Don’t let the last two years of viral pandemics deter you from enjoying life. For many, travel is one of the real joys of life. If you are like most of us you are planning a trip very soon. We are all ready to get back to the ‘old normal’ and abandon the ‘new normal’. I am not suggesting that the coast is totally clear nor that the authorities of healthcare have given the all-clear signal. There are still outbreaks in many countries of the Omicron sub-variant B.2. The UK just reported last week a daily average of 75,100 new cases. The dominant culprit there is the sub-variant B.2. This is a concern, but as yet we have not seen dramatic outbreaks in the United States, and we may not in the future. This variant appears not to cause severe illnesses, witnessed by the fact there has been no increase in deaths where there are outbreaks. Many are vaccinated and some are still wearing masks but I really think we’re on the downhill of this pandemic. I feel this so strongly, I will be traveling the day this is posted and will be crossing the pond to Europ.
Before we get to personal particulars, we need to consider if you are in the group recommended to have a 2nd booster. On March 29, 2022, the CDC made recommendations, following the FDA, for a second booster vaccine. In summary, certain immunocompromised individuals and people over the age of 50 who received an initial booster dose at least 4 months ago are eligible for another mRNA booster to increase their protection against severe disease from COVID-19. At this time, not much hard data for the merit of this exists. A study from Israel was just published in NEJM. This large study (1.2 million adults over 60) showed a second booster( fourth shot of Pfizer mRNA vaccine) provides short-term protection and a modest absolute benefit. Those who received a second booster were 78 percent less likely to die of Covid-19 than those who had received just one booster shot. Protection against infection appeared to peak four weeks after the second booster and by week 8, protection disappeared. Again this is an ongoing study, and only short duration data is available on these older adults.
Traveling safe means pre-planning and thoughtful packing. Your customary medications must be packed, and carry two days’ worth on your person in case luggage is lost. Recent imaging studies for conditions you are recovering from should be printed and packed. Should you need a refill early for your trip, ask the pharmacy, as they usually will accommodate your need. I carry a typed one-page summary of my medical history including medications. I don’t take my insurance cards unless staying in the US. I am packing masks with me, although shortly (April 18) airplanes in the US will follow others (British Airways, Icelandair, EasyJet) dropping requirements to wear while onboard. Yes, my hand sanitizer (80% alcohol) is on my person. Yes, airplanes are cleaned after flights but I keep it handy for onboard use in the lavatory or before meals and snacks.
I am not discounting a distinct possibility that an outbreak of new variants could emerge while I am on vacation. It has happened, usually, when a large number of individuals become infected, a new or sub-variant arises. Remember Delta variant gave way to Omicron variant and Omicron to its sub-variant- B.2. You know I will be wearing a mask. I don’t count on being able to buy masks, neither should you even if you are staying in the US. A short supply of products like masks is possible. Be prepared for your safe trip.
Today, rather than using natural sugars, man has found so many sugar substitutes. In a recent study, adults, who were attempting to live healthy by cutting out sugars and substituting artificial sweeteners, were followed for approximately 7.8 years. They were found to have a 13% higher risk of developing cancer compared with those who did not use sweeteners. Are all sweeteners equally bad? Specifics of this study in France found aspartame and acesulfame potassium (‘Ace K’) especially were the two culprits that seemed to drive this overall cancer risk. Both are used in the US and approved by FDA with the caveat that no direct evidence has been found that they are cancer-causing.
In this study, artificial sweeteners were associated with an increase (13%) in obesity-related cancers including colorectal, stomach, liver, mouth, pharynx, larynx, esophageal, ovarian, endometrial, and prostate cancers.*
Also noted was breast cancer increase has opposite associations, pre-and post-menopause women. Aspartame especially and sadly alone was linked with a 15% higher risk for obesity-related cancers and a 22% higher risk for developing breast cancer.*
These findings are no surprise to those who have read previous research findings. We are all guilty of ingesting artificial sweeteners, thinking they are a safe alternative to sugar. They are not! Here is yet another study showing a negative impact on our health.
‘Ace K’ is found in many everyday products from lip glosses to toothpaste. Also have a look at ingredients when buying frozen desserts, candies, beverages, and baked goods. THINK AS YOU READ LABELS. I have suggested this before, just because it is on a shelf and available does not equate with the item being good for you.
Anyone in academia will tell you, publications are critical. I was in academic medicine and was part of that mentality for decades. Yes, if you didn’t publish you would perish! No longer in academic medicine, I still feel the need to speak out, often doctors do so, in medical journals. I have been working to make the medical community, government, and people at large aware of prehospital medical care. The needs of those in prehospital medicine have increased dramatically with the pandemic and now as endemic. Under PRESS AND PUBLICATIONS, on this website, you can view my participation in spreading the word. I have tried to honestly analyze the data and give a voice to the many practitioners and prehospital medicine. Below are the publications for 2022 to date. The authors represent all the in the field of paramedicine.
You probably know, I’ve said it before here, that the flu shot is but an advanced educated guess of the three or four possible viruses that may attack in a given winter season. Vaccines are made using particles to stimulate antibodies against an Influenza A and B type virus. The need to prepare in advance necessitates the educated guessing as to what are the likely make-up of the trivalent and quadrivalent vaccines. Sadly this year’s was a relative bust meaning they did not educate guess correctly. Actually influenza A type H3N2 had been included but a sub-variant lineage is a culprit this season. Although I think the number for the vaccine effectiveness (VE) is 16% coverage of the viruses, according to CDC. The predominant influenza strain, for the 2021-2022 season is A(H3N2).
So back to respiratory infections, common in winter months with prevention such as continuing to wear a mask, treatment with antivirals (influenza antivirals such as baloxavir (Xofluza) or oseltamivir (Tamiflu) are paramount, especially for high-risk individuals. Most of us will not have complete immunity either from the flu vaccine or having had H3N2, a form of Influenza A. Listening to your body when you are unwell, seeking medical attention, and avoiding spreading your illness are smart moves.
Very possibly and reported, acute respiratory infections can be caused by an Influenza virus and accompanied by SARS-CoV-2.
Illness is on the rise with central and south-central regions of the US reporting more cases. Hospital admissions have been increasing each week for the past 5 weeks. The season has definitely started. CDC estimates that, so far this season, there have been at least 2.7 million flu illnesses, 26,000 hospitalizations, and 1,500 deaths from flu.
In ED, a Respiratory Pathogens test can be done that evaluates many different causes of respiratory infections. Viruses include flu-type influenza A & B, RSV virus, Parainfluenza virus, Rhinovirus, Adenovirus, Coronavirus,Enterovirus, Human metapneumovirus. and that is just viruses, also tested are bacteria including: Bordetella pertussis (whooping cough) and Bordetella parapertussis, Chlamydia pneumoniae and Mycoplasma pneumoniae. A respiratory infection spread rapidly and as you see there are many culprits most no cure and many treated differently. Check with your healthcare provider for information on home tests.
Home care is moving fast as early recognition can go a long way to better outcomes and less spread. One type is the rapid antigen tests: these generally involve inserting a swab into your nostril. The sample can then be analyzed at home with materials that are included in the test kit. Results are typically available in around 15 minutes. Other tests can be mailed in for results. You will be happy to learn rather than going to an emergency room or doctor’s office and being with other ill people, you could do an influenza test at home. Home-based, self-administered tests for influenza are comparable in accuracy to rapid diagnostic tests in clinical settings, according to a recently published. Thompson is the senior author of the study and a primary-care physician at UW Medicine.
After heart disease, cancer is the second leading cause of death in the US. Colon Cancer is the third most common cancer in the US and the second leading cause of all cancer-related deaths. Scary numbers. While there is some good news from 1999 to 2019, cancer death rates went down 27%. This is in a large part to early recognition from screening. More information is available at this CDC link.
This blog alerts readers to the value of early screening. Initial screening with a colonoscopy for colon cancer is recommended starting at age 45 and every 10 years, if negative until you’re 75.
Colon cancer does not discriminate by age. Are you at high risk? This is something you may not be able to determine on your own, find out, please. Early detection makes a large difference. Screening with a colonoscopy is important for those with a family history of colon cancer, those with polyps, chronic bowel conditions including inflammatory bowel disease.
If you have gastrointestinal symptoms, this procedure, allows a direct look ‘up’ your colon. Direct visualization is better than any imaging study, I include CAT scan and MRI study.
If you are having symptoms a colonoscopy may be recommended. Rectal bleeding pain, irregular bowel habits, weight loss are just a few of the common symptoms. While looking up your colon, the physician might biopsy – remove a polyp or take a bite’ out of a suspicious area of the bowel lining. This is termed a biopsy. Some polyps are precancerous, that is if left could with time degenerate to cancer. At present, there is no way to tell it would take 1 year or 15 years.
Everything you’d heard about preparing for this examination – looking up your colon from the rectum probably, is no longer true. The process of preparing your colon by emptying it has been simplified. A ‘prep fluid’ is now a smaller volume and does not need to be drunk all at once. The total volume of some preps now is down from 4 to 2 Liters, and some brands even have flavors available. I suggest using a straw to protect your tongue from the taste.
The procedure is quick 30 minutes, you’ll be comfortably sedated, much like taking a nap, you’ll wake up alert. If there are no abnormalities you will not need to go thru this again for 10 years.
I want you to have accurate information on breast cancer, it is ‘stupid simple’!
According to a large-scale clinical research study reported in the Journal of the AMA, 3-D mammograms detect 41% more invasive cancer than did two-dimensional mammography. As with anything, there are those who say more testing with mammography to screen for breast cancer isn’t worth the increase in stress. However, the stress, if you think about a patient’s radiation, chemo, and or surgery because something early is missed, definitely is food for thought. 3-D mammogram rate of false-positive is far lower than from a digital mammogram.
Family history of Breast cancer is seen in 20% of cases (use to be 10%). For women who have a first-degree relative (a parent, sibling, or child) who has had or has breast cancer, chances are double the 1 in 8 cases found in all US women. If you have two first-degree family members with breast cancer, sadly your risk increases much more. This translates to the average risk for a woman to develop breast cancer in her life is about 13%. Only skin cancer is more common in women. All women have BRCA1 and BRCA2 genes, but only some women have mutations in those genes. About 1 in every 500 women in the US has a mutation in either her BRCA1 or BRCA2 gene. Gene mutations in the BRCA position can increase the chance of breast cancer.
Men can also carry the BRCA gene. A few words about BRCA-1 and BRCA-2 are gene mutations. In men with the BRCA-1 gene a higher chance of developing breast cancer, prostate cancer and melanoma occurs. Men carrying the BRCA-2 mutation have been found to have an increased association with lymphoma, melanoma, and cancer in the pancreas gall bladder, and stomach.
Breast cancer is not only a disease of older women. Since 1970, the incidence in ages 25-39 has increased 2% every year. Cancer diagnosed in young women tend to be more aggressive, dangerous than when found in older women.
Mammographies had been recommended for women over the age of 50 because mammographies are not accurate in finding small tumors in young dense breast tissue. A baseline mammogram is covered by insurance and the standard at present is between35 and 39 years old. Once you’re 40, even Medicare pays for a screening mammogram every year. Thankfully present technology reduces radiation exposure, with 3D mammography making it harder for small cancer to hide.
Cure rates are good especially when the diagnosis is early, so please follow medical directions regarding getting imaging studies of both male and female breasts.
It would be excellent for our health if a doctor should write a prescription for sleep? You can save yourself! A prescription for a walk in the park will improve long-term survival for cancer victims. * Researchers followed over 1500 individuals over 4.5 years and found ‘independent and joint associations’ of daily sitting time and physical activity with mortality outcomes among cancer survivors over 40 in the US. The sedentary ones (sitting more than 8 hours a day) had a higher all-cause death including cancer. Oncologists will be writing for that walk in the park! Unlikely insurance will pay for it though! The science exists so please take a walk in the park for exercise and tranquility both important to good health. Remember sleep is vital, listen to my podcast on sleep and heart health. Also, please read my blog on sleep myths.
Exercise is so important and to that, I have blogged frequently on this. Do you have a plan? An idea about walking somewhere, climbing stairs to exercise? Develop one if you don’t have a regime. REREAD a previous blog on conquering anxiety about exercising. another recent blog titled Exercise Science – Starting Simple.
For many, developing an exercise plan should involve a medical professional who knows your health status.
Omicron (BA.1), has now mutated to a ‘BA.2’ type, a subtype- call it ‘sister lineage’. While Omicron has 60 mutations, BA.2 has 85. It has been termed “stealth variant” due to a mutation that renders it ‘invisible’ as Omicron to PCR testing. BA.2 has spread to over 40 countries, including the US, UK, India, Australia, and Norway. It is more transmissible. symptoms of new lineage are pretty much the same as from Omicron but the severity of infections from BA.2 is not yet known yet. No matter the number of boosters, nor the presence of antibiotics from having had COVID-19 you can ‘catch’ this variant. Recall the purpose of the antibody (whether from a vaccine or previous infection) is to find the virus and prevent it from binding to our cells and causing illness. Will B-2 be a ‘player worldwide? It is more transmissible at first flush but little else is known at present. Don’t think it will stop there, already there is a BA.3 identified! But the good news is it is believed by virologists that recovery from Omicron BA.1 will protect from infection from sub-variants.
Information about contagiousness is key. After a five-day quarantine, about a third of people infected with SARS-CoV-2 might still be infectious, according to new data from Lorna Harries of the University of Exeter Medical School in England. After a 10-day quarantine, one in 10 people might still be infectious, study showed some individuals are shedding virus as far out as 68 days. It is potentially noteworthy this study was carried out before Delta and Omicron variants began to spread.
It is simple to see that the CDC rule for 5-day quarantine is a potential spreading factor.
My concern for everyone in the recent finding is that even with a mild case, resulting long-hauler effects can occur. Common symptoms are chronic fatigue like fever, aching, prolonged tiredness, and depression. Also intermittent breathing problems. Nonrestful sleep, muscle aches, and pains can occur in not hospitalized COVID-19 patients.
Yes, overdoing sugar in your diet will cause obesity and diabetes however using sugar substitutes is not totally safe.
At present, the most widely used artificial sweeteners (AS) are saccharin, sucralose, and aspartame. Aspartame most widely used worldwide has been shown to cause obesity and metabolic syndrome in humans while in animal studies it has been shown to cause kidney damage.
Know there are many AS, see list below.
They are everywhere, hidden in toothpaste children’s chewable vitamins yogurts breakfast cereals, and many more everyday dietary items. Some sweetness comes with warnings -phenylalanine for example is dangerous for people with the genetic disorder phenylketonuria (PKU)
The fact is ‘good’ bacteria, E. coli (Escherichia coli) and E. faecalis (Enterococcus faecalis) live safely in our digestive tract. However, when ASs and these bacteria get together bad things can happen.
It has been known that these chemicals change the number and type of bacteria in our digestive tract (aka gut). The presence of these sweeteners can change the way our ‘good’ bacteria act and make them invasive. That is attacking the lining of the intestine wall. The study published in the International Journal of Molecular Sciences is the first study to show the conversion from a benign harmless bacteria in our gut to a pathogenic one. You ask how does this occurs. The AS as it passes through the lining of the intestinal wall causes bacteria to become invasive. Bacteria will go into our bloodstream unto the lymph nodes, the liver, and the spleen causing a number of infections. Remember bacteria is to live in the gut not to go elsewhere.
This new study discovered that the concentration of artificial sweeteners in as little as two cans of diet soft drink, no matter the artificial sweetener, causes increased adhesion of E. coli and E. faecalis to the intestinal wall developing a ‘biofilm’. Invasive activity occurs.Antibiotics can not get to these bacteria.
Saccharin is the exception to artificial sweeteners causing bacteria to invade the wall of the gut.
Bacteria in your bloodstream causes sepsis, overwhelming infection, and is a common cause of death.
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