Friday, November 28, 2008

anxiety

ok, i'm going lower case for this one, maybe to blunt its powerful commentary on our current worldview and the state of affairs in just about everything in america, but definitely in the area where i 'live', pediatric medicine. and for a deeper spiritual assessment of anxiety, look for my wife's blog on this subject to be added today at feedingthespirit.blogspot.com.
lots of anxiety exists when it comes to taking care of children.
i was sharing in this anxiety until recently, or at least sharing more in it, i can't just drop it completely any easier than you can. but i sure got a different perspective on it after listening to my favorite radio pastor, alistair begg, on november 7, 2008. much of what i'm writing he says in his podcast. no, i'm not putting myself in the place of God, trust me. i'm not qualified and i definitely don't want that job. i'm more in the ballpark with the airline pilot alistair mentions. it is this part that resounded with me so much.
if you are anxious on an airline flight, worried about crashing or the landing gear engaging or the weather or anything, to some extent you are thinking that you could do a better job than the pilot. despite no pilot training, you are at least, and probably/hopefully unconsciously, acting as if you could handle this situation better than the pilot. do you understand this concept? you have 'submitted' to the expertise of that pilot at least implicitly and once again possibly unconsciously. you know that, given the stick or the wheel or whatever they have to fly a plane, you couldn't handle it. sure, there are safeguards, like in the movies where someone comes from seat 23B and saves the day by landing the plane. but that's a movie.
i know the analogy breaks down when i translate it into patients as passengers and doctors as pilots. but hopefully you see the analogy to the degree that it applies.
the patients (i.e., the parents of the patients) often (very respectfully in general) question everything that i'm doing and recommending and have specific guidelines that they want to follow for their child/ren. these are often scenarios where i can easily say 'good luck' with an 'i'm sorry' ready for later when my advice should have been followed. i envy dr. phil his 'how's that working for you?'
i want to let you know that i really and truly share your concerns about your child/ren. and i really and truly do not want to harm your child or have anything i do or recommend turn out badly for you or your child.  there can be times when i'm wrong. i admit it, i've been wrong in the past, i'll be wrong in the future. i don't mind having my judgment questioned at times, and i understand the anxiety created by our current worldview that we are in control of everything and we have to get it all right every time or awful things will happen.
this is the most important piece of information i want you to grasp. you're not in control of things. i'm not in control of things. God is in control of things. regardless of how it looks at times, in the big picture, He's got it covered. we are supposed to rest in that. yes, you have to get up and feed and dress your kids and take care of them and yourself. i have to get up and go to the hospital and the office and give my advice and my prescriptions and you still have to go to the pharmacy and get and give the medicine, but God is in control. sometimes He concerns Himself with the tiny details of things - have you looked at your child lately and wondered how he/she started as a sperm and egg and ended up with ten fingers and ten toes and an attitude? He 'formed that child in your womb' it says in psalms. but as a society, as a world pretty much to one degree or another, we've stopped believing in a God who does all this and takes care of both little and big things, and guess who that leaves to handle everything? us! and that's scary! so i understand from whence the anxiety comes. listen to the world. read the world's opinions on things. but think of yourself as looking from sort of a google earth perspective, looking from a distance, and realize that you aren't in control and then be very grateful that you aren't supposed to be in control. and be very thankful that i'm not in control. i'm constantly looking to God, believe it or not, because i am very aware of my lack of control over things. regardless of what the world's wisdom tries to tell you, man's greatest wisdom is foolishness to God. if you can reset your worldview, and i have to do it daily, and recognize that we're all here because He wants us to be, and we're all doing what He would have us be doing, you will sleep easier tonight. you won't worry so much about sleep position and introducing solid food and bisphenol a and melamine and autism, you'll be more content with the stuff you've got to do, like the mundane 'get up, feed the baby, change the diaper, clean up the spitup, take a shower...repeat'.
in over 20 years of practice i've seen the number of concerns rise exponentially. it's amazing what people can be concerned about. some are given to this mentality from the start, and that's almost understandable, but sad, but many otherwise confident people become overconcerned lunatics where their children are concerned.
to summarize: i see myself as the pilot. i have the training, the expertise, and the skills to do the job for which i've been called, and for which i've been hired by my patients' parents. most have picked me from a very good lineup of possibilities, so that says hopefully that my expertise is appreciated somewhere. i know Who is in the real pilot's seat. He's not my copilot, by the way, i always thought that was a very prideful statement.
i don't begin to think i know everything. as my daughter, who is a first year med student, was told as her year started, 'half of what we teach you will be wrong in the future, we just don't know which half'. i understand that sentiment completely and could state it categorically at each visit. anyone who says or even thinks he/she knows it all at any given moment is seriously deluded and should be avoided. i have opinions, i have experiences that have taught me certain things i hold as truths, sort of like the pilot keeping the plane in the air and landing it safely. i also have areas where i question myself, my thoughts and practices, my feelings about how to accomplish certain goals and whether or not those goals are even important. much like the pilot who could choose more than one route from new york to los angeles, he has flown many of them many times and has picked the one he thinks is best based on his experience and guidelines he must follow. the takeoff and landing he knows will not differ much from airport to airport but the air in between could be clear or choppy or downright turbulent. in my case i 'take off' with many of you each time a new baby comes. 'landing' is way in the future, so we're stuck with all the air in between, and for the most part, as long as we don't crash, it's going to be fine. the time from takeoff to landing will differ, the route taken will differ, the pilot (with trust in a God who is in ultimate control) knows that he's going to get them where they're going in the best shape and in the best time possible. but the passengers must trust the pilot when he says 'sit back, relax, and enjoy the flight'.

Thursday, November 27, 2008

melamine

OK, what should we worry about? Is my kid (or am I) making little plastic pellet kidney stones as we speak? Why didn't someone keep this from happening? Why didn't they tell us sooner? 
First, it's likely that some amount of melamine or similar contaminant(s) has been in our food supply for quite a while and we are just now finding out about it. Last year it was cats and dogs, now babies who may suffer. One big lesson - look really hard at things 'made in china'. Sure, there are lots of good things made in china, and we probably couldn't get along in our current society without many of them. Another last year thing that had a 'china connection' (isn't it funny how 'last year' is so 'last year'?) was lead in the paint on toys. That passed, not too many people are asking about that lately. But still, consider whether you want to put something in your mouth if it's made in china. Just a warning. 
Second, related to the previous sentence, this will be 'last year' next year, so don't freak. I'm not envisioning kids peeing plastic pellets out at their parents during diaper changes.
Third, what else is there in our food and environment that's not good for us? Back to a paraphrase of a friend's quote about whether we should be concerned about the plastic in water bottles, etc., "when people aren't eating junk and getting obese and having diabetes and high blood pressure from doing stuff they know isn't good for them, then we can start worrying about the stuff we aren't so sure about...". Good, no great, point.
A story that I've used with my kids from time to time comes to mind as regards things that are present in things we are consuming (eating, watching, listening to, you name it): When her kids were watching movies that had 'just a little bit' of bad language and some sexual innuendo in them, a mom decided to teach them a little lesson. She baked them some brownies, and before they had eaten any she told them that she had put a little extra ingredient in the brownies. When they asked what she had put in, she replied "canine fecal matter" (which I will henceforth refer to as d.s. for those of you with sensitive eyes and I'll let the rest of you figure it out). She said she had put in 'just a little bit of d.s.' and that they wouldn't even notice that it was in there. Then she asked them if they wanted to eat the brownies.  They wouldn't eat any. They said that 'just a little bit' of d.s. spoiled the whole batch. After an appropriate period of time, during which they ranted and raved that she was nuts and they couldn't believe she had put d.s. in the brownies, she asked why 'just a little bit' of d.s. bothered them so much. They continued their protest until she asked if they knew where she had gotten the phrase 'just a little  bit'. When reminded of their use of the phrase regarding their choice of movies, they were forced to admit that 'just a little  bit' of bad can definitely spoil some things, and maybe it would spoil anything, especially once they were made aware of its presence.
OK, sorry, long story, but even 'just a little bit' of dog poop in anything is generally unacceptable. Well, I'll take that back, we've been told there are 'acceptable amounts' of insect parts in some of our meat products for years and we still eat hot dogs, so I'll give you that one. But in today's culture in America, we're all about full disclosure and responsibility so we agonize over shots with mercury in them and bisphenol A in plastic cups and bottles and now we have melamine in baby formula. Thank you, FDA. Or is ignorance bliss? Once informed, we're determined to get rid of whatever we've just discovered is present, and we're also quite inclined to blame everything from autism to global warming on whatever is this year's dog poop.
I guess one response would be to pull all baby formula off the shelves immediately. Hopefully you can see the problem inherent in this solution. We could vilify the makers of the 'tainted' formulas, except it seems that not all of their formula lines had melamine, just some. 
We could switch to 'safe' formulas, and I guess for now this is the best solution. When the next d.s. discovery is made, another group will be taken off (or put on) the list. Interestingly, one formula from each of the 'big 3' makers of formula contained some melamine or its byproducts, so no one was innocent, except maybe the Target and Walmart generic brands made by Wyeth Labs. Man, I wish they'd found some in the Walmart brand! The evil empire. The antichrist. Well, I really don't wish that because I have lots of patients on that formula and recommend it to patients often, so my interests shouldn't be put above the health of those babies.
My overall point is: remember lead paint in toys and bpa in bottles, they're pretty much 'old news'. 'Last year'. You can take it two ways. One, we are a 'what's in front of us is important regardless of its importance' society, so don't forget 'last year' stuff. Or, we are obsessed with our perceived control of everything and are disappointed when it gets proven that there are things beyond our knowledge and control, so don't worry too much and remember how many things have failed to live up to their gloom and doom predictions and have become 'last year's' concerns.
Stay tuned for my (maybe) next blog about how anxiety reveals the absence of humility and how we should 'sit back, relax, and enjoy the flight' rather than trying to fly the plane from 23B. For an audio on this from Alistair Begg on Truth for Life, where I stole these phrases and ideas, go to truthforlife.com or .org, I can't remember which, and go to November 7 "a Biblical approach to anxiety". For the whole deal, go back to the 6th and listen to it all. I'm praying for a kind heart as I write this blog! 

Thursday, November 6, 2008

'new' old parenting book

i have always remembered - and taught patients - the parenting lessons taught me by barbara coloroso in 'kids are worth it', but when i was learning these, they were available only as tapes, and they were very good, and very funny, and obviously made a great impression on me and my parenting style and teaching of parenting. so i 'rediscovered' the book version of this book and i was scanning it this morning and wow! it's everything i remember and more. i highly recommend going to amazon or wherever you go and search 'barbara coloroso' and 'kids are worth it' and get it. it's old enough that the shipping is more than the book, but it's very worth it, and will reveal to those of you who are patients of mine where i've stolen a great deal of my material. i'm going to add it to the bibliography of recommended books on my handouts, but i thought i'd share it in this venue first, for those of you blog-savvy moms and dads who check out 'radical thoughts' every once in a while. 

Wednesday, November 5, 2008

fall colors

Regardless of whether your guy won or lost yesterday, you will be happy to know that the trees are still beautiful this fall, not seeming to really care who the president-elect is or what his stance is on health care and other social issues. So nice to see that at least part of my world doesn't fret about gas prices or wars or the economy or autism and vaccines and plastics and sleep positions and antibiotics and yeast overgrowth or to spank or not to spank - you see that I need something to look at that is not commenting on or asking me about or for something. This year, and I probably will be told that I say this every year, the trees are the most beautiful I can remember. 
Not being a real outdoor person, I still love the fall. It is my favorite season, and it has nothing to do with football. The colors that come from green leaves amaze me every year. Even though the wind pretty much blew away the gorgeous reds of the maples yesterday, I have discovered a new favorite tree for this season. In the windy line to vote yesterday, I was told that this tree is the Chinese pistachio, but I don't know for sure, the guy who told me looked like he spent as much time in his yard as I did this year. Whatever it is, it has replaced the Bradford pear as the "parking lot tree", and I guess I was blind to it until this year.  
Here in Edmond, the most beautiful tree, or at least it's in the top 5, is on an ugly corner by a gas station at 2nd and Coltrane. It is the type of tree I was describing previously, so if anyone knows what it is, let me know. But it is so many colors that I couldn't even describe it adequately. It goes from orange and yellow to red and some leftover green, and pretty much every color in between. 
Just driving on the turnpike is a feast for the eyes right now. I'm impressed that someone was thinking enough to plan the trees along the Kilpatrick, especially at the intersections, especially at I-35 coming from the north.
The wind didn't spoil all the beauty at all, and maybe it even helped get rid of some old stuff that was in the way of new beauty. Even the cloudy/rainy skies this afternoon provided a backlight for some of the most orange/yellow trees that they seemed as if they were on fire but not being consumed a la Moses on the mountain.
So, to end this rambling, I am reminded that whatever happens, happens because the Creator made it happen, whether it be trees or presidents-elect. He's got our best interests in mind, regardless of how it may look at times. I've heard it said that He lets us see the back of the tapestry He is weaving, and I'm pretty pleased with the fall colors He's put in this year's addition to that tapestry.