Book Review: The 24-Hour Pharmacist

I’m conflicted about The 24-Hour Pharmacist, by Suzy Cohen. On onehand, I think it’s got tons of great information in it that will help
save lots of people from taking unnecessary meds and will help them
mitigate the negative effects of meds they have to take. But I think
that when she strays from her specific areas of research and expertise
she gives incomplete (and sometimes just plain incorrect) information,
and that the way the book is organized it’s hard to use as effectively
as it could be.

The strength of this book is that Cohen has been a pharmacist
for years, and that she worked with lots of elderly patients in a
nursing home so she’s seen what the long-term effects of different
medications are. She’s done a ton of research and tells us exactly why
different common medications (mostly for things that affect people in
middle age and higher, like high cholesterol and high blood pressure)
have the side effects they do. She’s really into nutritional therapies
(which of course won my heart immediately) and tells you what nutrients
are robbed by each med, and how to supplement to mitigate those
effects. That’s the reason to buy the book, especially if you have
parents who are on regular meds or are on regular meds yourself.
(I found out from the book that a med my mom takes for her bones has a
side effect of causing joint pain, which has been a huge problem for
her in the last couple of years that she’s been seeking treatment for.
Great. But better to know.)

She’s not so good in other areas. She mentions some alternative therapies, and has some great information about how and
why some of them work or don’t. But there are others she mentions but
doesn’t seem to have done even minimal research on.

The
most egregious example I noticed was in the birth control section, when
she gives a paragraph to Natural Family Planning/Fertility Awareness
Method, which she calls "Ovulation Method, a.k.a., the Rhythm Method."
A quick Google search can tell you that ovulation method is NOT the
same as the rhythm method, so that’s just sloppy. But what’s even worse
is that she mentions the Billings Ovulation Method and gives the
website, but then gives a warning that she asked two women who tried
this method and both got pregnant. She doesn’t mention, however, how
carefully the women followed the method, whether they used any other
body signs, etc. Just a blanket warning about something she clearly
didn’t do much research on. (If she had, she’d easily have come up with
at least two people who’d been using forms of NFT/FAM for birth control
for 5+ years with no failures.) If she wasn’t interested in doing
actual research about the method (including getting the basic name
right!) she just shouldn’t have mentioned it, or should have given a
huge disclaimer that she really didn’t know anything about it.

Obviously I’m sensitive about FAM because I’ve had such great personal experience with it, so it’s what jumped out at me. But I wonder how many of the other things she mentions are based
just on things she’s heard, and that made me lose a lot of faith in her
advice as a whole. I’d stick to the sections that mention scientific
processes and more extensive research, and take the other sections with
a huge grain of salt.

The other real problem I have with the book is that it’s just
too overwhelming sometimes. It seemed like every other page she had
something about a different med my dad’s taking. What I wanted was some
kind of flowchart about how the different meds can cycle around and
compound problems so I’d know where to start to unravel my dad’s big
rubber band ball of treatments. Instead, I just ended up feeling scared
and a little hopeless about helping my dad, and then angry about the
misinformation about NFT/FAM, and then apprehensive about the veracity
of other things in the book, and then tired.

I’m glad I read the book, and think I will refer to it in the
coming months to try to help my parents. But I think it could have been
a far better book if Cohen (and/or her editors) had done the following
things:

  • stick only to the treatments/cures Cohen has actually
    researched and not rely on one or two casual examples to prove or
    disprove a treatment
  • have a separate section for the supplements she
    thinks everyone could benefit from taking regularly, perhaps divided by
    age and gender
  • give us a roadmap of where to start detoxing if we’re on multiple meds

Anyone else?

Q&A: baby or vacation

Sarah writes:

"I’m going to be 30 in September and I’ve been married for 4 years. Myhusband and I are happy & employed and have decided to start
"trying" in August.

I really want to have a child & the
desire has increased over the past six months, but I also really want
to travel to Europe, especially London and Italy where we know people
& have never visited. We were told by a married family member with
kids to delay having children and "just travel." I would if we could
afford an expensive vacation & it would be a stretch, but we could
swing it. On the other hand, three of my under 30 friends have had
trouble getting pregnant, with all of them having to see specialists.

I’d love to travel to Europe, but I’d hate myself if I delayed having children and then had
difficulty getting pregnant.

As a married person with two kids, what is your advice?"

This isn’t something anyone else can decide for you, of course, but it certainly won’t stop me from giving my opinion. Before I do, let me say a few things that probably should be said before we all play "what would I do if I were in Sarah’s shoes?".

1) If you’re going to have problems getting pregnant, waiting two months to start isn’t going to make or break having a baby (it could take you more than two months to get in to see a specialist). So if the decision is to start trying in August or travel for your birthday in September, it’s not going to make much difference in the scope of things to wait to start trying until October. Or move your trip to July. Or start trying on your trip.

2) You can still travel after you have kids. Yes, it’s easier without them, but when you have one you can still go plenty of places (especially if you have a good backpack). Don’t listen to all the doonsayers. Perfect is the enemy of the good, so if you can deal with having things not be as simple and spontaneous as they were before you can still have a great time traveling once you have kids. (My favorite destination with a kid: Puerto Rico. Everyone we met loved kids, the food was toddler-friendly, it was easy to drive around, the rainforest was perfect for hiking with the toddler in the backpack, and kids love the beach. But don’t ask me for hotel recommendations, because we stayed with a family friend.)

3) If You’re goign to have to wait and save up for a trip to Europe anyway, why not just start saving now, see what happens with getting pregnant, and then go when you can afford it? Unless you’re hugely pregnant or the baby is under 5-6 months old you can go to Europe and have a great time with or without a child. You might be overthinking things, and will find that they’ll resolve themselves if you just stay loose and start working toward both things.

Now, having said that, if I were you I’d go to either Maine or San Francisco this summer, and start trying in August. Then if I wasn’t pregnant yet I’d go to either Costa Rica or Italy for Thanksgiving. If I was pregnant I’d go to Austin or New Orleans for Thanksgiving.

Who else wants to play?

Q&A: sibling without rivalry

Charissa writes:

"I bought the book, “Siblings Without Rivalry
on the recommendation of a friend (I have a 9-month-old and a three year old), and I’ve
started to thumb through it out of curiosity.  However, my three year old seems
largely happy to have a baby sister, and I’ve not observed much distress on
her part other than an occasional potty accident (she trained after the baby
was born) that seemed intentional, and some brief episodes of jealously, mostly
involving grandparents.  The thing that concerns me is that every thing that I’ve
read on the topic of sibling adjustment seems to suggest that the older sibling
is going to go through significant adjustment, which includes acting out
against the baby, saying hateful things about the baby, etc.  Is my child
repressing?  Am I just lucky?  Is this within the realm of normal?  I would be
interested in other peoples’ experiences…"

There are all sorts of possibilities here:

1) Your kids haven’t read the book, so they don’t know to act out.

2) You’re just lucky, and for whatever reason (personality, energy, etc.) your older one isn’t having trouble adjusting to her new sister.

3) The older one is going to have more problems adjusting later on, when the baby is mobile and starts getting into her stuff.

4) Something else.

I think as long as you keep talking about things so your older one knows she can tell you what she feels, positive or negative, and you know that things could get worse, you’ll be fine. Some kids don’t seem to have problems with a new baby, but really feel infringed upon by a mobile toddler. Or maybe she’ll just never have a problem with her. The important thing is that she knows she can express her feelings to you and you’ll accept her and help her through them.

Oh, and definitely read the whole book. Concepts from it (especially the chart about when to intervene in a fight) will come to you for years at important moments.

Did anyone else have an older child who never displayed much jealousy? Or an older sibling who had delayed adjustment problems? Please share your experiences.

Q&A: summer hives and getting rid of old car seats

Kamilah writes:

"My 19 month old is
thoroughly enjoying the summer weather (we’re in Southern
Ontario, so it’s a novelty to her); however, we are having
some issues with hives.  I’m pretty sure that they only develop when
she’s hot, regardless of actual sun exposure (e.g. she got them while
sleeping late last night after a rainy hive free day; her room was hot and
muggy).  I have no idea how to combat being hot while outdoors in the
summer!  Do I just need to accept Benadryl as a part of our daily routine?"

Yikes. That’s pretty gross for the poor little peanut. I know nothing about hives, so I’m hoping someone else will jump in here. My only suggestions would be to make sure she’s sleeping in and on only natural fibers (cotton, wool, modal, bamboo, etc.) because even a little bit of synthetics can causy rashy prickly heat in some kids (like mine). Also, make sure that her room has plenty of good air circulation (a fan or air conditioner).

Does anyone else have hive-prevention strategies for the hot weather?

CCP writes:

"Help. I’ve got a basement with – amongst other things –  one
newborn w/base car seat, a convertible car seat that a friend gave me
but turned out to have a missing piece and then an extra booster seat
that we no longer need. I’ve been searching high and low throughout the
web and can’t seem to find any information on how to properly dispose
of previously used car seats. I live in Seattle and so far it appears
that none of the local charitable organizations or child consignment
stores will take them due to safety reasons – which makes sense. So,
where do all the used car seats end up?

Many thanks for any direction you can steer me. Our basement is already overflowing with stuff we no longer need."

Good question. Here in the city people are so desperate to get grown-out-of car seats out of their apartments that we pass them on to anyone who’ll take them as soon as we can. I’ve never had to deal with getting rid of expired car seat.

You can’t donate them to someone who might use them in a car. It’s just not safe, and there are enough programs to give current seats to families who can’t afford them that you wouldn’t be filling a need.

My first thought was that maybe the plastic could be recycled, so I did a little internet research. Recycling + baby gear = MotheringDotCommune, no? Sure enough, there was a very helpful thread about this exact topic from last summer. It seems that you can’t recycle the seats, so they have to be thrown into the regular trash. To prevent people from dumpster-diving to get them and using unsafe seats, you should smash them into pieces first. A disappointing answer, but one that doesn’t surprise me. (The other suggestion was to call the local police department to see if they needed any more used seats for a passenger safety training program.)

Reader call: skills only one sex needs?

(Am I an idiot for posting this question and reigniting the discussion from a few weeks ago? Perhaps. I just think we should still be talking about all of this. Otherwise, how are we going to get anywhere?)

Craig writes:

"Regarding the Dangerous Book for Boys….

My wife and I have three boys and no girls and I’ve been following this discussion around the Internet with interest.  The controversy surrounding the fact that many (if not all) of the items listed in the book could apply equally to either sex sparked my curiosity.  I’m wondering if your readers (and you) can think of any skills required for one sex, but not the other (besides the obvious hygiene items).

Only one I can think of off the top of my head would be physical fist fighting.  While it is a good idea for a girl to know how to defend herself, that’s different than needing to know how (and when) to start and finish a fight which I feel is a skill needed for boys."

I think that there’s no real way to answer the question definitively, since there are different answers depending on how you look at it. For instance, I get the feeling that a lot of the commenters from the previous discussions on this topic (both here and on other sites) feel like we should be teaching both sexes exactly the same things because we want to create a genderless society. Others seem to feel like we should teach our kids the things they need to survive in the gender-divided society we have now. Is that glass half full vs. glass half empty? I don’t know.

At any rate, where you come down on the spectrum of the all-the-same-so-let’s-start-wearing-matching-grey-jumpsuits POV vs. the biology-is-destiny-and-the-market’s-regulating-itself-thankyouverymuch POV changes how you answer Craig’s question.

I tend toward thinking people need to keep the ideal in mind, but really need to be able to navigate the world we live in right now. So I’d say that boys need to have a working knowledge of the rules of the major sports in the country in which they live (that means baseball and football in the US) so they can have those watercooler "How ’bout those Yankees?" conversations that grease the wheels with other men. Since I’m not a man, I don’t know all the other little things men have to deal with that women don’t see.

For girls:

I think it’s important to develop a strategy for dealing with the urge to cry that comes over a lot of us in moments of intense emotion. It’s really inconvenient and unprofessional to cry in the middle of an important meeting just because you’re trying to make a point, so it helps to have figured out how to back yourself off that feeling before it overtakes you.

Learning to deal with the backbiting and gossip of junior high and high school. Girl World is brutal and always has been, and the only way to survive is to have someone to help you through it, even if it’s only friends you find in books.

Even though someone commented on an earlier post that she thought it was horrfying (or maybe  "repulsive," or something like that), I think girls need to learn how to walk in high heels. Knowing how to do it doesn’t mean you have to do it every day, or even every year. But you can’t tell me that you’re going to wear completely flat shoes to get sworn in as Secretary of State, and you don’t want to break your ankle walking across the stage.

I think girls have to learn how to say no. Men generally don’t have as many problems with this as women do, but it’s important to protect your own boundaries in all areas of life, so you need to be able to say no effectively, without guilt, and without alienating coworkers.

Your thoughts?

Q&A: social anxiety in a 16-month-old

Rebecca writes:

"My 16 month old son is having pretty intense social anxiety.  He is
also having separation anxiety so I’m not sure if they just go hand-in-hand?
He is having a really hard time in any sort of playdate situation.  He
is visibly stressed, upset, clingy, etc.  The slightest thing sets him
off and he comes running to me sobbing for comfort.  He is fine at home
with me and hubby, and actually does OK in other toddler arenas, for
example, the play gym, parks, etc.  I really think it’s mostly the
implied expectation of social interaction.  Even if we go to the park
and meet another Mom/Kid there, he is much more stressed than when we
just go by ourselves.  I also notice that he will separate himself from
the main kid-heavy areas and run off into more open spaces to be by
himself.  But again, he will do fine at our toddler gym or mall play
areas which can be quite overrun with kids!  So I’m a bit confused.
The worst scenarios are at someone’s home – confined to their playroom
in close proximity with one or more kids.  Total meltdown!!  And I am
always right with him so it’s not a trigger of my leaving him alone.
That sep anxiety is a whole different ball of wax…or is it?

Help! – will this go away or should I be more concerned?  Is this a
stage or his personality?  We have been doing playgroups, etc, since he
was born so socializing isn’t a new idea for him.  And he always did
fine until about two months ago.  I’ve heard the gamut of advice from
‘Have him evaluated…’ to ‘It’ll pass…just a stage.’  My inner Mommy
voice isn’t giving me a strong feeling either way! 

Thx!  I really like your site and find it refreshing to hear from Moms who are being truthful in their struggles!!"

If it were me I’d get him evaluated, for several reasons. The first is just magical thinking, which is that I’d figure that by the time I got through all the hoop-jumping to get the eval, he’d probably have moved on to the next phase. But I’d also rather do the eval and find out it was nothing than spend more months worrying about it. If it isn’t bothering you that much, then maybe you don’t want to get him evaluated. But since you took the trouble to email me about it, I’m guessing it’s bugging you enough to initiate the process to rules things out for your own peace of mind.

On one hand, it totally could be some kind of sensory integration thing. A friend of ours with a sensory integration disorder is fine in wide open spaces and when there are a bunch of kids not necessarily paying attention to him, but has problems in smaller spaces or one-on-one with another kid for a playdate. So it could be some mild form of this.

Or it could just be part of being 16 months old and going through some separation anxiety and dealing with the independence and control issues of that age.

If I had to place a cash bet on whether or not this was going to turn out to be anything, I’d bet that it’s just a phase. The reason I think that is because Rebecca’s Mom Spidey Sense isn’t going off. I really think that if we let ourselves trust our instincts we can tell the difference between something and nothing with our own kids. But I’d still get the evaluation just so I’d know whether it was something or nothing and could stop wondering.

My Q, Your A: business trip tips

So I’m going on a business trip for a few days next week. (I’ve set posts to autopost, so assuming technology works and I didn’t misschedule them, you should have a new post every day, even while I’m someplace else.) Some of you may recall that my first three days of work were a business trip. That was a little strange. But now I’ve been at my company long enough to actually know what I’m doing, so I’m thinking this might be a good time to share ideas about being a parent who travels occasionally on business.

My only tip (and I learned this from my mom, who figured it out when my dad was travelling on business when I was a kid) was to try to call in the morning to talk to your kids, so that they get that early-morning contact to start their day off. I’m planning on calling in the morning for them and in the evening for me (’cause I know that’s when I miss them the most).

What else do you have? Tips on dealing with missing your kids and staying in contact with them? Tips for the actual travel? Best wheelie suitcases? Where you can find a bottle of volumizing mousse for straight hair that’s 3 ounces or less?

(And I’d tell you where I’m going, but I have to socialize with the other people on my trip every night so I wouldn’t have time to see anyone anyway or go to the places you’d recommend.)

Q&A: weaning questions

Rachel writes:

"My daughter is 13 months and loves to nurse. I recently found out I am pregnant and due at the end of January. I began to wean her and during the day it has been great, she loves milk and eating just about anything. The problem is our 5:00 am feeding because I can’t distract her with the things that work during the day. I’ve heard horror stories about trying to night wean and thought maybe your readers would have some practical advice. I just need a break before I start this whole process over with another baby – am I crazy or can it be done?"

Congratulations on your pregnancy.

Plenty of us have weaned while pregnant, so it definitely can be done. Before you buckle down for a tough struggle, though, consider these two items:

  • Some women experience a drop in milk supply as the pregnancy hormones change, so the baby ends up weaning just because the milk dwindles.
  • After the first trimester sometimes the milk tastes salty and some babies will stop nursing because they don’t like the taste.

So it’s possible that your daughter will just wean herself in the next couple of weeks/months if you have one of these issues.

If she doesn’t, though (and my son didn’t wean himself, despite my fervent hopes that he would), you can still cut out that last feeding, although you’ll need help. Get down to that one feeding for long enough that she’s basically forgotten that she used to nurse any other time during the day. Then get your partner to go to her at the last feeding time (5 am-ouch!) for a week or two until she forgets about nursing entirely. The first few days are likely to be pretty rough for your partner. You may have to play the pregnancy card to get him or her to do it, but it’ll totally be worth it for all of you when you can get the extra sleep and can conserve some of your energy that would otherwise go into nursing. (I remember feeling like even one nursing session a day was sucking out all my life force during pregnancy.)

Does anyone else have any good suggestions for cutting out the last feeding? Bearing in mind that Rachel doesn’t have much energy to expend right now to do the actual weaning.

Q&A: solids feeding for allergic baby

Crystal writes:

"My son Jack is 11 months old and eats very little in
the way of solids (loves his breastmilk, though!) – maybe a total of 5
bites from his baby spoon a day.  He seems to have a sensitive gag
reflex, and is very in-tune to texture, so we are mostly stuck with
pureed foods.  There are a couple of "real" foods he eats (banana,
avocado) that I don’t have to mash up. 

I’d
like to a) get more variety to his diet, b) step up the amount of
solids, c) get rid of the jarred foods and replace them with foods in
their natural form.  My challenges are 1) allergies (he is allergic to
peas, and some other as-yet-unidentified issue that gives him eczema) –
so we are on a delayed schedule for food introductions, and 2) work –
my husband and I work full time so not only are we crunched for time
(i.e. making complicated baby food recipes is too much to think about)
but I am giving up a lot of control on the solids-feeding to our
daycare provider (who is wonderful but not as sensitive in noticing my
son’s digestive difficulties, probably because they happen at home due
to timing of his meals).

So,
I feel clueless on how to proceed.  Honestly, I don’t know if my son is
ready for more solids.  He seems completely content with his
breastmilk, only occasionally does he try to go after our food.

Am
I worrying too much about this?  At this point I hate solids and just
wish we could stick with breastfeeding (not really, but it is easier).

Thank you for any guidance you can give.  Links to toddler food prep ideas is highly appreciated, as
well."

There’s this theory that babies who have allergies sometimes refuse to eat as a protective mechanism until their systems are developed enough to deal with the foods. I don’t know if it’s true or not, but it seems to make as much sense as anything else we know about babies and feeding solid foods. Which is not much, frankly. There seem to be lots of opinions (which seem to vary widely from culture to culture) but not a lot of actual research (except, of course, for my second favorite study ever*, the Dutch one that showed that babies tend to choke less and do better when they feed themselves bigger chunks of food, so there’s no need to do the whole pureed baby food thing. I totally used that study to justify not doing the whole rice cereal and pureed squash thing with child #2, and he does seem to eat a ridiculously huge variety of foods and will try anything you offer him, and of course it has to be because of the way I introduced solids to him.<eyeroll>).

So your son could totally just be rejecting foods because his body’s telling him not to eat them. And there’s no reason he has to be eating solids at this point anyway. A baby can be completely and totally healthy up to and past 12 months of age just on breastmilk alone.

Also bear in mind that 11 months is one of those bumpy times in feeding (the other one I seem to get tons of questions about is 20 months, and that’s all about control) when kids sometimes just seem to stop eating solids for some reason (lots of times it seems like they only want to eat things they can self-feed, which doesn’t work too well if they don’t have many teeth yet). So there are plenty of 11-month-olds all over the place who are pretty much making it on just breastmilk or formula at this age anyway.

I’ve said it before with regards to solids feeding, and I’ll say it again: Don’t hate the player, hate the game. By "player" I mean either your kid (for not eating what he’s "supposed" to) or yourself (for not somehow magically making your kid eat what he’s "supposed" to). And by "game" I mean this idea that if your child isn’t eating X food or Y amount by Z time, he’ll never learn to eat (think about that for a minute and you’ll realize the goofiness of it), or that he’s getting better nutrition by eating rice gruel than healthy breastmilk or formula. If you provide a variety of healthy foods and your child does not have a metabolic disorder, he won’t let himself starve.

Personally, I think your son’s body is protecting him. If you want to back off the solids for a few weeks, just do it. There’s no sense in making yourself nuts (a little allergy humor there) and creating conflict with your son over something that’s so arbitrary at this age anyway. If it’s not going to hurt, could help, and makes things easier for you, you might as well try it.

Has anyone else had experience with either an allergic baby who wouldn’t eat solids, or a baby who survived on mostly breastmilk or formula for a long time?

* My favorite "study" ever is that Finnish one about babies being happier when their mothers ate chocolate during pregnancy.

Q&A: Timeline for new baby stress

Rachel writes:

"I’m waiting for baby #2 to arrive – today’s the due date, actually – and trying to recall:  How long is that super-newborn phase when I will be so overwhelmed with tending to the baby’s and my own most >basic needs that I will be thrilled to accomplish something like getting the outgoing mail into the mailbox?  Two weeks?  Two months? And how about the period during which I kind of have the basics down, but still am too sleep-deprived to do anything requiring actual cognition?  I know it depends on the delivery, the baby, the rest of the family, and so on, but I feel like there are ballpark estimates that might help me remember what to expect.  Thanks."

Well, yeah. I think second babies are way different than first babies
are, but let’s review first babies first. The general rule is that the
first six weeks are just shell-shock and constantly feeling like you’re
the most incompetent, exhausted person in the world. Physical ailments
on top and bottom, and every feeding feels like the baby might die if
it doesn’t eat enough.

Then from weeks six to 12 or 14, you’re struggling with how much you
love the baby and yet how much your minute-by-minute existence still
pretty much sucks rocks. By 14 weeks you can read the baby’s signals
better, and are starting to feel more human and more competent, but the
naps are still busting your chops.

Second babies are so different because the stress points are different.
The incompetent, white-knuckle feeling of the first six weeks isn’t so
strong, because you know you’ve done it before and can do it again.
You’re still tired and worn out, but there isn’t that horrible feeling
of "Can I do this?" permeating everything. You know there’s nothing
wrong if you don’t bond instantly, you know that either the
breastfeeding will work out or you’ll feed your baby with formula just
fine, and you know that eventually the baby will sleep.

I think the biggest stress point of having a second baby is having to
divide your attention between two kids. (This is why everyone says it’s
easier to go from two to three, and if you’re having three you might as
well have 10.) You always feel like someone’s getting shortchanged.
Either your older one has to wait while you do something with the baby,
or the baby has to wait while you do something for the older one. (If I
hadn’t learned to nurse my second in the wrap I’m not sure he ever
would have been fed some days at the beginning.)

So my opinion is that the stages are the same (first 6 weeks are awful,
6-14 are dicey, after 5 months it’s easier), but that the things you
think will be awful aren’t and the things you didn’t worry so much
about will be the complication.

Good luck! At this time two years from now it will all be a piece of cake.

Other conflicting or confirming opinions about the timeline?