YourHealthMatters

Welcome to YourHealthMatters

I hope this becomes an important source of health-related information for you. My practice and philosophy combines both conventional approaches and complementary approaches to improving health, treating disease and improving healthspan.

I ALSO HAVE A WEBSITE FOR THE PRACTICE- www.drbobsager.com

I am writing and posting content here frequently and if you sign up for email alerts on the left hand column, you'll get emails about new postings. There is also an RSS feed on the right hand side for people with RSS readers. I also plan to use the email alerts to let my patients know when Lynda & I will be away, when flu shots arrive and other news about the office.

I welcome questions, comments, and ideas for content. Please click on the categories on the right side to find information which I think is useful. You will find files to download on various health issues. Tell your friends and share what I have written.

I hope you explore this site and return often to sample the new content. 

To Your Health -

drBob

If You Want an H1N1 Shot, Can You Find One?

MSNBC reported on the weekend that only one in 3 people seeking the H1N1 vaccine can find it. There is an incredible shortage despite recent comments to the contrary by DHE Secretary, Kathleen Sibelius. I have had 500 shots on order for 6 weeks and have received 10. In Liberal the Public Health Department is running clinics to vaccinate the people in high risk groups. They do not seem to be distributing shots to local doctors. If you live in Liberal and want an H1N1 shot, call the Health Department.

Read this MSNBC article for their information on this widespread shortage which at this late date in the year should never have happened.

drBob

Who Will Get the Swine Flu (H1N1) vaccine first?

If you have been thinking about getting the H1N1 shot and you can't find any shots, here is the list in order of priority of high risk groups. When all of these groups have been immunized the rest of us will have our chance.

    •    Pregnant women;

    •    People who live with or care for infants younger than 6 months of age;

    •    Healthcare workers (HCWs) and emergency medical personnel;

    •    Persons 6 months to 24 years of age;

    •    Persons 25-64 years of age who have chronic diseases (including immunodeficiency states) that      pose risk for influenza.

When more vaccine becomes available, the following persons should be vaccinated:
    •    Healthy persons ages 25-64 years; and
    •    Adults 65 years of age and older.

Patients on the high-priority list should be vaccinated as soon as the vaccine is available. Individuals with the highest priority, as listed above, should be vaccinated first, but stringency of methods to restrict vaccine use is unclear.
Contraindications to the inactivated vaccine include:
    •    Previous Guillain-Barré syndrome;
    •    Life-threatening reaction to previous influenza vaccination; and
    •    Severe illness (a "moderately or severely ill" patient is advised to wait, but a mild upper respiratory infection or other illness is not a contraindication).
Note that pregnancy and breastfeeding are not contraindications to receiving the inactivated vaccine.
The above information is from an article posted yesterday on MedScape. I highly recommend you read it for further details, especially the contraindications to using the LAIV - live attentuated nasal vaccine, which is going to be the vaccine form used in many schools to mass immunize children in school without injections.

This article clarifies a number of issues around safety testing, side effects and vaccine production. Adjuvants such as squalene are NOT in this vaccine. Thimerosal (containing mercury) is in the vaccine. If you don't like this idea, think about the alternative which is risking death from the H1N1 infection. 46% of hospitalized adults with H1N1 complications had no prior medical history. The number of children dying from H1N1 is climbing. Read this article for further sad details.
 
Distribution of the shots to doctors in the US is through local Public Health Departments. I have had 500 shots on order since September and received only 10 so far which went to my high risk patients very quickly. No one can tell me when I might get more. No matter what you may see in the news about the shots being widely available., they are not as of now.

drBob

High Numbers of Children are Vitamin D Deficient

My usual readers will know of my interest in Vitamin D and how often I will try to optimize Vitamin D in adults for health improvement. Now comes this report of widespread low levels of Vitamin D in children.
The study found 1 in 5 children aged 1 to 11 were deficient and by a "looser" measure up to 90% of Black children and 80% of Hispanic children could be vitamin D deficient.
This report should be a wakeup call to parents to have vitamin D levels checked in children, especially in children with frequent infections or obesity.
I have recently written about the anecdotal reports of Vitamin D reducing the risk on catching H1N1 infection. If this is true and I think it is, perhaps the fast spread of H1N1 in schools could be partly due to deficient levels of D.

Here is a second site with more detail on the study findings on Vitamin D deficiency - the study leader is recommending children have levels of 75 ng/ml. By this measure 66% of children are deficient including 59% of white children. The lead investigator is a pediatrician at Children's Hospital in Boston.

Vitamin D deficiency has been connected to higher rates of diabetes, infections, high blood pressure and cancer. I find the same deficiency in the vast majority of adults that I test for Vitamin D. Optimal levels of Vitamin D in adults should be at least 55 ng/ml.The average recommended daily allowance of Vitamin D will not produce optimal levels in most people in my experience, not even close.

drBob

 

More "Good" News about H1N1 Vaccine !

Read this article and realize that once again the best laid plans may go awry!

We in the US may not get enough H1N1 vaccine fast enough to give people time to develop immunity soon enough in this pandemic. It takes 6 weeks to develop immunity on average from vaccines. It is known that the strain of H1N1 in the vaccine does produce antibody immunity to the currently circulating H1N1 virus infecting the public. But somehow not enough is being produced fast enough. There are a number of reasons cited in this article which could have been avoided perhaps with better preparation. One manufacturer still has not received FDA clearance to release the vaccine they are making. WHY NOT? One company is producing about half the planned number of doses at present. WHY?

So although I have recommended people consider this vaccine, especially people in high risk groups, there may not be enough vaccine soon enough to help people avoid getting an infection.

Plan B - make sure you know the symptoms of the H1N1 flu. You may wish to have a prescription of Tamiflu pills on hand in case an adult at home becomes sick with H1N1. Ask your doctor firmly for the prescription. Be scrupulous about hand-washing and cleaning hard surfaces anyone coughs or sneezes on.

I continue to see new infections in people every week. The infection still reacts quickly and well to Tamiflu. I have seen some very severe cases with chest infections. There has been one pregnant woman die in this area already and one boy died of spinal meningitis due to H1N1. The overwhelming infections develop quickly in often the first 24 hours.

I am submitting 2 samples per week to the KDHE from people I diagnose with H1N1 by history. These samples are being analyzed quickly with the latest PCR gene technology to identify the virus type and whether any mutations are occurring. The viruses recovered are also being tested for resistance to Tamiflu. I am also reporting weekly the number of new cases of H1N1 I am treating in the practice. This information is vital for us to see how fast or slow this virus is spreading and whether it is mutating.

Sadly, although I was the first physician in Liberal to sign up to receive H1N1 vaccine, I have only received 10 shots and they are gone. Public Health is distributing the vaccine as it slowly arrives and they have targeted high risk groups to receive it first which is the best way to use our very limited supplies.

I am resisting blaming any group for this huge error in planning but I know you know who is responsible.

drBob

Will That Be A Glass of White or Red with Dinner?

And now, for something completely different - here's a good study on the relative effects on tooth enamel of white wine versus red wine. Given that I much prefer reds to whites, I was happy to see this German study found white wines much more likely to damage tooth enamel than reds and lead to more staining of teeth by caffeine,etc.

A simple solution was offered for those who still prefer white wine - eat cheese to counter the acidity problem and don't brush your teeth for 30 minutes after the meal and glass is finished.

Read the report here.

drBob

 

To Take THE Shot or Not?

Well has my writing helped you decide about taking the H1N1 vaccine or just  made you more confused. I have had some of the highest page views ever on the days I post about H1N1, from my readers and across the country. What will I ever write about after the H1N1 pandemic settles?? I'd appreciate your comments on other topics we should get back to.

So will you take THE shot or not? That is the question it seems on many people's minds.

Some issues to remember.

First and most important H1N1 can rapidly overwhelm the lungs and kill by respiratory failure. Anyone with asthma or chronic lung disease is at higher risk of a severe H1N1 infection. These people need to take H1N1 shots when available. They should never take nasal inhaled H1N1 vaccine.

Second children under 17 seem unusually susceptible to complications of the H1N1, likely because they have never been exposed to any similar flu virus. This group needs to consider the immunization. H1N1 infection seem to spread easily in schools, far easier than I have seen it spread in families.

Third, anyone with a compromised immune system from chemotherapy or autoimmune disease should consider the benefits of protection from H1N1 with a shot versus the risks of getting the actual infection with a weakened immune system.

Fourth, pregnant women seem to be at high risk for a severe H1N1 infection. In this area one pregnant woman has died of H1N1.

Fifth, half of all hospitalized people with H1N1 complications have been very healthy prior to the infection. One in four  adults hospitalized with H1N1 were put in the ICU immediately.

So just staying healthy is no guarantee against a severe H1N1 infection.

drBob

A New Service for Veterans in Liberal

Ed Poley has started a new center in Liberal for veterans, their families and first responders. He is a veteran himself and was Director of our SouthWestern Technical School until recently when he retired and took on a new career and a new challenge.

He has opened an office called The Whirlwind Center to serve veterans and families with counseling and career guidance. Too many of our veterans come home suffering with PTSD (post-traumatic stress syndrome) which can ruin their lives here if they do not get help. The help for PTSD through the VA is a long way from Liberal which is part of the reason Ed decided he would open a center to offer local help. He is doing this on his own and I commend him for it. He has raised money to open the office and is seeing people now to begin helping them get back into society.

From his own proposal to start this center I quote:
"In order to entice these young people to seek assistance,we first must create a relaxed atmosphere where they truly believe they will be listened to and believed. Second, the individual working with the clients must be someone to whom they can relate, someone who has "walked in their boots".

I can tell you Ed has walked in their boots and has many skills to make this a success in Liberal. My hat is off to Ed Poley and please support his efforts and use his services if needed. You may not need his help directly but tell your friends and help Ed make this a model clinic for veterans that might spread far beyond Liberal.

His office is at 130 Pancake Blvd in Liberal. Phone 620-624-7684 Cell 620-482-3431  email ed.poley@yahoo.com

drBob

Who Gets Hospitalized with H1N1 Infections?

A major report on the prior health of hospitalized H1N1 patients this week showed that 46% of the hospitalized adults in the study did not have any major prior health problem, such as lung disease or asthma. In other words, just staying healthy and disease-free does not guarantee that an H1N1 infection may not lead to you being hospitalized.

Of the 1400 adults in the study, 34% did have asthma or other lung disease and 6% were pregnant.

The study of the hospitalized children was not completed. Read the article reporting on this study here.

Coupled with the WHO report last week that I posted here showing only mild side effects in 4 people out of 39,000 injected with the H1N1 vaccine, I recommend you seriously consider having the H1N1 vaccine shot when available. The first groups targeted to received the vaccine are children under 5, health-care workers, pregnant moms, and children under 17. Then other groups of adults will be encouraged to get the shot.

drBob

Have You Heard About Neem?

My wife and I have been using Neem as a supplement for some weeks and I want you to know about this natural product with many uses. The oil from the leaves of the Neem tree in India are used to produce many different forms of Neem. We have tried it in capsules, shampoo, soap, body lotion, toothpaste, mouthwash and oil for our skin and been very pleased with its effects.

Neem is a natural anti-bacterial, anti-fungal, anti-viral and anti-protozoal agent. It also helps stabilize blood sugar and may be helpful for diabetics and people with low blood sugar problems. The first patient of ours who took Neem capsules for her low blood sugar reported it quickly stopped her attacks of low sugar and also controlled her cravings for sugar. She has lost some weight as a result.

It has also been used on eczema, psoriasis, mild burns and acne. It may help recurrent bladder infections. It is considered safe for regular use except in pregnancy. Studies in India show that it improves immune strength by its effects on lymphocytes. Neem has been a traditional part of Ayurvedic medicine for 4000 years.

Here is the Wikipedia article on Neem.

We are now keeping this product in our office and also have some samples.

drBob

A Child Dies of H1N1

Here's what one little child had to go through when the swine flu overwhelmed her lungs. This is a risk in young children and a major reason why H1N1 shots are recommended for children. As I have written before, the nasal H1N1 vaccine has some limitations and should never be given to anyone with an asthma or lung disease history. Read this article posted on MSNBC.com. The vaccine shot does not have this limitation.

This lung problem can also occur in adults and pregnant women if they get an H1N1 infection. Because testing for flu is totally unreliable at present I am no longer relying on the nasal test to detect flu. But many doctors still do this and accept the negative result as proof the patient does not have H1N1 infection. If you have the symptoms of H1N1 but are told you are not infected on the basis of a negative nasal swab test, I'd get another opinion.

Although the majority of people I see with H1N1 infections still have mild infections and respond quickly to Tamiflu, the infection can last 7-9 days without treatment, which is an unacceptable loss of income to anyone in this economic climate.

76 children have died of H1N1 this year, some with no pre-existing medical problems. Pregnant women are also dying along with their unborn child.

The highest risk groups are pregnant moms (because their immune systems are depressed by pregnancy), children under 5, children under 17 in that order.

And to give you some local numbers, in the first week of October of all the patients I saw in the office, 10 percent had H1N1.

drBob