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.

help insomnia

Weighted Blankets May Help with Insomnia

Our concierge doctors note the stress resulting from the coronavirus pandemic affects large portions of our population. This has manifested in many ways, including a sharp increase in insomnia.

Even without the pandemic, the National Institutes of Health (NIH) estimates that between 30 and 40 percent of the population experiences insomnia regularly. A 2005 National Sleep Foundation (NSF) poll showed more than half of respondents reported experiencing insomnia at least a few nights a week in the past year. Thirty-three percent said they had insomnia every night or nearly every night for the past year.

And since the advent of the pandemic, prescriptions for sleep medications are up 15 percent, according to pharmacy benefit manager Express Scripts. The UCLA Sleep Disorders Center reports insomnia complaints have soared 20-30 percent.

An occasional sleepless night is not technically categorized as insomnia. It’s when it becomes a longer-term occurrence that it is officially called insomnia. Ironically, though, the occasional sleepless night can quickly turn into insomnia when the sufferer begins worrying that it will happen again. The worry feeds the arousal state in the brain, thus leading to night after night of wakefulness.

How to beat insomnia

You’ve probably heard the typical suggestions for how to help your insomnia:

  • Maintain a regular bedtime
  • Increase exercise
  • Turn off blue light-producing electronic devices (smartphone, computer, TV) at least one hour before bedtime
  • Don’t eat or drink alcohol within three hours of bedtime
  • Stop drinking caffeine no later than 2 p.m.
  • Avoid naps
  • Restrict the bedroom to sleep and sexual activity
  • Try to stay awake, instead of trying to fall asleep (known as paradoxical intention, which takes the pressure off trying to sleep)
  • Get up and leave the room if you haven’t fallen asleep within 20 minutes

These tips may work for those with occasional insomnia. If your difficulty is chronic or worrisome, talk to us. We can perform a physical examination to ensure your insomnia isn’t caused by a correctable physical condition, such as sleep apnea or thyroid problems.

We can also suggest other measures that have proven useful. Cognitive behavioral therapy, various relaxation and breathing techniques, light therapy to reset the body’s circadian clock, and even short-term medication, if necessary, can all help.

Weighted blankets seem to help

In addition to these suggestions, consider trying is a weighted blanket. They have been around for several years, and many users have given them rave reviews. They help you to fall asleep more easily, sleep more soundly and sleep longer.

Until now, however, such testimonials had little science to back them up. That was until a new study was published last month in the Journal of Clinical Sleep Medicine. It found those who slept with weighted blankets experienced better sleep. They also reported fewer symptoms associated with depression and anxiety during the day.

The 120 adult participants had all been clinically diagnosed with insomnia for at least two months. Also, each had been diagnosed with either major depressive disorder, bipolar disorder, generalized anxiety disorder (GAD), or ADHD. Half were given weighted blankets and half were given blankets that appeared the same as the weighted type.

After four weeks, those in the weighted-blanket group were almost 26 times more likely to have seen at least a 50 percent reduction in the severity of their insomnia. And they were nearly 20 times more likely to achieve full remission of their insomnia.

Researchers suggested that the results were due to the pressure the blanket applies to different parts of the body. This stimulates the sensation of touch similar to acupressure and massage.

“I was surprised by the large effect size on insomnia by the weighted blanket and pleased by the reduction of levels of both anxiety and depression.”

Lead researcher Dr. Mats Alder, consultant psychiatrist at the Karolinska Institute in Stockholm, Sweden, said in a statement.

Some cautions

If you’d like to try using a weighted blanket to help insomnia, be sure to purchase it at a place that allows for returns. Weighted blankets come in different weights, and weight preferences are highly individual. You may find you prefer a heavier or a lighter weight. Also be sure it’s washable. Opt for one without plastic beads, which could end up in the ocean.

Finally, if you have a tendency toward claustrophobia, you might not like the sensation of feeling trapped under a heavy object, so proceed with caution. You can try to simulate the effect of a weighted blanket by folding a large quilt in half and sleeping under that for a few nights. If you have no problem with that, then you may want to purchase a commercial weighted blanket.

In addition, never put a weighted blanket on a child under the age of three or one weighing less than 50 pounds, because there’s a danger of suffocation.

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.

e. coli

Take Care with Leafy Greens

Our concierge doctors absolutely recommend a diet high in vegetables, especially leafy greens, for optimal health. But a new study released this month highlights a problem with this otherwise beneficial food: E. coli.

The report, published in the journal Emerging Infectious Diseases, found leafy greens are a common source of food-borne illnesses. It notes that they’ve been implicated in 40 outbreaks of a serious strain of E. coli between 2009 and 2018. These outbreaks resulted in 1,212 illnesses, 420 hospitalizations, and eight deaths.

Products to look out for

As you might suspect from the frequent reports in the news, romaine lettuce was involved most often. In of the outbreaks related to leafy greens studied for E. coli contamination, romaine lettuce was responsible for 54 percent of cases. Spinach and iceberg lettuce caused 17 percent each. Kale, cabbage, and green leaf lettuce were linked for four percent of the outbreaks.

The study also found outbreaks linked to mixed greens. This included three romaine and iceberg mixes, a butter lettuce and radicchio mix, and a spinach and spring mix.

Researchers were uncertain why romaine lettuce was so often involved in E. coli contamination. They speculated the green’s growing popularity over the study period accounted for some of the increase. Also the shape of the leaf itself contributed to contamination. Because romaine’s crinkled leaves grow in an elongated rosette shape, it’s difficult to wash it sufficiently to remove all of the surface contamination.

What’s causing the bacteria growth

Agricultural practices in this country have also been implicated in contamination outbreaks in leafy greens, but especially romaine lettuce.

Nearly all romaine lettuce grown in the U.S. originates from two main areas: the Salinas Valley in California and the Imperial and Coachella valleys in Southern California and around Yuma, Arizona.

E. coli is common in animals, including goats, deer, feral pigs, and especially cattle. One recent widespread outbreak in 2018 was attributed to contamination of surface water possibly used to irrigate and harvest the crop (with high-pressure water knives, which are used to cut the vegetables, as opposed by slicing them from the roots by hand).

Perhaps not surprisingly, many of the outbreaks have occurred within weeks of the time when nearby farming operations fertilize their fields.

“We know from earlier outbreaks that a little bit of contamination in the field can lead to cross-contamination,” Benjamin Chapman, a professor and food safety specialist at North Carolina State University, told NBC News. Chapman was not involved in the current study.

Once the plant is contaminated, it’s “very difficult to remove,” he explained. Even though produce is triple-washed in processing plants and once at home, the consumer maybe be able to rinse off 90 to 99 percent of what remains. That may not be enough to ensure complete safety, he added.

Symptoms of an infection

Symptoms of E. coli bacterial infection include stomach pain or non-bloody diarrhea that worsens over several days. It can take up to 10 days to begin feeling symptoms after consuming affected food. This makes outbreaks so difficult to track down.

An E. coli infection is normally self-limiting, meaning the body fights it off with no complications other than feeling fairly miserable for a few days. But it can also lead to more severe complications, especially for infants and children under five, older adults, and those with compromised immune systems.

Reducing the risk

As we said earlier, we still encourage consumption of leafy greens. They’re an excellent source of fiber, vitamins, minerals, and phytonutrients. They’ve also been linked to a reduced risk of heart disease, some cancers, macular degeneration and type 2 diabetes.

So how can you keep your family safe? First, always assume leafy greens are contaminated, and rinse them thoroughly if you plan to eat them raw.

The Center for Disease Control and Prevention (CDC) provides the following advice to minimize the chances of contamination.

Check to see if your prepackaged leafy greens are labeled “ready to eat,” “triple washed” or “no washing necessary.” These leafy greens do not need to be washed again. Thoroughly wash all other leafy greens before eating, cutting or cooking.

Consumers should follow these simple steps:

  • Wash your hands for 20 seconds with soap and water before preparing leafy greens.
  • Discard outer leaves and any torn or bruised ones.
  • Rinse the leafy greens under running water and use your hands to gently rub the surface of the leaves.
  • Don’t soak leafy greens in a sink filled with water. They can become contaminated with germs in the sink.
  • Don’t soak leafy greens in a bowl filled with water, which can spread contamination through the water to other leaves.
  • Dry leafy greens with a clean cloth or paper towel.
  • Do not wash vegetables with soap, detergent, or produce washes.
  • Do not use bleach solution or other disinfectants to wash produce.

If you think you have become ill from eating contaminated foods, be sure to talk to us. While food poisoning may result in nothing more than a few days of misery, it can also be dangerous. We can advise you on the best ways to recover.

hurricane season

Preparing for Hurricane Season in the Age of COVID-19

Hurricane season in the Atlantic typically runs from the first of June to the end of November, but this year, for the fourth time in as many years, we’ve already seen our first named tropical storm in May. The National Oceanic and Atmospheric Administration (NOAA), along with other forecasters, predict that the 2020 hurricane season will be more active than normal but even so, it turns out that there is no correlation between the number of storms in a season and how often they make landfall.

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coronavirus covid19

How Viruses Work and How to Stop COVID-19

Our concierge doctors thought this would be a good time to tell you about viruses in general, especially the novel coronavirus known as SARS-CoV-2, aka COVID-19. SARS-CoV-2 is the name of the virus; COVID-19 is the disease it produces. This nomenclature is similar to the human immunodeficiency virus (HIV) and its resulting disease, acquired immune deficiency syndrome (AIDS).

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