Administration of influenza vaccines to egg allergic recipients: A practice parameter update 2017


Source: Administration of influenza vaccines to egg allergic recipients: A practice parameter update 2017


There is strong evidence that egg allergic individuals can safely receive IIV or LAIV if the latter vaccine is recommended for use once the concerns regarding efficacy have been resolved. Presence of egg allergy in an individual is not a contraindication to receive IIV or LAIV. Influenza vaccine recipients with egg allergy are at no greater risk for a systemic allergic reaction than those without egg allergy. Precautions, such as choice of a particular vaccine, special observation periods, or restriction of administration to particular medical settings, are not warranted and constitute an unnecessary barrier to immunization. Vaccine providers and screening questionnaires do not need to ask about the egg allergy status of recipients of influenza vaccine(1).

  1. Administration of influenza vaccines to egg allergic recipients: A practice parameter update 2017
    Greenhawt, Matthew et al.
    Annals of Allergy, Asthma & Immunology , Volume 120 , Issue 1 , 49 – 52

I received this medical update from Epocrates.

Patients will need to discuss recommendations concerning vaccination recommendations with you physician or provider.

, it seems that we can assure patients that its okay to proceed with influenza vaccination even if patients have an egg allergy, they can still proceed with vaccination.



Loneliness in Seniors

For some elderly women in Japan, prison offers companionship and a life free from worry.

via Elderly Japanese Women Are Turning to Crime to Find Companionship in Prison — Longreads

I am new to WordPress, but I am so happy I joined.  I’m finding the most relevant information through other bloggers.  This article came up on my feed.  I was absolutely fascinated with this topic.  I started reading this article and couldn’t stop.  Basically the author is reporting on how lonely living conditions are driving some elderly women to commit crimes in order to be incarcerated.  These women feel more connection and well being while incarcerated.

I did a quick article search and found research article an article on Pubmed that summarizes that loneliness leads to increased use of health care.

As a physician, I treat primarily geriatric age, or patients older than 65.  As I’m working through a busy day, I’m aware of a lack of social support.  I am very aware of  my sickest patients seeming to have the least amount of social support.

I am aware of how being lonely affects my patients health.  Typically, the human life toward the end is marked by more losses than gains.  Loss of career, spouses, siblings, and friends all while being surrounded  by a culture that is fascinated with all things youth related.

I won’t pretend to have an instant answer, but here are some of my observations and how I help seniors cope:

Social Media

For all its blessings, it can have many negatives.  Some say that social media may be driving us apart.  I notice in my senior patients, they often have a cell phone, but their life experience has not lead them to show much curiosity in any social media.  They will complain that none of their family reaches out to them, not realizing that within a few simple steps, they can connect with all of their younger relatives for free.  If you have an older relative, offer to give them a tutorial in Facebook or Instagram.  Its a great way to bond, and often opens up a world they did not feel they could be apart of.


Senior Centers

Many cities and counties have some sort of senior center, but often no one knows to look.  Younger family members are often so but they don’t realize there’e resources available to older relatives.  Here are a few links locally:

Oklahoma City Senior Programs

Midwest City Senior Center

US Department of Health and Human Services


I’m often encouraging my patients that you can help your brain with aging with challenges.  Taking on a new hobby or a class in something you’ve never done stimulates new neural connections and increases overall health.

This is a difficult topic.  We all want to age, and maybe we’ll find a better way to do this at some point.



Channeling and Reiki

In my previous post, I discussed the energy of Reiki.  I plan to get deeper into that later on, but its important to discuss channeling as this topic is likely to make most people considering Reiki for the first time uncomfortable.

I covered the various nature of energy.  Reiki is energy at a healing frequency.  We as humans require energy to be channeled.  Although we are surrounded by energy, its most efficient when its gathered, focused, and aimed in a direction.

One example of this, of course, is sound energy.  When you are using your cell phone, you can put the cell phone up to your ear.  The sound quality doing this is good.  You can also use your speaker.  The speaker will deliver sound, but it may be hard to hear very clearly if there is a lot of background noise.  The best sound quality is using your headphones.  The headphones focus the sound energy, block out outside noise, and therefore deliver the highest quality sound making your conversation easier.

The role of the Reiki practioner is to focus and deliver channeling energy.  The Reiki practioner operates best as a speaker, or focuser of this healing energy.  The very nature of Reiki does allow for the practioner to receive some of the healing energy (I like to think of this as a spill over) while aiming this energy for the best effect.

Anyone that is into metaphysics already may have concerns about this energy being able to do something other than healing.  The nature of the Reiki practioner as well as Reiki energy does not allow for any transmission of energy that does not lead to healing and only serves the highest good of the person receiving Reiki.

In healthcare, we already use enery delivery to treat disease.  On the other end of the spectrum, radiation treatment used in cancer care also requires something to focus high energy into an area of the body.  However,  this energy is used specifically to shrink cancer (this is only a comparison, not to be taken that Reiki can replace current treatment, please follow your physicians treatment plans as always).

Thanks again for visiting, and I will continue to dive deeper into this topic in later post.

Consult from Dr.Google


Patients frequently want to be proactive and research what’s going on with their bodies.  Of course, I’m not readily available, as are most physicians typically not available to answer instant questions (although my practice does have a patient portal that makes it fairly easy to ask questions).  So in comes Dr. Google.  Of course, I am not criticizing search engines at all…I’m hoping to find readers   through a search engine.

The issue becomes your symptoms may be serious, and the information that comes back to you may not be relevant, helpful, or could be harmful.  I don’t know right away who published this information.  Did they study medicine?  Are they trying to sell you something?

I’ll admit, I am willing to listen to the differential diagnosis generated by Dr. Google, but not for very long.  Patient visits are already too short, and I don’t want to waste valuable time sifting through symtpoms generated by Dr. Google.  Furthermore, I don’t want you as the patient to be worried about something that may not be a threat.

I often ask my patients if they are feeling the need to look up health information to be mindful of the source.  To be on the safe side, there are a few websites that I always refer patients because the information is non-commercial (there won’t be a drug company trying to sell you a medication) and the information is vetted.

Medline Plus

This website provides safe information concerning conditions and medications for you and your entire family.

Consumer Lab

One of my favorite references for herbal supplements.  I routinely consult this for information on herbal supplements.

I use Google just as everyone else does, but often during a visit, I don’t have the luxury of telling patients why I can’t use Dr. Google’s recommendations while I’m taking care of my patients.


Just as a reminder, these substitutes are not replacment for emergency situations or questions, so if you are having an emergency you should still go to the ER or call 911.  

Smoking and ways to quit

I want to provide fair information to patients.  I recently received a medical news update concerning how effective E-cigarettes are for someone who wants to stop smoking.

Anytime a patient is ready to stop smoking I want to encourage them as much as possible.  The use of E-cigarettes has grown in popularity, and in all honesty, most physicians don’t actually know how to advise patients.

This particularly study tells us that if a person is serious about stopping smoking, using an E-cigarette may not help.

Be willing to discuss the topic with your physician SEVERAL times…no matter how you choose to quit, it may take another attempt, and another..and another..its okay to get frustrated just don’t give up.

Medical Approach

I typically tell patients that the best way to stop smoking is still going to be use of medications, however, the failure rate of all methods (using nicotine replacement, E-cigs, vapes, or “cold turkey”) is high, so it will take multiple attempts to successfully quit.  Medications such as Chantix and Zyban are the highest performing.  These have been clinically studied.  With any medications, there can be side effects, and you’ll need to discuss with your physician if this option is best for you.

Mindfulness Approach

Reiki can help with any psychological issues, including addiction, and the relaxing nature of a self administered treatment or by a Reiki practitioner,  can help to alleviate the stress experienced during nicotine withdrawal.

When I discuss smoking with patients, I like them to analyze what they get out of smoking.  One aspect of smoking is the breathing…there’s a long inhale and a pursed lip exhale…very similar to the controlled breath of Yoga called Ujjiy Breath, or Victorious Breath.  This is a simple breathing technique frequently done  in Yoga classes.

Ujjiy Breath is done like so:

  1. Take in a deep breath through your nose.
  2. Exhale while gently closing off the back of your throat as if you’re sighing, keeping the lips slightly parted. The exhale should produce a sound, such as ocean waves or the wind blowing, and should be drawn out.  The long exhalation helps you to relax.
  3. Repeat several times, up to 10 if your comfortable.

You can do Ujjiy Breath at any time, and this is a great fast method to go to for Victory against smoking (haha…that was a joke…see what I did).

There is a technique some have heard of called EFT, or Tapping.  I like to recommend tapping as a tool to help a patient stop smoking as it helps with some of the wiring of the brain to eliminate many psychological and emotional issues. I am not trained in EFT but have experienced some of the benefits.  There is a free e-book and more resources on this at the EFT Universe.


Update on Effectiveness of Varenicline On Smoking Cessation after a Heart Attack

I received a Primary Care update from Practice Update  with new research  concerning using Varenicline (or Chantix) to help people stop smoking.  The link will take you to the abstract.  In summary, Varenicline is helpful in patients after they’ve had heart attack, but even in those patients that took Varenicline to stop smoking  the failure rate was still high (around 60% started smoking again within one year).

I prescribe Varenicline in patients that want to use it.  Stopping smoking is a big deal, and there is no one right way to quit.  But every patient needs support and care in their attempts to quit.  And keep quitting…expect failure;  it may take up to 13 attempts to quit, but be ready to try a new tactic.

I also came across a very nice post on Reiki Rays using Reiki to Heal addictions.


Introduction to Reiki

I plan to cover many topics but this post I’d like to delve into Reiki.

I first learned about Reiki from Sara Alavi at Yoga Home of Therapeutics .  Sara has taught me so much over the years and I’m so grateful to her.

I initially knew very little of Reiki.  I had taken an interest in Yoga and eventually completed my 200 hour certification to be a Yoga Instructor.  It was through yoga that I had my first experience with awareness of energy in the human body and how it could effect the physical body.

The fundamental purpose of Reiki is to channel high frequency energy into the body to encourage the body to heal itself.

Here is a link for a history of Reiki:

Reiki is channeled energy.   We are surrounded by energy.  The simplest example is heat energy from the sun, which we feel on our skin.  Another form of energy is infrared energy, which is used in remotes and many home devices, exists at a freqency that we can’t see or feel, but we do see the effects:

from NASA at

  X-ray energy, used in radiology to take x-rays and at airports to look into bags, exists at an even higher frequency.  We don’t see these wavelengths as our eyes are not tuned to operate at those frequencies.

from NASA at

We can see Visible Light,  which is a very small part of the energy spectrum.  Here is an example from NASA:

Energy can often be seen, such as the energy in the visible light spectrum, but as most of us are aware, our human sense do not typically allow us to feel energy that moves at a higher or lower frequency but we do see the effects.  The higher the frequency of the energy, the higher its ability to penetrate solid matter is.  You’ll notice on each graphic the height of the energy wave corresponds to a physical object, such as a hair, an atom, or a soap bubble.

Reiki is believed to channel energy that exists at a high frequency.  Now that we’ve covered how energy is the nature of Reiki, in future post, I’d like to delve into what it means to channel Reiki and how fundamentally this is how Reiki leads to body healing itself.