Opioids and OTC pain relievers have their drawbacks
A recent report in BMJ looked at the case of a 28-year-old male triathlete with hyperhidrosis (excessive sweating). After surgery to sever sympathetic nerves in order to control the problem, he couldn’t escape postoperative pain, despite taking medication and doing physical therapy. So he went to a spot where he’d started triathlons and jumped off a cliff into the icy seawater below. He returned to shore pain-free. Talk about a do-over!
We don’t recommend jumping off a cliff to manage chronic pain, but there are smart ways to deal with it. We mention this because of recent headlines about a randomized clinical trial of 240 patients from a Veterans Affairs hospital who had moderate to severe chronic back, hip or knee pain. The researchers provided an opioid-taking group with immediate-release morphine, oxycodone or hydrocodone. A non-opioid group took acetaminophen or a nonsteroidal anti-inflammatory drug. The researchers found that the opioid medications “did not result in significantly better pain-related function over 12 months” than nonopioid medications.
But there’s one thing the study didn’t mention: While there are complications and potential for addiction from opioids, NSAIDs aren’t without long-term problems. For example, taking NSAIDs for more than two weeks can cause intestinal bleeding, fecal incontinence, headaches and elevated blood pressure. Highdose, long-term acetaminophen usage is associated with liver toxicity.
Our recommendations: For chronic pain, get to a pain management specialist who explores medication choices along with meditation, acupuncture and physical therapy. Selfmedication can be like jumping off a cliff! It may work, but there also may be serious side effects.
Pepper your meals with food as medicine
Sgt. Pepper may have led the Lonely Hearts Club Band for the Beatles in 1967, but we’re promoting him to major general and spreading the pepper around as much as possible. Turns out this spice contains an ingredient called piperine that has amazing powers. It is, as a study in Frontiers in Cell and Developmental Biology points out, anti-oxidant, anti-inflammatory, immune-modulatory, anti-asthmatic, anti-convulsant, anti-mutagenic, anti-mycobacterial, anti-amoebic and anti-cancer. Seems it also increases levels and activity of detoxifying enzymes and suppresses stem cell self-renewal.
And while research in the petri dish and in animals confirms these powers, researchers are hoping to show that it is just as useful in fighting cancer in humans as it is in turning a bland meal into a tasty one. While scientists explore how to harness the power of piperine, we say add it to your “food as medicine” pantry.
Grind fresh black pepper (make the effort) onto veggies, soups, salads, lean proteins like skinless chicken, and even onto sweet cantaloupe or in smoothies for some zing. (But avoid taking piperine in supplements or using excessively without talking to your doc, because piperine can increase the bioavailability of some drugs.)
Wondering what you can add to your meals to increase the heart-, brainand gut-loving power of smart food choices? Here are six remarkable foodsas-medicine that you want to bring into your diet: black pepper, turmeric, salmon/sea trout, extravirgin olive oil, walnuts and berries. Bonus round: coffee, dark chocolate and red wine!
Question: One of my colleagues found out that his 10-month-old had elevated lead levels from exposure to lead paint dust in their Brooklyn apartment. It made me wonder how common this problem is. And what about adults — are they affected, too? — Katie D., Brooklyn, New York
Answer: Lead exposure among children is high where older housing stock (that’s pre-1978, although pre-1950s is most problematic) is riddled with dust-producing lead paint. Older rural and suburban homes also can be contaminated — and so can yards and fields where lead from lead-containing gasoline settled and remains to this day.
Adults are vulnerable, too. A recent study published in The Lancet estimates that 400,000 deaths annually in the U.S. are a result of chronic low levels of lead exposure, triggering cardiovascular woes.
There’s really no safe level of exposure to lead, and it appears to be a larger problem than we once realized. So, to test your home, water and yard:
■ Contact your state or county health department. Some provide testing services or maintain lists of services and certified lead professionals.
■ You can use a home dust test kit and send it to a lab for results. HUD standards for lead dust are 40 micrograms of lead per square foot for floors and 250 micrograms of lead per square foot for windowsills. Intact lead paint rarely is a hazard.
■ If you suspect or know that there’s a problem, have your child’s blood tested. A blood lead level of 10 ug/dl is a concern; you should reduce exposure pronto. At higher levels, medical treatment is required.
■ Don’t remove leadbased paint yourself.
■ Have your water and yard tested for lead.
■ A diet rich in iron and calcium, and low in saturated and trans fats, causes the body to absorb less lead.
Q: I heard that a natural extract from daffodils — an essential oil I think — has cancer-killing properties. Is that true? — Gregory F., Urbana, Illinois
A: Plant-derived essential oils and other substances that have a profound effect on human physiology are in the news lately, as researchers look for less-toxic and moreeffective therapies for everything from diabetes and cancer to depression and autoimmune diseases.
In fact, the National Cancer Institute has screened approximately 35,000 plant species for potential anti-cancer activities and found 3,000 species with reproducible anticancer activity. Isolation of several compounds from the mayapple, for example, ultimately led to the development of drugs that treat testicular and small cell lung cancer.
As for daffodils, new research has tested the anti-cancer properties of an extract from that flower called hemanthamine. It appears that down the road, its anti-cancer properties may be tested in clinical trials.
But that does NOT mean you should use daffodil extract/essential oil in hopes of battling or preventing cancer.
Some extracts of plantderived substances can be lethal if ingested or absorbed through the skin. For example, ingesting wintergreen oil is potentially health- and life-threatening. Furthermore, online extracts are generally NOT regulated. There’s no way to know what you’re getting (contamination or deception often adds unlabeled ingredients).
And a study presented at ENDO 18, the Endocrine Society’s 100th annual meeting in Chicago, reveals a potential link between abnormal breast growth in young boys and regular exposure to hormone disruptors in lavender and tea tree oils (they’re in consumer products).
However, for most adults, essential oil aromatherapy (using only essential oils like lavender) can help you sleep, feel less anxiety in an MRI or relieve pain.