Friday, August 28, 2009

H1N1 Vaccination - why the rush ?

It is never a good idea to cut corners in life. Whilst it is often easy to justify in the heat of the moment, down the track, the consequences, some predictable, others not will come back to haunt. It is with this in mind that I am increasingly uneasy about the rush to do mass vaccinations against the H1N1 virus, commonly known as swine flu.

Each year it is recommended that certain risk groups be vaccinated against the flu. This includes those over 65 and those with particular medical conditions. There is no mass vaccination against seasonal flu.

The Southern Hemisphere is getting to the tail end of winter. The number of cases of H1N1 is already waning. The number of deaths associated with it are less than with seasonal flu. There is nothing to suggest that the northern hemisphere winter experience will be any different.

So why are the authorities gearing up for mass vaccination. The vaccine has been tested on some hundreds of people. This is fine but side effects, which occur, say 1 in 10,000 will not be apparent yet but will be significant when 100 million are vaccinated. Rushing to market with inadequate testing is the worst form of cutting corners.

In the rush to do this multi dose vials are being used. These have not been acceptable for use by doctors for a decade due to risks of cross infection. Suddenly it is OK again. Governments are indemnifying manufacturers against claims that may be made in the event of side effects or harm caused. In the USA in 1976, in similar circumstances there were more than 500 deaths associated with the vaccine when 40 million were “mass vaccinated”. According to health authorities in Australia the new vaccine “seems to be very safe”.

In Australia, Medical Indemnity insurers are discussing whether doctors who administer the vaccine will be covered. If this isn’t resolved, no doctor will be able to administer it. I suspect that once again the government will step in and offer indemnity.

The big unanswered question in all this is why? What is the threat that justifies all the cutting of corners, that justifies rushing out a vaccine to use on people who wouldn’t normally even have a flu shot, that justifies allowing medical practices, which have been outlawed to be reinstated? H1N1 is not the bubonic plague. We are not seeing thousands of deaths. Compared to all other major flu outbreaks (1918, 1957 1967) this is mild. It is mild even when compared to seasonal flu where multi dose vials are not allowed and proper testing is done.

As I have written before, the best form of defense is having a healthy immune system (April 27 and June 10). As Louis Pasteur is reported to have said, “the seed (germ) is nothing, the soil (body) is everything. Whether you contract flu or not is about you rather than the virus.

The decision as to whether to have the vaccine against H1N1 must be left to the individual. Consider your own circumstances before deciding. Do not be influenced by Chicken Little “the sky is falling” fear.



Tuesday, August 18, 2009

Depressed, or a bit Down - There is a difference

It has been said that depression is the epidemic of the 21st century. Certainly the rates of diagnosis have increased over the last 10-15 years. Some claim that this is due to better recognition of the issue and that actual rates are unchanged. Others feel that we are collectively more depressed than in years gone by.

Figures from the USA (link 1) show that the number of Americans prescribed an antidepressant doubled between 1996 and 2005 and that those being treated took more tablets. Yet there is nothing to show that the population is better off. In fact the suicide rate has risen.

It is interesting to note hat $1 billion is spent each year on promoting anti depressants. Between 1999 and 2005 the amount spent on direct to consumer advertising nearly quadrupled.

When one looks at the definition of depression in the DSM4 (the psychiatry reference manual) there are a number of criteria, which need to meet for a diagnosis of depression. Some of these like a 5% change in weight are measurable; others like reduced concentration are subjective. There are 9 criteria 5 need to be present for at least 2 weeks and their needs to be an impact on the person’s ability to function either at work or socially.

This area is a touchy one. There are many people who feel bad, who have stress, who have issues that trouble them. These people may need help or assistance to get through a difficult time. There seems to be a tendency to label many of this group as being depressed. The rise in prescriptions in part represents a reclassification of stress as depression. The two may overlap but are not the same.

The de-stigmatizing of mental health has been a good thing. Mental health issues are no less real than any other. However, it has also led people to feel that having a bad hair day is somehow the same as having depression. I am staggered by the number of people who feel that because they are facing challenges in their life feel that they have got “a bit of depression”.

When “bad” things happen it is as normal to feel down as it is to feel happy when “good” things happen. To feel down after a relationship breakdown or job loss is no more abnormal than to feel happy after winning a lottery. There is a range of human emotion and feeling-all of which are valid.

We need to be careful about medicalizing the human condition. The idea that 3 year olds can have depression (link2) demonstrates this tendency. Children can have emotional and behavioral problems and those problems need help. This is not the same as saying they have a medical illness requiring a drug.

Without the dark we could not understand light. We all have lessons to learn in our lives. It is from the hardest times that the greatest growth and learning’s come. Some people will need medication to get them through or at least started. For a reasonable number of people who are experiencing life’s “downs” the answer is more likely to lie in confronting and resolving the issues rather than in a tablet.



Monday, August 10, 2009

Relationships - Pillar 7 of DIY Health

There are many relationships that we have in life. As I write in my upcoming book Dr Joes DIY Health –Putting you in charge of your health

“Humans are social creatures. We rely on relationships for our wellbeing. Relationships can broadly be regarded as external (those with others) and internal (which covers your view of yourself, your values and spirituality). Both are important to your health. If your relationships are out of balance then your health will be affected.

Arguably the most important relationship you have is the internal one you have with yourself. How you see yourself governs your mood, attitude, behaviour and beliefs. These beliefs and attitudes lie at your core. At another level are your thoughts and emotions

Our external relationships are first and foremost with other people. This includes our family, our friends as well as those we work with.”

Two reports in the last few months highlight the correlation between good relationships and good health.

The first (link 1) looks at life expectancy in older people. Those who have a good network of friends lived longer than those who didn’t. Other studies have looked at the role of friendship in cancer and heart disease and again found “good” relationships made a difference.

Whilst nobody has done a “reverse “study looking at the health impacts of bad or “toxic” relationships, I have had many people particularly with cancer tell me over the years how they felt toxic relationships had contributed to their illness

The second (link 2)looks at how marriage continues to “hold up” in this changing world. It has long been shown that the health of men in particular is improved in a good relationship (marriage or defacto). I have also seen recent reports about the adverse health affects of divorce.

Now the key in all of this is good relationships. Staying in a bad relationship for the sake of it is not the way to go. Equally life is not necessarily perfect so one always needs to be “working” at ones relationships. Perhaps tending them (like one might tend a garden) is a better analogy. After all if it feels like hard work then that may tell you something

We also have relationships with our environment –our home and workplace, and the broader environment. We all know that some places “feel “ right and other do not. Sometimes even the colors in a room affect how we feel. The in-depth study of this is of course Feng Shui .

There is also our relationship with the cosmos, universe, spirit world, or whatever term sits comfortably with you.

The first relationship to get “right” is the one with yourself. This is about acceptance of who you are in this current moment. You can strive to be better but not make your self-acceptance conditional on some future achievement. It is about forgiving yourself, and it is about being “present” in the moment

All other relationships that you have will in some way be a reflection of this central one. Relationships are pillar 7 of DIY Health



Sunday, August 2, 2009

DIY Health- Real Healthcare Reform

Health reform is front page news in The USA and Australia.(see links) Countries in Europe are also grappling with their health systems. The issues are the same in all developed countries-how can the” system” afford to pay for all the services that the population may want and need.

As I write in the upcoming book Dr Joes DIY Health-Putting you in charge of your health :

“The health system is in fact a disease system. Why? Because the only real way for you to enter the system is to have a disease. If you are healthy and you front up at your local doctor or hospital, there is a fair chance that you’ll be told to go away because there is nothing particularly wrong with you.
Despite the overall health of people having never been better, in an interesting paradox there is now a growing “crisis” and rising “burden” of disease which is crippling the various “health care” systems.

This burden of disease is a result of the lifestyles that people choose. Diseases such as diabetes, arterial sclerosis, hypertension, gastric reflux and irritable bowel syndrome, to name just a few, are called “lifestyle illness diseases” because they are brought about through elements of lifestyle. Western medicine tends to treat these conditions with medications rather than changes in lifestyle.”

Treatment with hospital beds and medication is expensive. Yet in all the proposals and discussions about ”reform” a fundamental assumption is always made-namely that people will continue to develop chronic illnesses in increasing numbers and will out increasing demands on the system to “fix them”. Essentially the arguments are about who pays how much, between the individual, private insurers and government. Hospitals, doctors and pharmaceutical companies are on the receiving end of these transactions

No consideration seems to be given to the notion of individual responsibility(interestingly the Australian report in its recommendations has the title “taking responsibility”).Most of the disease “burden” is preventable .The London based World Cancer Research Fund showed earlier this year that one third of cancers could be prevented through regular exercise and changed eating patterns .The diabetes toll could be massively reduced through dietary change.

None of this costs the system a cent and there is minimal if any cost to the individual. This will depend on the choices you make and how much you want to invest in your health. As I also say in the book

“The quality of your health will always be a reflection of the quality of your choices.
Some choices are better than others. Each day we make choices with regard to our health and in turn our health will always be a reflection of those choices.
The bottom line is; your health is your responsibility. It is not the responsibility of government, of the health system, the doctors, the natural health therapists or anyone else. It is solely your responsibility.

Maintaining your health has wrongly become thought of as very difficult and in this book I’ll tell you why that is and what you can do about it.
The message is clear: Your health is not reliant on anyone else except you. You have the power to be healthy. “

The 8 pillars of DIY Health a re a basis for being and staying healthy Whilst this will this reduce demands on the “disease system”- more importantly you will feel better and have more energy today as well as a significantly reduced chance of major illness later. Live and enjoy life for the duration of your stay on earth.