Our five year old son has been battling impetigo for the past couple of months. We’ve had it on the run several times, and actually thought it was completely gone at one point, but it’s kept coming back. Admittedly, a part of the problem was inconsistency on our part when treating the problem early on.

Treating impetigo, in the beginning

We first started treating his impetigo with Bactroban (mupirocin) ointment accompanied by regular pHisoderm baths. When that didn’t knock out the infection, he went on two rounds of Zithromax Z-Paks (azithromycin). The Z-Paks seemed to do the trick, and the impetigo seemingly disappeared.

Convinced that we had won, we stopped with the Bactroban. Unfortunately, the impetigo came back shortly thereafter. It’s unclear whether he got re-infected or if the original case never completely cleared up. Regardless, we started treating him again.

Treating impetigo, one more time

At this point, we were applying the Bactroban more or less daily. When the impetigo didn’t improve, he went back on a Z-Pak. This time around, there was no improvement, so we got referred out to a dermatologist.

The dermatologist suggested stepping up to twice daily Bactroban treatments accompanied by daily baths with a hypo-allergenic soap. He also recommended putting some Bactroban in his nostrils and on his anus once per day (nostrils first!).

When the dermatologist’s suggestions didn’t help, we went back to our family doctor who recommended that we try a new oral antibiotic. This time around, we went home with a prescription for Omnicef (cefdinir). We’re about halfway through that prescription and have seen a huge improvement.

As of today, his sores are on the mend, but we’re still hitting them Bactroban twice per day, and will continue to do so until we can’t find any spots to treat. We’re hopeful that we’ve finally got the upper hand, but we aren’t holding our breath. While we’ve dealt with impetigo in the past, it has never been this stubborn.

As an aside, we haven’t seen any red urine (a known side effect of Omnicef) this time around.

A couple of week ago, I noted that our son had started taking Intuniv to treat his nervous tics. He started out with a 1mg dose, increased to 2mg after a week, and then to 3mg a week later. Easing patients onto Intuniv in this fashion is the standard approach.

Unfortunately, shortly after he started taking Intuniv, he started having problems with insomnia. He’d fall asleep just fine but would wake up at 2AM or 3AM and then be unable to get back to sleep. After consulting with the doctor (who also checked with the pharmaceutical rep) we ended up switching from morning to evening doses.

The good news is that the nighttime sleep problems are gone. The bad news is that he now comes home from school absolutely exhausted. And by that I mean completely and totally wiped out. We’re hoping that he adjusts to the Intuniv in the coming weeks such that he’s no longer so tired in the afternoons, or so we can switch him back to morning doses without disrupting his sleep.

I’ll update when we know more…

As I’ve noted in the past, our oldest son has a history of tics and twitches. In the past, these have come and gone, often associated with stressful periods in our lives, and never lasting more than a few months.

This past fall, our son (eleven years old at the time) started middle school, and shortly thereafter the tics returned. They’ve presented as eye blinking, nose wrinkling, and a funny little mouth stretch (for lack of a better term). While we kept hoping they’d go away, they haven’t.

We’re now pushing six months, our eleven year old has turned twelve, and there have been no signs of improvement. Since this is by far the longest he’s had them, we decided to have him checked out.

After evaluating him, the doctor recommended two possible pharmaceutical solutions. I should note here that, in addition to the tics, he’s rather high strung, and we’ve also been having some issues with his aggression toward his brothers.

Lexapro vs. Intuniv

The two options that we were given were Lexapro (escitalopram) and Intuniv (guanfacine; the time release version of Tenex). Lexapro is a selective serotonin reuptake inhibitor (SSRI) that is often prescribed as an anti-depressant. This would help with his anxiety, and could also reduce the incidence of his tics.

Intuniv, on the other hand, is an alpha-2-adrenergic agent that is often prescribed for ADHD, and is also thought to be effective in treating tics. After a good bit of research, as well as consultation with our family practitioner, we decided to go with the Intuniv.

He started on a 1mg/day dose for the first week, going up to 2mg/day this week, and 3mg/day next week. We’ll then take him back in to get checked out by the doctor. While we still haven’t seen an effect, we’re still ramping up to therapeutic levels. I’ll update when we know more.

Real-world side effects of Intuniv

While our son hasn’t been on Intuniv for very long, we have noticed some minor side effects. For example, he’s had a bit of an upset stomach and reduced appetite, especially since we increased the dosage to 2mg/day. He’s also been more tired than normal, and has been waking up at night and having trouble falling back asleep.

We just picked up a Panasonic Lumix DMC-ZS3 digital camera for my lovely and talented wife. This new camera is a replacement of her old Casio Exilim EX-S600, which has been acting up over the past few months and appears to have ultimately died after less than three years of service.

Panasonic Lumix ZS3 review

In short, the Lumix ZS3 is a fantastic camera. It has a large (3 inch) LCD display, 10.1 megapixel resolution, 12x optical zoom, image stabilization, and it also records HD video. Very impressive, especially for the price.

Image quality is great, and the camera is very intuitive. It even has a fully-automatic mode that automatically recognizes your shooting conditions and switches between macro, landscape, portrait, sports, etc. so you don’t have to (unless you want to).

Also, if you’re trying to take shots of active subjects (like little kids), it has a nice focus lock that latches onto the subject and keeps them in focus no matter where they move within the frame. Very cool.

The ZS3 also has a little brother, known as the Lumix ZS1, which likewise shoots 10.1 megapixel pictures, but sports a slightly smaller display (2.7 inches, and records standard definition (640 x 480) video. For the price difference (about $60 on Amazon), the ZS3 is a no-brainer in my book.

Accessories for your Lumix ZS3 (or ZS1)

If you’re look for a great case to go along with either the ZS1 or ZS3, check out the Tamrac 5691 camera case. The main pocket is just right for the camera itself, and the outer pocket fits the battery charger perfectly.

As far as memory cards go, both the ZS1 and ZS3 use either regular or high capacity SD memory cards. We went with an 8GB card, which is likely way more space then we’ll need.

Am I the only one who loves the smell of Halloween candy? No matter what you’ve collected while out trick-or-treating, it always smells the same when you stick your nose in the bag.

If you’re not sure what I’m talking about, go take a whiff of the Halloween candy that your kids just collected. It’s amazing. It’s also virtually impossible to describe — sort of an emergent property that arises whenever you combine multiple types of candy in a small space.

Mmmmm… The sweet smell of Halloween candy… In this case, the whole is definitely greater than the sum of its parts.

Ready for a family movie night? Our local Publix grocery store recently replaced their MovieCube kiosks with Blockbuster Express kiosks. Movies are $1/night, just like RedBox, and the selection is actually pretty good.

Even better, there are a number of Blockbuster Express promo codes out there floating around. What follows is a list of codes that I’ve run across…

Blockbuster promo codes

(updated 11/23/09)

• OCTOBER (One free overnight rental; expires 10/31/09???)
• PTPX91X (One free overnight rental; expires 10/31/09)
• G29RA3 (One free overnight rental; expires 11/04/09)
• GW9RA4 (One free overnight rental; expires 11/04/09)
• GER9A2 (One free overnight rental; expires 11/11/09)
• GSNX9X8 (One free overnight rental; expires 11/15/09)
• PUBLIX1 (One free overnight rental; expires 11/25/09)
• PUBLIX2 (Rent one, get one free; expires 11/25/09)
• NOVEMBER (One free overnight rental; expires 11/30/09)
• GU9SA (Rent one, get one free; expires 12/2/09)
• G29SA1 (One free overnight rental; expires 12/3/09)
• PUBLIX3 (One free overnight rental; expires 12/21/09)
• KIOSK (One free overnight rental; expires expires 2/1/10)

Note that I haven’t tested all of these promo codes (yet), but the ones that I’ve used have worked perfectly. As far as I’m aware, these codes are good at any location so, you may even be able to use the “Publix” promo codes at Blockbuster kiosks in non-Publix locations. Your mileage may vary, but it’s worth a shot.

Oh, and one more thing… Yes, it seems that you can use these codes more than once as long as you use a different credit card — or at least that’s how it’s been working so far. Once again, YMMV.

As I write this, there’s a guy cleaning the carpet in the other room, and I’m starting to lose hope…

Ink on the carpet…

Six or eight weeks ago, Son #4 (currently four years old) went through a scribbling phase. He scribbled on the door frame and his desk with a pencil (no big deal), he scribbled on the hardwood floor with a black Sharpie (despite being “permanent,” it eventually came off), and he scribbled on the carpet in his bedroom with (supposedly) washable markers.

Unfortunately, we got sidetracked and didn’t get around to cleaning the marker off the carpet until today. My wife started out trying to clean one of the spots with Resolve. When that didn’t work, she called a local carpet cleaner. They were actually able to make it out here this afternoon, but the last I checked, the news wasn’t good.

…and it won’t come out

The worst of the scribbles are in the dead center of the room, and the steam cleaner was unable to make a dent in them. When I walked in the door from work, the cleaning guy was telling my wife that he was going to try a “heavy duty” cleaner, but that he suspected our son had gotten his hands on permanent markers.

We dug the markers out and, sure enough, they said “Washable” right there on the barrel. I’m guessing that what they really mean by “Washable” is more along the lines of “Washable, but if (and only if) you take care of the problem immediately.” We didn’t, and we might now have to live with the consequences.

Update: The carpet cleaner managed to make the stain fade, but the ink is still there, and it’s still fairly obvious. Oh well, I guess this is just something else to help us remember the “Terrible Fours.” Lesson learned… If you want to remove “Washable” ink from carpet, you should start cleaning immediately. If not, it will magically morph into permanent ink.

With Halloween just around the corner, I thought it would be fun to put together a list of Halloween costumes that our kids have worn over the years. What follows is an alphabetical list of the 33 costumes that we can remember*.

Halloween costumes 1997-present

• Achilles (the Greek hero)
• Anakin Skywalker (you know, the young Darth Vader)
• Batman (sorry, no Robin costume)
• Bob the Builder (yes we can!)
• Buzz Lightyear (of Toy Story fame)
• Clown (just a plain old circus clown)
• Cowboy (just a random cowboy costume – giddyup!)
• Dalmatian (of 101 Dalmatians fame)
• Darth Vader (oh, Anakin, what have you become?)
• Dinosaur (a Pachycephalosaurus to be exact)
• Frodo (Baggins, that is… from Lord of the Rings)
• Harry Potter (complete with the scar, glasses, wand, etc.)
• Indiana Jones (this was old-school Indy)
• Ironman (I am Ironman)
• Jack Bauer (from 24; for the older set)
• Jurassic Park Ranger (in honor of the original Jurassic Park book/movie)
• King (just a plain old medieval King costume)
• Little Devil (this was a toddler costume)
• Luke Skywalker (he used to bullseye womp rats in his T-16 back home…)
• Ninja (including nunchucks, but minus the throwing stars)
• Pirate (just a random pirate costume)
• Pirate (Jack Sparrow in particular)
• Power Ranger (can’t recall the details, but it was a red Power Ranger)
• Pumpkin (this was a baby costume)
• Rescue Hero (in honor of the Fisher-Price Rescue Heroes toys)
• Riddick (from Chronicles of Riddick)
• Spider Man (minus the spider webs)
• Star Wars Clone Trooper (Commander Cody)
• Star Wars Clone Tropper (Captain Rexx)
• Super Man (complete with Super Man muscles)
• Teenage Mutant Ninja Turtle (complete with a TMNT shell on his back)
• Wolverine (of X-Men fame)
• Zorro (he left his mark all over the neighborhood!)

If you’re particularly astute, you might have noticed that this list includes more costumes than we’ve had Halloween-years across our four boys. The reason for this is that, in some years, they’ve worn one costume to school and a different one on Halloween night. Also note that this list also includes the four costumes to be worn for Halloween 2009.

Please chime in and let us know what Halloween costumes your kids have worn.

Over the past week or two, our four year old has told us that his “pee” looks funny. When we’ve gone into the bathroom to check, he’s been right. His urine has looked darker than normal, tending toward reddish-brown. Given that he wasn’t showing any other symptoms, we chalked it up to something he had eaten and decided to keep an eye on things.

Well… He recently, he came out of the bathroom and said “Daddy, my pee is bloody.” When I went in to check, I was surprised (and a bit disturbed) to see how red it was. I called my wife into the bathroom, and she concurred. It looked a lot like blood.

Fortunately, a quick phone call to the pediatrician was enough to put our minds at ease. As it turns out, one of the side effects of the antibiotic Omnicef (i.e., cefdinir) is discoloration of urine. Sure enough, he’s been taking Omnicef, and the color change is fully consistent with what the doctor has seen in other patients.

Phew. He’s been totally football-obsessed as of late, and we were starting to think that he’d gotten hurt rough-housing with his big brothers.

Last week we went on another Disney Cruise. Those of you who were around a year ago might remember the Disney Cruise review that I published back in March of 2008. Instead of writing another full review, I thought I’d just write up some details of how this year differed from last year.

For starters, we had the exact same itinerary, and we stayed in the exact same staterooms. The ship was in great shape — in fact, it was actually taken out of service for a few weeks last fall for refurbishing and a number of upgrades. A nice change in the staterooms was that they replaced all of the old TVs with brand new 22″ LCD TVs. Topside, the ship also sports a new “Splash Zone” near the Mickey Pool for kids that are still in diapers and thus aren’t allowed in the regular pools.

Another change was that they re-did the age groups for kids programs. The Oceaneer’s Club is now home to the 3-4 and 5-7 year old programs, with the Oceaneer’s Lab housing the 8-10 year old program, and Ocean Quest housing the 11-13 year olds.

As before, the kids loved their programs, though they were once again a bit slow to warm up to being dropped off. Early in the week, they complained about not wanting to go the Club/Lab/Quest, but by the end of the week they didn’t want to leave.

Another big difference this year had to do with shore excursions. After our fantastic experience at Castaway Cay last year, we decided that we wanted to spend as much time as possible at the beach. Thus, we went to Seven Mile Beach at Grand Cayman, and then we hit up a private beach club called Nachi Cocom in Cozumel. We booked the former through Disney, and the latter on our own (we just caught a cab from the pier in Cozumel). Both beaches were beautiful, and very relaxing.

The only downside this year was that I got sick and spent one of our sea days recovering in our stateroom. Aside from that, we had a great time. It’s not cheap but, if you can swing it, a Disney Cruise makes for a great family vacation. For more details, check out last year’s review.