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The Bottom Line about NSAIDs (Nonsteroidal Anti-Inflammatory drugs) by Barbara Ebel, M.D.

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Many people I talk anymore are taking NSAIDs (nonsteroidal anti-inflammatory drugs), and they aren’t just baby boomers! Folks I know right now taking them range from the young to the old and take them chronically or acutely: a young man with residual knee pain from a sport’s injury, a young lady who sprained her back, a 30+ year old with a swollen hand from a wasp sting two days ago, and a 67 year old with generalized arthritis pain.

 

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And although I have tried every first-line treatment to avoid them, including acupuncture, I have finally succumbed to 24/7 usage of NSAIDs for hand joints that scream with discomfort from wear and tear and overuse! In addition, I have Chester the Chesapeake, my therapy dog and children’s book celebrity, on a NSAID as well. (See a vet for a prescription and proper dosage. Dogs do not take the equivalent weight dosage that humans do!).

I could write a very long article or a small book about NSAIDs if we wanted to cover everything, but my purpose is to give you two take-home messages.

First, to be clear, these are the common generic NSAIDs (and brand names) which can be purchased over-the-counter: Ibuprofen (Advil and Motrin), aspirin (Bayer), and naproxyn sodium (Aleve). There are even more NSAIDs that require a doctor’s prescription: celecoxib (Celebrex), oxaproxin (Daypro), indomethacin (Indocin), meloxicam (Mobic), naproxen (Naprosyn) and diclofenac (Voltaren), to name just a few.

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Many people know that over-the-counter NSAIDs are used for pain but don’t understand their ‘class’ or know about their pitfalls. Taking these are easy since they are so accessible … like buying a bottle of multi-vitamin tablets.

One of the more commonly known side effects of NSAIDs are their ability to cause stomach pain or stomach ulcers, especially if you’re over 60 years old. If you’re on NSAIDs, it’s helpful to take them with food. A former colleague of mine always took his with several saltine crackers and he stated he never ever had a GI problem. The little saltine packets were always available at work so there were no excuses!

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So what were two take-home risks I wanted to mention?

You may be more familiar with this first one. NSAIDs can increase your ability to bleed easily. From cutting your finger to injuring a blood vessel in a limb, you will more profusely bleed if you’re taking NSAIDs. This is particularly true if you’re taking a blood-thinner such as Coumadin. If you have started taking NSAIDs for a chronic pain problem and haven’t informed your doctor, it’s important to clear it with him or her and if approved, have it added to your list of medications. Your family should know your medications as well. Before any elective surgeries, or any surgeries, health care professionals such as your surgeon and anesthesiologist must be made aware that you’re taking them. They may order you to stop taking them even a week before your surgery to prevent an increased risk of bleeding.

Another important point for your health care is this – if you have started routinely taking NSAIDs and believe they will become routine in your medications, you should really check with your physician. NSAIDs can cause liver or kidney problems. To monitor the status of your liver, for example, baseline liver function tests (LFTs) should be done. In a year or less being on NSAIDs, new blood work can be drawn and a comparison made to the first lab results. If liver cells are being damaged, the liver function test numbers will show an elevation and the drug can be stopped before more damage is done. Even Chester gets routine LFTs done!

Although we didn’t cover the mechanism of action of NSAIDs or other in-depth information, I hope this blog tipped off some folks with important points to consider and to take action.
I hope you enjoyed my bi-monthly health blog and feel free to sign up for new posts to my blog. You can meet my therapy dog, Chester, at his own website: http://dogbooksforchildren.weebly.com

For more health pearls, check out my book Younger Next Decade. And my big news is that Silent Fear: a Medical Mystery, which was just published in March, is finding much success with readers and has continued to rank in the top twenty of two bestseller categories in Amazon’s Kindle’s store (such as mystery>thriller>suspense>medical). Check it out!  http://barbaraebel.weebly.com

Silent Fear a Medical Mystery eBook

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Boston Butt
Instead of posting an actual recipe this time, here’s some useful cooking information. Almost everyone loves a good barbecue sandwich once in a while, especially as we head into late spring. It’s not the healthiest thing to eat due to its fat content, but an appropriate sized serving on a bun will quench your desire for a great bbq sandwich.

Bake a Boston Butt at 1.6 hours/pound at 225 degrees Fahrenheit in a roasting pan. I cooked 10.3 pounds of meat for 16 ½ hours after rubbing bbq sauce on it. (You can search the web for meat thermometer suggestions). While roasting, the aroma in the house is mouth-watering. You can prepare it for a big group or make it and freeze meal-size portions in freezer bags to pop out for another time.

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