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View Diary: WHEE: Free Medical Advice (39 comments)

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  •  Response- some agreement some minor corrections (9+ / 0-)

    BMI is a basic measurement, you are correct of weight divided by height. It works for most people in defining whether you are underweight, normal weight, over weight or obese. It doesn't work for people who have more muscle mass than usual. Low tech, combining the BMI with a waist to hip ratio would give more information. Higher tech would be one of the measurements of body fat, there are some scales that do this and some hand held instruments. If you have a high BMI but low body fat, then you have high muscle mass. If you are in the obese category by BMI, but you are confident you are not obese because of your muscle mass, you may want to get your %body fat measured, just to confirm what you believe.

    I agree that starvation diets are harmful and usually self-defeating, they do not help in the long run.

    You mention that B12 assists in food absorption. I've never heard that. Some people with stomach problems, including pernicious anemia, have trouble absorbing B12 because they have low or no intrinsic factor. About 1% of B12 can be absorbed without intrinsic factor, so you can take B12 in oral doses of 1000 mcg daily and therefore won't need monthly B12 injections. We need about 1 mcg daily. So taking oral B12 at high doses can correct for those who have trouble absorbing B12, but B12 is used in manufacture of red blood cells and other body chemistries, I have never heard that it is useful in food absorption.

    There are a lot of inconsistencies in your discussion of pain medications to take and not to take. I would start off by saying opiods (narcotics) are helpful for short-term pain relief. Codeine, hydrocodone (Vicodin), propoxyphene (Darvon) are in that category. Short term pain relief usually means after surgery for a few days or after an injury for a few days. Do not take for long term or chronic pain because of the risk of addiction. Medications are added to opiods to potentiate the effect of the medication, so acetamenophen (tylenol) or aspirin are often combined with the opiod. The exception to the chronic pain is, of course, people who are terminally ill who should receive what they need for pain relief.

    Both tylenol and aspirin have issues when combined with the narcotic portion of the pain medication. Tylenol is liver toxic, as louisev points out, and if you take more pain pills than ordered you could overdose easily. More than 8 pills in an 24 hour period of Vicodin 5/500 (5 mg of hydrocodone and 500 mg of tylenol) would be an overdose. The risk for liver damage is increased by chronic, heavy alcohol use. If this is you, then you could ask to have your hydrocodone with ibuprofen (vicoprofen).  Many people take more than 2 grams of tylenol a day and it doesn't kill them or harm their liver. People on chronic tylenol should periodically have a liver enzyme test to check the function of their liver. People who drink heavily should not take tylenol.

    Aspirin is a platelet inhibitor, which means taking a daily baby aspirin is helpful to people with heart disease, as it keeps the platelets from clumping together or forming clots. It is not helpful for people with stomach ulcers or other sources for a bleed in the gastrointestinal system, so taking high doses of aspirin with your opiod could be a problem.

    Whether to add aspirin or tylenol (or which to add) to the opiod to increase its effectiveness would be based on your particular medical history. If you are concerned about the combinations, you can ask to have your opiod plain. Another alternative pain medication is Tramadol (Ultram), which is opiod like and this form does not have tylenol.

    I wouldn't recommend oxycontin to anyone, has tremendous addiction potential,  it shouldn't be typically ordered for someone with run-of-the-mill post op pain. Consider for terminally ill patients for pain control.

    •  But what if it works best? (4+ / 0-)

      I wouldn't recommend oxycontin to anyone, has tremendous addiction potential,  it shouldn't be typically ordered for someone with run-of-the-mill post op pain. Consider for terminally ill patients for pain control.

      I get what you're saying here, but I can't help but think that the "addiction potential" fear is overblown.  Why shouldn't a chronic pain sufferer take whatever works best?  It isn't as though the pain is going to suddenly go away, leaving no "medical" reason for the oxy but still leaving an "addictive" reason.

      If oxy manages chronic pain, what difference does it make that it's addictive?  Heck, if I suffered from chronic pain, I'd be addicted to ANYTHING that made it go away, no?

      "He that would make his own liberty secure must guard even his enemy from oppression." -Thomas Paine

      by sierrak9s on Sat Dec 26, 2009 at 07:21:51 AM PST

      [ Parent ]

      •  The problem with addiction (2+ / 0-)
        Recommended by:
        Pandoras Box, Clio2

        is that you get less pain relief from the medication over time, that you need higher doses to get the same response, that you have violent physical reactions when you don't take the medication. As you increase the dose, you increase the risk of side effects and overdosage and death.  Once you become addicted, it is very difficult to get medications you want legally since most medical professionals will not increase your dose even thought that is what you need to get pain relief. Once you are addicted, it overtakes your life and all you are thinking about is getting your next dose and it is never enough.

        If you have chronic pain, there are pain specialists that can work on developing a proper plan for your pain, perhaps alternative medications can help (tricyclic antidepressants and some antiseizure meds treat chronic pain without causing addiction, perhaps some nerve blocks, perhaps you need surgery or physical therapy, etc.

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