By Jessica Girdwain
Nearly 45 percent of older adults take over-the-counter medication daily or weekly to treat common ailments. If you're one of them, are you doing the right thing?
No one has time to run to the doctor for every stuffy nose or aching muscle, but relying on over-the-counter (OTC) drugs for seemingly minor health problems sometimes does more harm than good. In certain cases, medication can make symptoms worse or mask more complicated conditions. Read this, then decide which route -- a pill or an appointment -- is best for you.
The Problem: You woke up with congestion, a runny nose, and a phlegmy cough.
Pill or Doc? Pill. For up to one week while you ride out a cold, take a cold medicine that contains an antihistamine (to dry out passages) and a decongestant (to open airways), says Marc Leavey, MD, an internist at Mercy Medical Center in Baltimore. And don't forget to drink plenty of fluids. Though doctors may prescribe Z-Paks (six tablets of azithromycin, the most commonly prescribed antibiotic in the United States) to treat cold viruses, they're effective only against bacterial infections. "Some physicians may recommend antibiotics before they receive a patient's test results," says Leavey. "The intention is to get a jump on a smoldering infection, but in many cases, the drugs simply aren't necessary."
The Problem: You've been taking OTC acid reflux meds for weeks, but with every meal the burn returns.
Pill or Doc? Doc. If proton pump inhibitors (PPIs) -- drugs that reduce the production of stomach acid -- are no match for your heartburn after two weeks, continuing to take them could decrease your body's ability to absorb calcium, potentially putting you at risk for bone fractures. According to the label, nonprescription PPIs should be taken no more than 14 days straight within a four-month span; however, a 2011 study found that more than 60 percent of consumers take PPIs incorrectly or more than necessary. Have your primary doctor refer you to a gastroenterologist, who can get to the bottom of what's causing your persistent heartburn; she may suggest stronger prescription meds or dietary changes (fried foods, coffee, and alcohol are all common heartburn triggers). The problem could also be linked to a more serious condition -- like gastroesophageal reflux disease (GERD), which, over time, can damage your esophagus and put you at increased risk for cancer.
The Problem: You're signed up for a spin class tonight, but your legs are aching from yesterday's challenging workout.
Pill or Doc? Neither. If you're tempted to pop an OTC painkiller to power through your next exercise session, know this: A study in the journal Brain, Behavior, and Immunity found that runners who took ibuprofen before and during a race to reduce muscle soreness actually experienced an increase in inflammation. The study was done on ultramarathoners, but "this can happen to anyone who exercises," says coauthor David Nieman, director of the Human Performance Laboratory at Appalachian State University. "Our research suggests that the best medicine is fruits, vegetables, and fish. These foods are rich in compounds like flavonoids and omega-3s, which are naturally anti-inflammatory." For immediate relief, icing three times a day for 15 to 20 minutes can help reduce soreness. If discomfort lasts more than a week, head to your doctor to rule out serious injury.
The Problem: You get headaches almost daily. They aren't as bad as migraines, but you can't remember the last time you didn't take something to ease the throbbing.
Pill or Doc? Doc. Taking OTC pain meds at least 15 days a month for more than three months can increase the risk of chronic headaches, because overuse of medication can lead to changes in the pain-processing regions of the brain. Laying off the painkillers will likely lead to more intense pounders for a few days, but getting the meds out of your system should put an end to the vicious cycle.
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'Why Don't We Get Goose Bumps On The Face?'
We do get them on our cheeks, says Jessica Krant, MD, a board-certified dermatologist and assistant clinical professor at <a href="http://www.downstate.edu/" target="_hplink">SUNY Downstate Medical Center</a>. Goose bumps, or cutis anserine, occur where we have hair -- pretty much everywhere except for our palms and soles of feet, Krant says. She breaks down the process: Each hair follicle contains a microscopic muscle called arrectores pilorum that contracts in response to the sensation of cold, or the feelings of fear or excitement. The reason most of us, especially women, don't notice goose bumps on our face is because the peach fuzz there is usually fine and short, and our facial skin muscles are less robust than those in our arms and legs. Krant adds that if you find goose-pimply bumps on any part of your body that don't seem to be affected by fear or temperature, you might have <a href="http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002433/" target="_hplink">keratosis pilaris</a>, an eczema-like condition caused by inflamed follicles.
'Does Being Overweight Mean You'll Get Pregnant Easily?'
We don't see many images of fertility goddesses as skinny stick figures. And it's true that <a href="http://www.asrm.org/Abnormal_Body_Weight/" target="_blank">underweight women make a form of estrogen that can be too weak for successful conception</a>, according to the American Society for Reproductive Medicine (ASRM). But while obese women often have an overabundance of estrogen, this can affect their cycle to the point that they stop ovulating. Excess weight can influence fertility in other ways, too: A 2007 Dutch study of more than 3,000 couples (without any known ovulation problems) found that women with a body mass index of 30 or higher <a href="http://humrep.oxfordjournals.org/content/23/2/324.full" target="_blank">had significantly lower probability of becoming pregnant</a>, when compared with women with BMIs of between 21 and 29. This is why the ASRM stresses the importance of maintaining a healthy weight when trying to conceive. By the way, having full hips won't even provide an advantage during childbirth: "It's the front-to-back dimension that creates the tightest squeeze," discovered <a href="http://www.nathanaeljohnson.org/all-natural/" target="_blank">Nathanael Johnson</a> while exploring the science and history of childbirth (among other biological processes) for his book <a href="http://www.powells.com/biblio/62-9781605290744-0" target="_blank">All Natural</a>. So an average-weight woman has the best chance of getting pregnant naturally and giving birth more easily.
'Why Don't People Who Take Nitroglycerin For Their Heart Blow Themselves Up?'
This query usually exposes a childhood fascination with Road Runner cartoons, says <a href="http://www.med.nyu.edu/biosketch/wlg2" target="_blank">Billy Goldberg, MD</a>, a New York emergency room physician and the co-author (with Mark Leyner) of <a href="http://www.whydomenhavenipples.com/" target="_hplink">two</a> <a href="http://www.randomhouse.com/book/101276/why-do-men-fall-asleep-after-sex-by-mark-leyner-and-billy-goldberg-md" target="_hplink">books</a> about health trivia ("the stuff everyone wants to know, but that doctors aren't taught in medical school," Goldberg says). For those who've forgotten: <a href="http://www.youtube.com/watch?v=u9bC_3cNH34" target="_blank">Wile E. Coyote would blow himself up</a> with explosive nitroglycerin -- the same substance used in heart medication. In the commonly prescribed pill form, <a href="http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601086.html" target="_blank">nitroglycerin</a> helps increase blood flow to oxygen-deprived areas of the heart by dilating blood vessels. The medicinal dose of nitroglycerin in heart medication is infinitesimal compared with the amount in a stick of dynamite, explains Goldberg in <em><a href="http://www.amazon.com/Why-Men-Fall-Asleep-After/dp/0307345971" target="_blank">Why Do Men Fall Asleep After Sex?</a></em>. It's also highly diluted for safe handling.
'Can Sunshine Trigger A Sneezing Fit?'
Goldberg says this is one of his favorite questions -- mostly because he assumed it was too ridiculous to be true. While writing <em><a href="http://www.amazon.com/Nipples-Hundreds-Questions-Doctor-Martini/dp/1400082315" target="_blank">Why Do Men Have Nipples?</a></em>, he and Leyner pored over medical textbooks and studies to find out that some people have a strange reaction to blazing sunlight that causes them to sneeze uncontrollably. This is due to something called the photic sneeze reflex -- also known as autosomal dominant compelling helio-ophthalmic outburst, or ACHOO. A 2005 study of six Spanish families showed that <a href="http://www.ncbi.nlm.nih.gov/pubmed/16007510" target="_blank">there are usually two to three "achoo"s per episode of ACHOO</a>. This reflex is relatively under-studied and not completely understood, says Goldberg, but it is thought to have something to do with an accidental crossing of nerve signals.
'Why Does It Feel So Hot Out When It's 90 Degrees If Our Bodies Are 98.6?'
This question comes up all the time, says Goldberg (most likely during the sweltering East Coast summers). The answer is found in the human body's way of regulating temperature. We're constantly producing heat as we burn calories and exert energy, says Goldberg, and the heat needs to escape. He explains that it's easier to release pent-up heat when the temperatures outside are moderate or cool. When the temps soar, the body increases blood flow to the skin to help the heat escape through sweat. The hotter it gets, the more sweat and energy the body needs to exert, and the harder it ends up working. As a result, you feel like you're burning up.
'If You're Stranded On A Desert Island Should You Drink Ocean Water Or, Um, Your Own 'Water'?'
This is definitely one of the more far-fetched questions Goldberg has been asked in his 20-plus years as an emergency room doctor and <a href="http://www.med.nyu.edu/biosketch/wlg2" target="_blank">assistant professor of emergency medicine at New York University</a>. But the answer underscores the importance of staying hydrated at all times. Our drink of choice would have been seawater. But Goldberg informs us that we have it wrong: Seawater is three times as concentrated as human blood, and to process it, the body would need to excrete the excess salt through the kidneys as urine. As your body worked to flush out the salt, you'd lose precious fluids and become even more dehydrated. Before long, your muscles would atrophy, your heart would pound out of rhythm, and you'd eventually die of dehydration. He says it's probably safer to drink urine than seawater, but you'll probably be too dehydrated to make enough to quench your thirst.
'Can Pins And Needles In Your Feet Cause You To Become Paralyzed?'
Goldberg says he's seen many people end up in the ER because they've failed to respond to that weird prickly feeling, perhaps because they've been knocked out by alcohol, sleeping pills or a punch in the face. He explains that when you've been kneeling for too long (or doing something else that puts pressure on your leg), the arteries in that area can become compressed, preventing them from providing tissues and nerves with oxygen and glucose. This also blocks nerve pathways, causing some nerves to stop firing and others to go off like a 4th of July fireworks finale. When the brain receives these signals, it interprets them as that uncomfortable sensation of pins and needles. Prolonged pressure on the arteries can indeed lead to temporary or even permanent nerve damage, so it's important to respond to the feeling as soon as you notice it.