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CostaRica-1-325I recently returned from a week in Costa Rica, and I brought home some eye-opening knowledge about this Central American wonderland that I want to share.

Much of our time in Costa Rica was spent exploring with guides, who told us beautiful stories about themselves, their families, their work and their country. As a pediatrician and mom, visiting this eco-conscious paradise was fascinating. Here are some facts I learned and observations I made throughout our journey:

  • Over 25 percent of Costa Rica is protected as either a national park or wildlife preserve, which is more than any country in the world.
  • Costa Rica is home to more than 10 percent of the world's butterflies, 34,000 insects and thousands of bird and plant species. Everywhere you look and listen, you find nature blazing in all its glory. One man we met said, "We are not wealthy, but we are rich in volcanoes, birds, flowers and happiness."
  • Health care and college tuition are free to all residents.
  • Attending medical school is also free, so long as the physicians who earn degrees remain in Costa Rica to work.
  • Families with children who are too poor to have a home are provided one by their government.
  • Costa Rica has no military. It did away with its military in 1949 and, instead, created a civil police force. The government decided to spend more on education, vowing to "create an army of teachers." Costa Rica's literacy rate is 98 percent, one of the highest in the world.
  • Most food is fresh, healthy and cooked by hand, allowing flavors to develop slowly. The supermarkets don't sell many processed foods (aside from some sugary cereals) and fast food doesn't exist in Costa Rica like it does in America.
  • Cell phones are a rare sight. As we drove through the towns, we mostly saw kids playing outside, adults sitting and talking on their porches, and people working and laughing together. During the week, my cell phone didn't work. That was strange for about a day; but afterwards, it felt incredibly freeing.
  • Costa Rican people spend a lot of time together; generations of families often live together and spend much of their time talking, working and doing crafts that are handed down from one generation to the next.
  • The average life expectancy in Costa Rica is close to 80 years.
  • Costa Ricans are proud of being happy. Their saying "Pura Vida" was explained to me as having many meanings, including happy life, pure life, simple life, and is used in place of "hello," "goodbye," and as a motto that summarizes their people's outlook. Costa Rica is considered one of the happiest countries in the world, mostly because the people who live there don't stress about things the way most foreigners do. Our tour guide said, "We live simply and happily, and we just help each other."

During my time in Costa Rica, I was able to slow down, unplug from the hectic world, engage deeply with people, appreciate this beautiful planet and become re-energized with the joy of being happy and content.

We may be rich in America, but there's a lot we seem to have lost-like how to be happy inside ourselves, how to share happiness unconditionally with others, how to take care of each other and how to live healthy. I hope to take forward with me the "Pura Vida" that I learned from the people of Costa Rica and find ways to express it daily, in my life and in my community.

A young man named Raphael demonstrates how he makes clay and hand-sculpts it into vases

We spotted a 10-foot-long crocodile near our boat during a tour of Palo Verde National Park

Lunch at Nogui's in Tamarindo

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Flu-Vaccination-325As influenza season rolls into its fourth month, we at Eugene Pediatric Associates are working hard to get the children in our practice vaccinated.

During the third week of December, about 4 percent of visits to the emergency room were for flu-like symptoms, and a little over a third of those patients tested positive for influenza, according to the Oregon Health Authority. During the same week, 123 people in Oregon were hospitalized with influenza—so far, no deaths have been reported in our state.

In 1918, medicine was vastly different than today. The "germ theory" of disease was slowly replacing the idea that illnesses were caused by miasmas, or "bad air," and bloodletting was widely employed. Antibiotics did not exist, and children routinely died of scarlet fever (strep throat) or whooping cough.

At the same time, one of the lesser-feared illnesses, influenza (or "La gripe") caused a severe pandemic that killed over one-fifth of the world's population. Imagine the Ebola virus moving across the country in waves, leaving death and devastation in its wake. This is what influenza did in 1918. Victims of this deadly virus died rapidly. In addition to the usual vulnerable populations of the elderly and very young, a large number of healthy adults died, likely because they lacked immunity to this deadly strain of "Spanish Flu." To this day, we don't fully know why this flu was so deadly, nor if as lethal a strain is likely to reoccur.

Influenza is different from most other viruses because it is constantly changing. Two proteins on the outer surface of the virus, neuraminidase and hemagglutinin, are continually restructured, which is why we don't have a single, permanent vaccine for the virus.

Each year, the influenza vaccine is altered to match what is predicted to be the current year's circulating strain of virus. It is a bit of a medical game of chess—vaccine creators vs. the virus—each trying to stay one step ahead of each other.

Today's flu shot misconceptions
It's a pity that the flu shot is one of the less popular vaccines. The CDC estimates that influenza kills an average of 34,000 people and more than 200,000 are hospitalized, yet people don't worry much about the flu. Some people decline the vaccine, because they believe they will catch the flu from the shot, but that's a fallacy. After the influenza virus is grown, it is then killed/inactivated, so it is no longer alive and cannot cause any sort of infection.

Some think it is OK to skip the vaccine because they have heard that the current vaccine does not match the circulating strains and, thus, would be ineffective. Unfortunately, we really don't know how good the match is until after the fact, when the data about circulating viral strains can be reviewed.

Don't wait, vaccinate
The most compelling reason to vaccinate has as much to do with protecting your own health as it does with safeguarding your healthy 6-year-old or his or her classmate who is getting chemotherapy for leukemia, or the newborn baby cousin that they love to cuddle, or Great Grandma when they sit on her lap. Vaccinations protect more than just the child or adult receiving the shot.

Please contact us at Eugene Pediatrics to schedule a flu shot for your child. And be sure to get one for yourself, too. It's not too late, and it can help protect your family and our community.


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Posted by on in News
Last dinner together before Jack starts college
I am the mother of a college student. It's still hard to believe, even after flying nearly 3,000 miles across the country last week with my oldest son, Jack, to get him settled on the University of Virginia campus.

While this is a huge transition in both our lives, we experienced some really special moments on campus. In the aftermath of recent violence, the residents of Charlottesville and UVA students have come together in overwhelming numbers to show their solidarity for peace and their belief in the integrity of all people.

The same students who locked arms in concentric circles to protect the statue of Thomas Jefferson from a crowd of screaming, Tiki torch-bearing hooligans now hold signs declaring, "NO HOME FOR HATE HERE," and are wearing T-shirts emblazoned with "Not at my UVA." Candlelight vigils and school-wide meetings to discuss diversity, sexual assault prevention and the school-wide honor code are giving students some very clear messages about life on this college campus. As a mom, I was grateful to see that.

On this trip, I was reminded once again that starting college is an abrupt end to childhood and the comfortable routines of home. As Jack quipped, "There's nothing like dorm life to remind you to be grateful for the little things"—like private bathrooms with doors that lock, two-ply toilet paper, your comfy mattress back home and Mom's cooking.

As we walked around campus, and especially on the night of the Fall Convocation ceremony attended by 3,600 freshmen, I remembered that special kind of energy and atmosphere that exists in college but not in other phases of life. And I'm excited that Jack will get to experience that feeling in this chapter of his life.

After helping Jack settle in, the plane ride home wasn't easy. I was hit with the acute awareness that I have passed yet another phase of parenthood. First, there was the baby phase with what seemed like endless nights of nursing and diaper changes. Then came the elementary school phase with sweet, little voices singing during holiday programs and precious works of art covering the refrigerator. Soon after, it was violin practice, homework, school science projects and snacks for late-night study sessions.

The moments I may have taken for granted at the time are so precious to me now. Every single minute with my son holds an important place in my life. It's been a wonderful, wild ride for 18 years, and I pray both Jack and I will have many more meaningful and fun years and moments ahead.

I know one thing for sure—parenthood is a huge, joyful, emotionally hard-at-times, heart-tugging adventure. And I wouldn't trade it for the world.


The UVA Convocation for freshman on the Lawn

Last pieces of motherly advice sealed with a hug


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Posted by on in News
Baby-Food-325Questions are being posed about the manufacturing processes involved in baby food after a consumer watchdog group found detectable levels of lead in 20 percent of the food samples it analyzed.

The Environmental Defense Fund (EDF) studied data from the Food and Drug Administration's 2003-13 Total Diet Study data, which tracks nutrients, pesticides and metals.

Here's what it found:

  • Lead was present in 20 percent of the 2,164 baby food samples and 14 percent of the 10,064 other food samples.
  • Among the 57 types of baby food analyzed, 52 had lead in at least one sample. Specific brands were not identified.
  • The biggest offenders were fruit juice, with lead found in 89 percent of grape juice, 67 percent of mixed fruit juice, 55 percent of apple juice and 45 percent of pear juice samples.
  • Among other baby food types, root vegetables had lead in 65 percent of samples and baby food carrots had lead more often than regular carrots.
  • Lead was also found in 47 percent of crackers and cookies and 4 percent of cereals.

The EDF is calling on federal authorities and manufacturers to investigate how the lead is getting into the food.

The American Academy of Pediatrics (AAP) was quick to respond to the findings, saying: "Lead exposure has been associated with health, learning and behavior problems, and no amount is considered safe." The AAP encourages parents to consult with their pediatrician to better understand this issue and learn ways to limit their children's exposure to lead.

My advice to parents, based on these concerning findings is to:

  • Eliminate or severely limit juice for babies.
  • Prepare as much of your own baby food as possible. Most parents use at least some jarred baby food (as did I during some of these ten years that were studied), but this data may encourage parents to prepare more meals for their baby from fresh foods.

I have checked lead levels in thousands of children over the 25 years I've been in pediatric practice, and only on a few occasions have I found an elevated level. If you are concerned about lead and would like your child's levels checked, it requires drawing their blood. You can request we do that at your next office visit or well-check.

Tagged in: Baby Food
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IMG 0652-325My oldest child just graduated from high school. As he donned his cap and gown and accepted his diploma, the realization hit me like a brick. He's really growing up—and I'm not ready.

Parenthood is tricky. When our kids are babies, we are acutely aware that their lives depend on us. In every sense, we are responsible for their survival; we feed them, clothe them and remind them not to play in the street.

As our children grow, we teach them important life lessons, proudly taking in all their accomplishments and feeling empathy when they struggle or fall short of their own expectations and, perhaps, ours.

What we often fail to realize is that our children's victories are not ours, and their failures are not ours either; our children are their own people from the day they are born. As parents, we can guide them, but ultimately the path our kids take comes from their own decisions and hard work.

At some point in the teen years, we are supposed to magically know when and how to release some control over our kids' lives. We let them drive cars, stay out past dark and date. And yet, parents like me forget to also do one key thing—we forget to recognize that all of this means our children will soon leave the nest. And we don't prepare ourselves for that day. As a pediatrician, I advise parents on this very topic, but I forgot to listen to my own advice.

I'm now trying to come to terms with this as I reflect on eighteen wonderful years of memories with my son. I am remembering thousands of hours spent with Jack practicing violin, learning his multiplication tables, going to the zoo and celebrating birthdays at Lone Pine Farms with his classmates. I smile at the memory of reading bedtime stories and holding him in my arms when he needed extra hugs. And I'm reminded of the fact that inside that young man, who now towers nine inches above me, is still the boy who will always need his mom. It's that thought that comforts me and makes the next chapter of our lives not seem so scary.

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