With summer coming, many people are going to enjoy the sun…. unfortunately, some will not remember the sunscreen and end up with a serious sun burn. Just 1 serious burn will increase the risk of skin cancer by 50%. This factors to just about 1 person from 7 will develop skin cancer. The sun produces a few different types of ultraviolet rays… Ultraviolet A rays are longer rays which penetrate into the skin. These are the rays that cause tanning or burning. They also are the reason for wrinkles and premature aging. They also have the potential of causing cancer. Ultraviolet B rays are shorter and stronger than UVA rays. They also cause more burning and aging than UVA. These rays are the causes of malignant skin tumors (cancer tumors like basal cell carcinomas or melanoma).
Now you are thinking that in an earlier post I mentioned that many people are not going outside as much and need to because of vitamin D conversion. This is still important, so the best thing to do is to prepare yourself for the sun’s harsh rays…. wear sunscreen… protect your head, wear a hat… more clothes are better, covers more skin from the sun…be sensitive about the medications you are taking, so can cause photosensitivity which will increase your risk of burning. Make yourself aware of the problems and the available solutions, and enjoy the upcoming summer.
As many of the readers know, I lost my father to colon cancer that spread to the liver in 2000. This has kept me aware of current studies in colon cancer. This is a very easy cancer to fight and win if the cancer is caught early. Unfortunately, many people avoid the tests available to screen for colon cancer until it is too late. For instance, my father knew he had some sort of problem, but he never thought it was as serious as cancer…. at one point, it got the better of him and he knew he had to find out what it was. When they did diagnose the cancer, it was at stage 4, which is the most advanced stage for the tumor. He fought for a long time, but the cancer won in 2000. We miss him very much and he will always be remembered. Unfortunately for him and us, he did not get screened early when it would have been easier to win.
Why do most people avoid colon cancer screens… well it is an uncomfortable and embarrassing screen. You have to have a sigmoidoscopy or a colonoscopy exam performed. Before this test is done, many people have to fast for a day or two and drink 4 liters of Go-lytely- which is unpleasant in itself. Then the doctor inserts a scopy in the rectum and views the inside of the colon.
In most of American society rectal examination is very taboo. But lets look at it this way. If you end up with colon cancer, you will most likely have many of these test done. I think my father had to have about 6 of them done. Additionally, you will lose your dignity as you lose the control of your body and even in some cases, you will lose the ability to void yourself and have to wear a bag… these are the positive sides atleast you are still alive, the negative side is that you may have a hard battle which you will never win and leave your loved ones behind, which hurts the most. I remember seeing my dad suffer and it hurt and we all developed some issues that will take time to resolve… even 4 years later…
Get over the embarassment and schedule appointments, especially if you are over 40. It is recommended that an annual fecal occult blood test is done, while every 5 years a sigmoidoscopy is recommended, then every 10 years, a colonoscopy should be performed. If you have family history of colon cancer, it is best to discuss the case with your doctor, but you should start the screening earlier. I am a guilty one also… I know I should get screened even now, but the preparation turns me off more than the exam, though I know I need to get over this and schedule an exam… I think to myself I am only 24, so I don’t need it yet, but I should because family history is so strong. My father was only 42 when we lost him, who knows how long it was in his body… because colon cancer, in many cases, start as non-malignant polyps, which can be caught and treated even before they become cancerous.
For women, colon cancer is a huge killer, but many women do not think so. So many of us are aware of breast cancer and get annual screenings, but many women do not consider colon cancer as a danger to them. Unfortunately colon cancer is the 3rd most common type of cancer, and the 2nd leading cause of cancer related death. This is the scariest statistic because of the high success rates if the cancer is caught early enough.In women over 75 years old, colon cancer kills more than breast cancer.. Women have to be very careful, because of many females do not recieve sufficient sigmoidoscopy exams because the scopes are not being inserted deep enough. Additionally, as a person ages (men and women) this also becomes a problem.
Do yourself and your loved ones a favor, get over the embarassment and schedule yourself an appointment, especially if you experience anything unusual, especially blood in the stool, pain in the lower right side of your trunk, change in the appearance of the stool, long term constipation or diarrhea, rectal bleeding, painful defecation or feeling a mass.
3/31/2004
The dangers of sun burn and the link to skin cancer; women and colon cancer screening
3/30/2004
Can dieting cause osteoporosis? A comment on inhaler use in hospitals
As you watch tv, you see these little skinny people which has become the ideal body, which is not true. Most of these people are below their ideal body weight, which brings on a whole new perspective to problems, but that is another story. With these pictures in mind, many people, especially women feel that they have to look like a skinny person, so they do many drastic measures to loose weight. Many of these drastic, extreme diets cut out dairy products and many other products that give us the daily requirements of vitamins and minerals. Thus leading to less calcium in the diet, causing more bone loss.
The american journal of clinical nutrition put out a study that found women who were frequent dieters had a 16% lower bone mineral content than women that do not.
I am not saying losing weight is bad, especially in the cases where it is critical for quality of life issues, but the best thing to do is to eat a variety of foods, but in moderation. Also, exercise is important to help lose weight properly and to keep it off. It is important to develop a healthy lifestyle….not just “yo-yo dieting” every few months. Also remember, skinny in some cases is unhealthy– depending on your height, their is an ideal weight for you to be at.
I am doing my externship at a hospital and went around with the respiratory therapist for a day and it was very interesting. I learned a bit, but something that I wanted to mention is that they use community inhalers with spacers. Now, there are studies that say this is perfectly ok, but would you want your loved one sharing an inhaler for 6 other people? Different hospitals have different policies, but remember the patient can always request their own inhaler.
3/24/2004
Midweek and almost through….
The day is half way over right now… I have to go Rite Aid tonight and I don’t feel like it– I am too tired to go, but I will. Madhujit is back from his trip. As long as they are going to offer a decent salary, I think we may be moving to new jersey. This comes with mixed feelings for me. I know that I have to leave Toledo, but I was hoping it would not be so soon. As well as all of my family is in this general area…lolol… I told Madhujit if we were to move, he would have to get his pilot’s license and buy a plane so we can come to Toledo for a few weekends… I have phobias about bigger cities also. I like midsized cities like Toledo… anyways, I will focus more on that if we were to move.
Madhujit came back with a cold and I am wondering if I am experiencing the first signs of it… my head has been aching and my ears feel strange… oh well…
It is to be a nice weekend ( so predicts the weather people who are normally only 30% correct) but anyways, I hope to bathe Daisy and also take her for a few walks inbetween doing some homework.
I went around with a nutrition person today… and I got a chance to look at the menus at St. Charles… did you know that they have Spaghettios on the menu? I really never liked them and had some pretty bad childhood memories regarding these.
Daisy is doing better… though she is still not house broken. I wish she could pick it up faster because she is fustrating my busia but she is getting somewhat better.
Breast cancer and a link to over-use of antibiotics?
There is a new JAMA study that looks if antibiotics increase the risk of breast cancer. The study does not say that antibiotic use causes cancer, just it might be a risk factor. They have a factor of use of any antibiotic for more than 500 days for 17 years increases the risk. This is hard to figure, but keep in mind, for some people long term use of antibiotics are used ( ie, UTI prevention, acne treatment) and this is a scary thought…. did those 3 years of therapy increase my risk of breast cancer?
Don’t stop taking antibiotics. For most of the time, they are a necessary drug because if you don’t take them, and let the bacteria grow, it is possible for the infection to go systemic and cause even worse problems then those that might occur in the future.
It also could just mean the women that do not get antibiotics frequently are healthier and less prone to breast cancer…. who knows… this is just something that should be kept in mind for chronic antibiotic use– and also women should get their yearly mammogram.
3/23/2004
Mercedes Lackey and The Fairy Godmother
I love the books that Mercedes Lackey writes, and this new one, The Fairy Godmother is no exception. It is a re-written Cinderella story. This was a great read, for fairy tales are my favorite, done by a favorite author you could not go wrong.
This twists the Cinderella story to one never told before. The element of the “tradition” and trying to break the “tradition” helps the story flow, while in the end Cinderella gets her prince, it happens in a totally unexpected way…. she does not go to the ball, but gets a job that brings her prince to her.
I do not want to say too much more, but I highly recommend it for anyone that loves fairy tales. Additionally, look up other books by Mercedes Lackey, you should not be disappointed.
A discussion on Zinc nasal sprays and the issue of DVTs during long airplane flights, and the benefits of red fruit.
It has been long time since I last posted, so I will first bring events up to speed before I begin my discussions… I finished at Flower Hospital and now I am spending 3 weeks at St. Charles hospital in the East Side of Toledo… I really do not like it — the ride is long and other things… Madhujit has a job interview in New Jersey today and I wish him all the luck and hope they offer what he is looking for. I told Madhujit to stop in a pharmacy and ask for the average salary of a pharmacist, but he probably will not do it. Luckey spent the night yesterday and this was an experience… I have a princess bed, which is very high up from the ground and poor luckey could not make it up there… she did not sleep at all either, she just kept going from side to side, slightly whining, and I felt sorry for her, but I did not get much sleep at all. Everything here is getting settled, and we are waiting for Madhujit’s parents to get here.
On to the discussions.
First, as a product, Zicam, a zinc nasal spray, works wonders with the common cold if you use it as soon as you start feeling the symptoms of a cold coming on. It does shorten the duration if used properly. This is the product that I would recommend all the time for people that came in to ask me for something to treat a cold. Unfortunately now, I will not recommend it. Recently, though there is nothing to back this claim, it is said that intranasal zinc sulfate can cause loss of the sense of smell, in some cases, this loss can be permanent. Why does this happen? The theory is that applying high concentrations of zinc in the nose might damage the sensory nerves in the nose. Again, nothing has come out recently, but this is concluded from events in the past. In the 30s, zinc nasal sprays were used to treat polio. From this data, it was determined that about 25% of the people that used it, ended up with either permanent or temporary sense of smell.
Thus, I am no longer recommending this product, though at one time, I thought it was a great product, armed with this information, it is not worth the risk of loss of smell– imagine never being able to smell the fresh sweet aroma of Lilacs in the spring or the smells of mixing spices baking in an apple pie. Keep in mind that this is only associated with nasal sprays. Oral zinc is still ok to use.
On to DVTs. DVT stands for deep vein thrombosis, which is a blood clot in the leg. There is a concern that this can happen during plane flights, especially long plane flights. Most people are sitting for a long period of time and they are getting no circulation through the legs, increasing the risk of clotting. They even developed a special name for this “economy class syndrome”. The concern always existed for people with a history of clotting, recent major surgery, the elderly and also obesity, because the risks of clotting are higher. There is also a concern for women using oral contraceptives, because this can increase the risk of clotting also.
So what can you do to avoid this, because avoiding the flights are not an option to a person that loves to travel or people that travel long distances to bring families together regularly.
First, drink a decent amount of fluid before boarding. Although, caffeine and alcohol should be avoided because these are naturally diuretics ( meaning people have to urinate more). Additionally, do not take sedatives before your flight… this can increase the risk of clotting because you are not moving about. You can also prepare yourself by getting a pair of compression stockings. These are available through a prescription from your doctor, or a pharmacy should be able to order these for you. It is best to see the doctor beforehand because there are many pressures available and additionally they are expensive ( about 60 to 90 dollars for a pair of socks, but if ordered correctly, they can be a life saver). Though most insurances will not cover them, you can look into using your flex account to reimburse you for the stockings.
There is some discussion of whether taking 325mg of Aspirin might be helpful ( Aspirin acts as a blood thinner), though experts are still duking it out over this, but if you are not allergic to it, what will it hurt to take one…. it might even help with the pressure headaches that some people develop. Keep in mind, aspirin is not recommended for anyone already on blood thinners, like Plavix, Lovenox, Warfarin, or Coumadin.
While you are on the plane, there are some things that you can do to keep yourself from clotting. First, get up once in a while and walk around. Though this is not possible for some people ( I have a strange habit of just sitting in a plane and not getting up throughout the entire flight– I have an odd phobia about getting up in planes) it is possible to do some exercises while in your seat. Exercises such as knee lifts, ankle turns or heel lifting and toe moving can reduce the risk of clotting.
Enjoy travelling, but travel safely, especially if you fall into any of the risk categories.
The strawberries of summer are going to be upon us soon… recent studies recommend getting a good dose of these and other red fruits, like tomatoes and cranberries. Recommended doses are 5 to 9 servings per day. It is said that a diet rich in red fruit can help maintain healthly hearts, improve memory function, and maintain urinary tract healths. They contain phytochemicals that are showing to be helpful to our healths, so go ahead, break open a pomegranate and enjoy…
3/7/2004
retail pharmacists and customer complaints: is the customer always right?
As many of you know, I work as an intern in a large chain pharmacy here in Toledo. Not mentioning any names, the pharmacists were complaining about what this company calls “customer complaints”. For instance, about a week ago a lady came in for her prescription refill. Unfortunately, because of the federal laws, a prescription is good for a year… not that if it was written in febuary it is good for all of febuary, like this lady thought. It was written on Febuary 11th, 2003 therefore it is good until Feb. 11th 2004. This lady got into a huge argument that we were withholding something within her right, to get her prescription, because it was “good for all of febuary”. Not only did this lady think this and refused to take no for an answer, she had a new prescription for it in her hand, but she refused to let us fill the new one. We told her we cannot that it is against the law and she was unhappy with our answer and called the customer call center and a few days later, the pharmacist recieved a request to call the customer and apologize, but he refused. This is not a customer complaint, but a customer ignorance…. it is against the law for a pharmacist to fill a prescription over a year old… I could see if we were overly rude to the customer for her to be upset, but we were not… in reality, with the management of the company asking for the pharmacist to apologize for doing the job legally is underminding their position in the pharmacy. Retail pharmacies have the bottom line to make money, not serve the customers ( you see this in the way management values the job performance of the pharmacist) as it is legally and patient focused.
Here is just 1 more example of customer ignorance being given as a customer complaint. A customer came into the pharmacy wanting a refill on a prescription, but it was too soon for the insurance to pay for it. Now, as it turned out, the customer lost 10 pills and needed them until she was able to get her next refill and decided to overpass the insurance and pay cash for 10 pills. A few days later, it is time to refill the prescription, and with this being her last refill, she only had 20 pills left. She claimed that we are cheating her out of 10 pills, and that each refill, she is entitled to having 30 pills. We tried to nicely explain that when she took the 10 pills, she took from the total amount of pills given by the doctor, and that 30 minus 10 equals 20… but she refused to listen to reason. We even offered to call her doctor to get a new prescription to get 30 pills, but she did not want to get her doctor involved ( her words). She calls the customer call center and again there is a request to apologize to this customer. Again the pharmacist refused to apologize because in legality, the pharmacist did the correct action. We are not sure what happened, but management overstepped the pharmacist, and made the phone call themselves…. again underminding the way the pharmacist practices.
Notice the mention of customers. In retail pharmacies, there is more a focus on dollars than care, otherwise we would have our customers be referred to as patients, not customers… The customer is not always right. A pharmacist needs to use their judgment when it comes to issues, otherwise they could be causing a case against their license. We were trying to brainstorm what to do when customer complaints are really just customer ignorance and customers trying to “throw their weight around”. A few ideas we came up with is just refusing to apologize for issues where the pharmacist is right. Unfortunately we know management goes above their heads and apologizes anyways. Another idea is that everytime a customer abuses the pharmacist or the pharmacy staff, is to call the customer call center and put your own complaint that the customer is abusing the pharmacy staff. We are not sure of how management would react to that. And one more idea is to get management say that it is their policy to break the law and require pharmacists that work for them to do this becuase the customer is always right and that all customer asses should be kissed and have management sign it and have it witnessed. If they do this, atleast when they want you to do something stupid, you have it in writing that company policy requires it.
The profession of pharmacy is unfortunately treated like it is a business like McDonalds. Pharmacists are not compensated for their knowledge ( one of the only medical fields like this) and they are the most regulated by the government. Customers pull up in the drive through and expect their “order” to be ready in just 2 minutes. It is a scary thought of what this profession will turn out to be in 20 years, because the policy of (retail) pharmacies is to increase the buck and the customer is always right, not serve the customer as a patient focus on what the pharmacist’s knowledge of medicinal therapy and what is best for the patient while staying within legal rights.