Author: Wish I Knew Before

How to Raise Good Eaters

Wish I Knew Before4 Comments

Updated 9/2/2021

Feeding our children in this day and age is challenging – unhealthy food is too readily available and social norms of accommodating children can cultivate picky eaters. As parents, we’re met with a plethora of feedback from grandparents, pediatricians, parenting books, media, peers, societal norms, and social pressures and expectations.  

My kids, ages and 7 and 9, are good eaters, in the sense that they eat a wide variety of foods (meats, vegetables, grains), and will try new foods. Some of this may be luck, but it’s also due to habits. There are constant “turning points” in their eating career, and we can’t take their eating habits for granted at all. Their tastes and behavior continue to evolve and I’ve sometimes had to double down on some habits that wane easily. Below are our top 10 habits (10+ actually) to raising healthy eaters.

Today’s array of food options are endless

#1 Limit Snacks

Start with limiting snacks in quantity and frequency. This is very subjective – we’ve had friends who say they are limiting snacks but I see that their “limits” are quite different than ours. The basic idea though is that snacks, whether in the morning or afternoon, reduced my kids’ appetites for regular meals. 

Not over-snacking is fundamentally important to being a good eater at mealtime.  It’s totally fine and good for kids to be a little hungry or thirsty. The effectiveness of any other tactics that we use at mealtimes is very dependent on this habit of limiting snacks. I have seen a friend give his child a cupcake 30 minutes before dinner, and then fight with his son to have him finish a pasta dish. My friend didn’t realize that he himself had sabotaged his son’s appetite for that dinner. 

#2 Eat Only in Designated Areas 

We only allow eating in the kitchen and dining room, never in any other area of the house. First, it reduces ant and sticky toy problems. Secondly, it takes away the temptation to extend snacking and meal times and distract from the eating process itself – eating is not to be multi-tasked. Originally, we started this habit from when they were mobile because we didn’t want to be chasing them, or cleaning up after them all over the house. Then, I saw other kids running around their homes after taking a few bites, and coming back to the table for now cold food, and fighting with their parents about finishing their food. I realized we had conveniently sidestepped this battle. 

#3 Try Everything At Least 10 Times (not during the same meal)

I once read from one of those child nutritionist guides that people need to try something at least ten times to determine if they like that particular food or taste. Whether this is true or not, I have actually used that rule of thumb to great success. My children have expressed dislike for a lot of foods at one point or another. I tell them the rule and continue to put the foods that they dislike on their plates. My only requirement is that they have at least one bite of the food that they dislike and they can discard the rest. Over time, they surprisingly just started eating more of that food.

One of my kids hated mushrooms with a passion. Over the course of a year of seeing them on his plate regularly, he suddenly started eating them. So don’t give up. Keep making the food a part of their meals whether they eat it or not. Foods come in and out of “favor,” especially the vegetables, so if I remove them from the lineup altogether, I’ll never know when they’re coming back into favor!

# 4 Don’t Offer Alternative Foods During a Struggle

There have been times when my kids didn’t like the meal we had prepared for them, and basically looked like they were going to be missing a meal. Their grandparents have then suggested that I heat up some leftover pasta or other food that they knew the children liked. First, missing a meal here and there is okay. Second, try not to give in during those moments. All it takes is your doing this a few times, for your child to see your potential as a short order cook. 

#5 Prepare a “Reliable” Food

I might sound like a mean mom, but I don’t like my kids to go hungry either. To be proactive about avoiding a struggle, try to always have one aspect of the meal that is “reliable.” Reliable as in reliably eaten. That could be something as basic as rice, pasta or bread. If you’re introducing a new grain, then try to make sure either the meat or vegetable portion is “reliable.” That way, even if they’re not fully satisfied, they won’t “starve.” Or I might even heat up the “backup leftover food” and offer it as a side dish in advance, so long as they don’t think I got up specifically to go make a special dish that only they like to eat.

# 6 Offer Yucky Foods in a Variety of Ways

We prepare the “yucky” foods in different ways: different shapes, different spices, and different sizes. Our kids hated red bell peppers. Then I chopped them up and put them in chili (which has a pretty overwhelming flavor on it’s own). They noticed them, but couldn’t taste them. Gradually, I put the chopped bell peppers in less overwhelming dishes and before I knew it, they were eating large pieces without complaint (although still without love). 

#7 Have One Bite and Don’t Force Finish

We have a one bite rule. It doesn’t matter if they spit it out. The important thing is that they put it in their mouth. And the important thing is that they try it every time it’s offered. 

On the flip side, we never encourage the kids to finish their meal either. We encourage them to stop eating when they feel full even if it means leaving a lot of food on the plate. We don’t say just “a few more bites.” However, we also have limited snacks and don’t prepare special meals outside of meal times (unless someone is sick), so there’s no gaming the system for extra snack food.

#8 Offer a Variety of Foods Early On and Repeatedly

It’s now commonly encouraged for parents to introduce babies to a diverse diet as a way of limiting the likelihood of developing allergies. However, this advice has multiple benefits. It helps develop a diverse palate early on. The ability to eat a variety of foods early on makes it easier for kids to get the different vitamins and minerals that their growing bodies need. To avoid FOMO, even junk food, snacks, and desserts are all sampled – just in limited quantities! The important thing is to keep offering the variety even as it is rejected. . . possibly over and over again. 

#9 Control Meal Portions

Controlling how much food your children eat is contrary to most of the advice I found in baby-led weaning books, parenting books, and from our own pediatrician. All these sources advised that babies and young children know how to self-regulate and will stop eating when full. This ranks among some of the most incorrect advice I ever heard from “official” sources. Maybe this was true for breast-feeding, but absolutely wrong for milk and solids. Or perhaps this may have been true for humans prior to a world of processed foods, fiber-free food where eating bite after bite was not so easy. 

Yet given the ubiquitous advice, I tried this many times, and watched as my babies, and later, children absolutely did not know their limits over and over again when eating a food they liked (usually something fried, sweet, or a processed snack). In fact, adults often don’t know their limits either when it comes to snacking or foods they like in particular, and we somehow expect children to? Allowing kids to stretch their stomachs too much on a regular basis sets them up for a cycle of overeating and getting more than their bodies need. Try to limit meals to reasonable quantities until you’ve taught your kids to reliably know how to stop eating. 

#10 Educate About the Foods They’re Eating

Don’t underestimate the ability of your children to want to do right by their bodies. In past societies, food education may not have been so important, but with all the choices of foods these days, teaching kids how to navigate the food world is just as important as teaching them how to navigate cyberspace. 

I wasn’t very aware about food growing up, but the trends towards understanding what we put in our bodies and our babies has really heightened my awareness around food and its impact on our health. Talk to them often about what your family is eating and why it’s good for you. Or when you’re having junk food, talk about why it’s not good for you and why you shouldn’t eat too much of it. Talk about cultural differences in foods and diets and the relative healthiness of each. Talk about the evolution of food. Talk about it all repeatedly. Eventually, it will resonate. 

For example, you can explain in a way kids can understand more easily. An 8/18/21 study published in Nature Food, framed eating a hot dog to be akin to losing 36 minutes of healthy life! Eating nuts, on the other hand, added 25 healthy life minutes. That news gave my children pause!

#11  Educate About Junk Food, Peers, and Society

When we joined the food world through organized sports and school, our kids became inundated with birthday party pizza and cake, sport practices that included brown bags filled with a variety of processed/healthy/sugary snacks, and classmates who got to eat candies and chocolate milk regularly at school lunchtime. We had to teach our kids about how food and snacks are thought about differently by each family and why they might not get to eat as much of the snacks and sweets as their friends. Holding off the peer pressure to eat like their friends can be one of the toughest things to do, but it gets easier the longer you do it.

#12  Model Food Behavior

Finally, what if you’re a junk food junkie and / or a picky eater yourself? It’s extra, extra tough to raise your kids to eat differently than you do, so I had to model the food behavior I wanted them to have. 

I found myself learning to be a better eater by following the habits that I was trying to model for my kids. Interestingly, my appetite for junk (formerly quite strong), waned when I removed a lot of the items from my shopping list. After I learned to pay attention to labels and ingredients, the rational side of me was put off by many of the ingredients in a lot of packaged foods that I used to eat. 

Similarly, I hated lamb meat, eggplant, and brussel sprouts growing up, but in an effort to diversify and follow the behavior I was trying to encourage in my kids, we introduced it in meals periodically. Roasted brussel sprouts and spicy garlic eggplant are now in my list of favorite vegetable dishes. I’m still working on the lamb meat, one bite per meal. . .

Prevent Food Allergies With the Latest Research

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It may be too late for my children in some respect, but it seems there are more things that we now know about how food allergies develop that would have COMPLETELY changed the way we approached our kids’ diets at birth. If you’re concerned about your baby or child possibly developing allergies, below are some things you should absolutely consider. Actually, there are an increasing number of individuals who are developing allergies as adults, so it’s worth taking a read below even if you’re no spring chicken. 

Food Allergy Epidemic  

First, some statistics that I came across recently – according to Dr. Kari Nadeau, who is well-known in the food allergy treatment world:

  • 1 in 12 children in the US, Europe, China, Korea, and Japan have food allergies
  • 1 in 10 children in Australia
  • 1 in 10 adults had food allergies according to a recent survey of 40,000 adults. 50% weren’t aware of the allergies until they were adults.

I don’t have food allergies yet, but I’ve developed some environmental allergies as an adult. . . are food allergies on the way? Below are three food allergy prevention strategies that every one should know.

Food Allergy Prevention Strategy #1: Avoid Antibiotics and Heartburn Medications 

the cause of food allergies
This visual illustrates the theory of how modern life may be altering our body’s natural defenses

Avoid antibiotics and heartburn medications if at all possible –  they cause changes to your gut flora, which in turn, affects the way your body responds to food.For all ages, studies have come out showing a link between the increased likelihood of food allergy and the use of antibiotics or heartburn medications. While the studies have shown correlation and not necessarily causation, it’s suspect enough to reconsider your next antibiotic or heartburn medication RX. If there are alternatives, why risk it? Until recently, I didn’t realize that there are a lot of things to try before resorting to antibiotics or heartburn medications, so do your research on alternatives.  Your doctor may or may not be aware of this information, let alone warn you of the possible issues when prescribing these medications. For further understanding:

Food Allergy Prevention Strategy #2: Introduce Potential Food Allergens Early – Don’t Avoid Them

Neither my husband nor I have any food allergies – just hay fever, so I didn’t consider that my kids were at high risk for food allergies. Yet both kids ended up with nut allergies (and underwent oral immunotherapy). We followed the accepted approach at the time of avoiding nut introduction until age 1. 

Studies over the last few years have reversed that recommendation and pediatricians now recommend introducing potential food allergens as early as possible. This is a pretty time-sensitive, age-sensitive recommendation, so don’t miss this window if you want to try it. These two articles from verywellhealth.com give a good introduction on the change in recommendations as well as guidelines for how to do this early introduction to food allergens as safely as possible during COVID-19 (when you may be tempted to hold off). They write specifically about peanut, but it’s the same idea for all food allergens:

Alas, it’s also clear that there is still confusion and the guidance you receive will depend on your pediatrician. This study by Contemporary Pediatrics found that pediatricians today are still not necessarily recommending the current guidelines. Regardless of what your doctors say, do your own research too, especially given the inconsistencies across medical professionals, and come to your own conclusion about what you want to do. If you do introduce potential allergens early, do it with the support of a doctor because the risk levels vary by family.

Food Allergy Prevention Strategy #3: Control Eczema

The existence of food allergies has also been strongly linked to eczema, of which some forms are suspected to trigger food allergies. 30% of children with eczema also have food allergies. Researchers call this the “atopic march.” It’s described as a pattern, “in which eczema generally appears first, followed by food allergies, seasonal allergies, and asthma.” The link to eczema is so strong that the American Academy of Pediatrics first guideline  “recommends that the highest risk infants — those with severe eczema and/or egg allergy. . . — be introduced to peanut as early as 4-6 months of age, following successful feeding of other solid food(s) to ensure the infant is developmentally ready.”

For babies and children (and who knows, perhaps adults, too?), it appears particularly important to try and control eczema as best that you can to avoid the risk of further allergy development. This includes finding and avoiding the triggers for eczema as well as treating it topically. 

Both Western and traditional Chinese medicine have some strategies (listed extensively on the National Eczema Association website). In Western medicine, there are injections (like Dupixent), topical creams, and washes. In TCM, I’ve heard about herbal pastes that are applied topically as well as herbal medicines to alter the body’s reaction to triggers. I’ve read on the Facebook group for Dr. Xiu Li Min (an expert on integrated East/West approach to food allergies) that she believes part of the food allergy treatment involves addressing the severe skin issues first (which she has done with apparent success through Chinese herbs) before tackling the food allergy.

Resources

Antibiotics linked to development of food allergies

Heartburn medications linked to development of food allergies

The latest in food allergy prevention

Developing food allergies as adults

Eczema and food allergies

Free Printable Eye Charts

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Free printable eye chart
Free eye charts

Since I started trying to reverse my myopia and control my child’s myopia progression, I’ve found eye charts to be handy. During the pandemic with distance learning and increase in computer use, I have used eye charts as a way to check my kids’ vision regularly. However, I’ve also found that those sneaky kids have memorized the eye charts so it’s harder for me to check their vision accurately! So below I’ve included links to the best free printable eye charts that I found online as well as links to some eye charts that I can customize. 

Standard charts typically come in two formats, one designed for 10 feet viewing distance and one for 20 feet (6 meters) viewing distance. The 10 feet (3 meters) chart is useful when you don’t have enough space for a 20 feet check. 

Best, free standard eye charts

These were the best, free eye charts that I could find online:

20 feet, 6 meter – free standard eye chart in PDF format

10 feet, 3 meter – free standard eye chart in PDF format

Free, customizable eye charts 

I also made my own, so I could occasionally change the lettering. To customize either of the charts below, log in to your Google account while you are accessing the Google document. Select “make a copy” and modify the letters and spacing however you want in your copy. (Be sure to print them on default settings and not “custom scale” or “fit to page,” etc. as it will throw off the size of the printed letters.)

20 feet 6 meters customizable eye chart – 1

10 feet 3 meters customizable eye chart – 1

Eye Massage and Eye Acupressure Points for Myopia

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I reviewed some online literature on eye massage to add to my repertoire of things to try for slowing / reversing myopia. As an acupressure layman, I found the acupressure points and techniques seemed to vary just enough from site to site to confuse me initially. Finally, I cobbled together some basics. 

(Note: there are also eye exercises and acupressure points on other parts of the body that directly affect the eyes. I think I will have to review those thoroughly another time.)

My basic takeaway

  • The theory is that eye massage improves the blood circulation to the eyes and relaxes the eye muscles. Tight eye muscles are understood to eventually contribute to myopia. 
  • Eye acupressure is practiced regularly in schools in China, but studies haven’t been conclusive about their benefits on myopia and I’m not sure that any studies could ever be conclusive. After all, how could they really know if the kids were doing the massage correctly? Plus, there are so many other factors that may also affect myopia progression. 
  • You have to be able to do this pretty regularly for some duration to judge whether there is any benefit to you. 
  • I don’t get the feeling that eye massage could slow myopia down significantly on its own but perhaps it would be helpful as a supplement to other methods like myopia control.

Acupressure points for myopia

I cross-checked the acupressure points that children were taught to use in some of the myopia and acupressure studies with some other articles that I found about acupressure for improving vision and eye health. Below are the points (and diagram of what) I found. I listed all the variations in naming that I came across:

  • BL2 / Zan Zhu / Cuanzhu / 攢竹 – located on the inner end of the eyebrow
  • EX-HN5 / Tai Yang / 太阳 – located on the flat sides of the temple
  • BL1 / Jing Ming / 睛明 – located in the inner corner of your eyes
  • ST1 / Cheng Qi / 承泣 – located directly below the pupil between the eyeball and the intraorbital ridge. A questionable source, Dr. Deborah Banker identified this as the access point for the ciliary muscle. Although her credibility is unclear, the ST1 point is indeed frequently mentioned as an important acupressure point. 
  • ST2 / Si Bai / 四白 – located on the depression of the infraorbital foramen below ST1, about where the nostrils begin
  • Tianying / Ashi – I could only find mention of this point twice, but I included it because it was mentioned in articles that were specifically dealing with myopia.  It seems to be located vertically between BL2 and BL1. It is also the first point referred to in this video by Dr. Grace Tan, whose credentials seemed legit (if you are open to TCM). The Dr. Banker article stated that this point could manipulate the superior oblique muscle which is a muscle that can cause the eye shape to change.
  • Series of points covered by scraping along the eyebrow and just below the lower lash line, points which were included in both of the studies of Chinese students and also an easy to follow video of Dr. Grace Tan performing the massage: 
    • ST1 (see above)
    • TE-23 /Sizhukong / 丝竹空 – located on the outer end of the eyebrow
    • BL2 (see above)
    • EX-HN4 / Yuyao / 鱼腰 – located in the middle of the eyebrow in the hollow, directly above the pupil
    • GB1 / Tongziliao / 瞳子髎 – located on the outer corner of the eye
Eye acupressure points for myopia
Eye acupressure points for myopia

How to do acupressure on the eye points

For each of the points, there were different recommendations for what to do – it seems that you could do either a circular massage or a press and release: 

  • Circular motion – This is a circular kneading motion on the point with your fingers. Apply gentle pressure at the same time as kneading.
  • Press and release – Press at a 90 degree angle for 10-30 seconds and slowly release. Do this for a couple of minutes for each point. If you prefer a more precise time prescription, you’ll just have to make it up as I found a range in my review of the literature. 
  • Scraping – Apply light pressure and sweep your fingers along your brow line and below your bottom lash line. This encompasses stimulation of multiple points around the eyes.

Resources

Research on whether eye exercise or massage can be helpful:

Identifies different eye acupressure points and talks about the specific eye problems that they may address:

Explains how to do the acupressure:

Videos that show how to do eye acupressure:

Thoughts? More info? Better info? I’m all ears. Email me at:  wishiknewbefore20@gmail.com or leave a comment below.

Reversing Myopia: Update #1

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Reducing myopia: Going the other way seems doable. . . but slow

It has been about one year since I began trying to reverse myopia and I am relatively encouraged by the results after visiting the optometrist to validate my progress. If you’re new to trying to reduce your myopia, check out this post first: 

  • Going off of the contact lens prescription, my right eye improved by -1.00 diopter. My left eye improved by -1.25 diopters. 
  • Going off of the spectacle prescription, both my eyes improved by about -0.50 diopters (SPH), and neither eye needs astigmatism correction -0.50 (CYL) to see 20/20. 
  • I read on this post that the average rate of change on eye improvement forums seems to be about 0.25 to 0.75 diopters per year. 

In order to minimize variation in measuring my eyesight, I made sure to go to the same optometrist (actually, I’ve been to the same one for the last 13 years). Here is a chart of the optometrist prescription changes and my own reduced lens RXs over the last year:

Eye Exam DateGlasses RX (from optometrist)Contact Lens RX (from optometrist)My Reduced Glasses RX for reversing myopia during this time
October 2018Corrected to see 20/15:
R: -8.00 w -0.50 astigmatism
L: -6.25 w -0.50 astigmatism		Corrected to see 20/20:
R: -7.50
L: -6.50		I first started wearing reduced lens June 2019:
R: -7.25 w -0.50 astigmatism
L: -6.00 w -0.50 astigmatism
End of September 2019Corrected to see 20/15:
R: -8.00, no more astigmatism
L: -6.25 w -0.50 astigmatism

Corrected to see just up to 20/20:
R: -7.5, no more astigmatism
L: -5.75 w -0.50 astigmatism		Corrected to 20/20:
R: -7.00
L: -6.00		In October 2019, I started wearing:
R: -7.25 
L: -6.00 
Early August 2020Corrected to see 20/15:
R: -7.5
L: -5.75 w -0.50 astigmatism

Corrected to see just up to 20/20:
R: -7
L: -5.75 (no astigmatism correction)		Corrected to 20/20:
R: -6.50
L: -5.25		In March 2020, I started wearing:
R: -7.00 
L: -5.75 

Things that may have contributed to this vision improvement

I do think the improvement is significant enough to indicate that something about the reduced lens method could be working. At the current rate, I will have decent vision without glasses in 5-6 more years! Here are all the things that may (or may not) have contributed to this improvement:

  • I wore reduced lens by about 0.25 diopter from 20/20. Each time, I started to see 20/20 with my glasses, I reduced the lenses by 0.25 diopters more. For what it’s worth, -0.50 amount of astigmatism (CYL)  is approximately 0.25 (SPH) according to this helpful manual. I find that to seem about right in my own testing.
  • I did not wear differential lenses (for close up work) as suggested by some myopia reversal sites. It’s a bit of work to do that.
  • I tried to incorporate regular eye breaks during screen time with this cool timer (that I originally bought for my kids).  I used eye charts as a way to check my vision in a consistent way. Unfortunately, I still sometimes have 2-3 hours of uninterrupted screen time when I’m really focused. I used eye charts as a way to check my vision in a consistent way.
  • I averaged 6.5-7 hours of sleep at night. I’m trying to bring that up to 7-8 hours.
  • I average 1-2 hours outdoors everyday. 
  • I drank chrysanthemum tea with goji berries about 1-2x week on average.
  • I’m in my forties. According to some accounts, this is when distance vision gets a little better and close vision gets more difficult – but not typically by a lot.

Things to note

  • Night vision – on endymyopia, many folks seem to say night vision is challenging despite improvements to daytime vision. I agree night vision is definitely not as good as day vision, but I am probably still seeing 20/25 at night. My optometrist said that even measured at 20/20, I could expect my night vision to feel especially worse, because I was used to a certain amount of clarity at night (because I can be corrected to see 20/15 and am used to that clarity). 
  • Despite not doing a whole lot of conscious active focusing or print pushing or wearing a differential lens, my eyes did improve. I’m guessing that I will need to step up the active focusing on things, etc.in the next year to come if I want to keep improving my vision.

Thoughts? More info? Better info? Questions? I’m all ears. Email me at:  wishiknewbefore20@gmail.com or leave a comment below.

Chrysanthemum and Goji Berries Tea Recipe for the Eyes

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Are you trying to bolster your eye health? In our family, we are definitely doing what we can to strengthen the eyes. At any given time, members of our family will have red and/or itchy eyes, dry eye, or blurry / myopic vision. While we use artificial tears and allergy eye drops, we also do what we can to help address the root cause.

In traditional Chinese medicine, chrysanthemum (菊花, ju hua) is the go to herb for clearing and strengthening the liver which is apparently closely tied to our eye health, among other things. While there are extracts and capsules, our form of intake has always been through tea. 

Which kind of chrysanthemum (菊花) is best for eyes?

When I first looked up chrysanthemum tea recipes, I found many refer to chrysanthemum generally without specification. In fact, there are (at least) two main kinds of chrysanthemum, white (白菊花, bai ju hua) or yellow (黄菊花, huang ju hua). In the realm of eye health, yellow is much more popular and is indicated for dry, tired eyes. White is suggested more often for visual acuity. There was some conflicting info online (I’ve listed the main sources that I consulted below in ‘Resources.’) So I’ve settled on buying and drinking some of both. The white version is definitely more bitter and tastes more like medicine. 

You can buy chrysanthemum at your local Asian grocery, Chinese herbs store, or online. I’ve been buying an organic version from Starwest Botanicals that is sometimes available on Amazon as well as directly from their website.

White chrysanthemum from Starwest Botanicals

Which kind of goji (枸杞子) is best?

As with chrysanthemum, I didn’t realize there were different kinds. There are at least two different kinds of goji berries (also known as wolfberry, gou qi zi, 枸杞子). Until recently when someone gifted us a box of black goji berries (the exact product that I’ve linked to here), I had only heard of the red goji berries. But apparently, the black goji berries are even more powerful and have more antioxidants than red goji berries. You can supposedly chew the dried black goji as a snack (the red ones are definitely snackable and have raisin consistency), but when I tried the black ones, they were very dry and tasteless. Maybe I have the wrong kind. 

Red goji berries are sold at various grocery health food stores (Whole Foods and the like). They even sell them in bulk at our local Costco. Black goji berries are not so ubiquitous, but I found them at my local Chinese herbal store, online herbal stores, and even Amazon seems to have some selection these days. 

In the end, I concluded that choosing the goji berry depends on your needs at the time. Both are generally good for you – the red goji berry is sweet and more neutral in nature, and the black goji berry may be more powerful, but less tasty. We have some of each, as I like to hedge my bets and balance things out.

Goji berries from Costco

If you don’t have access to the variety, don’t get hung up on it. Any chrysanthemum and any goji will likely have some benefit. As with a lot of Chinese medicine, long term, steady consumption is advised for more benefit. My children’s TCM doctor told us that we, including the children, could safely have chrysanthemum tea everyday and that it would be great for subduing allergic tendencies. 

Basic Recipe

Ingredients (for 1 serving)

  • 4-5 dried white or yellow chrysanthemum flowers (this quantity is more dependent on taste, the more flowers, the stronger the tea, and so on)
  • A handful of goji berries (again, the quantity is also more about taste. The more you add, the sweeter the tea). Use either black or red berries, or both!
  • Honey (optional)

Directions:

  1. Boil water.
  2. When water comes to a boil, turn off heat. Throw in flowers and berries. Let it steep for at least 5 minutes. (More time won’t hurt; it’ll just taste stronger). Variation: Simmer the flowers and berries for a few minutes before steeping.
  3. Strain out the flowers and goji berries. 
  4. Add honey if desired and drink! 

Resources

Different kinds of chrysanthemum, indications for white vs. yellow:

Goji berries, red vs. black:

Other chrysanthemum tea recipe write-ups that I like:

Thoughts? More info? Better info? I’m all ears. Email me at:  wishiknewbefore20@gmail.com or leave a comment below.

My Favorite Free Printables

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Since the pandemic began, I’ve been supplementing home learning for the kids here and there. I’ve found a few free printables that we really like – because they print well, and have an interface that is easy to use.

(There are a lot of interactive sites that can supplement learning as well, but with all the Zoom and other digital resources that the schools are requiring the children to use, I’m trying to dial it back and reduce screen time for the kids.) 

Here’s a running list in the various categories of what I’ve found and used:

Favorite Free Math Printables

Both of the math sites listed here provide a lot of different printable worksheets that go up to at least 5th grade. I see calculus topics on Math Aids, and if I remember correctly – that would be high school!

  • https://www.math-aids.com/  – I use Math Aids quite a lot to give my kids the practice with basic addition, subtraction, multiplication, and division that they don’t get with common core at school. I think it helps them to understand the common core approaches better. There are a wide range of math topics on the site though that we haven’t reached at my kids’ age.
  • https://www.math-salamanders.com/ – I’ve used Math Salamanders less than Math Aids but I liked the mental math problems and it has a similar interface to Math Aids. A large variety of worksheets in a large range of math topics are available.
  • I used the blank multiplication chart on https://www.memory-improvement-tips.com/  to teach my kids their times tables. There are a variety of well laid out charts to choose from. The site also seems to have other cool brain games and memory improving techniques that I hope to explore more someday.
mathaids
math-aids.com Division section

Favorite Free Geography and Map Printables

https://online.seterra.com/ – We just started some geography and I found this awesome site called Seterra, for free, professional-looking blank maps for the seven continents to teach the kids all the countries of the world. The printables were just a minor part of the site. The site is an extensive free resource of games and resources on world geography.

Seterra

Favorite Free Comic Book Template Printables

http://allfreeprintable.com/blank-comic-book-template – My kids’ latest passions are in graphic novels and comic books, so of course they wanted to write their own books, too.

ComicBook
Just one of a variety of comic book templates from http://allfreeprintable.com/blank-comic-book-template

Favorite Free Chinese Learning Printables

Since extracurriculars have been cut down so much with the pandemic, we’ve been doing more Chinese lessons at home and these two printables are wonderful.

  • http://chineseprintables.com/  – This straightforward site called Chinese Printables allows you to print grid paper or practice paper in a variety of styles
  • http://chineseworksheetgenerator.org/ – I love, love, love this Chinese Worksheet Generator. You input any characters that you want and it will generate great looking practice worksheets, along with options for stroke order, etc.. This is especially useful for us because it’s curriculum agnostic and allows us to customize the worksheets for our kids to suit whatever we are learning or need to practice more.
ChineseWorksheetGeneratorBorder
Sample worksheet generated by chineseworksheetgenerator.org

 

Favorite Free Eye Chart Printables

If you’ve read my posts on myopia, you know that eye health is a biggie for me. To help with some of the myopia reversal techniques and also regularly check everyone’s vision, I use free eye chart printables. Since my kids’ tend to memorize the chart, I’ve even made my own customizable 10 feet and 20 feet eye charts.

eyechart
Read the message that I wrote for my kids with https://www.homemade-gifts-made-easy.com/eye-chart-maker.html

Other Favorite Free Teaching Printables

I found this site to have a lot of free teaching printables to help supplement home learning. It’s regularly updated by different sources, so it provides a bit of inspiration even if you don’t find exactly what you’re looking for. It’s UK-based, but many materials are still applicable for us. I’m sure there’s a US equivalent, but I just haven’t come across it yet.

Thoughts? More info? Better info? I’m all ears. Email me at:  wishiknewbefore20@gmail.com or leave a comment below.

Reduce Your Allergies Naturally

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phytocort asthma allergies
From left, Vitamin C, a bottle of liquid extract of Chinese medicine, Phytocort

Maybe Zyrtec doesn’t work for you lately or perhaps you don’t like its side effects. Personally, I fear that we don’t know much about the long-term use of these “safe” OTC antihistamines for allergy relief. Instead, I’m hoping to treat my sneezing family as naturally as possible. Below are some of the things that I’ve been reading about (and in some cases, trying out):

1. Avoid Antibiotics as Much as Possible

Scientists are increasingly looking at an imbalance in the microbiome as the root cause of many of the problems we have with our immune systems not working properly. These problems include both food and environmental allergies, asthma, and dermatitis.

It’s not too far of a stretch to see the problem with taking antibiotics, since antibiotics essentially kill all the bacteria you have, both the good and the bad.

I really wish I knew this before, both for myself and the rest of my family. Apparently, some of the good bacteria don’t come back. Antibiotic overuse has also been linked to people suddenly developing serious allergies later in life. It should also be noted that antibiotics can be found in our food and water supplies, so even if you’ve managed to avoid antibiotics for infections, you’ll probably still have some low level of exposure to it. (This topic deserves it’s own blog post.) But basically, avoid antibiotics as much as you’re able!

2. Try Traditional Chinese Medicine to Address the Root Cause

Perhaps strengthening your body in other ways can still help to address your immune system gone awry. I don’t want to be lugging an air purifier around for the rest of my life! Traditional Chinese Medicine (TCM) practitioners often claim that acupuncture and herbal medicine can alleviate symptoms as well as address the root cause of hay fever.

Since TCM is tailored to the individual’s constitution, I didn’t find any obvious herbal formulas to try for adults. Generally speaking, I found these herbs commonly listed in formulas to address the root cause of allergies: ginseng, huang qi (astragalus root), bai zhu, gancao. I’ve also read about PhytoCort which some people find to treat asthma and reduce allergies.

For children, I’ve been looking for ways to address what seems to be cough-variant asthma in one of my kids. A TCM practitioner recommended a combination of liquid extract formulas from “Gentle Warriors”, a line of children’s herbal formulas. The formulas were selected based on my child’s constitution and the presenting symptoms. I’m skeptical, but also hopeful. We’re trying it out for 1-2 months and I’ll be sure to update this post with our results.

Update as of 1/6/2021: After we tried these formulas last year, my child’s cough-variant asthma seems to have disappeared! After having this asthma cough for over 1 year, it’s now been gone for 5 months! We’ve managed to keep off of Qvar and Singulair, oral steroids that had bad side effects for us.

3. Eat a Diet Rich in Natural Antihistamines

If you’re in the midst of having allergic symptoms, this approach isn’t going to help you right away. However, over a couple weeks, it sounds like a person with mild allergies could benefit. Common foods with natural antihistamines include: bell peppers, citrus fruits, pineapples, broccoli, cauliflower, berries, apples, tomatoes, black/green tea, ginger.

My family has pretty good eating habits and many foods on this list are already a regular part of the diet. Yet we still have allergic symptoms so I’ll have to say this doesn’t get rid of all your allergies, although I guess they could always be worse.  Anecdotally, as a data point, I’ve noticed that my two kids who rate equally on the allergy scale, have different levels of allergic symptoms. The one who happens to eat a lot more fruits (2-3x more than the normal serving that everyone else eats), also happens to experience less allergic symptoms. Then I read this study about how a Mediterranean diet rich in fruit and vegetables was found to be associated with less allergy symptoms, which further boosted my small finding.

4. Take Natural Supplements to Boost the Immune System

The amount of natural antihistamines found in foods may not be enough for some allergies. Higher dosages in capsule or powder form enable higher intake to replicate the dosages given in scientific studies. These supplements include:

Vitamin C – I found Vitamin C at the top of many lists. Apparently, vitamin C both inhibits the release of histamine from anti-inflammatory cells as well as helps to break down histamine after it has been released. However, the current recommended daily allowances (RDAs) for children (25mg-45mg) and adults (65mg-90mg) may be too low to create the expected allergic relief. The current RDAs were in fact calculated as the amount needed to prevent scurvy and not other ailments. According to the ODS, the highest daily intake likely to pose no risks is:

  • 400 mg for infants aged 1–3 years
  • 650 mg for children aged 4–8 years
  • 1,200 mg for children aged 9–13 years
  • 1,800 mg for teenagers aged 14–18 years
  • 1,800 mg in pregnant or breastfeeding teenagers aged 14–18 years
  • 2000 mg for adults

For my kids, I decided to trial 400-500mg dose. We are only 1 week into it, so I will have to update this post when I have more observations.

Quercetin – this is an antioxidant also regularly included in everyone’s list. It’s high in leafy greens, apples, grapes, and onions to name a few. I saw a range of dosage recommendations for taking it as a supplement. For adults, I saw a range from 500mg daily to 1000mg 2x/day. For children, Dr. Weil says 200mg daily 2x/day for hay fever.

N-acetyl-cysteine (NAC) – this is an antioxidant that some websites report is stronger than Vitamin C. It’s touted as being able to break down mucous, and reduce allergy symptoms. While it can be found naturally in protein-rich foods that you might eat, like turkey, eggs, etc., a much higher dose is needed for therapeutic effect. I read that NAC caused stomach pain in high doses for some users, so I would proceed with caution. I saw recommended dosages of 300mg 2-3x daily.

Probiotics – Probiotics are the supplements that contain the good bacteria that your gut needs for a healthy immune response. Whether probiotics are effective in putting the good bacteria in your gut is still being studied. However, this doesn’t stop a lot of people from trying. There have been quite a few studies that suggest taking probiotics may result in less hay fever symptoms.

What has worked for you? If there is something that has really worked for you, I would love to know about it!

Email me at:  wishiknewbefore20@gmail.com or leave a comment below.

 

Resources

Natural allergy relief in general

On Traditional Chinese Medicine for children

https://www.craneherb.com/shared/articles/28_Gentle_Warriors.aspx

On Vitamin C

On quercetin

On NAC

On probiotics

On antibiotic use and allergies

Thoughts? More info? Better info? I’m all ears. Email me at:  wishiknewbefore20@gmail.com or leave a comment below.

7 Ways to Reduce Physical Exposure to Environmental Allergens

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I try to avoid the use of allergy medications as much as possible, so I’ve tested out a variety of non-medical ways to reduce my family’s environmental allergic reactions to tree pollens, grass pollens, and dust mites. Here are the things that we do that seem to have helped in order of suspected effectiveness.

1) Run the air purifier

We have serious dust mite allergies, so I run an air purifier on high in my children’s carpeted bedroom about 1 hour before their bedtime, then I switch it to low for the remainder of the night. We’ve been told to run it 24/7, but that seems excessive. Apparently, it takes approximately 1 hour for the air in the bedroom to be completely filtered. I also run it about 1 hour after I vacuum. Our vacuum doesn’t have a HEPA filter, and I’ve also read that even if it does have a HEPA filter, the sheer act of vacuuming kicks up enough dust (mites) that then need to be filtered. There seem to be a lot of fancy, pretty models on the market these days. We have a pretty old Honeywell one that looks like this model. It seems to do the job, so my thought is, you may not necessarily need a fancy medical grade one.

2) Avoid being outside between 5am to 10am

I only recently learned about this, but according to multiple online sources, pollen counts are highest between 5am-10am and after sunset. Close your windows before dark! I realized how true it was when one of my kids started having a runny nose every time we tried to do a 7am walk during shelter-in-place, but had zero issues when out in the afternoon. So much for trying to become an early morning exercise person.  On the other hand, now I feel a lot better about sleeping in.

3) Wear a face mask

ReduceEnvironmentalAllergens
I’ve got a lot of face masks around the house these days.

If you do have to be outside in the early morning, then try a face mask. This made a HUGE difference for my massive grass allergy when I was outdoors recently – it wasn’t even a PM 2.5 or N95 mask. Just a simple, single layer fabric mask seemed to do the trick. Fortunately, it’s become normal to wear masks these days, so my grass allergy symptoms have significantly improved.  I also suspect I have a temperature sensitivity allergy that is sensitive to the change from the warmth of my bed and being suddenly cooler. I swear it’s real, and putting on a mask immediately after getting out of bed seemed to help!

4) Vacuum regularly

By this, I mean once every 1-2 weeks. That may seem like a lot or very little to you. To me, it feels like a lot and so we have an iRobot that we set loose in the bedroom. It really helps, especially with getting under the bed and not making it seem like such a chore. Again, we have a very old model (older than this, so it’s not a true HEPA filter and doesn’t filter dust mites), but I still see a very full dust container at the end of each run. I run it twice for good measure. We run the air purifier to get rid of the resulting airborne dust mites (in theory).

5) Use a nasal spray / Neti Pot / eye wash

I keep a few canisters of regular saline spray by our home’s entrances. If it seems like a high allergen day, I have the kids do a thorough spray in each nostril and blow, when they’ve been outside. We’ve tried this Arm & Hammer brand and the Little Remedies brand with similar results. Arm & Hammer is available at our local Costco for a much better price. Ideally, I could teach them to use the Neti Pot, but it’s a little too involved.

My mom and kids seem to also have a strong reaction to allergens in the eyes and frequently have very red or itchy eyes after being outside. We have used allergy eye drops, but I don’t find them very effective. Instead, briefly washing the eyes out with a few artificial eye drops or eye wash seems to help clear or prevent the red. The sooner you do it after being outside, the better it works. We use these single use Refresh vials the most.

6) Use dust mite covers

These alone, didn’t seem enough to make an actual difference. My kids were still getting congested at night when we had these. I think the air purifier made the most difference. But now we have the dust mite covers for all their pillows, mattresses, and duvets, and I’m not about to remove them to test. All covers are not equal though, so I researched a bit and ended up using this website’s reviews to help with the selection and considerations.

7) Run pillows and comforters through the dryer on high heat

High heat is supposed to kill or at least reduce dust mites, so I run the kids’ pillows and comforters on high heat in the dryer for 20-30 minutes every month. Since I only do this about once a month, it’s hard for me to tell if this is a necessary step or if changing sheets along with the use of dust mite covers is enough.

Thoughts? More info? Better info? I’m all ears. Email me at:  wishiknewbefore20@gmail.com or leave a comment below.

Simple Dang Gui Soup or Tea Recipe

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As I mentioned before, dang gui (angelica sinensis, 当归) soup is my go-to Chinese herbal tonic for whenever I have any issues that I suspect may be remotely related to blood, circulation, or hormones. Men can benefit from this tonic in the same way, too. Whenever I drink it, I feel revitalized and relaxed at the same time, helping my sleep and energy. I swear by it, and so do 2,200+ years of traditional Chinese medicine.

(Whenever I think about how Western medicine would never suggest this as a simple remedy because it’s not evidence-based, I’m frustrated by how many people could benefit, but are missing out!)

Although the dang gui herb comes in extract, capsule, or powder, I have only had the tea form. Having tried taking other Chinese herbs in capsule form, I think that the brewed method is far superior in feeling immediate benefit.

There are two basic recipes either sweet with dates or savory with chicken drumsticks, that you can use to prepare the soup/tea. Personally, I LOVE the bitter and sweet flavor of the sweet tea. I asked my mom to write me the recipe as she always prepares it for me and I haven’t ever done it myself. Now I’ve written down the surprisingly simple recipe here for myself (and you!) and have no excuse not to be able to prepare it for myself.

Ingredients:

  • About 5 slices of dang gui (當歸)
  • About 8 red dates aka jujubes (红 枣 or 大枣) or more if you like it sweeter
  • Substitute the red dates with 2 chicken drumsticks if you prefer savory
dang gui slices for recipe
These dang gui slices are about 1.5-2 inches in length.
red dates for recipe
Dried red dates/jujubes above – they can be eaten as a dried fruit snack, too.  Terrible photo, I know, but the tea is delicious!

The number of dang gui slices and red dates are really more about the taste/effect that you prefer. The more dates you add, the sweeter the tea will be. Likewise, the more dang gui you add, the stronger the tea.

I get the dang gui from a local Chinese herbal store and recently have been able to find organic jujubes online at luckyvitamin.com.

Directions:

  1. Rinse both ingredients, then put them into a pot of water (about 6 rice bowls of water – that’s how my mom measures things, haha).
  2. Cook on medium high heat for about 20-30 minutes.
  3. Then turn to medium low heat until the soup is ready (stop brewing when the liquid is equivalent to about 2 rice bowls of soup/tea).
  4. If you prepared the savory version, you can salt to taste.

Keeping Produce and Cheese Fresh

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It’s probably obvious why I’ve been researching how to make fresh food last as long as possible (not including freezing, pickling, cooking, etc.). In an effort to go grocery shopping just once every two weeks, I’ve discovered my Achilles heel in my desire for fresh produce. Below are the methods I’ve found so far for some fresh food that I recently bought.

Keep produce fresh
Keep produce fresh

How to store cucumbers as long as possible

I found conflicting opinions. Epicurious says to clean, dry, and wrap them in a dry paper towel, tucked inside a plastic bag. However, kitchn.com begs to differ. Its writer says to keep them on your counter at room temperature, away from ethylene-gas-producing foods like banana, melons, tomatoes (which cause other foods to ripen/spoil faster).

Well, I’ve already tried the Epicurious method and it has never gotten me past a few days, so next time, I’m going to try the counter top method.

How to store leafy greens / salads as long as possible

I reviewed a bunch of expert-sounding sites, including another nice write-up in kitchn.com that actually compared 3 different methods. The overwhelmingly best method seems to be: wash, dry, and then store in layers of paper towels in a plastic container (not a plastic bag!) According to confident practitioners of this method, produce stored this way can last from 10 days to 1 month! Fantastic! Except I don’t currently have any plastic containers that would suit this purpose. . .

How to store tomatoes as long as possible

I used to toss tomatoes directly in the fridge. Well, now I know better. If they’re ripe and you’re not going to eat them right away, put them in the fridge.

If they’re not fully ripe, leave them on the counter at room temperature until they have become fully ripe. To allow them to ripen properly, Food52.com and a number of other reliable-sounding websites, says you should either place them stem side down or place a piece of tape over the stem “scar” to prevent moisture from leaving the tomato (drying it out) and keep air from entering which creates mold.

How to store broccoli as long as possible

We find our broccoli to go bad within a couple of days, so I can tell you for sure how NOT to store it: Don’t leave it in a plastic bag in your vegetable crisper. We get terrible results from this. Listonic and Wikihow offered two different options to try: 1) Wrap it loosely in a damp paper towel and it may last 4-5 days. 2) Store the broccoli like a bouquet in a bowl/jar of water, stem side down and it could last 5-7 days.

How to store zucchinis as long as possible

Storing zucchinis didn’t seem to be as interesting for the internet as tomatoes. The general consensus seems to be to avoid putting zucchinis in the fridge if possible because the cold ages the zucchini. If you do put it in the fridge, then put it in a plastic bag (partially open or perforated to slow down the oxidation process).

If you do leave it at room temperature in the open air, the zucchini will shrivel in about 2-3 days. Instead, it is recommended that you put it in a plastic bag, again with holes on the countertop. I’m not sure about this recommendation, as I have personally have found zucchinis to last at least one week unwrapped on the countertop.

How to store cheese as long as possible

Yeah, I know this isn’t produce, but I’m having a problem with this one, too, so I figured I’d just add it here until it finds a better home. The answer seems to be to wrap cheese in wax or parchment paper and then place in a plastic bag. There’s such a thing as a cheese bag which apparently works best, but I don’t own one and chances are, you don’t either. If the cheese sweats a lot, then you’re supposed to replace the paper each time you take the cheese out.

I’ll keep this post updated as I look up other veggies and storage methods. What suggestions do you have for making produce last? I’m all ears!

Revisiting “13 Things Mentally Strong Parents Don’t Do”

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During this time of “shelter in place,” I’m tempted to give myself a bigger break than usual when it comes to parenting. Then I remember two things: one, we don’t know how long we’re going to be dealing with this, if this is, in fact, the “new normal,” and two, if I relax my parenting now, I might be giving myself more work for later to fix habits I’ve undone in a couple of weeks (screen time, anyone?).

So to help me stay “strong,” I’m falling back on some great guidance I once found in “13 Things Mentally Strong Parents Don’t Do” by Amy Morin, a foster parent, therapist, and social worker. I’ve read a few parenting books and Amy Morin’s book definitely falls into the authoritative parenting category (as opposed to permissive or disciplinarian). I’m not always a mentally strong parent, but I certainly aspire to be!

The best thing about her book is that it’s practical and usefully laid out. For each “thing” that mentally strong parents shouldn’t do, she lists examples of ways we actually do what we shouldn’t do – without even realizing it. You will almost always find yourself in some of her examples. She shares a detailed story highlighting that “thing” parents shouldn’t do and then provides a variety of tips and guidance for what you should do instead. First, if you just want to read her list, see below. But the list doesn’t mean much without the context she provides in each of the chapters. She really brings each of these “Don’t Do’s” to life with lots of example situations and personal experience. 

13 Things Mentally Strong Parents Don’t Do, according to Amy Morin:

  1. They don’t condone a victim mentality
  2. They don’t parent out of guilt
  3. They don’t make their child the center of the universe
  4. They don’t allow fear to dictate their choices
  5. They don’t give their child power over them
  6. They don’t expect perfection
  7. They don’t let their child avoid responsibility
  8. They don’t shield their child from pain
  9. They don’t feel responsible for their child’s emotions
  10. They don’t prevent their child from making mistakes
  11. They don’t confuse discipline with punishment
  12. They don’t take shortcuts to avoid discomfort
  13. They don’t lose sight of their values

I’m dissecting my own behavior around this list as a form of parenting self-analysis. Starting with the #1 Thing that I should try not to do too often. . .

#1 They Don’t Condone a Victim Mentality

My kids will moan and complain that it’s their worst day ever. That it’s everyone else’s fault but their own that they weren’t focused during a basketball game. That their math book is stupid and that’s why they’re frustrated. Or they’ll let their sibling push their buttons until they explode while their sibling sits smugly and happily in the other room. 

Morin calls a victim mentality a learned behavior that can be learned from parents unfortunately. Some things that I’ve been guilty of as a parent:

  • Making excuses for my kids’ failures or shortcomings (yes, I’ve blamed their terrible tempers on their father and their negativity on genes from my pessimistic mom)
  • Thinking that my children are helpless sometimes

Instead of giving time to these thoughts, I should be helping my child focus on what he can control in his life. For example, being trapped more or less in our home now, I’m trying to empower them with how not to be fearful of coronavirus. I’m telling them that we have to train ourselves to wash hands automatically, not touch our faces, and to be mindful of space and contact with others at all times. If the kids get into fights with each other, I can ask them to think of what they can do to make themselves feel better and not expect me to solve it or punish the other child. 

I’ve had lots of opportunity to work on my parenting these last few days, and without getting too ahead of myself, I want to say that I’ve noticed more independent behavior. I’ll be sure to have another post on “#2 They don’t parent out of guilt” which I already know will give me some cringe-worthy self-reflection. . .

Lessons Learned in the Time of Coronavirus

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I’m home with my family this morning, following guidelines for self-isolation and social distancing. It is so surreal, but here are the actionable items that I’ve learned so far from living in the time of coronavirus. Most of us will survive the coronavirus, and this is why these learnings are important to me.

Photo credit: forbes.com

#1 Respond at the first hint of trouble, not at panic time

Determining what constitutes as “the first hint of trouble” is open to debate, but I will say that I responded somewhere in the middle between “the first hint of trouble” and “panic time.” 

I went to Costco two weeks ago and decided to purchase some stocking supplies. It was more crowded than usual and I could see a number of carts filled with an irregular amount of certain supplies. However, it was still a manageable crowd. I should have thought of precautionary preparation when the first case of coronavirus was diagnosed, rather than when I actually did. After all, there’s no downside to acting earlier.

A few days ago, I went back to Costco for some allergy medicine and it was panic time. The parking lot was almost full before the store even opened. The allergy medicine I wanted was out of stock, as were all of the panic items (paper towels, toilet paper, rice, pasta, disinfecting wipes, rubbing alcohol). Shoppers were elbow to elbow (great for our minimum 6ft social distancing requirement) and I am now hearing online reports from our neighbors of the continual crowds at all the local grocery stores.

#2 Always have 3 months worth on hand

Why 3 months worth? Well, I’m not sure that’s the correct number, but basically you want to be self-sufficient for some period in the event that you become isolated (due to say coronavirus, store closures, insufficient stock, or a major disaster renders everything unavailable to you except for your home (don’t forget to pack your emergency bag for when your home isn’t an option either). 

Here’s what I should have had 3 months worth of:

  • Food (that we would actually eat – not random cheap stuff for emergencies)
  • Household supplies (paper products, cleaning, and disinfecting supplies)
  • Toiletries (soap, shampoo, toothpaste, etc.)
  • Medications (common OTC items like cold and allergy medicines and prescriptions) 
  • Protection supplies (disposable gloves, garbage bags, plastic bags, N95 masks, face masks )

I wasn’t able to get some of these items during the current panic time. What I should have done is just gradually amassed 3 months worth of the above items like a regular consumer in the months/years prior and thereafter, just replenish stress-free any items that dipped below the 3-month threshold. 

If you don’t have enough room where you live, stockpile whatever amount is realistically maintainable in your available space. If organized purchasing is not your strong suit, use an inventory list – there are many online options to help.

#3 Don’t rely on doctors or the government

 . . . ever.  Assess your own risk. 

My elderly mom lives with us. One of my kids has asthma, as does their father. Initial government and public health/medical guidance was not enough for us. After a few days of discussion and wondering what we were waiting for, we pulled our kids out of public school. The next day, the public schools announced a 4 week closure. Given our high risk family members, I have already decided we will not go back in just 4 weeks even if that date holds true. 

If we don’t get the coronavirus soon (assuming my kids didn’t just contract it at school last Thursday), I will consider ourselves lucky this time. I already know a couple of families with members who have COVID-19-like symptoms. We were late to make the right decision for ourselves. Next time, I will trust my gut and not be afraid to seem overly cautious.

As far as how to treat COVID-19 if you do contract it, Western doctors are not likely to have the best approach. Western medicine is limited by evidence-based treatment, and there has not been time for this to emerge. A more holistic approach, merging Western and traditional Chinese medicine (TCM) may currently be the best option we have. For those who may be open to TCM or are familiar with it, there are clear TCM treatment plans for COVID-19 in China. These have already been used in conjunction with modern medicine for many patients in China – which certainly has experience by now. If you’re in a Western country, you’ll likely have to pull this treatment together on your own, because most Western doctors will dismiss TCM approaches completely.

#4 Change mindsets, lifestyles, and habits now

This is not likely going to be the last time that we or our children will experience pandemics or global crises in our lifetimes. I won’t miss this opportunity to make lasting changes to my own lifestyle and habits and to truly instill the same into my children so they won’t even have to think about these habits when they’re older. It will serve them well throughout their lives in any context.

Learn now 

  • Not to touch your face. I’ve toyed with the idea of wearing gloves or taping a Kleenex to my face to make me realize when I’m touching my face. Send me your suggestions!
  • To wash hands properly and automatically – we think we do, but oh, we do not. . .  

Protect and boost your immune system 

Recognize how decisions and actions you think that you are making for just yourself actually affects other people. This applies to so many things in our lives. The earlier our children learn this, and to act on this, the better our world will be.

There’s nothing groundbreaking here, but at my age, I’ve developed some unhelpful habits and sustaining change isn’t easy. But perhaps the threat of coronavirus to those I love can give me the motivation to sustain change. Plus, I’m not elderly now, but I most certainly will be someday. Hopefully, we’ll be better prepared then to handle anything life gives us.

Stopping OIT at One Nut

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I have to take my mind off coronavirus somehow, so I thought I would provide the latest update on our experience with oral immunotherapy for food allergies. 

We’re done for now

We have stopped oral immunotherapy updosing, after having reached a dose of 1 whole nut for each child (see why in the section below, “New information since we started OIT”). So now we are entering maintenance phase at a daily peanut for one child and a daily cashew for the other. Our allergist said that after about 3 months on the 1 nut dose, they would be protected from accidental ingestion of up to 2-3 times their dose – which would be about 2-3 nuts.

It’s the weight that matters, but seeing my nut-allergic kids eat an entire nut of these sizes was a little unnerving

Time involved

It took us 7 months, updosing on a schedule target of every 2 weeks, to go from roughly 2.5mg of nut flour to 1 of an actual, decent-sized nut. We had a few updoses with 2.5 to 3 weeks in between due to illness, scheduling availability, and travel. 

We’re only 30 minutes away from our food allergist. Each appointment was 1.5 hours long. I got used to measuring out the nut flours everyday. All in all, in retrospect (now that it’s over!), the time invested didn’t seem so bad.

Reactions during updosing

Overall, we had a pretty smooth experience with updosing. We did not have any anaphylactic reactions. We followed most of the guidelines: 

  • We usually dosed in the evenings around 7 to 7:30pm. Our kids go to bed around 9pm. We did occasionally dose late around 8pm.
  • We skipped dosing on particularly hectic/exciting days like Halloween.
  • We did shower after the dose a few times, but we kept it particularly short and not too hot and did not have reactions.
  • We dosed with Zyrtec on updose days and for 2-3 days after based on initial recommendations of our allergist.
  • Both my kids had occasional tummy aches, but I could never be certain if it was related to dosing. I suspect that some were and some weren’t. 
  • Twice, one child had the feeling of something in the throat. Both resolved with Zyrtec.
  • My peanut-allergic child had coughing reactions on 5-6 occasions within the two hour window of dosing that were resolved with Zyrtec. 
  • It was recommended that we treat our peanut-allergic child with Qvar or other asthma control medication because there were also environmental allergies that presented with allergy-induced asthma symptoms (periods of recurrent, mild coughing and more coughing symptoms during colds). Ultimately, we stopped the Qvar because of some behavioral changes that accompanied its use. 

New considerations since we started OIT

Our allergist basically recommended that we stop at 1 nut. This is a change in thinking since the time we began OIT last year. Originally, our provider thought that OIT would continue up to about 3-4 nuts. Here are the recent learnings that resulted in the change of their decision:

  • Clinically, our provider saw that patients in maintenance were having more reactions at 3-4 nuts versus patients who were doing very well on just 1 nut, while conferring a strong level of protection of up to 3 nuts. (Incidentally, for what it’s worth, I learned that a maintenance dose of 8-10 nuts is around the level of what is considered “free eating.”)
  • This supported my own anxiety-inducing findings on Facebook OIT groups where it seemed that many parents shared that their kids were having reactions, even anaphylactic ones on maintenance doses of 3-4 nuts or more. 
  • Palforzia, the “drug” containing pre-measured doses of peanut flour will also only go up to 300mg (1 peanut), so this falls in line with what is now considered “safe” and FDA-approved.
  • I also came across this 2018 Palforzia aka AR101 study that showed only 67.2% of patients who had been on a maintenance dose of 300mg peanut flour were able to pass an exit challenge of 600mg without dose-limiting symptoms. This made me less comfortable about the 2-3 nut protection level mentioned by our allergist. If you’re data-inclined, here’s the appendix for even more details (including the OIT dose schedule, patient characteristics, etc.) on the study.

Next Steps

All in all, our provider suggested that we stop at one nut for now and reassess in 3 months whether we would like to continue, given the recent findings and after we see how our kids fare on their 1 nut maintenance. Our provider also said that we would need to be completely reaction-free for the next 3 months to even consider updosing to reach 3-4 nuts (which is about 3-4 more updose appointments). 

Our peanut-allergic child with suspected underlying asthma conditions would not be recommended to continue past 1 nut due to the risk associated with the conditions, unless we resumed asthma control medications. We’ll have to think hard about that one because the behavioral changes were very unsettling. 

Our other cashew/pistachio-allergic child could be allowed to continue if there are zero reactions in the next 3 months. However, in that case, we would do a pistachio challenge of some sort. When we began OIT, we were told that desensitizing to cashew results in desensitizing to pistachio (due to the cross-reactivity) in about 80% of the cases. Our allergist now says that this is actually the case in 90%+ of the allergies, and after 3 months on the 1 cashew maintenance dose, they would recommend a challenge of eating 3 pistachios in the clinic to see if my child has desensitized to the pistachio as well (1 cashew = 2.5 pistachios).

In the meantime, I’ve been following the continuing developments linking food allergies to the gut and am hopeful that a cure, not just a treatment is in our future.

5 Tips for Dealing with Health Insurance

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I’m still on my health insurance rant. How many ways can the health insurance system screw you? If you’re a health insurance user, chances are you’ve been scammed, duped, or basically not given the coverage that you paid for because the health insurance system in this country has been intentionally/unintentionally designed to make sure that you won’t know how to use it and getting enough reliable information to avoid costly errors is practically impossible. (Help fight this by choosing the most cost-effective health insurance for you with some of these comparison spreadsheets.)

Here are five things I’ve learned about when dealing with health insurance:

#1 Health insurance representatives and provider office personnel often give wrong, different, or incomplete information

How are you supposed to know what information is correct if you get different information depending on who you talk to? What’s worse is that, you then usually make financial or health decisions based on this incorrect information.

Health insurance explanation of benefits (EOB) – did it really cost $1259.75?

If you ask about coverage benefits, the health insurance representative may forget to tell you that your deductible applies. I have been told over the phone that services from an out-of-network provider are covered 100% (no deductible mentioned). Only to find out after the claim has been denied and 15 phone calls later, that our deductible needed to apply first. Perhaps someone could have told me when I asked the first time? Get a summary of the plan benefits sent to you. Better yet, make them send you the long detailed version and look up the answer to your question. Don’t rely on over the phone answers. 

The provider’s office has also on occasion told me that they are out of network, even when I was able to find them in the online in-network provider directory and then confirmed it with a health insurance representative. In those cases, you can now get a confirmation number of the phone call along with a record of the call content. However, you have to ask for it. 

# 2 Services performed by in-network providers may need coverage by different types of insurances or may not be covered

Well, I didn’t know this was possible, but after being billed for the refraction portion of a visit to the ophthalmologist office, I discovered that you may need to break down claims to submit different portions of it to medical insurance and vision insurance. However, you have to figure this out in ADVANCE so that YOU can tell the eye care provider’s office which doctor will be allowed to perform which service on you.

These days, many eye care offices house ophthalmologist, optometrists and eye care shops in the same location. We needed to check on the sudden onset of myopia (therefore the need for an ophthalmologist), but checking the eye problem also involved the need to check vision, a refraction service which could be performed by either the ophthalmologist or the optometrist, both of which performed services on my son at the same visit. 

However, it turned out that we were only covered if we had the optometrist perform the refraction. So although the optometrist was seeing my son at the visit, the ophthalmologist happened to perform the refraction. Therefore, we had to pay for the refraction out of pocket. Make any sense? Somehow, you really need to do your research before you go to any doctor. I’m sure this happens in many doctors’ offices.  However, I bet you the doctor’s office won’t be able or willing to help you much when you ask questions BEFORE a visit. Who’s screwed? You’re screwed.

# 3 Surprise billing

They’re finally doing something about this “surprise billing.” I have an Explanation of Benefits (EOB) that now actually states what to do if you receive a “surprise” bill – they’ll try to help you fight it. In fact, there was even a recent article in the Atlantic about this, stating, “A fifth of U.S. patients get surprise bills from surgery—even if their surgeon and hospital are in-network.” 

Surprise billing occurs when you are receiving a medical service from an in-network provider  and, unbeknownst to you, part of your service is performed by an out-of-network provider. You will receive a “surprise” bill for that portion of the service. This could be $150 or lots of $$$ depending on the service. 

Two examples of situations where this might happen: 1) you’re getting lab work done at your in-network provider, but without notifying you, they send the lab to an out-of-network lab to perform some of the tests. This happened to me. 2) You’re getting surgery and the work has been pre-authorized by your insurance as in-network covered services. However, maybe the anesthesiologist or another doctor who does a little work on you (while you’re out cold) happens to be out-of-network. You get the bill for the out-of-network services. 

#4 FSA or HSA – not both

Maybe a lot of you knew this already, but not me. You can only have an FSA or HSA – not both. (However, you can have a limited purpose FSA that’s for vision and dental expenses only and HSA together.) We signed up for an FSA at the beginning of the year. Mid-way through the year, we had a job change and had to change insurance plans. We looked at the HSA and discovered that was a good option for us. BUT guess what, since we already had an FSA for the calendar year, we were not allowed to enroll in the FSA plan. And we were not allowed to cancel the FSA, in order to enroll in the HSA. No double-dipping, but you gotta read to figure this out because no one will point this out to you.

#5 Administrative labyrinth

I’m not sure if NOT getting to enroll in the HSA was actually a blessing in disguise. HSAs (and to some degree FSAs) are for those who are extremely good at keeping receipts, completing paperwork, reading the fine print, following up when claims get denied, resubmitting receipts, making phone calls that last 30 minutes each (at least), and a plethora of time to do these things. The administrative labyrinth also applies any of the problems mentioned above. You know yourself. Are you going to have the time to follow up on all of this (because you will inevitably have to)? Otherwise, it’s $$ to Uncle Sam or cash you can never use. 

Or if you don’t care about getting screwed – you can just save yourself time, and know you’re probably getting a bad deal with your insurance. But I say, keep calling them, keep irritating them, send your horror stories to the media, or we’re all going to have to deal with this miserable system forever. 

Do you have more to add to my list? Send them over!

Health Insurance Plan Comparison Spreadsheets

Wish I Knew Before4 Comments

Updated September 27, 2021

Changing jobs? Open enrollment? Recently, we were choosing between a variety of health insurance plans, including ones with HSA options. Before I thought to look online, I had already made my own comparison spreadsheet, but I guess that’s all well and good because it was a nice, eye-opening experience to think through the ridiculous rules of each of the health insurance plans myself. Even the plan representatives barely understand the rules.  Ultimately, I’ve started to prefer the HSA option, as I’ve increasingly realized that doctors are not that helpful for many of the smaller health issues on a $/value basis – but that’s really specific to each person / family’s needs.

Later on, I found a few different health plans spreadsheets online that I thought were helpful and collected the links below. There are also various calculators and comparison widgets on health websites, but they hide the logic and calculations they’re using to compare, so it’s not as useful. In the end, it’s a bit like picking stocks because of the assumptions and guesses you have to make about your future needs, but I still found it more useful than not thinking about it at all. Hope some of these are helpful to you too.

#1 Mr. Money Moustache and Reddit Health Comparison Spreadsheets

These two spreadsheets that I found on the forums of Mr. Money Moustache and Reddit are quite similar and straightforward to use. They compare a PPO plan to an HDHP w/HSA. They graph out the costs of the plans based on medical costs which is helpful to see around what cost point that the plans are most cost-effective. It comes down to what you think your costs are likely to be:

#2 Business Insider Picking Healthcare Plan Spreadsheet

This one posted by Anisha Sekar on businessinsider.com had a thoughtful, step by step post accompanying the spreadsheet:

#3 Healthcare Plan Worksheet on spreadsheetsolving.com

I also liked this spreadsheet on spreadsheetsolving.com (interesting site and worth further review for those of us who like spreadsheets!). The poster did a nice job of talking through the logic behind the calculations:

#4 Simple Worksheet at The Finance Buff

Recently (9/27/21), I came across this post at thefinancebuff.com called “Do The Math: HMO/PPO vs High Deductible Plan With HSA.” The post helps you to think about how to choose a healthcare plan and includes an abbreviated worksheet to work through a simple comparison, especially if you’re not in the mood to slog it through with a detailed spreadsheet. The Finance Buff website itself is a great resource for personal finance, btw!

#5 My Detailed Health Plan Comparison Spreadsheet(s)

To use any of the spreadsheet versions below, log in to your Google account while you are accessing the spreadsheet, then you will be able to select “make a copy” and modify it however you want in your Google Drive.

In each of the versions below, there’s a tab to estimate usage costs, and then another tab to see how the different deductible amounts for the plans actually played out based on the estimated costs. Don’t forget to adapt the spreadsheet logic to your own plans’ rules. Also, If you catch some obvious errors, I would love to be notified!

Health Insurance Plan Comparison V1 – February 2020

Health Insurance Plan Comparison V2 – May 2020

Health Insurance Plan Comparison – Reader-modified 2021

Got Body Odor? And Will Your Child, Too?

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I’d been sniffing the hair on my children’s heads – yes, moms do that. And found that they smell very different. I can’t even describe the smell though – one like vanilla soup and the other like citrus tea. That got me wondering what they might smell like as teenagers and then adults. Would my deliciously smelling kids become stinky people with various body odors? Would I need to arm them with deodorants? Was I going to need to do a 3 week research project on finding the best, non-toxic deodorants? 

I’ve noticed that men and women and folks of different ethnicities also seem to have different body odors. I’m of Asian descent and have never used deodorant in my life and have probably rarely needed it (although I suppose I should get some second opinions about that). My husband of European descent can have more distinctive scent, but many of my male Asian friends have claimed that showering after the gym is utterly unnecessary from a body odor standpoint.

I got searching. Researching trivial things is a guilty pleasure of mine.

Image credit: Lucas C. on somethingdrawn.com

The answer first

Here’s the bottom line on whether you and/or your child will be stinky: 

  • It’s linked to a gene! A gene called ABCC11 affects how much of a certain protein called MRP8 is secreted in the sweat from your apocrine glands (the sweat glands in your armpits). This MRP8 protein is “responsible for secreting odorous chemicals in a person’s armpit—chemicals which are converted into body odor by bacteria on the skin.”  
  • A mutated, non-functioning ABCC11 which results in lower secretion of MRP8 has been found in approximately 80-95% of East Asians (Chinese, Korean, Japanese, etc.) 
  • In the rest of the world, this gene mutation exists in only 0-3% of people of European and African ancestry, and 30-50% of people from South Asia, the Pacific Islands, Central Asia, and indigenous Americans. Those with a mutated ABCC11 aren’t completely immune from body odor, just that they will probably have a lot less of it and maybe indetectably so.
  • This gene incidentally also determines the type of earwax you have.  A non-functioning ABCC11 gene results in dry ear wax, whereas a normal expression of the ABCC11 gene results in wet ear wax. Therefore, the type of earwax you have (at any age) can help determine your levels of body odor.

What makes the actual body odor?

The main source of our body odor comes from our body’s sweat glands in combination with the bacteria on our skin. At birth we have eccrine sweat glands all over our body which excrete water and salt mostly, but at puberty we develop apocrine sweat glands in the armpit and groin regions. Apocrine sweat glands secrete proteins (including the odor causing MRP8 protein) and lipids and when they mix with the bacteria on your skin, body odor is created. 

What’s the connection to ear wax?

The ABCC11 gene that determines your body odor also determines your ear wax type. It’s expressed in humans as two alleles resulting in either sticky brown cerumen also known as “wet ear wax” or dry flaky cerumen aka “dry ear wax.”

The dominant allele, let’s call it “W,” produces wet ear wax and body odor. The recessive allele , say “D” (also referred to as the mutated version of the gene) results in dry ear wax and less of the odor causing protein. If you have two recessive alleles, DD, then you have dry ear wax. If you have wet ear wax then you either have WW or WD. For a refresher on genetic traits and to see how this will be passed down in your family, see here and here. 

Check your ears and your child’s ears if you’re curious. For evolutionary reasons still unclear, dry ear wax is found predominately in East Asian populations (as mentioned above).

Why don’t we all smell the same?

Aside from the genetics mentioned above, the bacteria we have on our skin also varies from one person to another and depends on a variety of factors, such as diet, environment, and lifestyle. Mix it with the goods from your apocrine sweat glands and you’ve got your own signature scent!

Things in your diet such as spicy, pungent foods in high quantities can come through your skin. Stress can increase the production of your apocrine sweat glands, and the breathability of your clothes can either trap in your sweat or allow it to evaporate. How often and when you shower (like post-workout) can also determine how much bacteria is on your skin and available to turn sweat into odor. 

Bacteria and surroundings nothwithstanding, your scent may also change with age due to a couple major factors.  Babies and pre-teens don’t have the apocrine sweat glands that produce the odor-causing proteins. For older people, scientists have discovered that people over the age of 40 emit an odor compound called 2-nonenal that occurs when chemicals breakdown in our bodies as we age. It appears to be linked to the muskier smell that people associate with older people. 

So I checked the type of earwax in my kiddos and I’ve got one wet and one dry. Looks like I might have some future Google research on deodorants after all.

Resources

The science behind body odor

Factors causing body odor

Why body odor varies

Some people don’t have much body odor. 

 

Can Axial Length Be Reduced?

Wish I Knew Before2 Comments

Updated 4/14/22

Image credit: myopiaprofile.com (a very helpful site, btw!)

This is a niche post for those of us trying to explore the causes and cures for myopia. Since the causes of myopia are not fully understood, the treatments are still under discovery and experimentation. If you search online, you probably won’t find much evidence that the axial length of the human eye can be reduced – this is a key measurement that folks are using as an objective way to determine if axial length myopia can be reversed. However, I suspect that there exists some evidence – it just hasn’t reached Google’s top search results. I discovered that the axial length of my child’s eye was reduced over a 3 month period, leading me to think some researchers out there may have similar data on children.

So my current answer to “can the axial length of an eye be reduced?” Yes, based purely on numbers and measurements for a single child data point – more on this below, along with the caveats. All in all, it’s still encouraging information. (Update as of 11/17/22: In absence of a new post on axial length, I wanted to share that our optometrist once described a case of one teenage patient whose axial length dropped significantly for an unknown reason and the patient’s RX correspondingly dropped about 2 diopters! So YES, axial length absolutely can change, but IF and HOW it will happen is not understood.)

Here are the axial length measurements on my 8 yr old child who has an RX of OD: plano, OS: -1.25:

DateLifestyle habits leading up to the measurement dateAxial length (on Carl Zeiss IOLMaster)
Start of June 201920-20-20 near work rule, outdoor time ~1.5-2 hrs/day, “active focus” 2-3x/wk for a few minutes at a timeOD: 24.37mm
OS: 24.65mm
End of June 201920-20-20 near work rule, outdoor time ~2-3 hrs/day, “active focus” 2-3x/wk for a few minutes at a timeOD: 24.36mm
OS: 24.66mm
End of August 201920-20-20 near work rule, outdoor time ~3-4 hrs/day, “active focus” 2-3x/wk for a few minutes at a time, plus lenses when readingOD: 24.43mm
OS: 24.75mm
Beginning of Dec 201920-20-20 near work rule, outdoor time ~1.5-2 hrs/day, “active focus” 1-2x/wk for a few minutes at a time, regular wear of multifocal soft contact lensesOD: 24.38mm
OS: 24.67mm

Things to note on the data

  • In a 3 month period, there was a .05mm reduction in the right eye and a .07mm reduction in the left eye. The practitioner wasn’t surprised by the positive change and said this was known to happen with the initial wearing of multifocal soft contact lenses, from which I inferred that more reduction isn’t to be expected. 
  • .07mm is estimated to be the equivalent of 0.25 diopters, according to our optometrist.
  • .12mm is the average growth/year in the axial length of non-myopic children, according to our optometrist.
  • Although we incorporated many good vision habits, the reduction in axial length did not occur until my child was able to wear multifocal soft contact lenses. 
  • Even though the right eye is not myopic, we decided to wear multifocals in both eyes to try and help prevent the right eye from becoming myopic. After one eye becomes myopic, it is common for the other eye to become myopic as well. 
  • The increase in axial length came during the summer at a time when we were able to spend a lot of time outdoors in a lot of sunshine, we no longer had school (less near work time), and when we had added the use of plus lenses for reading. 
  • I checked my child’s vision with an eye chart a few times a week, and it seemed to me like his eyes were getting better during the 3 months that there was an increase in the axial length.
  • Our attempts at “active focus” were so few per week that it’s not a significant factor for consideration. 
  • My child gets almost zero screen time. He reads books a lot but will only occasionally read as much as 45 minute blocks which are then peppered with a 20-20-20 rule.

Thoughts on the effect of the multifocal soft contact lenses

Since I’m sitting around with my single child data point, I’m wondering if the axial length reduction is more easily induced in children. Typically the younger you are, the more likely your body is able to recover or have positive changes. I’ve noticed those patterns generally with how quickly children can recover from the same cold that knocks adults out. Similarly, oral immunotherapy on preschool age children can cure their allergies vs older children and adults are more likely to become desensitized (which is not a cure). 

Multifocal soft contact lenses were originally created for adults with presbyopia, but many adults have trouble adapting to the vision that they get with multifocals because the contact provides center distance vision and essentially places patches of plus power throughout the lens. I guess adult eyes don’t accommodate as well as children’s eyes and they tend to see both the blurry and the clear images at the same time. Children, on the other hand, are known to adapt to multifocal soft contact lenses rather easily. It would be interesting to see if adults who have progressing myopia would benefit from wearing multifocal lenses to slow or halt their myopia.

Multifocal soft contact lenses and “active focus” – Since seeing that the contact lenses seemed to make the most difference in my child’s axial length, I’ve been thinking about how they work and how it might compare to the concept of active focus which I read about on endmyopia.org. According to endmyopia, active focus is the activity you need to do to stimulate your vision to improve – you look at something that’s just very slightly blurry and then focus on it to see if you can clear the blur. When you wear multifocals, your eyes also have to do something similar on a constant basis. Because there are patches of less clear vision, your eyes have to learn to adapt to pick out the parts that are clear to create the focused image that you finally see. I could be totally off-track, but just throwing it out there. Thoughts, anyone?

If you have any axial length measurements or similar experiences, please do share! Anyway, we’ll be measuring axial length again in another few months. Stay tuned.

Resources

This is a very helpful post in providing more numbers for understanding axial length, and understanding of possible ethnic differences, and growth differences in myopic and non-myopic children:

Here are other posts that are helpful for trying to understand how practitioners use axial length in managing your child’s myopia:

5 Reasons Not to Rely on Doctors

Wish I Knew Before1 Comment
Graphic credit: news.weill.cornell.edu

Just to be clear, this post is not about bashing doctors! We see many amazing, caring doctors. This post is about an over-reliance on what doctors in our healthcare system can do and taking charge of our own health. Maybe you already know different, but I grew up thinking that the doctor’s word was the final word. Unsure about anything? Go see a doctor. Nowadays, I still see a doctor, but I go online, research some more, and I take the doctor’s opinion into consideration as I decide what to do. Here’s why:

#1 They’re not always up to date on the latest research

Doctors are busy and many are in a practice where they are required to get through a certain number of patients each day. Maybe they don’t have time to keep up on the latest research on everything or have the time to communicate it to you.

For example, Benadryl, due to its lower safety profile, has no longer been the drug of choice for allergic diseases for at least a few years now. We’ve been seeing a variety of allergists and pediatricians regularly during that time, and none of them had informed us of this. We recently saw a new allergist, and were finally told of the preference to avoid Benadryl.

#2 They’re likely to overtreat

Doctors estimate that ~20% of medical care is unnecessary.  This overtreatment happens for a number of reasons. Doctors fear malpractice lawsuits for not doing enough. This causes what is known as defensive practices, such as ordering unwarranted labs and tests. They also can have financial incentives for getting more procedures done and finally, it’s the patients themselves who insist on getting tests and scans, etc. that they don’t really need.

#3 They’re specialists and only looking at part of your problem

We really do need doctors who understand a lot about one particular area – there can be so much to know. The problem is that they can miss a whole lot of other stuff because our body works as a whole! Furthermore, because of the way medical records are set up, primary physician sometimes don’t get all of your medical information from specialists and vice versa.

If you don’t communicate the information yourself or don’t fully know it either, you’re out of luck. Unfortunately, all this means more work for you in uncovering what else might be going on in your body and connecting any dots. Nobody else is really going to look at the big picture or track it, except for you.

#4 The research they rely on is not always reliable

Doctors generally provide evidence-based treatment. That is the profession and how they’re taught. However, they can only rely on the research available to make recommendations for you. But the problem is that alot of that research is flawed too. A 2014 Atlantic article wrote that Dr. John Ioannadis, one of the world’s leading experts on medical research, estimates that 90% of the medical research that doctors rely on is flawed.

I was surprised by this, but then I will readily admit that I used to be one of those people who would just skim to the “Conclusions” part of any research article. I decided to pay attention to the methods and the details for how the studies were conducted and I realized that some of the conclusions were really not so convincing.

That sucks, doesn’t it? Again, more work and thinking on our part. 

#5 They misdiagnose and can have widely different opinions

I’m sure you’ve often heard of getting a second opinion. In fact a third or a fourth opinion could be good, too. It’s natural that doctors will have different opinions about what could be wrong with you and prescribe different treatments. So what are you supposed to do? Which doctor’s opinion should you go with?

Recently, I had a cough that turned into some nasty cough and congestion. The family doctor told me I had a virus and if I didn’t get better, it must be bacterial and she would prescribe me antibiotics empirically. The allergist did a nose swab and said no bacteria. He gave me a skin rash test and  told me that I had really bad allergies, prescribed me steroids, and recommended that I start on a program of allergy shots. In the end, I did nothing (more out of uncertainty than anything), but thankfully recovered two weeks later. But I could have had an unnecessary course of antibiotics or steroids.

Final thoughts

Basically, the state of the US healthcare system (have you looked at your health insurance lately?), how it works, and how it impacts the medical care we receive really forces us to take charge of our own health and the decisions we make regarding our own care. Doctors provide recommendations, but now more than ever, it’s necessary and also possible (with a little Internet research) for us to ask more questions and evaluate the options better on our own.

Resources

Doctors overtreating due to habits

Doctors generally overtreating 

Doctors overtreating for fear of malpractice lawsuits  

Doctors overtreating due to patient pressure

Navigating the medical healthcare system:

Medical studies are not reliable (but it’s also the research that doctors rely on):

Doctors over or misdiagnosing for their own profit or simply because doctors have widely different opinions:

How Much Outdoor Light Do You Need to Prevent Myopia?

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Updated 12/7/22

If you’ve been reading about the latest findings on why we’re all becoming so nearsighted, then you know that researchers have found a strong link between myopia and outdoor light. They think that outdoor light (possibly even more so than near work) may have the strongest impact on protecting against myopia. However, the simple recommendation of spending more time outdoors is a little ambiguous and not enough information to decide whether following this recommendation was feasible or worthwhile.  As much as I would like to spend my entire day at the beach, in a time-constrained world, I wondered how much and what kind of outdoor light do we need for it to make a difference?

Looking into the distance may also be part of the reason outdoor time prevents myopia
Looking into the distance may also be part of the reason outdoor time prevents myopia

Why outdoor light matters

Why outdoor light matters is still unclear to researchers. There are a few candidate theories, but if the reason is unclear, that means the kind of outdoor light you need is, well, unfortunately, another educated guess. Here are the theories so far:

  • The dopamine theory: Outdoor light triggers retinal dopamine. Animal studies show that when the eye has low levels of dopamine, its’ axial length increases.
  • UV exposure: Being exposed to UV light in the range of 360 nm to 400 nm light may be the part that helps control myopia
  • Vitamin D levels: Vitamin D is believed to help proper eye growth and the body can only produce adequate amounts of Vitamin D levels through physical exposure to the sun’s UVB rays. One study found a correlation between low vitamin D levels and myopia in children.
  • More distance viewing: Being outside causes more frequent distance viewing, as opposed to near work and the closer viewing environment that we have when indoors.
  • Brighter, outdoor light: The higher light levels that are outside are thought to be key – this doesn’t necessarily negate the other theories above. 

How much light and how bright?

Based on the theories above, here are the study recommendations:

  • There was a range of “how much light” recommendations from the studies. On the lower end, I saw that 14 hours outdoors/week could lower the chances of myopia by ⅓. On the higher end, Dr. Ian Morgan, a researcher who specializes in myopia and the environment, has concluded that children need to spend at least 3 hours/day in light levels of at least 10,000 lux to be protected. 
  • 10,000 lux is described as “the level experienced by someone under a shady tree, wearing sunglasses, on a bright summer day.” For comparison, average indoor lighting is about 500 lux. Consequently, sitting by the window with natural outdoor lighting is probably more protective than being indoors without natural light.
  • Despite the fact that the UV exposure may play a role against myopia, it is still recommended that we wear UV protective eyewear and clothing. Since it’s unclear if and how much UV exposure is needed, doctors still recommend protecting against the damaging effects of UV light. However, since many contacts and glasses nowadays include UV protection, they are continuing to investigate the possibility that a different balance may be needed between UV protection and myopia protection. 
  • To get adequate levels of vitamin D (30 ng/mL or more), some experts recommend about 10-15 minutes of sun exposure on your arms and legs without sunscreen between 10a-3pm each day. However, you need to tailor this recommendation for yourself by factoring in sunscreen (which blocks UVB), your skin pigmentation (darker skin needs longer exposure), and where you live in the world. For example, if you live at latitudes 37 degrees north of the equator, there is less UVB exposure resulting in less if any vitamin D production. You may also look into adding more vitamin D rich foods or supplements to your diet.

Most of this research is around outdoor light and its impact on children’s myopia, but it’s probably meaningful to adults who have progressing myopia, too. All in all, 2-3 hours outdoors daily can be a tall order for over-scheduled, over-worked lives – both kids and adults, especially in winter! 

How much time do you and/or your family get to spend outdoors on average? If you’re already fighting myopia in your family, see my other posts on our experiences with myopia control for children and reversing myopia as an adult.

 Resources

How much outdoor light is needed – some different viewpoints

UV light is blocked in contacts and in glasses

Sun protection can still be used outdoors for myopia prevention

Vitamin D, myopia, and sun exposure