While it is completely inappropriate I couldn't help but laugh when I read an article about Alexa Ray Joel's potential overdose on the herbal pain remedy Traumeel. The article, appeared in the Los Angelas Times and written by Amina Khan was entitled "What Doesn't Kill You... probably doesn't do much anyway". You don't have to read much more than the title to get the jest of it. Attempted overdose on herbal preparations in America is, according to some, almost impossible. So... if it's not strong enough to kill you is it strong enough to help you clinically? According to this article, no.

I've always had mixed feelings about alternative medicine. On the one hand I believe that herbal medications work. I believe this enough to become terrified when I care for a patient who comes in with a long list of herbs and vitamins on their medication regime. The reason I get worried? Well, there's just not a whole lot of research on these medications here in the U.S. and I'm afraid that when I administer a prescription strength medication to this patient there may be an adverse drug/drug interaction. Unlike prescription drugs, I don't have a credible manual or a computer data base where I can look up each of these herbs and see what their potential side effects and adverse reactions might be.

On the other hand I've never had any experience with supplemental herbs and vitamins actually working, so I also kind of think they're a waste of money. In Europe, one of the most common anti-depressants prescribed is St. John's Wart. There are studies proving that this herb is effective at treating depression. However, when I tried this herb for depression I found that it didn't do squat. According to Khan's article that's because herbs in the U.S. are sold at a very low potency.

To sum up my personal opinion I think that if we're going to take herbs seriously, as a form of medicine, we need to put our money where are mouths are. I want controlled credible studies and standardized dosing. Will it happen? Probably not. Many people feel like the government already has too much control over what we put in to our bodies and they don't want the FDA regulating anymore than they already are. What do you think?

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The disturbing answer to the question we've all been asking ourselves since April 2009, what if the virus mutates, is finally being answered as reports of mutated H1N1 viruses come in from around the world. Eight reports of a mutation have come in from China and similar cases have been reported in the United States, Brazil, Norway, Japan, Mexico, and Ukraine according to an AFP article 3 days ago. In general medical experts seem to be playing down the mutations and adding extra emphasis to the fact that H1N1 drugs, Tamiflu and Relenza are still effective against the mutated virus.

What I find particularly disturbing is a case I read about in the Wall Street Journal, I quote, "... Norway reported a mutation of the flu virus in two patients who died and one who became severely ill. The mutation, while seen before, appeared to make the H1N1 virus cause infection deeper in the respiratory system than the regular swine-flu virus, a possible explanation for the more-severe cases, Norwegian scientists said."

In all of my research and coverage of the virus I have learned a few things. One is that the way that the H1N1 virus works is deep within the lungs. This is also the same way the pandemic flu virus of 1918 killed millions. I find the cases in Norway very disturbing. According the same WSJ article officials are claiming that the current wave of swine flu is peaking. The pandemic of 1918 occurred in three waves one in the spring and two more much deadlier waves in the fall and winter.

On a more positive note officials are saying that the current mutation is covered by the H1N1 vaccine as of now. All the more reason to put aside any apprehension you have about the vaccine and protect yourself from getting the virus in the first place.

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According to ABC News an entire lot of H1N1 vaccinations was pulled from the Canadian Market due to an unusual amount of negative side effects. The vaccine, called Arepanrix, is not approved for use in the United States so Americans shouldn't worry that they may have been given this vaccine. Experts are still arguing over the cause of the adverse reactions to the medication. According to the article six patients were injured by the medication but have since recovered from their illness.

Medical experts are encouraging people to consider the big picture. "We're actually seeing lower than that [expected one per 100,000 rate] in our overall vaccination campaign," says Timothy Vail spokesman for the Canadian Health Minister. Overall the H1N1 vaccine has proven beneficial and the medical field in general seems to be worried that this incident will discourage people from becoming vaccinated. Whatever caused the unusual side effects in this particular lot of vaccine is still being investigated.

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A new study at UT Southwestern Medical Center, supported by the Dallas VA Medical Center and the National Institutes of Health and reported in the November issue of Gastroenterology shows that gastroesophageal reflux disorder (GERD) may actually be an autoimmune disorder. The study showed that damage to the esophagus that occurs as a result of GERD is not from stomach acid but chemicals called cytokines which are released by esophageal cells in response to GERD.

The study was performed on rats. Researchers conducted surgery on the rats where they connected the duodenum (part of the intestine) to the esophagus to create similar conditions of GERD where stomach acid and bile were frequently spilling into the esophagus. Instead of appearing immediately as you would expect if stomach acid was the culprit of esophageal damage, damage to the esophagus did not appear for a number of weeks. "That doesn't make sense if GERD is really the result of an acid burn, as we all were taught in medical school," said Dr. Stuart Spechler, professor of internal medicine at UT Southwestern and senior author of the study. "Chemical injuries develop immediately. If you spill battery acid on your hand, you don't have to wait a month to see the damage."

"In animal models of reflux esophagitis designed to mimic the human disease, researchers hadn't looked at the early events in the development of esophageal injury," Dr. Souza, staff physician at the Dallas Veterans Affairs Medical Center and part of the Harold C. Simmons Comprehensive Cancer Center at UT Southwestern noted. "Most of those investigators have been interested in the long-term consequences of GERD, and we found virtually no published data about what happens later that induces gastroesophageal reflux."

Three days after the surgery researchers expected to see damage to the surface cells of the esophagus. Instead they found damage to cells deep within the tissue of the esophagus. GERD can cause sore throat, chest pain, and over time esophageal cancer. Similar studies will have to be preformed on humans to verify the results of this study. You can read more about this study on Newswise.

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According to Fox News gangs are making millions of dollars by selling fake versions of the H1N1 drugs Tamiflu and Relenza online. According to the report most of the fraudulent organizations are based in Russia. "As more and more cases of swine flu....come to light, it is essential that we all resist the panic-induced temptation to purchase Tamiflu online," said Sophos spokesman Graham Cluley. "The criminal gangs working behind the scenes at fake internet pharmacies are putting their customers' health, personal information and credit card details at risk." Cluley also said that the gangs were working under the name Canadian Pharmacy.

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Gordon Bernard, M.D., associate vice-chancellor for Research at Vanderbilt and a critical care pulmonologist is studying the role of statin drugs in H1N1 related deaths; particularly the statin drug Crestor. "We know from studying infections that it's not always the bacteria that will kill you, but your own reaction to the bacteria can deal a lethal blow. We're learning that statins have an impact on the immune system and can dampen down that deleterious component of the immune response," Bernard has been quoted as saying.

Dr. Bernard wants to conduct a study at Vanderbelt University Medical Center. He plans to enroll patients admitted to the ICU for H1N1 symptoms in the study. The patients will be divided into two groups. One group will receive Crestor and the other group will receive a placebo. "Once a person with suspected H1N1 reaches the ICU, their mortality can be 20 percent or higher. Statins offer the potential to reduce it to 10 percent. Statins, if effective, could also reduce the patient's time on a mechanical ventilator in half from a current average of 14 days," Bernard says.

The study will need approximately 3-4 million dollars of funding and will hopefully involve 2,240 patients.

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With respiratory season in full force millions of Americans are packing hand sanitizer. Businesses are placing it by their doors, and hospitals have placed hand sanitizer strategically throughout their buildings. But, which is best? Hand sanitizer or soap and water? This is a debate that has gone on for some time now. As an RN I've watched the hospital administration teeter on this issue from the beginning. Their first philosophy: hand sanitizer is bactericidal meaning that it kills germs, while soap and water either disables germs (by scrubbing) or sends them down the drain. We were told to always use hand sanitizer unless our hands were visibly soiled or had come in contact with body fluids.

A year later the guidelines changed. Saint Joseph's University medical microbiology expert Michael McCann, Ph.D. says that you should wash with soap and water whenever possible. Use hand sanitizer only when there is no soap and water available and only use alcohol based hand sanitizers. Hand sanitizers which kill bacteria using triclosan or other similar chemicals can actually create resistant bacterial strains in the same way that antibiotics do, he says.

So how do you wash your hands? Well, for starters you should scrub for a minimum of 15 seconds, (about as long as it takes to sing the alphabet). Scrub hard - friction damages the cell wall of bacteria which disables them. Turn off the faucet using a hand towel. Wash often, not just before you eat or after you use the bathroom. Wash when you come home from a public place, after you pet or handle pets, before holding infants, after handling money. Remember, germs are on everything and while millions of them are harmless it only takes one bad germ to cause life threatening illness.

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The pneumococcal polysaccharide vaccine (PPSV) vaccination helps to prevent cases of bacterial pneumonia. This may not mean a whole lot to you unless you know that one of the leading causes of death among patients infected with the flu (H1N1 and other strains) is caused by secondary infections with bacterial pneumonia. The PPSV shot should be given every five years, is recommended for all children less than 5 years old and all persons age 65 and older. It is also recommended for people aged 2-64 years with the following high risk conditions: heart disease, lung disease, diabetes, liver disease, alcoholism, cerebral spinal fluid leaks, cochlear implants, sickle cell anemia, splenectomy, and those with compromised immune systems. The PPSV can be given at the same time the 2009 H1N1 shot is administered or the seasonal flu shot. According to the CDC approximately 70 million people who qualify for this vaccine remain unvaccinated. Talk to your health provider about the PPSV shot.

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A new study reported at a meeting for the American College of Allergy, Asthma, & Immunology shows that patients who stopped using a neti pot had a 62 percent decrease in the occurrence of acute rhinosinusitis. The study followed 68 patients over a period of two years.

"I don't have anything against short-term nasal saline irrigation -- even aggressive nasal saline irrigation for three, four days or one week is totally fine," said Talal M. Nsouli, MD, of Watergate Allergy & Asthma Center in Washington. "But when we are doing it o on a daily basis, we are modifying the immunological biochemistry of the nose. This will lead us to a vicious cycle," Nsouli said. "More infections, more nasal saline; more nasal saline, more infections. We need to cut this cycle."

Those who stopped using the neti pot also had significantly fewer sinus infections. You can read more about this study on MedPage Today.

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Yes, it appears to be true; a 13 year old cat in Iowa tested positive for H1N1. This is most bizarre as it is fairly uncommon that flu viruses cross between different species and now H1N1 has been found in pigs, turkeys, a ferret and a cat. Occasionally flu viruses have crossed between birds and humans, or pigs and humans, but this is an unusually high number of various species for the virus to infect. So what does it mean? No one knows for sure but here are some probable theories: something sets the H1N1 virus apart from other influenza viruses we've studied, more animals have been tested since this is a full scale pandemic, there have been more opportunities for pets to become infected since this is a full scale pandemic.

Until more information is available vets are recommending that pets are treated the same way humans are regarding precautions to prevent the flu. This means isolating your pet from sick family members, covering your mouth when you cough, washing your hands and all the rest. And, take your pet to the vet if they appear sick. Basically, take care of yourself and your pets.

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