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Tuesday, June 17, 2014

Effects of chickenpox vaccine on development of shingles yet to be seen

As published in the Washington Observer-Reporter

As though chickenpox isn't enough of a scourge on its own, the virus (varicella-zoster virus) that causes the itchy blisters also gifts humanity with pox's daughter, shingles.

Commercials, brought to Americans by trusty pharmaceutical companies, have taught that one must have had chicken pox in order to be at risk for shingles later in life. The virus that causes both illnesses takes up residence inside nerves until a chance to reemerge later, such as times of increased stress, trauma or immune system compromise.

While this is true, the effect of the chickenpox vaccine, which was first recommended for routine use in 1995, on the incidence of shingles is a slightly more complicated topic. These individuals' immune systems never actually fight the virus but are exposed to it just enough to develop antibodies capable of preventing an actual infection in the future. But, is this low-grade exposure to the varicella-zoster virus enough to cause shingles?

An informal poll of physicians yielded conflicting answers to this question, with many siting the "promise" of shingles prevention as a part of the presumed value of the chickenpox vaccine when it was first promoted.

On the other hand, a recent study discusses a six-fold increase of shingles across all age groups, including children.

The answer seems to lay in the somewhat unpredictable behavior of live attenuated (or weakened) vaccines.

"Since the (chickenpox) vaccine is a live virus, it's possible that the attenuated virus lives in your nerves just like the real varicella-zoster virus," said Dr. Marc Yester, a pediatrician at Peters Township's Pediatrics South. "That makes it possible to reactivate like the real virus; although, it would be a lot less likely to, and, if it did, it should be a much, much milder version."

The "would" and "should" are the result of timing.

"We're just now seeing how the varicella vaccine works as kids grow up," said Dr. Yester, noting that those first vaccinated are around only 20 years old.

A complete answer to the question may not come for quite some time as the number one risk factor for shingles is increasing age. It is estimated that 50-percent of those living to age 85 will have an episode of shingles with 32-percent of Americans expected to have an episode during their lifetimes.

Varicella-zoster virus may cause both chickenpox and shingles, but their rashes have personalities all their own differing in both distribution on the body and pain.

"The location (of shingles) is going to follow one nerve and show up only in the area the the nerve covers," said Dr. Yester. "But, the standout feature is the pain; Very few rashes come with this kind of pain."

Pain that is preventable up to 50-percent of the time by the shingles vaccine, available to those 50 years old or older. Not only does the vaccine prevent these unpleasant episodes, but they also work to decrease the incidence of the chicken pox since shingles, too, is contagious with direct contact--an improvement upon the chickenpox which is also communicated when the individual coughs or sneezes, sending the virus into the air.

While society and scientists wait to witness the effects of the chickenpox vaccine on developing shingles, we can speak in terms of odds.

"It does not surprise me that people can get shingles even if they've been vaccinated," said Dr. Yester. "The vaccine doesn't put up a force-field around us, but having the vaccine should lower the risk."

Thursday, June 5, 2014

Correcting the half-truths of new parent advice

There are the things you're told about being a new Mom (Yes, proper noun.); There are the things you aren't told; And then, there are the things you're told but fail completely in their quest to represent reality.

This list is to correct those lies by omission.

1. Baby clothing sizes are just as whacked as the sizing of women's jeans.

There's teeny three months, huge three months and "three months years". 

The only thing left to do is change the lighting in Carter's to make you look like total crap.

2. Newborn diapers are suitable for 5-8 lb. babies…who make very little urine.

When my "early term" (read: almost premature) baby was still a feathery seven pounds, he began to literally pee through newborn diapers. Each diaper-soaking was, in fact, a complete costume change, until a lightbulb when on: Try a size one.

Size one diapers made my son appear to have quite the badonkadonk, but a dry badonkadonk it was.

3. Each lactating breast has a unique personality…and then they switch.

Like a set of menacing twins, this formerly seductive pair seeks to astonish and confuse. Just when you become accustomed to Leftie behaving as the Niagara Falls of milky cocktails, it then takes coaxing and empty promises to do its work…just before you rename it Cybil.

4. Follow your gut. "Mom" and "Dad" are credentials unto themselves.

On day nine of my son's life, I had a melt down: He was not pooping on schedule. His rectum had not read the text book, and it sent my stress level into the stratosphere.

My husband calmly asked me, "Do you honestly think there's something wrong, or are you freaking out because of what a lactation consultant told you?" The truth was in the latter part of his question, but I didn't have the confidence to trust myself or even him.

I was completely wrong.

There will come a day--and that may be on day one--when your baby cries, and you know exactly why. It isn't necessarily because of the tone of the cry or because "he acted this way the last time he _____", but just because you know.

It's the privilege of being present since this being was a cluster of cells. Trust yourself.

5. Stock your pantry with healthy foods…that can be prepared with one hand.

Buy healthy foods, they say. Cook meals ahead of time, they say.

"Breastfeeding burns more calories than growing a baby."

"Eat several small meals throughout the day."

The parrots who assault our eyes and ears with such advice said nothing about accessibility.

Our house was filled with uncut and unwashed veggies just after our son was born, as were blocks of celebratory cheese ("celebratory" because they were "illegal" in the prior nine months) and honey wheat pretzels that were kept under the padlock of an unopened, noisy, cellophane bag.

At 4 a.m. with a sleeping newborn nestled in the crook of your neck, an unpeeled carrot might as well sing nah-nah nah-nah nah-nah in your unwashed, haggard face.

Want to help new parents? Yeah, the lasagna is nice, but the more practical, appreciated option might be a large container of washed/peeled/cut veggies and fruit, cheese and any other healthy, easy-to-eat option for the 4 a.m. blood sugar plummets.

6. The back pain while pregnant is nothing compared to the back pain with a newborn.

Whether breastfeeding or bottle feeding, the Cirque du Soleil-like contortions of your upper body know no bounds.

If you are breastfeeding and your nipples look as though someone walked over them in cleats, the initial few seconds of each feeding inspires all sorts of subtle and overt clenches that would send any yoga instructor into convulsions.

Before you know it, your jaw is clamped down so tight that it feels like you've eaten five tablespoons of peanut butter; You've hiked your shoulders up so far toward said peanut butter mouth that severe scoliosis would be an improvement, and, generally, you look like the Hunchback of Notre Dame.

Keep calm, and remember that you can now take ibuprofen.

7. Your baby's clothes will fit for approximately five days.

After heeding the advice of the Moms who came before me, we owned only two newborn outfits, with an eye toward several 0-3 month ensembles.

Despite our son weighing over seven-and-a-half pounds, he positively swam in many of the 0-3 month outfits, leaving his feet curled up to his chest while the legs of his fleecy sleepers dangled below him like the limbs of a cheap puppet.

Magically, several weeks later, these outfits fit: The elasticized wrist bands met his delicate wrists and the footies, in fact, held his tootsies. (Because, several weeks after the birth of your child, you will talk like this.)

You bask in the glow of how cute your little bundle looks in his now well-fitting wardrobe. And, a handful of days later, you'll go to bed, only to wake up to 12 pairs of socks whose heel pockets lay at the middle of your baby's foot and footed pajamas whose fibers are holding on for dear life with every baby stretch.

In short, your baby will look like Harry Potter dressed in Dudley Dursley's cast-offs for huge portions of his first few months.