by himself (a lighter post)

Last week, I read The New Strong Willed Child by Dr James Dobson. It was a good read, very interesting to me, as the things he discussed are things I deal with every day. He described some general differences between a relatively compliant kid and a very strong-willed one. Of course, every child has a will of their own, but there are some who are just stronger willed than average. That is Nate. (Ben's more compliant.)

To sum up the advice he gave, in a few simple words (paraphrasing his own summary): Choose your battles and win decisively. But that's not really what I'm thinking about today.

One of the points he makes (as he does tend to rant quite a lot about permissive parenting and parents who do everything for their kids) is that anything kids are capable of doing on their own (even if they don't do a really great job), they should be doing for themselves. I don't think this goes for strong willed kids any more than compliant ones. It's good for any kid to do for her/himself what s/he can.

Nate has been bathing himself for several months now. He does not do a great job washing himself. Once a week, Rodgers or I will wash his hair for him, and one of us washes his face/neck/ears every night. Of course we do still clean him after he goes to the bathroom. He washes his own hands throughout the day.


I brush his teeth well at night, then he has a turn brushing. He brushes by himself in the mornings. He loves brushing his teeth, but again, doesn't do a great job.


He cleans up his own toys. If he's made a big mess, it overwhelms him. I think he honestly doesn't know where to start, so I help with that one. I give him bit-by-bit instructions: put all of the yellow blocks away, now the blue ones, put the cars in the basket...


Most recently, I rearranged the shelves in the boys' room, where we keep their clothes and extra diaper inserts/accessories. Nate's clothes are now on the lowest shelf (the only one he can reach), and he is responsible for picking out his clothes in the mornings. I tell him to get some undies (he wears a diaper overnight), shorts, a t-shirt, and socks if we're going out. We've been doing this for 3 days, and so far, he seems to be loving it. He does not like changing clothes, maybe because he doesn't like that I'm undressing and dressing him, rather than doing it himself. But, he seems to feel more in control if he's the one picking out his clothes. Now, to teach him how to get dressed on his own...

And something fun, for good measure

EDIT: I should add that doing things on his own doesn't mean he won't put up a fight. It doesn't mean he obeys all (or even most) of the time. There are still times when I end up scrubbing him in the bathtub, as he screams tortured screams, because he wouldn't wash himself. We both prefer him to do it, but he has to test regularly, "What would happen if I don't obey?"

Kenyan hospital

This is kind of a saga. It's the first time that one of my kids has been sick, so I'm sure I'm a little more emotional because of that. But, still. It's a doozy. We only saw doctors in the US for well visits, but I rather think they would have treated this illness differently.

Ben had a fever Friday evening. It was 101-102, but went down with paracetamol. Saturday morning, it was 99.5, so we decided not to take him to the doctor. Going to the doctor in Kenya is actually going to the hospital. There are neighborhood clinics, too, but it's better to go to the doctor at the hospital.

Saturday afternoon, his temperature was going up again, so Rodgers took him to the children's hospital. We don't have a lot of faith in them, but they are our best option right now.

A young doctor examined Ben, said his sinuses and ears were clear, but he had some inflammation in his throat. He would not specify which part, just that it was in his throat. They drew blood, which they always do when a kid comes in, so that they can look at the white blood cell count. This young doctor left the hospital after giving Rodgers the lab orders. Rodgers called me at that point, and I assumed the lab orders included a strep swab. Nope. They don't do those; just a white blood cell count.

The supervising doctor (SD) then took over. He never looked at Ben; he just read the file. This is normal. Only the  newer doctors and nurses actually look at the kids. They make their notes. Then either this SD or the head doctor (and owner of the hospital) reads the file and makes the final decisions.

The SD told Rodgers that Ben had a viral infection in his sinuses. Rodgers argued that the other doctor said differently. The SD wouldn't hear it. He was reading the file. He told Rodgers what virus it was, but Rodgers couldn't remember the name later. He did remember the symptoms, none of which Ben had besides fever. SD then told Rodgers that Ben needed to be admitted to the hospital for a few days. Rodgers asked why, but the SD couldn't give a reason, so Rodgers refused. Our confidence in their competence had dropped considerably.

The SD reluctantly sent Rodgers and Ben home, with several types of medicine. He had something like ibuprofen, antibiotic, saline nasal drops, and another nasal drop. Having been told Ben's sinuses were clear, though the SD said the file said differently, we weren't sure about giving him the nasal drops - I didn't even know what kind of medication they were (besides the saline). I also didn't want to give him an antibiotic when we were told he had a viral infection, regardless of the fact that he had no symptoms of that virus. We just didn't really know what to do. His temperature was down for the moment, so we put him to bed and started googling the medications to find out what we'd been given.

Rodgers called the receptionist at the hospital, to find out if the name of the virus was written in Ben's file. Then, at least, we could look that up and see what we were (potentially) dealing with. The file said that it's a bacterial infection. Which bacteria? Well, to find out, we'd have to do a culture, and that takes a long time. (Later we were told that they just don't do cultures for babies unless it's for research because it doesn't much matter what the kid has [whether it is bacterial or viral and what type], they are going to treat it the same way - antibiotics.)

So, we started giving Ben the antibiotic Sunday morning. Towards the afternoon, he sounded congested, so we started the nasal drops then. Not long after that, his temperature went up, fast. He was playing one minute and could hardly hold his head up the next. His temp was over 104, so Rodgers took him back to the hospital, after I gave him some more paracetamol.

They gave him IV antibiotics and a fever reducer (he hasn't run fever since then). Again, they refused to do anything to determine what Ben was actually sick with, but they did want to do a finger prick/blood smear to test for malaria, again (they did it Saturday, too). They insisted that Ben be admitted. Rodgers called me then, to tell me Ben was being admitted, and the doctors were refusing to determine what the infection was.

One of our friends came to get Nate and me later, so that we could go up to the hospital. I could make sure that Ben wasn't dying, and Rodgers could tell me what was going on.

I stayed with Ben in the hospital overnight, and Rodgers took Nate home to sleep. He seemed to be fine, but couldn't rest well, with other kids screaming all the time, people slamming doors, and the lights being on 24/7. We were in a semi-private ward, which was better than the general ward, but still not a place conducive to recovery.

Monday morning, Rodgers and Nate came back, and we started trying to get discharged. They still wanted to keep us until Wednesday or Thursday. Ben did obviously need the IV antibiotic on Sunday, but now that he'd had it, he was fine. Staying in the hospital would prevent him from being able to rest, as well as expose him to other illnesses when his immune system was already fighting an infection. Not to mention that it was an unnecessary expense for us. Being that Ben was in the higher-priced semi-private ward, we knew they wouldn't let him go willingly.

Around noon, the owner of the hospital finally came in. She wanted to be the one to discharge Ben, if he was to be discharged. I think she knew we weren't happy with their refusal to diagnose him or with their standard of care.

She asked when we started giving him the medications at home. I told her when. She was confused. The doctor had given us those meds and told us to give them to Ben. The doctor! I told her why we didn't want to give them, that they didn't correspond with what we'd been told Ben was sick with. She then proceeded to explain why we were given those medications. They won't do a throat or nose swab to test for bacterial infection because there are just so many types of bacteria present normally. Yes, Ben had a bacterial infection, but he would have been given antibiotics for viral infection, too. You see, in Kenya, the weather is different than in the US, so they have to treat everything with antibiotics. She said that some people from the US Embassy in Nairobi come to Mombasa from time to time. They were recently interviewing hospital owners to determine where they would take their kids if they needed a doctor while in Mombasa. They asked how often she gives antibiotics. She told them the same thing about the weather being the reason they give antibiotics for everything and that at least 80% of her patients will be given antibiotics. It doesn't really matter what the actual diagnosis would be (if they bothered to determine one), they just give them antibiotics. Her theory for Ben's infection is that it was caused by the weather.

We insisted she discharge Ben, and she did. It took a few hours to get out of there.

Ben has been happy at home, sleeping well in his own bed. This morning, he wants to play with his brother, but he's still very tired (recovering from being sick in addition to recovering from getting very little sleep in the hospital). He eats well, and he hasn't had any fever since that first dose of IV antibiotics.


I'm very curious where the US Embassy people will take their kids to the doctor while they're in Mombasa. We haven't found anything better than this place, yet, though we do have phone numbers of two other pediatricians we will check out. We already didn't have much faith in them, and so far, they have done nothing to inspire confidence.

look alike?

I don't usually think that Nate and Ben look all that much alike. I look at them every day, though. Their differences are so much more obvious to me. For that reason, I love to compare pictures of them at the same age, side by side.

 

Nate at 9 months +1 day. Ben at 9 months -5 days (he'll be 9 months on Friday).

Oh yeah. Definitely brothers.

...but no cake.

I have been telling Nate that when he eats food, it goes into his tummy. He always raises his shirt to look. Tonight, he asked if I was eating rice and beans. I was. I opened my mouth to show him. I swallowed and let him see my mouth empty, telling him the rice and beans were now in my tummy.

He proceeded to raise my shirt to look for the rice and beans. He pretended that he could see rice and beans in there. Then, he started saying something over and over, as he does, especially if it makes people laugh.

"Hey, wait a minute! I see...fruits and vegetables, a piece of chicken, milk, pastas... [a bit less enthusiastically] but no cake."

company

Since we've been here, we've had guests over for dinner at least once a week. We have been dinner guests several times ourselves.

The most striking difference between our way and theirs is this: if you go to dinner at the home of a Kenyan family, you won't really spend any time with the wife.

When guests arrive, the wife starts cooking. If the husband is home, he will sit with the guests. If he is not home, the guests are kind of left on their own. Drinks will be served while the guests wait and sometimes a little something extra. Often, they will send one of their children to get sodas for the guests. At my mother-in-law's house, we have had roasted corn on the cob and roasted cashews served while we waited for her to cook lunch.

When the meal is ready, a table will be set up wherever the guests are sitting. This is odd. We have been to homes which have a dining table and chairs, but if we were sitting on the couch when the meal was ready, the meal was served on a coffee table.

The meal is set out on the table. Sometimes there are forks to use for eating, sometimes spoons, and sometimes nothing at all. There are no napkins. The wife will carry a pitcher of water and a basin around the table, so that each person can wash their hands. Then, she leaves.

Many times, there is a community bowl of ugali, from which each person can take a handful when they need some. The rest of the meal is served into bowls or plates. A lot of times, people who've had more exposure to westerners will offer me a fork. If they are eating with a spoon or hands, I try to follow suit. I do need more practice eating with my hands without making a royal mess. I like to bring one of Ben's burp cloths to clean myself up as I eat.

The husband eats with the guests, while the wife and kids either eat in the kitchen, off to the side somewhere, or not at all. In one rare case, the husband was out of town, and the wife actually sat with us while we ate. She would not eat with us, though.

The water pitcher and basin are brought around again after the meal for more hand washing, and the plates are cleared. Then the wife returns to the kitchen.

I often wonder what our guests think of our method for serving them dinner. The meal is generally prepared when they arrive, though sometimes it needs a few finishing touches. We don't buy them sodas. Rodgers and I both cook and clean up afterwards. We offer them the sink for washing hands. Also, the boys and I stay with them the whole time, unless it's naptime or bedtime.