Dr. Dave Hnida's Blog

So today comes word that H1N1 has been found in commercial pig herds in the U.S. So what does this mean?

Lets talk about what it does not mean:

1. Its not a surprise, we expected crossover into all types of swine- a vaccine is, in fact, in development.

2. It does not mean the virus is mutating and humans are in danger because the germ is now turning into some super mutant. Not at all

3. Pork still safe to eat. Animals get illnesses all of the time- and the feds do a good job keeping sick animals out of the food chain. Nonetheless, the virus cannot survive in a dead pig that gets turned into , say, bacon

What this does mean: more worries for the pork industry- they dont need this kind of PR.

Start with a scary sounding disease, add one part confusing information, then top with a chance to make a buck, and youve got the perfect recipe for bogus products to prevent or cure swine flu.

Right now the FDA has a list of 140 "dont get fooled by these" products which claim to magically fight the swine. How about a shampoo which rids your head of any floating germs which may have used your head as a landing strip, or a magic wand that can zap H1N1 germs off ouf your clothes/body? Then there are the "Tamiflu" pills you can order online from India- which were probably manufactured in somebody's backyard. There's even a product called "Tamifly" which , I guess, gets the virus to fly out of your body.

Anyway, dont get taken in. You know how it works: if it sounds too good to be true (and youve got to pay for it), it probably is junk.

Here's a link to an updated list of weird products: http://www.accessdata.fda.gov/scripts/h1n1flu/

Pap smears arent much fun, now comes a report saying many women are having them unnecessarily. It seems that only 22% of primary doctors surveyed are followed the recommended guidelines for performing paps. The guidelines were last updated more than five years ago, so its not like this is all new info. And for some reason, doctors arent UNDERtesting, they are OVERtesting, doing annual paps on women across all age groups and circumstances.

Here's what the guidelines say:

First pap at age 21, or three years after they have sexual relations, whichever comes first.

Yearly paps thereafter until age 30, at which point the frequency can drop to every 2-3 years after three normal consecutive paps.

Can also stop having paps at age 65-70, if previous tests have been normal. Also can stop if have had a total hysterectomy for a non cancerous condition.

This doesnt mean you can stop having regular checkups. Its a good time to have a breast exam, blood pressure check, and other routine health screening.

Weird term, but "poop out" is exactly what experts call it when antidepressants stop working.

Its an odd phenomenon which we rarely see with other types of medicine, but it seems that about one in five people on medication for depression find that the medicine simply stops working.

If youre on a medication, were doing well, then seem to hit the skids, its not all in your head. There are several reasons some antidepressants just poop out. Sometimes the problem is simply a shift in brain chemistry, often triggered by stress, that causes your symptoms to worsen. Other times, the reason is an underlying medical condition such as anemia or a low thyroid; an interaction with a new medication you may have started; sometimes just no good reason whatsoever.

Bottom line, if you have depression and things were going well only, but now the sun has gone behind dark clouds, talk to your doctor. A change in dose, the medicine, a checkup, a fresh look at your diagnosis, etc. may all be needed.

President Obama has declared H1N1 a national emergency. But what does that really mean? I mean, national emergency sounds  terrifying.

Yet the nuts and bolts of the declaration tell a different story. This is really more of a "look-ahead" plan, as in "just in case", rather than "we're all going to get critically ill in the next few hours."

Its expected that H1N1 will continue along, plateau some, then take off again with another wave of illnesses in the months to come.

Here's what the order does. It allows hospitals in that time ahead, or even now,  to have the leeway to implement emergency plans without jumping through a lot of federal hoops.

Thats means sending patients to schools, nursing homes, or other facilities if the hospital is overrun with patients. It also smoothes out the traige, or screening process as sick people arrive at the ER.

So there's not as much to it as you might think, or fear. The bad news is that it does nothing to speed up the production and distribution of vaccine. No emergency order can fix that.

Interesting stuff from the American Cancer Society when it comes to cancer screenings. It seems the society is taking a new, and perhaps, more realistic look at the benefits of screening.

"The advantages of screening have been overstated." So says the head of the ACS, Dr. Otis Brawley.

It makes you wonder what exactly that means, and what we should be doing to find cancer early.

At the bottom of the page is a link to the original article, which appeared in the New York Times.

I think the gist of this whole thing is the benefits of screening for prostate and breast cancer are not as great as we've been hearing. But when it comes to screening for colon cancer or melanoma, the benefits seems clear.

Its a tough message. But I do worry people will get the wrong message, that is, cancer screenings may be a waste of time. Thats not so.

When it comes to breast cancer, stick to the recommended schedule for screening. I do think, however, prostate cancer screenings need to be recommended on an individual basis- in other words, one size may not fit all. We'll see where this one lands.

http://www.nytimes.com/2009/10/21/health/21cancer.html?_r=1&hpw

New numbers from the CDC today show H1N1 really is mainly a young person's illness. The stats from 27 states since September 1st show that 90% of deaths from H1N1 are in people under age 65. This is the complete opposite of what we see with seasonal flu, where 90% of deaths usually happen in people over age 65.

Here's a breakdown:

24% of deaths are in the under 25 age group

65% are in the 25-64 age group

11% are over age 65

It seems that most of those who have died have had some underlying medical problem such as asthma or diabetes. Yet some young people in apparent good health havent been able to recover from the disease.

A little word to the wise for parents. It is true that most children who get H1N1 will recover without problems- their illness is mild. But "mild" is a relative term. In this case, "mild" means feeling like you got hit by a truck.

Its important, therefore, to keep an eye out for signs that a normal case of flu has become a complicated one.

Confused

Lethargic

Continued vomiting

Chest pain, rapid breathing, problems breathing

Severe headache or stiff neck

Abdominal pain

These are just some of many symptoms that signal the need for medical care. If youre concerned, remember its better to play it safe and give your doctor a call.

If youve got a youngster who is a wizard at Wii, but whiny about aches and pains, it may be time to put the controller down.

A new study finds many young video game users have the same joints complaints as a person decades older... many decades older. Fingers and wrists seem to be the most prone to overuse. And the younger the player, the more likely they are to have sore joints.

Although all age groups can overdo it, it seems those under age seven are at highest risk (wrists tended to be the sorest joint for them.)

And those who play for more than an hour a day seem to have the most complaints.

The type of machine or console was studied, but it seems if the same type of game is played over and over again, youve got a higher risk of problems.

Researchers say young, growing muscles and tendons are ripe for overuse- something to keep in mind if youre youngster is glued to the buttons. Its unknown what the long term effects might be.

For years we've heard the best ways to keep your brain sharp as you get older is to go for a walk, read a book, or do a crossword puzzle. No question, they all work to make the synapses between brain cells happy. But if youre looking for instant gratification and smarts- log onto a computer.

A new study of people 55 and older shows those who are introduced to the computer and then used it regularly, showed improvement in memory, word recall, problem solving... you name it- all within seven days.

Thats right, seven days. Sounds like a commercial. Yet this study used actual brains scans to show improvement in blood flow and brain cell communication after people took to the keyboard. And the number one activity that was brain friendly: doing an internet search.

So, if youre looking for the ideal present for Mom, Dad, or grandparents, the web may be just what the cerebral doctor ordered.

Maybe not dishpan hands but I think Ive got H1N1 hands. I always do a good job washing up, but it seems like Im washing multiple times in the course of a visit rather than just at the end. And my hands are paying the price- but I suppose thats better than my lungs.

So as we all wait for vaccines- let's continue to wash away... keeping in mind that we should be good handwashers even after we're vaccinated against every virus under the sun.

My question to you, then: Should you wash with hot or cold water? And how about some other handwashing tidbits.?

1. You cant make the water hot enough to kill germs although some say the warmer the better, since higher temperature water may help remove skin oils that germs love to attach to. Overall, however, its the washing that counts, not the temperature. Use what you like.

2. Soap or no soap? Soap- helps the germs slide off the skin. Antibacterial- not any better.

3. Lather or not? Probably lather. Once again, helps the germs slide off the skin.

4. Time: minimum 20 seconds. 30 probably best.

5. Most important area: fingernails. Germs love cuticles, the edges, and areas under the nails.

6. Towel or drier? Paper towel since the running action removes more germs and moisture that may contain germs. The blower may be a little less effective.

7. Gel or water? Probably soap and water, though I dont have a sink in my pocket as I walk around touching things all day. A little hand sanitizer goes a long way.