Alert! The swine flu has marched its coughing army of viral genetics into your safe haven... it has blown its way into your home.
The porky enemy has infiltrated your territory. The siege is over and the swine have broken through your defenses. Your walls are breached and your pants are down. There are piglet particles everywhere.
Some of your team have been compromised, maybe even your second-in-command (your spouse). What do you do? Are you going to give up? Are you going to throw in the towel and run out screaming, 'the piggies are coming, the piggies are coming'? No! Heck, no!
You are one tough mommy! You don't fall weak at the sight of puke and pustules. You are supermom or superdad. Your motto is: 'Never give up! Never surrender!' Okay, so that's the motto from Galaxy Quest, but you borrowed it and tattooed it on your buttock.
So now that you have built up the resolve to take down the enemy swine, what do you do next? You do what any normal military person would do, you hedge off the areas that have been compromised, tend to the wounded, and do your best to keep from becoming a military casualty yourself.
At this point in the war on H1N1, you know that the time for bellyaching and fear-mongering is over. Now is the time for buckling down, rolling back your sleeves, and heading N95 mask first into the pig pen.
You remember all those old movies about the crusty old army sergeant that forges back into the line of fire to save a fallen comrade: well, that crusty old sergeant is you. This is your moment; you have trained for it and you are going to kick some swine flu butt. You stand in front of your sickly family and shout, "Are you with me?!"
Okay, so your family looks at you as if you are the village fruitcake. Maybe the two-year-old applauds, but they all return to their beds moaning and you are left to tackle the flu on your own.
Well, you're not entirely on your own; the CDC has established some steps to lessen the spread of flu in the home. They have offered you the almighty handbook of "Security Lock-Down 101."
Rule 1: Solitary confinement. The CDC suggests keeping the sick person away from the other members of the household as much as possible, especially those that are high risk for complications from the novel H1N1.
I have to say here, how in the heck is that supposed to work if you have children sharing a room and the only other room in your house is the only last safe haven you have from children, or at least it is until 3 am when your toddler comes jumping into bed with you because the boogie man set up shop in their closet.
But anyway, the CDC suggests that you keep the sick person or persons in a room separate from the common areas of the house. ("For example, a spare bedroom with its own bathroom.") And keep the designated sick room shut at all times.
Oh yeah, a three year old child is going to love the solitary confinement while they feel like crap. How many three-year-olds do you know of that enjoy being absolutely alone when they need comfort from mommy or daddy? And I doubt the six-year-old sick child is going to stay put.
The curious thing about children is that they can and will play up until they are so sick that they can hardly stand. At that time, they begin to shows signs of lethargy and confusion. At that time, they should be visiting ye ol' emergency room, sporting a face mask. While we adults, the first moment we feel ill, we're done playing. (I'll talk about this phenomena more in my posts on hypo- and hyperthermia.)
Rule 2: Careful Transport of the Compromised. The CDC suggests that if the sick person does have to walk through they should wear a mask.
Rule 3: Hedge off the Enemy, Don't Allow it to Compromise Other Bases. Try to keep visitors to a bare minimum. Children when sick can transmit the virus up to two weeks after the last symptoms have gone. So if their friends come over to visit, there is a high likelihood that they can catch the disease and bring it home to their own families. And I'm sorry, misery shouldn't like company.
Rule 4: Keep Yourself From Becoming a Military Casualty. When holding your sick child to comfort them, hold them so that their chin is over your shoulder and turn your head away when they cough. If you come down sick then who cares for your loved ones.
Also, if possible try to wear protective gear to prevent the spread of infection. When leaving the patient's room, remove the protective gear to a designated location and wash your hands.
Rule 5: Clean the Barracks. Laundry should be washed with hot water and bleach if possible. Don't hug laundry to yourself when placing it in the washing machine. Use a laundry basket and gloves. After handling laundry, wash your hands and wipe the area with disinfectant.
In the kitchen, designate a specific set of dishes and utensils for your sick loved one to use. And wash those dishes in hot water in a dishwasher, if possible. Try to keep those dishes separate from the rest of your family's dishes.
Wipe down surfaces, bathrooms, door knobs, etc. with disinfectant sprays constantly.
Rule 6: Call in for Backup When the Enemy Becomes to Powerful. I have listed a series of signs in past blogs of when to go to the ER. Keep in mind that the H1N1 comes on fast. It doesn't wait for a few days to gather its strength, it hits you like a ton of bricks on the fastlane.
A lot of primary care providers are concerned, because of the possibility that patients can come into their offices with seemingly harmless symptoms and within less than 24 hours are in deep distress with full-blown H1N1.
On a single day, a particular hospital reported that there were 50 admissions for H1N1 with 19 of them being transferred to intensive care. The majority of these cases appeared at first looking like they had the common cold.
Recognize when to cut your losses and go to seek professional assistance.
Rule 7: Like all Things, This too Shall Pass. The truth is that I have seen many cases of H1N1 in this last week, where the family has recovered together. Careful planning and attention to warning signs will help you and your family stay safe this flu season.
On a serious note, please keep hydrated. Please get enough rest and vitamins. And for the love of Miss Piggy, please seek medical attention when you start feeling an illness come on quickly.
If you have any more questions concerning H1N1, please utilize the comments section of this blog. I will try to reply to your questions as soon as possible.
Written by Internal Medicine physician, Dr. Christine Princeton, D.O., also known as the Little Prepper Doc. This is an educational blog covering every day medicine, wilderness medicine and disaster preparedness.
Tuesday, October 20, 2009
Saturday, October 17, 2009
Three Little Swine Flu Pigs: Huff and Puff and Cough Your House Down
There's something to be said about humor in medicine. Some say it's the spice of life. I say it is the anti-nausea drug of the healthcare profession.
Seeing gross things all day, leaves you with two options: You either blow chunks or you laugh... then again, technically you can do both, but I wouldn't advise it.
For instance, when you see the montauk monster of all diseased masses sitting on top of a beating heart, you can easily find yourself heading for the horror flick, "Breakfast Strikes Back." Yet, one good twisted sonnet from the anesthesiologist about his love for the Beatles and your stomach settles.
Then again, it's not like physicians spend all day long laughing at everything to keep themselves upchuck-free. Seriousness has its place. In fact, you can always tell the danger of the case by the amount of humor that passes between the surgeons and hospitalists. If they are singing songs about the names of the new residents, then they are prepared for the case. If they are silent, its bad news and something unexpected of which they weren't completely prepared for, has happened.
The point of these blogs is to utilize humor in preparing now for the serious disasters that can occur later. And there is nothing more serious than witnessing one of your family members suffer from a life-threatening illness. When a loved one starts to suffer, the first response should be to roll back one's sleeves and to take care of them. It shouldn't be 'to panic.'
True, you do have to have the stomach for the work. Not very many people can cleanup puke without dry-heaving. You should have seen how fast my brother's house cleared out of people when his toddler vomited on the couch. Everyone screamed and ran like she was one of the undead coming to feast on their brains. All that remained of her siblings were dust clouds.
Yet, even if you are a little queasy in the face of blood, guts, and gore, if you know beforehand what to do, then you'll quickly adapt.
The ability to laugh during a time of crises is a sign of a well-prepared person. The preparedness I am talking about is not just collecting the temporal materials necessary to survive, but more, the knowledge and training that would keep you from panicking. So, in my blogs, I intend to do my best to help you become mentally ready to face the trials that lie ahead... or at least, the disaster and medicine-related ones.
In this post, I am going to start with the CDC recommendations for taking care of a sick person and in the following blogs, we'll elaborate more. Then that will conclude the H1N1 series and we'll start working on wound care in the wilderness and what to do in the event of an earthquake. (That's my favorite stuff!)
Now, let's roll back our sleeves and get cracking on what to do if someone in your house has contracted the virus. (The following words of advice are derived from the CDC standard of home care in the event that someone has contracted the novel H1N1: http://www.cdc.gov/H1N1flu/guidance_homecare.htm)
First and foremost, if you have children or teenagers, DO NOT give them aspirin (acetylsalicylic acid). Doing so could cause them to acquire Reyes' syndrome. It is an incurable and potentially fatal syndrome that affects all organs, especially the brain and the liver, resulting in severe encephalopathy (swelling of the brain) and a fatty liver. ( For more information on Reye's syndrome: http://www.ninds.nih.gov/disorders/reyes_syndrome/reyes_syndrome.htm)
The over the counter drugs that the CDC recommends are Ibuprofen (Motrin, Advil, Nuprin, PMS-bane, etc.), Acetominophen (Tylenol), and Naproxen (Aleve). You can give children's tylenol to a baby 6 months old or younger (please contact your provider for details) and both ibuprofen and tylenol to children 6 months of age or older. (See also, the American Academy of Pediatrics parenting corner at http://www.aap.org/publiced/BR_Infections.htm)
I do have to mention here that we live in a more is better society. More makeup will hide that zit. More sugar will fix the bad taste of my spouse's cooking. More cartoons will keep my kids from tearing up the house. If it works a little, then more is better, right? Wrong.
Well, let's just put it this way: the only time "more" is better in medicine is when you apply more love to taking care of your patients, and even then, there are times when more is definitely not better. So, please for the sake of all that is good and holy, don't apply the 'more is better' analogy to the above mentioned drugs. Please, just follow your health care provider's advice on dosing or you might end up doing more damage than good. (Image taken from http://www.drugbuyers.com/freeboard/ubbthreads.php/topics/907257/Re_Funny_gifs_post_them_here). For instance, a painful death can result from taking more Tylenol than the maximum dose allowed. [The maximum dose of Tylenol in an adult that is allowed is: 1g/dose(1000mg per dose), and 4g/24h (4000mg per day)].
If you drink more than three alcoholic beverages per day, then one, you really should talk to your doctor before taking it, and two, never use more than 2g (2000mg) per day. Avoid Tylenol, if you have liver disease.
In addition to that, the American Academy of Pediatrics strongly recommends that parents should avoid giving any over the counter cough and cold medications to infants and children under the age of 2 years old, due to the risk of harmful and life threatening side effects. Also, many studies have shown that cold and cough products are not as effective in children younger than 6 years old. (Please see: Common Childhood infections, American Academy of Pediatrics, 2005, updated April 2008.)
So in a nutshell, please seek advice from your primary care physician before taking any pharmaceutical agents, for dosage instructions and any possible contraindications that you or your loved ones may have. (For more information on the side effects of these drugs, refer to: the Food and Drug Administration: http://www.fda.gov/ForConsumers/ConsumerUpdates/default.htm. And also, http://www.tylenol.com/page.jhtml?id=tylenol/children/subchild.inc, and https://online.epocrates.com/u/10a307/acetaminophen)
As for when to seek emergency care, I mentioned in an earlier post about what signs to look for. If the person you are taking care of, or you yourself have any of the following, then please seek medical help immediately:
*Has breathing difficulties
*Has chest pain
*Is vomiting (unable to keep liquids down)
*Has seizures (uncontrolled convulsions)
*Has purple or blue discoloration of the lips
*Acts less responsive than normal or becomes confused
*Shows any signs of dehydration, such as decreased or absence of urination, sunken eyes, dry mucus membranes (inside of mouth is dry), lack of tears when crying (in infants), or dizziness upon standing.
* Has a high output of diarrhea (That is if diarrhea is present. The CDC has indicated that some patients may experience diarrhea from the H1N1.)
In taking care of a sick person, it is important to keep them properly hydrated: 8 to 10 glasses of water a day. More, if they have vomiting and/or diarrhea.
Oral rehydration should be given to the patient in small amounts frequently, such as in small bottles for infants "paced to mimic sipping," and in spoonfuls or small sips for toddlers. (Except avoid giving water to infants under 6 months old, instead refer to your pediatrician for rehydration instructions.)
The WHO suggests replenishing fluids in cases of diarrhea and/or vomiting with rehydration solutions such as Pedialyte (Abbot Laboratories) or Gastrolyte (Aventis Pharmaceuticals). Or you could always go the cheaper route and water-down Gatorade (One part water, One part gatorade).
There is also the WHO solution for developing countries: One liter of pure water, two tablespoons of sugar, and one-half tablespoon of salt. I say add some lemon juice to it. Or you can always switch out the sugar for honey, except in cases of infants under the age of one. The American Academy of Pediatrics has strongly advised that children younger than 1 year of age should not be given honey because of the possibility of food contamination.
Another alternative remedy, you can try is the Apple cider vinegar mix:Two tablespoons of cidar vinegar (not the clear or distilled kind) and one tablespoon of honey combined in one cup of water each morning.
My favorite is mixing one tablespoon of honey, the juice of one lemon, a pinch of salt, a pinch of ginger, and a pinch of cinnamon in one cup of warm water. The mix should be done to taste. If the sick person can't handle the strength of regular ginger, than instead, use gingerale in place of ginger and water.
In the next post, we will discuss what measures should be taken to lessen the spread of flu in the home. Good luck until next time.
So, Ta Ta for now; I have echocardiograms to study.
Seeing gross things all day, leaves you with two options: You either blow chunks or you laugh... then again, technically you can do both, but I wouldn't advise it.
For instance, when you see the montauk monster of all diseased masses sitting on top of a beating heart, you can easily find yourself heading for the horror flick, "Breakfast Strikes Back." Yet, one good twisted sonnet from the anesthesiologist about his love for the Beatles and your stomach settles.
Then again, it's not like physicians spend all day long laughing at everything to keep themselves upchuck-free. Seriousness has its place. In fact, you can always tell the danger of the case by the amount of humor that passes between the surgeons and hospitalists. If they are singing songs about the names of the new residents, then they are prepared for the case. If they are silent, its bad news and something unexpected of which they weren't completely prepared for, has happened.
The point of these blogs is to utilize humor in preparing now for the serious disasters that can occur later. And there is nothing more serious than witnessing one of your family members suffer from a life-threatening illness. When a loved one starts to suffer, the first response should be to roll back one's sleeves and to take care of them. It shouldn't be 'to panic.'
True, you do have to have the stomach for the work. Not very many people can cleanup puke without dry-heaving. You should have seen how fast my brother's house cleared out of people when his toddler vomited on the couch. Everyone screamed and ran like she was one of the undead coming to feast on their brains. All that remained of her siblings were dust clouds.
Yet, even if you are a little queasy in the face of blood, guts, and gore, if you know beforehand what to do, then you'll quickly adapt.
The ability to laugh during a time of crises is a sign of a well-prepared person. The preparedness I am talking about is not just collecting the temporal materials necessary to survive, but more, the knowledge and training that would keep you from panicking. So, in my blogs, I intend to do my best to help you become mentally ready to face the trials that lie ahead... or at least, the disaster and medicine-related ones.
In this post, I am going to start with the CDC recommendations for taking care of a sick person and in the following blogs, we'll elaborate more. Then that will conclude the H1N1 series and we'll start working on wound care in the wilderness and what to do in the event of an earthquake. (That's my favorite stuff!)
Now, let's roll back our sleeves and get cracking on what to do if someone in your house has contracted the virus. (The following words of advice are derived from the CDC standard of home care in the event that someone has contracted the novel H1N1: http://www.cdc.gov/H1N1flu/guidance_homecare.htm)
First and foremost, if you have children or teenagers, DO NOT give them aspirin (acetylsalicylic acid). Doing so could cause them to acquire Reyes' syndrome. It is an incurable and potentially fatal syndrome that affects all organs, especially the brain and the liver, resulting in severe encephalopathy (swelling of the brain) and a fatty liver. ( For more information on Reye's syndrome: http://www.ninds.nih.gov/disorders/reyes_syndrome/reyes_syndrome.htm)
The over the counter drugs that the CDC recommends are Ibuprofen (Motrin, Advil, Nuprin, PMS-bane, etc.), Acetominophen (Tylenol), and Naproxen (Aleve). You can give children's tylenol to a baby 6 months old or younger (please contact your provider for details) and both ibuprofen and tylenol to children 6 months of age or older. (See also, the American Academy of Pediatrics parenting corner at http://www.aap.org/publiced/BR_Infections.htm)
I do have to mention here that we live in a more is better society. More makeup will hide that zit. More sugar will fix the bad taste of my spouse's cooking. More cartoons will keep my kids from tearing up the house. If it works a little, then more is better, right? Wrong.
Well, let's just put it this way: the only time "more" is better in medicine is when you apply more love to taking care of your patients, and even then, there are times when more is definitely not better. So, please for the sake of all that is good and holy, don't apply the 'more is better' analogy to the above mentioned drugs. Please, just follow your health care provider's advice on dosing or you might end up doing more damage than good. (Image taken from http://www.drugbuyers.com/freeboard/ubbthreads.php/topics/907257/Re_Funny_gifs_post_them_here). For instance, a painful death can result from taking more Tylenol than the maximum dose allowed. [The maximum dose of Tylenol in an adult that is allowed is: 1g/dose(1000mg per dose), and 4g/24h (4000mg per day)].
If you drink more than three alcoholic beverages per day, then one, you really should talk to your doctor before taking it, and two, never use more than 2g (2000mg) per day. Avoid Tylenol, if you have liver disease.
In addition to that, the American Academy of Pediatrics strongly recommends that parents should avoid giving any over the counter cough and cold medications to infants and children under the age of 2 years old, due to the risk of harmful and life threatening side effects. Also, many studies have shown that cold and cough products are not as effective in children younger than 6 years old. (Please see: Common Childhood infections, American Academy of Pediatrics, 2005, updated April 2008.)
So in a nutshell, please seek advice from your primary care physician before taking any pharmaceutical agents, for dosage instructions and any possible contraindications that you or your loved ones may have. (For more information on the side effects of these drugs, refer to: the Food and Drug Administration: http://www.fda.gov/ForConsumers/ConsumerUpdates/default.htm. And also, http://www.tylenol.com/page.jhtml?id=tylenol/children/subchild.inc, and https://online.epocrates.com/u/10a307/acetaminophen)
As for when to seek emergency care, I mentioned in an earlier post about what signs to look for. If the person you are taking care of, or you yourself have any of the following, then please seek medical help immediately:
*Has breathing difficulties
*Has chest pain
*Is vomiting (unable to keep liquids down)
*Has seizures (uncontrolled convulsions)
*Has purple or blue discoloration of the lips
*Acts less responsive than normal or becomes confused
*Shows any signs of dehydration, such as decreased or absence of urination, sunken eyes, dry mucus membranes (inside of mouth is dry), lack of tears when crying (in infants), or dizziness upon standing.
* Has a high output of diarrhea (That is if diarrhea is present. The CDC has indicated that some patients may experience diarrhea from the H1N1.)
In taking care of a sick person, it is important to keep them properly hydrated: 8 to 10 glasses of water a day. More, if they have vomiting and/or diarrhea.
Oral rehydration should be given to the patient in small amounts frequently, such as in small bottles for infants "paced to mimic sipping," and in spoonfuls or small sips for toddlers. (Except avoid giving water to infants under 6 months old, instead refer to your pediatrician for rehydration instructions.)
The WHO suggests replenishing fluids in cases of diarrhea and/or vomiting with rehydration solutions such as Pedialyte (Abbot Laboratories) or Gastrolyte (Aventis Pharmaceuticals). Or you could always go the cheaper route and water-down Gatorade (One part water, One part gatorade).
There is also the WHO solution for developing countries: One liter of pure water, two tablespoons of sugar, and one-half tablespoon of salt. I say add some lemon juice to it. Or you can always switch out the sugar for honey, except in cases of infants under the age of one. The American Academy of Pediatrics has strongly advised that children younger than 1 year of age should not be given honey because of the possibility of food contamination.
Another alternative remedy, you can try is the Apple cider vinegar mix:Two tablespoons of cidar vinegar (not the clear or distilled kind) and one tablespoon of honey combined in one cup of water each morning.
My favorite is mixing one tablespoon of honey, the juice of one lemon, a pinch of salt, a pinch of ginger, and a pinch of cinnamon in one cup of warm water. The mix should be done to taste. If the sick person can't handle the strength of regular ginger, than instead, use gingerale in place of ginger and water.
In the next post, we will discuss what measures should be taken to lessen the spread of flu in the home. Good luck until next time.
So, Ta Ta for now; I have echocardiograms to study.
Thursday, October 15, 2009
Board Exams are Evil Spawned by Satan
If the title of this post doesn't warn you that I'm pausing in the H1N1 series to vent, then could I remind you of that ocean front property in Ohio that I'm selling? :).
Seriously though, earlier today, if you didn't catch it, I posted a list of natural agents that have antiviral properties... so I haven't neglected my blogging duties.
Anyway, I just want to say that the National Board of Medical Examiners are evil! First, they develop these 8 hour exams which we spend months studying for, gaining weight, and eating whatever is close enough to our grasp that doesn't have mold on it, while we become greater zombies with hackers' tans because we haven't seen the light of day for months! And all the time, we are sacrificing our social lives for the will of the Board examiners. (Image taken from www.matt-willard.com)
Okay, that's not true, I do have a social life: I have a very exquisite relationship with Harrison's Internal Medicine book, which I often find myself cheating on by sneaking off with Crush the Step 2. Then to mix it up, I spent a few nights every so often with First Aid for the USMLE and USMLEworld. Believe me, we became very intimate during the last few months. I took them out, we had dinner together. Of course, I paid; it is the 21st century. We slept together: but often I found myself, sneaking off early in the morning pulling a coyote ugly to get to the next board exam review book. I admit that I wasn't very committed to just one.
Then as with any deep relationship, it had to end the day before the exam. I think I found a Dear John note on my pillow, stating, "I can't take the neglect anymore. Signed Harrison's." Therefore, I went cold turkey. No more board review books. My Exam analysts were saying that it was for my own good that I was to part with them for a few days. Believe me, it was hard. I could hear to books calling to me, saying sweet nothings and begging me to take them back. It took all I had to walk away and say no more.
So there I was exam day, getting frisked for possible study materials that I might have sneaked in over the Prometrics center border. It was seriously like Fort Knox. They take your finger prints, your picture, your driver's license, your certificate of exam eligibility, your first born child... it was dreadful. Forget about the fact that you're already nervous from having to take the daunting test that could determine your future, but you also get shaken down like a drug dealer during a meth bust. "Up against the wall. Okay, frisk 'em. If we find any cheat notes, you're going downtown buddy."
So after the airport security picked my pockets, I found myself sitting in front of the ugliest computer screen I had ever seen in my life. The darned PC looked like it was going to croak right in front of me. I was half ready to yell out: "Quick! Call a code and get an AED!"
It makes you think, "All that action and all I get is this is fossil?" Which it only added to my stress because the whole time, I kept thinking that the piece of computer would crash and they would make me take the test over.
Eight hours. Can you believe that they make you take a test for eight hours? Well, at least there were breaks, but still, it starts to wear on you. During the seventh stretch of the exam, I felt like I was ready to throw in the towel. The darned thing had sucked out my brain and was now spitting it back at me in defiance. I couldn't take it. I just wanted the torture to end.
So I looked at the clock running down. Fortunately, I had time to spare. Thank heaven to all those English lit classes that I took just to get out of taking math. I couldn't ask for better lessons on how to read as fast as lightning than trying to get through the evil book of Frankenstein.
So I had two and a half hours left on the clock and only one more block of test questions. So I did what any knowing, burnt out medical student would do. I went bowling. Yep, I signed out of the test in a designated break place, went through security, and went bowling. After a full game of throwing a huge marble ball at some pins to blow off some test anxiety, I came back through the top secret clearance squad and finished the test.
Yeah, but was that it? Oh heck no! I'm a D.O. We osteopaths are gluttons for punishment. I had to take the COMLEX a week later. The COMLEX, for those of you that don't know, is the osteopathic version of the board licensing exam. It's eviler than the USMLE... those twisted National Board of Osteopathic Examiner beastards! And another 400 question test brought me back to the same testing center, through the same frisking process, and back to the same archaic computer.
So here I am now, sweating it a month later, and still my test results for the COMLEX are not back yet. I mean really, how hard is it to grade a test that was taken on a computer?
There must be some logical explanation for them to take so long to report back, because making someone wait several weeks for test results that could determine their future is too cruel and too absurd to be without some severe cause. So, I've been considering a couple of possibilities as to why the NBOME are taking forever to post scores: not even Al-Qaeda would be so intentionally inhumane.
So the following are ten possible reasons as to why they would take so long on such a seemingly easy task:
1. The satanic computer, mad at me for saying a prayer that it would survive the exam, ate my test. Evil, evil computer!
2. An Dark Evil Overlord has infiltrated the NBOME, plotting to take over the world by turning young doctors into mindless zombies that spend their whole day checking online for their test results.
3. Terrorists have abducted the NBOME Chief of Score Reporting, holding him ransom for a pound of pickles.
4. It's the end of the world and they know it. They feel fine... Yeah, they feel fine about not giving us our test scores. Punks! Well, I don't feel fine: I'd still like to see my score... A passing score would put a positive spin on the world ending.
5. The NBOME is an alien organization mothership from the planet Zerthon bent on sucking the hope and life out of the earth's young physicians.
6. It's a government conspiracy to keep us from finding out our scores. I think the alien one is more convincing.
7. An evil artificial intelligence infiltrated the NBOME's computer files, deleting all our test scores to make us humans suffer.
8. Barney the Dinosaur broke in and beat up the NBOME staff so that they wouldn't be able to post our scores. I knew that dinosaur was evil!
9. The NBOME are a cult dedicated to sacrificing our test scores to their unholy gods.
10. A dorky space ranger from the future came back and shot all the NBOME staff with a freeze ray to keep them from posting our scores which would send about a chain of events that may destroy the universe as we know it! I hate that space ranger; I'd rather have my test scores.
See, maybe there are very good reasons for them torturing us poor, unlucky test-takers. At any rate, I feel better now that I vented. :)
Post to you next time.
Christine
P.S. I figured out the NBOME motto:
"It's not that we don't care; it's that we don't want to care."
Seriously though, earlier today, if you didn't catch it, I posted a list of natural agents that have antiviral properties... so I haven't neglected my blogging duties.
Anyway, I just want to say that the National Board of Medical Examiners are evil! First, they develop these 8 hour exams which we spend months studying for, gaining weight, and eating whatever is close enough to our grasp that doesn't have mold on it, while we become greater zombies with hackers' tans because we haven't seen the light of day for months! And all the time, we are sacrificing our social lives for the will of the Board examiners. (Image taken from www.matt-willard.com)
Okay, that's not true, I do have a social life: I have a very exquisite relationship with Harrison's Internal Medicine book, which I often find myself cheating on by sneaking off with Crush the Step 2. Then to mix it up, I spent a few nights every so often with First Aid for the USMLE and USMLEworld. Believe me, we became very intimate during the last few months. I took them out, we had dinner together. Of course, I paid; it is the 21st century. We slept together: but often I found myself, sneaking off early in the morning pulling a coyote ugly to get to the next board exam review book. I admit that I wasn't very committed to just one.
Then as with any deep relationship, it had to end the day before the exam. I think I found a Dear John note on my pillow, stating, "I can't take the neglect anymore. Signed Harrison's." Therefore, I went cold turkey. No more board review books. My Exam analysts were saying that it was for my own good that I was to part with them for a few days. Believe me, it was hard. I could hear to books calling to me, saying sweet nothings and begging me to take them back. It took all I had to walk away and say no more.
So there I was exam day, getting frisked for possible study materials that I might have sneaked in over the Prometrics center border. It was seriously like Fort Knox. They take your finger prints, your picture, your driver's license, your certificate of exam eligibility, your first born child... it was dreadful. Forget about the fact that you're already nervous from having to take the daunting test that could determine your future, but you also get shaken down like a drug dealer during a meth bust. "Up against the wall. Okay, frisk 'em. If we find any cheat notes, you're going downtown buddy."
So after the airport security picked my pockets, I found myself sitting in front of the ugliest computer screen I had ever seen in my life. The darned PC looked like it was going to croak right in front of me. I was half ready to yell out: "Quick! Call a code and get an AED!"
It makes you think, "All that action and all I get is this is fossil?" Which it only added to my stress because the whole time, I kept thinking that the piece of computer would crash and they would make me take the test over.
Eight hours. Can you believe that they make you take a test for eight hours? Well, at least there were breaks, but still, it starts to wear on you. During the seventh stretch of the exam, I felt like I was ready to throw in the towel. The darned thing had sucked out my brain and was now spitting it back at me in defiance. I couldn't take it. I just wanted the torture to end.
So I looked at the clock running down. Fortunately, I had time to spare. Thank heaven to all those English lit classes that I took just to get out of taking math. I couldn't ask for better lessons on how to read as fast as lightning than trying to get through the evil book of Frankenstein.
So I had two and a half hours left on the clock and only one more block of test questions. So I did what any knowing, burnt out medical student would do. I went bowling. Yep, I signed out of the test in a designated break place, went through security, and went bowling. After a full game of throwing a huge marble ball at some pins to blow off some test anxiety, I came back through the top secret clearance squad and finished the test.
Yeah, but was that it? Oh heck no! I'm a D.O. We osteopaths are gluttons for punishment. I had to take the COMLEX a week later. The COMLEX, for those of you that don't know, is the osteopathic version of the board licensing exam. It's eviler than the USMLE... those twisted National Board of Osteopathic Examiner beastards! And another 400 question test brought me back to the same testing center, through the same frisking process, and back to the same archaic computer.
So here I am now, sweating it a month later, and still my test results for the COMLEX are not back yet. I mean really, how hard is it to grade a test that was taken on a computer?
There must be some logical explanation for them to take so long to report back, because making someone wait several weeks for test results that could determine their future is too cruel and too absurd to be without some severe cause. So, I've been considering a couple of possibilities as to why the NBOME are taking forever to post scores: not even Al-Qaeda would be so intentionally inhumane.
So the following are ten possible reasons as to why they would take so long on such a seemingly easy task:
1. The satanic computer, mad at me for saying a prayer that it would survive the exam, ate my test. Evil, evil computer!
2. An Dark Evil Overlord has infiltrated the NBOME, plotting to take over the world by turning young doctors into mindless zombies that spend their whole day checking online for their test results.
3. Terrorists have abducted the NBOME Chief of Score Reporting, holding him ransom for a pound of pickles.
4. It's the end of the world and they know it. They feel fine... Yeah, they feel fine about not giving us our test scores. Punks! Well, I don't feel fine: I'd still like to see my score... A passing score would put a positive spin on the world ending.
5. The NBOME is an alien organization mothership from the planet Zerthon bent on sucking the hope and life out of the earth's young physicians.
6. It's a government conspiracy to keep us from finding out our scores. I think the alien one is more convincing.
7. An evil artificial intelligence infiltrated the NBOME's computer files, deleting all our test scores to make us humans suffer.
8. Barney the Dinosaur broke in and beat up the NBOME staff so that they wouldn't be able to post our scores. I knew that dinosaur was evil!
9. The NBOME are a cult dedicated to sacrificing our test scores to their unholy gods.
10. A dorky space ranger from the future came back and shot all the NBOME staff with a freeze ray to keep them from posting our scores which would send about a chain of events that may destroy the universe as we know it! I hate that space ranger; I'd rather have my test scores.
See, maybe there are very good reasons for them torturing us poor, unlucky test-takers. At any rate, I feel better now that I vented. :)
Post to you next time.
Christine
P.S. I figured out the NBOME motto:
"It's not that we don't care; it's that we don't want to care."
Going Natural: Cocconut Milk Can Kick Swine Flu Backside
I just flew back home from a conference with the International College of Integrative Medicine in Michigan and I have jet lag, so I'm going to try to keep to the bare essentials. Today, I'm just going to mention some natural things that you can use in the event that you or one of your family members catches the H1N1 or any virus for that matter. (Image taken from http://madure.multiply.com/journal)
Now this advice is not meant to replace going to your primary care professional. Far from it. In fact, so far from it that you could travel to Pluto and back before reaching it. If you begin to experience any of the symptoms of the H1N1, the first thing you need to do is get yourself to the hospital or make an appointment with your primary care physician. So basically, let's just put it this way, you avoid going to the doctor when you experience the flu symptoms, then you risk doing what is in the following image:
(Image taken from http://kickbutthumor.blogspot.com)
So, instead of replacing professional medical advice, this post is just meant to provide you with some additional tools by which you can strengthen your immune system to fight off infections. Having said that, let's get down to it:
To begin, I have come across a number of reputable natural products, which deserve acknowledgment here. I must state that I am not in any way trying to promote the sale of these supplements or have any monetary invested interest in them.
I just want to mention that studies have been done that show the efficacy of these agents in helping the body naturally handle viruses. I am sure that there are other products and companies out there with their own versions of these same supplements and are just as reputable. I just haven't heard of them yet. These I discovered, because they were from companies that were screened by physicians at the ICIM conference.
On the other hand, I would like to also provide a word of caution in regards to just going out and buying supplements. Be careful that the companies that you purchase from have been tested in independent studies as to being safe and free of harmful chemicals. For instance, 20% of the Ayurvedic Herbs sold in the Boston area had traces of Arsenic, lead, and mercury in them. (Quig,D. (2004) "Chronic Metal Toxicity: Assessment of Exposure and Retention," In Textbook of Natural Medicine, ed. J.E. Pizzorno, Fr. Elsevier, 3rd ed.)
In addition to that, make sure that the good quality supplements that you use do not have any contraindications that apply to you or your current medications. For instance, those currently taking Warfarin (Coumadin, Jantoven, Marevan, Lawarin, and Waran are some of its brand names) should be aware that over 90% of herbal supplements have adverse reactions with the drug. (See for more details: Lemos, et al. (1999). Herbal Interactions with Warfarin. http://www.vhpharmsci.com/Newsletters/1990s-NEWS/Article21.htm)
The following is a list of supplement categories, their descriptions, and the common products out there.
Lauric acid derivatives:
Lauric acid was first discovered in human breast milk. It is a medium chain, fatty acid that has antibacterial and antiviral properties. It also was discovered within coconut milk. I hear that "phew" of relief when I told you that it wasn't just found in human breast milk.
The most common form of lauric acid is Monolaurin, which is a glycerol ester of lauric acid and is more biologically active than lauric acid itself. Monolaurin is a natural antimicrobial agent that helps protect the immune system from a range of infectious critters.
To be more succinct, Monolaurin has the property of aiding the immune system in destroying envelope-coated viruses. In a study performed by the CDC, Lauric acid/Monolaurin was demonstrated to solubulize the enveloped membrane of 14 human RNA and DNA viruses. These viruses include influenza, Rubeola, RSV, Coronavirus, Newcastle's virus, Epstein-Barr Virus (EBV), Herpes Simplex types 1 & 2, Human Papilloma Virus type 6, and cytomegalovirus, to name a few. (Note: Monolaurin has no effect on naked viruses, such as encephalitis, coxsachie, pox, or polio viruses.)
This product works by disintegrating the envelope coat of the viruses. The bugs take in the fatty acid for use in their own replication, instead the lauric acid derivative destroys their envelopes, paving the way for the body's immune system to attack the virus. (See Hierholzer JC and Kabara JJ. (1982). In vitro effects of Monolaurin compounds on enveloped RNA and DNA viruses. Journal of Food SAfety, 4:1. See also, Lieberman, SC. Antiviral Intervention for Chronic Fatigue Syndrome. www.drshari.net. See also, Fierro, AA. (2007) Antibacterial, antiviral, and antifungal nutritional supplement: a combination of natural or neutraceutical compounds shown to have antibacterial, antiviral, and antifungal properties. US Patent Office. US 2007/0116778. See also, Clarke and May (2000). Effect of antimicrobial factors in human milk on rhinoviruses and milk-borne cytomegalovirus in vitro. J Med Microbiol, 49: 719-23).
Examples of Monolaurin products are:
Lauricidin (3-monolaurin) which can be found at http://www.lauricidin.com/. Refer to the company for correct dosing. I'm too lazy to include that information today. But if you're really interested, leave a question in the comments section below this post and I will send you the dosing instructions.
Monolaurin from Ecological Formulas. Which can be found on any natural supplement site.
Viraclear EPs 7630:
This is not a lauric acid derivative, but this is a homeopathic remedy for viruses that has been proven in more than 20 clinical trials as being effective in enveloped viruses. (refer to Chucalin, AG, et al. (2005) Treatment of acute bronchitis in adults with a Pelargonium sidoides preparation (EPs 7630): a randomized, double-blind, placebo-controlled trial. Explore,1:437-445. And also, Kamin, W. (2007). Pelargonium sidoides extract EPs 7630 in the treatment of respiratory tract infections in children and adults--an overview of recent results. Planta Med, 73:822.) No studies have been performed testing the effects of EPs 7630 on the novel H1N1, so the Integrative Therapeutics company, being a largely research based organization, makes no claims that it can help in treating the swine flu.
Yet, this product has been shown to the shorten duration of and reduce the severity of symptoms of upper respiratory infections, including the common cold, bronchitis, and sinusitis. I'm not saying that this agent is perfect for dealing with the H1N1, but it is something to consider. You can find this product at www.integrativeinc.com.
Herbs and Spices:
Origanum is a genus of about 20 species of herbal plants from the family of Lamiaceae, particularly the culinary herbs of Marjoram and Oregano. The most important of this group is Oregano, especially Oregano Oil. This oil has been shown to be effective in boosting the immune system against viruses, bacteria, and parasites. (Image taken from www.cure-nailfungus.com/Natures-Home-Remedy.html)
In fact, Preuss, et al. (2005) demonstrated that the essential oil Organum had bacteriocidal effects against microbials such as Staphylococcus aureus, Mycobacterium terrae, Helicobacter pylori, Klebsiella pneumoniae, and Escherichia coli. They compared it to monolaurin, which was also found to have bacteriocidal effects, but only on bacteria such as S. aureus, H.pylori, and M. terrae. Both fatty acids were also bacteriostatic to Bacillus Anthracis Sterne. (Preuss, H., et al (2005) "Minimum inhibitory concentrations of herbal essential oils and monolaurin for gram-positive and gram-negative bacteria." Molecular and Cellular Biochemistry, 272, 29-34. http://www.springerlink.com/content/r4141k0583264m7l/. See also, Batovska, et al. (2009). Antibacterial study of the medium chain fatty acids and their 1-monoglycerides: individual effects and synergistic relationships. Pol J Microbiol, 58: 43-7. And also, Soekmen, et al. (2004). In Vitro antioxidant, antimicrobial, and antiviral activities of the essential oil and various extracts from herbal parts and callus cultures of Origanum acutidens. J. Agric. Food Chem, 52:3309-3312.)
Elderberries: Why we love them
Professor Zakay-Rones, et al. (1995) demonstrated that Elderberry extract called Sambucol (SAM) reduced the hemagglutination of and inhibited the replication of several strains of influenza virus and reduced the associated symptoms. (Please refer to: Zakay-Rones, Z., et al. (2005) Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B in Panama. Journal of Alternative and Complementary Medicine, 4:361-369.) (Image taken from thriftyliving.net/?p=7)
PharmaCare Europe produces the Sambucol product and can be found at http://wwcol.comw.sambu/.
Pure Compounding Pharmacy (www.purecompounding.com) also offers a nice elderberry extract with dosing instructions as well as a Immune support package which includes it.
Peppermint Oil: It doesn't just smell good
In a study, Shuhmacher demonstrated that peppermint oil, the essential oil of Mentha piperita, was active against even the acyclovir resistant strains of enveloped viruses. "Considering the lipophilic nature of the oil which enables it to penetrate the skin, peppermint oil might be suitable for topical therapeutic use as virucidal agent in recurrent herpes infection." (See Schuhmacher, A. (2009). Virucidal effect of peppermint oil on the enveloped viruses herpes simplex virus type 1 and type 2. Phytomedicine, 10:504-510.) (Image taken from www.puremints.com/peppermint.htm)
Olive Leaf Extract: A few words
Well, I hadn't intended to include this extract, but I recently discovered research that shows its antiviral properties against viruses, such as HIV and VHSV. So, I decided to give the olive leaf extract an honorable mention in this list. (Lee-Huang, et al. (2003). Anti-HIV activity of olive leaf extract (OLE) and modulation of host cell gene expression by HIV-1 infection and OLE treatment. Biochemical and Biophysical Research Communications, 307, 4:1029-1037. And also, Micol, V., et al. (2005). The olive leaf extract exhibits antiviral activity against viral haemorrhagic septicemia rhabdovirus (VHSV). Antiviral Research, 66:129-136.)
So there you have it: a small list of natural items that you can add to your armory to prepare for the battle against the H1N1. Man, I'm tired.
Link of the day on Herbal Safety: http://www.peacefulmind.com/safety.htm This site gives a listing of the current herbs, their indications, contraindications, and side effects.(Image taken from www.seniorsworldchronicle.com/2009_05_01_archive)
Now this advice is not meant to replace going to your primary care professional. Far from it. In fact, so far from it that you could travel to Pluto and back before reaching it. If you begin to experience any of the symptoms of the H1N1, the first thing you need to do is get yourself to the hospital or make an appointment with your primary care physician. So basically, let's just put it this way, you avoid going to the doctor when you experience the flu symptoms, then you risk doing what is in the following image:
(Image taken from http://kickbutthumor.blogspot.com)
So, instead of replacing professional medical advice, this post is just meant to provide you with some additional tools by which you can strengthen your immune system to fight off infections. Having said that, let's get down to it:
To begin, I have come across a number of reputable natural products, which deserve acknowledgment here. I must state that I am not in any way trying to promote the sale of these supplements or have any monetary invested interest in them.
I just want to mention that studies have been done that show the efficacy of these agents in helping the body naturally handle viruses. I am sure that there are other products and companies out there with their own versions of these same supplements and are just as reputable. I just haven't heard of them yet. These I discovered, because they were from companies that were screened by physicians at the ICIM conference.
On the other hand, I would like to also provide a word of caution in regards to just going out and buying supplements. Be careful that the companies that you purchase from have been tested in independent studies as to being safe and free of harmful chemicals. For instance, 20% of the Ayurvedic Herbs sold in the Boston area had traces of Arsenic, lead, and mercury in them. (Quig,D. (2004) "Chronic Metal Toxicity: Assessment of Exposure and Retention," In Textbook of Natural Medicine, ed. J.E. Pizzorno, Fr. Elsevier, 3rd ed.)
In addition to that, make sure that the good quality supplements that you use do not have any contraindications that apply to you or your current medications. For instance, those currently taking Warfarin (Coumadin, Jantoven, Marevan, Lawarin, and Waran are some of its brand names) should be aware that over 90% of herbal supplements have adverse reactions with the drug. (See for more details: Lemos, et al. (1999). Herbal Interactions with Warfarin. http://www.vhpharmsci.com/Newsletters/1990s-NEWS/Article21.htm)
The following is a list of supplement categories, their descriptions, and the common products out there.
Lauric acid derivatives:
Lauric acid was first discovered in human breast milk. It is a medium chain, fatty acid that has antibacterial and antiviral properties. It also was discovered within coconut milk. I hear that "phew" of relief when I told you that it wasn't just found in human breast milk.
The most common form of lauric acid is Monolaurin, which is a glycerol ester of lauric acid and is more biologically active than lauric acid itself. Monolaurin is a natural antimicrobial agent that helps protect the immune system from a range of infectious critters.
To be more succinct, Monolaurin has the property of aiding the immune system in destroying envelope-coated viruses. In a study performed by the CDC, Lauric acid/Monolaurin was demonstrated to solubulize the enveloped membrane of 14 human RNA and DNA viruses. These viruses include influenza, Rubeola, RSV, Coronavirus, Newcastle's virus, Epstein-Barr Virus (EBV), Herpes Simplex types 1 & 2, Human Papilloma Virus type 6, and cytomegalovirus, to name a few. (Note: Monolaurin has no effect on naked viruses, such as encephalitis, coxsachie, pox, or polio viruses.)
This product works by disintegrating the envelope coat of the viruses. The bugs take in the fatty acid for use in their own replication, instead the lauric acid derivative destroys their envelopes, paving the way for the body's immune system to attack the virus. (See Hierholzer JC and Kabara JJ. (1982). In vitro effects of Monolaurin compounds on enveloped RNA and DNA viruses. Journal of Food SAfety, 4:1. See also, Lieberman, SC. Antiviral Intervention for Chronic Fatigue Syndrome. www.drshari.net. See also, Fierro, AA. (2007) Antibacterial, antiviral, and antifungal nutritional supplement: a combination of natural or neutraceutical compounds shown to have antibacterial, antiviral, and antifungal properties. US Patent Office. US 2007/0116778. See also, Clarke and May (2000). Effect of antimicrobial factors in human milk on rhinoviruses and milk-borne cytomegalovirus in vitro. J Med Microbiol, 49: 719-23).
Examples of Monolaurin products are:
Lauricidin (3-monolaurin) which can be found at http://www.lauricidin.com/. Refer to the company for correct dosing. I'm too lazy to include that information today. But if you're really interested, leave a question in the comments section below this post and I will send you the dosing instructions.
Monolaurin from Ecological Formulas. Which can be found on any natural supplement site.
Viraclear EPs 7630:
This is not a lauric acid derivative, but this is a homeopathic remedy for viruses that has been proven in more than 20 clinical trials as being effective in enveloped viruses. (refer to Chucalin, AG, et al. (2005) Treatment of acute bronchitis in adults with a Pelargonium sidoides preparation (EPs 7630): a randomized, double-blind, placebo-controlled trial. Explore,1:437-445. And also, Kamin, W. (2007). Pelargonium sidoides extract EPs 7630 in the treatment of respiratory tract infections in children and adults--an overview of recent results. Planta Med, 73:822.) No studies have been performed testing the effects of EPs 7630 on the novel H1N1, so the Integrative Therapeutics company, being a largely research based organization, makes no claims that it can help in treating the swine flu.
Yet, this product has been shown to the shorten duration of and reduce the severity of symptoms of upper respiratory infections, including the common cold, bronchitis, and sinusitis. I'm not saying that this agent is perfect for dealing with the H1N1, but it is something to consider. You can find this product at www.integrativeinc.com.
Herbs and Spices:
Origanum is a genus of about 20 species of herbal plants from the family of Lamiaceae, particularly the culinary herbs of Marjoram and Oregano. The most important of this group is Oregano, especially Oregano Oil. This oil has been shown to be effective in boosting the immune system against viruses, bacteria, and parasites. (Image taken from www.cure-nailfungus.com/Natures-Home-Remedy.html)
In fact, Preuss, et al. (2005) demonstrated that the essential oil Organum had bacteriocidal effects against microbials such as Staphylococcus aureus, Mycobacterium terrae, Helicobacter pylori, Klebsiella pneumoniae, and Escherichia coli. They compared it to monolaurin, which was also found to have bacteriocidal effects, but only on bacteria such as S. aureus, H.pylori, and M. terrae. Both fatty acids were also bacteriostatic to Bacillus Anthracis Sterne. (Preuss, H., et al (2005) "Minimum inhibitory concentrations of herbal essential oils and monolaurin for gram-positive and gram-negative bacteria." Molecular and Cellular Biochemistry, 272, 29-34. http://www.springerlink.com/content/r4141k0583264m7l/. See also, Batovska, et al. (2009). Antibacterial study of the medium chain fatty acids and their 1-monoglycerides: individual effects and synergistic relationships. Pol J Microbiol, 58: 43-7. And also, Soekmen, et al. (2004). In Vitro antioxidant, antimicrobial, and antiviral activities of the essential oil and various extracts from herbal parts and callus cultures of Origanum acutidens. J. Agric. Food Chem, 52:3309-3312.)
Elderberries: Why we love them
Professor Zakay-Rones, et al. (1995) demonstrated that Elderberry extract called Sambucol (SAM) reduced the hemagglutination of and inhibited the replication of several strains of influenza virus and reduced the associated symptoms. (Please refer to: Zakay-Rones, Z., et al. (2005) Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B in Panama. Journal of Alternative and Complementary Medicine, 4:361-369.) (Image taken from thriftyliving.net/?p=7)
PharmaCare Europe produces the Sambucol product and can be found at http://wwcol.comw.sambu/.
Pure Compounding Pharmacy (www.purecompounding.com) also offers a nice elderberry extract with dosing instructions as well as a Immune support package which includes it.
Peppermint Oil: It doesn't just smell good
In a study, Shuhmacher demonstrated that peppermint oil, the essential oil of Mentha piperita, was active against even the acyclovir resistant strains of enveloped viruses. "Considering the lipophilic nature of the oil which enables it to penetrate the skin, peppermint oil might be suitable for topical therapeutic use as virucidal agent in recurrent herpes infection." (See Schuhmacher, A. (2009). Virucidal effect of peppermint oil on the enveloped viruses herpes simplex virus type 1 and type 2. Phytomedicine, 10:504-510.) (Image taken from www.puremints.com/peppermint.htm)
Olive Leaf Extract: A few words
Well, I hadn't intended to include this extract, but I recently discovered research that shows its antiviral properties against viruses, such as HIV and VHSV. So, I decided to give the olive leaf extract an honorable mention in this list. (Lee-Huang, et al. (2003). Anti-HIV activity of olive leaf extract (OLE) and modulation of host cell gene expression by HIV-1 infection and OLE treatment. Biochemical and Biophysical Research Communications, 307, 4:1029-1037. And also, Micol, V., et al. (2005). The olive leaf extract exhibits antiviral activity against viral haemorrhagic septicemia rhabdovirus (VHSV). Antiviral Research, 66:129-136.)
So there you have it: a small list of natural items that you can add to your armory to prepare for the battle against the H1N1. Man, I'm tired.
Link of the day on Herbal Safety: http://www.peacefulmind.com/safety.htm This site gives a listing of the current herbs, their indications, contraindications, and side effects.(Image taken from www.seniorsworldchronicle.com/2009_05_01_archive)
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