I recently had the privilege of holding space for a frightened client as her child went through a complete cycle of a severe asthma attack.  What hit me hardest in walking with this mother, was the intense energy of fear. It was a “me too” moment. My own child has put me face to face with deep penetrating fear more than once.  This fierce love of our children creates the deepest attachments formed in life. When they are ill, fear of losing them can cut loose in our bodies and beings. There is no ritual to move this energy at this time.  Worse, you may even be shamed for feeling it. How many times have you been told, there’s nothing to worry about?  You go to the doctor and prescriptions and treatments are prescribed but who is helping us examine and move fear?  My best friend (Dr. Julie Von) has often told me that she felt her asthma was wrapped into her mother’s fear and anxiety.  She sensed that her body became a way of manifesting her mother’s fears, sadness and other unresolved emotions. If this sounds far-fetched, I encourage you to look deeper.  This is not to dismiss the physical realm of asthma or blame her mother. It’s to bring awareness. To continue to completely dismiss the psycho-spiritual aspects of pediatric medicine is absurdly bad science.

A child depends upon us to understand complicated situations or those that feel out of control.  Chest tightness and hypoxia definitely signal to the body that things are out of control. If this fearful child is met by the energy of fear from their mother, the potential for the entire situation to build energy towards chaos absolutely follows.  Now imagine this same child faced with a calm, grounded mother, acting from intuitive wisdom. Could you imagine how these two scenarios could create a completely different oxygen level in the same child?

So let’s pretend we’re not all the Zen calm mother in the second scenario all the time. Something big happens and we freak the f*ck out. How do we authentically experience our fear and not get it all over our kids?

As my client was battling her fear for her child and his asthma, my own child lay raging fever in his sleep.  I was already curious about fear, and now here I was standing in my own. My mindfulness practice helped me to know that I was caught in fear.  I cannot stress enough how important a mindfulness practice is to know what is going on! Without I would never have had access to even the first layer, which is simply recognizing the emotion. I feel terrified right now.  I then let myself breathe into the arising fear.  I literally sat down into this fear and traced it. And there it was.  It was connected to the scariest thing in this world.  The fear of losing him. I then let myself enter that awful layer. What would it be like if I lost my son?   Tears came hard as I dropped in fully. I allowed myself to actually feel the depth of what was happening to me.  It didn’t last super long and then the fear shifted. Simply by allowing it to be recognized, experienced and held; fear shifted.

There is no escaping fear when you love the way we do.  I agree that it is so very uncomfortable and would rather just not.  And then of course there is the bitter irony that it is bravery that is required of us to sit still enough to feel our less desirable feels.  To hold honor to what is there in the moment, without judging and welcoming it, will allow what is next to happen. It may be another fear. It may be something entirely different. 


Love and tenderness to each of you brave, brave souls as you journey the hard stuff.  -Heather




Radical Self-Care

Radical Self-Care

engine light

Radical self-care.  You will see me writing on this concept over and over again.  I want to ooze the importance of self-care with my existence.  I want to be contagious in my liberation to others.  Culturally as women, we are trained early on to place our desires on the back burner to better care for those around us.  It is therefore a revolutionary act when we move even momentarily from the demands of those outside of ourselves (the other) inward.  Caring for others can absolutely bring a wonderful sense of fulfillment and joy, however it requires a delicate balance and self-awareness.  It is through these two concepts we can prevent the slip into depletion.

Finding balance depends upon our inherent constitutions, stressors with us in the now, our immediate health and our ability to know ourselves and our own needs/desires.  Dr. Julie Von, fertility expert, has taught women through an exercise she calls “Find Your Pillars” how to identify the things in our lives that help hold us up (i.e., keep us sane). Once we have identified the parts of our lives that fuel the soul, the next trick is learning how to consistently make them a priority.  For me, I know I need to dance, practice yin/meditation, and have time in nature; however, despite this intellectual knowledge of my pillars, I let things get in the way.  

Currently there are around one million reasons each week that explain why I cannot take proper care of myself.  My personal favorites are guilt and too busy.  My own child would like to be next to me 100% of everyday.  Familiar to many of us loving Moms, is the heart wrenching tearful departure that comes from separating from our child, often regardless of their age.  As an empathetic mother, we share this pain when we part.  The natural maternal empathy is beautiful, however a disconnect happens when that awareness of other turns to guilt.  Though utterly unfounded, guilt strikes through tendrils of the unconscious notions of what a woman “should” be doing with her time and what a mother is.  This is an area worth exploring in oneself as it houses many obstacles to being able to fully step into balance.

Another great source of my barrier to self-care is time.  I mean the fact that I work two jobs and one of those jobs is running a busy practice on my own clearly validates the too busy, right?  Despite my best intentions, I sometimes overdo it.  And, if I let my own care slide, sometimes too busy gives birth to too tired.  And then, cue the check engine light!

Like any vehicle, each of us has a dashboard with indicators of how we are doing both physically and emotionally.  The flashing of my check engine light looks like this on the emotional plane:  A feeling of being near tears, mild irritability, resentment towards my husband, hypersensitivity and a sense of being overwhelmed.  (In many ways, this warning phase feels similar to PMS.)  After choosing to ignore these softer signs, I can begin to tip into serious engine damage.  On the physical plane my adrenal glands begin pumping out epinephrine to keep up with the demands I am putting on myself.  Here I can sense rage, despair, and rampant irritability.  The key to preventing this type of damage is early recognition.  Also, at a deeper level, I’ve had to work hard with a coach to heal the fun trans-generational pattern of worn-out, angry women.  Though all of them amazing and utterly justified in their anger, it is not how I choose to live my lifetime.  

As much as I’d love to be that infallible, magical superhero version of a mother that our culture has perpetuated to make all Mom’s feel inadequate, I’m not.  I am simply a human being that has her own needs.  So as I wave goodbye to my son to go have my hour of me time and the guilt comes, I remind myself of the miserable version of me I become when I don’t take care of myself.  I remind myself that self-care is prerequisite to the function of my higher intuition.  Then, it becomes a simple and clear choice and my heart lifts.  


Methylation Status

Methylation Status

Thanks to internet genomic services such as 23andme and genetic genie many of you have not only heard of the various methylation mutations, you know you have the dreaded MTHFR and you’re heterozygous for C677T!  The big question that is facing us, as our personal health information pool continues to grow, is what do we do with this data?  If you haven’t already, before you run out and perform these tests or begin supplementing with methylated folate, understand there are some risks and there are alternatives available.

If one knows they carry a risk of increased clotting, miscarriage, or Alzheimer’s, can this type of information influence our health outcomes?  Anxiety itself is a “dis” ease state.  Also, once we know we carry a defect are we inadvertently gathering kindling, fueling the fires of self-fulfilling prophecy of health mishaps?  Or on the brighter side, is it possible that this information will allow us to heal or prevent disease in more meaningful ways?  When I discovered I was under-methylating, I started making real changes in my diet and most importantly, my relationship with stress. I had known intuitively it was at the heart of my illness but there was more urgency for change when I saw my off the chart histamines come back from the lab.  The physical realm began to ground the more ethereal wisdom I had gained in my own healing process.  With my methylation status, I was immediately gifted insight into the physical pathways that stress was using to cause my disabling disease.  Yin yoga was given medicinal status and I could suddenly justify the time and the expense consistently.  Since that time of discovery and understanding of my methylation status, I have taken exponential strides in my own healing.  As an intuitive, I do not feel the need to confirm my exact mutations. Simply identifying myself as an under-methylator has been enough to create incredible change.  After 6 years of disabling bladder disease, I am truly healing and my genome has remained secret.

At this time insurance companies cannot use genetic information to calculate the cost of your health care.  Nor can they deny you access to coverage.  However, in the future, as we understand genetic disease susceptibility and methylation better, it is possible that this data will be released to insurance companies.   Remember these billion dollar industries have been known to influence Congress.  It is not impossible that in the future the laws that currently protect your family from genetic discrimination will be null and void.  There is no going back once your genomic data is collected.    

Importantly, you should know there exists another way of understanding your methylation status without releasing your genome.  It is simply done using whole blood histamines.  This practice was developed for clinical use by Dr. William Walsh, PhD.  In addition to Dr. Walsh’s work, functional psychiatrist, Judy Tsaffir, MD wrote a beautiful and approachable article summarizing much of his work.  Also, both of these authors responsibly discuss the complexity of supplement use.  Methylation pathways are vast, and in reality incredibly complicated.  Simply adding methylated folate to one’s diet can sometimes be disastrous.  I highly recommend if you are going to supplement that you are followed closely by a functional practitioner who understands the complexity of methylation issues.  Also be aware that supplements serve as an income for many practices.  Get clarity around this conflict of interest with your chosen provider before you buy something that your body may not agree to. 

My own healing has come completely through herbs, food sources and lifestyle changes.  Much damage is reversible in this way.  However do know there are extreme cases where the systems are so irrevocably damaged, that supplements are the only viable way they can begin to heal. Also, in these complex cases, the benefit of revealing the genome may be worth the risk. 

As you learn about methylation, you will see much of the exciting current research is in neuropsychiatry.  As a pediatrician, the most interesting data has been the relationship between methylation defects and the rise of autism.  Methylation is an enormous subject matter with discoveries being made currently! As you read you will see that authors conflict with one another.  Like anything, ultimately healing is intuitive.  However,  sometimes the right information from the physical realm can better point the intuitive beam.


MTHFR Reading:




Local Provider Resource:

Barry Smeltzer, MPAS, PAC




My Kid Never Gets Sick

My Kid Never Gets Sick


“My kid never gets sick.” This is the most common sentence I hear from prospective families when they reach out the first time.  I always smile when I hear it and here’s why. This sentence is partially true. The kids I care for in my private practice are well-nourished in body, mind and spirit.  Most have intact immune systems and very few battle chronic diseases.  The parents I serve are vigilant and catch illnesses early. In addition to this, many utilize holistic methods that prevent illnesses from going deeper and causing complications and secondary infections. The truth in this statement is my kid doesn’t seem to get terribly sick and they usually get better without issues on their own.  The reality is unless your kids are completely cloistered they are going to pick things up due to viral shift and drift (more to come on these as we head into this coming flu season).  That runny nose that looks like mild allergies is your healthy kids’ innate immune system effectively flushing out something that could land a more vulnerable child in an ICU.  Just because your kid isn’t flat out in bed doesn’t mean they are not “sick.”  This becomes very important in preventing the spread of communicable diseases. But, there is more at stake in starting conversations with this sentence.

This sentence contains evidence of a subtext and it is this deeper level that often proves most relevant.  I want to relieve my holistic community from a specific burden.  One of the reasons we start conversations with “my kids never get sick” is we hold a belief that others think we’re crazy and that we need to prove ourselves and our decisions through our kids’ brilliant health.  This belief is self-limiting.  Honor where it came from.  Most likely our need to defend or prove came as the result of cruelty and attack.  When we choose to let this hurt go we can breathe more freely in our power, we can stand in true confidence not on the defensive of our choices.  There is nothing to prove when one is acting from the seat of intuition.  With regards to this sentence, the next place to do some psychological dusting is around the idea that we have control over everything.  This related and common thread manifests in the holistic community within the concept that everything happens for a reason.  And this belief is great as long as you’re not holding yourself at the center of the reason that good or bad happens.  Sh*t happens sometimes. It’s not your fault and whatever you’re blaming yourself for happened and is most likely beyond your immediate control.  Again, feel free to let this one go into the bigger mystery that contains us. Breathe deeply into the gentler truth, which is most of this, we are merely here to witness.  Our conscious breath; our coming home to truly embody this life, this is where our true power lays.  Our job is to simply explore what keeps us from coming home.  That’s it.  Trust me, the rest is a crap shoot!  And yep, included in this is the fact that even healthy kids sometimes get sick.

Much love and tenderness as you explore around these spaces.  So many of us have been badly hurt by ignorance.  You are not alone.  You are living your truth and I love you for it.      

Back to School Immune Defense

Back to School Immune Defense


August means back to school season is upon us.  For normal people, this time of year brings happy visions of backpacks and fresh crayons.  At the urgent care clinic, gloom descends as we count down to packed waiting rooms and families made grumpy by the wait time.  In equal proportion to our sadness, little viruses can be found joyfully singing and dancing in the metaphoric streets. They know school means close contact for people who still put their hands in their mouths.  It doesn’t matter what you tell a kid about these sorts of things.  By their nature, they are all at least occasionally gross.  

Immunity for a kid is often a hard-earned battle.  As I was beginning to gather my own essential defense kit for my family’s return to disease season, this blog was born.  My family has methylation issues and so I am as judicious with supplements and herbs as I am with Western drugs.  For example something as simple as B12 can throw someone with my genetic makeup out of balance.  (Click here if curious about how and why.)  These chosen defense herbs/supplements I use are generally safe and well tolerated.  However, it is always a good idea to test a small amount of any supplement in your own body before giving it to your child. And go low and slow with initial dosing. For example, a popular children’s immune syrup that contained myrrh made me feel worse than the cold I had.  Remember just because it is natural doesn’t mean it’s gentle.

My Top 3 Picks for the School Year

Kids Defense  By Gaia Kids

kids defense

A wonderful all around product with good taste.  We use this tincture with raw honey to make a nice warming morning beverage my son affectionately named Stink Tea.  This does contain both echinacea and elderberry so this is not an everyday drink. Even natural antimicrobials can affect gut flora with prolonged use.  This is however a great option if you see sniffles or know you have been around someone who was sick.  Click the link above if your interested to see the entire ingredient list.  Though a tincture not meant for anyone less than 1 year old.

Garden of Life Chewable Kids Probiotic


I highly recommend buying your probiotics locally.  These are living organisms and they really need to be alive to do their job.  If transported without temperature control many of these guys die.  Probiotics have been shown to decrease incidence of both colds and GI illnesses; particularly in preschool-age children.  This one is delicious.  I actually take this as an adult.  I had kept forgetting to take mine.  Now my son doses us both daily. Anything that simplifies my life is a win.  Central Market and many HEBs carry this locally.  This is appropriate for anyone that can safely chew hard tablets.  

Garden of Life Vitamin C Spray


A tasty and convenient way to administer Vitamin C. This is best if used immediately following an exposure or as soon as one notices immune activation. Scratchy throat, energy dip, runny nose are often signs your innate immune system is kicking in. Vitamin C is gas to the cellular components of our immune system and is quickly depleted during an active infection.   Of note, I would not recommend taking high dose Vitamin C at the same time as your probiotic if you want those guys to make it to the gut alive.  Also, if you are sensitive to acid/base changes, I love estered-C as it is truly gentle on the gut and urinary tract. When you look at the milligrams of Vitamin C this product contains, it will seem low. However, these guys did their research to increase the bioavailability of natural Vitamin C by providing co-factors, sourcing from real food and managed to do it without GMO sources.       


Top 10 Items in my First Aid Kit

Top 10 Items in my First Aid Kit

first aid

Summer is here and in the pediatric urgent care I have begun to see more soft tissue injuries, broken bones and lacerations. While kids are out of school they have markedly more freedom to explore and with this they find creative ways to injure themselves.  It is important to have first aid supplies ready. I am going to share the top 10 items in my first aid kit and what I include for my family’s long trips away from civilization.  Please know the ready made first aid kits they sell in stores are overpriced and often fail to contain important items.

  1. Liquid Benadryl

  2. Decent tweezers

  3. Bacitracin ointment

  4. Peroxide/alcohol mix

  5. Epsom salt

  6. Ace wrap *velcro type

  7. Telfa

  8. Coban

  9. Hibiclens

  10. DoTerra Lavender Essential Oil


Benadryl liquid (generic is fine) is top of my list especially if we are going back country. Blame my likely too early exposure to My Girl that awful movie where the little girl dies from an anaphylatic reaction to bee stings. Literally if someone could have immediately gotten a teaspoon of Benadryl into her she might have lived.  Anaphylaxis happens more often today than it ever has in the past. The risks are real but the immediate treatment if you don’t already carry an EpiPen is oral diphenhydramine.  If you can’t figure out the dose remember this: 1 tsp for a little kid and 2 tsp for a bigger kid is a great place to start.  2tsp is equal to one adult 25mg capsule if that helps you to do the emergency calculation.  I got stung by a large black scorpion deep in the back country of the Grand Canyon and Benadryl made a nice difference in my ability to breathe easier.  I still got sweats and nausea but at least I could breathe.


Good tweezers made the list from another fun story of my own life in which I had taken the four year old hiking at Enchanted Rock State Park.  Despite my best efforts of telling him to stay on the trail he meandered off.  I heard such a shriek that I thought for sure he had been bitten by a snake.  Instead he turned back towards me and looked like a pin cushion.  God bless the Texas Prickly Pears.  I had my Swiss Army knife and if you have ever had to use the tweezers from it to pull thousands of microscopic cactus spines from a screaming kid you will understand why “good tweezers” made my top 10 list.


I am not crazy about Neosporin nor triple antibiotic ointment.  My husband is sulfa allergic and triple contains a sulfa antibiotic and so we don’t carry it.  Also kiddos can be sensitive to the Neomycin component of Neosporin.  A safer bet is plain Bacitracin.  This is a narrow spectrum OTC antibiotic ointment that does a great job on the typical skin flora invaders.  This will not help MRSA.  So if you have a known MRSA+ history best to carry Rx Mupirocin.



I carry a tiny little squirt bottle of 50/50 peroxide and rubbing alcohol to sterilize equipment like my tweezers and in the summer time to help ear canals.  In my Swimmer’s ear blog I discussed that this condition is preventable but you have to clean the ear canals right after swimming.  I have witnessed many a river camping trip ending in the urgent care with painful rotten ear canals.


5. salt-on-wooden-spoon

Epsom salt.  Yes I actually carry it in a zip lock bag.  Foot puncture wounds do well to be soaked immediately.


In the old days Ace Wraps had these miserable toothy clips.  Now days they are equipped with Velcro (ie hook and loop) closure systems.  These are inexpensive and worthy item to have in your kit. Can also be used as a tourniquet/compression above an arterial bleed. Familiarize yourself with wrist and ankle wraps as they are most commonly injured extremities.  Learn how to check for perfusion in the extremity you wrapped.  https://www.youtube.com/watch?v=WwhFALn7DN4


Telfa or non-adherent pads are way better than band-aids for dressing open wounds.  The last thing you want to do is accidentally peel off the healing that the body has already done.  It is also incredibly painful to remove sticky band-aids from a flesh wound.  But you may be thinking, how is this going to stay on an active kid?  You hold it on with Coban.



Coban is amazing. This stuff is flexible (great over knees) and sticks to itself like Saran Wrap. Plus it comes in many fun colors. Best price is Walmart for this and most of these items. You wash the wound with your Hibiclens and flowing water, air dry then add a bit of bacitracin ointment to the Telfa pad/wound and then cover the area with Coban to hold it all in place.  Works amazingly well and is super easy to change/remove.


Hibiclens does not sting yet it really works.  That is why I love this soap.  Studies have shown that wounds cleaned with fresh fast moving water and soap do better than any other form of torture a parent can come up with.  I swear by this stuff.   We use this as prep before suturing large open wounds.  No child has ever complained to me about this soap.  We also use it for soaking ingrown toenails prior to procedures.  A small bottle is sufficient as a little bit goes a long ways.


10. lavender

I travel with lavender essential oil.  In reality I travel with more EO’s but this one made my top ten for the first aid kit.  This stuff has great anecdotal evidence for everything from bug bites/bee stings, allergies to abdominal cramping.  It is also a great gentle cleanser. The 2007 data in the NEJM regarding Lavender causing precocious puberty should be approached with some careful consideration.  Indiscriminate use of any EO can be harmful as they are powerful medicines in their own right.  Especially one that has known estrogenic effects.  However, small scrupulous use on a bee sting is very different than slathering a young boy’s body (ie entire surface area) daily with lavender lotion.


Epsom Salt Baths

Epsom Salt Baths


Epsom salt (Magnesium sulfate) is one of the most inexpensive natural healing agents that one can buy at the grocery store.  This is a timeless treatment that my own grandmother used for a laundry list of ailments and injuries during the 98 years of her life.  I am a member of an amazing Facebook group called the Crunchy Moms of SA.  You can bet if someone asks a question to the group about a regular sick kid a following comment will mention Epsom salt baths.  I love intuitive medicine. In addition, I have this science nerd that lives in my head and always wants to know well now how does that work exactly?

It is very interesting that for more than a century folks have claimed a detoxification effect from Epsom salts.  Recently there has been much debate about the data on the common methylation defects that are emerging from the human genome project, specifically on the many MTHFR SNPs.  These folks, myself now included, have many associated vitamin defects.  These single nucleotide polymorphisms can lead to any combination of calcium, magnesium (Mg), zinc, N-acetyl cysteine (NAC), glutathione, iron and vitamins B1, B2, B12, D and folate deficiencies.  Methylation is not only important for our vitamin synthesis.  It is one of the bodies main avenues of detoxification and to make matters worse many of these vitamins act as co-factors and regulators in the processes.  Way back in 1992, Molecular and Cellular Biology published an article where Mg deficient rats had significantly elevated inflammatory markers (IL-1, IL-6, TNF-α) and went on to develop significant cardiac lesions.  Current research has expanded the role of magnesium as anti-inflammatory and immune modulator.  So what does this gobbledygook have to do with Epsom salt and your kid?

For a kid with a typical short-lived virus (fever <72hrs) and its associated acute cytokine driven inflammation an Epsom salt bath can provide a safe anti-inflammatory effect via magnesium’s effect on the cascade.  For a kid with any combination of MTHFR SNPs and an impaired ability to clear drugs this type of bath is a safer way to gently bring down a temperature and relieve the suffering of inflammation.  Also there is the extra bonus that the bit of magnesium absorbed can safely bring them towards better cellular levels and immune function.

I like the skin as a barrier and filter for supplementing children.  Oral supplementation is tricky and often requires bloodwork to be done properly.  Where in a bath the skin acts as a filter so that too much magnesium is not absorbed too quickly causing side effects or disrupting calcium balance.  Adults are to add 1-2 cups of Epsom salt to a bath and to soak for 10-20 min.  A small child is to use proportionately less.  I usually recommend a measured  ½ cup to a full bath.  Using too much Epsom, too little water, staying in too long, or doing this too often can result in lethargy and diarrhea.  I want to add this warning. Though many of us already have learned the hard way not to put a kid with diarrhea in any sort of bath, for first time parents trust me don’t do it.  A shower is a better choice.  Especially do not put them into an Epsom salt bath as the absorption of the magnesium will worsen the diarrhea.  Magnesium is a well-known laxative.  For children under 1 year of age I would consult with your provider.


My grandmother passed away this past year.  I can feel her presence as I write this particular blog.  The same woman that taught me the incredible beauty of maternal intuition and common sense also taught me to question everything.  This article is very much in her honor.