Dr. Vivi

Nothing like starting off the day to find that your children have mistaken your office as an art studio! 😂

Tick Removal Tips
1-Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible. The key is to remove the tick as soon as possible. Avoid using nail polish, petroleum jelly, or heat to make the tick detach from the skin.
2-Pull upward with steady, even pressure. Don’t twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If you are unable to remove the mouth parts easily, leave them alone and let the skin heal.
3-After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.

4-If you are my patient please Save the Tick safely in a sealed container.
I will mail it in for testing. The blacklegged deer tick (Ixodes scapularis) carries Lyme disease. You can identify your tick with a CDC page. Your tick can be tested for several tick borne diseases and this is not expensive. 

Prevention 
-Know where to expect ticks. Ticks live in grassy, brushy, or wooded areas, or on animals. Spending time outside walking your dog, camping, gardening, or hunting could bring you in close contact with ticks. Many people get ticks in their own yard or neighborhood. Soft ticks that spread tickborne relapsing fever (TBRF) most often live in caves and rodent-infested rustic cabins.
-Use Environmental Protection Agency (EPA)-registered insect repellents containing DEET, picaridin, IR3535, oil of lemon eucalyptus, para-menthane-diol, or 2-undecanone. Treat clothing and gear, such as boots, pants, socks and tents with products containing 0.5% permethrin.
-Treat dogs and cats for ticks as recommended by a veterinarian.
-Check for ticks daily, especially under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and on the hairline and scalp.
-Shower soon after being outdoors.
For more tips, see: www.cdc.gov/lyme/prev/

May we honor all lives lost in the fight for our freedom and democracy. May Jews, Muslims, Christians, Hindus, and Buddhists unite to stop terrorism in any form. Please remind our youth of the heavy price our ancestors paid to keep or democracy safe. The U.S. Civil War was devastating for families on both sides of the conflict—nearly 500,000 men died, or about 2 percent of the U.S. population at the time.

After World War I
America lost more than 100,000 soldiers.

Since 2000, people across the country have been asked to join in a moment of remembranceat 3:00 p.m. local time. Bells are tolled and NASCAR races are put on hold. Flags are flown at half-mast until noon, to signify a day of mourning.
This quote resonates with my heavy heart as the weekend approaches:
From the silence of sorrowful hours
The desolate mourners go,
Lovingly laden with flowers
Alike for the friend and the foe;
Francis Miles Finch.

Happy Early Mother’s Day!! Here is the Dr Vivi’s Rx for Moms everywhere this mother’s day weekend- all from lessons learned….
1. Do not host at your house
2. Do not eat out at a restaurant if your children are under 10
3. Plan protected time away from anyone who lives at your address (remind yourself of pregnancy and childbirth the moment you start to have any guilt)
4. Make sure to use your husband’s trick and let him know that your phone is about to die Saturday and Sunday morning as you head out for some alone time
5. Throw out all rotten food in your fridge if you plan to be gone for the day and husband may be preparing any meals/snacks

are people who help students to acquire knowledge, competence, or virtue, via the practice of teaching. There is no more important job in our society. Be sure to volunteer in the classroom more than once during the year. Also show your appreciation via a card, gift, or simply saying thank you! I taught for two years, riding my bike to class and staying up until midnight grading assignments. When I realized there was little possibility for me to pay off loans and buy a car on my pay, I decided to go to medical school. While I still find a way to influence children for positive change, I hold teachers to the highest regard for their hard work.

is a bit misleading, and some argue it to be a disservice, because we all have learned to disregard the warning at times. But as people pull out toys for their infants, they think twice. While many products should have warnings for high levels of toxic chemicals, California set some very high standards. The warning is everywhere (even disneyland!) because almost all products contain a trace amount of one of the 800-plus chemicals that the State of California considers harmful in large doses. It does not mean that the labeled products themselves are necessarily harmful or are in violation of any safety standard.

Many of the chemicals that are included under the warning have been routinely used in many everyday items -- such as alcohol, medications, food, dyes, additives, solvents, and pesticides -- for years, all without documented harm. Unless manufacturers can demonstrate that exposure to the chemical poses "no significant risk,” you will see the label. This warning is posted at every bar and gas station.

The threshold of exposure for reproductive toxicants is such that, even if multiplied by 1,000, they will not produce birth defects or other harm. For carcinogens, the threshold is calculated as the level that will result in not more than one excess case of cancer in 100,000 exposed individuals throughout a 70-year lifetime. In other words, your chances of getting cancer increase by no more than one case in 100,000 individuals if you are exposed to the chemical at that level every day for 70 years.

A Proposition 65 warning can mean either 1) that the amount of exposure to the listed chemical is above the risk threshold, or 2) the manufacturer would rather exercise caution and label any product containing a listed chemical. While concerning, the label usually means that the manufacturer is exercising an abundance of caution to inform its customers of the presence of any listed chemicals. Of course, you should still do your research and assure yourself of the brand’s commitment to your safety.

How often should a healthy person fart?
A person passes gas 12-25 times in one day and mostly at night when asleep. Only 1% of the gas humans release actually smells bad. The cause of the odor is intestinal bacteria that produce compounds containing sulfur. Most farts are caused by swallowed air or healthy gut bacteria that release gas after breaking down food.
While some smelly farts are due to certain foods, medications, infections and digestive problems or disorders, it can be a sign of a healthy gut! Always speak with your doctor if you’re having other symptoms related to passing gas.
Common Foods that Cause
Bloating and Gas
• Cabbage
• Broccoli
• Cauliflower
• Onions
• Beans
• Corn
• Oats
• Potatoes
• Apples
• Pears
• Milk
• Soft cheese
• Fluffy wheat
• Peaches
**p

February 3rd was chosen as Women Physicians Day to honor the birth of Dr. Elizabeth Blackwell, the first woman to receive a medical degree in the United States in 1849.
Currently, women comprise only 39% of Californian Physicians. This number is increasing every year. In fact over 50% of physicians residents are female. May we lift one and another up as we reach for the stars. It takes a village! .doctor.moms .psych.doctor .meagan_md

LUCIRA® by Pfizer COVID-19 & Flu Home Test, Results in 30 Minutes, First and Only At-Home Test for COVID-19 and Flu A/B, Emergency Use Authorized (EUA)

Similar to a PCR test, Lucira is a molecular test. In a clinical study, LUCIRA correctly positively diagnosed patients with COVID-19, influenza A, and influenza B 90% of the time. Negative test results were even more accurate, getting it right over 99% of the time for all three viruses.
While these numbers are high, a false negative is still possible, so you shouldn’t rely on the LUCIRA test to determine if you have COVID-19 or influenza.

This is a huge game changer! People can get results in 3 easy steps, delivered in just 30 minutes, at your home for 40 dollars. Available on AMAZON! :)

Please speak to your primary care provider regarding any febrile illness. Often people get secondary bacterial infections and these are deadly. You will still need to see your doctor. I cannot stress that enough. Ear infections and Pneumonia are common with Covid and flu.

can help build an understanding around normal stool. The goal is type 4. Ask your children to look and report if they see balls or cracks. Start a daily regimen at the first signs of constipation (type 1-3). Once the re**um is stretched out, it loses its reflex to empty. Only after many months on a strict bowel regimen, will the re**um shrink, and only then, the nerves learn to push the stool out for a smaller caliber stool. If your child is making large diameter stools, there is already a problem. Your body needs to have been soft stool for many months before you can stop your regimen. And hopefully, if your regimen is fiber filled foods, you never stop it at all! See my previous post for foods that help.
Here is a common list of issues asociated with constipation
-hemorrhoids!!
-eating poorly
- missed school and work
-increased risk of cancers
- incontinence and a**l leakage around impacted stool
-anxiety and depression
-increased acid indigestion and reflux
-poor sleep and ability to do sports due to gas
-frequent doctor and emergency room visits
**pdoc

Puberty is starting earlier than ever. Parents, here is what you need to know:

* Thelarche (breast growth) and increased growth velocity before age 8 in girls and ge***al development in boys before age 9 suggests precocious puberty
* Precocious puberty in boys represents a substantial risk of underlying pathology and requires urgent referral to a paediatric endocrinologist
* Many cases of precocious puberty in girls over 6 have benign causes, but precocious puberty can indicate serious pathology in some cases
* Discuss your concerns with the phone call to your doctor
* Timely referral is important to ensure children can benefit from treatment for precocious puberty, but patients need to know there is uncertainty over benefits and harms from investigation and treatment
* Precocious Puberty may have lasting repercussions on a child’s mental and physical development.
* The average age of puberty’s onset — ranging from ages 8 to 13 for girls in the U.S. — has been dropping by about three months every decade over the last 40 years, according to a 2020 a**lysis of global data. In the mid-19th century, girls had their first periods — which typically come about two years after they begin to show signs of breasts or p***c hair — at age 16.5, on average. Today, puberty begins between ages 8 and 13, on average, with girls typically having their first periods at age 12.4.
* Precocious puberty is still rare, affecting fewer than 1% of the U.S. population, according to the National Institutes of Health. It’s unclear why it’s happening more, although possible causes include diet, obesity, genetics, socioeconomic status and potential exposure to certain chemicals.
* Kids entering puberty earlier than the average can be mistakenly treated as older and inappropriately sexualized by society. Studies suggest early puberty may be linked to depression and anxiety. It may also increase the likelihood of developing eating disorders. Surprisingly, it can also keep children from growing to their full height because growth plates normally close toward the end of puberty.

I’m sad it took the Cal Department of Health so long to change COVID-19 return to school requirements. But now with the new updates, I hope people will be more safe and apt to test to protect the elderly. Young infants can present just like flu, which is always concerning for parents. Luckily this winter we have not seen the new covid19 strain behave like prior strains for pediatrics. In general, children are not being sent to the ICU due to Covid19 (unless they had prior medical issues).
The school guidelines from 1/9/2024 are:

1. Stay home if you have COVID-19 symptoms, until you have not had a fever for 24 hours without using fever reducing medication AND other COVID-19 symptoms are mild and improving.
* If you do not have symptoms, you should follow the recommend ations below to reduce exposure to others.
2. Mask when you are around other people indoors for the 10 days* after you become sick or test positive (if no symptoms). You may remove your mask sooner than 10 days if you have two sequential negative tests at least one day apart. Day 0 is symptom onset date or positive test date.
3. Avoid contact with people at higher-risk for severe COVID-19 for 10 days*. Higher-risk individuals include the elderly, those who live in congregate care facilities, those who have immunocompromising conditions, and that put them at higher risk for serious illness.

For our children and our children’s children, may we teach and celebrate the life of one incredible man. Happy Martin Luther King Day. Check out Nat Geo Kids for activities and educational literature for all ages

Like many, I cannot sleep these nights, worrying about lost loved ones and displaced families. Today I remind my children that this land was not always ours to live on. We practice gratitude at every meal and recognize that all we really need is each other (and certain meds like insulin 😂). May we never take our health and loved ones for granted! Happy thanksgiving to all the families I have been fortunate to care for. May you hold your children tight tonight and every night!

I met Devun 6 years ago after he lost his 15 yo brother at a sleepover party. A parent had left narcotics in a bathroom, and they looked like headache medicine. The ER sent the 15 yo home, against mom’s wishes, without administering Narcan. This double tragedy sent Devun through a life transition that proved his resilience. Devun and his family managed one day at a time. However, one year later, Devun almost died in Diabetic Ketoacidosis. A local urgent care misdiagnosed him with flu after several return visits. Mom called me one night for help. It was my first time caring for Devun and I was shocked that he was barely responsive. I sent them to CHOC ER where Devun was quickly diagnosed with Type 1 Diabetes. As an adolescent and teen, instead of worrying about the usual school troubles, Devun had no choice but to learn how to keep his blood sugars from plummeting or skyrocketing. Years later, I would never have imagined that I would be FaceTiming Devun with my son Dex. Devun was quick to show us how to use and apply the many devices that help type 1 diabetics. He made my son (and US!) feel calm as we entered an otherwise scary new reality.

Over this past weekend someone stole Devun’s insulin pump at a rock concert. His pump functions as a pancreas and costs over $5000. It was soul crushing as Devun now has to inject insulin for all carbohydrates he eats. Nonetheless, he came in with a big smile to get these drumsticks!

A few months ago, he came in for his well visit. I asked what excites him and he told me he was picking up drumming and perhaps one day would have a band. Ever since then I was on a mission to get him something special.

I couldn’t be more grateful to for making Devun’s winter a heck of a lot brighter! As any orange county pediatric specialist would probably attest, my best skill is asking for favors for patients!

After all my years in medicine- my only wish is for your child to be happy.

The rest works out one way or another.

RSV is here (I was caught off guard today!), but this season there is a monoclonal antibody to prevent long term lung disease. We just got both doses of Beyfortus in so book your shot. Only side effect in ~5000 children was site redness for one day. Talk to your pediatrician if you have a newborn or baby under 8 mos of age. Children up to 24 months of age who remain at risk of severe RSV disease through their second RSV season can also get it covered by insurance. And as most of you know, insurance doesn’t pay for expensive medication unless it truly helps! Your doctors are so excited about this, but a few of my parents seem to be even more thrilled as they have lived through RSV intubation. Don’t let it be your baby.

My fondest memories of Medical School in Israel are the long nights I spent in the hospital caring for Palestinian children. I stayed late after shifts, learning about their families. Arabs traveled safely across borders for better medical care. I found it fascinating that the hospitals were serving more Arabs than Jews. My medical ethics class was taught by a surgeon who saved the lives of terrorists. Level 3 trauma response is not partial to religion in Israel. The news wont show or tell that.

I have never been religious, and living in Israel made me all the more agnostic. In college I took a year abroad and lived in Jerusalem during the intifada. I created multicultural groups, became close with Arab students, and learned that the news in the US never showed the harmony between the hard working Arabs and Jews. Palestinians living at Hebrew University were the same as anyone and happily would abide by Israeli law. Arabs I met appreciated the innovation that the Jews and state of Israel had brought to what was once a barren desert. I would study, run, and live as friends with anyone and everyone. This was not reflected anywhere in the news.

At times I was told to carry a gas mask everywhere I went. Years later I left medical school to live in France during a time of war.

I could never fathom why humans cannot see any other human as extended family?

Was it the distortion I saw on the news?

Can a person really believe a god chose one life more important over another???

In Jerusalem, young Arabic children threw rocks at my head when I ran on the streets by their homes.

Why were they being taught to hate?

How can we break this cycle?
Violence is being taught from one generation to the next.

When I told my 8 yo son what has happened to our family and friends in Israel, he immediately wanted to kill the attackers.

It is my job to tell him that violence is not the solution.

We need to break this cycle.

We are one big human family. We are all a chosen people.

After a busy “back to school” month I am delayed to post some things on my mind (a fitkids interview on creating healthy eaters, developmental milestones, Covid19 vaccine, flu, as well as scary statistics on the current e-bike revolution). But tonight I had to share my 8 yo’s “coming to Jesus moment.” I think the whole Santa charade is nuts but entertainment as an adult Jew watching on the sidelines ... Dex is investigating as if he was playing Scooby doo clue. Ben sent me the screenshot as we were sitting on the couch. Be warned, all 2nd grade parents…. Mr. S aka Santa, is not going to last

A reminder to make sure you are filling your grocery cart full of fresh produce but not loading up on pesticides. Keep these lists handy the next time you hit the store so you know which fruits and veggies to buy organic, and which ones you can cut corners on and buy conventional.
What’s so important about organic?
The Environmental Working Group’s dirty dozen is based on pesticide data from the Department of Agriculture. They estimate that you can reduce your exposure by 80% if you switch to organic versions of the 12 organic foods listed as “The Dirty Dozen.” Conventionally grown, they have the highest level of pesticides, which have been linked to harming the developing brain according to several long-term studies.
Note: The benefits of eating fresh fruits and vegetables outweighs the known risks of consuming pesticide residue, so don’t avoid these foods altogether!

How do I know if it’s organic?
If your grocery store doesn’t have a dedicated organic produce section, look for the USDA Organic label, or check the numbered sticker codes on the produce itself. A four-digit code starting with the numbers 3 or 4 means that fruit or veggie was grown with conventional farming techniques (often involving pesticides). A five-digit code starting with the number 9 means that produce is organic.

Exercise Tips for Parents - https://askdrvivi.com/exercise-tips-for-parents/
Between parenting, being in a relationship, helping at school and working, how can you keep your body moving and fit?

If you have tried and failed, you may just need a few hacks to keep you on track.

FIRST- Determine your GOAL.
This requires some reflecting on your personal values and life experiences.
Did you put on the COVID19? Are you still working through your pregnancy weight?
Are you fatigued when playing with your kids?
Many of us identify with our past successes as a competitive athlete, dancer or runner;
Thus, we crave rekindling that part of our identity.

Your goal may start with any or all of the below:
-walk x number of miles a day
-build muscle mass
-lose weight
-get moving
-have time to dive into my thoughts
-give my body some self-care
-Increase my flexibility

Be easy on yourself with your goal. You can always increase it or change it later. You want to pick something that you can actually do!

For the first step it is just as important to recognize after every workout, that your movement helped you in additional ways outside of the original goal. Reflect on this list of examples as it will be important for helping you motivate. You may then add these as subgoals.
For example, increased blood flow during exercise:
1. Brings clarity of thoughts
2. Gives you a fresh space and time to ruminate over and/or resolve a work/life problem
3. Decreases back/body pain while working at a desk or playing with your kids
4. Improves your skin
5. Improves your hormones/mood and thus interactions with your family/friends/colleagues.

SECOND-List your OBSTACLES.

Write these on a piece of paper. Below I have listed the most common obstacles.
1. TIME. For most of us, time SEEMS to be the primary obstacle. Parents in particular feel guilty leaving a child with a babysitter or asking their partner to watch the kids while they indulge in time for themselves. Try to recall how happy you are for your partner when they do something healthy for themselves. With time constraints, always announce your workout/self-care times out loud. For example, if at home, wake up Saturday morning and state to your partner “I am going to go for a run today. Can I go when Johnny takes a nap?” If at work, block time over your lunch break and let others know you will be heading out on a walk/run. Don’t be shy about this. There is no “sneaking” in a workout. A break is indeed your time to use as you wish. AND consider how much you respect your coworkers who go hit the gym or workout before or after work. You don’t think “they are such slackers.” Rather, "Wow I wish I was motivated and successful like them!"

Always keep a regimen simple if you are starting from nothing. Don’t expect to start swimming laps at a club every other day. That is going to be way too time intensive. Start walking to and from the park or school. Get in the car less and less. Always park your car far away from an entrance and take the stars when able. Stars are a VERY efficient way to sneak in a workout in. So skip the elevator!

2. PAIN/DISCOMFORT. This one is easy because your obstacle is your solution! If it hurts, stop. Pick a new activity. If your body was not made to be a runner, try the elliptical, swimming or biking. If you have pain but love the sport, slow down or change it up. You will never stick with an activity that causes pain, and you may permanently harm your body. When you strain during a workout, you will hold yourself in an unnatural position just to avoid the pain. You may later have neck pain and headaches. You cannot afford to be injured. Check in to see how you feel during and after your exercise. If it does not feel good then change to some other form of exercise or lighten your workout so that it is comfortable. You will not be successful if you do not enjoy your activity.
3. EXHAUSTION. Consider your ebb and flow in a normal day and schedule your workout accordingly. People are genetically programed as morning or night people so don’t expect to wake up at 5 am to exercise if this is not your modus operandi. Plan to have your caffeine fix 1 hour before your exercise regimen so that you are not battling a caffeine crash when you are trying to get moving. Eat foods that are not processed or have added sugars. These will make you feel a low soon after you eat them.

THIRD- Make your PLAN (the when and where).
Set your routine to happen close to your home/office and plan for the routine to be only 15 mins. This short time requirement and proximity to your home make it easy to execute. Almost anyone can walk for 15 minutes. You may be able to fit in and enjoy 30 mins every time. But if you expect a 30 minute daily walk, when your lunch break is only 30 minutes long, you may set yourself up to fail. Also, if you have a hard time with commitment then remind yourself by 3 or 4pm that you need to commit to your health plan.

TIPS for a successful plan:
1. Plan to meet a friend if that brings you joy.
2. Seek out an exercise group if you enjoy meeting new people and find a social hour to be an added incentive.
3. If you like routine make one.
4. Make sure your meals are eaten more than an hour before your workout. Most people need 2 hours for running (ie-eat a snack at 10 am if you plan to run at lunch).
5. Pack lunch and healthy snacks in the morning. Always add in much more fresh food than you think you will eat. This ensures that your fruit and veggies get devoured over the tempting packaged snacks at work.
6. Have an extra set of shoes and workout gear at work or in your car.
7. Don’t come home early from work or a meeting if you have energy to exercise. Take advantage of the time you have. If you go home you likely won’t escape helping with homework, picking up, doing laundry and goofing around with the kids (albeit this can be equally rewarding and full of activity if you prefer!).
8. Schedule phone calls when you can walk or when you must be in the car (and already stuck sitting). Don’t sit at your desk any longer than you need to. When on a phone call get up and move if you do not need your computer. Opt out of a Zoom call unless it is required. You can even stretch on the floor of your office or living room while on the phone.
9. If plans change and you must be home during your set exercise time (nanny is sick, baby is sleeping etc), plan some active chores or activities around the house.
• Have a dance off with the kids and make sure you move to 4 songs.
• Walk to a park with the kids and make sure you get in all your steps.
• Play tag in the yard.
• Set up an obstacle course and race your kids through it.
• Walk to Starbucks with the stroller.
• Go to the beach/park with a wagon and pull the kids.
• Get wild with your kids. I joined a trampoline park when I signed my kids up. I always jump on the trampoline with them.

FORTH-Stick with it!
Consider these tips to success:
1. STOP before you start if your plan is not balanced. Extreme regimens may work - but likely only in the short term, and have lasting consequences on those around you. Have you ever felt awful for your friend married to the body builder or the ironman triathlete who is never around to help? I have known dozens of parents who drop 20 pounds and proudly announce they are fasting or on a ketogenic diet. One year later they are back to their same weight if not heavier. I predict it every time. Moreover, you need to model balance for your children (if not yourself).
2. Remember that light exercise burns fat!! So if you have to run an errand and are too tired to exercise, walk to your errand. Pick up what you need, and carry it where you need it. If you feel slow and are not moving like you’re usual, remind yourself that when "I GO SLOW- I BURN FAT." Building muscle comes when you pick up the intensity and you are out of breath. Key point- doing something comfortable burns fat. SO your workouts need not be intense, but daily. Shoot for 15-30 mins or more.
3. Plan it out and say it out loud to your spouse, colleague or friend. Hire a sitter to make sure you get time away. Skip the gym if you can find other options. For some, the time to drive back and forth is valuable exercise time. Consider that people pay money to vacation in Southern Cali so enjoy our weather and vistas while you break a sweat outside. Lastly, the gym’s babysitter club is often a mixture of new germs. Your kids are already exposed at school to enough colds.
4. On days you don’t feel fresh or energized, remind yourself that you can do anything for 15 mins.
5. Don’t wear tight clothing unless you need it for support. This is restrictive and makes a workout much harder than being in cotton. Some people will feel better if they skip the trendy tights and wear workout gear that fit like PJs.
6. Buy new shoes that are comfortable!! After 4-6 months even walking shoes need to be replaced. Also, remember that a good sock may be just as important. Make sure it covers any edge that may rub from your shoes. If you have bad knees make sure the sock does not slip in your shoes. Soles made from Ortholite (Hoka) are great for people needing more cushioning.
7. Don’t skip your routine because of your monthly cycle. You will feel much better if you exercise during your period. In fact, exercise is better than motrin/advil/ibuprofen at reducing cramps! Exercise moderates symptoms due by balancing hormones.
8. Get a good music app with workout songs you like. Pandora works great for many. Or make a spotify or apple play list. Studies show increased endorphins and increased “stick-to-it’dness” when listening to music while exercising.
9. Remove processed foods with added sugar. These foods will be addicting and bring energy drops. (Cliff bars and the like). Pair complex carbs with protein for snacks prior to exercise.
10. Find ways to save time. Instacart, Amazon, Door Dash and other times saving tactics are well worth their fees. You can consider them your gym membership! It buys you time to be with your kids or exercise. Looks for help online (try nextdoor or care.com for teens and nannies who can come with you to the park and watch the kids while you run laps around the periphery).
11. Try to exercise during your lunch break, as your work will be all the more productive in the afternoon.
12. Make sure you hydrate after exercise. The body can confuse dehydration for hunger.
13. Enjoy the burn, welcome it, and consider sweating an old fashioned cleanse.
14. Myfitnesspal and similar apps are great for helping you find out if you are overeating. I recommend people learn portion sizes and use these for 1 week to learn what calories in equates to calories out. Buy measuring cups and measure out your servings for one week. (Do not do this in front of children in the house).
15. Learn what you enjoy doing outside as this habit of being able to go out your front door will maximizes your lifetime access to fitness.
16. Hit the sand, stairs or hills to mix it up. Don’t expect to go as far but work out just as long.
17. ALWAYS BE KIND TO YOURSELF. You are your own best friend and how you speak to yourself makes a world of difference. Have you met a narcissist? Do you see how overly optimistic they are about their health and body. Try to be more like that!
18. Focus on the MANY additive mental and physical benefits:
• You release your energy and will experience FAR less snapping at your children, friends and loved ones. It’s a way to “let things go.”
• Exercise gives us time to reflect and be grateful. AND you are finally making time for yourself.
• You become a role model so that your family sees that movement is a priority.

Ideas for quick dry snacks to pack for a long day of play with kids- and YOU!
1. Always consider fiber rich dry cereal. You can save on packaging and they are always vitamin fortified. Fiber helps fill everyone up quickly and keeps the family regular. For picky eaters this is a must, since most snack foods will not have fiber.
2. Dried fruit and dried vegetable chips are great alternatives to the fresh. My family enjoys organic seaweed as well.
3. Buy chips made from beans, quinoa, lentils, flax seeds, chia seeds and vegetables. These things should appear as the first ingredients.
4. Don’t forget nuts and seeds! From selenium to omega fats, there is so much to be said about one serving of these guys. Just be careful not to supersize the serving. My family loves the 100 calorie almond packs.
5. If you and your kiddo won’t drink water in the morning make some flavored naturally decaffeinated tea. You can always chill it and bring it to work or the park to liven up a thermos.