Shoo flu!

Every year 200,000 people in the United States will contract the flu.  About 30,000 people die from the flu a year in the United States, which is about the same number that die from motor vehicle accidents.  In 1918, the “Spanish” flu caused 20 million deaths worldwide.

The word influenza comes from the Italian word for “influence”, because it was believed that the planets, stars and moon influenced the timing of the flu season.

If someone who has the flu sneezes on a table or hard surface, the virus can live between 2-8 hours.

The economic cost of the flu in the United States per year is $8.4 billion in lost worker productivity.

Getting the flu shot reduces your chance of getting the flu by 50-60%.  And you can’t get the flu from the flu shot!

shoo flue



Can you make the diagnosis?

Jennifer and her friend are having lunch. Jennifer’s friend notices that Jennifer’s left eye is red and asks her about it.

Jennifer shares that she has been having eye pain on the left for the last week, and also having some blurry vision and blind spots. She thinks her eye irritation is from her hay fever.

What should Jennifer’s friend advise her to do?

  1. See an eye doctor or go to the ER
  2. Tell her to take allergy medicine
  3. Tell her she may have pink eye, so she should be on antibiotic drops
  4. Tell her to put cool wash cloths on the eye


If you chose 1. See an eye doctor or go to the ER, you are right!

Jennifer may have glaucoma based on her symptoms.

Glaucoma is a condition that damages the eye’s optic nerve. It is caused when pressure is too high in the eye from fluid build-up.

Glaucoma is one of the leading causes of blindness.

Symptoms of glaucoma can include blind spots, tunnel vision, headache, eye pain, blurred vision, eye redness, and vomiting.

Regular eye exams are recommended by the American Academy of Ophthalmology:

If you are under 40 years old: Every 5-10 years

If you are 40-54 years old: Every 2-4 years

If you are 55-64 years old: Every 1-3 years

If you are over 65 years old: Every 1-2 years


Allergies would be unlikely to cause symptoms in just one eye. Pink eye (conjunctivitis) is a possibility, but doesn’t usually cause changes in vision, and is usually associated with eye discharge.


Is there a shot that can help heroin addicts?

Yesterday’s blog was about a shot that can help reduce the craving for alcohol.   The same shot also works for patients who are addicted to heroin or other opioids.

Vivitrol  (Naltrexone, other trade name is ReVia) works to reduce cravings for patients who are addicted to alcohol but also to opioids.

How does it work?  It binds to a receptor in the “Addiction Center” of the brain, which decreases the urge for heroin or other opioids.

Vivitrol is given as a shot once a month, and is to be used along with counseling for opioid addiction.

The cost for the shot is about $1250 per month, which some insurance plans cover.

The patient has to have stopped taking opioids for a period of time (about 7-14 days) prior to getting the shot.

Does it work?  There is a 50% success rate while on Vivitrol for patients with opioid addiction.

Other medications that can assist with opioid addiction treatment include oral medications Subutex and Suboxone. Success rate with these medications is 40-60% if the patient stays on the medication, but drops to 8% if the patient stops taking the Subutex or Suboxone.

The traditional form of treatment for opioid addiction is methadone. The long-term success rate from methadone is 13%. About 2% of patients who go on methadone die from methadone-related effects.


Is there a shot that can help alcoholics?

There is a shot that can reduce cravings for patients who are trying to stop drinking.

Vivitrol  (Naltrexone, other trade name is ReVia) for alcohol treatment is also the same drug that can be used to treat narcotic addiction.

How does it work?  It binds to a receptor in the “Addiction Center” of the brain, which decreases the urge to drink.

Vivitrol is given as an IM shot once a month, and is to be used along with counseling for alcohol addiction.  Vivitrol also comes in tablets.

The cost for the shot is about $1250 per month, which some insurance plans cover.

The patient has to have stopped drinking for a period of time (about 7-14 days)  prior to getting the shot.

Does it work?  There is a 25% reduction of heavy drinking for patients who use Vivitrol,  with more abstinent days per month.  It is a fairly new drug, so more studies are in process.


Can you make the diagnosis?

Sarah is on vacation at the beach, and having a great time with her friends.  They have a great seafood meal at their resort restaurant, then they have a glass of wine in the hot tub.

That night in her hotel room though Sarah starts to feel itchy, and can’t get back to sleep.  She finally gets out of bed and looks at her skin in the bathroom mirror:

hot tub

What does Sarah have?

  1.  Allergic reaction from seafood
  2.  Hot tub folliculitis
  3.  Reaction from drinking alcohol
  4.  Bedbugs



If you guessed 2.  Hot tub folliculitis, you are right!

Hot tub folliculitis is a skin infection of the hair follicles, and is caused by water that is contaminated with bacteria. Children tend to be affected more often than adults. It can also occur from other sources such as pools or water parks.

The infection can begin a few hours to days after being exposed to contaminated water. It begins as an eruption of itchy, red bumps.  The rash may be worse in the areas where the swimsuit contacted the skin.   

Hot tub folliculitis typically resolves without any treatment within 5-10 days. Topical treatments that can be helpful include silver sulfadiazine cream or white vinegar applied to the rash. Oral antibiotics can be used for 5-10 days if the rash is severe. 

An allergic reaction is a possibility, but that rash looks more like hives typically.  Patients with a reaction from drinking alcohol usually have other symptoms such as vomiting and stomach pain.  Bedbug bites create itchy welts in a zig zag pattern.

What happens when a smoker stops smoking?

When a smoker stops smoking:

In 8 hours, their oxygen level is back to normal.

In 24 hours, their risk of having a heart attack has decreased.

In 2 weeks, lung function has improved 30 percent.

In 10 years, the risk of having a stroke decreases by 50%.

In 10 years, the risk of lung cancer has decreased to the same as non-smokers!


Normal Lungs:               Smoker’s Lungs:


Can you make the diagnosis?

Doug is sitting in a meeting, when he notices a twinge of back pain.  He notices the pain seems worse on the left side.  He tries to ignore it.

Soon however the pain is much worse, and is radiating from his back to his groin.  He becomes nauseated and sweaty, and excuses himself from the meeting.   Doug makes it back to his office and tries to work.  He keeps shifting around in his chair to find a comfortable position, but the pain keeps getting worse.  Soon he is not sure he can even drive himself home because the pain is so bad.

What is causing Doug’s pain?

  1.  Muscular back pain
  2. A kidney stone
  3. Appendicitis
  4. A urinary tract infection




If you picked 2.  A kidney stone, you are correct!

Twelve percent of men and seven percent of women will get a kidney stone in their lifetime. Your chance of having a kidney stone doubles if you have a family member who has had one.  The average kidney stone is about 5 mm (0.2 inches).  Most kidney stones will pass on their own, but some need to be removed.

Patients who have kidney stones usually describe it as severe 10/10 pain that starts on the back on either the right or left side, and often radiates to the groin.  The pain is often associated with vomiting.

Muscular back pain usually has a subtle onset, and is more general low back pain though it can radiate to the legs.  It is not usually associated with nausea or vomiting.  Appendicitis pain usually starts in the mid-abdomen and then moves to the right lower side, and is often associated with vomiting.  Patients with appendicitis often want to lie very still however, and not writhe around like patients with a kidney stone.  A urinary tract infection usually starts with flu-like symptoms, and has burning with urination and fever.  A urinary infection that spreads to the kidney can also cause back pain.

Kidney stone:

kidney stone