Month: September 2023

CDC Recommendations for Fall-Winter Immunizations

The CDC recommendations for Fall-winter immunizations were updated as of September 29, 2023. A few states require a physician’s prescription for the RSV vaccine. Information varies on the web on which states require a prescription for the RSV vaccine. The Iowa Board of Pharmacy website is clear on the matter–you’ll need a prescription.

Most states don’t require a prescription for the RSV vaccine. The CDC recommends having a shared decision-making discussion with your doctor to help you decide about whether the RSV vaccine is right for you. The best thing to do would be to call your doctor, the state board of pharmacy, or your local pharmacy to find out how you should proceed.

Wendy’s New Pumpkin Spice Frosty

We got over to Wendy’s to try the new Pumpkin Spice Frosty yesterday. I thought it was pretty good. Sena was OK with it at first—but then decided she wouldn’t get it again.

We’re now focused on trying the Peppermint Frosty. We might have to wait until mid-November, though. I read this was out last year around the same time (mid-November). I don’t know how we could have missed it.

Covid-19 and Flu Vaccines Today

Today I got the new Covid-19 vaccine and the flu shot. I scheduled on line late last week and got right in. I didn’t have to wait long in line—and there were others getting the same vaccines. Sena will get them tomorrow.

It’s up to you.

Dr. Igor Galynker and The Suicidal Crisis Syndrome

I was looking at my bookshelves and found the copy of the book, “The Suicidal Crisis: Clinical Guide to the Assessment of Imminent Suicide Risk.” It was written by Dr. Igor Galynker. It’s a fit topic for this month because September is National Suicide Prevention Month.

This brings back memories. I still have a gift from Dr. Galynker. It’s a stuffed animal called Bumpy the Bipolar Bear.

It arrived at my office at The University of Iowa Hospitals & Clinics in 2011. It was in a box addressed to:

WordPress

Attn: James Amos

200 Hawkins Drive

Iowa City, IA 52242

 I’m still not entirely sure why he sent me Bumpy. There was no letter of explanation. I was writing a blog at the time called “The Practical Psychosomaticist” and I might have posted something about some research he published on suicide risk assessment.

I bought a copy of his book a few years ago. I barely had time to skim a few of the chapters because I was too busy conducting suicide risk assessments in the emergency room, the general hospital, and the clinics in my role as a psychiatric consultant. In fact, I think it’s an excellent resource.

I also found a YouTube video (posted about a month ago) in which he describes his suicide crisis syndrome assessment. You can find the actual set of questions for the assessment here and in a link posted in the description below the YouTube.

September is National Suicide Prevention Month

September is National Suicide Prevention Month. The 988lifeline website has many resources for getting the word out about the importance of not missing any opportunities to help prevent suicide.

In fact, there is a recently published article entitled “Multiple Missed Opportunities for Suicide Risk Assessment in Emergency and Primary Care Settings.” A few of the important take home points:

  • “Screening for suicide risk, while a critical step in potentially preventing death or injury by suicide, is fraught with additional challenges centering around the poor sensitivity and specificity of many of the screening tools. The widely used PHQ-9 question about suicide has poor sensitivity and specificity. A much better screening tool we recommend is the Columbia-Suicide Severity Rating Scale Screener which can be administered by both clinicians and non-clinician individuals who have been trained in its use.
  • So called “no harm contracts” are best avoided and, instead, replaced with approaches that emphasize joint planning that more respectfully builds upon patients’ innate resiliency to self-soothe, build upon one’s protective factors and reduce those risk factors that are modifiable, and problem-solve ways to create a series of “what-if” scenarios of what to do if suicidal feelings start to intensify
  • Firearms are the leading means of fatal suicides in the U.S. Effort to ensure patients at risk for suicide do not have access is critical
  • There is a bidirectional and undoubtedly complicated relationship between substance use and suicide.”

Thoughts on Jack Trice

I was outside doing yard work the day before yesterday and my neighbor across the street walked over to say hello. We got to talking about sports and football came up. His wife stopped watching football because it was so violent—but then switched to watching hockey. He wondered when the Iowa Hawkeye vs Penn State game was going to be on. No, I’m not going to discuss that any further.

Anyway, that led to my mentioning how brutal college football was back in 1923 when Jack Trice, Iowa State University’s first black athlete was killed on the field during a game with the University of Minnesota. My neighbor was incredulous. He’s in his 80’s and he’s never heard the story.

In fact, I had just learned about the whole Jack Trice story and commemoration event in his honor the day before that, only because Sena told me about it.

All this year long there has been a 100-year anniversary commemoration of Jack Trice, Iowa State University’s first African-American athlete. The program will culminate on October 8, 2023 with the closing ceremony.

Football was a rough game in that era—but rougher still because Trice was black. Many believe his injuries were deliberately and maliciously inflicted because of his race. It’s more than plausible. In 1997, the football stadium was renamed Jack Trice Stadium. It’s the only major college football stadium named for an African-American.

Sena and I moved to Ames in 1981 so that I could enroll in Iowa State University. I was so immersed in my studies that I never gave a thought to Jack Trice. I don’t remember the football field being named Jack Trice Field in 1984.

As I looked through the commemoration website, I wondered how it was possible for me to have ignored the story of Jack Trice while I was there.

I think it’s for the same reason I never knew anything about James Alan McPherson, the first African American to win the Pulitzer Prize for fiction and who was teaching at the Iowa Writers Workshop during the entire time I was in medical school, residency and a faculty member at The University of Iowa Hospitals & Clinics.

I was working hard. I finally found out about McPherson after reading a news item about a neighborhood park being named after him in 2021.

I should pay more attention. Anyway, Iowa State University did a tremendous job putting this commemoration event together.

RSV Vaccine Prescription Necessary for Some States

Sena and I were wondering if you need a prescription to get the Respiratory Syncytial Virus (RSV) vaccine.

It turns out only four states require doctor prescription to get RSV vaccine: Iowa, Georgia, Missouri, and Utah. Washington D.C. is working on making the RSV vaccine available without a prescription.

The Iowa Pharmacy Association blog post about the issue makes it clear a prescription is needed to get the RSV vaccine.

Brand Spanking New Air Purifier!

Sena got a brand spankin’ new air purifier and it’s whisper quiet. It’s made by RENPHO. Air purifiers probably don’t reduce virus particles but they at least they give you the impression you’re doing something to keep the air clean in your home.

We had an air purifier years ago, and the whole unit had to be cleaned occasionally. This one has a filter you change every 6 months or so.

It’s easy to operate. Basically, you turn it on and forget it. Some of the directions are a little interesting. One of them is a table of what the different button symbols are. The title is “Defination.”

The list of cautions includes the instruction, “Do not place anything on top of the appliance and do not sit on the appliance.”

Why it would occur to anyone but an extraterrestrial to sit on the air purifier is beyond me.

There’s an air quality sensor light which glows a different color corresponding to how good or bad the air is in your house. Blue is very good; Green is good; Orange is bad; Red is polluted. Ours always glows a nice, comforting blue.

There’s a note below the air quality sensor light description:

“Note: Compared with professional instrument, the detecting result of this air quality sensor may has tolerance in accuracy, we suggest you regard the sensor detecting result as a reference only.”

I’m not sure how to interpret this note. Does “tolerance in accuracy” mean it has only tolerably fair accuracy, meaning good enough for government work? Would a canary work just as well?

The trouble shooting section contains an entry that might be helpful:

Problem: You can’t adjust any of the controls.

Cause: An Extraterrestrial Biological Entity (EBE) is sitting on top of the air purifier. Some EBEs are pretty finicky about air purifier settings. They might prevent you from changing them by contacting their superiors, who will abduct you and conduct various experiments using large probes.

Solution: Let the EBE have its way.

A Summer Cold

Well, as I predicted in an earlier post, I caught Sena’s head cold. I have not had one of these in over 3 years, believe it or not.

It was easy to distinguish my cold from Covid-19, influenza, bubonic plague, and abduction by extraterrestrials. I usually get a dry cough, which causes a headache, a runny nose, mild fatigue and general achiness.

When I’m abducted by extraterrestrials, they usually just want directions to a decent rib joint.

I also had mild nasal congestion, for which I didn’t bother to take phenylephrine. I didn’t take aspirin, or acetaminophen. I didn’t have a fever. I did finally take some cough medicine, which I usually hate. I tend to think the guaifenesin makes me gag, although it’s more likely coughing itself causes that. Raspberry is definitely not my favorite cough syrup flavor.

I took a quick look at the CDC website about colds and found a page on how to distinguish colds from influenza. Colds aren’t that big a deal, but you can get pretty miserable. I don’t know if a summer cold is different from a winter cold. Rhinoviruses cause the common cold and infections tend to cluster in early fall and spring.

The head cold cramped my style. I was too busy sneezing, blowing, and coughing to practice juggling or exercise. It also interfered with sleep.

Interestingly, it didn’t stop me from watching the Men in Black trilogy on TV this week. Funny how that works.

I think we just caught a late summer cold. There was an old Contac commercial about it in the 1970s. I can find the jingle but I can’t find a video of the original commercial.


“A summer cold is a different animal, an ugly animal, ooo…cause it hits you in the summer, when you got a lot to do.”

I don’t have that much to do—but I’d rather not be down with a cold.