Archive for October, 2008
October 29th, 2008
Caution should be taken when using over the counter NSAIDs. NSAIDs are nonsteroidal antiinflammatory drugs such as aspirin, ibuprofen, motrin, aleve, and naprosyn to name a few. Serious gastrointestinal (GI) complications occur in 1-4% of NSAID users each year. These serious events such as bleeding or ulcerations can occur without any warning. NSAID induced events result in an estimated 100,000 hospitalizations and 16,500 deaths each year in the U.S.. These risks are greater with a history of peptic ulcer disease, taking steroids and anticoagulants at the same time, high-dose NSAIDs, and older age. Drinking alcohol while taking NSAIDs may increase the risk of the gastrointestinal complications.
NSAIDs are hard on your kidneys. NSAIDs can cause and or aggravate hypertension, heart failure, edema (fluid retention), and kidney problems.
NSAIDs may cause an increased risk of complications in people with known cardiovascular disease or existing cardiac risk factors. The cardiovascular complications could possibly include myocardial infarction (heart attack), stroke, heart failure, and hypertension. Ibuprofen may interfere with the cardioprotective effect of a daily aspirin dose. It is recommended, by the American Heart Association, for patients taking immediate release low-dose aspirin and ibuprofen, to take the ibuprofen at least 30 minutes after the aspirin or at least 8 hours prior to the aspirin dose. Naproxen has not been shown to interfere with the cardioprotective antiplatelet effect of low dose aspirin.
NSAIDs are effective analgesics for many different types of pain, especially pain due to inflammation. It is safest to take NSAIDs at the lowest dose for the shortest time they are needed. If you take NSAIDs regularly each day for longer than 10 days to 2 weeks, you should consult with your physician, especially if you have known risk factors of heart disease, gastrointestinal problems such as heartburn, reflux or ulcers. or kidney problems. Don’t assume over the counter medication is safe.
October 9th, 2008
This past month, I celebrated 25 years of marriage, so I dedicate this “blog” to my wife, Darice. What better time to acknowledge that “health-wise,” marriage is a good deal for men. While both married men and women are on average healthier and live longer than their unmarried counterparts, men tend to reap more health benefits from marriage than women. For example, long term data from one study shows that married men have a 25 percent lower rate of death from cancer, while women did not show any cancer survival benefit.
So men, we should recognize that marriage is like our own personal health insurance policy. Another study that tracked mortality over an eight year period found that individuals who never married were 58 percent more likely to die during that time than their married counterparts. So what health benefits are there? In addition to a lower death rate from cancer, married men suffer from fewer infections, have a stronger immune system and a reduced likelihood of dying from heart disease. Married men are also less likely to commit suicide, experience accidents, and, if their wives don’t kill them, they are less likely to be murdered. Not surprisingly, married men tend to have lower rates of mental illness, experience less depression, and have lower rates of alcoholism and anxiety disorders. Certainly, those married men who remain faithful reduce the likelihood of having sexually transmitted diseases and while they may fanaticize about their lives as bachelors, married men have sex more often than their unmarried counterparts.
The exact reasons why married men have a health advantage over their unmarried counterparts is unclear. One reason might be that healthier people are more likely to get married. Some of it may be social; living with someone reduces loneliness, and if you become ill or injured, your partner is there to help nurse you back to health.
Another reason may be financial. Married men tend to have higher incomes and save more. Wealthier individuals tend to have better health habits, smoke less, and are less likely to be sedentary or eat poorly.
However, there may also be physiological changes associated with marriage. Levels of stress hormones are lower in happily married men. High levels of these hormones can raise blood pressure, increase the risk of heart attack, and can adversely affect the immune system. One experiment showed that having a spouse hold your hand before receiving a painful shot reduced the activity in the area of the brain that triggers the production of stress hormones.
Now before all unmarried men propose to the next woman they see, there are a couple of warnings. One of them is that marriage is fattening. Married men are 20 percent more likely to be overweight. One possible explanation is that they may be more likely to be in a household with prepared dinners. Also, bad marriages, while maintaining some health benefits, can undo much of the marriage health benefits, and divorce is actually harmful to your health.
The last concern is that we men need to work to keep our wives healthy. There is truth to those tails about married men who die shortly after their wives. Again, this phenomenon of a married partner following their spouse into the grave is less likely for a woman.
So I suggest to men that the next time your wife gives you your daily instructions or tells you that you left the toilet seat up, don’t argue or protest just smile and thank her for the years she adds to your life.
October 6th, 2008
There are two very popular over the counter analgesics (pain relievers). Acetaminophen, also known as Tylenol, and NSAIDs (nonsteroidal anti-inflammatory drugs) such as aspirin and ibuprofen. People assume these type of medications are very safe because they can be purchased withouth a prescription, but this is not true. In this blog I will discuss acetaminophen. I will discuss NSAID use in a future blog.
There is 325 mg in regular strength acetaminophen and 500 mg in each extra strength pill. The maximum daily recommended dose for a short period of time is 4000 mg/day. Acetaminophen is hard on your liver. A study has shown taking 4000 mg of acetaminophen regularly, for a prolonged period of time, to cause an elevation in liver enzymes. The American Liver Foundation issued a warning in July 2006 recommending people not to exceed 3000 mg of acetaminophen each day for a prolonged period of time. This means if you take acetaminophen regularly for several weeks, the maximum dose per day should not be over 6 extra-strength tablets. Pediatric dosing is determined by the child’s weight; it is important to follow label directions and/or check with your physician for infant and young child dosing.
Alcohol is also hard on your liver. If you consume alcohol regularly, you should not use acetaminophen without speaking with your doctor. Also, acetaminophen should not be used by persons with liver disease.
A 2005 multicenter study indicated acetaminophen overdose to be the cause of 42% of acute liver failure. Acetaminophen is included in over 200 over the counter combination medications; such as cold, allergy, flu and headache medications. Acetaminophen is also included in combination pain medications such as vicodin, norco and percocet, to name a few. It is the unintentional overuse of acetaminophen that accounts for most of acute liver failure. Be aware of the content of pain medications you are taking and read labels when purchasing over the counter medications to avoid overuse of acetaminophen. Acetaminophen can be an effective medication for mild pain if taken correctly. It is the number one recommendation for pain in the American Geriatric Society guidelines.
October 1st, 2008
Restless Legs Syndrome (RLS) is a movement disorder that is characterized by an overwhelming urge to move the legs when they are at rest. This urge to move is usually, but not always, accompanied by unpleasant sensations that are described as creeping, crawling, tingling or pulling. This is quite different then a muscle cramp. The movements usually are worse when sitting or lying still. You can find temporary relief by stretching or moving the legs. The sensations usually appear in the calves, but some people have symptoms in the arms or other parts of the body. RLS occurs more often in women and in older people ans is also hereditary. It is unsure what causes RLS, but some medical conditions increase the chances of having it. Diabetes, arthritis, low iron levels in the blood, poor blood circulation in the legs, nerve problems in the spine or legs, alcoholism and certain vitamin or mineral deficiencies to name a few. Some medications like over the counter allergy and cold medications may trigger RLS. Caffeine, alcohol and tobacco use may make the condition worse. Some home remedies may help people with occasional or mild RLS. These include hot baths, massage, pain relievers, regular exercise, the elimination of caffeine, heat or ice packs. When symptoms are severe or home remedies do not work, you can take prescription medications to treat RLS. Contact your primary care physician or SwedishAmerican’s Sleep Disorder Center at 815-489-4429.
