Tuesday, November 20, 2012

The Big Flu Post

There's a chill in the air, the leaves have changed, lights are starting appear on houses, and there has even been a dusting of snow. You know what that means... It's cold and flu season! Yes, it's that special time of year when noses run and wadded up tissues adorn wastebaskets! I hear you all rejoicing!  (End ironic remarks.)

My first semester at BYU I took this totally amazing class called Wildlife Ecology and Range Management for my Biology GE instead of Bio 100. (It truly was AWESOME! It completely changed the way I looked at deer hunting, prairie dog poaching, large predators, wool sweaters vs. leather jackets, Mad Cow Disease, and a number of other issues.)

While all my other freshman compatriots were off learning about cell walls, my good friend Kim and I were learning about wildlife diseases. One of our first assignments was to basically pick five diseases we considered to be the biggest threats to humanity talk about why we considered them to be huge epidemiological threats. Of course a lot of the articles we had been reading talked about AIDS. However, in my paper, I chose influenza as being the most threatening disease.

Now, I really do think you can make a case for AIDS, but I chose influenza because the flu can be contracted more easily (casual contact vs. sexual contact, contaminated blood products, or hypodermic needles). You could be a nun and still get the flu and even die (maybe not as easily if you're one of those nuns who never leaves the convent, but I digress.) However, it probably would surprise most people that flu season actually ranks pretty low on my list of things to stress about. It's not that I don't think flu is a potential problem, it's just that we take a lot of care to prepare for and prevent disease.

One thing you have to understand about the flu is that there is a lot of misinformation out there. For example, did you know that there is compelling evidence that many of the deaths in the 1918-1919 H1N1 flu epidemic may have actually been due to lethal aspirin doses administered by well-meaning physicians? Or that the 1976 H1N1 scare actually only resulted in the death one person- an extremely motivated army private in basic training who had been confined to quarters due to illness but nevertheless snuck out, shouldered a fifty pound pack, went out for a several mile hike in the dead of winter and subsequently collapsed and died? (I think I would die under those circumstances too.) Because a post-mortem showed that he was carrying the H1N1 strain of flu and a few other privates tested positive for the same strain, public health authorities assumed that a pandemic must be coming. Another interesting fact, the young private's drill sergeant performed CPR on him when he collapsed and didn't get sick.

If you'd like to read a full, fascinating history of the H1N1 flu and a number of other relatively recent diseases, I highly recommend Laurie Garret's The Coming Plague, a recommendation from my Wildlife Ecology and Range Management professor.  I will say that while I feel Garret does an excellent job of documenting the history of outbreaks of mysterious diseases, she's very weak on actually coming to conclusions of why these diseases are spreading and how to stop them. At the end of her book when she attempts to briefly address these questions, she mostly parrots the typical mumbo-jumbo that the world is over-populated as a cause and that drugs and research are the answer.

So what am I doing (and not doing) to batten down the hatches and prepare for "the most wonderful time of the year"? Well here goes:

  • Food- I guess one thing you should probably understand about my views on healthcare is that I take tiered approach. The way I see it, diet changes are the first thing to look at with health problems. Then structural work (chiropractic, crania-sacral, acupuncture, massage, etc.). Then herbs, essential oils, homeopathics, and other natural substances. My last line of defense is more conventional things like ER visits, drugs, surgery and the like. But really, I believe diet is the most foundational component in immune function. It only makes sense that just like what we take into our bodies can affect things like our respiratory, nervous and circulatory systems, that the same applies to our immune system. Just like we can't expect our lungs to function well with tar and tobacco smoke or our heart to function well on a diet of mostly deep fried stuff and meat, we can't expect our immune system to function well when we don't give it the right fuel. We pretty much don't eat any refined sugar. As it gets cold, we tend to add a little meat into our diet, but keep it to a few times a month. We keep up on the greens but we've switched from smoothies to salads lately. I've noticed that the times in my life when I've tended to get sick have almost always been when I was eating badly or very stressed or both. Holidays like Christmas, Valentines' Day and Halloween tended to be the biggest times I got sick as a kid and I don't think it's a coincidence that those are the big candy holidays.
  • Stress reduction- As I said, the times when I have gotten sick have tended to be when I was eating badly, was stressed or both. A few years ago I go the flu when I was pregnant with Duckling. Malamute's brother and sisters and all their kids and pets (and drama) were all staying over at his parents place and it was something I had been dreading for months. On top of all the stress, we started giving in and eating chips and cookies and other things to be more sociable. We had just started doing green smoothies, so the whole thing was pretty new to us. Anyway, I did get sick. However, out of any time I have been sick, I did recover the quickest that time. (I think it was the fact that despite all the stress and diet lapses, we kept up our greens and fruit intake.) My stress level has actually hit an all time low since Malamute resigned from his previous tech job and we've started pursuing other avenues. So that's one really great thing about the coming cold and flu season that is in our favor.
  • Flu shot- OK, I'm going to get this one out of the way because I know a lot of people will be extremely upset over what I have to say here and I'm pretty much scared to death to even say this, so here goes. I personally have chosen not to get the flu shot. I don't think any less of you if you do. Some of the people I care about most get flu shots. But I have personally made the decision not to get a flu shot. One big problem I have with getting a flu shot is that as much as public health officials try to include the strains that they predict will be the most prevalent, there is still a very real possibility that you could contract another strain. I do understand that doctors and public health officials claim that the flu shot may help reduce the severity of the flu if you do contract a strain that the vaccine doesn't cover, but there really isn't a whole lot of evidence backing this up. Also, it takes two weeks for the vaccine to actually take effect, so until then you are fair game for any and all flu strains, both giving and receiving. With all of these limitations, I feel like if I were to get a flu vaccine, I would really need to use a second plan of extra precautions to protect me and others during the first two weeks and for the duration against the strains the vaccine doesn't cover, and at that point, why get it at all if I can just use other means to protect myself against the flu?  People really, really hate hearing this, but I am also not comfortable with the ingredients in the flu vaccine either. Afluria contains beta propiolactone, a chemical for which little data exists regarding its effects on humans, though animal studies have found tumors resulting in subcutaneous injection. It also contains potassium chloride, which can be used to treat extreme salt depletion, but is also used as the third and final drug in the lethal injection process and in smaller doses to induce late term abortions, something I am just not comfortable with during pregnancy. It also contains calcium chloride, which according to the Materials Safety Data Sheet is mutagenic and carcinogenic. Fluvirin also contains beta propiolactone. Fluarix, Fluzone and Flulaval all contain formaldehyde. FluMist seems slightly better, but I'm really not crazy about ingredients like MSG and hydrolyzed porcine gelatin. So as I said, I know many of you feel differently, but for me, I am just not comfortable with the flu shot  and feel there are other options available. And as I have refrained from criticizing anyone who gets a flu shot, I do hope that those of you in the pro- flu shot camp can return the favor and maybe even understand where I'm coming from. If anyone is interested, you can find a comprehensive list of vaccines (including flu shots) and their ingredients from the CDC here. If you or a loved one have allergies or sensitivities to certain antibiotics or egg products, it might be wise to consult a table like this before getting a flu shot to make sure you choose one free of any potentially allergenic ingredients.
  • Handwashing- Yeah, this is important. I think sometimes when we imagine the 1918-1919 flu pandemic, we have this vision of people in sanitized facilities dying helplessly while legions of citizens bravely washed their hands at every opportunity. The reality is actually quite different. Idea of washing your hands to prevent infections and the spread of disease is actually still fairly new and didn't really start to take off until around the middle of the 20th century. In fact, Laurie Garrett talks about how counsel from doctors during the 1918-1919 flu pandemic about how to avoid the flu didn't cover washing your hands. (However, medical advice to avoid dusty old books, German fish, Chinese people, open windows, closed windows, washed pajamas, and unwashed pajamas abounded. We think this is ridiculous now, but it was considered "science" then.) Evidence of the efficacy of hand washing against disease has actually been around since the late 18th century when ex-naval surgeon Alexander Gordon wrote a largely ignored treatise about how puerperal fever was spread by doctors not washing their hands in attending laboring women. In the early 1800's Dr. Ignaz Semmelweis published evidence from his own hospital showing how deaths from puerperal fever decreased dramatically after he began requiring that all doctors and visitors wash their hands before seeing patients. Unfortunately, Dr. Semmelweis was laughed to scorn by the medical establishment because everyone knew that the scientific explanation for puerperal fever deaths was women's tendency to become overly excitable and emotional (Inside the Victorian Home, Judith Flanders). Other "medical facts" of the day were that "Doctors are gentlemen and gentlemen's hands are always clean". The scorn from the medical community was so extreme that Semmelweiss later moved to a mental asylum where he died. One of the novel things that Florence Nightingale did in the middle of the 19th century was to simply mandate clean hospital facilities. At the time, this wasn't backed up by the "science" of the day, all she knew is that she couldn't stand to live and work in filth and didn't think sick people should either. I know, all this seems like a "duh" to us, but at the time, it was really new and not widely practiced, thus the massive spread of disease. Oh and once summer hits be sure to keep washing your hands. Those "summer colds" are usually non-polio enteroviruses. They are second only to the common cold virus in prevalence and some of them can cause paralysis, heart problems, and brain infection, just like polio. The CDC says hand washing is the best way to protect yourself from non-polio enteroviruses.
  • Hand sanitizer- I also include Clorox wipes and the like under this too. So these aren't bad ideas, but I don't really use them much. I think it goes back to when I got my food handlers' permit ten years ago in preparation to work as a banquet server the summer before college. So I was sitting there in food handlers' permit class and the instructor started talking about hand sanitizers and she said, "I actually cite facilities that have too many hand sanitizing stations because people tend to use those in place of hand washing and hand sanitizer is nowhere hear as effective as hand washing." OK, I thought. And then I started hearing about studies on the real world effectiveness of hand sanitizer.  Turns out that hand sanitizer kills 99.9% of all germs under laboratory settings. In real life, it's more like 46-60%. Wow. All those Young Women's rough camps where we used nothing but hand sanitizer for everything felt just a little bit germier. (But, hey, we all had an awesome time nonetheless!) So once you've thoroughly washed your hands or a surface, applying hand sanitizer or a Clorox wipe can kill some additional germs, but if you're touching a surface like the handrail of a public bus, a shopping cart handle, etc., you're still picking up a lot of microbes. Your best line of defense is still frequent hand washing, but if you work work with kids or in health care, hand sanitizers and wipes can give you an extra boost in fighting the flu.
  • Homeopathy- I have used homeopathic remedies for myself and my family with lots of success. However, I have to admit that I haven't used them for flu specifically. In fact, homeopathy has been used to both prevent and cure a number of epidemic diseases, from polio to pertussis to meningitis. There are a number of flu fighting and immune boosting homeopathic formulas that you can get at your local grocery or health foods store. I have used both Hyland's and Boiron brands of homeopathic remedies and do recommend them. One drawback to "OTC" homeopathic formulas is that they might not meet your specific needs. Homeopathy treats very specific symptoms. For example, if you go to a homeopath for a flu remedy, she will ask you what kind of coughing are you experiencing (dry, wet, productive, unproductive), when you're feeling nauseated, what kind of foods, if any, you do feel like eating, what kind of stomach pain you're feeling (dull, throbbing, aching, sharp), what your nasal passages feel like, are you feeling hot or cold, do you want to lie down or sit up to rest, which side of the body you want to lie down on, what your mood is like, etc, and based on all of these very specific symptoms, she'll prescribe a remedy or remedies. Then she'll have you return for a follow-up visit because as the disease heals, the symptoms will change and the type of remedy you'll need to help you will change. So this is why getting an OTC homeopathic flu remedy can be somewhat hit or miss, but can help you give you an extra "oomph" in fighting off a case of the flu. I often like to consult the online homeopathic Materia Medica to get an idea of which remedy will be best. You can get homeopathic preventatives for a number of diseases from a qualified homeopath and there has been some promising research done on the use of them during epidemics
  • Chiropractic- This is just kind of general habit for us. Certain subluxations can hamper your immune and respiratory function. Since we're pretty tight on money, we've been doing home adjustments on each other. (Not so much on me since I got pregnant, but I can do my neck and stretch my back.) I don't recommend doing home adjustments unless you've actually been to a supportive chiropractor quite a bit. All that being said, if you've had some good exposure to and knowledge of chiropractic, knowing how to do a home adjustment can be invaluable in treating your family, especially when someone isn't feeling well. Subluxations don't always come during office hours, so being able to administer chiropractic "first aid" can be extremely useful. I've used home adjustments on everyone in our family, but they actually seem to make the biggest difference with Malamute's mood and energy level. Whenever he's feeling sick or moody, he usually asks to be adjusted, something pops into place, and he feels much better. (Especially helpful when he's been carrying Duckling in the backpack carrier on a hike.)
  • Herbs and supplements- We don't tend to use these very often since we're not around a lot of crowds or young children other than Duckling. But if I were a schoolteacher, had kids who went to school, worked somewhere where I was around a lot of people, had a vocal recital coming up, or was super-stressed out, I would probably use some herbal immune boosters for myself and my family. One year when I was taking voice lessons in college, my teacher recommended Airborne to me, and I was able to fight off a cold with it. I've also had good experiences with Dr. Christopher's formulas and they do have an immune booster for both kids and adults. Traditional Medicinals makes some great therapeutic teas and they have an echinacea tea, a couple of cold care formulas, and several sore throat formulas. (I love their Lemon Echinacea Throat Coat, but then I love the taste of black licorice, so I know this won't be everyone's cup of tea- pun intended.) If you're especially enterprising, you can even make your own teas from loose herbs from a health food store. Get yourself a tea ball for a few dollars and you're set to go!

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