Tuesday, February 24, 2009


If not used properly, pain meds can do more harm than good

Use of over-the-counter pain medication is at an all-time high. One look at the headlines and it is little wonder why 36 million Americans reach for a quick fix for their aches and pains daily.

Sixty four percent of Americans feel there is no reason to be concerned when using over the counter medications, according to a study done by the National Consumer’s League. Yet 103,000 people will be hospitalized and 16,500 will die this year in the U.S. from adverse reactions to these very drugs. Clearly there is reason for concern.

By far the biggest culprit is failure to read and follow the label directions. When it comes to medications, the poison is in the dose. Most over-the-counter drugs are safe and work quite well if we follow the directions.

Consumers must also know and understand their own health history and any potential threats a particular drug may pose to them.

For instance, most people know that acetaminophen, the active ingredient in Tylenol, should not be taken by anyone with a history of liver problems. But did you know you should not take Ibuprofen, the active ingredient in Motrin, if you have suffered a stroke or have a history of blood clotting disorders? While we are talking about blood clotting, many people do not realize that the herb Gingko Biloba, promoted in this country as a means for increasing memory, causes thinning of the blood and so should never be mixed with aspirin or prescription blood thinners such as Coumadin.

There is also a wide variety of “combination drugs” targeted at an array of illnesses such as a cold or the flu. It is important to read the label to know what drugs you are ingesting to prevent an overdose. For example, an adult dose of Nyquil taken with two extra strength Tylenols would give you double the adult recommended dose of acetaminophen, and half the total amount allowed in a 24-hour period – all at one time.

Another potential problem with self medication without your doctor’s input is rebound headaches. Over-the-counter pain medications are intended for occasional use for mild to moderate pain.

But when you repeatedly take a pain medication over a prolonged period it can be a problem. The area in your brain that helps regulate the flow of pain messages stops being effective, and you may end up with an even bigger headache than the one you were originally trying to get rid of.

This creates a vicious cycle where you now take more medication, the headache returns even stronger, you repeat the dose, etc…. This situation requires a physician’s help to break the cycle that could have been avoided by simply following the directions.

The moral of the story is: Just because you can obtain a drug without a prescription does not mean that there are not potential serious side effects.

Discuss all medications you plan to take – including over-the-counter or herbal – with your health-care provider. By being informed consumers we can safely, and more effectively, keep our aches and pains in check.

Cindy Arpin, is a registered nurse and Stroke Coordinator at The William W. Backus Hospital. This advice should not replace the advice from your physician. Email Ms. Arpin and all the Healthy Living columnists at healthyliving@wwbh.org or comment on their blog at healthydocs.blogspot.com.

Tuesday, February 17, 2009


Don’t write off the much-maligned egg

February is National Heart Month and a good time to address the ambiguity of the poor egg.

Back in the 1970’s and 1980’s eggs were thought of as part of the dietary axis of evil. Recommendations were for no more than two egg yolks per week, because of the high cholesterol level contained within -- 212 mg per large egg.

The American Heart Association advised limiting dietary cholesterol to 200 mg per day (as they still do) as dietary cholesterol was believed to raise blood cholesterol levels, leading to higher risk of heart disease.

Ignored were the positive aspects of the chicken egg. This being the sole source of nutrition for the developing baby chick, the egg is an excellent source of protein -- six grams per large egg -- and a good provider of lutein, vitamin A, Vitamin E and folate. These compounds are mainly found in the egg’s yolk. Lutein is thought to be useful in protecting the eye from damage from UV light.

Studies are also finding that the link between dietary cholesterol and blood cholesterol is weak.

More important is the content of saturated fats in the diet for increasing heart disease risk. Eggs contain about five grams of fat, two grams being saturated fats. Compare this to: three grams of fat and 1.6 grams of saturated fat in two ounces of white meat chicken.

The American Heart Association recommendation for total intake of saturated fat is no more than 7% of total calories or 15 grams if 2,000 calories are consumed per day.

Eggs containing a higher amount of omega-3 fats can be found in the grocery store, providing even less saturated fat, 1.2 grams.

Eggs are a low cost source of protein. Prices range from 18.25 cents per large regular egg to 27 cents per egg for high omega-3 eggs.

When using eggs, take care to cook thoroughly, as there is a potential for salmonella contamination.

Raw egg products, unless pasteurized, should never be given to anyone with a compromised immune system, children or elderly persons. Always wash hands and preparation surfaces after handling eggs to prevent cross contamination with other foods.

Keep in mind that an egg is only as healthy as what you eat with it. Having your egg with whole grain toast and fruit is a better option than combining your egg with biscuits, sausage and cheese. Eggs in moderation can easily be part of a heart healthy nutrition plan.

Mary Beth Dahlstrom Green is a dietitian at The William W. Backus Hospital. This column should not replace advice or instruction from your personal physician. E-mail Green and all of the Healthy Living columnists at healthyliving@wwbh.org or comment on their blog at healthydocs.blogspot.com.

Monday, February 09, 2009


Global health begins at home

The concept of global medicine has recently become a popular area of interest for physicians and other health care professionals. It involves international cooperation in an effort to improve world health.

Interestingly, the United States has been a beneficiary of global medicine. American medical schools do not produce sufficient numbers of physicians to meet the health needs of this country. Rural and impoverished regions are where the shortage is most acute.

International medical graduates have been recruited to provide care in underserved areas of our country for decades. Many medical students from around the world, encouraged by organizations like Doctors Without Borders, Partners in Health and The Haitian Health Foundation, are choosing to spend part of their lives in the third world.

Dr. Jeremiah Lowney, a local orthodontist and founder of the Haitian Health Foundation, has been involved in global medicine for 27 years.

“I believe our greatest single impact in Haiti has been improving the maternal mortality rates,” Lowney said.

The Center of Hope, built by the Haitian Health Foundation, provides pre- and post-natal care for Haitian women.

Saint George’s University in the Caribbean has pioneered the field of global medicine for the past 30 years. Students from 140 countries have the opportunity to work together in the schools of Medicine, Veterinary Science and Public Health.

“Our students come from many diverse cultures brought together by a strong desire and dedication to help others,” said Dr. Calum Macpherson, Vice Provost for International Programs at Saint George’s. Electives in Kenya, Prague and Cambodia have proven to be very popular.

In a 2003 poll, more than 20% of all graduating American medical students reported having an international health experience during their training.

Dr. Stephanie Davis, a University of Michigan resident in pediatrics and medicine, said it best when quoting the motto of the Global Health Council: “There is no ‘them.’ There is only ‘us’.”

Anthony G. Alessi, MD, is Chief of Neurology at The William W. Backus Hospital with a private practice at NeuroDiagnostics, LLC in Norwich. This column should not replace advice or instruction from your personal physician. E-mail Alessi and all of the Healthy Living columnists at healthyliving@wwbh.org, comment on their blog or buy his book at backushospital.org.


Happy Meals now can lead to heart problems later

We usually don’t equate heart disease with children. However, research over the last 40 years has shown that cardiovascular disease begins early in life and progresses throughout our lifespan.

Two studies, the Muscatine Study and the Bogalusa Heart Study, have been tracking children’s cardiovascular risk as it relates to cholesterol profiles. In both studies, 70-75% of the children with elevated cholesterol levels continued to have cholesterol elevations as young adults.

While there is clearly a genetic component to one’s risk of developing heart disease, lifestyle choices -- such as diet and physical activity -- are equally important. The emphasis on a healthy lifestyle is the key in the prevention of the development of an abnormal lipid profile.

February is American Hearth Month. This annual event is the perfect excuse to incorporate heart healthy foods at mealtimes.

The American Academy of Pediatrics recently updated dietary recommendations for children older than 2-years and adolescents. These new guidelines recommend all children over the age of two follow a diet that includes the use of low fat dairy products.

Working healthier snacks and meals into your child’s diet can be as simple as recruiting their help in the kitchen.

Children as young as two years old love to help prepare food and they like to eat the foods they help prepare. They can help wash produce, tear lettuce or snap green beans.

Three-year-olds may enjoy mixing batter, spreading peanut butter or kneading dough.
Four or five-year-olds can begin measuring ingredients, beating eggs or mashing fruit or vegetables.

Here are some heart healthy tips for kids:

 Choose low fat dairy after age two. Skim or 1% milk, low fat yogurt and cheese.
 Eat lower fat condiments (light salad dressing, mayo or sour cream).
 Use a trans-fat free light margarine instead of butter, which is high in saturated fat.
 Bake, grill or roast meats instead of frying or sautéing them.
 Limit fast food to once per month. A McDonald’s cheeseburger Happy Meal with fries and 1% chocolate milk has 700 calories, 27 grams of fat and 1060 mg sodium.

To put this into perspective, a 5-year-old needs 1,200-1,400 calories per day and 40-46 grams of fat per day.

Here are some quick and easy healthy meal and snack ideas:

 Whole wheat English muffin pizzas with low-fat mozzarella cheese (1/2 for a snack, whole muffin for a meal)
 Whole wheat pasta with broccoli and matchstick carrots with red sauce. Alternative: Reserve ½ cup of the cooking liquid. Sauté fresh garlic with 1-2 tablespoons of olive oil; add a pinch of sea salt and the reserved liquid. Toss with pasta and parmesan cheese.
 Turkey burgers on whole wheat buns with some veggies on the side.
 Fruit kabobs with low fat yogurt for dipping.
 Fruit smoothies.
 Low fat string cheese, “ants on a log,” edamame (soybeans in pod, found in frozen foods).
 Blueberry or strawberry muffins (cupcake size, not mega).
 Raw veggies and low fat dressing for dip.
 Applesauce or apple slices with peanut butter or other nut butter.
 Instant pudding made with skim milk.
 Sugar-free hot cocoa made with skim milk.

Wendy Kane is a registered dietitian and certified diabetes education in the Backus Hospital Diabetes Management Center. This advice should not replace the advice from your physician. Email Ms. Kane and all the Healthy Living columnists at healthyliving@wwbh.org or comment on their blog at healthydocs.blogspot.com.

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