Posted in Health, news

To Avoid Getting Cheated in Rent and Salary, February Should be 31 Days!

Image above from Reader’s Digest Canada

Each month we pay our rent, mortgage, or car payment for our use each month. It’s the same cost in December as it is in January.  But February is only 28 days long. And is the price for three lost days deducted or reimbursed?  No.

And for those of us who get paid biweekly, there is no increase in pay. So essentially we get cheated when we pay our bills every February.

 

8281499_orig.jpg

 

Why is February the shortest month?

February has 28 days, except for leap years which occur every 4 years giving it 29 days.

In Roman times, the calendar used to be 10 months long and our current months of January and February didn’t exist. The year would run from March to December (Decem, Latin for ten), possibly because harvest months were worthy of mention.   But according to folklore, Roman king Numa Pompilius (713 BC) wanted to align the calendar with the lunar year, so tacked on two more months before March.  Supposedly these two months had 28 days, which brought the Roman Calendar to 355 days.

However, Numa was superstitious and even numbers were considered taboo.  Supposedly he did not want any months to have even days so all of them had either 29 or 31 days.  Yet in order to have the whole year winding up an odd number, one month had to have an even number of days, so kept Februarius at 28 days and since “unlucky,” the shortest month.

According to MentalFloss.com:

Numa’s calendar ended up looking like this:

Martius: 31 days
Aprilius: 29 days
Maius: 31 days
Iunius: 29 days
Quintilis: 31 days
Sextilis: 29 days
September: 29 days
October: 31 days
November: 29 days
December: 29 days
Ianuarius: 29 days
Februarius: 28 days

Historically it appears the number of days in February fluctuated over the next few centuries, until Julius Caesar decided to add days to the year to make it closer to the 365 solar calendar and align better with the seasons.

He was instructed by his astronomers however to add a leap day to account for the discrepancy between the lunar and solar calendars, hence is the father of the “Leap Year.”

But issues still arose and Pope Gregory XIII needed to adjust the Julian calendar as he created the Gregorian calendar.

Wired.com reports the following:

Though the Julian Calendar was more accurate than what preceded it, it wasn’t really as accurate as it needed to be. That’s because an Earth year is about 11 minutes short of 365¼ days: It’s 365 days, 5 hours, 48 minutes, 46 seconds. This was known, more or less, since the second century A.D., but by 1582, the calendar was 10 days out of whack, and Easter was falling too late in the real spring. So Pope Gregory XIII tweaked the Julian Calendar by subtracting three leap years in every 400 (years ending in 00, unless they are divisible by 400).

 

But the numbers that really don’t add up is why we pay for a 31 day month, and only get 28 days? The moral:  banks benefit the most from our shortest month and it’s up to us if we want to wait for the next Roman Empire, or Pope, to change it.

 

 

IMG_1781

The Baby Boomer’s Guide to Online Dating

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

 

 

Posted in flu, Health, news

CDC Reports More Severe Wave of Flu to Come

This season’s primary strain of H1N1 is becoming overshadowed by new H3N2 cases according to health officials.

The H3N2 strain is more deadly and was responsible for last year’s epidemic that claimed 80,000 lives.

For the week ending Feb. 16, 2019, the CDC reports the following:

The percentage of respiratory specimens testing positive for influenza viruses in clinical laboratories increased. While influenza A(H1N1)pdm09 viruses predominated in most areas of the country, influenza A(H3) viruses have predominated in HHS Region 4 and accounted for 47% of subtyped influenza A viruses detected nationally during week 7. During the most recent three weeks, influenza A(H3) viruses were reported more frequently than influenza A(H1N1)pdm09 viruses in HHS Regions 6 and 7 and influenza A(H1N1)pdm09 and influenza A(H3) viruses were reported in approximately equal numbers in HHS Region 2.

WebMd reports:

“It looks like we are moving from an H1 wave to an H3 wave,” said Lynnette Brammer, lead of CDC’s domestic influenza surveillance team. “There’s still a lot of flu to come.”

Fortunately the strains show susceptibility to antiviral medications such as oseltamivir and peramivir.

WHOPHL07_small.gif

It’s not uncommon for various strains of flu to case illness during a single flu season.

Last week, the CDC reported a mid-season efficacy rate of 47% for this year’s flu shot, up from 36% estimated efficacy last year. However this may change in light of these new reports.

In a good year flu shot efficacy may be 65%.  It’s difficult to reach higher numbers as viral flu strains mutate easily and immune systems of the general public are so varied.  Per the CDC the flu shot during the 2010-2011 flu season was one of the most effective.

 

vaccine-effectiveness_v3

This year the predominant flu strain was H1N1, in contrast to the more wily H3N2 which evaded being a sharp match for last year’s flu vaccine. However, now that H3N2 is making the rounds, we could see a drop in our flu vaccine efficacy.

They report the following:

Interim estimates of vaccine effectiveness based on data collected during November 23, 2018–February 2, 2019, indicate that, overall, the influenza vaccine has been 47% (95% confidence interval = 34%–57%) effective in preventing medically attended acute respiratory virus infection across all age groups and specifically was 46% (30%–58%) effective in preventing medical visits associated with influenza A(H1N1)pdm09 (6).

It is not too late to get the flu shot and medical providers are still recommending vaccination.

According to the CDC “preliminary cumulative in-season prevalence estimates indicate that influenza has caused 155,000–186,000 hospitalizations and 9,600–15,900 deaths.”

To date, 28 children have died this year from flu related illness.

Flu season peak is still occuring as winter appears to more severe this year, hence numbers can rise.

 

The Flu – Your Questions Answered

__________________________________________________________

When does flu season begin and how long does it last?

Flu season has begun already. It typically starts in the Fall, and ends late Spring.  So the range is described as October to May with it peaking December to March.

How bad will this flu season be?

It is difficult to predict, but already this early in the season we’ve had multiple flu related deaths reported by the CDC’s Flu View.

What is the flu?  How can one die from it?

The flu is caused by a virus. Multiple strains of virus’ can cause the flu.  The virus itself can be lethal, however the greatest risk comes with what it does to your immune system, thereby putting one at risk of secondary infections.  Pneumonia is the number one cause of flu-related deaths.  Secondly, it can exacerbate existing conditions such as asthma, seizures, even promote preterm birth, hence those who are pregnant or have preexisting medical conditions are urged to get vaccinated against the flu.  Moreover those who qualify should get the pneumonia vaccine as well.

 

h1n1-swine-flu-virus
h1n1 virus

 

What does this year’s flu vaccine cover?

According to the CDC, the trivalent vaccine covers for these three strains of flu virus:

  • A/Michigan/45/2015 (H1N1)pdm09–like virus
  • A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus
  • B/Colorado/06/2017–like virus (Victoria lineage)

Quadrivalent influenza vaccines will contain these three viruses and an additional influenza B vaccine virus, a B/Phuket/3073/2013–like virus (Yamagata lineage).

These vaccines are aimed at providing protection against the Swine flu, and some influenza A and B strains.

What about older individuals?

This year, those over 65 will have three options for their flu vaccine.

Fluzone High-Dose – a higher dose flu vaccine that will hopefully allow their immunity to protect against the flu longer

FLUAD – the trivalent flu vaccine with an adjuvant to stimulate more of an immune response.

Flublock Quadrivalent – provides protection against 4 strains.

What about the nasal spray vaccine?

This year, the CDC allows use of the nasal spray vaccine as it has shown to have improved efficacy from  prior years. However it is only recommended for  those who are between the ages of 2 and 49 and cannot be given to those who are pregnancy or who have compromising medical conditions as outlined by the CDC.

Who should get the flu shot?

All individuals 6 months old and older unless specified by their medical provider.

What if I’m allergic to eggs?

Most individuals allergic to eggs can still get the flu vaccine, but if the allergy to eggs is severe (anaphylaxis, angioedema, difficulty breathing), the CDC recommends notifying your medical provider and being in a facility to monitor you if you do get the flu vaccine.

Will I get the flu from the flu shot?

No.  The flu vaccine has a “killed” version of the virus meaning it’s not an active virus (as opposed to a live attenuated vaccine, a weakened down version of it).   A “killed” or “inactivated” vaccine merely has the pathogen particles to induce an immune response.  Additionally, when one states they got the flu despite the flu shot it could be that the flu shot only protects against 3 – 4 strains and they were infected with a more rare strain not covered by the vaccine.

How effective is the flu vaccine?

The average effectiveness each year hovers around 60%.  Last year’s efficacy was much lower and this year’s has not been predicted as of yet. Australia is still reporting active cases on their Department of Health website.

I feel sick after the flu shot, why?

For some, the immune response that ensues can make one feel mildly ill, but should not resemble the flu. Those who state they got the flu “immediately” after receiving the shot, might have already been exposed and had not had a chance to produce immunity prior to their exposure.

sneezing

 

What are symptoms of the flu? How is it different from a cold?

A cold comes on slower and less severe.  Flu symptoms are more abrupt and can include:

  • Fever
  • Body Aches
  • Cough
  • Sneezing
  • Sore Throat
  • Shortness of Breath
  • Fatigue
  • Headache
  • Nausea
  • Vomiting

Are there medications to treat the flu? Will antibiotics work?

There are antiviral medications available, such as Tamiflu, to treat the flu.  Antibiotics, however, will not work since the flu is not caused by a bacteria but rather a virus. However if a secondary bacterial infection takes over, antibiotics may be used.

How can I prevent getting the flu?

Besides vaccination, avoid being around those who are sick, thorough hand washing, and take good care of yourself.  A balanced diet, exercise and sleep regimen can help boost your immune system.

 

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The Baby Boomer’s Guide to Online Dating

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

Posted in economy, Health, news, taxes

Medical Tax Deductions You Never Thought You Could Use

It’s tax season and most of us are hoping to shave a few bucks off our tax bill.  Well many are not aware of the deductions that are available when it comes to medical expenses.

If you spent over 7.5% of your adjusted gross income on unreimbursed medical expenses during 2018, you may be able to deduct what you spent over this 7.5%, according to the IRS.

So, for example, if you make $100,000 a year, 7.5% would equal $7,500.  So lets say you spent $10,000 on medical expenses, subtract the 7.5 % ($7,500) from $10,000, and the remaining $2,500 is tax-deductible.

But the expenses made can also include those of your spouse, children and dependents. Combined, these could qualify you for descent deductions.

Publication 502 breaks down what services or items you purchased in 2018 that are tax-deductible and which are not.  Here’s a brief summary:

Tax Deductible Items:

  • Abortion (legal)
  • Acupuncture
  • Alcohol and Drug Treatment
  • Ambulance Service
  • Annual physicals
  • Artificial Limbs
  • Artificial Teeth/Dentures
  • Bandages – so supplies for wounds, burns, nose bleeds

 

wound_care_formulary_and_guideline.jpg

 

 

  • Birth Control Pills
  • Home Improvements
    • under the “Capital Expenses” section, the IRS states the following:
    • You can include in medical expenses amounts you pay for special equipment installed in a home, or for improvements, if their main purpose is medical care for you, your spouse, or your dependent. The cost of permanent improvements that increase the value of your property may be partly included as a medical expense. The cost of the improvement is reduced by the increase in the value of your property. The difference is a medical expense. If the value of your property isn’t increased by the improvement, the entire cost is included as a medical expense.

      Certain improvements made to accommodate a home to your disabled condition, or that of your spouse or your dependents who live with you, don’t usually increase the value of the home and the cost can be included in full as medical expenses. These improvements include, but aren’t limited to, the following items.

      • Constructing entrance or exit ramps for your home.

      • Widening doorways at entrances or exits to your home.

      • Widening or otherwise modifying hallways and interior doorways.

      • Installing railings, support bars, or other modifications to bathrooms.

      • Lowering or modifying kitchen cabinets and equipment.

      • Moving or modifying electrical outlets and fixtures.

      • Installing porch lifts and other forms of lifts (but elevators generally add value to the house).

      • Modifying fire alarms, smoke detectors, and other warning systems.

      • Modifying stairways.

      • Adding handrails or grab bars anywhere (whether or not in bathrooms).

      • Modifying hardware on doors.

      • Modifying areas in front of entrance and exit doorways.

      • Grading the ground to provide access to the residence.

  • Transportation (Uber, Taxi, Bus ride to medical office/lab/hospital)
  • Mileage (18 cents a mile for trips to medical office/lab/hospital)
  • Breast feeding/pump supplies
  • Medications that were prescribed by a provider
  • Hearing Aids
  • Insurance Premiums
  • Oxygen
  • Contact lens/glasses
  • Crutches
  • Service animal – and most of their expenses

 

dog costumw

 

  • Lodging and Meals when going to out-of-town medical facilities
  • Nursing home
  • Nursing expenses
  • Pregnancy tests
  • Wigs
  • Wheelchairs
  • Vasectomies
  • and the list goes on

 

Unfortunately the following cannot be written off:

  • Gym memberships
  • Cosmetic surgery (unless for reconstruction after cancer or trauma/disfigurement)
  • Dance lessons – despite using it for weight loss
  • Funeral expenses
  • Maternity clothes
  • Insurance premiums that were covered by the employer
  • Over the counter medications and supplements
  • Teeth whitening

 

shutterstock_small-whitening-300x214.png

 

So review the list and see what you can apply to your 2018 itemized deduction worksheet.  But make sure you have your receipts and logging of car mileage…. and start keeping track this year as well!

 

 

 

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The Baby Boomer’s Guide to Online Dating

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

 

Posted in Health, news, Sports

Lightsabering Is Now Officially A Sport

Image from Movies.com

Star Wars fans can now finally scream “It’s about time!!!!”

The French Fencing Federation has officially recognized dueling with lightsabers a sport.

Points are given based on where the light saber hits.  Rounds run 3 minutes and whoever scores the most points wins (or whomever hits 15 points first.)

The Associated Press reported the following:

Combatants fight inside a circle marked in tape on the floor. Strikes to the head or body are worth 5 points; to the arms or legs, 3 points; on hands, 1 point. The first to 15 points wins or, if they don’t get there quickly, the high scorer after 3 minutes. If both fighters reach 10 points, the bout enters “sudden death,” where the first to land a head- or body-blow wins, a rule to encourage enterprising fighters.
Blows only count if the fighters first point the tip of their saber behind them. That rule prevents the viper-like, tip-first quick forward strikes seen in fencing. Instead, the rule encourages swishier blows that are easier for audiences to see and enjoy, and which are more evocative of the duels in “Star Wars.” Of those, the battle between Obi-Wan and Darth Maul in “The Phantom Menace” that ends badly for the Sith despite his double-bladed lightsaber is particularly appreciated by aficionados for its swordplay.

Lightsabering embodies a variety of physical elements that utilize most muscle groups and requires balance. It qualifies as cardio, getting heart rate going, and the average participant finds it exhilarating.

Enticing young people to exercise may be made easier with this fun sport.  I’m a huge fan and hope this sticks!

Check out these guys…they’re fantastic!!!

 

 

 

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Learning Medical Spanish is Easy!!!

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

 

 

Posted in Health, news

Can’t Do 40 Push Ups? You May Be at Higher Heart Risk

A new study has found men who can do at least 40 push ups are in better shape from a cardiac standpoint than those who can’t do more than 10.

Researchers at Harvard T.H. Chan School of Public Health found testing one’s ability to do push ups could be an easy marker to assess cardiac health.

They followed 1100 middle-aged male firefighters over a 10 year period (2000-2010) and 37 cardiac incidents occurred during that time.  All but one of the cardiac events occurred in men who could only do 40 or less push ups at the beginning of the trial.  Each firefighter had an annual physical and completed medical questionnaires and the push ups were performed in a timed setting. The authors, after analysis, found those who  could do more than 40 push ups were at a 96% less cardiovascular risk than those who could barely do 10.

The study did not look at women and those of other age groups, but the correlation between physical endurance and cardiac health is again suggested.

On their website they report:

“Our findings provide evidence that pushup capacity could be an easy, no-cost method to help assess cardiovascular disease risk in almost any setting. Surprisingly, pushup capacity was more strongly associated with cardiovascular disease risk than the results of submaximal treadmill tests,” said first author Justin Yang, occupational medicine resident in the Department of Environmental Health at Harvard T.H. Chan School of Public Health.

 

What causes a heart attack?

A heart attack occurs when part of the heart muscle fails to receive the blood and oxygen it needs. This can occur by arteries supplying the heart muscle to become blocked. Coronary artery disease can be caused by plaque build up from fats, sugars, calcium, fibrin that settle on the blood vessel wall. These plaques can build up and occlude the lumen, obstructing blood flow.

Additionally a heart attack can occur when an unstable plaque rips off, tearing the blood vessel lining causing the body to form an immediate clot. This clot can also be deadly as it obstructs the lumen as well.

Heart disease, however, can be prevented……..

Firstly, we must know our risk factors. These include:

  • Family history of heart disease
  • Personal history of heart disease
  • High Blood Pressure
  • High Cholesterol
  • Diabetes
  • Smoking
  • Obesity
  • Inactivity
  • Males over 40
  • Females who are post menopausal
  • High stress
  • and even short stature has been cited as a potential risk factor.

As you can see, many of us can be at risk for heart disease.  Therefore secondly, we should be evaluated with an EKG, echocardiogram and any other exams our medical provider and/or cardiologist deem necessary.

Thirdly, reduce your risk by the following:

  • Maintain a normal blood pressure
  • Maintain normal blood sugar
  • Maintain normal cholesterol and lipid levels
  • Reduce stress
  • Maintain a balanced diet, rich in potassium-rich foods such as fruits and vegetables
  • Quit smoking
  • Stay active
  • Maintain a healthy weight.

 

 

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Learning Medical Spanish is Easy!!!

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

 

Posted in allergies, Health, news, weather

Allergy Season May Start Early This Year

Multiple states are bracing for “early” allergy seasons.

We still have a month left of winter yet grass is sprouting, leaves are growing and flowers are blooming.  Add just having a wetter winter and warmer-than-normal temperatures to the mix and this is the perfect recipe for an early allergy season.

Allergy season usually begins with the start of Spring in March.  Yet many may start their symptoms as early as February if they are allergic to what’s blooming.

Tree pollens start first in January and then taper off in April.  Grass pollen starts to rise in February and March.   Finally weed pollens join the party by the Spring and extend through the Summer and Fall.

Here are your questions answered:

What are allergies?

Allergies are the result of the immune response to a foreign particulate that our body senses.  One could be allergic to pollen, dust, dander, food, insects, mold, metals, transfused blood, grafts, medicine and anything the body senses as a foreign intruder.  Even though these may be individually harmless, a hypersensitivity reaction occurs as a result of their intrusion into the body.  IgE antibodies find the allergen (intruder) and activate mast cells in the tissue and basophils in the blood.  When these cells get activated, they release substances to help protect the body, including histamines, leukotrienes, and cytokines. These help the body attempt to sneeze and cough the allergen out, wall off the antigen, signal more antibodies, or produce tears and nasal secretions to flush it out.

What are symptoms of seasonal allergies?

Symptoms of allergies could include any or a combination of the following:

  • Sneezing
  • Coughing
  • Wheezing
  • Runny nose
  • Eye watering
  • Red Eyes
  • Itchy eyes
  • Itchy skin
  • Rash
  • Itchy throat
  • Fatigue
  • Congestion….. to name a few.

How do they differ from a cold?

Colds may have very similar symptoms to allergies.  However they are different.

The common cold is caused by a virus.  When one gets infected by the virus they may feel malaise, fever, and achy.  This does not occur with allergies.

Moreover, nasal secretions from allergies are usually clear.  In a cold, the mucous could be thicker and with color.

The same holds true with sputum.  During an allergy the cough may have little to no mucous and if so, be light-colored.  Thick mucus could be a sign of an infection.

An allergic sore throat will seem more dry and scratchy.  A sore throat from a cold is more uncomfortable and less easy to soothe.

Allergies may persist or be cyclical.  Cold symptoms will usually subside after a few days and rarely persist longer than 10 days.

Can allergies lead to a cold?

Yes and no.  Allergies should not in and of themselves cause an infection. However they may make one more vulnerable for a virus or bacteria to take over.    Hence a bronchitis, sinus infection, or pneumonia could uncommonly follow an asthma attack.

Are seasonal allergies dangerous?

As stated previously, if one is susceptible to colds, an allergic attack could make them vulnerable. Moreover if one suffers from asthma, an allergy attack could incite an asthma attack.  Very rarely would we see a life threatening anaphylaxis to an allergen such as pollen.

Allergy season is here: What are the worst offenders?

 

How can we prevent and treat allergies?

Avoiding, or decreasing exposure to the allergen is key.   We suggest the following:

  1.  Be aware of your local weather and pollen counts.  If the weather begins to warm and regional vegetation is blooming, allergy season may be upon you sooner than you know.
  2. Avoid outside pollen from coming into your house.  Avoid the urge to open all the windows during Springtime as wind will bring the pollen in.
  3. Clean your air filters.  Replace air filters frequently and consider using HEPA Filters
  4. Wash off pollen from your hair and clothes before you sit on the couch or jump into bed.
  5. Close your car windows when you park.
  6. “Recirculate” the air in your car
  7. Discuss with your medical provider if you are a candidate for medications such as antihistamines, nasal corticosteroids or leukotriene antagonists.  
  8. If you suffer from respiratory illnesses or a chronic medical condition, discuss with your medical provider if you need to start your allergy medication before allergy season hits. Some of these medications may take a couple of weeks to reach therapeutic levels.

How can I find my local pollen counts?

Local tree, ragweed and grass pollen counts can be obtained here.

 

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Learning Medical Spanish is Easy!!!

 

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in flu, Health, news

This Year’s Flu Shot Efficacy Improved Over Last Year

The CDC reports a mid-season efficacy rate of 47% for this year’s flu shot, up from 36% estimated efficacy last year.

In a good year flu shot efficacy may be 65%.  It’s difficult to reach higher numbers as viral flu strains mutate easily and immune systems of the general public are so varied.  Per the CDC the flu shot during the 2010-2011 flu season was one of the most effective.

 

vaccine-effectiveness_v3

This year the predominant flu strain is H1N1, in contrast to the more wily H3N2 which evaded being a sharp match for last year’s flu vaccine.

They report the following:

Interim estimates of vaccine effectiveness based on data collected during November 23, 2018–February 2, 2019, indicate that, overall, the influenza vaccine has been 47% (95% confidence interval = 34%–57%) effective in preventing medically attended acute respiratory virus infection across all age groups and specifically was 46% (30%–58%) effective in preventing medical visits associated with influenza A(H1N1)pdm09 (6).

It is not too late to get the flu shot and medical providers are still recommending vaccination.

According to the CDC “preliminary cumulative in-season prevalence estimates indicate that influenza has caused 155,000–186,000 hospitalizations and 9,600–15,900 deaths.”

To date, 28 children have died this year from flu related illness.

Flu season peak is still occuring as winter appears to more severe this year, hence numbers can rise.

 

The Flu – Your Questions Answered

__________________________________________________________

When does flu season begin and how long does it last?

Flu season has begun already. It typically starts in the Fall, and ends late Spring.  So the range is described as October to May with it peaking December to March.

How bad will this flu season be?

It is difficult to predict, but already this early in the season we’ve had multiple flu related deaths reported by the CDC’s Flu View.

What is the flu?  How can one die from it?

The flu is caused by a virus. Multiple strains of virus’ can cause the flu.  The virus itself can be lethal, however the greatest risk comes with what it does to your immune system, thereby putting one at risk of secondary infections.  Pneumonia is the number one cause of flu-related deaths.  Secondly, it can exacerbate existing conditions such as asthma, seizures, even promote preterm birth, hence those who are pregnant or have preexisting medical conditions are urged to get vaccinated against the flu.  Moreover those who qualify should get the pneumonia vaccine as well.

 

h1n1-swine-flu-virus
h1n1 virus

 

What does this year’s flu vaccine cover?

According to the CDC, the trivalent vaccine covers for these three strains of flu virus:

  • A/Michigan/45/2015 (H1N1)pdm09–like virus
  • A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus
  • B/Colorado/06/2017–like virus (Victoria lineage)

Quadrivalent influenza vaccines will contain these three viruses and an additional influenza B vaccine virus, a B/Phuket/3073/2013–like virus (Yamagata lineage).

These vaccines are aimed at providing protection against the Swine flu, and some influenza A and B strains.

What about older individuals?

This year, those over 65 will have three options for their flu vaccine.

Fluzone High-Dose – a higher dose flu vaccine that will hopefully allow their immunity to protect against the flu longer

FLUAD – the trivalent flu vaccine with an adjuvant to stimulate more of an immune response.

Flublock Quadrivalent – provides protection against 4 strains.

What about the nasal spray vaccine?

This year, the CDC allows use of the nasal spray vaccine as it has shown to have improved efficacy from  prior years. However it is only recommended for  those who are between the ages of 2 and 49 and cannot be given to those who are pregnancy or who have compromising medical conditions as outlined by the CDC.

Who should get the flu shot?

All individuals 6 months old and older unless specified by their medical provider.

What if I’m allergic to eggs?

Most individuals allergic to eggs can still get the flu vaccine, but if the allergy to eggs is severe (anaphylaxis, angioedema, difficulty breathing), the CDC recommends notifying your medical provider and being in a facility to monitor you if you do get the flu vaccine.

Will I get the flu from the flu shot?

No.  The flu vaccine has a “killed” version of the virus meaning it’s not an active virus (as opposed to a live attenuated vaccine, a weakened down version of it).   A “killed” or “inactivated” vaccine merely has the pathogen particles to induce an immune response.  Additionally, when one states they got the flu despite the flu shot it could be that the flu shot only protects against 3 – 4 strains and they were infected with a more rare strain not covered by the vaccine.

How effective is the flu vaccine?

The average effectiveness each year hovers around 60%.  Last year’s efficacy was much lower and this year’s has not been predicted as of yet. Australia is still reporting active cases on their Department of Health website.

I feel sick after the flu shot, why?

For some, the immune response that ensues can make one feel mildly ill, but should not resemble the flu. Those who state they got the flu “immediately” after receiving the shot, might have already been exposed and had not had a chance to produce immunity prior to their exposure.

sneezing

 

What are symptoms of the flu? How is it different from a cold?

A cold comes on slower and less severe.  Flu symptoms are more abrupt and can include:

  • Fever
  • Body Aches
  • Cough
  • Sneezing
  • Sore Throat
  • Shortness of Breath
  • Fatigue
  • Headache
  • Nausea
  • Vomiting

Are there medications to treat the flu? Will antibiotics work?

There are antiviral medications available, such as Tamiflu, to treat the flu.  Antibiotics, however, will not work since the flu is not caused by a bacteria but rather a virus. However if a secondary bacterial infection takes over, antibiotics may be used.

How can I prevent getting the flu?

Besides vaccination, avoid being around those who are sick, thorough hand washing, and take good care of yourself.  A balanced diet, exercise and sleep regimen can help boost your immune system.

 

spanish book

Learning Medical Spanish is Easy!!!

 

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

 

 

Posted in energy drinks, Health, news, teeth

Energy Drinks Can Rot Your Teeth

Image above from NY Post

A 21 year old student in England dropped out of school when his dentist found a mouth full of rotten teeth due to his energy drink habit.

Vinnie Pyner of Margate, England, told SWNS that he would drink 6 cans of Monster Energy drinks a day to get through school.  Eventually his teeth cracked and when he finally showed his mom, she rushed him to the dentist who said it was the worst case of tooth decay she had ever seen.

FOX News reported he had 24 filings and dentures to repair his front teeth and will soon return to college.

Teeth can rot easily when exposed to energy drinks due to their acidity and sugar content.  The protective enamel gets eroded and is irreplacible.  Moreover people may choose these drinks over healthier options such as water or milk, putting them at higher risk of dental disease.

Years ago, Demi Moore confessed on The Tonight Show with Jimmy Fallon that she lost two of her teeth. The 56 year-old actress cited stress as the reason.

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Stress could be a factor, however, that would mean all of us would lose our teeth before senior year high school.

What came to mind was a previous report on Moore’s diet.

In 2012, the actress was hospitalized and multiple rumors surfaced as to what caused her collapse.  Some reported an energy drink addiction, some cited anorexia, some said it occurred after inhaling the gas from a whip cream canister.  Witnesses reported seizure like activity.  According to Daily Mail,

A source told Radar: “She collapsed after having an epileptic seizure… she has not taken care of her health at all lately and has lost a ton of weight.”  “Demi is in getting treated for anorexia, as well as other issues that caused her seizure.”

After she recovered, it was revealed that her diet included: “Red Bull for breakfast. Red Bull for lunch. Red Bull for dinner, with a lettuce leaf and a tablespoon yes a tablespoon of tuna fish thrown in… That’s it.” as reported by Light987.com.

According to Medical Daily, Moore had been drinking energy drinks for over 10 years.

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Three energy drinks a day in the company of a poor diet could wreck havoc on one’s health. But what about teeth?

In 2012 a study from the Southern Illinois University School of Dental Medicine found the acidity of energy drinks to damage tooth enamel, thereby increasing risk of cavities.

Earlier this year, a 28 year old man from New Zealand, who allegedly drank three cans of energy drinks a day, lost multiple teeth and suffered from severe gum disease.

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JOSH MCKEE AND HIS XRAY DEMONSTRATING MULTIPLE TEETH LOST/MARION VAN DIJK

 

Energy drinks provide little in the type of nutrition gums and teeth require.  Our jaws, gums and teeth were designed to chew, face a variety of forces, and then get washed down with water and our own saliva to avoid damage from non-neutral pH compounds.  A balanced diet, with food we need to chew, low on sugar and acidity is just what the human mouth needs.

Other causes of teeth loss (edentulism) include:

  • Smoking
  • Diabetes
  • Poor dental hygiene
  • Periodontal (gum) disease
  • Heart Disease

So not only is it important to brush, floss, water pick and see one’s dentist regularly, but taking care of one’s non-dental health can be just as crucial to keeping our pearly whites.

Energy Drinks Can Increase Risk of Heart Attack Within 90 Minutes

 

A study from the University of Texas finds the consumption of energy drinks to have negative effects on the cardiovascular system by narrowing blood vessels that carry oxygenated blood as soon as 90 minutes.

Vessels that supply the heart, which may already be narrowed due to atherosclerosis, could narrow even more.

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Moreover the restriction of blood flow to vital organs implies the brain may not receive the optimal circulation it needs.

How dangerous are energy drinks?

The study was conducted by scientists who looked at the endothelial lining of blood vessels in 44 healthy non-smoking students and found within 90 minutes of drinking a 24 oz energy drink the vessel dilation dropped from 5.1% in diameter to 2.8% in diameter.

Now energy drinks contain various levels of caffeine, as explained below.  But they also contain taurine, sugar, vitamins and other ingredients. This study did not look specifically at caffeine but energy drinks, so the authors can’t specify what’s the culprit.

Demi Moore – Maybe Energy Drinks Caused her Tooth Loss

Last year, however, a South Carolina high school student collapsed in class and later died from allegedly consuming an energy drink.  The coroner’s report, revealed cited caffeine as the cause.  The caffeine induced a cardiac arrhythmia, abnormal heart rhythm,  and 16-year old Davis Allen Cripe tragically died within an hour.

What’s shocking is the amount of caffeine he ingested was not very high.  According to Richland County Coroner Gary Watts, Cripe drank, within a two-hour period, a large Mountain Dew, an energy drink, and a cafe latte from McDonalds. The teen had no medical problems or family history of heart issues.

A large Mountain Dew contains 54 mg per 12 fluid oz.  So a 20 oz drink would be close to 100 mg caffeine.

Energy drinks, depending on the brand, contain approximately 80 mg of caffeine per can.

A cafe latte from McDonalds, medium size, contains 142 mg of caffeine.

This in total would equal approximately 320 mg of caffeine ingested within a two-hour period.

The lethal dose of caffeine in adults range from 150-200 mg/ kg body weight.  So a 70 kg adult could consume a toxic level of caffeine at 10 grams (10,000 mg).

So 320 mg of caffeine is well below the toxic level.  But what caffeine could do could be the more dangerous part.

Caffeine has been known to induce arrhythmias.  It’s a stimulant, hence it can affect the heart’s electrical conductivity that manages the organ’s pumping  action.  Once the electricity is disrupted, the heart muscle fails to have a predictable, rhythmic stimulation, hence cannot pump effectively.

Caffeine also causes vasoconstriction, so blood flow to the heart could be compromised, potentially inducing a heart attack.

In 2014, researchers from Barcelona found energy drinks to be linked to rare cases of heart attack and arrhythmia.

A cup of coffee averages 95mg of caffeine whereas an energy drink contains 80mg.  But the latter is consumed much quicker than a hot cup of Joe that needs to be sipped, hence the consumer takes in a larger load of caffeine in a shorter amount of time.  This could be too much too fast for the heart.

The following is a chart of average caffeine content in common drinks:

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IMAGE FROM BUSINESS INSIDER

 

IN 2016 we learned that a 50-year old man with hepatitis C went into acute liver failure after drinking 4-5 energy drinks a day for a period of a three weeks. The culprit appeared to be the Niacin content in each energy drink (200%RDA) that accumulated over the days and became toxic to the liver.  Although this is the first time we’ve heard of this severe a hepatic side effect, energy drinks are not foreign to being hazardous to one’s health.

 

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So what’s in an energy drink?

Depending on the brand, ingredients can include the following:

Carbonated water

Sugars such as sucrose, glucose or high fructose corn syrup

Caffeine

Guarana extract- an energy supplement also high in caffeine

Taurine – an amino acid that has health benefits but could strain the kidney

Vitamins B 2, 3, 6 and 12 (and Vitamin A and C in some brands)

Sodium

and multiple other ingredients and additives (Ginkgo Biloba, Ginseng, etc. depending on the brand)

Why are energy drinks dangerous?

Energy drinks have been known to cause a variety of issues:  anxiety, insomnia, restlessness, caffeine withdrawal, a rise in blood sugar…. to name a few.

However the focus of energy drink risks has been on the heart.  One study from the Mayo Clinic found blood pressure and adrenaline to rise after drinking an energy drink.  In 2011 a case report looked at two teenage boys who went into atrial fibrillation, a deadly heart rhythm. In 2015, doctors blamed energy drinks for a 25 year old man’s heart attack.

We’ve learned that caffeine, though innocent-appearing in coffee and tea, can be deadly not only as a result of quantity but the administration of it.  A cup of coffee may have the same amount of caffeine as an energy drink (assuming the Guarana extract isn’t adding more to the total caffeine dose). But a hot cup of coffee is sipped slowly, whereas an energy drink served cold or at room temperature is usually chugged.  The huge bolus of caffeine may be too quick-too-much for the body to digest and distribute slowly.

The high sugar content of energy drinks could put one at risk of diabetes.  And with the recent case of acute liver failure, we are reminded that ingredients of energy drinks could at high doses cause hepatitis (inflammation of the liver).

Additionally, this week we learned that mixing alcohol with energy drinks, a popular party ritual, caused brain changes in mice similar to those caused by cocaine.

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I can’t convince everyone to reach for a piece of broccoli rather than an energy drink when in need of a boost, but at the very least we should deter use by children and teens, and educate those with vulnerable hearts, blood pressure, diabetes, kidney and liver issues that an energy drink may not be the wisest beverage choice.

 

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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician

Posted in Health, news, relationships, sex, Valentines

Valentine’s Day: The Least Liked Holiday of the Year

Valentine’s Day is one of the biggest holidays of the year, with consumers spending more than $20.7 billion a year in the US buying cards, chocolates, flowers, and teddy bears.  But what no one admits to is it is one of the most anxiety producing and miserable holidays of the year.

If you’re single….

When you’re single the last thing you need to be reminded of is just that….you’re single.  Valentine’s Day inundates us with the “normalcy” of being in a relationship such that anyone who’s single feels there’s something wrong with them.  Single people feel forced to shut off the TV, avoid shopping, avoid others and remain indoors for the week surrounding Feb. 14th.

If you’re married….

If you’re married, and have been so for some time, Valentine’s Day reminds you of how much you are lacking in sex and romance.  But worse yet, you are now compelled to do something for Valentine’s Day.  No credit for spontaneity.  No credit for being romantic, since the whole world seems to be celebrating Valentines.  And… it’s all pain, no gain.  If you mess up, and your gift or celebration is not very romantic, you’re in the dog house.  And if you forget about the holiday all together…Whoa Nelly…..

The candy….

When one thinks of candy they think of chocolate, lollipops, vibrant colors…..Valentine’s heart candy is the worst candy out there.  They’re pale, hard, practically crack your teeth, not very tasty and force you to read them before you eat.

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Be Mine?  Be my Valentine?

Don’t give me anymore work to do. You could be pretty high maintenance.  And what if I’m not ready to commit?

Your gift better measure up….

Valentine’s Day gifts are made to be publicized.  And even if you gave your sweetheart the gift in private, it will be posted on social media or broadcast at work the next day.  In fact, not sending the gift to their work could be a major faux pas.

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So how do we make this holiday more tolerable?

If you’re single….

If you’re single, use this holiday to celebrate the friendships you have.  Make it a singles night out and celebrate your freedom.  Or make a friend feel special by sending a “friend” valentine.  These could include:

  • a bottle of wine
  • a stuffed toy (with no heart attached)
  • a book
  • a gift certificate
  • a funny poem/desk calendar

If you’re married…..

Since the gift of spontaneity has already been hijacked by this holiday, do something creative and unpredictable.  Candlelight dinner, a poem, luxury bath, weekend trip, something sappy…..but do it right and you’ll get bonus points.

Don’t spend a lot

Here’s the silver lining. Most Valentine’s Day gifts/gestures do not have to cost a lot.  Valentine’s Day is about the heart and showing one how much you care.  So a note, poem, song, personalized song list, or even a cute little doodle can go along way.

ARTERIES ARE RED
VENULES ARE BLUE
MY GONORRHEA HAS CLEARED UP
HOW ABOUT YOU?

 

What to buy a man?

We make the mistake of thinking men want what we want. Let’s take cologne for that matter….men don’t want to smell like perfume or “parfume”y….they like smelling like men.  Forcing them to use toilet water is not cool.

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Another common gift given to men is a shaving set.  Does the average man like shaving, let alone every day? Top that off with wasting an opportunity for them to get a cool gift with one that includes shaving products???  Cruel, just cruel.

For men, many prefer steak for dinner, time alone in their man cave, or sex.  I think that’s about it.  Pretty easy.

 

So hope this helps you get through Valentine’s Day anxiety free and worry free.

And remember…. its only one day…just one day…. and will all be over Feb. 15th.

 

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The Baby Boomer’s Guide to Online Dating

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, iHeart Radio and Board Certified Family Physician

Posted in Health, marijuana, news

Marijuana Lollipop Suspected in Heart Attack Case

For years studies have found marijuana use to increase risk of heart disease and stroke. Now a marijuana lollipop has been linked to a man’s heart attack.

Treating his arthritis and insomnia, an 70-year old man licked a marijuana lollipop and within a half hour experienced crushing chest pain.  The lollipop contained 90 mcg of THC, which is multiple times more potent than an average joint, according to Fox News.

They report he experienced hallucinations and anxiety which led to a spike in his heart rate and blood pressure thereby stressing the heart.  Fortunately he survived.

 

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The lollipop was not intended to be a single use edible but many find it unsanitary to lick a few times and save for later.

Many studies have linked marijuana use to heart attacks, heart failure and stroke.

In 2017, Dr. Aditi Kalla and colleagues from Einstein Medical Center in Philadelphia analyzed 20 million health records of patients who were hospitalized in 2009 and 2010 and found those who used marijuana (1.5% of the patients studied) were at high risk of coronary artery disease, sudden cardiac death, heart failure and stroke.

What’s even more striking is the patients were younger, aged 18-55. Risk factors including obesity, high blood pressure, alcohol use and smoking were already taken into account.

One theory for the link between heart disease/stroke and marijuana use is that cannabis may affect the cardiac muscle cell’s ability to contract, affecting the pumping mechanism of the heart, thereby leading to heart failure. Another theory is marijuana, like cigarette smoking, may be increasing risk of clots.  Below is a report on a study linking marijuana use to Transient Ventricular Regional Ballooning (TVRB). This can also lead to heart failure. Another theory suggests cannabis causes a release of stress hormones, such as cortisol.

In 2016 study out of St. Luke’s University Hospital Network found marijuana to cause stress cardiomyopathy.  This is a temporary condition that causes a “ballooning” of a region of the ventricle known as Transient Ventricular Regional Ballooning (TVRB).  We know that many drugs can cause cardiomyopathy (affect the heart muscle) such as cocaine and stimulants causing dilated cardiomyopathy, but this is new in that a sedating type of drug such as cannabis/marijuana, can cause similar effects on the heart.

The condition of TVRB can mimic many different heart conditions because it presents with chest pain, shortness of breath and dizziness.  So many individuals admitted for these symptoms are evaluated for a heart attack, angina, pneumonia, and a variety of other diagnoses.

In this study, the researchers looked at data from 33,000 hospital admissions who had TVRB and saw a link between 210 of these admissions and marijuana use.  They are unsure how marijuana affects the heart, but theorize that it could be an increase in cortisol and stress hormones.  Although none of the marijuana users in this study died, the TVRB can cause cardiac arrest, heart attack.

History of Lollipops

For centuries civilizations had found ways to satisfy our sweet tooth.  Ancient Egyptians would mix nuts, fruit and herbs into a ball that could be skewered with a stick.  Putting candy on a stick was common as it allowed a sticky sugary or carmelized treat to be eaten easily.

However the modern style lollipop we believe was invented by George Smith of New Haven, CT in 1908.

The name “Lollipop” was trademarked in 1931 after he reportedly named the candy after a popular race horse, “Lolly Pop.”

 

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Learning Medical Spanish is Easy!!!

 

Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.