flu shot twindemic

Flu Shots Can Help Avert a ‘Twindemic’

The U.S. Centers for Disease Control and Prevention (CDC) recommends all adults and children older than six months receive a flu shot by the end of this month. The CDC says it takes at least two weeks for the vaccine to become effective. Then it won’t reach its peak effectiveness until another week after that. And children who are being vaccinated for the first time need two vaccines spaced a month apart to become fully protected.

Therefore, our concierge doctors suggest you get your flu shot for the 2020-21 influenza season as soon as possible. While there have been scattered reports of shortages around the country, The Washington Post recently reported a record number of flu vaccine doses—between 194 million and 198 million—have been ordered. Because the vaccine is shipped in stages, more is on the way.

“This year I think everyone is wanting to get their vaccine and maybe wanting it earlier than usual. If you’re not able to get your vaccination now, don’t get frustrated. Just keep trying.”

The CDC’s Dr. Daniel Jernigan, to the Associated Press (AP).

COVID-19 and flu overlap: a ‘twindemic’

We were fortunate the 2019-20 flu season was winding down this spring as the coronavirus crisis began to hit the country. This year, however, we’ll be looking at the possibility of a “twindemic”—both waves hitting at once.

So it’s especially important that as many people as possible get vaccinated for the flu this year. The flu shot won’t prevent COVID-19, but it can help reduce the strain on our already overburdened health care system.

“Since hospitals and doctors’ offices are going to be very busy caring for COVID-19 patients, a flu vaccine can help decrease burdens on the health care system and make sure that those who need medical care are able to get it.”

Dr. Susan Bailey, president of the American Medical Association (AMA) and an immunologist in Fort Worth, Texas, told CNN.

Last year, the CDC estimated that the flu killed 22,000 Americans, and resulted in hospitalization of an additional 400,000. By contrast, at least 215,000 Americans have died of COVID-19 since March.

Hopeful signs

Health experts are hopeful the precautions we’ve been taking to avert COVID-19—hand washing, social distancing, and wearing masks—will mean this season’s flu won’t take as severe a toll as in previous years. But they all insist that widespread vaccinations are necessary.

Even if the flu vaccine isn’t 100 percent effective in preventing influenza, it has been shown to reduce the length and severity of the illness in those who contract it. In addition, if you’re unlucky enough to contract COVID-19, you won’t want your body’s defenses to be weakened by a prior bout with the flu.

This is already present in the Southern Hemisphere, where each season’s flu strikes over the summer. From South Africa to Australia, public health experts reported remarkably low levels of influenza among their populations. They attributed this partly to coronavirus lockdowns and to extremely high participation in influenza vaccinations.

One pharmacy in Cape Town, South Africa, for example, reported that the demand for flu shots was four times higher than in previous years. People were trying to avoid the co-morbidity (simultaneous presence of two or more diseases) of contracting the flu in addition to COVID-19.

“People were lined up outside the pharmacy down to the corner of the street waiting to get their injections. We had to prevent people from coming into the store.”

Ellis Henen, owner of Sunset Pharmacy, told The Post.

Additional benefits of the flu shot

We hope Americans will have the same attitude to this year’s flu shot.

Some people think they’re still protected from the one they received last year. But having received a flu shot last year won’t protect you from this season’s strains of the virus. This is because your immunity from a year ago has deteriorated by now. In addition, manufacturers create a new vaccine each year based on which strains the World Health Organization (WHO) expects to be predominate. This is based on which strains were seen over the summer in the Southern Hemisphere. So this year’s shot will include strains different from those in last year’s inoculation.

It’s important to remember, even if you contract influenza after receiving the shot, it’s likely to be less serious than if you’d skipped being inoculated. And the flu vaccine offers additional benefits, especially among the elderly. For older people and those with chronic health conditions, recent studies show the extra benefits of a flu shot. It’s as effective in preventing a heart attack as quitting smoking, using cholesterol-lowering drugs, or taking blood pressure medications.

So be sure to let us know if you’re interested in getting a flu shot. If you encounter a shortage, we may be able to help you locate a supply nearby.

overcome chronic conditions

Healthy Habits Can Conquer Chronic Medical Conditions

We’ve heard a great deal lately about how those with chronic conditions—diabetes, high blood pressure, and obesity—are more likely to become sicker when exposed to the SARS-CoV-2 virus that causes COVID-19. Even leaving aside the coronavirus, many individuals have thought that having multiple chronic medical conditions such as those or others (cancer, asthma, coronary artery disease, and so forth) doomed them to a premature death.

But our concierge doctors have recently come across some good news for those people. It turns out that healthy lifestyle habits can overcome multiple types of chronic conditions and help extend your life.

Lifestyle impacts on chronic conditions

A new study reported last month in the journal PLOS One followed nearly 481,000 middle-aged adults in the U.K. for up to nine years. Of those, 93,746 had two or more chronic medical illnesses (known as multimorbidity) such as those mentioned above.

The researchers focused on four lifestyle factors: smoking, diet, physical activity, and alcohol consumption. They then weighted each of these factors (some healthy foods vs. a great deal, moderate physical activity vs. a great deal vs. none, and so forth) and broke them into four categories:

  • healthy
  • very healthy
  • unhealthy
  • very unhealthy

Then they assigned each study participant to a category.

Their results show that those who practiced the healthiest habits lived longer than those who did not, regardless of their current medical challenges.

In particular, men with a very healthy lifestyle were found on average to live 6.3 years longer than those with a very unhealthy lifestyle, while women in these same categories were found to live an average 7.6 years longer.

Even those in the third category, unhealthy, saw some benefit over those with a “very unhealthy” lifestyle.

Healthiest habits

Not smoking had the largest impact on life expectancy, according to the researchers. Smokers at age 45 were found to live five to six years less than non-smokers, regardless of other disease complications. Because the screening question asked only if participants were current smokers, it is fair to assume that the large study cohort included many former smokers. This proves quitting smoking at any age does confer health advantages.

Regular physical exercise also showed a significant benefit. Those who engaged in some type of regular physical activity lived longer than those who did not. Even if the exercisers had serious medical conditions. Researchers defined regular physical activity as that which met the global health recommendations: 150 minutes a week of moderate physical activity or 75 minutes of weekly vigorous activity.

Men who engaged in regular physical exercise gained an additional 2.5 years of life on average. The benefit for women was slightly lower; they gained 1.9 additional years of life.

Surprisingly, a healthy diet– defined as consuming at least five different fruits and vegetables daily– and moderate or no alcohol intake demonstrated little benefit in increasing life expectancy.

Never too late

We hope our patients find these results encouraging. They show that—even with multiple chronic illnesses—you can not only influence your life expectancy with healthier habits. And they show you can improve your quality of life by following standard guidance for a healthy lifestyle.

These include:

1. Diet

Avoid processed foods, and consume a diet high in seafood and fresh produce. Include fruits and vegetables, nuts, olive oil, and beans. and low in red meat, dairy, sugar, salt, and saturated fat.

2. Exercise

A daily minimum of a half-hour of any kind of mild-to-moderate exercise is crucial to overall health. If necessary, it can be broken into 10-minute increments throughout the day. Even a daily brisk walk will help.

But for optimal health, we recommend any kind of regular, vigorous movement. Try to add up to 150 minutes (2 ½ hours) per week.

3. Stress relief

When your body thinks it is constantly under attack, studies have shown such chronic stress puts you at greater risk for serious health problems, including cardiovascular disease, cancer, digestive disorders, impaired memory and concentration, anxiety, and depression.Reducing stress is crucial to maintaining good health, so:

  • take time for hobbies
  • practice relaxation techniques
  • exercise regularly
  • eat a healthy diet
  • stay in touch with friends

At the same time, avoid unhealthy stress relievers like smoking, excess alcohol consumption, and illicit drug intake. These practices merely mask stress triggers temporarily. They can cause damage to the body, as well as to your mental health, in the long run.

cholesterol

What You Should Know About Cholesterol

Since September is National Cholesterol Education Month, our concierge doctors want to review the often-confusing facts about this vital blood component.

What is cholesterol?

Cholesterol is a type of waxy, fat-like substance found in every cell in your body. Made by your liver and also present in some foods, it allows your cells to function properly. It helps synthesize Vitamin D in the body as well as some necessary hormones. These include cortisol and cortisone, and the sex hormones estrogen, testosterone and progesterone, among others. It also helps create the bile you need for digestion.

Cholesterol gets transported through the body on proteins called “lipoproteins.” There are two types of lipoproteins: high-density lipoproteins (HDL) and low-density lipoproteins (LDL). The LDL type makes up most of the cholesterol in the body (between two-thirds to three-quarters). The HDL type absorbs excess LDL cholesterol and returns it to the liver, where it gets flushed from the body.

Why is high cholesterol bad for you?

Despite the role cholesterol plays in keeping the body healthy, only a small amount is needed to maintain critical functions. When your body has too much of the LDL-type of cholesterol, it can build up on the walls of your blood vessels. This causes them to become narrow. This in turn begins to block the free flow of blood to and from your heart and other organs in the body. When blood flow to the heart is blocked, it can cause chest pain (angina), a heart attack or a stroke, among other cardiovascular problems. Therefore, too much LDL is “bad” for your body when it isn’t balanced by higher HDL levels.

The confusion surrounding “high” and “low” cholesterol no doubt arises from their names. If we say your cholesterol levels are too high, you might think, “But isn’t ‘high’ cholesterol the good kind?” High-density lipoproteins (HDL) are good, and the higher that number, the better. But when we say you have “high” cholesterol, we’re talking about the “bad” type, meaning the low-density lipoproteins.

To confuse matters even more, triglycerides that are too high further contribute to fatty buildup in the arteries. Triglycerides are the most common type of fat in the body. High levels of triglycerides combine with high levels of LDLs to raise the risk of cardiovascular disease even further.

How to lower bad cholesterol

The optimal mix is low triglycerides, low LDL levels and high HDL levels in the blood.

According to the National Heart, Lung, and Blood Institute (NHLBI), the leading cause of high LDL cholesterol and triglycerides are unhealthy lifestyle choices. Certain medical conditions and medications, as well as genetics, also play a role.

There are a number of LDL lowering drugs available, including the very successful statins. But, as always, it is preferable to try to lower LDL levels naturally first. There are a number of ways to go about this:

  • lose weight
  • avoid trans fats (most commonly found in fried foods and pastries as well as margarine)
  • avoid red meat and dairy products
  • cut sugar consumption
  • keep alcohol consumption no greater than one drink daily
  • keep stress levels low

These steps, combined with increasing HDL levels in the blood, are often sufficient for many people to remain healthy.

How to raise good cholesterol

Medications to raise HDL cholesterol have not proved effective in lowering the risk of heart attacks and strokes. The best way to increase your supply is through lifestyle changes:

  • quit smoking
  • increase aerobic exercise to a total of at least one hour a week
  • consume more monounsaturated fats, e.g., nuts, seeds, avocados
  • increase intake of polyunsaturated fats, e.g., salmon, tuna, trout, and walnuts
  • consume more soluble fiber, e.g., fruits, vegetables, whole grains, beans, and legumes

In addition, avoid drugs that contain testosterone or other anabolic steroids, which have been shown to lower HDL levels.

Because there are no symptoms of high cholesterol, the only way to know for sure if your levels are within acceptable levels is through a simple blood test. This is especially important if you have a family history of heart disease, are a smoker, are regularly exposed to cigarette smoke or have high blood pressure or diabetes. The National Institutes of Health recommends that all adults have their cholesterol levels checked beginning at age 20.

It’s not difficult to keep “bad” cholesterol levels in check, unless you have a genetic predisposition toward high LDLs. Let us help you sort out the confusion surrounding cholesterol and heart health.

proper breathing

Proper Breathing Can Improve Your Life and Help with COVID-19

Most adults breathe incorrectly, especially when they are experiencing stress, whether acute or chronic. The effects of improper breathing may surprise you: increased stress, insomnia, weight gain, high blood pressure, anxiety, a weakened immune system, and fatigue, among others.

In addition, although the novel coronavirus attacks every part of the body from the brain to the toes, it typically first makes its presence known with difficulty breathing. And those who experience lingering effects from its infection also complain of long-term breathing problems.

So our concierge doctors thought we’d offer a primer on correct breathing. Not only will this improve many aspects of your life, but it will also help strengthen your lungs before you contract the virus and assist in recovery afterward. It can also help relieve the anxiety so many of us are experiencing now during the pandemic.

Retrain your breathing habit

Babies breathe right naturally, but by the time we’re adults, we’ve been trained out of it. Between tight clothing, Spanx, or belts and constant admonitions to “suck in that belly,” shallow breathing becomes an unfortunate habit as we grow older.

Add to that the tendency to breathe quickly from the top of our lungs whenever we’re stressed, and you have a recipe for a cycle of more chest breathing. This creates more stress, leads to more chest breathing, more anxiety and so on.

Poor breathing habits disrupt the balance of oxygen and carbon dioxide in the blood. This tricks the body into thinking it’s constantly under attack: the so-called “fight or flight” mode.

Other symptoms of bad breathing can include:

  • frequent sighing or yawning
  • repeated throat clearing
  • lack of concentration
  • fatigue bordering on exhaustion
  • chest tightness
  • tingling in hands, lips, or feet
  • insomnia and disturbed sleep, including nightmares
  • cold hands and/or feet due to poor blood circulation
  • shortness of breath
  • headaches
  • panic attacks

If you are experiencing any of the above symptoms, be sure to let us know. They could signal a serious issue, but it’s possible they’re due simply to bad breathing.

Conversely, breathing from the abdomen, like we do as babies, can:

  • strengthen lungs
  • improve sleep
  • lower blood pressure
  • increase energy
  • aid weight loss
  • lower stress
  • improve digestion
  • improve symptoms of chronic obstructive pulmonary disorder (COPD)
  • strengthen the immune system

Are you breathing correctly?

To see whether you’re breathing correctly, place one hand on your chest and the other on your abdomen. Now take a deep breath. If you’re doing it right, the hand on your belly will rise, while the hand on your chest will barely move.

If you’re breathing incorrectly, the above exercise practiced three times daily will help to retrain your breathing. In addition, you can do it in the car, while waiting in line, watching TV, surfing the Internet, and—especially—at night in bed to help you fall asleep.

Be sure to always breathe in through your nose. Breathing from the mouth tends to encourage shallow breathing. In addition, breathing through your nose allows the cilia in your nasal passages to do their job. They protect you from invading viruses and bacteria.

Pre- and post-coronavirus exercises

If you should contract COVID-19, breath training can help boost the power of your lungs to fight off the illness. Many of those who have been infected find themselves struggling to relieve the congestion that settles in the lower part of this lungs with this disease.

Once you’re comfortable with belly breathing, practice the 4-7-8 technique three times daily for at least two minutes: Inhale (through the nose) to the count of four, hold it to the count of seven, and exhale (through the mouth) to the count of eight. If your lungs are so out of shape that these counts are difficult, lower them at first until you can work your way up to the 4-7-8 sequence.

As you learn to breathe correctly, you should find yourself with more energy during the day and more restful sleep at night.

And if you have contracted coronavirus, the following exercise has been touted by numerous survivors of COVID-19, including TV broadcaster Chris Cuomo and author J.K. Rowling. Developed by a British doctor, Sarfaraz Munshi of Queen’s Hospital in London, they can help the lower part of the lungs to expand and expel mucus. It’s a 5-5-5 twist on the 4-7-8 technique, followed by a strong cough at the end.

Munshi recommends beginning this exercise as early in the infection as possible and performing it five times daily.

Breath in for five seconds, hold for five seconds, then release for five seconds. Do this five times, then once more and cough strongly at the end of the release. Repeat this cycle twice.

The deep breathing followed by a cough helps release the mucus trapped in the lower lungs, a typical complaint of those who have COVID-19.

Finally, lie on your stomach taking slightly deeper breaths than normal for ten minutes. This position, called “proning,” has been used successfully in many hospitals to help coronavirus patients improve lung drainage and breathe more easily.

If you have any questions about proper breathing or COVID-19 recovery, please let us know.

Is a Clean Home Dangerous to Your Health?

You try to keep your family healthy in every way you can, including ensuring that the environment in your home is as clean as possible. But our concierge family practice doctors at MD 2.0 in Jupiter want to caution you that the cleaning products you may be using come with a host of possible dangers to your health and that of your family.

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