As New Jersey’s Gov. Christie would say, “Don’t be stupid, get a flu shot”. Whereas this article should have appeared in our Newsletter last fall, we believed at the time that there were enough warnings around that our prudent members would hie themselves to their local drugstore, doctor or wherever to have the shot administered. Since then, the flu epidemic has blossomed and there are still some who have adamantly refused vaccination. To those few who haven’t done it, please get your shot. The flu season lasts from November to April so there’s still time to get that shot.
Flu starts one to two days after infection. The flu victim is contagious from the day before he gets any symptoms until up to seven days later Flu can be transmitted three ways: direct transmission when someone sneezes or coughs on you, the airborne route when you inhale the virus hanging around in the air shortly after someone has sneezed or coughed and, also, when you touch a contaminated surface and then touch your mouth, nose or eyes. The virus can survive one to two days on hard surfaces like metal or plastic, five minutes on the skin and up to 17 days such as when it is in mucus on dollar bills. One sneeze can release up to 40,000 droplets and it takes only one droplet to give you the flu. One report indicates that smoking can increase the risk of infection as well as producing more severe disease symptoms. Flu is a viral infection and is especially dangerous for those with pre-existing conditions and for infants due to a weakened or not fully developed immune system.
Simple rubbing alcohol, bleach or antiseptics can be used on surfaces to kill the virus effectively.
It can be difficult to distinguish between the common cold and influenza in the early stages, but a sudden onset with high fever and extreme fatigue are key signs. Fatigue can last one to two weeks. The occurrence of a sudden relapse after you are feeling better is a dangerous warning sign. You may be experiencing a secondary bacterial infection such as pneumonia. Simple flu is usually treated with acetaminophen fever reducers and pain killers (such as Tylenol) but should bacterial infections occur, it’s time to take antibiotics (see your doctor). You should get plenty of rest, drink plenty of liquids and avoid smoking and alcohol. Flu has an interesting history. Hippocrates described it clearly 2,400 years ago. The early explorers spread it from Europe to the Americas. Almost all of the people in the Antilles were killed by flu in 1493 after the arrival of Christopher Columbus. The 1918-1919 worldwide flu epidemic was the worst of all recorded with an estimated 50 to 100 million people killed. The 1918-1919 epidemic had a fatality rate of roughly 2% as compared with the usual flu mortality rate which is around 0.1%.
The effectiveness of flu shots is roughly 62% but if you do come down with it, the symptoms will be less severe. If you haven’t gotten a flu shot, please give it serious consideration.
We have two articles this month.
Sunglasses are not just a fashion accessory. They can add greatly to your comfort, health and safety if you choose the proper pair.
UV radiation, whether from natural sunlight or artificial UV rays, can damage the eye, affecting surface tissues and internal structures, such as the cornea and lens. Long-term exposure to UV radiation can lead to cataracts, skin cancer around the eyelids, and other eye disorders. In the short term, excessive exposure to UV radiation from daily activities, including reflections off water, snow, pavement and other surfaces, can burn the front surface of the eye, similar to a sunburn on the skin.
Wear sunglasses that have 400 UV protection or more. A dark lens does not necessarily have UV protection. Avoid blue tinted sunglasses - they may look cool but blue tint actually emits ultra violet light, which is what you are supposed to be blocking out. Your best bet is plain gray, with green as a second choice.
Certain brands of contacts do protect eyes from the majority of UV rays. Look for contacts that are guaranteed to block more than 90 percent of UVA rays and 99 percent of UVB rays. To block the 10 percent of UVA rays and 1 percent of UVB rays that are not covered by your contact lenses, be sure to pair your UV-protecting contact lenses with certified UV-blocking sunglasses.
When choosing sunglasses for children consider the following:
Men tend to report less stress and put less of an emphasis on the need to manage it than women, according to results from a recent survey by the American Psychological Association (APA).
Although men are more likely than women to say they do enough to manage stress, in reality, their rate of stress-related illness appears to show that they’re not doing enough at all. According to the APA survey, Stress in America™: Our Health at Risk, men tend to put less emphasis on managing stress than women (52 percent vs. 68 percent, respectively, reporting that it is very/extremely important). Men are less likely than women to report using healthy stress management strategies, including reading (31 percent vs. 51 percent), spending time with family or friends (32 percent vs. 44 percent), praying (22 percent vs. 41 percent), going to religious services (17 percent vs. 24 percent), and seeing a mental health professional (1 percent vs. 5 percent). At the same time, men are more likely than women to report having been diagnosed with the types of chronic physical illnesses that are often linked with high stress levels, such as high blood pressure (32 percent vs. 23 percent), type 2 diabetes (12 percent vs. 7 percent), and heart disease or heart attack (6 percent vs. 2 percent).
Here in New Jersey, men have been particularly stressed out due to economic factors and additional worries about being able to provide for their families.
“We spend a lot of time talking about the impact of stress on mothers or women,” said New Jersey Psychological Association (NJPA) Public Education Chairperson and member of the staff at Overlook Medical Center, Rosalind S. Dorlen, PsyD. “However, the stress fathers and men face is just as real and gets far less attention, which, as research shows, is bad news for their health. It is important that men take action to manage their stress in healthy ways to avoid chronic illnesses.”
The NJPA recommends these approaches to men and fathers for healthier stress management:
The following Q&A article with William Dowling and Glen Bradish focuses on daily activities and issues that arise that can affect joint health.
William Dowling, MD, FAAOS, FACs is Chair of the Department of Orthopedics at Morristown Medical Center and Medical Director for Orthopedic Services, Atlantic Health System.
Glen Bradish, MD, FAAOS, is Chief of Surgery and an orthopedic surgeon at Newton Medical Center.
What lifestyle habits affect joint health?
Dr. Dowling: Weight reduction, having an active lifestyle and avoiding an excess of impact loading on the lower extremities. Some running is OK. It’s excessive, repeated running that’s an issue.
What are some of the risk factors for joint problems?
Dr. Bradish: Activity level is one. Athletes involved in running and jumping, manual laborers –these people are at more risk for osteoarthritis, the most common reason for joint replacement. Inflammatory arthritis can also be a risk factor, though not as common as degenerative arthritis. There isn’t always a cause. Sometimes it’s just genetic programming that causes the joint to wear out.
What are signs of joint problems?
Dr. Dowling: If you’re running into difficulty with a hip, the most common sign is pain in the groin. The other is stiffness. With the knee, it’s stiffness and swelling, so you lose mobility and see a difference in appearance. Most people are slightly bowlegged or knock-kneed. If that gets worse, that’s a sign the joint is deteriorating, as well.
When is joint replacement indicated?
Dr. Dowling: Everybody should have a fair trial at managing their problem nonoperatively. The first thing to try is Tylenol®; the second would be an anti-inflammatory, something over the counter, like Advil® or Aleve®. When you have to do it every day, other options start to present themselves. Injections of cortisone are temporary measures to relieve some of the discomfort. Unfortunately, nothing we have right now alters the underlying disease state; they treat the symptoms. You also have to weigh the risks associated with taking the medications.
So it’s a sequential progression in terms of what you require. It leads you to replacement. It’s not based on the X-ray; it’s based on how you feel. I’ve never had a patient yet who didn’t come back and say, “I know it’s time now.”
What’s life like after joint replacement?
Dr. Bradish: There’s a very high success rate in pain relief and increased function, but it’s not recommended to run or jump after joint replacement. Activities such as doubles tennis, low-grade skiing and weight training are okay. These recommendations are to increase the longevity of the implant.
What myths about joint health/replacement would you like to dispel?
Dr. Dowling: One of the most common is that the replacement joint will last 15 to 20 years. On the average, that’s true, but it doesn’t mean they can’t last a whole lot longer – or unfortunately, not that long. It’s the average, but it doesn’t mean it’s where you’ll be.
Another is about taking glucosamine and chondroitin. There’s probably very little supportive evidence that it restores the joint. But a small group of people feel it provides an alleviation of symptoms, and there’s relatively low risk.
Dr. Bradish: Most people think the surgery removes a segment of the knee. All it is really is a resurfacing of the ends of the bones. It’s not replacement at all; it’s like a cap on your tooth. That’s why a more accurate term than replacement is arthroplasty.
Sleep apnea is defined as recurrent episodes of narrowing or blockage (obstruction) of the air passage in the back of the throat during sleep. These apneas may occur anywhere from a few times per hour to more than once a minute in extreme cases.
Sleep apnea is highly prevalent, and may affect up to 25 percent of the middle-aged population. Unfortunately, the majority of those suffering from sleep apnea remain undiagnosed.
Sleep apnea often leads to repetitive disruptions in sleep throughout the night, leaving sleep apnea sufferers with excessive daytime sleepiness. Equally important, sleep apnea may cause numerous adverse health consequences as a result of the severe stress that occurs with each episode of apnea.
Cardiovascular disease, which includes hypertension, coronary artery disease, and stroke, is one of the most important medical conditions in our society. Cardiovascular disease affects a large percentage of the population, results in enormous costs for evaluation and treatment, and is a major cause of suffering and death. Sleep apnea is increasingly recognized to be an important and treatable risk factor for the development of cardiovascular disease.
Sleep apnea may be an important risk factor in the development of hypertension (high blood pressure), especially for those with moderate to severe sleep apnea. Treatment of sleep apnea has been shown to improve blood pressure.
There is growing evidence that sleep apnea contributes to the development of coronary artery disease.
Untreated severe sleep apnea is associated with a high risk of both non-fatal and fatal heart attacks and stroke. Sleep apnea may also worsen pre-existing coronary artery disease. A study from the Mayo Clinic found that sleep apnea increases the chance of having a heart attack during sleep. Treatment of sleep apnea may reduce the risk of heart attack or stroke.
Sleep apnea is a well-established cause of abnormal heart rhythms (arrythmias). Approximately 50 percent of patients with atrial fibrillation are found to have sleep apnea, and treating sleep apnea in these patients greatly improves the chance of successfully treating the heart arrhythmia.
Sleep apnea may weaken the heart muscle’s pumping ability, leading to congestive heart failure. Studies have shown that treating underlying sleep apnea in patients with this condition can significantly strengthen the heart muscle.
Clearly, sleep apnea is an important risk factor in the development of cardiovascular disease. Patients with cardiovascular disease should be screened by their doctor for underlying sleep apnea.
As the winter approaches and snow starts to fall, most people will be removing snow from their driveways and walkways. Before grabbing your snow shovel or revving up your snow blower, take a look at some of these helpful hints to keep you injury free – and out of the emergency room. Keep in mind you should always check with your physician regarding your ability to safely remove snow.
Shoveling can turn into a dangerous chore if you are not aware of some of the risks. Some safety tips include:
Even though snow blowers were designed to offer less stress on the body, it is especially important to follow safety guidelines when operating these machines. Some basic precautions include:
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