Newsletter 25 – April 30, 2018

During winter, it's cold and dark, the skies are gray, the trees are bare, the ground is hard, the grass is brown. It's dark when we wake up and dark when we leave work; it can seem endless. Then spring comes and reminds us that it's just one big cycle. Spring brings optimism, sunlight, green grass, buds on trees, flowers and birds chirping.

Vivaldi Spring - it's here! I am pumped! Watch this: https://www.youtube.com/watch?v=mFWQgxXM_b8

One of my patients sent me this excerpt below and I thought I would share it. We all face uncertainties in life that give us pause and provoke fear. Sometimes we may feel alone, sometimes grey and dreary and cold, like winter. But it passes.

The Surface and the Deep

" When under, remember the surface.
When on the surface, remember the deep."

When our days are turbulent and troubled, our challenge is to remember that the wave is not the sea. Though it pounds us, the pounding will pass. Though it tosses us about, the tossing will pass, if we don't fight it.
Often our fear misleads us to stay in close to shore, when the safest place is in the deep, if we can get there. Any swimmer knows: Stay too close to shore and you will be battered by the surf and undertow. We must swim out past the breakers if we are to know the hammock of the deep.
Stay on land or make it to the deep. It is the in-between that kills.

Here is a link to the source of the excerpt: From The Book of Awakening ~ Mark Nepo

Shingles, also known as herpes zoster, is a local reactivation of chicken pox on the skin. It can occur anywhere on one side of the body. Before the rash starts, the involved area may itch, ache or feel tingly. The rash has a predictable appearance and evolution.

I recommend getting the new shot for any of my healthy patients age 50 or over, even if you have had the previous vaccine called Zostavax. If you've received the Zostavax shot, you must wait at least 8 weeks before receiving the new one. The new vaccine, called Shingrix, is inactivated, as opposed to attenuated (live), like the previous shot. The CDC recommends this for healthy adults age 50 or older. It is given as a series of two injections with the second shot given anytime within 2 to 6 months of the first one. The side effects reported in trials were minor: the most common side effect was a sore arm. Most side effects were in younger patients.

If you have never had chickenpox, or are unsure if you've had it, before getting the Shingrix, contact me to see whether you may be better off getting the chickenpox vaccine instead.

The new shot is more efficacious than the previous: Zostavax loses its efficacy by about 15-25% after one year, and after nine years it's thought to no longer be effective; for Shingrix, studies have shown it's efficacy remains at 85% after four years. One out of 3 adults over the age of 60 will get shingles. It is a debilitating and painful eruption that can cause lingering pain, sometimes for weeks and even months.

The cost for the two shots is approximately $280. Part D of Medicare is apparently covering part of it, as are some prescription plans. The vaccine is being given at most area pharmacies. Call your pharmacy to confirm they have it, then let us know when you would like us to send in the prescription. If you do get the shots, please let us know so we can document it in your chart; pharmacies are supposed to let us know, but this is not always reliable.

Want more info? Go to this link:

https://www.consumerreports.org/shingles-vaccine/new-shingles-vaccine-shingrix-what-you-should-know/

Wishing you good health,

HAO

Harry A. Oken, M.D.

Office: 410-910-7500
Fax: 410-910-2310

Cell: 443-324-0823

Adjunct Professor of Medicine

University of Maryland School of Medicine