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Tips for summertime fun!

Go outside! The warmer months are a wonderful opportunity to explore, play and learn outdoors.

Here are a few tips to stay safe in the sun:

Bright Sun and Healthy Skin
• Keep your skin protected from sun damage to prevent sunburns, skin cancers and wrinkles later in life. Remember that small amounts of sun exposure over time causes most sun damage – It is important to protect yourself every day, not just on long pool days.
• Use sunscreen that is at least SPF 30 or higher, protects from UVA and UVB rays, and is water resistant if you will be spending time in the water. Re-apply every 2 hours and after getting out of the pool!
• Fight heat exhaustion! It can start slowly but become serious quickly.
– Drink plenty of fluids on hot days, especially during time in the sun.
– Be careful about moderate to heavy exercise at midday.
– If overheating, have your child lie down in the shade and seek medical care immediately if concerned.

 

Hiking and Camping
• There is Poison Ivy all around in Eastern Washington and North Idaho. Don’t forget: “leaves of three, let them be”.
• Check for ticks! Lyme disease, which ticks can carry, is not common in Washington. It is still important to examine for ticks and remove them quickly if they are found. Be sure to check behind the ears, scalp, under the arms and groin.
• DEET-containing insect repellent is safe for children older than 2 months old. Use 10-30% and apply one time per day. Do not apply to the face, or to the hands of young children.

 

Water Activities
• Learn about water safety. Swimming is fun and can be a lifelong healthy activity, but it is very important to know how to stay safe around the water. Nearly 1,000 kids drown each year – most in swimming pools.
• Plan to enroll in swimming lessons after the child turns four years old. Even if a child knows how to swim, all children deserve close observation when around water.
• Life vests are very important for kids to wear whenever they are near water.
• Install a fence around a pool if there is one in the home.
• If there is concern for drowning, pull the child out of the water, call for help/911, and if child is not breathing start CPR if you have been trained.

Learn more by asking your pediatrician!

by Marcus Baca, MD – Pediatrician at Valley Clinic

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Autism, what is it?

Autism spectrum disorder (ASD) is a complex developmental disability; signs typically appear during early childhood and affect a person’s ability to communicate, and interact with others. Your Pediatrician can start to recognize these symptoms between 1-2 years old and should be testing for concerns. ASD is defined by a certain set of behaviors and there is a wide spectrum as to how it impacts each child’s life.

There is no known single cause of autism, but increased awareness and early diagnosis/intervention and access to appropriate services/supports lead to significantly improved outcomes.

Many of the early signs of Autism deal with difficulties with social interaction. 

The range and severity of symptoms can vary widely. Common symptoms include:

  • difficulty with communication
  • difficulty with social interactions
  • obsessive interests
  • repetitive behaviors
  • difficulty making eye contact
  • poor motor skills’ and sensory sensitivities (overly sensitive to the feel of clothing or texture of foods).

A person with ASD may follow many of these behaviors or just a few, or many others as well. The diagnosis of autism spectrum disorder is applied based on analysis of all behaviors and their severity and how they impact that child life and learning.

Autism is treatable.

Children do not “outgrow” autism, but studies show that early diagnosis and intervention lead to significantly improved outcomes. For more information on developmental milestones, visit the CDC’s “Know the Signs. Act Early” site.

  • Lack of or delay in spoken language
  • Repetitive use of language and/or motor mannerisms (e.g., hand-flapping, twirling objects)
  • Little or no eye contact
  • Lack of interest in peer relationships
  • Lack of spontaneous or make-believe play
  • Persistent fixation on parts of objects

Early recognition, as well as behavioral, educational, and family therapies may reduce symptoms and support development and learning.

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Chickpea Sunflower Sandwich

Prep Time: 30 minutes

Serves: 3

Ingredients

1 15-ounce can chickpeas, rinsed and drained

1/4 cup roasted unsalted sunflower seeds (if salted, scale back on added salt)

3 Tbsp vegan mayo (sub tahini for a more earthy, nutty flavor)

1/2 tsp dijon or spicy mustard (if using tahini instead of mayo, use 1/4 tsp)

1 Tbsp maple syrup (or sub agave or honey if not vegan)

1/4 cup chopped red onion

2 Tbsp fresh (or 1 Tbsp dried) dill, finely chopped

healthy pinch each salt and pepper (to taste)

4 pieces rustic bread, lightly toasted (gluten-free for GF eaters)

optional: Sliced avocado, onion, tomato, and or lettuce for serving

 

Garlic Herb Sauce (optional)

1/4 cup hummus

juice of 1/2 lemon (~1 Tbsp)

3/4 – 1 tsp dried dill (or sub 2-3 tsp fresh)

2 cloves garlic, minced

Water or unsweetened almond milk to thin

 

Instructions

  1. Prepare garlic herb sauce and set aside.
  2. Add chickpeas to a mixing bowl and lightly mash with a fork for texture. Then add sunflower seeds, mayo, mustard, maple syrup, red onion, dill, salt, and pepper and mix with a spoon. Taste and adjust seasonings as needed.
  3. Toast bread (if desired) and prepare any other sandwich toppings you desire (tomato, onion, lettuce).
  4. Scoop a healthy amount of filling onto two of the pieces of bread, add desired toppings and sauce, and top with other two slices of bread.
  5. Sunflower-chickpea mixture will keep covered in the fridge for up to a few days, making it great for quick weekday lunches!

Nutrition Information (without sauce, bread or toppings)

Serving size: 1/3 of recipe Calories: 311 Fat: 16g Saturated fat: 1.7g Carbohydrates: 26g Sugar: 7.3g Sodium: 107mg Fiber: 9g Protein: 11.5g

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Cucumber, Watermelon and Arugula Salad

Number of Servings: 8

Serving Size: 1 1/4 cups

Yield: 11 cups

Start to Finish: 25 min

 

Ingredients

4 cups chilled seedless watermelon cut into small chunks

4 cups baby arugula

1 medium seedless cucumber, halved lengthwise and thinly sliced

1 cup thinly sliced red onion (1 large)

1/2 cup snipped fresh mint

3 tablespoons white wine vinegar

3 tablespoons olive oil

1/2 teaspoon kosher salt

1/2 teaspoon ground black pepper

1/2 cup crumbled feta cheese (2 ounces)

1/2 cup chopped walnuts, toasted (optional)

Directions

  1. In a large bowl combine watermelon, arugula, cucumber, red onion, and mint. If desired, cover and chill for up to 1 hour.
  2. For vinaigrette, in a screw-top jar combine vinegar, oil, salt, and pepper. Cover and shake well. Pour vinaigrette over watermelon mixture; toss gently to coat. Sprinkle with cheese and walnuts.

Nutrition Facts (per serving): 159 cal., 12 g fat (2 g sat. fat), 6 mg chol., 10 g carb., 209 mg sodium, 2 g fiber, 6 g sugar, 3 g pro.

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Easy Quinoa Salad

yield: serves 4

prep time: 10 minutes

total time: 10 minutes

 

Ingredients

FOR THE DRESSING:

1/4 cup olive oil

1 clove minced garlic

2 tablespoons lemon juice (1 large lemon)

1 tablespoon golden balsamic vinegar or champagne vinegar

1 teaspoon pure maple syrup or honey

Kosher salt and black pepper, to taste

 

FOR THE SALAD:

2 cups cold cooked quinoa

2 cups fresh spinach leaves, chopped

1 cup chopped cucumber

1 cup halved grape or cherry tomatoes

1 large avocado, pitted, peeled, and chopped

2 green onions, sliced

Kosher salt and black pepper, to taste

 

Directions

First, make the dressing. In a small bowl or jar, whisk together the olive oil, garlic, lemon juice, vinegar, maple syrup or honey, salt and pepper. Set aside.

In a large bowl, combine quinoa, spinach, cucumber, tomatoes, avocado, and green onions.

Drizzle salad with dressing and gently stir until salad is coated with the dressing. Season with salt and pepper, to taste. Serve.

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Avocado Tacos

Ingredients

  • 3 medium ripe avocados
  • Juice of 2 fresh limes
  • 1 lb. ground protein of choice (chicken, turkey, veggie crumbles, lean beef)
  • 1/2 of a yellow onion, diced
  • Homemade taco seasoning (or use store bought packet):
    • 1/2 Tbsp chili powder
    • 1/8 tsp garlic powder
    • 1/8 tsp onion powder
    • 1/8 tsp crushed red pepper flakes
    • 1/8 tsp dried oregano
    • 1/4 tsp paprika
    • 1 tsp cumin powder
    • 1/2 tsp sea salt
    • 1/2 tsp black pepper
  • diced tomatoes
  • pico de gallo
  • cilantro
  • olives
  • shredded cheese
  • avocado
  • Combine spices well, you will only use about half of this mix per pound of meat, or to taste

Instructions

  1. Cut avocados in half, brush with fresh lime juice, sprinkle with sea salt if desired.
  2. Brown meat with the onion in a skillet over medium heat.
  3. Once cooked through, drain well.
  4. Add homemade taco seasoning (I add a sprinkle at a time, and taste test until it’s right) and 1 Tbsp hot water.
  5. Simmer for 1-2 minutes until flavors combine.
  6. Scoop hot meat into avocados.
  7. Top with pico de gallo, cilantro, green onions and any other toppings you desire!

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Easy Pico De Gallo

Easy Pico de Gallo Recipe

2 servings

Ingredients

5 roma tomatoes diced

1/4 yellow onion diced

1/4 cup Cilantro minced

1/2 jalapeno pepper minced, seeded if you want a more mild taste

2 tablespoons freshly squeezed lime juice

2 cloves garlic minced or pressed

salt to taste

Instructions

  1. Place all ingredients into a large bowl.
  2. Mix and season with salt, to taste.
  3. Cover and place in fridge until ready to serve!

 

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Mango, Avocado and Black Bean Salad

Mango, Avocado and Black Bean Salad

6 Servings

Ingredients

15 oz. canned, no-salt-added black beans (1 can), drained, rinsed

2 avocados halved, cut into 1/2 inch cubes

2 mangos cut into 1/2 inch cubes

1/2 small red or white onion (about 1/4 cup), cut into 1/2-inch pieces

1 red bell pepper, seeded, cut into 1/2-inch pieces

1 or 1/2 jalapeño pepper, stems discarded, seeded, finely chopped

3 Tbsp. fresh lime juice

1 Tbsp. olive oil

2 Tbsp. fresh cilantro (chopped)

1/2 tsp. chili powder

1/4 tsp. ground black pepper

1/4 tsp. salt

Directions

Combine the black beans, mango, avocado, onions and jalapeño pepper. Do not mix until you add the dressing.

Combine the lime juice, olive oil, cilantro, chili powder, black pepper and salt together in a jar with a secure lid, shake together until mixed well and pour over the mango and avocado mixture.

Toss gently to coat and serve.

Cooking Tip: You can serve this with crunchy vegetables like cucumbers and/or jicama, cut into ¼ inch slices and used like chips.

Keep it Healthy: When using canned beans, drain and rinse under cold water for a minute to remove some of the sodium.

Tip: You can also enjoy this in a sandwich or wrap. It is a great dish to bring to potlucks or picnics.

Tip: This salad will keep in the refrigerator for a few days and the flavors keep improving.

 

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Pork Carnitas

Pork Carnitas

Servings: 10 – 12

Ingredients

5 lb / 2.5 kg pork shoulder (pork butt), skinless, bone-in (4lb/2kg without bone) (Note 3)

1 onion, chopped

1 jalapeno, deseeded, chopped

1 1/2 tsp salt

1 tsp black pepper

4 cloves garlic, minced

2 oranges, juice only (or sub with 3/4 cup fresh orange juice)

Rub

1 tbsp dried oregano

2 tsp ground cumin

1 tbsp olive oil

Instructions

  1. Rinse and dry the pork shoulder, rub in salt and pepper.
  2. Combine the rub ingredients then rub all over the pork.
  3. Place the pork in a slow cooker (fat cap up), top with the onion, jalapeño, minced garlic (don’t worry about spreading it) and squeeze over the juice of the orange.
  4. Slow Cook on low for 8 to 10 hours or on high for 6 hours (or 1h 30 m in an electric pressure cooker on high. If using stovetop pressure cooker, please see notes).
  5. The meat should be tender and falling off the bone. Remove from the slow cooker and let cool slightly. Then shred the pork using two forks.
  6. Skim off the fat from the juices remaining in the slow cooker and discard the fat. Then if you are left with a lot more than 1 1/2 to 2 cups of juice, then reduce it (either in the slow cooker on the sauté setting with the lid off, or in a saucepan). The liquid will be SALTY, it is the seasoning for the pork. Set aside.

To Serve

  1. Heat 1 tbsp of oil in a large non stick pan over high heat. Place shredded pork into the pan, drizzle over some juices. Wait until the juices evaporate and the bottom side is golden brown and crusty. Turn and just briefly sear the other side – you don’t want to make it brown all over because then it’s too crispy, need tender juicy bits.
  2. Repeat in batches (takes me 4 batches) – don’t crowd the pan.
  3. Remove pork from skillet. Drizzle over more juices and serve immediately (if you are using defrosted carnitas, this is not applicable as the juices are already on the meat – see Note 4c).
  4. If you are reheating the carnitas (Note 4), then flip and cook the other side briefly just to warm through. I really recommend only making one side crusty and leaving the other side juicy and moist.

Recipe Notes

  1. If you are using a piece of pork that is not the size I use, you MUST reduce the salt accordingly. If your pork is more than 1 lb / 0.5 kg larger or smaller than the prescribed size, ensure you adjust the other ingredients accordingly as well, not just the salt.
  2. To make this in the oven, add 1 cup of water to the braising liquid. Place in 325F/160C oven for 2 hours, covered, then roast for a further 1 to 1.5 hours uncovered. Add more water if the liquid dries out too much. You should end up with 1 1/2 to 2 cups of liquid when it finishes cooking.

If you make this recipe in the oven, you could skip the pan frying step because you will get a nice brown crust on your pork.

  1. Use pork with the skin removed but leaving some of the fat cap on. The fat adds juiciness to the carnitas!
  2. Taco Fixing suggestions: Diced avocado or make a real proper Guacamole, Pico de Gallo or salsa. Also try pickled red onion, cabbage, lettuce, tomato,
  3. MAKE AHEAD:
    1.  For overnight or up to 3 days, the best option is to shred the meat without pan frying, keep the juices separate, refrigerate, then pan fry to make it golden and reheat the meat, pouring juices over while it is browning per recipe.
    2.  To brown the meat ahead, the meat actually holds up pretty well in terms of staying crispy. It’s even pretty good refrigerated overnight – but a) is definitely better. Keep the juices separate and pour it over just before reheating the pork. You can reheat in the microwave, quickly reheat in the pan or if you have loads, in a foil covered roasting pan in the oven at 180C/350F for around 8 – 10 minutes.
    3.  To FREEZE: This holds up great in the freezer. Pour the juices over the pulled pork (pre browning) and store in ziplock bags or airtight containers. Freeze in small batches for convenience. To use, defrost completely before following the recipe to brown the pork.
    4. STOVETOP PRESSURE COOKER – use a rack to elevate it from the base OR add 3/4 cup of water. Then once the pork is cooked, remove it then simmer to reduce to around 2 cups of liquid.

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Cold or Allergies?

Spring is here and we are all looking forward to longer days and warmer weather. However, this time of year can also bring seasonal allergies for many.

There are two types of allergies, year round and seasonal. Allergy symptoms that last throughout the year are often caused by indoor allergens such as pet dander or dust mites. Seasonal allergies, or allergic rhinitis, occur when the immune system reacts to harmless substances including mold, dust mites, pet dander and pollen. In response, the body releases histamine, which can cause nasal drainage, sneezing, coughing, throat irritation, and itchy watery eyes.

Seasonal allergies are usually related to pollen from weeds, grass and trees. You may also notice that allergy symptoms are worse at certain times of day. Someone allergic to dust may have symptoms when they first wake up in the morning while someone who has a grass allergy may experience symptoms after being outside.

Because the symptoms of allergic rhinitis are similar to the common cold, it can sometimes be difficult to determine what is causing symptoms.


Questions to Consider:

  • Length of symptoms. The common cold typically resolves within 2 weeks. If symptoms last longer than this, it may be time to look at allergies as a possible cause.
  • Do you have a fever? Allergies do not cause a fever, so if your symptoms are accompanied by an elevated temperature, it is safe to believe you have virus.
  • Do you have eye symptoms? Allergy symptoms usually include itchy, watery and irritated eyes, while the common cold does not.

 


To diagnose allergies, your provider may order allergy testing through a blood or skin test. Many medications and lifestyle modifications can help control allergy symptoms. See your healthcare provider if you suspect allergies or have any questions or concerns about your symptoms or condition.