Gardasil- What's IN it?

Continuing the discussion about the HPV (Human Papillomavirus) Vaccine Gardasil...I'd like to step back and talk about exactly what is IN this vaccine. Much of the fear about immunizations surrounds concerns about the makeup of the vaccine, and what peripheral damage could potentially be caused from the content.

First of all, can you "catch" HPV from the vaccine? NO. Absolutely NOT. There are vaccines (like chicken pox or measles) that contain essentially watered-down versions of live virus, and as such, can in the course of an appropriate response cause a mild version of the disease as the body reacts to the vaccine, causing long-term immunity. However, the HPV vaccine does not work this way. There is only a tiny portion of the virus  (a surface protein called L1), that scientists extract, multiply and wad up into a ball. Our immune systems "see" this balled-up material as the whole HPV, and make very effective antibodies to fight it off.

What else is in the vaccine as a by-product? Is there thimerosol? NO. Is there Mercury? NO. Is there a tiny bit of aluminum? Yes. 225 micrograms of alum, to be exact, which is the same tiny amount that is allowed in infant formula (and yes, there is even aluminum in breast milk, though less than formula.) Why is there any aluminum in there at all? Well, aluminum is the most common metal found in nature- present in our water and much of our food. In vaccines, aluminum is an "adjuvant"- something added to improve the immune response.

BOTTOM LINE: The HPV vaccine Gardasil creates very effective immunity against the strains of HPV that cause 90% of genital warts and 70% of cervical cancers, and does NOT contain other byproducts that have raised concern in other immunizations.

PS Full disclosure: I am not on Merck's payroll in any fashion. I am a family physician with a special interest in STDs & I believe this vaccine will help prevent much disease & heartache.

Neti Pots- Helpful or Harmful?

In Austin, we feel often like we are the allergy capitol of the world...and we are approaching CEDAR season. One of the homeopathic remedies that works very well for patients with chronic sinus congestion is a Neti pot. Have you heard of these? Basically, they look like little genie lamps, and you use them to pour water into you nose and "flush out" your sinuses. I know- it's not for everyone. That being said, I have many patients that swear these daily washes have minimized their previously awful allergy symptoms.

The public health department in Louisiana has issued an important reminder about Neti pots this month, because their state had a second death this year from an amebic brain infection introduced to the victims via their sinus flushes. While drinking tap water that contains this ameba would not cause an infection in a healthy person, using that same tap water to flush your sinuses does have potential to cause serious infection.

While these infections are VERY rare, this serves as a good reminder NOT to use tap water if you are flushing your sinuses. Use only distilled, sterile, or previously boiled water as your irrigation solution, plus be sure to fully rinse and dry your device after each use.

On the PLUS side for sinus irrigation, a study published in September of this year showed significant improvement in quality of life for kids with chronic rhino sinusitis (nasal congestion & sinus pressure) when they had used daily sinus flushes for at least 3 weeks, whether the solution was purely saline (salt water) or saline plus an antibiotic. (See Safetty and efficacy of once daily nasal irrigation...)

BOTTOM LINE: If you have chronic sinus/allergy symptoms, talk to your doctor about whether daily sinus flushes could be beneficial for you, and remember to always use sterilized solutions!

Baby Stroller Recall!

Attention parents of infants and toddlers! In case you hadn't heard about this yet, Graco has issued a recall on its Quattro and MetroLite Strollers due to potential risk of entrapment and/or strangulation, especially for infants less than a year old and not harnessed. Very sadly, there were four reports of strangulation and several of entrapment, but it was enough for the company to voluntarily recall roughly 2 million strollers to prevent any further potential risk.

This is why it is important to register the products we buy for our homes, especially those for our children. If your stroller was registered with current address information, you should have received notice of this recall already. I'll admit to often forgetting to register items I have purchased, but this should serve as a reminder for all of us.

On the flip side, I LOVED my baby joggers and highly recommend that new parents invest in a nice stroller that will allow THEM to get some exercise and fresh air and sunshine while their baby enjoys new sights and sounds (or more likely, takes a nap!) This post is in no way to discourage strollers, and I applaud Graco for its voluntarily recall.

BOTTOM LINE: If you have a GRACA Quattro or MetroLIte Stroller, check with your retailer asap, as it has likely been recalled.

Now CALCIUM is Dangerous??

Have you heard about the latest study that showed CALCIUM supplements may increase your risk of heart attacks? What's next, finding out Vitamin C makes you sick? Okay, I'm being facetious here, but let's talk about this news from a couple different angles.
First of all, here is what the study from the BMJ (British Medical Journal) says. They looked at a bunch of studies with a total of roughly 12,000 patients and assessed whether those people who took calcium supplements of 500mg or more (without Vitamin D) had more or less heart attacks compared with those who took placebo pills. There were a total of 296 people who suffered heart attacks- 166 on calcium supplements, and 130 on placebo pills. Does this mean placebos CAUSED 140 heart attacks? NO. Does it mean that calcium supplementation by itself CAUSED heart attacks? No- but it does show "an association" with heart attacks, one that may or may not be present if you add Vitamin D, which plays a role in calcium absorption, bone health, and cardiac protection.
There is NO association of heart attacks with increased purely dietary calcium intake (meaning high calcium intake through eating dairy and other calcium-containing foods). What does this tell me? Once again, we are spending a zillion dollars to PROVE THAT GETTING OUR NUTRITION FROM WHOLE FOODS, RATHER THAN SUPPLEMENTAL PILLS, IS BETTER FOR OUR HEALTH.
We've got to stop looking for a quick fix, and start improving our diets (MORE fruits and veggies, less of everything else) and increasing our exercise. Common sense AND scientific studies have proven this over and over.
In the meanwhile, realize that medicine is constantly evolving. What we preach as doctrine today may be heresy tomorrow. Look at what we have recommended for positioning of newborn babies in the last couple decades as an example- first we said on their stomachs (so they don't choke if they spit up), then their sides, and now their backs. Each time, we are SURE we have the answer. Remember that doctors used to recommend smoking to relax- how crazy is THAT?
BOTTOM LINE: Calcium supplements are unlikely to be your greatest risk factor for heart disease- talk with your doctor about your total health picture before you decide whether or not to take ANY supplement!