Reader is tired of having winter illness

Q: I have had bronchitis twice this winter already. I went to a doctor the first time and she put me on prednisone to help open up my airway. I got over it but it reappeared back again about a month and a half later. I didn’t have a fever and felt fine other than the chest congestion and horrible cough. I have not coughed as much this second time around, though.

Are there any good home remedies to take once I begin feeling this coming on and that I might be able to take once I have it – again? I have been using a heating pad on my chest and drinking green tea with honey.

Thanks. Love your column.

A: To some degree, you are no different than every other individual on earth. We get sick and want a sure cure remedy that will make us all better in the snap of a finger. And, we get mighty frustrated when things don’t work the way we want them to. We (myself included) blame the doctor for not giving us medicine that works well enough or the pharmaceutical company because they didn’t put the proper ingredients in a product. We blame our bodies for not fighting off infections we don’t feel we should acquire. We don’t have the time nor the inclination to get sick. We are simply too busy, have too heavy a schedule, and have zero tolerance for such things as illness and glitches in the system. There are times when we just need to deal with issues as they present. Okay, enough grumbling. Let’s face the issues.

Bronchitis is inflammation of the lining of the bronchial tubes that carry oxygen to and carbon dioxide from the lungs. It may develop from a simple cold, a virus, from a smoking habit (or the smoking habit of others), pollutants in the air, or toxic fumes in the workplace or on the highway when we get behind a diesel truck that is belching out black smoke. Then too, our immune systems may be compromised and we may acquire illness more easily than others do.

Many physicians can diagnose bronchitis simply by performing an examination, listening to a patient’s lungs through a stethoscope, and taking a history of what preceded a visit to him or her. Antibiotics are often prescribed, yet if the bronchitis is from a viral infection (which in most cases it is), from pollutants, or from inflammation following an infection, antibiotics will not be effective. They can’t fight a virus. A physician can prescribe a cough medication, yet that may be counter-productive also. The cough actually helps remove the gunk from your lungs and that’s a good thing. A night-time cough suppressant might allow a patient to sleep better and help build back his or her immune system, and that might be considered. And, when things get as bad as yours did – and reappeared a second time – such things as prednisone that decreases inflammation or an inhaler that helps open up the airways, might be just the thing to get a person back up and running.

On the home front, your lungs have been compromised twice over this winter, and steps should be taken to stay clear of irritants whenever possible. If anyone in your house smokes, they should go out of doors to do so. Even such things as strong cleaning materials – at home or on the job – should be avoided if at all possible. You may find breathing less harsh if you wear a face mask until the fumes of a newly washed bathroom or kitchen floor dissipate. Consider the purchase of a humidifier that will keep the air in your home or bedroom moist. It may go a long way toward loosening the mucus in your airways.

It goes without saying that you should wash your hands frequently. If you don’t have access to fresh water, consider purchasing a tube of hand sanitizer at your local pharmacy that will help.

Try to stay clear of individuals who have symptoms of a cough or cold.

Steam therapy is very effective in most instances. Put the stopper in your bathroom sink and fill it with very hot water – either from the tap or from a tea pot of hot water. Add a bit of eucalyptus oil, tea tree oil, or pine oil and cover your head with a towel while leaning over the sink. Inhale deeply. Repeat as needed. Keep in mind that if the problem is chronic inflammation, steam therapy just may worsen the problem.

Gargle with warm salt water several times a day.

Eat well-balanced meals and get adequate sleep. Build up your immunity and keep those bugs away. Good luck.

Home remedy sought for H.pylori

Q: I have a friend in Honduras that has been diagnosed as having Helicobacter pylori. She has tried various antibiotics and over the counter treatments with very little success. Can you suggest a home remedy that might give her some relief?

A: H.pylori (for short) is a gram-negative bacterium commonly found in the stomach, although it can be present in other areas of the body. More than half of the world’s population have H.pylori within their upper gastrointestinal tracts and of those infected with the bacterium, over 80% are asymptomatic. Surprisingly, up to 85% of all individuals infected never even exhibit symptoms or complications. However, when symptoms do present in individuals, they appear as acute gastritis, bloating, belching, loss of appetite, weight loss, abdominal pain and nausea. Serological evidence of H.pylori is rarely found before the age of 10, increases to 10% in those between 18 and 30 years of age and to 50% in those older than age 60.

Researchers remain unsure how the disorder infects people. It may be passed through direct contact with bodily fluids such as saliva, fecal matter, or vomit. Then, too, it may be spread through contaminated water or food. Those at an increased risk for infection include living in areas where conditions are unsanitary, living in crowded homes with numerous individuals, not having a source of cleaning drinking water, and living with an individual who is already infected.

Diagnosis may be made through a number of test processes, of which two are considered better than others. The first is a breath test in which the individual swallows a substance that contains tagged carbon molecules. If H.pylori is present, carbon will be released once the solution breaks down in the stomach. The body naturally absorbs the carbon. Then the individual will exhale into a bag, and carbon molecules will be observed with the use of a special device. The second is a stool test that can also be utilized to determine if H.pylori antigens are present. Then there are such things as lab work (blood testing) or endoscopy that may be considered if there is a question of other digestive disorders that might be present. Some practitioners may order the blood work as a first-line test, bypassing the stool test. However, it has some limitations.

Treatment is commonly handled by the individual taking three medications – two different antibiotics and a PPR (protein pump inhibitor). Once the antibiotic therapy has been concluded, a physician will likely test a patient in about a month to determine if the therapy was successful.

On the home front, raspberries contain ellagic acid which is identified as a disease fighting compound. Thus, raspberries may help cure stomach issues caused by H.pylori.

Next comes cinnamon or cinnamon extract that is believed to prevent the bacterial from causing inflammatory reactions inside the stomach. Because the spice is rather pungent, it may be added to hot water or tea and consumed in that manner.

The most popular fruit to eradicate the bacteria in the stomach is coconut or coconut oil that is purported to reduce the pain and inflammation experienced.

There are certainly no promises on any of these home remedies. What may have ultimately been missing from your friend’s antibiotic regimen was that she wasn’t tested following completion of her medication to verify its effectiveness. She should speak with her physician in this regard. However, one of the problems with the blood test is that it will remain positive even after successful treatment. Therefore, tests of cure should not include the blood test.

Home remedies for arthritis are many

Q: Is there a home cure for arthritis or is it uncontrollable? Do home remedies, if they actually exist, rid the body of arthritis or just the pain?

A: Arthritis is defined as inflammation of one or more of the joints of the body. There are approximately 100 forms of arthritis. Those types most common include osteoarthritis and rheumatoid arthritis. Osteoarthritis is a breakdown of the tissue at the ends of bones where they form a joint. It is often referred to as wear-and-tear damage of the cartilage. Rheumatoid arthritis, on the other hand, is an autoimmune disorder that affects joint linings that become swollen and inflamed.

The Centers for Disease Control and Prevention indicates that obesity is a leading cause of arthritis, with almost 66% of all adults so diagnosed being obese. Those at an increased risk for developing any form of arthritis include having a previous joint injury from such things as a sports accident, being older, having a family history, and obesity. Women are more likely to develop rheumatoid arthritis than are men, while men are more likely to suffer from gout which is yet another form of arthritis.

On the home front, the herb turmeric used in cooking is purported to be helpful in treating the symptoms of arthritis. According to a research study conducted by Science Daily, turmeric inhibits NF-KB which is responsible for causing a person’s genes to aggravate the symptoms of arthritis. The product is available for adding to foods or in capsule form, with 500-600 mg daily recommended. The daily requirement should be divided into three equal doses. Of note, it should be avoided for those individuals taking an anticoagulant.

Ginger root is also considered helpful in reducing prostaglandins ( the chemicals responsible for triggering inflammation). According to MSNBC health, ginger is one of the best foods to fight arthritis. It is available in capsules or in its raw form from your local grocer store. It, too, should be avoided completely by those individuals on an anticoagulant.

Licorice, in moderation, helps block inflammation receptors. It is important to remember that the long-term use of licorice can elevate an individuals blood pressure dramatically; however, two capsules daily might be sufficient and within normal limits.

Alfalfa consumed in the form of tea might be considered. Instructions include adding one ounce of alfalfa in a quart of water , boiling it for one half hour, and then straining the liquid. If this method is attempted, stop the process after three weeks for one week, and then begin again maintaining the same regimen.

Flaxseed appears effective in treating the pain and inflammation of arthritis. Flaxseed oil is available in grocery stores. Two tablespoons of the oil can be added to a person’s diet on a daily basis. Flax seeds are also available but should be avoided by individuals who suffer from IBS, since they can exacerbate a person’s symptoms.

Olive oil is a good source of omega-3 fatty acids and is believed to reduce the inflammation of arthritis. This oil can be cooked with instead of other oils, margarines or butters.

Then there is raw garlic, bananas, massaging affected joints topically with warm olive oil, adding Epsom salts to bath water, and a great deal more. There are also more herbs not identified, simply because they may have unwanted side effects.

Whatever remedy you choose to try, be sure to speak with your primary care physician before beginning the regimen. Not everything will work for everyone, but home remedies are worth a try. If they fail to provide relieve, see your physician for a different direction.

Senior troubled by whooshing sound in head

Q: Primarily at night I hear a whooshing in my head that to me is the sound of blood swooshing through my head with each heart beat. It sometimes happens during the day in a stressful situation. It became more noticeable about a year ago, so my doctor send me to an ear-nose-and-throat doctor who thought it was sinus and suggested I take an allergy pill. Did not work.

I went back to my doctor five months later and was sent for a CT with contrast. The report was negative. I was then referred to a neurologist who requested another CT with contrast at a different facility. Negative.

In looking on my computer at tinnitus, I came across pulsatile tinnitus that I thought might be the problem but the neurologist I saw who requested the last CT said that it was related to ringing in my ears and this is now what I have. So, is this something that I will have to live with or is there some other explanation?

I’m a 73-year-old woman, borderline osteoporosis. I take one Actonel per week, Fortical Nose Spray daily, Oxybutynin, calcium B complex, vitamins D and E, and have recently been put on Trazadone daily for stress.

Please help!

A: Let’s consider a few options, the first of which is, as you pointed out, is ringing in the ears. The condition is rather common, yet when it continues as it has in your case, it is known as tinnitus. There are two types of tinnitus — specifically pulsatile and non-pulsatile. The first causes a rhythmic swooshing sound in the ear(s) that coincides with the heartbeat. This appears to be what you refer to. If it is caused by the flow of blood through the jugular vein, it can often be temporarily corrected with gentle pressure on that side of the neck. In rare instances, it can be the result of a blood flow abnormality through the carotid artery that courses through the ear, as well. This is a more serious condition that will require additional testing as yours will.

Individuals who over-use aspirin, ibuprofen, antibiotics, or who undergo chemotherapy often complain of tinnitus. So while we are on the subject of medications, let’s review what you are taking. According to Drugs.com, Actonel (risedronate) does list less common side effects of the drug to include ringing and pounding in the ears. Reported adverse effects have been mild to moderate with 7% of those in three clinical studies reporting tinnitus. You might choose to speak with your prescribing physician to determine if a trial with another drug might be effective in dissipating your “tinnitus”. You might also suffer from hypertension, a blood vessel laying across your hearing mechanism, or an infection.

So, while you have already been seen by one otolaryngologist, I recommend you request a referral to another at a top notch facility or teaching hospital who can review the test results on what has been done, check your blood pressure, and hopefully get to the bottom of things. Spring is almost here. It’s time to hear the birds chirp, not to be overcome by whooshing. Good luck.

Patient fearful of MRI procedure

Q: I have a dilated aorta. Does all of my body have to be scanned or does just my chest need to be under the donut? If only the chest needs to be seen, how long does this take? I am extremely scared and claustrophobic. Am I strapped in and can I take a sedative? If all of my body has to go through, how long will this take? I don’t care about my legs going through, just my head and body.

A: To begin with and for other readers who may not know what a dilated aorta is, I offer the following: An enlargement of more than one and one half times its normal size is known as a dilated aorta. And while an individual may experience back, leg or abdominal pain, there are many instances in which there are not symptoms at all, except if and when the aorta ruptures. It appears you are being tested for an enlargement of a thoracic aneurysm. Most commonly, aneurysms may be in the thoracic or abdominal areas. Those in the thoracic area are within the chest, while abdominal aneurysms are, as stated, within the abdomen. Those that involve both areas are referred to as thoracoabdominal aortic aneurysms.

As an aneurysm enlarges, it may cause compression of nerve roots that cause leg pain and/or numbness. Left untreated, the aneurysms have a tendency to grow, with the rate of enlargement varying from person to person. Medical imaging will be necessary to confirm or rule out the aneurysm and extent of enlargement. The possible risk of rupture of an abdominal aortic rupture is related to its size and shape.

Some aneurysms and pulsatile masses within the body may be found or questioned when a physician palpates an area during routine physical examination or because of a patient’s complaints. Listening with a stethoscope may reveal a bruit or unusual sound that results from turbulence within the aneurysm. This may be followed by an ultrasound that should, under normal circumstances, reveal a precise picture of the size of the aneurysm. Unfortunately, this is not the case with a thoracic enlargement, which is why your physician chose to order an MRI.

An MRI (magnetic resonance imaging) unit is noninvasive and uses radio waves and a magnetic field for high resolution images of organs and tissues within a body. The tube-like structure is open at both ends. While you will lie down on a movable table that slides into the tube, the procedure is painless and there are no moving parts around you. You can even listen to a radio or music as a means of remaining calm and to diffuse the sounds the machine makes. If you have claustrophobic tendencies, your physician can provide a mild sedative. The procedure may last approximately a half hour, during which time you will be asked to remain still. The area of the body of concern will be in the center of the scanner. Now for the good news. There are open MRI units available now for individuals with severe claustrophobia. Check with your physician or local hospital to determine the nearest imaging center to you.

It certainly appears you need answers, so I suggest you bring any and all questions to the attention of the physician in charge.

Teen has frightening calcium disorder

Q: I was diagnosed with slipping rib syndrome in 2008 that was followed by two surgeries to shorten rib 8 on both the left and right side by about three inches. In my last X-ray it was found that my floating rib cartilage is calcifying. My doctor didn’t give me a lot of information about it but he was disturbed that it was happening and he doesn’t know what is causing it for me.

I’m 18, in good health besides my ribs, and scared with what is happening. Any information would be helpful.

A: The ribs are attached to the spine and the flat bone in the center of the chest known as the sternum. Floating ribs are normal. There are instances when floating ribs can indeed slip out of place, putting pressure on internal organs. This may occur because of fracture, trauma, or because of other reasons. When a rib becomes dislocated and slips out of its socket, the condition is known as floating rib
syndrome.

There are ordinarily 12 pairs of ribs. Each is attached to the vertebrae in the back. The first seven are attached to the sternum in the front and are referred to as sternal or ‘true’ ribs, while the lower five actually do not connect to the sternum in the front of the body and are referred to as ‘false’ rib with the upper three false ribs connecting to the costal cartilages of those ribs just above them. However, the last two are not anchored in the front and are therefore referred to as floating. Floating ribs may cause pain that comes and gos. It may modify in intensity when an individual simply changes positions.

Calcium can build up in bodily tissues, causing that tissue to harden. Ninety nine percent of all calcium that enters the body is deposited in our teeth and bones. The remaining one percent is dissolved in our blood. A variety of factors can lead to that 1% of calcification in other bodily areas, including an injury, a genetic or autoimmune disorder that affect connective tissues and the skeletal system itself, osteoporosis or hypercalcemia (too much calcium in the blood), infection of the breast, the normal aging process, and more. If your physician has concerns, he may choose to have a tissue biopsy performed that can determine if the calcifications are benign or not. Calcifications may require follow-up monitoring with the outlook depending on the severity of the calcifications and their location. Your physician is the one to determine whether or not your particular case warrants further investigation. Or, he or she may also refer you to an orthopedic specialist or even to a chiropractor who can explain specific exercises to prevent your problem from recurring.

Vision changes can be very frightening

Q: I am a healthy 57-year-old female who frequently experiences double, blurred vision — even with glasses. This usually occurs after I’ve been reading, using the computer, or doing close work. My ophthalmologist has recently identified that it is only in my left eye.

A diagnostic test showed that the cornea surface is irregular, rather than even and concentric. He called it irregular astigmatism and said it can be corrected with specially- fit contact lenses. Can you please tell me more about it? Is it experienced by others?

A: A bit of brief blurred vision may be common, but not to the extent where a correctable disease is found. Unfortunately, you have an uncommon problem. It is typical for many individuals who sit at a computer all day, read for extended periods of time, do such things as intricate close-up work, and more to experience eye issues. This is not your case.

Regular astigmatism is a common visual problem experienced by many that, in most instances, can be corrected either with glasses or contact lenses. An irregular astigmatism, however, is not common and may not be corrected by glasses or regular contacts according to my sources. This disorder is identified when the cornea is marred by abnormal shapes, peaks, ridges and valleys that prohibits light from being focused properly on the lens. Depending on the severity of the case, mild irregular astigmatism may result in some blurring and distorted vision, whereas more severe cases can cause the appearance of multiple images that can be more difficult to treat and may be quite debilitating. While more difficult to treat than other forms of astigmatism, specialized contact lenses, followed only when necessary by a surgical procedure, is appropriate.

The condition may also result from keratoconus or from such things as having refractive surgery. If the treatment zone is not precisely centered, irregular astigmatism may occur. Custom RGP lenses have been found to be the best corrective option for patients with any type of irregular astigmatism. RGP lenses are rigid gas permeable lenses that is uniformly curved, rest on top of the cornea, and reduce how the imperfections in the corned affect incoming light. There are also laser surgeries performed that are not always completely perfect but do help most individuals see better than before. Keratoconus is a degenerative disorder of the eye caused by both thinning and a change in shape from the more normal curve to a more conical shape. It can cause major visual distortion that result in a sensitivity to light. This condition most commonly affects adolescents and can be managed by corrective lenses. It should be noted that some individuals have an irregular astigmatism from birth because of genetic factors.

You likely have problems focusing on close and far-range objects and have indicated your left eye is the only one affected. This situation has been observed in the past. Holding one eye closed may help, but it is not the answer. Visual issues such as this can result in headaches, nausea, and a gait abnormality and should be addressed.

It appears to me that your ophthalmologist is well-informed and while perhaps not answering your questions to the degree you would like, is managing your case well. Therefore, and providing you have the confidence in him or her, you might choose to follow the recommendations provided. Good luck.

What is the right treatment for osteopenia?

Q: This is a question about Reclast, a drug that is supposed to help your bones. I am 75 years old and my doctor says I have osteopenia. I am currently taking Fosamax. Would this new drug help my bones better?

A: Osteopenia is often a precursor to osteoporosis and is a condition in which bone mineral density is lower than normal. A loss of estrogen as an individual ages, a sedentary lifestyle, the excessive consumption of alcohol, the habit of smoking, the extended use of glucocortoid drugs, and more may contribute to the condition. According to the pharmaceutical company that manufactures Fosamax, in 2003 there were about eight million women determined to have a diagnosis of osteopenia and of that amount, approximately one third were taking an osteoporosis drug.

The treatment for osteopenia remains controversial. According to 2008 recommendations from WHO (the World Health Organization), therapy should be considered if the individual has specific readings on a DEXA report, if there is a probability of hip or major osteoporotic fracture in the upcoming 10 year period, or if the prescribing physician and patient together deem it appropriate because of the extended 10 year risk.

Fosamax (alendronate) is in a group of drugs known as bisphosphonates. Its purpose is to slow bone loss and increase bone mass which hopefully prevents bone fractures. It is commonly prescribed for women to prevent osteoporosis caused by menopause, as well as in those individuals who have been diagnosed with Paget’s disease or osteoporosis that results from taking steroids.

Reclast, also a bisphosphonate, is recommended for individuals with Paget’s disease, a diagnosis of osteoporosis determined by a bone mineral density scan, and other conditions. Because Reclast is an IV medication, it may be preferable if you are having gastrointestinal issues with your Fosamax.

On the downside, Fosamax, Reclast and other bisphosphonate therapies have been reported to cause osteonecrosis (bone death) in the jaw, so perhaps a change to another class of drugs may be appropriate in your case.

Did your physician show you the results of your scan? Either way, you need additional information and some questions answered prior to making a determination as to whether you should make the switch from one medication to another. In this and in all instances, every patient should be well informed of the potential risks, long-term effects, positive aspects, and all else he or she may have questions about. Make an appointment with the prescriber of your Fosamax. Determine how severe your diagnosed “osteopenia” is and ask about the potential risks and benefits of a switch. Without knowing your numbers, I cannot inform you what your best choice is. If you feel you may not be able to understand what he or she says, take a family member or friend with you and make it clear the individual is there at your request. Then you can make an educated decision and progress from there.

Kelp helps weight loss but has its own issues

Q: I was using a diet patch that contained bladderwrack kelp and garcinia cambogia in a menthol base. It worked in terms of reducing my appetite and urges to eat but after 26 days of using the patch, my skin turned red at the patch site and the right side of my abdomen, laterally from the belly button to the side, began to twitch and give spiking pain.

I also developed a bladder infection which was cleared immediately by Cystex. However, even after I stopped the patch, my abdominal twitching continued, as has the pain. I then started using Cipro which I had at the house from a previous colon issue and the twitching and pain subsided somewhat but is still present. I think the patch caused some type of reaction in my body. I don’t know what it is or how to treat it. What do you think?

A: Fucus vesiculosus a/k/a bladderwrack is a form of kelp readily accessible on the coasts of the Atlantic and Pacific, as well as countless other locations. It has been used for countless years to make medicines for thyroid disorders, iron deficiency, joint pain, arthritis, digestive disorders, constipation, emphysema, anxiety, UTIs, and other conditions too numerous to mention. Unfortunately, thus far there is insufficient scientific evidence to confirm it is effective for any of the conditions noted. As with many plants that originate from the sea, the product contains varying amounts of iodine, making it a rather inconsistent source of iodine. And, it has been proven that taking bladderwrack may actually hamper rather than help some thyroid conditions. The Natural Medicines Database, indicates there is insufficient evidence to even rate its effectiveness for obesity, arthritis, digestive issues, constipation, thyroid problems, arteriosclerosis, and more. They emphatically state that the product can affect the thyroid and should not be taken by individuals with a thyroid condition. The product may be purchased at most health food stores or natural vitamin facilities in capsule or tablet form, yet according to most sources, it should not be taken orally.

On to garcinia cambogia promoted as a popular weight loss supplement. In 2009 the FDA issued a warning for users to discontinue taking the product because of the potential for serious liver problems. Garcinia contains other products that could, in part, be to blame and this has led to varying opinions on its effectiveness and safety. What is known is that it may have unwanted interactions with asthma and allergy medications such as Singulair and Accolagte, with warfarin an anti-coagulant, with statin drugs taken for hypercholesterolemia, with pain medications, and diabetic meds that include both oral forms and insulin.

An allergic reaction at the site of any patch is not uncommon. When it comes to the spiking pain, remember that bladderwrack is harvested from waters that may be heavily contaminated with arsenic, lead and other metals that can cause kidney and nerve damage. While information varies, one website indicates the patch is possibly safe when applied to the skin but the prolonged high intake of dietary iodine is linked with goiter and an increased risk of thyroid cancer.

It may be that the specific amount of kelp in a patch is minimal. However, I would opt for making better choices when grocery shopping, coordinating a plan of exercise, and erring on the side of caution. And I am sorry to say that as far as the unilateral twitching is concerned, I’m at a loss to explain its cause.

Foreign sandals could cause a rash

Q: I have had a rash on the tops of my feet for almost two years. My primary physician and my dermatologist do not know what it is. I have used athlete’s foot medication, Benadryl cream, alpha hydroxy creams, hydrogen peroxide, and almost every moisturizer on the market.

This is a dry, red rash. No blisters. It is not between my toes, nor is it on the bottom of my feet. I do not spend any significant amount of time in the sun, especially this time of the year, as we live in a cold winter climate. I have COPD. My current medications are Azythromicin 250 mg every other day, Combivent and Qvar daily, Mucinex 1200 mg as needed, and Furosemide 20 mg as needed. If antibiotics, fungi and virus medications do not work, what could?

A: The first two things that come to mind are a medication reaction or a possible allergy. To begin with, Azythromicin is an antibiotic that fights bacterial infections but may be prescribed for other purposes. My guess is, you are taking it because of infection. Side effects may include dizziness, palpitations, a severe skin reaction, itching, and more. It also is known to interact adversely with numerous medications, OTCs, vitamins, and herbs. While unlikely, it is a possibility! Mucinex is an expectorant prescribed to relieve or reduce the symptoms of cough. Adverse side effects may include itching, rash, and hives. Again, while unlikely, it remains another possibility! The Combivent, Qvar and Furosemide you have been prescribed do not appear to cause the symptom you are experiencing.

So, your first step is to make an appointment for a second opinion to determine if your rash could be medication-related. If this is a possibility, ask your physician if he or she will consider recommending the discontinuance of one medication at a time. Or, perhaps there is another medication in each class that does not have the unwanted potential side effects noted. The reason for not discontinuing both at once to make you improve faster, is because you won’t be able to determine which medication is to blame. By stopping one for a period of time, you can determine if there is any modification. If there is no change noted within a reasonable period, you can go back on the prescription and discontinue the second one following the same plan.

Lastly, the tops of a person’s feet are extremely sensitive. An observation I have made is that some shoes — particularly those manufactured in foreign countries ––are often treated with chemicals to keep them soft and pliable. Unfortunately, this process can have an adverse reaction on the tops of your feet. The bottoms of your feet will likely remain unaffected because there is a liner, even in sandals, that acts as a barrier and prevents a rash. The only concern I have here is that two years is a long time, unless you are affected by a favorite pair of slippers, boots, or shoes you wear year-round. If this is a possibility, put the shoes aside (as in the trash bin) and refrain from wearing others that may be in the same category.