Protecting Your Health in Erie, PA | Erie County Medical Society

 

The Erie County Medical Society is a voluntary, non-profit professional organization of physicians, both MD and DO, in Erie, PA, founded in 1828. Our mission is to advance the standards of medical care, to uphold the ethics of the medical profession, and to serve the public with important and reliable health information.



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9:02 AM
December 2nd, 2018

Breast Cancer Awareness

Prevalence

 

About 1 in 8 U.S. women will develop invasive breast cancer over the course of her lifetime. Breast cancer accounts for 29% of all cancers in women; it is second only to lung cancer as a cause of cancer death among women.

 

In 2018, an estimated 266,000 new cases of invasive breast cancer are expected to be diagnosed in US women in the U.S., along with 63,960 new cases of non-invasive (in situ) breast cancer.

 

Although the overall US incidence of breast cancer is higher in white women, a larger proportion of African-American women are diagnosed with larger, advanced-stage tumors. In 2015, breast cancer death rates were 39% higher in African-American women than in white women.

 

Risk Factors

 

Increased age is a predominant risk factor in breast cancer. The disease is 7 times more likely in women over 50 than in those under 50. Nevertheless, when breast cancer occurs in younger women, it tends to behave more aggressively.

 

The incidence rate of breast cancer increases with age, from 1.5 cases per 100,000 in women 20-24 years of age to a peak of 421.3 cases per 100,000 in women 75-79 years of age

 

Family history is a further risk factor. The risk is 5 times greater in women who have two or more first-degree relatives with breast cancer. The risk is even greater if the relative was less than 50 years old when diagnosed with breast cancer. Further, ovarian cancer is also a consideration. Ovarian cancer in a first-degree relative doubles the risk of breast cancer.

 

Current oral contraceptive use seems to increase the risk of breast cancer by about 25%. To put this in perspective, it means that a hypothetical risk would rise from 20 in 10,000 to 25 in 10,000. However, risk returns to that of the average population within about 10 years following cessation of oral contraceptive use.

 

Increased risk of breast cancer in postmenopausal women has been associated with the following:

     Adult weight gain of 45 pounds above body weight at age  

     Diet high in animal fats and refined carbohydrates

     Sedentary lifestyle

     Consumption of 3-5 alcoholic beverages per week

 

Finally, increased risk of breast cancer has been associated with first pregnancy at a later age, early onset of menses, and late age of menopause.

 

On the brighter side, close adherence to a Mediterranean diet is associated with lower risk for breast cancer, especially for types that carry a poorer prognosis in postmenopausal women.

 

Types

 

Contrary to popular belief, breast cancer is not a single entity. There are almost a dozen different types of breast cancer. Two of these, infiltrating ductal carcinoma and infiltrating lobular carcinoma, account for almost 90% of cases. The different types of breast cancer are typically identified when the pathologist views the tissue specimens under a microscope. Some types behave much more aggressively than others.

 

Even within these types, there are certain characteristics that can make some cases behave differently from others. These individual characteristics may make some tumors more susceptible than others to certain treatments.

 

Signs and symptoms

 

Early breast cancers usually have no symptoms. Later breast cancers may show

     Change in breast size or shape

     Recent nipple inversion or skin change, including nipple abnormalities

     Skin dimpling

     Nipple discharge, especially if blood-stained

     Lump in the armpit 

 

Only 5% of patients first consult their doctor because of breast pain or discomfort.

 

Screening

 

Because of the absence of early signs and symptoms, screening plays an important role in early detection. Some evidence exists that, at 14 years follow-up, screening mammography reduces breast cancer deaths by about 20–35% in women 50–69 years old and slightly less in women 40–49 years old.

 

Mammography often detects a lesion 1 to 2 years before noted by breast self-examination. Nevertheless, partly due to lack of health insurance, 20-30% of women still do not undergo screening as indicated.

 

Debate continues among authorities regarding the appropriate interval between mammographic screenings, the age at which screenings should begin, and the age at which they are no longer necessary. However, there seems to be general agreement that annual mammography is more appropriate to younger women, that biennial mammography is more appropriate to slightly older women, and that screening mammography is not appropriate for women with a limited life expectancy. For specifics about ages and frequency intervals, each woman is referred to her own physician.

 

Treatment

 

Each case is different and the most aggressive treatments are not always necessary. Sometimes breast-conserving surgery suffices. Sometimes only partial breast irradiation at the tumor-removal site is appropriate. Sometimes chemotherapy is not required. No one should delay or avoid seeing their physician because of assumptions about treatment.

 

Conclusion

 

In brief, breast cancer remains a major death threat to women. There are several types of breast cancer, each behaving with its own degree of aggressiveness. Screening is important since early breast cancers show minimal symptoms. Each woman is referred to her own physician regarding screening specifics. Since each case is different, the most aggressive treatments are not always necessary. No one should delay or avoid seeing a physician due to false assumptions about treatment.

 

 

References

 

U.S. Breast Cancer Statistics. (n.d.). Retrieved September 15, 2018, from https://www.breastcancer.org/symptoms/understand_bc/statistics

 

Breast Cancer: Practice Essentials, Background, Anatomy. (2018, July 18). Retrieved September 15, 2018, from https://emedicine.medscape.com/article/1947145-overview

 

 

Thomas Falasca, DO

Breast Cancer Awareness

About 1 in 8 U.S. women will develop invasive breast cancer over the course of her lifetime.

 

& ...See More


Breast Cancer Awareness

Prevalence

 

About 1 in 8 U.S. women will develop invasive breast cancer over the course of her lifetime. Breast cancer accounts for 29% of all cancers in women; it is second only to lung cancer as a cause of cancer death among women.

 

In 2018, an estimated 266,000 new cases of invasive breast cancer are expected to be diagnosed in US women in the U.S., along with 63,960 new cases of non-invasive (in situ) breast cancer.

 

Although the overall US incidence of breast cancer is higher in white women, a larger proportion of African-American women are diagnosed with larger, advanced-stage tumors. In 2015, breast cancer death rates were 39% higher in African-American women than in white women.

 

Risk Factors

 

Increased age is a predominant risk factor in breast cancer. The disease is 7 times more likely in women over 50 than in those under 50. Nevertheless, when breast cancer occurs in younger women, it tends to behave more aggressively.

 

The incidence rate of breast cancer increases with age, from 1.5 cases per 100,000 in women 20-24 years of age to a peak of 421.3 cases per 100,000 in women 75-79 years of age

 

Family history is a further risk factor. The risk is 5 times greater in women who have two or more first-degree relatives with breast cancer. The risk is even greater if the relative was less than 50 years old when diagnosed with breast cancer. Further, ovarian cancer is also a consideration. Ovarian cancer in a first-degree relative doubles the risk of breast cancer.

 

Current oral contraceptive use seems to increase the risk of breast cancer by about 25%. To put this in perspective, it means that a hypothetical risk would rise from 20 in 10,000 to 25 in 10,000. However, risk returns to that of the average population within about 10 years following cessation of oral contraceptive use.

 

Increased risk of breast cancer in postmenopausal women has been associated with the following:

     Adult weight gain of 45 pounds above body weight at age  

     Diet high in animal fats and refined carbohydrates

     Sedentary lifestyle

     Consumption of 3-5 alcoholic beverages per week

 

Finally, increased risk of breast cancer has been associated with first pregnancy at a later age, early onset of menses, and late age of menopause.

 

On the brighter side, close adherence to a Mediterranean diet is associated with lower risk for breast cancer, especially for types that carry a poorer prognosis in postmenopausal women.

 

Types

 

Contrary to popular belief, breast cancer is not a single entity. There are almost a dozen different types of breast cancer. Two of these, infiltrating ductal carcinoma and infiltrating lobular carcinoma, account for almost 90% of cases. The different types of breast cancer are typically identified when the pathologist views the tissue specimens under a microscope. Some types behave much more aggressively than others.

 

Even within these types, there are certain characteristics that can make some cases behave differently from others. These individual characteristics may make some tumors more susceptible than others to certain treatments.

 

Signs and symptoms

 

Early breast cancers usually have no symptoms. Later breast cancers may show

     Change in breast size or shape

     Recent nipple inversion or skin change, including nipple abnormalities

     Skin dimpling

     Nipple discharge, especially if blood-stained

     Lump in the armpit 

 

Only 5% of patients first consult their doctor because of breast pain or discomfort.

 

Screening

 

Because of the absence of early signs and symptoms, screening plays an important role in early detection. Some evidence exists that, at 14 years follow-up, screening mammography reduces breast cancer deaths by about 20–35% in women 50–69 years old and slightly less in women 40–49 years old.

 

Mammography often detects a lesion 1 to 2 years before noted by breast self-examination. Nevertheless, partly due to lack of health insurance, 20-30% of women still do not undergo screening as indicated.

 

Debate continues among authorities regarding the appropriate interval between mammographic screenings, the age at which screenings should begin, and the age at which they are no longer necessary. However, there seems to be general agreement that annual mammography is more appropriate to younger women, that biennial mammography is more appropriate to slightly older women, and that screening mammography is not appropriate for women with a limited life expectancy. For specifics about ages and frequency intervals, each woman is referred to her own physician.

 

Treatment

 

Each case is different and the most aggressive treatments are not always necessary. Sometimes breast-conserving surgery suffices. Sometimes only partial breast irradiation at the tumor-removal site is appropriate. Sometimes chemotherapy is not required. No one should delay or avoid seeing their physician because of assumptions about treatment.

 

Conclusion

 

In brief, breast cancer remains a major death threat to women. There are several types of breast cancer, each behaving with its own degree of aggressiveness. Screening is important since early breast cancers show minimal symptoms. Each woman is referred to her own physician regarding screening specifics. Since each case is different, the most aggressive treatments are not always necessary. No one should delay or avoid seeing a physician due to false assumptions about treatment.

 

 

References

 

U.S. Breast Cancer Statistics. (n.d.). Retrieved September 15, 2018, from https://www.breastcancer.org/symptoms/understand_bc/statistics

 

Breast Cancer: Practice Essentials, Background, Anatomy. (2018, July 18). Retrieved September 15, 2018, from https://emedicine.medscape.com/article/1947145-overview

 

 

Thomas Falasca, DO

Avoiding Infections

An ounce of prevention is worth a pound of antibiotics. Preventive hygiene is still the best way to avoid infectious ...See More


Avoiding Infections

Avoiding Infections 

 

 

In the past century, science and medicine have provided many weapons to use on infectious diseases. There are antibiotics for many bacterial diseases, antivirals for some viral diseases, antimycotics for many fungal diseases, and even surgery for localized infections. But, the best way to deal with an infectious disease is still not to have it. Prevention remains a tool against infectious disease, indeed, a most efficacious tool with few drawbacks except the modest energy needed to employ it. 

 

 

Hand Washing

We touch our hands to our faces, according to some studies, an average of 20 times per hour. But the mucous membranes of eyes, nose, and mouth provide easy access to the body for germs, especially for viruses because of virus’ small size. It would be best for us to keep our hands away from our faces, even when the hands appear clean. However, this is sometimes not practical. Consequently, hand washing is important.

 

According to the Centers for Disease Control (CDC), frequent hand washing in a community reduces diarrheal illnesses by 31% and respiratory illnesses by 21%.

             

 

How to Wash Your Hands

Hand washing is not always intuitive.

 

First, use plenty of warm, running water and sufficient soap. At faucet temperature, the warmth of the water is not sufficient to kill germs, However, it renders hand washing more comfortable and, therefore more likely to be maintained for a time sufficient to be more effective.

           

Second, use sufficient soap and rub hands together. The idea is not to kill germs, but to remove them. The soap loosens germs from the skin and the rubbing dislodges them for carrying away by the water. Be sure to wash front and back, all fingers, between the fingers, and under the nails for at least 20 seconds. Twenty seconds is about the time it takes to hum two repetitions of the Happy Birthday Song.

 

Third, for drying, cloth towels may transfer other people’s germs. Better are electric hand dryers as found in public restrooms. To further avoid transferring germs to your hands, press the dryer’s on-off switch with your elbow. Nevertheless, paper towels, although the least ecological hand-drying option, are the most hygienic. Be sure to use a dry paper towel to turn off the faucet and to touch the door handle when leaving a public restroom. If there is no used paper towel depository by the door, let the paper drop to the floor, the maintainers of the public restroom will get the message to provide a depository.

 

When to Wash Your Hands

Although frequent hand washing is important, there are times when it is essential, such as

 

Before 

  •      Touching your mouth, including eating, drinking, and tooth brushing.
  •      Helping a sick person.

 After

     Using the bathroom.

     Changing diapers.

      Touching high-hand contact surfaces such as doorknobs, elevator buttons, handrails, and poles and handles on busses, trains,             

          and subways.

     Helping a sick person.

     Blowing your nose.

     Touching an animal, animal feed, or animal waste.

     Touching garbage.

     Tying shoes.

 

Before and after

     Helping a sick person.

     Treating a cut or wound.

     Preparing food.

 

Unfortunately, in some investigations, only 31 percent of men and 65% of women washed their hands after using a public restroom.

 

Hand Sanitizer

Hand sanitizers are a potent hygienic weapon when hand washing is not available. However, while hand washing removes germs and harmful chemicals, hand sanitizers only inactivate some of the germs. Hand sanitizers are less effective when hands are visibly dirty or greasy as the dirt can protect the germs from best contact with the sanitizer. Further, it is senseless to use the sanitizer to smear dirt more widely!

 

As with hand washing, rub front and back of hands, all the fingers, between the finger, and under the nails. Rub until the hands are dry.

 

Sanitizers should contain at least 60% ethyl alcohol, which inactivates germs by denaturing the proteins of bacteria and viruses. This only takes about 15 seconds. Unfortunately, sanitizers do not work well against norovirus, which is the most common cause of gastrointestinal illness in the United States.

 

Children should use hand sanitizers only with adult supervision as swallowing hand sanitizers can cause alcohol poisoning. Children may be particularly likely to swallow hand sanitizers that are scented, brightly colored, or attractively packaged. Hand sanitizers should be stored out of the reach of young children.

 

Fingernails

Fingernails can provide a cozy place under which germs can hide. Fingernails should be kept short, and the undersides should be cleaned frequently with soap and water. Finally, keep any remaining germs away from the mucous membranes of the mouth by not biting fingernails.

 

Routine fingernail care should also be done hygienically. Before use, nail clippers and files should be properly cleaned, even sterilized, if used among a number of people, as in a nail salon. Also, cuticles act as barriers to infection; avoid cutting or disrupting them.

 

In the Kitchen

The kitchen sink can be a source of spread for many germs. The kitchen floor just in front of the sink often has more bacteria than the trash can. Washing chicken in the sink can transfer intestinal germs such as campylobacter or salmonella from hands to sponges and to faucet handles. The sink should be washed often with special attention to faucets. Wet sponges can be sterilized by placing in the microwave for two minutes.

 

In the Bathroom

Flushing a toilet can disperse bacteria into the air and contaminate anything within a three-foot radius. Because of this, it is important to close the lid before flushing and to keep toothbrushes away from this radius.

 

Sharing cosmetics may result in sharing bacteria. Sharing toothbrushes can pass on such blood-borne viruses as hepatitis B and C, and infectious mononucleosis. Sharing razors may share MRSA (methicillin-resistant staph aureus) as well as blood-borne viruses.

 

Since children, and some adults, may not be conscientious about bathroom hygiene, it is essential to frequently clean bathroom light switches and door handles.

 

At the Front Door

Taking off shoes on entering the home and leaving them at the door keeps the house cleaner and avoids tracking in allergens and germs.

 

Although entering the front door in winter conveys a sense of warmth and comfort, the truth is that when the cool air in the house is heated, even with a substantial humidifier, it becomes capable of absorbing more moisture. It thus dries out the mucous membranes of the home's inhabitants, increasing violation of the mucous membranes by germs.

 

Disinfectants

Bleach contains hypochlorous acid, which attacks proteins in bacteria and some viruses. It is a powerful disinfectant, said to be about 99% effective.

 

Vinegar, thanks to its content of 5% acetic acid, is a disinfectant said to be 90% effective against bacteria and 80% against viruses. It kills flu virus but not staph. Although less effective against bacteria than bleach, it is cheap, nontoxic, and biodegradable.

 

Electronic Devices

Electronic devices can be an unsuspected source for germ transfer. One research project found thousands of bacteria on an Amtrak touch screen in the train station. Cold and flu germs can live on such hard surfaces for up to 48 hours. Swine flu has been shown to survive in this environment for up to five days. Hand washing, or at least hand sanitizer use, is essential after use of public touch screens.

 

Even personal electronic devices can transfer germs. One study showed 16% of cell phones to be contaminated with intestinal bacteria. It is imperative to clean the phone regularly, especially after lending it to someone, and to be careful where laying it down.

 

On Airplanes

Despite the public perception that the major airplane exposure is breathing recirculated contaminated air, the air in a plane is well-protected by high-efficiency filters, which remove more than 90 percent of known particulate matter.

 

A bigger concern than recirculated germs is low cabin humidity, about 10% when flying at 30,000-35,000 feet. This dries the mucous membranes of the noses and throats of passengers. Consequently, the mucus becomes too thick for easy movement and it remains longer in the upper respiratory tract. This gives entrapped germs more time to penetrate the passengers’ mucous membranes.

 

The most significant airborne exposure on a plane comes from fellow passengers. The most dangerous neighbors on a plane are those sitting within a two-seat radius since bacteria and viruses from coughs and sneezes do not readily transmit more than six to eight feet.

 

Airborne exposures aside, the usual concerns about contact surfaces remain, also on a plane. The worst exposure is the airplane bathroom, which has the exposures of other bathrooms but complicated by smaller space. Other important contact exposures on an airplane are seat-back trays and aisle-seat handles.

 

In a Hotel

Hotels are in the hospitality business and usually try to present a clean appearance. Nevertheless, germs are frequently abundant on bedspreads due to the difficulty in cleaning them. Light switches and bathroom floors are often contaminated with intestinal bacteria. However, the dirtiest site in the hotel room is usually the TV remote control.

 

Meanwhile, in the hotel restaurant, menus are the biggest carriers of germs, followed closely by the pepper shakers.

 

At the Gym

Keeping any cuts or injuries fully covered is imperative when working out at the gym. It is also essential to use the solutions and towels provided to wipe down the equipment before using it.

 

Plantar warts virus and athlete’s foot fungus can easily infect those going barefoot on gym floors and locker rooms. Wearing shower shoes in the shower and locker room is critical.

 

For yoga aficionados, it is important to bring one’s own yoga mat and to wear socks when not on it. 

 

At Work

One of the most important rules to follow for work is not to go if you are contagious. This rule is becoming easier to follow now that there are increased opportunities to work from home.

 

If someone at work is coughing or sneezing, maintain a social distance; as mentioned, six to eight feet is usually sufficient.

 

Other precautions to observe at work are

  •      Covering coughs and sneezes.
  •      Washing hands frequently.
  •      Regular cleaning of often-touched surfaces.

 

Flu Shot

Since meticulously following all of these precautions is not always possible, it is important to get an annual flu shot. The flu virus spreads from person to person through droplets coming from the nose and mouth when a contagious person coughs, sneezes, or talks. The flu virus may also spread when someone touches a surface with flu virus on it, and then touch their eyes, nose, or mouth. An annual flu inoculation helps protect from these exposures.

 

Conclusion

Again, the best way to deal with an infectious disease is not to have it. Prevention is a most efficacious tool with few drawbacks except the modest energy needed to employ it. 

 

Thomas Falasca, DO

 

Sources and Recommended Reading

Centers for Disease Control and Prevention. https://www.cdc.gov.

Fox, B. (2015). Introduction to Infectious Diseases. Chantilly, VA: The Great Courses.

Handwashing: Clean Hands Save Lives. (2018, October 09). Retrieved from https://www.cdc.gov/handwashing/index.html

Water, Sanitation & Environmentally-related Hygiene. (2011, February 01). Retrieved from      

     https://www.cdc.gov/healthywater/hygiene/hand/handwashing.html

Water, Sanitation & Environmentally-related Hygiene. (2009, December 30). Retrieved from  

     https://www.cdc.gov/healthywater/hygiene/hand/nail_hygiene.html

Seasonal Flu

Influenza, or “flu,” is a highly contagious respiratory illness that occurs in seasonal epidemics.   ...See More


Seasonal Flu

What Is Flu?

Influenza, or “flu,” is a highly contagious respiratory illness that occurs in seasonal epidemics.  An episode of flu typically runs its course over several days.  Although usually just a severe nuisance, flu can sometimes result in respiratory failure and death.

 

Symptoms

An attack of influenza is usually accompanied by muscle aches, headache, fever, sore throat, red watery eyes, runny nose, and cough.  Only some of the symptoms may be present.

 

These symptoms sound like a cold, and like a cold, flu is a respiratory infection. However, influenza is caused by a different virus and is more severe.

 

Severity

Each year about 200,000 Americans are hospitalized because of flu complications. The number of deaths varies depending on the annual virus strain; but American deaths have recently ranged from 3,000 to 49,000 in a year.  While human lives are most important, it is noteworthy that even mild strains of the flu can impact the American economy by $10 billion annually in lost productivity.

 

Contagion

Influenza is typically spread by the aerosol droplets propelled in the course of a cough or sneeze.  Even people six feet from a sneeze are at increased risk of infection from these micro particles.  

 

Flu can also be spread from surfaces.  If a person coughs into their hand or sneezes into a handkerchief and then touches an object such as a doorknob or computer keyboard, that object becomes contaminated. A person who touches the object shortly afterward can be infected, usually when they transfer the virus from their hand to a mucous membrane such as the nose, mouth, or eye.

 

Because of the high level of contagion, it is important that flu patients remain home to avoid infecting co-workers.

 

Infectivity

Once a person becomes infected by the virus, it takes 1 to 4 days before they exhibit symptoms.  However, they may transmit the virus to others even before symptoms become evident. Thus it is not sufficient to avoid persons who appear to be sick.  It is important to make a habit of frequent hand washing as this can reduce both virus dissemination and acquisition.

 

Complications

Occasionally influenza does not run its normally uneventful course but instead results in complications.  Some of the most serious of these are viral pneumonia, bacterial pneumonia, respiratory failure, an inflammation of the heart (myocarditis), an inflammation of the membrane surrounding the heart (pericarditis), and multiorgan failure.

 

Vulnerability

Fatalities are most common in infants and the elderly. Thus it is important that senior citizens receive vaccination, the “flu shot.”  Vaccination is also important for pregnant women.  Pregnant females are not at risk from the flu shot and they need vaccination because they are at increased risk of complications from flu and they need to pass on their immunity to the newborn.

Others who are at increased vulnerability are those who are immunocompromised from disease or chemotherapy.

 

Pandemics

A pandemic is an epidemic that occurs over a broad area.  Four flu pandemics have occurred in the last century.  These epidemics occurred when a highly contagious and aggressive strain of the virus emerged.  

 

The infamous “Spanish flu” of 1918 killed nearly 675,000 people in the US and a possible 50 million people worldwide.  

 

The “Asian flu” of 1957 killed about 69,800 people in the US.  

 

The “Hong Kong flu” of 1968 took the lives of 33,800 people in the US.  The relatively modest number may have been largely due to the availability of antibiotics to treat secondary bacterial infections.  

 

The “swine flu” of 2009 caused between 9,000 and 18,000 deaths.  The reduced number of deaths in this epidemic may have been due to the fact that 80 million people were vaccinated.

 

Flu Vaccination Does Not Cause Flu

Vaccination against flu can be by injection or nasal spray.  The injection contains virus that is inactivated (“killed”). The nasal spray contains virus that is attenuated (“weakened”) and so altered that it can be active only at the cooler temperatures of the nose and not in the warmer temperatures of the lungs. The result is that flu vaccination does not cause the flu!

 

Vaccination Side Effects

Serious vaccination side effects are quite rare.  They are circumvented by avoiding certain flu vaccinations in specific groups of people.

 

Traditionally, flu vaccine was produced using chicken eggs and was contraindicated in persons with egg allergy.  Since 2012 a vaccine prepared in a different manner has been available for persons 18 years of age and older who are allergic to eggs.

 

An inactivated virus vaccination rather than an attenuated virus vaccination is generally appropriate for persons with weakened immune systems congenitally, from illness, or from chemotherapy.

 

In short, some type of flu vaccination should be appropriate for most individuals 6 months of age and older.

 

So If I Get Vaccinated, I Can’t Get the Flu, Right?

Not quite!  In the recent past flu vaccination has had 70% effectiveness against influenza B and 60% effectiveness against influenza A.  This is so because:

  • The US Center for Disease Control (CDC) must project in advance the virus strains of the upcoming flu season.
  • Different individuals have different capabilities of manufacturing antibodies in response to the stimulus of the vaccine.
  • It takes 1-4 days after infection for flu symptoms to emerge.  Persons can be infected before they receive the vaccination.
  • It requires 7-14 days for the body to build antibodies from the stimulus of the vaccination. Vaccinated people can be infected with flu during this time period.
  • Symptoms of flu can be simulated by other virus infections.  Flu vaccinated persons who seem to get the flu may have these other infections.

 

How Can I Prevent the Flu?

The best method of dealing with the flu is not to have it!  In order to greatly reduce chances of getting the flu, it is most important to take these precautions:

  • Practice frequent hand washing, especially after contact with objects touched by infected persons or the general public.
  • Avoid proximity to infected persons.
  • If infected, stay home and avoid contact with others. Bear in mind that you are infectious for 4-9 days after onset of symptoms.
  • Finally, present yourself for vaccination.  This is your surest way of protecting yourself from flu.  As an added benefit, remember that by getting vaccinated, you are also protecting newborns, elderly, chemotherapy patients, and others unable to fully benefit from their own vaccination.

 

Conclusion

So please stay well this season and protect yourself from flu.

 

Thomas Falasca, DO

View this fact-filled video on flu symptoms from the US Centers for Disease Control!

 

Snow Shoveling Safety

The Erie County Medical Society wants you to enjoy winter without falling victim to snow shoveling perils, so here ar ...See More


Snow Shoveling Safety

The Erie County Medical Society wants you to enjoy winter without falling victim to snow shoveling perils, so here are some helpful tips.

 

First and foremost

  • Check with your doctor. Shoveling stresses the heart because of both exertion and cold. Consider hiring someone for the task.
    Do not shovel after eating or smoking as these activities reduce blood flow to the heart.
    Stop if you feel chest pain, or get excessively tired or have shortness of breath. You may need immediate professional care.
    Dress in layers with water-repellant clothing outermost. Remember hats, gloves, and warm socks because substantial body heat is lost from these areas.

 

Choose an appropriate snow shovel.

  • A curved-handled shovel helps keep your back straighter when shoveling.
    Choose a shovel with an appropriate length handle. The length is appropriate when, at the beginning of the shoveling stroke, it allows you to slightly bend your knees and bend your back less than 10 degrees while still holding the handle comfortably.
    A plastic shovel blade adds less weight to the lift than a metal blade.
    A smaller shovel blade may add to the time of the task; but, by picking up less snow, it reduces the risk of a heavy shovel load.

 

Be mindful of your shoveling actions.The American Academy of Orthopedic Surgeons recommends

  • If you must lift snow, squat with legs apart, knees bent, and back straight.
    Lift with the legs instead of bending at the waist; this reduces strain on the back.
    Scoop small amounts of snow with the shovel and walk to the dumping area.
    Outstretched arms exaggerate strain on the back.
    Remove deep snow in layers of an inch or two in thickness.
    Move feet instead of twisting.

 

In addition, remember that

  • Pushing the snow instead of lifting it reduces strain on the back.
    Gripping the snow shovel with your hands at least 12 inches apart increases leverage and decreases body strain.
    Throwing snow over your shoulder is dangerous. It twists the back and predisposes to injury.
    Warming up muscles before shoveling reduces the risk of strains and sprains.
    Frequent breaks to gently stretch back, arms, and legs reduce stress to these areas and distributes over time exertion on the heart.
    Wet snow is especially heavy and one shovelful can weigh 25 pounds.
    Clearing snow early and often to avoid dealing with a large amount of heavy, packed snow.

 

So follow these tips and avoid becoming a snow-shoveling casualty.

 

For more information, consult
· Colorado Spine Institute http://www.coloradospineinstitute.com
· AMERICAN ACADEMY OF ORTHOPEDIC SURGEONS http://orthoinfo.aaos.org/topic.cfm?topic=A00060
· National Safety Council www.nsc.org
· Toronto Emergency Medical Services
http://www.torontoems.ca/main-site/careers/safety-tips/show-shovelling.html

 

Thomas Falasca, DO



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Holiday Toy Safety

2018-12-02 09:40:10

Holiday Toy Safety from Cincinnati Children's Hospital ...