Friday, October 31, 2008

Health Care and Halloween

Today, Halloween, marks the annual event that millions of Americans and people around the world celebrate almost as much as Christmas. According to Wikipedia, Halloween is an international holiday celebrated on the evening of October 31; today it is often celebrated in the morning and afternoon as well. Halloween activities include trick-or-treating, ghost tours, bonfires, costume parties, visiting haunted attractions, carving jack-o'-lanterns, reading scary stories, and watching horror movies. Irish and Scottish immigrants carried versions of the tradition to North America in the nineteenth century. Other western countries embraced the holiday in the late twentieth century. Halloween is celebrated in several countries of the Western world, most commonly in the United States, Canada, Ireland, Puerto Rico, Japan, Australia, United Kingdom, and at times in parts of New Zealand. In Sweden the All Saints' official holiday takes place on the first Saturday of November.

According to Wikipedia, Halloween has its origins in the ancient Celtic festival known as Samhain. The festival of Samhain is a celebration of the end of the harvest season in Gaelic culture, and is sometimes regarded as the "Celtic New Year". Traditionally, the festival was a time used by the ancient Celtic pagans to take stock of supplies and slaughter livestock for winter stores. The ancient Gaels believed that on October 31, now known as Halloween, the boundary between the alive and the deceased dissolved, and the dead become dangerous for the living by causing problems such as sickness or damaged crops. The festivals would frequently involve bonfires, into which bones of slaughtered livestock were thrown. Costumes and masks were also worn at the festivals in an attempt to mimic the evil spirits or placate them. The term Halloween is shortened from All Hallows' Even (both "even" and "eve" are abbreviations of "evening", but "Halloween" gets its "n" from "even") as it is the eve of "All Hallows' Day", which is now also known as All Saints' Day. It was a day of religious festivities in various northern European Pagan traditions, until Popes Gregory III and Gregory IV moved the old Christian feast of All Saints' Day from May 13 (which had itself been the date of a pagan holiday, the Feast of the Lemures) to 1st November. Hundreds of years later, Halloween is now the United States' second most popular holiday (after Christmas) for decorating; the sale of candy and costumes are also extremely common during the holiday, which is marketed to children and adults alike. Over eighty percent of American adults planned to give out candy to trick-or-treaters, and 93% of children plan to go trick-or-treating.

The dental section of reports how to manage all that candy that comes home with kids after trick-or-treating on Halloween night. Sugary candy can lead to tooth decay, but following these simple steps can help you and your children have a fun Halloween without the nightmare of harming their teeth in the process:
--Don’t let your kids gorge on Halloween candy all night. Teaching your kids moderation on Halloween is important.
--Monitor that your children are brushing their teeth three times a day.
--Make sure that your children use an age-appropriate fluoridated mouthwash every evening.
--Have extra disposable dental flossers laying all over the house. You’d be amazed at what kids will do when their bored.
--Avoid or limit candy such as caramels, candy corn, jelly beans, and taffy. These particular candies are extra sticky, making it hard for saliva to wash away the sugar.
--Give your kids sugar free gum to chew. Not only does sugar-free gum help prevent cavities, it also helps neutralize the effects of sugar from the candy. Therefore, it combats the bacteria in plaque that causes cavities.

Halloween is a fun holiday and you shouldn’t have to worry about things like tooth decay as indicated by By practicing good oral hygiene and using moderation, your kids can have a fun and safe Halloween and still enjoy the candy! If you want to make sure your kids don't come home and gorge themselves on their Halloween candy, it can help to have a plan in place even before you go trick-or-treating. As a part of this plan, you might:
1.) Discuss how they can have a certain number of treats when they get home, but they must put the rest away for later. Unfortunately, depending on how much Halloween candy they get, 'later' can linger for days, weeks, or months, so you should also come up with a plan for this left-over Halloween candy.
2.) Allow them to keep a certain number of pieces of candy or a certain percentage of what they collect and then give the rest away to a food bank or other charity.
3.) Set a limit on how much candy they can collect on Halloween and don't let them fill up bag after bag after bag...
4.) Let them trade in their Halloween candy for something they have been wanting, like a video game, book, toy, trip to the movies, etc. or for fewer pieces of their favorite candy or treat.
5.) Prepare a healthier alternative to the Halloween candy that they will bring home, including fruits, sugar free treats, etc.
6.) Offer them alternatives to halloween candy as a trade for their candy when they get home from trick-or-treating, which itself is a lot of the fun on Halloween for many kids, and not so much eating the candy itself. Also, make sure your kids eat dinner before going trick-or-treating so that they won't be so hungry before they get home.

The Center for Disease Control (CDC) offers some practical safety tips for celebrating Halloween that make alot of sense, especially for children, for a SAFE HALLOWEEN:
1. Swords, knives, and similar costume accessories should be short, soft, and flexible.
2. Avoid trick-or-treating alone. Walk in groups or with a trusted adult.
3. Fasten reflective tape to costumes and bags to help drivers see you.
4. Examine all treats for choking hazards and tampering before eating them. Limit the amount of treats you eat.
5. Hold a flashlight while trick-or-treating to help you see and others see you.
6. Always test make-up in a small area first. Remove it before bedtime to prevent skin and eye irritation.
7. Look both ways before crossing the street. Use established crosswalks wherever possible.
8. Lower your risk for serious eye injury by not wearing decorative contact lenses.
9. Only walk on sidewalks or on the far edge of the road facing traffic to stay safe.
10. Wear well-fitting masks, costumes, and shoes to avoid blocked vision, trips, and falls.
11. Eat only factory-wrapped treats. Avoid eating homemade treats unless you know the cook well.
12. Enter homes only if you're with a trusted adult. Otherwise, stay outside.
13. Never walk near lit candles or luminaries. Be sure to wear flame-resistant costumes.

Halloween can be a fun time for kids. It also can be a scary time. Make sure that you monitor where your child goes, and what types of treats they get in their bags. Be careful when you are going door to door, especially in neighborhoods where you are not familiar with all the homes in the area. Check out the items before your child eats it to make sure there are no problems with the candy or other foods. Keep tabs on how much they eat. You don't want a fun time to turn into a big stomach ache later. Although Halloween is celebrated worldwide, don't let anyone pressure you into observing the event if you aren't open to celebrating it. Part of a healthy lifestyle, other than watching what you eat, is having a good feeling about your own mental well-being on this day.

Until next time. Let me know what you think.

Wednesday, October 29, 2008

Health Care and Hypoglycemia

Millions of Americans suffer from hypoglycemia--hard to pronounce and even harder to understand. Hypoglycemia, also called low blood sugar according to eDocAmerica, occurs when your glucose (blood sugar) level drops too low. When this happens, characteristic symptoms develop including: hunger, shakiness, dizziness, sweating, blurred vision, and weakness. Many people view hypoglycemia as a distinct disease. In reality, hypoglycemia is usually a manifestation of: 1) an underlying medical condition such as liver disease or a tumor of the pancreas, 2) a side effect of a medication, such as insulin or, 3) a poorly understood condition called "reactive hypoglycemia". Overall, diabetics are the most likely group to experience hypoglycemia, related to taking their glucose-lowering medications. In those without diabetes, reactive hypoglycemia is the most common cause for a low blood sugar. Reactive hypoglycemia is defined as low blood sugar occurring one to three hours after eating.

According to eDocAmerica, some of the causes of reactive hypoglycemia are known, but these represent only a small percentage of the total cases. For example, having stomach surgery can cause food to rapidly pass from the stomach into the small intestine with resulting hypoglycemia. In the majority of cases of reactive hypoglycemia, however, no specific cause is found. Some people may be more sensitive to the body's normal release of the hormone epinephrine, which can produce symptoms of hypoglycemia. A deficiency of a hormone called glucagon, that normally stimulates the release of glucose stores when blood sugar drops or a release of an excess of insulin in response to sugar in the diet are other possible explanations.

According to the National Institute of Health (NIH), Medications, including some used to treat diabetes, are the most common cause of hypoglycemia. Other medications that can cause hypoglycemia include:
--salicylates, including aspirin, when taken in large doses
--sulfa medicines, which are used to treat infections
--pentamidine, which treats a very serious kind of pneumonia
--quinine, which is used to treat malaria

If using any of these medications causes your blood glucose to drop, your doctor may advise you to stop using the drug or change the dosage according to the NIH.
1.) Alcohol drinking: Especially binge drinking, can cause hypoglycemia because your body's breakdown of alcohol interferes with your liver’s efforts to raise blood glucose. Hypoglycemia caused by excessive drinking can be very serious and even fatal.
2.) Critical Illnesses: Some illnesses that affect the liver, heart, or kidneys can cause hypoglycemia. Sepsis (overwhelming infection) and starvation are other causes of hypoglycemia. In these cases, treatment targets the underlying cause.
3.) Hormonal Deficiencies: Hormonal deficiencies may cause hypoglycemia in very young children, but usually not in adults. Shortages of cortisol, growth hormone, glucagon, or epinephrine can lead to fasting hypoglycemia. Laboratory tests for hormone levels will determine a diagnosis and treatment. Hormone replacement therapy may be advised.
4.) Tumors: Insulinomas, insulin-producing tumors, can cause hypoglycemia by raising your insulin levels too high in relation to your blood glucose level. These tumors are very rare and do not normally spread to other parts of the body. Laboratory tests can pinpoint the exact cause. Treatment involves both short-term steps to correct the hypoglycemia and medical or surgical measures to remove the tumor.

Assuming there is no serious underlying cause determined, reactive hypoglycemia can usually be controlled with lifestyle measures according to eDocAmerica. These include eating nutritionally balanced meals, getting regular exercise, and keeping weight under control. Of these, nutritional measures seem to be the most important. Recommendations for managing hypoglycemia are:
--Eat small meals or a snack every 2-3 hours.
--Eat a variety of foods that includes including meat, poultry, fish, or nonmeat sources of protein; starchy foods such as whole-grain bread, rice, and potatoes; fruits; vegetables; and dairy products.
--Eat a source of protein (soy foods, poultry, fish, cheese, eggs, peanut butter or meat) or a source of fat at each meal or snack.
--Eat high fiber foods to help stabilize blood sugar (whole grain breads and cereals, legumes, vegetables and whole fruits).
--Limit simple sugars such as candy, soda, and fruit juice, especially on an empty stomach. Sweet foods are better tolerated if eaten with meal since the other foods at the meal reduce the effects of the sugar.
--Limit consumption of alcohol and caffeine (coffee, tea, soda, chocolate).
--Have non-perishable foods (energy bars, nuts, dried fruits, etc.) available to eat with the first signs of hypoglycemia.
--Consider the Glycemic Index (GI) when considering food choices. Foods with a lower GI are more slowly digested, causing less of a rise in insulin, and possibly preventing hypoglycemia.

According to the National Institute on Health, there are ways to effectively treat hypoglycemia.
If you think your blood glucose is too low, use a blood glucose meter to check your level. If it is 70 mg/dL or below, have one of these "quick fix" foods right away to raise your blood glucose:
2 or 3 glucose tablets
1/2 cup (4 ounces) of any fruit juice
1/2 cup (4 ounces) of a regular (not diet) soft drink
1 cup (8 ounces) of milk
5 or 6 pieces of hard candy
1 or 2 teaspoons of sugar or honey
--After 15 minutes, check your blood glucose again to make sure that it is no longer too low. If it is still too low, have another serving. Repeat these steps until your blood glucose is at least 70.
--Then, if it will be an hour or more before your next meal, have a snack. If you take insulin or a diabetes medication that can cause hypoglycemia, always carry one of the quick-fix foods with you.
--Wearing a medical identification bracelet or necklace is also a good idea.
--Exercise can also cause hypoglycemia. Check your blood glucose before you exercise.
--Severe hypoglycemia can cause you to lose consciousness. In these extreme cases when you lose consciousness and cannot eat, glucagon can be injected to quickly raise your blood glucose level.
--Ask your health care provider if having a glucagon kit at home and at work is appropriate for you. This is particularly important if you have type 1 diabetes. Your family, friends, and co-workers will need to be taught how to give you a glucagon injection in an emergency.
--Prevention of hypoglycemia while you are driving a vehicle is especially important. Checking blood glucose frequently and snacking as needed to keep your blood glucose above 70 mg/dL will help prevent accidents.

Information supplied by reports that the body needs fuel to work. One of its major fuel sources is sugars, which the body gets from what is consumed as either simple sugar or complex carbohydrates. For emergency situations (like prolonged fasting), the body stores a stash of sugar in the liver as glycogen. If this store is needed, the body goes through a biochemical process called gluco-neo-genesis (meaning to "make new sugar") and converts these stores of glycogen to sugar. This backup process emphasizes that the fuel source of sugar is important (important enough for human beings to have developed an evolutionary system of storage to avoid a sugar drought). Of all the organs in the body, the brain depends on sugar (which we are now going to refer to as glucose) almost exclusively. Rarely, if absolutely necessary, the brain will use ketones as a fuel source, but this is not preferred. The brain cannot make its own glucose and is 100% dependent on the rest of the body for its supply. If for some reason, the glucose level in the blood falls (or if the brain's requirements increase and demands are not met) there can be effects on the function of the brain. Despite our advances in the treatment of diabetes, hypoglycemic episodes are often the limiting factor in achieving optimal blood sugar control. In large scale studies looking at tight control in both type 1 and type 2 diabetes, low blood sugars occurred more often in the patients who were managed most intensively. This is important for patients and physicians to recognize, especially as the goal for treating patients with diabetes become tighter blood sugar control.

The Mayo Clinic advises that if you have what appear to be symptoms of hypoglycemia, see your doctor. Hypoglycemia, if confirmed, can be an indication of any number of illnesses, all of which can be serious. By seeing your doctor, you can begin the process of having the underlying illness identified and treated. If you have diabetes and early signs of hypoglycemia don't improve with eating or taking glucose tablets, seek immediate help. Also, seek emergency help if someone you know who has diabetes or a history of recurring hypoglycemia loses consciousness. If you have diabetes, carefully follow the diabetes management plan you and your doctor have developed; and if you don't have diabetes but have recurring episodes of hypoglycemia, eating frequent small meals throughout the day may keep your blood sugar levels from getting too low.

If you have symptoms of low blood sugar, you need to eat or drink something with sugar in it according to WebMD. For example, you could eat raisins, graham crackers, or candy. You could also drink skim milk, regular (not diet) soda, or fruit juice. You may also take glucose tablets. It’s a good idea to find out about health problems or situations that can lead to low blood sugar. It’s also important to pay attention to your health and lifestyle. For example, talk to your doctor to see if you can change your diet, change the medicines you take, or change the way you exercise. In some cases, treating the health problem that is causing low blood sugar can prevent future problems.

Take care of yourself. If the problems you are having may be symptomatic of hypoglycemia, get to the doctor. Don't ignore the issue. Proper maintenance of personal health care is a essential to a healthy lifestyle.

Until next time. Let me know what you think.

Tuesday, October 28, 2008

Health Care and Rheumatoid Arthritis

After four decades on the decline, rheumatoid arthritis is on the upswing among women in the United States according to a study published by the Mayo Clinic and reported by Third Age Health. From 1955 to 1994, the incidence of rheumatoid arthritis had continually been on the decline. That apparently changed beginning in the mid-1990s. When Mayo researchers analyzed patient data from early 1995 to the start of 2005, they found that both the incidence and prevalence (percentage) of the condition were rising. Researchers say it's not clear why this is happening, but an environmental factor may have a role in the shifting incidence and prevalence among women.

Also, a Reuters news article posted on Medscape online indicates serious infections during infancy may predispose individuals to early onset rheumatoid arthritis, Swedish researchers report in the Annals of the Rheumatic Diseases. Previous studies have suggested that infections somehow trigger autoimmune diseases later in life, but the Swedish findings raise the possibility that infections may interfere with normal maturation of the immune system. The study included 333 cases of RA diagnosed between 16 and 29 years of age, and 3,334 cases of juvenile idiopathic arthritis (JIA). Each case was matched by age and gender with four control subjects. Results indicate that infections during the first year of life and possibly also factors related to size at and timing of birth may be of aetiological importance in the pathogenesis of RA and JIA. Rheumatoid arthritis (RA) is a chronic, debilitating disease that affects an estimated 2 million people, and healthcare costs from RA can reach $65 billion annually. Although the cause of RA is unknown, research is rapidly advancing to discover the mechanisms that lead to joint damage and subsequent arthritis, and those mechanisms may reveal targets for treatment. Markers for disease activity and outcomes in rheumatoid arthritis are crucial for tailoring the treatment to the needs of each individual.

According to, Rheumatoid arthritis (RA) is an autoimmune disease that causes chronic inflammation of the joints. Rheumatoid arthritis can also cause inflammation of the tissue around the joints, as well as in other organs in the body. Autoimmune diseases are illnesses that occur when the body tissues are mistakenly attacked by its own immune system. The immune system is a complex organization of cells and antibodies designed normally to "seek and destroy" invaders of the body, particularly infections. Patients with autoimmune diseases have antibodies in their blood that target their own body tissues, where they can be associated with inflammation. Because it can affect multiple other organs of the body, rheumatoid arthritis is referred to as a systemic illness and is sometimes called rheumatoid disease.While rheumatoid arthritis is a chronic illness, meaning it can last for years, patients may experience long periods without symptoms.

Typically, however, according to, rheumatoid arthritis is a progressive illness that has the potential to cause joint destruction and functional disability. A joint is where two bones meet to allow movement of body parts. Arthritis means joint inflammation. The joint inflammation of rheumatoid arthritis causes swelling, pain, stiffness, and redness in the joints. The inflammation of rheumatoid disease can also occur in tissues around the joints, such as the tendons, ligaments, and muscles. In some patients with rheumatoid arthritis, chronic inflammation leads to the destruction of the cartilage, bone, and ligaments, causing deformity of the joints. Damage to the joints can occur early in the disease and be progressive. Moreover, studies have shown that the progressive damage to the joints does not necessarily correlate with the degree of pain, stiffness, or swelling present in the joints.

The symptoms of rheumatoid arthritis come and go, depending on the degree of tissue inflammation. When body tissues are inflamed, the disease is active. When tissue inflammation subsides, the disease is inactive (in remission). Remissions can occur spontaneously or with treatment, and can last weeks, months, or years. During remissions, symptoms of the disease disappear, and patients generally feel well. When the disease becomes active again (relapse), symptoms return. The return of disease activity and symptoms is called a flare. The course of rheumatoid arthritis varies from patient to patient, and periods of flares and remissions are typical as reported by

When the disease is active, symptoms can include fatigue, lack of appetite, low-grade fever, muscle and joint aches, and stiffness according to Muscle and joint stiffness are usually most notable in the morning and after periods of inactivity. Arthritis is common during disease flares. Also during flares, joints frequently become red, swollen, painful, and tender. This occurs because the lining tissue of the joint (synovium) becomes inflamed, resulting in the production of excessive joint fluid (synovial fluid). The synovium also thickens with inflammation (synovitis).

In rheumatoid arthritis, as reported by, multiple joints are usually inflamed in a symmetrical pattern (both sides of the body affected). The small joints of both the hands and wrists are often involved. Simple tasks of daily living, such as turning door knobs and opening jars can become difficult during flares. The small joints of the feet are also commonly involved. Occasionally, only one joint is inflamed. When only one joint is involved, the arthritis can mimic the joint inflammation caused by other forms of arthritis, such as gout or joint infection. Chronic inflammation can cause damage to body tissues, cartilage and bone. This leads to a loss of cartilage and erosion and weakness of the bones as well as the muscles, resulting in joint deformity, destruction, and loss of function. Rarely, rheumatoid arthritis can even affect the joint that is responsible for the tightening of our vocal cords to change the tone of our voice, the cricoarytenoid joint. When this joint is inflamed, it can cause hoarseness of voice.

Since rheumatoid arthritis is a systemic disease, its inflammation can affect organs and areas of the body other than the joints according to Inflammation of the glands of the eyes and mouth can cause dryness of these areas and is referred to as Sjogren's syndrome. Rheumatoid inflammation of the lung lining (pleuritis) causes chest pain with deep breathing or coughing. The lung tissue itself can also become inflamed, and sometimes nodules of inflammation (rheumatoid nodules) develop within the lungs. Inflammation of the tissue (pericardium) surrounding the heart, called pericarditis, can cause a chest pain that typically changes in intensity when lying down or leaning forward. The rheumatoid disease can reduce the number of red blood cells (anemia) and white blood cells. Decreased white cells can be associated with an enlarged spleen (referred to as Felty's syndrome) and can increase the risk of infections. reports that firm lumps under the skin (rheumatoid nodules) can occur around the elbows and fingers where there is frequent pressure. Even though these nodules usually do not cause symptoms, occasionally they can become infected. A rare, serious complication, usually with long-standing rheumatoid disease, is blood-vessel inflammation (vasculitis). Vasculitis can impair blood supply to tissues and lead to tissue death. This is most often initially visible as tiny black areas around the nail beds or as leg ulcers. The first step in the diagnosis of rheumatoid arthritis is a meeting between the doctor and the patient. The doctor reviews the history of symptoms, examines the joints for inflammation and deformity, the skin for rheumatoid nodules, and other parts of the body for inflammation. Certain blood and X-ray tests are often obtained. The diagnosis will be based on the pattern of symptoms, the distribution of the inflamed joints, and the blood and x-ray findings. Several visits may be necessary before the doctor can be certain of the diagnosis. A doctor with special training in arthritis and related diseases is called a rheumatologist.

According to, the distribution of joint inflammation is important to the doctor in making a diagnosis. In rheumatoid arthritis, the small joints of the hands, wrists, feet, and knees are typically inflamed in a symmetrical distribution (affecting both sides of the body). When only one or two joints are inflamed, the diagnosis of rheumatoid arthritis becomes more difficult. The doctor may then perform other tests to exclude arthritis due to infection or gout. The detection of rheumatoid nodules (described above), most often around the elbows and fingers, can suggest the diagnosis. Joint x-rays may be normal or only show swelling of soft tissues early in the disease. As the disease progresses x-rays can show bony erosions typical of rheumatoid arthritis in the joints. Joint x-rays can also be helpful in monitoring the progression of disease and joint damage over time. Bone scanning, a radioactive test procedure, can demonstrate the inflamed joints.

The doctor may elect to perform an office procedure called arthrocentesis as reported by In this procedure, a sterile needle and syringe are used to drain joint fluid out of the joint for study in the laboratory. Analysis of the joint fluid, in the laboratory, can help to exclude other causes of arthritis, such as infection and gout. Arthrocentesis can also be helpful in relieving joint swelling and pain. Occasionally, cortisone medications are injected into the joint during the arthrocentesis in order to rapidly relieve joint inflammation and further reduce symptoms. There is no known cure for rheumatoid arthritis. To date, the goal of treatment in rheumatoid arthritis is to reduce joint inflammation and pain, maximize joint function, and prevent joint destruction and deformity. Early medical intervention has been shown to be important in improving outcomes. Aggressive management can improve function, stop damage to joints as seen on x-rays, and prevent work disability. Optimal treatment for the disease involves a combination of medications, rest, joint-strengthening exercises, joint protection, and patient (and family) education. Treatment is customized according to many factors such as disease activity, types of joints involved, general health, age, and patient occupation. Treatment is most successful when there is close cooperation between the doctor, patient, and family members.

RA affects 1.3 million Americans according to the Arthritis Foundation. Currently, the cause of RA is unknown, although there are several theories. And while there is no cure, it is easier than ever to control RA through the use of new drugs, exercise, joint protection techniques and self-management techniques. While there is no good time to have rheumatoid arthritis, advancements in research and drug development mean that more people with RA are living happier, healthier and more fulfilling lives.

Until next time. Let me know what you think.

Wednesday, October 15, 2008

Health Care and Diabetes

Millions of Americans suffer from Diabetes. Diabetes is infamous for leading to a slew of serious complications such as blindness and amputations. But complications don't have to be a fact of life for those with the condition according to Managing your glucose levels can be challenging when you have diabetes. You need to plan what you eat, take glucose readings, take your medication, see your doctor and more. Moreover, how your body responds is quite individual, but most people aren’t doing a very good job of taking care of themselves--and good, consistent care is what it takes if you want to live to 90 without complications.

Diabetes is a disease in which the body does not produce or properly use insulin as stated by the American Diabetes Association. Insulin is a hormone that is needed to convert sugar, starches and other food into energy needed for daily life. The cause of diabetes continues to be a mystery, although both genetics and environmental factors such as obesity and lack of exercise appear to play roles. There are 23.6 million children and adults in the United States, or 7.8% of the population, who have diabetes. While an estimated 17.9 million have been diagnosed with diabetes, unfortunately, 5.7 million people (or nearly one quarter) are unaware that they have the disease.

According to the American Diabetes Association, in order to determine whether or not a patient has pre-diabetes or diabetes, health care providers conduct a Fasting Plasma Glucose Test (FPG) or an Oral Glucose Tolerance Test (OGTT). Either test can be used to diagnose pre-diabetes or diabetes. The American Diabetes Association recommends the FPG because it is easier, faster, and less expensive to perform. With the FPG test, a fasting blood glucose level between 100 and 125 mg/dl signals pre-diabetes. A person with a fasting blood glucose level of 126 mg/dl or higher has diabetes. In the OGTT test, a person's blood glucose level is measured after a fast and two hours after drinking a glucose-rich beverage. If the two-hour blood glucose level is between 140 and 199 mg/dl, the person tested has pre-diabetes. If the two-hour blood glucose level is at 200 mg/dl or higher, the person tested has diabetes.

The American Diabetes Association indicates several types of diabetes:
--Type 1 diabetes: Results from the body's failure to produce insulin, the hormone that "unlocks" the cells of the body, allowing glucose to enter and fuel them. It is estimated that 5-10% of Americans who are diagnosed with diabetes have type 1 diabetes.
--Type 2 diabetes: Results from insulin resistance (a condition in which the body fails to properly use insulin), combined with relative insulin deficiency. Most Americans who are diagnosed with diabetes have type 2 diabetes.
--Gestational diabetes: Immediately after pregnancy, 5% to 10% of women with gestational diabetes are found to have diabetes, usually, type 2.
--Pre-diabetes: Pre-diabetes is a condition that occurs when a person's blood glucose levels are higher than normal but not high enough for a diagnosis of type 2 diabetes. There are 57 million Americans who have pre-diabetes, in addition to the 23.6 million with diabetes.

Diabetes is complex, and effective management takes effort according to It doesn’t hurt to have a few tricks up your sleeve. To help you stay on top of it all and avoid complications, here are 6 ways to take control:

1.) Stay Regular. Eat and test your blood on a schedule. Your readings will be more informative and dependable if you mostly take them at the same time under the same conditions, and you’ll also be more likely to take them if you are on an uninterrupted schedule. Getting in a hurry, losing your monitor or running out of test strips—that is, becoming too flustered to stay on top of things—is much less likely to happen when you make a schedule and stick to it.

2.) Set Goals. Diabetes can seem overwhelming at times, but the more you feel in control, the better you’ll do. Setting goals not only gives you something to aim for, it helps you know when to swing into action. This kind of attitude keeps you in charge, rather than your condition.

3.) Keep a Diary. Write everything down, not just your blood sugar readings but all your numbers: weight, blood pressure, cholesterol, along with what you eat. Each body responds differently to various food and medications, and the only way you’ll know how your body responds to the many variables is to pay attention and keep track.

4.) Make notes on the kind of day you are having as well: All sorts of things, such as menstrual cycles and stress or activity levels, can affect glucose readings. A week or so later, when you are noting those patterns, it will help to know which morning you missed your bus and had to walk extra blocks to work, or which afternoon you had a fight with your spouse.

5.) Join a Team. Diabetes management is not a solo job, so get support from your physician, a diabetes educator or dietitian, a personal trainer and other specialists, such as an eye doctor or podiatrist. They all will work with you to keep you healthy. However, they won’t do you as much good if you don’t keep them informed. This is one diary you’ll want to let other people read.

6.) Cut Yourself Some Slack. It is crucial to stay on top of your diabetes care if you want to avoid complications, but don’t be too hard on yourself. Trying to be too organized can backfire for some people causing them, for example, to get discouraged and not do anything at all. For those types, a more flexible approach works better. In order to develop a management plan that works, you have to know yourself. If one approach turns out not to work well for you, try something else.

The American Diabetes Association advises that people suffering from this disease build a health care team to help manage diabetes. No matter what type of diabetes you have, it affects many parts of your life. You can get help from health professionals trained to focus on different areas, from head to toe. A health care team helps you use the health care system to its fullest.

1.) Your Health Care Team: In centers that focus on diabetes care, health care professionals often already work as a team. Sometimes, your primary diabetes doctor (internist, family practice doctor, or endocrinologist) will refer you to other health care providers in the same clinic or a building nearby. Or you may need to work with your doctor to build a health care team, adding members as the need arises.

2.) Other Specialists: As your health care needs change, you may need to add other members to your team. If you plan a pregnancy, for example, you will need to bring an obstetrician onto your team. If you have blood flow problems in your legs or feet, you may need the help of a vascular surgeon. Your primary care doctor can help find the specialist you need and work with you and that specialist to coordinate your care.

3.) Visiting Your Health Care Team: The American Diabetes Association provides standards of medical care for people with diabetes. These guidelines give the most up-to-date information on taking care of your diabetes. Also, the guidelines let you know what to expect from your doctor and health care team.
--The First Visit: Your first visit to a doctor who will treat your diabetes should have four parts. Learn what those parts are.
--Future Visits: How often you should return to your diabetes doctor depends on many things. Learn what those things are in this section.
--Visits for Children and Teens: Standards of care for children are somewhat different. Children whose diabetes is not well controlled sometimes are slow to grow and mature.
--Visit with the Pharmacist: Make sure that you talk with the pharmacist about how to use medications and supplies for administering insulin and other medications to managet diabetes. Understand how the medications work and interact with other prescriptions and over the counter medications and supplements.

Most people with diabetes have health problems -- or risk factors -- such as high blood pressure and cholesterol that increase one's risk for heart disease and stroke. As noted by the American Diabetes Association, when combined with diabetes, these risk factors add up to big trouble. In fact, more than 65% of people with diabetes die from heart disease or stroke. With diabetes, heart attacks occur earlier in life and often result in death. By managing diabetes, high blood pressure and cholesterol, people with diabetes can reduce their risk. Nearly all people with diabetes have abnormal cholesterol levels which contribute to their increased risk for heart attack and stroke. By choosing foods wisely, increasing physical activity and taking medications, you can improve your cholesterol.

Diabetes if managed well is a disease that can be maintained with a healthy lifestyle. Make sure that you monitor blood sugar levels and wisely manage medications. Part of the fallout with the disease is emotional difficulties and mental denial of how severe the problems can be if diabetes is not regularly monitored. Get a support system in place to help you. Seek guidance from medical professionals, family, and friends in addition to the myriad of available resources to help maintain a healthy life.

Until next time. Let me know what you think.

Friday, October 10, 2008

Health Care and HPV

According to an article in the New York Times this week, one in four teenage girls have received the relatively new vaccine against cervical cancer. The figures represent the government’s first substantial study of vaccination rates for the vaccine, Gardasil, which is Merck & Company’s heavily advertised three-shot series that goes after the sexually transmitted human papillomavirus, or HPV. The vaccine protects against strains of the virus that cause about 70% of cervical cancers. Health officials recommend that girls get the shots when they are 11 or 12, if possible, before they become sexually active. Also, 11 is the age when children are generally due for a round of vaccinations. The survey covered children only from 13 to 17.

The results, according to the NY Times, are based on nearly 3,000 girls for whom the researchers could verify vaccination information through medical records. Proponents of the vaccine had been hoping for much higher vaccination rates, saying the shots could significantly reduce the nearly 4,000 cervical cancer deaths that occur each year in the United States. However, many families are cautious about the safety of new vaccines, and other aspects of the vaccine may also give some families pause. It is expensive, selling for about $375, although many health insurers now cover it. And there are questions about whether it confers lifetime immunity or if a booster shot will be needed.

According to the Centers for Disease Control (CDC), Most people with HPV do not develop symptoms or health problems. But sometimes, certain types of HPV can cause genital warts in men and women. Other HPV types can cause cervical cancer and other less common cancers, such as cancers of the vulva, vagina, anus, and penis. The types of HPV that can cause genital warts are not the same as the types that can cause cancer. HPV types are often referred to as “low-risk” (wart-causing) or “high-risk” (cancer-causing), based on whether they put a person at risk for cancer. In 90% of cases, the body’s immune system clears the HPV infection naturally within two years. This is true of both high-risk and low-risk types. Genital warts usually appear as small bumps or groups of bumps, usually in the genital area. They can be raised or flat, single or multiple, small or large, and sometimes cauliflower shaped. They can appear on the vulva, in or around the vagina or anus, on the cervix, and on the penis, scrotum, groin, or thigh. Warts may appear within weeks or months after sexual contact with an infected person. Or, they may not appear at all. If left untreated, genital warts may go away, remain unchanged, or increase in size or number. They will not turn into cancer. Cervical cancer does not have symptoms until it is quite advanced. For this reason, it is important for women to get screened regularly for cervical cancer. Other less common HPV-related cancers, such as cancers of the vulva, vagina, anus and penis, also may not have signs or symptoms until they are advanced.

To attain the greatest impact on cervical cancer prevention, the ACS provides the following supporting recommendations:
1.) Screening:
--It is critical that women, whether vaccinated or not, continue screening according to current ACS early detection guidelines.
--A preventive health care visit in which vaccination is discussed or offered represents an appropriate opportunity to offer Pap screening to sexually active patients.
--HPV testing before initiating vaccination is not recommended.
2.) Vaccine Implementation and Utilization:
--Public health and policy efforts are needed to ensure access and encourage high HPV vaccine coverage for all racial, ethnic, and socioeconomic groups, particularly for females of color, immigrants, those living in rural areas, low-income and uninsured females, and others who have limited access to health care services.
--Strategies should be implemented to maximize adherence to vaccination recommendations, including coadministration with other recommended adolescent vaccines, once sufficient safety data are available.
--The use of noncomprehensive visits (eg, minor illness visits, camp/sports physical visits) and alternative vaccination sites for adolescents unable to access comprehensive preventive care is encouraged.
3.) Education:
--There is a critical need for education of providers, policy-makers, parents, adolescents, and young women about cervical cancer prevention and early detection, including the need for regular screening even after vaccination.
4.) Research:
--Ongoing research and surveillance should be conducted in diverse populations, including research on duration of protective immunity, population- and lesion-based changes in type-specific prevalence for the full spectrum of carcinogenic and noncarcinogenic genital HPV types, changes in Pap test performance characteristics, changes in screening practices and behaviors, comprehensive surveillance for reproductive toxicities, increasing vaccine coverage and acceptability, and impact on safe sexual behavior.
--Safety and efficacy of prophylactic HPV vaccine for the prevention of other anogenital cancers and head and neck cancers in males, as well as females, should be evaluated.
--Research is needed regarding the design of sustainable vaccination programs in less developed countries.

According to the CDC, there are important steps girls and women can take to prevent cervical cancer. The HPV vaccine can protect against most cervical cancers. Cervical cancer can also be prevented with routine cervical cancer screening and follow-up of abnormal results. The Pap test can identify abnormal or pre-cancerous changes in the cervix so that they can be removed before cancer develops. An HPV DNA test, which can find high-risk HPV on a woman’s cervix, may also be used with a Pap test in certain cases. The HPV test can help healthcare professionals decide if more tests or treatment are needed. Even women who got the vaccine when they were younger need regular cervical cancer screening because the vaccine does not protect against all cervical cancers. Unfortunately, there is currently no vaccine licensed to prevent HPV-related diseases in men. Studies are now being done to find out if the vaccine is also safe in men, and if it can protect them against HPV and related conditions. The FDA will consider licensing the vaccine for boys and men if there is proof that it is safe and effective for them. There is also no approved screening test to find early signs of penile or anal cancer. Some experts recommend yearly anal Pap tests for gay and bisexual men and for HIV-positive persons because anal cancer is more common in these populations. Scientists are still studying how best to screen for penile and anal cancers in those who may be at highest risk for those diseases.

In the United States, each year it is estimated that over 6 million people are infected with genital HPV, according to the American Cancer Society (ACS). An estimated 20 million people in the United States, approximately 15% of the population, are currently infected as detected by HPV DNA assays. Almost half of the infections are in those aged 15 to 25 years. Point prevalence estimates for young women range from 27% to 46%. At least half of all sexually active men and women acquire HPV at some point in their lifetime, and modeling studies suggest that up to 80% of sexually active women will have become infected by age 50. There have been some concerns that the perception of safety resulting from introduction of a prophylactic HPV vaccine will lead to an increase in unsafe behaviors and premature sexual activity among adolescents ("behavioral disinhibition").

Some organizations have expressed their support for universal availability of HPV vaccines while emphasizing that vaccination should not be a substitute for sexual abstinence until marriage and fidelity after marriage as reported by the ACS. Media coverage has cited such concerns as a potential barrier to vaccine acceptance and implementation, and several small studies also have cited this as a barrier to parental and provider acceptability. Historically, similar concerns have been raised with regard to penicillin for syphilis, condom availability programs, and emergency contraception. Knowledge of HPV also varies among health care providers. Pediatricians and primary care providers may have limited familiarity with and understanding of HPV, whereas gynecologists may have greater understanding of HPV infection, regression, persistence, and progression to cervical cancer precursors.

Vaccinating against HPV is still a controversial issue. One consensus is that abstinence until marraige may be the best way to prevent contracting the disease in most cases. Another view is that vaccinations should be given to all girls starting at certain ages just as a purely preventive measure regardless of their personal home situation. Mandating vaccinations for HPV should be avoided, as it is not a disease that can be contracted by innocent contact with someone who has a disease such as measles or other communicable illnesses. Studies of patients who have been vaccinated are not entirely conclusive that there are no side effects or long term problems from receiving the medication to prevent HPV. The best way to maintain a healthy life and avoid HPV altogether is to wait until marraige before sleeping with someone and avoid sexual contact with anyone other than a monogomous heterosexual spouse.

Until next time. Let me know what you think.

Thursday, October 9, 2008

Health Care and Vaccines

Roughly 25% of parents are not sure about vaccines for children according to a new study by the Center for Disease Control (CDC) noted in an article announced by Reuters Health this week. And, their doctor is a big reason for that concern. Many times, their is a lack of trust between patient and provider, and information can be sometimes difficult to find or understand about possible side effects, especially if there is a language or culture gap. However, according to HealthLink at the Medical College of Wisconsin, vaccines offer safe and effective protection from infectious diseases that have caused millions of illnesses and deaths. Vaccines have already eradicated smallpox worldwide, eliminated polio in the US, and significantly reduced the number of cases of measles, diphtheria, rubella, pertussis and other diseases. But there are still some areas where low immunization rates have led to disease outbreaks. By staying up to date on recommended vaccines, you protect yourself, your family and your community from serious, life-threatening diseases.

HealthLink reports that vaccines work this way: when people are exposed to disease germs, they produce substances called antibodies to fight them off. Usually, the antibodies destroy the invaders and the illness is prevented. Vaccines are made from the same germs (or parts of them) that cause disease, but the germs in vaccines are either killed or weakened so they won't make us sick. Vaccines cause us to produce antibodies against that particular illness just as it would if the real disease was attacking. The antibodies usually stay in our immune system for a lifetime and protect us from getting sick with the same disease again. This protection is called immunity. Most childhood vaccines give immunity to 90% to 99% of the children who get them. But occasionally a child will not respond to certain vaccines. This is another reason why it's important for all children to be vaccinated. Children who haven't responded to vaccination have to depend on the immunity of others around them for protection.

For most of these vaccines, the first shots should be given when children are still babies according to HealthLink. Children can be vaccinated at the doctor's office or at the local health department. Keep a list of the shots each child has received so you know when your children need more shots. Children will need these records to start most schools. Most of these shots can be given at any age, and a child who has gotten behind does not have to start over. The shots already given will still count, and the child will still develop immunity. Contact your doctor or health department clinic for details about getting back on schedule. Children are especially vulnerable to infections, so most vaccines are given during the first five to six years of life. Recommended vaccinations begin soon after birth. Ask about special programs that provide shots for kids - many public health clinics offer free vaccines or charge a small service fee.
Being aware of the vaccines that are recommended for infants, children, adolescents and adults - and making sure you receive these immunizations - is vital to protecting everyone. More info on what vaccines, how they work, and when to be administered can be found on the HealthLink site.

Here are some tips about Vaccine Safety from HealthLink:
1.) Vaccines are very safe, but they are not perfect. Like any other medicine they can cause reactions. Usually these are mild, like a sore arm or a slight fever. Serious reactions are rare; your doctor or nurse can explain any risks. Keep in mind that in almost every case, getting the disease is much more dangerous than getting the shot.
2.) Tell your doctor if anyone in your family has had a bad reaction to a vaccine, and ask if there are any reasons why a vaccine is not recommended. After receiving a vaccine, children might be fussy due to pain, fever or other mild reactions.
3.) If children have pain:
Give acetaminophen (such as Tylenol). Do not give aspirin to children - it can have serious side effects in some cases.
4.) If children have a fever:
--Give them plenty to drink.
--Clothe them lightly - do not cover or wrap them tightly.
--Give them acetaminophen. Do not use aspirin.
--Sponge them in a few inches of lukewarm (not cold) bath water.
5.) If a child's arm or leg is swollen, hot or red where the shot was given:
--Put a clean, cool washcloth over the sore area for comfort.
--If redness or tenderness increases after 24 hours, call the doctor's office or clinic.
--Give acetaminophen for pain. Do not give aspirin.
6.) Call the doctor's office or clinic if children:
--Become pale or limp.
--Have been crying for more than 3 hours and won't stop.
--Have rectal temperature of 105°F or higher.
--Have a high-pitched cry that isn't normal.
--Are shaking, twitching or jerking.
--Continue to fuss for more than 24 hours.

The CDC recommends the following vaccines for teens and college students, especially new freshmen in college dorms:
--Tetanus-Diptheria-Pertussis vaccine
--Meningococcal vaccine*
--HPV vaccine series
--Hepatitis B vaccine series
--Polio vaccine series
--Measles-Mumps-Rubella (MMR) vaccine series
--Varicella (chickenpox) vaccine series
--Influenza vaccine
--Pneumococcal polysaccharid (PPV) vaccine
--Hepatitis A vaccine series

Keeping up with vaccinations at home and abroad is a very serious matter. Choosing to ignore them can be a very dangerous decision. So far this year, the US is seeing more breakouts of communicable diseases due to lack of vaccinations, especially in the new immigrant populations coming into the country. Additionally, there are reports of widespread pandemics in certain parts of the world, including many third world or underdeveloped nations, that have led to high death rate among both adults and children. Diseases such as Measles, Smallpox, and worse can be picked up easily if exposure to infected individuals happens, and you have not been vaccinated. For much detailed information about vaccines, you can visit websites such as or the to get up to speed on vaccinations.

Until next time. Let me know what you think.

Wednesday, October 8, 2008

Health Care and Health Insurance Cost Disclosure

Congress is interested in finding ways to lower healthcare costs and increase access to coverage for all Americans according to in an article released today. It would require that an employer disclose the amount of money it pays for an employee's health insurance coverage on the employee's annual Form W-2. The proposal also calls for employers to disclose the aggregate value of health insurance coverage under multiple plans, if employees are covered by more than one plan, such as major medical, dental plan and vision coverage.

If Americans could see clearly what healthcare costs, they would understand why wages have been stagnant in recent years according to the report. Once workers are informed, they might seek changes including improved efficiency, reduced waste and fewer unnecessary procedures, balanced with the natural need to have good coverage. As long as people are insulated from the cost and just think someone else is paying for it, then it's easy to overlook expenses. However, according to the article, once employees realize they themselves are paying for it, it should spark a genuine conversation about what to do.

According to, some business groups have said they oppose the proposed bill because some larger businesses already report health coverage costs in an annual compensation sheet that compiles the costs of health care, retirement, transportation and any other benefits that accompany wages. Others cited cost as a major concern because benefit information typically is kept separate from payroll information, and creating a way to "interface" the two systems would introduce significant new costs, CongressDaily reports. In addition, some business groups are concerned that disclosing the cost information to the government could lead to additional taxation or determining the amount of total payroll employers spend on health coverage. However, the senators believe that showing employees the cost of health care they lose in wages will encourage them to be more thoughtful in making health care decisions and help reduce health care costs.

The US Department of Health and Human Services (HHS) reports that disclosure is needed. For the benefit of their employees, employers are encouraged to request that the health insurance plans, third party administrators, providers, and others with which they contract make available to enrollees in the health plans they sponsor the cost or price of their care. As consensus develops through broad-based national collaborations on approaches for measuring and reporting cost or price information for the benefit of consumers, employers are encouraged to adopt these approaches and to request that those with which they contract do the same. And, employers are encouraged to work to assure that cost or price information is made available with quality information. Employers also are encouraged to request that those with which they contract join broad-based, public-private collaborative efforts to develop strategies to measure the overall cost of services for common episodes of care and the treatment of common chronic diseases.

According to the National Association of Self-Employed (NASE), health insurance premiums grew about 4.7% for family coverage and cost about $12,680 in 2008, as reported by the Kaiser Family Foundation. Congress is hoping more transparency among employers and employees regarding health costs is on the horizon. They have introduced legislation would require employers to report what they pay for all polices provided to workers, including health insurance or separate dental and vision plans. Earlier this year, the Congressional Budget Office argued that if workers knew what they or their employers pay for health care, it might encourage them to reign in health care costs more actively. The proposal would require employers to include the amount paid for health insurance coverage on the W-2 Form. It would inform workers about the total cost of their coverage and what they may be giving up in wages.

More disclosure would be beneficial to employees and consumers. When information is available, more intelligent decisions can be made when purchasing insurance. Legislation to make full disclosure might backfire if legislators are unable to develop language suitable to manage administration of disclosure. Private market insurance must work for more consumer friendly ways to make price disclosure available.

Until next time. Let me know what you think.

Wednesday, October 1, 2008

Health Care and the Flu

Flu season is upon us. Pediatrician Vincent Ianelli says that the CDC recommends that children and teens should start getting their flu vaccine in September, or as soon as the flu vaccine becomes available, so many kids have started getting flu shots already. That's great as we prepare for this year's flu season, but parents should remember that they do have more options this year, even as experts recommend that all children get vaccinated against the flu. That option is between a flu shot and FluMist - the nasal spray flu vaccine. FluMist isn't for every child, but it is a good option to consider in getting your child vaccinated against the flu if he is older than age 2 and doesn't have any health problems. And in recent years, the recommended ages for getting a flu vaccine has greatly expanded, from just high-risk kids a few years ago to all kids between the ages of 6 months and 2 years (2004), from all kids 6 months to age 5 (2006) to the current recommendations that all children older than ages 6 months to 18 years should get a flu vaccine (2008 and 2009 flu seasons).

The New York Times reports that the flu usually begins abruptly, with a fever between 102 and 106 °F. (An adult typically has a lower fever than a child.) Other common symptoms include a flushed face, body aches, chills, headache, nausea, and lack of energy. Some people have dizziness or vomiting. The fever usually lasts for a day or two, but can last 5 days. Somewhere between day 2 and day 4 of the illness, the "whole body" symptoms begin to subside, and respiratory symptoms begin to increase. The flu virus can settle anywhere in the respiratory tract, producing symptoms of a cold, croup, sore throat, bronchiolitis, ear infection, or pneumonia. The most prominent of the respiratory symptoms is usually a dry, hacking cough. Most people also develop a sore throat and headache. Nasal discharge (runny nose) and sneezing are common. These symptoms (except the cough) usually disappear within 4 - 7 days. And, sometimes, the fever returns. Cough and tiredness usually last for weeks after the rest of the illness is over.

According to the NY Times, Influenza A usually arrives in the late winter or early spring. Influenza B can appear at any time of the year. The most common way to catch the flu is by breathing in droplets from coughs or sneezes. Less often, it is spread when you touch a surface such as a faucet handle or phone that has the virus on it, and then touch your own mouth, nose, or eyes. Symptoms appear 1 - 7 days later (usually within 2 - 3 days). Because the flu spreads through the air and is very contagious, it often strikes a community all at once. This creates a cluster of school and work absences. Many students become sick within 2 or 3 weeks of the flu's arrival in a school. Tens of millions of people in the United States get the flu each year. Most get better within a week or two, but thousands become sick enough to be hospitalized. About 36,000 people die each year from complications of the flu.

One alternative to the traditional flu shot is to use Flumist. However, Dr. Ianelli also indicates that for one thing, Flumist can't be given to everyone, including:
--children younger than age 2.
--adults older than 50 years old.
--children with medical conditions, such as asthma or reactive airway disease, diabetes, chronic heart disease, chronic lung disease or a weakened immune system.
--children younger than age 5 who have had problems with recurrent wheezing.
--children who are taking aspirin.
--teens who are pregnant.
So, basically, that means it should mostly be given to healthy children, which leaves out most high-risk children who need a flu vaccine.

Also, according to the NY Times, if you have mild illness and are not at high risk, take these steps:
--Take medicines that relieve symptoms and help you rest.
--Drink plenty of liquids.
--Avoid aspirin (especially teens and children).
--Avoid alcohol and tobacco.
--Avoid antibiotics (unless necessary for another illness).

If the flu is diagnosed within 48 hours of when symptoms begin, especially if you are at high risk for complications, antiviral medications may help shorten the length of symptoms by about one day. The U.S. Centers for Disease Control and Prevention (CDC) recommends using oseltamivir (Tamiflu) or zanamivir (Relenza), which are active against both influenza A and B for patients who need to be treated. These medicines affect different viruses. Each of these medicines has different routes of administration and different side effects. Talk to your doctor about whether one of these drugs is right for you. Treatment is usually not necessary for children, but if the illness is diagnosed early and the patient is at risk of developing a severe case, it can be started. Oseltamivir (Tamiflu) is the best choice for children age 12 and older. Zanamivir (Relenza) is not FDA-approved for children under age 7. Treatment will only help if started early and only if the illness is actually influenza. It will not help treat a regular cold. A yearly flu vaccine is currently recommended for many people. Possible complications if you catch the flu, especially for those at high risk, include:
--Encephalitis (infection of the brain).
--Sinus infections.
--Ear infections.

According to the CDC, the single best way to prevent seasonal flu is to get vaccinated each year, but good health habits like covering your cough and washing your hands often can help prevent respiratory illnesses like the flu. There also are flu antiviral drugs that can be used to treat and prevent the flu. If you are not considered to be an individual in one of the high risk groups, it makes sense to get a flu shot or use the Flumist to prevent feeling really sick if you happen to catch the illness. Use common sense about personal hygiene, especially during flu season. Avoid close contact with anyone who may have the flu and practice good health habits. Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids, and eat nutritious food.

Until next time. Let me know what you think.