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Friday, December 14, 2012

What Cancer Patients Need to Know About the Flu

ByRita Rubin
WebMD Health News Reviewed byBrunilda Nazario, MD

What do cancer patients and survivors need to know about the flu? WebMD asked Lisa Richardson, MD, associate director for science in the CDC’s Division of Cancer Prevention and Control.

Should cancer patients get immunized against the flu?

Absolutely. The CDC recommends that everyone 6 months of age and older get a flu vaccine. That message is especially important for cancer patients, because if they get the flu, their risk of getting severe complications is higher, due to their weakened immune system.

What type of flu vaccine is best for cancer patients?

Flu shots are safer than FluMist, the nasal vaccine approved for healthy people ages 2 to 49. FluMist contains live, albeit weakened, flu virus, while flu shots contain killed virus, which can’t make you sick. (Some people run a low-grade fever after getting a flu shot, but that’s a sign your body is making antibodies against the disease, not a symptom of the flu itself.) If you’re over 65, the CDC recommends that you get the Fluzone High-Dose shot, which spurs the aging immune system to produce more antibodies against the flu. The CDC has not yet recommended that younger people with weakened immune systems, such as cancer patients, also get the high-dose vaccine.

What about survivors who have been cancer-free for a long time?

People who’ve had leukemia or lymphoma, which are cancers of the immune system, are most at risk for complications from the flu. Another group of survivors who have an elevated risk of complications from the flu are those who were treated with certain chemotherapy drugs that could alter their immune system long-term.

But if your immune system is compromised, does the flu vaccine work as well?

Getting a flu shot is better than not getting a flu shot, although it might not work as well as in a healthy person. If you do contract the flu after getting immunized, chances are you won’t get as sick as someone who hadn’t received a flu shot.

Does having cancer increase your risk of contracting the flu?

Some scientists believe cancer patients are more susceptible to coming down with the flu, but that hasn’t been confirmed. However, it is clear that once they become sick, they have a higher risk of complications.

Will a flu shot interfere with any cancer treatments?

Flu shots haven’t been shown to reduce the effectiveness of cancer therapy, but that misconception probably helps explain why many patients mistakenly refuse to get immunized.

What should cancer patients or survivors do if they think they might have come in contact with someone who has the flu?

Call your doctor. If you’ve had chemotherapy or radiation therapy within the past month, or if you have leukemia or lymphoma, your doctor might prescribe an antiviral medication to prevent you from getting sick.

Tips to Strengthen Your Immune System

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A guide to beating nasal allergies, from medication to self-care.

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Allergies Health Center

Help for Sinus Pain Email a FriendPrint Article Help for Sinus Pain and Pressure Next Article: Skip to Article Content Help for Sinus Pain and Pressure Is Your Cold Causing Sinus Problems? What happens to your sinuses when you have a cold, and what to do about it. Sinus Problems From Allergies What's the best way to treat a stuffy nose caused by allergies? Dealing With Sinus Pressure Don't let sinus congestion and pressure get you down. Here's how to cope. Sinus Headache Relief How do you know if it's really a sinus headache? What's Causing Your Sinus Problems? What to do when your sinuses misbehave. Home Remedies for Sinus Problems Creating a sinus-friendly environment at home. Your Sinus Action Plan 6 tips for relieving sinus pain and pressure. Sinus Terms to Know Check out this glossary of sinus terms. Using a Neti Pot for Congestion Can flushing out your nasal passages help? Natural Sinus Relief See 6 things you can do at home in this slideshow. False Allergies and Your Sinuses: Fighting Allergic Rhinitis A guide to the best stuff for stuffy noses, from prescription treatments to self-care. WebMD Feature

By R. Morgan Griffin

Reviewed By Laura J. Martin, MD

One in five adults in the U.S. has nasal allergies, or allergic rhinitis. Yet as common as it is, experts say that allergic rhinitis is terribly underdiagnosed, undertreated, and underestimated.

“Allergic rhinitis is a trivialized disease,” says Jonathan A. Bernstein, MD, an allergist at the University of Cincinnati College of Medicine. “Obviously, nobody dies from it. But it does cause a tremendous amount of sickness and suffering.”

All that sneezing, congestion, and teary-eyed misery takes a toll. Allergic rhinitis can cause missed workdays, and it can detract from your performance at school or on the job. Because of this, allergic rhinitis costs the country billions of dollars every year.

Nasal allergies can also lead to other conditions such as sinus problems. But they don’t have to.

“Allergic rhinitis is a treatable problem,” Bernstein says, “and when people get diagnosed and treated properly, they do very well.” If you’ve been limping through life with nasal allergies, it’s time to get the best of them.

Nasal Allergies and Sinus Problems

Allergy symptoms are miserable enough on their own. But in many people, allergic rhinitis can cause -- or aggravate -- other complications or conditions.

What’s the connection between allergies and sinus problems?

Sinuses are hollow pockets in the skull that are connected to the nasal passages. When allergies trigger swelling in the mucous membranes, the inflamed tissue can block off the sinuses. The sinuses can’t drain, trapping mucus and air inside. That leads to pain and pressure.

Take Allergy Symptoms Seriously

Despite the misery of allergies and their complications, many people don’t take the symptoms very seriously.

They don’t realize the impact that their allergies are having on their lives, especially when added up over years and decades, says Leonard Bielory, MD, director of the division of Allergy, Immunology and Rheumatology at New Jersey Medical School in Newark.

They get used to the congestion, chronic sinus problems, and mouth breathing. They get used to disturbed sleep and fatigue. After a while, they just don’t remember what life was like before allergies.

When symptoms get bad, they make do. They grab over-the-counter medicines at random at the drugstore. They make guesses at the cause of their allergies and half-hearted attempts to control their exposure, but never get a diagnosis.

That’s not the way to go about it, experts say. Given the impact that nasal allergies can have on your life, you really need to get proper medical evaluation and treatment.

Allergic Rhinitis Treatments: Over-the-Counter Medicine

For mild allergic rhinitis -- or symptoms that only strike for a few weeks a year -- over-the-counter medicines may be enough. OTC treatments for allergic rhinitis include:

Antihistamines. These drugs work by blocking histamine, a chemical that causes many allergy symptoms. They help relieve itching and sneezing. Examples include certirizine (Zyrtec), chlorpheniramine (Ahist, Chlor-Trimeton), diphenhydramine (Benadryl, Genahist), fexofenadine (Allegra), and loratadine (Agistam, Alavert, Claritin).

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WebMD does not provide medical advice, diagnosis or treatment. See additional information.

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Sinus Problems: Home Remedies and Tips

Do you have sinus problems? Here's how to make your home kinder to your sinuses. WebMD Feature

By Kathleen Doheny

Reviewed By Michael W. Smith, MD

Are you among the 37 million Americans who have sinus problems each year? If so, there's a lot you can do around the house to create a "sinus-friendly" environment -- reducing your risk for sinus pressure.

Even better, many of the measures are simple and inexpensive.

Sinus Problems: Getting to the Triggers

First, it's crucial to figure out why you have sinus problems, says Jordan Josephson, MD, a Manhattan ear-nose-throat specialist and author of Sinus Relief Now. "Allergies are a fairly common reason for sinus problems," he says.

Allergies that affect the nose, such as hay fever and indoor allergies, can cause the nasal membranes to swell, and the passages to the sinuses -- hollow spaces within the bones around the nose -- to become blocked. Mucus, which typically drains from the sinuses to the nose, can't drain.

Other reasons? "A dry nose leads to more sinus problems," says Richard F. Lavi, MD, an allergist in Beachwood, Ohio.

Whatever the trigger, you can pick and choose from these five tips, or adopt all of them.

Sinus Tip 1: Keep Your Cool

"When the heat is on, the membranes get dry," says Russell B. Leftwich, MD, an allergist in Nashville, Tenn. Mucus isn't cleared as effectively, boosting the risk of sinus problems, including sinus headache.

He can't recommend a specific indoor temperature range as ideal, but offers this guide: "You are better off wearing a sweater and keeping it cooler than cranking it up so you are comfortable wearing only a T-shirt."

Let your nose guide your indoor temperature range, suggests Lavi. "If you are not waking up with nosebleeds or congestion, that is probably a good temperature range."

Sinus Tip 2: Humidify Your Air

Strive for an indoor environment that's not too dry and not too humid. "Dust mites love greater than 50% humidity," Lavi warns. And if you're allergic to dust mites, that's bad news for your sinuses.

A too-humid indoor environment can also encourage the growth of mold, which can also set off sinus problems, says Todd Kingdom, MD, director of rhinology and sinus surgery at National Jewish Health in Denver.

Experts are divided on the value of room humidifiers for creating a sinus-friendly home.

Forget them, Leftwich says. "A room humidifier never makes a difference. There is too much air to humidify."

But Josephson says using humidifiers in the bedroom beginning in October through March or April can make a difference in keeping sinus problems at bay.

Vaporizers can keep you more comfortable if you are in the midst of a sinus problem, Leftwich says. But you need to have it close by. "It doesn't do any good to have a vaporizer on the other side of the room." And, he warns, the devices must be cleaned daily to keep bacteria from growing in them.

Breathe the mist coming from vaporizers, but not the steam, he warns. Steam can easily burn you. Ten minutes at a time is often recommended.

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WebMD does not provide medical advice, diagnosis or treatment. See additional information.

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What Causes Sinus Problems?

What to do when good sinuses turn bad. WebMD Feature

By Jennifer Nelson

Reviewed By Michael W. Smith, MD

If you are plagued by sinus problems, take a moment to consider these valuable parts of your head. What can turn good sinuses into problem sinuses?

Your sinuses are hollow air spaces within the bones between your eyes, behind your cheekbone, and in the forehead. They produce mucus, which helps keep the inside of your nose moist. That, in turn, helps protect against dust, allergens, and pollutants.

Interesting Sinus Facts

No one is completely sure why we have sinuses, but some researchers think they keep the head from being too heavy.

Sinuses are also are responsible for the depth and tone of your voice. This explains why you sound like Clint Eastwood when your sinuses are all stuffed up.

If the tissue in your nose is swollen from allergies, a cold, or environmental triggers, it can block the sinus passages. Your sinuses can’t drain, and you may feel pain.

There are eight sinus cavities in total. They are paired, with one of each in the left and right side of the face.

Two sinus cavities are located in the forehead. Two are behind each cheekbone. Two sinus cavities are within the bones between your eyes. Two are behind each eye. Common Sinus Problems

Sinus Blockages

Each sinus has a narrow spot, called the transition space (ostium), which is an opening that’s responsible for drainage. If a bottleneck or blockage occurs in the transition of any of the sinuses, mucus backs up.

An Extra Sinus

About 10% of people have an extra sinus. The extra sinus “effectively narrows that transition space,” says Ford Albritton, MD, chairman of otolaryngology at Presbyterian Hospital of Dallas.

Deviated Nasal Septum

Another common issue is a deviated nasal septum, the thin wall of bone and cartilage inside your nasal cavity that separates your two nasal passages. Ideally, your septum is situated in the center of your nose, equally separating the two sides. But whether from genetics or injury, in about 80% of people, the nasal septum is displaced to one side, making one nasal passage smaller than the other. A deviated septum is one reason some people have sinus issues. A deviated septum can also lead to obstructed breathing and snoring.

Narrow Sinuses

More often, certain people just have variations in their anatomy that creates a longer, narrower path for the transition spaces to drain. “It’s pure genetics, since it’s the way we’ve inherited how our sinuses are put together and how easy or difficult it is for them to stay open or become blocked,” Albritton says.

Sinus Sensitivity and Allergies

Finally, there are certain people who have sensitivity to things in the environment and to the foods they eat. This sensitivity triggers a dilation of blood vessels in the nose, and sometimes releases chemicals from cells in the nose that cause swelling.

Your doctor can prescribe medications to control your symptoms. People with sinus problems and allergies should avoid environmental irritants such as tobacco smoke and strong chemical odors, which may increase sinus problems.

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WebMD does not provide medical advice, diagnosis or treatment. See additional information.

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Distress Tied to Higher Risk of Stroke

ByBrenda Goodman, MA
WebMD Health News Reviewed byBrunilda Nazario, MD

Dec. 13, 2012 -- Older adults with high levels of distress are more likely to have certain kinds of strokes than those who aren’t as troubled, a new study shows.

Distress is a combined measure of stress, depression, negativity, and dissatisfaction with life.

“It’s really trying to capture more than negative mood. A lot of studies have looked a depression and how it relates to heart disease or stroke risk, and in this case what we really wanted to get at was a general tendency to have a negative outlook on life,” says researcher Susan A. Everson-Rose, PhD, MPH, associate director of the Program in Health Disparities Research at the University of Minnesota in Minneapolis.

A Visual Guide to Understanding Stroke

Tracking Distress in Older Adults

For the study, researchers surveyed more than 4,000 adults over age 65 in the three neighborhoods in Chicago. The majority of people who took part were women and African-American. Their average age was 77.

Each person in the study gave a detailed medical history. They also answered questions about their income, education, daily functioning, and mental outlook.

After an average of seven years, 452 people in the study were hospitalized for strokes, and at least 151 people died of one.

After researchers accounted for other known risk factors for stroke, like smoking, high blood pressure, chronic health conditions, weight, and age, they found that high levels of distress were associated with having an increased risk for having a hemorrhagic stroke, or a stroke caused by bleeding in the brain, rather than the more common stroke caused by a blood clot.

Researchers say they were surprised by that finding.

“Everything I knew about how measures of distress or depression link to heart disease and stroke went through [clotting] mechanisms. I’m really curious about what the biological mechanisms might be, but that’s really a task for future studies,” Everson-Rose says.

People in the study with the highest levels of distress also had roughly twice the risk of dying of a stroke compared to those with little distress.

More Research Needed

The study doesn’t prove that distress causes strokes. Instead, it shows relationships between distress and health that are probably more complicated than simple cause and effect.

Gabor Toth, MD, a vascular neurologist at the Cleveland Clinic in Ohio, says it would be nice to find out more about how distress and stroke are related.

“It may just be that you don’t take care of yourself when you’re under a lot of stress and don’t eat well, you smoke more. But at the same time, there could be some kind of hormonal, metabolic changes in the body that are brought on by stress that put you at a higher risk for stroke,” says Toth, who wasn’t involved in the research.

Whatever the connection may be, researchers say understanding that distress and poor health can go hand in hand is important.

“It’s really recognizing this general negativity, these emotions around distress, and realizing that they can have a physical impact,” Everson-Rose says. “It’s important to pay attention to them and find ways to alleviate the distress. Emotional states can have strong effects.”

The study was funded by the National Heart, Lung, and Blood Institute. It’s published in the journal Stroke.

View Article Sources

SOURCES:

Henderson, K. Stroke, Dec. 13, 2012.

Susan A. Everson-Rose, PhD, MPH, associate director, Program in Health Disparities Research, University of Minnesota, Minneapolis.

Gabor Toth, MD, vascular neurologist, Cleveland Clinic, Cleveland, Ohio.

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Friday, December 14, 2012

What Cancer Patients Need to Know About the Flu