How to combat head lice

Q: What can I do to remove the nits from my granddaughter’s hair. She is infested but does not have any lice. I treated that already.

A: Nits are the egg of a louse, a tiny parasitic insect that feeds on tiny amounts of blood drawn from the scalp. Lice are a very common problem, particularly for children. This is because they are highly contagious and can easily spread from person to person – particularly in settings such as day care centers, schools, and during slumber parties. Children have a tendency to share hats, scarves, pills, and combs or brushes, all activities that allow the spread to continue. The eggs are yellow, tan or brown in color, and very tiny before they hatch, resembling dandruff or grains of salt. Adult lice are about the size of a sesame seed or a grain of salt and the nymph is smaller still. Lice will lay their eggs on hair shafts rather close to the scalp because of the temperature that is conducive to hatching. The eggs will hatch within a week or two once they are laid. Following hatching, the eggs shell will remain firmly attached to the hair shaft. The eggs can’t be removed simply by brushing the child’s hair or attempting to whisk them away.

Treatment is accomplished with the use of a medicated shampoo, cream rinses, or lotions to kill the lice. Such remedies are available both over-the-counter and via prescription. This ordinarily kills the lice and nits, however it may take several days following the application before the itching will stop. For extremely difficult cases, an oral medication may be necessary. Keep in mind that treatment may not be completely successful if the solutions are not used correctly or if the lice are resistant to it. Following treatment, the nits should be removed with a very fine-toothed comb. The entire process may require a second go-round in a week to ten days so any newly hatched nits are also killed.

You don’t indicate how old your granddaughter is, so I can only generalize on how to remove the nits. For those children under the age of two, medicated lice treatments should not be used. For those older, use the fine-toothed comb mentioned above on wet, treated hair every three to four days for two weeks following the time the last live louse was seen. The purpose of wetting the hair is to temporarily immobilize the lice, allowing for easier removal. Wet fine-tooth combing is also another alternative to medicated processes for older children. Do not use a hair dryer on the wet hair since some scalp treatments contain flammable ingredients. Coconut shampoos have been found effective in some cases yet I must state that there have been numerous remedies with home products that include mayonnaise and olive oil that don’t resolve the issue.

Then, it is important to take steps to prevent recurrence. This can be accomplished by washing all bed linens and clothing in very hot water (130 degrees). Put the wet clothes in a dryer on a hot cycle for at least 20 minutes. For those items that may not be able to be washed such as some pillows and stuffed animals, they can be placed in an air tight plastic bag for at least three days or sent to a dry cleaner for processing. Carpets and upholstered chairs, pillows and couches should be vacuumed and the vacuum bag should be disposed wrapped in a plastic bag and discarded. This applies to any upholstery in your car, as well. Soak all hair care items such as combs, brushes, barrettes, head bands and clips in either rubbing alcohol or a medicated shampoo for at least one hour. A relatively new shampoo made of Benzoyl alcohol might be effective.

It’s important for every child (or adult) to realize that they may not be responsible for this unpleasant condition. They could lean against an infected pillow, borrow a hairbrush, or simply hug a friend and have the lice transfer from one person to another. As the saying goes — fog happens – and fighting these minute critters makes for a foggy period best avoided. Good luck.

Cranberry supplements believed to fight infections

Q: Since we started giving our kids cranberry supplements, we have cut antibiotic use by 90%. This might be something to explore and share with your readers if you think it has merit.

A: I have personally been promoting cranberries for years, whether they are fresh, dried, in 100% juice form, or as a supplement. However, there are always varying opinions on the subject of cranberries for any health benefits and many changes have occurred in recent years. For example, in April 2013, the BBC reported on the very subject, stating that many women swear by the healing powers of cranberry juice. They feel it not only helps cure painful bladder infections but also helps prevent future outbreaks as well. The article went on to state that the reason cranberries are thought to be special is that they contain substances called proanthocyanidins, thought to prevent bacteria from sticking to the walls of the bladder. Apple and grape juice and dark chocolate also contain proanthocyanidins, but not the right kind. Twenty four studies were done on the prevention of UTIs and, as you might expect, there were differing conclusions such as simply doing nothing.

One study involving 319 women with recent urinary tract infections were divided into two groups; half were given cranberry juice twice a day for six months and the other half were given a placebo juice that looked and tasted like cranberry juice but without containing any cranberries. The result was that drinking cranberry juice made no difference in the recurrence of infections.

Unrelated to the study, it appears, as mentioned above, some of the chemicals in cranberries keep bacteria from sticking to the cells that line the urinary tract, an area in which they can multiply. However, cranberries do not seem to have the ability to release that bacteria already stuck to these cells, which may explain why the cranberry may be effective in preventing urinary tract infections but may be ineffective in treating them.

An interesting observation is that some medications such as warfarin (an anti-coagulant) may interfere adversely with cranberries because of the potential for excessive bleeding. Drinking large quantities of cranberry juice may cause an upset stomach and diarrhea in some individuals. The juice has a high sugar content, so excessive amounts should be avoided by diabetics and those who are glucose intolerant. In this instance, sugar-free cranberry juice would be a better choice. Excessive amounts of cranberry juice may contribute to an increased risk of developing kidney stones because the juice contains high levels of oxalate, a chemical associated with the formation of specific types of kidney stones. The answer is to drink the juice or take a supplement in moderation, something that should be done when consuming literally any product.

The National Institutes of Health has taken the position that cranberry can help prevent urinary tract infections; however, such evidence is not definitive and additional research is necessary. It is not effective as a treatment for an existing UTI that should be managed with antibiotics prescribed by a physician. Despite this statement, drinking cranberry juice in moderation appears to be safe.

The bottom line? Enjoy cranberries in any form you prefer. There is a wealth of benefits from this fruit, as long as you remember moderation is key – with this and every edible thing on earth.

Is honey the answer for healing wounds?

Q: What is your opinion on the healing power of Manuka honey?

This honey is produced in Australia and New Zealand by bees that pollinate the manuka bush which is native to the country. Honey as a whole has been used for countless years to treat many conditions and it wasn’t actually discovered until the late 19th century that honey contains natural antibacterial qualities. Some honeys are known to stimulate the production of special cells that have the capability of repairing tissue damaged because of infection. Honey contains an anti-inflammatory that has the capability of reducing pain and inflammation.

As with so much in life, to a degree you get what you pay for and honey is no exception. The antibacterial quality of the product depends on the type of honey, when and how it was harvested. A surprising statistic is that some kinds of honey may be as much as 100 times more potent than others. A component of honey is hydrogen peroxide that provides disinfectant properties. The major antibacterial component in manuka honey is known as MG (methylglyoxal). This substance is found in most types of honey, but only in small quantities. In the instance of manuka honey, the MG comes from the conversion of dihydroxyacetone, another compound found in high concentrations in the nectar of the manuka flowers.

Honey producers have developed a rating scale for the actual potency of manuka honey. Referred to as UMF, the unique manuka factor corresponds with the concentration of MG and not all manuka honey is considered potent enough to be labeled as therapeutic. It is necessary that manila honey meets a 10 rating before it can be marketed as UMF manuka Honey or Active manuka Honey. Understand that bees forage in many places, not only on manuka flowers but on others in the area as well, causes the honey to receive different ratings.

So, how is manuka honey used medicinally? Generally speaking, the answer is to apply it to minor wounds and burns; however, it is also promoted as treating problems of the gastrointestinal tract, reducing systemic inflammation, treating eye/ear/sinus infections, preventing and treating cancer, and more. The jury is still out on whether or not manuka (or any other) honey is effective for the conditions listed. Several studies suggest manuka is effective when used topically on wounds and leg ulcers and that it is effective in fighting infection and promoting healing. And, there is some concern that manuka honey may actually delay the healing process in individuals who suffer from diabetic ulcers. Most studies on the product have involved small numbers of patients. Despite this, research will continue but that could take years before any conclusive evidence is extracted from the studies.

Possible side effects of the honey include a risk in the rise of blood sugar levels, a possible interaction with certain chemotherapy drugs, and allergic reactions in some individuals – particularly in those individuals allergic to bees. Honey – manuka or any other brand – should not be given to infants under 12 months of age.

I’m certain by now you are more confused than when you asked your simple question. Not knowing any of your medical history, I recommend you speak with your primary care physician for an opinion regarding a trial of the product that outwardly appears to have some positive aspects. If he or she agrees, stay connected with your doctor and report your results — positive or negative — so I can do a follow-up for others who may use you as a guide.

Home remedies to combat dandruff

Q: I have an embarrassing problem that just doesn’t go away. I have dandruff that is always present on my shoulders. It’s especially obvious when I wear dark clothing that gets covered with what I call ‘snow’. What are some of your remedies?

A: Dandruff is a chronic condition of the scalp marked by flaking scalp skin. While not contagious, it can be embarrassing as you have discovered. On the positive side, the condition should and is usually controlled with the use of a cleansing shampoo that is gentle on the scalp. Cases that are more difficult to treat may require medicated shampoos or home remedies for eradication.

Symptoms include a scalp that may itch and white flakes of dead skin that appear to stick in the hair and fall on shoulders. Causes may include failure of an individual to wash their hair regularly which will allow skin cells and oil to build up, having extremely dry skin, having a sensitivity reaction to shampoos and other hair care products, and shampooing too frequently. Other conditions such as seborrheic dermatitis, eczema and a fungus known as malassezia can mimic dandruff. Therefore, you may wish to visit your primary care physician before you take steps to remedy your problem.

You may be unaware that all of your skin sheds dead cells constantly from your arms, legs, and every other area of your body. In fact, every 28 days or so we get a new skin surface. And, our heads are no different. Researchers have determined that dandruff occurs when malassezia feeds on the fatty oils secreted by the hair follicles in your scalp. The fungus grows out of control, irritation occurs, and the cell turnover on the scalp speeds up. The scalp becomes irritated, dead skin cells shed more frequently than they should, and clumps of oily skin stick to the hair follicles and fall on your shoulders.

On to a healthy scalp. Because dry skin may be the cause of your dandruff, try drinking more water and fluids and add more fruits to your daily diet. Diet has long been known to play a role in healthy skin, and that include the scalp. Foods that contain omega-3 fatty acids such as salmon, those foods that contain zinc such as whole grains, red meats, nuts, shell fish, fortified cereals and dairy products and B vitamins such as eggs, legumes, broccoli, sweet potatoes and more may all help create a healthier scalp, although there is no scientific evidence to prove this. Consider – even if only for a while – discontinuing hair products such as gels, sprays, mousse, gels and waxes. A build-up of these products can occur and lead to scalp sensitivity which may lead to dandruff.

Wash your hair with a dandruff shampoo until the flakes subside. Once this occurs you can use regular shampoos but intersperse with the dandruff shampoo every second or third day. When you use a dandruff shampoo, leave it on your hair for at least five minutes to give it time to work. The best way to do this is to shampoo first, then wash the rest of your body. When you are done, rinse the shampoo from your hair. Brush your hair following shampooing to distribute the naturally occurring oils on your scalp.

Fight dandruff with yogurt. Once you have washed your hair, get out of the shower, dry off, and wrap up in a towel. Then rub plain yogurt into your scalp, leaving it on for 10 to 15 minutes. Then return to the shower and rinse, using as little shampoo as possible.

Or, instead of using regular shampoo, rub a handful of baking soda into your hair and onto your scalp. Leave on for one minute and rinse. Results may not be seen for two weeks but the baking soda washes should allow your scalp to produce natural oils and you should be free of dandruff.

Or, crush two aspirin and add them to your regular shampoo. Massage the infused shampoo into your hair for two minutes. Rinse.

Or, dilute one part apple cider vinegar with one part water. Wash your hair as you normally would. Pour the water/vinegar mixture onto your hair and massage your scalp, leaving it in place for 10 to 15 minutes which, again, will likely necessitate you getting out of the shower and drying off. Take care not to get the mixture in your eyes. Return to the shower once the time is up and rinse. Repeat this process every day for about one week.

Resistant cases require aggressive treatment that may include the use of a dandruff shampoo daily. Tar shampoos and those that contain selenium sulfide and zinc pyrithione are tried and true.

There are other countless remedies that utilize bananas, olive oil, coconut oil, mouthwash, egg yolks, lemon juice and more. Give the ones above a try and let me know if one or more are effective.

Patient struggles with hypercholesterolemia

Q: I would like to comment on statin drugs. Some people can’t take them at all. I took all of them at one point, even Baycol. They raised my ANA so high my doctor called me in and quietly told me I had lupus. I did some research on my own and discovered they can cause drug-induced lupus in some people. I had joint pain, fatigue and weakness. One of my first cousins can’t take them either, so it is something in our genetic makeup. I still have high cholesterol and nothing seems to help – not even diet and exercise. I am trying the red yeast rice, niacin, etc so maybe some day it will come down, I love your column. Thank you.

A: Thank you for writing. To fill in some of the blanks other readers may have, statins are drugs that work to help lower cholesterol levels. They do so by blocking a substance the body requires in order to make cholesterol. Further, they may help the body reabsorb the cholesterol that has built up plaque on arterial walls. Some of the more common brands include Lipitor, Crestor, Mevacor, and Zocor that are introduced on television and in the media quite regularly. Until 2013, the goal was a cholesterol level of 200 with attention paid to HDL and LDL levels. However, the whole guideline that was the gold standard for years was revamped to pay closer attention to the total risk of having a cardiac event within 10 years and physicians should now assess that risk. While it is based on a cholesterol panel, other diseases such as obesity enter the picture. Some individuals appear to eat all the right foods, avoid those high in cholesterol and exercise sufficiently, yet they still have abnormally high levels because of a family history, leading a sedentary lifestyle, being overweight, having peripheral artery disease, and more.

A concern with statins is that for approximately 10% of users, side effects such as muscle and joint pain, liver damage, elevated blood sugar levels, constipation, diarrhea, and memory loss or confusion may occur. Muscle pain, particularly in the leg calf, is most common. The higher the dose of the statin, the more likely this unwanted side effect will occur. Liver enzymes can increase while on this class of drugs, which is why a physician will perform periodic lab testing to be assured levels remain normal. Blood sugar levels may also increase which could eventually develop into type 2 diabetes. Again, lab testing is performed periodically to keep levels in check. When it comes to memory loss, discontinuing the drug will reverse the symptom – should it even occur. Some unwanted side effects will disappear on their own once the body adjusts to the medication but statins are taken long term, as in for life, so the decision to take them should be weighed accordingly.

You indicate you are now trying niacin and red yeast rice. Niacin is a B vitamin available over-the-counter or in higher doses through a prescription. One large study was discontinued early on because there was no real difference determined in those individuals in the study who took prescription-strength niacin vs those who took a placebo. Further, the study observed a slight increase in the risk of stroke for those who took niacin to increase their HDL levels, although this was not proven in later studies. In fact, according to the American Heart Journal, the slight but significant in stroke in the AIM-HIGH trial that examined the addition of extended-release niacin to simvastatin lost significance in a new multivariate analysis.

Some red yeast rice products contain lovastatin that can cause muscle issues that may lead to kidney impairment. Even the FDA has warned consumers not to buy or consume three products promoted via the web for treating high cholesterol levels because of the unwanted side effects.

I don’t have any magic answers, simply because each individual is different. However, if you are overweight, losing as little as five to ten percent of your total body weight may help lower your levels. Exercise more – perhaps by using the stairs at work rather than taking the elevator. Keep healthy snacks such as raw veggies in the refrigerator rather than relying on a fast-food snack when you feel the urge to eat. Eliminate the trans fats found in cookies and commercially baked products. Incorporate fresh fruits and vegetables into your daily diet. Choose foods rich in omega-3 fatty acids such as salmon, herring and mackerel. Avoid whole milk products, organ meats and egg yolks. Aim for a maximum of 300 mg of cholesterol each day. This may require reading labels before making purchases at your local grocery store.

Patient wants to avoid back surgery for disk problem

Q: What causes bulging disks and what can be done to avoid the possibility of surgery?

A: Disks are cushions between each of the 33 vertebrae in the spine. They are formed from a tough outer layer of cartilage that forms over softer cartilage within. Bulging disks extend beyond the space they should ordinarily occupy and are generally that specific outer layer of cartilage that protrudes. Bulging disks don’t ordinarily cause pain unless the bulge herniates into the spinal canal. Bulging disks are generally related to the lumbar spine area and most often occur as a result of the aging process. As a means of identification, a herniated disk often results from injury or trauma to the spine, while a bulging disk occurs gradually over time.

Some activities may actually speed up the development of bulging discs and are best avoided. Patients should use good posture, maintain a healthy weight for their frame and height, bend from the knees when lifting heavy objects, and exercise regularly in an effort to strengthen core muscles. Treatment begins with conservative measures such as rest and restrictions on weight lifting. Heat and ice may be effective. Anti-inflammatory medicines, both over-the-counter and via prescription, plus something for pain may provide a sufficient degree of relief. In the past, this might have been followed by cortisone injections; however, a July 3rd study released in The New England Journal of Medicine disproved the worth of epidurals, which implies this modality will be used much less in the future. Chiropractic manipulation, acupuncture, yoga, physical therapy and spinal decompression may be recommended. In most instances, the symptoms experienced from a bulging disc will diminish or totally disappear with conservative treatment. If they don’t, however, surgery may be recommended. While once considered extensive, expensive, significant, requiring hospitalization and longer recuperation, newer methods such as laser procedures are available and may even be performed on an out patient basis. Talk about advances through research!

What is correct for you will depend on your age, medical conditions, severity of symptoms, and a whole lot more. Because you don’t indicate if you are otherwise physically fit, are free from cardiac issues, diabetes, hypertension and other possible conditions, I cannot begin to guess what will be in store for you. As I indicated, most bulging discs are painless unless they are pressing against a nerve or become herniated or rupture. I surmise you are asking because you are in pain and may have been told surgery is on the horizon. If this is the case, make an appointment with the surgeon who will be performing the surgery for the answers you seek, or as another option, request a second opinion from a tertiary care center. Ask if laser or another procedure is recommended and why. You should never enter into this or any other invasive procedure without knowing what to expect in terms of hospitalization and recuperation. Only then will you know how to proceed. Good luck.

Are petroleum jelly products safe in the nose?

Q: For some time now I’ve used a cotton swab to place a little Vicks Vaporub just inside my nostrils before retiring and I’ve found that it helps to reduce my nasal congestion overnight. Do you see any problem with this use?

A: Nasal congestion a/k/a a stuffy nose is defined as a blockage of the nasal passages, a condition generally resulting from swelling or edema of nasal tissue. The condition may interfere with a person’s ears, hearing, speech, cause mild head pain and discomfort. For older children and adults it is generally an annoyance.

Causes for the condition may be from allergies to a whole host of other conditions , again most of which are relatively harmless. Some of the known allergies include dry air – either from the climate in which a person lives to the heating system in homes. Then there are season allergies such as from hay fever and ragweed, specific medications such as those taken for hypertension,pet dander, spicy foods, tobacco smoke, and stress. The possibilities are limitless.

Initially, it is important to determine why you continue to have a stuffy nose. If someone in the house smokes, that alone may answer the question. If your main source of heat is from a wood stove, that’s another possibility. If you are on specific medications, either research the common potential side effects or consult with the prescribing physician for his or her input. Perhaps you have a deviated septum that should be addressed by a health care professional, or a thyroid condition that has been overlooked.

If your stuffy nose is ongoing, you may unknowingly have nasal polyps – benign growths that can block nasal passages. Some individuals develop polyps without having had any previous nasal problems, yet more frequently polyps may be triggered by allergic rhinitis, chronic sinus infections, asthma, or from a response to NSAIDS (non-steroidal anti-inflammatories) such as aspirin, ibuprofen and others. People with nasal polyps often breathe through the mouth, snore, may have stuffiness and congestion and a diminished sense of smell.

Rhinitis is inflammation of the nasal cavity lining – frequently caused by allergies or environmental factors, infection and even stress. Allergic rhinitis occurs when a person’s immune system reacts to a foreign substance. While the allergen may be harmless in other ways, some individuals react adversely with congestion, headache and more.

The bottom line is that until a person knows what is causing the stuffy nose and need for treatment, the condition will likely continue. So, what can you do on the home front until this occurs? Consider using a humidifier or vaporizer. Drink plenty of fluids. Consider a nasal saline spray to help prevent your nasal passages from drying out. Use warm compresses on your face. Simply wet a wash cloth with warm water, sit back in a chair, and inhale the moist air. Or, fill your bathroom sink with hot water and place a tower over your head and inhale the warm water. Use a neti pot to irrigate your nasal passages. And, continue as you are with a small amount of mentholated salve under your nose to aid in opening your nasal passages.

Controversy has developed with petroleum jelly products being placed in the nose. Labels warn the ointment is for external use only. Petroleum jelly or mineral oil can cause a chronic form of pneumonia when aspirated into the lungs. Over time, the oil components cannot be cleared from the lungs and may cause reduced lung capacity, cough and shortness of breath. Many physicians feel a saline nasal spray is a more appropriate option health wise.

A rule of thumb is that if your condition is ongoing, it should be addressed by your physician or perhaps an otolaryngologist (an ear-nose-and-throat specialist) who can get to the bottom of the problem.

Active senior questions ankle pain

Q: I am a 79-year-old woman presently taking Benicar HCT, Aceon, Synthroid, a baby aspirin, and Lumigan drops. I had a mild stroke in 2002 but otherwise have been in good health and am active. I work out in a gym and am involved in other activities. My only surgery was tonsil removal when I was a child and thyroid cyst removal at the same time. I neither drink alcohol nor smoke. I did smoke for many years but haven’t since 2002.

I had a sudden onset of severe ankle pain with no trauma to cause it. The pain was so severe I had to walk holding onto things. After a day of the pain there was some swelling and redness around the ankle. I remained off my feet as much as I could (I live alone) and on the third day the pain diminished even though there was still some swelling and redness.

Do you have any thoughts as to what the cause of these symptoms could be? I considered thrombosis and gout, had it continued. I would have seen my doctor but the pain is mostly gone so I have not sought medical attention. Should I?

A: In a word, yes. Benicar is an angiotensin II receptor antagonist used to treat high blood pressure and for other purposes, as well. One possible side effect is swelling of the hands or feet, although because yours resolved and was unilateral, the medication is not likely to blame. . Aceon is an ACE inhibitor also used to treat hypertension, and to treat heart attack in those with coronary artery disease. There aren’t side effects from this medication that correlate with those you provide. Synthroid treats hypothyroidism (low thyroid hormone). This drug is generally well-tolerated, yet on rare occasions, it could cause, among other things, a feeling of discomfort and muscle weakness that dissipate on their own. Lumigan drops are used to treat open angle glaucoma. Common side effects may include body aches or pain, fatigue and weakness that again, dissipate on their own once the body adapts to the medication. All in all, it’s unlikely any of your medications are to blame for your ankle pain; however, to be on the safe side, you should take a list of your medications to your prescribing physician for his or her comments as to whether there may be a connection.

On to other possibilities. Common injuries that are spoken of together include sprains and strains. A sprain tears ligaments, while a strain stretches or tears a muscle or tendon. Sprains and strains commonly cause pain and swelling and an inability to move the affected joint. Could you have unknowingly hopped out of bed too quickly and twisted your ankle slightly, causing a mild sprain? This might have caused a ligament to stretch. A strain could have resulted from repetitive movement of a muscle from your workout at the gym or from other activities you perform. A condition known as pseudo gout is a form of arthritis that can cause painful swelling of a joint. While the knee is most commonly affected, the ankle can also bear the brunt of the pain and swelling that may last a few days or longer. Pseudo gout is linked with the presence of calcium crystals in the affected joint. Risk factors that might have a bearing on this condition include having an underactive thyroid, a mineral imbalance, and the aging process. Testing is accomplished through a simple blood test. Gout or pseudo gout could both be possibilities.

You certainly did the right thing by allowing your ankle to rest and improve on its own but the bottom line is that if you were concerned enough to write, you should visit your physician for his or her input – even if the pain has gone away. Your doctor can make an educated decision as to whether lab work, X-rays or other testing is appropriate which may either bring something to light or will allow you to get on with your active life.

Health woman hasn’t seen a doctor in years

Q: I am 49 and have never had health issues, so I have never been to a doctor since I have been an adult. I have never had children, nor any kind of surgery. I am too embarrassed to call to find a general physician but I do see an optometrist and dentist regularly. How do I start? Health insurance is not an issue. I do know that I have high blood pressure and have had it for quite a few years. Thank you.

A: If you read what you just wrote to me, you will understand completely why it is time to select and visit a physician. You take care of your eyes and your teeth – two extremely important parts of the human body – but you have neglected to consider the whole package. I do not know why you feel you have hypertension, unless you have a blood pressure cuff or use one at your local pharmacy that provides such information. And, if you haven’t done anything about your high readings at this time, let’s consider the consequences.

Hypertension (high blood pressure) is a very common health condition. It indicates the force of blood placed against the walls of your arteries is sufficient enough to potentially cause conditions such as heart disease or stroke over time. The condition can develop over years and be present without any symptoms at all. The problem is that even without symptoms, damage to your heart and blood vessels can develop.

Some individuals with hypertension may have an underlying condition to blame such as a thyroid problem, an adrenal gland tumor, kidney disorder, or sleep apnea. Then, too, specific medications such as over-the-counter pain relievers, cold remedies, specific decongestants and some prescription drugs (for others) may be to blame. Risk factors that may increase your chances of developing hypertension include being overweight, leading a sedentary lifestyle, advancing age, consuming too much salt in a daily diet, stress, or having a habit of excessive alcohol intake or smoking. Essentially, the longer your blood pressure is ignored and remains untreated, the greater the potential damage.

A normal blood pressure reading is around 120/80 mm Hg, although the Joint National Committee has raised the treatment range to begin at 150/90 for individuals older than 60. In the general population aged 18 to 60, the recommendation is to maintain a reading of less than 140/90; however, there are instances in which a physician may prefer some patients, because of other medical conditions, have lower readings. Once readings rise above 115/75, a person’s risk of developing cardiovascular disease increases. The first step in this condition is known as pre-hypertension, defined as a systolic (the first number) ranging from 120 to 139 mm Hg, or a diastolic (the second number) ranging from 80 to 89 mm Hg. I do not know what your readings are, so I cannot determine if you carry hypertension as a diagnosis or not.

There are steps that can be taken to attempt to lower your readings. Remove the salt shaker from your kitchen table and do not add salt to your foods while cooking them. Exercise regularly. Maintain a healthy weight. Stop smoking and drink in moderation if appropriate.

The point is, control is a step away and that step is making an appointment with a physician. There is no need for embarrassment. Determine if you have any specific requirements in a physician – young/old, male/female. Speak with a friend regarding a referral or phone your local hospital. Many facilities will match you up with someone that will meet your standards. Then, simply call for an appointment. There’s no need for an explanation. You have simply felt you didn’t need to be seen until now. However, it’s time. Expect a full examination, blood work, probable EKG, and perhaps even a chest X-ray if you are a smoker. Who knows? You may be looking at a clean bill of health without hypertension. Good luck.

Using the internet to shop locally

Q: I was told there is a website I could go on and put in my prescriptions, the amount, the milligrams and everything else it asks for. It will then tell me all the drug stores in my area that have the medication and how much it will cost. Do you know the website?

A: According to a Los Angeles Times article of February 24, 2012, internet start-up GoodRx enables consumers to find the best prices at nearby stores by typing in the drug and a zip code. The brains behind the scene, Scott Marlette, a former Facebook employee, stated he wanted to create a product where people could find the best pharmacy to go to in their own area anywhere across the country at no cost, and avail themselves of the best prices the area has to offer.

For example, a search for Crestor revealed a resident in downtown LA could purchase a one-month supply of 10 mg tablets at nearby CVS outlets for $130.29. And, GoodRx added a bonus by allowing readers to print out discount coupons before going to the store. Kmart offered the same product and quantity for $1523.97.

The database is believed to contain over one million prices at drug stores and mail order pharmacies nationwide for more than 6,000 brand or generic named drug. So, where does the money come from to keep the operation going? In a word – advertising. Another former Facebook employee who according to the website information is serving as GoodRx’s CEO, said the site will be looking to sell ads to marketers, as well as “enhancing listings” for drugstores seeking preferential placement. Hopefully, those who log on will not be drawn to the ads placed and will continue to price shop.

On the positive side, GoodRx will alert users when a prescription should be refilled and will update pricing to let internet users know where the cheapest prices can be found. The company’s founders feel there is clearly a need for greater transparency in health care costs and prescription drugs are an obvious candidate here. Even the well-insured who may not need to comparison shop for drugs will be able to see how wide a price disparity exists, particularly when it comes to generic drugs, and by how much money different chains appear to be profiting from their markups.

Consumer Reports states that shopping on the web is one of the best and fastest ways to compare drug prices and save money. Online pharmacies sell drugs for 35% or more off the regular price and while warning readers to “be careful” suggests using only US websites that have the VIPPS seal. VIPSS stands for Verified Internet Pharmacy Practice Site. They offer the following well-known sites of www.drugstore.com, www.familymeds.com, www.walgreens.com, and www.cvs.com. And www.costo.com.

Consumer Reports also offers those on patient assistance programs, Medicare low income subsidies and those with State drug discount cards appropriate sites for the purchase of cheaper drugs.

This trend is foreign to me, so I’d be very interested in hearing from readers who price shop on line and what their experiences have been. If sufficient information is received, I will print a follow-up and share the stories – good or bad – with readers.