The Rimland Center for Integrative Medicine
Patient Resources
News and Events
Bagged Salad Mix – Cyclospora Infections Updated 6/26/2020
Officials are currently investigating a multistate outbreak of Cyclospora infections linked to bagged salad mix.
Situation
- Location: U.S. Multistate (case count map)
- Description: Cyclospora infections, linked to bagged salad mix
- Number of infections: 122 (as of 6/23/20)
- Pediatric population affected: All pediatric populations at risk
Background
- Epidemiologic evidence indicates that ALDI Little Salad Bar brand Garden Salad, Hy-Vee brand Garden Salad, or Jewel-Osco brand Signature Farms Brand Garden Salad are a likely source of this outbreak.
- The following recalls have been issued:
- ALDI Little Salad Bar brand Garden Salad sold in Arkansas, Illinois, Indiana, Iowa, Michigan, Minnesota, Missouri, North Dakota, South Dakota and Wisconsin (Recall info)
- Hy-Vee brand 12-ounce bagged Garden Salad sold in Illinois, Iowa, Kansas, Missouri, Minnesota, Nebraska, South Dakota, and Wisconsin (Recall info)
- Jewel-Osco Signature Farms brand 12-ounce bagged Garden Salad sold in Illinois, Indiana, and Iowa (Recall info)
- Bagged salad mixes from ALDI, Hy-Vee, and Jewel-Osco do not explain all of the illnesses in this outbreak. CDC and FDA continue to investigate to determine whether other products are a source of illnesses in this outbreak.
- Sixteen percent of ill people have been hospitalized. No deaths have been reported.
- Illnesses started on dates ranging from May 11, 2020 to June 15, 2020.
Action
- Do not eat, sell, or serve any of the recalled bagged salad mixes from ALDI, Hy-Vee, and Jewel-Osco.
- Throw any remaining recalled salad away, even if some of it has been eaten and no one has gotten sick.
- Clinical Manifestations (Red Book)
- Diagnostic Tests (Red Book)
- Treatment (Red Book) - Antibiotics are needed only for patients who are very ill or at high risk for severe disease, such as people with severely weakened immune systems.
- Reporting (CDC)
- Control Measures (Red Book)
Resources
- CDC Outbreak Webpage
- Case Count Map
- Patient Education
- HealthyChildren.org: Food Poisoning and Food Contamination
- What to Tell Families
- Do not eat, sell, or serve any of the recalled bagged salad mixes from ALDI, Hy-Vee, and Jewel-Osco.
- Check your home for any of these recalled salads. Throw any remaining salad away, even if some of it has been eaten and no one has gotten sick.
- If you live in Arkansas, Illinois, Iowa, Kansas, Missouri, Minnesota, Nebraska, North Dakota, South Dakota, and Wisconsin and don’t know whether the bagged garden salad blend you have in your home is one of these recalled salads, do not eat it. Throw it away.
- Symptoms of a Cyclospora infection include:
- Watery diarrhea (most common)
- Loss of appetite
- Weight loss
- Cramping
- Bloating
- Increased gas
- Nausea
- Fatigue
- If you experience these symptoms, talk with your healthcare provider, and write down what you ate in the two weeks before you started to get sick.
- Do not eat, sell, or serve any of the recalled bagged salad mixes from ALDI, Hy-Vee, and Jewel-Osco.
Autism Treatment Effectiveness Survey
The Autism/Asperger's Research Program at Arizona State University is conducting an Autism Treatment Effectiveness Survey to evaluate the effectiveness of treatments for autism, including medications, nutritional supplements, diets, therapies, and education.
Our goal is to learn which treatments are most effective for different symptoms (language, anxiety, sleep, GI, etc.). Survey results will be posted on our website for families and clinicians, and published in a scientific journal. Your participation is voluntary. The survey will take 15-45 minutes, depending on the number of treatments you wish to rate.Take the Survey!
Statement from AAP on Arsenic in Rice
In order to help address potential member and parent questions around these issues, information was compiled/developed by the American Academy of Pediatrics, and made available online. See this article
healthychildren.org - A resource from pediatricians and the American Academy of Pediatrics
Read updates and articles about health care topics. Read more...
An Important Message about Lyme Disease
Since 2007 Virginia has experienced significant increases in the number of reported Lyme disease cases and other tick-borne infections. The risk of acquiring Lyme disease is no longer confined to northern Virginia. These significant increases are one reason Governor Bob McDonnell has declared May as Lyme Disease Awareness month in Virginia.
Please read this important message from the State Health Commissioner.
Information about Gardisil
See the link below for an important message from the Principal Investigator in the Gardasil trials.
An Interview with Dr. Diane M. Harper, HPV ExpertWhen to Call the Doctor
Wondering whether your child's symptoms are serious? Should you call the doctor, treat your child at home, or go to the emergency room? HealthyChildren.org now has an exciting new interactive tool to help parents evaluate their child's symptoms.
Try the HealthChildren.org KidsDoc Symptom Checker...After Hours Care
Our telephone is answered 24 hours a day. All after hours or weekend calls will be returned by the physician or nurse on call, however if your child requires medical care between 11:00PM and 8:00AM you will be referred to the emergency room. This telephone service is available for our primary care patients only. All other patients will need to call for assistance during regular office hours.
Housing options for out of town patients
Some of our out of town patients stay in Lynchburg for long periods of time. Within one block of the Rimland Center, there are furnished townhomes available with flex terms
Some of our patients stay at the Wingate Inn, which is just minutes from our offices and features a hot breakfast daily and free Wi-Fi.
Email Consultations
At The Rimland Center, we make every effort to be available and to answer questions regarding your child during your office and/or telephone visit. However, because of HIPPA regulations, we cannot answer medical questions over email.
Hope For You To Heal
A friend of the practice, Hugo Hanson, has allowed us to make the song "Hope For You To Heal" available on our website. This song was inspired by the vision we share.Download it here
Patient Learning Center
A Guide to Moving with Children Who Have Autism
Moving becomes a part of our lives at many different stages: When we move away from our parents, relocate for a job opportunity, or find somewhere new to retire. No matter your circumstances, it can be a stressful process. And if you're moving with a child with autism, it's especially important to help relieve moving stress for both you and your kid. MyMove has put together a guide to help parents of children with autism prepare for the stress and anxiety of moving day.
Read the GuideHealing Autism Academy
Healing Autism Academy is an online learning resource for families affected by autism spectrum disorders, taught, by world leaders in the field of autism.
Watch NowGet Your FREE COVID-19 Book
Paul Thomas, a friend and research colleague of mine, quickly wrote an EBook about natural ways to boost the immune system so we do not have to depend on prolonged isolation during COVID 19 as a bridge to putting all our hopes on a vaccine.
I am particularly eager for my patients to read the sections about Vitamin C, Vitamin D and melatonin. Stress management is another important factor to optimize the functioning of your immune system.
Click on the link and you will get a free copy. Food for thought!
Get your free COVID-19 EBookHealthy Child Guide - Preconception and Pregnancy Recommendations for a Healthy Child
The Neurological Health Foundation has put together a guide with the purpose of "Educating and empowering parents to have healthy children free of chronic health disorders who realize their full neurological potential"
Download the guideResources from healthychildren.org for expecting mothers
Visit the healthychildren.org prenatal resource center to prepare for delivery and beyond. Here are two resources especially recommended by Dr. Mumper and her staff:My Child's Teacher Is Mean to Her. What Can I Do?
"Typically, teachers who are described this way don't intend to be mean. More often than not, they lack awareness." Get tips from expert Bob Cunningham about how to work your child's teacher.Dosage Guidelines for Kids from the American Association of Pediatrics
Please see these medication dosage guidelines from the American Academy of Pediatrics to prevent mistakes that could be harmful to your children.Roanoke Learn, Connect, Hope conference lecture outline
Here is the outline for a talk Dr. Mumper gave called "Eating for a Healthy School Day".Flu Shots in Pregnancy
Please see this important information about flu shots and mercury during pregnancy.Complex Child Magazine
Here is a great resource for parents: "Complex Child is a monthly online magazine written by parents of children with special healthcare needs and disabilities. It is intended to provide medical information, along with personal experiences, in simple language that other parents can understand. Articles are on a wide variety of topics ranging from basic information on medical conditions and treatments to advice on how to beat insurance company denials."
Complex Child Magazine Complex Child Facebook PageWhich Sunscreen is Right for My Child?
Check out the site below from the Environmental Working Group on sunscreen recommendations. Our practice recommends 20 minutes a day of sun exposure without sunscreen in order to maintain good Vitamin D levels.
Annual Sunscreen GuideWhy is My Child on a Special Diet?
Of the thousands of parents who filled in the Autism Research Institute's survey concerning dietary intervention, 66% said their child improved on a gluten- and casein-free (GF/CF) diet. Please understand that this diet must be followed carefully because even a few crumbs of a cookie is a very big deal...
Help for special diets...What Can Be Done to Prevent Autism Now?
By Maureen H. McDonnell, RN
Although the entire mystery of what has caused the autism epidemic has not yet been solved, based on emerging science and parents reporting what specific treatment have improved (or in some cases recovered) their children...
Folic Acid Recommendation for Women Contemplating Pregnancy
In a large study (85,176 children born between 2002 and 2008) mothers who took folic acid from 4 weeks prior to conception until at least 8 weeks after their last menstrual period prior to pregnancy were less likely to have children diagnosed with autism. Adjusted odds ratio for autistic disorder in children of folic acid users was 0.61. This means that chances of having a child with autism were reduced almost 40%. However, these findings do not establish causality. Our practice recommends folic acid supplementation for women contemplating pregnancy. Read more...Vitamin D: An Absolute Requirement for Healthy Living
Many of us regularly assess laboratory values of vitamin D. Interpretation of the lab’s reference range can be a challenge to explain to your patient. What is the difference between “normal” and “optimal” and why is their reference range different from what you are recommending? Dr. Michael Stone created this handout a couple of years ago to answer those questions. It has become a very useful explanation that I often give to patients after I’ve done a brief overview of the importance of vitamin D and why I may be suggesting supplementation. We have added references to this document so that the more curious patients can have some evidence behind your suggestions. Additionally, they can take it to their other providers who may have some questions about those recommendations as well.
Everyone should have his or her vitamin D level checked at least once a year (infants through the elderly).
Below are conditions that have been associated with vitamin D levels:
< 10 ng/mL Severely deficient < 15 ng/mL Risk of rickets[i] < 20 ng/mL 75% greater risk of colon cancer[ii] < 30 ng/mL Deficient
Increased calcium loss from bones, osteoporosis[iii]
Poor wound healing[iv]
Increased muscle pain[v]
Increased joint and back pain[vi]
Greater risk of depression[vii]
Increased diabetes[viii]
Increased schizophrenia[ix]
Increased migraines [x]
Increased autoimmune disease (lupus, scleroderma)[xi]
Increased allergies
Increased preeclampsia[xii]
Increased inflammation
30–50 ng/mL Suboptimal levels < 34 ng/mL Twice the risk of heart attack[xiii] < 36 ng/mL Increased incidence of high blood pressure[xiv] < 40 ng/mL Three times the risk of multiple sclerosis[xv] > 50 ng/Ml 50% reduction in breast cancer, decreased risk of all solid cancers[xvi] 80–100 ng/mL Slowing of cancer growth in patients with cancer[xvii] > 100 ng/mL Increased risk of toxic symptoms (hypercalcemia)[xviii]
Natural Production of Vitamin D
Your skin makes vitamin D when it is exposed to a pinking dose of sunlight. How much vitamin D you make depends on your age, how much skin is uncovered, and your skin tone. Without sunblock and with arms and legs exposed, your skin will make 10,000 to 15,000 units of vitamin D in one pinking sun exposure, on average. Sunblock with an SPF of more than 15 blocks 100% of vitamin D production in the skin.
Depending on the latitude at which you live, you may only get enough radiation from the sun for vitamin D production between May and October. Also, the darker your skin, the more sun you need to make enough vitamin D.
Vitamin D Supplementation Doses
Normal dosing of vitamin D depends on your blood levels. Some practitioners recommend treatment doses for blood level ranges as high as:
| <10 ng/mL | 10,000 units per day |
| 10–20 ng/mL | 10,000 units per day |
| 20–30 ng/mL | 8,000 units per day |
| 30–40 ng/mL | 5,000 units per day |
| 40–50 ng/mL | 2,000 units per day |
If you are taking a vitamin D supplement, adequate calcium and magnesium intake are also required.
It is very difficult to get too much vitamin D. People can take up to 10,000 units per day for 6 months and not have any adverse effects. However, people with sarcoidosis, tuberculosis, Lyme disease, lymphoma, or kidney disease have to be supplemented carefully because of an increased risk of their blood calcium level becoming too high.
Rechecking Your Vitamin D LevelIt is recommended that you have your vitamin D level rechecked within 2 weeks to 2 months after starting supplementation, depending on your medical and health condition. Other lab tests for calcium, ionized calcium, magnesium, and parathyroid hormone levels (PTH) may also be done during the recheck.
*From the Institute of Functional MedicineNourishing Hope: Autism Diet and Nutrition Information
The website of Julie Matthews, Certified Nutrition Consultant and Autism Diet Specialist She understands, applies, and customizes the varied dietary strategies - as there is no "one size fits all" approach, nor one particular "autism diet."
Learn MoreAutism Videos from the Autism Research Institute
The Autism Research Institute has compiled videos of recovery stories. Learn more...Learning and Developmental Disabilities Initiative (LDDI) Consensus Statement on Environmental Factors
View their consensus statementGluten/Casein Free Grocery Shopping Guide
"Frustrated in trying to find Gluten-Free Casein-Free (GFCF) Products in your grocery stores? Tired of calling food manufacturers and guessing on nutrition labels? Well, help is here! Introducing Cecelia’s Marketplace Gluten/Casein Free Grocery Shopping Guide!"When to Call the Doctor
Wondering whether your child's symptoms are serious? Should you call the doctor, treat your child at home, or go to the emergency room? HealthyChildren.org now has an exciting new interactive tool to help parents evaluate their child's symptoms.Try the HealthChildren.org KidsDoc Symptom Checker...
MB12 Report Form
See our MB12 questionnaire. This is yet another example of the contributions of parents to the work of helping children with autism.Online Resources from the National Institutes for Health
Toxicology
LeadMercury
Pesticides
Toxicology Map
Tox Town
General Environmental Information
Portal to many resources on environmental healthPoisoning, Toxicology, Environmental Health
Household Products
Indoor Air Pollution
Home Page
Activities for Kids
Genes + Environment
The National Center for ToxicogenomicsChild Safety
NIH Child Safety ResourcesChild Sexual Abuse
News by Health Topic
Getting Children to Take Supplements
View this informative article with advice on getting your children to take supplementsTen Things Every Child With Autism Wish You Knew - by Ellen Notbohm
Download these great articles
Ten Things Every Child With Autism Wish You KnewTen Things Your Student With Autism Wishes You Knew
Books by Ellen Notbohm
Ten Things Every Child with Autism Wishes You KnewWinner of iParenting Media’s Greatest Products of 2005 Award
Buy from Amazon
1001 Great Ideas for Teaching and Raising Children With Autism Spectrum Disorders
Winner of Learning Magazine’s 2006 Teacher’s Choice Award
Buy from Amazon
Columns
Postcards From the Road Less Traveled, Autism/Asperger's DigestExceptional Children: Navigating Special Education, Children’s Voice
Resources for Ensuring a Healthy Environment for Your Child
Indoor Air Quality
Indoor Environmental Quality ReportHousehold Drinking Water
Water Filtration TechnologyFrom Countertop to Shower Filters to Whole House Systems
General Information on Household Toxins and Alternative Products
General Information on Household Toxins and Alternative Productswww.healthy-homes.com
US EPA Healthy Buildings, Healthy People
Natural Home and Garden
Formaldehyde Free Hardwood Plywood: uses soy based adhesives which perform better than and is just as cost effective as its urea-formaldehyde counterpart
Organic and Chemical Free Furniture
Natural lawn, garden and ornament fertilizers
Environmental Toxins
Children's Health and Environmental CoalitionEnvironmental Heath Strategy Center
An information system on environmental health hazards human reproduction and development
Our Facilities
Imagine an autism-focused health center located in the heart of a small Southern city full of hospitality and charm, where patients, families, and interested medical professionals can receive the individual care and education they so desperately need. Far more than just a doctor’s office, the RIMLAND Center includes not only exam rooms and lab equipment but also a state-of-the-art hyperbaric oxygen therapy center and a demonstration kitchen where families and doctors can learn first-hand how to implement the diets - gluten-free, casein-free, special carbohydrate - that have the potential to change their children’s lives.
Imagine a doctor’s office where, instead of an impersonal and anxiety-producing waiting room, patients enter a skylit room with brick walls, bistro tables, comfortable chairs and sofas - a relaxing environment made for the whole family. While they wait, children can enjoy the adjacent playroom, which also serves as an arena assessment area for physical therapists, occupational therapists and others. Plasma TVs bring to life educational videos, making the most out of the time between assessments and hyperbaric sessions, and the building can also serve as a community center where special needs organizations can meet outside of office hours.
The new mentoring center is international in scope, helping to bring the Defeat Autism Now! biomedical approach - autism is treatable, recovery is possible - to clinicians from around the globe. Over 80 doctors have already expressed their interest in participating in such a mentoring experience, and families from as far away as Italy have already made use of all the facility has to offer. Every doctor trained and every family served can help more children and bring us closer to the goal of restoring these children to their full potential.
Contact Us
The Rimland Center for Integrative Medicine2919 Confederate Ave.
Lynchburg, VA 24501
P: (434) 528-9075
When To Call The Doctor
Wondering whether your child's symptoms are serious? Should you call the doctor, treat your child at home, or go to the emergency room?
Try the HealthChildren.org KidsDoc Symptom Checker...After Hours Care
Our telephone is answered 24 hours a day. All after hours or weekend calls will be returned by the physician or nurse on call, however if your child requires medical care between 11pm and 8am you will be referred to the emergency room. This telephone service is available for our primary care patients only. All other patients will need to call for assistance during regular office hours.