Family medical Tips and Information

FAMILY MEDICAL TIPS There are some general methods and facts you can go by when, on occasion, you have some of the more common ailments. Also, there are things that you should never do. I’ll try to cover some of the ones that occur most frequently and some of the reasons I think they’re important. They may seem simple to some, but even the simple ones can cause a lot of anxiety and tears at times. Some are “dos” and “don’ts” that are also important. You can print this out and put it in your medicine chest, and maybe you’ll feel better about some of the things you do in the case of an illness or minor injury that you probably already know. I might even add to it from time to time as I get wiser. But after fifty years of doing this, maybe I can relieve the anxiety in some situations. The human body and mind are remarkable organs that have an uncanny way of healing themselves. Sometimes we just have to “do no harm” and let God do the rest. With Love……………………………………………….Donald Landers Cohagan, MD FEVER Aspirin and Tylenol (Acetaminophen) both work on fever, but sometimes the aspirin will irritate an already queasy stomach, and Tylenol usually doesn’t. Generally, go by the directions on the label for kids. Adults can take two Tylenol (500mg) every three to four hours with a maximum of eight (8) tablets in 24 hours. If necessary, you can add one aspirin every 3 – 4 hours to the Tylenol if it doesn’t upset the stomach. I don’t advise Advil/Ibuprofen for fever. It can really upset the stomach and doesn’t work as well anyway. The most urgent thing about fever is to stay hydrated, and that means plenty of plain water. A good replacement or substitute fluid for hydration is Pedialyte, which can be purchased in most pharmacies. NAUSEA AND VOMITING Remember…You will never starve to death, but you can become very ill from dehydration and then require intravenous (IV) fluids. Take small amounts of water/kool-aid/Pedialyte frequently. If no localized abdominal pain, you can use a Dramamine suppository for nausea. Kaopectate for diarrhea. Fever, especially 101 degrees and above, and localized pain or tenderness are danger signs. Low grade fever, 99 – 100, is not uncommon with a virus bug. Any bleeding with vomiting or diarrhea can be an urgent problem. If either vomiting or diarrhea cannot be controlled, especially with children, get help urgently. Again, dehydration is one of the greatest dangers. Dramamine about as good as anything. Comes in suppository. Small amounts of Pedialyte to rehydrate. If doesn’t stop in 2 – 3 hours, get help. Again, dehydration is the danger here. COLDS AND COUGHS The membranes of the nose, throat and bronchial tubes are moist, and they need to stay that way. If they become dry, or irritated from an infection or allergies, the mucous membranes become slightly irritated and they swell up and try to put out more secretions to stay moist. If there is associated infection, the secretions become a darker greenish or yellow color. This is when you “plug up”. If you take a “drying agent”, or something to “open you up”, you can make the “plugging” worse. Only when there is clear drainage with watery eyes and runny nose should you take a “decongestant”. Humidifiers do minimal good, if anything. Some think they just cause more humidity in the room and on bedding which can cause fungus to grow and make allergies worse. If the secretions from the nose, or in what is coughed up, is darkish green or yellow, there is probably an infection, and especially if associated with fever, should be treated with antibiotics. In milder “cold virus” or allergy conditions, where there is a lot of sneezing, watery nasal drainage with watery eyes and perhaps a dry cough, over the counter medications work very well. “Claritin D 12 Hour” is an allergy medicine that contains a decongestant with it. The decongestant is pseudoephedrine, which is what the addicts use to make meth. The Claritin part is an antihistamine, but it seems to help with the drying also. If your nose and chest are dry, irritated and hacky already, this will make it worse. The pseudoephedrine will also make your heart rate and blood pressure increase some too, and it will keep you awake. Best to take in the morning, because it lasts 12 hours. This does nothing for “infection”. If it is thick and green and there is a fever, you probably need an antibiotic. For straight allergies, the Claritin alone works well. Both of these are “over the counter”, but antibiotics are not. For coughs, I recommend a generic “Robitussin DM” which is a combination of Guifenisin (that loosens stuff up) and Dextromethorphan (which brings it up and suppresses the tickle-cough). You can take two teaspoons after each mealtime and at bedtime, or about every four hours. It doesn’t matter whether secretions are swallowed or spit out. We never want to “stop” a cough, just reduce its frequency and that irritated hacky feeling. This is a very safe product and can be taken two teaspoons full every four hours around the clock. Again, the magic ingredient here is the water you drink. Without hydration, everything is going to plug up. That’s when you get pneumonia. Vicks just makes you smell pretty – it doesn’t help otherwise. Neither do inhalers or nasal sprays unless you have really bad allergies with it, like asthma of hay fever. EAR ACHES: Ear aches can come from the external or the inner ear. The external is like “swimmer’s ear”. Most OTC drops are some kind of “oil “to try to separate the water from the skin. Might help before contact, but later, just a local effect. You probably should get a prescription med if too bad or especially with fever. If this is a problem, it’s best to use Swim Ear or some type of oily drop before getting in the water. DIAREHEA Diarrhea—The jury is divided on “slowing down the gut “with something like Lomotil. The gut is trying to tell you something—it wants to get rid of it. Kaopectate in pretty big doses is pretty safe to try to make the stool more solid. Things like Lomotil can bloat you up and lead to vomiting. Best to stay on clear liquids (water, Pedialyte, Kool Aid) until it stops. Again, the greatest danger is dehydration. Always try to take in water or fluids to keep the color and clearness of your urine as close as possible to the color of the water in the stool. If it’s really dark, you’re already a quart behind. The kidneys are the most happy when you’re putting out over a quart a day. Bright red blood in your stool or on wiping paper means bleeding somewhere down close to the anal opening or the lower gastrointestinal tract. It could be a hemorrhoid or a fissure, which is a small tear in the anal lining. A “sitz bath” or mild suppositories (Anusol) might help these if not too severe. The colon, which is the lower bowel, likes to have some “bulk” to work on to make soft stool. Otherwise it will clamp down on itself to try to make bulk, but it will just squeeze off mucous. A great way to get soft bulk for your colon is to give it fiber, such as Metamucil of Fiber-One. A black stool, or one that looks like tar, means bleeding higher up in the intestinal tract, like an ulcer in the stomach or in the first part of the upper tract. Any of these need medical attention as soon as possible. The black stool is the most urgent. SKIN CUTS, BLEMISHES, BRUISES, ETC. Rule One: Soap and lukewarm water. Pressure will stop 99.9% of all bleeding if you keep it on directly long enough. An “open” cut that won’t stop bleeding needs stitches. Also if it’s somewhere you don’t want an ugly scar. Any over the counter antibiotic ointment is fine if you want something on it, but important thing is sterile band aid or pad after washing in soap and water. All cuts and blemishes look terrible for the first 48 hours. Danger sign is swelling and redness going up or down the extremity. Infection doesn’t show up for 48 -72 hours and may have red streaks going up the arm or leg. If so—GET HELP! Bruises are due to rupture of tiny to larger blood vessels broken at the time of trauma. Hold pressure over it for 3 minutes steady. Ice doesn’t really do much. Cold can’t get deep enough. Pressure helps prevent spread. If already discolored, elevate it above level of heart and apply warmth (water bottle or heating pad on low. They all look much worse before they get better. There is NO Clot going to your heart. A bruise is “loose blood” in fatty tissue under the skin and not a clot to go somewhere. “Red streaks” are infection, and wouldn’t show up for 2 – 3 days anyway if the skin is broken. These need treatment as soon as possible anyway for antibiotic treatment. If a wound bleeds to the outside, it won’t “bruise” as much. ALWAYS BUY GENERIC DRUGS if available. They are just as good, regulated by the FDA and are MUCH CHEAPER. The Food and Drug Administration (FDA) regulates and controls all medications sold in the US as to strength and clinical effectiveness. The generic version of a brug must maintain the same “treatment capacity” as the name brand drug or the one protected by patent. You can always depend on the “generic” brand being the same “strength” as the registered drug, but the look and taste may be entirely different. Some of the generic brands are even made by the same company the makes the registered product. Even though developed in the US, many of our drugs are actually manufactured in foreign countries. Some generic names: “TYLENOL”--Acetaminophen “ADVIL”--Ibuprofen “ALEVE”—Naproxen By the way, Ibuprofen and Naproxen are very good “anti-inflammatory” agents. If a muscle or tendon is pulled, inflammation can develop, just like a sprained ankle or knee. Naproxin (Advil), taken with some food so it won’t irritate the stomach (like all anti-inflammatory drugs can do), really helps taken 2 or 3 times a day, with food, so you don’t get heartburn. It’s stronger than Ibuprofen (Advil). HEARTBURN, ACID INDIGESTION No carbonated beverages! The bubbles try to come up into your swallowing tube (esophagus). Any liquid anti acid will help for fastest result. “Prilosec” can now be purchased OTC as OMEPRAZOLE. These last TWELVE HOURS, so one at night, and one the next morning if needed. The best you can get that I know of. Liquid antacids might help for a faster response. HEADACHES Most headaches are due to tension or impulses in the skin and muscles of the scalp, and most of these come from the neck where the scalp nerves come from. When the nerves and the muscles get irritated or inflamed, the headaches can be miserable, affecting even the muscles around the eyes and down into the neck and shoulders. This can even seem to affect vision. Most will respond to rest and/or heat to the neck which causes relaxation and increased blood supply to the muscles. It is safe to take Tylenol (Acetaminophen) or Advil or aspirin for these. Pounding headaches are different, and may be coming from high blood pressure or increased pressure inside the head. This may also be associated with confusion, visual changes, nausea or vomiting, a short loss of consciousness or funny sensations. These are especially dangerous if occurring after some kind of blow to the head. If these are suspected, get help ASAP! Some could also be an early sign of a stroke. POISON IVY AND OTHER RASHES RULE ONE – UNO – FIRST !! Avoid contact! Get a book or google images and learn what the “poison” plants look like and stay away from them! Cool baths help. Some folks think oatmeal in the bath helps itching (a cupful in slightly cool water). If it’s a pretty small area, especially in an exposed area, some OTC cortisone cream may help the itching. Keep away from the eyes! The biggest complication is infection after scratching. This inflamed skin is very fragile, but a small amount of antibiotic cream might help if it really looks infected and crusting in a small area. FOREIGN BODIES (A SPECK) IN THE EYE Any solution that gets in the eyes should be irrigated thoroughly with water, lukewarm preferred. This will often remove small foreign bodies too. The eye will look red and awful after irrigation, but it’s a lot better than having something burn the eye or scratch it. Irrigation will neutralize or wash out most substances and foreign bodies. Turn on a faucet to barely lukewarm if preferred, cup the hands in the water stream, put your face right down in the water in the cupped hands, and open and shut the eye rapidly (blinking) for at least 15 - 30 seconds. The eye will look red, but it’s OK. A little Visene might even help. The most critical part of the eye is the cornea, which is the clear “bulge” over the colored part of the eye. NEVER use a QTip or other instrument on this part of the eye. It’s OK to use one over the “white” part of the eye if done gently, like when removing a “speck”. If the foreign body remains, especially if in the cornea, get help ASAP. After removal, if there is any question at all, such as a greenish discharge, go see a doctor or the ER to have it checked more thoroughly. The late danger is infection, often with a greenish discharge. Any redness or discharge the next day requires urgent help. Burning and stinging or bleeding on urination is BAD. Get help ASAP. Seizures are BAD. Get help ASAP. WHAT ABOUT VITAMINS? The only reason to take a multiple vitamin every day is if you think you are not getting everything you need every day in your diet. And the way many people eat today, I’m sure there are many who don’t get it. Most over-the-counter (OTC) vitamins are very safe to take if you wish. The only question is the need. There again, if you take them, consider the costs and take a generic. They are essentially all the same. The riboflavin in them can make your urine darker. SLEEP Literally millions of dollars are spent each year on medicines, articles, or chemicals to help induce sleep. Every person has a different “sleep pattern”, and some folks require more than others. The cycle also changes over time, at different ages, and according to different circumstances in our lives. Total relaxation is the greatest inducer of sleep, and one of the best “non-drug” methods I’ve ever heard of and practiced myself, is using the “conscious” mind to induce “total relaxation”. If you are in a dark, safe, and comfortable environment, you intentionally focus your mind on each segment of your body to submit to total “conscious” relaxation. You start with your toes and demand full relaxation of every muscle you have from there up, to you feet, your legs, your hips, your trunk, your fingers, arms shoulders and abdomen – all the way to your lips and scalp. This is done in a slow rhythmic fashion, with slow shallow breathing. The slow breathing leads to a slight increase of carbon dioxide in the blood, which assists the onset of sleep. Most folks who practice this have told me they seldom ever remember getting past the finger relaxation stage before they fall asleep. A “small amount of alcohol” or nighttime “toddy” is an excuse to drink. Alcohol is a stimulant in smaller quantities. Medication for sleep is really a misnomer. Anything over the counter that you take for sleep is usually just an antihistamine which can cause drowsiness or something like it that contains some aspirin or Tylenol. Most of these come in generic, cheaper forms too. ALWAYS read labels very carefully on any of these products, and remember they can cause delayed drowsiness even the next day. They can also cause dryness of the mouth, constipation and in some folks, blurry vision. ALCOHOL This might be as good a place as any to discuss alcohol, because all of us will be placed in situations where it will be consumed from time to time. The two most important things to remember about alcohol are that it is addicting and it is a sedative. The initial effect on drinking is stimulation, when most of us think we’re having the time of our lives and are much smarter, stronger, more beautiful, and much more talented than we really are. But remember…..it is a pharmaceutical drug just like anything else. It ultimately clouds the brain and nervous system, slows response times for reactions, reduces strength, tears up the intestinal system, reduces breathing and oxygen saturation in the blood while increasing the level of carbon dioxide, induces sleep to unconsciousness, and swells the brain with fluid to the point of making you stupid and provides a grand headache for the next day, all the while dehydrating you. And that is what we cry for when we go to a party, knowing full well the “stimulant” part will only last about an hour before the “stupid” part sets in! Almost everyone will “try” alcohol, mostly for the initial stimulating effect. What this really does is block or reduce moral and cultural inhibitions. As a “drug”, it depresses our cultural caution and good judgment. The real danger here lies in two areas. There is an attempt to increase or sustain these effects by taking in larger quantities, and these effects are delayed, so that the ultimate effects are not apparent to the suppressed mind until it is too late. As it is with any addicting drug, the tragedy of all of this is that many people are genetically susceptible to addiction with any of these substances and don’t even realize it. They are therefore much more prone to a lifetime of addiction even with smaller amounts or exposures to these substances. A short time of “social exposure” can lead to full addiction for them. BROKEN BONES (?) The main concern here is: “Is it broken? Can we wait to see? Should we splint it?” If there is a wound so bad the bone is sticking out through the skin, the answer is easy. But in even these cases and possible fractures, a general rule applies: Stop the bleeding with covering bandages and splint the part. A general rule on splinting is: immobilize the part above the injury and below it, and if possible, the joint above and below the wound. Keep the injured part as close as possible to alignment. NEVER put tight supporting bands above and below the injured area that would be so tight as to cut off blood supply. Application of large amounts of bandaging directly over the wound will control almost any bleeding.