Influenza

Flu season is in full force and often creates a flood of questions.   Let’s demystify the flu and answer the most frequently asked questions.  When we do this, you also will understand why getting a flu shot can be life-saving. 

What is the flu?  Influenza (the flu) is a virus, which is most active between October and May each year.  A unique quality about a virus is that it constantly adapts as it infects people by rearrangement of the virus’ genetic material.  That’s why the flu is tricky, as it changes from year to year.  H3N3 is the predominant type of influenza virus that has been identified this year.

Why must one be vaccinated annually?  Since all viruses change when they infect humans or animals (the genetic code transforms the virus so that it can more readily infect the cell).  Consequently, from year to year as the influenza virus changes, a vaccine must be developed to reflect the virus mutation.  The flu shot causes the body to produce antibodies to fight a specific flu strain, which is what we want.  Since antibodies decrease over time, and the virus changes, it necessitates a flu shot on an annual basis.  This year the flu shot protects against three specific influenza types H1N1, H3N3, and B.

Should I get vaccinated now?  If you have not been vaccinated, it’s not too late!   Get a flu shot since the flu can attack as late as May.  It takes about two weeks for the body to be protected against the flu – which explains why one can get the flu even if recently vaccinated.

Who should get the flu shot?  Anyone over the age of six months should be vaccinated as well as pregnant women, care-givers, and the elderly (over 65 years).  This is especially true for people who have chronic illnesses – asthma, emphysema, and diabetes.   The elderly, children, and chronically ill are at greater risk for complications for the flu resulting in hospitalization and death. According to the CDC, over 3,700 people have been hospitalized and 20 children have died due to the flu so far this season   People who have egg allergies, prior severe reaction to flu vaccine, or Guillain-Barre Syndrome (GBS) should talk to their doctor to determine if you should receive a flu shot.  

What medicines work against the flu?  Relenza (zanamivir) and Tamiflu (oseltamivir), anti-viral medications, are effective against the flu.  However, they only work within the first 24-48 hours of flu symptoms.  Most healthy people will recover from the flu without medical intervention.  But members of at-risk populations, including, but not limited to lung disease and diabetes, may benefit from medications.  See your doctor early if you suspect you have the flu and they can determine if you need a medication. 

What to do if you have the flu?  Stay home from work or school to recover so you won’t infect others.  Rest, drink liquids, wash hands, and use over the counter remedies for symptom management.  Talk to your pharmacist or doctor for guidance.  If you have confusion, difficulty breathing, or are unable to keep liquids down, see your doctor.  In children, watch out for bluish color, crying without tears, lethargy (no energy), fast breathing, rash, and irritability. If you see this, do not delay: seek medical attention! 

If you are in one of the high-risk groups, talk to your doctor about your risk for flu.  If you have not had a flu shot, get one ASAP!  Be well.

Let's Start 2013 Right!

Happy 2013!  The start of a New Year is the perfect time to take stock of what you can do to make 2013 a healthy year for you and your family.  Here are 10 tips that will help you get underway. 

1.     If you only do one thing in 2013, stop smoking!  Tobacco cessation adds years to your life by reducing the risk of lung cancer, heart disease, and stroke.  Consider trying hypnosis, acupuncture, and medications to help you break the habit.   Contact your local health department to find smoking cessation assistance in your area.  Don’t delay, start today. 

2.     Check your medicine cabinet.  Throw away all expired medications.  Crush medications and put in sandwich bag with kitty litter or coffee grounds and dispose in the trash.  Ladies, old and unused cosmetics should be treated with care, too.  This includes mascara that is 6 months old; as it may be harboring bacteria you don’t want in your eye.  Each time we open mascara to the air we introduce bacteria to the tube.  Check your skin creams for any discoloration as they will start to oxidize, as indicated by color change, and lose potency when they are repeatedly exposed to air.

3.     The pictures of the aftermath of Hurricane Sandy were shocking and were a reminder of the need for a home disaster kit.  Put together one for each member of the household. A backpack with water, protein bars, batteries, radio, solar cell phone recharger, water purification tablets, cash, medications (a week’s supply), nuts, and chocolate bar should get you through the initial days after a disaster.

4.     Make doctors’ appointments for the year.  This includes: pap smears, children’s physicals, teeth cleanings, eye exams, and mammograms.  

5.     Check your running shoes. How old are they? Are they in good condition? Buy new ones if yours are “going flat”.  Remember, if you are starting a new exercise routine make sure your feet are properly outfitted to prevent injury and provide maximize comfort.

6.     Think about changing your mattress and pillows.   Dust mites and dander live in our pillows and mattresses, so clean, replace, and/or cover them.  A new pillow/mattress can cut down on allergens and reduce coughing and sneezing.   (An old pillow can be recycled at local animal shelter to provide comfort for our four legged friends.)

7.     Buy a pedometer.  Walking 10,000 steps everyday puts you on the path to good health.  Exercise improves sleep, sugar control, and slims -down waistlines effortlessly.

8.     Check batteries in carbon monoxide and smoke detectors throughout your home. 

9.     Improve indoor air quality by changing AC/heater filter.  Disposable or reusable filters increase the life of your AC/heater and remove allergens from the air.  We spend more time indoors in the winter, so let’s breathe easy.

10. If you don’t make your final wishes known, then someone else will.  Create a durable power of attorney for healthcare so that your wishes will be honored if you are incapacitated.

Start out the New Year with theses healthy habits and be well. 

Holiday Eating

Thanksgiving and Christmas are fast approaching -- the eating holidays are here.    Now is the time to reign-in our eating habits so we will have less weight to shed in the New Year.  A few smart eating choices at the onset of the holidays will make a huge difference in the waistline.  Consider these easy activities:

1.     Know where you stand.  Remove your shoes, close your eyes, and step on the scale.  Now, take a look.  On a piece of paper write down your weight and then write down your “goal weight”.  Tape this to the refrigerator.   Knowing your current weight will help to positively influence food choices and move you closer to your goal.  If you are within a few pounds of your goal weight, good for you!  Keep it up.  Just don’t get down on yourself if you’re not losing as quickly as you’d like.  Weight loss takes time; just keep your goal in mind (and taped to the refrigerator door).  

2.     Exercise now.  Yes, schedules get more crowded during the holidays, but you can find the time for exercise if you choose to put health in your schedule.    There are 168 hours in a week:  dedicate 3 hours a week for exercise.  Re-activate that gym membership.  Use the Wii Fit purchased last Christmas.  Walk with your family or a friend, or while your child is at sports practice.  Set the alarm clock for a half-hour earlier and dust-off exercise DVDs.  Park at the back of the parking lot at work, the supermarket, and shopping mall.  Simply, move more.

3.     Portion control.  Replace dinner plates with salad plates whenever you can and load up on vegetables, fruits, and whole grains.   Use a bed of salad greens to line your plate, which helps you to consume more leafy green vegetables, and less fatty, calorie-dense foods. Not arriving ravenous to holiday parties makes it easier for better food choices, so eat before you go. 

4.     Don’t drink your calories.   Alcohol hides many calories in a small package.    Juices and mixers are full of sugar.  Scale back on the size of a drink to reduce calories. Coffee beverages with gingerbread, eggnog, and peppermint add fat that show up on the waistline.  Opt for sugar-free additives to your coffee.  Drink more water – it’s filling, healthy, and calorie-free.

Finally, enjoy the holidays!  Food is communal and an expression of love.  By following these easy steps before the holidays, you will create less guilt and less weight during and after the holiday season.  Be well.

Breast Cancer Awareness

“I love my breast, they’re fabulous” Samantha Jones – Sex and the City.

October is Breast Cancer Awareness Month, so it’s a good time to talk about mammography. Recently I spoke with a woman who had been weary of having mammograms.  Tired of all of the poking and prodding, she had had enough.  So she stopped having mammograms because she was convinced that she would never get breast cancer.  Sadly when she finally had a mammogram, after a lull of seven years, a lump was detected and she then became one of the “1 in 8” American women who are diagnosed with breast cancer each year.  Luckily – and it really was fortunate, she does not have disease outside of the breast.  If not for the mammogram her outcome may have been very different and she is blessed to be a cancer survivor, not a victim. Early detection saves lives. 

What should you know about mammography?

A mammogram is a radiographic image of breast tissue.  The actual process itself is uncomfortable for a few moments when the breast is pressed down.  It’s important to know that there is no need to be fearful of radiation exposure when you have the procedure done, as the exposure is similar to flying coast-to-coast in an airplane says breast radiologist Mimi Newell of Emory University’s Winship Cancer Center.

There are just a few simple rules to remember when you are going to have a mammogram.  1. On the day, if you wear deodorant, powders, ointments, or creams be prepared to remove it using underarm wipes for it can look similar to flecks of calcium and appear abnormal. 2. Avoid scheduling a mammogram the week before your menstrual cycle, so the breasts are not being pressed down when they are most sensitive.  3. Breastfeeding women should pump immediately before the exam.  4. Additional views will be need if breast implants are present, so as to not miss any part of the breast.   

It’s best to have all mammograms done at the same location in order for the radiologist to have easy access for comparisons, when necessary.  If you don’t have the mammograms performed at the same location, be prepared to sign a records release form in order for copies of films to be sent to the new radiology office.  Also, if cost is an issue, check with your local health department to find out if there are programs that would help cover the cost, or go to http://www.cdc.gov/cancer/nbccedp/about.htm for free screenings in your area. 

Finally, consider scheduling your mammogram and well woman exam the same time each year.  Make it your mission to remind sisters, friends, and family to have a mammogram.  It can be the difference between life and death.   Be well.

Who will take care of me in the hospital?

Patients admitted to the hospital have many concerns.  Paramount among them is, “Will my primary care doctor take care of me while I am in the hospital?”  If not, who will?       The answer is that when you are admitted to the hospital you will be under the care of a hospitalist – not your primary care doctor.  Let’s find out who these special physicians are and exactly what they do.  

Who: A hospitalist is a doctor who only works in the hospital.  A hospitalist has training in a medical specialty, for example, internal medicine, family practice, and pediatrics. 

When: Hospitalists coordinate patient care in the hospital.  In the same way surgeons and obstetricians are the experts on operations and babies, hospitalists are the experts on medical issues within the hospital setting.

Why: The need for in-patient physicians--hospitalists-- arose as changes in medicine made it increasingly difficult for primary care doctors to take time out of their hectic schedules to travel to the hospital and care for their patients. Additionally, hospital care is more complex, thereby creating the need for a physician dedicated to the care of “inpatients”.  Studies have shown that hospitalists provide timely, high quality care.  To be sure in a perfect world, your personal doctor would follow you wherever you go, irrespective of location – hospital or community. However it’s just not possible, given the complexities of medical treatments.  There must be an on-site physician to make the right decisions at the right time – which is whenever you enter the hospital, night or day. 

What: Among many other duties, a hospitalist talks to specialists, orders tests, admits and discharges patients, and works with myriad of healthcare workers including, but not limited to: nurses, social workers, and pharmacists.  The primary role of the hospitalist is to provide the best evidence-based care while simultaneously acting as the patient-advocate and guiding families through the intricate web of healthcare.

Your primary care physician (PCP) may not be aware that you are in the hospital.  Oftentimes it becomes impossible for the hospital to alert the PCP when patients are admitted. When you see your PCP at the post-hospital appointment, let your doctor know you were hospitalized and if possible request a copy of hospital medical records prior to office visit.

Hopefully, you won’t ever experience first-hand what a hospitalist does.  However, if you do, you’ll already know a lot about this burgeoning field of medicine. Be well.