Michael Carlston, M.D. - Family Practice & Complementary Medicine

Carlston, M.D.
Family Practice and Complementary Medicine

www.carlstonmd.com

April 28, 2009

Dear Patients,

Unfortunately, the topic of this newsletter exemplifies the need for this sort of rapid communication.

Yesterday morning we walked off our cruise ship in San Francisco to be greeted by the poor semi-indigent souls who pick up a few dollars working as porters helping arriving and departing passengers with luggage. As a physician, I am accustomed to interacting with homeless people, too many of whom suffer from poorly treated diseases, some of which, like tuberculosis, can be deadly. Imagine the irony when I noticed that they were all wearing facemasks, mandated to protect them from my fellow passengers and me.

Long time readers of this newsletter know of my critical response to the fear of avian flu expressed in the media and by some governmental organizations. You may also recall my discussion of the 1918 Swine Flu and how it was a different matter. This may turn out to be not such a serious problem, and there are very early optimistic indications. However, there is also reason for anxiety.

Influenza viruses are genetically very simple but also extremely changeable. To identify them, we use a genetic designation pertaining to the most important parts of their genomes (H and N). The genetic designation for Swine Flu is H1N1, because the archetype of the worst influenza was the Swine Flu pandemic 90 years ago. It was one of the worst biological disasters in human history, killing somewhere around 50 million people. Avian flu is H5N1. Avian flu is nasty, but presently almost never transmissible from person to person. The 1918 Swine Flu was as nasty as any flu has ever been and easily transmitted form person to person.

Today’s virus is H1N1, easily transmittable and lethal to some people, just as the 1918 virus was. Like the 1918 virus and unlike the usual influenza we see every year, this Swine Flu hits young previously healthy adults harder than anyone else. It is too early to be certain, but it may be that today’s virus is less or even much less lethal. It is spreading very quickly throughout the world, so we will know much more in the coming days.

Many of you have already asked me for my recommendations about preventing the illness. This newsletter seems to be the best way to convey them. Please understand that I am making these recommendations without yet knowing if this is the beginning of a truly horrendous event, or something we will be able to look back upon and chuckle about our needless worrying. I am, of course, very much hoping for a good case of the chuckles.

There are a number of things you can do to prevent the disease or minimize the severity of the illness. Vitamin D, for example, has been shown to reduce the incidence and severity of influenza specifically. Keeping well hydrated makes your mucous membranes more resistant to infections. I recommend working harder to do the right things for this next month or so, until the situation becomes clearer.

What to do?

Do all the things you should always do to take care of yourself, especially:

Keep hydrated – (keep your urine close to clear in the toilet)

Get enough sleep

Also be vigilant about your hand washing – soap and water work as well or better than the anti-microbial soaps, without raising the risk of other troubles. Alcohol-based hand cleansers are also fine. Make sure you wash your hands thoroughly (15-20 seconds), especially after contact with the public, before eating and after using the toilet.

At this time I would not recommend wearing a mask, but if the situation worsens, you should do so when out in public. Do remember to cover your nose and mouth with a tissue when you cough or sneeze and then through the tissue away.

If you become sick, do your part by resting at home, so that you recover quickly and avoid spreading your illness to others.

Vitamins

D3 – keep your blood levels over 50, or simply take 3-5,000 iu/day for the next month

C 2-3,000 mg

Mixed natural carotenoids (50,000 iu/day)

Herbs

Andrographis

Echinacea (purpurea and angustifolia – remember that if echinacea does not make your tongue tingle when you bite it, it is not of good quality)

Shitake mushroom

St John’s Wort (not if you are taking prescription medications)

Homeopathic remedies

Although we don’t usually think of specific homeopathic remedies as a preventive (except your own chronic remedy), it might be useful to take a specific influenza remedy like Oscillococcinum once every other day as a preventive.

If you develop symptoms

The symptoms of this Swine Flu are like other forms of influenza – fever, chills, cough, headache, body aches, sore throat and fatigue. Additionally, some experience nausea, vomiting and/or diarrhea. If you think you might have Swine Flu, contact me or another physician. There are other treatments, including prescription medications, homeopathic remedies and herbs, which might be useful. In addition, there might be a reason to send you in for testing to confirm that it is Swine Flu. Please note that current recommendations are that such testing should be limited to likely cases, so as not to overwhelm the laboratories

For more information

http://www.cdc.gov/swineflu/

http://pandemicflu.gov/faq/swineflu/

Best,
Michael Carlston, M.D.

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