"Walking is man's best medicine."
Hippocrates the "father of medicine"
Saturday, October 31, 2009
Friday, October 30, 2009
Thursday, October 29, 2009
H1N1 Vaccine
My office has been receiving many calls in regards to the H1N1 vaccine. There has been a tremendous amount of information presented by the media and internet about the vaccine. Here are some facts.
There are two types of H1N1 vaccines: the inactivated vaccine (injectable form) and the weakened live virus (nasal mist form).
The targeted groups include:
1. Pregnant women
2. Parents and caregivers of children under 6 months of age
3. Health care personnel
4. Individuals between the age of 6 months to 24 years
5. Individuals 25 years to 64 years with chronic medical conditions or compromised immune systems
Two doses 3-4 weeks apart are necessary for children 9 years and under to provide adequate immunity.
The H1N1 injectable vaccine does contain thimerosal, a preservative, but there is no convincing evidence that it will do any harm to children or pregnant women. It may cause localized swelling and redness at the injected site.
The vaccine is FDA licensed which means it has gone through clinical trials and has been found to be safe and effective. There is a probability that next year's seasonal flu vaccine will contain the H1N1 strand.
There has been over 11 million doses shipped throughout the United States. Schools have begun administering to students. The Federal Government has purchased about 250 million doses so there will be more vaccines available in the upcoming months.
The nasal mist (FluMist) is approved for healthy individuals between the ages of 2 years to 49 years and who are NOT pregnant.
FluMist should not be given to:
1. Pregnant women
2. Kids under two years or adults over 50 years
3. People with chronic medical conditions such as COPD, asthma, heart disease, or immuno-compromising diseases
4. Children under 5 years with history of wheezing
5. Children receiving aspirin
6. People with history of Guillain–Barré Syndrome that occurred after receiving influenza vaccine
7. People with allergy to eggs
The side effects of the H1N1 vaccines include:
1. Soreness and redness at the site of injection
2. Headache
3. Muscle ache
4. Low grade fever
5. Nausea
6. Runny nose with the nasal mist
Contact your primary care physician or go to the ED if the following occur:
1. High fever
2. Behavior changes
3. Difficulty breathing, hoarseness or wheezing
4. Swelling around the eyes or lips
5. Hives
6. Paleness
7. Weakness
8. Fast heart beat
9. Dizziness
The most frequent question I get is do I recommend the vaccine?
The answer is Yes.
I plan to give my daughter the mist when it arrives. I have also recommended my staff to get the vaccine in addition to their young children.
The second most frequent question is where to obtain the H1N1 vaccine. That is a difficult one to answer...it is state dependent. In Delaware, schools are currently getting their supply as are physician offices (if they pre-registered). Delaware Division of Public Health Clinics will also be providing the vaccine to high risk individuals by appointment only. For more information, please go to the Delaware Division of Public Health Website.
For more information about the H1N1 vaccine, please go to the CDC website.
There are two types of H1N1 vaccines: the inactivated vaccine (injectable form) and the weakened live virus (nasal mist form).
The targeted groups include:
1. Pregnant women
2. Parents and caregivers of children under 6 months of age
3. Health care personnel
4. Individuals between the age of 6 months to 24 years
5. Individuals 25 years to 64 years with chronic medical conditions or compromised immune systems
Two doses 3-4 weeks apart are necessary for children 9 years and under to provide adequate immunity.
The H1N1 injectable vaccine does contain thimerosal, a preservative, but there is no convincing evidence that it will do any harm to children or pregnant women. It may cause localized swelling and redness at the injected site.
The vaccine is FDA licensed which means it has gone through clinical trials and has been found to be safe and effective. There is a probability that next year's seasonal flu vaccine will contain the H1N1 strand.
There has been over 11 million doses shipped throughout the United States. Schools have begun administering to students. The Federal Government has purchased about 250 million doses so there will be more vaccines available in the upcoming months.
The nasal mist (FluMist) is approved for healthy individuals between the ages of 2 years to 49 years and who are NOT pregnant.
FluMist should not be given to:
1. Pregnant women
2. Kids under two years or adults over 50 years
3. People with chronic medical conditions such as COPD, asthma, heart disease, or immuno-compromising diseases
4. Children under 5 years with history of wheezing
5. Children receiving aspirin
6. People with history of Guillain–Barré Syndrome that occurred after receiving influenza vaccine
7. People with allergy to eggs
The side effects of the H1N1 vaccines include:
1. Soreness and redness at the site of injection
2. Headache
3. Muscle ache
4. Low grade fever
5. Nausea
6. Runny nose with the nasal mist
Contact your primary care physician or go to the ED if the following occur:
1. High fever
2. Behavior changes
3. Difficulty breathing, hoarseness or wheezing
4. Swelling around the eyes or lips
5. Hives
6. Paleness
7. Weakness
8. Fast heart beat
9. Dizziness
The most frequent question I get is do I recommend the vaccine?
The answer is Yes.
I plan to give my daughter the mist when it arrives. I have also recommended my staff to get the vaccine in addition to their young children.
The second most frequent question is where to obtain the H1N1 vaccine. That is a difficult one to answer...it is state dependent. In Delaware, schools are currently getting their supply as are physician offices (if they pre-registered). Delaware Division of Public Health Clinics will also be providing the vaccine to high risk individuals by appointment only. For more information, please go to the Delaware Division of Public Health Website.
For more information about the H1N1 vaccine, please go to the CDC website.
Wednesday, October 28, 2009
Lactose Intolerance
I had a 30 year old female present with complaints of intermittent abdominal cramping for months and diarrhea (non-bloody). She denied any vomiting, fever, chills, or urinary complaints. She attempted a food diary but found no direct correlation. Her medical and family history were unremarkable. Her medications included a birth control pill and over the counter Imodium and Tums (which slightly helped). The patient was told in the past she had irritable bowel syndrome. Diagnostic tests were performed and revealed results consistent with lactose intolerance.
Lactose intolerance is a condition where the body does not have enough lactase (an enzyme) to break down lactose (type of sugar found in dairy products) into glucose and galactose. Symptoms occur 30 minutes to two hours after eating or drinking milk or milk products. Severity is usually based on the amount of lactose consumed. Symptoms include:
1. Abdominal bloating and cramping
2. Diarrhea
3. Gas
4. Nausea
5. Foul smelling stools
6. Weight loss
Here is a short list of foods with lactose:
1. Dairy and dairy products
2. Bread and baked goods
3. Processed breakfast cereals and foods (doughnuts, waffles, pancakes, etc...)
4. Instant potatoes
5. Instant soups
6. Salad dressings
7. Margarine
8. Coffee creamers
9. Processed meats (bacon, ham, hot dogs, etc...)
10. Candy
11. Protein supplements and bars
12. Pizza
13. Mosts foods that are creamed, buttered, or breaded
Diagnosis is usually based on history but there are diagnostic tests (Hydrogen breath test and Lactose tolerance test).
Treatment includes:
1. Dietary modification (Good bye pizza)
2. Calcium supplementation (adults should maintain 1200-1500mg per day)
3. Lactase enzyme supplements (Lactaid pills)
Colitis, Celiac disease, irritable bowel syndrome, and infections can also present with abdominal pain and diarrhea. Contact your primary physician for further information.
Now here are some interesting statistics:
1. Nearly 100% of American Indians and Asians have some degree of LI.
2. Nearly 75% of people worldwide have some degree of LI.
3. Up to 80% of African Americans and Hispanics have LI.
4. 30 to 50 million Americans suffer from LI
5. About 1 in 9 Americans have a form of LI.
6. Lactase levels start to decline around 4 years of age and decreases with age.
Hope this was informative and have a nice day!
Lactose intolerance is a condition where the body does not have enough lactase (an enzyme) to break down lactose (type of sugar found in dairy products) into glucose and galactose. Symptoms occur 30 minutes to two hours after eating or drinking milk or milk products. Severity is usually based on the amount of lactose consumed. Symptoms include:
1. Abdominal bloating and cramping
2. Diarrhea
3. Gas
4. Nausea
5. Foul smelling stools
6. Weight loss
Here is a short list of foods with lactose:
1. Dairy and dairy products
2. Bread and baked goods
3. Processed breakfast cereals and foods (doughnuts, waffles, pancakes, etc...)
4. Instant potatoes
5. Instant soups
6. Salad dressings
7. Margarine
8. Coffee creamers
9. Processed meats (bacon, ham, hot dogs, etc...)
10. Candy
11. Protein supplements and bars
12. Pizza
13. Mosts foods that are creamed, buttered, or breaded
Diagnosis is usually based on history but there are diagnostic tests (Hydrogen breath test and Lactose tolerance test).
Treatment includes:
1. Dietary modification (Good bye pizza)
2. Calcium supplementation (adults should maintain 1200-1500mg per day)
3. Lactase enzyme supplements (Lactaid pills)
Colitis, Celiac disease, irritable bowel syndrome, and infections can also present with abdominal pain and diarrhea. Contact your primary physician for further information.
Now here are some interesting statistics:
1. Nearly 100% of American Indians and Asians have some degree of LI.
2. Nearly 75% of people worldwide have some degree of LI.
3. Up to 80% of African Americans and Hispanics have LI.
4. 30 to 50 million Americans suffer from LI
5. About 1 in 9 Americans have a form of LI.
6. Lactase levels start to decline around 4 years of age and decreases with age.
Hope this was informative and have a nice day!
Monday, October 26, 2009
Lung Cancer
A 66 year old female presented to my office with a chronic cough and right sided chest pain. She denied any fevers, chills, or weight loss. Her medical and family history were unremarkable but she did admit to smoking one to two packs a day for decades. Labs and ECG were normal but her chest xray demonstrated a "mass." CT of the chest was done the next day which confirmed a 5 cm lesion. Bronchoscopy was performed and she was diagnosed with small cell carcinoma (lung cancer).
Lung Cancer is bad. Tobacco is directly linked to about 80-90% of all lung cancers!!! I counsel patients daily on tobacco use and cessation but unfortunately people continue to smoke. The statistics are staggering:
1. Adults in the US who smoke: over 40 million
2. High School students who smoke: 3.5 million
3. Packs of cigarettes used by kids each year: 800 million/$2 billion in sales revenue
4. Kids who become new regular smokers each day: 1000
5. Health care costs caused by smoking: $80 billion and rising
6. Smokers lose an average of 13 years to their lives
7. Smoking during pregnancy causes more than 1000 infant deaths per year
8. Consumer cost of cigarette smoking per year: $3400
9. 3000 Americans die each year due to second hand smoke
10. Smoking kills over 400,000 people each year in the US
11. Smoking causes one in five American deaths
12. Someone dies from smoking every 72 seconds
13. 3000 young people begin smoking every day
14. Children of smoking parents have a higher risk of developing asthma, bronchitis, ear infections, etc...
15. 90% of smokers began before the age of 20.
As you can see, tobacco is deadly. Here are some statistics on lung cancer:
1. There have been over 200,000 new cases of lung cancer this year
2. Over 150,000 Americans have died from lung cancer in 2009
3. Lung cancer is the leading cause of cancer death
4. The overall 5 year survival rate for lung cancer is about 15%
5. The number of lung cancer deaths exceeds the total of breast, colon, and prostate combined!!!
6. About 400,000 people alive today have been diagnosed with lung cancer at some point in their lifetime.
What are the strategies for tobacco cessation???
1. You need to want it!!!
2. Set a quit date (anniversary, birthday, New Years)
3. Counselling/Behavioral support (Delaware Quitline 1-866-409-1858 or National Quitline 1-800-QUIT-NOW)
4. Reward yourself when you quit
5. Be prepared for relapse and keep trying
6. Nicotine replacement such as gum, patches, spray, lozenges
7. Medications such as bupropion, nortriptyline, or Chantix
8. One puff can cause a relapse so do not be exposed to a potential smoking environment
9. Quitting smoking does not increase anxiety!!!
10. For smokers with asthma, quitting smoking can improve lung function scores by 15 percent in less than two months
11. Combined therapy is best...About 35% are successful.
For more information, click on the following links
Quit Now
Delaware Quitline
American Lung Association
Lung Cancer is bad. Tobacco is directly linked to about 80-90% of all lung cancers!!! I counsel patients daily on tobacco use and cessation but unfortunately people continue to smoke. The statistics are staggering:
1. Adults in the US who smoke: over 40 million
2. High School students who smoke: 3.5 million
3. Packs of cigarettes used by kids each year: 800 million/$2 billion in sales revenue
4. Kids who become new regular smokers each day: 1000
5. Health care costs caused by smoking: $80 billion and rising
6. Smokers lose an average of 13 years to their lives
7. Smoking during pregnancy causes more than 1000 infant deaths per year
8. Consumer cost of cigarette smoking per year: $3400
9. 3000 Americans die each year due to second hand smoke
10. Smoking kills over 400,000 people each year in the US
11. Smoking causes one in five American deaths
12. Someone dies from smoking every 72 seconds
13. 3000 young people begin smoking every day
14. Children of smoking parents have a higher risk of developing asthma, bronchitis, ear infections, etc...
15. 90% of smokers began before the age of 20.
As you can see, tobacco is deadly. Here are some statistics on lung cancer:
1. There have been over 200,000 new cases of lung cancer this year
2. Over 150,000 Americans have died from lung cancer in 2009
3. Lung cancer is the leading cause of cancer death
4. The overall 5 year survival rate for lung cancer is about 15%
5. The number of lung cancer deaths exceeds the total of breast, colon, and prostate combined!!!
6. About 400,000 people alive today have been diagnosed with lung cancer at some point in their lifetime.
What are the strategies for tobacco cessation???
1. You need to want it!!!
2. Set a quit date (anniversary, birthday, New Years)
3. Counselling/Behavioral support (Delaware Quitline 1-866-409-1858 or National Quitline 1-800-QUIT-NOW)
4. Reward yourself when you quit
5. Be prepared for relapse and keep trying
6. Nicotine replacement such as gum, patches, spray, lozenges
7. Medications such as bupropion, nortriptyline, or Chantix
8. One puff can cause a relapse so do not be exposed to a potential smoking environment
9. Quitting smoking does not increase anxiety!!!
10. For smokers with asthma, quitting smoking can improve lung function scores by 15 percent in less than two months
11. Combined therapy is best...About 35% are successful.
For more information, click on the following links
Quit Now
Delaware Quitline
American Lung Association
Friday, October 23, 2009
Breast Cancer
A 44 year old female came to my office complaining of a right breast lump. She had done a self breast exam three days ago and noticed the lump. On examination, she had a palpable mass at the upper area of her breast with no surrounding redness. Her medical history was unremarkable. Diagnostics tests were performed which confirmed the mass and she was referred to the surgeon for further evaluation. She was diagnosed with breast cancer and eventually underwent cancer therapy and mastectomy.
I cannot stress enough the importance of breast cancer screening. Screening includes mammography, physician clinical exam, and the self breast exam.
Click here to see how to perform a self breast examination.
Here are some interesting Breast Cancer facts. Hopefully, with improved technology and surveillance, breast cancer will be beaten.
1. Breast cancer is the second most common cancer in American women. (Skin Cancer is number one).
2. One in eight women will develop breast cancer.
3. There will about 190,000 new cases of invasive breast cancer in the United States this year.
4. Every 13 minutes, a woman dies of breast cancer.
5. Breast cancer is the leading cause of cancer death in women between the ages of 15 and 54.
6. There are about 2.5 million breast cancer survivors!!!
7. About 400 men will die from breast cancer in the United States.
8. About 20-30% of women diagnosed with breast cancer have a positive family history.
9. Breast cancer risk increases with age but about 2-7% of breast cancers occur in women under the age of 40.
10. Women who perform regular self exams find 80-90% of all breast masses.
11. Breast cancer is the second leading cause of cancer death in women after lung cancer.
12. One percent of breast cancer occur in men.
13. Unfortunately, 10-15% of breast cancers are not detected by mammography (stressing the importance of clinical exams and self exams).
14. Over 90% of women who find and treat breast cancer early will be cancer-free after five years.
15. Breast cancer deaths rates have been declining by about 2% since 1990.
Hope the information is helpful. To learn more about breast cancer, click on the links below.
Susan G. Komen for the Cure
National Cancer Institute
American Cancer Society
I cannot stress enough the importance of breast cancer screening. Screening includes mammography, physician clinical exam, and the self breast exam.
Click here to see how to perform a self breast examination.
Here are some interesting Breast Cancer facts. Hopefully, with improved technology and surveillance, breast cancer will be beaten.
1. Breast cancer is the second most common cancer in American women. (Skin Cancer is number one).
2. One in eight women will develop breast cancer.
3. There will about 190,000 new cases of invasive breast cancer in the United States this year.
4. Every 13 minutes, a woman dies of breast cancer.
5. Breast cancer is the leading cause of cancer death in women between the ages of 15 and 54.
6. There are about 2.5 million breast cancer survivors!!!
7. About 400 men will die from breast cancer in the United States.
8. About 20-30% of women diagnosed with breast cancer have a positive family history.
9. Breast cancer risk increases with age but about 2-7% of breast cancers occur in women under the age of 40.
10. Women who perform regular self exams find 80-90% of all breast masses.
11. Breast cancer is the second leading cause of cancer death in women after lung cancer.
12. One percent of breast cancer occur in men.
13. Unfortunately, 10-15% of breast cancers are not detected by mammography (stressing the importance of clinical exams and self exams).
14. Over 90% of women who find and treat breast cancer early will be cancer-free after five years.
15. Breast cancer deaths rates have been declining by about 2% since 1990.
Hope the information is helpful. To learn more about breast cancer, click on the links below.
Susan G. Komen for the Cure
National Cancer Institute
American Cancer Society
Wednesday, October 21, 2009
Seatbelts
Seatbelts saves lives. Plain and simple.
I will usually ask during the first visit, whether or not the individual wears seatbelts. Most of the time the answer is yes but unfortunately there is an occasional no!
Here are some statistics:
1. Over 60% of people killed in accidents are NOT wearing seatbelts.
2. It is estimated that seatbelts save about 9000 lives annually.
3. Data suggests young males age 16-25 are the worst offenders.
4. Nationwide data shows 84% of people wear seatbelts.
5. Wearing a seatbelt cuts your risk of being seriously injured or killed by 50%.
6. When parents are buckled up, children are too...when parents are not buckled up, children usage goes down to 59%.
7. The fine in Delaware for not wearing a seatbelt is about $40.00.
8. The leading cause of death in people under 35 (not including newborns) is car accidents!!!
Please wear your seatbelt...you are not only protecting yourself but also your family and friends!!!
I will usually ask during the first visit, whether or not the individual wears seatbelts. Most of the time the answer is yes but unfortunately there is an occasional no!
Here are some statistics:
1. Over 60% of people killed in accidents are NOT wearing seatbelts.
2. It is estimated that seatbelts save about 9000 lives annually.
3. Data suggests young males age 16-25 are the worst offenders.
4. Nationwide data shows 84% of people wear seatbelts.
5. Wearing a seatbelt cuts your risk of being seriously injured or killed by 50%.
6. When parents are buckled up, children are too...when parents are not buckled up, children usage goes down to 59%.
7. The fine in Delaware for not wearing a seatbelt is about $40.00.
8. The leading cause of death in people under 35 (not including newborns) is car accidents!!!
Please wear your seatbelt...you are not only protecting yourself but also your family and friends!!!
Tuesday, October 20, 2009
Weight Loss
I get asked a lot about weight loss. It is a difficult complaint because many factors contribute to being overweight/obese. Here are some basic ideas to help shed off the extra pounds.
1. Walk, Walk, Walk...I recommend purchasing a pedometer and walking 10,000 steps a day. This is about five miles and about a 500 calorie loss each day. Several suggestions include taking the stairs, parking farther away, walking around the neighborhood, walking the dog, vacuuming, or walking with family or friends.
2. Exercise...the recommendation is at least thirty minutes of moderate activity (or three 10 minutes sessions) each day five times a week. Examples include walking a mile in 20 minutes, treading water, bicycling about 10mph, dancing, yard work, vacuuming, and actively playing with children.
3. Healthy Diet...Refer to the new food pyramid at www.mypyramid.gov. Dieticians recommend having colorful meals on smaller plates. Also, avoid "white" foods such as white rice, white potatoes, white pasta, or white bread. Also, eat fiber...veggies, whole grains, fresh fruits, beans, etc...
4. Eat breakfast to boost your metabolism.
5. Weight lifting twice a week will burn calories.
6. Set a realistic goal. 20 pounds in one year is more attainable and sustainable than 10 pounds in one month.
7. Try to eliminate 250-500 calories per day either by exercising, eliminating dessert, or switching from Coke (one soda has about 15 teaspoons of sugar!!!) to Diet Coke.
8. Drink water!!!
9. Know your BMI (Body Mass Index) and waist circumference.
10. Never go grocery shopping hungry.
There are many other ideas for weight loss. There are also medical conditions that make it difficult to lose weight such as cardiac disorders, thyroid disorders, hormonal disorders, and certain medications (antihistamines, progestins in birth control pills, Lithium, and beta-blockers).
Talk to your health care professional for further information about weight loss. Weight loss can be done but it is a long-term process. Always stay positive and drink a cold glass of ice water.
1. Walk, Walk, Walk...I recommend purchasing a pedometer and walking 10,000 steps a day. This is about five miles and about a 500 calorie loss each day. Several suggestions include taking the stairs, parking farther away, walking around the neighborhood, walking the dog, vacuuming, or walking with family or friends.
2. Exercise...the recommendation is at least thirty minutes of moderate activity (or three 10 minutes sessions) each day five times a week. Examples include walking a mile in 20 minutes, treading water, bicycling about 10mph, dancing, yard work, vacuuming, and actively playing with children.
3. Healthy Diet...Refer to the new food pyramid at www.mypyramid.gov. Dieticians recommend having colorful meals on smaller plates. Also, avoid "white" foods such as white rice, white potatoes, white pasta, or white bread. Also, eat fiber...veggies, whole grains, fresh fruits, beans, etc...
4. Eat breakfast to boost your metabolism.
5. Weight lifting twice a week will burn calories.
6. Set a realistic goal. 20 pounds in one year is more attainable and sustainable than 10 pounds in one month.
7. Try to eliminate 250-500 calories per day either by exercising, eliminating dessert, or switching from Coke (one soda has about 15 teaspoons of sugar!!!) to Diet Coke.
8. Drink water!!!
9. Know your BMI (Body Mass Index) and waist circumference.
10. Never go grocery shopping hungry.
There are many other ideas for weight loss. There are also medical conditions that make it difficult to lose weight such as cardiac disorders, thyroid disorders, hormonal disorders, and certain medications (antihistamines, progestins in birth control pills, Lithium, and beta-blockers).
Talk to your health care professional for further information about weight loss. Weight loss can be done but it is a long-term process. Always stay positive and drink a cold glass of ice water.
Monday, October 19, 2009
Sunday, October 18, 2009
Seasonal Flu
A five year old girl came to my office with a fever for three days. Her mother stated it had been as high as 102 but goes down with Children's Motrin. She also complains of cough and belly pain. The girl had no significant medical history and received her flu shot earlier in the month. Her physical exam was unremarkable. She was sent to the lab for testing and her results came back positive for Influenza A. Her mother was advised to provide supportive care and to follow up if the symptoms don't improve in several days.
There has been a lot of focus on the flu, especially the H1N1 virus. I have seen a decent amount of patients with "flu-like" symptoms but only a handfull who were positve for the H1N1 virus. The concern for the H1N1 is warranted with over 500 deaths in the US but we should not lose our focus on the seasonal flu. The seasonal flu typically hospitalizes 200,000 people each year and over 30,000 die due to the flu and its complications. Approximately, 10-20% of Americans get the flu. So, how do we prevent this disease???
1. Get a flu shot. (but you still can get a type of the flu that is not covered by the vaccine)
2. Wash your hands frequently.
3. Eat healthy and get enough sleep.
4. Cover your mouth when you cough or sneeze.
5. Avoid individuals with confirmed flu.
What are the signs and symptoms of the flu?
1. Fever (often over 101)
2. Cough
3. Stuffy nose
4. Body aches
5. Chills
6. Fatigue
Patients have told me that it's like being hit by a truck.
According to the CDC, the H1N1 is potentially more severe with associated vomiting and diarrhea.
The flu could last as short as two days or as long as 14 days. It can cause complications, especially with individuals with other medical conditions such as asthma, diabetes, and heart disease.
How do we treat the seasonal flu?
1. Drink, Drink, Drink...stay hydrated!!!
2. Use Motrin/Tylenol for the fever and aches (use the appropriate dose)
3. Saline nasal sprays
4. Rest!!!
5. Anti-viral medications if indicated but will need to be started within 48 hours of onset of symptoms
Is there a test for the flu?
Yes...there is a rapid nasal swabbing test that can be performed. This test does not differentiate between seasonal and H1N1 flu. For instance, as of this posting, Lebron James was tested and confirmed to have Influenza A on nasal swabbing but not H1N1. H1N1 and the seasonal flu are subtypes of Influenza A therefore if your rapid comes back positive for A it may or may not be H1N1. There is a test for H1N1 called RT-PCR but may take several days to return but usually does not alter typical influenza treatment.
Usually with some rest, fluids, TLC, and over the counter medications, the flu will subside. If the symptoms do not improve over a week, call your health care professional. In children, if the following symptoms occur, please contact their primary care physician:
1. Trouble breathing
2. Bluish or grayish skin
3. Not drinking well
4. Not urinating well
5. Not acting normally
6. Rash
7. Fever getting better then returning several days later
8. Being irritable even after the fever goes down
I hope this was informative. Keep those hands clean!!!
There has been a lot of focus on the flu, especially the H1N1 virus. I have seen a decent amount of patients with "flu-like" symptoms but only a handfull who were positve for the H1N1 virus. The concern for the H1N1 is warranted with over 500 deaths in the US but we should not lose our focus on the seasonal flu. The seasonal flu typically hospitalizes 200,000 people each year and over 30,000 die due to the flu and its complications. Approximately, 10-20% of Americans get the flu. So, how do we prevent this disease???
1. Get a flu shot. (but you still can get a type of the flu that is not covered by the vaccine)
2. Wash your hands frequently.
3. Eat healthy and get enough sleep.
4. Cover your mouth when you cough or sneeze.
5. Avoid individuals with confirmed flu.
What are the signs and symptoms of the flu?
1. Fever (often over 101)
2. Cough
3. Stuffy nose
4. Body aches
5. Chills
6. Fatigue
Patients have told me that it's like being hit by a truck.
According to the CDC, the H1N1 is potentially more severe with associated vomiting and diarrhea.
The flu could last as short as two days or as long as 14 days. It can cause complications, especially with individuals with other medical conditions such as asthma, diabetes, and heart disease.
How do we treat the seasonal flu?
1. Drink, Drink, Drink...stay hydrated!!!
2. Use Motrin/Tylenol for the fever and aches (use the appropriate dose)
3. Saline nasal sprays
4. Rest!!!
5. Anti-viral medications if indicated but will need to be started within 48 hours of onset of symptoms
Is there a test for the flu?
Yes...there is a rapid nasal swabbing test that can be performed. This test does not differentiate between seasonal and H1N1 flu. For instance, as of this posting, Lebron James was tested and confirmed to have Influenza A on nasal swabbing but not H1N1. H1N1 and the seasonal flu are subtypes of Influenza A therefore if your rapid comes back positive for A it may or may not be H1N1. There is a test for H1N1 called RT-PCR but may take several days to return but usually does not alter typical influenza treatment.
Usually with some rest, fluids, TLC, and over the counter medications, the flu will subside. If the symptoms do not improve over a week, call your health care professional. In children, if the following symptoms occur, please contact their primary care physician:
1. Trouble breathing
2. Bluish or grayish skin
3. Not drinking well
4. Not urinating well
5. Not acting normally
6. Rash
7. Fever getting better then returning several days later
8. Being irritable even after the fever goes down
I hope this was informative. Keep those hands clean!!!
Friday, October 16, 2009
Women and Heart Disease
At first I thought about posting a case about the flu but this case is more life-threatening...
I recently saw a pleasant 60 year old female who presented with the complaint of nausea. She also stated that she was getting more winded for the past couple of weeks. She denied any chest pain. Her medical history included tobacco use, elevated blood pressure, and high cholesterol. An ECG was performed which revealed "changes" and she was promptly sent to the emergency room. She was found to have heart disease and underwent cardiac catherization which revealed multiple blockages. The patient was treated and is doing well today.
This case illustrates the importance of understanding heart disease in women. Heart disease is the LEADING cause of death in women over 65 years of age. Almost half a million women die each year due to heart disease. Another surprising statistic is that heart disease kills more women over 65 than do all cancers combined. WOW!!!!
The most common symptom is chest pain, but in my experience (and from peers), they can present with "not" typical findings such as nausea, dizziness, fatigue, upper back pain, and shortness of breath. The risk factors include high blood pressure, Diabetes, family history, obesity, high cholesterol, smoking, post-menopause, and mental stress.
How do we stop heart disease????
First if you smoke...QUIT!!! More than half of heart attacks in women under 50 are associated with smoking.
Exercise...30-60 minutes per day five times a week. Also walk 10,000 steps per day.
Eat Healthy...Low fat, low cholesterol, low salt (watch the ketchcup).
Keep a healthy weight!!! Know your BMI (Body Mass Index). 25 or less is good.
Take your medications as instructed.
Please know that Hypertension (high blood pressure) is silent but potentially deadly so please, please, please take the medications!
If you have any risk factors or heart disease, please talk with your physician and develop a plan. Many of the factors are reversible or controllable such as smoking and obesity so talk with your primary physician.
I hope this increases awareness of heart disease in women. There are many useful websites such as the American Heart Association and FamilyDoctor.org.
I recently saw a pleasant 60 year old female who presented with the complaint of nausea. She also stated that she was getting more winded for the past couple of weeks. She denied any chest pain. Her medical history included tobacco use, elevated blood pressure, and high cholesterol. An ECG was performed which revealed "changes" and she was promptly sent to the emergency room. She was found to have heart disease and underwent cardiac catherization which revealed multiple blockages. The patient was treated and is doing well today.
This case illustrates the importance of understanding heart disease in women. Heart disease is the LEADING cause of death in women over 65 years of age. Almost half a million women die each year due to heart disease. Another surprising statistic is that heart disease kills more women over 65 than do all cancers combined. WOW!!!!
The most common symptom is chest pain, but in my experience (and from peers), they can present with "not" typical findings such as nausea, dizziness, fatigue, upper back pain, and shortness of breath. The risk factors include high blood pressure, Diabetes, family history, obesity, high cholesterol, smoking, post-menopause, and mental stress.
How do we stop heart disease????
First if you smoke...QUIT!!! More than half of heart attacks in women under 50 are associated with smoking.
Exercise...30-60 minutes per day five times a week. Also walk 10,000 steps per day.
Eat Healthy...Low fat, low cholesterol, low salt (watch the ketchcup).
Keep a healthy weight!!! Know your BMI (Body Mass Index). 25 or less is good.
Take your medications as instructed.
Please know that Hypertension (high blood pressure) is silent but potentially deadly so please, please, please take the medications!
If you have any risk factors or heart disease, please talk with your physician and develop a plan. Many of the factors are reversible or controllable such as smoking and obesity so talk with your primary physician.
I hope this increases awareness of heart disease in women. There are many useful websites such as the American Heart Association and FamilyDoctor.org.
Thursday, October 15, 2009
Welcome
Welcome to my blog. I am a small town family physician in Delaware. My purpose of this blog is to educate patients. I plan to present interesting cases from my practice and my colleagues. I also plan to increase awareness in various medical issues. This blog is for informational purposes only. Thank you and have a nice day.
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