I send birthday wishes to all my friends and close relatives, as best I can; I consider birthdays important. If you truly appreciate someone, once a year shouldn't be too often to show it, and, of course, one's birthday only comes once a year. Sending someone a birthday card, and e-mailing and/or calling to wish them a happy birthday, seems an appropriate way to show that you value the friendship or relationship with the person. My friends and relatives appreciate getting birthday greetings from me. I also be sure to thank all those who send me cards or wishes for my birthday.