Health Column: Five conditions that you should treat at home
MOHLER’S MEDICATION MAXIMS
Free Press Health Columnist
Need your gallbladder out? Having a heart attack or a stroke? A hospital is, hands down, the place to be. There are some conditions, however, where there is no place like home to get your care. Here are my top five common maladies that you should treat at your house.
There is no question that my failure to cure kids’ warts caused more ill feelings than any other disease I cared for during my career. A wonderful study done 10 years ago compared cryotherapy, with a doc freezing the warts (expensive), with application of plain old gray duct tape (cheap) applied to the wart for six days, off one day, and repeat. After six months, an amazing 85 percent of the duct-tape-treated warts were gone, but only 60 percent of the frozen warts were cured. Try to ignore your kids’ (and your own) warts. Multiple studies have shown that almost all warts disappear on their own in two years with or without duct tape or freezing. If you are compelled to treat warts, avoid physicians and buy your treatment at the hardware store.
We are in the season. Is there one person left in our county who has not heard that antibiotics don’t help most respiratory illnesses? Beware your docs office, however, as you increase your risk of having your caring, desiring-to-please physician AMOXICILLINIZE you! Instead, self treat with a teaspoon of honey every two to three hours for your cough (works better than the over the counter) products, Tylenol for headache, soft tissues for your nose, and salt water gargles for your sore throat.
B12 DEFICIENCY, PERNICIOUS ANEMIA
The oral treatment of B12 deficiency was established by studies done in the 1960s. That’s right. Pills. Injections of B12 are not necessary — oral supplements work well, even in pernicious anemia. They’re cheap and no lingering in a waiting room full of coughs. No needles needed. Ask your doctor to switch you over to B12 tablets.
Have you seen the ads for Jublia? Sounds like time for a celebration. Probably not! It’s the latest in a long line of expensive toenail fungus remedies that do not work very well.
A single course of Jublia costs $3,600 and it only works once out of every eight times it is prescribed. Remember that a significant proportion of deformed, discolored nails are caused by chronic injury, not fungi.
Avoid taking out a second mortgage on your home by carefully trimming your own (or asking your partner or friend to do it) thickened, crumbly toenails.
What do we patients want at the end of life? Do we want more time in the hospital? If additional treatments offer little possibility of benefit, do we want more invasive care? Research suggests that the care we get is not necessarily the care we want. In a large-scale study funded by the Robert Wood Johnson Foundation, most patients with serious illness said they would prefer to die at home. Yet most patients die in hospitals, and the care is rarely aligned with our wishes.
Tell your family and physician what you want at the end of your life. Two current best sellers — “Being Mortal,” by Atul Gawande, and “Can’t we talk about something more PLEASANT?” by Roz Chast — both address the issue that plagues both patients and physicians. That is our inability to have the difficult discussions about the end of life. These books are superb resources in terms of empowering each of us to be more assertive about our values and wishes. Write down “I want to die at home” in the form of an advanced directive. Are you worried, like many of us, that you will die in pain? Get hospice involved early on. Hospice professionals are the experts in management of pain, nausea, and shortness of breath at the end of life. We are blessed on the Western Slope to be served by Hope West, a world class hospice center.
Free Press health columnist Dr. Mohler has practiced family medicine in Grand Junction for 39 years. He has a particular interest in pharmaceutical education. Phil works part-time for Rocky Mountain Health Plans. Email him at firstname.lastname@example.org.
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