The Unexpected

(Note: I am adding links to resources as I find them useful)

Like many folks, we are just watching COVID-19 unfold around the world. I've been watching for awhile but really started paying attention about a month ago as epidemiologists and public health officials started seeing what this virus is capable of. I am not an alarmist and I'm not panicked. I am glad that the majority of folks I know are also treating this with the appropriate level of preparedness as possible (as opposed to folks I see in the comments section of news articles or in some community Facebook groups who somehow see the rising death tolls as manufactured by mainstream media).

Anyhow, I have little to offer in terms of COVID-19 preparedness that can't be found in a million better articles and blog posts online. The two pieces of advice I have is--think of what food and supplies you would like in your house today if you were to get sick and have about a 2 week supply of essential medication, pet food, and foods at home. This isn't doomsday prepper time. I really don't understand the rush to hoard toilet paper, in particular.

The major point I have taken away from the last 2 weeks is that it's important to slow the spread of this virus so that hospitals do not become overwhelmed to the point that sick and dying folks are turned away from or receive lesser services. I believe OSU made the right call by going online for the next 2 weeks (minimum...). I hope that others are heeding the calls to avoid unnecessary gatherings and are not using this time to jet off on lower priced vacations...(Here are two great articles with do's and don'ts of social distancing).

I'm not especially concerned about my immediate family, though we do have a supply of regular medicine and a few more snacks than usual.

That said, A is at a higher risk of upper respiratory infections because of her asthma. Her asthma has been harder to control this winter, with us having to switch back to a more powerful medication and use her rescue inhaler more frequently. Thus, we made the difficult decision that, barring unforeseen circumstances, even if our school district is in session, we are going to pull her from school for the couple of weeks after spring break. I briefly talked with her principal today and he was very understanding and reassured me that the district was considering these types of situations. It is quite possible (again, if they resume school as currently planned) there will be materials available online or as packets that can be picked up for students to have.
Because A was absolutely devastated to learn she would be missing her teacher and class at least 3 weeks, we discussed ways to make the days fun. I told her we could make a schedule and she ran with that. We created a table together in Word and she stuffed that schedule full (I learned she's becoming adept at MS Word shortcuts like copying and pasting!). I color coded it only for her to decide she didn't like that because she wanted to choose each activities' color. So ultimately we now look like a super overbooked family. I figure what we will learn most is how to deal with unmet expectations and falling short of one's best laid plans.

Given that I have to move lectures online and somehow manage to squeeze in clinical supervision meetings via phone or Zoom, keep writing, handle journal articles, and complete overdue reviews, I am certain this will just continue my lesson in failing all the things as gracefully as one can (I did like this article about not focusing on creating perfect online courses on the fly; I'm imagining some of my meetings will go as well as my favorite internet sensation). Between the teacher walkout 2 years ago and a delayed opening of her school this fall, I am feeling much better equipped to deal with the unexpected.

Because I know others are also dealing with similar struggles, I've compiled a list of things that might be useful in the coming weeks (by A's categories). I found this article to be super awesome and realistic--bonus that the author is in my beloved Harlan County, Kentucky. This is also a nice list of activities.

• Kid-Friendly Exercises:

https://www.cosmickids.com/category/watch/
https://www.gonoodle.com/blog/gonoodle-games-movement-app-for-kids/

(I will have to find more physical activity videos because most of the non-yoga one I have watched makes me want to poke someone in the eye)

• Research: 

So A wants to learn how to "research a topic" so I'm going to let her come up with questions and then help her find sources to read about them. I am guessing I will read a lot about squirrels in the coming weeks.

• Math:

A is obsessed with the math game Prodigy. Between that game and some Highlights/Scholastic workbooks she got this summer, she will keep working on it each day. One of her favorite activities is having me create math worksheets for her. I found a lot of "math facts" worksheets online that makes this easier. Once she is finished, I let her check her work with a calculator, which she loves.

• Science:

Science will be the most fun, of course. We still have tons of experiments we can do at home (how is our bread *still* not molded, by the way? we started that experiment on 2/28 to drive home the importance of hand washing--still not a speck of mold). She will be missing her first couple of weeks back to Tech Club so we will definitely need to find some fun coding activities we can do at home. We still have geodes we can bust open, and we might do some reading about climate science and about viruses since she has had a lot of questions about that this last week. And of course, I have 234 Pins on my Science Pinterest board...here is the site I am most excited to dive into.

https://mysteryscience.com

• Bake:

I would have never thought to add this to our list. I am excited to see what A decides she wants to bake.

• Read/Write:

I might find a few journal prompts but otherwise, reading, writing, and drawing will be entirely up to her. 

• Computer:

This google document provides a list of a ton of educational resources for free for the next few weeks. Scholastic is also offering some really cool free lesson plans. She also uses iStation at school and could choose to play on that or Starfall for a bit.

• Social Studies:

I'm thinking we will do more on global citizen and perhaps pick a country to learn about each day. She has enjoyed similar studies at art camp and at school. Additionally, we get a box with snacks from a different country; this month will be Brazil, I think! (February was France and that was a huge hit with the whole family!)

• Art/Music:

In addition to letting her draw or do other fun artistic projects, I saw that 12 museums offer virtual tours for folks so we might watch some of those. Unfortunately I think that might bore her a bit. However, we might also learn a bit more about her favorite artist, Frida Kahlo. I also am ordering her a tie dye kit and we have lots of rainbow loom bracelets and chokers to make. 

We also discovered that many amazing symphony orchestras and operas are now available online which might interest older kids.

Metropolitan opera

Berlin Philharmonic

Seattle Symphony

• Library:

I'm not exactly sure what she wants to do for library time but perhaps I'll just let her use that time to peruse the books available to her through the e-library on her tablet. Maybe? 

• Creative/Play:

See above. I'm also hoping she might want to spend some time building LEGO or putting together a puzzle. We will see. If she chooses to just play with toys during those times, I'm fine with that too.

• Unfun Friday:

So this is kind of a funny joke because A's school does "Fun Friday." However, she absolutely hates it so much. I really have no idea what they do in there and I don't know what she will want to put during this time but it's sure to be unfun. ;) 

~

Anyhow, in reality, like I said, I don't anticipate that we will stick anywhere near this schedule. I also am comfortable with more screen time than usual as these are unusual circumstances. In general, if she does some reading, plays on prodigy, plays with her toys and does some physical activity most days we are out, I will be happy. Hopefully, she will be too. I know she's going to miss her teachers and the staff at her school so much. So lots of lessons on emotion identification and validation planned as well. ;) 

Stereotype threat

This week I was asked to give a presentation to our undergraduate psychology honors society. The topic was women in academia. As luck would have it, we did not have adequate child care because the talk was at 5:30pm. Lesson #1 folks: no one asks for your schedule, they just set meetings and you rearrange things to make it work. Chad doesn't get home until 8:30, the people we would typically ask to watch A are all teachers (either at her school or in elementary schools) and often are not available until 6. Colleagues and graduate students had other obligations. So I finished a meeting at 4:30 and then picked A up from school and brought her back to work with me. I figured her presence might be a good testament to the reality of being a parent in an academic setting. 

People probably tire of hearing about how compliant and wonderfully behaved A is. I am always amazed but do attempt to keep those musings out of ear shot so that she can keep being her own person without worries about who I want her to be. But since she can't read yet  (& I can't hear you moaning "not again!"), I'll again say how very fortunate we are. It is hard for me to know how most 2 or 3 year olds would act in a class setting, but I feel confident it may have involved running, climbing, crying, tantrums, or getting into things that don't belong to them. I did not have to deal with any of that. She sat in a desk and colored for a few minutes, sat in my lap while a colleague presented, and played with blocks in the floor (blocks donated to my office by a colleague for such purposes). When it was my turn, she got a little antsy. Right after my introduction to the topic, she announced to everyone that she needed to go potty so we had to take a brief break to allow for that! I set her up with my phone to watch an episode of Super Why. She got upset when I was in front of the class (no! that's my mommy!) so I came back and sat near here. 

Overall, the presentation and her behavior were fine. It is just hard when you know the stereotype--women in academia with kids are a mess; they aren't productive. These stereotypes, like most, are largely untrue. When I was thinking about this topic, I thought I might be one of the first to connect stereotype threat to working moms. I should have known better as a number of other blogs and articles have touched on the relationship. 

Stereotype threat occurs when people fear they may confirm negative stereotypes about their social group. Research has suggested that SAT scores in African Americans may be undermined by asking the person's race/ethnicity or describing it as a test that is 'diagnostic of intellectual ability' (because an active stereotype is that African Americans are less intelligent than other groups). It is thought to occur because an individual fears that his/her performance might confirm a negative stereotype about his/her group. Other common areas of research are that females have worse performance on mathematics exams, in male-dominated jobs (i.e., entrepreneurship) or hobbies (i.e., chess). Now, I would be remiss if I did not note that there seems to be some fairly strong evidence that these effects may suffer from publication bias. But that fact doesn't really flow well with my current narrative. ;) 

I thought of the stereotype threat research after my presentation. Seeming disorganized, being distracted by the adorable toddler, and feeling far less put together than my male colleague made my presentation even less effective that it otherwise might have been. I could literally feel the students judging, even though I'm fairly confident this was a product of my own self-judgments. Trying to find the balance between showing the reality and epitomizing the stereotyped absentminded professor/mom is something I imagine I will continue to struggle with in years to come. 

In the presentation itself, I discussed some of my favorite parts of an academic career (piggybacking on my colleague's presentation) and tips for success, but I also talked a bit about the history of women in psychology; concerns of gender disparity within negotiations, publications, and tenure; and the impact of babies and housework on women in academic science/medicine. I highlighted the positives of OSU and being able to be in an environment that is incredibly family-friendly and has more females than the national norm. My hope is that the picture presented was accurate but not overly negative. I still feel amazingly lucky to get to work and parent. I know it isn't a decision that works for everyone but I am glad it works for us. 

In related news, I saw a Huffington Post article today which showcases women working around the world. I thought it was pretty beautiful so I am sharing it here.  

Worry...Leave my mind alone

Well, as I predicted, several people contacted me after the blog that I wrote for Dr Psych Mom (dealing with postpartum anxiety and my experience). There were a few common questions so I figured it was worth trying to answer them here. Once getting through them, though, I realized that this seems like a really weird and self-focused post. So forgive me for that!

I get why you didn't but...why didn't you call/tell me?!?! 

This is tough. I mentioned this in the original post; it was a Catch-22. It was difficult to feel the anxiety but I also felt like all of the things I was worrying about would come to fruition by talking about them. Again, this is a tricky place to be as a psychologist because I fundamentally recognized that this was anxiety's irrational trick. But it was quite the hurdle. I feel like I occasionally left little bread crumbs in conversations but I wasn't able to come right out and describe it and my little nuggets were so vague that no one really could have followed them to see what was going on.

How did you "get over" it?
I definitely wouldn't say that I'm completely over/through it (more about that later); however, I hit a turning point in March. I really hadn't been sleeping, A had recovered from another stomach virus, and her cough suddenly was bad again, particularly in the middle of the night. One night, it was particularly bad so I woke Chad up and explained what I had been experiencing. Although I had been feeling completely overwhelmed with the feelings of panic, I had been functioning fairly well. I went to work every day; I didn't talk about the anxiety; I was teaching and doing research, writing 2 grants, and keeping up with the house. So no one had noticed the anxiety but I was irritable a lot at home (I don't think that had gone unnoticed). So Chad was quite surprised to hear what had really been going on and he agreed that it didn't sound typical, or like something I should struggle with on my own. The admission alone lifted an enormous weight. It allowed me to recognize this was a problem and I needed support. I slowly started admitting it to other people, while also looking for resources. I blurted it out to my friend who is an anxiety researcher, on the way to lunch one day. I felt like just saying it, outside my house, needed to be done. And it was great. We talked about potential exposure exercises, mindfulness activities, and acceptance strategies and why they hadn't been working previously. I mentioned it to one of my mentors at lunch the next day and got lots of validation and suggestions for other ways to cope. Those three 'moments' of admission are what seemed to turn things around for me.

How are you doing now?
The most common question I got from those that contacted me was concerned with wanting an update on my current functioning. I'm doing quite well. Baby A has had several viruses since the spring (yay, daycare!) and I have handled it pretty well. I definitely have had my moments, though. Once we took A to OKC to play with Ben, Grace, and Avery at the water park and A vomited in the car. It turns out it was just car sickness but this set off several hours of concern that it might be a bug that would get the other kiddoes sick and lead to missing work. I have had to stop drinking caffeine entirely. Prior to graduate school, I could drink a mountain dew and then go to bed and sleep soundly. However, I stopped drinking it (as well as soda more generally) in 2008 for health reasons. Over the years, I started having an occasional Ale-8, sweet tea, or coca-cola and noticed that it really negatively impacted my sleep. Within the last year, though, caffeine would bring on a full bout of panic symptoms. Caffeine-related anxiety is fairly common. So I just avoid it. Again, a job hazard is recognizing these pit falls (technically, shouldn't I drink *more* caffeine so that I can engage in interoceptive exposure?) along with a number of safety behaviors I've picked up (I'm embarrassed to admit that taking A's temperature daily became a thing). But now I am better equipped to recognize thoughts as thoughts, and can notice them without letting them have such an impact. Like many parents, I've been pretty hypervigilant about EV-68. Recently I had one evening of heightened concern but, given A's history of breathing problems, I think this is actually pretty good for me to have kept it fairly under control. Admittedly though, I did engage in some reassurance seeking behaviors. I knew what I was doing when I did it, though.

Why did you decide to share this?
The unspoken question here is "Weren't you afraid of how people would perceive you?" and I think the answer is yes. Samantha had indicated some folks were interested in hearing thoughts about postpartum anxiety and she needed someone to write about her experience. So I said I would do it. The thing about mental health stigma is that we all say that we want to reduce it--as long as it doesn't touch us or our close family. Because I ultimately decided to keep this a public blog, anyone can see it. I often share it on Facebook for friends and family because a few have requested I make it easier to see new posts (here's my plug for subscribing to an RSS reader or email subscription!). This means that, if they were so inclined, colleagues and former students (& professors!) can see my posts (& it seems they do, given the comments and likes that I occasionally receive from them). So, on the one hand, I want to help to educate others and share my experience, but on the other, I didn't want it to negatively impact my professional persona. I'm pretty sure that's more evidence that we aren't where we should be in terms of stigma. In a sense, it was a little impulsive when I agreed to it. But I think it was an okay decision.

Funny enough, in my mind, I just knew that there would be other questions. There were a few that I 'feared' coming, which I think means they need to be addressed. ;)

Why didn't you get treatment? 
The fact that I described postpartum anxiety symptoms but didn't go to a psychologist for therapy or a psychiatrist or PCP for medication almost caused me to question talking about it at all. It seemed professionally irresponsible. Frankly, I don't know if I actually could have been diagnosed with PPA (or any disorder) but treatment likely would have been a good idea. At one point I looked into it and saw that there are only a handful of potential providers here in town that I could be interested in seeing. Of those, I personally know or am professionally connected with 75% of them. I actually don't have a PCP (though I'm working on this as I finally have scheduled an appointment with a doctor for a well check!) so medication seemed out, without a lot of work. I really did consider it and do grapple with my feelings that it seems irresponsible to tell others that they should seek help when I didn't myself. At least not in a traditional sense.

What do you mean prayer/exposure/mindfulness didn't work? Does that mean it/they don't?
I thought a lot before I included that statement. Nothing worked for me in those moments of panic but now they are really helpful. There has been evidence of the effectiveness/efficacy of each of these strategies and obviously I am a firm believer in evidence [and of course, I was trying to use them on myself which is probably pretty ill-advised for the therapy strategies]. It's still how I what I would recommend for a client if they presented with anxiety.

I thought you weren't anxious?
Me too. 

What's more common than PPD?

Postpartum anxiety: more common but less recognized than postpartum depression

You don't actually know what you're doing, do you?

I recently wrote a piece on postpartum anxiety for my friend Samantha's blog, Dr. Psych Mom. There are so many topics that seem taboo, especially related to mental health or difficulties as a new parent. This is the kind of post that is certain to get calls from family (ahem, mom) or close friends, upset that I hadn't shared this experience with them. Hopefully this post helps explain that, too. More than anything, I hope sharing my story provides some validation for others who have been through it. 

Becoming a parent is anxiety provoking. People who never worry suddenly become stricken by fear that they will accidentally drop their newborn baby as they stumble from room to room in a sleep-deprived state. Common/“normal” fears include hitting the baby’s head, forgetting the baby somewhere, something being wrong with the baby, or being a terrible parent. Sometimes, though, anxiety can become paralyzing. This was my experience. In general, I am not anxious. However, things changed after having my daughter...

You're a terrible mother

How angry would you be if someone told you (or someone you loved) that? Pretty mad, I'd bet. I know I'd be livid! Yet I hear myself and my friends saying it to ourselves all the time. "We are terrible parents, Alaina won't eat solid foods...doesn't use a sippy cup...doesn't get a bath every night...hasn't learned her colors yet...had an infection and we didn't know...can't solve a quadratic equation" and on and on. Clearly that's a combination of thoughts I've had, ones I've heard and just plain hyperbole. But it's pretty ridiculous really. I'm not sure why this realization surprised me given I know that self-talk outside of parenting can be downright nasty. My friend's husband told her over the holidays that she wasn't allowed to say it anymore. The funny thing is, she's nowhere near terrible. She's an amazing mom (you know you are)! She has the equivalent of two full-time jobs and yet has time to make it to her oldest's dance classes and home for baths every night. And she even cooks and cleans (at least occasionally). So in general, I think we are all doing pretty well. "Good enough" parenting is a real term with positive outcomes and I probably need to remind myself of that more regularly. Alaina's pretty lucky to have such awesome parents. :) I'm sure she will hear this a lot as a teenager. ;)

Where is this all coming from? A weird, unexpected reaction to Alaina's 9-month check up actually. In general, she's doing really well. First, the fun stuff. She is 18 pounds, 11 ounces (44th percentile), 26.75 inches (21st percentile), and her head is 17.75 (78th percentile). So she really is a little lollipop. Which I have been thinking she kind of looks like these days. :) She did really well with her two shots. Snoopy band-aids, if you were wondering.

So what went wrong? Well, nothing really. But in the waiting room, we always get a "Bright Starts" sheet that talks about milestones and what we 'should' be doing as parents. They tend to be fairly helpful and a confidence boost--"yay, I have friends who are parents that I can talk with about my struggles," "awesome! we always use a car seat, every time Alaina is in a vehicle," "look at us! we only leave her with trusted providers"--but yesterday, I noticed "feed 3 meals of solid foods," "start introducing more table foods," and "use a sippy cup" and got more overwhelmed than usual.

Parenting is a lot of work.

I fret over things that ultimately do.not.matter. Because of all of her sensitivities, Alaina has only had about 14 foods. I have seriously lost sleep at night wondering how she will possibly ever eat normal food because clearly we still have so many to go through, using a '4-days between new introduction' paradigm. Goodness, trying to imagine her eating mashed potatoes at a restaurant is enough to send me in a tizzy--before doing so, she would need to have tried white potatoes, milk/cream, butter, pepper, garlic, other seasonings, potentially other things I'm not even thinking of right now...and I'm terrified of dairy. I need to just give the kid yogurt and see what happens but I feel like before I do that, I need to meet with an allergist and have her tested. Ridiculous. She is not going to go into anaphylactic shock from a cheese cube. I am completely confident in that. So why the hesitation? And so what if at 12 months old, she isn't magically eating chicken nuggets and toddler muffins...? But how will she transition to the 1-year classroom where they feed them meals and snacks? And what about her birthday cake? She can't have frosting if she's never had dairy.

Seriously.

Yes, I hear myself.

So those were the things going through my mind before even being called back for her visit. So on the medical side of things, unfortunately, she still has/or developed a new ear infection. This is concerning because it is possibly the third ear infection since Thanksgiving. So some doctors start thinking about whether tubes are necessary (our doctor is not saying she needs tubes, just to be clear). So the pediatrician referred us to an ENT in town next week. Personally, I do not think tubes are warranted. I really, truly think this is allergies (or whatever the equivalent to allergies is in a 9-month old since allergies don't happen to babies...)/sinus issues. Chad and I both have allergies so she got hosed on the genetic lot for that particular problem. What if her ears are infected solely because she has had chronic sinusitis? Hopefully the ENT isn't 'tube happy' and will consider this as an option. Obviously if he recommends tubes, we would seek a second opinion. For now, we started her back on Suprax again. It seemed to help last time, at least while she was taking it.

The other issue we discussed at length is her lack of mobility. Although her teachers says she will roll at daycare, she almost never rolls at home (and they note that she rolls with less frequency than her peers). She is not crawling and she does not try to pull herself up. I've said before, I'm really not concerned about this. Developmental stages have long ranges of "normal". Her pediatrician also is not worried. However, she did say it might be a good idea to get a developmental evaluation just to make sure she doesn't need physical therapy. That said, while in the office, Alaina was standing with assistance and sitting up, sometimes pulling her knees to her chest. The doctor laughed at this and said this was evidence that her lack of mobility is very likely a motivation issue (or focusing her energy elsewhere, like on social or communication skills) rather than it being a gross motor delay. She noted that she has great posture and flexibility and is very limber. Anyhow, I have a call in to SoonerStart, our early intervention program for an eval. I'm actually a little excited about this because during my residency/internship, I did a number of developmental assessments for kids ages 0-3 and I've always wondered where Alaina falls in the various aspects; obviously I'm not going to test her myself. But I am a huge proponent of early intervention so if she does need therapy, I am glad we are getting assessed. Hopefully we can get some exercises to use with her at home, too.

I am trying to increase her food now, too. She's just been getting 1-2 tablespoons of food each day. So, starting today, I sent food to daycare as well. I had delayed this because I needed to order small glass bowls with lids, which came in yesterday.
And I'm alternating sippy and straw cups at dinner now.

Progress. But ridiculous how one appointment can cause such self-doubt and "mom guilt." And I didn't even get into the long, ugly thought process about nursing and preventing ear & upper respiratory infections...
But back to the topic at hand. Most moms are far more than "good enough". Long discussions with other moms about how "terrible" you are is just co-rumination at its worst and will exacerbate stress. So while it's one thing to feel terrible, I am promising myself (and my friend and her husband) not to engage in this destructive self-talk.

Anyhow, that was a whole lot of random rambling. Clearly baby girl is doing just fine. She's even starting to help around the house... ;)

New Years Eve...fun

Unfortunately, Alaina got really cranky this past Sunday evening and she has had a fever. It's ranged from 100-103. I ended up being awake with her most of the night from midnight to 4:30 am. Poor thing was so unhappy. She just wanted to sit in my lap. All.the.time.

On Monday night, we gave her infant ibuprofen at the advice of the after hours nurse line (since her fever was 102+ and ibuprofen is supposed to last longer than tylenol). Well, it brought her fever down quickly but it turned out to be a big mistake. She was wired and restless and refused to sleep for four hours.

Needless to say, she was not enjoying 2013.

Once we finally got her to sleep, she stayed asleep until 10:30 am though! She has never slept so late. She was feeling happier during the day.

I noticed that she was also fiddling with her ear and holding her head so this warranted a doctor's appointment. As we feared, another double ear infection. Poor thing just can't get a break. Her eating has also been really erratic. I know that she's obviously a chunk but it hurts to see that she's gone from the 99th percentile in weight to the 40th. She is obviously healthy, though. I just get too wrapped up in numbers and stats. Here she is pushing up. Still no crawling, pulling up, and very little rolling. She talks a lot, though. And she's off the charts cute.