Restless Legs Syndrome (RLS) is a condition of “pins and needles” in the the legs. It causes sleep loss, stress, and fatigue. Women are are twice as likely to be affected than men. Symptoms continue over time. By age fifty, it could progress to sleep disruption with daytime sleepiness. Hypertension, headache, and memory problems develop.

Twenty five to seventy five percent of affected people have a family history of RLS. Eighty five percent have difficulty falling asleep and daytime grogginess. 

Symptoms could be triggered by low blood iron, magnesium, and folate. Five to fifteen percent of the adult U.S. population may be affected. It’s more common in the elderly, but a third of severe cases have symptoms before age twenty. 

Nocturnal leg movements at night disrupt sleep. The condition gradually progresses in people over fifty. Those with a RLS family history could have symptom onset at age forty five. An overnight sleep study verifies the diagnosis. 

Prescription medicines used to treat RLS include Ropinirole (Requip), Pramipixole (Mirapex), Rotigotine (Neupro), Carbidopa/Levdopa (Sinemet), Gabapentin, (Neurontin), Enacacarbil (Horizant), Opioids (Codeine), muscle relaxants (benzodiazepines), and Pregabalin (Lyrica). 

Blood testing for magnesium, thyroid-stimulating hormone (TSH), Vitamin B-12, and serum folate is reasonable to rule our low levels of these hormones Exercise and stretching reduce symptoms. People with mild RLS should consider limiting caffeine and alcohol. 

 

Source:  http://emedicine.medscape.com/article/1188327-treatment

“If there is anything that links the human to the divine, is the courage to stand by a principal when everybody rejects it.” Abraham Lincoln.

 

http://emedicine.medscape.com/article/1188327-treatment

Have You Had Your Flu Shot?

     

Have You Had Your Flu Shot?

        Thousands of people in the U.S. die from the flu and its complications. Most fatalities are the elderly, young children, and those with a weakened immune system. Flu vaccine decreases of risk getting the flu. It is altered every year to protect people against strains expected in the late fall. The virus spreads person to person through respiratory droplets.
        The current “trivalent” vaccine protects against three virus strains. There is a “quadrivalent” vaccine that protects against four strains. These vaccines are available in an injection and nasal spray. They contain killed (inactive) viruses. They are approved for people six months of age and older.
         People who receive the vaccine might have a low-grade fever for a day or two. A higher-dose version is available for those sixty five and older. It is injected into the muscle or below the skin. Nasal spray flu vaccine contains live, weakened flu virus. It is approved for those people two through forty nine. It is recommended for people with asthma or children under five who have episodes of wheezing. It is not recommended for pregnant women.

           Flu vaccine should be received at the start of the flu season, usually in October. It can be given as late as March and still providing protection. The Centers for Disease Control and Prevention (CDC) recommends that everyone six months and older receive the vaccine. This includes:

·         Pregnant women or women who will be pregnant during the flu season;

·         Children six months to five years of age, especially those under two years of age;

·         Household contacts and caregivers of children under six months, including breastfeeding women;

·         Health care workers and those who live with health care workers and people who have long term lung or heart disease; 

·         Those with sickle cell anemia.

·          People who live in a nursing home or extended care facilities

·          People living with someone who has long term health problems.

·          Those with kidney disease, anemia, severe asthma, long term liver disease, diabetes, and chronic anemia.

·          People who have a weakened immune system, including cancer and AIDS.

·          Those who take physician-prescribed long-term steroids.

·          People nine and older should get a flu shot every year.

           Children six to eight years should get two flu shots at least one month apart, if they are receiving the vaccine for the first time.  Most people have no vaccine side effects. Soreness at the injection site and minor aches, or low grade fever could occur for several days. Likelihood of a flu-induced allergic reaction is rare. The seasonal flu vaccine is safe for pregnant women and their babies. Side effects of the nasal spray vaccine could include fever, headache, runny nose, vomiting, and wheezing. These symptoms are not severe of life threatening.
         Flu vaccine is not recommended for those under six months, people with a fever illness or moderate to severe reaction following a prior flu vaccine, those who have a fever or illness more than "just a cold," moderate or severe reaction from a prior flu shot, “Guillan-Bare Syndrome” within six weeks after receiving the vaccine, sickle cell anemia, and “certain blood disorders.”
          This current year’s vaccine is “recombinant.” It is not made from chicken eggs. However, people who are allergic to chickens or egg protein should notify their health care provider before receiving the vaccine.

 Source: Centers for Disease Control and Prevention (CDC). Summary Recommendations: Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP) United States, 2013-2014.
Source: http://www.cdc.gov/flu/protect/keyfacts.htm
Questions or comments: contact Dr. Clem at Clement.hanson@blogspot.com.