The Other Medications; Herbs, Vitamins, Minerals and Supplements

Many of us take Herbs and Supplements every day, even without thinking. Most of us think that extra Vitamin C can prevent a cold. B12 is touted to give one more energy. Cranberry juice is supposed to stave off a urinary tract infection. Saw Palmetto is used by many men with prostate problems. But do these medicines work? And are they safe?

Herbs have been used as medicines for many years. Before the manufacture of medicines, families used herbs in teas and poultices for what ailed them and their loved ones. While some may be old wives' tales, there are many herbs that are very effective. When you go to a nutrition store, or the vitamin section of your local grocery store, there are plenty of herbs, vitamins, minerals and supplements to choose from.

While it is true that we should get most of our nutrition from the food we eat, it is often impossible to get all of it from food alone. Some of the supplements that I recommend every day in private practice include:

• Calcium for stronger bones
• Vitamin D for better absorption of Calcium
• Multivitamins- no matter how well we eat, we need to make sure we have the recommended daily allowance of minerals and vitamins.
• Iron for iron deficiency anemia
• Super B Complex for pernicious anemia
• Vitamin C for general health and cold prevention
• Rose hips for arthritis pain
• Glucosamine/chondroitin for arthritis pain
• Folic acid for prevention of neural tube defect in pregnancy
• Probiotics for prevention of yeast infections after taking antibiotics
• Melatonin for insomnia
• Fish Oil for high cholesterol
• Flax Seed meal for high cholesterol and fiber
• Psyllium for constipation
• Aloe Vera for burns
• Primrose Evening Oil and Black Kohosh for hot flashes
• Echinacea for cold prevention
  

You may have other favorites to add to this list. Many herbs are safe. You have to take into consideration that supplements are not regulated by the FDA and actual amounts of these herbal medicines can vary from manufacturer to manufacturer. Try to find a good name brand of supplements and stick to that brand. Tell your health care provider and your pharmacist what supplements you are taking. Some may interfere with prescription and over the counter medicines you take.

The Pain of Arthritis

There are many kinds of arthritis. The most common types are Rheumatoid Arthritis and Osteoarthritis. If you have joint pain, your Health Care Provider can diagnose what type of Arthritis you have.

Osteoarthritis is the most common type of Arthritis. The pain of Osteoarthritis is caused by a gradual decrease of the amount of cartilage between joints and the rubbing of bone against bone. The most common sites of pain are the wrist, hands, hips and knees. Osteoarthritis is a very common ailment for all of us as we age. It can manifest itself as stiffness upon wakening and generally gets better as we move around in the morning. Stiffness usually lasts about 30 minutes and gets better as the day goes on. Osteoarthritis can lead to major joint damage, difficulty in walking, and eventual surgical joint replacement.

Common treatments for Osteoarthritis include:

• Tylenol or Acetaminophen. This is the first treatment recommended by the Arthritis Foundation. The maximum safe dose of Tylenol is two 500 mg capsules 4 times a day, a total of 2 grams/day. It works for many people. The advantage of this drug is that it does not cause stomach upset. The disadvantage is that it should not be taken by people with liver problems.
• Over the counter (OTC) non-steroidal anti-inflammatories (NSAIDS). Ibuprofen and Naproxyn Sodium are the most common OTC medications. Brand names include Motrin-IB, Aleve and Advil. They are very effective. The disadvantages to these drugs are stomach upset and the possibility of causing stomach ulcers. They should not be taken by patients with kidney problems.
• Prescription NSAIDS. These medications are stronger than their OTC counterparts and are very effective. Common names are Motrin, Daypro, Relafen, Votaren, Arthrotec. The disadvantages to these medications are they are more expensive and are more prone to cause stomach problems.
• Prescription pain medications. These medications are traditionally added on if other medications do not relieve pain. Two common medications are Darvocet and Lortab. These medications can provide pain relief. They can cause drug dependence and impaired mental function and decreased coordination. Care should be taken when taking these medications and driving or operating machinery.
• Herbs and Supplements. Glucosamine is a common OTC medication that brings relief to about 40 percent of patients that try them. Rose hips capsules have shown to be more effective than Glucosamine for Osteoarthritis pain.
• Arthritic rubs. Ben Gay has been around for years. Other popular rubs include Bio-Freeze, Capsaisin, Emu Oil, Aspercreme and countless others. These are safe if you are not allergic to the ingredients and give temporary relief to Osteoarthritis pain.
  
• Hot and cold treatment. Many patients say that a hot shower is the best relief for their aches and pains. Heating pads should be used with caution. Thermacare patches produce heat when applied to the skin. Other patients swear by cold packs applied to the painful joints. These treatments are inexpensive, generally safe and effective, but temporary.
  

When medications don't work there are other non-surgical options. There are several medications that can be injected into the knee to improve the viscosity between joints. These are usually given as a series of multiple injections and are more expensive than oral medications. These treatments are often covered by insurance. Injections can be done by your Health Care Provider or an Orthopedic Physician. They are often given under ultrasound or fluoroscopy guidance to make sure the medicine is given in exactly the right place.

Surgery is the last option for Osteoarthritis and performed by an Orthopedic Surgeon. When all the above treatments fail your Health Care Provider may refer you to an Orthopedic specialist.

The best treatments for Osteoarthritis are early treatments. Ask your Health Care Provider for advice about which treatments are best for you and your pain.

The Pain of Gout

If any of you have ever had gout, you know how painful it can be. Having not had gout myself, I have heard it described as throbbing and very painful, sort of like a toothache. It is obviously something you want to avoid.

What Is Gout?

Gout is the accumulation of uric acid crystals in the skin caused from a diet rich in alcohol, rich meats and rich cheeses or any food rich in protein.These foods and alcohol contain the chemical purine. When the uric acid crystals form in the skin it causes an inflammatory process that involves heat, redness, swelling and pain. Gout usually occurs in the big toes, but can affect other areas. The area is so painful that you cannot wear a sock or shoe. You cannot walk comfortably on the foot. And some sufferers say that even a sheet touching the toe at night is excruciating.

How Do I Treat An Acute Gout Attack?

An acute gout attack can be treated with a medicine called Colchicine. It is a drug that is given hourly until the pain subsides. The medication can cause some stomach upset. Elevating the affected limb helps, as does drinking lots of water to dilute the uric acid crystals. Other medicines like Indomethacin, an anti-inflammatory, are given to reduce the pain, redness and swelling.

How Do I Prevent Gout?

The best way to avoid an acute gout attack is to prevent it. Best prevention methods include:

• Stay at your ideal body weight; overweight people have more gout.
• Avoid high protein diets. Avoid rich food such as liver and other organ meat.
• Avoid foods high in purine
  
• Avoid alcohol

What Else Can I Do?

Ask your health care provider for more information about gout.

Weight Loss and Weight Watchers

Most of us have struggled with our weight. While some of you have "magic" metabolisms and can eat whatever you want, I am not one of them. I am envious of my younger sister that eats "like a horse" yet remains slender while I watch every calorie I eat and struggle to maintain a healthy weight. It just ain't fair. And while it is true that you don't have to be thin to be healthy, being obese is not healthy.

I have tried every diet in the book. I started out with The Scarsdale Diet, Adkins Diet, Butter Busters, The Zone and others. The best overall diet I have tried is really not a diet at all, but a healthy eating lifestyle: Weight Watchers. I joined Weight Watchers after I gave birth to each child to get back to a fighting weight. Along the way, I tried the other get thin quick diets. But I have come full circle to realize that you cannot really diet all the time. You have to change your eating habits for good and stick to a plan. Weight Watchers helps you do just that.

Weight Watchers has traditional weekly meetings and classes in your community. And for those of us with hectic schedules we can "do" Weight Watchers online. You have two choices available: you can eat low fat, low carb items in unlimited quantities, eating just enough to get full or you can use the point system. The point system is by far my favorite. You are given a set amount of points according to your height, current weight, activity level and ideal weight. You have online tools to calculate your points daily to include water, fruits and vegetables, multivitamins, protein, carbs, fats and your daily exercise.

Most of us probably need to lose a few pounds to be close to our ideal weight. I have lost 10 lbs in two months and have some more to lose. Weight Watchers has a weight tracker designed to track your weight each week and your first 5 lb loss, your 10 lb loss, you 10% weight loss and your ideal weight goal.

Informative and useful articles about eating on the run or using seasonal foods appear on the website. Success stories are shared. Exercise options are discussed. I cannot say enough good things about Weight Watchers. They have done their homework. That is why they are one of the most popular weight loss companies.

Come on, Give it a Try. With the upcoming holidays and all the tempting food choices, now is a good time to get started. Or you may want to really do something about your annual New Year's Resolution about weight loss. What have you got to lose?

Treasure Those You Love

Treasure Those You Love

I know this is not new information for many of you. But I want to remind you to treasure people while they are here with us. You never know when they will leave this world.

As I completed my posts on Pneumonia and Pneumovax this week, one of my favorite patients died this week of Pneumonia. Mr. Troy was a sharp older gentleman, a veteran. He loved to come for his frequent office visits and flirted with all the female office staff, even in front of his lovely wife, Salome. Mr. Troy had severe COPD (Chronic Obstructive Pulmonary Disease) and required continuous oxygen therapy. He had a number of other chronic illnesses that were well managed, ie: high blood pressure, heart disease, and diabetes.

He came to the office on Monday for what he thought was a cold. He had become more short of breath despite his oxygen and his breathing treatments he took during the day. He admitted he was a little run down. He had been taking care of his wife, who suffers from Alzheimer's Disease. She has been requiring more and more help with activities of daily living; bathing, dressing, eating, medication administration. Mr. Troy also wanted to know more about assistance he could get for himself and his wife. Just someone to come in a few days a week to help bathe his wife and fix a few simple meals.

Mr. Troy received prompt and appropriate medical attention including intravenous antibiotics. Despite our best efforts, he died Thursday afternoon. The news of his death was a shock to all of us. We all struggled to get through the day without breaking down and crying. I don't know about the other employees, but I cried all the way home Thursday night.

Working in a large Internal Medicine Practice I have many seniors as patients. While many remain healthy, many others have serious medical problems. Mr. Troy's death is a painful reminder that I need to treasure these patients and the relationship I have with them. I never dreamed that the last time I saw him would be just that; the last time I saw him.

The same is so true in our personal lives. We have elderly parents, grandparents, neighbors. My parents are 80 and 86, and in good physical and mental shape. They are very independent. But each time I hug and kiss them goodbye I wonder if this will be the last time. Be brave and bold and love others. Tell them you love them. Let them know by your actions. Treasure each moment you have with them. Life is so short.

Pneumonia Vaccine

This informative video discusses the real health hazards of pneumonia and the best prevention, the pneumonia vaccine, pneumovax.