Flu Killing Young and Healthy This Year

While it is true that this year's flu vaccine has only 40% coverage compared to previous years, that's still better than zero. Moreover, this is turning out to be a brutal year for influenza. Two young and healthy folks have died in my state in just the past week from flu-related respiratory failure. Seattle P-I:

A college student in Whatcom County died this week from a rare case of MRSA pneumonia -- prompting health officials to urge state residents to be vigilant about their health and to get a flu shot if they haven't. Chris Feden, 20, a student at Western Washington University, died Wednesday from what county health officials said was MRSA pneumonia, a rare staph infection that he may have contracted after getting the flu. Separately, an 18-year old Pacific County resident died last week from respiratory failure, which wasn't caused by MRSA pneumonia, although it was believed to have been flu-related. Respiratory illnesses, including the flu, typically peak in Washington in February and March and can be serious and even fatal. Cases of MRSA -- methicillin-resistant staph aureus -- are increasing in number nationwide, including in Washington, and can complicate influenza and other respiratory illnesses.

So why can't we get vaccinated for all the strains of influenza out there each year? Slate's explainer, explains:

It wouldn't be worth the effort, even if it were feasible. There are thousands of influenza subtypes infecting people around the world, but very few are likely to make someone in the United States sick. Vaccinating people against a disease they're never going to get is a risky proposition: We don't know how the body would respond to a barrage of flu vaccinations. The patient might also develop a strong immune response to an insignificant strain, while skimping on antibodies for a nastier virus.

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File Under: Sausage Being Made

Tainted Heparin killing people? Like everything else, we go back a look at where it is made and how -- and the lack of oversight and regulation. The Wall Street Journal has a series "following the heparin trail..."

In a small, damp factory here, blood-smeared men wring pulp from pig intestines, then heat it in concrete vats.
The activity at Yuan Intestine & Casing Factory is
the first step in the poorly regulated process of making raw heparin,
the main ingredient in a type of blood-thinning medicine that in recent
days has come under suspicion in the deaths of four Americans.
More than half the world's heparin comes from China.
The chemical is often extracted from pig entrails in small factories --
many as rudimentary as this one, which also manufactures sausage
casings from intestines. The heparin eventually ends up in drugs used
world-wide by patients having surgery or who need dialysis.

Technorati Tags: Heparin, China, Scary, regulation

Getting Old, Living Well

I turned 39 last week. As my wife reminded me, I'm just 16 years from turning 55 and qualifying to live in those gated "adult communities." Yikes. That said, I'm amazed at some of the 90+ year olds that come into my hospital. They live independently, are active and usually take only a daily aspirin. How do I get to live like that? I mean, if I'm going to live to 90, I want to LIVE.

Apparently, for men at least, it isn't that hard -- at least on paper. According to this morning's New York Times Health section:

Five behaviors in elderly men are associated not only with living
into extreme old age, a new study has found, but also with good health
and independent functioning.
The behaviors are abstaining from smoking, weight management, blood pressure control, regular exercise and avoiding diabetes. The study reports that all are significantly correlated with healthy survival after 90.
While it is hardly astonishing that choices like not smoking are
associated with longer life, it is significant that these behaviors in
the early elderly years — all of them modifiable — so strongly predict
survival into extreme old age.
“The take-home message,” said Dr. Laurel B. Yates, a geriatric specialist at Brigham and Women’s Hospital
in Boston who was the lead author of the study, “is that an individual
does have some control over his destiny in terms of what he can do to
improve the probability that not only might he live a long time, but
also have good health and good function in those older years.”

...after controlling for other variables, smokers had double the risk
of death before 90 compared with nonsmokers, those with diabetes
increased their risk of death by 86 percent, obese men by 44 percent,
and those with high blood pressure
by 28 percent. Compared with men who never exercised, those who did
reduced their risk of death by 20 percent to 30 percent, depending on
how often and how vigorously they worked out.

Even though each of these five behaviors was independently
significant after controlling for age and other variables, studies have
shown that many other factors may affect longevity, including level of
education and degree of social isolation. They were not measured in
this study.

Although some previous studies have found that high cholesterol
is associated with earlier death, and moderate alcohol consumption with
longer survival, this study confirmed neither of those findings.

A second study in the same issue of the journal suggests that some
of the oldest of the old survive not because they avoid illness, but
because they live well despite disease. In other words, instead of delaying disease, they delay disability.

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Battling Bedsores: The Team Approach

Technology has helped hospitals battle bed sores, but with more and more people living in long term care facilities, battling debilitating and deadly bedsores takes a team approach. According to research reported in the New York Times:

Experts estimate that two million Americans suffer from pressure
ulcers each year, usually through some combination of immobility, poor nutrition, dehydration and incontinence. The Centers for Disease Control and Prevention does not keep statistics on fatalities, but one prominent victim was the actor Christopher Reeve, who died of a bedsore infection in 2004 in the middle of a heroic battle against paralysis.
New research is suggesting that the battle against bedsores requires
a team approach, enlisting everyone from nurses and nursing assistants
to laundry workers, nutritionists, maintenance workers and even
in-house beauticians.
In a study of a collaborative program involving 52 nursing homes
around the country, The Journal of the American Geriatrics Society
reported last August that team efforts had reduced the number of severe
pressure ulcers acquired in-house by 69 percent.
“Preventing pressure ulcers is a 24/7/365 kind of job,” said Jeff
West, a clinical reviewer at Qualis Health in Seattle, who helped to
set up the collaborative in 2003. “It’s not as if one person can get it
all done. And if it fails just a little bit, just during the weekends,
for instance, you’re not going to get the results. It takes tremendous
consistency.”

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Diet Soda and Metabolic Syndrome

This should, of course, surprise me more, but it doesn't. Researchers have correlated diet soda consumption to metabolic syndrome -- which is obesity, hyperlipidemia, diabetes and high blood pressure. This could of course be something in the diet soda. Or it could very well be the psychology of someone who consumes an unhealthy carbonated carbohydrate. From the NYTimes.

Researchers have found a correlation between drinking diet soda and metabolic syndrome — the collection of risk factors for cardiovascular disease and diabetes that include abdominal obesity, high cholesterol and blood glucose levels, and elevated blood pressure.
The scientists gathered dietary information on more than 9,500 men
and women ages 45 to 64 and tracked their health for nine years.
Over all, a Western dietary pattern — high intakes of refined
grains, fried foods and red meat — was associated with an 18 percent
increased risk for metabolic syndrome, while a “prudent” diet dominated
by fruits, vegetables, fish and poultry correlated with neither an
increased nor a decreased risk.
But the one-third who ate the most fried food increased their risk
by 25 percent compared with the one-third who ate the least, and
surprisingly, the risk of developing metabolic syndrome was 34 percent
higher among those who drank one can of diet soda a day compared with
those who drank none.

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A few little votes

So there we were on a rainy Saturday. The Grays River was running muddy brown and near its banks. You can still see piles of silt that built up when the river flooded the valley last December. The Rosburg Hall has only been around 100 years or so -- long enough that most people used to come here by the docks rather than the road. The front steps face out toward the river.

There were only 20 or so Democrats that showed up at 1 p.m. for weak coffee and caucusing. As he gaveled us to order, most of the folks don't recognize Krist Novoselic from his former career as a rock star. We say the pledge or allegiance and introduce ourselves around the table. There are ten people in my Rosburg precinct -- four of us are for Obama -- the oldest woman and the three youngest men. The rest are for Clinton. After the initial tally we do our arguments. There's a guy who immigrated from Denmark who is opposed to Obama because he supports giving illegal aliens driver's licenses.

A crotchety old contrarian argues that he's opposed to "all this talk about change, what we really need is incremental steps." We all look at him like he's joking for a few awkward moments, then avoid his eyes when we realize that he's not. "We can't afford not to change," I say.

I make my pitch for Obama based on his ability to motivate many first time and young voters, and his appeal to independents. The oldest woman at the table states that she likes Hillary but thinks she's too polarizing a figure. "People just hate her, they can't say why, but they just do and that can't be good in the general election against McCain. I can't repeat some of the things they say about her."

A couple people speak up for Hillary in terms of experience, and the name recognition that will be needed to heal our relationship with the other nations of the world. Another woman points out that Hillary's already withstood everything the Republican noise machine can dish out. Interestingly, someone throws out the question -- "who was your first choice before John Edwards dropped out?" Nine out of ten of us say John Edwards.

After 20 minutes, we go around and say who were are for. Two people have changed their minds -- husband and wife. He's swayed by the arguments for Obama, and she's changed her vote to Hillary without explanation. Rosburg remains six to four in favor of Clinton over Obama - but that splits our delegates with one elected for each. The Grays River table selects two delegates for Obama and Deep River will send only one for Clinton. All told our little valley selects three Obama delegates and two Clinton delegates.

Voting is easy. Showing up and talking with your neighbors about the who and why of your decision is hard. It was clear that most of the people had thought through what they were going to say and had wrestled in deciding between the two Democratic candidates. What stuck me, however, is that I know all these people -- I see most of them every week -- and we never talk about national politics. This hour of democracy -- a show of hands over weak coffee as the rain misted outside -- was heartening and inspiring. It was humble and small and yet powerful too.

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