Young lungs

This spring we met a family here in Cairo who has been here since last summer, the same as us. They have a young baby who was born in the US but has lived here most of his life. Just recently, on their annual leave back the States, their American pediatrician confirmed what the parents had suspected: their baby has asthma, clearly exacerbated (if not caused) by Cairo’s polluted air.

The baby is now on hardcore steroids while they try to get his breathing under control and while they’re back in Cairo. For folks who don’t know–steroids can stunt a child’s growth, so my understanding is that they’re only prescribed to children in extreme situations.

The family was expecting to stay here another year, but their employer won’t allow them to, given the baby’s health concerns. The problem is two-fold: first, being here makes the baby’s asthma worse, and, second, the medical care here is such that the employer isn’t confident the baby can be treated locally in an emergency. Basically, Cairo makes the asthma worse, and the health care system isn’t up to par.

So, the mom and two kids are being moved back to the States while the dad is sent to a pretty awful place (like, what’s the last place in the world you’d want to live right now? bingo!) for the next year. They don’t have much choice or maybe any choice.

I’m sad to see this nice family leave and even sadder given the circumstances.

It also has me, a hypochondriac on behalf of my children, even more concerned about the poor air quality here (and I don’t mean LA bad; think Beijing bad). Bug had a really rotten cough for a long time this winter, which finally cleared up during the week we spent in Dahab. But now his cough is back, with hardly any cold symptoms. It’s just… a cough. A really bad cough.

There’s a scientifically established link between pollution and asthma. How long can we stay here before the kids suffer permanent lung damage? Our lifestyle here isn’t worth sacrificing the boys’ health.

This is a great question to bring to a a doctor, but we haven’t really established a relationship with a pediatrician here. My employer has a clinic for routine stuff, but I wouldn’t bring my kids to them for something unless it was urgent.

So I’m tempted to schedule an appointment with a doctor in the US, either our old pediatrician or perhaps a specialist… are there pulmonary pediatricians? Fortunately, College Town has a vast array of medical facilities so I can probably find someone.

I’m not sure exactly what I’d ask, but I think it’d go something like this: Doc, can my kid make it through several more months in Cairo without compromising his long term health?

And how about you readers? What would you do?

On religious cooperation

Thursday is a holiday called Mawled El Nabawi, the birthday of Mohamed (you know, the Prophet). And Sunday is the western Easter (can’t call it just “Easter” here because the Coptic and Ethiopian Orthodox Christians celebrate Easter next month).

This means we have a four-day weekend starting tomorrow, perfect for a trip to the Red Sea, just a couple of hours east of Cairo. We’re trying a new hotel that apparently has two pools and a lovely beach. That’s pretty much all we need.

The forecast this weekend is ridiculous: highs in the low to high 90s, peaking at 100 on Sunday (this after the past two weeks in the 60s and 70s). Yes, 100 degrees. I will hide in the shade and read while the boys frolic. I’ve been either sick with a cold or some nasty allergies (either no doubt exacerbated by the pollution), so I’m looking forward to a weekend where I can relax and the boys can play like mad. We’re also delighted that some friends are joining us there.

Our housekeeper/nanny is going to take care of the pup and our kitty (who wonders why we hate her so much that we brought a dog into the house; the dog, in the meantime, seems not to have noticed the cat despite her constant stalking of him).

Tonight I pack and take the pup back to the vet for another check-up. I also just realized that I should probably put together some semblance of an Easter basket for each of the boys. That’s the tough thing about adopting older kids: you don’t ease into these holidays slowly, but, bam, here’s a 5 year old wanting some candy. Maybe we’ll pack it and hide it at home for the boys to find when we get back.

So we’re off for a few days. In the meantime, let me know how you’re spending your weekend.

On antibiotics and cough syrup

The CDC says:

Authors of a meta-analysis of six randomized trials (in adults) concluded that antibiotics were ineffective in treating cough illness/bronchitis.
Antibiotic treatment of upper respiratory infections do not prevent bacterial complications such as pneumonia.

So, even though I was wavering, I think we’ll skip the antibiotics, especially since Bug seems pretty perky today (though he insists he’s still sick, as he somersaults around the house).

Here was the most interesting part of the CDC’s advice on bronchitis:

When parents demand antibiotics…

• Acknowledge the child’s symptoms and
  discomfort.
• Promote active management with
  non-pharmacologic treatments.
• Give realistic time course for resolution.
• Share the CDC/AAP principles and pamphlets with parents to help them understand when the risks of antibiotic treatment outweigh the benefits.

Now switch “parents demand” with “doctors prescribe.” I didn’t run all this by the doctor (I’m much more confident with Dr. Google than real doctors), but I’m frustrated that he doesn’t seem familiar with the latest research. Especially about the cough syrup, which was all over the news.

(I’m also thinking: Oh my. Has this become a mommy blog? Let’s hope not!)

Holidays

Today was my last day of work for a few weeks. Tomorrow begins the Muslim Feast of Abraham, which honors, well, Abraham. Specifically, his almost-sacrifice of his son until God/Allah intervened and said he could sacrifice a sheep instead. So naturally this holiday involves massive sheep killings. That happens on Wednesday. Tomorrow, Tuesday, is the first day, when folks who are on haj, or pilgrimage to Mecca, start their haj. Or something like that. I promise to do a bit more research and fill in some details while simultaneously blasting Christmas music through the house to drown out the sound of bleating sheep.

So, I have the rest of the week off for the Feast. Then, next week I have off for Christmas. Then I am also off for New Year’s Day, the Islamic New Year, and the eastern (Coptic) Christmas. Plus my employer is filling in the holidays with extra days off.

I highly recommend living someplace that celebrates multiple religious and national holidays. Works out beautifully.

All this time off has me wondering how to fill the days. I’ve been thinking about desert camping (a bit pricey for just the four of us) as well as a trip to Alexandria, which we’ll do next week.

And then today I had an amazing thought: Christmas cookies! I’ve never made them before, probably because I’ve never had so much time off around the holidays. So, here in Cairo, I have more time to celebrate Christmas traditions. You just wouldn’t expect that, would you? Nor would you expect to see Santa everywhere, but he’s here too, on stockings, on pictures, in displays, and, in person, at the boys’ school. Who knew Santa spent so much time in Muslim countries?

I filled in some of my time tonight with a visit to the pediatrician. Poor Bug has bronchitis, though of course I didn’t know that before El Doktor told me. He prescribed antibiotics, though I’m ambivalent about filling the prescription. He also prescribed cough medicine… which was in the news recently as being unsafe for kids under five. Right? Anyway, I’ll consult Dr. Google on this tomorrow and decide what to do.

Despite my dismissive attitude, the doctor was very nice and professional, US-trained, excellent English, and so on. Doctors here usually work late morning and then again in the evening, so Bug and I left home around 7:30 or so, waited about 15 minutes at the doctor’s office, and then were seen right away by the doctor. All this for LE 150, less than $30. Poor Bug has a fever, too, but it went down with some ibuprofen.

Now we’re all huddled into various beds in our room, and I’m going to turn off the computer so we can get some sleep.

It’s the water.

When I was about seven years old, my family took a vacation to Acapulco. My parents were so eager to share their excitement about Mexico with us that they took us to see Bo Derek and Dudley Moore in the movie Ten, filmed in Acapulco but more notable for featuring Bo Derek’s large and naked breasts. Oops!

Anyway, as we traveled, my parents emphasized that I should not drink the water. A few days into the trip, my sister was sick. The only water she had had was during tooth brushing. So, my parents, concerned I might get sick too, said to me, “Little Four, have you been drinking any water?”

I said, “No.”

“Then how are you brushing your teeth?” they asked.

“I haven’t been!” I explained very sensibly. Because how on earth can you brush your teeth without water?

This story came to mind as we’ve been talking to Giggle about regular and effective tooth brushing. He went back to the dentist today for his third visit. Last week he had three cavities filled, making four total fillings until today, when she filled two more. And discovered another two in addition to the previous seven. I can hardly keep up, but that makes nine cavities total.

After the fillings, he’s getting a flouride treatment. Oh, and then little Bug goes to the dentist. Health care is cheaper here, but we’re paying 300 LE (about $50) for each filling. Ouch all around.

Now, back to the tap water: we drink it. Not as our regular drinking beverage, though we did do that at first, until the chlorine taste got to us. Much to our surprise and delight, the tap water here is safe, most of the time, because of the chlorine. How do I know there’s a lot of chlorine in the water? It smells like a public pool. Also, people told me.

But we use it for brushing our teeth and cooking. So, this has me wondering: are there long term effects of chlorine consumption? Chlorine is, in fact, a carcinogen. Then again, bad water can kill you pretty fast too. Or, rather slowly but painfully.

In any case, clean tap water is an absolute luxury that we really appreciate.

Dental hygiene

I suspect that Giggle didn’t have a toothbrush in his younger years, and he agrees that he only started brushing his teeth when he arrived in Addis Ababa at the care center where he lived during the transition from his first family to us.

I suspected that he probably had some dental problems as a result, even though he’s now an enthusiastic tooth brusher.

So we got a recommendation for a good pediatric dentist, and today he went. Mr. Four said the dentist looked in his mouth for approximately one second and then turned to him and said, “He has seven cavities. We can put him under general anaesthesia and fill them all at once or do them one to two at a time.”

Mr. Four chose plan B, with the understanding that if Giggle resisted, she’d have to reschedule for the general.

Giggle was a champ. And so was Mr. Four, who stood at the end of the dentail chair, smiling happily at Giggle, throughout the entire procedure. When I arrived home from work this afternoon, Giggle proudly announced that he had six to go! I said “cavities?” but didn’t think it was actually true. Alas.

Mr. Four promised Giggle a trip to the bookstore and the opportunity to pick out a book once the seventh filling is done.

Poor kid. I can relate. I nearly lost my baby teeth from sugar rot and now have a filling in nearly every tooth, all of which had to be replaced a few years ago. It was a very expensive and uncomfortable few months of regular dental visits. The price tag isn’t quite so steep here, but my big concern is that this doesn’t turn off Giggle from the dentist forever.

Giggle heads back to the dentist next week; she said she’ll try for two fillings next time. And, as Giggle made sure to tell me, we are very proud of him.

Mummy tummy

You may know it as La Turista or Montezuma’s Revenge, at least when you’re in Mexico. Mr. Four and I like Pharoah’s Revenge or even the more dramatic Phraonic Revenge. But mummy tummy (so they call it here, that, and “Welcome to Egypt”) is what I’ve got.

I called in sick on my THIRD day of work at my new job. That’s gotta be some kind of record.

I hasten to add that I’m actually really sick! I even have a fever. I know because I checked before I called in to reassure myself that I wasn’t faking it. Which I’m not.

Health update

I may have given the impression I’m dying from an infection. I am not.

Three of us have colds (which came on about two days after the boys went to school), and one of us has been suffering from GI distress. All of us seem to be on the mend.

Iggy goes to the “best vet in Egypt” tomorrow.

Local medicine

Some skin irritations led me to seek out a doctor today, and thus far I am delighted with the Egyptian medical system.

I called around 1pm and was able to make an appointment for immediately (I hear this is quite uncommon). I waited about five minutes at the doctor’s office. The dermatologist was quite friendly and professional and diagnosed me with infected bug bites (sorry, I am trying to be vague so I don’t gross out anyone). Apparently this is quite common for newcomers like me, as the local bugs carry different germs than the ones back in the States. Who knew?

Mr. Four hasn’t even spotted a mosquito, and while I’ve only seen two, apparently one did enough damage that I’ve been prescribed an antibiotic, an antibiotic cream, and antifungal soap, and plain old claritin.

My doctor’s visit cost LE 120 (that’s Egyptian pounds), as did the various creams and prescriptions. Total for the day? $42.20 US. These are not co-pays, folks, but the total amount of the bills. Oh, and the doctor gave me her cell phone number in case I can’t reach her at the clinic. And the whole thing took less than an hour.

So much for my adaptibility, though.

*Update: I fixed the amount in US dollars. Not because the conversion was wrong but because I can’t add.