Podcasts


Medication Disposal [Show Notes]

The Regulation

The FDA and EPA agree that certain medications are okay to flush.  The comparison being, the medication, though diluted, are still being present in tap water after filtration and purification, or a kid or petor junkie eating it out of your trash and getting really hurt or dying.

This is usually the advice for extended release pain medications (tablets, liquids, or patches), narcotics, and other controlled substances.

Homemade Disposal

The goal of disposing medications at home is to make it unappetizing to anyone who may find it and try to eat it.

Ingredients:  Unwanted medications, Water,  Sand, Cat litter, or coffee grounds

Crush the tablets or capsules in a ziplock bag.  Add water to dissolve.  Add sand/cat litter/coffee grounds to absorb water.  Throw in trash.

Available for purchase

If you don’t want to DIY at home, Medaway bags are available at a pharmacy.  They have an activated charcoal compound in it.  Add pills, add warm water, and shake.  Adsorption = when one compound adheres to another compound and they can’t be separated.

Privacy Recommendations

It is advised to throw away the medications separate from the prescription bottle.  Best option is to remove labels and shred with other personal information.  At the very least, black out all of your personal information and the drug information before putting in the trash.  Even if your bottle is empty, if someone finds a bottle that previously held pain pills, that person may think you have more and it puts you at higher risk for crime.

Syringes

For syringe disposal, you can buy Sharps containers at a pharmacy.  All the instructions for using, and packing and shipping, including a prepaid return label, are included in the box.  If you don’t use an official Sharps container, it’s best to use an opaque jug or carton that 1) you can’t see through to see the needles easily, and 2) that has a small opening so it’s difficult for the needles to come back out (either by someone reaching in for them or by spillage).  Once it’s full, just seal it and put it in the trash (do not try to recycle that jug!).

National Prescription Drug Take-Back Day – local law enforcement agencies are set up to take back unused or unwanted medications from the public and will dispose of them properly.  Only certain locations will take controlled substances (check the website for your zip).

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“Stoned raccoons aren’t funny!” – @kendh

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Measuring [Show Notes]

Measuring Liquids

Medication for kids are usually in liquid form and require some kind of device to accurately measure the dose.

1 teaspoon = 5 ml

1 tablespoon = 3 teaspoons = 15 ml

1 fl oz = 30 ml

Milliliters = ml = cc = cubic centimeters –> all the same

Kitchen spoons and cooking teaspoons are not accurately calibrated to measure medication.

My Home Experiment

100 mg/5 ml = 20 mg/ml

Incorrect spoon #1:  4 ml < 5 ml (80 mg < 100 mg)

Incorrect spoon #2: 3.5 ml < 5 ml (75 mg < 100 mg)

Incorrect spoon #3: 6 ml > 5 ml (120 mg > 100 mg)

The cups that come with liquid OTC medications are calibrated accurately to measure medication.

Restaurant spoons are HUGE sometimes.

The Results

Maximum error when testing kitchen spoons is a 40% error (meaning it could be 40% below or 40% above the standard of 5 ml in a teaspoon).  For a 500 mg/5 ml medication – a 40% error is equal to 200 mg too much or 200 mg too few.  That could mean the difference in not being treated adequately and leading to complications (i.e. infection resistance) or being over-treated and experiencing side effects.

It’s a different story if you’re taking an adult dose (i.e tablet, capsule – which is already pre-measured) and putting it into something more palatable.

History of pharmacy: the only way pharmacists got medicine to people was by mixing it up and making the pills themselves.  The process of taking bulk ingredients and making specialized forms of medications is called compounding.

Brand to generic conversion: generics are only allowed to have a 5% variation from the brand name, and some companies are even more strict on themselves and follow a 3% error standard.

3% << 40%!!

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Medication Intolerances 3 [Show Notes]

Tidbits about Headaches

A headache is an ambiguous side effect because there are so many different things that can cause headaches.  Hormones are a big culprit of this.  Blood pressure medications can too.

For someone with chronic high blood pressure, the higher pressure becomes the body’s new “normal”.  Once medication starts to bring it down, even though the pressures are within a normal range, the body will experience symptoms of low blood pressure.

2 lies people tell about allergies

  1. No allergies – so then they take something they are allergic to and have an emergency
  2. Allergic to “everything” – because they experienced mild or moderate side effects.  Or in the case of pain pill seekers, they’re “allergic” to the weak pain meds to get the doctor to prescribe stronger ones.

Stimulants

Irritability, nervousness, jitteriness, or moodiness can be a side effect of amphetamines (used for ADD) or cold medicines (i.e. pseudoephedrine).

A factoid about ADD/ADHD:  the focus and attention area of the brain are underactive, so a stimulant helps it be more active so improve focus.

The biggest complaint people have from any stimulant is the inability to sleep at night.  Just need to make sure it’s taken early enough in the day so it wears off in time for bed.

Bones and Joints

In this case, we rarely want you to keep taking the medication if these side effects happen.  For example, cholesterol medications (i.e. statins, and fibrates) and quinolone antibiotics (Levaquin, Cipro, Avelox).  The quinolones have a rare but serious side effect of tendon rupture; it is painful and permanent.

Tendons: the connective tissue that anchors muscles to the bones.

Osteoporosis medications can lead to bone pain – since their job is to cause changes in the way the bones are built and rebuilt, it’s not uncommon to feel something.  But usually temporary.

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Medication Intolerances 2 [Show Notes]

3 drug intolerances that involve the skin

  1. Itching and rash – even though they are a big sign of allergies, they also can be typical side effects of medications
    • Narcotics – in hospitals, they give diphenhydramine (Benadryl) to calm an itching side effect
    • Sulfa antibiotics and tetracyclines – sun hypersensitivity.  Not a sunburn, though.  May require pain reliever to get comfortable.
  2. Flushing – redness and hotness of the skin
    • Niacin – used for cholesterol reduction.  Flushing is reduced by taking 81 mg of aspirin 30 minutes before taking niacin
    • Hormones – natural or in medication (birth control or hormone replacement).  Can be reduced or eased by taking before bed or taking with food
    • IV contrast – as the medication spreads through the body.
  3. Dryness – especially of skin surfaces that require moisture (i.e. mucous membranes)
    • Antihistamines and cold medications – dry eyes, dry nose
    • Overactive bladder medications – dry eyes, dry mouth, constipation
    • IBS meds that control diarrhea – constipation

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Medication Intolerances 1 [Show Notes]

Allergy vs Intolerance

Medication allergies, especially the dangerous, life-threatening kind, affect your entire body, multiple organ systems, and put you at serious risk of death.  They also require immediate medical attention.

Symptoms include:

  • Serious swelling
  • Not being able to breathe or swallow
  • Significant speeding or slowing of your heart rate or breathing
  • Blood leaking out of blood vessels into other regions of your body

Intolerances are usually related to regular side effects of the medications, but are so bad that you can’t tolerate it.  At no time should you be asked to keep taking something that makes you feel worse than death.  And in most cases, avoid it at all costs.  Other times, the discomfort can be short-lived or fixed by altering how the medication is used.

My main point is: intolerances to medication side effects are not true allergies (even though a lot of people will group them together when giving a medical history to a doctor or pharmacy).

Nausea

Nausea is a side effect of almost everything that you swallow.  It’s too vague and nondescript to be an allergy.  It is usually due to the increase in acid production by the stomach when it is trying to break down and dissolve the medication.

Nausea can be caused by:

  • Pain medications (narcotics)
  • Antibiotics
  • Any large, powdery elephant-sized tablet
  • Multivitamins

Nausea is a potential side effect of almost everything that you swallow.  It’s too vague and nondescript to be an allergy.  It is usually due to the increase in acid production by the stomach when it is trying to break down and dissolve the medication.

The main way to avoid nausea is to take the medication with food – and in some cases, a decent amount of food.

Some widespread advice is to take medications with milk because milk is a base to counteract the stomach acid.  Unfortunately, the calcium in milk and cause certain antibiotics to not work.  Also, some medications require acid to be activated, so making the stomach less acidic, reduces their effectiveness.

A Positive Side of Nausea?

Certain injectable medications for Type 2 Diabetes have a main side effect of nausea or indigestion.  With these medications, the patients are encouraged to keep taking them.  The logic behind this is that in most cases, someone with Type 2 Diabetes will be overweight.  And they may have been resistant to the lifestyle changes (i.e. diet and exercise) that would help improve their weight, thus also improving the diabetes outcomes.  So, if they take a medication that causes nausea thus reducing their appetite, it helps them limit their food intake, and the final results will most likely be weight loss.  This is really what the manufacturers think!

Diarrhea

Diarrhea can be caused by:

  • Antibiotics: They kill the bad bacteria that are making you sick, but also your good bacteria.
    • Take probiotics or eat live culture yogurt (the more diverse the better)
  • Certain cholesterol medications: Particularly, the ones that help trap up the fat in your intestines so it’s not absorbed and add it to your waste that is about to exit.  Fat is an oil.  Oil is slippery.  Poo that is slippery…you get the idea.
    • The less fat you eat, the less slippery things will be.
  • Metformin: It causes diarrhea in the beginning while the body is adjusting to it.  Diarrhea lasting a month sounds like forever, but is really not compared to the amount of time (aka the rest of your life) that someone may have to take this medication for Type 2 Diabetes.
    • The best way to control this is to start this medication low and slow.

The best way to counteract long-term diarrhea issues from medications is to use bulking fiber.  They help absorb extra water and add solid substance to stool so it’s firmer.

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Sleep Aids [Show Notes]

Who needs help falling asleep?  *raises hand*

WARNING: Do not mix any sleep aids with alcohol – compounded drowsiness, depressed breathing or depressed heart rate

Sleep Aids

  1.  Melatonin – the chemical your brain makes when it’s dark.  Electronic light can interfere with your natural production of melatonin after the sun goes down.
  2. Valerian Root – claims to promote calming and relaxation
  3. 1st Generation Antihistamines – Diphenhydramine (Benadryl) or Doxylamine (Unisom; also in NyQuil).  They have natural drowsy side effect, so using for the purpose of that side effect is a common practice.
  4. Rozerem – stimulates melatonin production in your brain
  5. Hypnotics – Ambien (zolpidem), Lunesta (eszopiclone). They seduce your brain to sleep in an unnatural way, thus they have high risk side effects (vivid dreams, sleep driving/walking/eating) and a high risk of dependence.  The side effects are due to the fact that the medications may get you to a deeper level of sleep before the rest of your body is prepared.  Your body has a natural paralysis process to ensure you don’t act out dreams in the REM cycle, but if your brain reaches REM before your body is paralyzed, you may do crazy things!
  6. Benzodiazepines – generic names end in -lam or -pam.  Also have a risk of dependence and side effects (mainly “hangover” effect).
  7. Tricyclic Antidepressants – a symptom of depression is sleeping too much, but insomnia can be a symptom of depression.  Also, insomnia can make you feel depressed – it’s a vicious cycle.  In small doses, they work to help rebalance the brain chemicals and reset the sleep-wake cycle.

Where to Start

Use as natural a solution as possible that is effective.  Physiological and neurological issues can lead to chronic insomnia that is not corrected by the most natural solutions, thus pharmaceuticals are needed – and that’s nothing to be ashamed of!

Sunlight stimulates your eyes and tells your brain to make serotonin.  When the light is gone, and that stimulation stops, serotonin stops and melatonin replaces it.  This is how we functioned and planned our days back in the “old days”.

Summertime brings on long days and lots of sunlight.  Thus we may not sleep as long because the long daylight hours keep us awake.  But this can also be the issue in the winter and for people who experience SAD (Seasonal Affective Disorder) – the shorter daylight doesn’t allow sufficient serotonin to be produced and we actually feel sad.

Analyzing your sleep patterns and knowing your options will allow you to have a productive conversation with your doctor – different medications are used depending on if you have trouble falling asleep or waking up halfway through sleep or both.

Audience Question

*Melatonin in nursing:  your natural melatonin gets in breast milk and is thought to help baby’s sleep cycle (especially early on when baby’s sleep-wake cycle may be backwards because that’s how they rolled in the womb).  Thus, if your natural melatonin gets into breast milk, then supplemented melatonin will get there too.  The rationale is that if you’re not sleeping (despite the exhaustion of having a new baby), then you may not be making enough natural melatonin.  If you’re going to take melatonin while breastfeeding, LOW dose is key to ensure the excess isn’t deposited in the breast milk to pass on to baby – 3 mg seems to be the highest recommended, and I agree.  PLEASE do your own research and discuss it with a medical professional you trust rather than just taking my word for it!*

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Sleep Hygiene

A Definition

Sleep Hygiene: how conducive your night time and bedtime habits are for restful sleep on a regular basis

Your body performs important processes while you sleep.

Risk of disease is increased when you don’t get enough sleep.  Heart disease, diabetes, and stroke, just to name a few.

4 Areas of Sleep Hygiene

  1. Environment
    • dark (all of our light-emitting toys are bad for our sleep) – your body makes serotonin stimulated by light, and then melatonin when the light is gone.
    • temperature – your body sleeps well when it’s cool, kind of like hibernation. Gotta get past REM sleep because REM sleep is not restful sleep
  2. Habits
    • no naps – recovery processes can be inefficient
    • exercise (vigorous exercise during the day; slow & calming exercise late at night)
    • getting adequate natural light – so your brain isn’t confused about which chemical it needs to make
    • consistent routine – your brain likes predictable patterns
  3. Consumption
    • stimulants – caffeine, nicotine
    • alcohol – initially makes you sleepy, but can disrupt sleep when the liver finishes processing it into sugar
    • large meals – can cause indigestion which can disrupt sleep
    • drastic dietary changes – fluctuating amounts of sugar in the blood stream or digestive discomfort
  4. Mindset
    • bed is for sleep – not a place for work or studying or eating
    • avoid emotional stress – positive (i.e. excitement) or negative (i.e. anger)

Tidbits

CPAP machine – helps in sleep apnea, which is wear the body doesn’t get enough oxygen during sleep.  Oxygen is needed for all sorts of processes.  If the body can’t get the oxygen, then it probably isn’t using the nutrients and energy sources available, and it can lead to feeling awful, even after a night of sleep.

Nothing good comes from a lack of sleep.

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Thrive with sleep [Show Notes]

3 Areas Thrive When You Sleep

1. Productivity 

  • Memory
  • Attention span
  • Creativity

2. Health

  • Decreased risk for cardiac disease
  • Inflammatory chemicals are cleansed out
  • Weight management – certain metabolism processes only happen while you’re sleeping
  • Tissues heal and rebuild
  • Reaction time improves

3. Emotions

  • Stress hormones are removed from your system
  • Gives your serotonin production a break, so you get a fresh supply in the morning (Serotonin is your happy chemical)

The Bottom Line

The cells in your brain (neurons) run on electricity (aka the flow of positive and negative charges).  Sleep allows the electricity to reset, so it’s really to flow quickly and efficiently the next morning.  You live longer when you get enough sleep.

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Know your body, love yourself [Show Notes]

Three ways to love yourself

1.  Know how your body works and how to know when something goes wrong

2.  If you have a chronic disease, know the ins and outs of it

2b.Finding friends or a community to support you

3.  Do research about the decisions that you make, don’t just trust ads and fads

4*. Choose a healthcare team that is willing to listen to you and work with you instead of just working on you.

*Bonus!

No matter what method you choose to enhance your health, my goal is for you to be empowered with knowledge and confidence to make a decision you’re happy with, and not be bullied into doing something you don’t want to do.

Just remember, we will not find you in a textbook!

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Yes, and I brag on @RachelCMayo – again!  Because, well, she’s AWESOME!

#BoPoTribe stands for Body Positivity, where we believe all bodies are beautiful bodies.  Founded by Susie @BeautyWithPlus

You can find the supportive community on Facebook, follow them on Twitter and Periscope, @bopotribe.

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Special Episode #1: Interview with Rachel Mayo

Hemoglobin A1C

This test measures the percentage of your hemoglobin (the protein in your red blood cells that carry oxygen) has been coated in glucose. When there’s a lot of extra sugar floating around, it tends to stick to the other things floating around with it.  Red blood cells live for 120 days*, so that’s a lot of time to let sugar hitch a ride.  And while a blood glucose measurement gives a snapshot of what the blood sugar level is right now, the A1c measurements gives us an idea of what the blood sugar level has been during all the times you’re not pricking your finger to measure over the last 3 months*.

*I do realize that 120 days equals 4 months and not 3 months, but the really old and decrepit RBC’s that are close to their expiration are exactly that – decrepit, so they’re not in good enough shape to give us a trustworthy measurement.

Goal

For those with diabetes, the goal is to have an A1c >7%.  For the average non-diabetic, A1c is ~ 5% (though with the American lifestyle, that “normal” number is creeping up – but that has more to do with Type 2 Diabetes).

Rachel received lots of support through the people she met through the Juvenile Diabetes Research Foundation (JDRF) and continues to support their cause and actively helps other T1D’s get connected.  She also participates in her local chapter of JDRF and participates in the Annual One Walk in Nashville (that’s where I got to hang out with Rachel for this interview!) You can find out what JDRF is all about by visiting JDRF.org and walk.JDRF.com.

++Time Sensitive ++ —> Follow Rachel on social media during the month of November to catch her Diabetes education Periscopes.

Meme of Rachel's "Type 1 Diabetic" tattoo, @rachelcmayo on instagram, periscope, pinterest, and twitter

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