The Pharmacy Mart

Is it a sinus infection or a common cold? Sometimes it can be difficult to distinguish the difference. Infection or inflammation of the sinuses also known as sinusitis affects millions of people every year and in many instances causes serious discomfort or pain. The symptoms of sinus infections actually depend upon which of the four sinuses are affected and whether or not the sinus infection is acute or chronic.

Acute sinusitis normally lasts eight weeks or less or occurs no more than three times per year with an average episode lasting less than ten days. Chronic sinusitis on the other hand normally lasts longer than eight weeks or occurs more than four times per year with symptoms usually lasting longer than twenty days.

There are many symptoms of acute sinus infection including nasal discharge, post nasal drip whereby mucus drips down the throat behind the nose, facial pain or pressure in the area of the affected sinus cavities, fever and headaches.

Symptoms of chronic sinus infection include chronic soar throat, chronic nasal discharge, bad breath, prolonged facial pain, discomfort below the eyes or across the bridge of the nose, toothaches and low-grade headaches.

It is often difficult to determine whether or not you have a common cold or a sinus infection. For example, a stuffy nose could be a symptom of a sinus infection or a common cold.

Your doctor can diagnose sinusitis using an assortment of methods including listening to your symptoms, doing a physical examination, taking X-rays, and if necessary, an MRI or CT scan (magnetic resonance imaging and computed tomography).

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“Meningitis” and “encephalitis” are two words that pop onto most people’s radar screens from time to time, and usually in some scary context, like hearing of a cluster of cases in their child’s school, or reading media reports of epidemics occurring nationally or internationally. While most people understand that these words mean there is some sort of infection of the nervous system, other distinctions and implications are often left unstated and, as a result, can be vague or confusing.

The basic concepts are built into the words themselves. Starting at the ends of the words and working forwards, “-itis” is the medical suffix meaning inflammation. Although it’s possible for inflammation to occur without an infection being present, as a practical matter, in most cases of meningitis or encephalitis the inflammation is indeed due to an infection.

The next step in understanding these concepts is to analyze the first parts of the words. “Mening-” refers to the meninges which are the membranous coverings of the brain and spinal cord. So “meningitis” means inflammation or infection of these membranous coverings. By contrast, “encephal-” refers to the encephalon or brain (originating from the Greek word “enkephalos”), so “encephalitis” means inflammation or infection of the brain itself.

Although no case of meningitis or encephalitis is trivial, depending on the particulars, some cases end up as temporary illnesses from which there is full recovery, while others can be severely damaging or even lethal. In a nutshell, cases of meningitis caused by viruses are usually associated with good outcomes (even without treatment), while cases of meningitis involving bacteria are very serious and require emergency treatment with powerful antibiotics. All cases of encephalitis–usually caused by viruses and not by bacteria–are serious, and antiviral treatment is available for some of the viruses involved, but not all.

Most cases of either meningitis or encephalitis start fairly abruptly, sometimes following an obvious infection elsewhere in the body and sometimes not. As with most infections, a fever is usually present in meningitis or encephalitis, but is not necessarily striking. In both cases the patient feels miserable in general and often complains of pain in the head, neck, or both.

Because encephalitis involves infection of the brain itself, symptoms of altered brain function–like confusion or decreased alertness–are usually present, while in cases of meningitis the patient is initially alert and, though understandably distracted by pain and misery, still in command of their mental processes.

In either case, prompt medical assessment is important. In both meningitis and encephalitis a lumbar puncture (also known as a spinal tap) is usually crucial in detecting the presence of an infection, identifying the infecting organism, and guiding successful treatment. While an imaging test like a CT scan or an MRI scan is often included as part of the evaluation, they do not replace the lumbar puncture in identifying the essential features of the infection.

A lumbar puncture is usually performed with the patient lying on one side, curled into a fetal position. The doctor preps and drapes the patient’s lower back to create a sterile field in which to work. After numbing the skin of the lower back the doctor inserts a needle in the middle of the spine, puncturing the meninges. In the lower back there is no spinal cord, so there is no risk of puncturing it, too. Watery fluid is collected into tubes as it drips out of the back of the needle. Then the needle is withdrawn.

This watery fluid is called CSF–short for cerebrospinal fluid–and because it resides within the meninges (and outside of the brain and spinal cord) it holds some of the keys to diagnosing the infection. Laboratory personnel can perform several tests on the fluid right away, like measuring the concentrations of red and white blood cells, as well as the concentrations of protein and sugar. An increase in concentration of white blood (“pus”) cells and an increase in protein concentration are expected findings when the meninges are infected by either bacteria or viruses, with the changes more pronounced in bacterial infections than in viral infections. Reductions in sugar concentration are common in bacterial but not viral infections. Other tests on the CSF involve inherent delays, like trying to grow bacteria from the CSF in Petri dishes or other culture media.

In truth, cases of encephalitis also usually involve inflammation of the meninges, so a stickler for linguistic accuracy could rightly maintain that they should be called “meningo-encephalitis” to reflect the involvements of both meninges and brain. But in common usage, the “meningo-” prefix is often dropped. So because CSF changes occur in cases of both meningitis and encephalitis, the main clinical feature that separates the two is the patient’s mental state, with confusion or decreased level of consciousness making a strong case for encephalitis.

Once the CSF has been collected, the doctor can begin treatment without risk of obscuring the fluid’s diagnostic features. So long as there is any likelihood of bacterial infection, the doctor administers one or more antibiotic drugs, usually via an intravenous catheter. If the clinical findings could also be interpreted as due to a treatable virus, the doctor concurrently administers an antiviral drug. With the seriousness of these illnesses, the benefits of over-treatment exceed its risks, and once the dust settles and the diagnosis is clarified, needless treatment can be discontinued without harm.

(C) 2005 by Gary Cordingley

The Best Help With The Medicare Prescription Drug Plan Could Be Online

No one missed the recent launch of the Medicare Prescription Drug Plan.

Countless newspaper and TV stories have chronicled the complex programs and the difficulties that many people have had finding the best plan to help them get the drugs they need.

However, many older Americans aren’t using the detailed medical information available on the Internet. A recent study by the Henry J. Kaiser Family Foundation found that only 21 percent of American senior citizens have gone online to research health information, confirming that most elderly Americans are not using the Internet to become better informed about their health and health care options.

The TV Services division of Microsoft Corp. has compiled a list of third-party online resources that seniors can use to find answers to their questions about the Medicare Prescription Drug Plan, including these sites:

• Medicare. The official government Medicare Web site now has answers to the many questions seniors have about the new Prescription Drug Plan. The site includes a Medicare Prescription Drug Plan Finder, an interactive tool that enables you to narrow your search for a Medicare prescription drug plan based on your personal preferences such as cost, coverage and convenience. Go to http://www.medicare.gov/pdphome.asp.

• AARP. AARP, the leading nonprofit, nonpartisan membership organization for people age 50 and over in the United States, has designed a site with many articles and detailed information to answer your Medicare questions. Visit http://www.aarp.org/ health/medicare.

• WebMD Inc. WebMD, the popular health information Web site, and the Henry J. Kaiser Family Foundation created a Medicare Drug Benefit Calculator to help seniors figure out what they will pay for prescriptions under the standard Medicare prescription drug plan. Visit http://www.webmd.com/content/article/113/110712.htm.

If you are a senior or you have an older family member who doesn’t use the Internet because it seems too complicated, did you know there are easy-to-use and affordable devices designed to help you get online? With the MSN TV 2 Internet & Media Player (http://www.msntv.com), you simply connect it to a regular television, plug in your phone line (for a dial-up connection) or broadband cable, sign up for MSN TV service, and you can be online within minutes, sending e-mail and researching valuable health and wellness information.

“Some Americans are still intimidated by technology and the Internet,” said Kevin Mizuhara, director of marketing for the TV Services division at Microsoft. “Our customers love MSN TV 2 because it’s easy to set up and doesn’t require computer skills to use.”

More important, the MSN TV 2 player is affordable for just about any budget. The MSN TV 2 Internet & Media Player sells for about $200 MSRP (U.S., plus monthly subscription fee). And, if you order directly from Microsoft (1-866-901-4882), monthly payment plans are available. In addition, the MSN TV 2 player is available at many retailers including Best Buy, Circuit City and Amazon.com.

“With MSN TV 2, you can check e-mail and surf the Web via a regular television from the comfort of your living room,” Mizuhara said. “And you can stay in touch with family and friends by sharing digital photos. With the rich resources available online, you can not only use the Web to research hobbies such as gardening, travel or genealogy, you can also find answers to almost any questions you may have about vital subjects such as Medicare, health, retirement and finances.”

Note to editors: The MSN TV 2 Internet & Media Player requires a subscription fee to MSN TV service and is subject to acceptance of the terms of service upon registration. A credit or debit card is required to pay for MSN TV service. MSN TV services are available as a local call in most areas. In some areas, long-distance telephone toll charges may apply.

It is important to pay attention to the signs of appendicitis if you suspect that you might be suffering from this illness. Appendicitis in general is a serious condition and in many cases it can even cause death. Appendicitis has many forms of manifestation in patients. There are two main types of appendicitis: chronic appendicitis and acute appendicitis. The signs of appendicitis in the chronic form of the illness are not always detectable. People with chronic appendicitis usually feel a generalized state of internal discomfort, fatigue and lack of energy. In the acute form of the illness, the signs of appendicitis are easier to detect, but they usually occur after the development of complications.

The signs of appendicitis have an unspecific character, also occurring in other conditions and diseases. The signs of appendicitis are usually more difficult to detect in elderly people, people with special conditions and very young children. Appendicitis refers to inappropriate activity of the vermiform appendix, a worm-shaped extension of the colon.

Appendicitis occurs due to blockage of the appendix and its ulterior infection with bacteria. In many cases, the blood vessels that irrigate the large intestine are also obstructed, speeding up the deterioration of the appendix and eventually causing its death. The most common form of treatment for appendicitis involves the extraction of the appendix from the body through a procedure called appendectomy. If the appendix isnt surgically removed in time, it becomes enlarged, fills up with bacteria and it eventually bursts, causing serious internal complications.

Considering the fact that the illness usually evolves rapidly, it is important to timely spot the first signs of appendicitis. The most common sign of appendicitis is abdominal pain. Patients perceive this pain in different regions of the abdomen and at different intensities. However, this first sign of appendicitis usually occurs in the umbilical region and later localizes in the right lower side of the abdomen. The abdominal pain seems to amplify with physical effort and any kind of sudden moves. Abdominal pain on breathing, coughing or sneezing is also a sign of appendicitis.

Other signs of appendicitis are loss of appetite, nausea, vomiting, constipation or diarrhea, abdominal bloating, bad breath, fatigue and moderate fever.

Although these signs of appendicitis are common in people with acute forms of the illness, they dont always occur in people with chronic appendicitis. There are also people with acute forms of illness that dont have any signs of appendicitis at all. This special category of people includes: people with diabetes, people with HIV, people that have previously suffered surgical interventions (organ transplants) and obese people. In the case of people with special conditions, the signs of appendicitis are revealed late, therefore long after the illness becomes severe. Due to the fact that the signs of appendicitis are usually spotted late in some forms of the illness, the patients chances of recovery are considerably reduced.

What is actually allergy rhinitis? Allergy rhinitis is an allergic disease, which is caused by the sensitinogen that reacting on the mucous membranes in the nasal cavity. It consists two types that are perennial and seasonal allergic rhinitis. Perennial allergic rhinitis occurs throughout the year; whereas, seasonal allergic rhinitis usually occurs during the blossoming or flowering season. In this season, plants start to release their pollen for breeding purpose. Pollen is one of the sensitinogens to the allergic rhinitis. Clinical features of allergic rhinitis are; itching in the nose, sneezing, watery nasal discharge and nasal obstruction. There are about 20 % of adults and children have seasonal or perennial allergic rhinitis [Otolaryngol Head Neck Surg 1986;94:470-5]. Although it is prevalence in most of the countries regardless tropical or seasonal, most of the conditions are not treated adequately and the consequence is that allergic rhinitis becomes chronic. The chronic state of allergic rhinitis usually will lead to more serious complications of the upper and lower airways such as asthma, sinusitis and otitis media with effusion. Otitis media is an inflammation of the middle ear. Fluid is built up in the middle ear and causes temporary lose of hearing. However, if this chronic disease is not treated properly, it may lead to permanent hearing impairment.

A few medical scientists had carried out surveys to study the epidemiologic links between allergic rhinitis and other airway diseases. What they had found out were, 78% of patients who had asthma were also had allergic rhinitis [Allergy 1983;38:25-9]. They also found out that 99% of adults and 93% of adolescents, who had allergic asthma, also had allergic rhinitis [J Allergy Clin Immunol 1997;99:S138]. Besides, the other study that had been carried out for 23 years was found out that college students who previously had allergic rhinitis had three times higher the possibility to have asthma compared to those students who had not had allergic rhinitis before [Allergy Proc 1994;15:21-5].

Many researches and works had been carried out to study the epidemiologic link between allergic rhinitis and sinusitis. The results had been well documented. The earlier study showed that 53% of children, who had allergic rhinitis, also had sinusitis [J Allergy Clin Immunol 1978;61:310-4]. They proved this from the children abnormal sinus radiographs. Whereas, recent study showed that up to 70% of children, who had allergy and chronic rhinitis, had abnormal sinus radiographs [J Allergy Clin Immunol 1988;82:935-40]. 78% of the patients who had recurrent sinus infection, rhinitis allergy was coming together with their extensive sinus disease. For the children who had otitis media with effusion, 40 to 50% of them had allergic rhinitis [J Allergy Clin Immunol 1997;99:S787-97.]. This was confirmed by positive allergy skin tests or increased serum IgE antibodies to specific allergens test.

Scientist had proposed a model for the development of sinusitis and otitis media. Their proposed model assumes that the earliest cause for sinusitis is not bacterial infection but it is due to the obstruction in the nasal cavity, which hinders the normal movement of air and secretions in and out of sinuses. Virus that causes nasal inflammation is upper respiratory tract infection (URTI) type, which is called rhinovirus. Research had been carried out to study the effect of this virus to the nasal diseases. The result showed that when rhinovirus is inoculated into the nasal passage of a group people, one third of these people would develop sinus abnormities and typical sinus disease symptoms [J Allergy Clin Immunol 1992;90:474-8]. Another study also showed that 87% of healthy adult, who voluntarily went through self-diagnosed colds, had maxillary sinuses illness [Engl J Med 1994;330:25-30].

Fluid inside the sinus cavity must be drained normally to keep the nasal healthy. When nasal being infected by bacteria or virus, or exposure to allergen, dust or chemicals, thicken secretion will be developed and it has higher possibility blocks the narrowed sinus ostia (opening that connect to the sinus cavity). Accumulation of these secretions in the sinus cavity will lead to further obstruction, mucosal swelling and also thicken the sinus mucosa. This will create an anaerobic environment that further favorite the bacterial growth and lead to infection. Congested sinus ostia must be resolved if not, it will lead to recurrent acute and eventually chronic nasal disease. This model also explained why chronic sinusitis is resistant to the antimicrobials treatment alone. To treat the sinusitis properly, antihistamines and corticosteroids have to be used as a combination with the antimicrobials treatment.

A similar model had been developed by scientist to explain the occurrence of otitis media with effusion. 83% of the children had at least once occurrence of acute otits media by the time they reach 3 years old [J Infect Dis 1989;160:83-94]. This model hypothesizes that nasal inflammation that is caused by allergens or URTIs virus will further cause inflammatory swelling and obstruction of the Eustachian tube. Obstruction of the Eustachian tube will increase negative pressure in the middle area and without improper ventilation; fluids will accumulate in the middle ear. Obstructed Eustachian tube will open occasionally with an effusion and this will suck the inner nasal secretion, which contain bacteria, virus and allergens into the middle ear cavity. Consequently, this will cause acute bacterial otitis media.

From the information above that have been gathered from various scientific publications, we know that common nasal allergy should not be left untreated. This is because it will lead to obstruction, fluid accumulation, bacterial infection and acute disease. If these diseases are not treated properly or successfully, a chronic state of inflammation, nasal congestion, and sinus infection will be developed and it can cause mucosal damage and ultimately, chronic disease. If the disease spreads to the middle ear, it will cause permanent hearing impairment

Medicare prescription drug coverage is now available to all people with Medicare. Everyone with Medicare can join a Medicare drug plan to get this coverage, regardless of your income or what drugs you take. You owe it to yourself to look into it, even if you have coverage now.

Medicare is here to help

Since Medicare prescription drug coverage is brand new, it’s natural to have questions like: Where can I get help choosing a plan? And, where can I get help joining a plan?

You can get answers from Medicare in several ways.

Where can I get help choosing a plan?

• Look for enrollment events in the area. Over the next few months, you’ll be able to get help with your drug plan choices at dozens of places throughout your community, like schools, senior centers, clubs, faith-based organizations, and your pharmacy. Or you can talk with friends and family or call your local office on aging for help. For the telephone number, visit www.eldercare.gov on the Web. The Eldercare Locator can help you find places to go to get personalized assistance.

• Use the Medicare Prescription Drug Plan Finder. Visit www.medicare.gov to get a personalized side-by-side comparison of up to three plans at a time based on cost, coverage and convenience. If you don’t use the Internet, call 1-800-MEDICARE (800-633-4227) to get the same information. TTY users should call 1-877-486-2048.

Where can I get help joining a plan?

• Visit Medicare’s Web site. You can join a drug plan at www.medicare.gov on the Web using Medicare’s online enrollment center.

• Call the plan. You can join over the phone by calling the plan’s toll-free number.

• Visit the plan’s Web site. Visit the drug plan company’s Web site. You may be able to join online (not all plans offer this option).

Is Drug Screening Too Costly To Do Or Do Without? One Company Has The Answer!

The director of telemarketing operations at a financial services company looks out across his 3600 square foot call center on a typical Monday morning. Look at all those empty chairs, he laments. It is sickly Monday and my partiers are taking their usual unscheduled day long break. The problem of the three day weekend or absenteeism in general doesnt just affect the manager in this setting. What about the other 80% of the work force who showed up? They are now burdened with additional duties while filling the vacancies that have temporarily developed.

With the challenge of recruiting qualified workers becoming more difficult all over the nation, the last thing American businesses can afford is to have major portions of its existing work force abusing drugs on or off the job. The truth is that most employees do not engage in illicit drug use and most do not want to work side-by-side with drug abusers. A majority of employees are parents who are concerned about the effects of drug abuse on their children, now and in the future. Given this profile of the typical American workers, it is clear that substance-abuse prevention can and should be viewed as a common concern of both employers and employees.

We interviewed one company that has recognized the true damage that drugs in the workplace causes and why it is still prevalent. Labwire, Inc. (http://www.labwire.com), a Houston, Texas based developer of online security solutions, began addressing what many medium and large size companies have consistently failed to addressthe true cost effectiveness of their testing programs. What stops companies from being effective about drug prevention in the workplace is the apparent cost to do so, states Dexter Morris, President of the company. What most companies dont understand is the wasted cost of NOT using the latest in technology management in handling such issues, he added.

Drug use in the workplace costs this country billions of dollars every year in lost productivity, increased health problems and workplace accidents, to say nothing of the problems it causes us at the federal and state level with associated family problems. Contrary to the typical portrayal of drug abusers, many apparently functional drug and alcohol abusers manage to hold down full or part-time jobs, masking their destructive problem from their employers. In fact, over seventy four percent of all current illegal drug and heavy alcohol * users hold down some type of job. *(Those drinking five or more drinks per occasion on five or more days in the 30 days preceding the survey). According to the U.S. Department of Labor, more than 8 million Americans use some type of illegal substance.

The overall cost of illicit drug abuse is estimated to have been $160.7 billion in 2000, and 69 percent of these costs are from productivity losses due to drug-related illnesses and deaths. Reducing substance abuse positively impacts Americas economic landscape.

Medium businesses bear the greatest burden of substance abusers. Traditionally, larger employers participate in drug-free workplace practices. As a result, medium to large employers who do not have drug free workplace policies in place are in essence adversely selected against in terms of the employees that are left to hire. Another thing to note is that substance abusers will steer away from drug-free workplace companies. They will work for those businesses that dont have a policy or a program and where there is no drug testing involved. Lets face it, no abuser wants to be detected.

The fact that medium and large size companies are at greatest risk is why we developed our web-based employee screening process. Any company can deploy this system inside of 30 days, says Morris confidently. In fact, we can train up to 100 human resource people on how to use our system in only 60 minutes online.

Morris went on to say that just the cost of workers compensation claims can bury a company.
Drug-using employees are 3.6 times more likely to be involved in workplace accidents and five times more likely to file a workers compensation claim. Between thirty eight and fifty percent of all workers compensation claims are related to substance abuse per the National Council on Compensation Insurance.. Substance abusers are three times more likely to use medical benefits than other employees.

According to Edward Poole, president and COO of OHS Health and Safety Services Inc., in Costa Mesa, Calif., several government and private industry studies concluded that each drug user in the workplace “can cost an employer an average of $11,000-$13,000 annually.” Despite studies and surveys that indicate a significant number of substance abusers hold jobs and work while under the influence, Poole points out that many employers have an “it can’t happen here” attitude about substance abuse in the workplace. “Once they get in there and implement a policy and start testing employees, they’re usually very surprised by the results,” he says.

Poole tells the story of one client who operated a small, local delivery service. When a representative from OHS Health and Safety Services visited the business owner, he stated repeatedly that there was no reason to conduct drug testing in that workplace. After all, the company had only 63 employees. After a couple of years of rebuffing them, the delivery service owner called OHS to start up an immediate screening program. Apparently the company had a change of heart after observing unusual behavior in their workforce. OHS showed up unannounced one day after performing roughly 45 days of drug free workplace education, and did what’s called a “sweep.” They were going to test every employee in the workplace.

Nine people immediately walked off the job. Says Poole, “One or two probably had deeply rooted beliefs in the right to privacy and all that crap, but it is probably safe to say that most of those nine employees would have tested positive.” Out of the 54 who took the drug test, 19 tested positive for marijuana and several tested positive for cocaine as well. “The employer was shocked,” says Poole, Most employers have no clue how many employees are working under the influence.”

Once a company decides to confront its potential workplace issue regarding illicit drug use the problem of finding the appropriate security company crops up. There are a lot of companies professing to have the expertise to address drug screening issues, Morris cautions. Just find out what their track record is and talk to some of their clients.

Many companies are heading the warnings about drug abuse in the workplace. According to data on companies that test employees, drug testing increased from twenty one and a half percent to almost eighty five percent in one six year period – a two hundred and fifty percent increase. Recent evidence suggests that drug testing has now leveled off and in fact has decreased slightly, but primarily among medium businesses. National studies indicate that sixty six percent of the country’s largest firms engage in some type of drug testing. Among Fortune 500 companies, during the late 1980s and early 1990s, drug testing likewise increased in use. For example, in 1985 about eighteen percent of Fortune 500 companies tested their employees. The number increased to a high point of forty percent by 1991. Among Fortune 1000 firms, forty eight percent of employees are subject to drug testing.

These are good trends overall, says Morris when asked about the increase in drug screening across the US. The weakness in screening program administrations (drug testing and background screens) by medium and large size businesses is the increasing focus of Labwires business model. We know what the solution is for tens of thousands of companies, and we are it, concludes Morris. With companies like Labwire, who are building affordable applications, coming onto the scene, maybe your call center manager will have better attendance on future Monday mornings.

Laura Betterly
Press Direct International

Pure Water Hydration in an Avian Flu Pandemic – The Value of Planning in Northern Virginia and the Washington D.C. Metro Area

A threat to the nations health is emerging in Asia and the Indian Sub Continent that has potentially devastating implications. Avian Flu (the H5N1 strain of Influenza A) is a fact in many parts of Asia, although to date the avian strain has not combined with human influenza in a sustained manner. If a new strain emerges in humans with the fatality profile of the H5N1 virus, the effect on the world population will be dramatic.

When the combination to create a human to human strain occurs however, and isolated cases may already involve human to human transmission, the conditions precedent to a world wide pandemic will be met. Pandemic flu is defined as a global outbreak of disease that occurs when a new influenza A virus appears in humans, causes serious illness and then spreads easily from person to person world wide. (Source: Grattan Woodson, MD, FACP) The original Avian Flu (H5N1) represents a deadly strain for humans with a 50% mortality rate and many experts believe that the pandemic could be equally lethal..

Pandemics occur when existing flu strains mutate and make their way from birds or swine to humans in a new strain for which humans have little no immunity. Historically pandemic influenza has caused widespread damage and death. Influenza pandemics are a regular occurrence in history.

Pandemics in History

To date, only influenza outbreaks account for pandemics and pandemics have occurred throughout history. Over thirty pandemics have happened in recorded history. All influenza pandemics infect many times more people than normal seasonal ( flu caused by viruses that are already among people) influenza outbreaks. In addition major pandemics can have severe adverse effects on the economy and daily life.

Three flu pandemics occurred in the 20th century with differing levels of intensity..

The 1918 Spanish Flu Pandemic- A “major level event” pandemic that accounted for over 50 million deaths world wide.( Originated in Kansas, USA)

The 1957-58 Asian Flu pandemic A minor level event pandemic that accounted for 36,000 deaths in the United States alone

The Hong Kong Influenza of 1968-69 A “minor level event “pandemic that accounted for about the same level of deaths as seasonal flu.

The severity of a pandemic depends upon the virus that causes it and the H5N1 Avian flu virus has proven to be particularly fatal to humans. One fact is clear: pandemic influenza will occur again it is only a question of when. When a virus starts to spread easily and rapidly among humans the conditions for a pandemic have been met.

The 20th century pandemic examples occurred in waves of illness of up to three waves over a 9-12 month period. Often the first wave was not the most severe. During the 1918 Pandemic, over 90% of the deaths of the pandemic occurred during the second wave.

Human Impact on Virginia of a Medium Level Event

Northern Virginia is a densely populated, high technology corridor adjacent to Washington, D.C.. Because of the buildup in the Homeland Defense industry as a result of the war on terrorism, the population is large and experiencing rapid growth. Many of the new comers are young professionals with young families.

Based upon historic data a medium level event, more serious than the Asian Flu Pandemic of 1957-58 but not as severe as the 1918 Pandemic, will result in the following estimates for the State of Virginia:

2,700 to 6,300 deaths

12,000 to 28,500 hospitalizations

575,000 to 1.35 million outpatient visits

1.08 million to 2.52 million people becoming sick

Estimates for losses from a major level event are significantly higher.

Infrastructure Impact

In addition to human damage, the effect on the infrastructure will be considerable. Having a large number of ill people will be very destructive to the infrastructure. A major pandemic will likely disrupt essential public services and supplies and create temporary breakdowns in food delivery, electric and water utility service and possible public order in major urban centers. These critical industries are highly dependent on raw materials supplied by vendors and key employees with the expertise to maintain operations.

An Integrated Economy

The United Sates enjoys the benefits of a highly integrated economy with highly efficient delivery of goods and services and rapid communications. This level of integration allows for more efficient management of material inventories but would break down rapidly in the event of dislocation in any part of the chain. Basic industries like electrical and water utilities would soon cease to function. Disruption of channels of distribution for the food industry would result in rapid and near total shortages of food and water.

What Can Be Done to Prevent a Pandemic?

Flu Shots and the Pandemic

Standard flu shots for seasonal (normal) flu will not guard against a new pandemic strain of the flu virus because each new flu mutations have different DNA characteristics. For new strains it takes many months to develop and distribute a vaccine and during this time the new strain will most like have run its course.

Anti-Viral Treatments

Presently, the only available anti-viral antibiotic effective against the H5N1 strain of influenza is Tamiflu (oseltamivir) . This drug is in short supply, requires a doctors prescription and is not manufactured in the United States. Other anti viral antibiotics are in the development stage but are not proven ready for production.

What Can Be Done to Prepare for a Pandemic? Prepare Now!!

Preparing now can limit the spread and effects of pandemic influenza. A pandemic would touch every aspect of society, so every part of society needs to prepare. Essential services may be disrupted, food and water supplies may be limited and medical care for those with chronic illnesses may be suspended..

Although most people will have little or no immunity to pandemic influenza, in the event of a flu pandemic proper planning and preparation will help mitigate the damage. Planning has already begun at the international, federal, state, local, community and individual business levels but experts agree that all planning must start at the family level.

The family will serve as the core of wellness and remedial care since hospitals and other health care provides will become quickly overrun with patients if a major level pandemic occurs.

As a basic unit of society, the family can provide first line care and prepare a preventative survival plan that can be rapidly implemented. These plans include improvement of basic hygiene, assembly of food, water and medical supplies and protocols for avoiding infection. Management of the protection of the family unit, with proper planning, can significantly reduce the impact of a pandemic.

Federal, state and local internet sites are the best source to help develop workable and effective Family Survival Plans. The State of Virginia and local counties in Northern Virginia like Fairfax County have initiated plans and planning out reach that will help mitigate the effects of a pandemic. Like all disaster plans, there is nominal cost associated with proper planning.

There are two parts of planning: resource planning and home treatment planning. Resource planning involves the stock piling of food, water, regular prescription and non prescription drugs and strategies for home care of infected individuals. Home treatment planning involves specific actions to treat infected individuals.

A key aspect of home treatment is treating dehydration.

Planning for the Treatment of Dehydration

As part of an overall pandemic disaster survival plan, the role of hydration cannot be overemphasized. The human body can survive for weeks without food but only days without water.

Preventing dehydration ranks highest of all treatments for influenza and many experts feel that preventing dehydration in flu victims will save more lives than all other treatments combined. (Source: Preparing for the Coming Influenza Pandemic by Grattan Woodson, MD, FACP)

Most family survival plans provide for a sufficient supply of drinking water to last for an extended period in the event that normal drinking water supply is disrupted. Pure water is required for both drinking and cooking. Many estimates call for 1 gallon per person per day for as long as the normal supply is disrupted.(At least two weeks and possibly more).

A good source of bottled water is required since normal supplies will be disrupted.

How to Choose a Water Supplier:

A family pandemic disaster plan needs to provide for a consistent source of pure drinking water. Tap and well water are unreliable sources during a pandemic and bottled water is considered the best source by many experts.

Purified water, because all minerals and contaminants have been removed, is the purest water and has the longest shelf life of any bottled water. Extended shelf life is important if the pandemic is extended by subsequent waves of infection.

Many believe that distilled/filtered/oxygenated water is the purest, best tasting water with the longest shelf life.

Pick a supplier with local manufacturing in the Northern Virginia area to avoid home delivery disruption. In the event that a pandemic disrupts channels of distribution, avoid bottled water suppliers who source their product from remote springs with long supply lines.

Although no one can predict with certainty the timing and virus strain of the next pandemic, the risk of an influenza pandemic is serious. Proper planning will serve to mitigate the effects of the pandemic.

Like all disaster planning, a small amount of serious planning is cost effective and good insurance to maintain good health. Plan for the worst and hope for the best.

A laxative is defined as,

A substance that is used to promote a bowel movement when you are constipated.

Laxatives work by starting and stimulating peristaltic action. Peristaltic action is a wave like movement that occurs throughout your gastrointestinal tract esophagus, stomach, small intestine, colon that helps move your food into your stomach, through your intestines, through your colon, and out your rectum.

There are drugstore products, natural occurring foods, special nutrients, liquid preparations, herbal substances, and homeopathic liquids that have laxative effects. I do not recommend using drugstore laxatives or any other form of drugs to clear a constipation problem.

All my recommendations are for using natural foods, minerals, special nutrients, or herbal products. And some of these natural methods should also be used only for the time it takes to clear your constipation.

Recommendation: You should use Drugstore laxatives or drug laxatives only under Doctors recommendations.

There are no safe drugstore laxatives. These laxatives are habit-forming and work by desensitizing your colon. Their use can irritate nerves and muscles along the intestinal lining, interfere with digestion and adsorption, cause cramps, deplete fluids, and create other physical internal problems.

Laxatives can enlarge and seriously damage your colon when used for a longtime. Eventually, after continual use, you will not be able to have a bowel movement without using them.

If you have been using laxatives for a long time, you will have to retrain your colon to activate peristaltic action. This training will have to be done under the care of a medical practitioner. If you are tempted to use drugstore laxatives remember that,

Laxatives bought in drugstores are of questionable safety. Because of the action these laxatives have on the small intestine and colon, doctors and other health practitioners recommend their limited use since they,

* have chemical side effects that affect your health

* produce an active force that can damage nerves that control the muscles in your colon walls

* desensitizes your colon so your natural peristaltic action is reduced

* become habit-forming

* rush food through your intestines so it does not digest and absorb nutrients or minerals properly

* kill friendly bacteria, unless they are fiber foods

* contain preservative, coloring, and other additives that are unhealthy.

* Remove excessive fluids and electrolytes from your body.

Recommendation: Never use a laxative, Drugstore or Natural, when you have acute abdominal pain, especially if the pain is on the lower right hand side, where the appendix is located. See your doctor right away.

Using Laxatives for the wrong reason can be life threatening.

If you use drugstore laxative, use them for just the time needed to clear your constipation. Then starting looking at what it takes to stop your constipation from occurring.

Whats one of the best ways to prevent osteoporosis? According to many experts in the field of bone health, its exercise. More specifically, strength training offers many benefits for men and women at risk of bone loss from osteoporosis.

Strength training, also called resistance training, uses resistance from free weights, resistance bands, and water exercise or weight machines to help build strength in muscles. It also can help work on the bones to prevent the loss of minerals that weaken them. In fact, according to sports doctors, strength training can increase your bone strength, reduce your risk of osteoporosis, improve the strength of your connective tissues, which increases joint stability and increase the functional strength of your muscles.

If you already have osteoporosis, say doctors, strength training can still benefit you in many ways, but you should work with your doctor or an experienced physical therapist to design a workout that will benefit your bones without increasing the risk of stress or compression fractures.

If your main intent is to prevent osteoporosis, you should work with heavier weights and more resistance. A study conducted at the University of Arizona and published in Medicine and Science in Sports & Exercise gives some answers to that. In that study, scientists recruited 140 post menopausal women with a history of sedentary lifestyle for a year-long regimen of three times weekly workouts. The women performed eight exercises specifically chosen to work on particular muscle groups .Scientists took bone scans both before and after the study. The results showed that the chosen exercises had a measurable effect on the bones of the hips, site of the most common fractures in post menopausal women. They also found that the greater the amount of total weight lifted over the course of the year, the greater the benefits to the bones.

If youre just starting a resistance and strength training program, doctors and physical therapists offer the following tips:

Consult your doctor and follow a program designed by a physical therapist which takes your strengths and needs into account.

Work out at a gym or health club under the supervision of professionals who can help monitor and adjust your workout program.

Start slow and build gradually. Strength and resistance training is a slow process.

Never increase weights in resistance training more than 10% at a time. Increasing more than that risks injury.

Lift and lower weights slowly. Avoid jerking them up to avoid injury.

Perform your resistance workout every third day.

Avoid exercise that puts a lot of strain on your joints and bones, and stay away from the rowing machine. The bending required puts your spine at risk of compression fractures.

If any area is particularly tender or stiff immediately after a workout, apply ice to it for 10-15 minutes to reduce inflammation.

Proper exercise, weight control and a healthy diet all contribute to keeping your bones strong and preventing the loss of bone density due to osteoporosis. Do your bones a favor and give them a good workout a couple of times a week.