Vac­cines are rec­om­mended for pa­tients with no spleen

Prince Albert Daily Herald - - OPINION -

loss, lung in­fec­tions and in­fec­tion with Clostrid­ium dif­fi­cile, a type of di­ar­rhea. The like­li­hood of these side ef­fects is low: Peo­ple who need pro­ton pump in­hibitors should stay on their med­i­ca­tions.

I wrote the col­umn be­cause I often see peo­ple who have been tak­ing pro­ton pump in­hibitors for years for only mild heart­burn symp­toms. Most peo­ple don’t need to take such pow­er­ful med­i­ca­tions for a pro­longed time.

DEAR DR. ROACH: Af­ter a com­pres­sion frac­ture in my L-2 ver­te­bra, which was re­paired with surgery, I am deal­ing with arthri­tis in my lower spine. I have tried in­jec­tions, a nerve block and acupunc­ture, without re­lief. What’s next? -- B.V.M.

AN­SWER: There is no re­li­able med­i­cal treat­ment for arthri­tis of the back that can stop pro­gres­sion of the dis­ease. You have iden­ti­fied some com­mon treat­ments, but I have a few com­ments that might help.

The first is that, al­though they don’t stop the dis­ease, med­i­ca­tions can ease symp­toms. Ac­etaminophen (Tylenol) is a rea­son­able first choice. Antiinflammatory drugs have more side ef­fects, but may still be worth­while in some peo­ple.

Ex­er­cise is my first-line treat­ment for arthri­tis. Ex­er­cise re­duces pain, in­creases func­tion and has few side ef­fects be­yond sore­ness, which comes es­pe­cially af­ter the first few ses­sions. A phys­i­cal ther­a­pist can be a fan­tas­tic re­source in help­ing to de­sign a per­son­al­ized pro­gram.

Spinal ma­nip­u­la­tion, as done by a chiropractor, os­teopath, or mas­sage or phys­i­cal ther­a­pist, has been shown to have mod­est ben­e­fit.

Surgery for the back is an op­tion that I rec­om­mend for very few. Those whose pain can­not be con­trolled with med­i­ca­tion or peo­ple with pro­gres­sive neu­ro­log­i­cal symp­toms de­serve sur­gi­cal eval­u­a­tion.

Let me fin­ish by say­ing that a com­pres­sion frac­ture of the spine should lead to an eval­u­a­tion for os­teo­poro­sis: If you haven’t had one, speak to your doc­tor.

DEAR ABBY: I am a divorced and re­mar­ried man with two teenage daugh­ters. My ex-wife has cus­tody of my girls one state away. I see them as often as time and the courts al­low -- two months dur­ing the sum­mer, a week dur­ing win­ter break, ro­tat­ing Thanks­giv­ings, etc.

Both of my daugh­ters are fail­ing mis­er­ably in school, but I am most con­cerned about my younger daugh­ter. She is 13 and is re­belling badly. I re­cently spoke with the prin­ci­pal at her school and was told she puts forth zero ef­fort. She ar­rives at school un­clean, and fel­low stu­dents have com­plained about the way she smells.

She blames her ac­tions on my ab­sence. This dev­as­tates me. I have al­ways tried my best to make her un­der­stand that she was not any part of the rea­son her mother and I divorced. I try to call her often.

My big­gest prob­lem is I’m not good at ca­sual con­ver­sa­tion and idle chitchat. Gen­er­ally when we talk, we end up sit­ting in si­lence un­til one of us says, “Well, I gotta go.” My ques­tion is, how do I get bet­ter at talk­ing to my baby girl so I can let her know how im­por­tant she is to me? -- “GOTTA GO” IN FLORIDA

DEAR GOTTA GO: Liv­ing one state away, you can’t force your child to shower and make sure she is clean and dressed in fresh clothes be­fore she goes to school -- but her mother can and should. Shame on her for al­low­ing it, be­cause the girl will be­come a so­cial pariah, if it hasn’t hap­pened al­ready. If her poor grades and hy­giene are caused by de­pres­sion, she should be see­ing a coun­selor.

Newspapers in English

Newspapers from Canada

© PressReader. All rights reserved.