Fosters Connect

Osteoarthritis

Osteoarthritis is the most prevalent rheumatic condition. It presents mainly when people reach their 50’s to early 60’s, affecting all people differently. Most often the hands, knees, hips, spine, and big toes are involved. Other areas that may be affected include the wrists, elbows, and shoulders.

Unfortunately you cannot change your age, but there are other modifiable factors that you can change to lessen the likelihood of developing osteoarthritis. Obesity increases your chances, as it puts extra pressure on your joints. Others include occupation and, though rare, genetic factors.

How do I know if it is osteoarthritis?

The most common complaints of osteoarthritis include morning stiffness and pain with activity. For those suffering from morning stiffness, you may notice that with movement the stiffness decreases. This is known as “gelling”. Pain may be most notable with activity and ceases when the active involvement of that joint ends. Osteoarthritis may be described as “deep and aching” and does not affect the body symmetrically, unlike rheumatoid arthritis.

If this description depicts your symptoms, you may be a candidate for self-treatment. However, it is advised to meet with your physician within 10 days of beginning any self-treatment for further follow-up and to rule out a more serious medical condition. Self-treatment is not appropriate if you have any of the following:

Exclusion Criteria

• Pain that does not cease with rest

• Pain lasting more than 10 days with treatment

• Pregnancy

• Certain medical conditions such as diabetes and congestive heart failure

• On a blood thinner, such as Coumadin®

• Pain that is symmetrical (example: both knees or both elbows equally affected)

What treatment options are available?

Lifestyle Modifications

• Diet and weight loss

Excess weight increases the load on your weight-bearing joints. Loosing as little as 10% of your total body weight can be very helpful.

Physical Therapy

• Heat/cold treatments

• Exercise

These treatments can reduce pain and aid in maintaining and restoring the range of motion in affected joints. Warm baths or water soaks may be useful for pain and stiffness. The use of heating pads should be cautioned due to the risk of burns. Exercise regimes that focus on stretching and strengthening can improve physical functioning.

Over-the-counter (OTC) Options

If you find that the non-drug treatment options are working or need further relief until you may be seen by your physician, there are a few OTC options available.

 

Typically Tylenol® (acetaminophen) should be tried first because it is inexpensive and effective. Tylenol® is more appropriate than Motrin® and Aleve® for people suffering from gastrointestinal issues, acid reflux, or on a blood thinner. The recommended daily dose is 650mg four times a day. This particular strength is marketed as Tylenol® Arthritis. It can take anywhere from two to three weeks to see a maximum effect. The maximum recommended daily dose is 4000mg per day, so be sure to check other products that you are taking to make sure that they do not contain acetaminophen (common in many “Cough and Cold” products). Do not exceed 2 to 3 alcoholic beverages per day while taking Tylenol®.  The most common side effects include upset stomach and nausea, but overall it is very well-tolerated.

If Tylenol® is ineffective, a non-steroidal anti-inflammatory such as Motrin® or Aleve® may be tried. Do not take one of these medications if you have acid reflux, past or current stomach ulcer(s), are on a blood thinner, or have a history of kidney impairment without first speaking to your physician. These medications decrease pain and inflammation. The recommended starting dose of Motrin® is 2 tablets three times daily with food. If one agent in this class is tried and does not provide the proper relief another may be tried. The recommended dose of Aleve® is 1 tablet three times a day with food. Side effects may include upset stomach, heartburn, and nausea. If you have tried a treatment for at least 10 days without relief, seek medical treatment.

Glucosamine and chondroitin have received much attention for their role in helping with the symptoms of osteoarthritis. Both can generally be found in single products and may be effective in reducing pain, improving mobility, and even promote cartilage health. Glucosamine is derived from oyster and crab shells and chondroitin from shark and bovine cartilage. If you have an allergy to any of these substances, do not take glucosamine and chondroitin supplementation. The recommended dose of glucosamine is 1500 mg per day and chondroitin 1200 mg per day. Combination products are produced in fixed doses that will enabled you to reach these recommended doses. It may take 2 to 3 weeks for a maximal response. Check with your physician before trying this supplementation if you have diabetes or another serious medical condition, as rarely increases in blood pressure, cholesterol, and blood glucose have been noted with its use. The most common adverse effects are usually gastrointestinal and include intestinal gas, abdominal cramping, and bloating.

Topical therapies may include products such as those listed above in the chart. Many of these products have ingredients that include methyl salicylate, camphor, menthol, or capsicum. These products are intended to be applied no more than 3 to 4 times daily. Some products effect is a cooling sensation or heat. One of the most widely known products is Capzasin®. When applied to the skin it produces a feeling of warmth or slight burning. With continued use (at least 14 days) the irritation to the skin decreases or resolves. Therefore it should be used on a daily basis to keep pain from returning. Safety considerations with topical products include skin rashes, burning, and stinging. Never apply a topical product to broken skin. Also, when using a product that produces a heat sensation, heating pads, tight, or occlusive bandages should not be placed over the product after it is applied.

For those of you wishing to try natural remedies there are several available. Peppermint oil can be used topically to treat arthritis pain and may be similar to products containing menthol. Common reactions include skin irritation or rash. Devil’s claw is taken by mouth and may improve pain tolerance when used in combination with non-steroidal agents like Motrin®, as does stinging nettle. There is evidence that oral or topical use of stinging nettle leaf extract may improve symptomatic pain associated with osteoarthritis. Side effects from stinging nettle may include gastrointestinal upset, sweating, and allergic skin reactions. SAMe (S-adenosyl-mehtane) is a supplement that is comparable to non-steroidal medications and may be associated with fewer adverse effects than Motrin® or Aleve®. However the response is delayed and is much more costly than other options.

Before starting any supplementation or OTC therapy, check with your pharmacist to make sure it will not interact with any of the other medications you are taking. Always follow package directions accordingly and if you have any further questions, contact one of you local Foster’s pharmacist.

 

Wake Up to the Facts of Sleep...or Lack of it.

 

Sleep, marvelous sleep. It’s one of those things you might take for granted—that is, until it eludes you.

How much sleep is needed varies greatly by age and from individual to individual. Newborns can sleep away three-fourths of the day. Toddlers and preschoolers need 11 to 14 hours of sleep each day. This need gradually declines until adulthood, when most people require around 7 to 8 hours—although seniors may find their sleeping patterns fluctuate due to changes associated with aging.

Unfortunately, seniors aren’t the only ones who struggle with a sound night’s sleep. According to the National Institutes of Health, more than 70 million Americans experience insomnia. That means they have trouble falling or staying asleep, or they wake up before they’ve gotten enough sleep.

You might find your sleep interrupted by night sweats during menopause. Or, a bed partner’s snoring might irk you. Still others have conditions such as sleep apnea or restless legs syndrome. A serious breathing disorder, apnea is marked by loud snoring and periods when breathing briefly stops. Restless legs syndrome is a neurological disorder that causes uncomfortable sensations in the legs. Seek treatment for problems like these.

No matter the cause, it can’t hurt to discuss your sleep problems with your doctor or me. I can go over the list of medications or supplements you’re taking to see if any could be interfering with your sleep. Some common culprits are antihistamines, antihypertensives, beta-blockers, and hormones. Even common pain relievers can pose a problem since many contain caffeine. But don’t stop taking any prescription medications without discussing this first with your doctor.

You can do many other things to improve your sleep. For starters, keep regular bed and wake times, even on the weekend. And use your bedroom only for sleep.

To prepare your body for sleep, avoid stimulating activities and substances during the evening hours. This includes alcohol, heaving eating—especially spicy or high-sugar foods—fluids, nicotine, or caffeine. Be sure to exercise, but do it at least a few hours before you go to sleep. Make the time right before bed really relaxing—with calming activities and soft lighting. A bubble bath by candlelight, perhaps?

Wearing earplugs or eye masks or using a fan, or heavy curtains may also create an environment more conducive to sleep. If you use night-lights, make sure they’re not too bright.

If all else fails, talk with your doctor about other ways to promote sleep, such as relaxation techniques or behavioral therapy. Sleep aids such as valerian or melatonin might help, but know that these are not regulated the way medications are.

Sleep medications may be an option if your insomnia is interfering with your daily activities. Your doctor can discuss potential choices. Hypnotics are prescription medications that promote sleep. Antidepressants are best used only if depression is a problem. Anxiolytics can ease anxiety that may be interfering with sleep. Seek advice before considering either prescription or over-the-counter (OTC) sleep medications. And be sure to discuss any troubling side effects that occur.

 

A Healthier Approach to the New Year

 

Here we go again. It's another new year, and you know what that means. "New Year's" and "resolution" are about as inseparable as Jack and Jill or salt and pepper. So what's it gonna be this year? Eat less, exercise more, quit smoking, or spend more time with your family?

Easy does it. Before you take the plunge, try rethinking your approach. Instead of making vague, sudden, and difficult-to-keep resolutions, think in terms of healthy lifestyle changes – more of a work in progress.1

Start small, with one goal at a time, and make a solid plan. Remember: small changes really do add up. One way to be more effective is to create SMART goals. These are the elements of SMART goals:

Specific. State exactly what you want to accomplish. Make sure your goal is not hard to understand. Getting fit is not a specific goal. Being able to run a 5K under 30 minutes is. Write down exactly what you plan to do as well as when and how often. Post it where you'll be sure to see it.1

Measurable. If a goal is measurable, can evaluate your progress and know when you've succeeded. For example, if your goal is to lose weight, you can check your body mass index (BMI) or see if you can get the zipper up on a smaller pair of pants.

Attainable. Maybe you want to lose 50 pounds by your class reunion this summer. But seriously, now, is this really realistic? Instead, have a conversation with your doctor about safe methods and rates of weight loss.  Losing one or two pounds a week might be more reasonable. Or, maybe you'd like to quit smoking cold turkey, but you know that tapering off will make it easier for you. Set yourself up for success by setting goals that are truly attainable.2

Relevant. Is this really a goal you're interested in? Or is it something a family member has foisted upon you? Make sure the steps you're taking will help you meet your specific goal.

Time-bound. It's human nature to put things off. So remember to set specific deadlines. Try setting lots of shorter time-bound goals. This may make it easier to stay on track and reach your final destination.2

You are also more likely to succeed if you are clear about why you want to make a particular change and know how it will benefit you. Also, identify your support system and ask for help when you need it. And come up with rewards for reaching specific goals. All these things can help you stay motivated.

It will also help to create visible cues that remind you that you want to make a change. Maybe that means keeping workout clothes within easy reach. By the same token, remove things that will undercut your will. 2 For example, if ice cream is your weakness, it won't help to know that there's a half-gallon of mint chocolate chip in the freezer with your name on it. But, remember: slip-ups happen. So don't beat yourself up. Just get back on the proverbial horse and keep going.3

Need more ideas about lifestyle changes you can make? Stop by the pharmacy and we can discuss your goals.

Sources

1. American Psychological Association: "Making lifestyle changes that last." Available at: http://www.apa.org/helpcenter/lifestyle-changes.aspx. Accessed April 18, 2012.

2. American Council for Exercise: "Reaching Your Goals the SMART Way." Available at: http://www.acefitness.org/fitfacts/fitfacts_display.aspx?itemid=2637. Accessed April 18, 2012.

3. Hungtington Medical Foundation: "Making lifestyle changes that stick." Available at: http://www.huntingtonmedical.com/about-hmf/hmf-newsletter/making-lifestyle-changes-that-stick/. Accessed April 18, 2012.


 

Ear Wax Basics

 

 

Earwax. Great table topic, right? Maybe not, but earwax is a natural, normal part of your body. It helps clean and lubricate your ears. Without it, your ears would become dry and itchy and pretty uncomfortable.

Earwax forms in glands located in the skin of the outer part of your ears. It traps dust and dirt, and gradually transports these "invaders," along with skin cells, to the ear opening. There, it flakes and falls out or gets washed out by you. When all goes well, you don't even need to clean your ear canals. Just wash your outer ears with soap and water when taking a shower or bath.1,2

But if earwax builds up, it's time to take action. You may have symptoms such as a feeling of fullness, ringing, discharge, itching, odor, or partial hearing loss.1 Here's another clue: Your family members have started teasing, "Didn't you hear me? Get the wax outta your ears!"

Start by cleaning the external ear with a cloth, but don't insert anything, such as a cotton-tipped applicator, bobby pin, piece of paper – or even your finger – into your ear canal. This does just the opposite of what you intend: It pushes wax deeper into your ear canal and can cause infection. You can also damage the ear canal or eardrum.2 Whatever you do, don't try a product called ear candles for extracting earwax. These involve inserting a cone-type device into the ear canal and setting the other end on fire! They can cause serious injury. 1,2

What if you still have symptoms? In most cases, home treatments to soften wax work just fine. A Foster's employee can direct you to some possible options in our store.

At home, lie on your side and deposit a few drops of one of these products in your ear. If this alone doesn't work, you can try ear syringing. This involves suctioning the wax out of year ears. Again, I can help you find these ear syringes here in our store. They work best if you put water, saline, or wax dissolving drops in the ear canal about 15–30 minutes beforehand.1

Before trying any of these products, it's best to discuss it with your doctor.2 If you have diabetes, a weakened immune system, perforated eardrum, or tube in your eardrum, a doctor should manually remove any built-up earwax, using special devices such as graspers and suction. A special ear, nose, and throat doctor called an otolaryngologist may be the best person for the job, especially if you have a narrow ear canal. 1 Occasionally, you may also need antibiotic eardrops for an infection.2

New nickname, Shrek? No worries. Some people make more earwax than others.2 If needed, you can see your doctor for preventive cleaning as often as every 6 to 12 months. 1

Nothing herein constitutes medical advice, diagnosis or treatment, or is a substitute for professional advice.  You should always seek the advice of your physician or other medical professional if you have questions or concerns about a medical condition.

Sources:

1. American Academy of Otolaryngology—Head and Neck Surgery: "Earwax." Available at: http://www.entnet.org/HealthInformation/earwax.cfm. Accessed April 18, 2012.

 

2. Nemours Foundation: "Dealing With Earwax." Available at: http://kidshealth.org/parent/general/eyes/earwax.html?tracking=P_RelatedArticle. Accessed April 18, 2012.

 

Are You At Risk For Diabetes?


Are You at Risk for Diabetes?

More than 25 million Americans have diabetes. This is a chronic condition that produces high blood sugar levels.1 Another 79 million have prediabetes, which makes them 5 to 15 times more likely to develop diabetes. But many of these people – whether they have prediabetes or diabetes – have no idea they're at risk.2 Could you be one of them?    Well, to begin, here are some questions to ask yourself. Are you:

  • 45 or older
  • Overweight
  • The child or sibling of someone who has diabetes
  • An African American, Hispanic/Latino Native American, Asian American, or Pacific Islander
  • Someone who had diabetes while pregnant or gave birth to a baby weighing 9 pounds or more
  • Physically active less than three times a week2
The more boxes you checked, the higher your risk for prediabetes. Talk with your doctor to see if you should have a blood test, especially if you're 45 or older and overweight.2

How else can you know if you're at risk? If diabetes develops slowly, you may not have any symptoms. But with have high levels of blood sugar, you may one or more of these symptoms:
  • Extreme thirst
  • Blurry vision
  • Tingling in hands in feet
  • Fatigue
  • Frequent peeing
  • Increasing hunger
  • Unexplained weight loss 3,4
Left untreated, diabetes can lead to serious problems. Blindness, serious infections, nerve or kidney damage – to name a few. And, diabetes can contribute to cardiovascular problems, making a heart attack or stroke more likely.3 That's why you should pay special attention to blood glucose levels if your blood pressure is also high.5

But I'm here to tell you not to throw your hands up in despair. You can do a lot to prevent or delay the onset of diabetes – at least the type that more often occurs in adulthood (Type 2 diabetes). Even losing just 5 percent of your weight can make a big difference. 2 For someone who weighs 180, for example, that's just 9 pounds. You can do that, now, can't you?

In case you're still skeptical, you should know that the benefits of modest weight loss is backed up by research. The Diabetes Prevention Program (DPP) trial found that reducing fat and calories and increasing physical activity led to modest weight loss and a 58 percent reduction in type 2 diabetes in high-risk adults. Better yet? The benefits of these lifestyle changes lasted over several years. It had the biggest bang for the buck in people 60 and older.6

Other simple diet changes may make a huge difference as well. For example, blueberries and applies are tied to a lower diabetes risk.7 And, one recent study showed a strong link between white rice and diabetes, with a 10 percent increase in risk for each additional serving eaten!8 Instead, explore the world of whole grains – brown rice, barley, quinoa, or buckwheat. You may find you've been missing some nutritious – and delicious – alternatives.

Still perplexed? Not sure what to do? Remember to check out the resources at www.healthmart.com.

Nothing herein constitutes medical advice, diagnosis or treatment, or is a substitute for professional advice.  You should always seek the advice of your physician or other medical professional if you have questions or concerns about a medical condition.


Sources
  1. CDC: "2011 National Diabetes Fact Sheet." Available at: http://www.cdc.gov/diabetes/pubs/factsheet11.htm. Accessed March 27, 2012.
  2. CDC: "Prediabetes: Am I at risk?" Available at: http://www.cdc.gov/diabetes/prevention/prediabetes.htm. Accessed March 27, 2012.
  3. PubMed Health: "Diabetes." Available at: http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002194/. Accessed March 27, 2012.
  4. WebMD: "Diabetes Testing." Available at: http://diabetes.webmd.com/guide/diagnosing-type-2-diabetes. Accessed March 27, 2012.
  5. U.S. Preventive Services Task Force: "Screening for Type 2 Diabetes Mellitus in Adults." Available at: http://www.uspreventiveservicestaskforce.org/uspstf/uspsdiab.htm. Accessed March 27, 2012.
  6. NIH News: "NIH study finds interventions to prevent type 2 diabetes give good return on investment." Available at: http://www.nih.gov/news/health/mar2012/niddk-22.htm. Accessed March 27, 2012.
  7. MedlinePlus: "Blueberries and apples tied to lower diabetes risk." Available  at: http://www.nlm.nih.gov/medlineplus/news/fullstory_123054.html. Accessed March 27, 2012.
  8. MedlinePlus: "As White Rice Intake Rises, So May Your Risk for Diabetes." Available at: http://www.nlm.nih.gov/medlineplus/news/fullstory_123031.html. Accessed March 27, 2012.
 
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