Do you wash your hands correctly?

Recently my wife & I enjoyed soup sampling at ChowdaFest at a middle school in Westport, CT. In the restroom of this public school I saw sign on how to wash your hands, aimed no doubt for the young students. What struck me about the sign was the length of time to wash, sing the Alphabet song twice, it suggested. That means about 20 seconds of hand washing. This is longer than advice I gave a few years ago, sing the Happy Birthday song twice, for about 10 to 15 seconds of washing.

Today we accept hand washing as good hygiene, but this was not always the case. Before germs were discovered and defeated, bad air or demons were blamed for illness. We know better now and yet we still get hand washing wrong.

Here's the right way to wash according to the Mayo Clinic.

• Wet your hands with running water.
• Apply soap.
• Lather well.
• Rub your hands vigorously for at least 20 seconds.
• Remember to scrub all surfaces, including the backs of your hands, wrists, between your fingers and under your fingernails.
• Rinse well.
• Dry your hands with a clean or disposable towel or air dryer.
• If possible, use your towel to turn off the faucet [and open the bathroom door]

Bottom Line

Always wash your hands after:

• Preparing food, especially raw meat
• Using the toilet or changing a diaper
• Touching an animal, animal toys, leashes, or animal waste
• Blowing your nose, coughing or sneezing into your hands
• Treating wounds or caring for a sick or injured person
• Handling garbage, household/garden chemicals, or anything really dirty like soiled shoes

Update: was watching the Tonight Show and guest Tim Allen mentioned handwashing and the Happy Birthday song. Jay responded, with yes, about 21 seconds?

Working While Sick

If your office is like mine, there are quite a few people at this very moment sniffling, coughing, wheezing, and otherwise sharing their cold germs with co-workers. It's flu season and, while I hope you got your flu shot and are protected from the flu, sadly there is no protection from the common cold. Yes, there are the preventative steps of isolation, hand washing, and wearing a facemask but no shot or pill will kill the cold virus that gets past these barriers.

Ideally you would stay home and rest when sick but you might not have that choice. If must work, here are 7 tips for working while sick from the blog Mind Your Decisions.

1. Get as much rest as you can. Get to bed early while sick.

2. Reschedule meetings and phone calls that you conduct. The idea is that you want look and feel your best when making a business presentation or conducting business. I would argue that you should not be in a small room with others when sick. Use the phone instead.

3. Work in short shifts.  You'll tire quickly when sick so work in short bursts and try to recuperate in between.

4. Do mindless tasks. Now is not the time for accounting or detailed work; you'll make way too many careless mistakes. Catch up on email, clean the desk, plan future assignments.

5. Use Home remedies to feel better:  soup, tea, healthy foods.

6. Ask for help. Delegate

7. Be considerate of co-workers.

"Cover your mouth and nose with a tissue when you cough or sneeze, throw the tissue in the trash after using it, and wash your hands frequently. And do not share your food or drink!"

Bottom Line

For remedies that work and those that don't check out the Mayo Clinic at www.mayoclinic.com/health/cold-remedies/ID00036

Time for Flu Shots

“Chain letters are the postal equivalent of intestinal flu: you get it and pass it along to your friends”
-Bob Garfield

A friendly reminder, get your flu shot! Many health plans cover the cost and some pharmacies like CVS will have low cost flu shoot events. Having the flu is nothing to sneeze at. During a typical year in the United States, 20,000 to 50,000 persons die as a result of influenza viral infection. About 5-10% of hospitalizations for influenza lead to fatal outcome in adults.

The flu is like a super-bully of a cold. There is extreme exhaustion and total misery. I came down with the flu at a Square Dance Convention in Vermont. Then my wife and a traveling companion got it the next day. Fortunately his wife did not get sick and drove us all home. There is no way those of us who were sick were in any condition to drive.

Bottom Line

If you're still not sure if you have the flu, here's a comparison of symptoms with the common cold.

Cold Symptoms
Slow onset.
No prostration.
Fever Headache is rare.
Runny nose, Sneezing.
Mild Fatigue.
Cough, chest discomfort.
Sore Throat.

Flu Symptoms
Swift, severe onset.
Prominent Prostration.
Flushed, hot moist skin.
102-104 degree temp.
Chills, body aches.
Extreme fatigue,
can last 2-3 weeks.
Cough, sore throat.

Drug Shortages

"The global market is starting to show cracks; the world is definitely not a flat billiard table. It's looking more and more like an out-of-balance roulette wheel."
-Edward Tenner, The Atlantic.com

I've seen a lot of buzz lately regarding a Washington Post story about a Shortage of Key Drugs.

A record 211 medications became scarce in 2010 — triple the number in 2006 — and at least 89 new shortages have been recorded through the end of March, putting the nation on track for far more scarcities. The paucities are forcing some medical centers to ration drugs — including one urgently needed by leukemia patients — postpone surgeries and other care, and scramble for substitutes, often resorting to alternatives that may be less effective, have more side effects and boost the risk for overdoses and other sometimes-fatal errors.

The article identifies three factors for the increasing scarcity:

1. Major pharmaceutical companies purchased smaller companies with patents on life-saving drugs. But when the patents expired, the big company abandons production because it will now be less profitable.

2. The pharmaceuticals claim there is tougher regulation of production by the FDA (which the agency denies).

"Shortages of pre-loaded epinephrine syringes and propofol, for example, occurred when suppliers dropped out just as the FDA was demanding additional documentation."

3. Globalization of manufacturing means a storm or natural disaster anywhere in the world can stop production of an item with many components. Globalization also raises concerns about the quality of the ingredients used.

The drug cytarabine has caused the most concern and gotten the most attention because it is highly effective for treating several forms of leukemia and lymphoma. [...] Many hospitals are running low, and some have run out completely. [...] Cytarabine’s scarcity was caused by hitches that two out of the three manufacturers hit in obtaining raw materials, as well as the discovery of crystals in some shipments.

At least 19 patients were sickened and nine died in Alabama this year after being infused with a solution through their feeding tubes that was apparently contaminated with bacteria by a pharmacy using an unfamiliar ingredient because of a shortage

Bottom Line

A common knee-jerk reaction is, "See this is what happens when companies control the heath industry. Government needs to be in control."  But look at Russia, Cuba, England for counter examples of lack of care and resources for the common man when the government runs the show.

The solution is greater competition (not patents). But reform is also needed at the FDA level. When regulation is too strict it becomes a barrier to entry and small companies can not compete. Regulation can also ban foreign companies. But too little regulation is also a problem as we know companies will cheat and defraud the consumer with fake or even dangerous drugs.

So how about this. Every day(?) take one random sample from production. Have a competitor test it for quality control. Perhaps monthly have FDA also test a sample to ensure that competitors are not in collusion and hiding bad test results.

When contamination is found, don't fine the company - that is not really a deterrent; that just pushes the fine to the consumer with higher prices. Instead prosecute the CEO for endangering the health of the public. Having a CEO (and other company officers) go to jail seems more effective than paying a fee from company profits. Prosecute for allowing a dangerous drug to be released. Not for intent or ill will. But negligence for failing to adequately test the quality of inputs and outputs. A company must be responsible for the drug it creates - no excuses.

Don't eat that armadillo!

"Or if there be any flesh, in the skin whereof there is a hot burning, and the quick flesh that burneth have a white bright spot, somewhat reddish, or white; Then the priest shall look upon it: and, behold, if the hair in the bright spot be turned white, and it be in sight deeper than the skin; it is a leprosy broken out of the burning: wherefore the priest shall pronounce him unclean: it is the plague of leprosy"
Leviticus 13:24-25, KJV

The New York Times says, "Armadillos Can Transmit Leprosy to Humans, Federal Researchers Confirm."

'Using genetic sequencing machines, researchers were able to confirm that about a third of the leprosy cases that arise each year in the United States almost certainly result from contact with infected armadillos. The cases are concentrated in Louisiana and Texas, where some people hunt, skin and eat armadillos."

This is good news for doctors who have been puzzled by U.S. Leprosy cases in individuals who had NOT traveled to leprosy hot spots around the world like India, Brazil, Africa, and the Philippines. The microbe that causes leprosy is a fragile one; it won't grow in petri dishes and survives only a week or two in moist soil. So researchers had been stumped tracking the U.S. source. But in retrospect the answer is not surprising. Leprosy only survives in two animals: humans and armadillos. Researchers have long used armadillos to grow the disease for testing.

According to the Times,

Leprosy now joins a host of other infectious diseases — including flu, H.I.V./AIDS and SARS — that are known to have jumped from animals to humans. Flu is thought to have first crossed to humans from migratory waterfowl several hundred years ago. H.I.V./AIDS first crossed from a chimpanzee about 90 years ago.

Ironically the disease may have first spread from humans to armadillos five hundred years ago. There are no traces of leprosy in the New World before Christopher Columbus.

Bottom Line

Left untreated, leprosy can cause permanent damage to the skin, nerves, limbs and eyes. Contrary to folklore, leprosy does not cause body parts to fall off, although they can become numb or diseased as a result of infection; infection results in tissue loss, so fingers and toes become shortened and deformed as the cartilage is absorbed into the body. Until recent times (1940s), leprosy was incurable and slightly contagious, so those infected (lepers) were shunned or forced to live in leper colonies. It is sometimes called the oldest known disease and there are many references to it in the Old and New Testaments. The Law of Moses required lepers to call out "Unclean, unclean" to warn others from touching them.

Today the infection is readily cured but it's important to catch it early before nerves are permanently damaged. Before the armadillo link was discovered, southern doctors never considered leprosy as the cause for the numb fingers their patients reported. Leprosy just made no sense if the patient had never traveled outside the U.S.

The return of HIV

"And there's no guarantee that if you get HIV and you take these triple therapies, or whatever comes along next, that they're going to be successful for you."
- Elton John

The Tennessean.com reports that health officials are seeing a surge in new HIV cases with young adults because they no longer fear the disease. Many people think the war against AIDS ended in the mid-1990s when a "cure" was found.

“I remember holding the hands of people dying of AIDS in my 24 years of being in this field, but the young people I talk to have not held the hands of folks dying with AIDS,” said Harris [a health educator]. “They don’t have a reality of this virus.”

With a lack of fear for HIV, “Behavior is back to where it was in 1980,” says a public health official where youth are seeking for and advertising unprotected sex.

Between 2005 and 2009, the number of Tennesseans 15 to 24 years old newly diagnosed with HIV jumped 32 percent, state health department figures show.

And the disease is not "cured."

While medical advances have largely turned what was once a death sentence into a chronic manageable disease, there is no guarantee that infected people can just take a pill and keep on living. How well medications work depends upon how soon HIV is detected and what mutations of the virus exist. ...
Almost one of six newly diagnosed people in 2007 was infected with a form of the virus that was resistant to at least one class of drugs used to treat HIV. One percent had mutations of the virus that were resistant to all three classes of drugs.

Bottom Line

If you have kids tell them that HIV is not "cured" and can still be fatal.

Heart Disease

“Follow your heart, but be quiet for a while first. Ask questions, then feel the answer. Learn to trust your heart.”

Yesterday I talked about cancer, the #2 killer in America with 559,888 deaths in 2006. The first place award goes to Heart Disease (more formerly known as Cardiovascular Disease or CVD) with 831,272 deaths in 2006 (34.3 percent of all deaths or 1 of every 2.9 deaths). What exactly is Heart Disease?

• Coronary heart disease: caused by atherosclerosis (ath"er-o-skleh-RO'sis), the narrowing of the coronary arteries due to fatty build ups. Partial blockage results in chest pain and total blockage cuts off blood to the heart muscle and results in a heart attack.
• Stroke: blood to a portion of the brain is cut off by a blood clot or a burst blood vessel.
• Heart Failure: occurs when the heart cannot pump enough blood to support other organs. The heart may still be beating but with insufficient strength.

The Center for Disease Control (CDC) recognizes the following risk factors for Heart Disease:
* high cholesterol
* high blood pressure - It's called the "silent killer" and greatly increases the likelihood of heart attack or stroke. 90–95% of the time the cause of high blood pressure isn't known but it is often treatable.
* smoking
* being overweight
* lack of exercise (people who are sedentary are almost twice as likely to suffer heart attacks as are people who exercise regularly.)
* African American women have the highest risk for death from heart disease
* Male pattern baldness, hair in the ear canals, and creased earlobes are associated with a higher risk for heart disease in white males.

On the positive side:

* People who eat beans at least four times a week have a lower level of heart disease (19% lower) than people who eat beans less than once a week.

Bottom Line

Heart attack and strokes can strike suddenly with no warning. They either kill outright or leave a person confused as to what just happened. Many don't recognize the symptoms. See:
http://perpetualpreparedness.blogspot.com/2010/11/stroke.html  (Stroke)
http://perpetualpreparedness.blogspot.com/2010/03/chest-pain.html (Heart Attack)

Heart failure is often a gradual process and does have symptoms which include—

• Shortness of breath during daily activities.
• Having trouble breathing when lying down.
• Weight gain with swelling in the legs, ankles, or lower back.
• General fatigue and weakness.

See http://www.medicinenet.com/edema/page3.htm (Edema)
and http://www.americanheart.org/presenter.jhtml?identifier=4585 (Congestive Heart Failure)

Health Supplements

"Faith and prayer are the vitamins of the soul; man cannot live in health without them."

- Mahalia Jackson

The Centers for Disease Control and Prevention (CDC) recently reported that 53% of all Americans use dietary supplements such as multivitamins, minerals and herbs. Sadly the 27 billion dollar supplement industry is not regulated by the US Food and Drug Administration (FDA) so supplement makers are not required to prove safety or effectiveness.

While many people think supplements make up for a poor diet, most doctors say there is no substitute for a healthy lifestyle. Research has show that some daily vitamin supplements just pass through the body and are barely absorbed, if at all. The body is more likely to retain vitamins and minerals when eaten in real food. There is also evidence that the body benefits from nutrients like lycopene, quercetin and indoles that give fruit and vegetables their bright colors and are not found in supplements (yet). Other health professionals disagree and argue that a daily multi-vitamin can help with trace minerals that your eating habits do not cover.

Be doubly careful when using herbal supplements. Many come from foreign countries and might not contain what they claim or in the dosage they claim. Always consult with a doctor first because herbs (and even multi-vitamins) may block or enhance medicines that you taking. Also ask your doctor about a safe dose level because sometimes more of a good thing (like vitamin D) can be deadly.

Bottom Line

A recent survey of parents by the YMCA found that only 14% of kids eat at least five fruits and vegetables a day. Even though 89% of parents rate themselves good or excellent in providing a healthy home environment, about a third of children in the USA are overweight. Only 16% say their kids are playing outside daily.

Resources

12 Supplements to Avoid
http://www.consumerreports.org/health/natural-health/dietary-supplements/supplement-side-effects/index.htm

Vitamin D
http://perpetualpreparedness.blogspot.com/2010/05/vitamin-d.html

Healthy Foods
http://perpetualpreparedness.blogspot.com/2010/05/healthy-foods.html

Vitamin Pills: A False Hope?
http://www.nytimes.com/2009/02/17/health/17well.html?_r=1&8dpc

Where in the world is ....?

“The world is not dangerous because of those who do harm but because of those who look at it without doing anything”

-Albert Einstein quotes

Each year the TED conference hands out TED prizes to individuals with an idea that can change the world. One winner talked about tracking disease epidemics world-wide with data from Google and other sources. Now it appears that that dream is alive and well.

Check out HealthMap at http://healthmap.org/en/. 

"HealthMap brings together disparate data sources to achieve a unified and comprehensive view of the current global state of infectious diseases and their effect on human and animal health. This freely available Web site integrates outbreak data of varying reliability, ranging from news sources (such as Google News) to curated personal accounts (such as ProMED) to validated official alerts (such as World Health Organization)."

The home page is a bit overwhelming with all outbreaks from the past three days. Hover the mouse over any pin to see the name of the disease.

I find the display more interesting when a single disease is searched. The default is the past 3-days but you can change this up to one month with the Advanced search options. I selected Typhoid in the past month and found cases in Algeria, China and Kyrgyzstan.

Bottom Line

This is a great resource for keeping an eye on swine flu or any other illness that you are concerned about.

Dirty Foods

“The more serious the illness, the more important it is for you to fight back, mobilizing all your resources-spiritual, emotional, intellectual, physical.”
- Norman Cousins

The Centers for Disease Control and Prevention estimates that 200,000 Americans experience food poisoning every day. This number could be as high as 800,000, according to Philip Tierno, author of The Secret Life of Germs. "Everyone in this country will get sick at least once this year from a foodborne virus, bacteria, or toxin," he says. But we may not know it and blame the mild symptoms—nausea, diarrhea, cramping—to a stomach flu.

Where do these germs come from? MensHealth.com identifies the “10 Dirtiest Foods.”  I’ll cover some highlights but be sure to read the entire article for all the details.

1. Chicken: Don’t be fooled by commercials of Perdue chickens enjoying a good life. Most chickens are raised in very dirty coops under crowded conditions. As a result, one in 10 chickens carry germs that can make you ill. To protect yourself
- Buy free range chickens which are raised (supposedly) in cleaner environments
- Do not wash chickens or chicken parts in the sink. This spreads the germs to anything that touches the sink. Instead put the chicken directly into a pan/pot and let heat kill the germs.
- Chicken should be cooked to a temperature of 180°F. Use a thermometer – don’t trust the color of juice when pricked.
- If the chicken touched a cutting board, clean the board and knife with a mild, diluted bleach solution.

2. Eggs: pasteurization has reduced the risk of dirty eggs to 1 in 200,000. But given the millions of eggs consumed in America, eggs sicken an estimated 660,000 people annually and kill 300.
- Only buy pasteurized eggs.
- Never use a cracked egg in a carton.
- Store eggs in the coldest part of your fridge (not in the fridge door).
- Wash your hands after handling eggs.
- Cook eggs to 160°F

3. Hamburger: In one USDA test, 53% of the ground chuck examined was infected with Clostridium perfringens which can cause illness.
- Buy beef that is "treated by irradiation" to kill germs
- 1 Tbsp. of Fresh oregano can kill E. coli in one pound of beef
- Cook beef to 160°F

4. Fresh fruit – because most fruit is eaten raw, any germs on the outside will not be killed by cooking. For example, Cantaloupe grows on the ground and has a netted exterior that makes it easy for Salmonella to sneak on; and once on it's hard to clean off.
- Clean the exterior of all fruits prior to eating. Wash your hands afterwards.
- Washing fruits will also remove any pesticides that were sprayed on.

5. Fresh vegetables : my mother is paranoid about washing lettuce. She grew up on a farm and has seen how dirty field conditions are for the produce and the workers. You also want to wash spinach and scallions thoroughly..
- "Just because something is wrapped in cellophane doesn't mean it's free of pathogens." Don’t be lulled by claims of being "triple washed."

6. Deli Meats: cold cuts have been labeled "high risk" of causing listeriosis by a joint team of researchers from the USDA, FDA, and CDC. The Listeria germ grows rapidly on cut meat even with ideal refrigeration; and then the cold cut is eaten without further cooking. The most likely source of Listeria-contaminated cold cuts is the deli slicer. Without regular cleaning, the blade can transfer bacteria from roast beef to turkey to pastrami and back.
- Toss any meat that is a week old
- Slather on the mustard. Researchers found that mustard killed off 90 percent of three potent pathogens—Listeria, E. coli, and Salmonella—within 2 hours.

Bottom Line

We like to think the food we buy is clean but the truth is that it’s not. The advice above will help prevent some common sources of illness.

The Return of Flu Season

“I like pigs. Dogs look up to us. Cats look down on us. Pigs treat us as equals.”

- Winston Churchill

From the British Telegraph, "The hospitals are gridlocked.” Winter flu is overwhelming hospitals in England. Four weeks of intense pressures from flu have left casualty departments (i.e. emergency rooms) “overwhelmed” with patients.  Desperately sick people have been left for hours waiting on trolleys.

"Dozens of NHS [National Health Service] units have cancelled surgery and clinics for outpatients. At least 10 major centres issued “black alerts” — the highest emergency warning — meaning they were at breaking point, forcing patients to be sent elsewhere.

Scores of hospital wards closed due to norovirus, the winter vomiting bug, which put more than 1,200 beds out of use in one week as nurses attempted to isolate the disease. "

Part of the problem is that people have no place to go after hours and on weekends.

"In many parts of the country out-of-hours services are absolutely inadequate, so what we get is people turning up at A&E [Emergency Rooms] simply because they do not know where else to go"

Bottom Line

Be prepared for a very bad flu season. In England the number of deaths from flu had almost doubled.

The Bane of Efficiency

"With twelve kids, one would think that there was always chaos, but Dad was an efficiency expert and used all of his methods from work at home during family life. One of the things he did was call family assemblies by blowing a whistle, everyone had to stop what they were doing and come immediately.  "
- Cheaper by the Dozen

A very common New Year's resolution is better fitness and health with more exercise. I was reminded today that an enemy to exercise is efficiency. In olden days most people had physically demanding jobs but today technology makes everything "Less Labor Intensive". Why beat a rug when a Roombot can vacuum for you? Or lead a mule on a plow when you can sit in an air conditioned tractor?

The need for speed and efficiency affects all aspects of our daily life. An old friend from college was amazed to watch drivers searching for the closest spot to park next to the fitness club. Are they afraid of working up a sweat before exercising? My wife had a similar complaint when she used a fitness club for physical therapy, all the therapy spots near the door were filled by healthy fitness patrons who did not want to walk.

I find that instead of making two trips to the basement or kitchen, I'll load up way too much to carry for a single trip. Ditto for carrying groceries from the car to the house. Or at work juggling food and drink back to my cube from the office kitchen instead of walking twice. There are co-workers with giant water bottles so they don't have to revisit the kitchen to refill during the day. Or a giant, all-day, mug of coffee from Duncan Donuts.

Bottom Line

As Michael Jackson says in Billie Jean, "(Do think twice) Do think twice".  Make that second trip. Walk more. Dare to park far away.

And in addition to doing things twice, consider also doing things in halves. That is, eating half-sized portions. I read of a very simple diet where you eat half of your "normal" sized serving and save the 2nd half for another meal. Definitely a good idea at restaurants; they serve way too much food. If you drink a huge soft drink and eat a giant hamburger with an extra large fries, it may contain as many as 2,000 calories in one sitting - more calories them most people need to eat in a single day. Those little hamburgers that now sell for $1 - $1.25 were the original size when "fast food" service began in the 40's. But then came the double burger, the triple, the quarter-pounder, the third of a pounder, etc, along with ever growing sizes of fries and drinks.

And eating half-sizes is not a bad idea at home since our idea of portion size has grown to match the restaurants. A co-worker of mine doesn't just eat the HungryMan, extra-large sized microwave meal, he eats two of them every day for lunch. For more on portion sizes, see my post at http://perpetualpreparedness.blogspot.com/2010/03/too-much-food.html

Whooping Cough

"We are eager to tunnel under the Atlantic and bring the Old World some weeks nearer to the New; but perchance the first news that will leak through into the broad, flapping American ear will be that the Princess Adelaide has the whooping cough." - Henry David Thoreau

Many years ago my sister lived in Watertown, NY, on the north-western edge of the state near the Canadian border. I'm glad she's not living there now since this region is experiencing an epidemic of Whooping Cough with some 300 cases to date.

Whooping cough, formally called Pertussis, is a highly contagious bacterial disease that causes uncontrollable, violent coughing. It is spread through the air by tiny droplets when a patient coughs or sneezes. The coughing is extreme and can make it hard to breathe; often a deep "whooping" sound is heard when trying to take a breath. It is a serious disease and the infection usually lasts 6 weeks.

Pertussis used to kill 5,000 to 10,000 people (usually children & infants) in the United States each year. Now, a vaccine has reduced the annual number of deaths to less than 30. But today parents are skipping the vaccine and the disease is returning. In 2004 the number of whooping cough cases spiked past 25,000, the highest level it's been since the 1950s.

Whooping cough begins like the common cold about a week after exposure. But 10 to 12 days later the coughing fits begin, they can last for more than a minute, and the patient may turn red or purple from lack of air (the "whoop" is a desperate gasp to breath!) Vomiting may also result from a coughing fit. Fits usually occur in groups, with multiple episodes every hour around the clock.

These extreme symptoms can be fatal with infants who rarely "whoop". Instead they gasp for air with a reddened face and may actually stop breathing for a few seconds during particularly bad spells or they may choke on vomit.

Treatment - antibiotics such as erythromycin are effective if Whooping cough is caught early BEFORE the coughing begins, but when diagnosed too late, the antibiotics will reduce infectiousness but not the symptoms. Infants younger than 18 months need to be monitored to ensure breathing and may need to be hospitalized. Curiously, cough mixtures, expectorants, and suppressants are usually not helpful and should NOT be used. Most cough mixtures loosen the mucus in the lungs to encourage coughing - with whooping cough the patient is already coughing too much and too frequently so the last thing you want is more coughing.

During recovery, let your child rest in bed and use a cool-mist vaporizer to help soothe irritated lungs and breathing passages. Be sure to follow directions for keeping it clean and mold-free. In addition, keep your home free of irritants that can trigger coughing spells, such as aerosol sprays, tobacco smoke, and smoke from cooking, fireplaces, and wood-burning stoves.

Kids with whooping cough may vomit or not eat or drink much because of frequent coughing. So offer smaller, more frequent meals and encourage your child to drink lots of fluids. Watch for signs of dehydration, too, including thirst, irritability, restlessness, lethargy, sunken eyes, a dry mouth and tongue, dry skin, crying without tears, and fewer trips to the bathroom to urinate (or in infants, fewer wet diapers)

Bottom Line

During a pertussis outbreak, unimmunized children under age 7 should not attend school or public gatherings, and should be isolated from anyone known or suspected to be infected. This should last until 14 days after the last reported case. Remember that the first symptoms do not appear for a week to 10 days and two weeks for the severe coughing. In rare cases it can be 21 days from infection to symptoms. So people may be infected and not know it.

All children should be immunized before the sixth birthday and given a booster shot between ages 11-12.

http://en.wikipedia.org/wiki/Pertussis
http://kidshealth.org/parent/infections/bacterial_viral/whooping_cough.html
https://health.google.com/health/ref/Pertussis

Mystery Medication

“I was under medication when I made the decision not to burn the tapes.” - Richard M. Nixon

A year ago my wife looked inside a pill bottle and noticed that one of the pills didn't belong. It was a different shape and color and size. There was no way she was going to swallow a mystery pill. Instead we brought it back to the pharmacy to point out an error in their quality control.

If you encounter an unknown pill and want to discover what it is, the National Institute of Health has a Beta website with pills organized by color, shape, etc. http://pillbox.nlm.nih.gov/

Bottom Line

I'm not sure exactly why this website exists (except for pharmacists). What person is going to say, "Hey, I found this cool looking pill on the sidewalk? I think I'll research what it is and then swallow it."

Perhaps it's useful if you find an unlabeled bottle in your medicine cabinet? Or pills that your child/spouse is hiding?

Leading causes of Death

“Have the courage to live. Anyone can die.” -Robert Cody

A commenter on yesterday's post about heat deaths offered a link to a Cato-at-liberty story that cites a paper (Goklany) on the leading causes of death. What stood out for me was this quote,

"Note that despite the hoopla about natural weather disasters, they contribute less than 0.06% to the annual U.S. death toll!"

In other words, extreme heat & cold, floods, tornadoes, lightning and hurricanes, COMBINED, account for less than 1 in 1000 of all deaths in the US.

So what are people dieing of (besides old age)? The Goklany report based on World Health Organization data shows that in 2002, globally people died as follows:

59% Non-communicable illness (cancer 12%, heart attack 29%, lung diseases 7%, and other)

32% Communicable Diseases (including AIDS 5%, Tuberculosis 3%, Diarrhea 3%, parasites 6%, starvation 1%, childbirth 5%)

09% Injury (Traffic accidents 2%, Murder 1%, War 0.3%)

00.03%  Extreme Weather

Now consider, which deaths get all the media attention?

Bottom Line

There is a huge disconnect between the dangers we fear and the dangers we will actually face. Exercise and diet are more likely to prolong your life than hurricane preparation. But weight control is a life style change while disaster prep is a quick fix that we can do once and feel safer afterwards.

It's Hot, Hot, Hot

“Some people change their ways when they see the light;
others when they feel the heat”

- Caroline Schoeder

What is the deadliest type of natural disaster? A supernova as pictured yesterday would top the list by frying the entire planet but we should be safe from that for several billion years. Other obvious candidates include hurricanes, massive earthquakes, and tidal waves. Hurricane Katrina may have killed 1700 people directly with a total of 4000 deaths if you include secondary causes. And yet according to a new book called "Hot Time in the Old Town" by professor Edward P. Kohn, the deadliest type of natural disaster in America is heat waves.

"We all enjoyed pictures of children playing in fountains and eating ice cream.  To the media, a heat wave means a holiday.  This obscures the sinister fact that heat waves are this country’s number one natural disaster killer. On average, heat kills more Americans than floods, hurricanes, and tornadoes combined. "

This summer Russian had a terrible heat wave that caused forest fires and burned wheat fields. American TV showed pictures of a smoke-choked Moscow but news agencies failed to mention the death count. The Moscow city government reported a doubling of deaths during the heat wave; every day three hundred additional people died over a period of  several weeks. This quickly adds up to a catastrophe.

The 1896 heat wave in New York City killed as many as thirteen hundred people who literally roasted to death in brick buildings. The media and the government basically ignored the emergency. The one person who took action was a young Theodore Roosevelt, President of the Board of Police Commissioners, who distributed free ice to the poor. No one learned anything from this and history continued to repeat itself. In 1972 as many as nine hundred people died during a New York heat wave.  The 1995 Chicago heat wave killed seven hundred, while a 2003 European heat wave killed over 50,000.

Bottom Line

Perhaps it was the 2003 European disaster that finally convinced cities to take heat waves seriously.

Today, most cities have heat wave response plans in place even before summer arrives.  Emergency cooling centers are set up in local community centers, and officials check on the elderly and chronically ill through phone calls and home visits. 

For more information on the risks of extreme heat check out these prior blog posts:

2009/07/greenhouse-effect-in-cars
2009/07/exercising-on-hot-days
2009/07/extreme-heat
2008/08/heat-exhaustion
2008/08/hyperthermia   (note: hyper not hypo)

Please don't eat the polar bear

"Millions of Americans take vitamins safely every day, including me. Vitamins and mineral supplements taken in recommended doses are safe. It's the designer supplements that are worrisome."
- Dick Durbin, US Senator.  

Today I learned an odd bit of trivia - twice - from two different sources. The first source is the Teaching Company lecture series, Nutrition Made Clear. The other source is http://www.survivalblog.com/, Providing Crucial Fats and Oils in Your Diet. Apparently Polar Bear liver is dangerous. "A quarter-pound of polar bear liver contains about 2,250,000 units of vitamin A. That is roughly 450 times the recommended daily dose for an adult weighing 175 pounds.)" - survialblog.com. Eating more than a quarter ounce of polar bear liver per month can cause vitamin A poisoning.

Vitamin A, along with D, E and K, are fat soluble meaning they are absorbed into the body's fat and stay there until the body needs them. A massive overdose of these vitamins can be fatal. It's also dangerous to greatly exceed the Recommended Daily Allowance (RDA) every day (without a Dr's OK). The excess is stored in the body and may reach toxic levels over time.

So how about the water soluble vitamins like the B's and C? Everyone knows these are safe in large doses. Wrong. The lecture series Nutrition Made Clear tells the story of a gymnast who was given a massive dose of B6 for an energy boost. Unknown to the coach, a B6 overdose causes numbness in hands and/or feet (and can be fatal). The gymnast fell from the parallel bars and suffered a spinal injury that ended her career.

Vitamin C is popular in mega-doses to fight colds but there is little medical evidence that this is effective. At best C will end a cold sooner but not prevent it. Too much vitamin C can cause diarrhea, kidney stones, hot flashes, headache, insomnia and tiredness.

Bottom Line

I often hear people say, it's natural so it must be healthy. They forget belladonna is 100% natural but very deadly. So are some wild mushrooms and puffer fish. I would not want to eat Poison Ivy or inhale it.

Also you'll hear, "if a little is good, more is better" when it comes to minerals and vitamins. Here's a short list of vitamin overdose symptoms.

Vitamin A overdose:
Blurred vision, dizziness, ringing in the ears, headache, insomnia, irritability, apathy, stupor, skin rash, nausea, vomiting, diarrhea, hair loss, joint pain, menstrual irregularities, fatigue, liver damage, abnormal bone growth, damage to the nervous system.

D vitamin overdose:
Calcium deposits, deafness, nausea, fatigue, headache, loss of appetite, kidney stones, weak bones, hypertension, high cholesterol

E vitamin overdose:
Pulmonary embolism, hypertension, muscular weakness, severe fatigue, breast tenderness, slow wound healing

Niacin vitamin overdose:
Acute flushing, peptic ulcers, liver dysfunction, gout, faintness, dizziness, tingling of fingertips, arrhythmia's, hyperglycemia

B6 vitamin overdose:
Problems with sense of position and vibration, reduced tendon reflexes, numbness in hands and feet, problems walking, problems with memory, depression, headache and tiredness

C vitamin overdose:
Taking mega doses for too long may lead to scurvy when mega doses are discontinued, kidney stones, hot flashes, headache, insomnia and tiredness.

Calcium overdose:
Depresses nerve function, can cause drowsiness, calcium deposits, and kidney stones

Iron overdose:
Damages liver, heart, and pancreas

Zinc overdose:
Fixed facial expression, difficulty walking, slurred speech, hand tremor, involuntary laughter

Cobalt overdose:
Goiter, heart damage

Selenium overdose:
Nausea, vomiting, fatigue, irritability, loss of fingernails and toenail.

Fruits of Obamacare

“Insurance: An ingenious modern game of chance in which the player is permitted to enjoy the comfortable conviction that he is beating the man who keeps the table.”
- Ambrose Bierce

The Washington Post reports that, "Some of the country's most prominent health insurance companies have decided to stop offering new child-only plans, rather than comply with rules in the new health-care law that will require such plans to start accepting children with preexisting medical conditions after Sept. 23." Existing policies will be honored but no new child-only polices. An industry spokesman points out that with no right of refusal, parents can "wait until their child becomes very sick before purchasing coverage." Under Obamacare, child-only plans could rapidly skew towards mostly children with expensive medical bills, either bankrupting the plans or forcing insurers to make up their losses by increasing premiums for all customers.

The skewing of insurance to the very sick is already happening in Massachusetts where anyone can buy health insurance last second. Many individuals buy when sick and cancel after treatment. In Massachusetts it is cheaper to pay the uninsured penalty than pay for coverage when not needed. Health care advocates can yell and scream, "[It] is immoral, and to blame their appalling behavior on the new law is patently dishonest." But it is the advocates who are dishonest. The Health Insurance is a for profit business, not a charity, and the advocates conveniently forget how Insurance companies work.

The theory behind insurance is simple: spread the risks of a few amongst the many. The sick are subsidized by the many healthy who are paying in. Just like Social Security for retirement is covered by the many employed paying in. Imagine that the aging population reaches the point where 50% of all adults in America are retired seniors. Then every person on Social Security would be funded by one working person. A working person would have to earn enough for his/her own family plus taxes plus enough to give a retiree a living income plus the overhead cost of a government bureaucracy managing the money. That just not feasible. Likewise with heath insurance, the system collapses if mostly the sick are the only ones making payments since each sick person is receiving back more than they are paying in.

A spokeswoman for the Department of Health and Human Services says, "We expect [insurance companies] to honor that commitment. Insurers shouldn't break their promise and turn their backs on some of our most vulnerable Americans." This is just absurd. There is no promise, no commitment, there is only business and the new law allows families to "game" the system and violate the priciple of insurance with a large pool where many contribute but only a few collect.

People may think the insurance model is "unfair". But it is no different than lottery systems or any gambling business. Many pay a small amount with the hope of a big payout. The size of the payout and the odds of winning are carefully balanced against the number of people paying. The lottery system would collaspe if there were "high risk" individuals who were super lucky and frequently picked winning numbers. The lottery would want to ban these individuals just like Casinos ban card counters from Black Jack or anyone else they think is having above average luck at winning. Obamacare is equivalent to telling the Lottery and Casinos that they must accept all players no matter how "lucky" they are. In response I would expect Casinos to stop playing Black Jack to prevent losses from card counters.

Bottom Line

The Washington Post article ends by pointing out that "most poor children with preexisting conditions already qualify for insurance through programs such as Medicaid and the Children's Health Insurance Program. And those who are not poor will be able to apply to new high-risk pools established by the law."  Also the insurers who will stop child-only policies will still accept children with pre-existing conditions with new family plans. The healthy family members help cover the costs of the sick child.

The idea that insurers "turn their backs" on sick children is just spin. What has happened is that government has changed the law in such a way that child-only policies may become unprofitable. Insurers are jumping ship before they get stuck with a loss for these specialized policies. Families may still buy family policies.

Best Way to Dry Your Hands

"Wouldn't you give your hand to a friend"
- lyrics to Midnight Blue

NewScientist.com has a brief health notice on drying your hands.  Common sense would say that air dryers are cleanest but a medical study has found that For clean hands, don't rub, scrub with a paper towel.

"When you rub your hands, you bring a lot of bacteria to the surface from the pores of your skin," says Anna Snelling of the University of Bradford, UK.

In the study bacteria counts on the hands changed as follows after washing:

Air Dry with hand rubbing - bacteria up 18%
Air Dry without hand rubbing - bacteria down 37%
Drying hands with a paper towel - bacteria down 50%

Bottom Line

Towels work best because they actually scrape off bacteria from the skin.

Zinc for Colds?

“A family is a unit composed not only of children but of men, women, an occasional animal, and the common cold”-Ogden Nash

According to the Archives of Otolaryngology (try saying that 3 times fast) a recent clinical trial has found that zinc nasal gels and sprays were ineffective in preventing or reducing the duration of the common cold. Moreover zinc applied to the nasal cavity can lead to a loss of smell, possibly permanent.

An earlier study that showed that zinc therapies reduce the severity of a cold was funded by the makers of the medicine used in the study. So perhaps there was a bit of bias?

It's important to know that homeopathic products that treat less serious illness, such as the common cold, can be sold over the counter and are exempt from "the rigorous premarket approval process" of the FDA.

Bottom Line

Be very careful of any "herbal medicine" or homeopathic drug sold over the counter. See my blog from last year about Dangerous Diet Pills.