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DocTalk

Discussion in 'Journalism topics only' started by DocTalk, Jan 27, 2007.

  1. 21

    21 Well-Known Member

    Dear Doc:

    Unrelated to anything above, I just never really understand the choice:

    Tylenol or Advil, and why?
     
  2. DocTalk

    DocTalk Active Member

    Tylenol or acetaminophen works as a pain reliever and will decrease fever. It is metabolized in the liver. Ibuprofen (advil, motrin) in addition to pain fever control works as an anti-inflammatory. It's is metabolized in the kidney. If the goal is to decrease inflammation, then ibuprofen is preferable. If it's just a pain issue or fever issue, it may come down to the side effect profile.

    Ibuprofen irritates the stomach and some people cannot tolerate the nausea. It should used cautiously in people who are taking anti-coagulation or blood thinner medications like Coumadin or Plavix, peopl who have a history of ulcer or other bleeding issues. As well, people with kidney disease should avoid it.

    While tylenol is relatively safe, even recommended doses over a period of tiem may be toxic to the liver. Therefore, people with liver disease including chronic alcoholics should not take tylenol. Many prescription pain medications combine a narcotic with tylenol (Tylenol #3, Vicodin, Lortab, Percocet); therefore, plain tylenol should not be taken in addition to these meds, again to prevent accident overdose.
     
  3. 21

    21 Well-Known Member

    Can you take them simutaneously?
     
  4. DocTalk

    DocTalk Active Member

    Tylenol and ibuprofen are compatible and may be taken together. Usually I suggest that patients leapfrog them, especially when trying t ocontrol fevers in kids. Tylenol can be taken every 4 hours and ibuprofen every 6-8.
     
  5. Bullwinkle

    Bullwinkle Member

    Thanks for the help, DocTalk! A friend told me today that if I had a tingling feeling in my fingers that I might have pinched a nerve --- I'm not sure if that's true or not, but I'm safe because I don't get that feeling :)

    The neck area is still sore and I definitely feel like it's strained while driving. But I'm glad to hear that there's a good chance I didn't screw anything major up, and that a little Ibuprofen will go a long way!
     
  6. DocTalk

    DocTalk Active Member

    June is draft month in pro sport and fans get to raise their hopes for the next season.

    June is also an interesting month in the hospital. The senior residents are leaving to begin their life in the real world and the communities that they choose will hopefully hold on to them for the next 30+ years. Aside from the medical care the doc provides, they will likely become an integral part of town life. It's too bad that there aren't enough docs to go around.

    The rest of the story is on the web site and unfortunately, it isn't pretty.

    Thanks for reading.

    www.MDdirect.org/blog
     
  7. Pencil Dick

    Pencil Dick Member

    Doc, what can you tell me about a blood disorder called polycythemia?

    My doctor has determined that my body produces too much blood, which I've never heard of. Other than donating blood once every 3-4 weeks (her suggestion), are there any other treatments or remedies?

    Apparently in the old days this would have been treated by applying leeches to the body ...
     
  8. DocTalk

    DocTalk Active Member


    Polycythemia is a conditon where there are too many red blood cells in the body. Most commonly, this occurs as the body's response for the need to carry more oxygen (for example in smokers or those who live at high altitude). Polycythemia vera or primary polycythemia is an illness where teh bone marrow makes too many red blood cells.

    The major complication is that of blood clotting because the blood starts to sludge within snaller blood vessels. As well, spleen enlargement can occur.

    The treatment of primary polycythemia is phlebotomy or removing red blood cells. Donating blood is a reasonable way to make use of the excess cells.

    Incidentally, elevated red blood cells and the ability to deliver extra oxygen to muscle cells is the intended effect of blood doping and epo use.
     
  9. DocTalk

    DocTalk Active Member

    It's high time that health care policy debates occur out in the open but as the White House and Congress talk philosophy, they should be reminded that the small decisions made every day by the individual patient will decide how well reform works. While millions have no health insurance, millions of others including those with insurance choose to burden the system with their personal choices of smoking, drinking to excess and failing to pursue health screening opportunities. The system will succeed or fail one patient at a time.

    More on the web. Thanks for reading.

    www.MDdirect.org/blog
     
  10. DocTalk

    DocTalk Active Member

    The Monday morning injury list keeps growing with players injuring arms (Sabathia, Guzman) shoulders (DiceK) and backs (Johnson). Muscles are fickle things. They allow the body to move but as we ask our bodies to do more, the downside is strains and tears. More about muscles on this week's web entry.

    www.MDdirect.org
     
  11. DocTalk

    DocTalk Active Member

    The frustrating part of being an insider in any industry occurs when people spin information that you know is wrong. The press perpetuates the concept that Michael Jackson died of cardiac arrest; everybody dies when their heart stops. Not quite true, a few people sustain brain death and are declared legally dead so that they can become organ donors, bu t I digress. The question becomes why did his heart stop when it did. Cardiac arrest does not equal heart attack or sudden cardiac death.

    More on the web. www.MDdirect.org

    Thanks for reading.

    Ben
     
  12. DocTalk

    DocTalk Active Member

    While hockey remain a religion for me, baseball is more closely related to my medical work. The decision making on the diamond mirrors those made in the doctor's office or hospital. Risk-reward, Benefit-liability trade offs have to be balanced in each decision. More of the web.

    Happy holiday,

    Ben
    www.MDdirect.org/blog
     
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