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Archive for the ‘Medication’ Category

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … http://www.LegacyEducators.org and click on “Cancer Information”

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October is Breast Cancer Awareness Month. Although breast cancer is only one of many cancers, I am pleased of the exposure that the many “pink” ribbon brings. It gives me hope that other cancers can have a similar banner of awareness…in the near future. Despite our many progress and technological advances in medicine, cancer remains the second leading cause of death in the United States. For example, Breast Cancer has over 220,000 new diagnosis annually, and over 400,000 deaths each year. Many are surviving a longer time thank in the past.

  • Overall, cancer has taken on a more “chronic” long term debilitating effect, for those who survive initial treatment and are then diagnosed with recurrence/metastatic disease.
  • One the most feared symptom in this category of patients is pain. Overall, 50% to 70% of people with cancer experience some degree of pain, which usually intensifies as the disease progresses.
  • Less than 50% of these patients receive adequate relief of their pain, either because they are afraid to ask because they fear “addiction”, or physicians are unlikely to prescribe adequate medication to attain relief that will allow the patient continued good quality of life.
  • Suboptimal pain control can be debilitating and caregivers are often times unsure how to address this issue.

pm_general_cp_pain_approachThe World Health Organization program for cancer pain control recognizes that 1 in 5 patients with cancer has uncontrolled pain and has a ‘three-step ladder’ for the rational use of analgesics including morphine (recommended adaption to 4-step-ladder – see HERE).

Analgesic pain 4Morphine has long been the ‘gold standard’ for the treatment of severe cancer pain. However, its side-effects, particularly sedation/drowsiness, and cognitive impairment have led to ‘opioid rotation’ to alternatives such as methadone and hydromorphone. The one I like to use most in uncontrolled pain situation is the 72-h transdermal patch for Fentanyl, which offers advantages of reduced side-effects and increased convenience over oral morphine. Another novel pain medication is Intravenous (IV) strontium-89 and bisphosphonate therapy which are effective for both short- and long-term control of metastatic bone pain.

Pain Management Physician Review

Patient Discusses Pain

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

 

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From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … http://www.LegacyEducators.org and click on “Cancer Information”

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Survivor – An individual is considered a cancer survivor from the time of diagnosis, through the balance of his or her life. Family members, friends, and caregivers are also impacted.

repairman with the tool on a white background. 3D image

Once cancer treatment is completed, patients transition from regular (daily, weekly, etc.,) healthcare provider’s attention, to follow-up regimen that is once every 3-4 months, twice/year or annually.  This may seem like an “unknown abyss” and some patient may even suffer a form of separation anxiety. What to do?

Patients are encouraged to become their own advocate. That includes, knowing follow-up guideline recommendations for your specific cancer. One size does not fit all! Ask your doctor to give you an idea of the follow-up plan for the next 2-5yrs…yes, you can ask for that. Many organization, including The National Comprehensive Cancer Network (NCCN) provides an update and recommendations annually regarding follow-up.

advocacyWhat does SELF-ADVOCACY mean for a cancer survivor? Well, for starters, here is a list of things you should discuss with your doctor at the end of treatment and during follow-up appointments (not all listed below will apply, but should be tailored to be cancer site specific).

  1. Late Effects/Long-Term Psychosocial and Physical Problems – what should I expect? What symptoms should be reported?
  2. Anthracycline-Induced Cardiac Toxicity – Not all chemotherapy affects the heart, but will the chemotherapy used for me affect me heart 20-30yrs down the road? What can be done to lower the risk?
  3. Anxiety and Depression – What symptoms should be looked for and what signs should be reported?
  4. Cognitive Function – What changes should I expect? Is “chemo-brain” real?
  5. Fatigue – Is it associated with treatment? How long will it last?
  6. Talk with your Oncologist and ask questions!

    Pain – What pain level should be tolerable? Can over-the-counter pain meds suffice? Which ones can be taken?

  7. Sexual Function (female/male) – If viagra does not work, are there other options for ED? What can be used to increase sexual desire in a woman?
  8. Sleep Disorders – how do  know if my sleeping problems are associated with past cancer treatment? Will the treatment be any different?
  9. Preventive Health
  10. Healthy Lifestyles
  11. Physical Activity – What is considered low, moderate and intense activity? Any examples? Are there limitations?
  12. Nutrition and Weight Management
  13. Supplement Use – Any specific type to avoid?
  14. Immunizations and Infections – Any immunization that should be avoided?

Self-advocacy is a lot of work! BUT, it is your life..take charge of it!

 

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

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From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org and click on “Cancer Information”

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APRIL IS IRRITABLE  BOWEL SYNDROME (IBS) AWARENESS MONTH!

The symptoms of IBS can vary widely from person to person and may even recognize other common disorders/diseases of the gastrointestinal (GI) tract. A “loud/grumbling” stomach, does not mean you have IBS, but it is worth learning more about – just in case!!

IBSAbdominal pain is often described as:

  • Crampy
  • Generalized ache with periods of cramps
  • Sharp, dull, gas-like
  • Modest pains are common
  • Increased gas
  • Altered bowel habits
  • Food intolerance
  • Bloating (distention)

The IBS discomfort or pain usually feels better after a bowel movement.  IBS is a “functional” disorder. Some risk factors for IBS include (but is not limited to): diet low in fiber, excessive use of laxative, longterm use of analgesics (pain medications), etc.,

DO YOU HAVE IBS?  Click  HERE and read page and pdf at bottom left of page.

TREATMENT

  • Though irritable bowel syndrome (IBS) doesn’t have a cure, your doctor can manage the symptoms with a combination of diet, medicines, probiotics, and therapies for mental health problems (anxiety or depression)
  • Traditional drugs include; fiber supplement, anti-diarrheal, anti-flatuents (decrease gas), anti-spasmodic drugs.
  • Eating smaller meals more often, or eating smaller portions, may help your IBS symptoms. You should avoid foods and drinks that make your symptoms worse.

Disclaimer: Use of these videos are for information purposes only and not a form of endorsement.

IBS

For more information please see below

Irritable Bowel Syndrome Awareness Month

International Foundation for Functional Gastrointestinal Disorders
700 W. Virginia Street, #201
Milwaukee, WI 53204
(888) 964-2001
(414) 964-1799
(414) 964-7176 Fax
iffgd@iffgd.org
www.aboutibs.org/site/about-ibs/april-ibs-awareness-month External Links Disclaimer Logo
Materials available
Contact: Nancy Norton

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

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From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org and click on “Cancer Information”

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Last week, we discussed/reviewed the basics of Acetaminophen (Tylenol). Now, you are able to take this drug without fear!

Let’s discuss Ibuprofen this week.

Ibuprofen-DosageAs you may recall, Non-Steroidal Anti-inflammatory drugs (NSAIDs) are a group of OTC medications used to decrease mild-moderate pain, reduce fever, and decrease inflammation without the worrisome effect of steroids.  Ibuprofen (Advil, Motrin, Caldolor, Midol, etc.,), Naproxen (Aleve, Naprosyn, Anaprox, etc.,), Aspirin (Zorprin, Bayer aspirin, St. Joseph aspirin, etc.,), among others are in this class of drug. Acetaminophen is NOT a NSAID.

Ibuprofen overdose occurs when someone accidentally or intentionally takes more than the normal recommended amount of this medication. Your ibuprofen dosage will depend on various factors, including age, weight, and what is being treated.  Below are the generally recommended dosages listed by age.  However, be sure to read the cautions below, and remember to take the minimum dosage that is effective. Be sure to take with a glass of milk or food, to protect your stomach from bleeding (see video below for more info)

motrin1Children under 12: Motrin is generally used for fever, pain and/or arthritis. Please consult with a Pediatrician and follow guideline chart given.

Adult (12 and up):

Fever:  200-400mg orally every 4-6 hours as needed.
Pain:  200-400mg every 4-6 hours as needed.  There is no evidence that a higher dosage will provide more relief.
Arthritis:  Be sure to talk to a doctor who knows your medical history.  The usual dose is 400-800mg every 6-8 hours initially, increased to a maximum of 3200mg per day divided into 3-4 equal doses.

  • Be sure to read labels carefully.
  • Adults should never take more than 800mg per dose or 3200mg per day.
  • Ongoing or regular use carries its own risks.
  • Again, Be sure to take with a glass of milk or with food.

Please see video below.

Ibuprofen (Motrin)

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

Read Full Post »

From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org and click on “Cancer Information”

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Have a headache? Grab some Motrin (Ibuprofen).

Knee pain? Use some Tylenol (Acetaminophen)

Headache persists? Take more Tylenol? Hip now hurting too. Can you take more Motrin?

Having pain medications available over-the-counter (OTC) is a good thing. But too often, many are not aware of some of the necessary, basic, associated precautions.  Recently, while visiting my Dad, he jokingly noted the ever growing, long list of “side-effects” spewed about medications in commercials.  Like most he wondered, “why take the medication, if the side effects seem to cause more harm?” But, that is for another blog *smile* Let’s tackle the pain medications that millions DO use daily! Let’s define NSAIDs and then we will start with Acetaminophen (Tylenol).

JUST THE BASICS

tylenol1Non-Steroidal Anti-inflammatory drugs (NSAIDs) are a group of OTC medications use to decrease mild-moderate pain, reduce fever, and decrease inflammation without the worrisome effect of steroids.  Ibuprofen (Advil, Motrin, Caldolor, Midol, etc.,), Naproxen (Aleve, Naprosyn, Anaprox, etc.,), Aspirin (Zorprin, Bayer aspirin, St. Joseph aspirin, etc.,), among others. Acetaminophen is NOT a NSAID.

  • The primary difference between NSAIDs and acetaminophen (Actamin, Pandadol, Tylenol) lies in the way each relieves pain. Acetaminophen works primarily in the brain to block pain messages and seems to influence the parts of the brain that help reduce fever. That means it can help relieve headaches and minor pains. But it’s not as effective against pain associated with inflammation.
  • Inflammation is a common feature of many chronic conditions and injuries. NSAIDs reduce the level of chemicals that are involved in inflammation. Treatment with NSAIDs can lead to less swelling and less pain.
  • Some pain pills, such as Excedrin Migraine, combine an NSAID — in this case aspirin – with acetaminophen

ACETAMINOPHEN

Acetaminophen (Tylenol) overdose is one of the most common poisoning worldwide! Why? Because taking too much pain reliever can cause liver failure or even death! YES…sudden liver failure (see videos below).

The FDA has set the recommended maximum for adults at 4,000 milligram (mg) per day. It is quite easy to hit this max though!  One gel tablet of extra strength Tylenol, for example, contains 500mg. Do you ever take just ONE Tylenol though? My colleague just indicated that he never takes less than 3 extra-strength pills at a time! That’s 1500 mg at one time…do this 3 times in one day and will be above the max!

tylenolOverdoses from acetaminophen send 55,000 to 80,000 people in the U.S. to the emergency room each year and kill at least 500, according to the Centers for Disease Control and Prevention (CDC) and the Food and Drug Administration (FDA).

Acetaminophen can be found in more than 600 over-the-counter and prescription products used by nearly one in four American adults every week, including household brands like Nyquil cold formula, Excedrin pain tablets, Theraflu and Sudafed sinus pills.

So how do these accidental acetaminophen deaths occur?

Imagine you’ve had major dental surgery, and your dentist prescribes a five-day supply of Percocet.

  • You take the recommended 2 pills every six hours for 2,600 mg of acetaminophen, well below the 4,000-mg-a-day safety threshold.
  • But you’re still experiencing pain, so you decide to add Extra Strength Tylenol, six caplets a day for another 3,000 milligrams.
  • Now you’re feeling better but you still have trouble sleeping, so you take Nyquil, for another 650 milligrams (unaware of the acetaminophen content of the other medications).

After a few days on this 6,250 milligram regimen, experts say acute liver damage is a real risk. Add a couple beers or wine to this…and, well, you get the picture! (Alcohol affects the liver also…)

DOSES:

  • Normal/Regular dose of Tylenol ~325mg
  • Extra-Strength 500mg to 650mg
  • MAX daily recommended dose 4,000mg

PLEASE continue to use Acetaminophen and Acetaminophen products, as needed. Just be aware of the dose limits and use wisely!

Now you know…

CNN REVIEW

ACCIDENTAL OVERDOSE 

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

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From the Physician’s Desk … Weekly Blog!

Don’t forget to visit … www.LegacyEducators.org  and click on “Cancer Information”

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TRIPLE NEGATIVE BREAST CANCER

Females are VERY vocal. If you were ever in doubt about the strength in numbers and just how vocal females can be regarding a cause of mutual interest … take a look at Breast Cancer.  Everyone knows pink = breast cancer.

However, despite the awesome global attention and exposure and the many research underway, there still exist a problem; patients are still not certain of the “labels” that physicians use in describing certain aspect of Breast cancer and are often times terrified by the information found on the internet – especially as it relates to triple negative breast cancer. The questions I am often asked are;

  1. What are receptors?
  2. What does “triple negative” breast cancer mean?
  3. Is “Triple Negative” breast cancer a good or bad thing?
Receptors - Complicated?

Receptors – Complicated?

What are receptors?  There are currently 3 receptors of interest in Breast Cancer: Estrogen Receptors (ER), Progesterone Receptor (PR) and Herceptin receptors (Her-2-neu)

Receptors are often times describe as, “little antennae’s” on the surface of cells that controls behavior, such as rate of growth, of the cell.  Clear as mud? Apologies, that is still “Doctor talk” that would not make sense to my non-medical Mom…so probably not for you either.

Uuhhhmmm….thinking, thinking…Lord Help me here…Hhhmmm. Got it! A bit overly simplified…but,

Think of Breast Cancer Growth being similar to a plant. There are 3 things required to make a plant grow;

  1. Soil
  2. Water
  3. Sun

Think of each of these components as a receptor, and things that make a cancer grow,

  1. Soil   (Estrogen receptor or ER)
  2. Water (Progesterone receptor or PR)
  3. Sun (Her2neu receptor)

When all 3 are present, the Plant grows (cancer grows).  We also have the ability to “block” each of these components in hopes of preventing the Cancer from growing.

  • If the soil is removed, the plant will be destroyed. (ER+, PR-, Her2Neu-)
  • If water is taken away from the plant, it will be destroyed. (ER-, PR+, Her2neu-)
  • If  Sun exposure is removed, the plant will be destroyed. (ER-, PR-, Her2neu+)

When there are positive receptors, we have available medications that will block the growth of cancer cells in addition to the regular treatment of surgery, radiation therapy and chemotherapy. Oncologist like this, because there are more options of Medications to use, and the more different types of drugs we have, it is believed that the chance of controlling the cancer, will theoretically improve. You may be familiar with some of these drugs Tamoxifen, Arimidex,  Herceptin, etc.,

Triple Neg How ChemoIn Triple Negative Breast Cancer (ER-, PR-, Her2neu-) … The example would be a plant that is not sustained by any identifiable component…yet it is growing; a plant in a dark room, without soil or water available…grows. What is causing it to grow? Other factors that are not hormone receptor related (Well research are ongoing in this area).  However, we are still able to offer the same Surgery, Chemotherapy and Radiation Therapy as for hormone positive tumors…we just lack that “extra arsenal” of hormone/Antibody blockade that we have for positive receptor tumors.  For this reason, triple negative breast cancer is sometimes considered more aggressive. BUT, others sees it as a Breast Cancer without the hormone treatment options…3 out of 4 still remains (surgery, chemotherapy, radiation therapy). Glass half empty or half full?

Now that you understand the basics, more will be explored next time! Questions? Let me know!

Click below to watch.

Robin Roberts speaks on Triple Negative Breast Cancer

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

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From the Physician’s Desk … Weekly Blog! 

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MAYHEM can occur to anyone (As the All-State commercials so aptly describes). However, you can decrease your likelihood of an ER visit with a few precautions/Safety tips!

JUNE is National Safety Month

Injuries are a leading cause of disability for people of all ages – and they are the leading cause of death for Americans ages 1 to 44. The good news is everyone can get involved to help prevent injuries.

burnDuring National Safety Month, Legacy Health Educator is working with community members to help reduce the risk of injuries. This June, we encourage you to learn more about important safety issues like prescription drug abuse, distracted driving, and slips, trips, and falls.

  • Prescription drug abuse: Prescription painkiller overdoses are a growing problem in the United States, especially among women. About 18 women die every day from a prescription painkiller overdose – more than 4 times as many as back in 1999.
  • Slips, trips, and falls: One in 3 older adults falls each year. Many falls lead to broken bones and other health problems.
  • Distracted driving: Doing other activities while driving – like texting or eating – increases your chance of crashing. Almost 1 in 5 crashes (18%) that injured someone involved distracted driving.
  • Watch out for motorcyclists … PLEASE!

You can make a difference. Find out ways to help reduce the risk of these safety issues.

See video below – may sound simple, but many of these activities lead to Emergency Room visits regularly!

Safety Starts With YOU!

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Remember …

Ipsa Scientia Potestas est    ———  Knowledge itself is power!

Don’t forget to visit my website … www.LegacyEducators.org 

Your Family Friendly Doc … Dr McGann!  

See you next week…

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