Tag Archives: #Prevention

Another Reason to Know the Source of Your Food.

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There have been many cases of food coming from other countries, being contaminated, causing significant health issues, and then we never really hear about it again. I have been asked recently a lot about the contaminated powdered milk and baby formula from a few years ago, if other foods had melamine in them, and what the big deal is?  I think this Melanine issue in foods from China merely highlighted the fact that we need to really take a good look at where our food comes from and the standards that we have in the US, UK, and EU are not shared worldwide.

What was the big controversy?

In 2007 and 2008, a factory in China that was producing formula, tried to undercut the competition, by cutting their milk production costs by using raw milk (non-pasteurized) and then cutting it with water to increase the volume. In order to make the milk products have that have the appropriate amount of protein, they needed to add something. Protein levels are usually checked through the levels of nitrogens present. What they decided to add is Melanine.  Melanine is and organic powdered chemical that is very high in nitrogens, and it is frequently found in adhesives, plastics, countertops, etc. It is NOT a form of food, and it has no nutritional value. Melanine was found in wheat gluten, rice proteins, frozen yogurt, some coffee drinks (with Milk products), and various pet foods that came from China. It is actually detrimental to our health, and this is not an approved additional supplement/practice by any of the organizations worldwide that regulate food.

What are the side effects of Melanine?

Most of all the information that we have regarding the effects of Melanine are from animal studies, as it is nowhere deemed safe for human consumption, so it has never been studied. When the pet food contaminated with Melanine were hitting the shelves in the US, large numbers of animals died, shortly after ingesting the foods. Melanine can cause irritability, blood in the urine, high blood pressure, and renal (kidney) failure.  It is assumed, based upon animals, that the Melanine crystallizes with other byproducts in the body, and can clog up the kidney tubules causing kidney stones and lead to total blockage of urine passing, leading to renal failure.

 What does this mean?

Well, since the issue in 2007 and 2008, the use of Melanine has become much more scrutinized, and foods from China are now being tested for it, so we are pretty certain foods do not have it.  But the whole issue made me really question foods processed outside the US.  I clearly try to live a clean lifestyle, I eat organically and minimally processed (as much as possible), and I like to think it works for me, and I realize it is not possible for everyone. But I really want you all to think about where your food comes from, where it is processed. I loved that when I lived in the UK, the food source was well labelled on the package; I knew exactly where my veg came from, my fruits, etc. if they were grown and packaged outside the UK. Think about buying fruits and veg at local food sources, like local farms, farm stands, farmers markets, or other stores that sell locally sourced organic foods. Join a Community Sustained Agriculture (CSA) group, and support local farmers all while ensuring you are eating fresh, organic, unprocessed foods.  It is a piece of mind for me, knowing that my food does not have anything, like Melanine, added to it that could kill me, my family, or my pets.

Food for thought!

Yours in Good Health

B

 

What is the most contagious STD?

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I was quite shocked that crabs (AKA pubic lice) is as prevalent as it is. But in the past week I have been asked about it three different times from people all over the US, which made me think that this topic needed a little discussion related to what crabs are, how you get them, and how to treat them.  I wasn’t sure how prevalent they are, but they are clearly around, and infections are on the rise.

What are crabs?

Crabs are also known as pubic lice (Pthrius pubis) and they are parasitic insects that feast off the blood of humans and live in coarse hair (i.e. pubic hair, eyebrows, eyelashes, chest hair, armpits, mustaches, & beards) causing itching, discomfort, and rashes. So you can understand how they can not only be really irritating, awkward, and kind of gross to think about, right?  They pass from person to person usually through sexual intercourse (or sexual acts) but they can also jump from person to person through hugging or other close contact (sharing towels, clothes, bedding, etc.) Despite the fact that crabs can’t live very long away from the warmth of a human body, they are still the most contagious STD, and if an infected person has sex with a non-infected person, the risk of getting crabs is about 90% for that previously non-infected person.  That is pretty shocking, and horrifying…a 90% chance?!?  Plus the lice live from about 1 to 3 months, and in that “lifetime” the average female lice has about 300 eggs, which means they breed quickly and frequently! These parasites spread quickly.

What are the signs and symptoms of infection?

Usually the only symptom is itching….extreme itching.  Sometimes you can visualize the bite marks on your skin, they are bluish in color, due to the bruising from them sucking your blood to the surface, but it is very hard to see. Sometimes there are little red bumps from the bites, and then scratching them. Most often the itching and discomfort brings people in to their HCP.

How do I treat it?

First, when you find out that you are infected, let the people you live with and sexual partners know about the crabs, and clean all sheets, clothing, towels, etc in water that is at least 130F and dry it thoroughly in a dryer to kill off the lice living in the sheets.  If some of these items cannot be washed, then have them dry cleaned.  You can also buy an over the counter (OTC) treatment from your local pharmacy, like Permethrin 1% creme, that you apply to the affected areas (not near eyes), leave on for 10 minutes, then wash out and with a fine toothed comb, comb through the hair to remove all eggs and dead lice.  Usually this one time treatment works, but you MUST see an HCP to get treatment if the OTC doesn’t work, if you are pregnant, children under 2 years old, or teens under 18.  There are some treatments that are prescription only, so you need to see your HCP and get diagnosed. One other option, after you treat the area, is to shave off all affected areas (this is a little radical and not usually suggested by most HCPs) but if there is no hair to cling onto, there will be no pubic lice….just make sure to kill off the current infestation you have. Makes sense right?

Can I prevent it?

Well, you can ask partners if they have crabs, which I would hope they would abstain from sexual contact if they knew they had crabs, but its worth an ask.  Unfortunately, condoms do not prevent the spread of crabs, which is a total bummer.  If you have previously been infected (or are infected currently), make sure to wash or dry clean everything (as stated above, use the OTC treatment, and if symptoms are not cleared up, go see your HCP for further treatment, and bleach your bathroom/anything you use on your hair/body hair for grooming.

So unfortunately, it is highly contagious and can be an awkward treatment, but limiting your sexual partners, and asking about STD’s is a start at prevention.  Also, use your intuition: if you see someone scratching their crotch or just all over when you’re out with them, ask them if they have some sort of skin issue or lice.  If they say they are just super itchy and they don’t know why?  Steer clear!!

Yours in Good Health

B

West Nile Virus: What is it??

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I know that mosquito bites are annoying, and we hear about West Nile Virus, and I see the signs all over that West Nile can come from mosquito bites, but do we really know what that means?  What are the symptoms of West Nile?  Is it a big deal? Do I even care? I have been getting a lot of questions about this especially since there have been numerous reports of West Nile Virus found in certain areas around where I live, and the Center for Disease and Prevention (CDC) has reported that 48 of the 50 states have fond cases this summer.  So, let’s get to the bottom of it!

What is West Nile Virus?

West Nile virus is a virus transmitted by mosquitos that can cause very generalized reactions, ranging from very mild to very extreme, with potential for very serious illness. It is considered a seasonal epidemic that flares up in the summer in North America and remains as a high threat through the fall. The CDC reports that this summer has the highest rates of West Nile (just shy of 1600 cases) since it was first found in 1999, and 70% of the cases are from Louisiana, Oklahoma, Texas, South Dakota, Mississippi, and Michigan.

What are the symptoms?

The virus is really defined by the symptoms really. Only about 1% of people who are infected will get a serious reaction and the two most determining factors seem to be age over 50 years old, and having a weakened immune system (due to transplantation, immunosuppression, chronic disease, etc.) It takes anywhere from 3-14 days to have symptoms of the virus after being bitten. Most people have absolutely no symptoms at all, while other people might have mild symptoms that include:

-fever

-headache

-bodyaches

-fatigue

-skin rash

-eye pain

-swollen lymph nodes

More severe symptoms include:

-high fevers

-neck aches/pain

-severe headache (like a migraine)

-stiff neck muscles

-disorientation/confusion

-muscle weakness and/or lack of muscle coordination

-coma

-partial paralysis

*These symptoms usually last a few days but the symptoms that are more severe last a week or more and some, like paralysis, can be permanent.  If you have these symptoms, you should seek medical care.

How is it transmitted?

WNV is primarily transmitted to humans and animals through mosquito bites, and the mosquitos become carriers after feeding on dead birds that are infected with the virus.  Other ways of transmission are through blood transfusion and organ transplantation, but it is now a virus that is screened for more thoroughly, so the risk is significantly diminished.  But, you are at your highest risk to become infected during warm weather, due to the nature of the transmission and high breeding levels of mosquitos!

How can I be diagnosed?

Your HCP will determine based on your symptoms if you need further testing, but they will start with lab tests to look for an increased level of antibodies to the WNV, which means that your body is fighting off the virus or has recently.  If you have increased antibodies, you will then most likely get a lumbar puncture (AKA a spinal tap) to assess for the virus in your cerebral spinal fluids (CSF); to help diagnose the meningitis (stiff neck, high fevers, muscle convulsions/rigidity).  The CSF that is drawn off, if infected will show high levels of white blood cells (WBCs) and also the WNV antibodies.  And finally, if you are having confusion/stupor, etc. you will be ordered for an MRI or an electroencephalography (EEG) to study your brain and the swelling (MRI), and the brain waves and function (EEG) to determined the severity of the infection.

Are treatments available?

Because it is a virus, not really, no.  Most of the “treatment” is just rest, and supportive care like Intravenous (IV) fluids if you are in the hospital, using tylenol/advil to treat fevers, eating a healthy diet, and focusing on regaining strength. There is some current research looking at interferon therapy, which is an immune modulating therapy, to help people with severe symptoms overcome the virus faster but the research is in pretty early stages, although at this point it looks promising, interferon therapy is a very intense therapy.

How can I protect myself?

From your home/living area, try to reduce breeding of mosquitos by eliminating any standing water, like change out bird bath date frequently, anything that has still sitting water in it, dump it, and clean out gutters.  Anything moist, damp, or filled with water is the perfect little breeding ground for mosquitos, so do what you can to eliminate them! Also, make sure to change out your animals water bowls that are left outside (if you have one). And how to prevent getting bitten? Wear long sleeves and long pants if going into mosquito ridden areas, especially at dusk or dawn as that is when they are most likely to swarm. Also use insect repellent with DEET (avoiding faces and hands of children) and for young infants you can cover their strollers with mosquito netting (do not use DEET on children under 2 months).  Use good sense, and use the monthly medications to prevent your dogs/cats from getting infected too!

If you are worried about your risk because you spend a lot of time outdoors, in the woods, or in high risk areas, then talk to your HCP about your risk and other ways to prevent WNV.  Also, talk to your HCP about any symptoms you may have had, they may want you to come in for further testing, or come in earlier if you experience symptoms again, to be able to diagnose you!  Wear that bug spray!!

Yours in Good Health

B

Too good to be true? A drug to Prevent HIV.

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Human Immunodeficiency Virus (HIV) is still a very real, and very serious risk for those that are sexually active, especially with the fact that there are around 50,000 new cases diagnosed even year in the US and it is  approximated that there are 240,000 undiagnosed carriers, unaware of their status, and around 1.2 million Americans live with the disease.  Those numbers are pretty staggering, right? And the FDA did approve a drug, Truvada, to help as a second preventative measure against HIV about a month ago.  But, there is some controversy related to the drugs approval.

How does it work?

Truvada has been on the market since 2004 to treat HIV, and it is two antiretrovial drugs in combination that tenofovir and emtricitabine that has a higher compliance rate because the two medications are fused into one pill.  The drug, in combination with others, help to prevent the replication of the HIV virus within the DNA, which is how the virus spreads, and usually very quickly. The use of antiretrovirals helps to prevent the virus from spreading.

How does it prevent HIV?

Well, the makers of the drugs did numerous studies with couples that have one HIV infected partner and looked at transmission rates.  Of course, they always encourage the partners to use condoms as that is the best way to prevent the spread of infection, creating a barrier technique.  There was one 3-year long study performed looking at gay and bisexual males, along with the use of condoms and counseling, and they found that the rate of HIV transmission was decreased by 42%.  In heterosexual couples with one infected partner, again with the use of condoms, the transmission rate was decreased by 75%. Those are pretty fantastic results, and give a lot of piece of mind for those at high risk.  It was already prescribed by some HCPs to patients that didn’t have HIV with HIV positive partners as an off label use, but now it is big news that the FDA approved it, which means preliminary research supports the fact that it does, in fact, help to prevent the transmission of HIV to those not infected.

Where’s the controversy?

Some HCPs and HIV/AIDS activists worry that people will ask their HCPs for the drug and be more reckless with unsafe sex because they will feel that they are able to engage in high risk activities (multiple partners, no condoms, sharing needles, etc.) and will not become infected with HIV.  That is not the point of the drug.  The drug is to be used by those at risk due to life circumstances, and they are still encouraged to use condoms and are to be counseled related to their risks and other preventative measures.

Remember that HIV can be spread when blood/genital secretions infected with HIV comes into contact with your blood/tissues, like those tissues of the oral/vaginal/anal mucosa, eyes, any cut or break in the skin.  Thus, some behaviors that put you at risk are having sex without condoms, sharing needles (not just for IV drug use, but for tattoos, steroid injections, and body piercing), and infected mothers can transmit to their babies during childbirth or through breast milk.  So try to abstain from these behaviors, and talk to your HCP about getting tested if you think you are at risk, or have been exposed. I happen to think routine testing is a good idea for anyone who is sexually active, so go for it, it will put you mind at ease!  If you your partner is infected, talk to your HCP and see if Truvada is right for you, but STILL USE CONDOMS!!  Have fun, and be safe.

Yours in Good Health

B

Dry, Itchy, Winter Skin?

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A common problem in the winter is that your skin becomes dry, flaky, itchy, and it can really be difficult to make your skin feel normal.  All the fluctuations with heat, feeling cold, warm showers, etc. make your skin worse, but the good news is that there are some pretty simple tips to help keep your skin moist and healthy….so you can live itch free this winter!

Why is dry skin an issue?
When you have dry skin the fine lines that you can’t normally see become apparent, and the skin also feels rough, and can appear flaky.  Medically, it is known as xerosis.  Now, even though you might think this is a purely visual issue, its not.  Dry skin can actually cause some major issues, like infections from the cracked skin just being open to the elements, or from bacteria under your fingernails getting embedded into the skin and cracks from scratching when it gets itchy. There can be large open sores, bacteria in the form of pus, and it can interfere with sleeping, and every day activities….not to mention it can make you feel like everyone is staring at your skin issues (even if they aren’t).

Signs of dry skin?
flakiness
redness
appearance of fine lines
cracks in skin
rough skin
itchy areas (that can crack and bleed)

What causes it?
Weather: when humidity is low along with temperatures, the moisture gets zapped from our skin
Heat: Central air, wood burning stoves, & space heaters all dry out the air
Hot Showers: despite then feeling really good and warming you up, hot showers deplete your skin of important lipids (fats) that help to keep them moist
Sun Exposure: excessive UV exposure (like sun burns) will also dry out your skin.

What can we do to treat it?
The good news is that most of the treatments are home remedies that are not expensive.  Yay!  Avoiding long hot shower is one place to start, try to keep the water warm, but not super hot, and finish your shower with a thick moisturizer. I use   the standard Palmers Cocoa Butter in the winter, and it keeps my skin moist, but I know some friends  that use thicker creams such as Eucerin which is full of emollients and fats.  I must say Palmers also created a line of skin care for dry winter skin, it is too heavy  for my skin, but if you like using cocoa butter, that line might be for you. But in general, you want to look for a cream that is thick (not thin and watery) and is in general free of dyes and scents. Also, some people will apply baby oil to their skin right after showering to add moisture, I just urge you to be careful because that can get slippery!! Use gentle soaps, that are made for the face, and are labelled as gentle with moisturizers added.  Use a humidifier in your home to offset the drying heaters, and allow some moisture in the air that can help your skin.  And, try to wear natural fibers like cotton, bamboo, etc because they are soft and less irritating to your skin than other man-made fibers.  And, finally, if your skin is super itchy, you can apply cool compresses to try to take the itch out of the area (as opposed to scratching) and applying an OTC hydrocortisone cream (1%) can help to stop the itching.  If it doesn’t you can talk to your HCP about getting a prescription cream to prevent the itching.  Also, if the scratches or cracks in your skin are painful ,red, or oozing you should see an HCP to treat a possible bacterial infection (usually a topical cream can be used).

So, keep those showers short, slap on that cream, and talk to your HCP if you continue to have trouble with dry skin, they may be able to write you for a prescription treatment.

Yours in Good Health!
B

Watch out: the Norovirus is lurking!

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Many people are coming down with rather similar symptoms lately: nausea, vomiting, diarrhea, & cramping.  There is a virus that is going around, which spreads quickly, and you could be at risk. I wanted to discuss what the Norovirus is, how to know you have it, treatments, and, most importantly, prevention!

What is the Norovirus?
It is actually the name for a group of viruses that all act similarly, if not the same, on the gastrointestinal (GI) tract and cause nausea/vomiting, diarrhea, abdominal cramping, etc. and are thought of as a gastroenteritis (an infection of the GI tract). They were once referred to as the “Norwalk Like” viruses after an outbreak of these viruses in Norwalk, Ohio in the early 1970’s. They also gained a lot of press after hundreds (if not thousands) of guests on cruise ships were getting infected, and ships had to go to port due to such high rates of illness (If I ever even ponder taking a cruise, I remember this fun time, and I’m all set; could you imagine how horrible that must have been? Gross!) The tough part of the Norovirus is that the virus strains are highly virulent, in that they spread from person to person quickly and easily, and infections from these viruses are usually at the highest during cold winter months. That is a true bummer for all of us living here in New England! Fun fact? Norovirus is the leading cause of food-related gastroenteritis in the United States.  Another fun fact: You will never forget how miserable you feel while infected!

What are the symptoms?
Nausea
Vomiting
Diarrhea
Stomach cramps
Low grade fever, chills
Headache
Muscle cramps
*the symptoms can occur very suddenly 12-24 hours after exposure to the virus, and normally last around 12 hours and people feel better within 48 hours (see below: you are still a carrier for much longer and can infect others)

How is it spread?
Most often it is spread from person to person through contaminated food and/or water, caring for an infected person, or through contact with contaminated surfaces. It can live on hard surfaces that are infected for around 12 hours and has been found in infected carpet fibers (i.e. an area that someone threw up on) for up to 12 days, plus it can withstand pretty high amounts of chlorine before being killed off. The viruses live in the stool (poop) and vomit from people with the virus, so when caring for children, elderly, or anyone who needs a lot of assistance with care/cleanup, there is a high rate of spreading the infection. You are contagious from the moment you are infected (even before you feel ill) until a full three days after your symptoms end! Which makes this virus so quick to spread especially in places where people live/work closely together, and it is hard to stop the spread once it starts.

My standard at home hydration "go to"

My standard at home hydration “go to”

What is the treatment?
There is no vaccine or antiviral for these viruses, unfortunately. And as we all know antibiotics only treat bacterial infections, so they are useless against the Norovirus. So you are really just trying to treat/prevent the dehydration that can occur after the diarrhea and vomiting; fluids such as gatorade and coconut water will help to replace fluids and nutrients lost, but really any fluids that you can get in and keep down will help to prevent severe dehydration. If your mouth and tongue are really dry and you cannot make saliva, you feel dizzy when changing positions, you aren’t urinating (or it is very dark), you are clinically dehydrated.  When dehydrated, if you are unable to take in fluids, you should go to the Emergency Department for intravenous (IV) fluids. With children, they often will become restless, cry without tears, and have dry oral cavities; they need treatment with IV fluids if they refuse, or cannot keep down, fluids. The best assessment of dehydration status is to watch your pee (frequency, amount, and color- if it appears on the darker side, drink more).

How do I prevent this from happening?
Wash your hands FREQUENTLY!!
Eat food that is thoroughly cooked if you are eating out (or unsure of food quality)
Wash fruits and veggies before eating them
Wash areas that have become contaminated with hot soapy water or bleach
Immediately wash all clothes, bed linens, etc that have become in contact with vomit or stool of an infected person
If you do get infected, avoid contact with others and preparing food until three days after symptoms are gone

Generally, the Norovirus is a nasty couple of days where you feel horrible (absolutely miserable), but it always ends and there are no long-term effects. But if you have chronic illnesses or other active diseases, it can be deadly because of the effects of dehydration and the electrolyte imbalances that can occur. In children, the elderly, and chronically ill, you need to make sure they are taking in fluids with nutrients (pedialyte, Gatorade, coconut water)and if they cannot, you need to seek medical assistance.  Even if you are vomiting, still try to push those fluids…even absorbing small amounts are better than nothing!

So wash your hands, cook that food, and steer clear of anyone with those symptoms and you will be Norovirus free this winter!

Yours in Good Health
B

Cold and Flu Prevention

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Cold and flu season is now upon all of us; we are all at risk, we all know that we should be getting flu shots, especially if you are considered high risk, and ideally you should get the flu shot before December, when flu season starts to hit its hardest. The flu can be a very devastating illness and can lead to complications of other medical issues and cause death.  Colds?  You just don’t want to feel crappy, so we should really try our best to prevent both, right?  Prevent illness in yourself and others, and you will be a MUCH happier person this winter!

The Flu Virus

Who is considered High Risk?
Per the CDC (Center for Disease Control) it is:
Pregnant woman
Children 5 and under
People with chronic medical conditions
People older than 50 years old
Anyone living in a nursing home or long-term care facilities
People who care for those at high risk (healthcare workers, caregivers for elderly or very young)

What else can I do to prevent colds and flu?
Get adequate sleep: I have certain unnamed friends that claim exhaustion if they get less than 10-12 hours of sleep a night, I am really happy with the average person if they get 7-8 hours of sleep; because that will refresh your body and help to keep your immune system strong.  And, if you are sick, then try to get more like 10 hours of sleep, and relax as much as possible, your body is trying to tell you something, and you need to let it recharge.
Keep your hands off your face:  Try not to bite your fingernails, wipe your nose on your hands, touch your eyes, or anything of that nature; it can spread germs all over your face, and increase your risk of getting a cold or the flu.
Beware of others: Wash your hands (or use and antibacterial gel) after shaking hands, and clean others belongings before you use it yourself (like phones, clothes, etc)  You never know how well other people clean things, and even something as benign seeming as borrowing a pen, can end up in a cold later on!  Plus, if someone is sneezing or coughing (showing any sign of illness), I would keep away from a big bear hug and be a little more wary of spending time in an enclosed space with someone who seems under the weather.
Eat Fresh: Eating a healthy, well-balanced diet of fruits, veggies, proteins can support a strong immune system, and if you aren’t eating all that well, pop a multi-vitamin to keep your immune system working optimally, and try to prevent illness as best you can.
Get your sweat on: Working out regularly keeps your immune system strong, and your body working like a well oiled machine, not to mention that you look good and feel good too.  So, despite shorter days, and cooler weather, make time to exercise and get your body moving.
Quit smoking: Just another reason to ditch the butts, it creates changes in your respiratory tract, and decreases your immune system, leaving your lungs as prime target for viruses and bacteria to attack and cause illness.  Yuck! (Really, as if I needed yet another reason to get on my soap box about quitting smoking!!)

If you do get sick?
Keep it contained to yourself and try to sneeze or cough into your elbow area, as to prevent the spread to others. Use fresh tissues at all times; I mean I always thought it was a little creepy that my Nana would use a tissue, then shove it in the wristband of her sweater for later, but as an HCP, I now know how truly germ-y and gross that is, and you can actually reinfect yourself by using dirty or old tissues!  Drinks lots of water (and coconut water to replenish your electrolytes), and get plenty of rest and sleep. I know easier said than done, but don’t overstress yourself when you are ill….make some “me” time, for sure, and stay away from work!  And, if you start to get really high fevers, and the illness doesn’t start to get better after a couple of days, see your HCP to make sure that it isn’t something more serious.

There is always an excuse NOT to work out and eat healthy, but there is no reason to want to get sick. So be proactive about your health: live a healthy lifestyle, and you will be a healthier person.  You’ll thank me!

Yours in Good Health
B

Asthma: Medications and Alternative Treatments

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As previously discussed, Asthma is a long-term disease that causes a narrowing of the airways due to an allergic or hypersensitive reaction.  The bronchus spasm, and make breathing very difficult.  There are numerous medications that can be taken either in pill form or inhaled, that are FDA  approved, or you can try some different alternative therapies: some include taking herbal supplements (which may or may not be helpful) and  some include diet, exercise, and breathing techniques.

Modern Medical Treatments:
Allergy medications– like Zyrtec or Claritin to prevent common allergies and possible flare-ups
Inhaled Corticosteroids- like Flovent or Pulmicort. These are inhaled medications that have low risks from long term use and take a few days to a week to build-up in your system and are used for long term prevention of symptoms.
Leukotriene Modifiers: Oral medications such as Singular that prevent asthma symptoms for 24 hours at a time. They can have some serious mental side effects like depression and hallucinations, so you need to be aware of any feelings of sadness that are new and unlike you.
Long Acting Beta Agonists (LABA): like Serevent are inhaled medications that open airways and prevent inflammation but they have been linked with severe asthma attacks if they are not taken along with an inhaled corticosteroid.
Combination Inhalers: a mixture of a LABA and corticosteroid, like Advair. They work well for long-term control of symptoms, but there is a risk of asthma attack because of the LABA involved.
Theophylline: a daily pill that helps to open the airways by relaxing the muscles around the airways. It is kind of a treatment of the past, and not used very frequently these days….it was a first line treatment years ago.

What are Alternative Treatments?
Breathing exercises: in which you stretch the volume of your lungs and learn to relax to take deep breaths, can help to decrease the amount you need medications. Yoga breathing techniques can help to learn to relax and the feelings involved with taking deep, relaxed breaths.
Diet: eating fresh fruits and veggies high in antioxidants can help improve lung functions and prevent asthma symptoms.  As well, Omega-3 Fatty Acids (found in fish, flax, etc) have been found to reduce inflammation throughout the body, including the lungs, so it can help to improve asthma symptoms as well.
Exercise: regular cardiovascular inducing workouts can hep to strengthen your lungs and improve their function.  Working out in cold weather can trigger asthma, or if outdoors during high allergy season, but in a gym with AC you can work out your lungs and body all at the same time!

Are there Herbal Supplements?
As always, they haven’t been extensively studied or FDA approved, so I can’t say I condone the use of herbal supplements but many people have reported decreased asthma symptoms when using these products, and they may benefit you: butterbur, dried Ivy, Ginko extract, Indian frankincence, reishi mushroom, and Choline.  It is best to take these under direction of your HCP or an herbal healer, so please discuss so they can talk to you about any interactions to look for and any reactions that may occur.

Does anything make Asthma worse?
Exposure to allergens: if you are allergic to something, and know it, it can make your asthma symptoms worse, or cause flare-ups so you should stay away from that allergen, or do your best to avoid it (like cigarette smoke, exhaust, or foods that cause allergic reactions.)
Cold weather: As stated above, it can cause constriction of the bronchioles and make asthma symptoms worse.
Foods:
– Anything high in saturated fats (meats, butters, etc) can make asthma symptoms worse
– Additives and preservatives can cause people to have reactions and common additives are artificial sweeteners and sulfites (found in cheeses, red wines, etc.)
– Milk products can cause an increase in mucus production and a thickening of the mucus, making asthma symptoms worse.

Asthma is different for everyone and the way we all react can be very different, so work with your HCP to see what best fits your lifestyle and your beliefs.  Work with your HCP on your Action Plan and take into account all aspects of alternative and medical therapies. You know your body best, so learn what your triggers are, and how to prevent them!

Yours in Good Health
B

Is too much exercise bad for your immune system?

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For years and years (healthcare providers) HCP’s have been telling you that “moderate” amounts of exercise are good for you, and your immune system, especially during the winter months to prevent colds, flu, respiratory infections, etc. And, I am not going to tell you any different, BUT I am going to give you an explanation as to why exercise can boost your immune system and how much exercise can actually put a strain on your immune system.  Actually, one study showed that people who didn’t exercise and started 12 weeks of moderate exercise had over a 50% drop in sick days over the next year!!

Who can benefit?
The best part is that everyone can!  Even with chronic diseases or autoimmune diseases, you can find YOUR level of moderate exercise and it will only benefit your body, your general health, and support a healthy immune system.  For example, if you are bed bound, there are arm exercises, rolling in bed, leg lifts…a form of exercise depends on what you are used to.  So, everyone should be getting some form of moderate exercise, there is NO excuse! There is always a way to find some small amount of time to add exercise to your day, even if it is taking stairs instead of the elevator running between meetings at work, parking far away from the place you need to be, or doing a fitness video at home; you can always shave a few minutes out of your day to fit it in!

How does it support your immune system?
So, the immune system is a whole network that has been created by our body to protect it from invasions from viruses and bacteria using various different hormones, chemicals, and cells to attack, as well as to remember the viruses in the future, to prevent further attacks and hone your body’s response.  In an effort to not get too deep into cellular anatomy and physiology, I just want to explain that some of the cells that respond are called cytokines (of which there are many different types).  Some of the cytokines release a signal to your white blood cells (the ones that increase in number to attack when there is an invader present in your system: your number will be elevated if you have a cold, for example, and get your blood drawn at your HCP, but it will drop back down to a “normal” level when you aren’t sick) that there is an invader (bacteria/virus), then there is an inflammatory response, and the white blood cells know to go in for the kill.  So, why am I telling you this?  Well, with a moderate amount of exercise, the cytokines are produced and released in moderate amounts, so your immune system is being challenged a little bit every time you exercise, and it strengthens your immune system because it is constantly working.

Why is too much bad?
If you overtrain, or exercise too much, you can cause damage to some of the muscles, or various different cells in your body, and it can stress your body.  When your body feels stressed, overexerted, or over taxed, your immune system is actually decreased because your body is working so hard to recover your muscles from training, that your immune responses can be lowered due to a release of higher cortisol levels.  Cortisol is a natural hormone that is released from the adrenal gland that helps to regulate metabolism, the immune system, inflammatory responses, as well as having other functions; it is basically your “stress” hormone and the one that jazzes you up during your “fight or flight” response.  The problem with is being constantly elevated, is that your body is never truly relaxed (which can occur in our modern way of living where everyone is running around, working tons, worried about everything, and constantly stressed even when we don’t realize it) and this can lead to slower immune system responses and slower healing by the body due to the way that cortisol makes your body react.  So, too much exercise can depress the cytokine release, and make your body slower to react to minor pathogens (viruses/bacteria) that may be trying to invade your body.

What is considered Moderate exercise?
Usually it is defined as 20-30 minutes of exercise 5 days a week.  For me, that is not enough because my baseline is much more than that, so that is a great guideline but it needs to be based on your level of exercise specifically.  So, I would tell you that “moderate” really means what you feel comfortable with in exercise, can get through without feeling tortured and on a scale of 1-10 (one being barely any effort and 10 being extreme effort), it would be a level 4-6; where you are comfortable and can even talk during the exercise (not a lot mind you, but you aren’t struggling for breath).  Moderate exercise can vary with days that are a 6-8 (a little harder) and days that are a 4-5 (a little easier) but try to stay around that range for cardio.  You can push harder twice a week, for better results, but if you are happy with how in shape you are, try to keep it relatively even.  As far as lifting, you definitely want to add some muscle strength on top of your cardio, but again, don’t stress yourself out (i.e. you can barely lift your arms afterwards), but push yourself daily to the point that you know you have worked out and feel stronger.

What is too much?
Pushing yourself to run at a super fast pace and for a long distance when every step you feel like to want to stop and your legs feel like lead…that is too much.  You need to listen to your body (and non-runners, will probably say, “my body says that every time I run”, so I’m talking to those who are runners baseline!) Or if you are working out on the scale of an 8-10 every day, that is too much!!  You can go 8-10 once or twice a week, but really no more than that. If you feel strains in your muscles or muscle tears, you need to take a break and your body will let you know.  I totally understand the feeling of wanting to push your body to the limits EVERY time you work out, I have done that in the past, and I looked fantastic, but it isn’t sustainable over time, because as you overtrain, your body loses interest in wanting to work out and it gets harder and harder to push yourself to do so. Not to mention, that it ends up decreasing your immune system.

For my avid exercising readers, just listen to your body; it will tell you when you are overtraining!  Sometimes every step feels so horrible you just can’t exercise- then STOP,  just lift weights, or take a break and catch up on some missed TV shows and DON’T FEEL GUILTY about it!! Just go back to your normal routine the next day, Nurses orders 🙂 You really need to look at exercise as everything else, do it in moderation, and it will be sustainable over your whole life, not something that you stop and start, which is the key to fitness; sustainability.

For those of you who don’t exercise, I hope this inspires you to park farther away from the store and get a walk, skip the elevator and take the stairs, and grab a friend (bundle up) and go for a wintry walk and a cup of coffee/tea!  Try to get out there and get that heart pumping to stimulate your immune system!!  It actually is good for you, gets you out, and can help you also beat the winter blues.

Yours in Good Health
B

Shoo Flu, Shoo!!

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With Flu season looming and everyone asking if you’ve gotten a flu shot, if you plan on it, and hearing (my favorite) “Eh, I’m not going to get it, I’m healthy and it’s only the flu, I don’t get what the big deal is…” That statement clearly comes from someone who hasn’t had the flu!!  Since I became a nurse, I have always gotten the flu vaccine, mostly because it is offered to you at the hospital, and they come to give it to you….it’s actually hard NOT to get it (and it is currently required at my hospital that all healthcare workers get it.)  But the year that I lived in the UK, I did get my US flu vaccine and considered myself all set, until I flew throughout the EU and to Bali and got the flu; the sickest I have been as an adult and it was MISERABLE.  So, yes, I am a believer in the flu vaccine, and it is one of the few vaccinations that I really encourage everyone to get.

Why is the flu shot such a big deal?

Approximately 49,000 people die each year directly from the flu or flu related causes.  In 2009 (Apr-Oct) approximately 34 million people were infected with H1N1, causing millions of hospital admissions, days of lost work, money out of YOUR pocket for co-pays/meds/lost work, and not to mention one of the highest death rates in children and adults from the flu!!  If getting a quick shot can prevent all that, why not get it?

There are two different vaccines out there for the flu:

A nasal spray and a flu shot.  Both are protective of three different virus strains that the CDC research indicates will be most virulent each season.  For example, these 2010-2011 Flu vaccines will protect against the 2009 H1N1 and the H3N2 as well as the Influenza B virus.  After about 2 weeks, you will build up antibodies against the flu that will help prevent you getting infected, and if you do, it will be a very mild form, like a cold. The flu shot (actual injection) is an inactivated (not living) form of the virus that is injected directly into your arm, and is appropriate for people over the age of 6 months, and for people who are healthy or with chronic medical conditions.  After the injection, you can have redness at the site, soreness, fever (low) and some aches that last 1-2 days. The nasal-spray flu vaccine is made with living, but weakened, flu virus  that do not cause the flu and it is approved for healthy people age 2-49 years old who are not pregnant. After the nasal-spray vaccine, you can have some side effects (for adults) such as: runny nose, headache, sore throat, and cough. For children, the side effects can be: runny nose, wheezing, headache, vomiting, muscle ache, and fever.  Since the flu season is technically October to February, you can get vaccinated at any time, but I always suggest to get vaccinated as early as you can!

Who should get vaccinated?
The CDC suggests that EVERYONE 6 months and older should get vaccinated yearly!  But here is a list of “high risk” people who should definitely get vaccinated:
-Pregnant women
-Children younger than 5 years old (because they start preschool) but even children under 2 are at risk and have low immune systems- they are also at high risk
-People 50-year-old and over
-People of any age with chronic conditions (i.e. asthma)
-People who live in nursing homes or long-term care facilities
-People who live with or care for those at high risk:
Healthcare workers
Household contacts of those at high risk for the flu
Household contacts and home care givers for those less than 6 months old

Who should NOT be vaccinated?
-People with an allergy to chicken eggs
-People that have had a severe reaction to Influenza vaccine in the past
-People who have developed Guillian-Barre syndrome* within 6 weeks of a flu vaccine
-Children under 6 months of age
-People with moderate illness that have a current fever (wait until the fever subsides and then you can get a flu shot)

*(Just as a quick aside, Guillian-Barre syndrome is an autoimmune disorder that affects the peripheral nervous system and it is activated by an infectious process; basically you lose control/function of all of your muscles from the bottom of your body up, and remember that your lungs are a muscle, so it usually requires a hospital admission and a breathing tube with an acute attack!! So, you would know if you had it in the past!)

I hope you all are encouraged to go out and get a flu shot soon, they are available at pharmacies and clinics everywhere!!

Yours in Good Health

B