anxiety

What to tell the kids when Grandpa is sick… and isn’t going to get better

/ Katie P. Tolley, RN, MSN, CPNP-PC / 1 Comment

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Keeping kids informed helps them understand what is going on. Kids know when things aren’t quite right in the family. So, keeping important information from them can actually be more harmful than protective.

So, what do you tell your little one when Grandpa is sick? You tell them the truth, on their level, of course. Answering any questions that your child asks will help keep them from being worried and scared. But, don’t wait for them to ask. They hear the conversations from the other room, they see daddy and mommy worried and upset; and this will make them worried and upset if they don’t have answers.

Just recently, I lost my father-in-law. There were a few weeks of doctors appointments and then a few weeks of daddy having to go to the hospital every night after work. Dinner was later than usual, things that usually got done were put aside for later, our schedules were just “off” with this sudden change.

I tried to keep my kids as informed as 9 and 13 year old grandchildren should be. Some answers were simple, and some were more difficult. But, the conversations were important no matter where they led. It was important for my kids to know that they could ask questions. They would be told the truth, and they could trust that we are honest with them about the real world and real life.

So, when you are wondering if you should tell your child about important family issues, my answer is yes. Do you have to tell them every little detail? I highly recommend NOT doing that. Too much information or information that is above their developmental level is just confusing and leads to more questions.

I’m sure some of you are wondering if my children attended the funeral? Yes, they did. I think they are old enough to understand, and want them to learn proper respect and etiquette in one of life’s most difficult situations. I want them to know it is ok to cry, to smile, to reminisce, to laugh, to be joyful for a life that was loved and will be missed. I also thought it was important for my children to be there for my husband, and for us to be there as a family. Doing things together makes us all stronger. Knowing we can lean on each other is important for all of us. It turned out well, and I got lots of compliments on my children and their behavior. I’m proud of them. Lets me know their father and I are doing something right. 😉

With all of the challenges life offers, it’s important to be able to lean on others through this journey. None of us has to do it alone. Some choose to, others can’t, most fall somewhere in the middle.

I hope that you learn to weather the storms along your journey so that you can appreciate and enjoy the rainbows.

Always Enjoy the Journey! 😉 

DEATH

/ Katie P. Tolley, RN, MSN, CPNP-PC / 2 Comments

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Death…. it changes everything…

Your perspective.

Your actions.

Your emotions.

Your daily thoughts.

Your goodbyes.

EVERYTHING.

High school was when I experienced the death of a friend for the first time. It changes you. Kevin had leukemia. All he wanted to do was graduate from HS, he made it to April. I WAS SO MAD! I wanted him to make it to graduation, just because that was his one goal. Over 25 years later, I’m still mad.

When I was 19, I lost 3 friends in 6 weeks…. That was reeeeaally rough. When my mom told me about Ashley’s accident, which was the 3rd one, I just lost it. The whys, the yelling, the crying… ugh, it was painful.  This time, death came knocking on their door in the form of auto and motorcycle accidents. Raises your anxiety level a bit on the roads… well, mine anyway. I was adamant that my boyfriend (now my husband) call me when he got home at night, so that I knew he was alright. We had the old “one ring signal,” kinda like all’s well; only then could I go to sleep at night. No texting or cell phones back then, just a telephone. Twenty years later, I’m still anxious.

The next one was a HUGE blow… Drew. This one put me on my knees. Drew was my husband’s cousin; but, they were more like brothers, one year apart, neighbors, always at Grandmom Kathryn’s house right next door. And, Yes, our Drew Elizabeth is named after Drew Alexander. My husband and I were not actually dating at the time, but had off and on for many years, and I knew Drew well. I also knew this was going to almost kill Mo (my husband). And, I wasn’t with him. That was hard for both of us. It wasn’t long after that we were back together for good. We joke that Drew and our friend Chris (one of the 3 accidents I mentioned above) had something to do with our happily ever after. To this day, Mo thinks about Drew every day of his life, it has truly scarred him. The pain I see in his eyes when Drew enters his mind brings me to tears. This truly broke a piece of my husband’s heart that nothing will ever mend. That makes me sad. It’s been over 17 years, we still cry.

Life as an obstetrical RN was thrilling and exciting and happy… most of the time. The day you lay in bed with a close friend mourning the loss of her stillborn child is heart wrenching, exhausting, and physically painful. I wish this on no one. To this day, I have a real attitude towards people that have a major preference for a boy or girl when they are expecting a baby. I kindly try to say, “it’s most important to have a healthy baby.”  My heart still breaks when I think of Abby. 

When my son was 6 months old, I watched a father cry on his knees begging God to save his newborn daughter in the wee hours of the morning. I was their labor and delivery nurse. While the mom was in labor, he was actually complaining that this 3rd child was another girl, he wanted a boy. I’m sure you can imagine how I felt about that, but to this day, there is part of me that feels sorry for him, there is no doubt he carries guilt about the loss of that baby girl. I couldn’t get home fast enough to hold my own baby. I don’t think I put him down the entire day, I was heartbroken thinking about how that mother must feel. I will always cherish the privilege of kissing my kids goodnight every. single. night.

Watching a best friend lose his sister was devastating. Especially since she left behind a 22 month old and 5 day old. They were both in my wedding. I shed a tear every time I look at Abbie in my wedding album. Children need their mothers, and these 2 girls will grow up with plenty of family, but there’s nothing like the love of a mother. Heartbreaking.

There have been other deaths that have touched me, one being one of our bravest heroes in uniform. He died saving others when his helo went down in the Middle East. It’s unbelievable what this kind of loss does for a small town. Everyone knows someone that knows that special Hero. Our Hero is Adam. I grew up standing at the bus stop with him. He left behind a beautiful little girl, and loving family. If your hometown has ever experience the loss of a soldier, has a family that has a missing father, son, mother, daughter, brother or sister that gave their life serving and protecting, you get it. It’s sad, especially when I see his dad. Adam’s dad wears his grief all over his face. 😦 

Ever lost the parent of a best friend? That’s a really tough one too, especially if you aren’t in the same town or same state, and can’t help. That’s unfortunately what happened to me. I cried when Ms. Connie died, it truly broke my heart. What broke my heart even more was that I was several states away and couldn’t get home to be there for my friend and her family; they were like my family when we were in high school. I can still hear Ms. Connie saying, “Hiii, Kate!” with that W. Va. accent that was so sweet. She was a special soul with a heart of gold. She always made me smile, no matter what was going on in my world. I smile every time I think of her still to this day. I can’t imagine the pain it has caused her daughters, they are amazing and strong women, I admire and adore them both. But, the death of their mom… life changing.

Oh… the unexpected call about a friend that hit a place so low he thought the only option he had was the wrong end of a gun… Again, life changing in so many ways. That story is still pretty fresh and very tough to swallow. Some things will never make sense. You can never know the thoughts and fears that someone is living with. We just wish he would have called, so many of us would have stood in line to answer the phone. These kind of deaths leave so many unanswered questions. Mo and I still get pretty choked up talking about Greg.

This week, I watched another parent, fiance’, group of friends, and a small town say goodbye to an amazing soul. Cancer. CANCER! UGH!! Cancer is so poisonous! Why? Why Mel, why are all of our other friends that have been diagnosed (and there are way too many) become survivors, but not Mel. It’s hard to understand. I’m so grateful that my other friends can say they are survivors, but they have no guarantees.

None of us have a guarantee. We don’t know if we will be here tomorrow.

So, PLEASE, live the “Golden Rule.” Treat others they way you want to be treated. Don’t judge. Always smile. Say “Hi” to that stranger you pass on the street. Hug your loved ones. Tell your friends and family how much you love and appreciate them. Live generously. Love completely. Hug like you mean it. Kiss the love of your life passionately. Kiss your children goodnight every.single.night! Don’t take anything for granted, EVER! 

This journey is full of ups and downs. Regardless of what life has thrown at me, I try my best to make the best of this journey. I hope you do too.

Helping Children Deal with Disaster

/ Katie P. Tolley, RN, MSN, CPNP-PC / 1 Comment

With all of the news coverage of Hurricane Sandy, aka “Frankenstorm” I thought I should write a post about helping children deal with natural disasters.

So, how can you help your child go through a stressful event and minimize worry and concern?

  • The most important thing to do is stay calm. Children look to the adults around them for support and comfort. Often, parents will appear anxious, worried, and constantly talk about their fears and “what if…” scenarios. When a child is exposed to these behaviors, they will most likely be more anxious and worried as well.
  • Turn the TV OFF! Watching images of destroyed property, angry weather, and listening to hyped up newscasters will only increase a child’s concern. Watch a family movie or play a family game instead.
  • Talk to your child about their fears and concerns. Children will often be worried about things because they have exaggerated or irrational predictions about what may happen.
  • If there are serious injuries or losses, make sure your child knows what is going on. Children that don’t know the reality of a situation will often assume the worse.
  • Encourage your child to ask you any questions they want. Discuss what they are worried about, the unknown can be scary.
  • Find time for friends. Having life return to normal as soon as possible can be the best way to help your child understand that things will be ok!
  • Spend time together, this will make your child feel comfortable and secure.
  • Remember, children are resilient, they often persevere during times of stress and turmoil!
  • Encourage your child to journal or draw to deal with their feelings.
  • Continue to practice habits for good health. Get adequate sleep, exercise and make sure you eat well. Taking care of your body in times of stress is important. For tips on nutrition, check out my post, Let them eat cake… for breakfast?

Helping children through times of high anxiety can be challenging. Recognizing that your child is having difficulty dealing with a situation is not always easy. Symptoms of stress and anxiety can present in multiple ways, such as: bad dreams, insomnia, bed wetting, not eating well, not wanting to venture away from a parent/caregiver, stomach aches, headaches, not wanting to play with friends, difficulty concentrating, difficulty in school, or even irritability. If your child seems to be having lingering effects for a prolonged period of time, I would recommend seeing your primary care provider. Children can have Acute Stress Syndrome, which occurs immediately or within a month of the precipitating even. Children can  suffer from Post Traumatic Stress Syndrome if the fear and anxiety symptoms last for weeks or months.

If you and your family had to endure the weather challenges of Hurricane Sandy, I hope you came through it without any serious injuries or damages. It sure was  one heck of a storm, definitely one for the record books. Going through natural disasters is an unfortunate part of life. It is part of the journey we could all do without!

Hopefully this part of your journey will be put behind you quickly, and make you and your children stronger on the flip side.

Anxiety in children and teens….could it be their environment?

/ Katie P. Tolley, RN, MSN, CPNP-PC / Leave a comment

Can children suffer from anxiety? YES, absolutely!

Can it interfere with everyday life and their overall well being? Again, YES, absolutely!!!

Do they tell us they are anxious?? ABSOLUTELY NOT!

Children and teens are not able to recognize signs and symptoms of anxiety. Most children are not mature enough to verbalize these unknown, uncontrollable and scary feelings. Often anxiety can be related to the child’s environment. It may be their home environment, school environment, or another environment such as sports, church, school bus, etc. It is not usually an easy diagnosis, nor is it easy for the parents to reach out for help. Often times, the parents may have anxiety issues as well. I have talked with many children that have anxiety issues, and find that more than half of them have one or both parents with anxiety issues. Some of these children have issues because of the parents anxiety. Some of these children have issues because of other problems related to their family, such as lack of good parenting skills, loss of a loved one, loss of a parent to divorce or death, an ill family member, or a recent stressful event. Just as often, this anxiety could be from an environment outside of the home, the issue could be bullying in school, traumatic events in the news, severe weather situations, an inappropriate or abusive relationship by a trusted adult, a stressful event at school or in the in the local community, natural disasters, and many other situations.

What does anxiety look like?? Anxiety in children and adolescents can present as shyness, fearfulness, acting out, impulsive behavior, sleep problems, headaches, stomach aches, restlessness, difficulty concentrating, irritability, muscle tension, chest pain, shortness of breath, and just an all over feeling of discomfort. The American Academy of Child & Adolescent Psychiatry (AACAP) describes anxiety as “the fearful anticipation of further danger or problems accompanied by an intense unpleasant feeling (dysphoria) or physical symptoms.” Anxiety is more common in children and adolescents than we realize. Statistics show that only 25% of childhood anxiety is actually diagnosed. That means there are A LOT of children out there dealing with more than they can handle, and they DO NOT know how to ask for help!

So, what can you do to help children with anxiety issues?

  • Write or draw in a journal daily.
  • Spend time together. Quality and quantity of time matter.
  • Exercise at least 3-4 days a week.
  • Eat 3 balanced meals a day.
  • Play an instrument.
  • Talk about fears/concerns.
  • Get adequate sleep. (See my post about sleep: Sleep is Crucial for Healthy Development)
  • Talk to your child’s primary care provider to determine if medicine is necessary for your child.

Anxiety can affect any child at any time. Don’t be afraid to ask for help. Recognizing anxiety in children is not always easy. Figuring out why a child is anxious can be quite challenging as well. Working closely with a professional can help you help your child.

In the next couple weeks, I will be cramming for my mental health certification. (All prayers are welcome! Thanks!) I am hoping to work more closely with children that have mental health challenges such as anxiety. These children are often mislabeled as shy, uncooperative, having ADHD or behavior problems. Talking to the right professional can make all the difference in how well the child is able to manage and cope with this challenging disorder. My goal will be to help these children and their families deal with and overcome these overwhelming feelings. If you have any questions or concerns, please feel free to send me an email.

I’ve said it before, and I’ll continue to say it… PARENTING IS THE HARDEST JOB YOU WILL EVER HAVE!!! No doubt about it. Regardless of the challenges, your child will always be worth the efforts you put into being a good parent.

I hope this bit of insight helps you Enjoy the journey! 🙂