My kids are now almost 6 and 8, we live in Canada. Our kids are hilarious and add a lot of joy to our lives.

Thankfully, we have grandparent support, though we still have had years where we paid 50K CAD for childcare and housekeeping, in order for us to both work big jobs.

At this stage of life, we want to spend lots of time with our kids as they really get more out of time with us than time in public school. We often speak about if we should optimize their schooling situation, our daughter is gifted and our son (likely like many other children of EAs) has high functioning autism and ADHD. Our son now has expensive therapy/tutoring 4 times a week. Our kids have lovely lives and will likely have significant impact, but I caution that their lives are valuable even if they can’t produce impact.

If someone starts an EA school accepting neuro atypical kids, please let me know.

I’m a 39 year old physician, so not in a high impact career (rather doing targeted donations), and I have found my motivation to work big hours/make more has waned in the last few years, as I increasingly value my time and energy. I do travel less as we have to trade off. I don’t know that my working less is directly because of my kids, but having kids provides a ‘good reason’ (read:socially acceptable especially for a woman) to say no to things I don’t want to do. There is a certain mental energy drained by family/household management.

Given that we have awesome kids and the infrastructure they require, we need my consistent income to sustain this, so that my husband can take a risk (he left his executive job) to have a greater impact.

I think many of the above issues would also extend to other caregiver roles, e.g. caring for a parent after a stroke.

I think this is a good idea.

As a physician, I see health reasons to eat meat - B12 and other micronutrient deficiencies, and sufficient protein intake to keep and build muscle. During their rehabilitation, I often encourage my patients to eat more protein, and there is evidence for this. I have seen lots of anecdotal evidence of carnivore/ruminant diets helping with metabolic and inflammatory disease, and mental health (ref: diagnosisdiet.com).

I also understand the animal welfare arguments, I want the animals I eat to have a good life.

In our family, we have settled this discordance by buying whole or large fractions of a grass fed cow from a local farmer (Dobson Farm), and that happy cow can feed our family for months (requires a large freezer). The farmer has proudly invited us to come visit the cows and see how happy they are in their field.

Grass fed beef is not as tasty, and this is known in the industry. The other things is that marrow bones and organ meats are quite nutritious, we also sometimes get ground beef with liver ground into it. Eating these parts of the animal is cheaper, and means that potentially fewer animals can feed us, as it is likely most beef cattle is produced for steak. Marketing the health and animal welfare benefits of grass fed and ‘non-steak’ cuts may lead to better animal health and efficiency of the industry.

Also - I’ve heard of a farm in Ontario, Canada, which posts videos on their social media to show their happy chicks, if I lived closer, I would buy from this farm. Maybe more farms should live-stream their happy animals?

Thank you. I appreciate thought leaders stepping up in this crisis, which points to the resilience of this movement. My husband was the happiest I’ve seen him in days when he found that you had written a new post.

I want to highlight a small section “ Be kind to yourself, ask what a friend would tell you, when you judge how much hardship it would be to repay; because I'm worried I know too many people who are going to be way too harsh about that.”

This is a technique in psychology called Mindful Self-Compassion, which I have studied and found very useful personally and with my patients (I’m a physician, not a psychologist). The three elements are self-kindness (vs self-judgement), recognizing our common humanity (vs isolation) and mindfulness (vs over-identification). See self-compassion.org for more

Be gentle with yourselves EAs.

I agree that treating ADHD is worth doing.

This is our story and some resources.

Anecdotally, my 7 year old son has significant ADHD and treatment with stimulant medication makes him feel so much ‘less attacky’ and allows his sweet personality to shine through, it also allows him to struggle through hard things academically. The difference is striking, he takes it happily and ‘feels awesome’ when it’s working. I think he’s going to need to get some dopamine extrinsically lifelong. ADHD is highly heritable and I think a trial of stimulant medication (prescribed by a physician) is a worthwhile experiment for many people with symptoms. (I’m a physician but this is not medical advice). Protein in the morning also seems helpful and this makes sense as it can be metabolized to increase dopamine (I’ve been shown a pathway but can’t reproduce it on the spot).

Of course, we’ve also done various types of therapy to varying degrees of success. Interestingly, here in Canada, high functioning autism qualifies as a disability for schools and tax purposes, allowing funding for services, while ADHD does not. So if there’s co-occurring autism (usually high-functioning) then it’s worth it to get that diagnosis for access to resources.

I’ve read a lot about ADHD in the last 2 years, the most helpful book for our family was Russell Barclay’s 12 Principles for Raising a Child with ADHD. Also helpful, and aimed more widely, is How to ADHD Youtube channel’s ‘How to fix the motivation bridge’.

A med school classmate of mine, with ADHD diagnosed in adulthood (life changing) describes it well as an attention modulation problem. The diagnosis helped her understand herself and her children.

If I could pay for another kid like mine to have medication for ADHD, I would.

If you happen to be a parent of a kid with ADHD/ASD, feel free to reach out because I’ve become an pretty knowledgeable case manager:)

GLP agonists are absolutely game changers in the obesity medicine space. (I’m a rehab physician with an interest in obesity medicine and recently have been offered positions in obesity clinics, largely to prescribe these medications). Basically clinics do counselling, dietician, etc., but really need physicians to prescribe these medications because they are so effective. Currently available by injection in Canada, but an oral one is coming. The GLP-1 agonist are covered by most insurance in Canada.

CBT for binge eating disorder also seems to have emerging evidence. Teaching people to feel their feelings instead of feeding them is very helpful. In terms of diets, I’ve seen a lot of evidence support low carbohydrate interventions, and I recommend dietdoctor.com and The Obesity Code (Jason Fung) to my patients.

Diabetes/Insulin resistance leads to most of the disability I see, as a disability specialist. I just presented a poster on this at a conference.

My story: I had terrible ‘ PTSD type’ nightmares after a home invasion in 2016. (I woke with a man standing over me, stealing my wedding ring and phone off my bedside table, I was pregnant and my toddler was in the next room. Alex chased off the guy). The nightmares lasted for 5 years, and would be worse when I was generally more worried in life. It sucked, but I was still able to be a functional professional.

Last year, after breaking my bedside lamp one night during a nightmare, I read The Body Keeps The Score and decided to try EMDR (Eye Movement Desensitization and Reprocessing). I did 8 sessions and it totally worked - from 8/10 bad to 1-2/10 bad. My situation of an isolated trauma works best for this tool, apparently. The sessions were exhausting, but I’m so glad I invested in solving the problem.

I hope me sharing this helps someone.

I would encourage the amazing brains on this forum to avoid alcohol.

I’m a physician specialist in Physical Medicine and Rehabilitation and a large part of my practice is neuromuscular medicine, where I see a lot of alcoholic neuropathy. I’ve been in practice 6 years. Before this, I drank about 2 glasses of alcohol a week, now I drink 0-5 a year.

My experience is that there so much disability caused by alcohol, less is better. I do remember a cardiologist in medical school saying something in red wine was protective of blood vessels, but I still think probably on balance it’s not worth it. My guess is that ‘advantages’ in the moderate alcohol groups are probably from confounding factors, like a healthy fat Mediterranean diet.

I definitely see alcoholic dementia in my work.

There’s a few major issues with alcohol:

1. it’s neurotoxic on it’s own
2. when people drink, they often neglect other nutritional needs
3. it affects sleep and mood, both can decrease cognition
4. acute affects of alcohol lead to accidents, injuries, lost productivity (5. fetal alcohol syndrome is a disaster)

This paper discusses some of the mechanisms of alcohol induced neuropathy. https://link.springer.com/article/10.1007/s40139-020-00214-w

Fun fact, there’s a father and son team from Mayo clinic, both Dr Dyck, who did a lot of the important work in this field. Alcoholic neuropathy can also contribute to ED;)

Thanks for your post. My biggest surprise from the pandemic was the failure of the institutions I had always trusted, which was deeply disappointing. I realized, we were more competent than the decision makers and took on additional responsibility. My husband, Alex D, is an epidemiologist in risk assessment/early warning. In early 2020 he was trying to warn our (Can) government about Covid and did ‘crazy’ things like refused to shake people’s hands, and brought in a basket on handmade masks to work at the emergency operations centre. He’s now had 4 promotions since 2020 and is in private sector, so at least people recognized an excellent decision maker after the fact. As a physician, I took on more responsibility at the hospital and try to overturn rules such as that we’re not allowed to open the windows (for better ventilation), I told my staff to wear masks and did myself, when it ‘wasn’t necessary’. We were relatively well positioned to make changes, as mid career professionals in institutions and it was still frustratingly non-responsive. Ideally, we’d have a relay team of rational ‘adults’ in a position to effect change, with even more power than we had, each taking turns sprinting. In my experience, some competent people have risen up through the ranks, while others have burned out - turns out, adulting is exhausting. I agree, after living these institutional failures, the EA community gives me hope.

I suspect this is down the road, but when it comes down to site selection, I follow the Eastern Ontario/Western Quebec (Canada) real estate market. This region has the benefits of political stability, fresh water, and relatively easy access, however getting permits to build geothermal and massive scale projects would be difficult as building, especially close to water, is quite regulated. There are 100+ acre properties like this one on a deep lake: https://www.realtor.ca/real-estate/24040099/950-ch-assad-lange-gardien which are coming up for sale as people realize their bush land/farm is valuable. You could buy up land like this for future use.