The benefit of the flu shot is that it reduces the likelihood of getting influenza by 88% in healthy adults. In elderly patients, it may also prevent pneumonia (which can occur secondary to influenza).
The only contraindication to getting the flu shot is a history of SEVERE allergy to eggs or prior flu shots.
Our office only uses the Trivalent inactivated influenza vaccine (TIV), which is essentially a dead virus. This vaccine is incapable of causing active influenza and is approved for use in patients with weakened immune systems. This vaccine may cause minor flu-like symptoms such as soreness, nasal congestion for 24-48 hours, but, no, it can not give you the flu.
When I diagnose patients with COPD, (for Chronic Obstructive Pulmonary Disease, an asthma-like condition that affects smokers), they usually stare at me in disbelief and say "how can this be due to smoking, I quit more than 20 years ago"? Here is how: Understand that we are all born with more lung function than we will ever need. That is important because when we work out to our maximum, it is usually our hearts that limit how much exercise we can do. Therefore, people can lose 20% of their lung function before they notice any impact on their exercise tolerance. In addition, our lungs continue to grow and expand until probably around our early 20s. After that, everyone will have a gradual decline in their lung function. For the vast majority, this will never result in any limitations because, again, we are usually limited by what our hearts can accomplish. But smokers are a different story. They will have an accelerated decline for 2 reasons. One is damage to the lung tissue itself, resulting in emphysema. This is a silent process that usually is only noticeable when someone has lost up to 50% of lung function. Patients usually present with gradual onset of shortness of breath. The other process relates to repeated injury to the airways. These patients have "chronic bronchitis" and are characterized by their stereotypical smoker's cough and frequent, repeat airway infections. Both the airway disease and emphysema result in accelerated decline in lung function, but it takes many years before it falls below a problematic level for patients. That is why most patients with COPD are diagnosed after the age of 50. There is clearly a genetic component whereby some light smokers can develop severe cases of COPD and some heavy smokers never develop it at all. In general, we believe that threshold at which someone has a significant smoking history is greater than 10 pack years (I.e. 1 pack per day for more than 10 years).
When I diagnose patients with COPD, (for Chronic Obstructive Pulmonary Disease, an asthma-like condition that affects smokers), they usually stare at me in disbelief and say "how can this be due to smoking, I quit more than 20 years ago"?
Here is how:
Understand that we are all born with more lung function than we will ever need. That is important because when we work out to our maximum, it is usually our hearts that limit how much exercise we can do. Therefore, people can lose 20% of their lung function before they notice any impact on their exercise tolerance. In addition, our lungs continue to grow and expand until probably around our early 20s. After that, everyone will have a gradual decline in their lung function. For the vast majority, this will never result in any limitations because, again, we are usually limited by what our hearts can accomplish.
But smokers are a different story. They will have an accelerated decline for 2 reasons. One is damage to the lung tissue itself, resulting in emphysema. This is a silent process that usually is only noticeable when someone has lost up to 50% of lung function. Patients usually present with gradual onset of shortness of breath. The other process relates to repeated injury to the airways. These patients have "chronic bronchitis" and are characterized by their stereotypical smoker's cough and frequent, repeat airway infections. Both the airway disease and emphysema result in accelerated decline in lung function, but it takes many years before it falls below a problematic level for patients. That is why most patients with COPD are diagnosed after the age of 50.
There is clearly a genetic component whereby some light smokers can develop severe cases of COPD and some heavy smokers never develop it at all. In general, we believe that threshold at which someone has a significant smoking history is greater than 10 pack years (I.e. 1 pack per day for more than 10 years).
In May, 2006, Chantix became the third FDA approved medication for smoking cessation. In order to attain FDA approval, Pfizer, the manufacturer of Chantix, needed to convincingly demonstrate through a rigorous series of clinical trials that the drug was more efficacious than placebo or the combination of other two approved drugs for tobacco cessation. The other two drugs that are approved for smoking cessation are Zyban, an antidepressant whose mechanism of action is unknown, and the nicotine patch, which works by substituting the nicotine in cigarettes with a prescribed amount of nicotine in the patch. Other methods used for tobacco cessation, e.g. hypnosis, have not been proven in clinical trials to work.
The results of the clinical trials were impressive. After 12 weeks, success rates for quitting were:
The most common side effect was nausea.
Chantix works by both blocking the nicotine receptors in the brain and also stimulating those same nicotine receptors at a low level. This is believed to block the craving effects for nicotine but prevent the withdrawal signs. The nicotine receptors in turn can cause dopamine release. This is probably the reason for many of the reported side effects such as nausea and vivid dreams.
The problem has arisen that some believe Chantix may cause worsening of underlying neuro-psychiatric conditions. This concern should, and I believe is, taken seriously given the mechanism of action of Chantix. The drug has not been pulled from the market, but it now carries a new warning and further surveillance is being performed. Aside from some sensationalized accounts of Chantix’s effects, most patients seem to tolerate the drug without much difficulty, so long as a physician follows them on it. Even the harmful effects being reported are completely reversible when the medication is stopped.
For patients who wish to quit smoking, but have not had success through other measures and do not have any underlying psychiatric condition, Chantix is certainly still worth consideration.