With opioid addiction soaring in the United States, it should come as good news that an opioid painkiller may not be needed after a sports-injury repair. A mix of non-addictive medicines may be safer and equally successful in managing pain after shoulder or knee surgery, a study from Henry Ford Hospital in Detroit indicates. Concerned about the opioid abuse epidemic, doctors there tested a different regimen for pain relief. They treated post-surgical pain with a combination of non-opioid medications, including anti-inflammatories, muscle relaxants and nerve pain relievers. Nearly half of the study participants required no opioids for pain relief. "It's a complete change," said lead author and orthopedic surgeon. He added that he was taught in medical school "the only mode of pain relief is opioid medication." Opioid overdose is the leading cause of accidental death in the United States, and orthopedic surgeons write a substantial number of opioid prescriptions, the authors said in background notes. The study builds on earlier research showing use of opioids after orthopedic surgery can be reduced, but goes further in suggesting that the drugs may be eliminated. Changing how pain is treated could keep people from ever being introduced to opioids, the surgeon said. The study focused on 141 patients who underwent anterior cruciate ligament (ACL) reconstruction, or repairs for a torn knee meniscus or rotator cuff and shoulder injuries. All received a combination of five drugs for pain relief before surgery. During surgery, a cocktail of three drugs was injected into surgical sites. Five drugs were given postoperatively and icing of affected areas was encouraged. Patients also were prescribed an opioid -- 10 oxycodone pills (5 mg) -- to be used if pain became too much. But they were asked not to take them, if possible, and to contact the on-call physician for help. One week after surgery, all of the patients said they were satisfied with pain management, and 45% avoided the available oxycodone. One patient required a prescription refill, the study authors noted. Those who did use the oxycodone (OxyContin) were more likely to report more pain, be female, and have a history of anxiety or depression. Of the four surgeries studied, ACL reconstruction was found to be the most painful, and 30 of the 49 patients who had that surgery used their oxycodone prescription, the researchers said. The surgeon said the specific drugs used were less important than employing a range of non-opioid pain relievers. His next goal is to expand the method to all orthopedic surgeries at Henry Ford Hospital. The approach "definitely makes sense," said a fellow orthopedic surgeon specializing in sports medicine at the Hospital for Special Surgery in New York City. He was not involved with the study. Opioids not only pose an addiction risk, he said, but have side effects. "Patients on opioids, they're out of it, and constipated," Dines said. Doctors following the protocol would have to coordinate several pain relievers after surgery instead of one opioid, the surgeon said. However, reports pointed out that patients on opioids may end up also needing stool softeners, laxatives and anti-nausea medicines. One potential concern was the protocol's use of ketorolac and other nonsteroidal anti-inflammatory drugs (NSAIDS), which animal studies indicate may inhibit tendon healing, reports said. Both The surgeon and Dines said that patients have turned against extended use of opioids. "People actually prefer the non-opioid approach," the surgeon said, urging patients to discuss pain relief options with their doctor. Part of managing pain is managing patient expectations, reports said. There is going to be pain after surgery, especially in the first week or two. Of the need for opioids after sports surgery, reports said that "most people can get by with none." The study was published recently in Arthroscopy: The Journal of Arthroscopic and Related Surgery.
Smiling can trick your mind into being more positive, according to a new study. Researchers at the University of South Australia found that the simple act of moving your facial muscles into a smile can make you view the world more positively. "When your muscles say you're happy, you're more likely to see the world around you in a positive way," said a human and artificial cognition expert at the university. He and his colleagues studied how people interpret various images of facial and bodily expressions that range from happy to sad, based on whether they were smiling themselves. The study involved 256 volunteers from Japan, Poland, Spain and Sweden. Participants were asked to hold a pen between their teeth, an act that forces facial muscles to replicate the motions of a smile. They were then shown images of facial expressions that ranged from frowning to smiling, and videos of a person walking in different positions, ranging from "sad walking" to "happy walking." The participants viewed each image or video with and without a pen in their teeth, and then evaluated if the evoked emotion was "happy" or "sad." The researchers observed that the participants were more likely to view a broader range of the images and videos as "happy" when smiling themselves. "In our research, we found that when you forcefully practice smiling, it stimulates the amygdala -- the emotional center of the brain -- which releases neurotransmitters to encourage an emotionally positive state," researchers said in a university news release. The results suggest that everyone, and particularly those suffering from mental health issues like anxiety and depression, may benefit from the simple act of smiling. "For mental health, this has interesting implications. If we can trick the brain into perceiving stimuli as 'happy,' then we can potentially use this mechanism to help boost mental health," researchers said. "A 'fake it till you make it' approach could have more credit than we expect." The study was published recently in the journal Experimental Psychology. Tips to Boost Your Mental Health
- Track gratitude and achievement with a journal. Include 3 things you were grateful for and 3 things you were able to accomplish each day.
- Start your day with a cup of coffee. Coffee consumption is linked to lower rates of depression. If you can’t drink coffee because of the caffeine, try another good-for-you drink like green tea.
- Set up a getaway. It could be camping with friends or a trip to the tropics. The act of planning a vacation and having something to look forward to can boost your overall happiness for up to 8 weeks!
- 4. Work your strengths. Do something you're good at to build self-confidence, then tackle a tougher task.
- Keep it cool for a good night's sleep. The optimal temperature for sleep is between 60- and 67-degrees Fahrenheit.
High blood pressure affects nearly half of American adults, and three-quarters of those with high blood pressure don't have it under control, The American Heart Association reported. High blood pressure is the leading cause of heart attack and stroke, and the most significant controllable risk factor for these conditions. It also contributes to poor outcomes in COVID-19 patients. "Now, more than ever, it is important for you to pay attention to your blood pressure, know your numbers, work with your health care provider to control your levels and manage your risks. Lowering your blood pressure is one of the most important things you can do to reduce your risk of having a heart attack or stroke," Dr. Mitchell Elkind, president of the American Heart Association (AHA), said in an AHA news release. Small changes can make a big difference in managing your blood pressure. Here are some tips: Check your blood pressure often. 120/80 or below is considered normal. If your blood pressure is 130/80 or above, that is high blood pressure, and it means you have an increased risk of heart disease and stroke. Take blood pressure pills as prescribed. Prescription medication can be one of the most effective ways to manage your blood pressure. Tell your doctor if you have any concerns about your prescriptions. Read the labels on over-the-counter drugs. Some common medications can significantly affect your blood pressure. For example, pain relievers such as ibuprofen (Advil, Motrin) and naproxen (Aleve) can raise blood pressure. Consider acetaminophen (Tylenol) for pain instead and talk to your doctor about which pain relievers are right for you, the AHA suggests. Maintain a healthy weight. Using a measurement of height and weight called body mass index (BMI), aim to maintain a BMI between 18.5 and 24.9. Eat a healthy, low-salt diet. Start with lots of fruits, vegetables and whole grains. Choose low-fat dairy products, lean meats, and cut back on saturated and total fat. Try to stay under 1,500 mg of sodium/salt a day or at least cut back by 1,000 mg per day. Be active. Get at least 150 minutes of activity per week, with a combination of moderate and vigorous aerobic activity. Limit alcohol. Have no more than one or two drinks a day. (One for most women, two for most men). If you don't drink, don't start. Don't smoke. Both tobacco products and vaping have nicotine that can raise your blood pressure.
Toddler behavior won't always be good. Outbursts are normal. Yet, you can also use those aggravating moments to help shape your little one's behavior, according to the American Academy of Pediatrics (AAP). Start by teaching the "house rules," the AAP advises. Put away valuables you don't want your toddler to touch. Consider setting up an area with books and toys where your toddler can safely play. When your toddler breaks a rule, use positive reinforcement rather than threats. Reprimand quickly to help with understanding. Use healthy distractions and try different approaches, but don't bribe with sweets, the AAP recommends. Toddlers have little natural self-control, so it's important to teach them to express their feelings through words rather than kicking, biting or hitting when angry. "We don't hurt each other," is one phrase you can say. Other tips include praising your child for appropriate behavior, controlling your own temper and staying strong when you need to discipline your child. It is important for your child to understand when he or she is in the wrong and to take responsibility for his or her actions. Time-outs are OK for kids as young as 1, the AAP says. It's important to supervise your child carefully when there are disputes with playmates. If it's minor, let kids solve the problem on their own. You must intervene if the fight is physical or keeps going, the AAP says. Make it clear that it doesn't matter who "started it." There is no excuse for trying to hurt each other. Instead of fighting, teach your child to say "no" in a firm tone of voice, turn his back or find compromises. But how much is too much when it comes to tough toddler behavior? The AAP recommends calling a pediatrician if your child seems unusually aggressive for more than a few weeks or you can't cope with his behavior on your own. Additional warning signs are physical injury to himself or others, attacks on you or other adults, being sent home or barred from play by a neighbor or school, or your own fear for the safety of those around him. The most important warning sign is the frequency of outbursts. Once you find effective ways to reward good behavior and discourage bad, you can use these to establish an approach that works both at home and away, the AAP says. Progress may be slow, but a stable, secure home life with loving discipline and full-time supervision is the best way to prevent aggressive behavior.
Dry and chapped lips are common during the winter, but there are several things you can do to protect them, an expert says. "Cold, dry weather; sun damage; and frequently licking your lips are just some of the reasons your lips might feel dry and chapped this winter," an American Academy of Dermatology news release reported. "Understanding these causes and anything else that might trigger your chapped lips goes a long way in preventing and treating them." The report offered the following advice on preventing and treating dry, chapped lips: Use non-irritating lip products. Stick to lip balms, lipsticks and other lip products that contain ingredients like castor seed oil, ceramides, dimethicone or mineral oil. Choose products that are labeled "fragrance-free" and "hypoallergenic." Avoid harsh ingredients. Camphor, menthol or eucalyptus can irritate your lips. If your lips burn, sting or tingle after using a lip product, stop using it. Refresh often. Apply your lip balm throughout the day and before you go to bed. If your lips are very dry and cracked, use a thick ointment, such as petroleum jelly. Ointment seals in moisture longer than waxes or oils. Protect your lips outdoors. Before going outside, apply a lip balm with an SPF of 30 or higher. Use a lip balm with titanium dioxide and/or zinc oxide and reapply it every two hours while outside. Don't lick, bite or pick at your lips. It may feel natural to lick your lips when they feel dry, but this can worsen the problem. Instead of licking your lips, apply a non-irritating lip balm. Keep metal away from your mouth. Don't hold metal items such as paperclips, jewelry and reusable metal straws with your lips. They can cause irritation. Stay hydrated. Drink plenty of water and use a humidifier at home, especially in your bedroom while you sleep. "Chapped lips are usually harmless, however, sometimes they can be a sign of a medical condition," the report said. "If your dry, chapped lips do not heal after following these tips for two to three weeks, talk to a board-certified dermatologist."