burned out man working late on computer - wellrx blog image

By Karen Eisenbraun, CHNC

Burnout is a widespread and serious problem. Heavy workloads and chronic stress—combined with a never-ending news cycle and the pressure to always stay connected to work—can lead to emotional and physical exhaustion, along with physical symptoms such as an impaired immune system, frequent illness, chronic headaches, and a change in appetite or sleep habits. 

Recent research shows that burnout may have more serious consequences than previously realized. A new study revealed an association between burnout and a higher risk for a dangerous heart condition. It’s important to learn the signs of burnout and take action before a serious health condition develops. 

What Is Burnout?

Burnout is defined as a state of excessive and prolonged stress that leads to physical, mental, and emotional exhaustion. 

Though traditionally associated with high achievers who work long hours and take on heavy workloads, burnout has become more widespread in recent years. A 2018 Gallup study found that out of 7,500 full-time employees, 44 percent reported experiencing burnout “sometimes,” while an additional 23 percent reported feeling burned out “very often” or “always.” That means that two-thirds of full-time workers feel burned out at work. 

And burnout isn’t limited to the workplace. Parents often experience burnout due to the chronic stress of parenting—a condition commonly referred to as mommy burnout, although it can affect dads as well. 

How to Identify the Signs of Burnout

Burnout is a term that often gets tossed around by people who are feeling emotionally or physically exhausted. And while it’s normal for a rough day or week to make you feel more tired than usual, it’s important for anyone who’s experiencing actual burnout to recognize the warning signs and know when to take action. The warning signs of burnout typically come on gradually and are often ignored. If unaddressed, burnout can lead to serious health consequences. 

You may be experiencing burnout if: 

  • Every day is a bad day 
  • You’re always exhausted
  • You constantly feel overwhelmed
  • You don’t have the energy to care about your work life or home life 
  • You feel like nothing you do is appreciated 

Health Effects of Burnout

Burnout can lead to both psychological and physical symptoms, including: 

  • Sleep disorders
  • Problems with memory and concentration 
  • Impaired decision making 
  • Impaired immune system 
  • Frequent colds 
  • Respiratory problems 
  • Back pain
  • Sexual dysfunction 
  • Depression

A recent study, published in the European Journal of Preventive Cardiology, also revealed that burnout is associated with atrial fibrillation, or AFib, a type of irregular heart rhythm that can be potentially fatal. 

AFib is a common condition that affects roughly 2.7 million Americans. In addition to an irregular heart rhythm, AFib is associated with chest pain, dizziness, shortness of breath, and blood clots. AFib increases the risk of stroke and doubles the risk of heart-related deaths, yet many people are unaware that it is a serious condition. Some people with AFib may not have symptoms and may not discover their condition at a regular medical checkup.

Burnout and Weight Gain

Burnout is also associated with weight gain. Chronic stress triggers the release of the hormone cortisol, which causes the body to store fat cells, particularly in the abdominal area. Cortisol also promotes the development of fatty liver disease, which can lead to cirrhosis and liver cancer.

Research shows that burnout also leads to unhealthy behaviors that promote weight gain. People who are feeling the effects of burnout are more likely to engage in emotional eating, to eat without stopping, choose foods higher in fat, and neglect physical exercise. 

How to Manage Burnout

It’s critical to get a handle on stress and burnout before serious health complications develop. If you’re already experiencing work-related burnout, you may need to speak with your employer about setting healthy boundaries. If possible, avoid work email or other work-related activities after working hours. 

Focus on getting adequate, quality sleep. Good sleep goes a long way toward warding off mental and physical health issues, and being sleep deprived can further impair your focus and decision-making abilities. If you’re having difficulty sleeping, talk to your doctor about prescription sleep aids. If your healthcare provider prescribes you a sleep medication, our ScriptSave WellRx savings card can help you find the lowest price.

Make time to exercise, even if it’s just a walk around the block or a short yoga session. In addition to helping control weight, regular exercise helps reduce stress, boosts the immune system, and lowers your risk of heart disease. 

Finally, consider seeing a therapist. Techniques such as cognitive behavioral therapy can help change negative behaviors that develop because of stress and may also improve your sleep. 

Karen Eisenbraun is a Certified Holistic Nutrition Consultant. She holds an English degree from Knox College and has written extensively about topics related to holistic health, clinical nutrition, and weight management.

References: 

https://journals.sagepub.com/doi/full/10.1177/2047487319897163

https://www.helpguide.org/articles/stress/burnout-prevention-and-recovery.htm

https://www.gallup.com/workplace/237059/employee-burnout-part-main-causes.aspx

https://www.today.com/parents/stop-yelling-how-you-know-if-you-have-mommy-burnout-t127583

https://www.heart.org/en/health-topics/atrial-fibrillation/what-is-atrial-fibrillation-afib-or-af

https://journals.sagepub.com/eprint/FIYPYFT6TF3ZYPX7FVWH/full

https://www.wellrx.com/rx-discount-card/enroll/

pediatric eye health - wellrx blog image

By Libby Pellegrini MMS, PA-C

The gift of eyesight is precious, yet often taken for granted. The foundation for a lifetime of eye health and good vision is established in childhood. In honor of August’s status as Children’s Eye Health and Safety Month, here is what you need to know about pediatric eye health.

Why Is Eye Health Important In Kids?

Being able to see at full capacity is critical to a child’s learning and development. Vision has a critical role in a child’s world by aiding in language comprehension and the ability to discern nonverbal social cues. Having full visual ability also helps to keep children safe, allowing them to be alert to dangers in their environment.

How Common Are Eye Conditions In Kids?

According to statistics from the National Center for Children’s Vision and Eye Health, up to 1 in 17 preschoolers has an undetected vision disorder. Vision disorders are even more common in children who are in Head Start programs, with an estimated 1 in 5 of these children having an undiagnosed eye condition.

Some of the most common eye conditions in childhood include:

  • Refractive errors: Visual conditions such as nearsightedness, farsightedness, and astigmatism fall into this category, and they represent the most common group of visual conditions in children.
  • Strabismus: In this condition, there is a misalignment of the eyes, which can cause other vision problems. This condition, which affects 2 to 4 percent of the U.S. population, can be corrected with ocular therapy or surgery.
  • Vision Loss: This can include partial blindness (difficulty seeing fully, even with corrective lenses or glasses) and full blindness. It is estimated that more than 1 million children in the U.S. suffer from vision loss.
  • Amblyopia: Known colloquially as a “lazy eye,” amblyopia is the most common cause of vision loss in children. It occurs when communication between the brain and the eye is impaired. This disconnect can be due to a number of factors, including cataracts, retinal scarring, or strabismus and, if undetected, can lead to blindness.

Additionally, children are also susceptible to eye infections, eye injuries, and, more rarely, malignancies of the eye.

Should My Child Have a Routine Eye Exam?

Children with vision conditions benefit greatly from early detection because these conditions are often completely treatable. As a parent, it is important to know when your child’s vision should be evaluated, how often, and by whom. Fortunately, general exams and screenings are already integrated into the routine well-child checks that are conducted by your child’s pediatrician at regular intervals, depending on your child’s age. Eye evaluations begin at birth and continue throughout the school years.

Particularly as children approach school age, it is important that their vision is assessed by their pediatrician to ensure they are able to view the board and other important elements of a classroom. If your child does not pass a vision screening, then he or she should receive a referral for a full evaluation by a pediatric eye doctor. However, experts recommend against generalized annual comprehensive eye screening in children.

What Measures Should I Take to Protect My Child’s Eyes?

In addition to being proactive in the fight against eye disease and vision loss, it is also vital to take measures to prevent unintentional eye injuries. According to the American Association for Pediatric Ophthalmology and Strabismus, nearly half of all eye injuries that occur in children are the result of sports and recreational activities, so encouraging regular use of protective eye gear is crucial.

Other measures that you can take to protect your child’s eyes include the following:

  • Make sure your home is safeguarded with child locks to prevent accidental eye exposures to bleach and other household chemicals.
  • Limit screen time to reduce eye-straining and premature eye aging.
  • Encourage a balanced diet with vitamins that support eye health, such as vitamin A.
  • Encourage your children to wear sunglasses or a sun visor when outside during peak sun hours.
  • Discourage dangerous activities such as running with sharp items or playing with fireworks.
  • Familiarize yourself with eye safety first aid tips.

How Can I Learn More?

For more resources, make sure to check out the National Center for Children’s Vision and Eye Health. You can also engage your kids by letting them partner with you in learning about their own eye health using these resources from the National Eye Institute.

Libby Pellegrini is a nationally certified physician assistant. She has worked in numerous healthcare settings, including the rural United States, an inner-city Level I trauma center, several suburban acute care centers, and a boutique, personalized medicine clinic in Southeast Asia. She graduated Magna Cum Laude from Northwestern University’s Medill School of Journalism.

References:

https://nationalcenter.preventblindness.org/

https://preventblindness.org/wp-content/uploads/2020/07/Snapshot-Report-2020condensedF.pdf

https://www.choosingwisely.org/societies/american-association-for-pediatric-ophthalmology-and-strabismus/

https://aapos.org/home

https://preventblindness.org/wp-content/uploads/2011/06/FS104_BlueLight.pdf

https://www.wellrx.com/grocery-guidance/categories/

https://www.nei.nih.gov/learn-about-eye-health/nei-for-kids/first-aid-tips

https://nationalcenter.preventblindness.org/your-childs-sight/https://www.nei.nih.gov/learn-about-eye-health/nei-for-kids

proper use of opiods

By Jacob Silvers, PharmD Candidate, Class of 2020,
The University of Arizona College of Pharmacy

Pain management has become a national issue with the opioid epidemic. Deaths from opioids have been on the rise; especially, synthetic opioids (fentanyl). According to the Centers for Disease Control and Prevention (CDC), the age-adjusted overdose death rate with synthetic opioids (not including methadone) increased from 0.3 per 100,000 people in 1999 to 9.9 per 100,000 people in 2018.

Opioid Use Outside of the Hospital

Despite this growing concern, opioids still have a place in pain management. For chronic or nerve pain, opioids should only be considered after other options including lifestyle changes, exercise, and other medications.

Acute Pain

Acute pain, or short-term pain, can occur from sudden damage or risk of damage to tissue. For example, a minor surgery or a sports injury would be considered acute pain. The risks of using opioids in acute pain is generally considered to be low.

In most cases, addiction and psychological factors will not be a major concern, and opioids can be prescribed for a short course of pain treatment in severe cases. The expectation of treating this pain with opioids would be a single short course of opioids; less than 14 days.

Chronic Pain

Chronic pain, or long-term pain, can occur from permanent or lasting damage to tissue.  This type of pain is often described as burning, throbbing, or aching. It includes conditions like arthritis and back pain. Chronic pain may or may not have an identifiable cause, and it can last indefinitely. This type of pain usually results in long term increased sensitivity in the area where the pain is, and it can be difficult to treat.

Opioids are generally not preferred for treating chronic pain, and the goals of treatment are different from acute pain.  The expectation of fully relieving the pain or healing back to full health can be unrealistic.  Instead, we try to achieve a “functional” level of control for that individual. Exercise, lifestyle changes, and other medications should all be considered prior to long term opioids. Other medications used are anti-inflammatories (e.g. ibuprofen, naproxen, Celebrex), Tylenol, and many others.

Nerve Pain

Nerve pain and be closely related to chronic pain. Permanent damage to nerves can result in pain that feels like burning or tingling. This type of pain is common among diabetics and as a side effect of some medications. Nerve pain is often managed with medications like gabapentin (a medication that can decrease nerve pain signals), or other medications that can modulate nerve signals, like duloxetine.

Opioids are very rarely used to treat nerve pain. For patients with certain medical conditions, like diabetes, lifestyle changes can be effective for treating or preventing nerve pain. Attaining a healthy weight, getting regular exercise, eliminating smoking, and limiting alcohol are some of the recommendations from the CDC for nerve pain.

Key Takeaways

Various types of pain are caused by different processes within the body, and opioids are not effective treatment for all of them. Opioids are commonly used after severe acute pain and are only used for a few days. Opioids should mostly be avoided in chronic or nerve pain, and if they are used, should be at the lowest possible dose.

References:

  1. CDC, “Prevent Complications.” Centers for Disease Control and Prevention, 1 Aug. 2019.
  2. Dowell D, Haegerich TM, Chou R. CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016. MMWR Recomm Rep 2016;65(No. RR-1):1–49.
  3. Hedegaard, Holly, et al. “Drug Overdose Deaths in the United States, 1999–2018.” NCHS Data Brief No. 356, CDC, Jan. 2020.
  4. Herndon, Chris M., et al. “Pain Management.” Pharmacotherapy: A Pathophysiologic Approach, 10e Eds. Joseph T. DiPiro, et al. New York, NY: McGraw-Hill.
  5. Schumacher, Mark A., et al. “Opioid Agonists & Antagonists.” Basic & Clinical Pharmacology, 14e Ed. Bertram G. Katzung. New York, NY: McGraw-Hill.
  6. Yaksh, Tony, and Mark Wallace. “Opioids, Analgesia, and Pain Management.” Goodman & Gilman’s: The Pharmacological Basis of Therapeutics, 13e Eds. Laurence L. Brunton, et al. New York, NY: McGraw-Hill.

psoriasis treatment - wellrx blog image

By Rosanna Sutherby, PharmD

August is Psoriasis Awareness Month.  According to a recent study, 7.4 million adults in the United States are living with psoriasis. It affects women and men equally and typically begins between the ages of 15 and 25.

Psoriasis is not only a health problem. This condition can also affect your self-esteem and interfere with your social interactions. Fortunately, you do not have to live with the discomfort and embarrassment of psoriasis flare-ups. Advancements in psoriasis treatment make it possible to effectively manage your symptoms and significantly improve your quality of life.

What Is Psoriasis?

Psoriasis is an autoimmune disease that affects your skin. If you have an autoimmune disease, your immune system, which normally protects your body from infection, instead attacks healthy cells.

Psoriasis causes red, itchy patches of skin that are covered with thick scales. These patches are the result of skin cells that grow abnormally quickly. The most commonly affected areas are the knees, elbows, trunk, or scalp; however, psoriasis can occur on any part of the body.

Although no cure exists for psoriasis, several forms of treatment can alleviate symptoms and improve your quality of life. The goal of psoriasis treatment is to slow cell growth and remove scaly skin.

The type of treatment that you receive for psoriasis depends on the severity of your symptoms and how you respond to treatment. The following are methods of psoriasis treatment commonly used today:

  • Topical treatment
  • Light therapy
  • Oral systemic medications
  • Biologics or targeted treatment
  • Oral targeted treatment

Topical Treatments for Psoriasis

Topical treatments are medications applied to the affected skin. Topical treatments for psoriasis are available as creams, ointments, lotions, gels, foams, sprays, or shampoos. Common topical medications used to treat psoriasis include the following:

  • Corticosteroids: Corticosteroids are the most commonly used medications to treat mild to moderate psoriasis. Your doctor may use a mild steroid, such as hydrocortisone, for sensitive areas like your face or skin folds. More potent steroids, such as triamcinolone, (Acetonide, Trianex) or clobetasol (Temovate), can be used on less sensitive skin or areas that are difficult to treat.
  • Vitamin D analogs: Synthetic vitamin D products, such as calcipotriene (Dovonex, Sorilux) and calcitriol (Vectical), may be used alone or combined with corticosteroids. They work by slowing down the growth of skin cells.
  • Retinoids: Drugs in this category include tazarotene (Tazorac, Avage).
  • Calcineurin inhibitors: Medications in this class, including Elidel (pimecrolimus) and Protopic (tacrolimus), help reduce plaque buildup.

Light Therapy for Psoriasis

Light therapy may be used alone or in combination with other therapies to treat moderate to severe psoriasis. Your doctor may recommend controlled amounts of exposure to natural sunlight or artificial light. Ultraviolet B (UVB) rays can slow the growth of skin cells.

Oral Systemic Treatment for Psoriasis

If topical products or light therapy does not adequately control your psoriasis, your doctor may prescribe oral medications. Commonly prescribed oral medications for psoriasis include the following:

Biologics or Targeted Therapy for Psoriasis

The newest advancements in psoriasis treatment include biologic medications. These medicines are cytokines, or proteins, that are made from living cells and target specific pathways that promote inflammation. They work by blocking immune system cells, such as T cells, or proteins, such as tumor necrosis factor-alpha (TNF-alpha), interleukin 17-A (IL-17A), or interleukins 12 and 23 (IL-12/23). Blocking these cells and proteins that are responsible for inducing the inflammatory process that promotes rapid cell growth in psoriasis helps reduce the cycle of inflammation.

Biologics are typically used in people with moderate to severe psoriasis who have not seen improvement with other treatments. Many people who use biologics notice an improvement in their symptoms within weeks.

Be sure to ask your doctor if biologics are safe for you. These drugs must be used with caution because they can suppress your immune system and increase your risk of infection.

Injectable biologics used to treat psoriasis include the following:

TNF-alpha inhibitors

IL-12/23 and IL-23 inhibitors

IL-17 inhibitors

T-cell inhibitor

New Oral Targeted Treatment for Psoriasis

Researchers have developed other treatments for psoriasis that selectively target immune cells in a way that is similar to biologics. However, these new drugs are smaller molecules and are available as tablets that can be taken orally.

These medications are typically taken daily and continuously, if well tolerated, to keep your psoriasis symptoms under control.

Oral targeted treatments for psoriasis include the following:

Be sure to talk to your doctor or pharmacist about the possible side effects and risks of taking these medications.

Biosimilars and the Future of Psoriasis Treatment

Although biologics offer significant advantages in psoriasis treatment, their high cost may be a barrier to access. Drug manufacturers have developed products called biosimilars to increase the availability and reduce the cost of effective therapy for patients with psoriasis.

Biosimilars are similar to biologic drugs on the market, but they are not exact replicas. To be approved by the FDA, biosimilars must be highly similar to the compared product, treat the same conditions, work in the same way, and come in the same form and dosages.

The following are currently FDA-approved biosimilars for psoriasis treatment:

  • Amjevita (adalimumab-atto) is biosimilar to Humira
  • Cyltezo (adalimumab-adbm) is biosimilar to Humira
  • Erelzi (Etanercept-szzs) is biosimilar to Enbrel
  • Inflectra (infliximab-dyyb) is biosimilar to Remicade
  • Renflexis (infliximab-abda) is biosimilar to Remicade

Further research is currently underway to develop and introduce other biosimilars in the future. These drugs can offer savings for some of the expensive psoriasis therapies.

If you are concerned about the cost of your psoriasis medicine, be sure to compare prescription prices before heading to a pharmacy near you. A free Rx savings card can help you save as much as 80% off your prescription psoriasis medication.

Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients’ concurrent conditions and potential drug interactions.

References:

https://www.jaad.org/article/S0190-9622(13)01268-1/fulltext

https://www.wellrx.com/health-conditions/about/health-condition/psoriasis/~default/

https://www.psoriasis.org/research/science-of-psoriasis/immune-system#:~:text=Researchers%20agree%20that%20psoriatic%20disease,by%20an%20overactive%20immune%20system.

https://magazine.medlineplus.gov/article/psoriasis-on-the-road-to-discovery

https://www.mayoclinic.org/diseases-conditions/psoriasis/diagnosis-treatment/drc-20355845

https://www.wellrx.com/HYDROCORTISONE/drug-information/

https://www.wellrx.com/TRIAMCINOLONE%20ACETONIDE/drug-information/

https://www.wellrx.com/CLOBETASOL%20PROPIONATE/drug-information/

https://www.wellrx.com/CALCIPOTRIENE/drug-information/

https://www.wellrx.com/CALCITRIOL/drug-information/

https://www.wellrx.com/TAZAROTENE/drug-information/

https://www.wellrx.com/PIMECROLIMUS/drug-information/

https://www.wellrx.com/TACROLIMUS/drug-information/

https://www.psoriasis.org/about-psoriasis/treatments/phototherapy

https://www.wellrx.com/ACITRETIN/drug-information/

https://www.wellrx.com/METHOTREXATE/drug-information/

https://www.wellrx.com/CYCLOSPORINE%20MODIFIED/drug-information/

https://www.psoriasis.org/about-psoriasis/treatments/biologics

https://www.wellrx.com/CIMZIA/drug-information/

https://www.wellrx.com/ENBREL/drug-information/

https://www.wellrx.com/HUMIRA/drug-information/

https://www.wellrx.com/REMICADE/drug-information/

https://www.wellrx.com/SIMPONI/drug-information/

https://www.wellrx.com/STELARA/drug-information/

https://www.wellrx.com/ILUMYA/drug-information/

https://www.wellrx.com/TREMFYA/drug-information/

https://www.wellrx.com/COSENTYX%20SYRINGE/drug-information/

https://www.wellrx.com/TALTZ%20AUTOINJECTOR/drug-information/

https://www.wellrx.com/SILIQ/drug-information/

https://www.wellrx.com/ORENCIA/drug-information/

https://www.psoriasis.org/about-psoriasis/treatments/oral-treatments

https://www.wellrx.com/OTEZLA/drug-information/

https://www.wellrx.com/XELJANZ/drug-information/

https://www.psoriasis.org/biologics

https://www.wellrx.com/pricing-basket/

https://www.wellrx.com/rx-discount-card/enroll/

https://www.wellrx.com/

why am i nauseous - wellrx blog image

By Karen Eisenbraun, CHNC

An upset stomach can strike at any time, and a sudden bout of nausea may have you racking your brain to remember what you ate or where you may have picked up a stomach bug. 

Nausea can be caused by many different things and is often a symptom of another medical condition. If you’re experiencing persistent nausea or nausea that makes it difficult to get the nutrition you need, you should see a doctor. If, however, you’re experiencing occasional or short-term nausea, one of these common causes may provide an explanation. While nausea can definitely be linked to something you ate or to a virus, many causes of nausea may surprise you.

1. Stress or Anxiety

Nausea is often a symptom of stress and anxiety. With many people currently experiencing higher levels of anxiety and depression due to the COVID-19 pandemic, it isn’t surprising if you’re experiencing unusual stomach symptoms as well. 

Stress triggers a cascade of physical symptoms throughout the body: it can have negative effects on cardiovascular health, blood sugar, hormone levels, the reproductive system, and—yes—digestion. The gut is lined with highly sensitive nerve cells. When you eat, these neurons sense that food has entered the gut, and trigger intestinal contractions that help move the food along the digestive tract. When you’re feeling stressed, the brain sends signals to those nerves, causing contractions beyond what’s required for normal digestion. The result can be intestinal problems such as abdominal pain, nausea, or diarrhea. 

If you’re experiencing gastrointestinal distress due to stress, you may want to consider therapy. Many therapists have started offering teletherapy during the pandemic to help people who need treatment during the current health crisis. Research has shown that for many people, online therapy is just as effective as in-person treatment. Practicing meditation can also help ease anxiety. 

2. Dehydration

Being dehydrated can cause symptoms such as dizziness, muscle cramps, weakness, and nausea. If nausea leads to vomiting, it can cause further water loss, making symptoms even worse. 

To prevent dehydration, make sure to drink plenty of water and other fluids throughout the day. You may need to take in extra fluids if you exercise, spend time outside in the heat, or have severe diarrhea. 

Drinking alcohol can also cause dehydration. Alcohol is a diuretic, which causes your body to expel fluids at a faster rate. If you’re drinking alcohol, it’s a good idea to drink at least one glass of water for every alcoholic beverage. 

3. Migraine

While migraines are typically characterized by debilitating headaches, they can also cause symptoms such as nausea, vomiting, and sensitivity to light and sound. 

If you’re prone to migraines, keep a journal to see if you can identify your triggers. Common migraine triggers include dehydration, severe heat or other extreme weather conditions, stress, changes in barometric pressure, hormonal changes, intense physical activity, changes in sleeping patterns, and certain foods, including caffeine, chocolate, alcohol, cured meats, and foods containing monosodium glutamate. 

You may also notice certain symptoms that appear 1 to 2 days before a migraine hits. These symptoms often include depression, low energy, irritability, and frequent yawning. When you feel a migraine coming on, try taking an over-the-counter (OTC) pain medication and drinking lots of water. If OTC medications aren’t strong enough, talk to your doctor about prescription migraine medications. 

4. Food poisoning

One not-so-surprising cause of nausea is food poisoning, which can be caused by bacteria, parasites, and viruses transmitted through food. Symptoms of food poisoning may also include stomach cramps, fever, diarrhea, and gas. 

Most people with food poisoning recover with no issues, although it may take several days for the illness to pass. While you’re riding it out, be sure to drink plenty of fluids. 

5. Medications

Nausea is a common side effect of many medications, including birth control pills, antidepressants, vitamins, and OTC medications. Often, nausea is caused by taking pills on an empty stomach, which can irritate the lining of the stomach. 

If you’re taking any medications—even vitamins or supplements—make sure you follow the directions and take them with food if necessary. Even a small snack, such as some crackers, might be enough to ward off nausea. Just be sure to eat first; eating after you take your pills won’t usually help. 

6. Ear infection

Nausea accompanied by pressure in the ear could indicate an ear infection. Sensors in the inner ear help you maintain your sense of balance. An infection in the inner ear can affect the fluid levels in the ear, causing dizziness and nausea, as well as other symptoms such as ear pain, changes in hearing, headache, and fever. Antibiotics may be needed to fight the infection. 

When to See a Doctor

Many of the conditions above can be improved or prevented with home care. If you’re able to identify the source of your nausea, take steps to avoid it in the future. Avoid migraine triggers, drink plenty of water, and always cook food thoroughly. 

Also avoid anything that could further irritate the stomach lining, including alcohol or spicy foods. If you’re able to eat, stick to bland foods. Ginger has properties that may improve symptoms of nausea. Try drinking ginger tea or ginger ale, or chew on a piece of candied ginger. 

If you have nausea that lasts for more than two days—especially if accompanied by vomiting—it’s important to seek medical attention. Other signs that you should see a doctor include severe symptoms such as chest pain, blurred vision, confusion, or blood in your vomit or stool. 

Karen Eisenbraun is a Certified Holistic Nutrition Consultant. She holds an English degree from Knox College and has written extensively about topics related to holistic health, clinical nutrition, and weight management.

References: 

https://www.health.harvard.edu/newsletter_article/stress-and-the-sensitive-gut

https://www.healthandwellnessalerts.berkeley.edu/blog/quelling-anxiety-with-mindfulness-and-meditation/

https://vestibular.org/labyrinthitis-and-vestibular-neuritishttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4818021/

cardiac risks of steroids - wellrx blog image

By Libby Pellegrini MMS, PA-C

Corticosteroids represent a potent class of anti-inflammatory and immunosuppressive medications, and they have a multitude of uses in the medical world. Recently, they have played a part in the conversation about therapies for COVID-19, particularly the corticosteroid dexamethasone.

While they are potentially beneficial, it is important to also be aware of the side effect profile of corticosteroids. Among other risks, they can negatively impact the cardiovascular system. Read on to learn more about corticosteroids and cardiac risk.

What Is a Corticosteroid?

Corticosteroids are a synthetic class of medications used to decrease inflammation in the body. Corticosteroids generally accomplish this by suppressing the body’s response to perceived threats; in doing so, they also have the effect of weakening the immune system. Corticosteroids closely resemble a hormone called cortisol that is naturally made by your adrenal glands.

Some commonly prescribed steroids include the following:

When Are Corticosteroids Prescribed?

Corticosteroids have a wide range of uses in medicine. They may be prescribed for the following conditions, and many others:

  • Addison’s disease
  • Adrenal insufficiency
  • Allergic conditions such as hives
  • Asthma
  • Blood disorders
  • Brain swelling
  • Cancer
  • Chronic obstructive pulmonary disease (COPD)
  • Inflammatory bowel disease
  • Multiple sclerosis
  • Rheumatoid arthritis
  • Systemic lupus erythematosus
  • Temporal arteritis

How Do Corticosteroids Impact the Cardiovascular System?

Medical scientists have been analyzing the impact of corticosteroids on the cardiac system for decades. Some studies have shown that users of corticosteroids in excess of 7.5 mg per day are 2.5 times more likely to suffer from an adverse cardiovascular event. Corticosteroids have been implicated in the following cardiovascular conditions:

  • High Blood Pressure: Researchers have found that higher doses of corticosteroids are associated with a greater risk of developing high blood pressure in people with chronic inflammatory disease. However, researchers are not sure what causes corticosteroids to increase blood pressure.
  • Fluid Retention and Heart Failure: One of the most common side effects of corticosteroids is fluid retention. For patients who have a medical condition that makes them sensitive to fluid overloads, such as heart failure, corticosteroids can worsen their condition.
  • Myocardial Infarction (Heart Attack): Corticosteroids may increase the risk of having a myocardial infarction (MI), which is also known as a heart attack. A study in the journal Rheumatology found, after analyzing hospital data of more than 200 patients, that current users of corticosteroids had a 68 percent increased risk of experiencing an MI. Other research has found that MI risk is increased with higher doses of corticosteroids.
  • Arrhythmias: Studies have shown that the use of corticosteroids, particularly in high doses, is associated with a greater risk of heart arrhythmia known as atrial fibrillation. In this abnormal heart pattern, the heart beats irregularly, and the blood flow to the brain can be impaired, increasing the risk of stroke. Another abnormal heart rhythm, known as atrial flutter, has also been associated with corticosteroid use, with steroid use doubling the risk of developing this condition.
  • High Cholesterol: Corticosteroids are thought to variably affect the lipid cholesterol profile, in some cases raising a person’s LDL or triglyceride levels. Researchers suspect this may have to do with the interplay between lipids and insulin, given that corticosteroids are known to increase insulin resistance. The effect of corticosteroids on lipids may also be due to the propensity of corticosteroids to redistribute body fat, increasing abdominal obesity.
  • Sudden Cardiac Death: Case reports of sudden cardiac death have been reported with the use of high-dose intravenous infusions of corticosteroids. However, this is exceedingly uncommon.

Despite these highlighted cardiac risks associated with corticosteroids, some of the data can be confounding because corticosteroids are commonly used to treat inflammatory conditions in which patients already have an underlying elevated risk of cardiac disease. A careful risk-benefit analysis, with attention to your personal medical history, is always the best course of action when deciding whether or not to take a corticosteroid.

What Else Should I Know About Corticosteroids and Cardiac Risk?

As with all side effects of corticosteroids, the shorter the duration of your prescription, the lower the chance of developing an unwanted side effect. An alternate-day dosing schedule or use of the lowest possible dose of the medication may also mitigate your risk; make sure to discuss both of these strategies with your medical provider.

Your cardiac risk while using a corticosteroid may also be altered by using a nonsystemic formulation, meaning a medication other than an oral, IV, or injected form. Nonsystemic options could include an inhaled or topical steroid. Generally, these types of steroids are only therapeutic in certain scenarios, such as when treating dermatologic, ophthalmologic, or pulmonary conditions.

If, after a careful conversation regarding the risks and benefits, your healthcare provider prescribes you a corticosteroid, make sure to use ScriptSave WellRx to get the lowest price at the pharmacy.

Libby Pellegrini is a nationally certified physician assistant. She has worked in numerous healthcare settings, including the rural United States, an inner-city Level I trauma center, several suburban acute care centers, and a boutique, personalized medicine clinic in Southeast Asia. She graduated Magna Cum Laude from Northwestern University’s Medill School of Journalism.

References:

https://www.who.int/news-room/q-a-detail/q-a-dexamethasone-and-covid-19

https://www.ncbi.nlm.nih.gov/books/NBK531462/

https://www.wellrx.com/prescriptions/PREDNISOLONE/

https://www.wellrx.com/prescriptions/METHYLPREDNISOLONE/

https://www.wellrx.com/prescriptions/Budesonide/

https://www.wellrx.com/prescriptions/dexamethasone/

https://www.wellrx.com/prescriptions/hydrocortisone/

https://www.wellrx.com/prescriptions/prednisone/

https://www.wellrx.com/prescriptions/kenalog/

https://www.wellrx.com/health-conditions/about/health-condition/chronic-obstructive-pulmonary-disease/~default/

https://www.wellrx.com/health-conditions/about/health-condition/hives/~default/

https://pubmed.ncbi.nlm.nih.gov/15545676/

https://pubmed.ncbi.nlm.nih.gov/32392512/

https://pubmed.ncbi.nlm.nih.gov/15253953/

https://www.atherosclerosis-journal.com/article/S0021-9150(06)00273-5/abstract

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/410283

https://pubmed.ncbi.nlm.nih.gov/19822824/

https://www.ncbi.nlm.nih.gov/books/NBK326739/

https://pubmed.ncbi.nlm.nih.gov/982545/

https://pubmed.ncbi.nlm.nih.gov/10787466/

https://www.wellrx.com/prescriptions/PREDNISONE/92614/?freshSearch=true

wear a mask - wellrx blog image

By Nancy Swezey, BSN, RN, CNOR

There are over 16 million confirmed cases of coronavirus globally and more than 600,000 deaths from the virus, and these numbers are changing quickly. The current estimation is based on inconsistent diagnoses and reporting of acute illness, and likely underestimates the global scale of coronavirus infection.

COVID-19 is the designation of the novel coronavirus disease of 2019. This coronavirus is “novel” because it was never identified before its appearance in late 2019 in China. The “coronavirus,” as we know it, is actually one type of coronavirus, which has many variations. Severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2 for short, is the virus that causes coronavirus disease 2019, or COVID-19.

A Hot Topic in Politics

What is to some a universal public health crisis has become to others a polarizing, highly political situation. The validity of the coronavirus and the means by which to reach a comprehensive resolution have stimulated discourse on issues of health, economy, individual rights, and social justice. Perhaps one reason is that, to a great extent, we still don’t know much about COVID-19 and its future. Another reason is that this disease has affected everyone. Whether it’s the transition to remote work, a canceled event or vacation, a retreat from social life, job or financial insecurity, or affliction with the virus itself, COVID-19 has, to some extent, touched all of our lives.

Transmission

Many epidemiologists believe that the spread of this coronavirus began in Wuhan, China, in late 2019, and it was potentially transmitted from animals to humans. Under a microscope, the virus most resembles two established coronaviruses found in bats. Since the outbreak in Wuhan, it has been transmitted mainly via person-to-person contact. The virus is believed to be spread via droplet transmission, where respiratory droplets suspended in the air from coughing, sneezing, and talking makes contact with another person’s mucous membranes, such as those in the eyes, mouth, or nose, thus infecting a new host. Droplets can also travel indirectly through contaminated surfaces that an infected person touches, such as thermometers and tabletops. Droplets rarely travel more than six feet.

Scientists believe that SARS-CoV-2 can also travel via the airborne route, where particles much smaller than droplets are suspended in the air. This can happen during certain types of medical procedures in the airway where an aerosol is produced, such as endotracheal intubation, bronchoscopy, and nebulizer treatment.

Data indicate that people with COVID-19 are most contagious at the earlier stages of infection, possibly before they even have symptoms if they develop symptoms at all.

Preventative Medications and a Coronavirus Vaccine

It was initially thought that hydroxychloroquine could be used to prevent infection after exposure, but data do not support this use. No FDA-approved postexposure prophylaxis for COVID-19 is available, although several clinical trials are underway. There is also no vaccine for COVID-19, but the World Health Organization has an increasing catalog of candidate vaccines and their stage of clinical evaluation.

Keeping Your Distance

The principle of social distancing is based on findings that the risk of coronavirus transmission increases as closeness and duration of contact increase among people. In most cities now, social distancing is sanctioned by local and regional government policies that prohibit or restrict access to nonessential public places where social proximity and crowds are likely, such as theaters, bars, and restaurants. In cities where such restrictions are not in place, individuals must use their own discretion when socializing. Even as restrictions lift, many choose to avoid public gatherings, particularly if they or a close family member is in a vulnerable state of health. Many essential services and organizations, such as public transportation and grocery stores, mitigate their inability to fully enforce social distancing by requiring masks, closing early to thoroughly disinfect, and, in some cases, restricting capacity.

Wearing a Mask

It is well established that wearing a mask over the nose and mouth largely prevents the inhalation of large droplets, such as those by which SARS-CoV-2 spreads. Historically, patients with upper respiratory infections, such as influenza, are advised—and required in healthcare settings—to use a mask. N95 respirators are different than cloth or surgical face masks in that they require fit testing to establish a seal around the nose and mouth. This allows the wearer to breathe only air filtered through the N95 mask, which can filter out very small airborne particles. N95 masks are not necessary for use outside of the healthcare setting, particularly in procedural areas, where healthcare workers are exposed to airborne and fluid hazards. Instead,  using cloth face masks is a prudent alternative in public spaces where social distancing is not feasible.

Hygiene and Lifestyle Practices

By protecting ourselves, we protect others. Social distancing and mask-wearing will protect us and others from spreading the virus, but there is more to protecting ourselves than our actions in public spaces. The importance of frequent handwashing and surface disinfection cannot be overstated. To many experts, having clean hands is the most important action to prevent the spread of any infectious disease.

High-quality nutrition and physical fitness are essential components of a healthy immune system, and scientists have made the case for both as protective factors against COVID-19. The availability of resources necessary to maintain a healthy lifestyle varies among different communities; thus, the current pandemic has further highlighted health disparities. That being said, healthy lifestyle recommendations amid the coronavirus are essentially no different than any other time: stay home when sick, wash your hands, eat well, and exercise. The only difference is that now we see clearly these actions in light of both their personal and social impacts.

Related stories:

What Are Social Determinants and How Do They Impact Your Overall Health?

COVID-19 Family Health Activities

How to Improve Your Mental Health During COVID-19

Nancy Swezey, BSN, RN, CNOR is a freelance writer and nurse researcher. She develops and presenting on initiatives in clinical settings, such as general healthcare, sustainability in surgery, and creating clinical teaching modules for nurses through CUNY Hunter in New York. NS also authors a blog on vegan and vegetarian topics. She is also a trained Epic EMR SuperUser.

Resources

https://www.cdc.gov/coronavirus/2019-ncov/faq.html#:~:text=A%20novel%20coronavirus%20is%20a,like%20the%20common%20cold.

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/situation-reports

https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-epidemiology-virology-and-prevention?search=coronavirus&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H2513094760

https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus-causing-covid-19-implications-for-ipc-precaution-recommendations

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/technical-guidance/naming-the-coronavirus-disease-(covid-2019)-and-the-virus-that-causes-it

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7191114/

https://www.pewresearch.org/politics/2020/06/25/republicans-democrats-move-even-further-apart-in-coronavirus-concerns/

https://www.nejm.org/doi/full/10.1056/NEJMp2021209?query=featured_coronavirus

https://www.wellrx.com/hydroxychloroquine%20sulfate/drug-images/

https://clinicaltrials.gov/ct2/results?cond=Coronavirus+Infection&term=exposure&cntry=&state=&city=&dist=

https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines

https://www.nejm.org/doi/full/10.1056/NEJMp2021264

https://www.vumc.org/coronavirus/sites/default/files/COVID%20Documents/Wearing%20a%20Mask%20During%20CV-19%20%28HC-2008%29%2005-2020.pdf

https://www.bryanhealth.com/app/files/public/4960/wear-a-mask_8-5×11-2.pdf

https://www.cdc.gov/handwashing/when-how-handwashing.html

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cleaning-disinfection.htmlhttps://www.cdc.gov/handwashing/index.html

history of american pharmacies - wellrx blog image

How They Started and Where They Are Today

By Rosanna Sutherby, PharmD

American pharmacies have come a long way from the years of colonial apothecaries to the modern automated pharmacies of today. Evolution in pharmacist education and changes in the legislature has shifted the roles of pharmacists. Read on for a brief history of pharmacies in the United States.

The Birth of American Pharmacy

In 1630, Governor John Winthrop, founder of Boston, hired British apothecary Robert Cooke to assist him in preparing remedies using herbs imported from England and other natural ingredients.

In 1729, the Irish immigrant Christopher Marshall opened one of the first apothecaries in colonial America. It was located in Philadelphia. For 96 years, the Marshall Apothecary served as a community pharmacy as well as a training ground for aspiring pharmacists. Marshall’s granddaughter, Elizabeth Marshall, took over the store in 1805 and became the second American female pharmacist. The first was Elizabeth Gooking Greenleaf, who bought and ran an apothecary in Boston in 1727.

In 1821, almost 100 years later, the first pharmacy school, Philadelphia College of Pharmacy, opened. Shortly after, in 1852, the first national pharmacy association, the American Pharmaceutical Association (APhA), was established.

Changes in Education

Initially, the way into the profession of pharmacy was through apprenticeship. Someone interested in pharmacy would train under the tutelage of an established pharmacist. The opening of the first pharmacy school shifted education to formal institutions, and even these institutions underwent several changes over the years. Early colleges offered a Graduate in Pharmacy (Ph.G.) degree, which could be turned into a Pharmaceutical Chemist (Ph.C.) degree with an additional year of study.

By the 1940s, the Bachelor of Science in Pharmacy (B.S.Pharm.) was introduced, and in 1997, the Doctor of Pharmacy (Pharm.D.) six-year program became the only accredited pharmacy degree.

The Role of the Pharmacist

Early American pharmacies were referred to as apothecaries, and pharmacists were often called druggists or chemists. The role of the pharmacist then included preparing and dispensing remedies and counseling patients. By the 19th century, Edward Parrish of the APhA standardized the name “pharmacist” for all pharmaceutical practitioners. Until the 1950s, pharmacists prescribed, made, and dispensed medicines and provided patient counseling.

The passing of the 1951 Durham-Humphrey Amendment to the Federal Food, Drug, and Cosmetic Act of 1938 shifted the role of pharmacists. Until then, pharmacists were able to prescribe and dispense any medication except narcotics. The Durham-Humphrey Amendment restricted pharmacists to dispensing medications only with a physician’s prescription. Pharmacist recommendations were limited to over-the-counter (OTC) medications, and their role shifted to dispensing drugs and ensuring medication safety.

In the 1980s, a movement toward clinical pharmacy began to expand the role of pharmacists. By 2003, the Medicare Prescription Drug Improvement and Modernization gave pharmacists the ability to, once again, counsel patients on prescription drugs as well as OTC medications. The clinical pharmacy movement expanded the pharmacist’s role in the community pharmacy to include administering vaccines, counseling patients, and other patient care services. Pharmacists now can focus on disease and chronic condition management, medication management, health and wellness, and other services that help improve patients’ quality of life.

The Evolution of Community Pharmacies

The role of modern-day community pharmacies differs from that of the apothecaries of colonial America. Pharmacists of colonial apothecaries prepared most of the remedies that they dispensed. By 1900, the industrial revolution introduced new forms of medications, such as tablets, gelatin capsules, and enteric-coated pills. These medication forms were mass-produced and lined the shelves of pharmacies of the 1900s. However, compounded medicines, including liquids, creams, ointments, lotions, eye drops, and eardrops, were still common. Today’s pharmacies are largely automated, with robots that count and bottle commonly used medicines, and compounding has become less common.

Record-keeping in the pharmacy has also seen significant advances. Pharmacists have moved from handwriting all prescriptions to using systems in which prescriptions are transferred electronically directly from the prescriber’s office to the patient’s community pharmacy.

To keep track of patient records, pharmacists handwrote all the patients’ prescriptions on index cards that used carbon to transfer the information to receipts. Today’s pharmacies keep electronic patient records.

As the roles of community pharmacists have evolved over time, so have those of pharmacy technicians. The support staff of precomputer pharmacies consisted mainly of cashiers. The introduction of computers in the pharmacy shifted the pharmacy support role from cashier to pharmacy technician. Technicians now are responsible for more than ringing up sales at the register. They can input prescriptions in the computer, answer telephone calls, and assist the pharmacist in preparing medications and setting up immunizations.

Pharmacies today can include patient care areas where pharmacists can provide various clinical patient care services. Clinics with prescribing practitioners inside the stores are becoming more prevalent. The role of pharmacists in community pharmacies has come full circle from colonial times, but today’s highly automated and computerized pharmacies are quite different from yesteryear’s nostalgic apothecaries.

Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients’ concurrent conditions and potential drug interactions.

References:

https://aihp.org/wp-content/uploads/2018/08/1-Early-Pharmacy-in-America.pdf

http://www.pharmacy.auburn.edu/about/pdf/history-pictures.pdf

https://www.aphafoundation.org/sites/default/files/ckeditor/files/WIP%20mural%20descriptions.pdf

https://brewminate.com/a-brief-history-of-the-pharmacy-in-the-united-states/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4821736/

https://www.stlcop.edu/practice/about.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6789634

https://www.pharmacytoday.org/article/S1042-0991(16)30677-6/fulltext

summer first aid - wellrx blog image

By Karen Eisenbraun, CHNC

Summer is well underway in North America, and after a springtime spent in isolation due to COVID-19, many people are venturing outdoors again. It’s more important than ever to be prepared for common summertime injuries and mishaps. Social distancing is still critical as COVID-19 cases continue to climb in many states. While you can still go to the ER for medical emergencies, many healthcare facilities are advising patients to use telemedicine for non-emergency health concerns when possible to reduce their exposure to the disease. 

Cuts, sunburns, poison ivy, infected bug bites, eye injuries, and broken bones often lead to emergency room visits during the summer. Whether you’re headed out to go camping, take a hike, or spend a day at the beach, be prepared by packing a first aid kit with a few healthcare essentials. 

Pack Your Own Kit

Store-bought first aid kits are a good start but don’t rely on them for everything your family needs, as they are often lacking some essential items. Build your own kit—and do so well before you need it—so you don’t risk forgetting anything as you head outdoors. 

It’s also a good idea to prepare a first aid kit for each family car. Keep it in the vehicle in case anyone experiences an injury while you’re away from home. Below are the items you should buy: 

Premade First Aid Kit

Store-bought kits are a great place to start because they often contain small quantities of essential items such as bandages, tape, and gauze. Choose a large kit with a sturdy case so you can add to it and customize it. You can also use a small backpack to hold all of your first aid supplies. 

Water Bottle

Any time you head outdoors, make sure you have plenty of clean drinking water. It’s important to stay hydrated in the heat, and you’ll also need clean water to clean out any wounds. 

Antihistamines

Pack over-the-counter antihistamines such as Benadryl (diphenhydramine) to treat allergic reactions to insect stings and plants. Include doses for children and adults. Benadryl can also be used to treat an attack of seasonal allergies. 

Hydrocortisone Cream

Over-the-counter hydrocortisone creams or ointments can treat almost anything that itches, such as poison ivy or insect bites. Soothing the itch can help prevent kids from scratching, which often leads to a secondary infection. 

Tweezers and Scissors

Tweezers will come in handy for removing splinters or anything else that can get caught under the skin, such as fishing hooks. A small pair of scissors allows you to cut gauze or bandages to the right size. You can also use them to trim fingernails or hangnails. You may also want to include a small magnifying glass. 

Note that tweezers are not the best way to remove ticks. Tweezers may remove the body but leave the head stuck in the skin. To remove a tick, cover it with a cotton ball soaked in soap for 30 seconds, or sterilize the edge of a credit card and use it to scrape the tick off. 

Alcohol Wipes and Soap

Use alcohol wipes to sterilize all your first aid instruments before using them. You can also use them to clean the skin. A small bottle of antiseptic soap can also be used to clean up wounds or remove ticks as mentioned above. 

Numbing Spray

Numbing spray can be purchased over the counter and can be used to soothe burns, sunburns, cuts, scrapes, and other irritations. 

Pain Relievers

Premade first aid kits will often contain some pain medications, but make sure to include liquid pain relievers for children if necessary. 

Sunscreen

Always use at least 30 SPF sunscreen if you’ll be outdoors for any length of time. Be sure to cover spots like the tops of the ears and the back of the neck. Even if you wear a hat or expect to stay in the shade, it can be easy to get burned when you least expect it. 

Bug Spray

Insect bites aren’t just annoying, they can also become infected if they’re scratched. Ward off bugs with a repellent containing 30% DEET. 

Clean Towel

A clean towel comes in handy if you need to set up a first aid station on the beach or in another outdoor area. If necessary, you can also use it to contain bleeding on larger injuries. Choose a microfiber towel that can be packed down and won’t take up a lot of space. 

Feminine Hygiene Supplies

In addition to their obvious uses, pads and tampons can also come in handy for treating wounds. A small tampon can be used to treat a nosebleed, and a maxi-pad can be used to control a bleeding wound. 

Prescription Medications

Be sure to include any prescription medications your family may need, including EpiPens or inhalers. 

When to Go to the ER

When your first aid kit isn’t enough, make sure you know the location of the nearest ER. A trip to the hospital may be necessary if anyone suffers a head injury or a fall without wearing a helmet, any loss of consciousness or altered behavior following a head injury, a broken bone, a high fever that doesn’t respond to over-the-counter medications, severe chest pain, or breathing problems. 

With some careful planning and preparation, your family can enjoy a safe and fun summer. Remember to wear a mask in public areas and practice social distancing as much as possible to reduce your risk of COVID-19. 

Karen Eisenbraun is a Certified Holistic Nutrition Consultant. She holds an English degree from Knox College and has written extensively about topics related to holistic health, clinical nutrition, and weight management.

References: 

https://health.clevelandclinic.org/yes-you-can-and-should-still-go-to-the-er-for-emergencies-during-the-covid-19-pandemic/

https://www.wellrx.com/health-conditions/about/drug/diphenhydramine/~default/

https://www.wellrx.com/health-conditions/about/drug/hydrocortisone/~default/https://www.healthychildren.org/English/health-issues/conditions/from-insects-animals/Pages/How-To-Remove-A-Tick.aspx

advancements in aids treatment - wellrx blog image

By Nancy Swezey, BSN, RN, CNOR

Hope for Those With HIV

The history of HIV treatment is one of continuous progress and, for many, a source of hope. Today, an HIV diagnosis is very different from what it was 30, 15, or even 10 years ago. Advancements in medicine and the establishment of HIV as a care specialty have made high quality of life with HIV a reality for many.

Being diagnosed with HIV is still, however, a life-changing and frightening experience. It requires lifelong diligence on the part of anyone with HIV, their partners, and their health care providers. If you are diagnosed with HIV, you may need to change your lifestyle and diet; adhere to consistent, lifelong treatment; and maintain proximity to your providers. Although the progress of HIV testing and treatment is promising, significant work still needs to be done on a global scale. It is estimated that of those infected, 81% are aware of their HIV status, and 67% are utilizing antiretroviral therapy (ART), the recommended treatment.

A Brief History of HIV Treatment

In the ’80s and early ’90s, an HIV diagnosis had a grim, fatal prognosis. The medical and science communities were baffled by what was then, and to some extent still is, a mysterious disease. In 1996, with the establishment of Highly Active Antiretroviral Therapy (HAART) as the treatment of choice, HIV began to be considered more of a chronic illness. Today, if you have HIV and are on a consistent, supervised treatment plan, you can reasonably expect to have a high quality of life and, in general, a near-normal life expectancy. In fact, most treated HIV-positive individuals today do not die from AIDS-related causes. Even pregnant women can protect their babies from HIV transmission with ART. Furthermore, day-to-day treatment regimens are generally simpler and easier than they used to be. 

Antiretroviral Therapy

HIV is a retrovirus, so-named because of the method by which it infects our body’s cells. Hence, the treatment for HIV involves a drug class called antiretroviral therapy, or ART. Most HIV medications include a combination of two to three of the multiple types of ART. ART is a lifelong medication for people with HIV. Side effects and drug interactions are specific to each type of ART, and ARTs are chosen by health care providers in accordance with patient-specific needs and circumstances. The initiation of antiretroviral therapies normally consists of one to three pills per day.

The goals of ART are to suppress the virus, improve quality of life, reduce the risk of transmission, optimize immune function, and conserve future treatment options. The preservation of treatment options requires the avoidance of drug resistance. Resistance can occur when HIV mutates, thus rendering certain medications ineffective against the virus. Mutations can result from a multitude of causes, including inconsistency in treatment. When a virus becomes drug-resistant, the already-limited number of HIV treatment options is reduced.

Preventing HIV

PrEP

Pre-exposure prophylaxis (PrEP) is intended to protect people at high risk for HIV, such as those with HIV-positive sexual partners or those who inject drugs. If you are taking PrEP to prevent sexual transmission of HIV, safe sex practices, such as using condoms, are still advised because PrEP does not protect against other sexually transmitted infections.

Prep uses a combination of antiretroviral medications to prevent the virus from creating an enduring infection in a new host. The most widely researched and prescribed PrEP regimen is Truvada, a once-daily pill that combines two HIV medications: emtricitabine and tenofovir disoproxil fumarate. Truvada is safe for most people and generally has minimal side effects, such as abdominal discomfort. If taken as directed, it can prevent transmission reliably and effectively in most cases. If you have kidney, liver, or bone conditions or are pregnant, Truvada may not be appropriate. In these cases, your provider can discuss alternatives with you.

PEP

Post-exposure prophylaxis (PEP) is intended to protect you if you’ve been exposed to HIV through sex, injection drug needle-sharing, or occupational exposure, such as that of health care workers. Similar to PrEP, PEP consists of antretroviral therapy or HIV medication. For PEP to work, the sooner it is taken, the better. The latest point at which PEP can be initiated effectively is 72 hours after exposure. PEP consists of a 28-day course of medication either once or twice daily. However, PEP is for emergency situations; it is not an alternative to PrEP. If you are at high risk for frequent exposure to HIV, PreP is a more appropriate option.

The Cost of HIV Treatment

HIV treatment is expensive, both from an individual and public health standpoint. For some individuals, the cost may prohibit them from pursuing treatment. Treatment and diagnostic pricing are highly variable, and they depend on insurance and government policies in your geographic area. It can be difficult for providers to navigate these systems and ensure optimal and cost-effective treatment. Fortunately, many ARTs either are or will soon become generic, and thus less expensive. Furthermore, discount prescription cards are available that can offer medication coupons and allow you to compare medication prices among local pharmacies.

The Future of HIV Treatment

Although great strides have been made in the treatment of HIV, work still needs to be done. People with HIV today are still more likely to develop health conditions such as kidney, liver, and heart disease, and cancer. They are also more likely to have age-related illnesses at a younger age than noninfected people. Research for an HIV vaccine has been ongoing since 1984; although it is still underway today, there is reason to hope that it may be available soon. At the 23rd International AIDS Conference in July 2020, the goals of 75% infection reduction by 2025 and 90% by 2030 were discussed at length, and new avenues of finding a vaccine, more effective prevention, and even a cure were explored. New milestones and next steps were announced in the progress of all of these areas, and scientists remain hopeful. 

Nancy Swezey, BSN, RN, CNOR is a freelance writer and nurse researcher. She develops and presenting on initiatives in clinical settings, such as general healthcare, sustainability in surgery, and creating clinical teaching modules for nurses through CUNY Hunter in New York. NS also authors a blog on vegan and vegetarian topics. She is also a trained Epic EMR SuperUser.

References:

https://www.wellrx.com/health-conditions/about/health-condition/hiv-and-aids-support/~default/

https://hivhistory.org/

https://www.cdc.gov/hiv/basics/livingwithhiv/healthy-living.html

https://www.hiv.gov/blog/final-hiv-research-highlights-aids-2020

https://www.uptodate.com/contents/initial-treatment-of-hiv-beyond-the-basics

https://www.uptodate.com/contents/hiv-and-pregnancy-beyond-the-basics

https://aidsinfo.nih.gov/guidelines/htmltables/1/7355

https://www.who.int/hiv/topics/drugresistance/en/

https://www.uptodate.com/contents/administration-of-pre-exposure-prophylaxis-against-hiv-infection

https://www.wellrx.com/TRUVADA/drug-information/

https://www.wellrx.com/health-conditions/about/health-condition/hepatitis/~default/

https://www.wellrx.com/health-conditions/about/health-condition/osteoporosis/~default/

https://www.wellrx.com/health-conditions/pregnancy-and-maternity/

https://www.uptodate.com/contents/patient-evaluation-and-selection-for-hiv-pre-exposure-prophylaxis

https://www.cdc.gov/hiv/basics/pep.html

https://www.uptodate.com/contents/management-of-health-care-personnel-exposed-to-hiv?search=pep&source=search_result&selectedTitle=1~25&usage_type=default&display_rank=1

https://aidsinfo.nih.gov/guidelines/html/1/adult-and-adolescent-arv/459/cost-considerations-and-antiretroviral-therapy

https://www.uptodate.com/contents/primary-care-of-adults-with-hiv

https://www.niaid.nih.gov/diseases-conditions/hiv-vaccine-research-history

insulin resistance - wellrx blog image

By Karen Eisenbraun, CHNC

Diabetes is a serious health condition that affects more than 34 million Americans. More than 90% of people with diabetes have a form known as type 2 diabetes. Type 2 diabetes most often develops later in life but can also affect children and teens. 

Diabetes is linked to serious health complications, including kidney disease, nerve damage, impaired wound healing, skin conditions, and eye damage. Severe cases can lead to blindness or limb amputation. Some long-term complications of diabetes can be life-threatening.

While type 1 diabetes is a genetic condition that cannot be cured, type 2 diabetes is linked to many different risk factors, some of which can be controlled. One of the first signs of type 2 diabetes is a condition called insulin resistance. As much as 50% of people with insulin resistance or prediabetes will eventually develop type 2 diabetes. Fortunately, you can make lifestyle changes to reduce your risk of diabetes.

Are you paying too much for your diabetes medications? 

What Is Insulin Resistance?

Insulin resistance occurs when the body no longer responds well to insulin. A hormone produced by the pancreas, insulin is responsible for moving glucose, or sugar, from the food you eat into the liver, fat, and muscle cells, where it is stored for later use. When the body becomes resistant to insulin, it leads to high blood sugar, a condition known as hyperglycemia, which can become a serious health problem. 

How Do You Know if You Have Insulin Resistance?

Insulin resistance often doesn’t cause any noticeable symptoms, so it’s possible to be resistant to insulin for years without even knowing it. You are at greater risk of insulin resistance if you are overweight, have high triglycerides, or have high blood pressure. Some people with insulin resistance develop dark patches of skin on the neck or in the armpits. 

If you think you are at risk of insulin resistance, talk to your doctor. There is no one test for insulin resistance, but your healthcare provider can monitor your blood sugar and check for symptoms of diabetes. 

How to Reverse Insulin Resistance

If you are starting to become resistant to insulin, you can make several lifestyle changes to improve your body’s response to insulin. Don’t wait until you are diagnosed with diabetes to begin adopting healthier habits. The earlier you start making changes, the better. 

Exercise Regularly

Regular exercise is one of the best things you can do for your overall health. Exercise burns off excess blood sugar, which can lower your blood glucose levels and improve your body’s insulin response over time.

If you are mostly sedentary, start getting more activity into your day. Choose an activity you enjoy, and try to do it at least three times a week. That could be walking, swimming, yoga, cycling, or even dancing. Moderate activity is best, but any activity is good. Get the family involved by playing a game outside while the weather is nice or taking a walk around the neighborhood in the evening. 

Avoid Sugar and Simple Carbohydrates

Foods that are high in sugar will increase your blood sugar. This includes simple carbohydrates such as white bread, pasta, and baked goods. As much as possible, avoid foods with added sugars; instead, choose complex carbohydrates. 

When you go grocery shopping, get in the habit of reading the nutrition facts panel and ingredients lists on the foods you buy. Many packaged foods are loaded with sugar. Check the ingredients for words such as sucrose, fructose, dextrose, brown sugar, syrup, corn syrup, corn syrup solids, cane sugar, and cane juice. 

You can also look for foods made with sugar alcohols, which don’t impact blood sugar the same way that sugar does. Common sugar alcohols include xylitol, maltitol, and erythritol. Use caution with sugar alcohols because they can cause gastrointestinal distress in some people. 

Choosing healthier foods may feel overwhelming at first, but eventually, you will find brands that you know you can trust. 

Eat More Complex Carbohydrates

Complex carbs, which include fruits and vegetables, have less of an impact on blood sugar. Make sure to get plenty of fresh plant foods in your diet. Ideally, every meal should include plant foods, protein, and a healthy source of fat. Instead of serving bread or rice with your dinner, choose another vegetable or a side salad. Including quality sources of protein and healthy fats in every meal will also help you avoid the energy crash that follows after you eat something high in sugar. 

ScriptSave’s Grocery Guidance app can help you find healthier alternatives to some of the foods you buy most often. Simply scan the barcode on any food package to reveal its WellRx Health Index and discover “better for you” alternatives. Download the app on the App Store or Google Play to get started. 

Karen Eisenbraun is a Certified Holistic Nutrition Consultant. She holds an English degree from Knox College and has written extensively about topics related to holistic health, clinical nutrition, and weight management.

References: 

https://www.cdc.gov/diabetes/basics/type2.html

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3891203/

https://www.wellrx.com/health-conditions/about/health-condition/type-2-diabetes/~default/

https://www.wellrx.com/grocery-guidance/

benefits of talking

By Stacy Mosel, LMSW

Talking to a counselor or therapist might not sound like your cup of tea, especially if you prefer to handle things on your own or you don’t like talking about or sharing your feelings. But everyone needs a compassionate ear sometimes. When things feel like they’re too much to handle, you might benefit from counseling or psychotherapy. The two are basically the same thing but with different time frames—counseling is usually short-term, while psychotherapy often takes place over the course of several months or even years).

Not only can a counselor or therapist provide an open and objective ear, but they can also help you develop deeper insight into your problems, help you work through issues, and even diagnose certain mental health issues, such as anxiety or depression, if that’s relevant to your situation. If you’re still not convinced, keep reading about the top 6 signs that you could benefit from talking to someone. 

1. You Feel Overwhelmed

Let’s face it—life is not always easy, and everyone struggles with different issues from time to time. When responsibilities pile up or you start to feel overwhelmed by circumstances that seem out of your control (such as the current COVID-19 pandemic, job burnout, family strife, other health issues, or job loss), it could be a good idea to see a counselor or therapist to vent your feelings, obtain a different perspective, and get some advice on how to best cope with the circumstances, even if there’s nothing you can do to change external events.

2. You Think You Might Have a Mental Health Disorder

We’re all tempted to do this from time to time, but it’s honestly never a good idea to try to self-diagnose mental health conditions. Knowledge is power, but obsessively searching online for your symptoms may only make matters worse and even give you the impression that you’re suffering from a mental health disorder you may not even have. By visiting a mental health professional (meaning a licensed counselor, social worker, psychiatrist, or other qualified therapist), you can talk about your symptoms and concerns and discuss whether you may have a diagnosable condition and what treatments might be best suited for your needs.

3. You’re Having Relationship Troubles

All relationships have their ups and downs. Most of the time, we think we’re able to handle things on our own and work through difficulties or struggles, which occur in even the best of relationships. When things get to be too much to handle on your own and you’re fighting all the time or you’ve lost a sense of intimacy with your partner, you might feel like throwing in the towel or imagining that things would be better with someone else. While this may or may not be the case, it’s often a good idea to get an outside perspective and talk things through with a nonjudgmental third party (i.e., counselor), who can listen objectively to both sides and help you see each other’s point of view.

You can also learn better communication methods, which is often the real struggle in many relationships. Consider seeking a therapist who offers Imago therapy, a specific type of couples therapy developed by psychologist and relationship expert Harville Hendrix, which is effective for helping couples work through issues, gain deeper insight, and learn how childhood issues affect present-day relationships. 

4. Your Family Life Is Suffering

Family life can be challenging, to say the least. Regardless of how you define family, any relationship situation that involves two or more people can present problems and struggles at times. When issues and challenges prevent your family from functioning in an optimal and healthy way, it could be a good idea to consult a family therapist. We all learn how to function in the world and operate in relationships through our primary relationships with our families, and when something is “off” or when your family experiences a setback or loss, it can be a strain on everyone. Family therapy can help you learn to communicate with each other in a more functional way, give everyone’s voice a chance to be heard, help you work through problems, and help you better understand each other.

5. You’re Using Substances (Drugs/Alcohol) to Cope

Using drugs or alcohol might seem to take the edge off when life gets difficult, but this can be a dangerous and slippery slope. Hiding from your feelings, masking them with substances, or using drugs and alcohol as a way to cope with stress can lead to addiction, which is a brain disease that can leave you powerless over drugs or alcohol. It’s better to nip the problem in the bud early on rather than let it progress to the point where things are no longer under control. A counselor can help identify the underlying issues, help you work through your feelings, teach you healthier coping skills, and refer you to a substance abuse treatment facility if necessary.

6. You’re Dealing With Life Changes

Whether positive or negative, life changes are almost always accompanied by a certain level of stress. Life changes can involve anything from marriage to divorce, expecting a new baby, the loss of a loved one, undergoing a career change or retirement, moving to a new state (or country), or anything else that feels like an important or challenging step in your life. A therapist can listen to your concerns and feelings, help you develop goals and a plan of attack (if applicable to your situation), and provide feedback to help you more easily navigate the waters of change.

These six reasons are not exhaustive, but rather are some of the most common reasons that people visit counselors or therapists. Suffice it to say that it’s generally a good idea to talk to someone anytime you feel you need support and a different perspective. You also don’t have to make a long-term commitment to therapy if you don’t want to; many types of counseling can provide at least some benefit after just a few sessions. Also keep in mind that it’s smart to research therapists and talk to them beforehand to ensure that you’re a good match because a positive therapeutic relationship is one of the most crucial factors for successful therapy. 

Stacy Mosel, LMSW, is a licensed social worker, psychotherapist, and substance abuse specialist. After receiving a bachelor’s degree in music from the State University of New York at Stony Brook, she continued her studies at New York University, earning a Master of Social Work degree in 2002. She has extensive training in child and family therapy and in the identification and treatment of substance abuse and mental health disorders. Currently, she is focusing on writing in the fields of mental health and addictions, drawing on her prior experiences as an Employee Assistance Program counselor, individual and family therapist, and assistant director of a child and family services agency.

References:

https://www.psychologytoday.com/us/blog/debunking-myths-the-mind/201005/the-dangers-self-diagnosis

https://www.psychologytoday.com/intl/therapy-types/imago-relationship-therapy

https://www.researchgate.net/profile/Shelley_Turner2/publication/248381591_The_Effectiveness_of_Family_and_Relationship_Therapy_A_review_of_the_literature/links/0deec51de0adf2e12d000000/The-Effectiveness-of-Family-and-Relationship-Therapy-A-review-of-the-literature.pdf

http://headsup.scholastic.com/students/stress-and-drug-abuse

https://www.family-institute.org/behavioral-health-resources/importance-relationship-therapist