Bamba not related to mysterious deaths of toddlers

Over the last few weeks, four toddlers have gotten ill and died suddenly of mysterious causes. Two children remain hospitalized; one is recovering and one is still in intensive care. The Health Ministry debated over whether to announce that they are investigating the deaths as they didn't want to induce panic. But if word got out about the investigation, the ministry would be accused of withholding information. They are awaiting final lab results but so far there no connection has been found among the children, who came from different parts of the country and had different symptoms. It seems to be a statistical anomaly, and at least one of the children had previous health problems.

Earlier this week an email rumor began circulating claiming that the deaths were related to contaminated Bamba, the heavily marketed children's snack food. One email forwarded to me this morning was about an uncle working in Superpharm who received a call asking him to take Bamba off the store's shelves.

Manufacturer Osem's stock dropped six percent in the stock market as a result of this rumor. My readers know that I am no fan of Bamba. But as a pediatrician friend pointed out, if even one batch of Bamba caused illness Israeli hospitals would be full to capacity with sick children. Negative health effects of Bamba, Bisli, Crembos and other snacks marketed to children are only incremental.

Jameel also wrote about this story.


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Sukkot in the ER

When we last met, I was injured at the bottom of a hill near Peduel. At this point I was pretty sure I would recover, so we went to our friends' house in the community of Revava. I sat and nursed my wounds while others prepared the delicious dinner. During the meal, the wrist on the hand that I used to catch my fall began to throb. I once read that to avoid a broken wrist you should fold your arms when you fall, but I'm not sure that advice applies on a rocky mountain. Anyway, I could not move the wrist and it was so painful that we decided to go to the moked, the after-hours care center for our health fund.

After we dropped off the kids at home, the nurse at the moked put a serious-looking bandage on my leg wound, which had started bleeding again. The doctor printed out a referral to the emergency room for a wrist. So we went from a hilltop in Samaria to an urban hospital in one day. We saw the orthopedist almost immediately. My husband had insisted that I mention bumping my head, even though the bump was so small as not to be noticeable. She wrote that we needed a surgeon to look at it. When I questioned this she said they are not "choffefanim." The best I can translate that is to say that they don't do a half-assed job, even though I prefer not to use such language on my blog.

She sent me for the x-ray, examined the wound, ordered a tetanus shot, and gave me a prescription for three days of antibiotics and Optalgin. The nurse handed me two doses of antibiotics to hold me over until the morning, but I refused the Optalgin.

When the orthopedist examined my wrist she said, "Yatzat bezol," which means that I got a bargain--I would probably escape without a cast. The x-ray came back clear, although the orthopedist warned me that it could flare up and a subsequent x-ray might show a crack.

The nurse wrapped up my arm, and another nurse, Ahmed, dressed the wound. The young, blond doctor complained to the nurse (or perhaps intern or medical student) about a patient scheduled for an operation. The operation was delayed because of a different operation. Instead of waiting patiently (no pun intended), he left for home. The previous operation got cancelled, and the hospital lost money because the operating room was ready and waiting for for the second patient.

The x-ray technician commented that Sukkot was the holiday of the "datiim," or religious Jews, but he loves it. It's true that because we tend to be busy on Friday and Shabbat, the week-long holiday is an ideal time to travel. Most Israelis seem to ignore Sukkot or leave the country.

When we first headed to the hospital I had imagined the benefits of a broken wrist: pity, no cooking or cleaning, and a chance to teach the kids a few more household skills. But all in all I was relieved by the diagnosis.

After I finished with the orthopedist I waited patiently for the surgeon. And waited, and waited, for almost an hour. Finally we asked the nurse what happened, and she had misplaced our file. And the doctor had been there all the time, chatting with a friend. But at that point he was treating someone else.

Finally the surgeon checked me out and explained that the health ministry requires anyone with a head injury to be under observation for six hours from the appearance at the hospital. But he also gave me the option of signing myself out, which I happily accepted despite the scary language of the form. He promised us me that if I came back, I would get a warm welcome.

I mentioned that I don't bring my children to the emergency room every time they get a bump, even if it's the size of a golfball. He admitted that he doesn't either. "But you're a doctor," I pointed out, "although I have six children, so I guess I'm almost a doctor by now." Okay, I'm not a doctor, but I still have a pretty good idea of when to bring my kids to the ER.

When we returned to the health fund to have the dressing changed on my leg, the nurse commented that with such a bandage she expected a bigger wound. I wanted to tell her how bad it had looked the night before, but instead I told my husband he could leave the line of forty people in the drugstore. I would skip the rest of the antibiotic.

My friend, a doctor, warned me that a wound on the calf can sometimes lead to an infection near the bone, but I seem to be out of danger. My wrist is still sore. So I guess someone else will have to chop the vegetables for Shabbat.

Teaching our children: Modeling is not enough

In my post Trusting Our Children, I wrote about things that children learn on their own. So what do we need to teach them?

I hate to disappoint you, but I don't have the answers. I can't, because they will be different for each family. Leora will make sure her children appreciate art and can express anger productively. RivkA's children have learned about physical fitness and coping with chronic illness. Sephardi Lady will emphasize being satisfied with what one has and sticking to a budget. And that is how it should be. Each of these concepts is important, some are essential, but no parent can give them all equal weight. We emphasize the skills and values that are currently part of our lives, taking into account our children's temperaments and inclinations. This is a good thing because it makes us a diverse, vibrant society.

I believe that teaching our children involves several elements. The first is expressed in this quote on education by Rav Yehuda Amital: [Hat tip: Hirhurim]

The greatest educational impact is achieved when the teacher is unaware that he is teaching and the student is unaware that he is learning. This is the meaning of "the Name of Heaven shall become beloved through you" (Yoma 86a) -- a person through his ordinary conduct should bring about a sanctification of God's Name, without even being aware that he is influencing others through his behavior. [Jewish Values, 150-151]

As we all know but often forget, modeling is critical. To quote a book blurb I saw recently, who we are is more important in how our kids turn out than anything else. But it's not enough. We also need to explain to our children what we are doing and why.

Since I just quoted Rav Amital, I'll give an example from our visit to Yeshivat Har Etzion last week (otherwise known as the Gush). To celebrate its 40th anniversary, the yeshiva invited graduates to visit with their families for the day. There were hikes, shiurim and other family activities. At mincha an announcement was made suggesting that parents take a moment to show their children about the beit midrash. Going to the beit midrash every day is a powerful statement, but if children don't understand what happens there, the impact is lessened. We have to interpret the world for our children according to our values.

Here's another example: We model safe behavior by wearing seat belts, and by expecting passengers to do the same. We refuse to drive unless children are properly restrained. But if the children don't understand why we wear seat belts, the first time they go with a friend's mother who says, "If you're sitting in between two people you don't need one," they may wonder whether that mother is right. (Kids get these "deprogramming" messages all the time.) So kids need to know that car accidents can happen anytime and anywhere, and that even a sudden stop can cause serious injury.

This concept also applies equally to Jewish rituals; we can explain that waiting between meat and milk reminds us to be compassionate to animals. Or thoughtfulness: "We need to call Grandma when we get home from the airport so she won't worry about us."

Another aspect of teaching that we tend to neglect is the "how." All too often our kids are away when we do chores and errands. When they are with us we tend to compartmentalize activities, as if quality time must involve kiddie entertainment. Then we resent it when we don't have time for anything else. (That's another post I've been meaning to write.) I find that summer vacation is a good time to teach one or two useful "hands-on" skills.

Below I attempt to categorize the types of things we teach our children. In many cases, setting an example and starting young is all you need, with some reinforcement along the way. This is prescriptive, by the way, not descriptive--I can't claim to have succeeded in passing on all of these to my children to a sufficient degree. Of course, it's hard to know for sure until they reach adulthood. And this list is far from comprehensive:

• Safety issues, like crossing streets and using helmets/car seats/seat belts.
  
• Torah, halacha, prayers, Jewish customs and culture, and Jewish perspectives on big and small questions.
  
• Learning and love of learning; how to find answers; critical thinking.
  
• Hygiene, including washing hands, toilet manners, and bathing. My 4-year-old recently decided she wants to take a shower herself, every day. She even washes behind her ears.
• Health issues, such as food safety and nutrition, exercise, sun protection, normal body function and illness.
  
• Order, caring for objects.
  
• Character traits like compassion, integrity and generosity. I don't believe these can be taught directly, but we can model and discuss them.
  
• Effective ways of expressing emotions and dealing with conflict.
  
• Everyday skills such as home maintenance, financial management and running errands.
• General behavior and manners. Sometimes I wonder whether we teach children to say "thank you" because we want them to feel grateful and show appreciation, or because we want them to be perceived as well-behaved. The answer will determine our response when they behave "badly."
  

Note: Sephardi Lady asked me about learning to talk. To me, speech falls into the category of things that we can trust our children to get on their own. A large group of normal children begin speaking late, and a proper evaluation can help determine which ones need intervention. It can be tricky. When one of my children spoke late, I found helpful information by Dr. Stephen Camarata of Vanderbilt University.

In which I share embarrassing moments with my blog audience

I tend to be secretive, but since I started blogging I find myself sharing all kinds of embarrassing things to produce amusing posts. Bear with me while I meander a bit--there is a punch line to the following story.

It started several months ago when I tore a leg muscle. Around that time I couldn’t figure out why my legs were tired all the time, even after a short walk. I was convinced that I had some horrible degenerative disease. Then, while carrying a cranky four-year-old, I tripped over a mound meant to prevent cars from entering a park. She got a bump on the head; I got a bruised knee and sore muscles. A few days later I tripped again, this time on nothing. Result: Two bruised knees and noticeable bruises on my face. Two weeks later the marks have just about disappeared.

After the second fall I realized that my shoes were causing the problem. I wear orthotics and orthopedic running shoes, and as everyone knows, running shoes wear out. (My metal orthotics never need replacing except for the leather lining.) Usually I am careful to replace worn-out shoes immediately; these were already eight months old so I should have thought of it. Instead I suffered extreme pain for two months while functioning on a suboptimal level, lacking stamina for walking or standing.

I hate running errands even when my feet don’t hurt, but I forced myself. In my town we have several orthopedic stores serving the large elderly population so I easily found a new, comfortable pair of shoes --white New Balance 627 for those who are interested.

Now that morning I had more cash on hand than usual. Even though conventional wisdom says that credit cards lead to excess spending, excess cash is the problem for me. In this case it was a reimbursement for a credit card purchase so technically I had already spent the money.

With feet uncurled from the joy of not having to hang onto flimsy shoes for dear life, I went to buy some new lipstick. My little girl had totally destroyed my last tube (or whatever you call a container of lipstick) months ago, forcing me to attend at least one wedding with bare lips. That is extreme even for me. After some debate I chose a shade. The saleslady generously applied blusher and convinced me to buy that too. (If not for the cash I believe I would have resisted.)

When my friend dropped off my daughter after playgroup she made a comment about my new makeup. I didn't think much of it, but my older daughter was quite concerned. She took one look at my face and said, “Did you fall again?”

I still haven't opened the blusher -- I'm planning to exchange it for something useful.