Thursday, June 9, 2016

Let's Talk Adult Vaccinations

There's a lot of talk about vaccinating children, but we don't hear a lot about vaccinations for adults. The conversation drops off the map, as if once a child has finished his or her scheduled vaccines, that's it, that's all. But that's not it, and that's not all.

The need for vaccines continues as we age, and then become even more important again when we enter the so-called senior years. And for those who want to travel to other parts of the world, some countries won't allow you to visit if you haven't had their required vaccines.

What types of routine vaccines should adults have? Health Canada and the Centers of Disease Control (CDC) have similar recommendations. To make things easier for me, I'll focus on Health Canada.

In general, Health Canada recommends that adults who have been vaccinated as children, should continue with the following schedule, unless recommended otherwise by their physicians:

  • Tetanus toxoid- reduced diphtheria toxoid (Td): 1 booster dose every 10 years.
  • Tetanus toxoid- reduced diphtheria toxoid- reduced acellular pertussis (Tdap): 1 dose 
  • Pneumococcal polysaccharide 23-valent:  1 dose at age 65 or older
  • Herpes zoster (shingles): may receive 1 dose at 50 to 59 years of age, recommended 1 dose
  • Influenza:  1 dose annually recommended for all adults without contraindications

There are also other vaccines, such as those for hepatitis A and B, which are recommended for people who are at risk of contracting the diseases.

Tetanus: Many people I speak with don't realize that they should get a tetanus booster every 10 years. I've heard many times, "Oh, I get a tetanus shot in the ER or at urgent care if I get a bad cut." But tetanus doesn't need a bad cut to take hold, so the booster route is a really safer route. I won't kid you, the tetanus shot does tend to be a bit more "uncomfortable" than many vaccines. But it is only once a decade. Perhaps you can bribe yourself with a nice treat after?

Pneumonia: The pneumococcal vaccine is primarily to help prevent pneumonia, although it does prevent other infections too. According to the National Foundation for Infectious Diseases,

It is estimated that about one million US adults get pneumococcal pneumonia each year. About 5-7% of them will die, and the death rate is even higher in those age 65 years and older. Fewer people will get pneumococcal meningitis or bloodstream infection, but the mortality rate for these infections is even higher.

So, while pneumococcal vaccine doesn't prevent all pneumonias, it does reduce the risk of this one, which can cause serious illness. It's particularly important for people who smoke, or who have respiratory diseases, such as COPD.

Shingles: I've had shingles; I was 44. One of my kids had shingles at only 21. I've known several people who had them before the age of 50. You don't want shingles. If you've ever had the chicken pox as a child, you are at risk of getting shingles. Remember, you don't want them. It's a horribly painful, uncomfortable virus that can knock you flat. There is also a complication called post-herpetic neuralgia, which can leave you with constant pain along the nerve line for years.

There is a treatment for shingles, but you have to recognize that you have the virus early enough for the treatment to work, and it really just knocks off a couple of days of suffering. It doesn't just get rid of the shingles. If you're on the fence about getting the vaccine, remember, you do not want to get shingles.

Influenza: The influenza vaccine seems to be the most controversial of the adult vaccination recommendations. Many people I know and love don't believe it in and refuse to get it. It's true that the vaccine isn't always effective. But I've seen what the flu can do, so the annual flu vaccine is a personal choice I make. Because I get so ill so fast with anything respiratory, I try to reduce my risk as much as possible.

Hepatitis A and B: I received this vaccine many years ago - it was required that nurses be vaccinated. I'm due for it again though, as it's supposedly worn off by now. The risk of getting hepatitis A is mostly for people who travel, but there is a combination vaccine that will protect you from both A and B at the same time. There is no vaccine for hepatitis C.

So, just because we're all grown up now doesn't mean we don't have to think about vaccinations.

Tuesday, June 7, 2016

Bigger Wine Glass = More Wine Consumed. Duh Study Time?

Long-time readers of my blog know that I live for finding Duh Studies. Those are studies that make me wonder how on earth the researchers received approval and funding for certain types of research. I found another one this morning.

Did you know that if you use a bigger wine glass, chances are you will drink more wine? I know. I was shocked too. Just as shocked as I was to learn years ago in nursing school that if we served meals on larger plates, people would want or add more food to these plates.

This new study from the University of Cambridge measured how much wine people bought/drank when they used larger glasses than when they used standard glasses. According to the press release:

Over the course of a 16-week period, the owners of the establishment changed the size of the wine glasses at fortnightly intervals, alternating between the standard (300ml) size, and larger (370ml) and smaller (250 ml) glasses.
The researchers found that the volume of wine purchased daily was 9.4% higher when sold in larger glasses compared to standard-sized glasses. This effect was mainly driven by sales in the bar area, which saw an increase in sales of 14.4%, compared to an 8.2% increase in sales in the restaurant. The findings were inconclusive as to whether sales were different with smaller compared to standard-sized glasses.

Ok, in all fairness, I did not read the study and I do only have this press release to go on, but seriously - is it really big news?

I have to say, I disagree with the researcher's quote here:

"We found that increasing the size of wine glasses, even without increasing the amount of wine, leads people to drink more," says Dr Rachel Pechey from the BHRU at Cambridge. "It's not obvious why this should be the case, but one reason may be that larger glasses change our perceptions of the amount of wine, leading us to drink faster and order more. But it's interesting that we didn't see the opposite effect when we switched to smaller wine glasses."

We do know. We know it's human nature. We see a lot in a small glass and a bit in a large glass, and we unconsciously believe that the amount in the smaller glass is more than in the larger glass.

Here are some earlier Duh Studies I wrote about:

It's Duh Study Time Again
Duh studies, not just for the public
Duh Studies, This Is News?

My interest in Duh Studies goes back to when I first worked as an online editor, and I came across a study that screamed, Bottle Feeding Dangerous For Babies (or something like that). It turns out, that the researcher had two case studies, both eerily similar. The first one involved a woman who boiled some water in a pan to heat up a bottle of formula. She took the freshly boiled pot of water over to her bed. Yes, to her bed. She placed the pan of water, freshly hot boiled water, ON HER BED. She put in the bottle of formula. She then GOT ON THE BED WITH THE BABY. As they were getting comfortable - you guessed it - the pot spilled freshly boiled water on the mum and baby, and baby was severely burned. Conclusion: Bottle feeding is dangerous.

I'm going to go have a cup of coffee in my enormous mug. Seems like I drink so little coffee that way. ;-)

Monday, June 6, 2016

Diseases, Deaths, and the Celebrity Effect

The world loves its celebrities, whether they be from sports, entertainment, or politics, or they're just famous for being famous. The celebrities rake in the money that many mere mortals are willing to pay so they can catch a glimpse of fame. Some of the celebrities embrace this adoration and use it to further causes they believe in, some mock it, and yet others try to live below the radar, avoiding the extra attention sent their way.

The attention focuses on, among other things, how celebrities live their lives, what they eat or don't eat, if they vaccinate or don't vaccinate, and what surgeries or procedures they may have had to keep their youthful look. But what fascinates is me the times when members of the public takes these celebrities as experts.  It's one thing to want to know what someone is wearing or how they decorate their home, but it's another to think that their celebrity makes them an expert on anything other than maybe being a celebrity. Is Gwyneth Paltrow really a nutrition and detox expert, or Jenny McCarthy an expert on vaccinations and autism?

And then there is the subject their health. When a celebrity announces a battle with an illness, their fans take notice and this drives awareness of conditions that may otherwise go unknown or misunderstood. Look at Angelina Jolie, and her decision to have a prophylactic double mastectomy and removal of her ovaries. She did this because she has a genetic mutation that greatly increases her risks of developing those cancers. This action and the publicity resulted in the Angelina effect, with many women with the same gene wondering if they should do the same thing - and experts appeared in all forms of media debating her approach.

Other celebrities who shared their battles with chronic diseases include:

Just last Friday, we lost another celebrity, a world-wide celebrity, to illness: Muhammed Ali. He, too, had Parkinson's disease, but his death was caused by septic shock. Patty Duke died in March from the same cause. (Disclaimer: I am content director for Sepsis Alliance, when sepsis or septic shock is listed as cause of death, it always attracts my attention.)

When celebrities or their families disclose illnesses or causes of death, this starts a conversation about them. How many people, particularly those in the age group who love Selena Gomez, had ever heard of lupus? How many people thought that HIV was still a problem in 2016? Before Michael J. Fox and Muhammed Ali announced they had Parkinson's disease, how many people realized it could affect people so young? And what about the educational benefits that came out from President Carter's announcement that he was undergoing immunotherapy for his cancer? 

I've read a few article comments and social media messages saying that the media shouldn't be writing about or playing up the illnesses after celebrities die, that they should be remembered for their roles in our society. But can't raising awareness of these illnesses be one of those roles? Is using that information taking advantage of the situation?

I believe that if celebrities or their families choose to disclose their health battles, then the idea was to help raise awareness - and that is a good thing. All diseases or conditions that affect our quality of life or that lead to an early death are important. But they don't all have the same amount of air time, of awareness. And if the news of one celebrity with one illness can change things, can help someone go for a diagnosis or maybe not feel so alone, then I think it's a good thing.