FROM THE EDITORS KEYBOARD

Why devote three radio programs to the subject of tetanus? And why reprint them here in a newsletter sponsored by an institution that views lifestyle change as the key to disease prevention?

Perhaps the last question is easiest to answer. Even though the Lifestyle Center of America is devoted to do all we can with lifestyle factors--like nutrition, exercise, and stress management--we do not exclude the appropriate use of other therapies. Vaccinations are members of one class of therapies that we believe have a legitimate role in disease prevention.

Ironically, immunizations are also a class of preventive agents that have been much maligned in some alternative medicine circles. The irony is that the effectiveness of vaccines actually serves to make their use look less important. After all, vaccines **do** have the potential to cause side effects. So, like any society that has high immunization rates, we are more likely to see side effects from an immunization than to see cases of the disease that it is designed to prevent. For example, when was the last time you heard of someone getting polio? Cases still occur in the unimmunized Americans, but those cases are few and far between. Even the unimmunized are actually at less risk today. Because of the vaccines widespread use and effectiveness, there are significantly less people who an unvaccinated person could catch the disease from.

Tetanus, however, presents a very different case than polio, measles, mumps, or chicken pox. We get tetanus from spores--not from other people with the disease. It is therefore important that we be aware of this life threatening and costly disease.

We round out this issue with a potpourri of more conventional lifestyle issues. These come to us from Phylis Austins Science/Health abstracts. Youll find information in todays issue on subjects as varied as sunshine, diet and caffeine.

SECTION II

TRANSCRIPTS FROM THE WELLNESSWISE RADIO PROGRAM

(All scripts copyright 1995 and 1996 by David J. DeRose, MD, MPH)

THE PRICE OF PREVENTION

A brush with death gives us a powerful lesson. I'm Dr. David DeRose, in a moment we'll look at "The Price of Prevention" on WellnessWise.

The 82 year old man was brought into the emergency room. He was short of breath and could no longer get out of bed. On the surface, his situation did not seem surprising: he had emphysema and often developed pneumonia.

However, here is where the plot thickened. The medical staff noticed stiffness in his jaw muscles and then learned that he fell two days before and cut his right elbow. The astute clinicians made the correct diagnosis--tetanus. Despite immediately starting the proper treatment, the disease progressed. While hospitalized, the elderly patient developed muscle spasms, then breathing failure and pneumonia. He needed to be put on a breathing machine--known as a mechanical ventilator.

After a hospitalization of five weeks, he was fortunate, he left the hospital alive. His bill: over $150,000.

The evidence is that this costly brush with death would never have occurred if the patient were adequately immunized. For public health clients in Kansas--where this incident occurred--full vaccine protection from tetanus costs less than $10.

The tetanus vaccine--it can save lives and thousands of dollars.

For WellnessWise, I'm Dr. David DeRose.

Refs.: Morbidity and Mortality Weekly Report, Vol. 43 number 17, "Tetanus--Kansas, 1993", pages 309-311.

TETANUS: THE INVISIBLE KILLER

What we don't see, we often don't fear. I'm Dr. David DeRose, in a moment we'll look at "Tetanus: The Invisible Killer " on WellnessWise.

Tetanus--also known as "lock jaw" is a leading killer in the world. Fortunately because of vaccination, each year, only about 50 people in the US even get the disease.

However, the rarity of the disease makes it even more dangerous. Since few people have ever seen tetanus in action they believe they face little risk. But this is **not** the case.

Tetanus spores are able to transmit the infection. And these spores are found in dust and soil throughout the whole world. They are extremely hardy and can survive for years.

Infection occurs when the spores gain entry into the body and then lodge in an area and produce tetanus germs. These germs multiply and release a poison called tetanospasmin. This chemical travels first through the blood and then along the nerves, finally affecting, the brain, spinal cord, and other nerves. Early signs of the disease include muscle cramps and stiffness. Later sudden muscle contractions and spasms occur. Involvement of the breathing muscles can cause breathing stoppage and death. Heart stoppage can also occur. Over 30% who develop the disease die from it.

Tetanus is almost entirely preventable. We'll look at what you can do in our next program.

For WellnessWise, I'm Dr. David DeRose.

Refs.: Last JM, and Wallace RB, editors. Maxcy-Rosenau-Last Public Health and Preventive Medicine, 13th edition. Norwalk, CT. Appleton and Lange. 1992, p.76-78

1994 American College of Physicians Adult Immunization Guide: p.130-133

Harrison's Textbook of Internal Medicine 12th ed. 1991 pages 577-579.

stats on annual cases: Oct 21, 1994; Morbidity And Mortality Weekly Report vol. 42 number 53.

TETANUS: WRAPPING IT UP

Another life threatening disease is virtually completely preventable. I'm Dr. David DeRose, in a moment we'll look at "Tetanus" on WellnessWise.

Tetanus--also known as "lock jaw" is a killer. Over 30 percent of those who develop the disease die from it. The casualties are greater among the very young as well as the middle aged and older. For example, if you're over 50 and get tetanus you have close to a 50-50 chance of dying from the disease. Furthermore, in the US, nearly two- thirds of tetanus cases occur in individuals who are over 60. Almost all of these cases could have been prevented by appropriate immunization.

It is not enough to wait until you have a dirty puncture wound to get a tetanus shot. The tetanus spores live throughout the world and are found in soil everywhere. Individuals have gotten tetanus and died without any evidence of a cut or other injury.

The only reliable protection is to make sure that you have had a primary series of vaccinations. This means three doses of tetanus vaccine over the course of one year. A tetanus booster every 10 years is also a good idea to keep your protection up. At a minimum, everyone should have that primary series and a booster at 50 years of age. Even with these precautions, wound care and additional injections may be needed after injuries especially if they are dirty or deep puncture wounds.

For WellnessWise, I'm Dr. David DeRose.

Refs.: Last JM, and Wallace RB, editors. Maxcy-Rosenau-Last Public Health and Preventive Medicine, 13th edition. Norwalk, CT. Appleton and Lange. 1992, p.76-78

1994 American College of Physicians Adult Immunization Guide: p.130-133

stats on annual cases: Oct 21, 1994; Morbidity And Mortality Weekly Report vol. 42 number 53.

SECTION III

SCIENCE/HEALTH ABSTRACTS

The intake of caffeine may produce symptoms of hypoglycemia (low blood sugar) at blood sugar levels which would not be troublesome without the use of caffeine. (Annals of Internal Medicine 119:799- 804, 1993)

SECTION IV

FROM THE LIFESTYLE CENTER OF AMERICA

Look for some exciting success stories from the front lines of Preventive Medicine. Selected patients of the Lifestyle Center of America will be featured in upcoming issues.

And by the way...

You or your friends can be part of this growing list of success stories coming from our state of the art preventive medicine center.

Call or e-mail today for information on special programs for reversing diabetes and high blood pressure, stopping smoking, optimizing your weight, preventing and treating heart disease (without more drugs or surgery), and a host of other specialized programs for other lifestyle- related conditions. Special pricing is still available for upcoming programs. For further details use the contact numbers below.

The Lifestyle Center of America (LCOA) is happy to sponsor the WellnessWise Electronic Journal. This e-newsletter provides a way for our Center to share its commitment to helping people deal with chronic disease without using drugs or surgery. Located midway between Oklahoma City and Dallas Texas, our state-of-the-art facilities feature structured residential lifestyle programs that can provide a turning point in your life.

PARTING WORDS

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