Category Archives: Just Crazy

Vitamin D Lowers the Risk of Getting Influenza A and Asthma Attacks?

Is it possible that vitamin D supplementation could reduce children’s risk of coming down with Influenza A by 58%, and of having an asthma attack by 83%?

Amazing as these claims might seem, this is what was reported in the March 2010 issue of the American Journal of Clinical Nutrition.

The students in this study – which was performed in Japan – ranged in age from 6-15 years of age, and they were given Vitamin D3 (cholecalciferol) at a daily dose of 1200 IU (International Units).

Although these improvements were observed for Influenza A and asthma attacks, there didn’t seem to be any effect on the occurence of Influenza B.

I first ran across this study in a article published in Reuters that was titled ‘Vitamin D helps fend off flu, asthma attacks: study’.

You can see a copy of it at this web address – http://www.reuters.com/article/idUSTRE62I3MK20100319 , and you can find a copy of the article they’re referencing at this web address – http://www.ajcn.org/content/91/5/1255.abstract?sid=39de4a22-ae42-40ad-82b8-77cc9f352efd .

If you want to read it you’ll have to buy a copy from the journal, but I’ve posted an excerpt from their abstract here for your review:

Results: Influenza A occurred in 18 of 167 (10.8%) children in the vitamin D3 group compared with 31 of 167 (18.6%) children in the placebo group [relative risk (RR), 0.58; 95% CI: 0.34, 0.99; P = 0.04]. The reduction in influenza A was more prominent in children who had not been taking other vitamin D supplements (RR: 0.36; 95% CI: 0.17, 0.79; P = 0.006) and who started nursery school after age 3 y (RR: 0.36; 95% CI: 0.17, 0.78; P = 0.005). In children with a previous diagnosis of asthma, asthma attacks as a secondary outcome occurred in 2 children receiving vitamin D3 compared with 12 children receiving placebo (RR: 0.17; 95% CI: 0.04, 0.73; P = 0.006).

Conclusion: This study suggests that vitamin D3 supplementation during the winter may reduce the incidence of influenza A, especially in specific subgroups of schoolchildren. This trial was registered at https://center.umin.ac.jp as UMIN000001373.

The reference for the article is:

Mitsuyoshi Urashima, Takaaki Segawa, Minoru Okazaki, Mana Kurihara, Yasuyuki Wada, and Hiroyuki Ida. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr May 2010 vol. 91 no. 5 1255-1260.

Two thoughts come to mind. 1. I wonder if the influenza vaccine can match these results for Influenza A?, and 2. I suppose it should improve adults odds also.

So, I’m going to keep on taking my 2000 IU of Vitamin D3 every day. Just in case.

Remember, I’m a pharmacist – not a doctor. Check with your doctor before changing your medication regimens or adding any supplements to your daily routine.

Doctors Doctor. Pharmacists Pharmacist. That’s how it’s supposed to be.

Medical Marijuana Probably Works? Are You NUTS?

So, let’s talk a little bit about the mechanisms that might be behind Medical Marijuana’s ability to affect so many illnesses.

I’m going to keep the discussion at the summary and overview level. This is much too complicated a subject to cover in a single blog entry.

But I will also provide you with some links that you can follow if you want to follow this topic down the rabbit hole.

There is a family of cell receptors in the body called cannibinoid receptors. There are at least two of them, CB1 and CB2. They’re influenced by chemicals your body makes called endocannibinoids, and the’re found everywhere in your body.

They undoubtedly serve many functions beyond what we’ve discovered so far.

But, in general we now know that the chemicals that interact with these receptors (the endocannibinoids) play key roles in the regulation of your body’s response to inflammatory conditions. They also act as ‘shock absorbers’ for your body’s nerve sytem’s reactions to chemicals that are associated with your responses to things that stress you out or cause you to be frightened – e.g. the ‘fight or flight’ system. AND, they are associated with immune system response.

Although Delta-9-THC is the chemical everyone talks about – because it seems to be the source of the most psychoactive effects of marijuana use – there are many, many more chemicals contained in whole marijuana extracts that are just as likely to exert positive effects on a person’s biochemical systems. In fact, synergy with these chemicals seems to be the key to Delta-9-THC’s use without serious anxiety related side effects.

This is not new information. It has been known for a very long time. I cannot tell you why it is not being made general information for the masses. I will simply state the fact that what is being made public is at best incomplete and misleading.

If you want a more detailed discussion of the endocannibinoid and cannibinoid chemicals and the receptors they affect I recommend you take a look at the info wikipedia has. A good web addess to start at is this one – http://en.wikipedia.org/wiki/Cannibinoids .

I also find the information at Dr Robert Melamede’s website extremely interesting. You can find it here – http://www.uccs.edu/~rmelamed/youtube_links.html . I think this one is a good place to start –http://www.youtube.com/watch?v=n31Nuj_AvTg .

I feel that I must also disclose that I am a stock holder in Cannabis Science Inc, and that Dr Melamede is the CEO and President of this company. The link to the company’s website is here – http://www.cannabisscience.com/ .

I stumbled across the company as a result of studying Dr Melamede’s publications. I was checking out whether the claims about Medical Marijuana (particulary Rick Simpson’s Hemp Oil claims) and its usefulness for cancer treatment made sense or not. See this link if you don’t know what I’m talking about – http://thatcrazypharmacist.com/?p=113 .

I don’t pay much attention to what this company is doing, I trust Dr Melamede and his collegues know what they’re doing. I have no idea if they’ll be able to succeed or not. They’re working against strong odds.

Again, I’m only providing information for you to consider and study. I am NOT recommending that you use marijuana. That is a discussion that should occur between you and your physician.

I also do not recommend stocks or investment strategies.

Remember, Pharmacists Pharmacist. Doctors Doctor. Stock Brokers Stock Broker. Let’s keep it that way.

Medical Marijuana – Just Another Excuse To Get Stoned?

Medical Marijuana is illegal in America.

Because of the position of the Federal Government, this is the bottom line despite Medical Marijuana laws that continue to be adopted by more and more states.

Pharmacists attempt to stay in line with the laws of the land, and always comply with the most restrictive interpretation of State and Federal law.

So – I am going to make sure that I state this clearly. I do not encourage the use of Marijuana in violation of Federal Law. I do not use Marijuana. I have never used Marijuana – and don’t intend to.

Having said this, I also want to tell you that I strongly believe that Marijuana (aka ‘hemp’) is a plant that has many medicinal and economic benefits – and the Federal government will undoubtedly be forced into changing its rules in response to the legislative tsunami that is sweeping across the states that make up the United States of America.

I am not going to debate the social and moral implications of casual marijuana use. I am agnostic on this topic. I am completely uninterested in the debate over whether people should be able to get ‘stoned’. Whatever society decides is ok with me, with the caveat that we’re spending a damned lot of money chasing people down and putting them into jails.

I am also not going to address the many industrial applications of the hemp plant other than to direct you to your local health food store and the many products that are being sold there after being imported from Canada and other countries around the world. It angers me to have to import these products and to sacrifice the money our farmers and factories could be making if they could produce and use hemp fiber, oils, seeds, and other products. It should anger you too. Obviously, I am not agnostic in this area.

OK, so now let’s talk about Medical Marijuana.

No one who has objectively studied the issue can deny that Medical Marijuana is effective, and in many cases as effective or more effective than what we presently offer through our medical system. Despite efforts from anti-marijuana entities, there is simply too much evidence coming to light around the world to be able to continue to deny the efficacy of Marijuana for the treatment of a multitude of medical conditions.

I first became really aware of Medical Marijuana in pharmacy school. We were given the task of designing a transdermal ‘marijuana’ patch. You know, kind of a ‘Pot’ version of the nicotine patch. It was kind of a joke project, but as I researched the topic I found that research into the use of marijuana compounds was progressing around the world, except in America. I also found that some of the most significant research was being done in Israel.

In fact, I found that an Israeli researcher had already figured out a way to make a Delta- 9-THC patch. As you might imagine, this made completion of my project easy. But, on my way to finding the researcher’s data I learned a lot about marijuana and its constituents’ chemical and medical properties – the most significant of which was the knowledge that delivering pure Delta-9-THC by mouth is a bad idea. Many people experience anxiety side effects when this drug is delivered through the gastrointestinal tract and the liver’s metabolism without the balancing effects of the rest of the chemicals that exist in natural marijuana extracts.

Then I forgot about the topic.

Until I had to research cancer therapies and alternative medicine approaches to cancer treatment.

By that time a marijuana extract inhaler had been approved in the United Kingdom and Canada for use in the treatment of Multiple Sclerosis and neuropathic cancer pain. (At this time it is also undergoing clinical trials in the USA, and other countries around the world. Amazing what the involvement of major pharmaceutical companies can catalyze, eh?)

I also stumbled across a video that was made by what appears to be an extremely dedicated and well meaning group of Canadians who are led by a man named Rick Simpson.

It’s  titled ‘Run From The Cure‘, and it documents the use of an extremely concentrated hemp extract for the treatment of a multitude of illnesses, the most significant of which is cancer.

Run From The Cure‘ presents an extremely interesting account of this group’s discoveries and the obstacles they ran into when trying to publicize them.

I want to emphasize this point – as far as I can tell, these folk are NOT hippies or drug addicts. They appear to be of the most sincere and down to earth persuasion you could find.

Although I continue to monitor the stories and information that is posted at their website(www.phoenixtears.ca), I do not know if their claims are true.

But I will tell you this, they make darned persuasive advocates for what they’re claiming – and I read their posts with great interest.

I will not bore you with the pharmacokinetics and pharmacodynamic information that I’ve factored into my assessment of their info right now. I’ll simply say that what they claim warrants serious consideration. If you are involved with a cancer patient I think you should also listen to what they have to say with an open mind.

You can find two of the most interesting videos that they’ve produced at these two web addresses.

(the Run From The Cure video and several others are available here)

http://phoenixtears.ca/hemp-oil/video-library/

(this seminar recording is broken up into several parts – i think there are 8 of them – increasingly interesting as you get further into them)

http://www.youtube.com/watch?v=-PwMmSxZANE&feature=player_embedded

Watch them with an open mind, and don’t get bogged down in the politics, etc… These people have been forced to do battle with Goliath, and that will cause you to get really opinionated and bitter. Stay focused on whether there might be something useful for treating cancer and other diseases. That’s the issue we’re wanting to investigate.

I am just a messenger delivering information in this posting. I am not advocating for your use of Medical Marijuana. I remind you that it is illegal – REALLY illegal – because the Federal Government says it is.

Put aside the reactions that you’ve been programmed to have to this topic. Watch the videos and read the information that is available with an open mind. Talk it over with your physicians

Remember, I’m CRAZY.

Pharmacists Pharmacist, Physicians Physician… as it should be.

Does Acetaminophen (aka ‘Tylenol’) Increase Cancer Risks?

What if I could show you evidence that strongly suggests that frequent acetaminophen use appears to be associated with substantial increases in the risk of cancer occurence?

Well, I can – and the journal articles that the information is in were published in world class publications and written by world class investigators from world class institutions who were documenting the results of world class investigations.

Unfortunately, the investigations were looking for reductions in cancer rates as a result of aspirin and NSAID use.

While the correlation between aspirin and reductions in cancer risk was clearly demonstrated in the two studies that I’ve most recently reviewed, it is a fact that the correlation between acetaminophen use and increased cancer risk was just as clearly demonstrated.

However, this correlation was either ignored or downplayed and rationalized away by the authors.

I don’t find this particularly unusual. By now everyone knows that aspirin (and sometimes NSAIDs) are strongly associated with serious reductions in cancer occurences and progression. In fact, this information has become so well known within the academic communities that it is now starting to spill over into the awareness of the general public. It is the norm for there to be an avalanche of data supporting discoveries like this once the fundamental claim has become accepted by the mainstream scientific community and researchers.

As Arthur Schopenhauer (1788-1860) is said to have prophetically written – ‘All truth passes through three stages: First, it is ridiculed; second, it is violently opposed; and third, it is accepted as self-evident.’

Along those lines, it simply isn’t acetaminophen’s turn to be reported on. But it will be. Correlations as strong as the ones shown in these two reports simply cannot be ignored forever.

I have seen similar information in other publications, but – like most – I have been so focused on reading the data that supports the publication’s research focus that I totally missed the acetaminophen correlation. But the studies I just reviewed were done so well and had been statistically analyzed so intensely that I just couldn’t ignore the point that acetaminophen and cancer occurence was strongly correlated for the studied conditions.

I encourage you to check this info out for yourself.

The first article is titled ‘Aspirin and the Risk of Hodgkin’s Lymphoma in a Population-Based Case-Control Study’ and its reference information is Chang ET, Zheng T, Weir EG, Borowitz M, Mann RB, Spiegelman D and Mueller NE. Aspirin and the Risk of Hodgkin’s Lymphoma in a Population-Based Case-Control Study. Journal of the National Cancer Institute February 18, 2004 Vol 96, N0 4, pp 305-315. You can get a free copy of it at http://jnci.oxfordjournals.org/content/96/4/305.full .

You can find a free copy of the second article at http://jama.ama-assn.org/cgi/reprint/291/20/2433 . It’s titled ‘Association of Frequency and Duration of Aspirin Use and Hormone Receptor Status With Breast Cancer Risk’. It’s reference is Terry MB, Gammon MD, Zhang FF, et. al. Association of Frequency and Duration of Aspirin Use and Hormone Receptor Status With Breast Cancer Risk. JAMA, 2004;291(20);2433-2440.

Although I don’t use acetaminophen, I intend to make sure my kids know about these studies and their findings… Hopefully they’ll limit their acetaminophen intake.

Oh yeah, in case you’re wondering… both studies noted above found strong correlations between daily aspirin intake and reductions in cancer occurence. Imagine that.

Remember – you must talk to your physician before starting any new medication regimen. Pharmacists Pharmacist – Doctors Doctor, as it should be.

Taking Iodine Supplements to Improve Your Health and Reduce Your Risk of Getting Cancer? Is That Crazy or What?

As I’ve cast around for ways to make my family member more resistant to cancer reoccurence I’ve run across a lot of crazy claims.

The majority of them have been looked at and discarded after careful consideration because there wasn’t any real evidence to support the claims, and I simply couldn’t figure out any way that they might be true or helpful.

However, the concept of iodine supplementation gains credibility with almost every enquiry I make.

We’ve talked about convergences between today’s theories and data and Doctor Gerson’s theories and practices in previous posts – and in one of those posts we briefly touched on the convergences of iodine supplementation.

What we haven’t really talked about is the fact that the most successful cancer healers of old – the ‘Quacks’, if you want to see them that way – incorporated similar types and quantities of iodine into their remedies.

That’s interesting.

For, although the conventional medicine folk would like you to believe that there was absolutely nothing to those healers’ claims of success treating cancers, I would like to put forth this thought for your consideration.

Do you REALLY think that people are that stupid? Do you REALLY think that people would keep going to these guys – even when they were being publically accused of being ‘Quacks’ and charlatans if nobody ever got ‘cured’ or helped in any way?

I don’t.

It is my opinion that people – even desperate people – are actually quite intelligent when it comes to figuring out where to go to try to save their lives. Especially those who have decided to forsake traditional treatments or those who have been through those treatments and then cast to the side to die. Money is always tight. It does not get frittered away someplace where believable and verifiable objective evidence of cures does not exist. The treatment might not work and they might die anyway, but I’m pretty sure they see what they’re trying as a viable option or they wouldn’t be there.

So, I pay attention to what was used in these so called ‘cures’ – from a Pharmacist’s point of view – and look for convergences.

I count this convergence as significant.

Significant enough that we’ve had many discussions about it amongst ourselves in the Pharmacy – and several of us, including the most hard core non-believers, have started ourselves and our loved ones on iodine supplements.

I will remind you, these are Pharmacists who have done this. Cold, hard, non-believing, conservative Pharmacists. We know I’m crazy, but I assure you they are not.

The conversations have been prolonged and intense enough that family members became aware of them before we Pharmacists had even made up OUR minds.

In fact, I remember waking up one day to find the family member who has been having to deal with cancer sitting on the side of the bed with a piece of paper in her hand. She handed it to me and told me that she’d asked her doctor what she/he thought about this iodine and thyroid supplementation ‘stuff’ – fully expecting to have a good laugh about it. In reply to the question the physician had handed her a copy of a document that talked about the use of iodine supplementation to cure fibrocystic breast disease, and the use of iodine supplementation and dessicated thyroid to treat what is now being called Type 2 Hypothyroidism and Hashimoto’s Disease.

I read that darned piece of paper – which was written by a doc for docs – multiple times.

Ultimately I found myself deciding that I’d better figure out the potential mechanisms behind these claims – and pretty darned quickly, because my family member was now hounding me for answers.

The best information I’ve found on this topic is at the website of a company that manufactures an iodine supplement called Iodoral™. That company’s name is Optimox, and their website is www.optimox.com. You can find their iodine supplementation papers at this website address – http://www.optimox.com/pics/Iodine/opt_Research_I.shtml . These papers were written by several physicians who have dedicated vast amounts of time to researching the history of iodine’s use in general, and its use to treat diseases in particular. They use iodine every day in their practices, as far as I can tell.

Another extremely valuable resource is the book ‘Hypothyroidism Type 2: The Epidemic’ by Doctor Mark Starr. His website is http://www.21centurymed.com/.

Doctor Jerry Tennant – the founder of the Tennant Institute for Integrative Medicine – also has interesting things to say about iodine supplementation at his website (http://www.tennantinstitute.com/TIIM_MAC/Iodine.html), in his book ‘Healing is Voltage: The Handbook (Vol. 1)’, and in his ‘How To Stay Well Pamphlet’. You can buy the book on Amazon.com and you can get the pamphlet for free at http://www.tennantinstitute.com/TIIM_MAC/Patient_Forms.html.

If you’d like to hear Dr Tennant and Dr Starr explaining their thoughts on a wide range of health topics listen to the series of youtube video posts starting with this one – http://www.youtube.com/watch?v=xEtLFZUAlV0 .

To really briefly summarize my findings it seems that most people – especially women – should be taking 6.25mg-12.5mg of iodine per day. There are two ways to do this. The first is the use of Lugol’s Iodine Solution. There are two strengths – a 2% and a 5%. Both contain iodine and potassium iodide. The 2% solution contains 2.5mg of iodine per drop, and the 5% contains 6.25mg/drop. So, one drop of 5% Lugol’s in a couple of ounces of water will give you the minimum that the people who believe in iodine supplementation say you should be taking. The other method is the use of iodine supplement tablets like the Iodoral™ tablet marketed by Optimox.

I use the 2% Lugol’s solution made by the J. Crow Company ( http://www.jcrows.com/ ). One of the other pharmacists uses the 5% Lugol’s and the Optimox tablets. Another uses only the Optimox tablets. The tradeoffs are that it’s a pain in the you-know-what to have to dilute the Lugol’s every time, and it tastes like iodine while the tablets are a little more costly, contain 12.5mg of iodine per tablet, and don’t taste like iodine.

Women are claimed to need much more iodine than men because the second and third biggest consumers of iodine are a woman’s breasts and ovaries. This is why goiters are reported to be 6 times more common in women than in men. Both men and women need iodine throughout the body – not  just for the thyroid gland. The amount of iodine in table salt is nowhere near what your total body needs – at least that’s the claim of these Docs – and it appears that salt actually fights against the absorption of the iodine.

OK. I believe.

The bottom line is that I’ve witnessed and experienced verifiable objective evidence that iodine supplementation works. That’s why I’m writing about it here.

BUT – Don’t try it without asking your physician if  it’s OK. There are conditions that might be made worse by iodine. Once you get your Doc’s OK take a look at some of the articles at the Optimox site, and buy and read a copy of Dr Starr’s book. Doctor Tennant’s book is also a good one to get and take a look at – especially if you’re looking for alternative health strategies. Take a look at Dr Tennant’s pamphlet – it’s free. Then, once you understand what is claimed and what to watch out for, start your doses low and go slow when you’re adjusting your doses.

Again, I’m Crazy – so always get your physician’s approval before you try what I’m writing about on this blog. I believe in what I’m writing, but the human body is an extremely complex machine, and only someone who has the training to put hands on you and assess your physical condition is qualified to give the OK to new medications and/or regimens.

Remember – Pharmacists Pharmacist – Doctors Doctor.

Flu Shots – Set Up For Pandemic Death? Try FluMist™ Instead.

It’s that time again.

The CDC and other organizations have started publishing their influenza (aka ‘The Flu’) data and recommendations again in preparation for the upcoming flu season. To sarcastically oversimplify their guidelines, they basically recommend that everyone who can breath or has a pulse needs to get a flu shot.

Who knows – they might be right. That many people may need flu protection this year.

But – in case you haven’t figured it out already, I do NOT like Flu shots. In fact, I am VERY anti-flu shot.

Instead, I propose you seriously consider getting the nasal vaccine – FluMist.

Not because of conspiracy theory debates about whether sinister forces are working to kill us all or not, or rumored links to autism, or any other reason along these lines.

Pharmacists hear these objections and get questioned about these topics all the time.

They are not the reasons that I am so anti-flu shot.

So, you might ask, then what the heck is your main hangup?

It’s simple. I think flu shots block you from building up long lasting antibodies that your body can rely upon to protect you from similar flu strains in the future.

All pharmacists know that the conventional flu shot that you get in your arm only gives you immunity for a time period measured in months. Then the immune response goes away and the body forgets it ever saw that strain of flu before.

If there is one thing you can guarantee, it’s that the flu viruses are going to mutate. Quickly. And, it is inevitable that one of these days we’re going to end up with a killer flu circulating aroud the world.

If your body has seen one of the earlier versions of a flu it may protect you to some degree from the currently circulating flu virus. You hear about this happening all the time for people who didn’t get as sick as others because they’d seen a relative of the current flu sometime in the past.

This phenomenom will be mentioned in passing in articles in the newspapers, on the radio, on TV -even on the internet. But few people are aware of the fact that they will not be getting that kind of protection from the flu shots they got this season unless they end up getting the flu anyway.

So…. you ask…. what do you recommend we do instead, Mr Smartie-pants? Take our chances and get the flu?

Well, I guess that’s exactly what I recommend – unless you have a serious medical problem that would make the flu life threatening. At least what I recommend is equivalent to getting the flu.

Taking the FluMist vaccine is the same as getting the flu from an immune system point of view.

I’m a huge fan of FluMist – the influenza vaccine that is squirted up your nose.

FluMist actually infects your nose with the flu, and after your body fights it off you will have an immunity to the flu strains that were included into the vaccine that will last for many years. At least this has been the case for as long as FluMist has been on the market.

And – it has been reported, and I believe it to be true – that FluMist gives you better protection if the flu strain changes a little from what was predicted.

Think of it this way.

Visualize the flu strain you’re being immunized against as a 7 foot tall troll with a hunched back, a bad attitude, blonde hair, one blue eye and one grey eye. The shots only identify the virus as having a grey eye. That’s all the information they’re capable of communicating to your immune system. FluMist – on the other hand – handcuffed and hog tied the sucker and let your immune system get a good picture of its every physical attribute as it beat the snot out of him. Later, if a relative comes through with a disguise – but having a bad attitude and showing a hunched back and a blue eye – your immune system is likely to beat the snot out of it because it has enough information to know that there’s a family resemblance.

A pandemic or killer flu might just be that relative with the disguise. different enough to avoid the info your immune system got from the shot, but not different enough to bluff its way through if you had FluMist.

You could actually take your chances with the flu. But, I do not think this is a good strategy, especially right now. I am quite concerned that this year’s flu season could be a very challenging one.

So, that’s what I’m going to do. I’m going to march my butt into my doctor’s office and get that darned FluMist vaccine squirted up my nose. I’m past the 49 year old cutoff for getting FluMist. Doesn’t matter. I’m going to twist my Doc’s arm till he/she gives it to me. It’s my understanding that the reason it’s not approved by the FDA for people who are older than 49 is that the company that invented it ran out of money and couldn’t finish the clinical trials. Think about it. You’re OK when you’re 49 and you turn into a pumpkin at 50? I got it last year, and I’m going to get it again this year. And so did and so are all the other members of my family.

(To share a kind of funny story with you, my daughter got FluMist a couple of years ago. She works for a drug development company, and – of course – all the people she worked with got the shot her company paid for. She called me up in the midst of the flu season and told me she was never going to get FluMist again. Concerned, I asked her why. She explained with a laugh that she was the only person who didn’t have the flu and everyone had been out for going on a week – and she was being expected to keep the projects on schedule all by herself. True story.)

Anyway –

One last note – FluMist does contain weakened live flu viruses. Not everyone can take it. As with all medicines – there are risks that are uniquely associated with it. But, I think it’s a WHOLE lot safer than getting the flu for most.

As always, these decisions must be made in consultation with your physician. Pharmacists Pharmacist, Doctors Doctor. Ask him/her if you’re healthy enough to get FluMist… Seriously consider getting yourself protected this year. Stay safe.