Swine Flu and You

For the past week, the media has been overflowing with stories on the swine flu, now officially called H1N1 flu. Some are advising an abundance of caution, restricting unnecessary travel and staying away from large gatherings. Others stress the importance of maintaining a normal life, advising hand washing and sanitizing but encouraging life as usual.

The ever-shifting news and advice can make it tough for anyone to decide what to do. If you have phobias, however, it is easy to become overwhelmed and even paralyzed with fear and indecision.

How to Control Dandruff

If you suffer from dandruff flakes, you might wonder what causes the flaking.

According to the Mayo Clinic, dandruff likely isn't caused by a dry scalp, overuse of hair products or poor hygiene, dandruff's biggest culprit is likely a fungus called "malassezia." Most adults have this fungus on their scalps, but it can get out of control on those who suffer from dandruff. The fungus tends to feed on oil secretions and causes clumps of dead skin cells.

The best way to fight dandruff is with a two-punch shampoo system. A shampoo containing zinc pyrithione, such as Head & Shoulders, kills the fungus. Follow this shampoo with one that has salicylic acid, which "scrubs" off the flakes.

Carpal Tunnel Styndrome

Carpal tunnel syndrome occurs when a nerve is pinched in the wrist. This nerve, called the median nerve, is the connection from the brain and spinal cord, down to the finger tips. In patients with carpal tunnel syndrome, the median nerve is pinched as it passes through the wrist. Because of the compression, the nerve does not function properly.

What is carpal tunnel syndrome?
Carpal tunnel syndrome is caused when there is pressure in the carpal tunnel that compresses the median nerve, causing the nerve to function improperly. Because the carpal tunnel is surrounded by bone on one side, and an inflexible ligament on the other, if pressure builds, the nerve has nowhere to go. Simply put, in carpal tunnel syndrome the nerve gets squished.

When carpal tunnel syndrome occurs, the median nerve is pinched, and the normal functions (as described above) are impaired. Problems that can occur in carpal tunnel syndrome include:

* Pain
* Numbness
* Tingling
* Weakness

Should You Fear H1N1 Swine Flu?

With increasing numbers of deaths in Mexico, and more incidents of possible swine flu being identified across the world, we seem to have little control over this advancing disease, possibly pandemic, giving us reason to fear it. But should we really fear the swine flu?

No. Fear is unnecessary. But a healthy respect is definitely called for.

A "Public Health Emergency"

It does sound frightening -- those words -- "Public Health Emergency." And calling swine flu a public health emergency most definitely gets our attention.

Behind those words, though, is the fact that the actual declaration is really a vehicle for making money available and suggesting that local governments begin using their predetermined plans for managing public health problems. It doesn't mean there is a crisis.

Let those words remind you to take precautions yourself. But don't be afraid of them.


Flu is Flu

H1N1 swine flu is one more strain of flu. It sounds really scary because it originally came from pigs, and that creates some mystery around it. It also sounds scary because we don't have any vaccine to protect those who are most vulnerable.

But it behaves like other flus. We catch it the same way, and we can protect ourselves the same ways. We can make choices to protect ourselves and our families.

Do you fear the seasonal flu? Probably not. And this flu is really no more frightening than seasonal flu. Seasonal flu takes tens of thousands of lives each year. Deaths from H1N1 swine flu have not approached those of seasonal flu.


Pandemic Describes Geography Only

We hear the word "pandemic" used by the media and that reminds us of history class in high school. It sounds like it means millions of people might die. But that's not what it means at all!

Pandemic simply means it is found large groups of people in many countries around the world. Pan comes from Latin and Greek meaning across or around. Demos means populations or people. Pan-demic. Geography and demographics. Not deaths.

Learn more about the definition of pandemic and how it could affect you in the 21st Century.

What About Those Face Masks?

When I see those masks on the people on TV, it reminds me of SARS and bird flu in China a few years ago. Again, that was scary because so many of the people who contracted those diseases did die.

Masks just keep the wearers from inhaling the water droplets that might be breathed out by someone who has the flu bug. Or when worn by someone who has any upper respiratory disease, they may contain some of the spread of that illness. They aren't a bad idea, but they don't indicate that the flu is any more dangerous than any normal flu.

Thousands of people die of seasonal flu each year, but we don't all wear masks.

Why Does It Seem Like We are Unprepared?

Another reason some fear the swine flu is because, unlike seasonal flu, we don't have vaccines available, people are still traveling, and we seem unprepared to stop it.

Again, this fear is unwarranted. Thousands of strains of viruses could potentially cause flu. We have no way of creating vaccines for all of them, nor would anyone ever be willing to be vaccinated against them all.

We do have two drugs available to help with symptoms, which the CDC tells us is in plentiful supply. Relenza and Tamiflu, both of which are used during seasonal flu seasons each year, are also useful for helping swine flu patients, too.

H1N1 Swine Flu 2009 Frequently Asked Questions

With so much in the news about swine flu, also called H1N1, it's wise to know what it is, what you can expect, and how to protect yourself and your loved ones. Empowered patients can use this knowledge to reduce their fear of swine flu.

What is swine flu?

The swine flu is a strain of virus that pigs contract and transmit. The swine flu of interest in 2009 is the H1N1 strain, which can be passed from pigs to human beings. It was first identified in pigs in 1930. Now it is causing illness in humans, with the potential of reaching pandemic levels.

What does H1N1 Influenza A mean?

The official, scientific name for swine flu, its serologic classification, is H1N1 Influenza A. The H means hemagglutinin and the N means neuraminidase and the 1s refer to their antibody type. Influenza A is a genus of the Orthomyxoviridae family of viruses, and refers to the fact that the virus is first identified in an animal, usually a pig or a bird. When put together, they describe the 2009 swine flu virus.

Why is this flu different from other flus?

There are thousands of different kinds of viruses that can cause the flu. New strains develop frequently and each one is different from the one before it. The seasonal flu is actually comprised of several different strains of flu. Swine flu is a new, different strain, as described above.

What are the swine flu stages I keep hearing about?

The World Health Organization, WHO, developed a plan to respond to health emergencies, like swine flu, which have the potential to become pandemic. Each stage represents a different level of response. For example, Stage 4 means that the disease can no longer be contained inside any specific country, therefore governments must take steps to handle community spread of the disease. If we get there, Stages 5-6 will indicate the swine flu has become pandemic. You can follow WHO swine flu staging for changes and updates.

What exactly is a pandemic?

WHO defines a pandemic along those stages mentioned above. They describe the prevalence of the disease, across populations and countries. There is a difference between a pandemic and an epidemic.

I keep hearing "swine flu" and "avian flu" in the same sentence.
What's that all about?

Avian flu is another name for bird flu. This pairing is heard as "swine, avian, human" and refers to the fact that this flu strain seems to be a combination of all three.

How is the swine flu transmitted?

The swine flu is transmitted just the way any viral disease is transmitted -- person-to-person contact, by touching something someone with a virus has already touched, or from droplets in the air which come from a sneeze or a cough of a person who has the swine flu.

What are the symptoms of swine flu?

Symptoms of swine flu are the same as typical flu symptoms. Fever, cough, sore throat, body aches, headache, chills and fatigue are the most prevalent symptoms. Some patients report diarrhea and vomiting, too.

Do people die from swine flu?

People can die, but most do not.


Is there a swine flu vaccine like seasonal flu vaccine?

No. The CDC and WHO report there is no vaccine available for this strain of swine flu. A vaccine may be developed, but if so, it will not be available until Fall 2009.

There are many spam emails circulating that claim a vaccine is available. Since this strain, the H1N1 strain, is only weeks old, it would be impossible for a vaccine to have been developed. Any claims to the contrary would likely be counterfeit.

Childhood Cholesterol Predicts Adult Heart Disease

Did you know that high cholesterol levels during childhood could be a predictor of heart disease in adulthood? Recent research has indicated this very fact. Normally, children do not need to worry about high cholesterol levels. However, if the child has a family history of high cholesterol or heart disease, leads a sedentary lifestyle, or consumes a diet high in fats, periodically checking his or her cholesterol may be a good idea.

COKE Manufactures Cholesterol-Lowering Orange Juice

Coca Cola and Minute Maid has recently launched a new product, Minute Maid Heart Wise orange juice. Although orange juice is healthy because of its high vitamin C content, this product is especially useful in battling high cholesterol levels because of the presence of plant sterols. Research has repeatedly demonstrated the effectiveness of plant sterols in lowering cholesterol levels.

H1N1 Update

In a new report, the Centers for Disease Control and Prevention share their findings on 30 people hospitalized with the H1N1 swine flu in California. The report shows that 64 percent of the patients had at least one underlying medical condition, thought to increase their risk for swine flu and its complications. Those underlying conditions included chronic lung disease (such as asthma), heart disease, diabetes, and obesity.

As of May 19, the CDC reported 5,469 cases of swine flu in 48 states (including six deaths). That same day, the World Health Organization reported 9,830 diagnosed cases in 40 countries, including at least 79 deaths.

While simple actions such as washing your hands frequently and avoiding touching your eyes, nose, and mouth can guard against swine flu, taking steps to boost your immune system may also help keep you healthy.

Can Colloidal Silver Cure Swine Flu?

As the H1N1 swine flu continues to spread, you may be seeking a powerful defense against this potentially life-threatening virus. Manufacturers of colloidal silver—a solution of tiny silver particles suspended in a liquid base—claim that their products can knock out swine flu, as well as protect against flu-related secondary infections such as pneumonia. However, there's little scientific evidence that colloidal silver can actually stave off disease or infection. What's more, this supplement may lead to adverse effects like argyria (an untreatable, permanent characterized by bluish discoloration of the skin).

Claims for the flu-fighting powers of colloidal silver are rampant on the Internet. But it's crucial to take caution when reviewing these claims: In a 2008 analysis of 49 websites providing information on silver-containing nasal sprays (one form of colloidal silver), researchers found that all linked to shopping sites where such products could be purchased.

Ginkgo for MEMORY

In a recent French study, 3500 men and women who took the herb ginkgo biloba for 13 years were 24% less likely to die. This study was unique int hat it looked at overall survival rather than at the effects of ginkgo biloba on memory loss.

Interestingly, those taking the gingko biloba appeared to have the same amount of memory loss as those who took other memory enhancers. The study was not randomized, so the people taking the ginkgo biloba may have been different from the non-takers.

New Anti-Psychotic Drugs work better than Old

A new study has shown that people diagnosed with their first episode of schizophrenia fare much better when treated with newer anti-psychotic drugs than with traditional medications. The double bind study was conducted in China by American and Chinese scientists. It is the first study to directly compare treatment with clozapine (Clozaril), an 'atypical' anti-psychotic medication, with chlorpromazine (Thorazine) in people who had an episode of schizophrenia for the first time.

200 patients diagnosed with first-episode schizophrenia were randomized to receive one drug or the other. Neither they nor the scientists knew who received which drug until all the data had been collected. The findings strongly suggest that clozapine works better than chlorpromazine in early schizophrenia.

The findings of this study were presented December 11, 2000 to the 39th Annual Meeting of the American College of Neuropsychopharmacology. Jeffrey A. Lieberman, M.D. of the University of North Carolina summarized the study this way: "We found that clozapine acts faster and produced fewer patients who drop out or stop treatment because of side effects. This is the first time a study's ever been done comparing the prototype of this new class of drugs with the old group in a large sample of patients."

Clozapine is the second most widely used medication for schizophrenia in China, but its use is restricted in the United States. The FDA approved clozapine as a 2nd- or 3rd-line of treatment for people who were unresponsive to other medications because early studies showed it suppressed the immune system's white cells in one percent of people who took it for more than six weeks . The authors conducted the study in China where these restrictions do not exist.

Based on the study's results Lieberman sees a wider role for the newer medications. "We think using these new drugs as first-line medications increases the likelihood of recovering from the illness and reduces the likelihood of a second episode when they remain in treatment. Patients who are at the beginning of their illness are extremely sensitive to treatment. That sensitivity makes them very responsive to the therapeutic effects of anti-psychotic drugs. They respond to all treatment including the newer and better treatments. However, they're also more sensitive to side effects and this can become a real problem in terms of their willingness to continue their medication and the likelihood of them stopping."

In a footnote, the study also found that patients in the study whose blood tests showed signs of exposure to the parasite toxoplasmosis had a poor response to treatment. Toxoplasmosis is a parasite borne by cats and some other domestic animals. Lieberman speculated on this result: "There's a theory that an infectious agent, a parasite or some other microorganism, can cause schizophrenia - and toxoplasmosis has an affinity for the nervous system, where it can lie dormant for a long time in its migration to the brain." Lieberman suggested that schizophrenic patients in a population with a high risk for toxoplasmosis should be given standard anti-psychotic medication along with one of the drugs typically used against the parasite.

Clozapine was the very first of the new 'atypical antipsychotic' medications. Other medications in this class seem to have some of the benefits without the infrequent dangerous side-effect. This study suggests that physicians should at least consider a medication in this class for patients newly diagnosed with schizophrenia. Is there still a role for older anti-psychotics? Maybe - but their role continues to shrink.

Tramadol - 10 Things You Should Know

TRAMADOL, the generic version of Ultram, is a synthetic analgesic medication. The exact mode of action of tramadol is unknown but it is said to work like morphine. Tramadol binds to opioid receptors in the brain -- receptors that transmit the sensation of pain throughout the body. Here are 10 things you should know about tramadol to ensure its safe use.

1 - Tramadol is prescribed to treat moderate to moderately severe pain.

Tramadol belongs to the class of drugs known as opiate agonists. Primarily, tramadol works by changing the way the body senses pain. Some people mistakenly believe that tramadol is an NSAID (nonsteroidal anti-inflammatory drug), but it is not.

2 - Tramadol is available in immediate release and extended release formulations.

Tramadol may be prescribed as an immediate release tablet (50 mg.) or as an extended release tablet (100, 200, or 300 mg.). The extended release tablets are usually reserved for patients with chronic pain who require continuous, long-term treatment. Your doctor will determine the appropriate dosage schedule for you.

3 - Tramadol extended release tablets must be taken whole, not split, chewed or crushed.

It is important to take tramadol properly and to follow prescribing instructions. If taken improperly or in a way that is not recommended, serious side effects and even death can result.

4 - Tramadol can be habit-forming for some people.

Do not take more tramadol than has been prescribed for you. Taking more tramadol or taking it more often can cause dependency on it. You should also not stop taking tramadol without first consulting your doctor. You may experience withdrawal symptoms if you stopped it suddenly. You doctor will likely decrease your dose of tramadol gradually.

5 - Drug interactions are possible with tramadol.

Be aware of the following possible drug interactions:

* Carbamazepine reduces the effect of tramadol
* Quinidine increases the concentration of tramadol by 50% to 60%
* Combining tramadol with an MAO (monoamine oxidase inhibitor) inhibitor or SSRI (selective serotonin reuptake inhibitors) can lead to seizures or other serious side effects.

Be sure to tell your doctor about all medications you are taking.

6 - Tramadol, when combined with certain other substances, can increase central nervous system and respiratory depression.

In other words, breathing may be affected or even stop if tramadol is combined with alcohol, narcotic drugs, anesthetics, tranquilizers, or sedatives.

7 - The use of tramadol during pregnancy should be avoided.

Because the safety of tramadol use during pregnancy has not been established, the medication should not be used during pregnancy. The safe use of tramadol in nursing mothers has also not been established.

8 - Tramadol is usually well-tolerated. Any side effects are usually temporary.

Some of the common side effects associated with tramadol include:

* nausea
* constipation
* dizziness
* headache
* drowsiness
* vomiting

Less common side effects include: itching, sweating, diarrhea, rash, dry mouth, and vertigo. There have been patients who developed seizures after taking tramadol.

9 - A Cochrane Review of tramadol to treat osteoarthritis revealed some small benefit.

The Cochrane Review stated that when tramadol is taken for up to 3 months, there may be decreased pain, improvements in function and stiffness and overall well-being. However, tramadol can cause side effects that are significant enough to require that the patient must stop taking the medication. Risks outweigh benefits for many people who have tried tramadol.

10 - If an overdose of tramadol has occurred, call your local poison control center, or call 911 if it appears to be an emergency situation.

Symptoms of an overdose include decreased pupil size, difficulty breathing or staying awake, unconscious, coma, heart attack, or seizure. Call for help, even if you are unsure about what to do.

Acetaminophen: 10 Things You Should Know

Tylenol (acetaminophen) is a widely used drug which is considered safe when used appropriately. Tylenol safety decreases the chance for undesirable side effects. Safety warnings about Tylenol should be respected. To enhance patient safety, Tylenol must be taken according to directions. If you take Tylenol or may take it in the future, here are 10 things you should know.
1 - Tylenol is a medication prescribed for pain relief and fever reduction.

Tylenol belongs to a class of drugs known as analgesics and antipyretics. Acetaminophen, the generic equivalent of Tylenol, is the most commonly prescribed and widely used analgesic (pain reliever) and antipyretic agent (fever reducer) in the world. Tylenol (acetaminophen) does not have anti-inflammatory properties though. Tylenol is prescribed for many health problems, one of which is arthritis pain.

2 - Acetaminophen, the active ingredient in Tylenol, is contained in more than 100 different products and combination products.

Acetaminophen is contained in countless pain formulations, cold products, sinus preparations, and more (e.g. Sinutab, Midol, Ultracet, Dristan). The wide availability of acetaminophen, sold over-the-counter and in prescription products, make it one of the most common drugs associated with intentional or accidental poisoning. Taking multiple products which contain acetaminophen and exceeding the maximum allowable daily dose can cause serious side effects and can have potentially fatal consequences.

3 - The maximum allowable daily dose of Tylenol (acetaminophen) is 4 grams (or 4000 mg) in adults and 90 mg/kg in children.

Tylenol (acetaminophen) is available as a tablet, chewable tablet, capsule, caplet, geltab, gelcap, extended-release tablet, or liquid suspension to be taken by mouth with or without food. It is also available as a suppository. Regular strength Tylenol is 325 mg per pill. Extra strength Tylenol is 500 mg per pill. For adults, 8 extra strength Tylenol tablets is the maximum allowed per day. If you exceed that amount, you risk serious consequences.

4 - You must be aware of the cumulative effect of taking various products which contain acetaminophen.

As previously explained, many products contain acetaminophen. It is your responsibility to add up the amount of acetaminophen you are ingesting daily, even if from more than one product, to be sure you are not exceeding the daily dose which is allowed. For example, if you take two Darvocets per day, that is equal to 1300 mg acetaminophen since one Darvocet contains 650 mg. acetaminophen. Darvocet contains propoxyphene and acetaminophen. If, in addition, to Darvocet for pain, you also take cold or sinus medication which contains acetaminophen, you must add the total amount ingested (e.g. add up the acetaminophen in both Darvocet and the cold medication) in order to be aware of the cumulative effect. The label on Tylenol recommends that you not take more than one product at a time which contains acetaminophen to ensure that you won't exceed maximum allowable dosages.

5 - Drinking alcoholic beverages while taking acetaminophen is not advised.

If you drink three or more alcoholic beverages every day or have had alcoholic liver disease, ask your doctor if you should take acetaminophen. The combination of alcohol and acetaminophen can be seriously damaging to the liver, with possibly fatal outcomes.

6 - Acetaminophen side effects can be serious. Know when you should call your doctor instead of assuming the problem will disappear.

Certain side effects can be signs of an allergic reaction or a situation which requires immediate medical attention, such as:

* Rash
* Hives
* Itching
* Swelling
* Hoarseness
* Difficulty breathing
* Difficulty swallowing

7 - Symptoms associated with acetaminophen overdose can be serious too, and require immediate medical attention.

The symptoms can occur whether the overdose is accidental or not:

* Nausea
* Vomiting
* Loss of appetite
* Confusion
* Sweating
* Extreme fatigue
* Unusual bleeding or bruising
* Pain in stomach (especially upper right portion)
* Yellowish skin or eyes
* Flu-like symptoms
* Diarrhea
* Irregular heartbeat

8 - There are recommendations and guidelines for how long you should take Tylenol (acetaminophen) if you are self-treating.

Current recommendations suggest that you may take acetaminophen for up to 3 days when treating a fever, and for up to 10 days when treating pain. If symptoms persist beyond that time frame, consult with a doctor to see if you should continue with acetaminophen or change your treatment plan.

9 - Acetaminophen is classified as FDA Pregnancy Category B, meaning, it is unlikely the drug would harm an unborn baby.

If you are pregnant, do not take acetaminophen without discussing it with your doctor. Acetaminophen passes into breast milk. Though it is considered safe to use during breastfeeding, discuss it with your doctor.

10 - When used as directed, Tylenol (acetaminophen) is considered generally safe. That's the bottom line.

When taken according to directions, side effects from acetaminophen are rare. The most serious side effect is liver damage. Kidney toxicity is also a possibility. The risk of liver damage increases with:

* Large doses of acetaminophen
* Chronic use of acetaminophen
* Concomitant use of acetaminophen with alcohol (i.e. taken together) or with other drugs that can also potentially cause liver damage

Breast Cancer Makes Us Thankful

Having breast cancer is an experience that changes you. It can strip away pretense and artifice, leaving only honesty and integrity in relationships. It can focus your fears. Betty Ford noted that cancer strikes not only the body, but also the spirit. When we are faced with our mortality, our true self is revealed. And we may become grateful for things which we previously took for granted. Here are some things for which breast cancer makes us grateful.

Relationships Valued, Tested and Proven

A Swedish study of breast cancer patients reported that their "relationships became more valuable" during and after treatment. Any life-threatening illness can affect your family members, coworkers, and friends. Breast cancer tests the strength of your relationships, shattering those with hidden cracks, and cementing others with shared adversities. Women have lost connections with spouses, partners, and friends during a round with breast cancer. They may have trouble facing mortality or dealing with loss. Fortunate indeed are those of us who find that tough times bring us closer to family and friends. Like survivors of a war, we find out whom we can lean on in the battle and in peace.