Setting the record straight regarding kratom
Michael Roizen, M.D. and Mehmet Oz, M.D.
When Hofstra University’s departments of earth sciences and geology helped put together a teaching guide for GeoTeach to sort out the facts from science fiction in the “Jurassic Park” movies, they acknowledged that the filmmakers got many things right … and a few facts wrong. For example, a Pteranodon — the name itself means “wings with no teeth” — couldn’t have swooped down, teeth bared, plucked a 12-yearold boy off the ground and flown away!
Well, we also made a mistake when we said that the Center for Science in the Public Interest included kratom in their investigation titled “Crackdown Urged on Supplements Marketed as Opioid Withdrawal Aids.” Their study specifically excluded kratom, the opioid substitute that’s also being touted on the internet as a healthy alternative. This product, which we were focusing on in our column, was the target of a Food and Drug Administration warning to consumers; it wasn’t part of the CSPI investigation, and we want to set that record straight.
What CSPI did urge authorities to crack down on were companies that produce products such as Mitadone Anti Opiate Aid Plus, Opiate Detox
Pro and TaperAid Complete. Both CSPI and the FDA stress that there are three FDA-approved, medically assisted treatments for opioid addiction withdrawal: methadone, buprenorphine, and naltrexone. These are treatments consumers can depend on, and we hope that others come along.
Consider this our “Redactyl” to our Pteranodon, and we look forward to the continued good work the Center for Science in the Public Interest accomplishes year in and year out.
Avoiding and managing varicose veins
On an episode of “Friends,” the gang arrives late to Monica and Chandler’s for dinner. “I bet that vein on Monica’s forehead is popping like crazy,” says Phoebe when Monica won’t let them in. When Rachel suggests eating leftovers instead, Monica warns, “You touch that, and you will be sorry!”
“Guys, I’d listen to her,” says Chandler. “The vein is bigger than I’ve ever seen it.”
Bulging veins in comedy go back to Sid Caesar in the 1950s, but varicose veins are a different story. They can be painful and disfiguring.
Veins carry blood back to the heart after oxygen is delivered to your cells. They accomplish their mission by using valves that open and close, keeping blood headed in the right direction. But if those valves weaken, blood can back up and pool, causing swollen, twisted veins. If you notice them on your calves or thighs, there are ways to ease the pain and stop them from getting worse:
■ Exercise regularly to strengthen vessel walls and move blood through your veins.
■ Don’t sit for long periods of time; elevate legs when resting.
■ Maintaining a healthy weight relieves pressure on veins.
■ Avoid tight clothes around the groin and thighs.
■ Wear compression stockings (the right compression pressure!) and put them on correctly, if prescribed.
■ Talk to your doc about routine aspirin use.
■ If VVs become painful or a clot forms, medical interventions include chemical injections (sclerotherapy); laser therapy (for small VVs); endovenous ablation (heat-sealing of veins); for severe cases, surgery.
Question: I’m a video editor and I’m chained to my desk for hours at a time. I get an occasional bike ride with the kids on the weekends, but what can I do at my workstation to keep my muscles toned? — Gus Y., Brooklyn, New York
Answer: When you have a busy schedule, it’s hard to find time during the week to stay active. So we have a couple of tips for you to keep toned during your desk-bound workweek.
First, there’s the “build abs while you wait” routine:
■ While you’re standing in line at the coffee shop before work or waiting for your computer(s) to load or boot up, stand tall, breathe in slowly as you move your shoulders back, clench your butt muscles, suck in your belly and tighten your abs. Exhale slowly while you hold it for 10 seconds; repeat as many times as you can.
Then, there are desk moves:
■ Sit ‘n’ Tone works if you take time once an hour to “walk” 100 to
200 steps by lifting your heels up and down off the floor. Then extend your arms out straight from your shoulders, palms up; rotate your straightened arms 25 times backward and 25 times forward. Then pinch shoulder blades together and release 25 times. Whew!
■ Consider a pedaling device or an actual pedal desk, or like Dr. Mike, get a treadmill desk. For video editing, you probably could use it only while waiting for downloads, compressions and transfers. But you could engineer a setup that works with a stand-up/sit-down desk.
There are “Take a Break” toners:
■ Set a timer to go off every 30 to 60 minutes. When it goes off, walk around the office or up and down the stairs.
■ Need a coach? Check out Mel Miller’s 10-Minute Workout Tips at www. Sharecare.com.
If that all seems like a lot of time while you’re working, you’ll be surprised at how much more work you get done when you stimulate your blood and brain with simple movements.
Q: My sister has cervical cancer and was told by her insurance company that they would pay for an external radiation beam treatment, but not internal brachytherapy. They claim that external beam is just as effective, but that’s not true, is it? — Coleen B., Omaha, Nebraska
A: You are right. Research shows that brachytherapy is the gold standard for treatment and has a higher success rate and fewer side effects than external beam.
According to the American Cancer Society, there are two kinds of brachytherapy for cervical cancer; low-dose rate (LDR) brachytherapy, in which the patient stays in the hospital for a few days for treatment, and highdose rate (HDR) brachytherapy, which is done on an outpatient basis, usually once a week. The two treatments are very different; one may be used for first-time treatment, and the other for a cancer that’s returned.
Recently, researchers at the University of Virginia School of Medicine pointed out that brachytherapy runs at more than two and a half times the cost of external beam therapy and said that the higher cost “may be a potential driver of reported national trends toward poor compliance with brachytherapy.”
Regardless, whatever treatment her doctor/oncologist decides is right for her — and sometimes it’s a combination of external beam and brachytherapy — that is what she should get. And even though brachytherapy is the gold standard for treating cervical, prostate, some breast and skin cancers, she should get a second opinion too.
If she gets a second opinion and the doctor agrees that brachytherapy is the way to go, that’s a lot of fuel for her argument with the insurance company. The primary oncologist and or oncological surgeon and your sister should re-petition the insurance company (maybe more than twice) for preapproval and/or prior authorization for the brachytherapy. Hang in there. There are a lot of success stories out there about people resubmitting and getting what they want and need. Good luck.