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Julia Winter

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since Aug 31, 2012
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Julia Winter currently moderates these forums:
Pediatrician with a Master's Degree in Nutritional Sciences. Moved to Portland, Oregon in the summer of 2013. Took Geoff Lawton's first online PDC in 2014.
Moved from south central WI to Portland, OR
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Recent posts by Julia Winter

How many feet of barrier do you have now?  I'd love to see a picture.

Is this a property you drive to on free days?
3 days ago

Leslie Russell wrote:I have so much wood around here that I could use if only I had a chipper. Does anyone have one or used one? Are they difficult to use and how dangerous are they?

You might want to look into renting a chipper.  They are the kind of thing you need use only a few times a year, it can make more sense to rent one than buy one.

They are noisy and you should wear hearing protection.  They throw bits all over and you should wear eye protection.  They could shred your hand, but you'd have to bypass the safety features for that.  If you feed big sticks into a chipper for hours, your arms get tired and the vibration can get to you.  Generally though it's not a big deal to use a chipper.

I should note that Paul (Wheaton) is not a fan of chippers and thinks bigger wood should go into hugelkultur and smaller twigs should be rough mulch.
6 days ago
With regards to the HPV vaccine, for ages it's been hard to get parents to agree to give that to their kids when they are in middle school or even early high school.  Meanwhile the experts were saying "It works better when you give it younger!  Give it to the young teens and pre-teens!"  I'm thinking "look, I'm having a hard time just giving the vaccine, don't bother me."  

Parents are sometimes upset, like "what are you implying about my daughter?!?"  I would try to point out that it's very hard to get college students to come back to the doctor's office for a series of painful shots.  I'm not saying anything about your kid's activity or morals.  We have the kid here, today.  Let's do this.

Then a couple of years ago the experts said "OK, new rule: if you start the HPV series prior to age 15, then you only need 2 to complete the series, instead of 3."  This has helped a lot.  Now I have a reason to encourage giving it sooner.  I usually give Tdap at 10, Menactra at 11, Gardasil at 12 and Gardasil at 13.  
6 days ago
MMR is one of the most studied vaccines in the world, given that Andrew Wakefield maligned it in a fraudulent paper.  Measles goes into the brain in one out of 1000 cases.  It's not the weak or fragile, it's just random.  This is where the deaths tend to occur.  There were 72 deaths from measles in Europe in 2018 but 110,000 deaths globally in 2017, the most recent year for which I could get a global total.

Pertussis (whooping cough) is the vaccine preventable illness from which I've personally witnessed the most deaths.  If you are over 5, you'll cough your lungs out for a hundred days.  If you are a baby, there's a decent chance you die.  My most recent death from pertussis was an Amish baby, in 2013.  He was exclusively breast fed.  They lived on a farm in Wisconsin, way out in the boonies, and raised their own food.  All his older siblings got the whooping cough, and he died.  That's how it used to go.

Our first vaccine for pertussis was rather effective, but also caused very real side effects in some people.  We switched to acellular pertussis vaccine over 20 years ago and now pertussis immunity is less persistent - you need to get boosters - all y'all, folks!  It's in the tetanus vaccine (Tdap) that you should get every 10 years.  You heard about the boy who got tetanus, right?

Strep pneumococcus is the bacteria that the Prevnar vaccine protects against.  When I would bargain with parents about vaccines, I used to be willing to delay the Prevnar vaccine in order to make sure the kid got the pertussis vaccine.  I thought "well, it causes pneumonia, but that's not so bad."  Then we had a non-vaccinated toddler, 16 months old (not sure how this happened, our vaccine policy insists on pertussis, prevnar and MMR) get strep pneumo.  It causes necrotizing pneumonia.  The kid was in the hospital for a month.  He was in the ICU for 8 days.  He was intubated for a week.  The PICU docs kept consulting the surgeons saying "Don't you want to stick a chest tube in this kid and suck out some of this goo?"  and the surgeons were like "No, we really don't.  You're doing fine, keep doing what you're doing."  After he got off the ventilator, he went into renal failure, because apparently that's a thing that happens when you get strep pneumo.  So, he went onto dialysis.  At the end he required physical therapy, occupational therapy and speech therapy because he'd regressed in his skills.

My brother in law is severely hearing impaired due to congenital rubella.  My dad suffered from post-polio syndrome in his last years.  The diseases are real.  

So yeah, I've been living this for decades now, and I've developed some rather strong opinions.  I think vaccines get blamed for all sorts of things they have nothing to do with.  I'm more worried about the toxic stew in which we all live and breathe and bathe.

As I say nearly every day at work, I went into pediatrics because I love children.  And so I make them cry.  Every. Single. Day.
6 days ago
My chickens knew, or at least I think they did.

Years ago my husband bought pesto at Costco.  This is a refrigerated product, but he stuck it in a kitchen cabinet.  Some time later, he cooked up a pot of noodles, poured out the water, then grabbed the pesto.  When he opened the jar it went PFFffffft, like it had been under pressure.  He dumped the pesto on the pasta, then stopped and thought about the sound.  Realizing that the food wasn't safe to eat, he walked outside and dumped the whole thing in the chicken coop.  

If he had asked me, I would have told him NO don't give that to my chickens, but I wasn't around.  When I heard about it and ran outside to see, I saw that the pieces of pasta without any pesto on them had been eaten, but none of the pesto was touched by the birds.  Over the next several days through a few rains, the pasta got rinsed off and then they ate all the pasta.  No birds were paralyzed.

When I was a pediatric resident in the mid-90's, we had a baby that was paralyzed by botulism.  The toxin produced by the bacteria binds irreversibly to the neuromuscular junction.  This child was completely paralyzed, could not swallow, but was able to breathe.  They were fed via a nasogastric tube and every 15 minutes the nurse came to suck out their mouth so they wouldn't choke on their own saliva.  After a few weeks, the baby started to move again, bit by bit.  We assumed the culprit was honey (this is why you're advised not to give honey to babies) but everybody denied giving the baby honey.  The baby did have a complete recovery, but it took a long time.  My attending said it was just luck that the diaphragm wasn't affected so the baby didn't need to be on a respirator.

I guess my point is, botulism is not to be taken lightly.
6 days ago
I've never made bacon without including pink salt.  You've created an anaerobic environment that is not acidic, the risk of botulism is significant.

I've made prosciutto without pink salt, but that involves packing the meat in dry salt and pouring off all the liquid, also crazy high concentrations of salt, and no sugar.
1 week ago
In Wisconsin I had a large area that was my pumpkin patch and I laid down huge pieces of cardboard every year to control weeds.  I would cut holes for planting the baby vines (not just pumpkins, I'd let tomatoes sprawl on the ground, other squashes and sometimes a patch of sweet corn) and cover the cardboard with straw to make it look nice.  

After the carboard was laid out I'd walk around and stab it with my gardening knife to make openings for rain to get through.  I'd try to visit it after a soaking rain, to poke holes anywhere water was puddling.  

The cardboard always disappeared by the next spring.
1 week ago
This place in Oregon is making houses out of shipping containers.
1 week ago
We are very much enjoying our Dexter cattle, their smaller size makes them great for beginners, and you can have more of them on less land.  We have more than 15 acres of pasture (I think) so more than what you have to work with, but I very much think that cattle need friends to be happy.  You should be able to have two - I'd buy a yearling steer and an older steer, and then get a new young steer every year.  Dexters are easy keepers, tend to be friendly and finish well on grass.
1 week ago
To be more precise, I'm limiting solid food intake to between 6pm and 9pm.  I'm making a latte with whole milk and I drink that at 1pm or later.  I'll have a few ounces of nuts (a home made mix of walnut, pecan, salted almond, salted pistachio, roasted hazelnut and salted macadamia nuts) after work at 6pm.  

My family of four often doesn't have dinner until 7:30pm or even after 8pm, and we don't have dessert every day, but when we have dessert, I have some.  Last night I had an ice cream milkshake with hazelnuts, chocolate and banana.  

Unlike the "6 miles to supper" lady, I'm doing this 7 days a week.  I'm also not getting in 14,000 steps a day (not even close!  I think the most I've clocked is 10,000 steps, or 4 miles).  

I am allowing my new/old (Series 2, but new for me) Apple Watch to run my life in that I try to get up at ten 'til the hour and I try hard to complete the "exercise" and "move" circles every day.  I will check my watch after dinner, or after getting the kids to bed and then go downstairs and get on the treadmill to finish out the rings.

I'm still overweight, but much less so and I feel like I could continue like this indefinitely, which is nice.  I'm still working up the nerve to try a longer fast.
1 week ago