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Berkeley, CA

510-325-4785

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Measles: what you should know (GetzWell Pediatrics)

Angie Needels

GetzWellLogo.gif
 

Whole Kid Newsletter

February 13, 2015 - Brought to you by GetzWell Pediatrics (www.getzwell.com)

Measles: what you should know

In light of the recent measles outbreak this winter, we have been fielding many questions from our families. In this summary, we hope to address some common questions and concerns about the disease in order to help you make informed decisions surrounding vaccination, prevention and treatment for your family.

As of February 10th, there have been a total of 121 cases confirmed in 17 states and Washington DC, with the majority being in California, and we are aware of at least one confirmed case in San Francisco this week. At this rate, the number of cases will easily surpass the 644 cases in 2014—the greatest number of cases since the disease was nearly eradicated in the early 2000s. Some of this year’s cases can be traced to exposure at Disneyland, while others are seemingly not linked.

An Overview

Measles is an extremely contagious, airborne viral infection that produces flu-like symptoms and a red rash all over the body. It is commonly spread by coughing and sneezing but can survive in the air for up to 2 hours after its host has left the area. Measles multiplies rapidly in the nasal cavity and then spreads to the lymphatic system, respiratory tract, and other organ systems. Symptoms usually appear 10-12 days after exposure, well after the virus is contagious, meaning that an exposed individual can spread the disease before they experience any symptoms. The virus can be killed by heat, light, and solvents so preventive measures can be effective especially if you suspect exposure. Nasal irrigation with a solution like Xlear can help flush out the virus before it spreads beyond the nasal cavity. Sanitization of surfaces and hand washing can help reduce the potential for exposure.

Rate of Infection

Despite the relative ease of killing the virus, its rapid proliferation makes rates of infection high. A person is contagious as soon as they are infected, for days before symptoms begin and for days after a rash develops. The likelihood of an unvaccinated person becoming infected after exposure is over 90% on average, and 94% for unvaccinated children ages 1- 4.

Symptoms

Initial symptoms are similar to influenza, and may include a fever of up to 105F, runny nose, cough, and pinkeye. One significant differentiating symptom is the brief appearance of white spots (called “Koplik spots”) inside the cheek during the early onset of measles. Following respiratory symptoms and Koplik spots, a red blotchy rash typically appears—first on the face, then spreading downward over the body. Unfortunately, because Koplik spots appear only briefly during early onset of measles, this symptom has often passed by the time a patient presents to their doctor.

Complications

Complications are greater among children under 5 and adults over 20, as well as those with nutritional deficiencies and individuals with weakened immune systems.

Common complications of measles include diarrhea, ear infection, and pneumonia. A less common but severe complication is brain infection, called encephalitis, which occurs in about 1 per 1000 cases. Encephalitis carries a 15% mortality rate and a 25% prevalence of lasting neurological damage.  As pediatricians, this is a risk that we worry about especially for unvaccinated children.  Very rarely, a fatal degenerative neurological condition known as SSPE may present up to a decade after apparent full recovery. This condition presents in about 1 per 100,000 measles cases, but always results in death.

Overall mortality for measles is 1-2 per 1000 cases, with the proportion being higher among young children. The risk is higher for infants under 1 year for whom the measles vaccine is not recommended except for short-term protection while traveling to high-risk areas, or in the event of an epidemic, which has not been declared in California. These very young children must rely on “herd immunity” to avoid infection, as their developing systems are less likely to respond to the vaccine.  Most experts say that herd immunity depends on a vaccination rate of 95%.   Our understanding is that the measles vaccination rate in the San Francisco Bay Area is currently around 91%.

MMR Vaccine

Among confirmed cases of measles in California, fewer than 2% were vaccinated against the disease.

MMR (measles-mumps-rubella) is the vaccine used to prevent measles infection. It is a live virus that creates a mild infection to elicit an immune response. The first dose is typically given at 12 to 18 months of age, with about 95-98% of these children developing protective antibodies. A second dose is given to ensure that those remaining 2-5% also develop immunity. This second round is typically given at 4 years but can be administered as early as 4 weeks after the first. An alternative to receiving both rounds of the vaccine is to draw titers (bloodwork to check for antibodies) to confirm immunity from the first vaccine.

Because MMR is a live virus, certain populations are not able to receive it and must rely on others’ immunity to be protected. This includes babies under 6 months, pregnant women, and immunocompromised individuals. Those with severe allergic reactions to certain components of the vaccine should also avoid MMR, though this is rare. MMR is considered safe for people with egg allergies.

Very rarely, the MMR vaccine may trigger an autoimmune reaction that causes brain inflammation, though this occurs less frequently than with the measles virus itself. Individuals with autoimmune disorders seem to be more susceptible to this complication. As noted above, compromised immunity is one of a few contraindications to receiving MMR.

So while we cannot say that MMR carries zero risk, we do know that the risk of developing serious complications like SSPE is many times higher among individuals who contract the measles virus compared to those who receive the vaccine (1 in 100,000 vs.1 in 1 million).

Prevention & Treatment

Vaccination at 12-15 months provides the most certain protection against the virus. Vaccination within 72 hours of exposure has been shown to prevent the disease in previously unprotected individuals.  Unvaccinated adults who are around young children should consider vaccination. 

In the event of infection, a high dose regimen of vitamin A may reduce risk of complications. The regimen is recommended by the World Health Organization for all children with measles. While there is a risk of toxicity with high dosing of vitamin A, this short-term protocol may help diminish adverse complications with relatively low risk of toxicity:

Administer once per day for two days…

• 50,000 IU for infants under 6 mos.

• 100,000 IU for infants 6-11 mos.

• 200,000 IU for children 12 mos. +

To boost the immune system and reduce the possibility of infection, maintain sufficient levels of vitamin D throughout the winter and be sure to eat plenty of vegetables and keep sugar intake to a minimum. Here are our tips on staying generally healthy through the winter months: Eat a Rainbow

Try to avoid fever reducers such as Tylenol and Motrin, which may actually worsen the severity of measles by tempering the body’s natural response to fighting infection. Reserve these for when discomfort from fever prevents adequate hydration and sleep, which are vital for recovery.

Please don’t hesitate to contact us for a custom consultation to further discuss measles and the MMR vaccine.

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© 2015 GetzWell Pediatrics, 1701 Church St. San Francisco, CA 94131

Kid Friendly Nourishing Savory Snacks - Part 1

Angie Needels

Want to offer your kids more healthy snack options that are easy to grab and go and will support their development, learning, play, immune and sleep? 

All of these snacks are based on a traditional way of eating, so they are either pastured, raw, cultured/fermented, and/or have healthy fats and proteins in them to bring in lots of great nutrients that will aid in keeping your child(ren) healthy and ready for another day. Many of these snacks can easily be made at home, bought in stores or online.

Please always consider the highest quality organic or pastured (no herbicides, pesticides, growth hormones or GMOs) foods for your family as an investment in your health. Reference our Traditional Foods on a Budget post to find out plenty of ways to make eating high quality whole foods easier on your pocketbook.

Stay tuned for upcoming posts with more snack ideas and simple recipes.
Next post = Kid Friendly Nourishing Beverages & Sweet Snacks... yum!

Want more ideas? Got Questions? Let me know!

SAVORY SNACK IDEAS

beef jerky / beef sticks
turkey jerky
salmon jerky, cured lox, or smoked salmon chunks
shrimp bites / niboshi (tiny dried sardines or anchovies)
hot dog bites

mini meatballs (beef, pork, lamb, turkey, chicken or mixed) with organ meats and veggies
chicken / turkey tenders with nut crust
sausage bites
liver pate on cucumber slices and other charcuterie
crispy chicken skins or pork rinds
bacon chips, salami chips, and prosciutto chips
roasted or cured sliced meats (roast beef, turkey, chicken, salami, etc.)
meat and cream cheese 'rolls'                                                                                                      
soft, hard or deviled pastured eggs
frittata bites or mini egg/cheese/meat muffins
parmesan chips "frico" (recipe below)
homemade savory crackers made with herbs, nuts, seeds, and cheeses
sprouted nuts and seeds / trail mix
veggie crudite (cut carrots, radish, snap peas, celery, etc.) with nut/seed butters, dips
sun-dried tomatoes
avocado
lacto-fermented dill pickle ‘sticks/chips’
olives (fresh or dried)
seaweed 
nori sheets /seaweed roll-ups
dried veggies chips (plantain, kale, brussel sprout, sweet potato, beet, mushroom)
teff injera bread 'chips'
popcorn with butter or coconut oil
pao de quejio (Brazilian cheese bread)
kabalagala (
plantain fritters)

Links for sourcing:
First check your local farmer's market. Many vendors make the markets diverse in ingredients and are conveniently in your neighborhood. For example...
HERE is the Berkeley Farmer's Market Vendor Directory. 
HERE you can find the closest Farmer's Market in your neck of the woods.

Vital Choice = seafood
US Wellness Meats = beef sticks, pork rinds
Grass-fed Beef Crisps / Jerky Chews / Caveman Fuel = jerky
Epic Bars = pemmican style snack bars
BackyardCSA = weekly traditional foods grocery with a variety to choose from
The Local Butcher Shop (Berkeley) = jerky, meat sticks and lots of charcuterie
Tara Firma Farms = (SF Bay Area) sliced deli meats
Thistle Meats = (Petaluma) sliced deli meats, pate
Sonoma County Meat Co.  = (Santa Rosa) meat

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RECIPE                                                                              

Savory Parmesan Chips (Frico)

1 cup parmesan cheese, grated
1 teaspoon sea salt
2 Tablespoons of fresh herbs (optional)
2 Tablespoons sesame seeds (optional)

Preheat oven to 300 degrees.

(optional) Toast sesame seeds in small skillet over medium heat, tossing continually until lightly browned.

Toss all ingredients in a small bowl. Make small clumps (approximately 1-2" in diameter) on a parchment lined baking sheet. Bake for approximately 8-12 minutes or until golden brown. Remove from heat and allow to cool completely. They will be crisp once cooled. 

Enjoy as crackers or chips. 

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From the Old Ways,
Primal Mama
primalmama@mamakai.org

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Thanks to Nom Nom Paleo for a super fabulous kid friendly snack foods image! We heart you!

Traditional Food on a Budget

Angie Needels

 

It can seem expensive initially when making the change to eating healthy, pure foods. However, there really are ways it can be done more economically and I'm happy to share a few things that have worked well for me and my family.

Consider eating whole foods as an investment in your health. By eating well and supporting your health, you'll have less out-of-pocket expenses on doctor's visits, missed days at work and expensive medications or supplements.

  1. Remember that you will be saving money on processed stuff you won’t be buying anymore! This is huge when you think about how much sugary boxed cereals cost, how quickly you can go through money on eating out/fast food and how expensive other packaged foods are.
  2. Meal planning. Try to sit down once a week and get a general plan for what you’ll be making for meals, then make a grocery list. If you have a thorough list, it really does cut down on the impulse buys and your time.
  3. Make foods at home. Homemade items like breads, crackers, creme fraiche/sour cream, yogurt, pickles, sauerkraut, salad dressings, condiments, soups, casseroles and snacks can be much cheaper made at home.
  4. Keep your kitchen well stocked and organized. Have extra staples on hand, so you don't have to do last minute trips to the store or pay high prices at the 'corner store'. You can keep a 'cabinet and/or freezer inventory list' on your fridge telling you what you have on hand. It may cost more in the beginning to do this; however, it will save you considerably over time.
  5. Shop at the farmer's markets. Decreasing the distance from the food source to your table, is not only more beneficial for our bodies and for our environment, it is easier on the budget by cutting out the middle man and the cost of fuel. Also, you can give yourself a budget to stick within much easier when shopping at the farmer's market. Simply allot an amount of cash you can spend and when your pocket is empty, pack up and go home. If you want even further discounts on produce, shop toward the end of the day at the farmer's market and many farmers will reduce their prices so they don't have to take their goods back to the farm. *** NOTE *** If you use food stamps or EBT for buying your foods, many farmers markets will accept those as payment now. In Berkeley they also have an amazing program called Market Match where you'll get extra free dollars to spend on produce if you use your EBT there.
  6. Buy in bulk and/or join a local co-op, buying club or CSA (Community Supported Agriculture). When you buy yourself or split orders with friends, you can take advantage of deeper savings in buying in bulk and larger quantities. This can include butchered pasture raised meats, fats and oils, dried pantry goods and spices, fresh produce for drying, canning or freezing, supplements and so much more. Check out: Azure Standard and even CostCo is carrying organic products. We'll be adding a Sourcing Page to MamaKai's Wellness Resource Library in the near future, so please check back soon to find loads of great places to buy high quality ingredients.
  7. Plant a garden. Gardening is very affordable when done from starter plants and even more so when starting from seeds. Even those of you with limited space can have container gardens or fresh herb planters and subsidize your overall food costs. Take pleasure in watching your food grow right before your eyes and pick/eat it when its perfectly ripe for maximum nutrition.
  8. Buy whole foods when on sale, discounted or with coupons. Plan your meals around what whole foods are on sale. Certain stores have specific days/times when things might be on sale, ask your preferred grocers and they'll let you know their schedule. There are plenty of recipe apps, magazines and websites that you can search to find new recipes to make with the ingredients that you find on sale. Crop Mobster is a listserve which alerts you when farmer's have an abundance of produce that they need to sell quickly at discounted prices.
  9. Buy the inexpensive cuts. When buying meats, buy and use more of the cheaper cuts like ground, stew meat, shoulder cuts, roasts, shanks, organs, bone-in and sausages. Because these generally have more fats, cartilage, bones and marrow and take longer to cook they are actually going to be healthier. They'll have a wider make-up of nutrients and those nutrients will be more accessible through slow cooking techniques. Not to mention they'll be much more flavorful and comforting to eat. 
  10. Buy whole pieces of meat. A whole chicken or duck is much cheaper by the pound than the sum of it's parts. You can roast it whole to serve for a couple meals or take off the bone and add to soup or make a chicken salad. You can save all bones, skin and cartilage for making nutrient-dense broths.  
  11. Buy in Season. Out of season produce is more expensive because it is being shipped from other places. If there are things you might like to have on hand throughout the whole year, buy them in bulk when they are in season and either dry, freeze or can them for later use. Farmers have special pricing for full flats or if you buy a pound/s of a particular item.
  12. Make your own bone broths and include them in your cooking. Bone broths are very economical to make. Save bones, skin and cartilage from meat or ask for knuckle, neck, or shank/marrow bones from your butcher. Instead of buying broths that are laden with MSG and other substances to make it taste like broth, Nourishing broths are deeply healing and will make every dish (soup, stew, sauce, gravy or cooked grain) taste rich and comforting.
  13. Make meals in large batches and freeze leftovers. You can make a double batch of any dish you make. So if you're roasting a whole chicken for dinner, roast two instead. Eat one for dinner and save the other for another night. Or you can pick a day a month to make several dishes in large quantity. Package meals in single serving containers for lunches or quick dinners. Simply label the dish name, date, freeze it and thaw it later to balance with side dishes. 
  14. Eat out less. You can buy several meals at home for the price of one at a restaurant. When you make meals at home, you also know all of the ingredients that are used, that they are safe and healing for you and your family's health. Pay less and get so much more!  
  15. Pack your bag with snacks. Take a few minutes before you leave the house to pack a drink and a few nutrient-dense snacks to take wherever you go. This will help you avoid buying fast food or snacks from vending machines that not only add up in costs but are detrimental to your health.
  16. Pack or plan food for trips. By car, take a cooler and have lunch on a picnic table or in a park. By plane, bring non liquid foods like canned fish, beef jerky, cheese, cured meat, dried fruit, sprouted nuts/seeds, homemade crackers. Also save money by staying in a place with a kitchen & shop at local markets, AirBnB makes it easy to do this all over the world. Check out Local Harvest and the Eat Well Guide for more food resources at your destination spot.
  17. Eat a few balanced 'vegetarian' meals a week. Use plant or dairy 'proteins' and healthy fats by incorporating cheeses, yogurt, soaked/sprouted gluten-free grains, bone broth, lard, tallow, coconut oil and nuts/seeds in your meals. You can have very nutrient-dense options for considerably less. Our ancestors didn't eat meat everyday, so maybe we shouldn't either.
  18. Do the best you can and don't stress about it. Make the best food choices with the resources you have. If you can’t afford all organic or pastured meats all the time, make it a goal to add more in when your budget allows.

From the old ways,
Primal Mama

primalmama@mamakai.org

No More Sugar Blues - Starting the Year with a Sugar Detox

Angie Needels

It’s that time of year and many of you probably have some sort of exercise regimen, weight loss program or cleanse at the top of your New Year’s Resolution List. A sort of "hit the reset button" right? 

After the holidays and maybe indulging in sweet treats at work, holiday parties or family dinners, it's time for us to recalibrate our sweet tooth.

Let's do a little sugar detox. This can help increase all of our health goals for the new year.

It’s important to give our bodies a break from sugar and an over abundance of carbohydrates. Too many carbohydrates in our diet are directly linked to fatigue, blood sugar issues, weight issues, brain fog, energy highs and crashes and much more.

In the old days, eating desserts or sugary snacks were a rare treat. Anything sweet that was eaten was from nature and coming with all the necessary components to digest and integrate the minimal carbohydrates in the most optimal way. However, in today's society we've come to expect sweet in our everyday life. By eliminating sugars even for a few weeks, your body can break this addictive cycle.

There are many ways to detox and reset your sweet cravings, here are couple:

2 Week Sugar Elimination - Remove all flours, sugars or sweeteners, including sugar substitutes and even natural sweeteners

Paleo Style Elimination Diet - Remove the above ingredients in the 2 Week Sugar Elimination as well as coffee, grains, beans/legumes, dairy, alcohol, and chocolate. So you're asking... "What the heck can I eat?" - Check out the Paleo dietary guidelines and meal plan generator in the link - http://paleologix.com/about/dietary-guidelines/

When eliminating sugars and carbohydrate rich foods from your diet, you force your body to use fats as a more sustainable source of fuel. Fats contain 9 calories versus the 4 in carbs. You'll find that your energy level is more sustained throughout the day, you have less crashes and a need for a sweet treat or cup of coffee in the afternoon. And not to mention you're body will start to burn the fats that you already have in your body, trimming you up and showing more of your natural muscle tone.

Below are links for more support. Feel free to email me if you've got questions along the way.

21 Day Sugar Detox - http://21daysugardetox.com/

Whole 30 Program - http://whole30.com/whole30-program-rules/              

Whichever detox you choose, keep in mind that it may be rough the first few days. Sugar withdrawals are similar to the addictive nature of kicking a drug habit. Some of these symptoms include headaches, fatigue, cranky-ness, and digestive issues. Please be sure to take things slow and consider working with a health care provider if you have other health issues.

These detoxes are ideal as they are not depriving your body along the way like some cleanses do. These detoxes are very nourishing and re-building.

To support your body during this detox, consider: getting more sleep, supplementing with high quality liquid B Vitamins, cod liver oil/salmon oil, and minerals.

Happy detoxing and starting your new year off with no more sugar blues!

From the old ways,
Primal Mama
primalmama@mamakai.org

URGENT Fukushima Petition

Angie Needels

Hello Friends, Please join me in signing a petition to the United Nations secretary, Ban Ki-Moon, to closely monitor and bring in international experts to help the Japanese government and Tepco decommission the Fukushima nuclear power plant.

The possible consequences of a botched removal job, or a failure of the containment pool are truly frightening. Journalist and activist Harvey Wasserman described it this way:

"The potential radiation releases in this situation can only be described as apocalyptic. The cesium alone would match the fallout of 14,000 Hiroshima bombs. If the job is botched, radiation releases could force the evacuation of all humans from the site, and could cause electronic equipment to fail. Humankind would be forced to stand helplessly by as billions of curies of deadly radiation pour into the air and the ocean."

The United Nations must compel Japan to bring together an international group of scientists and engineers for this job, instead of rushing the job without experts and international oversight.

Click HERE to sign the petition NOW!

Thank you everyone for ensuring our planet and our future are safe without this deadly threat!