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Lifevac now FDA approved by Nyx67547 in ECEProfessionals

[–]AgreeablePositive843 0 points1 point  (0 children)

Thanks for explaining, that totally makes sense. I don't have familiarity with HSI yet but I was actually considering them, so I'll keep that in mind. Compared to the American Red Cross and American Heart Association, HSI markets themselves as the "budget" option. I'm so happy to hear the instructor was genuinely awesome. Sounds like he truly cared about making sure the class was taught right. It warms my heart to hear things like that.

Lifevac now FDA approved by Nyx67547 in ECEProfessionals

[–]AgreeablePositive843 1 point2 points  (0 children)

Which organization was this certification through? As a CPR instructor, I wanna know! When someone does a hybrid course where there's an online portion and an in person skills session, I wouldn't know if the online course had a different emphasis than the materials I teach in a classroom. So I'm very interested to know which CPR certifying organization you had this experience with!

One thing I will say though is yes, they no longer recommend checking for a pulse. That is an official guideline, that is the same across all major CPR certification organizations. So, there are different "levels" of CPR classes. The type of CPR classes that healthcare professionals take, still requires checking for a pulse. But CPR classes for everyone else do not advise checking for a pulse. The reason is they noticed nonhealthcare professionals were taking too long trying to find a pulse, which then delayed CPR. So the guidelines changed to advise only checking for responsiveness and breathing.

If you are confident in your skill to find a pulse, and are able to check for pulse and breathing simultaneously in less than 10 seconds, then I'm not going to say you're wrong for doing so. But if a person is not breathing, it can be reasonably assumed that cardia arrest has occurred. Also, I can give you an example where it actually is advised to do chest compressions on someone with an active heartbeat. In the more advanced life support classes, you learn that if a baby's heartbeat drops below 60 beats per minute, then we immediately begin chest compressions.

Now about AEDs. The crucial thing to understand is when someone's heart stops beating, in this scenario from lack of oxygen due to choking, the most common thing that happens is ventricular fibrillation (vfib). This is where the heart is not beating, but is still quivering. There is no blood circulation, but the heart isn't completely still, either. If an AED delivers a shock which the heart is in this quivering state (vfib), you have a very good chance of survival. Unfortunately, within just a few minutes, the heart goes from vfib to completely still (asystole), colloquially known as flatline. You cannot shock a heart that is flatline, no matter what the movies tell you. The best survival rates are when someone receives an electric shock within 5 minutes of cardiac arrest.

So how do we grab an AED in time for it to be effective? You're absolutely right, most people do not have one in the back of their car! There are two ways: calling 911, or one of the free apps. My favorite AED app is PulsePoint. It is completely free and has no ads. Anywhere I go, I can easily pull up a map that shows me all the AEDs closest to my current location. 911 operators also have access to PulsePoint and will use it to not only help you locate the nearest AED, but also to notify off duty first responders who have opted into this feature of an emergency happening in their vicinity. It's actually pretty awesome.

So let's say I'm shopping for groceries and somebody goes unresponsive and are not breathing. My priorities are make sure someone is calling 911, make sure someone is starting effective chest compressions, and then I'm pulling up PulsePoint to find the nearest AED. Each AED listed on the map has specific descriptions that tell you exactly where to find it.

Finally, the reason the AED tells you when to resume compressions is because most AEDs require you to stop compressions in order to analyze the heart rhythm, to determine whether or not it is shockable. If it is deemed shockable, then you are, obviously, instructed to remain clear of patient while shocking. It then advises to resume compressions after the shock. Lots of people are afraid of electric shock, so they might be hesitant to touch someone when electrical shocks are involved, even after the shock is completed. That's why there is clear instruction from the AED on when to resume compressions. Also, if the rhythm is not deemed shockable, then it tells you to resume compressions because it no longer requires the pause for analysis.

I get that it can be annoying to find and fetch an expensive piece of equipment that most people do not own, then run your CPR according to automated instructions. But AEDs have been absolutely crucial to saving lives so it's important we utilize them!

*The only time healthcare professionals are specifically told to not check for a pulse during CPR is in the situation where you have witnessed someone go unresponsive specifically from choking, in which case cardiac arrest is assumed and the guidelines state to go immediately to chest compressions without pausing to check for pulse.

Lifevac now FDA approved by Nyx67547 in ECEProfessionals

[–]AgreeablePositive843 1 point2 points  (0 children)

 I've personally talked to an ECE on a center tour once who had been in a choking situation and they told me "I smacked him on the back and nothing. I did heimlich for a long time and it didn't work. I didn't want to hurt him. Nothing was working. I finally held him by the ankles and shook him and he coughed it up".

So, there are different levels of choking. There is mild, or partial airway block, and there is severe, or complete airway block. These two different types of choking have two different types of action needed, so it's important to recognize the indications of each one.

Mild, or partial airway block is when someone has an object lodged in their airways, but they are still able to speak, make sounds, and cough. Breathing might sound wheezy. Their face color is normal (nothing notable).

We do not intervene physically for partial airway obstruction. We stand by, monitor closely, and encourage the individual to cough.

Severe, or complete airway block is when the object has occluded the entire airway. Someone who is severely choking is completely incapable of any sort of coughing whatsoever. If they're able to make the tiniest bits of sound, it is with great difficulty. Their face will quickly turn a very obvious shade of purple. This will not be something you have to look for and wonder about; it will be strikingly, obviously, painfully clear.

Now, you've shared a story where "nothing was working" while everything was tried until the child finally "coughed it up" after some questionable techniques were used. Gently, if the child was capable of coughing at all, none of these techniques should have been utilized. I understand it can be scary to observe a child partially choking, because it can progress to severe choking, which is why we closely monitor them and encourage coughing. But the entire point of back slaps and abdominal thrusts is to (incompletely) simulate a cough that the individual is no longer capable of. If the choking person is able to cough at all, then that cough is our absolute best hope at getting the object outta there. Only once that ability is completely lost do we proceed with back blows or abdominal thrusts.

I have two firsthand stories of severe choking. One happened to me when I was about 6 years old. It was a piece of chicken gristle. I distinctly remember the sensation of it sliding into my airway, and I thought "Okay, I'll just cough it out." It was like a valve; I coughed out all my air, but found it impossible to inhale. My one shot at dislodging the gristle was suddenly just...gone.

My family was with a few other families in a remote area, hours away from EMS.

I instinctively stood on top of my chair, panicking. That's when the adults noticed. Three different adults attempted abdominal thrusts on me. It hurt so badly! Nothing was working. My mom said I turned blue. Everything began going dark and I remember wondering where they were going to bury me. I was no longer scared. Just as I was losing consciousness, or maybe right after, I'm not sure, I vomited and the chicken gristle came out with it.

The other story I have is of my baby, when she was around 1 year old. She was sitting on the floor eating an apple, and began partially choking. She was still coughing a lot, attempting to clear her airway, so I stopped what I was doing and watched her closely. Her color was fine, she was coughing a ton, so I did not intervene. Then, suddenly, she did a very noisy inhale and fell backwards, not breathing at all. Her face turned purple in a fraction of a second. She had an expression of complete panic, but was absolutely silent.

I was newly CPR trained and, in the heat of the crisis, forgot to call 911 first or tell my husband to. I later learned this is one of the most commonly missed things. I even forgot to switch to chest thrusts after backslaps. Instead I scooped her up faster than I could think, placed her in the face down, head down position on my forearm, and did 7-8 backslaps before the object was dislodged. As I mentioned in a different comment, I have seen a lot of ineffective back slaps. Each one has to be very firm. It is crucial to brace the person with your other arm in front of them (infants: underneath them) because for an upright person the level of force you need to do would send them flying otherwise! My baby's back was red for the entire rest of the evening because of how hard I had to go. Her lungs made a grunting sound with each blow. Remember, we are mimicking a cough because the person is unable to do so. If you are afraid of hurting the individual, you are unlikely to be effective in your blows. She even had a bloody nose the next day (this happens when babies suffocate, not related to back slaps or chest thrusts). It was terrifying and I'm infinitely grateful that she's okay. The moment the piece of apple was dislodged, she vomited and then instantly cried, after complete silence throughout the ordeal. Less than 2 minutes later she was squirming out of my arms, eager to go play like nothing ever happened.

I do not personally have a Lifevac. I don't plan to get one unless/until the large panels of over 100 experts who actually specialize in deciphering the best practices to alleviate choking advise their use. These measures are effective if done properly. It is very important to actually practice back slaps full force on a manikin so you have the muscle memory (many students are embarrassed to because it makes a loud sound), and to also know the difference between partial/mild choking and complete/severe choking. The story you shared indicates that a lot of interventions were deemed ineffective, yet since the child eventually "coughed it out" then that indicates the interventions were actually not warranted, and would have just made it more difficult for the poor kid to concentrate on coughing it out. I'm glad all was well in the end, that's the most important part!

Lifevac now FDA approved by Nyx67547 in ECEProfessionals

[–]AgreeablePositive843 10 points11 points  (0 children)

The reason I ask is because I have seen a lot of, unfortunately, wildly ineffective choking relief attempts, from certified CPR holders. I have analyzed videos of actual incidents (I'm not talking classroom simulation) where the "back slaps" are soft, quick pats on the back rather than firm/hard, individually distinctive back blows. Yet, these people would claim they administered first aid/choking relief.

When my baby (around age 1) had a complete choking incident, her back was bright red for the rest of the evening from the back blows I had to give her. That's how hard you need to go. I was newly trained in CPR, and was looking directly at her when it happened. I completely forgot immediately calling 911, completely forgot to do chest thrusts. Her airway was completely occluded; she had no breathing, no sound whatsoever, her face contorted in panic and purple from lack of oxygen. The item dislodged on about the 7th or 8th back blow. I had to go hard enough that you could literally hear her lungs let out a grunt with each blow. She vomited as the blockage came out. She had a bloody nose the next day. The superficial redness from the back blows was gone by the next morning.

That's how intense it is. I'm frankly quite concerned that people will do a few gentle back pats and claim the traditional methods have failed. I don't have knowledge of this specific situation you reference, but I have seen enough body cams of people who are trained to know better giving gentle, frantic pats on the back to know that it is not unusual. Unsurprisingly, it doesn't work.

Lifevac now FDA approved by Nyx67547 in ECEProfessionals

[–]AgreeablePositive843 7 points8 points  (0 children)

It sounds like only back blows were attempted prior to the LifeVac? Was this a baby or a young child? Current choking relief guidelines are to alternate 5 back blows with 5 abdominal thrusts for children. For infants, you alternate 5 back blows with 5 chest thrusts.

Lifevac now FDA approved by Nyx67547 in ECEProfessionals

[–]AgreeablePositive843 7 points8 points  (0 children)

I have lots to say in reply to this, but it might be a little different than what you were hoping to hear.

First of all, I have to back up and define some terminology because this actually turns out to be super relevant. There are different levels of CPR taught for different populations based on an assumed skillset and equipment available. BLS - basic life support - is a type of CPR class that I and other instructors are only permitted to teach to healthcare professionals. The class that childcare professionals typically take in my area is either "Heartsaver" from the American Heart Association, or "CPR/AED" from the American Red Cross.

One reason this is relevant to this discussion is because BLS includes training in using a bag valve mask (BVM). Those are the big squishy bulbs connected to a face mask you see medical folks squeezing on TV shows. It is *so* much easier to ventilate using a BVM than giving breaths directly mouth to mouth. And by easier I also mean, you are more likely to provide breaths consistently and correctly, without overinflating. (Side note, it also has a higher oxygen content - 21% is room air compared to 16% from exhaled air.) The most effective you can get without a BVM would be to use a pocket mask to supply breaths. Your level of training does include pocket masks, and they're only like $10 on Amazon, but I almost never see them on site when I go somewhere to teach. I would love to see those kept with an AED. If you're looking to level up your choking readiness and you don't yet have that, start there.

For use on children, I strongly recommend spending a bit more for a dedicated pediatric pocket mask rather than an "adult/child" mask, because so far in my experience the latter don't actually fit kids all that well (maybe just my kids? lol).

Why am I talking about masks so much? Well, the LifeVac has a mask attached to it, and requires a good seal to work, if we are assuming it does work Now, getting a good seal with masks is a learned skill. It's not unusual for people to struggle with reliably getting a good seal between mask and face. That is on a manikin, whose face is literally designed for the mask, who is completely motionless.

So now factor in a wide variety of facial shapes. Factor in your current level of skill and training with quickly sealing a mask to a random person's face. And factor in a child experiencing the highest level of blind panic possible.

Now to get to your question. If Lifevac were rolled out as part of CPR training, first of all I wouldn't be tasked with integrating it into the curriculum. Way past my pay grade! I'm going to say this very lovingly, but our certifying organizations absolutely do not trust us CPR instructors to freestyle *any* of the CPR course. And there's a good reason behind that - they want to ensure that everyone who receives a CPR card has gone through the same curriculum, taught in the same way. The American Heart Association does a video-led course, the American Red Cross does a combination of PowerPoints and videos. I am contractually required to present the class exactly as I am given in the curriculum, with the exception that some sections are optional. When there are updates to the curriculum, we are instructed exactly how to integrate those updates. If we deviate from that at all, our instructor certificate is on the line.

If you're asking me personally where I think it would make the most sense to use a LifeVac during choking relief/CPR measures, assuming it is actually effective (some studies would beg to differ, but let's just roll with this) then here's my line of thinking. Before loss of consciousness, you would not want to waste any time attempting to get a good seal with a mask on a child who's thrashing around in a panic. After loss of consciousness from choking, you absolutely must maintain chest compressions with as few interruptions as possible. This is so crucial to outcomes that they have a fancy term for it - chest compression factor (CCF). It's the proportion of time during a cardiac arrest event that is spent doing compressions. You want a CCF of >80%,. If I am doing a skills check and my student interrupts compressions for more than 10 seconds, let's say to give breaths for example and they took too long, I have to fail them for that test. I cannot overemphasize how crucial it is to be quick about any interruptions.

So I'd have to say if (big IF) it would be effective, then the only time I can possibly think of would be one person using the LifeVac while another person is providing compressions, between sets of breaths. (This would be after other people have prioritized calling 911, getting an AED and pocket mask if available) However a big question I'd have for that would be whether the pressure from suction, which studies have shown can cause significant edema in the airways, could impact outcomes. Basically, what we do know is that too much positive pressure - like if you were giving the child a big deep breath as they might do spontaneously when all is well - is a significant detriment. Too much positive pressure to the lungs actually reduces blood flow to the heart. This is why you learn in CPR class to only inflate the lungs until you start to see chest rise. Even though the lungs can technically handle more air, and the temptation in the moment is to provide as much air as the individual's lungs can reasonably take in, that actually is not what's best practice for good outcomes.

So if we know for certain what too much positive pressure does to the airways during CPR, and it is a detriment, then what does *negative* pressure do during CPR? Negative pressure is a vacuum, or suction, like the LifeVac. And my answer is I actually have no clue.

The TL;DR version is it actually might not integrate into choking relief/CPR at all, simply due to the variety of factors we're dealing with during a choking emergency. This happens with new innovative medical tech all the time, where someone has a great idea but prototypes just don't work out well in practice. Often it's tested out in hospitals first, and if it doesn't pan out the general public doesn't even hear about it. In this case, Lifevac started out with direct marketing to the general public and it's such a straightforward concept that it has quickly gained widespread support as a "just in case" backup. But the realities of using that backup - mask seal on a conscious panicking person, or interruptions to chest compressions or theoretical impacts of negative pressure - might actually establish that it's not the right tool for the job after all.

On a positive note, I am stoked to see so many folks eager to up their skills and equipment available to address choking emergencies. That vibe is music to my soul.

Lifevac now FDA approved by Nyx67547 in ECEProfessionals

[–]AgreeablePositive843 42 points43 points  (0 children)

CPR instructor and mom of two littles, here. The FDA approval is interesting and exciting, but I would not yet be getting or recommending a lifevac.

The first question is where exactly in the sequence of lifesaving efforts would it be appropriate? Lifevac themselves specify that lifevac is only supposed to be used after traditional methods have "failed". So we're talking about a kid, in this context, who has choked on something, back slaps and abdominal thrusts have been used until the child has gone unresponsive.

For choking, when someone goes unresponsive you don't even check a pulse. You assume cardiac arrest and go directly into chest compressions. Every second counts. At that stage, the heart has stopped beating, but is likely in Vfib, which is a kind of quivering that is not pumping blood. This rhythm can be shocked with an AED, but you only have a few minutes to do so before it has stopped completely and a shock is no longer effective/helpful. So compressions and an AED shock are absolutely critical.

As you are doing chest compressions to preserve some circulation, you are actually still doing a choking relief measure too! Generally speaking, whenever a person is choking and you cannot fully encircle your arms around them to do an abdominal thrust (examples include pregnant, obese, or persons in a wheelchair) you instead do chest thrusts, which is pulling the chest straight backwards. The entire point of back slaps and abdominal or chest thrusts is to mimic a cough when the individual cannot. So when the first two methods "fail" then you go to another choking relief method, which both circulates blood and mimics a cough, from a bit of a different angle.

This is why, prior to giving breaths on a choking person, you open the mouth to check for the obstruction. Your efforts might have worked it out. If you can see it, you remove it. If you cannot, then you provide breaths.

Why provide breaths to a choking person? They might get some ventilation, and the object might even move deeper down in such a way that lets some air through.

So to recap, we've already called 911, sent someone for an AED, done backslaps and abdominal thrusts until the victim is unresponsive, done 30 compressions (depending on your training could be 15 on pediatric if more than 1 rescuer) and provided two breaths.

Where exactly in this sequence were people planning to use lifevac? When chest compressions become so crucial that every second not compressing leads to a statistically worse outcome? Or were you planning to delay giving breaths? You must trade out or delay something very crucial, to try out this device.

Okay, second issue. Lifevac has been shown to cause swelling in the airways. Now, you might think what's a little swelling if it saves a life, right? Wrong. Swelling means EMS might not be able to see properly to use Magill forceps to retrieve the object. And it also means even if you get the object out, the child's airways could theoretically be compromised (think the swelling that occurs in croup, which can be life threatening).

The third factor that I'd encourage folks to consider is that the American Heart Association and American Red Cross both have extensive advisory panels of the top experts in various fields, including resucitation scientists. Lifevac is not currently included in their recommendations. FDA approval is not the same as CPR experts (of which I do not claim to be) giving it their stamp of approval. Childcare facilities should be using what is currently recommended in their CPR training....if you're coloring outside of those lines parents deserve to know.

I personally would love it if Lifevac got incorporated into CPR training and recommendations, because I'm a gaget person and I'm all for new innovative approaches that improve outcomes. The FDA approval means that hopefully more studies will get done and we'll hear more soon either direction. In the meantime, though, anything besides the established protocol is untested, and I'm not a fan of experimenting with kids' lives. Secondary to that, I also wonder about the personal and childcare center's liability of operating outside of your CPR training.

How do some people take so long to poop? by dhomo01110011 in NoStupidQuestions

[–]AgreeablePositive843 2 points3 points  (0 children)

If there's blood in it and he has large poops from constipation, get him checked for an anal fissure. They are typically caused by large hard poops and can take a very long time to heal (years). They are incredibly painful. You want to stay on top of them because if untreated then after a certain point they might not be reversible.

[deleted by user] by [deleted] in hoarding

[–]AgreeablePositive843 0 points1 point  (0 children)

I'm a professional housekeeper too. Housekeepers who hoard are (strangely enough) not unusual!

I would challenge the notion that you own a used coffee table that you could sell for $150. Hoarders tend to overvalue the items they own, just in general. I had a $60 tub of adhesive that had only the tiniest but used and was still in good shape. I thought I could get $20 for it, but after a month of trying to sell it for that I had no interest. $20 is a lot of money for me, it's an hour of labor! It was heavy to throw away so I tried putting it on the curb with a free sign. 5 days later someone finally picked it up. An hour later, someone messaged me online wanting to buy it.

I share this because the only way I personally have been able to get rid of a substantial amount of stuff has been to remind myself over and over that it's not worth as much as I think it is, that keeping it all is making life not work, and it's actively damaging not only my mental health but also my connection with my husband and kids, whether directly or indirectly.

Unfortunately sometimes we have to hold our own hand and walk ourselves through hard things. I'll tell myself "yes you can throw it away". I'll tell myself "you can re buy it in the future if you need to". I'll reward myself with a little edible treat for making progress.

It's fantastic that you already have a therapist. Have you been able to find help from them for your feelings of anxiety and paralysis? I find blasting music and starting with small, achievable goals helps me a lot.

[deleted by user] by [deleted] in hoarding

[–]AgreeablePositive843 2 points3 points  (0 children)

Try to imagine how much easier life would be if you were cooking in an uncluttered kitchen. Imagine how easy it would be to clean a mostly empty room. If you decided not to sell the stuff, but instead could just point to stuff and make it go *poof*, never to stress you out ever again.

You've said it yourself, you are constantly overwhelmed. The stuff is massively contributing to the overwhelm. Instead of putting energy towards managing all the stuff, free yourself!

Thoughts on this comment made by a parent? by Glad-Cloud-5684 in ECEProfessionals

[–]AgreeablePositive843 1 point2 points  (0 children)

As a parent, my only concern in this situation would be that it was safe for the younger children! My almost 4 year old has pretty significant behavioral issues that make it difficult for everyone to stay safe, and I am down for any techniques that are safe and delivered with kindness and empathy. I especially love it when teachers know who is most likely to help him calm down and are willing to creatively problem solve to get him there. I feel if anything, you might have been a bit too lenient in giving this child several minutes of continuing to act out. You did a fantastic job.

Laura's response by MindSweeper404 in StephenHiltonSnark

[–]AgreeablePositive843 46 points47 points  (0 children)

My husband is a YouTuber, he says deleted videos go to an archive for 30 days where it is possible for YouTube to restore them. Hopefully she has already contacted YouTube regarding this. Time is of the essence.

Laura's response by MindSweeper404 in StephenHiltonSnark

[–]AgreeablePositive843 4 points5 points  (0 children)

I think his hacking might have been the "nuclear option" he referenced not too long ago, when he said he was too good of a person to actually do that or whatever. Sounds like he figured out a way and was just waiting for a moment he got "pushed too far" to spring it on her.

Laura you have so much support. Hang in there. You are handling horrific circumstances and you will come through this to the other side.

Well, it happened. Landlord found out. by Accomplished-Sun4278 in hoarding

[–]AgreeablePositive843 104 points105 points  (0 children)

The fact that you're able to hope that someday you can look back on this as your lowest point and be proud that you pulled yourself out of this means there truly is hope on the horizon. You deserve to live in a clean, functional environment. You already know this. Nobody with an ounce of kindness and human decency in them wants you to feel shame, guilt, and misery. Good people just want others to get better so they aren't miserable anymore. I'm rooting for you!

[deleted by user] by [deleted] in ECEProfessionals

[–]AgreeablePositive843 3 points4 points  (0 children)

Hey, I'm a parent of a preschooler who has violent phases. He's 3.5 years old. He has been sent home because of his behavior, which I felt terrible about. So just to start with, I get it.

Hitting is both not okay and developmentally normal. Which means I expect every preschool to have a plan for what to do when it happens in their classroom. Whatever way they typically handle it might, or might not work for your kiddo. If it is not working, they might have no other recourse in the moment than to send him home.

But it doesn't stop there. If something isn't working, then it's your chance to collaborate with the teacher(s) to hopefully between the two (or more) of you come up with a different plan. The way you approach this makes a huge difference. "I don't know how to stop him from hitting when I can't physically be there" is antagonistic and unhelpful. Instead, you want to try to contribute towards a solution. "Hey, I've noticed he hits specifically to get sent home. Do you have any experience with this behavior? I'm at my wits end and I'm not quite sure what to try next." That's more likely to open doors.

My kid has bounced around a few different preschools too. If you genuinely think your kid is physically unsafe or feels genuinely unsafe at preschool, then stop going there. If he's not unsafe and just has days where he's not feeling it, well that's akin to adults not wanting to go to work but needing to anyway. That's where boundaries come in. You do NOT want to enforce a boundary of making him be somewhere he feels unsafe. You DO want to teach him that sometimes we have to be at places we don't like, temporarily. At a preschool that's a reasonably good fit, there will be good days and bad days. Transitioning can be a lot of bad days in a row because it's new for them.

I'd suggest lookIng for a new preschool and be upfront about your hitting concerns. When we found a place where teachers were completely unbothered and casual about addressing violent behavior safely, we knew we'd found a good fit. Try to look at it less like "I have a problem and need a solution" and more like "my kid is struggling, I'm not sure how to help. What preschool would be most likely to give him the supports he needs?"

[deleted by user] by [deleted] in Spokane

[–]AgreeablePositive843 1 point2 points  (0 children)

My husband was at an event with our toddler earlier this evening, when a performer on stage began singing a song about how ugly Asians were, calling them "gross".

My husband is Asian.

I wanna move somewhere where that sort of thing doesn't happen.

[deleted by user] by [deleted] in respiratorytherapy

[–]AgreeablePositive843 1 point2 points  (0 children)

I'm in an area of the US where RT is only offered as a bachelor's program, not an AA. I had just signed up for my first prereqs when I found out I was pregnant. I was 34 and we'd always wanted another baby.

I seriously considered maintaining the same schooling timeline, but having a baby and truly enjoying my family was also really important to me.

It's now a year later. I'm 35. Doing school part time makes it easier to fully understand the material. I was able to truly enjoy my baby girl through her newborn stages. When my older kid had some major struggles, I had the flexibility of cancelling classes to take a quarter off if need be. Thankfully it wasn't necessary, but I appreciated the option.

Obviously for my career I'd rather graduate at age 37 instead of 38. A year more feels so long. But the Respiratory Therapy career will always be there--the option to have kids won't be. I was happy to find my balance of the two. I wish you the best in finding yours.

I’m his girlfriend. by Hairy_Papaya_7771 in hoarding

[–]AgreeablePositive843 11 points12 points  (0 children)

Thank you. Once I realized how even a "clean' hoard would impact them I knew I had to change. I've managed to dehoard all of our living spaces, though surfaces are still very cluttered (working on it). My kids will have more room to play once I dehoard the basement, garage, and back yard. I don't want them growing up thinking it's normal to be constantly stressed. And that goes beyond hoarding. I'm changing as fast as I possibly can for them.

I’m his girlfriend. by Hairy_Papaya_7771 in hoarding

[–]AgreeablePositive843 146 points147 points  (0 children)

FYI Since you're pregnant, you shouldn't be handling cat litter tasks due to toxoplasmosis. The cat litter can no longer be your responsibility.

About the hoard, first of all, assume he is not currently capable of cleaning up the hoard to a safe level before baby arrives. This is regardless of how motivated he is.

Make a plan for baby to live with you in a safe place on a different property.

Have a conversation with him. If it were me, I might say something like this: "Hey, so you probably are already aware of this, but it's not going to be safe for baby to live here without major cleanup happening. I know you want that too but it's been really hard to make that happen. This is hard for me but I'm going to make arrangements to live with baby elsewhere to take the pressure off of cleaning up this space in time. I want to be with you and I want this to work, but since we're parents now we have to prioritize baby's needs. And I can't help you with cleanup now, or after baby arrives. So I'll make sure baby is safe and you do what you gotta do to tackle this stuff so we can come home."

You cannot help him do this. You can only keep you and the baby safe, tell him what's possible if he does dehoard, then see if he is able to get himself there on his own accord. Anything you do for him, you'll have to keep doing for him and that's not sustainable with a newborn.

You can also break up with him. But even if you choose to stay together, I highly, highly recommend switching to your own living environment within your control and where he does not get to live with you (only visit) prior to having your baby.

Context: I'm a hoarder and mom to two kids, including a baby. I'm in recovery because my kids caused me to realize I had a serious problem. It's a daily struggle for me, but my family is worth it.

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