5/12/23 - Happy Mother’s Day

For so many years I have struggled with anxiety, and if I'm really being honest, depression too, I was able to manage it, but was I happy?  No.  However, I was functional.  Then I found the practice of mindfulness, and that really seemed to shift me.  It made sense to me-especially since children are naturally born with this gift.  Littles don't ruminate about previous moments.  They don't worry about potential future moments or outcomes.  They just live each moment to its fullest potential.  I think that is beautiful.  And I worked so hard to be able to practice this way of life. Focusing on the "what is", not the “what if”." as my teacher Cory Muscara taught me.  

But then, managing the office through the Covid pandemic (not just the virus, but all of the uncertainty) just rocked my nervous system.  I lived in my sympathetic nervous system (fight or flight) for so long, I got to the point that I couldn't meditate.  My body physically couldn't settle long enough to be still for even 5 minutes.  So I had to restart my journey of self-healing.  I tried everything; I saw a holistic doctor.  I did acupuncture. I went into therapy.  But I never really felt peaceful or happy.  I felt like I was running on a hamster wheel.  Trying so many different things to get to this one final destination I couldn't reach, but I just kept running.  

This past March, I went on a conference for women in pediatrics.  In one of the many excellent lectures, I had a true "Holy Crap" moment.  I realized what the missing piece was all along.  The one element that kept me running on that hamster wheel.  I DIDN'T LOVE MYSELF.  The voice in my head was almost never kind to me.  My thoughts usually weren't positive or encouraging.  I hate that I have anxiety, I hate why I have anxiety.  I hate that I struggle.  I've dedicated my life to caring for others, but I didn't love myself enough to care for me.  Most of the time, while it’s hard to say out loud, I didn't even really like myself.   

So why am I sharing this, especially on Mother's Day?  Because I think I am not alone in feeling this way. And if there is a part of you that feels similar, YOU CAN SHIFT IT AND MAKE CHANGE.  I have.  I am kinder to myself.  I accept myself for all that I am-the positive AND the negative.  I'm not perfect, but so what?  I am human.  I am doing the best that I can.  I know this sounds too simplified and a little corny.  But it can be your truth.  It's a choice.  I choose to be happy.  I choose to take control of my thoughts rather than regurgitate the hurtful words others have said to me when I was a child as if they were my own voice.  I choose to have my own back. To set the necessary boundaries when I need to.  To choose to like the person I see when I look in the mirror.

The first step is the awareness as to who's voice is really behind your thoughts.  Own them. Take them back. Find your own voice. Listen to it.  Be kind to yourself.  And, we need to stop comparing ourselves to others (thank you Social Media).

I say it over and over, children learn the behaviors that they see.  If we want to raise happy, healthy kids, we need to role model this self-love to our children.  But first we need to truly own it ourselves.  We need to be authentic.  They need to see us thriving, supporting, and accepting ourselves for who we are. This will then stem all of the things we wish for our children, self-worth, resilience, happiness, positive body image, confidence, self-care.  And maybe, just maybe, if more people loved themselves, there would be less hate in this world.     

We at Happy and Healthy Pediatrics believe in you and you are a part of our community on this journey.  Happy Mother's Day.

5/25/22 - Choosing Hope

We all feel so depleted.  These last few years have been so tough; global pandemic, war, crime, fear, Monkeypox (This one really makes me feel like we are living in a Saturday Night Live skit).  And now ANOTHER mass shooting, killing children. I cried at my dinner table last night telling my girls.  I didn't want to tell them.  I am a firm believer that childhood should be "rainbows and unicorns".  But then I kept getting notifications from the school about all of the services, supports, increased security, resources, guidance counselor appointments, etc. (all of which I am so grateful for).  But then I knew I HAD to tell them.  I would rather them hear it from me than their friends at school.  I cried again this morning seeing the police car parked in front of my town's elementary school as I was on my way to Abigail's Pre-K graduation.

I wish I had the answer. Some idea on how we all just keep moving forward in a world that just seems to be getting harder by the minute. Some way to feel less depleted, empty and just downright sad.  There have been so many senseless killings, but this one in Texas resonates.  Safety is a trigger for me.  The thought of our children not being safe in one of the places designed to keep them safe is absolutely horrible...  But there are some things I DO KNOW:

1. We cannot predict the future. Covid taught us this lesson pretty effectively.  Any moment, life can change.  Uncertainty is not an easy emotion to sit with, but it's in the background of our lives every day.  That was true pre-covid also, we just weren't as aware of it.

2. Our children are really smart.  As I have written about in the past, I am so aware of how our words, behaviors, and attitudes shape our children.  I am DETERMINED to break the generational trauma that created my anxiety.  I don't want my girls to live with the anxiety I experience every day.  But it is not just anxiety that is role modeled.  It's LITERALLY FREAKING EVERYTHING!  Children are born pure.  They are the epitome of mindfulness.  They don't care about previous moments.  They don't care about future moments.  They are living each moment to its fullest.  That's even why kids tantrum-it's instinct-survival of the fittest.  I want what I want and I want it now.  That inner voice that is in our heads and helps us view the world, doesn't really start to be present until school age.  That's the voice that may say "the world is a terrible place", "this is unfair", "I am not good enough", etc.  You all know what I mean.  We all have that voice, the thoughts that literally color the lens in which we view the world.  The truth is, we create and model that voice in our children's heads!!!!!! It's the lens in which we view the world that will directly impact how our children will view the world.  And we can only fake it so much.  Kids are smart.  They feel our energy.  

3.  The kids are our future.  We NEED them to grow up to be STRONG, RESILIENT adults.  We need STRONG, CARING, EMPATHETIC leaders in all areas of this world to make us better.  

Watching Abigail today at her graduation from Pre-K made me cry happy tears filled with hope (I know, I cry a lot-it is part of who I am).  Her bright smile.  The pride in her eyes.  Children are our greatest teachers.  Hope is more than a feeling, it is a belief.  I still need to go through my process of mourning the loss of those young lives and it will take time. But through all of this, I am CHOOSING to be HOPEFUL.  The facts all make sense with this belief.  We can't predict the future, we want our kids to have hope because we need them to, since they ARE our future.  

Our vision for Happy and Healthy Pediatrics has always been to be a community.  There is always going to be tragedy.  We will always need to mourn that tragedy.  We invite all of you to join us on our journey in CHOOSING HOPE. Let's build something great.   Let's shift the energy lines.

5/6/22 - Happy Mothers (You) Day

Often when we become mothers, we dedicate so much of ourselves to our children, parts of us can get forgotten. Then add the pandemic which changed every element of our lives. The person we are consists of so many beautiful elements. Some we may have forgotten, or not explored in recent years, but they are still there within us. And some we are still working towards. I am striving to becoming a daily meditator.

Today we at Happy and Healthy Pediatrics wish you the happiest of Mother’s Days. But we also want you to celebrate you! To reflect upon all of the intricacies that make you you-even beyond your role of motherhood. To do the things that make you happy and bring you contentment. To do the things that inspire and fulfill you.

We need to be happy and healthy individuals in order to be happy and healthy mothers in order to raise happy and healthy children. So today, celebrate you!

10/28/21 - Parenting Support Skills Workshop

We often work to share resources that we find on the pediatric community to best support families in many capacities.  Unfortunately, due to the pandemic, most of the things we have shared have been Covid related.  We are happy to share some new resources that support families, particularly parents.  (Dr. Rubin has personally met with these people and was particularly impressed with their offerings and philosophy). Please see below regarding a Parenting Support Skills Workshop from Inspiring Wellness. Please note, we receive NO financial benefit from this, we are simply happy to provide resources to support our community! 

Inspiring Wellness (Private Practice Under Nicole L Coogan, PLLC)  is composed of a collaborative team of Clinical Social Workers, Licensed Marriage and Family Therapists, Mental Health Counselors, Reiki Practitioners and Mindfulness Facilitators. Our mission is to improve the emotional, physical, and mental wellness of children, adolescents, young adults, adults and families through counseling, mindfulness therapy, energy healing and meditation. We treat mental health concerns with a holistic approach that is flexible and individualized.

November Parenting Support Skills Workshop will include the following topics:

1.)   Parenting with Positive Discipline (this session will be an exploration of parenting styles and the philosophy, skills and approaches used in positive discipline)

2.)   Supporting Parent and Child Connections

3.)   Strengthening and Enhancing Parent/Child resilience (skills and strategies on how to manage and overcome daily life stressors)

4.)   Balancing Work and Family (screen time/time management and the value of healthy living)

Link to Register for Parenting Group:

https://docs.google.com/forms/d/e/1FAIpQLSfFmn5wO8IMxqXHfn1hUnjkl9DUDdwt2AVH8KkFdoGLa7p-yA/viewform

6/3/2021 - Join Me On the Next Mindfulness Retreat

Dr. Rubin, the owner of Happy and Healthy Pediatrics is continually focused on supporting families through all stages. In addition to medical care, she routinely shares her perspectives on numerous topics including parenting, mindfulness and the joys and challenges of children. Below are some of the articles and blogs that she has shared.

As these past years have gone by, I’ve asked myself a lot of questions surrounding overall well-being. I also have been very focused on how to raise resilient children, since this world only seems to be getting harder as the years progress. The one answer to all of these different questions for me always comes down to mindfulness.

As a pediatrician, I have been seeing so many children in our society emotionally effected by the pandemic in negative ways. As a mom, I KNOW that the only way to really raise children with a sense of mindfulness (and therefore a sense of resilience and coping skills) is to role model it. To make it part of your lifestyle and wellness.

I am merely a student myself on this journey of living a fulfilled life. Cory Muscara has been my most influential teacher. Here is some info about his next online retreat June 11-13th. I have no financial gain in posting this and he has not asked me to share this with anyone. I just know how much his teachings have helped me in the past, and I wanted to share that gift with the community.

- Dr. Elissa Rubin

About the retreat:
In this retreat, we will be taking a deep dive into the transformative power of mindfulness.

This retreat, however, will be solely dedicated to exploring the practice, theory, science of mindfulness. So if you’re a new meditator looking for an in-depth introduction to mindfulness, or an advanced practitioner longing to go deeper and to refresh your practice, this retreat is for you.

Without mindfulness, we are at the whim of our conditioning.

We will get caught in:

• Negative rumination and chronic worrying
• Impatience and edginess in our relationships
• An inability to focus
• Outbursts of anger or emotion
• Physical tension and stress
• Misalignment with our intuition and purpose
• Negative patterns around unhealed trauma
• An ability to be still; always needing to be busy
• Poor listening and attunement to others
• Unhealthy boundaries
• And much more

Developing mindfulness is like developing a form of mental fitness. It’s a way to tailor and optimize our minds to more skillfully and gracefully meet each moment of our life.

And the powerful thing about doing this within a retreat setting is that we can go deep in a short period of time, accelerating insights, healing, and growth.
The schedule for this retreat can be found at this link: https://corymuscara.com/retreat/

We will meet on zoom. While the encouragement is to attend all sessions (the ones in bold), I understand that current circumstances may make that difficult. All sessions will be recorded and available shortly after each session concludes. Please trust your intuition around how to best create this retreat experience for yourself.

2/9/2021 - What Parents Should Know About Heavy Metals in Baby Foods

We have been receiving a number of inquiries about this. This is not a new problem.  Every few years the media loves to blow this up and make everyone panic.  I think it is disgraceful that the FDA has not done more to rectify this problem, but we all need to do our part to lessen the pollution in our world. 

Heavy metals all are part of the earth’s crust, so they are naturally found in the environment. But most of the heavy metals in food come from soil or water that has been contaminated through either farming and manufacturing practices (such as pesticide application, mining, and smelting) or pollution (such as the use of leaded gasoline).

Crops take up heavy metals from the soil and water as they grow, and some absorb more than others.  Keep in mind that this includes all of the foods we eat, not just baby foods.  So even making your own baby food may lessen the risk, but probably will not eliminate the risk. 

So, what should we do?  One major step is to keep pressure on politicians and the companies that make baby food to fix this problem - but that’s a long term fix…

Right now, you should understand that while baby foods do likely contain these heavy metals, it is not at toxic levels that will cause immediate harm.  Below is a great list of resources, information and tips that we have compiled to provide additional context and to help you make good healthy choices.

Heavy Metals in Baby Food

​​Recent news about heavy metals found in baby food can leave parents wit​h a lot of questions.

Here's some information from the American Academy of Pediatrics about the risk of heavy metal exposure to children, and how to help minimize it.

Can heavy metals in baby food harm my baby?

The low levels of heavy metals found in baby foods likely are a relatively small part of a child's overall heavy metal exposure risk. However, exposure from all sources should be minimized. Heavy metal exposure can be harmful to the developing brain. It's been linked with problems with learning, cognition, and behavior. But keep in mind that many genetic, social, and environment factors influence healthy brain development, and heavy metal exposure is just one of these factors.

How do heavy metal get into foods?

Metals are found naturally in the Earth's crust. They also are released into our environment as pollution and get into the water and soil used to grow food. Metals can also get into food from food manufacturing and packaging. Some of the most common metals that get into food, according to the U.S. Food & Drug Administration, include inorganic arsenic, lead, cadmium, and mercury.

​How can I reduce my baby's exposure to heavy metals?

Stronger rules and regulations for testing and limiting the amount of heavy metals in foods for babies and toddlers are most important. But there are several steps parents can take now to reduce the risk that kids will be exposed to heavy metals in their diet, and from other sources:

·         Address lead hazards in your home. The most common source of lead exposure is from peeling or chipping paint from older homes. Soil, some cosmetics and spices, water, and certain occupations and hobbies can also be sources of exposure. More information about lead can be found here.

·         Check your water. Heavy metals can get into tap water: for example, arsenic can contaminate well water, and older pipes may contain lead. You can contact your local health department to have your water tested if this is a concern.

·         Don't smoke or vape. Secondhand and thirdhand​ smoke from both regular and e-cigarettes, may expose children to metals such as cadmium and lead. Vaping allows heavy metals from the vape coils to get into the air and be inhaled.  Secondhand smoke also contains harmful chemicals that can increase the risk of cancer.

·         Breastfeed if possible. Breastfeeding, rather than formula feeding, also can help reduce exposure to metals. The American Academy of Pediatrics (AAP) recommends breastfeeding as the sole source of nutrition for your baby for about 6 months.

·         Make healthy fish choices. Some types of fish can be high in a form of mercury called methylmercury, and other metals. Of most concern are large, predatory fish that eat other fish and live longer, such as shark, orange roughy, swordfish, and albacore/white tuna. Eating too much contaminated fish can harm a child's developing nervous system. But fish is also an excellent source of protein and other nutrients children need, and many are low in mercury. So look for better options like light tuna (solid or chunk), salmon, cod, whitefish and pollock.

·         Serve a variety of foods. Give your child a well-balanced diet that includes a variety of fruits, vegetables (wash in cool water before preparing and serving), grains, and lean protein. Offer toddlers and young children sliced or pureed whole fruits rather than juice. Avoiding apple juice, as like rice, apples can take up arsenic in the soil they are grown in, although keep in mind that infants shouldn’t be given any juice anyway. Eating a variety of healthy foods that are rich in essential nutrients can lower the exposure to metals and other contaminants found in some foods. Offering your baby a variety of vegetables, understanding that carrots and sweet potatoes are often the ones that are most heavily contaminated with heavy metals, so continue to give since they are also high in nutrients, but mix in with a lot of other veggies. 

·         Switch up your grains. Fortified infant cereals can be a good source of nutrition for babies, but rice cereal does not need to be the first or only cereal used. Rice tends to absorb more arsenic from groundwater than other crops. You can include a variety of grains in your baby's diet, including oat, barley, couscous, quinoa, farro, and bulgur. Multi-grain infant cereals can be a good choice. Try to avoid using rice milk and brown rice syrup, which is sometimes used as a sweetener in processed toddler foods.

• Look for rice-free baby snacks and limiting how many rice crackers and rice cakes your older kids eat.

• Avoiding teething biscuits, as they are typically made with rice flour

​Tips for choosing & cooking rice for your children

Keep in mind that, among different types of rice, brown rice tends to have the highest arsenic levels. White basmati and sushi rice tends to have lower levels. When making rice from scratch, rinse it first. Cook it in extra water and then drain off the excess when's it's done.​​

·         Consider making your own baby food. Because heavy metals can also get into food from food manufacturing and packaging, consider making your own baby food fresh at home. Use a blender or food processor, or mash softer foods with a fork. Homemade​ baby food may spoil more quickly than store-bought products, so store it in the refrigerator and check for any signs it has gone bad before​ serving it.

Is organic baby food better?

Organic baby foods may have lower levels of certain pesticides and other chemicals. Because heavy metals are found in the soil and can get into prepared foods from processing, however, organic foods often contain similar levels of heavy metals as non​-organic foods.​

Should my baby be tested for heavy metal​ exposure?

Until more information about metals in baby foods becomes available, experts say there's no need to get children tested. Tests that look at a child's hair for metal exposure also are not recommended, since this type of testing is scientifically unproven and often inaccurate.

Your regional Pediatric Environmental Health Specialty Unit (PEHSU) have staff who can also talk with parents about concerns over environmental toxins.

 Here is the lnk from Consumer Reports:

https://www.consumerreports.org/baby-food/baby-food-and-heavy-metals-advice-for-parents/?EXTKEY=NF12NCN1&utm_source=acxiom&utm_medium=email&utm_campaign=20210206_nsltr_food

12/14/20 - I’m Really Over This F’ing Virus

I know, I know, I am a pediatrician and I shouldn’t use bad words.  But these are very unique, trying times.  I also try very hard not to make broad generalizations or make assumptions about how others are feeling, but today I am going to. 

I feel that as a community we are just all OVER THIS pandemic.  It’s hard not to feel down right now.  I feel it for sure.  Several families in our practice have expressed the same.  It’s been almost a year now.  We are tired.  Tired of worrying.  Tired of living with restrictions.  I miss going out to restaurants.  I miss having normal holidays, dinner parties, and social gatherings.  We are social creatures by nature.  That’s why this feels so exhausting and wearing on us.  We are literally fighting our human instincts on a moment by moment basis in order to be safe.  And just as vaccines start to become available, this virus decides now is a good time to start mutating and possibly becoming not only more contagious, but more virulent in children.  AND, the roll out of the vaccine is slow.  It is hard to get appointments even for those who now qualify.  To me this added an entire new level of stress.  Beyond the constant uncertainty of this last year, now we have a race for time.  

So here is what I also know… our kids overall are doing great.  We project a lot of our own worries and concerns onto them, but the majority of kids are thriving.  We say to ourselves “I feel so bad for my child that they have to wear a mask all day”, “I hope my child is not getting socially damaged by not being in preschool at the age of 3 years”, “I wish my child could have playdates and socialize with more kids.  Are they going to be ok long term?”.  These are all thoughts we create in our own minds that only serve to create additional suffering for ourselves!  THE KIDS ARE FINE, THEY ARE HAPPY.  We, the parents, are the ones suffering. 

So why am I writing this?  To tell you, you are not alone.  My intention is to validate that we are all in this together, and that you are not alone in having any of these thoughts or feelings.  We are stuck in a global pandemic without a clear end in sight.  This sucks.  It’s ok to be tired.  It’s ok to miss “normal life” pre-pandemic.  It’s ok to lean on the collective community for support.  But what is not ok is to give up hope!  Things will get better.  There is light at the end of the tunnel-we just don’t know how long that tunnel is yet.  Hang in there. 

So last night I did Cory Muscara’s Day 5 of his 7 day New Year Challenge on the Mindfulness App entitled “Awakening Joy”, and it really spoke to me.  His point is that the world will never be perfect.  There will always be hardships and obstacles that will make feeling joy more challenging.  If we keep waiting for the world to align to our expectations as to when we will feel joy, we are going to be left missing out on a lot of happiness.  It’s within gratefulness, and being open minded and giving yourself permission to feel joy even in the little things in life is where we can learn to be happy, even if the world seems chaotic around us.  We don’t have to wait for that big vacation, or returning to “normal life”.  We can try to open ourselves to happiness and joy now, in any place you can find it.  A big hug, a great meal, taking a hot shower.  This is what our children do by nature of being children.  Children are so present and mindful of their worlds, and they find joy in many small things.  They are our role models.  And if we can role model to them that we are grateful for all we have, and we can still feel joy in hard times, then we are teaching our children the greatest lesson of all-resilience. 

We are all in this together.  We are so grateful to be able to serve this community and support you through these unprecedented times.  Have faith, things WILL improve.  Hang on, lean on us, focus your eyes to look through the tunnel to see the light. I invite you to open your heart to more joy, wherever you can find it.  We only get one shot in this world, and we deserve some happiness. 

12/14/20 The Importance of Wellness & Important Info on Vitamin D

Many of you know that I’m extremely interested in creating a better sense of wellness for ourselves and our families.  I am certainly not a homeopathic doctor, however, I wanted to share - I came across an MD and homeopathic doctor from California whom I really like.  Ironically, her name is Elissa Song, MD and her practice is called “Healthy Kids Happy Kids”.  With her permission, I wanted to share with you her free 2 hour webinar on keeping our kids safe and healthy during the pandemic, A Holistic Pediatrician’s UPDATED Guide to the Pandemic - Replay

Big disclaimer… There is a big sales pitch in this webinar.  And it’s a good one.  I think I am a pretty level headed human being, but by the end I was reaching for my credit card to buy her whole line of adult and pediatric supplements - I didn’t, and I have not personally tried any of them.  WE ARE NOT PROMOTING HER PRODUCTS SINCE WE HAVE NO EXPERIENCE WITH THEM, BUT REGARDLESS, WE THOUGHT THIS WAS STILL GREAT INFORMATION TO SHARE.  WE ARE GETTING NO FINANCIAL BENEFIT IN SHARING THIS.  Our only intention was to fill in the gaps with some great information that is beyond the scope of our training since we are not homeopathic doctors.   But I do think wellness comes in many forms, and we wanted to provide you all facets. 

Now I understand this is 2 hours of your life, but here are 5 points on what I really liked about this “Guide”…

1.       Dr. Song really goes into “Food as Medicine” and I LOVE this idea.  (In a parallel universe, I would have been a nutritionist, a chef and married to Jon Bon Jovi).  I think overall, even as a mom, heck even as a person, there is so much room to improve our eating habits.  In my opinion, we are often eating too much sugar, processed foods, food dyes, preservative, etc.  She has EXCELLENT slides showing which foods are highest in which nutrients and which ones to focus on for overall good well-being and Covid prevention. (How to get natural Vit A, zinc, Vitamin C, omegas, probiotics, etc.)  I have also been giving my kids these elderberry gummies daily since I like that they are low sugar and contain extra zinc and vit C: https://www.amazon.com/gp/product/B00MJ7VL1O/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&psc=1

2.       She emphasizes the importance of vitamin D which I have literally become obsessed in researching.  There in now hundreds of studies supporting the idea of the importance of vitamin D in Covid prevention and treatment.  Local hospitals are now giving adult patients IV vitamin D infusions as part of their treatment regimens. Previous “optimal” levels were thought to be 30-80 ng/mL in the blood, but research is showing 60-80ng/mL blood levels as really optimal protection (which is what she promotes with her patients).   

This is what we recommend regarding Vitamin D at Happy and Healthy Pediatrics:

·         In children under 12 months of age- 400 IU/day as recommended (please see our newborn handout for more info)

·         From the ages of 12 to 24 months- 1000 IU/day.

https://www.amazon.com/Carlson-Immune-Health-Support-Unflavored/dp/B0062QD5LM/ref=sr_1_8?dchild=1&keywords=carlson%27s+vit+D&qid=1607891083&sr=8-8

·         2 years of age-12 years of age-2000 IU/day.

https://www.amazon.com/Carlson-Immune-Health-Strength-Unflavored/dp/B06XSJ4DZP/ref=sr_1_6?dchild=1&keywords=carlson%27s+vit+D&qid=1607891127&sr=8-6

·         12 years of age +-4000 IU/day.

https://www.amazon.com/Carlson-Immune-Health-Strength-Unflavored/dp/B0090QNC8M/ref=sr_1_5?dchild=1&keywords=carlson%27s+vit+D&qid=1607891127&sr=8-5
Over the age of 1 year of age, we are recommending these supplements in addition to the multi vitamin with fluoride we recommend. 

If we have tested your child and found him or her to be deficient, we may have recommended doses higher than what is listed above.   The doses above are based on maintenance, not correcting for deficiency.

One brand we recommend for Vitamin D supplementation is Carlson’s because the vitamin D is suspended in an oil, but any supplement is ok as long as not a gummy (contain a lot of sugar and are sticky).  Please read ingredients to make sure you child is not allergic to any components of the supplement. And if your child has kidney disease in any form, please make sure they follow-up with their specialist who manages the issue before giving the additional supplement.

And adults, don’t forget about yourselves.  Call your primary doctors, see what your previous Vit D levels were, start supplementation based on their advice.  Dr. Fauci reports he takes 6000 IU/day.  The levels in your blood to see toxicity is over 120 ng/mL.   I think it would be very hard to get toxic, especially in the heart of winter when we are getting even less sunlight taking 6000 IU per day as an adult.  But again, check with your MD first.  Previous deficiency, other underlying conditions, having darker toned skin, and being overweight or obese can impact the decision as to how much vitamin D you need to be at optimal levels.  FYI, Carlson’s also comes as a pill if that is your preference.

3.       She also emphasizes the importance of good quality sleep, hydration (with water), exercise and fresh air!  Any day above freezing, it is ok to bundle up the kids and take them outside for at least 15 minutes for some fresh air. 

4.       Dr. Song also talks about the importance of mindfulness and positive affirmations.  She discusses how our nervous systems work better when we are in our parasympathetic nervous system, not our sympathetic “fight or flight” response.  How relaxation breathing can improve oxygenation levels in symptomatic patients.  How positive affirmations and thoughts about well-being can influence the recovery path.  I really believe in this mind-body connection. I find Cory Muscara’s daily Podcast “Practicing Human” and his mediation app “Mindfulness” very helpful on my own journey. 

5.       She also reinforces how often as parents we overuse Tylenol and Motrin to reduce fevers.  Fevers are nature’s way of healing us.  She agrees with our philosophy of not treating the number but treating the child.  We are all in agreement that these medications should only be used if the child is too miserable to sleep, rest or hydrate.  Otherwise, we should let nature do its thing to help heal the child.  She also provides a pressure point on the hand that you can apply pressure to that is supposed to naturally lower a fever. 

A few more disclaimers...  She does often quote very small studies (but she does emphasize that they were small studies when providing the information).  She also reports that only one child has died of Covid-19 in the US.  That is not accurate, but it may have been at the time she created this video.  The number is higher (almost 200 children), which is still a very small percentage considering how many children we know have become infected (0.1%).  Again, we are always looking to share information, regardless of the source that could help improve health and happiness!

With warm wishes,

Elissa Rubin, MD

Gratefulness is one part of mindfulness that I really try to practice on a daily level.  There is scientific research to prove that people who practice gratefulness are overall happier and healthier (pun intended).  Being grateful can actually build your immune system and make you a healthier person.   

We, as parents, tend to put a lot of pressure on ourselves to give our children "perfect holidays", or at least I do.  I hear so frequently from parents at the office "it's so unfair that our children can't have a normal holiday this year".  I want to re-frame that projection.   I think this may be one of their most memorable and happy Thanksgivings ever, even if it is not "normal".  Usually we are so busy getting ready for the holidays, we try to keep the kids occupied while we are cleaning, cooking, traveling, etc.  Now we can give them our full attention.  We can watch the parade in our pajamas without any time pressures.  We can cook together and talk about all the things we are grateful for without a structured agenda.  We can show our children through our attention how grateful we are for them in our lives.

So, there are many things to be grateful for this year, though it has been a hell of a year.  There is definitely more good in this world than bad, we just need to be open to see it.

I am grateful for:

1. Our homes.  How lucky to have a safe, warm, roof over our heads.  Our homes have become our sanctuary.  I think prior to this year, I took that for granted. I will never do that again.

2. I have been reminded this year more than ever the importance of family time, and the need to be present when I am with my family.  Life always moves so fast.  It was nice this year to slow down.  To not have so many activities or weekend plans scheduled.  To really appreciate spending time together.  And when we did get to see extended family or close friends outside in a safe way, how special it was.  Again, something I will never take for granted.  I am grateful for all of those parents who got to work from home (of course, that too had its challenges, but we persevered and learned to adjust).  For those who lost multi-hour long, stressful commutes.  For all those parents who got to stay home with their babies so much longer than their original short maternity or paternity leaves were.  

3. Our health.  This year made me so much more aware of the need for my own self-care. To eat better, try to get more sleep, fresh air, exercise, meditate and focus on my own well-being.   

4. Our schools and teachers.  I think the schools have been doing as awesome job keeping our kids safe and focusing on their well-being.  I am so grateful for each superintendent, principal, vice-principal, teacher, and other school employees who all have allowed us to keep our schools safe and open for as long as we have so far.  You guys are really rocking it.

5. Nature.  I used to take for granted going to the beach, being outside, taking a walk, appreciating nature.  Now I savor it. Sunshine on my face.  The feeling of the sand between my toes.

These are just a few of the things that have changed for me this year.  I feel the growth happening in me- my anxiety has been put to the wall, and there were times I didn't think I could handle it.  But I did.  And I developed a new relationship with my anxiety.  I have the confidence that even if I am scared, feel unsafe, feel overwhelmed, or just plain old panicked, I know that moment will pass.  I've had to give up my need for control, just because the world is so uncertain around me.   I am grateful for this growth, even though it was very painful.  But I feel stronger. 

So here are some ways to make this Thanksgiving "special" even though it won't be "normal":

1. Make yourself a gratitude tree: https://www.amazon.com/Stickers-Classroom-Thanksgiving-Activity-Decorations/dp/B07YKZGX5Z/ref=sr_1_8?dchild=1&keywords=wall+tree+craft+paper+thanksgiving&qid=1605987299&sr=8-8

I already checked-if you have prime, you can still get it in time.

2. Watch the parade snuggled in bed or under a blanket on your couch in your pajamas.

3. Do Thanksgiving "charades" where you act out all of the things you are grateful for, and the rest of the family has to guess what it is.

4. Cook together-remember, this year there is no rush.  In previous years I would rather just do the cooking myself because "I just wanted to get it done" before family started arriving. 

5.  Play board games and make it a family "game" day. 

6. My girls decided to write sealed letters to all the extended family we usually spend Thanksgiving with.  We are going to exchange these letters in a safe way before Thanksgiving (my husband is going to put in their mailboxes or exchange safely outside quickly using masks).  On Thanksgiving we are going to zoom when they open them.  In the letters is a message they wrote together about why they are grateful for that family member.

7. Make your signature dish and exchange with family in advance to keep some part of the traditions alive.  I am making extra of my cornbread stuffing, my sister in law is making her famous desserts and one grandmother is making her infamous sweet potatoes with marshmallows.  Again, we are going to safely exchange the night before and try to zoom during at least part of dinner. 

8. Snuggle up and watch a favorite family or Holiday movie.  Make a Thanksgiving music playlist.  Take a family walk or bike ride.

9. Get dressed up or stay in your pajamas the entire day.

10. This one is my favorite-story tell. Tell your kids what you were like when you were younger.  Tell them how you guys met and fell in love. Some of the jobs you had when you were younger.  Show your kids your wedding video if they have never seen it.  I understand not all of these are applicable based on your family unit, but you get the idea. Kids are fascinated in knowing about your life before they were born.  One day, God willing, we will be telling the story of 2020 to our Grandchildren.  

However you chose to celebrate, we wish you warm wishes.  We are incredibly grateful to live amongst and serve such a wonderful community of people.  Thank you for letting us into your lives and trusting us with the care of your children.  It is an honor to serve you.       

Happy Thanksgiving!

11/20/20 - Holiday Safety

This holiday season feels weird.  And this Thanksgiving is going to be quite different than we have known it to be in the past.  We are social beings and we crave that connectedness.  Stay tuned for my next post which will provide some ideas on how to still feel connected with our loved ones even if they are not sitting across the table from us this year.  But this year we have to be to very careful in our decision processes and really look at risks vs benefits. 

I am not saying any of this to scare anyone or tell anyone how to live their lives – that is not my role!  I just want to provide as much information and context from a medical perspective as possible to help everyone to make smart, educated decisions for the well beings of their families and our communities as Thanksgiving approaches.  Every decision in life is based on a risk vs reward ratio.  Just some points to consider. 

Unfortunately, sitting at a large family table is a very high risk behavior as far as possibly contracting Covid-19 is concerned.  Everyone is inside, in very close proximity, not wearing a mask while they are eating.  Everyone is talking and laughing and producing tons of droplets and aerosols into the air.  Several young adults may just be returning from college.  There may be some older, more high-risk people at that table, and some people may have traveled to be there.   Hosting or attending a large indoor gathering with people from outside of your immediate household is considered a high-risk activity as per the CDC.  This is just something to consider when making our decisions. 

One idea I’ve been seeing on social media is “I will have everyone tested for Covid-19 a few days before Thanksgiving and if everyone is negative then we are good to go”.  Unfortunately a negative Covid-19 test does not mean you don’t have Covid-19.  A test only captures one moment in time. It can take days before a new infection shows up on a Covid-19 test.  We know that the incubation period for covid-19 is up to 14 days.  Bottom line, you can be testing negative and have no symptoms but still be contagious.  I like the visual included in this post-I think it really brings this point home-whether you know you have been exposed or not (several people may be asymptomatic and you may have been exposed without even knowing it).

We have definitely seen a dramatic increase in the number of Covid-19 cases in our community.  All of the children we have diagnosed have had mild symptoms and have recovered very well, thank God.  But it is not the initial infections that keeps me up at night.  I am much more worried about the potential morbidities (long lasting health effects) that may result post infection.  In adults, this is already well defined.  They are termed the “long haulers” and there are already full programs in NYC to address their complications that have resulted from Covid-19.   These include long term neurologic damage, “brain fog”, kidney damage, heart damage, etc.  In kids, we know the association with increased risk of developing type 1 diabetes and Multisystem Inflammatory Syndrome.  And the NEW AAP recommendation is for each child known to have Covid-19 to get a full cardiac work-up after recovery to make sure there is no long term cardiac damage.  How Covid-19 is fully affecting children is still not fully understood and new research is coming out every day. AND WE WANT TO KEEP OUR KIDS IN SCHOOL!

As stated, our intention is simply to share information and perspective.  We wish everyone a TERRIFIC holiday season. Stay tuned for more Thanksgiving ideas next week.

8/28/20 Home Stretch to School - Parenting and Mindfulness Resources from Dr. Rubin

A common piece of feedback and theme that parents want to hear about is preparing for back to school.  Well, we are in the home stretch and almost there!  We have shared a lot of clinical and tactical information, masks etc.  I wanted to share two themes that I have been using and I find to have a high level of impact for the emotional and psychological preparation for our kids.  The first is a piece from the group Pandemic Parenting (a collaboration of two psychologists, scholars, and moms).  The second are some kids Mindfulness based techniques for stress reduction.  This was written in conjunction with Nicole Coogan LCSW (https://www.inspiring-wellness.org/about.html)  She also taught our virtual kids mindfulness classes.
 
What I keep seeing, even in my own parenting, is this predisposition to project my own worries and concerns onto our children.  Pandemic Parenting has yet again come up with an excellent webinar which helps guide us, based on developmental age appropriateness, on how to talk to our kids about Covid and going back to school.  THIS IS WORTH THE HOUR OF YOUR TIME. Included is one of their slides.  What they teach does not only apply to Covid, but really anything that can throw us a curve ball in life.  My definite personal number one goal in life, is to guide and role model for my children to become resilient adults who know how to catch any pitch thrown at them.  Pandemic parenting discusses their approach to back to school which is being POSITIVE, PREPARED AND PRACTICE.   I think this is excellent advice.
https://www.pandemic-parent.org/resources/talking-to-kids-about-covid-19?ss_source=sscampaigns&ss_campaign_id=5f3ea099e265a56a2f3b732d&ss_email_id=5f3ea5740737c750cc8e9114&ss_campaign_name=Webinar+recording+available%3A+Talking+to+Kids+about+COVID-19&ss_campaign_sent_date=2020-08-20T16%3A31%3A57Z
 
 
The MOST POWERFUL part of MINDFULNESS that helps me with my own anxiety is that we are not our thoughts.  I swear, it took me to 35 years of age to realize that my thoughts are not my reality.  They are just my thoughts.  And more often than not, they are not my reality.  Once I realized that, my thoughts had less power over me, again, because they were only thoughts, not my real world.  Teaching that idea to children at a young age is life changing.  I wish someone would have taught that to me when I was a kid, rather than endure all those years of anxiety,  A good example of this is the what is, what if idea: https://www.youtube.com/watch?v=9AkeP_uCSbk
 
Telling someone who feels anxious in the moment about wearing a mask to take a deep breath to calm down, may cause more harm than good.  Being that traditional breathing techniques may actually be counterproductive right now since everyone is wearing masks, I wanted to provide some other “grounding” techniques. So here is what I came up with.  The whole point of this is to try to get away from the anxiety-provoking thoughts (which again is only a thought) and to connect with our bodies more by using our senses.   Most of these can be adjusted to most age groups (including us grown-ups):
 

1. Feel your feet-Literally concentrate on the feeling of your feet against the floor. You can even gradually rock back and forth.  Feel connected to the Earth.   

2. "Draw" figure 8's on your thigh under your desk.

3. Look around the room for something that is your favorite color and focus on it for a few seconds.  A more expanded version is the Five Senses Exercise. The goal is to calm your mind by using your five senses to focus on your environment instead of your thoughts. 5, 4, 3, 2, 1...

   • Stand in a space, in or outdoors and name:
     5 things you can see
     4 things you can touch
     3 things you can hear
     2 things you can smell
     1 thing you can taste.
     This activity is often referred to as high 5. By using your senses it slows down your breathing and brings you back to the present moment instead of your mind being a million miles away. Attached you will find an explanation of how to do this activity with your child and then a worksheet for you to fill out and try it out!

4. Loving kindness meditation: practice at home-can say in your mind when needed for grounding: https://www.youtube.com/watch?v=i9X6tkUXa9o&t=15s

5. Tense and Release Muscle Relaxation -  pick one part of the body-maybe the legs so no one else can see- and squeeze them as hard as you can for 5 seconds, and then release them for 5 seconds-do 5 times.

6. Body scan mediation is an exercise that relaxes the mind and body by progressively tensing and releasing those large muscle groups. In this activity, you will gently tense and then release each large muscle group without straining too hard. Try to tense each muscle for approximately 5 seconds for the best results. This activity is perfect prior to going to sleep because it helps the body release tension. Have your child try this activity lying down after they get into bed for the night. Below you will find two YouTube videos allowing your child to follow along and try on their own. They can practice at home-can do a modified quicker version while sitting at their desk. 

   • https://www.youtube.com/watch?v=u3Jmy74UKcs&t=4s. 

   • https://www.youtube.com/watch?v=DRUy8F4bliA&list=PLZnnWZRQ21N5_bgzO7r5hUxQGb36bNNE9&index=10

Finally, spend some time every day, discussing something that you are grateful for!  Understanding gratitude and reinforcing everything that makes us happy goes a long way!

If you feel like you need additional support, please reach out to:
Nicole L. Coogan, LCSW (The beautiful person who helped me write this)
Inspiring Wellness, Private Practice Under Nicole L Coogan, PLLC
Licensed Clinical Social Worker & Children's Mindfulness/Yoga Instructor
186 W. Main St., Suite 3
Sayville, NY 11782
nicolecooganlmsw@gmail.com
www.inspiring-wellness.org
631-513-1059
 
https://mcusercontent.com/38b0ca172dd4418153d0766c0/files/8503e67c-e51e-4e15-a7b9-10f45c511a7c/Five_Senses_Explanation_Poster.pdf

https://mcusercontent.com/38b0ca172dd4418153d0766c0/files/b9bc48b0-cd41-4f87-881f-b232d3e08f1e/tense_and_release_muscle_relaxation.pdf

https://mcusercontent.com/38b0ca172dd4418153d0766c0/files/43ebb2c9-0a9c-4f1a-a6a3-684fc996d60d/Five_Senses_Grounding_Worksheet.pdf

8/17/20 - Review of Different Masks for Kids

As per the CDC and AAP, we know the importance of wearing masks, especially as the kids go back to school. But no one really has guided us to what are the best masks for kids and what features to look for when buying them. If a mask does not fit your child correctly, or meet the CDC recommendations for masks it’s still better than not wearing anything, but… we want to keep our kids as safe as possible, and not all masks are created equal. There are 100’s of options out there. Based on hours of research on professional listservs, medical social media groups from across the country, literature searches, and actually ordering all of these masks myself and trying them on my own children, I am going to provide you some guidance. I AM NOT AN EXPERT ON MASKS. I am just a concerned mom and pediatrician who wants the best for my children and our community.

Features of a good cloth mask should include:

·         FIT is EXTREMELY important for efficacy. According to ACS publications “gaps (as caused by an improper fit of the mask) can result in over 60% decrease in the filtration efficiency”. https://pubs.acs.org/doi/10.1021/acsnano.0c03252

·         Multiple layers of soft fabric that covers the nose (including the bridge), mouth, chin, and sides of the face (ideally 3 layers).

·         Have a nose wire or be sewn in such a way that it fits over the nose well without slipping off when talking or moving of the face.

·         Have adjustable ear straps for a snug fit.

·         Be able to breathe through easily.

·         Have a slot for a disposable filter or have a washable filter.

·         They SHOULD NOT have valves. Valves allow for the wearer to exhale potentially infected air into the space.

·         No gators or bandannas. They have been shown to be less effective.

·         A face shield is primarily used for eye protection for the person wearing it. At this time, it is not known what level of protection a face shield provides to people nearby from the spray of respiratory droplets from the wearer. There is currently not enough evidence to support the effectiveness of face shields for source control. Therefore, CDC does not currently recommend use of face shields as a substitute for masks.

How to properly wear a mask:

·         Wash your hands before putting on your mask

·         Put it over your nose and mouth and secure it under your chin by holding the ear straps

·         Try to fit it snugly against the sides of your face

·         Make sure you can breathe easily

·         Practice having the child move their faces under the mask and talk to make sure it will not slip once on.

·         DON’T TOUCH THE FRONT OF THE MASK-this is why those straps and lanyards to wear the mask around the child’s neck is not recommended.

·         Remove the mask by the straps, take out the disposable filter if used and throw away.  Then put it into the laundry and wash your hands.

The New York Times has a great visual showing examples explaining how to avoid common mistakes with mask wearing. https://www.nytimes.com/2020/04/08/well/live/coronavirus-face-mask-mistakes.html

Other Tips for effective mask preparation and use:

·         I would provide the kids with several masks (5-10 based on the age of the child-younger children would most likely need more) in their backpacks for the day. One for the morning, another one for the afternoon after lunch, and a few extra “just in case” (it accidentally falls onto the floor, gets wet from drool, sweat, sneezes, it gets visibly soiled, etc.) Keep two well marked sealable bags in their backpacks-one for clean and one for soiled.

·         Make sure you wash and dry the masks based on the recommendations of the company. Some have washable filters, so you have to keep track how many times you wash them before the filter is considered no longer protective. A good way to dry masks that are not recommended to go into the dryer is by using a belt hanger: https://www.amazon.com/Elong-Home-Hanger-Holder-Organizer/dp/B07L9X8MZN/ref= sr_1_7?dchild=1&keywords=belt+hanger&qid=1597593970&sr=8-7

·         The CDC also provides great information on how to clean your mask: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-to-wash-cloth-face -coverings.html

Masks we loved: (In no particular order-I think everyone’s face is a little different, so you have to find which one works best for your kids.)

Joahlove: https://www.joahlove.com/collections/mask

They are made of a very soft fabric, and the new version contains the slit for the filter. They don’t have the nose wire, but they are sewn in a way that provides excellent coverage of the bridge of the nose (without slipping) and the chin. They have great adjustable straps that provide a proper fit (patent pending on the design). They are very breathable and comfortable. And they are washing machine and dryer safe. Sizes are; KIDS: Between 2-6yrs, SM/MED: Older Kids, Tweens, Petite Adult Faces (Women Smaller Coverage), M/L = Women & Men with Fuller Coverage, XL= Fuller Faces / Men, Beards Just make sure you get the one with the slit for the filter since that is a newer option.

Andy & Evan Face Masks: https://www.andyandevan.com/collections/face-masks/face-mask

They are made of 3 layers of 100% cotton, have adjustable elastic straps, have the slit for a filter and are very breathable. They come in 3 sizes (children 2-7), youth (8 and up), and adult. They don’t have the nose wire, but they are sewn in a way that it “hugs” the bridge of the nose and your chin creating a snug fit against the cheeks too. They recommend washing in the washing machine and hanging dry, but I have been putting them in the dryer and they have held up well. The company also donates one pack of masks with every pack of masks purchased to underprivileged families in vulnerable populations.

Happy Masks: https://www.happymasks.com/

Happy masks is a Taiwanese-American mask company. Their masks for adults and kids have a reusable nanofiber membrane with > 99% filtration efficacy. The fabric domes over the mouth and nose for comfort and doesn’t interfere as much with talking. They are extremely lightweight, breathable, and comfortable with adjustable ear loops. The nose bridge wire also provides a good seal across the sides of the face as well as the nose and chin. The downside of these masks is that they can only be hand washed up to 50 times, so remember to keep track with a checklist. They have to air dry. The kid size fit my 9 year old well. My 12 year old did well with the medium adult size.

Mandala masks: https://wearmandala.com/collections/masks

They have an adjustable nose wire which prevents fogging of glasses. They have soft adjustable ear loops. Their outer layer is crafted from the same soft Spill Resistant & Anti Microbial fabric as their scrubs. They have a slit for the filters and each mask purchase Includes 3 replaceable PM2.5 Filters offering 95% BFE (Bacterial Filtration Efficiency) (you can buy extras on Amazon). The inner layer is lined with 100% Cotton fabric. They are machine washable. The downside is that it only fits older kids. My 12 year old loved it, my 9 year old could not get it to make a tight seal because the mask was simply too big for her face. This might be a better option for the High School aged kids.

Here are some of the ones we tried that we didn’t like:

Old Navy - has the three layers of fabric, but no nose wire, straps not adjustable, no slot for a filter, and they did not wash well.

JAANUU - has the three layers of fabric, but no nose wire, straps not adjustable, no slot for a filter. They wash well, but I found that it constantly slid down on my face and I was adjusting it which completely defeats the purpose.

TCG masks - has the three layers of fabric, but no nose wire, straps not adjustable, no slot for a filter. Comes in 4 sizes-small, medium, large and x-large. Even the small did not fit my 9 year old - it was too big.

Mambe waterproof masks - I liked that they were waterproof on the outside and have an adjustable strap in the back that is an interesting design. Has the three layers of fabric, has the nose wire, but no slot for a filter. My kids found them very uncomfortable.

Cottonique Allergy-free Apparel - made of 100% cotton and pH balanced. Marketed for people with very sensitive skin or eczema, etc. They are made of a soft cotton, they have the slot for the filter, and they have adjustable straps. They do not have a nose wire (and kept slipping down) and they do not cover the chin well. We also couldn’t get it to fit snugly around the sides of our faces. I think that as long as you wash and care for your masks as described above, all masks are allergy free and safe for use for most kids.

3 MD masks for kids - do not have the slit for the filter. They are heavy and thick, and my kids found it hard to breathe through them. Straps not adjustable so hard to get a tight seal. They do have the nose wire though. They have some other cool products though (check out or face shield section).

Starks masks - has no slot for filter but has an extra piece of fabric that goes over the nose which does not slip down. Straps are adjustable but could not get a snug fit on the sides of my kid’s faces. I do like that they have a water-resistant outer layer, a dust filter mid layer and a sweat absorbent inner layer. I do feel that the filter insert is safer though.

Crayola school pack - I wanted to love these since they are cute and convenient. They do not have the slit for the filter. They do not have great coverage over the chin. They do have adjustable straps, but they are tightened using plastic beads which hurt the back of my kid’s ears. I could not get a snug fit on the sides of my kid’s faces. They do have the nose wire. They are also only two layers of fabric.

Vistaprint Trumask - These masks do have adjustable ear loops, pockets for filters, and nose wires. The problem is that the fabric lacks structure and thus easily sticks to our mouths when breathing and talking. And they have specifically shaped filters that fit their masks, which I think you can only buy on the vistaprint website and cost $1 each.

ClearMask - was hoping would be a good option for a clear face design, but literally created no seal at all.

Clear face options:

Rafi Nova: www.rafinova.com.

Center is plastic. Has nose wire, adjustable straps that tie in the back, and sits well over the chin. Definitely fits snuggly against the sides of the face. For each purchase you make, the company donates a mask to a frontline worker. Use code TOGETHER for 15% off. Only problem is that the plastic does fog when speaking, and my children did not find it as comfortable to breathe through than a fabric mask. Not for all day use but may be good for children getting speech therapy for certain parts of the day, or for kids with hearing impairments.

For kids with sensory sensitivity:

Autism-products.com has a sensory friendly mask: https://www.autism-products.com/product/sensory-friendly-protective-fabric-mask/

It is made with 3 layers of 100% cotton. Soft spandex band goes over the entire head and rests over the ears to reduce “ear fatigue”. Easy to adjust the size and forms a good seal on the sides of the face. No nose wire, but sewn in a way that it doesn’t slip. No filter pocket, but may be a great option for kids with sensory sensitivities. Love that it has the 3 layers of fabric. It comes in 4 sizes and is washing machine and dryer safe. The fabric domes over the mouth and nose for comfort and doesn’t interfere with speech.

Face shields:

The CDC does not currently recommend use of face shields as a substitute for masks. But some parents may opt for the kids to wear them in addition to a mask-especially little ones or kids with sensory sensitivities. 3M makes 2 cool face shields. One is a sun hat and the other is a baseball cap.  You should wipe down the shield with soap and water or an alcohol solution to clean it after every use.

https://3mdmasks.com/collections/our-masks/products/kids-sun-ha T-face-shields

https://3mdmasks.com/collections/our-masks/products/face-shield-baseball-cap

Kids face shields can also be found on Amazon:

https://www.amazon.com/Vye-Protective-Corrosion-Resistant-Lightweight-Transparent/ dp/B087T7D45T https://www.amazon.com/gp/product/B08BRJ9ZB8/ref=ppx_yo_dt_b_asin_title_o07_s0 2?ie=UTF8&psc=1 https://www.amazon.com/gp/product/B08C4WSCHD/ref=ppx_yo_dt_b_asin_title_o09_s 00?ie=UTF8&psc=1

Filters:

They do make a kid’s size, but I find that the adult size still fits into most kids’ masks. And the adult size is less expensive. This link is 100 pack for $30. You do not have to use a filter in the mask, but it does add an extra layer of protection. They must be changed daily.

https://www.amazon.com/pack-Activated-Carbon-Filter-Insert/dp/B08D9GLTCX/ref=sr_1_4_sspa?c rid=VJMFTH9DPJUY&dchild=1&keywords=pm+2.5+mask+filters&qid=1597616649&refinements=p _85%3A2470955011&rnid=2470954011&rps=1&sprefix=pm%2Caps%2C184&sr=8-4-spons&psc=1& spLa=ZW5jcnlwdGVkUXVhbGlmaWVyPUEzQ0ZHTDBEWEhGSzRFJmVuY3J5cHRlZElkPUEwMDA2 ODQ3QkhaMTlIWEhGNjJXJmVuY3J5cHRlZEFkSWQ9QTAwNjM2ODkzUVZCQzg4Wlc0TkYzJndpZG dldE5hbWU9c3BfYXRmJmFjdGlvbj1jbGlja1JlZGlyZWN0JmRvTm90TG9nQ2xpY2s9dHJ1ZQ==

Here is another option: https://filti.com/#filterProducts They are more expensive than the others (about $1 per mask, but they got excellent reviews)

Disposable masks:

Disposable masks are an option, however there are a number of downsides: the fit can be challenging for kids, they can be very expensive, many have valves (which again do not offer protection for others), they add to the landfill and poor-quality masks may rip easily. Surgical masks are not necessarily better than cloth masks if the fit is poor or if worn incorrectly. For my kids, I couldn’t find any type that fit well and didn’t create a huge gap around their cheeks. Even the ones marketed as “children's sized”.

For teachers and other adults:

Rapid Response PPE: https://www.rapidresponseppe.com/

Offers unique reusable, lightweight, face shields with better coverage than the typical face shield. This might be a good option for teachers involved in speech therapy or with students who are deaf or hard of hearing where full view of the face is crucial for communication.

8/12/2020 - Now Us Parents Need Some Emotional Support…

I personally have found that as the summer progresses, my nervous energy surrounding school openings increases exponentially.  I wanted to try to provide some resources and mindfulness “hacks” to try to ease some of this for our community. 

Check out this website: https://www.pandemic-parent.org/resources/school-decision-making-during-covid-19

This was created by two psychologists (and moms) who are committed to sharing their expertise and research in ways to provide us emotional guidance and support.  I have watched their webinar  “To school or Not to School: Making Decisions in the Time of Covid-19 Resources & discussion questions”.  I think it is excellent, and honestly it made me feel better.  If you don’t have time to watch the entire webinar (it is about an hour) then check out their “big takeaways, tips and resource links”).  They really do provide an excellent perspective into why we are feeling the way we do.

Here are the major takeaways that really spoke to me:

1.       We are all in the same boat-seeing how others are feeling the same as I am really gave me a sense of community and made me feel less isolated.  

2.       “It works until it doesn’t”-we all have some degree of decision fatigue at this point, and knowing that no decision is permanent or unchangeable definitely takes some of the pressure off.

3.       Just keep trying to do the next right thing as things evolve. 

I have seen so many posts on social media about how horrible things are going to be for the kids in the Fall.  “They are going to be so afraid of the masks, they are going to not be able to touch or socialize, the list goes on...” Now I agree these are very unique and trying times, but we are the role modelers.  If the children see us getting “excited” for the upcoming year, rather than anxious, they will feed off of our positive energy.  Being anxious doesn’t serve us.  It only increases our own suffering over circumstance we can’t predict or control.  But if we can use all of this nervous energy and channel it into more positive neural pathways, it can serve us well.  Especially our kids. 

Cory Muscara is a well- known Mindfulness teacher and previous Monk, who runs the Long Island Center for Mindfulness.  He posted something recently that really spoke to me.  He says that the neural pathways between anxiety and excitement are the same.  The only thing that differs is our thoughts as they apply to those neural pathways.  None of us can predict the future.  So if we are going to be thinking about the future, why not use that energy to think positively about the future rather than negatively? 

Also, please don’t forget to ENJOY the rest of the summer.  All we have is 18 summers with our children. That’s’ it.  And then they are away at College.  Don’t let the months ahead steal the joy of our present moments (I have to remind myself of this multiple times/day-it is not easy, but important). 

Over the next week I plan on sending two more correspondences.   First will be tips for getting our kids to wear their masks (with a lot of info particularly for children with sensory issues or some anxiety around wearing it).  Secondly, I have personally purchased about 20 different masks and face shields and I will be providing a comprehensive description of which ones seem to work the best, meet the CDC recommendations, etc.  Stay tuned.

8/7/2020 - School Openings

As a pediatrician, this has been an extremely challenging time.  I want to make decisions based on knowledge and science, and unfortunately that is something we are short on right now.  This virus is still too new.  Research is coming out all the time, and often it contradicts itself.  We initially thought that younger children have a lower transmission rate.  Then this week there are new research articles stating children infected with the coronavirus “have at least as much of the coronavirus in their noses and throats as infected adults. In fact, “children younger than age 5 may host up to 100 times as much of the virus in the upper respiratory tract as adults,” the researchers found.

Here is the reality - I DO THINK THE KIDS SHOULD GO TO SCHOOL. BUT WE DON’T JUST WANT TO OPEN SCHOOLS, WE WANT TO KEEP THE SCHOOLS OPEN AND OUR KIDS SAFELY IN SCHOOL.  As a pediatrician, my entire career is devoted to preventative medicine.  For the kids going back to school, their protective gear (especially masks) is going to be the only way we not only open our schools but KEEP THEM OPEN. 

The teenagers present an even larger worry for me since they by nature of their age group are more defiant and feel more of that sense of “invincible”.  We need to make them aware of possible consequences for their actions, for themselves and others (high risk family members of their classmates at home, etc).  We need to use these incredibly unique circumstances to empower them with a sense of good citizenship.   Just like we teach them respect for our elders, respect for property, etc.  This can be done without eliciting anxiety if explained well.

This can all be a huge lesson in resilience if we present it to our children this way.  This is an opportunity for growth.  This can be an opportunity to reinforce acceptance since several kids may need to wear modified protective gear due to sensory or developmental issues. Some kids may need to wear a face shield in addition to a mask due to an underlying medical condition.  

I do not claim to be an expert-so in addition, I have included a video created by the “experts” at Northwell.  This was intended for school officials and medical healthcare professionals, but I think they did an excellent job.  It includes Charles Schleien, MD, MBASVP of CCMC & Pediatric Services Professor & Chair of Peds at Zucker SOM, Drs. David Fagan, Sophie Jan, Tom McDonagh and Lorry Rubin (Chief of Division of Pediatrics - Pediatric Infectious Diseases, North Shore University Hospital).  It is very long-but if you skip to about 33 minutes they talk about the need for personal protective equipment and how best it should be used, and in the last 5 minutes it talks about the need for us to follow these measures in order to keep our schools open and our kids healthy.  And they agree with my feeling, that we have the month of August to really get the kids ready for this in a positive way.

 https://youtu.be/vVvl8XN2vrc

I will continue to send out resources that may be helpful.   I found a great book written by a pediatrician for the younger school aged kids that can really help explain our new circumstances and prepare them for the year ahead. https://www.amazon.com/Achoo-Day-Corona-came-visit/dp/B08BWGWL7C/ref=sr_1_1?crid=K7DYI3Q9I34N&dchild=1&keywords=achoo&qid=1596561464&sprefix=achoo%2Caps%2C158&sr=8-1 

I have ordered and will be donating 10 copies to the East Williston Library by early next week.  We are all in this together, and we all have the same purpose-of keeping our kids happy and healthy!  Let's stay positive and we will get through this together.

7/28/2020 - School Openings

So, we are getting closer to the school year and new guidelines are beginning to be introduced.  Some seems vague at this point and there may be a lot left to the discretion of the local school districts.  Ambiguity typically brings anxiety and worry.  I want to make decisions based on knowledge and science, and unfortunately that is something we are short on right now.  This virus is too new.  New research is coming out all the time, and often it contradicts itself.  We do know that younger children have a lower transmission rate.  We do know they tend to have less severe symptoms – thank god!  But what keeps me up personally at night, is that we don't know what the long-term consequences may be, such as, the higher rates of autoimmune disease that may come out of this. We have also had 4 cases of children becoming type 1 diabetic in the past 4 months (since COVID started), where prior we had one case in 17 years, and we don’t understand if there are correlations yet.  There is also new research showing that healthy young COVID positive adults and teenagers may get chronic lung damage and be at increased risk of blood clots even without having symptoms of COVID.  The problem is, we just don't know.

As I have always said, people must weigh risks vs benefits when making any decision, and the attached article from the CDC I think lays out the details of this pretty well.  

https://www.cdc.gov/coronavirus/2019-ncov/community/schools-childcare/decision-tool.html

One thing that makes me sad about how the past few months have evolved, is that when this all first started, I thought this might unify us a species.  Unfortunately, I think the exact opposite thing happened.  Now we are more divided than ever.  Because this division makes me feel more scared and isolated, this is what I propose. Let's unite as the Happy and Healthy Community and commit to supporting each other through this.  We are all in the same boat and want the same things – for our families to be happy and healthy. 

Here is what we can offer-I commit to read everything I can as far as the research.  We have already purchased 15 different types of kid’s masks to see which ones we think are the best (only 5 arrived so far, so please give us a little time).  We promise to keep you updated with as much as we know.  And we will continue to try to introduce you to mindfulness tools so we can be emotionally strong as I too am already feeling the stress of this process. 

Many people have asked for my personal perspective so here it goes - I do think that wearing masks is a very likely requirement and a good thing for kids.  We are not "normalizing" wearing a mask-I hate that term.  NONE OF THIS IS NORMAL.  And it won't last forever.  Just like we strap our kids into car seats, have them where helmets when they are on their bikes, and teach them to look both ways before crossing the street, this is just another way to keep them safe – again, until we learn more  And kids can do it - sometimes I do not think we give these kids enough credit. Unfortunately, this past week I had a death in my family.  Up to the wake and funeral, my kids have never needed to wear a mask more than 10 minutes (we have been very strict).  But when faced with a situation in which they had to wear a mask for 4 hours straight (at the wake), and then in 100-degree weather (at the burial), they did great!

We also need to consider what’s best for other students and teachers.  Some students have underlying chronic medical issues that put them at higher risk.  If everyone is using the appropriate personal protective equipment, then everyone is as safe as possible.  And let's face it-kids are very oral fixated and just plain gross.  Especially the younger kids-they often suck their thumb, put their fingers in their mouths, "eat" the edge of their shirts and yes, they even pick their noses.  Having a mask on would deter those behaviors and therefore lessen the infection risks.

We scientifically know that wearing a mask does not interfere with their ability to get enough oxygen.  And I really don't think it will cause social emotional damage-AS LONG AS WE DON'T SET THEM UP FOR THAT.  This is all going to stem from our parenting and how we present it to them and role model healthy attitudes concerning it.  If we explain to our children that this is what we have to do RIGHT NOW to keep them safe, then they will adjust. We need to set this up as an ACT OF KINDNESS, which I genuinely believe it is.  Kids want to be kind and help others.  Explain to them how they are protecting their fellow classmates, teachers, family members, etc.  Empower them with the joy that comes from helping others.  And role model it.

We are social animals by nature.  We cannot depend on the kids to "Socially distance" at all times.  Especially the little ones, they instinctively want to be close and play.  And the older kids can just be downright defiant to the rules.  I really cannot see how masks will not have a place.

We will get through this, and we will protect our "cubs".  

https://www.nationwidechildrens.org/family-resources-education/700childrens/2020/05/masks-and-new-routines-helping-children-with-special-needs-during-covid-19?utm_source=facebook&utm_medium=referral&utm_campaign=facebook&fbclid=IwAR0IMA84IcHThhNrHRSIq6XI_HAs603Mlr1FRhj92t1Cjm_A5uLM4T7wFC0

These articles have also been added to our master resource list linked to our website.

Please also note that we have purchased several brands of kids/teens masks and plan on trying them out with our own kids so we can better guide you on what kind of masks seem best for them.  Stay tuned….

7/2/2020 - Preparing for Whatever the School Year Brings

I think we are now at a place where there is a lot of anxiety, both for us and our kids about what school will look like in the Fall.  I can say honestly, I have lost much sleep over this topic in the past few weeks.  I have attached the AAP recommendations for school re-openings.  This is just a recommendation, but I think it makes some interesting points.   

https://www.aappublications.org/news/2020/06/26/schoolreopening062620

What I want to offer all of you is the perspective I have been trying to take throughout this journey of 2020.  I really think our species is evolving into something better than we were before.  The reality is that this pandemic has forced us to live in a more mindful way, even if we are horribly uncomfortable during the transformation.  I strongly dislike not having the answers and not knowing what to expect.  With this virus, things have been changing day by day. It is making us more resilient just in the nature of the uncertainty.  We are all in this together, and we are here to support you in any way that we can.  WE WILL GET THROUGH THIS, AND OUR KIDS WILL THRIVE.  And I really think we will be better for it in the long run.  This is our chance to grow and in order to grow, we need to be uncomfortable.

This is a short video I first saw on a retreat with Cory Muscara and I think it makes this point in a very interesting way (I don’t like his doctor comment because I do think anti-anxiety meds and anti-depressants do have a place in the best care of patients-but I like the rest of what he says):    https://www.youtube.com/watch?v=dcUAIpZrwog 

This resilience can be our legacy to our children.  I am not saying any of this is easy-because it’s not.  I’ve been struggling too.  But I do recognize this opportunity to make our kids stronger and less anxious about what the fall will bring if we can role model it.

My suggestion, and what I plan to do with my own kids, is to not tell them any details of our schools re-openings until school is just about to start.  Here is why… Firstly, these kids deserve a fun summer and the longer they have to think about the details, the more likely they could develop anxiety about them.  Secondly, if you agree with the recommendations, and you present them in a positive light to your children, then what if the recommendations change as the Fall approaches? That will just bring them more disappointment and possible anxiety later on.  Thirdly, if you disagree with the recommendations, and you verbalize that to your child, you have now set them up for anxiety and set the tone for a negative experience. 

The role modeling piece of all of this is huge to me.  Kids learn everything from us including language, values, beliefs, coping strategies, outlook on life (including optimism and pessimism), and gratitude.  This has been harder than ever, since now many of us “are on” 24/7 due to the quarantine.  But I invite everyone to consider this idea when the school recommendations do come out.  Complain to your spouse when the kids are sleeping.  Vent to your friends on group text that the kids can’t see.  Feel what you need to feel, and process it how you need to.  And make the decisions for your family that your instincts tell you to make.  But I really do think how we set our kids up for this coming school year will really have a dramatic impact on them.

The one thing I would also advise, is to practice having them wear the mask so they feel comfortable in it.  I do think it is likely that wearing a mask will take some form in what lies ahead, and that is one proactive thing we can do to smooth the transition.  Another email to come soon with tips on wearing masks.

Let’s all try to just take this day by day and we will figure things out as they unfold! We are getting stronger, and we will raise stronger kids, we just have to get through this uncomfortable time as we are still actively growing.

6/19/2020 - Re-Opening and Safety

Now that the phases of re-opening has begun, we wanted to reach out to everyone with some updates:

First and foremost, safety and infection control for our patients and staff remains a priority for us here in the office.  We have not relaxed our efforts -  we have stepped up our game.  We have continued ALL safety protocols including but not limited to, the strict room cleaning and sterilization procedures we have been using for months, completely separating all sick children from well children in our office space, leveraging telemedicine, eliminating our waiting rooms and trying to maintain social distancing.  All staff are wearing appropriate masks, face shields and gloves and following strict hand washing procedures.  We have recently purchased UV lamps similar to the ones used in operating rooms and we are rotating them between all the rooms in our office to further sterilize our space.  Everyone's safety is our utmost concern, and we want to assure you we are doing everything in our power to provide the safest, best care available.

Many of you have been coming to us with questions about sending your kids to camp, daycare, seeing friends and family, etc. It would be amazing if we had the ability to provide you definite answers.  In order to do that then we would need to claim to have a higher understanding of this virus, more so than any other physician in the world, and the ability to predict the future.  I really don't mean this in a facetious way, but in a more truthful we know this sucks kind of way.  There is a lot we don't know, and things are constantly changing.   There will be decisions you have to make based on risk/reward that may have consequences we can't assure/predict. We all need to get comfortable being a little uncomfortable.  "Safe" is a relative word now.  We can tell you what we know and what we would do, but you have to make the decisions that are right for your family.  Like all the decisions we make in life, you have to weigh risks vs benefits. Things to consider is if anyone who is in a high risk category (older grandparent in the home, immunocompromised family member) is in your direct contact.  How well the camp or daycare is following the CDC recommendations for safety.  How well your kids are doing at home.  

The reality is, everyone is feeling this very differently.  When you ask us what we would do if it is our own children, we are answering that more from a "gut feeling" than science and we want to be very clear about that.  As health care providers I think we will always feel this in a more cautious way, plus we have the additional strong responsibility of keeping our families and patients safe.  I have thought for years that our world has been creating a society disconnected from trusting our instincts.  Now I think this is how we need to manage our lives.  Trust your gut and make the decisions that feel right for you and your family.  I truly believe that instinct will point you in the right direction.

One other piece of this we want you to consider though, is "are the other people around you are going to follow the recommendations in the environments you are placing yourself in".  For example, before all of this happened, my family loved going out to dinner.  I belong to several restaurant groups on social media because I loved seeing which new places opened and reading reviews.  Now all I see is patrons complaining and begging other patrons to please wear their masks in common areas and follow the social distancing rules.  There are restaurant owners pleading with their patrons to follow the recommendations because they fear for their own well being and those of their patrons.  So my family has decided that "outdoor dining" for us right now is curbside pick up and eating in our backyard.  That's what my gut tells me for now.  How well are small children going to be able to follow the recommendations in public pools?  Just things to consider.

Things look promising in that the numbers of cases per day in NY has been decreasing, but we don't know what the future brings.  Wherever your heart lands, please be kind and respectful to those around you who may be feeling this differently.  This is hard stuff, especially if spouses, extended family and friends are not on the same page.  Trust your instincts and protect your cubs in the way that feels right to you. That's all we can do for now.

We have attached three articles I thought could be helpful.

Is daycare safe during a pandemic:  (good article that I think also applies to camps):

https://www.usatoday.com/story/news/education/2020/05/18/coronavirus-daycare-safe-childcare-reopening-guidelines-cdc/5205192002/

CDC guidelines about re-opening:

https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/going-out.html?CDC_AA_refVal=https%3A%2F%2Fwww.cdc.gov%2Fcoronavirus%2F2019-ncov%2Fdaily-life-coping%2Factivities.html

An article from the Child Mind Institute discussing the anxiety during re-opening:

https://childmind.org/article/managing-anxiety-during-reopening/?utm_source=newsletter&utm_medium=email&utm_content=Managing%20Anxiety%20During%20Reopening&utm_campaign=Weekly-06-16-20

We just want to reiterate that we are your community and we are here to support you in anything you may need.  Cory Muscara posted this in a recent podcast (#160 of his daily podcast "practicing human") that I loved and wanted to share with you.  He calls it creating a container of safety you can offer other human beings:

We see you

We hear you

We feel you

And we will stay here with you

5/22/2020 - COVID and Mindfulness

A large part of mindfulness is living in the present moment really focusing in on our senses. Covid has really changed that experience for me. First is sight.  I can’t see people’s expressions anymore due to the majority of their faces being covered by masks.  I miss seeing the children smile.  It’s hard to “read” people and connect with them the way I used to. To me, it is another layer of social distancing in its own right. 

Then sound.  It is hard to hear people’s voices through the masks.  I think we take for granted how much looking at people’s mouths when they speak really helps us with our hearing and understanding of the spoken word, even for people with normal hearing.  And that makes sense to me since children learn language by looking at our lips as we form the words.  Everything sounds muffled to me and I find myself yelling behind the mask most of the day just to be heard. 

Then touch.  I dislike examining children wearing gloves. It seems cold and impersonal to me.  I hate that handshakes and casual hugs are now a thing of the past. 

This virus literally strips us of our sense of smell and taste, so there goes the last two senses.  Some people I know who had the virus months ago still have not regained these senses. 

Now let’s take a break from Mindfulness for a moment and talk about a few hot topics; the use of Masks, Natural Immunity and Antibodies.  

I used to love looking on Facebook seeing how people are doing during this quarantine.  Now it makes me crazy.  This virus has now become the victim of politics (which I refuse to engage), conspiracy theories, lack of human rights and downright divisive.  I know these topics are controversial, and I do understand both sides.  I would like to share MY perspective as a medical provider and pediatrician with almost 20 years of clinical experience.

MASKS DO NOT MAKE YOU SICK.  Let’s just think about this one logically for a second. Every Neurosurgeon preforming a 16 hour surgery to remove a brain tumor is not becoming hypercarbic (retaining carbon dioxide) and dropping dead.  Masks serve the function of reducing the transmission of contagious germs.  Droplets that fly out of our mouths, including when we speak, not just cough or sneeze, are the key transmission route for Covid-19.  Those droplets partially evaporate, becoming tiny particles that are almost impossible not to inhale if you are nearby.  Research has shown that a cloth mask dramatically reduces the number of virus particles emitted from our mouths.  And yes, oxygen and carbon dioxide do travel through the masks.  This is also true for the protective gear health care providers need to wear such as N-95 masks and face shields.  My face hurts at the end of the day, and my skin gets irritated, BUT I CAN BREATH OXYGEN IN AND CARBON DIOXIDE OUT. 

WE SHOULD JUST GET NATURAL IMMUNITY and wearing a mask is preventing me from doing that.  As a clinician, right now, this virus still scares me.  We are learning new things about this virus every day, and there is still information we don’t know.  For instance, we don’t yet know the long-term effects fighting this virus will have on our body.  We are still learning how it affects children.  3 weeks ago we thought children were asymptomatic, and now some are becoming seriously ill.  There are also new reports of young children developing diabetes who are covid positive. And we don’t know why it makes healthy adults with no known pre-existing conditions end up intubated on ventilators fighting for their lives.   Every decision we make in life is based on risk vs rewards.  Please weight this analysis before making personal decisions that could put you or your family at risk.

I HAVE ANTIBODIES THEREFORE I AM SAFE TO BE AROUND.  There is absolutely no medical evidence to prove this. This is why I refuse to do this testing since the rate of false positives are so high.  This is not a guarantee of your safety or of the people around you. 

Another huge part of mindfulness is KINDNESS and in my mindfulness training I learned of a meditation called a loving kindness meditation:

May you be happy. 

May you feel safe. 

May you be healthy. 

May you be free from suffering

I think wearing a mask is the ultimate act of this kindness.  To me, this is not about our rights as Americans being infringed upon.  I get it, people don’t like to be told what to do. Neither do I.   But don’t wear the mask for that because someone is telling you to.  Wear it because it protects the people around you. You should wear it because you may be an asymptomatic carrier and you can transmit the virus to other people even though you “feel fine” or “have antibodies”.  Yes, it is not comfortable.  Yes, social distancing is a sacrifice.  Wearing a mask does not make you weak, scared, stupid or “controlled”, it makes you kind and considerate of others.  The person you stop to talk to in your community may have a loved one at home who has poor immunity.  To me, this is about humanity.  We need to heal the world, and that starts with each and every one of us doing our part to protect and care for one another.   Wearing a mask means you are part of a community your care about. 

And this kindness needs to extend to the families that are choosing to wear masks and socially distance. I have families coming to me literally feeling peer pressured and made fun of from their friends for trying to do what they feel is the right thing for themselves and their families. We are too old for this form of bullying (though I do imagine this is what the teenagers must be going through which is why I see “herds” of teenagers everywhere in my community not socially distancing or wearing masks).  Let’s please respect each other in all forms and let kindness prevail. 

Let’s own it-this situation sucks.  We have no idea how long it is going to last.  I understand that the economy is suffering. Trust me, as a small business owner I have suffered too.  But I also know that thousands of people have and are still suffering too.  Families who have lost people they love.  People still battling this illness. Healthcare providers on the front lines who will forever be changed based on what they have experienced and how much they have sacrificed to help us.  People in our community who are too compromised to be able to go outside even with a facemask on.  We need to care for one another.  We need to heal humanity first.  I love our community and will always be here to try to support it in any way that I can. 

May you be happy. 

May you feel safe. 

May you be healthy. 

May you be free from suffering

With every breath I take I am releasing these words, this energy, this intention into the world!  Even if the breath is behind a protective face mask! 

Number one on my list is that I have no freaking clue how this is going to turn out.  I don’t know when schools are going to open.  I don’t know when a vaccine will become available.  I don’t know how long this quarantine is going to last.  I don’t even know how this virus works.  Last week, I was very comfortable by the idea that this virus was not affecting kids at all, but now based on new developments, I’m not so sure.  As a physician, and as a parent, I like to know things.  I like to know how to treat my patients with confidence.  But this is all new to us.  I crave for the control I used to have. 

Now I feel myself shifting.  I am forced to adapt. I feel is a positive result of this pandemic is that we are all going to be forced to be more mindful as a necessity.  As an adaptation.  We have to live moment by moment, because we really don’t know what the next moment brings.  And with that comes many benefits. We will feel more joy in each moment, even during our routine experiences. We will take less for granted.  Each hug we will feel deeper.   Each breath of fresh Spring air will feel more refreshing in our lungs.  The unpredictable nature of the moment ahead makes this moment somehow more impactful.   And it is this sense of presence in these moments that is transforming me into someone better than I was before. 

The second reason I feel so uncomfortable, is that my kids are suffering and I have no way to “fix” it for them.   Since they announced the school’s official closing for the remainder of the year, one of my two older daughters have been crying each day over the loss.  Sarah is upset that there will be no field day or “moving up” ceremony.  Ava misses her friends and her teachers.  And when they get upset, I just listen, hold them, and cry with them.  I can’t make the school re-open.  I can’t make the world change around us.  I tell them I understand and I am sorry they are missing all of these things they should be experiencing.  I agree with them that none of this is fair. 

But then the moment passes, and they are back to playing.  Sarah came to me a few days ago and said “Mommy, Ava and I were talking and maybe we can make our own field day in the backyard”.  And Ava has come to me and said “mommy, maybe we can surprise Sarah with a graduation party on the last day of school in our house”.  This pandemic is teaching us resilience.  And it is teaching our children resilience.  The world is often not “fair”, but overcoming that and finding alternative solutions is what measures true success in life.

 The third reason I feel uncomfortable is that I see several parents in the practice projecting their own fears and concerns onto their children.  I have spoken to several families this week who are worried about their baby’s or toddler’s lack of socialization as a “scaring process” to these kids. THESE KIDS ARE NOT EVEN GOING TO REMEMBER THIS. Other parents are worrying that their anxiety is affecting their children negatively, meanwhile the kids are happy and playing.  This is a clear projection of our own fears and STOP IT.  You are just creating suffering for yourselves.  Now for the older kids, yes they will remember this, but they will remember how the house felt during this time more than the details. Turn off the news in front of them.  Show them that rather than being “stuck at home”, your home is a sanctuary where they are safe and loved.

I don’t like feeling uncomfortable, but that is when we grow, improve, and flourish. We are all in this together.  And together, we will persevere.  This mother’s day just realize we are all in the process of becoming butterflies, we are just still in the goo phases.   And we have to transform into big, beautiful, strong butterflies that can kill Giant Murder Hornets, because if these insects hit Long Island, I swear that S*#T is going to push me over the edge.       

Happy Mother’s Day everyone!

4/29/2020 - The kids are happy, so why aren’t we?

I think as parent’s we want to do a good job raising our kids. I think that is a fair generalization.  We want our kids to be happy, healthy and successful in life.  And I think most kids are doing ok with the world the way it is right now.  Older kids for sure are feeling it.  As I have written about previously, Ava has had her moments of sadness and grief, but they quickly pass, and she is back to playing tag with her sisters. 

These are unprecedented times.  In the past, our hardest “mission” would be to keep the kids entertained at home during a rainy weekend.  Now we are approaching 7 weeks of isolation. On Friday I wrote about our need for self-care.  But I think there is more to be said about the way we are feeling parenting right now.

I start each day with the intention of being the best version of myself. I am definitely not meeting all of my goals, but I try to.  I’m starting to question what this even means.  This virus has impacted all areas of our lives-our sense of safety and predictability.  Our sleep.  Our health. Even our relationship to ourselves.  I feel like I am on a roller coaster of emotions.  One minute I feel angry and resentful when I see other members of my community not taking social distancing seriously, then intense moments of grief (my really good friend’s mother died this week from Covid), to fear, then to anxiety, then to sadness, then sometimes despair.  And as I wrote on Friday, I feel this strong need to be the best parent I can be among all of these feelings. 

I see it from the conversations I have been having with the families in the practice, and I know I am the same-I think we are projecting our fears and worries too much onto our kids.  Am I making my kids anxious?  Am I a bad mother because I let my child play video games for two hours today?  Am I a bad parent because I have been giving my kid mac and cheese every day for lunch for the past month?  Am I interacting enough with the kids?   Am I a terrible parent because I yelled at my child for refusing to go to sleep?  Am I supporting them through this well enough?   Am I giving them enough time outdoors?  Is there something I should be doing better?  Am I giving them enough of me?  We ARE PUTTING A LOT OF PRESSURE ON OURSELVES.  And that is not helping the emotional roller coaster we are all on.  

At the end of the day, the kids are happy.  And yet we are still constantly questioning ourselves “are we doing enough to make them happy?”  We are creating suffering for ourselves.  We are doing a good job.  And you know how I know that-because the kids ARE doing well.   We need to give ourselves a break. 

Maybe there is no “best version” of myself. Maybe every day I am someone new. Maybe I need to meet myself for who I am in each moment and accept myself with compassion rather than judgement.  We are all tired.  I think it is pretty safe to say, we all want to get off of this roller coaster now.  But that is unfortunately, not our current reality. 

So let us start a movement of self-acceptance.  Let’s try to move past the self-judgement and take some of that pressure off of ourselves as parents.  Let’s stop projecting our worries onto our children.  Let’s love ourselves for all of the hard work we put into raising good humans.  Let’s give ourselves a much needed emotional break from those feelings of guilt, worry and inadequacy.  Let’s strive to be happy too, like our kids. 

And for what it’s worth, I think all of you are doing a great job.  As a community, we are still thriving and our kids are thriving.  Keep up the great work.       

4/23/2020 - I Just Need 5 Minutes to Not Be Needed

First of all, it is amazing to me how differently everyone is experiencing this pandemic.  Some parents have been furloughed or laid off and can barely afford to put food on their tables.  While some of us are supporting local restaurants by ordering in on the weekends.  Some of us are essential workers and have to go to work.  Some of us aren’t allowed to leave our homes at all because we have been exposed to the virus.  Some of us have not experienced any symptoms of this virus, and others have struggled to recover.  Some of us have lost a loved one, and some of us haven’t.  I see people struggling in all different kinds of ways.

But my struggle being a parent trying to survive this pandemic is this overwhelming feeling that I just need 5 minutes to not be needed.  Children were meant to be raised by a village.  That is what I really think nature intended.  Now we are all alone trying to manage every aspect of our children’s lives-24/7.  We are chefs, launderers, home cleaners, teachers, playmates, entertainers, caretakers and more.  We change diapers.  We give them baths.  We kiss boo boos.  And as a parent, I don’t resent these things.  That is part of the role of being a parent.  I signed up for it and there are parts of it I really enjoy.  But the kids have been home for 6 weeks now.  I can’t even go to the bathroom by myself without one of my kids banging on the door needing something of me.  There are very few moments of silence when I feel like I can think straight.  It mostly feels like just a constant state of somewhat controlled chaos.  Most days go by where I feel like my entire day was one huge exercise in multitasking.   I think this is especially true for parents working from home.  

We have been getting so many calls from parents of newborns and young infants worried that their babies are fussy.  Parents have no support at home.  Babies in that age group want to be held all of the time.  These new parents are “on” 24/7 without the typical grandparents or other family members there to help them. 

I am an essential worker, so I am not home as much as other parents are. When I do get home, my struggle is to “fake it”.    No matter how exhausted I am, no matter how stressed I feel, no matter how much anxiety I am feeling, I have to walk into my home as if the world is “Rainbows and Unicorns”.  And do you know why?  Because that is what childhood should be for kids. 

So much literature is coming out saying that what predicts success later in life has nothing to do with school grades or IQ scores, it is resilience.  And I want to role model that for my children.  Trying to fake my feelings around the kids is really hard, and I have good days and bad days.  It is a fatiguing process, but they don’t deserve this burden.  They deserve to have the best of me when I am home, it is a sacrifice I make.  But what about me?  What about what I need?  That just gets put to the side for now. 

And those of you who are health care workers on the front lines, I honestly don’t know how you are doing this?  I have an unlimited amount of respect and admiration for all of you.  So many parents in the practice whom I have spoken to, or friends of mine who practice adult medicine, are unfortunately going down the path of Post-Traumatic Stress disorder.   How you are holding it together as a parent is amazing.  I am in awe of you guys.

I am not saying we should hide all of our emotions from our children.  One of my very good friend’s mothers is currently dying from Covid.  She is just waiting for the call from the hospital.  I was honest with my girls about the situation and we prayed for her as a family. They saw me cry and they gave me hugs.  We need to teach resilience in all forms during this pandemic.  Even after that experience, we still had to clean up after dinner, change into pajamas, brush teeth, do bedtime routines.  I was still needed.

So let’s talk about self-care for a minute.  I suck at self-care-I own it. And as much as I hate to make broad generalizations, I think most of us as parents suck at it.  There are just not enough hours in the day. But there is something to be said for the idea that when you are on an airplane, the safety message always says put on your oxygen mask first before putting on your child’s mask.  If we can’t breathe, we can’t parent.  I looked up a bunch of self-care articles and blogs from multiple different resources, and a lot of it was unrealistic crap.  “Wake up with a positive attitude and make a plan for your day”.  “Take a warm bath”.  If I can’t pee by myself, there is no way I am going to find the time to take a warm bath. 

So I came up with a realistic list of things we can do to get through this very challenging time. 

• Meditate for 5 minutes every day.  For a while, I was on a good rhythm when I was meditating 5-10 minutes per day and it really helped me.  Those were MY 5-10 minutes.  Not my kids, not my spouses, not my patients, not my staffs.  They were all mine. There are tons of great apps that help get you started with this.  Simple habit is my favorite.  Insight timer has a timed mediation bell.  10% happier, headspace, calm.  Several are free for health care providers.  JUST DO IT-I am talking to myself and not just you.  I HAVE TO get back on track.  Don’t think about it.  Don’t plan do it.  JUST DO IT. 

• Exercise-do something-take a walk.  There are many free online exercise classes you can do from home (including the one we are offering – click here).  Do them with the kids.  Put the baby in a carrier and do it that way.  We need to feel better and stronger-both physically and mentally.

• Be outside.  Last week I didn’t have my car and I walked home from the office (it’s only about 12 blocks).  I felt so much better after just being outside.  We need that fresh air.

• Listen to music-the kind of music that you really feel.  Not Kidz bop or the soundtrack to Frozen 2.

• Listen to Cory Muscara’s daily podcast “Practicing human”.   I swear, this is getting me through life right now.

• KNOW YOU ARE NOT ALONE.  This isolation is brutal.  We are all struggling in our own ways.  Feel connected to this community of parents just trying our best to get 5 minutes of not being needed.

4/22/20 - Dr. Rubin’s Daughters Blog

So my daughters wanted to contribute to our community by writing about how they feel as a kid going thought his process of the pandemic and being quarantined.

By Ava Doulos (6th grade)

Dear fellow kids, I feel alone. I feel sad! I feel anger and resentment. Everything is so different know. I miss going to school and seeing all of my teachers. There is so much to angry about. Everything is getting cancelled. All these thoughts are circling in my head. I think about these things multiple times a day.

This is a hard time. We kids should not have to go through this, but we are. This virus is scary and it is okay to be afraid. But we can't let that fear control us and let sadness overtake us. We are strong and we are going to get through this. We don't know when this quarantine is going to end, and that really scares me. A few days ago I started crying while doing homework. I just couldn't hold in my feelings anymore. I just needed to let them out, and then I felt better.

I have a lot of more schoolwork compared to my younger sister and also I don't want to work at home. I want to work in a classroom on a desk. I want to walk to my next class but I can't. I wanted to see my friends-their actual faces not on a screen. So I just sat to think for a while and said to myself "it is okay to be sad about this but you know what I am stronger than this stupid virus!" This is what I think of when I start to feel sad and overwhelmed by my feelings. I've learned that during the day it is okay to take a break when I need it.

I thought that I was alone. That all these feeling are just "whatever". I thought no one else felt the same, but when I spoke to my friends, I realized they felt the same way too. We kids are a community. We have to stick together to support each other. This virus is making everyone stay at home which is making us feel lonely. But this will not last forever.

If you are a kid reading this, know that you are not alone. It is okay to feel sad, angry, overwhelmed, and frustrated. If you feel this way, you should talk to a trusted adult in your home. Once I did that, I felt better. One thing that my mom taught me was to acknowledge what you are feeling and ask yourself "is this feeling doing any good for me or is it making me feel bad?" If the answer to the question is "it is making me feel bad", then take a deep breath and let that feeling go.

By Sarah Doulos (4th grade)

Dear kids, I know that this is a very hard time for everyone. This is a tough time in life. I have very strong feelings. One feeling that I have is sadness. I am so sad that all of these events that were planned are not happening. When I think about the whole quarantined thing, I think "When is this going to end?" I don't know at all when this is going to end but I know that I can make the best of it. Sometimes I just want to cry and let it out. My mom has taught me that it is okay to cry and that I should let my feelings go.

One feeling that I have is anger. I am so angry that I will probably not have Field Day this year or my Fourth Grade Moving Up Ceremony. I'm so angry that this has to happen and that as a kid I am going through this crisis because I hate it. I feel so overwhelmed right now and I feel like this is such a bad situation as a kid.

I am also feeling frustrated too. I just don't want this to happen right now because I was having such a great year. I miss my teachers and classmates so much. I feel so frustrated thinking about this situation. I don't want to be in this world crisis because kids should not be going through this. They should be living their lives right
now playing without a worry on their minds. But "no". We get this instead.

I'm very disappointed. We were supposed to be in the Caribbean right now on vacation, for the one vacation we do every year. I thought that I could spend 10 days with my mom when she is not working but now she has to work so much. I wanted to spend time with my family. But, I do know that my mom is helping so many people, and that makes me feel better.

I am feeling happiness too. I feel in my heart that this is making us closer together. When this is all over we are going to be closer to our family and friends and never take them for granted. Nothing will ever be the same again but it won't be terrible. Overall, we should not let fear control us, but I know that all of us are a little scared
and afraid so we should just acknowledge that these emotions are here and we should just know that we are going to get through this.

Another thing that I wanted to say was that mindfulness is helping me. Breathing helps me. It makes me feel relaxed and calm. For a minute I feel the sensation that everything is going to be alright. I am living in the moment. And in that moment the future and the past doesn't matter. Mindfulness doesn't fix the problem, it just helps with it. I feel like this is so bad and we can't see our friends or family (not immediate). But I think that mindfulness is a good strategy to do right now and always.

 And our little Abigail (2 ½ years of age) has been coping with our current situation by literally refusing to wear clothes for most of the day……

We encourage all of the kids to write down what they are feeling so that other kids can read it and then they won’t feel so alone.  If you child wants to, please have them write their own “blog” or draw us a picture and email it to us.  We will post all of them. 

Some time has gone by now, and things have definitely shifted.  Most of us, at this point have either had the virus, known someone who has, suffered watching someone you love go through it, still have someone you love intubated in the hospital, or have already lost someone.  How can one small organism do so much damage?   Sometimes I feel like we are living in a horror movie-like it’s all a bad dream.  So much fear and grief.  People taking 2 months to fully recover.  Several of my friends and family still have not gotten back their sense of smell and/or taste or just still don’t feel “well” weeks after the initial infection.  This is all just craziness.

Then there is the constant fear of getting the virus for those of us who haven’t had it yet or have had it without symptoms so we don’t know if we have had it or not.  I am not afraid of dying from the virus, though the thought has occurred to me what my children would grow up to be like if I wasn’t there. I am afraid of getting sick, not directly, but more so because I am afraid of getting my family and loved ones sick.  I am afraid of my staff (my second family) getting sick.  I am afraid of not being able to be here for my patients if I get sick.  And I am afraid of needing to be separated from my family for any period of time.  Having to wear a mask and living in constant fear going to the store trying to get milk or eggs is insanity.  But that is our real life right now.

Now let’s talk about home schooling.  Because then I feel like we are living in a “Saturday Night Live” skit.  When was the last time you wrote a hyperbole as an adult?  I have an MD degree and I have to google almost everything to help my kids with their 4th and 6th grade homework.  Most of us are not teachers.  The kids are frustrated.  We are frustrated.  And my energy levels for it feel so low right now.  I’m trying to do better, but it is a real struggle. 

Several kids in several age groups are really starting to feel this now too.  Older kids are acting out.  They are angry and sad and they are mourning the loss of the end of their school year.  I know the new date is May 15, but it doesn’t feel like these kids are going back for the rest of the year.  I may be wrong, but that is how it feels right now.  They are mourning the loss of graduations, chorus recitals, “moving up” ceremonies.  They miss their teachers and their routines.  They miss their friends.  Several of these kids are also worried about getting the virus or losing a loved one to it (if they haven’t already).  That is a huge burden for a child.  But these are all valid fears and valid reasons to grieve.  Here is where the feeling of helplessness kicks in.  Yes, as parents we can validate our kids feelings.  We can give them coping strategies.  We can initiate open discussions about their feelings.  We can recreate a graduation or chorus recital via zoom for family and friends.  But we really can’t fix any of this for them. 

Let’s own it.  We really have no idea how long this is going to last.  It’s hard to reassure everyone around you when deep down we really don’t know how this is going to play out.  As a pediatrician, I can reassure all of you that kids are really not physically getting sick from this virus.  THANK GOD. But as far as this way of life goes, I have no idea how long it will last.  None of us do.  And that uncertainty really sucks. 

And then there is that group of people who are not taking this quarantine seriously.  Almost every night when I drive home from work I see a herd of teenage boys who I know are not all siblings either walking or biking (without helmets none the less to increase my rage even further) close together through our neighborhood.  Or the adults who completely ignore the rules and then put their co-workers, family and community at risk.   We are all sacrificing so much.  Just everyone play along or this is just going to take longer. 

And I miss certain things too. Simple things.  Like going to Trader Joes.  Like going out to dinner with the kids on a Saturday night.   I miss seeing my friends.  We tried the zoom friend hangouts and it is just not the same.  If it’s not the same for us, imagine how the kids are feeling this. 

We are all just stuck in the tunnel with no light in sight yet.  I do truly believe intellectually that positive changes will come from this when everything returns to our new normal.  I think we will have a new respect for the importance of social connection. I think we will feel more gratitude and not take so many things for granted.  I think we will all really appreciate a new sense of safety and well- being.   I just can’t feel any of those things right now.  Now I just feel angry, resentful and uncertain. 

So my point in wrtting this is that YOU ARE NOT ALONE!  Even in this time of forced quarantine and social distancing, YOU ARE NOT ALONE.  If you can relate to any part of what I have written today, then please take comfort in that we are all struggling.  We are all one community trying to navigate these difficult times the best way we can.  So my mindfulness challenge for this weekend is to feel whatever it is you feel.  Don’t try to suppress it. Don’t try to hide it.  Don’t try to pretend it’s not there.   Just feel what you need to feel.  Then pull yourself together and let’s keep moving forward.  Day by day.  Moment by moment.  We will preserve.  And we will support each other through this.  There is a light at the end of the tunnel, we just can’t see it yet.  But it’s there. 

4/15/20 - Is This Serving Me?

So this Easter was “ok”.   We had a nice meal, the girls wore their Easter dresses.  I looked up every possible game, craft and activity I could find on Pinterest to try to make their day full and fun.  We zoomed with family.  But I felt sad.  And I tried my best to hide it.  It just didn’t feel the way the Holidays usually feel.  I had my morning coffee, acknowledged my sadness and disappointment, took a deep breath, and made the best of the day that I could for them and myself.  Those feelings were not serving me.

Monday when I got home for the office Andrew tells me Ava is “not feeling well” and she is laying on the couch watching TV.  Of course, my first reaction is one of complete anxiety-so afraid I brought home this virus to her and she was actually ill.  But he reassured me she had no fever and just seemed “down”.  I did my traditional “self-disinfection” process and had dinner, and then I went to sit with her.  She was on the couch under a blanket watching TV. We just sat for a while.  Then she enjoyed some left over desserts from Easter with no problem, so I knew she couldn’t have been truly sick, lol.

Then we snuggled in bed and I asked her “is there any chance you felt sad today?  Is that maybe why you were not feeling well.”  She immediately burst into tears.  “Yes mommy, how did you know? she said.  I said “It’s because I grew you-we are always connected and I understand because sometimes I feel the same.  And I told her that I had felt sad the day before, but named the emotion, I knew it was sadness, and then I realized the emotion was not serving me, so I took a deep breath and I let it go. 

This is a tactic I have learned through my mindfulness practice and I use EVERYDAY!  Especially now.  And sometimes I need someone close to me to literally ask me “is this emotion serving you?” if I am too overwhelmed to ask myself.  If the answer is no, I take a breath and move on.  Believe me, this is a practice and it is not easy.  But just like everything else in life, it has gotten easier the more I’ve practiced.

And then she asked me “why do even have emotions anyway?  And I said it is because that is what makes us human.   And there are so many wonderful emotions, like love, peace, happiness, excitement, surprise, accomplishment, gratitude, hope, pride. You have to know what sadness feels like to really know what happiness feels like.  You just have to name the emotion you are feeling in your mind when you are having the emotion and ask yourself “is this emotion serving me?”  If the answer is yes, then this will make the positive emotions feels even better.  If the answer is no, then take a deep breath and let it go. 

Practice this.  Teach this.  Kids right now are really going through significant periods of loss and grief, of a life they were used to living.  We all are.  What we need to do as families is to really connect with one another.  Our entire lives right now are about social distancing from our loved ones.  We have to tighten those connections at home-not just with our kids, but also with our partners.    We have to validate each other’s feelings and needs and to be able to be open with each other.  I really believe these bonds we are strengthening is one positive result of this pandemic.  And when all of this is over, and we go back to our new normal way of life, imagine how good it will feel to feel safe after all these months of fear. 

4/10/20 - Should Be’s

Last night my daughter Ava (who will be 12 in June) started to cry at our dinner table over something pretty trivial and it was unlike her.  She asked to be excused from the table so she could take a few minutes to herself and “take a few deep breaths”.  Of course, I said yes and I gave her a few minutes alone.  After some time went by, I found her sitting on the floor of our den, in the dark, crying. So I sat with her.  She then started to tell me how much she misses going to school.  How much she misses seeing her friends.  How she likes doing the daily zoom exercise class because she feels like she is helping kids stay active and not be bored, but how she really wishes all the kids could just be at the park playing instead.  She expressed sadness and disappointment because RIGHT NOW we were supposed to be in the Caribbean on the one big family vacation we take every year. Instead of having our toes in the sand, we were “stuck” in the house.   She was upset that as a family who typically celebrates both Passover and Easter, how the holidays just seem different this year.  She misses not being able to see our family in person on the holidays.  A Zoom Seder and Easter dinner is just not the same. 

So I sat on the floor, in the dark, hugged her and cried with her.  I agreed that none of this is fair.  That the Holidays do not feel the same this year.  That this virus really does suck ass and has changed everything in our world for now.  That I would give anything to have my toes in the sand right now with our family on vacation spending time together.  I tried my best to make her feel validated. 

She then said “things should not be this way”.  And even though I agree with her, that’s when I tried to have her (and myself) see a different perspective.  “Should be’s” are as dangerous as “what if’s” as far as our well- being.  “Should be’s” create suffering.  “Should be’s” create a perspective of the world that pulls us out of the present moment.  It is ok to be sad.  It is ok to mourn losses.  But once we start with “this shouldn’t be happening to me”, “this shouldn’t be the condition of the world right now”, then we are automatically making ourselves suffer due to the reality being so different from our expectations. 
So then I asked her “what is happening right now”?  “You feel warm in my arms and I can feel your heart beating”, she said.  And then we discussed that not everything is canceled.

• Spring is not cancelled.

• Love is not cancelled.

• Music is not cancelled.

• Imagination is not cancelled.

• Kindness is not cancelled.

• The Easter bunny is not cancelled.

• Hugs are not cancelled.

• Playing in the back yard is not cancelled.

• Family is not cancelled. 

• And the Holidays are not cancelled-just different this year. 

Here are some resources to help with our “different” Holidays this year, whatever you celebrate:
https://www.realsimple.com/holidays-entertaining/holidays/more-holidays/easter-activities-quarantine
https://www.merricksart.com/easter-activities-for-families/
https://worldinsidepictures.com/diy-easter-crafts-to-try-with-your-kids-during-corona-virus-quarantine/
https://www.aish.com/h/pes/f/9-At-Home-Passover-Activities.html
https://www.chicagoparent.com/play/holiday-fun/passover-activities-for-kids/
https://www.thebestideasforkids.com/toilet-paper-roll-bunny/?utm_medium=social&utm_source=pinterest&utm_campaign=tailwind_tribes&utm_content=tribes&utm_term=624645770_23539414_182948
https://www.happinessishomemade.net/easter-scavenger-hunt-free-printable/
 
THE MOST IMPORTANT THING TO REMEMBER IS THAT HOPE IS NOT CANCELED.   THINGS WILL GET BETTER.  THE MINDFULNESS CHALLENGE FOR THIS WEEKEND IS TO NOT GET STUCK IN THE “SHOULD BE’S” AND BE GRATEFUL FOR ALL THAT WE DO HAVE. 
HAPPY EASTER AND HAPPY PASSOVER.  EVERYONE AT HAPPY AND HEALTHY PEDIATRICS IS SENDING YOU PEACE, HAPPINESS, LOVE AND EVERY BLESSING FROM ABOVE.

4/8/20 - Get Rid of That Parent Guilt

We all have certain expectations about ourselves about the way we parent. For example, I try not to raise my voice.  I try to listen to all of their very long stories even if I think that their recap of how a fellow student misbehaved in Chorus class is crap.  I try to limit screen time.  I try to teach them healthy food choices and limit desserts and sweets.  BUT THESE ARE NOT NORMAL TIMES!!!!!

Think about what a S@#T Show parenting is for us right now.  What is the most common emotion new parents feel when they bring home their first newborn-ISOLATION.  Well now that is a joke since now we are all isolated.  The idea of the “village” is literally quarantined.  Let’s say you have a toddler or young school aged child or children at home.  Many of us are trying to work from home.  The balancing act is nearly impossible and this age group is likely going to act out and you are likely to see frustrating behaviors from them because they are trying to pull your attention away from everything else.  Kids are behaving as they are supposed to-their ultimate goal in life is to get your attention.  They don’t care if you are on a conference call.  And they don’t care if you are giving them positive or negative attention-they just want your attention.  Schedules are all screwed up.  Nap times and bedtimes are all screwed up.  This is craziness.  We will continue to provide you resources to help with these behaviors and please watch our weekly behavior analyst zoom session for additional support (Breanne Rocks!!)

Most of us are not teachers by trade.  Trying to home school is hard, especially with the older kids.  And for those of you who are teachers, the pressure of teaching your classes remotely while still trying to do your own kid’s school work is beyond a daunting task.
Now let’s assume you are an essential worker. You are out in the work force all day, doing your best-but let’s face it-your most likely coming home drained-not just from your regular work responsibilities, but also from this intense level of fear we are all living with right now while we are out in the world. 

And what about if you are a healthcare worker?  Then after you come home and completely disinfect everything you touch and then yourself, how much do you have left to give?   Some days when I get home I feel completely depleted and I am not even in the front lines working with adult patients in the hospitals.  Our kids don’t understand how hard our days are, and we can’t tell them.  We just have to “switch” gears and try to be ok and give our kids our love and attention.

So what is my point in writing this?  Please, give yourself a break.  WE ARE ALL STRUGGLING!  If your kids have more screen time than usual, then so be it.  If they have dessert every night, then so be it.   If you are less patient than usual, own it, apologize for it and then forgive yourself.  We are already experiencing so many emotions right now-anger, fear, uncertainty, exhaustion-just to name a few.  DO NOT ADD GUILT TO THE LIST.  WE ARE ALL DOING THE BEST THAT WE CAN.  Be gentle with yourself.  Forgive yourself.  Don’t create additional suffering for yourself.  We will get through this.  Just know you are not alone.

And even though so many of us are beating ourselves up inside over not feeling like we are being the best parents we can be, and we feel like we are struggling, our kids are still happy and healthy.  And that’s all that really matters at the end of the day. 

4/3/20 - Gratitude

I love this quote.  I really do believe that even in the darkest of times, there can be some glimpses of light.  In every situation, there can be something to be grateful for.  For example, I feel grateful for recognizing a part of myself I am not sure I knew existed prior to this pandemic.  I have had moments of crippling anxiety and despair, but then I found the strength to persevere.   I found this resilience I never would have known I possessed until being forced to need it.   I hope some of you could relate to this feeling.  

I also constantly think about us as humans.  We are social by nature.  That’s why all newborns want to be held all of the time.  That’s why hugs feel so good.   We are designed to thrive under the conditions of human contact.  But our society was getting to a place where a family or a group of kids would “share a meal” while all being on their phones.   I feel grateful that maybe this experience may shift our priorities.   That we will once again appreciate and respect the human social bonds.  

The mindfulness challenge for this weekend is to find something to feel grateful for throughout all of this.   We have to be the sunshine for ourselves and for our children to get through this.  If you have school aged kids, discuss this idea at dinner.  

We will get through this!  I know we will be okay.  We are a community and we will persevere.  We just need a little “sunshine” on this rainy day.   

4/1/20 - Stages of Grief

A friend of mine posted this on Facebook the other day, and it really grabbed me.  I feel like I am mourning a previous way of life that will never be the same.  I think I’m fluctuating now between sadness and acceptance-just depends on the day and my energy levels.  But this is where mindfulness really has come in to help me.  Every day that passes, is another day we made it through this.  And as long as I try to stay in the present moment, then I am not consumed by the constant worry of not knowing when and how this will all end. 

Please log in and join Nishant for the adult mindfulness program tomorrow night at 8:30pm.  I am really looking forward to it myself.   We also found an excellent adult yoga teacher who incorporates a lot of mindfulness in her practice.  I have taken her classes before, and they are excellent.  We are working on getting her onto the schedule. 

And I would also like to create another offering   for our community for a particular group of people that are suffering differently and more significantly than most-our health care providers.   Especially those of you in the front lines, working in the hospitals.  I would like to host a zoom virtual support group specifically for health care providers on Wednesday nights at 8:30 pm.  My intention is to discuss the feelings that we are all working through.  A safe place to vent.  I am not a mental health care professional, but I have a lot of mental health issues therefore I do consider myself an expert in the field, lol. 

The only way we are going to get through this is by leaning on one another.  Be safe everyone. 

3/26/20 - Pandemic Stress

A note from Dr. Rubin regarding managing our stress through this pandemic.

You guys have to remember, I’m right there with you.  I have generalized anxiety disorder and I have always been very open about that with my patients.  Yesterday one of my nurses who I have worked with for years said to me “thank God this happened now and not 7-8 years ago. We would have had to scrape you off of the floor.  You would never have been able to cope with all of this”.  And as much as I hate to think that is how my staff had perceived me in the past, I know she is right and I am so grateful for my mindfulness practice which helped me make change. 

I have moments where the fear is overwhelming. I feel it seeping out of every pore of my skin.  My chest feels tight.  It feels hard to breath.  My mind races.  I think to myself “I should be stronger than this, I shouldn’t be feeling this afraid”.  And then I remembered something Cory Muscara had taught me in the past.  I was creating suffering for myself by resisting the fear.  I was gripping against it.  It was my resistance to my emotions that was hurting me.  So instead I decided to surrender to it.  For now, this is our new way of life.  It won’t be forever, but I don’t have enough energy left to resist.  Fear is going to be walking beside us for quite a while.  I rather hold its hand than to spend what little energy I have left pushing it away.

We are all afraid-just surrender to it.  Don’t grip at it.  Don’t resist it.  Just let it be there.  We will all get through this together.  Check out Cory’s podcast number 75 “The moment before letting go” and this will make more sense to you. https://podcasts.apple.com/us/podcast/practicing-human/id1299444208

3/25/20 - Reality Check

Today I want to provide a kind of reality check.  I am seeing several parents getting to the point of panic.  Several of us are getting beyond concern and worry. I totally get it, but I want to try to get you to see another perspective.  Kids are the least affected by this virus.  Pediatric doctors in our local hospitals are being asked to help on the adult side since they are not seeing the pediatric population being hit by this virus.  Our recommendation for a child with a fever and /or cold like symptoms have stayed the same. 

• Make them comfortable. 

• Make sure they are not getting dehydrated (make sure they are urinating at least every 6 hours even if less than usual). 

• Make sure they are not miserable. 

• Monitor them for any signs of respiratory distress or trouble breathing (wheezing, having very noisy breathing, or breathing faster or harder than usual). 

If you are concerned for your child based on the symptoms above, of course we are here for you.  The point is simply, not to panic regarding a diagnosis, or potential diagnosis.  Even in patients with COVID-19, nothing is being done unless symptoms become severe.  Labeling the virus at this point is not significant, especially since we are already isolated and the testing is not readily available.

The flu is MUCH MORE LIKELY to cause these complications in kids than the Coronavirus.   And the flu definitely has a much higher mortality rate for children in this country than the Coronavirus.  Our children are going to be ok.  We will get through this.  We just need to come together and lean on (figuratively of course, practicing social distancing, lol) one another for support.

3/23/20 = Kids Role Modeling

One thing I have been thinking about a lot these past few days is just how freaking awesome kids are.  Especially as I watch my Abigail (who is 2 ½ years old) playing and jumping and singing without a care in the world.  Kids are the best version of us.  They are the epitome of mindfulness.   They are not caring about the previous moment.  They are not worrying about future moments.  They are just living. 

So many of the resources we have been and will continue to provide to you help in the way we role model resilience to our children.   But don’t forget, they are also our role models.  Breathe in their joy, their light-heartedness, their freedom from worry.  In so many ways, they are role modeling to us resilience.  I can understand the many frustrations that come from being home with your kids all day-trying to balance working from home and their mandatory school work.  I get it, I do.  But also let some of their innocence be contagious.  Let their joy seep into your pores.  Breathe their positive energy into your lungs.  Hold them close.  Give yourself the permission to not feel fear or worry even just for a few moments.  We are all going to be ok. 

1/1/20 New Years Message from Dr. Rubin!

So as some of our patients who have been with us for a while know, this time of year I like to post my reflections surrounding the new year.  To me, New Years is always a time to deeply look back at the previous year and try to set realistic goals for myself for the year ahead.  This year I feel I need to set those goals towards self care.  While this takes may forms, physical, mental etc, a main focus this year will be around mindfulness and my personal well being. 

I speak about the impact of Mindfulness often.  A few months ago I went on a mindfulness retreat with Cory Muscara, the Founder of the Long Island Center for Mindfulness.  Within the first hour of being there, I knew I made the right choice in attending.  We sat, as a group, to meditate.  I closed my eyes and took a few deep breaths.  And I started to cry.  That was the first time in God knows how long I stopped and checked in with myself.  To just stop and connect with my breath, my body, my feelings.  For so long I was just running.  Wake up, get the kids to school, completely engross myself in the office and my patients, dinner, and then be so exhausted I would go to sleep as soon as the kids were down.  Then... wake up the next day and do it all over again.  I never stopped long enough to just connect with myself.  Too busy to care.  

I see this constantly in the office.  Parents crying because they don’t feel like they are doing a good job parenting.  We feel short tempered with our kids and just exhausted.   Parents not enjoying their kids to their full potential because of the feeling of being so overwhelmed.  We are all just running.  We need to stop and breath.  

I understand because I am that parent too.  I felt like every minute of my day has been accounted for.  I didn’t have those 10 minutes to spare to connect with myself.  But you know what, that is bullshit.  I could find 10 minutes per day that were all mine.  Since the retreat I listen to Cory Muscara’s daily podcast (Practicing Human) and meditate 10 minutes every night before I go to bed.  And I feel the most composed, calm, grateful and happy I have felt in a long time.  

Social media over simplifies the idea of self care.  Taking a bath or getting your nails done is not what I’m talking about.  Especially because during those times we are often running through our ever long “to do” lists in our minds.  In my heart, I think true self care is calming your mind, focusing on your breath, and connecting with yourself.  

Parenting is hard and we all make mistakes.  Be gentle with yourselves.  Every moment is a new beginning.  I’ve been asked many times in my career: “How can I parent with less anxiety?”.  “How can I enjoy my kids more without feeling so overwhelmed?”  “How do I parent in a more calm way without getting so easily frustrated?”  I finally have the answers to all of these questions....Mindfulness!!!!

Get on your path.  Check out Cory’s podcast.  Meditate 10 minutes a day.  (By the way, I promise I get no financial kick back from recommending Cory Muscara-he has just been my best teacher in this life and I want all of you to gain the same insights).

I used to think that self care was selfish.  “I should be stronger.  I shouldn’t need a break.”   But I’m realizing it’s not selfish, it’s a necessity.  I know that if I made more time to exercise, meditate, rest when I need it, I’ll be a better version of myself in all other areas of life.  I can be a better mother, spouse, doctor, leader and friend.   That’s what I want to accomplish this year-to become a better, healthier version of my myself.   And I invite you all, as we are one community, to do the same!