Many factors are involved in understanding the prevalence of infectious diseases, including sanitation, nutrition, societal stressors, natural progression of the disease, and natural immunity. And a lot of these illnesses do not spread as much as they used to, thanks to improved nutrition, less crowded living conditions & improved sanitation, antibiotics, and vaccines.

How do immunizations work? Basically, a biological agent (the vaccine) is introduced into the body to stimulate its defenses against the disease, thus producing a state of immunity. If the child is later exposed to that particular disease, theoretically he/she is protected from developing any signs or symptoms of that particular disease. Sometimes one dose of a vaccine is not enough to protect a person for a lifetime; oftentimes, more than one dose is needed. Thus, many vaccines require “boosters”, separated by weeks, months, or even years.

The use of immunizations should conform to published policies and recommendations. There are two primary groups that publish such guidelines: The Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) (http://www.cdc.gov/vaccines/pubs/acip-list.htm) and the Committee on Infectious Diseases of the American Academy of Pediatrics (AAP) (found in The Red Book, or http://aappolicy.aappublications.org/).

The recommended vaccine schedule is evaluated each year, with changes announced in January, by the above agencies, in addition to the American Academy of Family Physicians (AAFP). The vaccines are scheduled for the age when the body’s immune system will work the best and will provide protection to infants and children at the earliest possible age. There are other “alternative” vaccine schedules out there that delay shots or space them further apart. These selective schedules encourage parents to give their kids vaccinations, just over a much longer period of time and typically requiring them to return to the office every 2 months for the injections.

Even if all manufacturers’ warnings and recommendations are followed, there may be side effects. The common side effects are swelling, redness, and tenderness where the shot was given, but they do not last long. Your child may also have a low grade fever and be fussy for a short period of time afterward. These symptoms are temporary and resolve spontaneously. It is very rare for side effects to be serious, but would include seizures, high fever (>103°F) and is <3 months old, or hives or black and blue marks in areas where the injection was not given. In these cases, it would be necessary to follow up with your primary care provider.

There are times when one should withhold immunizations due to risks or contraindications, such as when a child has a high fever, hypersensitivity to a component of a vaccine, patient is undergoing immunotherapy, or patient has altered immunity (children with cancer, those taking oral or injected steroids for lung or kidney conditions for example, should avoid live vaccines).

Whether to immunize your child or not is a difficult decision for many parents today. You must weigh the risks versus the benefits. Researching on-line or talking with family and friends can be overwhelming and confusing. Talk with your child’s primary care provider about your thoughts and concerns. Keep an open mind as you discuss all options. Check out the link that talks about each vaccine, the disease that it provides protection against, and how that disease is transmitted.

There are few easy choices as parents and there are virtually NO choices without consequences.

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NOTE:  All blog postings on the AFWC website are intended for purely educational purposes and not as personalized medical advice.  We advise you to speak with a healthcare professional before making any health or lifestyle decisions.

The Alaska Family Wellness Center is pleased to announce a new service available soon to patients, Autologous  Adipose-Derived Stem/Stromal Therapy!

Yes, we know that is a “mouthful” and may have caused a few eyes to glaze over. So let’s take that big term and break it down so you will understand what it means and how it may be of value to you.

“Autologous” refers to the fact that the source material for this treatment is harvested from your body, not another adult or a fetus but from you!  This means we are using your own body to heal yourself, just refocusing it. And there is no risk of an allergic reaction to a foreign substance.

“Adipose Derived” means we harvest these cells from your fat layer and most of us have some of that we are glad to put towards better use.  On women this is often on the outer thighs and on men it is on the abdomen or the “tires” on the sides. The other place sometimes used to harvest stem cells is the bone marrow.  However, our body fat has 500-1000 times more stem cells in a given volume than bone marrow and it is MUCH easier to harvest with much less discomfort.

“Stem/Stromal” refers to the special cells we harvest and use to trigger a uniquely natural but much more potent healing response.  The topic of stem cells has been much in the news recently.  The idea is that we all have cells that have the potential to be awakened into a replacement cell for a damaged or missing cell.  In our case, we use those stem cells to repair and replace damaged cartilage, ligaments, tendons or muscles. The reference to “stromal” tissue is the recognition that there is more going on with this technique that just stem cells.  Many of the other cells and materials harvested in this procedure play a key role in triggering this healing response.

How is this treatment used?

It is used to trigger the regrowth and repair of cartilage in arthritis or a torn meniscus, repair damaged and partially torn ligaments and tendons and finally in chronic muscle tears. This is especially good for those problems that haven’t responded to other forms of prolotherapy using dextrose or PRP, a concentrate of platelets sometimes used promote healing.

How is this procedure done?

We start by drawing blood which is then spun in a special machine to concentrate the platelets, known as Platelet Rich Plasma (PRP).  This takes a while so is being prepared while we harvest the stem/stromal cells. We do this by locating a good pocket of fatty tissue, clean the skin and numb the entry site for the fat harvest.  Then, using a technique very similar to liposuction a small volume of fat is harvested.  This is set up to settle out the layers and after a few minutes the stem/stromal cell level is isolated from the other layers. This is then mixed with the PRP in preparation for injection into the injured or damaged area.  We combine these two as they play different roles in the healing process.  Think of PRP as the brick mason who can do the repair of a damaged wall.  As long as he has some good bricks around, he can fix the wall on his own.  Think of the stem/stromal cells as the bricks and mortar.  When both are present the brick mason can rebuild the wall.  In reality, the “brick mason” is Dr. Fischer.  He uses an ultrasound machine to see exactly where the problem is located and puts the “bricks and mortar” stem/stromal cells and PRP on exactly the area where they are needed.  Patients have to avoid anti-inflammatory medications like ibuprofen to allow the natural healing process to proceed. The response time varies – some improve or resolve with one treatment and others need more than one treatment.  We generally watch for the slow change and resolution of problems over 1-3 months.  Sometimes we add a little boost to the process with a repeat of PRP injected on the problem area.

Watch our website and Facebook page for more information on this exciting new treatment!

Simply select the “Make A Payment” button in the lower right of any page on our website and you will be directed to Phreesia’s secure patient check-in.  Once you receive your next statement, simply log in and securely pay your balance, 24 hours a day, 7 days a week.  The Phreesia portal also has a Mobile display so paying on your smart phone is simple and easy!  The system will e-mail you a receipt as well.

Stay tuned as we publish further information to our website!

For many of us, cancer is one of the most fear provoking health challenges we have to face in this life.  And this is no surprise, considering its association with pain and disability, extremely toxic therapeutic interventions and worries about recurrence.  The field of oncology involves the warriors at the forefront of this battle and we honor and recognize their heroic efforts dealing with this terrifying disease.

But cancer, in my book, is one of those situations where the proverbial ounce of prevention is worth several tons of cure.  Medical science continues to gain ever deeper understanding of the process that leads to cancer and with that gives us ideas as to how to avoid cancer.

We need to start by acknowledging that the term “cancer” has a multitude of meanings to people and is in fact a vast array of manifestations. For the sake of simplicity we will use the term to refer to uncontrolled cell growth that has the potential to invade other tissues of the body.

Cancer is really a disease of our genes.  We may think this means we have inherited the problem from our parents but studies suggest that 5-10% of cancer is due to inheritable cancers.  What is the other 90%? – It is the stuff to which we expose our genes- the environment. More about that in just a moment.  At this time, we are unable to change those genetic risks other than recognizing who is at greater risk. For example a woman with a first degree relative with breast cancer has a 2 fold increased risk and with 2 first degree relatives with breast cancer a 5 fold increased risk, women of Eastern European Jewish descent have a dramatically higher risk of the BRCA1 and BRCA2 genes which in turn translate into an 80%  chance of breast cancer.  These women need to practice vigilance and be proactive about screening for cancer.

For most of us, cancer is the end result of the failure of our genetic repair systems. Over the decades of our lives we endure and repair damage to our DNA, but with time the damage can accumulate. Our cells handle literally 1000s of DNA “hits” per cell every day and efficiently handle those “hits” for the most part. At the end of our DNA strands is a section known as a telomere which maintains and repairs our DNA.  These are regulated by the enzymes known as telomerase.  Much research and speculation is now under way to fully understand the mechanism of telomerase and who to keep the system functioning. That discussion is beyond the scope of the note.  Suffice it to say this is an area rich with promise and already gives us some guiding principles to reduce our risks of cancer by protecting the activity of our telomerase enzymes.

So, there are several basic ideas we can derive from the research on basic science and epidemiology.

1. Focus on a diet based primarily on plant based foods.
2. Make an aggressive effort to avoid environmental toxins.
3. Maximize your body’s detoxification systems.
4. Avoid tobacco in any form.
5. Drink alcohol in moderation, if at all.
6. Maintain a healthy weight and be physically active daily.
7. Prepare and store foods safely.
8. Protect your skin from the sun
9. Get immunizations that reduce risk of cancer.
10. Avoid high risk behaviors.
11. Do cancer screening studies.

Over the next several blogs I will discuss each of these in greater detail to give you the tools to take charge!

The last 2 weeks have seen a sharp upsurge of people complaining of infections of all kinds but especially colds and sore throats.  No big surprise, we are a few weeks into the school year and kids are bringing bugs home to their families and passing them on to neighbors!  There are some things you can do to protect yourself:

1. Quality diet – Focus on whole foods, fruits, vegetables, quality lean protein, plenty of fluids in the form of water.   Choose the most colorful and freshest foods your budget allows for the best nutrition.  Avoid  sweets ( in general a good idea).
2. Sleep –  For most of us 7-9 hours is ideal. Few people can truly stay well with less and some  people need more.
3. Exercise – Something vigorous daily if possible and outside if possible – it will help you fight infections but if you are acutely ill it is likely best to put  that energy into recuperating so hold off on exercise for a few days.
4. Change of clothes – Have the members of your family turn over clothing frequently during the cold and flu season to reduce transmission of viruses in your household.
5. Wash hands and door knobs frequently – Once again to reduce the viruses visiting your household.
6. If you are sick, stay home and get well! - The temptation is for us to “tough it out” and go to work but that just means we expose our coworkers to the bugs.  Stay home to rest which tremendously helps your immune system.
7. Influenza vaccination – I think this is a simple measure that can help many people avoid significant illness.
8. Botanical support – I have found that the Chinese herb astragalus along with the extract of the black elderberry plant make a good combination to boost immune function to reduce risk of infection or shorten the course of a viral illness.  IMPORTANT: people with autoimmune diseases  should not use Astragalus but the black elderberry extract would be safe.
9. Fever – If you become ill and develop a fever, consider not medicating it away to allow your body to more effectively fight the infection.
10. If you develop a high fever( greater than 101.5) especially with sharp chest pain and/or shortness of breath or develop a sore throat with swollen nodes in your neck, persistent thick foul sinus drainage for over 7-10 days, you need to see your  health care  provider.
11.  Good luck!

We Alaskans know how precious the long days are in the summer and live them to the fullest. It has been a cool and rainy one this year but still the days have been long.  This time is short-lived, however, as September rolls forward with the return of kids to school and cold weather, the grasses and cow parsnips are turning from green to yellow.

Many Alaskans look forward to the shortening of the days, the falling of the light and eventually the arrival of snow and cold.  Others have a very hard time with the Dark Seasons.  For some this may be due to Seasonal Affective Disorder (SAD).  Simply stated, SAD involves the accumulation of too much of the sleep neurotransmitter, melatonin, in the brain due to the low light conditions of winter time.  In excess, melatonin makes us tired, promotes craving for carbohydrates and can even cause depression. The brain is designed to accumulate melatonin as the dark of evening sets on to put us to sleep and rest at night.  Then, as the sun comes up and shines on the sleeper then the melatonin production stops, levels fall and the sleeper awakens.

Our modern lifestyles involving artificial lighting and hours of awakeness that don’t correspond to the light cycle predispose us to problems.  This is markedly exacerbated with the extreme low lighting associated with the high latitudes of Alaska(“It’s dark when I go to work and dark when I go home!”) along with the cloudy skies prevalent here.

Some people are more sensitive than others. Some people have no problem with the low light and  even prefer it.  Others may become mildly irritable while others have difficulty functioning. This is a reminder of how unique we are, each a symphony  of genetics, lifestyles, behaviors and life circumstances put together of make up our experiences.

There are many ways of avoiding the issues of SAD.  The first step involves recognition of the problem. There is a questionnaire we use that identifies the patterns of SAD and depression. Second is to find ways to reduce levels of melatonin.

SAD lights have been developed for a simple approach.  These are lamps that use a fluorescent bulb that generates 10,000 lux (a measure for light brightness and 10,000 lux is really, really, really  bright!) It is important to have a layer of plastic between the light bulb and your eyes as the bulb produces ultraviolet light which is bad news for your eyes, the plastic absorbs that light.  Light brightness falls of using the rule 1/s squared, i.e., twice the distance away from the light source the light is 1/4^th as bright so how close you sit is important.  When you use the light is also important.  I generally tell people to use the light first thing in the morning for 30-60 minutes.

Getting outside during the middle of the day to get fresh air and a little exercise is also very helpful.  You will hear from me many times, diet is a cornerstone for all health.  In this case, avoiding processed foods and especially sweets ( sugar is a “psychoactive substance”) is key.

SAD is most effectively treated with the light if you start early. We generally suggest patients start now- early September- to avoid the accumulation of levels of melatonin.  It can be difficult to catch up once you get behind.

Vitamin D is also associated with light exposure and has an effect on mood but that is not affected by SAD lights and taking vitamin D won’t reduce melatonin levels.  More on vitamin D in a later blog.

A final important thought:  SAD  doesn’t always fully respond to the SAD Light and it can look like other forms of depression.  Depression can be an extremely serious, even life threatening disease if not addressed appropriately.  So, if you have concerns about SAD or depression,  please see a competent clinician who can help you find answers to your concerns.

To Your Health!

Our purpose is simple-to share ideas that promote health for all those who are interested.

We will help you keep well and reverse or minimize illness. As you know, awareness and knowledge empower you to take charge of your life!

Wellness is a dynamic process and requires ongoing work- you must exercise, eat well, reduce your exposure to toxins, develop loving and enriching relationships, link to something greater than yourself and pay attention to your genetics and the cycles of life.

This is a two way conversation; I invite your thoughts, comments, feedback to our blog!