note to self: next time, sell tickets

To the very pious children who stumbled on Aleph naked from the waist down in my parent's yard; then stood staring in a row, nervously fascinated half-smiles on their faces, whispering to each other (-Why are you looking? -I'm not looking! -[gasp] He put his hand on it!):

I'm not sure whether to say I'm sorry for the free show, or You're welcome.

Also, you really should have stuck around for the finale, when Bet and Aleph stood in a row and peed into the grass in synchrony.

in funnier news

Scene: Naked potty practice time at dinner. (What? Doesn't everybody do that?) Bet is looking down and pinching his penis, which usually means he's about to/has just begun to pee. I lean over to see if I need to intervene. Actually, it looks like he's... pushing his penis?

EEMA: What are you doing, Bet?

BET: I'm trying to put my penis back inside.

EEMA: [snort] Why [on earth] are you doing that?

BET: Because there's no pee in it right now.

***

Scene: Walking out of the subway.

BET: Look, somebody dropped a cheerio!

EEMA: Yeah, I guess they did.

BET: Somebody's like, hey, where's my cheerio!

PSA: but isn't carrying an epipen enough?

After being asked almost the same (entirely reasonable, considering public awareness campaigns on the subject) question by both a sister and a good friend - not to mention reading the story of someone who was well-trained on when to give her child the epipen, but was never told to call 911 immediately afterward* - it occurs to me that it might be useful to put the answer in writing.

So. Fun facts about epipens:

1. Epinephrine is the equivalent of... first aid. You give it because it is fast-acting; it is, for the same metabolic reason, fast-used-up. It can halt anaphylaxis within minutes. Anaphylaxis can recur minutes later as soon as it wears off.

This is why you want to be at the ER by the time it wears off.

2. Even if there is no immediate recurrence, another wave of anaphylaxis (in fact, the first instance) can come hours or days later. Evidently that's how an allergic reaction works: it peaks and fades, peaks and fades.

This is why, even after epinephrine, they will dose you to the gills at the ER. Something strong, but more important, something long-acting: generally, a combo of steroids + antihistamine + albuterol. They will track your vitals for the first 6-8 hours to make sure it's all working, then send you home on same for the next 4 days. All to make sure anaphylaxis doesn't come right back.

3. Epipens can misfire, expire, be rendered impotent by exposure to heat or cold, or sometimes simply be used too late to halt even the first wave of anaphylaxis.

This is why you might want more than one epipen on hand, even before the ambulance arrives. And why, although epipens are a solid part of an emergency plan, you don't want to count on them too much in the first place.

* Not to mention, most mind-boggling of all, the advice of a pediatrician friend that we could "just try" giving Aleph some rugelach at the shul kiddush and see if he reacts; "I mean, you have an epipen." There are so many things wrong with this I... well. To begin with, see all of the above. Then the fact that baked goods are one of the highest categories of risk. Then there's the lack of basic understanding of how cross-contamination works: if there is one peanut in the whole batch of rugelach, the fact that the last bite caused no reaction doesn't mean the next one won't. Finally, there's the fact that even though epinephrine usually works, anaphylaxis is a life-threatening condition. Would you try something just to see if it gave you a heart attack? Even in the middle of the ER?

I mean, maybe some people would. Me, no thanks.

disappointing the chilluns since: June 2009

More on the doctor's plot (it thickens) and the other brother (he's keeping us hopping, too) later. In the meantime, a quick scene: Shabbat dinner. You may want to hum one of Aleph's favorite songs while you read.

***

ALEPH: Is there [my favorite] butternut squash kugel?

EEMA: No, I'm sorry honey. I was all ready to make it, but then I realized I need to call the flour company, and the sugar company, and the baking powder company.

ALEPH: But... do they have mouths to answer you?

EEMA: [try not to giggle] [explain]

ALEPH: Well, what is there to eat that's special?

EEMA: Well, uh... fish?

ALEPH: Gefilte?

EEMA: No.

ALEPH: Salmon?

EEMA: No.

ALEPH: Oooh, I know. Is there chicken with sauce?

EEMA: Not exactly, honey. I roasted it with olive oil, lemon juice and garlic. See?

ALEPH: But... that won't taste saucy in my mouth.

***

Note to self: learn to make [nutfree mustardfree] mango chutney or teriyaki sauce or for pete's sake, at least duck sauce from scratch. Getting right on that.

haven't QUITE got the hang of this yet

Even when I think I know what I'm getting into, I don't.

***

Dinner today: french toast. One of Aleph's surefire meals, dunked in Vermont maple syrup. Bread (label: lists allergens other than nuts), eggs, milk, cinnamon (oops! forgot to check it.)

Time to serve it. Double oops. Maple syrup? Label says nothing. Jam? Label says nothing. Confectioner's sugar? Label says nothing.

Serve french toast with nothing.

Unsurprisingly, Aleph hardly touches it.

***

Dinner yesterday: veggie burgers he's had many times before (label: lists allergens other than nuts; vegetable proteins declared in detail), avocado, ketchup for dipping. Oops! Ketchup label says nothing.

Remove plates. Scrape ketchup off Bet's portion. Take Aleph's portion away completely; replace with untouched-by-ketchup portion. Scour fridge for something else to dip in. Chummus? Label says nothing. Salad dressing? Label says nothing. Finally settle for mayonnaise (label: lists allergens other than nuts.)

Aleph licks his plate clean.

And ends up with a bright red rash around his mouth.

***

2 days until the new allergist appointment. And counting.

the best defense is a good... wait, i think that's supposed to be me.

Aleph, on being carried out to the ambulance: [wailing] Nooooooooo! I want to go to the rocking chair!

Aleph, on being stuck in an ER bed for hours: When is this going to be finished? I can't wait to go home. [confidentially] How do we get out of here?

Aleph, on being released from the ER: [bouncing like a pogo stick] That was fun! [Eema: WHAT?!] Well, not the part that hurt. The other parts.

***

I'm trying really hard not to kill him, this boy of mine. We spent the most depressing shopping trip of my life crawling up and down the snack aisle together, trying to find Shabbat treats that won't land him back in the hospital. [Unsafe: 3,005. Probably safe: 2. Definitely safe: 1.] I wanted him to participate, because he needs to start learning right. now. that no food is safe for him unless we check the ingredients.

But witness the list of things I absentmindedly gave him to eat this past weekend, then smacked my forehead: Ice cream. Bakery challah. Craisins [label: processed in a facility that also processes peanuts]. Who knows what else.

The thing is, we've been avoiding peanuts for over 1.5 years, so I thought we knew how to do this. But that was for a mild external reaction, rash only. We were advised to carry an epipen, but not to even bother about "may contain trace amounts" unless of course it gave him another rash. This was a full-blown anaphylactic reaction. This was you don't know how minute an amount can trigger it, and you don't want to experiment either, because what if your epipen fails, or your cellphone battery dies, or the ambulance gets stuck in traffic. This is a whooooooooole new ballgame.

If all you're avoiding is actual peanuts, that's pretty easy. Suddenly we're trying to avoid the theoretical possibility of the former proximity of peanuts. I'm completely clueless. I am starting from square one.

Another thing that just dawned on me: those two or three times when Aleph threw up repeatedly for 24 hours, but had no other symptoms? Almost certainly an allergic reaction. Either to something I don't even know he's allergic to, or... something I didn't know was contaminated with peanuts.

Poor kid.

smart. aleck.

ALEPH: Eema, can you can you can you-

EEMA: I can't do anything right now. I am changing Bet's diaper.

ALEPH: Well if you can't do anything, how can you change Bet's diaper? That's doing something.

Seriously, how can these children not be toilet trained yet??? Aren't they in preschool law school by now?

the world according to aleph

I let the kids watch Bob the Builder today. Afterward, I heard Aleph singing the theme song.

Of course, in Aleph's version, it goes like this:

Can we fix it?
NO WE CAN'T!

Nobody who knows him would be the slightest bit surprised.

toilet training twins: take three

OMG. Am running away to join circus.

Pls have this taken care of by time I get back. Ok?thxbye.

on today's agenda:

• send hard copy of complaint letter to AMA and NY State
• order medic alert bracelet for Aleph
• expunge all traces of grownup peanut snacks from house
  
• expunge all traces of experience from my brain

If you know me at all, you know that I have a hard time bouncing back from trauma. I relive. I rehash. I obsess over what almost happened. I obsess over what should never have happened.

By most accounts, I did very well in the moment. I watched Aleph like a hawk after he licked that peanut butter, even though I'd been assured it would be fine. I called our pediatrician when things started to go wrong. I almost took Aleph alone to the ER, then caught myself and called an ambulance instead. I sent Lance running to get the ER doctor back as soon as the wheezing started. I was there for Aleph every minute.

The ambulance guy told me I was an amazing mother: so calm. I didn't try to articulate the difference between calm and extreme adrenaline-haze.

But it's clear to me that I'm struggling now. Well, Aleph (and Bet, in different ways) was struggling for the first few days too. He was probably still physically uncomfortable; he was definitely still emotional, crying at the slightest frustration, scared of anything medical, needing to be in close contact with me at all times. Also overtired and overwired, on the prednisone (I'm sure it was no coincidence that he scaled his crib like Mount Everest the very next morning.) But he's almost his old self, now.

I'm the one who felt heartsick for days every time I looked at his puffy (also from the prednisone) face. I'm the one who has flashbacks to when I had to hold him down for his epi shot - he jolted when the needle went in and screamed, like it was horribly painful - every time he cries and says "don't do that, it hurts" during a diaper change. I'm the one who got nauseous when I found the allergist copay receipt in my wallet.

This would have happened sooner or later, and it could very well have ended worse. But I can't get over the conviction that it should not have happened now.

I am still angry. And I am still scared.

2 peas in a pod

The only reason anyone in our house is sleeping right now:

the Peapod Plus

I thought I was prepared for this day, really I did. What I didn't realize - until the side railings actually came off - was that these are useless on a non-Ikea setup. It's true, they do attach to our cribs just fine; but they don't even come up as high as the top of the mattress. Ikea must have waaaaaay flatter mattresses.

(Does anyone else walk around Ikea feeling like all the furniture looks normal... except that it's 3/4 scale? Like, a dining room table only comes up to your knees? Aren't people taller in Sweden? What is going on?? But I digress.)

So anyway, we bought these for a bat mitzvah weekend where the hotel had no cribs, and knowing we might only use them once - if the kids even consented to use them at all - I kind of winced at the price beforehand. But it turned out to be one of my best purchases ever. The kids loooooooove them. They put their stuffed animals to sleep in them. They zip themselves in and out of them. They slept like logs in them. (Well, at night anyway; Bet can be a little nap-challenged, even in his own crib.) They - and this is my fervent hope for tomorrow - they didn't even get out of them when they woke up.

We should own some standard guard rails by the end of the weekend, and if not, we can always say goodbye to their cribs and put mattresses right on the floor.

But for tonight, my boys are camping out.

And I was kind of tempted to join them.

excitement of an entirely different sort

Drumroll please:

Aleph - finally - climbed out of his crib this morning.

Climbing is a generous word for what was, if the reenactment can be believed, more of a perch on the railing + flying leap into space.

Needless to say, railings are out of here.

Let the new (miserable) era begin.

what have we learned today, children?

So Aleph had his long-awaited allergist appointment today. He was tested for, it seemed like, 40 different common as well as history-specific allergens.

This is insane, by the way: they don't numb the skin beforehand, even for children, because it interferes with the results*; they test the child on his forearm, so he is looking right at the needles as they prick him; they do the pricks one after another, presumably so as to give maximal time to scream and try to get away; and then, when they finish the first forearm, they START ON THE SECOND ONE.

How many 3-year-olds do you know who would hold out that second arm?

Aleph was a trooper. He didn't start complaining until prick #36 or so, and then he said "This hurts a little bit. When is it going to be finished?" I will only take a tiny part of the credit, for my last-minute brainstorm of giving him the lollipop as pain relief during the test, instead of a reward right after the test.

So we wait the prescribed 20 minutes, and they take a look at his arms and say "He's allergic to chocolate and soy."

Huh? and OH NO! I say. He has both of those things all the time, he never reacts to them as far as I can tell, and oh he is going to be so.sad. if he can't have any more chocolate. Poor baby.

"Well, they were mild reactions. If you don't notice those foods bothering him, you don't need to restrict his diet."

Uh... but what about peanuts and mustard? The reasons we came here in the first place?

"Negative for both those things. Either he was never allergic, or he outgrew them."

Really??? I am dancing just slightly for joy.

"Opens up a whole new world, doesn't it?" Everyone beams. They shoo us happily out of the office.

Can you see where this post is going?

We come home from the allergist. Mary Poppins gives Aleph a spoonful of peanut butter to celebrate. And BAM! we spend the entire rest of the day at the ER.

Aleph went in short order from: making a face like he can't get it off the roof of his mouth --> crying --> throwing up --> lips and cheeks swelling up like a very sad chipmunk (have you seen that scene in Hitch? I thought they were exaggerating; and they were, but only a little) --> not getting any less puffy on Benadryl [note: somewhere here is where we called Hatzoloh] --> finally getting less puffy under observation at the hospital --> starting to look like himself again --> coughing a little --> coughing a lot --> wheezing so hard I was afraid he'd die before the doctor came back around the corner with his epi shot.

Seriously, those were the scariest 2 (million?) minutes of my life.

So he's fine now, albeit on a course of 4 different medicines for the next 5 days, and I am so - what's the word I'm looking for here. Angry? Relieved? Grateful? Wired? Spent? Yeah. I think that's it.

The end.

*I didn't want to give this away, but HA HA HA HA. HA.

we put the "dysfunctional" back in "fun"

Scene: Harmless playing. Apparently too boring.

BET: [apropos of nothing] NONONO NOTATALL, Aleph!

ALEPH: [does his latest move: thrust hand out as if to hit Bet, but stop right before his face.]

BET: Eema, Aleph is trying to hit me!

EEMA: I hope think he's just pretending. Listen Bet, do you remember what happens when you say nonono notatall?

[note: we're looking for "it makes people upset" here.]

BET: Yeah. People try to hit me!

another bagel summit talks breakdown

ALEPH: I want two halfs of bagel. I'll save one of them for you, Bet.

BET: I don't want a half of bagel.

ALEPH: Then I'm gonna eat two of them.

BET: I want one! I want one!

ALEPH: Then I will save one for you.

[pause for smiling / munching]

ALEPH: Why do you keep switching, Bet?

BET: [still smiling] I don't know. Just because.

ALEPH: But you have to say yes or no.

BET: Nononononono! Aleph don't talk to me! That is not okay!