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."
A New Year's resolution to take better care of yourself is one you should keep, especially in the era of COVID-19. Wearing a mask, maintaining a safe distance from others and washing your hands frequently are going remain important in 2021. But don't forget to prioritize a healthy lifestyle that improves your overall health and quality of life, and helps prevent cancer, according to experts at the Rutgers Cancer Institute of New Jersey. The institute offers the following tips: Eat a healthy diet and watch your weight. For cancer prevention, the American Institute for Cancer Research and the American Cancer Society recommend maintaining a healthy weight, staying active and eating a healthy diet. That's one rich in whole grains, vegetables, fruit and beans, with a minimum of red and processed meats, fast food and processed foods high in fat, starches or sugars. Avoid sugary drinks. Cutting out alcohol lowers the risk of many cancers, including breast cancer. Exercise regularly. It has many benefits for physical and mental well-being. Current guidelines recommend at least 150 to 300 minutes a week of moderate-intensity, or 75 to 150 minutes a week of vigorous-intensity aerobic physical activity. Muscle-strengthening activities should also be included. Sitting for a long time watching TV or using the computer is discouraged. Find fun ways to stay active, such as online exercise classes, or walking or jogging in your neighborhood. Quit smoking. Lung cancer is the leading cause of cancer death. Quitting smoking will lower the risk for many cancers, including those of the lungs, mouth, throat, blood, bladder, esophagus, stomach, pancreas and kidneys. Getting preventive care is an important step to manage your health. This includes cancer screenings, which can detect cancer before it spreads.
Many Americans are working at home or attending school virtually during the COVID-19 pandemic, leading to increased use of home heating and its potential risks, experts say. Heating sources can pose electrical hazards and fire dangers, noted officials of the pediatric trauma injury prevention program at Monroe Carell Jr. Children's Hospital at Vanderbilt University in Nashville, Tenn. "With pandemic restrictions in place, there are more people in the home during a time when it would traditionally be empty," officials said in a Vanderbilt news release. "Folks are needing to stay warm. And for some who are not working, they are trying to figure out how to stay warm on less income." That could lead to the use of unsafe heating sources, she cautioned. "During this time, it is so important that people know what heating sources the safest and which ones are to steer clear from to prevent a potentially hazardous situation," officials said. A major threat from heating sources is carbon monoxide, often called the silent killer. In the United States, 170 people a year on average die from carbon monoxide poisoning not associated with vehicles, according to the U.S. Consumer Product Safety Commission. Causes include: malfunctioning fuel-burning appliances such as furnaces, ranges, water heaters and room heaters; engine-powered equipment such as portable generators; fireplaces, and charcoal burning in enclosed areas. The hospital's experts offer these tips to prevent carbon monoxide poisoning:
- Install CO alarms near all sleeping areas in your home and test them monthly
- Have gas, oil or coal-burning appliances, chimneys and fireplaces checked by a professional every year
- Never use a kitchen stove or oven to heat your home
- Never use a grill, generator or camping stove inside your home, garage or basement
- Never leave a vehicle running inside a garage, even with the garage door open.
- Keep electric space heaters, humidifiers and vaporizers at least 3 feet from beds, curtains and other flammable items
- Use grounded (three-pronged) cords with all major electrical appliances
- Make sure that electrical cords are properly insulated, and that insulation shows no signs of wear or fraying
- Never run electrical wires under carpeting.
Puffy coats have their place, but it's not inside a car seat. The American Academy of Pediatrics (AAP) offers a variety of tips for keeping your little ones safe and warm while traveling by car. The first is to avoid dressing children in puffy coats or snowsuits before buckling them in, because car seat straps won't tighten enough. That creates a danger that the fluffy padding will flatten in the force of a crash and the youngster will slip from the seat and be thrown from the car. Puffy coats are not safe in a car seat or under a seat belt for someone of any age, the AAP said. "Parents may not recognize the potential danger of buckling up a child who is wearing a puffy coat," said Dr. Sarah Denny, a pediatrician with expertise in injury prevention. "A car seat harness or belt needs to fit snugly enough so that you cannot pinch the straps of the car seat harness. A safer alternative is to drape a blanket or coat over the car straps." The AAP offers additional tips, including staying warmer by storing the carrier portion of an infant seat indoors and packing extra socks, mittens and hats. If your child likes to suck his or her thumb, choose half-gloves with open fingers. Dress your child in thin layers. This would include close-fitting layers, such as a long-sleeved body suit and tights or leggings, a warmer top and pants and, finally, a thin fleece jacket. Long underwear is a safe layering option in very cold weather, the experts said. Infants should wear one more layer than adults, so think about what you have on when you're planning baby's outfit. Use a coat or blanket over car seat straps, but never use a car seat cover or other product that puts a layer under your child's body or between the child's body and the harness straps. Don't use sleeping bag inserts or stroller inserts because they haven't been crash-tested, the AAP warned. Be sure harness straps are tight enough. If you can pinch the straps, the car seat harness needs to be tightened to fit snugly against your child's chest. Also be sure to leave baby's face uncovered to avoid trapped air and re-breathing, the group advised in an AAP news release. Pack a bag with extra blankets, dry clothing, hats, gloves and non-perishable snacks in your car in case of an emergency. Get an early start, they suggested. This can help if the baby is uncooperative about being buckled in and can also give you extra time to get where you're going. "Pediatricians can help answer parents' questions about car seats and how to properly use them," Denny said. "Just as you would use layers of clothes to keep your child warm, you can use layers of prevention to keep your child safe."
The new year is the ideal time to focus on your health and one expert has some tips, especially for men, for doing that. According to health officials, "Men don't always focus on their health and, in fact, men are less likely to see a doctor or utilize health resources, and wait longer than women to seek care. Often, it's a man's spouse or partner who convinces him to see a doctor." As the COVID-19 pandemic continues, "a focus on health is especially important this year," officials said in a Loyola news release. Here are a few tips:
- Boost your physical activity.
- Men should exercise 150 minutes each week.
- Think about what you eat.
- January is a popular month to start a new diet.
- Smoke and drink
- Make unhealthy or risky choices
- Put off regular checkups and medical care
Be kind to your heart and health and turn off the news, doctors say. The COVID-19 pandemic has had a major effect on our lives. Many of us are facing challenges that can be stressful, overwhelming, and cause strong emotions in adults and children. Public health actions, such as social distancing, are necessary to reduce the spread of COVID-19, but they can make us feel isolated and lonely and can increase stress and anxiety. Learning to cope with stress in a healthy way will make you, the people you care about, and those around you become more resilient. Stress can cause the following:
- Feelings of fear, anger, sadness, worry, numbness, or frustration
- Changes in appetite, energy, desires, and interests
- Difficulty concentrating and making decisions
- Difficulty sleeping or nightmares
- Physical reactions, such as headaches, body pains, stomach problems, and skin rashes
- Worsening of chronic health problems
- Worsening of mental health conditions
- Increased use of tobacco, alcohol, and other substances