Dreams

Peace1I dream of a world where we all live together in peace, and each person is treated with equal respect and dignity.

I dream we all treat each other with respect, knowing we are all more alike than different.

I dream that every parent be loving and nurturing with their children, guiding them with love and respect. They too are trying to figure out this life journey thing.

I dream of a world where no person goes hungry, and the food we eat is free of toxins.

I dream of government and businesses that is guided by principles of doing what is best for everyone, with open books and disclosed conflicts of interest.

I dream of vaccines that are safe without toxic aluminum as the adjuvant, and that are tested for long-term safety.

I dream of a people who are living and learning the truth, not the distorted facts and “truths” that are intended to mislead.

Imagine

by John Lennon

Imagine there’s no heaven
It’s easy if you try
No hell below us
Above us only sky
Imagine all the people
Living for today…

Imagine there’s no countries
It isn’t hard to do
Nothing to kill or die for
And no religion too
Imagine all the people
Living life in peace…

You may say I’m a dreamer
But I’m not the only one
I hope someday you’ll join us
And the world will be as one

Imagine no possessions
I wonder if you can
No need for greed or hunger
A brotherhood of man
Imagine all the people
Sharing all the world…

You may say I’m a dreamer
But I’m not the only one
I hope someday you’ll join us
And the world will live as one

Dr Paul

What would a family health center look like?

appleI have often wished I could be the doctor for the whole family. The old-fashioned family doctor. In my Integrative Medicine training, I became board certified in Integrative and Holistic medicine that was for all ages. While heart disease and cancer are leading killers of the elderly, and there is a growing percentage with Alzheimer’s and Diabetes, it is obesity and hormone imbalances, nutritional deficiencies, and toxin/stress-driven health issues that most need our attention.

What if we developed a health center where the real important health and wellness issues were elevated to the top priority? What would that look like? How can we create a clinic that supports this transformation affordably and within the context of the current insurance industry? Can we create virtual support groups to assist us in staying accountable to our goals of exercise, good nutrition and reduced stress life-styles?

Until this utopia health and wellness center is your reality, I recommend the following:

1. Start exercising 20-30 minutes daily.

2. Eat organic and cut out the sugar/sweets and processed flour/ foods.

3. If you have an addiction – get help (counseling, 12-step, honesty).

4. Get your hormones checked (Vit D 3 , TSH, free T3, free T4, and for older adults– testosterone (free and total), and for ladies add estradiol, progesterone).

5. Take Vitamin D3, a multivitamin, and omega -3 supplement.

6. Get enough sleep. Adults absolute minimum 7 hours – ideal 8 – 9 hours.

7. Consider testing food sensitivities and micronutrient testing.

8. Reduce stress. There may be something you need to say “no” to.

9. Interact more with people you love – build and broaden your community.

Dr Paul

MMR Vaccine- New Recommendations

aap-logoThe American Academy of Pediatrics(AAP) is publishing these new ACIP recommendations on measles vaccination.

Two things stand out to me:

1. They are acknowledging that a blood test for IGG against measles is the best way to show immunity (not history of having had measles). Since in my practice we get these levels around age 5 or 6 years instead of a second MMR, I feel that our approach at Integrative Pediatrics is absolutely the best approach.

2. In the event of a measles exposure, they outline how this can be managed with immune globulin. Supplies would obviously go to the high risk individuals first, but there is a mechanism to treat after exposure. Since measles prevalence is so low in the USA (about 1/ million), our approach of waiting until at least 3 years of age to allow better brain development seems to be relatively safe.

Remember: The AAP, CDC/ACIP recommended schedule IS the recommended schedule. Information about vaccinating differently is provided to share what I might do if it were my child and to give insight and options to parents who are not willing to vaccinate according to the full recommended schedule.

Dr Paul

Below, you will find the article. This article comes from the AAPNews Website, and can be viewed here.

Recommendations for MMR vaccine updated
Jane F. Seward, M.B.B.S., M.P.H., FAAP

The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention voted unanimously in October to approve changes to its recommendations for the measles-mumps-rubella (MMR) vaccine. The changes focus on evidence of immunity to measles and mumps, vaccination of HIV-infected people, and use of immune globulin (IG) for measles post-exposure prophylaxis.

FromAAParticleOnMMRVaccine

The provisional ACIP recommendations will be available at www.cdc.gov/vaccines/recs/provisional/default.htm#acip.

 

Evidence of immunity

The criteria for evidence of immunity to measles and mumps for children and adults include the following changes:

  • Documentation of physician-diagnosed measles or mumps no longer is acceptable presumptive evidence of immunity.

  • Laboratory confirmation of measles or mumps is acceptable presumptive evidence of immunity.

Vaccination of HIV-infected people

The recommendations for vaccination of HIV-infected people were revised to simplify language (remove symptomatic and asymptomatic), to recommend that the second dose of MMR vaccine be given routinely at 4 to 6 years of age, and to recommend re-vaccination of children who got MMR vaccine before effective antiretroviral therapy (ART) was established.

  • Two doses of MMR vaccine should be given to HIV-infected people ages 12 months and older who do not have evidence of current severe immunosuppression. Absence of severe immunosuppression is defined as CD4 percentages ≥15% for six months or longer for children ages 5 years and younger, and CD4 percentages ≥15% and CD4 count ≥200 cells/mm3 for six months or longer for those older than 5 years of age, or other current evidence of measles, rubella and mumps immunity.

  • The first dose should be administered at 12 through 15 months and the second dose at 4 through 6 years, or as early as 28 days after the first dose.

  • People with perinatal HIV infection who were vaccinated prior to establishment of effective ART should receive two appropriately spaced doses of MMR vaccine once effective ART has been established unless they have other acceptable current evidence of measles, rubella and mumps immunity. Establishment of effective ART is defined as receiving ART for six months or longer in combination with CD4 percentages ≥15% for six months or longer for children ages 5 years and younger, and CD4 percentages ≥15% and CD4 count ≥200 cells/mm3 for six months or longer for those older than 5 years.

IG for post-exposure prophylaxis

The recommendations for the use of immunoglobulin products for measles post-exposure prophylaxis were revised as follows:

  • Infants younger than 12 months who have been exposed to measles should receive 0.5 mL/kg of body weight of IG given intramuscularly (IGIM) (maximum dose = 15 mL).

  • Pregnant women without evidence of immunity to measles who are exposed to someone with the disease should receive 400 mg/kg of IG given intravenously (IGIV).

  • Severely immunocompromised people exposed to someone with measles should receive 400 mg/kg of IGIV.

  • IGIM (0.5 mL/kg of body weight; maximum dose = 15 mL) can be given to other people who do not have evidence of immunity to measles. However, priority should be given to people exposed in settings with intense, prolonged close contact, such as in a household, child care setting or classroom.

These revised doses of immunoglobulin for measles post-exposure prophylaxis have been increased from previous recommendations due to a recognition that measles antibody levels have declined over recent years. This is likely due to a much higher proportion of donors with vaccine-only associated measles immunity.

The fully revised and updated ACIP recommendations for MMR vaccine will be published in Morbidity and Mortality Weekly Report in 2013. These recommendations will replace the 1998 ACIP recommendations and those that came out after 1998.

 

Dr. Seward is a CDC liaison to the AAP Committee on Infectious Diseases and acting associate director for epidemiological science, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention.

Febrile Seizures

A seizure typically involves rigid repetative movements. Febrile seizures occur only between 6 months and 6 years, are symetrical, and like all seizures, includes a postictal phase (your child is extra sleepy or tired) with no other cause for the seizure. Be calm, this is not a dangerous situation. For children who have febrile seizures, you will want to bring your child in to see the doctor sooner each time they have an illness that is associated with fever. You also want to avoid letting that child have high temperatures. You would treat any fever over 100 to 101 (38-39 C) with ibuprofen (if your child is older than 6 months). If your child had an ear infection, UTI, strep throat or bacterial pneumonia and a history of febrile seizures, we would treat with antibiotics to shorten the course of the illness and the amount of time they are at risk for a febrile seizure.

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