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Archive for January, 2018

Influenza

influenza

Influenza is transmitted by direct and indirect contact via respiratory droplets from coughing, sneezing or from just shaking hands.  The incubation period is several days and contagiousness can last as long as a week after the symptoms begin.  The best way to limit its spread is by frequent hand washing with soap and water for 15 to 20 seconds and by limiting close face to face contact with others when symptoms are present.  It is very important to know the difference between the common winter cold and influenza.  As opposed to a common cold, influenza has these distinguishing characteristics:

  • Very sudden onset
  • Fever
  • Aches
  • Sore throat

At the onset of influenza symptoms people often say they feel as if they had been “run over by a truck.”

The treatment for influenza is mostly symptomatic care:  plenty of rest, Tylenol or Advil (ibuprofen) for fever and aches, and maintaining adequate liquid intake.  There are drugs such as Tamiflu, available from a doctor which if taken within the first 48 hours of influenza symptoms may shorten the course of the illness by several days.  These are recommended for the elderly or chronically ill patients with influenza symptoms.

Being immunized by a flu shot significantly lessens one’s chance of getting the flu.  But as with any treatment there is no guarantee of 100% success.  One can still get a bad viral upper respiratory infection during the winter months even after the flu vaccine. Most people who receive the flu shot have no bad reaction to it.  Some people may experience redness and swelling at the injection site lasting a few days.  One cannot get the flu from a flu shot because it is made from a deactivated dead virus.  The benefit of the flu shot far outweighs the minimal risks.  Although the ideal time for a flu shot is from mid-October through November, the flu season can extend through May.

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atrialfib

Atrial fibrillation is an irregular often rapid heart rate, causing the heart’s two upper chambers to quiver instead of beating regularly. Fortunately, the lower two chambers still work normally and are able to pump the blood out of the heart, although not as efficiently. It is this inefficient pumping that can cause the frequent symptoms of palpitations, shortness of breath, weakness, and lightheadedness.

Atrial fibrillation is the most common heart arrhythmia. It is found in over 6 million Americans and accounts for some 90,000 deaths annually. It occurs in about 1% of individuals in their 60s increasing to up to 12%of adults in their 80s. Some 30% of people with atrial fibrillation are unaware of their condition.

Atrial fibrillation can be brought on by increasing age, prior coexisting heart disease, high blood pressure, thyroid disease, and drinking alcohol.  It can come and go or it can be chronic and permanent. It is usually not life threatening but it is a serious condition and needs to be treated.

There are two main goals in the treatment of atrial fibrillation. First is to attempt to control the rhythm, that is, get the rhythm back to the normal beating pattern. If a normal rhythm cannot be obtained then the second goal is to control the heart rate. Ideally one would want to have the rate 80 beats per minute or below.  Both of these goals can be accomplished with medication.

If one is very symptomatic or has relatively new onset atrial fibrillation, the heart can be electrically treated with a small electrical shock while under  brief anesthesia. This however is rarely a permanent solution.

One of the  main problems with atrial fibrillation is the chance of having a stroke. Blood clots can form in the quivering upper chambers. If a clot breaks loose it can go to the brain causing a stoke.  This can be prevented by taking a blood thinning medication. Another complication is heart failure due to a weakening of the heart muscle.

There is a new advanced procedure called ablation. In this case a catheter is inserted in a large blood vessel in the groin and threaded up into the heart. Through highly technical computerized imaging, the trigger area for the fibrillation in the upper chamber is identified and lightly treated with high frequency radio waves. This destroys the area where the abnormal impulses of atrial fibrillation are generated. The success rate for this procedure is around 70% initially and up to 90% if a second procedure is necessary.

Many people with atrial fibrillation are living relatively normal lives today when properly managed. It is a condition not to be feared but to be monitored closely and treated appropriately by your doctor.

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