Avoid Certain Foods While Taking Blood Pressure Medication?
Q. I was just diagnosed with high blood pressure. I heard that I should avoid certain foods while taking my medicine. Is this true? And if so, what foods?
A. Maintaining ideal body weight, minimizing sodium intake and understanding the relationship between certain foods and medications are the first steps to preventing and treating hypertension. Eat a diet rich in fruits, vegetables and low-fat dairy products. Decrease sodium intake to less than 6 gm per day, and limit alcohol to one to two drinks per day, depending on body weight. Avoid consuming grapefruit or grapefruit juice within four hours of taking medications. Chemicals in grapefruit can increase levels of certain drugs in the blood, interfere with the break-down of some medications, and increase the potential for side effects. Diuretics can effectively treat hypertension, but some diuretics may lower your potassium level while others may actually increase it. ACE-inhibitors may also increase blood potassium levels, which in excess can be harmful. Read the medication information regarding warnings, side effects and interactions, and consult your pharmacist or physician.
Mark C. Thel, M.D., FACC
The Chattanooga Heart Institute
2501 Citico Ave.
Chattanooga, TN 37404
(423) 697-2000
www. chattanoogaheart.com
Dental Sealants for Children?
Q. My neighbor and I were chatting, and she mentioned that her child had just gotten sealants at the dentist. Should my children be getting them also?
A. Yes, you should have them placed on your children’s teeth at their next dental appointment. Routinely placed on permanent teeth, sealants have been shown to effectively prevent cavities for over 30 years. A sealant is placed as a liquid in the groove of the tooth, called a fissure, the most common place to get a cavity. The sealant is cured in place with a curing light and then is ready to keep food particles and bacteria from getting in the grooves of the teeth. This is a fast, simple, painless procedure any child should be able to endure. I also recommend sealants for adult teeth without fillings. Many of us had sealants as children, but after 30 years they need to be replaced. Insurance routinely covers 100 percent of the cost of sealants for children so there is no reason not to get them.
Mark McOmie, D.M.D.
McOmie Family Dentistry
5999 Shallowford Road
Chattanooga, TN 37421
(423) 899-1112
www.mcomiedentistry.com
Vaccines Before Beginning College?
Q. My daughter is leaving for college in August. What vaccines should she get to prepare for her first year boarding on the campus?
A. Many colleges are implementing the American College Health Association (ACHA) recommendations for Institutional Prematriculation Immunizations (www.acha.org).
Two doses of the MMR (measles, mumps and rubella) vaccine are recommended as well as two doses of the varicella vaccine for those who do not have a history of chicken pox. In addition, Tdap immunization should be used for adolescents and young adults as their booster vaccine containing the diphtheria, tetanus and pertussis instead of tetanus and diphtheria alone (Td). Immunization to Neisseria meningitidis for college freshman living in dormitories has been recommended as well but is now extended to include all adolescents and college students beyond freshman year. Also recommended are vaccines against polio, hepatitis A and B as well as the vaccine against human papillomavirus, a cause of cervical cancer, which can be given to both males and females. Pneumococcal polysaccharide vaccine is recommended for those with chronic illness including asthma, diabetes, liver or kidney disease (check with your doctor), as well as college smokers. Each fall a flu vaccine should be administered. Special consideration for additional vaccines is given to any student who may be traveling to certain areas abroad.
Karin Alcantara, M.D., FAAP
Galen Medical Group
1651 Gunbarrel Road Suite 302
Chattanooga, TN 37421
423-899-2904
www.galenmedical.com
Hip Replacement or Resurfacing?
Q. My mother is scheduled for a hip replacement in September. My friend’s mother had her hip resurfaced instead. What is the difference between the two?
A. A hip resurfacing procedure is actually a total hip replacement. The difference between a standard total hip arthroplasty and a hip resurfacing is in whether or not the femoral head is actually removed during surgery. With a standard total hip arthroplasty, the femoral head and neck are resected at the level of the neck, and an implant which is placed into the hollow part of the femur is used for fixation of the femoral component. In hip resurfacing the femoral head is left in place and machined so it works essentially as a cap or resurfacing.
My personal bias is to avoid hip resurfacing as the short-term failure rate within five years is 3 to 5 percent, wherein the short term failure rate of a standard total hip arthroplasty in five years is less than 1 percent on the femoral side. Standard total hip arthroplasties can now be performed with metal on metal implants and larger heads, which was the other theoretical advantage of hip resurfacing. My recommendation would be to have your mother proceed with a standard hip replacement as scheduled in September.
William T. Hartley, M.D.
Center for Sports Medicine & Orthopaedics
2415 McCallie Avenue
Chattanooga, TN 37404
(423) 624-2696
www.sportmed.com
Acne at 40?
Q. At forty, I have begun noticing blemishes! I have never had acne a day in my life. What can I do to prevent this?
A. While it may seem that nothing will clear a case of adult acne, treatment can be effective. Often, combination therapy, a dermatologist’s help and a bit of patience are required. A topical medication that combines benzoyl peroxide and a topical antimicrobial such as clindamycin can be effective for adults with mild to moderate acne. An over-the-counter product that contains sodium sulfacetamide and sulfur helps some adults, and a topical retinoid is often used to treat the small bumps under the skin and blackheads. The topical retinoid alone often can maintain the results over time. An oral antibiotic also may be part of an adult’s acne treatment plan and can be used to help get the acne under control. If acne is severe or very resistant to treatment, oral isotretinoin may be prescribed.
When it comes to skin care for their patients with acne, dermatologists generally recommend gently washing the face with a mild facial cleanser. Avoid vigorous scrubbing, as it can irritate the skin and make acne worse. It is equally important to use only skin and hair care products labeled “non-comedogenic” or “non-acnegenic.” Above all, do not pick, squeeze or pop the lesions. This tends to make acne worse and causes scarring.
Karin M. Covi, M.D.
C. Rodney Susong, M.D., PC
2051 Hamill Road, Suite 301A
Hixson, TN 37343
423.870.3376
www.susongderm.com