The Pneumococcal vaccine (pneumonia shot) is given to prevent a specific type of pneumonia. There are over 80 different types of Pneumococcal bacteria and the current vaccine protects against 23 of those. The vaccine does not protect against other bacteria that cause pneumonia or against the other pneumococcus types not covered in the vaccine.

Updated guidelines for the use of the vaccine were recently printed in the Morbidity and Mortality Weekly Report (MMWR). Specific recommendations include:

• Adults from 19 to 64 years of age with chronic medical conditions including asthma or anything compromising their immune system should receive the vaccine.
• Adults from 19 to 64 years of age who smoke should receive the vaccine and smoking cessation information.
• Routine administration of the vaccine is no longer recommended for Alaska Natives or American Indians younger than 65 years old. However, for those in these two groups who are 50 to 64 years old and who reside in areas where the risk of invasive pneumococcal disease is increased, authorities may recommend vaccination.
• All persons should receive the vaccination at 65 years of age. If a person got the vaccination before age 65 and 5 years or more have passed since they received it a second dose should be given at 65 years of age or later. If the vaccination was received at age 65 or later only one dose is required. No re-vaccination should be given.
• For people 19 to 64 years of age who have no spleen or a non functioning spleen or a immunocompromising condition a second dose should be given 5 years after the first. There is no indication for further re-vaccination.

Pay particular attention to the last two bulleted points since there has always been confusion as to when or if someone should receive a second dose of the vaccine.

Chronic medical conditions in persons 19 to 64 years of age where the vaccine is recommended include: chronic heart disease except hypertension, chronic lung disease including COPD, emphysema, and asthma, diabetes, CSF leaks, cochlear implants, alcoholism, cigarette smoking, and chronic liver disease including cirrhosis.

Be sure to ask your physician about the pneumococcal vaccine (pneumonia shot). bjmdjd

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health · indications for receiving the pneumococcal vaccine · Morbidity and Mortality Weekly Report (MMWR) · pneumococcal vaccine · pneumonia shot · wellness

Even though I did a post on the flu vaccine back on August 1st you really can’t be reminded about it too often! The Centers for Disease Control and Prevention (CDC) recommends that everyone 6 months of age and older be vaccinated as soon as the vaccination becomes available which is now.

As usual the vaccine will protect against the three most likely strains of flu expected to be prevalent this flu season. This years shot will include coverage for the H1N1 virus that caused so much illness last season. With more manufacturers than before there is not expected to be a shortage of vaccine this season.

Vaccination is particularly important for those who are at high risk of flu complications including young children, pregnant women, people with chronic health problems like diabetes, asthma, heart and lung disease, and people 65 years of age and older. While children younger than 6 months of age are at a high risk they are too young to be vaccinated. It is important to vaccinate the people that take care of them and will be around them instead.

And once again…THE FLU SHOT DOES NOT AND CANNOT CAUSE THE FLU!!!  bjmdjd

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Centers for Disease Control and Prevention · flu shot · flu vaccine · health · wellness

You might feel that you are in pretty decent shape except for that few extra inches around your mid section. However, a study printed in the current issue of Archives of Internal Medicine begs to differ. Waist size in older adults is a mortality risk factor regardless of the all important body mass index (BMI).

The authors concluded that regardless of an older adults weight they should pay close attention to their waist circumference to avoid earlier mortality.

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Archives of Internal Medicine · body mass index (BMI) · health · waist circumference · wellness

First, let me apologize for the two week break between posts. Frankly I haven’t come across much that I thought you needed to know and I’m determined not to post just for the sake of doing it.

Now to the meat of the matter. It is too early to be giving much thought to the flu vaccine here on the 1st of August. What got me to thinking about it is the fact that the Food and Drug Administration announced on Friday that they had approved which strains will be included in the vaccine for the upcoming flu season. This years vaccine will include the H1N1 strain that everyone had trouble deciding whether to get or not in a separate vaccine last season.

I was planning on listing some great info on the flu vaccine on this post but I found a release by the FDA which you can read by clicking on the following link: http://www.cdc.gov/flu/protect/keyfacts.htm   bjmdjd

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flu season · flu vaccine · Food and Drug Administration · H1N1 · health · influenza · wellness

Folks taking the antidepressant Effexor will be happy to hear that a generic form of Effexor XR was approved by the Food and Drug Administration this week. Teva Pharmaceuticals announced that they will begin shipping the drug on July 1, 2010.

Teva is the world’s largest generic drugmaker and hopefully the generic form of Effexor XR will be a big relief for its users pocket books. bjmdjd

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Food and Drug Administration · generic form of Effextor XR · health · Teva Pharmaceuticals · venlafaxine hydrochloride · wellness

I have never been shy about expressing my opinion concerning healthcare reform. I have always said that I am a huge supporter of healthcare reform but not a supporter of the bill that was recently passed. It may be a good start but it has some serious flaws that I feel if corrected would free up lots of money to take care of the currently under served population.

Maybe it’s because of my past experience working in the emergency room but the waste and abuse of the system by some patients gets under my craw more than I can even express. If you spent a couple of hours as an observer in an ER you would be absolutely sickened by the way the system is abused by some. I recently sent an email to this effect to someone and got an interesting response. In fairness to all I decided (with her permission) to print her response.

I am fortunate to be a friend and student of a nice lady named Nora Johnson. She is a medical billing advocate. In other words, she scours medical bills for mistakes and saves patients thousands of dollars. You may have seen her on CBS News, CNBC, The Wall Street Journal, Smart Money Magazine, and the list goes on and on. This lady is no slouch. In addition to a top notch education, her experience and resume make her an expert. And like one of the television commercials of the past says, “When she talks, people listen.”

I appreciate Nora allowing me to print her words of wisdom. She did not write this for publication and I did not check for spelling or grammar so read it for content only.

access to care · health · Healthcare Reform · Nora Johnson · underinsured · uninsured

Sorry I’ve been absent for a while but we had some family drama that needed to be dealt with. Forunately all is well and I’m back in the saddle again.

Even though it’s not funny, one of the jokes in an emergency room I worked in was all of the trouble that some folks went to when trying to find an instrument to get some attention through a suicide gesture. Some thought they would try to “fake” it by using the readily available acetaminophen. Little did they know that this inexpensive over the counter medication is one of the most dangerous drugs you can take if you take too much.

A recent study at the University of Rochester in New York has found that a majority of teenagers and young adults take over the counter medications without even knowing what the medicine actually is or the possible dangerous side effects.

Even though various studies document that acetaminophen toxicity is the cause of more cases of acute liver failure than viral hepatitis, few adolescents realized the possible dangers of taking that drug or many others that are freely available to them.  In this study it was found that 77% of those studied that were determined to be “health literate” did not even know the maximum daily dose of acetaminophen.

While this study focused on young people the findings for adults are not much better. It is imperative that people educate themselves about the medications that they take and become familiar with the dosage instructions printed on the bottle. bjmdjd  

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acetaminophen · acetaminophen dangers · health · over the counter drug toxicity · University of Rochester · wellness

Sorry for being absent for the past few days but it was necessary and there hasn’t been a lot going on anyway.

I recently saw a segment on television about this story so I was glad to find some further information on it. It is also of some interest to me due to the fact that one of my family members is having fairly severe memory problems now.

Accoring to the April issue of the Journal of Alzheimer’s Disease there is now an  online screening tool that has been found to be better and more reliable that standard tests in diagnosing cognitive impairment. It not only can determine who did and did not have cognitive impairment but could also identify the stage of Alzheimer’s disease.

It was noted that 69% of people with Alzheimer’s are not diagnosed by their primary care physician which suggests that there are many missed opportunities to make this diagnosis in the early stages of the disease. This is important due to the advances in medications which can now make a big difference in functioning if started early in the disease process.

The investigators admit that the tool needs further validation but state that it appears to be very promising. A web site is provided in the article for physicians that would like further information.  bjmdjd

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Alzheimer's disease · cognitive imparment · health · Journal of Alzheimer's Disease · wellness

On March 9th ABC news ran a story about the long term use of Fosamax or its generic forms causing sudden femur fractures just below the hip joint. The next day the Food and Drug Administration reported that it had no evidence to support this belief.

While the ABC report only mentioned the drug Fosamax and the generic forms called alendronate there are several other drugs marketed in this class of medications called biphosphonates for the prevention and treatment of osteoporosis. The FDA recommended that patients not quit taking these drugs unless told to by their medical provider.  bjmdjd

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ABC News · alendronate · biphosphonates · Food and Drug Administration · Fosamax · health · wellness

The Food and Drug Administration (FDA) today approved the use of Botox for the treatment of increased stiffness and tightness in certain muscles of the upper extremities in patients with conditions like traumatic brain injury, stroke, and progressive multiple sclerosis.

They also reiterated that the treatment is not meant to be a substitute for physical therapy and rehabilitation and that there are many possible serious side effects with its use.  bjmdjd

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It looks like Medicare patients and the physicians that see them may be safe again for a while. The Senate today voted to delay the 21.2% Medicare physician pay cut until October 1, 2010. It will take effect if the House approves it and President Obama signs it. Both which will probably occur.

This is the same bill with extending unemployment benefits attached to it and extension of premium subsidies for those who are out of work under the COBRA program. Most Democrats voted for it in the Senate and most Republicans voted against it under the guise of not wanting to increase the deficit.

As I wrote earlier, I understand and agree with the deficit problem but the unemployed need some money to exist and Medicare patients need to be able to get an appointment to see their doctors. Hopefully Congress will finally create a permanent fix for the Medicare physician reimbursement problem that they have had to frequently cover with a band aid.  bjmdjd

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The results of two different studies that were scheduled to be presented today at the annual meeting of the American Academy of Orthopaedic Surgeons detail the high rate of severe injuries to children who ride all terrain vehicles (ATVs). These injuries include spinal injuries, amputations, and even death.

A pediatric emergency medicine specialist at the Cincinnati Children’s Hospital who was not involved in the studies said that ATV associated deaths increased almost 60% from 2000 to 2005 and non fatal accidents increased 48%. People, kids and adults, love them but these studies only reiterate what those of us in medicine already knew.  bjmdjd

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all terrain vehicles · American Academy of Orthopaedic Surgeons · ATVs · Botox · Food and Drug Administration · health · Medicare physician pay cut · muscle tightness and stiffness · Senate · wellness