big issues Archives - A Mommy Story

Mar 3, 2015

Opting Out of PARCC

Here in Ohio and several other states, it’s currently PARCC testing season. PARCC is short for Partnership for Assessment of Readiness for College and Careers, a standardized test created by Pearson (a textbook and testing company) that is being used by several states for assessment of learning standards for third grade thru twelfth, and it’s primary purpose is that it’s a significant factor for teacher and school district evaluations.

There’s only one problem: the test is an absolute hot mess.

I had started looking into this test last spring, after a district administrator gave a presentation on what was coming with this new test. Once I had a complete picture of it late last year, including taking the sample practice tests for myself on PARCC’s website, I couldn’t in good conscience let Cordy take this ridiculous test.

To begin, the test is far too long to be considered developmentally appropriate for younger children. Schools have a three week testing window to complete all testing. This was the initial testing schedule that was sent out just for Cordy’s class:

ELA Practice Test: February 5 12:45-2:00
Math Practice Test: February 10 10:00-11:45
Math PARCC Test 1: February 19 9:00-11:45
Math PARCC Test 2: February 20 9:00-11:45
ELA PARCC Test 1: February 23 9:00-11:45
ELA PARCC Test 2: February 25 9:00-11:45
ELA PARCC Test 3: March 2 9:00-11:45
Social Studies (4th only): March 4 9:00-11:45
Science (5th only): March 5 9:00-11:45

(ELA = English Language Arts)

If you add up all of the time, that’s over ten hours of testing, not including the practice tests. And that time also doesn’t include additional test prep done before the practice testing. Have you tried keeping a fourth grader completely on task for an hour and forty-five minutes?

And here’s the kicker – this is just round one. The kids get to go through all of this AGAIN across a three week period in late April-early May. Over twenty hours of time spent taking a test in the last third of the school year. At what point do kids have the time to squeeze in actual learning? It’s as if the school year has been cut short.

Additionally, this test has absolutely no impact on report cards or grade advancement for most kids. The third grade reading guarantee in Ohio is, as of this year, still governed by the OAA test, and the high school graduation requirements have additional methods to meet the same requirement that the PARCC test fulfills. Results of the current test being given won’t be available until November, far past the point when it could have made any impact on helping the student in any areas of deficiency.

The results that are provided will be vague at best. Many of the questions are manually graded, leaving it up to the human element to determine the score for each question. Because the test is proprietary, parents and students will never be given access to a completed test to see how each question was scored. So kids will spend 20+ hours of testing each year with no benefit to the student from the test, and no idea if there might have been an error in scoring.

Looking at this from a socioeconomic perspective, the PARCC test is designed to ensure poor, urban children have slim chances of passing. We don’t need this test to tell us which schools are “failing” because we can already predict what the results will be. These are computer-based tests. Urban school districts often lack the resources of more affluent suburban districts, unable to provide as much computer access. A student who has a computer at home and a computer lab at school likely has more experience with using a computer and mouse than a student who only uses a computer on rare occasions. Teachers are not allowed to provide help in any way on this test, including helping a student remember how to click and drag using a mouse. The technology gap will doom many kids to frustration and a failing test.

In our school, they’re testing one class at a time because there aren’t enough computers in the building for more than one class. Those computers are slow, glitchy Chromebooks, and as a result there have been multiple complaints of the test kicking kids out in the middle of the test, or just not allowing students to log on at all. (All of this just adds more time and frustration to testing for the kids.) Our school is one of the better off schools in our district, and I can’t imagine how some of the schools in poorer neighborhoods are dealing with this need. In the future, money will have to be diverted from needed services to fund the technology requirements demanded by this test.

And let’s not forget that each school district is paying per student for this test, too. It’s a costly waste of time and resources to “prove” that public schools are failing – a conclusion that Pearson already made prior to the test and so they have crafted the test to ensure the results match their hypothesis. Why? Because Pearson also owns a textbook and study guide empire. What better way to ensure that school districts spend a premium to have their textbooks and test prep guides in every classroom? If most kids did well on the test, they wouldn’t need to buy Pearson’s test prep and study guides.

Despite all of this, it was when I took the practice test for myself that I made up my mind. The questions are poorly written and designed to trip up a student – what I call “gotcha” questions. A math question that can’t be answered correctly if the student doesn’t recognize a particular above grade-level word is not properly testing the student’s math ability. A question that intentionally tries to misdirect a fourth grader to the wrong answer is not properly testing the student on math, either.

Along with this, we were informed this year that some of the test accommodations provided by Cordy’s IEP are not allowed for PARCC testing. The federal right for special needs students to have the necessary accommodations for their disability has now been limited by the strict requirements of this test.

It was an easy decision for us: we refused to allow Cordy to be given the PARCC test. Would she have done well on the test? Probably. She’s amazingly good at standardized tests, even bad ones. But was it worth putting her through the severe anxiety and long hours of testing time for no benefit to her? No way. Her school handled it very well and has made sure that she has supplemental enrichment activities to work on while testing is happening.

My only concern was the knowledge that refusing would result in her score being recorded as a zero, which would affect her teacher’s rating. However, Ohio has passed a “safe harbor” bill preventing nearly all repercussions for this year of the test, so it won’t affect her teacher. And even if it had, we had the full support of her school when we announced we were refusing the test. Many of the teachers and administrators don’t support PARCC and are happy to see parents pull their kids from the test. It’s only through a wide-spread refusal that parents can demand things be changed.

You don’t have to let your kids take the PARCC test, even if they’ve already started, and even if administrators tell you that they must. You have the right to determine what is best for your child, and you can refuse this test. Your kids have the right to refuse, too. They can be placed in front of a computer and they can sit there and refuse to do the test. (If your kids are brave enough for that.) It’s also a good time to email your state representatives and tell them you want something better than PARCC and are counting on them to step up and make it happen.

I want my kids to learn how to use their brains in school, not learning how to take a single standardized test. And I want them to learn for the entire school year, not just the first two-thirds.

I support public schooling. I’m not an anti-testing nut. My kids have probably taken more standardized tests and assessments than most, and nearly all of those were for their benefit. I believe in testing if it’s fair, appropriate, and useful for the student’s progress. I also believe we do need some way to fairly evaluate school districts and teachers, and I believe we need a strong set of educational standards for each grade level.

But PARCC isn’t the answer. It’s a public school witch hunt, with a push to give private industry more of our public education tax dollars, all wrapped up in the disguise of a test to hold teachers and schools accountable. It takes an obscene amount of time away from learning. It takes a ridiculous amount of money away from needed educational services. It attempts to vilify the very teachers we love and trust with our kids each year. And it uses our children as pawns in the game to profit on public education.

Filed Under: big issues, school ·

Feb 17, 2015

Broken

By Christina ·

Last month, we had what might be the biggest surprise we’ve ever experienced: I was pregnant. Unlike our first two, this one wasn’t planned or expected. Over a year ago, we had considered the possibility of a third child. A year of not preventing, but not trying, yielded no pregnancy. I had started to think I was moving into peri-menopause based on symptoms I had.

So that positive pregnancy test was a shock. I’d be lying if I told you we were instantly excited. Aaron and I had started the new year making plans for the year ahead, and that included increasing our running, more travel, visiting amusement parks…lots of things that were more complicated with a pregnancy/baby in the mix.

The first couple of weeks were filled with quiet discussions of worry and doubt. Were we really ready for this? Could we handle starting over again with a baby when our youngest will be eight this year? Did we need a larger car? Are we too old?

We talked after the kids went to bed, not willing to share the news with them at this point. After all, the first trimester is when a miscarriage is most likely, and since I’m officially AMA (Advanced Maternal Age – meaning I’m old), there was a higher risk of complications. We planned to tell the kids right before our trip to Walt Disney World, and if all was well, we’d announce our news to the world after I ran the Enchanted 10k.

Slowly, as the early pregnancy fatigue set in and I considered needing a new bra for my sudden buxom chest, we settled into an acceptance that this was happening. We began to get excited at planning for a new little person in our family, still keeping the news of this new addition to ourselves and only a few other people. We discussed baby names and wondered if Mira would enjoy being a helper for her little brother or sister. I marveled that I had practically no morning sickness this time (as opposed to my 24/7 nausea with Cordy and Mira), and I was assured by my doctor’s nurse that it was totally normal, as every pregnancy is different. While this was inconvenient timing, we knew we had the resources and the ability to care for a third child, and we’d make it work.

As my first doctor’s visit approached last week, I was nervous. Not excited, nervous. I had this nagging worry in my head, and needed to see that little blurry blob on the screen, healthy and growing. The ambivalence I felt when we first saw that positive test had changed, and I had now grown attached to this new life growing inside me.

On Thursday morning, after going through the usual questions and exam, it was time for my first ultrasound. My doctor and I had been chatting away the entire appointment: she asked how the kids were doing and about our upcoming vacation, I received reassurance that it’s fine to continue running while pregnant as long as I stay hydrated and listen to my body, we laughed about how the universe has a funny sense of timing.

And then as the image appeared on the screen, she fell silent. That was my first clue. She clicked to snap an image, clicking twice more to measure the image on the screen, then taking another image and measuring again. She finally broke the gaping silence with, “You’re 9 weeks pregnant, but the baby is only measuring 8 weeks, 3 days…”

That didn’t seem like a big discrepancy, but then came the confirmation of what I was also seeing on the screen: “…and I’m so sorry to say this, but I’m not seeing a heartbeat. By this point there should be a very visible heartbeat.” I knew this long before she said it. During her silence, I stared at the screen and could make out the head, the body, and the little arm buds, but I knew there should be a flicker on the screen coming from the body section. The body was still – no hint of a flicker.

“Yeah, I noticed that, too. Okay…” was all I could say at that point. There was no rush of emotion in that moment. I was in my clinical mind, as if what was on the screen didn’t belong to me. I don’t know why it didn’t hit me at that point. Maybe I was trying to be brave and not make it harder on my doctor to deliver such bad news. Maybe I was just numb.

She then began discussing the options of what to do next. I could wait it out and have a natural miscarriage, but there was a strong chance I’d be going through that while we were at Disney, and could risk having a partial miscarriage, requiring followup. I could try a pill to help speed things along, but it only had about a 50% chance of success this far along. Or I could have a D&C (Dilation and Curettage), removing everything at once so I’d be mostly healed in time for our trip. The D&C seemed to give me the most control over the situation – I had already lost the pregnancy, I didn’t want to ruin our planned vacation, too.

I signed the consent forms, and my doctor checked with the hospital to see if they had an open operating room for Friday. They were able to schedule it for 7am the next morning. Less than 24 hours between diagnosis and saying goodbye. My doctor gave me a copy of one of the ultrasound images to keep before I left.

Aaron couldn’t be with me for the visit, and I couldn’t bring myself to call and deliver the news via the phone. This really needed to be shared in person. It was a terribly lonely 30 minutes as the weight of this situation sat entirely on me.

It was during the drive home when it really hit me. I continued to remind myself of the facts I’ve known for a long time: if a baby stops growing in the first trimester, it’s usually due to a chromosome problem causing big developmental issues, and if that’s the case it’s for the best for the pregnancy to miscarry. But I couldn’t help but wonder what had happened just a few days before. The baby had stopped developing just a few days before my appointment – did I somehow cause this to happen by something I did on that day? Did I not want this pregnancy enough? Logic and emotion fought back and forth in my mind.

And yet…despite my insistence many years before this that if I ever had a miscarriage I wouldn’t get that upset about it because I knew it was nature’s way of doing a quality check, I learned that hormones and emotions can do a fine job at overpowering logic and reason in this situation. (Even though I did feel that way before, I never questioned anyone else’s grieving process – this was solely holding myself to that standard.) The first tears presented themselves without warning.

Delivering the news to Aaron was hard. Even though I knew this was something I had no control over, I still felt a heavy guilt like it was somehow my fault. Aaron’s response seemed to match my own; at first, he received the news with little emotion. Later that day the full emotional weight would sink in.

That evening we arranged for my mom to come to our house super early the next morning to get the kids ready for school while we were at the hospital. She was sad for us, and willing to do whatever needed to help us out. We also had to decide if we told the kids or not. They were going to ask why we wouldn’t be home in the morning.

Aaron felt it was important to be honest with them, so that evening before bed we shared everything with them. Mira’s eyes lit up when we told them that I was pregnant, cutting us off to say, “We’re going to have a little brother or sister? YAY!” It was so hard to immediately destroy her excitement with the “but…” They were disappointed, but more concerned that I had to go to the hospital. I reassured them that I would be fine and that it was a simple procedure. We tried to focus on the positives – like the fact that I’d now be able to ride all of the rides with them at Disney.

I barely slept that night. I cried off and on, wondering how so much could change in such a short amount of time. I was sad, but I was also angry that this happened after I began planning for and looking forward to the new baby. It felt like a cruel tease.

My mom arrived at 4:15am, and we left for the hospital at 4:30am on Friday morning. Admissions didn’t take long at all, and the nurses and staff were very understanding and kind as they got me ready for the D&C. Aaron was with me until about 45 minutes before surgery time, when we said goodbye and they took me to pre-op.

My doctor had told me the procedure could be done under general anesthesia or with sedation. I didn’t want the grogginess and sore throat that comes with general anesthesia, and I made my preferences known to the anesthesia team. Even though general anesthesia is easier for them, they realized how much it mattered to me and were willing to do it. Since you can still move around with sedation (you just don’t remember it), I agreed with them that if there were any concerns during the procedure, they would be allowed to switch to general anesthesia.

When my doctor visited me in pre-op, I was trying so hard to not be weepy, but the tears refused to stop. She squeezed my hand and, after a few words of reassurance, went back to discussing the procedure itself. That was actually helpful for me – I could push aside the sadness and let my nurse brain take over.

They were then ready for me. I was given a dose of versed to get me ready. Versed is an amazing drug – it’s an anti-anxiety medication that relaxes you before surgery, and it also produces amnesia while in your system. I remember transferring to the operating room table, and I remember them asking me to move my legs into a certain position…and then I remember nothing else until I was being wheeled up to my recovery room, fully alert and awake. I’m sure I was still be awake for part of that time, because they would have told me they were giving me the propofol to let me sleep, but I have no memory of any of it.

I was moved into a recovery chair, covered in blankets, and offered food and drink. Aaron arrived about ten minutes later – I was so glad to have him with me. I didn’t know what to expect, and I was happily surprised that I wasn’t in any pain, and only had mild cramping.

The tears were gone for the moment, replaced by a hollow, empty feeling. I arrived to the hospital that morning still pregnant, and left a few hours later not pregnant.

I had told Aaron before the surgery that if he wanted to share what had happened on Facebook, I wouldn’t object. This was a lot to bear on our own, and if sharing would help to shoulder the grief, I wanted him to do it. As I sat in recovery, he shared some of the messages he had received for us. I’ve never claimed to be all that private of a person (obviously), so while I waited to go home, I wrote a short update for Facebook as well.

I’m surprised how many friends have had similar experiences losing a pregnancy (or more than one, in some cases), and how many of those friends have never shared the details of it in public. I’ve never understood the social norm found in some areas that a miscarriage should be kept quiet, sharing what happened with as few as possible, and acting as if the pregnancy never happened at all. I suppose there’s an argument to be made for not making others uncomfortable by expecting some form of comfort from them, but I have no expectations from friends and family. We all handle uncomfortable situations differently. I wouldn’t hold it against a friend for saying nothing, just as I also wouldn’t judge someone for an enormous outpouring of support. We’re all different.

Now that I’m in the middle of it myself, I can’t imagine keeping all of this in. I never expected that losing a baby at only 9 weeks – a baby that we weren’t even all that excited about in the beginning – could cause such grief, and I’m not that strong to hold all of these feelings inside of me. So…I write it out. For me, mostly, but if it benefits anyone else, that’s okay, too.

There are questions to be answered at a later date. We didn’t expect this pregnancy, so the big question is if we’d ever consider a third child again. We don’t know at this point, and we’re in no state to make that kind of a decision for now. Perhaps in a month or two we’ll give it some thought.

I’m still running the runDisney Enchanted 10k this Saturday, running my furthest distance yet. I’m probably not as ready as I should be, but I need this race more than ever now. I was going to announce the pregnancy at the end of the race, but with this loss I feel like I must cross that finish line, just to have one win on my side. I only hope I can find some ultra-waterproof mascara so I won’t look like a mess when the tears inevitably flow at the end of the race.

This post ended up longer than I expected. If you read this far, you deserve a medal. To sum up: I’ll be okay. We’ll be okay. Time heals many things.

Filed Under: big issues, Family, pregnancy ·

Oct 21, 2014

Flu-Shot Shoulder Update

By Christina ·

I’ve recently had several people ask me how my shoulder is doing since getting my flu shot at the beginning of January. It’s now flu shot season, and judging by traffic to this site, others have also been wondering if the shoulder pain they’re experiencing after their shot is typical or not. So I wanted to provide an update on it.

Is my shoulder better now?

Yes. And no.

Back in February, a month after my flu shot, I saw an orthopedic specialist who diagnosed me with subacromial bursitis. I was given a cortisone shot directly into the joint to help with the pain and stiffness, and handed an order for physical therapy. The cortisone shot was like a miracle – my shoulder was more sore the day the shot was given, but by day three the pain was nearly gone. I still had some stiffness and ache if I moved my shoulder to the upper limits of a stretch, but otherwise I felt great.

I set up my physical therapy and completed six weeks of appointments, twice a week. The goal was to strengthen and stretch the muscles around that joint for better movement and (hopefully) no more pain.

By April, I thought that perhaps I was all in the clear. The pain was gone, and other than some “popping” in my shoulder for certain movements, it seemed completely normal.

Then in mid-June, I went to Chicago for a one-day trip: one plane ride there, half a day in a conference, and then a few hours wait in the airport before another plane ride home. While waiting for my flight home, I noticed that my shoulder felt a little sore. I had been carrying my bag on that shoulder for part of the day, so I assumed that the soreness was just muscle soreness from carrying the bag during a very busy day. My back was sore from uncomfortable seats on the plane, too, so I didn’t worry.

But then a week later I noticed that shoulder in particular was still a little sore with certain movements. Shouldn’t it have been better by now? I took some ibuprofen for the next week, restarted the exercises I was taught in physical therapy, and hoped it was just a small flare up that would go away.

I finally admitted this low-level, chronic ache wasn’t going away at the start of August (yes, AUGUST – I’m stubborn like that), and scheduled an appointment with the orthopedic specialist again. He took a look and said the range of motion was still better than it had been, but wanted to make sure there wasn’t anything else going on. X-rays were taken, and nothing could be seen from them, so he ordered an MRI.

The MRI thankfully showed no damage to the rotator cuff tendons. So, ruling out any other issues, we were right back to the original diagnosis – subacromial bursitis. He told me that the cortisone shot probably did a great job at keeping the inflammation in check, but that it eventually wears off for most people. It’s likely that the cortisone shot I received in February lost its effectiveness in June, allowing the inflammation caused by my improperly placed flu shot to come back.

My doctor suggested another cortisone shot, since the first one did help. When he was injecting the cortisone, the doctor said bursitis was definitely the diagnosis, as the joint capsule was very tight and he had to apply more pressure than usual to get the cortisone into the space.

For now, my shoulder feels fine. I have full range of movement, I can sleep on that side, and while I’m still a little weaker on the left, I can perform weight-bearing exercises on that side. The first cortisone shot did eventually wear off, but my shoulder was still in a better state at that point than it was before the first cortisone injection was given. My hope is that the second cortisone shot finishes the job and allows the joint to completely heal.

But the truth is, I don’t know for sure. It’s possible the cortisone will wear off again and I’ll be right back in my doctor’s office. It’s definitely a possibility. There was talk of surgery to essentially “clean out” the joint as a last resort – I’d like to avoid that if I can. Surgery is simply not something I even want to think about right now.

I’m still frustrated that I had to go through all of this due to a flu shot. SIRVA (Shoulder Injury Related to Vaccine Administration) is a serious issue, and while it only affects a small percentage of people, it’s entirely preventable by ensuring good form when giving an injection.

I still stand by the tips I provided in my first post about this. If the placement seems wrong, say something. Make sure the person giving the shot is at the same level as you. Consider carefully who will be giving the shot. And if you’re eligible for it, consider the Flumist instead.

This is a good spot for an injection. Not higher.

A stiff or painful shoulder after a flu shot can be completely normal. The pain is usually at its worst the day of and the immediate day after, fading quickly after that, and it’s felt in the muscle. If the pain gets worse on day two or day three, doesn’t start to decrease by day four, and is causing you to restrict your range of motion with that shoulder, it’s worth giving your doctor a call to get it looked at.

There’s a big push for everyone to get their flu shots at this time of year. I haven’t received mine yet, and I’ll admit to being a little more cautious about having it done this time. I’ll likely either choose the Flumist nasal vaccine, or let the nurse in my family doctor’s office give the shot, as I trust her to do it properly.

I won’t tell you that you must have a flu vaccine or that you should avoid them completely – that’s an individual decision for all of us. But I would urge you to pay attention if you do get one, and don’t be afraid to ask questions. It’s your health, and you have the right to make sure your vaccine is being given properly.

Note: a quick Google search helped me find this recent article for nurses, which specifically mentions techniques to avoid shoulder injury. It’s good to see the medical community taking more notice of this topic.

Filed Under: big issues, healthy living, me me me ·

Aug 26, 2014

CCS Transportation Department Twitter Abuse

By Christina ·

I mentioned that last week was a bumpy start to the new school year, but at the time of writing that, I had no idea what would happen the remainder of the day.

Right after I hit the Publish button on Friday, the school called. I learned that Cordy had been having a very rough day, eventually landing herself in the principal’s office. I talked with the principal, then with Cordy, and when I hung up the phone I was a stressed out mess, worried that Cordy wouldn’t be able to adjust to the gifted classroom and that there just wasn’t any possible good fit for her at school. (Note: Yesterday went much better, followed by an even worse day today. I’m trying to remain hopeful that these are just a momentary freak outs over her new routine and the roller coaster will smooth out soon. Now please don’t let the school call again tomorrow.)

I hoped that the bus would make it to the school on time Friday afternoon. The first two days it was 30 minutes late to the school, and while I was not too upset at the delay, I was frustrated at the lack of communication on the delay from the Transportation department of Columbus City Schools. Our district’s Transportation department has a Twitter account with the sole purpose of notifying parents about delayed bus routes. Yet for the first two days, our bus route wasn’t listed among the delay notices. I tweeted my frustration about this the first two days, pointing out the tool isn’t very useful if they only post some of the delays and not all.

When I checked the Twitter stream around the end of the school day, I was puzzled to see this tweet:

(I blocked out the name of our school in the image)

That’s our route, but according to this tweet it was on-time. This twitter account is for route delays, and they’ve never posted about a route being on-time. I was confused – why was there a need to post that?

But then it got even more bizarre:

So? This is not an update. The person replying has a real delay in need of an update, not us.

Again, this is not a delay and was completely unnecessary. Was the Transportation department mocking me with passive-aggressive tweets because I had complained about not updating all of the late routes? Surely they couldn’t be that unprofessional, right?

But then it continued:

Edits made by me to hide street names. I like all of you, but I’m not giving out the intersection near my house.

I was stunned by the childish behavior being demonstrated by a representative of Columbus City Schools. Meanwhile, other parents were sending tweets in reply saying their children’s routes were running late and they weren’t seeing the updates online. Was Transportation too busy playing this twisted game with me to actually do their job?

And finally:

I had to respond at that point.

What a petty, spiteful action to take because I called out the continuing communications breakdown with Transportation. Instead of productively using those complaints to improve services, they instead chose to be childish and harass me. Another bad decision in a series of bad decisions with this department.

But wait…it gets better!

I started calling attention to these tweets, pointing out the misuse of a district account and resources to act maliciously towards a parent. Others began commenting on the behavior. And then, over the weekend, POOF – ALL of the thousands of tweets ever sent from that account mysteriously vanished. At first, I thought they had blocked me from seeing any of their updates, but others quickly confirmed that they weren’t seeing any tweets in the account, either.

I wondered if maybe they were trying to destroy all evidence of the misbehavior, but I’d already told them I had screen shots of all of the tweets, so that seems silly. And deleting everything seemed a little extreme. For a district that’s already been found guilty of deleting student data, deleting district tweets seems like a really bad move to make.

The Twitter account was updating again as of Monday morning. But again, the slate was wiped clean before each new bus run. Why use a social media service when you plan to set each message with a self-destruct by the end of the day? Could it be they’ve figured out that leaving an electronic paper trail of the never-ending bus delays (or lack of updates on said delays) might be harmful to their reputation? Yet it’s even more harmful to deliberately cover your trail, too, especially for a group with a less-than-honest reputation.

Overall, I’m disappointed in the Transportation department and just as disappointed in the district. I emailed all of the Board of Education members and Dr. Good (the superintendent) on Sunday night about this issue, complete with screen shots of the tweets.

So far, the only response has been from the superintendent’s assistant, telling me he was occupied and she was forwarding my concerns on to the Transportation director. I know how to contact the Transportation director – had I wanted to email him, I would have included his email address on there the first time. I specifically chose not to include him because I don’t believe he can or will do anything to fix the situation, just like how nothing was accomplished to better track buses last year. (And in a plot non-twist…no response from him.)

No one else included in that email has reached out to me. I’d like to say I’m surprised by this, but it seems to be common around here. I did receive a voice mail from someone in the Customer Relations phone center, but I know those call center workers have no power to accomplish anything – their purpose is to create a public record that the school district responded to the complaint, despite actually doing anything to address it.

It’s sad. Sad that an employee of a school district could be so unprofessional and childish at his or her job. Sad that a Transportation department would rather stick its head in the sand rather than accept criticism to tackle the idea of making things better. And sad that the school district can’t see the enormous communications breakdown happening between the district and the parents, or care enough about parents to want to enact change.

Filed Under: big issues, school ·

Jan 14, 2014

Went For A Flu Shot, Got A Shoulder Injury Instead

By Christina ·

I’ve had a flu shot many times. No one really wants to get a flu shot, but many people generally consider it worthwhile if it keeps you from getting the flu. I have no time to be sick, so I usually get vaccinated each fall.

While the girls were already vaccinated, I had yet to get my flu shot this year. I meant to do it at my doctor’s office visit last month, but then forgot to ask about it. So a little over a week ago, when I heard of more flu cases creeping into our area, I decided to get my flu shot at Walgreens while I was picking up a few other items. Cordy was with me, too, and I thought it might be good for her to see me getting a shot, to reinforce that it’s not a big deal.

I answered the pharmacist’s questions and paid my $28 for the vaccine, then waited in the little cubicle they had set up for vaccinations. The pharmacist walked in and asked which arm I preferred. Seeing how I was already seated with my right arm to the wall, I said I preferred my left. It was my non-dominant arm, and I know from experience that the muscle is sore for a couple of days after the shot.

He opened an alcohol pad and cleaned off an area on my arm. Or rather, my shoulder. I noticed the area he chose seemed awfully far up on my arm. As an RN, I never gave shots that high up on the deltoid. But I’ve also been out of clinical practice for a few years, so maybe there was a new technique I wasn’t familiar with? I didn’t say anything, because I didn’t want to sound bossy and tell this young pharmacist how to do what he was surely well-trained to do.

The pharmacist stood beside my chair and quickly gave the shot, right at the area he had swabbed on my shoulder. I felt the initial poke of the needle through my skin, and then felt nothing else. “All done,” he said. I blinked. There was no pain, not even a slight burning sensation that has always accompanied a shot. I didn’t feel anything from the injection. Weird.

I tried to rationalize my confusion, and settled on believing this young pharmacist was a master at flu shots and somehow found a way to make them completely painless. I called to Cordy, who was standing nearby, scared at the idea of me getting a shot and unable to watch, and told her, “See? I’m done. And it didn’t hurt at all.” My smile to reassure her was genuine.

Later that night, my arm felt a little sore, which I knew was common with the flu shot, and I didn’t think anything of it. The next morning (Monday), my arm was significantly more achy when I moved it in certain directions. The ache felt different from how I remembered the muscle pain from a shot before. I attributed it to faulty memory. Monday night, I noticed that sleeping on my left side was uncomfortable.

Tuesday morning, the pain was worse. I was unable to move my arm in certain directions without a sharp shock of pain. I could lift my arm directly ahead of me, but couldn’t cross it over my body, and I couldn’t lift it out to the side by more than 45 degrees without the pain keeping me from going further. I had noticed the ache occasionally traveling down my upper arm into my elbow, too. And I was starting to develop some occasional tingling and numbness in my left hand and fingers, too. Tuesday night I had to sleep on my right side or back – the left side hurt far too much, and woke me up several times when I shifted in my sleep.

At that point I started to be concerned. Muscle soreness is typical with a flu shot, but this went beyond soreness. It was now the third day after the shot, and I should have been feeling better by now. Instead, I was counting the hours between ibuprofen doses and trying to search online for why my shoulder and upper arm were reacting in this manner.

By Thursday, the sharp pain had lessened quite a bit, but the intermittent numbness and a constant low-level ache had set in. I was also starting to develop some “popping” in my shoulder when I moved it. Prodded by conversations with a few people, and by some scary information from Dr. Google, I made an appointment with my doctor for Friday.

My doctor listened to the whole story with concern, then carefully examined my shoulder and arm, trying different motions to see which movements were uncomfortable and which didn’t cause any problems. She knows I’ve never had a shoulder injury, too. (Knees are another story.) Surprisingly, she agreed with Dr. Google: I have bursitis in my shoulder, with an outside possibility of a small rotator cuff tear, too.

When the pharmacist gave the injection, he was too high on the deltoid muscle. My doctor said that a lot of women don’t have a significant amount of muscle mass at that spot on the deltoid, and directly under it is the subdeltoid bursa, a pocket of fluid that is part of the shoulder joint, designed to reduce friction in the joint.

The deltoid muscle, in red. (Source)

So when he administered the injection too high on my arm, he went through the deltoid completely and punctured the bursa, injecting the flu antigen into the bursa. That would be why I didn’t feel any pain or burning when it was injected, and it’s also why I’m experiencing all of my shoulder pain symptoms.

The bursa is located just above the rotator cuff tendons, with the deltoid over all of it. (Source)

The bursa fluid isn’t meant to have a flu virus antigen mixed in with it. So it reacted with inflammation, pain, and stiffness in the joint. The numbness and pain into my elbow that I’m feeling is likely caused by the inflamed bursa putting pressure on the nerve.

My doctor thinks the symptoms should go away within a week or so. She recommended a conservative approach for now, and that we treat it with heat and ibuprofen. If it doesn’t get better within a week, then we may try a round of oral steroids to help it along. If that doesn’t fix it, then we’ll consider an MRI to see if the rotator cuff was damaged, physical therapy and begin thinking about long-term treatment plans.

That last sentence scares me. Long-term treatment. Long-lasting shoulder pain. I’m really hoping my doctor is right and it’ll resolve within a week. In doing research on this, I discovered that the government already has a name for this type of vaccine injury: shoulder injury related to vaccine administration, or SIRVA.

As of 2010, it’s a known type of vaccine injury, and a study on it found several identifying characteristics. In most cases, those affected were women, the person administering the injection was standing while the patient was seated, and the injection was placed too high on the arm, resulting in the injection being delivered into the bursa.

This led to the recommendation that “the upper third of the deltoid muscle should not be used for vaccine injections, and the diagnosis of vaccination-related shoulder dysfunction should be considered in patients presenting with shoulder pain following a vaccination.” (The Dept. of Health & Human Services accepted this recommendation, along with also recommending that the person administering the vaccine be seated if the patient is seated to reduce error.)

A report on this injury was given during a 2010 Advisory Commission on Childhood Vaccines meeting (pages 15-28 or so), where it was revealed that among those without prior shoulder injuries, only a third who developed SIRVA ever fully recovered. Meaning there’s a chance that an improper injection can lead to life-long joint pain in that shoulder.

And here’s the kicker: I still don’t have any immunity to the flu. My doctor said it’s unlikely that I gained any immunity from that shot, since it went into the bursa and not the muscle. I paid $28 to be given subdeltoid/subacromial bursitis, that has a chance of causing chronic shoulder pain. Lovely.

I don’t want anyone else to have to go through this, so here are a few tips for you the next time you have to have a flu shot (or any vaccine injected into your arm):

1. If it seems too high of a position, say something! I wish I had followed my own advice here. A shot should not be given just under your acromion process (the knobby end of your shoulder), but should be given at least two finger widths down. Needle size should be carefully considered, too. Better to say something rather than be injured. Not sure how to bring it up? Try this as a starter when the alcohol pad is rubbed on the spot: “Huh, that seems really high on my arm. I don’t remember getting any other shots that high.”

2. Ask if you can stand while the shot is given. If the provider would prefer that you sit, ask that person to sit as well, so that you’re both at the same level. Injecting from above tends to result in the injection being given higher on the deltoid, which increases your risks. Trying to estimate two finger widths down while standing provides a skewed view of the site and means your shot will likely be placed too high.

3. For the flu shot, ask if you’re eligible for Flumist. The Flumist version of the vaccine is sprayed into your nose – no needles! Not everyone is a good candidate for this version of the vaccine, since it’s a live vaccine, but if you’re eligible you’ll prevent any needle injury by avoiding it altogether.

4. Consider who administers your shot. Pharmacies are convenient for flu shots, but how well do you know your pharmacist? Many may not have the experience of your doctor’s office nurse. On the other hand, you may have a better relationship with your pharmacist than your doctor’s nurse. Ideally, you want someone who has a good amount of experience in giving shots, and who gives them with some regularity.

However, one point regarding this: sometimes, you get a bad shot, no matter the person giving it. I’ve had my flu shot at Walgreens in the past, by one of their pharmacists, and didn’t have any issues. Nearly any medical professional has a risk of giving a bad shot, even if they’ve been involved in your care since you were a baby. That’s why it’s important to pay attention and ask questions if something seems wrong, even if the professional is someone you trust.

I’m not going to say that the solution is to never get another shot. But I do think we should all consider each shot as a careful medical procedure. Any medical procedure has the ability to help, but most also have the ability to harm if done improperly. We should be cautious in who we choose to give us a shot, and we shouldn’t feel dumb or bossy to speak up and ask questions if we’re uncertain.

As of today (1 week, 2 days after the shot), my shoulder has almost a full range of motion again, although a few movements continue to be painful. A low-level ache is present nearly all the time (I’m told this is what arthritis feels like?) and I still can’t sleep on that side. I have occasional numbness/tingling in my fingers, but it’s less and less each day.

I have noticed a significant weakness in that joint now, so I’m taking it slow and easy with lifting anything or too much movement. And the “popping” in my shoulder has continued – with certain movements you can hear the pop across the room. I had a chiropractor recommended to me, and I will likely give him a visit to see if he can help. Hopefully it’ll be resolved soon and the only popping and ache will be the standard ones in my knees.

UPDATES

To see more about how I’ve been dealing with SIRVA, I’ve provided links to my update posts below:

An Update on My Shoulder – one week later

The Ongoing Shoulder Saga, Episode IV (A New Hope?) – one month later

Flu-Shot Shoulder Update – nine months later