeating. The bad days are not the full story. They are one chapter in a whole book.

    There are far more days – especially at the moment when the weather is deliciously cool – when I find myself awestruck by the thick, lush, beauty of this place. Or startled and delighted by a glimpse into a life lived so differently than mine. Or I wonder about something, and feel my capacity for empathy stretching in ways that are undoubtedly good for me.

    Often, very often, I am moved to gratitude.

    Last night Mike and I waited in front of our favorite fruit shake lady’s stall to place an order. In front of us were two men, laborers, who were also placing an order. We were intrigued to see the locals handing over the same amount of money as the tourists for their drink – five thousand kip, about 70 cents.

    Mike and I both found ourselves thinking about them as we walked home. How much hard work and time did that money represent to them? How would that compare to us buying a coffee from Starbucks or a Coldstone ice cream?

    There is just so much to be curious about here, to marvel at, to thrill to.

    Today, here’s a look at just a few of the really good moments and scenes that have moved me in the last four months – moments I would never willingly trade even on the bad days.

    Mike and I at our housewarming:

    The view from our front porch:

    The Mekong at sunset:

    Mike buying pineapple:

    Dragon boat racing:

    Spices drying outside a temple:

    Luang Prabang orchids:

    A Saturday at Tad Sae waterfall:

    Children playing in the river:

    Inside an older village school:

    Kids watching balloons rise into the air at the official opening ceremony of their new school:

    Women washing dishes in clean running water at their new gravity-fed water system tap.

    Being blessed by village elders:

    Rice fields at sunset:

    Sharing meals with Mike’s coworkers:

    Sharing a moment together:

    The vast majority of the time, Mike and I feel very lucky to spend a portion of our lives here. We are daily being granted the opportunities of experience that novelty and beauty afford. We are thankful for the chance to invest in work that we hope and pray will yield a crop of choices for the children in the villages. And we are grateful indeed for all the wonderful moments we’ve tasted during along the way.

    What price a child’s life?

    This afternoon Mike and I sat upstairs on the deck at our place, looking out towards the trees. It was pouring rain. Water was sheeting off the tin roofs of the houses behind us and running down the big green leaves of the coconut trees – arcing off and dropping towards earth in one, unbroken, stream.

    We were up there because Mike had quit the kitchen table, which was burdened by our two laptops and a stack of documents eight inches thick that he’d bought home to sign over the weekend. The stack was peppered with neon tags demanding his signature.

    “Mr Michael,” the tags read, one after another.

    Mr Michael. Mr Michael. Mr Michael…

    On this quiet Sunday afternoon Mr Michael had worked through all these documents, not pausing until near the end, when he came across three requests for reimbursement. These were all related to cases where a sponsor child had gotten sick out in their village and the district health centers hadn’t been able to address their problems and had recommended transfer to the provincial health center in Luang Prabang.

    It costs money to transfer sick children to the provincial hospital, and when three children get critically ill in one district within a month, it costs more money than has been budgeted for medical emergencies. Significantly more. As in, more than half the budget for the entire year.

    “It’s not three cases,” Mike reminded me, when I went to see where he’d gone and found him sitting at the table on our deck, staring out at the rain. “It’s four. We also have little orphan girl.”

    Ah, yes. Little orphan girl. Little orphan girl whose story began two weeks ago now, when Mr Michael received multiple phone calls on a Saturday requesting him to authorize the medical transfer of an eleven-year-old child from Luang Prabang to Vientiane. The doctors in Luang Prabang said they couldn’t treat her here, that she had a problem in her brain and that she would probably die if not flown to Vientiane for specialized medical care immediately.

    Mr Michael authorized the medivac. At first, it seems, the doctors in Vientiane thought she had Japanese encephalitis – she could not even sit up, or swallow – but after a week of testing these results came back clear. So she does not have encephalitis, but no one is any the wiser yet on what she may have.

    At least, this is what we think is going on. It’s very difficult to get accurate information. Whatever the doctors in Vientiane are saying gets filtered through at least two other Lao speaking staff before it reaches the office up here. To complicate matters further, little orphan girl herself doesn’t speak Lao, much less English. Little orphan girl is an ethnic minority child who is too poor to attend school, where she would learn Lao. So she only speaks Khmu, and the doctors only speak Lao.

    I was speaking about this with the local staff member on the case during our house-warming party on Friday night.

    “So, no one knows what is wrong with her brain,” I said, trying to make sure we were on the same page. “But now she needs help to get her muscles working again?”

    “Yes,” the Iokina replied. “But the doctors say the problem will happen again. They say she will die.”

    “But they don’t know what the problem is?” I said.

    In summary: No. They don’t know what the problem is. They don’t know when “it” might happen again. They don’t know when she might die – it’s just that Iokina seems pretty certain that she will, at some point, especially if we send her back to the village with her fourteen-year-old sister and elderly grandmother.

    “Do you think she should go back to the village?” I asked.

    “Yes,” Iokina said, shrugging a little in that helpless way that needed no translating.

    “We tried,” Iokina was saying, without words, “and there’s only so much you can do for one child.”

    So Mike and I are left wondering. Is that really what the doctors have said? How do you weigh and filter this information that has come up to us across many miles and two significant language barriers? Would physiotherapy help her, or is the primary problem neurological? Are there any Khmu speaking physiotherapists in Luang Prabang that could coach her on exercises she could do at home? If so, how could we find them? How are her sister and her grandmother going to be able to help her when they need to be tending the rice fields so they can all eat? And, of course, how much is this all going to cost?

    How do you put a price on the life of a child?

    “The emergency medical fund is for emergencies,” Mike said today as we sat on the porch watching the rain. “This case is no longer an emergency. We don’t have the capacity to take on long-term rehabilitation cases. We cannot continue to pay for her treatment indefinitely when no one yet knows what may be wrong with her. She has to come back from Vientiane.”

    “What then?” I asked.

    “I don’t know,” Mike said. “I have to go in to the office early tomorrow before we head out to the field. I’ll see if I can get some more information.”

    We sat and stared at the rain for a little while longer, and then we came inside and went back to work.

    Share