Jennifer Shoquist

Cheat Sheet / Updated 04-12-2022

Potty training is an important step in childhood development. As a parent, you need to recognize the signs that your child is ready for the toilet talk, institute a potty-training process, keep that process going, and recognize when your child is almost there. Along the way, you need to make sure that your child knows potty-trianing terminology, be able to spot problems that need medical attention, and separate potty-training myths from reality.

Article / Updated 01-23-2017

Keep an open mind as you check out your potty-chair choices: seats that attach to the big toilet, little potty chairs — and don't forget that you can always use that hand-me-down chair (from an older sibling or cousin), and let little sweetkins personalize it with stickers, making the throne hers alone. Encourage your trainee to sit on different chairs to check out size. How well each one fits her tiny backside can be a big factor in her speed of adapting to potty training. Find a nice fit: In the store, let her road-test a few and see which ones are comfy and best fit her baby-buttocks. The right chair will be sized so that she can rest her feet on the floor and use her muscles to bear down when she wants to start a BM (bowel movement). Feet dangling in the air aren't conducive to making the process work. Study the nitty-gritty: Check out potty chairs and toilet-toppers for basic practicalities, such as stability and easily removable catch bowls. Opt for a remove-from-the-top bowl over the type of bowl that you remove from the back, which isn't as user-friendly. Also, make sure the chair doesn't slide around. Try to predict your reaction to wild gadgetry before you buy a chair that sings to your toddler as she sits, or rings a bell when pee hits the bottom of the bowl, or any number of other combinations. Otherwise, your child will get confused if you suddenly deactivate her bell in mid-stream. Parents who find repetitive sounds annoying should definitely bypass the talking-singing potty chairs. If your chief desire is to avoid the noise of your trainee's potty chair, the process is doomed from the start. So, don't feel guilty if you decide to steer clear of the one that's crooning show tunes. Choosing the right style When it comes to potty chairs, you have two different styles to choose from: a stand-alone potty chair you put in the bathroom, or a special adapter seat you attach to the big people's toilet. Consider the smart-device factor: Some kids and parents like a chair that has all the bells and whistles — one setup has a potty chair, an adapter seat for later, and a stepstool. Foster a love connection between child and chair. If you get your toddler's thumbs up on a chair she likes, she'll feel more like the chair is her own. Going with a toilet-topper If your kid is turned on by the adults' toilet, she's already motivated, so get a special potty seat that hooks onto the toilet to make it fit a child. Figure 1 shows a toilet with a seat attached. Also, buy a little stepstool because she must be able to plant her feet firmly on a base (and push), for better bowel movements. Get a no-nuisance toilet-top adapter: If you're buying an adapter seat for the adults' toilet, try to find one that won't drive the rest of the family nuts because removing it is such a bother. Figure 1: A toilet-topper potty seat on an adult toilet. Opting for a potty chair Buy a private chair for an individualist: The child who's fond of the "mine" word will relate more easily to a potty-chair than to the big people's toilet. Typically, a kid likes having her own private little pee-pot, such as the one shown in Figure 2. Figure 2: An on-the-floor potty chair. With this type of seat, your child won't need your help in getting on the potty, as she may with the adults' toilet. The one downside: You have to clean out the bowl — and that gets old. A potty chair stationed on each floor of a multiple-level home is a good idea. You want to do everything you can to help your tot succeed — so, make it ultra-easy for her to complete the race to the potty. (Expect trips to be at warp-speed at first.) Potty chair paraphernalia Having a child in the house means you also have a lot of "stuff," from toys to clothes to gadgets. The potty-training stage also has its gadgets. Whether it's all necessary or not, is up to you. Boy-directed splash guards, such as the one shown on the potty chair in Figure 3, can be troublesome for boys and girls. Be sure you remove the urine guard from the potty seat or toilet ring because it can scrape your child as she moves on and off. This device is meant to keep urine from splashing, but don't take a chance. If your child gets hurt, she will think the toilet is scary, and that's a whole new set of problems. You don't want to go there. Figure 3: A potty chair with splash guard. Some ultra-practical accessories are Jonny Glow strips that have a night-glow that helps your child use the potty in the middle of the night. Given a 15-minute charge from a normal bathroom light, the strips will glow for 10 hours, and they're easy to stick on any toilet surface. If you want a little fluff in the bathroom, try a potty sticker chart or a bowl of tiny potty prizes displayed where your toddler can see it. She'll get the idea "If I get the hang of this potty thing, I can get stickers and a prize from that bowl — cool!" You could also hang up a hygiene chart, with pictures that take kids through the steps from wiping bottoms to cleaning hands.

Article / Updated 06-03-2016

Handling the physical aspect of training a child with a disability is wildly different with individual kids, depending on the disability. You may need to provide high-tech props that facilitate movement from walker or wheelchair to the toilet (see the "Working with Special Gear" section in this article.) On the other hand, your child may need nothing more than some bars to grab onto when she's sitting down — and your friendly assistance. One of the hurdles that parents and caregivers face is that kids with physical disabilities sometimes are so hamstrung by their limitations that even the idea of pleasing adults doesn't motivate them, the way it does other children. Also, some aren't moved by the idea of being a big kid or wearing big-kid underwear because they're happy being "little" and "dependent" — it feels safer, considering the physical mountains they must move every day, when they're trying to move around successfully. Obviously, different disabilities have special problems built in. To discover the best way to potty train your child, try some of the following ways of obtaining advice on potty training a child with a disability: Study up on your child's disability. A good resource for info is the Family Village. Seek insight from other parents of children with disabilities. Your community will probably have support groups, or you can join one of the many on the Internet. Ask an occupational therapist or psychologist for advice on potty training a child with a disability. Understanding muscle control issues While most children can control their bowels and bladders by about age 3, kids who have disabilities may take much longer. Their medical problems can delay the development of the muscle control a child needs to regulate herself. In some cases, a physical problem can even prevent a child from developing this ability. Check with your doctor to find out whether you can expect eventual potty use — or not. Remember, however, that a doctor is not a prophet. You have the advantage of knowing this particular child better than anyone. Therefore, if you're sure that she can be trained, you have nothing to lose by trying — as long as you're not pushy or critical. Coming to grips with your child's muscle control issues is key to helping her become potty-proficient. You'll discover, as you investigate, many strategies that work in training special-needs kids. Sometimes, a child's motor difficulties will make her use the potty only if you take her. Escorted, she will do it. Otherwise, she's a no-show. The good news is that eventually she'll decide to go on her own, but that may take time. Get your physician to be your ally. She should provide you with information on understanding your child's limitations and boundaries insofar as muscle control. You don't want to try to get your child to perform actions that are beyond her capacity, but you do want to be there with encouragement. Enhancing physical progress One of the best ways to enhance your child's physical progress is to potty train her as you would any child: "You can do this — I know you can. We'll find ways to work around your brace." To promote physical adjustment to potty training, you can forge mind/body links in the following ways: Help her connect bathroom with body functions: Move into the bathroom for diaper changes and emptying diapers — you want her to associate poop and pee with the place where the toilet is. Brag on tiny successes: Make sure your child gets huge bravos for the baby steps she makes, whether that's making a tiny dribble in the potty bowl or saying "I potty" after she has done it in her diaper. Help her handle nighttime frustration: For a child with disabilities, staying dry at night is hard. You can expect a child who lacks mobility to have trouble making it through the night dry, and she'll need special handling and empathy. You may need to transfer her from wheelchair to toilet many times before she's able to handle it by holding on to grab bars (see the "Working with Special Gear" section later). Before you kick off her program, make sure she's eating and drinking a nutritionally sound diet. You don't want constipation to get in the way of progress. Next, talk to her about the body signals that tell your child she needs to go potty. Unfortunately, certain physical disabilities tone down that urge feeling. Remember, too, that a child with a disability may have a muted sense of body in general, so being messy may not bother her. Your child may miss the potty sometimes, so you should tell her not to worry about accidents. She may also be pretty bad at cleaning herself. All toddlers are fairly messy at this stuff, but the disability may take your child's messiness quotient up a tad. If handling toilet paper is out of her league, just do the task for her. She may eventually learn how by mimicking your moves — but for now, you remove the possible frustration involved in her desire to be clean but lacking the coordination to accomplish that. After addressing diet, body signals, and messiness, try these ways of enhancing your child's potty progress physically: Set up a success-oriented environment. Get removable obstacles and stressors out of the way. Install handrails or other physical supports so that she can feel safe and sturdy when she sits on the potty. Pad the potty seat with foam (from a crafts store) or buy a softer, padded toilet seat if your child thinks the seat is too hard or cold. Use waterproof sheeting on surfaces where your child sits so that she can hang out clothed in just underpants or diapers. That way, she can be wet long enough for the feeling to bother her. The waterproof stuff is there just to make cleanup easier. Working with special gear You can train a child with a disability on a specialized potty chair (custom-made for the child); or build steps up to the potty; or mount a set of grab bars on the walls on each side of the adults' toilet. You can also purchase some terrific wheelchair-conversions that make potty use easier for a wheelchair-using child. A tot with motor developmental problems is often potty trained on an adaptive toilet seat or extra-high toilet, which you can shop for at a medical supply store, or online at Web sites such as the following: The Alliance for Technology Access Columbia Medical Invacare Another possibility is checking with your occupational therapist for availability. Some state agencies provide equipment for families whose incomes make these pricey toilet options out of the question. Some of the aids and options that are good for potty training a child with a disability are the following: A custom potty chair, or one that's modified from an existing chair. Check Able Generation — they work with kids and their parents to get the product just right. A wheelchair with a hinged center-section padded seat that lowers to become a commode chair. A cushion that self-inflates to assist a child in going from wheelchair (the getting-up part) and moving onto the toilet. Grab bars on each side of the toilet for leverage in moving from a wheelchair or walker to the toilet. Toilet supports that come with chest strap, safety belt, padded cushion, armrests, and footrest.

Cheat Sheet / Updated 03-27-2016

Besides a side-splitting headache, a variety of symptoms can occur when you have a migraine. Identifying common migraine signs will help: determine triggers (causes), create a plan to prevent migraines, and recognize warning signals that require medical attention. Steer clear of migraine myths so they don't hinder your diagnosis and treatment

Article / Updated 03-26-2016

As if migraines aren't big enough mischief-makers as it is, they also like to sing show tunes and take on different personas. So here we turn to migraine variants — the exceptions and odd lots that make finding your way to migraine diagnosis and treatment quite a challenging proposition. Abdominal migraines Abdominal migraines, which are sometimes diagnosed in children, are unusual because they cause pain in the stomach and lead to nausea and vomiting (sometimes without a headache). A child who complains of recurrent pain in his stomach may be experiencing abdominal migraines. Children who suffer from abdominal migraines are likely to have migraine headaches in adulthood. Abdominal migraines are usually treated with anticonvulsant drugs. Basilar migraines The basilar migraine was once known as the basilar artery migraine, or BAM. It was considered a problem that was found primarily in young women and adolescent girls, but it occurs in both sexes and all ages. Basilar migraines are extremely rare, but they have the potential to be a serious health hazard in that they can lead to a transient ischemic attack (TIA) or stroke. Symptoms to watch for are double vision, partial vision loss, terrible vomiting, dizziness, loss of balance, slurred speech, lack of coordination, numbness (on one or both sides of the body), weakness, and confusion. These symptoms typically go away at the onset of the actual headache, although they may last for days after the pain disappears. If you experience any of the symptoms that signal basilar migraines, see a doctor as soon as possible. Transient ischemic attacks, which can result from basilar migraines (although they rarely do), are essentially "mini-strokes." TIAs result from disruptions of the blood flow to the brain. Although a stroke can mean permanent disability, TIAs don't cause lasting damage. Any neurologic problems associated with TIAs, such as weakness in one arm and slurred speech, are resolved within 24 hours. Hemiplegic migraines Hemiplegic migraines are often caused by an inherited gene, but they occur in people with no family history of migraines. With hemiplegic migraines, you experience temporary paralysis or arm and leg weakness on one side of your body. The paralysis or weakness is then followed, usually within an hour, by bad head pain. The paralysis or weakness does not always go away when the headache disappears. These headaches often originate during childhood. Ocular migraines Ocular migraines are rare migraines that feature a repeated vision disturbance (temporary, partial, or complete vision loss in one eye) that lasts less than one hour. After the vision disturbance subsides, you're left with a dull ache behind the affected eye, and your entire head may ache, as well. If you suffer from ocular migraines, you need to be evaluated by a doctor (an ophthalmologist) to exclude other possible causes for your vision loss. Ophthalmoplegic migraines Ophthalmoplegic migraines are no longer believed to be migraines. They are now thought to be a type of neuritis (inflammation of a nerve). These headaches are associated with pain around the eyeball and the temporary weakness or paralysis of eye muscle(s). It's a condition that's usually diagnosed in children. The common symptoms of these migraines are a drooping eyelid, a dilated pupil, and double vision. Ophthalmoplegic migraines, which can last for days or months, require a thorough exam and testing to rule out conditions that are more serious. Status migrainosus The term status migrainosus refers to a migraine attack that goes on for more than 72 hours and leads to problems such as dehydration. If you have status migrainosus, you should go to the emergency room, where you will be treated with IV fluids and pain medication. Women-only migraines Certain migraines are uniquely attached to the hormonal swings that females experience. Migraines are commonly linked to menstruation. Some women get migraine headaches when they're on oral contraceptives. And in the case of women who are going through or are past menopause, hormone therapy migraines can be problematic. (Some older women have hormone-replacement-therapy-related headaches, while other women who have had migraines in the past no longer have them after menopause.)

Article / Updated 03-26-2016

Some kiddos' potty programs are thrown off track by outside caregivers who really, truly mean well — but they just don't get why you think consistency from home to daycare is such a big deal. However, whether caregivers understand or not, most are willing to listen to your comments. Tell them that you believe that changing approaches will mix up your tiny tyke who is barely used to using the toilet, anyway. Getting all caregivers to be consistent Go ahead and assume that most outside caregivers have their own ideas on potty training, so inform yours — right after Potty-Training Weekend — that you have a potty plan for your child. Telling the caregiver, "Here's what we do" at the very beginning is so much easier than trying to back track. (Think how much you've liked bosses who made their expectations clear upfront, versus those who told you what they wanted after you'd screwed up.) Daycare workers tend to use a one-size-fits-all method that works well with kids who are totally ready to cooperate. And your tot may not fit in that category. A center's method is usually based on the owner/director's potty-training beliefs, so the approach can range from as rigid as Nurse Ratched of One Flew Over the Cuckoo's Nest, to as quietly nurturing as Mr. Rogers from Mr. Rogers' Neighborhood. Basically, you can bet that few daycare centers do much personalizing of potty training. On the other hand, their method probably won't be counter to the Potty Training For Dummies way, except for being a bit less flexible and a bit more blame shifting. Most daycare personnel simply don't have the time for one-on-one teaching. Instead of asking a daytime caregiver what approach she takes with kids in potty training, just give her your handout and ask her to follow it. Otherwise, you'll have to say, "Your way doesn't suit me." Yuck. Ouch. So clearly, emphatically, and tactfully state your desires: "Please, during the day while I'm at work, follow this plan for helping potty train Tommy. She needs help, of course, but no forcing or punishing. She's going to make mistakes, and pressure just won't help — I'm sure of it." Youngsters can get confused easily. So, the best way to handle the possibilities for divergent ideas is to jot down the 1-2-3 of your child's potty regimen and hand it to caregivers. Leave no room for improvisation. Perhaps that will stave off the dicey situation of discovering that someone's doing things differently at daycare, and your kid is getting terribly confused. That forces you into a corner where you must ask for their cooperation and a switcheroo back to your way. If relatives or friends also care for your child from time to time, make them copies while you're at it. Let your child know what you're doing and why. "This way, Aunt Camilla and cousin Gina and Mrs. Fritz at daycare all will know what you like to do when it's time to go potty." Giving all caregivers the page Make a big point of giving your lead caregiver a page of instructions. You may want to set up an appointment so you'll really have her attention. Explain that you think you've found the best way to potty train your child, and you'll appreciate her compliance with the plan. Even go so far as to point out that you don't want anyone who takes care of Ava to meet you with a negative report at pickup time: "Your child was a total pee-renegade today — she wet her pants!" None of that stuff, thank you very much. But do ask your caregiver to jot down an end-of-week progress report so that the wee lassie's potty deeds won't be discussed in front of her — unless, of course, we're talking rave reviews. Request four weeks' worth of progress reports, and be sure she knows you mean simply a quick rundown — nothing elaborate or typewritten. Tell your caregiver, nanny, or relative: "I'd appreciate it very much if you'd follow this plan because we started it over the weekend, and Ally is doing just great. Otherwise, I'm afraid she'll get confused. Thanks so much, in advance, for your help." Emphasize that you know this person (relative, nanny, caregiver) will be a major player in helping your child succeed. "I really appreciate you being up for this." Here's the written plan that you can hand out: 1. Take the toddler to the potty every two hours if possible. (If she refuses, don't push it.) Be sure she potty-sits shortly after eating and drinking. Gentle prompting is fine. 2. Ask the child to tell you when she feels like she needs to go. 3. Give praise, even if nothing happens during the potty-sit. Don't apply any pressure. If she goes, she goes; otherwise, just say you're glad she tried. 4. Please don't make the child feel guilty if she messes up her pants. Just change them, and put on fresh clothing (if necessary). And, please say that you bet she will get it right the next time. 5. Let her pull up underpants and clothes, even when these efforts are sloppy and awkward. Don't jump in and straighten up. She needs to feel as if she's succeeding, so right now, tidiness doesn't count. 6. Tell the toddler that she has done something very good when she actually pees or poops in the potty. When you hand over the poo-and-pee-plan for your child's day, make sure the caregiver understands that you have faith in her attitude of teamwork. Word this in a way that shows your faith in her: "Of course, I never doubted for one minute that you wouldn't be on board for this, but I just thought I'd write it down, for your convenience. I know you have a million things on your mind every day."

Article / Updated 03-26-2016

So you go to see your doctor, and — oops! — you discover that she's just not "into" headache diagnosis. If you're not happy with her response to your concerns, shop around for another doctor. Find a doctor who'll agree to team up with you on a treatment plan. Some primary care doctors are old hands at treating headaches, while others may want to refer you to a headache specialist for diagnosis and treatment. You can also check out doctors on your own. If your doctor smirks or rolls her eyes when you describe your headache problem, you know you're in trouble. The signals probably won't be that obvious though. So you have to look for subtle clues that let you know that diagnosing and treating headaches just isn't your doc's cup of tea. (You show up with a nice case of strep throat, and she's totally in the groove — but headaches aren't her bag.) Truth is, some doctors aren't very knowledgeable about headache diagnosis and treatment, while others just think in terms of "too many headaches, too little time." Doctors often prefer that you get help from a specialist in the head-pain field — a neurologist, pain-management expert, or internist who has made treating headaches her special passion. However, physicians who don't treat headaches themselves can usually recommend a doctor who specializes in headache diagnosis and treatment. (This specialized doctor's home base may be a headache clinic.) The first doctor you visit may recommend a treatment plan that actually works. But if it doesn't help — or you're worried that you may have a complex problem that requires a specialist — ask your primary care doctor for a referral to a specialist. Don't be shy. Just ask your doctor if she thinks that you should see a headache specialist. Keeping the faith even if your doctor is a disbeliever Okay, you weren't thrilled with what your doctor said. You got a pat on the arm and were instructed to "take some acetaminophen," even though you clearly explained that you tried that approach already. If your doctor is skeptical about your headaches, find a headache specialist to diagnose and treat you. Don't let your doctor's lack of interest keep you from looking further for relief for your headaches. You're definitely doing the right thing by seeking additional opinions. You shouldn't feel any more reluctant to seek help for your headaches than you would if you had a gaping wound or chest pains. If you feel like you need to see another doctor, or if your doctor refers you to a specialist, don't take it as a sign that you have an awful disease lurking inside you. Actually, the chances of you having a serious health problem are fairly unlikely. You may have high blood pressure, which definitely requires monitoring and medication, or you may just need the right migraine medication and some lifestyle changes. Giving up on finding help is a bad idea. Help is out there, but it just may take a little effort to find it. Spotting signs that you need to look elsewhere for a doctor What do you do if your doctor seems marginal about treating headaches? She wants to help you, but she doesn't appear to be overflowing with headache knowledge. Or she is clearly leaning toward sending you to someone whom she considers better equipped to diagnose your problem. You need to be able to identify the components of a deal-breaker, the indications that point you to the exit door so that you can do some more doctor shopping. If you notice even one of these signals, keep looking for a doctor to treat your headaches: Your doctor makes a dismissive comment: "Well, after all, this is just a headache — not exactly anything earthshaking. . . ." or "Women have a lot of headaches due to hormone changes. . . ." Your doctor looks bored when you describe your symptoms, as if she has heard all this a million times before. Your doctor seems eager to refer you to a specialist. Your doctor looks confused when you describe your headache symptoms. Your doctor comes from the bite-the-bullet treatment school and wants you to go to bed and tough it out until the headache goes away (obviously, this healthcare provider has never had migraines herself). Your doctor doesn't discuss your medical history or answer your questions. (This bit of advice refers to doctors who are treating migraines, but be advised that this is not a good sign of a helpful healthcare provider in any domain!) Your physician seems eager to finish up and suggests a pain medication right away. Your diagnosis is still up in the air after a visit or two. You may want to shop around for a headache specialist if your primary care physician tells you that she doesn't feel comfortable trying to diagnose and treat your severe headaches, or if an existing medical problem leads you to believe that you may benefit from seeing a headache specialist. You may also need a headache specialist if you take over-the-counter medications almost every day, and you don't get any new solutions when you visit your doctor. If you see disinterest or reluctance on the part of your doctor to work with you on migraine management, don't hesitate to ask for a referral to a headache specialist. The specialist will probably be a neurologist or internist who specializes in treating migraines.

Article / Updated 03-26-2016

Ask any parent who has taught a child to use the toilet (one who is truthful, anyway), and you'll hear that kids have many pee and poop accidents. Just like when you were learning to drive and didn't get the gist of parallel parking right away, these tots are total novices, and should be treated with gentle understanding when they goof up. The more lovingly you handle this phase, the better you will cement the bond you're creating with your child. Be patient with the greenhorn. Soothe yourself with the knowledge that child development experts typically regard occasional bed-wetting as a normal thing until age 6! Don't view slips as bad behavior; keep reminding yourself that your child's body and mind have to work together for potty training to be a total success. If you think this is long, arduous, and frustrating to you, just think how it feels to him — a tough learning curve that thrives best with unwavering support. Tell your child, "I know you'll be using the potty all the time very soon — you'll learn to remind yourself." So what should you do? Don't bring up potty training at all for a two-day break. Both of you take a breather. Change those training pants like a trouper and say nothing at all about pee or poop. You're the three monkeys of see no evil, speak no evil, hear no evil. Practicing to avoid wet pants Run back over the whole potty routine. You can do this right after a slipup — unless he seems upset by his mistake. In that case, wait to have your chat until the mistake is a few hours behind him. Announce to your child: "You're going to practice how to avoid wet pants. You'll remember — you were getting very good at it a few weeks ago, and I know you can do it again." Take him through the steps, one by one. Go slowly. Speak clearly and with pure patience. If he resists ("I don't want to!") wait a few hours, then try again. Instead of taking a "you'll do as I say" tack, talk to your trainee like you're his best friend who just wants to help him learn something he needs to know. "This is what big kids do in school, so you need to know how to use the potty before then. I want you to feel comfortable in school someday." Encourage him to role play what he could do the next time he feels a need to pee. The spirit should be, "Hey, I know what you can do next time you need to pee." Keep it casual. "Show me what you'll do, the next time you feel an urge to go potty. I'll clap my hands when you get through. Let's pretend you need to go pee right now." Pause. "What I'd like to hear you say is, 'I think I can do that.'" Returning to training pants If your child has already advanced to wearing regular underwear, you can put him back in training pants for a few days. Tell him that you're not doing this because you're mad at him — you just want to provide some backup for a few days, until he feels ready to go back to underpants. Be sure that you have no hint of scolding or sarcasm in your voice. You'll know it's time to make this exception to the rule of never moving back to training pants when your child's embarrassment takes on scary proportions — he's crying and over-the-top upset. Tell him: "I know this is hard to do sometimes, and I can tell you get frustrated. But, don't worry — I'm with you all the way, and soon, you'll get to the potty on time — every time." In addition, if your child is experiencing some major-league backsliding, a return to pull-ups is probably a very good idea to reduce the embarrassment factor. Make it clear, though, that this is just for a few days. "It's just taking your body some time to adjust, and that's okay." Imagine his thoughts: "But what will we do? You gave the training pants away when I got my big pants!" "Sweetie, we'll buy some more. You probably will only need one package, and then you'll be back to using the potty again and wearing your big-kid underwear." Staying positive Say everything, do everything, feel everything. Use both words and actions to make him feel safe and secure, loved, and accepted. During the initial backsliding, do not refer to the potty chair at all for a few days. If he mentions it when he's with you in the bathroom, tell him that you're sure he will want to use it again. "You'll get back to it again, and that will be nice when you do. I'm sure you'll do well at using the potty again soon. You are a sweet, cooperative child, and I love you." If you're just real darn lucky and he's suddenly inspired to use it right then, agree that he should go ahead. And, feel free to act delighted that he brought it up. "What a good attitude you have! You want to try again." Stay low-key. Sometimes, when mom or dad or babysitter makes a huge, over-the-top deal of it, a child starts feeling weird or squeamish and decides that the issue is too heavily weighted, that he felt more comfortable when using the potty wasn't something that was expected. Being practical Try a brass-tacks approach to handling the practicalities of backsliding. In giving him tips, use a neutral here's-what-you-do tone that has absolutely no accusation in it. Just the facts, ma'am. You may want to use the following tips, which will help your child to get past his backsliding hurdle with no bad memories: Limit his intake of fluids right before bedtime. Encourage him to get out of bed as soon as he notices that it's wet. Don't force potty-sits or cleanup.

Article / Updated 03-26-2016

Several types of massage can be helpful in relieving the pain of migraine headaches. But there aren't enough studies to show how effective — or ineffective — these therapies are. Typically, migraine sufferers who benefit from massage use it as one component of their pain-relief plan, along with medications, lifestyle changes, and so on. You may want to give some of the following massage options a try: Craniosacral therapy: With this type of therapy, you lie back as a therapist gently massages your skull bones and your scalp. Your nerve endings get some touchy-feely attention, which soothes the nerves and lessens the pain waves they send. Neuromuscular massage: This therapy, which is also known as trigger-point therapy, is a muscle-relaxing treatment that applies moderate pressure to your body's trigger points (spots in a muscle that, when stimulated by pressure or touch, are painful). Some believe that it can reduce nerve compression and relieve pain in tense or overworked muscles. Reflexology: This therapy is based on the pressure and massage of points on the soles of the feet. The healing art of reflexology is often used to relieve stress and pain. For some headache sufferers, it's a godsend. It works on the idea that there are zones in the feet that correspond to all areas of the body. Therapists manipulate these zones, helping to benefit the corresponding areas throughout the rest of your body. Deep-tissue massage therapy: People get massages to get rid of pain and discomfort or to just give themselves a relaxing treat. A massage therapist uses pressure, movement, and stretching to render your body more pliable and comfortable. For headaches, a therapist will usually use therapeutic, deep-tissue techniques. Deep-tissue massages may serve to improve circulation and help reduce muscle tension. When performing a deep-tissue massage, a massage therapist focuses on specific areas of the body to relieve pain and release stress. Many believe that massage can reduce muscle pain and ease muscle tension and stiffness. Deep tissue refers to the use of deep finger pressure and slow strokes on areas of the body that are suffering from muscle tension or aches. Because deep-tissue massage works well on tense shoulders and necks, it can sometimes provide relief from headache symptoms. (If you aren't sure whether your physical condition is amenable to massage, check with your doctor before having a massage. Massage isn't recommended if you have varicose veins, a recent fracture, sprain, or nerve injury, or if you've recently had chemotherapy or radiation.) Acupressure: For headache relief, acupressure techniques are used to apply gentle finger pressure to various points on your head. It is believed that this therapy can help headache sufferers by calming muscle tension and enhancing blood circulation. In a more ethereal sense, some think that acupressure promotes self-healing of the body by re-establishing energy balance. At any rate, this therapy is painless. So if you want to try it, check with your physician. (He'll probably give you a go-ahead.) You can figure out how to perform a simple form of acupressure in minutes. Apply gentle and continuous fingertip pressure with two fingers for two to three minutes. Use one hand to work the top of your skull, and the other hand to apply pressure to the spot between your eyebrows. Of course, there are many other acupressure moves — you can get a book on the subject or have an acupressure practitioner take you through the steps. Rolfing: This therapy is one of many variations on the theme of massage. Its roots go back to the belief that most of us become all choked up with muscle contractions, which throws our bodies off balance. By applying deep pressure to your muscles, a Rolfing practitioner may be able to ease your headache pain by ratcheting down the tautness of your muscles. For some people, Rolfing reduces pain. For others, Rolfing is too vigorous for their taste. Rolfing is not for the person who's put off by aggressive body manipulation. (Basically, Rolfing is massage that is taken to a tougher intensity level. It's not a surefire headache remedy, by any means.) The pressure of any type of massage may cause some discomfort, but if you experience a great deal of pain, tell the therapist to stop. You may need to see your doctor for an evaluation. Check with a local school of massage for the names of qualified therapists in your area. And when you're interviewing therapists, ask to see proof of membership in the American Massage Therapy Association (AMTA). Therapists with membership in this association have completed a training program approved by the Commission on Massage Training Accreditation/Approval, hold a state license that meets AMTA standards, and have passed an AMTA exam or the National Certification Examination for Therapeutic Massage and Bodywork. You can also find trained massage therapists on the AMTA Web site.

Article / Updated 03-26-2016

A rebound headache is a headache that you end up with just because you go in search of a little relief from the constant pounding in your noggin. You feel bad, so you take a pill — you feel worse, so you take another, and so on, and so on, and scoobie-doobie-do. Basically, you wind up with a headache because you're overusing medications. Exceeding label or physician instructions when taking medications can result in rebounding into another headache. Other spin-offs of medication overuse include a more excruciatingly painful headache, addiction to medications, and other adverse side effects. Prolonged use of even over-the-counter medicines can cause liver and kidney damage. In the wild-and-woolly migraine arena, rebound headaches have to rank right up there at the top of the pain-wielding, mind-blowing, frustration-inciting extravaganza. Sometimes rebound headaches are migraines, and sometimes they're not. To help prevent future rebound headaches, you may be able to take a migraine-preventive medication or use lifestyle changes without medication. First, however, you must get past the vicious cycle of rebounding — you overmedicate repeatedly before realizing that you're perpetuating your pain. Your doctor can help you taper off your overmedicating, nonproductive ways. If some of the following signs apply to you, you're probably having rebound headaches (but be sure to see your doctor for evaluation of your problem to confirm that it's a headache and not something more serious): You suffer from headaches daily or every other day. Your pain intensifies about three hours after your last dose of medication. Your pain medications don't work as well as they used to. You take more medication, but your headaches are worse. You rely on more pills, and you take them more often. You take medication even for mild headaches, and you often try to ward off a headache by using a medication. You take pain relievers three to four days a week, and you average more than three tablets per day. (This depends on the kind of medication you're taking, so you'll need your doctor's advice.) Your pain runs the gamut from mild to moderate to horrible. Usually, the pain is a dull ache that you feel on both sides of your forehead and, sometimes, on the top or back of your head. Your headaches occur much more frequently. Because you're in pain, you may use medications too often. The theory behind the rebound headache is that the overuse of drugs makes the headache rebound after your body has absorbed all of the medication. Painkillers are supposed to relieve pain, of course, but if you overuse prescription or nonprescription drugs, they can turn on you and actually cause headaches. Essentially, an over-the-counter drug or a prescription medication that's taken too often can give rise to a brain-craving for more of the medicine. The episode begins when the brain gets some initial relief from pain, likes the effect, and then decides it will send out to room service for more of the same. Your brain continues to signal "pain" in its search for more of the drug, and you have to take increasing dosages to get relief. Therefore, your medication becomes less and less effective, and you create a cycle of increasing misery. If you rush to the emergency room with a killer migraine, the doctor will want to know what you took and when you took it last, so be prepared to supply this information. The emergency room physician needs to know if you overused medication and have a rebound headache. She doesn't want to treat you with a medication you overused, or with a medication that's not going to jibe with a drug you took recently. The typical medications that appear in the rebound scenario are aspirin and acetaminophen, alone or in combination with caffeine-containing products. Other drug culprits often implicated in rebounding are Caffeine Codeine Combination drugs such as Fiorinal and Midrin Drugs containing barbiturates Ergotamine tartrate Opiates Abortive drugs (such as the nonsteroidals ibuprofen and naproxen), triptans (Imitrex, Zomig, Amerge), and DHE (dihydroergotamine) may also induce rebounding, but they're less likely to do so.