Kid friendly spacer devices for asthma

It's now been almost 6 years since the little miss has been diagnosed with asthma. As any parent with an 'asthmaticky' kid knows, your life is ruled by allergies and drugs, colds and infections. Every tiny sneeze or cough has the potential of turning into a major production of hospital visits and machines etc etc. And sometimes, you never know what causes the first little cough. But before you know it, the first ominous signs of a full blown attack appear... Hack, hack, hack...wheeze, wheeze... Panic all around. It's times like that that I'm glad I have my spacer devices. After all, studies have shown that if you put 2 puffs into the spacer chamber (manufacturers will say the devices are not meant for this so I leave it up to your discretion) it works as well as having a nebuliser. Obviously, they are referring to pure salbutamol nebs alone and not the ones that mix atrovent or pulmicort in. (disclaimer: if your child is having a bad attack, they need to be seen in emergency. I certainly don't advocate sitting at home giving them puff after puff while they turn blue).

In any case, what I've realized is that if it is truly possible to avert an acute attack, very often it will be if I can get the inhaled salbutamol into her before the symptoms get too bad. Obviously, once we get home we have to do major allergy management... Meaning she gets tossed straight from the car into the shower for a massive wash down, maybe antihistamines and inhaled seretide to follow. It all depends on our initial management of the first cough and how bad the subsequent attack gets.

So... In the last 6 years, we have tried 3 devices. The first one I won't bother talking about since it was an infant device and pretty impractical for toting around being about 18 inches long. The other 2 are the Able Spacer by Clement Clarke and the AeroChamber by Boehringer Ingelheim.

Able Spacer

This is manufactured by Clement Clarke and marketed by LifeTronic Medical Systems in Bandar Sunway. Priced at RM70 + RM40 for the mask. It's not widely available in KL and I had to email the head office to get the details of their local distributor. I got my first unit in Singapore when I forgot to pack kiddo's spacer on what I thought was a short 2 day holiday (smack upside the head for an 'I should have know better' moment). My wonderful uncle rushed us to Mount Elizabeth and this is what they gave us. We elected to have it without the mask as kiddo is almost 8 and quite capable of holding her nose and breathing through her mouth. The inhaler fits neatly into the body of the spacer device and is amazingly compact. Fits my handbag and her school bag with no worries about squashing the mask or having the canister fall out somewhere. It is also very streamlined on the inside which makes washing less of a worry. My concern is that the canister being stored inside will scratch the sides and cause the salbutamol particles to stick to the walls and reduce efficacy per puff, but so far, there doesn't seem to be any appreciable difference in the effect on kiddo during an attack using either device. The big plus point for me is that kiddo goes to school with it in the bottom of her bag and I know that if she needs it, both device and canister will be in the same place. No worries about squashing the mask, and since it's in a zip lock bag, dust either. Recommended that devices are changed for new when the silicone parts appear aged.

AeroChamber

This is manufactured by Boehringer Ingelheim. Priced at RM82 at last check today with the pharmacy of a local hospital. One of the most widely available devices in Malaysia and Indonesia. Comes with attached mask. This is the device kiddo has grown up with. Not massively large though a bit cumbersome to fit in regular handbags, and great for kids who can't yet control breathing just through their mouths. So in an acute attack, when coordination is not great, this little fellow is wonderful. It has more intricate parts though, so cleaning can be a bit tricky for obsessive moms like me. I can't stick a bottle washer in at risk of scratching the insides, nor can I completely dismantle it to clean all the itty bitty parts. Also the silicon face bit can get a tad tacky if dust gets on it. Generally recommended that devices are changed for new every 6 months or so depending on usage.

My take on the both of them...

Ease of usage : the AeroChamber is definitely easier as the kid can breathe normally through it without holding her nose.

'Tote-ability' : for now, the AbleSpacer definitely wins out. It is so incredibly compact and easy to carry. As kiddo gets older and her hours away from home longer, one of my bigger worries are what would happen if she gets an attack in school. Getting a call from school and having to rush her inhalers there while I know she is struggling to breathe is one of my greatest nightmares. I firmly believe in making my child as independent as possible and this little device certainly does that. As the inhaler is stored within the device, the 2 items are always together and she doesn't have to waste precious moments scrabbling around for a missing part.

Usability : the AeroChamber is definitely the easier of the 2 to use. The child can breathe normally through nose and mouth. With the AbleSpacer, the child has to be coordinated enough to take a breath in, remove the device while holding their breath, breathe out, then take another breath through their mouth only.

Price : the AeroChamber is the cheaper all round option at Rm82 (with mask the AbleSpacer comes to RM110). Although without the mask the AbleSpacer is less.

All in all, I'm probably not going to give up kiddo's AeroChamber at home anytime soon, but the AbleSpacer (without mask) is a great device that the child can use into adulthood (since it has also been shown that spacer devices benefit adults too). In all pract

icality, the AbleSpacer is so compact that it's the only reasonable option for kiddo and myself. I find that I now carry it everywhere because it fits all my bags. So that means we no longer chance going out without her inhalers and rush home at the first sign of a cough, we ac tually treat immediately. Also, being a girl, she's going to be carrying a handbag one day, and if she's anything like me, she'll only carry it if it'll fit her evening purse :)

Photos to follow. My iPad doesn't allow me to load photos to my blog weirdly enough...

Here they are:

First off, this is a comparison of what will be going into your mummy bag... Top device is the AeroChamber and accompanying inhaler. Bottom device is the neat little AbleSpacer with inhaler inside.

Here's the AeroChamber and inhaler stuffed into my bag. Now that I don't need a diaper bag anymore, I prefer smaller totes. This is a problem as I sometimes (often actually!) elect to leave the device at home. I know, I know... bad mommy!

Here is the AbleSpacer. Isn't that nifty?! Slots into a tiny corner of my bag. Most days I don't even notice that I've gone out with it when kiddo is not with me. I was looking for that effect actually. For it to become so much a part of my bag that I would unconsciously carry it everywhere...

So there you go. My 2 cents worth on spacers. I'm all for finding the perfect balance between my kid's needs and my own. Trial and error!

Kiddo's all time favourite books

I think I've mentioned this in the past, Kiddo is a rather advanced reader. She enjoys stuff that is sometimes geared at the young adult level rather than for a 7 year old. I make sure it has none of that boy-girl 'stuff' but otherwise pretty much let her pick her own books. After all, she'll probably reread them over and over... Which means it's economical right?

Anyhow, I figured I'd put this list up in case someone else has an advanced reader and needs some book ideas. BTW if anyone is willing to share their list, I would be VERY grateful :)

So here it is...

Favourites:
1) Anything written by Adeline Yen Mah - She loves the Chinese Cinderella books and rereads them over and over

2) Luka and the fire of life - This is by Salman Rushdie. Written for his son and it's a lovely adventure story. Each person who reads it will see something different. Both kiddo and The Man got different conclusions from it and it's on my pile of kiddo-recommended books to read

3)The ark, the reed, and the fire cloud - by Jenny L. Cote. New favourite given to her by an aunt (also the parent of an advanced reader). It's about Max (scottie terrier) and Liz (cat) and their adventures in the times of the bible. Wonderful book.

4)Mao's Last Dancer - by Li Cunxin. About a Chinese ballet dancer and how he defected to America.

5)Half upon a time - by James Riley. This is a swell book! It's a new take on the fairy tales we grew up with. Another family favourite. By which I mean she reads it, then forces it on us because of how 'amazing' it is. Have to admit, I've read a couple of real gems this way.

6)21 balloons - by William Pene Dubois. She was thrilled it featured Krakatoa. I haven't got around to it yet but The Man says it's pretty good too.

Everything else she likes belongs in the secondary list. ie Geronimo Stilton, Thea Stilton, fairies, mermaids, princesses, Enid Blytons etc etc etc

Final thought about books. If available, get a kindle. The savings we have made on the books bought via kindle have already more than paid for the device... In fact, the savings have probably paid for my ipad too. Our family devours books, so despite liking the feel of a paper book, I'll go with the savings any day!

Happy reading!

5.5 going on 15

Disclaimer : If you don't want to hear totally nonobjective ramblings of a proud Mummy. Don't read any further...

A couple of things happened with the kid this week that I just have to record for posterity. Am still trying to work out how I should react to them, but have decided that for the time being, I'll just channel Yoda (small and silent unless he has something profound to say)...

1) Kiddo has 2 favourite dresses and a shirt/shorts combo that she will wear in preference to absolutely anything else. I'm not kidding. We've tried hiding them, delaying the washing... Nothing works. She will very calmly ask the maid to please wash it today so she can wear it tomorrow. Anyway, I was gazing upon her stuffed wardrobe, eyeing the lovely (expensive) clothes she has and decided that it was time for a little chat about this clothes issue. We went through colours ('it's not about the colour, mom'), flowers ('I just like the flowers on these, mom'), beads ('this one has pretty beads')... Finally, she just looked at me and said, 'Mom, you just can't POSSIBLY persuade me to change my mind...' Accompanied by an exasperated eye roll!! Uh. Dumbstruck mummy. Do I laugh at the statement, or yell about the eye rolling? That night The Man and I had a little discussion on how we would have worded this differently... 'Oi! I'm not changing my mind-lah!' was the general consensus on how we would have responded. Proud mummy was on one hand thinking what a grammatically elegant statement that was, on the other thinking 'Oh no, my kid can out-talk me at 5 and a half!! And what's with the whole eye rolling thing?! '

2) I've always known that kiddo is an advanced reader. After all, she read our Bill Bryson Aussie commentary when she ran out of books on holiday. So I decided to test her using the Sonlight homeschool reading assessment. My biggest worry is always selecting books with the appropriate content for a 5-6 year old. And Sonlight does provide some guidelines on book selection based on age/level. So there we were, reading through lists of words that are supposed to gauge reading readiness. 5 minutes later, kiddo had read all the words including those for level 7 (roughly age 13). The test stops there as beyond that, ability is no longer the limiting factor. Again, befuddled mummy. Then she turned to me and said, 'Mom, what's dominion, and sundry, and capillary and condescend...' Out of the 10 words, she understood none of them!! Ok, ok, some of them even I would have trouble explaining, but my most immediate thought was, 'Crap, what happens if she hasn't understood ANY of the gajillion books we've spent so much money on??' Response to my suddenly rabid insistence that she ask my about ANY word she doesn't understand from now on, 'But I haven't come across a word I don't know in a really long time mom.' So, I've decided that I shall be guided by the Sonlight curriculum and we shall have 'together' reading time so I can make sure she understands at least some of what she reads.

After all this,I feel like a totally inadequate mother. Either I'm complaining she's too mature and out talking me, or that she behaving like a toddler and whining. Poor kid...

I can picture Yoda in my head, perching upon a rock, swivelly ears, walking stick, googly eyes... 'Calm, you must be... For, though smart, child, she be...'

Temporary tattoos have hidden dangers..

Kiddo was at a friend's birthday party and got a lovely glittery temporary tattoo. I said yes knowing that she's had reactions in the past, but thinking to myself, 'Remember to wash it off later...' Well, what d'ya know, what with rushing to pack for today's Sambolo trip and dashing to the store at 8pm to get daddy a snorkel mask, I TOTALLY FORGOT!! Ugh! *smack self in the head* Added to that it was Daddy who did the bathing, so I didn't even see her till she was all covered up in her PJs.

This morning, kiddo woke up complaining of a tummy ache and when I felt the warm forehead, my heart just sank... I knew it! A forgotten tattoo! Out came the nail polish remover and thus commenced our 15min cleaning session. She was subsequently sent down for breakfast and instructed to drink lots and lots of water to, hopefully, flush out whatever chemical it was that was causing all this. Happily the tummy ache and fever settled within an hour of having the tattoo removed.

Googling temporary tattoos was an eye opener. Nowhere does it list the chemicals that go into them, it just says dyes should be US FDA approved. Then there are the 'water soluble slip layers' and the 'contact adhesives'. A whole lot of 'uh?'.

This has happened several times in the past. At first it was only after parties when we put down the tummy ache and fever to over excitement and junk food the previous day. The fever and tummy ache would go on for several days, probably until the tattoos eventually faded, but I didn't link the two before. Then we got a pack of these tattoos for fun and she had the SAME reactions at home. I could not believe it! But it happened EVERY SINGLE TIME we put it on! Since then, I've been pretty strict, no tattoos except for parties, and they get washed off the moment we get home. Unfortunately last night it got left on, and she had a whole night of marinating in those chemicals. Hopefully we got it off in time and her beach holiday won't be spoiled. Note to self... parties = tattoos! Inspect and WASH!

Kiddo's bedtime prayer tonight

'God Bless Daddy, Mummy and Me. Help me get better. Keep Daddy safe on his travels. God Bless Grandpa, Grandma, Ah Kong and Ah Ma. God Bless all the orphans. Let there be no tsunamis, earthquakes and volcanoes. Help me not whine, moan, cry, and tantrum. God bless all my new friends, old friends, and ab-so-lu-te-ly everyone. Help me sleep well and not wake up late for tomorrow's school trip to the zoo. Good night God. Amen.'

What can I say? A kid's environment certainly affects their thought processes. Much more so than one would imagine. I use prayer time as a guide to what the kid is thinking, and a spring board to talking about stuff. Ever since the recent spate of natural disasters have hit the local papers, she's been including tsunamis, earthquakes and volcanoes in her nightly prayers (Downside of a kid being able to read the back side of the paper while I'm reading the front).When I talk to her about it, I can tell she's concerned they will happen to us and people she knows. On one occasion, I remember having to sit down with her and the encyclopedia to work out how safe Jakarta, KL and Singapore were for the various friends and relatives she was worried about. And being here where poverty is so visible she has asked about the street children who beg at the car door. So has developed a slight obsession about orphans and their lack of parental love. Sigh... I guess if we were living in London she would pray about blizzards, gale force winds, tube delays and Indian summers.

Being an expat kid, she's had friends in KL, from her old school Tutor Time, and now in ACS. Not to mention the other expat kids that come and go. I can see how distressing that can be. I certainly do feel it when friends move away. The friendships tend to be rather like a summer romance, you know they're going to end right from the start, you make promises to keep in touch no matter what, and parting is wrenching. But once everyone's moved, it's only the occasional email or skype. Sometimes not even that. Thank God for blackberry messenger. These friendships tend to be quickly forged and quite intense, after all, no one really understands what an expat goes through other than another expat... She's also had to get used to Daddy traveling quite a lot. Now when she's had a scolding and says, 'I want to talk to Daddy!', Mummy has to do time zone as well as airline ETA computations. It's no longer just calling and having The Man furtively whisper that he's in a meeting and will call us back.

The moaning, whining bit... Well, that's totally my fault. because of my ear problem, anything above a certain frequency hits my brain like a laser beam and turns it into what feels like a cauldron of boiling lava with nails shooting into my ear drums. Her voice then echoes and reverberates in my skull, bouncing around and causing more churning of the lava and nails... Well, lava explodes, and so does mummy. That's generally when monster mummy makes a visit. My own yelling adds to the mix and I get even more steamed. Not nice for everyone... So every night, without fail, kiddo asks to not moan or whine. Depending on what's gone on at school, some times she adds in, 'help me to cheer not jeer (school lecture) and help me not mock or be smart alecky (heh heh)'

She throws in the 'help me get better' whether she's sick or not. Being an asthmatic and allergic-y kid, there have been times when she's on pills, syrups, puffers, sprays, creams for months on end. This is like a mantra for her. Can't sleep unless she says it. No matter, I don't imagine God would hold it against her...

All this is certainly a change from 2 years ago when her prayers were, 'God Bless Daddy, Mummy and Me. God Bless Grandpa, Grandma, Ah Kong and Ah Ma. God Bless Riesling, Cookie (our dogs), Baileys and Smokey (our cats). God Bless my friends. Help the woodpecker not eat all our fish...'

Return of the red-eyed fanged monster

630am : My alarm rings. No sounds of stirring through the monitor. No matter, kiddo doesn't really have to wake till 640am. Close my eyes for a quick catnap.

645am : Open my eyes thinking, 'Oh s@*#! Late!' Still no signs 0f kiddo stirring. Well, can't be helped, she has to get up. Crawl under the covers with her and try to gently wake her up. My mom used to yank the covers off me and slap a sopping wet towel on my face. Not a nice way to get up... Today though, I can see the virtues of the shock treatment.

650am : STILL not getting up. This is the kid who is usually up on her own at 630am singing! 'Come on kiddo... You're late...' (Mummy getting desperate here...) This is when the monster appeared... 'But moo-oommm, I'm still tired. WHY do I have to go to school now? I WANT it to be a weekend NOW!' Mum, 'It's the weekend tomorrow, you can sleep in and catch up, now quick! Go clean up!' Monster (with the added finger on chalkboard screech thrown in for good measure), 'But I don't wanna sleep in on weekends... I wanna wake up early and go downstairs MYSELF!!' Rapidly losing patience mum, 'Look, I turn off the alarm on weekends, and if you wake too early, then of course I'll ask you to go back to sleep.' Monster, 'NNOOOO!!! I WANNA WAKE UP EARLY' Punctuated with a foot stamp. Really needing a pee mum, ' WHATEVER!!! I need the loo, GO CLEAN UP!!'

7am : Monster still yelling and screaming that she wants to wake up early tomorrow. Totally lost it mum, 'IF YOU'RE NOT DONE AND READY IN 5 MINS I'M COMING IN THERE AND DRAGGING YOU DOWNSTAIRS, AND YOU CAN GO TO SCHOOL IN YOUR PAJAMAS!!! AND IF THIS IS THE WAY YOU BEHAVE AFTER PLAYDATES, THEN NO MORE PLAYDATES!!!!' *cough, cough* I'm out of practice, we haven't had a visit by the monster in a while, obviously my vocal cords need re-conditioning...

705am : Stomping heard on the stairs and down the hall. Minimally effective because it's tiled, but I guess effort counts.

710am : 12mins late. The kiddo is slowly re-appearing. Very grumpy though. So I just left her to a silent breakfast in the car while I hid behind the daily paper. She didn't even want to have her daily chat with my Dad. Left him pretty disappointed too. 'I'll talk to you after school, grandpa...'

740am : 5mins late for school. Assembly already in progress. She was whisked off by her teacher, smiling and chatting. Back to normal... Sigh.

At a quick count, 1 monster = 1 yelling mummy, 1 disappointed grandpa, 2 staff literally hiding from both monster and mummy. Can you believe it, 1 bad tempered kid spoils the morning for 4 people...!

Green day at school

Today was green day at school. All the kids had to wear a green top. There was a presentation by the WWF and the elementary kids will be having a recycled paper making session after school. I'm pretty impressed by the recycling efforts at her school. They have recycle bins everywhere. The kids don't really have an opportunity to not recycle actually. No regular bins. Only 'paper', 'plastic' and 'waste food' bins in groups of 3 wherever you go. Good idea really.

Anyhow, we've been home for a bit. I'm messing on the computer and she's reading something when all of a sudden, she comes up to me and says, 'Mummy, don't put your juice box in the bin. It has to be recycled. We have to look after the environment or the endangered rhinoceres (rhinoceri?) will have nothing to eat. There are only 60 left! Also, if we chop down trees to make paper, the squirrels will have no homes and no nuts. So recycle your paper ok? The lady was asking people to adopt rhinos in school today. Can we adopt one?' As I sit there a bit stunned by this deluge of information, my automatic reaction is, 'Sure. Let's adopt a rhino.' Then it occurs to me that kiddo might think we can bring the fellow home! So I cautiously say, 'You DO know that we can't bring it home right?' Kiddo, 'Of course mummy! They live in the national park and eat leaves and stuff. We just have to go there everyday to give it some love!' Riiiggghhhttt. 'Everyday?' I say, trying not to fall on the floor screaming with laughter. Bad for the child's self esteem, you know. 'Ye-ah' she says matter-of-factly, 'after school everyday, we'll just go to the park and play with it.'

Now, I have full respect for the WWF presenters having to deal with a bunch of yelling fidgety kids, but if I EVER see any of them I shall very strongly suggest that presentations to impressionable young kids include the statement, 'Adopting means your parents PAY for us to look after the animal. You may not visit, touch, or play with said animal.' Capisce??

Never trust dosages on the sides of bottles...

Kiddo had her booster DPT today. Much, much less traumatic than expected. Maybe it was the ice pack before that numbed the area, or maybe it was the nurse yelling, 'abracadabra, sim salavim!' right in her face. Whatever it was, it worked. No crying at all!! Just a rather bemused look on her face. What I call the 'is it worth bursting into tears' look. All in all it was ok until about 5pm, right after her Dora show (fancy that!), when she started to complain of an ouchie arm. Then came a bit of drama during the attempt to remove the plaster. Lots of cringing and shuddering and groans and whimpers. Following which mummy got fed up and ripped the half hanging plaster off in one fell swoop. Heh heh heh... (evil mummy) She was NOT amused. 'Stop laughing at me!!! It's NOT funny!!!' In any case, I decided to give her a dose of paracetamol before things got worse. On picking up the bottle, I saw printed on the side : 4-6yrs 1.5 teaspoons (1 teaspoon is about 5mls but NOT ACCURATE! Dosing spoons are infinitely safer), 160mg/5 ml, not more than 5 times a day.

Ok, at this point, all I could think was, 'please tell me I've checked the dosage in the past...' because for my kiddo, that would be an overdose. And as one of my consultants once said, 'Paracetamol should be a controlled drug. It's the easiest and nastiest way to kill yourself. It poisons your liver and you die horribly...' I remember shipping patients off to liver units with everyone up in arms over the fact that a much needed liver would be going to someone who willfully destroyed their own. Anyway, that's an argument I definitely don't want to start...

Back to kiddo's paracetamol. The recommended paediatric dose is 10-15mg/kg (UK 10, Aus 15) up to 4 times a day. Australia then caps the dose at 60mg/kg/day. Being UK trained, I go by 10mg/kg. That would bring kiddo's dose to 160mg 4 times a day. Total = 640mg/day max. 960mg a day if you use the higher Australian recommendation. Using the dosage suggested on the bottle, she would be taking 240mg 5 times a day. Total = 1200mg. That's 87.5% more than what she should be having!! Which also works out 25% more than even the higher Australian recommended dosage!! Last year at age 4 she was 14kg. Going by the dosage on the side of the bottle, she would have received 114% of her recommended daily dose! I shudder to imagine how much paracetamol parents out there are unknowingly giving their children thinking the dosage on the bottle can be trusted. Yikes!

From now on, I'm checking the dose of every drug that comes into this house. No more assuming the dose printed on the bottle is correct. After all, you know what they say about assumptions... If you assume, you make an ASS out of U and ME... So before you dose your kid, just do a quick google check on the recommended dose for that particular drug. Much easier to check than to deal with the consequences of damaged internal organs. Oh... and buy a dosing spoon. Teaspoons and tablespoons are only good for eating, not administering medicines...

Day 3 daddyless : Kidzania mania...

Since kiddo and I were at loose ends today, we jumped at the chance to go to Kidzania with a friend and her kids. 2 moms, 5 kids (2 were my friend's nieces), a WHOLE lotta screaming.... Result : utterly exhausted moms with hyper kids.

Buying the tickets was an experience in itself. You queue like you're checking in at the airport. Trust me, it was as crowded and noisy as Soekarno-Hatta on a Friday. Then they give you a ticket that looks exactly like your Air Asia plane ticket, and a wrist band which is colour coded depending on whether you're with a party, an unaccompanied kid etc. There are 8 categories. More on that later. The band is used for logging them into various activities. Yes, parents get banded too... No, you can't participate no matter how much you beg. All the doors have 'no adults allowed' signs. I was rather disgruntled as being only 5'1", there were kids there much taller then I am...

Top : Kidzos , Mid : bank card, Bot :
drivers license, L/R : back and front
of tickets

On entering, you first come to Main Square, where the food is. Very wide selection but don't expect Cordon Bleu. With time pressing (5 hours is waaayyyy too little time), you just want something quick. The kids didn't eat much anyway. Probably had 15mins before they were off to the next thing. There's a 'Metropolitan Theatre of Kidzania' where the kids can stage a magic show or Peter Pan. Kids imitate the staff, so there's not much memory work needed. Best of all, a plaque displaying the 'Independance Declaration of Kidzania' sits in front of this huge monument to kiddy emancipation! One of the statues looks like it's casting off chains! I kid you not!! Someone PLEASE tell me I'm wrong...!

For kids, it's great. Wonderful atmosphere. No need to speak softly or tip toe around adults. For adults, it's P.A.I.N.F.U.L. Noise, noise and MORE noise. For someone who already has hinky ears, I couldn't hear nuts. Kiddo had to yank on my arm every time she had something to say. Every hour on the hour, they play the Kidzania theme song. Ouch. The kids can join a marching band, ouch. That's in addition to the welcome song and dance and the farewell song. Everything being played at MAXIMUM volume. Also sirens for the fire engine, ambulans, police (kids have to catch an escaped felon while being coordinated by other kids in the 'control room'. He has tattoo sleeves and breaks out of the prison that has rubber bars. Hilarious...) OUCH.

All the different activities are in their individual sound proof rooms. Each room takes 5-12 kids and lasts 10-30mins depending on what the activity is. You MAY NOT help your kid. Which is why I hope the KL version will be more English based than this one. The default language here is Bahasa, unless the majority of the kids need English, they will conduct it in Bahasa even though the other kids can speak English. You get payed in Kidzos ('local' currency. Upon starting you are given a 'cheque' you have to bank in. Kids either use the 'bank card' issued or withdraw Kidzos from the ATM to buy things) to do certain things like, wash windows, be a dentist/ scientist/ doctor/ tax agent (Huh??) or pay for services. Eg. getting your photo taken... Some activities have minimum ages, like being a tax agent (8. Huh x2??), some have minimum age suggestions, like being a scientist in the Yakult lab (6. Free Yakult included in the job...). Others are ok for all ages. Usually the food related activities (eg ice cream factory, cookie factore, Aqua plant etc) will give you a free sample of that item. Little tip from my Kidzania veteran friend, C : get your kids to do the pizza/ burger making activity and the Aqua bottling activity just before lunch. See! No need to pay extra for food!

The cutest thing there is the driving activity. You have to drive around, get fueled up at the pumps, go through a car wash (no water moms, don't worry). But in order to do that, the kids need, wait for it, a DRIVERS LICENSE!! To get this they need to get a medical check up (not real moms, don't worry), go through a driving lesson, and pay 20 Kidzos. Check out the photo above, it looks and feels real! With this, they can also do a go kart like racing activity. Kiddo was not interested in that, though looking at it, those go karts didn't seem all that go to me. More like, amble karts...

All in all, it was a fabulous outing. Moms had to crash at the Times book store cafe with some rejuvenating beverages for bit (actually so long the staff kept wandering by looking at us) while kiddos had some down time reading. As kiddo said at bedtime, 'I had an amazingly, fun time mummy. Let's go again!' For sure, apple of my eye. Let's just wait till mummy can hear again shall we...

Miscellaneous information

Tips from today's experience and C

1) For first timers, don't bother rushing to the bank when you arrive to get a bank card and cash your cheque. You can quite happily go around without it till later when it quieter.
2) Check the age/ height limit before q-ing. No point standing there for ages then getting told your kid is too short/ young.
3) If you have 2 parents, while one is waiting for the kids, the other can scout out an activity that is finishing. That way, less waiting for kiddos and they get to fit more in.
4) Head upstairs early. People tend to stay downstairs for a long time before going up. Early on the 'factories' upstairs tend to be quieter.
5) Get there early. You will need EVERY second of your time there.
6) Wear comfy shoes. Parents do A LOT of running around.
7) Don't bring a lot of extraneous stuff. There aren't many seats around for adults so by the time 5 hours is up, you may feel like your glamorous Prada has morphed into a deformed saddlebag. Next time I'm bringing a backpack and foldable chair...
8) Call ahead. If avoidable, you don't want to be squeezing with a whole bunch of school kids. My experience thus far is they don't really have a good grasp of the concept of a queue. Also there are no roped off areas to form the q, so unless your kid is good at standing up for themself (mine isn't), they can get totally shoved to one side.

Toilets

Clean and easily used by unaccompanied kids. Kiddo is about 105cm (what can I say, pint sized like mummy), and had no problems going on her own. Even the sinks had 2 levels. Low and super low. Best of all, the sinks are outside, so if you're a hand washing freak like me, you can personally supervise the soaping (provided) and scrubbing.

Security

Everyone is tagged in one of 8 colours. Once the kids are in, they cannot leave the premises unaccompanied. Dropped kids are picked up by their guardians at a designated place and the adult has to bring some proof of identity. When we were leaving, the security personnel were going around asking blue tagged kids if they had call their pick ups etc. The are also constantly on walkie talkies at the exit relaying information on how many blue tagged kids were still inside. Really impressive. I don't now how fool proof the system is though. C's nieces came later and were blue tagged, and yet were allowed to leave with us when we said they were part of our group.

From R : Party; responsible
adult for the party; School
group; Responsible
adult for the school; Accompanied
kid/ Adult (that's us); toddlers
aged 2-3yrs; Unaccompanied kids;
Babies/ Adults >65

Location, price and timing

Pacific Place 6th floor.
021-5154 222 / 021-5154 888 ext 101, 191, 192
www.kidzania.co.id

Mon-Thurs : 0900-1600 (7hrs) - 2-3yrs Rp5ok, 4-16yrs Rp130k, +16yrs (that's us, moms) Rp90k
1100-1600 (5hrs) - 50k / 115k / 75k

Fri, Sat, Sun : session 1 0900-1400
session 2 1500-2000
50k / 115k / 75k

View from outside Kidzania

Holiday season : session 1 0900-1400
session 2 1500-2000
100k / 155k / 155k

NB : if you're a grandparent >65 with 2 or more grandchildren in tow, you get to go in free... Otherwise it's the standard fare. Hmm, I wonder i one can get away with 'borrowing' grandchildren...

As many stations as I can remember

Theatre, magic show, hp art studio, ponds sunsilk beauty saloon, burger place, pizza place, window washing, cosmos electrical shop, indomart, BCA, tax office (hee hee), yakult lab, archeological site, hospital (couple of different things there, there's a pretty lifelike surgery station), dentist, photo studio, fire station, construction site, wall painting, police station, telkomsel workshop, news station, radio station, Aqua bottling plant, Kapal Api factory, Walls ice cream factory, biscuit factory, cookie factory, milk production plant (box milk ok!! Not human!), baby nursery (kids are the nurses learning to diaper and clean baby dolls. Good for moms wanting to see if their kids might help with a younger sib??), Flight simulator, go kart track, driving track, driviers lessons... Waxworks pending... I definitely haven't got it all. Let me know what I've missed. Oh, and if the kids get tired, there are mini blue/ silver bird taxis and buses to get to their next destination... Pay in Kidzos please. Other currencies not accepted... Forget it big people, apart from the driver, no adult allowed. Check out the photo, the 'cab driver' can't even sit up straight!!

Are you listening to me, Doctor??

I remember back in the days when I was in medical school, 'communication skills' were the big thing. How to speak to your patients to get the best information, how to ask open questions so you get answers that are the patients own and not what they think you want to hear... And on and on ad nauseum. Well, I have had cause to visit a fair few medical practitioners since I've stopped working and I have come to realize a few things... It's easy to speak to doctors who are trained like I was. They're the ones looking earnestly at you and saying things like,'...and how did you feel then?' or '...what else happened after that?'. Things changed when we got here to Jakarta. For one, the poor air quality meant kiddo's asthma and allergies and what have you all made a massive comeback. Not to mention the food poisoning etc etc... So forever at the doctors clinics mean wading through a lot of chaff to get to the wheat.

The first thing I noticed was that people in general are very laid back and smiley here. Same for the medical staff. It's not that your problem is unimportant, but that's the way they are. Some more so, some less so. But in general, going to see a doctor here is a little like walking into a spa. They speak in the same soothing voice, same smiley face... I've essentially had to come up with a way of giving them information so that they get the important bits, and not wait for the polite pauses before they ask about the next symptom. I'm always concerned that they will forget something in the time it takes for the consultation to end.

This is what I do... I tell them everything that has happened in sequence, what I've done, whether it's been effective and what's happening now. E.g. I've had a cough for 4 days and a fever for 2. The fever goes away with panadol every 6 hours but for the last day I have had green phlegm and my chest hurts when I breath. 10mins condensed down to 1min. I never tell them what I think the diagnosis is because a) I don't want to influence their thinking b) I'm interested in their diagnostic processes c) there's a reason doctors are advised not to treat themselves or people close to them... I was once so annoyed by hubs complaining about a couple of spots that I missed the fact he actually had shingles!

Another thing I've noticed is that all the competent doctors in Jakarta only practice during office hours. Off hours, it's dicey. I have yet to see a doctor, or hear about someone seeing a doctor off hours that has left me feeling anything other than nervous. On our first trip here, kiddo fell and split her head open. We went to SOS and the doctor on call (she looked younger than my 20 yr old cousin!) had to call someone to ask for advice on whether she should put stitches in. Also consulted ME on whether the skull XRay was ok! Um... anxious mom dealing with freaking out husband and kids here!!! In any case, kiddo left sporting 3 stitches in the back of her, thankfully, unbroken head. Lots of other stories on weird and wonderful diagnoses to cover for the fact that some on call guys really have NO idea what's wrong with you... And obviously can't even make up plausible stories. Others are just forgetful. My husband got a metal splinter and the fellow forgot to ask about tetanus status! I had to ring the practice manager from KL where I was on holiday, and she had to then call the clinic and get it sorted. What a hassle!

Well, I discovered a handful of doctors that I trust. Top of the list is Dr.Ade, a GP at Global Doctors. She's there all week but not weekends. Lovely lady. Very competent though does appear very laid back. Very good diagnostically. The regular GP at SOS was good too though I have to say that I 'bonded' with Dr. Ade much better. For kids, the selection is better. Dr. Isabella and Dr.Lineus at Jakarta Women and Children Clinic are pretty good. Though I have had some raised eyebrow moments. Nothing horrific. Dr.Isabelle (different lady to that at JWCC) at Global is also very sensible and nice.

The one paediatrician I wish was still in the area is Dr.Johannes. He's a paediatric pulmonologist (chest doctor) who used to be at JWCC and is now somewhere in Tangareng. Not much bedside manner to speak of. Very brusque and hurried (unlike his other local colleagues) but he sorted out kiddo's asthma and allergies within 6weeks. Hats off to him, wherever he is...

All in all, medical services in Jakarta are probably not as terrible as made out to be. But how on earth do non-medical people decide which doctors to see?

Thank God she likes school...!

It was the quarterly parents-teachers meeting today. I am still in a state of bemusement.

The kiddo is in ACS (Anglo-Chinese School) International Jakarta. She loves school, including all the extracurricular activities offered. Ballet on Monday, Mandarin Club on Tuesdays and Fridays, Tennis on Wednesday and swimming on Thursday... Not to mention normal lessons that include computer classes, Mandarin classes, writing, reading, math, art... It's a full platter, but as long as she's coping and not morphing into some red eyed slavering beast at 5pm every night, I'm happy to go along with it. Then there are the daily bits of homework. Nothing taxing, but probably useful in getting the kids used to having to sit down everyday for a bit of work. Again, effort is the key, I've stopped the sickening 'you're sooo smart' gushing that only elicits an eyeroll from her... As Po Bronson (author of 'What should I do with my life') says, praise the effort not how smart the kid is. Kids who are always told they are smart end up afraid of tackling difficult tasks. I have noticed that kiddo appears happier at doing her work now compared with before. At the very least, she doesn't get upset anymore if her work is not done 'perfectly'. Ok, guess I should actually finish the book now...

Anyway, back to our little meeting today. The conversation was illuminating to say the least. Teacher thinks my little bushel of joy is very smart. Why? Because she can talk and listen at the same time!! Excuse me, but isn't that called interrupting?! And isn't it actually RUDE? I think Teach probably sensed my rising blood pressure because she very quickly asked me not to worry, they were slowly teaching her to wait while other people were speaking. Downside of her being an only child I suppose. No need to compete for willing ears... Besides, I can pull the 'mummy's ears are tired' line which the teacher probably can't.

Another topic that came up in our little chat was forgotten stuff. I have a policy... I ask her to pack her stuff once. If she forgets something, tough. After all, she's 5, it's hardly the end of the world if she forgets to bring her book to school. Better she learn to be responsible for her things now rather than later when it's more important stuff. Anyway, her teacher mentioned that a common excuse for forgotten things among the other kids was 'the nanny forgot'. Now, I'm all in favor of the occasional services of a part time nanny when the man and I want to join in (very) occasional late night poker parties (he plays, I anticipate how much shopping I can do with his winnings), but letting the kid become totally dependent on nannies is letting yourself in for a huge amount of pain later on. I have heard stories of men going away on business trips who need their mothers/ girlfriends/ wives to pack for them!

All in all, I'm very happy so far with this new school. A bonus point is that till just a few months ago it was a National plus school and was therefore significantly cheaper than some of the other international schools. It's a bit far, Setu exit, 15min on the toll road from the Pejaten entry, but the grounds and facilities are top of the range. Teachers seem to actually know the kids and most importantly, the kids actually look and behave like kids instead of jail baits in training. Even the early start is a price I'm willing to pay. School runs from 730am to 12noon or 1pm if ECAs are happening. She's in bed by 7pm and up at 640am. For now the multiheaded monster of doom only pays us occasional visits when she gets overtired, otherwise life is predictable and as calm as is possible with a 5 year old around. Just the way I like it....