Dec 23

A scientific look at Christmas stress

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For many people, Christmas and New Year is a time of increased stress and anxiety.

Writing in a recent edition of New Scientist magazine, Robert Rowland Smith, who is described as both a philosopher and management consultant, suggests that at least part of the reason for this state of anxiety is because we are forced out or our normal routine.

We are “crammed in a Christmas tunnel”, he suggests, “a narrow passage between one year and the next”, and we are apprehensive that we may not make it through to the other side.

However, maybe these days, in an era of greater environmental awareness we are simply worried about increasing our so-called carbon footprint. Consider all the wrapping paper that simply goes to waste!

Whatever the reason, we do know that heartburn and indigestion are very much more common at this time of year. Of course, it’s most likely these symptoms are caused by just eating and drinking to excess.

A few years ago the respected US-based business magazine, Forbes, published an article titled “Ten Top Hangover Cures”. Some were more mythical than medical; they included concoctions such as extract of prickly pear, said to be able to help overcome nausea, loss of appetite and dry mouth; and tripe soup made from the lining of cow’s stomach with the addition of chilli, garlic and other seasonings.

More likely to be effective are the fluid and electrolyte replacement products. Because alcohol–containing drinks (wine, beer and so on), despite being liquid themselves, actually take water away from the parts of our body which need it most. Drinks containing caffeine such as coffee, tea or cola can do the same.

So, to help prevent morning-after headaches, alternate your alcoholic drinks with plenty of water. It can be helpful also to drink some Hydralyte or Gastrolyte or an isotonic sports drink before bed. It may not seem like the ideal beverage at the time, but it could prevent that really awful feeling the next day.

If that pain you feel needs a pain reliever, the products with paracetamol are probably the best bet; they’re less likely than aspirin to cause stomach upset. Try a couple of Panadol Clear and pray the noise of the fizz is not too loud for you!

After a rich meal our stomachs have to work harder and pump out extra acid to help digest the food and alcohol. The pain or discomfort that follows this exercise in overindulgence can also occur with stress (not just the Christmas kind), cigarette smoking, pregnancy and some medicines.

If heartburn is the main problem, you might get relief with a liquid antacid like Gaviscon; and a range of potent antacids in tablet form is also now available without prescription.

For more advice and information tailor-made to your need to cope with the after effects of the festive season, or morning after problems at anytime, ask at your pharmacy for one of the Self Care fact cards titled Headache and Heartburn and Indigestion.

They’re available from pharmacies around Australia which provide the Pharmaceutical Society’s Self Care health information. You can call 1300 369 772 for the nearest location, or log on to the Pharmaceutical Society’s website at www.psa.org.au and click on Self Care Pharmacy finder.

From all the Pharmacy Self Care Team we wish you a safe Christmas and very Happy 2010.

©2009 Pharmaceutical Society of Australia

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Dec 16

Front teeth and penicillin

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It used to be said that penicillin was the Christmas gift to give someone who has everything!

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Today penicillin is no longer the cure all that it once seemed to be. While penicillin – or at least penicillin in some modified form, is still a useful, or indeed the first choice, antibiotic for some infections, it has been largely rendered useless by the development of resistant strains of bacteria. The same fate has befallen many other antibiotics as well – due mainly to overuse for often inappropriate conditions.

Three medical researchers – Scottish Alexander Fleming, Australian Howard Florey and German born Ernst Chain, won the Nobel Prize in 1945 for their discovery and development of penicillin. A year later, now more than two generations ago, the popular song All I want for Christmas is my two front teeth was first published.

These days, it’s likely children want a lot more for Christmas than their front teeth; however, healthy teeth and gums are certainly more important than just for keeping up appearances.

A genetic link has been established between dental disease and heart attacks. Just how exactly they are linked is unknown; but one suggestion is that bacteria involved in gum disease cause a low grade inflammatory response throughout the body, causing changes in the arteries and so leading to stroke or heart attack.

It sometimes seems that at Christmas time there is now more emphasis on gifts than goodwill; and although front teeth or even penicillin may not be front of mind when we make up our Christmas gift list, perhaps we could consider something healthy.

The original gifts of gold, frankincense and myrrh were all health related.

As well as its value as a precious metal, gold has also been used in healing. In the 17th century, gold cordials (gold mixed with alcohol) were prescribed for such ailments as melancholy, fainting, swooning and fevers. Although, there is no evidence that these treatments were in any way successful.

Frankincense, as the name implies, has for much of its 4,000 year history been used for is aromatic qualities. Today it is still in wide use as a component of perfumes and toiletries. Records of its medicinal use date back to the 3rd century, when it was recommended for gout, catarrh, colic and gastrointestinal haemorrhage.

In a pharmaceutical sense myrrh seems to have the best credentials. As recently as 50 years ago tincture of myrrh was an ingredient of pain relieving mixtures prescribed by Australian doctors. In Hebrew tradition, myrrh was often mixed with wine and given to a condemned man as an anaesthetic. These days myrrh is valued in some cultures for its antiseptic, antifungal and anti-inflammatory properties.

These items might now be more difficult to obtain – at least for those of us with a limited budget; but as a Christmas gift you might think about a more modern first aid kit.

There are ready prepared varieties for work, home or keeping in the car; or your pharmacists can help you tailor-make one for your own personal needs.

If you’re electronically minded, a home-use blood pressure measuring device (called a sphygmomanometer by the medicos) is a useful gift for someone whose blood pressure might need monitoring. And for people with diabetes the now miniature size blood glucose measuring machines are a must – they’re not much bigger than the “iPod” type music machine, and with the added bonus of no risk of industrial deafness with constant use.

Ask at your local Self Care Pharmacy for more information. Phone the Pharmaceutical Society on 1300 369 772 or check out the website www.psa.org.au for the nearest location. When you’re there you could pick up one of the fact cards on oral hygiene or the appropriate use of antibiotics.

©2009 Pharmaceutical Society of Australia

Dec 09

Travelling overseas? Beware the window seat

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The Australian Prescriber is a journal published four times a year and provides independent objective and up-to-date information about medicines to health care practitioners – doctors, dentists and pharmacists.

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The latest issue (December 2009) discusses plane travel and the possible problems with DVT – deep venous thrombosis. The topic is timely with many travellers heading to and from Australia during the holiday season.

DVT is a condition in which a blood clot, or thrombus, develops in a deep vein – usually in the lower leg. Symptoms of DVT are principally pain, swelling and tenderness around the affected area. The good news is that DVT can be detected by medical testing and effectively treated.

However, if the DVT is not identified and treated, there is the risk of developing a so-called thromboembolism. This can occur when the blood clot breaks away from the vein in the leg and travels through the body to the lung, where it lodges and blocks blood flow. The chest pain and breathing difficulties from what is then known as a pulmonary embolism might be the early signs of a fatal outcome.

Some eight years ago, following the death of a young English woman returning home from a trip to Australia, the World Health Organization (WHO) initiated a study to determine the causes of and possible prevention strategies for DVT. This project was known as the WRIGHT study – or WHO Research Into Global Hazards of Travel.

The WRIGHT study showed that the risk of developing DVT nearly doubles after travel lasting four hours or more. But it seems the risk applies not only for travel by plane – train, bus and automobile passengers also have that same increased risk when they remain seated and immobile for more than four hours.

It all happens because periods of prolonged immobility cause stagnation of blood in the veins, thus promoting clot formation.

Interestingly, plane travellers who have the window seat are more likely to get a DVT. Apparently window seat occupants just hate to leave the view to exercise their legs.

Apart from immobility and duration of travel, there are a number of other factors which increase risk. These include being overweight, being very tall or very short (taller than 1.9 metres or shorter than 1.6 metres) having varicose veins and the use of so-called combination oral contraceptives.

One study within the project, which examined airline travel in particular, found that taking multiple flights over a short period of time also increases the risk. This is because the risk of DVT does not go away completely after the flight is over; the elevated risk remains for up to four weeks.

The Australian Prescriber article summarises a number of comparatively high risk factors. These include recent surgery, active cancer, and congestive heart failure; but prolonged immobility during long haul flights remains the major problem – and this risk factor is largely preventable.

Doing regular sprints through the cabin is not usually practical, but exercising the calf muscles with up and down movements of the feet at the ankle joint will keep the blood flowing – and you can certainly do that from your window seat.

For those of us in the low risk category for DVT, the best options are keeping mobile and keeping well hydrated – plenty of water and fruit juice – but we should limit our intake of alcohol and caffeine containing drinks.

There is no evidence that aspirin protects against DVT; but some studies have shown that wearing lower-leg compression stockings might help.

If you have a high risk factor, or even a combination of moderate risks, check with your doctor before travel; an injection of what’s known as low molecular weight heparin may be suitable.

It used to be called “economy class syndrome”, but if doesn’t really mater in which end of the plane you travel, if you don’t move around you risk a DVT.

So before you make your next move pick up the Travel Health fact card from your nearest Self Care pharmacy (locations are on the Pharmaceutical Society’s website at www.psa.org.au/selfcare). There’s more information about DVT and many other travel health issues as well.

©2009 Pharmaceutical Society of Australia

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Dec 02

Respect and protect

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Twenty-one years ago the World Health Organization (WHO) declared 1 December the first World AIDS Day. Its aim was, and remains, to raise awareness about HIV/AIDS issues, and particularly the need for support and understanding for people living with HIV/AIDS.

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Since then, World AIDS Day has been established as one of the world’s most successful commemorative days. It is now recognised and observed by millions of people in more than 190 countries. And the day has also become an opportunity to highlight the need for continued development of education and prevention strategies.

HIV stands for human immunodeficiency virus. It is primarily transmitted in blood, semen and vaginal fluids via unprotected sex or sharing injecting equipment. HIV belongs to a group of viruses called retroviruses known for the capacity to copy their genetic blueprint onto the genes of the host person’s cells. HIV has been identified as the virus that causes AIDS.

AIDS (acquired immune deficiency syndrome) is not a single disease. It is a broad range of conditions that occur when a person’s immune system is seriously damaged after years of attack by the HIV. The terms HIV and AIDS are not interchangeable. It is important to remember that a person who is infected with HIV does not necessarily have AIDS. However, all people with AIDS have been infected with HIV.

HIV damages the body’s immune system and renders the body vulnerable to other diseases and infections – its symptoms are most commonly similar to those of any chronic viral infection. During advanced stages of HIV infection, a person may develop any of a number of so-called opportunistic infections considered to be AIDS defining illnesses.

The ability of HIV to live outside the body is very limited and, therefore, HIV is not particularly easy to transmit. It is a communicable disease, but it is not contagious like air-borne viruses such as influenza. HIV cannot be transmitted by hugging, shaking hands, coughing or sneezing. Nor can it be transmitted by sharing glasses, cups or utensils or by insect bite.

There are three main modes of HIV transmission: unprotected anal and vaginal sexual intercourse; sharing drug injecting equipment; and mother to child transmission during pregnancy, birth or breast feeding.

Exposure to HIV contaminated blood is another potential route of transmission. Injecting drug users who share needles and syringes are at risk of HIV infection because there is often a small amount of blood left in the syringe after injection. This type of exposure can also occur during skin piercing and tattooing procedures if equipment has not been properly sterilised after having previously being used on someone with HIV. Body piercing or tattooing should always be undertaken at licensed studios that use new ink pots for each procedure and disposable needles or an autoclave to sterilise equipment.

Worldwide, the prevalence of HIV infection has progressed to generalised epidemics, occurring mainly through unprotected heterosexual contact. There are about 35 million people living with HIV, two thirds of whom live in sub-Saharan Africa. Somewhere in the world, every 12 seconds another person contracts HIV infection.

The theme for World AIDS Day this year is “human rights and access to treatment” – two issues, in Australia, we tend to take for granted. Nevertheless HIV/AIDS is still a major concern in Australia where transmission continues to occur primarily through sexual contact between men. Among newly acquired HIV infection, male homosexual contact was reported in 86% of cases. Between 1981 and 2008 there were over 28,000 diagnoses of HIV infection, more than 10,000 diagnoses of AIDS-related illness and nearly 7,000 deaths.

Wherever we live we can combat AIDS by “respect and protect”. By respecting and protecting ourselves and others we can stop the spread of the HIV and put an end to prejudice. Check out the World AIDS Day website at www.worldaidsday.org and two excellent Australian websites www.worldaidsdaynsw.org and www.aidsday.org.au

Or you can get more information about HIV and AIDS from pharmacies around Australia providing the Pharmaceutical Society’s Self Care health information. Ask for the HIV/AIDS fact card.

©2009 Pharmaceutical Society of Australia

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