New immunization guidelines for kids, teens
Michael Roizen, M.D. and Mehmet Oz, M.D.
The first known reference to malaria is in a Chinese medical text penned around 2700 B.C. Since then, no commercially available vaccine has been developed (one is scheduled for Africa next year, and others may be on the horizon). Upward of 430,000 people — mostly children — die annually from the disease.
Fortunately, there are effective vaccines against many other diseases (smallpox was declared eradicated in 1979), and in the U.S., the Centers for Disease Control and Prevention issues an annual update to help people use them most effectively. The 2017 advisory for kids and teens is out, and we recommend all the inoculations. (Your chance of having a problem versus preventing a life-threatening disease is one in 40,000.)
■ For the Hepatitis B vaccine: The birth dose of HepB should be administered within 24 hours of birth.
■ For human papillomavirus (HPV) vaccine: Children 9-10 years old may be vaccinated (even in the absence of a high-risk condition). And the HPV vaccine has been updated to include the new two-dose schedule for persons initiating the HPV vaccination series before age 15. The bivalent HPV vaccine has been removed from the schedule.
■ For the flu vaccine: Live attenuated influenza vaccine (LAIV) has been removed from the schedule. Hiberix has been added to the list of vaccines that may be used for the primary vaccination series.
■ For the meningococcal vaccine: The CDC stresses the need for a meningococcal conjugate vaccine booster at age 16.
For an unabridged list of changes, go to www.cdc. gov and search for “2017 Immunization Schedules.”
Cleansing the cleanse: better safe than sorry
This just in from the almost-too-stupid-tobe-true department: Researchers at the University of Colorado investigating 10 years of toxicology records found that some folks in “alternative medicine circles” believe that drinking a solution of high-test, concentrated peroxide can be used for internal cleansing. That’s even though folks get sick and some have died … because it’s poison!
Even the world’s most famous peroxide blonde, Marilyn Monroe, knew that peroxide goes on the outside, not the inside. (Irony of ironies, even though Ms. Monroe was the stereotypical image of a dumb blonde, she was actually a very sharp woman who banked millions of dollars. Just one more reminder that you shouldn’t judge women on their outward appearance!)
Now, hydrogen peroxide, a very dilute form of peroxide, is useful for everything from keeping your kitchen clean to removing earwax. But aside from gargling and spitting out a diluted form of hydrogen peroxide to treat gum disease — with your dentist’s permission, of course — it’s NEVER taken internally. Some sur- geons use hydrogen peroxide to disinfect large open wounds and infected sores, but even those benefits haven’t been proven.
Interested in a safe cleanse? Try Dr. Oz’s 5-Day Summer Cleanse or a 48-hour weekend cleanse. But don’t go overboard. Stick with whole, organic foods and juices, and monitor how you are feeling. By the way, Dr. Mike doesn’t believe cleansing makes sense unless you’re going to change your nutritional behavior and make healthy food choices every day for the rest of your life.
Question: My coworker cracks his knuckles all day long! Sometimes he does it in meetings. It bothers me so much I want to throttle him. Is something wrong with me? — Haley O., New York
Answer: If you’re one of those people who can’t stand the sound of someone next to you chewing, cracking his knuckles or even breathing loudly, you may have a neuropsychiatric condition called misophonia.
Folks with misophonia have seemingly overthe-top reactions to everyday sounds. And since the condition was first identified in 2001, scientists have gone back and forth as to whether it is genuinely a medical condition. Presently, it’s not recognized in the Diagnostic and Statistics Manual, which catalogs every psychological diagnosis a person could have.
But a recent study has identified differences in the brains of people with misophonia, indicating that it might indeed be a distinct condition. Researchers at the Institute of Neuroscience at Newcastle University in the U.K. did brain scans on people suffering with the condition and noticed that they have an abnormality in their frontal lobe — the area that controls emotion. So while most people aren’t bothered by these everyday sounds, people with misophonia can’t control their emotional response; their brains go into overdrive, their heart rate goes up and they begin to sweat.
No one knows for sure how common this problem is, but if you find yourself driven bonkers by noises that others hardly notice, take comfort in knowing that there may be a reason you react this way. So, what can you do about it?
■ Limit your exposure to triggers (ear plugs and sounddampening earphones are effective).
■ Explain to colleagues who like to click their pen repeatedly or crack their knuckles that you may have a medical condition that makes those noises distressing to you.
■ If a noise is really bothering you, leave the room.
■ And when you feel distressed, close your eyes and take deep breaths to calm that emotional response.
Q: My 78-year-old grandmother was having trouble sleeping, so her doctor prescribed tranquilizers. That was 18 months ago! I think they have a terrible effect on her alertness, balance and overall health, but now she’s hooked! Should I intervene? — Georgia F., Fayetteville, North Carolina
A: You’ve identified a growing health issue that affects many elderly people: long-term use of benzodiazepines, such as Valium, Ativan and Xanax, to manage everything from anxiety and panic attacks to sleep disorders. In a recent study online in JAMA Psychiatry, researchers from the National Institute of Mental Health, Columbia and Yale universities and New York State Psychiatric Institute uncovered serious overprescription and long-term use of these tranquilizers despite concerns with “risks associated with long-term benzodiazepine use, especially in older patients.”
In fact, more than 11 million folks had prescriptions for benzodiazepines in 2008, and 31 percent of the long-term users were 65-80 years old. Plus, the researchers say, several studies have found that primarycare physicians rather than psychiatrists write the majority of such prescriptions. They also suggest that a combination of factors may be at play, including lack of knowledge of the risks to the elderly and lack of appointment time to explore alternative treatments.
Whatever the reasons, for older folks, long-term use of benzodiazepine (more than 120 days) can cause impaired cognitive functioning, reduced mobility, compromised driving skills and an increased risk of falls.
Georgia, if you go with your grandmother to see her doctor, you can ask questions, remember answers and explore the safest way to reduce her dependence. The researchers suggest “an effective intervention involves gradual supervised benzodiazepine withdrawal [it’s dangerous to stop abruptly], combined with psychotherapy focused on coping with dependency symptoms and underlying psychiatric symptoms.” In other words, it takes time and trained medical supervision.
You also can help her by identifying whatever form of physical activity she can manage (chair-based yoga, walking, swimming-pool exercises). It’s effective in reducing anxiety, improving sleep and helping her cope with withdrawal.