Having kids has given me an acquaintance with health care that I virtually would have never thought possible. My boys are not the unhealthiest of children, but their conditions (severe autism and apraxia for my elder son, slightly less severe autism and mild hypotonia for my younger) have required some further investigation.

We had one of these investigative moments this past year with my younger son, specifically regarding the possibility of a metabolic disorder causing his hypotonia (and perhaps contributing to his autism and global delays as well). To get more clues, blood work was needed to test for the level of certain amino acids and other chemical markers. One of these markers was lactic acid: elevated levels might indicate a metabolic disorder and provide something for a geneticist to work with.

There was a problem with this, however: lactic acid levels tend to rise with muscle exertion, so the blood needed to be drawn from my 18-month-old son without causing him to exert himself while we were trying to get blood.

If you’re not aware, taking blood from an infant is no walk in the park. Logistically, it’s not easy to get a needle into an infant’s miniscule* veins, and a tourniquet is needed to make the veins appear prominently enough. Guess what a tourniquet does? It causes muscle exertion. So when the first blood test for this was done, the lab techs taking the blood were instructed not to use a tourniquet. The result was not pretty: close to 20 minutes and a few sticks to get enough blood for the various tests, and even then a tourniquet was used briefly to get the needle in.

When that first test came back high for lactic acid, we came back in and were instructed to get a second blood sample to be on the safe side. The same thing applied here, except that it took us nearly an hour and probably 4-5 sticks before these different techs got enough blood (and again, they had to use a tourniquet). It was torture for all involved, not the least of whom was our infant. And lo and behold, there were high levels of lactic acid.

Finally, we saw a geneticist at the University of Illinois-Chicago, and we expressed our concern to him that these tests might not have been valid because of the way they were taken. At the end of the visit, the geneticist and genetic counselor took what turned out to be the final blood sample by putting on a tourniquet initially, finding the vein, and getting the blood drawn – all in around 45 seconds.

The test came back with normal levels of lactic acid.

I later mused about this whole experience with my wife and how difficult it was the first two times in comparison to the last. “The problem with the first two,” I remarked, “is that they had a very limited goal for their samples: Don’t use the tourniquet because it causes muscle exertion. The last one had a much better and broader goal: Get the blood without causing much muscle exertion. If the first two samples had been done with the broader goal in mind, then maybe they wouldn’t have abstained from using a tourniquet.”

And like many things, I realized that this notion applies just as much to me in the classroom.

When I plan for a school year, especially for a year-long class, I should be setting goals as to what I want students to be able to do at the end of the year, using semesters as a marker for what has been accomplished thus far – a formative assessment. But I didn’t keep larger goals like those in focus when I did my weekly and daily planning, and as a result, I was working to stem the tide for one day or get through a specific piece of material without seeing how I was impacting my students on a larger level. I don’t even know what kind of shape my students this past year left in, whether or not they accomplished the things I had hoped they would. That is a serious problem for me that needs to be remedied.

So when the next school year comes, I need to have goals – and the right ones, not myopic goals that will only get me through this day or this week – and monitor them diligently, changing my instruction as necessary to make the goals work.

Otherwise, I might just be stabbing away for nothing.

*I first typed in “miniscule” without any thought to the spelling, but my in-browser spellchecker said that was wrong. Turns out that we were both right, and I didn’t even realize there was any controversy over the spelling. Nice to learn something you never set out to learn.

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