Showing posts with label travel. Show all posts
Showing posts with label travel. Show all posts

Friday, July 17, 2020

Wide Open Wednesday and Tourist Thursday

Kristen’s hard work blogging continues. Days 4, 5, and 6 are completed. I’m not sure where she finds the energy as I basically collapse into a coma at the end of the day and am minutes from doing so again right now. 

Wednesday’s Day 4 adventures on Kristen’s blog are here. I earned my keep driving about 500 miles through half of Wyoming and most of South Dakota. I didn’t think this drive was as bad as everyone said it would be- though for sure it was much flatter and far less scenic than our previous few days. I enjoyed the sporadic surprises along the way. 

We stopped at Mount Rushmore and the Corn Palace which were both cool.  I love seeing the unique features of basketball arenas and this one was for sure the most unique arena I’ve ever seen. I’m missing the WNBA season pretty fiercely so a moment in my happy place (a basketball arena) was an awesome boost to a day of driving over 700 miles. We had plenty of time to discuss how nobody here really seems to be doing anything differently regarding the Coronavirus- except there’s probably more hand sanitizer available than usual. 

Wednesday we crossed the half way point. We listened to lots of music and some audio books. Both of us took car naps. We passed through Hartford, South Dakota which made me feel a lot closer to home. We didn’t hit the cow that was in the middle of the highway... I yelped a bit when I came upon it and may have awakened Kristen in shock.
(Please note the previously mentioned bug cemetery windshield, too).

Then Tourist Thursday came about where we did a bit less driving with a crash course in Chicago tourism with a visit to Navy Pier, the Cloud Gate aka the bean, and Giordano’s pizza for some deep dish. Unfortunately the Air BnB we had booked in South Bend, Indiana was a hot mess and after maybe 5 minutes walking around it and thinking we might not live to see the East Coast if we stayed, we hit the road and kept driving while finding a hotel room to crash in. I guess I’ll have to save Touchdown Jesus at Notre Dame for another time. I’ve still never seen that campus despite driving through here at least 3 times in my life. Somehow I never ended up there with UConn Women’s Basketball... and this visit tells me that maybe I’m just not meant to see what the Fighting Irish campus has to offer.  Kristen’s more detailed post is here.



Today we completed Indiana and booked it across Ohio and into Central Pennsylvania with the major highlight being a family visit.  Overall we’re making great time, haven’t run out of things to talk about, and are about an hour and a half away from splitting up to our final destinations. See ya tomorrow, CT!


Wednesday, July 15, 2020

Yellowstone and Grand Teton Tuesday

Day 3 went by so fast!  We didn’t drive very far but we explored two National Parks- Yellowstone and Grand Teton- both really awesome, though we both preferred Grand Teton. This has been my first visit to Wyoming and it was certainly a unique place to visit. 

Here’s the link to Kristen’s Day 3 post for you to check out! And a video clip from each park. 



Tuesday, July 14, 2020

Montana Monday

Hey again!  As previously discussed yesterday in this post, my friend Kristen and I are driving from Seattle to the East Coast. She’s an adventure blogger so she’s been writing all about our experiences and I’m a day behind her in reposting them. Here’s her post from yesterday.  Yesterday we spent the day in Montana with the highlight being Glacier National Park.

Feel free to follow along our journey... or text us. We’ve got 2000+ miles still to go!

Monday, July 13, 2020

Cross Country Road Trip Day 1!



Happy summer everyone!  Whatever summer looks like during a global healthcare and national humanity pandemic.  I’ve really been struggling to write blog posts the past several weeks because sharing PT knowledge isn’t as important to me as the time I’ve spent reading about the coronavirus and the systemic racism pervading the US. 

And then, I learned the sad news that my coworker pal, Kristen, (Who I went to Africa with and have previously written blog posts about) was leaving Seattle Children’s to join the PT crew at Boston Children’s Hospital. But moving during a global pandemic, which I did during May, is more challenging than usual. She wanted to drive but it’s so far to go alone, and so our plan to road trip across the country was born.  

Road tripping isn’t one of my usual blog posting topics, but Kristen writes about her adventures, so I’m sharing hers as a blog of our trip. Check out her day 1 post from yesterday at this link and make sure to comment on her posts and answer her question of the day! 



Monday, September 30, 2019

AASPT Traveling Fellowship

Fellows @ Cincinnati Football
Long before sunrise on the morning of Thursday, September 12, 2019, I boarded a sleepy airplane lightly coated in the typical Pacific Northwest mist heading towards a career-enhancing expedition.  After a brief pit stop in Denver, I continued on to Cincinnati airport, weirdly located across the Ohio River in Northern Kentucky.  Upon arrival at the CVG baggage claim I met two physical therapists who I would spend the next eleven days learning and observing various topics related to sports physical therapy. Rebecca Troulliet from North Oaks Health System in Louisiana and Patrick Barber from University of Rochester in New York joined me for the American Academy of Sports Physical Therapy (AASPT, formerly known as the Sports Section) Traveling Fellowship.  Sponsored by Kevin Wilk, LightForce and DJO Global/DonJoy. We spent about three days each at University of Cincinnati, Mayo Clinic locations in Minneapolis and Rochester, Minnesota, and The Ohio State University. 

What does it mean to be a Fellow?  According to Wikipedia, "a fellowship is a group of people who work together to pursue mutual knowledge or practice."  Though each of us had individual purposes for participation, we are all physical therapists working with athletes and we were all looking for growth in our careers.  Through observation and lecture attendance with more seasoned clinicians, we had exposure to different techniques and clinical approaches than our usual day-to-day experiences.  Now that I've returned to my usual swing of things and seeing my patients at Seattle Children's Hospital, I'm taking this opportunity to reflect on the experience and share why I chose to pursue this Fellowship along with some highlights from our trip. 

First: Why did I want to complete a Fellowship?

In May 2014, when I was completing PT School at the University of Connecticut, my career aspirations were to serve as a team physical therapist in the WNBA.  I had previously worked in a non-medical capacity for the Connecticut Sun for four seasons, but elevating to this new type of position as a new grad PT didn't seem remotely feasible.  Beyond the fact that I was a new clinician,  WNBA teams didn't have physical therapists, then, so this goal seemed unrealistic. (Most teams still don't, which I wrote about here)  I thought my fastest route to working with professional female athletes was to advance my education from PT School through a Sports PT Residency Program. In 2014 there were about twenty of those programs nation-wide, mostly offering one or two slots. I applied to three, including Ohio State, but was not successful in securing a position.  Now there are almost fifty SCS Residency programs with so many more opportunities nationwide! To search Residency programs in any PT Specialty area, click here.

Fortunately, physical therapists have an alternative route to obtaining board certification and specialization in sports physical therapy that does not require participation in a residency program.  You can find the requirements to do so hereAs I pursued the alternative route, I also landed a role with the Seattle Storm, and in March 2019 completed my Board Certification Exam.  In our cohort, Pat also took his exam in March following completion of the University of Rochester Residency program and Becca is currently working through the alternative route requirements to specialize in the future.  So because I did not complete a residency program but did pursue specialization, I felt like I lacked some of the mentorship and on-field hours that a residency would have provided, and this fellowship filled some of that gap.  


Second: What was the Fellowship like? 
Each location was very different from the others which helped us gain a broad spectrum of the possible roles and responsibilities for a sports physical therapist.  


Fellows and PT staff @Cincinnati
At the University of Cincinnati, we were hosted by Bob Mangine and Tim Machan and primarily spent our time in their athletic training room with them and on the sideline.  We had the chance to watch game-time coverage, led by Head Athletic Trainer Aaron Himmler and had a sit-down discussion with their concussion program and vision training expert, neuroscientist Dr. Joe Clark. We attended lectures on a variety of topics by members of their staff including wearable technology, use of the ACL-Return to Sport Index Outcome Measure, Neuroplasticity, Prevention of Catastrophic Injuries, and and we each presented our own lectures. My presentation examined the Impact of Fear Avoidance on Return to Sport, Becca discussed Sudden Cardiac Death and Pat outlined Upper Extremity Return to Sport Tests.  

With Timberwolves Robby Sikka and Matt Duhamel
After exploring Cincinnati, the three of us packed our bags to head to Minneapolis for the first half of our visit to the Mayo Clinic.  Our host in Minnesota was Corey Kunzer who is the coordinator of the Mayo Residency program.  The clinic in Minneapolis serves the community as well as having partnerships with the Minnesota Lynx (WNBA), Minnesota Timberwolves (NBA),  and Minnesota Twins (MLB).  Only days before our arrival, the Seattle Storm had knocked the Lynx out of the WNBA playoffs so I felt a little like I was in enemy territory, but I was glad to finally meet Emily Beyer, Lynx Team Physical Therapist as well as Matt Duhamel, Team Physical Therapist/Director of Athletic Therapy for the Timberwolves and Jeff Lahti, PT for the Twins.  We also met Robby Sikka, Timberwolves VP of Basketball Performance and Technology who uses wearable technology with the basketball players to improve their on-court performance.  Their basketball facilities are fantastic and, according to their staff is considered to be the best training site in the NBA. They have practice basketball courts with athletic training rooms and locker rooms for the teams right next to the medical clinics where they have physical therapists, orthopedic surgeons, physicians, athletic trainers, and other specialties who can thoroughly care for the athletes alongside the general public.  Can you imagine being at your PT session and rehabbing alongside (Lynx superstar) Sylvia Fowles or  (Timberwolf and UConn great) Shabazz Napier?! The Mayo providers collaborate with the team providers in their biomechanics lab which includes force plates and multiple angles of cameras for jump-testing and movement assessment as well as for recommendations for optimal care.  It was a really interesting arrangement for sports medicine for all levels of athlete.

Diagnostic Imaging with Dr. Jay Smith @ Mayo
Then we drove down to Rochester, MN, home of the original Mayo Clinic.  Founded in 1889, the Mayo Clinic is basically the entire town of Rochester and the area is spotted with old historical buildings that contain the most beautiful old libraries and intricate marble ceilings that tell the history of medicine in the US along with more contemporary constructions housing the huge variety of specialties that the Mayo Clinic houses.   We learned about Diagnostic Ultrasound from expert Dr. Jay Smith were taken to the Mayo Clinic Biomechanics lab which houses the machine used by Dr. Tim Hewett to extensively study ACL injury, and participated in a golf biomechanics lab.

Coach Tamika (Williams) Jeter @ OSU
After Minnesota we headed to Columbus, Ohio, home of The Ohio State University Buckeyes.  Our host, John Dewitt took us on a tour of their athletics and training facilities where I ran into former UConn and Connecticut Sun basketball player Tamika Williams for a quick reunion.  We attended a discussion on articular cartilage surgical procedures presented by Caroline Brunst and a lecture presented by Dr. Ken Yeager on Building Resiliency observed the nationally recognized Ohio State Marching Band rehearse, attended the marching band Skull Session pep rally and another football game.  We had the chance to meet many of the Ohio State Physical Therapy Residents studying in a wide variety of specialties including performing arts, oncology, sports, orthopedics, women's health, and neurology.  And I got to see some of my Ohio family living nearby, which was the cherry on top of a really awesome collection of learning experiences.

Fellows with John DeWitt @The Ohio State University
I can't recommend this Fellowship highly enough, and would be happy to connect with anyone considering application for future participation.  I'm sure that if you asked Pat and Becca, they would select different portions of our trip as their highlights or what was most impactful based on the differences between our patient populations and professional goals, but I'm so glad I was able to share this impactful experience with them.  Thank you so much, American Academy of Sports Physical Therapy for this opportunity!




Friday, September 6, 2019

Volunteering in Tanzania

Africa was never really on my bucket list. It's SO far away from Seattle and pretty expensive and I didn't see the point in taking so much vacation time to go somewhere that is portrayed the way Africa often is.  And on top of that, why would I take a vacation to work somewhere else for free?  I thought I was going to a very poor place, a desert that would have been all brown, ugly, and dirty, with people who I knew nothing about whose circumstances don't impact my life. I've heard that safaris were amazing, but I despise zoos because they make me sad for the animals and I thought that a safari would feel the same way.  So what reason would I have to put this on my bucket list?

Me and Kristen
A year ago, I met Kristen, my coworker at Seattle Children's Hospital and an East Coast transplant who says Florida like every other New Yorker ("Flaahhrida") and won't eat at a pizza restaurant that doesn't sell by the slice because that isn't the true New York way.  She exudes an incredible passion for life and is a really talented physical therapist.  And she LOVES Tanzania.  LOVES.  She invited me - and several of our coworkers- to go along with her as she supervised a group of PT students from her alma mater, Stony Brook University.  So with the above reasons I had identified not to go, among several others, one key reason on my "yes" list ultimately won: I realized that I wanted to.  It hadn't been on my bucket list because people weren't talking about it, because it's not a top travel destination, because I don't know anyone from Tanzania or even anyone who had ever visited. But I wanted to travel to a new place. I wanted to meet new people, experience new cultures and eat new foods.  I wanted to see an elephant and a giraffe and a zebra in the wild and see that it wasn't like the zoo.  I wanted to connect with my coworker outside our office - because we had already started to become friends - and what better way to really explore a new friendship than spending every minute together for two weeks?  I wanted to give my time to people who needed it more than those I usually give it to.  And I wanted to confirm or dispute all of my preconceived notions.

Mt. Meru
I learned that in many cases I was wrong.  I wasn't in the desert at all.  In fact, Tanzania doesn't have desert.  The Sahara doesn't cover the entire continent of Africa.  Yeesh...There were tons of sunflowers and trees and our hotel had this AWESOME view of Mt. Meru easily visible in the afternoons when the clouds had dissipated.  It even rained despite being the dry season.  The safari animals are truly free.  Lions out in the wild are breathtaking.  There are birds with so many bright colors, they gave Costa Rican parrots and exotic rain forest ornithological creatures a run for their money.  They cooked foods with curry and I didn't really have to eat that much rice, which was good, because I don't really like rice, but for some reason expected to be eating it all the time.  

In some cases I was also right.  I was eaten alive by mosquitoes despite bathing in bug spray and sunscreen.  If you've seen any of my Facebook posts where I'm wearing a bandana or a headband - those weren't for fashion.  They were bathed in permethrin in an effort to reduce my bug bites.  I think it helped - my face didn't suffer nearly as much as my arms and legs did.

Traveling Pharmacy
Our group collectively did need most of the pharmacy that I brought with me.  I exclusively consumed bottled water including for brushing my teeth, but many meals did not agree with  my digestive tract. I got a nasty cut on my finger that required first aid care. Others in my group experienced some illnesses. Plus, the anaphylactic reaction I wrote about here.  

Our work and the things we saw were emotionally intense and left my mind wandering into the wee hours of the night, limiting how much sleep I was getting. (I would never blame late night chats with Kristen for the lack of sleep... ) I over-estimated what was available to the people of Tanzania, and as such, was a bit shocked by what I saw and what I learned.  Now I've been back home for just over two weeks and I'm still processing the experience. When it came up in conversation today at work, a wave of emotions flushed over me, just as it did while I was there.  The number of times "how was your trip" gets asked declines exponentially, but the feeling hasn't changed yet. 
Sandals made from recycled rubber tires
I've really been struggling to write and talk about my experience volunteering in Tanzania.  As much as I have tried to explain it, my words and photos are insufficient.  It's far easier to talk about the animals on safari and pretend like the volunteer work never even happened.  The zebras don't really elicit my emotions.  But talking about my volunteer work sometimes comes out as if I saw a world of poverty, despair, and sadness.  This was not the case.  

The people I met in Tanzania were a wonderful community who prioritize hospitality, traditions, family, and kindness and who happen to live in a place that simply has less.  Less of pretty much everything.  Less material "stuff" available to them than where I come from. Like shoes - where multiple times I saw these sandals made from recycled car tires.  Less money (Tanzania has .03% of the world's wealth averaging $2716 per adult - 2nd from the bottom of this list - compared to the US which has 25% of the world's wealth and $201,319 per adult - 3rd from the top - and consider that we have 607 billionaires in America according to this article averaged in along with the Americans living beneath the poverty line).  Less opportunity.  Less healthcare (269 hospitals in the country for 50 million people over 365,000 square miles (5.38 hospitals per million people) compared to the US 6200 hospitals for a population around 320 million spanning 3.7 million square miles (19.375 hospitals per million people) which just means both countries have areas where people have to travel far for a hospital, but in Tanzania, there are many more people trying to use less facilities.  Shorter life expectancy: 61.8 years compared to the US 79 years. Less schooling for children with disabilities - we learned about every single school for children with disabilities and how many students they accommodate and how many teachers they had in less than 45 minutes.  For all of Tanzania. Less infrastructure.  Less electricity.  Less drinkable water.  Less education (27 universities and 15 colleges versus 4298 higher education institutions in the United States.
Shanga Employee Wheelchair

So they have less... but does that make it bad?  No. And in some cases, cases that really matter, they also have so much more.  They have more family time.  Families live in close proximity with one another and honor their past traditions as they try to be a little bit current while simultaneously adhering to their tribal laws.  They have more respect for their elders - in fact they even have a specific greeting intended to be used with elders rather than for peers. They have more kindness.  They have more generosity.  They have more sharing.  I'm pretty sure they have more work ethic than many of us, working in more labor intensive work than many of us face.  They have more connection to their land and to their animals and to their religion.  They have more healthful food that does not contain the chemicals and processing we add to ours. They have more national holidays.  They have better maternity leave (12 weeks fully paid). They have the same sun, moon, and stars in the sky, but less pollution obstructing your view to see them.  They have the benefit of waking daily to the crow of the rooster, rather than those annoying ring tones installed by Apple set to go off every 9 minutes.  I really started to like waking up to the roosters.

Despite what you may have heard, there may be one planet Earth, but the world is not the same everywhere.  Tanzania is nothing like the United States.  But that does not make the United States better.  It just makes us different.  And, at the end of the day, we're all human beings who bleed red and breathe the same air.

Glass beads made at Shanga
The group of volunteers I went with were four Physical Therapy students from Stony Brook, one of their professors, Kristen, and myself.  Seven Americans split between two facilities volunteering in Tanzania.  One of the facilities was a school for children with disabilities called Step by Step where Kristen supervised two students.  My team was at Shanga which is basically a workshop and store that makes and sells crafts from recycled products and employs people with physical disabilities.  Shanga provides employment and salaries to individuals who would otherwise have much more difficulty finding work  Through sale of their products, visitor donations, and their larger parent company, they can feed their families and have support with access to medical care and equipment.

George teaches group exercise class
At Shanga, we assessed the needs of the employees.  A year before us, they had been visited by Stony Brook students who had developed an exercise program that the staff would participate in about twice per week.  They embraced their new program last year and were eager for some upgrades.  The previous program had some limitations such as a key focus on mobility, but not very much on strength.  We were able to update the program and we taught the leadership team basic concepts of exercise and ways to modify the program to try to give them more ownership and ability to have variety.

We also did one-on-one evaluations of several employees experiencing pain or with mobility issues they were hoping to improve.  There were some employees who had amputations who needed assessments of their prosthetic limbs, something I never do at Seattle Children's but had done on my clinical affiliation in New Mexico during PT school.  Other employees had experienced injury or been having some health issues they wanted checked out like cardiac concerns.  Some had seen last year's PTs and wanted an updated program, as well.

And so, I've described my volunteering experience.  But really, I've tried to explain that the way we view the world from here is through a distorted lens.  I, too, am guilty of this.  It isn't gone now, I'm just a little more aware, now.  Our pre-occupation with money and objects in the United States may be holding us back from some of the other beautiful values seen around the world.  I pray that this experience helps me reflect on what is truly important and embrace those things more in the future.  

Monday, July 29, 2019

Vaccination for Africa!

In just a few days, I’m departing on an adventure, heading to Africa!   I’m headed specifically to Nairobi, Kenya for a day followed by two weeks in Arusha, Tanzania ending with a Safari!!!!  Thanks to my coworker pal Kristen who writes this blog (even more specifically, has several posts from her previous trips to Africa, here)... and we’re joining one of her PT School professors and 7 students from Stony Brook University to do some physical therapy-related work. I don’t have the details of what we’ll be doing yet- so stay tuned for the post-Africa blog posts for that... but the preparations for the trip have been very interesting and I thought I’d write about the medical preparations for the journey - along with some thoughts on vaccination.

From: http://pcwww.liv.ac.uk/epidemics/MAL_geography.htm
Let's talk about medications.  Thanks to Virginia Mason’s Infectious Disease Department- not only was I able to receive the shots and prescriptions I needed, but they also explained many of the possible risks and made recommendations for me. They collected my dates and destinations of travel in advance, prepared a stack of pamphlets for me, and had the shots and prescriptions I needed ready to go.  I now have a whole pharmacy packed based on things that my body might encounter that it doesn't generally experience at home. Specifically- Tanzania is in the malaria belt and Kenya has an escalated risk for contracting yellow fever. And so- I have malaria medications and I had a yellow fever vaccine this week. The provider who organized all my medical care for these travels, Lisa Roberts PA-C was very thorough and presented the options for all the medications - such as discussing my choices for malaria medicines because some of them can be hallucinogenic.

Some interesting facts about these diseases:
Malaria:
1) Link: There are five types of malaria parasites called plasmodium.  One type, Plasmodium Falciparum, can be life threatening and induce liver failure, kidney failure, and coma.  This is generally the type that you take preventive mediation for when traveling.
2) Link: Malaria is transmitted by mosquitos, so using bug repellent containing DEET, long sleeves and pants, and taking preventive medications are all useful preparations. The particular type of mosquito, the Anopheles Mosquito, cannot survive in climates cooler than 68*F, so since central Africa is so warm, this is a common region for the disease.  As global warming continues, the malaria belt is expanding.  Even though the United States has successfully managed to reduce malaria cases, we do house these mosquitos, so there is always the risk that malaria can become a bigger problem here at home.
3) Link: There is a malaria vaccine, but it has a low efficacy and requires four injections... so I'm not immunized, I'm taking preventive medications. The reason for this is that the DNA of that plasmodium reproduces so fast, it can build resistance - just like we've seen with antibiotics resulting in things like methicillin resistant staphylococcus aureus (MRSA - the SuperBug) which, by means of evolution do not respond to the usual medications.  I'm so glad I read "The Origin of Species" by Charles Darwin, and wrote about it here.

Yellow Fever:
1) Link: Yellow Fever is also transmitted by mosquitos.  About 15% of those who are infected will have severe symptoms including shock, organ failure, and possible death.
2) Link:  The vaccine against yellow fever is considered to be life-long protection and 99% effective.  and is a live vaccine, which means that scientists took the actual disease, weakened it, and then it gets injected into you to build up immunity to it. There is also a shortage of the vaccine with limited number of places where you can go to get one - so if you're looking to travel, plan ahead!  You need a specific yellow card marked with your immunization in some cases - for example if you spend time in Kenya before going to Tanzania, like we are, you need the shot.

In addition to malaria and yellow fever, we also discussed risks for hepatitis, rabies, measles, mumps, rubella, influenza, and diphtheria, along with multiple symptoms that could require treatment, particularly related to gastro-intestinal distress which I won't go into detail about but which also included some shots and medicines.

What is a vaccine, anyways?  A vaccine is a medicine used to prepare your immune system to fight a disease in case it ever comes into contact with it.  Our body fights off disease by using a system that requires exposure to something to build up a defense system.  The vaccine is the first exposure to a disease, usually a weakened or dead version of it, so the body can recognize invaders and be prepared to fight.  There is considerable controversy around the country with some parents believing that vaccines are dangerous - or they don't believe in inoculation for a variety of reasons.

While I've been going through these preparations and getting additional immunizations beyond the ones I've had for public schooling, college, graduate school, working on an ambulance and now working in a hospital-based system, Seattle Children's and many other places around the country, have been facing increased episodes of cases of measles. Seattle Children's publicized exposures there here and this article describes the over 1,000 cases identified in the US this year, a considerable increase since measles was considered to be eradicated in 2000.  Measles is a highly contagious disease spread through coughing or sneezing or bodily fluids of infected people and does not have a cure.  A contagious person will likely infect 90% of the non-immunized people they come into contact with.  There is a high risk of fatality from measles because of the complications of the condition - immune compromise and opportunistic infections like pneumonia.  The vaccine is only 97% effective, so even those who are immunized aren't perfectly protected, but because of the high risk, it's essential that people vaccinate their children.  I urge everyone to read about the signs and symptoms of measles, particularly if you are in an area where there has been a spike in cases as it looks like there is a current epidemic occurring or if you are a healthcare provider.

Volunteering Emergency Response in Israel in 2006
Several cases of measles in Washington have been linked back to being at Seattle-Tacoma International Airport, where I'll be headed to depart for Africa in just a few days.  Interestingly, I also found this article looking at the measles epidemic occurring on the east coast, reporting cases in New York in Orthodox Jews who do not inoculate their children and who had recently traveled from Israel (which has been having an outbreak as well).  This article also discusses the Orthodox Jews having this increase in cases.  Having been to Israel several times and lived there as a volunteer EMT in 2006, knowing that they're so advanced in their medical and technological developments, this shocked me!  Over 500 of the cases in the US are in NY in this population, and Washington is 2nd on the list.  As a Jew myself, I can't understand why the Orthodox aren't taking care of this.  It seems that some believe vaccination is against Jewish law, which is of course an interpretation of something, though I'm not sure what, because vaccines obviously did not exist at the time Jewish law was written. What is for certain part of Jewish law is to do anything that may save a life, and since vaccination can save lives, it seems to me that more Jews would support vaccination.

Even the APTA has a position on this.  Physical therapists are in a prime position to encourage families to get their immunizations as part of their regular health care.  The risks of not doing so many times could include fatality - to your own family member or to someone else.  The benefits far outweigh the risks.