Dr. Roach: Adult vaccines can boost immune system

Keith Roach
To Your Health

Dear Dr. Roach: I was wondering what adult vaccines should be given to enhance the immune system, in addition to improving sleep and diet.

P.P.

Dear P.P.: Our bodies’ immune systems are designed to protect us from outside invaders (bacteria, viruses, fungi, parasites) as well as internal errors (cancers), and they are very effective at doing so. Unfortunately, the germs and abnormal growths also are skilled at avoiding our immune systems, so there is a constant struggle going on. Giving your body proper nutrition and rest, and managing stress help your immune system perform at its best.

Vaccines improve your body’s ability to fight off particular infections, increasing your immunity to very specific bacteria and viruses. The vaccines that are generally recommended for healthy adults are:

■Flu vaccine (yearly)

■Tetanus, diphtheria and pertussis once, then tetanus/diphtheria every 10 years

■Human papillomavirus (three doses, up to age 26)

■Zoster, the shingles vaccine (once after age 60)

■Pneumococcal vaccine (PCV13 once, PPSV23 once or twice)

Depending on the person’s past history and risk factors, other vaccines — including the measles, mumps and rubella vaccine; meningococcal vaccine; hepatitis A and B vaccines; and haemophilus vaccine — also may be recommended. International travelers may need others. The Centers for Disease Control and Prevention maintains the most recent recommendations on its website at vaccineinformation.org.

Dear Dr. Roach: I was a healthy female until I had an injury to my back. I experience pain and tingling in my right side, going down the back of my right leg. Sitting is especially painful, as is standing in one place for too long.

Now the pain has started in my left side, also. I have tried chiropractors, acupuncture, physical therapy, epidural shots and pain pills. I also had two laminectomies (decompression surgery on the spinal canal) on L4/L5 last year, with no relief from the pain. Upon seeing another neurosurgeon, I have been told that I have some large Tarlov cysts (1 cm).

There does not seem to be a great amount of information about these on the Internet, plus I am not sure what information out there is accurate. One doctor on the Internet is all about having surgery on them. The neurosurgeon I am seeing does not want to do surgery just yet. He says that surgery does not always bring about pain relief.

Can you share some information about these Tarlov cysts and what can be done for the continued back and leg pain? Dealing with this for several years has caused me much emotional distress and depression.

F.H.

Dear F.H.: Tarlov cysts, also called perineurial cysts, occur along the lining of the spinal cord and nerve roots. In one study, in 500 people with MRI scans, 23 had Tarlov cysts, but only five had any symptoms from them. In this study, the cysts were drained by a needle, which relieved the pain, although the pain usually came back as the cysts refilled with fluid.

I agree with your neurosurgeon that surgery on these does not guarantee success. Since you have had two surgeries and multiple types of therapies that haven’t worked, I can understand your frustration. It might be worth talking to the neurosurgeon about a trial of draining the cysts to see if that helps the symptoms.

Email questions to ToYourGoodHealth@med.cornell.edu.