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Getting ready for flu season

Influenza (“flu”) season is unpredictable but usually starts in October each year and peaks around January or February. The Centers for Disease Control (CDC) currently recommends annual flu vaccination for all people older than 6 months. Getting vaccinated is particularly important if you or someone with whom you live has a chronic medical condition, like asthma or chronic obstructive pulmonary disease (COPD).

Here are some things I want you to know about influenza and vaccination:

First, influenza is a serious medical illness that can lead to hospitalization and even death. Annually, up to 200,000 people are hospitalized for influenza. Sadly, the H1N1 outbreak in the 2009 – 2010 flu season caused about 12,000 deaths.

Second, influenza vaccination is the best way to prevent you from getting the flu.

Third, you cannot get sick from getting the flu shot! Some people ...

Eliminating your risk for stroke

In the clinic, we work with stroke patients and their families to help them understand the risk of having a second stroke and what they can do to reduce their risk. Lifestyle and medical conditions determine your risk for a first, or second, stroke.

  • Do you have high blood pressure and/or high cholesterol?
  • Do you have diabetes?
  • Have you been diagnosed with atrial fibrillation?
  • Do you smoke?
  • Are you overweight?
  • Do you avoid exercise?
  • Has a close relative had a stroke?

If you answered yes to any of those questions, you’re at greater risk for having a stroke. If you’ve already had a stroke, your “yes” answers mean you’re more likely to have another one.

Your lifestyle can help you avoid a first or second stroke. And, because family history is a stroke risk factor, your entire family can benefit from a healthy way of life. Pledge to help each other stick to a routine that includes:

  • No smoking
  • Healthy eating
  • Regular exercise
  • Taking medications are directed
  • Losing weight if you are overweight or obese
  • Drinking alcohol only in moderation
  • Taking low-dose aspirin or a similar medicine (if recommended by your doctor)
  • Managing your blood sugar if you have diabetes.

What to do when Seattle gets hot

The area is heating up. The National Weather Service has announced an excessive heat watch for this Thursday and Friday, with temperatures that will rise into the low to mid 90s. When outside temperatures are very high, the danger for heat-related illnesses rises. Older adults, young children, and people with mental illness and chronic diseases are at particularly high risk.

Here are some safety tips to avoid overheating and things to consider for the weekend:

Stay cool:

  • Spend more time in air conditioned places. If you don't have air conditioning, consider visiting a mall, movie theater or other cool public places.

  • Cover windows that receive morning or afternoon sun.

  • Dress in lightweight clothing.

  • Check up on your elderly neighbors and relatives and encourage them to take these precautions, too.

Drink liquids:

  • Drink plenty of water; this is very important. Avoid drinks with caffeine, alcohol and large amounts of sugar because they can actually de-hydrate your body.

  • Have a beverage with you as much as possible, and sip or drink frequently. Don't wait until you're thirsty to drink.

If you go outside:

  • Limit the time you're in direct sunlight.

  • Do not leave infants, children, people with mobility challenges and pets in a parked car, even with the window rolled down.

  • Avoid or reduce doing activities that are tiring, or take a lot of energy.

  • Do outdoor activities in the cooler morning and evening hours.

  • Avoid sunburn. Use a sunscreen lotion with a high SPF (sun protection factor) rating.

  • Wear a hat or use an umbrella for shade.

What test is best for breast screening?

I often get asked why can’t a woman just get a breast MRI rather than a mammogram. The imaging tests that we do for breast cancer screening and evaluation of abnormalities have different strengths and weaknesses.

Mammograms are very useful as a screening tool. They can be done quickly and read efficiently by the breast radiologist. They have minimal radiation exposure. They can be done by a mobile coach in locations that are more convenient to patients. They are excellent for identifying abnormal calcium deposits within the breast tissue and for seeing disrupted tissue and masses. They may be less effective in women who have dense breast tissue but the digital techniques have helped some with that. 

Ultrasound is a great tool for evaluating a mass or tissue asymmetry found on mammograms. It can distinguish between a benign appearing solid mass, a fluid filled cyst, a mass that is suspicious for cancer, or normal appearing breast tissue. There is no radiation exposure. It is less reliable as a screening tool because it can be dependent on the skill of the physician or technologist doing the procedure. It is possible to miss abnormalities or to mis-interpret normal findings as abnormal. There are studies underway evaluating using an automated version of ultrasound as a screening test but the results are not conclusive and this is not considered ready for standard practice.

Breast MRI is a highly sensitive test that is very dependent on...

Getting a mammogram

Frequently women will ask me: Where should I get my mammograms? There are several things to think about.

First, you want to go to a Center that is accredited by the American College of Radiology. This means that they have high quality images and well-trained radiologists. It is preferable to have a digital mammogram but if that technology is not available, then film mammograms are better than not having one done. While it is not clear that digital mammograms improve survival, they do allow the radiologist to examine the images more clearly and to use computer assisted diagnostic tools.

The radiologists’ experience is also important. Dedicated breast centers usually have radiologists who are specialized in breast imaging. These sub-specialized radiologists are very experienced in using mammograms, ultrasound, and breast MRI to diagnose breast disorders and are less likely to miss abnormalities.

Convenience is also a consideration. You want to make it easy to get your mammograms. Some Breast Centers will have mobile mammography programs that will bring mammogram screening to your place of work, local community or senior center, or even your church or synagogue. If possible, it is a good idea to get your mammograms at the same Center or within the same hospital system every year. That way the radiologists have easy access to your prior studies and can compare them to the current ones.

Here are some other things to know about getting mammograms:

Gluten-Free in a Gluten-Filled World

For this French/Italian girl that grew up on bagels and loaves of bread, it wasn’t easy to read the lab results telling me gluten was the source of all my problems (digestive anyway). Despite a degree in nutrition, I’m here to break the news that it’s far from easy, not just for me, but the unfortunate waiter, the distressed party hostess, or the sibling that doesn’t quite understand why you are no help in devouring the Oreos.

This post is for anyone with a new diagnosis, those just coming to terms with an old diagnosis, and those that think that gluten intolerance might be a possibility. It’s also for the friends and family of those affected by celiac disease or gluten intolerance, and for those that just want to learn more about it.

What’s the deal with wheat, gluten, and these allergies?

Gluten is a protein found in wheat, rye and barley. You can be allergic to wheat, which is different than being gluten-intolerant (a broader category of things to avoid), which is different from having celiac disease. Here’s a little about each.

Celiac Disease

  • What it is: Not an allergy, but an autoimmune disorder that ....

When to get a second opinion

Dr. Carl Janzen and Dr. Mark Kasper discuss the importance of seeking a second opinion as well as when and why they can be most valuable:

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