From primary care physicians to cardiologists and dermatologists, explore answers to common questions from verified healthcare experts. Ask your non-emergency health questions and find informed answers from verified doctors like Aaron Baggish, Jordan Metzl, and Katherine Wojnowich.
A new flu vaccine is needed every year because the influenza virus is constantly evolving, changing its outer proteins. International flu surveillance centers are used to anticipate what strains will be most prominent in order to create a targeted vaccine for that season. Transcript: "So, why is there a new flu vaccine every year? Well, the influenza virus, like most viruses, contains a set of genes that are wrapped in a coat of protein. The way vaccines typically work is that for the flu vaccine, it stimulates the production of antibodies that then attach to the outer structures on this protein coat of the virus. And in doing so, it then disables the virus or prevents it from being able to actually enter into our cells and infect us. And so, given that, the way viruses go and the way the flu virus is, is that it is constantly evolving and when it evolves, it changes those outer proteins. And so, therefore, we need a new vaccine that is able to stimulate antibodies against the current proteins that's in the outer coat of the virus. As a result, we know that we have to really do a close surveillance, of which we have internationally, these influenza viral surveillance centers, that are really trying to see if they can anticipate what are the likely strains of the flu virus. That we could they can then use to target the future years vaccine towards. And so, what we do in north America is that we look to see what is happening in the other parts of the world, in Australia, et cetera, to then say can we anticipate that. And so, some years and some seasons we get it very close and accurate, and other seasons we don't. But this is why every year we get a new flu vaccine."
In general, an adult should visit the hospital if they have a fever of 104, 105, or possibly 103 depending on symptoms. Transcript: "So the question is, how high of a fever in an adult should prompt to a trip to the hospital? So as an ER physician, I have to say, in general, we treat patients. We don't treat numbers. However, it is important to know that the higher your fever is, the more likely you are to have a serious illness. So for example, if you have a fever 104, 105, I think the chance of that is sign off you should certainly come. And possibly even for a fever 103. Everything else completely depends on the context. For example, if you're immunocompromised and if you're not feeling well, you're having a cough, and you have no fever, you should still come to the hospital. So I'm making the point just to illustrate the range. Again, this very much depends on your symptoms. Not just the numbers of your fever. But again, fever 1004, 105 definitely, possibly 103 if you're an adult."
In most cases, both arches (top and bottom) need to be done in order to get a healthy smile with Invisalign. Ask your orthodontist or Invisalign provider what is best for you. Transcript: "Hi there. I get this question a lot. Is it possible to get Invisalign only in the bottom? And if so, what are the tradeoffs in this approach? In most cases, it's not. What we need to do in order to fix teeth, whether there's spacing or crowding, which is generally why most people come to us for Invisalign is to make sure that the teeth are functioning together, meaning they're able to chew. If the teeth are moving on the bottom and you don't move the top teeth, chances are your bite is going to get thrown off. And that's definitely not what we're looking to achieve here. We want a beautiful smile, but we also want a healthy one, where you're chewing and functioning as you were when you walked in, if not better. So there are limited cases where that's possible, but in most cases, both arches need to be done. Certainly ask your orthodontist or your Invisalign provider what's best for you."
If I had to give one piece of medical advice to a masters athlete, it would be to prioritize volume over intensity when it comes to exercise. Reduce high-intensity sessions to one or two at the most per week and focus on volume the other days. This will reduce medical complications of training while also improving performance in certain endurance sports. Transcript: "If I could give only one piece of medical advice to a masters athlete, what would that be? Well, that's a tricky question because I thoroughly enjoy working with masters athletes. And I love giving them just as much advice as they're willing to take. Thinking through all of the different tidbits that I typically try to provide from an advice perspective, if I had to choose one, it would be to think about the right balance of exercise volume and exercise intensity. As we age, our ability to perform high-intensity workouts over a short period of time tends to decrease. While young, highly-competitive athletes can oftentimes get away with three or four high-intensity sessions a week, as we age it becomes much more important that we prioritize volume over intensity. So for masters athletes looking to stay fit and competitive, I would advise them to reduce their high-intensity sessions to one or two at the most per week, and to really prioritize volume on the other days such that it's possible to train six if not seven days a week. But the vast majority of that training should focus on volume rather than high intensity. Not only will this reduce medical complications of training, but it will also actually translate into better performance in specific type of endurance sport. So really, it's a win-win situation."
Mommy brain is a superpower that helps you to care for your new infant's needs. The maternal brain changes structurally and functionally to better handle and protect your baby. Research suggests that the maternal brain looks like a teenage brain until around two years postpartum. Taking care of yourself, having a team of providers and a small circle of support are important in managing mommy brain. Transcript: "What is mommy brain? Great question. So society will deem mommy brain as a deficit and associate it with brain fog, forgetfulness, moodiness, different emotional challenges, being depleted, which can definitely be a part of mommy brain. And that is why having a big circle of providers of support and a small circle of support is super important during the postpartum period. But mommy brain is a superpower and this is something that we want to rebrand, right? Mommy brain is a superpower. It helps you to care for your new infant's needs. So the maternal brain will change both structurally and functionally to a certain extent so that you, the mother, can better handle and better take care of and protect your infant. So knowing what different cries mean is huge. That is a superpower as a mom that you have. Understanding like when you are changing the baby's diaper and you smell the baby's poop, how your breast milk composition will change to meet the demands, the nutrient demands, of your child. That is part of mommy brain. That mama bear feeling, that protective mode, figuring out what is safe for your child versus what is not safe for your child, that is all the maternal brain changing to better serve your baby. And there's a ton of research that still is being done. But what research is currently looking at is that the brain looks a lot like the maternal brain, that your new maternal brain looks a lot like your brain did when you were a teenager and then fully doesn't come back until around year two postpartum. So again, making sure that you are taking care of yourself. You have a team of providers, a small circle of support. And also something else is that there are other brain changes with fathers, grandparents and other caregivers too."
Burnout is very common in the ICU and can manifest in people leaving the ICU and clinical practice. It often results from the conditions of work and the emotional toll of working in the ICU. Symptoms include feeling disconnected, empathy tank being dry, and feeling like work doesn't matter. People sometimes attempt to cope with it in unhealthy ways such as drinking. Transcript: "Burnout is unfortunately really common for all health care workers and particularly common in the intensive care unit. And the easiest way to say how I've seen it manifest is in people leaving, leaving the ICU and leaving clinical practice altogether. This is especially true with nurses. We're having, you know, growing nursing shortages across the country, especially in the ICU. So I think burnout is unfortunately, you know, it's due to the conditions in which we work as well as the nature of the work itself sometimes and kind of the emotional toll of being in the ICU. But it can result in people outright leaving and before that it result, you know, the best sort of meme I ever saw was a vending machine that had a sign on it said that said the light is broken but I still work. And that's what it feels like, right? Your empathy tank is dry, you feel like the work you're doing doesn't matter and you're really disconnected from your sense of who you are. None of that is a good way to be when you are, you know, trying to take care of very sick patients and be there in their moment when they're the most vulnerable. And I think we feel that. We feel like we are letting ourselves and our patients down when we're very burned out. So it's unfortunately all too common and we see the effects of it kind of every day. And I think what's really scary is when people try to treat it, not by just fixing the symptoms and all this and not by going to therapy, which is probably really important too, but by for example drinking a lot."