Archive for 6.Featured
Tamiflu the choice for H1N1is available for children
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I recently read a headline from a medical news feed that claimed Tamiflu was not available in a liquid form for children. It is supplied like many pediatric medicines in a powder that can be mixed with water and taken as a suspension. There have been periods of time in our community when not every pharmacy had Tamiflu in capsule or powder in stock but it was available elsewhere. It appears to be effective against the novel H1N1 virus.
It has a few side effects, most of them are effects on the digestive system, but generally it is well tolerated. I have heard stories told to some one about a friend of a friend having a horror story about taking Tamiflu, but of the prescriptions I have written, the main complaint has been nausea and vivid dreams. Since nausea is a component of the flu, it was not clear that Tamiflu is the culprit.
I do not think Tamiflu is a panacea, but it is effective when started early in the course of the flu. Other things you can do to help yourself are to stay well hydrated before you get the flu – 2 quarts of water a day. Keep your stress level down, deep breathing once or twice an hour helps with this.
Get enough sleep! Extra rest, meaning more than normal when normal for you is less than 8 hours. Don’t stress your system with lots of extra sugar or over eating.
A few supplements are recommended also. Vitamin D3 at 1000IU per day when well and 3000IU per day when sick is a reasonable idea. Ask your doctor if these amounts are OK for you. A little extra selenium in the form of a few Brazil Nuts per week can be helpful but only a few a week are needed. Other nuts supply you with Vitamin E, alpha linoleic acid and fiber. Eating a tablespoon of ground flax seed is great too. They provide lots of fiber, lignans and other good stuff.
Which of these do you do? Do you have a habit that you think protects you from illness? Share it with us in the comments section.
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Tick Bites, Red Meat, and Hives
Posted by: | CommentsEver heard of a sugar contained in red meat called alpha-galactosidase? I never heard much about it except to know that it existed. If you haven’t taken and advanced physiology class you probably haven’t heard about it either.
Now, if you haven’t heard about ticks and problems from tick bites, I wonder where you have been living. Everyone with a rash in the summer or a tick bite thinks they have Lyme disease. Ticks can cause so many problems and now they can cause you to have a meat allergy.
This was brought to my attention by a patient that sent me a link to this article from the Washington Post. Dr. Thomas Platts-Mills is a prominent allergist with an international reputation at the University of Virginia. He has published a study of 24 patients from the south east with sudden meat allergy triggered by tick bites.
If you have had a recent food allergy to meat – beef, lamb or pork – first avoid it. Second, read the article and ask your doctor to get you into the UVa. study on this meat allergy/tick bite problem. If you have a meat allergy, I would like to hear from you. Leave me a comment or contact me.
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H1N1 Vaccine may not be the most important vaccine you need
Posted by: | CommentsTo remain healthy, you need healthy habits. That is the foundation of health. There are other things you can do to help yourself remain healthy in addition to habits. Vaccination against certain diseases can be very helpful in preventing them. Not all vaccines recommended right now are proven effective by long term use. One I especially am concerned about is HPV which is costly, and which might not do what is advertised and that is prevent cervical cancer.
It might surprise you to know that there are 50,000 deaths per year that are considered to have been preventable by vaccines. If that statistic holds up to close scrutiny that would mean more deaths from this cause than from Breast Cancer, AIDS or Traffic accidents. I don’t know about Mortality but Morbidity – preventable serious illness – would be greatly reduced.
What vaccines do you need and how can you find out? Go to the CDC vaccine information site to get more information than you probably need. To help you I have uploaded two PDFs at the end of this article. One is a blank immunization form and the other is a schedule of recommended adult immunizations.
What diseases are preventable by immunization? The list of entirely preventable diseases are Tetanus, Polio, Diptheria, Pertusis (Whooping Cough), Mumps and both types of Measles (Rubella and Rubeola). The Hepatitis Vaccines for type A and B are very effective in most individuals. Influenza vaccines, especially if you have received it more than twice, give year to year immunity but an annual booster is needed to maximize the immune response effectiveness. This is true if the person is young (under 18) or older (over 65). This is also true of many vaccines that have to be “boosted” to retain levels of immunity. Tetanus and Diptheria need to be administered every 10 years. After a childhood series of 4 immunizations, Pertusis or Whooping Cough Vaccine needs to be administered once during your adult life. Consult the vaccine schedule here that is attached as a PDF and the CDC site if you found this post over 2 years after it was written.
Questionably effective vaccines are those for Varicella, Zoster and HPV. Of the previous 3, Zoster gives the most protection for the cost. It is one I will likely take myself when I leave medicine and quit bieing regularly exposed to patients with Zoster. You can ‘t catch Zoster but Zoster does cause Varicella (Chicken Pox) in susceptible individuals and regular exposure does remind your immune system about Varicella virus. When I no longer have this advantage, I will take the vaccine.
In a healthy child, Varicella is not particularly harmful. The problem is from secondary infection due to scratching. With the appearance of MRSA, a resistant type of Staph germ, all those open sores on the skin of a child with varicella represent a problem. For this reason, the vaccine may be beneficial for healthy children as well as the child from circumstances that create greater susceptability to complications because of lack of care, ignorance and poor nutrition.
HPV has not proved itself yet. If it does not provide life long immunity with the series of 3 immunizations, it will not be a cost effective public health measure it is touted to be. The length of immunity is as yet unproven. If the vaccine was less expensive and if it ws being used to immunize people of the age group on whom it was tested (women age 16-25), I would be less hesitant. I have to believe that calling it an anti-cancer vaccine instead of a wart vaccine makes it seem life saving. In reality, cervical cancer is probably better prevented by regular pap smears. Men almost never get any cancer from HPV. I think it needs more research before it is legislated.
If you travel extensively, then you need special vacines, depending on where you go. Get a travel consult and see the Travelers section of the CDC Immunization site linked above for more information.
The two PDF files are included below.
adult-immunization-schedule
blank-vaccine-record
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Readers opinions wanted – tell me what is right
Posted by: | CommentsI am updating my content and editorial plan. The content here has become too broad and I have branched out into other areas. I am looking for your feed back. Take this reader poll and tell me what you like. There is an open or other category so you can include things I did not think about. I will be asking you for your negative opinion later but right now tell me what I am doing right and things you want more of. Thanks so much.
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Free Information and Coaching from Bruce L Bair
Posted by: | CommentsThere are a number of ways to get good information from me. I wanted to provide you with a list of what is available to you. You can find reference to most of it on my blog.
First is this Blog Get the Skinney You are reading it now.
Then you can read my 77 articles and growing at Articles By Bruce L Bair
I have a privileged Twitter feed. You have to ask me to be a follower. I am trying to keep junk out. My profile name on Twitter is BruceLBair.
I have a free weekly call. Sometimes it is just me and many times like Aug 5, 12, 13, and 19 I will have expert guests. You can sign up to be notified about each call (max 2 emails per week) by signing up at Ask Bruce Anything
I have a series of 20 free mp3 files I send to you over a month. They are all on wellness, diet, fitness, stress management topics. You sign up at PEPbyBruce.
Both PEP by Bruce and Ask Bruce Anything require you to reply to the first email and acknowledge that you want what is offered. It keeps you from being spammed. My Twitter account under the name BruceLBair requires you to ask to be accepted as a follower. I have an account under the name DurhamDad also. It was my first Twitter account and just includes who ever on the account.
These are all the ways I provide you with free content. I also run coaching groups, have workshops and do coaching with individuals. I am certified to use Coaching for Healthy Behaviors and the Circle of Life Coaching system. My Coaching in this way costs money but is far more specific. So you have a menu of choices. If you want more information use the contact me info on this blog and email me. Sign up for one or more of these free information streams so when you email me, you will have a better idea about me and how I sound and think.
If you have a general question, leave it in the comments section below. I know if you have it 20 or 30 other people do too.
Popularity: unranked [?]
A Personal Empowerment Plan
Posted by: | CommentsHave you thought you needed to do something about your health but were afraid to or did not know where to start? I know the feeling. I have felt like I needed to lose another 10 pounds while gaining some muscle and improving my fitness level some.
I would like to offer some free help you can use in the privacy of your own home. It is the nucleus of a Personal Empowerment Plan I will help you design. First, you need the basics, then the details.
The basics are 20 podcasts, delivered one per day for 5 days, then none for 2 days to allow you to discuss and assimilate information. Then 5 more on a different topic until you receive all 20. Each is about 10 minutes long. The links are delivered via email and you can listen on line or you can download them and listen on your mp3.
You can sign up to begin receiving them at http://www.pepbybruce.com. There is a paragraph or two of explanation and a sign up form. I hope you will listen and if you like them, tell your friends. I will be having some calls soon also that you can listen to over the web or on the phone. Each call will be either an Ask Bruce a health/wellness question or an interview with someone with special knowledge in an area of related interest.
OK, be sure you are signed up here and if you are, sign up to get the podcasts. It is completely safe. I pay Aweber to protect you, (not much about $15 per month) and to satisfy your Internet service provider that I am not sending out spam. I will never share or reveal your email address. Now it is time to click on the link and start your PEP.
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What can a Wellness Coach do for You?
Posted by: | CommentsDefine Wellness. Stumped? I define it as the effect of your habits on your ability to live and enjoy life. If your habits facilitate lots of energy, resistance to illness, prevention of illness, inner peace, quick healing and rapid recovery from physical stress, and long term high level functioning of your mind then you have wellness.
Whoa! you say. No, don’t balk. Stay with me here. These habits can be learned, they can be practiced until like breathing, we suffer when we don’t do them. We do them without thinking about them because we discovered them, incorporated them, and made them our own.
A Coach can help you identify changes to habits, new habits and ways to adopt changes that will help you grow in the way you want and at the pace you set on your priorities. Tiger Woods hires a golf coach or more likely coaches. He then learns what he needs to know from each of them and puts it into his game with lots of practice. He is reamarkable but he does not win every time. He wins so much of the time, we expect him to do it every time.
You can be like Tiger Woods. You can get the coaches you need and icorporate the best into your life a little piece at a time. First you have to find the coach.
I am a wellness coach and a Physician Assistant. I am giving some free coaching to groups of friends. I call them Personal Empowerment Sessions. Through some down loadable guides and a live audio event which you can access by phone or on your computer, we will identify your wellness vision, your wellness position, what you want to do first, develop a plan and then via Email we will review the plan and tweak it , prepare to implement it and take action over 4 weeks.
I will do this for 4 groups of 5 people in the next 6 months. After that it will cost each person in a Group $60 for the 4 hours as part of a group. Individually there is a separate set of charges. Inquire if you are intersted in an individual plan.
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Shrink Yourself by stopping Emotional Eating
Posted by: | CommentsI have a course to help you improve your wellness habits called Recipe to Look Better Naked. It is featured article #5, just click on the 5 to see it, but do that later. Right now I want to talk about something I don’t do well and that I recruited someone to hlep me do.
A large percentage of people eat for comfort. They eat for emotional reasons. To have good diet habits, they have to stop eating for emotional reasons. This is a big task and is best accomplished with some help I call coaching. Now, I am a wellness coach and do help others establish new healthy habits but someone else I really respect is much better with emotional eaters than I am. That person is Dr. Roger Gould. Dr. Gould is a psychiatrist from UCLA and is an expert in human behavior change.
I think that if you are an emotional eater you need to take his 12 week course. They offer a free 2 week trail membership and a choice of two different membership options. I won’t bore you with the details here, they will explain them much better than I ever could.
How do you know if you eat emotionally? Well you can take Dr. Gould’s quiz on his site but let me give you a general idea.
Do you become upset and the only thing that will help you calm down is a particular food?
Will you go get “The Food” no matter what time it is?
When you get the food do you eat it fast and ravenously even if you just ate a meal a short time ago?
Do you have to have that special food when you are angry, sad, lonely, or frustrated?
If you said yes to any of the above, then you may be an emotional eater.
Do this, go to my site if you are not reading this there. Once you are there, click on the big orange square
that is talking about “Shrink Yourself”. That is Dr. Gould’s program. When you get there you can take the quiz,
read about emotional eating and decide if the program is for you. Try it for 2 weeks and see how it goes then decide.
I hope you will consider this option to #1. see if you are an emotional eater and #2. do something about it if you are.
OK, now click on the big orange square! Leave me a comment if you do, let me know about your experience on the Shrink Yourself website.
Remember, wellness is just the sum of all your habits. Here is wishing you great wellness through healthy habits.
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How to insure Everyone?
Posted by: | CommentsPresident Obama has perceived correctly that we in America want change. We want things to have a low cost, we want protection from mistakes we make and we want someone to solve our health problems no matter what we have done. If we smoke, over eat, under-exercise, don’t brush our teeth or see the dentist regularly we want a bail out.
We perceive health insurance as a way to cover first costs and catastrophic costs. If we have great coverage, we don’t want to change it. If we are receiving outrageous renumeration for our services as many insurance company executives are, we don’t want it to change. Because of the tremendous financial clout of the insurance companies, they have many friends in Congress to represent their interests.
We have been fighting a war on two fronts in the name of national interests. Thousands of our own citizens have been killed or wounded and hundreds of thousands of the idigenous people have suffered the same or at best terrible lifestyle if you can call living in a war zone without protection of law, adequate food and little or no medical care a lifestyle. What is the national interest in our citizens health?
We have a national interest in helping our citizens to have good health and in providing them with the most accurate unbiased information on which to base their decisions. How should we do this? What should be covered by insurance and what should we have to pay? We are more and more aware of our finite financial position. We have borrowed against future earnings in order to pay for war and priviledge now.
Some are in favor of a single payer system like Medicare where the government is in control and there is no where to go to resolve problems. Others don’t want anything to change – they are doing fine with the system as it is. Some want insurance companies to be regulated like utilities. Some think insurance should only be for big unforseen circumstances and we should pay out of pocket for the rest.
I think we need a system that helps us out of a jam – if we get cancer we need some help but if we smoke or drink too much or eat too much and have disease related to over consumption of food we need to be responsible for that behavior. When I was trained years ago, renal dialysis was not paid for by medicare or medicaid. To receive it you appeared before a review committee and that committee composed of medical and social science professionals and people from the community decided yes or no. Literally life or death. If you were elderly, a felon, or had more than one complicating factor, you did not get it. I had problems with that system just like I do with this one.
It costs you to live. What should it cost you to have access to medical care? We consider cable TV, video games and eating out to be necessities – our rights! What are your rights? I think we have the right to knowledge and a level playing field. We have a right to live well and to have preventative care – but that care does not have to be provided by physicians. Prevention can be delivered by mid-levels (PAs and NPs) at a much lower cost.
Physicals and some things like colonoscopy, certain cardiac stress tests, etc… can be done by these mid-level practitioners. We need to pay physicians for thinking, not procedures. Is it worth more to do a hip replacement or to treat severe rheumatoid arthritis? There is a huge discrepancy in payment yet the person treating rheumatologic disease spends hours and hours in preparation for the visit. The surgeon spends hours learning the skill but once acquired the surgery is routine. The surgeon does not clear his patient for surgery, yet the person who does the thinking to say it is OK to have the surgery gets paid much less for the thinking than the surgeon does for the surgery. If there are post-operative complications, the surgeon keeps the fee he was paid even if the person requires many more days of care by “thinkers”. This is not to disparage surgeons who often are called upon to operate in emergency conditions on people who have neglected themselves for years.
There are no easy answers. There are lots of opinions! What is yours? How would you like to see this play out? I would really like to hear what you have to say in the comment section. Please, tell me what you think.
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Is it the drugs or compliance with therapy that is important?
Posted by: | CommentsThere is a lot of hype and a lot of confidence placed in a class of drugs called STATINS. These are the ones you see advertised on the evening news and the most famous and richest of them is Lipitor. The general public believe these drugs save lives. The truth lies somewhere in between they should be in the water and it is a conspiracy between drug manufacturers and Doctors to get everyone on them.
Right now if you have high (above 100) LDL cholesterol it is recommend you take them if a trial of diet and activity does not benefit you. If you have diabetes, hypertension or any form of heart disease you are supposed to take them. They are supposed to prevent plaques, reduce your risk of heart attack, and heart disease and help you live longer.
That all probably isn’t true. If you don’t die of heart disease, you will probably die of some other cause about the same time. As for heart disease, they are really only “proved” effective in men under age 65 with pre-existing heart disease.
Some studies have shown that it is those people who comply with therapy whether it was placebo or the actual drug under study that benefit most. There is something about the willingness to do what it takes that makes them better off even when they do not have actual therapy.
You have to decide with your doctor what you will do if and when you have a problem. I just do not want to take medication that makes me feel bad and costs me $300 per month and not have really GREAT benefits. I don’t want to pay that price for so-so benefits. I also hate to have people who can not afford it fretting they are going to die early because they can not afford the therapy.
The cost to save one life with these drugs is quite high. You have to treat hundreds of people to save just one life. It appears we are not treating the right part of the problem as some researchers think that cholesterol plaques are symptoms of the underlying cause and not the problem itself. The Statin drugs appear to be good at reducing inflammation that seems to be the real culprit since half of all heart attacks occur in people with normal cholesterol.
Dr. Mike Eades has a long but easily understood blog post/article on this topic that I recommend you read. He does a great job of guiding you through the maze of thinking and to some extent misinformation that exists on this topic.
I am not opposed to the drugs but to the mentality that they are the Holy Grail. We should not be shouting Eureka, I have found it, but shoud be saying, we have this crude therapy, how could we make it more specific and how could we really prevent heart disease. A pill probably isn’t the answer.
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