Thursday, November 20, 2008

Ideas to Fatten Up an Underweight Child

Queen Teen is tiny compared to other 13 year old girls. At 4'10" and 77 pounds she is just below the small end of "normal" on the growth charts. Her height and weight are proportional though, so she doesn't look too skinny. She's not starving for calories.In fact, she's healthy and eats enough food to fuel a linebacker. The problem is she burns so much energy just trying to maintain her balance and see where she's going, every calorie disappears and nothing remains to be converted into fat. Just breathing puts her food intake at a deficit.

Being so tiny is only a problem when she gets sick and stops eating, so to ward off the starvation that comes from catching the flue, I took her to see a Dietitian.

Every Nutritionist and Dietitian I've ever talked to has been grumpy. I guess I'd be too if people came to see me to discuss their diet and then promptly ignored everything I told them about what they should eat. Happily, the Dietitian Queen Teen and I talked to was cheerful and great with kids. She took out plenty of plastic models of food and let Queen Teen explore and chat about what she liked to eat. The woman had Queen Teen laughing and sharing ideas in less than ten minutes, which is a record these days. Most doctor's appointments begin with a surly mood the second we enter the building and it only gets worse from there. I guess props help, especially a piece of rubber Swiss cheese with holes you can look through like a spy glass.

The Dietitian and I discussed ways to help Queen Teen bulk up, including adding butter to EVERYTHING. Basically her diet is good, with plenty of fruits and vegetables, protein, and not too much junk. The Dietitian encouraged me to let Queen Teen eat anything she wanted, including junk food and ice cream, especially since Queen Teen doesn't have a big sweet-tooth. This is a kid who can use all those empty calories.

Here is a recipe for a milk shake which will add 600 extra calories to Queen Teen's diet:
Base: 1/2 cup whole milk.
2 T powdered milk (get the whole milk kind, not non-fat)
1/2 cup ice cream
1/4 cream
The base has 400 calories and 12 grams of protein.

Then add any kind of flavoring you wish. The more you add, the more calories.

2 T chocolate syrup, butterscotch syrup or any fruit syrup = 90+ calories
1/2 C mashed banana + 1/2 tsp. vanilla = 64 calories
2 T jam or jelly = 120 calories
3 T malt powder = 115 calories
1/2 C fruit or 1/4 C fruit juice = 40 calories

A couple of favorite combos are:

2 T chocolate syrup + 2 T peanut butter = 265 calories
2 T peanut butter = 1 T honey + 1/4 tsp vanilla = 240 calories

If you need to add more protein, use 1/2 pkg of Instant Breakfast (65 calories and 4
grams of protein) or 1/4 C egg substitute (70 calories and 6 grams of protein).

If I make Queen Teen a shake using the base (400 calories and 12 grams of protein) and add in the Chocolate and Peanut Butter favorite combo (265 calories and 9 grams of protein) plus some egg substitute for a bit more protein (70 calories and 6 grams of protein) I've created a shake with 735 calories and 27 grams of protein!

That should help add on a few pounds.

Other helpful suggestions were:
-Add powdered milk to yogurt, gravies, mashed potatoes, hot cereal and baked
-Add grated cheese to rice, vegetables, pasta and eggs.
-Eat veggies with lots of butter. Butter is Queen Teen's weight gaining pal.
Put it on everything!
-Add a dip with her snack, like peanut butter for her apple slices, or
cream cheese with her graham crackers. All those extra sauces and dips help
add more calories.
-Having ice cream every day is a good thing for an underweight child.

I plan to make milkshakes with Queen Teen every day after school to see if that helps her gain five pounds before we see the dietitian again in January. Ten pounds would be better. I just have to be careful not to dip into her chocolate sauce too much or I'll be the one gaining the weight (and this time of year, I don't need any more temptation. mmmmmm.... chocolate milkshakes. yummmmmm!).

Friday, November 14, 2008

Queen Teen Vs. The Big Purple Ball

Queen Teen is trying to capture her greatest nemesis, namely one big purple plastic ball. The ball is light and slippery, a little smaller than a soccor ball, and it loves nothing more than to roll away out of her grasp. But Queen Teen is determined. One day, she will tame that rotten ball and when she does the ball will quake in fear and relent to her commands.

The ball had bounced off the edge of her closet door when she was trying to put it away and rolled out of her bedroom into the living room.

"Darn ball!" she yells.

The breaks of her walker go "snap-snap" when she unlocks them and it rattles loudly as she races out of her bedroom after the ball. Balancing herself with one hand on the walker, she leans over to retrieve the ball. It gently rolls at the touch of her fingertips.

"Argh!" She leans a little further and the ball rolls even more. Straightening up quickly, she pushes the walker closer to the ball where it is wedged against a chair and scoops it up in her hand. "Got it." She sets the ball on the flat seat of her walker, where it instantly rolls off, bounces against the walker's front brace, and disappears into the kitchen.

"Oh no! Darn ball!" She races after it, her walker rattling like an old bicycle on a bumpy road.

I'm watching from my seat on the couch and debating whether to get up and help her. No, I decide. I'm going to watch what happens. How long will she fight this ball before she either captures it or asks for help?

The ball stops against the edge of the wall and Queen Teen scoops it up triumphantly. "Got ya!" She once again sets it on the flat seat of her walker and once again it rolls off and bounces away.

"Argh!!!!" She's sounding more frustrated. I want to offer assistance, tell her there's no way a round ball will stay on a flat, moving surface like her walker, but I keep silent. This battle is between Queen Teen and the big purple ball.

Her eyes narrow as the ball rolls away. It bounces against the living room chair and back into the hallway toward her room. She slowly walks forward, the walker's rattle less dangerous sounding, until she spots the ball in the dim hall. "There you are!"

She carefully moves her walker as close as she can to the ball then leans over to grab it. It bounces out of her hand, but pops back when it repels off the wall. She captures it between the wheel of her walker and her hand. Very slowly she places the ball on her walker where it sits still. "There!" But as soon as she moves her walker, the ball rolls off and heads back into the living room.

I really want to step in and help, but I know she has to figure this problem out herself. She's missing the cause and effect part. My telling her the ball can't stay balanced on the flat surface of the walker's seat won't SHOW her how impossible it is. Plus, she won't believe me; she is thirteen after all.

Queen Teen studies the ball which taunts her from where it has rolled, exactly where it had been when she began chasing it. Her lips purse and her eyes narrow again, then she slowly walks forward, one rattling, stealthy step at a time. I wonder what she is thinking as she creeps up on the purple ball; what plan has she formulating?

Standing above the ball, she announces, "I'm going to get you," then she kicks the ball with her foot.

The ball rolls away from her, but this time Queen Teen grins. She dashes after it and gives it another kick in the direction of her bedroom. It takes several attempts with a few missed kicks and the ball ricocheting in the wrong direction twice before it finally rolls into her bedroom. She slams the door behind it and shouts, "Got you!"

"That ball sure was giving you trouble," I say, still watching from the couch.

She walks over and plops down beside me. "Whew. That was hard." She sighs heavily as she wipes sweat from her forehead.

"But you did it. I knew you could!" I hug her quickly.

She grins. "Yeah. I did." She looks back at the closed door of her bedroom as if thinking, "You can't escape now, big purple ball."

I imagine the ball responding, "This time. But next time, you'll never catch me."

Saturday, November 8, 2008

Gravity is Most Definitely Still Working

On Thursday I was hurrying to the BART station to catch a train in time to make Fremont for my 9:00 am class. The sun was very bright as I walked directly east and the sidewalk was shaded by parked cars. I was thinking about all the homework I still had to do and the O and M skills test coming on Monday and the fact I have yet to update the Medusa's Muse website and.... BAM! I was sprawled out on the sidewalk. I had fallen into one of those large, square holes where there used to be a tree. The tree was gone, leaving a gaping trap for anyone blinded by sunshine and not watching where they were going to fall into.

I got up slowly and realized my foot hurt, but didn't seem too bad. My left knee throbbed, the palms of my hands were scraped, but I hadn't hit my head and wasn't limping. However, by the time I got off the BART train over an hour later, I was limping horribly with stabbing pain in my right foot. I made it to class, found an icepack, and spent the rest of the day long workshop (we were learning how to do vision assessments) with my foot propped up. Luckily one of my fellow students gave me a ride back to San Francisco where my car was parked at a friend's house. But I still had to drive the 2 hours back home that night, my foot and knee throbbing like crazy. Thank goodness for cruise control.

The next day, I felt every area that had made contact with the cement, namely the entire front of my body. I was bruised and aching and no amount of Tylenol could fix it. I spent the day working on my assessment report while watching Barabara Stanwyck movies, trying not to move.

If I'd been paying attention to where I was walking, I doubt I would've fallen. The hole was enormous, so regardless of the sun shining directly into my eyes, I probably would've seen it in time and avoided it. Instead, I plowed right through and ended up front down on the sidewalk.

It took falling to make me realize I am too much in my head these days. Not surprising; there's just too much to do and I feel that I'm constantly playing catch up, scrambling up a rocky hill that is collapsing under my feet. The amount of work is impossible and all needs to be done now. I made my list, distinguishing "Important" from "Unimportant," but everything is so dang IMPORTANT right now, not the least being a mom to my daughter. Because it all needs to be done, I'm not doing any of it very well. For a type A perfectionist like me, half-assed work is unacceptable.

Because I am such a perfectionist, it takes an injury to get me to slow down. I wish I'd learn to stop and breath BEFORE I fall into a gigantic hole in the sidewalk that anyone who'd been watching where they were going would've noticed. Now I'm stuck on the couch with my foot propped up, forced to sit still and pay attention to right now.

Right now I will make a pumpkin pie with my daughter, help her work on her scrap book, and practice Orientation and Mobility skills for the practicum on Monday (I wonder if I can guide someone while limping?). The rest of my homework and the edits due on my book will just have to wait. I promised my daughter we'd spend time together this weekend and I won't go back on my word. School and work will just have to be the half assed portion of the evening. My daughter comes first.

Wednesday, November 5, 2008

How can I Help?

I watched Obama's acceptance speech last night, stunned and weeping with joy. This is an incredible moment in history and I am so thankful I'm here to see it. Think about it. When I was a baby, Martin Luther King Jr was murdered. 40 years later, a black man has been elected to be our president.

His message, though, is important for us to grasp. We can't rest on our laurels and wait for him to "fix things." With two wars, a global economy on the brink of collapse, and anti-America sentiment vocally high, we all need to step up and ask, How can I help? Everyone must work for the change we desired when we voted for Obama. Even people who voted for McCain did so because they believed he was the best person to lead us out of this darkness. No one person, even one president, can get our country back on track and prosperous. It takes a village.

What can you do? Here's an example...

'Good Samaritan' saves crying woman's foreclosed home

Tracy Orr sat in the back of the room and prepared to watch her foreclosed home go up for auction this past Saturday. That's when a pesky stranger sat down beside her and struck up a conversation.

Tracy Orr faced losing her home to foreclosure when Marilyn Mock, a stranger, stepped in to buy it.

"Are you here to buy a house?" Marilyn Mock said.

Orr couldn't hold it in. The tears flowed. She pointed to the auction brochure at a home that didn't have a picture. "That's my house," she said.

Within moments, the four-bedroom, two-bath home in Pottsboro, Texas, went up for sale. People up front began casting their bids. The home that Orr purchased in September 2004 was slipping away.

She stood and moved toward the crowd. Behind her, Mock got into the action.

"She didn't know I was doing it," Mock says. "I just kept asking her if [her home] was worth it, and she just kept crying. She probably thought I was crazy, 'Why does this woman keep asking me that?' "

Mock says she bought the home for about $30,000. That's when Mock did what most bidders at a foreclosure auction never do. Watch why a woman would buy back a stranger's home »

"She said, 'I did this for you. I'm doing this for you,' " Orr says. "When it was all done, I was just in shock."

"I thought maybe her and her husband do these types of things to buy them and turn them. She said, 'No, you just look like you needed a friend.' "

"All this happened within like 5 minutes. She never even asked me my name. She didn't ask me my financial situation. She had no idea what [the house] looked like. She just did it out of the graciousness of her heart, just a 'Good Samaritan,' " Orr says. "It's amazing."

Not many of us have the cash to buy someones home back, but there are things we can do every day to help our neighbors, even something as simple as dragging the garbage cans out to the curb for the little old lady with arthritis who lives across the street. Our own food cupboards hold less than last year, but if we each give just one thing to the food bank their shelves won't be empty. Actions small and large are what it will take to create the change Obama talked about.

Queen Teen is currently going through her clothes and toys to find the things she doesn't play with or wear anymore so that "another child can have something new." This is a person who doesn't have a clear understanding of who the president even is. All she knows is that she wants to help someone.

Regardless of who you voted for, lets keep the flame alive and help Obama bring about the change we all hunger for, one tiny step at a time.