Clinical: Weird symptoms that no one can diagnose?

When your symptoms seem 'weird' to both you and your doctor always consider Lyme disease.

I had a man in his late 40's who I have seen once a year since 1990 for a physical. Apart from basket ball mishaps no other problems. All of a sudden he popped up complaining of an itchy rash along his belt line and we assumed he had developed a nickel allergy. I gave him a steroid cream and the rash went away but not the itching. His body had itching all over, off and on, with low grade hives. That weekend he was out to dinner with his wife and felt like he was going to pass out, was he dehydrated? It was, after all the height of summer. I ran an ECG on him and it was different from the ones he had been getting annually. Thank goodness he had been so consistent with his physicals.
The EGC was the final clue and I ran a Lyme disease test on him. It was the highest I have ever seen!
Within two days of starting treatment, he began to feel like his old self.

His new normal had consisted of fatigue and constant itching and 'weird symptoms' that changed from day to day.  Based on his blood test I would assume that he had had Lyme disease for quite awhile.
He had no recollection of a tick bite, joint pains or a target lesion on his skin which are the classic symptoms of Lyme infection. Sometimes its just a general feeling of not being well, or generalized body aches and malaise. It is always good to check.
In the meantime, prevention is better than cure. Check yourself and your pets for ticks when you come in from the outside especially if you have been in the yard or hiking. Insect repellants may also help.

Flu shots are here, should you get one?

The answer is probably yes, since there are minimal downsides and they are covered by almost every insurance (they have figured out that it costs them more if you get sick).
But that's too easy an answer, so let's look at it a little more closely.

What are the pros: you hopefully will not get sick if you are exposed to influenza. On the other hand  if you do, it will be less severe than if you have not been immunized. You will save the discomfort of being sick and the time off work, and the cost of trying to get better.

A case in point: yesterday, a plane load of passengers had to be diverted at JFK and were not allowed to enter the terminal because about a third of the passengers (all coming from Dubai) were sick, coughing, feverish and vomiting. It turned out they all had the flu. Ask Vanilla Ice, he was on the plane!
These people were all deplaning in New York, 10 of them were sent directly to the hospital from the airport.
This is an extreme case and that was a long flight, with almost 400 people sharing the same air, but it proves without a doubt that Influenza has arrived and it can be very contagious.

Does a flu shot guarantee someone will not get the flu? No. But isn't it better to have some protection than none? 

So, why would someone not want to get the flu shot? I'm not sure but I can tell you this, it would not be for medical reasons. I have never seen a patient allergic to the shot and when I ask my allergy colleagues they too have difficulty recalling ever having seen someone who was allergic as well.

Some people are scared of needles. Some like to proclaim that they have never had the flu before as if that means they don't have to worry about it.

Young children, the elderly and the people who have compromised immunity are strongly encouraged to get the flu shot. The sooner, the better and if you will be flying during the holidays, take that into account.

To be honest I have already had mine.

I'm happy to say that flu shots are now readily available in our office and you don't need to have an appointment to get one. So think about it and come on in.

Of interest, there is on-going research to create a vaccine that covers every strain, so that hopefully in the next few years once you get immunized you wont have to get it annually. But until that is available, get your annual flu shot with a smile knowing that you have done something proactive to keep yourself healthy this winter.

A new road sign............................South Africa

A different kind of road sign

If you ever have the opportunity to go to South Africa grab it with both hands and don’t think twice.

Cape Town is the most beautiful city in the world, it has to be seen to be believed. The whole of South Africa is phenomenal but especially the Cape area. From the vineyards to the beaches, from the mountains to the wildlife it is all amazing.

For your first trip it is well worth going with a tour company because you will see so much without having to worry about the logistics of getting around and experiencing everything.

I have attached one of my favorite road signs followed by a series of pictures, I took this month (June) with my phone.

Unfortunately, I can’t share enough shots to do the country justice but hopefully it will give you a little flavor of the awesome beauty of the place.

If you want to go and/or have questions I am always available to answer them. Enjoy!

Watch out!