Health tips for better life

No matter who you are, there is one constant. Everyone is afraid of real pain. What makes the fear strong is knowledge. If you have no choice. You get caught in an accident. The unexpected arrival of pain is something to deal with. Once the shock wears off, it is there and you cope as best you can. But if you are scheduled for major surgery, you know this caring doctor is going to cut you open, mess with your insides. You cannot help it. You are worried about how severe the pain is going to be after the operation. Although you read that pharmaceutical companies have produced better painkillers, that hospitals have become more caring places, that doctors and nurses are better trained, it is natural to be worried. So is fear justified?

There are a number of studies to guide us through this discussion. The first general thread tells us that people whose pain is controlled tend to recover more quickly and have fewer complications after surgery. To some extent, this is a psychological issue. If the pain is under control, you start moving around and rebuilding your body’s strength. You can focus on getting better. But if the pain is strong enough to make breathing difficult, then any kind of activity will be impossible. Muscle tone will be lost over time and healing will be delayed. So pain management is a balancing act. If you are only pain-free when full of drugs, you will not move around. If you are in too much pain, you will not move for fear of making the pain worse.

The most powerful response to pain is intravenous medication. The drugs drip through a catheter into your body alongside fluids. For short periods of time, the opiates and opioids can reduce even the most severe pain to a dull ache. Many hospitals allow patients some degree of control over when the drugs are administered. This empowers you and helps the mind cope with the pain. There are also techniques for reducing pain in particular parts of the body. These involve the use of an epidural or spinal anesthesia to deliver painkillers into the spinal chord, and nerve blocks to prevent pain messages from traveling through the nervous system to the brain.

The problems with all these approaches is that people come out of surgery and start taking pain medication from scratch. That is why the latest research suggests the better approach is to start taking the painkillers two days before surgery. This allows your body to build up a stable level of the active chemicals in your blood stream before the surgeon cuts you open. The research actually confirms that the use of a less powerful painkiller such as tramadol hcl is as effective as the more powerful drugs taken after the surgery. Think of it as being like preparing to play football. You strap on all that body armor before going out on to the field and letting strong people knock you around. Taking tramadol before surgery is like protecting yourself against the pain. There is also the advantage that people are less afraid. People who go into the operating theater believing they will come out feeling pain turn the experience into a self-fulfilling prophesy. Taking trusted painkillers before surgery means less stress and faster recovery.

This takes us back a few years to a time when stories began to surface about adverse side effects to the use of drugs used to treat erectile dysfunction. Men had begun to report changes to their eyesight. One or two men apparently lost their sight for short periods of time. On many occasions when side effects are reported under the Postmarketing Surveillance Program, the FDA does not react immediately. Sometimes, it does not react at all. Without going into the politics of its role, some critics suggest the FDA is in the pocket of the pharmaceutical industry and would never react to reports of side effects unless the evidence is too public and overwhelming to ignore. That’s what made it all the more surprising when the FDA decided to apply a watered down version of the precautionary principle to erectile dysfunction drugs. Just so we all understand, the precautionary principle says you pull a product off the market until it is proved safe. Since proving the negative is difficult, this can mean the product is off the market for a long time. With erectile dysfunction drugs, we are talking about retail sales in excess of one billion dollars in 2008. You do not mess with this market by shutting it down. The most you can do is change the label to warn users of potential dangers.

In July, 2005, the FDA issued a notice acknowledging rare reports of eye problems. The notice did not accept there was evidence of a link between the drugs and the vision problems. It simply advised men affected to seek emergency aid if the rare event affected them. From a scientific point of view, there is a strong likelihood of a link. These drugs target PDE5 in the body. The relevant arteries in the eye are controlled by PDE6. The drug may not be completely specific in all bodies and the effect on PDE5 may shade into PDE6. That said, the pharmaceutical industry had a marketing problem. Even though everyone acknowledged these were extraordinarily rare events, the release of the notice by the FDA did cause some alarm. The industry therefore commissioned some research which was published this year in the Archives of Ophthalmology. It’s good news. Some 250 men men with good eyesight and erectile dysfunction were recruited and given various dosages of the drugs, one pill per day for six months. Their vision was routinely monitored throughout the trial period. There were no significant differences found between their sight before and after the period. There was no measurable effect of any kind in any of the men (except their erections, of course).

One word of caution. To be able to generalize from one sample to the population at large, there should be more men included in the trial. Only 250 men is not statistically significant. That said, this is a detailed study and the results are encouraging. Viagra has not been given an absolutely clean bill of health, but this comes close. If the industry can be persuaded to recruit a sufficient number for the next trial, we can arrive at a definitive result. While we wait, buy viagra with (almost) complete confidence. There is no evidence anyone has ever lost their sight because of this drug.