A Gutsy Guide to Getting Your Mojo Back

Hiya Pinkies, and Happy Healthy Thursday!

Unless you’ve been sleeping under a rock for the past 5 months, you’ve heard all the crazed, paranoid, panicked fuss about the H1N1 influenza (Swine Flu) virus and corresponding vaccine. So let me just start by saying, PLEASE! Don’t panic. This is just the flu. While it can be deadly, it does not appear to be any more so than the seasonal flu, so RELAX. This is no time for conspiracy theories, anxiety, paranoia, and fear. Take a deep breath. IN OUT (don’t you feel better already?) Educate yourself from reputable sources, and trust that you will be just fine.

To add further chaos to the mix, the swine flu vaccine will soon be available, and in some cases, mandatory. Whew! You wanna get Americans up in arms? Tell them something in mandated. We cringe all the way back to our British roots, and it brings out the rebellious child in all of us. Don’t be messing with our freedom.

So what’s all the fuss about and what’s a Pinkie to do about it? It’s all so confusing. Who can you trust? Does the government really have our best interests at heart? Unfortunately, these are questions I won’t be able to answer for you.  But I wanted to at least make an attempt to collect some of the data for you so you can make up your own minds.

In the integrative medicine world, many oppose vaccination in general. I don’t tend to agree with blanket statements. My analytical mind prefers to look at data and analyze what we know, integrating it with what my gut feels and what I think.  In the case of the Swine flu vaccine, my approach leaves me feeling baffled, so I can only imagine how confused the rest of you Pinkies must feel.

In this post, I will attempt to answer some of the questions you Pinkies have asked Owning Pink. (We received hundreds of questions about this over the past few months, so forgive me if we fail to answer your exact question. Bear with us, Pinkies. It’s all for the sake of the greater good, I swear!). Later, I’ll offer some Pink Tips to stay healthy this flu season, vaccine or no vaccine.  Here we go. Deeeeeep breath…

Who is at high risk for swine flu (H1N1) infection?

According to the Center For Disease Control (CDC):

1. Children less than 2 years of age
2. Individuals >65 years of age (but this risk factor is tricky. Although the elderly are at higher risk of influenza complications, they do not appear to become infected as easily as younger people, perhaps because this age group has already developed immunity to some related viral strain that young people have not.)
3. Individuals <19 who are receiving long-term aspirin therapy and might be at risk for Reye syndrome after influenza infection
4. Pregnant women
5. Individuals with chronic medical conditions requiring ongoing medical care, including:

• Chronic pulmonary disease, including asthma (particularly if systemic steriods have been required during the past year)
• Cardiovascular disease (with the exception of isolated high blood pressure)
• Cancer
• Chronic renal insufficiency
• Chronic liver disease
• Diabetes mellitus
• Hemoglobinopathies such as sickle cell disease
• Immunosuppression, including HIV infection, organ or stem cell transplantation, and conditions requiring immunosuppressant medication
• Individuals who have any condition that can compromise handling of respiratory secretions (eg, cognitive dysfunction, spinal cord injuries, seizure disorders, neuromuscular disorders, cerebral palsy, metabolic conditions)
• Children with an underlying metabolic disorder who are unable to tolerate prolonged fasting

If I might have been exposed to swine flu, should I take Tamiflu?

Most healthy individuals who develop an illness that may be swine flu and appear to be recovering do not need medication. The majority of people recover completely without treatment. So who needs drugs? Here’s what the CDC has to say:

1. Anyone with suspected H1N1 influenza who is not getting better or develops complications such as pneumonia
2. Anyone who is hospitalized for H1N1 infection
3. Antivirals should be given as prophylaxis to anyone in the high risk group above who has been exposed to a case of suspected or confirmed H1N1 infection.
4. Health care workers who were not using proper precautions and came into close contact with an infectious patient

The CDC does not recommend antivirals for healthy children and adults who may have been exposed in the community. Why don’t they want to protect us? Because most healthy individuals will recover just fine and, in the face of a pandemic, drugs need to be reserved for those who need them most. If you or your loved one winds up in the hospital seriously ill, you want to be sure there’s enough medication around.

When will a vaccine be available?

We expect this vaccine to be available by mid-October.

Will the H1N1 vaccine be effective?

This is a very good question, and frankly, it’s too soon to really say. The New England Journal of Medicine reported one trial of 240 adults who received 2 doses of the H1N1 vaccine. Within 3 weeks of vaccination, 97% of individuals given the lower dose and 93% given the higher dose developed antibodies. Will these antibodies actually protect you from getting the virus, given that it may mutate and evolve? No one knows.

(Reference: Greenberg, ME, Lai, MH, Hartel, GF, et al. Response after one dose of a monovalent influenza A (H1N1) 2009 vaccine — Preliminary report. N Engl J Med 2009)

The efficacy of the regular seasonal flu vaccine depends on how much the virus mutates between when the vaccine is manufactured and when you actually get it. For example, during the 2004-2005 flu season, there was only a 5 % match between what was in the vaccine and the actual virus that spread during that flu season. As a result, that vaccine was only 10% effective. In 2006-2007, there was a 91% match, which made the vaccine 52% effective. As you can see, it’s a very imperfect science.

(Reference: Belongia, EA, Kieke, BA, Donahue, JG, et al. Effectiveness of inactivated influenza vaccines varied substantially with antigenic match from the 2004-2005 season to the 2006-2007 season. J Infect Dis 2009; 199:159.)

Will the H1N1 vaccine be safe?

Ah, the million dollar question. The truth is that nobody knows. Back in 1976, approximately 45 million people in the US were immunized against a type of swine flu, but the program was discontinued, in part because an increased incidence of Guillain-Barre syndrome was detected among those who were vaccinated. To detect a risk such as this, between 409,00 and 970,000 individuals would have to be tested in clinical trials to determine the safety of this vaccine. So while studies of very small populations do not show any significant risk, these studies are looking at hundreds, not hundreds of thousands of people, and they span only brief times.

(Reference: Evans, D, Cauchemez, S, Hayden, FG. “Prepandemic” immunization for novel influenza viruses, “swine flu” vaccine, guillain-barre syndrome, and the detection of rare severe adverse events. J Infect Dis 2009; 200:321.)

Many are rightfully concerned about the risk of vaccinating an enormous segment of our population, especially when this population includes particularly susceptible young children and pregnant women. The CDC reports that they expect a similar safety profile as they see with the seasonal flu vaccine. So what about the 1976 flu vaccine campaign that got halted? Good question.

For more, read this great article on the Guillain-Barre vaccine.

Will the vaccine have the adjuvants I’ve heard can cause Gulf War Syndrome and other complications?

According to the CDC, only vaccines without adjuvants will be used in the US during the 2009 season, which includes both the nasal spray vaccines and the injections. Because the safety of these adjuvants is unproven, the CDC reports that there is no plan at this time to recommend a 2009 H1N1 influenza vaccine with an adjuvant. What does that say about 2010? Uh…they’re not saying.

Who should get the vaccine first?

According to the CDC, the first to be vaccinated should be:

1. Pregnant women
2. Household and caregiver contacts of children younger than 6 months of age (e.g. parents, siblings, and daycare providers)
3. Health care and emergency medical services personnel
4. Children and young adults from 6 months through 24 years of age
5. Persons aged 25 through 64 years who have medical conditions associated with a higher risk of influenza complications

Once it is evident that there is enough vaccine, the CDC recommends that people over 65 be vaccinated.

Can I still get the H1N1 vaccine if I’m allergic to eggs?

If you have a severe allergy to eggs, your doctor will help you weigh the risks and benefits. If you’re healthy and have an egg allergy, you may be better off skipping it.

If I get the H1N1 vaccine, does that mean I can skip the regular flu vaccine this year?

No. They’re not targeting the same strains of virus. If you are high risk and choose to be vaccinated this flu season, you will need to vaccinate against both.

If I’m interested in getting the vaccine, how can I find it?

Vaccines will be allocated to health care providers shortly, so your doctor will likely receive the vaccine. If not, call your local public health department.

Is it true that the government is mandating that everyone be vaccinated?

No. But it is true that New York state has mandated that health care workers involved in direct patient care be vaccinated. Many are up in arms. But the edict is clear- get vaccinated or get fired. Are other vaccination mandates coming? I sure hope not, at least not until we know more about this particular vaccine.

I’ve heard that I can’t sue a vaccine manufacturer if something bad happens as the result of getting the H1N1 vaccine. Is this true?

Well, in this country, anyone can sue anyone, as proven by the women who took me to malpractice court for stealing her labia (no kidding. Totally true story. Only lawsuit ever brought against me. And yes, she was psycho and the case was dropped, but not until 3 years and 3 lawsuits later…but don’t get me started, Pinkies!)

But yes, the vaccine manufacturers have been granted immunity from legal liability in the US due to a law recently signed into effect.

Can we trust what the CDC has to say?
I honestly can’t say. I have to say that, as a physician, I have always trusted the CDC as a reliable source of objective information. But I admit that I’m shocked at how they’ve handled this pandemic so far. Maybe it’s my own naivety. I admit. Pandemics are not my specialty, and that’s their job.  But the reaction of the CDC seems out of proportion to the nature of the disease, when I hunt for how I feel in my gut.  After all, it’s the flu, and I live in California, surrounded by great hospitals and fabulous doctors (so maybe I’m spoiled). But seriously, people. Must we rush into a massive vaccination campaign without much data? Where’s the evidence to support safety, efficacy, and necessity? It makes a thoughtful doctor/mother/writer/leader stop and pause…

What can you do to prevent swine flu, aside from getting vaccinated?

So Pinkies, is your head spinning by now? Mine certainly is. Here are a few tried-and-true Pink prevention techniques that will keep the odds in your favor this  flu season:

1. Wash your hands, wash your hands, wash your hands. (Say it three times over. This is your new Pink mantra, and it’s the number one way to avoid getting swine flu). Also, avoid touching your eyes, nose or mouth, which can introduce the virus into your receptive passageways. If you cough or sneeze, use a tissue and throw the tissue away afterwards. This will help protect you and everyone else out there who is trying to avoid swine flu.
2. Eat immune boosting foods, and steer clear of sugar. Here are five that can help you.
3. Citrus. Loaded with Vitamin C, citrus fruits are a yummy, easy way to support your immune system. Grab a glass of OJ, or make some lemonade. Even better, mix lots of lemons into clean water with stevia (a natural sweetener) and cayenne pepper. Not only is it a zingy tasty treat filled with Vitamin C, it also alkalinizes your body, which helps it fight infection.
   Red chili peppers (cayenne). Cayenne pepper has long been appreciated for its medicinal properties and can help your body during states of  emergency. So chili it up for good health!
   Garlic. Filled with immune-boosting mojo, garlic has been used to treat everything from the common cold to the Plague. So load up on garlic and give your body a fighting chance.
   Carrots. Bursting with beta-carotene, carrots give your body a leg up when you’re fighting infection. Drink a few carrot juices to get enough in your body. Sweet potatoes and spinach also contain lots of beta carotene, so eat up.
   Fish. Fish like salmon, mackeral, and tuna are filled with omega-3 fats, which support white blood cells in fighting infection. Sushi anyone?
4. Snooze, baby, snooze! Sleep is underrated. When you’re well rested, your body fights infection more effectively. Check out these tips from naturopath Dr. Nicole Sundene.
5. Give up alcohol and caffeine for a while. Staying sober and decaffeinated helps your body mount immune responses.
6. Guzzle green juice instead. If you have a juicer stashed under your counter, now is the time to pull it out and load it with kale, celery, cucumber, swiss chard, lemon, spinach, ginger, garlic- whatever you’ve got around that can support your good health. Also, avoid processed foods and eat a whole foods diet.
7. Try not to drink out of the same cup as others. And avoid sick people, if you can.
8. Hydrate. Drink, drink, drink pure clean water. It keeps your mucous thin and helps you mucous membranes resist infection.
9. Try not to touch your nose, eyes, and mouth.
10. Get your exercise. While this may not be the best time to go to a crowded gym, a long hike in nature can do wonders for your immune system, your general health, and your psyche.
11. RELAX, and don’t panic. Stress weakens your immune system and makes you more susceptible to infection. Try meditation, deep breathing exercises, guided imagery, yoga, walks in nature, or whatever works to chill you out.

Supplements I Recommend to my Patients For Prevention & Treatment of Swine Flu:

(We offer these at CLEAR Center of Health, where I work. Some of these may not be available over-the-counter)

1. 10 Mushroom Formula.
2. Thymuril.
3. Echinacea. My favorite is Esberitox by Integrative Therapeutics.
4. Vitamin C supplements. If you take extra, it gets excreted in your urine, so it won’t hurt you to load up.
5. Probiotic bacteria, which alters the intestinal flora and helps your body resist infection.
6. Viraclear, made by Integrative Therapeutics.
7. High dose Vitamin D plus high dose Vitamin A.
8. If you’re feeling under the weather, take Elderberry syrup. It’s a natural anti-viral and can be particularly useful if your community runs out of Tamiflu and Relenza.

Will I get vaccinated? Will I vaccinate my 3 year old daughter?

Honestly, Pinkies, I haven’t decided. If a doctor doesn’t know for sure, it’s no wonder some of you may be confused. This has all happened so quickly. Am I anti-vaccination? No. Not for some things. But do I feel the need to inject a poorly tested vaccine that may or not protect me against something unlikely to cause serious complications in my healthy family? Maybe not. After all, this is not ebola we’re talking about. You’re not likely to bleed out of your eyeballs and croak when you get it.

Frankly, I think everyone needs to take a bit of a chill pill. (Or take a good long hike and start meditating!) But then no one’s asking me.

Well, no one but you Pinkies, who keep asking away.

So anyway, this is the best I can do for right now. I’ll try to keep you updated as more information comes in.

Oink oink (and big Pink love),

Lissa

p.s. For more sanity-saving, stress-reducing tips, check out this article on H1N1 by Mojo Mentors Lakenda Wallace and Simone da Rosa, Owning Pink’s Get Happy! Less Stress More Life Coaches.