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Eye twitching

Each of us has had one of the following scenes in our lives, we have either had one of eyelids twitch or we have noted it while looking at someone else. When it happens to you it is first an inconvenience but as it hangs around, it gets you to think, do I have a brain tumor, is this a seizure, do I have some other strange nerve disease?

For 99.9% of you there is no concern as this most often a benign condition. It is common in people who are under stress, or are going thru a stressful time. But there are other causes as well. Below is a list of possible causes that are a nuisance, avoidable and not dangerous:

-Tired/ exhausted
-Eye Strain- computer or over use. If you use a computer a lot, every 20 mins, look away and focus on an object 20 feet away and stare at it for 20 secs. 20-20-20 rule
-Caffeine- soda and coffee
-Alcohol – yes a few too many beers can cause it as well
-Dry eyes- from over use, medication (think antihistamines ) and contact lens wearing are a few causes of dry eyes
-Allergies – the interesting thing here is that histamine can cause twitching but also antihistamines can as well

If you have eye twitching, check out this list and see if you have any of these conditions, if you do try to correct the condition on your own. If you need the reassurance see your primary care physician and discuss the possible causes and what you can do. They will also give you other symptoms to watch for and be concerned about. These may include headache, visual disturbances, balance issues, each of these need further work up with your physician.

So if you are a stressed out computer programmer who takes antihistamines for their allergies, my only recommendation would be to not reach for a beer.

Flu Vaccines

Believe it or not, Summer is over and flu season is right around the corner.

Well each year we take a segment and do some flu education and information. This year there is an interesting twist. A study completed in England took a different view on what is the best time to get a flu shot. We all know the approximate time of the year to get the vaccine and we know the protection from the vaccine will last thru the flu season. Recently we have noted that as we age we need a high dose vaccine for those over the age of 65 and that vaccine is available again. Now we take a deeper look at senior vaccine times. This study which came out of Birmingham England shows that seniors who receive their vaccine between 9 am and 11 am have a higher response rate and offer greater protection to seniors when compared to seniors who received their vaccine in the afternoon between 3 pm and 5 pm. This is very interesting and is being studied again this year at multiple sites.

The thought is that it has to do with cortisol levels in your body, cortisol levels are at their highest about 1 hour after waking and decline as the day goes on. The hypothesis is that cortisol aids in the immune response for the flu vaccine. Future studies will verify this but for this year, it certainly would not hurt for seniors to receive their vaccines before 11 am.

Who needs a flu shot? Well lets start with seniors, they certainly need a flu shot. When we look at deaths associated with the flu, between 80-90% each year occur in individuals over the age of 65. Again this year we have the high dose trivalent vaccine for those individuals over the age of 65, there is also a new vaccine for seniors that has an adjuvant in it, which acts as a booster. All seniors should make sure they are receiving the high dose vaccine or the vaccine made with adjuvant. Essentially an adjuvant is a substance that makes the immune response stronger.

Another important change this year is that the Flu Mist will not be available. Remember earlier in the year we discussed the study that showed the Flu Mist did not provide a strong immune response and therefore the CDC has recommended that this not be used in the US. It appears it will still be available overseas. This year all the vaccines will come in the form of a shot. This is unfortunate for the individuals who do not like needles as it will be the only way to get protection. However there will be a vaccine that goes just under the skin versus the classic vaccine which is injected into your deltoid muscle. The intradermal vaccine may cause less discomfort than the vaccine that is injected into the muscle

The general public will have a few choices for vaccines this year. Historically we have always had a vaccine that protects us from 3 strains of Influenza. This year we will have vaccine that protects fro 3 strains and well as some vaccines that cover 4 strains.

As this is the 3rd year for the 4 strain vaccine I think we will start to see more transition to the 4 strain and away from the 3 strain. Although some vaccine is still produced using egg technology we have egg free vaccine as well for this who are allergic to eggs.

Which one will I get, I will be getting the quadrivalent (4 Strains ) vaccine that goes into the deltoid muscle in the arm. I know my arm will be uncomfortable but protection from that additional strain is important to me.

Just a few quick basic points that we try to cover each year.
The flu vaccine cannot cause you to have the flu, the vaccine is made from dead virus parts. There is no live virus in the vaccine

Yes you can still get the flu if you get the shot. There are 2 parts to this answer, the first is do we have the right strain in the vaccine, and the second is did you build up an immune response from the vaccine.

I got one last year why do I need another? This also has a 2 part answer. One reason is the strains of virus change each year and the second is your immune response will wain over a year.

How good will the match be this year? This we will not know until we start seeing flu in the US. We have sites that track and send in samples for testing and identification so the the tracking is done uniformly across the country

Why can’t the match be better? One reason is that viruses can mutate and as they change there is no protection so it is easy for them to spread.

Can you follow the tracking? Yes you can either thru the CDC which shows actual results or thru other websites that track internet searches (Google Flu was the first to do this)

The vaccine does not protect you as soon as you get the shot. The body needs 2 weeks for the immune response to build to a point you are protected.

How long is someone contagious with the flu. The bad thing about influenza is that you can be contagious before you have symptoms. So the individual who did not get the vaccine can actually spread it for days before they even know they have the flu
Will there be a shortage this year? The expectation is that we will have ample supply for those individuals who want a flu shot. Estimates are that close to 170 million doses will be available

Is Influenza dangerous? For most people influenza is just 10 days of suffering. High fevers, muscle aches, cough. However over 20,000 individuals die from Influenza each year. A large percentage are seniors. However diabetics, asthmatics and immunocompromised patients are also at risk for serious illness.