Written by Serrin Gantt, M.D.
November 11, 2015
FLU
It’s time to get your flu shot if you have not already. In this week’s news, the first case of Influenza, type A H1N1, was documented in Baltimore, Maryland. This year’s vaccine is protective against this strain of virus. Peak flu season is between December and February and the CDC recommends that anyone over 6 months of age be vaccinated. Lady Docs strongly encourages you to get a flu shot.
The nasal flu vaccine (FluMyst) is what is referred to as a live vaccine. It is a quadrivalent vaccine(protects against 4 strains of virus) that is approved for use in those ages 2 to 49 years old. Although it does not cause the flu there are a number of restrictions regarding its use. People with a weakened immune system either related to age, disease or a medication that they are on, should not take it. Please discuss these contraindications with your health care provider if you prefer a nasal spray as opposed to a shot.
According to “UpToDate Practice Changing Guidelines”, those with egg allergies can now receive the same vaccine as those without. It is recommended that all patients over the age of 6 months with an egg allergy, including even those with a severe allergic reaction (anaphylaxis) receive the influenza vaccine according to indications for patients without an egg allergy. They advise that it be administered as a single dose. Thirty minutes of observation following administration is suggested.
EDITORS NOTE: FROM THE CDC.GOV WEBSITE: “People who have ever had a severe allergic reaction to eggs can get recombinant flu vaccine (also known as FluBlok – it is produced differently, without any chicken or egg component) if they are 18 years and older or they should get the regular flu shot (IIV) given by a medical doctor with experience in management of severe allergic conditions. People who have had a mild reaction to egg—that is, one which only involved hives—may get a flu shot with additional safety measures. Recombinant flu vaccines also are an option for people if they are 18 years and older and they do not have any contraindications to that vaccine. Make sure your doctor or health care professional knows about any allergic reactions. Most, but not all, types of flu vaccine contain a small amount of egg.”
Personally, I would not administer the regular flu vaccine to someone with an allergy — MS
SEX
The FDA recently approved Flibanserin (Addyl) for female sexual dysfunction in premenopausal women after rejecting its approval twice. Increases in sexual desire were modest but did show statistical improvement with an average increase in “sexually satisfying events” over a 4 week range of 1-2.5 vs 0.6 to 1.5 with placebo. Onset of effectiveness may take 4 weeks. Alcohol increased the incidence of side effects which typically include low blood pressure, headache, feeling tired or dizzy. There is a black box warning noting that the drug may cause low blood pressure or one to pass out.
EXERCISE
Multiple studies have documented that exercise is good for one’s health however how much exercise is healthy is controversial. A recent unpublished study presented at the European Society of Cardiology in August (Sanjay Sharma, MD) suggested that endurance athletes had higher levels of calcium deposits in their coronary arteries (arteries that supply blood to the heart) than those that ran fewer than 35 miles a week or cycled less that 150km a week. The researchers also noted a correlation between speed and levels of coronary calcium, with slower athletes having significantly lower levels of coronary calcium. Slow moderate exercisers had less coronary calcium than the sedentary control group whereas the extreme exercisers (endurance athletes) had more. The good news was that the type of plaque found in the extreme exercisers was “dense” vs “soft” and it is felt that dense plaque is less prone to rupture and cause stroke or heart attack. The researchers suggest that perhaps the increase in coronary calcification in extreme exercisers relates to inflammation.