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Should I be worried about side effects from long-term use of SSRIs?

DEAR DOCTOR K: I'm nearing 60, and I've been on SSRI medicines for nearly 30 years, for depression. They work for me, but should I be worried about side effects from using them for so long?

DEAR READER: You've asked an important question -- one that should be asked of any medicine used for many months or years. All medicines can have side effects, and SSRIs are no exception. And some medicines can have side effects that become apparent only after long-term use.

Can exposing babies to common food allergens help prevent food allergies later on?

DEAR DOCTOR K: In a recent column you said that parents should give babies peanut products to help prevent peanut allergies. Does the new advice also apply to other common food allergens, like eggs or cow's milk?

DEAR READER: To answer your question I turned to my colleague Dr. Claire McCarthy, a primary care pediatrician at Boston Children's Hospital. For decades, the standard advice recommended by allergy specialists was to hold off on giving babies foods that commonly cause allergic reactions. Parents were advised not to give egg, dairy, seafood or wheat in their child's first year. And parents were told to wait until two or three years to give peanuts or other nut products. It turns out that was bad advice.

What is a POLST form?

DEAR DOCTOR K: My husband has terminal cancer. He has already signed a do-not-resuscitate order. His doctor recently suggested that he also complete a new form called a "POLST." Can you explain what this is?

DEAR READER: As you know (but other readers might not), a Durable Do Not Resuscitate Order (DDNR) lets your husband's medical team know that he does not want CPR if his heart stops beating or he stops breathing. It's usually for people who are near the end of their lives or have an illness that won't improve. It takes the burden of decision-making off family members.

I have chronic pain that interferes with my sleep. What can I do?

DEAR DOCTOR K: I have chronic pain from arthritis. Lately it's so bad that I can't get a good night's sleep. What can I do?

DEAR READER: Chronic pain and insomnia are, unfortunately, a common combination. What's more, chronic pain puts you in double jeopardy: First the pain robs you of restful sleep, then losing restorative sleep makes you more fatigued, which makes you more sensitive to pain.

Do shift workers have an increased risk for health problems

DEAR DOCTOR K: I'm a nurse, and I can be assigned to work the day shift, evening shift or night shift. I hear that shift workers can develop health problems. What is known about that?

DEAR READER: More than 9 million people in the United States are shift workers like you. Studies show that nearly 10 percent of night-shift workers have severe reactions to that schedule. Some become overwhelmingly sleepy during the night shift, when they need to be alert. Some have trouble concentrating and focusing on a task. Others can't really fall deeply asleep during the day, when they need to get some sleep.

Does the immune system really change with the seasons

DEAR DOCTOR K: A friend heard about a study that said a person's immune system changes with the seasons. That seems incredible to me. But if it's true, it's fascinating. Do you know what she is talking about?

DEAR READER: I think I know the study she is referring to. Before describing what it found, it's worth talking a bit about the immune system and also about genes.

Could I have PTSD?

DEAR DOCTOR K: Last year, a truck ran a red light, totaled my car and nearly totaled me. I spent several weeks in the hospital. Since then my body has healed, but I'm not myself. I'm very irritable, easily angered and sleeping poorly. A friend says I have PTSD, but I thought that occurred to people -- soldiers, for instance -- exposed to repeated threats.

DEAR READER: Your friend is astute. Post-traumatic stress disorder -- PTSD -- is a condition in which distressing symptoms occur after a major trauma. While the media often talk about PTSD in soldiers who have seen active combat, you don't have to be in battle to get PTSD. A single horrible event, like a bad auto accident, can surely do it.

Do I need a daily medicine to prevent gout?

DEAR DOCTOR K: I have had three attacks of gout in the past year. I never had it before. Now my doctor wants me to take a medicine every day, even though I feel fine. Is this a good idea?

DEAR READER: Well, you have a kindred soul in Doctor K, since I also have developed gout in recent years. The disease occurs when a natural chemical called uric acid finds its way into the joints that connect two bones. All of us always have some amount of uric acid in our blood. In people with gout, the amount of uric acid usually is higher than normal.

Is it dangerous to sleep too much?

DEAR DOCTOR K: I've heard a lot about the harmful effects of insufficient sleep. But are there any dangers of sleeping too much?

DEAR READER: Over the years we've learned that sleep is important for a variety of reasons. It appears to be vital for forming long-term memories. It also helps you to digest what you have learned the previous day. Sleep promotes concentration and restores energy; it helps to keep your immune system functioning well and to regulate eating patterns.

How does weight loss help control Type 2 diabetes?

DEAR DOCTOR K: I was recently diagnosed with Type 2 diabetes. My doctor said the best thing I can do right now is to lose weight. Why?

DEAR READER: Type 2 diabetes usually starts after a person becomes an adult. It is by far the most common type of diabetes. It has been clear for many years that people who are overweight are at much greater risk for developing Type 2 diabetes. In the past 20 years, research discoveries have begun to explain why.