ADVICE 6E www.hpe.com SUNDAY, JUNE 6, 2010 THE HIGH POINT ENTERPRISE
Reactions to tetanus vaccine seldom seen D
ear Dr. Donohue: Can one develop symptoms of tetanus after receiving the tetanus vaccine at age 70? After getting the shot, I had jaw swelling, swollen neck nodes and swelling in the lower legs. The shot is the only thing that we think could have triggered this reaction. – M.G. Tetanus is a frightful, terrible illness that’s caused by a poison (toxin) made by the tetanus bacterium. Those germs are widely found in soil. A puncture wound, a skin-penetrating splinter, a fracture that protrudes through the skin, burns and sharing of unsterilized needles are some of the ways that the germ gains access to the body. The toxin releases nerves from the body’s control, and they go wild. Muscles contract forcefully, arching the back and neck into a painful contortion. The mouth clamps shut (lockjaw). The muscle contractions are painful. During all this turmoil, the patient is fully awake and aware. Vaccination with tetanus toxoid has so reduced the number of cases of tetanus in the United States and Canada that most doctors have never witnessed a case. The tetanus vaccine should be repeated every 10 years. The vaccine is made from the tetanus poison that has been modified so it produces no symptoms, but does stimulate the body to make antibodies to tetanus poison. Those antibodies inactivate it. The reactions you describe are not the symptoms of tetanus. They could be due to an allergiclike reaction to the vaccine. Such a reaction causes joint pains, swollen nodes and swelling at the injection site. It almost never happens. I am not positive that your description duplicates such a reaction. Report this to VAERS,
the Vaccine Adverse Event Reporting System. It is an official orHEALTH ganization sponsored Dr. Paul by the Donohue Centers ■■■for Disease Control and Prevention. The tollfree number is (800) 8227967. You, your doctor or both of you can report it. Dear Dr. Donohue: Do you know anything about erythema nodosum? I have large, red, painful bumps on my legs below the knees. Accidentally brushing my legs against furniture, the car door or even the cat hurts. Indocin and steroid cream were prescribed and helped for a while. I had to stop taking the anti-inflammatory drug because it upset my stomach. What causes this ailment? Is there a cure? – K.M. Strep infections, fungal infections, salmonella infections, Crohn’s disease, ulcerative colitis, birth-control pills, sulfa drugs and a few cancers are some of the things that lead to erythema (red) nodosum (bumps). In about 55 percent of cases, a cause cannot be found. Nonsteroidal anti-inflammatory drugs – your Indocin – often provide relief. Taking Prilosec, Aciphex or other similar medicines that stop the outpouring of stomach acid can control stomach upset due to it and permit continued dosing with NSAIDs. Or a switch to a liquid preparation of potassium iodide can end the outbreak. The bumps usually disappear on their own accord within six or fewer months. Dear Dr. Donohue: It is very difficult for me
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to get outside. Can I get any benefit from the sun by sitting in front of a screen door? â&#x20AC;&#x201C; E.A. If the screen allows sunlight to land on your face, arms and hands, you will get a benefit.
How about putting a chair in front of the door and sitting there? All the sunlight you need for vitamin D production is 10 to 15 minutes three times a week. If the screen blocks the sunlight, and if you
canâ&#x20AC;&#x2122;t get to a chair in front of the door, then you have to rely on a vitamin D supplement to get your quota of this vitamin. You should take 1,000 IU a day. And donâ&#x20AC;&#x2122;t forget calcium â&#x20AC;&#x201C; 1,200 mg a day.
DR. DONOHUE regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475