Where’s the Turkey?

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iowapublicradio.org

Many of us are old enough to remember the little old lady opening the bun and asking “Where’s the beef?” Well, this Thanksgiving, some of us may be asking “Where’s the turkey?” Avian influenza (bird flu) is responsible for this turkey shortage. Detection of highly pathogenic avian influenza (HPAI) H5 influenza A viruses were detected in 21 US states last spring. These viruses occur naturally in wild aquatic birds and typically don’t make them sick. However, the viruses can sicken and kill domesticated bird species including chickens, ducks and turkeys. And, it is a highly contagious disease among flocks. Human infections can also occur and are usually due to transmission to humans from domesticated poultry. When these viral infections do occur in humans, they typically have a high fatality rate. Spread from human to human is rare at this time.

So, the US has a surveillance program for avian influenza A viruses in wild and domesticated birds. Most of the viruses detected are low pathogenic viruses. However, this spring, outbreaks of HPAI occurred in the Midwest and Western US. When detected in domestic poultry, the flock is culled to prevent further spread to other flocks and potential spread to humans. This spring, millions of poultry were culled. In fact, more than 48 million poultry were culled from infected flocks between December 2014 and June 2015. The outbreak decreased the US turkey supply by <10% of its total volume.

So, we may have a smaller turkey than usual at the table this year, but most of us are fortunate to have a cornucopia of dressing, side dishes, pumpkin pie and all the rest. And, we can be thankful for the plenty that we do have. And for being with family–the best part of  Thanksgiving.

References

https://www.aphis.usda.gov/animal_health/downloads/animal_diseases/ai/wild-bird-strategic-plan.pdf

https://www.aphis.usda.gov/

http://www.cdc.gov/flu/avianflu/outbreaks.htm

 

Get Smart about Antibiotics

Get Smart about Antibiotics

rhinoviruses_456pxIt’s getting to be that season…..respiratory viruses are starting to increase in our community. Influenza viruses typically peak during December through February, but there are cases out there already. It’s a great time to get your flu vaccine if you haven’t already. A recent study showed that the flu vaccine decreases your risk of getting hospitalized with influenza pneumonia. The cases of influenza reported so far this year are a good match with this year’s influenza vaccination, and protection is good.

So, flu vaccine can help keep you from getting influenza. But what about the other respiratory viruses? Rhinovirus, the usual cause of the common cold, is more common than influenza virus right now. And there are several other respiratory viruses to worry about. How do you prevent those?

There are not vaccines, but you can wash hands and use hand sanitizer often. Keep your hands away from your mouth and eyes. And, if possible, avoid sick people. (I know, you with young children just chuckled.) So, if you do get sick, what then?   Your first inclination may be to go to the doctor for antibiotics. After all, your head is stuffy, your nose is running, you have some fever, and now you are starting to cough. If you have body aches, fever and chills and a high fever (102 or higher), you could have influenza and could benefit from early treatment with an antiviral such as oseltamavir (Tamiflu®). Call or see your doctor to determine this.

If your symptoms are mild, however, you most likely have a non-influenza respiratory virus and antibiotics will not help you. In fact, they can harm you. Besides the usual side effects of gastrointestinal upset, antibiotics kill beneficial bacteria in your gut and change your microbiome. Your gut microbiome is the population of bacteria in your intestinal tract. Research is finding that the microbiome plays a very important role in our health. It helps to maintain our health and immune system. In fact, studies have found that changes in the microbiome can increase your risk for obesity!

There are things you can do to support you respiratory system and health while you have a cold. Decongestants can decrease nasal secretions, but they can increase blood pressure and cause a dry mouth.   Use a cold steam ultrasonic diffuser and add some essential oils or oil blends containing eucalyptus oil to soothe your nose and throat. Drink lots of fluids and stay well-hydrated. Hot tea including honey, lemon, and/or clove and cinnamon will help you stay hydrated and provide relief to your throat. Get plenty of rest.

This is “Get Smart about Antibiotics” week. Check out the Center for Disease Control and Prevention’s webpage on this topic and learn when to use antibiotics.

http://www.cdc.gov/Features/Rhinoviruses/index.html

http://www.cdc.gov/flu/professionals/vaccination/virusqa.htm

http://www.cdc.gov/flu/takingcare.htm

http://www.the-scientist.com/?articles.view/articleNo/44300/title/Microbesity/

http://www.npr.org/2014/04/14/302899093/modern-medicine-may-not-be-doing-your-microbiome-any-favors

Blaser, Martin. Missing Microbes. 2014. Henry Holt & Co.

http://www.cdc.gov/getsmart/community/index.html

 

 

 

Mosquito strategy

After the floods in South Texas, we are well aware of the mosquitos!  Mosquitoes detect the carbon dioxide we generate when we exhale. That is how they find us to get their blood meal. Since we can’t stop exhaling, we use strategies to confuse their sensor system or overwhelm the carbon dioxide detection to repel them.

Besides the bothersome itch and swelling of mosquito bites, mosquitos in the US can transmit West Nile Virus, and less commonly, St. Louis encephalitis, dengue fever, and other viral infections. There were 379 cases of West Nile Virus in Texas last year, and the first case has already been reported this year. Most people infected with West Nile Virus will experience no symptoms. About 20% of people will have fever, weakness, nausea and vomiting. Severe symptoms occur in about 1% of people resulting in fever and neurologic symptoms including weakness, neck stiffness, and disorientation resulting from brain infection. So, there is good reason to prevent mosquito bites!

We are using a multi-pronged strategy for mosquito control at our house.  1) Bug repellent.  The most effective ‘clinically proven’ and EPA-approved repellents include DEET (diethyltoluamide–at least 20%), and three other synthetic chemicals: picaridin (at least 20%), oil of lemon eucalyptus (at least 30%), and I3535. DEET has long been considered the most effective repellent, but Consumers Reports(R) did some testing and found that the picaridin and oil of lemon eucalyptus products performed better than DEET.  DEET can be neurotoxic if absorbed, so you can’t use it on the hands and face. Also, using more than 35% DEET is not recommended and only increases the potential for toxicity.  All of these should be used sparingly in children, and some cannot be used on infants or children under 3 years old.  Check the label.  Also, these synthetic repellents should not be used around food and hands should be washed after application.

Plant oils are considered “minimum risk” so commercial plant oil product claims are not evaluated by the EPA.  The commercial plant oil repellents did not last more than an hour in the Consumer Reports tests, but we don’t know all of the products that were tested, and what oil combinations were used.

Permethrin, a synthetic chemical similar to the pyrethrum produced by chrysanthemums, can be sprayed on clothes, tents and gear, and is effective for several washings.  It is not for use on skin. You can find these products at sporting goods stores and some drug stores. There are various brand names so you will need to read the labels to look for ingredients.

When I was in Africa for a photo safari two years ago, I used DEET for protection from mosquito bites. The mosquitos there carry the type of malaria that can kill people, so the benefit was worth the potential toxicity. I wish I had known about essential oils then so I could have put something natural on my face and hands!

At our recent “Make and Take” essential oils class we made some outdoor spray that I am able to use on my face and hands (about the only parts exposed when I’m in our swimming pool)!  It has made our time outside much more pleasant. It may need to be reapplied periodically.

In a 2 oz brown spray bottle add:

pinch salt

10 drops Purification

10 drops Eucalyptus

5 drops Lemongrass

5 drops Peppermint

5 drops Thieves

1 oz natural witch hazel

0.5 oz distilled water or carrier oil (sweet almond oil, frac coconut oil, other)

If you only have a limited number of oils, you can use

pinch salt

10 drops Purification

10 drops Lavender (avoid if you have bees)

5 drops Peppermint

1 oz natural witch hazel

0.5 oz distilled water or carrier oil

OR

pinch salt

10 drops Purification

10 drops Thieves

1 oz natural witch hazel

0.5 oz distilled water or carrier oil

2) We burn a stick of good quality incense (we get from Amazon). Recently we are using lavender or sandalwood. The smoke from the incense confuses the mosquito’s CO2 detection system. You can also use a candle (especially citronella) but it generates less smoke than incense.  These are only supplementary deterrents and likely will not work alone.

3) Empty all of your standing water–plant saucers, buckets, stagnant water collections in yard because these are breeding grounds for mosquitos. Most types of mosquitos in our area don’t travel far for their daily blood meal, so clearing the standing water in your yard can make a difference.

4) When you can, wear long sleeves and long pants when outside.

Another strategy is to keep a rotating fan near, and “blow away” the mosquitos.  We just visited with our relatives who are big into fishing and they gave great reviews of  Thermacell(R). It is a small portable device fueled by a butane cartridge that heats and diffuses allethrin, a synthetic version of the repellent in chrysanthemums.  It is said to produce a 15 X 15 mosquito-free zone.  Sounds like it could be another tool in the toolbox for mosquito strategy.

We are due for some more rain in South Texas. We could use your prayers for those families suffering losses and devastation in the floods.  God bless.

References

http://www.cdc.gov/westnile/index.html

http://www.mosquito.org/about-amca

http://www.cdc.gov/malaria/about/biology/mosquitoes/index.html

http://www.cdc.gov/westnile/faq/repellent.html

How to win the battle of the bugs.  Consumer Reports July 2015;80:34-37.

http://www.thermacell.com/mosquito-repellent/why-thermacell

 

Lavender – the Swiss Army Knife

 

Since I was introduced to the world of essential oils six months ago, I’ve been impressed with the flexibility, usability, and effectiveness of lavender.  Previously, I thought it was good for relaxing, especially in the bathtub.  But since joining the EO world, I’ve learned it can do so much more than that.  The word lavender comes from the Latin word “lavare” (to wash).  It is great in a bath–use lavender-infused Epsom salts so that the oil distributes throughout the water. The well-known relaxing effects can lead to decreased blood pressure and sleep quality.  It can also be used on burns, scrapes, sunburn, acne, or cold sores.  A famous story about the use of lavender on burns is about Rene-Maurice Gattefosse, a French chemist in the early 20th century.  He sustained burns on his hands during a laboratory explosion. The hands quickly developed what he described as gas gangrene, an almost universally fatal infection at the time.  He applied lavender oil, and healing began the next day.  Gattefosse coined the term aromatherapie and wrote the first book with that title in 1937.

Studies as well as anecdotal experience have shown that massaging lavender on the abdomen can relieve menstrual discomfort and cramping.  I use lavender in combination with lemon and peppermint diluted in coconut oil as carrier for relief from allergies and nasal congestion.  This “allergy bomb” can be applied to the lower part of the back of the neck and over sinuses (be careful with the peppermint–make sure it is diluted enough if you get close to the eyes, and do not get oils in your eyes!).  I also dab a cotton swab in the mixture and swirl in each nostril.  I have never breathed more clearly!  I have heard many times from colleagues, and continue to hear, this combination is effective for relief of allergy symptoms.  Just today, a friend told me that she previously relied on antihistamines almost daily, and has not used any since using essential oils.

Scientific studies about essential oils’ effects on clinical problems are relatively rare, but precious when we find them. This week, I came across a study done in an animal model showing that inhalation of lavender essential oil suppresses allergic airway inflammation.  The authors determined this by showing lower lung resistance and less peribronchial inflammatory cells in the group that inhaled lavender vs.  the control group.  While it is an animal model study, it gives credence to our anecdotes and such studies may eventually lead the way to more essential oil clinical trials in humans.

In any case, lavender does indeed seem to be the Swiss army knife of essential oils and if I was stranded on a desert island and could only have one essential oil, I think it would be lavender!

Juno MS et al. Effects of aroma massage on home blood pressure, ambulatory blood pressure, and sleep quality in middle-aged women with hypertension. Evid Based Complement Alternat Med 2013;2013:403251

Ueno-lio T et al. Lavender essential oil inhalation suppresses allergic airway inflammation and mucous cell hyperplasia in a murine model of asthma. Life Sciences 2014;108:109-115

Dehkordi AR et al. Effect of lavender inhalation on the symptoms of primary dysmenorrhea and the amount of menstrual bleeding: A randomized clinical trial.  Complementary Therapies in Med 2014;22:212-219

http://roberttisserand.com/2011/04/gattefosses-burn/

 

 

Combating Antibiotic Resistance

You may have heard about the White House report released this week “National Action Plan for Combating Antibiotic-Resistant Bacteria.”  It is a victory that this issue is on our national agenda.  As an infectious diseases physician, I have seen the life-saving and life-improving capabilities of appropriate antibiotic therapies many times.  I have also seen, however, the emergence of drug resistance in bacteria occurring over several decades. It has accelerated such in the past decade that we now see patients with bacteria that are resistant to all our usual antibiotic choices, and have to resort to toxic antibiotics used in the past, or sometimes no antibiotic at all.  The CDC estimates that drug-resistant bacteria cause two million illnesses and approximately 23,000 deaths each year in the US alone.  In case you haven’t read all 62 pages of the report, I am highlighting some of it here.

The goals of the National Action Plan (NAP) are:

  1. Slow the Emergence of Resistant Bacteria and Prevent the Spread of Resistant Infections
  2. Strengthen National One-Health Surveillance Efforts to Combat Resistance
  3. Advance Development and Use of Rapid and Innovative Diagnostic Tests for Identification and Characterization of Resistant Bacteria
  4. Accelerate Basic and Applied Research and Development for New Antibiotics, Other Therapeutics, and Vaccines
  5. Improve International Collaboration and Capacities for Antibiotic-resistance Prevention, Surveillance, Control, and Antibiotic Research and Development.

Our medical specialty of Infectious Diseases is thrilled to see this multi-pronged approach, and we have long advocated for judicious use of antibiotics and accelerated pathways for new antimicrobials.  As an essential oiler, I would like to focus on goals #1 and #4.

  1. Slow the Emergence of Resistant Bacteria and Prevent the Spread of Resistant Infections

While many of the multi-drug resistant pathogens we see are in the hospital, the bulk of human antibiotic prescribing in the US is done for outpatients.  It is estimated that 50% of antibiotic use may be unnecessary.  In 2010, 258 million courses of antibiotics were prescribed, or 833 prescriptions per 1000 persons.  The CDC’s campaign “Get Smart: Know When Antibiotics Work” educates the public and health providers that antibiotics aren’t always the answer.  For many common illnesses like viruses and flu, antibacterials will not help and can have harmful side effects, in addition to increasing drug-resistant bacteria.  We in the oily community are already aware that antibiotics are not always the best answer, and we use essential oils that have been shown to have some antimicrobial activity to fend off impending infection and also use oils to relieve symptoms of infection when they occur.  The NAP calls for monitoring of antibiotic use to assure appropriate use in both outpatient and inpatient settings.  In addition to this, wouldn’t it be great for providers and patients to know about the benefits of essential oils?

Surprisingly, 70% of antibiotics used in the US are given to livestock and poultry.  While the plan falls short of adopting antibiotic-free meats, the plan does recommend that more is done to decrease the use of antibiotics important to humans in growth promotion for animals.  Kudos to Chipotle, Panera, and Chik-Fil-A for deciding to buy antibiotic-free meats, and to McDonald’s for plans to stop using chicken raised with antibiotics important to humans!  This is progress.

4. Accelerate Basic and Applied Research and Development for New Antibiotics, Other Therapeutics, and Vaccines

This is where goal #4 comes in.  While there will be emphasis on developing new antibiotics, the goal also aims to identify new therapeutics.  And get this (from page 44 of NAP):

“Examples of non-traditional therapeutic strategies include:……

      • Identifying natural compounds with antibiotic activity (e.g., phytochemicals, essential oils,

organic acids, animal-derived lytic enzymes, and small interfering RNAs).”

So you see, essential oils are mentioned in the National Action Plan to combat antibiotic resistance! And why not?  There is already in vitro (laboratory) data and we know of many anecdotes.  We are just lacking clinical trials to demonstrate effectiveness in humans.  I found this mention of the oils in the National Action Plan very exciting.  We oilers are ahead of the game!

New vaccines for pathogens that become drug-resistant are also included as a therapeutic strategy and this is important.  Vaccines are one of the most significant public health developments of the 20th century and the more we can prevent infections, the less we have to use antibiotics!

So, the National Action Plan is a step in the right direction and even suggests developing alternatives such as essential oils.  While we love the benefits of our oils, it is no shame to use antibiotics when we do need them.  It is about using all the tools available to you—and using the right one at the right time!

References for more information:

https://www.whitehouse.gov/sites/default/files/docs/national_action_plan_for_combating_antibotic-resistant_bacteria.pdf

Hicks LA, Taylor Jr TH. U.S. Outpatient Antibiotic Prescribing, 2010. N Engl J Med 2013;368:15

Get Smart: Know When Antibiotics Work.  http://www.cdc.gov/getsmart/community/index.html

Chao SC, Young DG, Oberg CJ. Effect of a diffused essential oil blend on bacterial bioaerosols. J Essent Oil Res 1998;10:517-23.

http://www.chipotle.com/en-US/fwi/fwi_facts/fwi_facts.aspx

http://press.chick-fil-a.com/Pressroom/LatestNews/PressDetail/abf

http://marketing.panerabread.com/liveconsciouslyeatdeliciously/#!articles/antibiotic_free_answers

http://news.mcdonalds.com/press-releases/mcdonald-s-usa-announces-new-antibiotics-policy-and-menu-sourcing-initiatives-nyse-mcd-1179405

Dad’s Dementia

My dad has the most common form of dementia, Alzheimer’s disease. More than 5 million Americans are affected and the number is growing due to the increase in the geriatric population. As with other kinds of mental illness, the person with Alzheimer’s is not the only one affected. It affects all of the family and caregivers.

At first, it was subtle. He couldn’t remember what he did with his billfold and forgot what he had been intending to do. As the disease progressed, he would forget things that happened just a few minutes ago and became irritable with caregivers that needed to help him after my mother died. Poor judgment threatened his safety, like the time he took off to get his riding mower fixed—on the riding mower on a major thoroughfare. We were finally able to get him into assisted living. His deterioration continues. He no longer remembers where we live and what we do—previous major topics of conversation. He no longer talks about his wife of 70 years. In fact when I last visited and reminded him it was her birthday, he said “Tell me about her.”

There are days when he tries to “escape.” He’s in a wheelchair now, but will try to open the doors to exit from the unit. The doors are alarmed, and he’s not really able to get through in his wheelchair, but it is very disconcerting to the staff and to us. I visited him the day after he had one of those “escape” days and reminded him he needed to stay so he would be safe and we could visit him. He responded “Well, I guess I shouldn’t try to leave, right?”

It’s hard to watch these changes in someone who was so bright, hard-working, and independent. It’s another one of those things in life that don’t make sense. Why do our loved ones have to go through this?

Essential oils help me in my everyday life, and there is accumulating data with their use in long term care and end of life care. Experience indicates there can be decreased weight loss, agitation, insomnia, and enhanced pain control with the use of essential oils in long term care patients, and essential oils can also improve clarity and effectiveness among the staff.

So, I took my dad some essential oils the other day: Peace & Calming (a blend of tangerine, orange, ylang ylang, patchouli and blue tansy) and Stress Away (a blend of copaiba, lime, cedarwood, vanilla, ocotea, lavender). Both of these have helped me calm and de-stress, so why not give it a try? My dad’s open-minded physician readily prescribed these “as needed” and the nurse commented on how wonderful they smelled. (Maybe they’ll help her too!). These oil blends, and some melatonin for sleep, seem to be helping my dad. Next I’m getting Tranquil (lavender, cedarwood, Roman chamomile) and Rutavala (ruta, valerian, lavender) for him. These are roll-ons so will be even easier for the staff, and they are blends of some of my favorite oils.

My prayers continue for my dad’s well-being.

http://www.todaysgeriatricmedicine.com/archive/0714p30.shtml

http://www.best-alzheimers-products.com/aromatherapy-for-alzheimers.html

http://www.recreativeresources.com/aromatherapy.htm

http://birchhillhappenings.com/v1522012hospital.htm

Tools:  Family, Essential Oils, Faith, Medicine

St. Patrick

To many, Saint Patrick’s Day is simply a day to wear green and drink beer. Traditionally, San Antonio dyes the river green.  There is much more to this Saint, however.shamrock

Saint Patrick lived in the 5th century and is known as the Apostle of Ireland.  He was born in Britain, but captured by Irish pirates at a young age.  During his enslavement in Ireland, he converted to Christianity. He acted on a voice telling him it was time to go home; he escaped and returned to Britain.  A few years later, he had a vision of a man carrying letters, one headed “The Voice of the Irish” and appealing him to come walk among them.  He acted on the vision and returned to Ireland as a Christian missionary, baptizing many people.  Legend says that he used the three-leafed Shamrock to talk about the Holy Trinity.  He is also credited with banishing snakes from Ireland, but naturalists say there were no snakes in Ireland at that time to banish!  March 17 recognizes the date of his death and is a religious and cultural holiday in Ireland.

The day is meaningful to me because it is the birthday of two of my loved ones—my mother and one of my sisters, Zee Ann.  I never knew Zee Ann because she died in a car accident at age 3, before the days of car safety awareness and seat belts.  I am sure my mother was delighted that her first daughter was born on her birthday, and then how tragic and bittersweet each birthday following Zee Ann’s death must have been for her.  Zee Ann was a beautiful and precious child by all accounts.  She was a loving playmate for my brother David, developmentally delayed from asphyxia at birth.zeeann oval feathered

What I remember about my mother is her sense of humor, her faith, her love for children, and her ability to make friends.  Her friends adored her, and she had a nature about her that even made store clerks want to help her in any way possible.  She died in 2011 at 93 years old and it was a release for her because she was in poor health and pain the last few months of her life.  I miss her and wish I could still pick up the phone and talk to her.  I felt her presence after the death of my son and when I was in pain from uterine cancer surgery.   I know I will see her again in heaven, and I look forward to meeting  Zee Ann, too.Mother young

Tools:  Faith, Family

Pi Day ! 3.1415926…..

Today is pi Day, 3/14, and especially monumental since it is 2015, making it 3/14/15. Our friends, Barbara and Michael, have a pi Day party and started it at 9:26am– making it 3.1415926…. There was a long table of pies of all kinds – pecan pie, quiche pie, coconut cream pie, lemon pie, chess pie, cheesecake pie, pumpkin pie,  and spaghetti pie.  There was even a pie in the shape of a pi. Fun

pi partypi

It hasn’t been easy for us to go to parties.  In the 3 years since our son, Will, died, we haven’t much felt like seeing people and many of our friends don’t feel comfortable around us even still, so we have stayed home a lot.  It felt pretty good to just go to a party where we didn’t know many people.

The sprained foot/ankle is much better. The cycle of whirlpool/oils/icing is helping a lot, as is the boot immobilizer (using all the tools!).  Did upper body strength training at the gym today.  Gotta keep moving. Especially if I’m eating PIE at 10am in the morning!

And–it was a beautiful Texas spring day.  One of the best yet.  Short sleeves, sun, light breeze, redbuds blooming, and a gorgeous sunset at the ranch tonight. Peaceful.

sunset

Tools:  Family, Fun, Friends, Oils, Medicine, Fitness

Ouch!

bootSo proud of getting through the ski trip without a hitch–

Then went to Philadelphia for a meeting and SLIPPED ON THE ICE!  Foot twisted under me and sprained ankle and foot.  Ugh.  At least its not broken.  Got the CAM boot from my orthopedic friend so I can at least walk.  4-6 weeks slow down on the fitness just when I was getting more into it.  Will see what I can do with the upper body weight training….

But the meeting in Philly was good–meaningful work.

Oh, and yes I am using my anti-inflammatories on the injury.  Iced it and took ibuprofen the first couple of days.  Now using cycle of whirlpool, oils (frankincense, YL Deep Relief) and icing.  Doing much better.

Tools:  Function, Medicine, Fitness, Essential oils

Skiing

Skiing and me have had a hate-love relationship.  I hated it before I loved/liked it.  Because I learned to ski as an adult, it took a while for this overweight and relatively clumsy middle-aged woman to get it.  I finally did, and was glad I could participate with the guys in my family who really like to ski (and who learned when they were young!).

Anyway, just completed the annual ski trip w no injuries! Very proud of that.  An accomplishment.

Oh – the left knee got a little swollen after 3 days of skiing.  Used some frankincense on it and it worked great. No pain the next am.  Hmmm why frankincense?  Well-it turns out it is an effective anti-inflammatory.  Even some clinical studies published in a review in the British Medical Journal in 2008.  Worked for osteoarthritis, rheumatoid arthritis, inflammatory bowel disease. Imagine that!  BMJ. 2008; 337: a2813.  And, it smells wonderful!

Tool:  Family, Fun, Finding a new interest, Essential Oils