Thursday, October 27, 2011
This week the Advisory Committee on Immunization Practices (ACIP) unanimously voted to recommend that 11-12 year old boys be vaccinated against HPV (the Human Papilloma Virus)- hooray! Girls have NO monopoly on genital warts, which affect over one million Americans each year. They are COMMON. Sadly, in my clinical experience, little harms self-image like a young person developing these genital lesions, especially because we cannot simply cure them and make them go away forever.
Genital warts are transmitted by direct skin-to-skin contact, and though this usually occurs during sex, actual intercourse is certainly not required to pass them on. They are very contagious, with transmission rate of up to 65%. Warts typically recur despite treatment, and frankly, the treatment is unpleasant at best- we burn the warts chemically or with liquid nitrogen. If you've ever had a wart frozen/burned off your knee, you know what that feels like, and the genital area has more nerve endings. Enough said!
The Gardasil vaccine immunizes recipients against the two strains of HPV (6& 11) that cause 90% of genital warts. Additionally, Gardasil protects against the two strains of HPV that cause the majority of cervical cancers. While males don't have a cervix to get cancer, they do have other parts that get HPV-related cancers (anal & penile, as well as some head and neck cancers,) although certainly these cancers are less common.
Gardasil was approved for use in males over two years ago, but the public has mainly been aware of the use in females. I'm glad the CDC and ACIP are on board, and hope that with increased education, we can help protect the next generation against HPV-related diseases.
BOTTOM LINE: Gardasil- it's not just for girls! Talk to your family doctor about immunizing ALL your kids.
PS. I am NOT on anyone's payroll for this vaccine- but I absolutely do recommend it.
Wednesday, October 19, 2011
If you have a teenager (or if you ARE a teen), please take a few minutes and read this New York Times article: A Girl's Nude Photo, and Altered Lives The gist of the story is that an 8th grade girl sent a nude photo of herself to her 8th grade boyfriend on her cellphone. After they broke up, that boy forwarded the picture to another girl, who labeled it rudely and passed it to her contacts, encouraging every recipient to pass it on. Within hours, this naked photo was seen by thousands of people, including everyone at their school and numerous other schools as well as off into cyberspace.
As a parent, I can only begin to imagine the devastation. Three children were arrested and prosecuted, and could have been held for child pornography charges, complete with the permanent label of sex offender. All this in 8th grade- age 14. How does this happen?
I regularly speak to adolescents about sexually transmitted diseases. Regardless of their social, economic and religious status, what they tell me is that oral sex is NBD- no big deal -(90%) and anal sex isn't really either (50%). They don't "count" these activities as "real sex" and are unaware that these activities are risky for virtually every sexually transmittable disease- especially herpes. While the 40-plus crowd is gasping, let me rephrase- adolescents are very, very desensitized to sexual issues.
As such, it doesn't shock me that sexting (sending sexually explicit messages and/or pictures) is increasing. With that feeling of privacy and anonymity that an electronic device instills, combined with sexual acts being NBD, why wouldn't they feel comfortable sending these messages?
As parents, we have to deal with our own discomfort on the subject, and start having frank discussions with our kids about ALL forms of sexual intimacy- including oral sex, anal sex, and sexting. Please note that I am not saying you can't choose to promote abstinence based on your faith. I AM saying that if you define sex as traditional intercourse, you are leaving the door wide open for these other forms of intimacy...and the kids are walking right through that door with full belief that they are maintaining their virginity.
This is exactly why I wrote Seductive Delusions, which shares stories of "good kids" catching STDs, often despite their "virginity".
BOTTOM LINE: Educate yourself first, then push aside your embarrassment and start talking with your teen.
Sunday, October 16, 2011
Did you know that a lingering cough is one of the most common reasons people head to see their family doctors? With most "colds", after you get past the headaches, and stuffy nose part, you find yourself coughing. Sometimes it's a minor "clear your throat" type of cough, while other times, it's the crazy fits of coughing that keep you from sleeping.
Is there anything that can be done for a cough that wont go away? Absolutely, and that is the point of today's blog. "Cough" literally makes the top ten list every year for reasons to visit your doctor. After many upper respiratory viruses, coughs will linger... for up to SIX weeks! A cough does NOT mean you definitely need an antibiotic- in fact, typically, you do NOT. However, a cough that is not managed with over the counter medicines should be addressed by your physician. Coughing all day long at school or work (or keeping up your spouse with coughing all night) is NOT a good plan!
What can your doctor do? First of all, they do need to rule out any secondary infection such as a pneumonia. If you are a week into your symptoms, and suddenly you feel a ton worse and develop a fever, this might be a bacterial infection setting up shop AFTER the virus cleared the way past your body's defenses. More commonly, though, you may have developed some over-reactive airways and may benefit from some inhalers or other asthma-style of medicines. A prescription cough syrup used at night may help with the nighttime exacerbations, and your doctor can remind you of some traditional home remedies such as cool mist humidifiers that may help. Finally, sometimes a cough comes from other sources, such as acid reflux or sinus drainage, which require different treatments.
BOTTOM LINE: See your doctor to evaluate coughs that get worse after a respiratory illness, or that wont go away- don't expect antibiotics, but know there are other treatment options!!
Wednesday, October 12, 2011
Flu season can be a scary, challenging time for all of us, especially the last two years, thanks to H1N1 (formerly known as the Swine Flu). The BAD news this year is that we're already seeing some cases of the flu, but the GOOD news is that we already have this year's flu vaccine available, and it will provide immunity to several strains of the flu, including the 2009 H1N1. In fact, each year the flu vaccine has three parts, including an influenza A (H1N1) virus, an influenza A (H3N2) virus, and an influenza B virus.
There are two types of vaccines offered- a live vaccine, which is a weakened version of the virus (this is the nasal spray vaccine) and a "killed" vaccine, the traditional injection. I often hear patients say they "got the flu" from the vaccine, but that is impossible from the injection because those viral particles are NOT ALIVE- they can NOT cause disease. It takes about two weeks for your body's immunity to kick in after the shot, so plan ahead, especially if you are traveling.
In the 2010-2011 flu season, which peaked in early February 2011, was less severe than the pandemic flu season the year before, but still had very significant impact on our population. While most people infected have a miserable several days to a week of symptoms, there were over 300 deaths confirmed to be from influenza, including over 100 pediatric deaths (average age around 6 years.) This is not a disease to be ignored.
WHO should get the flu vaccine this year? The CDC recommends that "EVERYONE 6 months of age and older should get a flu vaccine as soon as the 2011-2012 vaccines are available." And that is NOW! Don't worry about the effects wearing off before the end of flu season, by the way, because the effects last throughout the whole season.
When is flu season? Though typically we say October to January, it really starts with September and most likely extend beyond February this year. Let's be proactive and line up early to receive a vaccination, and then follow up with consistent hand-washing and STAYING HOME if we get sick! I LOVE that all our grocery stores, and many other public places now have the anti-bacterial cleansers positioned right as you enter their store- USE IT!
BOTTOM LINE: Don't wait- head to your doctor's office or your pharmacy for a FLU VACCINE now!
Sunday, October 2, 2011
Can you believe that Halloween is right around the corner? We are officially in "treat yourself" season, as we hit the trifecta of food oriented holidays: Halloween, Thanksgiving and Christmas/Hanukkah. We tend to celebrate with nonstop EATING, and then what do we do every January? That's right, make New Year's resolutions where LOSING WEIGHT tops the list!
This year, let's THINK AHEAD...
Before you toss that bag of yummy Halloween candy in your grocery cart this week, recognize that Halloween is still four weeks away. Will that bag still be around at the end of the month? Come on, now, you know if you are buying it now, you are going to be eating it sooner than later. So, let's SAVE THE HALLOWEEN CANDY for...yes, HALLOWEEN! Start in the grocery store. Do NOT BUY the candy till the DAY BEFORE Halloween. It's way easier not to eat it when it is still sitting on the shelf in the grocery store, rather than sitting on your desk at work or your kitchen counter top. And forget the excuses here: "if I don't buy it now, they wont have my favorite kind", "I wont remember, then we wont have candy to give out", or "but I LOVE those little chocolate candy bars- how many calories does just one have?"
Okay, you asked, so here are a few of my favorites: Snack Size Butterfinger: 170 kcal, Fun Size Kit Kat- 50 kcal, and ONE plain M&M-4 kcal. Now, if you stop at ONE, it's really no big deal. but if you eat a handful of M&Ms each DAY for the next few weeks, or grab a couple fun size chocolate treats, BOOM-you will gain a pound right there. (Remember one pound is 3600 kcal- do the math.)
BOTTOM LINE: Don't wait for NEW YEARS to make a resolution for better health- start NOW by limiting Halloween CANDY to HALLOWEEN DAY!
PS. It's a new month, so CHANGE THOSE AIR FILTERS!