A new study found that people experienced less pain when the treatment provider expected a pain reliever to work. This may have been due, in part, to the provider’s facial expressions.

The findings were published in Nature Human Behaviour.

The study didn’t use real doctors and patients. Participants were assigned to play these roles. Those playing the doctor were first asked to rate their experience of pain relief after applying two creams on their own arms. The creams were actually the same. But the “doctors” were given different levels of mildly painful creams. That led them to believe that one was effective and the other wasn’t.

The doctors then tested the patients to see how they responded to the creams. Researchers analyzed the facial expressions of both participants. They found that the amount of pain displayed in the doctor’s facial expressions affected the patient’s overall pain rating. Patients experienced less pain when the treatment provider expected the pain reliever to work.

“When the doctor thought that the treatment was going to work, the patient reported feeling that the doctor was more empathetic,” says Dr. Luke Chang of Dartmouth College. “The doctor may have come across as warmer or more attentive. Yet, we don’t know exactly what the doctor was doing differently to convey these beliefs that a treatment works.”

The story was reported in News in Health, a newsletter of the National Institutes of Health.

According to the National Institute of Mental Health, it’s common to feel sad or discouraged after a heart attack, a cancer diagnosis, or if you are trying to manage a chronic condition like pain. You may be facing new limits on what you can do, and you can feel anxious about treatment outcomes and the future. It may be hard to adapt to a new reality and to cope with the changes and ongoing treatment that come with the diagnosis. Your favorite activities, like hiking or gardening, may be harder to do.

People with other chronic medical conditions have a higher risk of depression.

Temporary feelings of sadness are expected, but if these and other symptoms last longer than a couple of weeks, you may have depression. Depression affects your ability to carry on with daily life and to enjoy work, leisure, friends, and family. The health effects of depression go beyond mood—depression is a serious medical illness with many symptoms, including physical ones. Some symptoms of depression are:

Feeling sad, irritable, or anxious

Feeling empty, hopeless, guilty, or worthless

Loss of pleasure in hobbies or activities, including sex, that are usually enjoyable

Fatigue and decreased energy, feeling listless

Trouble concentrating, remembering details, and making decisions

Not being able to sleep, or sleeping too much. Waking too early

Eating too much or not wanting to eat at all, possibly with unplanned weight gain or loss

Thoughts of death, suicide or suicide attempts

Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not ease even with treatment

Remember: Depression is treatable—even if you have another medical illness or condition. For more information, click here to see the National Institute of Mental Health (NIMH) booklet on depression.

People with other chronic medical conditions have a higher risk of depression.

The same factors that increase risk of depression in otherwise healthy people also raise the risk in people with other medical illnesses. These risk factors include a personal or family history of depression or loss of family members to suicide.

However, there are some risk factors directly related to having another illness. For example, conditions such as Parkinson’s disease and stroke cause changes in the brain. In some cases, these changes may have a direct role in depression. Illness-related anxiety and stress can also trigger symptoms of depression.

Depression is common among people who have chronic illnesses such as the following:

Cancer

Coronary heart disease

Diabetes

Epilepsy

Multiple sclerosis

Stroke

Alzheimer’s disease

HIV/AIDS

Parkinson’s disease

Systemic lupus erythematosus

Rheumatoid arthritis

Sometimes, symptoms of depression may follow a recent medical diagnosis but lift as you adjust or as the other condition is treated. In other cases, certain medications used to treat the illness may trigger depression. Depression may persist, even as physical health improves.

Research suggests that people who have depression and another medical illness tend to have more severe symptoms of both illnesses. They may have more difficulty adapting to their co-occurring illness and more medical costs than those who do not also have depression.

It is not yet clear whether treatment of depression when another illness is present can improve physical health. However, it is still important to seek treatment. It can make a difference in day-to-day life if you are coping with a chronic or long-term illness.

It may have come as no surprise that people with a medical illness or condition are more likely to suffer from depression. The reverse is also true: the risk of developing some physical illnesses is higher in people with depression.

People with depression have an increased risk of cardiovascular disease, diabetes, stroke, and Alzheimer’s disease, for example. Research also suggests that people with depression are at higher risk for osteoporosis relative to others. The reasons are not yet clear. One factor with some of these illnesses is that many people with depression may have less access to good medical care. They may have a harder time caring for their health, for example, seeking care, taking prescribed medication, eating well, and exercising.

Ongoing research is also exploring whether physiological changes seen in depression may play a role in increasing the risk of physical illness. In people with depression, scientists have found changes in the way several different systems in the body function, all of which can have an impact on physical health:

Signs of increased inflammation

Changes in the control of heart rate and blood circulation

Abnormalities in stress hormones

Metabolic changes typical of those seen in people at risk for diabetes

It is not yet clear whether these changes, seen in depression, raise the risk of other medical illness. However, the negative impact of depression on mental health and everyday life is clear.

Do not dismiss depression as a normal part of having a chronic illness. Effective treatment for depression is available and can help even if you have another medical illness or condition. If you or a loved one think you have depression, it is important to tell your health care provider and explore treatment options.

You should also inform the health care provider about all treatments or medications you are already receiving, including treatment for depression (prescribed medications and dietary supplements). Sharing information can help avoid problems with multiple medications interfering with each other. It also helps the provider stay informed about your overall health and treatment issues.

Recovery from depression takes time, but treatment can improve the quality of life even if you have a medical illness. Treatments for depression include:

Cognitive behavioral therapy (CBT), or talk therapy, that helps people change negative thinking styles and behaviors that may contribute to their depression. Interpersonal and other types of time-limited psychotherapy have also been proven effective, in some cases combined with antidepressant medication.

Antidepressant medications, including, but not limited to, selective serotonin reuptake inhibitors (SSRIs) and serotonin and norepinephrine reuptake inhibitors (SNRIs).

While electroconvulsive therapy (ECT) is generally reserved for the most severe cases of depression, newer brain stimulation approaches, including transcranial magnetic stimulation (TMS), can help some people with depression without the need for general anesthesia and with few side effects.

For more information on conditions that affect mental health, resources, and research, go to MentalHealth.gov at http://www.mentalhealth.gov, or the NIMH website. In addition, the National Library of Medicine’s MedlinePlus service has information on a wide variety of health topics, including conditions that affect mental health.

It is difficult to imagine a drug injuring someone in the process of treating the person’s malady, but ADEs are relatively common, and the more people understand the potential risks involved with a medication, the better.

An ADE can be any injury caused by a medication. Think allergic reactions, a severe side effect, an overdose, or a medication error. Sometimes the problem lies in the relationship between the patient’s body and the medication itself, while other adverse events occur because of human error. Either way, ADEs are at the root of nearly 3.5 million physician visits each year, and studies estimate that more than 7 million patients are affected by preventable medication errors. With greater awareness and education, this number could be drastically reduced and save lives as well as healthcare dollars spent on doctor and emergency room visits. Let’s look at some of the drugs most notably associated with ADEs.

ANTICOAGLUANTS

ADEs caused by anticoagulants or blood thinners shouldn’t come as too great of a surprise. The nature of the drug inherently comes with more risk. Patients taking anticoagulants run the risk of severe bleeding events should they sustain an injury while taking the medication. For patients taking newer blood thinners like Xarelto or Pradaxa, the risk for adverse events was actually increased. When the anticoagulants were first introduced, they lacked an approved antidote to reverse the blood thinning effects of the drug. Before an antidote came to market for Xarelto, over 22,000 people suffered severe or fatal injuries, according to the FDA, and the drug’s manufacturer now faces a slew of patient lawsuits.

OPIOIDS

The current opioid crisis is nothing new for most Americans with trending headlines covering lawsuits against opioid pharmaceutical companies to doctors mishandling or blatantly abusing their prescribing responsibilities. However, what this crisis has done is exposed the prescription side of the epidemic. Between 1999 and 2017, prescription opioid overdose deaths increased five-fold, and one major study found that patients experiencing opioid-related adverse events following surgery had “worse cost and patient outcomes” including increased opioid use. While not all patients using opioids to recover from surgery experience an ADE, those who do suffer quite dire consequences.

ANTIBIOTICS

In today’s society, antibiotics are seen by many as a cure-all for some of our most common ailments. From ear infections to staph infections, antibiotics treat a variety of health issues – specifically those maladies caused by a bacterial infection.

And while it is common to see stories about antibiotic resistance make headlines, antibiotic adverse events are seldom discussed. In actuality, however, the CDC found that adverse reactions to antibiotics account for 16% of emergency departments visits for ADEs. That number is closer to 50% in children under the age of 6.

CONCLUSION

Suffice to say, not all ADEs are preventable, but for those that are, patients and doctors can both take proactive steps to avoid a real emergency. Both parties should be forthcoming with important relevant information. Patients should be open to discussing lifestyle habits and other medications they may be taking so that their doctor can prescribe the safest medication available. Doctors should be honest about any risks or potential side effects that may result from taking the medication; with this knowledge, their patient might stand a better chance of spotting and treating an adverse reaction early, avoiding more serious events.

Caitlin Hoff works as a Consumer Advocate at ConsumerSafety.org specializing in areas of drug safety, consumer news, and legal cases surrounding problematic consumer products, drugs, and medical devices. Caitlin works diligently to educate consumers on topics of prevention and safety.

The study appeared in the December issue of Pediatric Nephrology. It was conducted in a population of young people with chronic kidney disease but can teach how to track nonadherence in other patient populations.

“We want to have better ways to figure out who is nonadherent so we can focus our efforts better on those patients who may require more assistance or specific resources to improve adherence,” said first author Cozumel Pruette, M.D., M.H.S., assistant professor of pediatrics at Johns Hopkins Children’s Center. “There are resources we can provide to boost adherence if we know who needs them.”

Between $68 billion and $150 billion of avoidable health care costs in the U.S. have been attributed to nonadherence, which is defined as any deviation from agreed upon recommendations from a health care provider. These rates can be especially high in children and young adults with chronic diseases who have to manage a complex regimen of medications. Poor adherence among youth with chronic kidney disease is one of the primary drivers for progression of the disease to end-stage renal disease.

“We want to focus our efforts better on patients who may require more help to improve adherence.”

Minimizing levels of nonadherence is a critical part of practicing high-value health care. By improving patients’ adherence levels, avoidable long-term health care costs are lowered.

But there is no gold standard for identifying nonadherent patients. “At the bare minimum, it’s providers making an assessment of a patient during a clinic visit,” Pruette said. A doctor or nurse may use lab values, imaging scans and patients’ reports during the clinic visit to make informed guesses about adherence.

New technologies have recently become available that give more objective measures of whether patients are following their medication regimen–electronic medical records connected to pharmacy data can tell doctors whether patients are refilling their prescriptions as often as they should be, and electronic pill boxes that record when they’re opened can give even more detailed day-by-day data.

In the new study, Pruette and her collaborators used five different measures of nonadherence in a population of 87 adolescents and young adults, ages 11 through 19, with chronic kidney disease or end-stage renal disease. All enrolled patients were seeing one of 17 participating medical providers at one of three academic medical centers. The measures of adherence were provider reports (in which a health care provider estimated a patient’s medication adherence after a clinic visit), patient reports and caregiver reports (both being eight-question surveys), electronic pill boxes (which record the date and time of every pill bottle open), and pharmacy refill data.

Health care providers and electronic pillboxes both classified 34.5 percent of patients as nonadherent, although they disagreed about which patients were nonadherent. Patient reports, caregiver reports and pharmacy refill data all classified between 50 and 61 percent of patients as nonadherent. Combining provider reports and pharmacy refill data, the researchers showed, led to the most balanced sensitivity (0.90) and negative predictive power (.88).

“In general, providers are already doing assessments of patients’ adherence levels, and most clinical practices have the ability to access pharmacy refill data, so this is a very feasible thing to start doing in a clinical setting,” Pruette said.

More research is needed to show whether the combination of provider assessment and pharmacy data is the best way to measure adherence levels in other patient populations.

“We can’t say what other specific populations our findings apply to, but it’s likely generalizable that some kind of multi-modal approach is really the most meaningful in identifying nonadherence and providing us with the greatest level of information to help patients improve their adherence,” Pruette said.

The findings were reported in the December 19,2018 issue of the The Journal of Bone and Joint Surgery.

“Our data suggest that briefly overlapping surgery is a safe practice in the ambulatory orthopedic surgery center,” said lead author Charles A. Goldfarb, MD, of Washington University School of Medicine, St. Louis.

Overlapping surgery is used to increase the efficiency of operating rooms.

Goldfarb and colleagues compared the outcomes of overlapping versus nonoverlapping surgery at their university-affiliated orthopedic ambulatory surgical center (ASC). In overlapping surgery, the attending surgeon is present for “critical” parts of the procedure, leaving another surgeon to perform noncritical portions – typically skin closure. Overlapping surgery is commonly used to maximize operating room efficiency. According to this ASC’s policy, another attending surgeon -not a resident or fellow in training – was present during the overlapping portion of the procedure.

Although this practice is not new, it has become controversial in the wake of recent high-profile media reports. Most previous studies of overlapping surgery have focused on inpatient procedures, performed on hospitalized patients.

The analysis included more than 22,000 outpatient orthopedic procedures performed between 2009 and 2015. The patients underwent a wide range of elective surgeries, including knee, hand, and shoulder procedures. No joint replacement or spine operations were included in the analysis.

The overall complication rate (morbidity) was 0.66 percent in the overlapping surgery group and 0.54 percent in the nonoverlapping surgery group. After the authors adjusted for other factors, the morbidity risk was not significantly different between groups. The same was true for all individual complications considered: surgical site infections, noninfection surgical complications, and transfer to an inpatient hospital.

Anesthesia and overall surgery times were slightly longer in the overlapping surgery group, but these surgical factors did not increase the risk of complications.

The researchers noted that although this study includes a large number of outpatient orthopedic surgery cases, the statistics represent the experience of only one surgical center. Nevertheless, the results suggest that overlapping orthopedic surgery can be safely carried out in ambulatory surgery settings – at least as practiced at the authors’ institution.

60 to 80 percent of people surveyed in 2018 led by by University of Utah Health researchers in Salt Lake City and have not been forthcoming with their doctors about information that could be relevant to their health, according to a new study. Besides fibbing about diet and exercise, more than a third of respondents didn’t speak up when they disagreed with their doctor’s recommendation. Another common scenario was failing to admit they didn’t understand their clinician’s instructions.

THE REASONS PEOPLE LIE TO THEIR DOCTORS

When respondents explained why they weren’t transparent, most said that they wanted to avoid being judged, and didn’t want to be lectured about how bad certain behaviors were. More than half were simply too embarrassed to tell the truth.

“Most people want their doctor to think highly of them,” says the study’s senior author Angela Fagerlin, Ph.D., chair of population health sciences at U of U Health and a research scientist with the VA Salt Lake City Health System’s Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for Innovation.

“They’re worried about being pigeonholed as someone who doesn’t make good decisions,” she adds.

Scientists at University of Utah Health and Middlesex Community College led the research study in collaboration with colleagues at University of Michigan and University of Iowa. The results will be published online in JAMA Network Open on November 30, 2018.

Insights into the doctor-patient relationship came from a national online survey of two populations. One survey captured responses from 2,011 participants who averaged 36 years old. The second was administered to 2,499 participants who were 61 on average.

SEVEN COMMON SCENARIOS

Survey-takers were presented with seven common scenarios where a patient might feel inclined to conceal health behaviors from their clinician, and asked to select all that they had ever happened to them. Participants were then asked to recall why they made that choice. The survey was developed with input from physicians, psychologists, researchers and patients, and refined through pilot testing with the general public.

In both surveys, people who identified themselves as female, were younger, and self-reported as being in poor health were more likely to report having failed to disclose medically relevant information to their clinician.

“I’m surprised that such a substantial number of people chose to withhold relatively benign information, and that they would admit to it,” says the study’s first author Andrea Gurmankin Levy, Ph.D., MBe, an associate professor in social sciences at Middlesex Community College in Middletown, Connecticut. “We also have to consider the interesting limitation that survey participants might have withheld information about what they withheld, which would mean that our study has underestimated how prevalent this phenomenon is.”

The trouble with a patient’s dishonesty is that doctors can’t offer accurate medical advice when they don’t have all the facts.

“If patients are withholding information about what they’re eating, or whether they are taking their medication, it can have significant implications for their health. Especially if they have a chronic illness,” says Levy.

Understanding the issue more in-depth could point toward ways to fix the problem. Levy and Fagerlin hope to repeat the study and talk with patients immediately after clinical appointments, while the experience is still fresh in their minds. Person-to-person interviews could help identify other factors that influence clinician-patient interactions. For instance, are patients more open with doctors they’ve known for years?

The possibility suggests that patients may not be the only ones to blame, says Fagerlin. “How providers are communicating in certain situations may cause patients to be hesitant to open up,” she says. “This raises the question, is there a way to train clinicians to help their patients feel more comfortable?” After all, a healthy conversation is a two-way street.

###

In addition to Fagerlin and Levy, Aaron Scherer from University of Iowa, Brian Zikmund-Fisher and Geoffrey Barnes from University of Michigan, and Knoll Larkin from Wayne State University were co-authors on the study.

Major trauma victims who receive transfusions of packed blood 22 days or older may face an increased risk of death within 24 hours, according to a new study in Annals of Emergency Medicine. Following a major trauma, the leading cause of death is loss of blood.

“Our analysis shows that transfusions of packed red blood cell units stored for 22 days or longer are potentially toxic,” said Allison R. Jones, PhD, RN,CCNS, Assistant Professor, Department of Acute, Chronic and Continuing Care, School of Nursing, University of Alabama at Birmingham and lead study author. “To avoid adverse events or death, patients who require massive transfusions may benefit from receiving fresh stored packed red blood cells, or those stored for 14 days or less.”

Investigators found that packed red blood cells aged 22 days or more were associated with a 5 percent increase in mortality risk, according to the study, “Older Blood Is Associated With Increased Mortality and Adverse Events in Massively Transfused Trauma Patients.” The study was a secondary analysis of data from the Pragmatic, Randomized Optimal Plasma and Platelet Ration (PROPPR) trial. It looked at 678 patients in 12 Level I trauma centers across North America.

As more units of packed blood cells were transfused, the likelihood of harm increased.

As more units of packed red blood cells were transfused, the likelihood of harm increased, the study found. Major trauma victims can require massive transfusions of blood or blood products in a very short time. Clinical effects of stored blood toxicity include elevated risk of clot formation, infection, sepsis, organ failure and death.

“This study highlights a public health challenge that needs more attention — the nation’s health care providers are in the middle of a blood and plasma shortage. We all need to do a better job of encouraging qualified individuals to donate blood and blood products in order to avoid delays in lifesaving care and to replenish our blood supply,” Jones said.

The retrospective analysis looked at patients who received a mix of old and fresh blood. The authors noted that future studies are needed to compare patient outcomes among those who receive only fresh blood versus those who receive only old blood.

That is the rinding of  a 2018 study from researchers in the Perelman School of Medicine at the University of Pennsylvania. The study results, published this month in the Annals of Emergency Medicine, provide a unique opportunity for researchers and clinicians to learn from online reviews, which provide a raw narrative from consumers.

“Today’s world is very digital, and it’s very common for consumers to rate a restaurant, hotel or service online, a practice that is spilling over into health care,” said the study’s lead author, Anish Agarwal, MD, a National Clinician Scholars fellow and Emergency Medicine physician at Penn Medicine. “As an emergency department physician, patients often tell me that the internet is the first place they go for information about medical conditions and to research providers. Health systems and clinicians can learn a lot about the communities they treat and how people experience the services they provide by looking to online ratings and reviews.”

ONLINE REVIEWS ARE BECOMING COMMON FOR HEALTHCARE FACILITIES

In this new study, researchers, with the help of an automated system, analyzed high (five-star) and low (one-star) Yelp reviews for both emergency departments and urgent care centers, two venues that patients can select from when in need of acute care.

Researchers identified key themes in the five-star reviews of emergency departments, including bedside manner, treatment of family members, and access to care on nights and weekends. Urgent care centers were unique in receiving five-star reviews more often for factors including ease of refilling prescriptions and being positively recommended by others.

On the other side, emergency departments received negative remarks for speed of care, while urgent care centers received one-star reviews as a result of poor reception experiences and patients lacking confidence in the care received.

“We are seeing more and more that patients are sharing their experiences online, and they’re looking to social media platforms and online communities to help inform their decision-making,” said Kevin B. Mahoney, executive vice president and chief administrative officer of the University of Pennsylvania Health System. “Within these review and rating websites lies a trove of decision-making data that we can and should be culling through to help inform how care is delivered, and what matters most to our patients in emergency situations.”

URGENT CARE CENTERS HAVE PROLIFERATED WIDELY

Urgent care centers have proliferated widely across the country in the past 15 years. Between 2007 and 2016, visits increased by more than 1,700 percent. But while emergency departments have established surveys for patients and their families to report their experiences, there is not a clear equivalent for gathering direct feedback from patients who visit urgent care centers.

The study’s senior author, Raina Merchant, MD, director of the Penn Medicine Center for Digital Health and an associate professor in Emergency Medicine, believes Yelp reviews could fill a knowledge gap.

“Online reviews provide a rapid way of taking the pulse of how this acute care market is emerging and what consumers look for in these settings” said Merchant. “These platforms can also help us identify new focus areas, in an effort to provide better, more efficient care to patients based on their expressed needs.”

The researchers analyzed more than 100,000 Yelp reviews, posted between 2005 and 2017–in the midst of the urgent care boom–tied to 1,566 emergency departments and 5,601 from urgent care centers. During the study period, an average of one new review for an emergency department or an urgent care center appeared every hour of every day.

The reviews fell largely on one end of the spectrum or the other: five stars or one star. Roughly 47 percent of emergency department and 30 percent of urgent care center reviews fell in the one-star category. The disproportionate amount of negative reviews for acute care facilities, compared to other entities reviewed online, like hotels or restaurants, could be a result of what is at stake for the consumer.

“If a restaurant provides you with a quick meal exactly as advertised, they meet your expectations,” Merchant said. “With healthcare, things are different. People are often critically ill, the outcomes are uncertain, and the wait can be long–which are all things that sometimes can’t be controlled.”

The research team found that each type of facility received similar five-star reviews for comfort, cleanliness of facilities, pediatric care, and professionalism. One-star reviews for poor phone experiences, long wait times, billing difficulties, and pain management were tied to both emergency departments and urgent care centers.

Moving forward, the researchers hope to find more nontraditional sources to provide clues about patient experiences and use them to enhance care quality.

###

Other Penn Medicine authors of the study include Amy Lanza, Elissa Klinger, David Asch, Nick Fausti, and Christopher Tufts.

In exploring that question, a team of European researchers found that people underestimate the risks of treatments ranging from minor drugs to major and overestimate the benefits.

Published in the journal Risk Analysis, the study of 376 adults was led by Professor Yaniv Hanoch from the University of Plymouth School of Psychology, UK, together with Jonathan Rolison from the University of Essex, UK and Alexandra Freund from the University of Zurich, Switzerland.

In several hypothetical scenarios, the researchers asked participants to imagine that their doctor had recommended a treatment – a drug, dental surgery, ear surgery, kidney operation, or to take a newly developed medication – in order to treat an eye infection, a gum infection, a hole in their eardrum, a benign growth, and a blood disorder, respectively.

There’s a growing body of evidence regarding patients’ unrealistic optimism about medical treatment.

In each scenario, they were provided with precise information about the probability of success (saving a tooth) or the probability of the risks (liver damage). The treatments and side effects were taken from medical studies, but the probabilities of their happening were devised by the study authors for the research only.

Participants were then asked to indicate how likely they believed that they were to experience one of the benefits or risks by moving a pointer on a scale from 0% to 100%.

Results showed that on average, people perceived the benefit as higher than the benefit midpoint (average) actually was. In the case of the tooth, the perceived likelihood of benefit was 48%, compared with the midpoint of 45%. The perceived risk of the side effects – in the case of the dental procedure, a possible gum infection – was perceived to be 46%, compared to the risk average of 50%.

The biggest difference came with the most serious procedure: a kidney operation for a benign growth. The participants perceived a risk of 43 percent for paralysis, the worst side effect, But the actual risk was 53 percent.

Hanoch said: “These were really interesting results. By presenting participants with a wide range of medical scenarios, our findings lend support to a growing body of evidence regarding unrealistic optimism. These results suggest that clinicians may need to ensure that patients do not underestimate risks of medical interventions, and that they convey realistic expectations about the benefits that can be obtained with certain procedures. It would be good to carry out further studies on a larger population and also explore if and how clinicians can help manage expectations.”

Parents should brace themselves for cuts, bites, scrapes and other maladies “We buy jackets and decorate our homes for the various holidays. But we often miss another important task this time of year, which is to prepare for sniffles and scrapes by cleaning out and organizing the family medicine cabinet.

I advise parents to spend time going through what they already have and restocking with the most effective solutions. Having remedies handy, exactly when you need them, will help relieve the stress of caring for yourself or a sick child.

START BY DOING THE FOLLOWING:

• Choose a cool, dry storage place. Bathroom cabinets are okay as long as they don’t get warm and steamy during baths and showers. Many products degrade when exposed to humidity and warm temperatures.”
• Check expiration dates. Toss any expired products. Many pharmacies offer safe medication disposal.
• Safely secure all medications and supplements if there are young children in the house. Lock these products in a high cabinet.
• Carefully review all labels. Now is a good time to remind yourself of any precautions. Many over-the-counter (OTC) drugs have warnings regarding their use in those who have serious medical conditions such as heart, kidney or liver disease.
• Understand dosing instructions. Some products for children are dosed by weight or age. Others are not safe or recommended for children.”

Here’s what you might want to include, and avoid, in a medicine cabinet makeover:

• For bruises and muscle strains: Arnica, available in tablets or gel, is a homeopathic remedy that can be used for treating minor bruises and muscle strains. It can reduce pain and swelling and speed healing. Keep a flexible cold pack handy to manage pain and swelling from an acute minor injury such as a strain or sprain. Ibuprofen can help treat aches and pains.
• For the common cold: According to the Centers for Disease Control and Prevention, 22 million school days are lost annually in the United States because of the common cold¹. This year, you may want to stock up on black elderberry. It contains flavonoids called anthocyanins, which have a remarkable ability to stimulate the body’s immune system². Black elderberries have nearly double the amount of anthocyanins than is found in any other fruit. But unfortunately, you won’t find black elderberries at the grocery store. What you will find is a marvelous extract of black elderberry, sold over the counter as Sambucol Gummies. They are great because they are pectin-based, and contain no artificial flavors or colors. They are also free of all major allergies including gluten, nut, soy and dairy. Because this extract is the original and has been scientifically studied, I trust the natural power of the elderberry found in Sambucol to strengthen my patients’ immune systems.
• For dry eyes: Most of us suffer from dry eyes at one time or another. Overly heated rooms this time of year can be a major culprit. Similisan Dry Eye Easy Mist is an easy-to-use option. Just hold the pocket-sized mister three to four inches away from your face … close your eyes … spray and blink. There’s no dripping, and it won’t smudge makeup. The plant-based liposomes collect on your eyelashes. Each time you blink, they form a moisturizing film over your eye, keeping in moisture. What I like about this formula is that it can be used as often as needed, even by contact lens wearers. There are no harsh chemicals or preservatives.
• For sore throats: Buckwheat honey is great for managing a sore throat. It contains antioxidants and nutrients that help speed healing. It also lubricates and soothes a sore throat. Buckwheat honey can be given to children age one year and over and is available in most health food stores. Throat sprays with Echinacea, sage and peppermint can also help.
• For eczema/skin rash: Oatmeal baths can help relieve dry, itchy skin. Add 2 cups of ground colloidal oatmeal (not breakfast oatmeal) to a tub of warm water (hot water can further dry out and irritate skin). Then apply a moisturizer with soothing and hydrating ingredients such as vitamin E, aloe and lavender.
• For nausea, upset stomach: Studies show that the very potent anti-inflammatory compounds called gingerols found in ginger can help relieve motion sickness, dizziness, nausea and gas, and soothe the intestinal tract. You can find supplemental ginger in chewables and gummies in pharmacies and health food stores.

With these products readily available, you may be able to resolve many of your family’s typical health issues quickly and easily.

Bryce Wylde BSc (hons), DHMHS is a leading health expert specializing in integrative and functional medicine, homeopathy, clinical nutrition, and supplementation. As associate medical director at P3 Health in Toronto, and director of My Health Report, he blends the latest in science and technology with traditional and ancient remedies. Wylde is the author of three national best-selling books, previous host of CTV’s Wylde on Health, and regular guest health expert and medical advisor on “The Doctor Oz” show.