Friday, 22 February 2013

Have a miserable flight

Our 16 mo-old has been on almost 30 flights so far (poor child). You’d think we’d be pretty good at things by now, but our most recent flights to and from Tasmania were rather unpleasant. Here are some tips for flying with a young toddler to maximize your discomfort.

1. Schedule your flights during your kid’s witching hour. We had one 6:30 pm and one 8 pm flight. The babe usually goes to sleep sometime between 7-9 (I know; but this is kind of what bedtime is like at our house), so these were perfectly timed to coincide with his most cranky, hyperactive and frustrated time of day.

2. Bring no toys. Any useful blog out there will tell you that plane flights with toddlers are best when you come equipped with new, interesting toys to captivate your child. After my solo flight with the babe from Hawaii to San Francisco in December, during which the “bag of wonders” I had carefully prepared ahead of time both (a) was totally uninteresting after about 10 minutes and (b) included a balloon, which scared the shit out of the tot, I thought perhaps that was not the answer for our particular child. But on this last flight, much of which was spent pulling my hair, kicking the seats, banging on the tray-table, throwing the in-flight magazine, and crowing loudly, I regretted not having at least something made for children to attempt distraction.

Maybe planes should include baby cages? (please recognize I am joking)
3. Precede the flight with a long drive. Tasmania is not all that big, but we managed to start the morning of our return essentially as far from the airport as possible. It was a rainy, cold day so our stops to provide entertainment and relief from the car seat were also kind of dismal. We went to a restored windmill that actually mills flour with wind, but the babe kept grabbing and attempting to break non-child-friendly objects; then he got wet and cold outside in the gardens. We also went to a wetland area filled with venomous snakes, water, and shocking winds, and an interpretive center occupied by delicate taxidermied wildlife at toddler height. Finally, at the airport he was allowed to run wild for a short time, but it was already too late to burn off the pent-up energy.

When all else fails, handing the kid the camera sometimes works. Here is some of his resulting art.
4. Have an extremely social kid with intense FOMO (fear of missing out). Once allowed out of the seat after the seatbelt sign went off, the babe walked up and down the aisles greeting people. This was cute and enjoyed by all for the first several passes, after which they became a little bored and just wanted to read novels, doze off, etc. I guess it’s a little awkward having a 2-foot tall person standing in the aisle, staring at you longingly for several minutes until you glance up from a book to acknowledge them. So, once that got old for everyone else and he started stumbling with sleepiness, I tried to corral the child back into our seats to fall asleep—which only intensified the fear on his part that he might have missed interacting with someone, and turned into a tantrum. This sequence was repeated for the remainder of the flight.

You might imagine the excitement I have looking forward to our upcoming 10 hours of flights to visit Sri Lanka in a few weeks! At least we might be better prepared this time…who wants to lend me small toys with lots of buttons and lights and things?

Thursday, 21 February 2013

Why I love vaccines

We recently got back from a long weekend of camping in Tasmania. It was awesome, except the babe was mildly sick from some daycare pestilence, and he took a face-plant into the gravel on the first day (standing on his brand-new camp chair was not a good idea), making it almost impossible to wipe his snotty nose without hurting him. If vaccines existed for every irritating illness on earth, I’d give them to my son with no reservations. Here is why.

You may have heard about the “hygiene hypothesis” - people who are too clean seem to get sick more often or suffer from autoimmune problems like asthma. The idea here is that generally challenging the immune system makes it stronger – a bit like working out at the gym.
The hygiene hypothesis: why I encourage shoe-chewing and dirt-playing

Infective agents (bacteria, viruses, or other gross things like protozoans) make you feel sick by getting into the body, past the initial immune system defenses like the skin, and then multiplying. Symptoms that are produced, like a runny nose, are often side effects of your immune response; the infectors effectively use these gross bodily functions to spread to other hosts. Other symptoms occur because some invading organisms produce toxic chemicals that cause discomfort. Because the organisms have to multiply before you feel sick, it usually takes several days after the initial infection before you notice.

This first step after getting sick is to assign blame (as suggested by one of my grad school mentors when the lab instrument broke). Think back on all of the people you recently came into contact with who may have been sick themselves, and decide which of them is most likely to be at fault. But, that’s for another day. Back to vaccines.

The immune system is complex, and described well elsewhere; but the key to understanding the awesomeness of vaccines has to do with antibodies. Antibodies are proteins manufactured by white blood cells. Each new invading agent the immune system has not yet met triggers the production of antibodies that have a unique shape to attach to that invader, like a key fits into a lock. Once attached, depending on the kind of infective organism, the antibodies have different mechanisms for crippling them so they can’t reproduce and cause sickness. For example, an antibody might attach to a virus and stop it from entering a cell, thus preventing it from replicating.

Vaccines work in a slightly different way than the hygiene hypothesis mechanisms – more like training for a specific Olympic event: you can train all you want for the shot-put but it won’t help you win synchronized diving.

I love not being sick
Likewise the immune system works best, in terms of taking down an infective agent before it actually causes illness, when attacking an agent it has met before. Remember those antibodies? Every different potential infecting microbe triggers the immune system to produce specific antibodies to disarm that kind of microbe. Your body then keeps some of these antibodies in storage, like templates, for the next time it meets that same enemy. Instead of having to start fresh constructing a new antibody for a microbe the body has already attacked, the stockpile of antibodies goes on the attack immediately, and the body can make new antibodies fast enough to prevent infection since it knows the recipe already: thus you are now immune.

So, can I get around to vaccines already? Yes. Vaccines are just dead or severely crippled live microbes, small pieces of microbes, or their DNA. They are given to you orally or into the bloodstream, and the body goes into its normal immune system attack mode: make antibodies to get rid of the microbes. Your system makes antibodies, even though the vaccine microbes are either already dead or so weak that they couldn’t cause an infection anyway. But now you’ve got a stockpile of antibodies, in case you run across the actual live organism in the future. You will then be immune and not actually die or be permanently disfigured from some horrible, preventable, dread disease.

My artistry skills may not win awards, but this is the gist. (Note: antibodies can't think and microbes don't have facial features, in case you were wondering)
That is it. Vaccines are not some magical, scary medical invention. They are just a clever way to trick your body into using its natural defenses to protect you from becoming seriously ill.

Why else should you not be scared of vaccines? They do not cause autism. The preservative used in a few vaccines, Thimerosal, contains trace amounts of mercury at levels the FDA and WHO consider safe – less than the mercury you might eat in a can of tuna and in a chemical form that you will quickly excrete. 

There is no evidence that delaying vaccinations beyond the recommended schedule is helpful - rather, this leaves your child vulnerable to preventable illnesses longer than needed. The Centers for Disease Control sets the vaccination schedule to optimize the efficacy of vaccines (sometimes they work better at a certain age), as well as their safety. Also, because we are all exposed to millions of microbes daily that our immune systems fight off, there's no way to overload your body with too many vaccinations at once.

Remember too, that vaccinating is good for other people too: you won't be a carrier of disease that you can spread to other people, particularly infants yet to be vaccinated or kids sick with cancer who can't be vaccinated. 

So, go forth and get your vaccinations. Save your fear for things that are actually scary, like spiders.