Today's Task: Write a Blog Post in 10 minutes...

I'm putting together my writing cv.  It is, shall we say, a little 'thin'.  It's not that I don't have any experience in writing, you understand - over a thousand posts written on here alone are testament to that - it's just that I don't have so much experience in writing for publications that actually pay.

As I reached the end of this still-as-yet unfinished cv I realised that perhaps, if I'm going to refer to this blog, I probably should write something.  You know, like, a post.  It's been another month, after all...

So here I am.  With the ten minutes before I have to leave to collect the Boys from school the only time I'm likely to find in the near future.  What to tell you?

Well, Boys #1 and #2 are now ten and twelve years old.  How did that happen?  I was reminded of how far we've come today when I took them both to our local - excellent - hospital for their first allergy test in seven years.  It went smoothly, no problems (and yes, they are still allergic to nuts, dammit).  Now, the last time we did this was in London and it was something of a seminal experience for the three of us.  Boy #2 - three years old at the time, still chubby and toddling around - handled the whole experience with aplomb and dignity, whimpering a little as they scratched his arm, but generally behaving well.

His older brother?  Not so much.  There was a visit to the paediatric ward 'Quiet Room' involved, I remember, to allow him to calm down.  There were chocolate buttons (well - I can't remember the chocolate buttons, but since there were usually chocolate buttons or smarties involved in times of stress, I'm thinking I'm pretty safe in assuming they made an appearance here).  There would also have been wailing and gnashing of teeth, no doubt - obviously, since we were banished to the Quiet Room, I suppose.

But the thing is, I actually don't remember that many of the details.  I guess that may be due to having blanked it out as not having been our finest hour, who can say?  But whatever the reason, it's interesting to realise that however awful a parenting experience might be at the time (and I do remember that at least; it was awful), you actually are unlikely to remember the details in the future.

Which is a comfort, I suppose.  Especially as I look the teenage years squarely in the face.

And of course the other comfort is that whatever happens, and whatever the years ahead hold, there will, of course, still be this blog to refer to, to remind me that there were some difficult times before, and that we made it through those.  And there will still be smarties and chocolate buttons.  Or Green &; Blacks.  Whatever comes to hand, really...

There you go - a blog post in 10 (no, 12, actually) minutes.

The one where it turns out I'm not so brave, after all...

I try to be a relaxed parent when it comes to matters of health for my sons, really I do.  Nobody wants to be that mother who flinches every time her child sniffs, or wraps them up in cotton wool every time they set foot outside the front door in case they encounter a normal childhood illness.  I believe whole-heartedly in letting your child's body develop without undue interference from antibiotics unless they're absolutely necessary*.

But once the Fear has had you in it's grasp, it never really lets go.

I still remember it all; the gut-wrenching dread that stalks your every waking moment when you have a seriously ill baby.  The feeling of helplessness as your 6 day-old child is prodded and poked, pricked and injected.  The constant watch to make sure that his Moro Reflex** doesn't knock the canula out, resulting in yet more harrowing attempts to insert a new one into his tiny arm.  The crushing, awful powerlessness of not being able to pick up my crying baby because doing so might interfere with the effect the lights are having on his bilirubin levels.

I remember the guilt; did I cause this?  Was it because I wasn't very good at breastfeeding?  Would he not have developed jaundice if I had had more milk?  Was the way the Scalded Skin Syndrome took such a fearsome hold a result of his lowered immune system because of the jaundice?  Did he catch the SSS when that none-too-clean looking orderly gave him a bath in the hospital when he was less than a day old and I could barely move from the bed due to the emergency c-section?  Should I have followed my instincts and grabbed him from her arms, ordered her away from the bed and refused to let go of him until, exhausted from lack of sleep on the too-noisy ward, we left 24 hours later?

Nearly seven years on those questions and many others from that time still haunt me.  Most of them I can discount in daylight hours when I am feeling relatively sensible. But one that won't go away and which I repeatedly ask myself (just like, I am sure, many expat parents living far from their comfort zone), is this:

How would I cope if an accident or a serious illness happened to my children here, now, in Moscow?

The answer is, I truly don't know.  Certainly there would be support structures I could call on; a Husband who speaks excellent Russian and who knows the right people to go to, or if he were travelling, friends who speak far better Russian than I do and who I know would go through hell and high water on my children's behalf.  Recent experiences within our social circle of excellent levels of care in both Russian and expat hospitals comfort me to some extent.  But say what you will about the UK NHS; it is still light years ahead of what the average Russian can expect to encounter in their nearest hospital.  And who knows, in an emergency,where you will end up?  It might well be the all mod-cons expat hospital in the centre of town.  But on the other hand, it might not.

So on evenings like tonight, when one son has a nasty cough and the other is complaining of stomach pain, I am rather more attentive than perhaps I might be if we were still living in London.  Logically I know that Boy #1's stomach pain is not possible appendicitis, but instead the result of too many sit-ups at his Taekwondo class this evening (stomach muscles are not our family's strong point; if I manage 10 I'm a mess and according to him, they did 200...), and that Boy #2 is not developing pneumonia but has just picked up one of the many colds doing the rounds at school at the moment.  Logically, I know both those things.

But logic doesn't stop me wanting to move my duvet to the floor of their bedroom tonight.

Turns out that the Fear - it never leaves you.


*although long term readers will know that I am fierce in my support of treating eczema proactively to prevent it developing into a long term issue or something more serious.

**also called the Startle Reflex

Dealing with childhood eczema; from a parent who's been there...

I am unashamedly recycling a post. To those of you who have been kind enough to stick around reading this blog since August 2009, apologies for that, but after seeing a tweet this morning asking for help in dealing with childhood eczema, I think that what I wrote back then is still of value now, and could be useful for parents dealing with this condition in their children. And the title of this post is a suggestion that Tara at Sticky Fingers made in her comment on the post first time round - so thanks for that, Tara!

August 2009

A while back, a friend of mine suggested I wrote this post after hearing of our experiences with the Boys’ eczema, thinking that others might benefit. I haven’t written it before as I think it might come across as preachy – which I know I can be, especially on this subject as I'm quite passionate about it – so apologies if it does.

Question.

If you see a baby or a child with bad eczema, what is your first thought? Is it:

A: What a pity, such a shame, but it won't do any long term damage and I'm sure he/she will grow out of it...

B: Gosh, that looks uncomfortable. I suppose they've tried everything they can to shift it. I wonder if they've tried changing his/her diet?

C: I have a pretty good idea how the parents of this child might improve this situation, but they might not want to hear it. Should I say something, or should I just mind my own business?

Before my sons were born – or rather, before Boy #2 was born - I used to default to answer B. I’m a long-term sufferer of eczema myself, although nowadays you wouldn’t know it, and growing up in the 1970’s and 1980’s there was only one recognised way to deal with it; moisturising and steroid cream, lots of it. Oh, we knew that the latter could have nasty long-term effects, like thinning of the skin etc, but the benefits to me as a crusty-faced 14 year old girl of smooth skin vs resembling what I imagined at the time a leprosy victim looked like, meant that those potential drawbacks were usually ignored.

As often happens, my eczema decreased as I got older, leaving me only with the belief that there must be some way other than steroids to deal with this condition. I convinced myself that what I ate was the key, and tried various different diets throughout my early twenties, but looking back now I think I just grew out of it.

When Boy #1 was born, it turned out that he also suffered from fairly severe eczema. Remembering the scare stories from my youth, I tried everything under the sun rather than bring out the steroids. We went dairy free, we went soy free, he drank goat’s milk formula when he went onto bottles, we went wheat free. We even had him allergy tested at 7 months old, but nothing showed up, not even the nuts and sesame that would nowadays hospitalise him. It didn't help that 'eczema' is a generic term; there are many different things that can cause it, and at the time we had no idea what they might be.

Still he had those persistent patches of eczema that occasionally flared up into something nasty, and which would then necessitate a course of antibiotics and the grudging application of the thinnest layer of hydrocortisone cream imaginable. Basically, he itched, but got by.

Then, Boy #2 was born. He also suffers from eczema, initially even worse than his brother, and after 4 months of skin infections, hospitalisations and a constant round of on-again-off-again courses of antibiotics we discovered that MRSA is particularly fond of children with eczema. Not the best of times, but this last did at least get him treated – finally – by the excellent team of paediatric dermatologists at Chelsea and Westminster Hospital who helped us get a handle on the problem.

And you know what I found out?

Steroid creams have evolved. They are no longer as aggressive as they used to be, and nowhere near as harmful.

Now I freely admit to being a touchy-feely middle class parent. If there is a way of dealing with a problem without resorting to drugs, I will take it. If I feel a headache coming on, I’ll drink more water rather than take a pain killer, and if I feel bloated I’ll reach for the organic remedy rather than a pack of laxatives. But I’ve tried that approach to my children’s eczema, and it doesn’t work. This is one time when, as a parent, I had to forget about all the alternative therapies I automatically drifted towards.

It’s natural in today’s less intrusively-inclined culture not to want to put chemical substances on your children’s skins, and instead to change their diets, or to take them to chiropractors, cranial osteopaths, kinesiologists etc (all of which I put my hand up to, by the way) but believe me, I’m now a convert to the conventional medicine route in this situation. As a fantastic consultant once told me, a little bit of steroid cream and a rigourous moisturising regime as prescribed by someone who knows what they are talking about is a great deal better than dealing with the fallout of not treating eczema properly, and early.

Having seen my baby hooked up to an iv which delivered two different types of antibiotics because the skin cultures that had been taken from the infected area wouldn’t be back from the lab for 5 days – 5 days that we couldn’t afford to wait in treating our son - I have to agree.

However, therein lies the rub. ‘Someone who knows what they are talking about’ can be very hard to find. After the last six years of caring for my two eczema-prone sons, I know that in reality it’s practically impossible. I would even hazard a guess that I know more about the condition than most GP’s – and certainly most health visitors. And that’s not to blow my own trumpet, but simply to highlight how poorly informed they often are.

To look at my sons now, you wouldn’t notice they had eczema. Paradoxically, my younger son – who has been treated almost from the start in a much more aggressive steroid-slap-happy manner than his older sibling – is the one who now has much better skin. You can draw your own conclusions from that.

So, whilst I know that every child is different, and the root causes of this condition can be any one of a number of things, here is the checklist that we use and which I hand out to friends and family who find themselves at their wits’ end trying to sort out their child’s eczema.

1. If your child’s eczema is not simply the type that manifests itself as an occasional flare-up which can be treated with prescribed hydrocortisone, get your child referred to a paedriatric dermatology team as soon as possible. Some hospitals will have better teams than others I know, but all of them will be better equipped to deal with this than your local GP or health visitor.

2. Whilst you’re waiting for this appointment, you will no doubt find different ways of coping. We follow this routine;
a) Moisturising morning and night, even the eczema free zones. We use Cetraben lotion twice a day; I was told by a very experienced eczema nurse ‘this stuff is magic’, and compared to the others on offer out there I couldn’t agree more.
b) Our boys have a bath every day, rain or shine. It’s often said that children with eczema should only be bathed once a week, but this may not necessarily be the case. In fact, of the serious sufferers that I know, almost all of them have been prescribed daily baths by a dermatology consultant.
c) Before they get in we cover them with a mild anti-bacterial lotion; we use Dermol 500, and this replaces the need for soap.
d) We use a capful of fragrance-free Oilatum or similar in the warm water.
e) We wipe off the Dermol 500 with a clean flannel in the bath.
f) No soap, and once a week or so, the gentlest shampoo we can find. When we do wash their hair, we rinse them off with clean water from a shower attachment as they get out of the bath to avoid the shampoo staying on their skin.
g) After drying off, we moisturise all over as detailed in point a.

3. This is our routine only, but whatever you do, when you get your appointment with the consultant make sure to tell him exactly what you’ve been doing as they may wish to try something completely different.


Finally, as unfashionable as it may be to say it in today’s increasingly alternative therapy-keen society, whilst the routine I’ve listed above has improved our children’s skin immeasurably, it’s been using the prescribed drugs – the dreaded steroids - that has really made the difference.

Sometimes, the drugs do work.

Note: Oilatum Fragrance Free, Dermol 500 and Cetraben Lotion are all available over the counter from your pharamcist or on prescription from your doctor. I would recommend the latter; a large tub/bottle of each will set you back between £9 - £11, and will only last around 3 - 4 weeks (although I do have 2 children...).

Just a small request...

In the last seven days I have...

• Unwittingly started a revolution in food safety procedures at our school's cafeteria. This was a direct result of giving one of my children a chocolate chip cookie purchased from there only to discover - via a race to the medical office where they hold our anti-histmanines and a thankfully still un-used eip-pen - that the chocolate chips were, in fact nuts. (The helpful member of staff responsible for making the cookies in the cafeteria kitchen decided to substitute the chocolate chips they had run out of with nuts - without actually telling anyone.)

• Collected the same child, on a different day, from school, to be warned by his teacher that she thought he was a little 'under the weather'. We got home, where he proceeded throw up spectacularly all over the kitchen floor. This did not phase me however, since I was just thanking my lucky stars that we had got out of the car 4 minutes earlier and he had taken his snow suit off 2 minutes earlier. Let's see; sick on the lino, or all over the inside of the car, my son, and his brother? Call me glass half-full, but I know which I prefer...

• Rushed to hospital with the other child (have you noticed how they hate to be upstaged by their siblings?) after he had a major collision while sledging on an ice run and needed 5 stitches just above one eye.

So, if anyone up there is listening, can we have a slightly calmer week this time around, please?

Moving on #2

Boy #2's pearl of wisdom this afternoon, pronounced solemnly, feet on table, as he chomps (and burps) his way through an apple:

"If you eat the seeds you will definitely need to go to the hots-pital (sic)."

He's growing up - and I love that - but can I just say; when he starts to say 'hospital' correctly, I will mourn 'hots-pital's passing...

Note; this isn't the first time I've been here; I just realised that 18 months ago I wrote this post about the way he used to say 'helicopter'. Thank god for blogging so I can actually keep track of all this stuff...