Talk about gifted people and inspirational speakers! Yesterday I attended the 2010 Shilling Lecture at Southwestern University in Georgetown, where Dr. William Foege gave a superb speech to students and other attendees; his talk was moving and inspiring.

Dr. Forge is an epidemiologist who worked on the successful campaign to eradicate smallpox in the 1970’s.

The smallpox virus killed more than 300 million people during the 20th Century. When the vaccine first became available, it met with the familiar limitations encountered when epidemiologist try to create a plan to best utilize the resources available. One of the limitations in any plan is the restricted quantity of vaccine available to face such a devastating disease, when compared to the population susceptible to the illness.

Dr. Foege created a strategy of “surveillance and containment”, by which experts were able to identify focuses of disease and heavily vaccinate individuals around the focus. He made the analogy of a fire starting in a house. Firefighters must extinguish the existing fire, but by pouring water into the houses around the index case, they can assure the fire is not going anywhere, being able to better control the spread. The same tactic was utilized in the eradication of smallpox with very successful results: the disease was first contained and by 1977 the last case was reported in Somalia. The patient survived the illness, but the virus was dead. It had nowhere to go and was eliminated from the face of earth. What an accomplishment! It is estimated that more than 120 million lives where saved by the vaccine.

I get inspired when I meet people like Dr. Foege, and I hope the students of Southwestern University recognized a good example to follow. He encouraged them to participate in the making of history by writing their own individual chapter, to invest in life and to be ambitious with their dreams. He invited them to shake the world, to wake up every morning with a goal in mind.

Science is about people, Dr. Foege said. It is about making existence better for others by improving quality of life.

There is more work to be done. Young students today have an open book to write as he reminded us about the 200,000 children who die every week from vaccine-preventable illnesses. He mentioned the Tsunami a few years ago, and the terrible earthquake devastating Haiti and Chile.

About 200,000 people died in Indonesia during the tsunami and about the same number in Haiti. The whole world was moved by those disasters; cooperation and aid arrived from all around the globe and presidents joined the efforts to help the victims. The same number of children die every week from vaccine preventable diseases in the world; that information created a lump in my throat at the end of the lecture, as it really touched home. I see children in my practice everyday and I didn’t realize we still have so much work to do.

Another reality check was the information about contributions made by vaccine and drug  manufacturers to situations of need. Merck donated $ 250 million to the treatment of River Blindness in Africa. He also mentioned how, at one point, the incidence of HIV positive births at this particular hospital he visited in Africa was 40 %, and how just nine years later it had decreased to 4 %, thanks to medications and technology donated to the area.

At the end of the lecture a few students where invited to ask Dr. Foege questions. One asked a very intelligent question: “Is there a disease or ailment in the world today for which there is no sponsorship”? The good news seems to be that for most of the current threats existing in our world there is concern, investigation and help. He mentioned poverty, social conflicts, unemployment, etc, as examples of unsponsored issues menacing our communities. I am going to add one more; an epidemic threatening the health of children across national borders: the obesity epidemic.

One day we’ll have sponsored programs and international cooperation aiding in the decline of childhood obesity.

From this blog you will hear all about it when it happens. For now I will continue advising my patients, bringing awareness and help, one family at the time.

Thank you Natalie for inviting me to attend this lecture.

Marta Katalenas M.D.

Biography of Dr. William Foege

Dr. William Foege was director of the U.S. Center for Disease Control and became Chief of the CDC Smallpox Eradication Program in the 1970’s. In 1984 he was part of the Task Force for Child Survival, a working group for the World Health Organization, INICEF, The World Bank, the United Nations Development Program and the Rockefeller Foundation. He was Executive Director of he Carter Center, Fellow for Health Policy and Executive Director of Global 2000, Executive Director of he Task Force for Children Survival and Development, Presidential Distinguished Professor of International Health at the Rollins School of Public Health at Emory University and Senior Medical Advisor for the Bill & Melinda Gates Foundation. He is the author of over 120 professional publications and recipient of many awards; he holds honorary degrees from numerous institutions and was named a Fellow of the London School of Tropical Medicine and Hygiene. He attended Pacific Lutheran University, received his medical degree from the University of Washington and his master’s degree in public health form Harvard University.

They count among their members the invaluable presence of Andy Martinez, their President and CEO. I have known Andy for years and he is a good man. He feels energized and enjoys his work; his presence is the key to success for this organization.

Dinner was great and the Accomplishment Award Ceremony moving. They presented awards to many local businesses and corporations, but what impressed me the most was reading the bio of the Lifetime Achievement Award to Gilbert Martinez. I don’t know this man, but learning what he was able to accomplish in his life, and is still going, was an inspiration to me that I wish to be able to transmit to my adolescent patients.  He is a Korean War Veteran; he has worked as a banker, serving on the Board of Directors of City Bank, opened several businesses and still has time to give to the community. He served on the Board of Directors for the Austin Chamber of Commerce, the Austin Symphony, the Capitol Area Council of the Boy Scouts of America and the National Board of the Southern Regions of Boy Scouts of America. He was a member of the first Board of Trustees for ACC and Chairman of the City of Austin Planning Commission. He was appointed by President Bush to the State Commission on Judicial Conduct and was appointed to the Court Reporters Certification Board by the Supreme Court.

Are you still with me? I am not sure I am. As I am writing all this information about a human being my head starts to spin. He has been married to his wife of 52 years and they have three children.

He is obviously a gifted person; but we all have gifts to pursue and share.

I encounter teenagers in my practice that seem to be at the end of their ropes. They feel desolate because of a bump on the road; sometimes it is a family incident or failure in school, or boy/girl friend issues. It is hard for us, as parents, not to get emotionally involved and it is harder for me to offer a solution in a short office visit. I am certainly going to have my children read the accomplishments of this private citizen. I am sure he encountered a few disappointments and set backs; but they are not listed in his bio because he made them go away by trying again. I am sure he must be a very enthusiastic individual.

Talk to your children. Share information about what you went through in order to be where you are now. Offer them a snap shot of the future if they follow different directions. They don’t know and they lack experience; every one of us learned a few lessons along the road and that information is of great value to young minds. Even if they seem not to listen. Oh, they are listening, but they make us believe they don’t care about our bla, bla, bla…..

I will have to remember my own preaching as I welcome medical students to my practice. Yes, Dr. Jacomides and I are going to have rotating students from UT Medical Branch following us around. We may soon have some for A&M, to be fair to everyone.

Keep talking.

Marta Katalenas M.D.

I can save your airfare right now by showing you how to make Tortilla Espanola, right here. In the United States we think about breakfast when we serve eggs in any form, but Tortilla Espanola is mostly eaten as part of lunch or dinner, or as a “tapa” at any time of the day.

The nutrition advantage starts with the proportion of carbohydrates and protein provided by the potatoes and eggs; it also includes onion, adding vitamin C and fiber; and it ends with the flavor of olive oil that helps maintain your cholesterol in balance.

In itself, Tortilla Espanola is a meal. You can serve it for dinner and, with a lettuce and tomato salad, the Mediterranean flavor is complete. You may as well be sitting in a terrace at a café in Madrid.

Ingredients:

4 medium potatoes.
4 eggs.
1 medium onion.
Olive oil.
Salt.

Cut the potatoes in small cubes, after pilling them; add salt. Fry them in abundant olive oil.

Now, when it comes to answering the question of how much olive oil to use, I only can tell you A LOT. I remember when I prepared Tortilla for some friends in California, at their house, and they gave me a tiny container of olive oil to fry my potatoes. At the time, in the 80’s, there was a big “low fat” and “fat free” movement. The whole population was scared about eating anything containing fat, even if it was natural, monounsaturated fat that is good-for-you, as is the case with olive oil. My friends did not want to listen to my arguments and requested that I boil the potatoes, instead of frying them. I did, but the result was not spectacular, like it should be.

I encourage using enough olive oil where you can easily fry your potatoes without them becoming too dry and sticky. Mince the onion and add it to the frying pan after about 5 minutes, since onions cook faster than potatoes. During the frying process, I like to mash the potatoes with a rubber spatula, as they become softer. They are done when they are lightly brown. Take the potatoes and onion mixture out of the oil, squeezing out extra oil, and reserve.

Beat the 4 eggs and add salt to them. Add the fried potatoes and onions to the beaten eggs and mix all well.

In an 8” frying pan, put 3 tablespoons of olive oil and heat it up. When is hot, add the eggs, potatoes and onions mixture and turn the heat to medium. Shape the sides with a fork, making the edges round and smooth. Cook for about 5 minutes. Turn the omelet by placing a plate over the pan and flipping it over. Add one tablespoon of olive oil to the pan and place the omelet in the pan to cook on the other side for about 4-5 minutes.

Tortilla Espanola makes a nice dish that is enjoyed by all ages. If you have a concern about calories, eat a small piece. Remember, it is best to eat good quality food in small amounts. Get your stomach used to handling smaller portions of nutritious foods and you won’t feel hungry as often.

Marta Katalenas M.D.

Biology plays a significant role in weight. On HealthyChildren.org, the American Academy of Pediatrics cites a Danish study which compared the body mass index (BMI) of adults who had been adopted with their birth parents’ and with their adoptive parents’. Overwhelmingly, their BMI matched that of their biological parents, even though they had been raised with the eating habits of their adoptive family.

Without a doubt, it is more difficult for some children to maintain a healthy weight than it is for other children. But – and this is a key point – staying at a healthy weight is beneficial for all children. So whether it’s easy or difficult for a child to stay trim, the effort is worthwhile.

Children who are obese are more likely to suffer from asthma, joint pain, high blood pressure, severe headaches, gallstones… the list goes on and on. One of the most serious potential health issues an overweight child might face is Type 2 diabetes. With diabetes come daily blood sugar testing, possible injections, medications, frequent doctor visits, and constant vigilance that is much more onerous than losing weight would’ve been in the first place.

What should parents do when their children complain it’s not fair?

With kindness and understanding, parents should help their children to understand that each person must play the hand they’re dealt. In other words, what is, is. Every person is unique and must find her way through the world from her unique perspective, with all the advantages and disadvantages that go with it.
If a child was born with a propensity to gain weight, then he must work harder than his friends to keep that weight off. He must exercise more and eat fewer snacks. That’s just a reality of this person’s life, the same way that glasses or contacts are a reality of the life of someone who wasn’t born with 20/20 vision. By helping children to make this connection in their brains, parents help take the emotion out of it, especially the shame.

When genetics are a factor in a child being overweight, in all likelihood, her parents have struggled with the same issues. This, again, can be both positive and negative. If parents have given up the fight and keep an abundance of unhealthy foods in the house, then it’s nearly impossible for a child to lose weight. On the other hand, if the parents change their habits, start eating healthy and exercising more, they can be the best possible support system for their children. Their shared DNA means they can share the frustrations and triumphs, and grow closer than ever.

Losing weight for some families might not be easy, but by working together, they can do it. And because they made that commitment and stuck with it, those families will live happier, healthier, and longer lives.

Flu season in Texas is usually during the months of February and March; we did not see much activity yet, but I am sure it is still to come. Experts believe the H1N1 will continue to show activity throughout the season.

Human beings don’t kill each other for food and territory any more, at least it doesn’t happen in our civilized, modern society; but we spend lots of money and effort trying to investigate diseases in order to learn how to prevent and treat them.

Over the last 100 years the life expectancy for humans has been increased by a couple of decades. During the 19th century, a person of 40 years of age was already considered old, since he/she could expect to have about 20 more years around the mortals, if lucky. Today, a 40 year-old man or woman is in his prime time. We don’t consider a person old until in his 80’s. I can tell you that my personal definition of “old” has changed as I added birthdays to my calendar.

One of the biggest success stories of the 20th century includes the discovery and world-wide use of serums that, when injected, stimulates the production of defenses against infectious agents in such a way that, when you are in contact with the infective organism, it reduces the chances of getting sick by it. Very cool, right?

That is the way vaccines work.

And some vaccines have a double advantage: they protect you against the disease, but they also protect the whole community you live in. Every one of us becomes a vehicle to spread disease when we get sick with an infectious agent. When we are immune to it, we create a shield of protection for those around us, even those who are not immunized. If we all become immunized, the infectious agent will have nowhere to go and it could be eliminated from the face of the earth. This is exactly what happened with Smallpox; when enough people became vaccinated, the virus didn’t have any more susceptible hosts and disappeared.

The World Health Organization had the goal of eradicating Polio from the earth by the beginning of the 21st Century. The goal is not going to be met and many countries still suffer from this devastating disease. I just read an article explaining how politicians in some countries in Africa are discouraging their citizens from obtaining the vaccine, brought to them free of charge, because they don’t trust the intentions of those trying to promote it. Sounds familiar?

During the yearly flu outbreak many people can’t get vaccinated. It may be because they are allergic to some of the components of the vaccine; it may be because they have some disease of their immune system that keeps them from responding to the vaccine; they may be too young or too old. Some groups are at increased risk of getting sicker with the influenza virus, such as the elderly or pregnant woman. When you immunize a significant number of people, those individuals are more likely to be protected. Immunized individuals are not going to pass the flu along to their 80-year-old neighbor who may have asthma; they are not going to transmit it to the pregnant woman waiting in line next to them at Target; they are less likely to infect the small child on chemotherapy sitting next to them in church. This is HERD immunity. This is the way vaccines protect even those who are not vaccinated, by creating a shield of immune people around those who are susceptible.

In order for herd immunity to be effective the majority of the population must be immunized, that is, the number of susceptible persons must be minimized and the number of immunized persons must be maximized.

Talk to your doctor about this issues. Get informed. Get the facts.

Like Dr. Laura would say: “Go and do the right thing”.

Marta Katalenas M.D.

Well, I misspoke. I cannot cook without pimenton (Spanish paprika) and saffron, so I always have those two condiments at my fingertips. I strongly advise you to invest in buying them, since they can add the little kick of Mediterranean taste that some dishes need. They are both natural, unprocessed, no additives or chemical added ingredients you are going to love. But this days talking about price is important; I must say that Pimenton is not expensive since a small can of it (2.5 oz) can last months. Saffron, on the other hand, is considered the most precious and expensive spice IN THE WORLD. It comes in small filaments that are only the stigmas of the saffron flower (a member of the Iris family). Since each flower has only 3 stigmas and they must be removed from the flower by hand, it makes this spice one of the most expensive you can find. Luckily, you only need a few filaments to cook a meal!  Saffron has been known since ancient times, being mentioned in the Bible. Older civilizations used it for cooking because of its unique aroma and yellow coloring properties. They also used it to make perfumes and for its therapeutic properties. It was used to calm fevers, as a liver tonic and to calm nerves.

Anyway, the history is long and vast, since most ancient civilizations used it, including the Romans, Greeks and Egyptians. Today, it is indispensable ingredient in Spanish cuisine and used in all Mediterranean countries.
I remember the time before the internet, when I had to bring Pimenton and Saffron from Spain on every occasion I had. Today it is much easier. Check out www.latienda.com(there is a link in my web page).

Going back to the fish stew. Say it is Monday evening and you are driving home from work, exhausted and hungry. Let say you already have 4 potatoes, ½ onion, 2 garlic cloves, ¼ of a green bell pepper and some olive oil at home. Well, all you have to do is  pay a quick visit to your friendly HEB store and pick up some white fish. You can choose between basa, cod, halibut…it goes well with any white fish. You need about 1 ½ lb.

When you get home, before you change, cut the potatoes in pieces and set aside. Mince the onions, the garlic and bell pepper and cook it all in about 4 tablespoons of olive oil, until the onions are transparent. At this point you add the potatoes, in cubes, and add water to barely cover the potatoes. Add 2 teaspoons of Pimenton and 1 envelop of saffron. Cook over medium-low for 20 minutes.

Now you can go and change. You also have time to check out the evening news.

Now you are ready to cut the fish in small pieces, about 1×1” and add the fish to the cooking mixture. The fish will cook fast; you may need an additional 15 minutes. While you set the table and put together a salad, your fish stew will rest and absorb all the flavorings of its ingredients.

Ah! I forgot to mention 1bay leaf. You should add it to the stew when you add the fish. Look in the back of your pantry, you may have some.

By now you may be aware of the many studies praising the benefits of Omega 3 oils. Well, here you have them. Fish stew provides a balanced mixture of carbohydrates and protein, together with the vitamins and soothing effect of the herbs and vegetables.

Perfect for dinner. Your family will be able to enjoy from the door, the minute they step into the house.

I still remember the complaints of my kids when they were small. Those of you with kids know exactly what I am talking about. I had to mash everything with a fork before they would agree to eat it; they didn’t want to feel the fish, or the pepper, and blah, blah, blah. I also remember doing the exact same thing to my mother. Now we all enjoy this very simple and nutritious dish.

It is time for you to create traditions and memories. The best ones will come from your efforts, when you try to teach your children to enjoy good food.

Happy cooking!
Marta Katalenas M.D.

At this time we have only the injectable form of the vaccine. We are also administering the Seasonal Flu vaccine as well. We give vaccines during the week by appointment only. Please call (512) 733-5437 to schedule an appointment.

Pediatric Center of Round Rock.

One of the main contributing factors in high blood pressure for people of any age is too much salt. Salt should be used very sparingly and, in most cases, not at all.

What can parents do?

The fastest and most effective change you can make is to stop serving your child processed foods. Most of the sodium in our diets comes from processed foods. For example, when you make a box of Kraft macaroni and cheese, one serving has 580 milligrams of sodium. Weigh that against the recommended daily allowance of sodium for adults, 1500-2400 milligrams, then adjust for your child’s age and size. On the other hand, if you use a bag of pre-shredded cheddar cheese to make macaroni and cheese from scratch – skip the salt, which is unnecessary – it will take about the same amount of time but will cut the sodium by 25%! Even better, make it with low-fat cheese and a healthier alternative to butter, and serve it with a small salad to help fill up your child’s tummy.

Macaroni and cheese isn’t the only meal that comes from a box. Whenever you’re tempted to pick up a boxed type meal, at the very least, take a moment to look at the nutrition information provided. Do this in the grocery store, before you decide whether you really want to bring this food into your home. Once it’s home, you will make it, and your child will eat it. But if you read the nutrition information in the store and see that one serving has more sodium than your child should eat in a day, you will be more likely to return the box to the shelf and look for healthier alternatives. Soon, you may skip the packaged meal aisle altogether.

Honestly, healthy cooking doesn’t have to take any longer than putting together a prepackaged meal. One kitchen tool that I highly recommend is a steamer. You can throw a few frozen chicken breasts into the steamer basket along with the vegetables, turn on the steamer, and then walk away. Give the kids a bath and, by the time you’re finished, dinner is cooked. Sprinkle on some salt-free seasoning when the food is done. Nothing could be easier than that.

Fast food restaurants are notorious for using packaged foods, and like all packaged foods, they’re heavily laden with salt. Limit your trips to a fast food restaurant to no more than once a month. If you must eat out more often than that, choose a local restaurant where the food is cooked fresh.

Want to learn more about healthy eating for kids?

A good place to start is at www.HealthyChildren.org, a website developed by AAP to teach parents about all health issues facing your children. It’s your job to educate your children, and the first step is to educate yourself.

Here I am again, thinking up goals to accomplish in 2010. My list this year is long and diverse: I want to learn how to play baseball and dance flamenco. I am going to exercise in the morning at least 2 days per week and I am going to resume pilates and yoga, but this time I am not going to find excuses as regularly as I did during the old 2009. We are going to have “ board game night” with the kids on Friday night and I am going to take the dogs for a walk twice a day.

By having all of those projects I can be sure to accomplish at least one of them, you see.

I’m not the only one making a wish list at this time of the year. I can see television commercials advertising exercise plans, gym memberships and diet plans every time I tune in. We are all ready to go. We feel energized. We need to start over.

It gives us a good feeling to talk to people and find out their special projects and wishes for the new year.  I can sense the energy flowing from person to person and the positive thinking that makes anything possible running through the days during this very first part of the year. I love it.

I know I’m not going to meet all my goals but, you know what? I’m sure going to try.

Last week I was trying to explain to one of my adolescent patients how easy it is to lose 10 lbs in one year without a lot of pain and sacrifice. Imagine you have the habit of coming home in the evening and drinking a can of soda before dinner. Every can/bottle of soda has about 140 calories, but we are going to imagine it contains just 100 calories, to make the numbers easier to calculate. By giving up that evening soda alone you are going to miss 36,500 calories by the end of the year.  Since every 3,500 calories translates into 1 lb, by December 2010 you can be 10.4 lb lighter, without even trying hard; just by giving up a small part of your day. Can you imagine how much weight loss you can add to the equation by going for a walk around the block instead of sitting down to drink the soda? How about running around the block instead of walking? It would take just a couple of minutes! You get the picture.

Yes, it is not that difficult. But, like everything in life, you must be consistent and keep going. Don’t give up. Stick to your plan even when you don’t see immediate results.

We live in a society that claims instant gratification and we seldom recognize the value of persistence and stamina when it comes to accomplishing a goal.

Remember, the journey of 1,000 miles begins with one step.

Happy, Healthy 2010 to y’all!

Marta Katalenas M.D.