YourHealthMatters

H1N1 Flu Update

The web is such an amazing place to get current news on all sorts of topics. Here's what I have found lately about the H1N1 virus.

Two doctors have posted articles strongly suggesting that keeping your Vitamin D3 level high in your blood with supplements can minimize your chances of catching H1N1. If you are interested, get a blood level done for Vitamin D3 so you can supplement adequately.
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This article on MSNBC reports autopsy findings on people who have died from H1N1 have massize lung damage from the virus. So people with chronic lung disease from smoking or other reasons should consider taking the H1N1 shots. BUT, the first H1N1 vaccine may be an inhaled nasal preparation. In previous nasal flu vaccines there has always been a strong warning about giving this to anyone with asthma or chronic lung disease because of the risks. This same warning will be on the new nasal vaccine as reported here on MSNBC. That's an interesting problem. The people who most need this vaccine possibly, should not take the nasal vaccine. They must wait till the injectable vaccine is available. One shot of either vaccine type is now expected to work. Antibody levels will rise about 6 weeks after vaccination. So another reason for all adults to know their Vitamin D3 levels and optimize them now.

Last week a Harvard scientist told a meeting that so far the H1N1 infections in  children have been mild and the death rate is similar to the usual seasonal flu. This is news that has also been reported in Australia whose winter season has been going on while we have enjoyed summer.

My own experience with this virus all summer has been to see one case in a family, mostly adults with quick response to Tamiflu and no spread among other family members. Now that school is in, I'm starting to see children with H1N1 symptoms. They too seem to be mildly infected for the most part and respond well to Tamiflu. And I have yet to catch this virus, but then I take Vitamin D3 at high doses every day.

drBob

Only in America - a "Kill Granny" Campaign

President Obama has sparked a right-wing attack on his health care reform ideas by talking about living wills and right -to-die in his legislation proposals. He is suggesting Medicare actually pay for doctors to talk to seniors once every 5 years about preparing their living will and how they want to die on a VOLUNTARY basis. This has been jumped on by his opponents who are claiming he wants to kill off seniors, deny them care at the end of life,etc. Makes for good media content, doesn't it?

The MSNBC link to this idea is here.

Do I believe the government is out to kill Granny - absolutely not. Do I think talking about living wills and end-of-life issues is important? Absolutely yes, although once every 5 years is the real joke in all this. Don't people change their minds about such issues more often than that? Consider my own situation when I had to have neurosurgery to remove a cerebral aneurysm in 2008. I was not yet a "Grampa" and no doctor talked to me about living wills or end-of-life. Instead I went straight to my lawyer and had a living will prepared and much more importantly I had a Power of Attorney for Health Care prepared and signed to give my wonderful wife control of health decisions if I was unable to because of the surgery. This proved to be the most important preparation in my case. She spotted changes in me  in the first week that signaled problems and alerted the surgical staff who then quickly paid attention because she had Power of Attorney status. She and the neurosurgeon both were life-savers for me.
Again this whole media blitz misses the point. We should all have living wills and Power of Attorney documents prepared long before we reach "Granny" or "Grampa" age and why shouldn't this be a medical topic paid for whenever we want to talk about it to our doctor?
Doesn't this also prove that some opponents of health care reform will do or say anything to get media attention, even when they are totally wrong about the intent of the changes?
Doesn't this also prove that many bureaucrats know almost nothing about how health care reform should be done but they know how to get on the front page of their local paper?

Would I recommend all adults prepare and sign their living wills and Power of Attorney for Health Care long before they reach "Granny" or "Grampa" age - absolutely yes. Don't wait for government to tell you when to do this. You can never get these documents prepared too soon.

drBob

PS - if I sound a bit cynical in this post, I am. I worked 25 years for a terrible socialized health system in Ontario and 12 years here for a system that is too costly,  and doesn't work either.

Acetaminophen and Pain Pills - #2

The FDA has decided to leave acetaminophen on the shelves and in pills with some changes. The maximum dose per pill will be reduced and the maximum daily dose that is considered safe will be reduced to 3250 mg, down from 4000 mg. More warnings on all products with acetaminophen will be required. Also more warnings about mixing alcohol with acetaminophen will be required. The percentage of cases of liver failure is higher in people using alcohol with acetaminophen. What's missing perhaps is changing the adult maximum dose to one based on the person's weight.
So we can all breathe a little easier about this issue. I am relieved. For once the FDA has opted for more public education about the dangers of acetaminophen and reducing the doses in the medications.

drBob

ZICAM pulled from market

The FDA finally pulled ZICAM off the market because of reports of people using it suffering loss of smell. I noticed this problem a few years years ago when the product was first released and warned my patients to stop using it. The product was first sold in 1999 and that makes me ask how long does it take for the FDA to notice problems with drugs.

There are other safer alternatives for treatment of the common cold nasal symptoms. OTC products containg guiafenesin like plain Mucinex, help liquefy and loosen secretions in the lungs and sinuses. Allergy meds like fexofenadine may be helpful. Cough suppressants like DM as in Nyquil or Delsym help night-time coughing. Vitamin C in high doses can shorten the duration of a cold and so can echinacea. Certain mushroom mixtures can strengthen your immune system to respond quicker. And there is always garlic which will help a sore throat and also the other symptoms wen taken in large enough amounts.

Zicam contains zinc which the FDA says may damage nasal nerves for smell. I often recommend people use zinc lozenges for throat pain and to stimulate the immune system in the throat for a sore throat. These products do not seem to cause the same problem.

Read about the FDA announcement here on MSNBC.

drBob

A Capitalist-Socialist Experiment in Health Care

What we are witnessing right now in the US as President Obama addresses health care reform may be the first organized attempt to create a capitalist system alongside a socialist system for provision of health care.
I think it is essential we all recognize this is going on as we read the almost daily news on the developments in Obama's plans. I for one was quite afraid of the initial news I was seeing from the government about what they planned because I thought they were going to wipe out private health insurance (capitalist) as was done in Canada many years ago when the socialist health care system was introduced. Finally some Democratic members of the Congress and Senate have started to openly say we will all have a choice between two systems.

Research Fails to Show CAM Benefit

MSNBC is reporting that after spending $2.5 billion on research there has been almost no evidence that alternative medical treatments work for anything. The only exceptions are acupuncture studies showing some benefit for arthritis and ginger for nausea from chemotherapy. Hands up all of you who disagree with this finding from personal experience.
I certainly disagree with this finding and the results don't surprise me. Long ago when I was in Ontario, the Drug Benefit Plan for seniors paid for Vitamin E for a time when one of the premier's had a grandmother taking it. When the government changed it was calculated that the government was spending millions each year on Vitamin E with no proof of effectiveness. So the new government stopped paying for Vitamin E and instead started paying for a much more expensive drug alternative. Guess how many of my many patients on Vitamin E decided to take the expensive drug for free instead of paying $8/mth to stay on vitamin E.

You can read the  MSNBC article here.

This report does not make me want to go back to only offering conventional treatments by the way.

drBob

BP Drugs For All over 55?

British researchers think they have now shown that putting every adult over 55 on pills for blood pressure, even if their BP is only 110/70, could lower their risk of heart attack, heart failure and maybe stroke. But the research was an analysis of 147 previous studies that studied BP meds and health. Of these 37 studies have already been criticized by independent researchers as being unsuitable for analysis with the others. This is far too many studies to study at one time some American researchers have also suggested. A few years ago the British researchers sought to prove that putting every adult on a statin for cholesterol, ASA, and a drug for blood thinning and 3 BP drugs would also lower cardiac risk.This polypill as it was nicknamed was to have 5 pills in it.  This idea never took off and that was probably a good idea.

Do I agree with this and will I be putting all my patients over 55 automatically on BP meds? There are many natural ways to reduce cardiac risks without depending on meds to let you get away with eating unhealthy food, avoiding exercise and smoking. Uncontrolled inflammation in the body is the biggest trigger for plaque formation in the arteries. This can be assessed by a blood test called CRP and can be controlled and lowered with proper foods, exercise and supplements.

I have seen many older people who can not tolerate a BP of 110/70 without being faint and dizzy constantly. Lowering their BP further with meds seems to me to be foolhardy when they are so many natural methods to increase longevity and promote good health.

This study was published in the British Medical Journal in May 2009.

drBob

Burning Fat with Exercise - New Study

Here is a new study about exercise. metabolism and fat-burning which busts a few beliefs about fat-burning. The study was done at Duke University and also provides some insight into using exercise for muscle building, a favorite wish of many people.

Essentially the study looked at different combinations of exercise and metabolic effects. All study participants had controlled caloric diets. The conclusion - yes exercise does boost metabolism while you exercise and can burn fat while you exercise but when you finish these benefits will soon stop. There is no increase in metabolic rate during the next 24 hours as many people mistakenly believe. But there was a burning of fat for a maximum of 24 after the exercise, depending on the type of exercise.

AND, if you eat as many calories soon after, as you burned during the exercise, there will be no net fat burn. The study also looked at building lean muscle mass with exercise.

So skip the (un)healthy snacks right after the exercise. I still support the use of Dr. Sears' PACE system of exercise as the best way to burn fat with exercise and he has  the results to prove it. You can buy his PACE book and as well he now has a DVD on the system which is very useful for getting you started.

The Duke study was reported on MSNBC here.

drBob

Preventable Deaths Rising

The Harvard School of Public Health recently reported that 2 million people die in the US each year from causes that are preventable. I have to ask if this will be addressed adequately in health care reform this year.
Three factors, namely smoking, high blood pressure and obesity, are the top three preventable cause in this report, accounting for at least one million deaths each year.
Other listed preventabe factors listed in order were lack of adequate physical activity, elevated blood sugar, elevated LDL (the lethal kind of cholesterol), low intake of essential fatty acids found in saltwater fish (omega-3 fatty acids) high trans fat intake (read those labels), alcohol abuse, low vegetable and fruit intake and low intake of dietary polyunsaturated fatty acids (PUFAs). This last item must be watched carefully in your diet because over-heating of PUFAs can change them to dangerous trans fatty acids already on this list.

Alcohol may be protective of heart problems when taken in small amounts, when abused it was responsible for at least 64,000 deaths.

You can read an article with more information on the website of the Life Extension Foundation by clicking here .

What do you think can be done in health care reform to address this issue? Would you be in favor of higher taxes on tobacco and alcohol as a way to reduce use? When I practiced in Ontario the provincial government regularly raised taxes on cigarettes and alcohol and knew how many thousand people would likely stop either one for a specific increase in taxation.

Leave a comment on what you think would help these deaths from rising.

drBob

R.I.P. - Dr.Ian Yeats

Saturday morning in Denver my long time friend and colleague, Dr. Ian Yeats, died in his sleep. On Wednesday he had had ankle surgery and was out of hospital planning to come home on the weekend. Cause of death is unknown pending an autopsy.
I first heard about Ian back in Ontario about 1982 when he moved into my area to begin practice. He and I covered each other when one was away, delivered each other's babies if needed and practiced each in solo practice for 15 years in Meaford, Ontario. Then he moved here to Liberal and I followed him a few years later in 1997. Ian was 65 and I am 63 so his death has been a wakeup call for me.
My sympathies go out to his widow Trudy and their children, all of whom are grown up. I grieve for the loss of a friend and also because Ian worked very hard and was an excellent physician. He certainly deserved to retire back to Ontario or wherever and now he will not have that chance. He will be sorely missed in Liberal by many friends and patients.

R.I.P. Ian......

drBob